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3 Obesity and Diabetes surgery


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    Obesity is a common but often underestimated condition of clinical and public health importance in many countries around the world. Its general acceptance by many societies as a sign of well-being or a symbol of high social status, and the denial by healthcare professionals and the public alike that it is a disease in its own right, have contributed to its improper identification and management and the lack of effective public health strategies to combat its rise to epidemic proportions. In general, obesity is associated with a greater risk of disability or premature death due to type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) such as hypertension, stroke and coronary heart disease as well as gall bladder disease, certain cancers (endometrial, breast, prostate, colon) and non-fatal conditions including gout, respiratory conditions, gastro-esophageal reflux disease, osteoarthritis and infertility. Obesity also carries serious implications for psychosocial health, mainly due to societal prejudice against fatness. The body mass index (BMI) is a simple and commonly used parameter for classifying various degrees of adiposity. It is derived from the weight of the individual in kilograms divided by the square of the height in metres (kg/m2). By the current World Health Organisation (WHO) criteria, a BMI <18.5kg/m2 is considered underweight, 18.5–24.9 kg/m2 ideal weight and 25–29.9kg/m2 overweight or pre-obese. The obese category is sub-divided into obese class I (30–34.9kg/m2), obese class II (35–39.9kg/m2) and obese class III (≥40kg/m2). A BMI greater than 28kg/m2 in adults is associated with a three to four-fold greater risk of morbidity due to T2DM and CVDs than in the general population
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