A BARIATRIC SURGEON SPEAKS OUT - NOT THE EASY WAY OUT

I just read this great article written by a Bariatric Surgeon.  He is tired of people commenting about his profession - that he is an "enabler" for lazy, unmotivated fat people taking the "easy way" out of obesity.

He lists not only the difficulties of losing weight and maintaining that loss, the hoops people have to jump through to even get surgery and the fact that the AMA this year has declared obesity a disease and not just the cause of other diseases.

As a life long exerciser, a healthy eater and someone with knowledge of nutrition and of my own psychological issues - I can attest that it is not just a matter of eating less and exercising more.  Yes, for many people there is an issue with eating poorly and not exercising.  For many more of us it is far beyond that simple formula.  No one can really explain all the factors involved but the medical researchers are gaining awareness of the multiplicity of factors which affect different people.

Just as some people can smoke cigarettes all their lives and not get lung cancer, some people live long lives on a high fat diet and others drop dead in their 30's following a spartan diet and running marathons.  None of it is simple.

I had wanted to try weight loss surgery for over 10 years before I was given the opportunity.  As soon as I was aware of the Duodenal Switch I knew it was the solution for me.  I have never been a volume eater.  I have generally been a healthy eater - yes I have binged like pretty much anyone, for the most part I have been eating a high protein, low carb diet for 15 years so I knew I could maintain the dietary requirements.  When people "fail" following weight loss surgery and gain weight, it is probably because they didn't learn enough or know themselves well enough to commit to what it takes to be successful.

The surgery is a tool, not the final solution to the problem.  After all, we still have to eat!

ELASTIC, SPANDEX AND SLEEVES

I miss elastic waist pants. It was so much easier and faster getting in and out of the ladies room when that was my usual pant option. 

I know there is a lot of negativity around elastic waist pants - it's harder to recognise when you are putting on the pounds being the main objection; that they are not stylish being the second one.  For ease of wear - they were nice.  Now I have all kinds of fastening and buttoning and zipping everytime I make a trip to the ladies room. After so many years of slipping pants down and up in a single motion, it seems so time consuming.


Wish they would lengthen the sleeves!



I don't miss the limited clothing selection I had for years.  My daughter commented that she is enjoying seeing me express myself more through my clothes.  We went shopping together and I am getting more accustomed to having multiple departments to move through in search of things I need to fill in my wardrobe.  I don't really understand why there are so many departments with pretty much the same things being displayed, but I am getting used to it. 

I even bought a couple of pairs of work out pants at Costco.  Taking Zumba class is very different than just working out with weights and I need more supportive spandexy pants to sort of hold things in check.  New workout bras have helped, too.

My single frustration is the sleeves thing.  Losing over 100 pounds has left me in no position to leave my arms uncovered.  I have a lot of baggy, saggy skin going on and sleeves to my elbows are my preference.  For the gym I have worn shorter sleeved tee shirts, but I am not comfortable with the sleeveless or cap sleeve options most workout tops come in.  Luckily I have found a few long sleeved tops and shorted the sleeves for bike riding.  Gym wear is more challenging.

STOP FRETTING OVER FAT - SUGAR IS THE KILLER

Dr. Nancy Appleton, author of Suicide by Sugar, actually lists 146 reasons why sugar is ruining your health. Here are just a few of them:

(1) Sugar is a cancer cell's favorite food. Even without having cancer, we all have a few cancer cells floating around.

(2) Sugar creates glucose spikes that force the pancreas to produce insulin more often and beyond it's normal capacity. This wears the pancreas down, limiting insulin production that leads to diabetes. Type II diabetes is insulin resistance, which is preceded by metabolic syndrome at least partly attributable to high sugar intake.

(3) A depleted pancreas can't provide sufficient proteolytic enzymes to bust open cancer cell walls and render them defenseless from the immune system's killer cells.

(4) Processed sugar and fructose are stripped of all mineral content and wind up leeching minerals from our bodies, including our teeth. They also inhibit mineral absorption, including magnesium. Magnesium is a commonly deficient and vitally important for over 300 metabolic processes.

(5) Sugar is addictive. It stimulates central nervous system neurotransmitters dopamine and serotonin, giving you a pleasant buzz to crave more and promote overeating of processed foods.

(6) Many nutritional experts attribute the rise of obesity and cardiac problems to higher refined carbohydrate and sugar consumption. And the condensed fructose in HFCS is absorbed first by the liver, which cannot metabolize it all and has to store accumulated fructose as fat creating fatty liver.

Obesity, diabetes, and heart disease became epidemic after low and no fat diets were introduced while sugar and HFCS were increased in processed foods and beverages.

Chobani Blueberry Greek Yogurt

When manufacturers took out the fat from many of our foods, they added sugar to make up for the flavor and texture that was lost.  For example, (and this is a great illustration) read the labels on the non-fat yogurts we all think are so healthy.  They are full of sugar!  Just try to find a flavored yogurt on the market that has little or no sugar...

And honey?  That's sugar, don't let the name of the sugar fool you.  There are now dozens of names for sugars.  Read the Carb portion of the label to get the totals,  the ingredient list can be misleading.

AN OLD LOVE IS BACK IN THE DIET

One of the many things I did to prepare for my weight loss surgery was to get off the prescription drugs I had been taking for atypical migraine and for high blood pressure.  Those medications restricted me from eating grapefruit - which I have always adored.  So for about 13 years I have not had grapefruit - until today. 

I was in the produce section of the store and saw these little cartons of red grapefruit (unsweetened) and it suddenly came to me that I could eat it again!  I bought one little container to see how I tolerated it, and it was heaven.  I thought about it all day and stopped on the way home and bought a big container - equivalent to 10 grapefruits. 

I just had some more for dessert!

COUNTING DOWN THE DAYS

In twenty days I will be having my weight loss surgery.  Sometimes I feel so elated that I am surprised to hear others on the forums expressing their fears.  I know it is going to be painful and hard while recovering and I know it is going to be life changing but I feel as if I am being given a second chance.

This made me laugh.

My husband and I talked about it the other night.  He has now had time to absorb the idea and do a little of his own research.  We talked about some of the restrictions - beyond the pre-op diet I am currently following - he was pouting a bit about my not having cocktails when we were out.  We talked about how some people go through weight loss surgery and then don't change their habits or pay attention to the restrictions, which confounds me.  He said that in the 30 years he's known me I am such a healthy eater that he didn't think I will have a problem. Isn't it nice that he sees me that way? 

Many people assume if you are really big, like me, you must eat entire pizzas or order for 2 in the drive-thru and then eat it all. I have never been able to eat a lot at a sitting. Buffets are wasted on me. Plus, I hate to feel full.  I know I eat more than I should - even healthy foods have calories and they can add up.  I snack and nibble too much between meals.  I go on the occasional candy or baked goods bender.  But my new "plumbing" will prefer small meals through the day and the candy or whatever simple carbs I might want will give me gastric distress.  Good incentive to avoid them!

The duodenal switch surgery is the best for long term "getting back to normal" eating.  From what I can tell, the amounts remain small for life, the need to fill protein needs and take vitamins are first priority and the rest is pretty individual.  Some people can't tolerate dairy, some can, same with sweets and alcohol.  Some people even say their taste buds are different.  Foods they loved  don't taste good anymore.  Interesting how tied in all of our organs are!

So, 20 days to go.  I am down 7 of the 20 the surgeon wants me to lose, but I admit I am going to take a few days off from the protein drinks this weekend while we go to Yosemite for our 28th anniversary!