Key words: obesity, bariatric surgery, adolescence, gastroplication, innovative

"Exploring the boundaries of Bariatric Surgery"

The percentage of people who are seriously overweight is increasing and in the Netherlands is around 20% in adults and around 7% in young people. Obesity is associated with conditions such as cardiovascular disease, diabetes and sleep apnoea. In case of extreme overweight, stomach surgery is the only proven effective treatment in the long term, but there is insufficient knowledge about the effects in young people. This dissertation shows that also young people can be operated safely and successfully, but that this has to be done in a research setting to look at the effect in detail.

In addition, research was done into new operations that may work better than diet and lifestyle measures, but are associated with faster recovery and fewer complications than current operations. It was shown that folding the stomach from the inside - through the mouth and oesophagus - has a beneficial effect on eating behaviour, diet-related hormones, weight, high blood pressure, diabetes and sleep apnoea. It was also shown that electrical stimulation of the stomach had no demonstrable positive effect.

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