Bradley Waggoner, MD

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!

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

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).

 

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

Exercise Counters Negative Effects of Weight Regain, MU Researchers Find

With the obesity rate rising for American adults and children, health concerns such as diabetes and cardiovascular disease are a frequent reality. Although obesity itself is a major risk factor for disease, most of the threat may be associated with a cluster of risk factors called the metabolic syndrome (MetS). Losing weight can improve health and reduce these risk factors, but many people have difficulty keeping the weight off. Now, University of Missouri researchers have found that exercising during weight regain can maintain improvements in metabolic health and disease risk.¹

In the study, individuals who didn’t exercise during weight regain experienced significant deterioration in metabolic health, while those who exercised maintained improvements in almost all areas. The MU study, led by Tom R. Thomas, professor in the Department of Nutrition and Exercise Physiology in the College of Human Environmental Sciences, is the first to examine the role of exercise in countering the negative effects of weight regain on MetS and overall health status.

“Although many people are successful at losing weight through diet and exercise, the majority of them will relapse and regain the weight,” Thomas said. “The findings of this study indicate that regaining weight is very detrimental; however, exercise can counter those negative effects. The findings support the recommendation to continue exercising after weight loss, even if weight is regained.”

In the study, overweight men and women with measured characteristics of MetS were given a diet and aerobic exercise plan that included supervised exercise five days a week, for 4-6 months. After losing weight, participants underwent programmed weight regain and were separated into two groups, one that exercised and one that didn’t. The non-exercise group experienced rapid deterioration in weight-loss induced benefits to metabolic health. The exercise group maintained improvements in almost all measures, including LDL and HDL cholesterol, oxygen consumption (VO2max), blood pressure and glucose. Exercise didn’t maintain blood cholesterol and abdominal fat loss.

“It’s clear that the message to lose weight isn’t working because so many people regain weight; a new message is to keep exercising and maintain your weight to reduce disease risk and improve overall health,” Thomas said. “Don’t worry so much about losing weight, but focus on exercising and maintaining your current weight.”

The study will be published in the Journal of Applied Physiology in April. Thomas, adjunct professor in the Department of Cardiovascular Medicine, completed the study in collaboration with MU researchers in the Department of Internal Medicine; the Department of Medical Pharmacology and Physiology; the Harry S. Truman VA Medical Center; and the Department of Educational, School and Counseling Psychology.

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¹University of Missouri News Bureau. http://munews.missouri.edu/index.php

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

Contact Bradley Waggoner, MD:

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

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

Overweight in 20s could lead to serious problems in 40s

People who are obese and have type 2 diabetes in their 20s will be at higher risk of having a heart attack or stroke in their 40s if they do not change their lifestyle.

"If your blood pressure is 136/88 and you’re a man with a waist over 40 or a woman with a waist over 35 it spells trouble," said Dr. Dale J. Hamilton, diabetes clinical services chief at The Methodist Hospital in Houston. "These are two of the five symptoms of metabolic syndrome, a problem that can lead to type 2 diabetes. All you need is three to begin seeing increased atherosclerosis."

"High triglyceride levels over 150, insulin resistance and a low LDL (good cholesterol) are factors of metabolic syndrome, along with high blood pressure and central obesity. According to the American Heart Association more than 47 million Americans have it. Many of these patients will end up suffering with type 2 diabetes, which can eventually lead to coronary artery disease and stroke.

"Small changes every day can help curb big problems later on," Hamilton said. "Losing five to 10 pounds will help lower blood pressure. Reducing saturated fats, carbohydrates, and eating about two-thirds the amount you eat now will help you lose weight around the middle. Walk 45 minutes a day instead of 30."

Some experts believe replacing sugar with high fructose corn syrup in processed foods in the United States and Canada in the 1990s has played a role in the rise of type 2 diabetes cases. High fructose corn syrup is made by changing the sugar in corn starch to fructose, another form of sugar. It has become popular because it extends the shelf life of processed foods and is cheaper than sugar. It has also become a popular ingredient in many sodas and fruit-flavored drinks.

"The problem with high fructose corn syrup is that it promotes central obesity," Hamilton said. "Another problem with it is that it fools your body into thinking you are hungry. I don’t think you need to eliminate it from your diet, you just need to be aware of how much of it you are consuming on a daily basis because too much can lead to serious weight gain."

Keep in mind, he said, type 2 diabetes symptoms often go untreated because there are few or no symptoms until it is too late.

"Having three or more of the risk factors associated with type 2 diabetes over an extended period of time is the equivalent of already having a heart attack," Hamilton said. "These risk factors need to be treated aggressively in order to curb the problem and give you a better chance at a longer, healthier life."

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Story Source: Adapted from materials provided by  The Methodist Hospital - Houston.

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.

Recent Study Concludes Weight Loss Programs Should Not Exclude Depressed People

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

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

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

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

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

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

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

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

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

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

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

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

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

Contact Bradley Waggoner, MD:

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

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

Model Estimates Risks and Benefits of Bariatric Surgery for Severely Obese

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

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

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

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

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

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

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

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

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

* * *

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.

Helping the Obese Fight Loss of Muscle Function

Experts at The University of Nottingham¹ are working on ground-breaking research to determine, for the first time, precisely what damage obesity can inflict on the muscles in our body.

