New stomach shrinking procedure helps patients lose weight

A new experimental stomach shrinking procedure is helping obese patients lose weight, without bands, staples, or implants.

Reporter: Maureen McFadden

A new experimental stomach shrinking procedure is helping obese patients lose weight, without bands, staples or implants.

Every year, Americans spend $30 billion a year on diets, weight loss products and other weight loss services. Now, more than 200,000 people a year are going even further than pills or diets, and turning to surgery.

Teresa Flowers, a 54-year-old lifelong dieter, has tried numerous diets which all have failed. With a job that keeps her sitting eight hours a day, Flowers was ready to try something big.

"It's very frustrating to be obese and feel like your back is up against a wall and there's basically no hope,” says Flowers.

She became one of the first patients in the U.S. to undergo a new experimental weight loss surgery called gastric imbrication.

Gastric imbrication is a procedure that shrinks the volume of the stomach by 90-percent by folding and stitching it into a small, narrow tube.

Sunil Sharma, a doctor at the University of Florida’s Weight Loss Surgery Institute, says, “That translates into easy filling of the stomach, but eating less quantity of food."

"The fact that my stomach is only ten-percent the size that it was, it makes me make a conscious effort to not eat, and to eat wisely,” says Flowers.

The minimally invasive procedure is performed through several small incisions in the abdomen, or one cut through the belly button.

A pilot study in India on 30 patients showed participants losing 40-percent of their excess weight within the first year after surgery, all along with quicker recovery and fewer complications.

Two weeks after having the surgery, Teresa Flowers already had lost 23 pounds.

“I started at 313. I'd love to be down to about a hundred fifty pounds,” says Flowers.

Although at least two U.S. studies are now underway, gastric imbrication is still considered experimental and is not covered by insurance.

However, Sharma says that because it is less invasive than other bariatric procedures as well as not requiring the removal of any stomach tissue, the cost is much lower.

Gastric imbrication costing $12,500, compared to as much as $16,000 for lap band surgery and $19,000 for gastric bypass.

The process can be adjusted or even reversed as a result of the non-dissolvable sutures used in the procedure.

RESEARCH SUMMARY
TOPIC: SHRINKING STOMACHS...A NEW WAY
REPORT: MB #3228

BACKGROUND: There are a number of stomach-shrinking procedures that offer surgical solutions to bariatric complications. The most common is the Roux-en-Y Gastric Bypass procedure, wherein the patient's stomach size can be decreased by surgically segmenting it into two parts, using surgical stables or a plastic band. The top part is formed into a small, golf ball sized pouch, which is then connected to a section of the small intestine, bypassing about five feet of intestine before reconnecting. The small pouch allows the patient to feel full after consuming only one to two ounces of food, and the bypassed intestine prevents the patient from absorbing additional calories. The next procedure is called Gastric-Band Surgery, where an inflated, silicone band is wrapped and tightened around the upper area of the stomach to create a pouch which only allows about an ounce of food to enter. Saline is used to inflate the band, and is fed into a plastic tube, which is attached to the band. During Gastric Sleeve Surgery, anywhere from 60-75% of the stomach is actually removed, leaving a sleeve-shaped formation which can receive and break down food. Also known as a gastrectomy, or "Sleeve gastrectomy," this procedure naturally limits caloric intake. (SOURCE: University of Florida Weight Loss Institute and webmd.com)

GASTRIC IMBRICATION: Also called Gastric Plication Surgery, this reversible procedure is accomplished without removing any portions of the stomach, re-routing the small intestine, or using any stapling or cutting. During this procedure, the bulging portion of the stomach is folded onto its other half, and held in place with non-absorptive sutures. The stomach's size is therefore decreased to a gastric sleeve proportion, but without using any of the potentially harmful, foreign objects to do so. Unlike Gastric Bypass, Gastric Imbrication does pose the risk of malabsorption, and is in fact considered to be a low-risk and low-cost procedure with a quick recovery. The procedure is certainly promising, but there are no long-term results reported at this point. (SOURCE: University of Florida Weight Loss Institute, Weight Loss Surgery News)

