The Mount Sinai Journal of Medicine

 

Volume 71 Number 1
January 2004
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The Surgical Management of Severe Obesity 63-71

Daniel M. Herron

From the Division of Laparoscopic Surgery, Department of Surgery, Mount Sinai School of Medicine, New York, NY.

Address all correspondence to Daniel M. Herron, M.D., 3003 New Hyde Park Road, New Hyde Park, NY 11042.

Accepted for publication April 2003.

ABSTRACT

The prevalence of obesity in the United States is increasing to epidemic proportions. At present, more than 60% of Americans are overweight. While a variety of medications are available for the treatment of obesity, none results in the long-term loss of more than 10% of body weight. The current standard for the treatment of severe obesity, defined as a body mass index of greater than 35–40 kg/m 2 , is surgical. Several surgical procedures are currently available, including gastric bypass, biliopancreatic diversion with duodenal switch, and the adjustable gastric band. These operations may be performed using laparoscopic surgical techniques to minimize perioperative morbidity and postoperative recovery time. To optimize the outcome of this type of procedure, bariatric surgery should be performed on carefully selected patients, in centers specially equipped to care for the obese, within a broadly based, multidisciplinary setting providing lifelong postoperative care.

KEYWORDS

Severe obesity, morbid obesity, obesity, bariatric surgery, gastric bypass, biliopancreatic diversion, adjustable gastric band.


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