Can sugar make you stupid? Studies point to yes.


Can sugar make you stupid?  

Oh dear.   

If the following study regarding the ingestion of sugar and cognition is true — I should be gaining brains instead of losing them — considering that I eat about 95% less of the sweet stuff since I had roux en y gastric bypass surgery.  

However as we all know, *MY brains are very special since I had weight loss surgery.   

The combination of a high-sugar intake and a lack of Omega-3 Fatty Acids caused brain fail in rats!  

What about… us?  What if poor diet causes brain issues that aren't reversible?  This intrigues me.

National Geographic

 Sweet drinks scrambled the memories and stunted learning in lab rats in a new study—leading to "high concern" over what sugary diets may do to people, according to neuroscientist Fernando Gomez-Pinilla. (Read more about memory from National Geographic magazine.)

 For the study, Gomez-Pinilla's team first trained rats to successfully navigate a maze, giving them only water and standard rat chow for five days. During the following six weeks, the rats' water was replaced with syrups that were 15 percent fructose.

"Most sodas people consume are about 12 percent sugar, so imagine if you drank soda with sugar added instead of water," said Gomez-Pinilla, of the University of California, Los Angeles.m

During the six-week period, half the rodents were also given flaxseed oil and fish oil—both rich in omega-3 fatty acids. These antioxidants may protect against damage to chemical connections in the brain called synapses, past research suggests.

After six weeks of the fructose syrup, all the rats were slower at running the maze. However, those that had received omega-3s were slightly faster than their counterparts.

By studying the dissected brains of the study rats, the researchers determined that the high-fructose diets had sabotaged the ability of synapses to change, a key factor in learning. The sugary drinks had also disrupted the sugar-regulating protein insulin in a brain area called the hippocampus, which play a role in memory formation in both rats and humans.t

"I was very shocked to see how strong an effect these diets could have on the brain—I have high concern that the foods people eat can really affect mood and cognition," Gomez-Pinilla said.

Study Abstract

We pursued studies to determine the effects of the metabolic syndrome (MetS) in brain, and the possibilities to modulate these effects by dietary interventions. In addition, we have assessed potential mechanisms by which brain metabolic disorders can impact synaptic plasticity and cognition.

We report that high-dietary fructose consumption leads to increase in insulin resistance index, insulin and triglyceride levels, which characterize MetS. Rats fed on an n-3 deficient diet showed memory deficits in Barnes Maze, which were further exacerbated by fructose intake.

In turn, n-3 deficient diet and fructose interventions disrupted insulin receptor signaling in hippocampus as evidenced by a decrease in phosphorylation of insulin receptor and its downstream effector Akt.

We found that high fructose consumption with n-3 deficient diet disrupts membrane homeostasis as evidenced by an increase in the ratio of n-6/n-3 fatty acids and levels of 4-hydroxynonenal (4-HNE), a marker of lipid peroxidation.

Disturbances in brain energy metabolism due to n-3 deficiency and fructose treatments were evidenced by a significant decrease in AMPK phosphorylation and its upstream modulator LKB1 as well as a decrease in Sir2 levels. The decrease in phosphorylation of CREB, synapsin I and synaptophysin (SYP) levels by n-3 deficiency and fructose shows the impact of metabolic dysfunction on synaptic plasticity. All parameters of metabolic dysfunction related to the fructose treatment were ameliorated by the presence of dietary n-3 fatty acid.

Results showed that dietary n-3 fatty acid deficiency elevates the vulnerability to metabolic dysfunction and impaired cognitive functions by modulating insulin receptor signaling and synaptic plasticity.


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A fully reversible, NON SURGICAL device for weight loss? Obalon Therapeutics

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Obalon Therapeutics, Inc. received approval from the FDA and has begun enrolling its first clinical study in the United States to begin evaluating the safety and efficacy of a fully reversible device for weight loss.

  • Clinical trial results reported by Dr. Ariel Ortiz showed 34% excess weight loss in a three-month study in Mexico. 
  • Dr. Ortiz also announced preliminary results of approximately 45% excess weight loss in a similar European study.

Those are some amazing numbers.  I promise I am not thinking about adding this to my gastric bypassed belly, much.  I kid.

What is it?  Here’s information from the patent application

An implant configured for ingestion by a patient. After the implant has been swallowed by the patient and is disposed within the target location, e.g. the patient’s stomach, an inflation subcomponent causes the implant to expand from a compact delivery state to an expanded, volume-occupying, deployed state.

In the deployed state the implant creates a sensation of satiety in the patient stomach and thereby aids in limiting food intake and obesity.

After a predetermined time a deflation subcomponent is actuated and the implant reduces in size so as to allow it to pass through the remainder of the patient’s digestive track. The device may further incorporate tracking and visualization subcomponents, as well as pharmaceutical delivery subcomponents.


