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July 2013 posts

Harsh Physical Punishment in Childhood and Adult Physical Health

Is physical punishment in childhood linked to obesity?  (I hear you screaming YES!)  

http://www.drsharma.ca/physical-punishment-and-obesity.html

Study -

Harsh Physical Punishment in Childhood and Adult Physical Health.

BACKGROUND:  The use of physical punishment is controversial. No studies have comprehensively examined the relationship between physical punishment and several physical health conditions in a nationally representative sample. The current study investigated possible associations between harsh physical punishment (ie, pushing, grabbing, shoving, slapping, and hitting) in the absence of more severe child maltreatment (ie, physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, and exposure to intimate partner violence) and several physical health conditions.

METHODS:  Data were from the National Epidemiologic Survey on Alcohol and Related Conditions collected in 2004 and 2005 (n = 34 226 in the current analysis). The survey was conducted with a representative US adult population sample (20 years or older). Eight past year physical health condition categories were assessed. Models were adjusted for sociodemographic variables, family history of dysfunction, and Axis I and II mental disorders.

RESULTS:  Harsh physical punishment was associated with higher odds of cardiovascular disease (borderline significance), arthritis, and obesity after adjusting for sociodemographic variables, family history of dysfunction, and Axis I and II mental disorders (adjusted odds ratios ranged from 1.20 to 1.30).

CONCLUSIONS:  Harsh physical punishment in the absence of child maltreatment is associated with some physical health conditions in a general population sample. These findings inform the ongoing debate around the use of physical punishment and provide evidence that harsh physical punishment independent of child maltreatment is associated with a higher likelihood of physical health conditions.


When can I resume exercise after weight loss surgery?

ASMBS -  When can I resume exercise after my WLS?

Postoperative exercise

Exercise after surgery is absolutely imperative, and it may be the most important factor that can help a patient achieve long-standing and successful weight loss.

Regimen:

  1. Start walking from day 1.
  2. Increase your walking each day. Add other aerobic exercises like swimming and bicycle riding as your surgeon permits and as you feel so inclined.
  3. Start light weight training and sit-ups as your surgeon allows. Increase weights and number of reps gradually. This type of exercise will increase muscles mass which improves strength, increases bone density, and increases metabolism.
  4. Consider using a personal trainer to educate one about exercise, improve motivation, and help assure proper routines.

Independent of what phase a patient may be in before or after surgery, there are certain basic safe and reliable rules to follow in regard to exercise:

  1. 1. Consider your goals and how you want to accomplish them. You can achieve it!
  2. 2. Use exercise in combination with weight loss surgery to maximize results.
  3. 3. Remember everyone starts from a different state of physical ability and strength. Gradually increase your activity and exercise capacity. Mild discomfort from exercise is acceptable, but pain should be avoided. Ignore the cliché, “No pain no gain.”
  4. 4. Drink plenty of water before, during, and after exercise.

In addition to loss of fat mass, there are other numerous benefits to exercise. These benefits include prevention of loss of muscle mass when losing weight rapidly after surgery, and improved overall weight loss. One’s immune system is enhanced by exercise and this will help maintain overall general health. Exercise may also reduce a person’s appetite. Fatigue, which sometimes is problematic after surgery, may be reduced. Finally, there can be improved balance, improved self-confidence, and overall improved sense of well being.

http://asmbs.org/2012/01/bariatric-surgery-postoperative-concerns/#sthash.88t8iomM.dpuf


MM Sail Away Giveaway!

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I'm off on vacation -- let's have some fun while I am gone!

Carnival_Glory_at_Night
How about a givewaway from Wellesse?  How about FIVE?  

Wellesse products can be easily integrated into any routine by adding one ounce or less a day to a smoothie or protein shake, water or juice, helping bariatric patients achieve better compliance in taking their needed vitamins and supplements.  Our naturally flavored liquids become a fun, flavorful treat while fulfilling the important nutritional requirements of bariatric weight loss surgery patients on their journey to ever increasing good health.

I have FIVE Wellesse Summer Packages to share with you!

