Archive for February, 2010

Weight Loss Surgery May Help Obese Adolescents

Thursday, February 25th, 2010

HappyKids2

Childhood obesity is a serious and growing problem. Over the past 30 years, obesity rates among children have tripled. A recent study In the Journal of American Medical Association shows that gastric banding surgery, such as LAP-BAND®, can and have been, more effective than traditional weight loss programs promoting diet and exercise.

The February 10th issue of JAMA (Journal of the American Medical Association) reported that gastric banding may be more effective for achieving weight loss than lifestyle changes1.

The randomized controlled trial conducted by Paul E. O’Brien, M.D, FRACS, and colleagues of Monash University and the Centre for Adolescent Health, Royal Children’s Hospital, Melbourne, Australia, included 50 adolescents between the ages of 14 and 18, with a BMI higher than 35. Twenty five patients underwent laparoscopic gastric banding, while the remaining 25 entered a program of lifestyle intervention. This program included increased activity level, behavior modification and reduced calorie intake. Participants in both groups were followed for two years. (May 2005-September 2008).

Twenty four of the patients in the surgical group completed the study while 18 in the lifestyle group completed the program.

The study revealed that the gastric banding group lost an average of 76 pounds. This is an overall average loss of 28 percent of total body weight and 79 percent of excess weight. The lifestyle group lost an average of 6.6 pounds or an average of 3.1 percent total weight loss and 13 percent excess weight loss.

“At entry, 9 participants (36 %) in the gastric banding group and 10 (40%) in the lifestyle group had the metabolic syndrome. At 24 months, none of the gastric banding group had the metabolic syndrome compared with 4 of the 18 completers (22%) in the lifestyle group,” the authors noted.

“In this study, gastric banding proved to be an effective intervention leading to a substantial and durable reduction in obesity and to better health. The adolescent and parents must understand the importance of careful adherence to recommended eating behaviors and of seeking early consultation if symptoms of reflux, heartburn, or vomiting occur. As importantly, they should be in a setting in which they can maintain contact with health professionals who understand the process of care. This study indicates that, in such a setting, the laparoscopic adjustable gastric banding process can achieve important improvements in weight, health, and quality of life in severely obese adolescents,” the researchers concluded.

You can get more information on weight loss surgery such as gastric banding, gastric bypass or medically supervised weight loss programs by contacting one of our patient advocates today. The Surgical Specialists of Louisiana are committed to helping you reach your weight loss goals. Register for a free seminar and see which one of our weight loss programs has proven to be the most effective for weight loss in adolescent patients in Louisiana.

1. O’Brien, Paul E., et al. (2010). Laparoscopic Adjustable Gastric Banding in Severely Obese Adolescents. Journal of the American Medical Association, 303(6):519-526.

Why Sugar Alcohols Matter

Friday, February 19th, 2010

Knowing what’s in the food you eat is just as important, if not more important, that eating well. Weight loss success is extremely dependent on monitoring food content and ingredients, such as various types of sugar alcohols. Make sure you know what you are putting into your body by reading food labels. The following article, written by Kate H. Roundtree, LDN, RD will help you better understand one mystifying nutritional element: sugar alcohols. Kate works with the Surgical Specialists of Louisiana at their Lafayette office.

Sugar Alchohols: How do they fit in?

Kate H. Rountree, LDN, RD

sugarWhen learning how to read food labels, one topic of interest that patients continuously question is sugar alcohols. The population wants to know what these products are, why are they used, and how much is too much. Sugar alcohols can be consumed, but in moderation because they can cause unpleasant gastrointestinal side effects. Therefore, it is important to understand how to use these products and also where to find information on content when looking at food packaging.

Sugar alcohols are chemically formed sweeteners that can be found in many sugar free and no sugar added food products (candies, gum, baking mixes, ice cream, cookies, etc). These products are formed from naturally occurring sugar found in fruits, plants, and trees and contain approximately ½ the sweetness and calories of sugar that “regular” product have. The common names, which can be found in the ingredient list of food packaging, are mannitol, sorbitol, isomalt, lactitol, maltitol, erythritol, and xylitol.

Sugar alcohols are used to add sweetness with fewer calories. They are typically used in combination with high intensity artificial sweeteners (NutraSweet®, Splenda®, aspartame, etc) to offset the unpleasant after taste. They can also be used as a bulking agent in certain foods.

