Stress and Weight Gain

Stress not only takes a psychological toll on us in our daily lives, but it can also cause serious physical problems as well. With today’s hectic lifestyle becoming the norm, most Americans have accepted stress as a daily occurrence. As this trend has developed, it has become harder and harder to shake off stress.

Stress can lead us to eat more even when we aren’t necessarily hungry. It can also increase the secretion of the hormone called cortisol which increases sugar in the bloodstream, which can make us physically hungrier and make our bodies store additional fat. We’ve all had moments where we eat when we’re stressed, regardless of whether we’re hungry or not. Stress, at appropriate times, can offer us clarity of mind. Chronic stress however, something affecting more and more Americans today, is severely damaging to our health.

Stress is one of the leading causes of overweight and obesity issues in the United States. As such, eliminating stress from our lives may be one way to help in our weight loss journey.

Stress can be critical to success or failure after bariatric surgery as well. Much in the same way that it can cause weight gain in non-surgical patients, surgical patients are not immune. Stress after bariatric surgery will only hinder the weight loss process.

So what’s the answer? A large part of every solid support plan is to reduce incidence and the severity of stress. This can be achieved through a variety of channels including positive thinking, eating well, exercising regularly, taking yoga or Pilate’s classes and just about any other relaxation technique you can think of. No matter how you fight stress, it is important that stress plays less of a role in your life.

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What is the Body Mass Index and is it Useful?

We hear about the Body Mass Index, also known as the BMI, almost every day in fitness magazines, on television shows and on the Internet. After all, it is a useful tool. We can simply enter our height and weight and a computer program spits out a number that tells us if we are underweight, normal weight, overweight or obese. But what exactly is the BMI and how is it useful?

The BMI uses a ratio including height and weight to give us an approximation as to whether a patient qualifies for bariatric surgery. Those with a BMI between 35 and 39.9 may qualify for bariatric surgery if they have certain obesity related diseases.  Additionally, anyone with a BMI of over 40 may qualify for surgery.

However, the BMI is useful as a rough guide, and only that. The BMI was developed without regard for gender, age, body frame and muscle mass, which means that it is optimal for the average person. Of course very few of us match this average exactly meaning that our BMI calculations may actually vary slightly from what we see in front of us.

Because of the approximations that the BMI gives us, we only use it as a basic qualifier for bariatric surgery. The FDA also uses minimum BMI levels as a guideline for those who want to undergo bariatric surgery. However, the true determination of whether a patient qualifies for bariatric surgery requires several physical and psychological tests, which not only give us an idea of medical necessity but also surgical risk. We also need to know if the patient is ready for the significant lifestyle change responsibilities they will have after surgery. Taking this entire picture into account allows us to offer our patients the most effective and safe procedures for their particular circumstance.

So in conclusion, the BMI calculation is useful; however it is not the final say in qualifying for bariatric surgery.

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Support Starts Before Surgery

When most of us think of bariatric support, we think of post-surgical groups and lifestyle changes. However support is extremely important and effective even before undergoing bariatric surgery or any other life-changing procedure.

Support before bariatric surgery is a lot easier than you may think. There are many resources available to those who are considering or have decided on bariatric surgery, but have not undergone the procedure. These resources can range from support groups to websites and online applications and even support tools provided by our practice and medical device manufacturers. One of the great advances we have seen in bariatric field is the availability of online and smart phone applications. These programs not only help track weight loss and weight loss goals, but also assist with recipes, calorie counts other amazingly useful tools. This alone can help a patient or someone considering bariatric surgery learn more about their bodies.

Here at Healthy Steps we understand the value of support both before and after surgery. And we know the support system with which you surround yourself is crucial to your long-term success. Starting your support regimen before you undergo surgery not only allows you to learn more about post-surgical lifestyle changes, but will also make them easier to implement. Further, losing some weight and getting healthier before surgery may actually reduce the possibility of a complication during or shortly after surgery.

To learn more about opportunities to start your support program before surgery, please give our office call we will be happy to direct you to the resources that we believe are suitable for your particular situation.

