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May 2011 posts

Extreme Makeover - Weight Loss Edition

NO PAIN, NO WEIGHT LOSS: A woman who weighs nearly 400 pounds embarks on a one-year challenge in the premiere of the new series....

I know better than to watch weight loss, diet or exercise programming, because I  get angsty and bloggy.  

However,  I live this "I used to be 320 lb life" and seeing other obese people change dramatically DOES impact me more than your typical not ever obese person.

I am impressed, and I DO find myself doing a little cheer when someone does something SO GOOD for themselves.  The before and afters are always super motivational.  "LOOK AT WHAT SHE DID!  OMG!"

Picture 20
I caught most of ABC's Extreme Makeover last night, since I forced myself into bed at a decent hour and it happened to be on.

My first impression:  Perhaps this show also picks contestants based upon future looks.  They know who is going to make an UH-MAAAZING before and after slideshow.  The girl featured on last night's episode, whittled from 379 lbs to just over 200 lbs, and facially, she's a pageant winner.  You can't tell me that producers do not "see" that prior to casting.  (Yes, of course they do, it sells, the trainers are often Quite Pleasing too.)

Honestly, if you watch, read her face PRIOR, DURING and AFTER.  Her whole face changes, her smile turns ON.

My out loud thoughts during the show:

  • "They expect her to do this ALONE, at home, in her normal situation?"  That's what "The Biggest Loser and other shows have done to us, we don't think it's possible to lose weight sort-of-on-our-own anymore.
  • Throwing away Mama's groceries ain't gonna change nothin'.  It's up to the person who wants to lose weight.  You cannot be the food police.  Luckily in this case, after some drama, Mama lost 50 lbs with the contestant.
  • "I can't believe this girl is getting plastic surgery before she's DONE losing weight."  I cringed when the plastic surgeon grabbed on her pannus.  "It's not gone yet!  That's going to be mishapen if she loses more weight!"   
  • Now, I realize that maybe only massive weight loss patients who have had plastic surgery, or multiple consults, and have watched others go through the process might really GET that, but lots of loose skin is different than lots of skin covering fat.   
  • And, plastics prior to loss can lead to funny shaped bodies, as can regain after plastics.  "Hello, muffin."  No comment about that.  But, muffin lost 15 lbs in three weeks, and he looks normal.
  • (And, yes, I was compelled to grab my six years of skin, and play with it.  It's empty.)

I will watch again.  I was motivated by the before and after and the fact that this girl (she's just 22!) was able to lose so much weight, so young, and has the opportunity to start over.   Given the failure rates for typical diet and exercise, I would love to see an update in a couple years to see if this huge life change sticks with her and the other contestants to come.

What did you think of the show?


Barbequed Eggs? Sure!


Picture 106
NPR -

Barbecued Eggs - NO WAY?  WAY.  This intrigues me, and I am not a fan of The Egg.

Ingredients

  • 1 large bell pepper, the bigger the better
  • 2 eggs
  • hot sauce, salt and black pepper to taste

Directions

You'll need the bell pepper to sit stably on the grill, or else the raw egg will spill out and make a tragic mess. Place the pepper flat on your cutting board and slice in half parallel to the board. Scrape out the seeds and placenta (yup, that's really what it's called), being careful not to pierce the outer wall.

Crack an egg into each half of the pepper. Try to distribute the egg into the whole cavity.

Place the filled pepper over the hottest part of the grill. It tastes best with the pepper's skin charred. Close the grill. If you're going to eat it with a knife and fork, cooking it to over-easy is fine. But if you're going to serve it as finger food, cook it a bit longer, so you don't have a runny yolk. It's great on its own, but better still with hot sauce, salt and a little black pepper on top.

NPR 


Allergan Lap-Bands For My Teen(s)?

I stutter at posting articles like this, because I write about this industry, and Allergan is huge and has a huge impact.   Allergan is seeking to get approval to band teens.

BUT. 

I am ALSO reading this article as a consumer, not just a blogger who writes about weight loss surgery.  I am a potential consumer of THIS PRODUCT.  (What? You never know.)

