Medical Treatments for Obesity
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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?

<p>Bariatric medicine</p> Signup and view all the answers

Who are the ideal candidates for bariatric surgical procedures?

<p>People with BMIs greater than or equal to 40, or those with BMIs greater than or equal to 35 and serious health problems</p> Signup and view all the answers

What is the primary effect of bariatric surgical procedures on the stomach?

<p>Drastically reducing the size of the stomach</p> Signup and view all the answers

What is the name of the nonprescription form of orlistat available as a weight-loss aid for adults?

<p>Alli®</p> Signup and view all the answers

What is essential for weight-loss efforts, in addition to prescription medication or surgical procedures?

<p>Reducing calorie intake and increasing physical activity</p> Signup and view all the answers

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?

<p>Regular exercise and avoiding 'soft calories'</p> Signup and view all the answers

What is the function of the Maestro Rechargeable System, an FDA-approved weight loss device?

<p>Delivers intermittent electrical pulses to the major nerve involved in regulating stomach emptying and sensing stomach fullness</p> Signup and view all the answers

How does the AspireAssist device aid in weight loss?

<p>By allowing the person to drain a portion of their stomach contents into the toilet after a meal, reducing calorie intake</p> Signup and view all the answers

What is the purpose of intragastric balloons, and how do they aid in weight loss?

<p>Intragastric balloons delay stomach emptying, resulting in early satiety and reduced food intake, aiding in weight loss</p> Signup and view all the answers

What is the procedure for inserting an intragastric balloon, and how long does it remain in the stomach?

<p>A physician positions the balloon in the stomach and fills it with a salt and water (saline) solution, and it remains in the stomach for 6 months</p> Signup and view all the answers

Why is it essential for only properly trained physicians to insert or remove intragastric balloons?

<p>To reduce the risk of serious complications or death</p> Signup and view all the answers

What is a critical factor in achieving considerable weight loss using intragastric balloons?

<p>Using the device for the full 6 months</p> Signup and view all the answers

What is a common issue faced by patients who use intragastric balloons?

<p>Regaining much of the lost weight within 6 months after removal of the balloon</p> Signup and view all the answers

Who are not ideal candidates for using intragastric balloons?

<p>People who have had bariatric surgery or chronic digestive tract disorders</p> Signup and view all the answers

What is the approximate size of an inflated intragastric balloon in the stomach?

<p>About the size of a grapefruit, taking up about one-third of the stomach's capacity</p> Signup and view all the answers

What is the primary benefit of bariatric surgery besides weight loss, and what is the associated outcome for extremely obese individuals?

<p>The primary benefit of bariatric surgery besides weight loss is the production of dramatic health benefits. Extremely obese individuals who undergo bariatric surgery have lower overall death rates.</p> Signup and view all the answers

What is the average stomach capacity after a Roux-en-Y gastric bypass operation?

<p>The average stomach capacity after a Roux-en-Y gastric bypass operation is approximately 1.5 oz, which is about the volume of one egg.</p> Signup and view all the answers

What complications are often associated with gastric bypass surgery?

<p>Complications often associated with gastric bypass surgery include intestinal blockage, bleeding, leaks along the staple site, blood clot formation, and wound infections.</p> Signup and view all the answers

How do patients who undergo sleeve gastrectomy reduce their hunger sensations?

<p>The portion of the stomach that secretes ghrelin is removed during sleeve gastrectomy surgery, which reduces hunger sensations in patients.</p> Signup and view all the answers

What is the primary difference between adjustable gastric banding and other types of bariatric surgery?

<p>The primary difference is that adjustable gastric banding is reversible, whereas other types of bariatric surgery are irreversible.</p> Signup and view all the answers

Why do patients who undergo bariatric surgery need to make major lifestyle changes?

<p>Patients who undergo bariatric surgery need to make major lifestyle changes because the stomach pouch fills quickly with food, and overeating causes discomfort or vomiting.</p> Signup and view all the answers

What is the approximate volume of the stomach pouch after a sleeve gastrectomy procedure?

<p>The approximate volume of the stomach pouch after a sleeve gastrectomy procedure is 2 to 5 ounces of food.</p> Signup and view all the answers

How do bariatric surgeries reduce nutrient absorption?

<p>Bariatric surgeries, such as Roux-en-Y gastric bypass, reduce nutrient absorption by bypassing a section of the small intestine.</p> Signup and view all the answers

What is the advantage of laparoscopic bariatric surgical procedures?

<p>The advantage of laparoscopic bariatric surgical procedures is that they reduce recovery time and the risk of infections.</p> Signup and view all the answers

Why do patients who undergo gastric bypass surgery often develop micronutrient deficiencies?

<p>Patients who undergo gastric bypass surgery often develop micronutrient deficiencies because the bypassed section of the small intestine reduces nutrient absorption.</p> Signup and view all the answers

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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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.

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