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Adipositas – Stellenwert der bariatrischen Chirurgie

Obesity – Importance of bariatric surgery

  • Leitthema
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Der Gynäkologe Aims and scope

Zusammenfassung

Die Indikation zur bariatrischen oder metabolischen Chirurgie ist in erster Linie an den Body-Mass-Index (BMI) gekoppelt. Neuere Studienergebnisse zeigen jedoch, dass der metabolische Erfolg operativer Maßnahmen von anderen Prädiktoren abhängig ist. Daher ist eine Veränderung der Indikationsgrundlage insbesondere für die chirurgische Therapie des Diabetes mellitus Typ 2 notwendig. Die Nachsorge ist ein relevanter Aspekt für den Langzeitverlauf und Prävention von Hypovitaminosen.

Abstract

The indications for bariatric or metabolic surgery primarily depend on the body mass index (BMI); however, recent study results have shown that other markers are more reliable predictors of the metabolic success of surgical measures. A revision of the indication criteria is therefore necessary especially for surgical treatment of type 2 diabetes mellitus. The postoperative management is a relevant aspect for the long-term success and prevention of vitamin deficiencies.

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Literatur

  1. Berrington de Gonzalez A, Hartge P, Cerhan JR et al (2010) Body-mass index and mortality among 1.46 million white adults. N Engl J Med 363(23):2211–2219. doi:10.1056/NEJMoa1000367

    Article  CAS  PubMed  Google Scholar 

  2. Malik VS, Willett WC, Hu FB (2013) Global obesity: Trends, risk factors and policy implications. Nat Rev Endocrinol 9(1):13–27. doi:10.1038/nrendo.2012.199

    Article  PubMed  Google Scholar 

  3. Hauner H, Buchholz G, Hamann A et al (2007) 3. Interdisziplinäre Leitlinie der Qualität S3 zur „Prävention und Therapie der Adipositas“. Version 2.0 (Apil 2014). AWMF Register Nummer 050/001

  4. Curioni CC, Lourenço PM (2005) Long-term weight loss after diet and exercise: A systematic review. Int J Obes (Lond) 29(10):1168–1174. doi:10.1038/sj.ijo.0803015

    Article  CAS  Google Scholar 

  5. Wu T, Gao X, Chen M, van Dam RM (2009) Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: A meta-analysis. Obes Rev 10(3):313–323. doi:10.1111/j.1467-789X.2008.00547.x

    Article  CAS  PubMed  Google Scholar 

  6. Norris SL, Zhang X, Avenell A et al (2004) Long-term effectiveness of lifestyle and behavioral weight loss interventions in adults with type 2 diabetes: A meta-analysis. Am J Med 117(10):762–774. doi:10.1016/j.amjmed.2004.05.024

    Article  PubMed  Google Scholar 

  7. Södlerlund A, Fischer A, Johansson T (2009) Physical activity, diet and behaviour modification in the treatment of overweight and obese adults: a systematic review. Perspect Public Health 129(3):132–142

    Article  PubMed  Google Scholar 

  8. Kraschnewski JL, Boan J, Esposito J et al (2010) Long-term weight loss maintenance in the United States. Int J Obes (Lond) 34(11):1644–1654. doi:10.1038/ijo.2010.94

    Article  CAS  Google Scholar 

  9. Wing RR, Phelan S (2005) Long-term weight loss maintenance. Am J Clin Nutr 82(1 Suppl):222S–225S

    CAS  PubMed  Google Scholar 

  10. Padwal RS, Pajewski NM, Allison DB, Sharma AM (2011) Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity. CMAJ 183(14):E1059–E1066. doi:10.1503/cmaj.110387

    Article  PubMed  PubMed Central  Google Scholar 

  11. Sjöström L, Narbro K, Sjöström CD et al (2007) Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 357(8):741–752. doi:10.1056/NEJMoa066254

    Article  PubMed  Google Scholar 

  12. Sjöström L (2013) Review of the key results from the Swedish Obese Subjects (SOS) trial – A prospective controlled intervention study of bariatric surgery. J Intern Med 273(3):219–234. doi:10.1111/joim.12012

    Article  PubMed  Google Scholar 

  13. Adams TD, Stroup AM, Gress RE et al (2009) Cancer incidence and mortality after gastric bypass surgery. Obesity (Silver Spring) 17(4):796–802. doi:10.1038/oby.2008.610

    Article  Google Scholar 

  14. Adams TD, Gress RE, Smith SC et al (2007) Long-term mortality after gastric bypass surgery. N Engl J Med 357(8):753–761. doi:10.1056/NEJMoa066603

    Article  CAS  PubMed  Google Scholar 

  15. Münzberg H, Laque A, Yu S, Rezai-Zadeh K, Berthoud H‑R (2015) Appetite and body weight regulation after bariatric surgery. Obes Rev 16(Suppl 1):77–90. doi:10.1111/obr.12258

    Article  PubMed  PubMed Central  Google Scholar 

  16. Chakravartty S, Tassinari D, Salerno A, Giorgakis E, Rubino F (2015) What is the Mechanism Behind Weight Loss Maintenance with Gastric Bypass? Curr Obes Rep 4(2):262–268. doi:10.1007/s13679-015-0158-7

