Lap Band for Lower BMI Patients: New Study

low bmi bandMuch research has been done on the positive association between bariatric surgery and improvement or remission of diabetes. While the gastric sleeve and gastric bypass are very effective treatments, these procedures are generally reserved for obese patients only. However, there has been some research on the potential for the gastric band to be used on people who have less weight to lose. Now a new study has shown that gastric band surgery (commonly referred to as the Lap-Band) can help treat type 2 diabetes in people who are overweight but not classified as obese. Researchers from the Center for Obesity Research and Education at Monash University studied 50 overweight people with type 2 diabetes. They were randomly assigned either standard medical therapy, or gastric banding with the medical therapy. Two years into the trial, more than half of the banded group were in remission of their diabetes, while only eight percent of the standard medical therapy group was in remission.

The connection between excessive body weight and diabetes is well known, but while the benefits of weight loss for obese people suffering with diabetes have been well-documented, it has not been clear if those who were overweight – but not obese – would experience the same benefits. Currently, gastric banding is approved for patients with a BMI of 35 or greater, or 30 or greater for patients with an obesity-related health condition, like diabetes. This first-of-its kind study adds evidence to the benefits of surgery extending to people with diabetes who have a lesser amount of weight to lose.

At Chattanooga Bariatrics, we see first-hand how bariatric surgery options like the gastric sleeve and the gastric band can be highly effective tools for obese patients with diabetes. We are pleased to see research showing that the benefits may be extended to the overweight population as well.

You can learn more about gastric banding surgery here, and more about the gastric sleeve here.

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Large Study Shows Long Term Success of 3 Bariatric Procedures

If over 160,000 bariatric surgery cases were reviewed, what would the results show? Researchers answered that question with a new study they published in the Journal of American Medical Association (JAMA) last week. They analyzed data from many different studies to look at success rates in terms of weight lost, safety, and comparison of different procedures. The results showed what many obesity professionals have been seeing for years.

According to the report, all 3 primary bariatric procedures – the Lap Band, gastric sleeve, and gastric bypass – “led to substantial and durable weight loss with a low mortality risk.”  Overall, the gastric sleeve was found to have the strongest combination of safety and weight loss results. As seen previously, Lap Band (gastric band) patients have somewhat lower average weight loss than patients’ having other procedures, although band patients still showed significant and lasting results. Additionally, the band was the safest procedure with the lowest rates of complications.

An article in MedPage Today which covered the findings highlighted that, “bariatric surgery, overall, appears to be a very effective treatment for severe obesity, and it is a safe treatment in terms of mortality rate and complication rate.” In addition to weight loss, many of the patients in the study showed substantial improvement in health conditions. Patients with Type 2 Diabetes had remission rates of 86 – 92% depending on the type of study; patients with hypertension had remission rates of 75%; and patients with sleep apnea showed remission rates of around 90%.   At Chattanooga Bariatrics we are pleased to see a study of this magnitude reinforce the safety and efficacy of a variety of metabolic and bariatric surgeries.

We offer all the procedures and believe it’s important for patients and their surgeons to have the opportunity to work together to decide on a treatment plan that is best for that individual. We are happy to answer any questions you have, and can be contacted at 423-899-1000.

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Our Patients: Meet Phil

Meet Phil.

In August 2013 he weighed 389 lbs. They called him Philly G…..

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Exactly 6 months after the LapBand they now call him SKINNY G!

Congratulations Phil on losing 137lb in just 6 months!

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All of us at Chattanooga Bariatrics are so proud of Phil’s hard work and accomplishments.

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Want to meet another patient? Here are Mallory’s story and Susan’s story.

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Weight Loss Surgery: Not a Last Resort

chattbar_lastresortWeight loss surgery procedures have evolved over the past two decades, and are safe and effective treatments for obesity. Not only does weight loss surgery (or “bariatric surgery”) help induce weight loss, but also improves metabolic conditions. Many patients with diabetes who undergo surgery, such as the gastric sleeve or Lap-Band, experience improvement in their condition, and even remission. Although there are risks involved with weight loss surgery–just as any other surgery–the alternatives, such as anti-obesity and anti-diabetic drugs, have adverse affects and in the case of weight loss drugs, are generally not successful in weight loss more than 5-10%.

