Hello Everyone,

SWLC is proud to announce the publication of our 2^nd clinical research report in the prestigious “Obesity Surgery Journal” in September of 2011.  This study shows that the Lap-Band procedure can be safely performed in out-patient facilities – even for patients who would otherwise be considered high risk due to sleep apnea or respiratory problems. If you are a health care professional or you would like more information about this research report, please go to the SWLC HCP section.

This study documented that Laparoscopic Adjustable Gastric Banding (LAGB) can be safely performed in an outpatient facility in a group of patients at high risk for sleep apnea. This review was conducted in association with Dr. M. Kurrek, Dr. A. Kiss and Dr. S.L. Dain & Dr. Z. Wojtasik and myself from the Surgical Weight Loss Centre (SWLC). We reviewed 2,370 patients who undergone Lap-Band surgery between 2005 and 2009 who were classified as high risk for sleep apnea or met at least three STOP-BANG criterias.

A total of 746 of the 2,370 patients (31%) met criteria for or were at high risk for sleep apnea. There were no deaths and no cases of respiratory failure or re-intubation. The 30 day anesthesia related morbidity was less than 0.5%.

This clinical report was conducted due to the controversy that exists regarding perioperative management of patients at high risk of sleep apnea.

For more information on the clinical study, tables, figures and references, visit http://bit.ly/p2Vh5p.

Happy reading!

Dr. Cobourn

Link to Article | http://www.latimes.com/health/boostershots/la-heb-global-diabetes-20110914,0,3956419.story

Written by: Jeannine Stein

WEDNESDAY, September 16th, 2011 (LA Times)—–Diabetes isn’t just a problem in the U.S.–about 366 million people worldwide have the disease, says the International Diabetes Federation.

In addition, 4.6 million deaths are attributed to diabetes, and healthcare spending has grown to a staggering $465 billion.

The figures were released Tuesday in Lisbon, Portugal, at a meeting of the Assn. for the Study of Diabetes, in advance of the United Nations Summit on Non-Communicable Diseases Monday and Tuesday in New York. The IDF, an umbrella group of more than 200 national diabetes associations in over 160 countries, will release its Global Diabetes plan this weekend, outlining steps to combat the diabetes epidemic. The entire Diabetes Atlas, which includes breakdowns by region, will be available in November.

Read the rest of this entry »

Article: Long Term Outcomes of Laparoscopic Adjustable Gastric Banding

Authors: Jacque Himpens, MD; Guy-Bernard Cadiere, MD, PhD; Michel Bazi, MD; Michael Vouche, MD; Benjamin Cadiere, MD; Giovanni Dapri, MD

ABSTRACT

Objective: To determine the long-term efficacy and safety of laparoscopic adjustable gastric banding (LAGB) for morbid obesity.

Design: Clinical assessment in the surgeon’s office in 2009 (>12 years after LAGB).

Setting: University obesity centre in Brussels, Belgium.

Patients: A total of 151 consecutive patients who had benefited from LAGB between January 1, 1994, and December 31, 1997, were contacted for evaluation.

Intervention: Laparoscopic adjustable gastric banding.

Main Outcome Measures: Mortality rate, number of major and minor complications,  number of corrective operations, number of patients who experienced weight loss, evolution of comorbidities, patient satisfaction, and quality of life were evaluated.

Results: The median age of patients was 50 years (range, 28-73 years). The operative mortality rate was zero. Overall, the rate of follow up was 54.3% (82 of 151 patients). The long-term mortality rate from unrelated causes was 3.7%. Twenty-two percent of patients experienced minor complications, and 39% experienced major complications (28% experienced band erosion). Seventeen percent of patients had their procedure switched to laparoscopic Roux-en-Y gastric bypass. Overall, the (intention to treat) mean (SD) excess weight loss was 42.8% (33.92%) (range, 24%-143%). Thirty-six patients (51.4%) still had their band, and their mean excess weight loss was 48% (range, 38%-58%). Overall, the satisfaction index was good for 60.3% of patients. The quality-of-life score (using the Bariatric Analysis and Reporting Outcome System) was neutral.

Conclusion: Based on a follow up of 54.3% of patients, LAGB appears to results in a mean excess weight loss of 42.8% after 12 years or longer. Of 78 patients, 47 (60.3%) were satisfied, and the quality of life index was neutral. However, because nearly 1 out of 3 patients experienced band erosion, and nearly 50% of the patients required removal of their bands (contributing to a reoperation rate of 60%), LAGB appears to results in relatively poor long-term outcomes.

Arch Surg. Published online March 21, 2011. doi: 10.1001/archsurg.2011.45

__________________________________________________________________________________________

I have reviewed the article published in the Archives of Surgery by Dr. Jacques Himpens and colleagues from Belgium.  Review of the paper shows that the authors completed 151 gastric band procedures over a four year period (average of 38 procedures per year). The technique and device implanted are no longer used in today’s gastric banding procedures. This is an ill-constructed, single-center clinical assessment that does not meet the high clinical standards we should expect from peer-reviewed data, and is not reflective of today’s clinical standards. 

