CHAPEL HILL, NC — Some simple interventions used by pediatricians were enough to change a parent’s perspective about a child’s being overweight or obese, and change the parent’s behaviors at home to reduce those risks.
According to a study performed in North Carolina Children’s Hospital, researchers confirmed previous reports that parents of overweight or obese children do not recognize their child’s weight problem. But this time, by arming pediatricians with a “toolkit,” an easily used chart and a series of questions and suggestions, the researchers addressed several problems.
“Doctors often don’t have time to discuss overweight; they don’t have the tools to do it; and many aren’t confident that they’re going to make a difference in their patients’ lives,” said Eliana Perrin, MD, MPH, assistant professor of pediatrics at the University of North Carolina at Chapel Hill School of Medicine and lead author of the study, published in the July-August issue of Academic Pediatrics.
Nov 2, 2010
Overeating!
According to a new study accepted for publication in The Endocrine Society’s Journal of Clinical Endocrinology & Metabolism (JCEM), eating a meal quickly, as compared to slowly, curtails the release of hormones in the gut that induce feelings of being full. The decreased release of these hormones, can often lead to overeating.
“Most of us have heard that eating fast can lead to food overconsumption and obesity, and in fact some observational studies have supported this notion,” said Alexander Kokkinos, MD, PhD, of Laiko General Hospital in Athens Greece and lead author of the study. “Our study provides a possible explanation for the relationship between speed eating and overeating by showing that the rate at which someone eats may impact the release of gut hormones that signal the brain to stop eating.”
In the last few years, research regarding gut hormones, such as peptide YY (PYY) and glucagon-like peptide (GLP-1), has shown that their release after a meal acts on the brain and induces satiety and meal termination. Until now, concentrations of appetite-regulating hormones have not been examined in the context of different rates of eating.
In this study, subjects consumed the same test meal, 300ml of ice-cream, at different rates. Researchers took blood samples for the measurement of glucose, insulin, plasma lipids and gut hormones before the meal and at 30 minute intervals after the beginning of eating, until the end of the session, 210 minutes later. Researchers found that subjects who took the full 30 minutes to finish the ice cream had higher concentrations of PYY and GLP-1 and also tended to have a higher fullness rating.
“Our findings give some insight into an aspect of modern-day food overconsumption, namely the fact that many people, pressed by demanding working and living conditions, eat faster and in greater amounts than in the past,” said Kokkinos. “The warning we were given as children that ‘wolfing down your food will make you fat,’ may in fact have a physiological explanation.”
Other researchers working on the study include Kleopatra Alexiadou, Nicholas Tentolouris, Despoina Kyriaki, Despoina Perrea and Nicholas Katsilambros of Athens University Medical School in Greece; and Carel le Roux, Royce Vincent, Mohammad Ghatei and Stephen Bloom of Imperial College in London, United Kingdom.
The article, “Eating slowly increases the postprandial response of the anorexigenic gut hormone, Peptide YY and Glucagon like peptide-1,” will appear in the January 2010 issue of JCEM.
“Most of us have heard that eating fast can lead to food overconsumption and obesity, and in fact some observational studies have supported this notion,” said Alexander Kokkinos, MD, PhD, of Laiko General Hospital in Athens Greece and lead author of the study. “Our study provides a possible explanation for the relationship between speed eating and overeating by showing that the rate at which someone eats may impact the release of gut hormones that signal the brain to stop eating.”
In the last few years, research regarding gut hormones, such as peptide YY (PYY) and glucagon-like peptide (GLP-1), has shown that their release after a meal acts on the brain and induces satiety and meal termination. Until now, concentrations of appetite-regulating hormones have not been examined in the context of different rates of eating.
In this study, subjects consumed the same test meal, 300ml of ice-cream, at different rates. Researchers took blood samples for the measurement of glucose, insulin, plasma lipids and gut hormones before the meal and at 30 minute intervals after the beginning of eating, until the end of the session, 210 minutes later. Researchers found that subjects who took the full 30 minutes to finish the ice cream had higher concentrations of PYY and GLP-1 and also tended to have a higher fullness rating.
“Our findings give some insight into an aspect of modern-day food overconsumption, namely the fact that many people, pressed by demanding working and living conditions, eat faster and in greater amounts than in the past,” said Kokkinos. “The warning we were given as children that ‘wolfing down your food will make you fat,’ may in fact have a physiological explanation.”
Other researchers working on the study include Kleopatra Alexiadou, Nicholas Tentolouris, Despoina Kyriaki, Despoina Perrea and Nicholas Katsilambros of Athens University Medical School in Greece; and Carel le Roux, Royce Vincent, Mohammad Ghatei and Stephen Bloom of Imperial College in London, United Kingdom.
The article, “Eating slowly increases the postprandial response of the anorexigenic gut hormone, Peptide YY and Glucagon like peptide-1,” will appear in the January 2010 issue of JCEM.
Oct 15, 2010
Staying Away From Halloween Candy!
It happens every year…we vow not to gain weight over the holidays. Most people assume the trouble begins with Thanksgiving, but for many people the weight gain actually starts around Halloween. Follow these simple guidelines to keep from going overboard with the Halloween candy this year.
Tip #1 Avoid candy all together. Buy healthier Halloween treats like bags of pretzels, granola bars or sugarless gum, or pass out non-edible treats like stickers or Halloween pencils.
Tip #2 Buy Halloween candy at the last minute. Don’t buy bags and bags of candy three weeks before Halloween, even if it is on sale. The money you might save is insignificant compared to the extra calories and extra pounds you’ll put on from the inevitable candy binge.
Tip #3 Don’t overbuy. It’s better to run out of candy and shut the lights off early then it is to have piles of tempting treats leftover. If you do end up with extra candy donate it to a local homeless shelter or community center. Keep in mind some places have rules about donations so be sure to check into that ahead of time.
Tip #4 Out of sight out of mind. Don’t keep a big bowl of Halloween candy on the kitchen or living room table. You’ll be too tempted to grab a piece every time you walk by. Store it in a hard to reach place like a top shelf that you need to stand on a chair to get to or ask a reliable family member to store (or hide) extra candy for you.
Tip #5 Buy candy you don’t like. If Reese’s peanut butter cups are your all-time favorite candy, then don’t buy them to pass out to your trick-or-treaters. Why torture yourself?
Tip #6 Don’t skip meals. Skipping meals to allow for extra candy calories is not the way to go. Doing this will only make you more likely to over-indulge. Continue with your regular healthy eating plan and allow yourself a piece or two as a special treat.
Tip #7 Stay active. Keeping up with your normal fitness routine becomes even more important over the holidays. You may even want to add an extra 10 or 20 minutes of cardio to allow for those extra Halloween goodies.
Don’t make Halloween the enemy this year. Set realistic goals by ditching the “all or nothing” mentality. Focus on weight maintenance instead of weigh loss. Trying to stay away from the candy and failing is worse than allowing yourself some pre-planned leeway. "Giving in" can be associated with feelings of weakness and guilt that can drive you to emotionally eat. Maintain control by giving yourself permission beforehand to enjoy a few treats then get back on track.
Happy Halloween!
Tip #1 Avoid candy all together. Buy healthier Halloween treats like bags of pretzels, granola bars or sugarless gum, or pass out non-edible treats like stickers or Halloween pencils.
Tip #2 Buy Halloween candy at the last minute. Don’t buy bags and bags of candy three weeks before Halloween, even if it is on sale. The money you might save is insignificant compared to the extra calories and extra pounds you’ll put on from the inevitable candy binge.
Tip #3 Don’t overbuy. It’s better to run out of candy and shut the lights off early then it is to have piles of tempting treats leftover. If you do end up with extra candy donate it to a local homeless shelter or community center. Keep in mind some places have rules about donations so be sure to check into that ahead of time.
Tip #4 Out of sight out of mind. Don’t keep a big bowl of Halloween candy on the kitchen or living room table. You’ll be too tempted to grab a piece every time you walk by. Store it in a hard to reach place like a top shelf that you need to stand on a chair to get to or ask a reliable family member to store (or hide) extra candy for you.
Tip #5 Buy candy you don’t like. If Reese’s peanut butter cups are your all-time favorite candy, then don’t buy them to pass out to your trick-or-treaters. Why torture yourself?
Tip #6 Don’t skip meals. Skipping meals to allow for extra candy calories is not the way to go. Doing this will only make you more likely to over-indulge. Continue with your regular healthy eating plan and allow yourself a piece or two as a special treat.
Tip #7 Stay active. Keeping up with your normal fitness routine becomes even more important over the holidays. You may even want to add an extra 10 or 20 minutes of cardio to allow for those extra Halloween goodies.
Don’t make Halloween the enemy this year. Set realistic goals by ditching the “all or nothing” mentality. Focus on weight maintenance instead of weigh loss. Trying to stay away from the candy and failing is worse than allowing yourself some pre-planned leeway. "Giving in" can be associated with feelings of weakness and guilt that can drive you to emotionally eat. Maintain control by giving yourself permission beforehand to enjoy a few treats then get back on track.
Happy Halloween!
Healthy Eating
Healthy eating begins with learning how to “eat smart”—it’s not just what you eat, but how you eat. Your food choices can reduce your risk of illnesses such as heart disease, cancer, and diabetes, as well as defend against depression. Additionally, learning the habits of healthy eating can improve your health by boosting your energy, sharpening your memory and stabilizing your mood. Expand your range of healthy food choices and learn how to plan ahead to create and maintain a satisfying, healthy diet.
Healthy eating tip 1: Set yourself up for success
To set yourself up for success, think about planning a healthy diet as a number of small, manageable steps rather than one big drastic change. If you approach the changes gradually and with commitment, you will have a healthy diet sooner than you think.
• Simplify. Instead of being overly concerned with counting calories or measuring portion sizes, think of your diet in terms of color, variety and freshness—then it should be easier to make healthy choices. Focus on finding foods you love and easy recipes that incorporate a few fresh ingredients. Gradually, your diet will become healthier and more delicious.
• Start slow and make changes to your eating habits over time. Trying to make your diet healthy overnight isn’t realistic or smart. Changing everything at once usually leads to cheating or giving up on your new eating plan. Make small steps, like adding a salad (full of different color vegetables) to your diet once a day or switching from butter to olive oil when cooking. As your small changes become habit, you can continue to add more healthy choices to your diet.
