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Could shivering in the cold be a way to shed weight and possibly prevent diabetes?

Exposure to cold is the most well-known and well-studied mechanism for switching on energy-burning brown fat, which seems to protect mice from developing obesity. It remains to be seen whether the same process can help people.

Humans have three kinds of fat. White adipose tissue, or white fat, comprises the majority of fat in bodies; its purpose is to store energy for future use. Brown fat is different; its function is to generate heat to maintain body temperature.

Until recently, it was thought that adults did not have brown fat, that it only existed in babies to help them stay warm before they could move around and then it essentially vanished. But beginning in 2009, studies have found that many adults have brown fat and that people with more of it tend to be leaner and have lower blood sugar levels.

The third kind of fat, beige fat, appears to convert from white to brown when stressed by exposure to cold, and then back to white. This process is encouraging for scientists trying to figure out how to increase brown fat to improve healthy functioning of the body.

Paul Lee, an endocrinologist at the Garvan Institute of Medical Research in Sydney, where he leads the Brown Fat Physiology Group. said a balanced diet and regular exercise were the cornerstones of healthy metabolism, but sustaining either was difficult for most people.

Understanding how brown fat could benefit our health opens up a new direction in obesity research, he said.

It is not a solution to obesity, but it is an opportunity to explore an alternative strategy for curbing the obesity epidemic.

Dr Lee said that when the body sensed the cold, the brain released norepinephrine, a chemical that essentially ignites the fat-burning process within brown fat.

When there was not enough brown fat, the body had to turn to less-efficient heat-generating models, such as shivering.

Aaron Cypess, a clinical investigator at the National Institute of Diabetes and Digestive and Kidney Diseases, calls brown fat the principal organ responsible for generating heat in laboratory animals.

In mice and rats, chronic activation of brown fat [by exposing them to low temperatures or to drugs that target brown fat] ... is associated with a reduction in liver fat, a resistance to diet-induced obesity and improvement in insulin release, Dr Cypess said.

All of these benefits and others may also apply to people, but it will take much longer to prove because studies in humans have to be conducted differently.

While white fat is easy to spot in humans think abdomen, hips, buttocks and thighs brown fat tends to be located around the neck and above the collarbone, along the spine and near the kidneys.

Dr Cypess said humans were genetically more diverse than lab mice, which produces results with much higher variability.

Dr Lee said that when people are cold and begin to shiver, their muscles release irisin, a hormone that turns white fat into brown fat. The more a person shivers, the more irisin is released into the bloodstream.

A 2014 study by Dr Lee dubbed the ICEMAN study found that after a month of sleeping at cool temperatures, five men increased their stores of brown fat by 30 to 40 per cent and metabolised sugars more efficiently after a meal, which could be helpful for people with diabetes.

When the sleeping temperature was raised, the brown stores dropped.

(Another recent study found that brown fat also may be stimulated by taking a drug used to treat overactive bladder.)

Dr Cypess said this research made it clear that activating or increasing brown fat stores might prevent weight gain, lead to weight loss and provide a new avenue for treating diabetes and obesity.

Can the average person embark on a shiver diet to lose weight?

Dr Lee said he believed the current evidence did not support the notion that shivering might be a route to losing weight. (Despite the studys name, ICEMAN the Impact of Chronic Cold Exposure in Humans exposed participants to only mild cold, not shiveringly low temperatures.)

Dr Cypess said shivering to lose weight was an interesting idea, but there were many unknowns.

First, is it safe?

Dr Lee said shivering causes stress and could harm the body, which explains why the human body has evolved mechanisms to turn on brown fat or to turn white fat into brown fat.

In most people, Dr Cypess said, shivering caused increases in blood pressure that over the years could damage blood vessels in the brain, heart and kidneys.

Additionally, there was no evidence to prove that a low-temperature regimen could be effective long-term.

One of the biggest limitations of weight-loss interventions is that the body learns to compensate to maintain itself, and that might be true with a shiver diet.

Dr Lee and Dr Cypess agree that no weight-loss regimen should be recommended without a great deal of evidence that it will work for more than a few weeks or months and that the weight loss can be sustained evidence that doesnt exist.

Finally, Dr Cypess said, being cold is extremely uncomfortable.

While suggestions exist that long-term activation of brown fat could be beneficial to weight loss and diabetes reduction, this has yet to be proven, he said.

