HealthTalk
Doctor ’ s notes
Dr Rik Heymans is a general practitioner in Nerja and writes on developments in the world of medicine
Hunger signals
Freezing the posterior vagal trunk nerve using a minimally invasive , percutaneous technique significantly reduces appetite and results in substantial weight loss at 90 days , a small pilot study suggests . This study wanted to address the phenomenon of diet attrition , as it is well known that 95 % of patients who embark on their own weight loss attempts end up quitting . In addition to cutting off the hunger signal from an empty stomach to the brain , freezing this hunger nerve also slows down the transit of food through the stomach ; so patients who have had this procedure feel full faster and feel hungry less often ! So by using these two effects , dieting becomes easier for patients — that ’ s the goal and that ’ s what is being observed .
For the first 90 days following the procedure , all patients reported having a decreased appetite . Over half the group reported that they had “ very much less appetite ” compared with baseline . Moreover , excess BMI loss , as well as total weight loss , were comparable with other successful weight loss interventions followed over the same trajectory . Asked how long the freezing effect might last , it was reported that when interventional radiologists freeze nerves in the periphery , usually to treat pain , nerves grow back at a rate of about 1mm / day . So it would take about 12 months to regenerate from the distance of our cryoablation back to the connection in the brain was the assessment .
Weight loss and appetite
For every kg of weight they lost , patients in a new study were found to consume an extra 100 calories a day — more than three times what they would need to maintain the lower weight . This out-of-proportion increase in appetite when patients lost a small amount of weight may explain why longterm maintenance of reduced body weight is so difficult .
Previous studies show that metabolism slows when patients lose weight . However , new results suggest that proportional increases in appetite likely play an even more important role in weight plateaus and weight regain . Since the findings suggest that an increased appetite is an even stronger driver of weight regain than slowed metabolism , the message to doctors is , to not only push physical activity as a way to counter [ weight ] regain but also use medications that lower appetite . It was added that in the absence of restraining food intake following weight loss , this mechanism will result in eating above baseline levels with an accompanying acceleration of weight regain . The few individuals who successfully maintain weight loss over the long term do so by heroic and vigilant efforts to maintain behaviour changes in the face of increased appetite in an obesogenic environment . And since continued weight loss becomes harder as patients lose more weight , this study reinforces the message that patients should focus on making healthy lifestyle changes that they can live with over the long term .
Smoking risks
For people who think that smoking only one or two cigarettes a day carries little cardiovascular risk , a powerful new study maintains the only way to reduce risk is to quit , full stop . The investigators anticipated that smoking one cigarette a day would be associated with only about 5 % of the excess relative risk of smoking 20 cigarettes a day , but they found it actually accounts for 46 % of excess CHD risk in men and 31 % of the risk in women . For the less commonly reported smoking-related outcome of stroke , the excess risk associated with just one cigarette per day was 41 % for men and 34 % for women . The meta-analysis of data from 141 prospective cohort studies was published online in the British Medical Journal .
There lately has been a big shift from people smoking 20 to 25 cigarettes a day to only smoking a few cigarettes a day , with the assumption that ’ s good enough for their health . Their view is that smoking only a couple a day can ’ t be harmful . That ’ s probably not far off the truth for the risk for cancer . For many smokers that ’ s probably the first thing that comes to mind , but cardiovascular risk is the big one .
This report is actually stunning in that it proves it is an all-ornothing phenomenon now . It ’ s going to change our thinking . Of course doctors always wanted people to quit , and we were not only trying to encourage people just to reduce ; we would take that only as the third option if everything else failed . But now there are some hard data that says even one cigarette a day is harmful — and not just a little harmful , but increases your risk 50 % to 75 % of the time .
© Dr RIK HEYMANS c / Angustias 24 , Nerja . Tel : 95 252 6775
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