There are 4 messages in this issue.
Topics in this digest:
1a. Re: Favorite Protein Drinks
From: patty7194@aol.com
1b. Re: Favorite Protein Drinks
From: krsandahl@aol.com
2a. Final Research Paper
From: AlLee
2b. Re: Final Research Paper
From: Gena
Messages
________________________________________________________________________
1a. Re: Favorite Protein Drinks
Posted by: "patty7194@aol.com" patty7194@aol.com patty7194
Date: Wed Dec 16, 2009 8:11 am ((PST))
My absolute favorite protein drink is one called Click....it is a coffee/mocha flavor, absolutely delicious. 15g protein, I usually add 1/2 scoop of vanilla or cinnamon latte, and when blended it tastes a lot like something you'd buy from Starbucks! you can find it on amazon.com
Patty in UT
[Non-text portions of this message have been removed]
Messages in this topic (2)
________________________________________________________________________
1b. Re: Favorite Protein Drinks
Posted by: "krsandahl@aol.com" krsandahl@aol.com krsandahl
Date: Wed Dec 16, 2009 8:46 am ((PST))
oh my.....that sounds delish! off to amazon....
-----Original Message-----
From: patty7194@aol.com
To: afterweightlosssurgery@yahoogroups.com
Sent: Wed, Dec 16, 2009 11:10 am
Subject: [After Weight Loss Surgery] Re: Favorite Protein Drinks
My absolute favorite protein drink is one called Click....it is a coffee/mocha flavor, absolutely delicious. 15g protein, I usually add 1/2 scoop of vanilla or cinnamon latte, and when blended it tastes a lot like something you'd buy from Starbucks! you can find it on amazon.com
Patty in UT
[Non-text portions of this message have been removed]
[Non-text portions of this message have been removed]
Messages in this topic (2)
________________________________________________________________________
________________________________________________________________________
2a. Final Research Paper
Posted by: "AlLee" edallee32086@yahoo.com edallee32086
Date: Wed Dec 16, 2009 1:43 pm ((PST))
Hello,
Last month I asked for assistance with a queestionaire that I posted. This was part of my field research on my research paper. I was asked to share the final product. I want to thank everyone that participated with the survey.
Thank you,
AlLee
St Augustine, FL
Obesity Surgery:
Worth the Risks and Effects
Obesity and morbid obesity have extreme health consequences that can be reversed with surgical intervention. There are several surgical procedures available for individuals that meet the qualifications. The many diseases and illnesses that are related to obesity can be fatal if not cured. Despite the risks of obesity, there are side effects from surgery which require maintenance. The enormous ventures patients embrace during these procedures necessitate physical and mental changes before and after surgery. Although these surgeries are controversial due to negative public opinion of overweight people, the benefits far outnumber the risks of surgery in comparison to doing nothing at all and remaining obese.
Obesity has changed over the years. As early as 199 C.E., obesity was separated into moderate and immoderate obesity. As moderate obesity is tolerable; immoderate obesity "is a character flaw from a life of overindulgence and lust". In the 1950s, obesity became a medical condition and sickness, and thoughts that obesity was a moral issue were cast aside (Kelly Appendix B).
Being overweight is defined as having a body mass index, or BMI, of between 25 and 29. Individuals with a BMI of 30 or more are considered obese. Obesity among adults has doubled in the last 25 years. Today, two out of three adults are considered to be overweight, and about 27 percent of Americans age 20 or older are obese (Clancey).
Kelly states obesity classification between condition and disease can determine treatment, medicine, and healthcare coverage (89). "Obesity is the first human-made epidemic" (3). Factors of obesity include psychological (emotions), physiological (genetics), environment (home, work, community, etc.), parental influences, and advertising (120-121). People tend not to take care of their personal needs as a result to the bustle of life. Diet and exercise is commonly over looked. With processed and ready made foods, society is inclined not to pay attention to the amount of calories consumed. Television and computers contribute to a sedimentary lifestyle. An analogy made by Kelly is "genetics loads the gun, but environment pulls the trigger to make the perfect epidemic" (5). Obesity is currently considered a disease. It may not be contagious, but it can be life threatening.
