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Obesity is very common in Australia, affecting 1 in 3 adults.1 Its causes are multifactorial, so many factors must be considered when treating people living with obesity.2,3 This website aims to assist you and your patients who are trying to lose weight by providing information on the utilisation of bariatric surgery for treating obesity and its complications.
Bariatric and Metabolic Surgery
Effective treatments are available for people living with obesity.3,4 It is common to assume that bariatric surgery is a last resort for weight loss (after an energy-controlled diet and physical exercise have been unsuccessful). So it may be surprising to learn that research supports bariatric surgery as an effective treatment for inducing sustained weight loss as well as a cost-effective treatment for obesity and its complications.5-7
The National Obesity Strategy
Patient Pathways to Bariatric Surgery for Complications of Obesity
Type 2 Diabetes
Obesity increases the risk of developing type 2 diabetes and its complications.8 Clinical evidence supports bariatric surgery, in conjunction with medical management, as an effective treatment for inducing sustained weight loss and remission of type 2 diabetes.4,5,9,10
Our guide now includes points on how to avoid diabetes related stigmas and create opportunities for positive discussion.
Sleep duration and sleep quality are bidirectionally linked to obesity.11,12 Reduced sleep duration and quality can lead to weight gain, and obesity can increase the risk of sleep disturbances.11,12 Weight loss may help to improve sleep quality and reduce symptoms of obstructive sleep apnoea and excessive daytime sleepiness.13-16
Obesity can increase the risk of knee and hip osteoarthritis via mechanical wear and systemic inflammation.17,18 Bariatric surgery can effectively induce weight loss,4,5 which may improve osteoarthritis symptoms and help patients achieve better outcomes after joint surgery.19,20
Fatty Liver Disease
Metabolic (dysfunction) associated fatty liver disease (MAFLD) is a consequence of increased fat deposition in the liver caused by metabolic dysfunction.21 A recent position statement on the impact of bariatric surgery found that it had a positive effect on MAFLD and non-alcoholic steatohepatitis (NASH), and should be considered as a therapeutic tool among those patients with severe obesity (BMI>35).22
Covid + Public
COVID-19 and Obesity
Obesity and the Public System
Ethicon’s Metabolic Team
The Care Advantage Team are available to deliver tailored patient support solutions to our partners.
The J&J Institute (JJI) also invests in professional education programs that may be available to you.
1. Australian Institute of Health and Welfare. Overweight and obesity: an interactive insight. Cat. no. PHE 251. Canberra: AIHW. 2020. Available: https://www.aihw.gov.au/reports/overweight-obesity/overweight-and-obesity-an-interactive-insight (accessed May 2021).
2. Bray GA, Kim KK, Wilding JPH. Obesity: a chronic relapsing progressive disease process. A position statement of the World Obesity Federation Obes Rev. 2017;18(7):715-723.
3. National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. 2013. Melbourne: National Health and Medical Research Council.
4. Australian & New Zealand Obesity Society. The Australian Obesity Management Algorithm. 2020. Available: https://www.anzos.com/publications (accessed May 2021).
5. Pucci A, Batterham RL. Mechanisms underlying the weight loss effects of RYGB and SG: similar, yet different. J Endocrinol Invest. 2019;42(2):117-128.
6. Boyers D, Retat L, Jacobsen E, Avenell A, Aveyard P, Corbould E, Jaccard A, Cooper D, Robertson C, Aceves-Martins M, Xu B, Skea Z, de Bruin M. Cost-effectiveness of bariatric surgery and non-surgical weight management programmes for adults with severe obesity: a decision analysis model. Int J Obes (Lond). 2021;45(10):2179-2190.
7. James R, Salton RI, Byrnes JM, Scuffham PA. Cost-utility analysis for bariatric surgery compared with usual care for the treatment of obesity in Australia. Surg Obes Relat Dis. 2017;13(12):2012-2020. doi: 10.1016/j.soard.2016.12.016.
