How Weight Loss Helps the Heart http://www.usnews.com/health/family-health/heart/articles/20 09/08/11/how-weight-loss-helps-the-heart.html
By Ed Edelson

(Thanks to Kevin for sharing this information with us!)

HealthDay Reporter TUESDAY, Aug. 11 (HealthDay News) -- Losing a lot of weight rejuvenates the physical structure of the heart, and it makes no difference whether the weight is lost by surgery or by dieting, a new British study shows. The heart muscles of people who started with a body mass index (BMI) averaging 40 -- a BMI of 30 is the usual marker of obesity -- became noticeably thinner and more efficient when they brought their BMI down to 32.2 in a single year, according to a report in the Aug. 18 issue of the Journal of the American College of Cardiology. "Both diet and bariatric surgery led to comparable, significant decreases" in heart structure abnormalities and malfunction, the University of Oxford researchers reported. Bariatric surgery is designed to induce weight loss by reducing the amount of food people can eat, the amount of food they can metabolize or both. Weight loss averaging 21 kilograms (about 45 pounds), achieved by the 37 obese people in the study, "is typically what is seen after bariatric surgery," said Dr. Philip R. Schauer, director of the Cleveland Clinic Bariatric and Metabolic Institute. Noting that many of the obese people lost those kilograms by eating less, Schauer called it "quite unusual for someone to diet with that effect. These were a very special subset." And the problem with weight loss by diet is that "weight regain is the norm, whereas with bariatric surgery there is ample evidence that the weight loss is maintained," Schauer said. The Oxford researchers used cardiac MRI, a special X-ray technique, to obtain detailed information on the structure of the hearts not only of the 37 obese participants but also of 20 normal-weight volunteers, whose average BMI was 21. They found that the walls of the left and right ventricles, the blood-pumping chambers of the heart, were significantly thicker in the obese people. They also found impaired ability of the heart to hold blood at diastole, the resting point of the heartbeat, in the obese. A year later, after weight loss, the heart muscles of the obese people were less overgrown and the hearts could also hold more blood. Thickening of the aorta, the main heart artery, was also greatly reduced after weight loss. "These findings provide a potential mechanism for the reduction in mortality seen with weight loss," the researchers wrote. And it thus helps explain something of a medical mystery -- why people who are grossly overweight are more at risk of heart attack and sudden death than their numbers show, said Dr. Christine Ren, a bariatric surgeon who is an associate professor of surgery at New York University Langone Medical Center. "Most of them say they are pretty healthy, maybe with a slight elevation of blood pressure, but when you really drill down to it you can show an abnormal cardiac function," Ren said. "The point is that their heart is not normal and that already is having a negative effect on their health." Losing weight by dieting is desirable, "but the problem with diets is that statistics show maintenance of weight loss by diet is extremely difficult and quite rare," Ren said. Bariatric surgery is expensive, costing anywhere from $15,000 to $25,000, she said, and it is not perfect. "There is always going to be 5 percent of these people who gain most of their weight back, but it still is the best chance of having significant weight loss," Ren said. However, health insurance coverage of bariatric surgery is uncertain, varying from company to company and state to state, she said, and many plans are starting to put more limits on coverage. More information Bariatric surgery is described by the U.S. National Library of Medicine.  

Thank you to Guayas for this article.

Probiotics Help Gastric-Bypass Patients Lose Weight More Quickly

ScienceDaily (July 13, 2009) — New research from the Stanford University School of Medicine and Stanford Hospital & Clinics suggests that the use of a dietary supplement after Roux-en-Y gastric bypass surgery can help obese patients to more quickly lose weight and to avoid deficiency of a critical B vitamin.

In a study published in the July issue of the Journal of Gastrointestinal Surgery, John Morton, MD, associate professor of surgery at the medical school, showed that patients who take probiotics after the gastric-bypass procedure tend to shed more pounds than those who don't take the supplements. Probiotics are the so-called "good" bacteria found in yogurt as well as in over-the-counter dietary supplements that help in the digestion of food.

 

"Surprisingly, the probiotic group attained a significantly greater percent of excess weight loss than that of control group," said Morton, who wrote the paper with lead author Gavitt Woodard, a third-year medical student, and five other medical students at the Surgery Center for Outcomes Research and Evaluation in Stanford's Department of Surgery. Morton has performed more than 1,000 of these bypasses at Stanford Hospital & Clinics.

The researchers followed 44 patients on whom Morton had performed the procedure from 2006 to 2007. Patients were randomized into either a probiotic or a control group. Both groups received the same bariatric medical care and nutritional counseling, as well as the support of weight-loss study groups. Both groups also were allowed to consume yogurt, a natural source of probiotics. In addition, the probiotic group consumed one pill per day of Puritan's Pride, a probiotic supplement that is available online and in many stores. Morton has no financial ties to the company that makes the supplement.

The study showed that at three months, the probiotics group registered a 47.6 percent weight loss, compared with a 38.5 percent for the control group.

