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Il bypass gastrico per via laparoscopica Roux-en-Y con il posizionamento dell`impianto GABP RING mantiene la perdita di peso nel paziente a lungo termine

 

Un obiettivo importante alla base della chirurgia bariatrica è la perdita di peso e il suo mantenimento a lungo termine. L’efficacia del posizionamento dell’impianto GABP RING in aggiunta al by pass gastrico è stata valutata in un follow up di 4 anni, pubblicato in BMC Surgery.
Questo è il primo rapporto dei risultati milticentrici ottenuti dopo quattro anni.

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Banded gastric bypass maintains weight loss according to a study thought to be the first report of up to four years using the GaBP ring (Bariatec Corporation), published in BMC Surgery 

Although gastric bypass is the gold standard of bariatric surgery some patients show insufficient weight loss or weight regain. It is believed that dilation of the pouch or the pouch outlet may be the cause, but by banding the bypass surgeons overcome the dilation by placing an implant around the pouch or pouch outlet.

A total of 183 (118 women and 65 men) consecutive bariatric patients who agreed for GaBP implant were operated with banded gastric bypass between August 2007 and December 2010 at the Antwerp Medical Center, Belgium, the University of Schleswig-Holstein, the University of Freiburg, Germany, and the International Medical Centre, Jeddah, Kingdom of Saudi Arabia.

The mean BMI before the operation was 42.8 and mean excess weight was 60.9 kg. Patient weight and BMI were recorded prior to the operation, three and six months after the operation and at one, two, three and four years post-op.

All the cases were performed laparoscopically and a vertical tubular pouch 5–6cm was formed using linear staplers. The GaBP Ring was placed 4cm from the angle of and closed and fixed with two sutures. Rings with a circumference of 6.5cm (diameter of closed ring is 1.9cm) were used in all patients. The alimentary limb was created by dividing the jejunum 50cm below the ligament of Treitz. A gastroenterostomy was performed in an antecolic manner using a circular stapler or hand sewing anastomosis and the integrity of the anastomosis was tested with methylene blue.

In the perioperative and early postoperative period there were 8 (4.3%) complications, including:

  • One case of an intraoperative bleeding (0.5%) which made a splenectomy necessary
  • Two patients had postoperative intraabdominal bleedings and another two developed intraluminal bleedings which could be treated conservatively (2.1%)
  • In two cases (1%) an intestinal perforation was observed which resulted in revisionary surgery, but it was not necessary to remove the rings
  • One patient had a cardiac arrest (0.5%) in the early postoperative period with complete recovery

Outcomes

The results revealed that at six months follow up data was available for 147 patients: the mean EWL was 60% with a mean BMI 30.1. After one year mean EWL reached 75.3% with a mean BMI27 (n=110). After two and three years the EWL was 78.8% (n=49) and 79.9% (n=35). There was a mean EWL of 85% after four years. Thirteen patients finished a four year follow up period and mean BMI after 4 years was 25.2.

“We assume that ring implantation on the gastric pouch can indeed prevent pouch outlet and first jejunal limb dilation,” the authors write. “Since outlet dilation will probably not occur in the first year after gastric bypass, the effect of the banding is likely to be seen in a more than three year follow up.”

They note that banded bypass is not routinely used by most bariatric surgeons and state that it might be due to the fear of additional complications like infection, band or ring erosion, migration or stenosis. However, in this series they witnessed no ring-related complications besides one case where the ring was broken and had to be replaced.

Conclusion

“To our knowledge this is the first report of up to four years multicenter results using the GaBP ring for banded gastric bypass surgery. In the four year follow up we see a good weight loss in the first year and a further slight weight loss up to year four with no regain of weight,” the authors conclude. “However, one limitation of our study is that to date only 13 patients completed the four year follow. We assume that banding the pouch can prevent pouch outlet dilation and thus reduce the need for revisionary operations after gastric bypass surgery. We are looking forward to see the results of multicenter prospective comparison of banded and conventional gastric bypass.”

