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Busting Those Obesity Myths for Better Primary Care


Despite the increasing rate of obesity, and its 2013 recognition as a disease, obesity continues to carry a negative social stigma that has led, or at least contributed, to inadequate primary care. According to the article, “Dispelling the Myths About Obesity,” more than one-third of healthcare professionals (and mostly primary care physicians) argue that obesity is not a disease.

The lack of agreement among healthcare professionals affects their ability to provide proper care for their patients. Of the participants who responded that obesity is not a disease, 80% of those believe that obesity is a result of poor lifestyle choices. Patients, on the other hand, fail to ask their doctors important questions about their excessive weight, as they are always expecting to hear the same unhelpful solution: diet and exercise.

Obesity, by definition, is a disease in that it weakens body function, is a result from “dysfunction of a complex physiologic regulatory system, precipitated by multiple factors in modern society,” and negatively affects the patient’s quality of life.

Removing the Stigma to Fight the Disease

To better help patients with obesity requires a shift in pre-existing attitudes about what it means to be obese, even overweight, in our society. Stripping the stigma of obesity still leaves patients struggling with their health and lacking the help and support from the medical community. Dispelling myths about obesity may begin to change our opinion of it for the better.

The most common myths that vigorous medical study has disproved include:

  • Obesity is a self-inflicted medical condition.
  • To lose excess body fat is as simple as burning more calories than one consumes.
  • Obesity is a “first world” problem.
  • Addiction to unhealthy foods is caused by a lack of self-discipline, which leads to weight gain.
  • Obesity is a new disease.
  • Dietary modifications aren’t backed by scientific research.
  • If diet and exercise aren’t enough to lose weight, the patient isn’t trying hard enough.
  • Bariatric surgery is for purely vain purposes and shows no significant health benefits.

These myths continue to be a barrier to a better global understanding of this worldwide epidemic. The team at Clinique Michel Gagner is heavily involved in spreading awareness about this disease in order to invite more potential patients to seek the help they need. If you’re interested in speaking with someone about a solution to weight-loss surgery, contact Clinique Michel Gagner or fill out our patient questionnaire.

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Post-Menopausal Weight-Loss Linked to a Lower Risk of Breast Cancer

Obesity has long been linked to certain health conditions like type 2 diabetes, high blood pressure, heart disease, and stroke. It is also strongly related to some types of cancers, particularly breast cancer. Recently, a major US study concluded that post-menopausal women who undergo bariatric surgery have a lower risk of developing invasive breast cancer, even more than those who maintain their weight.

According to Reuters, more than 61,000 women were studied over a period of 11.4 years, and the findings were that woman who lost five percent or more of their excess body fat within the first three years of the study were at least 12 percent less likely to develop breast cancer within the next decade.

According to Dr. Daniel Schauer of the University of Cincinnati College of Medicine, the decreased risk of developing breast cancer is linked to the fewer hormone levels related to the number of fat cells. The hormone that is largely responsible for breast cancer development is estrogen. A significant drop in body mass index can reduce estrogen levels, which contribute to the lower risk factor.

The lasting impression of this test is that women who commit to stop gaining weight (and who also slowly lose it over time) will strongly benefit from a reduced risk of breast cancer.

Losing weight through proper nutrition and regular exercise is ideal but sometimes inadequate for obese patients with body mass indexes over 35. People with excessive body fat will find much more significant and more permanent weight-loss by undergoing bariatric surgery, which typically involves removing a percentage of the stomach volume and therefore decreasing the patient’s stomach. There is no wrong reason to want to lose excessive body weight. Regain your health with bariatric surgery. Contact Clinique Michel Gagner or fill out a patient questionnaire to get started!

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Bariatric Surgery Linked to Fewer Childbirth Complications

According to a Swedish study, weight-loss surgery reduces the likelihood of childbirth complications, such as emergency caesarian sections, hemorrhages, tears, post-term deliveries, uterine inertia, infections, and more. It has long been established that obesity leads to more complications, and according to the Center for Disease Control and Prevention in the US, obesity is on the rise in the pregnant population.

