Health

Incretin effect in relation to weight loss surgery Rapid transit of nutrients from the gastric pouch to the distal ileum in those with Roux-en-Y anatomy or the duodenal switch causes increased release of incretins (glucagon-like peptide-1, glucose-dependent insulinotropic polypeptide) with subsequent enhancement of glucose-stimulated insulin secretion and beta-cell sensitivity to oral glucose, especially in patients …

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What are the effects of bariatric surgery on obesity related comorbidities? Bariatric surgery has been shown to significantly reduce obesity-related comorbidities. Approximately 85% of patients with diabetes, hyperlipidemia, and obesity hypoventilation syndrome will have improvement or effective remission at 2 years after surgery. Glycemic control occurs immediately and dramatically after bariatric surgery, especially after gastric …

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How much weight do patients lose following bariatric surgery? Success following bariatric surgery is determined by both weight loss and improvement in obesity-related comorbidities. Most surgical studies report outcomes as percentage of excess weight lost (EWL) and consider loss of at least 50% of excess weight as a minimum criterion for success. The lap band …

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What is the option for malabsorptive surgery? Biliopancreatic diversion with and without a duodenal switch is a surgical option for malabsorption. A subtotal gastrectomy or sleeve gastrectomy is performed, leaving a gastric remnant of 250 to 500 mL. The small bowel is divided 200 to 300 cm proximal to the ileocecal valve, and the ileum …

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various surgical options for weight Loss I. Restrictive II. Malabsorptive III. Combination restrictive/Malabsorptive IV. Other Options for restrictive surgery • Vertical-banded gastroplasty (historical): A stapling device is used to divide the stomach vertically along the lesser curve to create a small (20 mL) pouch. A prosthetic device is then wrapped around the outlet of the pouch to …

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Relative contraindications to bariatric surgery • Endocrine disorders that cause or contribute to morbid obesity • Psychological instability • Alcohol or drug abuse • End-stage organ disease, unless used as a bridge to transplantation • Terminal cancer • Inability to comprehend or comply with postoperative nutritional and behavioral guidelines

What are the indications for obesity surgery? A National Institutes of Health (NIH) Consensus Conference held in 1991 recommended that the following patients be considered for bariatric surgery: • BMI ≥ 40 kg/m 2 • BMI of 35 to 40 kg/m 2 if associated with other severe obesity-related medical problems that are likely to improve with weight reduction (i.e., hypertension, …

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