This particular study in question contains various flaws and is contradictory to a large number of well-controlled clinical studies published in peer-reviewed literature today.  Specifically, I would like to call your attention to the following important facts that impact the study’s conclusions:

Read the rest of this entry »

Link to Article | http://www.newswire.ca/en/releases/archive/September2010/09/c8105.html

THURSDAY, September 9th 2010 (CNW) – New analysis of a landmark health survey by the University of Ottawa Heart Institute (UOHI) shows that 70% of Ontario adults are either overweight or obese, and have a strong prevalence of high blood pressure that could lead to heart attack or stroke.

The research, led by Dr. Frans Leenen of the Heart Institute’s Hypertension Unit, adds new information to a limited amount of Canadian data on obesity and high blood pressure. The analysis further strengthens the link between high blood pressure and above normal Body Mass Index (BMI), a formula for body composition calculated by height and weight.

Read the rest of this entry »

Link to Article | http://www.sciencealert.com.au/news/20101608-21235.html

MONDAY, August 16th, 2010 (Science Alert) — Inflammation-causing cells in fat tissue may explain the link between obesity and diabetes, a team of Walter and Eliza Hall Institute researchers has shown.

The discovery, by Professor Len Harrison and Dr John Wentworth from the institute’s Autoimmunity and Transplantation division, opens the way for new anti-inflammatory treatments that prevent insulin resistance (where the body is unable to respond to and use the insulin it produces) and other complications associated with obesity.

“We have shown that insulin resistance in human obesity is closely related to the presence of inflammatory cells in fat tissue, in particular a population of macrophage cells,” Professor Harrison said.

Read the rest of this entry »

Weight Loss Surgery Helps Obese Diabetes Patients: Study

Link to Article |http://www.nationalpost.com/Weight+loss+surgery+helps+obese+diabetes+patients+study/3405256/story.html

Written By: Julie Steenhuysen

MONDAY, August 16th, 2010 (Reuters) – Three-fourths of obese diabetics who had weight-loss surgery were able to quit taking diabetes drugs within six months of their operation, U.S. researchers said today, citing a new study.

They said the surgery may eliminate the need for chronic medications to treat the disease and reduce overall healthcare costs, providing a strong argument for insurance companies to pay for the procedures.

Once developed, diabetes and obesity are rarely reversed, Dr. Martin Makary of Johns Hopkins University in Baltimore and colleagues reported in Archives of Surgery, a medical journal.

Read the rest of this entry »

Obesity, Depression Grants Worth $1.3 Million

Link to Article | http://www.ottawacitizen.com/health/Obesity+depression+grants+worth/3330401/story.html

WEDNESDAY, July 28th, 2010 (Ottawa Citizen) – Carleton University researchers have received $1.3 million in funding to continue their investigations in depression and obesity. The Canadian Institutes of Health Research (CIHR) said Monday that it had awarded Alfonso Abizaid more than $543,000 for his investigation into the role that a hormone called ghrelin plays in the struggle with obesity. His current study looks at a link between this hormone and stress-induced obesity. So far, Abizaid has learned that the hormone may generate cravings for food, and other things humans find pleasurable, such as drugs, sex and gambling. Meanwhile, Hymie Anisman, who received $815,514, spearheaded an investigation into how stress and anxiety could lead to depression. His funding will be used to examine the biological process that might be responsible for making animals resilient or vulnerable to stressful situations. Both researchers are members of Carleton’s neuroscience department.

ASMBS: No Excess Risk with Gastric Banding in Teens

Link to Article | http://www.medpagetoday.com/MeetingCoverage/ASMBS/20936

Written By: Charles Bankhead

MONDAY, June 28th 2010 (MedPage Today) – Obese adolescents lost just as much weight as adults did with no increased risk after laparoscopic adjustable gastric banding, data from a case-matched cohort study showed.

Excess weight loss increased from 21.5% at six months to 35.1% at 24 months, virtually identical to adults’ weight loss among which averaged 35.8% at 24 months.

Read the rest of this entry »

“Lap-Band” Weight Loss Surgery in Very Obese Adults Improves Mental Health

Link to Article | http://esciencenews.com/articles/2010/06/21/lap.band.weight.loss.surgery.very.obese.adults.improves.mental.health

MONDAY, June 21st 2010 (E! Science News) – One year after weight loss surgery with laparoscopic gastric banding, extremely obese adults demonstrate not only better physical health but also improved psychological health, a new study shows. The results will be presented Monday at The Endocrine Society’s 92nd Annual Meeting in San Diego. “Surgical treatment, such as laparoscopic gastric banding, is increasingly recognized as the most effective means of achieving weight loss and improving blood sugar control in morbidly obese patients with Type 2 diabetes,” said study co-author Andrew Johnson, MD, of Southmead Hospital in Bristol, U.K.

Read the rest of this entry »

Genes Are Not Destiny When It Comes To Obesity: Study

Link to Article | http://toronto.ctv.ca/servlet/an/local/CTVNews/20100405/exercise_obesity_100405/20100406/?hub=TorontoNewHome

TUESDAY, Apr 6th 2010 (CTV News) – An hour a day of moderate exercise can help teens control their weight, even when they are genetically predisposed to obesity, a new European study finds.

The research finds that even those people with a common obesity-related gene dubbed “fatso” can beat their “genetic destiny and maintain their weight with enough daily exercise.

“Fatso” is the unfortunate nickname for the FTO gene, also called the Fat mass and obesity associated gene.

Read the rest of this entry »