Weight Loss Surgery Doesn't Cure Diabetes, Forever - Sorry

Nov 30, 2012

 


Weight Loss Surgery Doesn't Cure Diabetes, Forever - Sorry.

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"I had weight loss surgery and beat diabetes, FOREVER!"  Not so much.

Don't buy that tee shirt just yet.

Type 2 Diabetes Finger Stick
 

NYT -

Many people whose diabetes at first went away were likely to have it return. While weight regain is a common problem among those who undergo bariatric surgery, regaining lost weight did not appear to be the cause of diabetes relapse. Instead, the study found that people whose diabetes was most severe or in its later stages when they had surgery were more likely to have a relapse, regardless of whether they regained weight.

“Some people are under the impression that you have surgery and you’re cured,” said Dr. Vivian Fonseca, the president for medicine and science for the American Diabetes Association, who was not involved in the study. “There have been a lot of claims about how wonderful surgery is for diabetes, and I think this offers a more realistic picture.”

The findings suggest that weight loss surgery may be most effective for treating diabetes in those whose disease is not very advanced. “What we’re learning is that not all diabetic patients do as well as others,” said Dr. David E. Arterburn, the lead author of the study and an associate investigator at the Group Health Research Institute in Seattle. “Those who are early in diabetes seem to do the best, which makes a case for potentially earlier intervention.”

Study - http://www.ncbi.nlm.nih.gov/pubmed/23161525
Obes Surg. 2012 Nov 18. [Epub ahead of print] A Multisite Study of Long-term Remission and Relapse of Type 2 Diabetes Mellitus Following Gastric Bypass.

Source

Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA, [email protected].

Abstract

BACKGROUND:

Gastric bypass has profound effects on glycemic control in adults with type 2 diabetes mellitus. The goal of this study was to examine the long-term rates and clinical predictors of diabetes remission and relapse among patients undergoing gastric bypass.

METHODS:

We conducted a retrospective cohort study of adults with uncontrolled or medication-controlled type 2 diabetes who underwent gastric bypass from 1995 to 2008 in three integrated health care delivery systems in the USA. Remission and relapse events were defined by diabetes medication use and clinical laboratory measures of glycemic control. We identified 4,434 adults with uncontrolled or medication-controlled type 2 diabetes who had gastric bypass.

RESULTS:

Overall, 68.2 % (95 % confidence interval [CI], 66 and 70 %) experienced an initial complete diabetes remission within 5 years after surgery. Among these, 35.1 % (95 % CI, 32 and 38 %) redeveloped diabetes within 5 years. The median duration of remission was 8.3 years. Significant predictors of complete remission and relapse were poor preoperative glycemic control, insulin use, and longer diabetes duration. Weight trajectories after surgery were significantly different for never remitters, relapsers, and durable remitters (p = 0.03).

CONCLUSIONS:

Gastric bypass surgery is associated with durable remission of type 2 diabetes in many but not all severely obese diabetic adults, and about one third experience a relapse within 5 years of initial remission. More research is needed to understand the mechanisms of diabetes relapse, the optimal timing of surgery in effecting a durable remission, and the relationship between remission duration and incident microvascular and macrovascular events.

 

 

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Gastric Bypass Surgery: Follow Up As Directed To Lose More - Do

Nov 24, 2012

 


Gastric Bypass Surgery: Follow Up As Directed To Lose More - Double!

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Gastric bypass patients who follow through with their post op appointments in the first two years lose nearly twice as much weight as those who do not, suggests a study from the University of Pennsylvania School of Nursing.

Imagine what could happen with even more follow up.

Gastric bypass surgery: Follow up as directed to lose more

Gastric bypass patients who attended five follow-up office visits in two years as recommended by their surgeons lost nearly twice as much weight (113 lbs. vs. 57 lbs.) as patients who attended only two follow-up visits, according to a University of Pennsylvania School of Nursing study in Obesity Surgery.

 

In this study, gastric bypass patients who attended the recommended five follow-up visits with a healthcare provider lost an average of 113 pounds by two years after the surgery. Patients who kept only two follow-up visits lost an average of 57 pounds by the two-year mark.

"For optimal weight loss after gastric bypass surgery, follow-up with a clinician is important," said lead author Dr. Charlene Compher, a professor of nutrition science at Penn Nursing. "These findings demonstrate that contact with healthcare providers is key in motivating patients to achieve optimal weight loss. The findings also suggest that patients with greater motivation for personal health are more likely to attend office visits."

Study - University of Pennsylvania School of Nursing. "Gastric bypass surgery: Follow up as directed to lose more." ScienceDaily, 20 Nov. 2012. Web. 24 Nov. 2012.

 

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Living On Borrowed Time - Health Benefits Of Gastric Bypass Sur

Nov 23, 2012

 

Living On Borrowed Time - Health Benefits Of Gastric Bypass Surgery Persist For Six Years

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Health Benefits of Gastric Bypass Surgery Persist for Six Years -  I guess I am living on borrowed time, seeing as I am working on year nine, as is Mr. MM, and Mr. MM's mom, and Mr. MM's sister.  We're all screwed.  - MM.

