Surgical Procedures associated with obesity Flashcards

1
Q

What are 4 consequences of obesity?

A

Increased mortality
Increased hypertension risk
increased diabetes risk
Increased cancer risk

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2
Q

What is the Swedish obese subjects trail?

A

A prospective controlled intervention study of bariatric surgery

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3
Q

What is the What is the Swedish obese subjects trail primary aim?

A

Are bariatric surgery or weight loss induced by bariatric surgery reduced mortality?

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4
Q

What is the secondary aim for the Swedish obese subjects trail?

A

Whether bariatric surgery or weight loss induced by bariatric surgery cost efficienct and improve quality of life

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5
Q

What are 3 bariatric surgeries?

A

Gastric banding
Vertical banded gastroplasty
gastric bypass

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6
Q

does bariatric surgery reduce mortality compared to control?

A

yes

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7
Q

does bariatric surgery reduce weight compared to control over 20 years?

A

Not in banding or VBG
GBP leads to effective long term weight loss

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8
Q

does bariatric surgery improve T2DM profile compared to control?

A

Yes increases remission

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9
Q

does bariatric surgery reduce incidence of diabetes compared to control?

A

Yes

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10
Q

does bariatric surgery improve CVE profile compared to control?

A

Yes

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11
Q

does bariatric surgery improve cancer profile compared to control?

A

Yes but only in females

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12
Q

How is bariatric surgery achieving weight loss?

A

Caloric restriction
malabsorption of nutrients

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13
Q

How is the malabsorption of nutrients achieved?

A

Creating a smaller stomach - eating smaller quantities
vagal impaction
bypassing digestion and absorption in duodenum

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14
Q

Does the malabsorption theory hold out?

A

No

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15
Q

What cells make gastro intestinal hormones?

A

Enetroendocrine cells

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16
Q

What hormones are changed?

A

Ghrelin
GLP-1
PYY

17
Q

Where is GLP-1 made?

A

L-cells distal SI

18
Q

Why do GLP-1 levels increase after surgery?

A

precedes any significant weight loss - due to new anatomy rather than weight loss

19
Q

What is the name of a GLP-1 analogue?

A

Semaglutide

20
Q

What does semaglutide treat?

A

T2D & reducing risk of CVE in persons with T2D and CVD

21
Q

What was the results of the study with semaglutide?

A

86% of participants lost >5% body weight compared to 32% with placebo

22
Q

What is GLP-1 analogues used in combination with?

23
Q

What are characteristics of GIP?

A

Produced by K cells
Proximal small intestine
Levels rise after nutrient ingestion (satiety factor)

24
Q

Does gastric bypass change composition of bacteria in gut?

25
What happened when mice were given a fecal transplant from the mice that underwent surgery?
Weight loss seen
26
Do plasma bile acids increase or decrease after gastric bypass?
Increase
27
What is the location of bile acid release imprtant?
affects gut hormone release
28
When bile goes into the ileum which hormones increase (compared to duodenum)
GLP-1 levels increase PYY increases
29
What is dumping syndrome that is associated with bariatric surgery?
Follows high sugar meals leading to osmotic stress -> rapid transit of nutrients into Si which leads to cramps & diarrhea
30
How is food preferences changed in bariatric surgery?
Food tastes different increased sensitivity to sweet/fatty food MRI - rewiring of response to food