Oh, here’s a weight loss surgery study with great news for bariatric patients in general, and Lap Band patients specifically. The risks of death or complications from weight loss surgery is much lower than expected – particularly for Lap Band patients.
Now, a word to the wise for people looking at the safety rate. Weight loss surgery is frequently performed on severely obese and critically ill patients in a last ditch attempt to save their life, as happened for Lorraine Kay. Lorraine’s primary care physician wanted a gastric bypass because she was so ill that he didn’t think that she would lose weight fast enough with a Lap Band for it to save her life, but her surgeon didn’t think she would survive the surgery and wanted to perform a Lap Band instead. Her surgeon won out and Lorraine now weighs 125, her diabetes is in remission and her blood pressure back to normal – this from a woman in her late fifties, who weighed over 300 pounds, used 120 units of insulin a day and was weeks away from dying. So, these patients are frequently in real trouble when they go into surgery in the first place.
That being said, the numbers for weight loss surgery in general, are no higher than they are for other types of surgery:
Weight-loss surgery isn’t risk-free, but a new study suggests that in the hands of a skilled surgeon, it may be safer than previously thought. However, some people — including those with sleep apnea or a history of blood clots — are more likely to have problems with surgery than others, according to a study published this week in the New England Journal of Medicine.
Weight-loss surgery is safer, but could cause complications for people with sleep apnea or a history of blood clots.
“The overall conclusion that we reached is that bariatric-surgery safety is actually quite good,” said Dr. Bruce Wolfe, a professor of surgery at the Oregon Health and Science University.
In the past, bariatric procedures have been associated with death rates of 2 to 3 percent and complication rates of up to 24 percent. However, the obesity epidemic is fueling a rise in such surgeries, prompting concerns about their safety. In 2005, 171,000 people underwent bariatric surgery, more than 10 times the number that had the procedure in 1994.
To assess the safety of such operations, Wolfe and his colleagues looked at 4,776 patients in the first month after having a bariatric procedure. They found that 4.3 percent of patients had a serious problem, such as a blood clot or needing another operation, and 0.3 percent, or 15 patients, died within a month after surgery — a complication rate similar to other types of surgery.
Ahhh, but the news is even better for Lap Band patients – from another article on the same study:
“Nobody died within 30 days of the banding technique…”
As for the major complications:
The overall likelihood of major complications, including death, blood clots or the need for follow-up surgery, showed a similar pattern. It was 1 percent for banding, 4.8 percent for laparoscopic bypass and 7.8 percent for open bypass.
Wolfe said the pattern is not surprising because surgeons will not try laparoscopic bypass on patients with many risk factors. When they adjusted for risk factors, the chance of major complications was much more comparable between both types of Roux-en-Y bypass.
Dr. Malcolm Robinson of Harvard Medical School said in a commentary the complication rates ‘are similar to those seen in other major operations’ but since the study involved 33 U.S. surgeons certified as highly skilled, the results ‘may not be widely reproducible.’
Lastly:
Both Robinson and Wolfe recommend that any person considering bariatric surgery should choose a facility that’s been designated as a “Center of Excellence” because that means that the surgeon and the whole health-care team are qualified and experienced.
Here is Dr. Wolfe talking about how weight loss surgery allows people to live longer:
“[Research suggests that] surgery increases survival and makes people live longer, even taking into account mortalities,” said Wolfe.
That’s what it all comes down to – you have family and friends who love you and want you to live a long life. Think about your own sadness about the people who have left before you. If you kids or a spouse, you want them to feel that for as few years as possible. Weight loss surgery allows you to live longer and live happier – and that’s worth it.
than people who use diet and exercise. Even when the diet and exercise group are under a doctor’s supervision.
