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Fexaramine Tricks Mice Into Losing Weight Without Food?!

Lose weight without worrying about food? Imagine this?!

Via Popular Science "Safe and effective weight loss doesn't yet come in a pill, but maybe one day it will. A new study has found a chemical that keeps mice from gaining weight through overeating. The drug also seemed to protect lab mice from some of the harmful effects of obesity: When researchers measured the mice's blood, they found reduced levels of insulin, cholesterol, and other molecules, compared to obese mice who didn't get the drug."

'Imaginary meal' tricks the body into losing weight – Salk Institute – News Release.

“This pill is like an imaginary meal,” says Ronald Evans, director of Salk’s Gene Expression Laboratoryand senior author of the new paper, published January 5, 2014 in Nature Medicine. “It sends out the same signals that normally happen when you eat a lot of food, so the body starts clearing out space to store it. But there are no calories and no change in appetite.”

In the United States, more than a third of adults are obese and 29.1 million people have diabetes, according to the Centers for Disease Control and Prevention. Both obesity and diabetes lead to an increase in health spending, a greater risk of health complications and a shorter lifespan.

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Study - http://www.nature.com/nm/journal/vaop/ncurrent/full/nm.3760.html

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Weight loss surgery: ‘not everyone lives happily ever after’ – Medical News Today

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Weight loss surgery: 'not everyone lives happily ever after' – Medical News Today.

http://www.medicalnewstoday.com/articles/272432.php

I realize this is a very small sample study, but I can't say I don't disagree with most of it after living this WLS-life for ten years and observing hundreds of people in it.

http://www.medicalnewstoday.com/articles/272432.php

All women had undergone gastric bypass surgery – one of the most common bariatric surgery procedures. It involves rerouting a part of the small intestine past the stomach in order to reduce food intake, promote satiety and suppress hunger.

The majority of the women were interviewed twice. The first time was 1 year after surgery, while the second interview took place 2.5-4 years following surgery.

Groven says although most previous research suggests that weight loss surgery leads to an increase in quality of life for the majority of patients, her findings suggest that not everyone lives happily ever after following bariatric procedures.

Positive outcomes after surgery 'can feel like grief'

There is no doubt that weight loss surgery puts the body through a series of radical changes.

Groven says that although the procedure leads to a slimmer body – which others perceive as a "sign of success" – the surgery can cause many smaller problems that other people are unable to see.

Groven explains:

"Becoming slimmer and lighter is mostly perceived of as positive. At the same time it is ambivalent, since people start to behave differently towards the women after they've had surgery.

People are friendlier than before, and this may feel extremely provoking. And people often ask very invasive questions concerning the woman's radical weight loss."

The interviews revealed that some of the women experienced a boost in self-esteem after surgery, were more outspoken, and found other people were more likely to listen to what they were saying – particularly in the workplace.

Groven notes that although these factors are clearly positive outcomes, this could also be seen as a "grief" because the women realize they had to undergo weight loss surgery before seeing these outcomes.

Many of the women also felt embarrassment after the surgery, particularly when it came to speaking about their weight loss. Some women told others they had been on a diet to lose the weight because they were ashamed to say they had undergone bariatric surgery.

Excess skin promotes a negative self-image

Groven found that many of the women had mixed feelings about their naked body after surgery, and many of these feelings come from the occurrence of loose skin – a common consequence of rapid weight loss.

"It is given little focus before the operation. Patients are often told that this is something that can be fixed afterwards. But it is not so easily fixed, and the women are not prepared for the challenge of having to live with the loose skin," explains Groven.

Although women can undergo surgery to remove excess skin, Groven notes that many women are not prepared to take the risks associated with this procedure, which include hematoma or seroma formation, infection and risks associated with future pregnancies.

Groven found that some of the women interviewed even spoke about their excess skin in third person, which she believes is a way of distancing themselves from it.

Health problems and bad food relationships after weight loss surgery

According to Groven, five of the women interviewed reported a lower quality of life after they underwent weight loss surgery, compared with their quality of life before.