Francesco Celi, chair of the division of endocrinology, diabetes and metabolism at the Virginia Commonwealth University School of Medicine, said he expected future research will include conducting studies in humans that will test various interventions (drugs or environmental modifications) to expand and activate brown fat to help scientists determine what kind of metabolic improvements can occur.

And by studying the various responses to interventions, researchers will be able to determine which patients respond better to brown-tissue expansion and perhaps why they do.

Dr Cypess said he expected scientists to focus on determining to what extent adult brown fat contributed to getting rid of excess calories, how brown fat could be used to bring down blood sugar levels and how brown fat interacted with other organs to keep people healthy.

But even with all that, he said: Basically, the issue of losing weight is about controlling the amount of food we put into our mouths.

The Washington Post

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Could shivering help brown fat fight weight problems? - The West Australian

WASHINGTON There's a group of people who suffer from what I'd call "serial get-out-of-debt disorder."

I know it's a mouthful, but it's a real condition for folks who find themselves stuck in a cycle of getting in and out of debt.

This ailment typically affects people who live above their means. One long-term effect of this ailment is the inability to save enough for emergencies, retirement or sending children to college without incurring more debt.

Here is how you can tell if you have this disorder:

You stay in debt, mostly with credit cards. But it could also include personal loans or frequent borrowing from your retirement plan.

You are rarely without a car loan. You repeatedly trade in your car for an upgrade because you feel entitled. Or because you're tired of fixing your car even though the repairs are still far less expensive than purchasing another vehicle new or used.

You feel remorse about amassing more debt than you can handle.

Your regret creates anxiety, weight loss or weight gain. You can't sleep at night.

If you're married, you fight about the debt with your spouse, putting a strain on your marriage which can manifest in more spending.

You can't take the stack of bills anymore, and you declare that you're ready to be healed.

You hunker down, aggressively cut expenses and maybe even get another job or work more hours to get out of debt.

You finally pay off the consumer debt. You're in remission. But because you haven't dealt with why you got into debt, you're right back in trouble.

During a recent online chat, I received a plea for advice from a reader suffering from this condition.

"I am in debt. Again," the person wrote. "I promised myself it wouldn't happen again after I filed for bankruptcy in 2000, but 17 years later I'm back in debt."

The reader says this time the debt is moderate. She's got $10,000 in credit card debt, which includes charges for car repairs and utility bills.

"My mortgage is behind by one month," she wrote. "I have steady income, but it's just my income, as my husband is an entrepreneur and companies have started paying when they want, which is not on time."

To alleviate their symptoms, sufferers often turn to a common cure.

"I am considering asking a family member to co-sign or obtain a loan for me to cover the debt so I can have one bill," the reader wrote. "The $10,000 loan would put me at zero debt other than that loan and student loans. Freeing up money would maybe help get me back on track."

So her question to me: "Does this make sense? I know I won't default/mess up the family member. I can't get a loan on my own."

Here's the regimen of treatment I recommend for this disorder:

Diagnose why you keep getting into debt In this case, it could be the unpredictable payments to her husband's business. The Small Business Administration has resources to help. On its website, http://www.sba.gov, search for this blog post: "4 Ways to Better Manage Irregular Income."

But if the earnings from her husband's entrepreneurial enterprise are continually inadequate to meet this couple's household needs, then perhaps he could take on another job. Or maybe self-employment isn't working, which is why they are using credit to make ends meet.

Get help The reader said, "I've learned my lesson, really."

If income isn't the issue, you may need therapy if your spending is a symptom of psychological issues. Maybe you need to deal with childhood trauma. Perhaps you spend more when you're under a lot of stress. And when the stress is gone, you clear up your debt. But when it returns, you go back to shopping as a relief.

If it's just an aversion to budgeting, get help from a nonprofit credit-counseling agency. To find a local agency, go to the National Foundation for Credit Counseling's website: nfcc.org. The agency can also help you negotiate with creditors and set up a debt payment plan.

Don't put a Band-Aid on the problem by dragging in friends or relatives No, you should not ask a family member to co-sign a loan. You will be putting his or her financial health on the line. Besides, in my experience, when people get a consolidation loan, they get a false sense of financial freedom. The zero balances on their credit cards are too tempting.

Unless you address the root cause of your serial get-out-of-debt disorder and take steps to prevent its recurrence, this condition won't be cured.

Readers can write to Michelle Singletary c/o The Washington Post, 1150 15th St., N.W., Washington, D.C. 20071. Her email address is michelle.singletary@washpost.com.

