By Janis Jibrin, M.S., RD, Best Life lead nutritionist
Here’s a secret from a nutrition insider: Even experts find weight loss fraught and confusing. A recent paper by The Obesity Society, a scientific organization devoted to researching causes and treatments for obesity, says as much. In an attempt to provide clarity, the organization published core guidelines. Not earth-shattering by any stretch, they provide an un-faddist view of the basics of weight control.
BMI is just a screening tool, not a diagnosis of 25 to 29.9 is considered “overweight” and 30-plus is “obese.” If you’re at 25-plus, you don’t necessarily need to lose weight. But if you also have a waist circumference greater than 35 inches for women or greater than 40 inches for men, you likely do need to shed pounds.
Focus on percent of weight loss, not ideal BMI. Not everyone needs to drop below a BMI of 25 to be healthy, and some just cannot. Instead, if you have too much body fat, focus on losing at least three to five percent of your starting weight—it can significantly improve blood pressure and other aspects of your health. Losing more, like 10 percent, can be even more helpful. (more…)
Many people view weight loss surgery as the last-chance solution to obesity. Those who have a BMI of 40 or higher were the only ones eligible for bariatric surgery. That has changed with the release of new guidelines. Now, those with a BMI between 30 and 34.9, those who are considered mildly or moderately obese, with diabetes or metabolic syndrome can be considered candidates as well.
Dr. Joseph Colella, a leading bariatric surgeon, feels the new guidelines have many advantages. “More people who have lost the battle with their weight and are suffering from some of the significant medical consequences of obesity can now get real and effective helpbefore it’s too late.” The new guidelines are a significant change to those established in 2024 set by the American Society for Metabolic and Bariatric Surgery, the American Association of Clinical Endocrinologists, and the Obesity Society. (more…)
As the amount of weight loss surgeries in the U.S. continue to rise, doctors are finding different and better ways to surgically treat obesity. One of the newest players in the game is called an intragastric balloon, and as it’s not approved for use in the United States, many patients have chosen to cross the border to Canada to do the procedure.
The intragastric balloon is less invasive than traditional bariatric surgery. It involves inserting a tube down the esophagus into the stomach, so there’s no surgical incision. A deflated balloon is then threaded down the tube, and once placed, blown up to the size of an orange and filled with sterile blue water. It can stay there for up to six months, at which point it is removed to prevent ruptures. This can be done multiple times if the patient continues to need the support the balloon provides. The balloon decreases the patient’s feelings of hunger, making them eat less and lose weight.
Although the average weight of Americans continues to bound upward, there are still very few bariatric surgeries performed annually. Less than one percent of individuals who meet the criteria for bariatric surgery actually have surgery, according to the American Society for Metabolic & Bariatric Surgery. Each year, about 250,000 Americans choose to have some form of weight loss surgery, the most popular being gastric bypass, a gastric band, sleeve gastrectomy, or duodenal switch. These involve removing a portion of the stomach, restricting how much food can go into the stomach, rerouting the intestinal system, or a combination of these methods. The gastric sleeve is cheapest, costing around $10,000, while the others range from $17,000 to $35,000, according to the Consumer Guide to Bariatric Surgery. (more…)
Ten years ago, Today Show weather anchor Al Roker decided he needed a drastic change in his lifestyle when he tipped the scale at 340 pounds. He decided to have a gastric bypass surgery in 2002 and lost 100 pounds in eight months, eventually reaching 190 pounds lost. Then, five years ago, he received the devastating news that his mother had cancer, and his weight crept back up as he dealt with her terminal illness. After regaining and losing another 40 pounds through a 28-day cleanse and strict diet and exercise regimen, Roker writes about it all in his memoir “Never Goin’ Back,” released Dec. 31, 2024.
He talked about shedding the “fat guy image” and his new book this morning on Today.
Roker relates in his book that he chose to have bariatric surgery after losing his father to lung cancer in 2001. He had yo-yo dieted for years with no lasting results. He describes his aha! moment in an interview with PARADE magazine:
“[My father] was at Memorial Sloan-Kettering, and I would go in every day. We’d talk and joke, and then one day he got serious and said, ‘Look, we both know I’m not going to be here to help you with my grandkids, so you gotta promise you’re going to lose weight.” Seven days later he was gone. A few weeks afterward, [Deborah and I] found out we were pregnant with our son Nicky. I said, “Okay, I’m going to have to do something.”
Roker found success with a gastric bypass, but admits it is not for everyone, calling it just another tool for losing weight that was a very difficult choice for him. When his mother got sick, his healthy living routine went to the wayside as he balanced spending as much time as he could with her with the normal pressures of his work and family life. He thought he could handle a few slip-ups with his diet, eventually reverting back to old habits and secret binge eating, and used food as a form of self-medication. (more…)
The Doctors introduced a new bariatric surgery method last week. It’s called the Primary Obesity Surgery Endoluminal, or P.O.S.E.
POSE is performed without an incision, making recovery time significantly less. It is designed for patients wanting to lose between 25 to 60 pounds. The procedure, which takes about an hour, is done by inserting a tube through the mouth down to the stomach. Tiny tools then work to permanently fold sections of the stomach until its size is diminished sufficiently; in essence, shrinking the stomach. The device used in the surgery is cleared by the FDA for other tissue approximation procedures, but not yet for weight loss surgery.