It is hoped their research, funded by the Biotechnology and Biological Sciences Research Council (BBSRC), will lead to more effective treatment strategies for the obese to minimize muscle complications.

Professor Paul Greenhaff in the School of Biomedical Sciences along with Professor Michael Rennie in the School of Graduate Entry Medicine and Health has been awarded nearly £600,000 [$982,200 U.S.] to carry out the research. Professor Greenhaff said: “This work is essential because it will further our understanding of the health consequences of obesity which is all the more important given the purported obesity epidemic threatening to face the western world in future years.”

Based in the School of Biomedical Sciences, Professor Greenhaff and his team have already shown the release of cytokines — small inflammatory-inducing proteins — to coincide with molecular events that slow down the skeletal muscle making process and speed up the rate of muscle breakdown. Cytokines, released from the fat cells of the body, are elevated in obese individuals at low levels for long periods of time and the researches will be investigating what consequences this has on muscle.

Skeletal muscle plays an essential role in our daily lives — it helps us move, control our posture, and acts as an important fuel source when we become ill. Despite the increasing incidence of obesity and the potential loss of muscle function, the effect of low level and persistent inflammation — induced by obesity — remains largely unknown. Furthermore, the potential negative effects of obesity —induced inflammation on muscle processes — may become even more pronounced as we age due to the natural loss of muscle mass in later years.

Researchers are recruiting a group of obese and healthy normal-weight volunteers. Scientists will measure the rates of synthesis and breakdown of muscle proteins in conjunction with rates of carbohydrate oxidation in obese individuals and compare them to rates determined in healthy non-obese volunteers and see how they differ. Muscle biopsies will be taken to examine the molecular signaling events that underpin these processes. 

The researchers also want to know if an insulin sensitizing drug, known to limit the release of cytokines from fat cells, can reverse any effect of obesity on the synthesis and breakdown of muscle proteins and whether this could lead to functional improvements. These studies will determine, for the first time, the effect of obesity associated low-dose chronic inflammation on essential muscle events.

Professor Greenhaff said: “Despite the serious implications, there is a dearth of information on this topic. Our research is of such magnitude that if we can find the answers, it will create a multitude of future research avenues that could be explored by the wider scientific community. This could have wide-reaching implications for the many disease states characterized by low-grade chronic inflammation.”

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¹The University of Nottingham. September 16, 2009. http://research.nottingham.ac.uk/NewsReviews/newsDisplay.aspx?id=635. Nottingham was designated as a Science City in 2005 in recognition of its rich scientific heritage, industrial base and role as a leading research center. Nottingham has since embarked on a wide range of business, property, knowledge transfer and educational initiatives (www.science-city.co.uk) in order to build on its growing reputation as an international center of scientific excellence. The University of Nottingham is a partner in Nottingham: the Science City.
 
More information is available from Professor Paul Greenhaff on +44 (0)115 823 0133, paul.greenhaff@nottingham.ac.uk.

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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.

Osteoarthritis a Major Consequence of Obesity Epidemic, Claims Charity in New Report

Obese people are four times as likely to develop osteoarthritis of the knees as they are to develop high blood pressure or type-2 diabetes, according to a leading arthritis charity, launching a new online report.¹

But whereas high blood pressure and diabetes may be substantially improved on losing weight and are relatively easy to control with therapy, the changes resulting from osteoarthritis are irreversible, as worn cartilage cannot currently be repaired.

However, according to Professor Alan Silman, medical director of the Arthritis Research Campaign, there is good news for obese and overweight people whose knees become painful due to osteoarthritis as a result of their weight.

“Research shows that losing weight, however modest, when combined with exercise, is a panacea at every stage,” said Professor Silman. “Achieving a healthy weight reduces the risk of developing the disease in the first place, relieves existing symptoms and helps to prevent further deterioration. And weight loss and exercise has been shown to achieve the same level of symptom relief as joint replacement surgery.”

The medical research charity is concerned that while rising rates of obesity have been linked to a number of serious disorders and health concerns, the risk of potentially crippling  osteoarthritis have been, if not ignored, then certainly under-estimated.

The true impact of obesity in the development of knee osteoarthritis has only recently become clear, said the charity, pointing to a study which revealed that at the most extreme, very obese people with a body mass index of 36 or more have a 14-fold higher risk of knee osteoarthritis compared to those in the healthy BMI range.

Professor Silman warned there was a real concern that unless rocketing rates of obesity were tackled, the numbers of people needing joint replacement surgery would soar, which would have a considerable impact on the NHS.

“There are two major risk factors for developing osteoarthritis – ageing and obesity – and as both these factors are on the rise in the UK, it’s an obvious prediction to make that the outcome could be a massive cost to the health service,” he added.

Joint replacements are more likely to fail earlier in obese patients, and the heavier the patients the less likely it is that surgery will bring about an improvement in symptoms.

Very obese women are 19 times more likely to need knee replacement and four times more likely to need hip replacement surgery compared to women of a healthy weight.

A series of studies have shown that even modest weight loss and exercise can help to reduce not only pain but also mobility and the ability to perform everyday activities.

Professor Silman’s comments follow the publication of the charity’s online report, Osteoarthritis and Obesity, which warns the public of the hitherto little publicised dangers to their health and quality of life of obesity on their joints.

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¹Arthritis Research Campaign. July 15, 2009. http://www.arc.org.uk/news/pressreleases/awareness/obesity.asp.

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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.

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.