“Remember you are only one workout away from a good mood…..”
“Notice how you feel, breathing deeper, your lungs filled with air…do you feel stronger, happier?…”
“Remember these feelings later, and to call upon them to conquer your daily challenges.”
The instructor’s words motivated me as I pedaled through my 5:30 am spin class; they also made me think about not just the importance of exercise but how we convey that message in a way that really turns people on to it rather than as a burden or necessary evil; it was my patients I had in mind.
Here it was the crack of dawn, we’re all sweating, and people around me are smiling. Yawning but smiling too. And something besides burning calories keeps us all coming back. What brings us back is the feeling that exercise induces—a natural high of sorts—that lifts your mood and energy level throughout the rest of the day.
In a recent study by
Often it isn’t as much about the messenger, as it is about the way the messenger lays out the message that can be the big turn off. Receptivity relies upon whether “the way you are being told” resonates with you. The message could be advice, a suggestion, a warning, advising all in your best interest but leave you feeling small or mad or simply stimulate stubbornness.
Recently, at a conference a woman named Helen shared with me that it was her doctor, her primary care physician, who was getting on her nerves. “Every appointment the main focus is about my weight and how I need to lose it,” she said, obviously exasperated. “There are no questions or interest about other things going on with me or other issues that run in my family, like the fact that both my grandmother and mother deal with osteoporosis as well as bouts of depression.
Shouldn’t this matter?“
Despite being significantly overweight, she wanted her doctor to see her, and her health, not just through the prism of “obesity” and to approach her health from a different angle. Of course, the doctor had Helen’s best interest in mind because her weight clearly could impact her health but she was annoyed, not motivated, by the way he approached her. Listening to Helen, I had a hard time imagining her making another appointment anytime soon with her doc unless things were really bad.
Is Helen too sensitive or can you relate to her experience? How should a doctor talk to their patients when it comes to their weight and health?
Often when talking to a post op Weight loss surgery patient, the question of how much weight loss to expect after Gastric Sleeve, Gastric Bypass or Gastric Band comes up: "Am I losing too much?" or "Should I have lost more?" Sometimes the answer that occurs to me is something like "Well, you are older than most patients, and older people don't seem to lose so much, so you have done pretty well." The reality is though that many of us really didn't know how important age was on predicting weight loss surgery results. Recently we evaluated the relative importance of the factors that influence weight loss after Bariatric surgery. What we found was things like age and height and gender played a relatively small role--less than 2%. Ninety three percent of weight loss was predicted by how much a person weighed the day of surgery. Seven or eight percent of outcome was affected by factors unknown. Still the overwhelming predictor was initial body weight. Even the difference between Gastric Sleeve and Gastric Bypass amounted to very little difference in weight loss. We presented our results at a recent meeting of the American Society for Metabolic and Bariatric Surgery (see diagram). Ok, so do you want to know what you can expect to lose? Contact us now: email@example.com
Predicting Weight Loss!
Often when talking to a post op Weight loss surgery patient, the question of how much weight loss to expect after Gastric Sleeve, Gastric Bypass or Gastric Band comes up: "Am I losing too much?" or "Should I have lost more?"
Sometimes the answer that occurs to me is something like "Well, you are older than most patients, and older people don't seem to lose so much, so you have done pretty well." The reality is though that many of us really didn't know how important age was on predicting weight loss surgery results.
Recently we evaluated the relative importance of the factors that influence weight loss after Bariatric surgery. What we found was things like age and height and gender played a relatively small role--less than 2%. Ninety three percent of weight loss was predicted by how much a person weighed the day of surgery. Seven or eight percent of outcome was affected by factors unknown.
Still the overwhelming predictor was initial body weight. Even the difference between Gastric Sleeve and Gastric Bypass amounted to very little difference in weight loss. We presented our results at a recent meeting of the American Society for Metabolic and Bariatric Surgery (see diagram).
Ok, so do you want to know what you can expect to lose? Contact us now: firstname.lastname@example.org
Not to be a party pooper but in my opinion hydrating has become a national neurosis.
An otherwise normal looking cyclist left to fill his water bottle in the middle of our spin class yesterday. ER physicians who should know better routinely give fluids and tell patients they were dehydrated when anxiety, or unexplained complaint of another sort is the reality.
Dozens of my patients are busy trying to drink 64oz of water every day, and that is commonly in addition to the water portion of other liquids. As a doctor, I'm taught that the water from food roughly equals water loss from urine sweat and stool. So even without drinking, dehydration doesn't occur.
