Bariatric Weight Loss Procedures and the Names They Go By

It's Back to School week here at LivingAfterWLS! I love this time of year - new starts, refresher studies, and back to the art and craft of learning. Yesterday we reviewed the Four Rules of bariatric weight loss surgery. Today, for anyone considering weight loss surgery, for new patients or veterans of surgical weight management I present a brief review of the currently approved surgical procedures and the names they go by.

By Kaye Bailey

The advisory committee for the 2010 Dietary Guidelines for Americans reported grim news earlier this year when they confirmed that currently about two-thirds of American adults and one-third of American children are overweight or obese. The committee warned that Americans must slash their caloric intake and increase physical activity because the obesity epidemic is "the single greatest threat to public health in this century."

Given that discouraging news nearly 300,000 adult Americans will undergo bariatric surgery this year as a means to losing weight and treating chronic morbid obesity. There are at least 35 bariatric surgical procedures approved by the Food and Drug Administration (FDA) for the treatment of obesity. While each procedure is unique they are all generically referred to as Weight Loss Surgery (WLS). The American Society for Metabolic and Bariatric Surgery describes two basic approaches that weight loss surgery takes to achieve change:

Restrictive procedures that decrease food intake with the use of stapling or banding.
 

Malabsorptive procedures that alter digestion causing food to be poorly digested and incompletely absorbed so that it is eliminated in the stool.

Patients seeking surgical help for obesity quickly learn the nomenclature of bariatric medicine and can readily list the names by which different surgical procedures are known. Bariatric procedures are all effective in the treatment of morbid obesity, but differ in degree of weight loss and range of complications. The choice of procedure, according to the European Association for Endoscopic Surgery, should be tailored to the individual situation. Here we look at the most commonly performed bariatric procedures in the United States and learn the names they go by:

Gastric Bypass Surgery: Since the early 1990s gastric bypass has been the most commonly performed surgical weight loss procedure and the laparoscopic gastric bypass is considered the "gold standard" of bariatric surgery. The public at large often mistakenly calls all bariatric procedures gastric bypass. Gastric bypass is both a restrictive and malabsorptive procedure. Patients refer to it as WLS, GBS, Roux-en-Y Gastric Bypass (RYGB) or simply gastric bypass.

Adjustable Gastric Banding: This procedure, most commonly called lap-band, is restrictive with the use of a prosthetic band placed around the upper part of the stomach, much like a belt. There is no cutting or stapling of the stomach. A tube is connected to the prosthetic band to a small access port that is fixed beneath the abdomen skin. The band is adjusted through this port to help control weight loss outcome. Patients call this procedure banding, lap-band, or gastric banding. They refer to themselves as "Bandsters" or "Bandits".

Sleeve Gastrectomy: This is a purely restrictive procedure meaning there is no intestinal bypass. The sleeve gastrectomy is rapidly emerging as a reasonable alternative to adjustable gastric banding and other stapling procedures with patients favoring it over the malabsorptive procedures. Among patients the procedure is often called "gastric sleeve" or "the sleeve" and patients of this procedure refer to themselves as "sleevesters".

Laparoscopic vs. Open Procedure: Laparoscopic procedures are used for a variety of general surgeries and in the last decade have become the predominant technique for many surgical procedures. When a laparoscopic operation is performed a small video camera is inserted into the abdomen through small incisions made in the abdominal wall. The surgeon views the procedure on a separate video monitor. Laparoscopic procedures are considered less invasive than open procedures that require one long incision to open the abdomen. Studies indicate patients having had laparoscopic weight loss surgery experience less pain after surgery resulting in easier breathing and lung function and higher overall oxygen levels. In addition laparoscopy patients have fewer wound complications such as infection or hernia, and they tend to return to quickly to pre-surgical levels of activity.

Kaye Bailey (c) 2010 - All Rights Reserved

To learn how to make the most of these procedures,
take a look at this featured article from the  5 Day Pouch Test website:

Three Keys to Lasting Weight Loss Surgery Success 

Nearly a quarter-million people in the United States will undergo weight loss surgery this year to arrest their morbid obesity and lose weight. In spite of the drastic nature of gastric surgeries not all patients will reach a healthy weight and some may eventually regain weight they lost initially with surgery.  Read more

12 Years Ago Today - I Arrived

12 Arrivalversary - Celebrating In the Neighborhood

Today marks the 12th Anniversary of my gastric bypass surgery on September 13, 1999. As we do each year on this date Jim took my "AFTER" picture. This morning out in the yard with the beautiful sunshine KeepHerKitty decided to join me for a picture. Isn't she gorgeous? Like all of here at LivingAfterWLS she struggles with her weight, as you can see. And sadly I am a treat giving enabler to her. So here is the picture, my latest "After" in this ongoing journey of LivingAfterWLS.

Watch your inbox for the LivingAfterWLS Weekly Digest this week, I have collected and shared many of the lessons I have learned in these 12 years. You can subscribe to the free emails here: LivingAfterWLS Newsletters. I have been fortunate to learn so much from all of you wonderful Neighbors and it is an honor to able to share our collective experience.

So CHEERS to another 12 Years!

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LivingAfterWLS General Store
Great Coupon for September!!! Code: RENEW2011
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Do Not Let Dumping Syndrome Ruin Your Summer Celebration

By Kaye Bailey

Summer is a time to celebrate warm weather, sunshine, good friends and good times - often with food and drink. But for people with weight loss surgery celebrations bring the potential for a dietary crisis called dumping syndrome that has the potential to ruin a day of good old fashioned summer time fun.

Gastric Dumping Syndrome, or rapid gastric emptying, is a condition where partially digested food bypasses the stomach too rapidly and enters the small intestine. This causes the pancreas to release excessive amounts of insulin into the bloodstream and symptoms of hypoglycemia occur. Dumping Syndrome is most commonly associated with malabsorptive gastric surgery, specifically gastric bypass surgery. Patients will experience the symptoms of dumping syndrome immediately after eating or within three hours of eating. The symptoms may include nausea, vomiting, bloating, cramping, diarrhea, profuse sweating followed by chills, dizziness and fatigue. When insulin levels return to normal symptoms subside. Many patients experiencing dumping syndrome find comfort in lying down or sipping fortified water or energy drinks served at warm temperature.