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Do you have serial get-out-of-debt disorder? - South Bend Tribune

Friday, August 18, 2017 12:16 p.m. CDT

By Lisa Rapaport

Reuters Health - Doctors are doing fewer weight-loss procedures to implant adjustable bands around the stomach and more operations to remove the devices or alter them, a U.S. study suggests.

Researchers focused on a type of weight-loss surgery known as laparoscopic adjustable gastric banding, a minimally invasive procedure that involves placing an inflatable belt around the upper portion of the stomach that reduces the amount of food it can hold. People are advised to eat portions about the size of a shot glass post-surgery.

Nationwide, a total of 28,202 patients underwent procedures to implant laparoscopic adjustable gastric bands (LAGB) from 2007 to 2015, the study found. Over that same period, 12,157 people had gastric bands removed, or explanted.

Starting in 2013, though, surgeons did more procedures to take bands out than to put them in, the study team reports in the Journal of the American College of Surgeons.

A newer alternative in weight-loss surgery known as a laparoscopic sleeve gastrectomy that appears to be safer and more effective may be driving this trend, said senior study author Dr. Ninh Nguyen, chief of the division of gastrointestinal and bariatric surgery at the University of California, Irvine School of Medicine.

Compared to the adjustable gastric banding, the laparoscopic sleeve gastrectomy is associated with improved weight loss and lower incidence of late complications, Nguyen said by email. The late complication rate requiring revision (procedures) after sleeve gastrectomy is one-fourth that of gastric banding.

More than half of weight-loss procedures done today use the sleeve gastrectomy, which reduces the stomach to the size of a banana, according to the American Society for Metabolic and Bariatric Surgery.

Procedures to remove or adjust gastric bands were associated with longer hospital stays, a greater number ofserious complications and more admissions to intensive care units compared withoperations to implant the devices, the study found.

Researchers didnt find any difference in death rates or costs between implantation procedures and operations to remove or fix the bands, with both types of surgery costing an average of $11,600 to $12,000.

One limitation of the study is that researchers only examined procedures done at academic medical centers, although the authors suggest that trends might be similar at community hospitals.

Another drawback is the lack of data explaining why bands were removed. That makes it impossible to say if the removal happened after complications or because patients elected to switch to a different, newer alternative such as the sleeve gastrectomy to see if they could achieve more weight loss.

Most often, when the gastric bands are removed its either because patients couldnt tolerate the devices being tightened or because they didnt lose enough weight, said Dr. Anita Courcoulas, chief of minimally invasive bariatric and general surgery at the University of Pittsburgh Medical Center.

Because the sleeve is still relatively new, however, its too soon to say whether it will achieve better weight loss or fewer complications over the long term, Courcoulas, who wasnt involved in the study, said by email.

Enthusiasm for the sleeve as a replacement for the band should be tempered with the knowledge that longer-term outcomes are still sorely lacking, Courcoulas added. It will take time, patience, and a dynamic evaluation of the evidence as it evolves to draw more final conclusions about the longer-term comparative effectiveness of bariatric procedures.

SOURCE: http://bit.ly/2vL18Pf Journal of the American College of Surgeons, online July 25, 2017.

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Surgeries to remove weight-loss devices on the rise - KFGO

Stocks have been extremely strong, with the market having seen impressive results over the past eight years since the financial crisis. Yet some individual stocks have crushed the overall market with outrageous gains. Weight Watchers International (NYSE: WTW), Esperion Therapeutics (NASDAQ: ESPR), and Health Insurance Innovations (NASDAQ: HIIQ) have all managed to quadruple or more in just 12 months. Investors who've seen these stocks for the first time recently want to know if they can score any further gains from these companies. Below, we'll look more closely at them to see whether there's anything left in the tank for these high-flyers.

Weight Watchers gains momentum

Weight Watchers International has gotten a lot of attention in recent years, notably from the presence of high-profile investor Oprah Winfrey. Yet even though Winfrey's initial investment earned a lot of exposure for the company, Weight Watchers has continued its upward momentum purely from business results.

In the first quarter of 2017, Weight Watchers reported an impressive 16% rise in subscribers, reaching the 3.6 million mark and rising for the sixth straight quarter. The positive sentiment from a rising audience and an increase in paid weeks for weight loss programs offered by Weight Watchers continued into June, lifting the stock still higher, and the second quarter brought even better results. Looking ahead, Weight Watchers has a new CEO, plans to update its programs, make enhancements to its digital offerings, and expects to make meetings more useful for its members. That's a potential recipe for success going forward, and it's why investors are excited about Weight Watchers right now.

