Bariatric Surgery News & Research | Adelaide Bariatric Centre

Can you be overweight and still be healthy?

Mon, 14 May 2018 04:31:50 GMT

Over the years there has been a significant amount of research conducted by doctors worldwide focusing on issues affecting people who are obese or overweight, and for good reason. Obesity, and its associated conditions can have an extremely negative impact on a person's quality of life and eventually cut their life short if nothing is done in response.

With rising levels of obesity across the globe, the international health community has been tasked with asking and attempting to answer the toughest questions about the relationship between weight, diet, physical activity and emotional health.

One of the toughest questions to answer is: can a person diagnosed as overweight or obese still be considered healthy?

To answer that our first step will be to define what exactly being overweight or obese is. Secondly we will need to determine what we can consider a healthy lifestyle and the long term effects that lifestyle has on the human body.

Defining Obesity

The most common way the health community defines levels of obesity is with a mathematical system called the body mass index (BMI). To calculate a person's BMI we take their body mass in kilograms (their weight) and divide it by the square of their height in metres. A person with a body mass index that is over 30 is considered to be obese. Someone with a BMI over 40 is considered to be morbidly obese.

Although the BMI is a fairly accurate assessment tool for the most part it does have its limitations. For instance an athlete, who carries muscle mass which weighs more than fat, could potentially have a BMI over 30. In this case the BMI doesn’t give an accurate reading of their physical health.

There are factors present that the system is not designed to consider, however a physician could easily assess this particular persons reading. While an athlete rating above a 30 BMI may be defined as overweight based on that tool’s measurement, after factoring in their percentage of muscle mass compared to body fat and the lifestyle choices like diet and physical activity that are necessary to maintain that ratio, a physician would likely overrule the BMI reading and confirm that the athlete is very healthy.

There have also been cases reported where a person has a BMI over 30, with a higher percentage of body fat than muscle mass, but does not suffer from any of the negative health effects that typically are associated with obesity. These include:

Type 2 diabetes
Hypertension
High cholesterol
Heart problems
Obstructive Sleep Apnoea
Orthopaedic joint and back problems
Certain types of cancers

Although still physically overweight or obese, the person is metabolically healthy.

It is clear that obesity does not affect everyone in the same exact way and that the BMI system is not perfect. Genes, which control where fat is stored, can program fat to store in the hips and thighs which is less dangerous than fat that is stored around the abdomen.

The numerous factors that dictate how obesity affects the human body still require a large amount of research. Although cases of “healthy” obesity do exist, they are very rare and in many of these cases general health eventually deteriorates as the person begins to age. There are also the realities of social isolation, low self esteem and depression that may be harder to measure, but are very real conditions associated with obesity.

The general consensus amongst health professionals is to avoid obesity if possible and use effective medical intervention to manage it, like bariatric surgery, when other non invasive options have been exhausted.

5 Tips for Talking to Your Doctor About Obesity

Mon, 14 May 2018 04:23:55 GMT

Speaking to your doctor about something as sensitive about your weight can be a daunting task, even though we all know that it is for our own benefit. Sharing personal details about our lifestyle, diet and body isn’t always the easiest thing to do but it is a necessary process that you have to go through so that the medical professional that you are visiting leaves the session with as much information as possible so they can provide you with the best care available to help you take control of your weight loss.

Being prepared before you head off to your first visit can ease some of the anxiety you might feel when sharing sensitive information about your health. Here are five things you can do to be prepared for your first official chat about your weight with a medical professional that can make things a little easier.

1. Bring a list of your concerns

Trying to remember everything you want to ask your doctor at your appointment can be difficult, especially if you are nervous, anxious or embarrassed. It can be very helpful to write out a list of questions you have for your doctor before your appointment when you are more comfortable. This will ensure that you can get answers to some of the most important questions you have and make the best use of the time that you are sharing with your doctor.

2. Bring your information with you

When you are meeting with your doctor, they may ask you questions about you medical history and what medications you take. If possible, prepare a list with all the prescription drugs,herbal medications and supplements that you take regularly so that you can ensure that your doctor receives the most accurate information. If you have access to your medical records or have seen other doctors recently and have notes or feedback from that visit, providing this information can also be helpful.

3. Come with a family member or a close friend for support

Sometimes it is easier to cope with anxiety when you bring a familiar face along with you to share in the experience. The presence of family and friends can be a very effective way to help your appointment run smoothly, especially if they have some knowledge about your history that can assist in your doctor’s assessment.

4. Request an interpreter if you need one

Trying to deliver sensitive information can be extremely difficult and even impossible if you do not speak the same language as your doctor. If you require an interpreter it is important that you request one to be present so that you and your doctor can communicate effectively.

5. Bring a pen and paper to take notes

You will be provided with a large amount of information and potentially instruction during your visit with your doctor so feel free to take notes during the conversation that you can refer back to at a later date. Having a way to record some of the main points of your conversation can lessen the anxiety often associated with the effort of trying to remember everything in real time.

Speaking to your doctor is an important first step to addressing obesity or any weight-related health issues you may have. Being prepared to discuss a potentially sensitive subject will help your doctor get the best information to provide useful medical advice, and will help you to get the most out of your appointment.

Your doctor will be able to provide you with a referral to speak to one of the specialists at Adelaide Bariatric Centre who are very experienced and sensitive to patient’s needs when discussing obesity related matters.

Revisional Surgery

Thu, 26 Apr 2018 01:09:00 GMT

What is revisional bariatric surgery?

Revisional bariatric surgery is another surgical treatment following a previous bariatric surgery which did not lead to the desired results.

In most cases, revisional procedures are performed laparoscopically, which means that it is relatively non-invasive and low-risk. Only in very rare cases will laparoscopic revisional surgery need to be converted to an open surgery if we think that it is the safest way to complete the procedure.

When is revisional surgery appropriate?

A small percentage of bariatric surgery patients will experience less than expected results, such as less weight loss than desired or some weight re-gain.

