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London 2012: Future of Obesity Treatment

The good, the bad and the ugly

More aggressive approach to obesity required
Cost of surgery offset by against treating the patient’s co-morbidities
Nicolas Christou

Dr Nicolas Christou, McGill University, Montreal, Canada, examined the outcomes form bariatric surgery in a presentation entitled, ‘What are the long term outcomes of bariatric surgery? The good, the bad and the ugly’. He stated that data from the Canadian National Health and Nutrition Examination Survey (NHANES) has shown an increase in the average BMI in both men, women and more alarmingly, children. “And although the data has not yet confirmed this, I believe obesity has now surpassed smoking at the leading cause of death in North America,” he added. “There has to be a more aggressive approach to obesity, lifestyle changes work but only in the short term. Likewise, surgery does work but only when combined with sustained follow-up with lifestyle modifications. But which surgeries are effective?”

In a quick fire summary of the procedures, Christou outlined the type of procedure (predominantly malabsorptive, predominantly restrictive etc), the operative risk associated with each, as well as the re-operation and complications rates. “No matter which procedure you choose, the outcomes show weight loss and improvements in co-morbidities, as long as patients abide by their post-operative regime and attend follow-up sessions,” he stated. “What we must be careful of is that patients do follow post-operative regime and attend follow-up sessions so we can assess (among other things) any sign of nutritional deficiencies.”


Christou cited a Canadian study that showed bariatric surgery resulted in the reduction of co-morbidities and that within three and a half years, the cost of surgery had been paid for by the savings made in treating the patient’s co-morbidities. Many of the patients are expected to live for 15, 20 maybe 30 years, so the actual saving over a long period of time is very substantial, he added.

According to Christou, the perception of surgery needs to change as at the moment the public and the medical community need to understand that obesity is a disease and just like cancer, it kills.

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