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When to advise surgery for severe obesity.
1Rank Department of Human Nutrition, St Bartholomew's Hospital Medical College, London, UK.
Postgraduate Medical Journal
|January 1, 1989
Summary
Achieving significant weight loss requires a substantial calorie deficit, often necessitating long-term dietary changes or surgical interventions for severely obese individuals. Maintaining weight loss is challenging and may require ongoing support strategies.
Area of Science:
- Obesity Medicine
- Metabolic Health
- Bariatric Surgery
Background:
- Severely obese patients often carry significant excess weight, approximately 50 kg, representing a large caloric reserve.
- Sustainable weight loss requires a consistent energy deficit, typically 1000 kcal/day for optimal results.
Purpose of the Study:
- To outline the challenges and strategies associated with achieving and maintaining significant weight loss in severely obese patients.
- To discuss the role of dietary interventions, surgical procedures, and post-weight loss support.
Main Methods:
- Analysis of energy expenditure and caloric deficits required for substantial weight reduction.
- Review of current and potential interventions for weight loss and maintenance in severe obesity.
Main Results:
- Optimal weight loss of ~1 kg/week necessitates a year of strict dietary adherence.
- Surgical options like jaw wiring or stomach stapling may aid initial weight loss.
- Weight loss maintenance is difficult and may benefit from aids like waist cords.
Conclusions:
- Long-term dietary restriction is challenging for severe obesity management.
- Surgical interventions are considered for specific cases, but psychiatric conditions contraindicate their use.
- Post-weight loss strategies are crucial for sustained success.