Between 2011 and 2015, the rate of obesity among pregnant women increased by eight percent, which may be a greater indicator of an overall growth rate of obesity in the United States.

The study itself does not establish cause and effect; however, there is enough strong evidence to suggest that women who undergo major weight loss before pregnancy will have fewer risks during their term. Studies have also shown that weight-loss surgery can also be linked to premature childbirth and small babies.

The only proven way to sustain significant weight-loss is through bariatric surgery. The advantages of bariatric surgery, particularly procedures like the laparoscopic sleeve gastrectomy, is that they work with the body’s natural satiety mechanism to help the patient feel full with less food. Many procedures, like the LSG, can be revised in the case of weight gain; however, patients can experience significant weight loss (up to 75%) within the first year of their procedure.

Trying to get pregnant while overweight or obese should be carefully considered and endorsed by your doctor, as it can lead to major complications, especially if you have pre-existing health conditions, such as diabetes or heart problems. If you become pregnant, speak to your doctor about the inherent risks involved.

If you’re interested in learning more about weight-loss surgery before pregnancy, take a look at our general surgery guidelines or fill out a patient questionnaire to get started.


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Research Suggests Higher BMI leads to Lower Happiness and Satisfaction

A recent study published by the BMJ used a research technique called Mendelian randomization to determine if whether poor mental health and wellbeing can lead to poor physical health or whether poor physical health can lead to poor mental health and wellbeing. It’s a chicken and egg scenario. Using this technique has allowed researchers to determine that there is “a consistent causal effect of higher BMI on lower mental wellbeing.”

In other words, an individual’s level of overall happiness and satisfaction in life is consistent with his or her BMI. The higher the BMI, the lower the mental wellbeing. Satisfaction in life is based on more than an individual’s health and weight, and so the Mendelian randomization technique helps researchers rule out other factors that cause physical and mental wellbeing. Along with the body mass index, the study utilized 11 factors of physical health, including heart attack, cholesterol levels, blood pressure, and coronary artery disease, but only BMI showed a causal link to low mental wellbeing.

As for low mental well-being being a factor in any of the 11 health traits (including BMI), the researchers found a minimal causal effect in that direction.

Assessing Your Own Body Mass Index

Your body mass index, or BMI, is one of the first measurements that healthcare professionals use to determine the amount of fat in your body. A BMI range of 18.5 to 24.9 is in the normal or healthy zone. A healthy BMI can appear differently on a range of body types. If your BMI is higher than 30, you are considered obese and may be a candidate for bariatric surgery. Weight-loss surgery can significantly increase your chances of achieving long-term health and reducing or eliminating type 2 diabetes and the risk of heart disease. If you’re interested in a weight-loss procedure, please fill out our patient questionnaire to get started.

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Sleeve gastrectomie par laparoscopie : comparaison des résultats entre les adultes et les adolescents

La sleeve gastrectomie permettrait d’éliminer et de prévenir le diabète plus efficacement chez les adolescents que chez les adultes, tout en augmentant le pourcentage de poids perdus à long terme chez les patients atteints d’obésité morbide, selon une étude effectuée pour le Springer Science + Business Media, publiée le 11 février 2018.

Nesreen Khidir, Moamena Ahmed El-Matboulu, Davit Sargysan, Mohammed Al-Kuwari, Moataz Bashah et Michel Gagner ont comparé les résultats de l’opération en suivant les patients adultes et adolescents après l’intervention sur une période de cinq ans. Alors que la sleeve gastrectomie par laparoscopie (SGL) est une chirurgie qui suscite un débat lorsque pratiquée sur les adolescents, l’étude démontre que la SGL serait plus efficace chez ceux-ci.

