Article In Today's cecil Whig

Oct 13, 8:45 AM EDT Obesity Surgery Could Cure Diabetes By LINDSEY TANNER AP Medical Writer CHICAGO (AP) -- Patients who undergo obesity surgery get far more than cosmetic benefits - many also shed fat-related ailments including diabetes, high blood pressure and high cholesterol, researchers say. Their report - an analysis of 136 studies - suggests that in some cases, the drastic operations may alter the patient's body chemistry itself and relieve conditions that can lead to heart attacks, strokes and kidney failure. The analysis was funded by a Johnson & Johnson Co. subsidiary that develops and markets surgical instruments, including staplers for obesity surgery. But the results echo what many doctors have reported seeing. Diabetes was eliminated in nearly 77 percent of the affected patients; high blood pressure was eliminated in nearly 62 percent; cholesterol improved in at least 70 percent; and obstructive sleep apnea - episodes when breathing stops during sleep - disappeared in almost 86 percent. All four conditions are strongly linked to obesity and can have lethal consequences. While significant weight loss by diet, exercise or medication can have similar benefits, obesity surgery patients typically lose at least 30 percent of their body weight and keep it off long-term - results that are extremely difficult to achieve with other methods, said Dr. Samuel Klein, a Washington University obesity specialist who was not involved in the research. The study appears in Wednesday's Journal of the American Medical Association. About two-thirds of U.S. adults are overweight, and of those, almost half are grossly overweight, or obese. Surgery in which the stomach is reduced or restricted is typically reserved for people who are at least 100 pounds heavier than their recommended weight and for whom other weight-loss methods have failed. Doctors have long known that losing weight helps improve blood pressure and cholesterol levels by reducing stress on the cardiovascular system. But with diabetes, obesity surgery may have unique benefits, said University of Minnesota surgeon Dr. Henry Buchwald, the study's lead author and a consultant to the Johnson & Johnson subsidiary. AP Interactives Obesity in America Latest Obesity News Obesity Surgery Could Cure Diabetes Study: Nearly 200 Million Chinese Obese Latest Health News Obesity Surgery Could Cure Diabetes CDC Says Vaccine-Caused Polio Wiped Out Short Rehab May Lead to Higher Death Rate CDC Flu Plan Aims to Guard Those at Risk Study: Nearly 200 Million Chinese Obese Audio Buchwald says the study shows that along with marked weight loss, there are other benefits associated with obesity surgery. There is evidence that when the intestinal tract is rearranged in obesity operations, patients who were diabetic are "cured" even before they start shedding significant amounts of weight. That may be because such operations alter the intestinal hormones, Buchwald said. Buchwald and colleagues reviewed studies on obesity surgery published in English between 1990 and 2003. The studies involved 22,094 patients ages 16 to 64, at least two-thirds of them women. The researchers found patients lost an average of 61 percent of their excess weight. The greatest weight loss occurred with the most complicated surgery, an operation called a duodenal switch, which is more common in Europe. It involves removing three-fourths of the stomach and rearranging the intestine so digestion occurs in a shortened channel, resulting in less food being absorbed. The most common U.S. obesity surgery, gastric bypass, involves creating an egg-sized pouch in the upper stomach and attaching it to a section of intestine. The procedure reduces the amount of food patients can eat and results in less food being absorbed. The researchers found it resulted in a 62 percent loss of excess weight. Obesity surgery is a major operation, not cosmetic tinkering, Buchwald emphasized. The risks include malnutrition, stomach problems, infections and, in rare cases, death. The average 30-day death rate following surgery was about 0.6 percent in the reviewed studies. Buchwald said nonfatal complications also occurred, but no more than with other major surgery. A report last week from the government's Agency for Healthcare Research and Quality said about 20 percent of obesity-surgery patients experience complications, most of them minor. The report also said surgery is more effective than other methods for weight loss and for controlling obesity-related ailments. --- On the Net: JAMA: http://www.jama.com

Thanx for posting this, Linda! (((hugs))) -Karen

Here is an article of similar nature that was in Wednesday's USA Today: Gastric bypass study yields big health benefits By Nanci Hellmich, USA TODAY Extremely obese people who have weight-loss surgeries experience dramatic improvements in their health, a study in today's Journal of the American Medical Association reports. Seventy percent to 80% of the cases of diabetes, hypertension, sleep apnea and high cholesterol were eliminated or improved in patients who had gastric bypass, gastric banding and other bariatric operations. This news comes after two studies last week showed that patients who have gastric bypass live longer than similarly obese patients who don't have the surgery. About 140,640 bariatric surgeries will be done this year, according to the American Society for Bariatric Surgery. Gastric bypass creates a much smaller stomach and rearranges the small intestine. It's performed on people who are morbidly obese, which is 100 or more pounds over a healthy weight. Average cost is $26,000. Supporters say the surgery saves lives because excess weight increases the risk of diabetes, heart disease, cancer and other illnesses. Critics say the risks of the surgery, including malnutrition and other medical problems, far outweigh the benefits. For the latest study, researchers did a statistical analysis of 136 studies worldwide that included 22,094 weight-loss surgery patients. The findings: ? Patients lost an average of 61% of their excess body weight. ? Diabetes was eliminated or eased in 86% of patients; hypertension, 78.5%; obstructive sleep apnea, 85.7%. High cholesterol decreased in 70% of patients. ? One in 200 died in the month after the operation. (One of last week's studies suggested that one in 50 die within 30 days after gastric bypass.) "There are 8 million to 10 million people who are morbidly obese in this country, and we're operating on only about 1% to 2% of them," says lead author Henry Buchwald, a professor of surgery at the University of Minnesota School of Medicine. That "wouldn't be tolerated if it was any other illness." Resolution of the diabetes often occurred days after the bariatric surgery, before weight loss was achieved. This may be a result of changes in hormones brought on by the surgery, some of which are related to hunger, the researchers say. The study was paid for by a Johnson & Johnson Co. subsidiary that markets surgical instruments for the operations. Dawn Jackson Blatner, a registered dietitian at Northwestern Memorial Hospital Wellness Institute in Chicago, says gastric bypass should be a "last resort" after patients have exhausted all other options. But on the other hand, she says, "I've had patients lose 100 pounds just by cutting calories and exercising."