I was looking around for new and interesting studies and I found this one, which is two years old, from Paul O’Brien, JB Dixon and C. Laurie entitled Lap-Band or Medical Therapy for Metabolic Syndrome. Now here is how the American Heart Association defines Metabolic Syndrome:
The metabolic syndrome is characterized by a group of metabolic risk factors in one person. They include:
Abdominal obesity (excessive fat tissue in and around the abdomen)
Atherogenic dyslipidemia (blood fat disorders — high triglycerides, low HDL cholesterol and high LDL cholesterol — that foster plaque buildups in artery walls)
Elevated blood pressure
Insulin resistance or glucose intolerance (the body can’t properly use insulin or blood sugar)
Prothrombotic state (e.g., high fibrinogen or plasminogen activator inhibitor–1 in the blood)
Proinflammatory state (e.g., elevated C-reactive protein in the blood)
People with the metabolic syndrome are at increased risk of coronary heart disease and other diseases related to plaque buildups in artery walls (e.g., stroke and peripheral vascular disease) and type 2 diabetes. The metabolic syndrome has become increasingly common in the United States. It’s estimated that over 50 million Americans have it.
So, of course, we are studying how best to treat Metabolic Syndrome and this study finds that Lap Bands are far more effective.
Aims: The primary aim of this study was to conduct a randomized, controlled trial to compare the effectiveness of standard, nonsurgical therapy for weight loss with LAP-BAND in mild to moderate obese adults (body mass index [BMI] 30–35 kg/m2).
A BMI of 30-35 is our 5’4″ woman weighing between 169 and 197. It’s our 5’10” guy weighing between 209 and 243. Not huge. Not morbidly obese, by any means. But certainly quite a bit heavier than most people can carry and be comfortable. Check your BMI here.
Methods: Participants were eligible for inclusion if they were between 20 and 50 years of age, had a BMI of 30 to 35 kg/m2, and had an obesity-related comorbid condition (including severe physical limitations or clinically significant psychosocial problems related to their obesity). Participants were excluded if they had had previous bariatric surgery or medical problems that contraindicated treatment in either study group (ie, impaired mental status or drug or alcohol addiction). In addition, participants who had undergone an intensive, physician-supervised program that used very low caloric diets or pharmaco-therapy for weight loss were also excluded.
And what happened with that group of people? Well…
The percentage of initial weight loss (~ 13.8%) was the same for both groups at 6 months. However, the surgical group continued to lose weight at the 12-, 18-, and 24- month evaluations. At the end of the 2-year study period, thesurgical group had lost 87.2% of their excess weight. The nonsurgical group showed progressive weight gain after the initial weight loss described above. All of the patients who had surgery and eight of the 33 patients who were treated without surgery achieved satisfactory weight loss, defined as a loss of 25% of excess weight.
Basically, the people who had Lap Bands lost close to 90% of their excess weight. The people who were treated non-surgically, gained most of their weight back. At the end of the two year period, only8 of the 33 non-surgical patients had lost 25% of their excess weight.
Those non-surgical patients had a pretty optimal experience for losing weight. It’s not like they were handed a 28 page pamphlet and told to knock a few pounds off. They were aggressively treated with drugs, exercise and had appointments with a physician every six weeks. From the study:
The nonsurgical program was centered on behavioral modification and included a very low caloric diet, increasing physical activity, and pharmacotherapy. After an initial intensive 6-month period of very low calorie diet (500–550 kcal/d), patients were started on 120 mg
of orlistat once a day, which was then increased to 120 mg of orlistat before all meals. All participants were seen at least every 6 weeks by a physician. All participants were instructed in appropriate lifestyle behaviors, including healthy eating habits and regular exercise for at least 200 minutes per week regardless of the study group to which they were randomized.
Even under those ideal circumstances, most people couldn’t lose the majority of their excess weight in two years, unless they had the Lap Band surgery. And that is certainly experience that I have had in my life and if you’re reading this blog, I bet you have as well.
I frequently link to a study by Dr. Paul O’Brien at Monash University that found that the instance of mortality is lower among weight loss surgery patients than among obese people who don’t have a Lap Band.
