HealthNewsDigest.com, 14th December 2009

As the New Year is coming, it’s time for reflections, comparisons and new plans. The American Society for Metabolic and Bariatric Surgery don’t have the exact figures yet but more procedures are expected to have been carried out this year than in the previous years.

In 2010 even more bariatric surgeries will take place. This is partly due to the increasing number of patients with type 2 diabetes. By 2034, an estimated 44 million of Americans will suffer from this disease. The reason of this situation is the ageing of the population and the obesity epidemic.
Teenagers are the next group in which weigh-loss surgery will be carried more frequently in the next years, as the latest studies show improved heart health of obese teens after the procedure. This means that after the surgery, teenagers are less likely to have heart disease as adults.

In favour of bariatric surgery are also less invasive procedures, such as transoral gastroplastry. Studies will continue to ensure the new procedures are even less invasive and that the healing time is shorter.

One of the main problems after the weight-loss surgery at the moment is that patients are left with loose skin in visible areas. A new procedure, the corset trunkplasty, will be available in 2010. It targets above the belly button flab to recreate the before-the-obesity body in both men and women.

The new year will surely bring more information about new procedures, such as endoluminal sleeve (EndoBarrier Gastrointestinal Liner). This new surgery is still in the process of growth and consists on lining the upper small intestine with the impermeable sleeve. It will bring the benefits of surgery without complications and risks.

Not only patients with BMI of 35 and more will be eligible for the weight-loss surgery in the coming year. It has been planned to also include patients with lower BMI who suffer from diabetes.

On 1st November 2009 Cosmetic Bliss and Dr Michal Cierny PhD (Bariatric Surgeon) moved from the BMI Clinic in Brno where they had worked for over two years performing Gastric Band operations and Sleeve Gastrectomies, to Breclav Hospital near Brno.
The move was carried out to enable Dr Cierny to create a European Centre of Excellence in Bariatric Surgery. Dr Cierny plans to develop and extend his activities in the field of Bariatric Surgery by offering a wider range of procedures for Czech patients and also for patients from English-speaking countries who are brought to him and cared for by Cosmetic Bliss. The new centre, The Bariatric and Metabolic Centre, Breclav Hospital will fully integrate the disciplines of the dietitians, diabetologists, internal medicine specialists, anaesthetists and surgeon, and the comprehensive resuscitation, cardiac and ICU facilities of this large and well equipped hospital enable those patients with serious health problems to safely undergo surgery. Breclav Hospital is currently the only hospital in Europe to hold certificates for international standards ISO 9001. ISO 13001 and OHSAS 18001.
Dr Cierny said “I am more than ever convinced that it is vital to have a complete multi-disciplinary approach to the problems of obesity. Surgery is shown to be the long-term solution to morbid obesity, but surgery is only truly effective when the patients can receive the support and continuing encouragement and guidance of other professionals in the journey through their weight loss after their surgical procedure.”
Michael Dermody, one of the directors of Cosmetic Bliss, the UK company that arranges for English-speaking patients from UK, Eire and the USA to come for Weight Loss Surgery to Dr Cierny and Breclav Hospital welcomed this move, and suppported Dr Cierny’s comments. He added “I believe that psychological preparation for surgery, whether it is Banding, a Sleeve Gastrectomy, a Gastric Bypass or even a non-surgical intervention such as a stomach balloon is the most important factor in enabling the outcome of the procedure to be successful. I became even more aware of this during my own journey through weight loss after Dr Cierny performed a Sleeve Gastrectomy on me in September 2008. I have seen many cases of patients – both through the NHS and privately in the UK – going through weight loss surgery with inadequate preparation and information beforehand and little follow-up or counselling afterwards to enable them to understand the emotional changes and the changes in their relationship with food that weight loss after surgery brings about. We invest a great deal of our time and resources to ensure our patients are fully prepared for their procedure, and do our utmost to create a network of support, in terms of diet, nutrition and psychological assistance which our patients can call on in the months and years after their surgery. We really encourage our patients to maintain regular contact with us and with fellow patients. Quite honestly, Weight Loss Surgery is not a cheap nor an easy option, and it is wrong that people should make such a major investment, emotionally and financially, only to be left to fail because of inadequate preparation or poor support and follow up. In the UK, NICE (the National Institute for Clinical Excellence) has embraced the IFSO (International Federation of Surgeons in Obesity) criteria for acceptance of patients for surgical weight loss treatment, and part of those criteria involve careful psychological evaluation to ensure the patient is well placed to benefit from surgery. I know many UK PCTs set much tougher standards in terms of arbitrarily imposing higher BMI requirements on local candidates for surgery and this is clearly an attempt to limit the costs to the NHS of surgical procedures, but I believe they would be much better advised to concentrate on providing adequate support and counselling for those morbidly obese candidates for surgery they are able to afford to treat; in the long run this would prove a much more cost-effective option in terms of successful weight loss and the reduction of NHS costs in dealing with some of the co-morbidities associated with obesity such as Type II Diabetes and Hypertension”
Cosmetic Bliss is well placed to accept new patients for surgery with Dr Cierny in Breclav Hospital because of the new unit, though there is a waiting list of approximately 1 month.

Shift Work Disorder News, 10th December 2009

Society today is body obsessed and trying to lose weight no matter what. There are various ads that tempt us with miracle weight loss solutions such as diets, powders, pills… They show us thin and smiling people to convince us this is really going to work.

That is why we often forget that there is no magic in weight loss. The other thing is to be very careful before putting in the body something we don’t know much about. Strangely enough, very often these “magic� products have got a piece of information saying that in order for this product to work properly, it has to be combined with healthy diet and exercise. What do we need those products for, then?

Other “super� diets state that eating or drinking one specific product for some time will bring a desired result. This has nothing to do with this product. Taking half of the normal amount of the calories a day will bring you to the weight loss, no matter what you eat or drink. Is it healthy and wise? Of course not! Because once you get back to the normal eating routine, the weight will bounce back quickly.

If you’ve got a weight problem, act reasonably. Seek advice with the experts. Weight loss is not easy and won’t happen overnight. If you decide it’s time to change your body shape, this will certainly affect your diet and exercise plan. The results, though, will be satisfying and long lasting.

Scranton Times-Tribune, 2nd December 2009

It was accidentally discovered about 10 years ago that weight-loss surgery led to improvements in Type 2 diabetes.
The evidence today is even more sure which leads doctors to a conclusion that the surgery can be a cure for diabetes, no matter if the patient is overweight or not.

Dr. Walter J. Pories from East Carolina University said diabetes had been thought to be an incurable progressive disease which might cause amputations, renal failure and blindness. Now, weight-loss surgery seems to be a great opportunity for those who suffer from it as the operation takes only one hour and requires two days of hospitalization. And then the patients do not need to use their medicines any more.

As many as 86% of obese patients with Type 2 diabetes who underwent weight-loss surgery found the disease much easier to control after the procedure. Complete remission of the disease was found with 78% of the patients whereas 86% of them found the remission or improvement.

Obese patients quickly lose weight after the batriatic surgery which improves Type 2 diabetes. That allows for an easier control of their blood glucose levels. There is also strong point: as the stomach gets smaller after the surgery, and allows food to bypass part of the small intestine, it causes chemical changes in the intestine. Somehow the secretion of hormones in the gut responsible for appetite are being altered.

Studies show that weight-loss procedures make the reductions in ghrelin (hormone that stimulates hunger). Another conclusion says that the surgery alters the expression of genes that regulate glucose and metabolism.