Worth a read, and worth a watch. This mimics a bit of my experience, my family's experiences, and brings up some (deeper) questions. As someone who's had gastric bypass in 2004, I'm always intrigued at any new science that's discovered about the gut - brain connections.
"Nearly 200,000 Americans have bariatric surgery each year. Yet far more — an estimated 24 million — are heavy enough to qualify for the operation, and many of them are struggling with whether to have such a radical treatment, the only one that leads to profound and lasting weight loss for virtually everyone who has it. Most people believe that the operation simply forces people to eat less by making their stomachs smaller, but scientists have discovered that it actually causes profound changes in patients’ physiology, altering the activity of thousands of genes in the human body as well as the complex hormonal signaling from the gut to the brain."
"Obesity and excess weight is an expanding health problem for more than 60 percent of Americans, and a new study by Hugh Waters and Ross DeVol finds that it's a tremendous drain on the U.S. economy as well. The total cost to treat health conditions related to obesity—ranging from diabetes to Alzheimer's—plus obesity's drag on attendance and productivity at work exceeds $1.4 trillion annually. That's more than twice what the U.S. spends on national defense. The total, from 2014 data, was equivalent to 8.2 percent of U.S. GDP, and it exceeds the economies of all but three U.S. states and all but 10 countries. The report also highlights how this public health challenge can best be addressed."
Is obesity something that we should be tackling? My gut (no pun intended) says OMG OF COURSE YES, because we are looking at some very preventable disesases. Those are some cah-razy numbers. However, does the pharmaceutical industry care? I mean: obesity is Big. Money.
We moved house on Halloween, and in the process, my scale lost it's batteries.
I have avoided quite successfully, replacing the batteries to the scale. The scale, with it's cracked plastic face, still weighs and measures quite accurately and is that what I am afraid of? It hasn't been very long since I checked in with that scale. And my eating hasn't changed much at all, as it never does. I eat what doesn't kill me, and occasional OH MY GOD I MIGHT DIE BECAUSE I ATE THAT YOU SHOULD HAVE WARNED ME foods. I have been one of the most boring-est eaters since weight loss surgery you might ever know.
What I do know is that I am in need of clothes, it's nearly winter and I was wearing maternity clothes in a bigger size last year, and I have nothing right now that fits me appropriately and I really did not want to start this season in my kids' hand me downs. I am in that NO YOU CAN'T GAIN ANYMORE range, I know it. I don't need a scale to tell me that I can hold up a pair of size 14 jeans on my regain butt.
Then again, I'm also okay at this size, because it's also where I land every time I just simply eat what I feel like having without drama. Does that make any sense to you? I feel like if I just added exercise to my current-state-of-toast-and-protein, I would trickle back to my tighter self. Honestly, it's the lack of Doing, not the Poor Eating. I am a decent, not super, decent, better than many, eater. A few days a week of moving my ass would really do the trick.
Could someone just sell that as an edible product -- motivation? Because I don't have it. Aside from running a 13 month old up and down stairs, it's just not happening. All the advice in the world, I'll find excuses.
I know I haven't blogged in regular blogs, but we've spent the last two weeks moving -- and move day (s) turned into Hell Week.
This is mostly why.
Thank you CASEY MOVERS of Rockland, MA. (Waits for ads to change)
After a failed "full pack," Casey's "professional packers" left us with truck loads of stuff to pack before our buyers came to the house for their final real estate walk through. We were thoroughly embarrassed as we packed the last of our household into our own cars in the pouring rain, while the 18-wheeler LEFT US without taking everything.
On move in day, the movers showed up hours and hours LATE. After arriving, the mover team leader informed us that they "did not feel like" unloading the truck" and were going to go home for the night. WE WAITED ALL DAY LONG IN AN EMPTY HOUSE AND GOT BABYSITTERS TO UNLOAD THIS TRUCK. They did not "feel like" emptying the truck and wanted to sleep. The smell of vanilla cigars OVERWHELMED ME and I was disgusted at the men sleeping in my street in the van.
We asked that if they were going to LEAVE, please unhook the trailer in front of the property. They attempted to turn around the 53 foot truck in our brand-new cul-de-sac and GOT IT STUCK. Then, after un-sticking it, they TIPPED IT OVER!
