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While diet, exercise and behavior modification are essential components of obesity management, a successful long-term weight loss strategy should also include avoiding or minimizing medication-related weight gain, according to a new report from Weill Cornell Medicine.

The paper was published Feb. 10 in Gastroenterology.

Researchers from the Comprehensive Weight Control Center at Weill Cornell Medicine underscore the necessity for physicians to evaluate the potential side effects and interactions of medications they prescribe for patients with obesity.

Physicians know that some medications can increase weight, but they dont always know what alternatives are out there, said lead author Dr. Leon Igel, an assistant professor of clinical medicine in the Division of Endocrinology, Diabetes and Metabolism at Weill Cornell Medicine.

We want physicians who treat patients with obesity to feel more comfortable prescribing these alternatives. Our paper looks at how to practically manage patients with obesity by prescribing the optimal medications for them.

Numerous factors contribute to obesity and the bodys inability to shed excess weight, including commonly used medications such as steroids or contraceptives.

Additional impediments to weight loss may include medications such as insulin, metoprolol and paroxetine, which are vital for treating, respectively, diabetes, hypertension and depression chronic conditions that are common among people with obesity.

However, a patients weight loss desire does not typically guide a physicians prescribing practices. Each practitioner has a goal in mind, Dr. Igel said.

A cardiologist wants to lower blood pressure. A psychiatrist wants to make sure that mood is well regulated. Theyre not necessarily focusing on which medications will affect weight, but rather what will achieve their treatment goal.

It is essential, therefore, that internists and other physicians be aware of what medications their patients are taking and how they are likely to interact; recognizing when they can prescribe one medication as a substitute for another, or pair a medication that causes weight gain with one that minimizes its effect.

Not everyone can be taken off insulin, Dr. Igel said. But some patients might be able to couple insulin with other agents that promote weight loss to neutralize insulins effect on weight.

Obesity, which is defined as a body mass index of greater than or equal to 30, affects approximately one-third of all Americans.

Taking multiple medications to manage chronic conditions is common among this population. Less common is the use of dedicated weight loss medication, which many insurers do not cover, and few physicians are trained to prescribe.

Still, physicians should know which patients would be optimal candidates for each weight loss medication, and when certain weight loss medications should be avoided, Dr. Igel said.

For example, patients with uncontrolled hypertension, coronary disease, hyperthyroidism, or glaucoma should not take phentermine, an appetite suppressant that is also a stimulant.

We wanted to provide extra guidance, so that practitioners are using the right types of medications for the right types of patients, Dr. Igel said.

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News source: Weill Cornell Medicine. The content is edited for length and style purposes. Figure legend: This Knowridge.com image is credited to Weill Cornell Medicine.

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Avoiding drugs that promote weight gain when managing obesity ... - Knowridge Science Report

February 14, 2017

While diet, exercise and behavior modification are essential components of obesity management, a successful long-term weight loss strategy should also include avoiding or minimizing medication-related weight gain, according to a new report from Weill Cornell Medicine.

In the paper, published Feb. 10 in Gastroenterology, investigators from the Comprehensive Weight Control Center at Weill Cornell Medicine underscore the necessity for physicians to evaluate the potential side effects and interactions of medications they prescribe for patients with obesity, and to familiarize themselves with alternatives that may limit weight gain or may even assist with weight loss.

"Physicians know that some medications can increase weight, but they don't always know what alternatives are out there," said lead author Dr. Leon Igel, an assistant professor of clinical medicine in the Division of Endocrinology, Diabetes and Metabolism at Weill Cornell Medicine. "We want physicians who treat patients with obesity to feel more comfortable prescribing these alternatives. Our paper looks at how to practically manage patients with obesity by prescribing the optimal medications for them."

Numerous factors contribute to obesity and the body's inability to shed excess weight, including commonly used medications such as steroids or contraceptives. Additional impediments to weight loss may include medications such as insulin, metoprolol and paroxetine, which are vital for treating, respectively, diabetes, hypertension and depression - chronic conditions that are common among people with obesity.

However, a patient's weight loss desire does not typically guide a physician's prescribing practices. "Each practitioner has a goal in mind," Dr. Igel said. "A cardiologist wants to lower blood pressure. A psychiatrist wants to make sure that mood is well regulated. They're not necessarily focusing on which medications will affect weight, but rather what will achieve their treatment goal."