There are several possible reasons for these outcomes. The most common is diet choice – which our dieticians and clinical psychologists can help with – but other common reasons may be stretching of the stomach (or a portion of the stomach) or lap band movement. A revisional procedure may also be used to convert one type to bariatric procedure to another.

You should also know that not everyone is suitable for revisional surgery. You may be a candidate for revisional surgery if:

You have a BMI 40 or above.
You lost less than 50% of the weight you planned to lose after your initial bariatric procedure.
You regained some or all the weight you lost after your initial bariatric procedure.
You have regained enough weight to cause further health problems such as diabetes to return or occur.

As every case is different a complete evaluation of the medical history, lifestyle, treatment preference, and reasons why you gained the weight back should be evaluated.

What are the advantages of revisional surgery?

The greatest advantage of revisional surgery is to achieve the positive weight loss and health outcomes of the original bariatric procedure as safely and non-invasively as possible

With revisional surgery of previous weight loss surgery, a variety of problems or complications can also be addressed such as intractable ulcers, intractable reflux, deteriorations of the stomach wall, infections, staple – line failures, movements of the gastric band, erosions of the gastric band or strictures.

What are the risks of revisional surgery

Any bariatric procedure including gastric band, gastric sleeve, or gastric bypass can be revised. The revisional procedure is performed on the same part of the abdomen as the first and there is a possibility of encountering scar tissue. For this reason, there is a greater risk of complications occurring after the second surgery.

However, this does not mean that a revisional surgery does not have a good outcome. In most cases, revisional surgery successfully treats the complications of the initial bariatric procedure and the desired weight loss is achieved. Generally, patients will lose less weight after the revision surgery compared to primary bariatric surgery.

How to prepare for revisional surgery

Preparation for revisional surgery will depend on the exact surgical procedure that is going to be performed. It is important to carefully consider and evaluate the reasons why the initial surgery did not lead to the desired results.

You should always keep in mind that the process of losing weight with bariatric surgery is a challenging process that requires a certain period of time. If a patient hasn’t made the necessary dietary and lifestyle changes after their first surgery, then it is unlikely that a revisional surgery will be successful either.

A multidisciplinary approach is necessary when preparing for revisional surgery. At Adelaide Bariatric Centre the surgeons work closely with dietitians, psychologists, bariatric practitioners, bariatric nurses and exercise physiologists when helping you achieve your goal of losing weight.

After the procedure

Revisional surgery can be more technically challenging than an initial procedure. It is also associated with a higher risk of complications. The recovery period is normally longer than the first surgery and you may need to remain in hospital for two or three days after the procedure.

However, the recovery period at home is usually just the same just as with an initial bariatric procedure. In general, you will need a couple of weeks before resuming to your normal daily activities.

Pregnancy After Bariatric Surgery

Thu, 26 Apr 2018 01:02:00 GMT

Obesity is a common problem across the developed world, including Australia where nearly 30% of adults may be obese. There are many reasons why a person becomes overweight or obese. Leading a sedentary life, eating too much and especially eating unhealthy foods, stress or various medical conditions may all contribute to a high BMI.

Bariatric surgery is a non-invasive medical option which can help people to lose weight when diet and physical exercise are not helpful. In general, bariatric surgery is recommended for patients who have a BMI (Body Mass Index) greater than 35 or 40.

It’s perfectly reasonable for any woman considering a bariatric surgical procedure to question whether the surgery will affect their fertility and future possibilities to conceive and have children. This article answers some key questions about bariatric surgery, fertility and pregnancy.

Will you be able to conceive after bariatric surgery?

Yes.

Pregnancy after bariatric surgery is possible in in many cases is safer and more likely to be successful compared to the pregnancy of an obese woman. However, you should keep in mind that you generally should allow your body a certain amount of time to recover from your procedure before you try to conceive. You also may want to achieve a certain amount of weight loss or other health-related goal that you discuss with your doctor before trying to become pregnant.

Some doctors will suggest a waiting period of at least 12 to 18 months, while others suggest a waiting period of at least 2 years before getting pregnant. Getting pregnant too soon after bariatric surgery could lead to developmental problems for your baby, as this kind of surgery will help you lose weight quickly your growing baby might not get all the nutrients needed.

Benefits to conceiving and pregnancy of bariatric surgery

Obesity is associated with reduced fertility and often conceiving can be quite a challenge if you are obese or overweight, as a result of oligovulation or anovulation. Even if a woman gets pregnant while being overweight and especially obese, there is increased risk for various conditions such as gestational diabetes, hypertension or preeclampsia.

Weight loss is the best way to mitigate the risks of obesity, and bariatric surgery is an effective, relatively safe and non-invasive option. Studies also suggest that after bariatric surgery the menstrual cycles start becoming more regular, ovulation is improved, leading to a greater possibility of conceiving.

What are the risks to pregnancy after surgery?

The biggest risk when it comes to a pregnancy after bariatric surgery is not getting enough nutrients needed for the mother and for the baby. However, this is a problem easily solved with a proper nutrition plan, which may include vitamin and mineral supplements.

Other risks and possible complications in such cases include anemia, weight gain, low birth weight for the child, and possibly an increased risk of C-section.

How is pregnancy after bariatric surgery different?

In general, prenatal care during the nine months of pregnancy is the same just as for all other women. However, there are a few little differences in a pregnancy after a bariatric procedure.

Consulting with the surgeon who performed your procedure before trying to conceive is recommended, as they will know your medical situation best.

You may also need to take some additional or different supplement vitamins and minerals, to make sure that your growing baby is getting all the nutrients needed.

You can also expect to gain weight during your pregnancy. This is completely normal and healthy. Remember that it is recommended to gain 10 to 14 kg during pregnancy. As long as you eat well and remain active during the nine months of pregnancy losing this extra weight once the baby is born should not be a problem.

