Surgical treatment of obesity

Severe obesity may be treated by surgical removal of much of the excess adipose tissue — a procedure known as liposuction. Two further surgical treatments have also been used:

  • Intestinal by-pass surgery, in which the jejunum is connected to the distal end of the ileum, so by-passing much of the small intestine in which the digestion and absorption of food occurs (section 4.1). The resultant malabsorption means that the subject can, and indeed must, eat a relatively large amount of food but will only absorb a small proportion. There are severe side-effects of intestinal by-pass surgery, including persistent foul-smelling diarrhoea and flatulence and failure to absorb medication, as well as problems of mineral and vitamin deficiency. This procedure has been more or less abandoned in most centres.
  • Gastroplasty, in which the physical capacity of the stomach is reduced to half or less. This limits the amount of food that can be consumed at any one meal. While the results of such surgery appear promising, long-term follow-up suggests that a significant number of patients experience serious side-effects, and many regret undergoing the procedure.
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