This study looks at the risk of a major heart problem over the next 10 years.  It uses the Framingham risk score, which looks at a patient’s risk based on age, sex, blood pressure, cholesterol, diabetes and other factors.  Patients who underwent gastric bypass surgery lowered their risk by over 50%.  It is always impressive just how much your health can improve with weight loss.

Dr. J

Shrinking cardiovascular risk through bariatric surgery: application of Framingham risk score in gastric bypass.

Follow-up for patients who have a Lap Band is of upmost importance to have success.  As you know, simply having the band in place won’t result in much weight loss.   Follow-up and band adjustments are key.  In general there are 3 main criteria that determine if you need a fill.

1. Are you hungry between meals?
2. Do you need to eat a larger portion size to get full?
3. Are you losing at least 1-2 lbs a week on average?

You should feel full eating a small amount, not be hungry between meals and losing at least 4-8 lbs a month.  Only when all three criteria are met are you in your “sweet spot”.   Even if you are hitting 1 or 2 of the criteria, you likely need a fill.   The band needs to be adjusted to the right spot to drive away hunger.  It will take multiple adjustments after surgery to get you to this goal.  In the beginning, patients often will meet the criteria for only a limited time (a few weeks or months) and then feel they need another fill.  This is a normal part of the process.  As we get you closer to your “sweet spot”, you will need less frequent fills and be satisfied for longer periods of time.  It is not uncommon for patients who are years out to occasionally need a fill.  You should be satisfied and get the weight loss we all want.  If you have any question you need a fill, you likely do.  My goal is for you and I to both be happy at your fill level and with your weight loss, and we’ll keep doing fills until we reach it.

As far as being overfilled, the main symptoms are reflux and problems swallowing.  Reflux or heartburn type symptoms are often the first sign.  If you are experiencing any reflux, you can sometimes get some relief by taking an acid-blocker like Prilosec.  The problem often will get worse, however, until some fluid is removed.  It is important to come back and see us if you are experiencing any reflux.  We recommend seeing us before going to see a gastroenterologist or having tests done.   Often we just have to take a small amount of fluid out and it will relieve all your symptoms.  If you let the reflux progress, it can lead to worsening symptoms and eventually may lead to problems getting food down past the band due to inflammation.  All this can be resolved at any point by taking fluid out, we just often have to take more fluid out to relieve your symptoms if you let it progress to the point you are having problems passing solid food.  Earlier intervention just allows things to get back to normal much quicker

The key thing to remember is the band is never supposed to be uncomfortable.  The beauty of the operation is you can adjust it to control weight loss as well as any symptoms you develop from being too tight.  If you are experiencing symptoms, let’s fix it.  I’ve had many patients get upset when they have to have fluid removed, thinking they will go backwards or it’s a sign of defeat or failing.  You can actually do better and achieve more weight loss if you have fluid removed when you are filled too tight.  If you are too tight, you often can eat only soft and mushy food which will slide past the band easily.  This will actually never fill you up, so you will end up eating more calories because you will be hungry.  If you simply have some fluid removed, you can eat more regular food that will keep you full longer, thus cutting your daily calories and allowing more weight loss.

If you think you are too tight or are experiencing reflux, please make and appointment for an adjustment.   I’ve seen patients undergo expensive or invasive testing for reflux when all they needed was to have some fluid removed.   We can usually fix your symptoms with a simple removal of a small amount of fluid.  Our clinics can add you easily for an adjustment, usually that same day.  We are here to help.

Dr. J.

Here is an interesting article showing a significant reduction in cancer diagnosis after weight loss surgery compared to patients who did not undergo any surgery.  The group who underwent weight loss surgery had an 80% decreased reduction in cancer!  It is always amazing to me how much weight loss alone can improve your health in so many ways.

Dr. J

Weight-Loss Surgery Can Cut Cancer Risk, Study Shows

ScienceDaily — Successful bariatric surgery allows morbidly obese patients to lose up to 70 percent of their excess weight and to maintain weight loss. The latest study by Dr. Nicolas Christou of the McGill University Health Centre (MUHC) and McGill University shows that this surgery also decreases the risk of developing cancer by up to 80 percent.

The researchers compared 1,035 morbidly obese patients who underwent bariatric surgery at the MUHC between 1986 and 2002 with 5,746 patients with the same weight profile who did not undergo the operation. The number of cancer diagnoses in first group was 85 percent lower for breast cancer and 70 percent lower for colon and pancreatic cancers, and was also distinctly lower for several other types of cancer.

“The relationship between obesity and many forms of cancer is well established,” said Dr. Christou. “This is one of the first studies to suggest that bariatric surgery might prevent the risk of cancer for a significant percentage of morbidly obese people.”

Obesity affects the body in multiple ways, so a single hypothesis cannot fully explain these results, say the researchers. However, excess body fat is widely thought to be responsible for increased hormone production, a major risk factor for breast and colon cancer. Thus so modifications to the patient’s hormonal metabolism due to weight loss might explain the lower incidence of these cancers in patients who underwent surgery.

“Bariatric surgery is an extremely efficient tool in the treatment of morbid obesity and its consequences, and the MUHC is one of Canada’s leaders in this field.” Dr. Christou said. “We’re hoping that these results will help the government and public health authorities realize the importance of this procedure in the fight against the various pathologies associated with obesity.”

Dr. Christou presented his preliminary results June 18 at the 25th Annual Meeting of the American Society for Metabolic & Bariatric Surgery.

Since then, several large studies have confirmed the Canadian findings. American physiologist Ted Adams, PhD, MPH, compared 6,596 Utah patients who had gastric bypass with 9,442 severely obese individuals who had not, and found a significant decrease in the incidence of cancer and cancer-related deaths, primarily among patients with advanced cancers, after weight-loss surgery (Adams TD et al. Obesity 2009;17:796-802). The Swedish Obese Subjects (SOS) study of 2,000 patients who underwent diet therapy or gastric restrictive surgery showed a dramatic reduction in cancer incidence among women who had surgery (Sjöström L et al. Lancet Oncol 2009;10:653-662).

Hello to everybody!  I just want to start by welcoming everyone to our website.  This updated site was recently launched and contains a lot of new information about weight loss surgery, the various procedures we offer, frequently asked questions, and information on our office, staff, and upcoming informational seminars.  If anyone has any suggestions on how to improve it further, I’d be happy to hear them.

One of my main goals with the website is to provide continued education to our patients who have already undergone surgery.  I strongly feel Bariatric surgery requires constant learning to get the most success out of each procedure.  Most of the information on our website is structured for patients who have not been through the surgery and are trying to determine which procedure to pursue.  So one of the main ways I want to update our post-operative patients will be through this blog.  I’ll be providing frequent updates with the latest knowledge obtained about all the different surgeries, including news and journal articles as well as research papers.  We’ll be providing nutritional information and diet tips to keep you on target.  We’ll discuss any new surgeries or techniques that may improve your results.  We’ll discuss any recent updates about vitamin supplementation, and we’ll have guest entries by Plastic Surgeons and other healthcare professionals.  Weight loss surgery had been around for over 40 years, but just like everything in medicine, we are still learning fascinating things.  My goal is to pass that knowledge on to you.

To participate, just log-in to the site.  We’ll also update our Facebook site to let you know when there is a new blog, or you can just log-in and check back here.  Let me know if there is any specific topic you want discussed.  I wish everyone continues success in your new lives.

Will Johnson, MD, FACS