Bariatric Surgery- Current perspective and present challenges- A Narrative Review

Abstract Diet, exercise, cognitive behavioral therapy and pharmacotherapy are the means to assist patients to lose weight, with bariatric surgery being the most effective. Over the last two decades, due to increased awareness of the systemic benefits of bariatric surgery, as well as the safety and the wider use of the laparoscopic approach, has made bariatric surgery flourish. Obesity-associated mortality and co-morbidities such as type 2 diabetes, hypertension, dyslipidemia, obstructive sleep apnea, renal dysfunction and depression improve significantly with bariatric surgery. The mechanisms of weight loss extend beyond restriction and malabsorption and include changes in hunger and satiety, food preferences, and possibly energy expenditure. Despite its safety and efficacy, bariatric surgery is under utilized as less than 1% of adults with obesity receive it. In view of the evolution of obesity into a global threat, access to bariatric surgery should be revised, whilst developing safer and less invasive weight loss treatments. In summary, this narrative review provides a valuable resource for the management of obesity with bariatric surgery. By providing a comprehensive analysis of the latest evidence and elucidating the underlying mechanisms, this review seeks to establish a foundation for the development of innovative strategies in the management of obesity.