XENICAL DEIT PILL BLOG

Weight-loss surgery numbers on the rise in Ariz

January 29, 2007

TUCSON, Ariz. (AP) - At 18, Clyde Brown was a professional wrestler known as Buddy Boy Brown.

By 24, he was pulling in the crowds here as Little Gorgeous George.

But at 67, Clyde Brown is pinned to an easy chair as his health deteriorates while he waits for stomach surgery he hopes will help prolong his life.

Brown, who weighs 384 pounds, is diabetic, has kidney problems, congestive heart failure and sleep apnea. He ‘‘needs'’ three of those medical conditions to be eligible for bariatric (weight-loss) surgery.

Weight-loss surgery is growing in prevalence here as the number of morbidly obese adults continues to rise.

Just 320 bariatric surgeries were performed in 2004 in Arizona, according to a report, ‘‘Obesity in Arizona: Prevalence, Hospital Care Utilization, Mortality,'’ published in September 2006 by the Arizona Department of Health.

By 2005, the number of surgeries for obesity had nearly quadrupled here, to 1,130.

About a dozen hospitals in Arizona, including Northwest Hospital and Carondelet St. Joseph’s in Tucson, provide the surgery.

Tucson Medical Center doesn’t provide it nor does it cover bariatric surgery under its employee health insurance plan, according to spokeswoman Julia Strange, who said the procedures are still considered somewhat experimental.

The American Society for Bariatric Surgery sets standards for bariatric surgery programs in the U.S. It requires a facility to have at least two surgeons experienced in weight-loss surgeries.

For Brown, bariatric surgery could save his life.

He has been disabled for years by an industrial accident that damaged his spine. His surgically repaired knees can’t support his weight for long, so he can’t exercise to lose weight.

On Jan. 7, Brown, a Medicare patient, went to Phoenix to begin a six-month intake process at a hospital there that will lead to Medicare-approved stomach-banding surgery.

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Medicare covers bariatric surgery, but only after a six-month waiting period in which the patient is expected to diet and exercise to lose weight.

And it covers only facilities with high success rates and low death rates in bariatric surgery.

Only three facilities in Arizona - two in Phoenix and one in Scottsdale - provide Medicare and Medicaid-covered bariatric surgery.

No facility in Tucson has been Medicare-approved.

Brown heard about the bariatric surgery program at Carondelet St. Joseph’s Hospital and had been meeting with its bariatric surgeon but could not wait for it to become a Medicare-approved Center of Excellence in bariatric surgery.

As his health worsened, Brown and his wife, Joanne, who helps care for him around the clock, chose to get help from the surgeons at the Medicare-approved Scottsdale Bariatric Center, who operate at Scottsdale Healthcare Shea Campus Hospital in Scottsdale.

Brown said his cardiologist has given her approval for noninvasive (laparoscopic) surgery that will insert a band to reduce the size of his stomach but leave his small intestine intact.

The stomach band can be adjusted externally with a saline-pump device inserted in the abdomen, Joanne Brown said.

More invasive bariatric surgery cuts out part of the small intestine and surgically reduces the stomach. It requires cutting open the abdomen, a riskier procedure for obese people with multiple medical issues.

Brown said he is eager to undergo surgery and begin ‘‘to get my life back.'’

He wants to be able to walk easily next door to visit his granddaughter.

‘‘If I could just get rid of this,'’ he said, placing his hands on his belly.

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Jane Brody: 104 teenagers who are role models for weight loss

January 23, 2007

The problem is undeniable: American children, and especially American teenagers, are fatter than ever.

The prevalence of teenage obesity has tripled in the last 30 years, says Dianne Neumark-Sztainer, the author of “I’m, Like, So Fat.” Fifteen percent of teenage girls and boys are overweight, and another 15 percent to 20 percent are at risk of joining them.

Furthermore, wrote Neumark-Sztainer, who studies teenage eating behaviors at the University of Minnesota School of Public Health, dieting has been found to lead to weight gain among teenagers, and more than half of teenage girls and nearly a third of teenage boys use unhealthy weight-control behaviors, like skipping meals, smoking cigarettes, vomiting or taking laxatives.

Enter Anne M. Fletcher, author of the newly published “Weight Loss Confidential,” a study of how 104 overweight preteens and teenagers — 41 boys and 63 girls — lost significant amounts of weight and maintained their losses for two years or longer. The average loss was 58 pounds, with 26 of the participants having lost 75 pounds or more and 14 having lost 100 pounds or more. The losses become even more meaningful when you realize that many of the youngsters grew taller as they were losing weight.