The multitude of medical problems from obesity can be controlled by weight loss. Shown on the website U.S. Bariatric, obesity related diseases include: the number one killer in America - cardiovascular disease, , all types of cancer, cerebrovascular diseases including high blood pressure and strokes, respiratory disorders including asthma and obstructive sleep apnea (OSA), diabetes, orthopedic conditions such as arthritis and gait problems that cause pain and can lead to accidents such as falling, Alzeheimer's disease, and others take in account kidney disease, fatty liver disease, and septicemia (septic shock). Studies of brain scans in elderly, overweight woman exhibit considerable brain tissue loss that affects talking, understanding, and memory: "Some scientists surmise that as much as 25 percent of cases of dementia may be due to BMI and its relationship to high blood pressure, high cholesterol, and type 2 diabetes" (Kelly 85). Obesity results in early death in several ways. Doctors are now treating overweight patients more aggressively. "The NIH [National Institutes of Health] reports that 15 to 20 percent of all deaths in America are related to obesity" (Kelly 74).
Reports issued in 1954 document the first bariatric surgical procedures (Kelly App B). There are two main types of surgical procedures; they include food intake restriction, malabsorption, or a combination of both (Leach Vii). Gastric bypass, lap band, and the gastric sleeve are the most performed operations. The Roux-en-Y gastric bypass is the most noteworthy. "A gastric bypass patient will typically lose 75% of their excess body weight in the first 18 months which is maintained long term." A three ounce size pouch is created with the stomach. The small intestine is attached and redirected from the pouch. Gastric banding or lap band reduces the size of the upper stomach but does not affect the small intestines. This band can be adjustable or not, depending on the type chosen. Sleeve gastrectomy is a surgical procedure to remove "80% or more of the stomach" restricting food intake (Understanding). Surgical risks or complications can include blood clots, food and liquid can leak from the stomach, and possible infection at the incision site (McGowan 31). Additional surgeries may be required to correct hernias or remove gallstones (Kelly 138). Research varies with these different procedures but the risks of obesity are much greater versus obesity surgery; however, the outcome is not certain. Surgeons review each individual case and weigh the risks. The patient must prepare for surgery with counseling and preoperative testing to ensure an optimal outcome.
A side effect of malabsorption is a deficit in iron, B12, and other vitamins and minerals. Taking supplements such as multivitamins, iron, and calcium are suggested. Regular blood screens are monitored during follow up appointments with the doctor to ensure the levels are acceptable and do not become an issue. Bloating, nausea, stomach cramps, and diarrhea occur most during the first year and pass quickly but never go away entirely (McGowan 20-27). Dr Osvaldo C Anez has the following advice to avoid some side effects: eat slowly with extensive chewing, avoid consuming liquids until at least 35 minutes after eating, reduce fat intake and high sugar content food, and choose lactose free if milk becomes a problem. Pregnancy should be avoided until a stable weight is maintained or there can be damage to the fetus (Kelly 138). Based on the type of surgery, the diet that follows will vary. With bypass surgery, the caloric intake can be as much as 1800 – 2000 calories per day. It is recommended to eat low fat and high protein foods and drink water or low calorie drinks (McGowan 83-84). Restriction in food consumption, generally, lowers the calories eaten. Weight loss surgery has proven to be a long term solution, but it also requires lifestyle changes and adjustments by the patient with activity and diet training. "The pouch is a tool: a tool is something that is used to perform a task but is useless left on a shelf unused. Practice working with a tool makes the tool more effective" (Perez 3).
Short and long term effects vary from patient to patient. Most short term symptoms consist of lack of energy, dizziness, and nausea. Generally, this reaction is from the body adjusting to the extremely low intake of calories. Patients do adjust to these symptoms and they go away. Quick weight loss occurs during the first six months after surgery because of a lack of hunger and the stomach is swollen from the operation (McGowan 27). Depression was found to be the most common response felt after surgery. Patients question their decisions and may worry about their future. Antidepressants give quick relief, and psychotherapy is the most effective treatment to cope with these issues. The largest obstacle in long term effects is the psychological adjustment. Depression can continue with concerns of adaptation and changes in body images (Anez 4-5). Many helpful options are available such as counseling and support groups. Leach expresses how support groups with other surgical patients help her share issues, experiences, and successes. "The surgeons operated on our bodies, not our brains" (82). Follow up with the surgeon is imperative. Positive effects that might be relatively immediate include an improvement in medical condition which allows medications to be discontinued. Typically, long term effects are positive. Mary McGowan surveyed, "most people losing 65 to 75 percent of their excess weight within the first year". Some will regain the weight in the following 3 – 5 years, but most do not (27). In time, dietary and physical adjustment ease from surgery. Other long term effects may introduce additional surgeries due to the extreme weight loss and excessive loose skin. This can be costly, since these procedures are usually cosmetic and not covered by insurance.
