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89 Cards in this Set
- Front
- Back
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What percent of American adults are either overweight or obese?
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65%
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_______is the 2nd leading cause of unnecessary deaths each year.
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obesity
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What is the goal of healthy people 2010?
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-reduce % of obese adults to 15%
-develop measure to prevent excess weight and obesity |
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is obesity an epidemic or pandemic?
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epidemic
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A BMI greater than 30 is:
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obese
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4 causes of obesity?
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diet
exercise drugs familial & genetic factors |
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BMI greater than 25 is considered:
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overweight
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How is BMI calculated?
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dividing wt in kg by height in meters squared
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BMI greater then 40:
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morbidity obese
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Co morbid conditions of obesity regarding Urinary system: (3)
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-stress incontinence
-gout -renal disease |
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Comorbities of obesity regarding Integument status: (3)
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-Cellutitis
-fungal skin infections -panniculitis |
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Comorbities of obesity regarding endocrine system: (2)
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-diabetes type 2
-pancreatitis |
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Comorbities of obesity regarding the digestive system: (3)
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GERD
Gallbladder disease nonalcoholic steatohepatitis |
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Comorbities of obesity regarding the cardiovascular system: (6)
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-chronic venous insufficiency
-htn -hyperlipidemia -artherosclerosis -dvt -pvd |
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Comorbities of obesity regarding the nervous system: (3)
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carpal tunnel
stroke pseudotumor cerebri |
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Comorbities of obesity regarding the musculoskeletal system: (4)
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-osteoarthritis
-rheumatoid arthritis -sever's disease -vertebral disc herniation |
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Comorbities of obesity regarding the reproductive system: (7)
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-infertility
-menstrual abnormalities -pregnancy abnormalities -hirsutism -impotence -polycystic ovarian disease -neural tube birth defect |
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diet therapy should be a collaborative effort b/n:
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client
physician dietician |
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_______suppress appetite, which reduces food intake and over time may result in weight loss
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anorectic drugs
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Co morbidities of obesity regarding the immune system: (2)
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-cancer (breast, colon, prostate)
-poor healing of wounds & infection |
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co morbid conditions of obesity regarding the psyche: (4)
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low self esteem
depression isolation disturbed body image |
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3 ways to surgicall manage obesity:
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lipo
panniculectomy bariatric surgery |
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4 complementary and alternative therapy for obesity:
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acupuncture
acupressure ayurvedic hypnosis |
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surgical procedure used to reduce the amount of adipose tissue in selected areas of the body
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liposuction
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the excision of an apron of abdominal subcutaneous fat that lacks adequat supportive tissue from people who are morbidly obese
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panniculectomy
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when was gastric bypass developed?
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1960's
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approximently how many gastric bypass surgeries were done in 05'?
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140,000
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kuzmak developed _________ in 1986
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the lap band
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intraop complication of the lap band:
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hemorrhage
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after gastric bypass surgery, the new stomach can only hold how much?
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1/2 cup
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s/p gastric bypass diet
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water only
clear liq full liq pureed foods reg. food |
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drug therapy is an option for those clients w/a bmi of ___ or a BMI of __ with comorbidities.
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30
27 |
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what are some ways to non surgically manage obesity? (6)
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-diet programs
-diet therapy -exercise program -drug therapy -behavioral tx -complementary and alternative therapies |
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___% of dieters regain the weight they've lost within ___ years
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85
5 |
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who qualifies for obesity surgery?
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bmi >40 or...
bmi 35-39.9 w/serious medical conditions. |
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s/p gastric bypass diet
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water only
clear liq full liq pureed foods reg. food |
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drug therapy is an option for those clients w/a bmi of ___ or a BMI of __ with comorbidities.
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30
27 |
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what are some ways to non surgically manage obesity? (6)
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-diet programs
-diet therapy -exercise program -drug therapy -behavioral tx -complementary and alternative therapies |
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___% of dieters regain the weight they've lost within ___ years
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85
5 |
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who qualifies for obesity surgery?
bmi >___ or... bmi __-____ w/serious medical conditions. |
40
35-39.9 |
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With surgery, the obese client is more at risk for:
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pulmonary, thromboembolic complications and death
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Whats the most common gastric bypass surgery in the US?
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roux-en-y
(rygbp) |
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with gastric bypass surgery, half the weight loss occurs:
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in the first 6 months.
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with gastric bypass surgery, weight loss peaks at:
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18-24 mo
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adjustable silicone band lined with an inflatable balloon
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lap band
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the lap band restricts:
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food intake
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Balloon connected to a small reservoir that is placed under the skin of the abd.
