LIVIN' LARGE: Minimizing yourself and maximizing your life!When you have over 100 pounds to lose it can seem impossible to get started in the right direction.
I should say that I've never personally considered it (thought about it, but with no real intention). I've also seen far too many women on the diet boards who lose a fair amount fast, but then it slows down. I've also seen many come to the boards 5 years after, having gained the weight back. It is a tool when used at it's best. Just not for me.
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Originally Posted by sidonia
When they tell you in the office that you have to lose weight, I have never been given ANY kind of materials. Never...no diet plans...no exercise routines...nothing. I've never even been referred to a nutritionist! They referred me to a Bariatric surgeon...! That scares me because it make me feel like they gave up!
This is my big pet peeve in Canada (or at least Ontario, I can' speak for other provinces). We have socialized medicine (paid for through taxes, everyone gets it). Doctor visits are paid for, but not nutritionists. This makes no sense to me. I've known at least two woman who were told they were obese - go home and lose weight. One was at a height (4'11) that I think the difference between high acceptable and obese is something like 25 pounds. I just checked 123 is just under BMI of 25, 149 is over 30 and considered obese. I think she was 150, and although carrying a bit of fat, had a lot of muscle as well. I felt her smoking was a truly bigger deal.
And I hear of some women at my weight told to eat 1200 calories a day and exercise for an hour 3 times a week. And yes, from doctors - what book are they reading from? I'm trying to think of the last time I was offered any help. One was a referral to a nutritionist (which I would have had to pay for), and the second was to put me into a drug trial that the doctor's practice was running. One look at the side effects was enough to turn me off.
The one thing about some of the gastric bypass operations though is that I've seen some information that it literally appears to cure diabetes almost immediately. I forget the specific type of bypass, but I can see this being a reasonable solution for some people. In the end I have to get the weight off by lifestyle changes and finding exercises I enjoy doing. If I don't, there is no way I'll keep any lost weight off.
If I don't, there is no way I'll keep any lost weight off.
That's exactly how I feel... And the fact that my docs asked me if I would look into it...it what made me wanna do it myself!
I wasn't aware that the nutritionist referral would be extra where you are...that's so weird! It's always interesting what they consider extra or not. Even with insurance companies in NY.
I wasn't aware that the nutritionist referral would be extra where you are...that's so weird! It's always interesting what they consider extra or not. Even with insurance companies in NY.
I've always considered it odd because of our provincial health care (where everyone is covered). If the obese are such a drain on the system (I keep hearing this in the paper every now and then) it would make sense to try and do as much as they could to improve that. Interesting point that I only ended up in the hospital while trying to lose weight though. Most larger companies have extended health care plans (eye glasses, dentist, non-hospital prescriptions, etc.) that might cover it. I've had some that cover lots of extras, just never looked into it. If I'd wanted to visit a nutritionist I'd have likely paid for it. The only time I've even talked to one was when I was in the hospital, and couldn't eat what they were giving me. Pretty much pure carb/fat breakfasts, pudding/cakes as a lunch/dinner desserts. Don't get me wrong, in my bad days I'd have probably eaten them, but they weren't good. One of the nurses on the first day suggested I talk to the nutritionist, and although we argued, I got my way. The best part of the meals were the oranges I got substituted for desserts.
And you point out something that happens often in the Hospital Anne.
Even tho someone might be on a strict diet, the hopsital doesn't follow the Rules.
Bob's dad had Duhring's disease, which is like celiac's but in addition to the gut problems, he would get clear watery blisters all over his skin and itch all over. His orders said GLUTEN FREE on them, but inevitably there would be somethings with wheat, oats, etc on his plate. It's like the hospital was out to get him.
__________________ It all starts with the mind, but the thoughts, the intention aren't enough. Action needs to come next. Dream it, believe it, plan it, execute it, celebrate it. - Wendy
I saw a 60 Minutes about bariatric surgery in April. They had several people on it who had all had gastric bypass surgery, & the interviewer asked them, how many of you had diabetes prior to your surgery? Every person raised their hand. How many of you have diabetes now? No one raised their hand. About three quarters had sleep apnea prior to surgery; none have it now. The surgery also appears to significantly lower rates of cancer, which is closely correlated with obesity.
