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April 2013 posts

Didn't you know I want Michelle Obama arms?

I was at the gym last night when my local news showed this story, which also landed in my Google alerts this morning, which is also ON THE TODAY SHOW right now:

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A. surgery. every. ten. minutes.

Dear media - stop.  This makes me want to pull out my batwings and flap them around just because.

Hit the Google.  Search brachioplasty scars.

You do know you don't HAVE TO have plastic surgery, right?  It's not a requirement after massive weight loss.  Some folks do just fine living with excess skin whether it is due to necessity (insurance, financial, otherwise...) and some people are just fine living in their new bodies and live well OWNING their new selves.

It really is a mindset.

Please don't be sold into Michelle Obama Arms just because she has them.  Mrs. Obama doesn't have scars to her elbows after brachioplasty surgery, nor had she lost 150, 200 or more pounds first.  

You might want to.  I am still on the fence about having plastic surgery.  I have been on the fence for nine years.  (There's a lot to it.  This is not the post.  - MM)

Dwightgunshow001
Plastic Surgery.org

New statistics released by the American Society of Plastic Surgeons (ASPS) show that arm lifts in women have skyrocketed a staggering 4,378 percent in just over the last decade. It is a trend fueled, in part, by sleeveless fashions for women and more focus on strong-armed celebrities. In 2000, more than 300 women got upper arm lift procedures. Last year, more than 15,000 did.

Upper arm lifts can include liposuction or a surgical procedure known as brachioplasty, in which loose skin is removed from the back of the arms.

"Women are paying more attention to their arms in general and are becoming more aware of options to treat this area," said ASPS President Gregory Evans, MD. "For some women, the arms have always been a troublesome area and, along with proper diet and exercise, liposuction can help refine them. Others may opt for a brachioplasty when there is a fair amount of loose skin present with minimal elasticity."

Doctors say there is no single reason behind the increase, though celebrities from the White House to the red carpet may be having an influence. A recent poll* conducted on behalf of ASPS found that women are paying closer attention to the arms of female celebrities.

According to the poll, women most admire the arms of first lady Michelle Obama, followed closely by Jennifer Aniston. Actresses Jessica Biel and Demi Moore, and daytime TV talk show host Kelly Ripa also got votes for their toned arms.

"I think we are always affected by the people that we see consistently, either on the big screen or on TV," said ASPS Public Education Committee Chair David Reath, MD, based in Knoxville, Tenn. "We see them and think, ‘yeah, I'd like to look like that'."

That's just what happened to 24-year-old Natalie Robinson of Knoxville, who says she was inspired by the arms of the first lady. "I looked at Michelle Obama and said ‘Oh my gosh, I want her arms.' When I first started losing weight and started to tone up, I had her image in my head."

That was three years ago. Today, Robinson has lost more than 170 pounds and continues an amazing transformation through diet and exercise. But for all the weight she'd lost, Robinson says she still wasn't entirely happy.

"I had a lot of excessive skin around my upper arms," she said. "Every time I looked in the mirror there was a reminder of a heavier person and I just couldn't get rid of it."

That's when Robinson contacted Dr. Reath, who performed her brachioplasty. "Natalie had the perfect arms for this procedure," said Dr. Reath, "but it's not for everybody."

A brachioplasty requires an incision from the elbow to the armpit, generally on the back of the arm, leaving a visible and permanent scar. For Robinson, the scar was much easier to deal with than the excessive skin, but Dr. Reath cautions patients to carefully consider the pros and cons before having an upper arm lift, particularly a brachioplasty.

"It's a trade off. We get rid of the skin, but we leave a scar," he said. "So, as long as there's enough improvement to be made in the shape of the arm to justify the scar, then it's a great procedure."

Dr. Reath stresses the importance of proper diet and exercise as part of a healthy lifestyle to all his patients, but says some women simply can't achieve the look they want on their own. Many who simply want to tighten and tone their upper arms, but don't have a lot of excess skin, opt for liposuction instead of a brachioplasty.

