Review Questions to practice for 2026/2027 CSOWM || 100 %
Accurate Answers.
Roux-en-Y gastric bypass surgery (RYGB) accounts for about 80% of bariatric procedures in the
US and is usually done laparoscopically. During RYGB, a small part of the proximal stomach is
detached from the rest of the stomach, creating a stomach pouch of < 30 mL. Which of the
following preexisting conditions has been shown to go into remission in up to 62% of patients 6
yr after RYGB?
a. Hypertension
b. Diabetes
c. Obesity
d. Obstructive Sleep Apnea correct answers Answer: B: Diabetes is particularly likely to remit.
Remission rates are up to 62% after 6 yr. A and D: Other comorbid conditions that tend to abate
or resolve after bariatric surgery include cardiovascular risk factors (eg, dyslipidemia,
hypertension [A], diabetes), cardiovascular disorders, obstructive sleep apnea (D), osteoarthritis,
and depression. C: For RYGB, weight loss is 50 to 65% after 2 yr; weight loss after RYGB is
maintained for up to 10 yr. All-cause mortality decreases by 25%, primarily because
cardiovascular and cancer mortality is reduced.
Which of the following procedures is being used increasingly in the US as definitive treatment
for severe obesity (eg, in patients with a body mass index [BMI] > 60)?
a. Sleeve Gastrectomy
b. Roux-en Y Gastric Bypass
c. Adjustable Gastric Banding
d. Vertical Banded Gastroplasty correct answers Answer: A: Sleeve gastrectomy; because this
procedure causes substantial and sustained weight loss, it is being used increasingly in the US as
definitive treatment for severe obesity. Part of the stomach is removed, creating a tubular
stomach passage. The procedure does not involve anatomic changes to the small intestine. B:
Nonetheless, Roux-en-Y gastric bypass surgery accounts for about 80% of bariatric procedures
in the US. C: Use of adjustable gastric banding has dramatically decreased in the US. D: Vertical
banded gastroplasty is no longer commonly done because complication rates are high and the
resulting weight loss is insufficient.
,Contraindications to bariatric surgery include which of the following?
a. Body mass index (BMI) < 30 kg/m2
b. Current drug or alcohol abuse
c. Obstructive sleep apnea
d. High-risk lipid profile correct answers Answer: B: Current drug or alcohol abuse. A: The use
of bariatric surgery is controversial in patients with a BMI < 30. C and D: To qualify for bariatric
surgery, patients should have a BMI of > 40 or a BMI of > 35 plus a serious complication (eg,
diabetes, hypertension, obstructive sleep apnea [C], high-risk lipid profile [D]).
Bariatric Surgery Key Points correct answers Consider weight loss surgery if patients are
motivated, have not succeeded using nonsurgical treatments, and have a BMI of > 40 kg/m2 or a
BMI of > 35 kg/m2 plus a serious complication (eg, diabetes, hypertension, obstructive sleep
apnea, high-risk lipid profile) or a BMI of 30 to 34.9 with type 2 diabetes and inadequate
glycemic control despite optimal lifestyle and medical therapy.
Weight loss surgery is contraindicated if patients have an uncontrolled psychiatric disorder (eg,
major depression), drug or alcohol abuse, cancer that is not in remission, or another life-
threatening disorder or if they cannot comply with nutritional requirements (including life-long
vitamin replacement when indicated).
The most common procedures are sleeve gastrectomy and Roux-en-Y gastric bypass; use of
adjustable gastric banding has decreased dramatically in the US.
Monitor patients regularly after surgery for maintenance of weight loss, resolution of weight-
related comorbid disorders, and complications of surgery (eg, nutritional deficiencies, metabolic
bone disease, gout, cholelithiasis, nephrolithiasis, depression, alcohol abuse).
Which of the following increases the risk of cardiovascular disorders in patients with obesity?
a. Osteoporosis
b. Excess abdominal fat
c. Psychological disorders
, d. Gastric Ulcer correct answers Answer: B: Excess abdominal fat. Complications, including
coronary artery disease, are more likely in patients with fat that is concentrated abdominally.
Choices A, C, and D do not increase the risk of cardiovascular disorders in patients with obesity.
What is the role of ghrelin in food intake-regulating pathways?
a. It increases food intake.
b. It decreases food intake.
c. Level decreases when weight is lost.
d. It integrates energy balance signals. correct answers Answer: A: Ghrelin, secreted primarily by
the stomach, increases food intake. B, C, and D: Other hormones and regulatory substances have
these effects.
Which type of exercise is MOST effective for increasing BMR?
a. Aerobic exercise
b. Resistance exercise
c. Balancing exercise
d. Flexibility exercise correct answers Answer: B: Resistance (strengthening) exercises are the
most effective way to increase BMR. Resistance exercises increase muscle mass. Because
muscle tissue burns more calories at rest than does fat tissue, increasing muscle mass produces
lasting increases in BMR. Choices A, C, and D can also be effective in a weight management
program. A combination of aerobic and resistance exercise is better than either alone, particularly
when patients choose activities they enjoy.
Obesity Key Points correct answers Obesity increases the risk of many common health problems
and causes up to 300,000 premature deaths each year in the US, making it second only to
cigarette smoking as a preventable cause of death.
Excess caloric intake and too little physical activity contribute the most to obesity, but genetic
susceptibility and various disorders (including eating disorders) may also contribute.
