Aging and Obesity: Is Bariatric Surgery an Option for the Elderly Patient?

The good news is that improved life expectancy is allowing baby boomers to enter their golden years in unprecedented numbers. The bad news is that rates of obesity among this aging demographic are climbing in never-before-seen numbers as well, putting this population at risk of developing cancer, heart disease, diabetes, lower extremity arthritis, sleep apnea, and stroke, all of which can lead to disability. Treatment guidelines to lose weight in the elderly have been difficult to define, yet it is very clear that obesity in the elderly contributes to worsening of multiple parameters which along with the metabolic problems mentioned already, include cognition, functionality and quality of life. While ample evidence supports the safety and effectiveness of weight-loss aka bariatric surgery in the general adult population, more information is needed in patients age 60 years and older.

Surgical treatment of obesity in the elderly, particularly over 65, remains controversial; this is explained by the increased surgical risk or the lack of data demonstrating its long-term benefit. Few studies have evaluated the clinical effects of bariatric surgery in this population.

The risk of any surgical intervention increases as one gets older. However, weight-loss surgery is very safe, and the potential benefits routinely outweigh any of the associated risks if there are no other health issues that would dramatically increase the risk of surgery.

Ideally, a comprehensive assessment would focus on psychosocial and functional status in addition to physical data. An excellent support system of family, friends, or caregiver resources is imperative. The selected patient should be capable of engaging in physical interventions focusing on mitigating muscle loss and osteoporosis and of maintaining changes in eating behavior as needed as well. A recommended “pre-habilitation” program may include a physical therapist to assist with strength and endurance training and a nutritionist to aide in enhancing protein intake, vitamin D, and other nutrient sufficiency.

Identifying goals of care, quality of life, and improved function should be considered as primary objectives of undergoing surgery. Goals of the surgery include not only weight loss but also improvements in physiological function, comorbidity, and quality of life, and reduction in institutionalization.

If you live in the Las Vegas area and are considering bariatric surgery, VIPSurg is here to help. Dr. Tsuda and his team of experts can find the best treatment for your unique situation.

Old obese woman walking with stick

 

 

 

Stats Don’t Lie: Learn How Bariatric Surgery is Helping Hundreds of Thousands of People Regain Their Health

In the early nineties, fewer than twenty thousand bariatric surgeries were performed in the U.S. each year. Now the number is around two hundred thousand. Only in the past few years has what was once considered a high-risk and extreme measure been transformed into a relatively standard, safe, and straightforward one. There is strong consensus that bariatric surgery is effective, and Medicaid now covers it in forty-eight states. 

Research into conventional weight-loss methods has repeatedly pointed to an overwhelmingly dispiriting conclusion—that diet and exercise alone, no matter how disciplined the individual, fail all too often. Still, only about one per cent of those who medically qualify for bariatric surgery get it. 

Over the centuries, suggested strategies for losing weight have included bitter tonics, bleeding, sea air, amphetamines, Turkish baths, tapeworms, purgatives, low-fat diets, high-fat diets, cinnamon, more sleep, less sleep, and the “vigorous massage of the body with pea-flour.” Surgery is an old idea, too. One of the earliest surgical approaches to weight loss, dating back at least a millennium, was simple: the jaw was wired mostly shut. Another story from pre-anesthesia days tells of a rabbi “being given a sleeping potion and taken into a marble chamber, where his abdomen was opened, and many baskets of fat were removed.”

But the health risks associated with obesity have become apparent—higher rates of stroke and heart disease, Type 2 diabetes, infertility, sleep apnea, osteoarthritis, and an increased risk of certain cancers. In addition, bariatric procedures have improved dramatically. 

Robotic surgery and laparoscopy, which became the norm in the past decade, result in fewer complications like hernias. Physicians now have a better sense of how to prevent and treat the complications of surgery. 

As recently as seventeen years ago, there was a one-per-cent chance of dying from a bariatric procedure—a relatively high risk. Now it is 0.15 percent, which is less than that for a knee replacement, a procedure commonly recommended to people who have developed joint problems from carrying around excessive weight.

Around seventy-five per cent of bariatric patients have sustained weight loss five years after their surgery, and that percentage is higher if you don’t include lap-band patients in the analysis. Weight loss through diet and exercise rarely leads to more than short-term changes—a quite small percentage of patients see sustained weight loss. 

