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At the turn of the twenty-first century, morbid obesity has become a growing epidemic. Worldwide, multiple billion adults are overweight, including those clinically obese.1 Morbid obesity can be defined to be 100 pounds above ideal bodyweight, or twice the ideal body weight, or, more commonly, as a human anatomy mass index (BMI) of 40kg/m2 or greater. Portion control, usage of a low-fat diet, and regular physical activity are behaviors that protect against obesity; however, it is now increasingly difficult to adopt and maintain these behaviors in our modern society.2 A BMI of 40kg/m2 has been shown to be related to premature death, and obesity is the 2nd leading cause of 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 which was maintained over a 2-year period.5 Diets which can be lower in fat or low in carbohydrates often yield fat loss that is insufficient to alter comorbid conditions which are secondary to obesity. Pharmacologic therapy also has poor results. The most recent antiobesity agent, orlistat, has been shown to generate a maximum weight reduction of 10% body weight at 1 year, and weight is usually regained within 12 to 18 months.6 Surgery has been which may be the sole effective longterm treatment for morbid obesity. Patients are qualified to receive 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 certanly be 18 to 60 years 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 are not entitled to surgical intervention if obesity is related to a metabolic or endocrine disorder, if they have a history of substance abuse or psychiatric problems, or if surgery could be considered high risk; women who’ll attempt to become pregnant within the next 18 months also are ineligible for surgery.

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