Weight Loss
Lap-Band Weight-Loss Surgery Can Reverse Metabolic Syndrome in Obese Teens
A new study of obese adolescents has shown that laparoscopic gastric banding surgery—the “Lap-Band” procedure—not only helps them achieve significant weight loss but can also improve and even reverse metabolic syndrome, reducing their risk for cardiovascular disease and diabetes.
Metabolic syndrome is defined as a cluster of risk factors—high blood pressure; low levels of HDL or “good” cholesterol; excessive abdominal fat; and elevated levels of blood sugar, C-reactive protein and triglycerides—that increase a person’s chances of developing cardiovascular disease or diabetes later in life. The single biggest risk factor is obesity, and metabolic syndrome usually improves when a person loses weight.
The study was led by Drs. Ilene Fennoy, Jeffrey Zitsman and colleagues at NewYork-Presbyterian Morgan Stanley Children’s Hospital and Columbia University Medical Center and presented at the annual Endocrine Society meeting in Washington, D.C.
Gastric bypass provides long-term diabetes control
In more than half of obese patients with type 2 diabetes, their metabolic condition resolves after gastric bypass and they remain free from diabetes up to 16 years later, according to study findings presented last week at the 26th Annual Meeting of the American Society for Metabolic and Bariatric Surgery in Dallas.
In a study of 177 patients with diabetes who underwent gastric bypass for obesity, also referred to as bariatric surgery, between 1993 and 2003, the severity of diabetes before surgery was a key predictor of whether diabetes resolved in the long term. Moreover, long-term diabetes resolution correlated with the maintenance of weight loss.
“The most significant finding is that long-term resolution of diabetes seems to be linked to how severe the diabetes was at the time of surgery,” senior author Dr. James W. Maher, from Virginia Commonwealth University, Richmond, told Reuters Health. “Patients with diet-controlled diabetes had a 75 percent likelihood of being diabetes-free at long-term followup, while the figure was 65 percent diabetes-free in patients who were originally controlled with oral medications and only 28 percent of insulin-dependent diabetics had long-term resolution.”
Hormone May Help Combat Frailty in Older Women
Frail elderly women with unexplained weight loss may benefit from supplementation with the body’s appetite-stimulating hormone, ghrelin, or with similar agents, according to a new study. Results of the study, which was funded partially by the National Institutes of Health, were presented at The Endocrine Society’s 91st Annual Meeting in Washington, D.C.
Unexplained weight loss is a common problem in older adults. It can lead to the development of frailty, a debilitating syndrome of declines across multiple body systems.
Frail individuals have much higher rates of functional decline, hospitalization and death than healthier people their age, said study lead investigator Anne Cappola, MD, ScM, assistant professor of medicine at the University of Pennsylvania School of Medicine, Philadelphia.
Studies confirm weight-loss surgery beats diabetes
The most common form of diabetes disappears in most obese diabetics after weight-loss surgery, researchers said on Tuesday in a study that strongly affirmed the benefits of the operations.
The researchers combined data from 621 studies worldwide with 135,246 patients and found that 78 percent of obese diabetics returned to normal blood sugar levels and had no symptoms of diabetes following weight-loss operations, also known as bariatric surgery.
Another 8 percent saw their diabetes symptoms improve, although the disease was not eliminated.
“This is the most comprehensive study of the effect of bariatric surgery on type 2 diabetes. It includes every major paper that’s been written in this field,” Dr. Henry Buchwald of the University of Minnesota, who led the research published in the American Journal of Medicine, said in a telephone interview.
Weight loss improves mild sleep apnea
Losing weight through lifestyle changes can improve or even reverse mild cases of the nighttime breathing disorder, sleep apnea, a new study suggests.
The study, of 72 overweight adults with mild obstructive sleep apnea (OSA), found that those placed on a diet-and-lifestyle regimen not only lost weight but showed significant improvements in their sleep apnea.
OSA occurs when the soft tissues at the back of the throat temporarily collapse during sleep, causing repeated breathing interruptions. Major symptoms include loud snoring and daytime sleepiness.
Divorce, antidepressants, or weight gain/loss can add years to your face
Your mother’s wrinkles — or lack there of, may not be the best predictor of how you’ll age. In fact, a new study claims just the opposite. The study, involving identical twins, suggests that despite genetic make-up, certain environmental factors can add years to a person’s perceived age. Results just published on the web-based version of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), reveal that factors like divorce or the use of antidepressants are the real culprits that can wreak havoc on one’s face.
