Despite phenomenal growth in the use of bariatric surgical procedures,
research on these interventions continues to be reported primarily through
the case series of experienced practitioners1 and
has focused only on selected outcomes. As a result, there is a gap between
the proliferation of these procedures and the evidence base needed to understand
key components of their use. This gap includes an assessment of the effectiveness
of bariatric surgery in the population at-large, the total impact of bariatric
surgery on patients and the health care system, identification of which patients
are best suited for which procedures, and the physiological mechanisms that
promote weight loss after surgery. Understanding the circumstances that have
limited research in bariatric surgery should help direct future investigators
to the challenges that need to be addressed when studying this important and
increasingly performed group of procedures.
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