Severely obese people who received the LAP-BAND Adjustable Gastric Banding System to lose weight had a 72 percent reduction in their risk of dying compared to obese people who were not offered any specific weight-loss treatment, according to findings published in the December issue of the Annals of Surgery (1).
And here is the math:
The study involved two groups of people who were between 37 and 70 years of age with a Body Mass Index (BMI) of 35 or greater: A LAP-BAND System group, which included 966 patients (average age 47, average BMI 45 ) and a previously established population-based cohort of 2119 people who were not offered any specific weight-loss treatment (average age 55, average BMI). There were four deaths (heart disease, cancer(2) and suicide) in the LAP-BAND System group after a median follow-up of four years, vs. 225 deaths after a median follow-up of 12 years in the non-treated group. After statistically controlling for the differences in follow up time, sex, age and BMI, the hazard for death was 72 percent lower for LAP-BAND System patients compared to the non-treated group (hazard ratio for death: 0.28, 95% confidence interval: 0.10-0.85). LAP-BAND System patients lost an average of approximately 63 pounds 2 years after installation.
So, now we have this new study out that finds that weight loss surgery cuts the risk of cancer.
Weight-loss surgery significantly reduces cancer risk, says Dr. Nicolas Christou, Director of Bariatric Surgery at the McGill University Health Centre in Montreal, Canada.
“There is no question whatsoever that weight-loss surgery reduces your relative risk of developing a cancer,” says Christou.
He and his colleagues compared more than 1,000 morbidly obese people who had weight-loss surgery to thousands of people with the same weight profile who did not have the surgery.
He found that the surgery patients’ overall risk of cancer was 78-percent lower over the five years of the study. For breast cancer the risk was reduced by 83-percent.
An 83% reduction in the risk of breast cancer is huge.
I know that so many of my readers are guilt tripped by their family and friends when they announce that they are considering weight loss surgery. But there is no evidence that diet and exercise is an effective way to lose weight. Until weight loss surgery came along, it was the only way, but that’s now changed. We have the studies that prove that people who have weight loss surgery live happier lives, healthier lives and longer lives. So go for the happy! Get the surgery and have a real shot at living a longer, healthier life. What could be better than that?
I found this clip over at the Centennial Center For The Treatment of Obesity site. It’s two physicians talking about Lap Bands and diabetes. What one doctor says is that diabetes diminishes in Lap Band patients as their weight decreases. Interesting.
If you have diabetes, and have not yet read up on it, the numbers are pretty impressive. A study published in Obesity Surgery, found resolution of diabetes in Lap Band patients was 66% at one year, and 80% at two years.
Well, here’s some good news. The medical professional is starting to get confident about weight loss surgery for teenagers. I was a tiny little thing when I was teenager, and that was plenty traumatic as it was. I can’t even imagine what it is like to face your teen years obese.
— 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.
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.
Metabolic syndrome is something that most of us who are obese wrestle with, but to have to deal with this cluster of syndromes as a teenager must be just terrible.
In the new study, Dr. Fennoy and her colleagues followed 24 morbidly obese adolescents between the ages of 14 and 17 who underwent the Lap-Band procedure. The study participants either had a BMI of greater than 40 or greater than 35 if already suffering from diabetes or obesity-related illnesses.
Six months after surgery, they noted a significant drop in participants’ BMI, waist circumference, and blood levels of C-reactive protein. These indicators continued to improve among the 12 patients being followed up at the one-year point.
Other measures of metabolic syndrome such as blood lipid and sugar levels, the authors reported, came down quickly in the first six months, with “less dramatic” changes seen one year after surgery.
“Of all the bariatric procedures,” she says, “the Lap-Band is the most benign, with complication rates of less than 1 percent.” The device, inserted via minimally invasive laparoscopic surgery, consists of a simple band to make the stomach smaller and a balloon that can be decompressed when necessary, she explains.
For more information, patients may call (866) NYP-NEWS.
