Weight Loss, Cardiovascular Risk Factors, and Quality of Life After Gastric Bypass and Duodenal Switch

Background: Gastric bypass and duodenal switch are currently performed bariatric surgical procedures. Uncontrolled studies suggest that duodenal switch induces greater weight loss than gastric bypass.



Objective: To determine whether duodenal switch leads to greater weight loss and more favorable improvements in cardiovascular risk factors and quality of life than gastric bypass.



Design: Randomized, parallel-group trial. (ClinicalTrials.gov registration number: NCT00327912)



Setting: 2 academic medical centers (1 in Norway and 1 in Sweden).



Patients: 60 participants with a body mass index (BMI) between 50 and 60 kg/m2.



Intervention: Gastric bypass (n = 31) or duodenal switch (n = 29).



Measurements: The primary outcome was the change in BMI after 2 years. Secondary outcomes included anthropometric measures; concentrations of blood lipids, glucose, insulin, C-reactive protein, and vitamins; and health-related quality of life and adverse events.



Results: Fifty-eight of 60 participants (97%) completed the study. The mean reductions in BMI were 17.3 kg/m2 (95% CI, 15.7 to 19.0 kg/m2) after gastric bypass and 24.8 kg/m2 (CI, 23.0 to 26.5 kg/m2) after duodenal switch (mean between-group difference, 7.44 kg/m2 [CI, 5.24 to 9.64 kg/m2]; P < 0.001). Total cholesterol concentration decreased by 0.24 mmol/L (CI, ?0.03 to 0.50 mmol/L) (9.27 mg/dL [CI, ?1.16 to 19.3 mg/dL]) after gastric bypass and 1.07 mmol/L (CI, 0.79 to 1.35 mmol/L) (41.3 mg/dL [CI, 30.5 to 52.1 mg/dL]) after duodenal switch (mean between-group difference, 0.83 mmol/L [CI, 0.48 to 1.18 mmol/L]; 32.0 mg/dL [CI, 18.5 to 45.6 mg/dL]; P ≤ 0.001). Reductions in low-density lipoprotein cholesterol concentration, anthropometric measures, fat mass, and fat-free mass were also greater after duodenal switch (P ≤ 0.010 for each between-group comparison). Both groups had reductions in blood pressure and mean concentrations of glucose, insulin, and C-reactive protein, with no between-group differences. The duodenal switch group, but not the gastric bypass group, had reductions in concentrations of vitamin A and 25-hydroxyvitamin D. Most Short Form-36 Health Survey dimensional scores improved in both groups, with greater improvement in 1 of 8 domains (bodily pain) after gastric bypass. From surgery until 2 years, 10 participants (32%) had adverse events after gastric bypass and 18 (62%) after duodenal switch (P = 0.021). Adverse events related to malnutrition occurred only after duodenal switch.



Limitation: Clinical experience was greater with gastric bypass than with duodenal switch at the study centers.



Conclusion: Duodenal switch surgery was associated with greater weight loss, greater reductions of total and low-density lipoprotein cholesterol concentrations, and more adverse events. Improvements in other cardiovascular risk factors and quality of life were similar after both procedures.



Primary Funding Source: South-Eastern Norway Regional Health Authority.

The Only Way Is Essex: Gemma Collins loses almost four stone – want to see the sexy pictures?

Gemma Collins will be looking much more slim and svelte when she takes to our screens again later this month.




The buxom star of ITV2′s The Only Way Is Essex will be almost four stone lighter when she stars in the third series of the reality TV show, having undergone a strict health and fitness regime in recent months.







After swapping takeaways for salads, Gemma has stripped off for new! magazine and showed off her new size 14 body. Collins was a size 20 at her largest.



Gemma told the magazine: “I can’t wait to get down to Ann Summers! I’ve never felt sexier. As much as I said I was confident before, I really feel sexy now, not fake sexy. It was false confidence before.”



The blonde bombshell admitted that she had piled on the weight after being dumped by her boyfriend and starting to worry that she was never going to settle down, find love and start a family.



Collins explained that she was devastated when left single at the age of thirty, saying:





“I hit 30 and started to panic. I hadn’t found the love of my life – I just ballooned. I’d think, ‘No one loves me,’ and scoff another cake!



“It was scary. I thought, ‘Why the hell am I doing this to myself? I’m going to get fat and die.’



On what’s ahead for the future, Gemma mused:



“I want to meet someone new – I don’t want to date older men any more. I want a young, hot stallion.”

Primum Non Nocere

To do no harm has been a guiding tenet of medicine for millennia. In this context, bariatric surgery warrants serious consideration. Bariatric operations undoubtedly induce weight loss, but at what cost? Consideration of the balance between benefits and harms calls into question the overall utility of bariatric surgery and, most important, what the appropriate end points should be.




