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  #1   ^
Old Wed, Aug-07-19, 06:57
teaser's Avatar
teaser teaser is offline
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Default bariatric surgery mimicking hormone injection

https://www.sciencedaily.com/releas...90806101531.htm


Quote:
The findings came from a small study in which patients lost on average 4.4kg and the treatment led to substantial improvements to their blood glucose, with some patients' reducing to near-normal levels.

Obesity is a common problem in the UK and it is estimated that one in four adults are obese.

One of the most common types of weight loss surgery is a procedure known as gastric bypass surgery, which can be very effective in keeping excess weight off and improving blood sugar levels in diabetics. However, some patients decide against surgery and the procedure can cause complications such as abdominal pain, chronic nausea, vomiting and debilitating low blood sugar levels.

Previous research by Imperial College London suggested that one of the reasons why gastric bypass surgery works so well is because three specific hormones originating from the bowels are released in higher levels. This hormone combination, called 'GOP' for short, reduces appetite, causes weight loss and improves the body's ability to use the sugar absorbed from eating.

Researchers wanted to see if infusing patients with the GOP hormones glucagon-like peptide-1 (GLP-1), oxyntomodulin and peptide, to mimic the high levels seen after surgery, could aid weight loss and reduce high glucose levels.

Fifteen patients were given the GOP treatment for four weeks using a pump that slowly injects the GOP mixture under the skin for 12 hours a day, beginning one hour before breakfast and disconnecting after their last meal of the day. Patients also received dietetic advice on healthy eating and weight loss from a dietician.

Professor Tricia Tan, Professor of Practice (Metabolic Medicine & Endocrinology) at Imperial College London and lead author of the study, said:

"Obesity and type 2 diabetes can lead to very serious and potentially life-threatening conditions such as cancer, stroke and heart disease. There is a real need to find new medicines so we can improve and save the lives of many patients. Although this is a small study our new combination hormone treatment is promising and has shown significant improvements in patients' health in only four weeks. Compared to other methods the treatment is non-invasive and reduced glucose levels to near-normal levels in our patients."

The work, published in Diabetes Care and presented at the American Diabetes Association 79th Scientific Sessions meeting at San Francisco, took place at Imperial College London in collaboration with University of Copenhagen and University College Dublin. The treatment was trialled on patients at the National Institute for Health Research Imperial Clinical Research Facility at Hammersmith Hospital, part of Imperial College Healthcare NHS Trust.

Twenty-six obese patients with prediabetes (when blood glucose is too high but not high enough to be classified as diabetes) and those with diabetes were recruited to the study at Hammersmith Hospital from July 2016 to October 2018. Fifteen patients were randomly selected to receive the hormone treatment and 11 patients were given a saline (salt water) infusion as a placebo over a four-week period. The team also recruited 21 patients who had undergone bariatric surgery and 22 patients who followed a very low-calorie diet to compare the results of GOP. All patients were given a glucose monitoring device to track their glucose levels following treatment.

In the trial, patients on the GOP treatment lost an average of 4.4kg, compared with 2.5kg for participants receiving a saline placebo. The treatment also had no side effects.

However, patients who received bariatric surgery or who followed a very low calorie diet lost significantly more weight than GOP patients. The changes in weight were 10.3kg for bariatric patient and 8.3kg for patients who followed a very low calorie diet.

Professor Tan commented: "Although the weight loss was smaller, using the GOP infusion would be preferable as it has fewer side effects than bariatric surgery. This result shows that it is possible to obtain some of the benefits of a gastric bypass operation without undergoing the surgery itself. If further trials are successful, in future we could potentially give this type of treatment to many more patients."

The team also found that GOP was capable of lowering blood glucose levels to near-normal levels, with little variation in the blood glucose. Patients who received bariatric surgery also had an overall improvement in blood glucose, but the levels were much more variable, leaving them vulnerable to low blood glucose levels.

The team aim to carry out a larger clinical trial to assess the impact of GOP on more patients over a longer period of time.

The research was funded by the UK Medical Research Council (MRC) and the NIHR Imperial Biomedical Research Centre.

This research is an example of the work carried out by Imperial College Academic Health Science Centre, a joint initiative between Imperial College London and three NHS hospital trusts. It aims to transform healthcare by turning scientific discoveries into medical advances to benefit local, national and global populations in as fast a timeframe as possible.

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  #2   ^
Old Wed, Aug-07-19, 07:48
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Calianna Calianna is online now
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Quote:
However, patients who received bariatric surgery or who followed a very low calorie diet lost significantly more weight than GOP patients. The changes in weight were 10.3kg for bariatric patient and 8.3kg for patients who followed a very low calorie diet.

Professor Tan commented: "Although the weight loss was smaller, using the GOP infusion would be preferable as it has fewer side effects than bariatric surgery. This result shows that it is possible to obtain some of the benefits of a gastric bypass operation without undergoing the surgery itself. If further trials are successful, in future we could potentially give this type of treatment to many more patients."


So bariatric surgery, a very low calorie diet, and their shiny new hormone injections are the ONLY choices to lose weight and lower blood sugar?
Which to choose, which to choose, which to choose.... such a difficult decision...

Oh I know, I'll just stick to LC! No surgery, no injections, and no constant hunger or feeling like I'm going to pass out from starving myself on very low calories!