There is a lot of scholarship now that is validating the desirability of weight loss surgery for teens. Doctors are eager to see kids avoid the diseases that obese people develop as they age. What this study shows though is that the kids are getting the diseases early. No one should have hypertension at 14. It’s just crazy.
In Mexico, Dr. Ariel Ortiz has been one of the foremost surgeons providing obese teenagers with the Lap Band. His site has a fair amount of information, as well as interviews with several of the teens that he has worked with. If you’re considering this option your teen, Dr. Ortiz is a wonderful resource as well.
I’m a year late on this study. I have no idea how I missed it. It’s a tiny study, still it makes the point that for people for whom Gastric Bypass operations fail to help them leave morbid obesity behind, Gastric Bands can provide further support.
Results 11 patients (seven females, four males) were referred to our program for weight loss failure after RYGBP (six open, five laparoscopic). Mean age and BMI pre-RYGBP were 39.5 years (24–58 years) and 53.2 kg/m2 (41.2–71 kg/m2), respectively. Mean EWL after RYGBP was 38% (19–49%). All patients were referred to us for persistent morbid obesity due to weight loss failure or weight regain.
The average time between RYGBP and LAGB was 5.5 years (1.8–20 years). Mean age and BMI pre-LAGB were 46.1 years (29–61 years) and 43.4 kg/m2 (36–57 kg/m2), respectively. Vanguard (VG) bands were placed laparoscopically in most patients. There was one conversion to open. Mean OR time and LOS were 76 minutes and 29 hours, respectively. The 30-day complication rate was 0% and mortality was 0%. There were no band slips or erosions; however, one patient required reoperation for a flipped port. The average follow-up after LAGB was 13 months (2–32 months) with a mean BMI of 37.1 kg/m2 (22.7–54.5 kg/m2) and an overall mean EWL of 59% (7–96%). Patients undergoing LAGB after failed RYGBP lost an additional 20.8% EWL (6–58%)
What all of that means is that they took 11 people who had only lost, on average, 38% of their excess weight after a Roux-en-Y procedure. After they received a gastric band, they lost an additional 20.8% on average. It looks to me like some of them even got down to what would be considered “goal weight”. Good deal.
Anyway, good news for those of you who have failed to hit your goal with Roux-en-Y surgeries. Don’t get cynical. If this is important to you, talk to your doctor about a Lap Band.
I’ve written about this before, but I think it’s always good for a repeat. So many people hesitate to have weight loss surgery because they are concerned that there will be problems, and besides, surely they can lose the weight without such extremities.
To my mind, weight loss surgery is no more extreme than any other type of medical treatment. If I break my leg, I’m gonna get a cast on it, and I’m not going to engage in supersitious thinking that my broken leg is punishment for bad behavior and I therefore should heal without medical intervention. That’s just nonsense. It’s like the stigma against mental health treatment – schizophrenics can’t stop being schizophrenic. Depressed people can’t snap out of it. These are all medical conditions with medical treatments. Sometimes there are herbs that do the trick and sometimes accupuncture is the way to go. And most of us wind up with traditional western medicine of one kind or the other. The point is that if having a treatment will add years to your life – do it. Most of us have families who love us and want and need us around as long as they can have us. What’s wrong with giving your kids who love you an extra ten years? How many of us have grandparents or parents or even kids that we wish would have stayed among us longer?
A group from Monash University in Australia presented mortality data from two Melbourne cohorts [2]. A single surgical cohort of 1468 patients treated with laparoscopic adjustable gastric banding (LAGB) using the LapBand was compared with an established population-based cohort, the Melbourne Collaborative Cohort Study. Five deaths occurred in almost 6000 patient years in the surgical cohort, with vital status available for 98%. This group was compared with 2000 obese subjects in the Melbourne Collaborative Cohort Study. Five deaths occurred in almost 6000 patient years in the surgical cohort, with vital status available for 98%. This group was compared with 2000 obese subjects in the Melbourne Collaborative Cohort Study cohort in which 225 deaths occurred in 25,000 patient years. Adjusted Cox regression analysis revealed a 73% reduction in the mortality rate in the surgically treated cohort (hazard ratio 0.27, 95% confidence interval 0.09–0.81). The investigators concluded that LAGB surgery provided a significant survival advantage for this severely obese population.
