I signed on with a company to do a monthly product review of bariatric-approved products. My first product arrived this weekend, and in the spirit of full disclosure before I even start the review I have to tell you (...before I laugh, cry, or other?) that I hand-picked the first product because I know I like it. It's something I used to promote back in The Day of Blogging. (I do not know when the day ended, but it's no longer that day.)
The reason I am oversharing with you -- is because -- when I sniffed around the blog to find the first post about said product and it was written or even re-written MORE THAN EIGHT YEARS AGO. Guys. This means I could have written about this item nine or ten years ago and I am about to throw it back in your faces because I am:
Old As Hell (Did you figure out how long has been? Because I just had a minor heart failure.)
Still Around (Sorry?)
Crazy (...to still be around? LOL)
Have Five Kids To Feed And Free Product Sounds Amazing Right About Now
Clinical trial demonstrates additive effect of exercise following gastric bypass.
So. do. it. I know, I know, easier said than done.
Over 75 million adults in the US are obese. These individuals are predisposed to health complications, including diabetes, heart disease, and cancer. Gastric bypass surgery results in dramatic weight loss and can improve diabetes symptoms in obese patients. A new study in the Journal of Clinical Investigation reveals that exercise following bypass surgery provides additional benefit for obese patients. Bret Goodpaster and colleagues at the University of Pittsburgh conducted a study on individuals that had recently undergone gastric bypass surgery. One group followed a moderate exercise protocol for 6 months, while the control group underwent a health education program. Individuals in both groups exhibited dramatic weight loss and reduced fat mass. However, individuals in the exercise group had improved insulin sensitivity and cardiovascular fitness. The results of this study support the inclusion of an exercise program following gastric bypass surgery.
THIS! I saw Dr. Avena (the voice in this video) at OAC #YWM2013 and she was amazingly informative. WATCH.
As the video shows, the key player in the reward system of our brain — where we get that feeling of pleasure — is dopamine. Dopamine receptors are all over our brain. And doing a drug like heroin brings on a deluge of dopamine. Guess what happens when we eat sugar?
Yes, those dopamine levels also surge — though not nearly as much as they do with heroin. Still, too much sugar too often can steer the brain into overdrive, the video says. And that kickstarts a series of "unfortunate events" — loss of control, cravings and increased tolerance to sugar. All of those effects can be physically and psychologically taxing over time, leading to weight gain and dependence. The takeaway is pretty clear: If you're sensitive to sugar and inclined to indulge in a supersugary treat, do it rarely and cautiously. Otherwise, there's a pretty good chance that your brain is going to start demanding sugar loudly and often. And we're probably better off without that extra voice in our head.
Dietary support after bariatric surgery, along with pre-operative teaching and post-operative management, may mean the difference between weight-loss success and failure for patients with obesity, according to results of an on-line survey presented at the 31st Annual Scientific Meeting of The Obesity Society (OBESITY 2013).
“This study confirms the need to put into place the resources to support people after bariatric surgery, including the dieticians and behavioural therapists who are actively involved with their patients, and can be critical to their success or failure,” stated American Society for Metabolic and Bariatric Surgery past president, Scott Shikora, MD, Center for Metabolic Health, Brigham and Women’s Hospital, Boston, Massachusetts.
“People who have had bariatric surgery and are complying with the very basic principles of personal accountability, portion control, food intake, vitamins and supplements, proper nutrition and exercise are the ones who have been doing well long-term,” noted lead author Colleen M. Cook, Bariatric Support Centers International, Jordan, Utah, speaking here on November 14.
Cook and colleagues conducted a survey to assess adherence to specific, research-based, behavioural recommendations based on earlier research. Of their 535 total initial respondents, 255 were 5 or more years post-surgery. From this group, they took a final sample of 158 respondents comprised of 117 (74.05%) who reported achieving at least 80% of their excess body weight loss (the Highly Successful group) and 41 (25.9%) who reported achieving less than 40% of their excess body weight loss (the Not Highly Successful group).
