For those planning to have weight loss surgery, as well as for those who have already done so, extensive patient education is required – or at least it should be. There’s the excitement of having made this life-changing decision, and the thrill of the weight coming off after surgery – for some, fast and furious, for others slower and more steadily. We call that the “honeymoon period,” when you can almost stand in front of a mirror and watch the changes take place. You’re excited, committed and compliant. And then a year goes by, and another, and before you know it, you’re three or four or five years post-op…with a whole new set of issues, or maybe some of the old ones resurfacing. Dr. Cunneen would like his audience to think about what “success” really means for weight loss surgery patients, how to achieve it and, most importantly, how to make it last.
Thinking About Success and Failure in Obesity CareObesityHelp
Even though obesity has officially been classified as disease by important groups like the American Medical Association, many people – doctors included – put all the emphasis on the scale and on other measures like body mass index (BMI). In this talk we will look at how success is measured now and other ways to define success after bariatric surgery. Time allowing, we will also talk about some of the long-term issues related to health and nutrition after bariatric surgery, with a focus on things that contribute to weight regain.
WeightControl.com - Obesity and Weight Control Research InterviewsMarie Benz MD FAAD
The document discusses several studies related to weight control and obesity research from WeightControl.com. The main findings are:
1) A study found that bariatric weight loss surgery patients reported an increase in substance use 2 years post-surgery, with alcohol use increasing more for gastric bypass patients.
2) A study on zonisamide for weight loss found that 400mg per day plus lifestyle intervention led to 7.3kg weight loss after 1 year, with mild side effects.
3) A study found aerobic training was more effective than resistance training or a combination for reducing fat mass in overweight/obese adults over 8 months.
Exercise provides significant health benefits such as preventing osteoporosis, reducing low back pain, lowering the risk of various cancers and age-related diseases, improving cognitive performance, and reducing anxiety. Numerous studies have shown that exercise can act as a medicine to treat and prevent many health conditions.
Exercise Is Medicine: How a Medical Fitness Center Differs from a Health ClubMercy Medical Center
During his presentation on 2/25/14, Eldon Jones, director of health & fitness at Mercy Medical Center in Canton, Ohio, explains how exercise often is as effective as medication in treating certain chronic serious health conditions, including heart disease, diabetes and more.
Eldon also covered how a medical fitness center differs from a tradition gym or health club.
Other topics covered in the presentaton:
* The importance of prescribing exercise
* US Physical Activity Guidelines
* Cardiac rehabilitation and how it works
* Components of ExRx for risk factor reduction
* FITT principle
* Stages of conditioning
* Strength training
Obesity- Tipping Back the Scales of the Nation 19th April, 2017mckenln
This document summarizes strategies for inspiring behavioral change. It discusses the COM-B model of behavior as an interaction between capability, motivation, and opportunity. Successful behavior change techniques include self-monitoring and goal-setting. Commercial weight loss programs that incorporate cognitive behavioral therapy principles and habit formation show promise. Health professionals can play an important role by providing advice during "teachable moments". Nudging in appropriate contexts can also promote healthy choices. Overall, a multifaceted approach is needed to inspire lasting behavioral changes at both the individual and societal level.
This study evaluated adherence to dietary and lifestyle recommendations in 77 patients who underwent laparoscopic sleeve gastrectomy (LSG) bariatric surgery. The study found that only a minority of patients adhered to the recommended protein intake of at least 60 g per day at 3, 6, and 12 months post-surgery. Half of patients met the physical activity recommendation of at least 150 minutes per week at each time point. Adherence to supplementation recommendations was higher, ranging from 57.1-100% across time points. Adherence was generally medium to high but was not significantly associated with excess weight loss of at least 60% at 12 months.
Thinking About Success and Failure in Obesity CareObesityHelp
Even though obesity has officially been classified as disease by important groups like the American Medical Association, many people – doctors included – put all the emphasis on the scale and on other measures like body mass index (BMI). In this talk we will look at how success is measured now and other ways to define success after bariatric surgery. Time allowing, we will also talk about some of the long-term issues related to health and nutrition after bariatric surgery, with a focus on things that contribute to weight regain.
WeightControl.com - Obesity and Weight Control Research InterviewsMarie Benz MD FAAD
The document discusses several studies related to weight control and obesity research from WeightControl.com. The main findings are:
1) A study found that bariatric weight loss surgery patients reported an increase in substance use 2 years post-surgery, with alcohol use increasing more for gastric bypass patients.
2) A study on zonisamide for weight loss found that 400mg per day plus lifestyle intervention led to 7.3kg weight loss after 1 year, with mild side effects.
3) A study found aerobic training was more effective than resistance training or a combination for reducing fat mass in overweight/obese adults over 8 months.
Exercise provides significant health benefits such as preventing osteoporosis, reducing low back pain, lowering the risk of various cancers and age-related diseases, improving cognitive performance, and reducing anxiety. Numerous studies have shown that exercise can act as a medicine to treat and prevent many health conditions.
Exercise Is Medicine: How a Medical Fitness Center Differs from a Health ClubMercy Medical Center
During his presentation on 2/25/14, Eldon Jones, director of health & fitness at Mercy Medical Center in Canton, Ohio, explains how exercise often is as effective as medication in treating certain chronic serious health conditions, including heart disease, diabetes and more.
Eldon also covered how a medical fitness center differs from a tradition gym or health club.
Other topics covered in the presentaton:
* The importance of prescribing exercise
* US Physical Activity Guidelines
* Cardiac rehabilitation and how it works
* Components of ExRx for risk factor reduction
* FITT principle
* Stages of conditioning
* Strength training
Obesity- Tipping Back the Scales of the Nation 19th April, 2017mckenln
This document summarizes strategies for inspiring behavioral change. It discusses the COM-B model of behavior as an interaction between capability, motivation, and opportunity. Successful behavior change techniques include self-monitoring and goal-setting. Commercial weight loss programs that incorporate cognitive behavioral therapy principles and habit formation show promise. Health professionals can play an important role by providing advice during "teachable moments". Nudging in appropriate contexts can also promote healthy choices. Overall, a multifaceted approach is needed to inspire lasting behavioral changes at both the individual and societal level.