Weight loss is a good start. Bariatric procedures were devised to induce weight loss in patients who could not lose weight by modifying diet and exercise alone. The first operation was the ill-fated jejunoileal bypass, a procedure that caused substantial nutrient malabsorption resulting in weight loss. Because jejunoileal bypass was the first successful treatment for morbid obesity, clinicians embraced it until its substantial complication profile became evident (1): Years after surgery, bacterial overgrowth in the bypassed intestinal limb led to accumulated damage to the liver and cirrhosis. Roux-en-Y gastric bypass and biliopancreatic diversion procedures were devised to surgically induce weight loss and avoid the long-term complications associated with jejunoileal bypass.



We should have learned some important lessons from the jejunoileal bypass experience. First, operations should not be widely adopted until they have been studied in a controlled manner. In addition, procedures that induce intestinal malabsorption are unnatural and inherently dangerous. Extensive reviews of bariatric surgery have provided irrefutable evidence showing that bariatric surgery induces weight loss but also causes harm (2–4). Data on the effectiveness of these procedures

Weight Loss for Good

Weight loss for good is the goal of anyone unhappy with their current size and shape that's want's the resources to help them lose weight.




The information advice and tips on this site is aimed at anyone who wants weight loss resources that will really help keep it off... for good!



Exercise and a balanced diet are the key factors in fat loss and weight reduction. If you are eating more calories than you are burning off throughout the day the result will be that the calories will be stored as fat. The information on this weight loss site is aimed at helping you make a decision on how best to reduce body fat and get into shape.



Keep motivated and focus on your goals - everyone can lose weight and keep it off for good!

More reduce more fatty

I was thinner before and borned a kid be getting fatter.Control food, exercise weight reduction, puncture to reduce weight.If do yoga, the sit-up thin belly, run machine, ride bicycle to toughen thin leg, the Fu lies to support thin arms.The practice shouts the turn can lose a waist.Reduce weight expensive in the persistence.

The swimming reduces weight of ineffective, why?

From consume human body calories speak, it is undoubtedly very nice to exercise to swim.Because water is 26 times that of air to the conduction speed of the calories, be say, under the same temperature, the person is a land in the thermal energy depletion of Shui-li of 20 much and doubly, but why someone's swimming reduce weight ineffective?

Speak of sport with reduce weight a problem, want to understand to exercise first and the mechanism of energy depletion.Exercise process in, the energy depletion divides three stage completion, is sugar metabolism, fat metabolism and protein metabolism respectively, reduce weight to attain effect through a fat depletion.

The swimming is placed in to have no oxygen sport stage while starting.The energy consumes main depend sugar of have no oxygen Xiao solution, sport of this stage is very vigorous, the person breathes short, provide oxygen shortage, the root can't use fat.Again continue to exercise next go to, the human body starts getting into an Aerobic period.At subsequent of an hour in, in wait the sport appearance of strength under, the energy supply is provided energy by having of sugar oxygen metabolism.This hour can't also consumes fat, either in time.If the words that still insist that sport descend, just beginning from having an oxygen metabolism to consume fat of fat.Therefore, the swimming would not° until after continuously exercising for an hour at least start producing to reduce weight effect, some people exercise time isn't enough or exercise the quantity isn't enough, can not yield results.

The swimming reduces weight of still need to notice to be on a diet in the meantime.However, the person all has a phenomenon of"super quantity instauration" after exercising.In brief speaking is a human body to exercise for the orientation next stage the horizontal exaltation , after every time exercises, all want to absorb ratio before more energies, this was a kind of ego protection measured of the human body.So, the swimming often edibles behind people sleep fragrantly so much, consume calories again repair coming back, is even ander the rise than consuming of.Therefore, the inattention is on a diet and particularly exercise a period of time is behind again stop, most easily make the weight exceeded level originally.This important reason that would is many people sport to reduce weight failure.

Therefore, the person of physical endowment emaciation insists through a short date the unremitting swimming toughen, can often soon become burliness.And after fat person swim usually also more easily Be getting more hungry than the past, the energy absorbing is getting more more.The swimming seems to suited for more to want to lend this to make oneself become stronger person, but not too suit to make use of the person whom it reduces weight, particularly is those toughen indiscipline of reduce weight.

In fact, as long as the contrast once swims the athlete will discover, who once see which swim is the athlete a very thin?No matter men and women, the general figure is more plentiful full, the skin smooth circle is smooth, this is the skin fat more performance.Water of the water temperature of the overall massage function and ratio human body Wen Di, easily urge a stranger body skin bottom fat of growth.

I reduce 50 catties for 4 months

Naturally fat, for the sake of love I went ahead regardless

I am fat since the childhood and arrived greatly, the mother said my full moon had 13 catties and seemed to be naturally is a fatty.So have been having no how to want to reduce weight, until go to university, met an oneself adoring boy, vindicates to the boy, but the boy says that the request to the girl friend at least wants less than 60 kilograms.Hence, I started Zan foot vigorously reducing weight.

Reduce weight in January, it is topic to be on a diet

Cold winter February, I started my reducing weight process.I used this month the fastest, is also the most difficult method for bearing with-Be on a diet to reduce weight.

Most the time of beginning, the every morning isn't that an egg white or a small nest head's adding a cup bean milk then a day almost does eat anything, Be getting more hungry to wildly infuse mineral spring.The nothing doing time that at most adds a bag of sour milk still a Chan drinks.Because Be on a diet having a little of stanza suddenly, the stomach is good at to make, hungry of time, especially the time in the evening yell not to stop, time go to bed can feel.

