Mark Item. Close Print this page. Content: Citation Only. Citation and Abstract. Close About this journal. Current HIV Research. Intragastric balloon The intragastric balloon IGB has been a useful anti-obesity intervention since , and commonly consists of an endoscopically-deployed silicone balloon which is filled with saline and inflated in the stomach for a duration of 6 months.
Bariatric surgery Bariatric surgery is the treatment of choice when all other interventions have failed. Fig 1. Laparoscopic adjustable gastric banding An inflatable silicone band is placed around the upper part of the stomach to narrow its lumen, restricting food passage and forming a small proximal pouch of stomach which limits the quantity of food that can be ingested. Biliopancreatic diversion with a duodenal switch Biliopancreatic diversion with a duodenal switch BPD-DS is a two-stage, open or laparoscopic procedure which is also usually irreversible.
Revision and reversal of bariatric surgery LAGB revision or removal are relatively simple and commonly performed procedures due to high rates of band intolerance eg nausea, dysphagia , complications or failure.
Dumping syndrome A gastrointestinal complication of malabsorptive surgical procedures is dumping syndrome which arises from rapid gastric emptying leading to gastrointestinal and vasomotor symptoms. Nutritional deficiencies All bariatric procedures affect nutritional intake and can also have an impact on the absorption of micro- and macronutrients, in particular procedures which affect absorption RYGB, SG, BPD-DS. Psychological impact There is a reported increase in harmful behaviours and risk of suicide among post bariatric surgery patients and although the biological and behavioural mechanisms behind this is unclear, possible hypotheses include alterations in absorption of medications and imbalances in peptides, hormones and glucose.
Emerging therapies New drug treatments There are numerous pharmacological treatments currently in the clinical trial phase and these include. Endoscopic interventions In recent years, we have seen the rapid development of endoscopic therapeutic devices for the treatment of obesity, either as adjuncts to bariatric surgery or as an alternative for individuals who may not be suitable surgical candidates, who decline surgery because of the risks associated, or who would prefer to choose a less invasive therapeutic strategy.
Conclusion Obesity continues to be a growing epidemic associated with major health and economic implications to society, particularly in low- to middle-income countries and in the youth and adolescent populations. References 1. World Health Organization Obesity and overweight. Geneva: WHO, Body mass index, waist circumference and waist:hip ratio as predictors of cardiovascular risk — a review of the literature.
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London: PHE, NHS Digital, Royal College of Physicians Action on obesity: Comprehensive for all. Report of a working party London: RCP, Quantification of the effect of energy imbalance on bodyweight. Lancet ; — Nakamura T, Kuranuki S. Nutrition — Macronutrients. Elsevier, —7. Effect of low-fat diet interventions versus other diet interventions on long-term weight change in adults: a systematic review and meta-analysis.
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Eur J Clin Nutr ; 69 —8. National Institute for Health and Care Excellence Obesity: identification, assessment and management. Clinical guideline [CG].
Quick Links. Management of Adult Overweight and Obesity OBE The guideline describes the critical decision points in the Management of Adult Overweight and Obesity and provides clear and comprehensive evidence based recommendations incorporating current information and practices for practitioners throughout the DoD and VA Health Care systems. About the CPG. The guideline is formatted as a single clinical algorithm and 18 evidence-based recommendations. Guideline Links.
A general physical exam. This includes measuring your height; checking vital signs, such as heart rate, blood pressure and temperature; listening to your heart and lungs; and examining your abdomen. Calculating your BMI. Your doctor will check your body mass index BMI. A BMI of 30 or higher is considered obesity. Numbers higher than 30 increase health risks even more.
Your BMI should be checked at least once a year because it can help determine your overall health risks and what treatments may be appropriate. Measuring your waist circumference. Fat stored around the waist, sometimes called visceral fat or abdominal fat, may further increase the risk of heart disease and diabetes. Women with a waist measurement circumference of more than 35 inches 89 centimeters and men with a waist measurement of more than 40 inches centimeters may have more health risks than do people with smaller waist measurements.
Like the BMI measurement, waist circumference should be checked at least once a year. Checking for other health problems. If you have known health problems, your doctor will evaluate them. Your doctor will also check for other possible health problems, such as high blood pressure, high cholesterol, underactive thyroid, liver problems and diabetes.
Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Overweight and obesity. National Heart, Lung, and Blood Institute. Accessed May 3, Goldman L, et al. In: Goldman-Cecil Medicine. Elsevier; Kellerman RD, et al. Obesity in adults.
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