BMI » Mediterranean diet

MAKING THE MOST OUT OF LIFE AFTER BARIATRIC SURGERY

ramana — Sun, 08 May 2011 13:26:34 +0000

Those who undergo or contemplate bariatric surgery do so essentially as a second chance at life. I mean that the severely obese man or woman feels that he (or she) has lost out in life on multiple fronts. Here are a few examples:
Loss of body contour/beauty: you can’t forget how you were once before the fat started piling on.
Poor self image: you hate the thing you see in the mirror.
Poor quality of life: you can’t dance, surf, skip, run or walk without some kind of pain or discomfort. Going up one floor makes you breathless. You avoid holidays where you would need to walk, especially on hilly terrain.
Sexual issues: whether it is inability or unwillingness of one’s partner, sex life may take a back seat or even come unseated!
Health loss: you suddenly have been diagnosed to be having diabetes or heart disease (or anything else) and, suddenly, life sucks!
Social alienation: Even though there have never been as many obese people in the planet as the present, the morbidly obese individual catches everyone’s eye the wrong way. People make jokes, there is job discrimination, and even marriages get burnt!
The need for bariatric surgery serves as the wake-up call. What many people don’t realise is that bariatric surgery should not (and is not) a short cut. You cannot eat all you want and stay slim after the surgery. Therefore, if you look at the long term figures of weight loss after bariatric surgery, it may be as low as 40 to 50 percent, though the initial weight loss achieved may be 75%.
Obviously, we know weight regain is an issue for patients, and has to be addressed properly.
Even better is if you can program your life to prevent weight regain.
An unnamed BMI patient (we take our patients’ privacy seriously) writes to me:

Seems like such a long time ago that I was through surgery. I am still learning what I can and cannot do regarding food. I have a different attitude towards food now, which I never would have believed possible. I find the Paleo Diet hard to follow but have taken some of it on board and restrict foods, such as bread and potatoes to a bare minimum (a couple of slices of bread per week) and I haven’t eaten rice since surgery. I eat an egg for breakfast and sometimes mushrooms. The days of a full Ulster fry-up are long since gone, and dinner is served on a small side plate. I see the portions people eat and shudder. I have seen me ask for a children’s portion and still not finish it. I still have some milk in coffee and I eat natural yoghurt, which is not permitted but in general, my eating habits have really improved. Fresh fruit and veg, and some fish or chicken. I can only digest minced red meat and even then, only in small quantities, but nothing can equal how I feel.

(Eat This!)

(And This!)

As I keep saying, eat natural foods and avoid man-made food products.

(Stay strong when life tempts you!)

She reflects the pursuit of that kind of eating style (like primitive or Paleo man) that I teach. In addition, she has taken up kettlebell training and getting active in general. What does a lifestyle like this (without chips, pizza, cakes and bread on a daily basis) feel to the mind?

I can’t really explain the change which has occurred inside. I have my positive attitude back and feel I can tackle the challenges with more confidence than I have had in ages. The fact I am free of all medication is also a tremendous bonus.

And the bonuses keep coming to keep you motivated.

I saw my cousin today and she couldn’t believe how well I looked since the last time she saw me. I didn’t tell about the surgery, reasoning it was my business and she didn’t need to know. She congratulated me but then admonished me not to put it back on again. I assured her that wasn’t going to happen and left it at that.
I’m enjoying being normal and, for the time being, I am happy about that. I remember you saying that was a very low priority but for the moment, I am content. I now weigh what I did in 1995 and most people have never seen me this size so it comes as a bit of surprise.

Thank you, my dear (you know who you are): these words have inspirational content that mere doctors can only hope to provide!

All photos are original property of BMI.

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PREPARING FOR YOUR BARIATRIC OPERATION

ramana — Mon, 14 Sep 2009 05:06:11 +0000

(pic credit goes to this site)

If you have decided to go for a bariatric operation, you need to do some preliminary preparation for it.

1. We tell our patients to go on a liquid diet for 15 days before the day of surgery. This does not mean you can drink ghee, condensed milk, juices and colas. You can drink soups, milk, dal, meat stocks, etc. You could also take ultra-low calorie liquid supplements like Optifast. The caloric deficit created by this would lead to around 15-20 lbs of fat loss or even more.

2. Significant fat loss immediately preceding bariatric surgery is good in terms of improving post-operative results and also in making the surgeon’s job easier. Much of the effects of the pre-operative low calorie diet is to shrink the size of the liver. This causes better visualisation during surgery.

3. A last binge before surgery is NOT a good idea! This is understandable from the patient’s point of view, but really does not do much good to him/her. Often, the last binge gives rise to one more, and then one final one, and so on. Rather than losing weight, the patient puts on some more!

4. Stop smoking and drinking alcohol! This is simply non-negotiable. Bariatric surgery is not a painless, cosmetic solution to some excess blubber your body may have. It is a serious undertaking on your (and our) part, in order to restore health to your body. There can be no healthy life if you drink and smoke. One is not referring to the occasional social drink or cigar, but you know what we are talking about! Smoking increases post-operative respiratory complications like pneumonia, as well as heart attacks and deep vein thrombosis. All these complications are terrible and potentially fatal, so be careful! Nothing is worth losing your life and health to, so quit NOW!

5. Continue to take your diabetes and hypertension medicines, unless told otherwise.

6. If you have respiratory problems like asthma, please see a respiratory physician or therapist who would treat your lungs with nebulisers, antibiotics (when indicated), and chest physiotherapy. In some patients, vaccines against respiratory pathogens (like Pneumococcus and Hemophilus influenzae) are also prescribed. Patients suffering from sleep apnea may need a CPAP machine that helps to oxygenate the lungs during sleep.

7. Walking every day or doing some mobility exercises is good for you– this is also important for you. We encourage patients to be ambulant immediately after surgery, and this helps.

8. Prepare a food journal– this should become a habit after your operation, so start anyways.

9. Ask other patients about how they have adapted to life after bariatric surgery. Remember that they may have a different procedure and their adaptations and restrictions may not apply to you!

10. Do you need further counselling? Are you nervous or unsure about anything? Don’t hesitate. Ask your bariatric surgeon!

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LOW CARB DIET BETTER FOR DIABETES!

ramana — Tue, 01 Sep 2009 00:30:21 +0000

According to a study published in the Annals of Internal Medicine (September 1 edition), a Mediterranean diet low in carbs scored far better in diabetics than a low fat diet as recommended by the American Heart Association.

Article source here.

A summary in Medpage Today says that “Among diabetics who followed a Mediterranean-style diet, only 44% required antihyperglycemic drug therapy, compared with 70% of patients who followed a standard low-fat diet (95% CI -31.1% to -20.1%, P<0.001)”.

“Compared with a low-fat diet, a low-carbohydrate, a Mediterranean-style diet led to more favorable changes in glycemic control and coronary risk factors and delayed the need for antihyperglycemic drug therapy in overweight patients with newly diagnosed type 2 diabetes,” Dario Giugliano, MD, PhD, of the Second University of Naples, and colleagues wrote.

Full Medpage Today article may be read here.

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