Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2014:2014:917813.
doi: 10.1155/2014/917813. Epub 2014 May 12.

Bariatric endocrinology: principles of medical practice

J Michael Gonzalez-Campoy  1 , Bruce Richardson  1 , Conor Richardson  1 , David Gonzalez-Cameron  1 , Ayesha Ebrahim  1 , Pamela Strobel  1 , Tiphani Martinez  1 , Beth Blaha  1 , Maria Ransom  1 , Jessica Quinonez-Weislow  1 , Andrea Pierson  1 , Miguel Gonzalez Ahumada  1
Affiliations
Review

Bariatric endocrinology: principles of medical practice

J Michael Gonzalez-Campoy et al. Int J Endocrinol. 2014.

Abstract

Obesity, is a chronic, biological, preventable, and treatable disease. The accumulation of fat mass causes physical changes (adiposity), metabolic and hormonal changes due to adipose tissue dysfunction (adiposopathy), and psychological changes. Bariatric endocrinology was conceived from the need to address the neuro-endocrinological derangements that are associated with adiposopathy, and from the need to broaden the scope of the management of its complications. In addition to the well-established metabolic complications of overweight and obesity, adiposopathy leads to hyperinsulinemia, hyperleptinemia, hypoadiponectinemia, dysregulation of gut peptides including GLP-1 and ghrelin, the development of an inflammatory milieu, and the strong risk of vascular disease. Therapy for adiposopathy hinges on effectively lowering the ratio of orexigenic to anorexigenic signals reaching the the hypothalamus and other relevant brain regions, favoring a lower caloric intake. Adiposopathy, overweight and obesity should be treated indefinitely with the specific aims to reduce fat mass for the adiposity complications, and to normalize adipose tissue function for the adiposopathic complications. This paper defines the principles of medical practice in bariatric endocrinology-the treatment of overweight and obesity as means to treat adiposopathy and its accompanying metabolic and hormonal derangements.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Complications of obesity that interfere with its treatment (Copyright © Minnesota Center for Obesity, Metabolism and Endocrinology, PA).
Figure 2
Figure 2
Models of chronic disease management as a practical future approach to treatment of adiposity and adiposopathy [8].
See this image and copyright information in PMC

References

    1. Feneberg A, Malfertheiner P. Epidemic trends of obesity with impact on metabolism and digestive diseases. Digestive Diseases. 2012;30(2):143–147. - PubMed
    1. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults—The Evidence Report. National Institutes of Health. Obesity Research. 1998;6(2):51S–209S. - PubMed
    1. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Expert panel on the identification, evaluation, and treatment of overweight in adults. The American Journal of Clinical Nutrition. 1998;68:899–917. - PubMed
    1. Smith SR, Lovejoy JC, Greenway F, et al. Contributions of total body fat, abdominal subcutaneous adipose tissue compartments, and visceral adipose tissue to the metabolic complications of obesity. Metabolism: Clinical and Experimental. 2001;50(4):425–435. - PubMed
    1. NIH Health implications of obesity. National institutes of health consensus development conference statement. Annals of Internal Medicine. 1985;103:1073–1077. - PubMed

LinkOut - more resources