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lap band
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how many degress should the hob be elevated during the post op period from lap band surgerY?
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30
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when should you drink liquids?
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between meals not with meals.
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how many meals should you eat a day?
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3-6 small meals
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_______ is key in maintaining weight loss
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physical activity
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pre op evaluations for obesity sugery (4)
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medical clearance
surgical eval including gastroscopy nutrition consult psych consult |
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behavioral tx for the obese clients
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-self monitoring techniques
-stimulus control -reinforcement techniques -cognitive restructuring |
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what are some good reasons to get laparoscopic gastric bypass? (7)
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-less blood loss
-shorter hospital stay -less post op pain -less pulmonary complications -fast recovery -fewer would complications -better cosmesis |
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-better wt. loss than after purely restrictive procedures
-low incidence of protein-calorie malnutrition and diarrhea -rapid improvement or resolution of wt. related comorbidities -appetite reduction are all: |
advantages of RYGBP
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early complications of RYGBP: (7)
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-anastomosis leak
-pulmonary embolism -wound infection -gi hemorrhage -resp. insuff. -mortality |
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Late complications of RYGYP: (6)
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-incisional hernia
-bowel obstruction -internal hernia -stoma stenosis -micronutrient deficiencies -marginal ulcer |
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strict compliance, freq. follow up for band adjustments
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lap band
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late complications of lap band surgery
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band erosion into stomach
esophageal dilation failure to lose weight |
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post op complications of lap band surgery:
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-band slippage
-leakage of the balloon or tubing -port infection -band infection -obstruction -n/v |
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what are the advantages of lap band surgery? (8)
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-absence of anemia
-absence of dumping -lack of malabsorption -short hosp. stay -very low mortality rate -adjustability of band -reversibility -laparoscopic placement |
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how often should you monitor vital signs post operatively with lap band surgery?
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q2-4h
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how often should the patient, tubes and catheters be repositioned after lap band surgery?
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q2h
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how long can a pt. have a pca after lap band surgery?
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24-48hrs.
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whats important regarding bed rails in the post op lap band pt.?
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they shouldn't be touching the clients body and they should be wide enough to allow client to turn
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whats important about ngt post operatively in the lap band pt.?
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an ngt may be in place, never reposition the tube
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what are some post op nsg care suggestions for the lap band pt?
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c
db leg exercises early ambulation |
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what are some signs and symptoms of dumping syndrome?
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tachycardia
nausea diarrhea abd cramping |
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in the lap band client, you should use absorbant padding:
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between folds
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in the post op lap band client, you should observe skin and folds for:
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redness
excoriation breakdown |
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the post op lap band client most likely will be wearing what?
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abd binder
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why should you avoid chewing gum?
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it could block the stomach outlet if swallowed
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what kinds of sweets should you avoid?
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concentrated
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what are some co morbid cardiovascular conditions that are improved ater surgery?
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-chronic venous insuff
-htn -hyperlipidemia |
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what are some co morbid digestive conditions that are improved ater surgery?
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gastroesophageal reflux disease
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what are some co morbid endocrine conditions that are improved ater surgery?
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diabetes type II
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what are some co morbid musculoskeletal conditions that are improved ater surgery?
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-degenerative joint disease pains
-hiatal hernia -low back pain |
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what are some co morbid nervous system conditions that are improved ater surgery?
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-pseudotumor cerebri
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what are some co morbid reproductive conditions that are improved ater surgery?
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-infertility
-menstrual abnormalities -pregnancy abnormalities |
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what are some co morbid respiratory conditions that are improved ater surgery?
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-asthma
-obesity hypoventilation syndrome -sleep apnea |
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what are some co morbid urinary system conditions that are improved ater surgery?
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-urinary stress incontinence
-levels of uric acid |
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aerobic exercise should:
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begin slow and increase in intensity
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what type of intensity and duration exercise program is good?
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low intensity, short duration
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what are some diets?
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weight watchers
atkins jenny craig fasting grapefruit hollywood senoma |
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if someone tried other methods of weight loss and are still severly obese, do they qualify for surgerY?
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yes
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if someone is unable to physcially perform routine daily activities and your quality of life is seriously impaired due to the severity of obesity
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they qualify for surgery
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in order to qualify for obesity surgery, the pt. must understand:
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procedure
risks of surgery effects after surgery |
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in order to qualify for obesity surgery, the pt. must be motivated to:
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make a lifelong behavioral commitment-diet and exercise
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RYGBP has proven to result in durable:
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wt. loss and improvement in weight related medical illnesses.
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