Although bariatric surgery has wonderful results, there are several opposing viewpoints. As a rule, opinions are negative toward obese people. Weight loss surgery is revered as an easy way out and adds to the belief of laziness. It has become the general social attitude "that obesity is self-inflicted, and that people should not be sympathetic to a self-inflicted condition" (Kelly 95). While Jean Mayer reviews the opinions of the obese in literature, she states, "Gluttony demands less energy than lust, less industry than avarice. The fat human being, accordingly, is taken to be both physically and morally absurd, and to constitute a living testimony to the reality and vapidity of his sins" (85). As published in the Religion and Society Report, it states that since obesity is caused by "excessive eating", the solution is dieting. It continues on to say, "Certainly a term in a concentration camp (which we are not recommending) would eliminate the obesity problem" (Nakaya 2). This negative inference against the overweight is unacceptable and it should never be compared to a concentration camp. Another perception is this is a psychological problem and it can not be fixed with surgery. Other suggestion to avoid surgery is to pursue medical therapies such as new prescription drugs for weight loss (Nakaya 116). Pharmaceuticals are unsafe options as they cause cardiac and pulmonary problems. Some drugs have ingredients that affect serotonin in the brain, and others are fat blockers that cause dietary issues. Even herbs are unsafe, and ephedra has caused deaths (Nakaya 123-125). Addition concerns take into account the cost and coverage of insurance. Does the coverage take away from other medical procedures? Insurance companies are now seeing the benefits of obesity surgery, including the long term costs of severe medical conditions such as diabetes can be avoided. Weight loss surgery is not any easy way out. There are many requirements. The decision is life long and so are the effects. With proper support such as counseling, the patient grows stronger and better able to deal with the psychological changes. The inhumane ways society looks at overweight people is unbearable and unacceptable.
The benefits of surgery are unbelievable. Obese people that were once restricted from life now have an active part in living. Life changing events occur. In Mary McGowan's book, she recounts many surgery patients' stories. Jenny points out, "I have been given an incredible gift, a second chance, and I am making it work" (82). Laura explains, "This time it doesn't feel like a diet- it feels permanent, like a new way of life" (106). A poll of 100 patients, one year after surgery, showed that "93 percent were very satisfied with their surgery" (McGowan 36-37). In my survey of five weight loss patients, all were satisfied and most mentioned how this was a life changing event. The topic of obesity surgery is very personal to me as I had gastric segmentation in 2000. My story begins at 310 pounds. After gastric segmentation or gastric banding, I lost 175 pounds within 18 months. I became more outgoing and didn't feel secluded anymore. My increased activity level allowed more interaction with others. I was, and still am, able to experience my life after the weight loss. I enjoy more on account of the fact there are no restrictions with my weight. I do not regret my choice for surgery, and given the option, I would do it again.
In response to the debate as to whether or not obesity is a disease: "Any other condition that causes 300,000 deaths a year, millions of cases of pain and disability, and related to 30 or more health related problems would be a disease" (Kelly 95). Social beliefs toward the obese need to be changed and medical advances should be encouraged to solve this "stigmatized condition" (Kelly 89). Clancey observes, "Patients who underwent surgical treatment for obesity were also more likely to improve their health compared with those who did not choose surgery" (Conc.). Observed in my survey of five weight loss patients, all of the participants mention that surgery has made them much more aware of the food they eat. Weight loss surgery may be an extreme option to get a grasp on eating, but it is a great opportunity to help people reclaim their lives. "Remember that your life is a journey and a process in motion. If you are not taking care of yourself because other people depend on you, it is time for a reality check. Simplify your life. Actually stop and smell the roses" (Cherwony 1-2).
Work Cited
Anez, Osvaldo C. "Potential Side Effects and Management" Obesity Surgery Center. 1995. Galenored. 3 Sept. 2009. <http://www.obesitysurgerycenter.net>.
Cherwony, Heidi R. "Psychology." BariMD. 2009. 28 Sept. 2009. <https://www.barimd.com>.
Clancy, Carolyn. "Ready to Lose Weight in the New Year? Experts offer Guidance for Adults and Children." AHRQ. 6 Jan. 2009. 17 Sept. 2009. <http://orgin.www.ahrq.gov>.
Kelly, Evelyn B. Obesity. Westport: Greenwood Publishing Group, Inc., 2006.
Leach, Susan Maria. Before and After: Living and Eating Well after Weight Loss Surgery. New York: Harper Collins Publishers, Inc., 2004.
Mayer, Jean. Overweight: Causes, Cost, and Control. Englewood Cliffs: Prentice-Hall, Inc., 1968.
McGowan, Mary P. and Jo McGowan Chopra. Gastric Bypass Surgery: Everything you need to know to make an Informed Decision. New York: McGraw-Hill, 2004. NetLibrary 2004. 3 Nov. 2009.
