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

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

Written By: Richard Foot

FRIDAY, November 25th, 2011 (Vancouver Sun)– Canada’s health ministers issued separate but similar warnings Thursday that obesity – specifically child-hood obesity – is now a critical national health concern and a major contributor to rising health care costs.

Obesity is the “next epidemic,” said federal Health Minister Leona Aglukkaq, speaking in Ottawa to a Senate committee studying the health system.

Provincial and territorial health ministers, meeting in Halifax, were even more emphatic. “It’s not the next epidemic, it’s the present epidemic,” said Quebec Health Minister Yves Bolduc.

The ministers are gathered in Halifax for a two-day summit to start outlining priorities for the next national health accord, which will replace the existing 2004 health care funding agreement between Ottawa and the provinces that expires in 2014.

It’s not yet known whether the Harper government will renew the funding deal, in which Ottawa raises its health transfers to the provinces by six per cent a year, or whether federal cuts to the transfer are coming.

Nova Scotia Health Minister Maureen MacDonald was at pains to point out that the health ministers are not dealing with the details of a new accord. Those discussions are left to the country’s premiers.

TUESDAY, November 1^st, 2011—A year after introducing the expansion of SWLC services in the Toronto area, SWLC is pleased to announce the relocation of its Toronto-based services. Beginning December 1^st, SWLC Toronto will be offering its services at the newly launched The Plastic Surgery Clinic, Yorkville to continue offering SWLC patients for their post-op and consultation services. These services will only be offered at the Royal Health Care Centre until November 3^rd.

The beautifully designed downtown location first opened in June 2011 in the prominent neighborhood of Yorkville. Conveniently located on the corner of Bay and Scollard, across from the new Four Seasons Hotel and Residences, patients can easily access the clinic through the TTC subway system using the Bay Street exit on the Bloor subway line, and heading North on Bay Street.

The Plastic Surgery Clinic’s Yorkville location is also home to the Miracle 10 Skin Care boutique, a successful line of clinical, effective skin care created by The Plastic Surgery Clinic in 2005. Introduced by the renowned plastic surgeon, Dr. Frank Lista, the first class skin care products have been featured in top fashion magazines such as Elle, Fashion and Elevate Magazines, as well as newspapers such as the Toronto Star. The extraordinary skin care products deliver rejuvenating results for all skin types.

To schedule an appointment for the SWLC Toronto location in advance, please contact a patient coordinator at info@swlc.ca.

For more information on Miracle 10, please visit http://bit.ly/u25ZXn.

SWLC TORONTO

67 Scollard Street

Toronto, ON M5R 1G4

THURSDAY, October 13th, 2011 —SWLC is delighted to return to the largest trade show for women in Canada on Friday,  November 11 – Sunday, November 13 at the Toronto National Women’s Show at the Metro Toronto Convention Centre. This is SWLC’s 3^rd consecutive year in showcasing its clinic and effective weight loss programs for achieving and maintaining weight loss. Since 2005, SWLC has been a proud contributor and have helped over 3,000 patients overcome their struggle with obesity.

At this year’s National Women’s Show, SWLC will be introducing an exciting never before feature in which visitors will get a chance to meet a Lap-Band patient and ask their questions. This is a great opportunity for those interested in learning more about SWLC’s  program in recognizing the benefits and life-changing possibilities associated with the Lap-Band.

Most notably, SWLC Medical Director and Surgeon, Dr. Chris Cobourn, will be making an appearance on the Health & Wellness Stage on Sunday, November 13^th at 11:15am for his presentation on “The Lap-Band and Gastric Balloon: Innovative Solutions for Sustained Weight Loss”. Not only has Dr. Cobourn been a recognized surgeon in the medical community since 1989, but he has served on expert committees to help establish worldwide standards for bariatric surgery. In addition to his record of accomplishments, Dr. Cobourn is an international and national contributor to Lap-Band research regarding its effectiveness and safety with three publications in his profile.

Find out more by stopping at the SWLC booth! Meet Dr. Cobourn, ask your questions, and get free goodies during your visit!

See you there!

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

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.

“IDF’s latest atlas data are proof indeed that diabetes is a massive challenge the world can no longer afford to ignore,” said IDF President Jean Claude Mbanya in a news release. Mbanya, professor of medicine and endocrinology at the University of Yaounde I in Cameroon, added: “In 2011, one person is dying from diabetes every seven seconds. The clock is ticking for the world’s leaders — we expect action from their high-level meeting next week at the United Nations that will halt diabetes’ relentlessly upwards trajectory.”

There is reason to be concerned. Last month the journal the Lancet released a study that used past obesity trends in the U.S. and the U.K. to predict what could happen if rates continue to climb. By 2030 there could be more than 8 million cases of diabetes in the U.S., along with a 50% obesity rate.

