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Abdominal Fat - Fat that is centrally distributed between the thorax and pelvis and that induces a greater health risk.

Absorption - Process by which digested food is absorbed by the lower part of the small intestine into the bloodstream.

Adipose - Fatty; pertaining to fat

Aerobic Exercise - This is a type of physical activity that includes walking, jogging, running and dancing.

Analgesics - Compounds capable of relieving pain without the loss of consciousness or without producing anesthesia.

Anastomosis - Surgical connection between two structures.

Anesthetics - Drugs that are capable of inducing a total or partial loss of sensation, especially pain. They may act to induce general anesthesia, in which an unconscious state is achieved, or may act locally to induce numbness or lack of sensation at a targeted site.

Ascites - Accumulation or retention of fluid within the abdominal cavity.

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Bariatric - Pertaining to Weight or weight reduction. Adjective from the Greek words for weight and treatment, bariatric means related to weight loss.

Behavior Therapy - Constitutes those strategies, based on learning principles such as reinforcement, that provide tools for overcoming barriers to compliance with dietary therapy and/or increased activity.

Beta Blockers/Adrenergic Beta-Antagonists - Drugs that are used for treatment of high blood pressure, heart arrhythmias, angina pectoris, glaucoma, migraine headaches, and anxiety. They work by blocking beta-receptors causing a decrease in heart rate and of heart contractions causing a decrease in blood pressure.

Bezoar - Obstructing mass made up of high fiber food materials, hair, etc.

Biliopancreatic Diversion - This is a weight loss surgery where portions of the stomach are removed. The small pouch that remains is connected directly to the last 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.

Biphasic Defibrillator - Electrical device used to restore the normal rhythm to a heart that is beating irregularly.

BMI (Body Mass Index) - Method of calculating degree of excess weight (weight in kilograms divided by height in meters squared). The calculation is based on weight and body surface area.

Body Composition - Ratio of lean body mass to body fat mass

Borderline Personality Disorder - A personality disorder marked by a pattern of instability in interpersonal relationships, self-image, feelings, and marked impulsivity beginning by early adulthood.

BUN (Blood Urea Nitrogen) - The concentration of nitrogen in the form of urea in the blood

Bupropion - A drug used as an antidepressant and as an aid to stop smoking usually without the side effects of decreased sex drives and weight gain.

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Candidate for Surgery - well-motivated patient, 75 pounds or more excess weight; BMI of or over 40 – BMI 35 to 40 with severe co-morbid conditions.

Cardiovascular - Pertaining to heart and blood vessels.

Case-Control Studies - Studies, which start with the identification of persons with a disease of interest and a control group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.

Central Fat Distribution - The waist circumference is an index of body fat distribution. In the body fat patterns called android type (apple shaped) fat is deposited around the waist and upper abdominal area and appears most often in men. The gynoid type (pear shaped) of body fat is usually seen in women.

Cholecystectomy - Surgical removal of the gallbladder.

Cholecystitis - Inflammation of the gallbladder caused primarily by gallstones.

Cirrhosis - Widespread disruption of normal liver structure by fibrous tissue seen in chronic progressive conditions affecting the liver.

Clinical Pathways - Schedules of medical and nursing procedures, including diagnostic tests, medications, and consultations designed to effect an efficient, coordinated program of treatment.

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

Cohort Studies - Studies in which subsets of a defined population are identified. Cohorts are defined populations, which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.

Colon - Large intestine beginning at the end of the small intestine and ending at the rectum

CoMorbid - Associated illness (i.e., arthritis, hypertension) disabling conditions associated with clinically severe obesity or obesity-related health conditions.

Contraindications - Any symptom or circumstance indicating the inappropriateness of an otherwise advisable treatment (i.e., alcoholism; drug dependency; severe depression; sociopathic (antisocial) personality disorder).

Coronary Disease - An imbalance between heart muscle requirements and the capacity of the coronary (heart) vessels to supply sufficient blood flow.

CPAP-BiPAP - (continuous and bi-level positive airway pressure) Methods of facilitating ventilation and preventing upper airway collapse during sleep and sedation by using a tight fitting face mask connected to a machine. Often used at night in patients with sleep apnea.

