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…

Merry Christmas!

December 25th, 2013 | Posted by Sue in News - (0 Comments)

 

News around the World from the American Association of Bariatric Counselors – www.aabc-certification.org 
 
A Letter from S. Nicholas
Dear Dr. DietI have an unusual, very seasonal occupation that is being threatened by my size and both my doctor and my wife want me to lose weight. I am so much bigger than the little people that work with me and can barely fit into my uniform. It is getting very difficult getting up and down chimneys, and the flying reindeer are complaining about my girth. I can hardly HO HO HO and carry a big sack without huffing and puffing. How can I possibly stay away from my favorite holiday treats and expect to be jolly.

S. Nicholas
North Pole

Dear Nick

Perhaps we may be of help regarding your weight. However your concerns about complaints from outspoken reindeer, try writing to our colleague, Dr. Phil.

Confections and holidays go hand in hand throughout the world. Most of us overestimate our confectionary calorie consumption. What happens then ..the very same candy that is meant to be prized and enjoyed become the source of guilt …that guilty feeling is one of the factors that actually can cause overeating and weight gain.

Nick, our present to you are some facts that could assuage your guilt and prevent weight gain.

• According to a recent study of 5800 adults over 18, candy only accounts for (on the average) 20 calories in their dally diets. Whereas sugary drinks, grain based desserts, and sweetened fruit drinks make up 60% of their total intake of added sugars. Candy consumption was not correlated with obesity.

• Similarly, in a 4-year experiment conducted by Massachusetts Institute of Technology of ninety-six girls (8-12) consumption of energy-dense snacks were studied. Researchers did not find a correlation between “candy” and increase BMI and obesity. They did see a correlation with calorie dense beverages.

• The good holiday news is that in both in adults and children, there does not seem to be a relationship between increased BMI or Obesity and candy consumption.

• It appears that soda and sweetened beverages are the culprits.

Oscar Wilde said, “the best way to rid yourself of temptation is to yield to it.” Our advice to you is to guiltlessly enjoy the holiday confections but easy on the eggnog.

What would life be like without candy corn for Halloween, without chocolate for Valentine’s Day, without jelly beans for Easter and without candy canes for Christmas. We shudder to think.

 

Mexico’s War on Obesity

November 8th, 2013 | Posted by Sue in Food | News - (0 Comments)

“Never before has any civilization faced an epidemic that didn’t involve an infectious disease. Today, this situation is not only unprecedented, but a threat to the nation’s future.”

This comes from the president of Mexico’s National Institute of Medicine, Enrique Ruelas.

In Australia, 28% of the population is obese, which is comparable to Mexico, where the rate is 32%. Diabetes is increasing in adults and in children, and the finger is pointed squarely at the availability and social pressure to consume sugar-based drinks and calorie-dense fast food.

In Mexico, three times as many people die each year as a result of diabetes than of drug-crime related injuries. In response, Mexico has fronted the food and drink industry, and resisted lobbying and warnings that raising prices would do nothing to help the country’s economy. As a result of new taxes, the cost of food which is high in saturated fat, sugar and salt will increase by 8%. Sugary drinks will also become more expensive, and the funds will go to making drinking water more available in cities and schools.

While our own country is unlikely to take the food giants head-on in this way, each individual can make their own choices about what they buy, eat, drink and give to their children. Paerhaps now that we have our cigarettes in plain packaging, we may be able to tackle the lie that Cake adds life…

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%.

Drink yourself to Diabetes?

April 29th, 2013 | Posted by Sue in News - (0 Comments)

One daily soft drink increases diabetes risk by 22%

The Medical Observer reported on 26th Apr 2013 on a study in Diabetologia –

THE link between sugary soft drinks and diabetes has been demonstrated again in a new study that found just one sweet beverage per day significantly increased the risk of developing the condition.

Previous North American studies found those who drink a sugar-sweetened beverage each day increase their risk of developing type 2 diabetes by 25%.

Researchers from London’s Imperial College studied the soft drink consumption of 28,000 Europeans to see if the effect was replicated across the Atlantic Ocean – and it was.

They compared 12,000 Europeans with type 2 diabetes and 16,000 random Europeans and found that drinking one 336ml sugary soft drink – the standard size of a soft drink can in Europe – increased the risk of developing diabetes by 22%.

 

So – while surgery can help you to control how much you eat, you still need to be discerning about what you put in your mouth – not all liquids and solids sold for consumption are suitable food substitutes.