Bariatric Surgery May be the Best Solution for Patients with Type 2 Diabetes… Increased Risk of Bone Fractures after Weight Loss Surgery… Success After Bariatric Surgery Takes Commitment, Says Georgia Surgeon… For Those with Obesity, Weight Loss from Young Adulthood to Middle Age Significantly Reduces Diabetes Risk… Obesity Linked to Worsening Rheumatoid Arthritis… Severe Obesity Carries Increased Risk for Liver Failure… Obesity May Predict Stroke Outcomes in Nonwhite Adults… Family History of Obesity a Risk Factor for Early Onset Obesity in Children
Metabolic and Bariatric Surgery in the News
Is Bariatric Surgery Right for You?
Diabetes Forecast
When medication and lifestyle changes don’t help people with type 2 diabetes manage their blood glucose and weight, bariatric surgery may be the best solution, an article on the American Diabetes Associations consumer news website reports. The article provides an in-depth look at the differences between gastric bypass and sleeve gastrectomy for people with type 2 diabetes. Studies show that the two types of surgery, which account for more than 95 percent of bariatric surgeries performed on people with type 2 diabetes, offer significant benefits in addition to dramatic weight loss, such as partial to complete remission of type 2 diabetes and improvements in blood pressure and cholesterol. “People begin to benefit from bariatric surgery almost immediately,” says Dr. Samer Mattar, bariatric surgeon at Swedish Medical Center in Seattle and president of ASMBS. “It works by normalizing the blood glucose in the system, and it reverses many of the effects of diabetes. It also re-multiplies the beta cells in the pancreas that produce insulin. And most important, it reduces insulin resistance.” Traditionally, gastric bypass has been considered the gold standard procedure, but recent research attests to near-comparable benefits in sleeve gastrectomy. “Its a misperception that the sleeve is less effective than gastric bypass,” says Dr. Mattar. “Both operations are equally effective in the treatment of diabetes.” Dr. Mattar cautions against relying on statistics when evaluating the two surgeries and instead, advises surgeons and patients to consider individual needs, desires, and circumstances. “Were moving away from which operation is the gold standard, which operation is superior, to focusing on whats more appropriate for a particular patient,” says Dr. Mattar. “Were trying to customize and personalize surgery as much as possible.”
Weight Loss Surgery may lead to Long-Term Skeletal Consequences
News-Medical
A new review published in JMR Plus, the journal for the American Society for Bone and Mineral Research, notes that bariatric surgery can cause declines in bone mass and strength, and is linked with an increased risk of bone fractures. The researchers say nutritional factors, mechanical unloading, hormonal factors, and changes in body composition and bone marrow fat may contribute to the changes in bone health. According to the review, skeletal changes after surgery appear early and continue even after weight loss plateaus and weight stabilizes. “Current clinical guidelines do address bone health, but most recommendations are based on low-quality evidence or expert opinion,” says co-author Dr. Anne Schafer, of the University of California, San Francisco and the San Francisco VA Health Care System. “Future studies should address strategies to avoid long-term skeletal consequences of these otherwise beneficial procedures.”
Surgeon: Success after Bariatric Surgery is a Process
13 WMAZ – Georgia
Bariatric surgery calls for lifetime commitment to a healthier lifestyle. Dr. Danny Vaughn, a bariatric surgeon based in Macon, GA, says just because someone has weight loss surgery doesn’t mean they will never have to worry about their weight again. “Theres really three parts to success with weight loss after surgery,” explained Dr. Vaughn. “The surgery is one, diet is one, and exercise is one. If you don’t do diet and exercise properly you’re not going to have as good results.” He also says those who have the most success are the ones who take the diet and exercise component seriously. He cautions that despite the dramatic weight loss after surgery, people considering surgery should know that its not the easy way out. The process can take as long as three to six months to even get approved for the procedure and before approval candidates must be evaluated and complete the necessary work-ups before surgery. Contrary to what many people believe, bariatric procedures are not cosmetic surgeries. “Theres not a cosmetic component to this,” says Dr. Vaughn. “This is really to change your life and help you to be healthier and add years to your life.” Weight loss surgery, he adds, can help extend someones life for 10-15 years and significantly improve health related to diabetes, hypertension and other diseases.
Obesity in the News
BMI Changes Significantly Affect Diabetes Risks
Consultant360 )
Weight loss from young adulthood to middle age reduces a persons risk for diabetes by nearly 70 percent, according to results of a study published in Diabetes Care. Using data from the National Health and Nutrition Examination Survey, researchers assessed the lifetime risk for diabetes in the context of changes in BMI. Over 10 years, participants who had obesity and lost weight had a significantly lower risk for diabetes than those with stable obesity. “If those who were obese had become nonobese during the 10-year period, we estimate that 9.1% of observed diabetes cases could have been averted, and if the population had maintained a normal BMI during the period, 64.2% of cases could have been averted,” the researchers write. The researchers also note that more should be done to manage obesity in the United States. “The findings from this study underscore the importance of population-level approaches to the prevention and treatment of obesity across the life courseof individuals.”
