Improved
6112 HealthChanged
3786 LivesSaved
3568 Lives1 lives impacted in the last 24 hrs Learn More
Dr. Archelle Georgiou talks with Dr. Peter Vash at the Women's Conference on the best ways to lose weight with invasive medical procedures and medications.
Dr. Archelle Georgiou:
Welcome back. We are at the Women’s Conference 2010 and this is EmpowHER Live. I am joined today by Dr. Peter Vash who is the Executive Medical Director of the Lindora Clinic. Thank you so much for joining us today.
Dr. Peter Vash:
Pleasure to be here.
Dr. Archelle Georgiou:
We are talking about weight loss, an issue that so many people have issues with and so many women have issues with and what I’d like to focus on are all of the different methods that people can take part of to lose weight, and I want to focus specifically on some of the invasive methods.
So bariatric surgery, medication, liposuction – so let’s just start with, when should someone consider doing more than just diet and exercise?
Dr. Peter Vash:
I believe that bariatric surgery, invasive procedures, what you said, is a very important procedure. I have often told patients, I believe it’s important but they are operating on the wrong organ. They should be operating on the brain or the emotions to direct the person how to eat.
That said, if a person is basically very heavy, say 300-350 pounds and has really tried to diet many times and has failed repeatedly and their condition is getting worse, then I think bariatric surgery has some benefit.
There’s two major types of bariatric surgery – there’s a LAP-BAND® which is restrictive, meaning that it will slow the amount of food that you can eat and slow your eating time down. It’s for people who like to eat very quickly. The other one, which is the gold standard, is the Roux-en-Y. It’s actually a bypass and restrictive; it not only restricts the food but it has a malabsorption component. That’s great for people who are overweight and have diabetes.
Dr. Archelle Georgiou:
How effective are they in the long-term? I know that people lose weight short-term with those surgeries, but how effective are they in the long-term?
Dr. Peter Vash:
I think that they are really quite effective long term. Both the LAP-BAND® and the Roux-en-Y are effective. The Roux-en-Y is much more effective for the first two years, but at the end of the two years they’re both about the same, but five years down the road both are very effective to show a reduction of death rates and a reduction of morbidity. So they are bona fide and good procedures.
Dr. Archelle Georgiou:
Okay, let’s switch to medication. Just last week the FDA didn’t approve yet another weight loss drug. I actually silently applauded that just because I worry that as Americans we take too many medications and we have a ‘find it and fix it’ mentality, but are there any medications that do work for weight loss that are safe?
Dr. Peter Vash:
Yes there are. One of them has been used for about 40-50 years called Phentermine. It’s a medication which releases norepinephrine and dopamine, very much like caffeine, so you get a little bit of a rush, a little bit of boost of optimism. It really helps to reduce weight and appetite.
There’s another one called Topamax which seems to, it’s an anti-epileptic anti-seizure medication which kind of quiets the brain and quiets the emotional stimulus to eat. I must say however that if you look at this nation with 65% of the people obese or overweight and the FDA is not approving some drugs which have really been fairly well vetted, I think in some ways we are failing the obese population and physicians. These medications have been around for a long time. If they are used properly with a good physical background I don’t think they’re as dangerous as the public or the FDA makes them out to be.
Dr. Archelle Georgiou:
So in your opinion, do you think that maybe the FDA has been too restrictive on approving these sorts of drugs?
Dr. Peter Vash:
I think their hands have been tied because of the Fen-Phen procedure. They have had egg on the face; people saying Fen-Phen was very bad. In reality I think many people mistook the drugs, larger amounts and too long, it’s never been publicized so the FDA has to respond by being more restrictive and being much more conservative, much more careful. They are trying to do the best to help the public, but we have to realize that medications really are valid and important tools for the treatment of obesity.
Dr. Archelle Georgiou:
Does liposuction have any role in weight loss?
Dr. Peter Vash:
No.
Dr. Archelle Georgiou:
Is there anything that people can get at their health food store or that appears “natural” that you would recommend or that works?
Dr. Peter Vash:
To go back, I didn’t want to be too cavalier or abrupt. Liposuction is great for sculpting the body, for contouring. So if a person were to lose a fair amount of weight – 50, 60, 100 pounds and have some skin hanging or different bulges that could not be removed by diet, that’s where sculpting, that’s where liposuction would be of benefit – not to lose weight but after weight loss has occurred to take off some of the excess skin. It’s very helpful there.
Dr. Archelle Georgiou:
Thank you for that clarification. Let’s go back to the question about whether or not there are any natural ways to help weight loss.
Dr. Peter Vash:
I think the American public is being duped when they are told that there are natural foods to help burn calories or lose weight. I don’t believe or don’t know of any foods that will help a person lose weight. There are foods such as fiber that may fill the stomach; they may give you a sense of being full, that will help but I think protein helps to impart a sense of fullness and a sense of satiety.
So if you are asking about foods, stay away from the refined carbohydrates, that causes low blood sugar and a sense of wanting more carbohydrates later. Protein – low fat protein, fish, chicken, turkey, eggs – those will help you to maintain your sugar level and help you be feeling full for much longer period of time.
Dr. Archelle Georgiou:
Great information; thank you so much. I find that very helpful as well.
Dr. Peter Vash:
Pleasure.
Dr. Archelle Georgiou:
Thank you for joining us. This is EmpowHER Live at the 2010 Women’s Conference. Thanks for joining us.
Visit Dr. Georgiou's EmpowHER Profile
Visit Dr. Vash's EmpowHER Profile
Add a CommentComments
There are no comments yet. Be the first one and get the conversation started!