Today, obesity is second only to tobacco as a killer in this country. If you live in the Las Vegas area and are seeking long-term weight loss and health benefits, schedule an appointment at VIPSurg. We will help you find the best treatment for your unique situation.

Doctor examining  patient obesity on light background

Life After Bariatric Surgery

For many who think weight-loss surgery may be the only way to be healthy and live longer, the fear of how life might be after the procedure keeps them from taking life-saving measures. Be informed so that you can make educated decisions about your health. These facts can help you on the way to knowing what’s best for you and give you a glimpse into what one can usually expect after surgery.

Your recovery will depend on which procedure you choose (gastric sleeve, gastric bypass, lap-band, and duodenal switch surgery). For example:

  • Average Hospital Stay: Ranges from outpatient (return home same-day) to 2-3 days
  • Average Time Until Back to Work: Ranges from 3 days to 2 weeks
  • Average Time to Full Recovery: Ranges from 3 days to 6 weeks
  • Pain: Ranges from mild discomfort to manageable with pain medication
  • Diet: Ranges from a few limited foods to a strict and slow transition from clear liquids to solid foods
  • Back-to-Normal Activity: Ranges from 3 days to 4-6 weeks

Life after weight loss surgery includes (depending on your chosen procedure):

  • Full recovery in 1 to 6 weeks
  • Excess weight loss between 25% and 90+%
  • Many obesity-related health problems cured or improved
  • Significant diet and exercise changes
  • Good and bad changes in how friends, family, and strangers treat you
  • Challenges such as sagging skin, digestion issues, and weight regain

Improvements to your physical health can be as impressive as your rapid weight loss family-eating-at-the-table-619142_1920after bariatric surgery. Conditions such as Type 2 Diabetes, high blood pressure, GERD, and other issues related to metabolic syndrome have been shown to get better or completely go away following gastric sleeve, gastric bypass, lap-band, and duodenal switch surgery.

It is important to emphasize making healthy food and lifestyle choices even before weight-loss surgical procedures. Bariatric surgery is a tool. Use it to make changes for a long, healthy, productive, and happy life.

If you live in the Las Vegas area and are considering bariatric surgery, schedule an appointment at VIPSurg. Our team can help find the perfect treatment for you!

Bariatric Surgery: Busting the Myths and Misconceptions

Weight-loss surgery is a potentially life-saving procedure that helps you lose a substantial amount of weight by shrinking the size of your stomach and reducing food intake. Gastric bypass, lap band, and gastric sleeve are the three most recognizable names in bariatric surgery, but there are also a variety of other options thanks to continued medical advancements. Still, there remains a significant portion of the morbidly obese population who are unwilling to consider treatment for a variety of reasons; unfortunately, their reasons are often based on misconceptions or myths related to bariatric procedures.

Let’s bust 3 common weight-loss surgery myths:

Myth: Most bariatric surgery patients regain most if not all of their lost weight.Truth Vs Myth Bowling Facts Investigating Busting Untruth

Truth: Although some weight-loss surgery patients regain weight after their procedure, it’s not the norm. According to the American Society for Metabolic and Bariatric Surgery, up to 50% of patients may regain a small amount of weight in the years after surgery, but it usually only amounts to 5% of weight lost. Most patients embrace the life-changing effects of weight-loss surgery by improving their diets and habits.

Myth: The risks of weight-loss surgery outweigh the risks of obesity.

Truth: Weight-loss surgery is a quite safe procedure. Studies show that bariatric surgery patients reduce their mortality rates by up to 89% compared with severely obese people who avoid treatment.

Obesity is a disease linked with a number of serious health conditions including heart disease, stroke, diabetes, high blood pressure, and cancer. The National Institutes of Health lists obesity as the second leading cause of preventable death in the United States.

Myth: Weight-loss surgery is nothing more than a cop out for people who are too lazy to diet and exercise.

Truth: Those affected by severe obesity are resistant to long-term weight loss by diet and exercise. The National Institutes of Health Experts Panel recognizes that sustained weight loss is nearly impossible for those affected by severe obesity and may only be achievable through bariatric surgery. Diet, exercise, and lifestyle changes are part of treatment, but in order to shed the necessary amount of weight to make a life-changing, healthful impact, bariatric surgery may be the best option.

If you are struggling with severe obesity and are considering surgery, schedule a consultation at VIPSurg. Our team of experts will look at your personal situation and help find the right treatment for you.

