A small 3% reduction in weight can dramatically improve ablations' chances with overweight people:
medscape.com/viewarticle/99...
After 6 months, 88% who lost 3%-6% of weight before their ablation were AF free, compared with only 61% who lost less than 3%. After 12 months, the figures were 81% and 42% respectively.
I would suggest that this should be a criteria for an ablation, insufficient weight loss then no ablation.
Thanks for posting Mark. Other studies suggest 10% as a better goal if you are medically obese. Weight loss can be difficult, so for those that have tried the usual, there are now some newer drugs being used with excellent results.
Jim
I would be very wary of ' slimming ' drugs. As soon as you stop taking them the weight piles back on. I know only too well of the dangers, my first full on 999 episode brought on by taking the drug Adifax, now long withdrawn from the market.
I agree there are risks. But there are also risks of being medically obsese, not just in the context of afib, but of your health in general. Certainly a non pharmaceutical approach should be tried first, but for some, they are either not motivated, or it simply doesn't work. In these cases sometimes Bariatric surgery is suggested. The newer drugs are a much less invasive alternative. It's balancing risk versus reward.
Jim
any idea what those weight loss drugs are as I have never been overweight but in the last year with all my problems and inability to move around much it has poked on.
I did hear that some diabetic drugs help with weight loss but one if the side effects are frequent UTIs
Thsnknyou
That's interesting to hear Mark. I would also add that losing some weight makes you feel so much fitter too. I always think of 2lb or 1kg bags of sugar and how many of them people have clinging to them. Honestly anyone who wants to lose some weight just feel how heavy a bag of sugar is and think of how many of those you need to get rid of. To be honest I have one clung to my waist. Thank goodness I'm tall.
Jean
More revolting to think of a 2lb lump of lard.......🙄
I used the same metaphor Jean when I was losing weight! Every time up and down stairs, thinking about those bags of sugar I wasn’t having to carry any more!
Good to read and interesting to note that a weight loss of just 3% would have such an impact. That is very encouraging to know.
Problem is some of the beta blockers slow down the entire body making weight loss harder. Wife's just been put on Nebivolol which is a more targeted beta blocker and also claims can help weight loss.
Nebivolol hasn't done anything for me in losing weight! As I have aged I have reduced the amount I eat as I get full quicker . I very rarely actually feel hungry but if I just don't eat I get dropping blood sugar that sets off my afib. I don't eat junk food . The reduced amount of food has not made me lose any weight . I have problems with muscles and tendons that are getting worse so exercising is difficult though I am active and garden for 2/3 hours most days. If told to lose weight to get any sort of procedure done I would be in a pickle!
I wonder if this applies to those who just have a small(ish) spare tyre yet still within a healthy BMI?
Tha's interesting, indeed. I was discussing this only the other day with my wife. We are both lucky in being relatively slim and are trying to keep it that way against a commercial world that seems determined to convince us to guzzle and chomp our way through the day.
Steve
I am not affected by food advertising in the slightest. I cook from scratch and would never dream of setting foot in the sort of establishments that are advertised. I never watch ads anyway. I record any programs on commercial television so I can fast forward through them . I believe that children should be taught in schools how to ignore/ resist advertising beginning with the reality - that the sole purpose of an ad is to separate them from their money.
Well said. We do the same regarding TV and advertising but, ignore it or not, the cultural ethos is formed or at least reinforced by the media and the status quo has changed dramatically since I was young. I think the main changes are in portion sizes, ease of availability and the self-indulgent ethos that means greater quantities of fattening foods are eaten far more often during the day.
Wendy and I were discussing how important it is to stop our weight creeping up since it’s clearly so very hard to lose it once it’s on. I try to use my trouser size as my warning signal to eat smaller portions, which is, luckily, how I am able to keep my weight down. I’d dearly love to lose another 5kg to be back to my weight in 2010, but it’s so hard to do that.
Steve
You're right about portion sizes Steve. I think older people look better for a few extra pounds! A scrawny older person is not necessarily a good sight to behold and no fat reserves to get through a serious illness! (That's what I tell myself anyhow 😅)
I agree with you there. Mind you, my son, 38 and 6ft tall and just 12½ stone has me envying him!
Steve
I read an article recently that said once you were past 70 losing large amounts of weight was a bad idea. I am classed as obese by BMI and have been for many years . But I do not eat a lot ( get full quite quickly) and though I have quite a lot of fat on my lower abdomen and thighs I do not have a " spare tyre". I could give up my daily treats - a sherry glass of wine and a little dark chocolate . I could forgo a pudding everytime we go out to eat ( once a week) instead of sometimes when nothing on the dessert menu appeals to me. But I very much doubt it would make any real difference in my weight and I would feel deprived.
If you eat in posh restaurants here the portion sizes are not enormous. When looking on TripAdvisor to try out new places I am always encouraged if people complain about measly quantities of food- I know it will be quite enough for us!
Losing 3% or body weight if you are obese is not going to change your BMI category of obese.Obese at 300lbs is still obese at 270lbs.
Many athletes are considered overweight on paper by BMI - even obese. Jonah Lomu the rugby player was "obese" by BMI at the height of his fitness.
This is just one more example of the widely discredited BMI measurement being used as an excuse to deny treatment to a sector of the population.🙄These stats and the purported link to ablation success are a dog whistle to people to fat-shame - as if society needs encouraging to do that.🙄
There are many reasons why ablation fails and mostly, the doctors do not know why.
There is no doubt that being fit is better for health overall, but this study's stats are flawed.
HEART ABLATION...SUCCESS OR FAILURE
Losing weight
catheter ablation success
Ablation success ! 
Persistent AF - Success of Ablation?
