Bariatrics is the branch of
medicine that deals with the causes, prevention, and treatment of
obesity.
Terminology
The term ''bariatrics'' was coined around 1965,
[Dictionary.com, based on Random House Unabridged Dictionary, Random House (2006)]
Retrieved 15 April 2006 from the
Greek language, Greek root ''bar''- ("weight" as in
barometer
A barometer is a scientific instrument that is used to measure air pressure in a certain environment. Pressure tendency can forecast short term changes in the weather. Many measurements of air pressure are used within surface weather analysis ...
),
suffix -''iatr'' ("treatment," as in
pediatrics), and
suffix -''ic'' ("pertaining to"). The field encompasses
dieting,
exercise and
behavioral therapy
Behaviour therapy or behavioural psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviourism and/or cognitive psychology. It looks at specific, learned behaviours and how the environment, or ...
approaches to
weight loss
Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, by a mean loss of fluid, body fat (adipose tissue), or lean mass (namely bone mineral deposits, muscle, tendon, and other co ...
, 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 patients
Being
overweight or
obese are both rising medical problems.
There are many detrimental health effects of obesity:
[WHO factsheet on obesity](_blank)
Individuals with a
BMI (Body Mass Index) exceeding a healthy range have a much greater risk of medical issues.
These include
heart disease
Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, h ...
,
diabetes mellitus, many types of
cancer,
asthma
Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, co ...
,
obstructive sleep apnea, and chronic
musculoskeletal problems. There is also a focus on the correlation between obesity and
mortality
Mortality is the state of being mortal, or susceptible to death; the opposite of immortality.
Mortality may also refer to:
* Fish mortality, a parameter used in fisheries population dynamics to account for the loss of fish in a fish stock throug ...
.
Overweight and obese people, including children, may find it difficult to lose weight on their own.
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.
Some improvement in patient psychological health is noted after bariatric surgery. 51% of bariatric surgery candidates report a history of
mental illness
A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...
, specifically
depression, as well as being prescribed at least one psychotropic medication at the time of their surgery candidacy.
[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]
Methods of treatment
Although
diet
Diet may refer to:
Food
* Diet (nutrition), the sum of the food consumed by an organism or group
* Dieting, the deliberate selection of food to control body weight or nutrient intake
** Diet food, foods that aid in creating a diet for weight loss ...
,
exercise,
behavior therapy
Behaviour therapy or behavioural psychotherapy is a broad term referring to clinical psychotherapy that uses techniques derived from behaviourism and/or cognitive psychology. It looks at specific, learned behaviours and how the environment, or ...
and
anti-obesity drug
Anti-obesity medication or weight loss medications are pharmacological agents that reduce or control weight. These medications alter one of the fundamental processes of the human body, weight regulation, by altering either appetite, or absorpt ...
s are first-line treatment,
[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.](_blank)
medical therapy for severe obesity has limited short-term success and very poor long-term success.
Weight loss surgery
Bariatric surgery (or weight loss surgery) includes a variety of procedures performed on people who are obese. Long term weight loss through the standard of care procedures ( Roux en-Y bypass, sleeve gastrectomy, and biliopancreatic diversion ...
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.
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.
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.
The combination of approaches used may be tailored to each patient.
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
Bioelectrical impedance analysis (BIA) is a method for estimating body composition, in particular body fat and muscle mass, where a weak electric current flows through the body and the voltage is measured in order to calculate impedance (resistanc ...
, a method to measure
body fat percentage
The body fat percentage (BFP) of a human or other living being is the total mass of fat divided by total body mass, multiplied by 100; body fat includes essential body fat and storage body fat. Essential body fat is necessary to maintain life and ...
.
See also
*
Food addiction
A food or eating addiction is any behavioral addiction that is primarily characterized by the compulsive consumption of palatable (e.g., high fat and high sugar) food items which markedly activate the reward system in humans and other anima ...
*
Overeaters Anonymous Overeaters Anonymous (OA) is a twelve-step program founded in 1960 for people with problems related to food including, but not limited to, compulsive overeaters, those with binge eating disorder, bulimics and anorexics. Anyone with a problematic ...
Related conditions
*
Obesity,
childhood obesity
Childhood obesity is a condition where excess body fat negatively affects a child's health or well-being. As methods to determine body fat directly are difficult, the diagnosis of obesity is often based on BMI. Due to the rising prevalence of ...
*
Classification of obesity
Obesity classification is a ranking of obesity, the medical condition in which excess body fat has accumulated to the extent that it has an adverse effect on health.WHO 2000 p. 6 The World Health Organization (WHO) classifies obesity by body ma ...
,
classification of childhood obesity
Development of tools for monitoring growth
Defining the parameters for childhood obesity has created substantial public awareness over the past decades. Stuart/Meredith Growth Charts were among the earliest growth charts widely used in the United ...
*
Epidemiology of obesity
Obesity has been observed throughout human history. Many early depictions of the human form in art and sculpture appear obese. However, it was not until the 20th century that obesity became common — so much so that, in 1997, the World Heal ...
,
epidemiology of childhood obesity
*
Obesity and walking
Obesity and walking describes how the locomotion of walking differs between an obese individual ( BMI ≥ 30 kg/m2) and a non-obese individual. The prevalence of obesity is a worldwide problem. In 2007–2008, prevalence rates for obesity ...
*
Social stigma of obesity
Social stigma of obesity is broadly defined as bias or discriminatory behaviors targeted at overweight and obese individuals because of their weight. Such social stigmas can span one's entire life, as long as excess weight is present, starting ...
Physiology
*
Body fat percentage
The body fat percentage (BFP) of a human or other living being is the total mass of fat divided by total body mass, multiplied by 100; body fat includes essential body fat and storage body fat. Essential body fat is necessary to maintain life and ...
*
Relative Fat Mass (RFM)
*
Steatosis
Steatosis, also called fatty change, is abnormal retention of fat (lipids) within a cell or organ. Steatosis most often affects the liver – the primary organ of lipid metabolism – where the condition is commonly referred to as fatty liver dise ...
(also called fatty change, fatty degeneration, or adipose degeneration)
*
Subcutaneous fat
References
External links
{{Commons category
VIDEO: How Bariatrics Has Changed Our Understanding of Type II DiabetesDaniel McKenna speaks at the University of Wisconsin School of Medicine and Public Health, 2008.
MedLinePlus Portal on Weight Loss Surgery
Obesity
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