Bradley Waggoner, MD

Study Finds Obese Women Who Undergo Bariatric Procedures Before Pregnancy Are Three Times Less Likely to Have Gestational Diabetes

Obese women who have bariatric surgical procedures before pregnancy were three times less likely to develop gestational diabetes (GDM) than women who have bariatric operations after delivery, according to new research findings published in the August issue of the Journal of the American College of Surgeons. The retrospective study also found that delivery after bariatric procedures was associated with reduced odds of cesarean section—an outcome associated with GDM.

Gestational diabetes affects at least seven percent of all pregnancies in the United States, with rates as high as 14 percent among certain populations. Its prevalence is increasing among reproductive-age women, parallel to increasing rates of obesity and type 2 diabetes. Currently, 33 percent of women over 19 years of age meet the criteria for obesity (body mass index [BMI] > 30 kg/m2) and seven percent for extreme obesity (BMI > 40 kg/m2). Bariatric surgical procedures are the only intervention shown to produce sustained weight reduction in the vast majority of subjects.

“The major finding of our study is that women who had bariatric surgery before they delivered reduced odds of gestational diabetes when compared with women had bariatric surgery after they delivered,” said Anne E. Burke, MD, MPH, assistant professor of obstetrics and gynecology at the Johns Hopkins University School of Medicine in Baltimore, Md.

“Despite a growing body of evidence supporting the safety and efficacy of bariatric surgery in reversing obesity-related complications, few candidates for the procedure are referred to a surgeon to discuss their options,” stated Martin Makary, MD, MPH, associate professor of surgery at Johns Hopkins University School of Medicine and senior author of the study.

Researchers performed a retrospective study to compare rates of GDM and related outcomes between a group of women who had bariatric operations before pregnancy (n=346) and a group who had bariatric operations after delivery (n=354) between 2002 and 2006. Women who delivered after bariatric procedures had lower incidences of GDM (8 percent vs. 27 percent, odds ratio (OR) 0.23) and cesarean section (28 percent vs. 43 percent, OR 0.53) than those who delivered before bariatric procedures.

Women who delivered after bariatric operations were slightly older (32.5 years vs. 31.1 years, p < 0.001). The median time from surgical procedure to delivery was 19.6 months, which meant that the majority of women did not adhere to the current recommendation to defer pregnancy for two years after bariatric procedures were performed. Deliveries before bariatric operations  occurred at a median time of 16.5 months, meaning that most women waited more than a year after delivery before having bariatric procedures. The majority of women in each group had a bypass procedure (75 percent in the prebariatric delivery group and 87 percent in the postbariatric delivery group). Women who had a prebariatric delivery were more likely to have an adjustable banding procedure than women with a postbariatric delivery (9 percent vs. 3 percent).

 

* * *

Source: American College of Surgeons . http://www.facs.org

* * *

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 Bariatric Surgery Resolves Sexual Dysfunction in Women With Morbid Obesity

Bariatric surgery not only helps people lose weight, it can resolve or significantly improve female sexual dysfunction (FSD), a prevalent and complex condition that adversely affects women's health and quality of life, according to a new study presented at the 27th Annual Meeting of the American Society for Metabolic & Bariatric Surgery (ASMBS).¹

Researchers from The Miriam Hospital’s Weight Control and Diabetes Research Center and the Warren
Alpert Medical School of Brown University studied 54 sexually active women before and after having either laparoscopic adjustable gastric banding (LAGB) or Roux-en-Y gastric bypass surgery. Women in the study had an average body mass index (BMI) of 45 before surgery, meaning they were about 100 pounds or more overweight. Before surgery, 63 percent of the women had FSD as measured by the Female Sexual Function Index (FSFI), a standardized test used to assess sexual function. Using the same FSFI measurement, by six months after surgery, 68 percent no longer had FSD. Nearly all women in the study reported significant improvements in all aspects of sexual function, including desire, arousal, lubrication, orgasm, satisfaction and less or no pain during or after intercourse. Gastric bypass surgery patients lost an average of 60 percent of their excess weight while LAGB patients lost an average of almost 35 percent of their excess weight within six months.

“Sexual functioning appears to improve quickly and dramatically after bariatric surgery and it doesn't seem to matter if a patient undergoes gastric bypass or laparoscopic adjustable gastric banding,” said Dale Bond, Ph.D., study co-author and assistant professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University. “Clearly significant weight loss plays a role, but further research is needed to determine the extent to which improvements in body image, obesity-related diseases, hormonal mechanisms, and emotional health contribute to better sexual functioning.”