Now, this study in Utah on gastric bypass found a 40% reduction in the risk of death, with a bizarre stipulation:
A collaborative research project conducted in Utah compared mortality in 8172 patients who had undergone gastric bypass surgery in a single practice with the same number of community controls matched for age, gender, and body mass index [3]. This latter cohort was matched with the surgical cohort using a community driving license data set. Vital status was assessed using the National Death Index. The gastric bypass cohort had a 40% reduction in mortality (P 0.001). Significant reductions in deaths related to coronary artery disease, diabetes, and cancer occurred, but deaths related to accidents, poisonings, and suicide were significantly greater in the surgically treated group. This long-term study, with 18 years of follow-up, represents the largest gastric bypass cohort followed for mortality.
I don’t even know what to say about that, but I’d love to hear what the doctors think.
I just checked in with Dr. Chris Oliver, my favorite Lap Band blogger. He’s 16 months post-banding and has lost 55% of his excess weight. He’s riding in bicycle tournaments, competing in triathalons and he looks great. If you haven’t read his Lap Band blog, by all means, check in. Being a physician, he writes with a level of detail and precision we don’t get with most Lap Band bloggers.
Anyway, he’s blogging about Dr. Jean Biagini and Dr. Lamissa Karam’s Lap Band study out of Lebanon that followed 591 patients with an average BMI of 41.95 (that’s our 5’4″ woman at 235 and our 5’11” man at 290) that had a Lap Band procedure. Fifty-one of the patients wound up having their Lap Bands removed. The researchers followed their weight loss for up to ten years. After the first year, the patients had lost, on average, 66% of their excess weight. At the end of the second year, they had lost, on average, 72% of their excess weight. At the end of four years, 75.9%. And, most delightfully, at the end of six years they had lost, on average, 82.8% of their excess weight! How exciting to learn that people continue to lose as time goes on.
If you want to check your BMI, you may do so here. For the newbies, most insurance standards require that you have a BMI of 35 with at least two co-morbidities – meaning high blood pressure, diabetes, sleep apnea or high cholesterol before they will cover it. If you have a BMI over 40, usually you don’t need the co-morbidities. I have a link to a list of the standards for several dozen insurance companies here.
I was just looking around Lap Band Talk – an absolutely superb forum for people interested in Lap Bands – and discovered that thave a forum for teenagers who have questions about Lap Bands. The youngest bandee is fifteen though I know surgeons are doing Lap Band procedures on adolescents as young as twelve.
If you’re a parent of a teenager wrestling with obesity, some of the surgeons with New Hope Bariatrics work with teens as do several of the clinics in Mexico. Before you get the willies about going out of country for surgery on your child, just know that most of the surgeons who do Lap Band procedures in the US were actually trained by doctors from Mexico. Dr. Rumbaut, Dr. Ariel Ortiz, and Dr. Lopez Corvala all have a vast amount of experience working with Lap Bands.
Here’s a very brief assessment of a study on teens and Lap Bands, just in case you’re nervous that it’s completely inappropriate.
