2008-09-08T11:39:58Z No Author Copyright 2008, No Author SPHPBLOG Safe Weight Loss Surgery in Mexico - We offer adjustable gastric band surgery using the Lap Band by Allergan (formerly INAMED) or the newly FDA approved Johnson and Johnson Realize Bands, the Vertical Sleeve Gastrectomy (VSG) and Roux en Y Gastric Bypass (RNY) all performed using Laparoscopic approach by expert surgeons.


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]]> http://www.obesityhelpblog.com/index.php?entry=entry080320-055625 2008-03-20T00:00:00Z 2008-03-20T00:00:00Z
By Madeline Vann

Friday, December 21, 2007


FRIDAY, Dec. 21 (HealthDay News) --The morbidly obese may not be the only people who should be eligible for bariatric surgery to lose weight, U.S. researchers report.


People with a body-mass index (BMI) less than the required 40 could still reap heart health benefits from the surgery, they say.


BMI is calculated based on height and weight. A healthy BMI ranges between 18.5 and 25. A person with a BMI of 40 -- for example, someone 5 feet 9 inches tall and 270 pounds -- is considered morbidly obese. According to the Centers for Disease Control and Prevention, one in three adults is obese.


Bariatric surgery options include gastric bypass and lap band surgeries. Typically, a person must have a BMI of 40, or be at least 100 pounds over their healthy weight, to qualify for these surgeries. People who have a BMI greater than 35 and suffer from a life-threatening illness, such as non-insulin dependent diabetes, sleep apnea or heart disease, can also qualify.


However, researchers at University of Texas Southwestern Medical Center at Dallas published data in the December issue of Surgery for Obesity and Related Diseases suggesting that some otherwise healthy overweight people with a BMI lower than 40 may benefit. And they may benefit more from the surgery than people who are morbidly obese, the team added.


The study is among the first to evaluate the risk-factor relationship between BMI and cardiovascular disease as it relates to bariatric surgery criteria, said study author Dr. Edward Livingston, chairman of GI/endocrine surgery at UT Southwestern.


"Our results show that cardiovascular risk factors do not necessarily worsen with increasing obesity," Livingston said in a prepared statement. "They also support the concept that obesity, by itself, doesn't trigger an adverse cardiovascular risk profile or increased risk of death."


The research team analyzed health data from more than 17,200 adults who had a BMI greater than 20 and had participated in the Third National Health and Nutrition Examination. The researchers assessed their heart disease risk factors with respect to their BMI. They found a subgroup of people whose BMIs were lower than 40 but who had significant heart disease risk factors.


This suggests that some patients who are obese but not morbidly obese could benefit from bariatric surgery, which can help reduce cardiovascular disease, said Livingston.


The research team theorized that some morbidly obese people may be more efficient than moderately overweight people at storing fat in their cells, so it does not have as great an effect on the cardiovascular system.



HealthDay

Copyright (c) 2007 ScoutNews, LLC. All rights reserved.]]> http://www.obesityhelpblog.com/index.php?entry=entry080109-134522 2008-01-09T00:00:00Z 2008-01-09T00:00:00Z
Salt Lake City - Severely obese patients who undergo gastric bypass surgery significantly reduce their risk of death from coronary heart disease, diabetes, and cancer, according to research published in the Aug. 23, 2007, issue of The New England Journal of Medicine. The study was led by a team of researchers from the University of Utah School of Medicine and LDS Hospital.


The 14-year study evaluated 15,850 severely obese patients, half of whom underwent gastric bypass surgery to reduce their weight. The mortality rate from coronary heart disease was 56 percent lower in the surgery group than in the non-surgery (control) group. The surgery group also showed a 60 percent lower death rate from cancer and a 92 percent lower death from diabetes than the non-surgery group, according to Ted D. Adams, Ph.D., M.P.H., the study's lead author,
Adams is a professor in the Division of Cardiovascular Genetics at the University of Utah School of Medicine and co-founder of the Intermountain Health and Fitness Institute at LDS Hospital in Salt Lake City.


