Reader’s Digest, 29 October 2008

Losing weight is not easy. Gaining seems to be so quick and effortless but losing requires lots of good will and… a good plan.

Especially people with diabetes have weight issues. By losing extra ponds your blood sugar will be easier controlled, also your blood pressure and cholesterol will be lower.

How to start?

The very first thing to do is to set achievable goals. Researches show that people consider themselves to be successful after losing 50 to 100 pounds. Be reasonable and set a goal of losing 10 pounds at the beginning. Moderate weight-loss is much more beneficial especially for diabetes.

The other thing is to know your Body Mass Index (BMI). Consult the BMI table. If your BMI is less than 25, your weight is normal. If it’s between 25 and 30, you’re overweight; if it’s 30 and above – you’re obese.

Losing weight on your own is not that fun. What’s more, researches show dieting with someone else is more motivating and you are more likely to lose twice as weight as someone who diets solo.
Other researches show that joining a group for losing weight, tend to lose twice as much as people who diet alone. You can join Weight Watchers but check also local community centers, hospitals and churches for weight-loss support.

The best results for losing extra pounds give matching exercising with cutting calories. If you only cut calories, the results will not be that appealing. 250 calories a day can be burnt by a long brisk walk if only you don’t replace them with food.

Don’t leave without breakfast. It’s the best thing to start day with. What’s more, a breakfast cereal with fiber makes you fuller and helps you to eat less during the day.

Be careful with losing too much in a short period of time. Researches show that by doing that you are more likely to gain back most or all the weight. Much more effective is changing a lifestyle in order to keep the desired weight permanently. Another thing is being very careful not to deprive your organism of essential nutrients. If you need help in this matter, a dietitian might be the person to consult. Good news is that you can still eat your favourite foods if your weight-loss plan is designed by a dietitian.

Keeping a diary will definitively help in losing weight. Note down everything you eat and drink (even a small bite of the cheesecake). Noting the time and the amount of the food will also help as well as what you felt at the time. It’s a good thing to do as many people don’t realize how much they eat and why they eat. Then the diary should be reviewed with the dietitian.

As losing weight can cause bone loss, remember to supplement your diet with 500-600 milligrams of calcium twice a day.

If, however, losing weight in a natural way is not possible, consult a weight-loss surgeon. You will be informed about possibilities of losing weight via surgery, about advantages, side effects and which procedure is the best for yourself.

WebWire, 15 October 2008

Weight-loss surgery gives relatively quick effects. The body adjusts to the new system and, as patients claim, they tend to lose weight with almost no effort. Unfortunately, not everything looks that good. After the initial period after the surgery, patients’ behaviour needs changing in order to achieve a long-lasting success.

As Dr. Ajay Goyal, FACS, Director of Bariatric Surgery at Overlook Hospital said: “Weight loss surgery is not the end of the weight loss process, it’s the beginning. “Gastric Bypass, Lap Band and REALIZE Band surgery is only a tool to jump start weight loss. For long term success and weight maintenance it’s important for patients to adopt a healthy lifestyle, full of exercise and nutritious choices for life.�

The very first thing to do after the weight-loss surgery is exercise. It’s crucial to maintain not only the desired weight but also to stay healthy. Patients need to remember to start by slow and simple exercises and then change them into more demanding once their ability improves. Aerobic exercises need to be done at least 4 times a week for 30 minutes.

Another thing is being aware of the type of food provided to the body. This awareness can be risen by reading the nutritional labels, counting calories and keeping a food diary. All this will make you conscious and help to evaluate the progress.

A good way of controlling the body is weighting yourself once a week. This allows to spot on the weight gain quickly and react instantly.

Losing weight is difficult and demanding. It requires lots of good will. People need to realize, though, they will gain some weight back over lifetime. It’s natural but it cannot make patients put into a place of emotional eating for comfort. If there is an eating disorder, the patient has to admit it and find out its reasons.

