ABSTRACT
Surgical treatment for obesity is growing rapidly. This can be seen in Figure 8.1, which shows the number of surgeries performed to treat obesity over the past 15 years. After about 2000, there was a rapid increase in the number of surgeries, probably reecting the improvements in surgical procedures. The popularity of the procedure is due to the signicant weight reduction that follows the operation and in the long duration of this response for most patients. Once the surgical procedure is done, the patient can’t undo it. It is permanent until the surgeon reverses it. Because of this irreversibility, I call it a “noncognitive” treatment. It is similar to the effect on dental cavities of adding uoride to the drinking water. Fluoride reduces dental cavities over and above what can be done by brushing and ossing your teeth. After surgical treatment for obesity, patients modify their food intake, but with the reduction in size of the stomach or the rerouting of the intestinal contents, only occasionally do patients manage to eat enough to compensate for the surgery. Thus, surgery provides a form of long-term treatment for obesity that lifestyle, diet, exercise, and medications can’t yet match. The reduction in body weight reverses diabetes in nearly 80% of the patients who have diabetes, making it a very effective treatment for diabetes, and one that is cost-effective.
