Category Archives: Front Page

Holiday Gifts for the Bariatric Patient

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Overcoming and Preventing the Weight Loss Plateau

Have you had bariatric surgery?  Has your weight loss slowed or stopped?  Are you no longer seeing results, and don’t understand why? Well… you most likely need to learn how to stop weight-loss plateau. Weight loss, after bariatric surgery, is very significant early on; this typically occurs because the body is adapting to the lower calorie diet and is burning alternative energy sources. The body will first burn glycogen that is stored in the muscles and the liver (which causes a loss of water weight which is a significant amount of your overall weight loss), and the body then turns to fat and lean muscle mass. As your body burns muscle, your metabolism slows and this is typically what causes you to hit a plateau.  Before weight loss surgery, you still had quite a bit of muscle which is why it was so easy to lose weight shortly after your bariatric surgery. A person with lots of muscle mass will have a high metabolism, which means they will burn more calories throughout the day, even when just lying in bed, than a person with less muscle mass. As a lighter person, you no longer have as much muscle mass as you previously may have, so you may no longer be at a deficit with calories because of your lower metabolism.

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Micronutrients and You: Calcium and Bariatric Surgery Patients

After bariatric surgery, patients experience permanent changes to their digestive system in the way that nutrients are absorbed and processed. It’s important for both patients and their physicians to understand the role of ongoing nutritional support so they can maintain good health. This series of articles will focus on the importance of micronutrients for bariatric surgery patients. Specifically, the special needs they now have based on the surgical changes to their digestive systems, as well as the evidence-based products offered by Bariatric Advantage to support bariatric surgery patients in maintaining good nutrition and good health.

Calcium and Bariatric Surgery Patients

Calcium is the most abundant mineral in the human body. Ninety-nine percent of whole-body calcium is incorporated into the structure of bones and teeth. Calcium also plays a vital role in the body’s clotting capabilities. Lack of adequate calcium can contribute to poor bone health and other long term challenges.

When people do not get enough calcium, the body takes calcium from their bones. Over time, this “borrowing” of calcium can cause decrease bone health. Studies indicate that individuals who undergo bariatric surgery may be at risk for long-term challenges with bone health due to nutritional and other causes[1].

Getting Enough Calcium

Eating a calcium-rich diet is important. Calcium containing foods include dairy products, calcium-fortified products like soy and rice drinks, and leafy greens. In addition, experts recommend that individuals who have had bariatric surgery take calcium supplements to get enough of this important mineral. The recommended daily dose of calcium for bariatric patients is 1,200-2,000 mg a day, according to the guidelines published by the American Society for Metabolic & Bariatric Surgery, The Obesity Society, and The American Association of Clinical Endocrinologists.

Due to the changes that have been made to their digestive systems, bariatric surgery patients are at particular risk for challenges with specific absorption, including calcium and vitamin D. Bariatric surgeries may also increase bone turnover and loss of bone mass in patients, part of which is due to massive weight loss alone (which always results in the loss of some lean mass – including bone). Therefore, it is critical that bariatric patients regularly get adequate calcium to reduce the risk of deficiencies, bone loss, and to long-term health.

However, many types of commercially available calcium supplements may not be optimized for bariatric patients. Biologically, calcium from foods and some types of dietary supplements must become ionized in an acid medium in order to be absorbed in the small intestine. In bariatric patients, certain forms of calcium such as calcium carbonate (found in many over-the-counter vitamins) are not likely to be well-absorbed after surgery because they require interaction with hydrochloric acid which is limited after common procedures. After bariatric surgery, there is less contact of food with stomach acid, making it difficult to absorb calcium carbonate. For this reason, calcium citrate is generally recommended after bariatric surgery to support absorption[2].