After the weight-loss surgery some people are afraid of food. Food is not an enemy, though. Patients should eat healthy but not to be afraid of treating themselves from time to time. It would fend off the everyday temptations.

A rule of thumb is to follow the doctor’s guidelines after the surgery. Eating three times a day, avoiding snacks, fast food and liquid calories and eating slowly are very important to maintain healthy lifestyle.

The last, but not least, thing is to visit the doctor once a year. He/she will spot on problems and treat them quickly, and perform a nutritional evaluation to make sure the vitamins and proteins are at a good level.

BBC News 07/10/08
Soaring obesity levels look set to drain local health and public service budgets, which will mean higher taxes for all, experts warn.

Obesity could cost NHS in England £6.3bn by 2015 if no effective action is taken says the Department of Health.

Local councils in England and Wales are already shelling out tens of thousands of pounds on “fat-friendly” services, like widening crematoria furnaces.

This comes as work shows obesity levels may have been grossly underestimated. The Local Government Association, which represents over 400 councils in England and Wales, says that Britain is fast becoming the “obesity capital of the world” and even more must be done to stop the nation’s waistline continuing to expand.

Cllr David Rogers, LGA spokesperson on public health, said: “It’s a massive issue for public health but it also risks placing an unprecedented amount of pressure on council services.

“Obesity is increasingly costing the council taxpayer dear. It falls to social services to care for the house-bound obese adults, to invest money in encouraging people to be active and to replace school furniture that is just too small for larger pupils.

“Council equipment and infrastructure is having to be modified to deal with a population that is getting larger and larger.”
He said social services were increasingly having to consider taking action in cases where parents consistently placed their children at risk of morbid obesity through bad diet and lack of exercise.

He called for a national debate about the extent to which it is acceptable.

Tam Fry of the National Obesity Forum said “draconian” interventions were necessary. He warned that, as a nation, we are all getting fatter and risked early death as a result.

Chief Medical Officer Sir Liam Donaldson said: “Nothing has changed in my mind about the seriousness of this threat to the country’s future health.

“In England almost two-thirds of adults and a third of children are either overweight or obese.

“Without action this could rise to nine in 10 adults and two-thirds of children by 2050.”

A US doctor says Britain’s health calculations are wrong and that three out of four adults in this country are now overweight or obese, not two-thirds.

Dr Francisco Lopez-Jimenez of the Mayo Clinic told the National Obesity Forum in London many people with a normal body mass index or BMI – the figure typically used to determine obesity – still weigh too much because this measure does not distinguish between fat and muscle, which weighs more.

His study of more than 2,000 men and women with a normal BMI found one in five still had excess body fat, which Dr Lopez-Jimenez says is a true marker of obesity.

10 October 2008 By Julie Wilson Sunderland Echo
Obese and overweight patients cost the NHS £245million across Sunderland and County Durham last year, according to a shocking new report.
But that figure could rise to £272million a year by 2015 if no action is taken to combat the problem, says the Government.
In Sunderland, the annual cost to the NHS of diseases related to obesity and being overweight was £88.4million in 2007, according to the Department of Health report.

In County Durham the cost was £156.7million and in South Tyneside £54.2million.
The new figures show for the first time the cost of obesity and being overweight to every primary care trust in England.
Nationally, the total was £4.2billion in 2007, which will rise £6.3billion in 2015 if no action is taken.
The figures were released as part of a “toolkit” the Government hopes will help health and council workers tackle the country’s weight problem.
In Sunderland, work is already being done to help obese and overweight people, ranging from health campaigns to weight- loss treatment.
Services being introduced by NHS South of Tyne and Wear include exercise and slimming classes on referral, a weight-management team, wellness service, anti-obesity drugs and weight-loss surgery.
They aim to help a wide range of people, from the slightly overweight to those with extreme problems.

In Sunderland, 24.1 per cent of adults are obese, compared with a national average of 21.8 per cent.

A spokesman for Sunderland Teaching Primary Care Trust said: “We already realise the need to tackle obesity, and detailed local plans are now in place.
“Obesity is one of our local priorities. A range of services are in place and being developed to address this specific problem.”