Sugar alcohols can be problematic when consumed in abundance because they are only partially absorbed by the small intestine. The amount absorbed is dependent on the particular sugar alcohol ingested. Sugar alcohols not absorbed by the small intestine reach the colon and are fermented by bacteria and produce gases; sugar alcohols are incompletely metabolized by humans. Incomplete absorption can lead to abdominal bloating, cramping diarrhea, and flatulence. It is important to remember that the more sugar alcohol is consumed the more intense the symptoms can be.

The pros to using sugar alcohols include:

• Contains less calories than sugar
• Causes only a slight rise in blood sugar verses a large rise when using real sugar
• Does not cause tooth decay
• Improves texture of foods
• Retains moisture in foods
• Prevents foods from browning when heated

The cons to using sugar alcohols include:

• Poorly absorbed by the body, causing GI distress, when consumed in large concentrations
• Weight gain, if overeaten
• Hypoglycemia may result in diabetics if insulin dosage is dependent on specific amount of carbohydrate consumed since sugar alcohols are used when calculating total carbohydrate content

The United States Federal Drug Administration outlines specific instructions when labeling food packaging. In the instance of sugar alcohols products labeled as “no sugar added” or “sugar free” may still contain sugar alcohols, so it is vital to always read the nutrition label on all processed foods, especially those labeled “no sugar added” or “sugar free.” Consider the serving size and the amount of sugar alcohol per serving and keep in mind that as little as 10 gm of sugar alcohols can cause GI symptoms.

Understanding the pros and cons of sugar alcohols is a key ingredient in the recipe to weight loss success. Weight loss is a lot of hard work, but knowing all of the important ingredients and factors will make your weight loss success that much easier. Next time you are at the grocery store, pay attention to the labels and use the new tools you are now equipped with to make smart, weight loss motivated, decisions. If you seek professional help, contact the Surgical Specialists of Louisiana. Their medically supervised MyWeight™ weight loss program can help you become a healthier, happier you!

Fight Against Childhood Obesity makes progress with Michelle Obama announcing Let’s Move Campaign

Tuesday, February 16th, 2010

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The Surgical Specialists of Louisiana are thrilled to share with you some exciting news out of Washington. The Obesity Action Coalition (OAC) was one of the few select organizations to attend First Lady, Michelle Obama’s kick-off event for her National Campaign that will take a stand against childhood obesity. The new campaign, Let’s Move will get kids moving and will promote healthy weight loss in obese children. Below is an official Statement from the OAC.

Obesity Action Coalition Attends First Lady Michelle Obama’s Launch of her Childhood Obesity Initiative at the White House

Today was a step in the right direction when it comes to tackling the childhood obesity epidemic, giving it the National attention it needs. And, the OAC is proud to say that we were a part of this important step to help solve this growing problem.

This afternoon, First Lady Michelle Obama officially launched her National initiative to take on childhood obesity, unveiling her nationwide campaign – Let’s Move. The OAC was among the select few organizations to receive a personal invitation to the White House to attend the First Lady’s kick-off event for her National Campaign.

The goal of the Let’s Move Campaign is to solve the challenge of childhood obesity in our country through a partnered effort among communities, organizations, schools, government, parents and children. First Lady Obama mapped out many of the challenges that our country faces with this rising epidemic, along with the complex nature of solving this problem to positively impact the health of our nation’s children.

OAC was Proud to Attend

OAC President/CEO Joe Nadglowski was just rows away from the First Lady as she laid out her approach to help our country’s children. Joe was also accompanied by many high profile participants, including members of the President’s cabinet such as Health and Human Services Secretary Sebelius, Education Secretary Duncan and Surgeon General Regina Benjamin. In addition, the crowd also included members of Congress, Mayors from across the nation and leaders from the media, medical, sports, entertainment and business communities who have an interest in helping the childhood obesity epidemic.

The OAC is happy that our nation’s First Lady is making childhood obesity a priority and that she plans to include a variety of individuals in the discussion to solve this problem. We are honored that we were among the select few invited to witness this important announcement first-hand and plan to be included in future discussions on this issue with the White House.

The OAC encourages you to visit the Let’s Move Campaign Web site at www.letsmove.gov to learn more about this campaign and our nation’s childhood obesity epidemic and how you can start to make a difference.

Conclusion

Childhood obesity most often starts in the home so Louisiana based OAC encourages you, and your loved ones, to instill healthy eating, exercise and diet habits in children at a young age. By helping children develop good habits, you will help to make a difference in America’s childhood obesity epidemic. See what weight loss tools and information you can share with the people you love from the new Let’s Move Campaign today.