Owen Haskins – Editor in chief, Bariatric News

Riferimento Pubmed: (http://www.ncbi.nlm.nih.gov/pubmed/25391401.

http://www.bariatricnews.net/?q=news%2F111715%2Fbanded-rygb-maintains-weightloss-four-years&utm_source=IFSO+Member&utm_campaign=2c16edc684-BN+IFSO+November+2014+highlights&utm_medium=email&utm_term=0_69274c1fb4-2c16edc684-%5BLIST_EMAIL_ID%5D&ct=t%28BN+IFSO+November+2014+highlights%29

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LA CHIRURGIA BARIATRICA PUO` MIGLIORARE LA FUNZIONE RENALE

LA CHIRURGIA BARIATRICA PUO` MIGLIORARE LA FUNZIONE RENALE

 

Secondo uno studio recente, presentato durante la Settimana del Rene (Kidney Week 2014), alla Società Americana di Nefrologia (ASN), presso il Pennsylvania Convention Center di Philadelphia, un gruppo di ricercatori ha esaminato e correttamente evidenziato l’associazione tra la perdita di peso ottenuta dal paziente obeso, dopo un intervento di chirurgia bariatrica e la velocità di filtrazione glomerulare (eGFR) , stimata attraverso l’equazione CKD-EPI.

 

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“Bariatric surgery serves as a good model to examine the effects of weight loss on kidney function. Our findings suggest a beneficial impact on kidney function in patients with and without baseline kidney disease,” said Alex Chang from the Geisinger Medical Center, Pennsylvania.

The association between weight loss and resolution of albuminuria was examined in the subset of patients with baseline albuminuria (albumin/creatinine ratio >=30mg/g) and subsequent ACR quantification. Mixed effects models were used, adjusted for time and baseline weight, allowing intercepts and slopes to vary for each individual.

A total of 3,134 patients were followed for a median of 2.4 years and the mean age was 47.2, 36.6% had diabetes, and 6.4% had eGFR

They noted that every 5kg of weight loss was associated with a 0.50 ml/ min/1.73m2 (95% CI: 0.42 to 0.57; p<0.001) increase in eGFR. The association between weight loss and increased eGFR was stronger in patients with eGFR <60ml/min/1.73m2: 0.89 ml/min/1.73m2 per 5kg decrease (95% CI: 0.63 to 1.15; p<0.001) compared to 0.46 (0.39 to 0.54; p<0.001) for those with eGFR >60 ml/min/1.73m2 (p

“More emphasis should be placed on promoting healthy lifestyles to avoid morbid obesity, and prevent chronic kidney disease,” concluded Chang. “Additional studies using other markers of kidney function are needed to confirm the study’s findings and to examine the effect of weight loss on long-term kidney outcomes.”

Owen Haskins – Caporedattore, Bariatric News

Novembre 2014

http://www.bariatricnews.net/?q=news/111716/bariatric-surgery-could-improve-kidney-function

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LA CHIRURGIA BARIATRICA APPORTA UN SIGNIFICATIVO MIGLIORAMENTO DELLA STEATOSI EPATICA NON ALCOLICA (NAFLD)

 

Secondo una nuova ricerca presentata alla Digestive Disease Week (DDW), i ricercatori della University of South Florida-Tampa (USF) hanno scoperto che la chirurgia Bariatrica risolve l’infiammazione del fegato e riducendo i depositi di grasso, provoca un miglioramento della fibrosi epatica in stadio precoce, dell’ispessimento e la cicatrizzazione del tessuto epatico.

“About 30 percent of the US population suffers from this disease, which is increasing, and more than half are also severely obese,” said Dr Michel Murr, lead researcher of the study, professor of surgery and director of Tampa General Hospital and USF Health Bariatric Center. “Our findings suggest that providers should consider bariatric surgery as the treatment of choice for NAFLD in severely obese patients.”

Murr and his colleagues suggest that bariatric surgery be considered for patients with a BMI>35 and obesity-related co-morbidities or BMI>40. They note that traditional interventions, such as medications, have a low success rate with these patients.

