NEWS - NEW BARIATRIC SURGERY LESS INVASIVE -PLICATION

New bariatric surgery less invasive

Thursday, January 26, 2012

  By Sylvia Perez and Christine Tressel

January 26, 2012 (CHICAGO) (WLS) -- Laura Adair is ready for a change. She wants to be healthier but diet and exercise were not working.

When the scale tipped at more than 240 pounds a simple walk down to the beach got scary, and she knew she was losing control.
"As I was coming back up the stairs I had completely lost my breath like an asthma attack," Adair said. "And I was alone and I completely panicked. I realized at that moment I had lost my life."
Last October she made the decision to have bariatric surgery.
This is something new in weight loss surgery. Adair is undergoing a novel procedure at St. Joseph Hospital in Chicago called laparoscopic gastric plication.
Bariatric surgeon Dr. Rami Lutfi is performing and studying the procedure at St. Joseph.
"This operation does not involve removing stomach, cutting anywhere in the GI tract or altering the anatomy," said Dr. Lutfi. "It's simply folding the stomach on its self, a very simple concept.
By simply stitching the stomach up through small openings its volume is reduced by 80 percent, so patients can eat less and still feel full.
The operation is less invasive than gastric bypass or a gastric sleeve procedure, which involve removing a part of the stomach or rerouting the intestines.
Dr. Lutfi believes that because of its simplicity it will not only help people lose weight but have less complications.
"We are very excited about it, our patients are very happy with it," he said.
While still investigational it could be used to augment a lap-band, a removable device to aid weight-loss. There is also a possibility gastric plication could be undone.
Bariatric surgeons at the Cleveland Clinic say gastric plication can help get rid of 50-55 percent of excess weight.
That's more than the lap band, but less than the gastric sleeve or bypass, and if your body mass index is over 50 this may not be right for you.
"Most people who want to lose somewhere between 50 and 100 pounds are going to do quite well with this operation," said Dr. Stacy Brethauer, bariatric surgeon at Cleveland Clinic. I think its simplicity is behind the attractiveness to patients."
So far Adair says she has lost 47 pounds.
"At first it came off pretty fast, but now it's, you know, one or two three pounds a week it's always very steady," Adair said.
She says the change has been fairly easy. She has been eating healthier but still most of what she wants, just in smaller portions.
She doesn't feel starved, just content.
"I can mess around with my kids so housework and I feel good," she said. "I don't have to take a nap, I'm not tired I'm not grumpy, I'm not thinking about food all the time, I'm living my life again."
St. Joseph Hospital
Gastric Plication or other Bariatric Surgeries
773-665-3170
Tora Vinci
Media Relations
Cleveland Clinic
216-444-2412
Vinciv@ccf.org

NEWS - PAULA DEAN REVELS SHE HAS TYPE 2 DIABETES

Paula Deen reveals she has Type 2 diabetes

 

By Jeannine Stein, Los Angeles Times / For the Booster Shots blog

January 17, 2012, 10:03 a.m.

It's official: TV chef Paula Deen admitted on the "Today" show Tuesday that she has Type 2 diabetes and has become a paid spokeswoman for pharmaceutical company Novo Nordisk.

After rumors about her condition ramped up last week, Deen talked with weather anchor Al Roker (who underwent gastric bypass surgery in 2002) Tuesday about her diagnosis three years ago, and why she decided to wait so long before going public with the news.

"I'm here today to let the world know that it is not a death sentence," said an upbeat Deen, adding that she is being compensated by the pharmaceutical company and is collaborating with them on a website, DiabetesInANewLight.com. The site offers recipes and information about the disease. "I'm going to be there for you and help you manage every day of your life with this, because it can be done."

When asked why she waited three years to talk about her diagnosis, Deen said, "I came home [from seeing the doctor], and I told my children, I told my husband, and I said, I'm going to keep this close to my chest for the time being. Because I had to figure things out in my own head. I had to give time to think about it, talk with my doctor .... I had nothing to give to my fellow friends out there."

And what of the scuttlebutt that Deen delayed going public because it would damage her reputation as a Southern cook who uses copious amounts of butter and sugar in her recipes?

"People are not going to quit eating," she said. "If people quit eating, we're all out of here. I wanted to bring something to the table when I came forward, and I've always been one to think that I bring hope, because I've had lots of obstacles in my life, y'all."

Deen told Roker that she's always eaten in moderation. "People see me on TV two, three times a day cooking all these wonderfully Southern, fattening dishes, but that's only 30 days out of 365, and it's for entertainment. People have to be responsible." She also cited other risk factors for the disease, including genetics and age.

In a recent interview with USA Today, Deen said she had given up her favorite sweet tea, which she admitted to drinking from lunch until bedtime. She also said she's exercising regularly on a treadmill and taking Victoza, a Novo Nordisk non-insulin injected diabetes medication (ads for the drug are obvious on the website).

Fattening foods aren't Deen's only vice: In October she went on the "Dr. Oz Show" to get help for her 50-year smoking habit. In some studies, smoking has been shown to increase the risk of developing diabetes.

The Centers for Disease Control and Prevention reports that diabetes affects 25.8 million Americans. The most common form of the disease is Type 2 diabetes, characterized by insulin resistance or an inability by the body to produce enough insulin to sustain standard glucose levels.

Deen's son Bobby recently debuted his own show on the Cooking Channel, "Not My Mama's Meals," in which he lightens up his mother's traditional comfort food.

But will Paula change her cooking M.O.? She was a bit cagey about that, saying that on her show she advocates moderation.

"You can have that little piece of pie," she said, "but here's what I want to get across to people: I want them to first start by going to their doctor and asking to be tested for diabetes, then get on a program that works for you. I'm amazed at the people that are aware they're diabetic, but they're not taking their medicine. They're not doing anything."

ARTICLE - MORE WEIGHT LOSS SEEN WITH GASTRIC BYPASS THAN BANDING

More weight loss seen with gastric bypass than banding

A gastric bypass operation called Roux-en-Y involves reducing stomach size with staples and connecting the smaller "pouch" directly to the small intestine. It is irreversible.

Gastric banding, as its name implies, involves placing a band around part of the stomach to reduce its size. This procedure is reversible, the researchers noted.

"Both gastric banding and gastric bypass are currently performed for morbid obesity," said lead researcher Dr. Michel Suter, chief surgeon at Chablais Hospital in Aigle.

"Bypass is more effective in terms of directs results such as weight loss, but a bit more dangerous immediately than banding," he said.

However, banding often leads to long-term complications requiring some sort of major re-operation, Suter said.

"In addition, many bands are not going to stay in place for much more than 10 years; hence, banding is unlikely to be the only weight-loss procedure the patient will be submitted to," he said. "Patients should make a choice knowing this, and decide whether they accept a slightly higher early risk to improve their results, or if they want the least invasive procedure, but then accept a high risk of further surgery at a later time."

The report was published in the Jan. 16 online edition of the Archives of Surgery.

For the study, Suter's team followed for six years 442 patients who had either gastric bypass surgery or banding.

Although there were more early surgical complications among those who had Roux-en-Y surgery, these patients lost more weight faster than those who had gastric banding, the researchers found.

After bypass surgery, about 17 percent of the patients had complications, compared with more than 5 percent of those who underwent banding, the researchers noted.

But at six years there were more problems with gastric banding, including about 48 percent who had weight gain or the procedure reversed, compared with about 12 percent who had bypass surgery, the study found.

Gastric banding was associated with more long-term complications (more than 42 percent versus 19 percent) and more new procedures than bypass surgery (about 27 percent vs. 13 percent).

Cholesterol levels among those who had gastric bypass surgery were consistently lower than among those who had gastric banding, who saw no change over time, the researchers add.

This finding implies that blood sugar levels were also lower among those who underwent gastric bypass surgery, the study authors said.

Suter is concerned that many patients are only offered banding and not told of its drawbacks.

"There is, in the United States, an extensive campaign promoting gastric banding as 'the solution' for obesity, which is far from being true," he said.

It can result in significant weight loss, but it remains a surgical procedure, and is certainly associated with significant risks, both in the short and long term, Suter said.

"Patients must be informed that surgery alone is not sufficient to achieve significant weight loss, and they must be instructed about other things they have to do such as changing their eating and lifestyle habits," he said.

In addition, Suter said, "Patients calling or referred for gastric banding must be informed about the other available procedures for morbid obesity, and not offered band only, as is the case in several places."

