The annual number of bariatric surgeries in Canada (excluding Quebec and rural Manitoba) has risen from 78 in 2000–01 to over 1100 procedures in 2002–03, according to the Canadian Institute for Health Information Discharge Abstract Database. Studies have shown that patients initially lose between 35%–60% of baseline body weight and maintain weight reductions of approximately 16% after 8 years.1,2 No prospective, randomized trial has demonstrated a reduction in cardiovascular morbidity and mortality with bariatric surgery, although recent observational data suggest beneficial effects on these outcomes.2,3,4 Bariatric surgery is currently indicated in severely obese individuals with a body mass index (BMI) of 40 kg/m2 or a BMI of 35 kg/m2 in the presence of obesity-related comorbidities. — Raj S. Padwal and Richard Z. Lewanczuk, Edmonton, Alta.
Figure.
References
- 1.Brolin RE. Bariatric surgery and long-term control of morbid obesity. JAMA 2002;288:2793-6. [DOI] [PubMed]
- 2.Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351:2683-93. [DOI] [PubMed]
- 3.Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery. A systematic review and meta-analysis. JAMA 2004;292:1724-37. [DOI] [PubMed]
- 4.Christou NV, Sampalis JS, Liberman M, Look D, Auger S, McLean AP, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg 2004;240:416-24. [DOI] [PMC free article] [PubMed]