Labour and delivery

Is there a difference when it comes to labour and delivery during a pregnancy that occurs after bariatric surgery? In general, management of labour and delivery after bariatric surgery should be the same as with any other patient. You should also know that while rates of C-section delivery are higher among women who have had bariatric surgery in the past, the surgery is not an indication for C-section and a safe, normal delivery is still entirely possible.

What should you do to have a healthy pregnancy after surgery?

The most important things you can do for your own health and the health of your growing baby during pregnancy is to eat healthily and to be physically active. If you think you may want to try to conceive after surgery, speak to our doctors about the best exercise and nutrition programmes for your needs.

Of course, it’s also important to weigh any of these answers about bariatric surgery against the health, fertility and pregnancy consequences of untreated obesity as well. If you would like to speak to one of the medical experts at Adelaide Bariatric Centre for more information, please get in touch with us today.

Gastric Sleeve Revision

Fri, 12 Jan 2018 01:43:00 GMT

What is Gastric Sleeve Revision?

If you have recently had gastric sleeve surgery and it didn’t meet your weight loss requirements, or even you gained weight after it, a gastric sleeve revision procedure could be a suitable solution.

Sometimes, people suffer from acid reflux after their sleeve surgery. This may also be an indication that a gastric sleeve revision may be suitable.

There are four options for gastric sleeve revision. They are listed here in the order of their efficacy in losing weight in the long term in most cases. Your doctor will recommend the most suitable procedure based on your medical history and personal circumstances.

1. Duodenal Switch (DS):

The Duodenal Switch is regarded as a challenging procedure and is generally only performed by experienced specialists. Here, in Adelaide Bariatric Centre, we offer this surgery as it is the most effective in the long term for most patients.

DS involves removing the excess part of the stomach if it has stretched out after the previous gastric procedure, removing the gallbladder and rearranging the small intestine as shown in the picture. This stretching is the most common reason that some initial gastric procedures don’t achieve the desired results

Caloric and mineral malabsorption can happen after this procedure, so controlling your diet is so important[1].

2. Gastric bypass:

Unlike the duodenal switch, mineral malabsorption can only happen in this case, so it is safer. All the same, you should discuss your diet supplements with your doctor to reduce any risks of these deficiencies.

Roux-en-Y Gastric Bypass (RNY) involves removing the top portion of the stomach and ligating the esophagus with the lower portion. Also, the jejunum is connected to the stomach and the intestine as shown here.

3. Re-sleeve:

Re-sleeve is the most suitable surgical option in many cases when the stomach has stretched after a sleeve gastroplasty. However, like in sleeve gastroplasty, the stomach can re-stretch again without changes in eating and lifestyle habits accompanying the procedure.

On a positive note, re-sleeve is also the least invasive procedure among the surgical options of gastric sleeve revision.

4. Lap-band:

Many surgeons do not recommend this surgery as it has a high failure rate and can have uncertain results[2] for some types of patients. It involves banding the upper portion of the stomach with a ring that is connected to a tube to a small port under the skin as shown here. This port can control the size of the stomach entry part to control the amount of food required to fill the stomach.

Outcomes and advantages of Gastric Sleeve Revision

Gastric sleeve revision offers significant weight loss outcomes and prevents re-gaining weight after a sleeve gastroplasty.

Gastric sleeve revision also has an extremely low mortality rate.

However, patients should be aware that there can be more complications if there are any scars left behind the initial procedure.

Who is Gastric Sleeve Revision most suitable for?

Patients who underwent a previous sleeve gastroplasty and who lose weight in an inadequate manner or even re-gain weight following their initial procedure.

Normally, if you underwent a sleeve gastroplasty, you should lose 70% of your excess weight in the 12 months that follow the surgery. If this doesn’t happen, call your surgeon immediately.

Preparing for your procedure

In order to have fewer complications after the surgery and to get a higher weight loss results after the surgery, safe and proper preparation for the procedure is recommended.

Prior to the surgery, you should eat a lot of protein to compensate your body for its needs after the surgery as you will go on a rapid weight loss. Also, taking multivitamins is recommended. Your doctors will be able to give you specific dietary recommendations to suit your individual needs.

The night before the procedure, you may be required to fast starting from the midnight to have a clear gastrointestinal tract.

You may also have some psychological, dietician and upper gastrointestinal evaluations to measure your preparedness and suitability for the surgery. Several common tests like blood work, electrocardiogram and x-ray are also likely to be required of you.

After your procedure

Like after your initial procedure, your diet will mostly consist of clear fluids like fruit juices. You’ll soon gradually transition from fluids to solid foods.

High protein and healthy diets are generally recommended after the surgery. Remember, our ultimate goal is losing weight.

In the first week following the surgery, you need to have someone to help you with your daily activities as sudden exertion or straining should be avoided after the surgery.

Ultimately, you may need four to six weeks for a full recovery after your surgery.

Our multidisciplinary approach

Here at Adelaide Bariatric Centre, we offer you a multidisciplinary approach. The surgeons work closely with bariatric practitioners, dietitians, exercise physiologists, psychologists and bariatric nurses to help you lose weight.

[1] https://link.springer.com/article/10.1007%2Fs11695-017-2838-8

[2] https://link.springer.com/article/10.1007%2Fs00464-010-1250-4

Reducing mortality risk and comorbidities in obesity

Tue, 31 Oct 2017 01:54:00 GMT

The increase of obesity within the population has brought with it a rise in reduced life expectancy.

Numerous studies over the past three decades have sought to understand the correlation between obesity and mortality risk. While there is no general consensus, the results from studies in the United States have indicated that between 5% and 13% of deaths occur due to obesity.[1]

Although the exact figures vary, there is widespread consensus that obesity creates an increased risk of early mortality. A study by the National Health and Medical Research Council in 2003 found that mortality risk doubles with a BMI of 35.[2] However, the greatest mortality risk associated with obesity arises from the relationship between obesity and comorbidities.

Correlation between obesity and comorbidities

Comorbidities are additional diseases or disorders that occur at the same time as the condition in interest.

