Weight Loss Surgery in Adelaide and Perth
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A comparison of functional brain changes associated with surgical versus behavioral weight loss.

Obesity (Silver Spring, Md.), 2014.Obesity (Silver Spring). 2014 22(2):337-43.

Bruce Amanda SBruce Jared MNess Abigail RLepping Rebecca J,Malley StephenHancock LauraPowell JoshPatrician Trisha M,Breslin Florence JMartin Laura EDonnelly Joseph EBrooks William MSavage Cary R.

OBJECTIVE:Few studies have examined brain changes in response to effective weight loss; none have compared different methods of weight-loss intervention. Functional brain changes associated with a behavioral weight loss intervention to those associated with bariatric surgery were compared.

METHODS:Fifteen obese participants were recruited prior to adjustable gastric banding surgery and 16 obese participants were recruited prior to a behavioral diet intervention. Groups were matched for demographics and amount of weight lost. Functional magnetic resonance imaging scans (visual food motivation paradigm while hungry and following a meal) were conducted before and 12 weeks after surgery/behavioral intervention.

RESULTS:When compared to bariatric patients in the premeal analyses, behavioral dieters showed increased activation to food images in right medial prefrontal cortex (PFC) and left precuneus following weight loss. When compared to behavioral dieters, bariatric patients showed increased activation in bilateral temporal cortex following weight loss.

CONCLUSIONS:Behavioral dieters showed increased responses to food cues in medial PFC-a region associated with valuation and processing of self-referent information-when compared to bariatric patients. Bariatric patients showed increased responses to food cues in brain regions associated with higher level perception-when compared to behavioral dieters. The method of weight loss determines unique changes in brain function.

Citation data from PubMed

This International website has some good articles, and well-established forums.

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Sleeve Gastrectomy

September 25th, 2012 | Posted by Kristen in Sleeve Gastrectomy - (0 Comments)

Sleeve gastrectomy is also known as Tube gastrectomy or Vertical gastrectomy and is a relative newcomer to the field of weight loss surgery. Here is more information about what it is and how it works.

It has evolved from several earlier operations, and is still considered by some (including the Royal Australasian College of Surgeons) to be experimental. However, it is gaining wide acceptance in some surgical practices, and promising results have been published up to five years after surgery in increasing numbers of people.

Unlike the adjustable gastric band, this operation is not reversible.

However, there are several promising features and selected patients may benefit more from this operation than others.

How it works

Laparoscopic (keyhole) surgery is used to remove most of the stomach, leaving a narrow tube with a capacity of 150 ml, but no obstruction to the passage of food other than the normal intestinal muscles. Because the stomach is now much smaller, the person feels full after a much smaller meal, but can usually eat any kind of food. Many people do struggle to swallow soft white bread.

The stomach is mainly a storage facility. Most of the nutrients are absorbed in the small  intestine, which remains completely normal. This means it is still very important to choose healthy foods and avoid calorie-dense ones.

Some studies suggest that because the outer curve of the stomach is removed, a hormone called Ghrelin is no longer secreted, and this might reduce appetite, too.

However, this will not reduce the desire to eat when it is driven by emotions such as boredom, loneliness or social expectations. Any operation to help with weight loss is only as effective as the lifestyle changes that go with it.

What are the risks?

Laparoscopic surgery is generally safe compared with open surgery, but there are potential hazards. The procedure requires a general anaesthetic and patients are usually in hospital for one to two days.

Specific risks of the operation include:

  • Deep vein thrombophlebitis (clots in the legs) 0.5%
  • Pulmonary embolus (PE) 0.5%
  • Gastric leak and fistula 1.0%
  • Postoperative bleeding 2.0%
  • Strictures 2%
  • Splenectomy 0.5%
  • Pneumonia 0.4%
  • Death 0.25%

These risks are higher when the surgery is done in patients who have had previous gastric operations, or have a BMI greater than 50 kg/m2

Long term risks and side effects include:

  • Vomiting in 20%
  • Reflux (some surgeons suggest this occurs in all patients)
  • Anemia
  • Vitamin D deficiency
  • Inadequate weight loss, or late weight re-gain can occur.

Our goal is to lose 60% of excess weight. Published studies of weight loss over five years still only include 170 patients – very small numbers compared to our usual expectations in the medical literature. Not all operations were performed using the same techniques, but results were quite similar: there was an average loss of 64% of excess weight. That is to say, patients did not get all the way to their ideal weight, but got more than halfway there. Results for longer (10 years) have been published, but in much smaller numbers, and the operation has evolved significantly since 2005, so it is difficult to apply those to current practice.

 

Surgery for weight loss comes in many shapes and sizes – here is an overview of many different kinds of operation. (more…)