Dr. Madan And His Colleagues Point Out Possible Long-Term Issues with Gastric Bypass Surgery

Los Angeles, California (PRWEB) April 03, 2013

Out of the $ 190 billion that Americans spend annually on obesity, according to MSN Money, much of that relates to weight loss surgery. Gastric bypass is still the most popular, and 200,000 procedures are done annually, according to Discover Magazine. After 30 years, it is now accepted by most of the medical community that type 2 diabetes can be reversed after bariatric surgery takes care of weight. However, are there long-term complications with gastric bypass? Bariatric surgeon Dr. Madan suggests that LAP-BAND surgery should be considered a safe option for long-term weight loss, perhaps safer in some ways than gastric bypass.

The report in Discover also pointed to the fact that surgery can affect a patient's body in more ways that just weight loss. A former teacher at the Albert Einstein College of Medicine, Julio Teixeira says that even a minimally invasive Roux-en-Y gastric bypass leads to "manipulating the metabolism" of patients. This can lead to wonderful changes in diabetic patients, who have struggled against insulin resistance and high glucose levels that add to weight gain. However, there may be hidden problems associated with rapid bodily changes.

Such was the case with Hilary Lane, who didn't know that she had a rare genetic disease until her gastric bypass. USA Today ran an article this March about the wasting disease that was triggered by the bypass in 2006, though it did point out that death from the surgery itself is at 1% or less - about the same as for hip replacement. Most patients only need to take vitamins and watch their diet after a surgery, after whittling down on extra medications.

It is also true, says Dr. Madan-Maanasi (Internal Medicine), that lap band surgery is not without its risks. There's the possibility of band slippage, in which patients may experience discomfort or heartburn, which certainly doesn't happen after a successful surgery. He notes that after 2,000 bariatric procedures including lap band, patients could certainly benefit from following up with their physician after the surgery, to pinpoint slippage issues before they become a chronic problem requiring surgical adjustment. Eating too fast, and forcing down foods that have become stuck, are two big culprits.

However, lap band surgery requires only an adjustable band to be fitted around the stomach - no permanent changes to inner organs. The digestive tract alone has 200 hormones, including those that process alcohol. Dr. Madan Uprety agrees with Discover that "If you chop out or bypass certain sections, then, particular hormones can be reduced or eliminated", but says this may not be the best long-term option for those wanting to lose weight. Four years after Hilary Lane was pronounced a success for gastric bypass, she exhibited signs of urea cycle failure, in which protein turned to ammonia that couldn't exit out of her system. Though not a usual disease, it is linked to 300 other mutations, one or more of which may be linked to bone density issues. This is another reason for physical follow-ups, though untreated obesity is much more likely to result in health issues than surgery.

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 1-800-472-4900, or review more on Dr. Madan on http://www.obesityhelp.com/profiles/bariatric-surgeon/dr-atul-madan/.

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Dr. Madan And His Colleagues Compare Worrying Trends of Smoking With Morbid Obesity, As The US News Health Warned About The Effects Of Obesity And Smoking On March 12th

Los Angeles, California (PRWEB) April 03, 2013

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/ .

Dr. Madan and His Colleagues Caution Patients on Weight Loss Research Such as JAMA Insurance Study

Los Angeles, California (PRWEB) April 08, 2013

A new study posted in the highly regarded Journal of American Medical Association (JAMA) on February 2013, Titled "Bariatric Surgery Not Associated With Reduced Overall Health Care Costs", seems to show no health cost savings after weight loss surgery. Study results seemed to indicate that weight loss surgery, such as Lap-Band Surgery, patients spent the same amount on health issues after surgery as before. However, as reported in Florida Today on Apr 3, 2013 (Titled: Brevard doctors dispute bariatric surgery study; Report targets price tag, patient quality of life), some doctors dispute the numbers, saying that the study did not include adequate long-term factors, and depended on outdated information. Bariatric surgeon Dr. Madan cautions patients to properly research methods of weight loss before scheduling an operation, such as gastric bypass or lap band surgery, to see if it is right for them.

Per the Florida Today article, Dr. Madan does agree with comments made by bariatric surgeon Dr. Nathan Allison. It tends to take anywhere from 18 to 24 months to see the best results from lap band surgery especially, because unlike gastric bypass, gastric banding merely restricts access to food. Gastric bypass can permanently change how the internal organs process food, which can speed up weight loss in the first few years, but there have been studies showing that years down the road of weight loss, changes made via gastric bypass may not continue to be so positive.

Cost savings can be real, especially in the area of diabetic and cardiovascular medication, but it may take some years before the savings add up to the cost of surgery. The real savings, says Dr. Madan in agreement with Dr. Allison, comes through in the quality of life. One classic example is a Pennsylvania resident, whose post-surgery loss of nearly 200 pounds and multiple medications was reported in the York Dispatch on March 25, 2013 (Weight loss surgery leaves Dover Twp. man satisfied with less). The patient, Ron Dale, also said that he noticed a great difference in social interaction after losing weight. He said that rumors of a 'social stigma' attached to weight were absolutely true, and that he was listened to and respected much more as a thinner person.

Though the JAMA study seemed to say that the only real value of bariatric surgery seemed to be the improved health and well-being of persons undergoing the procedure rather than on cost savings, but there do seem to be issues with the study. Although the researchers claim to have reviewed 30,000 patient expenses over a six-year period (2002 to 2008), Dr. Allison says that only 10% of the patient data included a two-year span of data. In other words, not all of the patients were tracked consistently over that six-year period.

Dr. Mark Fusco of Florida agreed, stating there was a very high fallout rate within the patient data. Further, the study only documented claims made by Blue Cross Blue Shield patients, who may not have claimed non-insurance obesity costs, such as weight loss programs and over-the-counter medications. However, study results did show a marked reduction in pharmacy and physician office costs, and a significantly lower cost for laparoscopic methods (lap band and bypass) than for traditional gastric bypass surgery. What may have further skewed the numbers was that the old, full-on surgical method of gastric bypass (a much more expensive procedure) was out of favor by 2005, halfway through study data that ended in 2008. Currently, laparoscopic methods are advised much more, as indicated in a cohort study posted in Medscape, due to lower complication rates, shorter length of stay, lower financial cost, and lower mortality.

Many studies are made about weight loss medication and procedures, says Dr. Madan, and that's why he cautions patients to really do 'apples-to-apples' research before engaging in a life-changing operation. Although lap band surgery is one of the least invasive, and least time-consuming, it's true that life after surgery must be much different than pre-surgery. A low-calorie, higher protein diet plus regular exercise works just as well pre-surgery as post-surgery, and is required by many physicians. These lifestyle changes ensure that people get the most out of the procedure, instead of becoming discouraged by weight regain and having to spend more money on additional procedures, such as slipped band issues or follow-up inpatient procedures.

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/.