Common comorbidities associated with obesity compound the risk of early mortality. Obesity is a risk factor for heart disease, type 2 diabetes, osteoarthritis, some cancers, breathing problems and many more conditions.[3] This is often exacerbated by factors such as lifestyle, diet and the shape of a person’s body and where fat is predominantly stored.[4]

Permanent weight loss is generally the best treatment that will help obese and morbidly obese people lose weight will help to decrease the symptoms of pre-existing comorbidities whilst also reducing the risk of further conditions.

Bariatric surgery

Generally, calorie restriction and an exercise regime targeted towards weight loss can help to reduce comorbidities and lessen the risk of early mortality.

However, these can often be difficult to maintain and often are only a temporary solution for those who suffer with obesity. Surgery has been found to be the most effective treatment for motivated morbidly obese people.[5]

Bariatric surgery is an excellent option for people with a BMI of 35 and over who are looking for a safe solution that will help them improve their health and quality of life.

Many people have an initially negative perception of weight loss surgery due to misconceptions about complications associated with the procedures. While there are always risks associated with any surgery, many bariatric procedures are generally safe, with minimal complications when performed by an experienced surgeon.

There are a couple of different bariatric surgery options that are performed in Australia.

Gastric banding is the attachment of a silicone band to the top of the stomach, creating a small pouch that limits the amount of food the patient can eat and increases feelings of fullness. Gastric sleeves remove the lateral part of the stomach, leaving a narrow tube instead of a stomach sack. Gastric bypass surgery creates a small stomach pouch that is attached to the small intestine.

All these surgeries will help patients lose a significant amount of their excess weight within 2 years of the procedure. This helps lessen or eliminate some of the diseases and disorders that are associated with obesity.

Studies by the Centre for Obesity Research and Education at Monash University found that bariatric surgery had an effect on some common comorbidities associated with obesity. The bariatric surgery helped reduce, or in some cases remove, some of the symptoms of:[6]

Type 2 diabetes
Hypertension
Reflux oesophagitis
Asthma
Depression
Non-alcoholic steatohepatitis
Polycystic ovarian syndrome
Sleep apnoea

A study in 2000[7] that followed the progress of patients who underwent bariatric surgery found that over 95% of the significant comorbidities were resolved. Specifically:

Gastro-oesophageal reflux dis-ease – 98% eliminated
Type 2 diabetes – 98% eliminated
Sleep apnoea- 98% clinically resolved
Stress incontinence – 97% eliminated
Hypercholesterol – 97% reduced
Hypertension – 92% clinical remission
Symptomatic arthritis – 90% reduced

Those comorbidities that did persist after surgery were found to be significantly reduced in severity. All these benefits help to reduce the risk of mortality in obese people.

Adelaide Bariatric Centre

These benefits can be life changing for those who are suffering from obesity and any of the common comorbidities. However the treatment needs to be supplemented with a holistic approach that will support patients before and after surgery, to help them adjust.

Adelaide Bariatric Centre believes the best way to achieve significant and sustained weight loss coupled with an increased quality of life, is to combine bariatric surgery with a complete support program. Their multidisciplinary focus includes patient access to dietitians, exercise physiologists, and bariatric nurses who will help patients adjust to life post-surgery and get the best results possible.

[1] Zheng, H., Tumin, D. and Qian, Z. (2013). Obesity and Mortality Risk: New Findings From Body Mass Index Trajectories. American Journal of Epidemiology, 178(11), pp.1591-1599.

[2] National Health and Medical Research Council (NHMRC). (2003). Clinical practice guidelines for the management of overweight and obesity in adults. [online] Available at: The Department of Health [Accessed 26 Jun. 2017].

[3] Schelbert, K. (2009). Comorbidities of Obesity. Primary Care: Clinics in Office Practice, 36(2), pp.271-285.

[4] Wilkinson, L. (2013). A Second Look at the Link Between Obesity and Mortality | THCB. [online] Thehealthcareblog.com. Available at: The Health Care Blog [Accessed 26 Jun. 2017].

[5] National Health and Medical Research Council (NHMRC). (2003). Clinical practice guidelines for the management of overweight and obesity in adults. [online] Available at: The Department of Health [Accessed 26 Jun. 2017].

[6] Brien, P., Brown, W. and Dixon, J. (2006). Management of obesity: the role of surgery. Australian Family Physician, 35(8), pp.584-586. Availability: Adelaide Uni [cited 26 Jun 17]

[7] Wittgrove, A. and Clark, G. (2000). Laparoscopic Gastric Bypass, Roux en-Y - 500 Patients: Technique and Results, with 3-60 month follow-up. Obesity Surgery, 10(3), pp.233-239.

Gastric Bypass Surgery Changes Appetite

Mon, 12 May 2014 07:34:00 GMT

Undergoing Roux-en Y gastric bypass surgery is a life changing procedure, as it not only helps suppress appetite but also influences the types of food patients crave.
This finding was recently championed in a UK study, which found patients who experienced food aversions enjoyed significantly more post-operative weight loss and reduction in their BMI compared to those without such sensory changes.

Post-operative Changes to Appetite

The study conducted by researchers from Leicester Royal Infirmary sent questionnaires out to patients who had undergone the procedure at the University Hospitals of Leicester between the years 2000 and 2011. In total, 103 patients answered 33 questions relating to postoperative changes in their appetite, taste and smell.

Of the respondents, 97 per cent reported alterations to their appetite following the gastric bypass surgery. But of course, their experiences varied, with some subjects reporting that their sense of smell and taste were either unchanged, heightened or reduced. However, 73 per cent of patients noted some form of change in the way food tasted. Respondents especially noted a change in their liking for proteins including: chicken, beef, pork, roast meat, lamb, sausages, and fish; as well fatty and high carb foods such as: fast food, chocolate, and pasta.

