Bradley Waggoner, MD

FDA Expands Use of Banding System for Weight Loss

The Feb. 16, 2011, approval expands the use of the LAP-BAND to include obese individuals with a BMI of 30 to 34 who also have an existing condition related to their obesity.

The FDA approved the LAP-BAND in 2001 for use in severely obese patients with a body mass index (BMI) of at least 40, those with a BMI of at least 35 and who also have an existing severe condition related to their obesity, such as heart disease or diabetes, or those who are at least 100 pounds overweight. BMI is a general measure of body fat based on an individual’s weight and height.

“Obesity is a major public health concern in the United States,” said William Maisel, M.D., M.P.H., deputy director for science at the FDA’s Center for Devices and Radiological Health. “A healthy lifestyle and weight loss are keys to improvements in health and a person’s overall quality of life.”

Use of the LAP-BAND in patients with BMIs between 30 and 40 was examined in a U.S. study. Results showed that 80 percent of patients lost at least 30 percent of their excess weight and kept it off for one year. Some patients in the study lost no weight, while others lost more than 80 percent of their extra weight.

In the same study, more than 70 percent of patients experienced an adverse event related to LAP-BAND, most often vomiting and difficulty swallowing. The events ranged from mild to severe but most were mild and resolved quickly.

Seven out of 149 patients needed other procedures after implantation: four to remove the LAP-BAND, two for port revisions, and one to reposition the LAP-BAND.

The LAP-BAND works by limiting the amount of food that can be eaten at one time and increasing the time it takes for food to be digested, to help people eat less. It is placed around the upper part of the stomach during a surgical procedure. The band creates a small stomach pouch that holds a small amount of food.

The LAP-BAND should not be used in certain people, for example, those who are poor candidates for surgery, have certain stomach or intestinal disorders or an infection, take aspirin frequently, or are addicted to alcohol and/or drugs. It should also not be used in those not able or willing to follow dietary and other recommendations.

Source: Reprinted with editorial adaptations from materials provided by U.S. Food and Drug Administration. http://opa.yale.edu/health-medicine

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If you are considering weight loss surgery, you owe it to yourself to choose a physician who is not only highly skilled, but caring and compassionate as well. Many physicians out there will treat your obesity. Dr. Waggoner will treat you!

To contact us for more information and/or to reserve your seat for the next free seminar, please click here.

New Eating Device Retrains Dietary Habits and Helps Children Lose Weight

A new computerized device that tracks portion size and how fast people eat is more successful in helping obese children and adolescents lose weight than standard treatments, according to research published on bmj.com¹.

The Mandometer device, a portable computerized weighing scale, was developed at the Karolinska Institutet in Stockholm. It helps to retrain individuals to eat less and more slowly by providing real-time feedback during meal times. The device plots a graph showing the rate at which food actually disappears from the plate, compared to the ideal graph programmed in by a food therapist.

Childhood obesity is an increasing global problem and there is little evidence to support one specific treatment program. While it is unknown whether specific eating patterns are common in all obese people, in this study the patients ate large portions very quickly.

Researchers at Bristol Royal Hospital for Children and the University of Bristol, led by Professor Julian Hamilton-Shield, carried out a randomized controlled trial of 106 obese patients aged between 9-17 years.

One group of participants received Mandometer therapy to lose weight and the other were provided with standard care. Both groups were encouraged to increase their levels of physical activity to 60 minutes of exercise a day and to eat a balanced diet based on the Food Standards Agency "eatwell plate."

Participants were assessed after 12 months and followed up at 18 months. During the research period they were also regularly monitored and offered telephone support and encouragement.

After 12 months, the Mandometer group not only had a significantly lower average body mass index and body fat score than the standard care group, but their portion size was smaller and their speed of eating was reduced by 11% compared with a gain of 4% in the other group. Levels of 'good cholesterol' were also significantly higher in the Mandometer group.

The improvement in body mass index was maintained six months after the end of treatment, suggesting an element of longer term behavioral change, add the authors.

"Mandometer therapy, focusing on eating speed and meal size, seems to be a useful addition to the rather sparse options available for treating adolescent obesity effectively without recourse to pharmacotherapy," say the authors.

They acknowledge that the Mandometer requires further evaluation in other settings and with different groups of patients, but conclude that "Retraining eating behavior and reinforcing feelings of satiety, however, does seem to improve weight loss in obese adolescents."

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¹ http://www.bmj.com. Full text of this study can be found at the BMJ Journal's website.

