Gastroplasty for morbid obesity: the internist's view.

To evaluate the benefit of gastric surgery in terms of improvement in health risk factors, the loss of weight and its long-term maintenance, 28 non-diabetic morbidly obese subjects were followed during three to five years after vertical banded gastroplasty. Aside from a rapid and sustained loss of weight averaging nearly 75% reduction of weight excess, there occurred a concomitant improvement in glucose tolerance with 50% reduction in fasting insulinaemia and correction of hypertension. The improvement in cardiovascular risk factors also included the drop in plasma triglycerides associated with an increase in HDL-cholesterol, while uricaemia decreased to low normal levels. Gastric procedures are therefore an effective treatment of severe obesity and of its comorbid conditions, but they should be followed by careful medical and nutritional monitoring to prevent any possible digestive or nutritional complications.