The Doctors highlight the story of Gloria who chose the procedure after years of weight gain and useless dieting. She has lost 26 pounds so far, and expects to lose more. As with any weight loss procedure, changing her diet and fitness levels were also necessary. (more…)
An obese Ohio inmate is sentenced to die in January for crimes that took place decades ago. However, his lawyers have filed a complaint with the courts stating that this execution could result in a “tortuous and lingering death” because of his weight.
The Associated Press reported about convicted killer Ronald Post who is 480 pounds. He was convicted of shooting a killing a hotel clerk nearly 30 years ago and his execution date is set for January 16.
Post is claiming that his extreme weight, his limited vein access, scar tissue, and his other medical issues will lead to major issues during the execution process. It’s also questionable if the execution gurney will even hold Post during the procedure. The entire procedure is argued to be long and painful for Post.
Post has requested weight loss surgery while in prison after he’s failed to lose any weight during his years in jail. However, his request was denied. He’s had struggles exercising due to knee and back problems. Post has even broken exercise equipment from his large size as he’s tried to workout. Furthermore, It’s reported that Post’s depression affects his ability to limit his food intake. (more…)
Weight loss isn’t as simple an issue as some may think. While it’s easy to believe a person can simply cut back calories and be more active to drop the pounds, oftentimes this equation fails because there’s a story behind the weight that’s never really been dealt with.
Dr. Carolyn Ross, MD, knows all about this. As a consultant on eating disorders for The Ranch and integrative medicine for treatment facilities across the country, and the owner of her own weight loss treatment and counseling program in Colorado, she has seen how this equation fails first hand.
“In 30 years, I have yet to find a patient that is simple that I can just give a diet sheet and they lose weight,” she said. ‘In the Anchor Program, we provide a simple program for eating and exercising, and remove mental blocks to weight loss such as abuse the patient may have suffered earlier in life. We also address the emotional issues that are the root cause of their weight gain.’ (more…)
Many people who undergo bariatric procedures for weight loss like gastric bypass surgery, LAP band surgery, or gastric sleeve surgery enjoy drastic weight loss along with the elimination of many weight related diseases. Having a form of bariatric surgery happens to be one of the top ways to cure type 2 diabetes.
As many as 95 percent of patients with type 2 diabetes were cured of the disease through weight loss achieved as a result of their surgery. A new study done by the Mayo Clinic Arizona has recently shown that more than one-fifth of those who were cured have had their diabetes return within five years, even if the patient hadn’t gained any weight. Those who were most susceptible to this were those who had diabetes the longest prior to surgery.
In this study, 72 obese patients were monitored during the years 2000 to 2024 with all patients having had a Roux-en-Y gastric bypass surgery. Of those studied, a total of 66 patients had a diabetes reversal at some time, and then 14 of those patients had their diabetes return between three and five years after their surgery. Those who had diabetes for more than five years had almost four times the risk of it coming back than those who had it less than five years before surgery. (more…)
The first-ever endoluminal incision-free bariatric surgery was performed on January 22, 2024, at the 3rd Annual Apollo Bariatric Surgery Conference (ABSCON 2024) in Chennai, India. This operation was actually the first ever known endoluminal revision of a prior sleeve gastrectomy performed in the world.
The operation, which was shown via video link to 80 surgeons attending the ABSCON 2024 conference at the Hyatt Regency Hotel in Chennai, was performed by New York bariatric surgeon, Dr. Elliot Goodman and assisted by Dr. Rajkumar Palaniappan of the bariatric surgery service of Apollo Hospital in Chennai.
The 27 year old, male patient had previously undergone a sleeve gastrectomy in 2024 and has since lost 33 pounds. However, his weight stabilized and he had actually regained 4 pounds within the past month.
More obese Americans may be given the opportunity to have their weight loss surgery covered by insurance if device manufacturers have their way. Allergan Inc., makers of the LapBand gastric banding device, has been the most vocal in their efforts to give obese patients access to this life-altering surgery. Being able to have this surgery covered by insurance will give patients the tools they need to fight a host of life-threatening illnesses brought on by their obesity. Allergan proposes that allowing more people access to insurance coverage will save billions of dollars in healthcare costs for both the government and employers.
The Dilemma
Critics argue that bariatric surgery has high rates of complications which can reach into the thousands and that the surgery doesn’t change the underlying behavior.
Many who have struggled with their weight for a lifetime look to weight loss surgery methods like gastric bypass or the lap-band procedure to solve their weight problems. While these types of surgeries are successful for some people, many others still struggle after their operation.
For those with underlying psychological food issues, weight loss surgery can trigger other eating disorders. According to a 2024 Harvard study, 60 percent of all individuals seeking surgical treatment for obesity suffer from an eating disorder, usually binge eating. Those that have a previously unhealthy relationship with food and their body are at a higher risk of succumbing to other eating disorders after their operation.
Lap band and gastric bypass surgeries don’t typically create an eating disorder if there wasn’t previously one there. The major problem is that some who have these unhealthy food relationships have either left them untreated, or been unsuccessful in treatment prior to surgery. For binge eaters, the body cannot physically handle binge eating after surgery.
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