Abstract
Over 60% of the American population is either overweight or obese. Conventional treatment through decreased caloric intake and increased physical activity has been minimally effective in achieving sustained weight loss. Pharmacotherapies are effective in inducing some weight loss; however, lost weight is regained once the medications are stopped. Surgical weight loss is the only treatment that has been demonstrated to achieve durable weight loss, with sustained weight loss for at least 14 years and improvements in or complete resolution of associated comorbidities and improved quality of life. Based on the National Institutes of Health 1991 Consensus Conference guidelines, 16 million Americans are currently potential candidates for weight loss surgery. Although this is an effective treatment for appropriate candidates in the short term, education on nutrition and increased physical activity is more likely to be effective over the long term. One hopes that current research efforts in obesity and public awareness will lead to a decrease in the prevalence of this disease.
Similar content being viewed by others
References and Recommended Reading
Centers for Disease Control and Prevention: Prevalence of overweight and obesity among adults with diagnosed diabetes — United States, 1988–1994 and 1999–2002. MMWR Morb Mortal Wkly Rep 2004, 53:1066–1068. Detailed look at the prevalence of obesity and its impact on one of the primary obesity-related conditions, diabetes.
National Audit Office: Tackling Obesity in England: Report by the Controller and Auditor General. London: Stationary office, 2001. No.: HC 220 Session 2000–2001.
Calle EE, Thun MJ, Petrelli JM, et al.: Body mass index and mortality in a prospective cohort of US adults. N Engl J Med 1999, 341:1097–1105.
Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity. Accessible at http://surgeongeneral. gov/topics/obesity/
Olshansky SJ, Passaro DJ, Hershow RC, et al.: A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005, 352:1138–1145.
Yanovski SZ, Yanovski JA: Obesity. N Engl J Med 2002, 346:591–602.
Foster GD, Wyatt HR, Hill JO, et al.: A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med 2003, 348:2082–2090.
O’Meara S, Riemsma R, Shirran L, et al.: A rapid and systematic review of the clinical effectiveness and cost-effectiveness of orlistat in the management of obesity. Health Technol Assess 2001, 5:1–81.
Norris SL, Zhang X, Avenell A, et al.: Efficacy of pharmacotherapy for weight loss in adults with type 2 diabetes mellitus: a meta-analysis. Arch Intern Med 2004, 164:1395–1404.
Glazer G: Long-term pharmacotherapy of obesity 2000: a review of efficacy and safety. Arch Intern Med 2001, 161:1814–1824.
Mun EC, Blackburn GL, Matthews JB: Current status of medical and surgical therapy for obesity. Gastroenterology 2001, 120:669–681.
Buchwald H, Avidor Y, Braunwald E, et al.: Bariatric surgery: a systematic review and meta-analysis. JAMA 2004, 292:1724–1737. This meta-analysis reviews the literature dealing with weight loss surgery and analyzes the results in over 22,000 surgical patients. It offers an overview of the current operations performed and the surgical outcomes and long-term outcomes for obesity-related comorbidities.
Steinbrook R: Surgery for severe obesity. N Engl J Med 2004, 350:1075–1079.
Pories W, Swanson M, MacDonald K, et al.: Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 1995, 222:339–350.
Sjostrom L, Lindroos A, Peltonen M, et al.: Lifestyle, diabetes and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004, 351:2683–2693.
Potteiger C, Paragi P, Inverso N, et al.: Bariatric surgery: Shedding the monetary weight of prescription costs in the managed care area. Obes Surg 2004, 14:725–730.
Christou NV, Sampalis JS, Liberman M, et al.: Surgery decreases long-term-mortality, morbidity, and health care use in morbidly obese patients. Ann Surg 2004, 240:416–424. This study compares obese patients undergoing weight loss surgery with those without weight loss and documents an 89% reduction in the risk of death in those who underwent surgery.
Calle EE, Rodriguez C, Walker-Thurmond K, et al.: Overweight, obesity, and mortality from cancer in a prospectively studied cohort of US adults. N Engl J Med 2003, 348:1625–1638.
Hsu L, Benotti P, Dwyer J, et al.: Nonsurgical factors that influence the outcome fo bariatric surgery: a review. Psychosom Med 1998, 60:338–346.
Hall JC, Watts JM, O’Brien PE, et al.: Gastric surgery for morbid obesity. The Adelaide Study. Ann Surg 1990, 211:419–427.
Howard L, Malone M, Michalek A, et al.: Gastric bypass and vertical banded gastroplasty-a prospective randomized comparison and 5-year follow up. Obes Surg 1995, 5:55–60.
Smith CD, Herkes SB, Behrns KE, et al.: Gastric acid secretion and vitamin B12 absorption after vertical Roux-en-Y gastric bypass for morbid obesity. Ann Surg 1993, 218:91–96.
Martin LF, Tan TL, Horn JR, et al.: Comparison of the costs associated with medical and surgical treatment of obesity. Surgery 1995, 118:599–606.
Clegg AJ, Colquitt J, Sidhu MK, et al.: The clinical effectiveness and cost-effectiveness of surgery for people with morbid obesity: a systematic review and economic evaluation. Health Tech Assess 2002, 6:1–153.
Centers for Disease Control and Prevention: Physician and other healthcare professional counseling of smokers to quit-United States, 1991. MMWR Morb Mortal Wkly Rep 1993, 42:854–857.
Centers for Disease Control and Prevention: Receipt of advice to quit smoking in Medicare managed care-united States, 1998. MMWR Morb Mortal Wkly Rep 2000, 49:797.
Galuska DA, Will JC, Serdula MK, Ford ES: Are health care professionals advising obese patients to lose weight? JAMA 1999, 282:1576–1578.
Centers for Disease Control: Overweight and obesity: statebased programs. CDC’s state-based nutrition and physical activity program to prevent obesity and other chronic diseases. http://www.cdc.gov/nccdphp/dnpa/obsity/ Accessed 8/5/05.
FDA, NIH, CDC, and HHS: NIH releases strategic plan on obesity. http://www.fda.gov/fdac/features/2004/304_fat.html In this news release these government agencies announce their plans for funding and tackling the major public health concern of obesity.
Olshansky SJ, Passaro DJ, Hershow RC: A potential decline in life expectancy in the United States in the 21st century. N Engl J Med 2005, 352:1138–1145.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Khaitan, L., Smith, C.D. Obesity in the United States: Is there a quick fix? Pros and cons of bariatric surgery from the adult perspective. Curr Gastroenterol Rep 7, 451–454 (2005). https://doi.org/10.1007/s11894-005-0075-0
Issue Date:
DOI: https://doi.org/10.1007/s11894-005-0075-0