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Severe Obesity: A Growing Health Concern A.S.P.E.N. Should Not Ignore

From the Tufts University School of Medicine, Bariatric Surgery, Tufts–New England Medical Center, Boston, Massachusetts

Correspondence: Scott A. Shikora, MD, FACS, Tufts–New England Medical Center, Box 900, 750 Washington Street, Boston, MA 02111. Electronic mail may be sent to sshikora{at}tufts-nemc.org.

The definition of malnutrition in the published standards of the American Society of Parenteral and Enteral Nutrition (A.S.P.E.N.) is any derangement in the normal nutrition status and includes overnutrition, commonly referred to as obesity. The incidence of obesity is increasing and reaching epidemic proportions in the United States and even worldwide. This has significant financial impact as our society spends billions of dollars on fad diets, commercial weight-loss programs, nutrition and dietary supplements, prescription and over-the-counter medications, and health clubs. Another approximately $100 billion are spent to treat the medical consequences of obesity. Currently, for those patients with intractable morbid obesity, defined as having a body mass index >40 kg/m², surgery offers the only option for achieving meaningful and sustainable weight loss. The resultant weight loss dramatically improves health and decreases the cost of health care for these patients. Years of refinement in technology and the introduction of safer and less invasive procedures have dramatically reduced the short-term morbidities and long-term metabolic consequences of these procedures. This address will review the field of weight loss (bariatric) surgery and will offer a compelling request for A.S.P.E.N. to include obesity in its fabric.

Journal of Parenteral and Enteral Nutrition, Vol. 29, No. 4, 288-297 (2005)
DOI: 10.1177/0148607105029004288


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