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

VBloc takes the next step

July 8th, 2014 | Posted by Sue in News | Research - (0 Comments)

Our Adelaide clinic has been an integral part of the global study into VBLOC, a clever way to lose appetite – and improve health as a result. While it is not yet funded by Medicare or Private health insurance, it is a very promising option for weight control.

In the most recent clinical trial, the ReCharge Study, VBLOC Therapy treated patients demonstrated a clinically meaningful and statistically significant excess weight loss (EWL) at 12 months of 24.4%, sustained out to 18 months. The majority (52.5%) lost 20% or more of their excess weight and nearly one-third of VBLOC Therapy treated patients lost 30% or more. The 24.4% average EWL far exceeds the 10% to 15% thresholds at which patients experience substantial positive health effects.

VBLOC_EnteroMedicsThe American medical device authority, FDA, has approved the device for use, concluding that the device is safe when used as designed and has a reasonable assurance of efficacy.  They concluded that the relative benefits outweighed the relative risk. 

Bariatric Surgery Registry

July 1st, 2014 | Posted by Sue in Lifestyle | News | Research - (0 Comments)

Our clinics in Adelaide and Perth are enthusiastic participants in the Australian national Bariatric Surgery Registry.

This bariatric registry has been established by the Obesity Surgery Society of Australia and New Zealand in conjunction with the Monash University NHMRC Centre for Research Excellence in Patient Safety. It aims to capture and track all bariatric procedures performed across Australia and New Zealand, focusing not only on the safety of the initial procedure but also longer-term effects on weight and health, as well as the longer-term adverse events.

Quality and safety registries have been shown to improve health outcomes. Monitoring of outcomes following orthopaedic surgery through the Australian Joint Replacement Registry, for instance, recently led to the withdrawal of a defective hip prosthesis from the market.

The pilot phase of this project is now completed, and data is being provided for patients for more and more hospitals as they grant ethical approval. There is, of course, an opt-out clause. If you would prefer your data to be kept from the confidential registry, please let the staff know when you next come to the clinic.

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

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See Bariatric Surgery Source for More In-Depth Research About Weight Loss Surgery

Please let us know what you think of it…

Who needs surgery the most?

October 25th, 2013 | Posted by Sue in Lifestyle | Research - (0 Comments)

Quoting from Bariatric News:

“If we have to decide who should get the surgery first, it should be based on who has the highest risk of mortality,” said Arya Sharma, chair in obesity research and management, scientific director of the Canadian Obesity Network. “We looked at thousands of patient files and many different parameters, and surprisingly enough it came down to three things, if you’re male, you’re a smoker and you have diabetes, you have the highest risk. These surgeries are being done, but are the wrong people getting them? The current BMI cut-off is missing the boat on those who need it most. Having diabetes is more important than BMI as a risk factor. Our research showed BMI didn’t really matter, so size alone isn’t a good way to decide who should get the surgery.”
The research showed that diabetes was the strongest predictor of death, noting that obese patients with diabetes were more than twice as likely to die as obese patients without diabetes. Smoking increased risk of death 1.6 times, and being male increased risk 1.5 times. 
“We think this will be a useful tool for physicians,” added Padwa. “It’s simple math that will predict a patient’s risk of death. For example, if you’re a middle-aged, male smoker with diabetes, your risk of dying in 10 years is 10 times higher than that of a young, female non-smoker who doesn’t have diabetes—irrespective of BMI.”
The research was funded by the Canadian Institutes of Health Research.
 

So, the simplest thing to do to reduce your health risks is to stop smoking. This will also improve your results from surgery if it is required.

Secondly, there is evidence to support weight loss surgery for patients with less severe obesity if they have diabetes. The sooner you lose weight after first discovering diabetes, the better the result. Sometimes, the diabetes seems to completely disappear.

Sweeteners, weight and diabetes

June 4th, 2013 | Posted by Sue in Food | News | Research - (0 Comments)

Sucralose Affects Glycemic and Hormonal Responses to an Oral Glucose Load

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A title like this may not seem particularly gripping, but the article by M. Yanina Pepino (PhD) and colleagues in Missouri reports on a study that confirms the suspicions of many of us – artificial sweeteners may have no calories themselves, but they do have an impact on our metabolism.

