By Steven Reinberg
HealthDay Reporter

THURSDAY, July 17 (HealthDay News) — Despite wide-ranging efforts to encourage Americans to lose weight, the number of U.S. adults who are obese increased almost 2 percent between 2005 and 2007, a new report found.
In 2007, 25.6 percent of adults reported being obese, compared to 23.9 percent in 2005, according to the finding in the July 18 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
"The epidemic of adult obesity continues to rise in the United States, indicating that we need to step up our efforts at the national, state and local levels," Dr. William Dietz, director of CDC's Division of Nutrition, Physical Activity, and Obesity, said in a news release. "We need to encourage people to eat more fruits and vegetables, engage in more physical activity and reduce the consumption of high-calorie foods and sugar-sweetened beverages in order to maintain a healthy weight."
The percentage of adults who are obese varies by state and region, according to the report. For example, in Alabama, Mississippi and Tennessee, 30 percent of the residents reported being obese, compared with 18.7 percent in Colorado, which had the lowest prevalence of obesity.
Obesity was most prevalent in the South, with 27 percent of residents classified as obese. In the Midwest, the number was 25.3 percent; in the Northeast, 23.3 percent; and in the West, 22.1 percent, according to the report.
In terms of age, among those 50 to 59 years old, 31.7 percent of men and 30.2 percent of women were obese. For those 19 to 29, 19.1 percent of men and women were obese.
Breaking the numbers down by race/ethnicity and sex, obesity prevalence was highest for non-Hispanic black women (39.0 percent), followed by non-Hispanic black men (32.1 percent).
Education levels play a role, too. For men, obesity prevalence was lowest among college graduates (22.1 percent) and highest among those with some college (29.5 percent) and a high school diploma (29.1 percent). For women, obesity prevalence was lowest among college graduates (17.9 percent) and highest among those with less than a high school diploma (32.6 percent).
None of the states or the District of Columbia has met the "Healthy People 2010" goal of reducing the prevalence of obesity to 15 percent or less, the CDC said.
"Obesity is a major risk factor for a number of chronic diseases such as type 2 diabetes, heart disease and stroke. These diseases can be very costly for states and the country as a whole," Deb Galuska, associate director for science at the CDC's Division of Nutrition, Physical Activity and Obesity, said in a news release.
The CDC defines obesity as a body mass index (BMI, a ratio of weight to height) of 30 or above. An adult who is 5-feet, 9-inches tall is considered obese if he or she weighs 203 pounds.
In compiling the data, the CDC used its Behavioral Risk Factor Surveillance System, which collected information on more than 350,000 adults through telephone interviews. The researchers calculated BMIs using information reported by survey participants.
"These data from the CDC confirm that the epidemic of obesity continues to spread, whether looking at population trends in the short- or long-term," said Howard D. Sesso, an assistant professor of medicine in the Division of Preventive Medicine at Brigham and Women's Hospital in Boston.
The likelihood of America meeting the Healthy People 2010 objectives for obesity prevalence appears dim, Sesso said. "This report highlights the need not only to outright prevent the development of obesity over the life-course, but also to improve efforts to reduce body weight in those already classified as obese," he said.

