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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 -
Boletin Medico Del Hospital Infantil de... 2020Obesity prevalence has increased in the last decades worldwide leading to metabolic complications, such as type 2 diabetes, steatosis, cardiovascular disease, among... (Review)
Review
Obesity prevalence has increased in the last decades worldwide leading to metabolic complications, such as type 2 diabetes, steatosis, cardiovascular disease, among others; its development is influenced by genetic factors and environmental factors, such as intestinal microbiome. In Mexico, 33.3% of the adults present this disease. Obesity is defined as an excessive adipose tissue accumulation, provoking its dysfunction. Adipose tissue remodeling, which involves angiogenesis, hypoxia and inflammation, is implicated in the developing of obesity and metabolic modifications. Bariatric surgery is the most used and successful intervention to control morbid obesity, leading a maintained loss of weight and remission of some of its comorbidities as type 2 diabetes. Here, we review some of the molecular aspects of the metabolic changes provoked by bariatric surgery and its impact in weight loss and comorbidities remission. In summary, this article reviews the genetic aspects, microbiome and molecular facts (adipose tissue remodeling) that are involved in obesity development. In addition, some of the molecular aspects about bariatric surgery are described and the mechanisms that are regulated to control obesity and its comorbidities.
Topics: Adipose Tissue; Adult; Animals; Bariatric Surgery; Humans; Metabolic Diseases; Mexico; Obesity; Obesity, Morbid; Prevalence; Weight Loss
PubMed: 32115585
DOI: 10.24875/BMHIM.19000115 -
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 -
The Lancet. Gastroenterology &... Mar 2021Obesity and the corresponding burden of related diseases is a major public health issue worldwide that is reaching pandemic proportions. Bariatric surgery is the only... (Comparative Study)
Comparative Study Review
Obesity and the corresponding burden of related diseases is a major public health issue worldwide that is reaching pandemic proportions. Bariatric surgery is the only intervention that has been shown to result in substantial and lasting weight loss, and a decrease in overall mortality for patients with severe obesity. Consequently, the population of patients having undergone this procedure is increasing. Multifactorial weight-dependent and independent mechanisms underlying metabolic diseases could also drive preventable, but potentially life-threatening, long-term nutritional complications. However, given post-bariatric patients are prone to functional gastrointestinal symptoms and substantial weight loss, nutritional complications might be challenging. This Review is focused on the prevention and treatment of nutritional complications after bariatric surgery in the clinical setting.
Topics: Bariatric Surgery; Female; Gastrointestinal Diseases; Humans; Malnutrition; Metabolic Diseases; Obesity, Morbid; Postoperative Complications; Weight Loss
PubMed: 33581762
DOI: 10.1016/S2468-1253(20)30331-9 -
Obesity (Silver Spring, Md.) Feb 2021This study aimed to compare the effects of two aerobic exercise programs of different intensities on energy expenditure. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This study aimed to compare the effects of two aerobic exercise programs of different intensities on energy expenditure.
METHODS
This was a single-center randomized controlled trial of patients with severe obesity allocated to a 24-week moderate-intensity continuous training (MICT) program or a combined MICT with high-intensity interval training (HIIT/MICT) program. The primary outcome was energy expenditure during exercise (EEDE). Secondary outcomes included resting metabolic rate, cardiorespiratory fitness, and body composition.
RESULTS
A total of 82 (56% females) patients were screened, and 71 (55% females) patients were allocated to HIIT/MICT (n = 37) or MICT (n = 34). Per-protocol analysis showed that EEDE increased by 10% (95% CI: 3%-17%) in the HIIT/MICT group (n = 16) and 7.5% (95% CI: 4%-10%) in the MICT group (n = 24), with no differences between groups. In the 8- to 16- week per-protocol analysis, the HIIT/MICT group had a significantly larger increase in EEDE compared with the MICT group. Resting metabolic rate remained unchanged in both groups. HIIT/MICT and MICT were associated with significant weight loss of 5 kg and 2 kg, respectively.
