Bradley Waggoner, MD

Weight-Loss Surgery May ‘Remodel’ Heart

A study published in the Feb. 8 issue of the Journal of the American College of Cardiology, followed more than 400 severely obese people who had gastric bypass surgery, which reduces stomach size. Two years later, patients’ body mass index (BMI) fell from an average of nearly 48 (morbidly obese) to about 32. Their average weight loss was about 100 pounds.

Echocardiograms, or ultrasounds of the heart, also showed a “remodeling” of their heart structure, including a reduction in the left ventricular mass and right ventricular cavity area.

Those reductions in heart mass and volume indicate a heart that’s less stressed, isn’t having to work as hard pumping blood and has returned to a more normal shape and function, states Dr. Sheldon Litwin, senior study author and chief of cardiology at the Medican College of Georgia.

Source: Health.com - Obesity News & Headlines, Weight-Loss Surgery May 'Remodel' Heart by Jenifer Goodwin. http://news.health.com/2011/02/03/weight-loss-surgery-may-remodel-heart/

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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.

Gastric Bypass Alters Sweet Taste Function

Gastric bypass surgery decreases the preference for sweet-tasting substances in obese rats, a study finding that could help in developing safer treatments for the morbidly obese, according to Penn State College of Medicine researchers.

"Roux-en-Y gastric bypass surgery is the most common effective treatment for morbid obesity," said Andras Hajnal, associate professor, Department of Neural and Behavioral Science and Surgery. "Many patients report altered taste preferences after having the procedure."

This surgery involves the creation of a small gastric pouch and bypassing a portion of the upper small intestine. Unlike other weight-reduction methods, it produces substantial and durable weight loss and significant improvements in obesity-related medical conditions including diabetes.

Study results in obese rats suggest that post-surgery changes in the gastrointestinal anatomy affect change in the brain that relate to taste.

Obese rats given gastric bypass surgery showed a reduced preference for high concentration sucrose water when compared to obese rats that did not have surgery. Researchers observed a similar decrease in preference with other sweet-tasting substances, but not for salty, sour or bitter substances. Researchers observed no change in preference in lean rats that had gastric bypass surgery.

The obese rats used do not have the ability to produce the receptor for feeling satiated shortly after a meal because they lack the gut hormone CCK-1. As a result, these rats consumed larger meals and, over time, became obese and developed type-2 diabetes. Interestingly, previous studies lead by the Penn State investigators found an increased sweet preference in these rats, which is also often seen in people struggling with weight management.

"It appears that an uncontrolled appetite may get further boost from altered taste functions during development of obesity and diabetes," Hajnal said. "How much of this vicious circle is due to changes in the neurons inside the brain, which receive taste sensations from the tongue and report to the higher order motivational brain centers, we don't know."

The researchers recorded the activity of 170 taste-responsive neurons in the brain. These showed a shift in the neurons' firing activity similar to the behavioral response, which was measured in lick rates of the rats within a ten-second time period. Neurons in the obese rats' brain responded more vigorously to higher-concentration sucrose water placed on the tongue when compared to lean rats. These effects were reversed by gastric bypass surgery and matched the response of lean rats -- a preference for lower concentration sucrose.

The rats that had gastric bypass surgery lost weight comparable to humans who received the surgery -- 26 to 30 percent of their weight -- and maintained the loss for a long period of time after surgery. Following surgery, the obese rats also showed a higher tolerance for glucose, indicating improvement in diabetes.

"This supports the applicability of this rat model of Roux-en-Y gastric bypass to humans and also suggests that the observed taste changes following the surgery were not related to 'human factors' such as awareness and compliance to dietary and behavioral interventions," Hajnal said.

The researchers published their findings in the October issue of the "American Journal of Physiology, Gastrointestinal and Liver Physiology." The National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of General Medical Sciences funded this work.

"These findings confirm obesity-related alterations in taste functions and demonstrate the ability of gastric bypass surgery to alleviate these modifications," Hajnal said. "We do not suggest, however, that the findings reported in this paper are the only neural consequences of gastric bypass surgery related to altered postsurgical food preferences. Nevertheless, understanding the underlying mechanisms by which gastric bypass surgery affects taste may help in identifying therapeutic targets that mimic the beneficial effects of the surgery on appetite control and food choices, without the risks and complications of an invasive surgical procedure."