"We are genetically programmed to have different accumulations of fat in different areas, and for some women the arms can be a problem area," said Dr. Reath. "The arms are a very noticeable area and if excessive fat and skin are an issue, they tend to look more out of proportion than the rest of the body."

That was certainly the case for Robinson, but not anymore. Robinson says she never expected surgery to make her arms perfect, just more normal. "Well-proportioned is what I was going for, and I'm very happy. It was well worth the investment," she said. "I would do it again."

For more statistics released today on trends in plastic surgery including gender, age, regional, national average fees and other breakouts, refer to the ASPS 2012 National Clearinghouse of Plastic Surgery Procedural Statistics report.  Visitors can also find information about procedures and referrals to ASPS Member Surgeons.

* This poll was conducted online within the United States by Harris Interactive on behalf of the American Society of Plastic Surgeons from March 28-April 1, 2013 among 1,219 women ages 18 and older. This online poll is not based on a probability sample and therefore no estimate of theoretical sampling error can be calculated.

 


#YWM2013 Convention Contest!

The #YWM2013 Convention Registration Contest is ending this SUNDAY, April 28, at 11:59 pm EST.  That means there is still time for you to officially register for the meeting and enter-to-win for a chance to earn a FREE 3-night stay at the host hotel, the beautiful Arizona Grand Resort & Spa.

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If you are planning to attend and still need to register -

 


Pout face.

This may be the first time that Team MMBBGC has done so poorly in fundraising for the local walk.

It is likely because Team MMBBGC is so very little (..no really!  It is me, some out of towners that joined by accident, and that's it!) and Team MMBBGC has been pushing #YWM2013 bracelets hardcore and sort of let this Walk slide.

I NEED YOU.

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Remember, if I reach the goal, there are prizes, I gave away FOUR iPods/Wiis a couple months ago for our performance in 2012.

Please throw a buck in the pot.

 


This Chick Clicks - Giveaway

 

CLICK On Giveaway

MM LOVES CLICK.
BECAUSE of REASONS.

And they do nice things.

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Like this.

  • Canister of CLICK Espresso Protein Shake - Your Choice Of Flavor
  • CLICK CHICK Cap
  • CLICK CHICK Glitter Mug
  • Enter below!
  • a Rafflecopter giveaway

  • Check out the CLICK Sampler - http://drinkclick.com/shop/click-start-sample-kit.
  • And CLICK Recipes - http://drinkclick.com/category/recipes-fan 

  • Obesity Help Announces Keynote Speaker for 2013 National Conference

    Arya
    This pleases MM.  Very much so.  I might have suggested Dr. Sharma.  Thanks, OH for taking the suggestions from the community.  We like change.
    ______________________________
    Obesity Help -

    ObesityHelp, the leading weight loss surgery support community, announced today that Dr. Arya Sharma, world-renowned thought leader on obesity prevention and management will be the ObesityHelp 2013 National Conference Keynote Speaker.” The two day conference takes place in Anaheim, California.

    On Saturday, October 5, 2013, Dr. Sharma will present his keynote “Moving Beyond Diet and Exercise”. Dr. Sharma told ObesityHelp, “As anyone battling obesity is well aware, the age-old mantra “Eat-Less-Move-More” (ELMM) is about as effective for weight management as watching a comedy show is for treating depression.”

    During his keynote presentation, Dr. Sharma will discuss the many complex causes of weight gain and the many barriers to weight management including, time, stress, genetics, metabolism, sleep, trauma, mental health, medications and many others, to reveal why ELMM approaches to obesity management are so ineffective.

    For agenda updates or to purchase tickets visit http://events.obesityhelp.com.


    Slimpressions has gone big-time! Congrats!

