Surgical Procedures associated with obesity Flashcards
What are 4 consequences of obesity?
Increased mortality
Increased hypertension risk
increased diabetes risk
Increased cancer risk
What is the Swedish obese subjects trail?
A prospective controlled intervention study of bariatric surgery
What is the What is the Swedish obese subjects trail primary aim?
Are bariatric surgery or weight loss induced by bariatric surgery reduced mortality?
What is the secondary aim for the Swedish obese subjects trail?
Whether bariatric surgery or weight loss induced by bariatric surgery cost efficienct and improve quality of life
What are 3 bariatric surgeries?
Gastric banding
Vertical banded gastroplasty
gastric bypass
does bariatric surgery reduce mortality compared to control?
yes
does bariatric surgery reduce weight compared to control over 20 years?
Not in banding or VBG
GBP leads to effective long term weight loss
does bariatric surgery improve T2DM profile compared to control?
Yes increases remission
does bariatric surgery reduce incidence of diabetes compared to control?
Yes
does bariatric surgery improve CVE profile compared to control?
Yes
does bariatric surgery improve cancer profile compared to control?
Yes but only in females
How is bariatric surgery achieving weight loss?
Caloric restriction
malabsorption of nutrients
How is the malabsorption of nutrients achieved?
Creating a smaller stomach - eating smaller quantities
vagal impaction
bypassing digestion and absorption in duodenum
Does the malabsorption theory hold out?
No
What cells make gastro intestinal hormones?
Enetroendocrine cells
What hormones are changed?
Ghrelin
GLP-1
PYY
Where is GLP-1 made?
L-cells distal SI
Why do GLP-1 levels increase after surgery?
precedes any significant weight loss - due to new anatomy rather than weight loss
What is the name of a GLP-1 analogue?
Semaglutide
What does semaglutide treat?
T2D & reducing risk of CVE in persons with T2D and CVD
What was the results of the study with semaglutide?
86% of participants lost >5% body weight compared to 32% with placebo
What is GLP-1 analogues used in combination with?
GIP
What are characteristics of GIP?
Produced by K cells
Proximal small intestine
Levels rise after nutrient ingestion (satiety factor)
Does gastric bypass change composition of bacteria in gut?
Yes