· Module Code PM501 · Class/Group

·   Module Code PM501
·   Class/Group: GROUP X
·   Module Title: SKILL FOR STUDY
·   Assessment Title: argumentative Essay
·   Assignment Title: biometric
·   Tutor Name: Iain Donnelly
·   Student GU ID Number:
·   Date of Submission: (date)
·   Word count

Bariatric Surgery
The number of obese patients has been a growing trend over the past several decades and seems to be a serious problem among the whole world. There has a big increase on the number of bariatric surgeries over the past several years accordingly (Robinson, M. K. 2009:520-521)1 For the moment, bariatric surgery is highly proposed by the National Institutes of Health with a body mass index(BMI, a value derived from the mass and height of an individual, which defined as the body mass divided by the square of the body height.) of at least 40 and for those people with a less obesity with a serious comorbidities and a BMI of at least 35.However, the position statement on cunsensus for BMI was suggested to be an indicate for bariatric surgery by the American Society for Metabolic & Bariatric Surgery guidelines recently, they find it may be suitable for any patients with BMI of more than 30 with comorbidities. This essay will argue that whether the bariatric surgery is an effective way for obesity by focusing on the impact and effect on health.

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The open approaches to Roux-en-Y gastric bypass and laparoscopic and laparoscopic adjustable gastric banding take up 90% of bariatric surgeries through the whole world (Robinson, M. K, 2009:520-521)2 .In contrast with non-operative interventions, the bariatric surgery can effectively reduce the weight loss in the long term no matter in any kinds of surgeries. What is more, as for young people, considering that the risk of adult obesity is often higher in childhood, it is of great important to treat young obesity patients as well as adolescent patients particularly when have serious comorbidities, that is to say early intervention in weight loss may depress the danger of continuity obesity (Pratt et al. 2018:882-901)3. At the same time, it is common believed that bariatric surgeries are considered to be work best when help to boost their behavior on diet and enhance the quality of life. (Torpy, J. M. et al 2012:1173)4. In the meanwhile, weight loss during bariatric procedures is in connection with some abatements in some comorbidities of obesity, such as metabolic syndrome, diabetes, sleep apnea and so on?which means it can also reduce the risk of those comorbidities( Colquitt. et al, 2003,2009)5. There also has a distinct proof that the bariatric surgery may have the opportunity to reverse TYPE2 diabetes, especially if treated immediately after it has made a definite diagnosis. In the statistics, it can be seen that after the bariatric surgery, the incidence of diabetes, hypertension and some lipid disorders caused by obesity is significantly reduced.

However, the bariatric surgery may do damage to health sometimes. Compared with other obesity treatments, adult bariatric surgery has a relatively high probability of risk and postoperative complications. Some scientists have found that after some types of surgery, due to changes in the size of the stomach, the absorption of food has also been affected, and many essential nutrients and vitamins are not properly absorbed and absorbed, for about 2% of patients have a serious lack of nutrition and malabsorption. Without the nutrients necessary for these human bodies, there will be various postoperative complications due to inadequate nutrition. Most of the time, the malabsorption is combined with comorbidity as for diabetes(Latin, L.et al 2015:164-165)6. The nutritional intake of patients often does not reach the recommended level, and is related to some anemia or lack of nutrition, so it is necessary to increase the intake and absorption of nutrients after surgery. Even worse, there is growing evidence that bone health has been greatly affected after weight loss surgery. The effect of bariatric surgery on bones is a combination of factors that may involve nutrition, hormones, and bone damage after weight loss. This combination of factors makes bones more vulnerable to injury after surgery. This is also related to the difference in the type of surgery. Studies have shown that in the most obvious surgery for malabsorption, it is often accompanied by the most serious bone loss (Stein, E. M. and Silverberg, S. J,2014)7 Another study showed that VSG surgery is more likely to have high acute pancreatitis after surgery because of different procedures. However, gallstones are common postoperative complications in various types of bariatric surgery, so the risk gallstones is often reduced by surgical removal or medication. ( Parashar, A.2010)8
At the same time, obesity can also have some impact on society. Many obese patients have serious defects in their quality of life due to their own reasons. And the research data shows that compared with ordinary people, obese patients are also greatly affected in terms of work compared with normal people, studies also have shown that obesity patients have improved their weekly work efficiency and working hours after obesity surgery, and the number of absenteeism and sick leave applications has also decreased. This shows that bariatric surgery has great benefits for society. It can help obese patients return to normal society and reduce the cost of government welfare. Some of the jobs that lack employees are also filled.(Mancini, A. 2018)9
For obese patients themselves, weight loss has a double benefit to their health and mental health. After surgery due to weight loss, many comorbidities such as diabetes will return to a good level after bariatric surgery. Their mental health has also been greatly improved. Many people with obesity suffer from various kinds of discrimination from their peers and elders as well as the outside world. They themselves will fall into a tendency to blame themselves and become self-inflicted. Although there is no accurate research data support yet, it can be concluded from the big data statistics that most people with obesity have a greater improvement in mental health after returning to normal life.

Although weight loss surgery can bring some disadvantages in some aspects, such as postoperative complications, fractures, malnutrition, etc., it seems that, to a greater extent, it brings benefits to people, such as survival rate. High, the comorbidities are alleviated, the social burden is also reduced, and the patients themselves have been greatly improved. As more benefits of bariatric surgery have been discovered, it is also becoming more prevalent in current treatments for obese patients. In the future, weight loss surgery will become the mainstream guiding direction in the field of weight loss.

Reference
Robinson, M. K. (2009). Surgical Treatment of Obesity – Weighing the Facts. New England Journal of Medicine, 361(5), 520–521.

Robinson, M. K. (2009). Surgical Treatment of Obesity – Weighing the Facts. New England Journal of Medicine, 361(5), 520–521.

Pratt, J. S. A., Browne, A., Browne, N. T., Bruzoni, M., Cohen, M., Desai, A., … Zitsman, J. (2018, July 1). ASMBS pediatric metabolic and bariatric surgery guidelines, 2018. Surgery for Obesity and Related Diseases, 14(7),882-901
Torpy, J. M., Lynm, C., & Livingston, E. H. (2012). JAMA patient page. Bariatric surgery. JAMA?: The Journal of the American Medical Association, 308(11), 1173.
Colquitt, J. L., Pickett, K., Loveman, E., & Frampton, G. K. (2014, August 8). Surgery for weight loss in adults. Cochrane Database of Systematic Reviews. John Wiley and Sons Ltd.

Latin, L., Lo, C., Sanni, A., Ibikunle, C., Farinas, A., Pico, C. C., & Postoev, A. (2015). Are the postoperative outcomes of malabsorptive bariatric procedures truly superior to restrictive bariatric procedures? Surgery for Obesity and Related Diseases, 11(6), S164–S165. Retrieved from http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L72280309Stein, E. M., & Silverberg, S. J. (2014, February). Bone loss after bariatric surgery: Causes, consequences, and management. The Lancet Diabetes and Endocrinology.
Chauhan, V., Vaid, M., Gupta, M., Kalanuria, A., & Parashar, A. (2010, August). Metabolic, renal, and nutritional consequences of bariatric surgery: Implications for the clinician. Southern Medical Journal
Mancini, A. , Borel, A. L. , Coumes, S. , Wion, N. ,Arvieux, C. , Reche, F. (2018, July). Bariatric surgery improves the employment rate in people with obesity: 2-year analysis. Surg Obes Relat Dis.