Each are valued at approximately $55 each, full of Wellesse supplements and fun summer goodies!  If you'd like to be entered to win:

  • Make sure you have liked the Wellesse Page, tell them MM or BBGC Sent you!
  • Make sure you like liked the MM Facebook Page
  • Be SURE to leave a comment on this blog post so I know you want in!  I'll pick five winners when I get home - (Unless my dog sitter blogs for me.)
  • Please consider sharing this link, or a link to this blog on your Facebook or Twitter!  Sharing is caring.  
  • Want a FREE SAMPLE right now?  Click here for a sample pack from Wellesse!

100 degrees

It hit 100 yesterday, and we went to hide inside 'bucks a minute, except that it was full up.  I think we've hit the wall.  Day six.  

I am a human puddle.


They are BACK! Free shipping and 25% off!

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Calcet® Creamy Bites + Vitamin D contain calcium citrate which is highly absorbable by the body.

Each Creamy Bite is individually protected and sealed using the Pharma-Seal™ NitroPak to assure the maximum potency you expect, with the freshness and flavor you love.

  • Buy three boxes for free shipping -- and 25% off with this --
  • This is not an ad - I receive nada from this - it's just a good deal.
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Graham Eliot of Masterchef Has WLS - Already has the wrong idea

La-dd-graham-elliot-at-son-of-a-gun-tequila-ta-001
"Because of my line of work, the doctor specifically thinks this is the surgery best suited for me," he says. "With gastric bypass and other surgeries, there's some ingredients you can't eat because it will cause you to get sick. This procedure will allow me to still taste and try everything.” 
Not always, Graham.  You shoulda coulda talked to some people first.  Sleevers can dump!  AND DUMP LIKE A FRIGGIN' TRUCK, DUDE  Regardless, I am glad Graham is taking charge of his health and maybe he will take on a WLS Cookbook?
Maybe?  It could happen?  I will remain hopeful.
Congratulations, man.

Gastric Sleeve Surgery Long Term - It Works - Mostly!

Study from Medpage -  via SOARD 

VSG surgery works - mostly!

Gastric Sleeve Gastrectomy

In a single-center study, patients who underwent the procedure lost an average 57.4% of excessive body mass index (BMI) over 5 years, Ralph Peterli, MD, of Claraspital in Basel in Switzerland, and colleagues reported online in the journalSurgery for Obesity and Related Diseases.

Laparoscopic sleeve gastrectomy, first developed about a decade ago, "was initially intended to be a primary intervention in high-risk patients before laparoscopic Roux-en-Y gastric bypass or as the first step of biliopancreatic diversion duodenal switch," the authors noted in their introduction. But evidence has been mounting that sleeve gastrectomy itself is an effective surgery for weight loss.

Indeed, joint guidelines from the American Association of Clinical Endocrinologists, the Obesity Society, and the American Society for Metabolic and Bariatric Surgery were upgraded to reflect the utility of the procedure.

But there is still a dearth of long-term evidence for its benefit -- one reason Peterli and colleagues conducted a retrospective analysis of a cohort from their facility that had a minimum of 5 years' follow-up.

A total of 68 patients had laparoscopic sleeve gastrectomy at their center as either a primary bariatric procedure or as a re-operation after failed laparoscopic gastric banding between August 2004 and December 2007.

At the time of sleeve gastrectomy, mean BMI was 43 and 78% of patients were female. They had a mean follow-up of 5.9 years.

Overall, Peterli and colleagues found that the average excessive BMI lost after 1 year was 61.5%, and then 61.1% after 2 years.

By 5 years, average excessive BMI lost was 57.4%, they reported.

Those losses correspond with a BMI reduction of 12.6 kg/m2, 12.4 kg/m2, and 11.2 kg/m2, respectively.

"The main weight loss occurred in the first postoperative year and appeared in the following years for the most part stable," they wrote.

However, 34.3% of patients who had sleeve gastrectomy as their primary procedure and 50% of those who'd had it after a failed gastric banding still had a BMI above 35 kg/m2 after 5 years.

"Patients with a prior [gastric banding] show worse results concerning weight loss," they wrote, noting, however, that international consensus considers Roux-en-Y gastric bypass [RYGB] surgery as the best option following failed banding, not sleeve gastrectomy.

The study also showed that comorbidities improved considerably, with remission of type 2 diabetes in most of the patients who had the disease before the procedure.

