Weight Loss Surgery News Blog

Link: http://www.robertorizzi.com

A person 180 pounds over a healthy weight is susceptible to arthritis, has increased blood pressure, a weakened heart and could soon need a walker just to get around. Fat can be disabling.

Under the Americans with Disabilities Act, such a person could legally be labeled as disabled.

But should obesity be considered a disability? Recently the American Medical Association voted a resounding no at its annual meeting.

But in the USA where nearly one in three people is obese, laws do not always cover size discrimination, and many health insurance policies do not cover obesity treatments until a patient develops a more serious health condition.

Doctors are worried they could be legally reprimanded for discussing obesity with a patient who doesn't want to hear it. If obesity is designated as a disability, physicians could be sued or reprimanded for discrimination under the Americans with Disability Act if a patient takes offense at the physician discussing obesity.

Link: http://www.robertorizzi.com

During the 1980s, cardiovascular mortality rates observed in Brazilian metropolitan areas were ranked among the highest in a comparison with certain selected countries.1 However, since then, these Brazilian rates have been decreasing with a peculiar pattern. During the 1990s, mortality rates from stroke followed a downwards trend, but mortality rates from coronary heart diseases (CHD) are now reaching a plateau without any evidence of a fall.

On the other hand, three national cross-sectional studies performed in 1973-74, 1988 and 1996 showed an alarming and impressive increase in the prevalence of obesity, especially among city-dwellers.2 Over this period, the prevalence of obesity (body mass index greater than or equal to 30 kg/m2) increased from 2.4% (1973-74) to 6.9% (1996) among men, and from 7.0% (1973-74) to 12.5% among women.

Recently, one observational study has detected that the decline in CHD mortality deaths in the USA has been slower among patients with diabetes than among those without it. Other data from a cohort of American nurses has shown that the increase in body mass index explained an 8% increase in the incidence of CHD events.

It is reasonable to speculate that the slowdown in the decline of CHD deaths in Brazil has been due to an increasing prevalence of both obesity and diabetes. Considering this fact, the epidemic of obesity must be halted, or else there will very probably be a new peak of coronary deaths in Brazil, in spite of the improvements regarding smoking restrictions and hypertension awareness and control that have been observed over the last few years.

Paulo Andrade Lotufo, MD, DrPh. Editor, São Paulo Medical Journal, Director, General Internal Unit, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil.

Link: http://www.robertorizzi.com

People who have obesity operations, such as gastric bypasses or banding, double their risk of suffering fractures, US research suggests. They found a fifth of patients suffered fractures - twice the rate typical for their age - with most breaks occurring in the bones of the hands and feet.

Previous studies have shown that bariatric surgery results in an increased bone turnover, the rate of bone breakdown and bone formation. Suspicion that this could cause an increased risk of fractures prompted researchers at the Mayo Clinic in Rochester, Minnesota to begin analyzing available medical records of the 292 patients who underwent bariatric surgery at their facility between 1985 and 2004. The majority, 90 percent, of the patients had gastric bypass surgery, while the other patients had either gastric band surgery or biliopancreatic diversion.

After reviewing 97 cases (86 women; average age of 44), the researchers found that within an average of seven years following surgery, there were 31 fractures reported in 21 patients. When compared to individuals of the same age and sex in the general population, those having bariatric surgery were 1.8 times more likely to have a first fracture at any site of the body. Fractures were reported in the upper arms, hip, and spine, but fractures at the hand and foot were the most elevated, with an increase of more than three times and almost four times, respectively, greater than average.

The findings have been presented at the Endocrine Society Annual Meeting.

Link: http://www.time.com/time/world/article/0,8599,1890260,00.html?iid=digg_share

With thousands of miles of sun-kissed coastline, Brazil is a beach nation, one where people like nothing better than to spend weekends and holidays with a cold one on the sand. But the chances of spotting suntanned beauties in tiny bikinis are getting smaller and smaller, according to a government study released this week. Research shows that the number of Brazilians suffering from obesity is growing. And the trend toward the fuller figure is most prevalent among women. Obesity among women had stabilized in previous studies, and now there is an expressive increase.

Some 13% of Brazilian adults are obese — 12.4% of men and 13.6% of women — according to the study, which was carried out last year among 54,000 people for Brazil's Health Ministry. Meanwhile, almost half (47.3%) of adult males and 39.5% of females are considered overweight. Those figures are still low compared with industrialized nations like the U.S., where more than a third of all adults are considered obese (a condition defined by the ratio of weight to height). But Malta says the trend is clear and that Brazil is slowly on the same path. In 1975, similar studies showed that only 2.8% of men and 7.8% of women were obese; just seven years ago, the numbers were 8.8% and 12.7%.

The study, carried out for World Health Day (April 8), covered many health-related topics and offered some contradictory figures as well. Although Brazilians are getting fatter, they are eating less red meat and more fruits and vegetables. They are smoking less and taking more preventive tests such as mammograms and pap smears. But they are using less sunscreen and drinking more, especially to excess and often when driving.

Nevertheless, in body-conscious Brazil, the nation of plastic surgery and minuscule bikinis, it was the obesity figures that caused the most anxiety. Any suggestion that the girl from Ipanema is not necessarily tall and tan and young and lovely, but could possibly be short and pale and fat and ugly, can cause a scandal here. When the New York Times reported in 2005 that Brazilians were getting fatter, the correspondent came under attack in the media as a gay, Brazilian-hating heretic.

Already one-quarter of hospital beds are taken up by people suffering from weight-related ailments such as heart attacks, back surgeries and hip and joint replacements The number of stomach-reduction surgeries carried out in Brazil had risen 500%.

Link: http://www.endocrinetoday.com

Ten studies spanning several obesity-related issues were issued in an effort to educate medical professionals about the current obesity research. This report was published in the Journal of Clinical Endocrinology & Metabolism.

These articles define the state-of-the-art obesity research at present:

1. findings showed the prevalence of obesity increased in Brazil, Canada, Mexico and the United States. The increase in the presence of obesity may create challenges for public health and medical systems in those countries.

2. evaluated the relationship between metabolic complications and childhood obesity. Many children and adolescents exhibited metabolic complications, putting them at risk for early morbidity

3. determined there is a need to conduct large, community intervention programs focusing on exercise and a healthy diet in developing countries to prevent death-related type 2 diabetes and cardiovascular disease.

4. high hereditability of adiposity remains unexplained, although advances have helped to explain underlying genetic mechanisms of obesity

5. study’s results showed that in obesity, inflamed fat-secreted proteins were associated with insulin signaling impairment

6.in a study of obesity-associated liver disease, a review of literature demonstrated the most prevalent liver disease in Western countries was of metabolic origin

7. researchers examined literature from PubMed and The Handbook of Obesity 2008 in another study. The data demonstrated surgery was the most robust method for losing weight

8. researchers examined the results of studies of operations including adjustable gastric banding, gastric bypass and biliopancreatic bypass with duodenal switch

9. also evaluated abandoned and current procedures, complications and patient selection. Bariatric surgery should be the therapy of choice until better approaches become available

10. a review of literature in which findings showed that understanding the central regulation of food intake may help with finding useful treatment options