Vertical Sleeve Gastrectomy — Considerations and Nutritional Implications – Info
- September 25 – 28, 2014 - Orlando, Florida
From Dr. Alvarez, "Amazing "before and after" slideshow where Betsy, who had the gastric sleeve procedure at 12, shows her weight loss journey and results."
You bet I am torn about this.
I've met the surgeon who performed the surgery, several times… he's a lovely person with superb skill. He's awfully cute as well. (Of course I can't find the photo of us.) BUT I DIGRESS.
However. 12 years old? I can't get my 12 year old to shower on a predictable basis – how on EARTH would I get him to follow through with the long-term care and feeding of a bariatric surgery procedure?
Is it worth it to step in and thwart the long term effects of obesity at a very young age — or are we screwing with an adolescents development?
I am torn. Very.
PS. I suppose I should mention? The little girl is the niece of her surgeon. Wait, what? Right. She's got a bariatric surgeon in the family — whereas some of us can't get one on the phone. Dr. A, will you adopt me?
There could be a REASON why we fail diets. Or — diets fail us.
One year after initial weight reduction, levels of the circulating mediators of appetite that encourage weight regain after diet-induced weight loss do not revert to the levels recorded before weight loss. Long-term strategies to counteract this change may be needed to prevent obesity relapse.
Ghrelin. You may have heard of this evil little hormone.
*blink blink* Wikipedia tells me —
Ghrelin is a 28 amino acid peptide and hormone that is produced mainly by P/D1 cells lining the fundus of the human stomach and epsilon cells of the pancreas that stimulates hunger. Ghrelin levels increase before meals and decrease after meals. It is considered the counterpart of the hormone leptin, produced by adipose tissue, which induces satiation when present at higher levels.
In some bariatric procedures, the level of ghrelin is reduced in patients, thus causing satiation before it would normally occur.
Hormones regulating when a person feels hungry or sated do not rapidly adjust to weight loss, which may be a factor in the yo-yo effect observed among dieters, researchers found.
One year after losing weight, levels of appetite-regulating hormones didn’t revert to baseline levels, Joseph Proietto, PhD, of Heidelberg Repatriation Hospital in Australia, and colleagues reported in the Oct. 27 issue of the New England Journal of Medicine.
The findings suggest that the “high rate of relapse among obese people who have lost weight has a strong physiological basis and is not simply the result of the voluntary resumption of old habits,” Proietto and colleagues wrote.
It’s well established that heavy patients who lose weight dieting often fail to keep the pounds off, the researchers explained.
Studies have shown that restricting calories can lower levels of the hormones leptin — which tells the brain that the body is full — and ghrelin — which stimulates hunger.
Doesn’t this also help explain why some forms of weight loss surgery … work better overall in the long term? In certain types of WLS — most of ghrelin producing factor — is removed.
Go DS. Or not. It’s up to you. Surgery flame wars!
A benefit of removing a portion of the stomach is that it also greatly reduces the amount of ghrelin producing tissue and amount of acid in the stomach.
Ghrelin is the “hunger hormone” and by reducing the amount of the hormone produced the appetite is suppressed.
The Vertical "sleeve" Gastrectomy is a relatively
new procedure for weight loss and I was very cautious about getting any kind of
surgery at all. So how did I end up with a procedure that most insurance
companies still consider "experimental?"
Like most people, when I first looked into WLS, all I knew about was the lapband and RnY. And, like most
people, I had this idea that lapband was "safe" and RnY was
"dangerous". I also like the idea that the lapband was reversible. I
figured that if I turned into one of those people who WLS didn't agree with, I
could just take it out.
Of course, I know now that
I was hopelessly naive and also fairly ignorant as to what options were out
there and what the pros and cons are of the different surgery types. And, yet,
after learning a lot more about it, my initial analysis of bypass held.