Overcoming Genetics with Bariatric Surgery

Many of us have struggled with our weight. Whether it’s those 30 pounds of baby weight that have stubbornly hung around long after the baby was born or the 50 pounds gained after a back injury, weight gain is for many a constant struggle and a sensitive subject.

However, inactivity and poor diet are not the only causes of obesity. Research estimates that genetics determines at least 40 to 50 percent of our weight. Unfortunately, the specific genes are not well understood.

How can one overcome genetics? If everyone in your family is heavy, isn’t it a foregone conclusion that you will be heavy also? Not necessarily. Fortunately, we can level the genetics playing field with weight-loss surgery.

The most popular weight loss procedure in the United States is the laparoscopic sleeve gastrectomy. The surgery is minimally invasive, takes about an hour and requires an overnight stay in the hospital for most patients. The stomach, which regularly can hold about the volume of a football, is stapled and divided so that it is the shape and size of a banana.

Weight loss is achieved because the patient can no longer eat a large volume of food, and calories are proportionately decreased. The pylorus, the muscular valve at the outlet of the stomach, is left intact in this surgery. This also helps patients who have this procedure stay full.

Besides the effects of the procedure on restricting food volume, there is increasing evidence that the mechanisms in the brain that cause hunger are permanently modified by the sleeve gastrectomy. People state that they no longer feel hungry and no longer crave some of the high-calorie foods they used to.

Weight-loss surgery is a powerful tool in the hands of the patient, but it is not an “easyfix.” Sleeve gastrectomy requires commitment to healthy food choices and exercise on the part of the patient. The exciting news is that those struggling with obesity are not doomed to a life of aches and pains, poor health, and a miserable quality of life. There is help, and there is hope.

If you are in the Las Vegas area and are considering bariatric surgery, schedule an appointment with VIP Surg. Dr. Tsuda, Dr. Ryan, and their expert team can help find the right treatment for you.

Overweight Woman is Overjoyed

 

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Robotic Surgery Explained

Screen Shot 2017-10-10 at 12.35.38 PMRobotic surgery is a type of minimally invasive surgery. “Minimally invasive” means that instead of operating on patients through large incisions, we use miniaturized surgical instruments that fit through a series of quarter-inch incisions. When performing surgery with the da Vinci Si—the world’s most advanced surgical robot—these miniaturized instruments are mounted on three separate robotic arms, allowing the surgeon maximum range of motion and precision. The da Vinci’s fourth arm contains a magnified high-definition 3-D camera that guides the surgeon during the procedure.

The surgeon controls these instruments and the camera from a console located in the operating room. Placing his fingers into the master controls, he is able to operate all four arms of the da Vinci simultaneously while looking through a stereoscopic high-definition monitor that literally places him inside the patient, giving him a better, more detailed 3-D view of the operating site than the human eye can provide. Every movement he makes with the master controls is replicated precisely by the robot. When necessary, the surgeon can even change the scale of the robot’s movements: If he selects a three-to-one scale, the tip of the robot’s arm will move just one inch for every three inches the surgeon’s hand moves. And because of the console’s design, the surgeon’s eyes and hands are always perfectly aligned with his view of the surgical site, minimizing surgeon fatigue.

The ultimate effect is to give the surgeon unprecedented control in a minimally invasive environment. Utilizing this advanced technology, surgeons are able to perform a growing number of complex surgical procedures. Since these procedures can now be performed through very small incisions, patients experience a number of benefits compared to open surgery, including:

  • Less trauma on the body
  • Minimal scarring
  • Faster recovery times

If you’re facing general or bariatric surgery in the Las Vegas area, contact VIP SURG to learn about how we can help. Drs. Tsuda and Ryan specialize in minimally invasive procedures and are experts in robotic surgery. Call for a consultation at 702-487-6000.

Is Obesity a Disease?

Whether or not obesity should be considered a disease is a matter of debate. In 2013, the American Medical Association, the nation’s largest group of physicians, voted to recognize obesity as a disease. The decision was controversial to say the least.

The decision was meant to improve access to weight loss treatment, reduce the stigma of obesity, and underscore the fact that obesity is not always a matter of self-control. Others argue that calling obesity a disease automatically categorizes a large portion of Americans as “sick,” when they may not be. Instead, critics say obesity should be considered a risk factor for many diseases, but not a disease in and of itself.

Experts on one side of the issue say obesity, like alcoholism, depression, and anxiety, is a disease. There are definite medical patterns: hormone imbalances, neurotransmitter deficiencies, and nutritional exhaustion that all contribute to obesity. Many patients that are obese have underlying medical issues that need to be addressed.

