By Carolyn Johnson – ABC7 San Francisco
Is This A New Weight Loss Solution?
In May we followed a patient through a relatively new stomach reduction procedure, a Gastric Sleeve, and the patient was told to expect dramatic changes within the first three months. We wanted to see if the promises held true, so we went along for his three months checkup. Gregg Jossart, M.D., California Pacific Medical Center: “He’s a tall man, so he’ll probably lose about 70 to 80 pounds in the first ninety days, and his diabetes will probably be cured two to three months from now, and his blood pressure should be dramatically improved and that should be cured as well.”                                                                                                                                                          Bold predictions from Dr. Gregg Jossart, chief of minimally invasive surgery at California Pacific Medical Center.                                           Patient Scott Coffelt weighed in at 340 pounds the day of surgery. With small incisions, similar to those used for gastric banding or the “lap band”, doctors separated Scott’s stomach from the surrounding tissue and stapled off the majority of it, leaving just a tiny pouch. The rest of his stomach, removed for good along with the part that produces the hormone ghrelin, believed responsible for stimulating appetite. Unlike a gastric bypass, the intestines were not re-routed.                                                                                                                                                                Dr. Jossart: “You’ve lost 65 pounds in about 90 days.”                                                                                                                                       And with that weight loss came great gains.                                                                                                                                                          Scott Coffelt, stomach reduction patient: “I haven’t taken any medication since the day after surgery. Nothing for diabetes, high blood pressure, cholesterol, any of that. all the pills are gone.”

More http://abclocal.go.com/kgo/story?section=edell&id=5556228

By Bernard Purcell – Irish Independent – Thursday July 26 2007
AIRLINES and airports will be banned from charging for assisting disabled and elderly passengers under new EU rules. Airlines, airports and travel agents will now be obliged to ensure that would-be travellers with reduced mobility are afforded the same levels of access as the able-bodied. The airlines and airports now have a change-over period of a year until the new rules can be enforced.

The rules have three basic principles: equal treatment of persons affected by reduced mobility; free assistance in all EU airports; and free assistance on board. Regular wheelchair users and blind people can expect their chairs and guide dogs to be carried for free when the new rules – agreed by ministers and MEPs a year ago – are fully in force throughout the EU by no later than July next year.

In addition, the definition of restricted mobility has been broadened to include a whole spectrum ranging from the physically and intellectually disabled to the elderly and infirm, to those recuperating from surgery.

Until now airports and, mainly but not exclusively, the low-cost airlines have argued between themselves as to who must provide the facility and who should pay the cost, sometimes resulting in legal action by passengers. “Most airlines and airports do make genuine efforts to offer the necessary assistance but not all of them provide comprehensive assistance, free of charge,” said the Commission.
 

By EMMA MORTON -The SUN
August 03, 2007
 
FAT Brits who want to lose weight should just eat less, a top doctor claimed last night.                                                                                        Obesity is now “over-medicalisedâ€�, said British Medical Association chief, Dr Hamish Meldrum. He said too many adults use pills and surgery to try to slim – instead of cutting out junk food.

Dr Meldrum said: “People use fancy labels that suggest things are a medical problem. It is preferable for people to change their eating habits.�

Weight-loss surgery — like gastric bands — has risen six-fold in ten years, with 1,000 Brits having the op each year.

Slimming pill sales are also up with more than £48million a year spent on tablets.

COSMETIC BLISS WOULD WELCOME COMMENTS ON THIS ITEM

Here is some information from NICE (National Institute for Clinical Excellence) which puts the above comment into perspective, we think.  If the morbid obesity epidemic was able to be solved by the simple expedient of eating less, there would be no problem:

According to NICE, in 1998, an estimated 0.6% of men and 1.9% of women in England and Wales had a BMI of 40 or more. This represents 124,000 men and 412,700 women or 2500 people for a typical primary care trust population of 200,000. The prevalence of obesity is rising as the average BMI increases. Between 1994 and 1998 the average BMI increased by 0.44 for men and 0.57 for women.

“ NICE recommend that weight loss surgery may be offered if the patient fulfils all the following criteria:

Obesity surgery should be considered only for people who have been receiving intensive management in a specialised hospital obesity clinic .
individuals should be aged 18 years or over.
there should be evidence that all appropriate and available non-surgical measures have been adequately tried but have failed to maintain weight loss.
there should be no specific clinical or psychological contra-indications to this type of surgery.
individuals should be generally fit for anaesthesia and surgery.
individuals should understand the need for long-term follow-up.
Surgery should normally be reserved for those with a BMI of 40 or more but NICE accept that it may be offered to those with a BMI in excess of 35 if they have associated morbidities that may benefit from weight reduction.”

