HealthDay Reporter, 14th December 2008

Weight-loss operation is sometimes a life-saving procedure for severly obese patients. What’s more, gastric bypass extends those patients’ lives. Surgeons have got a difficult decision to make who should and who shouldn’t undergo such an operation.

Internists, cardiologists and endocrinologists are being asked if a patient will benefit or not from the operation. For Dr. Edward H. Phillips from the Department of Surgery and a surgeon at the Center for Weight Loss in Los Angeles is obvious that a 30-year-old will benefit but he’s wondering what age should be considered as too old for such procedure.

Another debate takes place about batriatic surgery for type 2 diabetes. Researches show this operation improves patients’ lives. After the procedure they no longer need the medication they would have taken until the end of their lives without the surgery.

“There’s more acceptance now of the concept that bariatric surgery is a truly life-saving type of therapy rather than just a way to shed pounds,” said Dr. Francesco Rubino, from Gastrointestinal Metabolic Surgery at Weill Cornell Medical College in New York City.

Long-term researches still need to take place to establish which patients should be allowed this type of surgery.

Each year more and more weight-loss procedures are performed. In 2007 about 205.000 operations took place. It’s 20% more that in the previous years.

Batriatic surgery is a very successful weight-loss surgery providing that patients make changes in their life-style, meaning change diet and start exercising. If a patient does not change a life-style, the post-surgery results might not be satisfying.

A research on 16.000 obese people was led by Ted Adams from University of Utah School of Medicine. Half of the group underwent weight-loss operation whereas the other part didn’t. After seven years after the operation the death rate in the group who had the batriatic procedure was 40% lower than in the other group. The death rate in the diabetes was cut by 92%.

Studies show that age is not a barrier for this kind of operations. In another research over 1.000 weight-loss procedures took place between 2001 and 2005. It turned out that patients over 60 years of age had the same safety and effectiveness than younger patients.

Some surgeons think, though, this kind of procedures should not be carried out in patients over 80 years of age.
“The likelihood of extending their lives is unknown,” said Dr. Phillips. “Also, if a complication occurs, they can’t survive it.”
Despite great results, the surgeons advice that all patients must be very careful as batriatic surgery is considered a risk associated procedure. “There should be careful assessment of the pros and cons of surgery and the pros and cons of remaining severely obese.” Dr. Adams said.

Thu Dec 11, 2008 5:20am GMTLONDON (Reuters) – A third of all British adults — some 13 million people — will be obese by 2012 if current trends continue, jeopardising their health and straining healthcare budgets, researchers said on Thursday.

Over-eating and lack of exercise mean more and more Britons are seriously overweight, with 32.1 percent of men and 33.1 percent of women now expected to be clinically obese in four years’ time.

Almost half of them will be from low income and disadvantaged communities, widening the health gap between the haves and have-nots, according to Paola Zaninotto of University College London and colleagues.

Type 2 diabetes, heart disease and certain cancers are all directly linked to obesity, and the condition causes at least 9,000 premature deaths each year in England alone, the research team said.

It also costs the economy around 7.4 billion pounds a year, they reported in the Journal of Epidemiology and Community Health.

Their forecasts of future rates of obesity are based on data collected each year from 128,000 adults that provides a nationwide sample of Body Mass Index readings, which relate height to weight.

Previous research has shown a rapid rise in British obesity levels, with its prevalence almost doubling in men from 13.6 to 24 percent between 1993 and 2004 and rising nearly 50 percent among women, from 16.9 to 24.4 percent.

Obesity is a mounting concern for healthcare officials worldwide.

Drug companies have tried for years to develop a successful anti-obesity pill but the field is littered with failures, with Sanofi-Aventis’s Acomplia — withdrawn in October over links to mental disorders — the most recent casualty.

Reuters UK, 3rd December 2008

Weight-loss surgery is a life-saving procedure for some patients. Unfortunately, the operation itself is not enough to come back in shape.

Patients who underwent such a procedure need to follow a diet and exercise. Studies show that more weight can be lost if these are taking into consideration.

In every day life exercising is needed to control the body weight. The role of physical exercise after the weight-loss surgery, however, wasn’t that clear. Recent researches show that regular physical activity after the weight-loss procedure show better results comparing to the patients who don’t exercise.

199 patients took part in the research. All of them underwent gastric bypass. Patients who were more active, lost more weight than those who remained inactive. Both groups had a Roux-en-Y gastric bypass where the upper part of the stomach is stapled off. This restricts the amount of food that can be taken. Also a bypass around the remaining part of the stomach is created and a portion of the small intestine. That reduces the quantity of food absorbed by the body.

Weight-loss operation itself makes undeniable changes but changing a lifestyle makes a difference.

Further researches are carried out to show how much exercise is necessary. Present researches define being active as getting at least 200 minutes of exercise per week. Gastric bypass patients who got this much physical activity after the operation lost about 15 pounds more than other patients.

Dr. Dale S. Bond, of the Brown Alpert Medical School in Rhode Island said there is no safer and more practical way to get active after such a procedure as walking. This simple activity might not only help in burning fat but also help in other medical obesity related problems, such as high blood pressure, high cholesterol or diabetes.

Science Daily, 1st December 2008

Lots of people have serious weight issues these days. Researches show that in 1980 15% of the American population was affected by obesity whereas in 2004 – almost 33%.

One of the problems related with obesity is NAFLD (Nonalcoholic fatty liver disease) – one of the most common liver diseases.
Batriatic surgery is not only an effective way of weight-loss; it’s also, as the recent researches show, a solution for histopathological features of NAFLD. There are numerous complications of NAFLD, such as steatosis, fibrosis and steatohepasis. Researches show they much improve or even resolve completely after weight-loss operation.

“Even today, the effect of weight loss after bariatric surgery on the liver, particularly NAFLD, remains unclear. There is a lack of well-defined trials exploring this relationship,” said Gagan K. Sood, MD, of the University of Texas Medical Branch. “Our team assessed and quantified this effect and found encouraging news: a majority of patients experience complete resolution of NAFLD after bariatric surgery, and the risk of progression of inflammatory changes and fibrosis seems to be minimal.”

Patients between 35 and 49 years old took part in the research. Their BMI varied between 19.11 and 41.76. After the surgery 91.6% of patients had improved steatosis, 81.3% – steatohepatitis, 65.5% – fibrosis and 69.5% were completely cured from NASH.

Further researches need to be carried out using uniform histopathological criteria for liver biopsy specimens.