Advertisement

Bariatric Surgery: Current State of Affairs

  • Katherine S. Blevins
  • Dan E. Azagury
  • John Magaña MortonEmail author
Chapter
First Online:

Abstract

Bariatric surgery has been shown to be an effective treatment for obesity and obesity-related comorbidities. The adoption of bariatric surgery has progressed over the last four decades, yet still only approximately 1% of those who qualify for surgical treatment of obesity actually have an operation. This, combined with the increasing prevalence of obesity, shows the unmet need in the treatment of obesity. Here, we review the adoption of bariatric surgery around the globe, examining factors that contribute to the implementation of surgical management. We also explore future directions in obesity management and bariatric surgery in the multidisciplinary care of obesity.

Keywords

Global bariatric surgery Current state bariatric surgery Bariatric surgery adoption Bariatric emerging technology Obesity surgical treatment gap 
This is a preview of subscription content, log in to check access.

Supplementary material

Video 2.1

We start today video: obesity surgery helps people reclaim their lives. (Courtesy of and produced by ASMBS) (MP4 329835 kb)

References

  1. 1.
    WHO | Obesity and overweight. WHO. Available at: http://www.who.int/mediacentre/factsheets/fs311/en/. Accessed: 8 Jan 2017.
  2. 2.
    Health implications of obesity. National Institutes of Health consensus development conference statement. Ann Intern Med. 1985;103:147–51.CrossRefGoogle Scholar
  3. 3.
    Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA. 2013;309:71–82.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Nguyen NT, Varela JE. Bariatric surgery for obesity and metabolic disorders: state of the art. Nat Rev Gastroenterol Hepatol. 2016.  https://doi.org/10.1038/nrgastro.2016.170.
  5. 5.
    Mingrone G, et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet Lond Eng. 2015;386:964–73.CrossRefGoogle Scholar
  6. 6.
    Adams TD, et al. Health benefits of gastric bypass surgery after 6 years. JAMA. 2012;308:1122–31.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;CD003641.  https://doi.org/10.1002/14651858.CD003641.pub4.
  8. 8.
    Sjöström L, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357:741–52.CrossRefPubMedGoogle Scholar
  9. 9.
    Mason EE, Ito C. Gastric bypass in obesity. Surg Clin N Am. 1967;47:1345–51.CrossRefPubMedGoogle Scholar
  10. 10.
    Nguyen NT. The ASMBS textbook of bariatric surgery – volume 1: bariatric. Springer 2017.Google Scholar
  11. 11.
    Ng M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–81.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Esteban Varela J, Nguyen NT. Laparoscopic sleeve gastrectomy leads the U.S. utilization of bariatric surgery at academic medical centers. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2015;11:987–90.CrossRefGoogle Scholar
  13. 13.
    NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991;115:956–61.CrossRefGoogle Scholar
  14. 14.
    Nguyen NT, Vu S, Kim E, Bodunova N, Phelan MJ. Trends in utilization of bariatric surgery, 2009–2012. Surg Endosc. 2016;30:2723–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Chang S-H, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003–2012. JAMA Surg. 2014;149:275–87.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Ponce J, et al. American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in 2015 and surgeon workforce in the United States. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2016;12:1637–9.CrossRefGoogle Scholar
  17. 17.
    Angrisani L, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25:1822–32.CrossRefPubMedGoogle Scholar
  18. 18.
    Finkelstein EA. How big of a problem is obesity? Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2014;10:569–70.CrossRefGoogle Scholar
  19. 19.
    Gallagher SF, et al. The impact of bariatric surgery on the Veterans Administration healthcare system: a cost analysis. Obes Surg. 2003;13:245–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Sampalis JS, Liberman M, Auger S, Christou NV. The impact of weight reduction surgery on health-care costs in morbidly obese patients. Obes Surg. 2004;14:939–47.CrossRefPubMedGoogle Scholar
  21. 21.
    Cremieux P-Y, et al. A study on the economic impact of bariatric surgery. Am J Manag Care. 2008;14:589–96.PubMedGoogle Scholar
  22. 22.
    Klein S, Ghosh A, Cremieux PY, Eapen S, McGavock TJ. Economic impact of the clinical benefits of bariatric surgery in diabetes patients with BMI ≥35 kg/m. Obes Silver Spring Md. 2011;19:581–7.CrossRefGoogle Scholar
  23. 23.
  24. 24.
    Kim JJ, Rogers AM, Ballem N, Schirmer B, American Society for Metabolic and Bariatric Surgery Clinical Issues Committee. ASMBS updated position statement on insurance mandated preoperative weight loss requirements. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2016;12:955–9.CrossRefGoogle Scholar
  25. 25.
    Stegenga H, Haines A, Jones K, Wilding J. Identification, assessment, and management of overweight and obesity: summary of updated NICE guidance. BMJ. 2014;349:g6608.CrossRefPubMedGoogle Scholar
  26. 26.
    Welbourn R, le Roux CW, Owen-Smith A, Wordsworth S, Blazeby JM. Why the NHS should do more bariatric surgery; how much should we do? BMJ. 2016;353:i1472.CrossRefPubMedGoogle Scholar
  27. 27.
    Capehorn MS, Haslam DW, Welbourn R. Obesity treatment in the UK health system. Curr Obes Rep. 2016;5:320–6.CrossRefPubMedGoogle Scholar
  28. 28.
    Welbourn R, et al. NICE-accredited commissioning guidance for weight assessment and management clinics: a model for a specialist multidisciplinary team approach for people with severe obesity. Obes Surg. 2016;26:649–59.CrossRefPubMedGoogle Scholar
  29. 29.
    Andreyeva T, Puhl RM, Brownell KD. Changes in perceived weight discrimination among Americans, 1995–1996 through 2004–2006. Obes Silver Spring Md. 2008;16:1129–34.CrossRefGoogle Scholar
  30. 30.
    Budd GM, Mariotti M, Graff D, Falkenstein K. Health care professionals’ attitudes about obesity: an integrative review. Appl Nurs Res ANR. 2011;24:127–37.CrossRefPubMedGoogle Scholar
  31. 31.
    Teachman BA, Brownell KD. Implicit anti-fat bias among health professionals: is anyone immune? Int J Obes Relat Metab Disord J Int Assoc Study Obes. 2001;25:1525–31.CrossRefGoogle Scholar
  32. 32.
    Obesity Treatment Devices – FDA Approved Obesity Treatment Devices. Available at: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ObesityDevices/ucm350134.htm.
  33. 33.
    Rafid R, Azagury D. Novel technologies and techniques in bariatric surgery. Minerva Chir. 2016;16:1683–4. [Epub ahead of print].Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Katherine S. Blevins
    • 1
  • Dan E. Azagury
    • 2
  • John Magaña Morton
    • 2
    Email author
  1. 1.Department of SurgeryStanford University School of MedicineStanfordUSA
  2. 2.Department of SurgeryStamford HospitalStanfordUSA

Personalised recommendations

Cite chapter

Buy options