I am also a parent of overweight children.  

A parent, of one child, who is nearly old enough, according to this article:  to have a Lap-Band put in her body.  She's within the BMI guidelines, and I KNOW that if given the chance -- SHE would jump on the opportunity to lose weight "forever."  

Taking any of MY (or yours) personal feelings of my own out of it, I know she would consider it.  

I see how she reacts to other kids, I see the size 0 peers on Facebook with shorts cut-up-to-here.  She shows me.  I know she would probably want to "do it" -- and push through the pre-operative counseling and testing just to get it done (like many of US DID, do you remember that feeling?) because the PROMISE of losing ___ pounds FEELS SO GOOD.

I'm trying to think back to being 13-15 years old, wondering if someone approached me with this idea, that they could install a device, that would help me lose 50-75-100 pounds, would I have done it?  I was ranged 175-220 pounds and definitely in the top 1/3 of my class in size.  

Would I have done it, back in 1993, 1994? 

Um.  Yes.  Twice.  Again?  

Now, think about it.  Overweight teenagers full of ANGST.

 "But, mooooom!  I have to have a Lap-Band!  It's the only way I'll ever be skinny.  You won't let me have a band because you HATE me."  

It will happen.  (I'm psychic, we know this.)

LapBandADAM19497

Chicago Tribune

With sales of its Lap-Band weight-loss device declining, Allergan Inc. has its eyes on a new set of potential customers — overweight teenagers.

The Irvine company has asked the Food and Drug Administration to approve Lap-Band surgeries for adolescents as young as 14, and is conducting clinical trials on teenage patients, said Cathy Taylor, a company spokeswoman.

Allergan says the device — a silicon ring fitted around the stomach to reduce food intake — has proved a safe and effective way for obese adults to shed pounds. With an estimated one-third of U.S. children now overweight, the benefits should be extended to teenagers, Taylor said.

"We identified a significant need with this patient population in terms of the increasing rate of obesity in younger populations," Taylor said. "Obesity, if left untreated, correlates to life-threatening diseases."

But many doctors and health experts are concerned that there are not enough data about the Lap-Band's long-term safety and effectiveness, something that would be particularly relevant when considering the device for children.

"It's hard to imagine taking a device … and putting it around the stomach and giving it a warranty for 50 or 60 years," said Mary Brandt, head of adolescent bariatric surgery at Texas Children's Hospital in Houston.

Brandt said she believes gastric bypass, surgically shrinking the stomach, is a better option because it does not require installing a foreign object in the body.

A recent European study found that many adult Lap-Band patients had "relatively poor long-term outcomes" and required additional surgeries to have the devices removed or replaced. Allergan took issue with that study, saying it was based on too small a pool of patients and that the device has been improved in recent years.

The procedure is performed under general anesthesia, and complications can occur. In the last two years, four Southern California adults have died within days of undergoing Lap-Band surgery.

Health experts said Lap-Band surgery should be a last resort for the morbidly obese, only after less radical methods, such as diet and exercise, have been exhausted.

"I'm concerned that FDA approval would send the wrong message, that this is a safe way to lose weight," said Diana Zuckerman, president of the National Research Center for Women and Families. "There are risks to this."

Doctors can already perform Lap-Band surgery on minors whose parents give their consent. FDA approval would allow Allergan for the first time to market the product for use on adolescents, said Jeffrey Gibbs, a former FDA attorney now in private practice in Washington specializing in medical device law. And it could make it more likely that insurers would pay for it, Gibbs said.

Taylor Blackburn of Palmdale had the Lap-Band installed in 2008, at age 14. Two years later, the Palmdale teenager had it removed after experiencing stabbing abdominal pains and diarrhea, her mother, Susan Blackburn, said.

"She got zero results. She was gaining weight," Blackburn said. "It was very discouraging for her."

Taylor Blackburn underwent gastric bypass surgery last year. She has lost 70 pounds, her mother said.

Allergan spokeswoman Cathy Taylor declined to comment, saying it "wouldn't be appropriate for us to comment on a patient when we are not privy to all the details."