Image source: Weight Watchers.

Esperion gets to the heart of the matter

Esperion Therapeutics has focused its attention on developing drugs to battle cardiovascular disease, and like most biopharmaceutical companies, Esperion needs to show successes in its pipeline in order to make progress toward reaching its long-term goals. Back in February, investors started bidding up the stock after a similar treatment from a rival drugmaker raised the chances that its cholesterol-lowering treatment, bempedoic acid, would eventually gain approval from the U.S. Food and Drug Administration.

That excitement got stronger heading into spring, as Esperion specifically said that it expected the FDA to accept a New Drug Application for the treatment based on data from the trials it was conducting, with an anticipated timeline of 2019. Fears about the ability for Esperion to have strong pricing power moderated those gains somewhat, but favorable trial results released earlier this month gave bullish investors reason to celebrate again. With a long timeline ahead of it, Esperion shares could see volatility in either direction, but if the trials keep going well, then further gains are quite possible.

Health Insurance Innovations sees strong demand

Finally, Health Insurance Innovations is the big winner on this list, having jumped more than 500% in the past year. The provider of short-term health insurance and hospital indemnity plans has seen a big jump in demand for its policies, and the corresponding rise in revenue and profits made the stock extremely intriguing. Just about the only hiccup in its share-price advance came in March, when company founder Mike Kosloske sold about $42 million in stock in a secondary offering.

Further gains have come due to the flexibility of Health Insurance Innovations' plan offerings compared to traditional health insurance. Even as healthcare reform efforts have moved forward in fits and starts, Health Insurance Innovations has catered to those who need supplemental coverage to their regular insurance or need specialized products like dental insurance. No matter whether Obamacare or Trumpcare end up being the law of the land for healthcare, Health Insurance Innovations seems poised to be able to tailor its offerings to meet its customers' needs.

Stocks like these inevitably appear in long bull markets, and each of the three companies has a lot going for them. As long as the favorable conditions that have spurred their respective gains remain in place, the potential for further share-price appreciation will be there for investors looking to get into these stocks now.

10 stocks we like better than Weight Watchers International

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David and Tom just revealed what they believe are the 10 best stocks for investors to buy right now... and Weight Watchers International wasn't one of them! That's right -- they think these 10 stocks are even better buys.

*Stock Advisor returns as of August 1, 2017

Dan Caplinger has no position in any stocks mentioned. The Motley Fool has no position in any of the stocks mentioned. The Motley Fool has a disclosure policy.

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These Stocks Have Quadrupled Since Last Year - Madison.com

Losing unwanted body weight isn't easy. A lot of us have tried and failed many times, subjecting ourselves to the dreaded yet common weight loss/weight gain merry-go-round. This vicious cycle can be demoralising, with many people convincing themselves that something must be wrong with them and they are destined to be overweight forever.

A common 'solution' is the meal or diet plan. After all, you've tried multiple diets and they haven't worked, so all you want now is a nutrition expert to give you a diet plan that will. You believe that if someone tells you exactly what to eat, how much to eat and when to eat it, then you'll lose the weight you want and have the body of your dreams. And why shouldn't you, after all, they're the expert.

However, while this strict diet plan approach may sound like the answer to your prayers, the reality is they very rarely work in the real world. You see, the real world has a habit of getting in the way of our best laid plans:

And whatever you do, don't get sick because the diet plan doesn't care how you're feeling. If you've been told to eat chia-seed pudding for breakfast three times per week, you'd better be prepared to make it no matter how you're feeling.

Think of all the factors in your life that could get in the way of the best laid meal plans, and ask yourself, 'how realistic is it to keep this up for the long run?'

But my friend went on a meal plan and she's kept the weight off for ages now...

There are exceptions to every rule, and if your friend has successfully lost weight and kept it off for several years since going on a diet plan, then I applaud them. However, there's no denying it's difficult to stick to these restrictive diets long-term.

But that's the point, meal plans are not supposed to be followed forever. How boring would life be if we had to eat the same foods in the same amounts at the same times every day for the rest of our lives? If you have a short-term weight loss goals then diet plans can be very effective. Just expect the inevitable weight gain when you're not on the 'plan' anymore.

