Considerable evidence has shown that being overweight plays an important role in the development of cancer.  Based on the American Cancer Society’s 2002 estimates for cancer incidence, 51% of all new cancers diagnosed among women were directly related to obesity.  Among men, cancers linked to obesity comprise approximately 14% of all new cancers.  In terms of mortality, for women obesity-related cancers cause 28% of cancer-related deaths, and for men, obesity-related cancers are estimated to cause 13% of cancer-related deaths.

Now, a recent study has looked at the effect of excess weight on the surgical treatment of men with prostate cancer.  Specifically, the study looked at the newest, advanced robotic technique for prostatectomy and analyzed the effect of excess weight on the difficulty in performing this surgery.  When normal weight patients (BMI=18 – 25) were compared with patients who were overweight (BMI=25-30) or obese patients (BMI greater than 30), they found a significant difference in outcomes.  For overweight and obese men there was more bleeding during surgery, the surgery time was longer (30 minutes longer for obese men) and obese patients stayed in the hospital one extra day.

This study sends a clear message that being overweight not only increases a person’s risk of developing and dying from cancer but being overweight makes surgery for cancer more difficult and costlier. In short, the results from surgery to treat cancer are worse for overweight or obese patients than for patients who are at a normal, healthy weight.  This is just one more reason to stress the importance of maintaining a healthy weight. 

For people who need help controlling their weight, The N.E.W. Program provides a new non-surgical weight control program in addition to a surgical program. Neither program promotes traditional diets, and both programs promote lifestyle management as the key to achieve long-term healthy weight goals.

The Covid-19 global pandemic has finally exposed the fact that obesity kills. The truth is, in the United States, obesity is now the most prevalent threat to your health. It’s not diabetes, heart disease or even cancer. Obesity affects 42% of all Americans and it’s a killer.

On July 24^th Public Health England reported that being overweight or obese “puts you at greater risk of serious illness or death from Covid-19.” In fact, having a body mass index (BMI) of 30-35 puts you at 40% higher risk of DEATH from Covid-19. That’s just 45 pounds of excess body fat if you’re 5’4” tall! And for a person with a BMI of 40, your risk of dying from Covid-19 goes up by 90%!!

The truth about your weight and the risk of death from Covid-19 is so well know that it was recently reported on Real Time with Bill Maher. https://youtu.be/vDaQOy7ML38

This is not new information to doctors. We have known for a long time that obesity and metabolic syndrome affects your immune system. A report from January 2016 in the journal Advances in Nutrition warned that the “increased risk of both metabolic and infectious diseases” caused by obesity was devastating. And if you are obese and hoping that a vaccine will solve your problem, think again. Vaccines are less effective in obese adults, and Covid-19 will likely be the same. When asked if there will be a Covid-19 vaccine tailored to work better in obese people, Dr. Shaikh, a professor of nutrition at the University of North Carolina, answered “No way.” In fact, when asked if the vaccines being developed will work in people that are obese the answer was “Our prediction is no.”

Since coronavirus epidemics will likely be part of our lives for years to come, doing something now to fix your problem with excess weight might be the most important thing you can do.

The world may be getting smaller, but it’s people are getting bigger……and bigger…..and bigger.

Back in 1963, when the boats that carry customers through Disneyland’s “It’s a Small World” ride were first designed, an adult’s height was roughly the same as today, but the average adult weighed far less than 200 pounds.  Not anymore.  Today, the boats at Disneyland’s famous ride frequently “bottom out”, overloaded with today’s overweight passengers.

The “Small World” ride has been handicapped by a “Big Rider” problem.  Instead of carrying mainly healthy-weight patrons, the ride must now accommodate adults who often weigh much more than 200 pounds.  Increasingly, over-weighted boats get to certain points in the ride and become stuck on the bottom of the pool.  In an attempt to avoid this problem, Disneyland employees have been trained to leave empty seats on many boats to compensate for hefty patrons, but this routinely upsets the hundreds of other paying customers waiting in line. When a boat does bottom out, the long line of boats backs up behind it, their passengers becoming upset while listening to the ride’s theme song over and over.  The ride monitors must then find the stuck boat and attempt to tactfully help a heavy rider, or two, to an exit at one of the emergency platforms.  To make things even more uncomfortable, some of the embarrassed, overweight riders do not deal with this situation graciously.

As a result of this growing inconvenience, Disney has been forced to close down the “It’s a Small World” ride for an entire year in order to complete a massive renovation in which the boats will be redesigned, and the flume deepened, to accommodate their patron’s additional poundage.  Unfortunately, this problem is not just isolated to Mickey Mouse’s home town.

