Treating Obesity by "Short-Circuiting" the Small Intestine

LEWIS and associates1recently reported on two obese patients in whom surgical "short-circuiting" of the small intestine lowered the serum cholesterol and β-lipoproteins. They commented that both patients experienced significant reduction in weight without troublesome side effects. Although weight loss was not the primary focus of their presentation, a review of the literature indicates that their report was the first detailed description of the long-term beneficial effects of this type of elective surgery. Their experiment was, in fact, so successful in reducing the cholesterol level and curing obesity that others may be encouraged to perform such operations on overweight patients. Lewis et al did not discuss the serious nutritional and metabolic complications which may follow such operations, and which therefore must be taken into consideration if this surgical approach to obesity is to be viewed in proper perspective. The purpose of this communication is to stress these complications, and