"Currently, Samantha's work focuses on conceptual portraiture, allowing her to explore human emotion from the inside out. She is working on an on-going self-portrait series focused on body image and healing that challenges viewers to question what is means to accept oneself. "
If everything goes as it should, the movers arrive in one month.
One 53 foot long truck. One day. Five men. All mine.
I asked for movers. Mr. MM works often seven days a week (he is working right now, it's a seven day week - fourteen day week - 28 day? I don't know?) and just, no. We don't have that much stuff, but moving from a house with three flights of stairs to another with the same - is a lot of painful lifting and, no. I don't have local friends. Call me lazy if you'd like. I've had enough head injury in the last year to say, HELL NAH I AIN'T DOING IT.
"Good luck getting help, too." It's easier just to put the crazy cost of moving on a credit card, paying it off with the next bonus, and skipping the potential vacation next summer. (Yeah, we skipped it this year too, because Elliott.)
If you have not bought or sold a house before, it can get quite expensive on either side. Stuff pops up (either expected, like inspections, known problems....) or unexpectedly like things that you simply must have done for a buyer's mortgage to go through. (There's many rules and regulations based on the kind of buyer.) We did not live here long enough or earn that much equity to really make out on the deal. We put a lot of money into the house, and you don't usually get it back.
In funner news! Cleaning up! Packing, a little? And...
We have to eat up all the remaining fresh food and the kids are like, this is all that is left:
Except I got the off-brand kind, and it's not EVEN THE SAME.
We have some serious problems over here. I'll be blogging real quick because I need to make grocery money.
Cows eat grass. Babies eat grass. It's good for, fiber, right? Fiber in, uh, this form, hurts my old cranky gastric bypass belly. I get (excuses) bezoars (/excuses) and I eat toast instead. I'm not suggesting that one goes and eats grass, but some things I see Dieters Eat isn't much different than what this baby got in during his outside play yesterday. :x You don't have to tell me to worry about "your baby eating gross that's so gross do you know what might be in there?!" Yes. He's baby number five. A lot worse will be eaten. Salad, anyone?
Earlier this year, the Food and Drug Administration approved a new weight-loss procedure in which a thin tube, implanted in the stomach, ejects food from the body before all the calories can be absorbed.
Some have called it “medically sanctioned bulimia,” and it is the latest in a desperate search for new ways to stem the rising tides of obesity and Type 2 diabetes. Roughly one-third of adult Americans are now obese; two-thirds are overweight; and diabetes afflicts some 29 million. Another 86 million Americans have a condition called pre-diabetes. None of the proposed solutions have made a dent in these epidemics.
Recently, 45 international medical and scientific societies, including the American Diabetes Association, called for bariatric surgery to become a standard option for diabetes treatment. The procedure, until now seen as a last resort, involves stapling, binding or removing part of the stomach to help people shed weight. It costs $11,500 to $26,000, which many insurance plans won’t pay and which doesn’t include the costs of office visits for maintenance or postoperative complications. And up to 17 percent of patients will have complications, which can include nutrient deficiencies, infections and intestinal blockages.
It is nonsensical that we’re expected to prescribe these techniques to our patients while the medical guidelines don’t include another better, safer and far cheaper method: a diet low in carbohydrates.
Once a fad diet, the safety and efficacy of the low-carb diet have now been verified in more than 40 clinical trials on thousands of subjects. Given that the government projects that one in three Americans (and one in two of those of Hispanic origin) will be given a diagnosis of diabetes by 2050, it’s time to give this diet a closer look.
When someone has diabetes, he can no longer produce sufficient insulin to process glucose (sugar) in the blood. To lower glucose levels, diabetics need to increase insulin, either by taking medication that increases their own endogenous production or by injecting insulin directly. A patient with diabetes can be on four or five different medications to control blood glucose, with an annual price tag of thousands of dollars.
Yet there’s another, more effective way to lower glucose levels: Eat less of it.
Glucose is the breakdown product of carbohydrates, which are found principally in wheat, rice, corn, potatoes, fruit and sugars. Restricting these foods keeps blood glucose low. Moreover, replacing those carbohydrates with healthy protein and fats, the most naturally satiating of foods, often eliminates hunger. People can lose weight without starving themselves, or even counting calories.
