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19 - Obesity surgery and the polycystic ovary syndrome

Published online by Cambridge University Press:  29 September 2009

By
John B. Dixon  and
E Paul O'Brien
Edited by
Gabor T. Kovacs  and
Robert Norman
John B. Dixon
Affiliation:
Centre for Obesity Research and Education
E Paul O'Brien
Affiliation:
Centre for Obesity Research and Education
Gabor T. Kovacs
Affiliation:
Monash University, Victoria
Robert Norman
Affiliation:
University of Adelaide
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Summary

Introduction

Obesity is a serious disease, which is associated with an array of comorbid conditions that have a major impact on both physical and mental health, and on quality of life. Obesity surgery provides the only reliable method of achieving and sustaining significant weight for those with severe obesity (body mass index (BMI) >35 kg/m2). The combination of an obesity epidemic, relatively ineffective conservative therapy, and advances in modern laparoscopic surgery has generated a demand for effective safe surgical methods to achieve significant weight loss. It is therefore not surprising that obesity surgery is one of the most rapidly developing and expanding areas of surgery today. Obesity, especially central obesity with insulin resistance, is commonly associated with features of the polycystic ovary syndrome (PCOS), namely disturbance of ovulatory function, infertility, and evidence of androgen excess (Hartz et al. 1979) and it is not surprising that weight loss has become an important goal in obese women with this condition.

Obesity surgery: mechanism of action

The traditional division of obesity surgery into malabsorptive and restrictive has been misleading as it has implied knowledge regarding the mechanism of action utilized to achieve and sustain weight loss. Currently two procedures make up the vast majority of bariatric surgical procedures throughout the world: these are the laparoscopic adjustable gastric banding (LAGB) (Fig. 19.1) and Roux-en-Y gastric bypass (RYGB) (Fig. 19.2), with neither producing malabsorption of macronutrients.

Type
Chapter
Information
Polycystic Ovary Syndrome , pp. 331 - 342
Publisher: Cambridge University Press
Print publication year: 2007

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