Nakaya Andrea C. The Obese should not Undergo Gastric Bypass Surgery. San Diego: Greenhaven Press, 2006. Opposing Viewpoints Resource Center. Gale Cengage Learning. SJRCC Library, St Augustine, FL. 10 Sept. 2009. <http://find.galegroup.com>.
Nakaya, Andrea C. Obesity Opposing Viewpoints. Farmington Hills: Greenhaven Press, 2006.
Perez, Sally. "Pouch Rules for Dummies." Online posting. 27 Jan. 2009. 14 Oct. 2009. <afterweightlosssurgery>.
"Understanding Surgical Options." Flagler Hospital. 2007. Scorpion Healthcare, Inc-Administration. 28 Sept. 2009 <http://www.flaglerhospital.org>.
U.S. Bariatric. 2005. 28 Sept. 2009 <http://www.usbariatric.com>.
Messages in this topic (2)
________________________________________________________________________
2b. Re: Final Research Paper
Posted by: "Gena" gena_g2000@yahoo.com gena_g2000
Date: Wed Dec 16, 2009 1:58 pm ((PST))
Excellent and well written piece!! Thanks for sharing!
Gena
Sent from my iPhone
On Dec 16, 2009, at 4:38 PM, "AlLee" <edallee32086@yahoo.com> wrote:
veryone that participated with the survey. Thank you, AlLee St Augustine, FL Obesity Surgery: Worth the Risks and Effects Obesity and morbid obesity have extreme health consequences that can be reversed with surgical intervention. There are several surgical procedures available for individuals that meet the qualifications. The many diseases and illnesses that are related to obesity can be fatal if not cured. Despite the risks of obesity, there are side effects from surgery which require maintenance. The enormous ventures patients embrace during these procedures necessitate physical and mental changes before and after surgery. Although these surgeries are controversial due to negative public opinion of overweight people, the benefits far outnumber the risks of surgery in comparison to doing nothing at all and remaining obese. Obesity has changed over the years. As early as 199 C.E., obesity was separated into moderate and immoderate obesity. As moderate
obesity is tolerable; immoderate obesity "is a character flaw from a life of overindulgence and lust". In the 1950s, obesity became a medical condition and sickness, and thoughts that obesity was a moral issue were cast aside (Kelly Appendix B). Being overweight is defined as having a body mass index, or BMI, of between 25 and 29. Individuals with a BMI of 30 or more are considered obese. Obesity among adults has doubled in the last 25 years. Today, two out of three adults are considered to be overweight, and about 27 percent of Americans age 20 or older are obese (Clancey). Kelly states obesity classification between condition and disease can determine treatment, medicine, and healthcare coverage (89). "Obesity is the first human-made epidemic" (3). Factors of obesity include psychological (emotions), physiological (genetics), environment (home, work, community, etc.), parental influences, and advertising (120-121). People tend not to take care of
their personal needs as a result to the bustle of life. Diet and exercise is commonly over looked. With processed and ready made foods, society is inclined not to pay attention to the amount of calories consumed. Television and computers contribute to a sedimentary lifestyle. An analogy made by Kelly is "genetics loads the gun, but environment pulls the trigger to make the perfect epidemic" (5). Obesity is currently considered a disease. It may not be contagious, but it can be life threatening. The multitude of medical problems from obesity can be controlled by weight loss. Shown on the website U.S. Bariatric, obesity related diseases include: the number one killer in America - cardiovascular disease, , all types of cancer, cerebrovascular diseases including high blood pressure and strokes, respiratory disorders including asthma and obstructive sleep apnea (OSA), diabetes, orthopedic conditions such as arthritis and gait problems that cause pain and can
lead to accidents such as falling, Alzeheimer's disease, and others take in account kidney disease, fatty liver disease, and septicemia (septic shock). Studies of brain scans in elderly, overweight woman exhibit considerable brain tissue loss that affects talking, understanding, and memory: "Some scientists surmise that as much as 25 percent of cases of dementia may be due to BMI and its relationship to high blood pressure, high cholesterol, and type 2 diabetes" (Kelly 85). Obesity results in early death in several ways. Doctors are now treating overweight patients more aggressively. "The NIH [National Institutes of Health] reports that 15 to 20 percent of all deaths in America are related to obesity" (Kelly 74). Reports issued in 1954 document the first bariatric surgical procedures (Kelly App B). There are two main types of surgical procedures; they include food intake restriction, malabsorption, or a combination of both (Leach Vii). Gastric bypass,
lap band, and the gastric sleeve are the most performed operations. The Roux-en-Y gastric bypass is the most noteworthy. "A gastric bypass patient will typically lose 75% of their excess body weight in the first 18 months which is maintained long term." A three ounce size pouch is created with the stomach. The small intestine is attached and redirected from the pouch. Gastric banding or lap band reduces the size of the upper stomach but does not affect the small intestines. This band can be adjustable or not, depending on the type chosen. Sleeve gastrectomy is a surgical procedure to remove "80% or more of the stomach" restricting food intake (Understanding). Surgical risks or complications can include blood clots, food and liquid can leak from the stomach, and possible infection at the incision site (McGowan 31). Additional surgeries may be required to correct hernias or remove gallstones (Kelly 138). Research varies with these different procedures but