“A person’s heritage may initially dictate how they age – but if you introduce certain factors into your life, you will certainly age faster. Likewise, if you avoid those factors you can slow down the hands of time,” said ASPS Member Surgeon and study author Bahaman Guyuron, MD, professor and chairman, department of plastic surgery, University Hospitals Case Medical Center. “In this study, we looked at identical twins because they are genetically programmed to age exactly the same, and in doing so we essentially discovered that, when it comes to your face, it is possible to cheat your biological clock.”
During the study, Dr. Guyuron and his colleagues obtained comprehensive questionnaires and digital images from 186 pairs of identical twins. The images were reviewed by an independent panel, which then recorded the perceived age difference between the siblings.
Growth hormone treatment after weight loss surgery prevents loss of muscle mass
Growth hormone treatment for six months after weight loss surgery reduces patients’ losses in lean body mass and skeletal muscle mass, according to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).
Weight loss surgery techniques, such as gastric banding, have been shown to be effective in reducing body weight and obesity-related diseases, such as diabetes. Although the results of these procedures are widely beneficial, there are some complications. Following surgery, patients are at risk of losing needed lean body mass and skeletal muscle mass due to the serious complications associated with rapid and sustained weight loss. This new study investigated whether growth hormone treatment could prevent or reduce these losses.
“Besides its more commonly known effect on linear growth during childhood, growth hormone benefits body composition throughout life by increasing muscle mass and reducing fat mass,” said Dr. Silvia Savastano, M.D., Ph.D., researcher at University Federico II of Naples in Italy and lead author of the study. “The results of our study show that the use of short-term treatment with growth hormone during a standardized program of low calorie diet and physical exercise is effective in reducing the loss of muscle mass and increasing the loss of fat mass after bariatric surgery.”
Physicians Agree Moderate Weight Loss Will Help Patients Manage Their Type 2 Diabetes
Physicians say they are counseling their overweight type 2 diabetes patients to lose weight, but patients say that the message is not getting through, according to a new survey announced today by the Behavioral Diabetes Institute.
Eight in 10 physicians surveyed said that they discuss weight issues with their patients every/almost every visit, yet half as many patients – only four in 10 – report having these discussions with such frequency. In particular, roughly half of overweight patients and a third of obese patients say their physician seldom or never discusses their weight with them.
Almost all of surveyed physicians (85 percent) acknowledge that losing even a little weight can help manage type 2 diabetes. When discussing weight issues with their patients, 90 percent of physicians surveyed report that they tell their overweight patients to lose weight. However, when the surveyed patients were asked whether or not their doctor ever suggested that they lose weight, only 66 percent of them said yes.
Help Possible for People Obsessed With Imaginary Physical Flaws
Worrying about a bad hair day or idly wishing for a more-perfect profile: we’ve all been there. However, people suffering from body dysmorphic disorder go far beyond that, obsessing over exaggerated or even imaginary physical defects, to the point where it affects their ability to work, attend school or have ordinary social contacts.
Now, a new review finds that both drug therapy and psychotherapy, alone or in combination, can effectively treat the condition. Moreover, treatment can bring be long-lasting relief, according to the South African research team.
“The key finding that treatment effects were maintained over a 4.5 month follow-up [period] after 12 weeks of cognitive behavioral psychotherapy indicates that such therapy may be effective in preventing remission over the longer term,” said lead reviewer Jonathan Ipser, whose work at the University of Stellenbosch in Tygerberg encompasses stress and anxiety disorders.
Who are you kidding?
The research was carried out by a team of researchers led by Sharon Herring, MD, MPH, an Assistant Professor of Medicine and Public Health at Temple University. She said, “Compared to normal weight women who accurately assessed their pre-pregnancy weight status, the odds of gaining excessively during pregnancy were increased seven-fold among overweight and obese women who thought they weighed less than they really did. Normal weight women who thought they were overweight had twice the odds of excessive gestational weight gain.”
The authors studied 1537 women enrolled in Project Viva, a US birth cohort, who were normal weight, overweight or obese at the beginning of their pregnancies. Underweight women were not included. Of the 1029 normal weight participants, 898 (87%) correctly reported that they were normal weight just prior to pregnancy, while 131 (13%) incorrectly thought they were overweight or obese. Of the remaining women who were overweight or obese, 438 (86%) accurately perceived their body weight status, while 70 (14%) under-assessed their size before pregnancy.
