BMI
Body mass index. One of the anthropometric measures of body mass. A formula for standardizing the extent of overweight.

Clinically severe obesity
The newer term for morbid obesity.

Dumping syndrome
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.

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 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.

Hernia
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.

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.

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

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

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.

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

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

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

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

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!)

Pouch
The new small stomach created during most bariatric surgeries.

Restriction operations (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 outlet. 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 (RGB)
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.