Factors Distinguishing Weight Loss Success and Failure at Five or More Years Post Bariatric Surgery

What makes someone a Weight Loss Success long term after bariatric surgery?  

According to a study by Colleen Cook of BSCI – it's following the rules of your WLS.

I've heard her say it a hundred times at bariatric events – fall back to the RULES of your surgery – because it DOES WORK –

(Nodding in agreement – I am proof.)

Here's the study details from ASMBS/TOS 2013

Dietary support after bariatric surgery, along with pre-operative teaching and post-operative management, may mean the difference between weight-loss success and failure for patients with obesity, according to results of an on-line survey presented at the 31st Annual Scientific Meeting of The Obesity Society (OBESITY 2013).

“This study confirms the need to put into place the resources to support people after bariatric surgery, including the dieticians and behavioural therapists who are actively involved with their patients, and can be critical to their success or failure,” stated American Society for Metabolic and Bariatric Surgery past president, Scott Shikora, MD, Center for Metabolic Health, Brigham and Women’s Hospital, Boston, Massachusetts.

People who have had bariatric surgery and are complying with the very basic principles of personal accountability, portion control, food intake, vitamins and supplements, proper nutrition and exercise are the ones who have been doing well long-term,” noted lead author Colleen M. Cook, Bariatric Support Centers International, Jordan, Utah, speaking here on November 14.

Cook and colleagues conducted a survey to assess adherence to specific, research-based, behavioural recommendations based on earlier research. Of their 535 total initial respondents, 255 were 5 or more years post-surgery. From this group, they took a final sample of 158 respondents comprised of 117 (74.05%) who reported achieving at least 80% of their excess body weight loss (the Highly Successful group) and 41 (25.9%) who reported achieving less than 40% of their excess body weight loss (the Not Highly Successful group).

The groups were compared on self-reported behaviours, including dietary intake, physical exercise, attendance at surgical follow-up visits, and participation in bariatric support groups.

The Highly Successful group reported significantly higher rates of compliance with dietary recommendations (P< .001); fewer total calories per day (1511.9 kCals versus 2190.0 kCals, P< .001 ); consuming a higher percentage of calories from protein (49% vs 36%; P< .001); higher frequency of eating protein first (P =.007); and lower percentage of calories from carbohydrates (31% vs 40%; P = .001).

The Highly Successful group was much more likely to regularly weigh themselves (P< .001); attend support groups (P = .002); and take supplemental multivitamins (P = .029), including calcium (P = .004), iron (P = .011), and B12 (P = .001).

The Highly Successful group was significantly less likely to eat mindlessly (P< .001); to “graze” (P< .001); to eat in front of the TV (= .002); to eat fast food (P< .001); and to eat food high in sugar (P< .001).

The groups also differed significantly on carbonated beverage (P = .02) and caffeine (P = .005) drinking patterns. The Highly Successful group reported significantly more physical activity at least several times per week than the Not Highly Successful group (P< .001).

The researchers found no significant differences, however, for ingestion of percentage calories from fat or the frequency of eating at sit-down restaurants, drinking calorie-laden liquids, or attending surgical clinic follow-ups.

Participants in this study averaged 51.7 years of age and 8.8 years post-surgery; 96% were female, 59% were married, and 89% were white. Both groups had similar demographics.

Funding for this study was provided by Bariatric Support Centers International.

[Presentation title: Factors Distinguishing Weight Loss Success and Failure at Five or More Years Post Bariatric Surgery. Abstract A-366-P]

Bariatric surgery leads to lasting improvement in health, studies say – TOS/ASMBS

From studies presented at this year's Obesity Society – ASMBS meeting in Atlanta, new data on weight loss surgeries long-term efficacy.

Not too shabby.  

LA Times



Fifteen years after they have weight-loss surgery, almost a third of patients who had Type 2 diabetes at the time they were operated on remain free of the metabolic disorder, a new study says. And six years following such surgery, patients had shaved their probability of suffering a heart attack over the next 10 years by 40%, their stroke risk by 42%, and their likelihood of dying over the next five years by 18%, additional research has concluded.

