Mama June: From Not to Hot premieres Feb. 24 at 10 p.m. ET on WEtv.
Mama June: From Not to Hot premieres Feb. 24 at 10 p.m. ET on WEtv.
Don't shoot the messenger, I'm sharing this for my blog's historical reference because it's AMAZING INFORMATION -- and even if you "don't agree," because it's not your experience, it's science!
“Bariatric surgery is probably the most effective intervention we have in health care,” says Laurie K. Twells, a clinical epidemiologist at Memorial University of Newfoundland. She bases this bold claim on her experience with seriously obese patients and a detailed analysis of the best studies yet done showing weight-loss surgery’s ability to reverse the often devastating effects of being extremely overweight on health and quality of life.
“I haven’t come across a patient yet who wouldn’t recommend it,” Dr. Twells said in an interview. “Most say they wish they’d done it 10 years sooner.” She explained that the overwhelming majority of patients who undergo bariatric surgery have spent many years trying — and failing — to lose weight and keep it off. And the reason is not a lack of willpower.
“These patients have lost hundreds of pounds over and over again,” Dr. Twells said. “The weight that it takes them one year to lose is typically back in two months,” often because a body with longstanding obesity defends itself against weight loss by drastically reducing its metabolic rate, an effect not seen after bariatric surgery, which permanently changes the contours of the digestive tract.
In reviewing studies that followed patients for five to 25 years after weight-loss surgery, Dr. Twells and colleagues found major long-lasting benefits to the patients’ health and quality of life. Matched with comparable patients who did not have surgery, those who did fared much better physically, emotionally and socially. They rated themselves as healthier and were less likely to report problems with mobility, pain, daily activities, social interactions and feelings of depression and anxiety, among other factors that can compromise well-being.
Equally important are the undeniable medical benefits of surgically induced weight loss. They include normalizing blood sugar, blood pressure and blood lipid levels and curing sleep apnea. Although bariatric surgery cannot cure Type 2 diabetes, it nearly always puts the disease into remission and slows or prevents the life-threatening damage it can cause to the heart and blood vessels.
Even in the small percentage of patients who ultimately lose little weight after surgery, significant metabolic benefits persist, according to findings at the Cleveland Clinic. In a study of 31 obese diabetic patients who had not lost a lot of excess weight five to nine years after surgery, a “modest” weight loss of just 5 to 10 percent resulted in a reduction of cardiovascular risk factors and blood sugar abnormalities, Dr. Stacy Brethauer and colleagues reported.
For the two most popular surgical techniques — the gastric bypass and the gastric sleeve — “the metabolic benefits are independent of weight loss,” Dr. Brethauer said in an interview. Both methods permanently reduce the size of the stomach. However, the gastric band procedure, which is reversible, lacks these benefits unless patients achieve and maintain significant weight loss, he said.
Furthermore, as a study last year of 2,500 surgical patients at the Veterans Affairs Medical Center in Durham, N.C., found, those who underwent bariatric surgery had lower overall death rates up to 14 years later than comparable patients who did not have weight-loss surgery.
Experts in the field regard the reluctance of some medical insurers, including Medicaid programs in many states, to cover the cost of bariatric surgery as a penny-wise, pound-foolish position. Failing to reverse extreme obesity can end up costing far more per patient than the typical $30,000 price tag of bariatric surgery — sometimes even millions of dollars more.
Counter to popular impressions that most people treated surgically regain most or all the weight they lose initially, the latest long-term research has shown otherwise. In a decade-long follow-up of 1,787 veterans who underwent gastric bypass, a mere 3.4 percent returned to within 5 percent of their initial weight 10 years later. This finding is especially meaningful because the researchers at the V.A. center in Durham were able to keep track of 82 percent of gastric bypass patients, a task too challenging for most clinics.
The study, by Matthew L. Maciejewski and colleagues published in August in JAMA Surgery, found that 10 years later, more than 70 percent of surgical patients lost more than 20 percent of their starting weight, and about 40 percent had lost more than 30 percent. Gastric bypass, an operation called Roux-en-Y, resulted in a somewhat greater weight loss at 10 years than the newer gastric sleeve surgery and significantly more than the adjustable gastric band (Lap-Band) surgery, which “has fallen out of favor in the last two or three years,” Dr. Maciejewski said.