The study also found that levels of vitamin B-12 were higher in the patients taking probiotics — a significant finding because patients often are deficient in B-12 after gastric-bypass surgery. The probiotics group had B-12 levels of 1,214 picograms per milliliter at three months, compared with the control group's levels of 811 pg/mL.

Morton said he now recommends probiotic supplements to his patients, and he plans to continue to look for ways to enhance the outcomes from the procedure.

Roughly 15 million Americans are morbidly obese, and bypass surgery is becoming an increasingly common treatment for the problem. Some 150,000 Americans who have a body mass index of more than 40 — who are typically at least 100 pounds overweight — have the procedure each year.

Morton said the study was prompted by the fact that some patients have problems eating after gastric-bypass surgery. "For some reason, the food doesn't go down right," he said. When no anatomical reasons could be found for blockages, he hypothesized that a build-up of bacteria in the intestine — bacterial overgrowth — might be the culprit.

"Bacterial overgrowth can be bad in that it changes your motility, how you empty," Morton said. "A lot of people aren't aware that we all carry about a lot of bacteria in our intestines and that they're extremely helpful in aiding digestion. And I thought, 'Well, if we give these patients probiotics, then maybe we can improve these symptoms.'

"Part of the obesity puzzle may be due to the kind of bacteria you have in your intestine," he said.

There was no outside funding for the study.

This article is from the WebMD News Archive

   

Drink More Diet Soda, Gain More Weight?

Overweight Risk Soars 41% With Each Daily Can of Diet Soft Drink By Daniel J. DeNoon
WebMD Health News Reviewed by Charlotte E. Grayson Mathis, MD  

 

June 13, 2005 -- People who drink diet soft drinks don't lose weight. In fact, they gain weight, a new study shows.

The findings come from eight years of data collected by Sharon P. Fowler, MPH, and colleagues at the University of Texas Health Science Center, San Antonio. Fowler reported the data at the annual meeting of the American Diabetes Association in San Diego.

"What didn't surprise us was that total soft drink use was linked to overweight and obesity," Fowler tells WebMD. "What was surprising was when we looked at people only drinking diet soft drinks, their risk of obesity was even higher."

In fact, when the researchers took a closer look at their data, they found that nearly all the obesity risk from soft drinks came from diet sodas.

"There was a 41% increase in risk of being overweight for every can or bottle of diet soft drink a person consumes each day," Fowler says.

More Diet Drinks, More Weight Gain

Fowler's team looked at seven to eight years of data on 1,550 Mexican-American and non-Hispanic white Americans aged 25 to 64. Of the 622 study participants who were of normal weight at the beginning of the study, about a third became overweight or obese.

For regular soft-drink drinkers, the risk of becoming overweight or obese was:

• 26% for up to 1/2 can each day
• 30.4% for 1/2 to one can each day
• 32.8% for 1 to 2 cans each day
• 47.2% for more than 2 cans each day.

For diet soft-drink drinkers, the risk of becoming overweight or obese was:

• 36.5% for up to 1/2 can each day
• 37.5% for 1/2 to one can each day
• 54.5% for 1 to 2 cans each day
• 57.1% for more than 2 cans each day.

For each can of diet soft drink consumed each day, a person's risk of obesity went up 41%.

Diet Soda No Smoking Gun

Fowler is quick to note that a study of this kind does not prove that diet soda causes obesity. More likely, she says, it shows that something linked to diet soda drinking is also linked to obesity.

"One possible part of the explanation is that people who see they are beginning to gain weight may be more likely to switch from regular to diet soda," Fowler suggests. "But despite their switching, their weight may continue to grow for other reasons. So diet soft-drink use is a marker for overweight and obesity."

Why? Nutrition expert Leslie Bonci, MPH, RD, puts it in a nutshell.

"You have to look at what's on your plate, not just what's in your glass," Bonci tells WebMD.

People often mistake diet drinks for diets, says Bonci, director of sports nutrition at the University of Pittsburgh Medical Center and nutrition consultant to college and professional sports teams and to the Pittsburgh Ballet.

"A lot of people say, 'I am drinking a diet soft drink because that is better for me. But soft drinks by themselves are not the root of America's obesity problem," she says. "You can't go into a fast-food restaurant and say, 'Oh, it's OK because I had diet soda.' If you don't do anything else but switch to a diet soft drink, you are not going to lose weight."

The Mad Hatter Theory

"Take some more tea," the March Hare said to Alice, very earnestly.
"I've had nothing yet," Alice replied in an offended tone, "so I can't take more."
"You mean you can't take less," said the Hatter: "It's very easy to take more than nothing." Lewis Carroll, Alice's Adventures in Wonderland

There is actually a way that diet drinks could contribute to weight gain, Fowler suggests.

She remembers being struck by the scene in Alice's Adventures in Wonderland in which Alice is offended because she is offered tea but is given none -- even though she hadn't asked for tea in the first place. So she helps herself to tea and bread and butter.

That may be just what happens when we offer our bodies the sweet taste of diet drinks, but give them no calories. Fowler points to a recent study in which feeding artificial sweeteners to rat pups made them crave more calories than animals fed real sugar.

