Five years later, John has gained and lost about 500 lb. through a succession of diets. He even tried a VLCD, but a year later gained back all the weight he had so diligently lost. At 370 lb., John can no longer fly without using a seat-belt extender and recently he had to buy a second seat. He has arthritis in both knees, hypertension, and type 2 diabetes. Three weeks ago John broke a chair at a coworker’s housewarming party. Because of the embarrassment about his size, John rarely attends social events where food is served. However, he still loves to eat—he now does so mainly by himself. Because of his health issues, Dr. Parnell suggested to John that he consider bariatric surgery. They had a lengthy discussion about it, and Dr. Parnell referred John to an experienced bariatric surgeon. 1. Is John a good candidate for bariatric surgery? 2. Estimate the excess weight that John might lose from bariatric surgery. 3. Pick one of the types of bariatric surgery and explain to John what he can expect postoperatively. 4. What will John need to do to maximize the weight-loss potential of this type of bariatric surgery?
Answer :
1) yes, john is good candidate for bariatric surgery because patient having overweight and other co morbid conditions such as diabetes mellitus and hypertension and osteoarthritis to both knees .
If he ignore about his conditions the complications will be more and may lead to death also .
2) patient weight is 500 lbs and his BMI also will be more than 40 ,he need to go for gastric bypass surgery to prevent further complications .
At Six months ,the patient will have lost a lots of weight ,if the patient have gastric bypass surgery patient can lost about 30-40% of excess body weight .with gastric banding patient can lost 1-2 pounds a week - so by aid months patient can lost 25- 50 pounds .
3) answer : gastric bypass surgery is the most commonly used surgery to reduce the overweight and advantages also more compared to other types of surgeries such as gastric banding etc .
Gastric bypass surgery is option for the people who have BMI above 40 and it is also option who have 35- 40 of BMI with the conditions such as type 2 diabetes mellitus and cardiac diseases ,hypertension etc .
For any surgery the complications are common
There will be chances for wound infections ,john may prone to get infections , pain will be present and fluid loss more and he needs monitoring and keen observation to rule out complications postoperatively .
John will be confident and feels happy post operatively because his negative feeling about his weight will be reduced because of surgery .
He will have more interest to keep his weight normal and his diseases such as diabetes and hypertension and arthritis will be controlled .
Self esteem will be increases after surgery and diet consciousness will be seen in patient .
4) answer :
He need to maintain diet control .
Do excercises and physical activity .
Dont be stressed
Eat small meals
Avoid sedentary lifestyles
Regular weight checking and regular followups .
Should not eat high fat diet
Five years later, John has gained and lost about 500 lb. through a succession of diets....
John took Xenical for about 1 year. For the first 7 months, until November, he was losing weight fairly steadily. Dr. Parnell had stressed the importance of watching his caloric intake and maintaining physical activity, and John complied pretty well. When he knew there was a social event on a particular day, he ate just a piece of toast for breakfast and had an apple at his desk for lunch, so he could eat more at dinner. He was able...