Having gastric bypass surgery has a ripple effect that causes family members to lose weight, eat better and exercise more, a new study shows.

The research found that spouses, relatives and even the children of patients who underwent the procedure dropped significant amounts of weight, doubled their activity levels and had other improvements that were still evident a year after the surgery. The findings suggest that doctors who perform gastric bypass operations may want to look at the procedure as a way to bring about change in entire families in need of help with their weight and exercise habits, said Dr. John Morton, the director of bariatric surgery at the Stanford School of Medicine and an author of the study, which appeared in The Archives of Surgery.

“If you have a committed and involved family,” he said, “you’re going to have better outcomes for the patient, and also by the same token, the family members can have a collateral benefit.”

Every year, about 200,000 people undergo the most common gastric bypass operation, known as Roux-en-Y. Patients typically see significant weight loss and improvements in overall health, but researchers hadn’t really looked at whether the changes could affect other members of a patient’s household. Dr. Morton got the idea for the new study when he noticed that his bypass patients would often come in for follow-up visits alongside family members who showed improvements of their own.

“Patients would come in with their spouses, and in the course of them telling me how great everything was, the spouse would say, ‘I’ve lost weight too, and we’re eating healthier,’” he said.

Social support can be a powerful motivator in breaking bad habits. Studies have shown, for example, that people tend to lose more weight — and keep it off longer — when they take part in weight loss groups or start a diet with a husband or wife. Smokers, too, are nearly 70 percent more likely to give up cigarettes if a spouse quits smoking.

To find out whether gastric bypass could have a similar effect, Dr. Morton and several researchers, including Dr. Gavitt Woodard, recruited 35 people preparing to undergo the procedure and followed them and their families for a year. Only family members who lived with the patients, including their children, were included in the study. Family members were asked to accompany the patients to all of their counseling sessions: three that occurred before the surgery, and five that took place in the year after. At the sessions, the subjects learned about portion control and were encouraged to eat meals high in protein and fiber and low in fat and sugar. They were also encouraged to exercise and cut back on alcohol and television.

A year after the surgery, the patients, who had all been morbidly obese at the start, had lost an average of 100 pounds and went from body mass indexes of 48.7 to 33.3. Their adult spouses and family members who were overweight, meanwhile, had lost an average of about 10 pounds and saw their B.M.I.’s drop from 38 to 36.3, which is on par with controlled medical weight loss trials. The obese children in the study saw their waist sizes drop several inches, though their B.M.I.’s did not change very much because they were growing and getting taller.

“The kids were on a steeper trajectory for higher B.M.I. before the parent’s surgery,” Dr. Morton said. “At the end of one year, that slope was less.”

The researchers also saw other beneficial changes in the young and adult family members. They watched less television, exercised more and reported fewer instances of uncontrollable and emotional eating. The adults drank significantly less alcohol, going from an average of 11 drinks a month down to just one. Dr. Morton said it was clear bariatric surgery could be an opportunity for intervention for many people beyond the patient.

“Obesity is a family disease,” he said, “and we do need to treat everyone involved and start thinking about bariatric surgery as a platform for change.”

Fuente: http://well.blogs.nytimes.com

Between skyrocketing insurance premiums, medical expenses, and lower pay, being overweight certainly comes at a price—but just how much does it cost to carry around extra pounds? (Search: No cost workouts) For women, being obese may cost $4,879 per year, according to George Washington University researchers who conducted a review of 94 studies last year. Compounded over 20 years, that’s close to $100,000 that could have been put toward retirement. Men pay a slightly lower price thanks to higher relative pay, but their bank accounts take a hit as well, to the tune of $2,626 annually. To understand where all that money’s going, we took a look at the research, spoke with experts, and crunched the numbers. Here’s what we found.

Medical Costs

Ailments associated with being overweight, such as high blood pressure, diabetes, and on-the-job injuries, can lead to big medical bills. (Find out how you can eat to beat diabetes.) Overweight people spend an additional $346 per year on medical costs, according to the George Washington University study; obese people shell out an additional $1,474 a year. This amount factors in co-payments, prescription drugs, and hospital costs, but doesn’t take into account any over-the-counter drugs, so the amount may be even higher, says Christine Ferguson, director of STOP Obesity Alliance and one of the researchers.

Income

Being obese doesn’t just cost you more money, it can also limit how much you rake in—if you’re a woman. Studies conclude that being obese can lower women’s wages by between 1.5 to 15%, which averages out to be a loss of $1,855 a year. “I think that this issue of lost wages really reflects a huge bias against people who are overweight or obese,” says Ferguson. In surveys, employers see obese women as lacking self-discipline and being less emotionally stable and competent than their thinner peers. However, heavier women also complete fewer years of education and retire earlier, both of which contribute to less money earned over time.

Why aren’t the salaries of obese men affected? “I suspect the labor market is more competitive for men than for women, so it is harder to discriminate against men,” says Eric A. Finklestein, an associate research professor in the Duke Global Health Institute at Duke University and author of The Fattening of America: How the Economy Makes Us Fat, if It Matters and What to Do about It.

Interestingly, two studies suggest some obese women are less likely to be employed, but obese African American men and women are more likely to be employed. While obese Hispanic and white women are less likely to be employed than their normal-weight counterparts, no such relationship was found for Hispanic and white men. However, obese African American men and women are more likely to be employed than normal-weight African American men and women. The researchers note that more in-depth study on the topic is warranted before a conclusion can be drawn.

Sick Days

Being obese might also cause you to lose more cash from work days lost to illness. Absenteeism causes overweight women to lose an additional $106 per year; obese men see a hit of $212, whereas obese women are set back $674.

Clothing

While there’s no one study that has calculated the added cost of purchasing plus-size fashion, there’s anecdotal evidence that buying bigger clothing is more expensive. For example, Old Navy’s standard boot cut jeans costs $34.50, but the plus-size version is $43. A cable-knit sweater from the same store costs $37; the same plus-size design sells for $40.

Fuel Costs

The George Washington University study estimated that overweight individuals spend between $8 and $10 more a year on gas than those with lower BMIs. Obese people shell out an extra $21 to $23 to fill the tank. Why? Just as an SUV requires more gas to operate than a Smart car does because of its sheer size, it takes more fuel to transport heavier passengers.

Travel

Under its customers-of-size policy, Southwest Airlines requires people who can’t fit into the planes’ 17-inch-wide seats to purchase two tickets, so obese individuals may have to spend twice as much to fly. You can, however, get a refund for your second ticket if the flight isn’t sold out. Air Tran plans to follow suit in spring 2012.

Life Insurance

In their report, the George Washington University researchers calculated that overweight people spend an extra $14 a year on life insurance. Obese people pay an extra $111 a year compared with normal-weight individuals.

Source: Fitbie

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