• Every change you make to improve your diet matters. You don’t have to be perfect and you don’t have to completely eliminate foods you enjoy to have a healthy diet. The long term goal is to feel good, have more energy and reduce the risk of cancer and disease. Don’t let your missteps derail you—every healthy food choice you make counts.
Think of exercise as a food group in your diet.
Find something active that you like to do and add it to your day, just like you would add healthy greens, blueberries or salmon. The benefits of lifelong exercise are abundant and regular exercise may even motivate you to make healthy food choices a habit.
Healthy eating tip 2: Moderation is key
People often think of healthy eating as an all or nothing proposition, but a key foundation for any healthy diet is moderation. Despite what certain fad diets would have you believe, we all need a balance of carbohydrates, protein, fat, fiber, vitamins, and minerals to sustain a healthy body.
• Try not to think of certain foods as “off limits.” When you ban certain foods or food groups, it is natural to want those foods more, and then feel like a failure if you give in to temptation. If you are drawn towards sweet, salty or unhealthy foods, start by reducing portion sizes and not eating them as often. Later you may find yourself craving them less or thinking of them as only occasional indulgences.
• Think smaller portions. Serving sizes have ballooned recently, particularly in restaurants. When dining out, choose a starter instead of an entrée, split a dish with a friend, and don’t order supersized anything. At home, use smaller plates, think about serving sizes in realistic terms and start small. Visual cues can help with portion sizes—your serving of meat, fish or chicken should be the size of a deck of cards. A teaspoon of oil or salad dressing is about the size of a matchbook and your slice of bread should be the size of a CD case.
Healthy eating tip 3: It's not just what you eat, it's how you eat
Healthy eating is about more than the food on your plate—it is also about how you think about food. Healthy eating habits can be learned and it is important to slow down and think about food as nourishment rather than just something to gulp down in between meetings or on the way to pick up the kids.
• Eat with others whenever possible. Eating with other people has numerous social and emotional benefits—particularly for children—and allows you to model healthy eating habits. Eating in front of the TV or computer often leads to mindless overeating.
• Take time to chew your food and enjoy mealtimes. Chew your food slowly, savoring every bite. We tend to rush though our meals, forgetting to actually taste the flavors and feel the textures of what is in our mouths. Reconnect with the joy of eating.
• Listen to your body. Ask yourself if you are really hungry, or have a glass of water to see if you are thirsty instead of hungry. During a meal, stop eating before you feel full. It actually takes a few minutes for your brain to tell your body that it has had enough food, so eat slowly.
• Eat breakfast, and eat smaller meals throughout the day. A healthy breakfast can jumpstart your metabolism, and eating small, healthy meals throughout the day (rather than the standard three large meals) keeps your energy up and your metabolism going.
Healthy eating tip 4: Fill up on colorful fruits and vegetables
Fruits and vegetables are the foundation of a healthy diet—they are low in calories and nutrient dense, which means they are packed with vitamins, minerals, antioxidants and fiber. Fruits and vegetables should be part of every meal and your first choice for a snack—aim for a minimum of five portions each day. The antioxidants and other nutrients in fruits and vegetables help protect against certain types of cancer and other diseases.
Eat a rainbow of fruits and vegetables every day—the brighter the better.
The brighter, deeper colored fruits and vegetables contain higher concentrations of vitamins, minerals and antioxidants—and different colors provide different benefits. Some great choices are:
• Greens: Greens are packed with calcium, magnesium, iron, potassium, zinc, vitamins A, C, E and K, and they help strengthen the blood and respiratory systems. Be adventurous with your greens and branch out beyond bright and dark green lettuce—kale, mustard greens, broccoli, Chinese cabbage are just a few of the options.
• Sweet vegetables: Naturally sweet vegetables add healthy sweetness to your meals and reduce your cravings for other sweets. Some examples of sweet vegetables are corn, carrots, beets, sweet potatoes or yams, winter squash, and onions.
• Fruit: A wide variety of fruit is also vital to a healthy diet. Fruit provides fiber, vitamins and antioxidants. Berries are cancer-fighting, apples provide fiber, oranges and mangos offer vitamin C, and so on.
Don’t forget to shop fresh and local whenever possible
The local farmer’s market, fruit stand or Community Supported Agriculture (CSA) group are great ways to get access to fresh, local produce.
Avoid: Fruit juices, which can contain up to 10 teaspoons of sugar per cup; avoid or dilute with water. Canned fruit is often in sugary syrup, and dried fruit, while an excellent source of fiber, can be high in calories. Avoid fried veggies and those with dressings or sauces—too much unhealthy fat and calories.
Water—a vital part of a healthy diet
Water makes up about 75% of our bodies and helps flush our systems of waste products and toxins. Yet many people go through life dehydrated—causing tiredness, low energy and headaches.
Caffeinated beverages, in particular, actually cause the body to lose water. Fresh fruits and vegetables, on the other hand, contain plenty of water and can help with hydration, especially when you are looking for an alternative to your eighth glass of water for the day.
Healthy eating tip 5: Eat more healthy carbs and whole grains
Choose healthy carbohydrates and fiber sources, especially whole grains, for long lasting energy. In addition to being delicious and satisfying, whole grains are rich in phytochemicals and antioxidants, which help to protect against coronary heart disease, certain cancers, and diabetes. Studies have shown people who eat more whole grains tend to have a healthier heart.
Healthy eating tip 1: Set yourself up for success
To set yourself up for success, think about planning a healthy diet as a number of small, manageable steps rather than one big drastic change. If you approach the changes gradually and with commitment, you will have a healthy diet sooner than you think.
• Simplify. Instead of being overly concerned with counting calories or measuring portion sizes, think of your diet in terms of color, variety and freshness—then it should be easier to make healthy choices. Focus on finding foods you love and easy recipes that incorporate a few fresh ingredients. Gradually, your diet will become healthier and more delicious.
• Start slow and make changes to your eating habits over time. Trying to make your diet healthy overnight isn’t realistic or smart. Changing everything at once usually leads to cheating or giving up on your new eating plan. Make small steps, like adding a salad (full of different color vegetables) to your diet once a day or switching from butter to olive oil when cooking. As your small changes become habit, you can continue to add more healthy choices to your diet.
• Every change you make to improve your diet matters. You don’t have to be perfect and you don’t have to completely eliminate foods you enjoy to have a healthy diet. The long term goal is to feel good, have more energy and reduce the risk of cancer and disease. Don’t let your missteps derail you—every healthy food choice you make counts.
Think of exercise as a food group in your diet.
Find something active that you like to do and add it to your day, just like you would add healthy greens, blueberries or salmon. The benefits of lifelong exercise are abundant and regular exercise may even motivate you to make healthy food choices a habit.
Healthy eating tip 2: Moderation is key
People often think of healthy eating as an all or nothing proposition, but a key foundation for any healthy diet is moderation. Despite what certain fad diets would have you believe, we all need a balance of carbohydrates, protein, fat, fiber, vitamins, and minerals to sustain a healthy body.
• Try not to think of certain foods as “off limits.” When you ban certain foods or food groups, it is natural to want those foods more, and then feel like a failure if you give in to temptation. If you are drawn towards sweet, salty or unhealthy foods, start by reducing portion sizes and not eating them as often. Later you may find yourself craving them less or thinking of them as only occasional indulgences.
• Think smaller portions. Serving sizes have ballooned recently, particularly in restaurants. When dining out, choose a starter instead of an entrée, split a dish with a friend, and don’t order supersized anything. At home, use smaller plates, think about serving sizes in realistic terms and start small. Visual cues can help with portion sizes—your serving of meat, fish or chicken should be the size of a deck of cards. A teaspoon of oil or salad dressing is about the size of a matchbook and your slice of bread should be the size of a CD case.
Healthy eating tip 3: It's not just what you eat, it's how you eat
Healthy eating is about more than the food on your plate—it is also about how you think about food. Healthy eating habits can be learned and it is important to slow down and think about food as nourishment rather than just something to gulp down in between meetings or on the way to pick up the kids.
• Eat with others whenever possible. Eating with other people has numerous social and emotional benefits—particularly for children—and allows you to model healthy eating habits. Eating in front of the TV or computer often leads to mindless overeating.
• Take time to chew your food and enjoy mealtimes. Chew your food slowly, savoring every bite. We tend to rush though our meals, forgetting to actually taste the flavors and feel the textures of what is in our mouths. Reconnect with the joy of eating.
• Listen to your body. Ask yourself if you are really hungry, or have a glass of water to see if you are thirsty instead of hungry. During a meal, stop eating before you feel full. It actually takes a few minutes for your brain to tell your body that it has had enough food, so eat slowly.
• Eat breakfast, and eat smaller meals throughout the day. A healthy breakfast can jumpstart your metabolism, and eating small, healthy meals throughout the day (rather than the standard three large meals) keeps your energy up and your metabolism going.
Healthy eating tip 4: Fill up on colorful fruits and vegetables
Fruits and vegetables are the foundation of a healthy diet—they are low in calories and nutrient dense, which means they are packed with vitamins, minerals, antioxidants and fiber. Fruits and vegetables should be part of every meal and your first choice for a snack—aim for a minimum of five portions each day. The antioxidants and other nutrients in fruits and vegetables help protect against certain types of cancer and other diseases.
Eat a rainbow of fruits and vegetables every day—the brighter the better.
The brighter, deeper colored fruits and vegetables contain higher concentrations of vitamins, minerals and antioxidants—and different colors provide different benefits. Some great choices are:
• Greens: Greens are packed with calcium, magnesium, iron, potassium, zinc, vitamins A, C, E and K, and they help strengthen the blood and respiratory systems. Be adventurous with your greens and branch out beyond bright and dark green lettuce—kale, mustard greens, broccoli, Chinese cabbage are just a few of the options.
• Sweet vegetables: Naturally sweet vegetables add healthy sweetness to your meals and reduce your cravings for other sweets. Some examples of sweet vegetables are corn, carrots, beets, sweet potatoes or yams, winter squash, and onions.
• Fruit: A wide variety of fruit is also vital to a healthy diet. Fruit provides fiber, vitamins and antioxidants. Berries are cancer-fighting, apples provide fiber, oranges and mangos offer vitamin C, and so on.
