Bariatric Surgery for Weight Loss

To end my blog for the month of April, I thought I would post some information on Bariatric Surgery since it is such a hot topic in weight loss methods right now. This method of losing weight is designed for the severely obesity individual that finds it difficult to treat their condition through diet and exercise alone. The operation promotes weight loss and reduces the risk of type 2 diabetes by restricting food intakes, and in some operations, interrupting the digestive process to prevent the absorption of calories and nutrients. The best results are achieved when bariatric surgery is followed with healthy eating behaviors/changes and regular physical activity, so don't think having this surgery is going to be a quick fix to your weight issues (THERE IS NO QUICK FIX)!!!

There are four types of bariatric surgery offered commonly in the United States: 1) adjustable gastric band (AGB), 2) Roux-en-Y gastric bypass (RYGB), 3) biliopancreatic diversion with a duodenal switch (BPD-DS), and 4) vertical sleeve gastrectomy (VSG). Each surgery has its own benefits and risks which you and your doctro should consider in great detail before making a decision in preceeding with gastric surgery.

Here are discriptions of each surgery with a diagram at the end (taken from my resource):

AGB - works primarily by decreasing food intake. Food intake is limited by placing a small bracelet-like band around the top of the stomach to produce a small pouch about the size of a thumb. The outlet size is controlled by a circular balloon inside the band that can be inflated or deflated with saline solution to meet the needs of the patient.

RYGB - works by restricting food intake and by decreasing the absorption of food. Food intake is limited by a small pouch that is similar in size to the adjustable gastric band. In addition, absorption of food in the digestive tract is reduced by excluding most of the stomach, duodenum, and upper intestine from contact with food by routing food directly from the pouch into the small intestine.

BPD-DS - usually referred to as a “duodenal switch,” is a complex bariatric operation that principally includes 1) removing a large portion of the stomach to promote smaller meal sizes, 2) re-routing of food away from much of the small intestine to partially prevent absorption of food, and 3) re-routing of bile and other digestive juices which impair digestion. In removing a large portion of the stomach, a more tubular “gastric sleeve” (also known as a vertical sleeve gastrectomy, or VSG) is created. The smaller stomach sleeve remains connected to a very short segment of the duodenum, which is then directly connected to a lower part of the small intestine. This operation leaves a small portion of the duodenum available for food and the absorption of some vitamins and minerals. However, food that is eaten by the patient bypasses the majority of the duodenum. The distance between the stomach and colon is made much shorter after this operation, thus promoting malabsorption. BPD-DS produces significant weight loss. However, there is greater risk of long-term complications because of decreased absorption of food, vitamins, and minerals.

VSG - historically had been performed only as the first stage of BPD-DS (see above) in patients who may be at high risk for complications from more extensive types of surgery. These patients’ high risk levels are due to body weight or medical conditions. However, more recent information indicates that some patients who undergo a VSG can actually lose significant weight with VSG alone and avoid a second procedure. It is not yet known how many patients who undergo VSG alone will need a second stage procedure. A VSG operation restricts food intake and does not lead to decreased absorption of food. However, most of the stomach is removed, which may decrease production of a hormone called ghrelin. A decreased amount of ghrelin may reduce hunger more than other purely restrictive operations, such as gastric band.

Once a patient has reached which surgery to proceed with, they need to remember that each can have major complications since these surgery's are still relatively new. Another fact is that 10 percent of all patients who undergo bariatric surgery may have unsatisfactory weight loss or regain much of the weight that they lose due to unhealthy food behaviors that don't get addressed before, during, or after surgery.

I personally don't believe in gastric surgery since I know of a couple of people who almost died from this procedure. However, if your weight issues are extreme and you are someone with severe weight complications, then this may be your best (last) option in keeping yourself alive. So, for quite a number of individuals this method is saving lives and giving them a chance to really have a life...I just hope they don't take this fact for granted and that they start eating healthy, make behavior changes with food, and be sure to stay active in order to improve the quality of their lives!

