How sugar affects the brain – or – why we are crackheads – or – why your diet failed – or – or – or

THIS!  I saw Dr. Avena (the voice in this video) at OAC #YWM2013 and she was amazingly informative.  WATCH.

As the video shows, the key player in the reward system of our brain — where we get that feeling of pleasure — is dopamine. Dopamine receptors are all over our brain. And doing a drug like heroin brings on a deluge of dopamine. Guess what happens when we eat sugar?

Yes, those dopamine levels also surge — though not nearly as much as they do with heroin. Still, too much sugar too often can steer the brain into overdrive, the video says. And that kickstarts a series of "unfortunate events" — loss of control, cravings and increased tolerance to sugar. All of those effects can be physically and psychologically taxing over time, leading to weight gain and dependence. The takeaway is pretty clear: If you're sensitive to sugar and inclined to indulge in a supersugary treat, do it rarely and cautiously. Otherwise, there's a pretty good chance that your brain is going to start demanding sugar loudly and often. And we're probably better off without that extra voice in our head.

Factors Distinguishing Weight Loss Success and Failure at Five or More Years Post Bariatric Surgery

What makes someone a Weight Loss Success long term after bariatric surgery?  

According to a study by Colleen Cook of BSCI – it's following the rules of your WLS.

I've heard her say it a hundred times at bariatric events – fall back to the RULES of your surgery – because it DOES WORK –

(Nodding in agreement – I am proof.)

Here's the study details from ASMBS/TOS 2013

Dietary support after bariatric surgery, along with pre-operative teaching and post-operative management, may mean the difference between weight-loss success and failure for patients with obesity, according to results of an on-line survey presented at the 31st Annual Scientific Meeting of The Obesity Society (OBESITY 2013).

“This study confirms the need to put into place the resources to support people after bariatric surgery, including the dieticians and behavioural therapists who are actively involved with their patients, and can be critical to their success or failure,” stated American Society for Metabolic and Bariatric Surgery past president, Scott Shikora, MD, Center for Metabolic Health, Brigham and Women’s Hospital, Boston, Massachusetts.

People who have had bariatric surgery and are complying with the very basic principles of personal accountability, portion control, food intake, vitamins and supplements, proper nutrition and exercise are the ones who have been doing well long-term,” noted lead author Colleen M. Cook, Bariatric Support Centers International, Jordan, Utah, speaking here on November 14.

Cook and colleagues conducted a survey to assess adherence to specific, research-based, behavioural recommendations based on earlier research. Of their 535 total initial respondents, 255 were 5 or more years post-surgery. From this group, they took a final sample of 158 respondents comprised of 117 (74.05%) who reported achieving at least 80% of their excess body weight loss (the Highly Successful group) and 41 (25.9%) who reported achieving less than 40% of their excess body weight loss (the Not Highly Successful group).

The groups were compared on self-reported behaviours, including dietary intake, physical exercise, attendance at surgical follow-up visits, and participation in bariatric support groups.

The Highly Successful group reported significantly higher rates of compliance with dietary recommendations (P< .001); fewer total calories per day (1511.9 kCals versus 2190.0 kCals, P< .001 ); consuming a higher percentage of calories from protein (49% vs 36%; P< .001); higher frequency of eating protein first (P =.007); and lower percentage of calories from carbohydrates (31% vs 40%; P = .001).

The Highly Successful group was much more likely to regularly weigh themselves (P< .001); attend support groups (P = .002); and take supplemental multivitamins (P = .029), including calcium (P = .004), iron (P = .011), and B12 (P = .001).

The Highly Successful group was significantly less likely to eat mindlessly (P< .001); to “graze” (P< .001); to eat in front of the TV (= .002); to eat fast food (P< .001); and to eat food high in sugar (P< .001).

The groups also differed significantly on carbonated beverage (P = .02) and caffeine (P = .005) drinking patterns. The Highly Successful group reported significantly more physical activity at least several times per week than the Not Highly Successful group (P< .001).

