弈乐麻将 2扑克那:胃分流术：谁可以接受？

了解这种减重手术所需要的条件。

Gastric bypass surgery is the most common type of weight-loss surgery. Gastric bypass and other types of weight-loss surgery, collectively known as bariatric surgery, make surgical changes to your stomach and digestive system that limit how much food you can eat and how many nutrients you absorb, leading to weight loss. 

胃分流术是最常见的减重手术。胃分流术和其他类型的减重手术一样，属于肥胖症治疗手术，对胃及消化系统进行手术，以限制食物及营养摄入，最终导致体重减轻。1

While that may sound appealing, gastric bypass surgery isn't for everyone. Like any major procedure, it has significant health risks and side effects. In addition, the long-term success of gastric bypass surgery depends on your ability to make permanent changes in your lifestyle. When you want to be considered for gastric bypass surgery, you must undergo a thorough evaluation to determine if it's suitable for your situation. 

尽管这听起来很有吸引力，胃分流术并不适合所有人。正如其他的手术一样，它有显而易见的健康风险和副反应。此外，胃分流术的长期成功取决于你长期改变生活方式的决心。当你考虑接受胃分流术时，你必须彻底评价你的决定是否符合你现在的情况。1

Guidelines to qualify for gastric bypass surgery

可接受胃分流术者指南

Gastric bypass and other weight-loss surgeries are major, life-changing procedures. While weight-loss surgery can help reduce your risk of weight-related health problems, such as type 2 diabetes, high blood pressure and sleep apnea, it can also pose major risks and complications. You may need to meet certain medical guidelines to qualify for weight-loss surgery. You likely will have an extensive screening process to see if you qualify. 

胃分流术及其他减重手术是改变生活的大手术。胃分流术有助于减少体重相关健康问题风险，像2型糖尿病、高血压及睡眠性呼吸暂停等，同时，胃分流术也可能构成重大风险和并发症。你可能需要满足一些医学指南以评价自己是否适合减重手术。你可能需要进行大量筛选以确定自己是否合适。1

In general, gastric bypass and other weight-loss surgery could be an option for you if:

通常来说，胃分流术及其他减重手术需要满足以下条件：

Efforts to lose weight with diet and exercise have been unsuccessful. 

（1）饮食控制及运动减肥无效者。

Your body mass index (BMI) is 40 or higher (extreme obesity). 

（2）体重指数为40或40以上者。

Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure or severe sleep apnea. In some cases, you may qualify for certain types of weight-loss surgery if your BMI is 30 to 34 and you have serious weight-related health problems. 

（3）体重指数为35-39.9（即肥胖症），并且有严重的体重相关健康问题，如2型糖尿病、高血压或严重睡眠呼吸暂停综合症。如果伴有严重的体重相关健康问题，可以将减重手术的标准下降至体重指数30-34。

Evaluating if you're ready for gastric bypass surgery

评价是否胃分流术术前准备是否完善：

Even if you meet these general guidelines, you still may need to meet certain other medical guidelines to qualify for weight-loss surgery. You likely will have an extensive screening process to see if you qualify. 

尽管满足以上普通条件，还需要满足其他医疗指南标准以评价是否合适进行减重手术。你需要进行大量的筛选工作。

A team of health professionals — usually including a doctor, dietitian, psychologist and surgeon — evaluate whether gastric bypass or other weight-loss surgery is appropriate for you. This evaluation generally determines if the health benefits of the surgery outweigh the potentially serious risks. The evaluation also determines if you're psychologically and medically ready to undergo the procedure. 

一组健康专家——通常包括一位医生、一位营养学家、一位心理学家及一位外科医生——共同评价你是否适合进行胃分流术或其他减重手术。这种评价一般取决于手术的健康获益是否高于潜在的风险。这一评价同样取决于你的精神及身体状况是否适合接受手术。

When conducting an evaluation for gastric bypass surgery, the health team considers:

当进行胃分流术的评价时，健康评估小组会考虑：

Your nutrition and weight history. The team reviews your weight trends, diet attempts, eating habits, exercise regimen, stress level, time constraints, motivation and other factors. 

（1）健康及体重史。健康评估小组回顾了解你的体重变化、食欲情况、饮食习惯、运动情况、压力分级、时间约束、减肥动机及其他因素。

Your medical condition. Some health problems increase the risks associated with having surgery or may be worsened by surgery, such as blood clots, liver disease, heart problems, kidney stones and nutritional deficiencies. The team evaluates what medications you take, how much alcohol you drink and whether you smoke. You also will have a thorough physical exam and laboratory testing. The results of these tests and exams may help determine eligibility for weight-loss surgery. 