Researchers compared liver biopsies from 152 patients, one at the time of the bariatric procedure and a second an average of 29 months afterwards. Mean pre-op BMI was 52±10 and mean excess body weight loss was 62±22% at the time of the subsequent biopsy.

In examining pre-operative biopsies, researchers identified patients with cellular-level manifestations of NAFLD, specifically, fat deposits and inflammation of the liver. These types of liver damage can lead to liver fibrosis and cirrhosis.

After reviewing post-operative biopsies, they found that bariatric surgery resulted in improvements for these patients. In the post-operative biopsies, researchers found that fat deposits on the liver resolved in 70 percent of patients. Inflammation was also improved, with lobular inflammation resolved in 74 percent of patients, chronic portal inflammation resolved in 32 percent, and steatohepatitis resolved in 88 percent.

In addition to these improvements, 62 percent of patients with stage two liver fibrosis had an improvement or resolution of the fibrosis. One of three patients with cirrhosis also showed improvement.

Murr noted that these findings on fibrosis reversal apply only to early-stage fibrosis, and not late-stage liver disease. 

“We are in the midst of an obesity epidemic that can lead to an epidemic of nonalcoholic fatty liver disease,” added Murr. “As a tool in fighting obesity, bariatric surgery could also help prevent the emergence of widespread liver disease.”

Tuesday, May 6, 2014 – 12:52

Owen Haskins – Editor in chief, Bariatric News

http://www.bariatricnews.net/?q=news%2F111450%2Fbariatric-surgery-can-reduce-liver-damage&utm_source=IFSO+Member&utm_campaign=270052366a-BN+Gen+06%2F05%2F14&utm_medium=email&utm_term=0_69274c1fb4-270052366a-%5BLIST_EMAIL_ID%5D&ct=t%28BN+Gen+06%2F05%2F14%29

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LA SLEEVE GASTRECTOMY LAPAROSCOPICA (LSG) HA I PIU`BASSI TASSI DI MORBILITA` LEGATI ALLA PROCEDURA

Secondo i risultati di un recente studio, condotto per sei anni e presentato al 29° Meeting Annuale ASMBS’ a San Diego, CA, l’intervento laparoscopico di Sleeve Gastrectomy (LSG) comporta una bassa morbilità e il più basso rischio di re-interventi, nel corso del tempo, se confrontato con altre procedure bariatriche: Roux-en-Y bypass gastrico (RYGB) e bendaggio gastrico regolabile laparoscopico (LAGB).

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“The aim of the study was to identify which of the bariatric procedures performed today is the safest in terms of procedure related morbidity,” said Dr Raul J Rosenthal from the Bariatric and Metabolic Institute and the Section of Minimally Invasive and Endoscopic Surgery, Cleveland Clinic Florida. “So we carried out a single institution retrospective review of our centre’s six year experience since LSG was introduced comparing the procedure with Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric band (LAGB).”

Rosenthal and colleagues retrospectively analysed a prospectively collected database in morbidly obese patients that underwent bariatric surgery between 2005 and 2011. They identified and compared complications, hospital stay, readmissions and re-operations in patients that underwent all three procedures.

A total of 2,433 bariatric procedures were performed during this period of time. There were no significant differences between the groups in terms of age, gender or BMI. Rosenthal explained that in his institution, banding is only applied to patients with a BMI 35-50, whereas LSG is applied to all patients including the high risk and RYGB is applied to all patients with a BMI of >35.

Outcomes

Of those procedures 1,492 were RYGB, 602 LSG and 339 LAGB. The number of readmissions was minimal in all three groups with RYGB 1.7 times, LSG 1.3 times and 1.5 times for LAGB. The percentage of procedures requiring reoperations due to complications or failures was 7.7% in the RYGB group, 1.5% in the LSG and 15.3% for the LAGB.

“LSG appears to have the lowest rate of re-operations when compared to banding and bypass, and surprisingly banding had the highest rate of re-intervention,” said Rosenthal. “The primary reason for removing bands was slippage, followed by failure and reflux.”

