Startling Statistics Reveal 95% of Parents Believe Their Obese Children To Be “Just Right”

Naturally, parents want to believe that they are raising their children right; that they are providing them with a healthy diet, and that an inclination for food amongst younger children is a sign of good health and vitality. This was confirmed by a team of researchers from NYU Langone Medical Center who looked at data on how parents perceive their overweight young children, revealing that 94.9 percent of parents believe their kids’ size to be “just right” Researchers studied two groups of young children: a group of 3,839 kids from 1988-1994, and another group of 3,151 kids from 2007-2012, and published the findings in the journal Childhood Obesity. Similar findings were reported last year in the journal Pediatrics.

Perhaps even more disturbing, researchers found that results worsened from the same survey taken 20 years earlier. Obese children today are roughly 30% less likely to be appropriately perceived by their parents than they were in the 1990s. Amongst those with the highest chances of inaccurate perceptions were low-income parents and African Americans.

In the study, parents were asked the pivotal question: “Do you consider [child’s name] to be overweight, underweight, just about the right weight, or don’t know?” Data showed that parental responses were pretty much the same within the two time periods studied, however there was one very noticeable difference: childhood obesity is much more widespread today than it was the first time the study was conducted, meaning more parents are viewing their obese children as “just right”.

Signs point to changing societal ideals and a redefinition of healthy body weight. As obesity keeps rising in North America, larger body types are becoming more and more commonplace. Even among kids aged 2 to 5, who were the subjects of this study, perceptions of weight ideals have drastically changed. If every other child is obese, parents are more likely to see their own child as “normal” because of its prevalence.

Lessons can be learned from this study, yet none of them may be pleasant. Firstly, childhood obesity isn’t going away anytime soon. Secondly, more work needs to be done by pediatricians on educating parents about healthy diets for their children in the face of rising obesity rates. Thirdly, most parents have obviously lost a clear idea of what a healthy child looks like.

The important thing is that we start taking action now, before these trends become irreversible.

Source: Washington Post

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Dr. Gagner Appears In Wall Street Journal – “Obesity Surgery Is Better At Treating Type 2 Diabetes In Obese Patients Than Diet And Exercise”

The Wallstreet Journal recently published an article on July 1st that reflected on the growing body of evidence that suggests that weight-loss may be an effective way to treat type-2 diabetes, in conjunction with Dr. Gagner’s editorial companion piece published in the JAMA Surgery Journal.

According to a small but rigorous randomized trial published by JAMA Surgery, evidence shows baratric surgery is superior to lifestyle changes in resolving type-2 diabetes. In the trial, obese patients were randomly assigned either a Roux-en-Y gastric bypass, a laproscopic adjustable gastric banding, or a lifestyle weight loss intervention plan. Results showed that patients who had had the Roux-en-Y gastric bypass procedure had the highest type-2 diabetes partial or complete remission rate with 40%; 29% with the laparoscopic banding; 0% with weight loss intervention patients. In other words, no one in the group who received intensive lifestyle intervention resolved their diabetes, which stands in stark contrast to those who received weight-loss surgery.

If the JAMA Surgery study didn’t convince you, Dr. Gagner points to another study –  the TODAY clinical trial on adolescents with recent-onset type-2 diabetes similarly indicates no benefits of intensive lifestyle intervention. For Obese patients with type-2 diabetes, surgery resulted in better glucose control than did medical therapy.

Dr. Gagner states – “We should consider the use of bariatric (metabolic) surgery in all severely obese patients with T2DM and start a mass treatment, similar to what was done with coronary artery bypass graft more than 50 years ago.”

Source: Wall Street Journal, JAMA Surgery

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IFSO EFC – Interview With The Expert – “Which Is The Most Important Trick To Avoid In Sleeve Gastrectomy Staple Line Leaks?”

Dr. Gagner gives his expert advice on how to avoid staple leaks in Sleeve Gastrectomy surgeries.

 

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A Score Of New Peer-Reviewed Articles From Dr. Gagner

Be up to date in the field of Bariatrics by reading the latest peer-reviewed articles from Dr. Gagner:

1. Gagner, M: Bariatric surgery saves lives. CMAJ. 2015 Jun 16;187(9):681. doi: 10.1503/cmaj.1150042. Link

2. Gagner M: Effect of sleeve gastrectomy on type 2 diabetes as an alternative to Roux-en-Y gastric bypass: a better long-term strategy. Surg Obes Relat Dis. 2015 Mar 24. pii: S1550-7289(15)00064-7. Link

3. Nedelcu M, Noel P, Iannelli A, Gagner M: Revised sleeve gastrectomy (re-sleeve). Surg Obes Relat Dis. 2015 Feb 14. pii: S1550-7289(15)00040-4. Link

4. Huang R, Gagner M: A Thickness Calibration Device Is Needed to Determine Staple Height and Avoid Leaks in Laparoscopic Sleeve
Gastrectomy. Obes Surg. 2015 May 30. Link

5. Manos T, Nedelcu M, Noel P, Gagner M: Pigtails Internal Drainage for 2-cm Gastric Leak After Sleeve Gastrectomy Prolongs Healing. Obes Surg. 2015 Jul;25(7):1261-2. Link