But what happens when you stop following the diet plan? What happens when life gets in the way? Or you decide that following a meal plan really sucks? Or you actually lose the weight you want?

Diet plans don't address one key factor for successful lifelong fat loss -- habitual and behavioural change. Being told what to eat may provide short term weight loss success, but unless you learn, understand and practice the fundamentals of healthy eating, you'll revert to your eating habits that got you where you were in the first place.

OK, so what do you suggest I do to lose weight?

We live in a fast-paced society, and we all want to lose our excess body weight by the end of the next 12-week challenge. But ask yourself, 'how long did it take to put on this weight that has now become my life?' I'm guessing months at least, but probably years. So why do you think you can get back to your ideal body weight in 12 weeks, and sustain it for the rest of your life?

If eating nutritious foods and having a lean body forever is your goal, most people simply don't need a strict diet plan. After all, we know that lean meats and vegetables is a healthier meal option than hamburgers and fries. But if takeaway food is your usual dinner-time meal, then successfully making the giant leap to eating healthily at every meal without any small steps in between is going to be virtually impossible.

We're already under enough stress with work, family, bills, relationships, and everything else going on in our lives, so don't add to it by trying to turn your eating habits upside down right from the start.

MORE ON THE BLOG:

You Can't Hate Yourself Happy, Or Punish Yourself Skinny

The secret to making lifelong habitual changes to your eating behaviour is to identify positive changes you can make to your diet, and tackle them one at a time. Yes, this will take a while, and you won't lose the 25kg in 12 weeks that your 'fitness expert' has promised you. But small, incremental changes to your diet will add up to extraordinary and lifelong changes in the long run.

I'm sure you already know of changes that you could make to your diet, but here are a few suggestions to get the ball rolling:

Notice how many of these suggestions aren't even strictly 'nutrition' tips. We already know we should eat whole foods most of the time. Your goal should be to have a healthy relationship with food, not love-hate.

So slow down, take it one step at a time, and release the pressure you've put on yourself to lose excess weight quickly through restrictive dieting. Small and realistic changes to your eating habits over the long run will deliver extraordinary results to your health, body weight and wellbeing.

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If Weight Loss Is Your Goal, Diet Plans Are Not The Answer - Huffington Post Australia

wowomnom/ShutterstockMore than two-thirds of adults in the United States are obese, and that can leave many at risk for serious health consequences, according to the National Institute of Diabetes and Digestive and Kidney Diseases reports. Now, research suggests a switch in the brain could be to blame for out-of-control weight gain.

The new findings, from scientists at Monash Universitys Biomedicine Discovery Institute and published in Cell Metabolism, indicate that an important process occurs in the brain after we eatand in obese people its possible this function is impaired. The researchers explain that, after we eat a meal, our brains begin the process of circulating insulin thanks to the increase in our blood sugars. The brain should send a signal to the body to begin burning some of that energya process thats referred to as browning the fat. The name comes from adipocytes, cells that store our body fat and change from white to brown and back again. Brown fat is desirable because of the positive effects it has on your metabolism.

When we fast, our brain tells the body to take the browned cells and convert them into white cellsthe long-term energy storage system for the body. This new research indicates that for the obese, the switch to convert brown cells to white flipped on all the timeand it doesnt turn off even while eating. (Here are ways to tell if your weight could be a problem.) This in turn, causes less energy usage and leads to weight gain, Tony Tiganis, PhD and study author explained to Science Daily. As a consequence, browning is turned off all the time and energy expenditure is decreased all the time, so when you eat, you dont see a commensurate increase in energy expenditureand that promotes weight gain, Dr. Tiganis said.

Dr. Tiganis hopes that with further research it might be possible to inhibit the switch mechanism in some way and cause our bodies to lose weight instead of gaining it. Obesity is a major and leading factor in overall disease burden worldwide and is poised, for the first time in modern history, to lead to falls in overall life expectancy, he said. What our studies have shown is that there is a fundamental mechanism at play that normally ensures that energy expenditure is matched with energy intake. When this is defective, you put on more weight. Potentially we may be able to rewire this mechanism to promote energy expenditure and weight loss in obese individuals. But any potential therapy is a long way off.