Among four insulin-dependent patients, only one still needed insulin therapy 5 years after laparoscopic sleeve gastrectomy. Two were able to switch to oral antidiabetic therapy, while one remained in full remission at 5 years, they reported.

In terms of complications, one patient had a leak, two had incisional hernias -- which were deemed unrelated to treatment -- and 11 patients had new onset gastroesophageal reflux disease, which typically resolved with proton pump inhibitor therapy.

Over 5 years of follow-up, 77.9% of patients developed vitamin D deficiency, 41.2% had iron deficiency, 39.7% had zinc deficiency, 39.7% had a vitamin B12 deficiency, 25% had a folic acid deficiency, and 10.3% developed anemia.

These deficiencies occurred "despite routine supplementation, in a higher rate than we had expected," the researchers wrote.

They also found that re-operation due to insufficient weight loss was needed in eight patients, or 11.8% of the study population.

But they concluded that sleeve gastrectomy is effective nearly 6 years after the initial operation, with nearly 60% of excessive BMI still gone and a "considerable improvement or even remission" of comorbidities.

"Although sleeve gastrectomy was initially only carried out as the first part of a two-step procedure," they wrote, "we could show that a rather small percentage needed a second-line procedure ... for treatment of insufficient weight loss."

Study from Medpage - via SOARD 

Background

Laparoscopic Sleeve Gastrectomy (LSG) is gaining popularity, yet long-term results are still rare.

Objectives

We present the five-year outcome concerning weight loss, modification of co-morbidities and late complications.

Setting

University affiliated teaching hospital, Switzerland.

Methods

This is a retrospective analysis of a prospective cohort with a minimal follow-up of 5 years. A total of sixty-eight patients underwent LSG either as primary bariatric procedure (n=41) or as redo-operation after failed laparoscopic gastric banding (n=27) between August 2004 and December 2007. At the time of LSG the mean body mass index (BMI) was 43.0 ±8.0 kg/m2, the mean age 43.1 ±10.1 years, and 78% were female. The follow-up rate one year postoperatively was 100%, 97% after 2, and 91% after 5 years; the mean follow-up time was 5.9 ±0.8 years.

Results

The average excessive BMI loss after 1 year was 61.5 ±23.4%, 61.1 ±23.4% after 2, and 57.4 ±24.7% after 5 years. Co-morbidities improved considerably; a remission of type 2 diabetes could be reached in 85%. The following complications were observed: one leak (1.5%), 2 incisional hernias (2.9%), and new onset gastroesophageal reflux in 11 patients (16.2%). Reoperation due to insufficient weight loss was necessary in 8 patients (11.8%).

Conclusions

LSG was effective 5.9 years postoperatively with an excessive BMI loss of almost 60% and a considerable improvement or even remission of co-morbidities.

 


OAC Calls on Boy Scouts of American To Revise BMI Criteria for Jamboree

OBESITY ACTION COALITION CALLS ON BOY SCOUTS OF AMERICA (BSA) TO REVISE THE BSA’S BODY MASS INDEX CRITERIA FOR PARTICIPATION IN 2013 BSA JAMBOREE

Tampa, Fla. – The Obesity Action Coalition (OAC) is calling on the Boy Scouts of America (BSA) to revise its body mass index (BMI) criteria for participating in the BSA 2013 National Jamboree. Currently, the BSA’s policy excludes scouts with a BMI of 40 or higher from participating in the national jamboree.

Continue reading "OAC Calls on Boy Scouts of American To Revise BMI Criteria for Jamboree" »


That Day I Deleted the BBGC

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"Hi Beth, I got an email that BBGC changed to secret but the link didn't work and it is no longer on my group list. Do I need to re-signup? Also, why the change? Not that it matters to me, just curious.
Thanks"
Yesterday, this happened.
I should come with a warning label

It's time for a crash-course in Facebook group admininstration, kids!
If you have a large group on Facebook, don't click the "secret" button.  
You. can't. take. it. back. 

