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This lecture is about basic concepts in obesity. The prevalence of obesity in the USA has increased from 30.5% to 42.4% since 2000, and it is projected to reach 85% by 2030.
Obesity is a multifactorial disease: e.g. genes give the body instructions to respond to changes in its environment and in some cases predispose to obesity. Gene modification is a long-term process but epigenetics may have a more direct and faster impact.
There are multiple risk factors that contribute to obesity development, and obesity increases the risk of various pathologies such as type 2 diabetes, dyslipidemia, sleep apnea, non-alcoholic fatty, and hypoventilation syndrome.
Surgical treatment of obesity, when weight loss is achieved, has an impact on obesity-related comorbidities. Sleeve gastrectomy and Roux en Y Gastric Bypass (RYGB) are the most common bariatric procedures, which act through different mechanisms in comorbidities resolution.
RYGB is more effective in producing resolution and remission of type II diabetes mellitus, particularly in patients at high risk for relapse. RYGB and sleeve gastrectomy are similar in their reduction of other obesity-related comorbid conditions with the exception of gastroesophageal reflux disease.
Finally, in conclusion, we ultimately need to change the environmental stressors that influence epigenetic markers.
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