BMI » Paleo

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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WHEN IS MEASURED EATING UNHEALTHY?

ramana — Wed, 12 Aug 2009 12:57:48 +0000

If you, like me, are interested in fat loss, you could do with a bit of calorie counting! If you don’t know what you are eating on a daily basis, the chances are you count yourself as one of those freaks of Nature who become fat in spite of eating ‘nothing’, someone who grows fatter with every glass of water s/he drinks!

I strongly urge you to maintain a food diary or journal where you can be judged as far as your nutrition is concerned. Various online journals like Fitday automatically and easily calculate your nutritional intake on a daily or even monthly basis, allowing yourself to judge where you are going wrong.

For example, you may realise that a lot of your calories are hiding behind the innocent biscuits and frapuccinos that you keep having, or the chips you absent-mindedly munched while watching TV.

Once you catch on to this, you can change your habits/eating style to effect a cutback in calorie intake. Similarly, you can detect the source of your caloric excess: usually they would be derived from carbohydrate sources like processed foods or sugary drinks.

So, I would say anyone keen on losing weight should first show me what they are eating. You really can’t plan nutrition unless you know the background of the patient.

However, at a point of time, calorie counting and portion watching and nutritional label checking grows to a point where people have an unguarded opinion that your sanity has taken a Southwards bend. Where you are actually a victim of orthorexia. When this happens, you have become neurotically obsessed about eating, health and getting thinner. This is also called OCE- Obsessive Compulsive Eating.

(image credit: awakeningcharlotte.com/…/ )

If you keep counting calories and macros (percent saturated fats, vitamin daily requirements, etc) to the point where you are using food as a capsule, not as a pleasurable source of sustaining your body’s engine, then you are losing out on life. You don’t want to end up unhappy and obsessed over crazy details. You want to get healthier and thinner without a ticket to the asylum.

There are ways to loosen up, enjoy life and food, and yet grow thinner. This can be achieved in various ways, which I will merely mention in this post. More detailed analysis will be separate posts for later.

1. Intermittent Fasting: If you fast for two days a week (for a full 24 hours each), you can lose 20% of your normal calorie intake in a week. Means losing fat. Provided you do some form of weight training, as you don’t want to lose muscle. You want to lose fat alone. There is growing research supporting IF.

2. The Warrior Diet: Popularised by Ori Hofmekler, the Warrior Diet also keeps you fasted through the day, and you end the day with a huge meal, eaten within a four hour span. This continues ad infinitum.

3. The Paleo Diet: More a lifestyle than a diet, the Paleo-philes advocate eating like Grok, the caveman. No processed foods, grains or dairy are allowed in this diet. It turns out to be a low carb, high protein and high fat diet. You can eat things like beef, pork, bacon, butter, ghee, etc. in plenty. If it is natural, it is likely to be Paleo. A great lifestyle, in my opinion!

4. The Cheat Diet: Not to be taken literally, if you eat sensibly through the week, you could have weekend cheat meals. This prevents uncontrollable cravings that generally destroy diets. It is considered important to give the patient some degree of flexibility in a diet.

5. Common Sense Approach: If you can eat sensibly, avoiding energy-dense foods like processed sugars, refined flour products, sugary drinks, and eat only when genuinely hungry, you can keep within reasonable caloric and nutritional balance. In this approach you eat natural foods as often as you can, but do indulge when you want to. If you are active physically, this might not get you into the gymnastics team, but you could manage in reasonable shape.

Too rigid a diet is counter-productive for several reasons:

* Dieters may go totally off the bandwagon if they succumb once to temptation. Studies back this up.

* They may decide the constant struggle for control is not worth it and give up.

* They may become orthorexic: constantly agonising over carbs, calories and other minutae.

* Not eating with other people (social eating) is a common phenomenon if you are very rigid about your diet. In this scenario, personality disorders can occur if you go overboard.

* Constant dieting may depress metabolic rate, something a cheat meal may kickstart. This may be a complex phenomenon acting through a leptin-mediated pathway.

Whichever diet plan you chose to follow, you must strike foot on rational ground, or you risk sliding into the morass of overating and bingeing with cyclical guilt trips, or becoming a Diet Nazi. Be careful!

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