We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Contempo Updates |

Bariatric Surgery and Long-term Control of Morbid Obesity

Robert E. Brolin, MD
JAMA. 2002;288(22):2793-2796. doi:10.1001/jama.288.22.2793.
Text Size: A A A
Published online


Obesity, defined as 20% or more than the ideal weight or body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) of 30 or more, has reached epidemic levels in the United States, affecting more than 30% of adults.1 Annual direct costs for treating obesity-related medical illnesses have been estimated at nearly $51.6 billion; the annual US expenditure on weight reduction exceeds $30 billion.2,3 It was recently estimated that the prevalence of obesity in US adults increased by 8% during the past decade. In the 21st century, obesity may be the number 1 US public health problem (http://www.surgeongeneral.gov/topics/obesity/).

Figures in this Article


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Figure. Bariatric Surgery Techniques
Graphic Jump Location
A, Vertical-banded gastroplasty. A 15 to 20 mL upper gastric pouch empties into the remainder of the stomach through a calibrated stoma. C, Roux-en-Y gastric bypass. A stapler fired across the cardia of the stomach creates a 20 to 30 mL pouch. The jejunum is divided distal to the ligament of Treitz with the distal end anastomosed to the upper stomach. D, Biliopancreatic diversion with duodenal switch. A sleeve resection of the greater curvature of the stomach is performed. The first portion of the duodenum is divided and the proximal duodenum and approximately half of the length of the small intestine (biliopancreatic limb) is excluded from digestive continuity. The small bowel is divided approximately 300 cm above the ileocecal junction, and the distal end is anastomosed to the first portion of the duodenum (alimentary limb). The distal end of the biliopancreatic limb is anastomosed to the ileum 50 to 100 cm proximal to the ileocecal junction.



Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

257 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.