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Tratamento cirúrgico da obesidade

( adaptado do capítulo – Obesidade – IDPC)

Dra. Cristiane Moulin
Endocrinologista - IMeN

Obesos grau III têm pior resposta ao tratamento clínico, com manutenção do peso perdido somente em 5-10% dos casos (55). A cirurgia bariátrica é atualmente a única terapia efetiva para obesidade grave. Não é considerada como cura, porém há melhora importante das comorbidades e promove perda de peso durável (56). É apenas uma parte de uma estratégia multidisciplinar para tratar obesidade grave. As taxas de morbi-mortalidade são pequenas, porém cada caso deve ser considerado individualmente, avaliando-se os riscos e benefícios. Os pacientes perdem em média: 40-75 % do excesso de peso ou 30-40% do peso inicial, dependendo da técnica específica (56). O sucesso da cirurgia é definido pela manutenção da perda de 50% do excesso de peso por 5 anos.
A cirurgia bariátrica está indicada em pacientes com IMC ³ 40kg/m2  ou ³ 35kg/m2 com comorbidades ou 200% acima do peso ideal (depende da população estudada: diferenças culturais), não respondedores ao tratamento clínico, conscientes dos riscos,desconfortos e necessidade de acompanhamento (57), em locais com equipe especializada disponível.

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