She notes that this was down to the development of chronic stomach and intestine problems, and one woman became so ill that she had to endure another operation because of problems with her scar tissue after the gastric bypass procedure.

The five women also said they felt as if they had complete lack of energy following weight loss surgery.

Furthermore, Groven found that many of the women reported having a negative relationship with food after the procedure.

Some women were worried about eating too much or too little, or eating the wrong food at the wrong time. Because of these concerns, some women experienced tiredness, nausea, dizziness and even intense shaking.

Some of the women who had problems with overeating before weight loss surgery continued to overeat after surgery, even though this made them ill. Groven says some women commented that "the eating disorder is not gone."

Groven says that while previous research suggests that patients can avoid testing their eating limits after surgery by following dietary advice, the reality is much more complicated.

She adds:

"It is reasonable to ask, I think, whether the eating disorders that some of the women develop after surgery are diseases, or if they may be understood as normal changes as a result of the operation."

No regrets

Although many women reported negative thoughts and health issues after weight loss surgery, none of them said they regret undergoing the procedure.

"They say they would have done the same today and that they had no choice considering their life before surgery. Some said that the pains were a small price to pay," says Groven.

She adds that this suggests women are influenced by society's perception of the ideal female body, and that being obese is not within this scope.

"They are living with a body which is not accepted by society, and they are constantly judged from their size," she says.

"The message from the media and medical science is that they are likely to get cancer or diabetes unless they lose weight and the surrounding world regards their obesity as self-inflicted. Some have children and are afraid to die and leave them alone."

Groven concludes that although it is true that obesity can lead to health complications, such as diabetes and heart attack, little is known about the long-term effects of weight loss surgery and what complications may arise from this procedure.

With this in mind, Groven plans to conduct further research that will look at the effects of bariatric surgery 3-10 years after patients have undergone the procedure.

http://www.medicalnewstoday.com/articles/272432.php

 

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.

 

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Study – Expectations for weight loss and willingness to accept risk among patients seeking weight loss surgery.

Just a warning, this is NOT a pleasant Rainbow and Butterflies study for those in the early or research stages of weight loss surgery.
Study –

Expectations for weight loss and willingness to except risk – JAMA

Importance  Weight loss surgery (WLS) has been shown to produce long-term weight loss but is not risk free or universally effective. The weight loss expectations and willingness to undergo perioperative risk among patients seeking WLS remain unknown.

Objectives  To examine the expectations and motivations of WLS patients and the mortality risks they are willing to undertake and to explore the demographic characteristics, clinical factors, and patient perceptions associated with high weight loss expectations and willingness to assume high surgical risk.

Design  We interviewed patients seeking WLS and conducted multivariable analyses to examine the characteristics associated with high weight loss expectations and the acceptance of mortality risks of 10% or higher.

Setting  Two WLS centers in Boston.

Participants  Six hundred fifty-four patients.

Main Outcome Measures  Disappointment with a sustained weight loss of 20% and willingness to accept a mortality risk of 10% or higher with WLS.

Results  On average, patients expected to lose as much as 38% of their weight after WLS and expressed disappointment if they did not lose at least 26%.

Most patients (84.8%) accepted some risk of dying to undergo WLS, but only 57.5% were willing to undergo a hypothetical treatment that produced a 20% weight loss.

The mean acceptable mortality risk to undergo WLS was 6.7%, but the median risk was only 0.1%; 19.5% of all patients were willing to accept a risk of at least 10%.

Women were more likely than men to be disappointed with a 20% weight loss but were less likely to accept high mortality risk.

After initial adjustment, white patients appeared more likely than African American patients to have high weight loss expectations and to be willing to accept high risk.

Patients with lower quality-of-life scores and those who perceived needing to lose more than 10% and 20% of weight to achieve “any” health benefits were more likely to have unrealistic weight loss expectations.

Low quality-of-life scores were also associated with willingness to accept high risk.

Conclusions and Relevance 

Most patients seeking WLS have high weight loss expectations and believe they need to lose substantial weight to derive any health benefits.

Educational efforts may be necessary to align expectations with clinical reality.