Although America is well known to have an obesity epidemic, the problem is not confined to American shores.  Even Mediterranean countries, touted for their heart-healthy diets, are being faced with expanding waistlines. In Italy, 42 percent of adults are overweight and 9 percent are obese, according to the World Health Organization. In France, 41 percent of adults are overweight and 11 percent are obese.

Though some experts blame America’s obesity problem on soft drinks or the use of high-fructose corn syrup as a sweetener, the problem goes much deeper.  We live in a culture that encourages lifestyle patterns that include frequent overeating and minimal physical activity.  Unfortunately, if obesity trends continue, researchers at Johns Hopkins University estimate that 75 percent of American adults will be overweight or obese in just eight years and 41 percent will in fact be obese.

Because obesity has been linked to at least 53 diseases, including diabetes, heart disease, stroke and cancer, and because the costs of obesity on society have become so huge, governments are now being forced to take action.  In countries like Mexico, Brazil and China, the health costs of excess weight are rapidly becoming a big part of their budget.  As a result, governments from Scotland to China are already debating how to tackle this issue.  Planned maneuvers include taxing sodas and sugary drinks, revamping agricultural subsidies to make fruits and vegetables cheaper, banning junk-food ads on children’s television, and demanding equal advertising time for healthy food.

However, no matter what government initiatives are applied, the first steps to rectify this epidemic need to be made on an individual level.  People must make positive changes in their lifestyle, especially eating habits, not just to lose their excess weight, but to avoid becoming overweight in the first place.  It’s a sad day in our society, when instead of being able to successfully address the underlying issue of obesity, we are forced to tear down a famous ride and rebuild it in order to accommodate our unhealthy way of life.

Metabolic Surgery should be offered to all obese people with diabetes. The evidence for this recommendation is now irrefutable.

In 2016, the American Diabetes Association, the International Diabetes Federation, and 43 other medical groups published guidelines, in the journal Diabetes Care, recommending surgery as treatment for people suffering from obesity and Type 2 diabetes. The guidelines state that people with Type 2 diabetes and a body-mass index (BMI) equal to or over 40.0, or a BMI from 35.0-to-39.9 and poorly controlled Type 2 diabetes, should be advised to undergo surgery, and people with poorly controlled diabetes and a BMI of 30.0-to-34.9 should “consider” surgery.

The STAMPEDE Trial followed three groups of patients, about 150 people, with poorly controlled diabetes and obesity. One group underwent gastric bypass; one got sleeve gastrectomy; and one group was placed on an intensive medical weight loss program, including counseling and medications. After five years, half of the patients who had surgery had a HbA1c level less than 7.0%, while less than a quarter of those in the medical therapy group had similar success. One in five patients that underwent surgery had complete remission of their diabetes (HbA1c of 6.0% or less, without medications) while there were no cases of diabetes remission in the medical therapy group. Surgical patients also lost a lot more weight and required fewer heart medications after 5 years. The surgical patients even scored higher on quality-of-life measures.

Only skilled surgeons with low complication rates should perform these technically demanding procedures. Risks include infections leaks and blood clots early after surgery, and ulcers, reflux, gallstones, and malnutrition months to years after surgery. People that have undergone gastric bypass surgery need to take supplemental vitamins and minerals for the rest of their life.

So you think that weight loss surgery is expensive?  Well, staying fat is more costly than you may realize!  Economic experts tell us that we are spending outrageous amounts of money treating obesity-related conditions like diabetes, heart disease, and cancer.  In fact, America spends more than $147 billion annually on obesity and this is projected to reach close to $1 trillion annually by 2030!

At the personal level, for people with just 50lb of excess weight (a BMI~30), the lifetime medical cost related to diabetes, heart disease, high cholesterol, hypertension, and stroke is $10,000 higher than it is for the average person at a healthy weight.

So, how does this relate to your daily personal finances? First, it’s a fact that your health is your most important asset. The cost of weight loss surgery pales in comparison to the long-term costs of obesity-related health problems.  In 2006, obese patients (BMI of 30 or greater) spent $1,429 annually more for their medical care than people in a normal weight range. A very significant study published in the American Journal of Managed Care reported that patients pay $900 per month less for healthcare just one year after bariatric surgery compared with similar weight people who don’t have surgery.

Even day-to-day living is more costly when you’re overweight. Plus-sized clothing costs 10% to 15% more than regular sized apparel.  Food is expensive and some experts estimate foods savings alone at more than $3000 per year after bariatric surgery.  Of course, you need to include how much money you are going to spend on another failed diet program. You won’t lose weight just because Jenny Craig’s wallet gets fatter.  One study broke this last fact down further by showing that for each pound of weight loss at Weight Watchers you will spend about $400!  That’s $4000 to lose ten pounds!

If you wonder if you can afford weight loss surgery, it’s time to ask yourself the real question.  Can you afford to stay fat?