Ricerc@Sapienza

Obesity has reached epidemic proportions worldwide. In the United States 71% of men and 62% of women are with overweight and 32% of men and 34% of women are with obesity. Although in Italy this phenomenon is less severe, still 35% of the adult population is affected by overweight and 13% by frank obesity.
Obesity is associated with a series of comorbidities including a high risk of deep vein thrombosis and pulmonary embolism. In addition, it is a strong predictor of myocardial infarction.
Bariatric/metabolic surgery is successful is reversing obesity-related comorbidities. We and other authors have, in fact, shown that surgery determines type 2 diabetes remission in the short and long term and also improves hypertension and hyperlipidemia.
It has been recently demonstrated in a large cohort of obese subjects who underwent Roux-en-Y Gastric Bypass (RYGB) and in matched controls (N=1724 in each cohort) followed up to 12 years that RYGB significantly reduces cardiovascular events (P=0.017) and congestive heart failure (P=0.0077).
A VLCD allows a weight reduction of 7.6 kg on average at 3 months, while 11.1 kg weight loss during the first 3 months of balloon treatment was shown.
We hypothesize a synergic effect on weight reduction with the combination of gastric balloon and a ketogenic VLCD with an overall weight loss at 3 months of around 19 kg. In fact, the mean weight loss in the first 3 months after RYGB is about 20 kg.
Our hypothesis is that a massive weight loss as it can be observed with RYGB or gastric balloon associated with a ketogenic VLCD will determine a significant improvement of the endothelial function, but that RYGB will perform better thanks to a weight-loss adjunctive action.