Furthermore, they said that diabetic symptoms such as high blood sugars went away almost immediately after surgery, even before the weight loss. So there does appear to be a relationship between diabetes & the portions of the stomach/duodenum that the bypass passes by. This has been confirmed in studies on diabetic rats: give them the bypass surgery, & their diabetes disappears; reverse the surgery, & the diabetes comes back. Apparently they are now doing a control study on a group of non-obese Type 2 diabetics, I believe in Brazil, to see if the surgery will relieve their diabetes. Normally, at least in the U.S., the only people who can get approval for this kind of surgery are people who are considered morbidly obese.
After seeing that show -- well. I will admit to previously having had a residual prejudice about the surgery, I think because of internalized judgments about all that crap about "fat people lacking willpower to control their eating" that is all over the culture, that has hit me too. And has also had affect on my feelings about my mom, who died in November 2005 of heart-related complications of diabetes. In her later years, all of us kids felt helpless & at the same time angry due to the perception that she wasn't doing enough to help herself, that she wasn't controlling what she ate. And the logical conclusion to that is that all the health problems she suffered at the end, & ultimately her death, was her fault. I've been struggling with that ever since -- blaming her for her own death. But now I know, without question, that that's not so. From what I understand now, yes, there is a metabolic problem that leads to obesity, over which the obese person has no control. It appears to be related to the metabolism of carbohydrates in particular (& hence, blood sugars & insulin), particularly refined carbs. Which are also implicated in cancer, cardiovascular disease, & other conditions. (Yes, & sleep apnea.) But what are you going to do in a society in which the government, all the major health organizations, & most doctors & nutritionists are insisting that high-carb diets are what we should be eating, & the entire food industry is geared for that? It makes it difficult to, as they say, "eat clean," even if one knows what, or what not, to eat. I don't think it will become "easy" if ever until the entire society takes a big huge paradigm shift.
I’m not saying that “low carb is the answer for everyone” – but it is becoming increasingly clear that diets high in carbs, especially refined carbs, are bad news for people who are insulin resistant/prediabetic/diabetic . And yet, the American Diabetes Association continues to recommend high-carb diets to diabetics – in my opinion, only making them sicker. There is also continued blame cast at the obese for being obese, & at obesity as the “cause” of insulin resistance & Type 2 diabetes, when recent research seems to be showing that it just might be the other way around: that people (or many people) become obese because they are insulin resistant. With related metabolic affects which have an impact on appetite & satiety: it's not just "emotional" eating, but also metabolically-driven hunger (affects of leptin & ghrelin, insuiln, & blood sugar volatility) that makes obese people eat. Let's also not forget the affect that wacked out blood sugars & related metabolic problems have on mood, which also can lead to hunger & the desire for "comfort food."
So was it my mom's fault that she died before her time of Type 2 complications? No. As much as I wish we'd known enough to support her in her early endeavors to eat low carb back in the '70s, I also wish we'd known about gastric bypass in the ‘80s & ‘90s. It might have saved her life too.
That said, I don’t believe that gastric bypass is really a “cure” for diabetes. I think it hits symptoms, not causes. Although followup studies I’ve looked at in PubMed indicate positive longterm outcomes for weight loss surgery, I’ve also seen references to people who’ve had the surgery still being obese – just not as obese. It doesn’t lead to lifestyle changes, though undoubtedly some individuals who have the surgery make changes on their own. In the end, it seems a typical Western medicine way of putting a bandaid on a problem with drugs or surgery, when we need to go a lot deeper than that – such as persuading our public health agencies & nonprofits like the ADA & American Heart Association to pay attention to health in their nutritional recommendations, instead of to which lobbyists from Big Agriculture or Big Pharma are lining their pockets.