Don’t forget to shop fresh and local whenever possible
The local farmer’s market, fruit stand or Community Supported Agriculture (CSA) group are great ways to get access to fresh, local produce.
Avoid: Fruit juices, which can contain up to 10 teaspoons of sugar per cup; avoid or dilute with water. Canned fruit is often in sugary syrup, and dried fruit, while an excellent source of fiber, can be high in calories. Avoid fried veggies and those with dressings or sauces—too much unhealthy fat and calories.
Water—a vital part of a healthy diet
Water makes up about 75% of our bodies and helps flush our systems of waste products and toxins. Yet many people go through life dehydrated—causing tiredness, low energy and headaches.
Caffeinated beverages, in particular, actually cause the body to lose water. Fresh fruits and vegetables, on the other hand, contain plenty of water and can help with hydration, especially when you are looking for an alternative to your eighth glass of water for the day.
Healthy eating tip 5: Eat more healthy carbs and whole grains
Choose healthy carbohydrates and fiber sources, especially whole grains, for long lasting energy. In addition to being delicious and satisfying, whole grains are rich in phytochemicals and antioxidants, which help to protect against coronary heart disease, certain cancers, and diabetes. Studies have shown people who eat more whole grains tend to have a healthier heart.
Sep 16, 2010
Study Finds Bariatric Surgery Lowers Gestational Diabetes Risk
But weight loss procedure has its own set of risks, experts note
THURSDAY, Sept. 9 (HealthDay News) -- Obese women who have weight loss surgery before they get pregnant are three times less likely to develop gestational diabetes and are also less likely to require a cesarean section, a new study finds.
U.S. researchers compared rates of gestational diabetes and related outcomes such as cesarean delivery among 346 obese women who had bariatric surgery before pregnancy and 354 obese women who had bariatric surgery after delivery. Most of the women in the study had a gastric bypass operation, with some opting for an adjustable band procedure.
Rates of gestational diabetes were 8 percent for those who had the surgery before pregnancy and 27 percent for those who had the surgery after delivery. Rates of cesarean delivery were 28 percent and 43 percent, respectively.
Makary and colleagues noted that most of the women who underwent weight-loss surgery did not wait the recommended two years afterwards before delivering a baby.
The study appears in the August issue of the Journal of the American College of Surgeons.
"Despite a growing body of evidence supporting the safety and efficacy of bariatric surgery in reversing obesity-related complications, few candidates for the procedure are referred to a surgeon to discuss their options," senior author Dr. Martin Makary, an associate professor of surgery at Johns Hopkins University School of Medicine, said in a journal news release.
Like all operations, however, bariatric surgery is not without risk. Potential complications, for example, include blood clots, infection, respiratory arrest, gastrointestinal bleeding, and death, according to the American Society for Metabolic & Bariatric Surgery.
THURSDAY, Sept. 9 (HealthDay News) -- Obese women who have weight loss surgery before they get pregnant are three times less likely to develop gestational diabetes and are also less likely to require a cesarean section, a new study finds.
U.S. researchers compared rates of gestational diabetes and related outcomes such as cesarean delivery among 346 obese women who had bariatric surgery before pregnancy and 354 obese women who had bariatric surgery after delivery. Most of the women in the study had a gastric bypass operation, with some opting for an adjustable band procedure.
Rates of gestational diabetes were 8 percent for those who had the surgery before pregnancy and 27 percent for those who had the surgery after delivery. Rates of cesarean delivery were 28 percent and 43 percent, respectively.
Makary and colleagues noted that most of the women who underwent weight-loss surgery did not wait the recommended two years afterwards before delivering a baby.
The study appears in the August issue of the Journal of the American College of Surgeons.
"Despite a growing body of evidence supporting the safety and efficacy of bariatric surgery in reversing obesity-related complications, few candidates for the procedure are referred to a surgeon to discuss their options," senior author Dr. Martin Makary, an associate professor of surgery at Johns Hopkins University School of Medicine, said in a journal news release.
Like all operations, however, bariatric surgery is not without risk. Potential complications, for example, include blood clots, infection, respiratory arrest, gastrointestinal bleeding, and death, according to the American Society for Metabolic & Bariatric Surgery.
The Last One Picked: Psychological Implications of Childhood Obesity
Children are often cruel to one another, and one can often see evidence of this when it comes to sports and the infamous “choosing of sides”. The slow, unskilled, the unpopular and, finally, the overweight child, are nearly always chosen last. This action may have devastating and long-lasting effects on a child’s self-esteem and spirit. While physical problems, such as hypertension, orthopedic problems, diabetes, metabolic syndrome and sleep disorders are complications associated with obesity, the psychological effects associated with obesity can be just as devastating to a child and his or her family.
Being obese today has an impact on both how children view themselves and how others see them. Many children with weight problems develop low self-esteem, which may in turn, give way to emotional and behavioral problems such as depression, defiance, bullying and poor school performance.
The Centers for Disease Control and Prevention has defined specific criteria for both overweight and obesity. Overweight is defined as having an age appropriate BMI between the 85th and 94th percentile, while obesity is defined as having a BMI in excess of the 95th percentile. BMI can be useful in estimating whether a child is overweight. It is calculated by dividing a child’s weight in kilograms by his or her height as meters squared. The incidence of obesity has doubled among 6- to 11-year-olds and tripled in 12- to 17-year-olds since 1980.
When working with the obese child, the physician should be looking not only at physical problems related to and often caused by obesity, but behavioral and emotional problems as well. The psychological impact of obesity has far-reaching implications for a child as they mature into young adults.
Being obese today has an impact on both how children view themselves and how others see them. Many children with weight problems develop low self-esteem, which may in turn, give way to emotional and behavioral problems such as depression, defiance, bullying and poor school performance.
The Centers for Disease Control and Prevention has defined specific criteria for both overweight and obesity. Overweight is defined as having an age appropriate BMI between the 85th and 94th percentile, while obesity is defined as having a BMI in excess of the 95th percentile. BMI can be useful in estimating whether a child is overweight. It is calculated by dividing a child’s weight in kilograms by his or her height as meters squared. The incidence of obesity has doubled among 6- to 11-year-olds and tripled in 12- to 17-year-olds since 1980.
When working with the obese child, the physician should be looking not only at physical problems related to and often caused by obesity, but behavioral and emotional problems as well. The psychological impact of obesity has far-reaching implications for a child as they mature into young adults.
Sep 8, 2010
Bariatric Surgery in Youth Population
In the past 30 years, the prevalence of overweight among pediatric age groups in the United States has almost tripled. Current conservative estimates indicate that 15.5% of children and adolescents are obese. Rates of obesity among youth are on the rise. Bariatric surgery can be a consideration as a treatment option for those adolescents who have developed extreme obesity. Experts in pediatric obesity and bariatric surgery recommend that surgical treatment only be considered when adolescents have tried for at least six months to lose weight and have not been successful.
Candidates should be extremely obese, have reached their adult height (usually 13 or older for girls and 15 or older for boys), and have serious weight-related health problems. These problems can consist of type 2 diabetes, sleep apnea, hypertension or heart disease.
Over the past few years, gastric bypass surgery has been the predominant operation used to treat adolescent extreme obesity. An estimated 2,700 adolescent bariatric surgeries were performed between 1996 and 2003.
Candidates should be extremely obese, have reached their adult height (usually 13 or older for girls and 15 or older for boys), and have serious weight-related health problems. These problems can consist of type 2 diabetes, sleep apnea, hypertension or heart disease.
Over the past few years, gastric bypass surgery has been the predominant operation used to treat adolescent extreme obesity. An estimated 2,700 adolescent bariatric surgeries were performed between 1996 and 2003.
Weight-Loss Surgery Helps with Certain Illnesses
Morbidly obese individuals with illnesses related to their weight, diabetes for example, have a good chance of losing these sicknesses after undergoing bariatric surgery. There are several types of weight-loss surgery: removing 80% of the stomach, banding or bypassing it. All of which reduce the capacity of the stomach and restoring the patient to normal eating. Obesity has been found to be a clear link with risk of Type 2 diabetes, hypertension and heart disease. Research finds that bariatric surgery can cure these metabolic complications.
One patient who had surgery just ten months ago shared, what he calls, a “life changing experience.” He stated, “My diabetes, blood pressure and gout have all disappeared completely after my surgery.” Studies have shown that patients get rid of their diabetes within just weeks of their surgery.
Weight loss has a close relationship with the disappearance of diabetes. The reason for this is because the pancreas is capable of producing enough insulin to cover the body mass which soon wipes away the existence of diabetes.
The purpose of bariatric surgery is to ensure that a person is restored to health and wellness. Obesity is an excess accumulation of fat, but morbid obesity if not just being lazy and eating heavy—it is a clinical condition. This can be determined by the Body Mass Index (BMI), a waist-hip ratio, and other existing medical conditions. Bariatric surgery may be the next step for those individuals who remain severely obese after trying nonsurgical approaches, especially if they have an obesity-related disease.
One patient who had surgery just ten months ago shared, what he calls, a “life changing experience.” He stated, “My diabetes, blood pressure and gout have all disappeared completely after my surgery.” Studies have shown that patients get rid of their diabetes within just weeks of their surgery.
Weight loss has a close relationship with the disappearance of diabetes. The reason for this is because the pancreas is capable of producing enough insulin to cover the body mass which soon wipes away the existence of diabetes.
The purpose of bariatric surgery is to ensure that a person is restored to health and wellness. Obesity is an excess accumulation of fat, but morbid obesity if not just being lazy and eating heavy—it is a clinical condition. This can be determined by the Body Mass Index (BMI), a waist-hip ratio, and other existing medical conditions. Bariatric surgery may be the next step for those individuals who remain severely obese after trying nonsurgical approaches, especially if they have an obesity-related disease.
Aug 20, 2010
Mobility Disabilities in Obese Patients
The World Health Organization defines a disability as a decrease in a person’s ability to perform normal daily activities. Simple questions such as, did you tie your own shoes today or did you walk a good distance
without looking to rest because you were out of breath, are questions that you should ask yourself when questioning your health conditions. Did you ever think that being overweight could cause a disability? This type of disability is described as a “mobility disability.”