Augsburg: Weight issues in children starting school
Immigrant children have a greater risk of suffering from overweight and obesity. This is the result of a study from Augsburg with 2306 children examined on starting school. Elisabeth Weber and her coauthors present the results in the current issue of Deutsches Ärzteblatt International (Dtsch Arztbl Int 2008; 105 [51-52]: 883-9). The doctors recorded not only the age, sex, weight, and height of the children, but also their mother tongue. Their parents had to answer a questionnaire covering sporting activity, amount of television watched, and eating behavior.
German was the mother tongue of 1398 of the children examined. Turkish was the most frequent foreign language (395 children), followed by Russian (183 children). Other languages were subsumed under “other” (419 children). In all, 302 children (13.1%) suffered from overweight and 133 children (4.9%) were obese.
Telephone as Effective as Face-to-Face Counseling in Keeping Weight Off
Face-to-face and telephone follow-up sessions appear to be more effective in the maintenance of weight loss for women from rural communities compared with weight loss education alone, according to a report in the November 24 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. In addition, telephone counseling appears to be just as effective as face-to-to face counseling for weight loss management.
“Rural counties in the United States have higher rates of obesity, sedentary lifestyle and associated chronic diseases than nonrural areas, yet treatment of obesity in the rural population has received little research attention,” according to background information in the article. Studies have shown that diet, exercise and behavior changes can produce significant weight loss and that extended care programs such as clinic-based follow-up sessions can improve weight loss maintenance. “However, in rural communities, distance to health care centers represents a significant barrier to ongoing care.”
Michael G. Perri, Ph.D., of the University of Florida, Gainesville, and colleagues conducted a randomized trial involving 234 obese women (age 50 to 75) who completed a six-month weight loss program in six medically underserved rural communities. The women were randomly assigned to three different extended-care programs consisting of 26 biweekly sessions for one year; 72 participants received telephone counseling, 83 received face-to-face counseling and 79 received biweekly newsletters containing weight loss maintenance tips. Estimated program costs were also assessed.
Gastric bypass cuts heart risks
The risk faced by obese people of having a heart attack or other cardiovascular “events” is reduced substantially after they undergo gastric bypass surgery to lose weight, according to a recent study.
The take-home message is that “bariatric surgery can be considered as a means to reduce cardiovascular risk (in obese patients) after conservative treatment options have failed,” Dr. John A. Batsis told Reuters Health.
Batsis, at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire and his colleagues identified six studies that looked at cardiovascular risk after bariatric surgery for obesity. The risk was estimated from standard tables that assigned a score for factors such as weight, blood pressure and cholesterol levels.
Parents foster significant misperceptions of children’s weight
Results of a survey presented at the American College of Gastroenterology’s 73rd Annual Scientific Meeting in Orlando revealed that many parents do not accurately perceive their children as overweight or at risk for adulthood obesity. Obesity in the United States is often accompanied by an increased risk of gastrointestinal diseases and has emerged as a major health concern, particularly the issue of obesity among children and adolescents.
Researcher Rona L. Levy, Ph.D. and her colleagues at the University of Washington in Seattle and the University of Minnesota measured parental perceptions of their children’s current weight and perceived risk for developing obesity as an adult.
Forty-six parents of children ages 5 to 9 with a body mass index (BMI) in the 70th percentile or higher were recruited for the study. Child height and weight were measured during a routine pediatric clinic visit. Parents were mailed a series of questionnaires, which included questions on their perception of their child’s current weight, and whether they perceived that their child was at risk for developing obesity as an adult.
Steroids Not as Effective in Obese Asthma Patients
Glucocorticoids, the primary controller medication for asthma, are 40 percent less effective in overweight and obese asthma patients than in those of normal weight, according to researchers at National Jewish Health, in Denver. The study also identified a potential mechanism involved in the resistance, which suggests therapeutic targets for future medications.
The study, by Associate Professor of Medicine E. Rand Sutherland, M.D., M.P.H., and his colleagues at National Jewish Health, appears in the first issue for October of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.
“This study identifies what could be a significant issue for the 20 million Americans with asthma; specifically, the main controller medication might be less effective if you are overweight or obese,” said Dr. Sutherland. “These findings should spur doctors to carefully evaluate response to treatment in overweight and obese asthmatics and consider optimizing therapeutic regimens as indicated. We also hope they will spur additional research into the treatment of obese patients with asthma.”