Most doctors — and the diabetes associations — portray diabetes as an incurable disease, presaging a steady decline that may include kidney failure, amputations and blindness, as well as life-threatening heart attacks and stroke. Yet the literature on low-carbohydrate intervention for diabetes tells another story. For instance, a two-week study of 10 obese patients with Type 2 diabetes found that their glucose levels normalized and insulin sensitivity was improved by 75 percent after they went on a low-carb diet.
At our obesity clinics, we’ve seen hundreds of patients who, after cutting down on carbohydrates, lose weight and get off their medications. One patient in his 50s was a brick worker so impaired by diabetes that he had retired from his job. He came to see one of us last winter, 100 pounds overweight and panicking. He’d been taking insulin prescribed by a doctor who said he would need to take it for the rest of his life. Yet even with insurance coverage, his drugs cost hundreds of dollars a month, which he knew he couldn’t afford, any more than he could bariatric surgery.
Instead, we advised him to stop eating most of his meals out of boxes packed with processed flour and grains, replacing them with meat, eggs, nuts and even butter. Within five months, his blood-sugar levels had normalized, and he was back to working part-time. Today, he no longer needs to take insulin.
Another patient, in her 60s, had been suffering from Type 2 diabetes for 12 years. She lost 35 pounds in a year on a low-carb diet, and was able to stop taking her three medications, which included more than 100 units of insulin daily.
One small trial found that 44 percent of low-carb dieters were able to stop taking one or more diabetes medications after only a few months, compared with 11 percent of a control group following a moderate-carb, lower-fat, calorie-restricted diet. A similarly small trial reported those numbers as 31 percent versus 0 percent. And in these as well as another, larger, trial, hemoglobin A1C, which is the primary marker for a diabetes diagnosis, improved significantly more on the low-carb diet than on a low-fat or low-calorie diet. Of course, the results are dependent on patients’ ability to adhere to low-carb diets, which is why some studies have shown that the positive effects weaken over time.
A low-carbohydrate diet was in fact standard treatment for diabetes throughout most of the 20th century, when the condition was recognized as one in which “the normal utilization of carbohydrate is impaired,” according to a 1923 medical text. When pharmaceutical insulin became available in 1922, the advice changed, allowing moderate amounts of carbohydrates in the diet.
Yet in the late 1970s, several organizations, including the Department of Agriculture and the diabetes association, began recommending a high-carb, low-fat diet, in line with the then growing (yet now refuted) concern that dietary fat causes coronary artery disease. That advice has continued for people with diabetes despite more than a dozen peer-reviewed clinical trials over the past 15 years showing that a diet low in carbohydrates is more effective than one low in fat for reducing both blood sugar and most cardiovascular risk factors.
The diabetes association has yet to acknowledge this sizable body of scientific evidence. Its current guidelines find “no conclusive evidence” to recommend a specific carbohydrate limit. The organization even tells people with diabetes to maintain carbohydrate consumption, so that patients on insulin don’t see their blood sugar fall too low. That condition, known as hypoglycemia, is indeed dangerous, yet it can better be avoided by restricting carbs and eliminating the need for excess insulin in the first place. Encouraging patients with diabetes to eat a high-carb diet is effectively a prescription for ensuring a lifelong dependence on medication.
At the annual diabetes association convention in New Orleans this summer, there wasn’t a single prominent reference to low-carb treatment among the hundreds of lectures and posters publicizing cutting-edge research. Instead, we saw scores of presentations on expensive medications for blood sugar, obesity and liver problems, as well as new medical procedures, including that stomach-draining system, temptingly named AspireAssist, and another involving “mucosal resurfacing” of the digestive tract by burning the inside of the duodenum with a hot balloon.
We owe our patients with diabetes more than a lifetime of insulin injections and risky surgical procedures. To combat diabetes and spare a great deal of suffering, as well as the $322 billion in diabetes-related costs incurred by the nation each year, doctors should follow a version of that timeworn advice against doing unnecessary harm — and counsel their patients to first, do low carbs.
