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Reasons for discontinuation of GLP1 receptor agonists: data from a real-world cross-sectional survey of physicians and their patients with type 2 diabetes
There are numerous complications with GLP-1 medications. Figure 2 outlines why so many patients have to stop these medications:
DMSO-141235-reasons-for-discontinuation-of-glp-1-receptor-agonists–data_092917
GLP-1 agonists: A review for emergency clinicians
GLP-1 Agosinsts have extensive and complex side effects and complications profile
This table is from a large review publication for Emergency physicians dealing with the complications of GLP-1 agonist medication.
Hard to believe Adjustable Gatric Band Is till considerend an option
The adjustable gastric band, the Lap Band, was approved in the US in early 2000 based on a small study with only 149 patients. Over the next decade, the Lap Band became very popular, as mixed data and high revision and complication rates were noted in the literature.
Large, small, and short and long-term publications reported a similar theme: The weight loss following Adjustable gastric banding is less than predicted, complications are higher, and further surgical care is needed.
Patients should ask themselves why a procedure’s reversibility should be promoted. For example, why is the Lap band advertised as easily reversible?
Would anyone consider a knee replacement surgery only if it can be reversed and the knee pain returns?
The reversibility of the procedure is promoted because most of them need to be revised over time.
One of the few papers that presented favorable results needs to be looked at closely, and the respondents were fewer than the patients who had been operated on (199+186=385 of the 1334 more than three years post-op)
A large meta-analysis reported the worst weight loss with the Adjustable gastric banding and the best with the duodenal switch operation.
In my opinion, given the proven data of the sleeve gastrectomy and other irreversible complications of the lap band, no one should get it done since the risks associated with complications and inadequate weight loss far outweigh any benefit.
Weight loss surgery benefits those with headaches
Idiopathic Intracranial Hypertension is a condition where the pressure builds up in the skull due to pressure gradient and blood flow restrictions due to weight gain. This manifests as a condition called Pseudotumor Cerebri, which improves with weight loss surgery, as reported previously.
There is recent publication further supports that patients with any weight gain should consider weight loss surgery if they have findings of increased intracranial hypertension, which may also manifest itself with vision-related issues.
Long-Term Effect of Bariatric Surgery on Liver Enzymes in the Swedish Obese Subjects (SOS) Study
Liver enzymes are quite frequently elevated in patients with any degree of obesity. This elevation is even further exacerbated by conditions such as diabetes, elevated cholesterol, and triglycerides. Scientific evidence shows that weight loss surgical procedures improve the lever enzymes in the long term even if transiently they may worsen. We had previously published this finding.
Modeling and Simulation for Identification of Possible Cause for Portal Vein Thrombosis: A Complication of Sleeve Gastrectomy.
Background: This study was performed to study possible causes of Portal Vein thrombosis, a potentially deadly complication of specific foregut surgical procedures. Methods: Mathematical models of blood flow to the foregut organs, stomach, duodenum, spleen, and liver were created in MATLAB. Pathologic conditions were created by removing or adding the electrical components in the circuit modeled in MATLAB. These modifications represented surgical variation and hemodynamic changes. Comparing the input and output waveforms and comparing them to the known wave from live subject samples were able to model conditions where the likelihood of portal vein thrombosis is most likely to occur. Results: Ligation of the gastroepiploic vessels produce significant flow disruption in our model, significantly more than dehydration, causing portal vein flow reduction and possible portal vein thrombosis. Conclusion: Summary and potential implications. Trial registration: No registration or IRB was required. The study did not involve any human or animal subjects.
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