Obesity Paradox Debunked by Researchers in UK

The Obesity Paradox is, to put it simply, a theory that obesity has more positive health effects on some populations. As the theory goes, body fat is thought to protect the body’s organs in the elderly and in people with certain diseases. This paradox has been largely criticized since its publication and has at last been debunked by researchers at the University of Glasgow.

Research Findings

The Scottish study that included almost 300,000 people revealed that the risk of stroke, heart attack and high blood pressure increased with body mass indexes higher than 23. It also determined that the risk was even higher for people who carried excess fat in their stomach. People with a BMI of 22–23 were at the lowest risk of heart disease.

Healthy Patients

The patients studied were all considered healthy, so it’s important to remember that this study did not research the effects of obesity in people with diseases. It is still believed that obesity protects people suffering from cancer, as the disease and treatment can cause significant weight loss.

Reverse Causation

The results of the Obesity Paradox test force us to question if whether its proponents have misdirected causation. In other words, people with lower BMIs may not have an increased risk of death, but rather, people who are sick or near death suffer from significant weight loss.

BMI and Weight Distribution

The study determined two important factors: that people who can maintain a BMI of 22–23 and keep excess weight away from their midsection have the lowest chance of heart attack, stroke, and high blood pressure.

If your body mass index is higher than 23, speak to your doctor or dietician who will help you develop a diet and weight-loss plan. Your doctor may also recommend weight loss surgery.

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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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Dr. Michel Gagner Performs All-New Type of Surgery

Clinique Michel Gagner was recently featured in Le Journal de Montreal for performing the country’s first non-invasive bariatric surgery of its kind, called aspiration therapy. The surgery will be performed on Hélène Sénécal-Blanchet, a Quebecoise woman suffering from obesity and diabetes. Invented in the United States, aspiration therapy was first approved last year in Canada, but has been used in Europe since 2012.

The Difference Between Aspiration Therapy and Bariatric Surgery

Unlike other forms of bariatric surgery, aspiration therapy requires zero removal of the stomach. A laparoscopic sleeve gastrectomy, for example, involves the removal of up to 85% of the stomach pouch. After an LSG procedure, the patient will experience satiation sooner as their stomach volume is significantly reduced. While safe, LSG procedures do require general anesthesia and are not reversible.

Aspiration therapy, or AspireAssist, is a whole new approach to weight loss surgery. Instead of removing the patient’s stomach volume, a tube is inserted into the patient’s stomach and out the abdomen, where food can be disposed of in the toilet via a button that is attached to the patient’s skin. By disposing of the food before it is digested, the patient will not absorb as many calories, which can therefore lead to weight loss. Patients are required to replace their AspireAssist kit every year, and the treatment is completely reversible.

More About Aspiration Therapy

AspireAssist costs roughly $9,000 compared to the $13,000 to $20,000 price tag attached to other bariatric surgeries. So far, aspiration therapy is only available through the private sector. With such a long waiting list for obese patients to receive proper bariatric care in this country, therapies like AspireAssist could significantly reduce wait times for people in need.

If you’re interested in learning more about how weight loss surgery may be right for you, please fill out this patient questionnaire or contact us for more information.

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Bariatric Surgeries on the Rise; Sleeve Gastrectomy at Top

According to the American Society for Metabolic and Bariatric Surgery (ASMBS), bariatric surgeries in the US has risen by 10 percent since last year, with the sleeve gastrectomy continuing to be the main procedure with gastric bypass coming into second. Since 2011, sleeve gastrectomies only represented 17.8 percent of the procedures performed, but that number has been steadily rising over the years and now represents almost 60 percent of the weight loss surgeries performed in the US.

Laparoscopic Sleeve Gastrectomy

Dr. Michel Gagner perfected the sleeve gastrectomy in 2000 and it has been a popular choice for high-risk bariatric patients and patients with a low BMI ever since. There are many advantages to undergoing the sleeve gastrectomy compared to other procedures, mainly that the surgery preserves gastric emptying and mineral absorption, causes less dumping syndrome and hypoglycemia, and can easily be revised in the case of weight regain. Laparoscopic sleeve gastrectomy is generally the first step in weight-loss surgery for many patients, as it is typically less invasive (the laparoscopic camera allows for more precise use of long surgical instruments) than other procedures, and patients can return to work in as little as two weeks.

The laparoscopic sleeve gastrectomy is a procedure wherein 60–85% of the stomach pouch is removed, leaving a sleeve-like shape that is much smaller in volume. Because of the reduced size of the stomach, the patient will feel fuller sooner.