Another 2011 Lancet study reported that the rates of Type 2 diabetes have more than doubled worldwide since 1980, going from about 153 million cases to about 347 million in 2008. Researchers attributed about 70% of the growth to population aging, and the other 30% to the increase in obesity.

THURSDAY, September 15th, 2011 —- The Surgical Weight Loss Centre (SWLC) is pleased to announce the latest added service dedicated to providing excellence in care for patients. Effective September 1^st SWLC can now assist our patients arrange financing with payments as low as $85 per week with $0 down payment.  As part of SWLC’s ongoing commitment in providing the highest quality of care to patients, not only will this new service provide assistance to those financing their weight loss procedures, but is also convenient.

Since 2005, SWLC has helped over 3,000 patients throughout Canada in achieving sustained weight loss to improve their overall health and quality of life. SWLC is Canada’s distinguished provider of the Lap-Band and Gastric Balloon programs. Its qualified surgeons are internationally known as experts and are active in research and submitting publications regarding the Lap-Band, its efficacy and safety.

For more information on how SWLC can assist with financing, please contact a patient coordinator at (905) 278-8000 or toll-free 1 (888)278-7952 or at info@swlc.ca.

Written by: Ted Michaels

WEDNESDAY, Sept 7th, 2011 (Sports Network)— Mike Jovanovich knew exactly when it happened.

The former offensive lineman, who graduated from Boston College, signed as a free agent with the Seattle Seahawks in 1992. He joined the Hamilton Tiger- Cats after being released by Seattle, and also played for the Toronto Argonauts, Ottawa and Montreal.

Like many of his peers, Jovanovich waged a running battle with his weight, during and after his playing days.

“My first year as a freshman at Boston College, I weighed 300 pounds,” he told Inside the CFL. “At the end of my playing days there, I weighed 285 pounds. In my CFL days, I played around 300-305 pounds.”

Then, he admits, the problems started.

“I left football in 1996, got married and started having kids. After all the years of lifting weights and maintaining my weight, you get to a stage in life where other activities become more important. I wasn’t as active as when I was playing, so in the first three years or so after I retired, I probably ballooned up to 340 or 350 pounds. It took me around three years to finally get motivated enough to go back into the gym and resume some sort of the grind, similar to when I was playing.”

However, as he points out, when you battle a weight problem, it’s not a matter of just exercising.

“My defining moment was in February 2009,” said Jovanovich. “I went for a physical. We did the usual tests, cholesterol, blood pressure and so forth. I was as healthy as a 6-foot-5, 250-pound person. But one of the comments from the doctor was ‘Mike, you’re in fantastic shape, but as you get older, as you carry this excess weight, it’ll start to put a toll on your body.’ I had the exercise part down, but the eating in moderation part wasn’t working. I’d go to the gym in the morning, and come home and eat three bagels.”

So, he decided to resort to a drastic measure: Laparoscopic band surgery.

“Dr. Chris Cobourn, my bariatric surgeon, is a pioneer in the field,” Jovanovich said. “In essence, in layman’s terms, they put a throttle on the gas tank. They put a band on the top of the stomach, and create a little pouch. It tricks your brain into thinking you’re fuller, faster, so it reduces the caloric intake. The band can either be constricted or you can fill it up. It’s not invasive surgery at all.”

The Toronto native says the decision wasn’t too difficult to make.

“A friend of mine had it, and had great results. I talked it over with my wife, and because I wanted to coach my daughters’ hockey team and we had travel plans, I just decided, I didn’t want to be big anymore.”

Jovanovich also knows he was a good candidate for the surgery, because, even though he weighed well over 300 pounds, he didn’t suffer from any long-term effects from playing football.

“I was pretty fortunate that I didn’t have serious injuries. I had pulled muscles, but never had reconstructive surgery on the knees or my back or shoulders. I was healthy bone-structure wise, but getting into my 40s, I thought I should do something about it.”

Once he had the surgery, he noticed the difference in his diet.

“I could eat a whole pizza for lunch, but now, I have a slice of pizza maybe once a month. I just know the volume of breads, starches and carbs that I consumed was a vast amount, and now, it’s 10 percent of what I used to eat.”

The reaction he gets from ex-teammates and friends is one of amazement, and concern.

“The first thing people ask me, is ‘Jovo, are you sick?’” he chuckled. “Normally you don’t see a lineman drop that much weight. I know it is a cause for concern for some O-linemen, because most of the guys I played with are now in their late 40ss.”

While he doesn’t recommend the surgery for everyone, he says, the numbers show that, for him, it’s a success.

“When I stepped on the scale prior to the surgery, I was 348 pounds and today, I’m about 257,” he said. “My waist size went from 50 to 40.”