Bradley Waggoner, MD

New Device Helps Monitor Low-Level Physical Activity With a Cell Phone

About two thirds of the American population is overweight or obese, putting them at higher risk for health problems such as heart disease, stroke, cancer and diabetes. The obesity epidemic in America is the result of poor eating habits, genetics, and a lack of exercise. It's therefore difficult for public health officials to get people to make a conscious effort to control their weight.

The Cell Phone Device That Helps You Exercise
This is why Chinmay Manohar in the Department Endocrinology, Nutrition and Diabetes of the Mayo Clinic is designing a device to help motivate people to be more active. His team has developed a program that helps people monitor their normal day-to-day physical activity using an every day device like a cell phone or mp3 player.

Mr. Manohar is presenting his team's work at the 2010 Experimental Biology meeting in Anaheim, CA (April 24-28). His presentation, entitled "Laboratory evaluation of the accuracy of a triaxial accelerometer embedded into a cell phone platform for measuring physical activity," is based on research performed with Shelly McCrady and James Levine of the Mayo Clinic, Rochester, MN; and Yuichi Fujiki and Ioannis Pavlidis from the Department of Computer Science at the University of Houston, Houston, TX.

Designing the Right Device
The idea took hold when a study published by Manohar's department showed that under a controlled diet, leaner people tend to spend two and a half more hours per day standing than did heavier people. The results indicated that leaner people were more active in their day-to-day activities even when they weren't exercising. According to Manohar, "If that is the case, why don't we encourage people to get out of their chairs?"

Manohar's group set out to design a device to promote more physical activity. The ideal device would be something that is affordable and commercially available. The team settled on the iPhone® and the iPod Touch® because many people already own these devices and they come with built-in motion sensors. The research group created a program called the Walk n'Play that can be downloaded for free through iTunes® to distribute the technology to a wider population. More and more Smart phones are using motion sensors and making the program compatible between platforms will not be difficult.

Walk n'Play: Designed for Everybody
The current version is fairly basic, according to Manohar. The user inputs their height and weight into the program and throughout the day, their score can be monitored. The program will tell the user if they are winning or losing against the computer. There is no pressure and the game does not ask you to do any specific exercise. But turning physical activity into a game makes people more competitive and more likely to get active.

Manohar says that most off-the-shelf devices tend to be unreliable for measuring the lower speeds detected by the Walk n'Play. This is because most of the devices on the market are used for measuring exercise like jogging or running, not for the day-to-day movement for which the Walk n'Play is designed. The program was tested for the ability to detect changes in movement as little as half a mile per hour. They tested positions from 31 volunteers like sitting, standing and lying down and tested seven speeds on the treadmill to determine how precise the program was. Using the results of these movement tests, Manohar's group developed a gold standard for typical movements used in daily activities.

The iPhone® and the iPod Touch® use motion sensors called accelerometers that detect motion. The program is designed to access the accelerometer in the phone and convert the motion that is detected into activity units as a way to measure the physical activity.

A Motivational Push
Over 10,000 people have already downloaded the Walk n'Play, but Manohar knows it will take more than a basic activity monitor to keep people's interest.

"You have to put an element of fun into the whole thing to encourage people to be more active," Manohar said, "we put people into a gaming mind-set and people unknowingly do exercise and have fun doing it."

The group further modified the program to integrate basic social networking. Fitness and weight-loss in general is easier to do with a buddy. The newer features will allow a person to play against their friends or even compete with people or top performers from other countries or time zones. Users can even post their performance as their Twitter status.

According to Manohar, most people know they need more exercise to maintain a healthy weight, but getting up the motivation for a workout plan can be daunting. Using programs like the Walk n'Play can encourage people to make incremental changes in their daily activities that can add up to better health, like promoting people to take the stairs more often to get in that extra little bit of exercise for the day.

* * *

¹FASEB. http://www.fasebj.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 Eating Device Retrains Dietary Habits and Helps Children Lose Weight

A new computerized device that tracks portion size and how fast people eat is more successful in helping obese children and adolescents lose weight than standard treatments, according to research published on bmj.com¹.

The Mandometer device, a portable computerized weighing scale, was developed at the Karolinska Institutet in Stockholm. It helps to retrain individuals to eat less and more slowly by providing real-time feedback during meal times. The device plots a graph showing the rate at which food actually disappears from the plate, compared to the ideal graph programmed in by a food therapist.

Childhood obesity is an increasing global problem and there is little evidence to support one specific treatment program. While it is unknown whether specific eating patterns are common in all obese people, in this study the patients ate large portions very quickly.

Researchers at Bristol Royal Hospital for Children and the University of Bristol, led by Professor Julian Hamilton-Shield, carried out a randomized controlled trial of 106 obese patients aged between 9-17 years.

One group of participants received Mandometer therapy to lose weight and the other were provided with standard care. Both groups were encouraged to increase their levels of physical activity to 60 minutes of exercise a day and to eat a balanced diet based on the Food Standards Agency "eatwell plate."

Participants were assessed after 12 months and followed up at 18 months. During the research period they were also regularly monitored and offered telephone support and encouragement.

After 12 months, the Mandometer group not only had a significantly lower average body mass index and body fat score than the standard care group, but their portion size was smaller and their speed of eating was reduced by 11% compared with a gain of 4% in the other group. Levels of 'good cholesterol' were also significantly higher in the Mandometer group.

The improvement in body mass index was maintained six months after the end of treatment, suggesting an element of longer term behavioral change, add the authors.

"Mandometer therapy, focusing on eating speed and meal size, seems to be a useful addition to the rather sparse options available for treating adolescent obesity effectively without recourse to pharmacotherapy," say the authors.

