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This thesis examines the surgical treatment of obesity from the perspective of the patient. The theoretical portion deals with etiopathogenesis, diagnosis, complications, related illnesses, conservative and surgical treatments (definitions, overview and types, principles of basic bariatric approaches, as well as effects and indications, side effects, and results of treatment. It also includes the specifics of the pre-operative preparation, immediate and long- term post-operative care, psychological preparation and post-bariatric-surgery nutrition. The empirical portion consists of quantitative research in the form of a survey instrument with closed-end questions with the possibility of individual responses. The respondents were patients who had been diagnosed as morbidly obese or third-degree obesity and who had also been through surgery within the past three years. One hundred and fifty surveys were distributed, 125 were returned, and 10 of those were not used for incompleteness, and another 6 were not used because the respondents did not meet the criteria. One of the primary goals of the research was to ascertain the information that patients were missing before bariatric surgery and whether this information had a significant effect on the result of the bariatric approach. Another primary goal of...

1) INTRODUCTION: Obesity is a global problem and its the prevalence is constantly rising. Overweight and obesity are key risk factors for many diseases. Obese patients are a greater economic burden for the state, they often rely on the help of others. The goal of obesity treatment is to reduce weight and then keep it within the recommended range. In an obese patient, it is not always just about the actual weight loss, but also about treating the associated diseases caused by obesity. Bariatric surgery allows patients to lose weight in a relatively short period of time and has a very positive effect on associated diseases. 2) OBJECTIVE: The aim of this diploma thesis was to evaluate the physical and mental condition before and after gastric bypass and to determine whether this surgery has a positive or negative effect on the physical and mental condition of the patient. The objective was further divided into sub-goals and hypotheses. 3) METHODOLOGY: The research was carried out using a quantitative method. This is an observational study, in which the mental and physical condition and advancement of patients who were about to undergo bariatric surgery - gastric bypass - were monitored for 6 months. Mental status was monitored using four standardized questionnaires: MAF, HADS, iADL, SF-36 in four time...

INTRODUCTION TO THE ISSUE: Obesity together with possible occurrence of many difficulties carries with it negative effect on physical and mental health. Many patients with severe obesity (class 3) cannot do physical activities or usual daily activities. These patients suffer from feelings of inferiority, decreased self-esteem and other mental issues. It could be classified as a vicious cycle for patients, but the bariatric surgery offers a way out. A gastric bypass is one of the bariatric procedures which is very helpful to reduce the weight of the patients who belongs into class 3 obesity. OBJECTIVES, METHODOLOGY: The main goal of this study was to find out if applying the gastric bypass to patients has positive or negative effect for their obesity level, quality of life, physical and mental state. The research sample was consisted of patients who were about to undergo gastric bypass. The patient's weight, BMI and body fat ratio were monitored to obtain data related to the assessment of the severity of obesity. The quality of life was evaluated using the SF-36 questionnaire (Short form 36). The standardized MAF (Multidimensional Assessment of Fatigue Scale) was used to review of patient's fatigue. The mental state of patients was subjectively assessed using the standardized HADS scale (Hospital...

Les chirurgies de type by-pass induisent des améliorations spectaculaires de l'homéostasie glucidique indépendamment de la perte de poids chez les patients obèses et diabétiques. Elles provoquent également une diminution de la préférence pour les aliments hypercaloriques. Un mécanisme proposé pour expliquer les effets sur le contrôle glucidique de ces procédures associe une diminution de la production hépatique de glucose et une augmentation de la néoglucogenèse intestinale. Les acides biliaires, décrits comme inhibiteurs de la néoglucogenèse, voient leur biodisponibilité modifiée après ces chirurgies. Ils sont en effet absents de l'anse alimentaire tandis que leur concentration est augmentée dans le sang. Nous avons donc testé l'hypothèse selon laquelle les acides biliaires plasmatiques inhiberaient la production hépatique de glucose alors que leur absence dans l'intestin induirait la néoglucogenèse intestinale. Pour cela, nous avons réalisé des dérivations biliaires chez le rat visant à reproduire le trajet de la bile dans les chirurgies de type by-pass. Nous avons montré que les dérivations biliaires entrainent une augmentation du taux circulant d'acides biliaires. Les dérivations provoquent une forte diminution de la production hépatique de glucose et une induction de la néoglucogenèse dans les portions d'intestin dépourvus de bile. Par ailleurs, la seule modification du trajet de la bile promeut une amélioration du contrôle glucidique et une diminution de l'appétence pour les aliments riches en graisse et en sucre. Ces données nous ont donc permis d'attribuer un rôle clé à la modification du trajet de la bile dans les effets bénéfiques des chirurgies de type by-pass / Gastric bypass procedures have emerged as an effective treatment for morbid obese diabetic patientssince they provoke a rapid remission of diabetes before any weight loss has occurred. Patients also report adisinterest in high calorie food. A suggested mechanism associated a decrease in hepatic glucose production toan enhanced intestinal gluconeogenesis. Bile acids, described as inhibitors of gluconeogenesis, see theirbioavailability changed after these procedures. Indeed, they are absent in the alimentary limb while theirplasmatic concentration is increased. We therefore tested the hypothesis that plasma bile acids may inhibithepatic glucose production while their absence in the gut could induce intestinal gluconeogenesis.For this, we performed bile diversions matching the modified biliary flow occurring after gastric bypassprocedures. We showed that bile diversions lead to an increase in plasma bile acids. Bile diversions promote ablunting in hepatic glucose production whereas intestinal gluconeogenesis is increased in gut segments devoidof bile. Moreover, the modification of bile routing per se improves glucose control and dramatically decreasefood intake due to an acquired disinterest in fatty food. This data shows that bile routing modification is a keymechanistic feature in the beneficial outcomes of gastric bypass procedures