Facing Morbid Obesity: How to Approach It.

Area of Science:

• Public Health
• Cardiology
• Metabolic Surgery

Background:

• Obesity, a significant public health issue in Western Europe (10-20% prevalence), has seen rising rates of morbid obesity (BMI >40 kg/m²).
• Morbid obesity negatively affects economic and social opportunities, quality of life, and is linked to intermediate risk factors, increasing mortality and reducing life expectancy.
• The increasing prevalence of morbid obesity has driven demand for bariatric (metabolic) surgery, which reduces metabolic comorbidities, cardiovascular (CV) risk, and overall mortality.

Purpose of the Study:

• To review and update the evaluation process for morbidly obese patients undergoing bariatric surgery.
• To emphasize the importance of comprehensive assessments, including physical, metabolic, cardiovascular, and respiratory evaluations.
• To guide the correct stratification of cardiovascular risk and inform optimal treatment strategies.

Main Methods:

• Review of current literature and clinical practices for evaluating morbidly obese patients.
• Integration of physical examination findings with metabolic, cardiovascular, and respiratory assessments.
• Emphasis on a multidisciplinary team approach involving various specialists.

Main Results:

• Bariatric surgery leads to significant improvements in metabolic health, cardiovascular risk factors, and mortality rates in morbidly obese patients.
• Accurate cardiovascular risk stratification is crucial for optimizing surgical outcomes and patient management.
• A multidisciplinary team is essential for comprehensive patient evaluation and effective treatment planning.

Conclusions:

• Comprehensive, multidisciplinary evaluation is critical for morbidly obese patients considering bariatric surgery.
• Effective cardiovascular risk stratification ensures better patient outcomes and management post-surgery.
• Bariatric surgery offers substantial benefits in reducing comorbidities and mortality associated with morbid obesity.