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The costs of obesity

A shocking report.  

"Obesity and excess weight is an expanding health problem for more than 60 percent of Americans, and a new study by Hugh Waters and Ross DeVol finds that it's a tremendous drain on the U.S. economy as well. The total cost to treat health conditions related to obesity—ranging from diabetes to Alzheimer's—plus obesity's drag on attendance and productivity at work exceeds $1.4 trillion annually. That's more than twice what the U.S. spends on national defense. The total, from 2014 data, was equivalent to 8.2 percent of U.S. GDP, and it exceeds the economies of all but three U.S. states and all but 10 countries. The report also highlights how this public health challenge can best be addressed."

Is obesity something that we should be tackling?  My gut (no pun intended) says OMG OF COURSE YES, because we are looking at some very preventable disesases.  Those are some cah-razy numbers.  However, does the pharmaceutical industry care?  I mean:  obesity is Big. Money. 

Read the report:

Weighing-Down-America-cover

http://assets1b.milkeninstitute.org/assets/Publication/ResearchReport/PDF/Weighing-Down-America-WEB.pdf


Smashing records, that's what we do.

This is totally a press release from the OAC because James writes them so fancy!

3-7-0.

Just wait until next year, guys.

-Beth

OBESITY ACTION COALITION’S 2ND ANNUAL YOUR WEIGHT MATTERS NATIONAL CONVENTION BREAKS ATTENDANCE RECORDS AND EDUCATES AND INVIGORATES MORE THAN 370 INDIVIDUALS SEEKING EVIDENCE-BASED WEIGHT MANAGEMENT STRATEGIES

Tampa, Fla. – More than 370 individuals from 32 states throughout the nation attended the Obesity Action Coalition’s 2nd Annual Your Weight Matters National Convention, Rise to the Challenge, in Phoenix earlier this month. Education, advocacy and support, the core principles of the OAC’s mission, were fully represented during this year’s Convention, tagged “YWM2013” across social media.

The hundreds in attendance were treated to three days of evidence-based information on a variety of topics, such as food addiction, weight bias, self-perception and many more. Led by thought-leaders in the healthcare field, each educational session was presented by one of 37 distinguished experts dedicated to helping individuals gain a better understanding of how their weight impacts their health. In addition to the world-class education, YWM2013 offered attendees a busy Exhibit Hall with 30 exhibitors all showcasing products and services geared toward those affected by excess weight and obesity.

“The education at this year’s Convention was truly unbelievable. As a speaker, I was able to see first-hand how this Convention changed lives. It brought individuals to a new level of awareness. It broke down topics that are often avoided; however, frequently questioned by those affected by the disease of obesity. What makes Convention so special is that it creates a safe and welcoming environment that is free from judgment. In doing so, it allows individuals to feel comfortable and absorb all that Convention has to offer. Being a part of YWM2013 was simply an amazing experience,” said Robert Kushner, MD, Convention Program Agenda Co-Chair.

The OAC is thankful for all those who volunteered their time in both planning YWM2013 and helping onsite. Countless hours were dedicated to ensuring all attendees received an experience like nothing else out there in the way of education and support.

“Last year’s Inaugural Convention in Dallas was amazing. Being in my home state of Texas, it felt surreal to see so many individuals all in one place wanting to learn more about their weight. I honestly thought it was going to be difficult to top the Inaugural Convention; however, YWM2013 did just that – and more. YWM2013 connected people, and when I say ‘connected,’ I am not just talking about attendee-to-attendee. It gave us, the OAC Board of Directors, staff and others, the opportunity to engage with the attendees, learn more about them and their needs, and most of all – help them rise to their own personal challenges,” said Lloyd Stegemann, MD, FASMBS, Convention Program Agenda Co-Chair.

The tremendous success of YWM2013 would not have been possible without the generous support of this year’s sponsors. The OAC would like to thank the 2013 National Sponsors for their generous support: Platinum – Eisai; Gold – Allergan and Vivus, Inc.; Silver – Covidien; Bronze – AmeriWell Bariatrics, Bari Life Bariatric Supplements, Bariatric Advantage, Celebrate Vitamins, Ethicon Endo-Surgery, and Geisinger.

The OAC is excited to announce that the 3rd Annual Your Weight Matters National Convention will take place in Orlando, Fla., at the Renaissance Orlando at Sea World, September 25-28, 2014. Information on next year’s Convention will be located at www.YWMConvention.com

The OAC is a National nonprofit charity dedicated to helping individuals affected by obesity. The OAC was formed to bring together individuals struggling with weight issues and provide educational resources and advocacy tools.


Lipozene - TO THE RESCUE! NO.

Lipozene sounds like a pharmaceutical drug doesn't it?

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8 weeks = 3.66 lbs weight loss in a study. "Wow."

