Weight Loss Surgery Archives - DSSurgery

The association of preoperative psychological assessments with long-term sleeve gastrectomy surgery outcomes

Dr. Ara Keshishian — Tue, 12 May 2026 14:45:03 +0000

Obesity is not a mental disorder. For years, we have maintained the position that patients do not gain weight primarily because of overeating and lack of exercise. Telling a patient to just eat correctly and exercise will cause weight loss, just as telling a patient that jumping up and down will make them taller. It completely negates other critical factors: genetics, hormones, microplastic-environment, stress, and many others. Our research has shown that psychological status and preoperative psychological evaluation bear no bearing on the long-term outcome of the weight loss surgery.

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Reasons for discontinuation of GLP1 receptor agonists: data from a real-world cross-sectional survey of physicians and their patients with type 2 diabetes

Dr. Ara Keshishian — Wed, 30 Oct 2024 16:00:13 +0000

There are numerous complications with GLP-1 medications. Figure 2 outlines why so many patients have to stop these medications: DMSO-141235-reasons-for-discontinuation-of-glp-1-receptor-agonists–data_092917

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GLP-1 agonists: A review for emergency clinicians

Dr. Ara Keshishian — Thu, 24 Oct 2024 23:51:28 +0000

GLP-1 Agosinsts have extensive and complex side effects and complications profile This table is from a large review publication for Emergency physicians dealing with the complications of GLP-1 agonist medication.

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Hard to believe Adjustable Gatric Band Is till considerend an option

Dr. Ara Keshishian — Tue, 01 Oct 2024 05:58:47 +0000

The adjustable gastric band, the Lap Band, was approved in the US in early 2000 based on a small study with only 149 patients. Over the next decade, the Lap Band became very popular, as mixed data and high revision and complication rates were noted in the literature. Large, small, and short and long-term publications reported a similar theme: The weight loss following Adjustable gastric banding is less than predicted, complications are higher, and further surgical care is needed. Patients should ask themselves why a procedure’s reversibility should be promoted. For example, why is the Lap band advertised as easily reversible? Would anyone consider a knee replacement surgery only if it can be reversed and the knee pain returns? The reversibility of the procedure is promoted because most of them need to be revised over time. One of the few papers that presented favorable results needs to be looked at closely, and the respondents were fewer than the patients who had been operated on (199+186=385 of the 1334 more than three years post-op) A large meta-analysis reported the worst weight loss with the Adjustable gastric banding and the best with the duodenal switch operation. In my opinion, given the proven data of the sleeve gastrectomy and other irreversible complications of the lap band, no one should get it done since the risks associated with complications and inadequate weight loss far outweigh any benefit.

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Long-Term Effect of Bariatric Surgery on Liver Enzymes in the Swedish Obese Subjects (SOS) Study

Dr. Ara Keshishian — Wed, 06 Dec 2023 18:24:42 +0000

Liver enzymes are quite frequently elevated in patients with any degree of obesity. This elevation is even further exacerbated by conditions such as diabetes, elevated cholesterol, and triglycerides. Scientific evidence shows that weight loss surgical procedures improve the lever enzymes in the long term even if transiently they may worsen. We had previously published this […] Read the Full Article

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Modeling and Simulation for Identification of Possible Cause for Portal Vein Thrombosis: A Complication of Sleeve Gastrectomy.

Dr. Ara Keshishian — Thu, 24 Nov 2022 18:09:32 +0000

Background: This study was performed to study possible causes of Portal Vein thrombosis, a potentially deadly complication of specific foregut surgical procedures. Methods: Mathematical models of blood flow to the foregut organs, stomach, duodenum, spleen, and liver were created in MATLAB. Pathologic conditions were created by removing or adding the electrical components in the circuit modeled in MATLAB. These modifications represented surgical variation and hemodynamic changes. Comparing the input and output waveforms and comparing them to the known wave from live subject samples were able to model conditions where the likelihood of portal vein thrombosis is most likely to occur. Results: Ligation of the gastroepiploic vessels produce significant flow disruption in our model, significantly more than dehydration, causing portal vein flow reduction and possible portal vein thrombosis. Conclusion: Summary and potential implications. Trial registration: No registration or IRB was required. The study did not involve any human or animal subjects.

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Surgical Treatment of Clinically Significant Reactive Hypoglycemia Nesidioblastosis, Post-Gastric Bypass

Dr. Ara Keshishian — Wed, 17 Mar 2021 16:33:13 +0000

Duodenal switch operation corrects the complications of gastric bypass.

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Weight Loss and Hypertension in Obese Subjects

Dr. Ara Keshishian — Sun, 19 Jul 2020 17:09:55 +0000

Arterial hypertension is strongly related to obesity. There may be different mechanisms which leads to hypertension in overweight patients. This may be the reason why the outcome of different surgical procedures varies between procedures.

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HYPERTENSION IN OBESITY AND THE IMPACT OF WEIGHT LOSS

Dr. Ara Keshishian — Sun, 19 Jul 2020 16:44:02 +0000

Hypertension is closely linked to high prevalence of obesity. Surgical weight loss is the most promising option for long-term control of hypertension. However there are certain limitations to accessibility.

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Effects of Bariatric Surgery in Obese Patients With Hypertension

Dr. Ara Keshishian — Sun, 19 Jul 2020 16:37:26 +0000

Weight loss surgical procedures improve hypertension. The efficacy of each procedure is different. However, Some patients have better outcome with gastric bypass.

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