    Screen Shot 2013-04-21 at 10.51.41 AM
    Slimpressions is on Zulily!  Congratulations!
    • First, you have to sign up > That'll give me credit and I'll love you.
    • Then > Shapewear > All the Slimpressions! 
    • And if you hurry!  WEEKEND SHOPPING SPECIAL Place an order, then enjoy FREE SHIPPING on additional orders placed before midnight pt tonight.
    You know what happens to companies after this. 
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    PS.  THE PRICES.   Like, uh, half-off?  Two days.  Shoo.  

    Medication malabsorption?

    I do not think I am absorbing my anti-epilepsy medication very well.   I know - surprise, surprise.

    Shocked-will-smith

    Keppra-12691_3

    I take two medications -

    Topamax

    • Topamax 200 mgs
    • Levetiracetam 2000 mgs
    • Both in divided doses

    My blood test results - suck -

    58148_10200208561311372_58561554_n

    My medication dosages are higher than the "therapeutic levels" suggested above - and my blood lab results don't seem to fit.  

    While my grand mal seizures are controlled (thank you Keppra?) I am having multiple complex partial seizures in clusters each week.  My family says they are increased, I can't tell the difference because they happen regardless of my awareness level.

    (Side note:  I am also still pushing along toward brain surgery for the removal of the area of the brain that is the trigger area for the seizures, however the neuro team has suggested that it's a very large section - larger than anticipated in earlier scans - and less likely to be a cure... I still have testing to visualize and narrow it down... another post.)

    • My point in posting my medication blood levels was that maybe someone out there has knowledge of this -- epilepsy AND gastric bypass AND medication levels or alternative dosing?  

    While I am aware that is NORMAL to have absorption issues post gastric bypass - I guess this is some proof - that medication just DOESN'T always work entirely.

    UIC College Of Pharmacy -

    The Roux-en-Y gastric bypass is most commonly performed in the United States and produces a more profound and sustained weight loss than the other two methods.2,5 This procedure uses a combined restrictive and malabsorptive approach to induce weight loss. During this procedure, a 30- to 60-mL portion of the stomach is sectioned off in an effort to limit food intake. The small intestine is then cut from the base of the stomach, and the lower intestine is connected to the pouch at the top of the stomach. The narrow opening to the small intestine slows the emptying of the stomach and produces a sensation of early satiety.By circumventing the lower portion of the stomach (90% to 95%) and much of the small intestine (the entire duodenum and part of the proximal jejunum), the surface area for absorption is greatly decreased and malabsorption can occur.2

    Drug absorption and bariatric surgery

    The mechanism of altered drug absorption depends partly on the type of procedure done-restrictive or malabsorptive. In general, drug absorption is affected by drug disintegration and solubility and the surface area available for absorption, all of which can be affected by restrictive procedures. 5,7 Disintegration of the dosage form is the first step needed for drug absorption. The smaller volume of the stomach with restrictive procedures may prevent adequate tablet or capsule disintegration due to reduced gastric mixing.Solubility of a drug is dependent on pH. Drugs that are more soluble at a lower pH are absorbed in the stomach, while those that are soluble in more basic environments are absorbed in the small intestine. Changes in the stomach volume after bariatric surgery result in a decrease in gastric acid production and a higher pH compared with the stomach as a whole. The change in pH may cause a decrease in the absorption of medications that rely on an acidic pH for solubility or absorption. A reduction in the surface area of the stomach may further decrease drug bioavailability. These changes may be especially important for drugs that are slowly absorbed, such as sustained-release formulations. Use of liquid formulations or chewing or crushing solid dosage forms (if appropriate) may help overcome some of these factors.

    Malabsorptive procedures bypass much of the small intestine.7 This technique not only decreases intestinal length but also limits mucosal exposure of drugs and alters intestinal transit time. Mixing of highly lipid soluble drugs with bile acids may be reduced, with a loss of enterohepatic recirculation and decreased absorption.