    Article  PubMed  Google Scholar 

  17. Pories WJ, Swanson MS, MacDonald KG et al (1995) Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 222(3):339–350

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Schauer PR, Bhatt DL, Kirwan JP et al (2014) Bariatric surgery versus intensive medical therapy for diabetes – 3‑year outcomes. N Engl J Med:1–12. doi:10.1056/NEJMoa1401329

    Google Scholar 

  19. Mingrone G, Panunzi S, De Gaetano A et al (2015) 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 (London England) 386(9997):964–973. doi:10.1016/S0140-6736(15)00075-6

    Article  Google Scholar 

  20. Cummings DE, Arterburn DE, Westbrook EO et al (2016) Gastric bypass surgery vs intensive lifestyle and medical intervention for type 2 diabetes: The CROSSROADS randomised controlled trial. Diabetologia 59(5):945–953. doi:10.1007/s00125-016-3903-x

    Article  CAS  PubMed  Google Scholar 

  21. Hsu C‑C, Almulaifi A, Chen J‑C et al (2015) Effect of Bariatric surgery vs medical treatment on type 2 diabetes in patients with body mass index lower than 35: Five-year outcomes. JAMA Surg 150(12):1117–1124. doi:10.1001/jamasurg.2015.2602

    Article  PubMed  Google Scholar 

  22. Panunzi S, Carlsson L, De Gaetano A et al (2016) Determinants of Diabetes remission and Glycemic control after Bariatric surgery. Diabetes Care 39(1):166–174. doi:10.2337/dc15-0575

    Article  CAS  PubMed  Google Scholar 

  23. Rubino F, Nathan DM, Eckel RH et al (2016) Metabolic surgery in the treatment algorithm for Type 2 Diabetes: A joint statement by International Diabetes Organizations. Diabetes Care 39(6):861–877. doi:10.2337/dc16-0236

    Article  CAS  PubMed  Google Scholar 

  24. Pekkarinen T, Mustonen H, Sane T, Jaser N, Juuti A, Leivonen M (2016) Long-term effect of gastric bypass and sleeve gastrectomy on severe obesity: Do preoperative weight loss and binge eating behavior predict the outcome of Bariatric surgery? Obes Surg 26(9):2161–2167. doi:10.1007/s11695-016-2090-7

    Article  PubMed  Google Scholar 

  25. Vidal P, Ramón JM, Goday A et al (2014) Lack of adherence to follow-up visits after bariatric surgery: Reasons and outcome. Obes Surg 24(2):179–183. doi:10.1007/s11695-013-1094-9

    Article  PubMed  Google Scholar 

  26. Heber D, Greenway FL, Kaplan LM, Livingston E, Salvador J, Still C (2010) Endocrine and nutritional management of the post-Bariatric surgery patient: An endocrine society clinical practice guideline. J Clin Endocrinol Metab 95(11):4823–4843. doi:10.1210/jc.2009-2128

    Article  CAS  PubMed  Google Scholar 

  27. Bond DS, Wing RR, Vithiananthan S, Sax HC, Roye GD, Ryder BA, Pohl D, Giovanni J (2011) Significant resolution of female sexual dysfunction after bariatric surgery. Surg Obes Relat Dis 7(1):1–7. doi:10.1016/j.soard.2010.05.015

    Article  PubMed  Google Scholar 

  28. Parent B, Martopullo I, Weiss NS, Khandelwal S, Fay EE, Rowhani-Rahbar A (2016) Bariatric surgery in women of childbearing age, timing between an operation and birth, and associated Perinatal complications. JAMA Surg. doi:10.1001/jamasurg.2016.3621

    Google Scholar 

  29. Feichtinger M, Stopp T, Hofmann S, Springer S, Pils S, Kautzky-Willer A, Kiss H, Eppel W, Tura A, Bozkurt L, Göbl CS (2017) Altered glucose profiles and risk for hypoglycaemia during oral glucose tolerance testing in pregnancies after gastric bypass surgery. Diabetologia 60(1):153–157

    Article  CAS  PubMed  Google Scholar 

  30. Reining F, Aberle J (2014) Chirurgische Therapie der Adipositas. Internist 55:1383–1390

    Article  CAS  PubMed  Google Scholar 

  31. Schulze zur Wiesch C, Lautenbach A, Aberle J (2016) Adipositas – Neue Aspekte in der internistischen Betreuung vor und nach bariatrischer Chirurgie. Dtsch Med Wochenschr 141(20):1437–1440. doi:10.1055/s-0042-112081

    Article  Google Scholar 

  32. L Sjöström, L Sjöström, (2008) Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study. International Journal of Obesity 32:S93-S97

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Sektion Endokrinologie und Diabetologie, Universitäres Adipositas Zentrum Hamburg, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

    A. Stumpenhagen, C. Schulze zur Wiesch &  J. Aberle

Authors
  1. A. Stumpenhagen
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  2. C. Schulze zur Wiesch
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  3. J. Aberle
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Correspondence to J. Aberle.

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Interessenkonflikt

A. Stumpenhagen, C. Schulze zur Wiesch und J. Aberle geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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K. Schaudig, Hamburg

A. Schwenkhagen, Hamburg

O. Ortmann, Regensburg

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Stumpenhagen, A., Schulze zur Wiesch, C. & Aberle, J. Adipositas – Stellenwert der bariatrischen Chirurgie. Gynäkologe 50, 94–98 (2017). https://doi.org/10.1007/s00129-016-4016-9

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