There are a couple of ways to define overweight, obese and morbidly obese body types.  One way to define these terms is to compare against a recommended weight.  The recommended weight is determined by a mass number of surveys done of the general population.  If your weight is 10% more than the “average” person, you are considered overweight.  People weighing 30% more than the norm are obese, and those reaching 50% more weight than their healthy counterpart are considered morbidly obese.  Morbidly obese people are at a dangerous weight with high risk factors for diseases such as heart, liver, and kidney disease, diabetes, certain cancers, and other life-threatening illnesses.

Another measurement used to determine obesity is BMI or Body Mass Index.  This calculation is done using height and weight.  It is a relatively simple calculation to do.  Your weight, in pounds, is divided by your height, in inches, squared.  The weight/height ratio is then multiplied by 703. A healthy BMI range is 18 to 25.  A BMI over 25 is an indication that you are overweight, while a BMI of 30 or more is obese.  In general, the BMI calculation is a good indicator of body fat percentage.  However, it does not always tell the whole story.  Those with a large percentage of muscle mass may be heavier, resulting in a higher BMI.  Though their BMI may indicate they are overweight, their body fat percentage may be very low.  Because of this discrepancy, other indicators, such as waist size, should be taken into consideration when determining obesity.  A waistline over 40 inches for men, and over 35 inches for women is a red flag that risk for obesity related disease is more imminent.

If you are overweight or obese, are you a good candidate for bariatric surgery?  Not necessarily.  All non-surgical options should be considered before deciding on a lap-band or gastric bypass procedure.  As with any surgery, there are risks.  It should be noted that bariatric surgery does not take the place of diet and exercise, and these options should be exhausted before resorting to an operation.  However, if you are morbidly obese – meaning your weight is immediately life-threatening – and you have not been able to maintain a healthy weight through diet and exercise, bariatric surgery may be the right option for you.

Focus 28 Team

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There are a few common side effects one might experience after having a bariatric surgery procedure done such as gastric bypass or Lap Band surgery.  Drastic weight loss can take a toll on the body, but if you educate yourself on the potential complications, you can reduce or eliminate side effects.

Hair Loss:  After bariatric surgery, the body is left with a much smaller capacity to take in food.  The number of calories you consume each day is greatly reduced from before.  Your body has to use the few calories it does receive as efficiently as possible.  The nutrients need to go to your vital organs and systems.  Cutbacks need to be made somewhere, and the hair follicles do not receive the nutrients they need to grow.  Some will remain in a suspended mode where they do not grow and others will fall out.

While hair loss cannot be completely prevented (we naturally lose hair on a day to day basis), it can be lessened.  Because hair is made of protein, it is important to follow your doctor’s recommendation for protein in your diet every day.  There are also protein shakes and supplements you can take to increase your protein intake.  In addition to protein, take care of your hair.  Heat and chemicals can damage your hair, so avoid your monthly dye job and go easy on blow dryers and flat irons.

Excess Skin:  Some people find they are left with unsightly hanging or excess skin after rapid weight loss.  If you have a large amount of excess skin, there is a possibility of chaffing and developing a rash in the folds and creases.  If skin is only a little loose, it may bounce back as you continue your diet and exercise regime.  If you really feel it is a problem, there are post- bariatric plastic surgery options.  A tummy-tuck, a face-lift, or even a whole body-lift are all routes you can consider in dealing with excess skin.

Vitamin Deficiency:  There are two reasons for vitamin deficiency after gastric bypass surgery.  First, the amount of nutrients you can intake is greatly reduced because you are eating much smaller portions.  Secondly, the section of the small intestine that is responsible for absorbing vitamins is bypassed.  The main vitamins of concern are calcium, iron, vitamin D and vitamin B12.  A vitamin supplement is necessary to counterbalance vitamin deficiency after bariatric surgery.  There are some supplements that are specifically formulated for post-bariatric surgery.

The bottom line:  Getting proper nutrition and exercise after surgery can reduce or eliminate potential side effects.  The more prepared you are to combat these sided effects before your surgery, the better results you will get.

Focus 28 Team

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Bariatric surgery consists of several procedures, all of which reduce or control the amount of food that passes through the digestive system. By reducing the amount of food consumed there is a reduction in the amount of nutrients and calories absorbed through the stomach and small intestine. While this leads to weight loss, it can also lead to a lack of nourishment, so people who undergo these operations must be vigilant with their diets. 

