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Pros & Cons of Bariatric Procedures Reviewed

Malabsorptive operations may be best in severely obese individuals

MONDAY, Dec. 17 (HealthDay News) -- In the surgical treatment of obesity, the decision of which bariatric surgery method to use should take patient factors into account and include an individualized discussion of benefits and risks of each method, according to a review article published in the Dec. 15 issue of The Lancet.

In the article, Michael Korenkov, M.D., of the University of Mainz in Mainz, Germany, and a colleague review epidemiologic trends and indications for bariatric surgery and discuss presently available bariatric procedures.

Bariatric surgeries have increased fivefold in the last five years in most developed countries, the authors indicate. Bariatric procedures include gastric restrictive procedures, such as gastric banding, which limit food intake; malabsorptive operations, such as biliopancreatic diversion, which limit food uptake; and methods that combine malabsorption and restriction, such as Roux-en-Y gastric bypass. Newer gastric stimulation techniques like gastric pacemaker are considered experimental and lack long-term data. Patients with severe obesity may be good candidates for methods with greater weight-loss potential such as Roux-en-Y bypass, whereas gastric restrictive procedures may be appropriate for milder cases of obesity.

"In summary, there is good evidence to show that bariatric surgery is more effective than non-surgical approaches in the therapy of morbid obesity. However, no single operation is ideal for every morbidly obese patient, and all operations also entail some disadvantages," the authors write.

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