Modificaciones en las hormonas gastrointestinales tras cirugía bariátrica

Abstract

Overweight and obesity have become a major health problem in developed countries. In 2014, according to WHO, the obesity rate has tripled since1980́s, with 900 million people over 18 years old with overweight of which 600 million (13%) are obese. In Spain the situation is not different with 22,9% prevalence of obesity (BMI>30 kg/m2) with a 1.8%. of morbid obesity (MO) (BMI> 40 kg / m2) Moreover, obesity is responsible of 3,4 million deaths and 3,9% life-years lost. It is also a risk factor for developing diseases such as cancer, cardiovascular disease and diabetes mellitus. In order to curb this situation, comprehensive strategies were implemented worldwide: dietary treatment with lifestyle changes, exercise and behavioral therapy together with adjuvant treatment with drugs when available. These actions achieved a good average of 5 -10% weight loss. However, long-term treatments outcomes have been disappointing, especially in patients with MO, because weight regain occurs in virtually all patients in less than five years term. To date, bariatric surgery (BS) is the only treatment that can improve these expectations in patients with BMI ≥ 35 kg / m2). The BS is associated with 25-50%, lower long term mortality rate, improves comorbidities and avoids further complications related to obesity. Currently the surgical option is indicated in patients with a BMI> 40 kg / m2 or those with BMI 35-40 kg / m2 with comorbidities in whom have failed medical therapy and without contraindications. Most currently used surgical techniques are: Adjustable gastric banding (AGB): a restrictive procedure where a silicone band is placed around the upper stomach and the catheter attached to the band is exteriorized and connected to an infusion port located subcutaneously. Reported %EWL is around 50% depending on the authors.