Bariatric surgery, regardless of the method used, is also much safer nowadays than it was even a decade ago, said Dr. Jon C. Gould, a surgeon at the Medical College of Wisconsin in Milwaukee who wrote a commentary on the V.A. study. However, he noted, the surgery is “vastly underutilized,” to the detriment of patients’ health and the nation’s health care costs.
“Less than 1 percent who would qualify for bariatric surgery are actually getting it,” Dr. Gould said. “Although the vast majority have health coverage, insurance companies and many Medicaid programs put it out of reach for most people by demanding that they already have several obesity-related health conditions and are taking a slew of medications to control them.”
For example, he said, to be covered for bariatric surgery, Wisconsin Medicaid requires that a person with dangerously high blood pressure has to be taking three or more medications for it and still not have a normal pressure.
He cited a further deterrent to bariatric surgery: “a perception that it’s dangerous and doesn’t work,” beliefs countered by the research findings cited above. Most of the surgeries are now done laparoscopically through tiny incisions.
Given the well-documented safety and effectiveness of bariatric surgery, it is now increasingly being performed in people whose obesity is less severe — those with a body mass index (B.M.I.) of 35 or perhaps even less — but who have a metabolic disorder like Type 2 diabetes related to their weight.
In recent years, the profession has promoted what Dr. Gould calls “centers of excellence,” where 100 or more bariatric operations are usually done in a year. Practitioners at these centers “learn from experience, share their knowledge and push for quality improvements,” he said.
Dr. Gould suggested that people interested in bariatric surgery seek out programs that have been jointly accredited by the American College of Surgeons and the American Society for Metabolic and Bariatric Surgery, which have combined forces to promote quality control.
While experts agree that money would be better spent on prevention than treatment, Dr. Twells pointed out that “we have yet to find a way to prevent obesity, and people whose health is compromised by their weight deserve to be treated by the most effective method we have.”
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:
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.
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.
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.
Dr. H says that "we" watch TV for four hours day, surely we have time to exercise that long, but FRANKLY, I DON'T WANT TO.
I am LAZY.
Do you honestly think I would have even considered it at my former size at ALL? NO freaking way. I am in a normal body weight range right now and there is zero point zero chance of getting me to exercise aerobically four hours daily -- at 320 lbs -- I would have sooner had weight loss surgery -- and I DID. Eleven years ago. LOL. It worked.
Many women opt for bariatric surgery in order to increase chances of maintaining a healthy pregnancy. A recent study suggests that weight loss surgery can help a woman do just that, but there are risks.
Personally, my full term post bariatric surgery pregnancy was different than my pre-WLS pregnancies. I was at a more normal bodyweight at the time of my daughter's gestation, and I did not seem to suffer the ill effects of obesity on pregnancy like I had with my prior children. I had no high blood pressure, no high blood sugar, nor did I land on bedrest - which I had with previous babies. My post RNY pregnancy offered me anemia and rampant hypoglycemia. I was not well.
She was born healthy, but small, in comparison to my earlier babies. I noted a lack of body fat at birth. This is several weeks old.
While the study found some risks for women who had surgery, including more babies born too small and a greater likelihood of stillbirths, experts said that overall the results were better.
The findings have implications for an increasing number of women and children, especially in the United States, where nearly a third of women who become pregnant are obese. Obese women have more problems in pregnancy, including gestational diabetes, pre-eclampsia, and stillbirth. Their babies are more likely to be premature, overweight or underweight at birth, have certain birth defects, and develop childhood obesity.
The study, published Wednesday in The New England Journal of Medicine, sought to find out if surgery could safely mitigate some of those effects. Swedish researchers, led by Kari Johansson, a nutritionist at the Karolinska Institute, evaluated records of 2,832 obese women who gave birth between 2006 and 2011, comparing women who had bariatric surgery before becoming pregnant with women who did not.
They found that women who had had surgery were about 30 percent as likely to develop gestational diabetes, which can lead to pre-eclampsia, low blood sugar, birth defects and miscarriage. They were about 40 percent as likely to have overly large babies, whose challenges can include lung and blood problems.
The outcomes were worse in some categories. Women who had surgery were twice as likely to have babies who were small for their gestational age, suggesting the need for better nutrition for pregnant women with surgically-reduced stomachs. And more of their babies were stillborn or died within a month after birth, although the number of such deaths in each group was very small and might have been due to chance, experts and the authors said. There was no significant difference in rates of premature births or babies with birth defects.
The study via NEJM -
Maternal obesity is associated with increased risks of gestational diabetes, large-for-gestational-age infants, preterm birth, congenital malformations, and stillbirth. The risks of these outcomes among women who have undergone bariatric surgery are unclear.
