Bradley Waggoner, MD

Study Finds Isolated Weight Loss Following Bariatric Surgery Results in Significant Improvements in Knee Pain, Stiffness and Function

Another new study released in February, 2011 analyzed the effects of isolated weight loss via bariatric surgery on knee osteoarthritis. The study involved 24 obese patients with knee osteoarthritis who were scheduled to undergo bariatric surgery. Patient weights and knee symptoms were recorded before the surgery and 6 and 12 months after surgery. Patients were not prescribed exercise or physical therapy, anti-inflammatory medications or knee injections post-operatively.

The study found that isolated weight loss following bariatric surgery resulted in significant improvements in knee pain, stiffness and function.

“Other studies have looked at the effect that a combination of weight loss, diet and exercise had on knee arthritis, but it was difficult to say which of these factors contributed the most to reducing knee pain,” says Christopher Edwards, co-investigator and a fourth year medical student at the Penn State College of Medicine. “Our study should send a message to patients, health care providers, and payers that weight loss is an important consideration in the treatment of knee arthritis.”

Source: Reprinted with editorial adaptations from materials provided by American Academy of Orthopaedic Surgeons. http://www6.aaos.org/news/Pemr/releases/release.cfm?releasenum=966

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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!

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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!

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Symptoms of Obese Heart Failure Patients Improved After Bariatric Surgery

A small Mayo Clinic study has found that morbidly obese heart failure patients who undergo bariatric surgery gain long-lasting and meaningful improvements in disease symptoms and quality of life. The results were presented today at the American Heart Association's Scientific Sessions 2010 in Chicago.

"This tells us that bariatric surgery may become part of the treatment of patients with heart failure and obesity if there are no major contraindications for the surgery — and that this might be especially important for patients with significant obesity," says the study's lead investigator, cardiologist Francisco Lopez-Jimenez, M.D.

He cautions, however, that because the study tested the effects of bariatric surgery on just 13 patients, "these results should be considered preliminary and suggestive of some benefit, but additional research is needed to confirm these results."

Although one-third of heart failure patients are obese, it appears that cardiologists do not often refer obese patients with heart failure for bariatric surgery, Dr. Lopez-Jimenez says.

The research team reviewed the outcomes of 13 patients, ages 44 to 64, who received bariatric surgery at Mayo Clinic in Minnesota between 1990 and 2005, as well as six heart failure patients, ages 52 to 72, who were followed in Mayo's Nutrition Clinic and did not receive the surgery.

In the group that received surgery, the mean body mass index (BMI) was 53, and in the comparison group, it was 42. After a four-year follow-up, mean BMI dropped in the surgery group to 37 and rose in the comparison group to 45.

Based on patient surveys, the researchers found that quality of life was significantly improved in those who received weight loss surgery, compared to heart failure patients who did not. Researchers also determined that symptoms such as swelling in the legs and labored breathing during exercise improved only in the surgery group.

Dr. Lopez-Jimenez points out that the health advantages seen in the patients who had bariatric surgery occurred even though most remained obese. "These patients had very advanced levels of obesity before the surgery, and although they lost significant amounts of weight, most remained obese. So, these good results suggest that the benefit does not require patients to reach a normal weight," he says.

Other authors of the study are William Miranda, M.D.; Michael Sarr, M.D.Maria Collazo-Clavell, M.D.; Matthew Clark, Ph.D. and Virend Somers, M.D., Ph.D.; all of Mayo Clinic, and John Batsis, M.D., Dartmouth-Hitchcock Medical Center.

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Mayo Clinic, (2010, November 14)

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Component in Common Dairy Foods May Cut Diabetes Risk

Scientists at the Harvard School of Public Health (HSPH) and collaborators from other institutions have identified a natural substance in dairy fat that may substantially reduce the risk of type 2 diabetes. The compound, trans-palmitoleic acid, is a fatty acid found in milk, cheese, yogurt, and butter. It is not produced by the body and so only comes from the diet.

Reporting in the December 21, 2010, issue of Annals of Internal Medicine, investigators led by Dariush Mozaffarian, associate professor in the Department of Epidemiology at HSPH and Division of Cardiovascular Medicine, Brigham and Women’s Hospital and Harvard Medical School, and Gökhan S. Hotamisligil, J.S. Simmons Professor of Genetics and Metabolism and chair of the Department of Genetics and Complex Diseases at HSPH, explain that trans-palmitoleic acid may underlie epidemiological evidence in recent years that diets rich in dairy foods are linked to lower risk of type 2 diabetes and related metabolic abnormalities.  Health experts generally advise reducing full-fat dairy products, but trans-palmitoleic acid is found in dairy fat.