Because of underfunding care for the obese in the NHS, we wonder if there are sufficient resources available to treat EVEN A FRACTION OF THOSE PATIENTS WHO MEET THESE CRITERIA

Source: Blackwell Publishing Ltd.  Date: July 31, 2007
Science Daily — Only one in seven UK doctors’ surgeries provide well-developed support programmes for obese patients, according to a survey of primary care nurses published in the latest Journal of Advanced Nursing.
Sheffield-based researchers surveyed just under 400 nurses in the north of England in mid 2006, including district nurses, practice nurses and health visitors.

Their aim was to ask the nurses about their clinical practice, views and support for patients with obesity.

The researchers discovered that 89 per cent of nurses recognise the need for more effective primary care services to tackle obesity and see obesity advice and support as part of their role.

However, one in five nurses also admitted that they felt awkward or embarrassed about talking to patients about obesity and only a fifth felt they were effective when it came to helping patients to lose weight.

Half said that they found providing care and support for obese patients particularly rewarding, but some also expressed negative attitudes and beliefs.

It’s estimated that one in five adults in the survey area — which covered four primary care trusts in the north of England – are obese, reflecting national UK trends.

Many of the nurses in the current survey also had weight problems – 14 per cent were obese and 29 per cent were overweight.

“Primary care nurses have an important role when it comes to helping patients to tackle obesity, which can lead to diseases like coronary heart disease and diabetes” says lead researcher Dr Ian Brown from Sheffield Hallam University.

“But they clearly need further training and organisational support to provide the help that obese people need to lose weight, in line with new UK health guidelines.

“Any training programmes should also address nurses’ beliefs and attitudes. While outright negatives stereotypes were rare, a number of nurses displayed potentially negative beliefs and attitudes relating to obesity and obese people. However, they were much less likely to do this if they were obese themselves”
Full Story:  http://www.sciencedaily.com/releases/2007/07/070730100245.htm

You and your doctor have agreed: surgery could be the answer to your weight-loss problems.

But what are the disadvantages – and the possible risks – of bariatric surgery? And how will this operation change your life?

Risks of bariatric surgery
Any operation that requires an anaesthetic, which takes between 1 and 3,5 hours to complete, is potentially dangerous.

If one also keeps in mind that patients who undergo these operations are morbidly obese and often suffer from a variety of associated complications such as respiratory disorders, diabetes and heart disease, the risks may be even more.

According to scientific literature, the following risks are associated with bariatric surgery:

a) During or shortly after the operation:

Pulmonary embolism (a blood clot in the lungs), which accounts for up to 70% of deaths that occur during or immediately after surgery
Major wound infections
Peritonitis (inflammation of the membrane of the abdominal cavity)
Narrowing of the entrance to the stomach
Abscesses
Slippage of the gastric band or staples which then require re-operation
b) After surgery

Vomiting
Dysphagia (inability to eat)
Hernia
Heartburn
Diarrhoea
Dumping syndrome (see below)
Malnutrition
Vitamin and mineral deficiencies (see below)
Regain of weight that has been lost
(Msika (2003), Sugermann (2001), Sugermann et al (2003)).

Dumping syndrome
According to Krause (2000), dumping syndrome is “a complex physiological response to larger than normal amounts of food and liquid in the upper parts of the small intestine” due to changes in the rate at which the stomach is emptied.

The symptoms associated with dumping syndrome usually start off with mild effects that include a feeling of fullness and nausea 10 to 20 minutes after eating. Patients may also experience flushing, heart palpitations, fainting, sweating and the urge to sit or lie down.

About one hour after eating, patients may develop abdominal bloating, winds, cramps and abdominal pain and diarrhoea.

Finally, the most extreme stage of dumping syndrome can cause hypoglycaemia (low blood sugar). Patients may perspire, feel anxiety, weakness, shakiness, or hunger, and may be unable to concentrate.

Ironically, the fact that these symptoms can be so severe, can act as a strong motivation to patients to stick to the post-operative dietary rules that they will need to follow for the rest of their lives.