Why then, is weight loss surgery overwhelmingly viewed as a “last resort” option? Read more

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Questionable Weight Loss Companies Charged with Fraud

You’ve probably seen lots of ads for weight loss products that seem too good to be true. There was a popular one over the last few years from Sensa, for a powder you could sprinkle on your food. It aired on the Home Shopping Network, and several other tv networks. The ads said you could “sprinkle, eat, and lose weight.” You may have also seen the ads for LeanSpa which has acai berry and colon cleansing supplements. These products sound great – and acai berry is often referred to as a ‘super food’ – so people around the country spent hundreds of millions of dollars on these products. Unfortunately, “too good to be true” is almost always “not true”. These companies used false advertising and made medical claims with no evidence. Read more

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Our Patients: Meet Mallory

 

Meet Mallory.

She was the winner of our “Free Lap Band” contest in 2011. This is Mallory and Dr Ponce on the day she won the contest.

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Mallory lost 83 pounds in her first year with the Lap Band, and 113 pounds by her 15th month.
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Mallory has done such great work – we can’t decide which picture we like best so we’re sharing a few of them! mallory_chatt
Want to meet another patient? Here’s Phil’s before/after.

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New Guidelines Encourage Referrals to Bariatric Surgeons

ponce_obesity_guidelinesNew obesity guidelines have been published to help primary care providers (PCPs) manage obesity more effectively. The guidelines, referred to as Obesity 2, were created by an expert panel and published by the National Heart, Lung, and Blood Institute (NHLBI) in partnership with the American Heart Association and the American College of Cardiology. The guidelines help providers answer questions about addressing the prevalence of obesity that they see in their patients.

Who should lose weight?

In terms of identifying those who need to lose weight, the report recommends using Body Mass Index (BMI) as a first step, but not the sole criterion.  What else can you look for? A large waist circumference – which is also a risk factor.  The first recommendation highlights that the greater the BMI and waist circumference, the greater the risk is for type 2 diabetes, cardiovascular disease and death. You can calculate your BMI here.

What should we do for overweight patients?

Once identified, the report advises that providers counsel patients who need to lose weight that lifestyle changes that produce even modest, sustained weight loss can lead to meaningful health benefits, with greater weight loss leading to greater benefits. For slightly overweight patients, lifestyle changes may be a good strategy, and weight loss therapy is also recommended.  Shedding just 3 to 5 percent of one’s body weight can result in reductions in levels of triglycerides and blood glucose, and decreases the risk of developing type 2 diabetes.

What about obese patients?

For patients who have a significant amount of weight to lose, Obesity 2 recommends that providers refer patients to experienced bariatric surgeons. Bariatric surgery for patients who meet the BMI criteria (BMI of at least 40 or BMI of 35 with an obesity-related illness) is advised as an appropriate option. The evidence statements in the report address safety, efficacy and predictors of success for procedures like laparoscopic gastric banding, gastric sleeve, and Roux-en-Y gastric bypass. The report says that greater amounts of weight loss can reduce blood pressure, further improve cholesterol levels, and reduce the need for medications to control  blood glucose levels, lipid levels and blood pressure.

At Chattanooga Bariatrics, we recognize that providing individualized, safe and effective recommendations and surgical care is just the first part of the journey. Success after surgery requires altering lifetime habits, which requires education, emotional support and commitment – and we are here to help patients make the necessary lifestyle changes that can lead to better health, and better weight loss results. You can learn more about our program by attending one of our free informational seminars. Register online here or call 866-214-4441.

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Our Patients: Meet Susan

Meet Susan.

This is Susan before she had bariatric surgery with Dr Ponce in 2006. She says: “Other then getting healthy I wanted to be able to get on my horse with out my husband boosting me up there, building me a set of steps, or holding the stirrup on the other side so I would not pull my horse over on me. At the time I had the band my boys were Jr. Rodeoing and I wanted to be able to travel and ride with them without them being embarrassed.”

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Susan lost 97.5 pounds. “Dr Ponce is a wonderful man. I love him dearly, he has changed my life so much.  Now I’m able to saddle my own horse, get on, and ride with my boys wherever they want to go!”