The HSPH researchers examined 3,736 participants in the National Heart, Lung, and Blood Institute-funded Cardiovascular Health Study, who have been followed for 20 years in an observational study to evaluate risk factors for cardiovascular diseases in older adults. Metabolic risk factors such as blood glucose and insulin levels, and also levels of circulating blood fatty acids, including trans-palmitoleic acid, were measured using stored blood samples in 1992, and participants were followed for development of type 2 diabetes.

At baseline, higher circulating levels of trans-palmitoleic acid were associated with healthier levels of blood cholesterol, inflammatory markers, insulin levels, and insulin sensitivity, after adjustment for other risk factors. During follow-up, individuals with higher circulating levels of trans-palmitoleic acid had a much lower risk of developing diabetes, with about a 60% lower risk among participants in the highest quintile (fifth) of trans-palmitoleic acid levels, compared to individuals in the lowest quintile.

“This type of observational finding requires confirmation in additional observational studies and controlled trials, but the magnitude of this association is striking,” said Mozaffarian, lead author of the study. “This represents an almost three-fold difference in risk of developing diabetes among individuals with the highest blood levels of this fatty acid.”

In contrast to the types of industrially produced trans fats found in partially hydrogenated vegetable oils, which have been linked to higher risk of heart disease, trans-palmitoleic acid is almost exclusively found in naturally-occurring dairy and meat trans fats, which in prior studies have not been linked to higher heart disease risk.

“There has been no clear biologic explanation for the lower risk of diabetes seen with higher dairy consumption in prior studies. This is the first time that the relationship of trans-palmitoleic acid with diabetes risk has been evaluated,” said Mozaffarian. “We wonder whether this naturally occurring trans fatty acid in dairy fats may partly mimic the normal biologic role of its cis counterpart, cis-palmitoleic acid, a fatty acid that is produced in the body. In animal experiments, cis-palmitoleic acid protects against diabetes.” 

“Unfortunately, with modern diets, synthesis of cis-palmitoleic acid is now driven by high amounts of carbohydrate and calories in the diet, which might limit its normal protective function. We wonder whether trans-palmitoleic acid may be stepping in as a “pinch hitter” for at least some of the functions of cis-palmitoleic acid,” said Mozaffarian.

Hotamisligil, the study’s senior author, also emphasized the magnitude of the risk reduction. “This is an extremely strong protective effect, stronger than other things we know can be beneficial against diabetes. The next step is to move forward with an intervention trial to see if there is therapeutic value in people.”

Because trans-palmitoleic acid, also known as trans-palmitoleate, is a natural compound, Hotamisligil said that conducting clinical trials should be possible. “This study represents the power of interdisciplinary work bridging basic science with population studies to realize exciting translational possibilities,” he said.

Support for the study was provided by the National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health and the National Institutes of Health Office of Dietary Supplements and National Institute of Neurological Disorders and Stroke. A subset of additional fatty acid measurements were supported by a Searle Scholar Award.

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Harvard School of Public Health, (2010, December 20).

Journal Reference: “Trans-Palmitoleic Acid, Metabolic Risk Factors, and New-Onset Diabetes in U.S. Adults,” Dariush Mozaffarian, Haiming Cao, Irena B. King, Rozenn N. Lemaitre, Xiaoling Song, David S. Siscovick, and Gökhan S. Hotamisligil, Annals of Internal Medicine, December 21, 2010.

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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!

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Limiting Salt Lowers Blood Pressure and Health Risks in Diabetes

For patients living with diabetes, reducing the amount of salt in their daily diet is key to warding off serious threats to their health, a new review of studies finds.

In the Cochrane review, the authors evaluated 13 studies with 254 adults who had either type 1 or type 2 diabetes. For an average duration of one week, participants were restricted to large reduction in their daily salt intake to see how the change would affect their blood pressure.

“We were surprised to find so few studies of modest, practical salt reduction in diabetes where patients are at high cardiovascular risk and stand much to gain from interventions that reduce blood pressure,” said lead reviewer Rebecca Suckling. “However, despite this, there was a consistent reduction in blood pressure when salt intake was reduced.”

Suckling is part of the Blood Pressure Unit at St. George’s Hospital Medical School, in London.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

Patients with diabetes need to be extra cautious to maintain their blood pressure at an acceptable range of less than 130/80 mmHg. However, in the 2003-2004 period, 75 percent of adults with diabetes had blood pressure greater than or equal to 130/80 mmHg or used prescription hypertension medications, according to the American Diabetes Association (ADA).

High salt intake is a major cause for increased blood pressure and, in those with diabetes, elevated blood pressure can lead to more serious health problems, including stroke, heart attack and diabetic kidney disease. The ADA also reports that diabetic kidney disease is the leading cause of chronic kidney disease, accounting for 44 percent of new cases in 2005.