Depending on the actual operation, either procedure costs between $10,000 and $20,000 plus follow-up costs, and insurance coverage is very inconsistent, according to Dr. Edward Livingston, who serves as the Dr. Lee Hudson-Robert R. Penn Chair in Surgery at the University of Texas Southwestern Medical Center, in Dallas.

Hospital stay for bypass is usually two days, and banding usually one day, but this can vary depending on surgeon, hospital and complications.

Dr. Jacques Himpens, from the European School of Laparoscopic Surgery at Saint Pierre University Hospital in Brussels and author of an accompanying journal editorial, is less concerned with a particular procedure than with the specific surgeon.

"Not all surgeons can do bypasses," he said. "Maybe they don't have the skills or the experience, but in any case it's not the best option because they are not up to it," he said. "That's the case for many surgeons."

In addition, it is not clear what the long-term results of a bypass are, because there is evidence that although a bypass "cures" diabetes, it does come back after time, Himpens said.

"The bypass is a very good procedure, but not everyone can do it and we have to be very careful and watch what the long-term effects of the procedure are," he said.

Also, while a gastric bypass causes changes in metabolism, banding does not, Himpens said.

"But the good thing is that it is reversible. When you take out the band, no harm has been done and you can still do another procedure if you need to," he said.

However, among patients who receive bands, only 40 percent retain them after 10 years, either because of complications or the desire to have it removed, Himpens said.

On the Web:

www.nlm.nih.gov/medlineplus/ency/article/007199.htm, the U.S. National Library of Medicine has more on gastric bypass procedures.

HUMOR - FOREIGN PIZZA

Foreign Pizza

An American businessman goes to Japan on a business trip, but he hates Japanese food, so he asks the concierge at his hotel if there's any place around where he can get American food.
The concierge tells him he's in luck, there's a pizza place that just opened, and they deliver. The concierge gives the businessman the phone number, and he goes back to his room and orders a pizza.
Thirty minutes later, the delivery guy shows up to the door with the pizza.
The businessman takes the pizza, and starts sneezing uncontrollably. He asks the delivery man, "What on earth did you put on this pizza?"
The delivery man bows deeply and says, "We put on the pizza what you ordered, pepper only."

ARTICLE - GET STREET SMART ABOUT SUPPLEMENTS-TIps to Becoming Supplment Savvy

Get Street-Wise About Supplements
- Tips to Becoming Supplement Savvy -- By Becky Hand, Licensed & Registered Dietitian
Going to the drug store lately can feel a little like a Saturday morning trip to the candy shop, with dozens and dozens of colorful vitamin and mineral supplements to choose from! Can’t you just sample a little bit of everything?

If you’re considering a supplement, heed some familiar advice—choose wisely and carefully. Filling up on this type of "candy" can do more harm than good.

Vitamin and mineral supplements are so popular that you can buy them just about anywhere—the drug store, grocery store, mall, the internet, and through home-based distributors. But do you really need them? Will they improve your health? Are they safe? How can you avoid being ripped off?

Food Is Still Best
Before you clear a medicine cabinet shelf to stock up on supplements, remember this truth: Food is still the #1 option for getting the nutrients you need for healthy living. A balanced multivitamin supplement is second best and is usually safe. Beyond that, individual nutrient supplements should only be chosen in special cases.

It is true that vitamins and minerals are essential in regulating various body activities. These nutrients do not function alone but work together with other nutrients. The best source of vitamins and minerals is food. Food provides the complete package. A balanced diet already contains the correct nutrients in just the right amounts. Individual foods also provide hundreds of other substances such as phytochemicals, zoochemicals, and antioxidants that help to prevent disease and boost the immune system.

True, it can be frustrating and possibly frightening to not know if you’re getting enough of a certain nutrient. That’s where the SparkPeople Nutrition Tracker can help. Before you go supplement shopping, use the Nutrition Tracker to get a clear picture of your nutrient levels. You may not need to change anything!Who Needs a Supplement?
The decision to take a supplement should not be made haphazardly. It is best to seek advice from your physician or consult with a registered dietitian. This health professional should assess your dietary habits and intake, medical status, medication history, alcohol intake, and lifestyle habits. Some people who may need to take a multivitamin-mineral supplement include:

• People with digestive diseases, illness or surgeries that can interfere with the absorption of certain vitamins and minerals and therefore increase needs
• Pregnant and breastfeeding women (increased need for iron, folic acid, and calcium)
• Vegetarians who avoid all animal foods and may have a deficit of vitamin D, vitamin B-12, calcium, zinc, and iron
• People who smoke (because smoking increases the need for vitamin C)
• People with certain major illnesses or injuries that can increase the need for healing nutrients
• Women with heavy menstrual bleeding (may need more iron)
• Menopausal women (might benefit from calcium)
• Women who are trying to conceive (preconception warrants an increase in folic acid to decrease the risk of certain birth defects)
• People taking certain medications that can increase or decrease the effectiveness of vitamins and minerals
• People following weight loss programs that severely restrict food intake or calorie levels (less than 1000-1200 calories per day), which can result in poor nutrient intake
• People with food allergies that require avoiding groups of foods and may result in nutritional deficiencies
• People who abuse alcohol (increases nutrient needs)

Being Supplement Savvy
Do not fall into the dangerous trap of thinking that, if a little is good, more is better. Excessive intake of vitamins and minerals can do no good. It is a waste of money. And in some cases, excessive intake can damage the body, have a toxic effect, interfere with medications, and may even result in death. To choose a safe, effective vitamin-mineral supplement, follow these tips:

• Choose a balanced multivitamin-mineral supplement rather than one or two specific nutrients, unless it has been medically prescribed.
• Choose a supplement that provides close to 100-150% of the Daily Value (DV) for recognized nutrients. The exception to this is calcium, magnesium, and phosphorus. If the supplement did contain 100% DV of these nutrients, it would be too large to swallow. Due to the cost, biotin is also often less than 100% of the DV. However, the need for supplemental biotin is rare.
• Look for the "USP" insignia on the label. This ensures that the supplement meets the standards for strength, purity, disintegration and dissolution established by the testing organization, U.S. Pharmacopeia (USP).
• Read the supplement label carefully. Follow serving size recommendations.
• Avoid supplements that contain unrecognized nutrients and substances. A number of substances like PABA, inositol, bee pollen, lecithin, have never been shown to be essential to humans. They do nothing but boost the price.
• Beware of gimmicks. Synthetic supplements that are made in a laboratory are usually the same as so-called "natural" supplements. The body knows no difference, but your wallet does. "Natural" supplements cost more.
• Do not give in to the temptation of added herbs, enzymes, or amino acids. This only adds to the cost.
• Avoid supplements that claim to be therapeutic, high-potency, or for stress. This adds cost with no additional benefits.
• Choose a supplement with an expiration date on the container. Vitamins can lose potency over time, especially in hot and humid climates. Follow storage advice. Supplements should be kept in a cool, dry place, with a tight fitting lid.
• Keep supplements in a locked cabinet away from children. Don’t leave them on the counter or rely on child-resistant packaging. Be especially careful with any supplements that contain iron. Iron overdose is a leading cause of poisoning deaths among children.

Bottom Line: A poor diet plus supplements is still a poor diet. Food remains your best source of vitamins and minerals. So spend a little more time and money on delicious, tasty meals and snacks to meet your nutritional needs. And remember, a supplement is just that…a little extra in addition to wise food choices. This little extra poses no danger and may be helpful at times– if chosen wisely.

NEWS -GASTRIC BYPASS SURGERY PATIENT SHOCKED TO LEARN WEIGHT LOSS WAS DUE TO DIET & EXERCISE

Gastric Bypass Surgery Patient Shocked to Learn Weight Loss Was Due to Diet and Exercise

How would you feel if you just spent your entire life savings on gastric bypass surgery only to realize that you were actually losing weight the old fashioned way, through diet and exercise?
The following story is a tale of will power and faith, as it is a classic example that what we believe, we can achieve.
Karren Knight, mother of two from Cheshire, England one day decided she was going to get a gastric band tied around her stomach, as no other method of weight loss seemed to work for her. Trying several diets and exercise programs in the past, Knight could not lose weight. At nearly 200 pounds overweight, Knight realized she had to do something, or the quality of her life was going to continue to get worse.
Determined and believing that having a gastric band fitted to restrict her appetite would be a success, Knight followed the doctor’s orders to eat very little and got some exercise. Even thought Knight expressed that it was no easy feat to take her mind off of food, she remained loyal to her recommended eating schedule.
After complaining to her sister about her desire to eat, think about, and be obsessed with food, Knight decided to do something enjoyable to keep her mind off of her hunger. She found a Zumba class that was offered just down the road from where she lived, figuring it would be an easy way to keep attending because it was nearby, not to mention very fun.

