Question: Comment 1: I agree with you that over use of NSAIDS is probable for his development of peptic ulcer disease (PUD). All though Mr. C is essentially taking three medications, the dosing schedule really requires a high level of compliance. It is very important to stress the importance of maintaining a steady regime. Some of the complications of PUD include "bleeding, perforation, and gastric outlet obstruction with hemorrhage being the most common complication" (Fashner & Gitu, 2015).

Comment 2: Before Mr. C would undergo surgery, he would need an extensive psychosocial evaluation to determine if he is an appropriate candidate. During the examination, several aspects of Mr. C's life would be assessed, such as, eating pattern, history of weight loss attempts, family history, substance use history, cognition, social support, coping skills, adherence and motivation/expectation about the surgery (Marek et al., 2016, p. 1143). As someone in the medical field, I would want to know how serious Mr. C was about wanting to lose weight and have him on a trial diet regimen for a few months to see if he can be compliant. I wouldn't suggest that he undergoes bariatric surgery if he was unwilling to change his lifestyle prior to the procedure.

Comment 3: like that you brought up a mental health issue with Mr. C as one of his actual/potential problems. There have been many studies regarding obesity and mental illness and it made me look deeper into research. I read in a recent study that lack of exercise can decrease serotonin synthesis and worsen depression and anxiety (Lu et al., 2018, p. 4). Also, because of the stigmatism of obesity, some people become socially isolated and are less likely to eat healthy (Lu et al., 2018, p. 4). On the other hand, depression and/or anxiety could've begun 2 to 3 years ago for Mr. C and therefore has resulted in the increased weight gain.