Obesity in early adulthood increases the odds of impairment of activities of daily living (ADLs) by 3.5times. A weight gain of more than 30 pounds between age 25 and ages 45-64 is also associated with impaired ADL’s. Physical activity and general mobility in overweight patients are affected by numerous health conditions. For example, degenerative joint disease, previous joint replacement and excessive adipose tissue are just a few conditions that can be caused by being overweight and can end up limiting one’s activities. Research has shown that the risk of osteoarthritis in the knee is 6.8 times greater in the obese population when compared to the lean population.
Do not let your weight get in the way of living your life!
Aug 16, 2010
BayChoice Bariatric & Digestive Center
BayChoice Bariatric and Digestive Center is a surgical weight-loss practice. Here at BayChoice we specialize and understand weight loss struggles and put forth our effort to help you reach a healthy life and lifestyle. Dr. Kenneth Hollis has practiced laparoscopic surgery for over 20 years. He began in 1989 as one of the first surgeons in the United States to perform minimally invasive procedures. Dr. Hollis and his incredible staff are aimed towards the same goal: to help you achieve your weight loss goals.
Dr. Hollis performs a variety of weight loss surgeries, including the Laparoscopic Gastric Sleeve and the LAP-BAND Adjustable Gastric Banding System. He also enjoys General Surgery cases including Laparoscopic Cholecystectomy, ventral and inguinal hernia repairs. He also performs hiatal hernia repairs for Gastroesophageal Reflux Disease.
Being overweight is a struggle and here at BayChoice Bariatrics we understand that. According to the Centers for Disease Control and Prevention (CDC), 44 million Americans are considered clinically obese. Since 1975, the number of obese Americans has risen from 47 percent to 66.3 percent. Studies have proven that an estimated $75 billion has been spent on obesity-attributable medical expenditures. These numbers are through the roof and put the obesity struggle more into perspective. It has been proven that weight-loss surgery improves Type II diabetes better than a low-calorie diet. It is stated that the short term weight loss by diet alone does not achieve the same improvements in diabetes as bariatric surgery does. Not only are you allowing yourself to live healthier, you feel better about yourself! Diabetes is not the only health consequences weight loss surgery helps. Obesity can cause an increased risk for cancer, hypertension, heart disease and asthma. Having the surgery can reduce these risks and get your life on the right track!
Call us today at 281.482.5300 with any questions or to set up a consultation with the BayChoice Bariatrics team! You can also visit our website at www. BayChoiceBariatrics.com for more information!
Dr. Hollis performs a variety of weight loss surgeries, including the Laparoscopic Gastric Sleeve and the LAP-BAND Adjustable Gastric Banding System. He also enjoys General Surgery cases including Laparoscopic Cholecystectomy, ventral and inguinal hernia repairs. He also performs hiatal hernia repairs for Gastroesophageal Reflux Disease.
Being overweight is a struggle and here at BayChoice Bariatrics we understand that. According to the Centers for Disease Control and Prevention (CDC), 44 million Americans are considered clinically obese. Since 1975, the number of obese Americans has risen from 47 percent to 66.3 percent. Studies have proven that an estimated $75 billion has been spent on obesity-attributable medical expenditures. These numbers are through the roof and put the obesity struggle more into perspective. It has been proven that weight-loss surgery improves Type II diabetes better than a low-calorie diet. It is stated that the short term weight loss by diet alone does not achieve the same improvements in diabetes as bariatric surgery does. Not only are you allowing yourself to live healthier, you feel better about yourself! Diabetes is not the only health consequences weight loss surgery helps. Obesity can cause an increased risk for cancer, hypertension, heart disease and asthma. Having the surgery can reduce these risks and get your life on the right track!
Call us today at 281.482.5300 with any questions or to set up a consultation with the BayChoice Bariatrics team! You can also visit our website at www. BayChoiceBariatrics.com for more information!
Apr 7, 2010
Spring has Sprung!
As we get back into the groove of things and wake up from our winter hibernations - avoiding exercise, indulging in comfort foods, and adding extra pounds - we realize it's time to put away the bulky sweaters and ready ourselves for warmer weather.
With spring comes baseball games, weekend picnics, company crawfish boils, and patio parties, but unless you're careful to watch out for spring's most fattening foods, you may actually notice a few additional pounds rather than shedding your winter weight.
10 Most Fattening Foods for Spring:
1. Ice Cream!
Forget the toppings, candy mix-ins, and waffle cones. Instead stick with just a single scoop of your favorite flavor or better yet, choose frozen yogurt or sorbet. Decide to stock you freezer at home with calorie-controlled ice cream sandwiches or bars and maybe even try the new light ice creams. To me, they taste like the premium brands.
2. Chocolates
Easter, Mother's Day, Father's Day, need I say more. Chocolate is everywhere come Spring and while dark chocolate does show some health benefits in small portions, like an ounce a day. Although they are cute and delicious, try to steer clear of eating the whole chocolate bunny.
3. Seasonal Beverages
Margaritas, iced coffees, ice cream drinks, tropical cocktails and smoothies - beware. Liquid calories add up quickly, especially with a few margaritas under your belt. Be sure to know what is going into your drink and limit the high-calorie offenders.
4. Passover Desserts
Calorie landmines! Passover desserts usually are made with nuts, chocolate, and coconut. A bite or two won't hurt, and instead try to have fruit for dessert.
5. Coconut
You'll find coconut in Spring dishes everywhere. Whether it's shrimp, cream pies, cookies, cakes or smoothies, coconuts are still very high in saturated fat and calories. Stay away from the coconut laden dishes and instead settle for a sprinkle over top here and there for added texture and flavor.
6. Hot Dogs
Whether you like yours plain, with relish, or smothered in chili and cheese, try to limit it to one hot dog with one topping. A hot dog alone is loaded with plenty of sodium and is high in fat.
7. Brunches
Casseroles, quiches, sausage, cheese, butter, cream, cinnamon rolls, pastries, the list goes on. In lieu of hurting feelings or missing out on time with friends and family by all means have brunch, just don't go overboard. Be mindful to select more nutritious options such as whole grain breads, simply prepared egg dishes, sliced meats, and fruit.
8. Salads
Almost everyone enjoys a nice salad on a warm Spring day every now and then. Don't overload the good a salad brings to the table with tons of mayo, such as in chicken or potato salads. You can always swap mayonnaise with a light mayo or include other healthier ingredients like grapes with the chicken salad or green beans with the potatoes.
9. Dressings, Toppings and Sauces
Hollandaise, whipped cream, ranch dressing, they are all amazing yet super high in fat. Choose lighter versions of your favorite topper, keep you calories in check, or just add a little dab.
10. Grill Me!
Spring is when we like to fire up the grill and enjoy our burgers, hot dogs, ribs, and steaks. In moderation and small portions, these are okay. But better yet, why not fill you grill with lower fat items such as grilled poultry, lean meats, fish, fruits, and veggies.
Keep to a healthier diet this Spring. Your body will thank you.
With spring comes baseball games, weekend picnics, company crawfish boils, and patio parties, but unless you're careful to watch out for spring's most fattening foods, you may actually notice a few additional pounds rather than shedding your winter weight.
10 Most Fattening Foods for Spring:
1. Ice Cream!
Forget the toppings, candy mix-ins, and waffle cones. Instead stick with just a single scoop of your favorite flavor or better yet, choose frozen yogurt or sorbet. Decide to stock you freezer at home with calorie-controlled ice cream sandwiches or bars and maybe even try the new light ice creams. To me, they taste like the premium brands.
2. Chocolates
Easter, Mother's Day, Father's Day, need I say more. Chocolate is everywhere come Spring and while dark chocolate does show some health benefits in small portions, like an ounce a day. Although they are cute and delicious, try to steer clear of eating the whole chocolate bunny.
3. Seasonal Beverages
Margaritas, iced coffees, ice cream drinks, tropical cocktails and smoothies - beware. Liquid calories add up quickly, especially with a few margaritas under your belt. Be sure to know what is going into your drink and limit the high-calorie offenders.
4. Passover Desserts
Calorie landmines! Passover desserts usually are made with nuts, chocolate, and coconut. A bite or two won't hurt, and instead try to have fruit for dessert.
5. Coconut
You'll find coconut in Spring dishes everywhere. Whether it's shrimp, cream pies, cookies, cakes or smoothies, coconuts are still very high in saturated fat and calories. Stay away from the coconut laden dishes and instead settle for a sprinkle over top here and there for added texture and flavor.
6. Hot Dogs
Whether you like yours plain, with relish, or smothered in chili and cheese, try to limit it to one hot dog with one topping. A hot dog alone is loaded with plenty of sodium and is high in fat.
7. Brunches
Casseroles, quiches, sausage, cheese, butter, cream, cinnamon rolls, pastries, the list goes on. In lieu of hurting feelings or missing out on time with friends and family by all means have brunch, just don't go overboard. Be mindful to select more nutritious options such as whole grain breads, simply prepared egg dishes, sliced meats, and fruit.
8. Salads
Almost everyone enjoys a nice salad on a warm Spring day every now and then. Don't overload the good a salad brings to the table with tons of mayo, such as in chicken or potato salads. You can always swap mayonnaise with a light mayo or include other healthier ingredients like grapes with the chicken salad or green beans with the potatoes.
9. Dressings, Toppings and Sauces
Hollandaise, whipped cream, ranch dressing, they are all amazing yet super high in fat. Choose lighter versions of your favorite topper, keep you calories in check, or just add a little dab.
10. Grill Me!
Spring is when we like to fire up the grill and enjoy our burgers, hot dogs, ribs, and steaks. In moderation and small portions, these are okay. But better yet, why not fill you grill with lower fat items such as grilled poultry, lean meats, fish, fruits, and veggies.
Keep to a healthier diet this Spring. Your body will thank you.
Health Care 101: How the overhaul will affect you
WASHINGTON, AP – It took lawmakers a year to shape President Barack Obama's health care bill. If it finally passes Congress, it'll take the better part of a decade to write the user manual for consumers and doctors, employers and insurance companies.
Some health insurance consumer protections would go into place immediately, significant but limited in scope. The big expansion in coverage comes in four years. More than 30 million people would sign up, with most getting tax credits to help pay premiums. Ripple effects continue well after Obama has to leave office in 2017, if he's re-elected.