The outcomes also revealed that average postoperative length of stay was longer following RYGB (3.75 days) compared with LSG (3.4 days) and banding (1.47 days). The leakage rate was 0.4% for the RYGB and 0.3% for the LSG (leakage rates are not applicable for LAGB).

“One of the weaknesses of this study, as with all retrospective studies, is that patients were not randomised,” he explained. “Therefore, it could be that there is a patient population in one group or another that could trigger a difference in the outcomes.”

“However, I believe that this study adds to the body of evidence, which includes randomised studies and meta-analyses, that LSG is an outstanding treatment option for morbid obesity,” concluded Rosenthal. “I think the message from this relatively small study is that at this point LSG is the safest procedure when treating morbidly obese patients.”

The co-authors of the study were Drs Abraham Fridman, Karan Bath, Andre Teixeira and Samuel Szomstein.

Owen Haskins – Editor in chief, Bariatric News

http://www.bariatricnews.net/?q=news/11321/lsg-has-lowest-rates-procedure-related-morbidity

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IN AMERICA, L`INTERVENTO LAPAROSCOPICO DI GASTRECTOMIA VERTICALE (SLEEVE GASTRECTOMY) HA ORMAI AMPIAMENTE SOSTITUITO, COME PROCEDURA BARIATRICA, IL BENDAGGIO GASTRICO

 

Secondo un articolo pubblicato sul Journal of American College of Surgeons, nei centri Accademici degli Stati Uniti, l’intervento laparoscopico di gastrectomia verticale (Sleeve gastrectomy) ha ormai ampiamente sostituito, come procedura bariatrica, il bendaggio gastrico

The study examined the popularity of procedures between October 1 2008 and September 30 2012. It found that by 2012, gastric banding made up 4.8% of all bariatric operations performed in US academic hospitals, a drop from 23.8% four years earlier. Over the same time period, sleeve gastrectomy rose from 0.9% to 36.3%.

Despite remaining the most popular operation, the number of laparoscopic gastric bypasses also decreased over the same period, from 66.8% of all operations in the fourth quarter of 2008 to 56.4% in the third quarter of 2012. The number of open gastric bypasses continued to decline, from 8.6% in 2008 to 3.2% in 2012.

The paper took data from the University HealthSystem Consortium Clinical Database, which collects data from all US academic health centres and affiliate community hospitals. It included data from 60,738 patients.

The authors say that it is the first paper to demonstrate the national trend in the increased use of laparoscopic sleeve gastrectomy in the USA. However, they note that their data did not include operations performed in private medical centres, which means that the numbers reported may not be completely accurate as a picture of bariatric surgery across the country.

The paper notes a number of factors which potentially led to the speedy acceptance of sleeve gastrectomy as a primary operation, at the expense of gastric bands – most notably, the support of the operation as a primary procedure by the ASMBS.

Other factors included the sleeve gastrectomy being found to engender greater weight loss than the gastric band; the willingness of third-party payors to fund the operation; and the perception that failed gastric bands were leading to an unacceptably high rate of explantation.

The paper also published the number of centres performing each type of operation, finding that while the number of centres performing bariatric procedures remained steady, the number of centres performing sleeve gastrectomy had risen by late 2012 to the point where there were over 80 centres identified as performing the operation in the sample, matching the number of centres performing gastric bypass. Conversely, the number of centres performing gastric banding dropped from almost 60 in 2010 to just over 20 in 2012.

Friday, March 1, 2013 
Pete Myall – Online editor, Bariatric News
http://www.bariatricnews.net/?q=news/11844/sleeve-gastrectomy-replaces-gastric-banding-usa
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L`American Medical Association (AMA) riconosce ufficialmente l`Obesità come “malattia”

AMA’S CLASSIFICATION OF OBESITY AS A DISEASE WILL ENHANCE PATIENT CARE, TREATMENT AND PREVENTION

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) commends the American Medical Association (AMA) on its announcement officially recognizing obesity as a disease.