Obalon Therapeutics, Inc. announced it closed a $16.5 million Series C private equity financing, began enrolling patients in a U.S. clinical trial, received CE Mark approval and had weight loss data presented at the IFSO European Congress (International Federation for the Surgery of Obesity and Metabolic Disorders).

Obesity is a worldwide epidemic. Although bariatric surgery has demonstrated strong weight loss results, the surgeries are costly, irreversible and used in less than 1% of the eligible population. Physicians, patients and payers all agree there is a compelling need for new products and technologies to address this gap.

Obalon is developing a novel, nonsurgical, fully-reversible device for weight loss. The device consists of a capsule containing a balloon that is swallowed and then remotely inflated. The balloon is intended to occupy space in the stomach to create a feeling of fullness to help people eat less. Additional balloons can be swallowed and inflated during the treatment period as indicated for weight loss. At the end of the treatment period, the balloons are removed.

Your thoughts?  Would you try this device had you not had weight loss surgery already? 


Weight loss surgery may not cut medical costs – study

A recent study suggests that even with weight loss surgery, the formerly obese are still costly to the medical system, at least in the first few years.  The prior evidence that weight loss surgery saved money in the long run was based primarily on young, obese females, who are the most likely to HAVE bariatric surgery and save money throughout their health-care cycle.  For example, people like me: a relatively straight-forward  case of morbid obesity. Gastric bypass may have kept me from developing costly issues related to my obesity. 

Weight-loss surgery may not cut medical costs – KTVN

"These three-year findings suggest that the return on investment for bariatric surgery isn't seen," said lead researcher Matthew Maciejewski, from the Center for Health Services Research in Primary Care at the Durham VA Medical Center, in North Carolina.

"It is possible, however, that if we could follow these [patients] for another three to five years, cost reduction may be seen," he said.

Bariatric surgery improved these patients' health in the short term, but without further weight loss or other lifestyle modifications, their risk remains high, he added.

Maciejewski said these patients, like most patents who have weight-loss surgery, gain much of the weight back, which may be why costs remain the same as before surgery.

The report was published in the July issue of the journal Archives of Surgery.  

Download study –

Surgeons use risk-benefit analysis in our decisions to operate on specific patients. Rarely do we consider the economic implication, instead using the assumption that an individual would want enhanced quantity or quality of life, regardless of cost. This decision-making process is further supported by a separation of those who receive the benefit and those who pay the bill. However, when surgeons want to justify a new procedure or piece of equipment, economic benefit is often argued. Those contemplating paying for the procedure will balance expense with the improvement of quantity or quality of life for the insured.

Bariatric surgery clearly reduces obesity-related comorbidities and has been touted to reduce overall costs.1Most of these studies examined a predominantly younger female cohort that represents most bariatric patients. True economic costs are hard to quantify because patients are mobile, expenditures occur in multiple disparate realms, and charges do not reflect actual expenditures. The study by Maciejewski et al2provides insight into a different group of patients: veterans treated in a truly integrated delivery system. Utilization of resources is efficiency captured, and the cost structure is standardized across the system. Comparing 847 patients undergoing bariatric surgery with 847 propensity-matched controls, the authors did not demonstrate a significant decrease in health care expenditures in the 3 years after the bariatric procedures."

For the study, Maciejewski's team looked at health-care spending in nearly 850 U.S. military veterans who had weight-loss surgery, comparing them to a similar number of veterans who didn't. The researchers analyzed expenditures for the three years before and after surgery.

The researchers found that in the years before surgery, hospital inpatient and outpatient costs for people who had bariatric surgery were about $600 lower than for those who didn't have the procedure. In the six months before surgery, however, the costs were $28,400 higher, including the operation.

Costs were almost $4,400 higher in the first six months after surgery, but then dropped to about the same level as before the procedure, the researchers found.

These findings, however, may only apply to this particular group of patients, who were mostly male, older and sicker than other patients who have weight-loss surgery, the researchers noted. In other groups, the procedure may reduce health-care spending.

Dr. Mitchell Roslin, chief of bariatric surgery at Lenox Hill Hospital in New York City, said patients should not be looking for a return on investment from any medical procedure.

"We do this medical procedure to make people improve medically — get rid of their diabetes, their sleep apnea — and feel better about themselves and let them have an improved quality of life," he said.

Roslin said the notion of cost reduction was something that "people created to try to get coverage for bariatric surgery. I don't believe, in a system like ours, there will ever be a return on investment for any medical procedure."

However, as we know some people simply DO become more expensive throughout the bariatric surgery journey.  *points to self*  

I cannot imagine the costs of my care without private health insurance in the last nine years.  Thanks to Mr. for being employed steadily, because WOW.  We still pay ridiculous co-pays, but I have been covered.

Before weight loss surgery, I had little expenditures in terms of health-care, but after, I have many. Some related — some perhaps related — to the fact that I had gastric bypass surgery.  My situation is NOT a very common result, however, without my husband's health coverage, I would be one expensive public healthcare patient!