This study evaluated adherence to dietary and lifestyle recommendations in 77 patients who underwent laparoscopic sleeve gastrectomy (LSG) bariatric surgery. The study found that only a minority of patients adhered to the recommended protein intake of at least 60 g per day at 3, 6, and 12 months post-surgery. Half of patients met the physical activity recommendation of at least 150 minutes per week at each time point. Adherence to supplementation recommendations was higher, ranging from 57.1-100% across time points. Adherence was generally medium to high but was not significantly associated with excess weight loss of at least 60% at 12 months.
Deborah Bade Horn presented on physical activity prescription for patients with obesity. She reviewed general guidelines for physical activity and discussed case-based application. For a patient needing bilateral knee replacements, Horn prescribed an initial focus on pool exercises and personal training before progressing to physical therapy and a presurgical exercise plan. The long-term goal was for the patient to maintain over 250 minutes of physical activity per week at a vigorous intensity and potentially return to doubles tennis. Through obesity treatment, the patient had both knee replacements and maintained over 120 pounds of weight loss long-term with minimal pain.
This document discusses principles of weight management and obesity treatment. It outlines that the goal of obesity therapy is no longer an "ideal" weight, but a healthier weight loss of 5-15% of initial weight. Long-term behavioral and pharmacological studies show maximum weight losses of 10-15% can be achieved and maintained. Challenges include facilitating acceptance of modest goals and developing long-term treatment models.
Diet programs work regardless of the specific brand, as all programs resulted in weight loss when compared to no diet at all. Low-carb and low-fat diets produced the most weight loss initially, with an average of 19 pounds lost for low-carb and over 17 pounds for low-fat by 6 months, dropping slightly to 16 pounds lost by 1 year for both. Moderate macronutrient diets produced an average weight loss of 12.5 pounds after 1 year. While specific brands differed slightly in results, with low-carb diets producing up to 4 more pounds lost than others, on the whole the differences between branded diet programs were small and not very meaningful to people trying to lose weight.
This document discusses strategies for staging patients with obesity based on their level of health risks and comorbidities. It presents the Edmonton Obesity Staging System (EOSS), which categorizes obesity into stages from 0 to 4 based on functional limitations, comorbidities, risk factors and mental health issues. Stage 0 indicates no health risks while stage 4 indicates end-stage disease. EOSS provides a framework for prioritizing clinical management and predicts mortality risk. The document also discusses how different levels of weight loss through various treatments can improve specific comorbidities like cardiovascular disease, diabetes and sleep apnea.
Dolores Van Bourgondien developed a model for a synergistic approach to health and wellness that combines medical care with fitness, nutrition, and mind-body disciplines. Prior approaches to health have been fragmented, with little collaboration between areas. This has led to increased rates of obesity, hypertension, and other preventable diseases. Van Bourgondien's thesis demonstrated that an integrated approach combining disciplines could decrease healthcare costs by focusing on prevention and wellness.
Fat and Skinner From The Branch Out SeriesBrian Curley
The document outlines a behavioral weight loss and fitness program that uses applied behavior analysis principles including daily self-monitoring of nutrition, exercise, and weight; establishing exercise and nutrition habits through a progressive system of small changes; and integrating participants into a behavioral community for social support during the 6 month program.
ABSTRACT- Obesity is the problem of global concerned. All over the world it is considered to be the most improbable dilemma both health and appearance wise. Obesity not only makes the person to feel low in society but also indulge them with other health related disorders. Present review tries to focus on the different aspects allied with the obesity. Diseases associated with obesity and different therapies of concerned are being dis-cussed.
Keywords: Obesity, BMI, Negative Energy Balance, Anti-Obesity Agents
This document discusses obesity and its relationship to health risks and workers' compensation claims. It finds that obesity doubles the rate of workers' compensation claims and is associated with many serious health conditions like high blood pressure, high cholesterol, diabetes, heart disease, and some cancers. A study found that for every 1% weight loss, there is a $213 reduction in annual healthcare costs for patients with type 2 diabetes. The rest of the document describes a program called VEEP that is designed to help people learn how to use food to improve health, reduce body fat, and control diabetes through lifestyle changes like nutrition and exercise education and tracking progress.
A thorough look at intermittent fasting and calorie restriction as a benefit ...Dr. Courtney Holmberg, ND
Many health trends come and go, but one dietary trend that has seemed to endure the craze is intermittent fasting.
The primary reason intermittent fasting (IF) has remained so popular is because it offers flexibility to fit a busy schedule, and (while I don't typically advise mindlessly eat as long as your fasting) it doesn't ultimately demand restricted eating.
This document discusses obesity and bariatric surgery as a treatment option. It notes that obesity is a global epidemic that causes numerous health issues like diabetes, high blood pressure, cancer, and early death. Bariatric surgery is presented as an effective treatment when diet and exercise have not worked for those with a BMI over 32.5 and obesity-related diseases, or a BMI over 37.5 without diseases. The document outlines different surgery options and explains how they work to restrict eating and alter hunger hormones to promote significant weight loss of 60-80% of excess weight. It highlights the health benefits of surgery like curing diabetes in 80% of patients and reducing risks of death, high blood pressure, infertility and more.
Systematic Review on Eat Less and Move More Is the Chemistry of Lifeijtsrd
"Dieting must be combined with exercise" This review explain the physical activity and exercise training are play vital role for weight loss or weight maintenance. To see prevention is better than cure, the patient is carried out 60 different tests by giving one time blood sample after fasting 12 14 hours. Eat less is the probable basic advice to lose weight. Increasing your vegetable intake can help you to lose weight. In this particular discussion, we focus on weight loss from different types of exercise training programs and calorie consumes. Clinically required weight loss is unlikely to occur. Patients wishing to lose weight should participate in physical activity and caloric restriction to improve the chances of weight loss. The less you consume, the faster you lose. At the same time, it is very important to follow a healthy, well balanced diet plan, so that you do not become ill or lose lean muscle. In ideal condition the advice of doctor, dietitian and nutritionist is must essential. The tests such as eosinohils, MCV, MCHC, RDW SD, Total cholesterol, LDL cholesterol, Non HDL cholesterol, TC HDL cholesterol ratio, LDL HDL ratio etc shows some deviations from the reference ranges as per the guidelines. S. M. Landge | M. G. Landge "Systematic Review on Eat Less and Move More; Is the Chemistry of Life?" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30909.pdf Paper Url :https://www.ijtsrd.com/engineering/mechanical-engineering/30909/systematic-review-on-eat-less-and-move-more-is-the-chemistry-of-life/s-m-landge
The document discusses the emerging role of diet coaching in obesity treatment and weight management. It notes that while dietitians receive training in nutrition science, they often lack skills in behavior change and coaching needed to help clients maintain long-term weight loss and lifestyle changes. The document argues that dietitians should receive additional training in techniques like cognitive behavioral therapy, neuro-linguistic programming, and health coaching in order to more effectively promote sustainable behavior change and wellness among clients.
