ASMBS BARIATRIC SURGERY CENTER OF EXCELLENCE® PROGRAM

January 26th, 2012

Truly excellent patient care is the result of both the individual surgeon and the facility at which the surgery is performed. The BSCOE designation is therefore awarded to both the surgeon and facility, which enables patients to distinguish specific providers who have met the requirements for delivering high-quality perioperative and long-term follow-up care from those who do not. Additionally, the ASMBS BSCOE program recognizes only one level of excellence, which differs significantly from other COE programs.

We are proud to announce on behalf of the American Society for Metabolic and Bariatric Surgery (ASMBS) and Surgical Review Corporation (SRC) that our program has earned the BSCOE Designation.

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Dr. Liu quoted on Livestrong.com

May 19th, 2011

Weight Loss & Birth Control Pills

Overview

The connection between birth control pills and weight loss sparks a contentious debate in the medical community. On one side are doctors backed by years of research that says that combination pills don’t affect your weight, and on the other side are legions of birth control pill users who attribute their unwanted pounds to the pills after reading that weight gain is a possible side effect. The truth is that they’re both right, and that a simple pill switch may help you shed the extra weight.

Combination Pills

Bariatric surgeon Dr. Carson Liu says that combination pills may lead to weight gain due to the actions of the individual hormones. “Estrogen can cause retention of salt and water, while Progesterone can make you very, very hungry,” he notes. Both factors can quickly lead to unwanted weight. University of Texas Medical Branch’s Associated Professor of Obstetrics and Gynecology Dr. Tristi Muir disagrees, however, citing research that showed no link between weight gain and oral contraceptive pills. She says, “The fact is that as women age, they gain weight. A study in Sweden found no difference in weight gain over time between those that took OCPs and those that did not. On average, people in both groups gained approximately one pound per year.” So the bottom line is that your weight gain may not be the fault of your pill, but switching may help you and isn’t likely to hurt you.

Single-Hormone Methods

If you are convinced that your combination pills are contributing to weight gain or keeping you from losing weight, switching to a single hormone may help. Dr. Muir recommends steering clear of progesterone-only injections or implants, because they have been shown to lead to a decrease of lean mass, which can lead to weight gain. Dr Liu agrees, noting that a low-dose estrogen only pill may be a better option — although it may still affect your weight, it may be more manageable than the combination pill.

Alternative Birth Control

If the prospect of battling a pill over your weight seems exhausting, talk to your doctor about switching to a non-hormonal form of birth control. Dr. Muir recommends condoms, diaphragms and IUDs for temporary measures, or you might consider more permanent methods like vasectomy or tubal ligation if you are not planning to have children. These options will leave your weight unaffected, and will not interfere in your weight loss.

Lose the Weight

If you choose to remain on birth control pills, Dr. Liu recommends you “be careful with the amount of salt and starches [you] intake, cut out sweets, and maintain healthy eating habits.” Both doctors feel that healthy food choices are the key to the equation, especially if you have an increased appetite. Daily exercise is important because the calorie burn can help mitigate some of the calories you take in throughout the day. Both doctors also agree that ultimately, every woman reacts differently to hormones. If you cannot lose weight despite a healthy diet and frequent exercise, consult your doctor about changing your birth control.

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Tags: weight loss
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Last Minute Reminders Prior to Weight Loss Surgery

May 9th, 2011

Are you scheduled for your weight loss surgery? When the big day arrives, you might feel somewhat anxious. Preparing ahead of time will help to ease your mind.

One decision you must make is who will drive you to the hospital for your procedure, and home again when your hospital stay is completed. A neighbor, family member or trusted friend are possible choices. Makes driving arrangements well in advance, so there is no doubt when the time arrives. Bring a soft pillow to cushion your abdomen while riding home in the car. When you arrive home, someone should be available to help you get settled in and ensure you are comfortable.

Prior to the day of your surgery, follow all of your Dr. Liu’s instructions exactly. Do not eat or drink after midnight the day before your surgery. When it is time to leave for the hospital, wear loose fitting, comfortable clothing that does not bind or pinch at the waist. Slip on shoes or hard-soled slippers are a welcome addition.

Pack a bag ahead of time with comfortable sleepwear, slippers as mentioned, and perhaps a robe to help you feel more at home. Your own toiletries will make your hospital stay more enjoyable. That novel you’ve been anxious to read, favorite music, or current magazines will help to pass the time.

