BaroNova?

Well this is something interesting?

• FDA has granted premarket approval to BaroNova for a device to treat obesity that is inserted into the stomach, where it delays gastric emptying. It is removed after 12 months.
• The device, called the TransPyloric Shuttle system, is placed and removed through the mouth in an endoscopic procedure.
• Approval was based on the company's 270-patient pivotal study in which people treated with the device lost three times more weight on average than patients who had a sham procedure in the control group.

 

Dive Insight:

Despite obesity prevalence at 39.8% in 2015-16, affecting about 93.3 million U.S. adults, according to the Centers for Disease Control and Prevention, therapeutic options have not made a dent. Conditions linked to obesity include heart disease, stroke, Type 2 diabetes and some forms of cancer.

Stubbornly high rates globally show the need for an effective treatment, despite substantial public health efforts to address the problem. Optimism at the start of the decade about progress has been tempered, according to a 2018 editorial in the Journal of the American Medical Association. The AMA recognized obesity as a disease in 2013. 

When lifestyle modifications are not enough, physicians may prescribe weight-loss medications or suggest weight-loss surgery. BaroNova's system offers a non-surgical option.

The BaroNova device is indicated to treat obesity in patients with a body mass index of 30-40 kg/m2. The company's clinical study met its primary endpoints for percent total body weight loss 12 months after the procedure and the proportion of subjects in the treatment group achieving 5% total body weight loss. Approximately 67% of people treated with the device lost 5% or more of their body weight, exceeding the pre-specified performance target of 50%. Forty percent (40%) of those treated with the device lost 10% or more of their weight.

The Mayo Clinic lists several surgical options to treat obesity. They include gastric bypass, in which the surgeon creates a pouch at the top of the stomach that is connected to the small intestine, allowing food and liquid to bypass most of the stomach. Other surgical approaches include gastric banding, where bands are placed at the top of the stomach to leave a small portion available for food. Biliopancreatic diversion and gastric sleeve procedures both involve removing part of the stomach.

Last week, FDA granted De Novo clearance to an edible hydrogel capsule that releases absorbent particles that swell in the stomach to create gel pieces with the firmness of plant-based foods, meant to create a feeling of fullness. The mechanical modes of action involve mean it's regulated as a medical device.

In 2015, FDA approved an implantable, vagus nerve blocking neuromodulation device from EnteroMedics, now known as ReShape Lifesciences. A pulse generator implanted under the skin in the abdomen sends electrical signals via wire leads and electrodes to the vagus nerve. 

Also in 2015, FDA approved two intragastric balloon devices sold by manufacturers ReShape and Apollo Endosurgery. In 2016, FDA approved a third balloon system, made by Obalon, that delivers three balloons in a swallowable capsule that are filled with air. 

In 2017, FDA alerted the public to complications with the liquid-filled devices, including four deaths tied to the Orbera balloon made by Apollo and one death linked to the ReShape balloon.

Other device-based treatments on the market include Aspire Bariatrics' AspireAssist that uses a surgically placed tube to drain some stomach contents and PureTech's edible hydrogel capsule, called Plenity, intended to create a feeling of fullness.

 

14 Years.

I didn't make a 12 or 13 year update?  Really?  It might be the distracted distraction: 

It occured to me that I don't have photos to share, partly because I have been sitting at the same. exact. weight. (within five or so pounds) for two-and-a-half years (*see distraction) and there's really nothing to update in that aspect.  

I started "this journey" more than 15 years ago.

 

My highest weight was 320 pounds.  I have reached a low weight of 145 lbs, once.  I gained over 210 lbs. while pregnant in 2006 and 2015. 

 

I have spent the majority of the last 14 years at or about 170 lbs.  

 

All of this is in the history here on the blog.

Self - last week

 

I would say that 170 is my eat-what-you-want and "don't do jack shit for cardio aside from chasing a hyperactive toddler/house cleaning and seizure" weight.

 

What do I eat?

 

Old-lady food.  I still loathe cooking.  I would not cook a thing, ever, if there weren't kids here.  I don't cook much anyway, since I was told "not to ever use a knife unattended" or "a stove," so, I just ... do, but I don't.  If money were no object, I'd be all over home delivery.

 

Coffee with almond milk, tea, whole grain toast, probiotic cottage cheese, frozen meals, chicken salad.

 

I mix it up with a take out meal about once a week, usually a cold sandwich like roast beef and all the veggies or a BLT.  

 

I regret most meals eaten away from home, so I am careful about food choices if we go out.  I trust no one not to kill me.  I dump on the most random things, or have awful reactions later, so I stick with what Should Work.  

 

I'd say I take in 1500 or so calories most days. Today?  

• Dave's Killer Bread + Light Butter
• Two bites protein cookie, the rest donated to the kid
• Frozen chicken a la king, tossed some of the chicken away
• And it's nearing 5pm.  Typical.  I'll eat dinner at bedtime.

