Glossary

Cardiovascular disease (CVD) is any disease of the heart or blood vessels or any abnormal condition characterized by dysfunction of the heart or blood vessels.

Cholecystitis is inflammation of the gallbladder

Cholelithiasis is the presence or formation of gallstones in the gallbladder or bile ducts.

Cholesterol is a soft, waxy substance manufactured by the body and used in the production of hormones, bile, and vitamin D. It is present in all parts of the body, including the nervous system, muscle, skin, liver, intestines, and heart. Cholesterol regulates membrane fluidity and functions as a precursor molecule in various metabolic pathways. However, too much “bad cholesterol” (low-density lipoproteins) may cause arteriosclerosis, the buildup of plaque on the artery walls.

Congestive heart failure (CHF) is a condition marked by weakness, edema (fluid retention), and shortness of breath that is caused by the inability of the heart to maintain adequate blood circulation in the peripheral tissues and the lungs.

Type II Diabetes. More than 80 percent of type II diabetics have complete resolution of their diabetes, and many others have greatly improved control.  This usually occurs within a few weeks of surgery for gastric bypass patients, and slightly longer for Lap-Band® patients.  Patients are usually able to come off their medications including insulin injections and return to normal blood glucose and Hemoglobin A1C levels.

Cost savings are reductions in all or any portion of the costs of providing goods or services.

Diabetes. Any of several metabolic disorders marked by increased blood glucose, excessive discharge of urine, and persistent thirst.

Diabetes mellitus. Elevations of blood sugar due to deficient insulin production or action.

Inflatable silicone band. Approved by the FDA in June 2001, the Lap-Band® is the newest and only adjustable and completely reversible surgical treatment for morbid obesity in the United States. It induces weight loss by reducing the capacity for food and drink in the stomach. Since its clinical introduction in 1993, more than 200,000 Lap-Band® weight loss surgeries have been performed around the world. Like a wristwatch, the band is fastened around the stomach to create a smaller pouch that limits and controls the amount of food the patient eats. It also creates a small outlet that slows the emptying process in the lower half of the stomach and intestines. As a result, patients experience an earlier sensation of "fullness" and are satisfied with smaller amounts of food.

Hypertension/High Blood Pressure. After bariatric surgery, over 70 percent of patients are able to come off all of their anti-hypertensive medications.  Many other patients are able to significantly reduce the number or dosages of their medications. 

High cholesterol. Over 80 to 90 percent of patients will develop normal cholesterol levels within two to three months after gastric bypass, with significant improvement seen for Lap-Band® patients as well.

Gout is a disturbance of uric acid metabolism occurring chiefly in males. Gout is characterized by painful inflammation of the joints, especially in the feet and hands, and arthritic attacks resulting from elevated levels of uric acid in the blood and the deposit of urate crystals around the joints. The condition can become chronic and result in deformity.

Infertility is defined as absent or diminished fertility; the persistent inability to conceive a child.

Insulin is a polypeptide hormone secreted by the pancreas. Insulin regulates the metabolism of carbohydrates and fats, especially the conversion of glucose to glycogen, which lowers the blood glucose level. Insulin can be synthetically created for use in the medical treatment and management of diabetes.

Lipids are organic (carbon-containing) substances that do not dissolve in water. Lipids, together with proteins and carbohydrates, constitute the principal structural components of living cells. Lipids include fats, waxes, phospholipids, cerebrosides, and related and derived compounds.

Sleep apnea syndrome / Hypoventilation. The large majority of patients have improved breathing at night and overall decreased shortness of breath following weight loss.  Sleep apnea is resolved in over 85 percent of patients.  Patients feel refreshed and usually no longer require accessory breathing apparatuses after weight loss.

Stress urinary incontinence is an involuntary loss of urine occurring simultaneously with increased internal abdominal pressure, such as when laughing, sneezing, coughing, or performing physical activity.

Osteoarthritis (Degenerative Joint Disease) occurs mainly in older persons and is characterized by chronic degeneration of the cartilage of the joints. This condition is also called degenerative joint disease. Patients with this disease have significant joint pain that limits their activities. After weight loss surgery, these patients can usually participate in many activities and social events, even sports. 

Lower back pain and disc disease can be relieved with as little as 25-30 pounds of weight loss. 

Acid reflux occurs when stomach acid leaks into the esophagus. Bariatric surgery is an excellent method of treating acid reflux disease.  Relief is usually noticed within a few days of the surgery. 

Polycystic Ovarian Syndrome (PCOS) is the most common syndrome in reproductive-age women and is often associated with obesity. PCOS is an accumulation of incompletely developed follicles in the ovaries and is characterized by irregular menstrual cycles, multiple ovarian cysts, and hirsutism (excessive hair growth) and often results in infertility.

Poor Outcomes. A system known as the Bariatric Analysis and Reporting Outcome System (BAROS) analyzes post-surgical outcomes including weight loss, quality of life, and improvements in obesity-related co-morbidities. Scores of three or less indicate fair outcomes or worse.

Major surgery is defined as extensive, relatively complex surgical procedures involving vital organs and/or posing a mortality risk. Major surgery, such as gastric weight loss surgery, that is performed using a minimally invasive laparoscopic surgical technique is still major surgery.

Sleep apnea is a temporary suspension of breathing occurring repeatedly during sleep that often affects overweight people, people with an obstruction in the breathing tract, an abnormally small throat opening, or a neurological disorder.

Successful long-term weight loss. For bariatric surgery to be considered successful, a patient must lose 50 percent of their excess body weight and keep it off in the long term. Therefore, in the case of a patient who is 200 pounds overweight, the gastric bypass or Lap-Band® operation is considered successful if the patient loses at least 100 pounds and keeps it off long term (more than six to 10 years).

Sibutramine is a drug used for the management of obesity that helps reduce food intake. It is indicated for weight loss and maintenance of weight loss when used in conjunction with a reduced-calorie diet.

Stroke is sudden loss of brain function caused by a blockage or rupture of a blood vessel to the brain.

Triglycerides are a type of fat found in your blood and the foods you eat. They are the most common type of fat in your body and are a major source of energy. Triglycerides commonly circulate in the blood in the form of lipoproteins (also referred to as neutral fat).

Waist circumference is the distance around your waist. Abdominal fat is a predictor of your risk for developing heart disease and other diseases. This risk increases with a waist measurement of over 40 inches in men and over 35 inches in women.

Thyroid is a gland in the neck that produces hormones designed to regulate the body's metabolism and organ function.

High-density lipoprotein (HDL) is a lipoprotein of blood plasma that is composed of a high proportion of protein with little triglyceride and cholesterol. HDL carries plaque away from artery walls, decreasing the probability of developing atherosclerosis. Therefore, HDL is commonly known as “good cholesterol.”

Weight loss drugs. There have been many pharmacological weight loss regimens offered to manage obesity.  Some of the early trials used amphetamine-like drugs or administration of thyroid hormone.  These were subsequently abandoned for a variety of causes including abuse, side effects, and weight regain upon withdrawal of the medication.  In the 1990’s the combination of phentermine and fenfluramine (“phen/fen”) was heralded as a pharmacological breakthrough.  This was later found to contribute to cardiac valvular disease and primary pulmonary hypertension and was subsequently withdrawn from the market.  There are some current medications that are used in various weight loss programs.  Medications like phentermine, sibutramine, or orlistat are examples and are generally reserved for individuals with a BMI over 30.  Unfortunately, the weight loss with these medications is limited and all drug trials have been disappointing.