Past News on Healthy Living and Updates in the Bariatric World

Past Dietary News

Feb 2008: 55-60.
Featured excerpt from Recipes for Life After Weight-Loss Surgery: Delicious Dishes for Nourishing the New You by Margaret M. Furtado, MS, RD, LDN and Lynette Schultz, LRCP, RT. For more information visit www.fairwindspress.com.

Betta Chedda, Weighing the Curds
Nutrition Action Healthletter December 2007
CHEESE is an excellent source of protein and a number of nutrients such as calcium, phosphorus, riboflavin, Vitamin B12, and Vitamin A. However, along with these great nutrients, it can contain more calories, saturated fat, and sodium than you think. Here are some things to consider when browsing the dairy section your local grocery store.
Serving size: 1oz. Be mindful of portions when slicing from blocks of cheese. Consider proportioned cheese sticks or slices to help with portion control. Read food labels carefully. If they appear lower in saturated fat, they may also have a proportionately smaller portion size. Beware of Saturated fat. 1oz= 15% day’s protein, 20% day’s calcium, AND 20-30% day’s sat fat! Check Sodium and limit to 250mg/oz. Avoid processed cheeses (ie: American). Taste may change with the fat content so try different brands. Some brands seem to be better than others, try: Cabot, Finlandia, Laughing Cow, Horizon Organic, and Denmark’s Finest.
Nutrition Action compared a number of cheeses to determine the “Best Bites.” Best Bites: Contain no more than 3g saturated fat and 250 mg sodium per 1oz.
Cheddar: Cabot 75% Reduced Fat Sharp, Kerrygold Reduced Fat Aged, Trader Joe’s Lite and Lite Sharp Celtic, Cabot 50% Light, Reduced Fat Jalapeno, Reduced Fat Pepper Jack, and Reduced Fat Sharp
Swiss: Jarlsberg Lite and Lite Deli Thin, Sargento Reduced Fat, Finlandia Light Deli Slices and Heavenly Light
Strings, Sticks, & Cubes; Sargento Light Mozzarella String, Trader Joe’s Light Part Skim Mozzarella String, Organic String, and Lite Mild Cheddar Snack Sticks, Horizon Organic Part Skim Mozzarella String, Sorrento Stringsters Reduced Fat Mozzarella and Part Skim Mozzarella
Mozzarella: Trader Joe’s Part Skim, Alpine Lace Reduced Fat
Havarti, Monterey: Jack, Provolone, etc., The Laughing Cow Mini Babybel Light
Sargento Reduced Fat Sliced Provolone, Trader Joe’s Lite Muentster, Alpine Lace Reduced Fat Provolone, Trader Joe’s Light Havarti, Legendairy Light Gouda
See the following link for more information about the nutrients found in dairy products. http://www.3aday.org/SiteCollectionDocuments/PDFs/Nutrients_in_Dairy_v_2.pdf
Websites for more dairy information:
http://www.nationaldairycouncil.org/NationalDairyCouncil/
http://www.3aday.org/Pages/Welcome.aspx
http://www.cspinet.org/nah/index.htm

What to do with those leftovers? Most likely there will be turkey to enjoy for several days after the festivities are over. Here are some ideas to add new spark to your turkey with every meal. Happy Thanksgiving!

Enjoy at breakfast in this scrambler: Scramble eggs and add turkey, green onions, and tomatoes. Slice leftover turkey and add to your salad. Create a turkey citrus salad. Chop turkey and add to mixed greens. Also add strawberries, mandarin oranges, and balsamic dressing. Make a quick, light, and cozy soup. Add turkey to low sodium chicken broth. Then, add sliced carrots, celery, and chopped onions. Enhance flavor with your choice of herbs. Shred and add to your favorite chili. Top with low fat shredded cheese. Create an open face turkey Caesar sandwich. Layer sliced turkey, tomato, and avocado on ½ horizontally split pita bread. Dress with ½-1T Light Caesar dressing. Create a turkey salad sandwich. Use low fat or fat free mayonnaise. Include chopped onion and celery. Use shredded turkey in place of chicken in your favorite Mexican recipes, such as enchiladas, quesadillas, tamales, etc.

Warm and Cozy Beef Stew
Winter’s finest fruits, complement lean beef in this hearty stew. Take advantage of pears and apples this season!
1 T.      Canola oil
2 c.      Chopped onion
4 ea      Garlic cloves
2 ea      Carrots, cut into 1-inch slices
1.5 lb   Lean stew beef, cut into 1-inch cubes
3 c.      Low fat, low sodium beef broth*
1.5 t.    Paprika
1.5 c.   mixed pears and apples, unpeeled and cut into 1-inch pieces
Fresh ground pepper and salt to taste
Optional: 1c mushrooms, 1/2c chopped celery, and/or ½ c Red wine

Instructions: Heat the oil in a large stockpot over medium-high heat. Add the onion and garlic and sauté for 5 minutes. Add the carrots and sauté for another 5 minutes. Add the meat and brown. Drain off any accumulated fat. Add the broth, paprika, pepper and salt (if desired). Bring to a boil over high heat. Reduce the heat and simmer, uncovered, for 1 hour, 15 minutes. Add the apples and pears and cover. Cook over low heat for 15-20 minutes until the apples and pears are soft, but not mushy.   *Have low sodium broth in the pantry but not low fat? Refrigerate canned broth so that the fat congeals on top of broth, skim and discard fat.
Nutrition information: Number of servings: 6               Serving size: 1 c
Calories: 223      Fat: 8g      Carbohydrate: 14g     Protein: 27g
Recipe based on Recipe of the Day by the American Diabetic Association
http://www.diabetes.org/recipeoftheday.jsp
Modifications and optional choices added by Michael Hanson
Apples contribute fiber and phytochemicals, which studies have shown to improve blood cholesterol and bowel function. Did you know that a medium apple contains 5g of fiber? This is more than many cereals provide. We all know apples are good for us. We all know apples are good for us. Let’s talk about pears. Unlike most fruit, pears improve in both texture and flavor after they are picked. Pears are very nutrient dense foods. In fact, they provide more nutrients per calorie than calories per nutrient. They are a good source of Potassium and fiber. It also “works” with another ingredient in this recipe. Beef provides protein and is an excellent source of iron. When consumed with a Vitamin C containing fruit or vegetable, iron absorption is improved. Pears contain 11% of the Recommended Daily Allowance (RDA) for Vitamin C. The pears in this recipe can actually help you improve your absorption of iron from this lean beef!

