[Therapy for obesity--conservative and/or surgical?].

On comparing surgical and conservative approaches in therapy for obesity it is accepted that there is a more rapid decline in body weight after surgery than by conservative measures. In contrast to widespread convictions, it has been shown that even in extreme obesity (BMI>60 kg/m²) both a meaningful and a long-lasting reduction of body weight is possible by conservative approach. There is an increasing body of evidence that bariatric surgery, especially malabsorptive and combined forms, causes endocrine disturbances and both vitamin and micronutrient deficiencies. Furthermore, alterations in drug pharmacokinetics are possible. Even bariatric surgeons have stated that surgery neither removes the chronic disease obesity nor is its final therapy.