More on Bariatric Surgery

From this online article:

Weight-Loss Surgery: Is It Right for You?
Posted by Cheryl Koch, R.D.
on Tue, Sep 13, 2005, 1:41 pm PDT Post a Comment
Do you feel like you have tried every diet and gimmick to lose weight and nothing has worked? Have friends, co-workers, and relatives reported success after weight-loss surgery? There may be some merit to their reports. The scientific literature shows that surgery can help severely obese people meet their long-term weight goals and improve their overall health.

You may have heard the term bariatric surgery, which refers to all types of weight-loss surgeries. Gastric bypass surgery, a procedure in which the stomach is made smaller to limit food intake and limit the absorption of some nutrients, is the most common type of weight loss surgery performed today. Studies have shown the following improved health outcomes after gastric bypass surgery:

Diabetes has completely resolved in 77 percent of patients and resolved or improved in 86 percent of patients who had the surgery.
High blood pressure was resolved in 62 percent of patients and resolved or improved in 79 percent of patients.
Abnormalities in lipids were improved in 70 percent or more of patients.
Obstructive sleep apnea was resolved in 86 percent of patients.

The improved health was one of the things that attracted me to checking into bariatric surgery. That and the first question asked--my answer was a resounding yes! As for the second, the answer was a worrisome 'no'. One good friend died after the surgery. I have heard a great many initial success stories but in the long run, it sounded like people were gaining a lot of the weight back!

I know I meet the requirements for having the surgery and I could call and make an appointment to start the process. I also know that just because I call and make an appointment doesn't mean I'd actually have the surgery. My doctor told me a good surgeon will make sure I go through a program and counseling to make sure I would be psychologically able to handle making the lifestyle changes.

The surgery changes the way your body absorbs vitamins and minerals, so you will need to take daily vitamin supplements. Also, the quantity of food you consume will be drastically less because the size of your stomach -- originally the size of a football -- will be reduced to the size of an egg.

I could deal with taking vitamins on a daily basis. I do that now. As for the quantity I eat, that's one of my issues. I have to relearn portion control.

You most likely will not be able to tolerate high-fat foods and carbonated drinks after surgery; if so, these foods may need to be eliminated from your diet.

No more diet soda? And as for the fat, I'm still learning to get the amount of fat I take in under control.

Many patients report diet-related problems such as lactose intolerance, nausea, diarrhea, dizziness, and other symptoms, called "dumping," when food travels too fast down the small intestine.

I don't like the sound of any of that.

All patients considering bariatric surgery want to know how much weight they will lose. Weight loss varies from patient to patient, but the average loss is between 60 percent to 70 percent of excess weight.

Ah so it doesn't all come off? Still, losing 60-70% would get me out of that awful sounding "morbidly" obese range. I used the 60% figure and found that it's definitely a number I could live with until I can get the rest of it off.

Just like more traditional methods of weight control, many patients report regaining some of the weight lost. But unlike some diets in which patients regain all the weight they'd lost -- and sometimes more -- patients who have had bariatric surgery usually regain 5 percent to 10 percent of total weight lost and, overall, maintain a greater weight loss than those who lose weight through traditional dieting.

Yes...I think that's because it's really hard to give up on favorite foods forever. It can be done. I quit a 2-pack-a-day smoking habit and haven't had a single cigarette in almost 20 years. But it was too difficult for my first husband to give up cigarettes forever--and he had a heart condition! He would sneak a cigarette or two a day and I don't know how much that contributed to his premature death. I'm sure it didn't help.

My TB has diabetes and it's really hard for him to stay 100% on his healthy eating plan. He stays away from almost all of the bad stuff but every once in a while he'll have an ice cream or pretzels.

As for whether bariatric surgery is for me: not at this time. I think I have a long way to go in changing my eating behaviors before I can consider messing with my body to such a great extent that I'd have to deal with nausea, diarrhea, and "dumping".

Interesting study, but is it legit?

Once again, which helps you lose more weight when you exercise -- eating more protein or eating more carbs? Back and forth we go. There was a low carb craze just a couple of years ago that boosted diets like Atkins and South Beach. It emphasized eating lots of protein and very little carbohydrates. Well, those diets aren't "in" anymore because while people following those diets lost a lot of weight at first they plateaued and, overall, lost about as much weight as those on Weight Watchers.

It's not about diet. It's about life style change.

Still, I'm like anyone else struggling with getting my weight under control. Is there any truth to the rumor that eating more protein and exercising is more beneficial than eating less protein? Here's a study, unfortunately conducted by the beef and dairy industry. Of course their study would find that we need to eat more meat, drink more milk and consume more cheese.

