Abdominal wall
The muscles and connective tissue that extend from the ribs to the pelvis.

Adjustment
A procedure where saline is added to or removed from the Realize™ Band in an effort to control the restriction of the band on the stomach. Adding saline (also called a “fill”) will tighten the band to increase the amount of restriction at the stoma allowing the patient to feel full sooner and longer with less food than before the adjustment.

Absorption and malabsorption
Process in which digested food is absorbed by the lower part of the small intestine into the bloodstream malabsorption – process in which digested food is not fully absorbed by the small intestine and some of it passes into the large intestine and out of the body.

Adipose
Fatty; having to do with fat.

Anastomosis
Surgical connection between two structures.

Band Fill
A procedure where saline is added to the REALIZE Band in an effort to increase the restriction of the band on the stomach. A fill will tighten the band to increase the amount of restriction at the stoma allowing the patient to feel full sooner and longer with less food than before the fill.

Bariatric
Having to do with weight or weight reduction.

Bariatric surgery
Weight loss surgery.

Bariatric program
The team may include your bariatric surgeon, primary care physician, psychological counselor, dietician, weight management center, and fitness expert.

Barium
A compound that shows up on X-ray and fluoroscopy. When you swallow a drink that contains barium sulfate, a fluoroscope tracks the barium’s path through your digestive system.

Barrett’s esophagus
A condition in the esophagus that is associated with an increased risk for esophageal cancer.

Biocompatible
A material that is not harmful or toxic to living tissue.

Body Mass Index (BMI)
Method of figuring out the degree of excess weight. Based on weight and height.

Carbon dioxide gas
A natural gas in the atmosphere that is also exhaled by humans.

Cardiovascular
Having to do with the heart and blood vessels.

Chronic pancreatitis
Ongoing inflammation of the pancreas that changes the normal structure and function of the pancreas.

Cirrhosis of the liver
A consequence of ongoing liver disease causing damage and scarring in the liver that leads to the loss of liver function.

Clinicians
Healthcare professionals such as surgeons, physicians, nurses, dieticians, or X-ray technicians.

Certificate of Coverage
A document provided by the 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
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
Related illnesses (e.g. Type 2 Diabees, high blood pressure, sleep apnea) or disabling conditions related to clinically severe obesity or obesity-related health conditions.

Colon
Large intestine that begins at the end of the small intestine and ends at the rectum.

Contraindications
Any symptom or situation that might put you at increased risk for an otherwise recommended treatment or situations where the risks are greater than the benefits that would be gained from surgery. Potential contraindications for bariatric surgery include severe heart or lung disease, cirrhosis of the liver, or chronic pancreatitis.

Criteria
Defines what is right for surgery.

Deep vein thrombosis
Blood clot.

Digestion
Process in which food is broken down by the stomach and small intestine and absorbed by the body.

Dilation
Process of enlarging or further opening a passage or anastomosis.

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

Dumping Syndrome
Uncomfortable feeling of nausea, lightheadedness, upset stomach, vomiting, and/or diarrhea, related to ingestion of sweets, fatty foods, high-calorie liquids, or dairy products by gastric bypass patients.

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

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.

Esophageal dysmotility
Inability of the esophagus to move properly, making it difficult to swallow.

Fluoroscopy
A video image similar to an X-ray that shows real-time movement of internal organs.

Gastric
Having to do with the stomach.

Gastric Bypass Surgery
A weight loss operation designed to restrict the amount of food ingested by making a small upper stomach pouch and to decrease the amount of calories absorbed by rerouting the small intestine.

Gastrointestinal
Having to do with the stomach or intestine.

Gastrojejunostomy Anastomosis
Upper connection of the gastric bypass surgery in which a segment of the small intestine is connected to the small upper stomach pouch.

Gastroplasty
Surgical operation for morbid obesity that changes the shape of the stomach.

Genetic
Having to do with inherited physical characteristics.

Healthcare team
The team may include your bariatric surgeon, primary care physician, psychological counselor, dietician, weight management center, and fitness expert.

Hernia
A weakness in the abdominal wall that allows some of the internal organs to protrude out of the abdominal cavity.

Hemoglobin
The protein in red blood cells that carries oxygen to the lungs and tissue.

Herniation
Process in which a hernia is formed.

Hiatal hernia
A condition when the stomach bulges into the chest through an opening in the diaphragm.

Hypertension
High blood pressure.

Ideal fill level
The amount of saline that needs to be added to the REALIZE Band to ensure that the patient is able to lose weight at a satisfactory rate without experiencing uncomfortable side effects. The ideal fill level varies from patient to patient, and from one adjustment to the next.

Ileum
The 10 feet of small intestine that handle absorption.

Incision
A surgical cut made in the skin and underlying tissue.

Jejunum
The 10 feet of small intestine that handle digestion.

Kilogram
Measure of weight equal to 2.2 pounds.

Laparoscopic surgery
Minimally invasive surgery in the abdomen.

Laparoscopy
Method that allows a doctor to see and treat intra-abdominal problems with long handled instruments and a fiber optic camera.

Mean
The arithmetic average; also called the arithmetic mean.

Minimally invasive
Another important benefit of gastric banding surgery is that it can be performed in a minimally invasive manner. Laparoscopic surgery is usually shorter in duration; there are no large incisions; it is less painful; and it allows you to go home from the hospital sooner.

Morbid
Having to do with disease, illness, and a higher risk of death

Morbid Obesity
A condition in which the Body Mass Index is 40 or more, which is roughly equal to 100 pounds or more over ideal body weight; a weight level that is life-threatening .

Mortality
Having to do with death.

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

NIH
National Institutes of Health.

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 greater
• BMI of 35 or greater with one or more obesity-related health condition

Obesity
A condition in which the BMI is 30 or more which leads to increased risk of obesity related illnesses.

Obstructions
Narrowing of an anastomosis or a part of the gastrointestinal tract that slows down the normal passage of food or waste.

Percent of excess weight loss (%EWL)
A number that evaluates weight loss over a period of time. The number is calculated in two steps: 1) dividing actual weight loss by ideal weight , then 2) multiplying by 100 percent.

Portal hypertension
High blood pressure in the large vein that carries blood from the digestive tract to the liver (portal vein); often occurs as a result of cirrhosis.

Psychotherapy
Treatment of mentally related disorders.

Pulmonary
Having to do with the lungs.

Pulmonary embolism
A sudden blockage of a lung artery by material circulating in the blood; most often a blood clot from a deep vein in the lungs or pelvis.

Regurgitate
To cause backward flow of food from the upper stomach.

Restriction
The tightening of the REALIZE Band around the stoma.

Saboteur
Someone who attempts to disrupt or discourage the progress of a patient’s success with the REALIZE Band.

Saline
A safe fluid frequently used in intravenous drips (IVs).

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 must meet federal regulations.

Septum
A sturdy silicone layer located at the top of the injection port.

Silicone
A solid, soft, and flexible material that does not contain gels or fluids.

Stoma
The location where the band is wrapped around the stomach. This placement creates a tight junction (passage) between the upper and lower stomach chambers.

Stoma obstruction
Stoma blockage.

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

Strictures
Narrowing of anastomosis or a section of intestine; 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 important information about their health benefits. This includes what is covered, 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 the health insurance company. 

Therapy
Treatment.

Type 2 Diabetes
Most common form of diabetes that causes an abnormally high level of sugar, or glucose, to build up in the blood.

Vertical Banded Gastroplasty
A type of surgical operation to treat clinically severe obesity that is not performed very often.

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