CBT along with bariatric surgery; is marijuana a good pain relief alternative to opioids?
Q: I'm 65 and have struggled with my weight for years. (I am 5-foot-5 and weigh 220 pounds.) Is it safe to get bariatric surgery at my age and weight? - Carol G., Akron, Ohio
A: The Annual Obesity Week meeting that wrapped up in Washington D.C. at the beginning of November offered new insights into the benefits and risks of weight-loss surgeries.
One major revelation was from a follow-up study that tracked 367 folks ages 60 to 75 who had either sleeve gastrectomy, or open or laparoscopic Roux-en-Y gastric bypass between 2007 and 2017. These participants had an average body mass index of 46.9 (yours is 36.6); were taking more than eight medications for various conditions; and almost 63 percent had Type 2 diabetes. (Obesity and stress make your RealAge - the physical age of your body and the real age-related risk for postoperative complications - much older.)
The participants' 90-day major and minor complication rates post-surgery were 5.6 percent and 16 percent, respectively, comparable to the rates of younger patients. At one year out, they'd reduced their daily meds by an average of three drugs. Three years after their surgery, the group had shed more than 60 percent of their excess weight, and almost 46 percent were free of Type 2 diabetes. Overall, the surgery was as safe and effective for older folks as for younger folks.
The conference also highlighted a study showing that cognitive behavioral therapy addressing disordered eating habits before weight-loss surgery helps make the benefits of gastric bypass more substantial and enduring.
One important warning: A University of California, Irvine, study found that people who had laparoscopic sleeve gastrectomy and were discharged on the same day as that surgery had over a five-fold increased odds of death versus those who were discharged the following day. Even though the overall risk in either case is low, if you opt for that form of weight-loss surgery, talk to your surgeon about staying overnight in the hospital!
Q: I have chronic back pain from a car accident, and my doctor prescribed oxycodone. I don't want to take it. I hear there's an effective pain-relieving extract from marijuana that doesn't get you high or addicted. Is it legit? - Michael J., Provo, Utah
A: That's an important question. We've been talking recently about how this country needs to encourage high-quality scientific research into the pain-relieving powers of cannabis/marijuana. It just makes sense to help people like you, who don't want to take opioids and need effective pain relief! But the bottom line is, we don't yet know the answer to your question.
What we kinda know: When it comes to using a marijuana derivative for pain relief, the best option appears to be an extract called cannabidiol, or CBD. It's a non-psychoactive component of marijuana (you don't get high); early research indicates that it can suppress chronic inflammatory and nerve pain without triggering addiction. And a lab (animal) study found that transdermal CBD reduces chronic arthritis pain. But we still need more data on its use for non-cancer-related pain.
On top of that, there currently are no Food and Drug Administration-approved applications for CBD, even though as of 2016, D.C. and 36 states had legalized medical cannabis and another 16 had allowed limited access to low-THC/high-CBD products.
Where does that leave you, Michael? Well, probably thinking about buying CBD online.
Beware! A new study in JAMA found that more than 42 percent of CBD products contained a higher concentration of CBD than indicated; 26 percent contained a lower concentration of CBD; and only 30 percent contained CBD that was within 10 percent of the amount listed on the label.
So, talk to your doc about alternative pain-reducing options, including: meditation; acupuncture; nutritional and supplement choices, such as DHA-omega-3; aspirin and other NSAIDs, such as cox-2 inhibitors; and cognitive behavioral therapy. Also, ask if it makes sense to try CBD, if a safe and legal (locally) source is available.
Distributed by King Features Syndicate, Inc.
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