    In addition to drug absorption, drug distribution can also be affected following bariatric surgery.Obesity-related factors that can influence drug distribution include increased blood volume, cardiac output, lean body mass, organ size, and adipose mass. After bariatric surgery, these factors are expected to change and, therefore, may necessitate drug dosing adjustments.


    Report: Some money in Lap-Band settlement to pay for billboards on weight-loss surgery risks

    AP -  Report: Some money in Lap-Band settlement to pay for billboards on weight-loss surgery risks

    LOS ANGELES — A company that promoted Lap-Band weight-loss surgery has agreed to pay $1.3 million to settle a false-advertising lawsuit, with some of the money going to billboards warning the public about the risks of weight-loss surgery, a newspaper reported Thursday.

    From 2009 to 2011, five patients died after Lap-Band surgeries at clinics affiliated with the 1-800-GET-THIN ad campaign, according to the Los Angeles Times (http://lat.ms/11knLBS ).

    The proposed settlement still needs the approval of Los Angeles County Superior Court Judge Kenneth Freeman, who asked attorneys at a hearing Thursday to provide more information and resubmit their settlement motion before he gives the deal his OK.

    Relatives of two of the dead patients, Ana Renteria and Laura Faitro, filed the lawsuit as a class action in 2011.

    The lawsuit sought damages from several companies and two brothers, Michael and Julian Omidi, who court documents said owned and managed Top Surgeons, a weight-loss business.

    John Hueston, an attorney for the Omidis, said the settlement was not an admission of wrongdoing.

    “Under the agreement, our clients ... are dismissed without any admission of liability, and made no contribution whatsoever to the settlements,” Hueston said in a statement cited by the Times.

    A lawyer for the surgery centers, Konrad Trope, said the action against the facilities was dismissed without admission of liability or financial penalty.

    The proposed settlement will be paid only by Top Surgeons, one of the companies behind the GET-THIN operation, the newspaper said. The company did not immediately return a message from The Associated Press.

    The lawsuits and other public documents showed that 1-800-GET-THIN was a marketing company that steered patients to a network of outpatient clinics, where thousands of weight-loss surgeries were performed.

    The company used dozens of billboards — along with ads on television, radio and the Internet — to promote Lap-Band weight-loss surgery.

    Some of the suits alleged that the clinics put profits above patient safety, employing physicians who were unqualified and allowing surgeries to be performed in unsanitary conditions, the Times said.

    The proposed deal calls for $100,000 to be spent on billboard advertising throughout Southern California “intended to explain the risks of weight-loss surgery.” The agreement does not specify the language to be used in the ads but says it must be approved by the court.


    Lawsuit filed against Rachel Ray for weight loss show

    • The lawsuit filed against Rachel Ray could mean trouble for every single weight loss show on television, it's the first five minutes of this episode...

    Study - Expectations for weight loss and willingness to accept risk among patients seeking weight loss surgery.

    Just a warning, this is NOT a pleasant Rainbow and Butterflies study for those in the early or research stages of weight loss surgery.
    Study -

    Expectations for weight loss and willingness to except risk - JAMA -

    Importance  Weight loss surgery (WLS) has been shown to produce long-term weight loss but is not risk free or universally effective. The weight loss expectations and willingness to undergo perioperative risk among patients seeking WLS remain unknown.

    Objectives  To examine the expectations and motivations of WLS patients and the mortality risks they are willing to undertake and to explore the demographic characteristics, clinical factors, and patient perceptions associated with high weight loss expectations and willingness to assume high surgical risk.

    Design  We interviewed patients seeking WLS and conducted multivariable analyses to examine the characteristics associated with high weight loss expectations and the acceptance of mortality risks of 10% or higher.

    Setting  Two WLS centers in Boston.

    Participants  Six hundred fifty-four patients.

    Main Outcome Measures  Disappointment with a sustained weight loss of 20% and willingness to accept a mortality risk of 10% or higher with WLS.

    Results  On average, patients expected to lose as much as 38% of their weight after WLS and expressed disappointment if they did not lose at least 26%.