（2）身体状况。一些健康问题会增加手术相关风险，甚至因手术而加重，比如血栓、肝脏疾病、心脏问题、肾结石及营养缺乏。健康评估小组评价你的药物摄入情况，饮酒量及是否吸烟。同样，你会得到一个完整的身体条件测试及实验室检查。这些测试的结果有助于决定你是否适合接受减重手术。

Your psychological status. Certain mental health conditions may contribute to obesity or make it more difficult for you to maintain the health benefits of gastric bypass surgery. These may include binge-eating disorder, substance abuse, depression, anxiety disorders and issues related to childhood sexual abuse. While these may not prevent you from having gastric bypass surgery, your doctors may want to postpone surgery to ensure that any condition is appropriately treated and managed.

（3）精神状况。一些精神状况可能导致肥胖，或者使你难以保持胃分流术的健康获益。这些精神状况包括暴饮暴食、药物滥用、抑郁症、焦虑症及儿童期性虐待的相关问题。尽管这些并不妨碍你接受胃分流术，医生可能会将手术延期以保证任何情况都已得到治疗及合理控制。

Your motivation. The team will also assess your willingness and ability to follow through with recommendations made by your health care team and to carry out prescribed changes in your diet and exercise routine. 

（4）动机。健康评估小组将评估你始终坚持健康护理小组给你的建议及认真执行日常饮食及锻炼计划的意愿和能力。

Your age. Although there's no specific age limit for gastric bypass surgery, the risks increase if you're older than age 65. The surgery remains controversial in people under age 18.

（5）年龄。尽管胃分流术没有特定的年龄限制，但如果你高于65岁，手术的风险会增大。18岁以下人群是否能接受手术仍存在争议。

Pre-surgery requirements

术前准备：

If you're approved for gastric bypass surgery, your health care team gives you instructions about how to prepare in the months or weeks before the surgery. These instructions may include restrictions on eating and drinking, undergoing lifestyle counseling to help you cope with big changes in diet and exercise, quitting smoking, and starting a supervised physical activity program. In some cases, you may be required to lose weight before having gastric bypass surgery. 

如果你获准接受胃分流术，你的健康护理小组会在手术前数月或数周之内告诉你怎样为手术做准备。这些指令包括限制饮食和饮水，接受生活方式咨询以帮助你应付饮食和运动的巨大改变，戒烟，以及开始监护下的体力活动计划。有时，你可能需要在在手术前减轻体重。

Even after gastric bypass surgery is scheduled, it can be delayed or canceled if your health care team determines that:

即使胃分流手术已定下日期，仍可能因为健康护理小组的以下决定而延期或取消：

You're not psychologically or medically ready for surgery

（1）你的身体或精神状况不适合手术。

You haven't made appropriate changes in your eating or exercise habits 

（2）你还未对饮食及锻炼习惯进行合适的改变。

You gain weight during the evaluation process 

（3）你在评估期内体重增加。

Preparing financially for gastric bypass surgery

胃分流术的最后准备：

If it's determined that gastric bypass surgery is appropriate for you, you will still have financial hurdles to negotiate. If you plan to rely on health insurance coverage for your gastric bypass surgery, you likely need to get preapproval from your health insurance company, Medicare or your state medical assistance program — whoever you have insurance through. The preapproval process typically requires documentation from your team of doctors that justifies your medical need for gastric bypass surgery. 

如果最终确定胃分流术适合你，你仍然需要最后的努力。如果你希望依靠健康保险来支付你的胃分流术，你需要提前得到医疗保险机构的批准。这份批准通常需要为你做胃分流术医药调整的医生出具的文件。

Different health insurers have different requirements to prove your medical need for gastric bypass surgery. Your health insurer may not cover gastric bypass surgery at all or may cover only parts of the process. In some cases, you may have to meet requirements, such as losing a specific amount of weight or following a formal diet plan, before your insurance will grant approval. To avoid unpleasant financial surprises, check to see what specific services are covered before starting the evaluation process. You may have to pay for some portion of the costs yourself.

不同的医疗保险机构有不同的要求以证明你对胃分流术这一医疗的需求。你的医疗保险可能完全不包括胃分流术或者只支付一部分。有时，你可能需要满足一些要求，比如在保险机构同意之前减去一定体重，或进行正规的饮食计划。为避免尴尬的费用问题，请于评估期之前检查医疗保险中是否有相关的特殊条款。你可能需要自行支付一部分费用。

Gastric bypass surgery: Is it for you?

胃分流术：是否适合你？

Gastric bypass surgery isn't a miracle procedure — and it isn't for everyone. Having gastric bypass or other weight-loss surgery doesn't guarantee that you'll lose all your excess weight or that you'll keep it off over the long term. Nor is it a way to avoid making changes in your diet and exercise habits. In fact, you can regain the weight you lose with gastric bypass surgery if you don't stick with the lifestyle changes. But if you think gastric bypass surgery might be right for you, talk with your doctor.

胃分流术并不神奇——并不适合所有人。接受了胃分流术或其他减重手术并不意味着可以减去所有多余的脂肪，或者你可以长期保持体重。如果饮食及运动习惯不改变，手术也无能为力。事实上，如果你不改变生活方式，体重会重新增长。但是如果你认为胃分流术适合你，你可以与你的医生讨论一下。