Since morbid obesity is known as a major cause of psychosocial problems beside its common adverse effects like cardiovascular and metabolic diseases, a lot of researches have been performed to find an effective treatment including surgery. Surgical methods were improved by invention of minimal invasive surgeries. Laparascopic Sleeve Gastrectomy (LSG) and Laparascopic Adjustable Gastric Banding (LAGB) are the methods which have become common in most of developed countries.

Due to cultural, economic and social differences between our country and developed countries, we have designed this research to compare the efficacy and complication of these two methods six months after operation in hospitals affiliated to Shiraz University of Medical Sciences.

Documents of patients operated with one of these two methods were reviewed, and necessary information was inserted in prepared forms. We called patients if further information was needed. Then this data was analyzed with Chi Square 2Sample Independent T- test and Paired T Test by SPSS 16 software.

Seventy patients were operated with LSG and 25 with LAGB. The Mean weight of LSG group was 120.73 and 120 for LAGB. The Mean weight loss in LSG was 29.99 and 19.60 in LAGB. There was no statistically significant difference regarding early complications between the two methods; although, long term complications such as gastric stenosis and band displacement were statistically more in LAGB.

It seems that both LSG and LAGB are efficient in weight loss but LSG can lead to more weight loss, better correction of blood pressure and less long term complications.

AGB (adjastable gastric bandin) is the most common method for treatment of obesity which is performed all around the world and provides a significant weight loss for patients. Despite all its benefits as a method that requires the least intervention, complications such as gastric prolapse, stoma stenosis and migration band may also occur. These complications rarely result in mortality, but usually the only treatment for them is surgery.

We report a rare complication of this procedure which had caused small intestine obstruction.

Small intestine obstruction caused by band migration is a very rare complication and must be considered as a differential diagnosis in patients with small intestine obstruction symptoms. Therefore correct surgical methods must be adopted for its treatment so that it may not let the surgeon get misled during the operation and let him do the treatment correctly.

Considering the importance of providing vitamins and minerals in body health, it obviously seems to be necessary to assess the deficiencies of these nutrients in obese patients.

The present study aimed to evaluate the level of hemoglobin, ferritin, and vitamin B12 in a sample of Iranian population with morbid obesity.

This cross-sectional study was conducted on 1252 consecutive patients with morbid obesity referred to obesity clinic at Rasoul-e-Akram hospital from 2009 to 2015 in Tehran, IR Iran. Morbid obesity was defined as body mass index (BMI) equal to or higher than 40 kg/m². Serum hemoglobin level (gr/dL) was measured using the cyan methemoglobin method. Serum ferritin level (ng/mL) can be measured by the human ferritin enzyme immunoassay test. Also, serum vitamin B12 concentration (pg/mL) was measured using the solid-phase, competitive chemiluminescent enzyme immunoassay method.

Overall, 1252 patients with morbid obesity were included in the study. The mean age of participants was 39.77 ± 10.84 years (ranged 10 to 70 years) and 80.3% of them were female. The mean body weight was 126.75 ± 21.58 kg and the mean BMI was also 46.99 ± 5.87 kg/m². In result, 9.8% were anemic according to the low value of hemoglobin level, 46.6% had ferritin lower than the normal range and the average serum level of vitamin B12 was lower than the normal value in 21.1%. By applying the Pearson’s correlation test, a positive association was found between BMI value and the level of hemoglobin (r = 0.074, P = 0.009).

Morbid obesity may result in two important hematologic and metabolic changes including increased hemoglobin level and reduced vitamin B12 level. Since, vitamin B12 has vital role in the body, providing adequate vitamin B12 is essential in these patients even by using vitamin supplements. Also, regular screening of the level of hematologic markers in these patients is strongly recommended.

Obesity, a major risk factor for fatty liver disease, is increasing worldwide. Morbid obese patients have a higher prevalence of fatty liver disease in addition to more severe complications, and high prevalence of abnormal liver function tests (LFTs). The aim of this study is to determine the pattern of LFT and liver ultrasonography of morbid obese Iranian patients undergoing bariatric surgery.

The study population included 308 morbid obese patients who were candidates for Laparoscopic Roux-en-Y Gastric Bypass surgery. Body mass index (BMI), age, gender, weight, height, blood tests including alanine transaminase (ALT), aspartate transaminase (AST), direct bilirubin (Bil D), total bilirubin (Bil T), and liver ultrasound reports were recorded for all of the patients. Patients with alcohol intake or hepatitis or human immunodeficiency virus (HIV) were excluded from the study. The data were entered and analyzed using SPSS-16. The chi-square, ANOVA and Independent-sample t- test used in the study analysis.

Data analyses showed that alkaline phosphatase (ALKP) is the most elevated serum enzyme in morbid obese patients 26 (87.6%). ALT, AST, bilirubin total and bilirubin direct were more than upper normal range in 70 (24.1%), 80 (26%), 2 (1.5%) and 15 (11.4%) in all patients, respectively. Ultrasonography of the liver showed that fatty liver disease occurred in approximately 280 (91%) of our patients. In our study, the only liver enzyme that had significant difference with fatty liver and normal groups was AST (P: 0.027). The patients were divided into three groups on the basis of the BMI: BMI of 35 - 40 kg/m², 40 - 50 kg/m², and above 50 kg/m². There is not any significant difference between the mean of ALKP, ALT, AST, bilirubin (direct and total) serum level and fatty liver in these three groups.

