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NCHS Data Brief Feb 2020Obesity is associated with serious health risks (1). Severe obesity further increases the risk of obesity-related complications, such as coronary heart disease and...
Obesity is associated with serious health risks (1). Severe obesity further increases the risk of obesity-related complications, such as coronary heart disease and end-stage renal disease (2,3). From 1999-2000 through 2015-2016, a significantly increasing trend in obesity was observed (4). This report provides the most recent national data for 2017-2018 on obesity and severe obesity prevalence among adults by sex, age, and race and Hispanic origin. Trends from 1999-2000 through 2017-2018 for adults aged 20 and over are also presented.
Topics: Adult; Age Factors; Ethnicity; Female; Humans; Male; Middle Aged; Obesity; Obesity, Morbid; Prevalence; Risk Factors; Sex Factors; United States; Young Adult
PubMed: 32487284
DOI: No ID Found -
Anesthesiology Clinics Mar 2020Obesity is considered a major comorbidity, and it is imperative for an anesthesiologist to put increased emphasis on preoperative evaluation and perioperative... (Review)
Review
Obesity is considered a major comorbidity, and it is imperative for an anesthesiologist to put increased emphasis on preoperative evaluation and perioperative management. A multidisciplinary team approach is the key for a successful outcome. This article encompasses basic tenets like pathophysiology and pharmacology pertaining to obesity. The authors also talk about important aspects of anesthesia care starting from preoperative assessment and optimization, intraoperative challenges and care, to recovery and discharge of these patients.
Topics: Airway Management; Anesthesia; Humans; Obesity, Morbid; Postoperative Care; Preoperative Care; Risk Assessment
PubMed: 32008653
DOI: 10.1016/j.anclin.2019.10.008 -
Seminars in Pediatric Surgery Feb 2020
Topics: Adolescent; Bariatric Surgery; Child; Humans; Obesity, Morbid; Pediatric Obesity; Young Adult
PubMed: 32238291
DOI: 10.1016/j.sempedsurg.2020.150891 -
The Journal of Allergy and Clinical... 2018
Topics: Angioedema; Bariatric Surgery; Cetirizine; Factor XII; Female; Humans; Middle Aged; Obesity, Morbid; Omalizumab; Recurrence; Wounds and Injuries
PubMed: 30033921
DOI: 10.1016/j.jaip.2018.05.009 -
Deutsches Arzteblatt International Nov 2023The prevalence of morbid obesity (BMI >35 kg/m2) has risen steadily in recent decades. With the corresponding rise in the number of bariatric operations,... (Review)
Review
BACKGROUND
The prevalence of morbid obesity (BMI >35 kg/m2) has risen steadily in recent decades. With the corresponding rise in the number of bariatric operations, anesthesiologists deal with this patient group more commonly than before, particularly in specialized centers.
METHODS
This review is based on publications retrieved by a selective search in PubMed, including current guidelines and recommendations issued by specialist societies, as well as expert opinion.
RESULTS
In the anesthesiological care of morbidly obese patients, a preoperative assessment and risk stratification are just as important as the thoughtful selection of the anesthesia technique, the drugs used and their dosage, and perioperative management. A thorough understanding of the pathophysiological changes and comorbidities of morbid obesity and the associated risks is essential. The risk of pulmonary complications such as respiratory failure, hypoxia, and apnea is markedly higher in morbidly obese patients, especially those with obstructive sleep apnea. Short-acting, less lipophilic anesthetic drugs are particularly useful, as is multimodal pain therapy for the avoidance of high opiate doses. The indication for intensified postoperative monitoring depends on the patient's preexisting illnesses, the type of anesthesia, and the type of surgical procedure. Regional anesthetic techniques should be used if possible.
CONCLUSION
The perioperative care of morbidly obese patients presents special challenges. The anesthesiologist must be aware of potential comorbidities, specific risks, and pathophysiological changes in order to provide adequate care to this patient group.
Topics: Humans; Obesity, Morbid; Anesthesia; Hypoxia; Comorbidity; Perioperative Care; Postoperative Complications
PubMed: 37874129
DOI: 10.3238/arztebl.m2023.0216 -
Current Opinion in Clinical Nutrition... Jul 2020To give an updated review on the underlying mechanisms and clinical effects of improved glucose control after bariatric surgery. (Review)
Review
PURPOSE OF REVIEW
To give an updated review on the underlying mechanisms and clinical effects of improved glucose control after bariatric surgery.
RECENT FINDINGS
The basic principles of the mechanism for the metabolic effects of bariatric surgery can be categorized into calorie restriction, deviation of nutrients, and reduced amounts of adipose tissue. Recent findings suggest the importance of early changes following deviation of nutrients to more distal parts of the small bowel resulting in altered release of gastrointestinal hormones, altered gut microbiota, and weight-reduction. In the long-term, loss of adipose tissue results in reduced inflammation and improved insulin sensitivity. From a clinical perspective these changes are associated with remission of diabetes in patients with morbid obesity and type 2 diabetes, prevention of diabetes in patients with insulin resistance without overt type 2 diabetes and prevention of both microvascular and macrovascular complications for all patients with morbid obesity.
