Consilium MedicumConsilium Medicum2075-17532542-2170Consilium Medicum93871Research ArticleLechenie morbidnogo ozhireniya u vzroslykh.Natsional'nye klinicheskie rekomendatsii---15042013154798628122021Copyright © 2013, Consilium Medicum2013[Manson J, Willett W, Stamfer M et al. Body weight and mortality among women. New England J Med 1995; 333: 677–85.][Kanell W, D\'Agostino R, Cobb J. Effect of weight on cardiovascular disease. Am J Clin Nutr 1996, 63 (Suppl.), 419S-422S.][Shaper A, Wannamethee S, Walker M. Body weight: implications for the prevention of coronary heart disease, stroke, and diabetes mellitus in a cohort study of middle aged men. Br Med J 1997; 314: 1311–17.][World Health Organisation. Obesity: preventing and managing the global epidemic. Geneva: WHO, 1997.][Freedman D, Ron E, Ballard-Barbash R et al. Body mass index and all - cause mortality in a nationwide US cohort. Int J Obes (Lond) 2006; 30: 822–9.][Gastrointestinal surgery for severe obesity. NIH Consensus Statement Online 1991; 9 (1): 1–20.][Clinical Guidelines on the identification, evaluation and treatment of overweight and obesity in adults. National Heart, Lung and Blood Institute, NIH, 1998.][Must A, Spadano J, Coakley E et al. The disease burden associated with overweight and obesity. JAMA 1999; 282: 1523–9.][Guh D, Zhang W, Bansback N et al. The incidence of co - morbidities related to obesity and overweight: a systematic review and meta - analysis. BMC Public Health 2009; 9: 88.][Lenz M, Richter T, Muhlhauser I. The morbidity and mortality associated with overweight and obesity in adulthood: a systematic review. Dtsch Arztebl Int 2009; 106: 641–8.][Obesity. The Report of The British Nutrition Foundation Task Force. Blackwell Science Ltd, 1999.][Eckel R. (ed.) Obesity: Mechanisms and Clinical Management. Lippincott; Williams & Wilkins, 2003.][Pate R, Pratt M, Blain S et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. J Am MedAssoc 1995; 273: 402–8.][Warburton D, Nicol C, Bredin S. Health benefits of physical activity: the evidence. CMAJ 2006; 174 (6): 801–9.][Avenell A, Broom J, Brown T et al. Systematic review of the long - term effects and economic consequences of treatments for obesity and implications for health improvement. Health Technol Assess 2004; 8: iii-iv 1–182.][Rucker D, Padwal R, Li S et al. Long term pharmacotherapy for obesity and overweight updated meta - analysis. Br Med J 2007; 335: 1194–9.][Anderson J, Konz E, Frederich R et al. Long - term weight - loss maintenance: a meta - analysis of US studies. Am J Clin Nutr 2001; 74: 579–84.][Avenell A, Brown T, McGee M et al. What are the long - term benefits of weight reducing diets in adults? A systematic review of randomized controlled trials. J Hum Nutr Diet 2004; 17: 317–35.][Orzano A, Scott J. Diagnosis and treatment of obesity in adults: an applied evidence based review. J Am Board Fam Pract 2004; 17: 359–69.][Douketis J, Macie C, Thabane L et al. Systematic review of long - term weight loss studies in obese adults: clinical significance and applicability to clinical practice. Int J Obes (Lond) 2005; 29: 1153–67.][Summerbell C, Cameron C, Glasziou P. WITHDRAWN: Advice on low - fat diets for obesity. Cochrane Database Syst Rev 2008; 16: CD003640.][Datillo A, Kris-Etherton P. Effects of weight reduction on blood lipids and lipoproteins: a meta - analysis. Am J Clin Nutr 1992, 56: 320–8.][Higgins M, D’Agostino R, Kannel W et al. Benefits and adverse effects of weight loss: observations from the Framingham study. Ann Intern Med 1993; 119: 758–63.][Pamuk E, Serdula M et al. Weight loss and subsequent death in a cohort of US adults, 1971–1987. Ann Intern Med 1993; 119: 744–8.][Williamson D, Pamuk E, Thun M et al. Prospective study of intentional weight loss and mortality in never smoking overweight US white women aged 40–64 years. Am J Epidemiol 1995; 141: 1128–41.][Williamson D, Pamuk E, Thun M et al. Prospective study of intentional weight loss and mortality in overweight white men aged 40–64 years. Am J Epidemiol 1999; 149: 491–503.][Buchwald H, Avidor Y, Braunwald E et al. Bariatric surgery: a systematic review and meta - analysis. JAMA 2004; 292: 1724–37.][Sjostrom L, Lindroos A-K, Peltonen M et al. Lifestyle, diabetes and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004; 