Thinking of Losing Weight? Beware of Gastric Banding...

Obesity is referring to excessive amount of body fat in a human body. The World Health Organization (2003) has reported that billions of people all over the world are overweight and roughly 300 million of these individuals are classified as obese. Based on the National Health and Nutrition Examination Survey, approximately 17.1% of the 3,958 children who participated in the research study were overweight and that 35% of children between the age brackets of 6 to 19 years old are seriously overweight (Ogden et al., 2006).

Obesity is a common health problem in developed and developing countries. A traditional way to lose weight is by controlling diet and promoting physical activities. In line with this, the American Heart Association and the American Dietetic Association has been strongly promoting the importance of following the low-fat dietary guidelines set for individuals who would want to lose their excess weight. On the other hand, the Atkins diet and Zone diet are suggesting the need to cut down on the intake of carbohydrates in a person’s diet.

Importance of Diet and Exercise
As compared to the practice of low-fat diet, the practice of low-carbohydrate diet was seen more effective in terms of improving weight lose and reduce the patients’ risk for cardiovascular diseases but not the patients’ blood sugar level (Hession et al., 2008). Regardless of the type of diet obese individuals would accept, several studies revealed that effective weight loss will improve cholesterol (Hession et al., 2008; Tay et al., 2008). Not applicable with high fat and low-carbohydrate diet, the research findings of Tay et al. (2008) showed that the adaptation of low-fat diet is more effective in terms of improving the LDL and total cholesterol levels but not the levels of HDL and triglyceride.

In the absence of a significant decrease in a person's weight, the practice of following either low-fat or low-carbohydrate diet will not improve the patient’s cholesterol level. The only benefit that obese patients would receive out of practicing low-carbohydrate diet and/or low-fat, high-carbohydrate diet is that obese individuals are unlikely to gain back the weight they have lost easily because of metabolic backfire (Howard et al., 2006).

Another kind of diet is the Mediterranean diet which strongly promotes the intake of high fiber and monounsaturated fats such as the use of olive oil in cooking foods. In line with the practice of this particular diet, Shai et al. (2008) revealed that Mediterranean diet is effective in terms of reducing weight more than the practice of low-fat diet especially in the case of diabetic patients.

Equally important in losing weight is physical exercise. Exercise enables a person to burn extra calories that can form as excess body fats when left unused. When combined with proper diet, studies revealed that physical activities could increase the success that obese individuals would lose weight safely (Tay et al., 2008; Howard et al., 2006; Ogden et al., 2006).

Advantages and Disadvantages of Gastric Banding
Gastric banding is a surgical procedure that is commonly used for decrease the weight of obese individuals. Basically, the main purpose of placing adjustable silicone band around the upper part of the stomach is reduces the size of the stomach. This is necessary to make obese person feel full and eat less.

The different types of gastric banding include the gastric bypass, laparoscopic adjustable gastric banding surgery and vertical banded gastroplasty (VBG). VBG procedure has a higher complication rate that the laparoscopic adjustable gastric banding surgery. Therefore, less commonly used today.

As a standard operating procedure, it is ethical for surgeons and other health care professionals to discuss with patients regarding the advantages and disadvantages of a particular medical or surgical procedure before allowing the patients to decide whether to accept or reject the treatment. However, there will always be some health care professionals who are after money more than promoting the welfare of the patients.

To give you a better idea regarding the health consequences of gastric banding, I have intentionally included some concrete evidences that could make more people think twice about deciding to go for gastric banding.

Any form of skin opening such as wound or surgical incision is a potential entry port for microorganisms to invade and destroy the natural flora of the human body. Except for the possibility that the silicone band might erode, this medical concept gives us the rationale behind further health complications of going through the surgical procedure.

Some excessively overweight individuals are willing to spend big amount of money for surgical procedures that will make them easily lose weight. Since there is a market for risky surgical procedures like gastric banding, there are medical professionals in different countries that aggressively promote gastric banding despite the potential health consequences the patients may experience in the future.

Dapri, Cadiere, & Himpens (2009) revealed that the practice of laparoscopic conversion of adjustable gastric banding is effective and feasible except for the incidence of one (1) death. Although gastric banding is effective in terms of enabling obese individuals to easily lose weight, it is undeniable that many of these individuals who undergo gastric banding are facing the risks of short- and long-term health-related complications.

With regards to the safety issue on gastric banding, Keller et al. (2009) revealed that 30 out of 50 obese individuals had to undergo open surgery and that 1 out of 50 and 3 out of 50 experienced early and late complications after undergoing the gastric banding procedure.

As of 2009, it has been reported that the possible health complications of gastric banding includes: esophagitis (28.8%), pouch dilation (15.3%), esophageal dilation (12.5%), port problems (11%), band migration (6.5%), and band leakage (6.4%) (Mittermair et al., 2009). For this reason, 251 or 32% of the total research participants (785) had no choice but to undergo a re-operation procedure (ibid).