Clearly an episode of dumping syndrome will disrupt any celebration and most weight loss surgery patients will benefit from taking precautions to avoid such an occurrence. Here are four basic dietary and lifestyle guidelines to follow that will help prevent a dumping episode from ruining your summer celebration:


Hydration. Drinking lots of water is the second sacred rule of weight loss surgery. This is of keen importance during the hot summer months when bodies release more fluid through perspiration thus becoming susceptible to dehydration. On warm days filled with outdoor activity be mindful to sip water throughout the day. As a guideline drink one ounce of water for every two pounds of body weight to ensure proper hydration. Vitamin fortified water or non-calorie sports drinks fortified to balance electrolytes may be enjoyed as well to prevent hydration. The symptoms of dehydration often feel like mild dumping syndrome, and some weight loss surgery patients report a higher likelihood of dumping syndrome when they are not properly hydrated.

Protein First. It is particularly important to follow the first rule of weight loss surgery, "Protein First" when partaking from an array of party foods including barbecue, picnic salads and sides, and bountiful desserts. Eating protein first will buffer foods that may potentially cause a dumping episode. Be wary of barbecue sauces that may be high in sugar or breaded and fried protein which is also known to cause dumping. If fried chicken is the only protein offered remove and discard the skin and breading and enjoy the meat without it. Remember to eat two bites of protein to every one bite of complex carbohydrate. When taking small bites of protein three forks will measure about one ounce of protein. The tight feeling in the gastric surgical pouch is a sign of fullness and the signal to stop eating. Avoid discomfort by following this signal and cease eating.

Taste Wisely. Celebrations are often a showcase for friends and relations to share their best dishes including gorgeous calorie and fat laden desserts. Who has not been tempted by the display of outrageous desserts at the annual family reunion? For the weight loss surgery patient unchecked enjoyment of such foods is likely to cause dumping syndrome in the short term and, in the worst case, weight gain in the long run. Patients can find a safe place in simply tasting one or two select desserts without imminent fear of dumping if they have stayed hydrated throughout the day and if they have eating a reasonable amount of lean protein prior to sweet indulgence. One or two bites of a sweet dessert should satisfy the palate and the persistent requests of a beloved relative who urges, "Come on, one little piece of my deluxe super duper chocolate mess is not going to hurt you."

Contribute Good Food. When the occasion allows take the opportunity to provide a weight loss surgery friendly side dish or dessert that you can safely enjoy and others may enjoy as well. It is a great time to demonstrate that healthy can be delicious and attractive. Present salads or side dishes featuring fresh seasonal ingredients and homemade dressings made of pure ingredients that are low in fat and sugar. Prepare sugar-free desserts or snacks following recipes that use popular sugar substitutes which, when enjoyed in moderation, do not cause dumping syndrome. Sugar free pudding and gelatin dishes also fare well at any potluck summer celebration. When a weight loss surgery patient provides safe food for a potluck meal they decrease the temptation to eat foods that are likely to cause dumping syndrome and ruin an otherwise fabulous summer celebration.


Kaye Bailey (c) 2010 - All Rights Reserved

Article Source: Weight Loss Surgery Patients - Do Not Let Dumping Syndrome Ruin Your Summer Celebration

2009 All Star Award - Email Newsletters

We have just learned that LivingAfterWLS has been awarded the Constant Contact 2009 All Star Award for Excellence in Email Marketing! That means the emails we provided to our LivingAfterWLS community free of charge meet the highest standards of excellence in the email marketing industry! I am so pleased with this and thrilled that we can continue to share with you, our loyal readers, quality material of interest, meeting the high standards you have come to expect. It is a beautiful day in the LivingAfterWLS Neighborhood!

LivingAfterWLS publishes three inspiring email newsletters that promote personal responsibility and positive self-empowerment as a means to succeed long-term with surgical weight loss. They are free to email subscribers whom we treat with respect and privacy never selling our list.

You Have Arrived is our flagship newsletter published twice monthly. You will find inspiring and motivational articles in addition to topics on nutrition, fitness, healthy cooking and bariatric news.

Recipe of the Week is our once weekly cooking and nutrition newsletter. Each week you will find great family friendly recipes using fresh healthy ingredients that will please your palate and enhance your well being while being mindful of the specific need of surgical weight loss patients.

Free 2009 Best of Cooking with Kaye Download
21-Page Download; 28 of your favorite Kaye recipes from 2009

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5 Day Pouch Test Bulletin is our monthly motivational newsletter that supports our back to basics program, the 5 Day Pouch Test. This program is for those who feel they are not fully using their weight loss surgery tool and is useful for those who have stalled weight loss, or perhaps regained some weight.

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Four Things You Must Know about Weight Regain After WLS

This article was published in the January 10, 2010 You Have Arrived Newsletter (subscribe here for free) and has generated much conversation in the LivingAfterWLS Neighborhood. Here is the full article and Link Here to follow the conversation and join us!

Weight Gain After Weight Loss Surgery:
Four Things You MUST Know
by Kaye Bailey Copyright 2010 - All Rights Reserved

I was born with the disease obesity and by the time I was out of college it had advanced to morbid obesity. At age 33 my disease was treated with laparoscopic gastric bypass surgery which affected a loss of weight that put my disease, morbid obesity, in remission. Three years later I suffered a relapse of my disease with a weight gain of 20 pounds. Through dietary and lifestyle compliance, much like a person with heart disease who suffers a relapse, I was able to put my disease, obesity, back in remission. I will always have the disease of morbid obesity and am fortunate that I was able, at a young age, to be treated with the best medically available option.

The Facts:

* Obesity is a disease.
* Weight loss puts the disease in remission.
* Weight gain puts the disease in relapse.
* Like most diseases, victims of obesity are responsible to make dietary and lifestyle changes that work with medical treatment to keep our disease in remission.
* Like most diseases, relapses occur, obesity manifests relapse in weight gain.
* We are not the disease, we have the disease.