Sensory Changes Assist Weight Loss

Further findings from the paper, published in the journal of Obesity Surgery, found that only four per cent of those surveyed experienced an aversion to fruit and vegetables. Comparatively, 73 per cent of of participants suddenly found themselves consuming less fatty foods losing an average of 8 kilograms more than their counterparts.

While researchers were not certain as to the precise cause of these sensory changes they believe it to be a combination of gut hormone and central nervous system effects. But whatever the reason, the patients who experienced food aversions were universally found to experience significantly more postoperative weight loss and reduction in BMI compared to those without such dislikes.

The Top 10 Tips BEFORE Gastric Sleeve Surgery

Tue, 18 Feb 2014 23:59:00 GMT

Along with life changing weight loss, Gastric sleeve surgery is also a life changing decision. So, here’s 10 timely tips to help you better understand and prepare for your bariatric procedure.

Change your diet. The sooner you prepare your body for life with a gastric sleeve, the quicker you’ll adapt. First, be ready for a liquid-only diet two weeks before surgery.
Change your groceries. It will be a while before you’re able to eat solids again, so stock up on clear soups and broths, skim milk, sugar-free clear jello and popsicles. Prior to surgery, it’s strictly protein-rich, liquid meals.
Stop smoking. Not smoking will speed up your recovery and reduce the risk of postoperative complications. But be warned, if you don’t, your doctor may refuse to operate.
Change of clothes. Make sure you have comfy and loose "transition" clothing. Your body will be sore and tender, as well as rapidly losing weight, so some interim op-shop clothes might help.
Your hospital bag. Your surgery and recovery time will mean an overnight hospital stay, so get your packed bag ready with comfortable clothes.
Your support group. Make sure your immediate family and friends understand what help you’re going to need during your healing process.
A lift and a pillow. You certainly won’t be in any shape for driving, so make sure you have a lift home organised. Also, holding a pillow tightly over your abdomen will help stop the pain from bumps in the road.
Prep list. If you can, clean the house, do the laundry and have your meals cooked and frozen. Also get your prescriptions, over-the-counter medication and stool softeners early.
Talk to your surgeon. Find out from your surgeon exactly what this surgery entails and what is about to happen. This will help reduce any anxiety about your surgery.
Protein, protein, protein! You'll need protein afterwards, so get used to it before hand. Find out which protein powders you like, along with the low-calorie protein rich foods you enjoy, and stock up!

Please note: these tips are for anyone preparing for, or recovering from, gastric sleeve surgery. They are a guide to help and not meant to supersede any advice your doctor gives you.

Top Ten Tips AFTER Gastric Sleeve Surgery

Wed, 12 Feb 2014 05:39:00 GMT

Follow your diet stages. Eating solid foods or high fat and sugar food too soon could risk damaging your stomach and yourself. Side effects include as nausea, vomiting and stomach cramps.
Back to work when you’re ready. It usually takes about 2 weeks after gastric sleeve surgery before a person can go back to work. Even then, it should be light duties only. Yes, walking is good exercise, but no heavy lifting.
Never miss check-ups. Seeing your physician well into your recovery is vital, to ensure you’re healing correctly… and on still track with your diet, exercise and weight loss goals.
Exercise when you can. Easy does it, but strengthen your muscles and start walking as soon as you comfortably can. Your body needs the strength to work with less calories.
Continue to educate yourself. Find new recipes so food doesn’t become boring after surgery. Your tastes will change, so try new things. Even food you disliked. You need to learn to listen to your new body.
Know when you need help. Initially, it may be difficult to move and do things. So, get lots of rest and have your support team ready to help.
Follow your prescription. Don’t wean yourself off medication, and let your doctor know about any discomfort. Also, diabetes or high blood pressure can be cured by this surgery, so following your doctor’s prescription is vital.
Take multivitamins regularly. Getting the correct nutrition from food alone is tough so get your routine going. Multivitamins ensure you’re getting the right nutrients; your doctor knows what you need. It’s a lifelong habit you now need, so start early.
Track your calories. 600-800 calories a day will ensure you lose weight, so avoid foods high in calories, sugar or fat. Again, your doctor knows you and your body and your specific target.
Don't drink your calories. Only drink low-calorie drinks like water, sugar-free juices and unsweetened ice tea. Fizzy drinks can stretch your new pouch because of the gasses -- and never drink alcohol after surgery.

These tips are for anyone preparing for, or recovering from, gastric sleeve surgery. They are a guide to help and not meant to supersede any advice your doctor gives you.

Image credit to Ralph and Jenny

Pick the Best Workout Music - According to Science

Wed, 11 Dec 2013 02:18:00 GMT

Anyone who’s ever worked out or gone for a jog with an iPod strapped to their arm is well aware that music can enhance any exercise session. But are the benefits mainly motivational and fun, or does it actually improve the workout?

Numerous scientific studies have shown that listening to music does, in fact, provide objective benefits when working out. Dr Costas Karageorghis, associate professor of sport psychology at Brunel University in the UK, has studied the effects of music on physical performance for more than two decades. Dr Karageorghis has found that music can indeed provide boost your performance during exercise - by as much as 15 per cent.

According to Dr Karageorghis' research, one of the key factors is the tempo of a song. Ideally, it should be between 120 - 140 beats-per-minute (or BPM). A high proportion of modern dance and rock music fits within that range. Interestingly, it also correlates with the heart rate of the average person (that is, non-elite athletes) during typical exercise.

In one study, which was published in the Journal of Sport & Exercise Psychology, Dr Karageorghis got participants to exercise on a treadmill while keeping in strict time to music, which was set at 125 BPM. The volunteers had the option of choosing between either a pop or a rock playlist. When compared to a control group that didn't listen to music, the study participants who exercised in sync to music enjoyed a 15 per cent improvement in endurance.

"The synchronous application of music resulted in much higher endurance," said Dr Karageorghis. "While the motivational qualities of the music impacted significantly on the interpretation of fatigue symptoms right up to the point of voluntary exhaustion."