I am prediabetic myself, & have been working pretty darn hard ever since my mom’s death awakened me to my own danger, to change my health including getting rid of my excess bodyfat. I’m doing it with diet (moderate or, currently, low carbs) & exercise. It’s really not as hard as “they” say it is, when one has the right information. Just don’t go to the ADA, the AHA, the USDA, or most medical doctors for it. My own experts (thus far) have been Diana Schwarzbein, Tom Venuto, John Berardi, & Lyle McDonald.
Just saw this thread, and I wanted to chime in (if anyone's still interested)...
I work with bariatric patients, pre- and post-op. I do their fitness assessments and then teach them their exercise program (walking pre-op, more extensive including some strength and flexibility post-op). The people I work with must pass a psych assessment (but I don't know the details or how extensive it is).
For at least one month before surgery (sometimes more, if surgery dates change), the patients are on a meal-replacement program (bars and shakes). I've seen them lose 50# in a month following this plan and doing their walking program. BEFORE their surgery.
So... if you know you CAN do this, why would you opt for dangerous surgery? I'm not saying it'd be pleasant to stay on the bars for months on end, but... I wonder if any of the patients have an A-ha moment and say "I can comply with a diet - maybe I should try some kind of diet plan for a while longer and see what happens." Haven't met one yet...
There is also a great deal of resistance to the idea that they will have to exercise to lose and maintain their loss, that exercise has to become a part of their life forever. I can usually tell who's just nodding along, and every once in a while I meet someone who actually seems motivated and learns to enjoy exercise... but that's rare.
I often hear "I've lost weight before (many times), but it always comes back. This time it will stay off because of the surgery." Well, uh, not necessarily. As mentioned in this thread, the relapse rate is pretty high - you CAN stretch out a stomach, even after the bypass... I've met 2 women who had bands put on AFTER they had bypass and restretched their stomachs.
I think WLS can be a helpful tool, but education and support could probably do as much or more for many people (which goes back to doctors not having the time or tools to support or educate). For people with severe comorbidities or lack of mobility, maybe it can be the major jumpstart they need... but without constant vigilance (just like is necessary for ANYONE who's ever had a weight problem), the surgery is just another tool that only works as hard as the person works, and only lasts as long as you continue to work the program.
I think the concern I have is that people seem to think it really is a no effort solution. From what I understand about 60% of a person's excess weight drops quickly. That still leaves them with 40% to lose through diet and exercise. I'm sure nobody enters into the decision lightly, but it does seem that way at times. One of the women on the weight loss board I post on has lost about 55lbs since February (I don't know if it was early or late). Lately she's slowed with her loss, regained a few pounds, lost them again, and is now talking about WLS.
I find the whole process scary, even though I was (and probably still would be) considered a good candidate for it. I mean, I know losing weight is hard. I just don't think I could have done it (or would ever). It just seems such a drastic solution. And when I hear women barely over 200lbs considering it that makes me really question the doctors doing it.
Be very careful, Sidonia. I would, personally, only opt for a lap band if anything (reversible), since rerouting the innards is FULL of problems--malabsorption, dumping syndrome, bad ju-ju in general, and surgical complications to include infection and death. Worst case, obviously, but it definitely happens!
HTH
Tina
I'm late to this thread, but it's worth mentioning that dumping syndrome is actually a desired consequence of the procedure (to an extent). Dumping syndrome is part of what decreases the patient's desire for sugary snacks, i.e., seems to decrease the desire for high carb foods.
The surgeons where I work perform, I believe, the largest number of gastric bypass operations in Canada, so I've become quite familiar with the complications. I've seen lots of post-op infections, a number of bowel obstructions due to internal hernias, and a handful of deaths. There is also an increased risk of colon cancer long term. That side of it is not pretty at all.
OTOH, one of the clerical workers in my department had the operation last fall and she's practically melting. She's lost 100lbs, I would guess. She used to be almost spherical in shape, but she's practically unrecognisable now. She's still overweight, but well on her way to a healthy weight.