Two years and several pounds later, Knight was very pleased at how the gastric band was working, or so she thought. After a follow up appointment, the doctor told her that the band had slipped off and it was not actually working at all. They both scratched their heads and asked each other how that was possible, until the light bulb went on in Knight’s head. “I thought surgery was an easy way to lose weight,” she said, “but I’ve discovered all it took was a bit of determination and finding some exercise I enjoyed.”
Weight loss happens when the number of calories ingested is less than the number of calories expended. Whether it’s through gastric bypass surgery, an increase in exercise, cutting back on the milkshakes, or a sustainable combination of a healthy diet and an exercise program that is fun, the weight will come off.
Although Knight opted to have the gastric band refitted, her story reminds us that our will, determination and faith are all very important factors in reaching our weight loss goals.

ARTICLE - WEIGHT LOSS SURGERY FOR DIABETICS

Weight Loss Surgery for Diabetics

By Rosemary Black
Reviewed by QualityHealth's Medical Advisory Board

If you're overweight and just can't seem to shed the unwanted pounds, you may be wondering whether surgery could be helpful in your quest to lose weight and get your blood sugar back in the normal range. Before you make a decision, weigh all the options. Many choices are available today to diabetics who opt for weight loss surgery, each with pros and cons.
Here's a rundown of what surgical options are out there. For each, the success rate means how many patients successfully lost and kept off the weight over time.
Gastric bypass surgery: The procedure involves stapling the stomach, creating a little pouch and a passageway for the food to bypass part of the small intestine.
This is the "gold standard" of weight loss surgeries, says Vadim Sherman, MD, a bariatric surgeon at Methodist Hospital in Houston, Texas. The success rate is high, about 70 to 80 percent of patients who have gastric bypass surgery continue to keep off the weight for 20 to 30 years, he says. Sherman says gastric bypass "has been shown to be the only surgery to resolve diabetes before any weight loss has even occurred." And, he adds, sometimes he sees patients have normal blood sugars even before they leave the hospital.
Gastric band surgery, (also known as Lap-Band adjustable gastric banding): This option is often a good choice for a recently diagnosed diabetic, says Mitchell Roslin, MD, chief of bariatric surgery at Northern Westchester Hospital in Mt. Kisco, New York.
To perform this, an inflatable band is put into place and divides the stomach into two parts as it wraps around the upper part. Once pulled tight, the band restricts the amount of food a person can eat. "We put a belt on the stomach that has a balloon inside and the balloon squeezes the stomach," Roslin explains. While it's simpler than the other surgeries and has a lower rate of complications, it's not as effective.
Individuals who have the gastric band surgery tend to lose less weight and to lose it more slowly than those who have the more radical procedures. The success rate is about 50 to 60 percent, Roslin says. This procedure also has the highest reoperation rate, he adds.

Updated: January 11, 2011

ARTICLE - SCIENTISTS HOPING TO HARNESS CALORIE BURNERS

Scientists Hoping to Harness Calorie Burners

Scientists are hoping to have found the key to burning calories. The researchers believe their findings could help people who have excess body fat lose weight. Academics from four groups have revealed a molecular mechanism that helps regulate how much energy our muscles burn.
After conducting preliminary tests on mice, scientists believe we could learn to control this molecular mechanism, and help people who have a hard time burning calories.

Experiments show that this mechanism is controlled by channels that are sensitive to something called adenosine triphosphate, or ATP. This is the “energy currency” that our cells use to keep our body moving. These channels can detect ATP and then, based on what they detect and how much energy they release, can regulate how our muscles perform. In many people, namely obese people, these channels can function in a way that store up excess energy or calories. This leads to having excess body fat since the muscles don’t get a chance to burn that energy.


But scientists feel that medical treatment may be able to target these channels and disable them. This could possibly allow obese people to naturally expend more energy and become leaner over time. Right now, the researchers hope to find out how this discovery can help people who aren’t prone to getting enough exercise.

ARTICLE - OBESITY & SNACKING BETWEEN MEALS

Obesity and Snacking Between Meals

Obesity is a rising problem, and there is plenty of conflicting information available about avoiding it. A new research survey out of Spain indicates that snacking between meals can increase one’s risk of becoming obese.
The University of Navarra’s Department of Preventative Medicine and Public Health conducted a survey of more than 10,000 college graduates for more than four years. The survey included 136 questions about eating habits, and all the participants were weighed before and during the course of the study.

According to the findings, participants who snacked between meals showed a 69 percent increased risk of becoming obese later on.
Of course, these results had a lot to do with what they were snacking on. The heaviest eaters snacked on junk foods, soft drinks and processed meats – referred to as “high-density” snacks – rather than healthy items like fruits or vegetables. These unhealthy snack choices added as many as 300 calories in each sitting.

 Adding the wrong snacks to three meals a day can often translate into weight gain, cravings for more of the same unhealthy foods, and a lack of energy, the researchers say. Occasional munchies between meals can be fine, they note, as long as you choose wisely.

ARTICLE - BARIATRIC SURGERY NOT A CURE FOR DIABETES

Bariatric Surgery Not a Cure for Diabete

 

January 10, 2012 —

Bariatric surgery (gastric bypass, sleeve gastrectomy, or gastric banding) leads to complete remission in only about one third of patients with type 2 diabetes, and should be viewed as a means for improving glycemic control, not as a cure, Dimitrios J. Pournaras, MD, and colleagues report in an article published online October 21, 2011, and in the January 2012 print issue of the British Journal of Surgery.
Using the recently updated American Diabetes Association (ADA) standard, which defined diabetes remission as hemoglobin (Hb) A1c levels below 6% and fasting glucose levels less than 5.6 mmol/L at least 1 year after bariatric surgery without hypoglycemic medication, the researchers found remission to be substantially lower than had been reported with earlier criteria.
Using data from 1006 patients, 209 of whom had type 2 diabetes at the time of gastric surgery, and a median follow-up of 23 months postsurgery, complete remission rates, using the new ADA standard, were 40.6% after gastric bypass (65/160 patients), 26% after sleeve gastrectomy (5/19 patients), and 7% after gastric banding (2/30 patients). However, the authors explain, "[t]he remission rate for gastric bypass was significantly lower with the new definition than with the previously used definition (40.6 versus 57.5 per cent; P = 0.003)." Remission rates for the other 2 procedures were not significantly different according to the new vs the old criteria.
The data, which were collected prospectively in 2 bariatric surgery centers in the United Kingdom and 1 center in Norway, also showed that on average, patients remained obese after surgery (preoperative body mass index [BMI], 48 kg/m² vs postoperative BMI, 35 kg/m²). After surgery, oral hypoglycemic medications were still used by 29.4% of gastric bypass patients, 63% of sleeve gastrectomy patients, and 83% of gastric banding patients.
HbA1c levels were significantly lower after surgery in all 3 surgical groups, with mean levels of 6.2% (compared with 8.1% before gastric bypass), 6.8% (compared with 7.5% before sleeve gastrectomy), and 6.3% (compared with 7.7% before gastric banding; P < .001 for each comparison).
Study limitations include the small number of patients with type 2 diabetes in the gastric banding and sleeve gastrectomy groups, as well as lack of data regarding the duration of diabetes.
The authors note that these findings are important for "[e]stablishing realistic expectations among patients, clinicians, and policy-makers" regarding bariatric surgery in the management of type 2 diabetes. They suggest that emphasis should shift to bariatric surgery as an aid in achieving glycemic control, rather than as a tool for achieving remission.
The authors conclude, "The principal benefit of surgery, however, would not be to improve glycemic control per se but rather to reduce microvascular and macrovascular complications associated with diabetes. The findings of this study emphasize the need for intensive follow-up of patients with type II diabetes following bariatric surgery, in order to review pharmacological treatment, monitor for complications of diabetes, and ensure that adequate glycemic control is achieved."
The study was supported by funding from the National Institute of Health Research Biomedical Research Center to Imperial College London. One author received a National Institute of Health Clinician Scientist award for work involving the trial. The authors have disclosed no relevant financial relationships.