And no side effects, other than increased energy, thinking more clearly, and decidedly decreased hunger!
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  #3   ^
Old Wed, Aug-07-19, 07:53
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Ms Arielle Ms Arielle is offline
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Calianna, you said it sooooo well!
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  #4   ^
Old Wed, Aug-07-19, 07:57
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GRB5111 GRB5111 is offline
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Interesting study.
Quote:
Professor Tan commented: "Although the weight loss was smaller, using the GOP infusion would be preferable as it has fewer side effects than bariatric surgery. This result shows that it is possible to obtain some of the benefits of a gastric bypass operation without undergoing the surgery itself. If further trials are successful, in future we could potentially give this type of treatment to many more patients."

Certainly GOP infusion would have fewer side effects than bariatric surgery. Bariatric surgery is a brute-force approach that causes trauma to the body and metabolism, and the reasonable assumption that the high rate of GOP in those patients after surgery is a response to the trauma.

So, my question: why infuse patients with something that is a response to trauma when better results were achieved in the trial for those on a "low calorie" protocol? I'm not going to quibble over what constitutes "low calorie," and I don't believe that cutting calories is the only answer to weight loss; however, the results prove that simple lifestyle changes enabling patients to avoid the trauma of surgery or even avoid "trauma mimicking" infusions without surgery is the preferable solution that isn't being recognized here. People are always looking for the "easy button" enabling a continued pursuit of the very lifestyle habits that got them into health trouble in the first place. While this study is informative, the article ignores the group with the most important outcome.

Final thought: I see a time when we look back at bariatric surgery with horror when it's considered to be in the same category as shock treatment, lobotomies, and leeches. We can certainly do better than this with our fellow humans.
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  #5   ^
Old Wed, Aug-07-19, 08:13
teaser's Avatar
teaser teaser is offline
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Weight loss wasn't much more than those given saline solution as placebo. They don't say what the blood glucose effects were for the saline solution, but it sounds like maybe those were the more significant effects.

I wonder about the glucose monitoring device. Hopefully it just tracked their glucose, and gave the patients no information on their own glucose levels. That might have an effect on what people eat. Also knowing that you're in a study with weight loss as a desired outcome can have an effect. What the patients knew or didn't really matters, here.

The article linked to the wrong study, and searching the author's name, it looks like the actual study's not on pubmed yet.
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  #6   ^
Old Wed, Aug-07-19, 08:56
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khrussva khrussva is offline
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Quote:
Originally Posted by GRB5111
...
Final thought: I see a time when we look back at bariatric surgery with horror when it's considered to be in the same category as shock treatment, lobotomies, and leeches. We can certainly do better than this with our fellow humans.


We haven't given up on leeches just yet...

https://www.popsci.com/medicine-leeches-blood-surgery/

I do agree with your point, though. George Washington might still be alive today were it not for the blood letting to drain our founding father of 'bad blood'.
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  #7   ^
Old Wed, Aug-07-19, 09:20
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WereBear WereBear is online now
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Quote:
Originally Posted by GRB5111
Final thought: I see a time when we look back at bariatric surgery with horror when it's considered to be in the same category as shock treatment, lobotomies, and leeches. We can certainly do better than this with our fellow humans.


Add statins to the list. Once the full picture becomes clear, I think it might rival the attempted genocides of the 20th Century.
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  #8   ^
Old Wed, Aug-07-19, 09:27
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WereBear WereBear is online now
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Bariatric surgery has been a bête noire of mine from the beginning. You’ve got better odds of survival being a POW. (There is no Geneva Convention for experimental surgery.)

Yes, people who had chunks of their digestive system taken out for unhealing ulcers, cancer, or injury lost a lot of weight in the aftermath. YA THINK?

Part of it is healing and part of it is that the whole system is stunned like the victim of a car crash. But the body struggles to survive. And the appetite (the villain of the piece) returns.

Then they get to feed convalescent hunger with a stomach the size of a golf ball. There’s circles of hell I’d rather visit than that.

One of my recent health issues resulted in me researching those drugs which switch off auto-immune. Sometimes it’s the only choice to save your life.

But, like bariatric surgery, it’s a devil’s bargain and you never know when he will show up.
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  #9   ^
Old Wed, Aug-07-19, 09:38
GRB5111's Avatar
GRB5111 GRB5111 is offline
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Plan: Very LC, Higher Protein
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Quote:
Originally Posted by khrussva
We haven't given up on leeches just yet...

https://www.popsci.com/medicine-leeches-blood-surgery/

I wondered whether some astute person would point out that leeches are used today, albeit differently than back when bad blood was thought to be the root cause of all maladies. Good clarification!
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  #10   ^
Old Wed, Aug-07-19, 09:46
WereBear's Avatar
WereBear WereBear is online now
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Plan: EpiPaleo/Primal/LowOx
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Quote:
Originally Posted by GRB5111
I wondered whether some astute person would point out that leeches are used today, albeit differently than back when bad blood was thought to be the root cause of all maladies. Good clarification!


From the ways carefully selected herbs keep the humans and cats doing well in our house, these scorned plants might be making a comeback.

There are studies throughout Europe showing that herbs can be more effective, and have fewer side effects, for many purposes. This is an important way they can keep their national health costs down.

I think herbs also contain little-known micronutrients that help us stay healthy. They are certainly now my favorite form of greens.
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