March 5th, 2008 by Dr. Val Jones in Health Tips, Opinion
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I’ve wrestled with this question for many years: “When is weight loss surgery an appropriate option?” I used to do weight loss research prior to working at Revolution Health. My studies focused on using “natural” methods to reverse type 2 diabetes – in other words, weight loss via diet and exercise. My study subjects were all obese, and most had struggled with weight for decades.
At some point during the trial, people would often ask: “Can’t I just have surgery for this and not have to struggle so much?” And I would gently remind them that surgery was no picnic, and to try diet and exercise first. “But it’s so hard!” they would say. I would acknowledge their difficulties and offer lots of empathy, and firmly encourage them to stick with their diet. In the end I found that only half of my study subjects could manage to stay on the diet for months at a time. So what should the other half do? Give up and let their diabetes ravage their bodies?
My friend and colleague Dr. Charlie Smith rightly points out that weight loss surgery can dramatically improve the health of people who have been unsuccessful at losing weight through diet and exercise. Heart disease, diabetes, and cancer rates were dramatically improved for morbidly obese people after weight loss surgery. So there is a clear benefit for some people to have the procedure.
However, the caveats should not be overlooked. First of all, weight loss surgery does not guarantee long term weight loss. It’s possible to gain back all the weight lost if eating behaviors are not changed. The human stomach is amazingly stretchy, and even if it’s surgically reduced in size, with repeated overeating it can eventually stretch to accommodate large meals again. Secondly, some types of weight loss surgery (like gastric bypass) can affect the body’s ability to absorb critical vitamins. Without enough of these nutrients, one can end up severely anemic, and osteoporotic just to name a few serious side-effects. And finally, the surgery itself is quite dangerous, carrying with it a potential risk of death as high as 1 in 200!
So weight loss surgery can be life-threatening, and is not a quick fix for a long term problem. However, morbid obesity itself is so dangerous (with the increased risk of heart disease, diabetes, and cancer) that it may require this extreme intervention to actually save lives. For people who have more than 100 pounds to lose, and have sincerely tried diet and exercise without success for a prolonged period, then weight loss surgery may be an appropriate option. For those whose lives are not at risk because of severe obesity, it doesn’t make sense to undergo such a risky procedure.
Are some people successful at losing a large amount of weight and keeping it off without surgery? Yes! The National Weight Control Registry keeps a list of thousands of Americans who have lost at least 30 pounds and kept them off for at least 6 years. What’s their secret? You guessed it – regular exercise and a calorie controlled diet. Some other things that these “successful losers” have in common: 1) they eat breakfast 2) they have a cardio machine at home 3) they weigh themselves regularly.
If you’d like to meet a group of people who are working towards long-term weight loss success, feel free to join my weight loss support group. We have weekly challenges, tools and trackers, a vibrant discussion group, and free medical insights to help you along your way. Weight loss is really hard to achieve by yourself. It takes encouragement, support, and a community of like-minded folks who are determined to make a difference. You can do it!… and I’d be honored to support you along the way.
P.S. There’s a special group forming at Revolution Health for folks who need to lose 100 or more pounds. It’s called “Overweight But Not Giving Up.” Check it out.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 4th, 2008 by Dr. Val Jones in Medblogger Shout Outs
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Here are some good ones from Mindy Robert’s book, “Mommy Confidential: Adventures from the Wonderbelly of Motherhood“:
***
Son (age 6): “Dad, did you have any friends of your own before you married mom?”
Father: “Of course I did.”
Son: “Well, are they all dead?”
***
Mom: “Will, would you like lunch now?”
Son: “Mom, not only do I want lunch, but I want that fly OUT of here!”
***
[Mother is with daughter at a public restroom]
Daughter (age 4): “Mommy, I need a smaller toilet.”
Mom: “Honey, these are the only ones we have right now.”