The two studies, both presented Wednesday at the annual meeting of the American Society for Metabolic and Bariatric Surgery in Atlanta, offer the first indications of weight-loss surgery's longer-term health benefits for patients. While researchers have demonstrated dramatic improvements in many bariatric patients' metabolic function in the short term, the durability of those improvements has been unclear.

Research suggests that over several years, many bariatric patients regain some of the weight they lose in the first two years — a fact that has raised doubts about the cost-effectiveness of the surgery, which can cost $20,000 to $25,000 for the initial procedure, plus a wide range of costs to treat complications after surgery.

The new studies' findings that patients' health prospects remain better for several more years may make weight-loss surgery a more appealing treatment for insurers to cover, and for obese patients with health concerns to seek out.

The study that followed 604 bariatric patients in Sweden for 15 years found that in the first two years after surgery, 72% achieved diabetes remission: They were able to cease taking medication for the metabolic condition. After 15 years, a little more than half of those had diabetes again. But 31% had remained in remission.

By contrast, only 16% of the comparison group — similarly obese patients with diabetes who did not get surgery — had seen their diabetes remit in the first two years. At 15 years out, diabetes remission was six times likelier in those who had surgery than in the those who did not.

In another study, researchers at the Cleveland Clinic in Ohio followed bariatric patients for an average of six years after surgery. They tallied those patients' likelihoods of developing a wide range of health outcomes at the time of surgery and six years later, and compared them. To do so, they used the Framingham risk calculator to estimate the before-and-after 10-year risks of heart disease, stroke, death, kidney disease and complications such as diabetic retinopathy and poor circulation.

(The Framingham risk calculator is derived from probabilities gleaned from following more than 10,000 subjects in Framingham, Mass., in the Framingham Heart Study, which started in 1948.)

In this study, the bariatric patients lost 60% of their excess weight and 61% saw their diabetes remit after surgery. Overall, their risk of having coronary heart disease, stroke or peripheral heart disease dropped by 27%.

Bariatric surgeon Dr. John Morton, a professor of medicine at Stanford University who was not involved in either study, suggested that the results of more modern bariatric surgical procedures may be superior. He added that reducing the stress of obesity on the body, even if some weight returns, may improve a patient's long-term health prospects.

"Carrying extra weight can carry forth year to year," said Morton, who is president-elect of the American Society for Metabolic and Bariatric Surgery. He likened long-term obesity to smoking cigarettes for years, suggesting that the number of years a person remains obese (or smokes) may interact with their degree of obesity (or how much they smoke) to influence his or her likelihood of developing health problems.

 

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.

Picture 6

Goodbye — and HELLO!

I'm off to Orlando tomorrow morning to attend ASMBS 2011.  

Picture 6

ASMBS holds giant meetings of professionals in the field of weight loss surgery:  bariatric surgeons, nurses, administration, registered dieticians, and lots and lots of vendors.  Last year there were more than 2500 attendees.   The pros have opportunities to take courses, share new material and research, network and meet with vendors for a week, off in the Florida sunshine.  

Follow informational bits via Twitter with #ASMBS2011.

I'll be there as a Brand Ambassador for Slimpressions during the Exhibition, because, I love my Slimpressions.  Come find me and ask me to show you my Slimpressions.  You'll note I am always showing my shapewear.  

Come find Slimpressions on Facebook!   Let them know I sent you!  

Admittedly — I'll also be busy jacking samples from my sponsors who always release NEW products for ASMBS and all the cool vendors for product discussions HERE on my blog.   I am always too excited about products.

I will check in via Facebook and Twitter, and hope to snag some laptop time for blogging during the week.  I have TMBTA (too much to possibly blog about but I shouldn't right now) syndrome, and the cure is some sunshine and a break.