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Bariatrics

What is Bariatric Medicine?

The medical treatment of obesity and associated conditions is called bariatric medicine. The term is derived from the Greek word "baros" meaning "weight." Bariatric medicine is the art and science of medical weight management.

The American Society of Bariatric Physicians (ASBP), founded in 1950, is a national, nonprofit professional association of physicians, nurse practitioners, and other health care personnel. According to the ASBP, a comprehensive medical weight loss program should include the following:

  1. An initial patient work-up to include medical history, physical examination, appropriate laboratory studies and an electrocardiogram if there is past or present evidence of cardiac disease or if the patient has coronary risk factors.
  2. Appropriate counseling on:
    a. Diet and nutrition, including reduced calorie diets and very low calories diets (VLCD) and dietary supplements when needed.
    b. Exercise, tailored to the capabilities and limitations of the overweight patient to ensure safe and effective exercise.
    c. Behavior modification (lifestyle changes), to include discussions of proper eating habits, dealing with stress-related eating, family meal planning changes, healthful snacking, etc.
    d. Prescription appetite suppressants, if indicated, as an adjunct to a comprehensive medical weight loss program, and other medications.
  3. If the use of appetite suppressants or other medications is indicated, the patient should be informed about the potential risks of such medication and the physician and patient should weigh the risks of the medication against the benefits, i.e., do the small risks of the medications outweigh the health risk of the patient remaining obese. (The use of appetite suppressants is not indicated for patients with only a small amount of weight to lose.) Often, the loss of only 5 to 10 percent of a patient's initial weight can lead to significant improvements in health status.
  4. Adequate periodic follow-up and counseling, to include a program to help the patient maintain the weight loss that has been achieved.