Belief that intentional weight loss is harmful to seniors is unfounded

Winston-Salem, NC – A new study by researchers at Wake Forest University Baptist Medical Center is the first to refute the widely held belief that intentional weight loss in older adults leads to increased risk of death.

In fact, the research shows that seniors who intentionally exercised and/or modified their diets to lose weight were half as likely to die within eight years of follow-up as their peers who did not work toward weight loss, said M. Kyla Shea, Ph.D., first author on the study and a research associate in the Department of Internal Medicine, Section on Gerontology and Geriatric Medicine.

“It was an unusually strong and surprising finding,” Shea said. “Our data suggest that people should not be concerned about trying or recommending weight loss to address obesity-related health problems in older adults.”

The study, funded by the National Institute on Aging, is currently available online and is schedule to appear in a future print issue of the Journal of Gerontology: Medical Sciences.

Prior to this study, research that has looked at the association between mortality and weight loss has not factored in the many different potential causes of the weight loss. So, using a more rigorous randomized trial approach, Shea and colleagues sought to prove or disprove the idea that older individuals who actively tried to lose weight increased their risk of death.

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Obese Teens Who Receive Gastric Banding Achieve Significant Weight Loss

Chicago — A higher percentage of severely obese adolescents who received laparoscopic adjustable gastric banding lost more than 50 percent of excess weight and experienced greater benefits to health and quality of life compared to those in an intensive lifestyle management program, according to a study in the February 10 issue of JAMA.

Adolescent obesity is a serious health challenge globally. In the U.S., more than 17.4 percent, or more than 5 million adolescents were obese in 2004, an increase from 14.8 percent in 2000. Obesity is associated with both immediate and late health effects and reduced life expectancy, according to background information in the article. Lifestyle programs that have included changes in diet, exercise, and behavior to promote weight loss often have poor results. “Bariatric surgery is now extensively used for adults and is being evaluated for adolescents,” the authors write. “Laparoscopic adjustable gastric banding (gastric banding) has the potential to provide a safe and effective treatment.”

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Overweight children may develop back pain and spinal abnormalities

Chicago – Being overweight as a child could lead to early degeneration in the spine, according to a study presented at the annual meeting of the Radiological Society of North America (RSNA).

“This is the first study to show an association between increased body mass index (BMI) and disc abnormalities in children,” said the study’s lead author, Judah G. Burns, M.D., fellow in diagnostic neuroradiology at The Children’s Hospital at Montefiore in New York City.

In this retrospective study, Dr. Burns and colleagues reviewed MR images of the spines of 188 adolescents between the ages of 12 and 20 who complained of back pain and were imaged at the hospital over a four-year period. Trauma and other conditions that would predispose children to back pain were eliminated from the study.

The images revealed that 98 (52.1 percent) of the patients had some abnormality in the lower, or lumbar, spine. Most of those abnormalities occurred within the discs, which are sponge-like cushions in between the bones of the spine. Disc disease occurs when a bulging or ruptured disc presses on nerves, causing pain or weakness.

“In children, back pain is usually attributed to muscle spasm or sprain,” Dr. Burns said. “It is assumed that disc disease does not occur in children, but my experience says otherwise.”

According to the Centers for Disease Control and Prevention, 15 percent of U.S. children (age 6 – 11) and 18 percent of U.S. adolescents (age 12 -19) are overweight. BMI, a mathematical ratio of body weight and height, is a widely used measurement for obesity. Lower BMI is associated with being underweight or a healthy body size; higher BMI scores are associated with being overweight or obese. Children above the 85th percentile are generally classified as overweight or at risk of being overweight.

The researchers were able to determine an age-adjusted BMI for 106 of the total 188 patients. Fifty-four had BMI greater than the 75th percentile for age. Thirty-seven (68.5 percent) of these children showed abnormal findings on their spine MRI. Fifty-two patients fell into the lowest three quartiles. Only 18 (34.6 percent) of the children at or below a healthy weight had an abnormal MRI of the spine.

