Absorption The process in which digested food is absorbed by the lower part of the small intestine into the bloodstream.

Adipose Tissue made up of mainly fat cells.

Anastomosis A surgical connection between two structures.

Bariatric A term having to do with weight or weight reduction.

Body Mass Index (BMI) A method of figuring out the degree of excess weight, based on weight and height.

Cardiovascular A term having to do with the heart and blood vessels.

Center of Excellence A Bariatric Surgery Center of Excellence is a bariatric program that has been designated a Bariatric Surgery Center of Excellence (COE) by the Surgical Review Corporation, a nonprofit corporation that: Establishes guidelines for assessing bariatric programs Evaluates bariatric programs to ensure they meet certain standards for recognition as a COE A bariatric program that has been designated a COE has met strict criteria and delivers bariatric care that meets high standards.

Certificate of Coverage A document provided by a health insurance company that describes the details of the plan’s policy, including requirements for eligibility, benefits, deductibles, maximums, and exclusions of coverage..

Clinically Severe Obesity A Body Mass Index of 40 or more, which is roughly equal to 100 pounds or more over ideal body weight; a weight level that is life-threatening. Also known as morbid obesity.

Co-Morbid Condition This is a disease or disorder related to a primary condition.

Colon The part of the large intestine that starts at the end of the small intestine and ends at the rectum.

Contraindications Any symptom or circumstance, such as substance abuse, emotional health issues, or other health conditions, that causes a healthcare professional to not recommend a treatment.

Criteria A standard on which a judgment or decision may be based.

Digestion A process in which food is broken down into absorbable forms by the stomach and upper small intestine.

Dilation The process of enlarging or further opening a passage or anastomosis.

Disease A process that is a hazard to health and/or longevity.

Divided Gastric Bypass Surgery A surgical operation that provides a way to manage clinically severe obesity.

Dumping Syndrome An uncomfortable episode of nausea, lightheadedness, upset stomach, vomiting, and/or diarrhea, related to ingestion of high-sugar, high-fat foods or liquids that can occur after certain bariatric surgeries, such as gastric bypass.

Duodenum The first 12 inches of small intestine immediately below the stomach. Bile and pancreatic fluids flow into the duodenum from the liver and pancreas.

Excess Weight Excess weight is the difference between the patient’s actual weight and a healthy weight.

Fully Insured Plan A type of health insurance plan in which the employer pays a monthly premium for a standardized health plan from an insurance company that assumes all risk and cost involved. The insurance company generally makes coverage decisions and must abide by state and federal regulations.

Gastric A term having to do with the stomach.

Gastric Banding Surgery This is a restrictive surgical procedure during which a silicone band is placed around the stomach, creating a small pouch. The band includes a balloon that is filled with a nontoxic fluid, most commonly a saline solution; adjustments are performed by a healthcare professional who accesses the balloon via a subcutaneous port.

Gastric Bypass Surgery This surgical procedure uses both malabsorption and restriction. During gastric bypass, the operating surgeon uses part of the stomach to form a small stomach pouch and reroutes a part of the small intestine. There are several variations of gastric bypass surgery including Roux-en-Y gastric bypass, extensive gastric bypass, and very long-limb gastric bypass.

Gastrointestinal This term describes the entire digestive tract.

Gastrojejunostomy Anastomosis Upper connection of the gastric bypass operation

Gastroplasty A surgical procedure for morbid obesity that changes the shape of the stomach.

Genetic This term pertains to inherited characteristics.

Hernia A weakness in the tissue of the abdominal wall that results in a detectable bulge.

Herniation A process in which a hernia is formed.

Hydration The condition of having adequate fluid in the body tissue.

Hyperosmolality Having highly concentrated substances that are capable of causing dumping syndrome

Hypertension This is a term for high blood pressure.

Ileum The 10 feet of small intestine responsible for absorption.

Improvement This term is used to describe limited relief of symptoms.

Jejunum The 10 feet of small intestine responsible for digestion.

Kilogram A measure of weight equal to 2.2 pounds.

Laparoscopy A method that allows a doctor to see and treat intra-abdominal problems with long fiber-optic instruments.

Morbid This term refers to disease or illness.

Morbid Obesity A Body Mass Index of 40 or greater, which is roughly equal to 100 pounds or more over ideal body weight, or a Body Mass Index of 35 or greater with one or more co-morbid condition; these weight levels can be life-threatening.

Mortality A term having to do with death.

Multidisciplinary Bariatric Program A team approach to testing and treatment of clinically severe obesity. It includes surgical, internal medicine, nutrition, psychiatric, exercise physiology, assessment, and treatment.

NIH The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary federal agency for conducting and supporting medical research.

NIH Consensus Report Summaries of meetings about clinically severe obesity and the assessment and treatment of obesity issued periodically by NIH.

NIH Surgical Criteria The National Institutes of Health has established minimum requirements for deciding whether bariatric surgery is the right treatment option: 100 pounds or more above ideal body weight or a BMI of 40 or greater1 BMI of 35 or greater with one or more obesity-related health condition1       NIH Surgical Criteria The National Institutes of Health has established minimum requirements for deciding whether bariatric surgery is the right treatment option: 100 pounds or more above ideal body weight or a BMI of 40 or greater1 BMI of 35 or greater with one or more obesity-related health condition1

Obesity A term having to do with excessive weight or adipose tissue.

Obstruction The narrowing of an anastomosis or a part of the gastrointestinal tract that slows down the normal passage of food or waste.

Psychotherapy The testing and treatment of emotional disorders.

Pulmonary A term having to do with the lungs.

Resolution The complete relief from symptoms of a disease or disorder, such that medical tests do not detect its existence.

Relative Risk The comparison of how likely an event is to occur to a person versus another person.

Roux-en-Y Gastric Bypass Surgery A surgical method of reconnecting the stomach and upper small intestine in a Y- shape.

Self-Funded Plan A type of health insurance plan in which the employer assumes all risks and costs in providing healthcare to employees and, therefore, decides what is and what is not covered, such as bariatric surgery. Self-funded plans are usually administered by an insurance company. This insurance company is often referred to as the third-party administrator (TPA) of the plan. The TPA performs administrative functions only and does not determine coverage. Self-funded plans are exempt from state regulations, including mandated benefits, premium taxes, and consumer protection laws, but they must meet federal regulations.

Staples Surgically sterile staples, similar in look and function to those used to fasten paper, for connecting tissue. Staples are usually permanent and made of stainless steel or titanium.

Strictures The narrowing of anastomosis or a section of intestine that is often related to scarring or ulcers.

Summary Plan Description Employers with self-funded health insurance plans are legally required to provide this document to their beneficiaries. The document provides plan participants with important information about their health benefits. This includes plan rules, financial information, and information on the operation and management of the plan. The information contained in the Summary Plan Description is similar to what is found in the Certificate of Coverage provided by a health insurance company.

Summary Plan Description Employers with self-funded health insurance plans are legally required to provide this document to their beneficiaries. The document provides plan participants with important information about their health benefits. This includes plan rules, financial information, and information on the operation and management of the plan. The information contained in the Summary Plan Description is similar to what is found in the Certificate of Coverage provided by a health insurance company.

Type 2 Diabetes A disorder of glucose and insulin metabolism.

Vertical Banded Gastroplasty A type of surgical procedure to treat morbid obesity that changes the shape of and restricts the stomach. This procedure is not performed very often.