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|Growth Hormone Treatment after Weight Loss Surgery Prevents Loss of Muscle Mass|
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Growth hormone treatment for six months after weight loss surgery reduces patients' losses in lean body mass and skeletal muscle mass, according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
Weight loss surgery techniques, such as gastric banding, have been shown to be effective in reducing body weight and obesity-related diseases, such as diabetes. Although the results of these procedures are widely beneficial, there are some complications. Following surgery, patients are at risk of losing needed lean body mass and skeletal muscle mass due to the serious complications associated with rapid and sustained weight loss. This new study investigated whether growth hormone treatment could prevent or reduce these losses."Besides its more commonly known effect on linear growth during childhood, growth hormone benefits body composition throughout life by increasing muscle mass and reducing fat mass," said Dr. Silvia Savastano, M.D., Ph.D., researcher at University Federico II of Naples in Italy and lead author of the study. "The results of our study show that the use of short-term treatment with growth hormone during a standardized program of low calorie diet and physical exercise is effective in reducing the loss of muscle mass and increasing the loss of fat mass after bariatric surgery."
In this study, Dr. Savastano and her colleagues evaluated women who underwent laparoscopic-adjustable silicone gastric banding surgery and were diagnosed with growth hormone deficiency after the procedure. These women were divided into two groups where both groups participated in a standardized diet and exercise program, but only one group also received growth hormone. After a follow-up period of six months, women receiving growth hormone experienced a significant decrease of fat mass and an increase in lean body and skeletal muscle mass.
"This evidence opens a new frontier for growth hormone therapy in the management of morbidly obese patients," said Dr. Savastano. "However, growth hormone treatment can be costly and a careful cost-benefit analysis that also takes into account the cost of commonly used therapy for management of morbidly obese patients is needed."
Other researchers working on the study include Carolina Di Somma, Francesco Orio, Gaetano Lombardi, and Annamaria Colao of University Federico II of Naples in Italy; and Salvatore Longobardi of Merck-Serono Italia in Rome, Italy.
The article "Growth Hormone Treatment Prevents Loss of Lean Mass after Bariatric Surgery in Morbidly Obese Patients," will appear in the March 2009 issue of JCEM.
About Bariatric Surgery
Bariatric surgery is a term derived from the Greek words: weight and treatment. In simple terms, bariatrics concerns the causes, prevention and treatment of severe overweight, a condition known as obesity. Bariatric operations are major gastrointestinal procedures which alter the capacity and/or the anatomy of the digestive system. Some bariatric procedures are performed using general anesthesia via a midline abdominal incision. Some bariatric surgeons also use laparoscopic surgical techniques, involving smaller instruments connected to cameras through which they view the operational site. Bariatric weight loss surgery fall into three general categories:
Restriction OperationsThere are two types of restrictive operations:
Gastric Bypass OperationsGastric Bypass Operations are combination operations. That is, they combine both restrictive and malabsorptive techniques:
Comparing the Weight Loss Procedures
Open Vs. Laparoscopic Surgery
Open and laparoscopic refer to how abdominal cavity is entered and not the type of surgery being performed. So each type of weight loss surgery may be performed as either an open or a laparoscopic procedure.
When performing open surgery, surgeons create a single incision to open the abdomen for the operation. Typically, for women it is 4 1/2 to 6 inches, and for men, it is 5 1/2 to 7 inches.
With laparoscopic surgery, multiple, small incisions are made in the abdominal wall to accommodate a small video camera and surgical instruments. The surgeon views the procedure on a separate video monitor. Most laparoscopic surgeons believe this gives them a better view and access to key structures.Although open surgeries are still more common, most surgeons now offer the less invasive laparoscopic procedure whenever possible since studies show patients who have had laparoscopic weight loss surgery experience:
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