My Four Truths:

Regain Is Likely: It is generally believed that 80% of people who undergo WLS will experience relapse (weight gain) of 10-30 pounds depending upon initial weight loss. It is further believed that 20% will relapse to their former weight and possibly gain more as the disease of morbid obesity advances. This relapse can be the result of failed gastric surgery (the surgery was improperly performed); a non-compliant patient who does not evolve their eating and exercise habits; the active intestine becoming more efficient at absorbing calories; and potential stomach pouch stretch. Statistics are not available indicating which patient regains weight for what reason.

Dr. Anita Courcoulas, chief of minimally invasive bariatric and general surgery at the University of Pittsburgh Medical Center said, "Regaining weight down the road is a common phenomenon for weight loss patients. These patients need to be educated and prepared for it if it happens."

2. 100% Conviction: It is my experience that 100% of patients who take to the operating table for the treatment of their disease say, "I'm not going to be one of "those people" who gain weight after surgery." You can bet the farm I said that - and imagine my embarrassment and shame when I did in fact become one of "those people." At the time I didn't understand my disease had relapsed, in part because I had loosened my newly evolved eating and exercise habits, but also because my body has a disease that wants to store excess fat. I thought I gained weight because I was a failure at surgery . Just one more diet I couldn't get right.

I am not alone in my feelings of failure over weight regain. Dr. Courcoulas said, "These are people who feel that they have failed at everything they tried in their lives. If they feel that they are failing surgery, they're embarrassed and they don't want to come back for help." How sad for us. When a cancer patient suffers a relapse do they take it as a personal failure? I sure hope not.

Popular media perpetuates the belief that weight gain equals failure. WLS celebrities are splashed across mainstream media and tabloids alike for weight regain. But the celebrity with cancer who suffers relapse? Charity benefits are hosted bearing their name and their bravery is lauded. With a relapse in obesity the celebrity becomes the brunt of jokes for late night comedians. No wonder we don't want to become one of "those people" but statistics are not on our side
3. I Am Not Obese. Since kindergarten the word "fat" defined me and I actually thought that was who I was because "You are fat" and "I am fat" were constant words in my world. By about age 40 I finally figured out that I am not fat. I have obesity, a disease. Have you heard a heart attack patient say, "I am heart disease" or a leukemia patient say, "I am cancer"? We are not the disease! We have a disease that is part of the whole person that makes us the wonderfully unique and powerful person we are. I must actively engage in mindful thinking daily to assure myself the things that I am that are not about my disease. The old self-loathing talk is much easier to indulge, we are so much more comfortable with it than self-kindness. But please join me in stepping out of your comfort zone and celebrating all the brilliant wonderful things that define you. You are not these disease. You are lovely spectacular beautiful you.
4. Relapse to Remission: Just like other disease, obesity relapse can be put into remission. There is hope! As noted above there are (at least) four reasons for relapse including: failed gastric surgery (the surgery was improperly performed); a non-compliant patient who does not evolve their eating and exercise habits; the active intestine becoming more efficient at absorbing calories; and potential stomach pouch stretch. Keeping in mind that statistically weight regain is likely, that you are not a failure, and that you are not the disease, you can pragmatically go about mapping a plan to fight your relapse.

* Seek medical help and treatment: you are fighting a killer disease
* Assess your eating and exercise evolution and return to the lifestyle prescribed at the time of surgery
* Educate yourself on nutrition, physical and spiritual health so they may work in harmony to heal your body
* Seek support, family, friends, community, and fellow patients to help maintain your personal motivation
* Educate others to stop the ignorance and blame and promote the understanding of this illness we are fighting


Struggling with Regain? Try Kaye's 5 Day Pouch Test - Get the Owner's Manual

Countdown to my 10-Year Arrivalversary

Hey Neighbors!!!

This coming Sunday, September 13, 2009, will mark my 10 year Arrivalversary!!! I am gobstruck that 10 years have come and gone. It seems like the 6 months prior to WLS lasted forever while I was in the waiting mode. And now 10 years of Living are behind me. And what a great 10 years they have been. I'm so grateful to be healthy and fit and more importantly that the LivingAfterWLS Project was born and raised during that time.

The big celebration of my Arrivalversary is the publication of my new book - Day 6: Beyond the 5 Day Pouch Test which will be out October 27th. (Shameless advertisement - you can reserve your copy here with our pre-publication sale. First 100 copies signed & numbered by me). Honestly - that should be enough of a celebration....

BUT -- I want to do something really big (not bungee jumping MOUJ) --- Any suggestions?

....
And here's what they came up with:

--From BeJean"Congrats!

I say get a tatoo, the LAWLS ribbons (logo) w/ "10 years" ."

--My Reply"OMG! Thank you, everyone. I just burst into tears reading this thread and I'm pretty sure it is down home sentimentality, not the hormones talking! I've wanted a tattoo for years but never thought of anything that "fits" --- but the LAWLS ribbon rainbow! Perfect. Thanks Jeanie for the suggestion. Jim is getting his first tat next month (grandson Mason designed it for him) and I think I'll go along for some ink of my own. Perhaps on the ankle? Ribbon Rainbow with "You Have Arrived" seems perfect!!! (Does it hurt to get inked?)"

So what do my dear blogger friends think??

Dumping Syndrome Revisited

Recently Ky, author of Turtle + Butterfly = Turtlefly Adventures left this comment on the LivingAfterWLS General Store post:

"Hello. I found your blog tonight after reading your article, "Dumping Syndrome: The Dirty Secret Gastric Bypass Patients Keep". I found your article doing a google search on dumping syndrome. I am 2 years 1 month post op (Gastric Bypass) and lost 205 lbs which I have also kept off. I haven't however been able to avoid dumping and your description of how you dump almost mirrors mine. I have become very frustrated, and just wanted to say that when I read your article I didn't feel so isolated or alone. Thank you for sharing your journey and helping me to know that there isn't something wrong with me - but rather that I need to focus on the basics in order to avoid this very uncomfortable and distressing consequence of WLS. Anyway - thank you again."

