Is Bariatric Surgery the Best Option for Diabetic Teenagers?

When comparing the progression of type 2 diabetes in teenagers with obesity treated with either medication or bariatric surgery, researchers found that surgery improved the control of diabetes better than medication alone, in a study published in JAMA Pediatrics. The study compared 30 teenagers who had bariatric surgery, and 63 teenagers who were treated non-surgically. Overall, the glycated hemoglobin decreased in the group of teenagers that had surgery and the glycated hemoglobin of patients who didn’t have surgery actually increased, demonstrating a deteriorating control of their type 2 diabetes. Additionally, the patients who had bariatric surgery showed more improvement in other complications that can occur with type 2 diabetes, such as high blood pressure. The researchers say it is becoming apparent that teenagers with type 2 diabetes show a faster progression of disease than adults and as a result bariatric surgery should be performed sooner rather than later to slow down the progression of the disease and the associated complications.

Pediatricians are fond of arguing that children are NOT just smaller sized adults, and that they require special treatment.  This study demonstrates exactly that.  Diabetic adolescents actually have a more significant type of diabetes and faster progression of the disease.  That means faster progression to blindness, heart attacks, strokes, kidney failure and peripheral vascular disease and amputations.  Many parents are reluctant to allow their children to consider bariatric surgery, preferring instead to believe that their child will simply “grow out of it’, or that they are simply “big for their age”.  Diabetes is a chronic, deadly disease which should be taken VERY seriously.  Interestingly, morbid obesity is also a chronic, deadly disease which should be taken VERY seriously.

Bariatric surgery, in most cases,  can act as a “cure” for both.

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The NJBI Team

Obesity Is a Disease, Not a Choice, Experts Advise

Effective weight management requires a paradigm shift in the way healthcare professionals treat obesity, according to Lee Kaplan, MD, PhD, director of the Obesity, Metabolism and Nutrition Institute at Massachusetts General Hospital in Boston. In his presentation at the Pediatric Academic Societies 2018 meeting, Dr. Kaplan told delegates, “obesity is a disease,” and must be treated with pathophysiologic processes, just like type 2 diabetes and other chronic diseases. Like diabetes, obesity is never “cured,” patients can “still have the disease of obesity, even though they no longer meet the definition of obesity by our measurements,” Dr. Kaplan explained. Physicians who treat obesity often take a history to identify triggers for eating, exercise patterns, stress levels, sleep patterns and related circadian rhythm imbalances, and any drugs that can promote obesity. “We take that history in detail and then we say to the patient, ‘eat less and exercise more’,” with little understanding of the biologic basis of obesity or its heterogeneity. The body defends a fat mass just like it defends a mass of red blood cells, Dr. Kaplan explained. Since obesity is a pathophysiologic state, the treatments used to modify this state need to be physiologic in nature to drive down the elevated fat-mass set point that propels people to overeat, Dr. Kaplan explained. Currently, treatments for obesity include a healthy diet, exercise, stress reduction, improved sleep health and the re-establishment of normal circadian rhythms, antiobesity medications that promote weight loss, and bariatric surgery. However, there is an enormous variability each antiobesity intervention, according to Dr. Kaplan, who, along with his team, is exploring the potential of a genetic risk score to help determine the likelihood of an individual’s response to a particular therapy.

There is so little which is actually understood about the human body and how it performs its daily functions.  There is even less understood about obesity, or why operations for obesity work as they do.  Frankly, no one currently KNOWS the answers.  No one!

The good news is that we do KNOW that currently the best and most effective treatment for the DISEASE of obesity is Bariatric surgery.  Its no different than heart disease or Cancer.  Its deadly, and should be treated in effected individuals, PERIOD!

Call us, We can Help!  It’s what we do.

Dr Bertha and the Team at NJBI

Study shows, healthy diets linked to larger brain volumes

Research from the Journal Neurology indicates that “people who eat healthy diets may have larger brain volumes.” For the study, investigators “asked more than 4,000 older people in the Netherlands (average age: 66) about what they ate and analyzed brain scans over 10 years.” The study revealed that individuals who “ate healthier diets resembling the Mediterranean diet – rich in fruits, vegetables and healthy fats from sources like fish, and low in red meat – showed larger total brain volume.” In addition, they “had more grey and white matter” and a larger hippocampus.
Who wouldn’t like a larger brain?

Better load up on the fruits and vegetables and put away the Oreos and Doritos . . .

Best in Health,
The Team at NJBI

Chemicals used in fast-food wrappers may be linked to weight gain, study suggests

TIME (2/13) reports on a study which suggests that exposure to chemicals frequently used in fast-food wrappers “could make it harder to keep weight off after dieting.”

HealthDay (2/13, Mozes) reports, “Widely used manmade chemicals called perfluoroalkyl substances (PFAS) may undermine dieters’ attempts to maintain weight loss by slowing down the body’s metabolism, the new study” indicates. The findings were published online in PLOS Medicine.

MedPage Today (2/13, Monaco) reports that “people in the highest tertile for PFAS concentration had on average approximately 3.75 to 4.85 pounds more weight regain during the 6-24 months after initial weight loss versus those in the lowest tertile of exposure.” Notably, “this association with weight regain – seen across five types of PFAS – was most” pronounced “among women,” the study found.


This sounds like a joke right?  It’s not the package that causes weight gain, it’s the food content, right?  Well, that’s actually true.

On first look this study seems to suggest that the packaging is a risk regarding obesity- particularly in women.  What it REALLY says though is: in people who had already been successful in their weight loss through dieting, the women who used fast food items and were exposed to the packaging tended to gain weight more easily than others.  They also noticed that they tested positive for holding onto the chemicals found in the packaging.  However, the presence of those chemicals was not the CAUSE of obesity.  They were ASSOCIATED with the weight gainers.  Association is NOT causation.

