Getting the most from gastric bypass

As gastric bypass surgery becomes more mainstream, with more than 200,000 people each year choosing the procedure each year – from celebrities like Al Roker and Carnie Wilson to the average Joe – research has begun to shine a light on whether it really works for long-term weight loss.

Dr. Gary D. Miller, an associate professor at Wake Forest, praises the efficiency of weight loss via gastric bypass –- but he’s made it his mission to find a way to get the weight loss to stick.

“You wouldn’t invest $25,000 to remodel your home and not maintain it. Shocking as it may seem, follow-up on diet and exercise just isn’t the norm with gastric bypass,” says Miller, who heads a team studying the surgery. “With so many more people seeking gastric bypass each year, we can improve the long-term outcome of gastric bypass by keeping up with patients as they figure out their new lifestyle.”

He says many patients are left to figure out how to maintain weight loss after surgery on their own, and it just isn’t working. In fact, studies show that more than half of patients regain at least 20 percent of the weight lost.  To help gastric bypass patients realize the full health benefits of the procedure, researchers at Wake Forest have launched a new study to prove that the follow-up care patients receive is just as critical as the weight loss surgery itself.

“We expect our six-month, randomized trial to show that surgery plus supervised exercise and diet might be the best, most efficient option for weight loss in obese and morbidly obese people,” Miller says.

Additionally, Miller’s team, which includes surgeons from Wake Forest Baptist Medical Center, has found the surgery yields health benefits beyond weight loss.

The team’s latest research shows that gastric bypass significantly reduces the inflammation associated with diseases including cancer and diabetes. The study appears online in advance of print publication in the peer-reviewed journal Surgery for Obesity and Related Diseases.

“We’re amassing evidence that weight loss is a very important part of changing the way the body’s systems work in people with high-risk diseases like diabetes and heart disease,” says Miller. “It can be encouraging for people who have these diseases and need to lose weight. We’re proving that the benefits of dropping the weight are excellent.”

Previous research at Wake Forest also found that:

  • Surgery followed by diet and exercise targeted fat loss inside the abdominal cavity. Increased levels of this abdominal fat, also called visceral fat, is known to boost the risk of developing diseases including cancer. This is the first study to compare levels of visceral vs. subcutaneous fat after gastric bypass.
  • Younger people undergoing gastric bypass increased their mobility and improved performance of daily activities within about three weeks, compared with about seven months in older patients. This study seems to dispel the myth that rapid weight loss leads to loss of muscle mass and physical function.

“I’m hoping this research will help us show people that weight loss is not just about dropping the pounds or about looking different,” Miller said. “It’s about changing your body’s disease-fighting power, too.”

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