CiteScore: 1.5     h-index: 24

Document Type : Original Article


Tyumen State Medical University of the Ministry of Health of Russia, 54 Odesskaya str., Tyumen, 625023, Russia


The use of bariatric surgery in the treatment of morbid obesity is most effective for metabolic syndrome. The greatest decrease in body weight occurred in the first 3 months after intragastric balloon and biliopancreatic diversion, whereas with a laparoscopic adjustable gastric band, the best effect was observed in the period from 3 months to 1 year. With an intragastric balloon, a decrease in body weight of 6.6% was observed in the first 3 months and 13.5% after 6 months, with an average decrease in body mass index of 5.7±2.3 kg/m2. After a laparoscopic adjustable gastric band, there was a 14.1% decrease in body weight at 3 months, a 21.4% decrease at 6 months, and a 27.9% decrease in body mass index at 1 year, with a 13.3±2.5 kg/m2 decrease in body mass index. Considering intragastric balloon surgery, as early as 6 months after balloon removal, almost 33% of patients showed regain of initial body weight, and 1 year later – almost 50% of patients. It should be noted only after a laparoscopic adjustable gastric band and biliopancreatic diversion, 3 months after the operation with preservation of results 1 year after treatment, a significant reduction of systolic and diastolic blood pressure and levels of total cholesterol and low-density lipoproteins was observed. If the body mass index is over 50 kg/m2 and the metabolic syndrome is present, biliopancreatic diversion surgery is the best option also for the treatment of carbohydrate and lipid metabolism disorders, blood pressure regulation, and other diseases associated with obesity.

Graphical Abstract

Metabolic Changes after the Surgical Treatment of Morbid Obesity



According to World Health Organization (WHO) experts, obesity and overweight are a growing health and social problem that threatens not only public health but also the economies of different countries [1]. The prevalence of obesity is increasing rapidly among people of different ages, sex, social status, and different ethnicities. In Russia, this problem is as widespread as in other countries of the world. Scientists report that the prevalence of overweight in adults in Russia in the past decade was 60% for males and 59.2% for females, with a prevalence of 6.8% for males and 5.3% for females among children and adolescents under 17 years of age [2,3]. Many studies have found a clear association of body mass index (BMI) with cardiovascular risk and mortality [4-6]. Often obesity has a systemic effect on the following diseases: Arterial hypertension, type 2 diabetes, coronary heart disease, dyslipidaemia, and some types of malignancies [7-9]. The main cause of obesity has been an energy imbalance with the predominance of caloric diet over body energy expenditure, i.e. consumption of high-energy food rich in fats, simple carbohydrates, with low energy expenditure due to hypodynamy [10]. Many obese patients often show signs of metabolic syndrome (MS), which most often occurs against a background of long-term stress states, and manifests as obesity, followed by insulin resistance, dyslipidaemia, and arterial hypertension. The metabolic syndrome manifests clinically in a combination of certain functional disorders that accelerate the development and progression of atherosclerotic vascular disease and diabetes [11].

Conservative treatment is only effective in patients who are slightly overweight, whereas morbid obesity is resistant [12]. The 2013 European Clinical Guidelines and the 2016 Russian National Clinical Guidelines for the Treatment of Morbid Obesity in Adults state that adequate treatment of obesity should be based on realistic aims to reduce body weight and, hence, health risks; it should include initiation of weight loss, maintenance of the

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