Abstract
A 41-year-old male presents for follow-up of weight management. He has struggled with obesity for most of his adult life and is currently at his highest weight of 300 lbs. He states that he cannot stop eating until he is “uncomfortably full” and sometimes eats because of stress and not necessarily hunger. In the past, he has successfully lost weight through commercial weight loss programs but has been unable to keep the weight off for more than 1 year. The most weight that he has ever lost was approximately 20 lbs. Because of his weight, he has difficulty walking and climbing stairs. He denies daytime somnolence, joint pain, exertional dyspnea, binge eating, or depressed mood. Past medical history is significant for hypertension, type 2 diabetes mellitus (T2DM), gastroesophageal reflux disease (GERD), and dyslipidemia. His medications include hydrochlorothiazide 25 mg daily, atorvastatin 40 mg daily, metformin 500 mg daily, and omeprazole 40 mg daily. Physical exam is notable for a body mass index (BMI) of 43 kg/m2 but is otherwise unremarkable. Labs reveal normal complete blood count, basic metabolic panel, and liver function tests. His fasting lipid panel is as follows: total cholesterol 184 mg/dL, LDL 97 mg/dL, HDL 30 mg/dL, and triglycerides 155 mg/dL; and his hemoglobin A1c is 7.4%. Today the patient inquires about his surgical options and would like to know if surgery is an option for him.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Picot J, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:1–190, 215–357.
American Society of Metabolic and Bariatric Surgery. Who is a candidate for bariatric surgery? 2018. https://asmbs.org/patients/who-is-a-candidate-for-bariatric-surgery.
Brethauer SA, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg. 2013;258:628–36.
Courcoulas AP, et al. Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310:2416–25.
Apovian CM, Aronne LJ, Powell AG. Clinical Management of Obesity Bariatric Surgery, 1st edition. West Islip: Professional Communications. 2015;10:251–85.
Sjostrom L. Review of the key results from the Swedish Obese Subjects (SOS) trial – a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219–34.
Jensen MD, et al. 2013 AHA/ACC/TOS Guideline for the management of overweight and obesity in adults. A report of the American College of Cardiology/American Heart Association task force on practice guidelines and the obesity society. Circulation. 2014;129:S102–38.
Madalosso CA. The impact of gastric bypass on gastroesophageal reflux disease in morbidly obese patients. Ann Surg. 2016;263(1):110–6.
American Society of Metabolic and Bariatric Surgery. Bariatric surgery procedures. 2018. https://asmbs.org/patients/bariatric-surgery-procedures.
O’Brien PE, et al. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2013;257:87–94.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Tchang, B.G., Umashanker, D. (2019). Surgical Options and Criteria for Bariatric Surgery. In: Aronne, L., Kumar, R. (eds) Obesity Management. Springer, Cham. https://doi.org/10.1007/978-3-030-01039-3_11
Download citation
DOI: https://doi.org/10.1007/978-3-030-01039-3_11
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-01038-6
Online ISBN: 978-3-030-01039-3
eBook Packages: MedicineMedicine (R0)