الفهرس 
Definition, Pathophysiology and Complications of Morbid Obesity
Physiology and Regulation of Food IntakeOnly 14 pages are availabe for public view
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Abstract
Obesity is a serious global epidemic and poses a significant
health threat to humans. The prevalence of obesity is
increasing not only in adults, but also among children and
adolescents.
Obesity is usually defined using the BMI. Generally
speaking, a BMI 30 kg/m2 defines a state of obesity while
BMI 40 kg/m2 is defined as severe or morbid obesity.
At its simplest, obesity is caused by an excess of energy
intake over energy expended. Any excess energy intake over
and above an individual’s daily requirement will result in that
energy being stored. Energy is stored as fat and deposited
subcutaneously and viscerally.
Etiology of obesity includes genetic and familial,
psychological, endocrinal, environmental, hypothalamic factors
and drugs.
Obesity related comorbidities are variable, widespread
and sometimes serious. It includes osteoarthritis, hypertension,
non-insulin dependent diabetes mellitus, dyslipidemia, coronary
heart diseases, cardiovascular dysfunction, neurological
disorders, thromboembolic diseases, respiratory problems,
sleep apnea, genital disorders, gastrointestinal complications,
endocrinal dysfunction, renal complications, cancers, hernias,
skin infections, social and psychological problems and increased risk of mortality at all ages. So, one can easily see the
seriousness of the problem in today’s society medically, socially
and economically.
Non-operative treatment of obesity has commonly been
ineffective, and bariatric surgery has been shown to be effective
in achieving substantial weight loss and improving obesityrelated
co-morbidities in the long-term. Thus, the demand for
surgical treatment of morbid obesity has increased dramatically
in the past decade. The success of a bariatric procedure is
defined by the percentage of EWL and the resolution of
obesity-related co-morbidities that have a major effect on the
life expectancy of the morbidly obese patient. Although a 50%
EWL is generally considered successful, better results can be
expected in the long term after RYGB which is considered the
gold standard bariatric procedure.
Despite the validity of weight loss and comorbidcondition
remission after RYGB, 15 to 35 % of patients either
fail to lose sufficient weight or regain weight. Experts have
attributed regaining weight to various factors, including
anatomical, behavioral, and psychological elements. For
example, anatomical factors specific to RYGB, such as an
enlarged or dilated gastric pouch may play a role in weight
regain. In fact, pouch and/or anastomosis enlargement resulting
in lack of restriction is the most common reason for failure.Thus, LPR has been proposed to treat IWL or WR after
RYGB and appears to be an effective and safe treatment option.
Percent EWL and BMI loss from the pre-revision period to
post-revision period have demonstrated favorable results with
marginal rates of complications.