My BBGC group had nearly 3,000 members yesterday when we had a blip moment and I decided to make the group "secret" to slow membership for a short time.  Then, I realized, Facebook doesn't allow you to take your group OUT of secret-mode.  
You might ask:
  • "AWESOME!  NOW NO ONE WILL EVER FIND US!"
  • "But, why wouldn't you want a secret group, isn't that a good thing?"
  • "Don't you talk about TMI?"
  • "That means my friends/family can't see what I post!"
First -- we need people to find us -- it's a support group.  What purpose does a support group serve without new members cycling IN and old members helping?  The cycle of WLS support is CONSTANT.  
We're on the internet, nothing is ever private.  Even in a secret group, consider this when posting anything, anywhere, ever.  
 
Yes, our group happens to be based on weight loss surgery so TMI topics happen in every 4th thread!  
We were always a "closed" group (...until I clicked 'secret') so the only people seeing what is posted in the group were group members.  Your family and Facebook connections won't see your posts about TMI unless they are also in the group.  
The BBGC was never meant to be an exclusive, secret WLS clique.  Because, no.  If you'd like one of THOSE, I can offer suggestions.
Tumblr_inline_mh0mymzUMA1rq0hnm

Otherwise we wouldn't have 3,000 members from all types of situations.  I apologize for the screw up.  But I do that.  A lot. 
Please find the new link here -- 1100 have already made it over!  
Go on - there's a $100 gift certificate up for grabs --  thanks for being kind.

Spanx High Waisted Shorts - Or - Beth - How Do You Work Out?

I totally wear these under my pants at the gym. And everywhere. Because.

They're tight enough.  And smart enough.  And damn it.  Thank you Spanx.


So this is our summer.

Summer vacation is in full-swing in the MM household. Look at the "f-u-n" we are having. Luckily there is a bribe of a vacation dangling in a couple weeks and getting out of this non-air-conditioned house.  And, this trip -- is for the whole family -- everyone at one time! That has not occurred for us since 2007. If we survive that vacation, we're immediately planning another. Just saying.


Tara Costa Biggest Loser Star Sued for Regain

As if the show weren't bad enough, Tara Costa who lost 155 pounds on The Biggest Loser several years ago -- is now being sued for twenty two pounds of bounce-back regain.  

Seriously!?  

She BEAT THE ODDS!  Most dieters regain much, much more!  She did wonderful!  

You can't win.  PS.  To anyone signing up for these weight-loss shows and subsequent sponsorship deals, READ THE FINE PRINT - make sure it includes a "REAL LIFE CLAUSE."

Tara Costa Biggest Loser Regain


Prove me wrong. I dare you.

  • We have 39 days to reach our team goal.
  • If we raise $89 per day -- we will reach it!
  • We've only received one donation in the last two weeks.  Thank you Julie!
  • We have nearly 3000 BBGC members, and need approximately $3200 to the high goal I set. 
  • That's LESS THAN $1 per member donated.
  • The first $1000.00 came from US - now it's up to YOU.
  • Remember, all prizes earned will be given back to the donators.  Thank you!

Show us your strength.

Continue reading "Prove me wrong. I dare you." »


Hello maintenance or the no-stress apathetic no-diet plan for long term WLS patients.

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I suppose this is maintenance.
I'll take it.  I apparently maintain at this caloric intake at this activity level.
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It's magic. 

I have also been extraordinarily "lazy"  (in Beth terms) in the last 30 days -- with very little gym time. Calorie Control.org doesn't have a setting for extraordinarily lazy - but if they did - or a setting for extraordinarily lazy post bariatric patient who eats 1200-1400 calories per day, that would be me.
PS.  I'm not really that lazy, but, I am not about to own running half-marathons up in this bitch, because, no.
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I suspect that as soon as I get back into a routine at the gym (... school is out and it's hot and we are whiny)  that one or two things will happen:
I will see a bounce up because "YAY! MUSCLE!"  Or my trend down will start again - although as it has been - very slowly.  I still have body-fat to lose while I grow/gain muscle which I desperately need.   Either option is fine with me.  I have no goal, other than health with no stress in doing so.
Welcome to the apathetic non-diet plan for WLS'ers.  
It works.  

No-Bake Peanut Butter Balls

It is currently pushing 90 degrees inside my house.  Hold me.   Wait.  I take it back.  Don't touch me.  

Go cook something.  I found this on USP Labs - No Bake Peanut Butter Balls -

Intriguing.  Maybe I'll have the kids make it to keep busy for five minutes whilst we melt.