Reproduced with permission from Obesity Action Coalition. Please visit www.oac.org

The Surgical Specialists of Louisiana are committed to helping our patients achieve a healthy lifestyle and a healthy weight. Whether you are interested in weight loss surgery or medically supervised weight loss counseling, we can help you take control of your eating and your weight. Join us for a free seminar or take a weight loss quiz to help you get started.

Is Obesity the Last Acceptable Form of Discrimination?

Wednesday, February 10th, 2010

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Obesity remains a socially acceptable injustice and often referred to as “the last acceptable form of discrimination.” Overweight individuals are often the subject of jokes in the media which can translate to real life discrimination. In this article, printed with permission of the Obesity Action Coalition, Rebecca Phul, PhD discusses the difference between “stigma” and “discrimination” and what legal ramifications, if any, can take place to protect overweight individuals.

Weight Discrimination: A Socially Acceptable Injustice

By Rebecca Puhl, PhD

Obesity is highly stigmatized in our society. Overweight and obese individuals are vulnerable to negative bias, prejudice and discrimination in many different settings, including the workplace, educational institutions, healthcare facilities and even within interpersonal relationships.

Unfortunately, weight bias remains very socially acceptable in North American culture; it is rarely challenged, and often ignored. As a result, thousands of obese individuals are at risk for unfair treatment, and there are few outlets available to provide support or protection.

What is the difference between “stigma” and “discrimination?”

Weight stigma or bias generally refers to negative weight-related attitudes toward an overweight or obese individual. These attitudes are often manifested by negative stereotypes (e.g., that obese persons are “lazy” or “lacking in willpower”), social rejection and prejudice. Weight stigma includes verbal teasing (e.g., name calling, derogatory remarks, being made fun of, etc.), physical aggression (e.g., hitting, kicking, pushing, shoving, etc.) and relational victimization (e.g., social exclusion, being ignored, avoided, or the target of rumors).

Many obese individuals report being treated with less respect or courtesy than thinner persons and being called names or insults because of their weight. Thus, weight stigma can emerge in subtle forms, or it can be expressed directly.

Discrimination is distinct from stigma and negative attitudes, and specifically refers to unequal, unfair treatment of people because of their weight. For example, an obese person who is qualified for a job but is not hired for the position because of his or her weight may have been the victim of weight discrimination.

Other examples include being denied a job promotion or fired from a job because of one’s weight; being denied certain medical procedures or provided inferior medical care because of one’s weight; or being denied a scholarship, a bank loan or prevented from renting or buying a home because of one’s weight.

In each of these cases, the behaviors directed toward the obese individual depict inequitable treatment with no justifiable cause, and legal recourse may be an appropriate response in these situations.

Obesity Discrimination on the Rise

Despite the increasing prevalence of obesity, it appears that incidences of weight discrimination are only becoming worse.

In our research, we examined trends of weight discrimination throughout a 10 year period from 1995-2005 and found that the prevalence increased by 66 percent during this decade, from 7-12 percent of the general population. This finding was not a result of increasing obesity rates, but rather specifically demonstrates that more people are experiencing weight discrimination.

How common is weight discrimination?

Given the social acceptability of negative attitudes toward obese individuals, it may not be surprising to learn that weight discrimination is common in the United States.

In a recent study, we examined the prevalence of multiple forms of discrimination in a nationally representative sample of 2,290 American adults and found that weight discrimination is common among Americans, with rates relatively close to the prevalence of race and age discrimination. Among women, weight discrimination was even more common than racial discrimination. Among all adults in the study, weight discrimination was more prevalent than discrimination due to ethnicity, sexual orientation and physical disability. Almost 60 percent of participants in our study who reported weight discrimination experienced at least one occurrence of employment-based discrimination, such as not being hired for a job.

On average, a person’s chances of being discriminated against because of weight become higher as their body weight increases. In our study, 10 percent of overweight women reported weight discrimination, 20 percent of obese women reported weight discrimination and 45 percent of very obese women reported weight discrimination.

Rates for men were lower, with 3 percent of overweight, 6 percent of obese and 28 percent of very obese men reporting weight discrimination. This finding also tells us that women begin experiencing weight discrimination at lower levels of body weight than men.

What legal action can be taken for victims of weight discrimination?

Unfortunately, there are few legal options available for individuals who suffer weight discrimination. Currently, there are no federal laws that exist to prohibit discrimination based on weight.

