Shedding Health Risks with Bariatric Weight Loss Surgery.ppt

Shedding Health Risks with Bariatric Weight Loss Surgery By Susan Gallagher Camden, RN, CBN, MSN, PhD Nursing2009, January 2009 2.5 ANCC/AACN contact hours Online: ? 2009 by Lippincott Williams Wilkins. All world rights reserved. Bariatric weight loss surgery (BWLS) Patients having BWLS in the U.S. grew 644% from 1995 to 2005 400,000 had the surgery in 2008 One reason is growing awareness of obesity’s effect on morbidity and mortality How BWLS combats diabetes Obesity is a major independent risk factor for type 2 diabetes In the U.S., most people diagnosed with diabetes are overweight Research shows that 90% of patients who have BWLS no longer need medication for diabetes Who’s a candidate for BWLS? National guidelines set forth criteria - body mass index of 40 kg/m2 or more - 35 to 39.9 kg/m2 with severe comorbidities Insurance reimbursement looks for documentation of 3 unsuccessful attempts at weight-loss programs Who’s a candidate for BWLS? Physical exam to include health and weight history Screening of physical or emotional disorders Not considered a candidate if: Unstable cardiac or pulmonary condition Prader-Willi syndrome Known endocrine disease Unresolved psychological issues Typical screening protocol Preoperative evaluation compromises two main parts: psychological testing clinical interview Psychological testing Typically, Minnesota Multiphasic Personality Inventory-2 Includes family and social situation Any eating disorders or psychological issues must be addressed Patients must be made aware of commitment to weight loss, exercise, changes in eating habits postoperatively Clinical interview Consists of comprehensive assessment of patient’s medical, surgical, psychiatric, and psychosocial history Drug or food allergies Alcohol and tobacco use and medication history Sorting out surgical options Roux-en-Y gastric bypass combines gastric restriction and malabsorption strategies, is most common weight loss procedure performed in U.S. S