Wednesday, May 25, 2011

Lethal Inactivity - Beyond Exercise

Dr James Levine - Mayo Clinic Article NYT

I have read ( and probably blogged) about his research before. This is particularly good.

I had a "standing desk" in Duluth, and it was wonderful. Almost made one of his homemade treadmill desks - just for 1 mile per hour non-exercise energy expenditure.

This is how we redesign our society from the bottom up!

Dietitian's dilemma

Many very certain lectures have been given on this subject.... - Beware certainty! Even though I am quite certain of the data with bariatric surgery, we are only beginning to understand HOW things work.

High fructose may not be the answer

Also, beware the non-surgeon's lack of data on the single case, short term success (also frequently brought out for lectures to convince you that it's just a willpower problem)

Yale's Rudd Center on regain risk

Unfortunately, the Rudd Center doesn't seem to get quoted on the relative success rate of surgery at 20 years (still an average of 50% excess weight off) versus their database of 800 patients (collected from around the world) at one year...

Ask your dietitian for long term data in their practice!

Weight Loss Surgery superior for Diabetes, Heart Disease?

Cardiovascular superior results

Your primary doc will soon be following the data in "Pay for Performance" Unfortunately, too many people die needlessly every day of disease that was avoidable with CURRENT evidence and techniques.

As Dr Adams says in the article - while surgery will always have some risk, in those with Type 2 Diabetes, the non-operative risk is actually much higher.

I am continuing to offer physician education in clinics, as well as at conferences, dinners, and elsewhere. Please encourage your primary and specialty providers to educate themselves!

I recently heard an esteemed local endocrinologist make the excuse "well, I don't know much about surgery". I am scandalized that one could purport to be an expert in a disease and be willfully ignorant of a therapy that could put over half of his patients into full remission. Yes, discrimination is that strong even among docs!


Tuesday, May 17, 2011

Older patients benefit from surgery

Minnesota study of over 65 patients

I have operated on several patients as old as 73 - definitely have to take extra time for individual goals and risks, but these folks are often the ones with the very worst mobility limitations, and daily pain.

Sunday, May 15, 2011

Diabetes - Quote from the National Institute of Health

Gastric bypass and other bariatric surgeries to treat extreme obesity may resolve type 2 diabetes independently of weight loss, opening the door to discovery and to new therapeutic options for some individuals.

Diabetes strategic research plans for NIH

Article about the strategic plan

NIH Obesity Strategic Plan

Then they go on to mostly talk about strategies that don't involve remission... well, be glad you have control over your own health in some way. People feel disempowered because insurance is difficult, but there are almost always options.

Science Genetic Control of Diabetes

It's great that research will be taking us forward. Years will pass, and if you are diabetic right now, the disease is hurting you faster than the research will produce more than the tools we have in front of us. If you want your diabetes in remission, there is a tool available.

Science Insulin Sensitivity

Good Reason to wear your CPAP!

Mortality of sleep apnea in elderly improves with CPAP use

Of course, probably the best thing is to put the disease into remission.

This would be a great study for the very elderly with gastric plication... We are certainly reluctant to do anything with patients over the age of 75 - will try to get more information on these issues at the upcoming ASMBS (American Society for Metabolic and Bariatric Surgery) meeting.

Tuesday, May 03, 2011

Mice aren't all the same either!

Turns out we don't even know as much as we thought about mice... and so many are out jumping to conclusions on very little detail in humans. Let's be careful with the knowledge we have - life doesn't have many guarantees.

Not all skinny mice live longer

Monday, May 02, 2011

Liposuction for shaping, not for fat reduction

This is clarifying - we have seen it individually - nice to know that there is a study to validate.

Fat comes back other places after liposuction

Polycystic Ovary Syndrome (PCOS) and Infertility Links

We are learning more about the vulnerability of different people to certain diseases. Why some are Diabetic with just modest excess weight is one of the most important.

Fat tissue is an active endocrine organ - making and processing signals that the body uses to regulate energy sensitive tasks, especially. Female and even male fertility are very sensitive to these changes, but not in the same way for everyone.

PCOS and diabetes risk - characterizing the mechanisms

Obesity Action Coalition review article on Infertility