A link has now been shown with diabetes and weight gain – I’ve annotated the article’s abstract below:

“Nonnutritive sweeteners (NNS), such as sucralose, have been reported to have metabolic effects in animal models. However, the relevance of these findings to human subjects is not clear. We evaluated the acute effects of sucralose ingestion on the metabolic response to an oral glucose load in obese subjects.”   (more…)

Gastric banding is safe and it works

May 7th, 2013 | Posted by Sue in News | Research - (0 Comments)

The team at Bariatrics Australia Research Centre – including Adelaide Bariatric Centre and the Western Surgical Health – have just published a series of Swedish Adjustable gastric bands in the Canadian Journal of Surgery. There have been plenty of studies on gastric band results in general, but this is the largest published series of patients using the latest Swedish adjustable gastric band. Between us, we followed 1000 patients over the course of our year-long program. On average, people lost more than 18 kg. This was nearly 40% of their excess weight.  73% of type 2 diabetics saw improvement in their sugar control, and many were able to stop their diabetes medications completely.  The procedure was very safe with no deaths and a complication rate below 5%.

Sleep apnoea

March 18th, 2013 | Posted by Sue in Lifestyle | News | Research - (0 Comments)

A recent study at the Perelman School of Medicine at the University of Pennsylvania has shown that when Sleep Apnoea is treated by CPAP mask alone, high blood pressure does not improve significantly. However, when it is treated with CPAP as well as weight loss, the high blood pressure improves rapidly.    (more…)

Sweet baby James

In a recently published article, researchers have found that newborn babies have thicker aortas when their mothers are overweight or obese.

This implies that the child will be at higher risk of high blood pressure, high cholesterol and heart disease later in life.

The article was published in Arch Dis Child Fetal Neonatal Ed 2013, and was reporting on a study done on mothers in Melbourne and Sydney.

If you are obese, losing weight will improve your chances of conceiving naturally, having a healthy pregnancy and a healthy baby, and now we have some evidence that your children will continue to benefit as they become parents themselves.

Weight loss surgery to cure diabetes?

November 30th, 2012 | Posted by Sue in News | Research - (0 Comments)

A new study has recognised that Gastric Bypass (RYGB) is not 100% effective in treating type 2 diabetes. This would suggest that Gastric Banding and Sleeve Gastrectomy would be similar.

Although most patients either demonstrate a relapse of their symptoms within five years or never experience complete resolution of their symptoms, even the temporary remission of symptoms which most patients experience may have health benefits.

They followed 4,434 gastric bypass patients with type 2 diabetes who had surgery between 1995 and 2008, and found that 32% of the patients never experienced a remission of their symptoms, and of those that did, 35% experienced a relapse within five years, meaning only 44% of patients experienced a durable remission in their condition. The median length of remission was 8.3 years.

Best results were seen in patients who had less severe diabetes or where surgery took place soon after the diabetes was diagnosed.

The author of the study, Dr David Arterburn, said that the results confirmed that prevention remains “by far the best medicine” for the condition. “Gastric surgery isn’t for everyone, but this evidence suggests that, once you have diabetes and are severely obese, you should strongly consider it, even though it doesn’t seem to be a cure for most patients.”
The period of remission experienced by most bariatric patients was likely to have had significant health benefits for the patients, including less damage to eyes and kidneys, and fewer heart attacks, strokes and deaths. He is currently performing research to investigate this possibility.

Although bariatric surgery doesn’t provide a cure for everyone, it remains the most effective method of treating type 2 diabetes, with lifestyle interventions alone proving relatively impotent.

A Multisite Study of Long-term Remission and Relapse of Type 2 Diabetes Mellitus Following Gastric Bypass.
Obesity surgery, 2012.
Arterburn David E, Bogart Andy, Sherwood Nancy E, Sidney Stephen, Coleman Karen J, Haneuse Sebastien, O’Connor Patrick J, Theis Mary Kay, Campos Guilherme M, McCulloch David, Selby Joe.