Maybe you're not fat; Maybe you are just a "mutant"

It seems no matter what you read in the scientific literature today you read about this gene and that gene.  Genes are everywhere – literally.  

Now we may come to realize some obesity may be a genetic mutation.  A gene called MRAPZ – now, that would be a good name for a first born – when disabled caused mice to gain twice as much weight as their siblings.  

It is rare in humans but may explain why some people have such a hard time losing weight.  How many people do you and I know who have a hard time losing weight?  

As a Florida Plastic Surgeon, I encounter "hard losers" frequently

Hmm – maybe it is more common than we think.

Loosing weight did NOT cut heart attacks and strokes

Type II diabetes affects millions of Americans.  It usually comes later in life and is associated with excessive weight gain.  

At meeting held recently, the American Diabetes Association reported that weight loss programs aimed at overweight adults DID NOT cut the risk of heart attacks and strokes.  

This was quite surprising in view of our common belief that obese individuals arre more prone to heart attacks and strokes. 

There was a silver lining, however. Weight loss did cut the development of chronic kidney disease.  

As a practicing cosmetic surgeon who consults with obese people regularly, I was puzzled by this report.  The study, conducted over 10 to 13 years, was stopped short due to the fact it was obvious weight loss was not going to effect heart disease.

Tummy Tucks in Fort Myers and Southwest, Florida

Tummy Got You Down?

There used to be a time when women who gave birth viewed their stomachs afterwards and concluded there is nothing they could do about the residual skin and stretch marks. Similarly, women (and men) who lost weight and ended up with loose skin and stretched abdominal muscles had the same problem. Last year, however,  more than 150,000 American women and men had abdominoplasty surgery. 95% of those who had it said it was “worth it”, according to realself.com,  Abdominoplasty is also known as a tummy tuck. It is not an “instant fix” or replacement for weight loss. It is important to lose the weight first.  You should be in good health before having any surgery. The more weight you lose, the trimmer you will look. It's important after surgery to have a good dietary regimen in order to control your weight. It is common to think  you’ll be bedridden recovery for days after surgery. But, as a plastic surgeon, I recommend getting up the day after surgery to promote circulation. This encourages the area to receive much needed blood to promote healing. This also helps you feel better after surgery and gets you back on your feet. Within six weeks, most patients are able to do cardiovascular exercises like running and elliptical machine exercise. Caution: weight-lifting requires too much exertion and could strain the sutures and incisions. If you’re unsure of whether or not a tummy tuck is right for you, look at before-and-after photos either on my  website or on a patient education site like www.surgery.org. Tummy tuck photos can show you pictures of individuals who might have a similar body type and their results after surgery. Of course, the most important patient safety tip is: see a board-certified plastic surgeon.

Raspberry Ketone Diet

Recently I keep seeing ads touting the “new” raspberry ketone diet. 

This, like so many, is the new holy grail of weight loss.  

But hold on!  There was an interesting article about it in the Wall Street Journal.  Raspberry ketones give raspberries their natural aroma.  A study was done by Japanese researchers in 2005 that showed mice fed a high fat diet AND raspberry ketone gained less weight than mice fed a high fat diet alone. 

To my knowledge as a Cape Coral cosmetic surgeon no studies have been done on humans.  But the media hypes it and people buy it.  One thing to keep in mind, studies done in mice don’t necessarily translate the same results in humans.  

More research in humans is needed.  Sorry!

Update: This subject has received a ton of comments. While we are grateful the the implied endorsement of those who comment, we can' vet them all and we from time to time post dubious websites. We certainly don't endorse them, but merely include them for your evaluation. May 2013 shine on you with bounty. 

Complications in men after body contouring

Cosmetic surgery is no longer associated only with women. I perform cosmetic surgery for men quite frequently. Eyelid lifts and chin lifts are common. Now, body contouring is seeing resurgence due to more and more patients losing massive amounts of weight.  

It is not uncommon to see people losing 100 or more pounds.  

I recently did a tummy tuck on a woman who lost 140 pounds through diet and exercise.  

I will soon be expanding weight loss programs in my office.  More will be available on my website and blogs.

A recent study shows men who undergo body contouring surgery, i.e. removing excess skin in abdomen, chest, back or arms- had a 4x greater risk of hematoma (collection of blood) than women.  

However men were NOT at higher risk of more serious complications such as infection.

We don't know why this is so.  

I do know that hematomas in men following facial cosmetic surgery is greater due to greater blood supply.

OBESITY – WHAT REALLY WORKS?