    Most patients (84.8%) accepted some risk of dying to undergo WLS, but only 57.5% were willing to undergo a hypothetical treatment that produced a 20% weight loss.

    The mean acceptable mortality risk to undergo WLS was 6.7%, but the median risk was only 0.1%; 19.5% of all patients were willing to accept a risk of at least 10%.

    Women were more likely than men to be disappointed with a 20% weight loss but were less likely to accept high mortality risk.

    After initial adjustment, white patients appeared more likely than African American patients to have high weight loss expectations and to be willing to accept high risk.

    Patients with lower quality-of-life scores and those who perceived needing to lose more than 10% and 20% of weight to achieve “any” health benefits were more likely to have unrealistic weight loss expectations.

    Low quality-of-life scores were also associated with willingness to accept high risk.

    Conclusions and Relevance 

    Most patients seeking WLS have high weight loss expectations and believe they need to lose substantial weight to derive any health benefits.

    Educational efforts may be necessary to align expectations with clinical reality.

    /end study

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    NO SHIT, REALLY?!  Go back and READ IT AGAIN.

    Now go read this: http://www.drsharma.ca/how-much-are-people-willing-to-risk-for-bariatric-surgery.html

    WHAT HAVE WE BEEN TELLING YOU?!  Please.  START.  LISTENING.


    Octane xR6 Series Recumbent Elliptical Machine

    Dear Octane People, Thanks for making this. This product works for me.  I am able to use this pretty effortlessly after using the treadmill for an hour -- and I am NOT complaining yet.  

    <3, The new girl at the gym with excess skin who does not enjoy flopping it all around.


    Regain After Weight Loss Surgery.

    903692_10200195893914695_225320087_o

    Left -  Fitbloggin' 2012  Right - This Week - Lost the regain  - Also, 3 pounds to my lowest weight.

    Several years ago, a woman messaged on a weight loss surgery forum and told me that my weight chart resembled a roller-coaster and that she wanted to "help me get control."  After a quick Google search -- I noted she was seeking a new client for her weight loss surgery coaching business and dumped her "friendship."
    Thumbs_Up!
    Friends do not pay friends to help them lose weight, maintain weight loss or to help them lose regained weight after weight loss surgery.  If you are paying someone for your friendship, it might be time to redefine that friendship -- just saying.  I suppose this changes if your friend happens to be a weight loss professional?  But how often does that happen -- and how many weight loss professionals would potentially destroy a friendship with aligning with your weight loss journey?
    Um.  No.  A professional would NOT.
    • Weight loss is personal.
    • It is something you choose for yourself when you are ready.
    • Weight loss is not something you can be talked into - nor shamed into.  

    Regain after weight loss surgery is also a very touchy subject.  Countless bariatric patients go through it -- and less want to talk about it.  But it seems like everyone wants to sell "us" something to fix it.  

    Let me repeat -

    • Weight loss is personal.
    • It is something you choose for yourself when you are ready.
    • Weight loss is not something you can be talked into - nor shamed into.  

    Yet it seems like the larger community wants "us"  (the regainers) to feel shamed for regaining and wants to sell us another quick-fix.

    Let us discuss:  Regain is common.  How much?  Some is very typical.  Sometimes even a lot of regain is normal.  You do not have to be sold into another diet, quick-fix, or scam.  You need to remind yourself why you had weight loss surgery to begin with --

    ...for your HEALTH.  

    Some good links on regain -

     

     

     

     



    Boston, you're my home.

    A few days ago, we coming home from Beth Israel Hospital (where my neurologist is located - another post to come...) on a different route suggested by my car's GPS system.  It brought us through downtown Boston.  I distinctly recall commenting on the brick buildings - and how I'd be the perfect resident to this area of Boston, because I am a pedestrian non-driving citizen - and "Look at all the places I could walk to!" and then the realization of the $800,000 and up price-tags hit me.