Today’s Dietitian, June 2007 100 Calorie Pack CultureFad Diets   You may have already tried many types of diet. Maybe you found the diet easy to adhere to, or maybe it was difficult? Maybe you had success… but only temporarily? Let’s start by naming a few types of diets. The following lists a small variety: Controlled Carbohydrate (ie: Atikins, The Zone, The Carbohydrate Addicts Diet), High Carbohydrate, Low Fat (ie: Dr. Dean Ornish: Eat More, Weight Less, The Good Carbohydrate Revolution), Controlled portion size  (ie: Volumetrics Weight Control Plan), Liquid (ie: Slimfast), and Food combining (ie: Fit for Life).  Even though all of these diets have very different concepts, recommend different techniques, and propose varied food composition, they all have one thing in common…approximately 1500 calories per day. This calorie restriction will promote weight loss- no matter what the composition of carbohydrate, protein, or fat. However, the composition is important for nourishment… your health, healing, energy, appearance, etc. For weight loss and maintenance, remember, calories in vs. calories out.        3500 calories = 1 pound   You want to achieve balance here. You want to provide your body with the fuel it needs and not excess of that. Any excess calories consumed will be stored as fat… the body does not discriminate whether those excess calories come from carbohydrate, protein, or fat. For example, drinking undiluted juice can really add up in calories. Most serving sizes are between 1/3 – 1/2 cup. If you drink 2- 16oz bottles per day, you would be consuming 480-720 calories in addition to those you get from your foods. If the calories in the foods you consume do not exceed what your body needs then, you could gain one pound every 4-7 days due to the calories in the fruit juice.   Take caution when encountering any plan recommending a “very low calorie diet” (less than 1200 calories per day). This can slow your metabolism as well as put you at risk for malnutrition. Practice good portion control and moderation. Eat a variety of foods. Include exercise in your daily/weekly regimen. These changes together create an optimal opportunity for success with weight loss and maintenance for a lifetime. A bigger commitment to health than a quick temporary fix will have an immense impact on your well being and future. How can you tell if it is a Fad Diet?Fad diets will grab your attention. You can identify them easily. Ask yourself these questions:
Does this program promise:
              greater than 2 pounds of weight loss per week?
              you will not have to give up fatty foods?
              you will not need to exercise?
              Sounds too good to be true? Most likely.
              Is the program expensive?
              Does the program limit food choices, not encourage balanced nutrition, and/or exclude any food groups?
              Is the diet safe? Is it practical?
              Does the program list “good” and “bad” foods?
              Do they draw a simple conclusion from complex medical research?

Sharon Palmer, RD Recently, many of you have been asking about the 100 calorie packs. Your questions come at a convenient time since I have just read an article reviewing this product line. First, here is a brief background. The 100 calorie packs were first introduced by Kraft in 2004. Many other manufacturers have since followed their lead. The 100 calorie packs have become very popular. The combination of convenience, portion control, and low calorie appears to be the formula for their success. Now, the big question… 100 calorie packs are low calorie but are they the most healthful choice? Well, read your food labels. Many of these little packages are processed, including refined flour and sugar as main ingredients. They are also low in protein. Most offer very little nutritive value.

Although the 100 calorie packs are a better alternative than pastries, ice cream, or cookies, the calories can add up quickly if you treat yourself to a few. They can easily and unintentionally push out other more healthful foods from your diet, such as lean protein, beans/legumes, fresh fruits and vegetables, and whole grains. When including these snacks in your well balanced diet, look for whole grain options, for example: South Beach whole wheat crackers or Pop Secret 100 calorie pop. Both of these contain 3g fiber each. This article also reminds us that nature has its own 100 calorie packs which are loaded with nutrients as well as low calorie. You can choose from 1.5oz cheese, 1 small fresh fruit, 8oz skim milk, or 2 slices of lean ham… just to name a few. Bottom line: 100 calorie packs are a great concept. While they may not always be the best choice, if a 100 calorie Oreo pack satisfies a craving that otherwise would have been spent on ice cream or cookies, then they may have just served their purpose. As with everything, enjoy in moderation!

Read between the lines

My favorite (courtesy of Nutrition Action, Weighing the diet books) is that many of these programs will also tell you: “You’re overweight because you are eating the wrong food”… not too much food. “You’ll lose weight because you eat the right food”… not less food
So, all that being said, what should you do?Be practical. Set realistic goals, both short term and long term.
Focus on your overall health. Maintain balanced nutrition, including; lean protein, vegetables, fruits, and whole grains. Reduce fat intake (less than 30% of total calories from fat) Control portion sizes And… Exercise! Please visit www.eatright.org (The American Dietetic Association) for daily nutrition tips and more information about fad diets. Nutrition Action Health Letter, Weighing the Diet Books, Jan/Feb 2004 http://www.cspinet.org/nah/01_04/cover.pdf
www.quackwatch.com

Salad on a Stick with Cilantro Lime Dressing ½ cup fresh vegetables cut into 1-inch chunks (cucumber, zucchini, tomato, peppers, radish, and mushrooms)
1.5 oz. 2% milk fat cheddar cheese cut into cubes
1 cup plain, low-fat yogurt
1 T      minced cilantro
2 T       minced onion
2 T      fresh lime juice Salt to taste       Enjoy!

Salad: Alternate vegetable and cheese cubes on a skewer. To create the salad, use spinach leaves and layer between vegetables.

Cilantro Lime Dressing: In a small bowl, combine the yogurt, cilantro, onion, and lime juice. Add salt to taste. Set aside for at least an hour to allow flavors to meld. Will keep for 3-4 days in refrigerator.

Nutritional Information: (salad/dressing)
Calories: 90/16, Fat: 3g/0g, Protein: 11g/1g, Carbohydrates: 4g/2g
Serving size: 1 stick/ 1oz Number of servings: 1/ 8

As summer approaches, a number of your favorite fruits and vegetables are coming into season for you to enjoy. This recipe offers a sample of cool, fresh vegetables with the convenience of your favorite finger foods and bursting with nutrients such as dietary fiber, Vitamin A, and Vitamin C. This satisfying recipe also contains 1 ½ servings of dairy. Dairy is an excellent source of calcium and also provides 8 other essential nutrients, see http://www.3aday.org/3aDay/yourhealth/pdf/Nutrients_in_Dairy_v_2.pdf.

Calcium: Recommendations

19-50 years old 1000mg/day

51+ years old 1200mg/day

Post-menopausal 1500mg/day

You may be taking a calcium supplement to help reach this recommendation. Calcium Citrate is one of the most easily absorbed forms of calcium.

