Studies show benefits of exercise, bypass surgery for obese

As she neared 400 pounds, Mytrice Singleton said, her doctor sat her down and painted a bleak picture of her future.


“If I don’t do something about it, I might be dead or in a wheelchair in the next two years,” she said.

After getting gastric bypass surgery in 2001, however, she has dropped about 150 pounds and no longer needs her blood pressure medications.

“It’s done a lot for my blood pressure,” she said.

A study out Tuesday in the Journal of the American Medi­cal Association that includes research from Georgia Health Sciences University backs up her claim of long-term benefits from the surgery.

The same journal also contains a GHSU study showing that daily exercise in overweight and obese children can have a significant impact, including reducing the risk of developing diabetes.

Coincidentally, both studies are being released at the same time an annual report finds that states are getting fatter and projects that in 2030, in some states, including South Carolina, more than 60 percent of people will be obese.

“That’s a huge impact on our society,” said Jeff Levi, the executive director of Trust for America’s Health, which helped prepare the annual “F as in Fat” report.

His group and the Rob­ert Wood Johnson Foun­da­tion urged states to take measures to curb obesity, such as pushing for more healthful food and more physical activity in schools. The GHSU study shows compelling evidence that such measures can make a difference, said the lead author, Dr. Catherine L. Davis, a professor of pediatrics, physiology and graduate studies.

More than 200 overweight or obese 9-year-olds were divided into groups that got daily exercise for 20 minutes or 40 minutes, or no extra activity. Those receiving the most exercise got the most benefit in terms of reduced body fat, and both exercise groups had an improvement in fitness and insulin resistance, a risk factor for diabetes.

Nearly 30 percent of the children were considered to have prediabetes, and after daily exercise for 13 weeks “many of the kids in the study actually did move into the lower risk category, from high to moderate” risk of developing diabetes, Davis said.

More important, 94 percent stuck with the program, which shows children will get active “if it is done in a charming way,” she said, which included games.

“It needs to be the easiest option for them; it needs to be appea­l­ing; it needs to be easy for their parents,” Davis said. The study used after-school programs in which children were bused directly from school.

“This essentially says that this kind of thing should be implemented daily after school as widely as possible,” Davis said.

Levi said it shouldn’t be difficult to implement.

“We’re not talking about total transformation. We’re talking about 20 minutes a day making a huge difference in people’s health trajectories,” he said. “Integrating 20 minutes a day of physical activity into a school system is not hard to do. This doesn’t require formal (physical education) courses. It can be physical activity during recess. It can be having kids walk to school more often.”

For some, more exercise and dieting aren’t going to be possible. One of the fastest-growing segments of the obesity epidemic is the severely obese, and for it gastric bypass surgery might be the best solution, said Dr. Sheldon E. Litwin, GHSU’s chief of cardiology.

“People ask me all of the time, ‘Wouldn’t it be better if people lost weight by changing their diet and exercising?’ The answer is yes, of course it would,” Litwin said. “But the reality is it just doesn’t work.”

Litwin and colleagues at the University of Utah did a six-year follow-up study with 418 patients who had gastric bypass surgery and compared them with a similar number of severely obese patients who were evaluated but did not choose the surgery, and with another randomly selected control group that was not seeking the surgery.

Compared with their peers, the rate of new diabetes cases was reduced 79 percent to 89 percent in the surgery patients, and more than 60 percent who were diabetic had their diabetes resolved.

“Certainly, the resolution of diabetes is huge,” Litwin said. “Diabetes just has so many complications, from the eyes to nerve problems to heart problems.”

There were similar benefits with cardiovascular risk factors and cholesterol levels.
Litwin and colleagues have received a third round of funding to do a 10-year follow-up and are hoping that at some point there will be a improvement in mortality.

“Every year that you have those complications, that you have diabetes and hypertension, they have cumulative effects on your body,” Litwin said.

Levi, who is urging states to work on getting the obese to reduce weight just 5 percent to improve their health and health care costs, acknowledged that extreme measures might be necessary for some, in addition to healthy community initiatives and lifestyle changes,

“All together will help us address this problem,” he said.

Staff Writer Sandy Hodson contributed to this article.

Obesity conference looks to address Georgia's weight problem
Obese and severely obese could raise costs in the future, study says

The annual "F as in Fat" report by the Trust for America's Health and the Robert Wood Johnson Foundation looks at obesity by state and projects it out into 2030, including the impact on disease and health care costs. Here's a look at their latest numbers. The national ranking is in parentheses:

2011 obesity rate28% (24)30.8%(8)
2030 obesity projection 53.6% (35)62.9% (5)
2030 projected new diabetes 11,405 (40)13,156 (16)
2030 projected new heart disease and stroke23,032 (45)28,886 (16)
2030 projected health care cost increase24.3% (5)12.6% (35)
Children overweight or obese37.3% (3)33.7% (13)

The percentage of obese and overweight U.S. high school students:

Database: Childhood obesity
Editorial: A large-scale problem
Editorial: Straining under the weight
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