: BY KEVIN GRAMAN, THE SPOKESMAN-REVIEW, SPOKANE, WASH.
Dec. 28–Morbidly obese patients on government-sponsored health care can no longer receive gastric bypass surgery in Eastern Washington because of low reimbursement rates and high medical malpractice premiums, according to a local doctors’ group.
Surgical Specialists of Spokane, one of three regional health care providers approved by the state to perform the controversial but potentially life-saving procedure on Medicaid patients, this month stopped offering gastric bypass surgery to patients covered by Medicaid or Medicare.
The decision of the medical group comes after Physicians Insurance served notice of a 25 percent insurance surcharge to the premiums of doctors who perform gastric bypass to facilitate weight loss.
A Physicians Insurance spokesman said the surcharge is justified because of the risks associated with the procedure, which dramatically reduces the size of a patient’s stomach and bypasses part of the intestine, resulting in fewer calories being absorbed by the body. At the same time, the state has limited the number and types of bariatric surgeries it will pay for because of studies that show high morbidity and mortality rates.
Gastric bypass is done for health, not cosmetic, reasons, say the three doctors who perform the surgery for Surgical Specialists. It is done when other weight-loss treatments have failed, a patient’s body mass index is 40 or higher or the patient is 100 pounds or more overweight, and the patient has a life-threatening or disabling condition related to weight.
“Gastric bypass is a last resort, but it is the only resort for some people,” said Christie Fresh, administrator for Surgical Specialists. The week before Christmas, she had to inform 35 patients expecting the surgery that for now they cannot have it done in Spokane.
Between 1998 and 2002, the number of bariatric surgeries performed in the United States more than quadrupled to about 70,000 a year, according to a University of California, Irvine, study reported in HealthDay News. That number may have doubled by 2004 due to the increased use of less invasive laparoscopic surgery using small incisions, according to the American Society for Bariatric Surgery.
At 41, Dena Fannin, of Ritzville, has fought obesity her entire life. For the last year and a half, she said, she also has fought the state Department of Social and Health Services, trying to win approval for gastric bypass surgery to be paid for by Medicaid, the state and federal health insurance for low-income patients. Fannin, who is 5 feet 10 inches tall, weighs 409 pounds, is disabled and lives on Social Security income.
“I am sick. I need to lose weight to help my health,” said Fannin, who has arthritis and suffers from a variety of ailments associated with obesity, including diabetes and heart problems. “I swear that Medicaid was outwaiting me, thinking something would happen to me before I was approved.”
But on Dec. 15, a Surgical Specialists nurse called to tell her she had been approved for surgery by Dr. Lawrence Schrock, the only surgeon east of the Cascades who performs gastric bypass on Medicaid patients.
“It is one of the more rewarding surgeries that I’ve ever done,” Schrock said. “The patients are extremely grateful for having a new life given back to them.”
However, within a week of being approved for the procedure, Fannin received a call from Fresh telling her the group had stopped performing gastric bypasses on government-sponsored patients. Her only options were to go to Seattle or Portland for the surgery. She has already begun a required six-month preoperative process during which she works with a dietician to lose at least 20 pounds and undergoes a psychiatric evaluation to determine her suitability for the life-altering procedure.
“It was like my last chance,” Fannin said. “I have to have surgery by June or go through the whole process again.”
Fannin is part of a class of patients whose medical options are limited by a combination of factors contributing to the U.S. health-care crisis - medical costs rising much faster than inflation, low reimbursement rates for government-sponsored care, and the growing price of medical malpractice insurance.
“It’s one of the byproducts of the system we have that access to care is being threatened by necessary costs,” said Gary Morris, general counsel for Physicians Insurance.
Morris said the 25 percent surcharge on doctors performing gastric bypass, including Surgical Specialists of Spokane, is justified because of the risk of the surgery.
“That’s what insurance is all about,” he said, “spreading the risk across a larger group of people in as fair a fashion as possible.”
There have been several studies on mortality rates associated with bariatric surgery showing death rates from one in 50 operations to one in 500.
“When we started looking at this we noticed a huge variation in mortality among hospitals, from 0 to 40 percent depending on the hospital,” said Dr. Jeffery Thompson, chief medical officer for the state Department of Social and Health Services.
Finding this variance unacceptable, DSHS put a moratorium on gastric bypasses two years ago while it commissioned a University of Washington study to determine who should be getting the surgery and who should be performing it.
For the past 18 months, Thompson said, DSHS has approved Medicaid coverage for gastric bypass for patients with a body mass index of 35 or greater and who have diabetes as a result of their obesity. Surgeons whose clinics have performed at least 100 procedures in the last five years are approved provided they can show a mortality rate of no more than 2 percent and a morbidity rate - patients developing health problems like malnutrition as a result of the surgery - of less than 15 percent.
“No longer are we exposing our clients to excessive mortality risk for an unknown benefit,” Thompson said.
