The book is needed for several reasons. Bariatric surgery is one of the most clinically effective and cost effective services in any field of medicine, and is growing in popularity, and the non-specialist family practitioner, allied health professional and pharmacist need to know exactly what it involves. Bariatric surgery is in everyone’s interest – whether medic or patient, as it offers improvement in diabetes, heart disease, sleep apnoea, fatty liver and many cancers, whilst reducing benefits, housing costs and the general burden on the economy. There is a lot of flawed thinking on surgery in primary care, with only a minority of family practitioner specialists making the majority of referrals, whilst many are denying their patients access because of their own misconceived ideas. A ‘back to basics’ book will help tackle the negative views surrounding the topic, and improve the volume and quality of referrals. Very often patients turning up to obesity centres have been given poor advice, and inappropriate treatment, and arrive with little or no idea what to expect. Many medics prioritise other conditions first, overlooking the underlying cause, i.e. obesity. Basic education on obesity and co-morbidities is fast becoming essential.

lgli/3030833984.7z

lgrsnf/3030833984.7z

zlib/Medicine/Surgery, Orthopedics/David Haslam, Aseem Malhotra, Matthew S. Capehorn/Bariatric Surgery in Clinical Practice_22456244.7z

Chapter 4 Obesity Is a Disease

William P Martin

Springer Nature Switzerland AG

Erscheinungsort nicht ermittelbar, 2022

In clinical practice, S.l, 2022

Switzerland, Switzerland

1st ed. 2022, 2022

2021

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Obesity is a subcortical brain disease characterised by the pathognomonic symptoms of excessive hunger and/or reduced satiation after a meal. Distinct subtypes of obesity are recognised, although the rising incidence of polygenic obesity resulting from incompletely elucidated gene-environment interactions is of greatest public health concern. Obesity complications are well documented; their reversal with sustained intentional weight loss is a reason for optimism and motivation to seek treatments targeting pathophysiological mechanisms of obesity. Although lifestyle modification to achieve net energy deficit represents an important facet of obesity management, it is imperative to remember that hypothalamic dysfunction underpins this dysregulated state of energy metabolism and that solely appealing to patients' cerebral cortices through motivational strategies will ultimately prove futile for many. Most patients will regain all the weight that they have lost if the treatment strategy does not make them less hungry and/or more satisfied with smaller meals (Dombrowski et al. 2014). Instead, we must expand our understanding of the pathophysiology of obesity and target our treatments to correct the subcortical brain disturbances which perpetuate aberrant feeding behaviours. Until our clinical tools improve, we can serve our patients better by recognising obesity as a disease and treating it with the same strategies and compassion we apply to all other chronic and disabling diseases

In Clinical Practice
Erscheinungsdatum: 25.08.2022

2022-08-26