218 Chapter 11Dealing with Weight extremes
Decades of scientific studies support
a link between having a healthy
weight and overall physical well-
being. although some people with
a Bmi above 30 exercise enough
to maintain overall fitness, research
shows that most overweight people
are too sedentary. on balance,
carrying significant excess weight
over a period of years correlates strongly with increased
risk of chronic diseases and disorders, including type 2
diabetes, atherosclerosis, hypertension, and sleep apnea.surgery can be an option for treating
extreme obesity
some extremely obese people have surgery that reduces
the amount of food they can eat. typical candidates are
people with a Bmi of 40 or higher, or who have an obesity-
related disease. one option is gastric bypass surgery, which
closes off most of the stomach and bypasses several feet
of the small intestine (figure 11.24a). a less drastic choice
is gastric banding. there are several types of banding
procedures, but in each a plastic band cinches off part of
the stomach so that only a small pouch can hold food. a
device placed under the skin of the abdomen allows the
patient’s doctor to adjust the band (figure 11.24B). With
either type of surgery, the person can
eat only a small amount before feeling
full, which reduces the amounts of
nutrients that can be absorbed.some obese people who have weight-loss surgery lose as
much as 70 percent of their excess fat. the surgery isn’t an
easy way out, however. minor to serious complications can
arise, and the patient must be willing to commit to long-term
lifestyle changes that include healthy diet and regular exercise.eating disorders can be life-threatening
it’s probably safe to say that most of us overeat from time
to time. some people, though, develop a habit of binge
eating—they eat an abnormally large amount of food in a
few hours and do so at least twice a week for 6 months or
more. emotional factors are at the root of this and other
forms of compulsive eating. psychological counseling may
help a binge eater regain a healthier perspective on food.
emotions sometimes can influence weight gain and loss
to a dangerously extreme degree. people who suffer from
anorexia nervosa see themselves as fat no matter how thin
they become. an anorexic purposely starves despite feeling
hungry and may overexercise as well. Common side effects
include heart arrythmias, osteoporosis, and cessation of
menstruation (amenorrhea). although anorexia nervosa is
most common among younger women, more cases are
being reported among older women and young men.
anorexia nervosa typically is rooted in a complex blend
of psychological and emotional issues and social factors
(table 11.8). female dancers or athletes may becomeFigure 11.24 Gastric surgery is an
option for treating severe obesity.11.15
anorexia nervosa Eating
disorder in which a person
purposely starves and may
become dangerously thin.
binge eating Routinely
eating an abnormally large
quantity of food within a few
hours.
A gastric bypass
In gastric bypass, surgical staples restrict
the stomach to a small pouch that the
surgeon connects to the lower jejunum,
bypassing the rest of the stomach, the
entire duodenum, and the upper jejunum.
The stomach pouch holds only a few
tablespoons of food at a time.EsophagusEsophagusDuodenumJejunumLarge
intestineStomachSmall stomach
pouchSmall stomach
pouchStomachSurgical
staplesPortGastric bandBypassB gastric banding
A gastric band is placed slightly beyond the
gastroesophageal sphincter at the entrance
to the stomach, creating a small pouch that
can receive food. The opening is adjustable
by way of a port placed under the skin of
the adbomen.FOCUS ON HEALTH© Cengage Learning© michaeljung/Shutterstock.comCopyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).