I still keep pretty cherishing a life, afraid famished, so a week, half after, feel the physical strength really didn't go to occasionally eat some thing at noon and ate spicy very hot rinse vegetables.Eat for several days after repeat again previous.This is the first month, hungry dropped 10 catties, but not just very obvious.

I of so can insist down, also thank very much nearby of the sisters.I advance and then tell them to eat to make me see, fearing will control not to live oneself.Thering wered evening lights in a sky to all extinguish my bedroom four elder sisters aring hungry to steal to steep bag powder silk having no dare the Zhi voice make me listen to, but that thing has flavor, I smelt flavor and sat a while.My four elder sisters sees I get up a thief to resolutely carry a box to rush out to go to, the Leng squats down hallway to finish eating to just come back.

Reduce weight in February, skip rope to sign big achievement

Time to the second month I discovered a plateauing stage and only was on a diet not make, got to the Internet and search and discover to skip rope to reduce weight to consume calories biggest, Be on a diet of also start skipping rope in the meantime.The bedroom was just- bought to shout at that time turn, also make use of last, jumped a hour rope for a day, swayed half again for hour of shout turn.

This month of effective, reduced more than ten catties, have already reduced 135 catties at the end of month, see have been pretty much obvious on the body figure.Because I skip rope in the bedroom hallway every day, a lot of persons see I lose to all start jumping, I still blew one to skip rope breeze to shout!

For prevent°froming rapid lose down a skin to become flabby, I also insist bathing with the milk and make own skin drawn tight so much, can't because of reducing weight to become loose loose Kua.

Reduce weight in Marchary, harvest love

BE skipping rope, shake to shout the foundation of turn up, for the sake of health, I slowly started recovering lunch.But is not complete either to recover, just eat vegetables, rice is basic don't eat.Didn't touch rice for a few months, I loved to eat again, absolutely was a molestation.

But, the effort doesn't take an observant and conscientious person and reduced 8, 9 catties this month, more happy matter, the boyfriend accepted me.Although this is that I haven't arrived less than 60 kilograms.

Reduce weight in April, carry it through is a victory

The time in the fourth month how basically didn't be on a diet, say is don't be on a diet in fact is develop a habit and is an oil greatly don't eat, the junk food doesn't eat, clean Jian is eating of some Jingses every day, for example benefit in reduce weight of bean curd, celery, sea tangle what of, really cannot help but eating meat and then definitely don't eat rice noodles these staple food.Beverage snack that more and all broke.

Skip rope and shout the turn is certainly the required course in everyday.All a little bit easily consume calories in summer, the fourth month I have already reduced 118 catties.Insisted mid- June, I already 111 catty.

Be satisfied with to oneself now, keeping the shape is root

BE not likely to be during a lifetime depend on skipping rope to reduce weight, hence, I slowly reduce, until is washed up July.I am very strict to own food request, so, have never sprunged to make me very happy.

Oneself in nowadays, the weight goes back and forth in the 56-58 kg, healthy, I am very satisfied to I.But, the good food habit always can not forget.Although stopped to skip rope, sometimes also shake to shout turn, also start learning to do yoga, let oneself keep the appearance in nowadays.

It's airtight to reduce weight organization

An industry insider reveals, make use of many weight reduction females are eager to beg of mental state, the commitment of some types that reduce weight organization always first with"the time of × × reduces weight the × × Li rice", "the time of × × takes effect" pulls a customer and get fed up with a son paste with some cats that the fresh behavior knows again lane person.Know some"secret"s can availably defend "suddenly and leisurely" in the weight reduction process among them.

a

Measure first"fat"5 Li riceses of bodies

First is while signing agreement, all generally will make the body, register reduced weight ex- body condition first, some beauty salons usually make the customer adopt this time even lie of posture, select by examinations an angle that customer's view cannot compares with, in order to"let out" size 5 Li rices or so report to customer.

 two

The part massages to lose efficacy on stopping

Secondly, the short date reduces weight of a kind of method is a part massage, after general week can immediately take effect.This because, the humidity of part inside the body is continuously ejecting with the output calories under the massage, will appear the effect that the weight eases;The partial fat tightens under the massage, will appear to round one degree effect for cutting;Keep on massage to also make the partial fat visited to leave, attain the effect for reducing weight, but if massage not and continuously carry on, the fat soon will re- come together.

three

Ordering what cave hairdressing depend is to endure hunger

Another beauty salon manager who is engaged in hairdressing profession for 17 years tells a reporter, the beauty salon returns a knot bottom or for earning money, if the weight reduction can really have so proud effect, need not flower so much money advertised.With order cave hairdressing for example, the hairdresser will tell the customer goes home edible cucumber, tomato, can not drink water etc. and use a way like this, anyone need not go to beauty salon, hungry also hungry Be getting thinner.This manager thinks that the best way of weight reduction is a reasonable food and sport of the adequacy, the taking out of now's fat etc. method make the person is quickly emaciated, but to body of the bane is biggest.