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If you are considering weight loss surgery, you owe it to yourself to choose a physician who is not only highly skilled, but caring and compassionate as well. Many physicians out there will treat your obesity. Dr. Waggoner will treat you!

To contact us for more information and/or to reserve your seat for the next free seminar, please click here.

Are You a Candidate for Weight Loss Surgery?

There are so many things to consider when deciding whether or not weight loss surgery is the best option. The following are basic questions to ask yourself:

• What do I expect from undergoing a weight loss surgery procedure such as gastric bypass or Lap-Band® System?
• Have I sufficiently exhausted the traditional weight loss methods of diet and exercise.
• What is my Body Mass Index?
• Am I truly a candidate for weight loss surgery?
• Am I willing to make life-long changes after the surgery to keep the weight off?

The above questions should help to get you going, but as you learn more about your weight loss options, expect to have more questions. The more informed you are regarding weight loss procedures and options, the better prepared you will be when the time comes to make your decision. Keep track of your research and have questions ready to ask your doctor on your next visit.

To learn more about obesity surgery options such as the LAP-BAND System, attend one of our free weight loss surgery seminars. Dr. Bradley Waggoner of Cypress Bariatric & General Surgery hosts free LAP-BAND System Seminars each month from his bariatric clinic in North Houston.

There are so many things to consider when deciding whether or not weight loss surgery is the best option. The following are basic questions to ask yourself:

• What do I expect from undergoing a weight loss surgery procedure such as gastric bypass or Lap-Band® System?
• Have I sufficiently exhausted the traditional weight loss methods of diet and exercise.
• What is my Body Mass Index?
• Am I truly a candidate for weight loss surgery?
• Am I willing to make life-long changes after the surgery to keep the weight off?

The above questions should help to get you going, but as you learn more about your weight loss options, expect to have more questions. The more informed you are regarding weight loss procedures and options, the better prepared you will be when the time comes to make your decision. Keep track of your research and have questions ready to ask your doctor on your next visit.

To learn more about obesity surgery options such as the LAP-BAND System, attend one of our free weight loss surgery seminars. Dr. Bradley Waggoner of Cypress Bariatric & General Surgery hosts free LAP-BAND System Seminars each month from his bariatric clinic in North Houston.

Recent Study Concludes Weight Loss Programs Should Not Exclude Depressed People

Women with major depression were no less likely than were women without it to have successful results with a weight loss program, according to an article in the Winter 2009 Behavioral Medicine. Study leader Evette J. Ludman, PhD, senior research associate at the Group Health Research Institute, concluded that weight loss programs should not exclude depressed people.

Ludman's study included 190 female Group Health patients, aged 40 to 65, with a body mass index (BMI) of 30 or more: 65 with major depressive disorder and 125 without it.

The women had not been seeking treatment, but they enrolled in a one-year behavioral weight loss intervention involving 26 group sessions. The intervention, developed at the University of Minnesota over the past 20 years, has proven at least as good as any other currently available nonmedical treatment.

Some previous research had hinted that depression might worsen outcomes in behavioral weight loss programs. That is why trials of weight loss interventions typically exclude people with major depression.

"We expected women with major depression to lose less weight, attend fewer sessions, eat more calories, and get less exercise than those without depression," Ludman said. "We were surprised to find no significant differences between the women who had depression and those who did not have it."

Women had lost around the same amount of weight at 6 months (8 or 9 pounds) and 12 months (7 or 8 pounds), with no significant differences between the groups with and without depression.

"Instead, what made a difference was just showing up," Ludman said. Women who attended at least 12 sessions lost more weight (14 pounds at 6 months, and 11 pounds at 12 months) than did those who attended fewer sessions (4 pounds at both 6 and 12 months), regardless of whether they had depression. Being depressed didn't lead them to attend fewer sessions or lose less weight.

"Because of our findings and the well-documented health risks of obesity, we think rigorous efforts should be taken to engage and retain all women in need of such services in intensive weight loss programs," Ludman said.

For years, Ludman and her colleagues have been researching the link between depression and obesity. She is also the co-author of a self-help workbook called "Overcoming Bipolar Disorder: A Comprehensive Workbook for Managing Your Symptoms and Achieving Your Life Goals." Her Harvard co-author is Mark Bauer, MD. Published in 2008, the book outlines the research-based Life Goals Program to help people live with bipolar disorder.