We identified 627,693 singleton pregnancies in the Swedish Medical Birth Register from 2006 through 2011, of which 670 occurred in women who had previously undergone bariatric surgery and for whom presurgery weight was documented. For each pregnancy after bariatric surgery, up to five control pregnancies were matched for the mother’s presurgery body-mass index (BMI; we used early-pregnancy BMI in the controls), age, parity, smoking history, educational level, and delivery year. We assessed the risks of gestational diabetes, large-for-gestational-age and small-for-gestational-age infants, preterm birth, stillbirth, neonatal death, and major congenital malformations.
Pregnancies after bariatric surgery, as compared with matched control pregnancies, were associated with lower risks of gestational diabetes (1.9% vs. 6.8%; odds ratio, 0.25; 95% confidence interval [CI], 0.13 to 0.47; P<0.001) and large-for-gestational-age infants (8.6% vs. 22.4%; odds ratio, 0.33; 95% CI, 0.24 to 0.44; P<0.001). In contrast, they were associated with a higher risk of small-for-gestational-age infants (15.6% vs. 7.6%; odds ratio, 2.20; 95% CI, 1.64 to 2.95; P<0.001) and shorter gestation (273.0 vs. 277.5 days; mean difference −4.5 days; 95% CI, −2.9 to −6.0; P<0.001), although the risk of preterm birth was not significantly different (10.0% vs. 7.5%; odds ratio, 1.28; 95% CI, 0.92 to 1.78; P=0.15). The risk of stillbirth or neonatal death was 1.7% versus 0.7% (odds ratio, 2.39; 95% CI, 0.98 to 5.85; P=0.06). There was no significant between-group difference in the frequency of congenital malformations.
Bariatric surgery was associated with reduced risks of gestational diabetes and excessive fetal growth, shorter gestation, an increased risk of small-for-gestational-age infants, and possibly increased mortality. (Funded by the Swedish Research Council and others.)
PS. Post RNY baby is eight years and four months old now. She's fine.
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.
Read the article released earlier this week in JCI: http://buff.ly/1wlKroB
It, fits? OH COME ON.
The NEW AND IMPROVED LAPBAND!
You can do better!
Apollo Endosurgery, Inc., the leader in minimally invasive endoscopic surgical products for bariatric and gastrointestinal procedures, today announced the launch of the “It Fits” campaign, aimed at rejuvenating the LAP-BAND® System and educating a broad range of patients about the benefits of the minimally-invasive weight loss procedure.
“It Fits” supports the company’s decision to place greater emphasis on the unique advantage of the LAP-BAND® System – the only FDA approved device for weight reduction for people with at least one weight-related health problem, and having a BMI of 30 or greater.
Read more: http://www.digitaljournal.com/pr/1989812#ixzz34taKYjn9
The new ad spot - from Apollo - tugs right there at your heart, don't it? I might be tearing up over all of the completely stereotypical situations right here in this here commercial! OMG I CAN FIT IN THE AEROPLANE SEATBELT WITHOUT AN EXTENDER COULD YOU PLEASE PUT ME IN A COMMERCIAL ALTHOUGH I WAS NEVER SUPER MORBIDLY OBESE I AM JUST AN ACTOR!
Until this and my tears dry up!
Because of course we will ignore the patient histories of thousands -- to have a procedure to lose how much weight?
Just as a frame of reference, that makes me qualify in a few BMI points. Confession: when I reached my high weight about the same time the new BMI-qualifications for the Allergan-owned lap-band came around, I decided THAT WAS IT. I could not possibly do it again, my butt was not revising band-over-bypass for that much weight, not after watching this weight loss community for 12 years. Nope.
I am easily distracted online by quizzes, gadgets, tools, and "Who Will You Be When You Grow Up?" (Which said TEACHER, BTW, ME, The Kid Who Failed Half Her High School Classes...) quizzes, which is when I saw this - Online Tool Designed to Help Patients Evaluate Potential Bariatric Surgery Outcomes - thingamajig - I did it myself even though I am already ten years and two months post gastric bypass.
How cool is this?
LA Times -
A new tool nveiled at the annual meeting of the American Society for Metabolic and Bariatric Surgery may help patients with a body mass index over 30 -- the threshold at which obesity is diagnosed -- to navigate those complexities. Based on the accumulated experiences of 75,000 bariatric surgery patients, the Bariatric Surgery Comparison Tool details the expected outcomes of gastric banding surgery, gastric bypass surgery and sleeve gastrectomy, the three most common bariatric procedures.
