【Introduction to our center】
Modern lifestyle and the pursuit for fine food lead to the global surge of obesity incidence and premature ageing of general population. Obesity is a serious medical condition that increases the incidence of hypertension, type 2 diabetes, high cholesterol, cardiovascular disease, arthritis, gout, and fatty liver disease. Studies show that only 5-10 % decrease in body weight significantly reduces these complications. For obese subjects with type 2 diabetes or hypertension, weight reduction help to improve glucose and blood pressure control.
In order to provide correct medical counseling pipelines to improve health care of obese subjects, we established in the Center for Obesity, Life Style and Metabolic Surgery in the National Taiwan University Hospital. This center combines medical unit, surgical unit, dietitian, metal health specialists, physical therapy and rehabilitation medicine specialists, and sleep medicine specialists. We provide patients with multidisciplinary and integrated healthcare, ranging from endocrinological evaluation, diet evaluation and diet prescription, cardiopulmonary evaluation and exercise therapy prescription, drug treatment, and weight-loss surgery. We also integrate clinical practice to the academic research platform of National Taiwan University Hospital and National Taiwan University to promote scientific research.
【Featured】One-stop, integrated, and individualized service
Through case managers, we provide integrated multidisplinary medical care crossing medical unit, surgical unit, dietitian, metal health specialists, physical therapist, rehabilitation and sleep medicine specialists.
【Weight-loss surgery [bariatric] and metabolic surgery】
For people who are severely obese, gastric bypass surgery is the only long-term and effective way to reduce body weight and ameliorate obesity-related complications including diabetes, hypertension, high cholesterol, sleep apnea, and hepatic steatosis. However, gastric bypass surgery is associated with considerable peri-surgical complications and mortality. Therefore, much effort is devoted to improve the surgical procedure to be safer and faster than traditional gastric bypass surgery in recent year. To meet the diverse need of patients, we provide a variety of surgical options including "gastric sleeve resection", "gastric bypass surgery", "adjustable gastric banding" and "gastric balloon placement" for different patients.
Obesity is generally a multi-factorial phenomenon caused by complex causes. However, certain endocrine diseases including hypothyroidism (inadequately low thyroid function), Cushing’ syndrome (excessive adrenal function), or pituitary disease can cause obesity. Therefore, endocrinological evaluation is needed to exclude these causes. Furthermore, obesity-related complications including hypetension, hyperlipidemia, and diabetes require medical control.
Currently approved weight-loss medical therapies include lipase inhibitor (e,g., Orlistat) and glucagon-like peptide -1 agonist (e.g.,Liraglutide). The former is associated with gastro-intestinal discomfort and hepatic toxicity. The latter need to be injected subcutaneously and is more suitable for those with diabetes. Both drugs are not reimbursed by National Health Insurance system. New drugs will be available in the future.
【Sleep Center】 http://www.ntuh.gov.tw/SLP/
Obesity is often complicated by sleep apnea (stop of breath during sleep) and hypoventilation syndrome (suppressed breath during sleep) due to fat compression and structural change of airway. There sleep problems often lead to sleepiness at daytime and aggravates hypertension and diabetes. For those with sleep disturbance, our center provide polysomnography, multiple sleep latency test, 24-hr actigraphy, and continuous blood oxygen monitoring to evaluate sleep problems associated with obesity and to provide positive-pressure ventilator to resolved these sleep problems.
【Physical Therapy and Rehabilitation Medicine】
We provide cardiopulmonary exercise test, anthropometric evaluation, and physical assessment and referral to physical therapist for exercise consultation and design of exercise program.
Diet control is fundamental for obesity management, which is mainly conducted by adjusting food type and portion in order to reduce total calorie intake. The design of post-surgical diet also requires dietitian expertise. However, there is no single diet prescription for everyone. Therefore, dietitian in our center will design individualized diet for each patient.
【Case Manager/Nursing specialist】
The process of weight management is a long-term complicated process which requires the co-ordination between different medical specialist and patients. Case manager (nursing specialists) will bridge the gap between the need of patients and medical specialist. Case managers/nursing specialist will play a pivotal role in our team to evaluate, design, co-ordinate, and solve problems for patients to provide one-stop, interactive, communicative and sustained patient care.
( The Center Webside is updated : 2019/02/01 )