The facts seem to suggest that if patients are carefully selected for this operation, there is a significant improvement in long term health.
It really does need to be the last choice after all other avenues have been exhausted, and any ethical surgeon would agree (the group here is not doing these for their own financial benefit----it pays well, but they could make the same money doing easier procedures).
I'm coming to this really late, but I'll throw in my $0.02 anyway.
I think that in almost every case, getting bariatric surgery is a mistake that's, over time (usually far less time than the people who've opted for it could have imagined) doomed to failure.
Most fat people aren't that way because they overeat. Let me clarify; I'm not saying that some fat people don't overeat, but that that isn't the reason for their fat in most cases. After all, plenty of thin people over overeat all the time. The difference between the thin overeater and the fat one is not what they're eating, but the way they're processing it.
Thin overeaters are less efficient at energy (calorie) storage than fat overeaters.
Outside of being extremely diligent about diet and exercise every day of their lives, the key to people who are prone to fatness becoming and maintaining thinness isn't food restriction via surgery, but discovering a way to cause a fat person's body to process food like a thin person's body.
Bariatric surgery flat out doesn't do that; as of yet, nothing does.
It simply doesn't matter how little food you take in after you've been cut, the way the calories are processed will still remain the same as they do with anyone prone to fatness.
This is why practically everyone who gets that surgery ends up regaining most or all of their weight over a long enough time line.
I have a billion other reasons why I think bariatric surgery is unwise, but I'll stop here.
This is why practically everyone who gets that surgery ends up regaining most or all of their weight over a long enough time line.
While it would be correct to say that most available studies of various bariatric procedures assess a relatively short interval due to the fact that the procedures have become common only in recent years (i.e., many studies assess weight loss at 1 year post-operatively), I have seen no systematic evidence to support what you have written. If you believe what you have written to be the case, then I would appreciate if you could post references from indexed scientific journals to support your contention, as just saying it doesn't make it so.
Most fat people aren't that way because they overeat. Let me clarify; I'm not saying that some fat people don't overeat, but that that isn't the reason for their fat in most cases. After all, plenty of thin people over overeat all the time. The difference between the thin overeater and the fat one is not what they're eating, but the way they're processing it.
Thin overeaters are less efficient at energy (calorie) storage than fat overeaters.
Honestly, the longer I'm at this the less I agree with what you've said. I used to think that I had a low metabolism, but I'm beginning to think that's untrue. My mother is one of those thin people who can pretty much eat what she wants (at 80yrs and 120 lbs she's technically a little over what she should weigh, but marginally). She eats 1800 - 2000 cals a day... plus candy and chocolate that's not counted in that. On those numbers she should gain, however, she's never at rest. I call her the poster child for NEAT. At my heaviest I maintained a substantial weight (over 400 pounds) with way more intake (ie. I should have been heavier), although I was still relatively active with a day job that kept me moving all day.
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Originally Posted by russ
While it would be correct to say that most available studies of various bariatric procedures assess a relatively short interval due to the fact that the procedures have become common only in recent years (i.e., many studies assess weight loss at 1 year post-operatively), I have seen no systematic evidence to support what you have written. If you believe what you have written to be the case, then I would appreciate if you could post references from indexed scientific journals to support your contention, as just saying it doesn't make it so.
I waver on this one. On a weight loss board I hang out on I see an occasional post from someone who had the surgery (various kinds) years ago and eventually gain some (even all) of the weight back. I suspect the surgeries make it harder, but not impossible to do so. Interesting point is that most of the current women undergoing (current or just planning) don't want to discuss failures with these women. If it were me I'd want to find out why they failed in order to avoid it myself. I suspect that the doctor's performing the surgeries have no vested interest in tracking long-term success. I mean, if the success rate is 80% 1 year out and even 60% 2 years out it might stop some people from signing up.
The numbers used there are ficticious, just used for an example. I do think sometimes it's an acceptable tool for people, however, I do think some people think it's a quick fix. That's what I find most concerning.
