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Q: 10 points!!!!!!!!summarize please?
With no magic weight-loss pill available and more focus on the increasing rate of obesity among adults, people struggling with obesity are turning to surgery, especially procedures that have become less invasive.

For local surgeons and hospitals, that demand translates into a growing business for bariatric — stomach reduction — surgery. Some Bay Area hospitals and medical groups that have performed the surgery for a few years are now expanding, hiring more surgeons and buying more equipment geared for operating on people who weigh as much as 600 pounds.

“There are more people understanding the significance of the health risk,” said Dr. Mary Estakhri, director of minimally invasive surgery for ValleyCare Health System in Pleasanton. “Years ago, it was seen as incredibly drastic or it was seen as taking the easy way out. But now, frequently patients know other people who have had it, and it’s more of a reality.”

Since 2000, Estakhri has performed stomach reduction surgeries at ValleyCare with laparoscopic surgery, a technique that is less invasive. The health system recently hired another surgeon since officials expect a 25 percent increase in bariatric patients over the next year.

The procedure involves inserting a small camera in the surgical area through a small incision, and surgeons view the area on a video screen. They operate with instruments inserted through other small incisions.

In the last three years, stomach reduction surgeries have almost doubled, increasing from almost 37,000 in 2000 to over 63,000 for the year ended in June, according to the American Society for Bariatric Surgery. About 90 percent of those surgeries were performed in this country.

Given average surgery costs of $25,000, that translates to more than $1.4 billion spent on bariatric surgery in the United States in the most recent year. And though many insurers cover it, some only cover a specific type of bariatric operation.

It is not uncommon for patients to foot the bill themselves, hospital administrators say. For instance, 20 percent of the patients who have had stomach reduction surgery by Drs. Robert or John Rabkin in San Francisco pay for the surgery themselves, according to their office.

Demand for surgeries in the future is expected to remain strong, though it’s hard to say what it will be exactly since the decision to undergo the procedure is a personal one. The surgery is meant for morbidly obese people or those people at risk for diseases such as diabetes, hypertension and back problems. About 16 million people in this country are morbidly obese, or at least 100 pounds overweight.

“It’s a service line that for most hospitals is profitable at this time,” said Ken Steele, CEO of St. Mary’s Medical Center in San Francisco.

A combination of factors make the surgery more popular now, Estakhri and others say. In the last few years, celebrities including singer Carnie Wilson and NBC weather forecaster Al Roker have had stomach reduction surgery.

And national attention has spotlighted the fact that more Americans are obese and that obesity is a high risk for diabetes, hypertension, a host of back problems and ailments like sleep apnea.

Dr. John Feng, part of Laparoscopic Associates, a practice in San Francisco headed by Dr. Gregg Jossart, frequently sees patients at satellite offices in Petaluma and Eureka. Three surgeons in the practice perform three kinds of laparoscopic surgery on at least 200 patients a year, mostly at California Pacific Medical Center. The surgeons hold online chat sessions with patients to help them with questions about their recovery.

“It’s such a growing field right now that I think it will drive a lot of doctors to get this expertise especially in laparoscopic surgery because patients specifically look for that,” Feng said. “It’s not unusual to have patients come into the office who have read a lot about this surgery and they come into the office and ask” for a specific kind of surgery.

“Unless we can find the underlying problems causing obesity, and those are multifactorial, I think it will only grow,” Feng said of the demand.

The surgeries reduce the size of the stomach and the rate at which calories are absorbed. So after surgery, a person does not want to eat as much. Results of the surgery vary but a person can lose anywhere from half to at least 70 percent of their excess body weight over a period of a year or two following surgery.

The surgery can be especially beneficial for adults under age 60, Feng said, because it often enables them to get off expensive medication.

Earlier this year, St. Mary’s Medical Center in San Francisco spent about $500,000 to equip an operating room with special tables and equipment. CEO Ken Steele has been engineering a turnaround for the Catholic Healthcare West hospital, which is close to breaking even after losing more than $12 million in 2001.

Steele estimates that about 160 bariatric opera

A: I’m not going to read all of that and write a summary about it when you are perfectly capable of doing it yourself. Stop trying to get other people to do your work for you, it’s not helping you any.