Further research is needed to determine what causes the neural and behavioral changes, according to Hajnal.

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Source: Reprinted with editorial adaptations from materials provided by Penn State University. http://live.psu.edu/tag/research

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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.

Bariatric Surgery in Diabetic Adults Improves Insulin Sensitivity Better than Diet

Gastric bypass surgery improves Type 2 diabetes by other mechanisms in addition to weight loss and does so better than a low-calorie diet despite achieving equal weight loss, a new study finds. The results will be presented Monday at The Endocrine Society’s 92nd Annual Meeting in San Diego.

“Our study shows that in the short term, weight loss by diet alone does not achieve the same improvements in diabetes as gastric bypass surgery,” said the presenting author, Judith Korner, MD, PhD, assistant professor of medicine at Columbia University College of Physicians and Surgeons, New York.

Korner and her colleagues found that gastric bypass surgery better improved insulin sensitivity, the body’s ability to successfully clear glucose sugar from the bloodstream into the cells. Insulin sensitivity is impaired in people with Type 2 diabetes, and obesity adds to this problem. The result is a buildup of sugar in the blood.

The study compared the effects on diabetic adults of a low-calorie diet versus Roux-en-Y gastric bypass, the most common gastric bypass procedure. Roux-en-Y gastric bypass decreases the size of the stomach and reroutes the digestive tract to bypass most of the stomach and part of the small intestine. After gastric bypass, many diabetic patients achieve normal blood glucose control or vastly improved control, and some may no longer require diabetes medications.

In the study, seven obese patients with Type 2 diabetes received a daily 800-calorie liquid diet and no surgery, while seven other obese diabetic adults underwent gastric bypass surgery. The study ended when both groups lost the same amount of weight: an average of 8 percent of body weight. However, the surgery-treated patients lost the weight faster: in about 3.5 weeks compared with 8 weeks for the dieters.

Surgical patients were able to discontinue all of their diabetes medications by the study’s end, but the dieters reduced their medication use by 55 percent, Korner reported.

The researchers found significant improvements in the surgery group in measures of insulin sensitivity and function of beta cells, the insulin-producing cells in the pancreas. Improvements in insulin sensitivity in the low-calorie diet group were not statistically significant and beta cell function improved to a lesser extent.

Korner speculated that hormonal changes may be responsible for the improvements resulting from Roux-en-Y surgery in individuals with Type 2 diabetes.

“It will be important to understand how surgery works to produce these results so that we can develop medical therapies of equivalent efficacy,” she said.

The National Institute of Diabetes and Digestive and Kidney Diseases funded this study.

 

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Source: The Endocrine Society . http://www.endo-society.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!

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

2011 Schedule Set for Free Weight Loss Surgery Seminars in Houston Area

 

"It’s not who you are that holds you back, it’s who you think you’re not."
~ Anonymous

 

Meet Dr. Waggoner And Learn More About
Your Weight Loss Surgery Options!

Houston Area: If you've been thinking about bettering your health and life-expectancy by having a surgical weight loss procedure, then we encourage you to attend our free weight loss surgery seminar.

Dr. Bradley Waggoner will host these seminars and will be on hand to answer all of your questions as they pertain to your weight loss surgery options such as Sleeve Gastrectomy, Gastric Bypass Surgery or LAP Band System Surgery.

Below are the Weight Loss Surgery Seminar dates for 2011. The seminars will be held at North Cypress Medical Center Hospital* in the Houston, Texas area.

Dr. Bradley Waggoner's Free Seminar Schedule Please Call 281-640-8373 to Reserve Your Space
January 2011
January 18	NCMC	6:00 pm
February 2011
February 12	NCMC	10:00 am
March 2011
March 1	NCMC	6:00 pm
April 2011
April 16	NCMC	10:00 am
May 2011
May 3	NCMC	6:00 pm
June 2011
June 7	NCMC	6:00 pm
July 2011
July 9	NCMC	10:00 am
August 2011
August 2	NCMC	6:00 pm
September 2011
September 10	NCMC	10:00 am
October 2011
October 4	NCMC	6:00 pm
November 2011
November 17	NCMC	6:00 pm
December 2011
December 20	NCMC	6:00 pm

Weight Loss Surgery Seminar Location:
North Cypress Medical Center Hospital
21214 Northwest Freeway
Cypress, TX 77429

For more information, directions, and/or to reserve your seat, 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.