Here's another heads-up from Dr. Robert Brueck MD, Fort Myers plastic surgeon who works with patients seeking weight loss.

New studies/reports show that bariatric surgery or weight loss surgery is more effective than medicine in controlling blood sugar in obese patients. The study appeared in the New England Journal of Medicine recently.

EAT CHOCOLATE FOR A THINNER YOU!

More good news from Dr. Robert Brueck MD.

We all know friends who are chocoholics.

A new study of people living in Southern California reveals that people who eat more chocolate tend to be thinner. The chocolate eaters actually consumed MORE calories that those that didn’t eat chocolate.

The study, however, may link the frequency of eating chocolate to weight loss. People who ate a small amount of chocolate 5 days a week had a lower BMI or body mass index.

IS THERE SUCH A THING AS “GOOD FAT”

I guess if you are trying to lose 20 lbs or so the answer would be a resounding “NO”!

Now, scientists have identified a baby fat called “brown fat”. It was thought that brown fat went away as we got older, but now we know adults have persistent brown fat that is active.

Interestingly the heavier a person is, the LESS brown fat they have. Brown fat gets it’s color from the iron contained in it.

As a Fort Myers plastic surgeon who deals with weight loss patients, I'm always for looking for ways to burn off more "bad" fat.

A study recently showed in mice that excess white fat can be turned into brown fat which is more metabolically active than white fat, ie. it burns more calories.

Cold also increases brown fat activity. Will we see a rush to go “ice fishing?”

So the quest is on to increase the amounts of brown fat in our bodies.

It is thought if we could increase the amount of brown fat in our bodies, to say 3 ounces, only 3 ounces, we could lose an extra 500 calories a day for 52 lbs. a year! Now that’s weight loss!

NEW INDICATION FOR BOTOX

Today's question from Fort Myers plastic surgeon, Dr. Robert Brueck MD: What will they think of next?

I guess the only limitations of finding uses for Botox is your own imagination.

Now they are injecting Botox in a patients stomach. These injections are NOT in the patients skin on the outside, but are actually injected with a needle to the mucosa or lining of the stomach.

I was watching a doctors' show – it seems there are as many as there are 7-11 stores – and a gastroenterologist was injecting Botox into a patients stomach.

The idea is that by injecting Botox into someone’s stomach it slows down the emptying of the stomach – hence – the patient feels “full” and does not eat as much.

At last, a new weight loss program (?).

The GI doctor (gastroenterologist) who spoke about this has had her stomach injected and has lost 7 pounds over several weeks. Who knows a “Botox” cocktail may be just around the corner.

SMOKING- GOOD FOR YOUR HEALTH?

Dr. Robert Brueck MD, Fort Myers plastic surgeon, does not smoke and does not advocate smoking. But, he does report interesting findings in the world of health and medicine, such as this message.

"It seems we live in a contradicting world. We hear this food or supplement is bad for us. Then, a year or more later, we hear it’s good for us. Coffee is bad for us. Now, it’s good for us. No wonder there is a long trail of confusion.

A recent pilot study in the journal “Neurology” found that nicotine patches could improve memory, mental processing and attention. Seventy-four patients took part in the study. The nicotine patches worn by a set number of patients found enhanced cognitive function. A little side bonus was a loss of weight in some patients and lower blood pressure. See, Nicotine also has an anorectic effect as well (loss of appetite).

I certainly am not advocating one should take up smoking but these are dilemmas we face. This explains why so many smokers gain weight after they stop."

FAT NO MORE

If there is one thing 70%, 80% or 90% of Americans have done, it’s gone on a diet.

Americans are obsessed with weight loss-dieting. The real problem is that there are way too many good tasting, tempting foods. Why couldn’t cauliflower be a chocolate Sunday and brussel sprouts a banana cream pie. It just never really made sense to me.

Well, our never-ending frustration may soon be over.

Researchers of MD Anderson Hospital in Hourton have found a drug that kills a type of fat cell by destroying its blood supply. This new potential miracle drug is called ADIPOTIPE!

The initial studies were done in Monkeys now they are waiting to do some early human trials. These studies will help identify side effects as well as proper dose.

Sit tight-help may be on the way. But then again they would need to get FDA approval. Unfortunately that could take a Lifetime. Oh well, it’s still encouraging.

I care about weight and dieting because they influence how you look as well as how you feel. That is a combination that is essential in my Fort Myers Florida Plastic Surgeon's practice.

Bariatric Surgery Nutritonal Side Effedts

This is the place where Dr. Robert Brueck MD blogs about issues of health from his perspective as a plastic surgeon in Fort Myers, FL

I think everyone can agree we have a “Big” - no pun intended - weight problem in our country today.