Accurate Answers.
Roux-en-Y gastric bypass surgery (RYGB) accounts for about 80% of bariatric procedures in the
US and is usually done laparoscopically. During RYGB, a small part of the proximal stomach is
detached from the rest of the stomach, creating a stomach pouch of < 30 mL. Which of the
following preexisting conditions has been shown to go into remission in up to 62% of patients 6
yr after RYGB?
a. Hypertension
b. Diabetes
c. Obesity
d. Obstructive Sleep Apnea correct answers Answer: B: Diabetes is particularly likely to remit.
Remission rates are up to 62% after 6 yr. A and D: Other comorbid conditions that tend to abate
or resolve after bariatric surgery include cardiovascular risk factors (eg, dyslipidemia,
hypertension [A], diabetes), cardiovascular disorders, obstructive sleep apnea (D), osteoarthritis,
and depression. C: For RYGB, weight loss is 50 to 65% after 2 yr; weight loss after RYGB is
maintained for up to 10 yr. All-cause mortality decreases by 25%, primarily because
cardiovascular and cancer mortality is reduced.
Which of the following procedures is being used increasingly in the US as definitive treatment
for severe obesity (eg, in patients with a body mass index [BMI] > 60)?
a. Sleeve Gastrectomy
b. Roux-en Y Gastric Bypass
c. Adjustable Gastric Banding
d. Vertical Banded Gastroplasty correct answers Answer: A: Sleeve gastrectomy; because this
procedure causes substantial and sustained weight loss, it is being used increasingly in the US as
definitive treatment for severe obesity. Part of the stomach is removed, creating a tubular
stomach passage. The procedure does not involve anatomic changes to the small intestine. B:
Nonetheless, Roux-en-Y gastric bypass surgery accounts for about 80% of bariatric procedures
in the US. C: Use of adjustable gastric banding has dramatically decreased in the US. D: Vertical
banded gastroplasty is no longer commonly done because complication rates are high and the
resulting weight loss is insufficient.
,Contraindications to bariatric surgery include which of the following?
a. Body mass index (BMI) < 30 kg/m2
b. Current drug or alcohol abuse
c. Obstructive sleep apnea
d. High-risk lipid profile correct answers Answer: B: Current drug or alcohol abuse. A: The use
of bariatric surgery is controversial in patients with a BMI < 30. C and D: To qualify for bariatric
surgery, patients should have a BMI of > 40 or a BMI of > 35 plus a serious complication (eg,
diabetes, hypertension, obstructive sleep apnea [C], high-risk lipid profile [D]).
Bariatric Surgery Key Points correct answers Consider weight loss surgery if patients are
motivated, have not succeeded using nonsurgical treatments, and have a BMI of > 40 kg/m2 or a
BMI of > 35 kg/m2 plus a serious complication (eg, diabetes, hypertension, obstructive sleep
apnea, high-risk lipid profile) or a BMI of 30 to 34.9 with type 2 diabetes and inadequate
glycemic control despite optimal lifestyle and medical therapy.
Weight loss surgery is contraindicated if patients have an uncontrolled psychiatric disorder (eg,
major depression), drug or alcohol abuse, cancer that is not in remission, or another life-
threatening disorder or if they cannot comply with nutritional requirements (including life-long
vitamin replacement when indicated).
The most common procedures are sleeve gastrectomy and Roux-en-Y gastric bypass; use of
adjustable gastric banding has decreased dramatically in the US.
Monitor patients regularly after surgery for maintenance of weight loss, resolution of weight-
related comorbid disorders, and complications of surgery (eg, nutritional deficiencies, metabolic
bone disease, gout, cholelithiasis, nephrolithiasis, depression, alcohol abuse).
Which of the following increases the risk of cardiovascular disorders in patients with obesity?
a. Osteoporosis
b. Excess abdominal fat
c. Psychological disorders
, d. Gastric Ulcer correct answers Answer: B: Excess abdominal fat. Complications, including
coronary artery disease, are more likely in patients with fat that is concentrated abdominally.
Choices A, C, and D do not increase the risk of cardiovascular disorders in patients with obesity.
What is the role of ghrelin in food intake-regulating pathways?
a. It increases food intake.
b. It decreases food intake.
c. Level decreases when weight is lost.
d. It integrates energy balance signals. correct answers Answer: A: Ghrelin, secreted primarily by
the stomach, increases food intake. B, C, and D: Other hormones and regulatory substances have
these effects.
Which type of exercise is MOST effective for increasing BMR?
a. Aerobic exercise
b. Resistance exercise
c. Balancing exercise
d. Flexibility exercise correct answers Answer: B: Resistance (strengthening) exercises are the
most effective way to increase BMR. Resistance exercises increase muscle mass. Because
muscle tissue burns more calories at rest than does fat tissue, increasing muscle mass produces
lasting increases in BMR. Choices A, C, and D can also be effective in a weight management
program. A combination of aerobic and resistance exercise is better than either alone, particularly
when patients choose activities they enjoy.
Obesity Key Points correct answers Obesity increases the risk of many common health problems
and causes up to 300,000 premature deaths each year in the US, making it second only to
cigarette smoking as a preventable cause of death.
Excess caloric intake and too little physical activity contribute the most to obesity, but genetic
susceptibility and various disorders (including eating disorders) may also contribute.