Bariatric Surgeries in the US

There is an estimated 24 million people in the United States who are eligible for bariatric surgery. In 2016, roughly 216,000 surgeries were performed or roughly one percent of the population who are eligible. Are you considering bariatric surgery as the next step in your weight loss journey? Fill out our Patient Questionnaire or contact Clinique Michel Gagner for more information.


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How Well Are We Treating Obesity in Canada: A Quick Overview

When it comes to access to bariatric surgery in Canada, our country’s report card could be better. The highest score we received was a C for waiting times between consultations and surgery, which doesn’t even apply to all provinces. Part of the reason for our low scores is that despite the fact of obesity in this country, not one province considers it a chronic disease, which has a major effect on how obesity patients receive health care.

Despite the Millions of Obese Patients in Canada, there are only 113 Bariatric Surgeons

Of the millions of obese patients in the country, every single one of them must rely on the training and expertise of a very low percentage of surgeons. That is not to say that these physicians are fairly spread out throughout the country. For instance, bariatric surgery is not even available in PEI or the territories. This is not reflective of the number of patients who are eligible for bariatric surgery. On average, bariatric surgery is only available to 0.54% of the population of Canadians who qualify.

Limited to No Access to Prescription Medication

There are only two approved anti-obesity medications in Canada. However, neither of these are offered by provincial drug benefit plans, and only less than 20% of Canadians with private insurance have access to these two drugs. Canada and the provinces/territories all scored an F on access to anti-obesity medications.

Access to Obesity Specialists

There are only 40 specialists in the country who are qualified and trained to provide obese patients with interdisciplinary care. The majority of these services entail dietetic services, while mental health support and cognitive behavioural therapy access is severely limited. Interdisciplinary treatment for obesity management is simply unavailable for the many people who need it, and Canadian physicians are just not seeking formal training in obesity management.

Clinique Michel Gagner is committed to providing our Canadian and international patients with superior service in bariatric surgery. Fill out this patient questionnaire or contact us today for more information.

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Constats sur la chirurgie bariatrique: Des résultats positifs dévoilés à la conférence FALS 2017

Du 6 au 8 octobre dernier, 180 chirurgiens bariatriques ont eu la chance de recevoir une formation dans le cadre d’un programme organisé par la Indian Association of Gastrointestinal Endosurgeons (IAGES) pour une deuxième édition à Mumbai. Lors de cet événement, plusieurs sujets comme l’avancement dans le domaine de la chirurgie bariatrique et des résultats de recherches concluantes à propos, par exemple, du bienfait des chirurgies bariatriques sur le diabète, l’obésité et d’autres maladies chroniques ainsi que sur l’importance de l’éthique dans le domaine. Le Dr Michel Gagner faisait partie des invités internationaux.

Les chirurgiens suivant cette formation de 3 jours ont pu en apprendre sur les bases de la chirurgie bariatrique, ses aspects techniques et les résultats possibles de celle-ci, sur les procédures postopératoires et la façon d’évaluer les patients pour ce type de chirurgie. Ils ont aussi pu assister à des discussions et le partage de résultats d’études menées sur le sujet.

 Des résultats positifs sur plusieurs maladies chroniques

Le Dr Phil Schauer de la clinique de Cleveland a dévoilé des résultats sur les bienfaits de la chirurgie bariatrique sur les patients souffrant de diabète type 2 au terme de l’étude Surgical Therapy and Medications Potentioally Eradicate Diabetes Efficiently (STAMPEDED), qui s’est étendue sur une période de cinq ans. Effectivement, l’étude a démontré que ces patients ont de meilleures chances de rémission qu’avec des traitements conventionnels incluant médications et mode de vie sain. «La chose la plus surprenante, spécialement pour les patients ayant subi un pontage gastrique, est de constater que presque un tiers ont connu une rémission complète du diabète.» A-t’il témoigné.

Zahabiya Khorakiwala, de l’Hopital Wockhardt a aussi partagé qu’au moins 3000 millions adultes souffrent d’obésité et que ce problème est associé à plusieurs maladies chroniques comme l’hypertension, crise cardiaque et plusieurs types de cancers. La perte de poids serait plus efficace lors de chirurgie bariatrique et il s’agit d’un traitement plus bénéfique que les thérapies et diètes conventionnelles.

 L’importance de l’éthique

Directeur du département de chirurgie bariatrique et métabolique à l’Hopital Wockhardt, le Dr Ramen Goel a souligné l’importance d’une pratique éthique sur le terrain. Avec plus de 17 ans d’expérience, il affirme qu’il ne s’agit pas de se demander quels patients opérer, mais bien de se questionner sur les patients à ne pas opérer, mentionnant qu’un docteur devrait avoir le courage de refuser une chirurgie si un patient est psychologiquement instable ou s’il souhaite une intervention chirurgicale pour des raisons d’apparence seulement.