Creatine - An amino acid that occurs in tissues and in urine. In muscle tissue, creatine generally occurs as phosphocreatine. Creatine is excreted as Creatinine in the urine.

Criteria - Defines potential candidate for surgery.

CT Scan - Body scan X-Ray.

Current Procedural Terminology (CPT) - Descriptive terms and identifier codes for reporting medical services and procedures performed by physicians. It is produced by the American Medical Association (AMA) and used in insurance claim reporting for Medicare, Medicaid, and private health insurance programs.

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Deep Vein Thrombosis - The formation or presence of a thrombus or clot within a vein.

Digestion - Process by which food is broken down by stomach and upper small intestine into absorbable forms.

Dilation - Process of enlarging a passage or anastomosis.

Disease - Process injurious to health and/or longevity.

Divided Gastric Bypass - Operation providing a tool for management of clinically severe obesity.

Dumping Syndrome - When stomach contents move too rapidly through the small intestine. Uncomfortable feeling of nausea, lightheadedness, upset stomach, diarrhea, associated with ingestion of sweets, high-calorie liquids or dairy products.

Duodenum - First 12" of small intestine immediately below stomach. Bile and pancreatic fluids flow into the duodenum through ducts from liver and pancreas respectively.

DyslipidemiaI-Hyperlipidemia - An excess of lipids (fats) in the blood.

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Electrolytes - Chemical Elements found in the blood stream and body tissue.

Endoscopy - Examines parts of the gastrointestinal tract by means of long, slender, flexible, fiber optic instrument.

Endotracheal intubation - This is the introduction of a tube into the trachea to provide an open airway to administer oxygen, gaseous medication, or anesthetics. May also be done to remove blockages, or to view the inside walls of the trachea.

Epinephrine - The active hormone from the adrenal glands (located upon the kidneys) that causes systemic constriction of the blood vessels, gastrointestinal relaxation, stimulation of the heart, and opening of the bronchi and cerebral vessels. It is used in asthma and heart failure and to delay absorption of local anesthetics.

Esophagitis - Inflammation of the esophagus caused by bacteria, chemicals, or trauma.

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Foundation Bariatric Surgery Program - Also known as Weight Wise.

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Gastric - Pertaining to stomach.

Gastric Banding - A band made of special material that is placed around the stomach near its upper end, creating a small pouch of the upper stomach and a narrow passage into the larger remainder of the stomach.

Gastric Bypass - Operation designed to make non-functional a portion of the stomach. Surgical procedure used frequently in the treatment of morbid obesity. A small section of the upper stomach is stapled of from the rest of the stomach. Then this small stomach is connected to part of the small intestines (jejunum).

Gastro Esophageal Reflux - Flow of gastric juice (gastric acid) and/or duodenal contents (bile acids, pancreatic juice) into the esophagus, commonly due to a faulty lower esophageal sphincter (band of muscle) and/or presence of a hiatal hernia. "Heartburn" is the symptom associated with this.

Gastrointestinal - Pertaining to stomach or intestine.

Gastrojejunostomy anastomosis - Upper connection of the Gastric Bypass operation.

Gastroplasty - Operation for morbid obesity, which reshapes the stomach.

Genetic - Pertains to transmitted hereditary characteristics.

Glucose Intolerance - A disease in which blood glucose level is less than approximately 140mg/I OOml of plasma after fasting, and above approximately 200mg/I OOml plasma at 30-,60-,or 90-minute intervals during a glucose tolerance test. This condition is seen frequently in diabetes mellitus, but also occurs with other diseases and malnutrition.

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Hematocrit - The volume of packed red blood cells in a blood specimen.

Hernia - A weakness in the abdominal wall resulting in a detectable bulge. The protrusion of abdominal contents through a weakness or defect in the abdominal wall. Ten to twenty percent of patients who have the open weight- loss surgery may develop a hernia in the incision.

Herniation - Process in which a hernia is formed.

Hyperosmolality - Presence of highly concentrated substances capable of producing dumping syndrome.

