Clinical trial demonstrates additive effect of exercise following gastric bypass.
So. do. it. I know, I know, easier said than done.
Over 75 million adults in the US are obese. These individuals are predisposed to health complications, including diabetes, heart disease, and cancer. Gastric bypass surgery results in dramatic weight loss and can improve diabetes symptoms in obese patients. A new study in the Journal of Clinical Investigation reveals that exercise following bypass surgery provides additional benefit for obese patients. Bret Goodpaster and colleagues at the University of Pittsburgh conducted a study on individuals that had recently undergone gastric bypass surgery. One group followed a moderate exercise protocol for 6 months, while the control group underwent a health education program. Individuals in both groups exhibited dramatic weight loss and reduced fat mass. However, individuals in the exercise group had improved insulin sensitivity and cardiovascular fitness. The results of this study support the inclusion of an exercise program following gastric bypass surgery.
Apollo Endosurgery, Inc., the leader in minimally invasive endoscopic surgical products for bariatric and gastrointestinal procedures, today announced the launch of the “It Fits” campaign, aimed at rejuvenating the LAP-BAND® System and educating a broad range of patients about the benefits of the minimally-invasive weight loss procedure.
“It Fits” supports the company’s decision to place greater emphasis on the unique advantage of the LAP-BAND® System – the only FDA approved device for weight reduction for people with at least one weight-related health problem, and having a BMI of 30 or greater.
The new ad spot - from Apollo - tugs right there at your heart, don't it? I might be tearing up over all of the completely stereotypical situations right here in this here commercial! OMG I CAN FIT IN THE AEROPLANE SEATBELT WITHOUT AN EXTENDER COULD YOU PLEASE PUT ME IN A COMMERCIAL ALTHOUGH I WAS NEVER SUPER MORBIDLY OBESE I AM JUST AN ACTOR!
Until this and my tears dry up!
Because of course we will ignore the patient histories of thousands -- to have a procedure to lose how much weight?
Just as a frame of reference, that makes me qualify in a few BMI points. Confession: when I reached my high weight about the same time the new BMI-qualifications for the Allergan-owned lap-band came around, I decided THAT WAS IT. I could not possibly do it again, my butt was not revising band-over-bypass for that much weight, not after watching this weight loss community for 12 years. Nope.
I am easily distracted online by quizzes, gadgets, tools, and "Who Will You Be When You Grow Up?" (Which said TEACHER, BTW, ME, The Kid Who Failed Half Her High School Classes...) quizzes, which is when I saw this - Online Tool Designed to Help Patients Evaluate Potential Bariatric Surgery Outcomes - thingamajig - I did it myself even though I am already ten years and two months post gastric bypass.
A new tool nveiled at the annual meeting of the American Society for Metabolic and Bariatric Surgery may help patients with a body mass index over 30 -- the threshold at which obesity is diagnosed -- to navigate those complexities. Based on the accumulated experiences of 75,000 bariatric surgery patients, the Bariatric Surgery Comparison Tool details the expected outcomes of gastric banding surgery, gastric bypass surgery and sleeve gastrectomy, the three most common bariatric procedures.
I did it myself, based on my start weight - height - though I have lost an inch of height. (Shut up.)
Start weight - 320, start height 5 ft 4. I am close to 5 ft 3 now.
The 24 month data is EXACTLY right! I am ten years post op and 149 - 158 lbs!
I guess what I am saying is -- that the data for this "tool" -- (and you know I loathe that word) is there, it is right on the money.
Some goobledegook from Ethicon -
The tool (officially named the Ethicon Bariatric Surgery Comparison Tool) pools data from more than 75,000 U.S. people who have had bariatric surgery, and based on personally provided, anonymous information, shows what people of similar demographics have experienced after undergoing bariatric surgery. The tool shows data for gastric bypass, sleeve, and adjustable gastric band surgeries.
o Ethicon understands that no two patients are identical. For example, when considering bariatric surgery, obesity related conditions like diabetes, hypertension and cholesterol need to be taken into consideration – this tool helps do just that.
o Based on patients who have had similar conditions to theirs, prospective patients using the tool are able to see what surgical outcome looked like for patients just like them and can use this as a discussion point with their doctor about which treatment option might be most appropriate for them (i.e., gastric bypass, gastric sleeve or gastric band).
Some things you should know about bariatric surgery and the tool
Bariatric surgery is used in severely obese adult patients for significant long-term weight loss. It may not be right for individuals with certain digestive tract conditions. All surgery presents risks. Weight, age, and medical history determine your specific risks. Individuals should ask their doctor if bariatric surgery is right for them.
The tool is provided for educational purposes only and is not intended to be a medical evaluation, examination, consultation, diagnosis or treatment. The tool provides potential results by procedure type including pounds lost and medication reduction over time based on personal information provided by the user of the tool. Patients should consult a physician or other health care provider to determine whether or not bariatric surgery is right for them and for guidance on expected outcomes benefits and risks.
The weight loss, medication, and diagnosis information provided by the tool is derived from statistical analysis of historical claims and clinical databases as well as research published in peer-reviewed journals. While predictive modeling techniques were used, the results cannot predict the specific outcomes for any individual. The information presented does not represent any statement, promise or guarantee by Ethicon Inc. concerning a patient’s eligibility, experience, or potential outcomes. Individual patient results may vary.
I had gastric bypass in 4/2004 in Boston, MA with Dr. Michael Tarnoff
Importance The prevalence of obesity and outcomes of bariatric surgery are well established. However, analyses of the surgery impact have not been updated and comprehensively investigated since 2003.
