The neurological complications of bariatric surgery

Weight is a national obsession. In 1999, Americans spent more than $300 million on prescription medications for obesity,(1) and 2.5% of the adult population reported using such preparations at the end of the 20th century.(2) By some esti W mates, the total cost of obesity in the United States is $1000 billion annually. Obesity is now officially recognized by the surgeon general of the United States as a significant health risk factor. Obesity increases the risk for numerous medical illnesses, among them, diabetes mellitus, hypercholesterolemia, hypertension and other cardiovascular disorders, pulmonary disease, osteoarthritis, and some forms of cancer.(4,5) Obesity also increases the risk of death from all causes; it is estimated that 300 000 adults in the United States die of obesity-related causes annually.(6) Obesity currently ranks as the seventh leading cause of death in the United States.' The problem of obesity is a global phenomenon consequent to the ready availability of food with high caloric content and the reduction of daily energy expenditure. While the percentage of overweight adults in most western European countries has not surpassed that of the United States, their overweight population is increasing rapidly. The percentage of obese children in many of these countries, such as England, is growing rapidly(7) and has outstripped the percentage of obese children in the United States. In major population centers of developing countries, obesity is also seen with increasing frequency.