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Can Sleep Apnea Be Cured With Weight Loss Surgery?

by Weight Loss Solutions Sunshine Coast | Jul 6, 2017 | Health and Obesity

Weight loss surgery decisions are rarely only cosmetic-related. Some people who are considering bariatric surgery are experiencing serious medical problems connected to their excess weight. Obstructive Sleep Apnea/Apnoea (OSA) is often associated with obesity. This is a condition where you stop breathing during your sleep. It’s a pretty dangerous condition and can lead to reduced mental alertness on a daily basis, as well as increase your risk of diabetes, heart attack, stroke or depression in the long term. Can sleep apnea be cured?

We examine the causes of and treatments for this condition, and the efficacy of weight loss surgery as a treatment for OSA in many cases where excess weight is a factor.

This week is Sleep Awareness Week (3-9 July 2017). The Sleep Health Foundation is partnering with CRC for Alertness, Safety & Productivity to focus this year on Better sleep=smarter, safer workplaces. Chronic poor sleep can lead to driving and workplace accidents through drowsiness, as well as reduced productivity. Along with obesity, the rates of sleep disorders like sleep apnoea are increasing in our modern world. Insufficient sleep is now recognised as a public health problem that according to research by the Sleep Health Foundation, is costing Australia more than $5 billion per year.

What are the rates of Obstructive Sleep Apnoea?

It is estimated that approximately 9-21% of women and 24-31% of men experience some form of OSA. Studies show that the prevalence of OSA is “over double among the obese,” Sleep epidemiology–a rapidly growing field.

How does obesity cause sleep apnoea?

The Sleep Health Foundation explains why many with OSA are overweight:

“Being overweight can cause a narrowing of the throat due to fatty tissue. Also, having a large waistline can make the lungs smaller during the night, which makes the throat more likely to collapse.”

Can OSA be treated?

There are a number of ways you can treat OSA. In moderate to severe cases, this is absolutely essential to prevent further health complications. Two of the most common ways to treat OSA include:

A nasal continuous positive airway pressure (CPAP) mask which covers your nose and holds your throat open during the night while you sleep.
An oral appliance fitted by a specialist dentist.

Should these methods fail, there are also several surgical operations your specialist may offer you.

Can sleep apnea be cured?

Whilst therapies like CPAP or oral devices work well to treat OSA, they can’t cure it. Surgery for OSA addresses the underlying cause – either by removing excess tissue from the nose and throat, or weight loss surgery. Your decision to have surgery will depend on the severity of your OSA and its impact on your daily life and overall health. You can find out more about various surgeries for OSA on the Sleep Health Foundation website.

If you are obese, you may consider weight loss surgery. Weight loss has shown to improve OSA. As well, it can reduce other health problems you may be experiencing such as hypertension, diabetes, heart problems and more. The positive impact of bariatric surgery on OSA has been studied many times. In a recent abstract “The impact of bariatric surgery on obstructive sleep apnea: a systematic review” 69 studies of 13,900 bariatric patients was reviewed. The abstract concluded that over 75% of patients saw at least an improvement in their OSA.

Will weight loss surgery cure my OSA?

In cases where weight is the only underlying cause, weight loss through surgery can relieve OSA. Improvement in OSA symptoms is one of the first things many (but not all) of our bariatric patients notice in the weeks after surgery.

Despite the positive impact, we would generally advise patients to exercise caution with OSA therapies following weight loss surgery. They should continue to monitor their condition with their specialist. Other anatomical differences may also be contributing to OSA. In this case, whilst weight reduction would improve OSA, it may never reverse it completely, and you may still require your CPAP or oral appliance.

Sleep apnoea or sleep apnea?

The United States uses apnea, whilst the United Kingdom uses apnoea. In Australia, both spellings are used to describe the condition in various contexts.

For more information on sleep and your health visit the Sleep Health Foundation website.

Are you curious about how weight loss surgery could change your life?

Weight loss can have positive results on your health and wellbeing. Visit our website to find out more about our procedures for patients across the Sunshine Coast and Fraser Coast region.