As a result of this policy, DSHS has approved Medicaid coverage for only three institutions: the UW Medical School in Seattle, Oregon Health Sciences in Portland and Surgical Specialists of Spokane. The Spokane group has performed only six Medicaid-funded gastric bypass procedures in the past 18 months, with another 40 patients in line, Thompson said.
“It would be nice if the government approved more of these patients,” said Dr. Scott Nye, of Surgical Specialists, who has been performing gastric bypass about a year.
Nye said this surgery is done “not to make them skinny. You are doing it so they can lose weight and get off medications.” He cites studies that show patients who have gastric bypass show improvement in such conditions as diabetes, high blood pressure and sleep apnea.
A study at McGill University Health Centre in Montreal comparing obese patients who had surgery with obese patients who did not have surgery found “an 89 percent reduced risk of death” in the patients who had surgery, according a 2004 Annals of Surgery report.
“I’m alive today because of gastric bypass surgery,” said Ann Campeau, 66, of Spokane, who had the procedure two years ago.
Since then the 5-foot-8 woman has seen her weight decrease from 470 pounds to 270 and counting. Private insurance paid for her surgery.
“Nobody wanted to handle me because I was such a high-risk patient,” Campeau said. “They all recommended surgery, but nobody wanted to do it.”
Without the procedure, she said, she was given a 60 percent chance of being alive in another six months. She was told she had a 50 percent chance of surviving the surgery. She was taking 20 pills a day for conditions related to obesity, including high blood pressure, a heart condition, diabetes, cholesterol and sleep apnea.
Today she is taking two pills a day and the minimum amount of insulin, she said.
“I’m saving my insurance company hundreds of thousand of dollars a year,” said Campeau, who one year racked up more than $400,000 in medical bills.
She believes there are people who cannot lose weight, and for them the option of gastric bypass should be available. “But you have to be prepared to make life-altering changes.”
Since Schrock performed her procedure, Campeau can eat no more than three ounces of food at a time, and there is a lot of food she cannot eat. She has to chew everything thoroughly to avoid pain and vomiting.
Campeau said her insurance company turned her down three times for the procedure before a medical review board finally approved her. While in support groups, she heard people’s stories about what they had to go through to get surgery. Some had to mortgage their homes. Her insurance company will no longer cover gastric bypass.
“A lot of people are going to die from lack of necessary surgery because they don’t have the resources,” she said.
Any surgery has its risks, Schrock said, especially surgery involving such high-risk patients as the morbidly obese. “But is it any higher risk than working on the pancreas, or liver, or coronary artery patients? I don’t know if that’s true,” he said.
Schrock regrets not being able to perform gastric bypass for patients on Medicaid and Medicare, the federal health plan for the elderly and some disabled people. He said patients who would qualify under other insurance plans are being excluded unreasonably.
“I’m disappointed in not being able to do this,” Schrock said. “I don’t say we’re quitting the program. We’re putting a moratorium on the program until we get these issues looked at.”
His medical group has asked Physicians Insurance to explain the surcharge.
“From a malpractice point of view they have shown us nothing that justifies a 25 percent surcharge,” he said. “Show us the statistics that this surgery is any riskier than surgeries they are not surcharging.”
Fresh said the surcharge will increase the group’s malpractice premiums from about $500,000 a year to about $600,000. She said notice of this increase came immediately after the state’s Nov. 8 elections, in which Initiative 330, limiting non-economic damages in medical malpractice claims, and Initiative 336, regulating doctors with multiple malpractice claims, were both defeated.
None of the Surgical Specialists of Spokane doctors has had malpractice claims for gastric surgery, said Fresh. A 2003 malpractice claim against Dr. Mark MacFarlane, which was denied by a Spokane County Superior Court judge, was unrelated to bariatric surgery, and according to Physicians Insurance had no bearing on the regionwide gastric bypass surcharge.
MacFarlane said his group donated nearly $30,000 worth of medical services last year but has reached a critical point where it can no longer afford to give care to low-reimbursement payers.
“It comes to a point if we don’t get higher reimbursements or malpractice relief, we can’t afford to do the work,” he said. “Legislators have ignored the issue, and doctors do not have the power to do it.”
Under state law, doctors apparently have no avenue to appeal the insurance price hike with the Washington state Insurance Commission.
As a medical malpractice carrier, Physicians Insurance is required to file rate increases up to 25 percent with the commission within 20 days of initial use, according to Beth Berendt, the state’s deputy insurance commissioner for rates and forms. Though the insurer has been asked to make minor changes in its filing, these are unlikely to change the outcome.
“Many carriers consider this higher-risk surgery,” Berendt said. “Many do not write this policy.”
Among Physicians Insurance’s two main competitors, Medical Protective does not offer malpractice insurance to doctors performing gastric bypass. The other, The Doctors Company, also has a surcharge, Berendt said.
She said Surgical Specialists’ decision creates “a significant access problem” for Eastern Washington and encouraged the group to sit down with Physicians Insurance officials and “find out why they are taking this route.”
Meanwhile, Dena Fannin waits for the procedure she hopes will change her life.
“I’ve heard a lot of people say it’s like a new birthday,” she said. “If they don’t do the surgery soon, I don’t think I’m going to be able to have it done.”