Sarah Hallberg is medical director of the weight loss program at Indiana University Health Arnett, adjunct professor at the school of medicine, director of the Nutrition Coalition and medical director of a start-up developing nutrition-based medical interventions. Osama Hamdy is the medical director of the obesity and inpatient diabetes programs at the Joslin Diabetes Center at Harvard Medical School. A version of this op-ed appears in print on September 11, 2016, on page SR1 of the New York edition with the headline: The Old-Fashioned Way to Treat Diabetes.
We were able to successfully find a buyer on the first day of showings and that meant that we had the Find A House Immediately. Why are we doing this?! Because, my parents sold their house (my childhood home) and moved in. Our house isn't large enough to fit myself, the husband, the five kids AND my parents. We discussed doing just this a year or two ago -- but then Elliott arrived (... which I still haven't really discussed here on the blog?) and life has just been warp speed.
We had tossed around the idea of building an in-law apartment, or addition, but it just was not going to work out on this property. So, sell the house - find another! Easy enough!
For me: A House Is Just A Shell. You move shells as your life changes. You - your family gets bigger, you get smaller. I see other people who get very attached to the material part of their homes, and want to drag it around with them - but? Shake that shit off.
I do not get that attached to my shell. I like moving. I see it as a fresh start, a new beginning. Putting aside all the monetary costs involved, $1000 deposit, $1000 home inspection, etc etc etc. moving can be really f - u - n.
Right at the moment, we are nine people living in a house with one bath on the main floor and one kitchen and too many teenagers and a mobile baby and it can be A Bit Intense.
Everyone in this house likes their own space. My kids don't want to share bedrooms. They have been sharing here, there, everywhere, just to make it work -- and the baby hasn't had a room anywhere, yet. He still won't in the new house. He has been in my bed since day one.
I really can't worry about that, I mean, there's a garage? (KIDDING.) All I had asked for was a bedroom and a bathroom I could have access to without a queue at any given time. SCORE. And maybe a kitchen to roller skate in where I could line up 12 pizzas at a time for too many teenagers and guests.
We found one close to our current location, so that the kids can remain in college, 12th, 9th, 4th grade in their current schools. It is quite nice - and with the basement in-law, it's larger than ours. If all goes well with inspections, we should be moved in by November 1.
-Send Xanax, groceries, cleaning ladies, moving men and anti-seizure vibes! Also seeking product to review.
All I know right. now. is that it has taken me until 2pm to start this post because BABIES ARE A BIG HUGE FAT PAIN IN THE ASS AND I MEAN NO DISRESPECT TO BIG HUGE FAT ASSES BECAUSE I HAVE ONE AND I LOVE FATNESS, mmkay? If you ever need a reason not to get things done? Babies. Babies who are mobile and big trouble and right at the very moment seeking things to hurt themselves as if driven by a baby-seeking motor of "WHAT CAN HURT ME IN THIS ROOM" are what you need to stop everything from being accomplished. Baby who is now standing on my chair. Baby who is now crying.
For reference, the top photo is baby, day one at home with Dad at just under five pounds.
The second photo is baby, this week, with me, but you can't see my head, because he's grown a bit.
Babies have a tendency to do this. Mine, usually grow right off the growth chart.
He has a check-up next week and we'll see if he's finally on the chart -- because -- he wasn't for a while. Both of my post weight loss surgery babies started out smaller than my pre weight loss surgery babies. Elliott, above here, is also the first baby I gestated while on a huge amount of anti epileptic medications, and I often wondered if he would be effected by marinating in toxins like my brain did (and still does... )
The researchers screened 1808 adults aged 25 to 64 years with type 2 diabetes and a body mass index (BMI) ranging from 30 kg/m2 to 45 kg/m2 and allocated 43 participants by concealed, computer-generated random assignment. Participants were assigned to undergo RYGB or intensive lifestyle and medical intervention.
The participants in the intensive lifestyle/medical intervention cohort exercised 5 days per week for at least 45 minutes. Their diet was directed by a dietitian to lower weight and glucose levels, and all participants had optimal diabetes medical treatment for 1 year.
“Our trial and other relevant [randomized controlled trials] demonstrate that commonly used bariatric/metabolic operations (RYGB, sleeve gastrectomy, and gastric banding) are all more effective than a variety of medical and/or lifestyle interventions to promote weight loss, diabetes remission, glycemic control, and improvements in other CVD (cardiovascular disease) risk factors, with acceptable complications, for at least 1 to 3 years,” the authors wrote.
