Pharmaceutical Dietary & Surgical Interventions

Homework LM-12: Pharmaceutical, Dietary & Surgical Interventions

Please provide a self assessment score:

**Please keep in mind that answers to the first two homework questions will be part of your final project (see the assignment section) and these answers need to be in your own words.

1. What from the module resonates with your past experiences and what from this module (knowledge, skills, mindsets, resources, etc.) might be useful for you to remember for your future? Consider the different sections: supplements, medications, very low calorie diets, and surgery. List four or more things.
2. List one or more innovative solutions and/or entrepreneurial ideas that occurred to you as you read the module materials. If you wanted to, what next steps could you take to act on your ideas?
3. Your client has a BMI of 40 and is considering taking medications to support her weight loss. She has some questions for you:

1. “Will I need behavior change AND take the medication or will the medication take care of things?”

• “What side effects might I experience?”  

• “How much does the drug cost and do you think my insurance will cover the cost?”

4. Your client is considering whether to buy an over the counter weight loss medication called Alli or a vitamin, mineral and herb “metabolism stimulator” supplement. He has some questions for you:
5. “Which of these will likely work better?”
6. “The supplement is more natural and therefore safer right?”

5. Your client has a BMI of 45. He suffers from arthritis, diabetes, and sleep apnea. He has been obese since childhood. He suffered neglect, trauma, and bias in childhood and struggles with depression and anxiety today. He takes medication for his blood pressure and diabetes.  He uses food and alcohol to cope with stress. He says moving around is painful and he feels self-conscious whenever he tries to exercise. He has tried numerous weight loss approaches. He says he is truly ready for better health and a permanent change. He has come to you for weight loss advice.
   1. Which types of medical interventions does he meet the criteria for? (medication, surgery, and/or very low calorie diet)
   1. Of the possible weight management interventions, which would you advise and why?
   1. What type of exercise (if any) would you recommend for this client?
   1. Assume you recommend surgery, with procedure would you recommend and why?
   1. He asks you what behavioral changes he will need to make if he gets surgery. What are the main things he needs to know?

6. True or False. The FDA requires that a dietary supplement be proven both safe and effect before it can be marketed to the public.

7. True or False. The FDA checks dietary all supplements to be sure that the ingredients listed are actually in the supplement, in the right amounts. Moreover, it also checks for unlisted and potentially dangerous ingredients such as diuretics and contaminants such as lead.

8. Dietary supplements can include:
9. Vitamins/minerals
10. Herbs
11. Botanicals
12. Metabolites
13. Extracts
14. Any combination of above
15. True or False. A liquid formula diet that supplies 800 calories is considered a very low calorie diet.

10. The most serious potential complication of very low calorie diets is:
    1. Reduced metabolic rate
    1. Increased risk for binge eating
    1. Gall stones
    1. Problems concentrating
    1. Dizziness, fatigue, weakness
    1. Hypokalemia and sudden heart attack (low blood potassium levels leading to a heart attack)
    1. All of these are potential complications but the heart attack is probably the worst followed by gall stones which is pretty bad because you’ll have to have your gall bladder removed.

11. True or False. MD oversight is needed for people following VLCD, especially for people taking medications.

12. True or False. While on a VLCD your body will break-down muscle as well as fat.

13. True or False. Although VLCD’s produce significantly greater weight loss in the short-term, compared to LCD’s, there is no difference in the weight loss between the diets in the long-term.

14. True or False. Liquid or whole food meal replacement weight loss approaches (Slim Fast, Jenny Craig, and NutraSystems) have been shown to effectively help people lose weight. (The answer is true. The problem is maintaining the weight loss. Reduced energy expenditure, increased sensation of hunger and often a lack of change in people’s environment make it very hard, but not impossible, to maintain after rapid weight loss.)

15. After gastric bypass surgery, a typical diet at 8 weeks would include:
    1. Bread
    1. Eggs
    1. 8 oz. of liquid with meals
    1. Corn
    1. Ice cream

12. True or False. Weight loss of only 3%-5% that is maintained has the ability to produce clinically relevant health improvement such as reduced blood pressure, improved insulin sensitivity, and reduced risk for diseases such as heart disease and diabetes. 

14. Which of the following nutrient deficiencies are gastric bypass clients at risk for in the years following surgery?

1. Iron
2. Calcium
3. B₁₂
4. Antioxidant plant chemicals such as lutein, lycopene, and anthocyanins
5. Zinc
6. Folate
7. Copper
8. All of the above.

15. What disease can develop if gastric bypass clients fail to take supplements? 

1. osteoporosis
2. Wernicke encephalopathy
3. anemia
4. peripheral neuropathy
5. All of the above

16. True or False: Gastric band clients are at risk for the same deficiencies and diseases. Why or why not?

17. Which of the following are FALSE:

1. 60% of patients with diabetes have remission after gastric bypass   
2. For many people, bariatric surgery reduces long-term health care costs
3. Bariatric surgery forever changes the way people approach meals and eating
4. After they are healed, bariatric surgery patients are encouraged to eat large amounts of fibrous and filling fruits and vegetables.
5. All of these are true

Homework LM-12: Pharmaceutical, Dietary & Surgical Interventions

1. What from the module resonates with your past experiences and what from this module (knowledge, skills, mindsets, resources, etc.) might be useful for you to remember for your future? Consider the different sections: supplements, medications, very low calorie diets, and surgery. List four or more things.