Most fat people aren't that way because they overeat. Let me clarify; I'm not saying that some fat people don't overeat, but that that isn't the reason for their fat in most cases. After all, plenty of thin people over overeat all the time. The difference between the thin overeater and the fat one is not what they're eating, but the way they're processing it.
Thin overeaters are less efficient at energy (calorie) storage than fat overeaters.
Outside of being extremely diligent about diet and exercise every day of their lives, the key to people who are prone to fatness becoming and maintaining thinness isn't food restriction via surgery, but discovering a way to cause a fat person's body to process food like a thin person's body.
It simply doesn't matter how little food you take in after you've been cut, the way the calories are processed will still remain the same as they do with anyone prone to fatness.
This is why practically everyone who gets that surgery ends up regaining most or all of their weight over a long enough time line.
I have a billion other reasons why I think bariatric surgery is unwise, but I'll stop here.
Hmmmmm... ok. I think that some (I might even say many) who have bariatric surgery don't lose "enough" (whatever that is) and many regain some or most of their weight. BUT many also have success. I've met plenty of people whose lives turned around after the surgery.
The main difference I see in the people who have long-term success is that they changed their lives. They didn't break their diet rules, they didn't restretch their stomachs, and they became much more active.
Were they more active because they lost weight and can move more easily / lessened their comorbidities, or did the activity lead to more weight loss? Probably an interaction of the two.
The ones who were more successful also changed their mental attitudes, through therapy and self-examination and an ongoing committment to make this life change. The ones who felt it was a magic cure are the ones who I've seen struggle the most.
My "issue" with surgery is that lifestyle change isn't emphasized enough. People who DO have great success (with surgery and lifestyle change) might have achieved the same results without risky invasive surgery if they'd simply stuck to the changes they made anyway along with the surgery.
So... having said all that - I'm very curious as to HOW you feel the body processes calories differently and thus dooms people to failure. What is this "different" process? How do thin people who eat a lot digest, store and utilize energy differently than fat people? How do you account for those who do lose weight and maintain their loss, either through diet/exercise/lifestyle changes or bariatric surgery?
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Originally Posted by russ
I have seen no systematic evidence to support what you have written. If you believe what you have written to be the case, then I would appreciate if you could post references from indexed scientific journals to support your contention, as just saying it doesn't make it so.
My "issue" with surgery is that lifestyle change isn't emphasized enough. People who DO have great success (with surgery and lifestyle change) might have achieved the same results without risky invasive surgery if they'd simply stuck to the changes they made anyway along with the surgery.
This is my problem as well, some (not all) doctors prescribe this as some sort of miracle. When you are in their office, they make claims like "you'll get your life back" "you'll be happier" but like you said many times the reasons we're fat aren't just connected to we eat more and don't move around, it's deeper than that. If you're not ready to do some deep psyche, and make a huge life overhaul...you'll have your life back for awhile, and then you'll lose it all over again by gaining the weight back...the same way you did the first time. It took some therapy for me to realize why I ate do much to really re-frame my thought process. And now it's taking lots of hard work to keep what I've lost off, and lose more. It comes down to, it's easier to get the surgery, for those who aren't afraid to go under the knife. It seemed that way to me until I spoke to people and knew people who had gone through it.
Surgery is not a miracle...unless you make it one with hard work and life changes!
To those who've responded to my post and had questions about it, I want to be clear that I make no claims about my being a scientist or researcher. What I am is a constant reader, and I do my very best to read as much as I can on both sides of a debate because I think it's important to get as full a picture as possible about any worthwhile subject.
That said, I'll gladly provide references for anyone who's interested. Unfortunately, I'm typing this from work, so don't have the materials handy. I'll absolutely have them up by tomorrow though.