    Today it was torn apart.  By bombs.

    This is not supposed to happen here -- nor anywhere.  This feels like we have stepped (again?) into a movie.  Earlier today I was watching The Boston Marathon while I walked on the treadmill.  I watched the winners cross the finish line.  I had no idea the trauma that would unfold later today.  

    Just.  Too.  Much.

    “One of the marvelous things about community is that it enables us to welcome and help people in a way we couldn't as individuals. When we pool our strength and share the work and responsibility, we can welcome many people, even those in deep distress, and perhaps help them find self-confidence and inner healing.” 

    ― Jean VanierCommunity And Growth

    How can you help?  


    1200 calories burned.

    Screen Shot 2013-04-11 at 1.13.54 PM
    I am not known for being ... "active."
    28681-nicki-minaj-Hell-no-gif-LuBd

    When I post this image, it's a big deal for me.  This indicates that Beth Has Been On The Treadmill For An Hour Almost Every Day 9/10 Days.  I also don't typically chart my activity unless I do something on purpose so - this is "doing something on purpose."
    I am trying to make a habit -- to create a new habit -- to learn to enjoy exercise before I develop complete loathing for it.  Because it isn't that I hate exercise, I don't.  I just don't enjoy many of same things that others LIKE to do and I am not cut out for a lot of the things that many of you might enjoy.
    For example - I will never be a long distance outdoor runner.   It just won't happen.  I can't run outdoors, unsupervised.  Why? I am an uncontolled epileptic and likely to dash into traffic.  I can't swim alone for the same reason, nor can my kids.  I can't kayak.  I can't use a bike.  Nor can I take my kids on bike rides.   Yeah, yeah.  It sucks.  Whine whine.  LOL.
    I CAN walk briskly on a treadmill with a safety clip on - with people around me.   (10 times, 10 hours. 3/5-4 miles each. I haven't fallen.)
    GIF-Cats-on-a-treadmill
    Nobody needs to know I am a high-fall risk.  (Even though I am.)    I take two medications that cause "dizziness" and "sleepiness" among other things.
    I CAN walk with the family away from the road, in the woods, trails, etc.    I can hula hoop.  I can roller skate!   (I just did.)  I can take classes at the gym when I can GET there.   I've been lying to myself about all the "can'ts."  
    It is really more about won'ts, isn't it?
    So.
    I don't really have an excuse.  I CAN.

    Weight Loss Surgery Connected to Increased Risk Of Colon Cancer

    GET. YOUR. COLONOSCOPIES.  IT COULD SAVE YOUR LIFE.  Don't be scared. It's no big thing. Really. The preparation is harder than the procedure.  (My spouse is at this very moment, searching for a GI to make that appointment he canceled more than five years ago.  He's a high-risk patient with family history.)

    With that, I tell you - BOTTOMS UP!

    (Reuters Health) - Obesity is already linked to a higher risk of colon or rectal cancer, but a new study suggests this risk is even greater for obese people who have undergone weight-loss surgery.

    Based on a study of more than 77,000 obese patients, Swedish and English researchers found the risk for colorectal cancer among those who have had obesity surgery is double that of the general population.

    Though colorectal cancer risk among obese patients who didn't have the surgery was just 26 percent higher than in the general population, researchers said the results should not discourage people from going under the knife.

    "These findings should not be used to guide decisions made by patients or doctors at all until the results are confirmed by other studies," said Dr. Jesper Lagergren, the new study's senior author and a professor at both the Karolinska Institute in Stockholm and King's College London.

    Each year more than 100,000 people in the U.S. have surgery to treat obesity.

    Lagergren and his colleagues point out in their report, published in the Annals of Surgery, that obesity is tied to elevated risks for a number of cancers, including colorectal, breast and prostate (see Reuters Health story of November 3, 2011 here: reut.rs/t9sYxO).

    Whether surgery to lose weight can affect those risks is uncertain.