It is essential, therefore, that internists and other physicians be aware of what medications their patients are taking and how they are likely to interact; recognizing when they can prescribe one medication as a substitute for another, or pair a medication that causes weight gain with one that minimizes its effect. "Not everyone can be taken off insulin," Dr. Igel said. But some patients might be able to couple insulin with other agents that promote weight loss to neutralize insulin's effect on weight.

Obesity, which is defined as a body mass index of greater than or equal to 30, affects approximately one-third of all Americans. Taking multiple medications to manage chronic conditions is common among this population. Less common is the use of dedicated weight loss medication, which many insurers do not cover, and few physicians are trained to prescribe. Still, physicians should know which patients would be optimal candidates for each weight loss medication, and when certain weight loss medications should be avoided, Dr. Igel said. For example, patients with uncontrolled hypertension, coronary disease, hyperthyroidism, or glaucoma should not take phentermine, an appetite suppressant that is also a stimulant. "We wanted to provide extra guidance, so that practitioners are using the right types of medications for the right types of patients," Dr. Igel said.

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New USC research finds that children with asthma were 51 percent more likely to become obese over the next decade compared to kids who did not have asthma.

Researchers at the Center for BrainHealth at The University of Texas at Dallas have found a link between having an impulsive personality and a high body mass index (BMI).

A study from the University of Aberdeen has found that mothers' weight gain in pregnancy is not linked to increased risk of premature death in their adult children.

University of Alabama at Birmingham researchers are trying to find out whether changing a person's eating schedule can help them lose weight and burn fat.

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Avoiding medications that promote weight gain when managing obesity - Medical Xpress

MANCHESTER, NH--(Marketwired - February 14, 2017) - Following a healthy diet can be difficult, even with the surplus of weight loss options available in the market. Identifying harmful dietary habits and avoiding certain types of foods is a struggle for most individuals, despite easy accessibility to diet plans. Even though many dieters successfully lose weight in the short-term, the chances of consistent weight loss or weight loss retention for 5 years or more is as low as 5%. Emotional eating and inactive lifestyles make weight loss even more challenging.

The Mediterranean Diet, regularly praised as one of the healthiest diets out there, has helped many individuals lose weight consistently. It involves following a balanced regimen of high amounts of olive oil, legumes, unprocessed cereals, fruits and vegetables; moderate amounts of fish, dairy, and wine; and restricted consumption of non-fish meat or meat products. It offers many benefits such as reducing health issues like heart disease and diabetes and improving brain function.

The Mediterranean Diet promotes healthy weight loss based on balancing protein, carbohydrate and fat consumption. One of the best things about this diet is its flexibility as it can be easily customized to an individual's health and nutritional needs. Nevertheless, it can be confusing to maintain a diet in the long-term, no matter how effective it may be in the short-term. It is, therefore, important to set habits that set dieters up for weight loss success in the long run. This is exactly what Diet Doc, a nationally recognized weight loss center, aims to help patients accomplish.

Diet Doc offers direct nutritional counseling and doctor-supervised diet planning to all patients. Adherence to the Mediterranean Diet is made possible by examining individual body composition, dietary needs and specific weight loss goals prior to dieting. At Diet Doc, the primary goal is to optimize fat loss with minimal muscle loss.

Simply pursuing a well-known diet like the Mediterranean Diet does not guarantee weight loss success. Long-term diet planning based on nutritional needs and changing lifestyle choices is crucial. At Diet Doc, a nationally recognized weight loss center, dieters are advised to pursue doctor supervision and nutritional customization instead of pursuing fad diets to "lose weight fast". Ideally, a diet should add currently lacking nutrients and eliminate foods that enhance weight gain. At Diet Doc, patients receive custom-designed weight loss programs and diet consulting. With a safe, doctor-supervised diet plan and guidance for life, Diet Doc patients gain the following benefits within the very first month:

Diet Doc programs and aids have a long history of alleviating issues like heart disease, high blood pressure and hypertension through healthy weight loss. With a team of doctors, nurses, nutritionists and motivational coaches, Diet Doc helps patients curb hunger and lose weight fast. In fact, more than 90% of Diet Doc patients lose 20 or more pounds every month.

Patients can get started immediately, with materials shipped directly to their home or office. They can also maintain weight loss in the long-term through weekly consultations, customized diet plans, motivational coaches and a powerful prescription program. With Diet Doc, the doctor is only a short phone call away and a fully dedicated team of qualified professionals is available 6 days per week to answer questions, address concerns and support patients.

