الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
SUMMARY The prevalence of obesity is increasing worldwide at an alarming rate. In 2006, the number of overweight and obese people in the world overtook the number of malnourished. Obesity is usually defined using the BMI, generally speaking, a BMI 30 kg/m2 defines a state of obesity while BMI 40 kg/m2 is defined as severe or morbid obesity. Obesity related comorbidities are variable, widespread and sometimes serious. It includes osteoarthritis, hypertension, non insulin dependent diabetes mellitus, dyslipidemia, coronary heart diseases, cardiovascular dysfunction, neurological disorders, thromboembolic diseases, respiratory problems, sleep apnea, genital disorders, gastrointestinal complications, endocrinal dysfunction, renal complications, cancers, hernias, skin infections, social and psychological problems and increased risk of mortality at all ages. So, one can easily see the seriousness of the problem in today’s society medically, socially and economically. The primary goal of treatment is to improve obesity related comorbid conditions and reduce the risk of developing future comorbidities.
Summary
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A multidisciplinary team approach involving a physician with a special interest in obesity, a dietitian, a psychologist or psychiatrist interested in behavior modification and eating disorders and a surgeon with experience in bariatric procedures is optimal. Practical assessment requires a comprehensive history, physical examination and appropriate further investigations. The aims are to assess the severity and degree of health risk associated with obesity, to identify possible underlying causes of obesity and the presence of any comorbidity or complication of obesity. Surgical treatment is the only proven method to achieve long term weight control for morbid obesity. Bariatric surgery now offers a validated approach that has a much greater objective success rate of maintaining weight loss (up to 50% of original weight). Actually surgical treatment of morbid obesity is gaining in popularity and there is obviously increased interest and acceptance of bariatric surgery as a golden way to achieve stable reduction of body weight in morbidly obese patients. Bariatric surgical techniques are divided into malabsorptive procedures such as biliopancreatic diversion
Summary
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with gastrectomy or duodenal switch, restrictive procedures such as gastroplasty, gastric banding and sleeve gastrectomy and combined malabsorptive and restrictive procedures as Roux-en-Y gastric bypass. Many authors consider Roux-en-Y gastric bypass the ‗‗gold standard‘‘ surgical treatment for morbid obesity. It combines a restrictive and malabsorptive mechanism that has long term efficacy in the reduction of excess weight. Laparoscopic bariatric surgery is a major advance because it improves outcomes by reducing operative morbidity and recovery. The weight loss in laparoscopic Roux-en-Y gastric bypass is superior to other gastric restrictive procedures. Laparoscopic Roux-en-Y gastric bypass reduces the incidence of early postoperative complications in patients considered to be high risk. There is also a significant reduction in hospital stay in patients submitted to the laparoscopic procedure