Obesity and Bariatric Surgery Intervention Essay

Introduction

Obesity is a chronic problem that can affect individuals’ health significantly. The case study presents Mr. C., the patient seeking information about bariatric surgery. This report provides information about the clinical manifestations, functional health patterns, and health risks. The report aims at evaluating the patient’s diagnosis and appropriate interventions. The paper concludes that the patient should undergo bariatric surgery but be aware of possible health risks associated with it.

Case Study

The patient shows high levels of blood pressure, fasting blood glucose, total cholesterol, and triglycerides. His body mass index (BMI) is approximately 48, which means that Mr. C. is obese. The risks caused by obesity can be severe and decrease an individual’s health level significantly. They include hypertension, type II diabetes, heart diseases, sleep apnea, and kidney diseases (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.). The patient is already exposed to some of these risks; he can be considered at a pre-diabetic stage.

It is possible to say that bariatric surgery is an appropriate intervention for the patient. The American Society for Metabolic and Bariatric Surgery (2019) reports the following criteria for the candidates:

1. BMI ≥ 40 or being overweight more than 100 pounds;
2. BMI ≥ 35 with the presence of at least one disease associated with obesity, such as hypertension and sleep apnea;
3. Inability to lose weight effectively with prior efforts.

The patient’s BMI complies with these requirements; moreover, Mr. C. has comorbidities related to obesity. It is necessary to mention that although the man is a good candidate for the intervention, he should be informed about the possible risks associated with the procedure. They include changes in the level of blood pressure, cholesterol, and hemoglobin (Lager et al., 2017). In addition, bariatric surgery may result in weight gain in the future.

Mr. C.’s functional health patterns can be analyzed from the perspectives of health perception, sleep-rest, activity-exercise, self-perception, and nutrition.

• Health perception: The patient is aware of the fact that he is overweight and is seeking a solution to this problem. The potential problem may be that Mr. C. has not developed a system of health-supporting behaviors, as he has been gaining weight. In addition, his cholesterol and glucose levels are high, identifying that he is at risk of developing diabetes.
• Sleep-rest: The patient has sleep apnea, which can be considered a complication of obesity (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.). The symptoms of the condition can be decreased if Mr. C. loses weight.
• Activity-exercise: Currently, the possible problem is that the patient works at a catalog telephone center, which means that he is not physically active for the majority of the day. Such a lifestyle can prevent Mr. C. from losing weight and lead to the development of the symptoms associated with obesity.
• Self-perception: The patient is aware of his poor health state and wants to manage this issue. The possible problem is that the surgery may not eliminate all of the exiting problems (Lager et al., 2017). Thus, it is vital to discuss the patient’s expectations regarding the intervention.
• Nutrition: The patient is trying to restrict dietary sodium to reduce the effects of high blood pressure and sleep apnea. The current problem is that Mr. C. may not be following a healthy diet, as he continues to gain weight.

End-stage renal disease (ESRD) is the last stage of chronic kidney disease (CKD) (Wang et al., 2019). Obesity and hypertension are among the factors contributing to the development of ESRD. The illness is defined by the level of kidney function and can be measured by the glomerular filtration rate (GFR). The CKD has the following stages:

1. GFR > 90 mL/min;
2. GFR = 60-89 mL/min (mild CKD);
   1. GFR = 45-59 mL/min (moderate CKD) (Wang et al, 2019);
   2. GFR = 30-44 mL/min (moderate CKD);
3. GFR = 15-29 mL/min (severe CKD);
4. GFR <15 mL/min (ESRD) (Wang et al, 2019).

Patient education for Mr. C. can include the information about the risks associated with CKD and ESRD, including a high level of blood sugar and blood pressure, as well as heart diseases (Centers for Disease Control and Prevention, 2017). Mr. C. should be advised to avoid salty foods, eat more vegetables and fruits, pay attention to his blood pressure, and become physically active. This strategy will improve his health, prevent the development of the disease in the future, and help him to avoid deterioration of his renal status.

The resources available for patients living with the disease include remote patient management, outpatient ESRD facilities, rehabilitation centers, and hospital-based dialysis units (Wallace et al., 2017; Heung et al., 2015). The appropriate type of multidisciplinary approach is the implementation of patient education, appropriate dialysis setting, and cost reduction measures to improve health outcomes (Heung et al., 2015). In addition, individuals should use devices, such as bioimpedance scales and glucometers to assess their health state. For those living far from ESRD facilities, it is vital to find temporary local living facilities to reduce the transportation burden or use remote patient management. Patients’ living conditions should be appropriate to reduce the level of stress in individuals. When returning to employment, patients should take time off after surgery until they are fully recovered. This issue should be discussed both with employers and medical professionals.

Conclusion

The report shows that Mr. C. is at risk of developing complications caused by obesity, including diabetes. He is a good candidate for bariatric surgery as his BMI is high and he has related comorbidities. The patient is at risk of developing ESRD due to hypertension. The resources available for him include remote patient management, rehabilitation centers, outpatient ESRD facilities, and hospital-based dialysis units.

References

American Society for Metabolic and Bariatric Surgery. (2019). Who is a candidate for bariatric surgery? Web.

Centers for Disease Control and Prevention. (2017). Prevention & risk management.Web.

Heung, M., Faubel, S., Watnick, S., Cruz, D. N., Koyner, J. L., Mour, G.,… Vijayan, A. (2015). Outpatient dialysis for patients with AKI: A policy approach to improving care. Clinical Journal of the American Society of Nephrology, 10(10), 1868-1874.

Lager, C. J., Esfandiari, N. H., Subauste, A. R., Kraftson, A. T., Brown, M. B., Cassidy, R. B.,… Oral, E. A. (2017). Roux-En-Y gastric bypass vs. sleeve gastrectomy: Balancing the risks of surgery with the benefits of weight loss. Obesity Surgery, 27(1), 154-161.

National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Health risks of being overweight. Web.

Wallace, E. L., Rosner, M. H., Alscher, M. D., Schmitt, C. P., Jain, A., Tentori, F.,… Foo, M. (2017). Remote patient management for home dialysis patients. Kidney International Reports, 2(6), 1009-1017.

Wang, T., Xi, Y., Lubwama, R., Hannanchi, H., Iglay, K., & Koro, C. (2019). Chronic kidney disease among US adults with type 2 diabetes and cardiovascular diseases: A national estimate of prevalence by KDIGO 2012 classification. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 13(1), 612-615.