Absorption: Process in which digested food is absorbed by the lower part of the small intestine into the bloodstream

Adipose: Fatty; having to do with fat

Anastomosis: Surgical connection between two structures

Bariatric: Having to do with weight or weight reduction. 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.

Body Mass Index (BMI): Method of figuring out the degree of excess weight. Based on weight and height. One of the anthropometric measures of body mass. A formula for standardizing the extent of overweight.

Cardiovascular: Having to do with the heart and blood vessels

Clinically severe obesity: Body Mass Index of 40 or more, which is roughly equal to 100 pounds or more over ideal body weight; a weight level that is life-threatening. Also known as morbid obesity. The newer term for morbid obesity.

Co-Morbid: Related illnesses (i.e., arthritis, hypertension) or disabling conditions related to clinically severe obesity or obesity-related health conditions

Colon: Large intestine beginning at the end of the small intestine and ending at the rectum

Contraindications: Any symptom or situation that is inappropriate for an otherwise recommended treatment (i.e., alcoholism, drug dependency, severe depression, sociopathic [antisocial] personality disorder)

Criteria: Defines what is right for surgery

Digestion: Process in which food is broken down by the stomach and upper small intestine into absorbable forms

Dilation: Process of enlarging or further opening a passage or anastomosis

Disease: Process that is a hazard to health and/or longevity

Divided Gastric Bypass Surgery: Surgical operation that provides a way to manage clinically severe obesity

Dumping syndrome: Uncomfortable feeling of nausea, lightheadedness, upset stomach, vomiting, and/or diarrhea, related to ingestion of sweets, high-calorie liquids, or dairy products 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.

Duodenum: First 12 inches of small intestine immediately below the stomach. Bile and pancreatic fluids flow into the duodenum through ducts from the liver and pancreas.

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.

Gastric: Having to do with the stomach

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.

Gastric Bypass Surgery: Operation designed to make a portion of the stomach nonfunctioning and to reroute the small intestine

Gastrointestinal: Having to do with the stomach or intestine

Gastrojejunostomy Anastomosis: Upper connection of the gastric bypass operation

Gastroplasty: Surgical operation for morbid obesity that changes the shape of the stomach

Genetic: Having to do with inherited physical characteristics

Hernia: A weakness in the abdominal wall that results in a detectable bulge. 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.

Herniation: Process in which a hernia is formed

Hyperosmolality: Having highly concentrated substances that are capable of causing dumping syndrome

Hypertension: High blood pressure

Ileum: The 10 feet of small intestine that handle 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: The 10 feet of small intestine that handle digestion

Kilogram: Measure of weight equal to 2.2 pounds

Laparoendoscopic: Abbreviated "Lap." Operation performed using a laparoscope, a thin fiber-optic scope introduced into a body cavity through 4 or 5 small stab wounds.

Laparoendoscopy: Method that allows a doctor to see and treat intra-abdominal problems with long fiber-optic instruments

Laparoscopic: Abbreviated "Lap." Operation performed using a laparoscope, a thin fiber-optic scope introduced into a body cavity through 4 or 5 small stab wounds.

Laparoscopy: Method that allows a doctor to see and treat intra-abdominal problems with long fiber-optic instruments

Malabsorption: Impaired intestinal absorption of nutrients, causing food to be poorly digested and absorbed.

Morbid: Having to do with disease, illness, and a higher 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: Having to do with death

Multidisciplinary Bariatric Program: Team approach to testing and treatment of clinically severe obesity; includes surgical, internal medicine, nutrition, psychiatric, and exercise physiology, assessment, and treatment

NIH: National Institutes of Health

NIH Consensus Report: Summaries of meetings about clinically severe obesity and the assessment and treatment of obesity; issued periodically by NIH

NIH Surgical Criteria: The National Institutes of Health has established minimum requirements for deciding whether bariatric surgery is the right treatment option: 100 pounds or more above ideal body weight or a BMI of 40 or greater OR BMI of 35 or greater with one or more obesity-related health conditiion

Obesity: Having to do with excessive weight or adipose tissue

Obstructions: Narrowing of an anastomosis or a part of the gastrointestinal tract that slows down the normal passage of food or waste

Open: Making an incision to do the operation; opening the abdomen.

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!)

Periop: Surrounding surgery (Peri="around", as in periscope ["around-looking"]). The time/events before, during and after surgery.

Postop: After surgery (Post Operation).The time/events after surgery.

Pouch: The new small stomach created during most bariatric surgeries.

Preop: Before surgery (Pre Operation). The time/events prior to surgery.

Psychotherapy: Testing and treatment of mentally related disorders

Pulmonary: Having to do with the 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 Surgery: (RGB) A surgical method of reconnecting the stomach and upper small intestines in roughly a Y shape 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 they are permanent and made of stainless steel or titanium

Strictures: Narrowing of anastomosis or a 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) A type of surgical operation to treat clinically severe obesity. Changes the shape of and restricts the stomach. Not performed very often. 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.

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