Monday, May 16, 2011

Evidence Supporting the Safety and Effectiveness of Lap Band Surgery

The US FDA embraced lap band bariatric surgery, to some extent, by lowering the BMI from 35 to 30 for persons with specific cormorbidities. However, there remain lingering opinions that the FDA should not have have lowered the limits, because lowering the limits will encourage some persons to seek lap band bariatric surgery, when non surgical weight loss approaches would be more appropriate. Further, there are some doubts that lap band surgery is effective, long term. Well, study results recently released, may give some relief to those who doubt the effectiveness of lap band surgery.

The study, abstracted in PubMed, suggests that lap band surgery is both safe and effective. In the study, a single surgeon in a community practice, 442 patients who had received lap band surgery were followed for about five years. The patients in the study had a mean BMI of 47. The results of the study were as follows: “The average percentage of excess weight loss was 27% at 6 months (n = 384), 38% at 12 months (n = 301), 44% at 18 months (n = 260), 48% at 24 months (n = 190), 51% at 36 months (n = 135), 58% at 48 months (n = 66), and 60% at 60 months (n = 31). By 60 months, 10% had failed to lose ≥25% of their excess body weight.”

According to the results, most of the patients receiving the surgery were able to maintain more than 25% of their excess weight loss after five years. There was also a low complication rate. These results are important, since they lend support to the use of the lap band for weight loss.

It's important to note that the researchers emphasize the significance of post-operative support for the weight loss surgical patients, stating that “the results depend heavily on meticulous long-term follow-up.” We believe that bariatric physicians can play an important role in the long-term follow process. Therefore, the expansion of patient access to lap band surgery can broaden the opportunities for bariatric physicians.

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Sunday, May 1, 2011

Exercise May Improve Cognitive Restraint

Exercise, alone, will not enable one to lose and maintain weight loss long term. In fact, studies show that diet may be more important to weight loss than exercise. However, exercise should be an integral part of a weight-loss program, since it helps one maintain weight loss, long term. Indeed, exercise may improve one's ability to adhere to a diet by improving one's ability to restrain eating.
A study, reported in Medscape, concluded that exercise improves cognitive restraint. Specifically, the researchers suggested that "men who added exercise to dieting had increases in cognitive restraint and decreases in hunger. They also lost more weight than those who dieted without exercise."
Therefore, exercise is important in a weight loss program. So employing interventions that motivate an overweight individual to exercise is essential. A recent study, reported in ScienceDaily, showed that interventions directed at improving activities such as self monitoring and goal setting induce people to exercise, while interventions directed at providing knowledge and changing attitudes do not.
Studies lend support to the importance of exercise as part of a weight loss and weight management program. Studies also highlight the importance of choosing the right kind of interventions to get a person to exercise, since interventions that cause a person to engage in physical activity are the most productive. Intensive counseling is an intervention that has been shown to change behavior.
So weight loss providers should target exercise with their counseling. Because, with increased exercise, there is a good chance an overweight individual can restrain food intake, thus improve weight loss and weight maintenance.
Most weight loss professionals agree that diet and exercise are indeed important in weight loss and weight management. But now we are learning that exercise improves one's ability to stay on a diet. This bit of knowledge might help weight loss providers better guide their overweight and obese patients.
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