    Two earlier studies, one from the U.S. and the other from Sweden, found that the chances of obesity-related cancers decline after women have weight-loss surgery.

    But an earlier study from Lagergren's group found the risks for breast and prostate cancers were unaffected by obesity surgery, and colorectal cancer risk increased.

    To investigate that finding further, Lagergren's team collected 29 years' worth of medical records on more than 77,000 people in Sweden who were diagnosed as obese between 1980 and 2009. About 15,000 of them underwent weight loss surgery.

    In the surgery group, 70 people developed colorectal cancer - a rate that was 60 percent greater than what would be expected for the larger Swedish population.

    When the researchers looked only at people who had surgery more than 10 years before the end of the study period, the number of cancer cases was 200 percent greater than the expected risk for the general population.

    In contrast, 373 people in the no-surgery group developed colorectal cancer, which was 26 percent more than would be expected in the population and that number remained stable over time.

    A two-fold increased risk for colorectal cancer is not a "negligible risk increase, but it should not be of any major concern for the individual patient since the absolute risk is still low," Lagergren told Reuters Health in an email.

    In the U.S., for instance, 40 out of every 100,000 women and roughly 53 out of every 100,000 men develop colorectal cancer each year.

    Doubling that risk would make the annual figures 80 out of every 100,000 women and 106 out of every 100,000 men.

    Lagergren said that more studies are needed to confirm his results before they should be included in clinical decision-making about whether patients should undergo weight-loss surgery.

    The study results cannot prove that the surgery is the cause of the elevated cancer risk.

    And, Lagergren says it's also not clear why the surgery might be tied to an elevated risk of colorectal cancer.

    • One possibility is that dietary changes after surgery, and increasing protein in particular, could raise cancer risk, he speculated.
    • Because the gut plays a significant role in the immune system, he added, "Another potential factor is that the bacteria that naturally reside in the intestines may change after surgery and alter future cancer risk."
    • Lagergren noted that he also couldn't rule out the possibility that residual excess weight and weight gain after surgery might be involved.

     

    SOURCE: bit.ly/10TcCGy Annals of Surgery, online March 6, 2013

    The study -

    Annals of Surgery 

    http://journals.lww.com/annalsofsurgery/Abstract/publishahead/Increased_Risk_of_Colorectal_Cancer_After_Obesity.98506.aspx

    Abstract

    • Objective: The purpose was to determine whether obesity surgery is associated with a long-term increased risk of colorectal cancer.
    • Background: Long-term cancer risk after obesity surgery is not well characterized. Preliminary epidemiological observations and human tissue biomarker studies recently suggested an increased risk of colorectal cancer after obesity surgery.
    • Methods: A nationwide retrospective register-based cohort study in Sweden was conducted in 1980-2009. The long-term risk of colorectal cancer in patients who underwent obesity surgery, and in an obese no surgery cohort, was compared with that of the age-, sex- and calendar year-matched general background population between 1980 and 2009. Obese individuals were stratified into an obesity surgery cohort and an obese no surgery cohort. The standardized incidence ratio (SIR), with 95% confidence interval (CI), was calculated.
    • Results: Of 77,111 obese patients, 15,095 constituted the obesity surgery cohort and 62,016 constituted the obese no surgery cohort. In the obesity surgery cohort, we observed 70 patients with colorectal cancer, rendering an overall SIR of 1.60 (95% CI 1.25-2.02). The SIR for colorectal cancer increased with length of time after surgery, with a SIR of 2.00 (95% CI 1.48-2.64) after 10 years or more. In contrast, the overall SIR in the obese no surgery cohort (containing 373 colorectal cancers) was 1.26 (95% CI 1.14-1.40) and remained stable with increasing follow-up time.
    • Conclusions: Obesity surgery seems to be associated with an increased risk of colorectal cancer over time. These findings would prompt evaluation of colonoscopy surveillance for the increasingly large population who undergo obesity surgery.