More generally, Allergan executives have said the Lap-Band has proved effective at helping patients lose weight safely and has advantages over some other bariatric surgeries. Unlike bypass surgery, Lap-Band surgery is relatively easy to reverse and has a lower mortality rate, said Allergan Chief Executive David E.I. Pyott.

Jacy Johns, a Jacksonville, Fla., student, got the Lap-Band at her mother's urging when she was 15. She said it has transformed her life for the better.

Johns had tried Slim-Fast and Atkins diets without success. Before her June 2008 surgery, she weighed 225 pounds at 5 feet, 5 inches and looked to be developing diabetes. Afterward, she lost 95 pounds and joined her high school cross-country team. She recently attended prom.

"When I came back to school, everyone was blown away. Everyone was shocked," said Johns, now 18. "They told me I looked great. They wanted to know what I was doing."

Allergan has become a darling of Wall Street by catering to Americans' vanity with products including wrinkle-erasing Botox, Natrelle breast implants and Latisse eyelash lengthener. Lap-Band accounted for less than 5% of the company's $4.9 billion in revenue last year. But the company is moving aggressively to expand that business.

Allergan's focus on teens marks its latest effort to expand the customer base for the weight-loss device. In February, the FDA approved the company's request to reduce the weight requirements for adults to be eligible for the Lap-Band, adding millions of Americans to its approved pool of potential customers.

The change meant that a 5-foot-10-inch man with one obesity-related illness now needs to weigh at least 209 pounds to qualify for the surgery, down from 243 pounds, according to a body mass index table available on the U.S. Department of Health and Human Services website.

More than 600,000 people worldwide have had Lap-Band surgeries since 1993. It was approved for use in the U.S. in 2001. But U.S. sales have slumped during the economic downturn. The procedure can cost as much as $20,000, and some insurers won't cover it or require expensive co-payments. First-quarter sales of Allergan's obesity intervention products, primarily Lap-Band, were down 15% from a year earlier.

Allergan's Taylor declined to say how many U.S. children would be eligible for the surgery if the FDA lowers the age limit. About 12% of U.S. high school students are obese, according to a 2009 federal survey. Census data put the number of U.S. residents ages 14 to 17 at more than 16 million.

Teenagers would qualify only if they met specific weight requirements and had at least one obesity-related health condition such as heart disease or diabetes, Taylor said. They would need to be heavier than adults of the same height.

A girl who was 5 feet 6 inches would need to weigh 216 pounds — 30 pounds more than an adult of that height — and have one of the health conditions to qualify, according to the body mass index table. And youngsters would have to prove they have tried other weight-loss methods, Allergan's Taylor said.

"We're not talking about someone who's 20 pounds overweight who's looking to fit in a prom dress," she said. "You're looking at an adolescent who's morbidly obese, 100 pounds or more overweight, who has significant health problems because of their obesity."

Neither the FDA nor Allergan executives would say when they expect a decision regarding approval of the Lap-Band for teens. The company submitted its FDA application nearly two years ago, but it does not expect to conclude clinical trials until 2013. The approval process can take years, so the length of the process "is not unusual at all," said Stephen D. Terman, a medical device attorney in Washington.

Robert Cywes of Jacksonville, Fla., is one of the surgeons participating in Allergan's clinical trial of young patients. He said he has performed more than 500 of the procedures on adolescents, including Johns. Cywes said many children can't lose weight and keep it off because they're addicted to high-carbohydrate foods.

"Our adolescents are getting fatter, and there's really not anything outside of surgery that is reducing that in a significant way," he said.

The trend is discouraging to Russell Pate, a professor of exercise science at the University of South Carolina. He said the nation should be pushing diet and physical activity instead of making it easier for children to get weight-loss surgery.

"What we're saying is it's perfectly fine for us to become overweight because we're just going to apply treatment whenever that happens, and everyone will be good to go," Pate said. Obesity is "a preventable problem, and we really ought to be working to prevent it."

Chicago Tribune


I need a healin'.

Fig12

How's this for POSITIVE?

We've been asked to be positive.  And, to surround ourselves in positvity and only by positive people.  Fine.  I am trying.