“The AMA’s announcement is a tremendous step forward in legitimizing the severity of the obesity epidemic in our nation,” said Dr. Gerald Fried, SAGES President. “AMA’s decision will increase coverage and patient access to necessary treatment options for the disease, including weight-loss surgery, which  is the most effective treatment for morbid obesity, producing durable weight loss, improvement or remission of comorbid conditions, and longer life.”

SAGES 2013The United States has experienced a steady rise in obesity prevalence over the last 20 years and has the highest national rate of obesity. At the turn of the millennium, nearly two-thirds of Americans were overweight or obese, and almost 5% were morbidly obese [1]. This trend is ominous, because morbid obesity predisposes patients to comorbid diseases which affect nearly every organ system. These include: type 2 diabetes, cardiovascular disease, hypertension, hyperlipidemia, hypoventilation syndrome, asthma, sleep apnea, stroke, pseudotumor cerebri, arthritis, several types of cancers, urinary incontinence, gallbladder disease, and depression [2-4]. Obesity shortens life expectancy [5], with increasing body mass index (BMI) resulting in proportionally shorter lifespan [6].

According to SAGES Bariatric Group, Co-Chaired by Dr. Marian Kurian and Dr. Kevin Reavis, “From a purely medical standpoint, AMA’s move will provide primary care physicians with the diagnostic license to specifically treat obesity, alongside other co-morbidities, and to also prescribe necessary wellness and prevention programs which will go a long way toward treating the disease, improving quality of life and increasing life expectancy.”

  1. Flegal KM, Carroll MD, Ogden CL, Johnson CL (2002) Prevalence and Trends in obesity among US adults, 1999-2000. JAMA 288:1723-1727
  2. Must A, Spadano J, Coakley EH et al (1999) The disease burden associated with overweight and obesity. JAMA 282(16):1523- 1529
  3. Overweight, obesity, health risk: National Task Force on the prevention and treatment ofobesity (2000) Arch Intern Med 160:898-904
  4. North American Association for the study of obesity (NAASO), theNational Heart (1998) Clinical Guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. National Institutes of Health, Bethesda, MD, NIH publication 98-4083
  5. Mizuno T, Shu IW, Makimura H, Mobbs C (2004) Obesity over the life course. Sci Aging Knowledge Environ 2004(24): re4 (ISSN 1539-6150)
  6. Fontaine KR, Redden DT, Wang C et al (2003) Years of life lost due to obesity.
    JAMA 289(2):187-193

SAGES has been at the forefront of best practices in laparoscopic surgery by researching, developing and disseminating the guidelines and training for standards of practice in surgical procedures. SAGES Guidelines for Clinical Application of Laparoscopic Bariatric Surgery,  were issued in 2008 and are a series of systematically developed statements to assist physicians’ and patients’ decisions about the appropriate use of laparoscopic surgery for obesity.

Guidelines are available at SAGES website – Guidelines for Clinical Application of Laparoscopic Bariatric Surgery.

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LA CHIRURGIA BARIATRICA RIDUCE IL RISCHIO DI ARRESTO CARDIACO

LA CHIRURGIA BARIATRICA RIDUCE IL RISCHIO DI ARRESTO CARDIACO

Secondo i ricercatori della University of East Anglia, l’Università di Manchester e l’Università di Aberdeen, i pazienti sottoposti a chirurgia bariatrica dimezzano il rischio di avere un arresto cardiaco.
Lo studio, pubblicato sulla rivista International Journal of Cardiology, ha esaminato i dati di quattordici studi che hanno coinvolto più di 29.000 pazienti sottoposti a Chirurgia bariatrica. I risultati sono impressionanti: la mortalità è stata ridotta del 40% e gli attacchi di cuore, in particolare, sono diminuiti della metà, rispetto alle persone obese, che non hanno subìto un intervento chirurgico.

The researchers said that they believe the is the first comprehensive review of the impact of surgery on heart disease, stroke and death.

