الفهرس 
Introduction & Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Overweight and obesity are estimated to be present in 1.7 billion people in the world. It is estimated that 25 million of deaths per year in the world are related to overweight. Morbid obesity is present when body mass index (BMI), determined by dividing body weight expressed in kilograms by height expressed in square meters, is greater than 40 kg/m 2 or greater than 35 kg/m 2 with concomitant obesity-related morbidity. Complex interactions between biological (including genetic and epigenetic), behavioural, social and environmental factors (including chronic stress) are involved in regulation of energy balance and fat stores, and obesity. Severe obesity is associated with multiple co-morbidities which reduce the life expectancy and markedly impair the quality of life. The comorbidites of morbid obesity affect essentially every organ system. The efficacy of long-term, sustainable weight loss has continued to elude researchers and clinical practitioners. The reasonable doubt of efficacy has left many to question the provision of weight management services in the context of medical management. The goals for treatment of overweight and obesity are to reduce body weight, and to maintain lower body weight over the long term. An alternative goal is to prevent further weight gain as a minimum goal in patients who are unable to lose weight. Successful treatment of obesity should result in a preferential reduction of abdominal fat, an amelioration of obesity-related health risks, an improvement in quality of life, and a reduction in mortality rate. Nonsurgical methods fail to maintain clinically significant weight loss more than 5 years in patients who are morbidly obese. Surgery is the effective treatment for the truly morbidly obese patient and all conservative treatments are doomed to long-term failure in 95% of patients. Bariatric operations are classified according to mechanisms of action to 4 categories: malabsorptive, malabsorptive/restrictive, restrictive, and other procedures. The most commonly performed procedures are Laparoscopic Roux-en-Y Gastric Bypass (RYGB), laparoscopic adjustable gastric band (LAGB), biliopancreatic diversion with duodenal switch (BPD/DS), and, more recently, sleeve gastrectomy. The main goals of bariatric surgery is to offer the patients the best chance of weight loss success, aid in the resolution of specfic co-morbidities, an acceptable quality of life, and a favorable risk-to-benefit ratio ratio, Surgeons performing bariatric surgery are encouraged to understand the advantages and disadvantages of most available procedures to be able to answer the patients’ questions, and proper selection of optimum bariatric procedures. Laparoscopic surgery has many advantages over the open surgery, including, shorter hospital stay, quicker return to normal activity and work, less postoperative pain, and better cosmesis. Also,the incidence of incisional hernia clearly is diminished. Other advantages include less systemic and immunologic stress, reduced adhesion formation, and reduced incidence of ileus. Conclusion: Morbid obesity is a world-wide epidemic problem, associated with serious co-morbidities, and affects the quality of life of the obese patient, and associated with considerable mortality. Non surgical treatment of morbid obesity usually fails to achieve sustained weight loss, and long term weight loss can be achieved by bariatric surgery. Because of obesity co-morbidities and operative risk, candidates of bariatric surgery should be well-selected according to specific criteria. Many bariatric procedures were developed in the second half of last century, and development of laparoscopic techniques introduced minimally invasive procedures for weight loss, with more advantages over the traditional open procedures. The type of bariatric procedure should be tailored according to the morbidly obese patient, for achievement of the best benefits from the bariatric surgery, especially weight loss, and resolution of co-morbidities, with the minimal operative risk.