Getting started with Diet Doc is very simple and affordable. New patients can easily visit https://www.dietdoc.com to quickly complete a health questionnaire and schedule an immediate, free online consultation.

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LinkedIn: https://www.LinkedIn.com/company/diet-doc-weight-loss?trk=biz-brand-tree-co-logo

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Diet Doc Nutritional Experts Help Mediterranean Diet Patients Achieve Long Term Weight Loss Success - Marketwired (press release)

Fitness coach Alan Williams has blasted TV shows and social media experts for causing the spread of unhealthy weight loss programmes.

He believes that some fitness professionals are exploiting people with unrealistic expectations and causing competition over who can generate the most rapid weight loss.

Fitness has become the cool thing. Its almost turned into a competition of who can look the best, said Williams, who is based in Sligo.

Alan Williams

We are being pressured into thinking we have to look or act a certain way to comply with societys expectations.

They (fitness professionals on TV and online) seem to be in a competition among themselves to see who can post the best stat online with their clients results.

Williams, who is one of Irelands leading fitness coaches, believes that people flaunting their dream bodies online can shame others and create unrealistic expectations.

He has warned that rapid weight loss can cause serious health issues, such as headaches, irritability, fatigue, dizziness, menstrual irregularities, hair loss, muscle loss and, in some cases, an increased risk of developing gallstones.

No client can safely lose more than two pounds a week, Williams added.

Im all for people getting in shape but it has to be done in a healthy way. Now things seem to be about losing weight in the quickest time possible. Whatever happened to training for health?

Getting in shape is as simple now as it was fifty years ago, because the truth doesnt change. What works long term is healthy eating and exercise. For sustainable weight loss, aim to lose on average 1 2lbs a week.

When clients feel like thats not enough for their efforts I always remind them that even losing one pound a week would leave them almost two stone lighter in six months time.

With every client I work with, I encourage them to set training and exercise goals. Take the focus off the scales. Try to enjoy your training and eating healthily. If you do that, everything else will take care of itself.

Williams is hosting a Change Your Own World seminar at the Landmark Hotel in Carrick-on-Shannon, Co Leitrim, on Wednesday, February 22 at 8pm. The seminar will cover healthy eating, exercise, mindset and motivation. See: http://www.alanwilliamscoaching.com.

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Fitness coach slams professionals who promise rapid weight loss plans - Irish Examiner

The first thing I should make clear is that there is no one-glove-fits-all approach to nutrition for sustainable weight loss. Despite some bold marketing campaigns from some of the big players in the health industry, we must understand that weight loss takes commitment. It requires a deliberate, persistent effort to curate a lifestyle which is individualised to you and your circumstances. Over the next few paragraphs, I hope to provide some useful tips on how the available science suggests we eat and train to successfully lose weight for the long term.

The BMR equation is not an exact science and I am not suggesting that you count the number of calories in everything you eat for the rest of your life. Rather, it serves as a starting point from which to begin a weight loss programme, as having a rough idea of how many calories are in each meal will enable you to regulate portion size and macronutrient ratios. Over time you will develop your knowledge around food, and more importantly, which food groups offer superior nutritional quality over others.

Rather, nutritionists and experts are suggesting that diets rich in dietary fats and low in carbohydrates are closely associated not only with sustained weight loss but reduced inflammation and blood sugar control, too.

Adopting a low-carb and high fat diet is slightly more onerous than it sounds. How much is low, and how much is high? In relation to the meta-analyses referenced above, the studies examined categorised low carbohydrate intake as between 33-47 per cent of total daily intake. High fat intake is not so well defined but a Mediterranean diet which is rich in olive oil, fish and nuts is consistently shown to reduce fasting glucose levels, improve total cholesterol values and improve blood pressure.

Despite having a relatively limited amount of conclusive evidence to support boycotting conventional dietary advice, it is clear that the UK government guidelines are not working. Nutrition and cardiology experts such as Tim Noakes, Gary Taubes and Aseem Malhotra are continually presenting a case for reducing carbohydrate intake and increasing our fat consumption by including butter, full fat dairy, oily fish and meat in our meals.

From my experience in working with clients who wish to lose weight, here are some simple guidelines to encourage sustainable weight loss in 2017.

