Monday, April 27, 2015

Bariatric Surgery Continues to Show Benefits

Before bariatric surgery is considered, diet, exercise, and pharmacotherapy are most often used for weight loss and weight loss maintenance. However, bariatric surgery is gaining in popularity, usage, and broader applications. There are reasons why this is the case. The surgery does lead to weight loss success for super obese individuals. The surgery does appear to resolve a number of obesity-related comorbidities. And the surgery improves the quality of life for many persons who get the surgery.

Bariatric surgery is usually indicated for persons with a BMI greater than 40, and for persons who have a BMI greater than 35, plus obesity related comorbidities. However, in one study, experts concluded that bariatric "surgery is safe and effective at reducing weight and comorbidity" for persons with a BMI less than 35.  In the study, 1,000 subjects were studied. And it was found that most of the subjects benefited from the surgery.

But some forms of bariatric surgery are more effective than others. Roux-en-Y gastric bypass (RYBP) surgery and sleeve gastrectomy {SG) appear to be more effective at reducing weight and resolving type 2 diabetes than some other forms of the surgery. As the investigators in one study indicated, "Bariatric surgical procedures that modify the upper gastrointestinal tract anatomy (RYBP and SG) are more successful in producing weight loss and remission of T2D than those that simply restrict stomach capacity," such as LAGB (laparoscopic adjustable gastric banding).

Also, bariatric surgery has been found to substantially improve the health-related quality of life (HRQoL) for many patients "after bariatric surgery." It was also noted that  "much of the initial HRQoL improvements were maintained over the long term."

Now bariatric surgery is not always successful at improving HRQoL. Indeed, "In super-obese patients, perceived poor control over eating 2 years  after bariatric surgery was associated with lower HRQoL" But success may depend on the person's "network of social and emotional support ." Good support could improve the person's HRQoL.

At any rate, while not perfect,  bariatric surgery is an important tool for weight loss and the resolution of comorbidities associated with obesity. And the surgery can improve a person's quality of life.

Monday, April 20, 2015

Laparoscopic Sleeve Gastrectomy Gains in Prominence

Bariatric surgery is a top weight loss approach. Not only is bariatric surgery viewed as a top weight loss method, bariatric surgery appears to be a good way to resolve type 2 diabetes in many patients. Therefore, bariatric surgery continues to gain prominence. The three leading forms of bariatric surgery are laparoscopic gastric bypass surgery, laparoscopic sleeve gastrectomy (LSG), and laparoscopic adjustable gastric band (LAGB). And laparoscopic sleeve gastrectomy is gaining in popularity in many quarters of the world.

For example, LAGB is used less and less in New Zealand. This lessening of usage prompted investigators to launch a comparison study to look at some different bariatric surgery results from a single surgeon's practice. The study consisted of 228 patients, where approximately 41% of the patients had undergone LAGB and about 58% of the patients had undergone LSG. The study concluded that LAGB produced "a significantly reduced level of weight loss but higher complications than LSG."

In another study, LSG was evaluated for effectiveness in patients with a BMI between 30 and 35. In the study, 192 patients were divided into two groups. Patients with BMI's between 30 and 35, approximately 26% of the patients, comprised one group, and patients with a BMI greater than 35, approximately 75% of the 192 patients, comprised the other group. The study's investigators concluded that "LSG achieved excellent outcomes without severe complications for mildly obese patients." Further the investigators concluded that "LSG could serve as a safe and effective stand-alone procedure to achieve sustained weight loss and comorbidity resolution in patients with a lower BMI.

The two above-mentioned studies can be beneficial to bariatric surgeons and non-surgical obesity medicine specialists. These studies show why many believe that laparoscopic sleeve gastrectomy is safe and effective. And these types of studies can enable both bariatric surgeons and non-surgical obesity medicine specialists to have more confidence in the LSG weight loss approach.

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