Análise do impacto da cirurgia bariátrica em uma população do centro do estado do Rio Grande do Sul utilizando o método BAROS

Effects of Roux-en-Y gastric bypass on the metabolic profile and systemic inflammatory status of women with metabolic syndrome: randomized controlled clinical trial

BACKGROUND

Obesity remains a public health problem worldwide. The high prevalence of this condition in the population raises further concerns, considering that comorbidities are often associated with obesity. Among the comorbidities closely associated with obesity, metabolic syndrome (MS) is particularly important, which potentially increases the risk of manifestation of other disorders, such as the prothrombotic and systemic pro-inflammatory states.

METHODS

A randomized, controlled clinical trial was performed involving female patients (n = 32) aged between 18 and 65 years, with a clinical diagnosis of MS, with severe obesity undergoing Roux-en-Y gastric bypass (RYGB). The study design followed the Consolidated Standards of Reporting Trials statement (CONSORT). Lipid profile, blood glucose and adipokines (adiponectin, leptin, and resistin) and (cytokines IL-1β, IL-6, IL-17, IL-23, and TNF-α) in blood plasma samples were evaluated before and six months after RYGB.

RESULTS

Patients undergoing RYGB (BSG) showed a significant improvement from preoperative grade III obesity to postoperative grade I obesity. The results showed that while HDL levels increased, the other parameters showed a significant reduction in their postoperative values when compared not only to the values observed before surgery in the BSG group, but also to the values obtained in the control group (CG). As for systemic inflammatory markers adiponectin, leptin, resistin, IL-1β, IL-6, IL-17, IL-23 and TNF- α it was observed that the levels of resistin and IL-17 in the second evaluation increased significantly when compared to the levels observed in the first evaluation in the CG. In the BSG group, while the levels of adiponectin increased, the levels of the other markers showed significant reductions in the postoperative period, in relation to the respective preoperative levels. The analysis of Spearman's correlation coefficient showed a significant positive correlation between IL-17 and IL-23 in the preoperative period, significant positive correlations between TNF-α and IL-6, TNF-α and IL-17, IL-6 and IL-17, and IL-17 and IL-23 were observed postoperatively.

CONCLUSIONS

According to our results, the reduction of anthropometric measurements induced by RYGB, significantly improves not only the plasma biochemical parameters (lipid profile and glycemia), but also the systemic inflammatory status of severely obese patients with MS. Trials registration NCT02409160.

Polysonographic changes in obese patients with indication of bariatric surgery

INTRODUCTION

obstructive Sleep Apnea Syndrome (OSAS) is a serious confition that compromises the quality of life and survival of patients. Its main risk fator in adults is obesity and the gold standard test for diagnosis is polysomnography (PSG), mainly through the apneia-hypopnea index (AHI). Objective: to analyze the sleep pattern of obese patients with indication for bariatric surgery, determining the main polisomnographic parameters compromised by obesity.

METHODS

This work is a cross-sectional study with analysis of polysomnography perfomed in patients with obesity in the peroperative period of bariatric surgery at a clinic in Vitória da Conquista/BA during 2017. The Epi Info 7 platform was used for analysis of the data.

RESULTS

58 polysomnographic reports were analyzed, with 56,9% morbdly obese and 43,1% non-morbid. The prevalence of OSAS was 70,68% and de AHI ranged from zero to 84,6 with a mean of 19,47±22,89 e/h. morbidly obese, compared to "non-morbid", had a longer saturation time below 80% and 90% (0,4±0,93 vs. 0,12±0,45 e 4,87±7,38 vs. 1,36±2,87 respectively; p-value=0,02 in both), worse index respiratory disorders ((29,24±25,36 vs. 16,88±16,21; p-value=0,02), higher AHI (24,71±25,68 vs. 12,56±16,67; p-value=0,02), higher hypopnea index values (16,41±17,10 vs. 6,99±8,52; p-value=0,006) and lower minimum saturation (78,24±9,80 vs. 85,24±6,33; p-value=0,004).

CONCLUSIONS

the high prevalence of OSAS found confirms its indication in the preoperative period of bariatric surgery. The main respiratory event involved in most individuals with OSAS was the hypopnea index.

Improvement in Food Intolerance Resulting from Roux-En-Y Gastric Bypass after Speech Therapy Intervention in Chewing

INTRODUCTION

Food intolerance is expected during the postoperative period following gastric bypass and may be associated with inadequate chewing.