While mortality rates for specific diseases were lower in the surgery group, Adams said mortality rates from other causes such as accidents and suicide were 58 percent higher among those who had the weight loss surgery than the control group.


This study helps to further define the effects of gastric bypass surgery on long-term mortality. Reduction in death by any cause, and disease-specific deaths such as coronary heart disease, diabetes, and cancer were significantly reduced in surgery patients compared to the non-surgical control group, he said. However, rates of death not caused by disease were shown to be greater in those who underwent the weight-loss surgery when compared to controls.


The paper suggests at least some of these non-disease deaths in the surgery group may be due to unrecognized pre-surgical mood disorders or post-traumatic stress disorders, which appear to be more common in severely obese patients. Adams said the research shows the need for better methods of evaluating candidates for the surgery, including the possible need for psychological evaluation and psychiatric treatment before surgery, and aggressive follow-up after surgery.


The reduced mortality for any cause of death is likely related to significant health improvements that follow gastric bypass surgery, such as reduced blood pressure, improved or resolved diabetes, and reduced sleep apnea, says Adams.


Women accounted for 84 percent of the patients involved in the study.


The average body mass index (BMI), which is calculated by dividing a person's weight in kilograms by the square of the person's height, for patients in the surgery group was 45.3, and 46.7 for the non-surgery group.]]> http://www.obesityhelpblog.com/index.php?entry=entry071019-181826 2007-10-20T00:00:00Z 2007-10-20T00:00:00Z
By BELINDA YU
Special to the Journal Sentinel
Posted: Sept. 16, 2007


Dana Brown lay on an operating table at Froedtert Hospital waiting for a surgeon to shrink her stomach from the size of a football to roughly the size of an egg.


At 239 pounds, she had battled type 2 diabetes for the last 10 years. Gastric bypass surgery, she believed, was her best chance of surviving the disease.


A normal body secretes the hormone insulin, used to burn glucose from food for energy. People with type 2 diabetes, however, don't produce enough insulin to properly digest sugar.


The accumulating sugar causes blood vessels to thicken, damaging the body's organs. Left untreated, diabetes can lead to serious health problems like high blood pressure, blindness and heart disease.


By the time of her surgery in December 2006, Brown's blood sugar levels were so high that she needed an insulin pump to deliver constant doses of the hormone.


As she heard the clinking and scraping of the surgical tools on its metal tray, her throat tightened. She said a prayer for herself and her family. Then she fell into a deep, drug-induced sleep.


Earlier that year, Brown, 35, of Milwaukee, had hoped to introduce a newborn daughter to her husband and young son. But Brown's health was rapidly deteriorating. Hormones produced during pregnancy caused her blood sugar levels to surge. She felt thirsty and hungry, and developed a lingering bone-deep fatigue.


A mother's diabetes is dangerous for a developing fetus. Diabetic women are more likely to have babies born with major birth defects and abnormally large birth weights.


Moreover, according to the American Diabetes Association, women with type 2 diabetes are more than twice as likely to have babies who die within a month of birth.


Two days before Brown was scheduled to deliver, she learned that the baby, whom she had named Amari Annette, had died. The doctors blamed diabetes. That day in March, Brown decided to go through with gastric bypass surgery.


Many people think of gastric bypass surgery as obesity surgery. Because the surgery profoundly limits the amount of food that can be consumed at one time, it helps many people lose weight.


A study from the University of Utah School of Medicine found that severely obese people who underwent gastric bypass surgery were 92% less likely to die from diabetes compared with a control group that did not undergo surgery after seven years.


Resolving diabetes The researchers followed up with 7,925 surgical patients and compared their outcomes with 7,925 people of similar age and body weight.


Overall, gastric bypass patients had a reduced mortality rate of 40%. The study was published last month in the New England Journal of Medicine.


But what surgeons like James Wallace, director of Froedtert Hospital and Medical College of Wisconsin's bariatric surgery program, have found is that the surgery also has a positive effect on type 2 diabetes.


