Sunday, August 28, 2016

The AspireAssist Device As a New Tool to Fight Obesity

In light of our obesity epidemic, obesity-related treatments have continued to gain FDA approval. Within the last five years, at least four obesity drugs and at least four obesity-treatment devices have been approved by the FDA. The approved obesity drugs include Belviq, Qsymia, Contrave, and Saxenda. The approved obesity related devices include two intragastric balloons and a vagal nerve signal blocking tool called the Maestro® Rechargeable System. And the most recent obesity-treatment device obtaining FDA approval is the AspireAssist.

The AspireAssist, produced by King of Prussia, Pennsylvania based Aspire Bariatrics, is a pump device that can be used to remove stomach contents. "The device is considered minimally invasive and includes a tube that goes from the inside of the stomach to a port on the outside of the abdomen. The pump can be attached to the outside port as needed to remove about a third of the stomach's contents at a time."

According to an FDA news piece, 'The AspireAssist approach helps provide effective control of calorie absorption, which is a key principle of weight management therapy.' In a study consisting of 111 patients that the FDA reviewed, the 60 control participants lost 3.6% of their total weight, compared to 12.1% for the participants who used the AspireAssist device.

The AspireAssist device joins other devices that were recently approved by the FDA to fight obesity. Other recently FDA approved devices include two intragastric balloons and the Maestro® Rechargeable System. The intragastric balloons are endoscopically placed in the stomach, allowing a person to feel satisfied while eating less food. The  Maestro® Rechargeable System is placed in the body via minimally invasive surgery. This system blocks signals sent from the digestive system to the brain, via the vagal nerve. These signals contain messages associated with hunger, satisfaction and fullness. The system can cause a person to eat less.

Keep in mind that the AspireAssist device can have side effects, including nausea, constipation, indigestion and diarrhea. And there are risks associated with the placement of the device. The risks include bleeding, infection, and inflammation. Still, the device does add another tool to a growing obesity-fighting toolbox. And for some individuals, the device may prove beneficial.

Thursday, August 18, 2016

Bariatric Surgery May Be Appropriate for Adolescents

Bariatric surgery has been used as a treatment for obesity in adults for many years. But there is some question as to whether bariatric surgery is appropriate for adolescents. Guidelines are established for adult bariatric surgery, but no guidelines have been set for adolescent bariatric surgery. Still, the surgery is being considered because adolescent obesity is a problem. Recent studies have shown that bariatric surgery can enable adolescents to lose weight, improve mobility, and the comorbidities associated with obesity.

In a study consisting of 242 obese adolescents, the study participants reduced their weight by 40%, starting with an average BMI of 51.7. These adolescents also experienced a reduction in the extent of their comorbidities associated with the obesity. Further, adolescent participants experienced increased mobility. After six months, 195 of the participants were able to reduce the amount of time it took to complete a 400 meter walk by 29 seconds. The time to make the walk went from 6.3 minutes to 5.8 minutes.

So, bariatric surgery can improve the health of obese adolescents. As one Washington Post article concluded: “a growing number of clinicians and researchers say that weight-loss surgery may be [adolescents'] best chance to take off significant weight and either correct or avoid such conditions as diabetes and heart disease, which often go hand-in-hand with obesity.”

Still, opting for bariatric surgery requires that weight loss practitioners and their adolescent patients first try diet, exercise and behavior modification. Only when these endeavors fall short should bariatric surgery be considered.

Further, there may be drawbacks to the surgery for adolescents. One drawback of bariatric surgery for adolescents might be interference with an adolescent's growth. The surgery may prevent adolescents from receiving important nutrients.

More research is of course needed to determine if and when bariatric surgery is appropriate for adolescents. Anyway, bariatric surgeons and obesity medicine physicians should work together to arrive at the most appropriate weight loss treatment. And bariatric surgery likely has a place in the treatment of obese adolescents.

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