Rates of Obesity are on the Rise

The global obesity rate has nearly doubled since 1980, and there are now over 200Screen Shot 2017-09-27 at 11.51.03 AM million obese men and nearly 300 million obese women, according to the Harvard School of Public Health. In the United States, more than one third of adults (or 78.6 million people) are obese, according to the Centers for Disease Control and Prevention (CDC).

Obesity is usually defined by using a ratio of height to weight called body mass index (BMI), which usually correlates with a person’s level of body fat. According to the CDC, an adult with a BMI of 30 or higher is considered obese.

At a fundamental level, obesity occurs when people regularly eat more calories than they burn, but actually a number of factors can contribute to obesity, including:

  • lack of physical activity
  • lack of sleep
  • genetics and certain medications that slow calorie burn, increase appetite, or cause water retention, such as corticosteroids, antidepressants, or some seizure medications

Modern culture, conveniences, and other environmental factors also, in part, contribute to obesity. According to the National Heart, Lung, and Blood Institute, environmental factors that promote obesity include:

  • oversized food portions
  • busy work schedules that don’t allow for physical activity
  • lack of access to healthy foods at supermarkets
  • lack of safe places for physical activity

Because friends share similar environments and carry out activities together that may contribute to weight gain, obesity has also been found to “spread” socially among friends according to a 2011 study published in the American Journal of Public Health.

Certain health conditions also can lead to weight gain, including:

  • Hypothyroidism — an underactive thyroid gland that slows metabolism and causes fatigue and weakness
  • PCOS, or polycystic ovarian syndrome — which affects up to 10 percent of women of childbearing age and can also lead to excess body hair and reproductive problems
  • Cushing’s syndrome — which stems from an overproduction of the hormone cortisol by the adrenal glands and is characterized by weight gain in the upper body, face and neck
  • Prader-Willi syndrome– a rare condition in which people never feel full, and so they want to eat constantly, according to the Mayo Clinic

Although there are lots of fad diets, such short-term dietary changes are not the best way to maintain a healthy weight, the CDC says. Instead, 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 percent of your total body weight – can have health benefits, the CDC says.

For people who are still severely obese after attempting to lose weight through diet and exercise, other treatments, such as bariatric surgery, may be an option. Bariatric surgery is recommended for people with a BMI of 40 or more, or if they have a serious health problem related to their obesity and have a BMI of 35 or more. In many cases, people with a BMI of 30 or more are eligible for one type of bariatric surgery if they also have at least one health problem linked with obesity.

If you’re struggling with obesity and live in the Las Vegas area, schedule an appointment with VIP Surg. Our experts can help find the right treatment for you.

 

Advertisements

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

 

Gastric Bypass for a Longer Life

According to research by the Geisinger Health System, one of the largest health service organizations in the U.S., patients with severe obesity who have gastric bypass surgery reduce their risk of dying from obesity and other diseases by 48% up to 10 years after surgery, compared to similar patients who do not undergo the procedure. This is significant considering that the American Society for Metabolic and Bariatric Surgery estimates about 24 million Americans have severe obesity, which would mean a BMI of 35 or more with an obesity-related condition like diabetes or a BMI of 40.

Researchers from the Geisinger Health System followed nearly 2,700 patients who had gastric bypass at the system’s nationally accredited bariatric surgery center between 2004 and 2014. Mortality benefits began to emerge within two years after surgery and were significant within four years. The biggest reduction in risk occurred in patients 60 years or older at the time of surgery and in patients who had diabetes before surgery.

“The long-term survival benefits these older patients and those with diabetes experience likely relate to improvements in long-term metabolic and cardiovascular health, among other risk factors,” said Michelle R. Lent, Ph.D., a Geisinger Obesity Institute researcher. “While this study did not evaluate specific-cause mortality, as expected, we did find significant improvements or remission in diabetes and high blood pressure.”

In the study, more than 60 percent of patients with diabetes before surgery experienced diabetes remission about five years after surgery. Previous studies have shown death from heart disease and even certain cancers are lower in gastric bypass patients than patients with severe obesity who do not have the operation.

People with obesity and severe obesity have higher rates of heart disease, diabetes, some cancers, arthritis, sleep apnea, high blood pressure and dozens of other diseases and conditions. Studies have shown individuals with a BMI greater than 30 have a 50 to 100 percent greater risk of premature death compared to healthy weight individuals.Live Longer

If you live in the Las Vegas area and are interested in learning what bariatric surgery can do for you, schedule an appointment with Dr. Shawn Tsuda. He and his team of experts can help you choose the best treatment for your unique situation.

 

Obesity: The Disease that Keeps on Growing

A number of studies have shown that individuals who are obese are often stereotyped as “lazy” or “lacking in willpower.” However, obesity is no longer considered a cosmetic issue that is caused by overeating and a lack of self-control. The World Health Organization (W.H.O.), along with National and International medical and scientific societies, now recognize obesity as a chronic progressive disease resulting from multiple environmental and genetic factors.