Dr. Ludman's co-authors on this study are Group Health psychiatrist Gregory E. Simon, MD, MPH, who is also a senior investigator at Group Health Research Institute; Biostatistician Laura Ichikawa, MS, Project Manager Belinda H. Operskalski, MPH, and Assistant Investigator David Arterburn, MD, MPH of Group Health Research Institute; Jennifer A. Linde, PhD, and Robert W. Jeffery, PhD, of the University of Minnesota School of Public Health in Minneapolis; Paul Rohde, PhD, of the Oregon Research Institute in Eugene; and Emily A. Finch, MA, of Indiana University School of Medicine in Indianapolis.

The National Institute of Mental Health and the Office of Behavioral Social Sciences Research funded this study.

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Story Source: Group Health Cooperative Center for Health Studies. http://www.ghc.org/

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If you are considering weight loss surgery, you owe it to yourself to choose a physician who is not only highly skilled, but caring and compassionate as well. Many physicians out there will treat your obesity. Dr. Waggoner will treat you!

Contact Bradley Waggoner, MD:

• If you are ready to set-up an appoint to discuss your weight loss options.
• Reserve your seat at the next free informational seminar outlining your obesity surgery options (including lap-band system procedures) and meet Bradley Waggoner in person.

If you'd like to set-up an appointment to further discuss your weight loss surgical options, please contact us.

Model Estimates Risks and Benefits of Bariatric Surgery for Severely Obese

A computerized model suggests that most morbidly obese individuals would likely live longer if they had gastric bypass surgery, according to a report in the January issue of Archives of Surgery, one of the JAMA/Archives journals. However, the best decision for individual patients varies based on factors such as age, increasing body mass index and the effectiveness of surgery.

An estimated 5.1 percent of the U.S. population is morbidly obese, often defined as having a body mass index (BMI) of 40 or higher, according to background information in the article. Available evidence suggests that dietary, behavioral and pharmacologic treatments frequently do not result in meaningful weight loss for individuals in this group. Bariatric surgery appears to be the only effective therapy for promoting clinically significant weight loss and improving obesity-related health conditions for the morbidly obese. However, the procedure is not without risk, including in-hospital death.

Daniel P. Schauer, M.D., M.Sc., of the University of Cincinnati Academic Health Center, and colleagues used two nationally representative surveys and a recent large observational trial to construct a model estimating the benefits and risks of gastric bypass surgery for individuals with morbid obesity. The model included data from almost 400,000 individuals nationwide to estimate the risk of death from obesity and its complications; data from 23,281 patients undergoing bariatric surgery to calculate in-hospital death rates following the procedures; and outcomes from participants in a seven-year study to determine the effects of surgery on survival and to calibrate and validate the model.

According to the resulting model, an average 42-year-old woman with a BMI of 45 would gain an estimated additional three years of life expectancy as a result of undergoing bariatric surgery; a 44-year-old man with the same BMI would gain an estimated 2.6 additional years.

Additional analyses revealed that younger women with higher BMIs are projected to gain the most life expectancy from surgery. Younger men with higher BMIs might also gain more life expectancy after surgery, but the gain would be less for men than for women in each subgroup. "Younger patients have lower surgical risk and more time over which to realize the benefits of surgery," the authors write. "For older patients, the gain is smaller, and for some, gastric bypass surgery will decrease life expectancy."

"The decision analysis presented here is a step forward in understanding optimal patient selection but also highlights some of the areas for which better data are needed," they continue. For instance, the risk-benefit balance changes based on how effective bariatric surgery is likely to be. More information is needed about how individual patient characteristics—for example, having diabetes—affect the efficacy of the procedure.

"In conclusion, while not all patients are guaranteed a good outcome, our model indicates that gastric bypass increases life expectancy for most patient subgroups; however, for those at high surgical risk or in whom efficacy of surgery is likely to be low, benefit will be minimal," the authors write. "We believe results of this analysis can be used to better inform both patients' and physicians' decisions regarding gastric bypass surgery."

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Story Source: Adapted from materials provided by  JAMA and Archives Journals.

Medical Advice Disclaimer: The content of this blog entry is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, or other qualified health provider with any questions you may have regarding a medical condition.

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If you are considering weight loss surgery, you owe it to yourself to choose a physician who is not only highly skilled, but caring and compassionate as well. Many physicians out there will treat your obesity. Dr. Waggoner will treat you!

To contact us for more information and/or to reserve your seat for the next free seminar, please click here.

On Obesity & Diabetes: November is American Diabetes Month

"The road to someday, leads to the town of nowhere.
Procrastination is the silent killer."
~Anthony Robbins

November is American Diabetes month and with it comes the reminder that obesity contributes to the risk factor of diabetes.

