Estimated 120,000 patients will have gastric bypass surgery in 2008

There isn't a magical weight-loss pill, but the way some people talk, there is a magic weight-loss knife. However, Carlos Carrasquilla, M.D., F.A.C.S., director of the Florida Center for Surgical Weight Loss Control in Fort Lauderdale, Fla., cautions that weight-loss surgery isn't an easy fix. It requires adopting new eating and exercise habits for life, as well as coping with the risks of surgery. Still, both bariatric and laparoscopic weight-loss surgery are increasingly common.

One medical analyst predicts more than 120,000 Americans will have the procedures this year, with an average cost of $25,000 per surgery (an amount that is not always covered by health insurance).

We asked the man who brought the laparoscopic surgery procedure to South Florida for the low-down on the answers to the growing number of questions about weight-loss surgery.

Bulletin: Weight loss surgery isn't for everyone. Who is the ideal candidate?

Dr. Carrasquilla: We go by Body Mass Index (BMI). People with a BMI of more than 40 are, on average, 100 pounds above average weight. Those people are considered "supermorbid obese." They have tried everything possible. But once you get above 100 pounds above your ideal weight, there is a 98 percent failure rate in [other] weight-loss treatments. More >>

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New device test, alternative to gastric bypass surergy

Portland, OR

Oregon Health and Science University is testing a new implantable device that promises to reduce or eliminate hunger pains.

The device is implanted just underneath the skin near the stomach.

Normally, a particular nerve in your abdomen tells your brain if you're hungry. But this new device sends signals up certain wires, blocking the message of hunger.

OHSU doctors say 15 million obese people in the U.S. could benefit from what's called VBLOC therapy.

The surgery is less risky than gastric bypass and should be less expensive.

Previous studies show obese people lost about 20 percent of their weight after using the device for one year.

Dr. Bruce Wolfe, the OHSU surgeon in charge of the study, said the device is only for the obese rather than just someone who wants to lose 10 or 15 pounds.

"It still is surgery," Wolfe said. "General anesthesia is required. There are incisions made. So it's possible to have a complication. By virtue of it being a less invasive procedure, it's reasonable to predict that serious or life-threatening complications will be quite few."

OHSU is now looking for candidates for the experimental trial. Doctors will see how well it works over the course of five years.

Right now, people with the device must also wear a battery pack outside their body, shaped like a small ring. Doctors expect it to be completely implantable in the future.

If you want to be part of the study, informational meeting will begin Wednesday and will be held through April 2 at OHSU. Call 1-866-356-4199 for more information.
Click here to find out more!

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Dozens of gastric bypass malpractice lawsuits against bariatric surgeon costs him medical license, leads to new law

Wilmington, NC

The case of former Wilmington surgeon Dr. Steven Olchowski, who for years performed the wrong surgery on dozens of patients, helped bring to light the need for changes at the North Carolina Medical Board. One change requires the Medical Board to publish more information about disciplinary action taken against physicians. But some think the law doesn't go far enough.

From 2000 to 2002, former Wilmington bariatric surgeon Steven Olchowski was performing gastric bypass surgery on dozens of patients. During that time, his North Carolina Medical Board record was clean. Olchowski promised his patients one form of gastric bypass surgery but instead performed a short-cut bariatric operation.

It took three years and three-dozen gastric bypass surgery malpractice lawsuits against Olchowski for the North Carolina Medical Board to revoke his license in 2005. While the gastric bypass malpractice lawsuits were litigated, the medical board was limited in what it could make public.

A state law that went into effect last Fall requires the Medical Board to release more disciplinary information. State Representative Lucy Allen sponsored the legislation.

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Genes may determine success of gastric bypass surgery

Danville, PA

Researchers study genetic factors in success of gastric bypass surgery and other bariatric procedure.

Two obesity-related genetic variations may be associated with higher body mass index (BMI) among severely obese patients (BMI of 40 or higher) who have bariatric surgery to help them lose weight, say American researchers.

Bariatric surgery is a highly effective treatment for severely obese patients, according to background information in the study. However, some patients don't lose weight after bariatric surgery.

"Identification of variables that determine the success of bariatric surgery have shown little consistency, and long-term success may depend on not yet identified factors," noted the researchers at the Geisinger Clinic in Danville, Pa.

They studied 707 severely obese (average BMI 51.2) patients who had gastric bypass surgery. Blood samples from the patients were analyzed for two common single nucleotide polymorphisms (SNPs) previously found to be associated with obesity. SNPs are variations caused by alteration of single building block of DNA.

The researchers found that about 21 percent of the patients had two copies of one obesity-related SNP, 13 percent had two copies of the other SNP, and 3.4 percent had two copies of both SNPs.

There was no significant BMI difference between patients with two identical copies of either one of the SNPs and those without two identical copies. However, patients with either two copies of both SNPs, or two copies of one and one copy of the other SNP, had much higher BMIs than other patients. Less than 20 percent of the patients in the study had these genetic features.

The findings were published in the March issue of the journal Archives of Surgery. More >>

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Carnie Wilson's war: Weight gain after gastric bypass bariatric surgery

Gaining weight after bariatric procedures such as gastric bypass surgery can be discouraging as it is unhealthy.

For many veterans of crash diets, killer workouts and tailored meal plans, weight loss surgery is the nuclear option in a battle against the bulge.