Who should consider bariatric surgery? 

Someone who is severely obese, with a body mass index near 40 may be a candidate. If this person has tried different diets throughout their life without results and is prepared to do anything to lose their excess weight, bariatric surgery may be something to consider. Consulting with your doctor is the best advice any reference guide could give, as your doctor is capable of evaluating each case and determining who may be eligible for such drastic treatment. The patient must be severely overweight, with a body mass index of 40 or higher. A Body mass index of 35 or higher may also be considered for bariatric surgery but the patient must also have conditions that affect their health, like diabetes or heart disease, even respiratory problems. The most important factor is that a patient has the determination to complete their weight loss journey by following strict dietary guidelines for the rest of their life. 

For those who meet this criteria, these surgeries could be a life saver. While these surgeries offer life saving benefits, they also carry with them some hardships including surgical complications and a lifetime of routine centered around eating much, much less. 

While these procedures can be a miracle for some people, for others who are overweight, proper nutrition and proper exercise is at least a step in the right direction. The surgeries do not do all the work and there is a strict diet to go along with it. In fact, before a patient even goes under the knife he or she will have to show their doctor they have the focus to stay on a strict diet by eating only the foods they will be eating after surgery.  These patients must take into account the routine they must follow, the costs of the surgery and the supplements they will be taking, even the possible cost of therapy and cosmetic surgery down the road. 

Focus 28 Team

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For those who have been unable to lose weight through diet fixes and exercise, bariatric surgery is a possible step that may lower their body mass index, improving their health.  

There are several surgical options to choose from. Each one has the normal surgical risks attached to it, and consulting your doctor is the safest way of securing the most information about these procedures. Candidates for these procedures must have a body mass index of 40 or higher, or 35 or higher with at least one health risk or obesity related disease. After surgery patients will often have a rigorous diet to commit to and have to take vitamins and supplements to make up for their lack of nourishment. These surgeries all work by making the patient feel fuller faster while reducing the amount of calories absorbed into the body. 

Roux-en-Y gastric bypass surgery is a popular form of bariatric surgery where medical staples are used to create a smaller stomach, leaving the rest of the stomach alone. A section of the small intestine is attached to the new small stomach pouch so that food bypasses the stomach altogether. This procedure has been around the longest, and surgeons have become quite good at these operations. Without a stomach to break down certain foods, dietary guidelines are strict and must be followed diligently.  

The LAP-BAND operation uses a silicone band filled with saline to create a small stomach pouch near the top of the stomach. Unlike gastric bypass where no food ever reaches the stomach, food still passes through the small portal made by the adjustable band. This procedure is increasing in popularity because of the lessened diet restrictions and reduced use of staples. The adjustable band procedure is performed laparoscopically so there is less scarring as well.

With a sleeve gastrectomy, a large portion of the stomach is permanently removed, leaving the stomach as a tube or sleeve shaped remainder, 15% the original size. No foreign body is left inside the patient, and this procedure can be done as the first of two procedures on very obese patients, which a normal gastric bypass as the second procedure. 

Focus 28 Team

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Weight loss surgery, through all its risks and complications, carries with it many positive benefits. After a gastric bypass or lap-band procedure, rapid weight loss occurs quickly. During this rapid weight loss patients will often find their previous conditions start to slow, or disappear completely. Many morbidly obese diabetics have gone on to watch their diabetes shrink until they no longer need to take insulin. Other diseases that have been associated with obesity include heart disease, high blood pressure, depression, high cholesterol, sleep apnea, osteoarthritis, and infertility. These too may improve after surgery. 

One of these conditions in particular must be paid special attention. Infertile women who undergo weight loss surgery are likely to become more fertile. This is a wonderful blessing for those who want children but were unable do to obese infertility. However, there are many concerns in the area. In the two years after the surgery is when most excess weight is lost, as much as 77% in as short as 12 months. During this period the patient is eating very small portions and may not be getting all the nutrients their body is used to. A pregnancy during this time would have a much larger chance of miscarriage, low birth weight, and a host of complications. The first trimester is critical to the development of a baby’s organs and neurological system, and without the nutrition required it is considered unsafe to conceive at any time during this “rapid weight loss.” But is pregnancy ever safe for post-op bariatric patients who have lost the weight and are keeping it off?  

