According to background information in the article, an estimated 1.7 billion people worldwide are overweight or obese. Overweight is defined as having a body mass index (BMI) of 25 or higher; obesity is defined as a BMI of 30 or higher; and morbid obesity as 40 or higher. Being obese is associated with a greater risk for type 2 diabetes, hypertension, heart disease, stroke and asthma. The loss of life expectancy due to morbid obesity is significant: in comparison with a normal-weight individual, a 25-year-old morbidly obese man has a 22 percent reduction in expected remaining lifespan, representing an approximately loss of 12 years of life. For treating obesity long term, diet therapy has been found to be relatively ineffective.

Henry Buchwald, M.D., Ph.D., of the University of Minnesota, Minneapolis, and colleagues conducted a review of 136 studies published between 1990 and 2003, which included 22,094 patients who underwent bariatric surgery, to determine the impact of bariatric surgery on weight loss, operative mortality outcome, and four obesity related disorders (diabetes, hyperlipidemia, hypertension and obstructive sleep apnea). The bariatric surgery procedures included gastric banding, gastric bypass, gastroplasty, biliopancreatic diversion or duodenal (part of small intestine) switch, and others (such as jejunoileal bypass, a bypass of a section of the small intestine). Nineteen percent of patients were men and 72.6 percent were women, with an average age of 39 years. The average body mass index for 16,944 patients was 46.9 before surgery.

The researchers found that the average percentage of excess weight loss was 61.2 per
'"/>

Contact: Molly Portz
612-625-2640
JAMA and Archives Journals
12-Oct-2004