RT Book, Section A1 Schirmer, Bruce D. A2 Zinner, Michael J. A2 Ashley, Stanley W. A2 Hines, O. Joe SR Print(0) ID 1160041252 T1 Surgical Treatment of Morbid Obesity and Type 2 Diabetes T2 Maingot's Abdominal Operations, 13e YR 2019 FD 2019 PB McGraw-Hill Education PP New York, NY SN 9780071843072 LK accesssurgery.mhmedical.com/content.aspx?aid=1160041252 RD 2024/10/04 AB The surgical treatment of obesity originated with the concept that a surgical intervention to alter digestive anatomy and physiology could benefit patients with a metabolic related disease. At the University of Minnesota in the 1950s, surgeons performed an operation to bypass the distal small bowel to limit absorption of lipids in a patient with severe hyperlipidemia.1 Over 60 years later, the field of metabolic and bariatric surgery has evolved to provide increasingly safe and effective surgical treatment options for patients who suffer the consequences of severe metabolic disease, such as type 2 diabetes mellitus. As these treatments have evolved, there has been a concurrent improved understanding of the physiology underlying the diseases being targeted. This has often been a result of the observations of treatment effects of surgical procedures. Increased insight and knowledge have also arisen as a result of trying to better understand how these interventions can be optimally used for disease treatment. The comorbid metabolic diseases that arise secondary to morbid obesity are generally much better understood than the actual disease of obesity itself. Consequently, surgical treatment has to date focused more on the improvements and resolution of those diseases rather than the disease of obesity. The major manifestation of the disease of obesity, weight itself, certainly has been the focus of bariatric surgery. However, the underlying genetic, physiologic, and metabolic factors that contribute to create the obesity disease state are still not well understood. Hence, surgical therapy has focused on weight as the parameter for treating the disease, while underlying causes are still not directly targeted. Indeed, as investigation continues as to the etiologies of the disease of obesity, surgical therapy may have a more limited role in the future. However, at this time it remains the single most effective treatment for reversing the disease, both in terms of the obvious problem of weight itself as well as the comorbid medical problems that accompany the disease in varying frequency from individual to individual.