Study - Weight-Loss Surgery Linked To Increased Suicide Risk

Another OBVIOUS. 

Reuters -

“These findings suggest that more effort may be needed to improve access to mental health care services in these patients should they need them, and perhaps some screening in the second year and onwards,” Bhatti said. 

During the first three years after surgery, 111 patients received emergency care for self-inflicted injuries, or roughly 1 percent of people in the study. While small, the risk of these emergencies was 54 percent higher after surgery than it was before.

Study - JAMA

Importance  Self-harm behaviors, including suicidal ideation and past suicide attempts, are frequent in bariatric surgery candidates. It is unclear, however, whether these behaviors are mitigated or aggravated by surgery.

Objective  To compare the risk of self-harm behaviors before and after bariatric surgery.

Design, Setting, and Participants  In this population-based, self-matched, longitudinal cohort analysis, we studied 8815 adults from Ontario, Canada, who underwent bariatric surgery between April 1, 2006, and March 31, 2011. Follow-up for each patient was 3 years prior to surgery and 3 years after surgery.

Main Outcomes and Measures  Self-harm emergencies 3 years before and after surgery.

Results  The cohort included 8815 patients of whom 7176 (81.4%) were women, 7063 (80.1%) were 35 years or older, and 8681 (98.5%) were treated with gastric bypass. A total of 111 patients had 158 self-harm emergencies during follow-up. Overall, self-harm emergencies significantly increased after surgery (3.63 per 1000 patient-years) compared with before surgery (2.33 per 1000 patient-years), equaling a rate ratio (RR) of 1.54 (95% CI, 1.03-2.30; P = .007). Self-harm emergencies after surgery were higher than before surgery among patients older than 35 years (RR, 1.76; 95% CI, 1.05-2.94; P = .03), those with a low-income status (RR, 2.09; 95% CI, 1.20-3.65; P = .01), and those living in rural areas (RR, 6.49; 95% CI, 1.42-29.63; P= .02). The most common self-harm mechanism was an intentional overdose (115 [72.8%]). A total of 147 events (93.0%) occurred in patients diagnosed as having a mental health disorder during the 5 years before the surgery.

Conclusions and Relevance  In this study, the risk of self-harm emergencies increased after bariatric surgery, underscoring the need for screening for suicide risk during follow-up.

Link -

Fat Shaming.

I don't know if any of you watched the original. I posted it to my personal profile when I saw it. I was TORN. THE. HELL. UP. Why? Because my family was personally affected and moved to lose weight due to fat shaming.  It worked in our cases, here.  I don't know why.  


WHAT I WANT TO SAY TO FAT PEOPLE ---> #DearFatPeople This is my response to Nicole Arbour's video (& all body shamers!) S2 of #MyBigFatFabLife premiers Wed. 9/9 at 9 on TLC! #NoBodyShame

Posted by Whitney Way Thore on Saturday, September 5, 2015

Airline to Begin Weighing Passengers for ‘Flight Safety’

Airline to Begin Weighing Passengers for ‘Flight Safety’

Oh, this will go over well in the US. Eventually. I see it coming. Miles away.



Download Uzbekistan_airways_-_preflight_procedures_-_2015-08-07

Dear passengers!

Please be informed that Uzbekistan Airways airline carries out the procedure of preflight weighing for determination of the average weight of passenger with hand baggage.

According to the rules of International Air Transport Association, airlines are obliged to carry out the regular procedures of preflight control passengers weighing with hand baggage to observe requirements for ensuring flight safety.

 After passing check-in on flight and prior to boarding into the aircraft, we will suggest you to pass the procedure of weighing with the special weighing machine placed in the departure gate zone.

The weighing record will only contain the corresponding passenger category (i.e. male/ female/ children). As for the rest, the full confidentiality of results is guaranteed.

We will appreciate your assistance and thank you in advance for the help in the solution of our common task of flight safety!

Gastric bypass surgery lowers women's alcohol tolerance

Download 2015-08-gastric-bypass-surgery-lowers-women

A small study indicates that changes in how  is metabolized after surgery can speed its delivery into the bloodstream, resulting in earlier and higher peaks in blood-alcohol levels. Studying  who had undergone surgery, the researchers found that those who had consumed the equivalent of two drinks in a short period of time had blood-alcohol contents similar to women who had consumed four drinks but had not had the operation.