the risks of obesity are much greater versus obesity surgery; however, the outcome is not certain. Surgeons review each individual case and weigh the risks. The patient must prepare for surgery with counseling and preoperative testing to ensure an optimal outcome. A side effect of malabsorption is a deficit in iron, B12, and other vitamins and minerals. Taking supplements such as multivitamins, iron, and calcium are suggested. Regular blood screens are monitored during follow up appointments with the doctor to ensure the levels are acceptable and do not become an issue. Bloating, nausea, stomach cramps, and diarrhea occur most during the first year and pass quickly but never go away entirely (McGowan 20-27). Dr Osvaldo C Anez has the following advice to avoid some side effects: eat slowly with extensive chewing, avoid consuming liquids until at least 35 minutes after eating, reduce fat intake and high sugar content food, and choose lactose free if milk
becomes a problem. Pregnancy should be avoided until a stable weight is maintained or there can be damage to the fetus (Kelly 138). Based on the type of surgery, the diet that follows will vary. With bypass surgery, the caloric intake can be as much as 1800 - 2000 calories per day. It is recommended to eat low fat and high protein foods and drink water or low calorie drinks (McGowan 83-84). Restriction in food consumption, generally, lowers the calories eaten. Weight loss surgery has proven to be a long term solution, but it also requires lifestyle changes and adjustments by the patient with activity and diet training. "The pouch is a tool: a tool is something that is used to perform a task but is useless left on a shelf unused. Practice working with a tool makes the tool more effective" (Perez 3). Short and long term effects vary from patient to patient. Most short term symptoms consist of lack of energy, dizziness, and nausea. Generally, this
reaction is from the body adjusting to the extremely low intake of calories. Patients do adjust to these symptoms and they go away. Quick weight loss occurs during the first six months after surgery because of a lack of hunger and the stomach is swollen from the operation (McGowan 27). Depression was found to be the most common response felt after surgery. Patients question their decisions and may worry about their future. Antidepressants give quick relief, and psychotherapy is the most effective treatment to cope with these issues. The largest obstacle in long term effects is the psychological adjustment. Depression can continue with concerns of adaptation and changes in body images (Anez 4-5). Many helpful options are available such as counseling and support groups. Leach expresses how support groups with other surgical patients help her share issues, experiences, and successes. "The surgeons operated on our bodies, not our brains" (82). Follow up
with the surgeon is imperative. Positive effects that might be relatively immediate include an improvement in medical condition which allows medications to be discontinued. Typically, long term effects are positive. Mary McGowan surveyed, "most people losing 65 to 75 percent of their excess weight within the first year". Some will regain the weight in the following 3 - 5 years, but most do not (27). In time, dietary and physical adjustment ease from surgery. Other long term effects may introduce additional surgeries due to the extreme weight loss and excessive loose skin. This can be costly, since these procedures are usually cosmetic and not covered by insurance. Although bariatric surgery has wonderful results, there are several opposing viewpoints. As a rule, opinions are negative toward obese people. Weight loss surgery is revered as an easy way out and adds to the belief of laziness. It has become the general social attitude "that obesity is
self-inflicted, and that people should not be sympathetic to a self-inflicted condition" (Kelly 95). While Jean Mayer reviews the opinions of the obese in literature, she states, "Gluttony demands less energy than lust, less industry than avarice. The fat human being, accordingly, is taken to be both physically and morally absurd, and to constitute a living testimony to the reality and vapidity of his sins" (85). As published in the Religion and Society Report, it states that since obesity is caused by "excessive eating", the solution is dieting. It continues on to say, "Certainly a term in a concentration camp (which we are not recommending) would eliminate the obesity problem" (Nakaya 2). This negative inference against the overweight is unacceptable and it should never be compared to a concentration camp. Another perception is this is a psychological problem and it can not be fixed with surgery. Other suggestion to avoid surgery is to pursue medical
therapies such as new prescription drugs for weight loss (Nakaya 116). Pharmaceuticals are unsafe options as they cause cardiac and pulmonary problems. Some drugs have ingredients that affect serotonin in the brain, and others are fat blockers that cause dietary issues. Even herbs are unsafe, and ephedra has caused deaths (Nakaya 123-125). Addition concerns take into account the cost and coverage of insurance. Does the coverage take away from other medical procedures? Insurance companies are now seeing the benefits of obesity surgery, including the long term costs of severe medical conditions such as diabetes can be avoided. Weight loss surgery is not any easy way out. There are many requirements. The decision is life long and so are the effects. With proper support such as counseling, the patient grows stronger and better able to deal with the psychological changes. The inhumane ways society looks at overweight people is unbearable and unacceptable.