Diets and exercise just don’t work – let’s face it. Fewer than 5% of people who lose weight through diet and exercise manage to keep it off. There are reasons for this, as I have written about before, that have nothing to do with self-discipline. You can’t lose weight and keep it off for some very sturdy evolutionary reasons – your body likes having all that handy-dandy energy just packed away for a rainy day. Or more precisely, a non-rainy season. So when you lose weight, after a certain amount, your body starts cranking down your metabolism. Youve been losing weight on 1200 calories a day? No more. That fifteen pounds you’ve lost that has you feeling svelte is gonna come right back, if your body has any say over the situation. And your body does have say over the situation. So, your metabolism goes down and your hunger level goes up. Your body floods you with chemicals that make you feel hungrier than you’ve ever felt. Oh, you think you’re just being undisciplined and you feel guilty for eating. But that’s not what’s happening. Your body is pushing you to eat, eat, eat, and it’s slowing your metabolism down so that you can pack the weight right back on. Good bye, little red dress. Hello, big black dress. Have you ever stood in the kitchen eating something, hating yourself for eating it because you’re actually losing weight, but you can’t stop because you’re so darn hungry? That’s normal. That’s your body functioning as it should. The curious thing is that obese people’s bodies functions normally when they’re heavy and their bodies cease to function normally when they lose weight. Factor in that we now know that around 75% of weight gain is genetic, and we’re all in a dire situation.
Look, there are lots of reasons to lose weight besides vanity – you’ll live longer. And if you’re like most people, you have family who love you and want you to live as long as possible. That right there is good reason to do it. You’ll be happier. And more physically comfortable. And you’ll probably earn more money. And have more sex. So with all those motivations, if losing weight was really possible, you would do it. Some of us master the literally Sisyphean task of weight loss and peel off 120 pounds or maybe more. But then, because of biological imperatives, we gain it back again. Over and over.
That’s where Lap Bands come in. Dr. Favretti, one of the first surgeons to work with Lap Bands, completed a 12 year study on the effectiveness of Lap Bands and the news is good – people don’t gain the weight back. The study covered over 1700 patients over twelve years both morbidly obese and super obese. The average weight of the patients started out around 260 pounds plus or minus 37 pounds with an average BMI of 42.6 – that’s our 5’3″ woman at 236 pounds or our 5’10” guy at 292 pounds. At the end, they weighed on average 185 pounds plus or minus 60 pounds with an average BMI of 31.6 – putting our woman at 175 pounds and our man at 216.
If you want to check your BMI, you can do so here at the Centennial Treatment Center For Obesity in Nashville, Tennessee.
I know all of you reading this think, “Oh no, I want to lose a lot more weight than that!” Well, of course you do, and as far as I can tell, you can. You do have to exercise though and to make that point, I’m going to quote Dr. William Lee of Blue Earth, Minnesota in the Mankato Free Press:
Lee said his patients can be divided into two groups, those who shed 6 to 8 pounds a month and patients who lose 10 to 15 pounds a month. “The difference between these two groups,” he said, “is exercise.”
So, just keep that in mind – you’re gonna have to buy a trampoline, a pair of Nordic Walking Poles or get yourself a backyard treadmill. And if you do, and if you follow the doctor’s directions, and get yourself into a support group, you’re going to have a really good shot at getting down to the tiny little person you’d really rather be. 🙂
I know I have a lot of people checking to find out whether Lap Bands are appropriate for adolescents. I’ve featured several stories about kids who have lost a tremendous amount of weight with Lap Bands and are much happier for it. The key is that you must be serious about losing weight and be capable of eating reasonably.
If you’re a teenager in Southern California, and you’re interesting in having a Lap Band procedure, UCSD may be looking for you.
Millions of adults have turned to surgery when diet and exercise don’t work. Now, with childhood obesity sharply on the rise, researchers are exploring whether surgery may be a viable option for teens. As part of a multi-center clinical trial, UCSD Medical Center will evaluate whether or not a minimally invasive procedure called gastric banding is a safe and effective weight loss treatment in obese adolescents ages 14-17.
“Gastric banding is known to be highly successful in adults. The question to answer is whether or not the procedure can help morbidly obese teens, who on average are overweight by more than 100 pounds,” said Santiago Horgan, M.D., director of the UCSD Center for the Treatment of Obesity. “Over a period of five years, we will closely monitor the patient’s weight, in addition to their overall health and well being.”