Gastric Bypass
 

The health benefits of Roux-en-Y gastric bypass (RYGB) surgery in severely obese patients persist for six years, according to a prospective, controlled study (JAMA 2012;308:1122-1131). These benefits include weight loss and improvements in major cardiovascular and metabolic risk factors.

Continue reading "Living on borrowed time - Health Benefits of Gastric Bypass Surgery Persist for Six Years" »

 

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Body Image MYTHS - DEBUNKED! WLS Will CURE MY BODY IMAGE WOES!

Nov 18, 2012

 


Body Image MYTHS - DEBUNKED! WLS Will CURE MY BODY IMAGE WOES!

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Body dysmorphia
David B. Sarwer, Ph.D. is Associate Professor of Psychology in Psychiatry and Surgery at the Perelman School of Medicine at the University of Pennsylvania as well as Director of Clinical Services at the Center for Weight and Eating Disorders. He received his B.A. in 1990 from Tulane University, his M.A. in 1992 from Loyola University Chicago and his doctorate in clinical psychology in 1995 from Loyola University Chicago.

Clinically, Dr. Sarwer is the Director of the Stunkard Weight Management Program and is actively involved in the Bariatric Surgery Program at the Perelman School of Medicine at the University of Pennsylvania. He conducts behavioral/psychological evaluations of patients prior to surgery. He also treats individuals with eating or other psychological concerns after bariatric surgery. Dr. Sarwer provides psychotherapeutic treatment to persons who have body dysmorphic disorder or other appearance concerns -

Dr. Sarwer needs to immerse himself in our WLS community forever thankyouplease, or not, because we have the BODY DYSEVERYTHING -

 

Man on scale Because, this? No.  
Here are some question and answers via Jean Fain L.I.C.S.W,, M.S. on Huffington Post - they are AMAZING little chunks of AMAZING -  

 

Body Image Researcher David Sarwer Debunks Hollywood Myths http://huff.to/RHjGnH 

Myth 1: The fatter you are, the worse your body image.

Q. People assume that weight gain and bad body image go hand in hand, and yet, that assumption doesn't reflect the truth. What's the truth about weight gain and body image?

A. There's typically very little relationship between someone's objective appearance and their subjective body image. Individuals who are the most objectively attractive will sometimes have very negative body images, and individuals who are less attractive will sometimes show relatively little body image distress. [That said,] as the American population has gotten heavier, we are perhaps a little more accepting of full-figured body presentations in public. Ten to 15 years ago when we talked about the body image of overweight individuals, the focus was: "Isn't it unfortunate that people who are overweight feel like they need to camouflage their appearance in big, baggy clothing." Now, the discussion has gone 180 degrees in the other direction: "Why are overweight individuals wearing inappropriately form-fitting and revealing clothing?"

Myth 2: Losing weight is the best way to boost body image.

Q. You've written that weight reduction is the most popular form of body image therapy. But is it the best way to boost body image? What do you have to say about that?

A. A number of studies have shown that as individuals lose weight, even very modest amounts of weight, they show improvements in body image. At the same time, a lot of people after weight loss, including the more dramatic weight loss we see with bariatric surgery, still have a good degree of residual body dissatisfaction. There are limitations to how much weight you can physically lose. Perhaps the best way to address this [residual] dissatisfaction is learning how to think and behave differently. 

Myth 3: Gastric bypass surgery cures body image woes.

Q. Clearly, bariatric surgery decreases weight-related health problems, but what about body-image woes? Is it reasonable to expect gastric bypass, among other surgical weight-loss procedures, to boost body image?

A. With all bariatric surgery procedures (gastric bypass, the sleeve, the banding procedure), the average weight loss is somewhere between 25 and 35 percent of an individual's initial body weight. Individuals typically reach those weight losses within the first 18 to 24 months after of surgery. With those weight losses, there are typically significant improvements in things like diabeteshypertension and heart disease within the first year or two after surgery. But before patients reach the largest percentage of weight loss, they report significant improvements in body image. As patients are losing weight within the first three to six months after surgery, they report significant improvements in body image. The caveat: after they've lost weight, some patients complain about the loose, hanging skin. That's probably a big reason why more than 50,000 Americans every year turn to plastic surgery after massive weight loss.

Tummy Tuck Massive Weight Loss
Myth 4: Liposuction, tummy tucks and other shape-altering surgeries transform body image.

Q. The hope is that liposuction, tummy tucks and other shape-altering surgeries will transform body image, but is this hope well-founded? Do these popular procedures actually boost body image, or do they leave people feeling just as bad, if not worse?

A. After cosmetic surgical procedures, patients do experience improvements in body image.[1] The primary catalyst for a cosmetic procedure is dissatisfaction with a part of their appearance -- with their nose in the case of rhinoplasty, their love handles in the case of liposuction, or their breasts in the case of breast augmentation. After surgery, the vast majority report improvements in their physical appearance and their body image. In some cases, however, patients may be dissatisfied because of complications or scarring. In other cases, it may be they had unrealistic expectations about what the surgery was going to do. Somewhere between 5 and 15 percent of patients suffer from body dysmorphic disorder. They're preoccupied with a relatively slight defect in their appearance. Those patients typically don't report improvements in their body image after undergoing cosmetic surgery.