8. Chobot A, Górowska‐Kowolik K, Sokołowska M, Jarosz‐Chobot P. Obesity and diabetes—Not only a simple link between two Epidemics. Diabetes Metab Res Rev. 2018;34(7):e3042. DOI: 10.1002/dmrr.3042
9. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, Brethauer SA, Navaneethan SD, Singh RP, Pothier CE, Nissen SE, Kashyap SR. Bariatric Surgery versus Intensive Medical Therapy for Diabetes — 5-Year Outcomes. N Engl J Med. 2017;376(7):641-651. doi:10.1056/NEJMoa1600869.
10. Panunzi S, Carlsson L, De Gaetano A, Peltonen M, Rice T, Sjöström L, Mingrone G, Dixon JB. Determinants of Diabetes Remission and Glycemic Control After Bariatric Surgery. Diabetes Care. 2016;39(1):166-174. DOI: 10.2337/dc15-0575.
11. Bayon V, Leger D, Gomez-Merino D, Vecchierini M-F, Chennaoui M. Sleep debt and obesity. Ann Med. 2014;46(5):264-272. DOI: 10.3109/07853890.2014.931103.
12. Cooper CB, Neufeld EV, Dolezal BA, Martin JL. Sleep deprivation and obesity in adults: a brief narrative review. BMJ Open Sport Exerc Med. 2018;4(1):e000392.
13. Castriotta RJ, Chung P. Cutting for Cures: Bariatric Surgery and Obstructive Sleep Apnea. J Clin Sleep Med. 2019;15(10):1391-1392.
14. Ming X, Yang M, Chen X. Metabolic bariatric surgery as a treatment for obstructive sleep apnea hypopnea syndrome: review of the literature and potential mechanisms. Surg Obes Relat Dis. 2021;17(1):215-220.
15. Nastałek P, Polok K, Celejewska‑Wójcik N, Kania A, Sładek K, Małczak P, Major P. Impact of bariatric surgery on obstructive sleep apnea severity and continuous positive airway pressure therapy compliance—prospective observational study. Sci Rep. 2021;11(1):5003.
16. Pinto TF, Carvalhedo de Bruin PF, Sales de Bruin VM, Lopes PM, Lemos FN. Obesity, Hypersomnolence, and Quality of Sleep: the Impact of Bariatric Surgery. Obes Surg. 2017;27(7):1775-1779. DOI 10.1007/s11695-016-2536-y.
17. Coggon D, Reading I, Croft P, McLaren M, Barrett D, Cooper C. Knee osteoarthritis and obesity. Int J Obes Relat Metab Disord. 2001;25(5):622-627.
18. Springer BD, Carter JT, McLawhorn AS, Scharf K, Roslin M, Kallies KJ, Morton JM, Kothari SN. Obesity and the role of bariatric surgery in the surgical management of osteoarthritis of the hip and knee: a review of the literature. Surg Obes Relat Dis. 2017;13(1):111-118. DOI:10.1016/j.soard.2016.09.011.
19. Heuts EAF, de Jong LD, Hazebroek EJ, Wagener M, Somford MP. The influence of bariatric surgery on hip and knee joint pain: a systematic review. Surg Obes Relat Dis. 2021;17(9):1637-1653.
20. Murr MM, Streiff WJ, Ndindjock R. A Literature Review and Summary Recommendations of the Impact of Bariatric Surgery on Orthopedic Outcomes. Obes Surg. 2021;31(1):394-400.
21. Eslam M, Newsome PN, Sarin SK, Anstee QM, Targher G, Romero-Gomez M, et al. A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement. J Hepatol. 2020 Jul;73(1):202–9.
22. Mazzini GS, Augustin T, Noria S, Romero-Marrero C, Li N, Hameed B, et al. ASMBS Position Statement on the Impact of Metabolic and Bariatric Surgery on Nonalcoholic Steatohepatitis. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2022 Mar;18(3):314–25.
Disclaimer: There are risks with any surgery, such as adverse reactions to medications, problems with anaesthesia, problems breathing, bleeding, blood clots, inadvertent injury to nearby organs and blood vessels, even death. Bariatric surgery has its own risks, including failure to lose weight, nutritional or vitamin deficiencies and weight regain. Patients should consult their doctor to determine whether this procedure is appropriate for their condition. Alternative options to surgery include a healthy energy-controlled diet and physical activity.
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