Protein Diet, Exercise Aids Weight Loss

By JIM PAUL
The Associated Press

URBANA, Ill. - A high-protein diet can make regular exercise more effective for women trying to lose weight - helping to build muscle while trimming body fat, a small study suggests.

In a four-month period, the protein-rich diet along with exercise significantly reduced abdominal fat and triglycerides, risk factors for heart disease, according to findings published in the August issue of the Journal of Nutrition.

"People thinking about doing exercise want a return on that investment," said Donald K. Layman, a professor of nutrition at the University of Illinois' Urbana-Champaign campus, who led the study. "Our way of looking at it is the protein-rich diet basically boosts the benefit of doing exercise."

The study was largely funded by beef and dairy interests. A nutritionist not involved with the study said that what the research really showed is that exercise is important for losing fat and preserving muscle.

"That's exactly what we want to have happen in a weight reduction diet," said Roberta Anding, a clinical dietitian at the Baylor University College of Medicine who works with the Houston Texans football team.

She cautioned that diets should not be protein-dominant and noted that the average American eats "more protein than we need to begin with."

Many high-protein diets, such as the Atkins plan, have fallen from favor with consumers in recent months. Layman's diet for the study was lower in fat and called for more fruits and vegetables than the Atkins diet.

The research was funded by the Illinois Council on Food and Agricultural Research, the National Cattlemen's Beef Association, Kraft Foods and the Beef Board.


Forty-eight women took part in the study, eating about 1,700 calories per day. Half ate a diet rich in meat and dairy while half ate a diet that contained more complex carbohydrates, such as rice or pasta.

Each group was then split between women who were asked to walk 30 minutes a day, five days a week, and women who were required to walk at least that much and participate in two 30-minute weightlifting sessions per week.

The low-exercise group was voluntary and averaged less than 100 minutes per week. The other group was supervised and averaged more than 200 minutes of exercise per week, Layman said.

All the women who exercised at least 200 minutes per week lost about the same amount of weight whether they ate a high-protein or a high-carb diet. But almost all the weight lost by those who ate the protein diet was fat, while almost one-third of the weight lost by those on the high-carb diet was muscle.

While the research involved only women, there is no reason to believe that men would not have the same results, Layman said.

Shirley Washington swears by Layman's diet. Even though she is still overweight at 267 pounds, she has lost 90 pounds while following it.

"It's been really easy," said Washington, a 55-year-old Chicago grandmother. "I tell anyone if you can't make it on this eating plan, you can't make it."

---

Is this true? I really would rather lose fat than muscle!

Update

I've been feeling better as each day goes by. I'm not able to exercise yet but I began driving a little the other day and I figure I'll be able to go to a WW meeting next week. Once I'm sure I won't fall I'll begin to exercise again.

I lost some more weight after having the surgery and have been trying to watch what I eat. My daughter's 17th birthday was on Monday and it was too hard not to have a piece of cake. Next time, though, we'll get a much smaller cake. It didn't need to be big enough to last 2 days!

I was just reading an article about how more obese seniors are opting to get gastric bypass surgery to improve the quality of their lives. It seems like such a good thing, doesn't it? Still, I've read more and more about people who've had the surgery who are slowly gaining the weight back...and it seems that they don't lose everything they need to in the first place.

Before I go tinkering with my insides, I have to thoroughly buy into a permanent lifestyle change. It can't be, oh, well, I can eat this or that fattening thing every now and then. The reason why it can't is because "every now and then" inevitably becomes every day. Eating some of these foods is like drinking too much alcohol. I cannot have just a little bit. That's why I want to go through Weight Watchers first, all the way through maintenance. I think I would have a better chance of sticking to a healthier lifestyle permanently.

The article about seniors and gastric bypass is here.

9/11/2005 

Food Logs

I've lost weight since I first started making goals and keep track every week and so I made a new ticker to keep myself motivated.




Logging really helps, especially using the Fit Day website. I can look back at my daily intake and figure out which foods I need to eliminate or cut back on. Before my surgery, I'd noted that I was eating way too much fat in my food although I thought I was mostly eating fresh fruits and vegetables. It's true, I was, but the fat I did take in was the wrong kind and too high.

For example, as a snack I'd have some cheddar cheese and a cup of grapes. An ounce of cheese looks small and harmless but it's got a high fat content! I love Ken's raspberry walnut vinaigrette ... but it's got a high fat content! Antipasto seemed healthy--all those veggies and cheese with little to no carbs, right? Once again, the fat in the cheese and olives and other goodies is very high.

