Grand Canyon-NRS441V: The Metabolic/Bariatric Surgery Patient

Literature Review
Uchenna Ekwonye
Grand Canyon-NRS441V
Professor:
Date
Buchwald, H., Ikramuddin, S., Dorman, R. B., Schone, J. L., & Dixon, J. B. (2011). Management of the metabolic/bariatric surgery patient. The American journal of medicine, 124(12), 1099-1105
The article reviews the benefits of using metabolic/bariatric procedures to manage obesity, and the patients selected for the study had a BMI ≥ 40 kg/m. The authors considered the impact of lifelong care in enhancing patient outcomes and reducing the risk of surgery complications. Bariatric surgery was identified as a successful strategy to manage obesity, and this supports the proposed changes. Monitoring nutrition intake should be prioritized for post operative bariatric patients to individualize care and manage the obesity. Even as few studies focus on the metabolic mechanism associated with bariatric surgery, the procedure is helpful and provides insights on the etiology of obesity.
Coughlin, J. W., Guarda, A. S., Clark, J. M., Furtado, M. M., Steele, K. E., & Heinberg, L. J. (2013). A Screening Tool to Assess and Manage Behavioral Risk in the Postoperative Bariatric Surgery Patient: The WATCH. Journal of clinical psychology in medical settings, 1-8.
In addressing the problem of obesity nonsurgical and surgical methods are often use, and even as there is weight loss, there is also risk of weight gain among some obese individuals. As such, the article highlights the importance of employing a Screening tool (WATCH) administered to address the risk of weight gain, nutritional deficiencies and even disordered eating habits. The study is relevant to the proposed changes, while emphasizing the benefit of postoperative care among bariatric patients to avoid relapse. Using the screening tool is necessary to identify cases that require referral and follow up to manage the obesity better.
Crémieux, P. Y., Buchwald, H., Shikora, S. A., Ghosh, A., Yang, H. E., & Buessing, M. (2008). A study on the economic impact of bariatric surgery. Am J Manag Care, 14(9), 589-596
The researchers assessed the benefits and costs of bariatric surgery in the US for third –party payers, where obese patients who underwent bariatric surgery and those who did not were compared. To improve comparability, the cases were matched based on their close characteristics and the return on investments for bariatric surgery were $ 16,000- $ 26,000. The costs were recouped between 2 and 4 years, while there were also cost savings for bariatric surgery support. The case for bariatric surgery is that it improves patient outcome for those with obesity and is cost effective. This is consistent with need for changes to undertake bariatric surgical operations and post care management.
DeMaria, E. J., Pate, V., Warthen, M., & Winegar, D. A. (2010). Baseline data from American society for metabolic and bariatric surgery-designated bariatric surgery centers of excellence using the bariatric outcomes longitudinal database. Surgery for Obesity and Related Diseases, 6(4), 347-355.
Laparoscopic adjustable gastric banding (LAGB) is the second most popular weight loss procedure after Laparoscopic Roux-en-Y gastric bypass (LRYGB). In the article, the researchers obtained data from > 800 surgeons and 450 facilities based on the Bariatric Longitudinal Database (BOLD). Even as the females constituted 78.6% of the study population, the patients were diverse, and the data revealed the characteristics of patients undergoing bariatric surgery. The article supports surgical weight loss procedures, which are safe and effective procedures where the mortality rate was .13%. Typically, the laparoscopic procedures are done with open approaches chosen when there are difficult operations.
Dixon, J. B., Zimmet, P., Alberti, K. G., & Rubino, F. (2011). Bariatric surgery: an IDF statement for obese Type 2 diabetes. Diabetic Medicine, 28(6), 628-642.
Multidisciplinary health practitioners identified bariatric surgery as an effective intervention to treat and prevent type 2 diabetes among obese patients. The participants in the convention suggested the benefits of bariatric surgery helped in controlling glycemic control. More research on the effectiveness of bariatric surgery is necessary to improve health outcomes among diabetic patients who are obese. The article supports the case for bariatric surgical intervention, and the experts were in agreement that the health policies affected the adoption of surgical approaches meant to manage obesity. Bariatric surgery is a viable option for patients with type 2 diabetes and obese whose health status has failed to improve with medical therapy interventions.
Heber, D., Greenway, F. L., Kaplan, L. M., Livingston, E., Salvador, J., & Still, C. (2010). Endocrine and nutritional management of the post-bariatric surgery patient: an Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology & Metabolism, 95(11), 4823-4843
The article identifies guidelines for managing post operative bariatric surgery patients to treat diabetes mellitus. Even as bariatric surgery is effective in most cases, there are instances where less effective than anticipated, and the guidelines emphasize the endocrinal and nutritional aspects that are considered in postoperative management. The protein requirements among adults correspond with the body weight and should be considered to maintain free mass for the postoperative diet. The researchers go further and highlight the importance of managing nutritional deficiencies when there is malabsorption of nutrients. Since the article addresses bariatric surgery interventions and postoperative management, it provides clues on effective strategies to reducing obesity and limit weight gain.
Klein, S., Ghosh, A., Cremieux, P. Y., Eapen, S., & McGavock, T. J. (2011). Economic impact of the clinical benefits of bariatric surgery in diabetes patients with BMI≥ 35 kg/m2. Obesity, 19(3), 581-587
People who are morbidly obese are ineligible for bariatric surgery, even as this procedure is potentially lifesaving. The obesity epidemic in the US is increasing while the healthcare costs of obesity are much higher compared to patients without diabetes. The researchers estimated the economic effects of bariatric surgery among diabetic patients with a BMI ≥ 35 kg/m. For patients who underwent laparoscopic surgery, the related costs were recoverable after 26 months. Bariatric surgery is then cost effective, and the reported findings are consistent with previous studies that bariatric surgery is clinically effective and is likely cost effective in the long term.
Kulick, D., Hark, L., & Deen, D. (2010). The bariatric surgery patient: a growing role for registered dietitians. Journal of the American Dietetic Association, 110(4), 593-598.
The article discusses the role of dietitians and nutritionists in managing weight loss for bariatric surgery patients. The rate of bariatric operations has increased rapidly in the last two decades. Studies show that bariatric surgery is more successful than nonsurgical approaches in reducing weight. However, lifestyle changes with emphasis on dietary changes postoperative are crucial to maintaining healthy wellbeing. The article highlighted nutritional assessment and therapy as crucial aspects to improving surgical outcomes. Merely undergoing bariatric surgical procedures is not enough if there is no follow up and proper management practices to address comorbidities conditions like obesity and uncontrolled diabetes.
Nicoletti, C. F., Lima, T. P., Donadelli, S. P., Salgado Jr, W., Marchini, J. S., & Nonino, C. B. (2011). New look at nutritional care for obese patient candidates for bariatric surgery. Surgery for Obesity and Related Diseases. Surgery for Obesity and Related Diseases 9: 520–525
This was an evaluation of the preoperative deficiencies that affected patients who...