BMI is a useful screening tool for obesity. It is not an absolute determination of obesity due to its areas of weakness which include elderly people who may have loss muscle mass and athletic people who have large muscle mass(19,Obesity). The patient has a BMI of 59.4. A normal weight person according to the BMI scale, should have a BMI between 18.5-24.9. This patient is 34.5 points above the higher end of the normal range.
2. Two types of gastric bypass surgeries include the Roux-en-y and the sleeve gastrectomy. The roux-en-y procedure is the most common gastric by pass surgery. It is virtually irreversible. This procedure is completed when the top of the stomach is sealed off from the rest of the stomach resulting in a small pouch like stomach which is able to hold about an ounce of food at one time. The small intestine is then sewn directly to this new smaller stomach. After the procedure, food bypasses the majority of the stomach and quickly goes to the small intestine. This procedure reduces the amount of food that can be eaten and the number of nutrients that can be absorbed (19,gastric bypass surgery).
The sleeve gastrectomy is a newer gastric surgery. It effectively assists patient to lose weight through the removal of approximately ¾ of the stomach. This removal of a portion of the stomach makes it a permanent surgery. The removal of this portion of the stomach causes greater gastric emptying and hormone changes such as in the level of ghrelin and insulin secretion. This procedure effecti...
... middle of paper ...
...he necessity of taking supplements as the body will not absorb as many nutrients.
In the first year, the patient should be followed every three months and as needed with appropriate lab work being drawn. After the first year, the patient should be followed yearly with primary care doctor consulting the bariatric team as needed for guidance. The doctor should continue to assess the patients general well being from physical to mental and changes with each visit.
Teaching for the patient and the family is vitally important. Subjects which may be covered in teaching include: wound care and what to do should signs of infection occur, signs of infection, pregnancy risks following surgery, diet, dumping syndrome, signs of hypoglycemia, fluid restrictions, signs of dehydration, exercise and life style choices, weight gain, fatigue, depression and vitamin supplementation.
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