In addition to weight loss, the benefits of RYGB include all of the following EXCEPT:
The long-term benefits of RYGB include a high incidence of resolution of the comorbidities of obesity, such as type 2 diabetes and sleep apnea, and a reduced mortality risk due to these and other illnesses. The success of the operation is dependent upon the patient's success in adopting a healthy eating habit, despite continued cravings for snacks and sweets.
The gastric sleeve procedure originated as part of what operation?
The first stage of the duodenal switch procedure is creation of a gastric sleeve. This is intended to promote weight loss in morbidly obese candidates whose massive obesity creates an unacceptable risk of perioperative complications of a prolonged procedure. The gastric sleeve portion of the procedure was seen to be so effective that the second stage of the duodenal switch was sometimes postponed indefinitely, and the gastric sleeve became a treatment option alone.
In addition to the effects of weight loss, the resolution of type 2 diabetes mellitus after the gastric sleeve procedure and RYGB is thought to be contributed to by:
Gastrectomy removes much of the ghrelin-producing portion of the stomach, and is thought to contribute to weight loss after both gastric sleeve and RYGB procedures. GLP-1, the enteric hormone which augments insulin release, is dramatically increased after RYGB, and is increased after gastric sleeve as well. A profound suppression of appetite and food craving has been found to follow these procedures, presumably due to the altered hormonal status of peptides which affect the satiety centers of the central nervous system.
Adolescent patients with morbid obesity are increasingly being referred for consideration of bariatric procedures due to failure of medical management and the risks associated with a lifetime of obesity. What nutritional deficiencies require life-long treatment after RYGB, the most common procedure performed in this age group?
Loss of intrinsic factor produced in the gastric fundus, impaired iron absorption, and a deficiency of the fat -soluble vitamins present life-long risks after RYGB and other malabsorptive bariatric procedures. Vitamin replacement and nutritional monitoring are therefore mandatory in bariatric patients.
The gastric sleeve procedure and RYGB result in similar degrees of resolution of all of the following EXCEPT:
The resolution of obesity-related comorbidities after gastric sleeve procedures is nearly equivalent to that seen after RYGB, with the exception of the resolution of gastroesophageal reflux disease (GERD). Whereas more than 90% ofRYGB patients report relief of GERD, some studies show an increase in GERD symptoms after gastric sleeve surgery.
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