Recent Bariatric and Healthy Living News

Pregnancy in Obese Women                                                        Added December 17, 2008 

The following is a summary of the article “Pregnancy in obese women: What you need to know” from Contemporary OB/Gyn, November 2008:

  • It is estimated that approximately one third of pregnant women are obese in the United States.  Both overweight and obesity are linked with a number of maternal and fetal complications.
  • The complications can include gestational diabetes and hypertensive disorders in the mother, and congenital malformations such as heart and neural tube defects in the baby.  The risk of an infant who is stillborn also increases.  In fact, the risk of fetal death is more than twice the rate in obese women.
  • Prepregnancy management can make a big difference to decreasing the above risks as well as additional risks to the infant later in life.  Research shows that infants born to mothers with a higher weight during pregnancy are more likely to become obese as adults.
  • If you are overweight or obese and are planning to become pregnant, please discuss your plans with your physician.  Weight loss can prevent complications and also increase your fertility.  Management of obesity during pregnancy usually involves the avoidance of excessive weight gain.  Significant weight loss during pregnancy is generally discouraged.
  • Weight loss surgery is one tool that can be used to help morbidly obese patients.  There is evidence showing that obese women undergoing bariatric surgery to revert to a lower weight prior to pregnancy can prevent the complications described above.  It’s important to note that pregnancy is not recommended until at least 12 months after bariatric surgery.  At LifeWeigh we recommend waiting 18-24 months.
  • If you are overweight or obese and are currently pregnant, discuss a balanced diet with a dietitian to ensure you can meet all your nutritional needs without gaining excessive weight.  Supplemental folic acid up to 5 mg may also be recommended as obesity is associated with lower blood values and an increased risk of neural tube defects.  However, do not take any supplements without first discussing your needs with your physician.
  • It is important to get back to a healthy weight after your pregnancy as well.  A nutritionally balanced diet and exercise are just as essential during the post-partum period.                

                                                                                   -Summary compiled by Sherrill Johnson, RD, LDN

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Healthy Eating News

Hair Loss in the Bariatric Patient

Hair loss is a concern for many people, including bariatric patients.  Hair loss has many causes.  Those causes specific to the bariatric patient include: major surgery, rapid weight loss, low protein intake, iron or zinc deficiency and certain medications such as beta blockers, anticoagulants or retinoids.  Hair loss rarely lasts more than six months unless there is a dietary cause.  Iron deficiency is often linked to hair loss and research indicates that a ferritin level less than 40 ug/L is highly associated with hair loss in women.  Low protein intake is also associated with hair loss.  Bariatric surgeries that reduce the size of the stomach, which in turn reduces hydrochloric acid, pepsinogen and normal stomach churning, may contribute to maldigestion of protein which could result in hair loss.  Hair loss can also be caused by thyroid disease and polycystic ovarian syndrome.  Genetics also plays a role.  If you are a recent bariatric patient and are experiencing hair loss, know that time and patience and good nutrition will help hair grow back.  If you had bariatric surgery more than six months ago, speak with your Physician. 


Healthy Activity News 

HEART RATE MONITORS
It is significantly important to monitor your heart rate during exercise if you truly want to maximize your potential weight loss benefits...Studies have shown that by monitoring your heart rate during physical activity, one can expect to improve your resting metabolic rate or resting metabolism...Your resting metabolism is your body's ability to be able to burn calories while you're at rest...Why is this significant? We're at rest most of the time and not exercising...Often times, we can get so concerned with how many calories we're burning while we're on the treadmill, but you should be more concerned with how many calories you're burning when you step off of it...Most of the time we're not exercising, so if you can improve your body's ability to burn more calories while at rest, it will make your job much easier not only getting to your goal weight but more importantly, being able to keep it there...Now you might ask what does resting metabolisms have to do with heart rate monitors? Good question but here's an even better answer...Long term studies show that the longer you exercise at your target heart rate, the more you improve your resting metabolism...The best way to figure out what your target heart rate, is to make an appointment with Life Weigh for and exercise assessment...The best way to monitor your heart rate, is by simply using a heart rate monitor...