“We observed a trend toward increased spine abnormality with higher BMI,” Dr. Burns said. “These results demonstrate a strong relationship between increased BMI in the pediatric population and the incidence of lumbar disc disease.”

According to Dr. Burns, data revealed in the study could signal a significant public health problem given the health costs of back pain in the U.S.

“Back pain causes significant morbidity in adults, affecting quality of life and the ability to be productive,” he said.

Source: Radiological Society of North America

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Lap band surgery effective for morbidly obese children

In FDA-approved trial, adolescents had 45 percent weight loss two years after surgery

Washington, DC — A surgeon at Children’s National Medical Center and his colleagues from New York University have found laparoscopic adjustable gastric banding (Lap band) to improve the health of morbidly obese adolescents.

The study, published in the Journal of the American College of Surgeons, involved nearly 50 girls and boys ages 14-17. The participants showed significant decreases in total and android fat mass 2 years after surgery. Android fat has been linked to the development of obesity-related illnesses, such as diabetes, heart disease, and insulin resistance.

“This study is the first to demonstrate the improvements in overall health and distribution of weight loss after Lap band surgery in adolescents,” said Evan Nadler, MD, the lead author and pediatric surgeon at Children’s National. “While weight-loss surgery should always be a last resort for adults and adolescents, these findings show us that surgery in adolescents reduces the risk of significant health complications.”

The study found that Lap band surgery improved glucose metabolism, reducing the adolescents’ risk of developing insulin resistance. Additionally, bone mineral density was not impacted by the surgery, suggesting that bone growth is not affected.

Dr. Nadler is the co-director of the Obesity Institute at Children’s National Medical Center, which is comprehensively addressing the epidemic of childhood obesity. Staff includes pediatricians, nutritionists, psychologists, cardiologists, gastroenterologists, and surgeons who treat patients and families in a clinical setting. The Obesity Institute also includes researchers looking at genetic differences and racial disparities, particularly among children and adolescents, as well as community-based research among different ethnic groups.

Dr. Nadler was an investigator for Allergan, which makes the device used in the study. Funding was provided by the Harris Obesity Prevention Effort at New York University and performed at NYU Medical Center.

Source: www.childrensnational.org

Linking weight loss to less sleep apnea

Temple-led study, the largest of its kind, finds weight loss has significant impact on the disorder

More than 12 million people in the U.S. suffer from sleep apnea, most common among the overweight and obese. More than just loud snoring, it can lead to high blood pressure, stroke, cardiovascular disease and a poor quality of life. For years, doctors have told patients with sleep apnea that their best bet for alleviating it would be to lose weight, but there’s been very little research-based evidence to prove that.

“Existing research has been limited by a number of factors, so there are very few studies that show whether the recommended amount of weight loss – about 10 percent – is enough to sufficiently improve sleep apnea,” said Gary Foster, director of the Center for Obesity Research and Education.

Foster and colleagues from six other universities recently completed the largest randomized study on the effects of weight loss on sleep apnea in patients with type 2 diabetes. They found that among patients with severe sleep apnea, those who lost the recommended weight were three times more likely to nearly eliminate the number of sleep apnea episodes compared to those who did not lose weight. The results are published in the Sept. 28 issue of the Archives of Internal Medicine.

The new study, called Sleep AHEAD, looked at 264 obese patients with type 2 diabetes already enrolled in the Look AHEAD trial, an ongoing 16-site study investigating the long-term health impact of an intensive lifestyle intervention in 5,145 overweight or obese adults with type 2 diabetes. Participants were between 45 and 75 years old.

The 264 participants were broken into two randomized groups: the first received a group behavioral weight loss program developed especially for obese patients with type 2 diabetes, portion-controlled diets, and a prescribed exercise regimen of 175 minutes per week. The second attended three group informational sessions over a one-year period that focused on diabetes management through diet, physical activity and social support.