Sarcopenic obesity is a chronic condition, which is due to progressively aging populations, the increasing incidence of obesity, and lifestyle changes. The increasing prevalence of sarcopenic obesity in elderly has augmented interest in identifying the most effective treatment. This article aims at highlighting potential pathways to muscle impairment in obese individuals, the consequences that joint obesity and muscle impairment may have on health and disability, recent progress in management with attention on lifestyle management and pharmacologic therapy involved in reversing sarcopenic obesity. Recent findings: It has been suggested that a number of disorders affecting metabolism, physical capacity, and quality of life may be attributed to sarcopenic obesity. Excess dietary intake, physical inactivity, low-grade inflammation, insulin resistance and hormonal changes may lead to the development of sarcopenic obesity. Weight loss and exercise independently reverse sarcopenic obesity. Optimum protein intake appears to have beneficial effects on net muscle protein accretion in older adults. Myostatin inhibition causes favourable changes in body composition. Testosterone and growth hormone offer improvements in body composition but the benefits must be weighed against potential risks of therapy. GHRH-analog therapy is effective but further studies are needed in older adults. Summary: Lifestyle changes involving both diet-induced weight loss and regular exercise appear to be the optimal treatment for sarcopenic obesity. It is also advisable to maintain adequate protein intake. Ongoing studies will determine whether pharmacologic therapy such as myostatin inhibitors or GHRH-analogs have a role in the treatment of sarcopenic obesity.
4th year medical students initiate a quality improvement project for health care providers. Be sure to visit http://wp.me/p4V1Uc-sb for the pre and post test and more information.
Yoga has benefits for cancer patients by reducing stress, inflammation, and side effects of treatment. This document discusses the role of stress and inflammation in cancer development and progression. It outlines different types of yoga and their benefits. Studies show yoga lowers stress hormones and inflammatory biomarkers in cancer patients. One study found breast cancer patients who practiced yoga during radiation therapy had better quality of life and physical functioning after treatment compared to other groups. Another study found yoga helped maintain blood pressure and blood sugar levels in cervical cancer patients undergoing chemotherapy and radiation.
Exercise provides health benefits but is not effective for weight loss alone. Strength training and high intensity interval training are recommended exercise modalities that can improve health outcomes. Strength training three times per week for 40 minutes plus 20 minutes of high intensity interval training is a good starting prescription. Exercise should be used as an adjunct to nutritional counseling, which should focus on a simple, supportive approach to improve dietary compliance.
How much does a zebra weigh? With Kyle Brown at #OH2014ObesityHelp
Self confidence comes from building a sound mind in a healthy, strong body. Celebrity fitness & nutrition expert and host of “The Empower Hour” on ESPN Radio, Kyle Brown will help you discover the fitness & nutrition secrets of the animal kingdom, learn what only world class athletes and health gurus know, and feel the happiness and confidence of a champion.
Awkward! Dealing with uncomfortable food situations & social settings after w...ObesityHelp
A business lunch. A family gathering. A first date. These events can be stressful enough by themselves, but after weight loss surgery they can be, well, awkward! Bariatric Foodie author Nikki Massie discussed how to get through some of life’s most challenging food situations.
What to expect when you're expecting weight loss surgery to work by Diana Vog...ObesityHelp
This document discusses the expectations and realities of weight loss surgery from the perspective of someone who underwent the procedure. It notes feelings of hunger that were unexpected, impatience, loose skin, mood changes, a new relationship with food, and ultimately completing a marathon, which was an unexpected accomplishment years after the surgery. The overall message is that the journey of weight loss surgery involves both meeting and defying expectations.
Yoga is not a 4-letter word: How Yoga supports your weight loss journey from ...ObesityHelp
This document contains 10 photos from Flickr that are available for use under various Creative Commons licenses, such as Attribution, Non-Commercial, and Share-Alike. The photos show a variety of subjects like nature scenes, buildings, and people and were uploaded by different users. All photos include information on the photographer and license for how they can be legally used or shared.
I am changing...and I am perfect as I am by Angela Taylo, LCSW at OH2014ObesityHelp
It can be a challenge finding the balance between motivation to change and acceptance of where you are. It is easy to become self-critical rather than self-loving as you focus on losing weight, improving health and changing your body. This workshop reminded people that weight loss and body changes are exciting and should be celebrated, but we can get into trouble when we put weight loss on too high of a pedestal and we become obsessed with the body. Join Angela, to learn to how to celebrate your body changes, while also learning how to love yourself exactly as you are.
Deborah Bade Horn presented on physical activity prescription for patients with obesity. She reviewed general guidelines for physical activity and discussed case-based application. For a patient needing bilateral knee replacements, Horn prescribed an initial focus on pool exercises and personal training before progressing to physical therapy and a presurgical exercise plan. The long-term goal was for the patient to maintain over 250 minutes of physical activity per week at a vigorous intensity and potentially return to doubles tennis. Through obesity treatment, the patient had both knee replacements and maintained over 120 pounds of weight loss long-term with minimal pain.
This document discusses principles of weight management and obesity treatment. It outlines that the goal of obesity therapy is no longer an "ideal" weight, but a healthier weight loss of 5-15% of initial weight. Long-term behavioral and pharmacological studies show maximum weight losses of 10-15% can be achieved and maintained. Challenges include facilitating acceptance of modest goals and developing long-term treatment models.
Diet programs work regardless of the specific brand, as all programs resulted in weight loss when compared to no diet at all. Low-carb and low-fat diets produced the most weight loss initially, with an average of 19 pounds lost for low-carb and over 17 pounds for low-fat by 6 months, dropping slightly to 16 pounds lost by 1 year for both. Moderate macronutrient diets produced an average weight loss of 12.5 pounds after 1 year. While specific brands differed slightly in results, with low-carb diets producing up to 4 more pounds lost than others, on the whole the differences between branded diet programs were small and not very meaningful to people trying to lose weight.