On the other hand, with more than one third of the American population presently classified as obese, it is clear that there are many causes for excessive fat accumulation like genetic issues, too little exercise/physical activity, too much food, inappropriate food selection, eating while watching television, etc. In many cases, obesity is the result of a specific lifestyle which can typically be reversed (at least in the short term) by adopting a different lifestyle.

Obesity increases the risk of developing a number of serious health conditions, including:

  • Coronary heart disease
  • High blood pressure
  • Stroke
  • Type 2 diabetes
  • Cancer
  • Sleep apnea
  • Gallstones
  • Osteoarthritis
  • Infertility or irregular periods

The Center for Disease Control (CDC) says people should aim to make long-term changes, such as eating healthy on a regular basis, and boosting daily physical activity. Even small amounts of weight loss — such as 5% to 10% of your total body weight – can have health benefits.

For some, obesity as a disease invalidates the importance of discipline, proper nutrition, and exercise and enables individuals with obesity to escape responsibility. For others, obesity as a disease is a bridge to additional research, coordination of effective treatment, and increased resources for weight loss.

Ultimately, obesity is a complex entity that can have many causes; some are endocrine (like thyroid malfunction or hyperfunctioning of the adrenal gland or Cushing’s syndrome), but often the condition is from a combination of inactivity and overeating. For others, there are genetic factors that produce a tendency to be overweight even with the consumption of what would be for most people an appropriate number of calories. Whether the causes are hormonal, genetic, or reside in the brain is often difficult to determine.

If you’re in the Las Vegas area and looking for treatment for obesity and the life-threatening conditions that often accompany it, schedule an appointment with VIP Surg. Our experts can help you find the right treatment for your unique situation.

Bariatric Surgery Found to Help COPD

According to estimates, 6% of American adults have chronic obstructive pulmonary disease (COPD), and 35% of those COPD patients are considered obese. In addition to being common among COPD patients, studies have also suggested that obesity leads to a higher risk of acute exacerbations, indicating that obesity may be a risk factor. Now a U.S. study suggests that obese people with COPD who get weight loss surgery may go to the hospital less often with acute breathing problems after their operations. The study found that among obese adults with COPD, those who had bariatric surgery to lose weight, needed to go to the emergency room or have inpatient care half as often as before surgery.

The researchers examined data on 481 obese adults aged 40 to 65 who had COPD and underwent bariatric surgery in California, Florida and Nebraska. They followed patients from 2005 through 2011 to see how hospital and emergency room visits for COPD in the two years before weight loss surgery compared to the two years afterwards.

At the start of the study, when patients were 13 to 24 months away from getting their operations, 28 percent of them had an emergency department (ED) or hospital visit for acute COPD symptoms, researchers report in Chest. During the second year of the study, the 12 months right before surgery, these rates didn’t change much, but compared with that first year of the study, the chances of an ED or hospital visit dropped by 65 percentin the first year after bariatric surgery. Just 12 percent of patients had a COPD visit during that time. During the last year of the study, 13 to 24 months after surgery, the odds of an ED or hospital visit were 61 percent lower than in the first year of the study. These findings suggest that benefits of bariatric surgery may extend beyond remission of chronic health problems associated with obesity to include COPD and other respiratory conditions.

If you are considering bariatric surgery in the Las Vegas area, schedule a consultation at VIP SURG. Our expert team can help you find the right treatment for your unique situation.

COPD Chronic obstructive pulmonary disease health medical concept

The True Size of the American Obesity Epidemic

To understand the true magnitude of the American obesity epidemic, we first need to understand what it really means to be overweight. Doctors and nutritionists classify people as either underweight, healthy weight, overweight, or obese. These different classifications are determined by body mass index (BMI), or a measure of body fat based on your height and weight.

To get a basic idea, this chart from the CDC approximates what that means for someone who is 5’9” tall.

Height Weight Range BMI Considered
Source: CDC      
5′ 9″ 124 lbs or less Below 18.5 Underweight
  125 lbs to 168 lbs 18.5 to 24.9 Healthy weight
  169 lbs to 202 lbs 25.0 to 29.9 Overweight
  203 lbs or more 30 or higher Obese

As for what is driving America’s chronic weight problem, there are no definite answers. Scientific studies often reach conflicting conclusions. Many theories are out there, but the preponderance of evidence points to the two causes most people already suspect: too much food and too little exercise.

Bigger portions, confusing “diet” for “nutrition,” and lack of exercise are a deadly combination. Today, each American puts away an average of 195lbs of meat every year, compared to just 138lbs in the 1950’s. Consumption of added fats also shot up by around two thirds over the same period, and grain consumption rose 45% since 1970.