OBJECTIVE

To evaluate chewing before and after speech therapy intervention in subjects undergoing Roux-en-Y gastric bypass who present with food intolerance.

MATERIALS AND METHODS

This was a randomized controlled trial, approved by the Brazilian Ethics and Research Committee under n. 438,600. The study population was allocated into two groups: the study group (SG), who received speech therapy intervention, and the control group (CG), who did not receive any intervention, in six visits at 7, 15, 30, 60, and 90 days (v7, v15, v30, v60, and v90) after the initial visit (v0). During v0 and v90, a chewing evaluation was performed according to the MBGR protocol adapted. The significance level adopted was 5%.

RESULTS

A total of 30 females (88%) and 4 males (12%) were analyzed. The SG had 18 subjects, and the CG had 16, with mean ages of 50.17 ± 12.28 years and 45.69 ± 9.78 years, respectively. The postoperative time ranged from 4 to19 months. In the SG, a marked improvement in the number of episodes of food intolerance was observed (p < 0.001), an improvement in the intake of cereals and meats (p = 0.004 and p < 0.001, respectively), and an improvement in chewing capacity and swallowing (p = 0.002 and p = 0.011, respectively).

CONCLUSION

Speech therapy intervention in chewing led to a marked improvement of food acceptance and food intolerance resulting from Roux-en-Y gastric bypass.

Evaluation of quality of life, weight loss and comorbidities of patients undergoing bariatric surgery

OBJECTIVE

to assess the efficacy of weight loss, the evolution of comorbidities, the quality of life and the BAROS protocol (Bariatric Analysis and Reporting Outcome System) in the postoperative period of patients undergoing bariatric surgery.

METHODS

we conducted a cross-sectional, quantitative study with 95% true strength (P=0.05), with 103 patients submitted to SLEEVE Vertical Gastrectomy (40) and Roux-en-Y Gastric Bypass (63), from four months after surgery. We carried out the research at the Ambulatory of General Surgery of the Clinics Hospital of the Federal University of Pernambuco, using the BAROS protocol.

RESULTS

the majority of the patients were female (89.3%). The mean age was 44.23 years. The mean percentage loss of excess weight was 69.35%. The mean postoperative follow-up time was 41.87 months (±37.35). The comorbidities with the highest percentage of resolution were sleep apnea (90.2%), diabetes (80.7%) and hypertension (70.8%). The most frequent complications were hair loss (79.6%), nutritional deficiency (37.9%) and anemia (35%). The BAROS protocol demonstrated that patients positively evaluated quality of life in 93.2% of the cases. The Moorehead-Ardelt questionnaire showed that quality of life "improved" or "improved greatly" for 94.1% of patients.

CONCLUSION

bariatric surgery has been shown to be an effective procedure in the treatment of morbid obesity and in the control of comorbidities. Quality of life analysis was evaluated positively through the BAROS protocol.

THE ALCOHOL CONSUMPTION IS AMENDED AFTER BARIATRIC SURGERY? AN INTEGRATIVE REVIEW

BACKGROUND

Bariatric surgery has been an alternative when conservative methods of weight loss fail. Patients undergoing bariatric surgery have an increased risk of up to 6.5% of problems related to alcohol.

OBJETIVE

To review the literature about the changes on alcohol consumption in this public.

METHOD

Database was accessed from June of 2015 to January of 2016 by searching "bariatric surgery" AND "alcoholism", and their Portuguese equivalents. Science Direct, PubMed, Lilacs and Medline, besides manual search, were searched. To be included, the paper should have been published between 2005-2016 and related to bariatric surgery and alcoholism. Theses, dissertations, unpublished papers, case reports and theoretical studies were excluded. In 2005 there was only one review of change in alcohol metabolism in patients undergoing bariatric surgery. There were no publications in 2006. In 2007, only one study was published, and it did not meet the inclusion criteria. In 2010, there was an increase of 13% in publications and of 20% in 2012, reaching 40% in 2013.

CONCLUSION

The prevalence and incidence of alcohol consumption in relation to the postoperative time was six months to three years with higher incidence in men. Roux-en-Y gastric bypass showed greater association with increased alcohol consumption during the postoperative period. This and other studies showed that the pattern of alcohol consumption is important to be faced as a problem in bariatric surgery follow-up.