A proper diet combined with a regular exercise is still the safest way to lose weight. Before you even think about going through a gastric banding procedure, think about the health consequences first. The last video shows how bad a gastric band erosion looks like.

References:

1. Dapri, G., Cadiere, G., & Himpens, J. (2009). Laparoscopic conversion of adjustable gastric banding and vertical banded gastroplasty to duodenal switch. Surgery of Obesity and Related Diseases , July 10. [Epub ahead of print].
2. Hession, M., Rolland, C., Kulkarni, U., Wise, A., & Broom, J. (2008). Systematic review of randomized controlled trials of low-carbohydrate vs. low-fat/low-calorie diets in the management of obesity and its comorbidities. Obesity Reviews , 10(1):36 - 50.
3. Howard, B., Manson, J., Stefanick, M., Beresford, S., Frank, G., Jones, B., et al. (2006). Low-fat dietary pattern and weight change over 7 years: the Women's Health Initiative Dietary Modification Trial. Journal of American Medical Association , 295(1):39-49.
4. Keller, P., Romain, B., Nicolae, M., Perrin, P., & Meyer, C. (2009). Is laparoscopic gastric bypass a dangerous procedure during the early phase of the learning curve? A prospective study of the first 50 cases. Journal de Chirurgie , September 17. [Epub ahead of print].
5. Mittermair, R., Obermuller, S., Perathoner, A., Sieb, M., Aigner, F., & Margreiter, R. (2009). Results and Complications after Swedish Adjustable Gastric Banding-10 Years Experience. Obesity Surgery , September 18. [Epub ahead of print].
6. Ogden, C., Carroll, M., Curtin, L., McDowell, M., Tabak, C., & Flegal, K. (2006). Prevalence of overweight and obesity in the United States, 1999-2004. The Journal of the American Medical Association , 295(13):1549 - 1551.
7. Shai, I., Schwarzfuchs, D., Henkin, Y., Shahar, D., Witkow, S., Greenberg, I., et al. (2008). Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. New England Journal of Medicine , 359(3):229-241.
8. Tay, J., Brinkworth, G., Noakes, M., Keogh, J., & Clifton, P. (2008). Metabolic effects of weight loss on a very-low-carbohydrate diet compared with an isocaloric high-carbohydrate diet in abdominally obese subjects. Journal of the American College of Cardiology , 51:59 - 67. doi:10.1016/j.jacc.2007.08.050.
9. World Health Organization. (2003). Retrieved September 21, 2009, from WHO definition of Health : http://www.who.int/about/definition/en/print.html

Does your child show symptoms of ADHD? Learn more about the evidence-based assessment of ADHD in children.

From CNN News:

Attention deficit hyperactivity disorder (ADHD) is “a childhood mental disorder characterized by inattentiveness, impulsiveness and over activity” (Hazelwood, Bovingdon, & Tiemens, 2002). As one of the most common mental health disorder among children and adolescents, a higher number of ADHD cases in male children and adolescents who belong to low-income families.

ADHD is a serious mental health condition since the child’s inattentiveness, impulsiveness and over activity could negatively affect the child’s academic performance, self-esteem, and the child’s relationship with family members and friends. ADHD can also lead to behavioural problems which often make the child unable to socialize with other people.

In the absence of proper treatment like medicine and behavioural therapy, children with ADHD could cause behavioural problems not only at home but also in school and work environment. This type of mental health condition can also cause relationship problems with the opposite sex which may lead to depression, frustration, and the use of illegal drugs.

Early medical intervention is necessary to prevent worsening of the child's mental health condition. As part of assessing whether a child has ADHD, medical professionals would often use analogue methods like conducting an interview with the child, go through the patient’s medical history in relation to the child's social, emotional, educational, and behavioural patterns, physical exam, and the use of behaviour rating and/or checklist in detecting ADHD. Likewise, laboratory measures such as the Conners’ Continuous Performance Test (CPT) and Gordon Diagnostic System – a self-contained computer device can also be utilized in detecting symptoms of ADHD.

There are so many assessment techniques that are commonly used in detecting ADHD in children. In line with this, it is safe and accurate to make use of self-report rating scales when assessing the ADHD symptoms in adult patients because adults are capable of verbalizing their behavioural experiences with the psychiatrists but not the children. Since children are unable to accurately verbalize their personal behaviour, the use of self-reporting rating scale is not advisable in assessing children for ADHD. Instead, psychologists should have a direct observation on children within a natural setting when using assessment method like CPT, BRIEF, DSM-IV factors, Conners’ Scales, and/or the behaviour assessment scale for children.