Honestly, the longer I'm at this the less I agree with what you've said. I used to think that I had a low metabolism, but I'm beginning to think that's untrue. My mother is one of those thin people who can pretty much eat what she wants (at 80yrs and 120 lbs she's technically a little over what she should weigh, but marginally). She eats 1800 - 2000 cals a day... plus candy and chocolate that's not counted in that. On those numbers she should gain, however, she's never at rest. I call her the poster child for NEAT. At my heaviest I maintained a substantial weight (over 400 pounds) with way more intake (ie. I should have been heavier), although I was still relatively active with a day job that kept me moving all day.
I waver on this one. On a weight loss board I hang out on I see an occasional post from someone who had the surgery (various kinds) years ago and eventually gain some (even all) of the weight back. I suspect the surgeries make it harder, but not impossible to do so. Interesting point is that most of the current women undergoing (current or just planning) don't want to discuss failures with these women. If it were me I'd want to find out why they failed in order to avoid it myself. I suspect that the doctor's performing the surgeries have no vested interest in tracking long-term success. I mean, if the success rate is 80% 1 year out and even 60% 2 years out it might stop some people from signing up.
Please define in what sense you're using the phrase "long term" regarding bariatric surgery.
For the time being, medium term ~ 1 year, long term ~3-5 years. 5-10 years from now, those definitions will no longer hold.
My request to you, based on what you wrote initially, is to provide evidence from indexed sources which demonstrate that most patients regain most or all of the weight they've lost.
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I do think some people think it's a quick fix. That's what I find most concerning.
I can speak only for the bariatric program with which I'm familiar, but I can tell you that the people I know who perform the procedure (about 5 surgeons at my institution) view it as a last resort and have in place a program which places a great deal of importance on the psychosocial issues applicable to the people undergoing the procedure.
For the time being, medium term ~ 1 year, long term ~3-5 years. 5-10 years from now, those definitions will no longer hold.
My request to you, based on what you wrote initially, is to provide evidence from indexed sources which demonstrate that most patients regain most or all of the weight they've lost.
As I've written above, I'm at work, and don't have the sources handy. I'll post them tomorrow.
However, even without them, I must say defining 1-5 years as "long term" with this sort of drastic surgery hardly seems appropriate. It would seem that 10 years would be a more logical (bare) minimum. Not for the least of which reason is the surgery's tendency to create serious problems with calcium absorption. I've never been able to figure out what the point is of having people take do much calcium after having that surgery, when their bodies can barely do anything with it anyway.
It'll be interesting to see in twenty years at what the rate the people who've had the surgery suffer from osteoporosis, along with other ailments that are linked to calcium deficiency, compared to the general population.
Again, until they can find a way to make fat bodies deal with food like thin bodies, things like bariatric surgery will remain an unreliable and, in spite of the spin many doctors tend to put on it, ultimately unhealthy patch that will continue to be relied upon.
Most fat people aren't that way because they overeat. Let me clarify; I'm not saying that some fat people don't overeat, but that that isn't the reason for their fat in most cases. After all, plenty of thin people over overeat all the time. The difference between the thin overeater and the fat one is not what they're eating, but the way they're processing it.
Thin overeaters are less efficient at energy (calorie) storage than fat overeaters.
This was what I disagreed with. You seem to take my mention of my mother as an agreement. She can process more calories because she's freakin' active all the time. Barring some illnesses/medications I truly believe it's calories in vs. calories burned. The reasons you used above is what a lot of overweight people use to delude themselves into thinking there is nothing they can do about it.
I can speak only for the bariatric program with which I'm familiar, but I can tell you that the people I know who perform the procedure (about 5 surgeons at my institution) view it as a last resort and have in place a program which places a great deal of importance on the psychosocial issues applicable to the people undergoing the procedure.
You may be correct, however, on the weight loss boards I'm amazed by how frequently woman are offered this as an option. Especially when they haven't asked for it. They'll go in to see their primary care physician about something else and have it suggested to them.
I won't go into my thoughts on the Canadian health care system that pays for doctors, but (unless it's changed) does not pay for diet counseling or such. No, just tell people they're overweight and hope that they find something that works. And I'm not talking about myself, but I've seen it happen to friends.
