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In the preface, Dr Linner outlines the two main problems in bariatric surgery. First, he notes the general reluctance of physicians to accept the concept that morbid obesity is a disease rather than a simple lack of willpower. The second and more serious concern arises from the failure of surgical therapy to control effectively morbid obesity. The chief shortcomings are the late complications from jejunoileal bypass and the inability of many gastric reduction procedures to maintain the usual early weight loss: "It is to these concerns that this book is addressed."
The first chapter, "Medical Aspects of Morbid Obesity," deals with the concept of obesity as a disease. The author comes to the currently popular conclusion that "the hypothalamus is the ultimate integrator of energy balance." Presumably, the gastric reduction procedure relays signals to this center, readjusting the "set point," thus decreasing the patient's appetite. Narrowing the lower esophagus fails
LIECHTY RD. Surgery for Morbid Obesity. Arch Surg. 1984;119(11):1352–1353. doi:10.1001/archsurg.1984.01390230114033