Weight Loss Surgery News

Want to know the latest developments in weight loss surgery? Read on.

Can Weight Loss Surgery Relieve Low Back Pain?
Preliminary Study Says Yes

CHICAGO, April 2008 — Research has shown that weight loss surgery can improve type 2 diabetes, heart disease, sleep apnea and other known complications of obesity. Now a new study shows that weight loss surgery can also take the bite out of pre-existing back pain. The findings were presented at the 76th annual meeting of the American Association of Neurological Surgeons in Chicago.

More than one-third of U.S adults were obese in 2005-2006, and as many as 85 percent of all Americans will experience an episode of back pain at some point in their lives. Despite these converging epidemics, little is known about how obesity affects low back pain, also known as lumbar spine degeneration.

In the new study of 38 people with low back pain who underwent gastric bypass surgery, participants not only lost weight, they also showed a 44 percent reduction in the intensity of their back pain in the year following their surgery. What's more, study participants also showed improvements on standardized measures assessing their quality of life and disability following the weight loss surgery.

Specifically, the average weight decreased from 317 pounds to 232 pounds in the year after surgery, and body mass index (BMI) decreased from about 52 to 38, the study showed. A BMI takes height and weight into account to measure body fatness. A BMI of 30 or above in adults is considered obese. [Read more about body mass index, and use our BMI calculator.]

"This study provides evidence that substantial weight reduction following bariatric surgery results in moderate reductions in preexisting back pain within six months of weight loss," the study authors conclude. "While this initial research is promising, larger long-term trials are needed to prove the efficacy of this treatment."

Source: Khoueir P, Black MH, Crookes PF, et al. Prospective Assessment of Axial Back Pain Symptoms Before and After Bariatric Weight Reduction Surgery. Presented at: 76th annual meeting of the American Association of Neurological Surgeons in Chicago, April 26 -May 1, 2008

Is Obesity in Your Genes?

DANVILLE, Pa., March 2008 — Genetic research may shed light on why some people gain weight back after weight loss surgery.

A combo of two obesity-related genes may be linked with an increased body mass index (BMI) among severely obese patients who are undergoing weight loss surgery, according to a new study reported in the March issue of Archives of Surgery. People with the gene combo may be more likely to pack on pounds after weight loss surgery than their counterparts who do not have this combination of genes.

Weight loss surgery is a highly effective treatment for patients with severe obesity, or a BMI of 40. A body mass index takes height and weight into account to measure body fatness. A BMI is a person's weight in kilograms divided by their height in meters squared. [Click here for more on body mass index, including how it's calculated using pounds and feet, as well as a handy BMI calculator you can use.]

"Recent data on the long-term effectiveness of bariatric surgery on BMI suggest that, for most patients, BMI will be maintained substantially below preoperative levels, though some patients regain weight and relapse toward morbid obesity," the authors conclude. This subgroup may carry genetic susceptibilities to obesity that overcome the effects of bypass surgery. "The identification of such susceptibility genes may therefore be important in identifying patients at high risk for postoperative weight gain," they add.

To that end, researchers at the Geisinger Clinic, Danville, Pa., assessed 707 morbidly obese adult patients with an average age of 45.9 and an average BMI of 51.2 who were undergoing gastric bypass operations at their facility. They scanned the genetic material, looking for two common single nucleotide polymorphisms (SNPs) previously found to be associated with obesity. The two obesity genes are called rs9939609 (FTO) and rs7566605 (INSIG2). In a nutshell, SNPs are variations that occur when a single building block of DNA is altered.

They showed that about 21 percent of the patients had two copies of one obesity-related SNP variant, 13 percent had two copies of the other SNP and 3.4 percent had two copies of both.

The average BMI among those with two identical copies of either obesity-related SNP were not significantly different from those who did not have two copies. But those with two copies of both SNPs, or two copies of one and one copy of the other, had significantly higher BMIs than the other groups. These individuals comprised less than 20 percent of the total group.

More research is needed to validate these findings and determine exactly how these genes influence obesity and/or the results of weight loss surgery. Stay tuned.

Source: Chu X, Erdman R, Susek M, et al. Association of morbid obesity with FTO and INSIG2 Allelic Variants. Arch Surg. 2008;143:235-240

Gastric Bypass Case Comparison Shows No Significant Difference in Complications Between Younger Patients and "Carefully Selected" Older Patients

CLEVELAND, June 2007 — Is gastric bypass surgery safe for older patients? A case review of 892 gastric bypass surgery patients found no statistically significant difference in post-surgery complications or death rates.

The patients, who had gastric bypass surgery sometime from 1998 to 2006, were divided into four groups with the aim of comparing outcomes for older people with those for younger people, as well as Medicare recipients with non-Medicare recipients. For example, 46 patients age 60-66 were in Group One, which was compared with 846 patients age 18 to 59 in Group Two. And 31 Medicare recipients age 31-66 were in Group Three, which was compared with the 861 non-Medicare recipients age 18-64 in Group Four.

The study documented age, gender, body mass index (BMI), time spent in the operating room, length of stay, other illnesses, complications and death.

"No mortality was seen in the older group (Group One) at 30 days, 90 days, or one year," reported the study authors. "Three deaths occurred within 30 days in the younger group (Group Two), with one additional death within one year." While Medicare patients had a greater average BMI, spent an average of 14 minutes longer in the operating room, and stayed an average of a day and half longer in the hospital, there was no significant difference from non-Medicare patients in complications or death.

The study authors concluded that age and Medicare status should not be the sole basis for denial of gastric bypass surgery. Peter T. Hallowell, MD, and other researchers at University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, conducted the study.

More details are available in the study report published in the June 2007 issue of the journal Archives of Surgery, which is produced by the Journal of the American Medical Association.

FDA Panel Rejects Weight Loss Drug Rimonabant

WASHINGTON, D.C., June 2007 — An FDA advisory panel recommended in a unanimous vote that the agency not approve Zimulti (rimonabant) for sale in the United States.

The panel had concerns about potential side effects of the drug, made by French company Sanofi-Aventis, such as depression, sleep difficulties, and anxiety. Rimonabant was designed to block food craving signals in the brain, targeting the same brain receptors that trigger intense hunger after marijuana use. The manufacturer's studies showed patients lost 5% more weight than diet alone during a 12-month period and enjoyed a reduced waist size as well as higher levels of "good" cholesterol. But the FDA panel said obese patients were two times more likely to have suicidal thoughts (which Sanofi-Aventis disputes) or mental problems such as depression. The panel is also concerned about high drop-out rates in the clinical trials.

Sanofi-Aventis has proposed that patients be screened for depression and reassessed five times during the first year of using the drug. A final decision from the FDA may come in July.

In February 2006 the FDA rejected rimonabant for use as a smoking cessation drug, though at the time it did issue an "approvable" letter for its use in weight loss, on condition that more conclusive research be submitted.

[Page updated April 2008]