I read with great interest the article “Gastric Migration Crisis in Obesity Surgery” recently published in Obesity Surgery. The author, Dr. Runkel, is concerned about the increasing numbers of intra-thoracic migration of gastric sleeve leading to GERD and Barrett’s esophagus development. Continue reading “Gastric Sleeve Migration in Weight loss Surgery”
“Without data, you are just another person with an opinion”, concluded R. Cohen MD his attack and critique of the novel weight loss procedure, endoscopic sleeve gastroplasty also known as Endosleeve. Cohen et al conducted a systemic review regarding the efficacy and safety of endoscopic sleeve gastroplasty. The authors found no supporting scientific evidence to recommend the use of endoscopic sleeve gastroplasty for treatment of obesity in clinical practice. Continue reading “Endoscopic Sleeve Gastroplasty Under Fire”
A recent study by Courcoulas et al titled “Patient behavior and Characteristics Related to Weight Regain after Roux-en-Y gastric Bypass” highlights certain behaviors associated with weight regain years after bariatric surgery. Continue reading “Weight Regain after Bariatric Surgery”
Mini-gastric bypass also known as single anastomosis gastric bypass surgery is a non-endorsed weight loss procedure by the American Society of Bariatric and Metabolic Surgery, ASMBS. Bile reflux and the risk of malignancy have been the main concern with mini gastric bypass when compared to the standard Roux-en-Y gastric bypass surgery. Continue reading “Is Mini Gastric Bypass a Safe Option for Weight Loss?”
The National Institute of Health, NIH, conducted a prospective randomized study on a group of twenty healthy volunteers, average BMI=27. The recruits were randomly divided into two groups. First group of individuals consumed a diet of ultra-processed food for two weeks then unprocessed diet for two more weeks. Continue reading “Processed food and Weight Gain after Gastric Sleeve”
Gastric sleeve surgery is a restrictive bariatric procedure. Stomach volume is greatly reduced resulting in small meal consumption. Weight loss, however, is not related to stomach volume reduction. Gastric sleeve induced weight loss is a physiologic result of altered gastrointestinal neuro-hormonal signals secondary to increased Continue reading “Is Your Gastric Sleeve Dilated?”
I have recently evaluated a patient for severe heartburn and food regurgitation following gastric sleeve surgery performed in 2013 in Houston. The patient was happy with weight loss results. She had excellent restriction but suffered from severe GERD related symptoms poorly controlled with high dose proton pump inhibitors. Continue reading “Single Incision Gastric Sleeve Surgery”
Bariatric surgery, including gastric sleeve surgery, is the most effective treatment for type 2 diabetes. The combination of post-sleeve gastrectomy weight loss, decreased food intake and neuro-hormonal changes result in durable blood glucose improvement and in many cases Diabetes remission. Few studies, however, have addressed the preventative effect of gastric sleeve and bypass surgery on new onset type two diabetes development. “Preventative effect of bariatric surgery on type 2 diabetes in morbidly obese patients: a national French survey between 2008 and 2016 on 328,509 morbidly obese individuals” is a newly published study in the Surgery for Obesity and Related Diseases journal. This French nationwide retrospective study shows 82% reduction in new onset type 2 diabetes development following bariatric surgery in obese patients. Gastric sleeve surgery and gastric bypass were equally effective in reducing the development of type 2 diabetes.
Obesity is a major risk factor for type 2 diabetes. If you live in Houston and suffer from excess weight or type 2 diabetes, bariatric surgery may be a great solution for you. Don’t wait until you develop advanced type 2 diabetes to consider a safe, effective and minimally invasive procedure like gastric sleeve surgery. Gastric sleeve surgery unlike insulin supplementation reverses the underlying pathophysiology of type 2 diabetes. Gastric sleeve surgery increases gastric emptying. Gastric sleeve surgery promotes the secretion of neuroendocrine signals that favor lower insulin resistance, lower blood glucose levels and weight loss. Take control of your health today and invest in it, for your health is your best wealth. Early intervention in the form of sleeve gastrectomy is associated with a higher success rate of type 2 diabetes remission and lower rate of type 2 diabetes related complications.
Year after year, 70% of all Houstonians who struggle with excess weight pledge to eat less, exercise more and lose weight. Hunger control is, however, crucial to successful weight loss. Gastric sleeve surgery patients report increased satiety with very small meals. Patients on low calorie diet, on the other hand, feel hungry most of the time. The constant feeling of hunger is hard to fight and as a result most Houstonians fail to achieve durable weight loss. Within a month from the start of the new year, all dieting efforts are dropped, and the weight loss cycle repeats itself every year.
The best approach to increasing satiety and decreasing hunger for durable weight loss hinges on understanding obesity and its underlying pathophysiology. Obesity is a state of starvation. The neuro-hormonal imbalance associated with obesity channels most ingested calories to fat cells leaving the rest of the body including the brain calorie deficient. A calorie deficient brain leaves us hungry and craving for calorie rich food items. A low-calorie diet, in such a situation, exacerbates the starvation state and increase hunger level. One of the key signals in the neuro-hormonal imbalance leading to fat cell calorie accumulation is insulin. Without insulin fat cells cannot hoard calories and accumulate fat. Carbohydrates and in particular processed carbohydrates like white bread, white rice, and sugary drinks increase insulin secretion and lead to increased hunger levels and fat accumulation. Accordingly, the first step to weight loss and hunger control relies on decreasing insulin blood levels. This implies stopping carbohydrate intake including fruits, grains, starch rich tubers and all forms of processed food rich in high fructose corn syrup.
There are many books, publications and seminars supporting decreased carbohydrate intake to lose weight. Keto diet is the extreme form of a low carbohydrate diet approach to weight loss. Keto diet relies on fat as the primary source of energy. It forces the body to go into ketosis to help mobilize fat deposits and promote weight loss. Most importantly, patients on keto diet have increased satiety levels allowing them to reduce their overall calorie intake hence resulting in durable weight loss.
For 2019, Houston Weight Loss Surgery Center invites you to better understand obesity and weight loss methods. We are here to help you overcome any weight loss hurdle you may encounter so that you can start enjoying your life again. If you have any questions give us a call today.
I read with interest the new study “Assessment of Sleeve Gastrectomy Surgical Technique: First Look at 30-Day Outcomes Based on the MBSAQIP Database” published by my colleague Dr. Chaar in JACS current issue. The author compares different techniques in staple line reinforcement in sleeve gastrectomy cases collected in the MBSAQIP database. Continue reading “Sleeve Gastrectomy Technique: Does It matter?”