Functions - Strong bones and teeth, muscle tissue, regulates heartbeat, muscle action and nerve function, blood clotting
Sources - Low fat or nonfat milk products, calcium fortified soy milk, green leafy vegetables

Tips to get more calcium in your diet:

1. Put a slice of cheese on your sandwich
2. Use skim or 1% milk instead of water to prepare soups, hot cereals, sugar free pudding
3. Substitute yogurt for sour cream, mayonnaise, or butter
4. Cook calcium-rich vegetables for a short time in a small amount of water or steam cook
5. In cooking, substitute ricotta for cottage cheese and gain an extra 257 mg of calcium per ½ cup
6. Practice moderation when drinking coffee, tea, and alcohol. Excess caffeine, oxalates (in tea), and alcohol can all hinder calcium absorption.

For more information, please visit www.nationaldairycouncil.org and www.3aday.org.

Zucchini Pizzas

2 zucchini about 2inches in diameter, peeled and cut into ¼ inch slices
Pizza sauce
2T. 2% milk fat mozzarella cheese, shredded

On each slice of zucchini place ingredients in order. Place on a baking sheet and broil until cheese is melted and bubbly, about 3-5 minutes.

Serving size: 2 each
Nutritional Information Calories: 95 Fat: 5g Protein: 8g Carbohydrates: 5g

This is an excellent meal choice that packs a ton of nutrition into a small bite. Zucchini contains a variety of vitamins and minerals including vitamin C, magnesium, thiamin, iron, phosphorus, riboflavin, niacin, vitamin B6, folacin (folic acid), and vitamin A. A ½ cup of zucchini meets 30% of the daily value for vitamin C and 8% of the daily value for fiber. The short cook time and dry cooking method in this recipe optimizes retention of vitamin C. The pizza sauce compounds the nutritional offerings as another vegetable and it’s topped off with a lean protein source.

Past Exercise News

You've probably heard countless times how exercise is "good for you." But did you know that it can actually help you feel good, too? Getting the right amount of exercise can “rev” up your energy levels and even help improve your mood.

Rewards and Benefits Experts recommend that people should get 45 minutes or more of moderate to slightly vigorous physical activity each day. Here are some of the reasons: Exercise benefits every part of the body, including the mind. Exercising causes the body to produce a chemical called an endorphin. This is a chemical that can help a person to feel more peaceful and happy. Exercise can help some people sleep better. It can also potentially help some people who have mild depression and low self-esteem. Plus, exercise can give people a real sense of accomplishment and pride at having achieved a certain goal — like beating an old time in the 100-meter dash. Exercising can help you look better. People who exercise burn more calories and look more toned than those who don't. In fact, exercise is one of the most important parts of keeping your body at a healthy weight. Exercise helps people lose weight and lower the risk of some diseases. Exercising to maintain a healthy weight decreases a person's risk of developing certain diseases, including type 2 diabetes and high blood pressure. These diseases, which used to be found mostly in adults, are becoming more common in teens. Exercise can help a person age well. This may not seem important now, but your body will thank you later. Women are especially prone to a condition called osteoporosis (a weakening of the bones) as they get older. Studies have found that weight-bearing exercise, like jumping, running or brisk walking, can help girls (and guys!) keep their bones strong.

There are three components to a well-balanced exercise routine: aerobic exercise, strength training, and flexibility training. In the next several months, we will discuss the benefits, similarities, and differences between each of the exercises.

New Years Resolutions

The New Year is here. During the holidays, you probably indulged in turkey, stuffing, pumpkin pie and many other tempting goodies. Now you step on the scale and much to your dismay, you've gained a few pounds in addition to the extra weight you may have already accumulated throughout the year. How can you make this the year to slim down and keep the weight off for good? Researchers say losing just five to 10 percent of your excess body weight can make a big difference in your health, including lowering cholesterol and reducing the risk for diabetes. So where do you start? You've all made New Years resolutions about getting back in the gym, beginning a new exercise program. But what happens after a few weeks? You'll notice that the health clubs describe you? The main reason why there's such a drop off of people at the heathat were packed at the beginning of the year are now back to normal levels. Does this lth clubs or why people just "give up" with their exercise is mainly due to loss of motivation, which can be attributed to not getting the results that you expected to be getting...The problem is not the exercise, but more that you are exercising incorrectly. You know exercise is good for you, and that it's in your best interest to make this the year you start and/or maintain regular physical activity. So you might be wondering, "Where do I begin?" It's a common question among many overweight individuals but one that appears to have an easy answer; EXERCISE! But it is a little bit more difficult than that...What specifically does one need to do with their exercise program to help maintain consistency? Here are some tips in maintaining your exercise program:
·Check with a doctor before beginning an exercise program.This is especially important as you get older or if you have a history of health problems.
·Keep an exercise log.This is a good way to keep you consistent and review your goals and remember why you're doing exercising.
·Wear comfortable shoes with good support when exercising.Nothing can derail an exercise program faster than a foot-related injury caused by poor footwear.
·Make thetime to exercise. Pick a time of the day when you'll always have time to exercise and stick to it. Don't make excuses not to exercise. Instead, try setting a schedule for the week indicating which days you'll exercise and the time.
·Find the right kind of exercise for you.Choose activities that you enjoy and that fit your personality
·Start slowly. This will help you achieve the most benefits with the least risk, especially if you have not been physically active for some time.
·Get up and move!Incorporate exercise during the day, even while you're at work. If you sit at a desk most of the day, get out of your chair at least once an hour and walk around. "Use the five minute per hour rule." Look for ways to just get up and move." Some suggestions: Take the stairs instead of the elevator, walk down the hall instead of using the phone or e-mail, or take a walk during a morning or afternoon break.
·Pace yourself. Make sure you're exercising at your target heart rate. This will help prevent you from overtraining and also help your body's ability to burn more calories while at rest.
·Find an exercise buddy.Get a friend or family member involved and be each other's motivator, or join a group. The advantage to this approach is that you know other people are counting on you and you don't want to let them down.
·Be patient. You did not gain all your weight in a month, so don’t expect to lose it all in that same time frame. ·Set short term goals. Have a weight loss goal at the end of each month. That way, it allows you to do be more focused on the job at hand. Long term goal planning can lead to procrastination. If you achieve all your short term goals, it will lead to a long term goal, eventually.
Reward yourself. Every time you achieve a short term goal, go reward yourself. (NOT to indulge yourself with ice cream and pizza). Reward yourself by buying newer and smaller clothes that fit your new body.