This document discusses strategies for staging patients with obesity based on their level of health risks and comorbidities. It presents the Edmonton Obesity Staging System (EOSS), which categorizes obesity into stages from 0 to 4 based on functional limitations, comorbidities, risk factors and mental health issues. Stage 0 indicates no health risks while stage 4 indicates end-stage disease. EOSS provides a framework for prioritizing clinical management and predicts mortality risk. The document also discusses how different levels of weight loss through various treatments can improve specific comorbidities like cardiovascular disease, diabetes and sleep apnea.
Dolores Van Bourgondien developed a model for a synergistic approach to health and wellness that combines medical care with fitness, nutrition, and mind-body disciplines. Prior approaches to health have been fragmented, with little collaboration between areas. This has led to increased rates of obesity, hypertension, and other preventable diseases. Van Bourgondien's thesis demonstrated that an integrated approach combining disciplines could decrease healthcare costs by focusing on prevention and wellness.
Fat and Skinner From The Branch Out SeriesBrian Curley
The document outlines a behavioral weight loss and fitness program that uses applied behavior analysis principles including daily self-monitoring of nutrition, exercise, and weight; establishing exercise and nutrition habits through a progressive system of small changes; and integrating participants into a behavioral community for social support during the 6 month program.
ABSTRACT- Obesity is the problem of global concerned. All over the world it is considered to be the most improbable dilemma both health and appearance wise. Obesity not only makes the person to feel low in society but also indulge them with other health related disorders. Present review tries to focus on the different aspects allied with the obesity. Diseases associated with obesity and different therapies of concerned are being dis-cussed.
Keywords: Obesity, BMI, Negative Energy Balance, Anti-Obesity Agents
This document discusses obesity and its relationship to health risks and workers' compensation claims. It finds that obesity doubles the rate of workers' compensation claims and is associated with many serious health conditions like high blood pressure, high cholesterol, diabetes, heart disease, and some cancers. A study found that for every 1% weight loss, there is a $213 reduction in annual healthcare costs for patients with type 2 diabetes. The rest of the document describes a program called VEEP that is designed to help people learn how to use food to improve health, reduce body fat, and control diabetes through lifestyle changes like nutrition and exercise education and tracking progress.
A thorough look at intermittent fasting and calorie restriction as a benefit ...Dr. Courtney Holmberg, ND
Many health trends come and go, but one dietary trend that has seemed to endure the craze is intermittent fasting.
The primary reason intermittent fasting (IF) has remained so popular is because it offers flexibility to fit a busy schedule, and (while I don't typically advise mindlessly eat as long as your fasting) it doesn't ultimately demand restricted eating.
This document discusses obesity and bariatric surgery as a treatment option. It notes that obesity is a global epidemic that causes numerous health issues like diabetes, high blood pressure, cancer, and early death. Bariatric surgery is presented as an effective treatment when diet and exercise have not worked for those with a BMI over 32.5 and obesity-related diseases, or a BMI over 37.5 without diseases. The document outlines different surgery options and explains how they work to restrict eating and alter hunger hormones to promote significant weight loss of 60-80% of excess weight. It highlights the health benefits of surgery like curing diabetes in 80% of patients and reducing risks of death, high blood pressure, infertility and more.
Systematic Review on Eat Less and Move More Is the Chemistry of Lifeijtsrd
"Dieting must be combined with exercise" This review explain the physical activity and exercise training are play vital role for weight loss or weight maintenance. To see prevention is better than cure, the patient is carried out 60 different tests by giving one time blood sample after fasting 12 14 hours. Eat less is the probable basic advice to lose weight. Increasing your vegetable intake can help you to lose weight. In this particular discussion, we focus on weight loss from different types of exercise training programs and calorie consumes. Clinically required weight loss is unlikely to occur. Patients wishing to lose weight should participate in physical activity and caloric restriction to improve the chances of weight loss. The less you consume, the faster you lose. At the same time, it is very important to follow a healthy, well balanced diet plan, so that you do not become ill or lose lean muscle. In ideal condition the advice of doctor, dietitian and nutritionist is must essential. The tests such as eosinohils, MCV, MCHC, RDW SD, Total cholesterol, LDL cholesterol, Non HDL cholesterol, TC HDL cholesterol ratio, LDL HDL ratio etc shows some deviations from the reference ranges as per the guidelines. S. M. Landge | M. G. Landge "Systematic Review on Eat Less and Move More; Is the Chemistry of Life?" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30909.pdf Paper Url :https://www.ijtsrd.com/engineering/mechanical-engineering/30909/systematic-review-on-eat-less-and-move-more-is-the-chemistry-of-life/s-m-landge
The document discusses the emerging role of diet coaching in obesity treatment and weight management. It notes that while dietitians receive training in nutrition science, they often lack skills in behavior change and coaching needed to help clients maintain long-term weight loss and lifestyle changes. The document argues that dietitians should receive additional training in techniques like cognitive behavioral therapy, neuro-linguistic programming, and health coaching in order to more effectively promote sustainable behavior change and wellness among clients.
Sarcopenic obesity is a chronic condition, which is due to progressively aging populations, the increasing incidence of obesity, and lifestyle changes. The increasing prevalence of sarcopenic obesity in elderly has augmented interest in identifying the most effective treatment. This article aims at highlighting potential pathways to muscle impairment in obese individuals, the consequences that joint obesity and muscle impairment may have on health and disability, recent progress in management with attention on lifestyle management and pharmacologic therapy involved in reversing sarcopenic obesity. Recent findings: It has been suggested that a number of disorders affecting metabolism, physical capacity, and quality of life may be attributed to sarcopenic obesity. Excess dietary intake, physical inactivity, low-grade inflammation, insulin resistance and hormonal changes may lead to the development of sarcopenic obesity. Weight loss and exercise independently reverse sarcopenic obesity. Optimum protein intake appears to have beneficial effects on net muscle protein accretion in older adults. Myostatin inhibition causes favourable changes in body composition. Testosterone and growth hormone offer improvements in body composition but the benefits must be weighed against potential risks of therapy. GHRH-analog therapy is effective but further studies are needed in older adults. Summary: Lifestyle changes involving both diet-induced weight loss and regular exercise appear to be the optimal treatment for sarcopenic obesity. It is also advisable to maintain adequate protein intake. Ongoing studies will determine whether pharmacologic therapy such as myostatin inhibitors or GHRH-analogs have a role in the treatment of sarcopenic obesity.
4th year medical students initiate a quality improvement project for health care providers. Be sure to visit http://wp.me/p4V1Uc-sb for the pre and post test and more information.