The groups were compared on self-reported behaviours, including dietary intake, physical exercise, attendance at surgical follow-up visits, and participation in bariatric support groups.
The Highly Successful group reported significantly higher rates of compliance with dietary recommendations (P< .001); fewer total calories per day (1511.9 kCals versus 2190.0 kCals, P< .001 ); consuming a higher percentage of calories from protein (49% vs 36%; P< .001); higher frequency of eating protein first (P =.007); and lower percentage of calories from carbohydrates (31% vs 40%; P = .001).
The Highly Successful group was much more likely to regularly weigh themselves (P< .001); attend support groups (P = .002); and take supplemental multivitamins (P = .029), including calcium (P = .004), iron (P = .011), and B12 (P = .001).
The Highly Successful group was significantly less likely to eat mindlessly (P< .001); to “graze” (P< .001); to eat in front of the TV (P = .002); to eat fast food (P< .001); and to eat food high in sugar (P< .001).
The groups also differed significantly on carbonated beverage (P = .02) and caffeine (P = .005) drinking patterns. The Highly Successful group reported significantly more physical activity at least several times per week than the Not Highly Successful group (P< .001).
The researchers found no significant differences, however, for ingestion of percentage calories from fat or the frequency of eating at sit-down restaurants, drinking calorie-laden liquids, or attending surgical clinic follow-ups.
Participants in this study averaged 51.7 years of age and 8.8 years post-surgery; 96% were female, 59% were married, and 89% were white. Both groups had similar demographics.
Funding for this study was provided by Bariatric Support Centers International.
[Presentation title: Factors Distinguishing Weight Loss Success and Failure at Five or More Years Post Bariatric Surgery. Abstract A-366-P]
The speculation all started when Miranda showed up at the AMA Awards showing off her extreme weight loss. She reportedly dropped 25 pounds from her 155-pound frame in a very short span of time, which led to rumors that she may have secretly gotten her stomach stapled.
However, Life & Style’s report claims that Miranda is now firing back against the rumors, and claiming that neither plastic surgery nor a gastric bypass had anything to do with her weight loss. Apparently, she did NOT lose 30 pounds in 8 weeks via a shortcut, but old-fashioned hard work. Eh. It’s still difficult to believe, but with celebrities, you never know – they have a ton of free time and access to the best trainers and the best food. It’s possible that Miranda just worked really, really hard to lose all that weight so quickly, even if it sounds a tad bit unbelievable.
Nobody really cares if you "got your stomach stapled," and those of us who understand "stomach stapling" know that you could not have it done at 5' 4" and 155 lbs.
Celebrate says -- This is MUCH MORE than a protein shake. This is as close that you will ever get to having an ALL IN ONE bariatric supplement! Our Celebrate ENS shake is a one of a kind way to get your multivitamin, calcium, fiber AND protein all in one. Each ENS (Essential Nutrient System) shake contains a high potency multivitamin, 500 mg of calcium citrate, 4 g of fiber, and 25 g of whey isolate protein in each serving. This product is the best option for patients immediately following surgery.
Created for surgical weight loss patients, our ENS (Essential Nutrient System) shake contains a high potency multivitamin, 500 mg of calcium citrate, and 25 g of whey isolate protein in each pack. Our integrated formula provides maximum solubility and ensures that the vitamins and minerals are readily bioavailable. This product is the best option for patients immediately following surgery.
* The vitamin and mineral content of each pack is equal to taking one chewable multivitamin, plus 500 mg of calcium, plus 25 g of protein. * Due to the nature of the formulation, this product is appropriate for any surgical weight loss procedure. As with any of our other delivery systems, you may need additional supplementation based on surgery type. * It is recommended to be blended with 8 oz of cold water, shaken, and consumed but can be mixed with as much or as little water as you want. It may also be mixed with milk. * Each pack also contains 4 g of soluble fiber, added electrolytes and a 500 mg antioxidant blend, and a 200 mg green tea blend. * Like our other products, taste is important and this has a delicious vanilla flavor that will make you think that you are drinking a glass of milk flavored like cake batter. * Since quality is a critical element of all of our products, we utilize an ultra refined whey isolate protein that scores 100 on the PDCAAS scale.