The benefits of surgery are unbelievable. Obese people that were once restricted from life now have an active part in living. Life changing events occur. In Mary McGowan's book, she recounts many surgery patients' stories. Jenny points out, "I have been given an incredible gift, a second chance, and I am making it work" (82). Laura explains, "This time it doesn't feel like a diet- it feels permanent, like a new way of life" (106). A poll of 100 patients, one year after surgery, showed that "93 percent were very satisfied with their surgery" (McGowan 36-37). In my survey of five weight loss patients, all were satisfied and most mentioned how this was a life changing event. The topic of obesity surgery is very personal to me as I had gastric segmentation in 2000. My story begins at 310 pounds. After gastric segmentation or gastric banding, I lost 175 pounds within 18 months. I became more outgoing and didn't feel secluded anymore. My increased activity
level allowed more interaction with others. I was, and still am, able to experience my life after the weight loss. I enjoy more on account of the fact there are no restrictions with my weight. I do not regret my choice for surgery, and given the option, I would do it again. In response to the debate as to whether or not obesity is a disease: "Any other condition that causes 300,000 deaths a year, millions of cases of pain and disability, and related to 30 or more health related problems would be a disease" (Kelly 95). Social beliefs toward the obese need to be changed and medical advances should be encouraged to solve this "stigmatized condition" (Kelly 89). Clancey observes, "Patients who underwent surgical treatment for obesity were also more likely to improve their health compared with those who did not choose surgery" (Conc.). Observed in my survey of five weight loss patients, all of the participants mention that surgery has made them much more
aware of the food they eat. Weight loss surgery may be an extreme option to get a grasp on eating, but it is a great opportunity to help people reclaim their lives. "Remember that your life is a journey and a process in motion. If you are not taking care of yourself because other people depend on you, it is time for a reality check. Simplify your life. Actually stop and smell the roses" (Cherwony 1-2). Work Cited Anez, Osvaldo C. "Potential Side Effects and Management" Obesity Surgery Center. 1995. Galenored. 3 Sept. 2009. . Cherwony, Heidi R. "Psychology." BariMD. 2009. 28 Sept. 2009. . Clancy, Carolyn. "Ready to Lose Weight in the New Year? Experts offer Guidance for Adults and Children." AHRQ. 6 Jan. 2009. 17 Sept. 2009. . Kelly, Evelyn B. Obesity. Westport: Greenwood Publishing Group, Inc., 2006. Leach, Susan Maria. Before and After: Living and Eating Well after Weight Loss Surgery. New York: Harper Collins Publishers, Inc., 2004. Mayer, Jean.
Overweight: Causes, Cost, and Control. Englewood Cliffs: Prentice-Hall, Inc., 1968. McGowan, Mary P. and Jo McGowan Chopra. Gastric Bypass Surgery: Everything you need to know to make an Informed Decision. New York: McGraw-Hill, 2004. NetLibrary 2004. 3 Nov. 2009. Nakaya Andrea C. The Obese should not Undergo Gastric Bypass Surgery. San Diego: Greenhaven Press, 2006. Opposing Viewpoints Resource Center. Gale Cengage Learning. SJRCC Library, St Augustine, FL. 10 Sept. 2009. . Nakaya, Andrea C. Obesity Opposing Viewpoints. Farmington Hills: Greenhaven Press, 2006. Perez, Sally. "Pouch Rules for Dummies." Online posting. 27 Jan. 2009. 14 Oct. 2009. . "Understanding Surgical Options." Flagler Hospital. 2007. Scorpion Healthcare, Inc-Administration. 28 Sept. 2009 . U.S. Bariatric. 2005. 28 Sept. 2009 . --MYNAT5GHZ3ul6e5MkxhgmN6FQyz9M6lO8x1WfVf Content-Type: text/html; charset=ISO-8859-1 Content-Transfer-Encoding: quoted-printable
Hello,
Last month I asked for assistance with a queestionaire that I posted. This was part of my field research on my research paper. I was asked to share the final product. I want to thank everyone that participated with the survey.