 

 

Bob and I at his police graduation, 2017, his 14 years is next month

 

I have that excess 20- 25 lbs hanging around.  I know how to lose it. I don't do it. At least I have not in the last few years. With my last (POST WLS!) baby who is now eleven, I would get walking for miles, but I don't anticipate that happening anytime soon with my special-fall-on-the-ground-head-crack seizures that developed in the last few years (*see the timing correlation?) Well, at least I did it back then and did not realize I was falling down.

 

Christmas Day, 2017 - Myself and all the "kids"

 

I have two cardio machines in the house. I'm not using them and my excuse is the youngest child that climbs on them with me. (YOU HAVE TO KNOW HIM.  HE IS THAT CHILD.)  Getting up before he does or climbing out of bed after he sleeps to exercise is ... not tempting. I'm just not that into it, yet.  Clearly exercise is not a priority. 

 

I think that remaining upright -- is?

*On that topic which some of you don't like to read, but it's a huge part of my life/day -- I'm taking lots of medications, which need a little tinkering (again, usually once a year I'm in the hospital for a tune up) since I am obviously having lots of seizure activity.   I currently take ONFI, Topamax, Banzel, and as needed Lorazepam.  They are treating my various types of seizures.  I just tapered off of a huge amount of Keppra. I suspect these will change in the near future, because me.

 

People ask me if I blame my gastric bypass for this "condition" or it's increasing changes/etc.  No.  I was born with the brain malformation that causes seizures, and at this point in my life I believe I had seizure activity longer than anyone knew (maybe since I was very small, in the form of smaller seizures that no one noticed, I understand the symptoms now) -- but the gastric bypass caused a trigger by changing my gut.  The science shows that the gut can affect the brain -- and I feel that in some way the WLS lowered my seizure threshold by altering my gut, and making my malformation -- "turn on" and show it's full power.  I feel that there's a cure in my lifetime, if it's fecal transplants, brain stimulators or who knows what else - because there are many of us out there with post WLS seizures. 

 

What do you want to know about "long term" post weight loss surgery life?  

 

Any questions, I am a too-open book.  Ask here or Facebook.  Just don't sell me anything unless you plan on sending it to me free.

 

 

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The Doctors - A Pacemaker For Obesity

Worth a read. New York Times article about a year in the life of bariatric surgery

Worth a read, and worth a watch.  This mimics a bit of my experience, my family's experiences, and brings up some (deeper) questions.  As someone who's had gastric bypass in 2004, I'm always intrigued at any new science that's discovered about the gut - brain connections.

"Nearly 200,000 Americans have bariatric surgery each year. Yet far more — an estimated 24 million — are heavy enough to qualify for the operation, and many of them are struggling with whether to have such a radical treatment, the only one that leads to profound and lasting weight loss for virtually everyone who has it. Most people believe that the operation simply forces people to eat less by making their stomachs smaller, but scientists have discovered that it actually causes profound changes in patients’ physiology, altering the activity of thousands of genes in the human body as well as the complex hormonal signaling from the gut to the brain."

Article - New York Times

A very powerful self-photography project of weight loss surgery.

Finally.  Something I can post.

"Currently, Samantha's work focuses on conceptual portraiture, allowing her to explore human emotion from the inside out. She is working on an on-going self-portrait series focused on body image and healing that challenges viewers to question what is means to accept oneself. "

 

Her photos are shocking if not absolutely realistic and raw if you have lost hundred(s) of pounds with weight loss surgery. 

If you have yet to do so, I would not be alarmed.  Question the photos.  Dig into them.  Feel it.  This is is what we know.

Cropped image. 

• Go to her full photography site to see the full photos. 
• Facebook Page

Bariatric Embolization - new procedure?

12 years.

It is that time again. Time to "celebrate" my big tool on my surgiversary, and reset my pouch by "going back to basics."

I know.  Bullshit.  What is different this year?  Nothing has changed. I am exactly the same physical weight I was last year, but this year I have a sack-of-potatoes baby, too!

No, not the first baby, he's turning seventeen in a week and a half, and six foot two.  The one in the second photo.  He's five months.  

Oh, since you're here - you can find my yearly updates in the archives.  Dig, dig, dig:

• March 2016
• October 2015
• September 2015
• August 2015
• July 2015
• June 2015
• May 2015
• April 2015
• March 2015
• February 2015
• January 2015
• December 2014
• November 2014
• October 2014
• September 2014
• August 2014
• July 2014
• June 2014
• May 2014
• April 2014
• March 2014
• February 2014
• January 2014
• December 2013
• November 2013
• October 2013
• September 2013
• August 2013
• July 2013
• June 2013
• May 2013
• April 2013
• March 2013
• February 2013
• January 2013
• December 2012
• November 2012
• October 2012
• September 2012
• August 2012
• July 2012
• June 2012
• May 2012
• April 2012
• March 2012
• February 2012
• January 2012
• December 2011
• November 2011
• October 2011
• September 2011
• August 2011
• July 2011
• June 2011
• May 2011
• April 2011
• March 2011
• February 2011
• January 2011
• December 2010
• November 2010
• October 2010
• September 2010
• August 2010
• July 2010
• June 2010
• May 2010
• April 2010
• March 2010
• February 2010
• January 2010
• December 2009
• November 2009
• October 2009
• September 2009
• August 2009
• July 2009
• June 2009
• May 2009
• April 2009
• March 2009
• February 2009
• January 2009
• December 2008
• November 2008
• October 2008
• September 2008
• August 2008
• July 2008
• June 2008
• May 2008
• April 2008
• March 2008
• February 2008
• January 2008
• December 2007
• November 2007
• October 2007
• September 2007
• August 2007
• July 2007
• June 2007
• May 2007
• April 2007
• March 2007
• February 2007
• January 2007
• December 2006
• November 2006
• October 2006
• September 2006
• August 2006
• July 2006
• June 2006
• May 2006
• April 2006
• March 2006
• February 2006
• January 2006
• July 2005

 

 

From and including:

Monday, April 5, 2004 to, but not including Tuesday, April 5, 2016

12 years 4383 days

378,691,200 seconds

6,311,520 minutes

105,192 hours

Posted by Melting Mama on Tuesday, April 5, 2016

Gastric bypass surgery lowers women's alcohol tolerance

Download 2015-08-gastric-bypass-surgery-lowers-women

A small study indicates that changes in how alcohol is metabolized after surgery can speed its delivery into the bloodstream, resulting in earlier and higher peaks in blood-alcohol levels. Studying women who had undergonegastric bypass surgery, the researchers found that those who had consumed the equivalent of two drinks in a short period of time had blood-alcohol contents similar to women who had consumed four drinks but had not had the operation.

The research is published Aug. 5 in the journal JAMA Surgery.

"The findings tell us we need to warn patients who have gastric bypass surgery that they will experience changes in the way their bodies metabolize alcohol," said first author M. Yanina Pepino, PhD, an assistant professor of medicine in the Division of Geriatrics and Nutritional Science. "Consuming alcohol after surgery could put patients at risk for potentially serious problems, even if they consume only moderate amounts of alcohol."

Although this study included only women, it is likely that men who have gastric bypass surgery experience similar changes in how their bodies metabolize alcohol.

The researchers studied alcohol's effects in 17 obese women. Eight of the women had undergone Roux-en-Y gastric bypass surgery—the most common bariatric surgical procedure worldwide—one to five years before the study began. The other nine participants had not yet had the operation.

As part of the study, the women spent two days, about one week apart, at Washington University's Clinical Research Center. On one visit, each woman randomly consumed either the equivalent of two alcoholic drinks or two nonalcoholic beverages during a 10-minute period. At the second visit, each was given the beverages not received during the first visit. At both visits, the researchers measured the women's blood-alcohol contents and used a survey to assess their feelings of drunkenness.

The women in the gastric bypass group had an average body mass index (BMI) of 30, which is considered obese, but it compared with an average BMI of 44 for the women who had not yet had the surgery. Among those who had not undergone surgery, blood-alcohol content peaked about 25 minutes after they finished consuming the alcohol and measured 0.60. In women who had the surgery, blood-alcohol content peaked at 5 minutes after drinking and reached 1.10, significantly above the legal driving limit of 0.80.

"These findings have important public safety and clinical implications," said senior investigator Samuel Klein, MD, the William H. Danforth Professor of Medicine and director of the Center for Human Nutrition. "After just two drinks, the blood-alcohol content in the surgery group exceeded the legal driving limit for 30 minutes, but the levels in the other group never reached the legal limit.

"The peak blood-alcohol content in the surgery group also met the criteria that the National Institute on Alcohol Abuse and Alcoholism uses to define an episode of binge drinking, which is a risk factor for developing alcohol problems."

Women who had undergone gastric bypass also reported feeling the effects of alcohol earlier and for longer periods of time than women who had not had the surgery.

The study is not the first to find that gastric bypass surgery can alter alcohol metabolism, but Pepino said it is significant because earlier studies had measured blood alcohol less vigorously and were less clear about the extent of the changes in alcohol metabolism.

"The women who had the surgery only received the equivalent of two drinks, but it was as if they had consumed twice that amount," she said. "Consuming alcohol after surgery the way one did before the operation could put patients at risk for potentially serious consequences, even when they drink only moderate amounts of alcohol."

More information: Pepino MY, Okunade AL, Eagon JC, Bartholow BD, Bucholz K, Klein S. Effect of Roux-ex-Y gastric bypass surgery: converting 2 alcoholic drinks to 4. JAMA Surgery, published online Aug. 5, 2015. DOI: 10.1001/jamasurg.2015.1884 

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Long-term followup of type of bariatric surgery finds regain of weight, decrease in diabetes remission

While undergoing laparoscopic sleeve gastrectomy induced weight loss and improvements in obesity-related disorders, long-term followup shows significant weight regain and a decrease in remission rates of diabetes and, to a lesser extent, other obesity-related disorders over time, according to a study published online by JAMA Surgery.

