Questions and Answers
What are the names of the FDA-approved weight-loss medications that can be prescribed for long-term use, as of January 2020?
Contrave®, Saxenda®, Qsymia®, and Xenical® (orlistat)
What is the primary function of orlistat in weight-loss medication?
Reducing fat digestion by about 30%
Why do patients using orlistat often need to take a vitamin supplement?
To replace fat-soluble vitamins eliminated in feces
What is the medical specialty that focuses on the treatment of obesity?
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Who are the ideal candidates for bariatric surgical procedures?
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What is the primary effect of bariatric surgical procedures on the stomach?
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What is the name of the nonprescription form of orlistat available as a weight-loss aid for adults?
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What is essential for weight-loss efforts, in addition to prescription medication or surgical procedures?
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What is a crucial factor in maximizing weight loss and maintaining a lower body weight over time, in addition to an intensive diet and lifestyle management program?
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What is the function of the Maestro Rechargeable System, an FDA-approved weight loss device?
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How does the AspireAssist device aid in weight loss?
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What is the purpose of intragastric balloons, and how do they aid in weight loss?
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What is the procedure for inserting an intragastric balloon, and how long does it remain in the stomach?
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Why is it essential for only properly trained physicians to insert or remove intragastric balloons?
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What is a critical factor in achieving considerable weight loss using intragastric balloons?
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What is a common issue faced by patients who use intragastric balloons?
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Who are not ideal candidates for using intragastric balloons?
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What is the approximate size of an inflated intragastric balloon in the stomach?
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What is the primary benefit of bariatric surgery besides weight loss, and what is the associated outcome for extremely obese individuals?
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What is the average stomach capacity after a Roux-en-Y gastric bypass operation?
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What complications are often associated with gastric bypass surgery?
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How do patients who undergo sleeve gastrectomy reduce their hunger sensations?
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What is the primary difference between adjustable gastric banding and other types of bariatric surgery?
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Why do patients who undergo bariatric surgery need to make major lifestyle changes?
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What is the approximate volume of the stomach pouch after a sleeve gastrectomy procedure?
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How do bariatric surgeries reduce nutrient absorption?
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What is the advantage of laparoscopic bariatric surgical procedures?
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Why do patients who undergo gastric bypass surgery often develop micronutrient deficiencies?
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Study Notes
Medical Treatments for Obesity
- Weight-loss medications approved by the FDA for long-term use include Contrave®, Saxenda®, Qsymia®, and Xenical® (orlistat)
- Orlistat reduces fat digestion by about 30%, and undigested fat is eliminated in the feces, which can cause oily discharge and loss of fat-soluble vitamins
- Patients using orlistat may need to take a vitamin supplement containing fat-soluble vitamins
- Women who are pregnant or may become pregnant should consult their physicians before using these medications
Bariatric Surgical Procedures
- Bariatric surgery is an effective method for treating people with BMIs ≥ 40 or BMIs ≥ 35 with serious health problems
- Surgical procedures drastically reduce stomach size, limiting food intake and leading to significant weight loss
- Patients often achieve normal blood pressure, glucose levels, and triglyceride levels after surgery
- Death rates are lower for extremely obese people who lose weight after undergoing bariatric surgery
- Common surgical approaches in the US include Roux-en-Y gastric bypass and gastric banding procedures
Roux-en-Y Gastric Bypass
- During the procedure, the surgeon staples the upper part of the stomach to create a small pouch, reducing stomach capacity to about 1.5 oz
- The surgeon also cuts the small intestine and attaches the lower end to the newly formed stomach pouch
- Complications may include intestinal blockage, bleeding, leaks, blood clot formation, and wound infections
- Patients can develop micronutrient deficiencies and bone loss, but can reduce risk by taking vitamin and mineral supplements
Sleeve Gastrectomy
- During the procedure, the surgeon staples the stomach to form a banana-shaped pouch that holds about 2-5 ounces of food
- The surgery does not involve bypassing a section of the small intestine, so nutrient absorption is not reduced
- Patients can eat only small portions of solid foods, contributing to rapid weight loss
- The portion of the stomach that secretes ghrelin is removed, reducing hunger sensations
- Surgery is irreversible because the unused portion of the stomach is removed
Adjustable Gastric Banding
- During the procedure, the surgeon creates a small stomach pouch with an adjustable band instead of fixed surgical staples
- The band determines the size of the stomach, allowing for adjustable gastric banding
- Laparoscopic gastric banding procedure is easier to perform and safer than other types of bariatric surgery
- Procedure is reversible, but patients lose weight more slowly and lose less weight compared to gastric bypass or sleeve gastrectomy
FDA-Approved Devices
- Maestro Rechargeable System is a rechargeable electrical pulse generator that delivers intermittent electrical pulses to the major nerve that regulates stomach emptying
- Device helps adult obese patients lose weight and maintain weight loss after surgery
- AspireAssist® device is implanted into the stomach with an endoscope and has a tube leading from the stomach to an opening port on the abdominal skin
- Device allows patients to drain a portion of their stomach contents into the toilet after a meal, resulting in weight loss
- Intragastric balloons are a temporary weight-loss aid that helps simulate the feeling of a full stomach
- Balloons delay stomach emptying, leading to early satiety and reduced food intake
- Balloons are filled with a salt and water solution and remain in the stomach for 6 months before being removed
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Description
Explore medication and surgical options for treating obesity, including the pros and cons of bariatric surgical procedures. Learn about weight-loss medication and its effects.