Weight loss surgery improves sexual function in men

New York, NY

Sexual dysfunction that commonly occurs in morbidly obese men improves after weight loss surgery, according to a new study.

"Sexual dysfunction should be considered one of the numerous potentially reversible complications of obesity," the study team concludes.

Dr. Ramsey M. Dallal, from Albert Einstein Healthcare Network, Philadelphia, and colleagues measured the degree to which 97 morbidly obese men suffered from sexual dysfunction and then analyzed the change in sexual function after substantial weight loss following gastric bypass surgery.

Before surgery, the morbidly obese men had significantly lower sexual function relative to that of a previously published reference control group of men before surgery, the investigators report.

After losing an average of two thirds of their excess weight, men experienced significant improvements in sexual function, with the amount of weight loss predicting the degree of improvement.

"We estimate that a man who is morbidly obese has the same degree of sexual dysfunction as a nonobese man about 20 years older," the investigators report. "Sexual function improves substantially after gastric bypass surgery to a level that reaches or approaches age-based norms."

"Sexual function is an important aspect to quality of life and is now well documented to be a reversible condition," Dallal explained.

"We are interested in examining sexual function in females, as well as understanding the mechanism of obesity-related sexual dysfunction," Dallal added.

 Subscribe to Gastric Bypass Surgery News

Man says he dodged death by losing 430 lbs., going from 640 to 210

New York, NY

Today is the first day of a year that Ernesto Suncar and his doctors feared he might never see.

Weighing 640 pounds, wearing 10X shirts and with a 70-inch waist, the 33-year-old New Yorker was told by doctors he would likely be dead within 12 months.

Realizing it was a choice between losing weight and dying, the proud father of three, who had tried every diet imaginable, underwent gastric bypass surgery - and has shed more than two-thirds of his former self.

"I want people to feel inspired when they look at me," says the Hell's Kitchen resident, who's down to 210 pounds. "Hopefully, if they have a weight issue, they will finally do something about it, starting right now.

"Losing this weight saved my life. Without the operation, I doubt I would be here to celebrate New Year's.

"It's scary to think what might have happened."

The business management student says his body ballooned after he came to the U.S. from his native Dominican Republic at the age 7.

"I was a normal, active kid who used to run and play outdoors in the tropical climate," he recalls. "When we moved into a small apartment where it was cold, I stayed inside and didn't get any exercise.

"The only games I played were video games."

His love of chow didn't help. He would gorge himself on Spanish-style fried pork chops, rice and plantains, McDonald's, pizza and pasta.

"My mom would tell the guys at the corner deli not to serve me, so I'd just walk to another block," Suncar admits.

He once lost 64 pounds on a 1,800-calorie-a-day diet, but then gained 120 pounds. At his heaviest, the 6-foot-2 food junkie tipped the scales at 640 pounds.

"My little son had to tie my shoelaces," he says. "I poked fun at myself, but inside I was hurting."

The turning point came when chronic breathing difficulties and the immense strain on his heart threatened to kill him.

"The doctor said, if I carried on as I was, I would be dead in a year," Suncar says.

Dr. Elliot Goodman, chief of bariatric surgery at Beth Israel Medical Center, performed the gastric bypass.

There were minor complications, but this winter, after following a nutritious eating plan and increasing his fitness at the gym, Suncar has reached - and maintained - a healthy weight.

His waistline has shrunk to 34 inches and, instead of having to buy expensive outsize clothes on the Internet, he shops for stylish gear at The Gap.

"I feel reborn," he says. "These days I can cycle along the Hudson River, play with my kids and this summer, I'm planning on taking a flight. Before, I couldn't have fit in an airline seat.

"I keep some of my old things in my closet to remind me of how I used to look. But there's no going back."

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery economics: Hospitals gain from weight loss

Cincinnati, OH

The owners of Good Samaritan Hospital and Mercy Hospital Fairfield have started comprehensive weight-loss centers, offering services ranging from bariatric surgery to exercise and nutrition classes.

The Good Samaritan Weight Management Center opened in mid-November in the adjacent medical office building in University Heights, housing a mental health counselor, dietitian and exercise physiologist. Fees include $500 for a full pre-surgical program and $75 for a three-month program with a dietitian.

The new Mercy Healthy Weight Solutions is in Springfield Township now but will move to the Fairfield HealthPlex early next year. It includes similar services plus a six-month membership to any Mercy HealthPlex and a wellness coach. Fees range from $300 to $1,200, including follow-up programs after surgery.

While hospitals and doctors have offered similar programs for years, the increasing popularity of weight-loss surgeries have persuaded them to package the services offered both before and after surgery to capitalize on their own brand names and create a bigger revenue stream.

It also comes as obesity rates increase, adding health-care cost to an already overburdened system. That could mean increased demand for a full-range of weight-loss programs, said Tom Urban, chief executive officer at Mercy Fairfield.

“We think it’s a service that’s needed in this area,” Urban said. “We think it will be profitable, but only because it’s a needed service.”

