Question

Gastric Bypass Sleeve Case Study

Michael S. – basic history and case outline

MS is an instructor at a Culinary College

He has battled weight his whole life

He had the gastric sleeve surgery done

MS is a 57 year old male

Before going into surgery he was 300 lbs

He walked into our office at about 260 lbs because he had hit the wall (thus lost 40 lbs directly from surgery)

As you will see we are progressively taking weight off MS and we have added an additional 30 lbs of weight-loss in a very healthy progressive way

For the purposes of this case you are starting with him at 260 lbs, like we did

MS has a sweet tooth and craves sweets

MS can get sweaty and irritated when not eating

MS has bouts of diarrhea and constipation on and off

MS does nothing more than just walk for exercise maybe once per week with is dog

MS drinks very little fluids and was drinking crystal light beverages as recommended by RD at hospital due to its low calorie count.

MS is divorced and in no relationship at this time

MS is taking care of an ill parent currently

MS comes across as a very caring, friendly warm individual.

MS has been told he might have to go on Metformin and/or Statin drug (he doesn’t want to because the reason he had done the surgery was to prevent all these issues) – MS wants to do all in his power to achieve optimal health and not be on medication

MS understands he has limitations, but wants to be healthier and happier, he wants to stop feeling “disgusted” with himself as he puts it.

1.Identify Michael's chief complaint?

2. What if any further lab tests are necessary?

3. Comprise a 1 day food protocol treatment plan.

4. Identify any dietary, supplement and lifestyle modifications that Michael should make.

Answer 1

1. Michael’s chief complaint is overweight. He just wants to stop feel disgusted about himself.

2. Further lab tests like blood glucose, thyroid test can be done as they are related with overweight.

3. Food protocol

Breakfast : one fruit, one glass of skimmed milk, one bowl of whole grain

Mid morning snach : fruits

Lunch : vegetables, poridge, bread or chapati, grilled chicken or vegetables

Dinner : plain omelette, vegetables, fish, fruits.

4. Dietary modifications:

• Cut down on excessive calories
• Eat small meals every 2 hours
• Avoid fried fatty foods
• Avoid junk food
• Include more fruits and vegetables to the diet
• Avoid excess sugar
• Avoid canned juices and drinks, insted have fresh frhit juice

Lifestyle changes :

• Incorporate exercise into your daily activities
• Spend atleast 20 min daily in gym
• Go for regular brisk walks
• Swimming and cycling are good whole body workout activities
• Take stairs instead of lift, park your car farther away from the office or home.

Supplements :

• Weight reduction medications can be prescribed by a physician along with diet and exercise