We’ve put together a list of songs with tempos between 120 - 140 BPM to get you started:

Beat It - Michael Jackson (139 BPM)
Gangnam Style - PSY (132 BPM)
Sexy & I Know It - LMFAO (129 BPM)
Pumped Up Kicks - Foster The People (128 BPM)
Born This Way - Lady Gaga (125 BPM)
Seven Nation Army - The White Stripes (124 BPM)
Breathe - The Prodigy (130 BPM)
Enter Sandman - Metallica (123 BPM)
Uprising - Muse (132 BPM)
Bohemian Like You - The Dandy Warhols (138 BPM)

IMAGE CREDIT: John Loo

One In Ten Australians Diagnosed With Diabetes

Wed, 27 Nov 2013 04:19:00 GMT

Latests numbers released by the International Diabetes Federation have revealed that the number of Australian adults diagnosed with diabetes has reached almost 1.7 million - or one in ten.

Worryingly, an estimated 814,000 Australians remain undiagnosed.

“Diabetes is an emergency in slow motion,” said Peter Soelberg, Managing Director, Novo Nordisk Australasia.

“Whenever the IDF updates its figures, the numbers grow. This year is unfortunately no exception.“

IMAGE CREDIT: Alden Chadwick

The data also estimates that at the end of 2012, over 46 per cent of type two diabetes patients people with type two diabetes were not achieving their blood glucose goals.

Poor blood glucose control can lead to a variety of serious diabetes complications, such as cardiovascular disease, blindness, kidney failure and amputation of limbs.

The latest IDF numbers support the data in an Australian report released last year, entitled Diabetes: the silent pandemic and its impact on Australia. The report was researched and written by Baker IDI Heart & Diabetes Institute in partnership with Diabetes Australia, the Juvenile Diabetes Research Foundation and Novo Nordisk.

It is expected that by 2025, type 2 diabetes - Australia’s fastest growing chronic disease - will triple in prevalence, with three million Australians diagnosed.

Type 2 diabetes is potentially preventable in an estimated 60 per cent of cases.

Surgery Still Beneficial 3 Years Post-Op

Wed, 20 Nov 2013 03:52:00 GMT

A study has found that bariatric patients continue to enjoy significant weight loss three years after their operation, in addition to improved health outcomes.

The study, published in the Journal of the American Medical Association, looked at health outcomes for severely obese patients three years after they underwent bariatric surgery. It also found improvements in obesity-related health complications, including diabetes, hypertension and high cholesterol.

Led by Dr Anita Courcoulas, a bariatric and general surgeon at Magee-Womens Hospital of UPMC, the researchers examined data from a multicenter observational cohort study at 10 US hospitals in six geographically diverse locations. The researchers gathered information on bariatric surgery patients and followed them over the course of three years.

The study volunteers ranged in age from 18 to 78 years; 79 per cent of them were female. Of the patients involved, 1738 underwent gastric bypass surgery and 601 had laparoscopic gastric banding.

At the three year post-surgery follow up, researchers observed significant weight loss, with most of the reduction having occurred in during the first year. Participants who underwent gastric bypass surgery experienced median weight loss of approximately 32 per cent, while laparoscopic gastric banding patients experienced median weight loss of 16 per cent.

Of the gastric bypass patients suffering from specific obesity-related health problems before surgery, 67 per cent experienced partial remission from diabetes and 38 per cent remission from hypertension. Furthermore, high cholesterol resolved in 61 per cent of the bypass patients.

Of those who underwent laparoscopic gastric banding, 28 per cent experienced partial remission from diabetes, 17 per cent experienced remission from hypertension and high cholesterol was resolved in 27 per cent of patients.

"Longer-term follow-up of this carefully studied cohort will determine the durability of these improvements over time and identify the factors associated with the variability in effect,” Dr. Courcoulas said.

IMAGE CREDIT: phalinn

Bariatric Surgery Can Improve Women’s Sexual Health

Wed, 13 Nov 2013 05:14:00 GMT

It is already known that the benefits of bariatric surgery are myriad, including sustained weight loss and reduced cardiovascular risk. Now, a new study has found that bariatric surgery can also improve a woman's sexual health.

Researchers at the University of Pennsylvania examined factors such as women's sexual functioning and hormone levels, as well as their quality of life, body image and symptoms of depression.

For the purpose of the study, which was published in JAMA Surgery earlier this month, the researchers followed 106 female bariatric surgery patients. Of those women, 85 had undergone a gastric bypass, while the other 21 had gastric banding procedures.

The women in the study had lost, on average, 33.5 per cent of their pre-surgery weight two years after bariatric surgery. They also reported additional benefits, including improvements in body image, increased sexual satisfaction and sexual functioning, and improved reproductive hormone levels.

"Two years following surgery, women reported significant improvement in overall sexual functioning and specific domains of sexual functioning: arousal, lubrication, desires and satisfaction,” the authors of the study wrote.

Dr David Sarwer, the lead author of the study, said that for many people sex was an “important part of quality of life”.

"The massive weight losses typically seen following bariatric surgery are associated with significant improvements in quality of life," Dr Sarwer said.

"This is one of the first studies to show that women also experience improvements in their sexual functioning and satisfaction, as well as significant improvements in their reproductive hormones."

According to the researchers, the results suggest that improved sexual health can be added to the list of benefits associated with bariatric surgery and resulting weight loss.

“Our study provides new information on changes in sexual functioning, reproductive hormone levels, and psychosocial functioning in women in the first 2 years after bariatric surgery,” they wrote.

“Future studies should investigate if these changes endure over longer periods of time, and they should investigate changes in sexual functioning in men who undergo bariatric surgery.”

IMAGE CREDIT: mozzercork

Obesity Risk Inherited Via Father's Sperm

Wed, 06 Nov 2013 02:46:00 GMT

South Australian research has found that the sperm of obese men may pass on the risk of obesity and diabetes for two generations.