Résultats sur le diabète

Un total de 139 adultes, âgés de 37 ans en moyenne et de 91 adolescents, âgés de 17 ans en moyenne La SGL ont subi la SGL. Après cinq ans, 68,2% des adultes et 62,5% des adolescents étaient guéris du diabète. Par ailleurs, 13% des adultes ont rechuté alors que ça n’a été le cas pour aucun adolescent.

Résultats sur la perte de poids

Le pourcentage du poids perdu au total était de 23% chez les adolescents et de 26,9% chez les adultes, après un an. Au bout de cinq ans, le pourcentage a augmenté à 35,8% chez les adolescents, alors qu’il est resté sensiblement le même chez les adultes, soit 26,3%. Au fil du temps, on remarque donc que l’opération a été bénéfique pour les patients en plus bas âge à long terme, puisqu’ils ont continué à perdre du poids. Les auteurs de l’étude ont conclu que la meilleure tranche d’âge pour subir une chirurgie bariatrique est entre 19 et 21 ans.

L’obésité et le diabète demeurent des problématiques de santé fortement présente, que la SLG permet d’améliorer. Selon le docteur Michel Gagner,  elle «fonctionne avec le mécanisme de satiété normale de l’organisme, provoquant les patients à manger moins naturellement. La chirurgie du gastrique sleeve peut également restreindre l’appétit en réduisant la production d’hormones liées à la faim dans l’estomac, ce qui contribue également à la perte de poids».

Comme mentionné dans l’étude, les risques de morbidité et de décès associés à l’obésité chez les enfants augmente alors qu’ils atteignent l’âge adulte. Une intervention chez les adolescents peut réduire le risque de développement de ce problème de santé dans le futur. Le diabète est une maladie liée de très près à l’obésité. Il s’agit d’un sujet qui suscite beaucoup de questionnement, notamment en lien avec les problèmes comme la dépression chez les adolescents qui peuvent survenir avec l’obésité. Cette étude sur la sleeve gastrectomie par laparoscopie chez les adultes et les adolescents représente les premiers pas démontrant qu’il est possible d’opérer des patients plus jeunes pour contrer efficacement le diabète et le surplus de poids.

Pour plus d’informations sur la SLG, n’hésitez pas à contacter la clinique du docteur Michel Gagner, le premier à avoir explorer la chirurgie comme première étape d’une intervention chirurgicale visant une perte de poids pour les patients à risques élevés, en 2000.  Elle est devenue l’une des procédures les plus pratiquées dans le monde.


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The Post-Gastric Sleeve Diet: What Should LSG Patients Eat?

It’s no secret that patients undergoing a laparoscopic sleeve gastrectomy will have to face many lifestyle changes following their surgery. Your diet will experience a dramatic transformation. Before and after your surgery, we’ll discuss with you the various foods and serving sizes that are safe and advisable to eat, as well as foods, drinks, and substances that you should avoid.

The First Week

In the few days leading up to your procedure, you will be asked to switch to a liquid diet consisting of sugarless protein shakes, broth, water, gelatin products, popsicles, and sugarless, decaffeinated drinks. In the week following your procedure, you’ll be asked to continue this liquid diet to avoid complications and prevent obstructions, leakage, or other digestive upsets. At this time, avoid sugary foods and drinks, caffeine, and sodas. Make sure to stay as hydrated as possible with water or low-calorie electrolyte drinks.

Week 2

While it’s still not advisable to consume solids at this point, you can slowly transition into thicker liquids, such as protein shakes, sugar-free frozen yogurt, oatmeal, pudding, broth, and instant breakfast drinks. At this point, your appetite will slowly come back; however, we strongly advise you to avoid solid foods, as there is still a risk of complications. It will take up to a month before you can start eating small amounts of solid, unprocessed foods.

Week 3

Three weeks after your surgery, you may start to eat food that’s the same softness and consistency as baby food or purée. This includes puréed or mashed avocado, bananas, scrambled eggs, soft tofu, plain yogurt, cottage cheese, and hummus. It is still not advisable to drink caffeine at this point. Try your best to avoid heavy spices or seasoning.