The researchers found no significant differences, however, for ingestion of percentage calories from fat or the frequency of eating at sit-down restaurants, drinking calorie-laden liquids, or attending surgical clinic follow-ups.

Participants in this study averaged 51.7 years of age and 8.8 years post-surgery; 96% were female, 59% were married, and 89% were white. Both groups had similar demographics.

Funding for this study was provided by Bariatric Support Centers International.

[Presentation title: Factors Distinguishing Weight Loss Success and Failure at Five or More Years Post Bariatric Surgery. Abstract A-366-P]

Miranda_lambert_gastric

Miranda Lambert – “My Diet Is Better Than Gastric Bypass”

Miranda_lambert_gastric

Miranda Lambert, you're not making friends with your target market  (…Did You Notice That 70% of America is Overweight?!) with these ridiculous articles.

Via Life & Style Magazine - 

The speculation all started when Miranda showed up at the AMA Awards showing off her extreme weight loss. She reportedly dropped 25 pounds from her 155-pound frame in a very short span of time, which led to rumors that she may have secretly gotten her stomach stapled.

However, Life & Style’s report claims that Miranda is now firing back against the rumors, and claiming that neither plastic surgery nor a gastric bypass had anything to do with her weight loss. Apparently, she did NOT lose 30 pounds in 8 weeks via a shortcut, but old-fashioned hard work. Eh. It’s still difficult to believe, but with celebrities, you never know – they have a ton of free time and access to the best trainers and the best food. It’s possible that Miranda just worked really, really hard to lose all that weight so quickly, even if it sounds a tad bit unbelievable.

Nobody really cares if you "got your stomach stapled," and those of us who understand "stomach stapling" know that you could not have it done at 5' 4" and 155 lbs.  

Screen Shot 2013-12-06 at 7.29.31 AM

http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm

Frankly, as someone who is nearly THAT size – I am a bit miffed that people would suggest bariatric surgery at a weight that I have been told is "too skinny."  

This is so silly.  

 

 

File_1_15

Celebrate ENS Video – All in one vitamin, protein, and more!

Celebrate says — This is MUCH MORE than a protein shake. This is as close that you will ever get to having an ALL IN ONE bariatric supplement! Our Celebrate ENS shake is a one of a kind way to get your multivitamin, calcium, fiber AND protein all in one. Each ENS (Essential Nutrient System) shake contains a high potency multivitamin, 500 mg of calcium citrate, 4 g of fiber, and 25 g of whey isolate protein in each serving. This product is the best option for patients immediately following surgery.
Created for surgical weight loss patients, our ENS (Essential Nutrient System) shake contains a high potency multivitamin, 500 mg of calcium citrate, and 25 g of whey isolate protein in each pack. Our integrated formula provides maximum solubility and ensures that the vitamins and minerals are readily bioavailable. This product is the best option for patients immediately following surgery. 

* The vitamin and mineral content of each pack is equal to taking one chewable multivitamin, plus 500 mg of calcium, plus 25 g of protein. 
* Due to the nature of the formulation, this product is appropriate for any surgical weight loss procedure. As with any of our other delivery systems, you may need additional supplementation based on surgery type. 
* It is recommended to be blended with 8 oz of cold water, shaken, and consumed but can be mixed with as much or as little water as you want. It may also be mixed with milk. 
* Each pack also contains 4 g of soluble fiber, added electrolytes and a 500 mg antioxidant blend, and a 200 mg green tea blend. 
* Like our other products, taste is important and this has a delicious vanilla flavor that will make you think that you are drinking a glass of milk flavored like cake batter. 
* Since quality is a critical element of all of our products, we utilize an ultra refined whey isolate protein that scores 100 on the PDCAAS scale. 

-Celebrate Vitamins 

Who would benefit from this product? 

1. Early post-operative patients – Since this may be diluted to taste, there are virtually no issues with taste aversion. 
2. Athletes – If you are a surgery patient turned athlete, this can help to flavor that boring water that you need to drink. Water is critical and taking your vitamins and calcium while hydrating makes it easier. 
3. Anyone looking for a convenient alternative to pills or chewables.