Analysis of obese patients' medical conditions in the pre and postoperative periods of bariatric surgery

Objective

to compare the clinical conditions of obese patients in the pre and postoperative period of bariatric surgery.

Methods

we carried out a descriptive, retrospective, quantitative study by consulting the charts of 134 patients who underwent bariatric surgery in the period from 2009 to 2014. We collected the data between September and November 2015. We performed a descriptive statistical analysis and comparative analysis of anthropometric, metabolic, biochemical and clinical variables, considering six months before and after surgery.

Results

the majority of the patients were female (91.8%), with a higher prevalence (35%) in the age group 18-29 years old, complete high-school education (65.6%) and grade III obesity (60.4%). Six months after surgery, weight and lipid profile reduction were significant in both genders, but the impact on biochemical, anthropometric, metabolic and clinical parameters was significant only in female subjects, with a reduction in morbidities associated with obesity, such as arterial hypertension, diabetes mellitus, dyslipidemia and metabolic syndrome and in the use of drugs to control them.

Conclusion

bariatric surgery was effective in weight loss, with improvements in anthropometric, metabolic and biochemical parameters and in the reduction of morbidities associated with obesity.

Resting Energy Expenditure and Body Composition of Women with Weight Regain 24 Months After Bariatric Surgery

BACKGROUND

Weight regain 24 months after Roux-en-Y gastric bypass (RYGB) and low protein intake in patients without protein supplementation can favor fat-free mass loss and reduce resting energy expenditure (REE). We aimed to assess REE and its association with the body composition of women with weight regain and no protein supplementation in the late postoperative period of RYGB.

METHODS

We determined the body mass index (BMI), REE by indirect calorimetry, body composition by tetrapolar bioelectrical impedance analysis, and energy intake by two 24-h recalls of 34 patients with at least 5 % of weight regain and no protein supplementation. The software SPSS v.17 analyzed the data calculating measures of central tendency and dispersion and using Pearson's correlation to test the association between the variables and the multivariate linear regression model at a p < 0.05 significance level.

RESULTS

Postoperative period was positively associated with weight regain (r = 0.39; p = 0.023). The mean percentages of fat and fat-free masses were 45.1 ± 8.3 % and 54.3 ± 8.1 %, respectively. The mean REE was 1424.7 ± 187.2 kcal (14 kcal/kg of the current weight), mean energy intake was 1258.6 ± 454.3 kcal, and mean protein intake was 0.9 g/kg of the ideal weight ± 0.3. Fat-free mass was positively associated with REE regardless of protein intake and postoperative period.

CONCLUSIONS

Female bariatric patients with weight regain and no protein supplementation lose fat-free mass, lowering their REE. Health practices that promote maintenance of BMI and body composition may lead to improved outcomes of bariatric surgery.

Gastric and jejunal histopathological changes in patients undergoing bariatric surgery

BACKGROUND

- Morbid obesity is a multifactorial disease that is increasingly treated by surgery.

OBJECTIVE

- To evaluate gastric histopathological changes in obese, and to compare with patients who underwent gastrojejunal bypass and the jejunal mucosa after the surgery.

METHODS

- This is an observational study performed at a tertiary public hospital, evaluating endoscopic biopsies from 36 preoperative patients and 35 postoperative.

RESULTS

- In the preoperative group, 80.6% had chronic gastritis, which was active in 38.9% (77.1% and 20.1%, respectively, in the postoperative). The postoperative group had a significant reduction in Helicobacter pylori infection (P=0.0001). A longer length of the gastric stump and a time since surgery of more than two years were associated with Helicobacter pylori infection. The jejunal mucosa was normal in 91.4% and showed slight nonspecific chronic inflammation in 8.6%.

CONCLUSION

- There was a reduction in the incidence of Helicobacter pylori infection in the postoperative group. A longer length of the gastric stump and longer time elapsed since surgery were associated with Helicobacter pylori infection. The jejunal mucosa was considered normal in an absolute majority of patients.

GASTRIC AND JEJUNAL HISTOPATHOLOGICAL CHANGES IN PATIENTS UNDERGOING BARIATRIC SURGERY

Background:

Morbid obesity is a multifactorial disease that increasingly is being treated by surgery.

Aim:

To evaluate gastric histopathological changes in obese, and to compare with patients who underwent gastrojejunal bypass and the jejunal mucosa after the surgery.