Daughter: [Every time she wiggled onto the seat to get into a comfortable position, the automatic flushing mechanism was triggered, scaring the girl nearly to death.] “Mommy, make it stop!”This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 3rd, 2008 by Dr. Val Jones in Uncategorized
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Ok, it’s no surprise why Dr. Val is leading a weight loss group
here at Revolution Health. She is a serious food lover. And for those of you who are equally smitten with all things gastronomical, check out the list of folks that I’ll be schmoozing with next month:
Daniel Boulud
Gary Danko
Dean Fearing
Gael Greene
Jess Jackson
Thomas Keller
Sirio Maccioni
Danny Meyer
Robert Mondavi
Robert Parker
Jacques Pepin
Paul Prudhomme
Wolfgang Puck
Ruth Reichl
Phyllis Richman
Mimi Sheraton
Martha Stewart
Jeremiah Tower
Charlie Trotter
Jean-Georges Vongerichten
Alice Waters
Tim and Nina Zagat
It’s the 30th Anniversary Celebration of the Inn at Little Washington! Let me know if you’re planning to be there… or if you’re just jealous.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
March 1st, 2008 by Dr. Val Jones in True Stories
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I was reading Keagirl’s latest post about a urology consult that she did in the psychiatric lock-down unit. Her patient was hearing voices – specifically that his left testicle was speaking to him. The good doctor was able to maintain a straight face through the exam and interview. There have been times when I suspect that my expression has given away my underlying feelings. A few of my awkward moments:
***
Dr. Val: Hello, Mr. R. I understand that you’ve had thrush in the recent past, and that your CD4 count has been as low as 25. Have you had any problems with thrush lately?
Mr. R: Oh, not at all. I found a way to cure it.
Dr. Val: Oh, very good. Tell me what works for you [expecting to hear ‘nystatin swish and swallow’ or ‘diflucan,’ I smile hopefully at the patient].
Mr. R: Well, basically since I started drinking my own urine the thrush has gone away.
Dr. Val: Oh… [pregnant pause] I see [scribbles note on clipboard as she takes one step back from the bedside.]
***
Dr. Val: [interviewing new patient in the inpatient drug detox program] So tell me a little bit about what brings you here today, Mr. S.
Mr. S: Well, you know, I have a real problem with crack cocaine, heroine, and alcohol.
Dr. Val: Yes, I see. Well, it’s good that you’re here now. [I smile genuinely].
Mr. S: But doc, I have to tell you why this all started.
Dr. Val: [Leaning forward, expecting a potentially important insight] Yes, what do you think is behind the drug addiction, Mr. S?
Mr. S: Well, I was born with a deformed penis and I think a lot of this has to do with my low self-esteem.
Dr. Val: Hmm. Well, I can see how that might be very challenging to overcome [eyebrows furrowing in a concerned expression mixed with mild awkwardness and some surprise].
Mr. S: I’d really like to show you what I’m talking about.
Dr. Val: Um… well, I uh… don’t think that will be necessary at this time. I trust you…
***
Nurse: [calling from psychiatric lock-down unit]: Is this the rehab consultant?
Dr. Val: Yes, I’m on call for rehab today.
Nurse: We have a man here with difficulty swallowing and we were wondering if you could take a look.
Dr. Val: Ok, what brought him to the psychiatric lock down unit?
Nurse: Well, he tried to kill a nurse at the transferring hospital – she got too close and he got a hold of her neck. But he’s not too hard to pry off because he has no eyes.
Dr. Val: No eyes?!
Nurse: Yeah, he cut them out several years ago during a psychotic episode. He used a piece of broken glass to gouge out his eyes and cut off his nose and ears too.
Dr. Val: Oh my gosh… that’s really terrifying. [Pauses with images of Silence of the Lambs floating through her mind] May I ask why he can’t swallow?
Nurse: I don’t know why he can’t swallow. That’s why I’m calling you.
Dr. Val: Well, I mean, how do you know he’s not swallowing? Did you see him choke?
Nurse: No he’s not drinking at all.
Dr. Val: Well, is there a cup next to him? Does he know it’s there?
Nurse: [silence]
Dr. Val: Ok, I’ll put him on my consult list…
***
You can’t make this stuff up.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