"If you offer your body something that tastes like a lot of calories, but it isn't there, your body is alerted to the possibility that there is something there and it will search for the calories promised but not delivered," Fowler says.

Perhaps, Bonci says, our bodies are smarter than we think.

"People think they can just fool the body. But maybe the body isn't fooled," she says. "If you are not giving your body those calories you promised it, maybe your body will retaliate by wanting more calories. Some soft drink studies do suggest that diet drinks stimulate appetite."

DISCLAIMER - This is just some information/suggestions. It is in no way a complete list or meant to take place of advice from your physician. You should always seek the advice of your surgeon.

Certain medications are prone to causing ulcers in post op bariatric patients. Typically these ulcers will require surgical intervention. The following is a list of medications I have found, that are not to be taken by bariatric patients.

No NSAID's. (non steroidal anti-inflmmatory drugs)

Aches-N-Pain Advil Tablets & Caplets Aleve
Alka Seltzer Alka Seltzer Antacid/Tablets/Cold Anaprox
Advil
Alka Seltzer
Anacin
Ascriptin
Asprin
Anaprox DS Anacin Tablets/Caplets/Max. Strength
Ancid Ansaid
Arthritis Pain Formula Arthritis Strength Tri-Buffered Bufferin
A.S.A. Enseals Ascriptin A/D Caplets
Ascriptin
Ascriptin Extra Strength Caplets
Asperbuf
Aspergum Aspirin - all brands including childrens
BC Powder/Cold Powder Bufferin-Regular & Extra Strength Buffex
Befferin
Buffinol Cama Arthritis Strength
Cataflam
Celebrex
Clinoril Coumadin
Coricidin
Cortisone
Daypro
Dolobin
Disalcid Dipyridamole
Doan's Pills
Dolobid Easprin
Emperin
Excedrin
Empirin
Ecotrin Caplets/Tablets/Max. Strength
Excedrin/Any Type
Feldene Fiorinal
Feldene
Fioinol
Halfrin
Ibuprofen Ifen
Indocin
Ibuprofen
Indocin
Lodine Magnaprin
Maprin/Maprin 1-B
Measurin Mediprin
Midol Caplet/200
Mobigesic Motrin
Meclomen
Motrin
Nalfon
Naprosyn
Norgesic
Nalfon
Naprosyn Norwich Tablets
Nuprin Caplets/Tabs
Orudis P-A-C Analgesic
Pamprin
Persantine Pepto-Bismol /Any Type Ponstel
Relafen Rimadyl
Sal flex
Tolectin
Ticlid Tolectin
Tolmetin
Toradol Trendar
Trigesic
Ursinus Inlay/Tabs Vanquish Analgesic Voltaren
Vanquish
Vioxx
Warfarin Wesprin Buffered
Zorpin

In addition to these in the paperwork I recieved from my surgeon, it was also stated to NOT take any form of tetracycline and not to take azythromycin (z-pack).

Again, you are encouraged to consult your physician on any medications you begin taking or are considering taking, to assure they are safe for you.  Your bariatric doctor is the most knowledgeable in this area. If as you review this list , you note you are taking one of the listed meds, consult your bariatric doctor or his nurse to verify it is safe for you.  Many family physicians are not experienced enough with bariatrics to know all of the restrictions of the bariatric population, as this is not thier specialty.
I encourage you to print this list out and keep it handy for easy reference in the future.

If sweets, especially candy, is one of your weaknesses, the upcoming trick – or – treating tradition may prove to be a difficult one for you. If you really enjoy handing out  goodies to the little ghosts and goblins, here are some suggestions to help you make it through this year, without falling victim to the tasty treats that abound.

 

1.        Have someone else go shopping for the treats that you will be handing out. This will reduce your exposure to all of the temptations and help you resist giving in to trying “just one?.

2.        Be sure to pick a candy that is one you do not like personally. This too, will help to reduce the risk of temptation while handing out the goodies to the neighborhood kids.

3.        Consider going to your local dollar store and getting a bag of small toys to give out instead of the consumable treats. Kids love stickers, and other little trinkets. Parents appreciate it too.

4.        Choose sugar free candies to give out, then if you must have “just one? you are not going to be getting in all those sugars that can really derail you for your wls journey.

5.        Have someone else hand it out if it is difficult for you.

6.        If you have children that will be out there collecting the goods, be sure to insist that they keep their treasures put away in a place that you will not be tempted to “just take a peek? to see what they collected.

7.       Be sure to keep some wls safe treats on hand, so if you just have to have a treat of your own, you have safe choices available to you.

8.       If worst comes to worst, just resolve to not hand out the goodies this year.

 

Remember this is your journey, and you must make the most of it. Have a plan in place to make sure you protect yourself from the next day dread that you will certainly encounter, should you happen to give in.

 

The taste of something lasts but a moment. The effects of it can linger for days, or even set you on a path of struggle that can last a very long time. It is best to avoid it altogether! It is just not worth the risks involved.