Ingredients:

  • 1 cup natural peanut butter
  • 1 scoop vanilla  (...a favorite right here!) or chocolate protein powder
  • 1/2 cup whole oats
  • 1/2 cup chopped dates or blueberries
  • 2-3 Tbsp. dairy or coconut milk 

Directions:

Combine ingredients in a large bowl, adding enough milk until a doughy consistency is reached. Roll into bite-sized balls and refrigerate until served.

Yields 12 balls

Per ball:

  • 151 kcal
  • 7.8 g carbs
  • 10 g fat
  • 7.8 g protein

Do you buy brand-names or generic?

When you go to the pharmacy or big-box retailer do you choose brand-name or off-brand generic over the counter medications and pills even with the same active ingredients?

This kind of thing enthralls me.  I love you NPR. 

Why do people choose what they choose when given the option of the same product in different packaging?  

Some of you are SO. INSISTENT

"I MUST HAVE THIS BRAND!"  

"It is the ONLY ONE!"

I Want It Now GIF
Don't EVEN bring it to crazy-town with mayonnaise.   But we're taking about medication today.

My line of thinking (...when making that choice in the aisle) goes to:

  • Is is *exactly the same?*
  • Does it have the same efficacy?
  • Is the generic brand safe and effective?

When side-by-side store branded pills versus big brands aren't all that different, same active ingredients, similar labeling, the only thing that stands out to many of us is the pricing.  So why do you choose the more expensive product, if you do?

If I am being completely honest, I don't buy off-brand super inexpensive pills from big box retailers like Wal-Mart (...or a Dollar Store, shiver!) because quite frankly I am terrified at the potential of an eighty-eight cent price point and where THAT came from.  It's not that I am a brand snob, but just, no.  I read the packaging of every side-by-side product and if the ingredients match by percentage and you can see the source -- I do not mind paying less per pill.

I will admit for some things I have brandsnobbery  (...but even so much less lately and not really. I have even downgraded to generic huge tubs of coffee.  RIP Starbucks at home, entirely.  Thanks to blogging not being so, uh, lucrative, don't quit your dayjobs!)  But not for over the counter medications.  I bought approximately three boxes of generic gas medications, gut-fail medications and the like prior-to and during my trip to Portland last week because of desperation and it worked and kept me from ROTTING ON A PLANE THANK YOU VERY MUCH.

generic tylenol

NPR -

Why does anyone buy Bayer aspirin — or Tylenol, or Advil — when, almost always, there's a bottle of cheaper generic pills, with the same active ingredient, sitting right next to the brand-name pills?

Matthew Gentzkow, an economist at the University of Chicago's Booth school, recently tried to answer this question. Along with a few colleagues, Gentzkow set out to test a hypothesis: Maybe people buy the brand-name pills because they just don't know that the generic version is basically the same thing.

"We came up with what is probably the simplest idea you've ever heard of," Gentzkow says. "Let's just look and see if people who are well-informed about these things still pay extra to buy brands."

In other words, do doctors, nurses and pharmacists pay extra for Tylenol instead of acetaminophen, or buy Advil instead of ibuprofen?

Gentzkow and his colleagues looked at a huge dataset of over 66 million shopping trips and found that, "lo and behold, nurses, doctors and pharmacists are much less likely to buy brands than average consumers," Gentzkow says. (Their findings are written up here.)

Pharmacists, for example, bought generics 90 percent of the time, compared with about 70 percent of the time for the overall population. "In a world where everyone was as well-informed as pharmacist or nurse, the market share of the brands would be much, much smaller than it is today," Gentzkow says.

I asked several people who had a bottle of Bayer or Tylenol or Advil at home why they'd bought the brand name. One guy told me he didn't want his wife to think he was cheap. A woman told me Bayer reminded her of her grandmother. Another guy, a lawyer, said he just didn't want to spend the time to figure it out, and decided it was worth the extra couple bucks to buy the brand.

In general, we often buy brands when we lack information — when, like that lawyer, we decide it's easier to spend the extra money rather than try to figure out what's what.

Jesse Shapiro, one of the co-authors of the headache paper, told me he buys Heinz ketchup rather than the generic brand. He likes Heinz. He thinks it's better than the generic, but he's not sure. "I couldn't promise that, if you blindfolded me, I could tell them apart," he says.