L’honorable Bhikku Sanghasena, possible candidat au prix Nobel de la paix en 2017 a aussi pris la parole pour soulever un point important  en  faisant remarquer aux médecins qu’au-delà du partage de leur expertise, leurs connaissances, du diagnostic et de la sélection du bon traitement, la compassion fait une grande différence.

Cette formation, à laquelle le spécialiste Dr Michel Gagner assistait, a permis d’en savoir plus sur la chirurgie bariatrique, si vous souhaitez avoir plus d’informations sur ce type d’intervention, n’hésitez pas à contacter la clinique Michel Gagner, votre spécialiste dans le domaine.

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Obesity Linked to Greater Risk of Developing Certain Cancers

According to the American Centre of Disease Control (CDC) Newsroom, there is a strong link between being overweight or obese and cancer. In fact, these recent CDC findings link as many as 13 different types of cancer to obesity. While the rate of newly developed cancers has slowed down since the 1990s, obesity-related cancers are slowing down this rate.

Overweight and Obesity-Related Cancers

The main cancers associated with being overweight or obese are: meningioma, adenocarcinoma of the esophagus, multiple myeloma (blood cell cancer), and cancers of the thyroid, breast, liver, gallbladder, kidneys, ovaries, uterus, pancreas, colon and rectum, and upper stomach. The rate at which people are developing obesity-related cancers in the United States has risen by 7% since 2005.

Obesity in America

In 2014, over 600 thousand people were treated for overweight and obesity-related cancer in the United States. Two-thirds of these patients were between 50 and 74. Since two out of three Americans are considered overweight or obese (according to their body mass index), this has led to a global concern for the American people, especially since it seems as if not many Americans are aware that being overweight can pose a greater risk of developing cancer.

Lower Your Risk

From a healthcare perspective, more needs to be done to spread awareness about these types of cancers, to encourage patients to exercise and eat right, and to make healthy foods available to all demographics. Over half the cancer diagnoses in women and almost a quarter of the diagnoses in men were related to being overweight or obese. That staggering figure demonstrates the absolute need for overweight and obese people to make major life changes. Losing weight and reducing your BMI into a normal range will significantly lower your risk.

However, sometimes eating right and increasing your exercise is not enough to lose weight. If you’re morbidly obese, you may need more help. If you’re considering bariatric surgery, please feel free to fill out our patient questionnaire or to contact Clinique Michel Gagner for more information.


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Dr. Gagner to Debate at IBC World Congress at Oxford University

Between March 26th and 27th, Dr. Michel Gagner will take part in a debate with Dr. David Kerrigan over the motion that “staple line reinforcement with buttressing should be the standard of care in sleeve gastrectomy.” The debate is to take place at the first International Bariatric Club (IBC) World Congress at Oxford University, England. The theme of the congress is “Managing Obesity & Diabetes: From the Laboratory to Clinic to Operating Room to the World” (click here for more info or to register).

The International Bariatric Club
The IBC represents a group of bariatric surgeons from all over the world who discuss recent issues and industry news, provide support, share videos of surgeries, participate in live discussions, and host webinars. It is a closed member-only group and a global network for surgeons in this field. Dr. Michel Gagner is an IBC board member.

The IBC was established by three professors of surgery in Ohio: Dr. Tomasz Rogula, Dr. Raul Rosenthal, and Dr. Philip R. Schauer and began as a series of seminar broadcasts based in Cleveland. Of note, all three surgeons have received training in various degrees by Dr. Gagner. In 2010, the IBC opened a Facebook webpage and has since expanded its membership by promoting a sense of community where the world’s bariatric professionals can freely discuss issues related to their field.

Sleeve Gastrectomy

The topic of debate, that is, what should be considered the standard care in sleeve gastrectomy, will be interesting for Dr. Gagner to discuss, as he pioneered the procedure in 2000 and has been performing it ever since. Sleeve gastrectomy procedures have been a popular weight-loss surgery option for high-risk patients and as an alternative to gastric banding.

Check our news page for updates on recent publications, appearances, discussions, and interviews with Dr. Michel Gagner. If you’re interested in learning more about laparoscopic sleeve gastrectomy and how it can help improve your quality of life, please contact Clinique Michel Gagner today.

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Type 2 Diabetes in Youth Causes More Health Problems Than Type 1, Research Finds

A recent study published in the Journal of the American Medical Association determined that young patients with type 2 diabetes were more prone to developing health problems than youth with type 1 diabetes.

The SEARCH for Diabetes in Youth study found that young patients with type 2 diabetes developed early signs of kidney disease, nerve disease, and eye disease, as well as showed greater signs for risk factors of heart disease. The preconceived notion that children and young people don’t typically exhibit health complications from their diabetes is largely refuted by this evidence. Of the patients studied, the average age of the first sign of complication was 21 years old in 33% of type 1 patients and 75% in type 2 patients.