Here is the short version of what they are looking for:
The nationwide study population will consist of 150 adolescents recruited from seven weight management centers. Twenty two participants will be recruited at UCSD Medical Center. Potential participants must demonstrate a history of obesity for at least two years and have failed more conservative non-surgical weight-reduction alternatives such as a supervised diet, exercise, and behavior modification programs.
And here is their contact info along with a statement of purpose by the researching physician:
“By addressing obesity at an early age, we may be able to avoid life-threatening conditions such as diabetes, cardiovascular disease, and depression,” said Horgan who has performed more than 1,000 gastric banding procedures. “In the long run this could potentially save billions of dollars now spent on obesity related healthcare.”
UCSD Medical Center has a comprehensive program dedicated to the holistic treatment of obesity. Through a compassionate team approach, patients and their families are offered leading-edge medical care combined with nutritional training, fitness counseling, and psychological support.
To learn more about the gastric banding clinical trial for adolescents, including potential risks and side effects, call UCSD Medical Center at 619-471-0447 or email misresearch@ucsd.edu.
This press release is from last summer, so the program may be full already, but it seems to me that if you’re a teenager who needs to lose over 100 pounds, it would be more than worth it to contact them and see what the story is.
Here’s an interesting study from a year ago. For those of you who are pre-diabetic, I think you’ll be interested.
NEW YORK (Reuters Health) – After having “lap band” surgery for weight loss, men and women show large increases in sensitivity to the blood-sugar-regulating hormone insulin — even if they remain obese — a new study shows.
From Dr. Joan Carroll, at the University of North Texas Health Science Center (can you imagine what their business cards look like?) in Fort Worth:
To investigate, Carroll and her team have been following 37 lap band patients for up to one year. Those followed for six months have lost 23 kilograms (51 pounds), on average, while average weight loss for those who have been followed for a year is 34 kg (75 pounds).
Their level of insulin resistance had fallen by 60 percent after six months, she told Reuters Health, even though the patients remained clinically obese.
Given that resistance to insulin greatly increases the risk of developing type 2 diabetes, which has a number of other health consequences including heart disease and even amputations, “over the long term it’s really a benefit for all the body systems,” Carroll said.
Lorraine Kay, in her interview, talks about needing 120 units of insulin a day and that, of course, made losing weight impossible. Her diabetes is in full remission.
From a study at the University of Illinois at Chicago, we find out just how quickly patients get to leave insulin behind:
For example, nearly all patients stopped requiring insulin injections by postoperative day 2, owing to caloric restriction, he said.
Now, admittedly, you’re living on soup broth and there’s nothing there to toy with your blood sugar. Still, for people who live with injecting themselves, to learn that there is way to reliably lose weight and that insulin injections can cease almost immediately is very good news.
And, of course, there’s the other good news we already know:
Hadar Spivak, MD, from Emory University Hospital in Atlanta, reported on the health effects of this procedure in a separate study involving 535 patients. After at least 16 months of follow-up, Dr. Spivak and colleagues observed statistically significant improvements in gastroesophageal reflux disease (GERD), hypertension, diabetes, hyperlipidemia, asthma, and diabetes (P < .05).
These researchers assessed the health impact of the procedure by monitoring changes in medication use. “We’ve been asked whether decreased medication is a good way to judge this,” Dr. Spivak said. “We think it is, because we are independent of the primary care physician; they have full control [over patient medication].”
I just received this press release from New Jersey’s Bariatric Center’s Dr. Ajay Goyal on bariatric surgery and pregnancy. He says that pregnancy is safe for a Lap Band patient six months after surgery, though there may not have been enough weight loss in that time frame to prevent obesity related complications. Lastly, he says nutritional supplements are a necessity since you will be eating such small amounts of food.