An overwhelming majority of Wallace's patients with diabetes - 85% - experience an improvement in the condition after surgery. Many patients, post-surgery, are no longer considered diabetic.


Wallace said he tells his patients if they've had diabetes for less than 10 years, they have a 95% chance that it will resolve.


While Wallace believed the surgery would improve Brown's diabetes, he remained anxious about her operation.


Diabetics are prone to infections and organ damage; she could experience serious complications.


As Brown slept, Wallace carefully made five small incisions in her body into her abdomen.


He created a small, walnut-sized pouch and separated it from the rest of the stomach. Then he cut the intestines and attached it to the newly formed gastric pouch.


Many people have trouble losing weight, Wallace said, because the body defeats even the most well-intentioned dieter.


Everyone produces hormones that regulate hunger. When a person restricts food to lose weight, hunger signals spike. This is the body's way of protecting itself from starvation.


"You can resist . . . for a few days, weeks, months or even years. But eventually that signal will win," Wallace said.


A success


Two days after the operation, Brown no longer needed her daily insulin injections. Her blood sugar levels returned to normal in a matter of weeks. Her surgery was a success.


Gastric bypass helps improve diabetes because people with a gastric pouch can no longer consume vast quantities of carbohydrates and sugar without feeling sick, Wallace said. But it is possible to defeat gastric bypass surgery if someone were to eat continuously.


Brown's commitment to a healthy diet helped her lose 80 pounds and counting. She feels extraordinary. She walks an hour five days a week, and three days a week she does a half-hour aerobics workout.


It hasn't been easy. Instead of cheeseburgers, she opts for ham sandwiches. Instead of pancakes with sticky syrup, she eats toast. And she doesn't go anywhere near soda.


"I don't just believe it saved my life," Brown said. "I know it did."]]> http://www.obesityhelpblog.com/index.php?entry=entry071019-170322 2007-10-19T00:00:00Z 2007-10-19T00:00:00Z

The technique, involves the use of a device called StomaphyX, which has been approved by the US Food and Drug Administration. The device is inserted with an endoscope via the mouth into the stomach, where suction pulls the stomach walls against the device. Staple-like fasteners are then deployed to create pleats in the walls, effectively reducing the size of the stomach.


"The incisionless surgery helps to recreate the patient's smaller stomach, causing early satiety and further weight loss," Dr. Dean Mikami, a surgeon involved in the development of StomaphyX and the first to perform the operation in the US, said in a statement. "This is currently the only endoscopic or nonsurgical way to reduce the size of the stomach after gastric bypass surgery."


Since April, a total of 22 such gastric bypass revisions have been performed at OSU. On average, patients dropped 10 pounds after 1 month, 15 pounds after 2 months, and 20 pounds after 3 months.


According to Mikami, between 10 and 15 percent of patients who undergo gastric bypass surgery will require a revision 2 to 15 years later.


Good candidates for treatment with StomaphyX, Mikami said, include those who have regained some of their weight after gastric bypass surgery and are compliant with their diet, exercise regularly, and do not experience early satiety during meals.]]> http://www.obesityhelpblog.com/index.php?entry=entry071019-165513 2007-10-19T00:00:00Z 2007-10-19T00:00:00Z who had weight loss surgery two weeks ago, has new hope.


Gary and Cynthia Stocklaufer said when the child they consider their son, Max, was put into foster care in July they were denied a re-hearing. Which meant the case was basically closed.


But Wednesday, the couple learned they were granted a new hearing, and another chance to bring baby Max back home.


"Ecstatic. Speechless. I'm overly thankful that the judge has reconsidered," said Gary Stocklaufer.


It's been two and a half months since five-month-old Max was taken away from Gary and Cynthia Stocklaufer.


At the time, a commissioner denied the couple's adoption petition and a re-hearing even though Max is a blood relative given to the Stocklaufer's to adopt.


The Stocklaufer's court appointed guardian said the couple was denied adoption because there was concern that Gary might develop diabetes or sleep apnea because of his size.