Methods:

This is an observational study performed at a tertiary public hospital, evaluating endoscopic biopsies from 36 preoperative patients and 35 postoperative.

Results:

In the preoperative group, 80.6% had chronic gastritis, which was active in 38.9% (77.1% and 20.1%, respectively, in the postoperative). The postoperative group had a significant reduction in H. pylori infection (p=0.0001). A longer length of the gastric stump and a time since surgery of more than two years were associated with Helicobacter pylori infection. The jejunal mucosa was normal in 91.4% and showed slight nonspecific chronic inflammation in 8.6%.

Conclusion:

There was a reduction in the incidence of Helicobacter pylori infection in the postoperative group. A longer length of the gastric stump and longer time elapsed since surgery were associated with Helicobacter pylori infection. The jejunal mucosa was considered normal in an absolute majority of patients.

THE ALCOHOL CONSUMPTION IS AMENDED AFTER BARIATRIC SURGERY? AN INTEGRATIVE REVIEW

Background

Bariatric surgery has been an alternative when conservative methods of weight loss fail. Patients undergoing bariatric surgery have an increased risk of up to 6.5% of problems related to alcohol

Objective:

Integrative review out to analyze the change of alcohol consumption in this public

Method:

Database was accessed from June of 2015 to January of 2016 by searching "bariatric surgery" AND "alcoholism", and their Portuguese equivalents. ScienceDirect, PubMed, Lilacs and Medline, besides manual search, were searched. To be included, the paper should have been published between 2005-2016 and related to bariatric surgery and alcoholism. Theses, dissertations, unpublished papers, case reports and theoretical studies were excluded, and a database was subsequently composed

Results:

In 2005 there was only a review of change in alcohol metabolism in patients undergoing bariatric surgery. There were no publications in 2006. In 2007, only one study was published, and it did not meet the inclusion criteria. In 2010, there was an increase of 13% in publications and of 20% in 2012, reaching 40% in 2013

Conclusion:

The prevalence and incidence of alcohol consumption in relation to the postoperative time was six months to three years with higher incidence for follow-up treatment by men. Roux-en-Y gastric bypass showed greater association with increased consumption of alcohol during the postoperative period. Alcohol consumption proved to be essential to be faced in bariatric surgery.

[Comparative study of the nutritional evolution of patients/candidates for bariatric surgery attended by the Unified Health System and the Supplemental Health Network]

A cross-sectional comparative study was conducted on the nutritional evolution of severely obese patients who are candidates for bariatric surgery attended by the Unified Health System (SUS) and the Supplemental Health Network (RS). The average preoperative follow-up period was 14.3 ± 7.7 months in the SUS and 2.4 ± 1.7 months in the RS. There was a predominance of females among patients attended by the SUS (80.6%) and by the RS (75.7%). A significant reduction in weight, BMI and waist circumference (WC) and total cholesterol values of patients of both health networks was observed. Patients attended by the SUS showed no significant decrease in LDL, Triglycerides and Fasting Glycemia, while patients assisted by the RS showed a significant reduction of these values. The greater weight loss among SUS patients is explained by the fact that they had been monitored for a longer period. The insignificant reduction of most biochemical indicators of SUS patients can be justified by the fact that they had a more advanced degree of obesity.

Nutritional status and life quality in patients undergoing bariatric surgery

Background

The obesity has achieved an alarming increase in recent years, which led this disease to global epidemic condition.

Aim

To evaluate the nutritional status as well as the quality of life of obese patients undergoing bariatric surgery.

Methods

A transversal study was conducted with obese adults of both genders who underwent bariatric surgery by Fobi-Capella technique for at least 30 days. It was evaluated: age, gender, marital status, occupation, weight before surgery, current weight, height, preoperative and current BMI, weight loss and loss of excess weight percentages, presence of clinical manifestations and food intolerances.

Results

The sample consisted of 70 patients, being 81.4% female, 37.1% aged 30 to 39 years, 58.6% were married, 41.4% have undergone the bariatric surgery in the last 12 months. It was observed a reduction in BMI from 37.2 kg/m² (one to three months) to 28.9 kg/m² (>12 months) and consequent increase in weight loss and loss of excess weight percentages. The most frequent clinical manifestation was alopecia (62.9%). The most reported food intolerance was on the red meat (24%). According to the Baros questionnaire, 50% of patients were classified as having good quality of life.