New Jersey Bariatric Center’s Ten Guidelines to Follow for a Safe Pregnancy Post-Surgery:
1. Avoid pregnancy for one year after weight loss surgery
2. Take multivitamins (Vitamin A, B1, B12, Iron, Folic Acid)
3. Make regular appointments with your bariatric surgeon and obstetrician
4. Obtain regular blood test to check for vitamin deficiency
5. Eat multiple small meals a day (at least four meals per day) and spend 30 minutes to eat each meal
6. Eat high-protein, low-carbohydrates and a low fat diet
7. Take 30 grams of proteins in supplements
8. Drink plenty of water (40 – 60 ounces per day)
9. Continue regular low impact exercise for both body and mind
10. For lap band or realize band patients, one can remove the restriction by an adjustment if patients develop pregnancy related nausea.
The National Institute of Health maintains a website that links to thousands of open medical studies that are looking for participants. I thought I’d post the link and maybe someone will find a study that helps pay for part of their surgery, or provides the surgery entirely. Wouldn’t that be nice? I’d search “Lap Bands”, gastric banding, laparoscopic gastric banding and bariatric surgery.
This is interesting – a study being done involving 150 morbidly obese teenagers who are having Lap Band procedures to see if gastric banding is an effective means for dealing with teen obesity. I can’t imagine much worse than being an obese teen – it’s painful enough when you’re trim.
The nationwide study population will consist of 150 adolescents recruited from seven weight management centers. Twenty two participants will be recruited at UCSD Medical Center. Potential participants must demonstrate a history of obesity for at least two years and have failed more conservative non-surgical weight-reduction alternatives such as a supervised diet, exercise, and behavior modification programs.
“By addressing obesity at an early age, we may be able to avoid life-threatening conditions such as diabetes, cardiovascular disease, and depression,” said Horgan who has performed more than 1,000 gastric banding procedures. “In the long run this could potentially save billions of dollars now spent on obesity related healthcare.
On Dr. Ortiz‘ site, he has a testimonial from Cassie, a 13 year old girl who has had a lap band procedure, and who was apparently on the Oprah Winfrey show this year. Hopefully, I can find something on YouTube later. His Obesity Control Center will perform surgeries on people from 13 up. They have a host of psychological tests they put the kids through, and go from there. They also have a support group just for kids as well.
“It took more than a year to get our study approved, but since then, it’s gone very well.”
The FDA approved the procedure for adults in June 2001.
By this year, it was all Drs. Kevin Montgomery and Brad Watkins, weight-loss-surgery specialists, wanted to perform.
“We sat around one day saying we would never let someone in our family have gastric-bypass surgery performed on them, so why were we still doing it?” Watkins said. “With gastric bypass, you have to stay overnight in the hospital, and [Lap-Band surgery] is done laparoscopically as an outpatient procedure.”
The two recently opened the Northwest Weight Loss Surgery center, performing Lap-Band surgeries on adults. Seeing the problem of obesity in children, the two decided to join NYU, the Minimally Invasive Bariatric Center in Chicago and other facilities in conducting studies on youths.
The same basic standards apply to kids as apply to adults, however, in the case of the teens, the doctors are performing the surgeries at the hospital rather than at the surgery center.
The Northwest Weight Loss Surgery center will conduct up to 50 surgeries on youths 16 and 17 who have a body-mass index (BMI) of 40 or higher, or a BMI of 35 with a serious health problem related to obesity. The index is a height-to-weight ratio that provides a rough estimate of body fat. A normal BMI is about 25.
The center expects to perform the operations on youths over three to five years. Locally, though most adult Lap-Band surgeries are completed at the center, one requirement of the study is that all adolescent procedures be completed at the Kirkland hospital.
One of the things we do is confuse obesity with immorality. We see excess weight, even in children, as evidence of moral failure and dump enormous amounts of shame on the obese. It’s sadistic, literally. Shaming people for situations they have very little control over is incredibly manipulative and destructive. To my mind, the more kids we can pull out of that cycle early, the better we are as a culture.
I’m going to do more reading on teenagers and Lap Bands. This is interesting stuff.
Love My Lap Band! 