Obesity was recognized as a global epidemic by the World Health Organization 15 years ago and rates of obesity have since been increasing. Obesity is currently considered a severe health hazard and a risk factor fordiabetes mellitus, hypertension, abnormal lipid levels, heart failure, and other related disorders. Bariatric procedures are reportedly the most effective strategy to induce weight loss compared with nonsurgical interventions. Laparoscopic sleeve gastrectomy (LSG) is a common and efficient bariatric procedure with increasing popularity in the Western world during the last few years, but data on its long-term effect on obesity-related disorders are scarce, according to background information in the article.

Andrei Keidar, M.D., of Beilinson Hospital, Petah Tikva, Israel, and colleagues collected data on all patients undergoing LSGs performed by the same team at a university hospital between April 2006 and February 2013, including demographic details, weight followup, blood test results, and information on medications and comorbidities.

A total of 443 LSGs were performed. Complete data were available for 54 percent of patients at the 1-year follow-up, for 49 percent of patients at the 3-year follow-up, and for 70 percent of patients at the 5-year follow-up. The percentage of excess weight loss was 77 percent, 70 percent, and 56 percent, at years 1, 3 and 5, respectively; complete remission of diabetes was maintained in 51 percent, 38 percent, and 20 percent, respectively, and remission of hypertension was maintained in 46 percent, 48 percent, and 46 percent, respectively.

The decrease of low-density lipoprotein cholesterol level was significant only at years 1 and 3. The changes in total cholesterol level (preoperatively and at 1, 3, and 5 years) did not reach statistical significance.

"The longer follow-up data revealed weight regain and a decrease in remission rates for type 2 diabetes mellitusand other obesity-related comorbidities. These data should be taken into consideration in the decision-making process for the most appropriate operation for a given obese patient," the authors write.

More information: JAMA Surgery. Published online August 5, 2015. DOI: 10.1001/jamasurg.2015.2202 

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FDA approves non-surgical temporary balloon device to treat obesity -

And I sigh.  I feel like this is asking for an eating disorder, but what do I know. 

________________________

The U.S. Food and Drug Administration today approved a new balloon device to treat obesity without the need for invasive surgery. The ReShape Integrated Dual Balloon System (ReShape Dual Balloon) is intended to facilitate weight loss in obese adult patients. The device likely works by occupying space in the stomach, which may trigger feelings of fullness, or by other mechanisms that are not yet understood.

The ReShape Dual Balloon device is delivered into the stomach via the mouth through a minimally invasive endoscopic procedure. The outpatient procedure usually takes less than 30 minutes while a patient is under mild sedation. Once in place, the balloon device is inflated with a sterile solution, which takes up room in the stomach.

The device does not change or alter the stomach’s natural anatomy. Patients are advised to follow a medically supervised diet and exercise plan to augment their weight loss efforts while using the ReShape Dual Balloon and to maintain their weight loss following its removal. It is meant to be temporary and should be removed six months after it is inserted.

“For those with obesity, significant weight loss and maintenance of that weight loss often requires a combination of solutions including efforts to improve diet and exercise habits,” said William Maisel, M.D., M.P.H., acting director of the Office of Device Evaluation at the FDA’s Center for Devices and Radiological Health. “This new balloon device provides doctors and patients with a new non-surgical option that can be quickly implanted, is non-permanent, and can be easily removed.”

_______________________

Download Press Announcements > FD...device to treat obesity

 

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Gastric Pacemaker in use in Boston

 

This procedure is now done where Bob and I both had our weight loss surgeries 11.5 years ago.   I recall posting about it years ago when it was in testing.  

I think it's a neat idea.

CBS Boston- 

If you think about weight loss surgery, there are three main options: Gastric Bypass, the Lap Band, and the Gastric Sleeve. But there haven’t been any other weight loss procedures approved by the FDA for over ten years, that is, until now. Back in January the government agency approved a new device that’s less complicated, safe, and effective.

“Most all of my life I have been overweight.” Mike Magnant from Carver loves to spend time on the tugboat he built, but the extra pounds he carried around took a toll. “High blood pressure, high cholesterol, pains in my legs and pains in my knees,” Mike explains. “I couldn’t do the things I wanted to do.”

He tried a slew of diets but every time, he regained the weight and then some.

At a max of 291 pounds, he knew he had to do something drastic. So Mike enrolled in a clinical trial at Tufts Medical Center studying a new minimally invasive weight loss system called vBloc Therapy by EnteroMedics.

