Since the Focus28 office lines have been ablaze with phone calls over the last week relating to the recent publicity relating to the potential of obesity surgery being a potential cure for diabetes we felt it was most appropriate to reference an article published earlier this year by the Associated Press relating to the subject.

Obviously this news is monumental and could change the lives of many of those who have been battling both obesity and diabetes for years. Please stay tuned as we continue to report the latest news on the Focus28 expert blog and remember - everyday is a journey and is worth celebrating.

Be well,

The Focus28 team

www.focus28wellness.com

Obesity surgery seen as potential diabetes cure

CHICAGO, Illinois (AP) — A small new study gives the strongest evidence yet that obesity surgery can cure diabetes

Obesity is a major risk factor for diabetes; rates for both are climbing.

Patients who had surgery to reduce the size of their stomachs were five times more likely to see their diabetes disappear over the next two years than were patients who had standard diabetes care, according to Australian researchers.

Most of the surgery patients were able to stop taking diabetes drugs and achieve normal blood tests.

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“So, why do you perform bariatric surgery?” This is a question that patients, healthcare providers, and even some of my own family members ask. This question is the very reason why many of us become Bariatric Surgeons.

My exposure to Bariatric Surgery is probably not much different than your own surgeon. In the early 1990’s, I was fortunate to train in a program where some of the best and brightest attending surgeons were doing an operation called the Roux-en-Y Gastric Bypass. It was relatively unknown by many patients at that time. I worked with my mentors in Bariatric Surgery every opportunity I could, and I enjoyed the technical aspects of the procedure. As I completed my training, I knew that I wanted to develop a career fashioned after my mentors who trained me.
 
When I completed my training, I began my own practice as a Bariatric Surgeon. It really wasn’t until I saw first hand the impact these lifesaving procedures had on people that I began to understand why my teachers performed Bariatric Surgery. It isn’t really about the weight loss. Rather, it is about taking a person who struggles with diabetes; or the person who suffers with obstructive sleep apnea; or even someone who cannot participate in life because of body size limitations, and embarking on a journey with them to help them find a new life. The ability to offer people a new life, without the burdens of diabetes, sleep apnea, that can now move more freely to enjoy life is a very satisfying experience.
 
Bariatric Surgery has come a long way since the 1990s.  Multidisciplinary programs allow bariatric surgeons to interact with a broad range of healthcare professionals like dietitians, physical therapists, behavioral health specialists, exercise specialists and nurses who all work together to achieve one goal: help people achieve a healthier life. So why do I do Bariatric Surgery? I, like your own surgeon, do it because I believe it is the best job in medicine. If you haven’t visited your bariatric program in a while, please do so. We all are committed to not only perform the surgery but also support your ongoing success.

By Troy Glembot, MD, FACS

Anyone who has experienced significant weight loss must then face what may be the real challenge, keeping the weight off. The most important factor, I believe, is setting attainable goals. If you try to do something that is too difficult, then you will not be able to do it for any sustained period of time. I believe that finding a realistic, doable approach that works for you is the key element in keeping off the weight you have lost. In listing my recommendations below, I classify each as:

1. Easy.
2. Not too hard.
3. Too hard.

Focus on numbers 1 and 2 and see what can realistically be done to move a number 3 down to a number 2.

First the easy ones, eat breakfast daily. Avoiding this meal is a natural, yet wrong approach that many people use. It might seem that if you are not really hungry for breakfast and you eat less by skipping a meal that cannot hurt, but skipping breakfast or any other meal is a terrible strategy that has been shown time and time again to undermine the effort to keep off the weight you have lost. Your body is pretty smart and if you skip a meal, you will more than make up for it later. Again, this is an easy commitment you can make, just do it.

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Skin-reduction surgery or a ‘tummy tuck’ is often desirable following significant weight loss. As a person loses weight, the body utilizes fat for its energy requirements and the visible results are a smaller size and reduced weight. Skin, however, doesn’t shrink as rapidly as fat, and this results in areas of excess skin. The lower abdomen, inner thighs and tricep area of the arms are the most common anatomic locations where this occurs.

Of course, individuals experience varying degrees of excess skin after significant weight loss. The younger a person is, the more elasticity the skin has and the greater the likelihood that the skin will eventually shrink to fit the new body. Factors such as smoking, a history of ultraviolet skin damage, age, and a BMI greater than 50 are some of the causes of decreased elasticity. While exercise is great for minimizing weight regain and supporting the heart, muscles, mind and spirit, it doesn’t do much for the skin.

The decision to proceed with a tummy tuck or removal of excess skin from the thighs or arms should be made at the right time and under the best possible conditions. It is very important that goal weight be achieved first. If skin reduction is done too soon, the re-development of redundant skin is likely once goal weight has been achieved. As a general guideline, the minimum time to wait before proceeding with a tummy tuck or skin reduction surgery is 18 months after gastric bypass. This allows sufficient time to lose the necessary weight and give the skin time to shrink.

If you make the decision to proceed with plastic surgery, it is highly recommended that you go to a plastic surgeon who is experienced in performing surgery on patients who have undergone bariatric surgery.

by  Dr. David  Diaz

When a post-op bariatric patient comes to my office complaining of weight gain, the first question I ask is “are you eating breakfast, lunch, and dinner?” More often than not, the patient’s response is they often skip breakfast or lunch. That is the fatal flaw!
 
Breakfast is the most important meal of the day. I’m sure you have heard this saying before but did you ever know why it is true? Believe it or not, the answer goes back to our caveman ancestors - something called the “thrifty genetic tendency”. Our ancestors often went for prolonged periods of time without food (catching a mammoth can be difficult). Our bodies adapted to this difficulty by slowing our metabolism during times when food was scarce.

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“Dumping Syndrome” occurs when carbohydrates or sugars enter the small intestine without being digested by the stomach.

After a Roux en Y Gastric Bypass, the patient develops a relative intolerance to sugars. Conveniently, this prevents digestion of large amounts of carbohydrates that would significantly hinder the weight loss process . Not all post-gastric-bypass patients have the same reaction following the ingestion of carbohydrates. Some people experience a mild case of dumping syndrome causing them to become flushed. Others experience an increase in heart rate, followed by light headaches, and in some extreme cases, severe abdominal cramping and diarrhea may also occur.

Once again the Dumping Syndrome is a desired effect of the Roux en Y Gastric Bypass and acts as a deterrent to ingestion of large amounts of carbohydrates. While the spectrum of dumping ranges from none or very mild to severe, most patients fall in between these extremes. As a patient comes close to achieving his or her goal weight, carbohydrates can slowly be further introduced into the diet. If larger amounts of carbohydrates are ingested, the symptoms of dumping can be expected. There are a small percentage of patients who do not experience any dumping symptoms at all. These patients need to be more vigilant about their intake of carbohydrates.

by Michael Perez, M.D.