Hypertension - The more common term for this is high blood pressure.

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Ileum - Ten feet of small intestine, responsible for absorption.

Insulin Resistance - Decreased effectiveness of insulin in lowering blood sugar levels. It is associated with obesity.

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J-Shaped Relationship - This is the relationship between body weight and mortality.

Jackson-Pratt Drain - Soft plastic drain effective in excavating blood and other body fluids.

Jejunoileal Bypass - A surgical procedure, no longer performed today, that was used to treat extreme obesity. The first part of the jejunum was connected to the last portion of the ileum, so as to bypass the area of the intestine where nutrients are absorbed.

Jejunum - Ten feet of small intestine; the part responsible for digestion.

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Ketones - Breakdown products of fatty tissue.

Kilogram - Measure of weight equal to 2.2 pounds.

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Laparoscope - Thin fiber-optic surgical scope used to view and examine an internal organ that is introduced into the body through a small incision.

Laparoscopic - Abbreviated "Lap," this operation is performed using a laparoscope and other small surgical instruments that fit through small incisions.

Laparoscopic Adjustable Gastric Banding (LAGB) - In LAGB, an adjustable silicone band is placed around the upper stomach to create a small pouch and a restricted outlet to the rest of the stomach. The diameter of the outlet can be changed by injecting or removing saline (salt water) through an opening (port) under the skin. If necessary, the band can be removed. Though a large body of evidence, especially from European studies, suggests that LAGB is effective and safe for weight loss, long-term data are still limited in the U.S. Complications from gastric banding include band movement or erosion, gastro esophageal reflux disease (GERD), esophagitis, and port or tubing problems.

Laparoscopic WLS - Like open gastric restrictive procedures, laparoscopic WLS (weight loss surgery) has proven effective at producing significant and sustained weight loss, along with improvements in other medical problems associated with obesity and quality of life. Because it is less traumatic to the body than open surgery, it also shortens recovery time. Laparoscopic surgeons gain access to the stomach via several small incisions. They insert a tiny video camera through one of the incisions, and surgical instruments through the others. They operate by watching their work on a large-screen monitor.

Laparoscopy - Method of visualizing and treating intra-abdominal problems with long fiber-optic instruments.

Low Molecular Weight Heparin - An effective agent used to prevent blood clots with less risk of hemorrhage (bleeding) than heparin with greater molecular weight.

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Medline - Medical Literature, Analysis, and Retrieval System Online is the U.S. National Library of Medicine’s (NLM) premier bibliographic database that contains over 12 million references to journal articles in life sciences with a concentration on biomedicine.

Meta-Analysis - A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine.

Micronutrients - Essential dietary elements or organic compounds that are required in only small quantities for normal physiologic (body functions) processes to occur.

Morbid - Pertaining to disease, illness, increased risk of death.

Morbid Obesity - Body Mass Index of 40 or more, which is roughly equivalent to 100 pounds or more over ideal body weight; a weight level that is life risking

Mortality - Pertaining to death.

Multi-disciplinary - Team approach to evaluation and treatment of clinically severe obesity; includes surgical, internal medicine, nutrition, psychiatric, and exercise physiology assessment and treatment.

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Narcotics - Drugs that have potent analgesic (pain reducing) effects associated with significant changes in mood and behavior, and with the potential for dependence and tolerance following repeated administration.

Nicotine Replacement Therapy (NRT) - Administration of nicotine (the active ingredient in tobacco) in different forms (gum, transdermal patch, nasal spray, inhaler, sublingual tablet and lozenge), and has been shown to relieve withdrawal symptoms and to double abstinence (quitting) rates compared to placebo (a substance that looks like a drug, but has no effects) for people trying to quit smoking.

NIH - NIH is the National Institutes of Health.

NIH Consensus Report - Summaries of meetings regarding clinically severe obesity and assessment and treatment of obesity; issued periodically by NIH.

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Obesity - Pertaining to excessive weight or adipose tissue.

Obstructions - Narrowing of an anastomosis or segment of gastrointestinal tract which retards normal passage of food or waste materials.

