weight loss – Page 2 – watercress words by Dr Aletha

The ReShape Integrated Dual Balloon System was approved by the U.S. Food and Drug Administration in July 2015. The device can be offered to adults with

BMI 30-40
At least one obesity-related condition- hypertension, diabetes, elevated cholesterol

The device is placed into the stomach by going through the mouth and down the esophagus with a tube called an endoscope. It takes about 30 minutes and requires only a mild sedative, not general anesthesia. Once in the stomach the “balloon” is inflated; by taking up space in the stomach it can trigger a feeling of fullness.

Patients follow their eating and exercise plan and the device is removed in 6 months.

My reader asked if people with heartburn, reflux or a hiatal hernia can use the device safely and effectively. So first let’s understand what these mean.

Heartburn should probably be called “esophagus burn”. It’s that painful sensation in the chest due to acid from the stomach flowing backwards into the esophagus- that’s called reflux, or gastro-esophageal reflux, aka GERD (the D is added to call it a Disease if it’s frequent, persistent, or severe).

A hiatal hernia is related to GERD but not the same thing. To enter the stomach, the esophagus passes through a hole or hiatus in the diaphragm – the large flat muscle that separates the chest from the abdomen. Sometimes this hole becomes stretched so much that part of the stomach gets pulled up into the chest (where it should not be). This enlargement is called a hernia, in this case a hiatal hernia.

In many cases a hernia is associated with reflux of stomach contents but the person may not experience heartburn. Or,a person can have reflux and heartburn without the hernia.

Here is an overview of heartburn from FamilyDoctor.org.

Thanks to Pixabay for this nice illustration of the digestive tract.

digestive organs — the human digestive system

Now to answer the question.

ReShape Medical writes on the web site that the device should not be used if the hiatal hernia is larger than 5 cm, about 2 inches. Even with a smaller hernia, it should not be used if reflux symptoms are severe and persistent.

Persons with any condition affecting the esophagus, stomach or intestines, or previous surgery in these organs probably should not consider this weight loss method. Unfortunately, since so many people experience gastrointestinal disease, this method’s use will be limited.

This post has been updated July 22, 2021

On this blog we’ve looked at

how lifestyle changes can make losing weight possible and

which weight loss programs work best.

But what if those do not work? Studies show that any low fat, low carb , or other restricted calorie diet can lower weight, but then weight tends to plateau and may even rise again.

For severely overweight people, especially with a BMI of 30 or more, this means that even if they lose weight, they still have not reached a healthy weight. For them, some type of weight loss (bariatric) surgery may be considered.

For some, medication is a good option for weight loss. — For some people, medication is an acceptable option for weight loss.

One option is prescription medication. Prescribing drugs for weight loss is not new, and has been an approach used by some retail weight loss clinics, “weight doctors”, for years.

Most of these programs used stimulant type drugs, amphetamines, to decrease appetite. People do lose weight on these because they eat less, but the drugs’ effect tends to diminish with time. They also have high potential for abuse and dependence.

When the non-amphetamine drug Meridia (sibutramine) was released, we thought we had found the solution- an effective drug without the risk and side effects. of amphetamines. However, once a significant risk of serious cardiac effects was found, its use was suspended.

Another drug, orlistat, seemed promising. Known by the brand names of Xenical and Alli, it works in the gut to block the absorption of fat. But patients found the unpleasant side effects of gas, diarrhea and oily stools not worth the benefit.

In past few years several new drugs have come to the party.

Belviq, lorcaserin, a serotonin agonist with uncertain action on appetite; as of September 2020, this has been withdrawn from the market.

Qysmia, a combination of two drugs- phentermine/topiramate,a stimulant and an antiseizure drug,

Contrave, also a combo -naltrexone, used for alcohol dependence and bupropion, an antidepressant

Saxenda, liraglutide; unique in that it is taken by subcutaneous (SC) injection similar to insulin; it also is used for diabetes under the name Victoza

Wegovy, semaglutide, also a subcutaneous injection, given just once weekly, rather than daily like Saxendra

Please note: none of these drugs are approved for use in pregnancy, and are in fact contraindicated, meaning they are unsafe in pregnancy and probably unsafe while breastfeeding.

These drugs all work in the brain to control appetite and increase satiety, the feeling of fullness. The long term solution to preventing and reversing obesity may lie in finding new ways to control the processes in the brain that control eating behavior. Much of obesity management research is directed to this area.

Learn more about the use and side effects of these drugs here-

via Diet Pills, Prescription Weight Loss Drugs, Appetite Suppressants.

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