ARTICLE - SLEEP APNEA AMONG OBESE WORSENS WITH AGE

Sleep Apnea Among Obese Worsens With Age

Sleep apnea among obese adolescents is serious, and the latest research indicates that it gets worse as the teens age. This video reveals a possibly reason why. Recent research shows that obese adolescents run a risk of developing obstructive sleep apnea, and the older the adolescent is, the more severe the symptoms may be.
Researchers examined data from 234 children between the ages of 2 and 18. All of the children were obese and were already suspected to have sleep-related breathing problems. The doctors separated the children by age groups and then assessed them during an overnight sleep study.

Doctors were surprised to find that more of the older children demonstrated sleep apnea symptoms than the younger children. One possible reason why older obese children suffer from sleep apnea to a greater degree is that they have larger tonsils.
Sleep apnea occurs when soft tissue in the back of the throat collapses and blocks the airway when a person is asleep. This makes it hard for the person to breathe. Researchers speculate that the larger tonsils of the older children may interact with their extra mass to cause serious breathing problems while they sleep.

 But, they say, adolescents with snoring problems who are obese should be referred to a physician, regardless of their tonsil size.

ARTICLE - WEIGHT LOSS SABOTAGED BY WRONG CALORIE COUNTS ON MENUS

Weight Loss Sabotaged By Wrong Calorie Counts on Menus

Weight loss can be hard if you don’t know how many calories you take in. A new study suggests that some restaurants offer deceptive menu information.
 
Research has shown that people make smarter choices when restaurants list the calorie counts on their menu. But what happens if the numbers aren’t accurate?
Researchers at the Friedman School of Nutrition Science and Policy at Tufts University  found that roughly 50 percent of the food you get at places such as Wendy’s, Applebee’s, Olive Garden, Denny’s, Dunkin’ Donuts, P F Chang’s, Domino’s, McDonald’s and Taco Bell is more fattening than those places say they are. In the worst cases, some foods had twice the calories stated on the menu. The average dish had 18 percent more calories than advertised.

The same study also took a look at some frozen foods from Weight Watchers and Lean Cuisine – foods that are supposed to be the dieter’s choice. A close examination revealed that some of their offerings contained 8 percent more calories than what was listed.

 The study’s lead author, Susan Roberts, said this amount of extra calories may not seem like much. But for those watching fat, calories and salt, the difference can add up fast for people expecting to lose a few pounds in a certain timeframe.

ARTICLE -OBESITY LINKED TO 'CLEAR-CELL'CANCER

Obesity Linked To ‘Clear-Cell’ Cancer

Obesity and a particularly dangerous form of kidney cancer have been linked, according to scientists.

A form of cancer known as “clear-cell renal cell cancer” is one of the most deadly kidney diseases. And American researchers have found a strong association between obesity and developing this illness.
Memorial Sloan-Kettering Cancer Center in New York examined more than 1,500 patients who had kidney tumors. Eighty-eight percent of them were suffering from malignant cases, and 61 percent of these malignancies were classified as “clear-cell.” Also, many of the deadly cases were found among males. But when the researchers also considered the patient’s weight and body mass index, they found that the obese kidney tumor patients had a 48 percent greater chance of developing the lethal “clear-cell” cancer. Also, they were able to verify that this lethal cancer risk increased 4 percent for every extra body mass index point they measured among the patients.
This relates to a story we recently reported about the American Institute for Cancer Research and some of the findings. One of the institute’s studies linked excess body fat to nearly 14,000 cases of kidney cancer, with more to come. Many may wonder why. The research at the time suggested that obesity can raise insulin levels, which can prompt the growth of cancer cells.

ARTICLE -OBESITY INCREASES RISK OF ANESTHESIA

Obesity Increases Risk of Anesthesia

 Obesity has long been associated with sleep apnea. But doctors are saying that even during weight loss surgery, obesity can make “going under” risky.

 As if obese people don’t have enough obstacles: Another one they may face is undergoing anesthesia in a safe way.
A new national campaign warns that being overweight or obese may affect how your body responds to “going under.”

The American Society of Anesthesiologists has launched a new campaign to make potential surgery patients, especially obese patients, aware of what can go wrong when asleep during an operation. Some obese people who undergo surgery, even if it’s weight loss surgery, can still suffer from the sleep apnea symptoms that obstruct their airways and make breathing difficult.
Of course, during surgery, medical staff can provide breathing tubes, but this may require special equipment or techniques. And so anesthesiologists often have to be ready for this and even have to warn certain patients about complications that may arise. In rare cases, patients who are morbidly obese and already suffer from sleep apnea are actually ordered to lose some weight before they are allowed to even undergo weight loss surgery.
And so, as part of the campaign, the American Society of Anesthesiologists urges obese people to request a thorough physical exam prior to undergoing any surgery that involves anesthesia.

ARTICLE - NEW CLUES TO HOW GASTRIC BYPAS SURGERY COMBATS DIABETES

New Clues to How Gastric Bypass Surgery Combats Diabetes

By Kathleen DohenyHealthDay Reporter April 27 3,519 8 5

WEDNESDAY, April 27 (HealthDay News) — Gastric bypass surgery has been known to improve blood sugar control, often sending people with type 2 diabetes into remission, but experts have long wondered exactly how that happens.
Now, a new study provides some clues.
Circulating amino acids linked with insulin resistance decline dramatically in those who have the bypass surgery, the researchers discovered. They compared 10 obese people with diabetes who had the surgery with 11 who lost weight through dieting.
"Something happens after gastric bypass that does not happen as much after the diet-induced weight loss," said Dr. Blandine Laferrere, an associate professor of medicine at St. Luke's Roosevelt Hospital Center and Columbia University, both in New York City.
The study is published in the April 27 issue of Science Translational Medicine.
The surgery, which reduces the stomach to the size of a small pouch, also modifies the junction between the stomach and small intestine. It leads to a dramatic reduction in the level of circulating amino acids that have been linked with diabetes.
"The fact that gastric bypass results in the remission of diabetes in the majority of patients is not new," said Laferrere. According to background information in the study, 50 percent to 80 percent of diabetes cases go into remission after the surgery.
What doctors have been trying to figure out, she said, is why the bypass surgery is so good at making the diabetes disappear. "The diabetes improves almost immediately, before a significant amount of weight loss occurs," she said. "That points out it is something other than the weight loss."
In the new study, the researchers evaluated biochemical compounds involved in metabolic reactions in the participants. Each group had lost about 20 pounds.
The investigators found that the bypass patients had much lower levels of amino acids known as branched-chain amino acids, and the amino acids phenylalanine and tyrosine.
"Those changes in the amino acids could be implicated in the mechanism of diabetes remission after gastric bypass," Laferrere said.
Experts know the amino acids are linked with insulin resistance partly due to animal studies, she said. "If you supplement the diet of rats with branched-chain amino acids, you can induce more insulin resistance," she explained.
However, Laferrere said, the finding does not mean all obese people with diabetes should pick surgery over dieting. The surgery is highly invasive, she noted, and not everyone is a candidate.
While the findings are intriguing, she said, it's too early to apply them to diabetes treatment. Eventually, she added, after experts understand more about how the surgery affects the amino acids, it may be possible to apply the findings to develop better diabetes treatments or a less invasive surgery.
The new study adds weight to other research finding a link between the
decline in branched-chain amino acids and the decline in insulin resistance,
said Dr. Thomas J. Wang, associate professor of medicine at Harvard
Medical School, and a coauthor of the perspective accompanying the
study.
"It's known that gastric bypass rapidly reverses insulin resistance,
which is one of the principal biochemical abnormalities that precedes
diabetes," Wang said.
"This study really does help to confirm that hypothesis that
branched-chain amino acids do go down more in people who have weight loss
surgery," he said. While it lends support to the idea that there is a link
between the reduction in the amino acids and the decline in insulin
resistance, it does not yet prove cause and effect, Wang added.
"It shows people who get weight loss surgery have a bigger drop in their
branched-chain amino acids. What is not yet proven is whether that reduction
in branched-chain amino acids is the reason their insulin resistance
declines," he pointed out.
Wang and his coauthor, Dr. Robert Gerszten, are co-inventors on patent
applications related to metabolite predictors of diabetes.
Wang and Gerszten also pointed out that the number of obese people with type 2 diabetes was 171 million worldwide in 2000. By 2030, that number is expected to double. Therefore, they wrote, a detailed understanding of the role of the amino acids in diabetes would be valuable.
More information
To learn more about gastric bypass surgery, visit the U.S. National Library of Medicine.

