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.

 

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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.

What you Need to Know about Protein

You probably know you need to eat protein, but what is it and where exactly do you find it? The answer is – everywhere – if you’re talking about the body. Proteins make up about 42% of the dry weight of our bodies. The protein collagen—which holds our skin, tendons, muscles, and bones together—makes up about a quarter of the body’s total protein. Protein builds, maintains, and replaces the tissues in your body. Your muscles, your organs, and your immune system are made up mostly of protein. All of our cells and even blood are packed with protein molecules.

Proteins, along with fats and carbohydrates, are the macronutrients that form the basis of our diets. Once consumed, some people associate protein only with helping to build muscle, but keep in mind that’s not all it does for us. In our bodies, protein performs a range of duties, from building new cells to regulating metabolism to helping cells communicate. Proteins help shuttle oxygen throughout the body in the form of hemoglobin, as well as build muscle.

When you eat foods that contain protein, the digestive juices in your stomach and intestine go to work. They break down the protein in food into basic units, called amino acids. The amino acids then can be reused to make the proteins your body needs to maintain muscles, bones, blood, and body organs.

Amino acids are the building blocks of proteins. Our DNA directs the body to join various combinations of amino acids into a variety of sequences and three-dimensional shapes for an arsenal of over 2 million different proteins, each serving a unique function. Our bodies can make some of these amino acids, but there are nine that are considered “essential amino acids” because we must consume these through our diet.

Many foods contain protein, but the best sources are:

  • Beef
  • Poultry
  • Fish
  • Eggs
  • dairy products
  • Nuts
  • Seeds
  • legumes like black beans and lentils

While our bodies can store fats and carbohydrates to draw on when needed, we do not have a storage pool of amino acids. We need a fresh source each day in order to build the body proteins we need. If the body is missing a particular amino acid to form the protein it needs, it will pull that amino acid by breaking down existing muscle protein. If we consistently lack certain amino acids we will lose muscle weight, energy and, eventually, fundamental functions.

The amount of protein you need depends on your weight and health. The Recommended Daily Allowance (RDA) for protein for the healthy individual is 0.8 grams of protein per kilogram of body weight or 3 to 4 grams per 10 pounds, and two to three servings of protein-rich food will meet the daily needs of most adults. Athlete’s protein intake recommendations may be higher.

The good news is that you don’t have to eat all the essential amino acids in every meal. As long as you have a variety of protein sources throughout the day, your body will grab what it needs from each meal.

You can look at a food label to find out how many protein grams are in a serving, but if you’re eating a balanced diet, you don’t need to keep track of it. It’s pretty easy to get enough protein.

*Dr. Shawn Tsuda is a General Surgeon specializing in robotic bariatric surgery. Schedule a consultation to learn more.
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Get the Facts about Bariatric Surgery

Bariatric surgery is an option that many obesity medicine specialists say is too often ignored or dismissed. Yet it is the only option that almost always works to help very heavy people lose a lot of weight. Weight-loss surgery can also make some chronic conditions vanish entirely.

Here are some facts about bariatric surgery and what it does:

  • Twenty-four million, Americans are eligible for bariatric surgery according to the American Society for Metabolic and Bariatric Surgery. The criteria are a body mass index (BMI) above 40, or a BMI of at least 35 along with other medical conditions like diabetes, hypertension, sleep apnea, or acid reflux.
  • Fewer than 200,000 have the surgery each year.
  • There are four surgical types in use today. The two most popular procedures are the Roux-en-Y gastric bypass and the gastric sleeve. Both make the stomach smaller. The bypass also reroutes the small intestine. A simpler procedure, the gastric band, is less effective and has fallen out of favor. And a much more drastic operation, the biliopancreatic diversion with duodenal switch, which bypasses a large part of the small intestine, is rarely used because it has higher mortality and complication rates.
  • The average cost of a sleeve gastrectomy is $16,000 to $19,000, and the average cost of a gastric bypass is $20,000 to $25,000. Most insurance plans cover the cost for patients who qualify, though some plans require that patients try dieting for a certain amount of time first.
  • Bariatric surgery is not a magic bullet that will solve all of your weight-related problems. Leading a healthy lifestyle full of healthy foods and exercise post surgery is crucial.

If you live in the Las Vegas area, have a BMI above 40 or any of the other conditions mentioned above, schedule a consultation with Dr. Shawn Tsuda. He and his expert team can help you find the treatment that’s right for you.

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The Decision that will Change your Life

Weight-loss surgery is a major, permanent life change. Most people don’t even consider it if they haven’t exhausted all of their other options. As a matter of fact, many people research weight-loss surgery for years and never take action. Whether it is fear of a drastic life change or fear of failure, making this choice could be a matter of life and death.