Like a pacemaker, the device is inserted under the skin and electrodes are fed into the abdomen and secured around the vagus nerve which controls hunger. Dr. Sajani Shah, a surgeon at Tufts Medical Center who specializes in weight loss surgery, explains, “It blocks the nerve to the brain and basically tells patients that they’re less hungry and they get satiated for longer periods of time.”

About three years ago, Mike underwent the procedure with Dr. Shah. He went home the same day, back to work three days later, and has lost more than 70 pounds. He says he still enjoys a good meal, but just doesn’t eat as much. He doesn’t feel hungry.

Studies showed patients lost about 30% of their excess weight. “If diet and exercise aren’t working because unfortunately the yo-yo dieting is sometimes hard,” says Dr. Shah, “But they don’t want the other things we have to offer, like the bypass or the sleeve because it’s really complicated, then this is a great, safe alternative for patients to treat their obesity.”

And even though the system is reversible, Mike says it’s his to keep. “I’ve told them. I’m never giving it back. I don’t want anybody to take it back,” he smiles.

Mike says not only has he maintained his weight loss but he has saved a lot of money. He takes fewer medications for blood pressure and cholesterol, has fewer doctors’ appointments, eats less food, and spends less on clothing because now he doesn’t have to buy at the big and tall stores.

Just last week, Tufts Medical Center became the first hospital in the country to perform the surgery on a patient outside of a clinical trial.

Year Eleven, Plot Twist.

Oddly enough last year was my best in terms of weight loss and weight maintenance after my roux en y gastric bypass now eleven years ago.

I just searched the blog for my yearly *cringe* "surgiversary" updates and it appears it really was.

 "Best."  I maintained a nearly-normal bodyweight for half of the year, guys.  If I look back on my averages over the last ten years, the weight is smack-dab in the middle of average.  I am just that.  

Super-average.  

I started out the year at my near lowest, while using the gym and eating decently.  My goal had been to continue that - and ignore weight if I could add muscle tone.  

One of the most common questions I get inboxed to me is:  What Do You Eat Everyday - What Do You Do?!  Here is the thing:  PEOPLE VARY DRASTICALLY.  I realized that my intake vs. output is a delicate balance.

Here's my intake for the most part of the last 90 days:

This looks mostly like this, with days of "Want pizza for dinner?  Who wants mozzarella sticks?"  Once a week.  I eat very little meat, though I am still cooking it a couple times a week for the family.

Breakfast - 

• Coffee - unsweetened almond milk - cocoa powder
• Frozen tofu based meal, other

Lunch -

• Leftovers from dinner or
• Soup or salad or
• Bread + cheese

Snack - 

• Chickpeas, whole grain crackers, cheese, veggie burrito

Dinner - 

• Protein, veggie, carb - whatever is made for the family or...
• Frozen vegan meal

Snack -

• More dinner, usually, I honestly don't eat at dinner time... I eat before bed.  I might have a few bites at dinner time, especially if I am cooking, and then I don't want anything.  

This isn't much different than my eating of the year before - and I maintain my weight at this level of calories.  I would assume I eat about 1500 - 1700 most days with days lower, and days higher (rare).  

I actually lose weight at this intake if I am moving enough.  

Disclaimer, BMI SUCKS and I have NEVER been in the normal category for more than two minutes because I am SHORT AND I AM SHRINKING so if I want to EAT, I HAVE TO MOVE MY ASS.

I was.  I'm not.   No excuses.  

My intentions were good, but life always seems to have different plans.  

I developed some super fun back pain that coincided with less time at the gym (...yes I think movement HELPS pain, but getting past pain to MOVE is now the problem!) and was diagnosed with some degenerative disc disease.  My time working out was cut drastically with my spouse's work schedule changing - kid's school schedules and just having no means to go.  Adding the lack of gym time to pain = Beth not moving her ass because it hurts = Beth not moving.  I started slugging out at home from August (...when the schedule changed) to this winter.  I hate to whine because Everybody Huuuurttttts.   I'm also super realistic and I know I'm getting older, and it is unlikely that my back will Get Better at this age.  It isn't going to benefit me to complain about it now because it's going to get worse with time.  

Grinding along through back pain is difficult though, when it makes every part of your day a little more complicated - you'd think just sitting would be restful - easy.   Sitting here is the most painful part of my day aside from attempting to sleep laying down, I live in a series of twitchy z-z-z-zaps.  If I could pace all day long, I'd be fine.  

And I just may start doing that.

Why?  *changing tenses, writing badly but writing*

There was a single motivation -- I got on the scale after knowing that I was not fitting in my size medium running pants.   THEY SQUISHED ME LIKE A SAUSAGE.  I knew I had gained weight, I could see it - but - I kept squishing into them.  So what if my legs are more puffy?  Whatever.  

And then my boobs.  MY BOOBS.  I didn't HAVE ANY, and a few weeks ago I'm all - O - O - and WHY DO THEY HURT I'd better start my cycle RIGHT NOW or I am going to cry and I just might cry right now or throw up.