Yoga has benefits for cancer patients by reducing stress, inflammation, and side effects of treatment. This document discusses the role of stress and inflammation in cancer development and progression. It outlines different types of yoga and their benefits. Studies show yoga lowers stress hormones and inflammatory biomarkers in cancer patients. One study found breast cancer patients who practiced yoga during radiation therapy had better quality of life and physical functioning after treatment compared to other groups. Another study found yoga helped maintain blood pressure and blood sugar levels in cervical cancer patients undergoing chemotherapy and radiation.
Exercise provides health benefits but is not effective for weight loss alone. Strength training and high intensity interval training are recommended exercise modalities that can improve health outcomes. Strength training three times per week for 40 minutes plus 20 minutes of high intensity interval training is a good starting prescription. Exercise should be used as an adjunct to nutritional counseling, which should focus on a simple, supportive approach to improve dietary compliance.
How much does a zebra weigh? With Kyle Brown at #OH2014ObesityHelp
Self confidence comes from building a sound mind in a healthy, strong body. Celebrity fitness & nutrition expert and host of “The Empower Hour” on ESPN Radio, Kyle Brown will help you discover the fitness & nutrition secrets of the animal kingdom, learn what only world class athletes and health gurus know, and feel the happiness and confidence of a champion.
Awkward! Dealing with uncomfortable food situations & social settings after w...ObesityHelp
A business lunch. A family gathering. A first date. These events can be stressful enough by themselves, but after weight loss surgery they can be, well, awkward! Bariatric Foodie author Nikki Massie discussed how to get through some of life’s most challenging food situations.
What to expect when you're expecting weight loss surgery to work by Diana Vog...ObesityHelp
This document discusses the expectations and realities of weight loss surgery from the perspective of someone who underwent the procedure. It notes feelings of hunger that were unexpected, impatience, loose skin, mood changes, a new relationship with food, and ultimately completing a marathon, which was an unexpected accomplishment years after the surgery. The overall message is that the journey of weight loss surgery involves both meeting and defying expectations.
Yoga is not a 4-letter word: How Yoga supports your weight loss journey from ...ObesityHelp
This document contains 10 photos from Flickr that are available for use under various Creative Commons licenses, such as Attribution, Non-Commercial, and Share-Alike. The photos show a variety of subjects like nature scenes, buildings, and people and were uploaded by different users. All photos include information on the photographer and license for how they can be legally used or shared.
I am changing...and I am perfect as I am by Angela Taylo, LCSW at OH2014ObesityHelp
It can be a challenge finding the balance between motivation to change and acceptance of where you are. It is easy to become self-critical rather than self-loving as you focus on losing weight, improving health and changing your body. This workshop reminded people that weight loss and body changes are exciting and should be celebrated, but we can get into trouble when we put weight loss on too high of a pedestal and we become obsessed with the body. Join Angela, to learn to how to celebrate your body changes, while also learning how to love yourself exactly as you are.
Rachel Kugel is a phenomenal lawyer. She genuinely cares about your well being and always keeps you informed. At many points during my case I was was confused as to not knowing what could happen.
The document discusses different methods for quantifying dormitory decorations, including counting the total number of decorations, categorizing the types of decorations, rating decorations on a scale of femininity to masculinity, measuring the wall space covered by decorations, and combining counting and categorization. It suggests that unique research may require developing customized coding methods.
Escuela superior politécnica de chimborazoVanessa GE
Las TIC son herramientas digitales como hardware, software y redes que se usan para acceder, procesar y transmitir información. Son importantes en la enseñanza porque permiten actividades académicas y laborales globalizadas. La Web 2.0 permite que profesores y estudiantes creen y compartan contenidos educativos de manera colaborativa y a través de redes sociales.
El documento describe la estructura y función del sistema nervioso. Se divide anatómicamente en el sistema nervioso central y periférico, y funcionalmente en somático y autónomo. Está compuesto principalmente de neuronas, que son la unidad funcional, y células de soporte. Las neuronas se clasifican en sensitivas, motoras e interneuronas dependiendo de su función.
The Vietnam War began in 1954 after France lost control of Vietnam to Ho Chi Minh's Viet Minh forces. Vietnam was divided at the 17th parallel, with Ho Chi Minh controlling North Vietnam and Ngo Dinh Diem controlling South Vietnam. The US initially provided aid to Diem's repressive government in South Vietnam and gradually increased military involvement over the following decades. Despite massive US bombing campaigns and increasing troop deployments, the Tet Offensive in 1968 showed that the US was not winning the war. Growing anti-war sentiment led Nixon to begin withdrawing troops in 1973, and South Vietnam fell to Communist rule in 1975. The human and financial costs of the war were immense.
Las células satélite son células gliales pequeñas que rodean los somas neuronales en los ganglios. Proveen aislamiento eléctrico y un microambiente para el intercambio metabólico entre las neuronas y las células satélite. En los ganglios periféricos y paravertebrales, las prolongaciones neuronales deben introducirse en las células satélite para establecer sinapsis.
The document provides an overview of contemporary Britain, covering its economy, industries, agriculture, science and technology, transport, environmental issues, and tourism. Some key points include:
- Britain has the 5th largest economy in the world and 2nd largest in Europe, with over 70% of its GDP coming from services like banking, insurance, and tourism.
- Agriculture accounts for only 1% of GDP but uses 80% of land, mainly for crops like wheat, barley, and sugar beets. "Mad cow disease" significantly impacted the farming industry in the late 20th century.
- Science and technology are important sectors, with Britain earning 46 Nobel prizes. Several prominent science museums attract visitors across the country.
Este documento presenta la lista de útiles escolares requeridos para estudiantes de 1ro básico en el Colegio Sofía Infante Hurtado. Incluye los cuadernos, lápices, colores y otros materiales necesarios para las asignaturas de Lenguaje, Matemáticas, Historia, Ciencias, Inglés, Religión, Tecnología, Música y Artes Visuales. Además, enumera los útiles de uso diario como estuche, lápiz, goma y sacapuntas. Finalmente, enfatiza la importancia
Este documento presenta un plan lector para primero a octavo básico que incluye actividades antes, durante y después de la lectura del libro "Las dos miradas". Las actividades se enfocan en desarrollar habilidades de comprensión lectora como predecir, empatizar con los personajes, recordar detalles y comparar. El plan propone estrategias como predecir la trama a partir de palabras clave e ilustraciones, visualizar parte del texto para conectarse emocionalmente, y aconsejar a los protagonistas. El objetivo es formar lect
Clase brindada por la Dra Andrea Acencio y el Dr Juan Apendino, ambos residentes de primer año del Hospital Provincial de Neuquén, Dr Eduardo Castro Rendón. En la misma se profundiza sobre el uso de benzodiacepinas y las diferencias que existen entre ellas.