Miriam Davidson, locality director of public health, for County Durham and Darlington, said obesity was a key public health issue which posed a risk to health, well-being and life expectancy. She said: “Levels of obesity in County Durham and Darlington are among the worst in England. Actions under way to tackle obesity include promotion of breastfeeding, extending the Healthy Schools programme, increasing opportunities for outdoor play and promoting sport and leisure. There is also funding for a range of family based programmes for children and their whole family to change their lifestyle together.”

The Government’s toolkit, called Healthy Weight, Healthy Lives, includes advice for health workers on helping people to eat better diets and be more active.
Chief Medical Officer Sir Liam Donaldson said the link between obesity and preventable illnesses, such as diabetes, heart disease and cancer “is undeniable”.
He warned: “In England, almost two-thirds of adults and a third of children are either overweight or obese. Without effective action this could rise to nine in 10 adults and two-thirds of children by 2050.”
Public Health Minister Dawn Primarolo said: “Obesity is the biggest health challenge we face. Every year 9,000 people die prematurely. And many people simply just don’t know that being overweight can lead to major health problems including heart disease and cancer.

“We are leading the world when it comes to facing up to the problem and tackling obesity.”

EarthTimes, 08 October 2008

The latest studies show that injecting fat in breasts after the augmentation surgery can be safe and shows great effects. The study is controversial and will be discussed in further details by the American Society of Plastic Surgeons.

The MD of the ASPS, Gregory Scott, says that the appearance of the breasts after fat injection would be much improved and make the patients really happy with the results. “The initial implant reconstruction sometimes leaves them with contour deformities or wrinkling, but fat injections can correct these problems and give their breasts a smoother, softer, more natural appearance,” he said.

21 patients took part in the research. They underwent 42 transfers for contour deformities and wrinkling. They had fat injected about 9 months after the breast surgery. The fat was taken from their tights or abdomen. The study after the injection showed that breast shape improved, implant wrinkling was corrected and the reconstruction was safe for the patient.

Despite those benefits, this procedure is controversial. “Should We Inject Fat IntoThe Breast� is a title of 2008 discussion for the plastic surgeons where medical and legal risks as well as other aspects will be considered.

“At this point, there are no good scientific studies about cosmetic use of fat in the breast – this is an evolving issue without any scientific data,” said William P. Adams, Jr., member of the ASPS Emerging Trends Committee. “We need to have good, sound, scientific studies to determine the usefulness and safety of this methodology before we offer it to our patients.”

Two main reasons for the controversy are that fat in the breasts can obscure mammograms and be mistaken for fibrous cancer growths and surgeons do not know how much fat is needed to enlarge the breasts, how much of it will the body absorb and how much time it will take.

About 350.000 breasts enlargement surgeries took place in 2007. Surgeons agree that the fat injection issue has to be studied to see how useful and safe they are for the patients in order to start the procedure.

PR Web – United Kingdom, October 12, 2008 –(PR.com)–
Due to the financial pressures on the UK National Health Service, the vast majority of patients who are urgently in need of Obesity Surgery are forced to pay privately for their operations.
Searching for the right option for private surgery can be difficult, and sometimes confusing. Prices vary enormously, as does the extent of care and support offered before, during and after surgery. Making the right choice when dealing with something as important as major surgical procedures is vital. Cost, though important, is only one factor when deciding where to go for safe surgery.

Dr Michal Cierny PhD, the Chief Surgeon at the BMI Clinic in Brno, Czech Republic and a highly regarded Bariatric Surgeon specialising in Laparoscopic Vertical Sleeve Gastrectomy and Laparoscopic Gastric Banding, has announced that he will co-operate exclusively with Cosmetic Bliss for all English-Speaking patients, recognising their commitment to safety and patient care.