Research published by the World Health Organization found that a rise in fast food sales correlated to a rise in body mass index, and Americans are notorious for their fast-food consumption. It is not just how much we eat, but what we eat.

The role of diet in the obesity epidemic is obviously major, but it’s also complex. Consumers are sent mixed messages when it comes to what to eat and how much. Larger portions, processed packaged food, and drive-thru meals are branded as almost classically American — fast, cheap, filling, and delicious, but yet we spend billions of dollars annually on weight loss schemes.

Lack of exercise is also a major culprit in the obesity epidemic. A far greater majority of us are sitting throughout our workday. According to one study, only 20% of today’s jobs require at least moderate physical activity, as opposed to 50% of jobs in 1960. Other research suggests Americans burn 120 to 140 fewer calories a day than they did 50 years ago. Add this to the higher number of calories we are packing in, and we get a perfect recipe for weight gain.

A number of other factors are thought to play a role in the obesity epidemic, such as the in- utero effects of smoking and excessive weight gain in pregnant mothers. Poor sleep, stress, and lower rates of breastfeeding are also thought to contribute to a child’s long-term obesity risk. Of course, these factors are not explicit or solitary causes of obesity, but they are reliable indicators of the kinds of systemic problems contributing to this crisis.

In the end, though, we can’t lose sight of the big picture. Over the past years, diet fads have come and gone, with people rushing to blame red meat, dairy, wheat, fat, sugar, etc. for making them fat, but in reality, the problem is much simpler. Genetics and age do strongly influence metabolism, but as the CDC points out, weight gain and loss is primarily a formula of total calories consumed versus total calories used.

If you are looking for answers to debilitating obesity and the health issues that often accompany the extra weight, contact VIP Surg at (702) 487-6006. We can help you find the right treatment for your unique situation.

A pair of female feet on a bathroom scale

Most Common Surgical Treatments for Clinically Severe Obesity

The obesity epidemic continues to grow in our country, and with obesity comes a whole host of additional health risks, like type 2 diabetes, heart disease, high blood pressure, osteoarthritis and stroke. Those looking to reduce these obesity-related health risks are turning to bariatric or medical weight-loss surgeries like gastric bypass.

With weight-loss surgery, your surgeon makes changes to your stomach or small intestine, or both. The procedure resolves diabetes 80 percent of the time, and patients lose an average of 70 percent of extra weight. However, gastric bypass isn’t the only choice. Learn about your options:

Laparoscopic Adjustable Gastric Band – The surgeon puts a small band around the top of your stomach. The band has a small balloon inside it that controls how tight or loose the band is. The band limits how much food can go into your stomach. This surgery is done using a laparoscope. Advantages include:

  • Minimally invasive with small incisions
  • Short hospital stay
  • Adjustable without additional surgery
  • Can support pregnancy
  • Removable at any time

Laparoscopic Gastric Sleeve – This surgery removes most of the stomach and leaves only a narrow section of the upper part of the stomach, called a gastric sleeve. The surgery may also curb the hunger hormone ghrelin, so you eat less. Advantages include:

  • No cutting, bypassing, or stapling of the intestine
  • Little concern about vitamin and calcium absorption
  • No adjustments or artificial devices put into place
  • Most foods are possible

Laparoscopic Roux-en-Y Gastric Bypass Surgery – The surgeon leaves only a very small part of the stomach (called the pouch). That pouch can’t hold a lot of food, so you eat less. The food you eat bypasses the rest of the stomach, going straight from the pouch to your small intestine. This surgery can often be done through several small incisions using a camera to see inside (laparoscope). Doctors can also perform a mini-gastric bypass, which is a similar procedure also done through a laparoscope. Advantages include:

  • Tiny incisions, resulting is less scarring and easier healing
  • Excellent cosmetic result
  • Little pain
  • Few wound complications
  • Fast recovery
  • Short hospital stay
  • Resuming physical activity soon
  • Little risk of hernia formation

Duodenal Switch- This is complicated surgery that removes most of the stomach and uses a gastric sleeve to bypass most of your small intestine. It limits how much you can eat. It also means your body doesn’t get as much of a chance to absorb nutrients from your food, which could mean you don’t get enough of the vitamins and minerals you need. Advantages include:

  • Results in greater weight loss than other methods, i.e. 60 – 70% percent excess weight loss or greater, at 5 year follow up
  • Allows patients to eventually eat near normal meals
  • Reduces the absorption of fat by 70 percent or more
  • Causes favorable changes in gut hormones to reduce appetite and improve satiety
  • Is the most effective against diabetes compared to other methods

If you’re considering bariatric surgery, schedule an appointment with Dr. Shawn Tsuda. He can help you decide which, if any, of these treatments is right for your unique situation.Fat man running