/end study

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NO SHIT, REALLY?!  Go back and READ IT AGAIN.

Now go read this: http://www.drsharma.ca/how-much-are-people-willing-to-risk-for-bariatric-surgery.html

WHAT HAVE WE BEEN TELLING YOU?!  Please.  START.  LISTENING.

Type 2 Diabetes Finger Stick

Weight Loss Surgery Doesn’t Cure Diabetes, forever – Sorry.

"I had weight loss surgery and beat diabetes, FOREVER!"  Not so much.

Don't buy that tee shirt just yet.

Type 2 Diabetes Finger Stick

NYT

Many people whose diabetes at first went away were likely to have it return. While weight regain is a common problem among those who undergo bariatric surgery, regaining lost weight did not appear to be the cause of diabetes relapse. Instead, the study found that people whose diabetes was most severe or in its later stages when they had surgery were more likely to have a relapse, regardless of whether they regained weight.

“Some people are under the impression that you have surgery and you’re cured,” said Dr. Vivian Fonseca, the president for medicine and science for the American Diabetes Association, who was not involved in the study. “There have been a lot of claims about how wonderful surgery is for diabetes, and I think this offers a more realistic picture.”

The findings suggest that weight loss surgery may be most effective for treating diabetes in those whose disease is not very advanced. “What we’re learning is that not all diabetic patients do as well as others,” said Dr. David E. Arterburn, the lead author of the study and an associate investigator at the Group Health Research Institute in Seattle. “Those who are early in diabetes seem to do the best, which makes a case for potentially earlier intervention.”

Obes Surg. 2012 Nov 18. [Epub ahead of print]

A Multisite Study of Long-term Remission and Relapse of Type 2 Diabetes Mellitus Following Gastric Bypass.

Source

Group Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA, 98101, USA, arterburn.d@ghc.org.

Abstract

BACKGROUND:

Gastric bypass has profound effects on glycemic control in adults with type 2 diabetes mellitus. The goal of this study was to examine the long-term rates and clinical predictors of diabetes remission and relapse among patients undergoing gastric bypass.

METHODS:

We conducted a retrospective cohort study of adults with uncontrolled or medication-controlled type 2 diabetes who underwent gastric bypass from 1995 to 2008 in three integrated health care delivery systems in the USA. Remission and relapse events were defined by diabetes medication use and clinical laboratory measures of glycemic control. We identified 4,434 adults with uncontrolled or medication-controlled type 2 diabetes who had gastric bypass.

RESULTS:

Overall, 68.2 % (95 % confidence interval [CI], 66 and 70 %) experienced an initial complete diabetes remission within 5 years after surgery. Among these, 35.1 % (95 % CI, 32 and 38 %) redeveloped diabetes within 5 years. The median duration of remission was 8.3 years. Significant predictors of complete remission and relapse were poor preoperative glycemic control, insulin use, and longer diabetes duration. Weight trajectories after surgery were significantly different for never remitters, relapsers, and durable remitters (p = 0.03).

CONCLUSIONS:

Gastric bypass surgery is associated with durable remission of type 2 diabetes in many but not all severely obese diabetic adults, and about one third experience a relapse within 5 years of initial remission. More research is needed to understand the mechanisms of diabetes relapse, the optimal timing of surgery in effecting a durable remission, and the relationship between remission duration and incident microvascular and macrovascular events.

Gastric Bypass

Living on borrowed time – Health Benefits of Gastric Bypass Surgery Persist for Six Years

“It’s very relevant,” Dr. Ponce said. “There were tremendous benefits with the surgical group. The control groups showed if you don’t do surgery, the patients will continue to have diabetes. The longer you leave it alone, the more problems you’ll have.”

Does your proximity to a bar increase your RISK for alcoholism?

Does a person's proximity to a bar trigger over-indulgence?  

A recent study suggests (Duh?!) perhaps it ACTUALLY DOES!  To bring the weight loss surgery community into it — consider locality of bariatric-themed community events.  Where Do The Food Addicts Gather At These Events? Which events get the most attendance?