Surgical options in obesity and diabetes

Abstract

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Obesity is a chronic, progressive, and multifactorial disease. Hypocaloric diet associated with lifestyle modification and physical exercise represents the first step of treatment for obesity, but weight loss and remission of comorbidities are difficult to maintain in the long term. Bariatric surgery has demonstrated to be the most effective therapy in the long term for severely obese patients and for the treatment of type 2 diabetes mellitus (T2D) in obese subjects. There are different bariatric techniques, with important differences between them, related to the weight-loss effect, complication rates, and postoperative evolution of the different comorbidities and nutritional sequelae. In this chapter, we will review the actual evidence about the mechanism of action of the different bariatric techniques and their clinical results in terms of weight loss and remission of comorbidities, mostly T2D.