I did it myself, based on my start weight - height - though I have lost an inch of height. (Shut up.)
Start weight - 320, start height 5 ft 4. I am close to 5 ft 3 now.
And now -
And the tool gave me these results based on the potentials of experiences of 75,000 patients (... surveyed out of the most common WLS)
The stats for the gastric bypass are damn close to what my surgeon "quoted" me for my landing place after my procedure.
I bottomed out lower than this, my very lowest was 147 lbs, but wouldn't you know I bounced exactly to 175 lbs and maintained around there for a good portion of the years after my RNY? The gastric bypass got me there, everything after that was a lot more work. (See the blog. I was pregnant immediately after. And, so on. This was 2005, guys.)
The 24 month data is EXACTLY right! I am ten years post op and 149 - 158 lbs!
I guess what I am saying is -- that the data for this "tool" -- (and you know I loathe that word) is there, it is right on the money.
Some goobledegook from Ethicon -
o Ethicon understands that no two patients are identical. For example, when considering bariatric surgery, obesity related conditions like diabetes, hypertension and cholesterol need to be taken into consideration – this tool helps do just that.
o Based on patients who have had similar conditions to theirs, prospective patients using the tool are able to see what surgical outcome looked like for patients just like them and can use this as a discussion point with their doctor about which treatment option might be most appropriate for them (i.e., gastric bypass, gastric sleeve or gastric band).
Now is a promising time for people in need of support for obesity and illnesses associated with it (such as type 2 diabetes). There are safe, effective ways for physicians to help patients better manage their conditions. There’s a growing body of clinical evidence that shows that bariatric surgery not only helps with weight loss, but that it also can help with issues like type 2 diabetes.
Some things you should know about bariatric surgery and the tool
Bariatric surgery is used in severely obese adult patients for significant long-term weight loss. It may not be right for individuals with certain digestive tract conditions. All surgery presents risks. Weight, age, and medical history determine your specific risks. Individuals should ask their doctor if bariatric surgery is right for them.
The tool is provided for educational purposes only and is not intended to be a medical evaluation, examination, consultation, diagnosis or treatment. The tool provides potential results by procedure type including pounds lost and medication reduction over time based on personal information provided by the user of the tool. Patients should consult a physician or other health care provider to determine whether or not bariatric surgery is right for them and for guidance on expected outcomes benefits and risks.
The weight loss, medication, and diagnosis information provided by the tool is derived from statistical analysis of historical claims and clinical databases as well as research published in peer-reviewed journals. While predictive modeling techniques were used, the results cannot predict the specific outcomes for any individual. The information presented does not represent any statement, promise or guarantee by Ethicon Inc. concerning a patient’s eligibility, experience, or potential outcomes. Individual patient results may vary.
I had gastric bypass in 4/2004 in Boston, MA with Dr. Michael Tarnoff
Importance The prevalence of obesity and outcomes of bariatric surgery are well established. However, analyses of the surgery impact have not been updated and comprehensively investigated since 2003.
Objective To examine the effectiveness and risks of bariatric surgery using up-to-date, comprehensive data and appropriate meta-analytic techniques.
Results A total of 164 studies were included (37 randomized clinical trials and 127 observational studies). Analyses included 161 756 patients with a mean age of 44.56 years and body mass index of 45.62. We conducted random-effects and fixed-effect meta-analyses and meta-regression.
In randomized clinical trials, the mortality rate within 30 days was 0.08% (95% CI, 0.01%-0.24%); the mortality rate after 30 days was 0.31% (95% CI, 0.01%-0.75%). Body mass index loss at 5 years postsurgery was 12 to 17. T
he complication rate was 17% (95% CI, 11%-23%), and the reoperation rate was 7% (95% CI, 3%-12%).
Gastric bypass was more effective in weight loss but associated with more complications.
Adjustable gastric banding had lower mortality and complication rates; yet, the reoperation rate was higher and weight loss was less substantial than gastric bypass.
Sleeve gastrectomy appeared to be more effective in weight loss than adjustable gastric banding and comparable with gastric bypass.
Conclusions and Relevance Bariatric surgery provides substantial and sustained effects on weight loss and ameliorates obesity-attributable comorbidities in the majority of bariatric patients, although risks of complication, reoperation, and death exist. Death rates were lower than those reported in previous meta-analyses.