To avoid dumping syndrome, the following guidelines should be applied:

Eat only small meals, which should be spread throughout the entire day (6-8 meals per day).
Eat mainly high-protein, low-fat foods.
Include some dietary fibre if you find that you can tolerate this (e.g. brown bread, oats, brown rice).
Try to rest or lie down one hour after your meals to slow down stomach emptying.
Avoid drinking liquids with your meals, but make sure that you have small quantities of liquid (no more than 100ml), all day long between meals to prevent dehydration.
Avoid cold drinks, juices, pies, cakes, biscuits and frozen desserts or any very sweet foods.
If you find that milk and dairy products don’t agree with you or worsen the symptoms of dumping syndrome, then you may have to avoid them. In such cases, it is essential to take a calcium supplement. Cheese and yoghurt can usually be eaten without discomfort.
Vitamin and mineral deficiencies
Post-operative vitamin and mineral deficiencies are common in patients who have undergone bariatric surgery, namely:

Iron deficiency which can cause anaemia (this is particularly common in female patients who menstruate)
Vitamin B12 deficiency, which can also lead to megaloblastic anaemia
Calcium deficiency, which may cause osteoporosis later in life
Folic acid deficiency
Most bariatric surgery patients need to take vitamin and minerals supplements for the rest of their lives and your surgeon or dietician will advise you which products to use. Regular monitoring of vitamin and mineral levels in the blood is a recommended precautionary measure to pinpoint potential deficiencies.

Advantages of bariatric surgery
The greatest advantage of bariatric surgery is, of course, the significant weight loss that morbidly obese patients achieve. Losses of up to 120kg have been reported.

As these patients lose weight, many of their so-called co-morbidities either disappear or improve dramatically, for example type 2 diabetics may find that they no longer have to take medication and can control their condition with diet alone.

Improvements are also seen in: hypertension, sleep apnoea, obesity hyperventilation syndrome, gastro-oesophageal reflux, venous stasis, urinary incontinence, female sexual hormone dysfunction (e.g. polycystic ovarian disease), degenerative joint disease, and most other obesity-related diseases.

Any patient who has lost a third to half of his/her body weight will naturally be more mobile and active.

In addition, patients experience a great increase in self-esteem, less depression and anxiety, and feel much more self-confident. Patients also find it easier to get jobs and find romantic partners.

by Tony Chen 
July 26, 2007 

The politics and science around obesity continues to become more complicated and more urgent. Just about everyone sees it as a problem, but no one seems to be addressing it in a meaningful way. Maybe it’s because obesity has emotional, social, psychological, physiological, socioeconomic, racial/cultural, and genetic dynamics all entangled together. As an example, just take a look at the obesity-related news from the last few week:

- HealthAffairs: This is why a fat tax doesn’t make sense – if done the wrong way, it could actually increase the cardiovascular-related death rate. If fatty foods are too expensive, people will just end up buying and eating more salty foods.

- NYT: Apparently, Obesity is socially “contagious�. Do you have an obese friend? Even if the friend lives hundreds of miles away, you are 3x more likely to also be obese.

Obesity can spread from person to person, much like a virus, researchers are reporting today. When a person gains weight, close friends tend to gain weight, too.

The author of the study explains why in this BBC article:

“Rather, there is a direct, causal relationship. What appears to be happening is that a person becoming obese most likely causes a change of norms about what counts as an appropriate body size.

“People come to think that it is OK to be bigger since those around them are bigger, and this sensibility spreads.�

- FOXNews: A Missouri man claims that he was denied adoption because of his weight.

- SanDiego Union Tribune: Maybe this will all be irrelevant if we can all just pop anti-obesity pills. Another potential obesity drug just announced great results – 620 people lost an average of 10% of their body weight in 6 months. Interestingly enough, this new drug candidate is actually a combination of an anti-convulsant and an anti-depressant.

Nonetheless, the word “epidemic� is increasingly being used for obesity (and diabesity). And for an epidemic, it’s not getting enough press. I think the million (or trillion) dollar question is this: How do you get 300 million people to take more walks and eat less?
Story c/o http://www.worldhealthcareblog.org

       Written by Amy Nutt    
Thursday, 19 July 2007 
Cosmetic surgery has changed a great deal since doctors began using such procedures to repair birth defects and repair facial wounds caused by war or service. The procedures that were once a necessity became popular among rich people striving for perfection and eventually became an accessible option for anyone wanting to reshape part of their face or body.

Moulding the Body

The idea of reshaping or molding the body is not a new practice. Cosmetic surgeries have been done for roughly 4,000 years. It wasn’t until the 18th century, however, that surgeons began using anesthesia during this reconstruction. Furthermore, it wasn’t done in America until 1891 when John Roe reduced the risks associated with it.

Repairing the Body from War

World War II brought on a surge of cosmetic surgeries as men returned from the war with facial wounds. Cosmetic surgery was used to reconstruct and reshape the faces of men who were missing parts or had abnormal shapes due to wartime fighting. Though doctors couldn’t remove the agony from the soldier’s minds, they could fix the soldier’s appearance.

The Changing Purpose of Cosmetic Surgery

The purpose of cosmetic surgery has changed over time. While it once served a valuable service to people who needed facial and body reconstruction, it has become a way for people to change features they simply don’t like.