Laboratory studies at the University of Adelaide found that molecular signals in the sperm of obese men can lead to obesity and diabetes symptoms in the men's children and grandchildren - despite the offspring eating healthily.

"A father's diet changes the molecular makeup of the sperm," said Dr Tod Fullson, the lead author of the paper. "With obese fathers, the changes in their sperm - in their microRNA molecules - might program the embryo for obesity or metabolic disease later in life."

"For female offspring, there is an increased risk of becoming overweight or obese. What we've also found is that there is an increased chance of both male and female offspring developing metabolic disease similar to type 2 diabetes.

Dr Fullson said this is the first report of both male and female offspring inheriting metabolic disease due to the father's obesity.

According to the study, which was published in The FASEB Journal, the second generation of descendants also showed signs of obesity and metabolic disorders - although not as severe as the first generation.

Dr Fullston said that even if the obese father did not show any signs of diabetes, metabolic diseases similar to diabetes were still seen in their children and grandchildren.

"It's been known for some time that the health of a mother before, during and after pregnancy can impact on her child's health, but the father's health during this period is often overlooked," Dr Fullston said.

"A focus on the mother's health is extremely important, but we're seeing that the father's health is also important for conception. It's possible that by showing additional attention to diet and exercise in the father, this could have a positive impact on his future children and grandchildren."

Image Credit: Iqbal Osman

Stomach Desensitised To Fullness Even After Dieting

Wed, 30 Oct 2013 03:05:00 GMT

Research conducted at the University of Adelaide has found that the nerves in the stomach that signal fullness become desensitised in obese people - and fail to revert back to normal even after the patients lose weight through dieting.

The team behind the study, which was published in the International Journal of Obesity, believe this could explain why most people who lose weight through dieting later regain the weight.

"The stomach's nerve response does not return to normal upon return to a normal diet," said Associate Professor Amanda Page, from the university's Nerve-Gut Research Laboratory. “This means you would need to eat more food before you felt the same degree of fullness as a healthy individual.”

Leptin, a hormone produced by the body, is known to regulate food intake - but can also alter the sensitivity of the nerves in the stomach that signal fullness. Normally, leptin stops food intake in healthy people. However, in the case of obesity induced by a high-fat diet, leptin desensitises the nerves in the gut.

"These two mechanisms combined mean that obese people need to eat more to feel full, which in turn continues their cycle of obesity," Associate Professor Page said.

"Unfortunately, our results show that the nerves in the stomach remain desensitised to fullness after weight loss has been achieved.”

According to associate Professor Page, the results have "very strong implications" for obese people and those trying to lose weight or maintain weight loss through dieting.

"We know that only about 5 per cent of people on diets are able to maintain their weight loss, and that most people who've been on a diet put all of that weight back on within two years," she said.

Associate Professor Page said that more research needs to be conducted in order to determine whether the desensitisation is permanent.

IMAGE CREDIT: jeffreyw

Obesity Shown To Increase Pancreatic Cancer Risk

Thu, 17 Oct 2013 22:17:00 GMT

A new study has found the first direct link between obesity and pancreatic cancer.

Pancreatic cancer is one of the most lethal forms of cancer, with a five year survival rate of 3-5 per cent and the average length of survival after diagnosis being just four to six months. In Australia, it is the fifth most common cause of cancer death.

Like with most cancers, early diagnosis improves the prognosis. However, pancreatic cancer usually isn’t detected until the disease is at an advanced stage, as it doesn’t typically display early symptoms.

The study, conducted by researchers at UCLA's Jonsson Comprehensive Cancer Center (JCCC), discovered that mice fed a high-fat, high-calorie diet until they were obese developed abnormally high numbers of the pancreatic lesions known to be a precursor to pancreatic cancer.

Mice in the genetically identical control group, who were fed a normal diet, gained an average 7.2g over 14 months. In comparison, the mice fed the high-fat, high-calorie diet gained more than twice as much weight - an average weight gain of 15.9 g.

Tests showed that the mice in the control group generally had normal pancreases with very few lesions, while the obese mice tended to have less healthy pancreases, with significantly more pancreatic lesions. They also had metabolic abnormalities and higher insulin levels.

"The development of these lesions in mice is very similar to what happens in humans,” said Dr Guido Eibl, who led the study.

“These lesions take a long time to develop into cancer, so there is enough time for cancer preventive strategies, such as changing to a lower fat, lower calorie diet, to have a positive effect."

This is the first animal study to demonstrate a direct, causal link between obesity and cancer of the pancreas.

Image Credit: ReneS

Bariatric Surgery More Effective For Diabetes Than Medical Therapy

Tue, 15 Oct 2013 05:27:00 GMT

A recent study has reported that gastric surgery procedures are more likely to help obese patients with type 2 diabetes than medical therapy alone.

The study, which was published in the BioMed Research International journal, identified three randomised controlled trials from a retrospective literature search of 269 publications. They included 170 patients in the bariatric surgery group and 100 patients in the medical therapy group.

The researchers found a significant contrast between the surgery group and medical therapy group in diabetes remission rates, with bariatric surgery being associated with an increase in diabetes remission. The researchers also noted that, according to the results, bariatric surgery could improve patients' glycaemic control two years after undergoing the procedure.

“This meta-analysis showed that bariatric procedures could significantly induce and maintain well-glycaemic control, which was confirmed by the results of several other studies,” the researchers wrote.

Patients in the bariatric surgery group were significantly less likely to have hypoglycaemia when compared to the medical therapy group. Furthermore, bariatric surgery was associated with a notable reduction in the patients' weight, in comparison to patients who only underwent medical therapy.

"Bariatric surgery could not only significantly decrease... the amount of medicines (including hypoglycaemic, antihypertensive, and lipid-lowering ones), weight, and triglycerides, but also increase the rate of diabetes remission and the levels of high-density lipoprotein," the researchers wrote.

"Meanwhile, there were no statistical differences in the serious adverse events between surgical and medical groups.”