With the exception of one state law (Michigan) and a few local jurisdictions that address discrimination on the basis of weight or appearance (e.g., San Francisco), the vast majority of people who experience weight discrimination in the U.S. must pursue legal recourse through other indirect avenues.

In particular, obese individuals have depended on the Rehabilitation Act of 1973 (RA) and the Americans with Disabilities Act of 1990 (ADA). Most cases filed under these categories pertain to weight-based discrimination in employment settings, and only a few cases have been successful. In addition, whether it is appropriate for obesity to be considered a “disability” under the ADA is questionable and could perpetuate bias further.

Overweight people who are not “morbidly obese,” but who experience weight discrimination cannot file claims under the ADA because they are not considered disabled under this law. It places an unfair burden for individuals to prove that their obesity is debilitating and disabling in order to obtain fair and equitable treatment in the workplace.

These unresolved issues, in addition to public perceptions that place blame on obese people, have led to inconsistent court rulings and often deter obese individuals from taking any legal action.

Clearly, legislation is badly needed to protect individuals from weight discrimination. Massachusetts recently introduced legislation (House Bill 1844) to prohibit weight-based discrimination in employment settings. The hearing was held on March 25th 2008, with no opposition present at the hearing, and all expert testimonies were in favor of the bill. No decision has yet been made, but if this bill passes, it will be an important step in encouraging other states to follow suit.

Reducing weight bias requires major shifts in societal attitudes, and national actions are needed to establish meaningful legislation to ensure that obese persons receive the equitable treatment they deserve.

This article first appeared on www.OAC.org. Reproduced with permission from Obesity Action Coalition. Please visit www.oac.org

The Surgical Specialists of Louisiana are committed to helping our patients achieve a healthy lifestyle and a healthy weight. Whether you are interested in weight loss surgery or medically supervised weight loss counseling, we can help you take control of your eating and your weight. Join us for a free seminar or take a weight loss quiz to help you get started.

About the Author:

Rebecca Puhl, PhD, is the Director of Research and Weight Stigma Initiatives at the Rudd Center for Food Policy and Obesity at Yale University. Dr. Puhl is responsible for coordinating research and policy efforts aimed at reducing weight bias.

References:

Puhl R, Brownell KD. (2001). Bias, discrimination, and obesity. Obesity Research, 9:788-805.

Puhl, R.M., Andreyeva, T., & Brownell, K.D (2008). Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. International Journal of Obesity. doi: 10.1038/ijo.2008.22

Andreyeva, T., Puhl, R.M., & Brownell, K.D (2008). Changes in Perceived Weight Discrimination Among Americans, 1995-1996 through 2004-2006. Obesity. oi:10.1038/oby.2008.35

Brownell, K.D., Puhl, R., Schwartz, M.B., Rudd, L. (Eds.) (2005). Weight Bias: Nature, Consequences, and Remedies. New York: Guilford Publications.

Sugary Beverages and Their Link to Childhood Obesity

Wednesday, February 3rd, 2010

There has been a lot of controversy lately regarding soda, sugary drinks and their link to obesity.  Some lawmakers have even proposed extra taxes on these beverages to help curb the problem.  In this article, printed with permission of the Obesity Action Coalition, Dr. Rodrick D. McKinlay discusses the role liquid calories play in obesity among children.

Childhood Obesity: The Link to Drinks

sugary_drinksChildhood obesity rates have doubled throughout the past 30 years in the United States for children ages 2-5 and 12-19, and tripled in the age group of 6-11. Obesity for children is defined as a body mass index (BMI) at or above the 95th percentile for similar age and gender youths1.

Social and Environmental Pressures

Many social and environmental pressures lead to greater obesity in children. Chief among these influences is the wide variety and availability of sugar-sweetened drinks that contain little to no nutritional value. These beverages include:

•    Soft drinks
•    Sports drinks
•    Fruit drinks
•    Flavored teas and coffees
•    Energy drinks

Throughout the past 10-15 years, these drinks have exploded on to the consumer scene, flooding grocery stores, gas stations, convenience stores and vending machines.

Americans have doubled their consumption of soda pop in the last 25 years, a trend that closely follows the obesity epidemic. The average American drinks 1.6 cans of soda pop a day, more than 500 cans a year. Soda drinking is particularly rampant among teenagers. Data indicates that soft drinks account for 13 percent of a teenager’s caloric intake – by far the largest source of calories in his or her diet. For decades, milk was the most common beverage consumed by children, but by the mid-1990’s, boys and girls were drinking twice as much soda pop as milk.