But even if the 2,700-plus-page bill passes, it's only the end of the beginning. The Obama blueprint will be carried out under less-than-ideal circumstances. Rising medical costs and an aging population will keep squeezing the federal budget. Lawmakers will have to revisit hard choices they sidestepped.
"This is going to play out over a generation," said Andrew Hyman, who oversees health insurance research for the nonpartisan Robert Wood Johnson Foundation. "It will address how people get coverage, how health care is delivered, and how health care is paid for."
The House is expected to vote on the final legislation this week, with the Senate to follow later. Here's a primer on some of the major effects for consumers and other key players:
IMMEDIATE CHANGES
Uninsured people with medical problems will have a workable alternative. The bill pumps $5 billion into high-risk insurance pools run by the states to provide coverage to those in frail health. Taxpayer-backed insurance won't be free, but premiums should be much lower than what's charged by private insurers willing to take those in poor health.
For people with private health insurance — about two-thirds of Americans — there would be some new safeguards. For example, insurers would be barred from placing lifetime dollar limits on coverage and from canceling policies except in cases of fraud. Children could stay on their parents' coverage until age 26.
THE SELF-EMPLOYED
Starting in 2014, self-employed people and those whose employers don't offer coverage would be able to pick a plan through a health insurance exchange, like a supermarket. It's modeled on the federal employee health program available to members of Congress, with a range of private plans. Small businesses could also join.
More than 30 million people would buy coverage through state exchanges, and nearly 6 in 10 would be eligible for help with their premiums. The new tax credits would be computed according to income and other household characteristics. The money would go straight to the insurer. To consumers it would look like a discount — generous for lower-income families, less so for those solidly in the middle class.
For example, a family of four making $44,000 would pay $2,763 in premiums _about 6 percent of its income_ for a policy worth $9,435.
But a similar family making $66,000 would have to pay $6,257 in premiums, close to 10 percent of its income. That may be less than a mortgage, but it's more than a car payment.
Once the exchanges open, most Americans would be required to carry health insurance or pay a fine. Medicaid would be expanded to cover childless adults living near poverty.
People with employer-provided insurance would not see major changes. But if they lost their job, they'd be able to get coverage through the exchange.
SENIORS
Seniors have been understandably worried about the health care plan, much of it financed with Medicare cuts the government's own experts say could be unsustainable.
In the crosshairs are subsidies to private Medicare Advantage insurance plans, which now enroll about one-quarter of seniors. The government overpays the plans when compared to the cost of care under traditional Medicare. That largesse translates to lower costs for seniors in the plans, and the overhaul could trigger an exodus from Medicare Advantage as insurers are forced to raise rates to stay in business.
But seniors stand to gain as well. Obama would gradually close the coverage gap in the middle of the Medicare prescription drug benefit. The so-called doughnut hole would start to shrink immediately, but it wouldn't be fully closed until 2020. In the meantime, seniors in the gap would get a 50 percent discount on brand name drugs.
The plan also improves preventive benefits for seniors in traditional Medicare.
DOCTORS
Primary care doctors and general surgeons practicing in underserved areas such as inner cities and rural communities would get a 10 percent bonus from Medicare. But the more significant changes for doctors would unfold slowly. The goal is to start rewarding doctors for keeping patients healthy, not just treating them when they get sick.
The plan would use Medicare as a testing ground for new ways of coordinating care for patients with multiple chronic illnesses such as high blood pressure, diabetes and heart problems, a common combination. Primary care doctors would become care managers for such patients, keeping close tabs on medications and basic health indicators.
Doctors and hospitals would be encouraged to band together in "accountable care organizations" modeled on the Mayo Clinic.
EMPLOYERS
Obama's plan wouldn't require employers to provide insurance to their workers, but it would hit them with a stiff fine if even one of their workers gets a federally subsidized coverage. Companies with 50 or fewer workers would be exempt, and those with 25 workers or fewer could get federal assistance.
But the fines could turn into a big headache for many employers, particularly since they may not be able to tell if their workers are getting benefits from the government. For example, a company with 100 employees that fails to provide coverage could face a fine of $140,000 under the plan Obama unveiled Feb. 22. Getting the bill from the IRS would become a dreaded moment for business owners.
INSURANCE COMPANIES
Health insurance companies would face unprecedented federal regulation and particularly close scrutiny of their bottom line. A fixed percentage of income from premiums would have to go to medical care, otherwise insurers would be forced to provide rebates to consumers. That share is 85 percent for large group plans, and 80 percent for plans in the small group and individual markets.
One of the central reforms of the bill won't start until 2014, when the exchanges open. From then on, insurers will not be able to turn away people with medical problems or charge them more.
Some health insurance consumer protections would go into place immediately, significant but limited in scope. The big expansion in coverage comes in four years. More than 30 million people would sign up, with most getting tax credits to help pay premiums. Ripple effects continue well after Obama has to leave office in 2017, if he's re-elected.
But even if the 2,700-plus-page bill passes, it's only the end of the beginning. The Obama blueprint will be carried out under less-than-ideal circumstances. Rising medical costs and an aging population will keep squeezing the federal budget. Lawmakers will have to revisit hard choices they sidestepped.
"This is going to play out over a generation," said Andrew Hyman, who oversees health insurance research for the nonpartisan Robert Wood Johnson Foundation. "It will address how people get coverage, how health care is delivered, and how health care is paid for."
The House is expected to vote on the final legislation this week, with the Senate to follow later. Here's a primer on some of the major effects for consumers and other key players:
IMMEDIATE CHANGES
Uninsured people with medical problems will have a workable alternative. The bill pumps $5 billion into high-risk insurance pools run by the states to provide coverage to those in frail health. Taxpayer-backed insurance won't be free, but premiums should be much lower than what's charged by private insurers willing to take those in poor health.
For people with private health insurance — about two-thirds of Americans — there would be some new safeguards. For example, insurers would be barred from placing lifetime dollar limits on coverage and from canceling policies except in cases of fraud. Children could stay on their parents' coverage until age 26.
THE SELF-EMPLOYED
Starting in 2014, self-employed people and those whose employers don't offer coverage would be able to pick a plan through a health insurance exchange, like a supermarket. It's modeled on the federal employee health program available to members of Congress, with a range of private plans. Small businesses could also join.
More than 30 million people would buy coverage through state exchanges, and nearly 6 in 10 would be eligible for help with their premiums. The new tax credits would be computed according to income and other household characteristics. The money would go straight to the insurer. To consumers it would look like a discount — generous for lower-income families, less so for those solidly in the middle class.
For example, a family of four making $44,000 would pay $2,763 in premiums _about 6 percent of its income_ for a policy worth $9,435.
But a similar family making $66,000 would have to pay $6,257 in premiums, close to 10 percent of its income. That may be less than a mortgage, but it's more than a car payment.
Once the exchanges open, most Americans would be required to carry health insurance or pay a fine. Medicaid would be expanded to cover childless adults living near poverty.
People with employer-provided insurance would not see major changes. But if they lost their job, they'd be able to get coverage through the exchange.
SENIORS
Seniors have been understandably worried about the health care plan, much of it financed with Medicare cuts the government's own experts say could be unsustainable.
In the crosshairs are subsidies to private Medicare Advantage insurance plans, which now enroll about one-quarter of seniors. The government overpays the plans when compared to the cost of care under traditional Medicare. That largesse translates to lower costs for seniors in the plans, and the overhaul could trigger an exodus from Medicare Advantage as insurers are forced to raise rates to stay in business.
But seniors stand to gain as well. Obama would gradually close the coverage gap in the middle of the Medicare prescription drug benefit. The so-called doughnut hole would start to shrink immediately, but it wouldn't be fully closed until 2020. In the meantime, seniors in the gap would get a 50 percent discount on brand name drugs.
The plan also improves preventive benefits for seniors in traditional Medicare.
DOCTORS
Primary care doctors and general surgeons practicing in underserved areas such as inner cities and rural communities would get a 10 percent bonus from Medicare. But the more significant changes for doctors would unfold slowly. The goal is to start rewarding doctors for keeping patients healthy, not just treating them when they get sick.
The plan would use Medicare as a testing ground for new ways of coordinating care for patients with multiple chronic illnesses such as high blood pressure, diabetes and heart problems, a common combination. Primary care doctors would become care managers for such patients, keeping close tabs on medications and basic health indicators.
Doctors and hospitals would be encouraged to band together in "accountable care organizations" modeled on the Mayo Clinic.
EMPLOYERS
Obama's plan wouldn't require employers to provide insurance to their workers, but it would hit them with a stiff fine if even one of their workers gets a federally subsidized coverage. Companies with 50 or fewer workers would be exempt, and those with 25 workers or fewer could get federal assistance.
But the fines could turn into a big headache for many employers, particularly since they may not be able to tell if their workers are getting benefits from the government. For example, a company with 100 employees that fails to provide coverage could face a fine of $140,000 under the plan Obama unveiled Feb. 22. Getting the bill from the IRS would become a dreaded moment for business owners.
INSURANCE COMPANIES
Health insurance companies would face unprecedented federal regulation and particularly close scrutiny of their bottom line. A fixed percentage of income from premiums would have to go to medical care, otherwise insurers would be forced to provide rebates to consumers. That share is 85 percent for large group plans, and 80 percent for plans in the small group and individual markets.
One of the central reforms of the bill won't start until 2014, when the exchanges open. From then on, insurers will not be able to turn away people with medical problems or charge them more.
Doctors Ponder Health Care Reform's Impact
HOUSTON, Jeremy Desel/11 News -- The health care reform plan is leaving many doctors with questions about the long-term health of their practices.
“Reimbursement? Money? Making money?--We are also making a living. You know, we are not going to compromise people’s health, but it is a business," said Houston doctor Roland Maldonado.
Doctors depend on negotiated rates with insurance companies -- companies doctors expect will want to pay less from now on because of health insurance reform.
The Obama administration is claiming the bill will have immediate impacts, like removing pre-existing conditions exclusions for children, adding patient protections, extending coverage to young adults under their parents' plans and protections from rescinding insurance when claims are filed.
In actuality, those headline-grabbing items don't really take effect for six months.
University of Houston economist Scott Imberman said that is not unusual.
