Bariatrics

Question 1

what diseases are obese people at risk for:

Answer 1

diabetes

hypertension

heart disease

OSA and other breathing problems

osteoarthritis

some cancer

Question 2

when the BMI is greater than _____, bariatric surgery becomes a consideration

Answer 2

35

Question 3

when the BMI is greater than what, surgery is the treatment of the choice?

Answer 3

40

Question 4

What is a contraindication to bariatric surgery according to the NIH criteria?

Answer 4

substance abuse

psychoses

or

uncontrolled depression

Question 5

what is roux-en-y gastric bypass?

Answer 5

restrictive and metabolic - part of the stomach is stapled and small bowel re-routed, reducing absorption

60-65% excess body weight loss

Question 6

what happens about 18-24 months after a bypass?

Answer 6

the intestinal lumen increases its absorptive capacity, so people typically gain some weight - depending upon eating habits, it can be all of it

Question 7

what is a biliopancreatic diversion with duodenal switch?

Question 8

what is sleeve gastrectomy?

Answer 8

a portion of the stomach is removed (leaves the antrum of the stomach, where mixing and absorption of B12 occurs)

Question 9

what are the pros and cons of sleeve gastrectomy?

Answer 9

laproscopic surgery

fairly rapid initial weight loss

elimination of

faster SI transit time - means

increased insulin sensitivity

peptide YY - satiety hormone

Question 10

what is leptin?

Answer 10

satiety hormone produced mainly in adipose tissue

regulates energy balance, inhibits hunger

in obesity, increased production, decreased sensitivity

Question 11

what is ghrelin?

Answer 11

hunger hormone that is produced mainly in the fundus

opposes leptin

decrease will lessen hunger, but does not affect satiety