Be sure to take all pain medication prior to leaving home as instructed by Dr. Liu, and bring your pain medication with you, along with a complete list of all other current medications. If you found time to fill your prescriptions prior to your hospital visit, bring a two-day supply to maintain regular dosages during your hospital stay.

Another important reminder – place your health insurance information, living will, medical directive, and other key documents in an envelope and pack these in your bag as well.

If you are scheduled for weight loss surgery, please contact Dr. Liu’s Los Angeles, California weight loss surgery practice to ask questions about last minute reminders.

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Working With Your LAP-BAND® Surgeon

April 22nd, 2011

For thousands of people suffering from obesity, LAP-BAND® weight loss surgery has proven to be a satisfying, long term weight loss option.  Before you can make plans to have surgery, however, it is vital to consult with a qualified weight loss surgeon who can perform a comprehensive evaluation, answer your questions, and guide you in choosing the best weight loss option. In Los Angeles, California, that surgeon is Dr. Carson Liu.

Dr. Liu is board certified in General Surgery and offers advanced laparoscopic skills and experience. Having completed more than 2600 bariatric surgeries, Dr. Liu has the comprehensive training to expertly guide patient selection, surgical options, peri-operative care, and long-term patient management. Dr. Liu’s extensive research has led to being widely published in the fields of bariatric and gastrointestinal surgery. As a nationally recognized bariatric surgeon, Dr. Liu lectures extensively to professional societies.

When you meet with Dr. Liu during your initial bariatric surgery consultation, he looks forward to answering your questions, including:

• What is your experience with weight loss surgeries?
• How may gastric bypass procedures have you successfully completed?
• How may gastric banding procedures have you successfully completed?
• Can you explain to me how the device works?
• What is the average weight loss I can expect to achieve?
• Will this procedure improve my obesity-related health conditions?
• What risks and complications should I be aware of?
• Does this procedure require a hospital stay?

Choosing the right weight loss surgeon is a very important consideration. Take your time, and listen carefully to Dr Liu’s responses to determine if weight loss surgery is right for you. Only when you and Dr. Liu work together can you be assured of the very best outcome.

In Los Angeles, California, please contact Dr. Carson Liu to schedule your weight loss consultation.

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SPIDER Surgical System

March 28th, 2011

Traditional laparoscopic surgical technique requires several incisions to be made. This is not what many potential bariatric patients want to hear. After all, many bariatric patients want to lose weight to regain health and self-confidence, but don’t want several incision scars to have to explain. While these small scars may be part of the package, Dr. Liu understands that they can bother his patients. Not only are there scars, but the incisions take time to heal.

In an effort to reduce the number of incisions that you need during bariatric surgery, Dr. Liu has added the SPIDER® Surgical System to his state-of-the-art-technology he uses in his Los Angeles, California bariatric surgery practice. The SPIDER Surgical System works differently than traditional laparoscopic surgical tools. During your surgery:

• The SPIDER is inserted through an incision in your navel
• It expands like an umbrella and has a variety of bariatric tools for Dr. Liu to use, as well as a camera so that Dr. Liu can see what he’s doing
• Once your laparoscopic procedure is completed, the system is closed and removed through your navel

The only scar is the incision in the navel, which is difficult to see. It is also only one incision, so you will heal much faster than if you needed several.

For more information on how you may benefit from the SPIDER® Surgical System during your bariatric surgery, please contact Los Angeles, California area bariatric surgeon Dr. Carson Liu for an initial consultation.

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Dr. Liu quoted in Hollywood Life

March 17th, 2011

Los Angeles weight loss surgeon Dr. Carson Liu was quoted in Hollywood Life discussing Leann Rimes and how skinny is too skinny. If you live in the Los Angeles area and would like to talk with a weight loss surgeon, contact Dr. Carson Liu today.

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Serious Economic Costs of Obesity

February 28th, 2011

According to a recent story in the New York Post, the Society of Actuaries released a report showing obesity costs the US $270 billion a year. This is the result of a country that continues to gain weight, which leads to health problems. These health problems then must be dealt with through medical care, but also affect productivity levels.

According to the study, the estimated cost of obesity on the US economy is:

• $115 billion for medical care caused by overweight and obese patients
• $45 billion for lost productivity caused by excess mortality
• $40 billion lost to disability for active workers
• $65 billion for productivity lost to overweight and obese disabled workers

By comparison, obesity in Canada costs that country a relatively small $30 billion annually.

Obese individuals are probably already aware that health problems associated with their weight, such as diabetes, sleep apnea, osteoarthritis, and high blood pressure come at a cost that is beyond money.