ARTICLE - BELLY FAT INCREASES PANCRIATIC CANCER RISK

Belly Fat Increases Pancreatic Cancer Risk

Excess belly fat can increase the risk of pancreatic cancer, according to a new study, which shows that obese women are more prone to the deadly disease.

 A new study published in the Archives of Internal Medicine indicates that women who carry excess weight around their stomach face a higher risk of pancreatic cancer.
The study, conducted at New York University School of Medicine, analyzed 2,170 people with pancreatic cancer and 2,209 people without the disease. Researchers found that for all participants, there was a correlation between an increased body mass index (BMI) and an increased risk for pancreatic cancer. Patients with a BMI in the top fourth had a 33 percent higher chance of having pancreatic cancer.
When researchers reviewed the overall weight categories, overweight women had a 31 percent higher risk of pancreatic cancer when compared to women of a normal weight, and obese women had a 61 percent greater risk of developing the disease.

Women who had a large waist in relation to their hips also had a higher risk. According to the study findings, women with the biggest waist to hip ratio had an increased pancreatic cancer risk of 87 percent.
“These findings, along with those from previous studies, strongly support the role of obesity in pancreatic cancer development,” wrote lead researcher Dr. Alan A. Arslan.

ARTICLE - GASTRIC BYPASS 'BEST FOR DIABETES WEIGHT LOSS'

Gastric bypass 'best for diabetes weight loss'

5 January, 2012 | By The Press Association

Although not a type 2 diabetes cure, gastric bypass weight-loss surgery can help people better control their blood sugar, a study suggests.

Some researchers have argued that as many 80% of people with diabetes who receive a gastric bypass procedure go on to be rid of the disease.
However a study at Imperial College London, which was said to have used stricter test criteria, found that the rate of remission was closer to 40%.
Many people with diabetes who get stomach surgery to reduce their weight have discovered their condition has got better, some even before they had lost the weight.
The disease is typically treated with insulin and drugs to control blood sugar.
The study in London reviewed data on 209 people who have type 2 diabetes to try to establish the most effective type of weight-loss surgery and concluded that gastric bypass caused the best rate of remission, 41%.
Carel le Roux, at Imperial College London’s medicine department, said: “”Using the new criteria we don’t get such eye-catching figures as some that have been quoted in recent years. But it’s clear that weight-loss surgery, particularly gastric bypass, has a significant beneficial effect on glucose control.”
Meanwhile, specialists in the US recently agreed to define “complete remission” as the condition of returning to normal glucose metabolism under no medication for at least a year after surgery.

• Pournaras DL, et al. Effect of the definition of type II diabetes remission in the evaluation of bariatric surgery for metabolic disorders. BJS 2011; Advance online publication

ARTICLE -INCREASED ALCHOHOLISM RATES SEEN AFTER GASTRIC SURGERY

Increased Alcoholism Rates Seen After Gastric Bypass Surgery

 

Gastric Bypass Associated With Higher Alcohol-related Diagnoses Compared With Banding

by David Wild

Chicago—European researchers have found that gastric bypass patients have an increased risk for postoperative alcohol dependence, according to data presented at the 2011 Digestive Disease Week (DDW) meeting (abstract 266). Based on the findings of a retrospective cohort analysis of more than 12,000 bariatric surgery patients, the investigators are calling for clinicians to examine gastric bypass patients for alcohol-related diagnoses.
“The results of this study clearly indicate the need for physicians to screen for alcohol abuse as part of the workup prior to bariatric surgery and to follow patients who undergo this operation carefully for signs of alcohol abuse,” said Craig Fisher, MD, MPH, associate professor in the Department of Surgery, Weill Cornell Medical College of Cornell University, New York City, who was not involved in the study.
According to primary investigator Magdalena Östlund, MD, a researcher in the Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, patients’ increased risk for acute alcohol intoxication and dependence after gastric bypass surgery may stem from greater alcohol absorption in the small intestine and a more immediate spike in blood alcohol levels. Because of this, she said, gastric bypass patients can experience significant impairment after consuming even a single glass of wine, and dependence can lead to weight gain.
Dr. Östlund and colleagues in Sweden and England examined data from 12,277 Swedish gastric bypass and restrictive surgery patients treated between 1980 and 2006 and followed for a mean of 8.9 years postoperatively. They compared data between these patients and 122,770 age- and gender-matched controls who did not undergo bariatric surgery; the researchers did not control for obesity in the matched group.
Compared with controls, bariatric surgery patients had significantly higher rates of psychosis, depression, attempted suicide and alcohol-related diagnoses, such as acute alcohol intoxication and alcohol dependence before surgery. Preoperative rates of these illnesses were similar among patients undergoing restrictive and gastric bypass procedures; however, patients undergoing gastric bypass were 2.3 times more likely than those receiving banding procedures to get inpatient treatment for alcohol-related diagnoses postoperatively (odds ratio, 2.3; 95% confidence interval, 1.7-3.0 for bypass vs. banding). The only other diagnosis that changed in frequency after surgery was psychosis, which decreased in both groups.
“Patients need to be warned of the risks of alcohol consumption following gastric bypass,” Dr. Östlund told DDW attendees.
Dr. Fisher, who moderated the press conference where the data were presented, said the strengths of the study’s design make the findings exceptionally reliable.
“These data are unique in that they capture a population with very complete follow-up information,” said Dr. Fisher. “In the United States, researchers often find it difficult to follow patients continuously, since they sometimes receive initial treatment at one center but go somewhere else for follow-up care. As there are a limited number of bariatric surgery centers in Sweden, the researchers here were able to track all of the patients who underwent surgery in Sweden.”

ARTICLE -BARIATRIC SURGERY EFFECTIVE IN METOBOLIC SYNDROME

Bariatric Surgery Effective in Metabolic Syndrome

By: ALICIA AULT, Family Practice News Digital Network

HOT SPRINGS, VA. – An analysis of a large database of bariatric surgery patients has found that those with metabolic syndrome had dramatic improvements in comorbidities but a slightly higher rate of adverse events after 90 days.

Overall, patients with metabolic syndrome tend to be sicker and to have a greater incidence of adverse outcomes and higher mortality than do obese patients who don’t have the syndrome, said Dr. William B. Inabnet III, professor of surgery at Mount Sinai School of Medicine in New York.

He and his colleagues at Mount Sinai also determined that the reduction in weight was procedure dependent. "A careful assessment of risk-benefit ratio is warranted to develop the optimal clinical pathway for treating these patients," said Dr. Inabnet at the annual meeting of the Southern Surgical Association.

The researchers examined BOLD (Bariatric Outcomes Longitudinal Database) to identify patients who had undergone bariatric surgery from June 2007 to November 2010 and had metabolic syndrome.

BOLD is maintained by the American Society for Metabolic and Bariatric Surgery Center of Excellence program, and includes 1,157 surgeons at 884 hospitals. The data are self-reported, but some data are verified by on-site inspections. The surgical interventions covered in the registry include gastric banding, Roux-en-Y gastric bypass, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch.

A modified scoring system (0-5) was used to assess comorbidities. For the purposes of the study, metabolic syndrome was defined as a hypertension score greater than 3, a diabetes score greater than 2, a dyslipidemia score greater than 2, and a sleep apnea score greater than 3. (Sleep apnea is not usually included in the definition of metabolic syndrome, but the researchers were interested in the condition as a comorbidity, said Dr. Inabnet.)

Overall, there were 186,567 patients in BOLD, including 23,106 patients who had metabolic syndrome. Those with metabolic syndrome were more likely than other obese patients to be male, older, and white, and to have sleep apnea and an ASA (American Society of Anesthesiologists) classification of 3 or greater. Body mass index was similar for both groups at 47 kg/m².

Gastric bypass was the most commonly performed procedure, and was the preferred method in patients with metabolic syndrome, followed by gastric banding, sleeve gastrectomy, and duodenal switch. And, said Dr. Inabnet, the researchers "were truly amazed to see that the vast majority of these cases were performed with laparoscopic approaches."

At 30 days, those with metabolic syndrome had increases in mortality, serious complications, readmissions, and reoperations, compared with other obese patients. The increases continued as time went on, and became more pronounced at 90 days post surgery, said Dr. Inabnet.

