The definition of
malnutrition in the published standards of the American Society of Parenteral and
Enteral Nutrition (A.S.P.E.N.) is any derangement in the normal nutrition status and includes
overnutrition, commonly referred to as
obesity. The incidence of
obesity is increasing and reaching epidemic proportions in the United States and even worldwide. This has significant financial impact as our society spends billions of dollars on
fad diets, commercial weight-loss programs, nutrition and dietary supplements, prescription and over-the-counter medications, and health clubs. Another approximately dollars 100 billion are spent to treat the medical consequences of
obesity. Currently, for those patients with intractable
morbid obesity, defined as having a body mass index >40 kg/m2, surgery offers the only option for achieving meaningful and sustainable
weight loss. The resultant
weight loss dramatically improves health and decreases the cost of health care for these patients. Years of refinement in technology and the introduction of safer and less invasive procedures have dramatically reduced the short-term morbidities and long-term metabolic consequences of these procedures. This address will review the field of
weight loss (
bariatric) surgery and will offer a compelling request for A.S.P.E.N. to include
obesity in its fabric.