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“Dr. Ponce saved my life, my migraines have decreased, my cholesterol is way down from what it was and I don’t feel like I am carrying boulders around on my chest.

I eat healthier. I have not had a Pepsi in 7 yrs and I was a die hard Pepsi addict. I recommend the band to all my friends and my best friend had it done and she has grand children and is so much healthier and happier.”

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My best advice to anyone having lapband done is to keep a photo diary. To see how far you have come on this amazing journey. I hold a special place in my heart for Chattanooga Bariatrics!

Want to see more patients? Meet Phil or Mallory

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Dr Ponce Finishes Term as President

Did you know that for the past 17 months, Dr Ponce has served as the 27th President of the American Society for Metabolic & Bariatric Surgery? In addition to treating patients, he has led the largest society for metabolic and bariatric surgery in the world. Last week in Atlanta, GA Dr Ponce gave his Presidential Address, ending his time in this role. Thponce_asmbs_presidentousands congratulated and thanked Dr Ponce for his dedication to helping not only his own patients, but people around the country and world.

Since first joining ASMBS, Dr Ponce has seen the society’s membership numbers grow from approximately 500 to over 4,000 professionals all dedicated to the treatment of obesity and related diseases. Accomplishments during his term followed the theme of “a new face”. In addition to Obesity Week, the new face of the annual meeting, he highlighted the new mobile app and new website that ASMBS just launched to serve members, patients and the healthcare community overall. He also presided over the launch of Connect, the new online magazine of ASMBS which is available for anyone in the general public to read and learn from. Although ASMBS operates on a national level, the state and local levels of the society are a high priority for Dr Ponce. Throughout his term the state and regional chapters of ASMBS grew in both number and function, to better serve the patients and communities dealing with obesity and the need for treatment. Another accomplishment during Dr Ponce’s term was the finalization of MBSAQIP - which represents the new standard in accreditation for bariatric and metabolic surgery facilities. Accreditation saves lives by putting facilities through a rigorous quality review. 

Dr Ponce ended his presidential address by thanking those he works with. He is especially grateful to his practice and hospital staff for their support, and for all his patients for their flexibility during a very busy time for him, and their enthusiasm for the work he has been doing.

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Sleeping Too Much or Too Little? Both are Linked With Health Conditions

CB_weightlosssurgery_sleepHow much sleep are you getting at night? Are you sleeping well? Scientists have gone to great lengths to fully understand the benefits of sleep. In studies of humans and other animals, they have discovered that sleep plays a critical role in immune function, metabolism, memory, learning, and other vital functions. In terms of maintaining a healthy body weight, it’s been shown that getting adequate sleep also plays a role.

Now a new study has shown that adults who sleep too little (six hours or less) or too much (10 or more hours) are more likely to suffer from a chronic disease, including coronary heart disease, stroke, diabetes, obesity and frequent mental distress. The study involved more than 54,000 participants age 45 or older in 14 states. The short sleepers (under 6 hours/night) reported a higher prevalence of obesity, frequent mental distress, coronary heart disease, stroke, and diabetes, compared with optimal sleepers. The same was true for long sleepers (10+ hours/night), and the associations with diabetes, stroke and coronary heart disease were seen even more in this group.

While inadequate sleep has been linked with obesity, it may be more difficult for people who are obese to sleep well due to sleep conditions like obstructive sleep apnea (OSA), a serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. Many of the patients we treat at Chattanooga Bariatrics have sleep apnea, and carrying extra weight is a risk factor for the disorder. People with untreated sleep apnea stop breathing repeatedly during their sleep, sometimes even hundreds of times. This means that the brain may not get enough oxygen and often leads to daytime drowsiness and feeling like you’re in a “mental fog”.

Sleep conditions such as OSA may work against an obese person’s efforts to get a good night’s sleep, but there is treatment shown to both promote weight loss and improve sleep quality: bariatric surgery. Adding to the evidence that bariatric surgery patients often have improved sleep quality, a recent study showed that more than 80% of the studied Lap-Band patients experienced resolution or improvement of OSA by 2 years after their surgery. Our surgery patients, whether they have a gastric sleeve or lap band procedure, often see improvements in many other health conditions too, including diabetes and high blood pressure. You can learn more about the benefits of these procedures here or register to attend one of our free educational seminars.

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