"As far as changes in law go, six months is about as immediate as you are going to get," he said.
But it may have an impact on some patients, especially those who could have coverage dropped due to claims.
"The insurance company may kind of speed up that timeline, and say, well we are not going to be able to drop them six months from now so we might as well go ahead and drop them now," Imberman said.
That could leave adult patients exposed until pre-existing conditions exclusions are banned four years from now.
In the end, health care reform may well be like many of the conditions Maldonado sees in his patients.
"Wait and see how it really affects us over time," he said.
“Reimbursement? Money? Making money?--We are also making a living. You know, we are not going to compromise people’s health, but it is a business," said Houston doctor Roland Maldonado.
Doctors depend on negotiated rates with insurance companies -- companies doctors expect will want to pay less from now on because of health insurance reform.
The Obama administration is claiming the bill will have immediate impacts, like removing pre-existing conditions exclusions for children, adding patient protections, extending coverage to young adults under their parents' plans and protections from rescinding insurance when claims are filed.
In actuality, those headline-grabbing items don't really take effect for six months.
University of Houston economist Scott Imberman said that is not unusual.
"As far as changes in law go, six months is about as immediate as you are going to get," he said.
But it may have an impact on some patients, especially those who could have coverage dropped due to claims.
"The insurance company may kind of speed up that timeline, and say, well we are not going to be able to drop them six months from now so we might as well go ahead and drop them now," Imberman said.
That could leave adult patients exposed until pre-existing conditions exclusions are banned four years from now.
In the end, health care reform may well be like many of the conditions Maldonado sees in his patients.
"Wait and see how it really affects us over time," he said.
Mar 26, 2010
Erin Asprec Named CEO of Memorial Hermann Southeast
The Memorial Hermann Healthcare System recently announced the appointment of Erin Asprec as CEO of Memorial Hermann Southeast.
"I look forward to the opportunity to work closely with the physician leadership and employees at Memorial Hermann Southeast to continue to expand upon the high quality clinical care and patient-and family-centered services provided to our community," said Asprec.
For the past six years, she has served as the CEO of the Memorial Hermann Heart and Vascular Institute-Texas Medical Center. Asprec began her career with the Memorial Hermann Healthcare System in 2002, working as the director of business development and then as the executive liaison to Dan Wolterman, the President and CEO of the system.
“Erin has made a lasting, positive impact on the care we provide to patients at the Memorial Hermann-TMC Campus,” said Juanita Romans, CEO of Memorial Hermann-Texas Medical Center and Memorial Hermann’s Central Market Leader. “I am confident that she will bring her talent and skill as a leader to the Southeast Campus.”
Under Asprec’s leadership, the Memorial Hermann Heart and Vascular Institute moved into a new home in 2008 becoming the first free-standing heart hospital in the area. The Institute has also earned a range of prestigious honors from several leading organizations, including Thomson Reuters, the Institute for Healthcare Improvement and the American Heart Association.
Asprec completed her undergraduate studies in Chemistry at The University of Texas at Austin in 1994 and later earned a Masters in Healthcare Administration from Saint Louis University. Asprec and her family currently reside in Pearland, TX.
"I look forward to the opportunity to work closely with the physician leadership and employees at Memorial Hermann Southeast to continue to expand upon the high quality clinical care and patient-and family-centered services provided to our community," said Asprec.
For the past six years, she has served as the CEO of the Memorial Hermann Heart and Vascular Institute-Texas Medical Center. Asprec began her career with the Memorial Hermann Healthcare System in 2002, working as the director of business development and then as the executive liaison to Dan Wolterman, the President and CEO of the system.
“Erin has made a lasting, positive impact on the care we provide to patients at the Memorial Hermann-TMC Campus,” said Juanita Romans, CEO of Memorial Hermann-Texas Medical Center and Memorial Hermann’s Central Market Leader. “I am confident that she will bring her talent and skill as a leader to the Southeast Campus.”
Under Asprec’s leadership, the Memorial Hermann Heart and Vascular Institute moved into a new home in 2008 becoming the first free-standing heart hospital in the area. The Institute has also earned a range of prestigious honors from several leading organizations, including Thomson Reuters, the Institute for Healthcare Improvement and the American Heart Association.
Asprec completed her undergraduate studies in Chemistry at The University of Texas at Austin in 1994 and later earned a Masters in Healthcare Administration from Saint Louis University. Asprec and her family currently reside in Pearland, TX.
Mar 22, 2010
Prevalence of Impaired Glucose Tolerance (Diabetes) among Children and Adolescents with Marked Obesity
The recent epidemic of Childhood Obesity has also been accompanied by an increase in the prevalence of Type 2 Diabetes among children and adolescents. Thus are the findings of a Yale University School of Medicine study in a multi-ethnic group of 167 obese children and adolescents.
Impaired glucose tolerance was found in 25 percent of the 55 obese children ages 4-10 years of age and 21 percent of the 112 obese adolescents ages 11-18 years of age. While, Type 2 Diabetes, "the silent killer", was found in 4 percent of the obese adolescents. To read more about the study click here.
The study concluded that impaired glucose tolerance is highly prevalent among children and adolescents with severe obesity regardless of their respective ethnic group.
Impaired glucose tolerance was found in 25 percent of the 55 obese children ages 4-10 years of age and 21 percent of the 112 obese adolescents ages 11-18 years of age. While, Type 2 Diabetes, "the silent killer", was found in 4 percent of the obese adolescents. To read more about the study click here.
The study concluded that impaired glucose tolerance is highly prevalent among children and adolescents with severe obesity regardless of their respective ethnic group.
Recent Obesity Trends Will Snuff Out Health Gains from Decline in Smoking
Researchers from Harvard and Michigan have concluded that the health consequences of obesity in our population will offset the health gains made by our population's significant reduction in smoking. The study's conclusion states that the increase in life expectancy that our population should experience as a result of decreased smoking behavior, will be reduced due to the dramatic increase in obesity. Most alarming, if past trends continue, nearly half of our population - 45 percent - will be obese by the year 2020.
To read the full Harvard Science study, click here...
To read the full Harvard Science study, click here...
Mar 19, 2010
8 Minutes a Day to Tone Your Upper Body
You've made it through your weight loss journey. Now what? Whether it's the little black dress in winter or, for men, stripping down to your shorts in summer, those wobbly bits around the upper arms, chest and back can easily spoil the look. Here's an 8 minute body toning workout to banish the wobbly bits.
Equipment Needed
Any exercise aimed at toning your body needs something to provide resistance for your muscles to work against. Most of the exercises below use hand-held weights to provide resistance: these can be as simple as water bottles (or even tins of food) you can grip comfortably, or dumbbells in the range of 1lb-5lb/0.5-2kg.Timing and Repetitions
10 reps of each exercise should take about 8 minutes. As with all exercise you should warm-up first. Marching or jogging on the spot for a few minutes interspersed with some gentle stretches will do the trick.Caution
Body toning exercise can be a pretty painful experience if muscles have lain dormant for a while. The problem is, it's not until 24-48hrs after your workout that you'll realize you've overdone it! Body toning exercises should not be painful while you are doing them - if it is you're using too much weight. If you've not been exercising your muscles recently it's best to start with a weight that feels "very easy" and build up gradually from there.The Workout
Exercise 1 - Chest and Shoulders
Lie on your back and grasp your weights with the palms of your hands facing up, and your arms outstretched to the sides. With your elbows slightly bent, lift your arms above your chest until your hands are almost touching. Return to starting position and repeat.Exercise 2 - Chest and Shoulders
Lie on your back and grasp your weights with the palms of your hands facing up, and your arms outstretched above your head. Grip your weights and bring them over your head and down to your hips, by your sides - a semi-circular motion. Lift back to starting position and repeat.Exercise 3 - Chest and Back
Sitting with your back straight (preferably supported) and legs straight out in front of you, hold your weights in at your chest with your elbows out to the side (parallel to the floor). Push your arms out straight in front of you then pull them back in. Repeat.Exercise 4 - Back and Shoulders
Stand with feet shoulder width apart and arms by your sides, gripping the weights with palms facing outwards. Making sure your movements are slow and concentrated, tense your shoulder and upper back muscles, then slowly "shrug" them up and down.Exercise 5 - Shoulders and Upper Arms
Stand with feet shoulder width apart and arms raised straight up above your head, grip your weights with your palms facing behind you. Slowly bring your arms forward and down, without bending at the elbow, until level with your shoulders. Lift back to starting position and repeat.Exercise 6 - Upper Arms, Shoulders and Back
Standing with feet slightly apart, grasp your weights and bend at the waist until your torso is parallel to the floor. Extend your arms towards the floor with palms facing outwards. Lift your arms out to the side, keeping them straight, until parallel to the floor. Return to the starting position and repeat.Exercise 7 - Upper Arms, Shoulders and Back
Standing with feet slightly apart, position your arms straight down in front of you almost against your body - with your weights almost touching. Bend your elbows and lift your weights towards your chin, bringing your elbows out to the side, in line with your shoulders. Return to the starting position and repeat.Exercise 8 - Arms and Chest
The classic push up. With your hands shoulder width apart place your palms on the floor. Stretch out your body with either your knees on the floor, or if you're feeling ambitious, your toes - so you are supporting your body weight. Keeping your back straight and using your arms lower yourself gently toward the floor until you are hovering just over it. Push yourself slowly back to your starting position and repeat. Remember - don't lower yourself to the point where you come into contact with the floor, it'll be much harder to push back up.Exercise 9 - Arms
In a sitting position with your back straight, relax your arms in line with your body. Grip your weights with your palms facing upwards and curl them up towards your shoulders, then back down again. Repeat. Keep your torso still and back straight, let your arms do the work.Exercise 10 - Forearms
Holding your weight with your arm outstretched in front of you, tilt your wrist up and down repeatedly. Try doing this with both an overhand and underhand grip on your weight. Do one arm at a time.Mar 17, 2010
Under Obama Plan, Health Premiums Would Rise
Mar. 15: President Obama is introduced by Connie Anderson, sister of cancer patient Natoma Canfield, who wrote the president saying she could no longer afford her health insurance premiums.
AP, WASHINGTON -- Buyers, beware: President Barack Obama says his health care overhaul will lower premiums by double digits, but check the fine print.