1. Early post-operative patients - Since this may be diluted to taste, there are virtually no issues with taste aversion. 2. Athletes - If you are a surgery patient turned athlete, this can help to flavor that boring water that you need to drink. Water is critical and taking your vitamins and calcium while hydrating makes it easier. 3. Anyone looking for a convenient alternative to pills or chewables.
Major finding: The incidence rate of heart failure during a median 15 years of prospective follow-up after bariatric surgery was 3.1 cases per 1,000 person-years, compared with 5.2/1,000 person-years in obese controls.
Data source: The Swedish Obese Subjects study included 2,010 obese subjects who underwent bariatric surgery in 1987-2001 and 2,037 closely matched obese controls. It is a nonrandomized, prospective, observational study.
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.
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.
Left - Fitbloggin' 2012 Right - This Week - Lost the regain - Also, 3 pounds to my lowest weight.
Several years ago, a woman messaged on a weight loss surgery forum and told me that my weight chart resembled a roller-coaster and that she wanted to "help me get control." After a quick Google search -- I noted she was seeking a new client for her weight loss surgery coaching business and dumped her "friendship."
Friends do not pay friends to help them lose weight, maintain weight loss or to help them lose regained weight after weight loss surgery. If you are paying someone for your friendship, it might be time to redefine that friendship -- just saying. I suppose this changes if your friend happens to be a weight loss professional? But how often does that happen -- and how many weight loss professionals would potentially destroy a friendship with aligning with your weight loss journey?
Um. No. A professional would NOT.
Weight loss is personal.
It is something you choose for yourself when you are ready.
Weight loss is not something you can be talked into - nor shamed into.
Regain after weight loss surgery is also a very touchy subject. Countless bariatric patients go through it -- and less want to talk about it. But it seems like everyone wants to sell "us" something to fix it.
Let me repeat -
Weight loss is personal.
It is something you choose for yourself when you are ready.
Weight loss is not something you can be talked into - nor shamed into.
Yet it seems like the larger community wants "us" (the regainers) to feel shamed for regaining and wants to sell us another quick-fix.
Let us discuss: Regain is common. How much? Some is very typical. Sometimes even a lot of regain is normal. You do not have to be sold into another diet, quick-fix, or scam. You need to remind yourself why you had weight loss surgery to begin with --
The Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient has been updated for the first time since 2008. There are changes and updates and suggestions for your clinicians - the entire text is available online below -
Abstract: The development of these updated guidelines was commissioned by the AACE, TOS, and ASMBS Board of Directors and adheres to the AACE 2010 protocol for standardized production of clinical practice guidelines (CPG). Each recommendation was re-evaluated and updated based on the evidence and subjective factors per protocol.
Examples of expanded topics in this update include: the roles of sleeve gastrectomy, bariatric surgery in patients with type-2 diabetes, bariatric surgery forpatients with mild obesity, copper deficiency, informed consent, and behavioral issues.
A lifetime history of substance abuse disorder is more likely in bariatric surgery candidates compared with the general population (211 [EL 3, SS]). In contrast, current alcohol and substance abuse in bariatric surgery candidates is low compared with the general population (211 [EL 3, SS]). The LABS study demonstrated that certain groups including those with regular preoperative alcohol consumption, alcohol use disorder, recreational drug use, smokers, and those undergoing RYGB had a higher risk of postoperative alcohol use disorder (212 [EL 2, PCS]). A web-based questionnaire study indicated that 83% of respondents continued to consume alcohol after RYGB, with 28.4% indicating a problem controlling alcohol (213 [EL 3, SS]). In a prospective study with 13- to 15-year follow-up after RYGB, there was an increase in alcohol abuse (2.6% presurgery to 5.1% postsurgery) but a decrease in alcohol dependence (10.3% presurgery versus 2.6% postsurgery) (214 [EL 2, PCS]). In a survey 6-10 years after RYGB, 7.1% of patients had alcohol abuse or dependence before surgery, which was unchanged postoperatively, whereas 2.9% admitted to alcohol dependence after surgery but not before surgery (215 [EL 3, SS]). Finally, in a retrospective review of a large electronic database, 2%-6% of bariatric surgery admissions were positive for a substance abuse history (216 [EL 3, SS]). Interestingly, 2 studies have demonstrated better weight loss outcomes among patients with a past substance abuse history compared with those without past alcohol abuse.