Overall mortality was very low (0.1%) for the entire cohort of 186,567 patients.

Mortality rates differed by procedure, however. The gastric band patients had the lowest rate (0.1%), followed by 1.2% for duodenal switch, 0.3% for sleeve gastrectomy, and 0.4% for gastric bypass. The serious complications, readmissions, and reoperations at 90 days were also lowest for gastric band patients, followed by duodenal switch, sleeve gastrectomy, and gastric bypass patients.

 

Metabolic syndrome was associated with the greatest risk for serious complications, according to the authors’ regression model. Those who received the gastric band had a 2.79-fold increase in risk at 90 days, compared with bypass patients, who had a 1.34-fold increased risk.

Follow-up data at 1 year were available for a little more than half of those with metabolic syndrome (12,144 patients). The data show that the decrease in BMI was procedure dependent. The greatest decrease in mean BMI (from 51 to 32) was seen in those who had a biliopancreatic diversion. Mean BMI dropped from 46 to 39 in gastric band patients, from 49 to 36 in those who had a sleeve gastrectomy, and from 48 to 32 in those who had the bypass.

Reduction of comorbidities was also greatest in the duodenal switch group, followed by the bypass, sleeve, and gastric band procedures. For instance, diabetes resolved in 74% of patients who had the duodenal switch, compared with only 28% of those who received the band. There were big reductions in hyperlipidemia and sleep apnea for all the procedures.

The data are limited in that they are self-reported, noted Dr. Inabnet. Even so, the "study confirms the previously held hypothesis that metabolic syndrome confers increased morbidity," said Dr. Bruce Schirmer, vice-chair of the department of surgery at the University of Virginia, Charlottesville. In discussing the paper, Dr. Schirmer noted that BOLD also seemed to show lower overall weight loss and resolution of comorbidities than was previously reported by individual institutions.

The database, however, has its advantages, said another discussant, Dr. William O. Richards, chair of the department of surgery and director of the surgical weight loss center at the University of South Alabama, Mobile. "This paper is important because it’s another one of the studies emanating from prospective [collections of data across the United States] from hundreds of surgeons, and convinces me we are ever more confident in reporting results not just from a single surgeon but from actual practice," said Dr. Richards.

He questioned whether the low mortality rate was a reflection of surgeons’ opting to avoid procedures in high-risk, older obese patients, or whether it was a reflection of the success of the centers of excellence system.

Dr. Inabnet said that there were 200 patients older than age 75, and although the data are currently too young to allow the measurement of any trends, it doesn’t seem that older patients are being operated on less often than are younger patients.

"What is the best operation? That really is the million dollar question," he said. The data show that the Roux-en-Y procedure provides the best overall risk profile, but he added that the sleeve gastrectomy is increasing in prevalence and may eventually prove to be a good choice.

Dr. Inabnet, Dr. Schirmer, and Dr. Richards reported no conflicts.

ARTICLE -IRON DIFICIENCY ANEMIA 'UNINTENDED CONSEQUENCE'OF GASTRIC SURGERY

Iron Deficiency Anemia 'Unintended Consequence' of Gastric Bypass

By: DOUG BRUNK, Family Practice News Digital Network

SAN DIEGO – About one-quarter of patients referred to a private hematology practice had iron deficiency associated with gastric bypass surgery.

In addition, 57% demonstrated symptoms of pica syndrome – a craving for and compulsive eating of non-food substances such as ice and starch.

"As morbid obesity has become a large problem in this country and more and more people are undergoing gastric bypass surgery, iron deficiency anemia is an unintended consequence," Dr. Thomas A. Bensinger said at the annual meeting of the American Society of Hematology. "Some of these patients get very severely anemic."

Dr. Bensinger and his associates at Maryland Oncology Hematology in Greenbelt reviewed the medical records of 300 adults referred to the practice between March and November of 2010 with a diagnosis of anemia. Of the total, 130 demonstrated iron deficiency anemia after undergoing laboratory studies that included complete blood count, ferritin, iron/total iron-binding capacity, reticulocyte count and review of the peripheral blood film.

Of the 130 patients, 122 (94%) were women, 4 of whom were pregnant. Heavy menstrual bleeding was the most common cause of iron deficiency anemia (62%), followed by gastric bypass surgery (24%), gastrointestinal abnormalities (6%), and heavy menstrual bleeding associated with the presence of uterine fibroid (5%). In addition, 12% of patients had both heavy menstrual bleeding and had undergone gastric bypass surgery. The remaining 3% of patients were male.

More than half of patients (57%) demonstrated symptoms of pica syndrome, primarily the urge to eat ice. Two patients reported an urge to eat toilet paper while one patient reported eating leaves that were stripped from a plant in her garden. Such symptoms "were often not reported by the patient unless the patient was questioned in detail with the exception of a small subset of patients who had performed an internet search and found pica for ice to be associated with iron deficiency anemia," Dr. Bensinger said.

Pica syndrome symptoms typically resolved within 7-21 days of intravenous iron administration. "I speculate that the craving for ice is related to enzymes that are in the oral cavity in the mucosa," he said. "They get iron depleted and somehow the ice makes them feel better. When you give them the iron, those enzymes get repleted. It’s a very interesting phenomenon. Some of our patients know when they start to get iron deficient again because they realize they’re eating ice."

The study’s overall findings underscore the importance of paying close attention to key indicators of iron deficiency anemia, including low mean corpuscular volume and various forms of pica syndrome.

"You have to keep paying attention to the causes of anemia," he said.

Dr. Bensinger reported having no relevant financial disclosures.

NEWS -LOWCOUNTRY COACH CONTINUES TO LOSE WEIGHT AFTER COMMUNITY PAID FOR GASTRIC BYPASS (WITH VIDEO)

Lowcountry coach continues to lose weight after community paid for gastric bypass

 By: Andy Wontor | WCBD
Published: January 04, 2012 

 

It's a small thing...the thought of his nieces sitting on his lap, that brings tears to Clay Owens' eyes. When asked if he was looking forward to the opportunity, he struggled to answer without crying.
The hundreds of pounds that created a barrier between him and the people he loves...are gone...His wife Suzie explains,"Now he has a lap, and they can sit on his lap. They love their Uncle Clay and that is going to be wonderful for him to actually have a place for them to sit."
Clay Owens has easily lost the weight of a man - or two - in the past two years. Once weighing 660 pounds, two years and a regimented diet have carved out a new man with a trim face and transformed body.
The latest surgery to remove excess skin the most rewarding for the football coach and history teacher at Hemingway Middle and High School.
"To me I couldn't see it, but this I can see. I can see the quantitative part of it. When I woke up in the recovery room I started feeling around, to see exactly what was still left and what was gone."
What is gone? 47.5 pounds of excess skin. "I've told people all I ever wanted to be was normal, because 660 pounds is just not normal."
Clay's weight-loss and his life owed to members of his community who took it into their own hands two years ago by raising money for the gastric bypass surgery...and every surgery since. "Without that I am pretty sure I would have died in the last two years sometime."
 Owens now trying to save others by speaking out against insurance companies, like his own, who do not pay for the surgery. "The insurance companies need to cover the gastric bypass. It is not a surgery to change people, it is a tool to get people healthy."

ARTICLE - GASTRIC BYPASS CUTS DEATH RISK -STUDY SAYS

Gastric bypass cuts death risk: study

AFP January 4, 2012


WASHINGTON: Obese people who undergo gastric bypass surgery are less likely to die from heart attack and stroke than people who receive more conventional treatment for their weight condition, a Swedish study said Tuesday.
The study, published in the January 4 issue of the Journal of the American Medical Association, included about 4,000 patients in Sweden who were recruited between 1987 and 2001.
The surgery patients either had gastric bypass (13.2 per cent), banding (18.7 per cent), or vertical banded gastroplasty (68.1 per cent), and all lost 16-23 per cent of their body weight in subsequent years.
The control group did not have any type of surgery and showed a 0-1 per cent weight loss at follow-up periods of two, 10, 15 and 20 years.
“Bariatric surgery was associated with reduced number of fatal heart attack deaths (22 in the surgery group vs. 37 in the control group),” said the study led by Lars Sjostrom of the University of Gothenburg, Sweden.
Bariatric surgery was also linked to a lower number of heart attacks overall, fewer strokes, and fewer fatal strokes.
But when the researchers looked at weight change alone, they could find no significant relationship to cardiovascular events in either group, suggesting that the weight loss itself might not be the driver of fewer deaths.
“There are many benefits to bariatric surgery and that some of these benefits are independent of the degree of the surgically induced weight loss,”said the study.
Other studies have shown that the benefits of gastric surgery for extremely obese people can include long-term changes of body weight, better quality of life, and fewer incidences of diabetes and cancer.
“The message is clear — bariatric surgery saves lives,” said Mitchell Roslin, chief of obesity surgery at Lenox Hill Hospital in New York, who was not involved in the study.
Roslin noted that the most common type of surgery in the study, vertical banded gastroplasty, has been replaced by newer methods that are even more effective, so the cardiovascular death risk is likely even lower today.
As many as 200,000 gastric bypass operations, in which the stomach is sectioned off so that the smaller amounts of food can fit inside, are done annually in the United States, where about a third of people are obese.