There is no single method that could provide the medical practitioners with a justifiable result given that the use of each assessment technique will generate a totally different result. Because of the limitations of each type of assessment method available in examining a child with ADHD, developing a comprehensive assessment technique is necessary before treating a child with ADHD. In line with this, the use of BADDS and ADHD rating scale is best when used in predicting clinical diagnosis.

Can Parents be Held Liable for having Obese Children?

From Yahoo News:

It is the obligation of parents to care and provide the needs of their children. However, it is difficult to draw the line with regards to the extent parents should care for them. This includes the food intake of each child. There are some parents who would allow their children to eat more than one serving even though their child is already overweight.

Studies show that obesity is related to abnormal food intake, genetic factors like metabolic defect, leptin deficiency and the use of steroids (Styne, 2005; Link et al., 2004; Roth et al., 2004). In line with abnormal eating, television advertisements play a significant role in attracting children to eat high-calorie and fatty foods. In fact, most of unhealthy food advertisements are using toys, colourful images, convincing music, and popular personalities to effectively capture the attention of children to patronize unhealthy food products (Morley et al., 2008).

Regardless of the main cause of child obesity, being extremely overweight could result to a long list of serious health concerns such as heart diseases, Type II diabetes and the different types of cancer. There are cases wherein obesity could cause the child to encounter social adjustment disorders or social discrimination especially among children of the same age.

“Times.com recently reported that there is a Scottish couple who lost custody over two of their six children because they were not able to reduce the weight of their children. Recently, the mother of the 14-year-old son weighing 555 lbs. is currently facing child-neglect charges.”

Although there are millions of children around the world who are obese, it does not necessarily mean that is solely the fault of the parents. Not all factors that causes obesity is controllable. Since obesity can be caused by genetic factors like metabolic defects, it is irrational to sue mothers for negligence only because they failed to keep their children’s weight down.

What will you do if the someone tells you that you have just lost your custody over your own children because one of your child is extremely overweight?

The Health Benefits of Pancit-Pancitan

The Philippines is a country with a diversified flora, home of many different plant species which have scientific medicinal value recently found in the current research made by the Philippine Department of Health (DoH). One of these plants is the "Pansit-pansitan".

These plants are shallow rooted and have shiny stems which are also succulent. The leaves are transparent, alternating in as turgid and heart-shaped. These plants grow easily in clumps within lightly shaded damp areas, loose soil and are conspicious in the rocky parts of canals or streams.

Pansit-pansitan is a native Philippine herb (scientific name: Peperomia pellucida) - also known as "Ulasiman bato" or English name "Peperomia" or "Shiny Bush". Pansit-pansitan is one of the crude plants known and approved by the Philippine DoH to provide relief and treatment of rheumatic pains and gout.

Pansit-pansitan plants are quite edible, from the flowers, stems and leaves. These plants grow to a length of one-and-a-half feet. Once harvested and washed, pansit-pansitan can be readily eated as salad. Likewise, these plants can also be made into a decoction by boiling one cup of washed and cleaned stems and leaves in two cups of water. Decoction should be taken twice a day - one in the morning and one in the evening. Decoction of pansit-pansitan leaves and stems are good for kidney problems as well as abdominal pains.

Pansit-pansitan can also be used to treat skin disorders such as pimples, boils, and abcesses. To create a poultice, the stems and leaves are heated and pounded to form a paste which can be applied directly to the affected area. Decoction can also be used as a wash to treat and rinse the skin disorders as well as facial problems.

The Health Benefits of Malunggay for Breastfeeding Mothers

I encourage each and every Filipino family to grow malunggay trees in their backyard. Since malunggay trees are readily available in different parts of the Philippines, Filipino doctors and nurses should continuously promote the health and nutritional benefits of eating malunggay. Malunggay leaves are not only rich in vitamin A and C, calcium, potassium, and protein, but also have antibacterial properties which is commonly used for medicinal purposes.

Each year, millions of pregnant women give birth to their babies. Although the Philippine Department of Health (DoH) has been very firm in promoting the importance of breastfeeding for the health of the newborn babies, it is very rare that we can hear nurses promoting the advantages of eating malunggay during the patients' breastfeeding period. As a result, there are a lot of cases wherein breastfeeding mothers experience mastitis – also known as “the inflammation of the breast caused by the blocking of the milk ducts while mothers are lactating”.

The mere fact that there are only few healthcare professionals who are publicly promoting the nutritional benefits of malunggay leaves suggest the strong need to enhance the general knowledge and learning experience of our future healthcare professionals. By knowing the health benefits of incorporating malunggay in the diet of lactating mothers, health care professionals can play a very important role in ensuring that each mother and their newborn baby willl not only receive proper nutrition but also protect them from possible infection caused by bacteria such as streptococcus, legionella, and staphylococcus.