← Obesity and Other Risk Factors for Bowel Cancer How to Improve Heart Health Through Physical Activity →

Obesity and Other Risk Factors for Bowel Cancer

by Weight Loss Solutions Sunshine Coast | Jun 15, 2017 | Health and Obesity

Did you know that if you are overweight or obese, you have a higher risk of developing bowel cancer? June is Bowel Cancer Australia’s Bowel Cancer Awareness Month. Australia has one of the highest rates of bowel cancer in the world, and year on year it’s increasing. As both general surgeons who operate on the gastrointestinal tract, and specialist bariatric surgeons, this issue is an important one for us. We take a look at the risk factors for bowel cancer, and the symptoms you need to be aware of which could save your life.

The Facts about Bowel Cancer

According to Bowel Cancer Australia at present 14,962 people are diagnosed with bowel cancer in Australia every year. By 2020, it’s predicted we will reach 20,000. It is also the second biggest cancer killer, claiming 4,162 lives every year. This is because often the symptoms go undiagnosed until it’s too late.

What is Bowel Cancer?

Bowel cancer is also known as colorectal cancer. Many growths in the colon or rectum begin as polyps. These are benign lumps on the wall or lining of the bowel. Whilst many are harmless, some can turn into malignant growths.

So What Are The Risk Factors for Bowel Cancer?

Your chances of developing bowel cancer may increase if you:

Have a family history of bowel cancer, or inherited gene mutations
Are over 50 (although you can never be too young).
Have inflammatory bowel diseases and ulcerative colitis
Obesity

As well, a whole host of other diet and lifestyle factors are risk factors for bowel cancer, such as:

High red meat consumption
Alcohol consumption
Smoking

Bowel Cancer Australia states your risk of bowel cancer can increase by 2 per cent per BMI unit over your optimal weight.

“Studies show convincing evidence that:
i. greater body fatness is a cause of bowel cancer (2% increased risk per kg/m2);
ii. abdominal fatness is a cause of bowel cancer (17% increased risk with increased waist to hip ratio)

Bowel Cancer Australia Increased Bowel Cancer Risk

For example, if you are a BMI of 40, then you are 30% more likely to develop colorectal cancer than someone who is not overweight.

Obesity and Cancer Rates.

In addition to being one of the risk factors for bowel cancer, being obese also increases your risk of developing other cancers. According to a U.S. National Cancer Institute report on Obesity and Cancer, obesity has been shown in observational studies to increase your risk of developing:

Endometrial cancer
Esophageal adenocarcinoma
Gastric cardia cancer
Liver cancer
Kidney cancer
Multiple myeloma
Meningioma

Pancreatic cancer
Colorectal cancer
Gallbladder cancer
Breast cancer
Ovarian cancer
Thyroid cancer

What are the Bowel Cancer Symptoms I Need to Watch Out For?

According to the Cancer Council of Australia, not all bowel cancers show symptoms and experiencing symptoms does not necessarily mean you have bowel cancer. However, you should see your doctor if you notice:

bleeding from the back passage or any sign of blood after a bowel motion;

a change in usual bowel habit, such as straining (constipation) to go to the toilet or loose motions (diarrhoea)

abdominal pain or bloating;

weight loss for no obvious reason, or loss of appetite

symptoms of anaemia – including unexplained tiredness, weakness or breathlessness.

How Do I Decrease My Risk For Bowel Cancer?

Overall, a healthy lifestyle is your best defence against bowel cancer. Giving up smoking, reducing your intake of alcohol, and adopting an exercise routine can decrease your risk. As well, improving your diet, including plenty of fibre-rich foods and reducing the level of red and processed meat you consume can help.

If you are overweight or obese, a serious talk with your doctor on the best approaches to weight loss will help you decrease your risk of bowel cancer, and indeed, many cancers. For those people who are at high risk of obesity-related diseases, or who are morbidly obese, bariatric surgery can be a life-saving option. You can find out more about whether you may be a candidate for weight loss surgery here.

Early Detection Can Save Your Life

“90 per cent of bowel cancer cases can be treated successfully if found early. Fewer than 40% are detected early,” Bowel Cancer Australia.

Regardless of your age, if you are unsure if your bowel symptoms are normal, book a check-up with your G.P. A bowel cancer screen test is widely available and is worth asking for if you have symptoms or a family history, or for anyone over 50 years of age.

For more information, a great place to start is the Bowel Cancer Australia website, and of course have a chat with your G.P. about your risk factors, family history and symptoms.