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Undersanding Supplements

Vitamin and mineral supplementation after bariatric surgery is a very important part of staying healthy and losing weight safely. After surgery, your body will be going through many changes precipitated by the surgery itself as well as significantly reduced caloric intake and absorption. As a result many patients will find that their body needs a nutritional boost. Proper nutrition can help or avoid:

  • Anemia caused by lack of iron
  • Muscle tissue breakdown from a lack of protein
  • Vitamin deficiencies
  • Hair loss

Nutritional supplementation may include vitamins B12, C and D as well as iron calcium and protein. Each of these vitamins and minerals can cause minor or major problems if not in equilibrium within the body

The decision on which brand of vitamins and supplements to choose can be a difficult one, especially because the industry is not regulated in the same way as pharmaceuticals. This is where we, or your bariatric practice, can become a great resource. In all likelihood your surgical practice, like ours, has taken the time to evaluate the different nutritional offerings from the wide variety of vendors out there. So consult with your surgical practice and dietician to understand the various offerings and which ones may be right for you.

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Choosing a Bariatric Surgeon

First and foremost, you should congratulate yourself for making the life-changing decision to undergo bariatric surgery, a decision that can positively affect you, your family and those around you.

With that decision under your belt, choosing a surgeon becomes the most important next step in the bariatric process. Choosing a bariatric surgeon is no easy task, and even though bariatric surgery has become relatively safe, especially when compared to the risks of living with obesity, it is still major surgery. The choice must be the right one for you and must be backed up by thorough research.

Each patient makes the decision to undergo surgery by weighing different criteria, and choosing a surgeon is no different. Some patients may be attracted by price, others may be referred by a friend or colleague, and yet others may respond to advertising. But no matter how you find your shortlist of practices, it is important to remember there’s no right surgeon for everyone – rather, there’s the right surgeon for you. That means that it is crucial that you have a connection with your surgeon and surgical practice and are comfortable knowing that not only will you be putting your health in their hands during surgery, but you will also be relying on them for support for months and years after surgery.

First, do your research online and ask for referrals from friends and your primary physician. Next, create your short list of surgeons based on their qualifications and experience, and then sign up for each of their seminars in order to learn more about their practices and their staff. It is also important to speak to former patients. Ask lots of questions. No question is silly – remember, these former patients were once at a crossroads like you. They know what you’re going through, what fears and doubts fill your mind, and just how much this journey can change your life.

Ultimately, no matter which practice and surgeon you decide on, we cannot stress enough how important it is to spend the time to really get to know the practice you choose. Bariatric surgery is not a one-size-fits-all procedure, and as such, choosing the right team for you is a crucial first step in your long-term success.

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Body Image after Bariatric Surgery

There’s no doubt that we can be our own worst enemy. This is often especially true when it comes to our sense of body image after bariatric surgery. For most of us, it took us years to become obese. It was a gradual and difficult transition, and we watched as our bodies changed before our eyes. It gave us plenty of time to develop our strong opinions of our appearance, self-worth and changing selves. But unlike the slow gaining of weight, losing weight after surgery happens over a matter of months; it happens very quickly. This means that sometimes our brains do not catch up with our eyes and we just don’t believe that we’ve made the progress that we actually see. We’re still stuck in an old mindset, and no matter what progress is proven by our waistbands or on the scale, we have difficulty grasping our success.

All too often after surgery, we see patients who cannot believe they have been successful or cannot appreciate the degree of weight loss that they have achieved. This discouragement is natural in doses, however if serious enough, and left unchecked, it can lead to lessened resolve and a slow-down in weight loss progress.

There’s no doubt that appreciating your true body image is difficult and takes time, but we want to suggest some tips and tricks to help you get to the point where you fully appreciate the progress you have made. First, if you’re comfortable, open up to friends and family. Keeping them close to you can help keep your weight loss in perspective. After all, they’ve known you before and after your surgery.

You may want to keep your old clothing or old pictures of yourself for a tangible reminder of how much weight you’ve lost and how many inches have disappeared from your waist. This is a great visual tool especially when you’re feeling down. And if you have any, you can also use your excess skin – that portable trophy, to remind you how far you’ve come.

No matter how you see yourself, measure your progress by the numbers. How much lower is your cholesterol? How has your weight changed? How many inches have you lost? Don’t let the little voice inside get you down.

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The Big FAT Truth

There’s a lot of information out there about fat. Good fat, bad fat, low-fat, and trans fat are buzz words that are frequently thrown around by nutrition experts. What do you need to know about fat that will help you with your surgical weight loss and keep you healthy?

Five Fat Facts

1. You need fat. Our bodies use fat to grow cells and protect our vital organs. Fat is also essential for absorbing vitamins, storing energy, and keeping our bodies warm.

