Obesity by itself isn't good, but mixing it with smoking can increase anyone's health risks. US News Health (http://health.usnews.com/health-news/news/articles/2013/03/12/lung-transplant-hazard-may-rise-with-obese-recipients-smoking-donors) reported in March 12, 2013 that "serious illness and death" can result when obesity and smoking meet. The specific story centered around a lung transplant donor who indulged in smoking, and the obese receiver of the transplanted lung, along with a case study of 1,300 donors and donees. Bariatric surgeon Dr. Madan suggests that the effects of both smoking and obesity can be counteracted in time with healthy lifestyle changes, but that patients with a BMI of over 40 or more might consider LAP-BAND surgery to speed a healthy process of long-term weight loss.
What's surprising about the study mentioned in US News Health is that there was such a small increase of PGD or "primary graft dysfunction"(5%) between lung donors who had smoked, and those who had not. PGD happens when a transplanted organ doesn't settle well in its new home. Perhaps the phrase, "previous smokers" may be a clue, because the body can recover from smoking in a relatively short time.
In March 2013, the National Institutes of Health (NIH) issued a press release, stating that smokers should officially stop worrying about weight gain as a justification for smoking. The study indicated that an additional 5-10 pounds did not outweigh the good effects of putting down cigarettes. Quitting smoking for non-diabetes patients cut heart health risks in half, while non-smokers had a 32% chance of developing heart issues.
However, US News said that extra weight certainly added to risk factors in lung transplant. Just being overweight (with an additional 50 pounds or less) added 7% to PGD numbers, and obesity added 11%. Since the lungs are so essential to the body, it only takes 3 days to know whether or not the new lungs have taken to their new environment. PGD increases by 18% the risk of death within 90 days of the transplant, according to instructor Dr. Joshua Diamond of the University of Pennsylvania's School of Medicine. Differences do not even out with time, either. The same researchers found a 23% risk increase between those with PGD and without.
This would not be as worrying, says Dr. Madan, if it weren't for a number of studies indicating that many morbidly obese patients (with a BMI of 40 or more) tend to gravitate toward over-smoking as well as over-eating. In fact, a 2010 study by BioMed Central stated that more weight often went along with more smoking: "A patient with morbid obesity had a 2-fold increased risk of becoming a smoker." Of course, the researchers considered whether or not these numbers and risk factors may have been inflated, due to unhealthy diet and lack of exercise. However, it seemed clear that heavy smoking, heavy drinking, and heavy eating tended to go together. Study results only confirmed the common perception, that smokers tend to be thinner than non-smokers, up to a BMI of 25.
One of the reasons why Dr. Madan encourages a return to classic weight-loss methods, along with bariatric procedures such as lap band surgery, is that many people can become discouraged at slow or seemingly non-existent results when only following better diet and exercise habits. With discouragement can come the inclination toward returning to unhealthy habits, including smoking, for relaxation. With an actual lap band surgery comes follow-up appointments with the physician, including checkups on progress, and band adjustments.
Dr. Madan has written 175 articles, and was the first in Memphis to perform a laparoscopic gastric bypass. To date, he has performed over, and was first to offer an incision-less treatment for post-operative weight gain. As the former Chief of Laparoendoscopic and Bariatric Surgery Division at the University of Miami, Dr. Atul Madan may well be considered an expert in his field. Dr. Madan won the 2007 SAGES Young Investigator Award, was honored by the American Medical Association Physican's Recognition Award, among others. Dr. Madan's patient reviews are consistently high, and he received the 2011 and 2012 Patients' Choice Award.
For more information on Dr. Atul Madan or the LAP-BAND procedure, call (213) 973-2263, or review more on Dr. Madan on http://dr-madan.com/ .
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