The prevalence of abnormal LFTs in Iranian morbid obese patients is in high status especially the level of ALKP. Liver ultrasonography has high sensitivity for the fatty liver in morbid obese patients but LFTs rise only in few patients with fatty liver.

Klinefelter syndrome is a disorder of chromosomes in which common karyotype is (47XXY). Hypogonadism, gynecomastia and azoospermia could be detected in this syndrome. Decreased basal metabolic rate and interest in activities, loss of muscle mass, weight gain, the deficiency of sex hormone and mood changes cause obesity which cause morb obese in this case.

A 34-year-old morbid obese (BMI = 60.40) male was come to the Laporoscopy research center of Iran University of Medical science at 26 January 2016. He was diagnosed as Klinefelter syndrome by genetic testing (47XXY karyotype). He reported suffering from knee cellulitis, headache, low back pain and varices. His nutrition habits was fast eating, Sweet eating and Snack eating. The beginning of his obesity was in his childhood. The best treatment for his obesity and its side-effects is altering in his life style, low calorie diet. Finally, if these methodes fail to lose weigth, bariatric surgery is suggested.

In morbid obese patients apporopriate diet, change in calorie intake and life style should be considered as a first line of treatment and finally, surgery may be an option to treat obesity. These two methodes can often help reduce the risk of other diseases (e.g., diabetes, heart disease, and sleep apnea) that are associated with severe obesity.

After cessation of smoking, the best way to prevent health-threatening conditions is to treatment of obesity. Also, obesity treatment, cause alleviation or cure of other diseases. Bariatric surgery in selected obese patients is the best option for preventing health-threatening conditions. Despite the health benefits, this method of treatment -just like other surgical procedures- may be associated with various side effects.

A 55-year-old female with BMI of 46.5 underwent laparoscopic Omega Gastric bypass surgery. She was admitted due to dyspnea and pulmonary embolism 14 days later. In conducted surveys, platelet count was less than 25,000. In multiple assessments, no cause found for the thrombocytopenia. Corticosteroids prescribed for her with the diagnosis of ITP; which fully responded to treatment.

Thrombocytopenia is a rare complication of gastric bypass surgery. Managements include rule out of other causes of thrombocytopenia and medical treatment.

Migraine is a common and chronic neuro-inflammatory disease with progressive and episodic headache manifestation that leads to considerable disability. Many studies recognized that obesity is a risk factor for progression of migraine. Furthermore, both migraine and obesity is highly prevalent and important risk factors of chronic cardiovascular disease, stroke, and other inflammatory disease. Thus, it is very important if weight loss could alleviate the migraine headache and its related comorbidities.

The present review article was conducted to assess the potential effect of Bariatric surgery on improvement of migraine headaches in morbid obese patients.

Scopus, PubMed and web of science electronic database were systematically searched with key words of “Bariatric surgery”, “gastric Bypass”; “Morbid Obesity” and “Migraine headache” for interventional studies investigated the impact of Bariatric surgery on migraine headache.

The findings suggest significant improvement in headache frequency, duration, migraine-induced discomfort and migraine derived symptoms (nausea, phono and photophobia and) occurs as early as 3 months after bariatric surgery. Moreover, patients who had higher weight loss were more likely to experience a 50% or higher reduction in headache frequency, duration and severity.

The entire evidences suggest patients with indications of bariatric surgery will benefit from the improvements in the Migraine headache after surgery. However, it remains unclear whether Bariatric-induced endocrine, gut-brain axis alterations, or reduction in adipokine contribute to migraine improvement, so further studies are needed to confirm and clarify these findings.

Obesity is widely considered as an important risk factor for impaired physical function and disability. Even mild to moderate weight loss has been shown to improve physical function. This study aimed to evaluate the effect of Roux-en-y gastric bypass (RYGB) surgery on some fitness parameters in women with morbid obesity.

Seventy two women with morbid obesity body were included in this study. They were followed for six months after RYGB surgery. Some fitness parameters including body composition (using bioelectrical impedance), muscular strength (leg press in lower limb and hand power grip in upper limb) and six minute walk test (6MWT) were evaluated before surgery and that at intervals of 1, 3 and 6 months after surgery. One way repeated measure ANOVA was applied to determine the data changes during the follow up period.

BMI and body weight of all samples declined constantly during 6 months follow up after surgery. Also, by the end of the study, the body fat percent decreased from 48.2 (3) to 36.4 (4) (P < 0.05). The distance which patients paced in 6MWT increased 22% during 6 months follow up (P < 0.0001). Although handgrip and leg press of the participants decreased following the gastric bypass surgery, the power grip/weight ratio and leg press /weight ratio improved significantly through the study (P < 0.0001).

RYGB surgery may positively affect fitness parameters in morbid obese women. The endurance capacity, body composition and even muscle strength seem to be enhanced after gastric bypass surgery.