MAGE CREDIT: aldenchadwick

Gastric Banding Reduces Cardiovascular Disease Risk

Wed, 02 Oct 2013 02:22:00 GMT

Patients who undergo laparoscopic adjustable gastric band (LAGB) surgery enjoy a significant reduction in long-term cardiovascular risk just one year post-surgery, according to a recent study published in the journal Advances in Therapy.

The team of researchers behind the study set out to examine whether weight loss in obese patients treated with LAGB surgery was associated with reductions in the estimated 10- and 30- year cardiovascular disease (CVD) risk, 12–15 months after surgery.

Obese adult patients (with a BMI above 30) treated with lap band surgery were identified through a large US healthcare database, and matched to non-LAGP patients by age and gender. Match criteria also took into account baseline measures for BMI, systolic blood pressure, diabetes, and smoking status.

The data revealed that the ten- and thirty-year estimated cardiovascular risk decreased from 10.8 to 7.6% and from 44.34 to 32.30% respectively, 12–15 months after LAGB surgery. More importantly, improvements were significantly greater than in non-LAGB patients.

The researchers concluded that the data showed patients who undergo lap band surgery have significant weight loss, reduced CVD risk factors and reduced estimated CVD risk, further confirming the effectiveness of the LAGB procedure as an option for management of obesity.

“These results add to the evidence of the cardiovascular benefits of significant weight loss among obese individuals and the potential long-term clinical impact of the LAGB procedure as a therapeutic intervention for obesity,” the researchers wrote.

The researchers cautioned that larger, long-term studies are needed to determine whether the effects of LAGB on CVD risk factors translates into a reduced incidence of CVD.

Gastric Band Not Only For Obese Diabetics

Wed, 11 Sep 2013 02:43:00 GMT

Weight loss surgery is often portrayed as something that is only for morbidly obese people, but a study out of Melbourne’s Monash University may change that idea.

Researchers trialled gastric band surgery on 51 people who had type 2 diabetes, but were merely overweight and not obese. The study represents a breakthrough because although we already know that obese people will benefit from weight loss surgery, the effects have not been studied on diabetics who are overweight but not obese.

Comparing the results of those who received surgery with a control group that were put on an exercise and diet plan, the surgery recipients lost more than 10 times as much weight: 11kg on average vs 1kg in the diet and exercise group. The average starting weight of all the people studied was 81kg, significantly less than conventional gastric bypass patients.

More than half of those who received the surgery saw their diabetes go into remission, while the rest required less medication to control their disease. Other benefits noted included improved blood pressure, insulin resistance and cholesterol levels.

“Offering bariatric surgery to people who are overweight has helped them lose more weight and delivered much better diabetes outcomes than non-surgical intervention,” researcher Dr John Wentworth said.

“We found that, at two years following the surgery, around half of the patients sustained weight-loss that effectively put their diabetes into remission.”

The findings were presented in Sydney last week and may soon challenge the standard recommendation that gastric bands only be applied to those with a BMI greater than 35.

It follows a recommendation from the American Society for Metabolic and Bariatric Surgery that suggested weight loss surgery as a viable option for those with a BMI between 30 or 35. The announcement, which occurred early this year, stated: “The existing cutoff of BMI at 35 was established arbitrarily nearly 20 years ago. There is no current justiﬁcation on grounds of evidence of clinical effectiveness, cost-effectiveness, ethics, or equity that this group should be excluded from life-saving treatment.”

Can you get a gastric band if you’re overweight but not obese?

In some circumstances, doctors may recommend surgery for diabetics that are not obese, but depends on the individual’s situation and health issues. The Monash University study has not changed any guidelines yet, but it is likely that further studies will be conducted. If you are not obese but considering surgery, your best option is to talk to our team and book an appointment to talk about your circumstance.

IMAGE CREDIT: davidd

Imagining the future helps women lose weight

Mon, 09 Sep 2013 06:10:00 GMT

We’re always getting media messages about exercising our bodies, but how often do we think about exercising our willpower? A strong sense of discipline goes hand in hand with a strong body. Previously, scientists realised that overweight people tend to struggle with delayed gratification, that is, the no pain, no gain principle. Studies have found that overweight people are more likely to say yes to immediate pleasure even if it comes at a long-term cost.

But if willpower is not your forte, there is hope: a new study shows that behavioural intervention techniques work just as well on overweight women as they do on lean women. Researchers at University at Buffalo taught women of various body weights the technique of prospection, or mentally simulating the future. They found that those who used the technique when offered temptation were better able to exercise delayed gratification.

“This research is certainly welcome news for people who have struggled to lose weight, because it shows that when people are taught to imagine, or simulate the future, they can improve their ability to delay gratification,” says renowned obesity expert Leonard Epstein, who authored the study.

“In the current study, we show that episodic future thinking works equally well in overweight and obese women in comparison to lean women,” says Epstein. “That’s important since several studies have shown that overweight/obese women are more impulsive.”

“The fact that projecting oneself into the future and imagining future scenarios works equally well for lean and overweight/obese women is important for designing interventions to reduce impulsive decision making in women who need to lose weight.”

It’s not the first time Epstein’s team has delivered good news for overweight women: they found that these women ate less when told to imagine themselves in enjoyable future scenarios.

How to exercise delayed gratification

Confused about how to start applying these principles? The good thing is you probably already are applying them. If you’ve ever thought about how great you’re going to feel after your run to motivate yourself to lace up those shoes, then that’s prospection. Or if you have ever bought clothing a size too small as a future reward for losing weight, that’s also prospection, because you imagined your future self as a motivational tool.

The most important thing with motivation and willpower is not to do it alone. That’s why we have a trained psychologist on staff, as well as exercise counselling. And for the days you’re not visiting us, our Pinterest boards can help you remember what’s important.

Image: Obesity expert Leonard Epstein discusses behavioural techniques that anybody can learn. [ courtesy of University at Buffalo. ]