Morbid Obesity and its Treatment / 日本農村医学会雑誌

ABSTRACT

Morbid obesity is synonymous with “clinically severe obesity” and correlates with a body mass index (BMI) of 40kg/m<SUP>2</SUP>, being associated with real severe physical problems inducing to highly mortality rates. While obesity, of itself, is a risk factor, most mortality and morbidity is associated with the co-morbid conditions, including hypertension, hypertrophic cardiomyopathy, hyperlipidemia, diabetes, cholelithiasis, sleep apnea syndrome, hypoventilation, degenerative arthritis and psychosocial impairments. And, most obvious is an increased mortality and morbidity rates directly related to weight increase. Therefore, it must be emphasized that morbidly obese patients should be treated positively and urgently in USA and European countries, where have had the common social problem of obesity. With the obvious failure of conservative medical treatments of producing permanent weight reduction in patients with morbid obesity, which successfully achieved initial weight loss but failed to maintain it, operative approaches have to be adopted occasionally and become popular in Western countries.<BR>Although the population of morbidly obese patients in Japanese people is muchsmaller than in Western people, the hazardous due to obesity is recognized more serious among Japanese people. Furthermore, the rate of obesity as well as morbid obesity among a people in our country is increasing apparently not only in urban but also in rural district. The most important strategy against the problem of morbid obesity is the precausion. But, we have to recognize even in Japan that surgical treatment is medically necessary because it is the only proven method of achieving long term weight control enough to treat the severe complications for the morbidly obese patients. Bariatric surgery involves reducing the size of the gastric reservoir, with or without a degree of associated malabsorption.