Weeks 4 and 5

At this time, it is safe to start introducing solid food into your diet. Be sure to stick with healthy, unprocessed or minimally processed foods. As a rule of thumb, food that is located on the outer perimeter of the grocery store is usually the healthiest: artisanal bread, fruits, vegetables, fresh meat and fish, and low-fat dairy.

We will be with you every step of the way to ensure you’re adhering to your post-procedure eating plan to maximize the benefits of your sleeve gastrectomy. Contact Clinique Michel-Gagner for any questions you have about your bariatric procedure.

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Clinique Michel Gagner Now Accepting All American Patients

For years, Dr. Michel Gagner has performed bariatric procedures on patients in hospitals all over the world. His contributions to weight-loss surgery have long-since made him a trusted name in the industry. He has participated in numerous conferences, written several journal articles, and is responsible for pioneering many of the most common weight-loss procedures in use today. While maintaining his Montreal practice, Dr. Gagner and his team are now proud to accept ALL American patients.

The Status of Obesity in the US

It’s no secret that obesity in the United States is one of the leading health concerns in the country, costing upwards of $210 billion dollars in healthcare a year. It is estimated that by the year 2030, half of the American population will be obese and there will be six million cases of type II diabetes and five million new cases of coronary artery disease. Obesity does not discriminate, although it does tend to be more prevalent in low-income, ethnic, and low-education communities.

Obesity in Children and Teens

While we tend to think of obesity as a result of years of unhealthy life choices, children, tweens, and teens are just as susceptible to becoming overweight and obese. For instance, over 21% of Arkansas high school students are obese. These numbers are usually explained by high rates of inactivity, unhealthy food choices, and large amounts of free time engaged in sedentary activities. But obesity is also influenced by pre-existing genetic factors.

Expansion Hopes to Mitigate Stigma of Obesity

 Dr. Michel Gagner, his team, and his peers have fought for decades to fight the stigma of obesity, which tends to fill patients with shame and guilt for their health condition, rather than encourage them to find life-saving solutions that can drastically improve their quality of life. By opening his doors to American patients, Dr. Gagner hopes to make bariatric surgery possible for more people.

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Why Is it Taking So Long for us to Embrace Bariatric Surgery?

For years, we’ve been guided by the basic principle that diet and exercise staves off obesity, and that eating sugar and living a sedentary lifestyle makes us fat. However, studies have shown that this just isn’t true…at least, it’s not that simple. Despite our endless gym memberships and extreme diets, our waist sizes are increasing. In Canada, 28% of the population is obese. In a recent  Globe and Mail article, this question is put forward: why aren’t more obese patients getting sleeve gastrectomies?

The Simplicity and Effectiveness of the Sleeve Gastrectomy

A sleeve gastrectomy has been characterized as a straightforward procedure. Unlike diet and exercise, the procedure not only shrinks the size of the stomach but also reduces the body’s ghrelin levels, the hormone that stimulates hunger sensations. The procedure involves the removal of 60–85% of the stomach pouch, thus restricting the amount of food the patient now needs to feel full. The whole procedure takes just under an hour, and patients can expect to return to work in as little as two weeks.

Why Is the Procedure Not More Common?

Quebec is ahead of other provinces in terms of weight loss surgery numbers. One in 90 obese people receive surgical treatment for their obesity, however, that is nothing if you consider that almost a third of our population would benefit from a procedure. So why isn’t more being done to help obese Canadians when “simple” diet and exercise isn’t enough? Cutting through the red tape and the haze of bureaucracy reveals the unfaltering and incorrect stigma that obese people are somehow to blame for their weight, which makes government-funded weight-loss surgery a politically and ethically charged subject on which nobody agrees.

More and more evidence is emerging that points the “blame” to something that not a single person on the planet can control: their genetic makeup. If you carry the gene variant called rs9939609, you share the same characteristic with every other obese person on the planet, which might be more to blame than unhealthy lifestyle choices.