The research is published Aug. 5 in the journal JAMA Surgery.

"The findings tell us we need to warn patients who have  that they will experience changes in the way their bodies metabolize alcohol," said first author M. Yanina Pepino, PhD, an assistant professor of medicine in the Division of Geriatrics and Nutritional Science. "Consuming alcohol after surgery could put patients at risk for potentially serious problems, even if they consume only moderate amounts of alcohol."

Although this study included only women, it is likely that men who have gastric bypass surgery experience similar changes in how their bodies metabolize alcohol.

The researchers studied alcohol's effects in 17 obese women. Eight of the women had undergone Roux-en-Y gastric bypass surgery—the most common bariatric surgical procedure worldwide—one to five years before the study began. The other nine participants had not yet had the operation.

As part of the study, the women spent two days, about one week apart, at Washington University's Clinical Research Center. On one visit, each woman randomly consumed either the equivalent of two  or two nonalcoholic beverages during a 10-minute period. At the second visit, each was given the beverages not received during the first visit. At both visits, the researchers measured the women's blood-alcohol contents and used a survey to assess their feelings of drunkenness.

The women in the gastric bypass group had an average body mass index (BMI) of 30, which is considered obese, but it compared with an average BMI of 44 for the women who had not yet had the surgery. Among those who had not undergone surgery, blood-alcohol content peaked about 25 minutes after they finished consuming the alcohol and measured 0.60. In women who had the surgery, blood-alcohol content peaked at 5 minutes after drinking and reached 1.10, significantly above the legal driving limit of 0.80.

"These findings have important public safety and clinical implications," said senior investigator Samuel Klein, MD, the William H. Danforth Professor of Medicine and director of the Center for Human Nutrition. "After just two drinks, the blood-alcohol content in the surgery group exceeded the legal driving limit for 30 minutes, but the levels in the other group never reached the legal limit.

"The peak blood-alcohol content in the surgery group also met the criteria that the National Institute on Alcohol Abuse and Alcoholism uses to define an episode of binge drinking, which is a risk factor for developing alcohol problems."

Women who had undergone gastric bypass also reported feeling the effects of alcohol earlier and for longer periods of time than women who had not had the surgery.

The study is not the first to find that gastric  can alter alcohol metabolism, but Pepino said it is significant because earlier studies had measured blood alcohol less vigorously and were less clear about the extent of the changes in alcohol metabolism.

"The women who had the surgery only received the equivalent of two drinks, but it was as if they had consumed twice that amount," she said. "Consuming alcohol after surgery the way one did before the operation could put patients at risk for potentially serious consequences, even when they drink only moderate amounts of alcohol."

More information: Pepino MY, Okunade AL, Eagon JC, Bartholow BD, Bucholz K, Klein S. Effect of Roux-ex-Y gastric bypass surgery: converting 2 alcoholic drinks to 4. JAMA Surgery, published online Aug. 5, 2015. DOI: 10.1001/jamasurg.2015.1884 

Long-term followup of type of bariatric surgery finds regain of weight, decrease in diabetes remission

While undergoing laparoscopic sleeve gastrectomy induced weight loss and improvements in obesity-related disorders, long-term followup shows significant weight regain and a decrease in remission rates of diabetes and, to a lesser extent, other obesity-related disorders over time, according to a study published online by JAMA Surgery.

Obesity was recognized as a global epidemic by the World Health Organization 15 years ago and rates of obesity have since been increasing. Obesity is currently considered a severe health hazard and a risk factor for mellitus, hypertension, abnormal lipid levels, heart failure, and other related disorders. Bariatric procedures are reportedly the most effective strategy to induce weight loss compared with nonsurgical interventions. Laparoscopic sleeve gastrectomy (LSG) is a common and efficient bariatric procedure with increasing popularity in the Western world during the last few years, but data on its long-term effect on obesity-related disorders are scarce, according to background information in the article.

Andrei Keidar, M.D., of Beilinson Hospital, Petah Tikva, Israel, and colleagues collected data on all patients undergoing LSGs performed by the same team at a university hospital between April 2006 and February 2013, including demographic details, weight followup, blood test results, and information on medications and comorbidities.