Bariatric surgery may prevent heart failure

Bariatric surgery may prevent heart failure

Major finding: The incidence rate of heart failure during a median 15 years of prospective follow-up after bariatric surgery was 3.1 cases per 1,000 person-years, compared with 5.2/1,000 person-years in obese controls.

Data source: The Swedish Obese Subjects study included 2,010 obese subjects who underwent bariatric surgery in 1987-2001 and 2,037 closely matched obese controls. It is a nonrandomized, prospective, observational study.

What does 2000 calories look like!?

I might be slightly disturbed by this, and it is blatantly obvious why I was 320 lbs, and even more clear How Easy It Is To Regain Weight After Bariatric Surgery.

Just a few calories a day – it adds up so damned fast.

My before-WLS diet would easily dwarf this 2000-calorie business.  

Related articles

Screen Shot 2013-03-02 at 8.28.11 AM

Weight-Loss Surgery’s Weird Alcoholism Risk (It’s not weird.)

Weight-Loss Surgery’s Weird Alcoholism Risk | The Fix.

Copied entire article from Weight-Loss Surgery’s Weird Alcoholism Risk | The Fix. – because – BECAUSE –

Screen Shot 2013-03-02 at 8.28.11 AM

Gastric bypass surgery is something of a medical marvel. In Roux-en-Y surgery, a small pouch is made from part of your stomach, building a new, smaller one. The pouch is then connected to the middle portion of the small intestine (the jejunum), bypassing the upper part (the duodenum). Because your new stomach is about 90% smaller than your old one, you feel full with much smaller amounts of food and take in many fewer calories. Another popular smaller-stomach operation is adjustable gastric band surgery, in which an inflatable silicone device is placed around the top of the stomach.

In all, the American Society for Metabolic and Bariatric Surgery estimates that approximately 200,000 people have bariatric surgery every year. The Roux-en-Y operation generally costs between $15,000 and $30,000; the band is cheaper by about $10,000. Many private insurance policies offer no coverage for what they consider an elective procedure.

There have been previous reports of bariatric surgery patients having serious trouble with alcohol use after their surgeries. A 2012 Archives of Surgery study by the New York Obesity Nutrition Research Center looked at 100 people who had Roux-en-Y and 55 who had the adjustable band. The post-op patients were significantly more likely than the general population to use addictive substances, especially two years after the procedures. The Roux-en-Y cohort seemed particularly susceptible to alcohol use.

If food has always been your drug, and surgery abruptly denies you your fix, you turn to other drugs.

A much larger 2012 study in the Journal of the American Medical Association came to a similar conclusion. University of Pittsburgh researchers followed almost 2,000 people who had Roux-en-Y, adjustable band or another weight-loss surgery. Before their operations, 7.6% of the group abused alcohol; after the knife, 9.6% did so. And, the patients who had the Roux-en-Y surgery were twice as likely to abuse alcohol as those who had the gastric band.

Health experts have long known that obesity and depression often go hand-in-hand. Depression can lead to becoming obese, and the opposite is also true. Many obese people are depressed before they have surgery and are therefore at high risk of depression afterward. For one thing, recovery is a slow process, and health complications of the surgery are very common; 40% of patients suffer from infection and post-operative bleeding. Perhaps more important, bariatric surgery is no magic bullet, and some patients become disillusioned as they realize that in order to “solve” their serious weight problems, they have to maintain good eating and exercise habits—lifestyle changes that likely proved elusive in the past. 

Addiction experts see the problem as one of switching addictions. People become obese because they use eating as a drug. Excessive eating is a form of self-medication for painful feelings associated with depression, anxiety and deeper personality disorders. Like most drugs, food, especially carbs and sugars, trigger the brain’s reward pathways, causing a feeling of pleasure. But sustained excessive eating causes the brain to lose its capacity to produce these feel-good chemicals. That’s whenaddiction starts.

