Q: When can I resume normal behavior?

Weight Loss Surgery Terms
Absorption: Process by which digested food is absorbed by the lower part of the small intestine into the bloodstream.
Adipose: Fatty; pertaining to fat
Anastomasis: Surgical connection between two structures
Bariatric: Pertaining to weight (from the same root as in barometer — measuring the “weight” of air) Bariatric surgery may be performed by bariatric surgeons. Bariatric physicians are usually internists who specialize in non-surgical weight management.
BMI: Body mass index. One of the anthropometric measures of body mass. A formula for standardizing the extent of overweight.
Clinically severe obesity: The newer term for morbid obesity. Body Mass Index of 40 or more, which is roughly equivalent to 100 pounds or more over ideal body weight; a weight level that is life risking.
Cardiovascular: Pertaining to heart and blood vessels.
Co-Morbid: Associated illnesses (i.e, arthritis, hypertension) and disabling conditions associated with clinically severe obesity or obesityrelated health conditions.
Colon: Large intestine beginning at the end of the small intestine and ending at the rectum.
Contraindications: Any symptom or circumstance indicating the inappropriateness of an otherwise advisable
treatment (i.e., alcoholism, drug dependency, severe depression, sociopathic personality disorder)
Criteria: Defines potential candidate for surgery
Digestion: Process by which food is broken down by stomach and upper small intestine into absorbable forms.
Dilation: Process of enlargement a passage or anastomosis
Disease: Process injurious to health and/or longevity
Duodenum: First 12 inches of small intestine immediately below stomach. Bile and pancreatic fluids flow into duodenum through ducts from liver and pancreas, respectively.
Gastric: Pertaining to stomach.
Dumping syndrome: Whereby stomach contents move too rapidly through the small intestine. Symptoms include nausea, weakness, sweating, faintness, and, occasionally, diarrhea after eating, as well as the inability to eat sweets without becoming so weak and sweaty that the patient may have to lie down until the symptoms pass.
Esophagus: The tube that connects the pharynx (throat) with the stomach. The esophagus lies between the trachea (windpipe) and the spine. It passes down the neck, pierces the diaphragm just to the left of the midline, and joins the cardiac (upper) end of the stomach. In an adult, the esophagus is about 25 centimeters long. When a person swallows, the muscular walls of the esophagus contract to push food down into the stomach. Glands in the lining of the esophagus produce mucus, which keeps the passageway moist and facilitates swallowing. Also known as the gullet or swallowing tube. From the Greek oisophagos, from oisein meaning to bear or carry + phagein, to eat.
Gastric Bypass: Operation designed to make nonfunctional a portion of the stomach.
Gastrointestinal: Pertaining to stomach or intestine.
Gastric banding: In this procedure, a band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach.
Gastrojejunostomy Anastomosis: Upper connection of the gastric bypass operation
Obesity: Pertaining to excessive weight or adipose tissue
Obsruction: Narrowing of an anastomosis or segment of gastrointestinal tract that retards normal passage of food or waste materials
Extensive gastric bypass (biliopancreatic diversion): In this more complicated gastric bypass operation, portions of the stomach are removed. The small pouch that remains is connected directly to the final segment of the small intestine, thus completely bypassing both the duodenum and jejunum.
Although this procedure successfully promotes weight loss, it is not widely used because of the high risk for nutritional deficiencies.
Gastroplasty: Operation for morbid obesity that reshapes the stomach.
Hernia: The protrusion of a loop of an organ or tissue through a weakened opening. Ten to 20 percent of patients who have weight-loss surgery develop a hernia.
Hypertension: High blood pressure
Ileum: Ten feet of small intestine responsible for absorption.
Intestinal bypass (no longer done): This procedure has evolved and improved since it was first introduced some twenty years ago. In the early days, intestinal bypass — which is totally different from gastric bypass — had some very serious complications.
Compared to the intestinal bypass, gastric bypass is relatively safe with fewer complications.
Jejunum: Ten feet of small intestine; the part responsible for digestion.
Open: Making an incision to do the operation; opening the abdomen.
NIH: National Institutes of Health
Preop: Before surgery (Pre Operation). The time/events prior to surgery.
Postop: After surgery (Post Operation). The time/events after surgery.
Periop: Surrounding surgery (Peri=“around”, as in periscope [“around-looking”]).
The time/events before, during and after surgery.
Panniculectomy: The removal of the tissue and skin from the abdomen; a tummy tuck. (Never use the term “tummy tuck” when communicating with an insurance company. They like to deny this surgery!)
Pouch: The new small stomach created during most bariatric surgeries.
Malabsorption: Impaired intestinal absorption of nutrients, causing food to be poorly digested and absorbed.
Morbid: Pertaining to disease, illness, increased risk of death.
Morbid Obesity: Severe obesity in which a person's BMI is over 40. This is generally equivalent to having 100 or more pounds to lose.
Mortality: Pertaining to death
Multidisciplinary: Team approach to evaluation and treatment of clinically severe obesity; includes surgical, internal medicine, nutrition, psychiatric, and exercise physiology, assessment, and treatment
Psychotherapy: Evaluation and treatment of mentally related disorders.
Kilogram: Measure of weight equal to 2.2 pounds.
Laparoscopy: Method of visualizing and treating intra-abdominal problems with long fiber-optic instruments.
Psychotherapy: Evaluation and treatment of mentally related disorders.
Pulmonary: Pertains to lungs.
Restriction operation (weight-loss surgery):

Restriction operations are the surgeries most often used for producing weight loss. Food intake is restricted by creating a small pouch at the top of the stomach where the food enters from the esophagus. The pouch initially holds about 1 ounce of food and expands to 2-3 ounces with time. The pouch's lower outlet has a small opening. The small outlet delays the emptying of food from the pouch and causes a feeling of fullness.

Restriction operations for obesity include gastric banding and vertical banded gastroplasty.

Both operations serve only to restrict food intake. They do not interfere with the normal digestive process.

Roux-en-Y gastric bypass (RGB):

This operation is the most common gastric bypass procedure. First, a small stomach pouch is created by stapling or by vertical banding. This causes restriction in food intake.

Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the duodenum (the first segment of the small intestine) as well as the first portion of the jejunum (the second segment of the small intestine). This causes reduced calorie and nutrient absorption The procedure is more extensive than the VBG (below). Some people prefer it because of a a sick feeling that results (called “dumping”) when post op patients overeat. This can be a powerful feeback/learning mechanism whereby people lose their interest — at a “gut instinct” level — in eating excessive carbohydrates.

Staples: Surgically sterile devices for connecting tissue; usually permanent and made of stainless steel or titanium.
Strictures: Narrowing of anastomosis or section of intestine; often related to scarring or ulcers.
Therapy: Treatment
Type 2 diabetes: A disorder of glucose and insulin metabolism.
Vertical banded gastroplasty (VBG): This procedure is becoming the most frequently used restrictive operation for weight control. It is less extensive than the RNY (above). Both a band and staples are used to create a small stomach pouch. The procedure works best on individuals who are not binge
eaters.