Premiums are likely to keep going up even if the health care bill passes, experts say. If cost controls work as advertised, annual increases would level off with time. But don't look for a rollback. Instead, the main reason premiums would be more affordable is that new government tax credits would help cover the cost for millions of people.
Listening to Obama pitch his plan, you might not realize that's how it works.
Visiting a Cleveland suburb this week, the president described how individuals and small businesses will be able to buy coverage in a new kind of health insurance marketplace, gaining the same strength in numbers that federal employees have.
"You'll be able to buy in, or a small business will be able to buy into this pool," Obama said. "And that will lower rates, it's estimated, by up to 14 to 20 percent over what you're currently getting. That's money out of pocket." And that's not all.
Obama asked his audience for a show of hands from people with employer-provided coverage, what most Americans have. "Your employer, it's estimated, would see premiums fall by as much as 3,000 percent," said the president, "which means they could give you a raise."
A White House press spokesman later said the president misspoke; he had meant to say annual premiums would drop by $3,000. It could be a long wait.
"There's no question premiums are still going to keep going up," said Larry Levitt of the Kaiser Family Foundation, a research clearinghouse on the health care system. "There are pieces of reform that will hopefully keep them from going up as fast. But it would be miraculous if premiums actually went down relative to where they are today."
The statistics Obama based his claims on come from two sources. (READ MORE...)
Premiums are likely to keep going up even if the health care bill passes, experts say. If cost controls work as advertised, annual increases would level off with time. But don't look for a rollback. Instead, the main reason premiums would be more affordable is that new government tax credits would help cover the cost for millions of people.
Listening to Obama pitch his plan, you might not realize that's how it works.
Visiting a Cleveland suburb this week, the president described how individuals and small businesses will be able to buy coverage in a new kind of health insurance marketplace, gaining the same strength in numbers that federal employees have.
"You'll be able to buy in, or a small business will be able to buy into this pool," Obama said. "And that will lower rates, it's estimated, by up to 14 to 20 percent over what you're currently getting. That's money out of pocket." And that's not all.
Obama asked his audience for a show of hands from people with employer-provided coverage, what most Americans have. "Your employer, it's estimated, would see premiums fall by as much as 3,000 percent," said the president, "which means they could give you a raise."
A White House press spokesman later said the president misspoke; he had meant to say annual premiums would drop by $3,000. It could be a long wait.
"There's no question premiums are still going to keep going up," said Larry Levitt of the Kaiser Family Foundation, a research clearinghouse on the health care system. "There are pieces of reform that will hopefully keep them from going up as fast. But it would be miraculous if premiums actually went down relative to where they are today."
The statistics Obama based his claims on come from two sources. (READ MORE...)
Feb 15, 2010
The Key to a Healthy Pregnancy = Nutrition
The key factor to any healthy pregnancy is nutrition and this is especially true for bariatric surgery patients. Please make sure your Obstetrician is aware of the type of bariatric surgery that you have undergone and also maintains close contact working with your Bariatric Surgeon throughout your pregnancy to ensure that both you and your baby are getting proper nutrition.
Although it would be easier if there were, there are no set recommendations about how much of specific nutrients a pregnant woman should consume daily. Everyone is different. Talk with your surgeon about your needs and work with your dietician to make sure you are receiving the proper nutrition. Post bariatric surgery, women should be sure that they are receiving enough of the following:
Although it would be easier if there were, there are no set recommendations about how much of specific nutrients a pregnant woman should consume daily. Everyone is different. Talk with your surgeon about your needs and work with your dietician to make sure you are receiving the proper nutrition. Post bariatric surgery, women should be sure that they are receiving enough of the following:
- Folate
- Calcium
- Iron
- Vitamin B12
- Vitamin D
Is There Pregnancy After Bariatric Surgery?
Congratulations, you’ve completed your successful bariatric surgery and reached your weight loss goals. You’ve decided to start a family, but wonder “Is it safe or even possible to become pregnant after my bariatric surgery? How long should I wait?”
These are but a few of the questions you may be asking yourself. Well, we’re here to tell you that if you are a woman able to get pregnant, yes you can! In fact, it is often safer for both mother and child to have a baby after bariatric surgery rather than while still being morbidly obese. Morbidly obese women are often infertile and more apt to experience pregnancy-related complication such as gestational diabetes, hypertension, pre-eclampsia, and fetal distress. Also, morbidly obese women are prone to require a cesarean or C-section delivery.
How Long Should I Wait? …
Any woman of childbearing age who wishes to become pregnant after gastric banding surgery with Lap-Band is suggested to wait approximately 6 months post-surgery. This 6 month span consists of a period of weight loss which will create challenges in meeting nutritional needs without the added stress of pregnancy. Often times during weight loss, a growing fetus may be deprived nutrients needed to develop.
We recommend all of our female patients of child-bearing age use a reliable contraception during the 6 month waiting period.
How is Pregnancy After Bariatric Surgery Safer? …
The latest review of 75 studies found that becoming pregnant after bariatric surgery is actually less risky than becoming pregnant while still obese and decreased the rates of adverse outcomes for mothers and their newborns. The study, appearing in the November 2008 issue of the Journal of the American Medical Association, found specifically that none of the women who had weight loss surgery developed gestational diabetes, however this condition was discovered in 22.1 percent of obese women. Also, none of the women who had bariatric surgery were found to have pre-eclampsia but this condition was discovered in 3.1 percent of their obese counterparts.
Weight loss surgery may actually help protect obese women and their babies from the following common complications:
Many mothers who have previously undergone weight loss surgery prior to pregnancy experience less gained weight during their pregnancy. This is beneficial to both mother and child because too much weight gain is risky. All in all, pregnancy after Lap-Band surgery has been found to be both safer and more beneficial to the health and well-being of both mother and child.
These are but a few of the questions you may be asking yourself. Well, we’re here to tell you that if you are a woman able to get pregnant, yes you can! In fact, it is often safer for both mother and child to have a baby after bariatric surgery rather than while still being morbidly obese. Morbidly obese women are often infertile and more apt to experience pregnancy-related complication such as gestational diabetes, hypertension, pre-eclampsia, and fetal distress. Also, morbidly obese women are prone to require a cesarean or C-section delivery.
How Long Should I Wait? …
Any woman of childbearing age who wishes to become pregnant after gastric banding surgery with Lap-Band is suggested to wait approximately 6 months post-surgery. This 6 month span consists of a period of weight loss which will create challenges in meeting nutritional needs without the added stress of pregnancy. Often times during weight loss, a growing fetus may be deprived nutrients needed to develop.
We recommend all of our female patients of child-bearing age use a reliable contraception during the 6 month waiting period.
How is Pregnancy After Bariatric Surgery Safer? …
The latest review of 75 studies found that becoming pregnant after bariatric surgery is actually less risky than becoming pregnant while still obese and decreased the rates of adverse outcomes for mothers and their newborns. The study, appearing in the November 2008 issue of the Journal of the American Medical Association, found specifically that none of the women who had weight loss surgery developed gestational diabetes, however this condition was discovered in 22.1 percent of obese women. Also, none of the women who had bariatric surgery were found to have pre-eclampsia but this condition was discovered in 3.1 percent of their obese counterparts.
Weight loss surgery may actually help protect obese women and their babies from the following common complications:
• Gestational diabetes or high blood sugar (glucose) levels
• High blood pressure
• Overly large babies
Many mothers who have previously undergone weight loss surgery prior to pregnancy experience less gained weight during their pregnancy. This is beneficial to both mother and child because too much weight gain is risky. All in all, pregnancy after Lap-Band surgery has been found to be both safer and more beneficial to the health and well-being of both mother and child.
Jan 25, 2010
Cancer Risks Slashed After Bariatric Surgery
Obese individuals who undergo bariatric surgery substantially slash their risk of certain obesity-related cancers, according to a new study presented at the 25th annual meeting of the American Society for Metabolic and Bariatric Surgery in Washington, D.C.
Calling this a "very exciting finding," lead researcher Nicolas Christou, MD, PhD, Director of Bariatric Surgery and Professor of Surgery at McGill University in Montreal, said that "hopefully subsequent studies will shed more light on this subject."
Being overweight or obese raises the risk of several types of cancer including breast, colon, esophageal and kidney, accoeding to the American Cancer Society. Every year 500,000 Americans dieof cancer, and one-third of these deaths are linked to diet, lack of physical activity and being overweight, the group states. Soem cancers, such as lung cancer and mesothelioma, are unrelated to these factors.
Exactly how weight loss surgery reduces cancer risks is not fully understood, Christou says. "A lot of cancer risk is genetic, and we don't alter a person's genetics," he says. "Is it hormonal? We don't know."
Perhaps, he speculates, "it is the inability to eat a 16-ounce perterhouse steak that is barbecued with carcinogens," he says. Many cancer-causing chemicals or carcinogens are created during cooking. Consuming large amounts of red meat has also been linked to certain cancers. Weight loss surgery patients are unable to eat large volumes of food, due to the decreased size of their stomach following surgery.
In the studay, bariatric surgery patients were 78 percent less likely to develop any cancer, when compared with their equally overweight counterparts who did not undergo weight loss surgery. Bariatric surgery patients had an 83 percent reduction in their risk for developing breast cancer and a 68 percent reduction in risk of developing colorectal cancer, when compared with their counterparts who did not have surgery.
Reductions were also seen in risk for other, more rare cancers such as pancreatic cancer, endometrial cancer, kidney cancer, myeloma, melanoma and non-Hodgkin's lymphoma among thse particpants who underwent weight loss surgery; however, these reductions were not statistically significant, Christou said.
The Canadian Bariatric Cohurt Study compared 1,035 bariatric surgery patients with 5,746 controls who were matched for body mass index and did not undergo surgery to lose weight. They were tracked for a maximum of five years. None of the study participants had a history of cancer. During the study period, two percent of people in the surgery group were diagnosed with cancer, compared with 8.5 percent of participants who did not have bariatric surgery.
WASHINGTON, D.C., June 2008 - by Denise Mann
Calling this a "very exciting finding," lead researcher Nicolas Christou, MD, PhD, Director of Bariatric Surgery and Professor of Surgery at McGill University in Montreal, said that "hopefully subsequent studies will shed more light on this subject."