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This document discusses weight control and obesity. It explains that weight control involves regulating food intake and exercise to control fat levels in the body. Obesity increases health risks, while being overweight does not necessarily mean someone is obese. The document then discusses causes of obesity like overeating, inactivity, genetics, and diseases. It also outlines ways to control obesity such as dieting, exercise, surgery, and addressing psychological factors.
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It's easy to become dissatisfied with your weight loss efforts. Many people struggle to lose weight and maintain their weight loss. When you look at human metabolism in the context of a large picture of yourself, however, it's actually quite simple.
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This document discusses myths and realities around thinness and obesity. It debunks several common myths, such as thin people having faster biochemical functions or digestion being more efficient in thin individuals. Regular exercise of 30 minutes per day can help burn calories after exercise for 3-24 hours. Studies have shown that a combination of yoga, Ayurveda, sensible eating and maintaining an active lifestyle can promote fitness and healthy living for 100 years. Maintaining physical fitness through daily exercise and a nutritious diet along with strong family relationships can reduce cancer risks.
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Maintaining a trim midsection benefits you in more ways than just one. It can help you live longer. Heart disease, diabetes, and even cancer are all linked to having a larger waistline. Losing weight, especially belly fat, improves blood vessel function and sleep quality.
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1) Weight loss is determined by creating a calorie deficit through consuming fewer calories than are expended. While many factors can influence weight loss, a calorie deficit is the primary driver.
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Similar to What to Do When the Honeymoon is Over by Dr. Scott Cunneen (20)
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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What to Do When the Honeymoon is Over by Dr. Scott Cunneen
1. What to do When the Honeymoon
is Over
Scott Cunneen MD FACS FASMBS
Director Center for Weight Loss
Ceadars-Sinai Medical Center
Los Angeles, CA
August 16, 2014
2. A recent study has found
that women who carry a
little extra weight live
longer than the men who
mention it.
6. It’s hard to argue with logic like
that, but there are a few other
reasons that this statement is
true...and especially frustrating
for weight loss surgery patients
who are “doing everything
right!”!””
8. Counterintuitive Nature of Obesity & Surgery
“The nature of obesity is that it’s in many ways
counterintuitive. And the way these operations work is
also counterintuitive. The notion that they work by
physiology and NOT by restricting how much you eat,
the notion that they change energy balance…that itself
is counterintuitive; however, it’s also very enabling to
the use of these operations that they work in such a
physiological way.”
7
9. Obesity & The Energy Balance Equation
8
“If we’re getting more obese
as a society, it must be the
case that our caloric intake
exceeds our caloric
expenditure. But I think the
vast majority of people who
think at all about this have a
very inaccurate version of
what that mismatch
between caloric intake and
caloric expenditure actually
looks like, and that they
view it as a situation where
patients are massively
increasing their caloric
intake to gain that weight.
But nothing could be
further from the truth.”
10. The Leptin Bathtub
9
“In this analogy, the
amount of water is the
same as the amount of
adipose tissue in your
body. Your body is paying
attention to the amount
of adipose tissue you
have. And that is the
defended parameter;
that is, when you try to
push the amount of
water, in this case the
amount of body fat, in
either direction, the
brain is going to fight
back by being able to
alter how hungry you are
and how rapidly you’re
burning calories.”
11. Defense Of A Set Point
10
“The end result of all this
regulatory activity on the
part of the body is to
defend a particular set
point for energy storage,
which turns out to
effectively be body
weight…On the left side
is why diets don’t work.
And this whole process is
determined
physiologically. ”
+ -
13. The Myth Of Weight Management
12
“I think one of the durable
misconceptions in the area
of weight regulation and
obesity is that it results
from abnormal or
inappropriate behavior…
“You have to either engage
the body’s regulatory
system to make it want to
weigh less or you have to
fight it. So, this myth comes
from the fact that people
believe that the best way to
do it is to fight it.”
14. The Body’s Defense Of Set Point
13
“What weight you
defend is not a static
variable. It’s a variable
that can change over
time and over
circumstance. But just
because those animals
at the bottom hadn’t
ever been at that
weight, didn’t mean
that they didn’t know
they should be at that
weight and actively
work to defend it.”
Bernstein, IL. Proc Soc Exp Biol Med; 1975 Nov; 150(2): 546-8
The data presented in the above graph is from a study conducted on laboratory rats
15. The Body’s Defense Of Set Point
14
“Under different
dietary conditions, the
exact same signal of
leptin provides a
different response…
The point here is
things in our
environment are
changing the biological
signals that relate to
what weight the body
sees as appropriate.”
The data presented in the above graph is from a study conducted on laboratory rats
16. Environmental Changes Driving Obesity
Four Environmental Changes
• Altered Food Supply
• Decreased Physical Activity
• Stress and Distress
• Drugs
“Those four categories of changes in the environment are so profound that they
create the perfect storm for re-regulating energy balance, re-regulating set point, and
creating obesity.”
15
18. Evidence for Physiological Mechanisms
“There are a variety of clinical observations that provide evidence that these
operations can’t work primarily by physical restriction or malabsorption of
ingested calories.”
Bariatric Surgery
Evidence for Physiologic Mechanisms
• Dramatic Effects on Hunger and Satiety
• Few Patients become Underweight After Surgery
• Transient Weight Gain During Pregnancy
• Little or no Weight Loss in Thin Patients or Animals
• Changes in GI Endocrine Markers-Gherlin, PYY, GLP-1 Amylin
• Increased Energy Expenditure (Bypass Procedures)
• Ability to Reverse the Effects of Surgery with Drugs and Genetic
17
Manipulation
19. Surgery Changes Set Point
“What surgery is doing is it’s changing the nature of these physiological
curves so that the control of appetite, or energy intake, is blunted in a way.
So as you lose body fat you end up with less of a rise in energy intake. And
as you lose body fat you see less of a conservation of energy expenditure.”