Thank you,
AlLee
St Augustine, FL
Obesity Surgery:
Worth the Risks and Effects
Obesity and morbid obesity have extreme health consequences that can be reversed with surgical intervention. There are several surgical procedures available for individuals that meet the qualifications. The many diseases and illnesses that are related to obesity can be fatal if not cured. Despite the risks of obesity, there are side effects from surgery which require maintenance. The enormous ventures patients embrace during these procedures necessitate physical and mental changes before and after surgery. Although these surgeries are controversial due to negative public opinion of overweight people, the benefits far outnumber the risks of surgery in comparison to doing nothing at all and remaining obese.
Obesity has changed over the years. As early as 199 C.E., obesity was separated into moderate and immoderate obesity. As moderate obesity is tolerable; immoderate obesity "is a character flaw from a life of overindulgence and lust". In the 1950s, obesity became a medical condition and sickness, and thoughts that obesity was a moral issue were cast aside (Kelly Appendix B).
Being overweight is defined as having a body mass index, or BMI, of between 25 and 29. Individuals with a BMI of 30 or more are considered obese. Obesity among adults has doubled in the last 25 years. Today, two out of three adults are considered to be overweight, and about 27 percent of Americans age 20 or older are obese (Clancey).
Kelly states obesity classification between condition and disease can determine treatment, medicine, and healthcare coverage (89). "Obesity is the first human-made epidemic" (3). Factors of obesity include psychological (emotions), physiological (genetics), environment (home, work, community, etc.), parental influences, and advertising (120-121). People tend not to take care of their personal needs as a result to the bustle of life. Diet and exercise is commonly over looked. With processed and ready made foods, society is inclined not to pay attention to the amount of calories consumed. Television and computers contribute to a sedimentary lifestyle. An analogy made by Kelly is "genetics loads the gun, but environment pulls the trigger to make the perfect epidemic" (5). Obesity is currently considered a disease. It may not be contagious, but it can be life threatening.
The multitude of medical problems from obesity can be controlled by weight loss. Shown on the website U.S. Bariatric, obesity related diseases include: the number one killer in America - cardiovascular disease, , all types of cancer, cerebrovascular diseases including high blood pressure and strokes, respiratory disorders including asthma and obstructive sleep apnea (OSA), diabetes, orthopedic conditions such as arthritis and gait problems that cause pain and can lead to accidents such as falling, Alzeheimer's disease, and others take in account kidney disease, fatty liver disease, and septicemia (septic shock). Studies of brain scans in elderly, overweight woman exhibit considerable brain tissue loss that affects talking, understanding, and memory: "Some scientists surmise that as much as 25 percent of cases of dementia may be due to BMI and its relationship to high blood pressure, high cholesterol, and type 2 diabetes" (Kelly 85). Obesity results in
early death in several ways. Doctors are now treating overweight patients more aggressively. "The NIH [National Institutes of Health] reports that 15 to 20 percent of all deaths in America are related to obesity" (Kelly 74).
Reports issued in 1954 document the first bariatric surgical procedures (Kelly App B). There are two main types of surgical procedures; they include food intake restriction, malabsorption, or a combination of both (Leach Vii). Gastric bypass, lap band, and the gastric sleeve are the most performed operations. The Roux-en-Y gastric bypass is the most noteworthy. "A gastric bypass patient will typically lose 75% of their excess body weight in the first 18 months which is maintained long term." A three ounce size pouch is created with the stomach. The small intestine is attached and redirected from the pouch. Gastric banding or lap band reduces the size of the upper stomach but does not affect the small intestines. This band can be adjustable or not, depending on the type chosen. Sleeve gastrectomy is a surgical procedure to remove "80% or more of the stomach" restricting food intake (Understanding). Surgical risks or complications can include blood clots,
food and liquid can leak from the stomach, and possible infection at the incision site (McGowan 31). Additional surgeries may be required to correct hernias or remove gallstones (Kelly 138). Research varies with these different procedures but the risks of obesity are much greater versus obesity surgery; however, the outcome is not certain. Surgeons review each individual case and weigh the risks. The patient must prepare for surgery with counseling and preoperative testing to ensure an optimal outcome.