Plan Your Meals Taking the time to plan what you are going to eat 24 hours ahead can help you to make the correct choices when it comes to meal time. Before training you may want a light snack and afterwards your body would benefit from eating a quality source of protein. Planning these meals reduces the likelihood of getting distracted and picking at the biscuits in the office.

Remove refined carbohydrates gradually An unprocessed, balanced diet of meat, fish, fruit, legumes, nuts, seeds and pulses will help to regulate our cells and hormones. Reducing your refined carbohydrate intake will help to maintain a stable blood sugar level and moderate energy. Gradually removing them over time will reduce the feeling of depravity.

Eat colourfully Eating a colourful plate of food is always an indication that your meal will be rich in phytochemicals, vitamins and minerals.

Eat protein with every meal Protein is the nutrient behind healthy muscle tissue. Good quality sources of protein come from meat, fish, lentils, beans and dairy.

Dont be scared of fat Vitamins A, D, E and K are fat soluble vitamins. This means that we are unable to produce them within our body and must ingest them through diet or supplementation. Dietary fat improves cell health, bone strength and regulates hormones. Sources of recommended dietary fat comes from Avocados, olive oil, oily fish and nuts.

Train regularly and lift weights Maintaining muscle mass and increasing BMR should be the focus of your training programme. Research into the benefits of high intensity interval training show that you can reap the rewards of long duration steady state exercise in half the time if completed at the correct intensity. When working the main muscle groups of your body in the gym (legs, chest, back and shoulders), opt for a high number of repetitions (12-15) with a medium weight.

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The weight loss diet plan that's realistic and sustainable - GQ.com

New York Times

Why Weight Loss Surgery Works When Diets Don't New York Times In reviewing studies that followed patients for five to 25 years after weight-loss surgery, Dr. Twells and colleagues found major long-lasting benefits to the patients' health and quality of life. Matched with comparable patients who did not have ... New Developments in Gastric Bypass SurgeryWeight Loss Surgery Channel UAE doctors suggest insurers to cover weight-loss surgeryThe Filipino Times (press release) all 42 news articles »

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Why Weight Loss Surgery Works When Diets Don't - New York Times

Avoiding medications that promote weight gain when managing obesity Science Daily While diet, exercise and behavior modification are essential components of obesity management, a successful long-term weight loss strategy should also include avoiding or minimizing medication-related weight gain, according to a new report from Weill ... and more »

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Avoiding medications that promote weight gain when managing obesity - Science Daily

A surgery developed at East Carolina University that can put an end to insulin shots for patients with diabetes has been recognized as a "standard of care" for some patients with the chronic disease.

More than 20 years after Dr. Walter Pories published evidence that a type of bariatric, or weight-loss, surgery led to a long-term remission of diabetes symptoms, the official journal of the American Diabetes Association, Diabetes Care, has said the operation should be considered a way to treat type 2 diabetes in patients who are obese.

"The thought was always that diabetes was an incurable, progressive disease, but with a fairly simple operation that takes about an hour, you can cure it," said Pories, the founding chair of the Department of Surgery at ECU's Brody School of Medicine. "We found that diabetes disappears completely between two to four days after surgery."

Type 2 diabetes is a long-term metabolic disorder characterized by high blood sugar, insulin resistance and a relative lack of insulin. Long-term complications include heart disease, stroke, blindness, kidney failure and poor circulation, which can result in limb amputation. It generally occurs as a result of obesity and not enough exercise, according to the National Institute of Diabetes and Digestive and Kidney Diseases and the World Health Organization.

In eastern North Carolina, 11 percent of the population suffers from diabetes, surpassing state and national averages. According to the ADA, 1.4 million people in the U.S. are diagnosed with diabetes every year.

"It's an epidemic here, and it's my belief that we have one of the highest diabetes rates in the United States," Pories said in an interview this month with Public Radio East.

It affects African-Americans, who make up 22 percent of the state's population, at a rate 1.7 times greater than non-Hispanic whites, according to the American Diabetes Association. And a quarter of all people with diabetes don't know they have it, says the National Institutes of Health.

But two decades ago, Pories found his work with a type of weight-loss surgery that creates a small stomach pouch and reroutes the small intestine to it pointed to a remission of diabetes.

