Abstract
Multidisciplinary evaluation of candidates for bariatric surgery is the current standard of care. Many patients with extreme obesity endure embarrassment because physicians’ offices are not equipped to carry out a complete examination. Bariatric treatment centers should secure the appropriate spaces and equipment to provide a supportive environment for surgical candidates. An individual who is familiar with management of extreme obesity and the diagnosis of all important comorbid conditions should conduct a complete medical history including a weight history and a physical exam. Close questioning based on awareness of all known surgical risk factors is an essential component. An assessment of functional status and capability for physical activity is emerging as an important component of the patient evaluation and selection process. A simple functional assessment with metrics should be part of the initial medical evaluation.
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References
NIH Consens Statement Online. Gastrointestinal surgery for severe obesity. 1991;9(1):1–20. http://consensus.nih.gov/1991/1991gisurgeryobesity084html.htm. (cited Mar 25–27, 1991).
Wolfe B. Presidential address—obesity discrimination: what can we do? Surg Obes Relat Dis. 2012;8:495–500.
Maciejewski M, Winegar D, Farley J, Wolfe B, DeMaria E. Risk Stratification of serious adverse events after gastric bypass in the Bariatric Outcomes Longitudinal Database. Surg Obes Relat Dis. 2012;8:671–8.
Benotti P, Wood C, Winegar D, Petrick A, Still C, Argyropoulos G, Gerhard G. Risk factors associated with mortality after Roux-en-Y gastric bypass surgery. Ann Surg. 2014;259(1):123–30.
Kral J. Patient selection for treatment of obesity. Surg Obes Relat Dis. 2005;1:126–32.
Bianchini F, Kaaks R, Vainio H. Overweight, obesity, and cancer risk. Lancet Oncol. 2002;3: 565–74.
The Longitudinal Assessment of Bariatric Surgery Consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361:445–54.
Turner P, Saager L, Dalton J, Abd-Elsayed A, Roberman D, Melara P, et al. A nomogram for predicting surgical complications in bariatric surgery patients. Obes Surg. 2011;21:655–62.
Gupta P, Franck C, Miller W, Gupta J, Forse A. Development and validation of a bariatric suurgery morbidity risk calculator using the prospective multicenter NSQIP dataset. J Am Coll Surg. 2011;212:301–9.
Egberts K, Brown W, Brennan L, et al. Does exercise improve weight loss after bariatric surgery? A systematic review. Obes Surg. 2012;22:335–41.
Vatier C, Henegar C, Ciangura C, et al. Dynamic relations between sedentary behavior, physical activity, and body composition after bariatric surgery. Obes Surg. 2012;22:1251–6.
Mc Cullough P, Gallagher M, Dejong A, et al. Cardiorespiratory fitness and short-term complications after bariatric surgery. Chest. 2006;130:517–25.
Hennis P, Meale P, Hurst R, O'Doherty A, Otto J, Kuper M, et al. Cardiopulmonary exercise testing predicts postoperative outcome in patients undergoing gastric bypass surgery. Br J Anaesth. 2012;109:566–71.
King W, Belle S, Eid G, et al. Physical activity levels of patients in the Longitudinal Assessment of Bariatric Surgery Study. Surg Obes Relat Dis. 2008;4:721–8.
American Thoracic Society. ATS statement: guidelines for the six minute walk test. Am J Respir Crit Care Med. 2002;166:111–7.
Robinson T, Wu D, Sauaia A, Dunn C, Stevens-Lapsley JE, Moss M, Steigman G, Gajdos C, Cleveland J, Inouye S. Slower walking speed forecasts increased postoperative morbidity and 1-year mortality across surgical specialties. Ann Surg. 2013;258:582–90.
Fritz S, Lusardi M. White paper: “walking speed: the sixth vital sign”. J Geriatr Phys Ther. 2010;32:2–5.
Simonsick E, Montgomery P, Newman A, Bauer D, Harris T. Measuring fitness in healthy older adults: the health ABC long corridor walk. J Am Geriatr Soc. 2001;49:1544–8.
Collazo-Clavel M, Clark M, McAlpine D, et al. Assessment and preparation of patients for bariatric surgery. Mayo Clin Proc. 2006;81(10 Suppl):S11–7.
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Benotti, P.N. (2014). Initial Medical Evaluation. In: Patient Preparation for Bariatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0906-3_4
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DOI: https://doi.org/10.1007/978-1-4939-0906-3_4
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