I realize this is a very small sample study, but I can't say I don't disagree with most of it after living this WLS-life for ten years and observing hundreds of people in it.
All women had undergone gastric bypass surgery - one of the most common bariatric surgery procedures. It involves rerouting a part of the small intestine past the stomach in order to reduce food intake, promote satiety and suppress hunger.
The majority of the women were interviewed twice. The first time was 1 year after surgery, while the second interview took place 2.5-4 years following surgery.
Groven says although most previous research suggests that weight loss surgery leads to an increase in quality of life for the majority of patients, her findings suggest that not everyone lives happily ever after following bariatric procedures.
Positive outcomes after surgery 'can feel like grief'
There is no doubt that weight loss surgery puts the body through a series of radical changes.
Groven says that although the procedure leads to a slimmer body - which others perceive as a "sign of success" - the surgery can cause many smaller problems that other people are unable to see.
"Becoming slimmer and lighter is mostly perceived of as positive. At the same time it is ambivalent, since people start to behave differently towards the women after they've had surgery.
People are friendlier than before, and this may feel extremely provoking. And people often ask very invasive questions concerning the woman's radical weight loss."
The interviews revealed that some of the women experienced a boost in self-esteem after surgery, were more outspoken, and found other people were more likely to listen to what they were saying - particularly in the workplace.
Groven notes that although these factors are clearly positive outcomes, this could also be seen as a "grief" because the women realize they had to undergo weight loss surgery before seeing these outcomes.
Many of the women also felt embarrassment after the surgery, particularly when it came to speaking about their weight loss. Some women told others they had been on a diet to lose the weight because they were ashamed to say they had undergone bariatric surgery.
Excess skin promotes a negative self-image
Groven found that many of the women had mixed feelings about their naked body after surgery, and many of these feelings come from the occurrence of loose skin - a common consequence of rapid weight loss.
"It is given little focus before the operation. Patients are often told that this is something that can be fixed afterwards. But it is not so easily fixed, and the women are not prepared for the challenge of having to live with the loose skin," explains Groven.
Although women can undergo surgery to remove excess skin, Groven notes that many women are not prepared to take the risks associated with this procedure, which include hematoma or seroma formation, infection and risks associated with future pregnancies.
Groven found that some of the women interviewed even spoke about their excess skin in third person, which she believes is a way of distancing themselves from it.
Health problems and bad food relationships after weight loss surgery
According to Groven, five of the women interviewed reported a lower quality of life after they underwent weight loss surgery, compared with their quality of life before.
She notes that this was down to the development of chronic stomach and intestine problems, and one woman became so ill that she had to endure another operation because of problems with her scar tissue after the gastric bypass procedure.
The five women also said they felt as if they had complete lack of energy following weight loss surgery.
Furthermore, Groven found that many of the women reported having a negative relationship with food after the procedure.
Some women were worried about eating too much or too little, or eating the wrong food at the wrong time. Because of these concerns, some women experienced tiredness, nausea, dizziness and even intense shaking.
Some of the women who had problems with overeating before weight loss surgery continued to overeat after surgery, even though this made them ill. Groven says some women commented that "the eating disorder is not gone."
Groven says that while previous research suggests that patients can avoid testing their eating limits after surgery by following dietary advice, the reality is much more complicated.
"It is reasonable to ask, I think, whether the eating disorders that some of the women develop after surgery are diseases, or if they may be understood as normal changes as a result of the operation."
Although many women reported negative thoughts and health issues after weight loss surgery, none of them said they regret undergoing the procedure.
"They say they would have done the same today and that they had no choice considering their life before surgery. Some said that the pains were a small price to pay," says Groven.
She adds that this suggests women are influenced by society's perception of the ideal female body, and that being obese is not within this scope.
"They are living with a body which is not accepted by society, and they are constantly judged from their size," she says.
"The message from the media and medical science is that they are likely to get cancer or diabetes unless they lose weight and the surrounding world regards their obesity as self-inflicted. Some have children and are afraid to die and leave them alone."
Groven concludes that although it is true that obesity can lead to health complications, such as diabetes and heart attack, little is known about the long-term effects of weight loss surgery and what complications may arise from this procedure.
With this in mind, Groven plans to conduct further research that will look at the effects of bariatric surgery 3-10 years after patients have undergone the procedure.
This is that moment where I put my tail between my legs and come to you and say it -- because this is what I Need To See - Proof That A Thing Works?
I have a very literal type brain. (More on that later this year. I promise you. My next appointment is Valentine's Day.)