Weight-loss surgery fixes the outside of a person, but not the inside. While it can reduce the harm of obesity, it leaves the needs driving your addiction untouched. So if food has always been your drug, and stomach-minimizing surgery abruptly denies you your fix, you turn to other drugs. Alcohol, being legal, is the most available, but patients can take their pick among the panoply of addictive substances.

Hogwash, says John Morton, MD, a bariatric surgeon at the Stanford School of Medicine and member of the executive council of the American Society for Metabolic and Bariatric Surgery. Like many other surgeons who specialize in this procedure, he favors a physical rather than a psychological or switching-addiction explanation for the high risk of alcohol abuse. “[There is a] heightened sensitivity to alcohol [and it is] purely physiologic,” Morton says. Along with the liver, the stomach produces alcohol dehydrogenase, an enzyme that breaks down alcohol into other, less toxic molecules. Because gastric bypass patients have much less stomach, and therefore less of that enzyme, more alcohol enters their bloodstream.

“As a result,” Morton says, “you get drunker faster and stay drunker longer.” The same phenomenon occurs with people who have their stomachs removed because of cancer. If alcohol abuse in bariatric patients were due to psychological issues, you wouldn’t expect cancer patients to have greater alcohol sensitivity, Morton argues.

Mitch Roslin, MD, a specialist in bariatric medicine at New York’s Lenox Hill Hospital, agrees. He calls the switching-addictions theory “BS.” Drinking alcohol in your post-Roux-en-Y life is “the epitome of drinking on an empty stomach”—after all, your stomach is almost nonexistent. “Essentially,” Roslin says, “drinking alcohol after Roux-en-Y is like having an alcohol IV.”

“Essentially, drinking alcohol after Roux-en-Y is like having an alcohol IV,” Roslin says.

But why does alcohol sensitivity show up more in the second year after the surgery? Roslin suggests that the second year is when you realize that your surgery will not, by itself, keep you healthy, that you do indeed have to “fix the inside.” At that point, you might feel depressed, use alcohol to escape and comply less with your post-op instructions. 

Morton’s and Roslin’s explanations may account for why people who have had gastric bypasses can get a buzz by drinking a small amount of alcohol, but they don’t quite explain why some people who never abused booze before end up becoming post-op alcoholics. Nor do they account for another, even more serious, health risk for people who have had gastric bypasses: suicide.

Two recent studies—in Pennsylvania and Utah—reinforce the link between obesity and emotional distress by focusing on suicide rates. A study of 17,000 weight-loss surgeries performed in Pennsylvania from 1995 to 2004 showed a surprisingly high incidence of suicide. Of the 440 deaths that occurred, 16 resulted from suicide or drug overdose; by comparison, the rate for the general population is only three. And this August, a study published in The New England Journal of Medicineshowed that a group of almost 10,000 bariatric patients had a 58% higher than average risk of dying in an accident or suicide. When the bariatric patients’ suicide rate was compared to that of obese people who had not had surgery, it was close to double, 11.1 per 10,000 compared to 6.4 per 10,000.

When the high risk of suicide is coupled with the high risk of alcohol abuse, a psychological, if not a switching-addiction, explanation is almost inescapable. Patients may be aware of these risks, but the need for the surgery overrides such concerns. While prospective patients often undergo psychological evaluations before the procedure, doctors often do not follow up with the patients and patients often do not participate in post-surgery counseling. The addiction to food is typically viewed as more or less having been “treated” by the gastric bypass. The danger of developing a new addiction remains low on the list of health priorities.

There is no denying the benefits of bariatric surgery. Without it, many people struggling with obesity would be doomed to lives burdened with diabetes, heart disease, mobility problems and high risk of stroke and early death. At the same time, it’s clear that the surgery’s benefits would be increased by improved screening of patients for mental health problems—and addiction—before surgery as well as deeper, longer counseling afterward. This may mean fewer people will be eligible for the surgery—a prospect that neither doctors nor patients would embrace. At the very least, reframing how patients understand the surgery is in order: It is not a magic bullet but one in a serious of interventions that are, like it or not, lifelong.