5 ObesityA condition of excessive fat accumulation in the body to the extent that health and well being are adversely affected.WHO 1997
6 Ideal Body Weight (IBW) As defined by the Metropolitan Life Insurance Tables Of 1983for height, sex and body-frame, is that weight which is associated with the lowest death rate in insured populations.Cowan et alSurgery for the morbidly obese patientsChapterCowan et al ,Surgery for the morbidly obese patients,Chapter 9 ,2000
9 Morbidly Obese Patients Are those individuals who weigh at least 45 kg over the ideal body weigh.This approximates a body mass index (BMI) of at least 40 kg/m2Cowan et al ,Surgery for the morbidly obese patients,Chapter 9 ,2000Cowan et al ,Surgery for the morbidly obese patients,Chapter 9 ,2000
10 Weight Loss EWL = Excess Weight Loss = (preoperative weight) – (ideal weight)% EWL = % Excess Weight Loss= weight loss / excess weight x 100
11 Magnitude of obesity problem Management of ObesityMagnitude of obesity problem
15 Health hazards of obesity Cowan et al ,Surgery for the morbidly obese patients,Chapter 9 ,2000Cowan et al ,Surgery for the morbidly obese patients,Chapter 9 ,2000
16 Health hazards of obesity Karl et al SCNA Oct. 2001Karl et al SCNA Oct. 2001
17 Health hazards of obesity Wadden et al SCNA OCT 2001
18 Health hazards of obesity Bray et al CE&M 1999Bray et al CE&M 1999
19 Cost Related to Obesity “The costs of obesity is substantial and accounts for 2-8 % of the total health care expenditure in countries such as The Netherlands, France, USA, Australia and Sweden.”The Lancet August 1997The Lancet August 1997
27 Dietary approaches to reduce body weight Dietary ProgramsStarvation diets (fewer than 200 kcal /day).Very low energy diets (VLED)kcal/day, commercial formula.Low energy diets (LED)kcal/day, natural food.Ad libitum low fat diets15% - 25 % less fat, high CHO & protein.Atkins dietHigh protein low CHO.
29 Physical Activity Programmed physical activity. regular scheduled activity at a relatively high intensity level.Lifestyle physical activity.increasing energy expenditure during the course of the day.
31 Drug therapy of obesity Drugs that reduce food intakeNor-adrenergic drugs (phentermine).Serotonin-norepinephrine re-uptake inhibitors (Sibutramine).Drugs that alter metabolismPre-absorptive agents (Orlistat).Post-absorptive agents (Metformin).Drugs that increase energy expenditureEphedrine & Caffeine.
41 What is Laparoscopic Sleeve Gastrectomy What is Laparoscopic Sleeve Gastrectomy ? (longitudinal G, Vertical G , Stomach reduction)Resection of Greater CurveSleeve of stomach left in place(Sleeve Gastrectomy) (Vertical Gastrectomy) (Stomach Reduction)
42 A Prospective Randomized Study Between LGB & LSG Results after 1&3 years Jacques Himpens Obesity Surgery 16( )2006
51 King Faisal Specialist Hospital Experience in Bariatric Surgery Dr Patrick O’ReganDr Abdelrahman SalemDr Fahad BamerhizMinimally Invasive Surgery ServiceKing Faisal Specialist Hospital & Research CenterRiyadh S. A.
52 Obesity Surgery Program Started October 2002OfferingGastric balloonGastric bandingVBGGastric bypassGastric sleeveTotal casestill December
53 King Faisal Specialist Hospital Experience in Bariatric Surgery
73 SummaryObesity is a major health problem worldwide, as well as in the Kingdom.It is secondary to imbalance between energy intake and expenditure.Approach to management, should be team approach.Main aim of management, is to change the behavior, which ultimately will reduce weight.
74 SummarySurgery is the only management option that proved to be effective in weight reduction of obese patients in long term.We believe LSG is one of safe options of the armamentarium of beriatric surgery.
75 SummaryObesity surgery program at KFSH&RC offering a battery of beriatric surgery operations to match the need of different beriatric patients.