Wednesday, February 26, 2014

Predicting the Effectiveness of Bariatric Surgery

Bariatric surgery is among the most effective weight loss methods. In addition to being an effective weight loss tool, bariatric surgery has also been shown to resolve type 2 diabetes in some cases. And now, a biomarker may help determine when bariatric surgery is likely to be an effective type 2 diabetes treatment.

Studies show that bariatric surgery, especially gastric bypass surgery, can resolve type 2 diabetes and other harmful metabolic conditions. But exactly which type 2 diabetics the surgery will probably help is generally not known. However, scientists at Helmholtz Zentrum München and the University of Cincinnati in Ohio report that GLP-1, a hormone "secreted by the gastrointestinal tract, can predict the metabolic efficacy of a gastric bypass," at least in rats.

GLP-1 normally increases in the blood after gastric bypass surgery. And looking at the animal study results, the researchers found that "the more responsive the animals were to GLP-1, the greater the efficacy of the gastric bypass turned out to be regarding glucose metabolism improvements." These results may help providers and patients decide on the appropriateness of bariatric surgery rather than less aggressive treatments.

Indeed, more understanding of when bariatric surgery is or is not appropriate, in general, is important for reasons other than treating type 2 diabetes. While some experts believe that bariatric surgery reduces healthcare costs, some researchers conclude that bariatric surgery does not necessarily reduce  long term healthcare costs, because "hospital stays for complications from the procedure exceed savings from obesity-related illnesses..." Furthermore, the surgery is not always effective for long term weight loss.

So, developing a biomarker to determine the appropriateness of bariatric surgery for type 2 diabetes may lead to methods that can help healthcare providers decide when the surgery is appropriate for weight loss, and when it is not. Bariatric surgery may not provide the results desired, and the surgery may not always be cost effective.

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Saturday, February 15, 2014

Company Wellness Programs Are Not Providing the Desired Benefits

In an attempt to improve the overall health of their employees, some companies offered employees wellness programs. Among these programs’ most important components are assistance with diet and exercise. With these programs, companies endeavored to keep employees healthy, and lower health care costs. But often the companies' efforts did not lead to success.

Experts had believed that putting wellness programs in place would enable organizations to be more profitable by improving employee health. In fact, according to the U.S. Preventive Medicine organization, an effective wellness program could "yield a $3 to $6 return on investment for each dollar invested."

Further, according to Right Management, a subsidiary of Manpower Inc., an organization’s wellness program could improve the organization’s competitive edge by increasing employee productivity and performance.

Some insurance providers have also indicated that they have a positive view of wellness programs. Believing that the programs would be beneficial, CIGNA purchased Kronos Optiman Health Company, a health and wellness company, based in Phoenix.  This acquisition enabled CIGNA to expand its wellness program offerings, including its online services.

Despite these past actions, organizations are not currently seeing the predicted positive results from wellness programs. So some companies are taking more drastic measures to try to improve program results.

Indeed, "companies are taking advantage of rules under President Barack Obama's health care overhaul ... to punish smokers and overweight workers. Some will even force employees to meet weight goals, quit smoking and provide very personal information or pay up to thousands more annually for health care."

Although drastic, these measures may motivate more employees to participate in their company's wellness program and adhere to the program's guidelines. We believe that wellness programs can be beneficial. Further, obesity medicine specialists may be able to play a key role here. Obesity medicine specialists, and other healthcare experts, may be able to work with employers and wellness program organizers to help find ways to improve the results of company wellness programs.


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