It has been a long time since we talked about Dumping Syndrome on this Blog so it seems appropriate to drag out this old article from my syndication library. This is the article to which Ky refers. I still dump occasionally, still don't know why all the time. But the more I follow the Four Rules the less it happens. Take a look at this article and let me know about your experience with dumping syndrome.

Dumping Syndrome: The Dirty Secret Gastric Bypass Patients Keep
By Kaye Bailey

Dumping syndrome is an effective result of the gastric bypass system which alerts the body of inappropriate eating. Dumping syndrome is described as a shock-like state when small, easily absorbed food particles rapidly dump into the digestive system. This results in a very unpleasant feeling with symptoms such as a cold clammy sweat, pallor, butterflies in the stomach and a pounding pulse. These symptoms may be followed by cramps and diarrhea. This state can last for 30-60 minutes and is quite uncomfortable.

That was the clinical description of dumping.

This is what I experience when I dump: shortly after eating a food I don’t tolerate (sugar, milk, sugary milk products or starchy carbs) I begin to feel a bit disoriented, maybe dizzy and then an overall sense of confusion or panic takes over my mind and body. This is a mild state of delirium. Then I begin sweating. Profuse sweating that can completely soak my hair, my clothes; it drips and glistens on my skin. During this state of sweaty panic I feel like I’m out of my mind! A few times during extremely dramatic dumping episodes I literally thought I was dying, the state of distress was that severe.

At this point during a dumping episode I have learned it is best to lie down on my side and let it nature take its course. The body is efficiently, albeit painfully, correcting a chemical imbalance in the cell system. It takes great presence of mind to calm myself and lay down, but even in a state of near-delirium I now know this is the only action to be taken. I know the event is passing when the sense of panic is replaced by exhaustion and cold chills instead of sweating. Occasionally I have suffered diarrhea at this point. If I have the luxury I’ll try to take a nap or go to bed after dumping. If it is in the evening I’ll sleep through the night, and wake feeling like I’ve been run over by a truck.

The mild delirium associated with dumping is the result of an interruption of nerve impulses affecting cerebral metabolism. The interruptions are caused by metabolic disturbances such as fluid or electrolyte imbalance. When the incorrect foods are consumed and dumped into the digestive system the electrolytes get out of balance. Dehydration will also cause an electrolyte imbalance. This mild delirium is characterized by a reduced ability to maintain attention to surroundings or disorganized thinking. The daily routine can become confusing. In extreme cases a person who is dumping may experience rambling, irrelevant or incoherent speech.

After the dump passes the interrogation begins: what caused that dump? I have dumped on yogurt, sugar cookies, lobster bisque and blackberry sorbet. I have dumped after one margarita. A particularly impressive dump followed a love-fest with a piece of pecan pie. Salty potato chips that should have never crossed my lips knocked me flat quicker than a prize-winning boxer could have. I have dumped a few times for which I never determined a cause. In most cases eating the inappropriate food for my gastric bypass system is the culprit. Through trial and error I can predict most things that make me dump and I avoid them contemptuously.

The most efficient way to avoid dumping is to maintain the strict regimen practiced during bariatric infancy: follow the four rules. Eat protein first making sure it comprises one-half of every meal. Avoid snacking. Avoid all sources of simple sugar; and yes, this includes cookies, cakes, candy, sodas, ice cream and sorbet. Sip water throughout the day. When you practice this eating behavior your blood sugar will not fluctuate and you will not dump. Most patients, who crave a taste of something sweet, have learned they can tolerate a bite of fruit at the end of the meal. Proceed with caution and discover what works for you.

The first reaction when dumping begins is to try and make it stop. There is a feeling of helplessness – like trying to stop an earthquake. I have tried eating myself out of it. I have tried flushing it away by drinking water. I have tried physical motion – pacing – to get myself out of it. I have not successfully stopped a dumping episode. I don’t know anyone who can successfully halt a dumping episode. Sipping a sports drink like Gatorade will relieve my symptoms, although my surgical weight loss specialists do not recommended this practice. If you find something to bring relief during a dump, and it causes no further harm, then do it.

It is important to note that the dumping experience is different for every person. Some will always have extreme dumps and others more mild episodes. Individuals will notice dumping episodes will vary by incident. No two people dump the same and no two dumps are alike.

Dumping is a bittersweet fact of life after weight loss surgery. Because we must fuel our bodies by eating we will experience dumping. Adherence to the four rules will prevent dumping in most cases. However, every now and again we will be blindsided by a dump caused by a food never suspected. Keeping a list of poorly tolerated foods will help you avoid them. The acutely dramatic event of dumping is a convincing motivator to follow the rules and avoid the foods that have triggered a dumping episode.

More articles on the First Year Post-Weight Loss Surgery

Rumbly-Grumbly Tummy

Recently I was asked about the "inactive stomach" that is separated from the pouch in a gastric bypass surgery. Here is one of my syndicated articles that addresses the issue of the rumbly-grumbly tummy:

If you’ve been enjoying life after gastric bypass surgery you will know exactly what I’m talking about. That rumbly-tumbly stomach growl that’s more bark than bite. It’s the inactive tummy talking, the lower part of the stomach that was bypassed. And it growls at the oddest moments seldom accompanied by hunger pains. My inactive tummy is particularly talkative at bedtime, I think it remembers the refrigerator front bedtime binges from my previously life.

Remember the surgical diagrams you studied before surgery: a tiny stomach portion we call the pouch was separated from a larger portion, which is the inactive or bypassed stomach. In the gastric bypass procedure the stomach is left in place with blood supply – it is still and active organ yet no longer a reservoir for food. In some cases it may shrink slightly and the muscles may atrophy, but for the most part it remains unchanged. In fact, the “inactive” tummy is quite active. The inactive tummy is an around-the-clock chemical factory keeping your body in balance.

