Love My Lap Band!

Everything you want to know about life and weight loss with a Lap Band!

Posts Tagged ‘metabolic syndrome’

Lap Band Surgery Patients Lose More Weight

Posted by Lori on July 25, 2009

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, the surgical 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, only 8 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.

Good to know.


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Lap Bands and Weight Loss For Teens

Posted by Lori on July 9, 2009

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.

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Lap Bands and Caffeine II

Posted by Lori on February 18, 2008

I’m getting a lot of traffic through here wondering whether caffeine is allowed after a lap band. I suspect the question is about drinking coffee, so we are dealing with three separate issues in this case:
1. coffee
2. caffeine
3. artificial sweetners

Some of the physician sites warn against drinking coffee because it is a diuretic and thus, causes your body to lose fluid. And because bandees are restricted in the amount they can consume, they must be careful to drink proper amounts of water. If your cup of coffee is flushing the fluids you do drink right back out, that’s bad for you especially if you’re getting just enough in the first place. Other physicians are fine with coffee but require you to drink it black or use sweeteners.

However, caffeine itself may well be a problem for people who want to lose weight. Researchers at Duke University have now documented that caffeine causes blood glucose level to spike (at least in Type 2 diabetics) after meals and that alone, my friend, will make it harder for you to lose weight – most likely whether you are diabetic or not (though the referenced study only deals with diabetics).

Sweetners are also problematic. A recent study by Lyn Steffen at the University of Minnesota found that people who consumed even one can of diet soda a day were more likely to develop metabolic syndrome –the collection of risk factors for cardiovascular disease and diabetes that include abdominal obesity, high cholesterol and blood glucose levels, and elevated blood pressure – than people who didn’t. What researchers suspect is that your body tasting something sweet, gears up for a big calorie dump. When it doesn’t get the calories it’s expecting, it responds by holding on even tighter to the next batch of calories it does get and you gain weight.

In short, there is not an accepted standard on the issue of caffeine consumption and lap bands. From the point of view of this coffee and tea with cream and sweetner lover, there is plenty of reason to avoid both caffeine and artificial sweetners if your goal is weight loss. What to do? What to do? Listen to your doctor, I guess.

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