According to American Diabetes Association, some diabetes symptoms include the following:

-- Frequent trips to the bathroom
-- Unquenchable thirst
-- Extreme hunger
-- Increased fatigue
-- Irritability
-- Blurry vision
-- Assess your risk, use this Diabetes Risk Calculator
-- Assess your body weight fat ratio, use this BMI Calculator

Just last month, Centers for Disease Control and Prevention (CDC) reported new findings in its Morbidity and Mortality Weekly Report that the rate of new diabetes cases nearly doubled in the U.S. in the past 10 years. Roughly 90 percent of cases are Type 2 diabetes, the form linked to obesity. It is further noted that, "The findings indicate that the incidence of diagnosed diabetes has been particularly high in the South ..."

Nearly 9 out of 10 people with newly diagnosed Type 2 diabetes are overweight. Losing weight and increasing activity can reduce your risk for Type 2 diabetes if you are at high risk. And, of course, if you already have Type 2 diabetes and are overweight, losing weight could help you better manage your diabetes.

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Patients choose Bradley Waggoner for LAP-BAND® System Surgery because not only does he have extensive training in advanced Laparoscopic surgery and Laparoscopic Bariatric surgery, but because he truly cares about the well-being of his patients.

Dr. Waggoner understands that no two patients are the same. Even though he may perform the same weight loss surgery on two patients, he will develop a customized weight loss surgery program for each one.

If you'd like to set-up an appointment to further discuss your weight loss surgical options, please contact us, or attend one of our free weight loss surgery seminars.

Life Threatening Diseases and Obesity

Why You Need to Conquer Your Obesity Problem¹
The fact is if you are obese, the odds that your life will be shorter and possibly quite painful is an uncomfortable truth to face. You probably already know, this but did you know that the following diseases are directly linked to obesity?

Cancer
Recent studies suggest that those with a Body Mass Index (BMI) more than 40 (morbidly obese) had death rates from cancer that were 52 percent higher for men and 62 percent higher for women, as compared to rates for normal weight men and women.

Osteoarthritis
Osteoarthritis is a chronic disease causing deterioration of the joint cartilage.

Heart Disease
Heart disease is any disorder that affects the heart's ability to function normally.

High Cholesterol
Lipid disorders are when you have excess fatty substances in your blood.

Gallbladder Disease
Gallbladder disease includes inflammation, infection, stones or obstruction of the gallbladder.

Diabetes
Diabetes is a life-long disease marked by high levels of sugar in the blood.

Sleep Apnea
Sleep apnea is a condition characterized by episodes of stopped breathing during sleep.

Stroke
A stroke occurs when a blood vessel (artery) that supplies blood to the brain bursts or is blocked by a blood clot.

¹Obesity Cancer Coalition. "Obesity-Related Conditions From A-Z." <http://www.obesityaction.org/resources/oacnews/oacnews2/obesityrelatediseases.php>
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If you are new to this blog space, welcome!
Here in this space you will find information not only about bariatric surgery options such as LAP-BAND System surgery, but you will also learn more about how to deal with your obesity problem as well as what to expect before and after your surgery. You are also invited to attend one of our free informational seminars on LAP-BAND surgery. During the course of the seminar you'll have the opportunity to meet with Dr. Bradley Waggoner, other prospective patients such as yourself, as well as patients who have had bariatric surgery.

Pre-Operative LAP-BAND System Surgery Questions

Of course you have a lot of questions regarding LAP-BAND System Surgery. So, let's start at the beginning.

Pre-Operative Research
First, we want to make sure that you are a LAP-BAND candidate. See this blog posting, "Do You Qualify for Lap-Band Surgery?" to begin your research.

Next, if in the Houston area, you are invited to attend a free seminar on LAP-BAND System Surgery hosted by Dr. Bradley Waggoner. To find out why patients feel so comfortable in choosing Dr. Waggoner to perform their Lap-Band Surgery, see this link. The free LAP-BAND seminars are ongoing and can be attended at any time.

During the seminars, you'll have the opportunity to meet patients who will share their LAP-BAND System surgery experience, have your questions answered and gain encouragement. The seminar schedule is continuously updated for each month's meeting place and time and can be viewed on this blog and on Dr. Waggoner's website.

Stay-tuned for the next installation of this blog where we will discuss any post-operative questions you may have. Until then, feel free to contact us at any time to learn more about lap-band surgery or to schedule a personal appointment with Dr. Waggoner.