In the Cochrane review, the participants’ average salt intake was restricted by 11.9 grams a day for those with type 1 diabetes and by 7.3 grams a day for those with type 2.

The reviewers wrote that reducing salt intake by 8.5 grams a day could lower patients’ blood pressure by 7/3 mmHg. This was true for patients with both type 1 and type 2 diabetes. The reviewers noted that this reduction in blood pressure is similar to that found from taking blood pressure medication.

Suckling acknowledged that studies in the review only lasted for a week and that the type of salt restriction probably would not be manageable for longer periods.

“The majority of studies were small and only of a short duration with large changes in salt intake,” she said. “These studies are easy to perform and give information on the short-term effects of salt reduction.”

However, Suckling said, the review also found that in studies greater than two weeks, where salt was reduced by a more achievable and sustainable amount of 4.5 grams a day, blood pressure was reduced by 6/4 mmHg.

Diabetes specialist Todd Brown, M.D., of the Division of Endocrinology and Metabolism at Johns Hopkins University, said that practicing low-salt diets of these types is quite challenging for most patients with diabetes even though they know the health risks.

“The effects of salt on blood pressure are well known to health professionals and most patients, but what is less well known is where the salt comes from in our diet,” Brown said.

“The overwhelming majority comes from the processed foods that we eat,” he said. “If we are going to realize the benefits of sodium reduction on blood pressure and other health outcomes, we should focus less on the salt shaker and more on what we buy in the supermarket and at chain restaurants.”

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Health Behavior News Service, Part of the Center for Advancing Health (2010, December 7). 

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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!

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Carbohydrate Claims Can Mislead Consumers, Study Finds

Food manufacturers advertise a variety of foods on grocery store shelves by using nutrient claims on the front of packaging. A study in the September/October issue of the Journal of Nutrition Education and Behavior evaluates how consumers are interpreting certain carbohydrate-related content claims and the effects of claims on consumer perceptions of food products. Findings from this study reveal that consumers misinterpret low carbohydrate claims to have health benefits and weight loss qualities beyond their nutrition facts.

In the early 2000s, low-carbohydrate claims gained huge popularity in response to such books as Dr. Atkin's New Diet Revolution and The South Beach Diet. In a study published in AC Nielsen Consumer Insights, it was noted that there was a 516% sales increase in low-carbohydrate food products from 2001 to 2005 showing that front of package claims can play a large part in consumer decisions.

Existing research suggests that consumers are less likely to turn to the back of a package to look at the Nutrition Facts panel when there is a claim on the front of the package. In the new study, researchers at the United States Food and Drug Administration, Center for Food Safety and Applied Nutrition sought to determine whether low-carbohydrate claims might lead consumers to perceive products to have benefits that are not necessarily related to being low in carbohydrate. Using an online questionnaire, 4,320 consumer panelists rated products for their perceived healthfulness, helpfulness for weight management, and caloric content based on front-of-package-only conditions (nutrition claims versus no nutrition claims) and availability of Nutrition Facts panels.

This study documents that in the absence of Nutrition Facts panels, "low-carbohydrate claims led to more favorable perceptions about products' helpfulness for weight management, healthfulness, and caloric content. Because an individual packaged food product's usefulness for weight management as part of an overall diet, its healthfulness, and total calorie content are not dependent solely on the amount of total carbohydrate it contains, the study demonstrated that consumers could misattribute benefits to products that claim to be low in carbohydrate."

However, the researchers found that when the Nutrition Facts panels are available "participants' perceptions became more consistent with the nutrition profile of the products…By showing the claims and the NF [nutrition facts] side-by-side, both pieces of information were equally accessible to participants as they answered the study questions. The presence of the NF, however, allowed participants to use this more diagnostic information to judge the product."

One limitation mentioned in this study by Dr. Judith Labiner-Wolfe, former consumer science specialist at the United States Food and Drug Administration (now an evaluation specialist at the United States Department of Health and Human Services' Office on Women's Health) and colleagues is that "the online venue for viewing the stimuli and answering the study questions may have fewer distractions than situations in which consumers make real product judgments, such as in a busy grocery store. Therefore, this study may overestimate the effect of the Nutrition Facts panel. Findings from this research are consistent with previous experimental studies that found participants misattribute health benefits to products with claims and that nutrition information has an independent effect on perceptions." The authors' state, "although exposure to the Nutrition Facts has the potential for mitigating inappropriate benefits attributed to products claiming to be low carbohydrate, previous consumer research suggests that when a food product carries a front-of-package claim, consumers are less likely to turn the package over to look at the Nutrition Facts panel."

Within the article, the researchers emphasize the important role nutrition educators have in helping consumers better understand the limited meaning of front- of- package claims and to further emphasize the importance of using the Nutrition Facts panel when making food choices.

