Management of Obesity: The Surgical Perspective


  • Amabara Dodiyi-Manuel Department of Surgery, Braithwaite Memorial Specialist Hospital, Port Harcourt
  • Sotonye Dodiyi-Manuel Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt


Obesity, Bariatric surgery, Restrictive, Malabsorptive


Background: Obesity which is one of the most prevalent diseases worldwide continues to increase with its associated complications. Bariatric surgeries have been described as the preferred method of treatment for morbid obesity. The objective of this review is to give an overview of bariatric surgical procedures and the possible outcomes.

Method: Literature review was conducted using Goggle Search Engine and Highwire Press. Selected papers were taken and books from the author's collection were used for further reference.

Results: Bariatric surgery is the most effective treatment for morbid obesity producing long lasting weight loss and remission of co-morbidities. Restrictive procedures are more commonly performed because they are simpler and achieve good weight loss in addition to the avoidance of metabolic complications associated with malabsorptive procedures.

Conclusion: Specific criteria must be met and the patient must be motivated and fully informed before performance of bariatric surgery for obesity preferably with restrictive procedures


Monkhouse SJW, Morgan JDT, Bates SE, Norton SA. An overview of the surgical management of morbid obesity. Postgrad Med J 2009; 85: 678-681

Mokdad AH, Bowman BA, Dietz WH, Vinicor F, Bales VS, Marks JS. Prevalence of obesity, diabetes and obesity-related health risk factors. JAMA 2003;289:76-79

Mokdad AH, Bowman BA, Ford ES, Vinicor F, Koplan JP. The continuing epidemics of obesity and diabetes in the United States. JAMA 2001;286:1195-2000

Sturm R. Increases in clinically severe obesity in the United States. Arch Intern med 2003;163:2146-2148

Fleqal KM, Carroll MD, Oaden CL, Johnson CL. Prevalence and trends in obesity among US adults. JAMA 2002;288:1530-1538

Allison DB, Fortaine KR, Manson IE, Stevens I, Vanltallie TB. Annual deaths attributable to obesity in the United States. JAMA 1999;282:1530-1538

Liu IH, Zinamond D, Etzioni DA, O'connell IB, Maggard MA, Livingstone EH et al. Characterizing the performance and outcomes of obesity surgery in California. Am Surg 2003;69:823-828

Akinkugbe OO. Non- communicable diseases in Nigeria, the next epidemics: Nigeria preparedness. Third Biennial Abayomi Bamidele Memorial Lectures. Niger J Clin Pract 2000; 3: 37-42

Simimialayi IM, Emem-Chioma PC,Dappa DV. The prevalence ofobesity as indicated by BMI and waist circumference among Nigerian adults attending clinics as out patients in Rivers State. Niger J Med 2008; 17:340-345

Flier JS, Maratos-Flier E. In Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, Loscalzo J (eds). Harrison's Principles of Internal thMedicine, 17 edition. New York. Mc Graw Hill 2008; 444-447

Inni A, Asakawa A, Bowers CY. Ghrelin, apetite and gastric motility: the emerging role of the stomach as an endocrine organ. FASEB J 2004;18:439-456

Lall S, Tung LY, Ohlsson C, Jansson JO, Dickson SL. Growth hormone-independent stimulation of adiposity by Growth hormone secretagogues. Biochem Biophys Res Common 2001:280:132-138

Hewson AL, Dickson SL. Systemic administration ofghrelin induces Fos and Egr-1 proteins in the hypothalamic arcuate nucleus of fasted and fed rats. J Neuroendocrinol 2000;12:1047-1049

Dickson SL, Lukman SM. Induction of C-Fos messenger ribonucleic acid in neuropeptide Y and growth hormone releasing factor neurons in the rat arcuate nucleus following systematic injection of the growth hormone secretagogue, growth hormone releasing peptide-6. Endocrinology 1997;138:771-777

Jerlhag E, Egecioglu E, Dickson SL, Andersson M, Svensson L, Engel JA. Ghrelin stimulates locomotor activity and Accumbal Dopamine-overflow via central cholinergic systems in mice: implications for its involvement in Brain Reward Addiction. Biology 2004;11:45-54th

Elia M. In Kumar P, Clark M (eds). Clinical Medicine, 7edition. Spain. Saunders 2009; 22817.Bray GA. Medical consequences of obesity. J Clin Endocrinol Metab 2004;89:2583-2589

Probert C, Monkhouse SJW, Morgan JDT, Norton DA. Obesity Surgery. In: Probert C(ed). Recent advances in gastroenterology 11 London: Royal society of medicine press Ltd,2009:75-93

Goodrick GK, Foreyt JT, Renquist KE. A decade ofchange in obesity surgery. Obes Surg 1997;7:189-197