LIPOZENE!  (What sounds like a...) HARDCORE FAT BURNER TO THE RESCUE!

It's NOT.

But, the commercials, websites and marketing might make you think so.

It is a fiber - glucomannan -

http://en.wikipedia.org/wiki/Lipozene

A health advisory was released by Health Canada stating the following: "natural health products containing the ingredient glucomannan in tablet, capsule or powder form, which are currently on the Canadian market, have a potential for harm if taken without at least 8 ounces of water or other fluid. The risk to Canadians includes choking and/or blockage of the throat, esophagus or intestine, according to international adverse reaction case reports. It is also important to note that these products should NOT be taken immediately before going to bed."[10] The health advisory was issued after authorization of some products containing glucomannan for the purposes of appetite reduction, weight management, treatment of constipation and management of high cholesterol levels

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"Lipozene is made from the Konjac root, most commonly known as >Glucomannan. This water-soluble fiber expands and acts as a dietary fiber gel in your stomach that helps you feel full, so you eat less and as a result, reach your weight loss goals quicker.

 This water-soluble fiber has been cultivated as a weight loss aid in Japan for generations. In fact, there are even studies that connect its main ingredient Glucomannan with alleviating constipation, reducing cholesterol and regulating blood sugar.

 Lipozene is natural and does not contain any stimulants. There are no known harmful side effects when used as directed.

 Lipozene is not a pharmaceutical drug and is available without a prescription.

You should not be taking this "dietary fiber gel" that "expands" inside your stomach if you have had bariatric surgery.

Stop it and talk to your physician.

 


Cleveland Clinic study shows RNY bariatric surgery restores pancreatic function by targeting belly fat

Just to keep you on your toes, a couple days ago I shared the study that stated that WLS doesn't save you money in the long run.

Now, we hear once AGAIN that roux en y gastric bypass bariatric surgery fixes diabetes damn near immediately. This is just another study on THAT topic.

We already knew this.

Thanks, pancreas!  *thumbs up for working so well!*

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*Waves to all the post bariatric reactive non-diabetic hypoglycemics*

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Cleveland Clinic study shows bariatric surgery restores pancreatic function by targeting belly fat

2-year study indicates how gastric bypass reverses diabetes. In a substudy of the STAMPEDE trial (Surgical Therapy And Medications Potentially Eradicate Diabetes Efficiently), Cleveland Clinic researchers have found that gastric bypass surgery reverses diabetes by uniquely restoring pancreatic function in moderately obese patients with uncontrolled type 2 diabetes.

Continue reading "Cleveland Clinic study shows RNY bariatric surgery restores pancreatic function by targeting belly fat" »


No long-term cost savings with weight loss surgery

Weight loss surgery does not lower health costs over the long run for people who are obese, according to a new study.   Shocking?  Meh.  No.

Pre-op patients don't want to know this sticky business, so maybe you should close your eyes or click away.  NOW.  I don't want to pop your bubbles.  I am not in the biz of selling weight loss surgery up in heah.

I don't think it would come as a surprise to many long-term post bariatric patients.  I know you understand.  We live it.

But that is just me, consider my stance as a nine year gastric bypass post op, married to a nine year gastric bypass post op, with a mother in law and sister in law who are both gastric bypass post ops.  Collectively we have about 30 years of missed "obesity" costs, but we have increased our health-care costs in other areas.  (*Looks at my current tally at the hospital.*)

Tumblr_lwj43hxcbD1ql141xo1_400The four of US (yes, this is totally biased because it is my immediate circle and what I know...this is understood, I am not arguing, I do not care to sell WLS nor unsell it!) are currently all maintaining a normal or slightly overweight body weight 6-9 years post bariatric surgery, however between us, we have created some seriously HUGE bills and other health conditions since having weight loss surgery.  (I have not shared much of it because I'm already TMI and HIPPA cries.)

Imagine now if any of us have a full and complete regain - which is a totally and absolutely typical pattern.  What then of our health?  What if we have the comorbids of obesity come back?  (Some of which don't always go away.... have you met my legs?)  Just saying.  I know we have made it this far, but it has NOT been cheap.

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Reuters -

Some researchers had suggested that the initial costs of surgery may pay off down the road, when people who've dropped the extra weight need fewer medications and less care in general.

The new report joins other recent studies challenging that theory (see Reuters Health story of Jul 16, 2012 here: reut.rs/NrQKPU).

"No way does this study say you shouldn't do bariatric surgery," said Jonathan Weiner from the Johns Hopkins Bloomberg School of Public Health in Baltimore, who led the new research.

But, he added, "We need to view this as the serious, expensive surgery that it is, that for some people can almost save their lives, but for others is a more complex decision."

According to the American Society for Metabolic and Bariatric Surgery, about 200,000 people have weight loss surgery every year.