A total of 443 LSGs were performed. Complete data were available for 54 percent of patients at the 1-year follow-up, for 49 percent of patients at the 3-year follow-up, and for 70 percent of patients at the 5-year follow-up. The percentage of excess  was 77 percent, 70 percent, and 56 percent, at years 1, 3 and 5, respectively; complete remission of diabetes was maintained in 51 percent, 38 percent, and 20 percent, respectively, and remission of hypertension was maintained in 46 percent, 48 percent, and 46 percent, respectively.

The decrease of  level was significant only at years 1 and 3. The changes in total cholesterol level (preoperatively and at 1, 3, and 5 years) did not reach statistical significance.

"The longer follow-up data revealed weight regain and a decrease in remission rates for type 2 and other obesity-related comorbidities. These data should be taken into consideration in the decision-making process for the most appropriate operation for a given obese patient," the authors write.

More information: JAMA Surgery. Published online August 5, 2015. DOI: 10.1001/jamasurg.2015.2202 

FDA approves non-surgical temporary balloon device to treat obesity -

And I sigh.  I feel like this is asking for an eating disorder, but what do I know. 


The U.S. Food and Drug Administration today approved a new balloon device to treat obesity without the need for invasive surgery. The ReShape Integrated Dual Balloon System (ReShape Dual Balloon) is intended to facilitate weight loss in obese adult patients. The device likely works by occupying space in the stomach, which may trigger feelings of fullness, or by other mechanisms that are not yet understood.

The ReShape Dual Balloon device is delivered into the stomach via the mouth through a minimally invasive endoscopic procedure. The outpatient procedure usually takes less than 30 minutes while a patient is under mild sedation. Once in place, the balloon device is inflated with a sterile solution, which takes up room in the stomach.

The device does not change or alter the stomach’s natural anatomy. Patients are advised to follow a medically supervised diet and exercise plan to augment their weight loss efforts while using the ReShape Dual Balloon and to maintain their weight loss following its removal. It is meant to be temporary and should be removed six months after it is inserted.

“For those with obesity, significant weight loss and maintenance of that weight loss often requires a combination of solutions including efforts to improve diet and exercise habits,” said William Maisel, M.D., M.P.H., acting director of the Office of Device Evaluation at the FDA’s Center for Devices and Radiological Health. “This new balloon device provides doctors and patients with a new non-surgical option that can be quickly implanted, is non-permanent, and can be easily removed.”


Download Press Announcements > FD...device to treat obesity


Alcohol Sensitizes Brain Response to Food Aromas and Increases Food Intake in Women, Research Shows

Something I feel like we already knew?  Sigh.  Please read.

PR from The Obesity Society -

Alcohol Sensitizes Brain Response to Food Aromas and Increases Food Intake in Women, Research Shows

First study of its kind ties hypothalamus, in addition to the gut, to the aperitif phenomenon

SILVER SPRING, MD – The first study of its kind measuring the brain's role in mediating caloric intake following alcohol consumption among women shows that alcohol exposure sensitizes the brain's response to food aromas and increases caloric intake. The research, led by William J. A. Eiler II, PhD, of the Indiana University School of Medicine's Departments of Medicine and Neurology, adds to the current body of knowledge that alcohol increases food intake, also known as the "aperitif effect," but shows this increased intake does not rely entirely on the oral ingestion of alcohol and its absorption through the gut. The study is published in the July issue of the journal Obesity published by The Obesity Society (TOS).

"The brain, absent contributions from the gut, can play a vital role in regulating food intake. Our study found that alcohol exposure can both increase the brain's sensitivity to external food cues, like aromas, and result in greater food consumption," said Dr. Eiler. "Many alcoholic beverages already include empty calories, and when you combine those calories with the aperitif effect, it can lead to energy imbalance and possibly weight gain."

Researchers conducted the study in 35 non-vegetarian, non-smoking women at a healthy weight. To test the direct effects of alcohol on the brain, researchers circumvented the digestive system by exposing each participant to intravenously administered alcohol at one study visit and then to a placebo (saline) on another study visit, prior to eating. Participants were observed, and brain responses to food and non-food aromas were measured using blood oxygenation level dependent (BOLD) response via fMRI scans. After imaging, participants were offered a lunch choice between pasta with Italian meat sauce and beef and noodles. 

