Bariatrics

Template:Short description Template:Human body weight Bariatrics is a discipline that deals with the causes, prevention, and treatment of obesity,<ref>Template:Cite journal</ref> encompassing both obesity medicine and bariatric surgery.

TerminologyEdit

The term bariatrics was coined around 1965,<ref name="dictionary.com">Dictionary.com, based on Random House Unabridged Dictionary, Random House (2006): [1] Retrieved 15 April 2006</ref> from the Greek root bar- ("weight" as in barometer), suffix -iatr ("treatment," as in pediatrics), and suffix -ic ("pertaining to"). The field encompasses dieting, exercise and behavioral therapy approaches to weight loss, as well as pharmacotherapy and surgery. The term is also used in the medical field as somewhat of a euphemism to refer to people of larger sizes without regard to their participation in any treatment specific to weight loss, such as medical supply catalogs featuring larger hospital gowns and hospital beds referred to as "bariatric".

Bariatric patientsEdit

Being overweight or obese are both rising medical problems.<ref name="reynolds">Template:Cite journal</ref><ref name="hedley">Template:Cite journal</ref> There are many detrimental health effects of obesity:<ref name="WHO">WHO factsheet on obesity Template:Webarchive</ref><ref name="Bray2004">Template:Citation</ref> Individuals with a BMI (Body Mass Index) exceeding a healthy range have a much greater risk of medical issues.<ref name="Gregg2005">Template:Citation</ref> These include heart disease, diabetes mellitus, many types of cancer, asthma, obstructive sleep apnea, and chronic musculoskeletal problems. There is also a focus on the correlation between obesity and mortality.<ref name="flegal">Template:Cite journal</ref>

Overweight and obese people, including children, may find it difficult to lose weight on their own.<ref name="Bagozzi2004">Template:Citation</ref> It is common for dieters to have tried fad diets only to find that they gain weight, or return to their original weight, after ceasing the diet.<ref name="Ikeda1999">Template:Citation</ref> Some improvement in patient psychological health is noted after bariatric surgery.<ref>Template:Cite journal</ref> 51% of bariatric surgery candidates report a history of mental illness, specifically depression, as well as being prescribed at least one psychotropic medication at the time of their surgery candidacy.<ref>Hensel J, Selvadurai M, Anvari M, et al. Mental illness and psychotropic medication use among people assessed for bariatric surgery in Ontario, Canada. Obes Surg.2016;26:1531–1536.</ref><ref>Ward H.B., Yudkoff B.L., Fromson J.A. Lurasidone malabsorption following bariatric surgery: A case report. J. Psychiatr. Pract.. 2019;25(4):313-317. doi:10.1097/PRA.0000000000000402</ref>

Methods of treatmentEdit

Although diet, exercise, behavior therapy and anti-obesity drugs are first-line treatment,<ref name="guidelines">Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, The Evidence Report. NIH Publication NO. 98-4083, September 1998. NATIONAL INSTITUTES OF HEALTH National Heart, Lung, and Blood Institute in cooperation with The National Institute of Diabetes and Digestive and Kidney diseases. Template:Webarchive</ref> medical therapy for severe obesity has limited short-term success and very poor long-term success.<ref name="NIH">Template:Cite journal</ref> Weight loss surgery generally results in greater weight loss than conventional treatment, and leads to improvements in quality of life and obesity related diseases such as hypertension and diabetes mellitus.<ref name="cochrane">Template:Cite journal</ref> A meta-analysis of 174772 participants published in The Lancet in 2021 found that bariatric surgery was associated with 59% and 30% reduction in all-cause mortality among obese adults with or without type 2 diabetes respectively.<ref name=":0">Template:Cite journal</ref> This meta-analysis also found that median life-expectancy was 9.3 years longer for obese adults with diabetes who received bariatric surgery as compared to routine (non-surgical) care, whereas the life expectancy gain was 5.1 years longer for obese adults without diabetes.<ref name=":0" />

The combination of approaches used may be tailored to each patient.<ref name="Gerwecka2007">Template:Citation</ref> Bariatric treatments in youth must be considered with great caution and with other conditions that may not have to be considered in adults.

Techniques used in bariatrics include bioelectrical impedance analysis, a method to measure body fat percentage.