الفهرس 
DEFINITION OF OBESITYOnly 14 pages are availabe for public view
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Abstract
Overweight, defined as a body mass index (BMI) of 25 kg\m2 and more, and obesity, defined as a BMI of 30 kg\m2 and more, associated with an increased risk of several morbid conditions such as hypertention, non-insulin-dependant diabetes mellitus (NIDDM) and cardiovascular diseases
Health defined morbid obesity as a BMI of 35 kg/m² or greater without comorbidity, superobesity is a term sometimes used to define individuals who have a body weight exceeding ideal weight by 225%or more, or a BMI of 50 kg/m2 or greater
Obesity prevails in various communities of the world. Its prevalence is escalating at an alarming rate to epidemic proportions through out the developed world. Furthermore, obesity is no longer just a concern for developed countries, but s also becoming an increasing problem in many developing countries. According to WHO report, there are more than 250 million obese adults and about 1.1 billion overweight people worldwide
Obesity is a chronic condition that develops as a result of a complex interaction between a person’s genes and the environment characterized by long-term energy imbalance due to excessive caloric consumption, insufficient energy out put [sedentary lifestyle, low resting metabolic rate (RMR)] or both.
Measurement of body fat mass is extremely challenging, because no direct method exists other than in vivo neutron activation analysis (very limited availability) and chemical analysis of the cadaver (useful for animal studies only).
Fat distribution correlates with certain health hazards. Abdominal or central obesity determined by an increases waist-ship circumference ratio (WHR) is particularly related to coronary heart disease (CHD), stroke, premature death, high-blood pressure and non-insulin dependent diabetes mellitus
Medical therapy for sever obesity has limited short-term success and almost nonexistent long-term success. These medical tools available for weight management include diet therapy, a regimen of physical activity, behavior modification, and pharmacotherapy.
Combination strategies using diet, exercise and behavior therapy have been shown to be more effective in the short-term than diet or exercise alone. However, are usually ineffective in people who are morbidly obese. Although weight reduction by as little as 5% of body weight has been shown to improve many obese co-morbidities
All approaches used in medical treatment of morbid obesity lead to average loss of 15 kg or less at the end of medical treatment with experienced regaining of weight5 of about 10 kg at one year later
Weight loss leads to the improvement or disappearance of co-morbidities, and surgery has been found to be the only method capable of maintaining proper and long-lasting weight loss.
At present, bariatric surgery is the only therapeutic modality that produces sustained weight loss and resolve comorbidities. This success results from the ability to perform the operation reliably, usually laparoscopically, with low mortality.
Patients should meet the following criteria for consideration for bariatric surgery: BMI > 40 kg/m2 or BMI >35 kg/m2 with associated medical comorbidities, failed dietary therapy
There are different bariatric procedures such as vertical banded gastroplasty (VBG), Roux¬en-Y gastric bypass, biliopancreatic diversion with or without duodenal switch, and digestive adaptation& intestinal resection with a restrictive gastroplasty
Decreasing gastric capacity without altering the continuity of the upper digestive tube while maintaining access for endoscopic examination may represent an advantage, because it allows an additional operation to be performed in case there is failure in weight loss or regain