The module resonates with my experiences, especially in the use of supplements. I often take Vitamin and Iron supplement but have realized that some barely have effects. The content could be lesser or different from what is listed in their packages. FDA may need to provide quality check of the numerous supplements that have bombarded the market.

• List one or more innovative solutions and/or entrepreneurial ideas that occurred to you as you read the module materials. If you wanted to, what next steps could you take to act on your ideas?

As I read the module materials, it occurred to me that an effective weight management program is necessary for the Americans. Obesity is a latent but a national disaster and preention would be better than cure. Looking at the contemporary lifestyles, it would be unrealistic to sanction some food types; it is rather more feasible to establishment physical activity programs for all localities.

• Your client has a BMI of 40 and is considering taking medications to support her weight loss. She has some questions for you:
• “Will I need behavior change AND take the medication or will the medication take care of things?”

The medications may not be effective on their own so a behavior change in the perspective of nutritional pattern and physical exercise would be recommended to complement the effect of the medications in reducing weight.

• “What side effects might I experience?”  

The  medications can cause adverse effects on the body and your body be more prone to allergies , asthma, and nausea, among others. You can also experience drug-drug or food -drug interaction meaning some two medicines containing the same drug can increase the level of that drug than the required level; or two opposite drugs can cancel the effects of each other.

• “How much does the drug cost and do you think my insurance will cover the cost?”

There are a variety of drugs that are used to support weight loss with their prices ranging from as low as $20 to as high as $1,500. It would be rare for the cost to be covered by insurance unless one has subscribed to a private cover.

• Your client is considering whether to buy an over the counter weight loss medication called Alli or a vitamin, mineral and herb “metabolism stimulator” supplement. He has some questions for you:
• “Which of these will likely work better?”

As a lipase-inhibitor, Alli has been shown to reduce the absorption of dietary fat by about 30% ( 2 ). Because dietary fat is high in calories, this leads to fewer calories being processed by the body, which can lead to weight loss. However, the fact that it inhibits absorption of fat means that it does not deal with the fat that is already accumulated in the body. The metabolic stimulator supplement would be the appropriate one as they high rate of metabolism would burn stored fats in the body.

• “The supplement is more natural and therefore safer right?”

Being natural does not make the supplement safer than the drug, it could be having toxins and other lethal substances.

• Your client has a BMI of 45. He suffers from arthritis, diabetes, and sleep apnea. He has been obese since childhood. He suffered neglect, trauma, and bias in childhood and struggles with depression and anxiety today. He takes medication for his blood pressure and diabetes.  He uses food and alcohol to cope with stress. He says moving around is painful and he feels self-conscious whenever he tries to exercise. He has tried numerous weight loss approaches. He says he is truly ready for better health and a permanent change. He has come to you for weight loss advice.
  • Which types of medical interventions does he meet the criteria for? (medication, surgery, and/or very low calorie diet)

As per the information provided in the question he has a lot of other health issues which clearly depicts that surgery is not applicable to him. Low-calorie diet might not affect him as he has already tried taking a low-calorie diet previously. The only better option which suits him will be medication.

• Of the possible weight management interventions, which would you advise and why?

I would advise medication for him as other methods will not be beneficial and might cause adverse outcomes.

• What type of exercise (if any) would you recommend for this client?

Walking or jogging offers the benefit of decreasing your BMI while improving your cardiovascular health. The Centers for Disease Control and Prevention, or CDC, recommends that adults get at least 30 minutes of moderate aerobic exercise, such as a brisk walk, five days per week. The CDC also recommends five hours of exercise per week for an even greater health benefit. The advantage of these types of cardio workouts is that they are easy to do, do not require any expensive fitness equipment and just about anyone can do it.

• Assume you recommend surgery, which procedure would you recommend and why?

I would recommend bariatric surgery whose qualifications include:

• BMI ≥ 40, or more than 100 pounds overweight.
• BMI ≥ 35 and at least one or more obesity-related co-morbidities such as type II diabetes (T2DM), hypertension, sleep apnea and other respiratory disorders, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.
• Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts.
  • He asks you what behavioral changes he will need to make if he gets surgery. What are the main things he needs to know?

Assessing weight management practices and eating behaviors after surgery, as well as problematic substance use, can significantly affect how much weight the patient loses.

• True or False. The FDA requires that a dietary supplement be proven both safe and effect before it can be marketed to the public.

False. Unlike drug products, there are no provisions in the law for FDA to “approve” dietary supplements for safety or effectiveness before they reach the consumer. Once a dietary supplement is marketed, FDA has to prove that the product is not safe in order to restrict its use or remove it from the market.

