الفهرس 
Pathophysiology of obesityOnly 14 pages are availabe for public view
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Abstract
Excess of body fat that frequently results in impairment of health
push patients to bariatric surgery centers. Obesity is the second leading
cause of preventable death in the United States. Obesity is most common
in minorities, low-income groups, rural populations, and women, but is
increasing in all socioeconomic groups.
Obesity is a multifactorial disease, it develops from
integration of genetic, environmental, social, behavioral, physiological,
metabolic, neuroendocrinal and psychological factors, and the exact
etiology is unknown.
The complications of obesity may be endocrinal, respiratory,
cardiovascular, abdominal, cancer psychological, articular,
gynaecological complications.
Bariatric operations produce weight loss through two mechanisms;
restriction of intake & malabsorption. Postoperative follow-up for the
various operations has some common overall themes to determine wound
healing, tolerance of oral intake, adjustment to the operation and return to
activity to confirm the postoperative nutrition and exercise plan.
A multidisciplinary team approach including the nutritionist is
essential. Psychologic support and patient-oriented support groups can
add significant value to preparation for surgery and afterward.
An estimation of the patient’s motivation to change eating habits is
important.
Medical treatment for severe obesity is aimed at reducing body
weight through combination of decreased caloric intake and
accompanying increases in energy expenditure from moderate exercise.
Pulmonary system, intravenous fluid therapy, anesthetic
considerations, nutritional therapy are considered perioperative
evaluation.Vomiting can be problematic after bariatric surgery , dumping
syndrome is common in the first several months after surgery , patients
with symptoms and signs suggestive of hypoglycemia warrant close
evaluation.
Prophylaxis for thrombotic disorders in bariatric surgical patients remains
controversial, the goals of dietary treatment in the immediate
postoperative phase are to facilitate weight loss and reduce the risk of
nutritional deficiencies.
Change occurs rapidly after bariatric surgery, and medical
evaluation and biochemical testing at follow-up visits should be tailored
to the patient’s profile of obesity associated comorbidities.
Nutritional deficiencies are frequent after malabsorptive types of
bariatric surgery as iron, calcium, vitamin D, vitamins A, E, and K,
vitamin B1, vitamin B12, minerals and trace elements.
Diabetes mellitus, hypertension and obstructive sleep apnea are
common in obese individuals. Bariatric surgery has been shown to have a
positive effect on these diseases .
Finally simple surgical intervention in bariatric surgeries result in
simple Perioperative management of bariatric patients.