· Make exercise fun. If you buy home equipment, put it in front of the television. That way, you won't get bored when you're exercising. Varying your routine will also help you not only by keeping things fresh, but also avoid hitting long lasting plateaus.

· Strength train safely. When beginning a strength-training program, it's important to work with an expert (such as a trainer) who is knowledgeable about equipment and proper exercise methods. "You need someone to show you safe techniques for what to do". Read more information regarding our LifeWeigh Health and Fitness program.

Why Strength Train? Scientific research has shown that exercise can slow the physiological aging clock. While aerobic exercise, such as walking, jogging, or swimming, has many excellent health benefits—it maintains the heart and lungs and increases cardiovascular fitness and endurance—it does not make your muscles strong. Strength training does. Studies have shown that lifting weights two or three times a week increases strength by building lean muscle mass and bone density. One 12-month study conducted on postmenopausal women at Tufts University demonstrated 1% gains in hip and spine bone density, 75% increases in strength and 13% increases in dynamic balance with just two days per week of progressive strength training. The control group had losses in bone, strength, and balance. What is the significance of this: Improving lean body mass has shown to increase your resting metabolic rate, which is your body's ability to burn calories at rest. When you improve your ability to burn calories at a higher rate when you're not exercising, it makes your job a lot easier not only getting to your goal weight but also being able to maintain it. The significance of improving bone density is that you are able to reduce your risks of osteoarthritis or osteoporosis. Strength training programs can also have a profound effect on reducing risk for falls, which translates to fewer fractures.
Other Reasons Why?
Arthritis Relief Tufts University recently completed a strength-training program with older men and women with moderate to severe knee osteoarthritis. The results of this sixteen-week program showed that strength training decreased pain by 43%, increased muscle strength and general physical performance, improved the clinical signs and symptoms of the disease, and decreased disability. The effectiveness of strength training to ease the pain of osteoarthritis was just as potent, if not more potent, as medications. Similar effects of strength training have been seen in patients with rheumatoid arthritis.

Restoration of Balance and Reduction of Falls   As people age, poor balance and lack of flexibility contribute to falls and broken bones. These fractures can result in significant disability and in some cases fatal complications. Strengthening exercises, when done properly and through the full range of motion, increase a person's flexibility and balance, which decrease the likelihood and severity of falls. One study in New Zealand in women 80 years of age and older showed a 40% reduction in falls with simple strength and balance training.

Improved Glucose Control More than 14 million Americans have type II diabetes—a staggering three-hundred percent increase over the past forty years—and the numbers are steadily climbing. In addition to being at greater risk for heart and renal disease, diabetes is also the leading cause of blindness in older adults. Fortunately, studies now show that lifestyle changes such as strength training have a profound impact on helping older adults manage their diabetes. In a recent study of Hispanic men and women, 16 weeks of strength training produced dramatic improvements in glucose control that are comparable to taking diabetes medication. Additionally, the study volunteers were stronger, gained muscle, lost body fat, had less depression, and felt much more self-confident.

Healthy State of Mind  Strength training provides similar improvements in depression as anti-depressant medications. Currently, it is not known if this is because people feel better when they are stronger or if strength training produces a helpful biochemical change in the brain. It is most likely a combination of the two. When older adults participate in strength training programs, their self-confidence and self-esteem improve, which has a strong impact on their overall quality of life.

Sleep Improvement  People who exercise regularly enjoy improved sleep quality. They fall asleep more quickly, sleep more deeply, awaken less often, and sleep longer. As with depression, the sleep benefits obtained as a result of strength training are comparable to treatment with medication but without the side effects or the expense.

Healthy Heart Tissue Strength training is important for cardiac health because heart disease risk is lower when the body is leaner. One study found that cardiac patients gained not only strength and flexibility but also aerobic capacity when they did strength training three times a week as part of their rehabilitation program. This and other studies have prompted the American Heart Association to recommend strength training as a way to reduce risk of heart disease and as a therapy for patients in cardiac rehabilitation programs.

Staying motivated during the winter months People who are outdoor exercisers usually justify not working out as much during the winter months due to the poor weather conditions however there are some things you can do to allow yourself to be consistent with your exercise goals. Most of the time when moving your work outs from outdoors to indoors during the winter months, people tend to be less motivated and not exercise as much which will be detrimental to losing or maintaining ideal body weight. One thing you can do to keep yourself motivated is to consider moving your workout sessions from outdoors to indoors for safety and comfort. That's probably a lot easier to do for those of you who have been working out year after year, making the summer, fall and winter transition seamlessly and without any bumps in the road.
But for beginners and those who need a bit more motivation, changing your workout with the change of season may be more difficult. Perhaps you don't want to go through the hassle of finding a winter workout, or maybe you haven't found anything that compares with a summer filled with running along the lake, mountain biking or rowing on the river. But it's important to remember, experts say, that sticking to your workout all year can lead to improved health and fitness.
During the frigid, cold days of winter many people go to the local gym. If the weather turns nasty, the gym--with its climate-controlled environment and abundance of workout equipment--may be the best option for you. If you want a substitute for your morning neighborhood run, try the treadmill. If you want to continue your cycling routine, try the stationary bike. Hey, if you're paying for the equipment, you should use it.

Another way to stay motivated during the winter months is to join a class or try group exercises. High-energy, high-cardio workouts such as spinning, kick-boxing and aerobics are great ways to maintain your workout. Fitness classes are also a great way to meet other exercisers who may help to keep you motivated. Another advantage to working out at the gym is the equipment you have at your disposal. Some fitness centers have indoor courts. Want to shoot some hoops? Indoor basketball courts are a very popular attraction in some gyms. Once you're done with your cardio workout, either from the fitness class or the treadmill, you can proceed to the weight area for some strength training. The more complete your workout the better you'll feel. If you don't have the option of working out at a gym, you may want to try exercising at home. It can be a great choice, because you don't have to worry about using a lot of equipment and you can exercise any time you want. If you need more direction, consider buying a workout video or two, or write down and track how well you meet your fitness goals. If you've got cable TV, consider starting your day with your favorite TV instructor. It may also be the time to try something new. Why not invest in a treadmill, stationary bike or rowing machine to add a new dimension to your movements?

When it comes to working out, if you burn out or get bored easily, you might consider getting some of the latest equipment that can provide variety. You can change up your cardio workout by running on the treadmill for 30 minutes instead of working out with the exercise video. Resist the urge to hibernate during the winter months. Staying active will improve your circulation and help to build your immune system during peak cold and flu season, experts say. At-home workouts can also be fun and inexpensive. Try step aerobics on the stairs or jumping rope in the basement, anything to get--and keep--the body moving.