← Getting to the Heart of Obesity-Related Hypertension Can Sleep Apnea Be Cured With Weight Loss Surgery? →

Low-Carb Vs Low-Fat: What’s The Best Diet For Weight Loss?

by Weight Loss Solutions Sunshine Coast | Jun 1, 2017 | Weight Loss Diet

When it comes to tackling obesity and treating and preventing other related diseases such as type-2 diabetes, heart disease and even some cancers a good diet is a critical component. But what is a good diet? Is it low-fat? Is it low-carb? We look at some of the recent research and opinion around diet for weight loss, and what that means for people struggling with obesity and related health issues.

Recently there has been a lot of press about the benefits of clean eating, and even more so, on the benefits of low-carb, high protein diets. But the two terms aren’t necessarily the same thing. So what do the experts say could be the best diet for weight loss and managing obesity-related diseases?

Studies on Low-Carb Benefits

A significant clinical study on low-carb versus low-fat diets was recently completed in Australia by the CSIRO.
The CSIRO undertook a two-year study comparing different dietary approaches for the management of type-2 diabetes. One was a low carbohydrate, high protein and high ‘healthy fat’ diet. The other was a more traditional diet high in unrefined carbohydrates and low in fat. All participants also participated in a supervised exercise program.

According to study findings, there was a “clear link” between a low carbohydrate diet and diabetes management. Low carb diets led to a 40 percent reduction in the volume of diabetes medication required. The second finding was that this diet also reduced the number of blood glucose spikes experienced by diabetic patients throughout the day.

Should We All Switch to a Low-Carb Diet for Weight Loss?

The CSIRO’s Associate Professor and principal research scientist Grant Brinkworth says our traditional approach may need changing.

“This research shows that traditional dietary approaches for managing type-2 diabetes could be outdated, we really need to review the current dietary guidelines if we are serious about using the latest scientific evidence to reduce the impact of the disease,” Professor Brinkworth said.

In the race to tackle obesity and diabetes, it is tempting to make a quick switch to a high-protein, low-carb diet. But rushing into any diet for weight loss can be risky.

A couple of things about the study should also be noted:

BOTH groups lost around 10kg of weight on both diets.
BOTH groups did so with the support of a Dietitian.

So whilst low-carb diets could be beneficial, it is often the right support on the diet and finding one which addresses unique nutritional needs which produce the best result. Further research is needed in this area before all people with Type 2 Diabetes are switched to a low carb diet.

For instance, feasting on bacon, eggs and Camembert cheese every day is a low-carb diet. But it is certainly not a healthy or balanced one.

Good Food Vs Good Diets

One point which is worth highlighting in the study is that both diets used in the CSIRO study were very well balanced nutritionally and both calorie-controlled. A diet rich in good nutritious food is always the best choice for anyone’s health and well-being.

Principal Dietitian at Simply Nutrition Dietitians, Kate Stoker said that Australians generally should eat good quality carbohydrates such as whole grains, legumes, fruit, vegetables and dairy. They should also read the labels on the back of packaged products to understand nutritional value, however, the less label reading you do the better, as this means you are choosing fresh unprocessed foods.

“All carbs are not equal in their nutritional value, there is a big difference between the carbohydrates found in brown rice and a bowl of potato chips.”

“Carbohydrates are the main fuel for our entire body especially the brain. Consuming inadequate amounts of carbohydrates can leave people with fatigue, headaches, lethargy, and brain fog and so I would worry about promoting their total removal the diet,” Ms Stoker said.

In Summary

This is interesting research into diet and diabetes as well as for obesity in general. Do our dietary guidelines need reviewing as the CSIRO suggests? Possibly.

But for the person struggling with their weight, the overall message we can take away is:

Try to lower the total amount of total calories in your diet
Eat more unprocessed foods especially more fruit and vegetables
Choose nutritious sources of protein
Eat less empty carbohydrates often found in today’s processed and packaged food.

Remember, there is no ‘one size fits all’ approach when it comes to your diet. Everyone has different nutritional needs. The best diet for weight loss is a healthy diet, rather than a fad diet. One which includes plenty of whole foods. Fresh, unprocessed food is best.

The ideal way to tackle your diet when it comes to obesity and all related diseases is with the ongoing support of a qualified Dietitian.

