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HEALTH

You Docs: Tips on bariatric surgery and a teen with a messy room

Monday, December 10, 2012 - 12:01 am

Q: I'm 85 pounds overweight and have type 2 diabetes, so I thought bariatric surgery might be the answer. But I started doing research and got confused. Is lap-band surgery as effective against diabetes as gastric bypass, and what is gastric sleeve surgery? — Phil M., Upton, Ma.

A: Let's clear this up for you. There are three types of bariatric surgery: gastric bypass surgery, gastric sleeve surgery and gastric band (or lap band) surgery. The lap band procedure has fallen out of favor because the band can slip, causing complications. So we're only going to look at the first two types.

Gastric bypass surgery staples your stomach to make it smaller and bypasses part of the small intestine. After a year, 67 percent of people on insulin go med-free and 96 percent of those on oral meds stop taking them.

Gastric sleeve surgery, or sleeve gastrectomy, removes about 85 percent of the stomach, so that it takes the shape of a tube or sleeve. There's less data on this procedure, but it does take longer to lose weight with this than with gastric bypass.

These procedures also are known to cure sleep apnea and gastric reflux disease, and seem to reduce high blood pressure and cholesterol levels.

However, gastric bypass and gastric sleeve surgery may lead to decreased bone density (although the National Institutes of Health doesn't think there's conclusive evidence). And these surgeries reduce the nutrients you take into your gut. It's important to eat right; take multivitamins and vitamin B-12; drink lots of water; go easy on alcohol, caffeine, sodas and acidic foods; and get plenty of exercise.

Bariatric surgery is a major advance in treating type 2 diabetes, if you're overweight and can't control your blood sugar levels. Just make sure you go to an experienced center, ask to see info on its results, and ask for references from post-op patients to see what their experience has been.

Q: I don't want to yell at my 16-year-old son, but he won't clean his room. My husband says to let it go, but I cannot ignore it! What can I do? — Tamara K., Brecksville, Ohio

A: It's tough being a teenager, but often it's a lot tougher being the parent of one! There's a good chance your son's sloppiness is a normal teenage expression of independence (“I don't have to live by your rules!”). That can be irritating, but it's not really serious.

Still, we don't recommend that you do nothing, if that causes you stress. What you want is a healthy, somewhat orderly house, and believe it or not, it's possible.

First, determine exactly why the situation bothers you. Is it a hygiene thing? Do you think it's disrespectful? Or do you just want every room in your house to be how you want it? Then, think about what compromises you can make, and present a plan that's open for discussion. For example, suggest a schedule for him to clean his room, and set out rules (no dirty dishes in his room overnight). Once you reach an agreement, let him know there are penalties (like missed activities) for not doing what he's agreed to do.

One cautionary note: If your son used to be a neat kid and suddenly he's a slob, it could be a sign of distress. And if his grades are slipping, his eyes are red and he sleeps a lot, he may be depressed, have a substance-abuse problem, be getting bullied at school or have relationship/sexual problems. If these behaviors continue for more than two weeks, let him know that you care, and then get him help.

But you probably have a normal teenager who won't mind some household guidelines once they're put into action. To help him understand his feelings, you can get him (at the library) our book, “You: The Owner's Manual for Teens: A Guide to a Healthy Body and Happy Life.” Just put it by his bedside. Good luck!

Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is Chief Medical Officer at the Cleveland Clinic Wellness Institute. Submit your health questions at www.doctoroz.com.