A side effect of malabsorption is a deficit in iron, B12, and other vitamins and minerals. Taking supplements such as multivitamins, iron, and calcium are suggested. Regular blood screens are monitored during follow up appointments with the doctor to ensure the levels are acceptable and do not become an issue. Bloating, nausea, stomach cramps, and diarrhea occur most during the first year and pass quickly but never go away entirely (McGowan 20-27). Dr Osvaldo C Anez has the following advice to avoid some side effects: eat slowly with extensive chewing, avoid consuming liquids until at least 35 minutes after eating, reduce fat intake and high sugar content food, and choose lactose free if milk becomes a problem. Pregnancy should be avoided until a stable weight is maintained or there can be damage to the fetus (Kelly 138). Based on the type of surgery, the diet that follows will vary. With bypass surgery, the caloric intake can be as much as 1800 - 2000
calories per day. It is recommended to eat low fat and high protein foods and drink water or low calorie drinks (McGowan 83-84). Restriction in food consumption, generally, lowers the calories eaten. Weight loss surgery has proven to be a long term solution, but it also requires lifestyle changes and adjustments by the patient with activity and diet training. "The pouch is a tool: a tool is something that is used to perform a task but is useless left on a shelf unused. Practice working with a tool makes the tool more effective" (Perez 3).
Short and long term effects vary from patient to patient. Most short term symptoms consist of lack of energy, dizziness, and nausea. Generally, this reaction is from the body adjusting to the extremely low intake of calories. Patients do adjust to these symptoms and they go away. Quick weight loss occurs during the first six months after surgery because of a lack of hunger and the stomach is swollen from the operation (McGowan 27). Depression was found to be the most common response felt after surgery. Patients question their decisions and may worry about their future. Antidepressants give quick relief, and psychotherapy is the most effective treatment to cope with these issues. The largest obstacle in long term effects is the psychological adjustment. Depression can continue with concerns of adaptation and changes in body images (Anez 4-5). Many helpful options are available such as counseling and support groups. Leach expresses how support groups with
other surgical patients help her share issues, experiences, and successes. "The surgeons operated on our bodies, not our brains" (82). Follow up with the surgeon is imperative. Positive effects that might be relatively immediate include an improvement in medical condition which allows medications to be discontinued. Typically, long term effects are positive. Mary McGowan surveyed, "most people losing 65 to 75 percent of their excess weight within the first year". Some will regain the weight in the following 3 - 5 years, but most do not (27). In time, dietary and physical adjustment ease from surgery. Other long term effects may introduce additional surgeries due to the extreme weight loss and excessive loose skin. This can be costly, since these procedures are usually cosmetic and not covered by insurance.
Although bariatric surgery has wonderful results, there are several opposing viewpoints. As a rule, opinions are negative toward obese people. Weight loss surgery is revered as an easy way out and adds to the belief of laziness. It has become the general social attitude "that obesity is self-inflicted, and that people should not be sympathetic to a self-inflicted condition" (Kelly 95). While Jean Mayer reviews the opinions of the obese in literature, she states, "Gluttony demands less energy than lust, less industry than avarice. The fat human being, accordingly, is taken to be both physically and morally absurd, and to constitute a living testimony to the reality and vapidity of his sins" (85). As published in the Religion and Society Report, it states that since obesity is caused by "excessive eating", the solution is dieting. It continues on to say, "Certainly a term in a concentration camp (which we are not recommending) would eliminate the obesity
problem" (Nakaya 2). This negative inference against the overweight is unacceptable and it should never be compared to a concentration camp. Another perception is this is a psychological problem and it can not be fixed with surgery. Other suggestion to avoid surgery is to pursue medical therapies such as new prescription drugs for weight loss (Nakaya 116). Pharmaceuticals are unsafe options as they cause cardiac and pulmonary problems. Some drugs have ingredients that affect serotonin in the brain, and others are fat blockers that cause dietary issues. Even herbs are unsafe, and ephedra has caused deaths (Nakaya 123-125). Addition concerns take into account the cost and coverage of insurance. Does the coverage take away from other medical procedures? Insurance companies are now seeing the benefits of obesity surgery, including the long term costs of severe medical conditions such as diabetes can be avoided. Weight loss surgery is not any easy way out.
There are many requirements. The decision is life long and so are the effects. With proper support such as counseling, the patient grows stronger and better able to deal with the psychological changes. The inhumane ways society looks at overweight people is unbearable and unacceptable.
The benefits of surgery are unbelievable. Obese people that were once restricted from life now have an active part in living. Life changing events occur. In Mary McGowan's book, she recounts many surgery patients' stories. Jenny points out, "I have been given an incredible gift, a second chance, and I am making it work" (82). Laura explains, "This time it doesn't feel like a diet- it feels permanent, like a new way of life" (106). A poll of 100 patients, one year after surgery, showed that "93 percent were very satisfied with their surgery" (McGowan 36-37). In my survey of five weight loss patients, all were satisfied and most mentioned how this was a life changing event. The topic of obesity surgery is very personal to me as I had gastric segmentation in 2000. My story begins at 310 pounds. After gastric segmentation or gastric banding, I lost 175 pounds within 18 months. I beca
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