Reference:

US Dept of Health/Human Services; Weight-Control Information Network: http://win.niddk.nih.gov/publications/gastric.htm

Support System

When you think about working out, do you think about doing it on your own or with a group?? When you think about what you are planning for dinner, are you planning for yourself or for more than one?? These are simple questions, but they are bringing up a point that I want to make. When you are trying to manage your weight and health, don't you find it easier and more supportive when you have a support system in place or someone else to work at it with you. I know that I do....That is why I have found that I really enjoy blogging on this topic. For me weight management is soooo stressful and it's a daily, everyday process in choice making. What am I planning to eat today, when am I planning to get in exercise, what type, and for how long....
I have found that by having the friends, family, and network system in place it can help me to stay motivated and encouraged. Especially with exercise - I live within three miles of my parents who are starting to get into their "golden years" and I want to make sure they stick around for as long as possible. So, when I am over there I will talk my Dad into taking hikes up at the park, playing catch with a softball, going for walks around the block, or helping to mow/do lawn work. These activities done with them encourages not only me, but keeps my parents moving and active.
Another big thing is when I go out to dinner, I like going out with my friends who know what a struggle food choices are for me. They help me by encouraging me with eating healthy foods while I eat healthy foods. Thus, we keep each other going and making good choices. Weight management isn't easy, but it makes it more fun/something you can live with if you have the friends and family in your life that will work at it with you. So, while you read this blog I hope you realize that I am here for you and will continue to encourage you because we are all trying to live a healthy lifestyle together!!!

Portion Control

I know trying to be healthy can be a lot of work and that many things can play a large part in helping you to reach your goals. One major area that can have an impact is how much food we put on our plates and the portion amounts that we actually eat. When you eat out or put food on your plate, do you realize just how many calories you end up eating?? Most of us really don't think about the portion size of our food when we sit down to eat. What we want is to have a plate that is full with a wonderful tasting meal - even when this works against us and is at the expense of our own health.

The portion size that you put on your plate is important because it impacts how many calories you take in. When you take in excess amounts of calories that your body does not need, then your body (being the smart machine that it is) turns around and will store this for later use. By storing the calories for later use you end up gaining weight which then impacts all area of your health from increasing your blood pressure to even leading to disease like diabetes. So, how do you control the portion size and make sure that you keep your calories within a healthy range?? Well, there are many wonderful ideas and suggestions out there to help you....Here are just a few to get you started:

1) Use smaller dishes at meals (use salad plates for your main meal, etc...)

2) Measure ingredients with a food scale

3) Serve food in smaller portions and don't go back for seconds.

4) Put away leftovers in separate/portion-controlled amounts. Consider freezing the portions you likely won't eat for a while.

5) Don't eat straight from the bag or carton (make a fancy table setting and treat yourself to a quiet environment).

6) Don't keep platters of food on the table (you may nibble and this adds up quickly).

7) Ask for half or child size portions when at a restuarant.

8) Ask up front for a doggie bag and pack half the meal for latter enjoyment.

9) Share a dessert with a group of people so you all get a taste of the treat or do a mini-shot (Many restuarant now offer mini-shot sized desserts).

And many more....

Portion control may seem like a lot of work at first, but in the long run it will help you to keep your body healthy. Isn't the smaller size actually worth is to you if it keeps you living longer?? I would like to think that less in means longer time to be around to enjoy the things that are important in life. Just like the type of food you take in is important so is the amounts. Here are two images to think about too. One shows changes in portions serving and another shows how to split your dinner plate in order to keep portions in control and gives you a variety of healthy options:

Inside PA

Does anyone else notice how the weather in Spring can end up derailing your outdoor exercise routine?? For me, I try not to let the weather get the best of me. Although I enjoy working out outdoors, I know that sometimes I won't always get the chance to be outside. I also know that I still need to figure out some sort of physical activity plan when going outside is not an option. Exercise is really important, not just because of all the health benefits; but, because it can make you feel better when the weather may be getting you down. Today I am looking at going with plan B since the skies outside my balconey doors are showing overcast skies and dark rain clouds.
What is Plan B you may be wondering - well, for me this is a list of indoor activities that can get my heart rate up and give me at least 30 minutes of some form of exercise. For me, I have to do something that I consider is fun - one of the things I have on hand is a number of exercise DVD's. I have everything from walking exercises, BellyDance Routines, Pilates, and some Hip-Hop dance options. This type of exercise lets me move my furniture around and release a lot of pent of energy in a fun and energetic way. Another form of indoor PA I have is that I own a boxing bag, and when my frustration levels are high I slip on my gloves and pound away at the bag. It is amazing how much cardio you can get from DVD's or having a simple piece of exercise equipment.
But what do you do when you don't have money to buy DVD's or equipment? This is when you have to use your imagination. I have found that I do simple muscle movements when I am in the kitchen like standing on one leg (waiting on microwave dinner to get done), or calf raises while cleaning dishes at the sink. Another option would be use your chairs to do tricept dips and ab crunchs on the floor. Even though you are stuck inside with weather making it hard to get out, you can always find a way to get 30 minutes of some exercise in. What other suggestions do you have, ideas?? I would love to hear them all...