In my practice, I am seeing more and more patients who have lost 100-150 pounds or more. I congratulate them all for taking control of their liver and losing all that weight.

A recent study done at Emory University at their School of Public Health found that 12% of 155 patients they were following post-bypass had severe copper deficiency. Copper is an essential trace mineral necessary for normal body functioning. Severe deficiencies, if uncorrected, can lead to irreversible paralysis.

An important lesson to be learned is that after massive weight loss one must be diligent at all times.

MELTING AWAY FAT

Dr. Robert J. Brueck MD FACS reports regularly on developments in health, medicine and cosmetic surgery. Additional thoughts on cosmetic surgery by Fort Myers plastic surgeon, Dr. Brueck, may be found at his web site, Beauty-by-Brueck.com

Who knows what will come in the next century. Certain goals, certain desires seem to survive the hands of time. One that I see in my practice everyday is weight loss. If ever there was something most people face as a challenge is to shed those extra pounds. Another is the appearance of cellulite.

Well we soon may have a new weapon in the battle of the bulge - Fat Dissolving Injections.

Years ago, there was a lot of hype about Meso Therapy and Fat Dissolving Injections. For some, they worked, but for many it was a tremendous let down. One area in which it worked was the area of fat under the chin on the "turkey gobble" neck.

But as the fat melted away the patient was left with an empty sac of loose hanging skin. Also, there were so many available drugs or pharmaceuticals available to inject in the soft tissues or fat of the body. The doses to be chosen and the combination of agents possible were unlimited so what might work on one person might not work on someone else.

But now Kythera Biopharmaceuticals in Los Angeles is conducting phase 3 studies to evaluate a product called ATX-101 which is an injectable for dissolving substance.

Stage 3 studies mean they are advanced and may soon yield results that may be available to patients in the not to distant future. The studies are for submental or chin fat removal. They have involved 720 patients in various European countries. They performed a similar study last year, 2010 here in the United States.

Dr. Robert J. Brueck MD, FACS is a Board Certified Plastic Surgeon in Ft. Myers and Cape Coral, FL. Visit his website at beauty-by-brueck.com to learn more about him or other procedures he does.

Plastic Surgery and Weight Control - The YoYo Effect

Thoughts from Fort Myers plastic surgeon, Dr. Robert Brueck - We occasionally encounter patients who are considering liposuction or other body contouring as a "substitute" for actual weight loss.

We discourage it strongly. It is not the right solution for people struggling with obesity. It does lead us, however, to give thought to successful weight loss regimens. And those that are not successful.

We are all familiar with the “yo-yo”. As a young boy growing up in the streets of Chicago I spent many hours playing with a yo-yo. It would go up and it would go down, it would go up and it would go down. It seems weight gain and loss is a yo-yo phenomenon for many people. You gain 20 pounds, you lose 20 pounds and you regain it. The cycle goes on and on. Along with this come anxiety, depression, and frustration. All are often futile attempts to get the “perfect” body shape.

The National Institutes of Health has defined weight maintenance as maintaining a 10% loss of weight for a time period exceeding 1 year, which I found quite interesting.

A national registry called the “National Weight Control Registry” ,commonly referred to as the NWCR, was created in 1994 to track the weight of people who lost over 30 pounds for a period greater than 1 year. What they found is interesting and may prove beneficial to you as you try to get off the yo-yo treadmill.

The following observations were made.

Number one – greater than 90% exercised regularly for about an hour a day. Exercise is critical to maintaining weight loss.

Number two – eat breakfast daily. Over 78% of registry participants ate breakfast regularly. Skipping breakfast produces a long fasting state which leads to increased calorie consumption as the day wears on. Now that doesn’t mean we go out and eat a dozen eggs and 3 pounds of sausage every morning.

Number three – self monitor your weight. They found that 75% of registry participants weighed themselves at least once a week.

Number four – avoid sedentary activities i.e. don’t sit down and watch television for 4 – 6 hours a day. Walk up the stairs instead of taking an elevator unless your office is on the top floor of a 110 story office building. But then again, that might not be so bad after all. You just need to get up an hour earlier to begin the journey. LOL

I hope these points prove beneficial to you as you go on to maintain a healthier more productive lifestyle.

If after serious, sustained weight loss you find body fat just won't go away, you may be a candidate for body sculpting. For more information, visit Dr. Brueck's web site at http://www.Beauty-by-Brueck.com. or call us at 239-939-5233.