And for all it’s hard work what do we do? We don’t feed it. No wonder it’s talking!

The lower stomach still contributes to the function of the intestines even though it does not receive or process food - it makes intrinsic factor, necessary to absorb Vitamin B12 and contributes to hormone balance and motility of the intestines in ways that are not entirely known. So when you hear that rumbly-tumbly stomach growl you can smile happily knowing your body is hard at work keeping you chemically healthy and well.

Participant Request: Your Personal WLS Experience

Hello Neighbors!

I am appealing to you for help with a book being developed by Tricia Greaves, owner/president of "Be Totally Free". She is the founder of a program to address issues of weight control, weight loss and eating disorders. Her work is very good and very much aligned with our LivingAfterWLS Empowerment Philosophy. As part of her growing body of work and support network she is researching weight loss surgery.

You are invited to participate in the survey and contribute to this exciting project. I have done the survey and I trust that Ms. Greaves will treat our topic with utmost sensitivity, accuracy, and kindness.

Click here: Weight Loss Surgery: Your Personal Experience

Neither myself or LivingAfterWLS is affiliated with Be Totally Free, or Ms. Greaves and we will not receive compensation for your participation. However, I do ask that you mention the LAWLS Neighborhood as part of your response to Question 8 about your support network. I do not think we can ever over-emphasize the value of support in this life long journey.

Thanks for taking a moment from your busy day to help build on the growing body of information about our very unique way of life.

CHEERS!
Kaye

Weight Loss Surgery is Easy, Right? WRONG!

This is one of my syndicated articles with Ezine Articles. Just this morning I listened to another news story about how surgical weight loss is easy, and a cop-out. Those who take this path are weak and too lazy to do it the "old fashioned way" (diet & exercise). Who says we don't follow a diet and exercise? Reports like this anger me! Nine years after getting "gut whacked" I'm still working to control my health by maintaining my weight, exercising and following a mindful diet. How about You? Has weight loss surgery been easy for you?

I hope you enjoy this article - Please leave your feedback.

CHEERS!
Kaye


Gastric Bypass: The Easy Way Out of Fat Land - Right?
By Kaye Bailey

If you listen, even for a moment, to the talk in overweight communities you will almost always hear that gastric bypass weight loss surgery is the “easy way out” of Fat Land. People with weak spirits and good insurance get a lucky break, have their stomachs whacked and stapled and lose weight the easy way. Weight Loss Surgery: seen by pious public to be surgical baptism for the guilty gluttonous slothful.

But those of us who step in the water to be cleansed of our fatty sins know better. Weight loss surgery is NOT the easy way out, a simple dunking of the repentant, the sins atoned, and the price paid, the soul and body healed. We know the atonement is paid every day for the rest of our lives when we set our healthy house in order with gastric bypass.

We understand that WLS is not easy. Why, then, does the public think it’s redemption to weight loss?

First: what the public sees is a rapidly diminishing person recently repaired by gastric bypass. The pounds melt away seemingly in a plain sight. What hides behind the curtain are the ugly demons. Dumping? We don’t talk about it. Vomiting? We don’t tell our regurgitating stories. Head games driving you insane? Who you going to tell? Who is listening? Exercising? Nobody wants to hear about the “E” word. So what the public sees front and center stage is a person consistently succeeding at massive weight loss; a person glowing in their own rebirth and betraying the fat and hopeless around them. How else can it be explained? WLS must be the magic pill, the easy-way-out of obesity hell.

Second: the WLS grass-roots public relations machine tells the public gastric bypass is easy, thus we become our own worst enemy. Tell me if this doesn’t sound familiar: “I can still eat the same things, just less of them! ha ha ha!” or how about, “I lost 145 pounds and never had to do a moments exercise – WLS is fabulous that way – no exercise required.” And so the popular belief perpetuates that fat glutton slobs can lose weight just by eating less of the same foods and never exercising. Brilliant! How easy is that?

Let me tell you what weight loss surgery is really like for me.

I am six years post-op. Two nights ago I vomited my dinner (bacon-seared sea scallops and green beans) because it was just a bit too greasy for my sensitive stomach. A week before that I became deathly ill, it’s called dumping, from snacking mindlessly on Chinese chow mein noodles. Disorientation, hot sweats and then cold chills – dumping – a dire consequence of eating the wrong foods with the malabsorptive system. This morning, just like most mornings, I walked two brisk miles on the treadmill to begin my day. This evening I spent 25 minutes strength training to maintain my muscle tone, keep my metabolism running high and making damn sure I don’t regain one single pound.

And this is how it will be for the rest of my life. I will vomit, dump, exercise and be vigilant day in and day out if I want this easy weight loss surgery to work for me.

My body does not take weekends off from weight loss surgery. I don’t get chocolate cake just because it’s my birthday. I do not have a double-cheeseburger with fries and a shake just because I’ve had a stressful day and I deserve it. My body is on the gastric-bypass plan 24-7.

Do you think that’s easy?

Weight Loss Surgery post-ops understand what I’m talking about. Many of us go through a phase of fighting the gastric bypass and engage in snacking or grazing. We out-eat the stomach pouch and regain weight and we become self-loathing. We vomit and dump and do it all over again thinking we can somehow trick the body. Eventually we learn and we get it: WLS is for life.

Weight loss surgery pre-op patients want badly to understand this, but the dieting culture has taught us to be strict for X-number days and then we get a free day. The culture has taught us if we can stick to a plan for X-weeks and lose X-pounds then we can “get back to normal”. We are all expert dieters by the time we elect to have gastric bypass surgery.

There is no back to normal after WLS – it is a lifetime lifestyle commitment.

Kaye Bailey © 2005 - All Rights Reserved

Article Source: http://EzineArticles.com/?expert=Kaye_Bailey http://EzineArticles.com/?Gastric-Bypass:-The-Easy-Way-Out-of-Fat-Land---Right?&id=71012

9 Years Post Weight Loss Surgery

Hello Neighbors!