Are You A Weight Loss Surgery Patient?

If you have had, or will have weight loss surgery then ‘fad diets’ of any kind are unsuitable. We believe the ongoing support of a dietitian is the best approach for good nutritional health after surgery. A dietitian can ensure an adequate uptake of nutrients while supporting your weight loss goals. Find out more about the importance of diet after weight loss surgery.

The Role of a Dietitian In Your Weight Loss Journey →

Getting to the Heart of Obesity-Related Hypertension

by Weight Loss Solutions Sunshine Coast | May 4, 2017 | Health and Obesity

Did you know that close to one in four Australians has high blood pressure? This week is the Heart Foundation’s Heart Week (30 April – 6 May 2017). The topic on the agenda this year, is Hypertension, the medical term for constant high blood pressure. Hypertension is recognised as one of the risk factors for cardiovascular disease and stroke. Studies have also shown a close relationship between hypertension and obesity. We examine how hypertension relates to your heart health. We also see how obesity can make you more at risk of hypertension. Finally, we look at your options for preventing, managing and treating obesity-related hypertension.

The topic of high blood pressure is often on the agenda with patients, for both our general surgery and bariatric practices. It is one of those early warning signs – in any person – that your health needs attention. Because in many people, hypertension can be prevented or treated, having your G.P. take your blood pressure is one of the best health checks you can partake in regularly.

Causes of and Treatments for High Blood Pressure

In some people, hypertension has a specific medical cause, and once treated they can be cured. But in most other people, age and or lifestyle factors have caused hypertension. Medications can play a significant role in treating hypertension, and often people with a tendency to hypertension will be on medication for life. But medications can only go so far. Lifestyle modification is also an important part of treatment.

For many people, their G.P. will also prescribe a better diet, including a restricted sodium and higher potassium intake. They will insist sufferers give up smoking if they do so. In addition, they will encourage them to get more active with an exercise program and to reduce stress in daily life. These aspects all help to reduce blood pressure in hypertension sufferers. (1)

The problem is, controlling hypertension in an obese patient becomes more difficult.

About Obesity-Related Hypertension

It has been noted that blood pressure increases as body mass index increases. A 2013 study Treatment of Hypertension in Obese Patients found that for every 10% increase in body weight, systolic blood pressure is estimated to increase by 6.5mmHg (2). So it is evident that increasing body weight increase your risk of developing hypertension.

Firstly, the study also shows, and in our own experience, obese patients can be at a greater risk of being resistant to the medication required or may require more medication at higher doses to control high blood pressure (3).

Secondly, following the general guidelines for managing blood pressure can be difficult for someone who is obese. If you are a person with a body mass index of 40 or more, the advice to ‘get moving and lose a little weight,’ whilst still valid, can be incredibly difficult to achieve. We recognise that for many patients obesity is the disease which must be addressed, well before hypertension.

Surgical Treatment

For those people who are morbidly obese, hypertension can co-exist with other life-threatening obesity-related health issues. These can include type 2 diabetes, heart disease, obstructive sleep apnoea, back and joint problems, depression and even some cancers.

Metabolic surgery can intervene to reverse some obesity-related diseases, and in particular, it has been shown to be particularly effective in reducing obesity-related hypertension.

A review of 33 studies involving 3,997 patients showed that on average, 75% of patients experienced resolution or improvement of their hypertension after laparoscopic sleeve gastrectomy (LSG) surgery.

“Based on our systematic review, LSG has a significant effect on hypertension, inducing resolution or improvement in the majority of cases. Therefore, LSG remains a viable surgical option in obese patients with hypertension,” the 2013 review concluded (4).

We believe addressing excess weight and obesity has nothing to do with appearance, and everything to do with living a long, healthy life. Surgery is a life-saving choice for many patients who cannot lose weight with diet and exercise alone and should be viewed that way.

Don’t Forget to Check!

It must be noted, that although obese people are at a higher risk, high blood pressure can happen to anyone. Most times the symptoms of Hypertension are silent but can be managed if caught early. If left untreated, hypertension can lead to a heart attack; stroke; heart disease and kidney disease. So don’t forget to reach out and have a heart this week, encouraging someone you love to get their blood pressure checked. You could just save their life!