Oh.  

I'll save you the dramatic implosion that occurred after three of those, but I've been to the MD twice, and I see a maternal-fetal medicine doctor tomorrow.    I was not planning this, obviously, nor was I telling anyone, but a certain spouse outed me - and a lot of people took it as a joke.  

I don't find it funny.

I've got this.  I have never had a pregnancy WHILE on anti-epileptic medications, so that is of course of concern as I CANNOT be unmedicated and live safely.  If you recall, my seizure activity became evident during my first post-RNY pregnancy and it was undiagnosed for a very long time.   Also, apparently, I AM OLD.  I am "Of Advanced Maternal Age."  

ADVANCED.  AGE.   3-5.  This was the year, that I told my husband, I think we are old enough to have kids now.  Forget that my oldest is the same age as I was when I got pregnant with her.  

She said, "Well, at least it isn't me."  Yes, thanks for that.

Grandma MM doesn't really have a ring to it.  And I think my mother would explode. 

 

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FAAAAAHTS or Gastrointestinal colonization with methanogens increases difficulty of losing weight after bariatric surgery

FAAAAAHTS or Gastrointestinal colonization with methanogens increases difficulty of losing weight after bariatric surgery

Gastrointestinal colonization with methanogens increases difficulty of losing weight after bariatric surgery.

This is totally my gut.

 

I feel like we knew this - have you lived with a gastric bypass or duodenal switch patient for a period of time?  I'm just saying, those of us with altered bariatric intestines  LIVE with "MARSH ASS."   Welcome to the world of pre-biotics, probiotics, fart-smell-better products and I kid you not, LINED UNDERWEAR.  

 

Hey, I never said I was a professional.  Read the studies.

 

What is a methanogen?  Wisegeek says --

"Methanogens are a type of microorganism that produces methane as a byproduct of metabolismin conditions of very low oxygen. They are often present in bogs, swamps, and other wetlands, where the methane they produce is known as "marsh gas." Methanogens also exist in the guts of some animals, including cows and humans, where they contribute to the methane content of flatulence. Though they were once classified as Archaebacteria, methanogens are now classified as Archaea, distinct from Bacteria.

Some types of methanogen, including those of the Methanopyrus genus, are extremophiles, organisms that thrive in conditions most living things could not survive in, such as hot springs, hydrothermal vents, hot desert soil, and deep subterranean environments. Others, such as those of the Methanocaldococcus genus, are mesophiles, meaning they thrive best in moderate temperatures.  Methanobrevibacter smithii is the prominent methanogen in the human gut, where it helps digest polysaccharides, or complex sugars."

Gut bacteria may decrease weight loss from bariatric surgery March 6, 2015

 

Source: Cedars-Sinai Medical Center

The benefits of weight loss surgery, along with a treatment plan that includes exercise and dietary changes, are well documented. In addition to a significant decrease in body mass, many patients find their risk factors for heart disease are drastically lowered and blood sugar regulation is improved for those with Type 2 diabetes.

Some patients, however, do not experience the optimal weight loss from bariatric surgery. The presence of a specific methane gas-producing organism in the gastrointestinal tract may account for a decrease in optimal weight loss, according to new research by Ruchi Mathur, MD, director of the Diabetes Outpatient Treatment and Education Center at Cedars-Sinai.

"We looked at 156 obese adults who either had Roux-en-Y bypass surgery or received a gastric sleeve. Four months after surgery we gave them a breath test, which provides a way of measuring gases produced by microbes in the gut," said Mathur. "We found that those whose breath test revealed higher concentrations of both methane and hydrogen were the ones who had the lowest percentage of weight loss and lowest reduction in BMI (body mass index) when compared to others in the study."

The methane-producing microorganism methanobrevibacter smithii is the biggest maker of methane in the gut, says Mathur, and may be the culprit thwarting significant weight loss in bariatric patient. Mathur and her colleagues are conducting further studies to explore the role this organism plays in human metabolism.

While that research continues, bariatric patients may still have options to improve weight loss after surgery.

"Identifying individuals with this pattern of intestinal gas production may allow for interventions through diet. In the future there may be therapeutic drugs that can improve a patient's post-surgical course and help them achieve optimal weight loss," said Mathur.

The study, "Intestinal Methane Production is Associated with Decreased Weight Loss Following Bariatric Surgery" was done in collaboration with the Mayo Clinic. The paper is being presented by Mathur Thursday, March 5, at the 97th annual meeting of the Endocrine Society in San Diego.