Today marks nine years since I was gut-whacked; uh, I mean had laporoscopic gastric bypass surgery in San Diego, California. Nine years. You know, some times I do not remember what it was like to be morbidly obese. Then again, most of the time I never forget what being overweight was like.

A couple of days ago I bought a new pair of denium jeans: size 8. I was pretty disgusted with myself since at my lowest weight I could wiggle into a size 4 and at my best and most consistent weight I was quite comfy in a size 6. "How could you let yourself go like this?" I asked myself. Do we ever get over being our own worst critic?

Size 8 isn't so bad. In fact, on September 13, 1999 if you told me in nine years you will be a healthy and fit size 8 I would have thought I won the lottery. Size 8 wasn't imaginable: I was wearing a size 26-28 the day I arrived.

I'm still learning to work my tool and still have struggles. I dumped a few weeks ago after eating onion rings: 3 of them. I know greasy food makes me dump. I ate them anyway. On Wednesday I ate my breakfast too quickly and did not chew-chew-chew. You guessed it: I gave it up minutes later.

But for every struggle there are successes. I can run and play with my new puppy and not get winded. I can walk three miles on the treadmill in under 40 minutes, and still have energy to clean the house or work in the gardens. I can walk past the bakery counter without even noticing my former mistress: the glazed doughnut. More often than not I need to remember to eat rather than remember not to eat. I feel good. I feel healthy: both mentally and physically.

Sure, I would love to be back in my size 6 clothes and trust me I have a small boutique full of size sixes. But, maybe size 8 isn't so bad afterall.

LivingAfterWLS Food Editor Reaches Goal Weight!

Barbara (left) and Lynn (right) at the LivingAfterWLS Directors' Meeting:

Our good Neighbor and LivingAfterWLS Food Editor Celadon (Barbara Gibbons) has reached her weight loss goal!!! And she is just too darn sweet and modest to post about it. Registered member read about it in her blog: About Goal and Maintenance.

I consider Barbara my dear friend and power player in the LivingAfterWLS community. I can assure you, my darling Neighbors, that she always Always ALWAYS lives the best LivingAfterWLS way of life possible. She is an eager student, an over-achiever, and a down-to-earth sweetheart who believes in the best of all of us.

Congratulations Celadon --- You Have Arrived (in style!)!

The LivingAfterWLS Library

It's me again with my weekly Tuesday update. I find it hard to believe Tuesday is here again so soon! For the past several days and nights I've been face to face with my design computer writing code to finish the new and improved LivingAfterWLS Library - a project that has been back burnered several times since January. I am bound and determined to get it finished this week. Entering the content is something I do myself because having written most of the content I know what exists and have it in my mind the "RIGHT" way to put it on pages. Each Library pages takes 20-30 minutes to build so you can just imagine how time consuming this is. Hence, my vanishing act here in the Neighborhood the last several days. I have missed everyone! Thank you for taking care of one another .

The new Library has 13 Categories each with 8-16 articles and links back to active conversations in the Neighborhood or other Library pages.

When you see this button look below it for article titles. As you roll the cursor over the titles they change color to indicate they are links. Give a click and your article will open under this title button:

One of our most read areas is "Emotional Journey of Massive Weight Loss" --- and this section is now complete. You'll find articles there about body dysmorphia, anger, sex and the infamous Girls Gone Wild article.

The categories are listed under this button: and you will see it on all category index pages and the article pages. Open any category to find the articles in that area.

And to link to relevant Neighborhood topics look for the links under this button:


And finally this button will lead you to some of our valued site sponsors.


I hope you find this new layout friendly and informative. I really love the look of our new website and am anxious to continue coding (did I really say that?) in order to get it all organized so we may make full use of all that LivingAfterWLS has to offer us. And remember - you can always link directly to the Library from the top toolbar here in the Neighborhood.

Hunger is NOT an Emergency

Just this week I had a breakthrough moment when I read that naturally slender people do not treat hunger as an emergency. “Most of us who struggle with extra pounds tend to view hunger as a condition that needs to be cured – and fast,” writes Judith S. Beck, PhD, author of the Beck Diet Solution. “If you fear hunger, you might routinely overeat and avoid it,” she says adding, “Thin people tolerate hunger because they know hunger pangs always come and go, buying them some time.”

Hunger defined: the painful sensation caused by a lack of food that initiates food-seeking behavior.

Hunger is not an emergency. Interesting, don’t you think? Since publishing the 5DPT I’ve received tremendous feedback. Some people are amazed to not feel hungry, even on those difficult first two days. Others report “climbing the walls” hunger. I believe each of us responds differently to the 5DPT and there are certainly extremes between lack of hunger and ravenous hunger.

Here are some tricks for learning to treat hunger the way slender people do – a condition that comes and goes.

- Drink water or flavored water the curb hunger pangs.
- Ignore the hunger and acknowledge that you will survive.
- Establish a predictable and consistent eating schedule so your body becomes accustomed to when you will eat.
- Eat protein first thing in the morning and again at lunch and dinner.
-Supplement protein intake with Total Protein.
- Minimize visual cues that trigger hunger pangs (avoid/ignore media advertising, place snack foods in closed cupboards, avoid the office break room, etc.)
- Exercise. Take a brisk walk before giving in to hunger (this will rev your metabolism).

Finally, just as hunger is not an emergency, it is also not a failure. If you feel hunger during the 5 Day Pouch Test then take one of the steps above to ignore it. And if you are still hungry then eat something from the approved list of foods for the day. Associating hunger with feelings of failure often leads to destructive eating and inappropriate food choices. The 5DPT is a powerful tool and a great step toward building a better relationship with food and your weight loss surgery.

Read: Understanding Food Intake, Hunger, Appetite and Satiation

Gastric Bypass on CBS 60 Minutes

The CBS news magazine 60 Minutes aired a piece on gastric bypass on April 20. To date it is one of the most fair pieces I have seen, yet there was still the feel of "easy fix". Here is a summary:

(CBS) An operation performed primarily to reduce weight in the obese has some startlingly positive side effects. Gastric bypass surgery can send type 2 diabetes into complete remission, in some cases almost instantly. It can also alleviate sleep apnea, common among obese patients, which causes them to intermittently stop breathing in their sleep.

