Drugs, Gimmicks, and Bariatric Surgery.
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Drugs, Gimmicks, and Bariatric Surgery.

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There are better ways of losing flab.

There are better ways of losing flab.

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  • Exercising doesn’t work for everybody. Ot be effective, it should be moderate at the least. Light exercising does not reduce weight effectively, on the contrary, it may stimulate your appetite and make you consume more calories.To help people with aversion to vigorous exercising or any exercising at all, a FIM method makes a great alternative. It is a natural self control. You initiate self regulating mechanisms.
  • Weight Loss DrugsObesity often requires long-term treatment to promote and sustain weight loss. As in other chronic conditions, such as diabetes or high blood pressure, use of prescription drugs may be appropriate for some people. While most side effects of prescription weight loss drugs are mild, serious complications have been reported. More on that below.Keep in mind that these drugs are not a cure-all for obesity. The use of weight loss drugs should be combined with physical activity and improved diet to lose and maintain weight successfully over the long term.Using prescription weight loss drugs to treat obesity should be used as an option for the following individuals:People with a body mass index(BMI) of 30 and above with no obesity-related conditions.A person with a BMI of 27 and above with obesity-related conditions, such as diabetes or high blood pressure. Types of Prescription Weight Loss DrugsCurrently, most available weight loss drugs approved by the FDA are for short-term use, meaning a few weeks or months.One type of weight-loss medication is "appetite suppressants." These drugs generally come in the form of tablets or extended-release capsules (pills that release medication over a long period of time). Appetite suppressants can be obtained by a doctor's prescription or purchased over the counter. One common prescription appetite suppressant is phentermine.Another type of prescription weight loss drug is a fat absorption inhibitor. Xenical is the only example of this type of treatment approved for use in the U.S. Xenical works by blocking about 30% of dietary fat from being absorbed. Xenical is now sold over-the-counter as Alli.Xenical is the only weight loss drug approved for longer-term use in significantly obese people, although the safety and effectiveness have not been established for use beyond two years.Newer drugs are being studied as potential treatments for obesity, some of which are showing promise and may be available in the near future.
  • How Do Appetite Suppressants Cause Weight Loss?Appetite suppressants promote weight loss by tricking the body into believing that it is not hungry or that it is full. They decrease appetite by increasing serotonin or catecholamine -- two brain chemicals that affect mood and appetite.
  • Xenical works by blocking about 30% of dietary fat from being absorbed. Xenical is now sold over-the-counter as Alli.Does Xenical Really Work?In general, Xenical is moderately effective, leading to an average weight loss of 12 to 13 pounds over a one-year period, more than what would be expected with non-drug treatments. Most of the weight loss is generally experienced in the first 6 months. Over the short term, weight loss from prescription drugs may reduce a number of health risks in obese people. However, there are currently no studies to determine the effects of these medications over the long term.When considering long-term weight loss drugs for obesity, the following possible concerns and risks should be discussed with your doctor:Addiction. Currently, all prescription obesity drugs except Xenical are "controlled substances." This means that doctors are required to follow certain restrictions when prescribing them since they could be addictive.Developed tolerance. Most people's weight tends to level off after six months while taking a weight-loss medication. This leads to a concern that the person has developed a tolerance for the medication. However, it is unclear whether this leveling off is indeed due to a developed tolerance or if the drug has reached its limit in effectiveness.Side effects. Most side effects of weight loss drugs are mild (although some can be unpleasant) and usually improve as your body adjusts to the medication. Rarely, serious and even fatal outcomes have been reported.The Side Effects of Prescription Weight Loss DrugsMost appetite suppressants are used as a short-term treatment for obese people. Not only do the drugs' effects tend to wear off after a few weeks, but they can also have some unpleasant side effects, including:Increased heart rateIncreased blood pressureSweatingConstipationInsomnia (inability to sleep or stay asleep)Excessive thirstLightheadednessDrowsinessStuffy noseHeadacheAnxietyDry mouthSome side effects with Xenical include abdominal cramping, passing gas, leakage of oily stool, increased number of bowel movements, and the inability to control bowel movements. These side effects are generally mild and temporary, but may be worsened by eating foods that are high in fat. Patients should eat a low-fat diet (less than 30% of calories from fat) before starting treatment with Xenical. Because Xenical reduces the absorption of some vitamins, people taking Xenical should take a multivitamin at least two hours before or after taking the medication.Because these drugs are not recommended for long-term use, it is important for people who are trying to lose weight to learn new eating habits and to exercise while the drug is still effective. Once healthy eating and regular exercise have been learned and established, it is important to continue eating right and exercising if you hope to continue losing weight and keep lost weight from returning.Weight loss drugs are not for everybody. For example, there are limited studies on these medications' effects on older adults and on children.Changes in your bowel function frequently occur because of the unabsorbed fat. Fatty/oily stool, oily spotting, intestinal gas with discharge, a feeling of needing to have a bowel movement right away, increased number of bowel movements, or poor bowel control may occur. These side effects may get worse if you eat more fat than you should. If these effects persist or worsen, notify your doctor promptly.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Stop taking this medication and tell your doctor immediately if any of these rare but serious side effects occur: symptoms of liver disease (such as persistent nausea/vomiting, severe stomach/abdominal pain, dark urine, yellowing eyes/skin), symptoms of kidney stones (such as back pain, pain when urinating, pink/bloody urine).
  • Bariatric surgery (weight-loss surgery) includes a variety of procedures performed on people who are obese. Weight loss is achieved by reducing the size of the stomach with an implanted medical device (gastric banding) or through removal of a portion of the stomach (sleeve gastrectomy or biliopancreatic diversion with duodenal switch) or by resecting and re-routing the small intestines to a small stomach pouch (gastric bypass surgery).Long-term studies show the procedures cause significant long-term loss of weight, recovery from diabetes, improvement in cardiovascular risk factors, and a reduction in mortality of 23% from 40%.[1] However, a study in Veterans Affairs (VA) patients has found no survival benefit associated with bariatric surgery among older, severely obese people when compared with usual care, at least out to seven years [2]The U.S. National Institutes of Health recommends bariatric surgery for obese people with a body mass index (BMI) of at least 40, and for people with BMI 35 and serious coexisting medical conditions such as diabetes.[1] However, research is emerging that suggests bariatric surgery could be appropriate for those with a BMI of 35 to 40 with no comorbidities or a BMI of 30 to 35 with significant comorbidities.[3]
  • The failure rate when all patients are followed for at least 10 years was 20.4% for morbidly obese patients and 34.9% for super obese patients.The overall complication rate of this type of surgery ranges from 7% for laparoscopic procedures to 14.5% for operations through open incisions, during the 30 days following surgery.Gastric bypass surgery has an emotional, as well as a physiological, impact on the individual. Many who have undergone the surgery suffer from depression in the following months.[14] This is a result of a change in the role food plays in their emotional well-being. Strict limitations on the diet can place great emotional strain on the patient. Energy levels in the period following the surgery will be low. This is due again to the restriction of food intake, but the negative change in emotional state will also have an impact here.[15] It may take as long as three months for emotional levels to rebound. Muscular weakness in the months following surgery is common. This is caused by a number of factors, including a restriction on protein intake, a resulting loss in muscle mass and decline in energy levels. The weakness may result in balance problems, difficulty climbing stairs or lifting heavy objects, and increased fatigue following simple physical tasks