I must have proof of a thing in order to believe it. I do not blindly follow anything without seeing results, documents, charts that show me "IF YOU DO X, Y will be yours." This is why I am a hard "sell" and you rarely see reviews here anymore. (More on that, coming, too.)
In 2012 I was in a regain pattern and found myself hitting a high weight that I could not imagine after RNY.
I refused to allow it although I know realistically it is possible. I've been there before. And knowing that I need to eat food -- I realised I needed to do something different because obviously eating as much food as I want/need to and not moving my ass was no longer working.
I added a little bit of exercise -- and I saw a little bit of endurance increase. And I struggled to keep going, and keep at it and now I finally see body results.
The scale is in solid maintenance mode. I see range of up 5 lbs down 5 lbs up 5 lbs down lbs every single month. But I guarantee my muscle mass is increasing. I will get a new assessment done at some point to ensure this -- and see because I am interested in knowing the percentage of change.
This is where those people who used to scream at me to MOVE MY ASS get to say, "WE TOLD YOU SO." I did not listen. I was (...somewhat, but not really) lazy. I thought I could get away with just "eating okay" and being relatively active.
Nope. I am proof it (...sitting on your ass) doesn't work.
What makes someone a Weight Loss Success long term after bariatric surgery?
According to a study by Colleen Cook of BSCI - it's following the rules of your WLS.
I've heard her say it a hundred times at bariatric events - fall back to the RULES of your surgery - because it DOES WORK -
(Nodding in agreement - I am proof.)
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]
From studies presented at this year's Obesity Society - ASMBS meeting in Atlanta, new data on weight loss surgeries long-term efficacy.
Not too shabby.
LA Times -
Fifteen years after they have weight-loss surgery, almost a third of patients who had Type 2 diabetes at the time they were operated on remain free of the metabolic disorder, a new study says. And six years following such surgery, patients had shaved their probability of suffering a heart attack over the next 10 years by 40%, their stroke risk by 42%, and their likelihood of dying over the next five years by 18%, additional research has concluded.
The two studies, both presented Wednesday at the annual meeting of the American Society for Metabolic and Bariatric Surgery in Atlanta, offer the first indications of weight-loss surgery's longer-term health benefits for patients. While researchers have demonstrated dramatic improvements in many bariatric patients' metabolic function in the short term, the durability of those improvements has been unclear.
Research suggests that over several years, many bariatric patients regain some of the weight they lose in the first two years -- a fact that has raised doubts about the cost-effectiveness of the surgery, which can cost $20,000 to $25,000 for the initial procedure, plus a wide range of costs to treat complications after surgery.
The new studies' findings that patients' health prospects remain better for several more years may make weight-loss surgery a more appealing treatment for insurers to cover, and for obese patients with health concerns to seek out.
The study that followed 604 bariatric patients in Sweden for 15 years found that in the first two years after surgery, 72% achieved diabetes remission: They were able to cease taking medication for the metabolic condition. After 15 years, a little more than half of those had diabetes again. But 31% had remained in remission.
By contrast, only 16% of the comparison group -- similarly obese patients with diabetes who did not get surgery -- had seen their diabetes remit in the first two years. At 15 years out, diabetes remission was six times likelier in those who had surgery than in the those who did not.
In another study, researchers at the Cleveland Clinic in Ohio followed bariatric patients for an average of six years after surgery. They tallied those patients' likelihoods of developing a wide range of health outcomes at the time of surgery and six years later, and compared them. To do so, they used the Framingham risk calculator to estimate the before-and-after 10-year risks of heart disease, stroke, death, kidney disease and complications such as diabetic retinopathy and poor circulation.
(The Framingham risk calculator is derived from probabilities gleaned from following more than 10,000 subjects in Framingham, Mass., in the Framingham Heart Study, which started in 1948.)
In this study, the bariatric patients lost 60% of their excess weight and 61% saw their diabetes remit after surgery. Overall, their risk of having coronary heart disease, stroke or peripheral heart disease dropped by 27%.
Bariatric surgeon Dr. John Morton, a professor of medicine at Stanford University who was not involved in either study, suggested that the results of more modern bariatric surgical procedures may be superior. He added that reducing the stress of obesity on the body, even if some weight returns, may improve a patient's long-term health prospects.
