Michael Nusbaum, chief of bariatric surgery and director of Bariatric Services at Morristown Medical Center and Newton Medical Center, said the studies emphasize how well these procedures work keeping people healthy. “It shows what we have seen — that bariatric surgery is the only way to take the weight off and keep it off,” said Nusbaum, whose center performs 600 to 800 procedures a year. The study focusing on children is especially important to stress how safe the procedures are, particularly the gastric banding which can be reversed, Nusbaum said. “One of my concerns has always been whether a 15 or 16 year old can make a decision about a permanent surgery when they may not be mature enough,” he said. The national Institute studies on weight loss reduction surgeries, launched in 2003 with adults and 2007 among teens, are among the longest and broadest of their kind, according to the journal articles. Other studies have shown patients had loss more weight, but those studies ended sooner and focused on patients in a more concentrated geographic area.
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Unfortunately, estimates predict that meeting fuel economy standards will drive up the cost of small and midsize vehicles by $1,800 to $3,000 or more an unhappy outcome for automaker and car buyer alike. The big question, then, is how to create incentives for change. From a governmental point of view, the solution has been to set new mandates and regulations and impose taxes. Based on announced country and regional targets from around the world, CO2 emissions from passenger vehicles are expected to drop 20 percent or more from current levels. Racing to catch up with much of the rest of the world, the U.S. is targeting emissions levels of less than 107g of CO2 per kilometer by 2025 about half what is permitted today.
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