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Your Body Has a Brain Switch to Burn Fat after EatingHere's How It Works - Reader's Digest

Any kind of addiction needs both medical and behavioral interventions. Obesity even today is not commonly looked upon as a disease. People who have weight issues are not treated well and often made fun off. As with the most chronic diseases it is important that obesity is also treated with care and proper involvement of health professionals. Obesity is not only an epidemic it may even be considered as an addiction which is very difficult to get rid of. Obesity management needs all sorts of intervention from drugs to diet to exercise to surgery to behavioral support. Although studies done so far have no conclusive outcome on behavior being a modality for reasonable and sustainable weight loss but further studies in this direction will definitely show the way.

Endocrine Society released new guidelines on the treatment of obesity which includes the following:

1. Diet, exercise, and behavioral modification to be a part of all obesity management protocols.

2. Obesity management to be followed for anyone with Body Mass Index (BMI) of 25 kg/m 2 or higher.

3. Drugs may be used in patients where weight loss routine adherence is an issue.

4. To make weight loss doable and to promote long-term weight maintenance, approved weight loss medication can be used.

5. Anti-diabetic medications that promote weight loss (such as Glucagon-Like Peptide-1 [GLP-1] analogs or Sodium-Glucose-Linked Transporter-2 [SGLT-2] inhibitors should be used for obese diabetics.

6. In hypertensive patients use of Angiotensin-Converting Enzyme (ACE) inhibitors, Angiotensin Receptor Blockers (ARBs), and calcium channel blockers are preferred.

7. Oral contraception recommended over injectables in women with a BMI of 27 kg/m 2 or more.

With these guidelines, recently a study published in Preventive Medicine, looked at the role of behavioral intervention to manage obesity. This study looked at research published in the month of February 2016 across various databases and identified twelve studies representing 1862 participants with a mean BMI of 37.5-48.3 kg/m 2 and a mean age of 30-54 years. The study looked at both behavioral and pharmacological interventions both together and independently. The evaluated data was not able to clearly establish the relationship of behavioral intervention as a sustainable modality in reducing weight over a period of 12 months. The authors of this study suggest a more scalable study on interventions in weight management to be undertaken. In such a situation where obesity is becoming a real challenge to mankind we really need to broaden our understanding of this condition and tackle it effectively so that those suffering because of this can lead a healthy and better lifestyle.

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Obesity- The new addiction - Times of India

One in five patients who undergo one of the most popular weight-loss surgical procedures is likely to develop problems with alcohol, with symptoms sometimes not appearing until years after their surgery, according to one of the largest, longest-running studies of adults who got weight-loss surgery.

The finding reported online in Surgery for Obesity and Related Diseases, the journal of the American Society for Metabolic and Bariatric Surgery indicates that bariatric surgery patients should receive long-term clinical follow-up to monitor for and treat alcohol use disorder, which includes alcohol abuse and dependence.

We knew there was an increase in the number of people experiencing problems with alcohol within the first two years of surgery, but we didnt expect the number of affected patients to continue to grow throughout seven years of follow-up, said lead author Wendy C. King, associate professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.

She and her team discovered that 20.8 percent of participants developed symptoms of alcohol use disorder within five years of Roux-en-Y gastric bypass (RYGB). In contrast, only 11.3 percent of patients who underwent gastric banding reported problem alcohol use.

Starting in 2006, King and her colleagues followed more than 2,000 patients participating in the National Institutes of Health-funded Longitudinal Assessment of Bariatric Surgery-2, a prospective observational study of patients undergoing weight-loss surgery at one of 10 hospitals across the U.S.

RYGB, a surgical procedure that significantly reduces the size of the stomach and changes connections with the small intestine, was the most popular procedure, with 1,481 participants receiving it.

The majority of the remaining participants, 522 people, had a less invasive procedure laparoscopic adjustable gastric banding where the surgeon inserts an adjustable band around the patients stomach, lessening the amount of food the stomach can hold. That procedure has become less popular in recent years because it doesnt result in as much weight loss as RYGB.

Both groups of patients increased their alcohol consumption over the seven years of the study; however, there was only an increase in the prevalence of alcohol use disorder symptoms, as measured by the Alcohol Use Disorders Identification Test, following RYGB. Among patients without alcohol problems in the year prior to surgery, RYGB patients had more than double the risk of developing alcohol problems over seven years compared to those who had gastric banding.

Because alcohol problems may not appear for several years, it is important that doctors routinely ask patients with a history of bariatric surgery about their alcohol consumption and whether they are experiencing symptoms of alcohol use disorder, and are prepared to refer them to treatment, King said.

