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Surgical Treatment for Obesity
Does medical therapy have a role in the morbidly obese?
Non-Surgical Treatment of Obesity
Bariatric surgeons would argue that non-surgical treatment of the morbidly
obese (BMI >40) is often futile, because the weight loss resulting
from surgery is so much more dramatic than that achieved by medical treatment.
However, modest weight loss in less obese individuals produces beneficial
changes in blood pressure and lipids. Is it really necessary to achieve
'surgical' weight loss in order to reap health benefits? Do drugs work
as well in the morbidly obese? What is the best use of healthcare resource
in this very overweight group?
There is surprisingly little published
evidence to help us answer these questions This lecture explores whether
weight loss alone is the most appropriate clinical end-point to judge
'successful' treatment outcome and questions whether more subtle clinical
and economic analyses might allow the relative merits of medical and surgical
demands on healthcare resource to be considered in a more balanced way.
Weight Loss Surgery & Obesity
The conclusion drawn is that firmly held medical and surgical beliefs
have a very weak evidence base. Imperfect analyses do seem to indicate
that surgery is the more cost-effective treatment of severe obesity, particularly
when improvements in quality of life are considered. However, many important
questions remain unanswered. A well-designed long-term prospective comparison
of surgical and non-surgical therapy in morbid obesity is urgently needed
to inform the debate amongst healthcare purchasers attempting to tackle
the consequences of the obesity epidemic.
Source: Mr David Kerrigan, Consultant Surgeon, University Hospital Aintree,
Liverpool, UK. (2002)
Obesity Help
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