Beginning in 1980, the outcomes of 837 patients who had weight-loss surgery at Pitt County Memorial Hospital, now Vidant Medical Center, were meticulously recorded and studied by a group of ECU physicians led by Pories. In 1995, he was the first to report hard evidence that diabetes was no longer a hopeless disease but could be reversed by bariatric surgery.

"It was met with resistance and disbelief, especially when it became apparent that the 'Greenville gastric bypass' operation pioneered by Pories also reversed hypertension, decreased the prevalence of cancer and improved other health issues," said Dr. Betsy Tuttle-Newhall, chair of the ECU Department of Surgery.

Gastric bypass is now established as an effective and safe therapy for morbid obesity and its associated conditions. And no other therapy has produced such durable and complete control of diabetes mellitus.

Pories, 87, is still on the faculty at ECU's Brody School of Medicine, where he is involved in diabetes research and serves as a professor of surgery, biochemistry and kinesiology. He was recently honored as an "Icon in American Surgery" by the American College of Surgeons for his work. Pories is the first North Carolina surgeon to receive this honor.

Peter Makuck to read at ECU

Longtime eastern North Carolina resident Peter Makuck will present a public reading from his poetry and fiction on Wednesday, Feb. 15 at 7:30 p.m. in ECUs Bate building, room 1026.

Makuck, distinguished professor emeritus, taught English and creative writing at ECU from 1978 until his retirement in 2006. Founder of the internationally acclaimed literary journal Tar River Poetry, he also is the author of eight books of poetry and four collections of short stories, including one of each published in 2016.

Makuck grew up in New London, Conn., and has a doctorate in American literature from Kent State University. He has been a Fulbright Exchange Professor at Cambery, France, and a visiting writer at Brigham Young University and N.C. State University. He and his wife, Phyllis, live on Bogue Banks.

Five Makuck short stories have received honorable mentions in the Best American Short Stories collections, and a personal essay on guns was named a Best Essay of 2000. For poetry, he has received the Zoe Kincaid Brockman Award for best book of poems by a North Carolinian.

The reading is sponsored by ECU's Department of English. Admission is free and open to the public.

Upcoming events

Thursday: Reception, Desegregating Health Care in Eastern North Carolina, 4:30-6:30 p.m., Laupus Library Fourth Floor Gallery. An exhibit celebrating Dr. Andrew A. Best and Dr. Milton D. Quigless and their work to dissolve racial barriers in eastern N.C.s health care centers.

Thursday: Reception, Tenth Photographic Image Biennial Exhibition, 5 p.m., Speight Auditorium and Wellington B. Gray Gallery. A national juried exhibition of photographic images on display through March 3.

Saturday: Spring Day of Dance, 7:45 a.m. to 2 p.m., Messick Theatre Arts Center. Classes in ballet, modern, jazz and tap designed for ages 10-11, 12-13 and 14+. Contact galaskat@ecu.edufor more information.

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ECU Notes: Journal: Weight-loss surgery should be a standard of care for some diabetes - Greenville Daily Reflector

UPMC Hamot patient lost about 140 pounds after going back for second surgery.

CAMBRIDGE SPRINGS Renee Hanby's gastric-band surgery was a success, at first.

The Cambridge Township woman lost almost 30 pounds in the first three months after bariatric surgery at UPMC Hamot in 2012, but then the weight loss stopped, a common experience for about half of gastric-band surgery patients.

It's an outcome that has led surgeons at Hamot and other hospitals around the country to rethink the types of bariatric surgery they perform.

"I got pregnant twice and had babies just one year and 21 days apart," said Hanby, 31. "By the end of the second pregnancy I weighed 252 pounds, the most I ever weighed. My doctors would tighten the belt but I still couldn't lose any weight."

Bariatric surgeries are done to help people lose large amounts of weight. The surgeries involve reducing the size of the stomach, bypassing part of the small intestine, or both.

Gastric-band surgery has been one of the most popular types of bariatric surgery because it is not as complex as the others and it can be easily reversed. But surgeons have discovered fewer patients, including Hanby, lost significant amounts of weight than patients who undergo other types of bariatric surgery.

A study published inGastroenterology Research and Practice showed that only 49 percent of patients who underwent gastric banding lost "excessive" weight, compared to 65 percent of patients who underwent gastric bypass surgery and 73 percent who underwent biliopancreatic diversion with duodenal switch the surgery with the highest weight-loss success rate.