Drugs, Gimmicks, and Bariatric Surgery. Presentation Transcript

  • 1. Alex Nedvetsky MD, PhD www. 7steps2aleanu.com Shape up, USA!
  • 2. Drugs GimmicksBariatric Surgery
  • 3. Bad - Weight Loss GimmicksWorse - Weight Loss DrugsThe worst – Bariatric Surgery
  • 4. Drugs and gimmicks – just a folly!Gut havoc-wreaking surgery – a defeat!
  • 5. Appetite Suppressants Fat Absorption InhibitorsPrescription drugs is an option for the following individuals: BMI of 30 and above with no obesity-related conditions. BMI of 27 and above with obesity-related conditions (e.g. diabetes or high BP).
  • 6.  Phentermine Diethylpropion Phendimetrazine Orlistat Infamous for their side effects!
  • 7.  difficulty sleeping  arrhythmias dizziness  mental/mood changes irritability  agitation dry mouth  uncontrolled anger nausea  hallucinations  nervousness vomiting  uncontrolled muscle diarrhea movements constipation  impotence
  • 8. XenicalWorks by blocking ~30% of dietary fat from being absorbedMost peoples weight tends to level off after six monthsAverage weight loss - 12 -13 pounds over a one-year period
  • 9.  Problems  drug intolerance Side effects  fatty/oily stool  oily spotting  intestinal gas with discharge  poor bowel control  hepatitis  kidney stones Just Gross!
  • 10.  Tape Worm - Works like a charm, but dangerous and stupid Sensa – Do you really know what you sprinkle on your food, guinea pig? Pray that it is just a placebo! Gels – Expand in the stomach after swallowing. Might work if proven safe
  • 11. The fat comes back!
  • 12.  Stomach size reduction  Removal a portion of the stomach  Gastric banding Resection and rerouting small intestines (gastric bypassU.S. National Institutes of Health recommends surgery if:  BMI > 40  BMI > 35 & coexisting medical conditions 200,000 obesity surgeries a year are performed at an estimated cost of $3 - 5 billion.Brilliant business!
  • 13.  Postsurgical complications: 7 – 14.5% Depression Nutrient deficiency Dumping syndrome Weight regain (failure rate):  20.4% morbidly obese patients  34.9% super obese patients
  • 14. YES!
  • 15. Vigorous - Moderate Exercising orFood Intake Modification Method
  • 16. FIM & Exercising