Monkhouse SJW, Morgan JDT, Bates SE, Norton SA. A overview of the management of morbid obesity. Postgrad Med J 2009;85:678-681

O'Brien PE, Brown WA, Dixon JB. Obesity, weight loss and bariatric surgery. Med J Aust 2005;183:10-14

SAGES Guidelines Committee. SEGES guidelines for clinical application of laparoscopic bariatric surgery. Surg Endosc 2008;22:2281-2300

Di Cosmo L, Vuolo G, Piccolomini A. Bariatric surgery: early results with a multidisciplinary team. Obes Surg 2000;10:272-273

National Institute for Health and Clinical Excellence. CG43 obesity guidelines, December 2006

Benjamin E, Schneider MD, Edward C, Mun MD. Surgical management of morbid obesity. Diabetes Care 2005;28:475-480

Kellom M, Kuemmerle JF, O'Dorisio TM, Rayford P, Martin D, Engle K et al. Gastrointestinal hormone responses to meals before and after gastric bypass

Wittgrove AC, Clark GW, Temblay LJ. Laparoscopic gastric bypass, Roux-en-y: preliminary report of 5 cases. Obes Surg 1994;4:353-357

Tritos N, Mun EC, A B, Grayson R, Maratos-Flier E, Goldfine A, Serum ghrelin levels in response to glucose load in obese subjects post gastric bypass surgery. Obes Res 2003;8:919-9

Mun EC, Blackburn GL, Matthew JB. Current status ofmedical and surgical therapy for obesity. Gastroenterol 2001;120:669-681

Schaur P, Ikramuddin S, Hamad G,Gourash W. The learning curve for laparoscopic Roux-en-y gastric bypass of 100 cases. Surg Endosc 2003;17:212-215

Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 1995;222:339-350

Schauer PR, Burguera B, Ikramuddin S, Cottam D, Gourash W, Hamad G, et al. Effect of laparoscopic roux-en-y gastric bypass on type 2 diabetes mellitus. Ann Surg 2003;238:467-484

Wittgrove AC, Clark GW. Laparoscopic gastric bypass, roux-en-y: 500 patients: technique and results with 3-60 month follow-up. Obes Surg 2000;10:233-239

Rubestein R. Laparoscopic adjustable gastric banding at a US center with up to 3 year follow-up. Obes Surg 2002;12:380-384

O'Brien PE, Dixon JB, Brown W, Schader LM, Chapman L, Burn AJ, et al. The laparoscopic adjustable gastric band: a prospective study of medium- term effects on weight, health and quality of life. Obes Surg 2002;12:652-660

O'Brien PE, Dixon JB. Weight loss and early and late complications: the international experience. Am J Surg 2002;184:42S-45S

DeMaria EJ, Surgerman HJ, Meador JG, Doty JM, Kellum JM, Wolfe L, et al. High failure rate after laparoscopic adjustable gastric silicon banding for treatment of morbid obesity. Ann Surg 2001;233:809-818

Fauretti F, Cadiere GB, Segato G, Himpens J, DeLuca M, Busetto L, et al. Laparoscopic banding: selection and technique in 830 patients. Obes Surg 2002;12:385-390

Mason EE. Vertical banded gastroplasty for obesity. Arch Surg 1982;117:701-706

Nightengale MC, Sarr MG, Kelly KA, Jensen MD, Zinsmeister AR, Palumbo PJ. Prospective evaluation ofvertical banded gastroplasty as the primary operation for morbid obesity. Mayo Clinic Proc 1991;66:773-782

Sugerman HJ, Londrey GL, Kellum JM, Wolf L, Liszka T, Engle KM, et al. Weight loss with veftical banded gastroplasty and roux-en-y gastric bypass for morbid obesity with selective versus random assignment. Am J Surg 1989;157:93-102

Masceau P, Biron S, Borque RA. Bilopancreatic diversion with a new type of gastrectomy. Obes Surg 1993;3:29-35

Mishra RK. Text book of Practical Laparoscopic and Surgery(2 edition),2009. Jaypee, New Delhi, 267

Payne JH, Dewind LT. Surgical treatment of obesity. Am J Surg 1969;118:141-147

Deitel M, Shahi B, An and Pk, Deitel FH, Cardinell DL. Long-term outcome in a series of jejunoileal bypass patients. Obes Surg 1993;3:247-252




How to Cite

Dodiyi-Manuel, A., & Dodiyi-Manuel, S. (2015). Management of Obesity: The Surgical Perspective. The Nigerian Health Journal, 12(1), 1. Retrieved from

Similar Articles

1 2 3 4 5 6 7 8 9 > >> 

You may also start an advanced similarity search for this article.