Question

Rodney is 55-years-old, stands 6’ tall, weighs 280 pounds and has a 44” waist circumference. He has always had a sedentary job and loves to cook. Both his mother and father are overweight, and his father suffered a heart attack at age 45. During his annual physical exam, Rodney’s doctor diagnosed him with metabolic syndrome and suggested that he may be a candidate for bariatric surgery, as his lab results and family history put him in the high-risk category chronic diseases.

Question 1: Explain what the doctor means by “metabolic syndrome” and how this syndrome affects risk for chronic disease. Be sure to address each component of metabolic syndrome specifically. Support your answer with data, facts, key terminology, specific examples and other information drawn from the textbook and at least one other supplemental source.

Question 2: Define the criteria for bariatric surgery and explain to Rodney the risks and benefits of surgery. Include in your response specific data, facts, examples, key terminology and other information drawn from the textbook and at least one other supplemental source.

Answer 1

Metabolic syndrome

Metabolic syndrome is a group of metabolic disorders that increase the risk of chronic diseases such as heart disease, Diabetes, Hypertension and stroke. The conditions associated with Metabolic syndrome are high blood sugar, high cholesterol or triglycerides,  excess body fat, high blood pressure etc.

Studies show that around 1/3rd of American population are suffering with Metabolic syndrome.

Metabolic syndrome and Risk forChronic diseases:

The main cause of metabolic syndrome is Obesity, that may be due to physical inactivity. The criteria for risk for occurrence of Metabolic syndrome is that the person should have minimum three of the following conditions :

* Excess body fat around waist ( more than 40inches in man and more than 35 in woman.

* Glucose level ( Fasting) ; more than 100 mg/ dL

* Abnormal  cholesterol, low HDL level ( <40mg in men, < 50mg in women ) and triglyceride level; more than 150mg /dL.

* High blood pressure ( systolic: >130 and diastolic: >85 mm Hg.

Metabolic syndrome affect the risk for chronic diseases as this syndrome is often associated with obesity. Obesity is a state of being obese due to an excess of body fat. This may leads to Insulin resistance, a condition that cells start to ignore or resist insulin or doesn't respond to it so that cells can't take up glucose. This inturn results in high glucose level in the blood ( Diabetes Mellitus).

Abnormal cholesterol in the blood due to improper or excess fat intake especially triglycerides in the diet and physical inactivity may increase the risk of accumulation of fatty plaques in the blood vessels, leads to hardening and narrowing of arteries. This condition may results in High blood pressure, stroke ( The losd of brain function arising from the blood supply to the brain is suddenly interrupted.) and heart attack and other heart diseases.

Studies show that obesity is the leading cause of Cardiovascular disease especially Coronary artery disease. Body mass index at or above 30 is considered as obese. Around 2.5 million deaths world wide are due to obesity.

Bariatric surgery

Bariatric reffering to the branch of Medicine bariatrics, the treatment of obesity and weight problems. Bariatric surgery is an operation that make changes in the digestive system or decrease the stomach capacity so that it helps for  the weight loss in individual.

Criteria:

* Body mass index is at or above 35 , with one or more  co morbidity ( Hypertension, Diabetes, fatty liver disease, heart problems, abnormal cholesterol )

* Body mass index, at or above 40

Rodney's BMI is

BMI = weight ( kg)/ height in meter square

= 127 kg/ (1.82) 2

= 38.34

(1pound = 0.4535kg, 1 foot = 0.3048 meter)

* Individuals who are unable to achieve weight loss ( sustainable and healthy) after a lot of weight loss measures.

Risk of Bariatric surgery

* Dilation of esophagus and possible acid reflux

* Obstruction and infection in the stomach

* Inability to eat certain food items

* Chronic nausea and vomiting

Long term complications such as low blood sugar, ulcers, malnutrition may occur.

Gastric bypass surgery or partial Gastrectomy ( surgical removal of a part of stomach) surgery may leads to the complications associated with surgery such as leakage or breakage, perforation of stomach, injury to spleen or neighbouring organ, hernia, hemorrage etc.

Benefits :

* Improved cardiovascular health

* Relief from depression and increased self esteem

* Remission of Diabetes Mellitus ( type 2)

* Relief from obesity complications such as sleep apnoea and joint pain, abnormal lipid level

* It may improve fertility

* One can live longer a better life with bariatric surgery. Studies show that there is 90 % reduction in death associated with Diabetes in bariatric patients and death associated with heart disease reduced to 50% in bariatric patients ( according to American society of Metabolic and Bariatric surgery, ASMBS).