Obesity, Weight Loss Linked to Worse Rheumatoid Arthritis in Study
UPI
People with severe obesity and rheumatoid arthritis are more likely to see a rapid progress of their rheumatoid arthritis, according to a new study published in Arthritis Care. Researchers found that patients who lost weight unintentionally or had severe obesity saw increased progression of rheumatoid arthritis. “While patients and rheumatologists may be focused mostly on disease activity, we should also consider [obesity], which can contribute to problems that are usually attributed to the arthritis itself,” says Dr. Joshua Baker, a researcher at University of Pennsylvania. “In addition, unintentional weight loss should alert us that the patient may be becoming frail and is at risk for developing new disability.” Baker and colleagues analyzed data on 23,323 patients with rheumatoid arthritis and found that at enrollment, disability scores were higher among patients with severe obesity than for those who were overweight. The researchers say the worsening disability was not associated with features of their arthritis, including inflammation in joints, noting the disability worsened more quickly in those that had lost weight. The researchers say “patients with rheumatoid arthritis and obesity would benefit from intentional weight loss through a comprehensive management strategy.”
Morbid Obesity Increases Risk for Acute-On-Chronic Liver Failure
Healio
Patients with a BMI of 40 or higher — class III obesity — are at an increased risk for acute-on-chronic liver failure (ACLF) and have a higher prevalence of renal failure, according to a recently published study in the Journal of Hepatology. Researchers analyzed data of liver transplant waitlist patients with decompensated cirrhosis and at least one decompensating event such as ascites, hepatic encephalopathy or variceal hemorrhage. ACLF at the time of waitlist registration was significantly more prevalent among patients with class III obesity compared with patients without obesity and those with class I or II obesity (BMI 30-39). Additionally, obesity was significantly correlated with ACLF at time of liver transplantation and the prevalence of renal failure as a component of ACLF increased significantly with increasing obesity class. “We propose that the link between class III obesity and increased risk of ACLF is due to an obesity-related chronic inflammatory state,” Vinay Sundaram, MD, from the Cedars-Sinai Medical Center, California, and colleagues wrote. “Given the high mortality and health care burden associated with obesity, along with its rising prevalence among patients with cirrhosis, we suggest an even greater emphasis on weight reduction among cirrhotic patients with class III obesity. For patients unable to reach their weight loss goals via lifestyle modifications alone, bariatric surgery may be an effective preventative measure.”
Obesity May Predict Stroke Outcomes in Black Adults
Healio | Endocrine Today
A new study published in Obesity Science &Practice finds that patients with obesity diagnosed with an intracerebral hemorrhage are more likely to experience a poor disposition outcome compared to patients with normal weight or overweight and that black adults with obesity have markedly higher risk for experiencing poor outcomes compared to white adults. Researchers reviewed all neuroimaging studies and records of discharge locations from 428 patients with a diagnosis of spontaneous intracerebral hemorrhage. Outcome measures were hematoma expansion at 24 hours (defined as at least 30% expansion in intracranial hemorrhage volume) and discharge disposition, defined as a good outcome if discharged to home or an inpatient acute rehabilitation, and a poor outcome if discharged to a nursing facility, long-term acute care facility or death. Researchers found that BMI did not influence hematoma expansion outcomes and that race did not influence disposition or hematoma expansion outcomes. Nonwhite adults with obesity were more likely to experience a poor disposition outcome compared to nonwhite adults of normal weight and nonwhite adults with overweight. “Although race did not influence the overall study results, within the nonwhite population, obesity was associated with poor hospital discharge disposition outcome, a result that was not observed in patients with normal weight and overweight,” Ifeanyi O. Iwuchukwu, MD, an assistant professor of neuroscience at Louisiana State University, and colleagues wrote. “Interestingly, this observation was not detected in the white population group.”
Study Reveals Risk Factors Involved in Early Onset and Severity of Obesity in Children
News-Medical
Findings from a study published in Frontiers in Endocrinology suggest a family history of obesity, high blood pressure, high blood lipid levels, type 2 diabetes and coronary heart disease should be considered high risk factors for early onset and severity of obesity in children. Researchers assessed these risk factors together from the parents, siblings and grandparents of more than 250 children with overweight and obesity ages two to 17. If parents, siblings and grandparents suffered cardiovascular and metabolic diseases, it increased the likelihood of the early onset and severity of obesity in the children. Researchers also highlighted that children suffering from severe obesity, even those who were very young, showed signs of insulin resistance. Lead author Dr. Domenico Corica says, “This is a very important finding that underlines the need for early intervention care programs involving health providers, schools and other government institutions, primarily to modify the lifestyle — i.e. eating habits, physical activity, screen time — of obese children and their families.”