Studies also suggest gastric bypass patients greatly reduce their risks from certain obesity-related cancers, according to the American Cancer Society.

60 Minutes correspondent Lesley Stahl reports on the effects of gastric bypass surgery this Sunday, April 20, at 7 p.m. ET/PT.



Dr. Eugenia Calle, managing director of Analytical Epidemiology at the American Cancer Society, tells Stahl the incidence of many types of cancers increases with weight gain. "Our estimate is that 100,000 individuals in the U.S. a year…die of cancer because of their weight," she says. But, she tells Stahl, it's been hard to prove whether losing weight reduces the risk of cancer because most Americans will regain weight they lose. This makes gastric bypass patients interesting research subjects because they tend to keep off the weight they lose. "And in those populations, very interestingly, the…overall cancer risk is…cut in half," says Calle.

Another beneficial side effect of the procedure may have more to do with the surgery than the weight loss. Doctors noticed that bypass surgery can force type 2 diabetes into remission, sometimes right after surgery. Dr. Francesco Rubino, director of the Gastrointestinal Metabolic Surgery Program at New York Presbyterian/Weill Cornell, tells Stahl, "We thought it could have something to do with the small bowel." Operating on diabetic rats, he proved that eliminating the flow of food through the upper part of small intestine caused the remission. Rubino now hopes his findings will lead to a "diabetes surgery."

Currently, NIH Guidelines, established in 1991, recommend the bypass surgery only to the morbidly obese, or to those severely obese with a related health problem, like diabetes. Dr. Neil Hutcher, the former president of the American Society for Metabolic and Bariatric Surgery, says it's time to reevaluate the guidelines, and allow more diabetics access to surgery. "I think we have clear-cut evidence that we can do terrific things for diabetics," he says.

In reporting the story, Stahl met Dr. Bruce Miller, a family practitioner from Hopewell, Va. who also lost 120 pounds in a bypass operation. He says it affected all his health problems. "I don’t take any blood pressure pills anymore. I don't take any cholesterol pills anymore, as well as my diabetic medicine," he says. Miller is now recommending the surgery to many of his obese patients and says he no longer sees it as a last resort, as many doctors do. "They haven’t walked the walk," he tells Stahl.

Read our Neighborhood Discussion about this featured report.

The Bariceutical Prescription

Nutritionally deprived, wrinkled, drained and tired is not what Silvia Demeter envisioned when she underwent gastric banding surgery in 2003. But that is how she found herself feeling after losing weight.

"I felt like I was starving. My skin was wrinkled, my hair was falling out. I felt drained and tired. Even grocery shopping or caring for my family was a chore. By 5PM each day I was a couch potato," said Silvia. Even as an obese person Silvia was mindful of nutrition turning to organic solutions to meet her nutrional needs. " After surgery I was taking the hard-tablet vitamins prescribed by my surgical weight loss center. But with a gastric band hard vitamins get stuck and I suffered from acid reflux."

But worse than the acid reflux was the inability of Silvia's body to absorb the greatly needed nutrients in the vitamins. Studies indicate that it takes a normal digestive system as long as four hours to absorb as little as 20% of the nutrients in a vitamin. The inactive ingredients in vitamins such as binders, fillers, artificial colors, flavors, wax coatings and preservatives slow down absorption.

No wonder Silvia and so many weight loss surgery patients are nutritionally deficient.

In her very personal struggle to become nutritionally healthy Silvia visited health food stores and started mixing her own cocktail of liquid vitamins. But it wasn't enough. "I started attending conventions and consulting with an absorption specialist, along with many bariatric professionals because there had to be a better way to meet my nutritional needs," said Silvia.

Silvia became her own scientist and surrounded herself with the best experts in the fields of nutrition, absorption and bariatrics. The result: The BariCeutical Prescription, the only patent-pending bariatric supplements specifically designed for the bariatric patients and endorsed by top physicians in the United States.

BariCeutical liquid vitamins immediately release nutrients in the gastrointestinal tract within thirty seconds of consumption and the overall absorption is 98%. Silvia says, "With each vitamin supplement that we make our goal is to provide you with meaningful vitamins that provide you maximum benefit. Through research, quality control and quality ingredients that's the BariCeutical Prescription difference. It's our life's work."

Silvia Demeter is the real deal: she is one of us. Her passion for living well after gastric weight loss surgery is unsurpassed. "I founded this company for me because I wanted to feel like my old self, full of energy and ambition. Now it is my pleasure to share these products with the world of weight loss surgery so that everyone can be nourished and feel the energy of a healthy weight well-fed body."

Learn more about The BariCeutical Prescription and living a well-balanced nutritionally fit life.

Visit These Blogs!!

Hello!

As you know, at LivingAfterWLS we celebrate the WHOLE person, not just the person who happens to have undergone surgical weight loss treatment. Apparently we are not alone - check out these blogs from real life, real people who are fighting morbid obesity and LIVING! That's what I'm talking about! Take a click - you won't be disappointed!


To inspire and motivate your creativity! by Jana in Alaska
Don't kid yourself, Jana doesn't just stamp, she cooks, she inspires and she motivates. Bookmark her today! BTW, in the LivingAfterWLS Neighborhood she's earned the title, "OneHOTMama" but you'll see her posts by OneTallMama. You be the judge: I think she is pretty darn hot!

Fairly new to blogging, this WLS Sister just joined the century club (100+ pound weight loss). She is blunt and honest and darn right funny. Click to read Unsaved Loved Ones and feel the love! She doesn't mince words and softly mocks "the hills are alive" PollyAnna mentality of some blogs (livingafterwls.blogspot.com included) but she is the real deal. She gets the weight loss surgery gig and is worth your bandwidth in a good time reading.