“We looked at the outcomes for patients who undergo bariatric surgery, and compared them to figures for obese people who had not received surgery,” said Senior author, Dr Yoon Loke from UEA’s Norwich Medical School. “We saw that surgery was potentially life-saving and could lower the risk of having a heart attack and stroke by almost 50 per cent.”

The mean age of participants was 48 years old, and 30 per cent of participants were male. The original studies were carried out the North America, Europe and Australia, and patients were followed-up from two years to 14 years.

After conducting a literature search, they identified 14 studies that met the inclusion criteria, and this included 29,208 patients who underwent bariatric surgery and 166,200 non-surgical controls (mean age 48 years, 30% male, follow up period ranged from 2 years to 14.7 years).

They found that compared to nonsurgical controls, there was more than 50% reduction in mortality amongst patients who had bariatric surgery (OR 0.48 95% CI 0.35–0.64, I2=86%, 14 studies). In pooled analysis of four studies with adjusted data, bariatric surgery was also associated with a significantly reduced risk of composite cardiovascular adverse events (OR 0.54 95% CI 0.41–0.70, I2=58%).

Bariatric surgery was also associated with significant reduction in specific endpoints of myocardial infarction (OR 0.46 95% CI 0.30–0.69, I2 = 79%, four studies) and stroke (OR 0.49 95% CI 0.32–0.75, I2 = 59%, four studies).

“Obesity is a worldwide problem with significant consequences on individuals and society. It is associated with heart disease, type 2 diabetes, many cancers, and a shorter life expectancy,” added Loke. “The latest (UK) government figures from 2011 show that obesity affects about one in four people in the UK and this figure is growing. During 2011-12, the NHS reported 11,736 hospital admissions due to obesity, which represents an 11-fold increase compared to the 1,019 admissions in 2001-02.

“These findings suggest that surgery should be seriously considered in obese patients who have a high risk of heart disease. This is the right time for a large, high-quality trial of bariatric surgery in the NHS to confirm the potential benefits.”

Owen Haskins – Editor in chief, Bariatric News

Approfondimenti:
http://www.bariatricnews.net/?q=news%2F111413%2Fbariatric-surgery-reduces-risk-cardiac-arrest-and-stroke

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LA CHIRURGIA BARIATRICA RIDUCE IL PESO E MIGLIORA IL METABOLISMO DEL GLUCOSIO NEI PAZIENTI OBESI

Il “Journal of Hepatology”  (Volume 60, Issue 2 , Pages 377-383,  febbraio 2014) ha pubblicato uno studio in relazione agli effetti della chirurgia bariatrica sulla sensibilità all’insulina epatica, che risulta sensibilmente migliorata già dopo sei mesi dall’intervento chirurgico. Detti effetti metabolici sono stati accompagnati da una marcata riduzione del volume epatico e del contenuto di grassi.

Abstract

Background & Aims
Bariatric surgery reduces weight and improves glucose metabolism in obese patients. We investigated the effects of bariatric surgery on hepatic insulin sensitivity.

Methods
Twenty-three morbidly obese (nine diabetic and fourteen non-diabetic) patients and ten healthy, lean control subjects were studied using positron emission tomography to assess hepatic glucose uptake in the fasting state and during euglycemic hyperinsulinemia. Magnetic resonance spectroscopy was performed to measure liver fat content and magnetic resonance imaging to obtain liver volume. Obese patients were studied before bariatric surgery (either sleeve gastrectomy or Roux-en-Y gastric bypass) and six months after surgery.

Results
Insulin-induced hepatic glucose uptake was increased by 33% in non-diabetic and by 36% in diabetic patients at follow-up compared with baseline, but not totally normalized. The liver fat content was reduced by 76%, liver volume by 26% and endogenous glucose production by 19% in non-diabetic patients. The respective changes in diabetic patients were 73%, 24%, and 25%. Postoperatively, liver fat content and endogenous glucose production were almost normalized to lean controls, but liver volume remained greater than in control subjects.