Moreover one can run on negative for quite a while before 'dehydration'
becomes a reality. In fact, short of voluminous vomiting, diarrhea, or a long stint under the desert sun 'dehydration' hardly occurs. Why? Because our water balance, honed by eons of Darwinian selection is carefully regulated by our sense of thirst and our kidneys each respectively regulating our intake and output.
So why all this concern over 'hydrating' and 'dehydrating'? I may be flat out paranoid but I think the bottled water and sodapop industry is fearmongering us into buying products we dont need. And the beauty of it is that they don't have to worry about side effects. The same finely tuned physiology that protects us from dehydration also protects us from overhydration: so, if we drink too much we just pee more. Ironic that mother nature would protect the bottled liquids industry but she does.
All that having been said, there is a role for water in post op patient routines. Drinking water can keep you feeling full without adding calories.
The routine of drinking often keeps patients from feeling like snacking.
Conversely, not drinking after meals will keep you feeling full, rather than flushing the food through more quickly. In my view, none of it has to do with concern over hydration.
It's always important to get dietary advice as part of preparation for surgery. Most surgeons' offices have dieticians, handbooks, recipes and the like, and it's important to study and adhere to the plan. I remember years ago though, getting my first pair of contact lenses. The doctor put them in for me, showed me how to use all the solutions for proper care. When I tried to get them out the first time, I realized how little of the information I'd been able to absorb in all the excitement and unfamiliar routine.
Making a plan and preparing for post op intake is something that patients should do before surgery, so that they can feel secure in the weeks to come.
Eating post-op especially after Sleeves and Bypasses sometimes gets little attention, but it is important. It's trickier than the dietary intake down the line, a few weeks after surgery. Here's why:
Surgery itself is sufficient to stop the gastrointestinal tract from about 80% of its function. This situation can be expected to last a day or two. Then, a crampy gas sensation and sometimes a diarrheal bowel movement indicate that things are back to normal.
The important thing to realize is that the surgery has usually eliminated most hunger sensations. This can be a very strange new feeling for many patients; a freedom in some ways. The temptation though, can be to not eat at all; this is where the preparation and pre planning become important.
If your body does not get the proper pre planned intake, then it can go into a starvation state, in which food nauseates and vomiting is increasingly likely to occur. If this goes on for a few days, a thiamine deficiency ensues and the patient gets increasingly sick and weak.
To avoid this I encourage patients to deliberately sip down a few hundred calories--mostly liquid protein--daily for the first week or so following surgery and the resumption of normal gastrointestinal activity. Patients should be encouraged to accept this as an obligation to eat, even if they aren't hungry. Stick to the plan!
Thereafter, patients have to shift their thinking from the initial obligation to eat, to allowing hunger to be relied upon to guide intake which typically is a few hundred calories only.
Remember, we are here to educate you but also to support you while you get into your new routine emotionally and physically. Reconnect with me, your dietician, your Success manual, or our support leaders.
Remember too, at all times carbohydrate snacking is to be avoided like cigarettes and heroin--too habit forming to be safe.
The holidays are quickly approaching, and with them, the expectations of joyous celebration and good cheer. Unfortunately, many people also experience frustration and uncertainty of managing weight and health in the coming years.
If you are 50 pounds overweight or more, and each year at this time you decide on a new approach to loosing the weight, it’s time to take a serious look at your past attempts. The options today are endless. There are many great programs that offer diet, exercise, online support, etc. Your yearly experience has probably familiarized you with much of what’s available. You’ve probably already discovered too, that no one weight loss plan fits all. Recently released studies show that a diet that works for one person may not produce good results for another.
5 important factors to consider when making a decision on addressing your over weight issues:
1- Choose a healthy diet that can be maintained. This needs to be a commitment to both the food you choose and to your eating habits.
2- Make sure that you choose a diet that will work well with existing medical conditions. A large majority of overweight people have diseases related to their weight, such as diabetes, hypertension, etc.
3- Any diet that basically denies you enough calories per day to sustain energy and a normal life is not only dangerous but can create a worse situation in your struggle to gain control of your life and how and what you eat.
4- Emotional problems can be hampering your success. It’s important to consult a therapist if your struggles are based on emotional issues. Consider whether all you need is a partner- a life coach or personal trainer to keep you accountable or motivated.