18
20. RYGB vs Dieting
19
“All of these physiological
changes are consistently
in the opposite direction
after surgery as compared
with dieting, and so what
that tells you once again is
that dieting engenders a
counter-regulatory
response that pushes you
back to your original set
point. Surgery, by having
the arrows go in the
opposite direction, must
be changing the
physiology.”
The data in the chart above are from multiple studies, presented here in aggregate.
22. VSG Doesn’t Mechanically Restrict Intake
21
“Three weeks after the
surgery the animals
that got a VSG went
back to eating what
they were before. The
reason I point that out
is, ‘Where’s the
restriction?’ The
animals are capable of
consuming the same
amount of calories as
before. It’s not the
case that their
stomach is so small
that they aren’t
capable of consuming
sufficient calories.”
The data presented in the above graph is from a study conducted on laboratory rats
23. VSG Influences Food Choice
The data presented in the above graphs are from a study conducted on laboratory rats
“We give the animal a choice between a nutritionally complete high-fat diet (HFD) and a
nutritionally complete low-fat diet (LFD). Animals who haven’t had surgery prefer HFD. You
would too HFD tastes a little like sugar cookie dough. You look at an animal that’s had surgery
and that preference for HFD is almost entirely gone. The animal is choosing to make a change
in its behavior as a function of the biological changes of the surgery.”
22
25. Biological Factors Influence Outcomes
“We now have evidence that there are biological factors, including but not limited
to genetic factors, that have a great deal of importance in determining how much
weight you’re going to lose after any one of these procedures. And once you
recognize that, you recognize that the response to surgery is complex.”
24
26. The Role Of Genetics In Surgical Outcomes
25
“If you share all of your
genes with somebody,
your outcome after
bariatric surgery is going
to be very closely similar
to the person you share
your genes with. If you
share NO genes with
them, regardless of
whether you live with
them, you’re going to
have much less similarity
in the outcome. Taken
together this suggests that
there’s a very strong
genetic component and
some people are wired to
lose more weight than
others in response to the
same operation.”
28. Average Percentage of
EXCESS BODY WEIGHT LOSS
Gastric bypass 65%
Sleeve gastrectomy 60%
Lap Band 50%
29. Let’s try to redefine success…
• How has your overall health
changed?
• How has your energy level
changed?
• How do those achy knees, hips
and/or back feel these days?
• How does your accomplishment
make you feel?
• Do you ever get tired of hearing
“Oh, my GOD!” when you run into
people who haven’t seen you in a
while?
• Do you fit into those skinny jeans?
(Oh well, five out of six ain’t bad!)
30. What are some of the
benefits you’ve enjoyed by
losing weight?
• Lower cholesterol
• Lower blood pressure
• Lower risk of heart attack and
stroke
• Diabetes remission
• Back and joint pain reduction
• Resolution of sleep apnea
• Increased energy
• Probable increased life
expectancy!
Now...name some others!
31. The Rules!
1. Eat slowly and chew well
2. Limited or no alcohol.
3. Minimize liquid calories.
4. Vitamins and calcium are non-negotiable!
5. Small portions, balanced meals.
6. No aspirin/ibuprofen; limit caffeine.
7. 8 glasses of water a day.
8. 75 grams of protein a day.
9. Don’t drink while you eat.
10. Exercise, exercise, exercise. !
32. The dreaded truth about
exercise...here’s how it helps
to keep your weight off in the
long run:
• Burns more calories than
sitting on your couch
• Builds muscle which burns
calories more efficiently than fat
• Actually helps to control hunger
• Keeps you motivated to continue
making good food choices
WHAT ELSE???
33. Of course, there are other ways to
burn calories every day…
• Pick a parking spot far from your
destination.
• Take the stairs rather than the
elevator.
• A little mid-week gardening never
killed anyone.
• Walk the dog, walk the dog, walk the
dog.
• Find a little kid — or rent one — to
take to the park.
Any others???
34. At times, the lifestyle changes
you’ve committed to may
seem difficult...but
remember, what doesn’t kill
you makes you stronger!
35. Just remember…
...where you started!
...how hard you worked to get
where you are!
...you KNOW what to do, even if
you temporarily fall off the wagon!
— and especially —
...YOU’RE the ones who make us
surgeons look good, so remember
that we’re always in your corner!
36. Doctors have been trying to
answer this question for
decades...if anyone can
figure it out, please
let me know!
Any other questions?
38. Metabolic Impact Of Surgery
37
“One of the most
remarkable things about
what we’ve learned
about bariatric surgery
over the last twenty
years is what a profound
impact it has on
metabolic disease.”
Kaplan, LM et al. Bariatric Times. 2012;9(7):12–14.
39. Surgical Effects Of Glucose Regulation
38
“Both surgeries,
despite the fact that
we’re doing them on
stomach and intestine,
have potent effects to
change what’s going
on in the pancreas…
“I think this provides
clear evidence that
these bariatric
procedures, including
VSG, have metabolic
impacts beyond what
you can imagine from
just weight loss alone.”
The data presented in the above graph is from a study conducted on laboratory rats
40. Just For Fun…
39
“They (the animals) don’t
have a registered dietician
who’s been telling them
about how to lose weight,
or how to count their
calories. They don’t show
up at the experiment
because the rat next door
made fun of them, or they
didn’t like what they saw
in the rat mirror.”
41. Genetic Markers
40
“There’s a region on
chromosome 15 where
the dots go very high…this
reproducibly shows that
this region of
chromosome 15, if you
have a particular version
of that gene, you’re going
to predictably lose more or
less weight.”
42. Classifying Surgical Failure
“We should think about surgical failure more as a
relative or subjective concept.
“And we should divide failure into primary failure,
which is the failure to lose an adequate amount of
weight or to improve comorbidities in direct response
to the surgery, versus…initial success but because of
weight regain or significant worsening of diabetes or
other comorbidities, you would call that secondary
failure.”
41
Editor's Notes
Thank you for the kind introduction. I am a weight loss and metabolic surgeon and I hope I can help you in your weight loss journey.
I always enjoy talking with patients, rather than talking at them, so in addition to answering any questions you may have a little later, I’ll be asking for your participation throughout this presentation. Talking with patients actually helps me improve what I do.
This may be an appropriate life lesson, but Seriously, I talk about weight and health issues with patients everyday and where you are in this journey to improve your life and your health you really need to pay attention to your goals every day. It also helps if you enlist your family and friends as long as they do it a positive way.