When participants received intravenous alcohol, they ate more food at lunch, on average, compared to when they were given the placebo. However, there were individual differences, with one-third of participants eating less after alcohol exposure when compared to the placebo exposure. In addition to changes in consumption, the area of the brain responsible for certain metabolic processes, thehypothalamus, also responded more to food odors, compared to non-food odors, after alcohol infusion vs. saline. The researchers concluded that the hypothalamus may therefore play a role in mediating the impact of alcohol exposure on our sensitivity to food cues, contributing to the aperitif phenomenon.

 "This research helps us to further understand the neural pathways involved in the relationship between food consumption and alcohol," said Martin Binks, PhD, FTOS, TOS Secretary Treasurer and Associate Professor of Nutrition Sciences at Texas Tech University. "Often, the relationship between alcohol on eating is oversimplified; this study unveils a potentially more complex process in need of further study."

Study authors agree and call for further research into the mechanism by which the hypothalamus affects food reward.

"Today, nearly two-thirds of adults in the U.S. consume alcohol, with wine consumption rising, which reinforces the need to better understand how alcohol can contribute to overeating," continued Dr. Binks.

Read the full article in Obesity here.

'Anyone with a functioning brain' makes sure they look good in a bikini

What the who!?

'Anyone with a functioning brain' makes sure they look good in a bikini

Clipped from Raw Story - 

“If you are offended by an ad with a woman on it or a hot girl or a hot guy then seek therapy,” Fox News host Jedediah Bila advised on Monday. “I mean, go to a therapist. There’s something wrong with you.”

“At this time of year, anyone with a functioning brain asks themselves that question, ‘Are you beach body ready?'” Tantaros insisted. “In fact, I ask myself that question every single day. And I bet you people who have a problem with this ad going into summer time are not beach body ready.”

“It’s such a bunch of bull,” the Fox News host said of critics. “Everyone wants to know if they look good in a swimsuit!”

“You should grow up wanting to look like that anyway,” guest host Chris Plante quipped.

Gastric Pacemaker in use in Boston


This procedure is now done where Bob and I both had our weight loss surgeries 11.5 years ago.   I recall posting about it years ago when it was in testing.  

I think it's a neat idea.

CBS Boston

If you think about weight loss surgery, there are three main options: Gastric Bypass, the Lap Band, and the Gastric Sleeve. But there haven’t been any other weight loss procedures approved by the FDA for over ten years, that is, until now. Back in January the government agency approved a new device that’s less complicated, safe, and effective.

“Most all of my life I have been overweight.” Mike Magnant from Carver loves to spend time on the tugboat he built, but the extra pounds he carried around took a toll. “High blood pressure, high cholesterol, pains in my legs and pains in my knees,” Mike explains. “I couldn’t do the things I wanted to do.”

He tried a slew of diets but every time, he regained the weight and then some.

At a max of 291 pounds, he knew he had to do something drastic. So Mike enrolled in a clinical trial at Tufts Medical Center studying a new minimally invasive weight loss system called vBloc Therapy by EnteroMedics.

Like a pacemaker, the device is inserted under the skin and electrodes are fed into the abdomen and secured around the vagus nerve which controls hunger. Dr. Sajani Shah, a surgeon at Tufts Medical Center who specializes in weight loss surgery, explains, “It blocks the nerve to the brain and basically tells patients that they’re less hungry and they get satiated for longer periods of time.”

About three years ago, Mike underwent the procedure with Dr. Shah. He went home the same day, back to work three days later, and has lost more than 70 pounds. He says he still enjoys a good meal, but just doesn’t eat as much. He doesn’t feel hungry.

Studies showed patients lost about 30% of their excess weight. “If diet and exercise aren’t working because unfortunately the yo-yo dieting is sometimes hard,” says Dr. Shah, “But they don’t want the other things we have to offer, like the bypass or the sleeve because it’s really complicated, then this is a great, safe alternative for patients to treat their obesity.”

