Tag: weight loss
Here we go again…. There is a new cure for obesity, Gastric Balloon, with minimal to no risk, is an outpatient procedure and/or can be done in the surgeons office with no anesthesia. Have we not similar claimed like this before (Adjustable gastric band) ?
Randomized sham-controlled trial of the 6-month swallowable gas-filled intragastric balloon system for weight loss published in Surgery for Obesity and Related Diseases 14 (2018) 1876–1889, by Sullivan et. al reports
“Conclusions: Treatment with lifestyle therapy and the 6-month swallowable gas-filled intragastric balloon system was safe and resulted in twice as much weight loss compared with a sham control, with high weight loss maintenance at 48 weeks.”
This sound very promising, however is very vague and leaves out significant, critical, and pertinent information.
The outcome of weight loss at 24 weeks was reported in Total Body weight loss % (TBWL%), Excess weight % (EWL), weight loss, and BMI change. Of those, the last three were statistically significant changes.
It is stated that the Gastric Balloon is temporary device that needs to be removed in 6 months and should be considered in low BMI patients (<35kg/m2). It is is important for those patients who are considering this temporary expensive measure for minimal weight loss to entertain the alternative of the same temporary results that may be obtained by lifestyle changes. These results may be maintained by a healthy lifestyle, exercise, and eating without the need for a device.
Liver is a vital organ. It has many roles in the physiologic pathways including protein productions, clotting function, iron metabolism, production of bile and cholesterol, etc. as well as metabolism and filtering of waste products. We should think of it as a refinery, for conversion of raw material from food to energy used by our body, in addition to a processing and distribution center for mineral, and nutrients. Liver injury can have devistating effects and long term ramifications if unchecked.
Liver is also very resilient and forgiving to stressors and injury. The liver will tolerate repeated insults caused by Medication (both prescription and over the counter) , obesity, Diabetes, alcohol, and herbal supplements, to name a few, but only if care is taken and the offending stressor is removed. During the injury phase, however, the liver may have a difficult time keeping up with bodily function needs due to loss of fully function cells.
The anatomy of liver can change from normal (both visually to the naked eye and under microscope) to mild inflammation and reverse back to normal if the underlying causes of injury are removed. IF, however, the anatomy of the liver changes with fibrosis, it crosses to an irreversible range where it can only be prevented from progressing rather than reversing.
In the obese population, Non-alcoholic Fatty Liver Disease (NAFLD) causes inflammation and a slow diminishing functionality of the liver. NAFLD is the leading cause of liver disease in the U.S. Unchecked or untreated NAFLD can progress to NASH (Non-Alcoholic Steatohepatitis. NAFLD or “fatty” liver disease is an accumulation of fat within the liver. NASH is a progression that can lead to inflammation of the liver cells or advance to fibrosis and cirrhosis. In addition to liver injury, there is some evidence that NAFLD also correlates with cardiovascular disease.
Causes of NAFLD:
- Type 2 Diabetes Mellitus
- High cholesterol
- Sedentary lifestyle
Symptoms may include fatigue, right upper quadrant pain, liver enzyme elevation
During bariatric or weight loss surgery we visualize and occasionally biopsy the liver to define the degree of injury, if identified. Following weight loss surgical procedure a rise in liver function enzymes may be expected due to the processing of waste products following fat mass loss. However, long term bariatric procedures can significantly improve NAFLD and NASH. Bariatric procedure require the adherence to protein and supplement requirements as well as regular physician visits. Past blog of liver disease.
Exercise and it’s benefits for body, mind and weight loss can’t be over emphasized. Everyone can benefit from some form of exercise whether it be a brisk walk, chair exercises, exercise bands, aquatics, running, hiking or biking. As a family we try to exercise often and attempt to participate in at least one event a month or so. These types of events tend to keep us more accountable and motivated. The group atmosphere, energy and vibe only add to the experience. Listed below are some of our favorite exercise events. We will update this list and add to it.
- Weight loss and maintenance can be a benefit of exercise. It also improves muscle function and strength.
- Improves Type 2 Diabetes and Metabolic Syndrome
- Reduces some Cancer Risk
- Improved Cardiovascular Health
- Improved “Good” cholesterol
- Strengthens and improves Bone Health
- Living longer
- Improved Sleep
Mental Health Benefits:
- Reduce Stress
- Boosts Endorphins
- Helps with Anxiety
- Improved Self Confidence
- Being in the Great Outdoors and Sunlight (increases Vitamin D)
- Prevent Cognitive Decline
- Sharpen Memory and Cognitive Function
- Help with Addiction
- Increase Relaxation
One important key note is to pay close attention to hydration with exercise, not only with fluids but electrolytes as well. Exercise increases fluid loss due to sweat and increase circulation to muscle. You need to increase fluid intake to compensate for these losses.
Exercise events by the month:
The Los Angels River Ride is one of our families favorites. Great ride for a great cause.
The Prudential 401K Run is to promote saving for retirement and is a FREE event at the beautiful Rose Bowl
The Aloha Run brings a little Hawaiian feel to the fall.
City of Hope’s Walk for Hope
Santa to the Sea (must bring a gift for a child)
Varying months depending on location:
CicLAvia a Los Angeles area quarterly biking event.
I had the opportunity to be in a meeting with Dr. Hess in November of 2004. He presented a lecture about the history of the Duodenal Switch and his collaborative work with Dr. Scopinaro, the pioneer surgeon of the Biliopancreatic Diversion. The BPD was the the foundation of the Duodenal Switch operation. The first patient ever to have had the Duodenal Switch was a revision from a failed vertical banded March of 1988 by Dr. Douglas Hess. At the time of this particular meeting (in 2004), the patient was 17.5 years post op.
This is a copy of the slide that he shared with the surgeons present at the Duodenal Switch meeting on November 21, 2004.