Describe three bariatric surgical procedures, including the overall benefits and adverse side effects

Question

What will be an ideal response?

Answer 1

In gastric bypass, the surgeon constructs a small gastric pouch and connects it directly to the jejunum so that the flow of food bypasses a substantial portion of the small intestine. In gastric banding, the surgeon creates a small gastric pouch using an inflatable band placed near the top of the stomach. The band is tightened or loosened by adding or removing fluid via an access port placed under the skin. Finally, in sleeve gastrectomy, the surgeon removes 70 to 85 percent of the stomach and staples the remaining portions together to create a vertical tube-shaped stomach with limited capacity.
Almost 200,000 such surgeries are performed in the United States annually. Bariatric surgery suppresses hunger and alters metabolism by changing production of hormones. Changes in appetite, food preferences, and GI microbiota may also influence weight losses. The results are significant: depending on the type of surgery, 20 to 30 percent of the excess weight remains lost after 10 years. Importantly, most people experience dramatic and lasting improvements in their diabetes, blood lipids, and blood pressure; the risk of heart attacks, strokes, and cancer is also reduced. Some evidence suggests improvements in depression and anxiety as well. Overall, bariatric surgery provides clear advantages for greater weight loss and long-term survival over nonsurgical options for obese adults.
The long-term safety and effectiveness of surgery depend, in large part, on compliance with dietary instructions, making nutrition care plans essential in follow-up treatment. With limited food intake and reduced absorptive surfaces, vitamin and mineral deficiencies are common, and have been linked to problems such as periodontal disease. Care plans include instructions to improve food selections as well as prescriptions for dietary supplements. Weight regain may occur and psychological problems—such as disordered eating behaviors—may also develop. Lifelong medical supervision is necessary, but the possible health benefits of weight loss—improved blood lipids, blood pressure, and insulin sensitivity—may outweigh the risks. Overall risk of death and heart disease is lower for obese people after successful surgery than for obese people who do not undergo surgery.