Bariatric surgery remains a safe and
effective intervention for select patients with obesity. A team approach to perioperative care is mandatory with special attention to nutritional and metabolic issues.
Obesity continues to be a major public health problem in the United States, with more than one third of adults considered obese in 2009- 2010, as defined by a body mass index (BMI) 30 kg/m2 (1 [EL 3, SS]). Obesity has been associated with an increased hazard ratio for all-cause mortality (2 [EL 3, SS]), as well as significant medical and psychological co-morbidity. Indeed, obesity is not only a chronic medical condition but should be regarded as a bona fide disease state (3 [EL 4, NE]). Nonsurgical management can effectively induce 5%-10% weight loss and improve health in severely obese individuals (4 [EL 1, RCT]) resulting in cardiometabolic benefit. Bariatric surgery procedures are indicated for patients with clinically severe obesity. Currently, these procedures are the most successful and durable treatment for obesity. Furthermore, although overall obesity rates and bariatric surgery procedures have plateaued in the United States, rates of severe obesity are still increasing and now there are approximately 15 million people in the United States with a BMI 40 kg/m2 (1 [EL 3, SS]; 5 [EL 3, SS]). Only 1% of the clinically eligible population receives surgical treatment for obesity (6 [EL 3, SS]). Given the potentially increased need for bariatric surgery as a treatment for obesity, it is apparent that clinical practice guidelines (CPG) on the subject keep pace and are kept current.
Since the 2008 TOS/ASMBS/AACE CPG for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient (7 [EL 4; CPG]), significant data have emerged regarding a broader range of available surgeries for the treatment of obesity. A PubMed computerized literature search (performed on December 15, 2012) using the search term ‘‘bariatric surgery’’ reveals a total of 14,287 publications with approximately 6800 citations from 2008 to 2012. Updated CPG are therefore needed to guide clinicians in the care of the bariatric surgery patient.
What are the salient advances in bariatric surgery since 2008?
The sleeve gastrectomy (SG; laparoscopic SG [LSG]) has demonstrated benefits comparable to other bariatric procedures and is no longer considered investigational (8 [EL 4, NE]).
A national risk-adjusted database positions SG between the laparoscopic adjustable gastric band (LAGB) and laparoscopic Roux-en-Y gastric bypass (RYGB) in terms of weight loss, co-morbidity resolution, and complications (9 [EL 2, PCS]).
The number of SG procedures has increased with greater third-party pay or coverage (9 [EL 2, PCS]).
Other unique procedures are gaining attention, such as gastric plication, electrical neuromodulation, and endoscopic sleeves, but these procedures lack sufficient outcome evidence and therefore remain investigational and outside the scope of this CPG update.
There is also emerging data on bariatric surgery in specific patient populations, including those with mild to moderate obesity, type 2 diabetes (T2D) with class I obesity (BMI 30-34.9 kg/m2), and patients at the extremes of age. Clinical studies have demonstrated short-term efficacy of LAGB in mild to moderate obesity (10 [EL 1, RCT]; 11 [EL 2, PCS]; 12 [EL 2, PCSA]; 13 [EL 3, SS]), leading the Food and Drug Administration (FDA) to approve the use of LAGB for patients with a BMI of 30 to 35 kg/m2 with T2D or other obesity-related co-morbidities (14 [EL 4, NE]). Although controversial, this position was incorporated by the International Diabetes Federation, which proposed eligibility for bariatric procedures in a subset of patients with T2D and a BMI of 30 kg/m2 with suboptimal glycemic control despite optimal medical management (15 [EL 4, NE]). Thus, the term metabolic surgery has emerged to describe procedures intended to treat T2D as well as reduce cardiometabolic risk factors. In 1 study, metabolic surgery was shown to induce T2D remission in up to 72% of subjects at 2 years; however, this number was reduced to 36% at 10 years (16 [EL 2, PCS]). In a more recent study, patients who underwent RYGB sustained diabetes remission rates of 62% at 6 years (17 [EL 2, PCS]). The overall long-term effect of bariatric surgery on T2D remission rates is currently not well studied. Additionally, for patients who have T2D recurrence several years after surgery, the legacy effects of a remission period on their long-term cardiovascular risk is not known. The mechanism of T2D remission has not been completely elucidated but appears to include an incretin effect (SG and RYGB procedures) in addition to caloric restriction and weight loss. These findings potentially expand the eligible population for bariatric and metabolic surgery.