One recent, independent peer-reviewed study from Harvard demonstrated a strong link between consumption of sugar-sweetened beverages and childhood obesity2. Although some studies conflict regarding the causality between sugar-sweetened beverages and obesity, a number of research studies confirm the Harvard group’s findings that increased soft drink and sugar-laden beverage consumption is a risk factor for obesity3.
Not only do sugar-sweetened drinks likely lead to obesity, they are also associated with tooth decay and weakening bones.

Energy Drink Emergence

In the past decade, energy drinks have exploded into the marketplace. In 2006 alone, 500 new energy drinks were launched. Energy drinks, which typically contain large amounts of sugar and caffeine, are equally if not more dangerous to children. Although the target market for energy drinks is young adults aged 18-35, teenagers are consuming significant quantities of these beverages.

Caffeine by the Can

The amounts of caffeine found in such drinks as Red Bull or Rock Star are about 10 grams per ounce. With that in mind, take a look at the amount of caffeine found in other beverages:

•    Red Bull (8.3 oz can) = 83 grams
•    Rock Star (16 oz. can) = 160 grams
•    Coca-Cola Classic (12 oz. can) = 34.5 grams
•    Pepsi-Cola (12 oz. can) = 38 grams
•    Coffee (8 oz. cup) = 57 grams

Most experts recommend that children consume well under 100 grams of caffeine per day.

Effects of Caffeine on Children

Pharmacologic effects of caffeine are notable in children, most commonly seen as hyperactivity, sleep disturbances and restlessness. Drinking large amounts of caffeine can also be associated with high blood pressure and frequent headaches.

Researchers have reported that a new practice among college-age students is the simultaneous consumption of energy drinks and alcohol, which allows greater consumption of alcohol since alertness is perpetuated by the energy drink4. In addition, the sugar content of energy drinks is comparable or higher than most soft drinks. For example, an 8 oz Red Bull contains 27 grams of sugar and a 16 oz Rock Star has 60 grams of sugar, while the typical non-diet soft drink contains 40-45 grams of sugar.

How to Combat the High-calorie Beverage Craze

So what can be done to limit the amount of nutritionally-poor liquid calories that children and adolescents are consuming? On an individual-basis, the best approach is simply to replace soda and sports drinks with water or low-fat milk in children’s diets. Water is the best hydrator available. Low-fat milk not only hydrates, but delivers calcium, protein and vitamin D.

Children should be monitored at home with their choice of liquids. A glass of 100 percent fruit juice per day is beneficial, but excessive soda, sport drinks or energy drinks is unhealthy. What happens at school may be out of the immediate control of a parent, but parents can petition the school to eliminate vending machines that sell soft drinks and energy drinks in favor of bottled water.

Moderation in guiding children, of course, is appropriate. Children who are constantly deprived of treats are more likely to binge eat or drink. Also, parental modeling is important. Studies suggest that children who are raised by parents who exert excessive dietary restraint may be more likely to become obese5.

Children possess the ability to internally regulate their caloric intake. If they see their parents struggle with alternating dis-inhibited eating (abandoning the effort to control food or drink intake) and restrained eating (conscious decision to restrict intake to control weight), they may pattern their own eating and drinking behavior after their parents instead of allowing their internal energy regulation to guide them. This in turn seems to lead to greater obesity in children.

Conclusion

Parents should adopt healthy eating and drinking patterns, limiting consumption of soft drinks and other sugar-sweetened drinks, and to do so without obsession. Helping children develop a love for the refreshing taste of water or a cold glass of milk will pay immediate health rewards for children as well as dividends for their future health and weight control.

This article first appeared in the OAC News Vol.5/ Issue 1 October 2009.  Reproduced with permission from Obesity Action Coalition. Please visit www.oac.org

The Surgical Specialists of Louisiana are committed to helping our patients achieve a healthy lifestyle and a healthy weight. Whether you are interested in weight loss surgery or medically supervised weight loss counseling, we can help you take control of your eating and your weight. Join us for a free seminar or take a weight loss quiz to help you get started.

References:

•    Childhood Obesity in the United States: Facts and Figures, Fact Sheet 2004, Institute of Medicine.
•    Ludwig et al, Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis. Lancet 2001; Feb 17; 357 (9255):505-8.
•    Wolff et al, Medscape J Med 2008; 10(8):189.
•    Malinauskas et al, Nutrition Journal 2007; 6:35.
•    Hood et al, International Journal of Obesity 2000; 10:1319-1325.