For more information, visit the Heart Foundation’s Heart Week website.

Weight Loss Surgery For Type 2 Diabetes Should Be Standard Treatment: Report Concludes.

by Weight Loss Solutions Sunshine Coast | Jun 6, 2016 | Recent Developments

Weight loss surgery for type 2 diabetes is now being supported around the world as a standard treatment for some patients, with medical experts providing further evidence of its effectiveness. Metabolic (bariatric) surgery refers to procedures such as gastric sleeve surgery and gastric bypass.

Metabolic surgery (gastric sleeve, gastric bypass), previously designed solely for weight loss, has been recognised as playing a significant role for diabetic patients. In some patients, metabolic or bariatric surgery has been show to improve blood sugar levels to the point where patients have experienced long term remission of type 2 diabetes.

Weight loss surgery for type 2 diabetes is now globally recommended for patients with a body mass index of 30 or more, where high blood sugar is not controlled well, despite treatment with either oral or injectable diabetes medications. These new evidence-based guidelines for the surgical treatment of type 2 diabetes have emerged from an international diabetic conference. The guidelines and approach to diabetes have been “hailed as the biggest change to the treatment of the disease in almost a century.” A Sydney Morning Herald article reports.

You can read the full report here: Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organisations.

How could weight loss surgery for type 2 diabetes help?

When a patient undergoes metabolic surgery huge changes take place in the gastro-intestinal anatomy. These changes can lead to weight loss, and in some cases they can also improve the patient’s ability to process sugars. There are many theories as to why this happens. Some experts say that changes in gut hormones allow the patient to process glucose better. Others point to surgery leading to a more effective bile acid metabolism. Others say surgery can improve the rate of nutrient sensing and metabolism in the intestinal tract. New theories also point to an improvement in gut microbiota following surgery.

You can read more about this research here: Metabolic Surgery for Type 2 Diabetes: Changing the Landscape of Diabetes Care

What do these findings mean for type 2 diabetics?

These conclusions should mean improved clinical approaches to type 2 diabetes in Australia and internationally.

Currently in Australia, some of the costs of procedures such as gastric sleeve, gastric bypass, and lap band surgery are partially covered under Medicare for morbidly obese patients. These surgeries are also eligible for rebates under the Private Health System. We are hoping that this consensus on the effectiveness of metabolic surgery in diabetic patients, will mean better access to metabolic surgery under our health care systems for type 2 diabetic patients in Australia who fit the recommended criteria.

Professor John Dixon, physician and diabetes researcher at Baker IDI Heart and Diabetes Institute agrees.

“We’ve got to shake up our public hospital system in each state and remove the barriers that are preventing people for getting this treatment,” Professor Dixon told SMH.

Both diabetes, and obesity are diseases which have grown to epic proportions in our society. Physicians look to this research to provide the type of guidance which will ensure that all Australians are given better health outcomes going forward. Exactly why metabolic surgery is effective in treating diabetes type 2, and ultimately, why this disease occurs at all, are exciting and important questions researchers can begin to ask in this field.

Weight Loss Surgery

Would you like to know more about weight loss surgery for type 2 diabetes?

We offer the full range of weight loss surgery procedures for the treatment of obesity and metabolic disease. We provide gastric sleeve surgery, gastric bypass surgery, lap band surgery as well as non-surgical intra-gastric balloon, at two Sunshine Coast hospital locations.

Contact a bariatric surgeon to discuss your options.

About Weight Loss Solutions Sunshine Coast

Weight Loss Solutions Sunshine Coast is an integrated team of bariatric surgeons and weight loss health professionals, focused on long term patient outcomes for the treatment of obesity and metabolic disease. The surgery team consists of Dr James Askew, who consults at Sunshine Coast University Private Hospital; and Dr Garth McLeod, who consults at Noosa Private Hospital. The Surgeons operate together at both hospital locations. Weight Loss Solutions Sunshine Coast offers bariatric/metabolic surgery procedures such as gastric sleeve, gastric bypass and lap band surgeries. Both surgeons are highly experienced bariatric and general surgeons. Patient recovery and long term wellness following surgery is enhanced with the assistance of a dietician, a psychologist and an exercise physiologist.

Weight Loss Surgery for Type 2 Diabetes to Be Funded by Qld Govt. →