Jeffrey I. Mechanick, Adrienne Youdim, Daniel B. Jones, W. Timothy Garvey, Daniel L. Hurley, M. Molly McMahon, Leslie J. Heinberg, Robert Kushner, Ted D. Adams, Scott Shikora, John B. Dixon and Stacy Brethauer
Article first published online: 26 MAR 2013 | DOI: 10.1002/oby.20461
alcoholism, Bariatric surgery; Obesity; Metabolic surgery; Diabetes surgery; Metabolic syndrome; Clinical practice
guidelines; Best practice guidelines; Weight loss surgery, gastric bypass, obese, obesity, RNY, roux en y, WLS
2-year study indicates how gastric bypass reverses diabetes. In a substudy of the STAMPEDE trial (Surgical Therapy And Medications Potentially Eradicate Diabetes Efficiently), Cleveland Clinic researchers have found that gastric bypass surgery reverses diabetes by uniquely restoring pancreatic function in moderately obese patients with uncontrolled type 2 diabetes.
Over a six-week period, the team of experts fed one group of mice a low-fat diet, while feeding a second group of mice a high-fat diet, so that they could analyze how the different foods impacted the behavior of the animals.
Eleven percent of the calories in the low-fat diet consisted of fat, and 58% in the high-fat diet. This caused the high-fat group an 11% increase in their waist size, but they were not yet considered obese.
Fulton and her team then examined the association between rewarding mice with food and their behavioral and emotional outcomes by using a variety of methods that have been scientifically proven. The brains of the animals were also analyzed so that the experts could observe any changes that had occurred.
The researchers found that the high-fat group showed signs of anxiety, for example, they tried to avoid areas that were open. According to the authors, the animals' experiences physically changed their brains.
Dopamine was one of the molecules in the brain that was observed. It allows the brain to reward people with good feelings, which in turn, motivates individuals to acquire particular behaviors.
Dopamine is a chemical which works the same in humans as it does in mice and other animals. CREB is a molecule which regulates the activation of genes that play a part in the functioning of human brains, including the ones that cause dopamine to be produced. It also contributes to the forming of memories.
While the holidays typically come with a great deal of celebration and joy, they can also bring up feelings of loss, regret or depression. And that's the problem: no matter the emotional response, an emotional eater will often turn back to food.
"Many people use eating as a way to cope with difficult emotions, not only bad ones, but also happiness, excitement and celebration, for example," says Alexis Cona, a clinical psychologist in private practice and a researcher at New York Obesity Research Center.
Researchers believe that many emotional eaters turn to food to numb emotions that are too painful or difficult to process. As Cona explains, it can be a mindless cycle in which an emotional eater suddenly finds himself in front of the fridge, not quite knowing how he got there.
Family time during the holidays can be a particular challenge, as many disordered eating habits begin with poor boundaries between family members, Cona says. Preparing oneself for difficult and triggering interactions might be an important aspect of getting ready for the holidays.
What's more, during this season, food is more plentiful. Many people have favorite, traditional treats that they only eat during this time of year.
"There are all sorts of memories associated with family favorites -- these foods are imbued with expectations," says Ellen Shuman, president of the Binge Eating Disorder Association and an emotional and binge eating recovery coach. "That feeling of deprivation can make an emotional eater feel like they have to eat their fill in that moment. They become forbidden foods -- and that brings out the rebel in many emotional eaters."