The American Society for Metabolic and Bariatric Surgery currently recommends that patients be screened for alcohol use disorder before surgery and be made aware of the risk of developing the disorder after surgery. Additionally, the society recommends that high-risk groups be advised to eliminate alcohol consumption following RYGB. However, given the data, King suggests that those who undergo RYGB are a high-risk group, due to the surgery alone.

The LABS-2 study was not designed to determine the reason for the difference in risk of alcohol use disorder between surgical procedures, but previous studies indicate that, compared with banding, RYGB is associated with higher and quicker elevation of alcohol in the blood. Additionally, some animal studies suggest that RYGB may increases alcohol reward sensitivity via changes in genetic expression and the hormone system affecting the areas of the brain associated with reward.

In addition to RYGB, the LABS-2 study identified several personal characteristics that put patients at increased risk for developing problems with alcohol, including being male and younger, and having less of a social support system. Getting divorced, a worsening in mental health post-surgery and increasing alcohol consumption to at least twice a week also were associated with a higher risk of alcohol use disorder symptoms.

King and her team found that although RYGB patients were nearly four times as likely to report having received substance use disorder treatment compared with banding patients, relatively few study participants reported such treatment. Overall, 3.5 percent of RYGB patients reported getting substance use disorder treatment, far less than the 21 percent of patients reporting alcohol problems.

This indicates that treatment programs are underutilized by bariatric surgery patients with alcohol problems, King said. Thats particularly troubling given the availability of effective treatments.

Adolescent and young women may have increased chance of disrupted menstrual patterns after a concussion, according ...

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Alcohol May Become Problem For Weight-loss Surgery Patients - Wheeling Intelligencer

KARE 11 Staff , KARE 12:38 PM. CDT August 17, 2017

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While it is important for people of all ages to pay attention to their bodies year-round, the stats show that men are not taking their health as seriously as women. But they should.

In fact, men are 24 percent less likely to visit the doctor for regular check-ups than women. Additionally, they are 22 percent more likely than women to neglect their cholesterol tests. Thats a key reason why men suffer heart attacks more frequently in their 50s than women.

Larry Richmond, MD, is a family medicine doctor withPark Nicollet Clinic in Plymouth. He has some practical, easy tips to help men stay healthy, and warns of potentially dangerous warnings that should be checked out.

Why are men less likely to make regular visits to the doctor?

Dr. Richmond: That is a great question. For some who are in good health, they may not think it is necessary. But the reality is that men of every decade need routine checkups. There are conditions that should potentially be checked.

Another reason could be the comfort factor. Maybe they arent comfortable with the idea of getting an exam or a blood draw. Or maybe they have the dread factor, thinking they are going to learn some bad news or get a lecture. That couldnt be further from the truth. We are not here to make people feel bad; we want to help you stay healthy.

What is the number one condition that men are most likely to ignore?

Dr. Richmond: Heart disease is the No. 1 killer of men. Unfortunately, it can affect men in their 40s and younger. The good news is that it can be prevented.

Cancer takes the No. 2 spot, and there are also important screening tests based on age and family history for this.

What are some of the warning signs for heart disease?

Dr. Richmond: People who smoke, dont exercise, have a family history of heart disease, have high blood pressure, or have unhealthy cholesterol or blood sugar levels are all at highest risk. I highly recommend having a physical exam to assess for these risks. Chest pain and difficulty breathing can be signs of current heart disease. I recommend being seen as soon as possible for any chest symptoms.

What types of things can men do to combat these symptoms?

Dr. Richmond: To start, weight management is key. Dont get caught up with shortcuts like energy drinks or weight loss supplements. These have no benefit, and can actually cause health issues like unhealthy heart rhythms. Instead, keep it basic: focus on portions, and stick with sustainable and very specific exercise goals.

The idea of eliminating your favorite foods long-term just isnt realistic. On top of that, Ive had many patients who get going on a commercial weight loss program, or jump into a temporary 60-day challenge program, lose the weight, but end up gaining it all back.

Lifestyle choices are the key to success. Everything in current medical literature suggests that being a non-smoker, active and maintaining a healthy body weight is the best way to minimize heart disease, diabetes, stroke, kidney disease, and even anxiety and depression.

Another condition men are often concerned with but are nervous to ask about is low testosterone. Is this something you can talk about during a regular check-up?

Dr. Richmond: Absolutely. However, the first thing you should know is that routine or baseline testing for low testosterone isnt necessary. Most men do not have low testosterone. There are medications that can help treat this, but there are risks associated with these treatments. Honestly, avoiding alcohol and maintaining a healthy body weight are two easy ways you can combat this.

