Wednesday, October 30, 2013

Research into Bariatric Surgery Methods Opens Doors to Potential Therapies for Metabolic Conditions

Bariatric surgery is an important option for those experiencing severe obesity.  Indeed, for long term weight loss, bariatric surgery is generally more effective than diet, exercise, drugs, or lifestyle modification. Not only is bariatric surgery effective for weight loss, the surgery has also had beneficial effects on some harmful metabolic conditions.

For some time, we've felt that research into how bariatric surgery leads to weight loss and positive metabolic changes in the body will contribute to non-surgical weight loss treatments. Indeed, surgical research results will be useful to surgical and non surgical experts who develop therapies for treating obesity and metabolic diseases.

Many people believe that bariatric surgery causes weight loss by making changes, in the body, that limit the amount of food a person wants to eat.  Or that the surgery modifies the intestine to reduce calorie intake. However, as we've said before, the changes in the body, following bariatric surgery, are more complex than simple physical changes.

For example, Swedish researchers concluded that bariatric surgery is instrumental in gene expression modifications. These modifications are apparent in at least two genes. The genes are "called PGC-1 alpha and PDK4." These two genes are positively correlated with obesity. However, the effects of these two genes are reduced "after surgery-induced weight loss."

In a China mice study, researchers found that duodenojejunal bypass (DJB), an intestinal bypass procedures sometimes used in bariatric surgery, causes the intestine to absorb less glucose. The researchers concluded that DJB reduces the activity of the protein, SGLT1. SGLT1 or "sodium glucose co-transporter 1" is active in getting glucose into the small intestine. Understanding the function of this protein may enable researchers to produce drugs that target this hormone, and thereby treat type 2 diabetes.

While more DJB studies are required, the China study shows how important it is for researchers to investigate the effects of DJB, as well as bariatric surgery procedures. This type of research can lead to non-surgical therapies for weight loss, weight control, and metabolic diseases. 

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Sunday, October 6, 2013

Reducing Prepregnancy Obesity Can Reduce Undesirable Infant Health Issues

Past research has indicated that there is a link between a woman's prepregnancy weight and the future weight of her child. In fact, if a woman is overweight or obese before pregnancy, there is a greater chance that the woman's child will be overweight two to three years after birth. However, a woman's overweight or obesity can create problems for her child well before the child is two or three years old.

According to a recent report produced in Atlanta, Ga, "prepregnancy obesity is a strong risk factor for adverse fetal and infant outcomes." The report suggests that if we could eliminate the effects of prepregnancy obesity, we could put a stop to fetal deaths, spina bifida, congenital heart defects, and hydrocephalus.

The report's results are similar to the results from a 2007 study which concluded that "Mothers of offspring with spina bifida, heart defects, anorectal atresia, hypospadias, limb reduction defects, diaphragmatic hernia, and omphalocele were significantly more likely to be obese than" non-obese prepregnant women.

Further, some research indicates that "Women who are obese before they become pregnant are at higher risk of having children with lower cognitive function than mothers with a healthy prepregnancy weight..." And that "the effects of prepregnancy obesity were equivalent to a seven-year decrease in the mothers’ education and significantly lower family income..."

So prepregnancy women should be made aware of the importance of maintaining a healthy weight before they become pregnant. This is particularly true for low-income women.  One report concluded that 'prepregnancy obesity remains a critical issue for low-income women. Overall the prevalence of prepregnancy obesity increased steadily among low-income women from 1999 to 2008.'

Clearly, health care providers should place appropriate emphasis on encouraging prepregnant women to maintain a healthy weight. And indeed, weight management counseling should be given to low-income prepregnancy women. Obesity medicine practitioners should see these efforts as actions that help patients, society, and the community.
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