“It is most important to me that Bariatric patients are fully informed of the risks and benefits of surgery, that they have an understanding of the surgical procedures involved, and that, as far as possible, detailed checks as to their suitability for surgery have been completed before they arrive at the clinic for the in-depth pre-operative medical assessment.

“To have the best chance of successful long term weight loss, patients also need to have on-going support and contact, to help them through the process.

“I have worked closely with Cosmetic Bliss over the last 18 months, and know their approach to all aspects of patient care is excellent. Deborah from Cosmetic Bliss spends a great deal of time with the English patients here in my Clinic; fully informing them and reassuring them, enabling them to feel at ease when having surgery outside their home country. This is a valuable service to them, and to me.

“Pre-operatively Cosmetic Bliss does everything possible to ensure patients are fully prepared for surgery, and they provide me with detailed medical information on each patient to enable me to make an informed decision on suitability for surgery. Post-operatively they support and monitor patients, and enable me to keep the detailed records on Weight Loss and co-morbidities I require for purposes of evaluation.

“For these reasons I have decided to co-operate exclusively with Cosmetic Bliss in bringing English-Speaking patients to my Clinic. I am delighted to have them as partners, as they share my own aims of safe and successful Bariatric Surgery.�

Michael Dermody of Cosmetic Bliss said: “We feel honoured by the trust and recognition Dr Cierny and his clinic have shown us, and believe that we can continue to provide our patients with extremely safe, supportive and competitively priced Obesity Surgery at the BMI Clinic. We fully understand that travelling abroad for surgery can be daunting, and hope that the very personal service we give our patients allows them to feel secure and confident in their choice, and to be successful in their post-operative weight loss. We also welcome dialogue on co-operation from other companies promoting Weight Loss Surgery who wish to take advantage of the levels of patient care and service we and Dr Cierny provide.�

Following a BBC 10-o’clock news item on Thursday 9th October on the dangers of having Gastric Banding in Belgium, Cosmetic Bliss, who, of course, co-operate exclusively with Dr Michal Cierny PhD in Brno, Czech Republic for all bariatric surgery felt the need to respond.
Cosmetic Bliss hold no brief for Belgian Weight Loss Surgeons, and strongly support IFSO guidelines on appropriate BMI levels being used as a factor in risk assessment of patient suitability for surgery. All surgery performed under general anaesthesia carries a risk however, and the laparoscopic techniques used in Gastric Banding and Sleeve Gastrectomies, although proven to have several advantages over open surgery, are not risk-free. Nevertheless, under the care of an experienced specialist surgeon such as Dr Cierny, and with the support of a good surgical team the risks of surgery for a patient are much smaller than the risks involved in remaining obese. It is the duty of the surgeon and his team to make an assessment of a patient’s
suitability for surgery on the basis of this risk assessment.

Here is the text of Cosmetic Bliss’ response to the BBC item:

“Following the report on BBC News concerning Gastric Banding in Belgium, we wish to make the following points.

1. No RESPONSIBLE bariatric surgeon, abroad or in the Uk would offer surgery on a patient that did not meet the IFSO guidelines on BMI (same as NICE guidelines), and those surgeons who do perform surgery on patients who fail to meet the guidelines do so for one reason only – MONEY!!

2. The fact that a patient is refused surgery under the NHS does not necessarily mean that they are not suitable candidates for bariatric surgery. The chief reason surgery is denied by the NHS is because of cost. The figures speak for themselves. In 2006 almost 750,000 UK residents met the NICE (& IFSO) guidelines for surgery – only 7,000 operations were performed. The health service simply cannot afford to offer surgery to more than a fraction of those “qualified” to have it. More often than not local health authorities set much higher limits on BMI before considering a patient for NHS Surgery. That is why most patients seek a solution in the private sector, and why such companies as ours exist.