Find a primary care doctor at:

HealthPartnersInternal MedicineorFamily Medicine

Park NicolletInternal MedicineorFamily Medicine

Stillwater Medical GroupInternal MedicineorFamily Medicine

HealthPartners Central Minnesota Clinic

Hudson Hospital & Clinic

Westfields Hospital & Clinic

Amery Hospital & Clinic

2017 KARE-TV

Read the original post:
Real Men Wear Gowns: Why men aren't taking their health seriously - KARE

Theres a group of people who suffer from what Id call serial get-out-of-debt disorder.

I know its a mouthful, but its a real condition for folks who find themselves stuck in a cycle of getting in and out of debt.

This ailment typically affects people who live above their means. One long-term effect of this ailment is the inability to save enough for emergencies, retirement or sending children to college without incurring more debt.

Here is how you can tell if you have this disorder:

You stay in debt, mostly with credit cards. But it could also include personal loans or frequent borrowing from your retirement plan.

You are rarely without a car loan. You repeatedly trade in your car for an upgrade because you feel entitled. Or because youre tired of fixing your car even though the repairs are still far less expensive than buying another vehicle new or used.

You feel remorse about amassing more debt than you can handle.

Your regret creates anxiety, weight loss or weight gain. You cant sleep at night.

If youre married, you fight about the debt with your spouse, putting a strain on your marriage which can manifest in more spending.

You cant take the stack of bills anymore, and you declare that youre ready to be healed.

You hunker down, aggressively cut expenses and maybe even get another job or work more hours to get out of debt.

You finally pay off the consumer debt. Youre in remission. But because you havent dealt with why you got into debt, youre right back in trouble.

[The economic impact of racism]

During a recent online chat, I received a plea for advice from a reader suffering from this condition.

I am in debt. Again, the person wrote. I promised myself it wouldnt happen again after I filed for bankruptcy in 2000, but 17 years later Im back in debt.

The reader says this time the debt is moderate. Shes got $10,000 in credit card debt, which includes charges for car repairs and utility bills.

My mortgage is behind by one month, she wrote. I have steady income, but its just my income, as my husband is an entrepreneur and companies have started paying when they want, which is not on time.

To alleviate their symptoms, sufferers often turn to a common cure.

I am considering asking a family member to co-sign or obtain a loan for me to cover the debt so I can have one bill, the reader wrote. The $10,000 loan would put me at zero debt other than that loan and student loans. Freeing up money would maybe help get me back on track.

So her question to me: Does this make sense? I know I wont default/mess up the family member. I cant get a loan on my own.

[Ways to tame your finances]

Heres the regimen of treatment I recommend for this disorder:

Diagnose why you keep getting into debt. In this case, it could be the unpredictable payments to her husbands business. The Small Business Administration has resources to help. On its website, http://www.sba.gov, search for this blog post: 4 Ways to Better Manage Irregular Income.

But if the earnings from her husbands entrepreneurial enterprise are continually inadequate to meet this couples household needs, then perhaps he could take on another job. Or maybe self-employment isnt working, which is why they are using credit to make ends meet.

Get help. The reader said, Ive learned my lesson, really.

But have you? Really?

If income isnt the issue, you may need therapy if your spending is a symptom of psychological issues. Maybe you need to deal with childhood trauma. Perhaps you spend more when youre under a lot of stress. And when the stress is gone, you clear up your debt. But when it returns, you go back to shopping as a relief.

If its just an aversion to budgeting, get help from a nonprofit credit-counseling agency. To find a local agency, go to the National Foundation for Credit Counselings website: nfcc.org. The agency can also help you negotiate with creditors and set up a debt payment plan.

Dont put a Band-Aid on the problem by dragging in friends or relatives.No, you should not ask a family member to co-sign a loan. You will be putting his or her financial health on the line. Besides, in my experience, when people get a consolidation loan, they get a false sense of financial freedom. The zero balances on their credit cards are too tempting.

Unless you address the root cause of your serial get-out-of-debt disorder and take steps to prevent its reoccurrence, this condition wont be cured.

Read more:

Why youre more likely to have a prenup than your parents were

Why you need to hit pause on your busy work life

This one mistake can cost millennials millions

Is there a freeloader living in your home? Set some ground rules.

Go here to read the rest:
Are you plagued by the serial get-out-of-debt disorder? - Washington Post

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