In the United States, epidemiological data from a study that measured the actual body size of thousands of Americans, showed that 34 percent of adults more than 20 years old are affected by obesity and 68 percent are overweight (2007-2008 data). Obesity affected 10 percent of children between two and five years of age, 2 percent of those between 6 to 11 years old, and 18 percent of adolescents.

Throughout the last 3 decades, the prevalence of obesity has been increasing at an alarming rate. Since 1985, the Center for Disease Control (CDC) has supported an ongoing study, conducted on a yearly basis by state health departments, to examine changes in obesity prevalence state-to-state, and has found the following:

  • In 1990, the obesity prevalence for most of the states was 10 percent or less.
  • By 1995, more than half the states had a prevalence of 15 percent.
  • By 2000, nearly half the states had a prevalence of 20 percent or higher.
  • Five years later (2005), all but three states had a prevalence greater than 20 percent and nearly a third had a prevalence of 25 percent or more.
  • By 2010, the data show that most of U.S. states had a prevalence of 25 percent and many had a prevalence of 30 percent or higher.

Obesity is considered a multifactorial disease with a strong genetic component. Acting upon a genetic background are a number of hormonal, metabolic, psychological, cultural and behavioral factors that promote fat accumulation and weight gain.

Many other conditions associated with obesity contribute to the progression of the AdobeStock_69574863 (2).jpgdisease. Obesity reduces mobility and the number of calories that would be burned in the performance of activity. Weight gain may also cause psychological or emotional distress which, in turn, produces hormonal changes that may cause further weight gain by stimulating appetite and by increasing fat uptake into fat storage depots.

Sleep duration is reduced by weight gain due to a number of conditions that impair sleep quality such as pain, sleep apnea and other breathing problems, a need to urinate more frequently, use of certain medications, and altered regulation of body temperature. Shortened sleep duration, in turn, produces certain hormones that both stimulate appetite and increase the uptake of fat into fat storage depots.

Weight gain also contributes to the development of other diseases such as hypertension, diabetes, heart disease, osteoarthritis and depression, and these conditions are often treated with medications that contribute to even further weight gain. In all of these ways and more, obesity ’begets’ obesity, trapping the individual in a vicious weight gain cycle.

Multiple factors acting upon a genetic background cause weight gain and obesity. Conditions associated with weight gain and biological changes in the body that occur as a result of weight gain contribute to progression of the disease, often trapping the individual in a vicious weight gain cycle. Obesity is a complex disease influenced by several issues, including genetic, physiological, environmental, and behavioral.

If you live in the Las Vegas area and are concerned about your weight, schedule an appointment with Dr. Shawn Tsuda to learn more about how to improve your weight and health.

 

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.

AdobeStock_125554661.jpeg

 

Weighty Misperceptions

People generally assume that obesity is strictly a matter of personal choices, the product of bad choices about physical activity and diet. That kind of thinking gets in the way of actually dealing with obesity as a health condition.

Obesity is a very complicated condition. About 50 to 70% of one’s risk of obesity is genetically determined. You can make choices that make it better or worse, but that’s just like any other chronic disease. When the blame and shame that is so common gets in the way, it makes it hard to actually improve the health of people living with obesity.

A lot of health plans have had broad, blanket exclusions for obesity, thinking that it is a cosmetic condition. However, the rise in the prevalence of obesity that’s happened over the last 3 decades has made it clear that it’s creating a burden of chronic disease ranging from cardiovascular disease to diabetes to many cancers.

Because weight-based stereotypes and prejudice so often emerge from attributions that obesity is caused and maintained by personal characteristics such as laziness or lack of willpower, there is a clear need for increased public awareness and education about the complex biology of obesity and the significant obstacles present in efforts to achieve sustainable weight loss. The prevailing societal and media messages that reinforce blame on obese persons need to be replaced with messages that obesity is a chronic disease with a complex etiology, and is a lifelong condition for most obese persons.

A number of studies have consistently demonstrated that experiencing weight stigma a fat man with a big belly holding scalesincreases the likelihood of engaging in unhealthy eating behaviors and lower levels of physical activity, both of which exacerbate obesity and weight gain. Among youths, several studies have demonstrated that overweight children who experience weight-based teasing are more likely to engage in binge-eating and unhealthy weight control behaviors compared with overweight peers who are not teased, even after control for variables such as BMI and socioeconomic status. Other research has consistently documented a positive association between weight-based victimization and eating disorder symptoms and bulimia. Weight-based victimization among overweight youths has been linked to lower levels of physical activity, negative attitudes about sports, and lower participation in physical activity among overweight students.

If you’re looking for treatment for this very real, physical disease, contact Dr. Shawn Tsuda for an appointment. Our expert team understands the complexity of obesity and all of the issues that come with it. We can help find the right treatment for you.