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At the turn of the twenty-first century, morbid obesity has turned into a growing epidemic. Worldwide, several billion adults are overweight, including those clinically obese.1 Morbid obesity could be defined to be 100 pounds above ideal body weight, or twice the ideal weight, or, more commonly, as a body mass index (BMI) of 40kg/m2 or greater. Portion control, consumption of a low-fat diet, and regular physical activity are behaviors that drive back obesity; however, it is becoming increasingly difficult to adopt and maintain these behaviors inside our modern society.2 A BMI of 40kg/m2 has been shown to be connected with premature death, and obesity is the 2nd leading reason for preventable death in the United States after tobacco use. Obesity has been estimated to cause 280,000 deaths annually in the United States.3 Elevated BMIs are also of a heightened risk for heart disease, hypertension, diabetes, hypercholesterolemia, sleep apnea, osteoarthritis, and gallbladder disease.4 Medical therapy for morbid obesity has limited short- and long-term success. Randomized controlled trials employing lifestyle modifications or pharmacologic interventions for weight loss resulted in only approximately a 7-pound loss that was maintained over a 2-year period.5 Diets which can be reduced in fat or reduced in carbohydrates often yield weight reduction that is insufficient to change comorbid conditions which can be secondary to obesity. Pharmacologic therapy also offers poor results. The newest antiobesity agent, orlistat, has been shown to produce a maximum weight reduction of 10% body weight at 1 year, and weight is frequently regained within 12 to 18 months.6 Surgery has been which may be the only real effective longterm treatment for morbid obesity. Patients are eligible for bariatric surgery if they have a BMI of 40kg/m2 or greater or have a BMI between 35 and 40kg/m2 with significant comorbidities, and have failed other medically managed weight-loss programs.7 The eligible patient must be 18 to 60 years old and prove to have the motivation for weight-loss maintenance.7 Approximately 12 million people in the United States currently meet these criteria. Typically, patients aren’t entitled to surgical intervention if obesity is related to a metabolic or endocrine disorder, if they’ve a history of substance abuse or psychiatric problems, or if surgery could be considered high risk; women who will attempt to become pregnant next 18 months also are ineligible for surgery.

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