After one year, members of the first group lost an average of 24 pounds. More than three times as many participants in this group had complete remission of their sleep apnea (13.6 percent compared to 3.5 percent), and also had about half the instances of severe sleep apnea as the second group. Further, participants in the second group only lost about a pound, and saw significant worsening of their sleep apnea, which suggested to Foster and his team that without treatment, the disorder can progress rapidly.

“These results show that doctors as well as patients can expect a significant improvement in their sleep apnea with weight loss,” said Foster, the study’s lead author. “And a reduction in sleep apnea has a number of benefits for overall health and well-being.”

For more information about weight loss benefits don’t hesitate to contact us.

Weight-Loss Surgery Can Break a Family’s Cycle of Obesity

New study finds the intrauterine environment may determine whether a child is destined to become obese

Adolescent and young children of obese mothers who underwent weight-loss surgery prior to pregnancy have been found to have a lower prevalence of obesity and significantly improved cardio-metabolic markers when compared to siblings born before the same obese mothers had weight-loss surgery. This new study has been accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM).

Obesity can lead to insulin resistance, cardiovascular disease and pregnancy complications and is a major contributor to causes of death in industrialized nations. Previous studies of obese pregnant women have shown that obesity and its co-morbidities can be transmitted to their children, which indicates that the intrauterine environment may determine whether a child at birth is already destined to become obese.

“Our study confirms previous research showing that the intrauterine environment may be more important than genes and the post-natal environment when it comes to the association between maternal obesity and childhood obesity,” said John Kral, MD, PhD, of SUNY Downstate Medical Center in Brooklyn, N.Y. and co-author of the study. “Any medical or surgical treatment to reduce obesity and existing metabolic disorders before pregnancy can be an investment in the life of future offspring.”

Weight-loss surgery limits the amount of food a person can consume. Some of these operations also restrict the amount of food that can be digested. This particular study focused on women who had undergone biliopancreatic diversion (BPD) prior to becoming pregnant. BPD changes the normal process of digestion by making the stomach smaller and directing food to bypass part of the small intestine resulting in fewer calorie absorption.

Specifically, researchers studied 49 mothers who had undergone BPD surgery and their 111 children (between the ages of 2.5 and 25 years). All mothers in this study had children born before and then after their weight-loss surgery. The research found that children who were born after their mother underwent weight-loss surgery had reduced birth weight and waist circumference and were three times less likely to become severely obese. Furthermore, children born after their mother’s weight-loss surgery had improved cardiovascular markers including reduced insulin resistance and lower cholesterol.

“To our knowledge, our paper is the first to demonstrate that dramatic maternal weight loss causes metabolic improvements in their children,” said Kral. “Our findings show that obese women should be encouraged to lose weight before becoming pregnant, and then, once pregnant, should limit their weight gain. For those women interested in both surgical treatment and having children, we believe surgery should come first. Preventing obesity and treating it effectively in young women could prevent further transmission to future generations.”

Other researchers working on the study include J. Smith, K. Cianflone, S. Simard and Picard Marceau of the Centre de Recherche Institut Universitaire de Cardiologie et Pneumologie de Quebec in Canada; S. Biron, S. Lebel, S. Marceau, O. Lescelleur and L. Biertho of Laval University in Quebec, Canada; and J.G. Kral of SUNY Downstate Medical Center in Brooklyn, N.Y.

The article, “Effects of maternal surgical weight loss on intergenerational transmission of obesity,” will appear in the November 2009 issue of JCEM.

For information about weight loss surgery in Argentina feel free to contact our surgeon Norman Jalil.

Source: The Endocrine Society

Weight loss Before and After Photos: Gastric Bypass

In general defined, gastric bypass surgery describes any bariatric procedure that alters the digestive tract so that certain parts are “bypassed”. The food when passes through this altered tract, the body absorbs from it less calories than usual. The gastric bypass is the operation more commonly used to neutralize obesity.

Here are some photos before and after a gastric bypass surgery. For more information feel free to contact Doctor Norman Jalil.