PhD defence S.R. (Stefanie) van Mil

This thesis on morbid obesity consists of two parts; the first part focuses on the consequences of morbid obesity on cardiovascular disease, while the second part deals with different aspects of the surgical treatment of morbid obesity.

People suffering from morbid obesity have an increased risk of cardiovascular disease and premature death. This thesis shows that the degree of morbid obesity does not seem to influence the level of cardiovascular risk; the distribution of excess fat within the body may contribute to this finding. Other striking differences between people with and without morbid obesity were seen in this thesis. Where healthy weight women experience an increase in cardiovascular risk after menopause, morbidly obese women are somewhat protected from this increase.  People, who, in addition to morbid obesity, suffer from diabetes, show more signs of atherosclerosis and therefore have a higher risk of cardiovascular disease. It is thought that a low-grade inflammation could contribute to this finding, but this role of inflammation could not be demonstrated within this thesis.

With regard to the surgical treatment of morbid obesity, increasing interest is shown in obesity surgery in adolescents. In terms of type of surgery, the sleeve gastrectomy would be the preferred procedure. However, before such surgery can be offered as a standard treatment for adolescents, an extensive perioperative (counseling) program is required. The perioperative care of obesity surgery can be further optimized by using an Enhanced Recovery protocol and postoperative checklists.

Due to corona, the PhD defences do not take place publicly in the usual way in the Senate Hall or in the Professor Andries Querido Room. The candidates will defend their dissertation either in a small group or online.