When FOX 4 broke the Stocklaufer's story in late July the couple was bombarded with weight loss doctors from around the county offering help.


Gary, who weighed more than 500 pounds, dropped about 10 pants sizes after having gastric bi-pass surgery in Dallas two weeks ago.


"Since surgery, I've lost a considerable amount of weight and even before surgery I've lost weight. My physician in Dallas has stated by this time next year I'll be about 250 ..275," said Gary.


Gary's wife said the judge may have had a change of heart since Gary had the surgery.

"It definitely has shown that he is willing to do whatever it takes. There's no mountain they can put in front of him that he's not willing to climb," said Cynthia.


With the hearing set for November 29, the Stocklaufer's have new hope that Max will be returned home.


"My goal is to walk out of the courthouse with my son and let the media and everybody aware of what's happened and go on with our private life," said Gary.


The hearing is set for a week after Thanksgiving. The Stocklaufer's said they'll hold off on their Thanksgiving celebration until the judge allows Max to come home.


Monica Evans, FOX 4 News
]]> http://www.obesityhelpblog.com/index.php?entry=entry071019-165057 2007-10-19T00:00:00Z 2007-10-19T00:00:00Z FDA to approve gastric band for adolescents by 2009


By (BI) Sara Feldkamp

Story Created: Oct 1, 2007 at 12:14 PM EDT

Story Updated: Oct 18, 2007 at 11:44 AM EDT


WALTHAM, Mass. -- Millennium Research Group forecasts that the gastric band market, currently valued at over $190 million, will exceed $630 million by 2012.


The expected 2009 FDA approval of the LAP-BAND device for adolescents aged 14 to 18 will significantly expand the potential patient base into one of the most rapidly growing segments of the obese population, according to Millennium Research Group's US Markets for Laparoscopic Devices 2008 report.


The two surgical approaches to obesity, laparoscopic adjustable gastric banding (LAGB) -which uses devices such as Allergan's LAP-BAND-and gastric bypass surgery , primarily involve restricting food intake into the stomach, thereby limiting caloric intake.


A LAGB procedure involves the placement of an adjustable gastric band around the upper part of the stomach, while gastric bypass surgery changes the anatomy of the digestive system to limit the amount of food that can be eaten and digested.


Gastric bypass surgery may currently be performed on adolescents because it does not need FDA approval. Promoters of LAGB point to lower risk of life-threatening complications, adjustability, and reversibility which will encourage further penetration of LAGB procedures among adolescent patients.


"There has been an alarming growth in the number of obese adolescents in the US," says Barbara Prud'homme, Senior Analyst at MRG.


"The approval of the LAP-BAND for adolescents will provide an additional option to treat these younger patients. The FDA stamp of approval of the LAP-BAND will likely make LAGB performed at an increasing rate by doctors."
]]> http://www.obesityhelpblog.com/index.php?entry=entry071019-164522 2007-10-19T00:00:00Z 2007-10-19T00:00:00Z

Khaliah Ali, fashion designer, author and daughter of former heavyweight champion Muhammad Ali, experienced a life-changing "moment of truth" the year after her son was born. At 335 pounds, more than 100 pounds heavier than her father's best fighting weight, Ali feared her battle with weight would prevent her from seeing her son grow up. Like others who are more than 100 pounds overweight, this "moment of truth" drove Ali to recognize the severity of her fight with obesity and seek a solution.


Now more than 100 pounds lighter, Ali has teamed up with ObesityHelp, a leading resource for obese individuals, and Allergan, Inc., the makers of the LAP-BAND® Adjustable Gastric Banding System for the "Moment of Truth" obesity health education campaign. This campaign aims to help the millions of individuals who are more than 100 pounds overweight recognize the physical and emotional impact obesity has on their lives and motivate them to engage in discussions with their healthcare professionals about appropriate, safe and effective weight-loss solutions.


