SURGICAL MANAGEMENT OF MORBID OBESITY.

Abstract

Obesity is a far-reaching problem in the world and is considered the most common disorder of metabolism . Morbidly obese individual is defined as one who has reached two times or more of his ideal body weight and maintained this level for five years or more. Measurement of obesity can be done in relation to body weight using a cuarial tables or in relation to height using body mass index and patients who weigh 20% above his ideal body weight or have body mass index greater than 28 kg /m 2 are considered obese . Other recent methods can be used in measurement of obesity as , ultrasound , infrared interactance , computed tomography and magnetic resonance imaging , total body potassium , and total body electrical conductivity . Several factors are considered in relation to the aetiology of obesity as , genetic , familial, psychological , enviromental , hypothalamic ,drug induced , and endocrinal factors . It may even considered a simple problem of energy intake being greater than energy expenditure . Morbid obesity is clearly associated with hypertension , dyslipidemia , Non insulin dependent diabetes mellitus , coronary heart disease , respiratory problems , sleep apnea , cancers , gall bladder diseases , and osteoarthritis . Because the previous associated diseases and increased incidence of morbidity and mortality,management of obesity is very important.There are two line of treatment, medical (diet, drugs , behavior modification , and intragastric balloon ) , and surgical procedures . Diet management means the use of low or very low calorie diets to decrease energy intake than energy expenditure . Drug therapy may be effective but the patient rapidly develop tolerance to these drugs and regain the weight they lost.