New Study Shows Similar Benefits, No Additional Risks for Seniors Who Have Gastric Bypass

Comparable Weight Loss, Complication Rates and Hospital Stays for Young and Old

Morbidly obese seniors, age 65 and over, who had laparoscopic gastric bypass surgery lost nearly 76 percent of their excess weight after two years and had low complication rates and short hospital stays comparable to younger surgical patients, according to a new study presented today at the 26th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS).¹

“Bariatric surgery in the older population is underutilized because of a misperception that old age alone puts patients at higher risk for complications and mortality,” said Joseph Kuhn, MD, co-author and director of General Surgical Research at Baylor University Medical Center in Dallas, TX. “We found seniors can benefit just as much as younger people from bariatric surgery without taking on additional risk.”

In one of the largest series of laparoscopic gastric bypass surgeries performed on elderly patients, researchers from Baylor University Medical Center analyzed a prospective database of 100 patients over age 65 and compared safety and outcomes to a younger population. All patients had laparoscopic gastric bypass surgery between January 2005 and July 2008.

Prior to surgery, older patients demonstrated higher operative risk profiles compared to their younger counterparts in relation to sleep apnea (45% vs. 34%), Type 2 diabetes (65% vs. 33%) and hypertension (81% vs. 57%). Older patients ranged in age from 65 to 77 with an average BMI of 45, and younger patients ranged in age from 18 to 64 with an average BMI of 47.

Post-operative excess body weight loss (EWL) and complication rates were comparable in both groups. At 12 and 24 months, both lost nearly the same amount of weight -- patients over age 65 showed 75.9 percent EWL after one year and 75.5 percent after two years; patients under 65 showed 77.8 percent EWL after one year and 79.2 percent after two years. Neither group reported any deaths in the two year follow-up period, and post-operative complications were low: bleeding (>65 1% v. < 65 1.3%), pulmonary infections (>65 3% v. <65 1.3%), cardiac (>65 2% vs. <65 0.36%) and wound infections (>65 1% v. <65 1.7%). Due to the age and overall health status of the older group, researchers noted it was particularly interesting to also find length of hospital stays (1.9 vs.1.3 days) and 30 day readmissions rates (6% vs. 7.4%) to be so comparable.

About 26 percent of people 65 and older in the U.S. are obese and another nearly 40 percent are overweight,² putting them at a higher risk for Type 2 diabetes, high blood pressure and heart disease. Since 1990, the prevalence of obesity has increased more than 50 percent in the elderly.³

“The population is getting older and unfortunately more obese, so we will see a corresponding increase in the number of patients over 65 who are eligible for bariatric surgery and surgery needs to be an option for them,” said Christopher Willkomm, MD, study co-investigator from Baylor University Medical Center.

People who are morbidly obese are generally 100 or more pounds overweight, have a BMI of 40 or more, or a BMI of 35 or more with an obesity-related disease, such as Type 2 diabetes, heart disease or sleep apnea. According to the ASMBS, more than 15 million Americans are considered morbidly obese and in 2008 an estimated 220,000 people had some form of bariatric surgery. The most common methods of bariatric surgery are laparoscopic gastric bypass and laparoscopic adjustable gastric banding (LAGB).

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¹American Society for Metabolic & Bariatric Surgery. June 25, 2009. http://www.asmbs.org/Newsite07/resources/asmbs_items.htm. The ASMBS a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits. For more information about the ASMBS, visit www.asmbs.org.

²Rhoades, J. Overweight and Obese Elderly and Near Elderly in the United States, 2002: Estimates for the Noninstitutionalized Population Age 55 and Older. Statistical Brief #68. February 2005. Agency for Healthcare and Research Quality, Rockville, Md. http://meps.ahrq.gov/mepsweb/data_files/publications/st68/stat68.pdf.

³Physical Activity and Older Americans: Benefits and Strategies. June 2002. Agency for Healthcare Research and Quality and the Centers for Disease Control. http://www.ahrq.gov/ppip/activity.htm.

PL-207. SURGICAL WEIGHT LOSS OVER 65 - IS IT WORTH THE RISK? Christopher M. Willkomm, MD; Colleen Kennedy, MD; Tammy L. Fisher, RN; Gregory Barnes, MD; Joseph A. Kuhn, MD; Surgery, Baylor University Medical Center, Dallas, TX, USA

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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 seminar on Lap-Band Surgery 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.

