Exploring the implication and application of multimodal strategies to bariatric surgery to improve the treatment of obesity

Obesity is a complex, chronic multisystem disease which requires life-long management strategies. One of the primary challenges in managing patients with obesity is not weight loss in itself but weight loss maintenance. Studies have demonstrated that bariatric surgery is a safe and effective means of inducing clinically significant weight loss which is sustained, while also treating obesity related complications. Although bariatric surgery is a critical element in the management for patients with obesity, the care for patients with what is recognised as a chronic, progressive disease could be improved by adopting a multimodal approach to treatment. Drawing from experience from the treatment of other conditions such as cancer or vascular disease, surgery is one element in the overall management strategy however it is carried out in conjunction with additional staging, diagnostic and treatment modalities which are essential to improving outcomes. Herein, I have investigated the potential to implement additional modalities to improve the staging and diagnosis of patients with obesity while exploring the patient perspective of such an approach. Additionally, I have investigated means of combining medications with surgery as well as adjunctive treatments to further improve long-term outcomes for patients undergoing surgery. The treatment of obesity is challenging despite the availability of effective treatments such as bariatric surgery. The results of this work demonstrates the principle that adopting a multimodal approach to treatment by combining surgery with accurate staging, additional diagnostic modalities and adjunctive therapies, whilst incorporating the patient perspective is essential in improving care for those living with obesity.