Surgical management of obesity: current state of procedure evolution and strategies to optimize outcomes.

Surgical treatment of morbid obesity remains the most effective modality available. Procedures have evolved over the past 50 years and have utilized caloric restriction and malabsorption, alone or in combination. Optimizing outcome and preserving good nutrition health is the goal of the multidisciplinary care that these patients need.

Feeding the critically ill obese patient: the role of hypocaloric nutrition support.

Obesity and its many metabolic and physiologic comorbidities are becoming more common. Thus, a strategy to approach the nutritional needs of obese critically ill patients is warranted. The adverse effect of obesity on the respiratory system is well established.

Enoxaparin for thromboprophylaxis in morbidly obese patients undergoing bariatric surgery: findings of the prophylaxis against VTE outcomes in bariatric surgery patients receiving enoxaparin (PROBE) study.

Background: Obese patients undergoing bariatric surgery are at significant risk for venous thromboembolism (VTE). We performed a multicenter, retrospective survey to evaluate the safety and efficacy of enoxaparin for thromboprophylaxis in patients with morbid obesity undergoing primary bariatric surgery.

Methods: From January to December 2002, 668 patients who underwent primary bariatric surgery at 5 centers were analyzed retrospectively.

Morbid obesity and nutrition support: is bigger different?

Morbid obesity (body mass index >40 kg/m2 or >35 kg/m2 in the presence of an severe-obesity-related comorbid disease) is increasing in frequency in the United States and worldwide. This population has a variety of medical and surgical disorders that result in hospitalizations. It is not unexpected to encounter these patients on the nutrition support service.

Bariatric surgery for morbid obesity: why, who, when, how, where, and then what?

Bariatric surgery is not a cure, but it can take weight off and keep it off, improve most obesity-related conditions, reduce the risk of premature death, and improve quality of life. Given the interest in the procedure, primary care physicians need to understand the risks and benefits to help patients determine if this therapy is a good option, and they need to know the health changes that may occur after surgery when following these patients.

The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial.

Background: The effect of limb-length on weight loss after Roux-en-Y gastric bypass (RYGBP) is controversial; hence, the optimal limb-lengths have not been determined. This study evaluated the effect of different limb-lengths on weight loss after RYGBP.

Methods: The study was a prospective randomized clinical trial in which patients undergoing RYGBP (110 F, 24 M; mean age 39.