Striae in the Popliteal Fossa

Striae in the popliteal fossa: Striae or stretch marks result from stretching of the skin, or other influences such as Cushing's syndrome. Most pregnant women experience striae at some point during their pregnancy. This picture shows striae in the popliteal fossa (the area on the back side of the leg at the knee joint). When the striae first appear they have a violaceous (red-purple) color, but over time they take-on a dull white appearance.

Different Types of Weight Gain

Weight gain in the area of and above the waist (apple type) is more dangerous than weight gained around the hips and flank area (pear type). Fat cells in the upper body have different qualities than those found in hips and thighs.

Lipocytes (Fat Cells)

When energy input is equal to energy output, there is no expansion of fat cells (lipocytes) to accomodate excess. It is only when more calories are taken in than used that the extra fat is stored in the lipocytes and the person begins to accumulate fat.

Roux-En-Y Stomach Surgery for Weight Loss

The Roux-en-Y gastric bypass procedure involves creating a stomach pouch out of a small portion of the stomach and attaching it directly to the small intestine, bypassing a large part of the stomach and duodenum. Not only is the stomach pouch too small to hold large amounts of food, but by skipping the duodenum, fat absorption is substantially reduced.

Obesity and Health

Obesity increases a person's risk of illness and death due to diabetes, stroke, coronary artery disease, hypertension, high cholesterol, and kidney and gallbladder disorders. Obesity may increase the risk for some types of cancer. It is also a risk factor for the development of osteoarthritis and sleep apnea.

Adjustable Gastric Banding

Restrictive gastic operations, such as an adjustable gastric banding procedure, serve only to restrict and decrease food intake and do not interfere with the normal digestive process.

In this procedure, a hollow band made of special material is placed around the stomach near its upper end, creating the small pouch and a narrow passage into the larger remaining portion of the stomach. This small passage delays the emptying of food from the pouch and causes a feeling of fullness.

The band can be tightened or loosened over time to change the size of the passage. Initially, the pouch holds about 1 ounce of food and later expands to 2-3 ounces.

Vertical Banded Gastroplasty

Restrictive gastic operations, such as vertical banded gastroplasty (VGB), serve only to restrict and decrease food intake and do not interfere with the normal digestive process.

In this procedure the upper stomach near the esophagus is stapled vertically to create a small pouch along the inner curve of the stomach. The outlet from the pouch to the rest of the stomach is restricted by a band made of special material. The band delays the emptying of food from the pouch, causing a feeling of fullness.

Biliopancreatic Diversion (BPD)

Malabsorptive operations, such as biliopancreatic diversion (BPD), restrict both food intake and the amount of calories and nutrients the body absorbs.

In a BPD procedure, portions of the stomach are removed. The small pouch that remains is connected directly to the final segment of the small intestine, completely bypassing the duodenum and the jejunum. A common channel remains in which bile and pancreatic digestive juices mix prior to entering the colon. Weight loss occurs since most of the calories and nutrients are routed into the colon where they are not absorbed.

Biliopancreatic Diversion with Duodenal Switch

Malabsorptive operations, such as a biliopancreatic diversion with duodenal switch (BPD/DS), restrict both food intake and the amount of calories and nutrients the body absorbs.

In this procedure, a larger portion of the stomach is left intact, including the pyloric valve that regulates the release of contents from the stomach into the small intestine. The duodenum is divided near this valve and small intestine divided as well. The portion of the small intestine connected to large intestine is attached to the short duodenal segment next to the stomach. The remaining segment of the duodenum connected to the pancreas and gallbladder is attached to this limb closer to the large instestine. Where contents from these two segments mix is called the common channel, which dumps into the large intestine.