Wednesday, June 27, 2012

Laparoscopic Sleeve Gastrectomy May Have a Bright Future

Bariatric surgery has been shown to be an effective weight loss tool, because the surgery enables an individual to lose a large amount of weight. Moreover, the surgery resolves a number of comorbidities and improves quality of life. And a relative new form of bariatric surgery, laparoscopic sleeve gastrectomy, is now becoming an important weight loss procedure.
Laparoscopic sleeve gastrectomy (LSG) is a type of bariatric surgery where a small stomach pouch, similar in shape to a banana, is constructed to restrict food intake. When first employed, the surgery was one stage of a two stage bariatric surgical procedure. Gastric bypass surgery, for example, might have been the second stage.

One of the advantages of sleeve gastrectomy is that no alterations are made to the gastrointestinal tract anatomy, as in gastric bypass surgery. So some of the risks associated with gastric bypass surgery -- and other procedures where the small intestine is modified --  are reduced.

However, like gastric bypass surgery, LSG causes increased alcohol absorption, according to a 2010 study done in Chile. The study consisted of twelve obese patients, who were given specific quantities of wine before and after LSG surgery. The researchers followed the participants in the study for several months. At the end of the twelve month period, the researchers concluded that the participants experienced "higher and longer blood alcohol values for equivalent amounts of alcohol."

Still, other research has demonstrated that sleeve gastrectomy is an effective bariatric surgical procedure -- especially in the short run. And recent research indicates that "In severely obese and high-risk patients, laparoscopic sleeve gastrectomy provides superior total weight loss at 2 years." So it is quite likely that LSG will prove effective for the long term.

Therefore, laparoscopic sleeve gastrectomy will receive more attention, as it becomes an important bariatric surgical procedure. Offering this surgery could give a surgical weight loss center a competitive advantage.

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Monday, June 11, 2012

Gut Microorganisms and Obesity

Because obesity is such an important problem throughout the world, researchers are investigating many aspects of the disease. One interesting aspect of obesity is the role gut microorganisms play in the ailment.  And understanding how these gut inhabitants participate may enable us to target the organisms in a way to better manage a person’s weight.

Studies have shown that ‘[i]ntestinal microbiota may play a pivotal role in converting nutrients into energy. Variations in the composition of microbiota are found in obese humans and mice. Increased energy yield from diet in obese mice and humans could be a contributing factor to obesity…’

Although the process is not fully understood, a recent study indicates that diet and inflammation can influence the makeup of gut microciota. The study was done at Columbia University.

According to the study, ‘Gut microbiota have been implicated in the regulation of body weight.’ And ‘[t]he relative abundance of specific members of the microbiota was correlated with circulating leptin concentrations and gene expression levels of inflammation markers in subcutaneous white adipose tissue in all mice. Together, these results suggest that both host adiposity and diet composition impact microbiota composition, possibly through leptin-mediated regulation of mucus production and/or inflammatory processes that alter the gut habitat.’

Finally, a French study has shown, in mice, that by taking microbiota  from healthy mice and implanting the microbiota into other mice, the investigators were able to 'prevent the development or liver inflammation and insulin resistance.’ Therefore, gut microbiota may one day be used as a therapy in the treatment of liver disease and diabetes.

We think these studies could lead to gut microbiota targeting-methods that might help control weight. Indeed, if we can determine, for example, what diets modify the composition of gut microbiota, and if we can determine what gut microbiota is most conducive to a healthy weight, weight loss service providers can then endorse these diets. Indeed, diet, as part of weight loss therapy to target gut microbiota, may be treatments that medical weight loss or surgical providers can offer.

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