I am positively in pain.  Again!  

My undiagnosed lower left quandrant is in another cycle of "Well, this could be damaging me interally somehow."  

It keeps going slightly away and coming back to this point.  Right at this moment, it feels like my lower intestine and uterus are being lit aflame and someone is turning a dull corkscrew into my left ovary.

Tylenol doesn't change the pain, and the trial of Bentyl that I have hasn't seemed to effect me yet, if it is at all a spamsmodic reaction.

It is the same as previously, with less upper gut stabbing.  When the upper gut stabbing hit, I went to the ER.  I thought I was having a heart attack.  It was pancreatitis.  This part is extra.

Someone emailed yesterday to ask if I'd consider "childhood abuse" as the cause of my cyclical uterine/colon pain.  Um.  No?  I realize that we are in a community that has a high level of obesity related to abuse, I am not in that segment and I am thankful.

I guess it's time to find another doctor, who may likely shrug their shoulders at me, like the last OB I saw, "What do you want me to tell you?" after he pushed and prodded and told me I probably had fibroids and  "Did anyone ever mention a hernia?"  

Which came after surgery to discover this pain, BEFORE that, that revealed nothing out of the ordinary.

I walk around holding "it."   I lay in bed, lifting up and sitting back, trying to find an indication of an external hernia.  I can't tell.  

It's broken.  Something in my lower left gut/or girl parts is BROKEN, and HAS BEEN since at least December 2010.  I am telling you, if  I  end up gutted like a fish and the doctors find a tumor filled with errant sugar alcohols, I TOLD YOU SO.

I'm just "positive" about it right now because DAMN IT, it hurts.  

 


You can HELP, for FREE! Please!

Vivint is giving away $1.25 Million to charities. Help us win!

A message from the OAC's Joe Nadglowski - Please help out!

"The OAC needs your help! As some of you may have seen on our Facebook or Twitter Pages, we are participating in a Facebook contest for nonprofits sponsored by Vivint. This is a great opportunity for the OAC because the grand prize, going to the nonprofit who receives the most overall votes, is $250,000!

 

Right now, Phase 1 of the contest is taking place and will come to a close on June 11. At that time, the top 20 nonprofits from each region (there are five different regions and we are part of the Eastern region) will advance to Phase 2. The top 20 nonprofits from each region will be announced on June 14 and then voting will resume.  As of today, the OAC is close but not yet in the top 20 for our region.

We are reaching out to you to help the OAC advance in this contest. All we are asking is that you vote for the Obesity Action Coalition and that you share this contest with all your followers on Facebook. This contest allows individuals to vote for one charity, once a day, every day, by signing in with their Facebook account. You can vote for the OAC by visiting this Web site: http://www.vivint.com/givesbackproject/charity/233.

You place your vote by clicking the “endorse” button. Right above that button is a message that says “I just endorsed Obesity Action Coalition on the Vivint Gives Back Project. Vivint is giving away $1.25 million dollars to local charities and I want Obesity Action Coalition to win.” If you click yes, this message will then be displayed on your Facebook for all your Facebook Friends to see. If possible, the OAC asks that you share this link on your Facebook so we can get the word out to as many people as possible.

With everyone’s help and support, we believe we can win this contest and use the money to continue helping those affected by obesity through education, advocacy and support.

Thank you for your help."

Picture 80


Tolerance

Oh, give a little,
Tolerance, tolerance
We need you more and more
So lend a hand or simply hold a friend
That's in need of a life support
Draw a picture, share a whisper
Anyway that you can rise above...