And even though the system is reversible, Mike says it’s his to keep. “I’ve told them. I’m never giving it back. I don’t want anybody to take it back,” he smiles.

Mike says not only has he maintained his weight loss but he has saved a lot of money. He takes fewer medications for blood pressure and cholesterol, has fewer doctors’ appointments, eats less food, and spends less on clothing because now he doesn’t have to buy at the big and tall stores.

Just last week, Tufts Medical Center became the first hospital in the country to perform the surgery on a patient outside of a clinical trial.

Blogging as a business as blogging.

A post by a Facebook friend the other day got me thinking about blogging.  It seems that many of us who used to Write All The Time for ourselves, have stopped.  Why is that?  Why is it that blogging has become a chore?  Why did we start writing in the first place and what changed?

I will tell you what happened:  PEOPLE GOT GREEDY.  For me, I started blogging because I needed an outlet that would "listen" neutrally.  The faceless internet seemed like a good idea.  

As I wrote, somehow I got an audience, and an audience creates attention, and attention sends advertisers.  I took on advertisements and started earning a part time living from this blog. Heck, I started a blog about blogging because I made a GOOD living from it for a very short time.

The thing is:  I have very strong opinions and cannot be paid to be swayed.  It tears me up when I read sponsored posts and Tweets and Facebook plugs from other bloggers after they've been given ad money and the posts are no longer in their voice. 

Some blogs and connected social media become nothing but pitches.  #spon #ad

Where did genuine bloggers go?!  Where are you?!

I didn't want to become that, and honestly I hate being called a shill.  I used to enjoy writing about product because I USED IT or I LOVED IT or my favorite:  I hated it.  

I have lost that because everyone and their Mama is overexposing EVERYTHING hoping to get paid.  I did get paid.  I still have a trickle of advertising, but I can't push it as hard as I "could" because I feel like it alienates those who read my stuff (...for whatever reason they do?) and feel pressured.  Bloggers who used to "connect" with me, I realize, I am no longer useful to them if they can't use me.  It's sad.

Sometimes I felt like a fake by posting about products I didn't really like.  I lost my oomph and advertisers took notice and dumped me.  Sadly, sometimes I think it was a relief.  I'm not your salesperson.  You didn't hire me. 

I think these days, most sponsored content needs to come organically.  Why do "we" push so hard to be paid to do what we were already doing for free, for ourselves?  If someone wants to pay me to be MYSELF, bring it.  I can't change or remain silent because you don't like me as I am.  

I feel like I have censored myself for so long because I have been afraid of the ADVERTISERS getting mad.  

No more.  Fuck them.  If they're paying me to share product, it's because I AM WORTH IT, and if they choose not to?  That's fine too. 

Sorry.  If I write about your product, it's because I USE IT, I LOVE IT or IT SUCKS.  There's no ulterior motive, unless I specifically state that there is.  ;)

Fat Kid.

This video was made as a part of The Bridge Exchange, an exchange program for young artists between VidCon and the Brave New Voices Festival to bridge the spoken word and online video communities. Learn about the project here:

Watch more videos here:
Seize Her by Lerato Lee Mokobe:
Hereditary by Rhiannon McGavin:
Dear Winchat by Belinda Zwahi:
Fat Kid by Travis Thompson:
Dear Pluto by Amelia Xanthe:
Princess by Arianna Burrell:
Monster by Unique Hughley: 

More about VidCon:
More about Brave New Voices:

More about The Bridge Exchange:

Written by Travis Thompson
Video Directors - Jackson Adams, Bayan Joonam, Georgia Koch 
Program Producer - Jose Vadi
Editor - Andy Golibersuch

Year Eleven, Plot Twist.

Screen Shot 2015-04-08 at 2.45.29 PM

Oddly enough last year was my best in terms of weight loss and weight maintenance after my roux en y gastric bypass now eleven years ago.

I just searched the blog for my yearly *cringe* "surgiversary" updates and it appears it really was.

 "Best."  I maintained a nearly-normal bodyweight for half of the year, guys.  If I look back on my averages over the last ten years, the weight is smack-dab in the middle of average.  I am just that.  


I started out the year at my near lowest, while using the gym and eating decently.  My goal had been to continue that - and ignore weight if I could add muscle tone.  