PS.  Also worth mentioning, WLS patients who become healthier – don't die as fast – and cost more.

Sorry about that.

Sax HC. Questioning the Economics of Bariatric Surgery: Comment on “Health Expenditures Among High-Risk Patients After Gastric Bypass and Matched Controls”. Arch Surg. 2012;147(7):640-641.  doi:10.1001/archsurg.2012.1021.

ASMBS – Weight Loss May Change Brain

Have weight loss surgery – change your brain?  Interesting suggestions here –

MedPage Today

MRI scans done after bariatric surgery reveal different patterns of brain activation in response to food cues according to a study reported here.

See you in San Diego! ASMBS 2012

I am off in the very early morning to go to San Diego for a few days of ASMBS.  I will land in San Diego and meet up with none other than Michelle of The World According to Eggface, and we will be roommates because she doesn't sleep and I can keep her entertained at times.  True story.

ASMBS is yearly event for bariatric professionals, like surgeons, patient coordinators, nurses, nutritionists.  ASMBS is an opportunity for these pros to get together to learn about new techniques, studies, products and services for the care of the bariatric patient.  It's the biggest event each year, attended by thousands.  

The pros attend seminars, classes and lots of informational type events while vendors prepare and offer their goods to the pros.  It's one of the only opportunities that the docs and offices get to talk to these companies one-on-one and see if their products or services match the surgeons/others needs.

I have been very fortunate to attend in 2010, 2011 and this year, 2012.  I attended via a couple vendors the first year, and worked for another vendor last year, and this year I am not working the event, but just going for a couple days to get my fill of the products and services for our community — and to attend the OAC reception.  

Like I have said before: the ASMBS vendor exhibition hall is like going to the candy-store for me, a blogger who writes about mostly bariatric surgery and products suitable for the bariatric patient.  As if I needed more — I have the opportunity to sample new product and bring it home to you.  This pleases me, as I am all about products and want to somehow work in the field of product marketing when I grow up.  That said it's likely that going as an attendee is more fun that working at a booth.  Although, I would give anything to get in to some of the educational seminars and pretend I was Dr. MM.  Just saying.

I will see you on Facebook until I get home!  


Study – Successful Weight Loss Among Obese U.S. Adults – How?

What WORKS to lose weight?  

Most of you know that weight loss surgery often works in the long term to lose weight, but not everyone (No, really…)  is a candidate for surgery

 Also, in the long-term it's not unusual for bariatric surgery post ops to again embark on diet plans to lose regained weight.  Shocking, I know!

What works?  What can we do to lose weight successfully?

Not fad diets.  Also, SHOCKING?  /end sarcasm 

If you want to lose weight, eat less fat, exercise more, and prescription weight loss pills.  Wait, really?  

That's what works?  Apparently, according to a new study from the American Journal of Preventative Medicine.


"Researchers analyzed data from more than 4,000 obese people over the age of 20 with a body mass index of 30 or more and then interviewed them one year later. Over half of them were trying to lose weight when the study began. By the end of the study, 40 percent said they lost at least 5 percent of their body weight, while 20 percent of participants lost 10 percent or more.

Among the participants who shed pounds, they often reported working out and eating fewer fatty foods. Those who were in weight loss programs lost even greater amounts of weight.

Duh.  Right?  More from CBS

What didn't work? Those people who participated in popular diets, liquid diets nonprescription weight loss pills and diet foods/products didn't see the scale tip in the right direction.

"It's very encouraging to find that the most of the weight loss methods associated with success are accessible and inexpensive," senior author Dr. Christina Wee, co-director of research in the division of general medicine and primary care at Beth Israel Deaconess Medical Center,  said in the statement.

"There are lots of fad diets out there as well as expensive over-the-counter medications that have not necessarily been proven to be effective, and it is important that Americans discuss product claims with their doctor before trying such products."

No fad diets.  Did you read that?  Stop it.

The study –

Successful Weight Loss Among Obese U.S. Adults
May 2012, Vol. 42, No. 5

Background: Little is known about weight control strategies associated with successful weight loss among obese U.S. adults in the general population.

Among those attempting weight loss, 1026 (40%) lost 5% and 510 (20%) lost 10% weight after adjustment for potential confounders, strategies associated with losing 5% weight included eating less fat; exercising more; and usingprescription weight loss medications 

Eating less fat; exercising more; and using prescription weight loss medications were also associated with losing 10% weight, as wasjoining commercial weight loss programs.

Adults eating diet products were less likely to achieve 10% weight loss Liquid diets, nonprescription diet pills, and popular diets had no association with successful weight loss.


A substantial proportion of obese U.S. adults who attempted to lose weight reported
weight loss, at least in the short term.  Obese adults were more likely to report achieving meaningful weight loss if they ate less fat, exercised more, used prescription weight loss medications, or participated in commercial weight loss programs.