Does the type of bariatric surgery affect your metabolism?

When speaking with patients who are considering the Lap-Band procedure for morbid obesity, it is very common to hear be offered the explanation that their inability to lose weight is due to a problem with a slow “metabolism”. It will be of benefit to anyone considering bariatric surgery to explain exactly what your metabolism is, and how it can be affected.

When speaking of metabolism, we are talking about a combination of the amount of energy (calories) we utilize just being alive which is called the Basal Metabolic Rate (BMR), plus the number of calories we burn being physically active and keeping our body temperature steady at 37⁰C.

BMR is determined for the most part, by your lean body mass, or in other words, the amount of muscle (and bone) you have. Fat tissue is not very active and therefore does not significantly contribute to your BMR. One of the major advantages of the Lap-Band procedure is that the weight loss occurs typically at the rate of 1 – 2 pounds per week.

Many studies have shown that at this rate of weight loss, patients will preferentially burn fat while building muscle. When you lose fat, while maintaining or increasing muscle mass, this type of weight loss will increase your BMR at the same time you are losing weight. Thus you have the secondary benefit of increasing your BMR while you lose weight.

Other bariatric surgery procedures such as the gastric bypass lead to weight loss at a much higher initial rate. Studies have shown that this rate of weight loss will reduce the lean body mass and may actually reduce your BMR.

The point is that the gradual and steady weight loss achieved with the Lap-Band procedure will have a beneficial effect on your metabolism, making ongoing weight loss more efficient.

~CC

As a highly respected bariatric surgeon in Canada and an international contributor to Lap-Band research, Dr. Chris Cobourn of the Surgical Weight Loss Centre (SWLC) will now be adding “blogger” to his resume as he officially posts his first blog (the Cobourn Critique) exclusively on the SWLC website. Serving on expert committees to help establish worldwide standards, Dr. Cobourn’s opinions are highly regarded in the medical community, his peers and patients. Not only will the Cobourn Critique blog offer smart and honest views, but also thought provoking perspectives on the subject of obesity and the Lap-Band.

Happy reading!

__________________________________________________________________________

The Canada – Vital Signs 2011 report (http://www.vitalsignscanada.ca/nr-2011-index-e.html) was released this week. This report is a compilation of quality of life reports cards from 22 communities across Canada. It is a very interesting look at how Canadians view and report their perceived quality of life.

This study shows that even though Canada has been actively attempting to address the problem of obesity for more that a decade, obesity rates continue to rise. Some of the initiatives that have been instituted include better food labelling, healthier food options in schools, reduction of trans fats in our food supply and tax incentives to promote physical activity.The estimated cost to Canadian communities is $4.6 to $7.1 billion each year.

The most recent statistics (2010) show that 18.1 per cent of Canadian adults describe themselves as obese, an increase of 2.8 percentage points since 2003. Unfortunately the current efforts by policy-makers, businesses and non-profits are not working.
When asked to comment, Dr. Arya Sharma, scientific director for the Canadian Obesity Network said:

“We have nurtured the obesity epidemic – through sedentary work and lifestyles, a constant time crunch, and our fast-food culture – and now we must accept that it is a chronic disease,”

Sharma said most anti-obesity programs in Canada offer short-term solutions, which are not effective because, as research shows, most obese people may be able to lose weight but unfortunately they are not able to keep it off.

This has been the overwhelming experience of patients who have received Lap-Band surgery at the Surgical Weight Loss Centre. Many patients have experienced repeated cycles of weight loss followed by weight gain, often with the gain being greater than the loss. It is now accepted in the medical community that the most effective method of achieving sustained weight loss is with bariatric (weight loss) surgery such as the Lap-Band procedure.

The Vital Signs report discusses some of the societal initiatives that may hopefully reduce the incidence of obesity, but in addition we need to discuss effective ways to deal with those individuals for whom prevention has not been successful and for whom effective treatment is required.

We will discuss effective treatment strategies in future blogs.

~CC