2. Moderation is key. Dietary fat should only make up about 20 to 35 percent of your total calories.

3. There are good fats and bad fats. Good fats include monounsaturated fat, polyunsaturated fat, and omega-3 fatty acids. Bad fats include saturated and trans fats.

4. Good fats can reduce your risk for disease. Unsaturated fats and essential fatty acids can help lower your “bad” cholesterol and improve your cardiovascular health.

5. Reading labels can help you find the bad fats. The FDA requires that food manufacturers disclose the amount of total fat content, including saturated and trans fats. Stay away from products with saturated and trans fats.

A healthy diet will be comprised of mainly good fats and very few bad fats. Good fats can be found in olive oil, safflower oil, seeds, nuts, vegetables oils, salmon, canola oil, flax seeds, and walnuts. Damaging fats are often found in fatty meats, butter, fried foods, full-fat dairy products, and some baked goods.

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Enjoy the Trophies You’ve Earned

Most people might think it a bit odd to raise your excess skin onto a podium and consider it a trophy, but that’s exactly what it is. The excess skin you see developing on your body is common after extreme weight loss and often occurs after bariatric surgery, dieting or pregnancy. Our skin is much like a rubber band inasmuch as it can only stretch a certain amount. Once it reaches the elastic limit, the skin doesn’t snap back like it once did. As time goes on, depending on your age and genetics, the excess skin may be minimized, however, it is likely that there will always be some remaining.

Bariatric patients sometimes find themselves in a situation where, despite what their scale tells them, they do not feel like they have made progress. Similarly, patients who may be having body image issues will see their excess skin as yet another failure. It’s time to change that. The excess skin is one of the most visible and measurable quantifiers of success – and should be celebrated.

That’s not to say that, if appropriate and safe, a bariatric patient can’t correct the excess skin through cosmetic surgery – that is a personal choice to be made with your healthcare professionals. Rather, while it’s there, it should be treated as a tangible sign of progress. In bariatric surgery, as in life, we will always have signs, small or large, that we don’t always recognize as positive. But by simply re-training the way we think, and the way we look at ourselves, we can not only be happier, but more motivated for further success.

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Choosing to Be Healthy

The next time you are stuck in an office meeting with a less than healthy catered box lunch or you happen to run into an old friend on the street who wants to grab a bite, don’t let it derail your progress. When a sticky situation threatens to end in a high calorie snack at a bistro, remember this… You don’t need to divulge your weight loss avenue to anyone. And when stuck in a less than ideal food situation, you do not need to make excuses to anyone.

The truth is, you are taking control of your health. Weight loss is a natural result of this. You have chosen to eat healthy foods, and when the situation you are in does not afford a healthy option, you can choose to opt out. This is not an excuse; it’s an affirmation of your commitment to yourself.

There is no, “I can’t have this,” or “There is nothing here I can eat.”  The correct response is…I honor myself and so I choose to avoid this. This eliminates the possibility of the usually-destructive excuse mentality. And making excuses doesn’t just hurt a bariatric patient in their weight loss journey, but negatively affects most people – obese or not – to some degree in all aspects of life.

So will a lengthy, out-of-town business trip result in a less than healthy catered box lunch?  Will a run-in with an old friend threaten to end with an unwanted between-meal snack at a high calorie restaurant?

Not if you don’t let it.

You are more in control than you might think. And with that control comes the greatest responsibility – to yourself.

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Abdominal Obesity and Heart Health

Research indicates that abdominal obesity and extra weight can dramatically increase the risk of cardiovascular disease and death from cardiovascular causes in younger adults. In fact, some researchers estimate that excess weight and obesity account for as many as one-third of all cardiovascular deaths.

Researchers at the Netherlands Heart Foundation in the Hague conducted a population-based study and analyzed data of over 20,500 Dutch adults between the ages of 20 and 65. Of the people studied, 42% of the men and 30% of the women were considered overweight, while 10% of the men and 11% of the women were considered obese. Waist circumference was elevated in 19% of the men studied and 26% of the women.

The study found that both higher waist circumference and obesity were associated with higher rates of cardiovascular death. Additionally, larger waist circumference and obesity doubled the risk for non-fatal cardiovascular disease in people under the age of 65. After an average follow-up of 10 years, cardiovascular disease was found to be 10 times more common than cardiovascular death, with 1,131 hospitalizations for non-fatal cardiovascular disease compared with 111 deaths.

The population review confirms the importance of healthy weight maintenance in order to prevent or counteract cardiovascular disease.

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