Conclusion

The operation of Fobi-Capella proved to be effective in promoting gradual and lasting weight loss. Quality of life was considered good in most patients, indicating that the operation had a positive impact on their lives.

Impact of Bariatric Surgery on Patients from Goiás, Brazil, Using the BAROS Method - A Preliminary Study

Introduction

As obesity is currently a major public health problem, bariatric surgery has been widely indicated due to the difficulties involved in the clinical management of obese adults.

Objectives

Assess the quality-of-life (QOL) of patients who had undergone Roux-en-Y Gastric Bypass (RYGB) in the State of Goiás, Brazil, where as yet no studies have been published on the QOL of patients who underwent bariatric surgery.

Methods

A retrospective study, using the Bariatric Analysis and Reporting Outcome System (BAROS), was carried out in Goiânia and Rio Verde, Goiás, Brazil, with 50 over 18-year-old patients of both genders, who had undergone RYGB and had at least three months of postoperative time.

Results

Before RYGB, 48% of the individuals were classified as morbidly obese. Average weight and body mass index (BMI) of the 50 patients interviewed were 119.37 ± 18.44 kg and 43.54 ± 5.33 kg/m², respectively. By contrast, after the RYGB these parameters decreased significantly to 78.01 ± 11.06 kg and 28.46 ± 3.61 kg/m², respectively, mainly from the 3rd to 85th month of postoperative time (p < 0.0001). As well as that, 78% reported having presented preoperative comorbidities, especially hypertension (44%), rheumatism (34%), dyslipidemia (24%) and diabetes (20%). However, after surgery, the resolution rates were 77, 24, 100 and 100%, respectively, for these same clinical conditions. In terms of QOL, some patients reported feeling better (8%) or much better (92%) after RYGB. The outcome of the BAROS method for those patients was classified as fair (2%), good (8%), very good (24%) and excellent (66%).

Conclusions

Preliminary results indicated that RYGB could be a successful surgical procedure to promote satisfactory and sustained reduction in the body measurements of morbidly obese patients from Goiás, Brazil. Furthermore, the final BAROS score showed improvements in associated comorbidity and also in the QOL of these patients.

Use of alcohol before and after bariatric surgery

OBJECTIVE: to assess alcohol intake in the bariatric surgery pre and postoperative periods. METHODS: Patients were interviewed atSurgery Clinic of the Hospital das Clínicas da Universidade Federal de Pernambuco - HC/UFPE (Brazil) from July 2011 to March 2012. We analyzed socioeconomic, anthropometric and clinical variables. We used the Alcohol Use Disorders Identification Test (AUDIT C). RESULTS: One hundred nineteen patients were enrolled (mean age: 41.23+11.30 years), with a predominance of the female gender (83.2%), non-Caucasian race (55%), married individuals or in a stable union (65.5%), with a high school education (40.3%)and active in the job market (37%). Weight and body mass index (BMI) were 128.77+25.28Kg and 49.09+9.26Kg/m2,respectively in the preoperative period (class II obesity) and 87.19+19.16Kg and 33.04+6.21Kg/m2, respectively in the postoperative period (class I obesity) (p<0.001). Hypertension was the most frequent disease in the pre (66.6%) and postoperative (36.5%) periods. The prevalence of alcohol use was 26.6% in the preoperative period, of which 2.2% of high risk, and 35.1% in the postoperative period, of which 1.4% of probable dependence; this difference did not achieve statistical significance (p=0.337). CONCLUSION: The prevalence of abusive alcohol intake and/or probable dependence was low in both the pre and postoperative periods, with little evidence of risky consumption among the patients submitted to bariatric surgery.

Nutritional repercussions in patients submitted to bariatric surgery

BACKGROUND

Few studies evaluated the association between nutritional disorders, quality of life and weight loss in patients undergoing bariatric surgery.

AIM

To identify nutritional changes in patients undergoing bariatric surgery and correlate them with weight loss, control of comorbidities and quality of life.

METHOD

A prospective cohort, analytical and descriptive study involving 59 patients undergoing bariatric surgery was done. Data were collected preoperatively at three and six months postoperatively, evaluating nutritional aspects and outcomes using BAROS questionnaire. The data had a confidence interval of 95%.