If you think you qualify for bariatric surgery and diet and exercise have not helped, fill out of patient questionnaire to find out if surgical weight-loss treatment is right for you.

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Dr. Michel Gagner to Participate in AIS World Bariatric Series 2018

Along with three prominent bariatric surgeons, Dr. Michel Gagner will perform a live surgery as part of the AIS World Bariatric Surgery Series for the purposes of education and surgical training experience. The first part of the series is scheduled from April to July, while the second round begins again in September.

Joining Dr. Gagner are Dr. Camilo Boza, Medical Director of Clínica las Condes, Santiago, Chile; Bruno Dilleman, Director of the Center of Obesity Surgery at AZ Sint-Jan Hospital, Bruges, Belgium; and Robin Blackstone, Professor of Surgery at University of Arizona School of Medicine.

Series Schedule

Dr. Gagner will be performing a gastric sleeve to duodenal switch on June 13th, which can be viewed by registering for the series. The first part of the online training series will give learners the chance to participate in a bariatric revision surgery. Dr. Gagner and his associates will have the chance to discuss the surgery before performing it live. The second part of the AIS learning series will discuss the outcomes of the procedure, as well as any complications that arise.

What Can Participants Expect to Learn from the Series?

Anyone participating in the discussions and live surgeries will gain plenty of knowledge and experience from this series. Participants will have a deeper understanding of pre-surgery patient selection and preparation. They will have a chance to interact and discuss revisional surgery with industry-leading experts, as well as discuss other complex cases and the strategies for improving the outcomes of revisional surgery. Lastly, participants will have the chance to observe the use of safe and effective surgical technologies.

The next surgery is scheduled for May 24 and will be conducted by Dr. Bruno Dillemans. For more information about the AIS World Bariatric Series 2018 or to register, visit the official website. Registration is open to professionals as well as bariatric patients.

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A Decrease in Type 2 Diabetes Linked to Bariatric Surgery

A French study conducted between 2008 and 2009 showed that almost half of bariatric surgery patients stopped taking their anti-diabetes medication within six years of their surgery. Of the many bariatric surgeries studied, the biggest drop in anti-diabetes and insulin medication use was from patients who had undergone a gastric bypass procedure.

On an individual level, however, every patient will experience a varied mid- and long-term prognosis of obesity-related conditions. Patients who have only just started taking anti-diabetes medication are more likely to overcome their condition with bariatric surgery than patients who have been taking anti-diabetes medications including insulin for decades.

What is Gastric Bypass? 

Clinique Michel Gagner performs two variations of gastric bypass procedures: Mini Gastric Bypass and Laparoscopic Roux-en-Y Gastric Bypass.

The difference between a Mini Gastric Bypass and Gastric Bypass procedure is that the “mini” procedure involves only one connection or anastomosis of the stomach and intestine, whereas a Gastric Bypass involves two. This procedure combines two factors in achieving affective post-surgical weight-loss: intestinal malabsorption and gastric reduction. This is achieved through creating a gastric pouch near the esophageal sphincter, which is then attached to the first part of the intestine.

A Roux-en-Y Gastric Bypass procedure was developed by Dr. Gagner in 1996. As with the Mini Gastric Bypass, a Roux-en-Y Gastric Bypass also involves creating a gastric pouch, but with the first part of the intestine being cut into two sections and attached to the newly formed gastric pouch and further down the Roux limb.

Link Between Obesity, Diabetes, and Pharmaceutical Companies

In the article recently released about the French study, Dr. Michel Gagner posited that the number of patients examined represented only a small number of patients who have diabetes, and that the staggering number of money spent on anti-diabetes medication ($38.8 billion dollars in the United States alone) could afford to treat over a million people surgically.

Contact Clinique Michel Gagner today or fill out our patient questionnaire to start your weight loss journey.

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