Oh no, I'm sorry, I was once offered a chance to get in on a drug trial one was running (not primary care) for Rimonabant/Acomplia even though he was already aware I'd made a fair amount of progress on my own.
This was what I disagreed with. You seem to take my mention of my mother as an agreement. She can process more calories because she's freakin' active all the time. Barring some illnesses/medications I truly believe it's calories in vs. calories burned. The reasons you used above is what a lot of overweight people use to delude themselves into thinking there is nothing they can do about it.
On what are you basing the fact that she's processing more calories because she's more active. What, all the fat people you know spend most of their time reclining on sofas while drinking Hershey's chocolate syrup straight from the squeeze bottle?
I can honestly say, I have my share of very thin friends who're are not only huge eaters, they're physically inactive and shutter outright at the thought of exercise. Just as I have some fat friends who're comparatively much more physically active (at least one walks to work everyday just because he likes the view from the bridge. Five miles from home to job; that's 25 miles a week) and are much more conscious of what they put in their mouths than the skinnies.
And of course, I have all kinds of friends that fall somewhere in between, which is most of them.
Honestly, if it was as simple as calories in/calories out, then everyone who overeats would be fat. Clearly, this isn't the case.
However, even without them, I must say defining 1-5 years as "long term" with this sort of drastic surgery hardly seems appropriate. It would seem that 10 years would be a more logical (bare) minimum.
Only if you have large scale data from 10+ years. That's why I qualified the definitions I used.
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things like bariatric surgery will remain an unreliable and, in spite of the spin many doctors tend to put on it, ultimately unhealthy patch that will continue to be relied upon.
Again, saying it doesn't make it so. You haven't provided any evidence to support the contention that it's ultimately unhealthy in most cases or that it is even relied upon in more than a relatively small percentage. The current evidence, while not sufficient as it can't look years into the future, does not support what you've said. You seem merely to be stating your personal belief and hoping to have it accepted as fact.
Regarding hypocalcemia---this is an issue post-operatively, though it seems to be at least partially reversible with supplementation. Absorption is not completely eliminated.
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Originally Posted by realdcn
You may be correct, however, on the weight loss boards I'm amazed by how frequently woman are offered this as an option. Especially when they haven't asked for it. They'll go in to see their primary care physician about something else and have it suggested to them.
I'm not denying their experience, but the primary care physician can suggest it, but has no say in the ultimate decision. That is up to the surgeon, and the surgeons I know use it as a last resort, not a primary intervention.
That being said, Im not of the belief that gastric bypass or banding will be the ultimate answers for obesity, i.e., that these procedures are with us for good. My guess is that our ability to solve the obesity issue will improve with time to the point where such procedures become obsolete.
Quote:
I won't go into my thoughts on the Canadian health care system that pays for doctors, but (unless it's changed) does not pay for diet counseling or such.
I'm not a health economist, so I'm not in much position to give an opinion as to whether or not such services should be covered. Perhaps diet counseling is considered a luxury rather than a need, but I really don't know.
I won't go into my thoughts on the Canadian health care system that pays for doctors, but (unless it's changed) does not pay for diet counseling or such.
BTW, this is a real question. I"m not being a smartass...
I'm curious. How often does diet counseling work in the US? I know several people who have gone to it here and they're still fat. I went once, years ago, wasn't motivated and got right back into my bad habits.
Perhaps it's not covered in Canada because it doesn't work? I'm not saying that it shouldn't be tried before surgery (it certainly should), but without the motivation to lose weight, they're not going to lose weight. If they were motivated to lose weight, they wouldn't need surgery.
Again, I don't know the stats and I'm curious about it.
Honestly, if it was as simple as calories in/calories out, then everyone who overeats would be fat. Clearly, this isn't the case.
Seriously? I'm not saying all thin people have healthy diets, but the laws of thermodynamics are just that - laws. People who eat more and maintain a lower weight burn enough calories to compensate for (burn) what they eat. Whether they fidget more or move more or whatever, they burn the calories. Heavy people who aren't losing (or are gaining) and who are still active are getting calories from somewhere - even if you don't SEE them eating every bite.
