Bariatrics, Metabolic Dysfunction and the Surgeon

Abstract

Life expectancy has increased over the course of the preceding century. The phenomenon of epidemiological transition reflects the fact that there has been a shift in the major causes of death and disability from communicable, maternal and perinatal causes to chronic, non- communicable ones. The nutritional transition is being witnessed today on a global scale. As a country develops and more people buy processed food rather than growing and buying raw ingredients, an increasing proportion of calories tend to be drawn from sugars added to manufacture food and from relatively cheap oils. Alongside the change in diet, changes in food products and the technology of work and leisure lead to decreases in physical exercise. The consequent epidemic of diet related non-communicable diseases (obesity, diabetes, hypertension and CVD) co-exists with residual under nutrition and is projected to increase rapidly. For example, in India and China a shift in diet towards higher fat and lower carbohydrate is resulting in rapid increases in overweight among all adults in China and mainly among urban residents and high income rural residents in India. Countries which have completed the transition to over nutrition are experiencing a continual increase in levels of obesity, as high fat, high sugar diet and low exercise permeate society.