[Clinical evidence for metabolic surgery]

Area of Science:

• Metabolic Surgery
• Obesity Management
• Diabetes Mellitus

Background:

• Bariatric surgery's metabolic benefits are established for morbid obesity (BMI > 40 kg/m²).
• Increasing use of metabolic surgery for obesity grades I (BMI 30-35 kg/m²) and II (BMI 35-40 kg/m²).
• Debate exists regarding indications for metabolic surgery in lower obesity grades due to limited evidence.

Purpose of the Study:

• Evaluate the efficacy of metabolic surgery versus conservative therapy in patients with obesity grades I and II.
• Assess the impact of metabolic surgery on glycemic control, diabetes remission, and comorbidities.

Main Methods:

• Analysis of recent high-quality randomized clinical trials comparing metabolic surgery to conservative therapy.
• Focus on short-term follow-up data (12-36 months).

Main Results:

• Metabolic surgery demonstrates unquestionable short-term efficacy compared to conservative therapy for obesity grades I and II.
• Significant improvements in glycemic control and diabetes remission observed.
• Positive effects on diabetic complications (retinopathy, nephropathy, polyneuropathy) and comorbidities (hypertension, dyslipidemia).

Conclusions:

• Metabolic surgery is a highly effective short-term treatment option for patients with obesity grades I and II.
• The procedure offers benefits beyond diabetes management, impacting associated health conditions.
• Future research should investigate long-term effects, optimal patient selection, and surgical procedure choice.