RESULTS

The majority of patients was composed of women, 47 (79.7%), with 55.9% of the series with BMI between 40 to 49.9 kg/m(²). In the sixth month after surgery scores of quality of life were significantly higher than preoperatively (p<0.05) and 27 (67.5 %) patients had comorbidities resolved, 48 (81.3 %) presented BAROS scores of very good or excellent. After three and six months of surgery 16 and 23 presented some nutritional disorder, respectively. There was no relationship between the loss of excess weight and quality of life among patients with or without nutritional disorders.

CONCLUSION

Nutritional disorders are uncommon in the early postoperative period and, when present, have little or no influence on quality of life and loss of excess weight.

CLINICAL AND NUTRITIONAL ASPECTS IN OBESE WOMEN DURING THE FIRST YEAR AFTER ROUX-EN-Y GASTRIC BYPASS

BACKGROUND

Clinic care for morbid obesity is not very effective. Bariatric surgery is being considered the best way of intervention for this kind of obesity.

AIM

Evaluate the clinical and nutritional evolution during the first year of obese women submitted to Roux-en-Y gastric bypass.

METHOD

Retrospective series non-concurrent with 61 women. The variables were weight, BMI, weight loss percentage, loss of excessive weight percentage, waist circumference, hip circumference, lipid profile, daily use of supplements, practice of physical exercise, occurrence of sickness, nausea, constipation, diarrhea, asthenia, alopecia, dry skin, cramps and brittle nails.

RESULTS

They presented significant weight and IMC reduction as well as improvement in their lipid profile, in all consultations. After one year they presented 36,6% loss of the initial weight and 75% loss of excessive weight. The waist circumference also presented a considerable reduction on all the moments, decreasing from 122,1±13,4 cm to 94,1±10,6 cm. Regarding the intercurrences, the most frequent were alopecia, asthenia, dry skin and cramps.

CONCLUSION

The Roux-en-Y gastric bypass was effective in promoting and maintenance weight loss during the period of the first postoperative year.

Determinants of weight regain after bariatric surgery

BACKGROUND

Bariatric surgery leads to an average loss of 60-75% of excess body weight with maximum weight loss in the period between 18 and 24 months postoperatively. However, several studies show that weight is regained from two years of operation.

AIM

To identify the determinants of weight regain in post-bariatric surgery users.

METHODS

Prospective cross-sectional study with 64 patients who underwent bariatric surgery with postoperative time > 2 years valued at significant weight regain. The variables analyzed were age, sex, education, socioeconomic status, work activity related to food, time after surgery, BMI, percentage of excess weight loss, weight gain, attendance monitoring nutrition, lifestyle, eating habits, self-perception of appetite, daily use of nutritional supplements and quality of life.

RESULTS

There were 57 (89%) women and 7 (11%) men, aged 41.76 ± 7.93 years and mean postoperative period of 53.4 ± 18.4 months. The average weight and BMI were respectively 127.48 ± 24.2 kg and 49.56 ± 6.7 kg/m2 at surgery. The minimum weight and BMI were achieved 73.0 ± 18.6 kg and 28.3 ± 5.5 kg/m2, reached in 23.7 ± 12 months postoperatively. Regained significant weight occurred in 18 (28.1%) cases. The mean postoperative period of 66 ± 8.3 months and work activities related to food showed statistical significance (p=000 and p=0.003) for the regained weight.

CONCLUSION

Bariatric surgery promotes adequate reduction of excess body weight, with significant weight regain observed after five years; post-operative time and work activity related to eating out as determining factors for the occurrence of weight regain.

[Bariatric surgery: its effects for obese in the workplace]

This descriptive exploratory research aims to analyze the effects of bariatric surgery in the lifestyle of people with class III obesity in the workplace, through individual interviews with patients undergoing gastric bypass in gamma-Rouz. Data collection was conducted in June and July, 2011, by means of individual interviews, yielding three Collective Subject Discourse: "More willingness to work" "Life without comorbidities" and "Other effects of bariatric surgery." 30 patients with mean age 44 +/- 12 years old, 24 (80%) female, 19 (63%) performed paid professional activities, 10 (34%) did not work and one (3.3%) students, 23 (96%) hypertension and eight (33%) with a diagnosis of diabetes mellitus were included in the study. Difficulty handling with physical appearance: 13 (43%) and the emotional aspect: 21 (70%). Bariatric surgery positively affected the lifestyle of obese at work with reduction in comorbidities and physical and emotional problems, favoring social and professional reintegration of the individuals.