Target Heart Rate (THR)
Target heart rate (THR) training is an important tool to help lose weight and even more important for weight maintenance. One can use THR as a tool to determine whether to speed things up, slow things down, or maintain your pace that you're currently exercising at. It's important that you do not exercise too strenuously or vigorously because research shows that intense exercise compromises both consistency and duration and that those two factors are the most important factors regarding any exercise program. Studies have shown that the longer you exercise at your specific target, the more you improve your resting metabolism; which is your body's ability to burn calories while you're at rest. How long should someone be exercising at their specific target? Studies show that the majority of your work out should be at your THR, specifically 80% of your time. Heart rate is widely accepted as a good method for measuring intensity during running, swimming, cycling and other aerobic activities. Exercises that do not raise your heart rate to a certain level and keep it there for 20 minutes won't contribute significantly to cardiovascular fitness.
Target Heart Rate (THR)
The heart rate you should maintain is called your target heart rate. There are several ways of arriving at this figure. One of the simplest is: THR= (220 - age) x 50% (lower limit) -and- THR= (220 - age) x 75% (upper limit) (220 - age) is actually an estimate of your maximum heart rate. In other words, your THR during exercise should be about 50 percent to 75 percent of your maximum heart rate. Calculate both the lower and upper limit to find your THR zone. Your THR falls within this zone. When your heart rate reaches a value within this zone during exercise, it means you have achieved a level of activity that contributes to your cardiovascular fitness. Note: Your heart rate during exercise should not exceed the upper limit of this zone!
Individualized Target Heart Rate
Some methods for figuring the target rate take individual differences into consideration such as the karvonin method. For example:
1. Subtract your age from 220 to find Maximum Heart Rate.
2. Subtract resting heart rate (see below) from Maximum Heart Rate to determine Heart Rate Reserve.
3. Take 70 percent of Heart Rate Reserve to determine Heart Rate Increase.
4. Add Heart Rate Increase to Resting Heart Rate to find THR.
Resting Heart Rate
Find out your resting heart rate by taking your pulse after sitting quietly for five minutes. Count your pulse for 10 seconds, and multiply by six to get the per-minute rate. Exercise Heart Rate
When checking heart rate during a workout, take your pulse within five seconds after interrupting exercise because it starts to go down once you stop moving. Count your pulse for 10 seconds, and multiply by six to get the per-minute rate. Reasons for not being able to get your heart rate to your target zone:
1. Beta-blocker medications: Beta-blockers not only lower blood pressure but they also lower resting heart rate levels, making it difficult to get your heart rate up. If you're on a beta blocker, a good heart rate for you to be exercising at would be to calculate your resting heart rate and then to add 20-30 beats from your resting. For Example: An individual with a RHR of 65 would add 20-30 beats towards their resting making their exercise HR between 85-95 beats per minute.
2. Genetics: Some people genetically have a difficult time getting their HR not because they're not exercising hard enough, but because they're genetically inclined to. Lower your intensity percentage from 60-80% of your maximum HR to 50-70% , making it a bit easier.

Adjusting water intake

Water is the most abundant component of the body (60% + by weight), and is able to leave the body through skin pores, which allows for perspiration. Adequate hydration is very important in the maintenance of body temperature. When muscles contract they generate heat which must be dissipated from the core to the body surface. In order for this mechanism to work well one must have adequate water to maintain adequate blood volume. Nearly all the bio-chemical reactions that occur at the cell level in your body depend on water and electrolytes (sodium, potassium, calcium, chloride, phosphorous, magnesium, etc.). These balances are not only vital to maintaining life but also affect physical and mental performance.

Blood, kidney, heart and lungs are made of 80% or more water. Muscle, spleen, brain, intestines, & skin are 72 - 75% water. Bones have 22% water and fat tissue is 10% water. On a normal, moderate temperature, inactive day you would lose 1.5 liters (6 glasses) of water through kidney filtration (urine production) and another 0.750 - 1 liter (3 - 4 glasses) through the skin and respiration. So an average person needs 8 - 9 glasses of fluids per day just to replace average losses. It is true you get some of that from fruits, vegetables, other beverages and food. My "rule of thumb" for water requirements is weight in pound / 2 = oz. of water / day. Caffeinated, alcoholic and many carbonated beverages have a diuretic effect and actually increase the daily fluid requirements. One should choose water or a high quality sport beverage in some circumstances.

Naturally, daily fluid requirements will vary with environmental conditions, clothing and exercise intensity and duration. Even mild dehydration - 1% of body - which would represent approximately .75 to 1 litre of water (1% of 75 Kg = 750 ml.) can create a reduction in muscle performance and start to show dehydration symptoms. Early symptoms include: headaches, dry eyes (ask any contact lens wearer what happens after a couple of glasses of wine), drowsiness, loss of concentration, irritability. If the dehydration is 2 - 3 % , serious performance inhibition occurs. Muscle cramps are also a sign of inadequate fluid replacement and electrolyte loss, particularly potassium, calcium and magnesium. Even "Lactate threshold" - an indicator of maximal work performance ability is lowered which is not a good thing in high intensity, endurance competition. Thicker blood, fast heart rate, negative changes in blood pressure are other symptoms.

Don't wait until you are thirsty to decide to drink. Fluid replacement is part of a daily plan. Thirst is a late sign of dehydration and performance is already impaired. You actually lose significant fluid just sitting in an air conditioned car or office. Frequent drinks of water during a long automobile trip will reduce apparent road fatigue. The same applies to sitting at your desk. Here are typical water losses during exercise : 1 hour of weight training = 8 oz; 45 minutes of swimming = 10 oz, a softball game = 16 oz; 5 mile run = 24 oz, 45 minutes of full court basketball = 24 oz; bicycling for 1 hour = 33 oz. and a marathon = 116 oz.

As the weather gets warmer and more humid outside, you need to pay more attention to your hydration levels. Exercising or performing daily tasks outdoors in humid weather forces your body to use up more fluids and therefore, causes additional sweating. Be sure to increase the amount of water that you would normally consume to make up the difference in fluids lost. Also, an increase in either exercise intensity or duration will force your body to use additional fluids as well, so be sure that you're drinking more water with increased activity.

One last point - cool beverages are absorbed better than room temperature or warm beverages.