"UPMC basically stopped doing gastric-band surgeries over the past three, four years," said Jawaid Kalim, M.D., a Hamot bariatric surgeon. "The studies of long-term success were not favorable, patients weren't losing as much weight, and there is a need for more intense follow-up than for other surgeries."

Kalim and his staff at Hamot worked with Hanby to reduce weight by adjusting her gastric band, but they agreed a second surgery would probably be more effective. In December 2015, she underwent what Kalim called a modified duodenal switch.

Instead of placing a gastric band around the stomach, Kalim removed more than 80 percent of Hanby's stomach and bypassed about half her small intestine. She would lose weight because it would take only a small amount of food to feel full, and her body wouldn't absorb as many nutrients and calories.

It is a more invasive surgery than gastric banding, but it does not require as much follow-up care, Kalim said.Hanby visits Kalim's office every six months now, instead of every two to three months after the gastric-band surgery.

The effect of the second surgery has been dramatic.

"I lost 100 pounds in just the first five months," Hanby said. "I now weigh about 110 pounds and went from a size 22 to a size zero. My cholesterol, which was originally almost 400, is now 140 without any medication and my A1C score (for diabetes) has improved."

In fact, Hanby said she is about 10 to 15 pounds underweight, and is having trouble gaining it back. Since she can only eat a small amount of food less than the size of her clenched fist at one sitting, she has to remember to frequently eat snacks in addition to her regular meals.

But her energy level is much higher than before the surgery. She can run around with her three children and two stepchildren all younger than 12 and still work around 50 hours a week with Youth Advocate Programs in Meadville.

Finding time to sleep is one of Hanby's biggest challenges.

"I try to catch up on my sleep on Saturdays," Hanby said with a smile. "Or when my youngest, Lakelynn, goes down for a nap, I nap, too."

Kalim recommends a second surgery for most gastric-band patients who have trouble losing weight, though he said a follow-up surgery can sometimes be more difficult.

"When patients undergo an initial surgery, their stomach, liver, spleen, everything is usually visible," Kalim said. "When you're doing a second surgery in that area, it's a completely different picture due to scarring."

Besides gaining some weight, Hanby's plan is to get stronger.

"I have lost a lot of muscle,"Hanby said. "I picked up Owen, my 3-year-old, and it's a struggle. But I am so glad I had this (second surgery) done. Otherwise I would be dead at an early age due to heart problems."

David Bruce can be reached at 870-1736 or by email. Follow him on Twitter at twitter.com/ETNbruce.

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Second bariatric surgery was key for Crawford County woman - GoErie.com

New Delhi: Eman Ahmed, the Egyptian woman believed to be the world's heaviest at 500kg, was recently flown in to Saifee hospital in Mumbai from Cairo to undergo a bariatric surgery to help her lose weight.

Doctors said Eman, who has already lost about 30kg in the last two months under the supervision of Dr Muffazal Lakdawala, still needs to lose another 100kg before undergoing the procedures.

Dr Lakdawala, who had himself travelled to Alexandria to assess Eman's health, is the founder of Centre for Obesity and Digestive Surgery CODS, Mumbai, and chairperson of Institute of Minimal Access Surgical Sciences and Research Centre, Saifee Hospital.

The team of doctors monitoring Eman, led by DrLakdawala, is expected to announce the further course of treatment today. According to surgeons, who have performed surgeries on similar obese patients, Eman's entire treatment could take as long as four years.

Here are some important facts you must know about bariatric surgery:

- Restrictive surgery This technique works by physically restricting the size of the stomach and slowing down digestion.

- Malabsorptive/restrictive surgery This is a more invasive surgery. In addition to restricting the size of the stomach, this procedure physically removes parts of the digestive tract, interfering with absorption of calories

- Internal bleeding or excessive bleeding

- Infection

- Blood clots

- Lung or breathing problems

- Leaks in gastrointestinal system

- Adverse reactions to anesthesia

- Gallstones

- Death (rare)

People who have had weight loss surgery need to make to a rigorous and lifelong changes to their lifestyle a carefully controlled diet, regular exercise - to avoid putting weight back on or long-term complications.

Although bariatric surgery provides many benefits, experts recommend that people should opt for a healthy, calorie-controlled diet and regular exercise to lose weight.

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Eman Ahmed, world's heaviest woman, in Mumbai for bariatric surgery: What to expect from weight loss surgery - Zee News

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