SUMMARY
At present, bariatric surgery remains the most effective treatment option to improve glucose control and long-term complications associated with hyperglycemia in patients with obesity.Although the mechanisms behind these metabolic effects remain only partially understood, further knowledge on these complex mechanisms may help identifying durable treatment options for morbid obesity and important metabolic comorbidities.
Topics: Bariatric Surgery; Blood Glucose; Glycemic Control; Humans; Hyperglycemia; Insulin Resistance; Obesity, Morbid
PubMed: 32205577
DOI: 10.1097/MCO.0000000000000657 -
Journal of Laparoendoscopic & Advanced... Aug 2018The epidemic of morbid obesity in the United States has reached dramatic proportions. Because of the associated comorbidities and because life style changes and exercise... (Review)
Review
The epidemic of morbid obesity in the United States has reached dramatic proportions. Because of the associated comorbidities and because life style changes and exercise have limited effect, bariatric surgery has been used more often during the last 10 years as it has been shown to be safe and effective in decreasing weight and resolving comorbidities. Recently many studies have focused on a potential complication of bariatric surgery, gastroesophageal reflux disease, mostly because of the increasing use of sleeve gastrectomy. This article reviews the pathophysiology of reflux in morbid obese patients, the proper work-up before a bariatric operation, and the selection of the procedure based on the individual patient's characteristics.
Topics: Bariatric Surgery; Gastroesophageal Reflux; Humans; Obesity, Morbid; Postoperative Complications; Weight Loss
PubMed: 30004286
DOI: 10.1089/lap.2018.0396 -
Endocrinology and Metabolism Clinics of... Sep 2016Obesity is associated with several comorbidities, including cardiovascular disease, type 2 diabetes, sleep apnea, osteoarthritis, and several forms of cancer. Obesity... (Review)
Review
Obesity is associated with several comorbidities, including cardiovascular disease, type 2 diabetes, sleep apnea, osteoarthritis, and several forms of cancer. Obesity and its comorbidities also come with a significant psychosocial burden, impacting numerous areas of psychosocial functioning. The evaluation of psychosocial functioning is an important part of the assessment and treatment planning for the patient with obesity. This article provides an overview of the psychosocial burden of obesity. The article also describes the psychological changes typically seen with weight loss. A particular focus is on the psychosocial functioning of individuals with extreme obesity who present for and undergo bariatric surgery.
Topics: Bariatric Surgery; Comorbidity; Humans; Obesity, Morbid; Weight Loss
PubMed: 27519139
DOI: 10.1016/j.ecl.2016.04.016 -
Obesity Surgery Sep 2019A peculiar category of persons with obesity lacking common metabolic disturbances has been depicted and termed as metabolically healthy obesity (MHO). Yet, although MHO... (Review)
Review
A peculiar category of persons with obesity lacking common metabolic disturbances has been depicted and termed as metabolically healthy obesity (MHO). Yet, although MHO patients are free of obesity-associated complications, they might not be entirely precluded from developing cardio-metabolic disorders. Among patients with morbid obesity (MO) who are referred to bariatric surgery, a subset of metabolically healthy MO (MHMO) has been identified and the question arises if these patients would benefit from surgery in terms of mitigating the peril of cardio-metabolic complications. We revisited the pathophysiological mechanisms that define MHO, the currently available data on the cardio-metabolic risk of these patients and finally we reviewed the benefits of bariatric surgery and the urge to better characterize MHMO before submission to surgery.
Topics: Bariatric Surgery; Cardiovascular Diseases; Humans; Metabolic Diseases; Obesity, Metabolically Benign; Obesity, Morbid; Patient Selection; Risk Factors
PubMed: 31273650
DOI: 10.1007/s11695-019-03964-8 -
Best Practice & Research. Clinical... Aug 2023Obesity is currently a global pandemic, with increasing trends worldwide. Data from the WHO, US CDC, and the UK show an increasing trend, with 50% and 25% of the US... (Review)
Review
Obesity is currently a global pandemic, with increasing trends worldwide. Data from the WHO, US CDC, and the UK show an increasing trend, with 50% and 25% of the US population expected to be obese and morbidly obese by 2030. Obesity affects several aspects of health, with increased risks of cardiovascular disease, diabetes, metabolic syndrome, and several malignancies. Morbid obesity significantly impacts several aspects of female life and health, from adolescence, through the reproductive years, to the postmenopausal age group. In gynecology, there is a higher prevalence of menstrual disorders and infertility and reduced success rates of assisted reproduction; increased risk of miscarriage; pelvic organ prolapse; and endometrial, ovarian, and breast cancers. Surgery in the patient with morbid obesity is associated with several logistical challenges as well as increased surgical and peri-operative risks and increased cost. In this review, we provide an overview of the current literature, with a focus on challenges of morbid obesity in gynecological practice.
Topics: Humans; Female; Gynecology; Obesity, Morbid; Prevalence; Reproduction; Infertility
PubMed: 37473647
DOI: 10.1016/j.bpobgyn.2023.102379