New Data on Weight Gain Following Bariatric Surgery

Here's MM, jumping up and down, telling you, I TOLD YOU SO, SIX YEARS AGO!  RNY MAKES SOME OF US HUNGRY HUNGRY HIPPOS with constant blood sugar fluctuations!  However, I know this reads like PRbecauseitsortofis, it is much truth -

New Data on Weight Gain Following Bariatric Surgery | Lenox Hill Hospital -

Gastric bypass surgery has long been considered the gold standard for weight loss. However, recent studies have revealed that this particular operation can lead to potential weight gain years later. Lenox Hill Hospital’s Chief of Bariatric Surgery, Mitchell Roslin, MD, was the principal investigator of the Restore Trial – a national ten center study investigating whether an endoscopic suturing procedure to reduce the size of the opening between the gastric pouch of the bypass and the intestine could be used to control weight gain in patients following gastric bypass surgery. The concept for the trial originated when Dr. Roslin noticed a pattern of weight gain with a significant number of his patients, years following gastric bypass surgery. While many patients could still eat less than before the surgery and become full faster, they would rapidly become hungry and feel light headed, especially after consuming simple carbohydrates, which stimulate insulin production.

The results of the Restore Trial, which were published in January 2011, did not confirm the original hypothesis – there was no statistical advantage for those treated with suturing. However, they revealed something even more important. The data gathered during the trial and the subsequent glucose tolerance testing verified that patients who underwent gastric bypass surgery and regained weight were highly likely to have reactive hypoglycemia, a condition in which blood glucose drops below the normal level, one to two hours after ingesting a meal high in carbs. Dr. Roslin and his colleagues theorized that the rapid rise in blood sugar – followed by a swift exaggerated plunge – was caused by the absence of the pyloric valve, a heavy ring of muscle that regulates the rate at which food is released from the stomach into the small intestine.

The removal of the pyloric valve during gastric bypass surgery causes changes in glucose regulation that lead to inter-meal hunger, impulse-snacking, and consequent weight regain.

Dr. Roslin and his team decided to investigate whether two other bariatric procedures that preserve the pyloric valve – sleeve gastrectomy and duodenal switch – would lead to better glucose regulation, thus suppressing weight regain.

The preliminary data of this current study shows that all three operations initially reduce fasting insulin and glucose. However, when sugar and simple carbs are consumed, gastric bypass patients have a 20-fold increase in insulin production at six months, compared to a 4-fold increase in patients who have undergone either a sleeve gastrectomy or a duodenal switch procedure.

The dramatic rise in insulin in gastric bypass patients causes a rapid drop in glucose, promoting hunger and leading to increased food consumption.

“Based on these results, I believe that bariatric procedures that preserve the pyloric valve lead to better physiologic glucose regulation and ultimately more successful long-term maintenance of weight-loss,” said Dr. Roslin.


WLS Means Nothing.

I get to memorialize my grandmother today.  She passed months ago, but she wanted a simple service in the spring.  I am taking the day off.  But in doing so, I am asking you all a favor:  

Please stop the hate.  Please stop the posts about hate or drama or hating drama.  It's creating a much bigger issue than there even IS and causing serious collateral community damage.  

These posts are not helping at all, they are further dividing us.  No one knows what you are talking about. I should thank you for the hours of damage control I've had to do today, and the loss of vital connections in the community.  It's not helping.  

Our community needs group therapy, not angry blog posts directed to pseudo-gangs.  Most of our collective followers don't even know who the hell is going on.  Mine don't know what the hell I am ranting about half the time, or now, because I've been sitting on my fingers for months.

Do you WANT peace?  It doesn't seem like it.  

(And, I am hyper defensive because I keep getting attacked.  SO, I know it looks like I want to rumble.  I don't. I can't.)

What can we do -- together?  I'm open to it.  Goodness knows, I CANNOT DO THIS.

I will do my part.  I'm here.  I'm listening.

Everyone deserves a voice, I am just as worthy of having a voice as any of you.  

Please just do your part to end the fighting, sniping, attacking, and hurting.  I don't care that we are "all WLS patients" we are all HUMAN. Who gives a flying shit about WLS?  This is part of the reason why we are such a diverse community - it's at times - the only thing we have in common with each other.  The WLS means nothing if we are bullied into silence and cannot share our collective experiences.


WLS Email Sales Propaganda: "I'm Desperate!" Playing on FEAR OF REGAIN.

Picture 9
I recieved a series of emails from a bariatric company this week.  I ignored them the first time, deleted them the second time, and read them the third time.  Apparently it's within a series of "scare the weight loss surgery patient" sales pitch emails from this company.  This one is regarding playing on the fear of the longer term post op weight loss surgery patient.