The 5 components of fitness are a necessary tool to not only help lose weight , but for weight maintenance as well. Earlier this year , we discussed 3 of the components "muscular strength/muscular endurance" and " cardiovascular conditioning " as being an important tool to help improve overall physical fitness levels. A fourth component that's equally important would include flexibiltiy. Flexibilty is defined as the measurement of the achievable distance between the flexed position and the extended position of a particular joint or muscle group. the flexibility of a joint depends on many factors, particularly the length and looseness of the muscles and ligaments due to normal human variation, and the shape of the bones and cartilage that make up the joint. More times than not , people do not place enough importance behind improving your range of motion and often times, flexibility is the one component of fitness that gets neglected in many work out sessions. However, this should not be the case. Improved flexibility has been shown to help minimize your risk of developing a muscular injury such as a possible muscle pull or worse, muscle tear. Many times people complain of muscle soreness in their lower backs when often times it is attributed to poor flexibilty in their lower back muscles. Improving your range of motion in your lower back will help release tension in your lower back and therefore minimize the discomfort level in that particular area. Improved flexibilty can help you perform your daily tasks at home and make them easier to perform. It can also aid with your weight/resistence traning exercises. Studies have shown that improved flexibility can help tone and condition your muscles as evidenced by yoga/pilates/dance classes. Flexibility is an important part of a healthful life. Being flexible means that you can reach up to take an item down from a bookshelf, for example, or bend down to tie your shoe laces, without feeling that your movements are restricted in any way. When you are young, you tend to take flexibility for granted. But as you start growing older, you need to spend a bit of time enhancing and maintaining your range of motion. Anyone can start a daily routine of simple stretches at any age to restore or increase that flexibility to your muscles as well as joints. Some studies show that you are never too old to reverse the reduced level of range of motion that comes with age. It really doesn’t matter as to how long it has been building up. Flexibility can be temporarily increased by regular stretching of the muscles either by performing specific exercises or by actively participating in activities that take the joints through their full range of movement and lengthens the muscles. Muscles are wrapped in connective tissues, which, rather like chewing gum, are resistant to being stretched when cold. For this specific reason, it is very important to attempt stretching exercises only when your muscles are warm. It is recommended that you stretch either after your warm up session or after your exercise all together. Stretching prior to warm up or exercise can increase your risk of a muscular injury. When the fibers of your muscles are cold, they are more susceptible of being injured. However, when muscles are more warmed up, they become more elastic and therefore much easier to stretch. When stretching, a slight degree of tension should be felt in the muscle. Attempting to stretch too far may cause physical discomfort or even pain and can further result in an injury. So in order to maintain your range of motion, stretches need to be held for at least ten seconds which gives connective tissues enough time to lengthen.

5/2007 The 5 components of fitness are a necessary tool to not only help lose weight , but for weight maintenance as well. Earlier this year , we discussed 2 of the components "muscular strength/muscular endurance" as being an important tool to help improve overall physical fitness levels. A third component that's equally important would include cardiovascular conditioning. Cardiovascular conditioning is defined as strengthening and conditioning of the heart and blood vessels. One of the many benefits of improved cardiovascular conditioning is that it helps improve stroke volume of the heart while it lowers resting heart rate. Stroke volume is the amount of blood your heart is able to pump out per each beat. When you lower your resting heart rate, it means that the heart doesn’t have to work as hard to do the same amount of work as before because it's pumping more blood. Your heart is muscle and if it's worked too hard, it will enlarge and not pump blood as efficiently as it should. Lack of exercise can lead to changes in the body that threaten the heart. If you combine lack of exercise with overeating, you gain excess weight and your cholesterol rises. This can lead to heart disease and circulation problems. As your body and heart become fit, your blood pressure lowers, HDL cholesterol, the "good" cholesterol, goes up, and you lose fat. All these changes are good for the heart. The American Heart Association advises doing 30 to 60 minutes of aerobic exercise at least three or four times each week. Exercising 4 or more times a week will increase your health benefits. Sticking to this advice advances heart and lung fitness. It's recommended for weight loss purposes , to exercise at least 5 days per week to help improve your body's resting metabolism. Your resting metabolism is your body's ability to burn calories while you're at rest. This is very significant in not only weight loss , but also in weight maintenance. Typical aerobic activities include: walking, hiking, jogging, bicycling, aerobic dancing and swimming. Aerobic exercise uses large muscle groups for a continuous period of time. The muscles need more oxygen to handle this workload. This requires the heart to beat faster. Your breathing gets heavier and faster to meet the demand for more oxygen. In order for your heart and lungs to benefit from your workout, you must exercise within the aerobic heart-rate range. There is an easy test to see if you are in that range. If you can breathe and speak without gasping, you are probably exercising in your aerobic range. If you can not talk comfortably to a companion while you're exercising, you should slow your pace. Get a medical checkup before starting any exercise program. Beginners should work with a certified exercise leader to be sure you're getting a proper workout program for your health needs. To learn more, visit your local bookstore or library, or call your local YMCA or YWCA.

Past Dr. Rosen News

Surgery News August, 2007 Bariatric Surgery Yields Long Term Cost Savings
A study performed out of the University of Pittsburg followed 67 patients that were morbidly obesity over a 3 year period. 37 patients underwent Bariatric Surgery and the other 30 received medical treatment for weight loss. The groups were matched to be similar and were from one insurance plan so all costs could be determined not calculated by formulas. The study showed there is a medical cost savings of 39% over the 3 year period for the Bariatric patients, about $6,000 for the three year period.

Laparoscopic Gastric Banding Deemed Safe, Effective for Teens.
A study out of New York University has shown in their 73 patients having Lap BAND surgery since 2001 that they can do well with good improvement or reversal of several co-morbidities. This is a group of patients that we are waiting to hear from the FDA for placement in the under 18 age group.

Diabetes Resolved after Bariatric Surgery
A study out of Australia has shown that 73% of patients had remission of their diabetes after Bariatric surgery compared to 15% of the patients that did not have weight loss surgery. This is in a group of patients with a BMI 30-40. The use of the medication Metformin was down to only 10% of the Surgery and patients and up to 90% of the control or non-surgical group.

General Surgery News August, 2007
Cost in Context: The Economics of Bariatric Surgery
11.5 Million People in the US are candidates for weight loss surgery. Only 200,000 were performed in 2006. Surgery with life style changes may be the only long term effective treatment for morbid obesity. By 3.5 years of follow up there is a break even point in cost in recouping costs from surgery.

From Surgery News Feb, 2007 and Surgery for Obesity and Related Diseases Jan/Feb, 2007:
Gastric bypass decreases risk factors for heart disease based upon biochemical markers in the blood including cholesterol, HDL, LDL, Hypertension, diabetes and inflammatory markers. These studies only addressed gastric bypass patients but we will keep an eye out for the Lap Band research as well.