GLP-1 PALYS A ROLE IN GLUCOSE CONTROL AFTER GASTRIC BYPASS

GLP-1 Plays Role in Glucose Control After Gastric Bypass

Last Updated: January 03, 2012.

 There is a positive association between glucagon-like peptide-1 (GLP-1) concentrations and insulin concentrations following gastric bypass surgery in patients with type 2 diabetes, suggesting a role for GLP-1 in glucose control, according to a study published in the January issue of Diabetes Care.
TUESDAY, Jan. 3 (HealthDay News) -- There is a positive association between glucagon-like peptide-1 (GLP-1) concentrations and insulin concentrations following gastric bypass (GBP) surgery in patients with type 2 diabetes, suggesting a role for GLP-1 in glucose control, according to a study published in the January issue of Diabetes Care.
Bart J. Van Der Schueren, Ph.D., of St. Luke's Roosevelt Hospital Center in New York City, and colleagues studied 15 obese patients with type 2 diabetes (one man, 14 women) before GBP surgery and one, 12, and 24 months following surgery. Glucose and GLP-1 concentrations were measured during an oral glucose challenge.
The researchers found that weight, glucose area under the curve from 0 to 180 min (AUC_0-180), insulin sensitivity index, and the homeostasis model assessment of insulin resistance all decreased significantly up to one year following GBP, but did not decrease any further at the two-year marker. The decrease in insulin AUC_0-180 became significant at the two-year point. GLP-1 AUC_0-180 was positively associated with insulin AUC_0-180. Glucose AUC_0-180 started decreasing in magnitude one month after surgery, while the GLP-1 AUC_0-180 increased in magnitude one month after GBP, but did not achieve increased variance until the one-year follow-up point.
"The association between GLP-1 and insulin concentrations supports the idea that the incretins are involved in glucose control after GBP," the authors write.

NEWS - CARNIE WILSON STILL STRUGGLING WITH WEIGHT ISSUES AFTER GASTRIC SURGERY

Carnie Wilson Still Struggling With Weight

Jan. 3, 2012 Staff -- HispanicBusiness

Carnie Wilson wants to drop some pounds in 2012. Don't we all? But the 43-year-old Wilson Phillips singer lost 150 pounds since her gastric bypass in 1999, and is still struggling. That's one of the side effects of sober living and motherhood, apparently. "I've had so much stress in the last year so it's really a struggle," Carnie Wilson told Fox News, as reported by TV Guide. "I can't smoke a joint. I can't have a glass of wine because I want 10 joints and 10 glasses of wine." Carnie Wilson says she doesn't hide her weight or addiction issues from her children, Lola, 6, and Luciana, 2. Wilson got sober after giving birth to Lola. She sees herself in Lola, and it worries her. "Lola knows I struggle with (weight). I see Lola loving sugar like all the other children but I also see her pay a little more attention like when there's a birthday party, I see her being the first in line to get the cake. I see me in her," Wilson says.

ARTICLE - WHY WERE GETTING FATTER--AND WHAT TO DO ABOUT IT

Why we're getting fatter -- and what to do about it

By David Frum, CNN Contributor

updated 7:51 AM EST, Mon January 2, 2012

 

 

Editor's note: David Frum, a CNN contributor, was a special assistant to President George W. Bush from 2001 to 2002. He is the author of six books, including "Comeback: Conservatism That Can Win Again," and is the editor of FrumForum.

(CNN) -- Monday is the second day of the year, which means millions of Americans have started new diets. They resolved to lose weight, get in shape, and they are starting strong.
Sadly, the odds are that almost all of these resolutions will soon be broken and abandoned. Close to half of all dieters end up heavier than ever. Virtually none will lose weight permanently.
The same is true for the country as a whole. Obesity has become the country's leading public health problem. Yet as we talk and talk about the issue, the country only becomes fatter and fatter.


The problem for the country echoes the problem for individuals: Willpower is not enough. "(It's a) basic instinct, even stronger than the sexual instinct, to store calories to survive the next period of starvation. And we live in an environment where there's food every half mile. It's tasty, cheap, convenient, and you can eat it with one hand."
Thus says Martijn Katan of the Institute of Health Sciences at VU University in Amsterdam, author of one of the many studies on the limits of dieting, quoted in U.S. News & World Report.
If you as an individual want to change your weight, you must change your whole life. Likewise, to reduce obesity in modern society, we will have to alter the way society is organized.
Weight gain is driven by two trends: increases in calories consumed and decrease in calories expended. Modern America induces both.
For example: The after-inflation cost of sugary soda has declined by an estimated 48% over the past 20 years. Correspondingly, consumption of sugary soda has soared: Sugary soda is now the single most important source of calories in the American diet.
For example again: The number of Americans who work at physically taxing jobs continues its steady decline. Even those jobs that demand physical labor -- manufacturing, for example -- are much less grueling than they used to be, as electrically powered machines do the lifting and shifting that used to consume human energy.


While Americans expend fewer calories at work, they spend more time in cars -- almost twice as much as in the 1970s. They spend 26 hours per week consuming TV or online entertainment. Americans could theoretically compensate for more sedentary lifestyles by stepping up their recreational exercise -- but only about 20% of Americans bother. Some 80% never do -- including presumably all those failed dieters.
Want to change this? It's no small project. It would involve the redesign of cities, the relocation of schools, the reinvention of our modes of eating and amusement.
First lady Michelle Obama has made healthy eating her special project. Good for her, and let's hope her efforts lead to success. But if we are to succeed, we should understand: The campaign against obesity will have to look a lot less like the campaign against smoking (which involves just one decision, to smoke or not to smoke) and much more like the generation-long campaign against highway fatalities, which required the redesign of cars, the redesign of highways, and changes in personal behavior like seat-belt use and drunk driving.
The good news is that the campaign against highway fatalities has yielded real progress: down two-thirds since the mid-1960s. The bad news is that, for most of us, it will take more than a New Year's resolution. However, if you are seriously resolved, congratulations -- and see you on the jogging path.

BOOK - "SUCESSUL WEIGHT LOSS WITH GASTRIC SLEEVE" NOW AVAILABLE FOR IPAD/KINDLE/NOOK

“Successful Weight Loss with the Gastric Sleeve” Now Available for iPad, Kindle and Nook

Release Date: 2012-01-02 Category: Medicine

Mexico bariatric surgeon Dr. Guillermo Alvarez releases his book "Successful Weight Loss with the Gastric Sleeve" on the iPad and Amazon Kindle and Barnes and Noble Nook.

 Successful Weight Loss with the Gastric Sleeve is now available on the iPad, Kindle and Nook. This book is one of the first of its kind to appear in digital format, according to the book’s author, Mexico bariatric surgeon Guillermo Alvarez, who hopes it reaches a wide population of people interested in bariatric surgery, specifically the gastric sleeve procedure.

“Successful Weight Loss with the Gastric Sleeve” is a comprehensive resource for potential bariatric surgery candidates. After exploring the general topics of obesity and weight loss treatments, the book goes into greater detail about gastric sleeve surgery. It includes an explanation of the surgery itself, guidelines for post-operative diet and exercise and a list of potential complications. “Successful Weight Loss with the Gastric Sleeve” concludes with powerful patient testimonials.

Gastric sleeve, otherwise known as a vertical sleeve gastrectomy, is an operation to reduce the size of the stomach so it can hold less food, thereby restricting the patient’s caloric intake. Some bariatric surgeons consider it advantageous over gastric bypass because it does not require rerouting the intestinal tract, and produces steady, rapid weight loss.

