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.

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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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.

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!

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

New Research Findings Link Fat to Decreased Heart Function

Researchers from Boston University School of Medicine (BUSM)¹ have shown that fat collection in different body locations, such as around the heart and the aorta and within the liver, are associated with certain decreased heart functions. The study, which appears on-line in Obesity, also found that measuring a person’s body mass index (BMI) does not reliably predict the amount of undesired fat in and around these vital organs.

The prevalence of obesity is rising rapidly in the United States. Recent estimates suggest that approximately 30 percent of the adult population meets this criterion. Past studies have shown that fat accumulation in the liver and around the heart are linked to cardiovascular disease and type 2 diabetes.

BUSM researchers compared fat volumes in obese persons (BMI over 30), all of whom had high blood pressure and/or diabetes, and lean healthy persons (average BMI of 22). All subjects underwent magnetic resonance imaging (MRI) and proton MR spectroscopy to quantify pericardial and peri-aortic lipid volumes, cardiac function, aortic compliance and intra-hepatic lipid content. Fasting plasma lipoproteins, glucose, insulin, and free fatty acids were also measured among the subjects.

The researchers found fat collections in anatomically separate locations, such as within the liver and around the heart, to be associated to cardiovascular function – including a decrease in cardiac pumping function – as fat around the heart increased. However, they also found that the amount of fat around the heart and aorta was not predicted by the BMI of the individual in this population.

“Our study found that fat collection around the heart, the aorta and within the liver is clearly associated with decreased heart functions and that an MRI can quickly and noninvasively measure fat volume in these areas. Our study also found that looking at BMI of the individual does not reliably predict the amount of undesired fat in and around organs,” said James Hamilton, PhD, senior author and project leader, and a professor of biophysics, physiology and biomedical engineering at BUSM.

According to the researchers, this method of measuring cardiac function and fat deposits can be done in less than one hour, and may provide a basis for future individualized treatment.

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¹Digravio, Gina M. (2009, November 13). Boston University School of Medicine.  http://www.bu.edu/research/highlights/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!

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

Study Finds Waist Size is a Predictor of Heart Failure in Both Men and Women

Adding to the growing evidence that a person’s waist size is an important indicator of heart health, a study led by investigators at Beth Israel Deaconess Medical Center (BIDMC) has found that larger waist circumference is associated with increased risk of heart failure in middle-aged and older populations of men and women.

The findings, published online in the April 7 Rapid Access Report of the journal Circulation: Heart Failure, showed that increased waist size was a predictor of heart failure even when measurements of body mass index (BMI) fell within the normal range.

“Currently, 66 percent of adults in the United States are overweight or obese,” explains Emily Levitan, ScD, the study’s first author and a Research Fellow in the Cardiovascular Epidemiology Research Unit at BIDMC. “Knowing that the prevalence of heart failure increased between 1989 and 1999, we wanted to better understand if and how this increase in obesity was contributing to these rising figures.”

A life-threatening condition that develops when the heart can no longer pump enough blood to meet the body’s needs, heart failure (also known as congestive heart failure) is usually caused by existing cardiac conditions, including high blood pressure and coronary artery disease. Heart failure is the leading cause of hospitalization among patients 65 and older, and is characterized by such symptoms as fatigue and weakness, difficulty walking, rapid or irregular heartbeat, and persistent cough or wheezing.

The researchers examined two Swedish population-based studies, the Swedish Mammography Cohort (made up of 36,873 women aged 48 to 83) and the Cohort of Swedish Men (43,487 men aged 45 to 79) who responded to questionnaires asking for information about their height, weight and waist circumference. Over a seven-year period between January 1998 and December 2004 the researchers reported 382 first-time heart-failure events among the women (including 357 hospital admissions and 25 deaths) and 718 first-time heart-failure events among men (accounting for 679 hospital admissions and 39 deaths.)

Their analysis found that based on the answers provided by the study participants, 34 percent of the women were overweight and 11 percent were obese, while 46 percent of the men were overweight and 10 percent were obese.

“By any measure – BMI, waist circumference, waist to hip ratio or waist to height ratio –our findings showed that excess body weight was associated with higher rates of heart failure,” explains Levitan.