Obstructive Sleep Apnea - A disorder characterized by repeated periods of not breathing during sleep despite repeated efforts to breathe. It is due to upper airway blockage. Frequent periods of waking up occur throughout steep, resulting in relative sleep deprivation and daytime tiredness.

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Pancreatobiliary Diversion - This is a malabsorptive weight loss operation.

PCA (Patient-Controlled Analgesia) - Self-administration of analgesics (medication that decreases pain) by a patient instructed in doing so. It usually refers to self-dosing with intravenous opioid (e.g. morphine) administered by means of a programmable pump.

Prader-Willi Syndrome - A chromosomal disorder associated with mental disorder and obesity.

Protein-Energy Malnutrition - The lack of sufficient energy or protein to meet the body's metabolic demands, as a result of either an inadequate dietary intake of protein, intake of poor quality dietary protein, increased demands due to disease, or increased nutrient losses.

Psychotherapy - Evaluation and treatment of mentally related disorders.

Psychotic Disorder - A serious mental disorder in which the mind does not function normally and the ability to deal with reality is impaired or lost.

Pulmonary - Pertains to the lungs.

Pulmonary Embolism - A blood clot or thrombosis from another part of the body (e.g., lung) that travels to the lung with grave consequences.

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Randomized Controlled Trials - Clinical trials or tests that involved at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test and control- treated groups, and in which the treatments to be administered are selected by a random process.

Refractory Obesity - Obesity that is resistant to treatment.

Registry - A place where data, records, or laboratory samples are kept and usually made available for research or comparative study.

Roux-en-Y Gastric Bypass - RYGB is the gold standard WLS (weight loss surgery) in the U.S. today, and the most frequently performed. It involves creating a tiny stomach pouch and rerouting a portion of the digestive tract to reduce absorption of food in the intestine. Proven benefits of RYGB include improvement of obesity- related problems and significant long-term weight loss. Its risks include infrequent but serious surgical complications (e.g., staple line failure, PULMONARY EMBOLISM, wound infection, and intestinal leak); long- term deficiencies of vitamin B 12, folate, and iron; and weight regain.

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Sleep Apnea - A serious, potentially life-threatening disorder characterized by repeated cessation of breathing due to either collapse of the upper airway during sleep or absence of respiratory effect.

Splenectomy - Surgical removal of the spleen.

Staples - Surgically sterile devices for connecting tissue; usually permanent and made of stainless steel or titanium.

Stoma Size - The size of a new opening created surgically between two body structures.

Stress Disorders, Post- Traumatic - Psychiatric illnesses that are caused by a traumatic event that may be re experienced by flashbacks, as well as other symptoms, such as arousal, depression, and sleep disturbances.

Strictures - Narrowing of anastomosis or section of intestine; often related to scarring or ulcers.

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The CLNAHL Database - Database for nursing and allied health literature.

Thiamine - Also known as Vitamin B, it is found in bran, yeast and meat. It is necessary for carbohydrate metabolism and normal activity of the nervous system.

Thoracic Epidural Analgesic - This is the relief of pain without loss of consciousness through the introduction of a pain reducing drug into the epidural space of the vertebral canal. It is differentiated from epidural anesthesia, which refers to the state of insensitivity to sensation.

Thoracic Surgical Procedures - Surgery performed on the thoracic (chest) organs, most commonly the lungs and the heart.

Transaminases - A subclass of enzymes of the transferase class that catalyze the transfer of an amino group from a donor (generally an amino acid) to an acceptor (generally a 2-keto acid).

Type II Diabetes - Type II Diabetes is a disorder of glucose and insulin metabolism.

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Vertical Banded Gastroplasty (VGB) - This procedure is becoming the most frequently used restrictive operation for weight control. Both a band and staples are used to create a small stomach pouch. The procedure works best on individuals who are not binge eaters.

Visceral Fat - One of the three compartments of abdominal fat. Retroperitoneal and subcutaneous are the other two components.

Vitamin B- Also known as Thiamine, it is found in bran, yeast and meat. It is necessary for carbohydrate metabolism and normal activity of the nervous system.