A model case of a positive outcome in super-super XXXX .

@entity1 @entity6629 @entity356 @entity28
For an increasing number of @entity28 @entity1 , bariatric surgery is considered as the treatment of choice after the failure of conventional strategies. While numerous studies on bariatric surgery have shown substantial health benefits, there is a broad inter-individual variation in the long-term outcome, which is insufficiently understood. Here we show a favourable long-term outcome following multidisciplinary care in a @entity6629 @entity1 . The @entity1 suffered from numerous typically @entity28 -associated comorbidities and limitations. He underwent multidisciplinary care including two-step bariatric intervention. Endoscopic intragastric balloon positioning was followed by @entity356 without Roux-en-Y gastric bypass. His body weight dropped from 260   kg (body mass index [BMI] 79.4   kg   m(-2) ) to 85   kg (BMI 25.9   kg   m(-2) ) within 16 months and continued to be stable at 90   kg (BMI 27.8   kg   m(-2) ) at the end of the follow-up period of 48 months. The loss of excess body weight was associated with the remission of numerous @entity28 -related comorbidities and with a concomitant pronounced increase in the quality of life and in the socioeconomic status. Eventually, the @entity1 was able to lead a normal life with a decreased risk of long-term complications. We attribute the positive long-term outcome to the following potential determinants: individualized bariatric surgery, multidisciplinary care, the @entity1 's long-term compliance, adequate adherence to the aftercare, physical exercise after surgery, family support, the cooperation of the primary care physician and the financial coverage by the health insurance. Some of these factors remain to be evaluated as predictors of a favourable long-term outcome in prospective trials.