Compare Lap-Band System Surgery and Gastric Bypass Surgery

There are multiple options when it comes to choosing a weight loss surgery plan. We want you to be as informed as possible, and to start you on this journey, the below¹ is a very basic outline of advantages on two of the most successful types of weight loss surgeries available.

But before we get started, we advise that you also conduct an interview with your doctor to make sure the plan you choose will fit-in with any pre-existing medical conditions you may have.

Dr. Bradley Waggoner is a very experienced advanced laparoscopic surgeon who is now focusing the majority of his practice toward laparoscopic bariatric surgery, of which include both of the procedures we will be outlining today. 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.

LAP-BAND® System

• Lowest mortality rate
• Least invasive surgical approach
• No stomach stapling or cutting, or intestinal re-routing
• Adjustable
• Reversible
• Lowest operative complication rate
• Low malnutrition risk

Gastric Bypass Surgery

• Rapid initial weight loss
• Minimally invasive approach is common
• Longer clinical experience in the U.S.
• Slightly higher total average weight loss reported than with purely restrictive procedures

The above comparison shows some of the advantages of these two weight loss surgeries. To learn more about Lap-Band System Surgery click here, and to learn more about Gastric Bypass Surgery, click here.

To learn more about the differences between a lap-band procedure and a gastric bypass procedure, click here.

¹Source: LAP-BAND System/Allergan, Inc.

What is Gastric Bypass Surgery?

Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus the calories consumed.

Bypassing part of the intestine also results in fewer calories being absorbed. This leads to weight loss. The most common gastric bypass surgery is a Roux-en-Y Gastric Bypass.

Click here to learn more about Gastric Bypass Roux-en-Y Surgery.

Have Questions about Your Medical Options for Weight Loss Surgery?
You're invited to attend one of Bradley Waggoner's free weight loss surgery seminars. Attend one of these seminars and learn more about your options for weight loss surgery. Dr. Waggoner will be available during the course of each seminar to answer your questions.

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

What is Lap-Band System Surgery?

Approved by the FDA in June 2001, LAP-BAND System is the safest, least invasive and only adjustable surgical treatment for morbid obesity in the United States. It induces weight loss by reducing the capacity of the stomach, which restricts the amount of food that can be consumed.Since its clinical introduction in 1993, over 200,000 LAP-BAND procedures have been performed around the world.

"Lap-Band System" is the brand name of the FDA-approved, adjustable gastric band used in the procedure. A Lap-Band is a silicone belt that goes around the top of the stomach. This results in the ability to control your hunger and achieve a "feeling of fullness," or satiety. Ultimately, you eat much less and should feel full sooner.

A key component of the Lap-Band System is its adjustability. The band is connected to a port, which enables the device to be inflated over time to expedite the weight loss.

To learn more about Lap-Band System Surgery please click here.

Did You Know?
We want you to have the FAQs about your weight loss surgery options! Attend one of our free weight loss surgery seminars this summer. Dr. Bradley Waggoner, Bariatric Surgeon, will be hosting these free seminars discussing medical weight loss options on June 3, and June 28. Call us for more information and to reserve your seat.

If you cannot make one of the June seminars, more weight loss surgery seminars will be scheduled throughout the summer. Check back here often to learn more.

Findings Show Gastric Bypass Surgery May Help Resolve Erectile Dysfunction

Losing weight can help resolve erectile dysfunction in obese men, according to findings presented at the American Urological Association (AUA) 2008 Annual Meeting.¹

Morbid obesity can cause sexual dysfunction independent of other common contributors, including diabetes, hypertension, and smoking. In this study, from researchers in Boston and Philadelphia, sexual function was normalized in some men who underwent Gastric Bypass surgery for weight loss.

"This study [95 patients underwent gastric bypass surgery for weight loss] shows that weight loss and other risk factors that are alleviated by weight loss, may be keys to restoring sexual function," said Anthony Y. Smith, MD, from the University of New Mexico, in Albuquerque, a member of the AUA Public Media Committee. "These results give men another reason to improve their health by losing weight."

For more information on weight loss surgery options such as Gastric Bypass Surgery or Lap-Band System Surgery, contact Bradley Waggoner.

¹Source: Medscape Medical News