When they were questioned by Fletcher, a registered dietitian from Mankato, Minn., these “big losers” had successfully managed their new weight for just over three years on average, with 22 for at least four years and 14 for at least five. So this is not the story of a quick-fix solution to a lifelong problem.

Many of these youngsters had tried fad diets and weight-loss gimmicks, only to regain what they lost and then some. They succeeded only after coming to terms with their self-destructive eating habits and sedentary ways, and making permanent changes in how they deal with food and how they move their bodies.

This survey by Fletcher, who also wrote “Thin for Life,” a study of 100 adults who had lost 30 or more pounds and maintained their losses for three or more years, shatters several myths about teenage weight loss, among them that children of overweight parents cannot lose weight.

The adolescents in her book, from across the United States and Canada, lost weight against heavy odds. At least 60 came from overweight families, with 23 having two overweight parents. More than half had been overweight since age 10 or before. Seventy percent said they had lost and regained weight multiple times. Few followed restrictive diets (occasional desserts and fast-food forays were allowed). And nearly all lost weight without developing an eating disorder or adopting some other unhealthy habit like smoking or obsessive exercise.

A look at the reasons the teenagers gave for gaining weight helps in understanding the steps they took to reverse the process. At least three-fourths of the youngsters listed “too much snacking,” “portion sizes too large” and “not enough exercise” as their main reasons for weight gain. Other reasons checked by at least one-quarter of the participants were “ate too many sweets and desserts,” “emotional causes like eating when lonely, bored or sad,” “spent too much time in front of the TV, computer, and/or video games,” “ate too much fast food,” “it runs in my family” and “too many fattening foods served at home.”

Fletcher does not necessarily blame parents for their children’s weight problems. After all, one of the study participants was her son Wes, who said part of the problem was that his parents did everything “right.” But clearly many families needed to make changes in the foods they bought, how they cooked, how food was served and where they ate.

Most important, though, was a change in how the youngsters felt about their weight and about the role that food and exercise (or lack thereof) played in their lives.

Fletcher was surprised that health was cited as often as appearance in deciding once and for all to lose weight.

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“My main concern was to become healthier,” said Taylor S., who once weighed 250 pounds and lost 100 pounds over two years. “I didn’t want to die in my 40s because of my eating habits.”

Angel W., who had high blood pressure when she weighed 240 pounds, brought it down to normal without drugs by losing 65 pounds.

Of course, appearance mattered a lot to these teenagers, many of whom wanted to be more attractive to the opposite sex and be able to wear fashionable clothes. Improving self-esteem and being free from teasing and ridicule were other common motivations for weight loss. And about a quarter of the participants said their weight was holding them back from doing what they wanted, including participating in sports.

Fletcher warns that to succeed at lasting weight loss, teenagers — like adults — have to be truly ready to come to grips with their weight problem. She quotes Sari M.: “Unless you want to do something about your weight for good reasons, you probably won’t stick with it. If you’re happy with the way you look — or you’re not unhappy enough with it to do something about it — then let it be. You’ll only feel worse about yourself afterward if you don’t succeed.”

Over and over, the teenagers told Fletcher that the motivation had to come from within. Nagging by parents or nasty comments from coaches only prompted many of the youngsters to eat more.

The study participants took one of two routes to weight control: 49 slimmed down on their own, and 52 succeeded with the help of a health-care professional (usually a dietitian) or a program (such as a summer camp for overweight teens, Weight Watchers or TOPS). Two in this group who had serious weight-related health problems underwent bariatric surgery to correct their obesity. Three others started losing on their own, then joined a program to reach their goals.

Leading the pack of slimming strategies was exercise or becoming more active, listed by 86 of the participants as their main route to a healthier weight. The most popular activities were running, walking and lifting weights. Next was cutting back on high-fat foods, listed by 48; going on a diet, 47; cutting out certain foods, 42; counting calories, 29; eating all foods, but less of them, 26; skipping meals, 14; using a liquid supplement or energy bar as a meal replacement, 11; using weight-loss drugs, 5; fasting, 3; and smoking cigarettes, 1. None used measures like vomiting or laxatives.

All the successful losers restructured their eating habits. They learned to eat when they were hungry and to stop eating when satisfied. Dishing up smaller portions, eating filling foods that were low in calories and eating fewer foods high in fat were popular strategies.

Many avoided a sense of deprivation by allowing themselves a treat now and then. When out with friends, they tried to choose foods that were healthier and less caloric. Although relatively few counted calories, many started reading nutrition labels and became more aware of the caloric and nutrient value of the foods they regularly ate.

Keeping off the weight they lost was sometimes harder than losing it. Strategies included exercising regularly; weighing themselves weekly and cutting back if they gained; learning more about nutrition; and paying closer attention to biological — as opposed to psychological — hunger.

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