Meet Jodi Klucher: WLS hero and champion of that little talked about topic: Post Traumatic Stress Syndrome after Childbirth. A must read for all moms and moms-to-be out there. Don't miss it. Jodi is one of only a handful talking about PTSD after childhood: I see a book in her future. Who else can talk about these two topics with personal experience, knowledge and compassion. Again, we learn from her, you never need to walk alone.

Blog on my friends! You are a valued part of our WLS growing body of knowledge even as our own bodies shrink! I am proud of each of you!!

Hunger is NOT an Emergency

Just this week I had a breakthrough moment when I read that naturally slender people do not treat hunger as an emergency. “Most of us who struggle with extra pounds tend to view hunger as a condition that needs to be cured – and fast,” writes Judith S. Beck, PhD, author of the Beck Diet Solution. “If you fear hunger, you might routinely overeat and avoid it,” she says adding, “Thin people tolerate hunger because they know hunger pangs always come and go, buying them some time.”

Hunger defined: the painful sensation caused by a lack of food that initiates food-seeking behavior.

Learn More: Understanding Hunger, Appetite and Satiety

Hunger is not an emergency. Interesting, don’t you think? Since publishing the 5 Day Pouch Test I’ve received tremendous feedback. Some people are amazed to not feel hungry, even on those difficult first two days. Others report “climbing the walls” hunger. I believe each of us responds differently to the 5DPT and there are certainly extremes between lack of hunger and ravenous hunger.

Here are some tricks for learning to treat hunger the way slender people do – a condition that comes and goes.

- Drink water or flavored water to curb hunger pangs.
- Ignore the hunger and acknowledge that you will survive.
- Establish a predictable and consistent eating schedule so your body becomes accustomed to when you will eat.
- Eat protein first thing in the morning and again at lunch and dinner.
- Minimize visual cues that trigger hunger pangs (avoid/ignore media advertising, place snack foods in closed cupboards, avoid the office break room, etc.)
- Take a brisk walk before giving in to hunger (this will rev your metabolism).

Finally, just as hunger is not an emergency, it is also not a failure. If you feel hunger during the 5 Day Pouch Test then take one of the steps above to ignore it. And if you are still hungry then eat something from the approved list of foods for the day. Associating hunger with feelings of failure often leads to destructive eating and inappropriate food choices. The 5DPT is a powerful tool and a great step toward building a better relationship with food and your weight loss surgery.

Learn more about the 5 Day Pouch Test and get back your surgical weight loss tool.

Thanksgiving Desserts for Surgical Weight Loss

Have you started planning your Thanksgiving menu? In just two short weeks we'll be carving the great American turkey and giving thanks for life's bounty.

Desserts always present a special challenge as we try to follow our weight loss surgery dietary guidelines, but also desire to participate in family rituals and traditions of Thanksgiving. Today I opened my treasured Neighborhood Cookbook and found this great recipe for pumpkin pie that works just fine for all those who will be seated at my table. I hope it will find a spot on your holiday menu. The Neighborhood Cookbook is a collection of recipes from our Neighborhood - Real cooks living real lives and doing their best with weight loss surgery.

Kabuki's Sugarless Pumpkin Pie
Page 155 - Neighborhood Cookbook

This is a fine substitute for traditional pumpkin pie. If you truly want to go low carb omit the crust and serve as pudding.

Ingredients:
1 pre-baked pie shell
2 small boxes sugar free vanilla instant pudding
2 cups milk
2 cups plain canned pumpkin
1 1/4 teaspoon pumpkin pie spice

Blend all ingredients using a wire whisk until smooth. Pour into baked pie shell and chill until serving. May serve with a dollop of lite whipped topping or freshly whipped heavy cream.

Serves 8. Per serving: 178 calories, 4 grams protein,8 grams fat (3 grams saturated), 23 grams carbohydrate and 2 grams dietary fiber.


If you have the Neighborhood Cookbook consider these Sensible Dessert recipes this holiday season:

Chocolate-Almond Macaroons (page 150)
Gingerbread Cake (page 152)
Macadamia White Chocolate Dessert (page 158)
Pumpkin Mousse (page 161)

To order you cookbook Click Here. It's on sale now for $18.00 and comes with your choice of a free gift!

When Surgery Does Not Work

Published in the October 2, 2007 You Have Arrived Newsletter

Thoughts From Kaye
When the surgery doesn't work

When someone is frustrated with their surgical weight loss, perhaps by a plateau, complications or even weight gain, I often hear the words of despair, "I guess I'm just one of those who the surgery is not going to work for." Early in my weight loss surgery work I thought this was a false statement, perhaps even a cop-out. But lately I have come to understand that it is, collectively, a true statement: Weight loss surgery does not work for the patient, any patient. What? How can so many patients thrive with weight loss surgery and so many others struggle? Consider this:

The surgery does not work for the patient; the patient works for the surgery.

The surgery does not make our food choices.
The surgery does not drink our water.
The surgery does not do our exercise.
The surgery does not chose to follow or break the rules.

The patient makes the choices; the patient works for the surgery.

In our pre-op counseling we nod our heads and agree to the weight loss surgery incantation, "surgery is only a tool." I don't know about you, but I secretly hoped that surgery was going to be, after all, the easy way out. Turns out, it was just a tool.

A tool is a device used to accomplish a task. Consider a carpenter at his workbench with his tools. Before him is a saw, a hammer, wood, a measuring stick and nails. All tools of his trade. The carpenter could stand before his tools and yearn for the tools to craft a magnificent treasure box. But the tools will not work on yearning alone. The carpenter must select the correct tool for the task and then work for that tool using it to the best of his capability to craft the magnificent treasure box. The carpenter works for the tools, the tools do not work for the carpenter.

And so it goes with our weight loss surgery tool. Yearning and desire will not cause the tool to craft the treasure of a new healthy body. The tool will not work on hope alone. As owners of this powerful weight loss surgery tool we become stewards to work for it, to pursue our greatest potential through knowledge, practice and personal responsibility. We must use the tool as a device to accomplish a task. When we start taking responsibility for working the tool our chances for success increase tenfold.

It is true, the surgery does not work for me. I work for the surgery.