The article is "Effect of Low-carbohydrate Claims on Consumer Perceptions about Food Products' Healthfulness and Helpfulness for Weight Management" by Judith Labiner-Wolfe, PhD; Chung-Tung Jordan Lin, PhD; and Linda Verrill, PhD. It appears in the Journal of Nutrition Education and Behavior, Volume 42, Issue 5 (September/October 2010) published by Elsevier.

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Elsevier Health Sciences (2010, October 11). Carbohydrate claims can mislead consumers, study finds. ScienceDaily. Retrieved November 7, 2010, from ScienceDaily.com.

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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!

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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!

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New Study Strengthens Link Between Everyday Stress and Obesity

Stress can take a daily toll on us that has broad physical and psychological implications. Science has long documented the effect of extreme stress, such as war, injury or traumatic grief on humans. Typically, such situations cause victims to decrease their food intake and body weight. Recent studies, however, tend to suggest that social stress--public speaking, tests, job and relationship pressures--may have the opposite effect--over-eating and weight gain. With the rise of obesity rates, science has increasingly focused on its causes and effects--including stress.

A recent study conducted by the Departments of Psychiatry and Biomedical Engineering at the University of Cincinnati College of Medicine, examined the effects of stress on the meal patterns and food intake of animals exposed to the equivalent of everyday stress on humans. The results suggest that, not only does stress have an impact on us in the short term, it can cause metabolic changes in the longer term that contribute to obesity.

The study was conducted by Susan J. Melhorn, Eric G. Krause, Karen A. Scott, Marie Mooney, Jeffrey D. Johnson, Stephen C. Woods and Randall R. Sakai at the University of Cincinnati College of Medicine, Cincinnati, OH. Their study was published in the American Journal of Physiology – Regulatory, Integrative and Comparative Physiology. 

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Source: Reprinted with editorial adaptations from materials provided by The American Physiological Society. http://www.the-aps.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.

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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.

Focusing on Immediate Health Effects May Improve Weight Loss Success

Most weight loss programs try to motivate individuals with warnings of the long-term health consequences of obesity: increased risk for cancer, diabetes, hypertension, heart disease and asthma.  New research suggests the immediate health benefits—such as reduced pain—may be the most effective motivator for helping obese individuals shed extra weight and commit to keeping it off.

 

In a pilot research study, University of Cincinnati (UC) researchers found that 21 percent of participants in a local dietary weight loss program reported significantly less pain in the lower extremities and back after losing an average of 10 pounds. Additionally, study participants reported a 20 to 30 percent reduction in overall bodily pain after weight loss.

 

Researchers say their results indicate that even small weight loss can relieve pain and reduce the burden excessive weight puts on the musculoskeletal system.

 

"By focusing on an immediate benefit that can be felt—like pain reduction—instead of the future health impact of obesity, weight loss programs may be able to inspire overweight individuals to lose weight,” says Susan Kotowski, PhD, study collaborator and director of the Gait and Movement Analysis Laboratory in the UC College of Allied Health Sciences.

 

Kotowski and colleague Kermit DAvis, PhD, report their findings in the August 2010 issue of the journal Work.

 

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. Previous studies have estimated obesity-attributable medical expenditures in the United States at $75 billion, with half of these costs financed by Medicare or Medicaid.

 

"Obesity has become a national health crisis, but compliance for weight loss programs is notoriously poor. One potential reason for this is that current programs target long-term diseases, with little direct relevance to the person’s current health status,” adds Davis, senior author of the study and director of the Low Back Biomechanics and Workplace Stress Laboratory at the UC College of Medicine’s environmental health department. "Our study results challenge people to rethink the way they structure weight loss programs.”

 

For this pilot study, UC researchers partnered with a Cincinnati-based weight loss clinic to recruit study volunteers. Thirty two women between the ages of 22 and 76 participated in the study and data was collected over the course of a 12-week dietary weight loss regimen.

 

Researchers collected baseline individual weight and musculoskeletal pain data related to nine body regions: neck, shoulders, elbows, hands and wrists, upper back, lower back, hips, knees and lower legs and feet. Participants were then tracked each week to record any weight loss and asked to rate their pain on a scale of zero to 10 every other week.

 

Significant associations were found between weight loss and overall pain reduction, as well as pain reduction in the elbow, hip region and upper and lower back.

 

Researchers say these preliminary results could have ramifications for companies with a high prevalence of overweight workers with musculoskeletal problems—particularly in industries that require manual or repetitive weight-bearing labor.

 

"From an ergonomics perspective, we can only do so much to alter the work environment to remove body stressors,” explains Kotowski. "Excess weight adds additional stress to the musculoskeletal system and that can only be relieved through weight loss.”

 

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Source: University of Cincinnati . http://www.healthnews.uc.edu/news/

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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!

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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.