Not only is childbearing possible for post-op patients (after the initial rapid weight loss period), but many women seek these types of surgeries in the hope that the weight loss will resolve their infertility issues, allowing them to finally have a baby and be able to “keep up” with it. When a patient eventually conceives, a healthy pregnancy and complication-free birth can result if the mother and child stay nutritionally balanced. The patients’ doctor and dietician closely monitor every case, adjusting dietary needs and vitamin and mineral supplies. The fetus is closely monitored during the entire term to make sure growth restriction is not an issue. The mother is encouraged to be as close to her goal weight as possible prior to the pregnancy. As with any mother, healthy weight gain during the pregnancy is still required.   

Focus 28 Team

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I am an obese American. There is a good chance if you are reading this that you are an obese American. As a nation we can’t seem to get our proper nutrition and exercise. Perhaps, like me, you can lose weight slowly if you work hard at it, but then put it back on easy as pie, perhaps a 16 inch deluxe. A couple weeks of eating pizza and watching playoffs or eating fast food and I am right back where I was. Why is this? Why are we as a country getting fatter? Why are our children getting fatter? Why is staying motivated and losing weight so hard these days? 

There are many factors involved here. First, we live in a society with money to float around. Even though we are facing “tough economic times” people are still paying for cell phone service, TV service, the internet, their cars, and of course, food. Technology has surrounded our lives, making them “easier.” Unfortunately, the more channels a TV provides the longer you or I will sit in front of that TV. This may result in profit gains for some, but leaves us with weight gain and no motivation.  

Second factor, the food we eat is just terrible. There are so many products in our grocery store available to us. The healthy products are in there somewhere, but we tend to shop more with our wallets than with our waistlines. Whatever is on sale catches our eye, when we should be reading nutrition labels. Today’s foods are packed with sugars and starches. A cheap alternative, high fructose corn syrup, has replaced sugar in many products. Once we buy these products rich with saturated fats and high calorie counts and put them in our kitchen it will be very difficult to refrain from eating them. Of course if we don’t buy groceries there is an even worse alternative, the relatively cheap, incredibly unhealthy fast food drive thru line. 

Our kids are facing the same problems as us, but at a developmental age when they need to be the most active of all. This equates to one tough road ahead. Not only are they battling all the kids’ television stations, internet sites, happy meals, and video games, but parents who watch the increased coverage on sexual predators are not as eagerly pushing their children out to play. When I was a kid I would ride my bike to all my different friends’ houses in the neighborhood, just to see if they were home. Now kids can just hop on the internet and not only communicate with their friends, they can play games with them, leaving their bikes untouched. Kids need to burn more energy than the rest of us, making it that much easier to become obese if they stay dormant. 

As a nation we must buy healthy, get off the couch, stop drinking so much soda, and find a physical hobby that suits us. 

Focus 28 Team

www.focus28diet.com

In the world of bariatrics most of the emphasis is put on the price a person must pay if they really want such a life altering procedure. Chances are a morbidly obese person is already paying quite a high price already, both in physical health issues and ridicule from the general public for being so obese in the first place. After a bariatric surgery, the price to be paid is in dedication, motivation, and a commitment to a whole other lifestyle.   

But what about the real cost in the terms of money? How much does an operation like this cost, and who pays for it? 

As far as the actual surgery, prices can vary based on which procedure is done, what surgeon is doing it, how long the patient will be in the hospital, and the cost of anesthesia and other medical supplies. Costs can range from 20 to 30 thousand dollars for one of the major bariatric operations like a gastric bypass or lap band procedure. Insurance may cover some or all of the procedure costs, but there will still be costs that the patients will have to cover by themselves. This may include the dietary supplements, protein shakes, etc. that a post-op patient will be taking the rest of their lives. Surgeries down the road to remove excess skin or other cosmetic procedures will also not be covered by insurance. Sometimes patients have a hard time accepting their new body image and will require counseling or therapy.  

Insurance coverage for these surgeries also varies by which insurance provider is involved and what state the patient lives in. Some insurers will pay a large portion but not all the expenses, and it is important a candidate for weight loss surgery contacts their insurance and finds if their plan covers the procedure. To help the cause, doctors will submit information to the insurance company on behalf of the patient. This information may include the patient’s height, weight, and body mass index history as well as a history of the obesity-related health conditions suffered by the patient and how this affects their daily lives. One of the most important submissions is a history of supervised diet plans the patient has undergone in past years. 

