Tune in to the Oprah Winfrey Network on Tuesday, April 12 to see Dominique’s story. Dominique is a 600 pound woman, who has six daughters. Her children are worried for her health and life, because she is so heavy that she can no longer leave her own home.
The whole family hopes that Dominique will undergo weight-loss surgery, but her current weight is too high for even this treatment. She must first lose 112 pounds to qualify for the surgery. This reality segment will follow Dominique as she struggles to lose the weight and save her life.
Kate Setter is a member of the media relations team at Cincinnati Children’s Hospital Medical Center, where she contributes to and manages Change the Outcome (www.cincinnatichildrensblog.org), the hospital’s corporate blog. She most often writes about pediatric public health issues, including obesity, pre term birth and immunization.
Perhaps nothing has been written, talked about or wrestled with more in health care circles the past few years than obesity- and for good reason. Obesity is becoming a national epidemic. The cost to treat its related ailments is approaching $150 billion a year and almost one in three children in the United States is overweight or obese.
Pediatricians across the country, including at Cincinnati Children’s, are doing their best to address overweight and obesity issues with patients and families, but many morbidly obese teenagers are finding themselves out of options to reverse the trajectory of their weight issues.
At 31-ounces of iced coffee or tea, the Starbucks Trenta size is hardly anything to lose sleep over. However, at 64 ounces, almost the size of a 2-liter, the 7-Eleven Double Big Gulp is a calorie catastrophe. (more…)
A new study examined the two of the most popular weight loss surgeries, Lap-Band and gastric bypass, has come to the conclusion that gastric bypass is the better option. While the rate of complications in both procedures was about the same, gastric bypass surgery patients lost 64 percent of their excess weight after a year, while those who had the Lap-Band device placed only lost 36 percent of their excess weight.
“It’s a dramatic difference,” said Dr. Guilherme Campos of the University of Wisconsin School of Medicine in Madison.
Tennessee’s TennCare may not want to pay for nutritional counseling, but the National Institute of Health requires some psychological counseling prior to any bariatric surgery. This counseling includes a psychological evaluation, often with a standardized objective test, as well as interviews to determine a patient’s preparedness for the life change required by weight loss surgery and information about those changes. One reason behind this requirement is that gastric bypass surgery cannot be reversed. It also requires major behavioral change to be successful; if a patient is not compliant with all behavior changes he or she can become very ill – I have even been told about the possibility of death. These are severe consequences for not following doctors orders implicitly.
Yet, the behavior change required is also severe. As a therapist, I see asking that kind of change from someone as setting them up for failure or disappointment because so much change is extremely stressful and mentally and emotionally taxing. I would caution any of my clients attempting such overnight life change, and counsel them on forgiving themselves when they do not stick to their plan. Eating more than planned one day may be a disappointment for someone committed to weight loss, but it can have devastating effects for someone who has had gastric bypass surgery.
At what point can we say that we are honestly in an obesity crisis in the developed world? If there’s anything we humans are not so good at, it’s dealing with problems before they are palpable in our lives. Obesity isn’t a big deal… until you have a heart attack, or can’t get up the stairs without breaking a sweat or huffing and puffing.
Well, if you need anymore concrete evidence that obesity is a serious issue that needs to be dealt with in major changes on a micro and macro level, here’s some more disturbing news: hospital admissions in the UK for obesity are up 30 percent over the period of a year.
Picture this: A world where the majority of the population has to take insulin shots, and the life expectancy of children is lower than their parents’. That’s exactly where we’re headed, according to the documentary Killer at Large: Why Obesity is America’s Greatest Threat.
The film opens with an obese 12-year-old child. Brooke Bates and her parents list reasons for her weight gain and explain that diet and exercise didn’t work for her. So, instead of seeing a dietitian or personal trainer, they choose liposuction surgery to resolve the problem.
On Friday, a Food and Drug Administration panel recommended expanding the use of gastric bands, or LAP bands, to treat obesity. Currently, only patients who are morbidly obese can qualify for stomach band surgery, which can aid in weight loss by restricting the amount of food that the stomach is able to hold. If adopted, the new recommendation will allow about 12 million more obese people to receive the implant.
About 15 million people currently qualify for gastric banding surgery, which means they have body mass index score of 40 or higher, or 35 or higher if the person has weight-related health condition. The new guidelines would lower the BMI score to 35 or 30 with a health condition.
There is some alarming news coming from a new study: Overweight teenagers are undergoing laparoscopic gastric band surgery in increasing numbers, even though the procedure is not approved for anyone under 18 years old.
Researchers examined a database of bariatric surgeries in California, and found that gastric band operations increased seven-fold from 2005 to 2007. They also found that 590 people between 13- and 20-years-old underwent gastric band or gastric bypass surgery during the study period.
Another point noted was that 93 percent of the weight-reduction surgeries were performed in hospitals that are not affiliated with nationally recognized children’s hospitals.
While “manufacturers have touted the banding procedure as less invasive, many [medical] centers have abandoned gastric banding because of poor long-term results,” say the study’s authors. (more…)
In a follow up to yesterday’s post, I watched the Nightline episode in which Carol Poe’s amazing brain surgery to lose weight was profiled. During the surgery, in which she was awake and responsive, a local anesthetic was applied to her skull. Because the skull and brain contain no pain receptors, no other anesthetic was needed and Poe remained alert and engaged for the duration of the surgery.
The neurosurgeons, Dr. Michael Oh and Dr. Donald Whiting, decided to target the brain instead of the stomach to facilitate weight loss. They drilled through both hemispheres of the brain to a depth of about about 10 centimeters, through a pathway of tissue that does not affect other functions, and ended at a point in the hypothalamus, which controls the stomach. A wire was introduced that would eventually carry an electrical impulse, and when activated, the plan was to alter the level of electricity that’s generated by that region naturally, thereby giving Poe the sensation of feeling full.
“During this procedure, when we have the electrode in this target, we will be asking her about stimulation-induced responses, whether she has a feeling of hunger [or] whether she has any memory responses,” Oh explained on Nightline. (more…)
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