Adolescent Morbid Obesity Is there any role of surgery?

Abstract

During the past decade, severe obesity has gained recognition as a significant health problem facing a large proportion of adults and children in the United States ,Due to a lack of nonsurgical options for severely obese adolescents and a demonstrated safety and efficacy record in adults, there has been increasing interest in surgical procedures for weight loss ("bariatric surgery") for selected obese adolescents with severe obesity. Clear understanding of the pathophysiology of morbid obesity is essential for management and prevention of this disaster. There are several factors concerning the occurrence of obesity, the first one in this mechanism is the genetic control also central nervous system control, afferent signals, pattern of feeding, socioeconomic factors, exercise and pattern of distribution of excess adipose tissue, leptin also, have a role in the mechanism of this disease.Leptin is the best known of the afferent fat signals and the best candidate for primary signal communication of body fat information to the central controller. Children and adolescents with severe obesity are at risk for important comorbidities, including obstructive sleep apnea, diabetes, hypertension, cardiac hypertrophy, and nonalcoholic steatohepatitis, as well as depression and impaired quality of life. Therefore, treatment that is targeted at obesity may treat or prevent these problems and improve long-term health outcomes.The goal of weight-loss therapy is to improve health by modifying obesity-related diseases and the risk for future obesity-related medical complications