1: 

On another note, Class, do you believe that this method of bariatric surgery weight loss treatment will completely eliminate Mr. C’s obesity and other health problems, your thoughts?

2: 

Very insightful posts everyone. A colleague of mine had bariatric surgery and lost about 160 pounds.  She claims that her health is much better, but the surgery only fixed the amount you can eat at a time and how you digest the food. What it doesn’t fix is the reasoning behind why someone takes comfort in food.  Why they allow themselves to overindulge in something they know is not good for them.  It is the same concept as an alcoholic; it is a process in recovery. It doesn’t happen overnight and if you do not work through certain things in your life, you can gain the weight back or turn to a different addiction.  It is very important to educate the patient in this matter and that they are referred to therapist for intensive therapy.

Class do you agree? Share your thoughts? How do you care for these special population of patients?

3: 

This is an essential question to ask anyone thinking of bariatric surgery. A detailed eating and activity (not just exercise) history is essential prior to approval for surgery. It is my opinion that Mr. C is very young and although he has co-morbid diseases he does not exercise, according to the case presentation, and his eating habits are questionable. He also has a sedentary job which more than likely is at least 8 hours a day. He needs to be given a strict regimen for diet and exercise for minimum of 6-9 months revealing that he is committed to lifestyle modifications.  Several of my fellow classmates talked about the need for psychological intervention prior to surgery and this is essential as well. There may be underlying reasons for his obesity that could be resolved, and surgery would not be essential.

Having bariatric surgery is not a process to be taken lightly. This is a commitment that can’t be forgotten. Normal anatomy is altered with the possibility of complications.

4: 

Wow, your post is very thorough. I agree that Mr. C needs a major lifestyle change before getting the surgery. Hyperglycemia needs to be assessed further to see if he has Type 2 diabetes which is more than likely considering his medical history.  Hyperglycemia affects people who have diabetes. Several factors can contribute to hyperglycemia in people with diabetes, including food and physical activity choices, illness, non diabetes medications, or skipping or not taking enough glucose-lowering medication which is something that MR C. is doing. Thank you. 

                                                           Reference

Mayo Clinic. (2019). Retrieved from https://www.mayoclinic.org/diseases-conditions/hyperglycemia/symptoms-causes/syc-20373631