"Carrying extra weight can carry forth year to year," said Morton, who is president-elect of the American Society for Metabolic and Bariatric Surgery. He likened long-term obesity to smoking cigarettes for years, suggesting that the number of years a person remains obese (or smokes) may interact with their degree of obesity (or how much they smoke) to influence his or her likelihood of developing health problems.
"So you're a blogger, are you going to write about this?"
"If I told you..."
I might have already put it on Facebook because I have compulsive posting issues.
I had my Very First Fitness Profile At A Gym yesterday.
Just Because Someone Has Bariatric Surgery - It Does Not Make Them A Magical Athlete Who Runs Marathons, Lifts Weights Or Even Gives A Flying Fuck About Doing These Things.
"But all the people on the Facebooks -- they post photos of the try-athelete-a-thons -- and the Things They Can Do Just Six Weeks After Surgery, and all their new muscles and how they can make it rain, and Why Can't I?"
No. It is not *typical.
Here comes Beth -- pissing on your surgiversary parade again. Boo-hoo. This is my opinion only. If you do not like it, fine.
However individuals that have bariatric surgery -- they are tore up. One does not go from super morbid obesity to Athlete! *with added sparkles and instant motivation* overnight. It just does not happen that way.
Sometimes it takes a very long time to get some any motivation, inspiration to get your butt off the couch and do something anything! In my experience over the past ten years post weight loss surgery: motivation comes cyclically and there's always an underlying trigger and goal.
For a select few post WLS patients, just losing weight is enough of a motivation to get going. You see this in the "honeymoon stage" of weight loss repeatedly - people get all sorts of excited during the rapid stages of weight loss and sign up for their gym - get into a class - buy a piece of equipment for home use - sign up for their first walk, run, "I did my first 5K!" These kind of things are all common.
For me, this happened ever-so-briefly. I got out and walked miles and miles and miles to the Black Eyed Peas - it was 2005. I reached to my "goal" weight. We joined the YMCA. Things were going swimmingly in All Things Weight Loss!
But you know what - life happens sometimes.
"WHAT IS THIS THING YOU CALL LIFE?!?! HOW DARE IT INTERFERE WITH MY SIZE 6 PANTS?!"
Shit happens. You deal.
I threw away my size six pants, bought maternity pants, and she's now seven. (And cute. We'll keep her.) However that wasn't the only Life That I Got. My life imploded at about the same time - and I haven't had a normal living/working situation since.
Again, I'll say this:
Shit happens. You deal. (OR. You don't. And it's pretty obvious when you aren't.)
It looks like a bad ride on the rollercoaster until about one year ago.
And you know some health-coach-wannabe posted that on my weight chart a few years ago - and I nearly tore her head off. It was truth.
My weight chart reflects that I was not dealing very well with my shit.
That kind of honesty hurts sometimes - and I am sorry if it bothers you. But we - as former current-always-cycling-obese folks (...I will always be a big girl) wear our issues. When I stop weighing myself, checking in with my jeans-that-should-fit, eating as I know I should, I need to check MYSELF.
Weight is very personal. Let me repeat this. When I stop weighing MYSELF - it means something is out of balance. It means FOR ME - that I have made a choice to stop doing something right elsewhere: usually my eating choices. To be perfectly honest, it takes very little change in calories or types of food to increase my body weight at this stage so I notice upswings immediately.
(This is when the trainer reading this realizes he got way more than he bargained for. Why did I ask for this URL!?)
A little more than a year ago - I was in a regain pattern. I saw a number on the scale that frightened me. (Personally. We ALL have a number. Your number may be different than my number may be different than her number. I am five foot three, and my personal number was the qualifying number for WLS again.)
I knew that something had to change and I knew that I had to do something different because I was stuck in a rut of this pattern up cycling up so many pounds and back down so many pounds.
I have been a weight loss patient for many years - I know how to lose weight - goodness knows I can regain it - but - maintaining is different. I had to think about it: what haven't I done before?
Um. #1 - Exercise on a regular basis.
*SHOCK AND AWE - GASP!*
No shit, right? Nope. My exercise motivation over the last ten years has been apathetic. I have more excuses than most of you, honest. I still do, and it's hardly worth throwing them out there because there are people out there with much bigger challenges than you or I - that are busting their butts - and we aren't.
"What do you mean, EXCUSES, Beth?"
I can't drive a car, when I was diagnosed with intractible epilepsy I had to lose my drivers' license, I can't get to the gym on my own, I am not supposed to exercise near the road, I can't walk on my own, I have four kids, begging them to go is a pain... yadda yadda yadda...
And, the worst of all?
