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CSOWM Metabolic And Bariatric Surgery With Complete Solutions
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CSOWM Metabolic And Bariatric Surgery With Complete Solutions
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Solution 2024/2025Pepper
CSOWM Metabolic And Bariatric Surgery With
Complete Solutions
Bariatric & Metabolic Surgery Procedures ANS✔✔ Group of surgical procedures that impact the physiological regulation
of body weight and improve morbidity and mortality rates
Purely restrictive weight loss surgery ANS✔✔ Laparoscopic adjustable gastric band (LAGB)
Weight loss surgeries that are combination (Malabsorptive & restrictive) -Gastric manipulation, causing some restriction
& neural/hormonal) ANS✔✔ Sleeve gastrectomy (SG) & Roux-en-Y Gastric bypass (RYGBP)
Bypass surgery that is combination of malabsorptive/restriction and of both macronutrients & micronutrients ANS✔✔
Biliopancreatic Diversion (BPD/DS)
Cholecystokinin (CCK) ANS✔✔ Hormone secreted by the duodenum; suppresses appetite and levels decrease during
dieting and weight loss
Glucose-dependent insulinotropic polypeptide (GIP) ANS✔✔ Hormone secreted by the duodenum and jejunum; normal
function for energy storage; Levels increase during dieting and weight loss
Ghrelin ANS✔✔ Hormone from the gastric fundus; Functions to stimulate appetite for high fat, high sugar foods; Levels
increase during diet and weight loss
Glucagon-like peptide 1 (GLP-1) ANS✔✔ Hormone secreted in the ileum of the small I; Functions to suppress appetite
and increase satiety; Levels have a decreased functionality with diet and weight loss
Peptide YY (PYY) ANS✔✔ Hormone secreted in the distal small I; Suppresses appetite; There is a decrease in this
hormone found in obese persons with weight loss
, Solution 2024/2025
Pepper
Insulin ANS✔✔ Hormone secreted from the beta cells of the pancreas; Functions to regulate energy balance and signal
satiety in the brain; There is resistance to this hormone in obese persons; Levels decrease after dieting
Leptin ANS✔✔ Hormone secreted from the adipocytes; Regulates energy balance & suppresses appetite; Levels
decrease during weight loss
Metabolic and bariatric surgery changes to gut hormones? ANS✔✔ The opposite of restrictive dieting
RYGB + SG changes in gut hormones ANS✔✔ They don't see a decrease in RMR; decrease in appetite and hunger;
increase in satiety; decrease in ghrelin, increase in GLP-1, PYY, CCK, and amylin
Amylin ANS✔✔ co-secreted with insulin by beta cells in response to nutrient stimuli. Delays nutrient uptake and
suppresses glucagon secretion after meals. Satiating effect.
LAGB + Hunger hormones ANS✔✔ Studies show an increase in ghrelin 6-12 months s/p procedure; may be why
decrease in wt loss with this Adjustments and food choices essential for wt loss and maintenance
LAGB - Too tight fitting ANS✔✔ Dysphagia, reflux/cough, regurgitation, maladaptive eating
LAGB- Goal of fill (Saline fill) ANS✔✔ Satiety, small meals satisfying
LAGB- Needing a fill (saline fill) ANS✔✔ Hungry, big meals, looking for food
LAGB downside ANS✔✔ Soft meals still go in easy, which can still allow for increase in calorie intakes to weight gain (Ex:
increase in refined, icecream, etc)
LAGB history ANS✔✔ First approved in 2001 in US; Lost <25-30% of excess weight in up to 40% of patients; Many
complications found: Band erosion, infection, intolerance to band symptoms, slippage of band, difficulty swallowing,
GERD, Pouch dilation, port infection (Most now having removed than put in)
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