 

 

 

Defining Obesity

To define what obesity means today, we can’t count on a dictionary. However, since obesity has become a growing national health problem in the U.S., it has perhaps never been more important that we have a working definition that we can all agree on.

In order to understand how someone is categorized as overweight or obese, the world’s health organizations have adopted the use of body mass index (BMI) to classify and communicate about body weight. BMI is a widely recognized weight-for-height index.

Unfortunately, this index does not quantify total body fat or convey information concerning regional distribution of fat — both of which are key to how obesity affects health. Nonetheless, BMI is an easily obtained measure that has been recommended for use in all age groups. Most clinical studies assessing the health effects of overweight and obesity rely on BMI.

Currently, the National Institutes of Health and the World Health Organization use the same measures of BMI for defining overweight. obese-3011213__340 (2)

  • If BMI is 25.0 to <30, it falls within the overweight range.
  • If BMI is 30.0 or higher, it falls within the obese range.

Since BMI describes body weight relative to height, it correlates strongly (in adults) with total body fat content. However, some very muscular people may have a high BMI without undue health risks.

Obesity is often from a combination of factors, based on both genetics and behavior. Accordingly, treating obesity usually requires more than just dietary changes.

Being overweight is a significant contributor to health problems. It increases the risk of developing a number of diseases including:

  • Type 2 diabetes
  • High blood pressure
  • Stroke
  • Heart attack
  • Congestive heart failure
  • Cancer (certain forms such as cancer of the prostate and cancer of the colon and rectum)
  • Gallstones and gall bladder disease
  • Gout and arthritis
  • Osteoarthritis (degenerative arthritis) of the knees, hips, and the lower back
  • Sleep apnea

Ideally, health-oriented definitions of overweight and obesity should be used that are based on the amount of excess body fat that puts an individual at a higher risk for health problems. Unfortunately, no such definition currently exists. Health risks associated with increasing weight are part of a continuum. People can have weight-associated health problems at BMIs lower than 25, and others can have no identifiable health problems at BMIs significantly greater than 25.

Easily determine your BMI with this free calculator: http://bit.ly/1D0ZqDv.

If you’re interested in bariatric surgery, schedule an appointment with us. Our team of experts can find the right treatment for you.
 

Bariatric Surgery: Impacting High Blood Pressure Through More Than Weight Loss

According to the Centers for Disease Control, about one in three U.S. adults has high blood pressure (hypertension). Risks include family history, advancing age, poor diet, consuming excessive amounts of alcohol, and being overweight or obese.

Lifestyle changes are a big part of controlling high blood pressure. The main tenets include:

  • Following a healthy diet, which may include reducing salt. The DASH (Dietary Approaches to Stop Hypertension) diet is often recommended. In addition to lowering salt intake, DASH is replete with fruits, vegetables, and low-fat or nonfat dairy. The diet emphasizes whole grains and is rich in potassium, magnesium, calcium and fiber.
  • Exercising regularly.
  • Maintaining a healthy weight.
  • Keeping stress levels at bay. (Stress can cause us to engage in unhealthy blood pressure-raising behaviors.)
  • Drinking only moderate amounts of alcohol.
  • Taking your medications as prescribed.

There are many types of prescription medications that can help control blood pressure and reduce the risk of heart attack or stroke. These medications may need to be taken for life to maintain their effect.

New research is showing, however, that bariatric surgery can allow obese people taking a lot of antihypertensive medications to cut way back on them. Study subjects’ blood pressure was maintained in the normal range with only one agent or even without drugs.

Within a year, those in a recent trial who had bariatric surgery were more than six times as likely to have cut back on their number of blood pressure (BP) medications by hypertension-867855__340about a third. Half of the surgical patients didn’t need any antihypertensive meds to maintain their BP at healthy levels. On the other hand, all of the “standard-care” patients in the study needed antihypertensive medications to keep BP that low, and half of them needed at least three different ones.

Interestingly, most patients in the gastric-bypass group achieved the primary end point in the first month of the postop period. That seems to indicate that something more is happening beyond just weight loss.

That something is likely to be related, at least in part, to the metabolic changes in the surgery group compared with the control group, which included significant improvements in fasting plasma glucose, HbA1c, LDL cholesterol, triglycerides, and high-sensitivity C-reactive protein in addition to the lowering of blood pressure.

If you live in the Las Vegas area and are wondering if bariatric surgery might be right for you, schedule an appointment at VIP Surg. Dr. Tsuda and his team can help 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