The way modern men lead their lives—or sometimes are led by it—is
far different than the way our ancestors did. The speed of this change has
not been followed, however, by the natural physiological modifications that
would adapt us to less physical effort and more food availability.We ate the
necessary, now we eat unnecessarily. We strived for food, now we call for
delivery. The advance of obesity (and its well-known consequences) is the
most trivial result in this conjuncture.
Bariatric surgery has grown exponentially in recent years, but its
contribution has had little impact on the pandemic of morbid obesity. This
book goes into some detail of the history, the present day application of
our science to the problem, and predictions for the future.
Several bariatric procedures have been developed in the
past decades and were diffused throughout the world. Techniques such as the
gastric bypass procedure (GBP), the treatment of choice in some countries
(i.e., US and Brazil), may not display the same status in others, with
different cultural and socioeconomic conditions. Biliopancreatic diversions
(BPDs) are the choice in some other places (Italy, Canada) and gain more
adepts in the United States every day. The adjustable gastric banding is the
preference in most of Europe and in Australia.
The reader will quickly see that this is not a book based solely on
technique, pre- and post-op care, minimally invasive surgery, or any other
specific entities peculiar to bariatric surgery. It is all the above, and,
as a special treat, a number of videos on technique are included. Our
purpose is to emphasize the fact that bariatric operations go far beyond
being “just an operation.” A book a bit different from the usual
was then pursued, for being a bariatric (or metabolic) surgeon demands
knowledge not only of technical aspects of the procedures accepted to date,
but also, and perhaps even more, of the physiological complexities involved
in the anatomical modifications imposed by each one of them. These
alterations have indeed led us to a wide range of new information that we
still begin to assimilate. Today, we bariatric surgeons discuss physiology,
hormones, central nervous system (CNS) signaling and interact with a variety
of medical specialists.
understanding of each technique was described by its respective inventor.
Endocrinologists, psychologists, clinicians, and researchers were also
invited to this debate.
We could summarize all
this as a great achievement. It is extremely exciting to know that we
managed to unite in one publication the most reliable worldwide experience
on obesity surgery so far.
Cid Pitombo, MD, PhD
Kenneth B. Jones, Jr., MD
Kelvin D. Higa,
José Carlos Pareja, MD, PhD