Weight Loss Surgery News Blog

Pregnancy after gastric bypass surgery appears to involve no more risk than might be expected from morbid obesity.

A study concluded that obstetric and neonatal outcomes were similar in gastric bypass patients and matched controls who had not undergone the procedure.

The comparison showed no differences in preterm labor, preterm delivery, gestational diabetes, induced labor, or Caesarean delivery. Similarly, neonatal outcomes did not differ in birth weight, Apgar score, NICU admission, or congenital anomalies.

Interest in pregnancy outcomes after bariatric surgery grew from recognition that about half of the 200,000 procedures performed each year involve reproductive-age women. The medical literature contained little information on bariatric surgery and pregnancy.

Primary source: American Journal of Obstetrics & Gynecology

Link: http://www.robertorizzi.com

Genetics and heritage may account for 77 per cent of obesity, while environmental factors make up less that 25 per cent, suggests new research.

The study, by University College London researchers, followed 5,092 pairs of twins and highlights the complexity of the obesity issue.

Evidence for a strong genetic influence on childhood adiposity despite despite the force of the obseogenic environment is concluded in the report

A lot of focus has been placed on the food industry to improve their products, provide clear labeling and reduce advertising to children.

Twin studies are a good way for determining genetic and environmental influences of health and behavior as monozygotic twins (identical genes) can be compared with dizygotic twins (non-identical, sharing half the genes).

The researchers analyzed the Body Mass Index (BMI) in a UK sample of 5,092 twin pairs aged eight to 11 years, born between 1994 and 1996.

The results showed that the monozygotic correlations were similar in boys and girls, and greatly exceeded those of the dizygotic twins, suggesting a strong genetic influence.

Researchers concluded therefore that adiposity heritability amounts to 77 per cent for BMI. Shared environment effects were 10, and non-shared environment effects were 13 per cent.

Obesity is clearly a multifaceted issue, with many contributing factors, and requires a combination of solutions.

With approximately 1.6 billion adults overweight worldwide and 400m obese, according to the World Health Organization, the study shows the importance of providing nutritional food, to counterbalance the effect of genetics and help those who are more susceptible to obesity.

Source: American Journal of Clinical Nutrition
February 2008, Volume 87, No. 2, Pages 398-404

Interesting report from the Netherlands! Obese people will have lower lifetime Health Cost then the health and fit people because the healthy ones live longer!

The research paper suggests that preventing obesity might result in increased public spending on medical care.

Many countries are currently developing policies aimed at reducing obesity in the population.

However, it is not currently clear whether successfully reducing obesity will also reduce national healthcare spending or not. Pieter van Baal and colleagues, from the National Institute for Public Health and the Environment in the Netherlands, created a mathematical model to try to answer this question.

In their study, van Baal and his co-workers created three hypothetical populations of 1000 men and women, all aged 20 years at the start:

1. a group of obese, never-smoking individuals;

2. a group of healthy-never smoking individuals of normal weight;

3. a group of smokers of normal weight.

The model produced an estimate of the likely proportion of each group who would encounter certain long term (chronic) diseases, and then estimated what the approximate cost of medical care associated with each disease was likely to be.

The researchers found that the group of healthy, never-smoking individuals had the highest lifetime healthcare costs, because they lived the longest and developed diseases associated with aging; healthcare costs were lowest for the smokers, and intermediate for the group of obese never-smokers.

Link: http://www.francoerizzi.com.br/cirurgia-diabetes.htm

Weight-loss surgery works much better than standard medical therapy as a treatment for type 2 diabetes in obese people, the first study to compare the two approaches has found.

The study of 60 patients showed that 73 percent of those who had surgery had complete remissions of diabetes, meaning all signs of the disease went away. By contrast, the remission rate was only 13 percent in those given conventional treatment, which included intensive counseling on diet and exercise for weight loss, and, when needed, diabetes medicines like insulin, metformin and other drugs.

In the study, the surgery worked better because patients who had it lost much more weight than did the medically treated group — 20.7 percent vs. 1.7 percent of their body weight, on average. Type 2 diabetes is usually brought on by obesity, and patients can often lessen the severity of the disease or even get rid of it entirely by losing about 10 percent of their body weight. Though many people can lose that much weight, few can keep it off without surgery. (Type 1 diabetes, a much less common form of the disease, involves the immune system and is not linked to obesity.)

But the new results probably do not apply to all patients with type 2 diabetes, because the people in the study had fairly mild cases with a recent onset; all had received the diagnosis within the previous two years. In people who have more severe and longstanding diabetes, the disease may no longer be reversible, no matter how much weight is lost.

The operation used in the study, adjustable gastric banding, is performed through small slits and loops a band around the top of the stomach to cinch it into a small pouch so that people eat less and yet feel full. Other weight-loss operations are more extreme and involve cutting or stapling the stomach and rearranging the small intestine. Of the 205,000 weight-loss operations performed in the United States last year, 25 percent to 30 percent used the gastric banding.

Remission of type 2 diabetes after weight-loss surgery is not a new finding; doctors have known about it for years. But the new research is the first attempt to find out scientifically how the surgery measures up against medical treatment in similar groups of patients with the disease.

The study reflects a growing interest among researchers in the idea of using surgery specifically to treat type 2 diabetes, even in people who are not as obese as those who typically undergo operations to lose weight. The new interest is in some sense a measure of desperation, as the United States and the world face ever-increasing rates of the disease and its devastating complications, which can include heart attacks, blindness, kidney failure and amputations. To many doctors, the time is ripe for studying surgery as a potential cure for diabetes, and also as a means of understanding the disease better and developing better drugs to treat it.

Medical societies in the United States and abroad that once called their specialty “bariatric” surgery, a term that refers to weight loss, have started adding the word “metabolic” to their titles to emphasize the new focus on diabetes.

“I think diabetes surgery will become common within the next few years,” said Dr. John Dixon, the lead author of the study and an obesity researcher at Monash University in Melbourne, Australia, where the research was conducted.

The study and an editorial about it are being published in The Journal of the American Medical Association.

By DENISE GRADY
Published: January 22, 2008
Source

Link: http://www.robertorizzi.com/obesity-surgery-package.htm

Bariatric surgery is highly effective for controlling obesity and its complications. Roux-en-Y Gastric Bypass is the most performed bariatric surgical procedure. It is often not covered in the insurance policy because of high cost and unpredictable expenses.

A study is to evaluate the predictability and reproducibility of the estimated expenses in 150 consecutive patients who underwent LRYGBP was published in a recent Obesity Surgery journal. It confirms the experiences of Franco e Rizzi.

France e Rizzi offer a fixed package which included hospitalization, operative room expenses, medications, multidisciplinary support, and professional cost was established based on experience and is close to the results of the study published.

In the published study the average age of the patients was 38.5 with an average BMI (Body Mass Index) of 43.5. The mean number of co-morbidities per patient was 1.7.

The average hospital stay was 3 days. Complications occurred in 13 patients (just under 10%).

The conclusion of the report was that the costs of a gastric bypass can be accurately predicted and are highly reproducible when surgeries are performed by an experienced team and potentially lethal complications do not occur.