• True or False. The FDA checks dietary all supplements to be sure that the ingredients listed are actually in the supplement, in the right amounts. Moreover, it also checks for unlisted and potentially dangerous ingredients such as diuretics and contaminants such as lead.

False. The FDA does not check dietary all supplements to be sure that the ingredients listed are actually in the supplement, in the right amounts; they rely on the reports from the manufacturers.

• Dietary supplements can include:
• Vitamins/minerals
• Herbs
• Botanicals
• Metabolites
• Extracts
• Any combination of above
• True or False. A liquid formula diet that supplies 800 calories is considered a very low calorie diet.

True. Very low calorie/energy diets are typically a liquid formulation that contains up to 800 kcal/day (3350 kj/day). They are enriched in protein of high biologic value (0.8–1.5 g/kg of ideal body weight per day), and are supplemented with essential vitamins, minerals, electrolytes, and fatty acids.

1. The most serious potential complication of very low calorie diets is:
   1. Reduced metabolic rate
   1. Increased risk for binge eating
   1. Gall stones
   1. Problems concentrating
   1. Dizziness, fatigue, weakness
   1. Hypokalemia and sudden heart attack (low blood potassium levels leading to a heart attack)
   1. All of these are potential complications but the heart attack is probably the worst followed by gall stones which is pretty bad because you’ll have to have your gall bladder removed.
2. True or False. MD oversight is needed for people following VLCD, especially for people taking medications.

True. People on a very low-calorie diet for 4 to 16 weeks report minor side effects such as fatigue, constipation, nausea, and diarrhea. Gallstones are the most common serious side effect of very low-calorie diets. Gallstones are more common during rapid weight loss.

1. True or False. While on a VLCD your body will break-down muscle as well as fat.

True. when you lose weight fast during VLCD, you lose about three times more muscle than you would if you took things slowly.

1. True or False. Although VLCD’s produce significantly greater weight loss in the short-term, compared to LCD’s, there is no difference in the weight loss between the diets in the long-term.

True. In the long term the weight loss using the two approaches are comparable with VLCD having 6.3 % and LCD having 5.0 %

1. True or False. Liquid or whole food meal replacement weight loss approaches (Slim Fast, Jenny Craig, and NutraSystems) have been shown to effectively help people lose weight.

The answer is true. The problem is maintaining the weight loss. Reduced energy expenditure, increased sensation of hunger and often a lack of change in people’s environment make it very hard, but not impossible, to maintain after rapid weight loss.

1. After gastric bypass surgery, a typical diet at 8 weeks would include:

A typical diet at 8 weeks after gastric bypass surgery would include bread, eggs, and corn. Fluids with meals are discouraged; to help meet both nutrition and fluids needs you need to keep fluids separate from meals by at least 30 minutes. Patient exhibit intolerance to bread after the surgery and therefore should keep track of the intolerances before introducing them in the diet.

12. True or False. Weight loss of only 3%-5% that is maintained has the ability to produce clinically relevant health improvement such as reduced blood pressure, improved insulin sensitivity, and reduced risk for diseases such as heart disease and diabetes. 

It is true. The treatment of obesity cannot be a short-term “fix” but has to be a lifelong commitment to proper diet habits, increased physical activity, and regular exercise.

14. Which of the following nutrient deficiencies are gastric bypass clients at risk for in the years following surgery?

1. Iron
2. Calcium
3. B₁₂
4. Antioxidant plant chemicals such as lutein, lycopene, and anthocyanins
5. Zinc
6. Folate
7. Copper
8. All of the above.

All the above. The most common deficiencies are vitamin B12, folate, zinc, iron, copper, calcium, and vitamin D. To avoid complications, dietary supplementation often begins shortly after surgery, while the patient is still in the hospital.

15. What disease can develop if gastric bypass clients fail to take supplements? 

1. osteoporosis
2. Wernicke encephalopathy
3. anemia
4. peripheral neuropathy
5. All of the above

All the above. Failure to take supplements of the lacking nutrrients can lead to secondary problems, such as osteoporosis, Wernicke encephalopathy, anemia, and peripheral neuropathy.

1. True or False: Gastric band clients are at risk for the same deficiencies and diseases. Why or why not?

True. Both procedures reduce the size of the stomach and thereby limit the absorption rates of vitamins and minerals.

17. Which of the following are FALSE:

1. 60% of patients with diabetes have remission after gastric bypass   
2. For many people, bariatric surgery reduces long-term health care costs
3. Bariatric surgery forever changes the way people approach meals and eating
4. After they are healed, bariatric surgery patients are encouraged to eat large amounts of fibrous and filling fruits and vegetables.
5. All of these are true

Stating that 60% of patients with diabetes have remission after gastric bypass is false; A study found that 74 percent had remission of their type 2 diabetes. During the first five years after surgery, the remission rate remained at 70 percent or higher. However, people in the study who were on insulin before the surgery were less likely to go into remission (https://www.webmd.com/diabetes/news/20190207/gastric-bypass-means-diabetes-remission-for-many#1)

Browse more products here

Order Here