OBESITY STATISTICS: An August, 2010 obesity reports called "Vital Signs: State-Specific Obesity Prevalence Among Adults -- United States, 2009," found that in 2007, no state had met the 2001 Surgeon General-issued obesity goals, published as the Call to Action to Prevent and Decrease Overweight and Obesity. These goals aimed to reduce the presence of obesity amongst American adults to only 15%. The overall self-reported figure was in fact 26.7%, varying over many characteristics. The highest numbers were found in adults aged 50-59, 31.1%, 60-69, 30.9%, non-Hispanic blacks, 36.8%, (non-Hispanic black women in particular, 41.9%), Hispanics, 30.7% and Midwestern and Southern residents, 28.2% and 28.4% respectively. In all, men measured at 22.9% and women at 18.6%, with the largest group of them being found in the group without a high school degree and the smallest in the group with a college degree.

FOR MORE INFORMATION, PLEASE CONTACT:
Sunil K. Sharma, MD
University of Florida
Weight Loss Institute
(904) 633 -0834
sunil.sharma@jax.ufl.edu

Source

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Do Free Radicals Really Cause Aging?

By Jessica Marshall


These much maligned molecules may not be entirely harmful after all. In fact, a new study suggests they could help us live longer.

THE GIST

• Free radicals are an important part of our body's normal functioning and may even be good for us in certain doses.
• Worms that made extra free radicals lived longer than typical worms, but the effect was reversed when they were treated with antioxidants.
• Research does not support taking more antioxidants than we consume via diet, researchers say. 

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Conventional wisdom has held for decades that free radicals cause aging, and that antioxidants, which squelch the reactivity of these highly reactive molecules, are a way to slow the process. But new work adds to a growing body of research that suggests the story is not so simple.

In the new study published in PLoS Biology, worms that made more free radicals or that were treated with a free-radical-producing herbicide actually lived longer than normal worms.

What's more, when the longer-lived mutant worms were given antioxidants, the effects were reversed, and the worms had a conventional worm lifespan. The finding flies in the face of the idea that antioxidants battle the effects of aging.

According to study author Siegfried Hekimi of McGill University in Montreal and others, what is emerging from this and other experiments is a view of free radicals -- or, more precisely, reactive oxygen species -- as a normal part of the body's stress response, with beneficial effects at certain levels.

"Maybe the reason why free radicals and aging are correlated is because free radical production in the mitochondria (part of the cell) is a stress reaction to the damage of aging," Hekimi said. "The organism tries to counter with free radical production."

Hekimi and others point out that part of exercise's benefit may be because exercise causes mild increases in the levels of reactive oxygen species that are actually good for us.

The emerging view casts a pall on the idea of popping antioxidant pills in hopes of slowing the aging process or protecting against disease.

"When clinical trials have been done with antioxidants, they have not shown benefits," Hekimi said.

"If we're right that reactive oxygen species are fundamental to maintain normal fitness and also adaptation to stress, then you don't want to take too many antioxidants," said Navdeep Chandel of Northwestern Medical School in Chicago.

Indeed, Chandel suspects that the beneficial effects of limited alcohol consumption come not from antioxidants in red wine but from the mild oxidative stress the alcohol provides.

"Who am I to say if you should take antioxidants or not," he added. "All I would say is there is no evidence that taking more antioxidants than you get through diet is needed."

Free radicals do cause damage, Hekimi said, but at normal levels their beneficial effects are perhaps more important. If the stress of aging or disease increases sufficiently, he said, the damage caused by the free radicals might overwhelm their positive effects.

"You cannot live without them, nor should you wish to, but they will probably help to kill you in the end," agreed Barry Halliwell of the National University of Singapore, of reactive oxygen species. "Learning how to stop the latter whilst preserving the useful functions of reactive oxygen species should be a major research priority in the next few years."