When studies like this come out, it creates a perception that obese individuals are a drain on the overall economy. Unfortunately, some obese individuals have tried everything they can to lose weight to no avail. Some of these people may find they can lose and keep the weight off with bariatric surgery.

Bariatric surgery is almost always the final place obese patients find themselves because they have already tried everything else. This procedure alters your digestive system so that the food consumed is minimized. It has a high success rate and is a life-changing and life-saving surgery.

If you are interested in finding out how you can benefit from bariatric surgery, please contact Los Angeles, California bariatric surgeon Dr. Carson Liu today.

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FDA approves wider use of Lap-Band

February 17th, 2011

The Food and Drug Administration has approved marketing the Lap-Band weight-loss surgery to patients who are significantly less obese than those who now use the device, according to an announcement Wednesday by its maker, Irvine-based Allergan Inc.

The approval allows Allergan to market the device to patients with a body mass index of as low as 30 if they have at least one weight-related medical condition, such as diabetes or high blood pressure, the company said.

That would make an estimated 11 million more Americans eligible to receive the device, which shrinks the size of the stomach to reduce food intake — assuming they can persuade their insurance companies to pay for the $25,000 cost of the device and the surgery to implant it.

Overall, an estimated 37 million Americans now meet the criteria for receiving the device, Allergan said in a news release.

The device is an inflatable ring that is surgically implanted around the upper portion of the stomach. Once the surgical wounds have healed, saline solution is injected into the ring to expand it and limit the amount of food that can be consumed during a meal.

The Lap-Band is one of two surgical approaches to losing weight. The other is the gastric bypass, in which surgeons create a small pouch in the stomach to limit food intake and bypass part of the intestines to reduce absorption of food.

The bypass operation is considered particularly desirable for treating patients with Type 2 diabetes because symptoms of the disease typically clear up within a few days of the surgery.

With the Lap-Band, however, the symptoms of diabetes are not mitigated until the patient actually loses weight, which can be several months after the procedure.

Last year, there were about 220,000 weight-loss surgeries in the U.S., according to medical societies, about 60% of them gastric bypasses.

Both types of surgeries were initially reserved for patients with a body mass index, or BMI, of 40, which translates to a 5-foot-9 patient who weighs 270 pounds.

In the last couple of years, surgeons and the FDA have looked favorably on using both procedures on patients with a BMI of 35 and at least one medical condition. That translates to a patient of the same height with a weight of 236 pounds.

In December, an FDA advisory panel recommended that the Lap-Band be approved for patients with a BMI of 30 if they have failed at diets and weight-loss drugs and have at least one weight-related medical condition. For the 5-foot-9 patient, that translates to a weight of about 203 pounds.

The risks of the device include the initial surgery in which it is implanted, slippage of the ring after it is inflated, leakage of saline fluid and erosion of the plastic. Some patients also have inadequate intake of crucial vitamins and minerals. Some critics thus say it should be reserved for use only after all other approaches have failed.

The FDA approval was based on a study of 149 patients who had an excess weight averaging 62.8 pounds and had been obese, defined as a BMI greater than 30, for an average of 17 years.

More than 65% of the patients were no longer obese after one year, according to Allergan, and there were improvements in their cholesterol levels, diabetes, hypertension and quality of life. About a third of the patients had their conditions completely resolved.

The FDA approval should make it more likely that insurance companies will pay for the procedure for patients with BMIs under 35.

But many patients with BMIs between 35 and 40 have reported difficulties in gaining approval for either surgical procedure. Companies often require six months of dieting under a doctor’s care, for example, before they will even consider paying for the procedure.

Medicare, however, will pay for it for patients older than 65.

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Lap Band Risks

February 16th, 2011

In hearing about the recent news of Lap Bands in California, we express our deepest sympathies to the families of those affected. Dr Carson Liu has done over 1,900 Lap Band Procedures, and feels his success is in part due to the attention he gives his patients compared to more of the ‘mass focused’ offices offering the lap band procedure.  Surgical technique, close follow-up with the patient, and a customized protein supplement during the aftercare program are methods that Dr Carson Liu employs to keep patients healthy.

Dr Liu reminds those considering Lap Band that any medical procedure can be dangerous, and to make sure that they do through research on the doctor, the practice, and of course the procedure itself.  Please use our Lap Band Information center to help learn about the procedure, and contact our office for any questions you may have.

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Dr. Liu selected for inclusion on the Super Doctors ® 2011 list.

January 28th, 2011

Tags: Dr. Liu, super doctors
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