But while such procedures can indeed lead to dramatic weight loss, for some the pounds return. Such appears to be the case with musical star Carnie Wilson, whose fluctuating figure dominated tabloid front pages this week in the latest chapter of her widely publicized fight against obesity since her gastric bypass surgery in 1999.

Wilson, 31 at the time, weighed more than 300 pounds before the procedure that reduced the size of her stomach to that of an egg.

By all accounts, Wilson's gastric bypass bariatric surgery was a success; she dropped 152 pounds.

Until recently she sported a trimmer figure. New photos released by the celebrity Web site TMZ.com Tuesday show the singing star significantly heavier than before.

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After years battling weight, Trib writer turns to bariatric surgery - gastric bypass

Waco, TX

Waco Tribune staff writer Terri Jo Ryan has battled weight problems most of her life. After a frightening diagnosis, she weighed pros and cons and opted for bariatric surgery. She shares her story with others who might be fighting obesity and studying their options.

In the final years of her life, my mother had three killers stalking her — chronic obstructive pulmonary disease, chronic heart disease and diabetes. On March 18, 2007, diabetes won.

So I was alarmed when my doctor told me that my mother’s killer had me in its sights, too. In June, I found out I had type 2 diabetes.

After the diagnosis, I was depressed and frightened. I am one of eight siblings, nearly all of us overweight, and I did not want to be the first one to die of obesity.

I spent a weekend re-evaluating my life and made a resolution: I would not continue to commit slow-motion suicide by eating whatever the heck I wanted. I rejoined the YMCA, where I do water aerobics three or four days a week. I gave up sugar, sodas, white potatoes, white bread and ice cream. I cut my portions in half.

Weight-loss surgery had been an option rolling around in my mind for more than a year. I’d been reading up on various procedures, side effects and mandatory lifestyle changes that come from having your innards rerouted for life.

A decade earlier, I would have sneered at the suggestion that I have surgery to correct the consequences of irresponsible consumption. But as someone who had tried numerous diets only to gain it all back and then some, I have come to appreciate the powerful tool that weight-loss surgery can offer in the perpetual battle against the bulge.

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Gastric bypass a drastic solution but works for Florida teen

Deerfield Beach, FL

Haleigh Fenlon did not feel pretty and couldn't fit into cool clothes. Her parents worried about her aching knees, ankles and back, her lethargy, and the risk of future disease.

In August, her family and doctors made a controversial decision: The 242-pound, 5-foot-1 Deerfield Beach student had gastric bypass surgery. She was 16.

Today, Haleigh is 80 pounds lighter. Now 17, she said she feels great, has had no side effects and is marching toward her goal weight of 120.

"It's the best thing I've done," said Haleigh, who is getting her high school diploma online and working part-time. "I did it for vanity reasons. I didn't want to be deprived of life. I would not settle for fat-girl clothes."

With her surgically reduced stomach, she lives on 800 calories a day — less than half of a typical teen girl's diet — eating mini-portions of chicken, cheese, eggs and vegetables.

Gastric bypass for those younger than 18 is rare and controversial. Few bariatric surgeons take children, saying surgery is a last resort to be used only after exhausting all other avenues of weight loss. Others say teens may choose surgery for wrong reasons, such as peer pressure, and may lack the maturity to undertake the disciplined post-surgery lifestyle.

No studies have been done to show the effects of a highly restricted diet over many years, but clinical trials researching those issues are in the works. A record 1,000 teens had bypass surgery last year.

"We had reservations because she was so young," said Haleigh's stepfather, George Dupont, "but it has turned out well so far." More >>

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Bariatric patients find more options than just gastric bypass surgery

Wausau, WI

Local weight-loss surgery programs are facing competition for patients from an eastern Wisconsin program.

Midwest Bariatric Solutions and Theda Clark Medical Center in Neenah will hold a bariatric surgery information session Thursday. Dr. Raymond Georgen, a member of the practice, said it holds seminars outside the Fox Valley on a regular basis.

"Our practice is statewide," Georgen said, noting he has had several patients travel from Wausau, central Wisconsin and Michigan's Upper Peninsula for gastric bypass surgery and a procedure using an adjustable band to reduce the stomach's capacity. More >>

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Would you get gastric bypass surgery, Lap-Band surgery?

From CNN - Paging Dr. Gupta

A few weeks ago, a good friend told me that she'd be getting a Lap-Band procedure done.

She told me about her upcoming weight-loss surgery over a sushi lunch and very excitedly explained all aspects of the procedure. It would be minor surgery -- minimally invasive, take about an hour, no major side effects, covered by insurance for a mere co-pay of $20.

She wouldn't need to stay overnight in the hospital, she told me, but her doctor liked to be safe. "I have the same doctor as Al Roker for when he had it done," she added.

To be honest, I was stunned, when I know I shouldn't have been. After all, we do weight-loss stories of all kinds as part of the Fit Nation series. Lap-Bands, which restrict the size of the stomach, really do work for a lot of people. In fact, in a January issue of the Journal of the American Medical Association, one small study found that 75 percent of people who got Lap-Band surgery experienced a remission of their type 2 diabetes -- possibly because of fewer calories being consumed. In the group that just tried diet and exercise, only about 14 percent experienced remission. More >>

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