We all know that fast food is not the best choice, perhaps this just gives you another reason to make better choices.


Best in Health,

Dr Bertha and the NJBI Team


Americans are More Obese than Ever — And Exercise Isn’t Helping

More Americans than ever have obesity, according to a new study from the CDC’s National Center for Health Statistics (NCHS). Based on the statistics, gathered from January through September 2017, 31.4 percent of U.S. adults aged 20 and over have obesity – up from 19.4 percent in 1997. In the same time period, the number of Americans over 18 who met the 2008 federal physical activity guidelines for aerobic activity reached 53.8 percent, up from less than 45 percent in 1997. The article notes “although common sense would indicate that the more you exercise, the more weight you’ll lose, a number of studies have shown that that’s not necessarily the case.” It points to previous studies that found diet has a bigger impact on weight than exercise.

If you consider the number of Gyms around compared to 10 years ago or 20 years ago, and the number of people who run around daily wearing exercise gear, you would think that the problem must be decreasing rather than increasing.  Wrong.

Exercise is beneficial.  Do not misinterpret this article as stating that exercise does not have value.  It’s very beneficial in many respects and does prolong length and quality of life.  However, like so many other things, it is not an effective prevention or cure for obesity.  As in many other interventions, it might be PART of the equation, but by itself is not enough.  Obesity is a complex disease with a complex number of items coming together to lead illness and to premature death.  There is not a single cause, nor is there a single cure.

In 2018, the best known option for fighting obesity is Bariatric surgery- PERIOD.  Exercise will always be recommended as an adjunct because it IS good for you, but with all due respect to “The Biggest Loser” and similar programs, they are not the answer.  Your choices are out there.  You simply need to educate yourself and find the choice which makes you the most comfortable.

Call us, We can Help!

Dr Bertha and the NJBI Team

Obesity Drives Risk for Influenza-Related Hospitalization

Among adults with overweight or obesity, each 5 points increase in BMI is associated with a 40 percent increase in the risk for influenza-related hospitalization, according to a study in the International Journal of Obesity. The increased risk is comparable to adults who have cardiovascular disease or diabetes. Compared with normal-weight adults, those with BMI between 30 kg/m² and 40 kg/m² were 27 percent more likely to receive an influenza diagnosis, whereas adults with a BMI at least 40 kg/m² were 69 percent more likely to receive an influenza diagnosis.

This was a “bad” flu season and it has stretched for a long time.  There are multiple scientists working on a more universal vaccine, but the bottom line is that we have not completely figured out the flu and people still die from it.  In 1918 nearly a third of the planet had it and millions died.  THAT was a “BAD” flu.  Regardless of which flu, obesity increases your susceptibility.  Not good.  Another unwanted obesity related complication.  Diabetes, Heart disease, arthritis, Stroke, Joint disease and now flu.  You may ask:  Does it ever end?

Only after surgical weight loss . . .

Call us, we can help!

Dr Bertha and the Team at NJBI

How to Combat Your Craving for Comfort Foods

When feeling stressed, many often turn to comfort foods, but according to a 2014 study by psychologist Traci Mann found, eating comfort foods doesn’t actually boost mood any faster than eating nothing at all. The foods we yearn for in times of stress are often rooted in childhood and according to a study published in the journal Appetite, there is a deeply social and emotional component to foods that provide us solace.

This is one important reason why surgery is not the WHOLE answer for Bariatric surgery patients.  At NJBI, We understand that the patient is more than a set of wounds, or an altered body part.  We have carefully selected nutrition and behavior professionals who are not simply there to check boxes on clearance forms.  They are specifically trained, experienced professionals who have been carefully vetted to be certain that they understand the issues that our patients face, and are capable of adding value to their pre surgery and post surgery experience.  They are independent contractors and therefore are constantly judged by the efforts rather than being just another source of income for our practice or medical organization.  At NJBI, it’s all about the patient.  That’s one BIG reason why we have better outcomes and well adjusted post op alumni.

Best in Health,

The Team at NJBI

Obesity Paradox’ Fails to Hold Up in Study

While some experts have implied that there is an “obesity paradox,” the idea that people with obesity live longer than those of normal weight. Now, a new study in JAMA Cardiology refutes that claim, finding that obesity was associated with an increased risk for cardiovascular disease and a two- to three-year shorter life span. The study pooled data from 10 studies of 190,672 people followed from 1964 to 2015. Compared with those of normal weight, men who had overweight had a 21 percent higher lifetime risk of cardiovascular disease and women a 32 percent higher risk. Among those with obesity, the cardiovascular disease risk was 67 percent higher for men and 85 percent higher for women. The risk was even higher for those with morbid obesity. Longevity in men who had overweight but not obesity was similar to that of men of normal weight, but still carried an increased risk of cardiovascular disease at a younger age.

First some definitions:

Overweight (5-30 lbs over ideal)

Obese ( 31-69 lbs over ideal)

Severely obese (70-100 lbs over ideal)

Morbidly obese (>100 lbs over ideal)

As you can see from the study, each category above “normal” increases risk.  The further from normal, the greater the risk.  This is not a surprise when the factors which accompany the excess weight are considered.  Diabetes, High serum lipids, Sleep apnea and hypertension are all increased with weight and cardiac risk factors.  Even in the situation where these items have not been formally diagnosed, we know that they exist to some extent.  Eliminate the weight, eliminate the comorbid conditions.  Eliminate the weight eliminate the cardiac risk.  Cardiac disease is the #1 killer in the world each year.  Eliminate the weight, extend your life.  It’s up to you.

Bariatric surgery is safe, available and effective.  You have everything to gain but the weight . . .

Call us, We can Help!

Dr Bertha and the Team at NJBI