They acknowledge that the Mandometer requires further evaluation in other settings and with different groups of patients, but conclude that "Retraining eating behavior and reinforcing feelings of satiety, however, does seem to improve weight loss in obese adolescents."

* * *

¹ http://www.bmj.com. Full text of this study can be found at the BMJ Journal's website.

* * *

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.

***

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

* * *

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.

What You Eat After Exercise Matters

Many of the health benefits of aerobic exercise are due to the most recent exercise session (rather than weeks, months and even years of exercise training), and the nature of these benefits can be greatly affected by the food we eat afterwards, according to a study published in the Journal of Applied Physiology

“Differences in what you eat after exercise produce different effects on the body’s metabolism,” said the study’s senior author, Jeffrey F. Horowitz of the University of Michigan. This study follows up on several previous studies that demonstrate that many health benefits of exercise are transient: one exercise session produces benefits to the body that taper off, generally within hours or a few days.

“Many of the improvements in metabolic health associated with exercise stem largely from the most recent session of exercise, rather than from an increase in ‘fitness’ per se,” Dr. Horowitz said. “But exercise doesn’t occur in a vacuum, and it is very important to look at both the effects of exercise and what you’re eating after exercise.”

Specifically, the study found that exercise enhanced insulin sensitivity, particularly when meals eaten after the exercise session contained relatively low carbohydrate content. Enhanced insulin sensitivity means that it is easier for the body to take up sugar from the blood stream into tissues like muscles, where it can be stored or used as fuel. Impaired insulin sensitivity (i.e., “insulin resistance”) is a hallmark of Type II diabetes, as well as being a major risk factor for other chronic diseases, such as heart disease.

Interestingly, when the research subjects in this study ate relatively low-calorie meals after exercise, this did not improve insulin sensitivity any more than when they ate enough calories to match what they expended during exercise. This suggests that you don’t have to starve yourself after exercise to still reap some of the important health benefits.

The paper, “Energy deficit after exercise augments lipid mobilization but does not contribute to the exercise-induced increase in insulin sensitivity,” appears in the online edition of the journal. The authors are Sean A. Newsom, Simon Schenk, Kristin M. Thomas, Matthew P. Harber, Nicolas D. Knuth, Haila Goldenberg and Dr. Horowitz. All are at the University of Michigan. The American Physiological Society published the research.

The study included nine healthy sedentary men, all around 28-30 years old. They spent four separate sessions in the Michigan Clinical Research Unit in the University of Michigan Hospital. Each session lasted for approximately 29 hours. They fasted overnight before attending each session, which began in the morning.

The four hospital visits differed primarily by the meals eaten after exercise. The following describes the four different visits:

• They did not exercise and ate meals to match their daily calorie expenditure. This was the control trial.

• They exercised for approximately 90 min at moderate intensity, and then ate meals that matched their caloric expenditure. The carbohydrate, fat, and protein content of these meals were also appropriately balanced to match their expenditure.

• They exercised for approximately 90 min at moderate intensity and then ate meals with relatively low carbohydrate content, but they ate enough total calories to match their calorie expenditure. This reduced-carbohydrate meal contained about 200 grams of carbohydrate, less than half the carbohydrate content of the balanced meal.

• They exercised for approximately 90 min at moderate intensity and then ate relatively low-calorie meals, that is, meals that provided less energy than was expended (about one-third fewer calories than the meals in the other two exercise trials). These meals contained a relatively high carbohydrate content to replace the carbohydrate “burned” during exercise.

The exercise was performed on a stationary bicycle and a treadmill. The order in which the participants did the trials was randomized.

In the three exercise trials, there was a trend for an increase in insulin sensitivity. However, when participants ate less carbohydrate after exercise, this enhanced insulin sensitivity significantly more. Although weight loss is important for improving metabolic health in overweight and obese people, these results suggests that people can still reap some important health benefits from exercise without undereating or losing weight, Dr. Horowitz said.

The study also reinforces the growing body of evidence that each exercise session can affect the body’s physiology and also that differences in what you eat after exercise can produce different physiological changes.

The research team is now performing experiments with obese people, aimed at better identifying the minimum amount of exercise that will still improve insulin sensitivity at least into the next day.

* * *

Story Source: Adapted from materials provided by  The American Physiological Society.

* * *

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.

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.

What is Gastric Bypass Surgery?

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

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

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

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

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

Beat The Heat and Attend Dr. Bradley Waggoner's Free Seminar on Weight Loss Surgery This Summer!

We don't need to tell you how hot the long summer days can be in the south! And if you've been carrying excessive weight, the humidity can become quite unbearable and even quite possibly a hazard to your health. So, if you think you may be a candidate for weight loss surgery and have been waiting for the right moment to talk to a weight loss surgeon, we have the perfect solution for you!

Dr. Bradley Waggoner will be on hand throughout the summer months hosting free weight loss surgery seminars. Among your options to consider is Lap-Band System Surgery which will be a topic of discussion you won't want to miss. You'll be in good company along with fellow candidates who might ask questions you may not have thought to mention.

The first of the seminars will be held on June 3rd at 6:00PM followed by a second seminar on June 28 at 10:00AM. Both weight loss surgery seminars will be located at North Cypress Medical Center in northwest Houston. Click on the below address which will forward you to contact information for reserving a seat, along with driving directions.

North Cypress Medical Center
21214 Northwest Freeway
Cypress, TX 77429

Additional seminars will be hosted throughout the summer. Stay tuned for additional dates. We look forward to seeing you soon!