Do I Really Need Surgery For Weight Loss?
By Brandon R. Cornett

Each person who considers bariatric weight-loss surgery will have unique circumstances and concerns. We are, after all, a world of individuals. But with that being said, there are certain frequently asked questions about bariatric surgery that many patients ask, and it will help you to understand the answers to these common questions.

Is surgery the only option for you, in terms of increasing your health and losing weight? Of course not. There are other options to consider as well, such as the all-important lifestyle changes of eating better and being more active. But for some patients who are morbidly obese, surgery may be the only option to get them on the right track.

But there's the rub. While bariatric surgery used to be reserved for these types of patients -- patients who would otherwise die from their weight conditions -- it now seems to be "in style." You hear about weight loss surgery on the news a lot more these days, and the number of surgical procedures has skyrocketed in recent years.

Here's what you need to remember. Despite all the glossy bariatric brochures with happy, skinny models smiling back at you, this is still surgery we are talking about here. And it has very real risks associated with it. So you should consider other non-surgical options as a matter of course.

Lifestyle Changes Still Required

Here's another thing that many people don't realize about weight loss surgery. Even with the surgery, you still have to change the behavior that led to the overweight condition in the first place. In other words, you have to make lifestyle changes.

So if you have to make those changes anyway, even with surgical intervention, why not start by making those changes first. See what you can accomplish without surgery. Need some serious motivation? How about this. The cost of bariatric surgery runs anywhere from $10,000 to $40,000, and insurance doesn't always cover it. The risks associated with these procedures range from vitamin deficiency to death.

If those two facts don't motivate you to change your lifestyle for the better, then how can you expect surgery to be a magical cure?

Brandon Cornett is the publisher of Bariatric Learning Center, an educational website that covers all aspects of this topic, from bariatric vitamins to surgery criteria and beyond. Learn more by visiting http://www.bariatriclearningcenter.com

Article Source: http://EzineArticles.com/?expe...
http://EzineArticles.com/?Do-I-R...

Bariatric Vitamins - Taking Supplements After Weight Loss Surgery
By Brandon R. Cornett

Most patients of weight-loss surgery will at some point discover the need for vitamin supplementation. In fact, medical and nutritional experts are virtually unanimous on the subject of bariatric vitamins as a post-procedure regimen.

But what are these vitamins and supplements in the first place, and who should take them? That's what we will examine in this article. With that being said, please note that I am merely the publisher of an educational website on bariatric surgery -- I am not a doctor. The information presented in this article comes from my own research and information gathering.

Why Take Vitamins After Surgery?

A lot of doctors state that patients of a bariatric (weight loss) procedure should supplement their diets with certain vitamins and minerals after their surgery. This is especially true for the gastric bypass surgery. When you think about what is taking place from a physical perspective, you have to admit that the gastric bypass is brutal on the body. The patient's stomach is segmented into a smaller upper area and a larger lower area. The upper area is the only usable part, which is what leads to decreased eating and (by extension) weight loss.

This is where bariatric vitamins come into the picture. During a traditional gastric bypass procedure, the patient's small intestine is rerouted to the newly created upper section of the stomach (the smaller segment). This can lead to problems with malabsorption, which is a medical way of saying the body is not absorbing nutrients and vitamins as well as it did before surgery -- or as well as it should.

The Medical Advantages of Supplementation

Given what we have talked about above, you can probably see the medical advantages to taking certain vitamins after a bariatric surgery procedure. If your post-procedure body cannot absorb certain nutrients from the foods you eat, then you'll have to get those essential nutrients by way of supplementation (mainly by taking vitamins).

What should you take? Well, I would consult with your physician about that. But here are some of the things that came up repeatedly in my research. Calcium and iron are two of the essential items that patients do not absorb as well after bariatric surgery. So when health experts recommend vitamin supplementation after such procedures, these two items are often high on the list.

Deficiencies in vitamins A, D, E and K are also reported in a lot of patients. This is why many nutritionists recommend a good multivitamin for people who under go a gastric bypass surgery. A deficiency of vitamin D can lead to osteoporosis later on down the road, while a severe lack of vitamin A can negatively affect your vision. So clearly, these are not things you want your body to lack!

Brandon Cornett is the publisher of Bariatric Learning Center, which offers information on all aspects of weight-loss surgery. Learn more about bariatric vitamins and related topics by visiting http://www.bariatriclearningcenter.com

Article Source: http://EzineArticles.com/?exp...
http://EzineArticles.com....