From 7/2007

From June, 2007
Surgery for Obesity and Related Diseases 3 2007
Theories on why diabetes improves almost instantly after gastric bypass versus the Lap-BAND. Lack of the caloric stimulation on the smalll intestine that is bypassed may lead to less insulin resistance. Other theories work on the nutrients arriving in the later parts of the small intestine more quickly than in no bypassing. This response leads to a better tolerance of glucose in the blood system. These are theories that may have some validity and the basis for this explanation is from coolected data that state reversal of diabetes in some bypass operations may be as high as 80+% versus 50% in adjustable band data. The second conlusion is related to the fact this change in the diabetes may occur right after surgery in the bypass patients and not directly related to weight loss factors. We will follow this for future topics.

From the journal Obesity Surgery; 17, 920-925 July 2007.

Treatment with Lavender Aromatherapy in the Post-Anesthesia Care Unit reduces pain medication needs in patients having the Lap-BAND procedure.

This article from New York University followed 54 patients having Lap-BAND surgery. Lavender oil was applied to the oxygen mask used in the recovery phase after the operation. 82% of the patients without the therapy required Morphine for pain control. In the Lavender group only 46% of the patients required Morphine. The quantity needed of Morphine was also less in the Lavender group. This only suggests that aromatherapy may help reduce the demand and quantity of Morphine needed in this patient group. This may provide advantages in patients especially if they have sleep apnea and may not need narcotics after surgery. This is something to watch for the future. This is not a conclusive study and will not change all treatments until studied further and the results reproduced.

From Bariatric Times June, 2007 The Endocannabinoid System as a Mechanism Regulating Appetite and Energy Balance

Can the receptors that are affected by cannabinoids cause hunger as seen when people take marijuana. Several studies have shown the receptors and proteins that control mechanisms related to the cannabinoids help in hunger and energy metabolism. There is a CB (cannabinoid) blocker Rimonabant that can help control hunger and has in early trials led to some improvement in weight loss, waist size, insulin resistance and serum triglycerides. The weight loss average at 1 year was 6.3 Kg for patients with a BMI ≥ 30 or BMI≥27 with obesity related comorbidities for more than 2 years. Side effects included: anxiety, depressed mood, nausea, fatigue, dizziness, upper respiratory tract infection, headaches, diarrhea and vomiting. The drop out rate was 51% despite good weight loss. These medications may show promise in the treatment of obesity but we will wait to see if the FDA approves this medication.

Past Barb News

Kitchen Management Ghost summary also by Briana
(Summary of article by Dave Fouts, “Kitchen Management for the Bariatric Patient” from May 2007 Bariatric Times)Eating out may be preceived as quick and easy, but can challenge your diet program. Most restaurant foods are high in calories and the portion sizes are overwhelming. Your kitchen is the crucial area in the home where all the nutrients and micronutrients that your body needs are found to keep you healthy and fit. Plan ahead and schedule time for meal preparation and meal time. Make meal planning a priority. Plan your meals for a week- breakfast, lunch, and dinner, and snacks. The first planning may take more than an hour, but as plans are set, they can easily be modified. Plan what resources will be needed when eating meals, i.e. refrigerator, microwave. To save time, choose foods that have already been cut up or cooked. An example, roasted chicken can be used in salads or fajitas. Try to avoid prepared frozen meals; many are high in fat, sodium, and calories. Be sure to read the labels. Some good choices include: Wishbone salad spritzers, Mrs. Dash 10 minute marinades, Amy’s vegetarian organic refried beans, Kashi entrees, and Morning Star Farms lentil rice or nine bean loaf. Also, be sure to keep the following staples stocked in your pantry: beans, brown rice, oatmeal, and barley. Choose fruits and vegetables that are on sale and in season. Consider keeping some frozen vegetables in your freezer so that you always have a variety on hand. Whole Foods or a Boston Market has prepared foods that are quick and healthy. Good selections include: sesame crusted salmon, roasted sirloin, fresh steamed vegetables, and seasonal fresh fruit salad. Make a shopping list before going to the store and shop for only what is on the list. This not only saves time and money, but also ensures healthy food selection. Food preparation hints: For quick cooking, choose thinner cuts which will cook faster. Thick cuts use a slow cooking method such as a crock pot. When preparing foods that do not require cooking such as cheese, raw vegetables, and lunch meats, cut them bite size. Use low-fat salad dressing to add flavor. Good nutrition and healthy eating are within reach regardless of time with careful planning and the right resources. Other hints:· Pack meals/snacks in ½ cup containers or snack size bags to help with portion size· Use small plates· Always carry water bottle or calorie free beverage for adequate fluid intake. There are many varieties of calorie free powders available.
Obstructive Sleep Apnea

4/07 Alcohol Use after Weight Loss Surgery
(Summary of article by Cynthia K. Buffington, “Alcohol Use and Health Risks: Survey Results” from March 2007 Bariatric Times)
Gastric bypass surgery may enhance alcohol sensitivity by changing the rate alcohol is absorbed and metabolized. This increases the risk of alcohol toxicity leading to liver disease, cardiomyopathy (disease of the heart), loss of muscle mass and strength, neuromuscular and cognitive defects, stomach irritation, pancreatitis, acid reflux, and vitamin deficiencies. Alcohol use may also increase the risk of hypoglycemia (low blood sugar). There is also risk of addiction transfer from food to alcohol. A survey was conducted with over 300 patients on the affects of alcohol after surgery. According to the survey, 83 percent had consumed alcohol after surgery and reported that they were far more sensitive to the effects of alcohol. Many (44%) could ‘feel’ the effects of alcohol after a few sips. Increased alcohol sensitivity following gastric bypass is most likely due to a more rapid increase in the rate of alcohol absorption. Alcohol quickly passes from the pouch to the jejunum and is rapidly absorbed. Gastric bypass patients also have a quicker peak of blood alcohol content than someone who has not had an alteration in gastrointestinal anatomy. The length of time the effects of alcohol persist can be longer or shorter than before surgery. The alcohol is metabolized by the liver and a variety of processes which may be dependent on body fat mass. Alcohol may cause low blood sugar by interfering with the body’s ability to break down glucose, generate glucose, lowered response to stress hormone, and inappropriate insulin secretion. According to the survey, 49% of respondents said they had symptoms of hypoglycemia when drinking alcohol. The symptoms occurred after 1 or 2 drinks and lasted up to 2 hours. Addiction transfer is another concern with alcohol usage. In the survey, 28.4% pf participants reported having a problem with alcohol control. In contrast, only 4.5% of patients said they had a problem managing their use of alcohol prior to surgery. Dr. Rosen addendum: Alcohol may affect Lap-BAND patients in similar ways as there is not a large amount of food in the stomach and this may lead to a faster absorption of the alcohol into your body. Please be very careful when taking alcohol because of the side effects mentioned above and the faster elevation of serum blood alcohol levels.