Surgery is typically recommended for people with a body mass index (BMI) - a measure of weight in relation to height - of at least 40, or at least 35 if they also have co-occurring health problems such as diabetes or severe sleep apnea.

A five-foot, eight-inch person weighing 263 pounds has a BMI of 40, for example.

For their study, Weiner and his colleagues tracked health insurance claims for almost 30,000 people who underwent weight loss surgery between 2002 and 2008. They compared those with claims from an equal number of obese people who had a similar set of health problems but didn't get surgery.

As expected, the surgery group had a higher up-front cost of care, with the average procedure running about $29,500.

In each of the six years after that, health care costs were either the same among people who had or hadn't had surgery or slightly higher in the bariatric surgery group, according to findings published Wednesday in JAMA Surgery.

Average annual claims ranged between $8,700 and $9,900 per patient.

Weiner's team did see a drop in medication costs for surgery patients in the years following their procedures. But those people also received more inpatient care during that span - cancelling out any financial benefits tied to weight loss surgery.

One limitation of the study was that only a small proportion of the patients - less than seven percent - were tracked for a full six years. Others had their procedures more recently.

The study was partially funded by surgical product manufacturers and pharmaceutical companies, including Johnson & Johnson and Pfizer. Claims data came from BlueCross BlueShield.

It's clear that surgery can help people lose weight and sometimes even cures diabetes, Weiner told Reuters Health. But it might not be worthwhile, or cost-effective, for everyone who is obese.

That means policymakers and companies will have to decide who should get insurance coverage for the procedure and who shouldn't.

"It's showing that bariatric surgery is not reducing overall health care costs, in at least a three- to six-year time frame," said Matthew Maciejewski, who has studied that topic at the Center for Health Services Research in Primary Care at the Durham VA Medical Center in North Carolina, but wasn't involved in the new study.

"What is unknown is whether there's some subgroup of patients who seem to have cost reductions," he told Reuters Health.

In the meantime, whether or not to have weight loss surgery is still a personal decision for people who are very obese, Weiner said.

"Every patient needs to talk it through with their doctor," he said. "It obviously shouldn't be taken lightly, but shouldn't be avoided either."

SOURCE: bit.ly/K8qAyI JAMA Surgery, online February 20, 2013.

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Importance  Bariatric surgery is a well-documented treatment for obesity, but there are uncertainties about the degree to which such surgery is associated with health care cost reductions that are sustained over time.

Objective  To provide a comprehensive, multiyear analysis of health care costs by type of procedure within a large cohort of privately insured persons who underwent bariatric surgery compared with a matched nonsurgical cohort.

Design  Longitudinal analysis of 2002-2008 claims data comparing a bariatric surgery cohort with a matched nonsurgical cohort.

Setting  Seven BlueCross BlueShield health insurance plans with a total enrollment of more than 18 million persons.

Participants  A total of 29 820 plan members who underwent bariatric surgery between January 1, 2002, and December 31, 2008, and a 1:1 matched comparison group of persons not undergoing surgery but with diagnoses closely associated with obesity.

Main Outcome Measures  Standardized costs (overall and by type of care) and adjusted ratios of the surgical group's costs relative to those of the comparison group.

Results  Total costs were greater in the bariatric surgery group during the second and third years following surgery but were similar in the later years. However, the bariatric group's prescription and office visit costs were lower and their inpatient costs were higher. Those undergoing laparoscopic surgery had lower costs in the first few years after surgery, but these differences did not persist.

Conclusions and Relevance  Bariatric surgery does not reduce overall health care costs in the long term. Also, there is no evidence that any one type of surgery is more likely to reduce long-term health care costs. To assess the value of bariatric surgery, future studies should focus on the potential benefit of improved health and well-being of persons undergoing the procedure rather than on cost savings.

 


The FDA's Assessment of Two Drugs for Chronic Weight Management — NEJM

The FDA's Assessment of Two Drugs for Chronic Weight Management — NEJM.

 

Nejm_colmanp_10-25-2012

 

  • Listen to the podcast above - it's amazingly interesting
  • Qsymia is a combination of phentermine, a sympathomimetic amine anorectic, and topiramate extended-release, an antiepileptic drug, indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:   30 kg/m2 or greater (obese) (1) or 27 kg/m2 or greater (overweight) in the presence of at least one weight-related comorbidity such as hypertension, type 2 diabetes mellitus, or dyslipidemia  

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You should always consult with your physician before introducing any changes to your diet or level of physical activity.

Indication

Qsymia is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of:

  • 30 kg/m2 or greater (obese) or
  • 27 kg/m2 or greater (overweight) in the presence of at least one weight-related medical condition such as high blood pressure, type 2 diabetes, or high cholesterol

 NEJM - http://www.nejm.org/doi/full/10.1056/NEJMp1211277?query=featured_home