3. We agree that support post-operatively is essential to successful management of obesity, but that too is not always available to patients who have had surgery under the NHS, and I do not agree with the secretary of BOSS – Alberic Fiennes’ assertion that post-band patients should need to have access to “immediate” adjustment to the band. If the adjustments are performed by either an experienced bariatric surgeon OR qualified bariatric nurse, they should be safe and effective, and not require “emergency” correction. We have safely and responsibly arranged and accompanied more than 100 patients for successful surgery in the last 12 months alone, and do think it is entirely unfair to promote the idea that responsible surgery can only be assured in the UK, that “Johnny Foreigner” is more likely to breach guidelines for profit than a UK surgeon, and that competent aftercare is only available in the UK from the NHS. Many surgeons who perform Gastric banding for NHS patients, where the NHS “barâ€� is set MUCH higher than the NICE/IFSO guidelines also perform the same operations on private patients with lower BMI.Expertise and a commitment to care is not confined to the UK or the NHS, and there is a whiff of Xenophobia in this report which maybe has more to do with retaining a profitable private business for UK surgeons than a real concern over patient safety. It was very noticeable that although the straw poll conducted by BBC News cited UK Bariatric surgeons who had treated patients who had gone abroad for surgery, the question of how many patients were treated following surgery – either through the NHS or privately in the UK was never asked. We feel that the BBC has departed from standards of fair and balanced reporting in this instance, and find this very regrettable.”

Best Syndication 18 September, 2008

Liposuction as a quick way of loosing fat, is a very common cosmetic surgery these days. Thanks to the procedure the flat tummy and slim lights are possible to achieve.

The surgery is safer than other weight-loss operations but patients need to be aware of the potential risks.

The benefits of the liposuction are numerous. The surgery can be seen as a body sculpture as the doctor shapes the chosen parts. One of the differences between liposuction and other weight-loss surgeries is that here the last effect depends more on patients.

Patients are very active in the whole procedure as they tell the surgeon not only which parts of their body they want to be changed but also how these parts they want to look. Another great thing is that the results of this operation are quick. After only a few hours a new flat and smooth body can be seen.

Liposuction is a very good solution for all those who have tried diets and exercising with no results. Such patients will be amazed to see they can fit into their clothes or even wear the ones they could never wear before.

Unfortunately this surgery also carries risks. Whereas some of them might be quite serious, the others are not too much of a problem.

After the surgery the patients are given antibiotics to prevent the infection. One of the major problems is that some patients still get them even being given antibiotics. The infections can be quite serious and may require hospitalization.

Another potential issue is heart problems. These problems might appear if, in order to keep patients hydrated, too many liquids are injected. If it’s the case, the heart cannot cope with that causing problems.
Patients preparing for liposuction need to prepare themselves for the pain. In some patients it can last longer than in the others.

There is also a risk that the surgery removes the fat unequally if the skin is not elastic enough to snap back into place after the fat being removed. This would cause the need of another surgery to mend the effect.

As all surgeries, also liposuction has both benefits and risks. Potential patients should do a detailed research on which one is the best for them. The best way is to make an appointment with a surgeon who will present the options.

Economic Times September 25, 2008

Recent studies show that weight-loss surgeries assisted by a robot make the operation safer for patients.

605 patients took part in the research. Doctors at the Texas University Medical School analysed several factors such as operation times, how long the patients stayed in the hospital and what complications they had. The patients underwent either a gastric bypass procedure with doctors or with robotic help.

The major difference was the gastrointestinal leak rate. Six patients who underwent the operation without the robot’s assistance had this complication within 90 days after the procedure. Eric B. Wilson, the study co-author, said that even though the robotic surgery takes more time and is more expensive, the results are better and “decreased leak rates may offset the cost to some extent”.

What’s more, during the surgeries carried out with robot’s help, there is clear, three-dimensional view of the operative field. That helps the doctors to see better tissue planes and place sutures more precisely.

The gastrointestinal leak can cause abdominal and chest pain, fever, nausea, vomiting, shortness of breath and death in rare cases.

Other results of both operations were similar. In comparison, the surgery assisted by a robot was 17 minutes longer. Patients from both groups had to stay in hospital for three days and had the complication rate of 14%.