1. The Management of Obesity Celso M. Fidel MD,FPSGS,FPCS Diplomate Philippine Board of Surgery

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

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

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

70. Vertical Banded gastroplasty

78. Adjustable gastric band

87. Roux en y gastric bypass

104. biliopancreatic diversion with duodenal switch

110. Thank You