diabetes Lap Band Or Gastric Surgery For Weight Loss

[Pete53]

LOS ANGELES - The first long-term studies of stomach stapling and

other radical obesity treatments show that they not only lead to lasting

weight loss but also dramatically improve survival. The results are

expected to lead to more such operations, possibly for less severely obese

people, too.

Researchers in Sweden and the United States separately found that

obese people who underwent drastic surgery had a 30 percent to 40 percent

lower risk of dying seven to 10 years later compared with those who did

not have such operations.

The research, published in Thursday's New England Journal of Medicine,

should put to rest uncertainties about the benefits and risks of

weight-loss surgery and may cause governments and insurers to rethink who

should qualify for the procedure, some doctors said.

Also Online Link: New England Journal

Link: Body Mass Index calculator

"It's going to dispel the notion that bariatric surgery is cosmetic

surgery and support the notion that it saves lives," said Dr. Philip

Schauer, director of bariatric surgery at the Cleveland Clinic in Ohio, who

had no role in the research.

Obesity surgeries have surged in recent years along with global

waistlines. In the United States alone, 177,600 operations were performed

last year, according to the American Society for Metabolic & Bariatric

Surgery. The most common method was gastric bypass, or stomach-stapling

surgery, which reduces the stomach to a small walnut-sized pouch and

bypasses part of the small intestine where digestion occurs.

The Swedish study is the longest look yet at how obesity surgery

affects mortality.

Researchers led by Dr. Lars Sjostrom of Goteborg University compared

4,047 people with a body-mass index over 34 who had one of three types

of surgery or received standard diet advice. BMI is a standard measure

of height and weight and a BMI over 30 is considered obese.

After a decade, those in the surgery group lost 14 percent to 25

percent of their original weight compared to 2 percent in the other group.

Of the 2,010 surgery patients, 101 died. There were 129 deaths in the

comparison group of 2,037 people.

In the U.S. study, Ted Adams of the University of Utah led a team that

looked at 7,925 severely obese people in the state who had gastric

bypass. They were matched with similar people who did not have the

operation and who were selected through their driver's license records listing

height and weight.

After an average of seven years' follow-up, 213 people who had surgery

died compared to 321 who did not have the procedure. The study did not

look at weight loss.

Deaths from diabetes in the surgery group were dramatically cut by 92

percent; from cancer by 60 percent and from heart disease by 56

percent. Surprisingly, the surgery group had a higher risk of death from

accidents, suicides and other causes not related to disease. The researchers

were puzzled by this.

Both studies were done before surgery advances that have led to

smaller incisions and faster recovery time. Experts say future long-term

survival rates from obesity surgery should be even better.

While neither study was the gold standard test, where patients are

randomly given one treatment or another, surgery's dramatic benefits make

it ethically hard to deny patients the operation, said Dr. George Bray

of the Pennington Biomedical Research Center at Louisiana State

University.

Herb Olitsky, a 53-year-old business owner from New York City, credits

his improved lifestyle to gastric bypass.

A diabetic, Olitsky was given months to live after developing a

life-threatening bacterial infection near his heart muscles.

Olitsky, who stands 5 feet 8 inches, underwent stomach-stapling

surgery in 1999 and went from 520 pounds to his current weight of 160. He no

longer struggles to walk a quarter block and has managed to control his

blood pressure and heart rate.

"I knew I had to get it and that's what's kept me alive," Olitsky

said. "I'm healthier now than I've ever been."

More than 400 million people worldwide are obese and surgery is the

only proven method to shed significant pounds in a short time. In the

United States, it costs $17,000 to $35,000 and insurance coverage varies.

Weight-loss surgery is considered relatively safe with the risk of

death from the surgery at less than 1 percent. Common complications

include nutritional deficiency, gallstones and hernia.

U.S. guidelines recommend that surgery be considered only after

traditional ways to slim down have failed. Candidates must be at least 100

pounds overweight and have a BMI over 40, or a BMI over 35 plus an

obesity-related medical condition such as diabetes or high blood pressure.

This fall, a panel of experts from the National Institutes of Health

will revisit the obesity surgery guidelines. It's not yet known whether

a BMI change would be considered, said spokeswoman Susan Dambrauskas.

Susan Pisano, a spokeswoman for America's Health Insurance Plans,

which represents 1,300 insurers, said the group will rely on any new

recommendations from the federal government.

The Sweden study was paid for by the government-funded Swedish Medical

Research Council, drug makers Hoffmann-La Roche Inc. and AstraZeneca

PLC and Cederroth, which makes health care products. The U.S. study was

supported by an NIH branch; one of the researchers has received a

lecture fee from a company that makes equipment for obesity surgery.

[robert51]

Hey pete here in the Philippines i met a guy who just had a lap band august 2 and he paid less then 8,000 total .... the same doctor who has done over 15 of these operations says even the by pass one is under 10,000 ..my friend says he has shed 35 lbs so far....

[Pete53]

Robert if I can get cleared for the surgery it will cost me 100 bucks using my Medicare HMO. I have been trying to get it done for almost a year. I have lost 22 lbs on my own in 1 year though.

[JohnM]

Pete: I hope you can get it done. I had it done May 2005 ( BYPass) and have lost 150. My HMO would not pay for it but medicare did. Out of pocket it cost me $1300. My life has changed, My health overall is better. And once again I feel Sexy and Happy. I love the comments I recieve, Although I would like to lose 10 more everyone tells me I shouldn't because I look good now. If you have it done take a picture of yourself the morning of surgery and then every 3 months after for a year and you will be amased to see yourself and happy to show those pictures off. Join the support group if you have one in your area. don't be afraid of trying different foods, just be aware of what makes you sick and stay away from them. For me I can not eat anything cooked on a grill or anything too spicy. certain barbacue sauces have to much sugar in them so watch out for that. Otherwise today, I can eat anything else. Just be aware of what your stomache is telling you, I go out to eat and thinking I am starved start to eat and after a few bites of food my stomache will let me know that I am full. I know look at what people put on their plates and think " I use to eat that much" Sometimes I feel jeaulos but would not change anything. Its mind over matter.

Good Luck to You

JohnM's Wife Dianne

[Pete53]

Diane:

I am gearing up to try to get approved again. It requires another stress test :) and ok from cardiologist. I will call Monday to start the appointments. My Lap Band Doc made the news a couple of weeks ago offering a free procedure for a man who weighed 500 lbs and a Judge denied him the right to adopt a kid. The Judge told the man he could not place a child whoes father was going to die soon.

Congrats on your success and confirmation that I can do it. My goal is 60 to 100 and even 40 would be better. I have lost 22 lbs on my own and it is hell.

Edited August 25, 2007 by Pete53

[Rebecca]

VA has been doing them for years-just have to be at the right VA.They are doing them in Portland,OR-I see the head of that surgical department. I have been at other VA's who are astounded that the VA does them.I'm sorry to say,recent research is that they do not last.I put a lot of my weight back on.