4/2007

When it comes to losing weight or weight maintenance, people tend to focus only on diet and not enough emphasis is placed on exercise. Exercise will play a pivotal role in helping improve your resting metabolism. Your metabolism can be described as your body's ability to burn calories while at rest. An easy way to make sure that you are doing enough exercise is to follow an exercise program based on the 5 components of fitness. The first two components of fitness include muscular strength and muscular endurance. Strength conditioning is defined as training in which the resistance against a muscle generating a force is progressively increased over time. The main difference between muscular strength and muscular endurance is the number of repetitions and amount of resistance. In muscular strength, one would add more resistance and perform less repetitions over time; usually muscular strength would be anywhere between 6-10 repetitions while muscular endurance would be 12-18 repetitions with less resistance. Resistance levels are usually determined based on a 1-rep max or an estimate of one. 1-rep max means the amount of weight or resistance your muscle is able to perform one time. Traditionally, muscle strength has been shown to increase in response to training between 60 and 100% of the 1 RM. 1-rep max generally applies to the large, core muscles of the body. Examples of this would be for the chest/bench press, hamstrings/squats, quadriceps/leg press or lunges, and the back/lat pull downs or seated rows. It would not apply to the assisting muscles, such as biceps, triceps, or abdominals.
BENEFITS
Improving muscular strength and endurance has been shown to improve overall bone density. This is important for women who are more susceptible in developing osteoarthritis or osteoporosis as they continue to get older. Strength training can minimize these risks. Improved muscular strength and endurance has also been shown to improve your lean body mass, which is the quality weight of the muscles, bones, tendons, and joints. This is especially important since your lean body mass regulates your metabolism. Muscle burns more calories per minute than fat does so the more muscle you have, the more calories your body will be able to burn during exercise and at rest. Strength training also helps improve insulin action and your ability to perform your daily tasks and chores at home. To make your weight loss goals attainable incorporate these components into your exercise program.

(Summary of article by Stephanie B. Jones, MD, Jeffrey M. Ellenbogen, MD, and Daniel B. Jones, MD, FACS, “Perioperative Implications of Obstructive Sleep Apnea” from April 2007 Bariatric Times) Obstructive sleep apnea is a serious medical condition that leads to a reduced quality of life and increases risks of complications after surgery. It is estimated that this may occur in as high as 77% of morbidly obese patients. Obstructive sleep apnea is defined as the complete stopping of breathing or the reduction of airflow while sleeping. This results in restless sleeping, frequent awakenings, and daytime sleepiness. This can lead to stress on the heart, high blood pressure, stroke, or even death.
Careful screening can help identify patients who are at risk for having obstructive sleep apnea. Some signs include: daytime sleepiness, snoring, restless sleep, frequent waking, falling asleep while driving, frequent need for nap, memory problems. Diagnosis is made in a sleep laboratory by observing the patient as they sleep.
Treatments include: CPAP (continuous positive airway pressure), BiPAP (bilevel positive airway pressure, oral appliances (to move the jaw forward to open the airway for those with mild obstructive apnea), surgery to remove airway tissues, autotitration CPAP (variable pressures).

Dr Rosen comment: Many patients are suprised when they are diagnosed with sleep apnea. We recommend if you have CPAP or Bi-PAP to get retested 6-12 months after weight loss surgery if you have had a good weight loss. The pressures of the machine may be too high and you may not need the machine.

From Bariatrics Today 2007 Issue I

Rome Diabetes Surgery Summit The hopes of this conference include the following about forming a consensus statement: Bariatric surgery in particular gastric bypass has properties that enhances glucose tolerances and may help diabetes regardless of the weight loss component. Bariatric surgery may be an option for patients with BMI 30-35 with Type II diabetes. If this does occur and societies also accept this then there may be a change in insurance carriers to cover weight loss surgery even in lower BMI patients. We will not know these outcomes for many months to years.

From Bariatric Times Vol 4 Number 3

Transfer of Addiction and Considerations for Preventative Measures in Bariatric Surgery: Part II. Education of the possibility of addiction transfer is a priority. Acknowledging that addiction transfer exists is one of the important steps in helping the patient identify if a problem may exist. Addiction transfer may show up as uncontrolled spending, food or alcohol consumption, drug related problems, smoking, sexual promiscuity or compulsive gambling. Learning from Alcoholics Anonymous may help us understand that addictions are life long. In order for patients to identify early signs of addictive behavior education before and after surgery may be helpful. Patients need to find healthy coping mechanisms and apply lifestyle changes to curb the addiction.

4/07
In the Bariatric Times Jan/Feb edition there are 2 excellent articles related to morbid obesity. Please check out the website by clicking here, Resources. The first article is related to Body Weight Regulation. This article describes in detail the many hormones and neuropeptides that influence hunger and satiety. I found this to be interesting but the final message is that we know there are many pathways to weight maintenance but we do not understand them as yet. As stated in the article: The old adage "You are what you eat" should be modified to "You are what you eat, adjusted for genetic influence, leptin resistance, effect of medication, ethnicity and exposure to viruses."
The second article of interest is related to our last Support Group Meeting 2/2007 click here to review our meeting on Addiction Transfer. This article traces some of the history of Psychological testing for Bariatric Surgery. There are two concepts I found to be of interest. The first idea is the Psychological Satiety, described as the feeling of well being. The lack of this satiety may lead a person to Cravings and Inability to control their own behaviors. This may be a reflection upon their reaction to their own affect, feelings and emotions. This may explain the shame feelings some patients have for the inability to control their eating behaviors. If this sounds familar this is very similar to the feelings of an addicted patient to drugs or alcohol. One can live without the drugs or alcohol but one cannot live without food. Coping mechanisms also play a very important role for everyone. This is why we discuss coping skills before after surgery otherwise the lack of coping skills can lead to addiction transfer to other substances. We do know that there is no cure to addictions. If we look at bariatric surgery in similar ways to a recovery program we are providing the patient to help control the addiction. Please see the article for more information. There is a part 2 coming out next month.