I made changes in what I ate before going into the hospital. One day, the only cheese I had at all was 1 slice of provolone on a sandwich. It had 8 grams of fat in it. I had a cup of cinnamon toast crunch as a snack and that had 9 grams. Anything else was 4 grams or less. I ate poultry, fresh fruit and fresh raw vegetables at meals and used dijon mustard on my bread instead of mayo. That day, my fat consumption was just under 20%.

Thanks to keep the log and looking at the charts, it's easier for me to see which choices I need to make. If I want to have cheddar cheese as a treat then I need to make sure I'm not getting fat from too many other sources. Cheese has to become one of those "once in a while" treats.

I don't always remember to log and need to make it a bigger priority. It's such a useful tool that I need to totally internalize it -- like setting an alarm to get up and go to work or something. It has to be done. I got this the other day in my email, from beliefnet:

What is it about logging that makes you stop after only a few days? Is it too much work? Are you suffering a problem with the discipline? Is it making you painfully aware of some things you'd rather not face?

OR, please allow me to really get deep. Is it that you don't want to lose weight or get healthy at all? Let's be real with each other. If you do not change some habits, like starting to eat less or healthier, or use your body daily, you will not lose weight.

I used to think, oh, I know what to do, what to eat and what to avoid. I don't need to keep a log. Now I realize I shouldn't be so arrogant & self confident. Obviously, I didn't know everything I should avoid. It's not too much work. I can discipline myself to do this regularly and I wil.l.

Women & Exercise

One week ago at this time, I was in the operating room. I am so happy with the results of breast reduction surgery. I'm looking and feeling more better every day. Another thing I'm looking forward to is walking again--more strenuously. My posture is so much better. I can really feel the difference! When I'm able to walk again regularly, I'm sure I'll see my fluffy tummy flatten out.

This was my "tip of the day" yesterday from Heart Health newsletters:

Women: Reasons to Get Active!

Physical inactivity raises your risk of heart disease — more than you might think. It boosts your chances of developing heart-related problems even if you have no other risk factors. It also increases the likelihood that you will develop other heart disease risk factors, such as high blood pressure, diabetes, and weight gain.
Yet most women aren't getting enough physical activity. According to the Surgeon General's Report on Physical Activity and Health, 60 percent of women in the United States don't get the recommended amount of physical activity. More than 25 percent of women are not active at all during their free time. Physical inactivity is especially common among African American and Hispanic women. Besides the elevated risk of heart disease, lack of physical activity leads to more doctor visits, hospitalizations, and use of medicines for a variety of illnesses.

For women, physical inactivity also increases the risk of osteoporosis, which in turn may increase the risk of broken bones. This is worrisome, since women tend to become less physically active as they age. Fortunately, research shows that 30 minutes of moderate activity on most, and preferably all, days helps to protect heart health. This level of activity can reduce your risk of heart disease as well as lower your chances of having a stroke, colon cancer, high blood pressure, diabetes, and other medical problems. Examples of moderate activity are taking a brisk walk, raking leaves, housecleaning, or gardening. If you prefer, you can divide your 30-minute activity into shorter periods of at least 10 minutes each.

Walking is my favorite exercise and I'm sure I'll work it in where ever I can when I'm stronger...I mean, I'll do the 30 minutes fast walking but also fit in more periods of strolling and meandering just because I like it!

No To Ice Cream

I am totally amazed with myself. I'd gotten my dh to go out and buy me a pint of Ben & Jerry's peanut butter cup ice cream and not only did I not devour it all, I felt totally dissatisfied with it. I asked hubby to go out only because I am bored with being unable to do anything. I knew it was stupid the minute the words were out of my mouth. I didn't tell him to forget it, though, because I thought, well, maybe it will be distracting, it's just this once, and everyone else seems to want a snack.

As I began to eat the ice cream though it felt too thick and too sweet in my mouth. I was surprised because I've always been weak for ice cream, especially when it has peanut butter in it. I guess after a year of no ice cream, my taste buds have changed. Gee, what a waste of money I thought. I really should try to finish it.

Then I wondered: why? My body was obviously communicating with me. Why force this stuff down my throat when I know it's emotionally and physically unhealthy for me? Why not just stop now and put it away? So I did...I'd eaten less than half a dozen bites, maybe not even one serving.

After I put it away, I noticed my TB put his ice cream back too.

This is the right direction!

Yes, I'm still fluffy but I'm also flat!