Q: critique my essay on anorexia?
The first occurrence of the eating disorder anorexia nervosa or anorexia as it is commonly called was first seen in 1694; however it wasn’t actually recognized as a real disease until about the 1870’s where at this juncture people would actually become diagnosed. Dunglison’s medical dictionary defined the disease as a “lose of appetite” in 1865. In 1868 an English physician William Gall was the first to lay claim to the name anorexia and it was his idea that a persons family directly contributed to someone’s eating disorder. Dr Gull claimed the cause of the disease was undetermined and that most women developed anorexia at any age from sixteen to twenty three. In years past most people associated starvation with theological practices or folklore but Gull’s text “Anorexia Hysterica” created more fascination with the psychological aspects of the disease.

Anorexia is commonly referred to as an eating disorder but in actuality it is also a psychological disorder. Those who have the disease usually start out by dieting but this lose of weight becomes a virtual obsession. The anticipated weight loss gives the person in general, a feeling of mastery or control over their body. On a psychological level those with the disease value the feeling of control over physical weight loss. Anorexia mainly derives from a self imagine problem. Although one may associate lack of eating with anorexia, those with the disease will also exercise fervently, take some sort of diet pills or weight loss enhancers, and receive numerous enemas to try to flush out excess water in order to loss weight. Anorexia usually starts to become evident during adolescents but, younger children and adults also may develop the disease. More often than not Caucasians tend to become anorexic more so than other races and lower class families are less likely to become anorexic. Anorexia affects almost every organ in the body detrimentally as a person starves themselves. As a result of not eating a person’s heart rate and blood pressure tend to decrease significantly, which may ultimately lead to hypertension. In addition starvation and anorexia also affects the liver. As a person beings to starve more and more enzyme levels in the liver start to change negatively, in some cases even resulting in liver failure. Those who are anorexic generally have lower red and white blood cells causing not only anemia but a weakened immune system. Not only does anorexia cause internal complications, but it also causes noticeable physical signs like flaky skin, breakdown of nails, and tooth loss. Some physiological and behavior symptoms of anorexia include depression, irritability, and attention deficits. A majority of individuals with anorexia tend to develop extreme fixation with food and eating. They may hide food within their pockets, eating inordinately slow, and even eat minuscule portions of food at a dawdling rate.

At this current juncture there is no unambiguous cause for anorexia but as time progresses psychologists are beginning to develop more ground breaking theories. One suggested theory is genetics. Currently psychologists believe that person’s genetics will be a determinant of an individual’s propensity of developing eating disorders. Some believe that a certain chromosome 1p may hold the clue in determining if a person will have anorexia. Others within the scientific field contribute poor feeding habits as well as under eating as signs of a potential case of anorexia. In addition people who strive to be thin and attractive as well perfectionist usually are more likely to be anorexic. Popular culture and the media may also be the case. The young girls developing mind is easily deceieved and many adolescent girls tend to emulate what they see on television. It is no question that most movie stars, singers, and celebrities are abnormally thin. Young girls look up to these women as role models and to seek to be like them. This may lead to a self image problem and a desire to lose weight in order to look similar to those on TV.

One noteworthy study on anorexia nervosa is being done by Neuroendocrine Clinical Center. They are attempting to prove the correlation between anorexia and osteoporosis. They concluded that almost half of woman with anorexia usually experience some form of osteoporosis. They also determined that some of them had bones similar to that of elderly women. Due to lack of calcium, under nutrition and over production of glucocorticoids (stress hormones), are reasons behind bone loss and are all contributed to anorexia. One experiment in particular is giving young girls and women with anorexia low doses of the female hormone estrogen to see if that will slow down the breakdown of bones. Another notable experiment done by the Neuroendocrine Clinical Center that includes males and females, attempts to discover the causes and signs of bone loss in people with anorexia. The physicians will tes

A: Wow, lots of great information there!

The only thing that really strikes me is that your essay focuses on the anorexic’s need for control (which is correct), but you only touch on the control aspect with regards to weight issues.

An anorexic’s need for control can also extend FAR beyond anything to do with weight. In my case, it was a way to control (or numb out) painful emotions. There’s a strong correlation between anorexia/eating disorders and sexual or physical abuse. By starving yourself, you can actually become numb and devoid of emotion…. and therefore you don’t have to feel the pain.

All in all, your points are very good. Hope they mark you well on this :)

Take care!

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