Laparoscopic adjustable gastric banding for morbid obesity - Home Study Program

AORN Journal,  May, 2003  by Dorothy Roedel Ferraro

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Table 2 DISEASES ASSOCIATED WITH MORBID OBESITY (IN ORDER OF IMPORTANCE) (1)

Type 2 diabetes mellitus

Degenerative joint disease--risk of developing arthritis is increased by 9% to 13% for every 2-lb increase in weight

Hypertension--twice as common in adults who are obese than in those who are of normal weight

Coronary artery disease

Gallbladder disease

Certain types of cancer (eg, breast, colon, gallbladder, kidney, prostate, uterine)

Gastroesophageal reflux disease

Pulmonary disease (eg, sleep apnea, asthma)

Psychological problems (eg, depression)

Infertility

High-risk pregnancy

Stress incontinence

NOTE

(1.) J B Dixon, M E Dixon, P E O'Brien, "Quality of life after lap-band placement: Influence of time, weight loss, and comorbidities," Obesity Research 9 (November 2001) 713-721.

Table 3 ISSUES TO EVALUATE IN THE PSYCHIATRIC ASSESSMENT

Availability of support systems

Current living situation

Family members' and friends' attitudes toward the proposed surgical intervention

History of psychiatric problems, type and effectiveness of treatment, and need for psychotropic medications

History of physical or sexual trauma, rape, or suicide attempts

Personal and social history

The patient's general

* Affect

* Appearance

* Attitude

* Behavior

* Cognitive function and content of thought

* Eating patterns and history of binge eating, fasting

* Facial expressions and ability to make eye contact

* Insight, judgement, and expected outcomes

* Vomiting or use of laxatives or diuretics for the purpose of weight loss

* Exercise patterns

* Feelings of guilt, disgust, or depression associated with overeating

* Mood

* Speech patterns

* Weight fluctuations

Effect of weight on

* Relationships

* Self-esteem

* Work

Table 4 PATIENT SELECTION CRITERIA FOR OBESITY SURGERY (1)

Body mass index (BMI) of 40 or higher

BMI of 35 or higher with comorbidities

Long-term history of obesity

Multiple unsuccessful attempts at nonsurgical methods of weight loss

Ability to comply with dietary and behavioral changes as recommended by the weight management team

NOTE

(1.) "Prevalence of overweight and obesity among adults: United States, 1999-2000," National Center for Health Statistics, Centers for Disease Control and Prevention, http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese/obse99.htm (accessed 7 March 2003).