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!

IF YOUR DOC HAD A PILL THIS EFFECTIVE, HE OR SHE WOULD KNOW EVERYTHING ABOUT IT! Don't let them hide.

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.

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.

Diabetes and Cancer link

cancer risks of diabetes

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

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

Obesity in pregnancy - Health of the Newborn

Iron deficiency, possible effects and causes

Technology that will make a real difference - comfort and colonoscopy

As someone who has done hundreds of colonoscopies, I am really looking forward to this finding its way into our working endosuites.

As someone who has had 3 colonoscopies, I hope my next one can be done without sedation.

Advanced Colonoscope using fiberoptic nanotechnology

Canadian Outreach Day Plans

Saturday May 21 we are planning an outreach day in the Vancouver area. More to follow as times get set, and invites sent out.

Here is one of the recent Vancouver Sun articles on WLS... 2011 is ticking by.

Access issue in Lower Mainland BC worsens

Call for "Dirty Dozen" Ignoring Evidence for Diabetes, Obesity Access to Care

I have been saving some of these up last few weeks on call - hoping to get PeaceHealth to change its out of date access to care restrictions that are anything but "evidence based" (quote from PeaceHealth Mission Statement)

If you want to send me your organization's absurd restrictions, I will post a "dirty dozen worst plans in Washington State' after the ObesityHelp meeting in Seattle this June.


HERE ARE SOME GREAT EXAMPLES OF THE EVIDENCE TO FOLLOW (just in case any executives happen to read this post)


ASMBS statement for Access to Care


Britain's National Health Service Diabetes Study

Wow! Here's a great quote from a socialized medicine perspective!

Alberic Fiennes, a bariatric surgeon and chairman of the National Bariatric Surgery Registry (NBSR) Data Committee, said the treatment should be made more widely available on the NHS.

"An approach that limits treatment to a fraction of those who would benefit is one which the NHS will rue in years to come as these patients become an unsustainable burden on the health service," he said.

"Prevention strategy alone has proved ineffective; there are at least two generations of morbidly obese patients who are now presenting with diabetes, stroke, heart disease and cancer for whom preventative measures are utterly irrelevant."

International Diabetes Federation Statement

IDF press release


Increased Heart Disease Risk for Teens

Arkansas State Employee coverage

Pregnancy, newborn risks, hysterectomy risks

I am always talking with my OB/Gyn colleagues about preoperative liquid diets like we use for Bariatric surgery to get "room" to work inside the abdomen. Here is data to show that the heavier abdomen is truly a more hostile surgical environment.

If you want to find out more about a 2-4 week high protein, low calorie liquid diet, I will try to post on that with a later edit to this date... or you can call our office 360-752-9888.

Articles from UK

Cancer risks and Diabetes - we can intervene

Here is real opportunity to save lives - forward to your Human Resources or legislator.

Major Increase in Cancer risk for Diabetics

Why everyone has to learn about QALY

This is ridiculous - to not consider the cost of a medication, but then demand that other types of care be subjected to "cost effectiveness" tests... We need a level playing field for what value taxpayers and patients are getting - Quality Adjusted Life Years, or QALY is the way to do that.

Please see the quote from Dr David Flum at University of Washington in the article from day 1 of the NYC Diabetes Conference.

A billion dollars for less than 2 more months of life?

The data is Here... more NYC Summit

Nobel Laureates speaking as keynotes, Swedish long term data

I think we can say definitively that the science is in! There is always more to learn for exact mechanisms, and refining techniques. Insurers and the government may hedge because of perceived costs, but for most individuals the question is answered. Your life and health are better with surgical control of Diabetes and Obesity. To deny this is to simply put money ahead of people...


even the American Heart Association recognizes the benefit

News from NYC Diabetes Summit

Cost effectiveness of surgery for Diabetes

Profound Emotional Suffering - worldwide now

It is inspiring to see a researcher who is so sensitive to the impact of society's dysfunctional judgements. So many of us internalize that incredibly demeaning and disempowering hatred. I guess the only upside is what going through hell can teach you about compassion...

Traditionally tolerant societies showing intolerance, anti-obesity attitudes