A Brief History of the Surgery for Obesity to the Present, with an Overview of Nutritional Implications

Abstract

Massive obesity results in serious diseases, which are a major public health problem. Surgery is frequently the only means to achieve and sustain significant weight loss. This historical overview is aimed at providing knowledge and appreciation of this surgery to scientists in other complex areas of nutrition. The development of these operations is provided, including their potential nutritional sequelae. Because type 2 diabetes frequently improves or resolves postoperatively, related operations are being investigated in patients with lower weights.

Key teaching points:

• Severe obesity is often resistant to conservative therapy.

• Operations providing weight loss via gastric restriction with early satiety or intestinal bypass with malabsorption have evolved over the past 50 years.

• These operations are now being performed laparoscopically rather than by an open approach.

• Among the obesity-related diseases that resolve with weight loss, type 2 diabetes (T2D) is of great importance, and bypass operations are being modified for T2D in patients with less obesity.

• Postoperative surveillance and multivitamin supplementation are necessary, especially for vitamin D, calcium, iron, B₁₂, and folate.

Key words:

• morbid obesity
• bariatric surgery
• diabetes type 2
• restrictive and malasorptive operations
• nutritional surveillance