Published 22 September 2009, doi:10.1136/bmj.b3402
Cite this as: BMJ 2009;339:b3402

Clinical Review

Surgery for obesity in adulthood

Daniel Richard Leff, academic clinical lecturer in general surgery 1, Dugal Heath, consultant laparoscopic and bariatric surgeon and honorary senior lecturer2

1 Department of BioSurgery and Surgical Technology, St Mary’s Hospital, London W2 1NY, 2 North London Obesity Surgery Service (NLOSS), Department of Surgery, Whittington Hospital NHS Trust, London N19 5NF

Correspondence to: D Heath Dugal.Heath@whittington.nhs.uk

The first 150 words of the full text of this article appear below.


Morbid obesity is associated with comorbidities and reduced life expectancy
Bariatric surgery is the only treatment for morbid obesity that has been shown to produce long term weight loss
Common procedures used for weight loss include gastric banding, Roux-en-Y gastric bypass, and sleeve gastrectomy
Bariatric surgery has been shown to lead to sustained weight loss, resolution of comorbidities, and improved life expectancy


The relation between morbid obesity, serious morbidity, and early mortality is well known (fig 1Go and table 1Go).1 2 A recent systematic review of over 890 000 participants found that each 5 point increase in body mass index (kg/m2) over 25 was associated with a 30% increase in overall mortality.3 Conservative approaches to managing obesity (dieting, exercise, and cognitive behavioural therapy) achieve long term weight loss in only a small minority of highly motivated individuals.4 Weight loss drugs such as orlistat and sibutramine produce modest weight loss . . . [Full text of this article]


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