Surgical Approaches in the Treatment of Obesity

Abstract

Bariatric-metabolic surgery is the most effective treatment option for clinically severe obesity that offers significant and durable weight loss. In this chapter, we examine the evidence for the common bariatric surgical procedures. We explore the mechanisms of action of surgery on weight loss and glycemic control, including changes in key hormones related to energy balance and glucose homeostasis. We discuss the role of the endocrinologist in helping decide the appropriate patients for bariatric-metabolic surgery and addressing non-surgical aspects of perioperative care, most notably nutritional and metabolic support. The acute post-surgical and longer-term nutritional and metabolic complications of surgery as well as recommendations for post-operative lifestyle, nutritional and comorbidity follow-up are also reviewed.