Regardless of whether the following plan causes actual realistic loss or maintenance for the patient, the delivery is awful.

Continue reading "WLS Email Sales Propaganda: "I'm Desperate!" Playing on FEAR OF REGAIN." »


From the DUH Files: Study -Gastric bypass weight-loss surgery increases risk of alcoholism

Alcohol-HarmfulPrint

Click to enlarge - from Recovery Roadmap

Timely.

Post weight loss surgery, many people are fighting with already addictive behaviors.  Be. careful.

LA Times

Gastric bypass surgery for weight loss doubles the risk of developing alcoholism compared with Lap-Band surgery, Swedish researchers reported Monday. Researchers already knew that bypass surgery allows the body to absorb alcohol quicker, but the new findings, reported at the Digestive Diseases Week meeting in Chicago, are the first to suggest an increased risk of problems associated with the effect.

Dr. Magdalena Plecka Ostlund of the Karolinska Institutet in Stockholm and her colleagues examined medical records for 12,277 patients who underwent bariatric surgery in Sweden between 1980 and 2006. The patients had a mean age of just under 40 and three-quarters of them were female. The team compared them with 122,770 carefully matched healthy controls in the general population. Prior to their surgery, the obese patients were significantly more likely than those in the general population to be treated for psychosis, depression, attempted suicide and alcoholism. After the surgery, the risks of the various disorders remained higher than normal, with the exception of psychosis, Ostlund said.

After the surgery, however, the risk of developing alcoholism among the patients who underwent Roux-en-Y surgery, commonly known as gastric bypass, was 2.3 times higher than in the group who underwent Lap-Band surgery. The Roux-en-Y procedure creates a smaller stomach pouch and bypasses part of the intestines. The Lap-Band procedure, in contrast, involves placing an inflatable silicon band around the stomach to restrict food intake, but food continues to pass through the entire stomach.

Dr. John Morton, a bariatric surgeon at the Stanford School of Medicine, noted that alcohol is normally at least partially metabolized in the stomach by enzymes there. When a patient has a gastric bypass, this digestion does not occur and the alcohol reaches the intestines largely intact. The finger-like structures called villi on the interior surface of the intestines absorb alcohol extremely well, so that the drug reaches high concentrations in the blood more quickly. "A single glass of red wine can make a bypass patient legally intoxicated regardless of weight loss," Morton said.

Researchers are not sure, however, how that increased absorption may increase the risk of alcoholism. Nonetheless, patients undergoing the surgery should be counseled to limit their consumption of alcohol. "They shouldn't drink as much and they shouldn't drink and drive afterwards," Morton said.


'Cause everything inside me screams, "no, no, no, no..."

I stare at my reflection in the mirror...
Why am I doing this to myself?
Losing my mind on a tiny error,
I nearly left the real me on the shelf...
"no, no, no, no..."

To lose it all in the blur of the start!
Seeing is deceiving, dreaming is believing,
It's okay not to be okay...
Sometimes it's hard, to follow your heart.
Tears don't mean you're losing, everybody's bruising,
Just be true to who you are!
(Who you are)x11

Brushing my hair, do I look perfect?
I forgot what to do to fit the mold, yeah!
The more I try the less is working yeah yeah yeah
'Cause everything aside me screams, "no, no, no, no..."

To lose it all in the blur of the start!
Seeing is deceiving, dreaming is believing,

It's okay not to be okay...
Sometimes it's hard, to follow your heart.
But tears don't mean you're losing, everybody's bruising,
There's nothing wrong with who you are!

Yes?, he goes, fake shows
Like "wow", just go, and leave me alone!
Real talk, real life, good love, goodnight,
With a smile...
That's my own! (that is my own) "no, no, no, no..."

To lose it all in the blur of the start!
Seeing is deceiving, dreaming is believing,
It's okay not to be okay...
Sometimes it's hard, to follow your heart.
Tears don't mean you're losing, everybody's bruising,
Just be true to who you are!
Yeah yeah yeah