One of the most common questions I get inboxed to me is:  What Do You Eat Everyday - What Do You Do?!  Here is the thing:  PEOPLE VARY DRASTICALLY.  I realized that my intake vs. output is a delicate balance.

Here's my intake for the most part of the last 90 days:

Screen Shot 2015-04-08 at 3.06.56 PM

This looks mostly like this, with days of "Want pizza for dinner?  Who wants mozzarella sticks?"  Once a week.  I eat very little meat, though I am still cooking it a couple times a week for the family.

Breakfast - 

  • Coffee - unsweetened almond milk - cocoa powder
  • Frozen tofu based meal, other

Lunch -

  • Leftovers from dinner or
  • Soup or salad or
  • Bread + cheese

Snack - 

  • Chickpeas, whole grain crackers, cheese, veggie burrito

Dinner - 

  • Protein, veggie, carb - whatever is made for the family or...
  • Frozen vegan meal

Snack -

  • More dinner, usually, I honestly don't eat at dinner time... I eat before bed.  I might have a few bites at dinner time, especially if I am cooking, and then I don't want anything.  

This isn't much different than my eating of the year before - and I maintain my weight at this level of calories.  I would assume I eat about 1500 - 1700 most days with days lower, and days higher (rare).  

I actually lose weight at this intake if I am moving enough.  

Disclaimer, BMI SUCKS and I have NEVER been in the normal category for more than two minutes because I am SHORT AND I AM SHRINKING so if I want to EAT, I HAVE TO MOVE MY ASS.

I was.  I'm not.   No excuses.  

My intentions were good, but life always seems to have different plans.  

I developed some super fun back pain that coincided with less time at the gym (...yes I think movement HELPS pain, but getting past pain to MOVE is now the problem!) and was diagnosed with some degenerative disc disease.  My time working out was cut drastically with my spouse's work schedule changing - kid's school schedules and just having no means to go.  Adding the lack of gym time to pain = Beth not moving her ass because it hurts = Beth not moving.  I started slugging out at home from August (...when the schedule changed) to this winter.  I hate to whine because Everybody Huuuurttttts.   I'm also super realistic and I know I'm getting older, and it is unlikely that my back will Get Better at this age.  It isn't going to benefit me to complain about it now because it's going to get worse with time.  

Grinding along through back pain is difficult though, when it makes every part of your day a little more complicated - you'd think just sitting would be restful - easy.   Sitting here is the most painful part of my day aside from attempting to sleep laying down, I live in a series of twitchy z-z-z-zaps.  If I could pace all day long, I'd be fine.  

And I just may start doing that.

Why?  *changing tenses, writing badly but writing*

There was a single motivation -- I got on the scale after knowing that I was not fitting in my size medium running pants.   THEY SQUISHED ME LIKE A SAUSAGE.  I knew I had gained weight, I could see it - but - I kept squishing into them.  So what if my legs are more puffy?  Whatever.  

And then my boobs.  MY BOOBS.  I didn't HAVE ANY, and a few weeks ago I'm all - O - O - and WHY DO THEY HURT I'd better start my cycle RIGHT NOW or I am going to cry and I just might cry right now or throw up.


10451177_10204725999004491_2964017476059225186_n (1)

I'll save you the dramatic implosion that occurred after three of those, but I've been to the MD twice, and I see a maternal-fetal medicine doctor tomorrow.    I was not planning this, obviously, nor was I telling anyone, but a certain spouse outed me - and a lot of people took it as a joke.  

I don't find it funny.


I've got this.  I have never had a pregnancy WHILE on anti-epileptic medications, so that is of course of concern as I CANNOT be unmedicated and live safely.  If you recall, my seizure activity became evident during my first post-RNY pregnancy and it was undiagnosed for a very long time.   Also, apparently, I AM OLD.  I am "Of Advanced Maternal Age."  

ADVANCED.  AGE.   3-5.  This was the year, that I told my husband, I think we are old enough to have kids now.  Forget that my oldest is the same age as I was when I got pregnant with her.  

She said, "Well, at least it isn't me."  Yes, thanks for that.

Grandma MM doesn't really have a ring to it.  And I think my mother would explode.