Fifteen participants underwent RYGB and 17 were assigned to the intensive lifestyle/medical intervention. Participants were followed for 1 year, and all were equivalent in baseline characteristics, although the RYGB cohort had a longer diabetes duration (11.4 vs 6.8 years; P=.009).
The percentage of weight loss at 1 year was 25.8% among participants who underwent RYGB and 6.4% in the intensive lifestyle/medical intervention group (P<.001). Participants in the intensive lifestyle/medical intervention exercise program had a 22% increase in VO2max (P<.001), while the VO2max levels in the RYGB group remained unchanged.
The rate of diabetes remission at 1 year was 60% in the RYGB group and 5.9% with the intensive lifestyle/medication intervention (P=.002). HbA1c declined in the RYGB cohort from 7.7% (60.7 mmol/mol) to 6.4% (46.4 mmol/mol), and the intensive lifestyle/medication intervention cohort's HbA1 declined from 7.3% (56.3 mmol/mol) to 6.9% (51.9 mmol/mol), although the decrease occurred with fewer diabetes medications after RYGB (P=.04).
“These results apply to patients with a BMI <35 kg/m2, and our study and others show that neither baseline BMI nor the amount of weight lost dependably predicts diabetes remission after RYGB, which appears to ameliorate diabetes through mechanisms beyond just weight reduction,” the authors noted.
“These findings call into serious question the longstanding practice of using strict BMI cutoffs as the primary criteria for surgical selection among patients with type 2 diabetes.”
PLEASE. This shit is not indecent, it's because the women are a little. bit. jiggly.
Get the fuck over yourselves.
Have any of you watched a Vickie's Secret Ad lately?!
Lane Bryant: Plus-Size Fashion Retailer's Commercial Reportedly Rejected by Multiple TV Networks The ad, promoting the company's #ThisBody campaign, was rejected by ABC and NBC, TMZ reported. NBC told TMZ they asked for a "minor edit to comply with broadcast indecency guidelines."
“These findings suggest that more effort may be needed to improve access to mental health care services in these patients should they need them, and perhaps some screening in the second year and onwards,” Bhatti said.
During the first three years after surgery, 111 patients received emergency care for self-inflicted injuries, or roughly 1 percent of people in the study. While small, the risk of these emergencies was 54 percent higher after surgery than it was before.
Study - JAMA
Importance Self-harm behaviors, including suicidal ideation and past suicide attempts, are frequent in bariatric surgery candidates. It is unclear, however, whether these behaviors are mitigated or aggravated by surgery.
Objective To compare the risk of self-harm behaviors before and after bariatric surgery.
Design, Setting, and Participants In this population-based, self-matched, longitudinal cohort analysis, we studied 8815 adults from Ontario, Canada, who underwent bariatric surgery between April 1, 2006, and March 31, 2011. Follow-up for each patient was 3 years prior to surgery and 3 years after surgery.
Main Outcomes and Measures Self-harm emergencies 3 years before and after surgery.
Results The cohort included 8815 patients of whom 7176 (81.4%) were women, 7063 (80.1%) were 35 years or older, and 8681 (98.5%) were treated with gastric bypass. A total of 111 patients had 158 self-harm emergencies during follow-up. Overall, self-harm emergencies significantly increased after surgery (3.63 per 1000 patient-years) compared with before surgery (2.33 per 1000 patient-years), equaling a rate ratio (RR) of 1.54 (95% CI, 1.03-2.30; P = .007). Self-harm emergencies after surgery were higher than before surgery among patients older than 35 years (RR, 1.76; 95% CI, 1.05-2.94; P = .03), those with a low-income status (RR, 2.09; 95% CI, 1.20-3.65; P = .01), and those living in rural areas (RR, 6.49; 95% CI, 1.42-29.63; P= .02). The most common self-harm mechanism was an intentional overdose (115 [72.8%]). A total of 147 events (93.0%) occurred in patients diagnosed as having a mental health disorder during the 5 years before the surgery.
Conclusions and Relevance In this study, the risk of self-harm emergencies increased after bariatric surgery, underscoring the need for screening for suicide risk during follow-up.
Link - http://archsurg.jamanetwork.com/article.aspx?articleid=2448916