Type 1 diabetes is developed in infancy and occurs when the body does not naturally produce insulin, the most powerful hormone in your body that stabilizes your metabolism and feeds your body the necessary sugars its needs to survive. There is no recourse for patients with Type 1 diabetes, other than to receive lifelong injections of insulin. A balanced diet and proper exercise contribute to a type 1 patient’s overall health. Type 2 diabetes, also known as sugar disease, can develop in people of all ages and occurs when the body doesn’t use insulin efficiently or doesn’t produce enough insulin. Type 2 diabetes is typically caused by lifestyle choices, such as being inactive and eating a nutrient-deficient diet. The fact that type 2 diabetes is affecting children more than ever is indicative of the obesity epidemic in North America and around the world.

The study illustrates the importance of learning how to delay these complications, and in a broader sense, it demonstrates the fundamental need to pre-screen children and youth who may be at risk of developing type 2 diabetes. This disease is caused and worsened by morbid obesity, and while both health conditions are reversible, help is sometimes required in cases where losing weight is difficult or dangerous. If you’re considering bariatric surgery, please take a minute to fill out our patient questionnaire, or contact Clinique Michel Gagner today.

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Diets Might Be Unpopular, but We Never Stop Trying Them

In a recent New York Times article, writer Taffy Brodesser-Akner explores the current landscape of dieting and weight loss and how, after almost a century of thin people telling fat people the key to losing weight, we are now no closer to ending the social stigma—or the existence—of obesity.

When Dieting Stopped Being a Thing

Atkins, South Beach, Jenny Craig, Paleo, and other dieting names have been making promises to people for decades. In practically every dieting method, a macro-nutrient is vilified as being the main culprit for excessive weight and promises that by cutting out this essential nutrient (carbohydrates and fats are usually the main bad guys), weight loss will naturally occur. The problem with diets have long been documented: none of them promise long-term sustainability, and dieters usually gain the lost weight soon afterward. Without one’s honest effort to increase their physical activity and change their relationship with food, unhealthy patterns are bound to repeat themselves. This, of course, ignores the fact of extreme obesity, where efforts to change one’s lifestyle and eating habits are almost never enough to lead to a dramatic drop in weight.

Recently, the word “diet” has fallen out of favour in the wake of anti-fat-shaming campaigns and the global movement of overweight men and women who are beginning to embrace their weight while shedding Western society’s narrow (some might say impossible) definition of beauty that made them start dieting in the first place.

Healthy Eating is Dieting in Disguise

Today, you’d be hard-pressed to hear the word “diet” uttered from anyone’s lips. The pejorative term hardly denotes the modern ideals of health and fitness. After all, dieting is bad. But what’s so terrible about eating greens, using natural sugars, eliminating gluten, drinking plenty of water, eating lean protein, choosing whole grain, drinking coconut water, brushing our teeth with charcoal, eating local, fresh, and seasonal, strengthening our cores, working on our yoga poses, and getting our butts kicked in high-intensity interval training?

While some might argue that the mental shift from fat-loss to “staying healthy” is a step in the right direction, others, including Brodesser-Akner, point out that healthy eating is a more self-conscious synonym for dieting. If we should love our bodies no matter what, then why are we letting Hollywood fitness gurus with BMIs we’ll never achieve in a million years tell us what to eat and how to work out?

Oprah Winfrey and Weight Watchers

In 2015, Oprah—the most recorded yo-yo dieter in history—became the official spokesperson for Weight Watchers, and within a year, membership had skyrocketed. Oprah, who has given up dieting several times in her past, is supposed to embody a higher state of being, a sense of enlightenment, notions of self-acceptance, self-love and all that. Although she remains all that and more, there is no denying that by accepting her weight as it is, she is also accepting the inevitability that she will develop type 2 diabetes (which runs in her family) and other obesity-related health issues.

The ideal weight will forever be a social construct that is loosely based on health statistics but more often blown out of proportion by the media and advertising companies who have spent decades convincing people of the existence a problem in order to sell them the solution. However, underneath the Atkins and the Weight Watchers and the gluten-free bread lies a serious health concern for people with extreme obesity; a health concern that dieting simultaneously ignores and undermines.

If you are morbidly obese, extreme dieting will not likely show you the results you’re looking for. While healthy diet and exercise can reduce your risk of developing heart disease, diabetes, and certain cancers, it may not be enough to significantly lower your BMI. Contact Clinique Michel Gagner or get started with our Patient Questionnaire to find out if bariatric surgery is right for you.

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