CONCLUSIONS
Patients completing a 24-week combined HIIT/MICT program did not achieve a higher EEDE compared with those who completed a 24-week MICT program. The HIIT/MICT group experienced, on average, a 3-kg-larger weight loss than the MICT group.
Topics: Energy Metabolism; Exercise; Exercise Therapy; Female; Humans; Male; Obesity, Morbid; Weight Loss
PubMed: 33491314
DOI: 10.1002/oby.23078 -
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 -
Forensic Science, Medicine, and... Jun 2022Three morbidly obese men aged 69, 49 and 45 years with respective BMIs of 46.3, 49.1 and 59.3 died suddenly from underlying cardiovascular disease. At autopsy all were...
Three morbidly obese men aged 69, 49 and 45 years with respective BMIs of 46.3, 49.1 and 59.3 died suddenly from underlying cardiovascular disease. At autopsy all were found to have marked penile shortening typical of an entity known as "buried penis." This condition arises in adulthood most commonly from morbid obesity as the penile shaft becomes enveloped by encroaching suprapubic adipose tissue. It is associated with infective, obstructive and malignant complications. Histology will be required to identify less-common causative conditions or any inflammatory or premalignant/malignant changes.
Topics: Adipose Tissue; Adult; Body Mass Index; Humans; Male; Obesity, Morbid; Penis
PubMed: 35195846
DOI: 10.1007/s12024-022-00461-w -
The American Surgeon May 2024Bariatric surgery is currently the most effective long-term treatment for morbid obesity as well as type-2 diabetes mellitus. The field of metabolic and bariatric... (Review)
Review
Bariatric surgery is currently the most effective long-term treatment for morbid obesity as well as type-2 diabetes mellitus. The field of metabolic and bariatric surgery has seen tremendous growth over the past decade with dramatically reduced risks. This article aims to provide an update on bariatric surgery, highlighting the latest outcomes, improvements, and challenges in the field. Recently, the American Society of Metabolic and Bariatric Surgery (ASMBS) and the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) released a major update to the indications for bariatric surgery at BMI ≥35 kg/m regardless of co-morbidities and 30-34.9 kg/m with obesity-related comorbidities. Sleeve gastrectomy has emerged as the most popular bariatric procedure in the last 10 years with its remarkable efficacy and safety profile. The implementation of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) and Enhanced Recovery After Surgery (ERAS) protocols have significantly improved the quality of care for all bariatric patients. The recent introduction and FDA approval of Glucagon-Like Peptide-1 (GLP-1) agonists for chronic obesity has garnered significant media coverage and popularity, but no guidelines exist regarding its use in relation to bariatric surgery. This update underscores the need for tailored approaches, ongoing research, and the integration of evidence-based medicine and innovations to enhance patient care.
Topics: Humans; Gastric Bypass; Bariatric Surgery; Obesity, Morbid; Diabetes Mellitus, Type 2; Comorbidity; Gastrectomy; Treatment Outcome; Retrospective Studies
PubMed: 38060198
DOI: 10.1177/00031348231220576 -
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 -
The Surgical Clinics of North America Apr 2021Bariatric surgery has emerged as the most effective means of achieving weight loss. Obesity surgery is a quickly expanding field. Laparoscopic vertical sleeve... (Review)
Review
Bariatric surgery has emerged as the most effective means of achieving weight loss. Obesity surgery is a quickly expanding field. Laparoscopic vertical sleeve gastrectomy is a great option for patients because it is simple, exceedingly safe, has a fairly defined postoperative complication profile, and is as effective as more complex bariatric surgery options. Specific consideration of patients' comorbidities, assessment of surgeon's skill, and knowledge of preoperative, perioperative, and postoperative course is a must for all surgeons who wish to perform this procedure. If properly used, vertical sleeve gastrectomy is a powerful tool in combating obesity and its deleterious effects.
Topics: Gastrectomy; Gastric Bypass; Humans; Laparoscopy; Obesity, Morbid; Weight Loss
PubMed: 33743962
DOI: 10.1016/j.suc.2020.12.015