Review Questions to practice for
CSOWM Questions with complete
solution 2026
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 answer ✔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 answer ✔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 answer ✔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 answer ✔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 answer ✔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 answer ✔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 answer ✔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 answer ✔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.
CSOWM Questions with complete
solution 2026
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 answer ✔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 answer ✔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 answer ✔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 answer ✔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 answer ✔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 answer ✔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 answer ✔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 answer ✔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.