 

Honey Boo Boo Weight Intervention

Nutritional Deficiencies and seizure activity

#myfatstory

 

Katie Hopkins: My Fat Story

Discovery - http://press.discovery.com/uk/tlc/programs/katie-hopkins/

Premieres Friday 2nd January, 9.00pm

Outspoken TV personality, Katie Hopkins has hit the headlines for her controversial views on obesity; insisting that fat people are lazy, saying that she would not employ someone who is overweight, and claiming that losing weight is easy. Earlier this year Katie hit the headlines again revealing her new three stone heavier figure. Sick of hearing people's excuses for being overweight and justifying Britain's obesity crisis, Katie had decided to prove her argument by piling on the pounds to experience being weight, before attempting to lose it again by simply eating less and moving more. This two-part special exclusively follows Katie through every step of her project, as she struggles to put the weight on and deal with her increasing size, and then as she loses the weight. Will she prove her point or will she have to eat her own words?

Probably not.  It's different in the UK right now, the National Health System is socialised medicine, and the patients have their weight-loss surgeries done "on the system" sometimes waiting a long time for treatment -- and people may feel differently about the care being done on the UK's dime.  

I suppose I'd have to watch it, and it's meant to be inflammatory.   I mean -- "FAT PEOPLE ARE LAZY."

Really.  Throw that out there and watch the reaction.  BAIT.  FLAME.  RAWR.

Would you watch?  What do you think?

Health is Not Measured in Pounds

Bariatric Surgery Linked To Increased TASTE Sensitivity - Does Taste Perception CHANGE After Bariatric Surgery?

I think mine is broken. I go for SALTY every time.

I hereby define this study in the flesh.  Everything tastes too, everything to me.

-MM

Via Science Daily from ASMBS -

People with obesity may have an unexpected ally after weight-loss surgery: their tongues. New research from the Stanford University School of Medicine finds patients who reported a decrease in taste intensity after bariatric surgery had significantly higher excess weight loss after three months than those whose taste intensity became higher.

Findings from the new study, "Does Taste Perception Change After Bariatric Surgery?", were presented here at the 31st Annual Meeting of the American Society for Metabolic and Bariatric Surgery (ASMBS) during ObesityWeek 2014, the largest international event focused on the basic science, clinical application and prevention and treatment of obesity. ObesityWeek 2014 is hosted by the ASMBS and The Obesity Society (TOS).

In the study, the majority (87%) of patients reported a change in taste after bariatric surgery, with 42 percent reporting they ate less because food didn't taste as good. However, those who said their taste intensity decreased, lost 20 percent more weight over three months, than those whose taste intensified.

"In our clinical experience, many patients report alterations in their perception of taste after bariatric surgery. However, little evidence exists as to how and why these changes affect weight loss after surgery," said study author John M. Morton MD, Chief, Bariatric and Minimally Invasive Surgery, Stanford University School of Medicine. "It appears it's not just the flavor that influences weight loss, it's the intensity of the flavor. Patients with diminished taste intensity lost the most weight. A potential application to these findings may include teaching taste appreciation in hopes of increasing weight loss."

Before surgery, patients with severe obesity had lower total taste scores than a control group of individuals with no obesity. The 88 patients in the study were on average, 49-years-old, had an average age of 49.2 years, more than half were female with an average preoperative body mass index (BMI) of 45.3. Prior to surgery, the patients and controls completed a baseline validated taste test that quantified their ability to identify the primary taste, using paper strips with varying concentrations of each taste solution, presented in random order. The tests were then performed again at 3-, 6- and 12-months after surgery.

"The study provides excellent new insight on taste change after bariatric surgery," said Jaime Ponce, MD, medical director for Hamilton Medical Center Bariatric Surgery program and ASMBS immediate past-president. "More research is needed to see how we can adjust for taste perception to increase weight loss."

Study - American Society for Metabolic & Bariatric Surgery (ASMBS). (2014, November 4). For some, losing weight after bariaric surgery may be a matter of taste.ScienceDaily. Retrieved November 5, 2014 from www.sciencedaily.com/releases/2014/11/141104083132.htm

Bariatric Surgery Can Worsen Depression

From the no shit files, and specifically the WE COULD HAVE TOLD YOU THIS IF YOU'D HAVE JUST ASKED SECTION - 

Yale Daily News -

A recent Yale study has found that while bariatric surgery — a medical procedure to reduce obesity — improves the moods of the majority of obese patients, it could potentially worsen depression for some.

The study, published in September in the journal Obesity Surgery, examined the possible causes and frequency of depression in patients after bariatric surgery. Though the study concluded that most of the patients’ emotional well-being improved in the months following surgery, the researchers also discovered that a subgroup of the 107 study participants experienced a relative increase in depression six months after the procedure.

“The majority of patients with discernible worsening in mood experienced these mood changes between six and 12 months post-surgery,” said Valentina Ivezaj, associate Yale scientist in psychiatry and the study’s lead author. “We suggest that this may be a key period to assess for depression and associated symptoms following gastric bypass surgery.”

The participants suffering from extreme obesity completed emotional evaluations before the surgery. Six months and then a year after, they completed the same evaluations. The self-reported questionnaires assessed depression, eating disorder behavior, self-esteem and social functioning. The study used these data to produce a numerical BDI — Beck Depression Inventory — rating.