Objective To examine the effectiveness and risks of bariatric surgery using up-to-date, comprehensive data and appropriate meta-analytic techniques.
Results A total of 164 studies were included (37 randomized clinical trials and 127 observational studies). Analyses included 161 756 patients with a mean age of 44.56 years and body mass index of 45.62. We conducted random-effects and fixed-effect meta-analyses and meta-regression.
In randomized clinical trials, the mortality rate within 30 days was 0.08% (95% CI, 0.01%-0.24%); the mortality rate after 30 days was 0.31% (95% CI, 0.01%-0.75%). Body mass index loss at 5 years postsurgery was 12 to 17. T
he complication rate was 17% (95% CI, 11%-23%), and the reoperation rate was 7% (95% CI, 3%-12%).
Gastric bypass was more effective in weight loss but associated with more complications.
Adjustable gastric banding had lower mortality and complication rates; yet, the reoperation rate was higher and weight loss was less substantial than gastric bypass.
Sleeve gastrectomy appeared to be more effective in weight loss than adjustable gastric banding and comparable with gastric bypass.
Conclusions and RelevanceBariatric surgery provides substantial and sustained effects on weight loss and ameliorates obesity-attributable comorbidities in the majority of bariatric patients, although risks of complication, reoperation, and death exist. Death rates were lower than those reported in previous meta-analyses.
All women had undergone gastric bypass surgery - one of the most common bariatric surgery procedures. It involves rerouting a part of the small intestine past the stomach in order to reduce food intake, promote satiety and suppress hunger.
The majority of the women were interviewed twice. The first time was 1 year after surgery, while the second interview took place 2.5-4 years following surgery.
Groven says although most previous research suggests that weight loss surgery leads to an increase in quality of life for the majority of patients, her findings suggest that not everyone lives happily ever after following bariatric procedures.
Positive outcomes after surgery 'can feel like grief'
There is no doubt that weight loss surgery puts the body through a series of radical changes.
Groven says that although the procedure leads to a slimmer body - which others perceive as a "sign of success" - the surgery can cause many smaller problems that other people are unable to see.
"Becoming slimmer and lighter is mostly perceived of as positive. At the same time it is ambivalent, since people start to behave differently towards the women after they've had surgery.
People are friendlier than before, and this may feel extremely provoking. And people often ask very invasive questions concerning the woman's radical weight loss."
The interviews revealed that some of the women experienced a boost in self-esteem after surgery, were more outspoken, and found other people were more likely to listen to what they were saying - particularly in the workplace.
Groven notes that although these factors are clearly positive outcomes, this could also be seen as a "grief" because the women realize they had to undergo weight loss surgery before seeing these outcomes.
Many of the women also felt embarrassment after the surgery, particularly when it came to speaking about their weight loss. Some women told others they had been on a diet to lose the weight because they were ashamed to say they had undergone bariatric surgery.
Excess skin promotes a negative self-image
Groven found that many of the women had mixed feelings about their naked body after surgery, and many of these feelings come from the occurrence of loose skin - a common consequence of rapid weight loss.
"It is given little focus before the operation. Patients are often told that this is something that can be fixed afterwards. But it is not so easily fixed, and the women are not prepared for the challenge of having to live with the loose skin," explains Groven.
Although women can undergo surgery to remove excess skin, Groven notes that many women are not prepared to take the risks associated with this procedure, which include hematoma or seroma formation, infection and risks associated with future pregnancies.
Groven found that some of the women interviewed even spoke about their excess skin in third person, which she believes is a way of distancing themselves from it.
Health problems and bad food relationships after weight loss surgery
According to Groven, five of the women interviewed reported a lower quality of life after they underwent weight loss surgery, compared with their quality of life before.
She notes that this was down to the development of chronic stomach and intestine problems, and one woman became so ill that she had to endure another operation because of problems with her scar tissue after the gastric bypass procedure.
The five women also said they felt as if they had complete lack of energy following weight loss surgery.
Furthermore, Groven found that many of the women reported having a negative relationship with food after the procedure.
Some women were worried about eating too much or too little, or eating the wrong food at the wrong time. Because of these concerns, some women experienced tiredness, nausea, dizziness and even intense shaking.
Some of the women who had problems with overeating before weight loss surgery continued to overeat after surgery, even though this made them ill. Groven says some women commented that "the eating disorder is not gone."
Groven says that while previous research suggests that patients can avoid testing their eating limits after surgery by following dietary advice, the reality is much more complicated.
"It is reasonable to ask, I think, whether the eating disorders that some of the women develop after surgery are diseases, or if they may be understood as normal changes as a result of the operation."
Although many women reported negative thoughts and health issues after weight loss surgery, none of them said they regret undergoing the procedure.
"They say they would have done the same today and that they had no choice considering their life before surgery. Some said that the pains were a small price to pay," says Groven.
She adds that this suggests women are influenced by society's perception of the ideal female body, and that being obese is not within this scope.
"They are living with a body which is not accepted by society, and they are constantly judged from their size," she says.
"The message from the media and medical science is that they are likely to get cancer or diabetes unless they lose weight and the surrounding world regards their obesity as self-inflicted. Some have children and are afraid to die and leave them alone."
Groven concludes that although it is true that obesity can lead to health complications, such as diabetes and heart attack, little is known about the long-term effects of weight loss surgery and what complications may arise from this procedure.
With this in mind, Groven plans to conduct further research that will look at the effects of bariatric surgery 3-10 years after patients have undergone the procedure.