Numerous physiologic pathways lead to obesity; those related to hunger, satiety, the breakdown and absorption of nutrients, and the regulation of energy. Given the complexity of obesity, it's not surprising that diet and exercise aren't currently effective and that drugs have had only modest success. Bariatric surgery, on the other hand, which reduces the size of the stomach (and, in some versions, also reroutes part of the small intestine so that food bypasses it) is extremely successful. Many patients that have undergone the Roux-en-Y gastric bypass procedure have sustained losses of 50% of their excess weight out to ten years and beyond. Now companies with minimally invasive devices for the treatment of obesity hope to fill the therapy gap between dieting and invasive surgery. It's too early to claim victory, but start-ups and scientists are benefiting from a better understanding of why gastric bypass surgery works.
By now, obesity is recognized as the world pandemic that it is:
a disease that is not merely a question of excess weight, but of a
long string of co-morbidities—diabetes, hypertension,
obstructive sleep apnea, hyperlipidemia, stroke, several types of
cancer and the list goes on. Obesity not only impairs quality of
life, but duration of life. The morbidly obese female gives up
about nine years of life expectancy, and the morbidly obese male
about 12. Our children's generation may be the first in a century
to witness a decrease in lifespan, because of rising obesity
rates.
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