Tips for Bariatric Patients

The following suggested guidelines can help bariatric surgery patients ensure that they are taking calcium supplements that will meet their needs for life:

  • First, consult with your physician to be sure you understand the guidelines for nutritional supplementation before and after your surgery, and for the rest of your life.
  • When selecting a supplement, look for one that uses calcium citrate, the form most commonly recommended after bariatric surgery to support absorption.
  • Make sure that your calcium supplement also contains Vitamin D
  • Some patients may prefer a form of calcium other than the traditional tablets that are swallowed. “Chewy bites” are a tasty option with the texture of a caramel candy, and are available in different flavors. Powders and chewable tablets are also popular choices for those who dislike swallowing pills.
  • It is best to look for options that are low in sugar or sugar-free.. Lactose-free options are also available.
  • Because bariatric patients generally need more supplemental calcium than adults who have not had this surgery, selecting a dose with a higher amount of calcium – say 500 mg versus 250 mg – means taking fewer pills and may make adherence easier.

To learn more about Bariatric Advantage’s new 500 mg Calcium Citrate Chewy Bite, the first to combine 500 mg Calcium Citrate and 500 IU of Vitamin D3 in one tasty, sugar-free soft chew, read the official press release here. To learn more about calcium and bariatric nutrition call 800.898.6888 or visit www.bariatricadvantage.com.

[1] Berarducci A, Haines K, Murr MM 2009 Incidence of bone loss, falls, and fractures after Roux-en-Y gastric bypass for morbid obesity. Appl Nurs Res 22:35–41

[2] Goode LR, Brolin RE, Chowdhury HA, Shapses SA. Bone and gastric bypass surgery: effects of dietary calcium and vitamin D. Obes Res. 2004;12:40-47. [EL 2]

Reviewed and Prepared by:
The Science Desk
Bariatric Advantage

 

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Ban the F-Word: Fat-Shaming

Ban the F-Word: Fat-Shaming
by James Zervios, OAC Vice Presideant of Marketing and Communcations

 

The fight to end fat-shaming always seems to be instantly met with resistance. The Obesity Action Coalition (OAC) took on a high-profile issue with the “Dr. Ken” show, starring real life doctor Ken Jeong.  Within minutes of TMZ reporting the story, comments such as this began popping up online:

“I do not understand why people get offended enough to feel censorship is warranted. I understand some cannot help weight issues due to certain medical conditions, but there is no reason for them to be offended by comedy.” – Karvey Kardashian (screenname)

“If fat people don’t want to be fat-shamed they should go on a diet and go to the gym. It’s that simple. Obesity should not be accepted.” – Denvermommy (screenname)

“So a joke is what is pushing all these fat people into depression? How about their mirror, their hand to mouth habit, sweets, overeating, lazy – You look at a bus and say ‘It is a bus’ – You look at a fat person and say ‘That is a fat person’ 0 it is what it is – donut get your pants in a wad!” – Shata (screenname)

It seems that the general public has three main areas of concentration when it comes to the majority response to fat-shaming: censorship, personal responsibility, and the idea that approaching the subject comically helps people lose weight. Let’s take a moment and examine each one of these areas and see if we can provide some justification for any of them.

Censorship

As far as we’ve progressed in this country with acceptance and respect, obesity is most certainly last in line for that dose of tolerance.  We are so quick as a society to throw the word “censorship” around when it pertains to something that “we” do not approve of, but if you’re on the other side of that coin, you may have a different opinion. Everyone has the right to hateful speech, but people should not be surprised when they become marginalized because of it.  As a result, they might find that businesses do not want to give them a stage from which to broadcast their hateful views.

Is what we asked for “censorship” by definition? Sure, it sounds like it to me. And we can still ask for it because what was being said was wrong and unacceptable. Just as the writers of “Dr. Ken” had the freedom of speech to say what they did, we (the OAC) have the same right to say “it’s wrong.”  To me, the most obscene form of censorship is when individuals DO NOT speak up for what they believe. To me, that is censorship in its ugliest form.

For decades, other disease groups fought for their rights to be heard, accepted and treated with respect.  One comment about the “Dr. Ken” issue said, “If you don’t like what’s on TV, then change the channel.” My response to that is, “If you don’t like what the OAC is asking for, take a moment to educate yourself about obesity and weight bias.  You just might change your mind.”