6. Gagner M: Bariatric surgery: To bypass or switch? That is the question in obesity surgery. Nat Rev Gastroenterol Hepatol. 2015 May;12(5):255-6. Link

7. Roslin MS, Gagner M, Goriparthi R, Mitzman B: The rationale for a duodenal switch as the primary surgical treatment of advanced type 2
diabetes mellitus and metabolic disease. Surg Obes Relat Dis. 2014 Nov 25. pii: S1550-7289(14)00463-8. doi: 10.1016/j.soard.2014.11.017. Link

8. Sato T, Yamaguchi S, Harada M, Koyama I, Gagner M.Impact of laparoscopic surgery on survival of patients with small bowel adenocarcinoma and peritoneal metastasis. Hepatogastroenterology. 2014 Nov-Dec;61(136):2253-5. Link

9. Sato T, Yamaguchi S, Harada M, Gagner M: Long-term outcome of laparoscopic resection for stage IV colorectal cancer. Hepatogastroenterology. 2014 Nov-Dec;61(136):2232-5. Link

10. Nedelcu M, Manos T, Cotirlet A, Noel P, Gagner M: Outcome of leaks after sleeve gastrectomy based on a new algorithm adressing leak size and gastric stenosis. Obes Surg. 2015 Mar;25(3):559-63. doi: 10.1007/s11695-014-1561-y. Link

11. Gagner M: Decreased incidence of leaks after sleeve gastrectomy and improved treatments. Surg Obes Relat Dis. 2014 Jul-Aug;10(4):611-2. Link

 

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Bariatric Surgery and the Regression of Subclinical Atherosclerosis

Atherosclerosis is a chronic disease that essentially involves the hardening of arteries due to inflammation. It’s a disease that can progress for a long while before any outward symptoms are displayed.  Atherosclerosis that has not progressed enough to present symptoms is known as subclinical atherosclerosis, and can be difficult to screen for.

If left unchecked, the progression of atherosclerosis can lead to serious health problems such as heart disease, angina, and heart attacks.

There is good news, however: a new study has shown that bariatric surgery can cause a relatively fast regression in subclinical atherosclerosis. This means not only will you lose weight due to the surgery, but your risk of developing cardiovascular disease will go down as well.

According to this study lead by Dr Jose Roberto Matos­Souza from the State University of Campinas/UNICAMP Clinics in Brazil, individuals undergoing bariatric surgery saw a regression in atherosclerosis 1 month after their procedure, and results showed that this reduction was sustained after 1 year.

The regression of atherosclerosis demonstrated was most significant within 3 to 6 months of the bariatric surgery procedure, and was correlated with a reduction in LDL cholesterol and an increase in HDL cholesterol. The atherosclerosis reduction occurred before significant loss in body weight.

This finding makes bariatric surgery more than just a procedure that is good for weight loss. It will also improve your overall health and reduce the complications associated with inflammation in your cardiovascular system.

 

 

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“To Bypass or Switch?” Dr. Gagner Writes Article For Prestigious Journal, Nature Reviews.

In a recent article written by Dr. Gagner and published by Nature Review: Gastroenterology & Hepatology, Dr. Gagner comments on the debate on which surgery is best to achieve weight loss and improve health. In light of a new study, duodenal switch is considered superior to gastric bypass for weight loss in patients with a BMI >50, but patients suffered more adverse affects.

In this study conducted by Risstad and colleagues, 60 patients with a BMI between 50 and 60 were randomly assigned to receive either a gastric bypass or a duodenal switch, and then observed over a 5-year period. It was found that, on average, those who had received a gastric bypass had an average BMI reduction of 13.6, while those who had duodenal switches saw reductions of 22.1. Moreover,  only 14% of duodenal switch surgeries were considered unsuccessful versus 55% for gastric bypasses.

Duodenal switch was also associated with more gastrointestinal adverse events, however. In the opinion of Dr. Gagner, “the quality of life in those who received duodenal switch might have been underestimated by a higher frequency of adverse effects as a result of learning curve issues than in those who received gastric bypass”. This means that patients who received a duodenal switch had substantially more hospital admissions than patients with gastric bypass.

Take a look at Nature Reviews’ April issue to learn more: http://www.nature.com/nrgastro/journal/v12/n5/index.html

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La chirurgie de bypass gastrique peut détecter d’autres problèmes et sauver votre vie

Le bypass gastrique est une procédure qui nécessite des tests préopératoires extensifs avant son exécution. Un des avantages de ce genre de tests est que les médecins peuvent parfois finir par découvrir d’autres conditions préexistantes qu’ils ont manquées auparavant.

Dans un cas récent, un patient est allé pour une chirurgie de bypass gastrique et les médecins ont réussi à trouver des preuves de cancer de l’estomac au cours de leurs diverses procédures préopératoires. Le patient en question avait une histoire familiale de cancer, mais en raison de sa jeunesse et de sa bonne santé générale, les médecins n’auront jamais pu découvert la tumeur naissante si le patient n’avais pas été l’objet d’un bypass gastrique. Les médecins ont réussi à détruire complètement la tumeur, ajoutant potentiellement des décennies à la vie du patient.