Further breakdown of the numbers showed that among the women with a BMI of 25 (within the normal range), a 10-centimeter higher waist measurement was associated with a 15 percent higher heart failure rate; women with a BMI of 30 had an 18 percent increased heart failure rate. In men with a BMI of 25, a 10-centimeter higher waist circumference was associated with a 16 percent higher heart failure rate; the rate increased to 18 percent when men’s BMI increased to 30.

Furthermore, adds Levitan, among the men, each one-unit increase in BMI was associated with a four percent higher heart failure rate, no matter what the man’s waist size. In women, she adds, BMI was only associated with increased heart failure rates among the subjects with the largest waists. Finally, the authors found that the association between BMI and heart-failure events declined with age, suggesting that the younger the person, the greater the impact of weight to heart health.

“This study reinforces the importance of maintaining a healthy weight,” says Levitan. “Previous research has looked at various types of heart disease and related health issues, and no matter the particulars of the study, they’ve all been pretty consistent in determining that excess body weight increases a person’s risk of heart disease.”

Study coauthors include BIDMC investigators Murray A. Mittleman, MD, DrPH (senior author), Amy Z. Yang, BA and Alicja Wok, DrMedSci.

The study was supported by grants from the National Institutes of Health, the Swedish Research Council and the Swedish Foundation for International Cooperation in Research and Higher Education.

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¹Beth Israel Deaconess Medical University. April 7, 2009.  "Study Finds Waist Size is a Predictor of Heart Failure in Both Men and Women" <http://www.bidmc.org/News/InResearch/2009/April/WaistSizePredictorofHeartFailure.aspx>

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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.

Obesity and The Heart: Heart Attack Symptoms In Women Differ From Men

"Just don't give up trying to do what you really want to do.

Where there is love and inspiration, don't think you can go wrong."

~Ella Fitzgerald

Jean C. McSweeney, professor of nursing at the University of Arkansas for Medical Sciences reported in her comprehensive survey on heart disease in women that the two most common early warning signs were fatigue and disturbed sleep.¹

According to the American Heart Association, cardiovascular disease (CVD) is the largest single cause of mortality among women, accounting for 38 percent of all deaths among females. In fact, “nearly all women are at risk for CVD, underscoring the importance of a heart-healthy lifestyle in everyone”.

The 2007 Guidelines for Preventing Cardiovascular Disease in Women published in a special women’s health issue of Circulation: Journal of the American Heart Association strongly emphasizes lifestyle strategies to reduce risk in all women.

They include recommended lifestyle changes to help manage blood pressure and include weight control, increased physical activity, alcohol moderation, sodium restriction, and an emphasis on eating fresh fruits, vegetables and low-fat dairy products.

Are you at risk for heart disease? Take this quiz to learn more.

1The Harvard Medical School Family Health Guide, Heart Attacks in Women

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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.

Weight Loss Surgery Health Benefits

Over the last year, several studies have been published that point to the benefits of weight loss surgery for the morbidly obese. The latest study published in January 2008 in the Journal of the American Medical Association found that 73% of the 60 obese patients with type 2 diabetes who had laparoscopic gastric banding surgery experienced remission of their diabetes while only 13% of the patients who went through a conventional weight loss program experienced remission.

Further, two separate studies, one in Sweden and one in the United States, and published last summer in the New England Journal of Medicine, separately found that obese people who had weight loss surgery had a 30% to 40% lower risk of dying 7-10 years later compared with those who did not have such operations.

In the U.S. study, a team that looked at 7,925 severely obese people in the state who had gastric bypass surgery. They were matched with similar people who did not have the operation. Deaths from diabetes in the surgery group were dramatically cut by 92 percent; from cancer by 60 percent and from heart disease by 56 percent. Both studies were done before surgery advances such as lap-band surgery.

To compare the benefits of gastric bypass surgery and lap-band surgery, click here. To learn more about the health benefits of bariatric weight loss surgery call Dr. Bradley Waggoner who has extensive experience in performing both weight loss surgeries. You can also opt to attend one of several free lap-band surgery seminars held monthly in the North Houston area.