Personal Responsibility

This is one of favorite arguments that I’ve heard throughout the past decade in reaction to obesity.

“You did it to yourself.  You ate too much.”

Wow, such a profound statement.  Except, it’s not THAT simple. I will be the first to say that there definitely is personal responsibility in obesity.  However, guess what? There’s personal responsibility in everything you do in life.  We are responsible for ourselves, and we all have actions that may not be the most responsible thing.

  • Did you drive one mile per hour over the speed limit to work today?  Maybe your car insurance provider should drop you.
  • Did you smoke a cigarette today? Well, maybe your health insurer should deny you respiratory treatment seeing as how you did the damage to yourself.
  • Are you reading this at work? Hmmm, I wonder if your employer should fire you for not doing your job.
  • Did you apply sunscreen before going outside today? I really feel you should pay out-of-pocket for any skin-related health issues you have. It really is your fault.

What do you think of these statements? You know what I think of them?  They’re all idiotic. They’re all just as idiotic as the argument of someone with obesity has done it ALL to themselves.  That’s right; they may have never gone through an emotional time (divorce, death of a loved-one, loss of employment). They may have never been diagnosed with any other disease that can impact their weight or have taken a medication that caused weight gain.  Nope, it never happens.  Right, keep telling yourself that.

The cold, hard truth is that I’ve never met someone who denied all personal responsibility for their weight and health.  I know, It’s shocking right?  Your “personal responsibility” argument is invalid.  Want to know why? I’ll tell you why. Because people with obesity are personally responsible for their weight. Nobody has ever denied that. They’re personally responsible for their weight, health, kids pets, spouses, employment, car, what they eat, who they talk to, where they go and so on.  Guess what? Personal responsibility is one of life’s natural occurrences, so if you’re going to use it as an argument against our cause, it won’t make a difference.

“Approaching the Subject Comically Helps People Lose Weight”

YES! I love this one.  I am going to respond to this one very clearly. Ready?  Fat-shaming does not (and never did) help anyone lose weight. While most people think shaming encourages someone to make a change, it actually just causes them to feel worse about themselves and not make a change.

According to the Rudd Center of Food Policy and Obesity: Obesity-related campaigns that were rated to be stigmatizing were no more likely to instill motivation for improving lifestyle behaviors than campaigns rated as more neutral. In addition, stigmatizing campaigns were also rated as inducing less self-confidence to engage in health behaviors promoted by campaigns, and viewed to have less appropriate visual content compared to neutral campaigns.

Fat-shaming, whether it’s on TV, in a song or said in-person, does absolutely no good in helping someone make a change in their life – period. In fact, studies have shown that it can actually cause people to gain weight.

No other disease is the target of humor in today’s pop culture. Throughout time, various topics have become off-limits, for perfectly good reasons, to joke about as comedy.  Make no mistake about it; obesity is a serious condition affecting more than 93 million Americans. Heart disease, diabetes, sleep apnea, some cancers, GERD, and arthritis are all just some of the diseases related to obesity.

I think it’s safe to say that the arguments frequently voiced by the public in regards to obesity and fat-shaming are completely invalid and based on absolutely zero scientific evidence.  Some of you may be reading this and think, “He’ seems angry.”  Well, I am.  I’m angry that I didn’t write this sooner.  I am frustrated with the comments regarding obesity and fat-shaming.  Fat-shaming is wrong, and it needs to stop.

To think that we live in a society where it’s okay to make fun of someone because of their size is simply ridiculous.  Fat jokes aren’t funny. Do we joke about HIV or AIDS? Do we joke about cancer?  Do we joke about diabetes? We don’t joke about these things because we know that people affected by them wouldn’t appreciate it, and it’s simply not right.

Some people emailed me asking if “we’re serious.” The answer is yes, we’re very serious, and we’re going to keep tackling bias issues until we finally see a day where weight bias and fat-shaming are no more. Now if you have a problem with that, well, I suggest you not censor yourself, take some personal responsibility and learn more about obesity and weight bias.

 

 

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