Cette situation est loin d’être rare. Beaucoup de gens ne cherchent pas les soins médicaux jusqu’à ce qu’ils commencent à développer des symptômes très visibles. Dans ce cas, leurs maladies peuvent avoir sensiblement progressé pendant ce temps. Le fait de découvrir une maladie qui est dans les premiers stades de développement peut faire la différence entre la vie et la mort, en particulier dans le cas du cancer. Les tumeurs qui sont détectées au début de leur développement peuvent être enlevées avant qu’ils ne se propagent.

La détection précoce de la maladie cardiaque peut aussi aider les gens à recevoir un traitement au bon moment. Certains médecins peuvent même arriver à trouver les caillots sanguins chez les patients avant qu’ils ne provoquent des situations d’urgence menaçant la vie du patient. La chirurgie de bypass gastrique est un excellent exemple de la façon dont une procédure peut sauver directement et indirectement la vie des patients.

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MICHEL GAGNER, MD, FACS and CINE-MED, INC. Announce Release of New Book

Woodbury, CT, US – Cine-Med, Inc is pleased to announce the release of its latest surgery book, Atlas of Hepato-Pancreato-Biliary (HPB) Surgery, edited by Michel Gagner, MD, FACS and Daniel B. Jones, MD, MS, FACS.

This oversized atlas includes 42 chapters written by 72 internationally recognized names in HPB surgery. The chapters include: 19 Biliary, 13 Pancreatic, and 10 Hepatic procedures.

The editors have provided written commentary for each chapter offering their perspectives on the procedures as well as alternative methods for performing the surgical techniques.

Presented in step-by-step format, each chapter is accompanied by full color illustrations and intraoperative photos. Surgical videos will be added to the text in the coming months.

“It took 5 years to write, and there is more than 20 years worth of experience written in this book” says Dr. Gagner. “It’s an accumulation of  my life’s work. It’s my baby! It shows how to perform the different surgeries I have helped develop throughout my career. On top of that, there are photos and diagrams that can help students and professionals who are interested in the field of pancreatic surgery. It’s no ordinary book, that’s for sure.”

To order a copy of this book, please contact Mary Panagrosso, Cine-Med, Inc. 800-253-7657 or visit Cine-Med.com; Product ID: HPB-01, Price: $285 US

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Dr. Gagner Helps SurgiBot Clear GLP Studies

In recent Bariatric and surgical news, TransEntrix, Inc., a medical device company that is heavily involved in the development of robotics and flexible instruments for the use of minimally invasive surgery, announced on April 16th the successful completion of one of the key steps prior to 510(k) submission for their new SurgiBot system, a patient-side robotic surgery system.

The completion of the GLP (Good Laboratory Practice) Studies, means that FDA filing could be ready as soon as mid-2015.

Upon further investigation, the SurgiBot system would utilize flexible instruments through articulating channels controlled directly by the surgeon, with robotic assistance, at the patient’s bedside, effectively making the surgeons’ job easier. The flexible nature of the system allows for multiple instruments to be introduced and deployed through a single incision.

Dr. Michel Gagner of Montreal, Canada and President of the 2014 World Congress of the International Federation for the Surgery of Obesity & Metabolic Disorders was one of the lead investigators for the GLP Studies using the SurgiBot system.

The GLP studies also included multiple procedures performed by surgeons from varying specialties to demonstrate the SurgiBot’s abilities to handle critical tasks commonly performed during the rigors of laparascopic surgery.

“The SurgiBot system proved to be capable of effectively performing surgery in this completed study”, said Dr. Gagner. “The system provided articulating vision and multiple instruments through a single incision. The user experience keeps the surgeon in the sterile field with familiar laparascopic movement. I prefer to be at the patient’s side during surgery, and appreciate maintaining the approach and movement of gold standard laparscopic surgery while adding the features of robotic assistance.”

Source: Business Wire 

 

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Bariatric Surgery Helps Hip Replacement Patients

While obesity is known to contribute to several health complications such as cardiovascular disease and diabetes, carrying an excess of weight also affects mobility and takes its toll on joints. As such, not only is it advisable to lose weight through bariatric surgery in order to lead a healthy lifestyle, but it has also proven to be beneficial for those undergoing hip replacement surgery.

Recently, two studies have shown that bariatric surgery helped to improve the outcomes of patients who had hip replacement surgery. These studies were presented at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons in Las Vegas.

Previously, the benefits of bariatric surgery for morbidly obese hip replacement patients was unclear, but these studies have shown that it brings clear benefits, and should be considered for insurance coverage benefits under these circumstances.

Improve Recovery and Reduce Complications

Being obese puts a lot of strain on your your hips and legs. This can be problematic especially if you will be undergoing hip replacement or knee replacement surgery in the near future. Weight loss helps to improve recovery and eliminate pain and subsequent damage to your hips and legs.

Bariatric surgery has always been a cost-effective solution for weight loss, especially for the morbidly obese. Now, these new studies have shown that it can also lend its efficiency as a weight loss tactic to other procedures, further reducing costs and improving people’s lives.

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