"It took me more than 30 years to reach my 'moment of truth' and realize the impact obesity had on my life both physically and emotionally. Until then, I was constantly fighting my weight, trapped in an endless cycle of diets and exercise, and humiliated by the misperception of others that I simply lacked will power," states Ali. "No matter how hard I tried, I was losing the fight against obesity and feeling a deep sense of shame and helplessness. I truly felt like a part of me was dying inside."


Ali is not alone in her fight, as obesity continues to be a growing national epidemic. In the United States, approximately 60 million adults are obese and 9 million are severely obese. This chronic disease is caused by any one or a combination of environmental (social and cultural), genetic, physiologic, metabolic, behavioral and psychological factors and in 2000 cost this country an estimated $117 billion in direct and indirect costs. Unfortunately, these costs are not expected to decrease anytime soon. A RAND study, recently published in Public Health, analyzed data collected between 1986 and 2005 in the United States from a household telephone survey. The results showed that the prevalence of individuals with a self-reported Body Mass Index (BMI) over 30 (classified as obese) increased by 24 percent between 2000 and 2005, but the prevalence of those with a self-reported BMI over 40 (classified as morbidly obese) increased by 50 percent. In addition, people who are significantly overweight or obese face serious health consequences, including increased risk for Type 2 diabetes, heart disease, stroke, high blood pressure, sleep apnea and premature death.


Like Ali, many individuals cycle through ineffective diets and despite consistent efforts to lose weight, many struggle for years or sometimes a lifetime with obesity. In 2004, tipping the scales at more than 270 pounds, Ali fought back with the help of the LAP-BAND® System procedure, the only FDA-approved adjustable gastric band for use in weight reduction for severely obese adults, and ended her battle with obesity.


"I now have the tool I need to win my fight against obesity and achieve sustained weight loss," states Ali. "By sharing my journey, it is my hope to help others reach their own 'moment of truth' and see the possibility of life without obesity."


While obesity is now recognized by leading government health authorities, such as the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH), as a disease, unfortunately, treating this disease remains a challenge. The NIH has reported that people in weight-loss programs lose only about 10 percent of their body weight and gain most of it back within five years. For people who are morbidly obese, or more than 100 pounds overweight, weight-loss surgery has become a clinically-accepted effective treatment option for long-term weight control. According to a report published by the Agency for Healthcare Research and Quality, data strongly supports surgical treatment as a superior option for weight loss and to help control co-morbidities associated with excess weight, like Type 2 diabetes and hypertension, in morbidly obese patients. "Obesity is the greatest national health issue facing this country; yet, there is a tremendous lack of knowledge among the obese and primary care physicians about safe and effective weight-loss options," said George Fielding, M.D., Associate Professor of Surgery at New York University School of Medicine and Ali's surgeon. "It's critical that those fighting the battle with obesity understand the fight is not hopeless and proactively speak with their doctor about a weight-loss treatment that will work for them. Obesity is a disease and needs to be identified as such by both the medical and patient communities." ]]> http://www.obesityhelpblog.com/index.php?entry=entry071019-163557 2007-10-19T00:00:00Z 2007-10-19T00:00:00Z

by Nanci Hellmich / USA Today
May 2, 2006


Adjustable gastric banding is much more effective long-term than a very low-calorie diet for people who are about 50 pounds overweight, a study shows.


Medical guidelines support this surgical procedure -- which puts a band around the top of stomach to create a feeling of fullness -- in patients who are extremely obese, about 100 or more pounds over a healthy weight, or those who are almost as overweight and have serious medical conditions, such as type 2 diabetes.


Researchers at Monash University Medical School in Melbourne, Australia, recruited 80 patients who were on average 52 pounds over a healthy weight. Half had the laparoscopic adjustable gastric band surgery.


The other half followed a medical program that included a variety of strategies such as a very-low-calorie diet (500 calories a day) with liquid meal replacements, prescription weight-loss medication and behavioral therapies.


Findings in today's Annals of Internal Medicine:
After six months, both the surgery patients and the low-calorie dieters lost an average of 14% of their starting weight.


