Carnie Wilson Speaks At WLSFA 2013 Las Vegas Luncheon
Regain after weight loss surgery is also a very touchy subject. Countless bariatric patients go through it -- and less want to talk about it. But it seems like everyone wants to sell "us" something to fix it.
Let me repeat -
Yet it seems like the larger community wants "us" (the regainers) to feel shamed for regaining and wants to sell us another quick-fix.
Let us discuss: Regain is common. How much? Some is very typical. Sometimes even a lot of regain is normal. You do not have to be sold into another diet, quick-fix, or scam. You need to remind yourself why you had weight loss surgery to begin with --
...for your HEALTH.
Some good links on regain -
Wait up OH.
I thought we did the tenth a few years ago? Talk to me.
Irvine, CA. (March 23, 2013) – Obesity Help -
ObesityHelp is excited to announce the 10th Annual ObesityHelp National Conference at the Crowne Plaza in Anaheim, California on October 4th and 5th, 2013. The ObesityHelp National Conference is a celebration of health and wellness for those navigating their weight loss surgery journey. You’ll walk away inspired, motivated and with a larger support system than you started with. You will be part of change, gain knowledge from experienced professionals, and witness (or have your own) non-scale victories right at the conference.
The Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient has been updated for the first time since 2008. There are changes and updates and suggestions for your clinicians - the entire text is available online below -
Download here -
Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient - 2013 Update -
Abstract: The development of these updated guidelines was commissioned by the AACE, TOS, and ASMBS Board of Directors and adheres to the AACE 2010 protocol for standardized production of
clinical practice guidelines (CPG). Each recommendation was re-evaluated and updated based on the
evidence and subjective factors per protocol.
Examples of expanded topics in this update include: the roles of sleeve gastrectomy, bariatric surgery in patients with type-2 diabetes, bariatric surgery forpatients with mild obesity, copper deficiency, informed consent, and behavioral issues.
A lifetime history of substance abuse disorder is more likely in bariatric surgery candidates compared with the general population (211 [EL 3, SS]). In contrast, current alcohol and substance abuse in bariatric surgery candidates is low compared with the general population (211 [EL 3, SS]). The LABS study demonstrated that certain groups including those with regular preoperative alcohol consumption, alcohol use disorder, recreational drug use, smokers, and those undergoing RYGB had a higher risk of postoperative alcohol use disorder (212 [EL 2, PCS]). A web-based questionnaire study indicated that 83% of respondents continued to consume alcohol after RYGB, with 28.4% indicating a problem controlling alcohol (213 [EL 3, SS]). In a prospective study with 13- to 15-year follow-up after RYGB, there was an increase in alcohol abuse (2.6% presurgery to 5.1% postsurgery) but a decrease in alcohol dependence (10.3% presurgery versus 2.6% postsurgery) (214 [EL 2, PCS]). In a survey 6-10 years after RYGB, 7.1% of patients had alcohol abuse or dependence before surgery, which was unchanged postoperatively, whereas 2.9% admitted to alcohol dependence after surgery but not before surgery (215 [EL 3, SS]). Finally, in a retrospective review of a large electronic database, 2%-6% of bariatric surgery admissions were positive for a substance abuse history (216 [EL 3, SS]). Interestingly, 2 studies have demonstrated better weight loss outcomes among patients with a past substance abuse history compared with those without past alcohol abuse.Bariatric surgery remains a safe and effective intervention for select patients with obesity. A team approach to perioperative care is mandatory with special attention to nutritional and metabolic issues.
Obesity continues to be a major public health problem in the United States, with more than one third of adults considered obese in 2009- 2010, as defined by a body mass index (BMI) 30 kg/m2 (1 [EL 3,
SS]). Obesity has been associated with an increased hazard ratio for all-cause mortality (2 [EL 3, SS]), as well as significant medical and psychological co-morbidity. Indeed, obesity is not only a chronic
medical condition but should be regarded as a bona fide disease state (3 [EL 4, NE]). Nonsurgical management can effectively induce 5%-10% weight loss and improve health in severely obese
individuals (4 [EL 1, RCT]) resulting in cardiometabolic benefit. Bariatric surgery procedures are indicated for patients with clinically severe obesity. Currently, these procedures are the most successful and durable treatment for obesity. Furthermore, although overall obesity rates and bariatric surgery procedures have plateaued in the United States, rates of severe obesity are still increasing and now
there are approximately 15 million people in the United States with a BMI 40 kg/m2 (1 [EL 3, SS]; 5 [EL 3, SS]). Only 1% of the clinically eligible population receives surgical treatment for obesity
(6 [EL 3, SS]). Given the potentially increased need for bariatric surgery as a treatment for obesity, it is apparent that clinical practice guidelines (CPG) on the subject keep pace and are kept current.
Since the 2008 TOS/ASMBS/AACE CPG for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient (7 [EL 4; CPG]), significant data have emerged regarding a broader range of available surgeries for the treatment of obesity. A PubMed computerized literature search (performed on December 15, 2012) using the search term ‘‘bariatric surgery’’ reveals a total of 14,287 publications with approximately 6800 citations from 2008 to 2012. Updated CPG are therefore needed to guide clinicians in the care of the bariatric surgery patient.
What are the salient advances in bariatric surgery since 2008?
Download here - via -
Jeffrey I. Mechanick, Adrienne Youdim, Daniel B. Jones, W. Timothy Garvey, Daniel L. Hurley, M. Molly McMahon, Leslie J. Heinberg, Robert Kushner, Ted D. Adams, Scott Shikora, John B. Dixon and Stacy Brethauer
Article first published online: 26 MAR 2013 | DOI: 10.1002/oby.20461
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.*)
The 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.
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.
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.
Search my blog -
Get an appointment within days, not weeks, at the nationally recognized bariatric surgery program at Einstein
© 2013 Bariatric Bad Girls Club, BBGC, Melting Mama ® Pouchworthy WLS, Inc.
<div align="center"><a href="http://www.meltingmama.net" title="melting mama"><img src="http://i268.photobucket.com/albums/jj32/meltingmama/MeltingMama-125.gif" alt="melting mama" style="border:none;" /></a></div>
Recent Comments