I. am. *lazy. I have always been lazy. I may always BE lazy. I may never really enjoy Exercising On Purpose. It may always feel like work to me.
"Just put in a DVD."
That's where lazy comes in. See? That has happened maybe five times in my life -- and each of those times I ended up blogging about the video instead of working out. TV + Me = No.
So, there's that - I started moving my ass just a little bit.
It worked. It did not take much. I don't try very hard. *See above, lazy. I lost every pound of the regain, plus some, and I have maintained the loss for six months.
As for exercise - if you have been following me on Facebook - I try to get to the gym at least three days a week or more - it is increasingly difficult with my husband's work schedule and six of us in this house but we do what we can. When I do get there - I aim for a full sixty minutes of cardio on a cross-trainer or elliptical machine, and sometimes another fifteen to thirty on another machine or treadmill at a lower intensity.
I was not able to do that much exercise right away. It was overwhelming to me -- which was why I started to write this post to begin with. I started with FIVE MINUTES on the machine, many months ago and pushed through to where I am now. Because you know what -- six months ago -- had you told me "Go do an hour on that machine --" I'd have laughed at you.
That is why I am sharing - because - it's NOT too late to start. I was nine years into my journey when I started "again."
#2 - Food journaling, eating of Le Crap.
*GASP! What do you MEAN the Bad Girl Does Not Actually Eat Cupcakes?*
I cannot validate the caloric-cost. Sorry. I never really have. To be honest: I don't know why that was really ever equated with ME - because - I HATE CAKE. If you knew me at all, you'll know that if we go to the local cupcakery (1-2 times a year) they sell frosting shots, I buy ONE. I put it in the freezer. It's about 2 ounces of pure butter and sugar. It's enough carbohydrates and fat to put a horse in a coma. I am a SUGAR-CRACK-HEAD. I dump on sugar. Therefore, I can't, I don't. But I would if I could. I know myself. I do not purchase nor eat much in the way of junk.
Let me rephrase that: I eat a fair share of what I consider crap, I purchase none of it and I try hard not to allow a lot of stuff in my house. I have a harder time avoiding it if it's in my face, I try to make choices based on what's left in my alloted calories for the day. I do okay.
I aim for 1200-1400 calories, I land around 1400-1600 most days, some around 2000 calories.
I journal about 60-75% of the time lately, days where I am distracted by stuff get forgotten (yesterday was totally lost...) and holidays tend to be screwed the heck up, but overall I have done okay with assessing my intake and my weight has stayed the same.
Where am I now? Where do I "start?"
I passed everything except flexibility - which may have sucked because I just had a brain angiogram and I have a plug in my groin. LOL. (I didn't tell the trainer that.) However, that sit-reach thing brought back awful memories of elementary school and the Presidential Physical Fitness Test. Blech. I couldn't ...
I find this quite amusing -- the suggestions were to lose "two pounds of body fat" to be in the "fit" range, which I did by taking off my clothes and going potty this morning.
I'm fit. "I fit."
And, to add resistance training - because my personal goal is to gain muscle mass and retain health. This is my start.
It's not too late. Have you done a fitness profile?
Teenagers -- some even with lots of comorbidities fare well after weight loss surgery.
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.
We are not discussing my brain after bariatric surgery, we are discussing yours. Because, mine is very special. *insert photo of my special brain here*
- See more at: http://conscienhealth.org/2013/10/your-brain-after-obesity-surgery/#sthash.hBbCJfvF.dpuf
Your brain after obesity surgery responds to food differently than before surgery and differently than it does after a behavioral weight program. Likewise, brain function improves in children with excess weight and low fitness after treatment with an aerobic exercise program. These observations come from two new studies in Obesity that provide a glimpse of the growing understanding about how obesity and its treatment affect brain function.
Amanda Bruce and colleagues compared functional MRI scans of a sample of patients before and after gastric banding surgery to scans from a matched sample of patients losing similar amounts of weight in a behavioral treatment program.
The demographics of the two samples were also matched. The found changes in brain responses to food for both groups after weight loss. But the nature of the changes were different.
The response to food cues by the banding patients suggested that the cues were less relevant and rewarding to them. Food cues seemed to command more attention from participants in behavioral weight programs than they did from band patients.
"To be honest, I don't even know how heavy I was. I was probably somewhere over 380 pounds," Portinga said.
After trying numerous methods to lose weight, Portinga decided to get gastric bypass surgery.
And he kicks ass. Just saying.