Conclusions
This study shows that bariatric surgery leads to a significant improvement in hepatic insulin sensitivity: insulin-stimulated hepatic glucose uptake was improved and endogenous glucose production reduced when measured, six-months, after surgery. These metabolic effects were accompanied by a marked reduction in hepatic volume and fat content. Overall, the gain in hepatic insulin sensitivity in diabetic patients was quite similar to non-diabetic patients for the same weight reduction.

Abbreviations: BS, bariatric surgery, T2DM, type 2 diabetes, EGP, endogenous glucose production, HGU, hepatic glucose uptake, VLCD, very-low-calorie diet, PET, positron emission tomography, 18F-FDG, 18F-fluorodeoxyglucose, MRI, magnetic resonance imaging, SG, sleeve gastrectomy, RYGB, Roux-en-Y gastric bypass, OGTT, oral glucose tolerance test, MRS, magnetic resonance spectroscopy, LFC, liver fat content, HbA1c, glycosylated haemoglobin, hs-CRP, high-sensitivity C-reactive protein, IL-6, interleukin-6, IL-8, interleukin-8, MCP-1, monocyte chemotactic protein-1, GLP-1, glucagon-like peptide-1

http://www.journal-of-hepatology.eu/article/PIIS0168827813006685/abstract

 

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IL 63,8% DEGLI ADULTI IN INGHILTERRA SONO IN SOVRAPPESO O OBESI

Map of England showing obesity % prevelence                 (Source: www.sepho.nhs.uk/NOO/e-Atlas/adult/atlas.html)

 

New data published by Public Health England (PHE) has confirmed that 64% of adults are overweight or obese. The data also shows for the first time the considerable variation in the numbers of people who are overweight or obese in different parts of England, as well as the extent of the challenge many local authorities and the local National Health Service face.

However, the rate of  increase in overweight and obese adults has slowed in recent years and in children, levels are stabilising. However, welcome though this is, given the health problems associated with being overweight or obese there are no grounds for complacency.

“Overall health problems associated with being overweight or obese cost the NHS over £5 billion each year,” said Professor Kevin Fenton, Director of Health and Wellbeing at PHE. “There is no silver bullet to reducing obesity; it is a complex issue that requires action at individual, family, local and national levels.

We can all play our part in this by eating a healthy balanced diet and being more active.”

The report shows that Copeland in West Cumbria is the local authority with the greatest obese population area in England, where 75.9% of the population are classed as overweight or obese. The North East is the region with the largest obese population with 68% of the population are overweight, followed by the West Midlands at 65.7%.

By local authority

1. Copeland in west Cumbria (75.9% are overweight or obese)

2. Doncaster in South Yorkshire (74.4%)

3. East Lindsey in Lincolnshire (73.8%)

4. Ryedale in North Yorkshire (73.7%)

5. Sedgemoor in Somerset (73.4%)

6. Gosport in Hampshire (72.9%)

7. Castle Point in south Essex (72.8%)

8. Bolsover in Derbyshire (72.5%)

9. County Durham (72.5%)

10. Milton Keynes (72.5%)

By county

1. Cumbria (68.3%)

2. Lincolnshire (68.2%)

3. North Yorkshire (67.9%)

4. Staffordshire (67.9%)

5. Northamptonshire (67.5%)

6. Essex (67.3%)

7. Derbyshire (66.9%)

8. Nottinghamshire (66.4%)

9. Norfolk (65.7%)

10. Worcestershire (65.5%)

By region

1. North-east (68%)

2. North-west (66%)

3. West Midlands (65.7%)

4. East Midlands (65.6%)

5. Yorkshire and the Humber (65.4%)

6. East of England (65.1%)

7. South-east (63.1%)

8. South-west (62.7%)

9. London (57.3%)

The figures are based on adjusted, self-reported height and weight measurements collected via questions in the Active People Survey by Sport England since January 2012.

Owen Haskins – Editor in chief, Bariatric News

http://www.bariatricnews.net/?q=news/111337/638-adults-england-are-obese

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