The truth is, bariatric treatment could drastically improve the health, happiness, and lifespan for the over 18 million Americans who currently qualify. If you are one of them, and you’re hesitating to have the surgery, here are some things to consider:

Why are you considering bariatric surgery? Freeway Sign - Decision - Yes or No

  • Obesity-related health problems
  • Depression
  • Out of breath quickly
  • Obesity discrimination
  • Relationship problems
  • Poor self-image
  • Failed diet and exercise programs

If you and your bariatric doctors decide that surgery makes sense for you, be prepared to do a lot of work both before surgery and for the rest of your life. Bariatric surgery should be thought of as one of the most effective tools available, but in order to succeed you must be ready to completely change your life.

According to the National Institutes of Health guidelines, you could be a good candidate for bariatric treatment if one of the following applies…

  • You have a body mass index (BMI) of 40 or more (“morbidly obese” or “super obese”), or
  • Your BMI is between 35 and 39.9 (“severely obese”) and you have a serious obesity-related health problem.

As mentioned above, bariatric treatment may be the best tool to make you happier and healthier, but that’s all it is — a tool. You will be the key to making it successful.

If you would like to talk to a doctor to see if bariatric surgery is a good option for you. Schedule a consultation with Dr. Shawn Tsuda. He and his teams of experts can help you make the right decision for you.

Bariatric Surgery and Maintaining Weight Loss

Weight-loss surgery helps people drop a significant amount of weight, but can patients maintain their weight loss? A new study confirms that much of the weight appears to stay off for at least 10 years.

This study suggests that patients interested in bariatric surgery, especially gastric bypass surgery, should be able to lose a significant amount of weight and keep that weight off for a very long time. While other research has found that weight-loss surgery is the most effective treatment for obese patients, there is less data on long-lasting effects. That’s what makes this new study exciting – because of a decade-long follow-up.

Gastric bypass surgery involves making the stomach smaller, and attaching the lower part of the small intestine directly to the stomach, so much of the small intestine is bypassed. After surgery, people feel much fuller, faster. The surgery also appears to alter gut hormones, gut bacteria and metabolism, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

Weight Loss SurgeryAt the study’s one-year mark, those who had the bypass had lost 31 percent of their starting weight, but the non-surgical patients had lost just 1 percent. At 10 years, the researchers had weight information on 564 of the nearly 1,800 patients who had the gastric bypass. Only 19 of them had regained so much weight that they were nearly back to their starting weight; the rest kept off the weight. Compared to the non-surgical group, the bypass group weighed 21 percent less than at the start of the study.
Next, the researchers compared three types of weight-loss surgeries: gastric bypass; sleeve gastrectomy; and adjustable gastric banding. As with gastric bypass surgery, both of these procedures leave people feeling full faster.

After four years, those who had gastric bypass lost nearly 28 percent of their starting weight. People who had sleeve gastrectomy lost about 18 percent and those with gastric banding lost about 11 percent, the researchers found.

Weight-loss surgery is not a “cure” for obesity. Losing weight and maintaining the loss require commitment and lifestyle changes. If you live in the Las Vegas area and are interested in learning whether bariatric surgery is a good option for you, schedule an appointment with Dr. Shawn Tsuda.

Preparing for Bariatric Surgery

One of the most common questions patients ask when they begin their weight-loss journey is, “Why do I have to wait to get bariatric surgery?” The answer is more complicated than they think at first, but ultimately they understand how important laying the groundwork can be maximizing their chances for success.

The first part of the answer has to do with your insurance company. Most insurance plans mandate that patients spend anywhere from three to six months undergoing medically supervised weight loss before they will be approved for surgery. The rationale the insurance companies use is that they want to ensure the patients are dedicated to losing weight before the insurance company assumes the significant cost of weight loss surgery.

The second part of the answer has to do with what is best for the patient and what helps the patient’s chances of being successful long-term with weight loss surgery. It takes a while to get used to eating healthily. Eating small meals frequently helps patients get used to life after surgery because all of the operations involve limiting how much food patients can eat. Small, frequent meals mean you are eating before you get hungry and minimizes the risk of overeating. Overeating after surgery almost invariably leads to pain and/ or vomiting. Learning how to eat right takes practice.

The third part of the answer deals with physical conditioning. Many patients are not in good physical shape when they start. Improving physical conditioning before surgery helps patients recover more quickly and with fewer problems after the operation.

The final piece of the weight loss puzzle relates to the emotional issues related to overeating. A common misconception is that the operation will fix all of the problems obese patients have. Patients must prepare emotionally for their upcoming operation. It is a lifestyle change patients are undergoing, and making sure patients understand what changes will occur after surgery is vitally important. Building the foundation for a lifestyle change starts before the operation, and that foundation-building takes a little time.

If you live in the Las Vegas area and are considering bariatric surgery, schedule a consultation with Dr. Shawn Tsuda. He and his expert team can help you find the right treatment.

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