5- Be your own advocate ---- Know your struggles and realize when it’s time to talk with medical professionals who can advise you on all options available to you. Success is your goal.
The single most important thing you can do is be well educated. Seek out dedicated professionals in their field, whether it’s a weight loss program, fitness training, life coaching, therapy or weight loss surgery. It may be a combination of all of the above. Be open to accepting that what you have done in the past hasn’t worked or you wouldn’t be facing this same problem each year. Imagine the new resolutions you can have if you conquer this issue once and for all. Success in this part of your life will open up unlimited possibilities.
If you are one of the many people who struggle with weight, keep in mind that ultimately it may take a more effective, long term solution to achieve the results you want and need for improving your overall quality of life and well being.
If weight loss surgery may be the final answer, as you try different diets and programs, it’s important to be under a doctor’s supervision---and keep copies of all medical records of your efforts. Many people are unaware that most medical insurers now require these records to show your attempts with non surgical weight management.
Dr. Owens and Coastal Center for Obesity welcome your questions and comments regarding permanent weight loss options.
My friend tells me at breakfast that recent studies show that small group problem solving tends to exceed that of the brightest member of the group. Kind of the opposite of what Kennedy noted at a white house dinner. He remarked to a group of Nobel Prize winners that the average IQ in the room had never been higher, with the possible exception of when Thomas Jefferson dined alone. Who could doubt that the average IQ might in some sense be summative and even Jefferson would have taken a back seat to the combined intelligences?
If the talks on TED are right, kids teach themselves better interacting in small groups than learning from the expertise of the teacher. All of this seems to me to be part of a tectonically slow but huge paradigm shift in our thinking; away from the confrontational and competitive, to the cooperative and supportive. In medicine, it is not just the Colon Health Lady who is supporting the idea of balancing our biologic populations! Creating an environment for health, rather than fighting some aspect of ill health, is gaining popularity in many areas. The vast and intricate interaction of cells and organisms with each other and their environment to promote and enhance survival is growing daily as the more targeted therapies are diminishing.
As the world heats up and the environment shrinks and number of species left diminishes daily it seems only proper that we should start rethinking our relationships.
Who knows?: Maybe in a few years we will be sending the Army Corps of Engineers somewhere to build up a country’s infrastructure. Imagine what it would do to our image if we infiltrated a country to do it good instead of raining hellfire missiles on the populace first? Of course we would have to study the culture first. We’d need to know how to influence and alter it so as to make our mutual existence better. We might have to change too; that could be painful. Still it seems to me that the Wars on things—the War on Drugs; the War on Terror needs to be rethought along the lines of adjusting to a complex overall environment. The targeted approaches aren’t working. mlo
It is alleged that through much of his career Lance Armstrong used Epo and blood doping to enhance his performance. The purpose of blood doping is to increase the number of oxygen carrying red blood cells per unit volume in the blood and thus to deliver more oxygen to the muscles during exercise.
On the face of it this ought to work, i.e. the more red cells the more oxygen delivery. However, given the same cardiac pumping effort blood flow tends to slow rapidly as cells are added due to the increased viscosity of the blood—kind of a molasses effect. In a textbook of physiology that was biblical to us as medical students, Guyton pointed out that blood oxygen delivery peaked when the number of red cells per unit volume was about three quarters of what it normally is. It made sense he explained that we should deliver more oxygen after losing some red cells because this would increase the likelihood of survival for an injured animal or person.
In a recent article it was noted that “Regular blood donation may reduce blood viscosity and increase oxygen delivery in men.”* In summary blood doping may be more a handicap than a help. Ironic that he should be taking so much heat for using performance decreasing rather than performance enhancing drugs. To me it points out that the fundamental weakness in this drug based witch hunt is its arbitrariness and lack of scientific investigation. Performance enhancement is bought at a high price in many forms of competitive sports (think pro football) and enjoys a variety of approaches and a rigorous scientific background.
From one point of view everything from Lasik surgery to aspirin can be considered performance enhancing so why not take a scientific look at the performance enhancing drugs and and make them just one more on the list of tools an athlete can choose to use or not? *Rheologic Dissimilarities in Female and Male Blood www.mcgowan.pitt.edu
Having lost 167 lbs Paco went from overweight to healthy, happy and successful through finding Dr. Milt Owens, well know bariatric surgeon. Paco talks about his journey from obesity to health and what having an experienced surgeon and friend has meant to him and his success.Also watch this video on You Tube: http://youtu.be/svcTYSig7MU
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