Bariatric surgery does not come without costs, both financially as well as mentally. The benefits, though, often make these costs worth it as health issues dissipate and lives are prolonged.

Focus 28 Team

www.focus28diet.com

With all the talk about health care and health concerns in this country, it is important to point out the dangers of obesity in any population. Obesity is like a dirty sink. You can’t use the sink to clean dishes until you clean the sink itself. For those who are overweight and facing serious health risks, it is hard battling their diabetes or heart disease unless they lose their excess weight or undergo risky bariatric surgery. Americans are becoming fatter than ever thanks to several factors.  

First, our diets are terrible. Even in these tough economic times when corporations are posting continuing losses, fast food companies like McDonalds continue to report quarterly gains. Even the food we purchase at the grocery store is rich with starch and sugar. High fructose corn syrup is a cheap substitute for sugar, and is far more destructive to your body as it is harder to break down in your body than sugar. Most products that should include natural sugar now include high fructose corn syrup. In the late 1800s an average American consumed 13 grams of sugar every day. Today the average American consumes over two hundred grams of sugar every day. Sugar is in almost everything, and that much sugar is not healthy. 

With our addiction to fatty foods we must also include the psychological aspect of why we are an obese nation. Self-image is an important part of a person’s psyche, and is also a tool used to sell products. If a company that manufactures denim wants you to buy their jeans, they are going to start an ad campaign that showcases a pair of their jeans on a model, perhaps in an exotic setting. The company wants to show us how good we could look if we wore their jeans (and lost the weight to match the model’s body type) When we the consumers are bombarded by advertising of this nature, our self-image takes a hit. In response to this we feel “a step below the rest.” Over time this can lead to mild depression, which is easily suppressed by eating foods.    

Once we become obese it opens the doors to diseases such as diabetes, high blood pressure, heart disease, high cholesterol, sleep apnea, respiratory problems, heartburn, infertility, and menstrual irregularities, and osteoarthritis. It is imperative we retain the mental presence to combat these diseases by preventing them through proper diet and exercise. 

Focus 28 Team

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There are different types of surgeries with different procedures. All of them share the same goal: to help you lose weight through lessening the amount of food you crave and the amounts of nutrients absorbed from that food.  

There are two surgeries that are the most popular, the Roux-en-Y bypass, or “gastric bypass” has been around the longest. In this procedure a small pouch is created near the entrance of the stomach where food is diverted into an attached section of small intestine. The food bypasses the stomach and some small intestine, hardly allowing the absorption of calories and nutrients from the food. 

The other popular surgery, laparoscopic adjustable gastric banding, is increasing in popularity due to its simpler techniques and shorter hospital stay. The “lap-band operation” uses an adjustable band placed around the top of the stomach that pinches together, creating a pouch similar to that formed in a gastric bypass. The band’s strength can be adjusted by controlling the amount of saline inside the band. In both types of surgery the patient will feel full faster. The difference here is that food still passes through into the second half of the stomach. Weight loss is slower here than with a gastric bypass, but does not have as many food restrictions. 

After the operation patients will not only have to undergo a change in how much they eat, but also what they eat. Some foods like simple sugars need to be broken down by the stomach before reaching the small intestine. Without a stomach to do this work gastric bypass patients must avoid sugars or face unpleasant symptoms like those related to food poisoning.  In addition these patients will also have to increase their intake of vitamins and nutrients like iron and B12, calcium and especially proteins. Without these crucial ingredients a body cannot function properly, and illnesses like anemia can set in.  

While it is best to lose weight through proper diet and exercise, some people’s weights are causing health concerns. Those with a body mass index of 40 or higher, or those with a BMI of 35+ with additional obesity-related health problems are the ideal candidates for bariatric surgery. Because of the psychological effects before and after surgery, doctors require that bariatric patients are strong enough mentally to meet the challenges they will face after surgery. The bariatric community is full of support groups, both live and online. These support groups along with the patients’ own self-accountability will help in achieving the motivation needed to keep on the right path.  

Focus 28 Team

www.focus28diet.com