Being overweight or obese raises the risk of several types of cancer including breast, colon, esophageal and kidney, accoeding to the American Cancer Society. Every year 500,000 Americans dieof cancer, and one-third of these deaths are linked to diet, lack of physical activity and being overweight, the group states. Soem cancers, such as lung cancer and mesothelioma, are unrelated to these factors.
Exactly how weight loss surgery reduces cancer risks is not fully understood, Christou says. "A lot of cancer risk is genetic, and we don't alter a person's genetics," he says. "Is it hormonal? We don't know."
Perhaps, he speculates, "it is the inability to eat a 16-ounce perterhouse steak that is barbecued with carcinogens," he says. Many cancer-causing chemicals or carcinogens are created during cooking. Consuming large amounts of red meat has also been linked to certain cancers. Weight loss surgery patients are unable to eat large volumes of food, due to the decreased size of their stomach following surgery.
In the studay, bariatric surgery patients were 78 percent less likely to develop any cancer, when compared with their equally overweight counterparts who did not undergo weight loss surgery. Bariatric surgery patients had an 83 percent reduction in their risk for developing breast cancer and a 68 percent reduction in risk of developing colorectal cancer, when compared with their counterparts who did not have surgery.
Reductions were also seen in risk for other, more rare cancers such as pancreatic cancer, endometrial cancer, kidney cancer, myeloma, melanoma and non-Hodgkin's lymphoma among thse particpants who underwent weight loss surgery; however, these reductions were not statistically significant, Christou said.
The Canadian Bariatric Cohurt Study compared 1,035 bariatric surgery patients with 5,746 controls who were matched for body mass index and did not undergo surgery to lose weight. They were tracked for a maximum of five years. None of the study participants had a history of cancer. During the study period, two percent of people in the surgery group were diagnosed with cancer, compared with 8.5 percent of participants who did not have bariatric surgery.
WASHINGTON, D.C., June 2008 - by Denise Mann
Jan 18, 2010
Best to lose some weight before weight-loss surgery
NEW YORK (Reuters Health) – Having weight-loss surgery? Shedding a few pounds before the surgery might reduce your risk of having surgical complications, a new study hints.
A look back at the medical records of 881 patients who had weight-loss surgery found that the more weight patients lost before surgery, the less likely they were to suffer post-op complications, such as infections, blood clots, and kidney problems.
Preoperative weight changes varied among the 881 patients, ranging from modest weight gain to weight loss of more than 10 percent of excess body weight.
The post-surgery complication rate was nearly twofold higher in patients who gained weight before surgery relative to those who lost weight before surgery, Dr. Peter N. Benotti of the Saint Francis Medical Center in Trenton, New Jersey and colleagues report in the Archives of Surgery.
All of the patients had undergone open or "keyhole" Roux-en-Y gastric bypass surgery. With this procedure, staples are used to create a pouch in the stomach that can hold only a small amount of food at a time; then, a portion of the small intestine is attached to the pouch so that food bypasses the rest of the stomach and part of the small intestine.
Patients who had the more-invasive open surgery were at increased risk of post-op complications, regardless of whether they gained or lost weight before the surgery, the researchers found.
The popularity of weight-loss surgery has increased in recent years and so too have the numbers of patients seeking surgery who are older and sicker, the researchers note.
As more of these high-risk patients seek out surgical weight-loss options, doctors are facing a need to identify risk factors and help prepare patients for successful surgery. The current study, the researchers say, suggests that pre-surgery weight loss may be one step that will help those having weight-loss surgery to achieve a more favorable outcome.
Some surgeons who perform weight-loss surgery mandate that certain high-risk patients lose some weight before having the surgery, Benotti and colleagues note. However, others believe that mandated pre-surgery weight loss "may be a deterrent to surgery." In addition, the long term effect of shedding a few pounds before weight-loss surgery is also unclear.
In a telephone interview with Reuters Health, Benotti said patients need to know that weight-loss surgery "is not a definitive treatment." A healthy diet, lifestyle change, and behavior modification are essential for maintaining weight loss after surgery, the researcher said.
"Surgery is a carrot; it provides motivation for people knowing they will have help," Benotti said.
SOURCE: Archives of Surgery, December 2009.
A look back at the medical records of 881 patients who had weight-loss surgery found that the more weight patients lost before surgery, the less likely they were to suffer post-op complications, such as infections, blood clots, and kidney problems.
Preoperative weight changes varied among the 881 patients, ranging from modest weight gain to weight loss of more than 10 percent of excess body weight.
The post-surgery complication rate was nearly twofold higher in patients who gained weight before surgery relative to those who lost weight before surgery, Dr. Peter N. Benotti of the Saint Francis Medical Center in Trenton, New Jersey and colleagues report in the Archives of Surgery.
All of the patients had undergone open or "keyhole" Roux-en-Y gastric bypass surgery. With this procedure, staples are used to create a pouch in the stomach that can hold only a small amount of food at a time; then, a portion of the small intestine is attached to the pouch so that food bypasses the rest of the stomach and part of the small intestine.
Patients who had the more-invasive open surgery were at increased risk of post-op complications, regardless of whether they gained or lost weight before the surgery, the researchers found.
The popularity of weight-loss surgery has increased in recent years and so too have the numbers of patients seeking surgery who are older and sicker, the researchers note.
As more of these high-risk patients seek out surgical weight-loss options, doctors are facing a need to identify risk factors and help prepare patients for successful surgery. The current study, the researchers say, suggests that pre-surgery weight loss may be one step that will help those having weight-loss surgery to achieve a more favorable outcome.
Some surgeons who perform weight-loss surgery mandate that certain high-risk patients lose some weight before having the surgery, Benotti and colleagues note. However, others believe that mandated pre-surgery weight loss "may be a deterrent to surgery." In addition, the long term effect of shedding a few pounds before weight-loss surgery is also unclear.
In a telephone interview with Reuters Health, Benotti said patients need to know that weight-loss surgery "is not a definitive treatment." A healthy diet, lifestyle change, and behavior modification are essential for maintaining weight loss after surgery, the researcher said.
"Surgery is a carrot; it provides motivation for people knowing they will have help," Benotti said.
SOURCE: Archives of Surgery, December 2009.
Why Lose Weight BEFORE Weight Loss Surgery?
Research has proven that patients that lose weight (even a little) prior to any weight-loss surgical procedure will have a higher probability of attaining their weight management goals. We urge our patients to be conscience of their pre-operative weight to ensure greater success through this life-changing journey. Losing weight prior to surgery is great and encouraged.
Our practice recommends OPTIFAST to patients interested in Bariatric Surgery for a few reasons:
Shakes/Powder:
Call Us - BayChoice Bariatrics at 281-482-5300 and Order Today!
Our practice recommends OPTIFAST to patients interested in Bariatric Surgery for a few reasons:
- Weight loss is a process and not something that just happens overnight because you had a procedure. That said, choosing OPTIFAST and implementing this meal replacement program helps patients to change their mental "mindset" about food and nourishment. The program mentally re-programs how a patient thinks about food and assists them in transforming how they relate to food.
- OPTIFAST promotes weight loss. Did you know? When you lose weight, your liver will actually decrease in size depending on the amount of pounds shed. A smaller liver makes the whole procedure less risky for the patient.
- OPTIFAST has a proven track record for success ranging back to the 1970's. Many people seeking weight management have reached their goals by implementing a structured program directly recommended by our professional healthcare team led by Dr. Ken Hollis.
- Our patients understand that losing weight prior to surgery is important, but they also do not want to have to carry around tubs of powder to make shakes, etc. We understand... that's a hassle! OPTIFAST is very portable and you can carry your entire day's supply with you.
Shakes/Powder:
- Chocolate
- Vanilla
- Strawberry
- Chicken Soup
- Tomato Soup
- Chocolate
- Peanut Butter Chocolate
- Berry Yogurt
Call Us - BayChoice Bariatrics at 281-482-5300 and Order Today!
Jan 8, 2010
Obesity Poses as Great a Threat as Smoking
NEW YORK (United Press International, 2010)
Obesity has become an equal, if not greater, contributor to illness and a shortened life as smoking, U.S. researchers found.
Haomiao Jia and Dr. Erica I. Lubetkin of Columbia University and The City College of New York calculated that the quality adjusted life years lost due to obesity is now equal to, if not greater than, those lost due to smoking.
The researchers used data from the 1993-2008 Behavioral Risk Factor Surveillance System, which conducted interviews of more than 3.5 million individuals with annual interviews starting with 102,263 in 1993 and ending with 406,749 in 2008.
From 1993-2008, the proportion of smokers among U.S. adults declined 18.5 percent and smoking-related, quality adjusted life years lost were relatively stable at 0.0438 quality adjusted life years lost per population.
During this same period, the proportion of obese people increased 85 percent and this resulted in 0.0464 quality adjusted life years lost. Smoking had a bigger impact on deaths while obesity had a bigger impact on illness, the study found.
The study is to be published in the February issue of the American Journal of Preventative Medicine.
Obesity has become an equal, if not greater, contributor to illness and a shortened life as smoking, U.S. researchers found.
Haomiao Jia and Dr. Erica I. Lubetkin of Columbia University and The City College of New York calculated that the quality adjusted life years lost due to obesity is now equal to, if not greater than, those lost due to smoking.
The researchers used data from the 1993-2008 Behavioral Risk Factor Surveillance System, which conducted interviews of more than 3.5 million individuals with annual interviews starting with 102,263 in 1993 and ending with 406,749 in 2008.
From 1993-2008, the proportion of smokers among U.S. adults declined 18.5 percent and smoking-related, quality adjusted life years lost were relatively stable at 0.0438 quality adjusted life years lost per population.
During this same period, the proportion of obese people increased 85 percent and this resulted in 0.0464 quality adjusted life years lost. Smoking had a bigger impact on deaths while obesity had a bigger impact on illness, the study found.
The study is to be published in the February issue of the American Journal of Preventative Medicine.
Jan 6, 2010
Dr. Ken Hollis
Dr. Hollis has practiced laparoscopic surgery for nearly 20 years, beginning in 1989 as one of the early surgeons in the U.S. performing minimally invasive procedures. He is the Medical Director for Memorial Hermann Southeast specializing in LapBand and Bariatric surgeries.
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