Some surgeries, such as rhinosplasty, are necessary for proper breathing, but more often than not, cosmetic surgery is done for purely aesthetic reasons.

Cosmetic surgery is an operation performed on many people in the general population to make themselves look and feel better. Our society is obsessed with beauty and perfection, making cosmetic surgery an option for anyone interested in changing the way they look.

Surgery for the Rich

Celebrities used to try and hide it if they did have cosmetic surgery to improve their appearance or reduce aging and it would turn into a huge media frenzy if someone was “outted”. These days, however, celebrities are not as afraid to talk about having cosmetic surgery and they certainly aren’t the only ones having it done.

Though cosmetic surgery was once considered only for rich people, it has grown in popularity and has become more widely accepted in recent years.

Risks and Side Effects of Cosmetic Surgery

The goal of cosmetic surgery is to improve your look or reshape deformities, but there are also risks associated with the procedure. You may experience nerve damage, blood loss, infection, tissue damage or scarring. The other risk is that the end result of the surgery may not be what you desire. Changes from cosmetic surgery are permanent and additional surgeries might be required to correct size, shape or functionality.
 

By Rebecca Smith, Medical Editor Daily Telegraph
Around 60,000 people in Britain could be infected this year with the most widespread hospital superbug despite campaigns to tackle the problem, new figures out today show.

In the first three months of this year 15,592 people over the age of 65 were infected with Clostridium difficile, a two per cent rise on the same period last year. The bug takes hold in the guts of patients who have been given antibiotics and causes thousands of deaths. There were a total of 55,634 cases of C.Diff in 2006. The new figures from the Health Protection Agency show rates of the other major health care associated infection, MRSA, are dropping. There was a 6.4 per cent fall in the three months up to March 2007, with a total of 1,444 bloodstream infections reported in England compared with 1,542 in the last quarter. The full-year data shows there has been a 10 per cent drop in the number of MRSA cases.

Between April 2006 and March 2007, 6,378 cases of MRSA were reported, compared with 7,096 for the previous year.

The Chief Medical Officer highlighted the need for patients to challenge their doctors to wash their hands

more :  http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/07/25/nmrsa125.xml

Article in Australian News
June 03, 2007 12:00pm
OVERWEIGHT or single parents are more likely to breed chubby children, new research has found, debunking the idea that parenting style is linked to obesity.
A study published in the Medical Journal of Australia shows a parent’s weight and marital status have more influence on childhood obesity than their parenting style.
The study found that family conflict, negative life events, and maternal depression were not likely to affect a child’s tendency to become overweight or obese.
“We found that parenting style was not associated with childhood obesity,” said lead author Dr Lisa Gibson, a psychologist with the Telethon Institute for Child Health Research in Perth.
“Previous indications of a link between poor family functioning and childhood obesity were based on studies without population-based data and without observations across a range of theoretically important factors.”
But parenting practices regarding eating and exercise may play a role in childhood weight problems, Dr Gibson said.
“Children from single-parent families, particularly when there is a family history of obesity, may struggle to maintain a healthy weight in an obesogenic environment with restricted access to nutritious foods and adequate facilities for recreational exercise,” she said.
“The association between children’s weight, maternal BMI (body mass index) and family structure confirms the need to find ways of targeting prevention and intervention efforts for childhood obesity at families with overweight parents, particularly under-resourced single-parent families.”
http://www.news.com.au/story/0,23599,21841181-2,00.html

May 31, 2007 7:52 a.m. EST
Nidhi Sharma – AHN Staff Writer
Brussels, Belgium (AHN) – Obesity is the major problem facing more than half of adults in European Union nations and a staggering amount of young people in the region, as well, according to the EU’s top public health official.
EU Health Commissioner Markos Kyprianou says that people are developing unhealthy food habits with diets mostly consisting of fatty and sweet ingredients combined. The unhealthy diet, coupled with lack of physical activity account for six of the seven top factors leading to poor health.
Recalling the fact that the EU Commission has constantly warned governments to act, but no action was taken, the minister added, “Everybody has to be blamed – including the authorities, including the industry, including the consumers,” Kyprianou said.
Expressing his concern over the ever-expanding waist size of children, Kyprianou stressed on the need to act urgently as “today’s overweight children will be tomorrow’s heart attack victims.”
According to statistics provided by the EU, over 21 million children are overweight and the rate of increase of that number is more than 400,000 children a year.
The overall consumption of fruit and vegetables is lower than medical recommendations. Additionally, the intake of fat and saturated fats is high throughout the continent, while the consumption of cereals has fallen by a quarter since the 1960s in Europe.
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