Not trying to steer this conversation off topic, but the bottom line is that if you eat less than you burn, you will lose pounds. You can put your body into starvation mode and have hormonal changes that affect your body's efficiency - but the bottom line is that if you eat less than you burn, you lose pounds. The AMOUNT of calories and movement required differ among individuals, but the law of thermodynamics doesn't change.
Bytsi said it the way I should have. It really doesn't matter what your perception is, people do not gain weight unless they eat more than they burn. And people who appear to eat a lot and do not gain are likely more active in ways that are not obvious.
Quick note on my mother, she's one of those people who really doesn't sit still. I adjusted the setting on my HRM one Sunday when I wasn't using it earlier this year. This didn't include any gardening, housework, heavier tasks, etc. Just a nice restful day. During a period where she was supposedly doing very little (typing a letter on the computer, having lunch, resting before swim, followed by a 20 min casual swim) she burned somewhere in the neighbourhood of 90-100 cals per hour.
This is because:
- while typing the letter she stopped many times and went away and did other things (up and down the stairs at least a couple of times).
- while making lunch she probably stopped and did a few more things
- while resting ... she got up and did other things
The point is, through observation, she's rarely at rest. Yet, if you asked her at the end of the day what she'd done she would probably say 'very little' or 'nothing'. That day she would likely say that she typed a letter, had lunch, had a rest, had a swim. What she likely did is 20 small tasks that she didn't think worth mentioning. The difference is that on days I do nothing, I really do nothing.
BTW, this is a real question. I"m not being a smartass...
I'm curious. How often does diet counseling work in the US? I know several people who have gone to it here and they're still fat. I went once, years ago, wasn't motivated and got right back into my bad habits.
Perhaps it's not covered in Canada because it doesn't work? I'm not saying that it shouldn't be tried before surgery (it certainly should), but without the motivation to lose weight, they're not going to lose weight. If they were motivated to lose weight, they wouldn't need surgery.
Again, I don't know the stats and I'm curious about it.
Sadly, you're probably right. I remember trying to help a friend lose weight years ago. She'd been at the doctor's where he'd told her she was obese and needed to lose weight. Now, she's quite short (just under 5') and if I'm remembering correctly she was perhaps a few lbs over what her BMI put her at. Not that she didn't need to lose weight, but her job was active and she had a lot of upper body strength (ie. I would say that a straight BMI wasn't the best indicator.
at 4'11" - 148 is obese, 124 is overweight, 123 and under come up healthy
I think he sent her home telling her to drop at least 25lbs but with no real suggestions on how. At the time I was losing weight and someone I worked with did help her with getting her to eat a better diet. To be fair, her diet was atrocious. Really, not kidding.
Bkfst/morning snack - 2 doughnuts, 2 coffees (double/double)
Lunch - something bought locally (ie. fast food)
Dinner - sandwich of some kind, sweet of some type (cake/brownie)
Honestly, not a fruit or vegetable. He loaned her a copy of his Zone book (big follower of it, and a bodybuilder) but eventually I helped her find things simple she could fix, but better overall. I think I gave up and the bodybuilder got her a good deal on zone bars for mornings. This was a gal who was always late, making breakfast was not an option.
Having said that, at almost 50, she really knew nothing about nutrition. She didn't have a clue about where to start. She wasn't computer literate, didn't own a home PC (although I'm not sure if you don't have a clue that the internet is a good place for research). I do think she could have benefited from professional advice. Working as a temp, with no benefits, she had no extra money to pay for it out of pocket though.
Did she lose weight? Yes (probably about 20 pounds fairly fast). Did she keep it off? I think so. I saw her in the spring and she looked pretty good, but I didn't ask specifically. By the numbers she's probably still considered overweight, but in street clothes doesn't look it.
And the fact that my docs asked me if I would look into it...it what made me wanna do it myself!
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