Instead, Shuman counsels patients not to have once-a-year foods. If they love a certain dish, they should make it occasionally all year long to avoid that panicked feeling of scarcity.
So what's someone with a history of stress-based eating to do as the holidays loom large?
First of all, work on mindfulness. Cona asks her patients to check in with themselves before they eat anything. Do you feel physiologically hungry? Rate your hunger on a scale. And if you aren't actually hungry, but you want to eat, think about what you might be feeling and what underlying desire is at the bottom of the impulse to eat.
Cona also recommends practicing kindness to oneself, especially in the aftermath of an overindulgence. "Trying to find acceptance can be challenging, especially in a society that condemns us for having eaten this way; especially if our bodies don't look the way society says they should. But it's important not beat ourselves up over it. If this happens, try to learn from it. Don't shame yourself."
But Shuman adds, you may not be the only person you need to forgive. Letting go of painful family history could help prevent the emotional eater's cycle. "Keep in mind that you don't have to spend the holidays with your history with Mom -- just with Mom in that moment."
"Atkins, a US-based diet brand, has launched Atkins Frozen Meals that will be available across the nation from January 2013. (They can be found in SOME WalMarts NOW...)
The new menu item includes Farmhouse-Style Sausage Scramble, Tex-Mex Scramble, Chicken & Broccoli Alfredo, Roast Turkey Tenders with Herb Pan Gravy, Beef Merlot, Crustless Chicken Pot Pie, Meatloaf with Portobello, Mushroom Gravy, Italian Sausage Primavera and Chile con Carne.
The items are prepared with whole food ingredients such as freshly-picked vegetables, real creams and sauces, and premium custom meats. They contain no added sugars or preservatives, offer 310-370 calories and also contain 7g of net carbs or less, said the company.
Atkins Nutritionals chief marketing officer Scott Parker said that the company's Frozen Meals line offers homemade food and fresh ingredients and provides a convenient solution to help facilitate weight loss.
The meals will have a MSRP of $4.49 for lunch and dinner variety. The breakfast variety will be available for $3.99."
For lunch I heated up Atkins Roast Turkey Tenders With Herb Pan Gravy - 9 ounces
Ingredients: Turkey Tender Medallions (Turkey Tenders, Water, Less than 2% Autolyzed Yeast Extract, Maltodextrin, Salt, Turkey Stock, Flavor, Gum Arabic, Potato Starch, Canola Oil, Sodium Bicarbonate, Natural Flavorings, Paprika), Green Beans, Water, Turkey Fat, Red Bell Peppers, Cream Contains Less than 2% of the Following: Chicken Flavor Concentrate (Chicken Meat Including Chicken Juices, Chicken Fat, Yeast Extract, Potato Flour, Onion Powder, Sea Salt, Flavor, Carrot Powder), Canola Oil, Resistant Maltodextrin, Flavorings, Turkey Base (Turkey Meat Including Turkey Juices, Salt, Flavorings, Potato Starch, Carrot Powder), Modified Food Starch, Xanthan Gum, Caramel Color, Salt, Soy Lecithin, Disodium Inosinate and Disodium Guanylate.
And now you have a heart attack thinking a about all that fat, just note the lack of carbs and how perfect this is for a low-carb diet or if a person ate a portion of it at one time. If you were following an otherwise low carb diet this falls right into it.
Heated up - the turkey is nice and tender. The gravy has a nice creamy, almost buttery texture to it, and the green beans are fresh and crisp and go nicely with the turkey.
As a nearly nine year gastric bypass post op, I was able to eat the entire dish and it was filling -- 9 ounces for 360 calories/10 carbs/23 protein.
I would suggest these dishes for someone following the Atkins plan COMPLETELY because they are very high in fat, and you shouldn't really over do it on them. Two in one day would blow your fat grams through the roof.
Product - Atkins Roast Turkey Tenders with Herb Pan Gravy