After two years, the gastric band patients lost 22% of their starting weight. That was about 87% of their excess weight, or roughly 45 pounds. They also showed marked improvement in their health and quality of life.
At the end of two years, the dieters had regained much of their lost weight but were still 5.5% below their starting weight. They had lost 22% of their excess weight, or about 12 pounds.


Researchers are still analyzing the weight-loss data. "I'm very happy that the gastric band patients are continuing to maintain their weight loss," says lead author Paul O'Brien, director of the university's Centre for Obesity Research and Education. Since the study, he received grants from INAMED Health, maker of the LAP-BAND® System.


In this study, the surgery was as safe as the diet program, but O'Brien notes the procedure does carry risks, and some may need follow-up procedures, such as readjusting the band position. The surgery costs $14,000 to $18,000 in the USA, he says.


Insurance companies vary widely in coverage of gastric banding or gastric bypass, a more complex surgery that creates a much smaller stomach and rearranges the small intestine. Average cost: $26,000. Under certain conditions, Medicare covers both surgeries.


Many surgeons in the USA use gastric bypass because bypass patients lose more weight overall and lose it faster, says Neil Hutcher, president of the American Society for Bariatric Surgery and a surgeon in Richmond, Va.


Thomas Wadden, an obesity expert at the University of Pennsylvania School of Medicine in Philadelphia, says gastric banding "is a very effective procedure, but it's not a rational, cost-effective solution to the epidemic of obesity."


"Because we have limited health-care dollars, we have to decide how best to invest them. Are we going to provide bariatric surgery for a relatively small number of people or instead invest in the prevention of obesity so our children hopefully won't need this surgery?"


Copyright © 2006 USA Today. All rights reserved.]]> http://www.obesityhelpblog.com/index.php?entry=entry071019-163048 2007-10-19T00:00:00Z 2007-10-19T00:00:00Z


Department of Surgery, California Pacific Medical Center, San Francisco, CA, USA.


BACKGROUND: The vertical gastrectomy http://www.alighterme.com/surgery_vg.html (VG) is the restrictive part of the technically difficult biliopancreatic diversion with duodenal switch operation (DS). The VG was originally conceived of as an independent operation-the first stage of a two-stage DS that would reduce mortality and morbidity in the high-risk superobese because of a shorter operating time and no anastomoses. This article presents two-year data after VG. METHODS: Laparoscopic VG was performed in a nonrandomized fashion in obese patients that met the NIH criteria for bariatric surgery. By using 5-7 firings of 45-60-mm linear 3.5-mm GI staplers along a 32-Fr bougie, a greater-curvature gastrectomy is performed and a 60-80-ml gastric tube is created. VG was compared to adjustable Lap-Band placement, Roux-en-Y gastric bypass (RGB), and DS. RESULTS: Between November 2002 and August 2005, 216 patients underwent VG. The mean age was 44.7 years (range = 16-64) and 173 (80%) were female. The mean preoperative weight and body mass index (BMI) was 302 +/- 77 lbs and 49 +/- 11 kg/m2, respectively. Of the 216 patients, 5 (2.3%) had a BMI > 80 kg/m2, 6 (2.8%) had a BMI of 70-80 kg/m(2), and 25 (11.6%) had a BMI of 60-70 kg/m2. The mean operative time was 66 +/- 11 min (range = 45-180) and the mean length of hospital stay was 1.9 +/- 1.2 days. Complications occurred in 20 (6.3%) patients (vs. 7.1% after Lap-Band). Leaks occurred in 3 (1.4%) VG patients, reoperations were performed in 6 (2.8%), and no conversions to open or deaths occurred. Weight loss on par with the DS and RGB was achieved with just the VG alone. CONCLUSION: The VG operation is able to achieve significant weight loss comparable to the RGB and DS operations but with the low morbidity profile similar to that of Lap-Band placement.

]]> http://www.obesityhelpblog.com/index.php?entry=entry071017-191556 2007-10-18T00:00:00Z 2007-10-18T00:00:00Z