Halliwell said that evidence supports that reactive oxygen species probably contribute to the progression of cancer and neurodegenerative diseases, despite having beneficial effects at lower levels. They also probably cause skin wrinkling, he added.

Hekimi hopes further experiments will determine exactly how reactive oxygen species increase lifespan in the worms.

He and his colleagues used the nematode worm Caenorhabditis elegans, an organism used widely in lab studies, but Hekimi believes the findings will translate into higher organisms like mice and humans, because these systems are so fundamental.

Halliwell noted, though, that C. elegans can not be used to study the effect of free radicals on stem cells, which evidence suggests may be important. Also, the study only shows the effects of free radicals on longevity, and can say nothing about quality of life.

Source

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How to increase metabolism and lose weight faster--without dieting

Learning how to increase metabolism can lead to weight loss up to five times faster.

By using effective weight management strategies, people can avoid health effects of obesity and being overweight; they can lead to chronic diseases as well as premature death. Obese individuals have a greater risk of having cancer, diabetes, stroke and other health problems.


Dieting and long workouts are not required to improve metabolism. Dieting usually doesn’t lead to lasting weight loss, especially when it involves starvation, because it slows down metabolism.

Inactivity also leads to a slower metabolism and weight gain.  Some people participate in lower levels of activity, but this usually does not lead to any significant effect on weight loss. High level activity can boost metabolism and lead to faster weight loss.

According to a new study by Arlene Hankinson, M.D. and her team, maintaining high levels of activity was associated with smaller gains in body mass index (BMI) and waist circumference compared with low activity levels. Lower levels of activity had little effect on preventing weight gain. High level activity was the only kind that made a significant difference on weight gain prevention in the study. High-level activities included basketball, running, an exercise class and brisk walking.

This study was published in the December issue of Journal of the American Medical Association.

What they did: A prospective longitudinal study of habitual activity of 3554 men and women aged 18 to 30 years at baseline was done. Habitual activity was defined as maintaining high, moderate and low activity levels. Follow-up of participants was done for 20 years. The relationship between habitual activity levels and changes in body mass index (BMI) and waist circumference was evaluated for over 20 years.

Results from the study suggest that people will gain significantly less weight by middle age -- especially women -- if they engage in high activity levels through young adulthood. Weight gain in participants of the study was evaluated for over 20 years.

What is the biggest roadblock for most people trying to increase their metabolism?

Most people are too busy and time-starved to participate in long workouts.

What’s the solution?

Here’s the good news for people who are too busy to carve out a 30-minute block of time to work out:  Exercise research studies have shown that shorter workouts can boost metabolism higher and lead to greater fat burning compared to longer workouts. The secret is interval exercise.

Researchers at Australia's University of New South Wales and the Garvan Institute found that interval exercise burn three times as much fat as running twice as long at a moderately hard, steady pace.

They studied 45 overweight women over 15 weeks. They went through a 20-minute cycling regime in which they sprinted on a stationary bike for eight seconds followed by 12 seconds of cycling lightly. They lost three times more weight as other women who exercised at a continuous, regular pace for 40 minutes.
       
Results from this study can also be applied to swimming, rowing, running and walking.
Many Americans are overweight or obese and they’re not able to participate in high-level activities. Walking is an ideal workout for most people. Even overweight and obese individuals can participate in a walking exercise program.

The problem is that walking for 60 minutes, seven times a week does not result in much fat loss for most people. The solution for a lot of overweight people is interval walking.

Starting even with just 10 minutes a day and increasing to 30 minutes of interval walking can boost metabolism and increase weight loss.

A study done at the University of Virginia showed that women who did three shorter, fast-paced walks a week ( in addition to two longer, moderate-paced walks) lost 5 times more belly that those who strolled at a moderate speed 5 days a week -- without dieting!

Multiple studies show that shorter workouts, such as interval walking or cycling, can increase metabolism and lead to weight loss faster -- even without dieting.

In the San Francisco Bay Area, many cities have walking trails. Local parks, beaches, lakes and even shopping malls can be great for walking.

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