351: 2683–93.][Sjostrom L, Narbo K, Sjostrom D et al. Effects of bariatric surgery on mortality in Swedish Obese Subjects. N Engl J Med 2007; 357: 741–52.][Brechner R, Farris C, Harrison S et al. A graded evidence - based summary of evidence for bariatric surgery. Surg Obes Relat Dis 2005; 1: 430–41.][Interdisciplinary European guidelines for surgery for severe (morbid) obesity. Obes Surg 2007; 17: 260–70.][American association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic and Bariatric Surgery Medical Guidelines for Clinical Practice for the perioperative nutritional, metabolic and non - surgical support of the bariatric surgery patient. Surg Obes Relat Dis 2008; 4 (Suppl. 5): S109–84.][Bernstein D. Cardiovascular physiology. In Morbid Obesity. Perioperative management. Edited by Alvarez A. 2nd Edition. Cambridge University Press, 2010.][Lemmens H. Perioperative pharmacology in morbid obesity. Curr Opin Anaestesiol 2010; 23: 485–91.][Management of obstructive sleep apnoea/hypopnoea syndrome in adults. A national clinical guideline. Scottish Intercollegiate Guidelines Network – National Government Agency [Non-U.S.]. 2003.][Practice parameters for the indications for polysomnography and related procedures: an update for 2005. American Academy of Sleep Medicine – Professional Association. 1997 (revised 2005 Apr 1).][Kushida C.A., Littner M.R., Hirshkowitz M et al. Practice parameters for the use of continuous and bilevel positive airway pressure devices to treat adult patients with sleep - related breathing disorders. Sleep 2006; 29 (3): 375–80.][Screening for obstructive sleep apnea in the primary care setting. University of Texas at Austin School of Nursing, Family Nurse Practitioner Program – Academic Institution. 2006.][Hsu L, Benotti P, Dwyer J. Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med 1998; 60: 338–46.][Herpertz S, Kielmann R, Wolf A et al. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obes Res 2004; 12: 1554–69.][Kalarchian M, Marcus M, Levine M et al. Relationship of psychiatric disorders to 6-month outcomes after gastric bypass. Surg Obes Relat Dis 2008; 4: 544–9.][Tindle H, Omalu B, Courcoulas A et al. Risk of suicide after long - term follow - up from bariatric surgery. Am J Med 2010; 123: 1036–42.][Sarwer D, Cohn N, Gibbons L et al. Psychiatric diagnoses and psychiatric treatment among bariatric surgery candidates. Obes Surg 2004; 14: 1148–56.][Van Hout G, Verschure S, Van Heck G. Psychosocial predictors of success following bariatric surgery. Obes Surg 2005; 15 (4): 552–60.][Wadden T, Sarwer D. Behavioral Assessment of Candidates for Bariatric Surgery: A Patient - Oriented Approach. Obesity 2006; 14 (Suppl.): 53S–62S.][AACE Diabetes Mellitus Clinical Practice Guidelines Task Force. American Association of Clinical Endocrinologists medical guideline for clinical management of diabetes mellitus. Endocr Pract 2004; 10: 112–8.][Dronge A, Percal H, Kancir S et al. Long - term glycemic control and postoperative infectious complications. Arch Surg 2006; 141: 375–80.][Geerts W, Pineo G, Heit J et al. Prevention of venous thromboembolism: the seventh ACCP conference of antithrombotic and thrombolytic therapy. Chest 2004; 126 (Suppl. 3): 338S–400S.][Yang C, Lee W, Wang H et al. The influence of Helicobacter pylori infection on the development of gastric ulcer in symptomatic patients after bariatric surgery. Obes Surg 2006; 16: 735–9.][De Witt L, Mathus-Vliegen L, Hey C et al. Open versus laparoscopic adjustable silicone gastric banding: a prospective randomized trial for treatment morbid obesity. Ann Surg 1999; 230: 800–7.][Lujan J, Frutos M, Hernandez O et al. Laparoscopic versus open gastric bypass in the treatment of morbid obesity: a randomized prospective study. Ann Surg 2004; 239: 433–7.][Kim W, Gagner H, Kini S et al. Laparoscopic vs. open biliopancreatic diversion with duodenal switch. Gastrointest Surg 2003; 7: 552–7.][Polk H, Christmas A. Prophylactic antibiotics in surgery and surgical wounds infections. Am Surg 2000; 66:105–11.][Mognol P, Vignes S, Chosidow P et al. Rhabdomyolysis after laparoscopic bariatric surgery. Obes Surg 2004; 14: 91–4.][De Freitas Carvalho D, Valezi A, de Brito E et al. Rhabdomyolysis after bariatric surgery. Obes Surg 2006; 16: 740–4.][Favretti A, O’Brien P, Dixon J. Patient management after LAP-BAND placement. Am J Surg 2002; 184: 385–415.][Dixon A, Dixon J, O’Brien P. Laparoscopic adjustable gastric banding induces prolonged satiety: a randomized blind crossover study. J Clin Endocrinol Metab 2005; 90: 813–9.][Brolin R, Robertson L, Kenler H. Weight loss and dietary intake after vertical banded gastroplasty and Roux - en - Y gastric bypass. Ann Surg 1994; 220: 782–90.][Stoker D. Management of the bariatric surgery patient. Endocrinol Meatb Clin North Am 2003; 32: 437–57.][Service G, Thompson G, Service F et al. Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric bypass surgery. N Engl J Med 2005; 353: 249–54.][Goldfine A, Mun E, Devine E et al. Patients with neuroglycopenia after gastric bypass surgery have exaggerated incretin and insulin responses to a mixed meal. J Clin Endocrinol Metab 2007; 92: 4678–85.][Brolin R, Kenler H, Wilson A et al. Serum lipids after gastric bypass surgery for morbid obesity. Int J Obes 1990; 14: 939–50.][Brolin R, Bradely L, Wilson A et al. Lipid risk profile and weight stability after gastric restrictive operations for morbid obesity. J Gastroenterol Surg 2000; 4: 464–9.][Martin L, Finigan K, Nolan T. Pregnancy after adjustable gastric banding. Obstetr Gynecol 2000; 95 (6, pt. 1): 927–30.][Gerrits E, Ceulemans R, Van Hee R et al. Contraceptive treatment after biliopancreatic diversion needs consensus. Obes Surg 2001; 11: 303–6.][Endocrine and Nutritional Management of the Post - Bariatric Surgery Patient: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2010; 95: 4823–43.][Aasheim E, Hofso D, Hjelmesaeth J et al. Vitamin status in morbidly obese patients: a cross - sectional study. Am J Clin Nutr 2008; 87: 362–9.][Ybarra J, Sanchez-Hernandez J, Perez A. Hypovitaminosis D and morbid obesity. Nurs Clin North Am 2007; 42: 19–27.][Carlin A, Rao D, Meslemani A et al. Prevalence of vitamin D depletion among morbidly obese patients sеeking gastric bypass surgery. Surg Obes Relat Dis 2006; 2: 98–103.][Snijder M.B., Van Dam R.M., Visser M et al. Adiposity in relation to vitamin D status and parathyroid hormone levels: a population - based study in older men and women. J Clin Endocrinol Metab 2005; 90: 4119–23.][Hamoui N, Kim K, Anthone G, Crookes P.F. The significance of elevated levels of parathyroid hormone in patients with morbid obesity before and after bariatric surgery. Arch Surg 2003; 138: 891–7.][Hjelmesaeth J, Hofso D, Aasheim E et al. Parathyroid hormone, but not vitamin D, is associated with the metabolic syndrome in morbidly obese women and men: a cross - sectional study. Cardiovasc Diabetology 2009; 8: 7–13.][Goldner W, Stoner J, Lyden E et al. Finding the optimal dose of vitamin D following Roux - en - Y gastric bypass: a prospective randomized pilot clinical trial. Obes Surg 2009; 19 (2): 173–9.][Carlin A, Rao D, Yager K et al. Treatment of vitamin D depletion after Roux - en - Y gastric bypass: a randomized prospectiveclinical trial. Surg Obes Relat Dis 2009; 5 (4): 444–9.][Rosen C, Brown S. Severe hypocalcaemia after intravenous bisphosphonate therapy in occult vitamin D deficiency. N Engl J Med 2003; 348: 1503–4.][Collazo-Clavell M, Jimenez A, Hodson S et al. Osteomalacia after Roux - en - Y gastric bypass. Endocr Pract 2004; 10: 195–8.][Maricic M. New and emerging treatment for osteoporosis. Curr Opin Rheumatol 2007; 19: 364–9.][Brolin R, Leung M. Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. Obes Surg 1999; 9: 150–4.][Skroubis G, Sakellapoulos G, Pouggouras K et al. Comparison of nutritional deficiencies after Roux - en - Y gastric bypass and after biliopancreatic diversion with Roux - en - Y gastric bypass. Obes Surg 2002; 12: 551–8.][Gasteyger C, Suter H, Gaillard R et al. Nutritional deficiencies after Roux - en - Y gastric bypass for morbid obesity often cannot be prevented by standart multivitamin supplementation. Am J Clin Nutr 2008; 87: 1128–33.][Brolin R, Gorman J, Gorman R et al. Prophylactic iron supplementation after Roux - en - Y gastric bypass: a prospective, double - blind, randomized study. Arch Surg 1998; 133: 740–4.][Rhode B, Arseneau P, Cooper B еt al. Vitamin B-12 deficiency after gastric surgery for obesity. Am J Clin Nutr 1996; 63: 103–9.]