Morbid Obesity

Edward R. Woodward, MD; J. Howard Payne, MD; Peter A. Salmon, MD; J. Patrick O'Leary, MD
Arch Surg. 1975;110(12):1440-1445. doi:10.1001/archsurg.1975.01360180010002.
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The incidence of massive exogenous obesity appears to have greatly increased during the past 25 years. This pathologic condition causes and aggravates a number of medical conditions that can substantially reduce functional capacity and very strikingly limit life expectancy. Intestinal short circuit was introduced by Payne et al1 and developed by them into the currently used jejunoileal shunt. The procedure, initially used with caution in only a few centers under clinical experimental conditions, is now undergoing more widespread use. The following panelists were asked to answer ten questions concerning the basic disease, its surgical control by shunt surgery, and the consequences thereof.

Question 1: What do you consider to be the cause of morbid obesity?

Dr Payne: The primary cause is uncontrollable, compulsive eating, and there is probably variation in the capacity to assimilate and store fat. However, endocrine disturbances are very rare.

Dr Salmon: The basic cause is


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