Other hospitals also offer the same services. For example, St. Luke Hospitals in Fort Thomas and Florence has seen 8,000 patient visits during the last three years at its Tri-State Surgical Weight Loss Center and is scheduled to perform its 1,000th surgery in January.

Nationally, obesity and overweight patients cost the health-care system about $117 billion a year, mainly through increased diabetes, heart disease and hypertension, says the American Society for Metabolic and Bariatric Surgery. More than 200,000 people had bariatric surgery last year, the group said, but that still is only 1 percent of the eligible population.

Insurance coverage still is spotty for full-scale bariatric surgery, which can cost $20,000 or more.

For example, Anthem Blue Cross and Blue Shield of Ohio does not cover bariatric surgery as a standard benefit, but large companies can include it as a rider for their employees. Anthem said it tries to identify patients who need surgery and hospitals that provide the best care.

Insurers offer more incentives for weight-management programs, including diet and exercise habits. Corporations are starting more wellness programs to encourage employees to eliminate bad health habits.

George Kerlakian, medical director of the Weight Management Center at Good Samaritan, said bariatric surgery will become even more common as the technology improves and the population ages. About half of 2,500 patients during the last six years have ended up having surgery, and the center is trying to double total volume during the next several years.

“It brings patients in,” Kerlakian said of the center. “Obese patients have or will have a lot of medical problems in the future. That connection is important to us as we take care of them.

“We don’t look at surgery as an end-all,” he added. “We really stress the fact that it’s a tool.”

More than half of bariatric surgeries are gastric bypass, where the stomach is reduced and then attached to the small intestine. A gastric banding wraps a band around the stomach, while an emerging procedure called a sleeve gastrectomy removes about 85 percent of the stomach.

Cindy McBride of Bridgetown, a patient at the Good Samaritan center who also works at the hospital, had the sleeve gastrectomy in April and has lost 107 pounds. She’ll be doing follow-up work for more than a year, including visits with a physical therapist and a nutritionist.

“I think it’s a great way to do it because your physicians and your support staff are all on-site,” McBride said.

 Subscribe to Gastric Bypass Surgery News

Gastric bypass surgery resolves diabetes in teens

Los Angelos, CA

Teenagers who undergo gastric bypass surgery are often immediately relieved of Type 2 diabetes, according to research published today in the journal Pediatrics.

Studies on adults with Type 2 diabetes show that gastric bypass can result in disease remission or better disease control. However, this study is the first to explore the effects of the surgery in children. The study examined adolescents with Type 2 diabetes, which is usually related to obesity and is being diagnosed with alarming frequency in American children and teenagers.

Dr. Thomas Inge, director of the Cincinnati Children's Surgical Weight Loss Program for Teens, studied 11 extremely obese teens with Type 2 diabetes who had gastric bypass surgery and 67 obese teens who were receiving medical management for Type 2 diabetes. Among the 11 teens who underwent surgery, all but one had a remission in diabetes. The response was so rapid, the patients often discontinued medication for diabetes control before leaving the hospital after surgery. These teens lost an average of 34% of their body weight one year after surgery. In contrast, the teens who were medically managed did not have any weight change after one year and were all still taking medication for diabetes. The adolescents who had surgery also had improvements in blood pressure, cholesterol and triglyceride levels.

"The results have been quite dramatic and to our knowledge, there are no other anti-diabetic therapies that result in more effective and long-term control than that seen with bariatric surgery," Inge said in a news release.

Inge and his co-authors noted that future studies will be needed to track the long-term health of teenagers who participated in the study. Cincinnati Children's Hospital is home to a study funded by the National Institutes of Health that will collect and report outcomes on 200 teens undergoing weight-loss surgery nationwide.

 Subscribe to Gastric Bypass Surgery News

Physicians debate best candidates for gastric bypass

Washington, D.C.

Recent studies showing that gastric bypass surgery extends the lives of obese patients is forcing surgeons to make tough decisions about who should go under the knife and who shouldn't.

Internists, cardiologists and endocrinologists, more than ever, are referring patients who traditionally haven't been candidates for the weight-loss surgery, also called bariatric surgery.

"I am being asked to operate on 78-year-olds with co-morbidities of heart disease and diabetes," said Dr. Edward H. Phillips, executive vice chairman of the Department of Surgery and a surgeon at the Center for Weight Loss at Cedars-Sinai Medical Center in Los Angeles. Phillips questions whether these patients will benefit, or if the damage has already been done.
ad_icon

"So, while it is obvious a 30-year-old will benefit, at what age is too old?" he asked.

The success of gastric bypass is also stoking debate about its use as a treatment for type 2 diabetes. Mounting evidence suggests this type of surgery may dramatically improve patients with the disease, freeing them from a lifetime of diabetes medications.

"There's more acceptance now of the concept that bariatric surgery is a truly life-saving type of therapy rather than just a way to shed pounds," said Dr. Francesco Rubino, chief of Gastrointestinal Metabolic Surgery at Weill Cornell Medical College in New York City.