To learn more about Dr. Alvarez, his book or his Mexico weight loss surgery practice, please call 1-866-MY-SLEEV.

More about Dr. Guillermo Alvarez

Dr. Guillermo Alvarez is a weight loss surgeon who focuses on laparoscopic procedures, including gastric sleeve, gastric sleeve plication and Lap Band in Mexico. His practice is located in Piedras Negras, near the border of Texas. Dr. Alvarez is committed to providing the safest and most effective bariatric surgery procedures to improve a patient’s health and overall well-being.

For more information, please visit http://www.endobariatric.com or contact us today.

ARTICLE -ANTI-OBESITY ADS FEATUING OVERWEIGHT KIDS SPARK CONTRAVERSY IN GEORGIA

Anti-obesity ads featuring overweight kids spark controversy in Georgia 

Harsh ad campaign makes overweight kids look miserable

By Rheana Murray / NEW YORK DAILY NEWS

Monday, January 2 2012, 10:31 PM

A series of stark anti-obesity ads featuring miserable, overweight kids has sparked controversy in Georgia.
The ads feature children talking about their weight issues in between harrowing messages such as, “Some diseases aren’t just for adults anymore,” and “Being fat takes the fun out of being a kid.”
Children’s Healthcare of Atlanta, which co-founded the Strong4Life ad campaign, intended for the ads to be grim, hoping the clips would help parents recognize the severity of the obesity epidemic in Georgia, where it is the second highest in the nation.

“We felt like we needed a very arresting, abrupt campaign that said: ‘Hey Georgia! Wake up. This is a problem,’” said Linda Matzigkeit, a senior vice president at Children’s Healthcare, according to the Atlanta Journal-Constitution.
“If we do not wake up, this will be disastrous for our state,” Matzigkeit said to ABC.
Critics are slamming the campaign for its use of shock tactics, saying the ads don’t actually offer a solution to child obesity, ABC reported.

“There is no mention about what a parent can do other than to say ‘stop sugarcoating the problem,’” said Dr. Lori Feldman-Winter, a pediatrics professor at the Robert Wood Johnson Medical School.
Experts also worry the campaign will create self-confidence problems for overweight children.
“Blaming the victim rarely helps,” said Dr. Miriam Labbok, a health professor at the University of North Carolina at Chapel Hill, to ABC. “These children know they are fat, and they are ostracized already.”
According to Dr. John Morton of the Stanford University School of Medicine, the ads might be harsh, but they could work, ABC reported.
“To change deep-seated social and physiologic behavior like eating will require enormous work, and these ads will help the family start thinking about prevention,” he said.

ARTICLE -OBESITY RISK REDUCED BY LONGER BREASTFEEDING?

Obesity Risks Reduced By Longer Breastfeeding?

Obesity risk in later life appears to be more slim when babies are fed solid food at a later age, according to one study.

 The debate about how long to breastfeed has gone on for some time. But now, new research indicates that mothers who wait until their baby’s fifth month to introduce solid food may reduce the child’s risk of obesity later in life.
Researchers at the University of Copenhagen looked at a sample of more than 5,000 adults who were born between the years 1959 and 1961. The common wisdom of that time was to begin feeding a child solid food between the ages of four and six months old – but some parents began sooner than four months.
Some of the children had only been breast-fed until they were two and a half months old.
Researchers discovered that among the sample participants, body mass index was lower and healthier among the people who had been breastfed until they were at least four months old. The participants were all in their forties at the time of the study, and yet the researchers were able to determine that the odds of being overweight had been lessened 5 to 10 percent for each month they were not fed solid food.

 These findings are consistent with other medical opinions. Currently, the American Academy of Pediatrics recommends breast feeding up to age one, and the World Health Organization recommends it for at least six months.

10 WAYS TO REV UP YOUR MOTABOLISM

Even before you start exercising, you can use plenty of tricks to eliminate visceral fat, improve your flab-burning metabolic process, and start losing weight fast.
1. Don’t Diet!The Men’s Health Diet isn’t about eating less, it’s about eating more—more nutrition-dense food, to crowd out the empty calories and keep you full all day. That’s important, because restricting food will kill your metabolism. It makes your body think, “I’m starving here!” And your body responds by slowing your metabolic rate in order to hold on to existing energy stores. What’s worse, if the food shortage (meaning your crash diet) continues, you’ll begin burning muscle tissue, which just gives your enemy, visceral fat, a greater advantage. Your metabolism drops even more, and fat goes on to claim even more territory.
Eat and Still Lose Weight! Try these 15 New Superfoods.
2. Go to Bed Earlier
A study in Finland looked at sets of identical twins and discovered that of each set of siblings, the twin who slept less and was under more stress had more visceral fat.
3. Eat More ProteinYour body needs protein to maintain lean muscle. In a 2006 study in the American Journal of Clinical Nutrition, “The Underappreciated Role of Muscle in Health and Disease,” researchers argued that the present recommended daily allowance of protein, 0.36 grams per pound of body weight, was established using obsolete data and is woefully inadequate for an individual doing resistance training. Researchers now recommend an amount between 0.8 and one gram per pound of body weight. Add a serving, like three ounces of lean meat, two tablespoons of nuts, or eight ounces of low-fat yogurt, to every meal and snack. Plus, research showed that protein can up post-meal calorie burn by as much as 35 percent.
Check Out These 5 Perfect Protein-Packed Gym Snacks!
4. Go Organic When You CanCanadian researchers reported that dieters with the most organochlorines (pollutants from pesticides, which are stored in fat cells) experienced a greater than normal dip in metabolism as they lost weight, perhaps because the toxins interfere with the energy-burning process. In other words, pesticides make it harder to lose pounds. Other research hints that pesticides can trigger weight gain. Of course, it’s not always easy to find—or to afford—a whole bunch of organic produce. So you need to know when organic counts, and when it’s not that important. Organic onions, avocados, grapefruit? Not necessary. But choose organic when buying celery, peaches, strawberries, apples, blueberries, nectarines, bell peppers, spinach, kale or collard greens, cherries, potatoes, and imported grapes; they tend to have the highest levels of pesticides. A simple rule of thumb: If you can eat the skin, go organic.
5. Get Up, Stand UpWhether you sit or stand at work may play as big a role in your health and your waistline as your fitness routine. In one study researchers discovered that inactivity (four hours or more) causes a near shutdown in an enzyme that controls fat and cholesterol metabolism. To keep this enzyme active and increase your fat burning, break up long periods of downtime by standing up—for example, while talking on the phone.
Try These 17 Shortcuts to Better Health
6. Drink Cold WaterGerman researchers found that drinking 6 cups of cold water a day (that’s 48 ounces) can raise resting metabolism by about 50 calories daily—enough to shed five pounds in a year. The increase may come from the work it takes to heat the water to body temperature. Though the extra calories you burn drinking a single glass don’t amount to much, making it a habit can add up to pounds lost with essentially zero additional effort.
7. Eat the HeatIt turns out that capsaicin, the compound that gives chili peppers their mouth-searing quality, can also fire up your metabolism. Eating about one tablespoon of chopped red or green chilies boosts your body’s production of heat and the activity of your sympathetic nervous system (responsible for our fight-or-flight response), according to a study published in the Journal of Nutritional Science and Vitaminology. The result: a temporary metabolism spike of about 23 percent. Stock up on chilies to add to meals, and keep a jar of red pepper flakes on hand for topping pizzas, pastas, and stir-fries.
Check out these 26 ways to feed your body for better results.
8. Rev Up in the Morning
Eating breakfast jump-starts metabolism and keeps energy high all day. It’s no accident that those who skip this meal are 4 1/2 times as likely to be obese. And the heartier your first meal is, the better. In one study published by the American Journal of Epidemiology, volunteers who got 22 to 55 percent of their total calories at breakfast gained only 1.7 pounds on average over four years. Those who ate zero to 11 percent of their calories in the morning gained nearly 3 pounds.
9. Drink Coffee or TeaCaffeine is a central nervous system stimulant, so your daily java jolt can rev your metabolism 5 to 8 percent—about 98 to 174 calories a day. A cup of brewed tea can raise your metabolism by 12 percent, according to one Japanese study. Researchers believe the antioxidant catechins in tea provide the boost.
10. Fight Fat With FiberFiber can rev your fat burn by as much as 30 percent. Studies find that those who eat the most fiber gain the least weight over time. Aim for about 25 grams a day—the amount in about three servings each of fruits and vegetables.