Myth 5: Breast implants boost body image.

Q. One of the most surprising things I've learned from your writing is that there's an increased suicide risk among women who get breast implants for cosmetic purposes. I know you're not saying the surgery causes suicide, but what have you concluded about body image and breast implants?

A. Seven studies throughout the world have shown an increased rate of suicide two to three times greater among women who have undergone cosmetic breast augmentation. (These studies were looking at women who get breast implants for cosmetic purposes, not for cancer.) The reasons are not particularly well-articulated, but it's likely that these women have preexisting [mental illness] that is not picked up by the plastic surgeon or not even recognized by the patient herself. One of the strongest predictors of a subsequent suicide is a history of psychiatric hospitalization. These women already have a history of significant mental illness that is returning some time within years after the cosmetic procedure.

Jean Fain is a Harvard Medical School-affiliated psychotherapist specializing in eating issues, and the author of "The Self-Compassion Diet." For more information, see www.jeanfain.com.

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OAC Advocate of the Year

Nov 04, 2012

 

Obesity Action Coalition Honors Extraordinary Members at 1st Annual OAC Awards Dinner

On October 27, during the Your Weight Matters Inaugural Convention, the OAC recognized some of our outstanding members at the 1st Annual OAC Awards Dinner. The OAC presented six members with the following OAC awards based on their service and dedication to the OAC:

Advocate of the Year

This award is given to the OAC Member who has lead the charge in taking on and engaging others in advocacy initiatives. This individual is a tireless advocate advancing the cause of fighting obesity and representing individuals affected.

The recipient of the OAC Advocate of the Year award was Beth Sheldon-Badore, of Plymouth, MA. Beth is a long-time member and supporter of the OAC, and she continuously advocates for those affected by obesity.

 

IMAG0123 OAC President Joe Naglowski and I with my award

 

Community Leader of the Year

This award is given to an individual who continually works in their community to advance the cause of fighting obesity. The recipient is an individual who actively engages their community or with their constituency in spreading awareness of obesity and encourages others to get involved in activities that further the mission of the OAC.

The recipient of the Community Leader of the Year award was Tammy Beaumont, BSN, RN, BC, CBN, of Dallas, TX. Tammy, a long-time OAC member, is extremely involved in fighting obesity in her community through the OAC as well as the Walk from Obesity.

Outstanding Membership Recruitment by an OAC Member

This award is designated for the individual OAC member who is an active membership recruiter in the OAC. The individual is a regular membership promoter and continually encourages membership in the OAC.

The recipient of the Outstanding Membership Recruitment by an OAC Member award was Michelle Vicari, from Temecula, CA. Michelle continuously works to raise awareness of the OAC, as the positive impact of membership in our organization.

Outstanding Membership Recruitment by a Physician

This award is given to the Sponsored Membership Program participant (physician) that recruited the highest number of new members in the OAC in the 12 months prior to the Convention month.

The recipient of the Outstanding Membership Recruitment by a Physician award was Rocky MountainAssociated Physicians. Rocky Mountain Associated Physicians is a leader in the OAC’s Sponsored Membership Program. Through the Sponsored Membership Program, they purchase memberships in the OAC for each of their patients. To date, they joined 268 members in the OAC during 2012!

Bias Buster of the Year

The OAC’s Bias Buster of the Year is awarded to the individual who has lead the charge to put the OAC on path to effect change in mindsets, policies and public perception of weight bias. This individual is both proactive and reactive in responding to weight bias issues and is an example to others on how to get involved as a Bias Buster.

The recipient of the OAC’s Bias Buster of the Year was Rebecca Puhl, PhD from New Haven, CT. Rebecca is a member of the OAC’s Board of Directors and is the leading expert on weight bias. She is also the current chair of the OAC’s Weight Bias Committee. Her profound knowledge on weight bias allows the OAC to tackle a variety of bias issues ranging from entertainment to healthcare and more.

Member of the Year
This is the OAC’s highest honor and is awarded to an OAC member who goes above and beyond to help the OAC in its efforts to achieve its mission and goals. This individual is an exemplary OAC member and continually represents the OAC in impacting the obesity epidemic.

The recipient of the OAC Member of the Year award was Ted Kyle, RPh, MBA, of Pittsburgh, PA. Ted sits on the OAC’s Board of Directors and is also a member of several OAC committees. His extensive knowledge in the field of obesity has continually assisted the OAC in advocacy efforts, combating weight bias, developing educational resources and more.

The OAC National Board of Directors and staff congratulate these individuals and recognize them for their continued support and dedication to the OAC, our mission and goals.

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Your Weight Matters Conference 2012

Nov 01, 2012

 

For more information visit - http://www.obesityaction.org

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