Still, more long-term studies are needed, and clinicians and policymakers must reach a consensus on who should have access to this type of surgery, noted Rubino, who directed the 1st World Congress on Interventional Therapies for Type 2 Diabetes, held in New York City in September.

An estimated 205,000 bariatric surgeries were performed in the United States in 2007, according to the American Society for Metabolic & Bariatric Surgery (ASMBS). That's an increase of almost 20 percent from two years earlier.

If patients commit to making necessary changes in their diet and exercise regimens, gastric bypass surgery can provide long-term, consistent weight loss, according to the Mayo Clinic.

Not only does it help shed pounds, but a pair of studies published last year in the New England Journal of Medicine found that it can help obese people live longer.

One study, led by Ted Adams of the University of Utah School of Medicine, tracked almost 16,000 obese people, half of whom had weight-loss surgery. After an average of seven years, the death rate was 40 percent lower for people who had the surgery compared with those who didn't. Diabetes-related deaths were cut by a whopping 92 percent.

The other study, led by a Swedish team, involved more than 6,000 obese patients. After an average follow-up of more than a decade, those who had bariatric surgery were 29 percent less likely to die than those who did not undergo surgery.

 Subscribe to Gastric Bypass Surgery News

Weight loss surgery may cure form of diabetes

Tampa, FL

Gastric bypass surgery helps thousands lose weight, but it may also be a cure for Type Two Diabetes. The drastic weight-loss approach means some diabetics never need insulin again.

Cheryl Bishop's weight has been a life-long battle. “I was always the chunky kid and it just got progressively worse and worse and worse until it was out of control," she said. At 44, she weighed 350 pounds and struggled with Type-Two Diabetes. “It was horrible. It got to the point where I knew I had to have the surgery or I wasn't going to live."

Cheryl had bariatric surgery. Surgeons sectioned off a small pouch of her stomach and attached it to her intestine. The goal is weight loss, but surgeons like Doctor Michel Murr, of Tampa General Hospital, discovered another dramatic effect: Cheryl's Type Two Diabetes disappeared. He says, “There's a function of the stomach that we don't understand very well, but as soon as we divert food away from it, the diabetics control their blood sugar much, much easier."

Studies show up to 90-percent of diabetics go into remission after bariatric surgery. Cheryl says, “I went from taking 100 units of insulin three times a day with blood sugar still 200, 300 plus. Within a week after surgery, probably none."

Right now, bariatric surgery is only for the extremely obese, but doctors believe it could be the key to reversing Type Two Diabetes, regardless of a person's weight.

Doctor Murr says, “We may be looking into this as one of the treatments for diabetics."

One-hundred-thirty pounds lighter, Cheryl's enjoying her new life, one that's healthier and diabetes free. She says, "It's gone. The diabetes is gone."

Almost 18 million Americans are diagnosed with Type Two Diabetes and roughly six million others have it, but don't know. Researchers in Brazil are studying whether bariatric surgery is safe and effective for type two diabetics who are not severely overweight.

 Subscribe to Gastric Bypass Surgery News

New Weight-Loss Surgery Helps Keep It Off

Miami, FL

New Surgical Tools Allow Surgeons To Reduce The Size Of The Pouch And Stomach Through The Patient's Mouth Without Making Cuts

Each year 200,000 people have gastric bypass surgery, and while about 15 percent of them will regain the weight, there's a new procedure helping those patients get back on track.

Suyin Marti is 42 years old, and had gastric bypass surgery 12 years ago. Her weight has been a lifelong battle.

"I gained weight and I lost it so many times over. A hundred pounds I gained and lost three times. Each time I would gain all that weight back and more," admitted Marti.

The weight is back again, and Marti blames family tragedy and the medication she's taking for depression contributing to her gain.

"Everybody always has the license to tell you how heavy you are but they don't know what it is to have this disease," Marti tearfully proclaimed.

Dr. Nestor de la Cruz Munoz is helping patients like Marti take back control of their lives by introducing them to the Rose procedure.

"It's a new procedure that we're going through the mouth rather than having to go through the abdomen with a camera and a transport system that allows us to put stitches in from the inside instead of from the outside," explained Dr. de la Cruz Munoz.

The Rose procedure restores the patient's pouch and stomach to match original post surgery sizes. That's important because scar tissue in the abdomen could complicate surgery for these patients.

Patients will spend one night in the hospital and wake up with a sore throat but no abdominal pain. They can return to normal activities in a day or two. Still, the doctor said patients still need to exercise and attend support groups for the entire process to work.

"We know that none of the surgeries cure obesity. They're just tools that you have to use. So if you don't use the tools correctly they're not going to work for you long term," warned Dr. de la Cruz Munoz.

Marti is prepared to do what it takes to lose the weight and regain her health. "I'm hoping they can go ahead and do the revision and take out the band and fix the problem that I had originally and it will help me lose the weight," said Marti.

The procedure is not currently covered by insurance, and can cost up to $12,000.

 Subscribe to Gastric Bypass Surgery News