It is estimated that up to 43 percent of women are affected by some form of sexual dysfunction with higher rates linked to advancing age, decreasing estrogen levels, and medical conditions including obesity, Type 2 diabetes and high blood pressure. In this prospective study, women with morbid obesity had a 25 percent higher prevalence of sexual dysfunction than the general female population and the level of sexual dysfunction was significantly worse.

People who are morbidly obese are generally 75 to 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 have morbid obesity and in 2009 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).

In addition to Dr. Bond, co-authors of the study were Rena R. Wing, Ph.D. and Sivamainthan
Vithiananthan, MD from The Miriam Hospital and The Warren Alpert Medical School of Brown University;
Harry C. Sax, Esq. from The Warren Alpert Medical School of Brown University; G.D. Roye, MD and Beth A. Ryder from Rhode Island Hospital and The Warren Alpert Medical School of Brown University; and Dieter Pohl and Jeannine Giovanni, MD from Roger Williams Hospital.

* * *

¹Source: American Society for Metabolic & Bariatric Surgery. http://www.asmbs.org/

* * *

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.

Managing the Emotions Behind Eating

How many times have you, after a particularly hard day, reached for some chocolate or ice cream? It's common for many people, but for those trying to lose weight, it can be detrimental to their long term success, and most weight-loss programs never even address it.

They focus on choosing healthier foods and exercising more, but they never answer a key question: how can people who have eaten to cope with emotions change their eating habits, when they haven't learned other ways of coping with emotions?

Researchers at Temple's Center for Obesity Research¹ are trying to figure out the answer as part of a new, NIH-funded weight loss study. The new treatment incorporates skills that directly address the emotional eating, and essentially adds those skills to a state-of-the art behavioral weight loss treatment.

"The problem that we're trying to address is that the success rates for long-term weight loss are not as good as we would like them to be," said Edie Goldbacher, a postdoctoral fellow at CORE. "Emotional eating may be one reason why people don't do as well in behavioral weight loss groups, because these groups don't address emotional eating or any of its contributing factors."

The study has already had one wave of participants come through, and many participants have seen some success in the short term, but have also learned the skills to help them achieve long term success.

Janet Williams, part of that first cohort, said she lost about 17 pounds over 22 weeks, and still uses some of the techniques she learned in the study to help maintain her weight, which has not fluctuated.

"The program doesn't just help you identify when you eat," said Williams. "It helps you recognize triggers that make you eat, to help you break that cycle of reaching for food every time you feel bored, or frustrated, or sad."

Williams said that the program teaches various techniques to help break that cycle, such as the "conveyor belt," in which participants, when overcome with a specific emotion, can recognize it and take a step back, before reaching for chips or cookies, and put those feelings on their mental "conveyor belt" and watch them go away.

"I still use the skills I learned in the study," she said. "I've learned to say, 'I will not allow this emotional episode to control my eating habits.'"

* * *

¹Temple University. http://www.temple.edu/

* * *

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.

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.

* * *

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

* * *

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.

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

_______________________________________________________________

 

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.

Infertility and Obesity: Another Reason to Lose Weight

Obesity brings with it many lifestyle and health obstacles. Consider the following if you are obese and are having problems conceiving.

Infertility is Not Gender Specific
Obesity in men and women alike may be a contributing factor to infertility. Recent studies conducted by UH researchers found that obese men have lower sperm count.¹ In separate studies conducted in Amsterdam, women who were severely obese were 43% less likely to achieve pregnancy than normal-weight women or women who were considered overweight but not obese.²

Possible Signs in Women of Infertility³
Includes irregular or infrequent menstrual cycles and later, an increased risk of miscarriage. According to the American Society for Reproductive Medicine, more than 70 percent of women who are infertile as the result of body weight disorders will conceive spontaneously.

Although the above studies point to the link of infertility in obese people, the studies are also quick to mention that there are of course other factors which may be involved.

* * *

¹ The Daily Utah Chronicle. July 30, 2008. "Study Links Male Obesity with Infertility"  <http://media.www.dailyutahchronicle.com>

²WebMD/Infertility and Reproduction Health Center. December 11, 2007 "Obesity Linked to Infertility in Women" <http://www.webmd.com>

³If 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 Us:

• 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.