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The Management of Obesity Celso M. Fidel MD,FPSGS,FPCS Diplomate Philippine Board of Surgery
Introduction   ,[object Object],[object Object]
 
Assessing Severity   ,[object Object],[object Object],[object Object]
Assessing Severity   ,[object Object],[object Object]
Assessing Severity   ,[object Object],[object Object]
Assessing Severity   ,[object Object],[object Object]
Assessing Severity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Assessing Severity ,[object Object],[object Object],[object Object]
Assessing Severity ,[object Object],[object Object],[object Object],[object Object]
Assessing Severity ,[object Object],[object Object]
 
Assessing Severity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology   ,[object Object]
Etiology   ,[object Object],[object Object]
 
Etiology   ,[object Object],[object Object]
Nutritional and Metabolic Properties of the Common Macronutrients Properties Fat Protein Carbohydrate Alcohol Kcal/g 9 4 4 7 Energy density High Low Low Hjgh Nutrient-induced thermogenesis (percent of energy content) 2-3% 25-30 % 6-8% 15-20% Storage capacity High None Low None Autoregulation Poor Good Good Poor Ability to suppress hunger Low High High May stimulate hunger
Etiology   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Nutritional and Metabolic Properties of the Common Macronutrients Properties Fat Protein Carbohydrate Alcohol Kcal/g 9 4 4 7 Energy density High Low Low Hjgh Nutrient-induced thermogenesis (percent of energy content) 2-3% 25-30 % 6-8% 15-20% Storage capacity High None Low None Autoregulation Poor Good Good Poor Ability to suppress hunger Low High High May stimulate hunger
Etiology   ,[object Object],[object Object]
Etiology   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology   ,[object Object],[object Object],[object Object]
Etiolog y   ,[object Object],[object Object],[object Object]
Etiology   ,[object Object],[object Object]
Etiology   ,[object Object],[object Object],[object Object]
Etiology   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology   ,[object Object],[object Object]
Etiology   ,[object Object],[object Object],[object Object]
Etiology   ,[object Object],[object Object]
  Medical problems associated with Obesity   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
  Medical problems associated with Obesity   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
  Medical problems associated with Obesity   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medical problems associated with  Obesity   ,[object Object],[object Object],[object Object],[object Object],[object Object],
Medical problems associated with Obesity   ,[object Object],[object Object],[object Object],[object Object],
Medical problems associated with Obesity  ,[object Object],[object Object],[object Object],[object Object],[object Object],
Medical management of Obesity   ,[object Object],[object Object],[object Object],
Medical management of Obesity   ,[object Object],[object Object],[object Object],[object Object],
Medical management of Obesity   ,[object Object],[object Object],
Medical management of Obesity   ,[object Object],[object Object],
Medical management of Obesity   ,[object Object],[object Object],
Guidelines  Treatment of Overweight and Obese Patients BMI/m Kg/m2  Health Risk Risk with comorbidities Treatment <25 Minimal Low Healthy eating,exercise & lifestyle changes 25-26.9 Low Moderate 27-29.9 Moderate High All of the above plus low caloric diet 30-34.9 High Very High All of the above plus pharmacotherapy or very low 35-39.9 Very High Extremely High Caloric diet >40 Extremely High Extremely High All of the above plus Bariatric Surgery
Surgical management of obesity ,[object Object],[object Object],[object Object]
Surgical management of obesity ,[object Object],[object Object],[object Object],[object Object]
Surgical management of obesity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical management of obesity ,[object Object]
Surgical management of obesity ,[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical management of obesity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Criteria for Surgical Treatment of Obesity ,[object Object],[object Object],[object Object],[object Object]
Criteria for Surgical Treatment of Obesity ,[object Object]
Preoperative Preparation ,[object Object],[object Object]
Preoperative Preparation ,[object Object]
Preoperative Preparation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Preoperative Preparation ,[object Object]
Preoperative Preparation ,[object Object]
Preoperative Preparation ,[object Object]
Preoperative Preparation ,[object Object]
Preoperative Preparation ,[object Object]
Preoperative Preparation ,[object Object]
Historical Perspective and Overview ,[object Object],[object Object],[object Object],[object Object]
Historical Perspective and Overview ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
.  Major Types of Bariatric Surgical Procedures ,[object Object],[object Object],[object Object]
.  Major Types of Bariatric Surgical Procedures ,[object Object],[object Object],[object Object]
.  Major Types of Bariatric Surgical Procedures ,[object Object],[object Object],[object Object],[object Object],[object Object]
.  Major Types of Bariatric Surgical Procedures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
Vertical Banded gastroplasty
 
Efficacy of VBG ,[object Object],[object Object],[object Object],[object Object],[object Object]
Efficacy of VBG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Efficacy of VBG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Efficacy of VBG ,[object Object],[object Object],[object Object],[object Object],[object Object]
Efficacy of VBG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laparoscopic Gastric banding ,[object Object],[object Object],[object Object],[object Object]
Adjustable gastric band
Efficacy of lGb ,[object Object]
Laparoscopic Gastric banding ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laparoscopic Gastric banding ,[object Object],[object Object],[object Object],[object Object],[object Object]
Laparoscopic Gastric banding ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laparoscopic Gastric banding ,[object Object],[object Object],[object Object],[object Object],[object Object]
Laparoscopic Gastric banding ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
Open roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object]
Roux en y gastric bypass
Efficacy of Open roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Efficacy of Open roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object]
Efficacy of Open roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Efficacy of Open roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Efficacy of Open roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object]
Efficacy of Open roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Efficacy of Open roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Laparoscopic roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laparoscopic roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object]
Laparoscopic roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laparoscopic roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Laparoscopic roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laparoscopic roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laparoscopic roux en y gastric bypass ,[object Object],[object Object],[object Object],[object Object],[object Object]
biliopancreatic diversion with duodenal switch
Bilio pancreatic procedures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bilio pancreatic procedures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bilio pancreatic procedures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
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The Management Of Obesity

  • 1. The Management of Obesity Celso M. Fidel MD,FPSGS,FPCS Diplomate Philippine Board of Surgery
  • 2.
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  • 16.  
  • 17.
  • 18. Nutritional and Metabolic Properties of the Common Macronutrients Properties Fat Protein Carbohydrate Alcohol Kcal/g 9 4 4 7 Energy density High Low Low Hjgh Nutrient-induced thermogenesis (percent of energy content) 2-3% 25-30 % 6-8% 15-20% Storage capacity High None Low None Autoregulation Poor Good Good Poor Ability to suppress hunger Low High High May stimulate hunger
  • 19.
  • 20. Nutritional and Metabolic Properties of the Common Macronutrients Properties Fat Protein Carbohydrate Alcohol Kcal/g 9 4 4 7 Energy density High Low Low Hjgh Nutrient-induced thermogenesis (percent of energy content) 2-3% 25-30 % 6-8% 15-20% Storage capacity High None Low None Autoregulation Poor Good Good Poor Ability to suppress hunger Low High High May stimulate hunger
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  • 44. Guidelines Treatment of Overweight and Obese Patients BMI/m Kg/m2 Health Risk Risk with comorbidities Treatment <25 Minimal Low Healthy eating,exercise & lifestyle changes 25-26.9 Low Moderate 27-29.9 Moderate High All of the above plus low caloric diet 30-34.9 High Very High All of the above plus pharmacotherapy or very low 35-39.9 Very High Extremely High Caloric diet >40 Extremely High Extremely High All of the above plus Bariatric Surgery
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  • 87. Roux en y gastric bypass
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  • 100.  
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  • 104. biliopancreatic diversion with duodenal switch
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Editor's Notes

  1. blindness