Studies suggest there is ubiquitous stigmatization of obesity in society, which can decrease obese individuals’ overall quality of life, said Yale psychiatry professor John Krystal.

The patients evaluated in the study were mildly depressed prior to surgery on average. But after a year post-surgery, 87 percent of the study participants no longer identified themselves as depressed.

According to Ivezaj, while it is generally true that bariatric surgery minimizes depression in obese patients, it is not always that simple.

The data revealed that 13 percent of patients actually experienced an increase in BDI, while another 13 percent experienced a BDI decrease. Seventy-four percent reported no psychological differences six to 12 months post-surgery. Four percent of patients reported increased depression a year after surgery. Increases in symptoms of depression correlated with higher body mass index and increased incidence of emotional difficulties like low self-esteem and poor social functioning.

Obesity does not just affect the body physically, said Gerard Sanacora, professor of psychiatry at the Yale School of Medicine and director of the Yale Depression Research Program. According to Krystal and Sanacora, obesity has biological underpinnings, which influence an individual’s health, brain function and behavior.

Ivezaj said that she conducted the research in order to dispel the common misconception that bariatric surgery is an easy way out.

“I am inspired by my work with patients who have undergone bariatric surgery,” she said. “In order to be successful following bariatric surgery, patients transform their lives and it takes hard work, determination and dedication to make the required lifestyle changes.”

She said she hoped that the research will help identify individuals with a predilection for depression after bariatric surgery, so that future prevention and intervention implementation might ameliorate the quality of patient life.

Ivezaj said that POWER — the Program for Obesity, Weight and Eating Research — led by Yale School of Medicine professor of psychology and psychiatry and the study’s senior author Carlos Grilo, intends to collaborate with the Yale Bariatric Surgery Program to organize a longitudinal study that will comprehensively assess patients’ eating behaviors, mood, weight and psychological functioning post-bariatric surgery.

According to the Centers for Disease Control, more than a third of American adults are obese.

Obesity Surgery -

When Mood Worsens after Gastric Bypass Surgery: Characterization of Bariatric Patients with Increases in Depressive Symptoms Following Surgery

Background

Depression levels generally decrease substantially following bariatric surgery; however, little is known about bariatric patients who might experience increases in depression following surgery. We examined the frequency of bariatric patients who experienced discernible increases in depression levels following surgery and explored their correlates.

Methods

Participants were 107 patients with extreme obesity who underwent gastric bypass surgery and were followed up at 6 and 12 months postsurgery. Participants completed self-report questionnaires about depression (BDI), eating disorder psychopathology (EDE-Q), self-esteem (RSES), and social functioning (SF-36) at baseline and again at 6 and 12 months postsurgery.

Results

Fourteen (13.1 %) participants reported discernible increases (BDI-Increase), 14 (13.1 %) reported discernible decreases (BDI-Decrease), and 79 (73.8 %) did not report discernible changes (no change) in BDI scores from 6 to 12 months postsurgery. Presurgically, there were no differences between the three groups. By 12 months postsurgery, the BDI-Increase group had significantly higher depression scores and significantly lower self-esteem and SF-36 mental component scores than did the other groups. For the BDI-Increase group, BDI Change was significantly associated with body mass index, self-esteem, and SF-36 physical component scores.

Conclusions

Findings highlight that a subgroup of individuals report discernible increases in depressive scores postsurgery and may differ in potentially clinically meaningful ways from those who do not report discernible increases in depressive symptoms. Future research is needed to better understand the long-term trajectory of patients with discernible worsening mood following gastric bypass surgery.

The Biggest Loser Meltdown Moment

Did you watch this last night?

"I don't want you to go through what your dad has gone through." -Dr.

So -- you KNOW I am thinking it -- I probably yelled AT THE TV.

I would like to know what happened to Rob's dad after all this crying and freaking out with the shaming of the wheel-chair.  I hate when information about weight loss surgery is thrown out there to the general public like "this" without any context.

Biggest Loser, please explain.  I understand that the producers like to create 'breakthrough' moments with the contestants to get them motivated and moving forward and to tear off all excuses, but why create a stigma around weight loss surgery? 

Video Post - Lifelong Success After Bariatric surgery - How to prevent gaining weight after bariatric surgery

Lifelong Success After Bariatric Surgery 

How to prevent gaining weight after bariatric surgery

Dr. Matthew Weiner

Worth the WATCH!  Maybe twice!

Vertical Sleeve Gastrectomy — Considerations and Nutritional Implications

Note - I pasted most of this article in full from "Today's Dietician" as it is chock full of good nuggets of information and vitamin information - scroll down - I do not own this information the links are all below -  GOOD GOOD STUFF here!  -MM  

Thank you Bariatric Fusion for the tip!

Vertical Sleeve Gastrectomy — Considerations and Nutritional Implications.  

All below.