So, let’s start with a look back at your own journey. Remember the day when it all started for you? Ask who’s had which surgery or if anyone is still pre-op.
Talk a little about what the honeymoon period is…and then ask what HAPPENED to it? Where did it GO?
Next…….Is is like the old saying literally “Gone with the Wind”
Or is it ……… Something that can be recovered with simple lifestyle changes?
Or are more drastic measures required?
Is it simply a matter of the passage of time and there is nothing to do about it or
Are there things that can be done to improve your weight loss and your health easily and effectively?
Is it a factor of aging and what can be done to make your body “feel and act” younger?
It’s slowing down, sometimes to a crawl, other times it stops altogether. What gives? This is true for all of us as we get a little older, but my patients of all ages are struggling with this. Explain the set point.
I would like to take a step back and discuss a few fundamental principles on how your body works and the fundamental principles of how these surgeries help you lose weight and keep it off.
Some of these principles may not have been what you understand or were told but just try to keep an open mind as we set the foundation to help you navigate your journey once the honeymoon period is over.
Just to get you an example of how finely regulated the system is: an excess of 11/cal/day equal a pound at the end of a year.
The green line represents energy intake
The yellow line represents energy expenditure
The area between those two lines on either side of the bar represent energy balance , weight loss or weight gain
As you move away from the set point the body increases expenditure or wastes more and signals you to take in less energy and eat less
Notice the exponential rise as you move away from the set point which is represented as a BMI of 25 by the red bar.
So to make it simple:
Your body has a preprogramed set point that it defends vigorously and if you want to move it to a different place you need to do something relatively drastic and permanent.
Lets move on to energy balance and weight management
I cant emphasize this enough……..your body is behaving the way it was designed to behave. The greatest driver for weight gain is determined by your body’s physiology.
In order to be successful in losing weight and maintaining that weight loss we have to make your body, your physiology want to weigh less, change its setpoint.
Shear will power is seldom successful alone. Our bodies are smarter than that, if we want to change that setpoint we must come at it from all angles.
The set point changes with time, but unfortunately it does so in the wrong direction.
In this study, several concepts are illustrated:
That if you severely limit your diet you can force weight loss……these animals were simply not given any acess to food so that they could not gain weight.
The second concept is that the body always remembers……….when the animals were then given free access to food they quickly gained weight that they should have had back……their body remembered the set point.
This slide is confusing, but what it demonstates is that LEPTIN the signal that is supposed to tell us how much energy is onboard doesn’t work the way it is supposed to if we change the composition of the diet.
When consuming a high fat diet the body ignores the signal to stop and not take in or waste calories the way it is supposed to effectively pushing up your genetically determined setpoint.
So as most of you probably realize, genetic isn’t the only thing contributing to the epidemic of obesity. Our environment plays a critical role.
Those four categories of changes in the environment are so profound that they create the perfect storm for re-regulating energy balance, re-regulating set point, and creating obesity.”
So how does bariatric surgery work?
Read slide
What these two graphs are demonstrating is that surgery is changing the bodies response to the movement of the set point. There is much less resistance as far as increasing appetite and conserving energy by turning down the furnace than there is prior to surgery.
Here is a comparison of gastric bypass to regular dieting
And what this shows is that the physiology of the weight loss is different and tends demonstrate opposite directions.
This is why the success rates are different, when you diet your body responds much more aggressively to return you to its setpoint.
Volume or the ability to “get the calories in” does not seem to be the mechanism for weight loss. In this study, the ability to get calories in returned rather quickly from a mechanical standpoint.
The sleeve operation seems to influence food choice, pushing toward the appetite for a lower fat diet which resulted in the consumption of fewer calories.
So what do we have to do to optimize surgical outcomes?
There are biologic factors, including genetic factors which determine your response to these surgeries.
In a gastric bypass, for example, EWL is about 65% but most patients are clustered somewhere between 50-100% EWL.
at one year.
Genetics plays a huge component in how much weight you are going to lose with surgery.
In this graph the bigger the bars the greater the difference in weight loss between two individuals.
This difference appears even greater than the environment.
So the first set in improving outcomes is setting appropriate expections and measures of benefit
First, let’s talk about what to expect when you decide to have weight loss surgery. In your pre-op educational sessions, you no doubt heard about managing your expectations. A lot of people are so excited about the prospect of finally losing a significant amount of weight, they don’t even HEAR what’s being said about what the real possibilities are. Let’s talk about what is reasonable to expect. [Define excess body weight as opposed to what you would actually like to weigh and discuss percentages for each surgery.]
So lets try to redefine success
It should not be who has lost the most weight.
Contrary to popular belief, there is not a med school class or seminar at bariatric surgeons’ conferences where we sit around and figure out how to torture our patients. These rules that you are taught pre-op, or some version of these rules, will quickly become your new habits that represent your change of lifestyle. You’ll adapt to them over time. Some of them need to be forever. Others can be negotiated with your doctor as time goes by. Let’s take them one by one…[then ask if they have any others]
As much as I hate to sound like a broken record, the patients with the best outcome, the ones who have continued success AFTER the honeymoon is over, the ones who get the most weight off and keep it off…they’re the ones who exercise regularly. One of my patients reports that when she signs in at the gym, the desk guy says, “Enjoy your workout.” She tells him, “Enjoy is a strong word.” But she also admits, like so many others, that she feels better on the days she works out than on the days she doesn’t. So do I.
Here are some of the little things you can incorporate into your routine that help burn calories without even thinking about it, starting with NOT driving around the parking lot for half an hour looking for the closest spot at the supermarket. And like the rules we talked about, they soon become second nature.
Virtually all of us know someone – a cousin, friend of a friend, brother-in-law – who gained back a significant amount of weight and say that surgery “didn’t work” for them. In reality, it’s not the operation that didn’t work, it’s that they didn’t work the operation, or didn’t incorporate all the necessary changes into their own lifestyle. Weight loss surgery is not the easy way out. It’s not for sissies. It takes time and it takes your attention, every single day.
As you get back into what we all know as real life, there will be bumps in the road. There’s not one person in this room who doesn’t know what to do. Go back to the beginning in your head. Get that enthusiasm back, get that excitement back. Remember that heady feeling you had in the beginning and strive to reclaim it. That’s why there’s such things as Second Honeymoons. [applause applause! Click right to the last slide]
I’ll try to answer any questions you may have…except this one.