A heart rate monitor is a device that allows a user to measure their heart rate in real time. It usually consists of two elements: a chest strap transmitter and a wrist receiver (which usually doubles as a watch). Strapless heart rate monitors are available as well, but lack some of the functionality of the original design. Advanced models additionally measure heart rate variability to assess a user's fitness.
The chest strap has in contact with the skin to monitor the electrical voltages in the heart. When a heart beat is detected a radio signal is transmitted, which the receiver uses to determine the current heart rate. This signal can be a simple radio pulse or a unique coded signal from the chest strap; the latter prevents one user's receiver from using signals from other nearby transmitters.
There are a wide number of receiver designs, with all sorts of advanced features. These include average heart rate over exercise period, time in a specific heart rate zone, calories burned, and detailed logging that can be downloaded to a computer.
Heart rate training are not only used by world class athletes for improved performance, but also everyday people as well...From runners, joggers, bicyclers, and swimmers, to walkers, and people performing either water or chair aerobics...The brand name "Polar", were the first to come up with heart rate monitors and are the best ones on the market...You can purchase your Polar Heart Rate Monitor at Life Weigh by calling our Downers Grove office at 630-261-9393...

Bariatric News from Dr. Rosen

Surgery for Obesity and Related Diseases 3 (2007)

Participation in 150 min/wk of moderate or higher intensity physical activity yields greater weight loss after gastric bypass surgery.

This is a study from Virginia Commonwealth University and The Miriam Hospital in Rhode Island. This study compared the weight loss outcomes at 12 months from gastric bypass surgery in relation to a patient’s participation in 150 minutes or more per week of moderate to higher intensity exercise compared to those not meeting this requirement.

They followed several hundred patients at 3, 6 and 12 months after gastric bypass surgery. They found the patients that followed their recommendations of 150 minutes or more per week did significantly better in weight loss, %excess weight loss, total %weight loss and BMI reduction than other patients who did not comply with the exercise recommendations.

The reason for the better outcomes can be related to several reasons but some of the theories include improvement in Basal Metabolic Rate (BMR) and maintaining muscle mass. BMR is your ability to burn calories while you are at rest. When one decreases their caloric intake then the BMR decreases as well. We discuss this with each patient whether a patient has weight loss surgery or non-surgical weight loss. The study addresses gastric bypass patients but can be applied to Gastric Banding patients as well.

We encourage you to find an efficient way to get your exercise accomplished for the week. Call our exercise physiologist to set up an exercise assessment to help establish your 150 minutes of exercise per week. The exercise time is important but during that time you must be efficient that is being in the right range of intensity of the work out

Bariatric News from Barb MacTaggart

Obesity in Young Children  Summary of article by Deborah Krepcio, RN, MSN, CPNP, Kathleen Foell, RD, MS, Sara C. Folta, PhD and Jeanne P. Goldberg, RD, PhD

Childhood obesity is a rapidly growing health problem which extends across populations, races, ethnicity, income, or education.  Children in the U.S., ages 2 to 5, approximately 26% are overweight (greater than the 85th percentile on BMI charts).  Weight problems lead to other health problems.  Obesity is the most common cause of abnormal acceleration of growth in childhood.  It leads to early puberty in girls and abnormalities in sexual development in boys. Diabetes mellitus is becoming more prevalent also.  Obese children are more likely to become obese adults, and obese adults have a greater risk of developing health problems such as hypertension, dyslipidemia, coronary heart disease, diabetes mellitus, gallbladder disease, respiratory disease, certain cancers, gout, and arthritis.  Childhood obesity has psychosocial consequences also.  Studies have shown that even young children are sensitized to obesity, and older children rank overweight children as low potential friends.

Causes of childhood obesity:  Hormonal imbalances are rare, and account for less than 1% of children.  Inactivity contributes to obesity and has been documented even in babies less than a year old.  The percentage of body fat is inversely related to their activity level.  Dietary trends also contribute to obesity.  Compared to 25 years ago, children have doubled their intake of soda (almost all is regular, not diet).  Children are also consuming foods higher in calories, such as pizza and snack foods.  Consumption of vegetables has decreased, except for fried potatoes, which has increased.  Families eat more meals away from home, and these meals typically have more fat and saturated fat, less dietary fiber, and less nutrients, and large portions.  Television viewing also contributes to obesity, not only because it displaces physical activity, but also food intake increases.  Children view advertising which affects food preferences.  Typically, these foods are nutrition poor.

Interventions:  Limit children’s television and video game time.  Keep a food diary and review with a health professional.  Avoid using food as a reward for good behavior or to keep the child occupied.  Schedule meal and snack times.  Caloric restriction is ineffective for managing children’s weight.  Encourage children to eat slowly.  Eating should not be in front of the TV.  Decrease the amount of calorie dense foods offered to the child.  Encourage physical activity the entire family can participate together.  Make realistic goals with one or two changes at a time with positive reinforcement  

Dr. Rosen Note:  This is the same calories in – calories out equation we all talk about.  We are learning that our bodies and minds can influence this equation to a great extent and there are multiple influences including genetics that can make calories in worse and our society can make the calories out less.  Let’s all work on these for all of our families to become healthier.

General Health (Outside source)

Science Topics (Outside source)