The Dangers of Yo-Yo Dieting

 

Obesity is a main cause of preventable illness and death in the developed world.

It is estimated that at any one time at least 25% of the population is trying to diet and yet the obesity epidemic continues to grow.

Losing weight improves health, right? Absolutely if the weight loss can be maintained in the long term.

However, there is a group of people who do not benefit, these are those people who lose weight, regain the weight, lose weight, regain weight and so on, we call this yo-yo dieting or weight cycling.

A study shows that up to 35% of men and up to 55% of women report having yo-yo dieted.

We find that many Gateway Health patients have a history of yo-yo dieting prior to choosing Bariatric surgery.

Often before making the final decision to choose bariatric surgery, many patients tell us that they will try one last diet. We always wish them well, but sadly know that a significant number of those patients will be back in touch soon to book their surgery.

Long term yo-yo dieting causes multiple health problems, plus of course leads to much frustration.

When dieting the hormone leptin decreases and your appetite increases as your body is trying to increase its depleted energy levels.

Studies show that yo-yo dieting often leads to loss of muscle mass as well as fat, but when the weight is regained it is usually just fat that is regained, particularly around the abdomen. Abdominal fat or ‘belly’ fat increases the risk of type two Diabetes

Studies also show that several cycles of yo-yo dieting can cause fatty liver disease (excess fat inside the cells of the liver.) A fatty liver changes the way the liver metabolises sugars and fats, these changes increase the risk of getting type two Diabetes.

Yo-yo dieting has also been shown to increase the risk of Coronary Heart Disease (narrowing of the arteries that supply blood to the heart). The more times someone yo-yo diets the higher the risk.

The weight re-gain after a diet can also cause hypertension (high blood pressure.)

The negative health problems as a result of yo-yo dieting can last years but can fade and resolve once weight is lost and maintained over years.

If you are frustrated with one diet after another, the constant up and down weight, worried about the adverse health effects that this is causing, why not consider weight loss surgery?

Surgery for obesity is the most effective proven method in terms of weight reduction and improvement in obesity related health conditions, often these conditions disappear completely.

Gateway Health are a highly qualified experienced team of Bariatric experts who are committed to providing compassionate, caring individualised care. We offer time served, evidence-based weight loss surgery procedures alongside an aftercare programme that addresses dietary, lifestyle and psychological support, which we know is needed to prevent weight regain in the years following surgery.

Our prices are competitive and all consultations are free of charge.

Gateway Health 0345 9000 339

 

Preventing common problems after surgery.

Tips to prevent common problems:

Eat slowly, chew foods thoroughly and stop eating as soon as you feel satisfied to avoid discomfort, nausea and vomiting and ultimately stretching your stomach pouch.

To prevent nutritional deficiencies always take your vitamin and mineral supplements as directed by your bariatric team alongside a healthy balanced diet. Symptoms of deficiencies can be: fatigue, achy muscles, tingling feet, calves or hands.

Some hair loss can be experienced around months 4-8 post surgery, this is caused by rapid weight loss and/or lack of protein or vitamins/minerals in the diet. To prevent this, patients should consume the amount of protein recommended by their bariatric dietitian (usually 60mg daily) and take vitamins/minerals as directed. Gateway Health patients are usually recommended to take 2 x complete multi vitamin and mineral supplements per day or 1 x prescribed Forceval vitamin and mineral supplement a day. Be reassured that we do find that hair does grow back after 12 months and often thicker than it was before surgery.

Dehydration is caused by drinking too little fluid or by persistent vomiting. Signs and symptoms include dark and strong-smelling urine, dry mouth, headache, and fatigue.  Drinking with meals is to be avoided after bariatric surgery, so it is important to sip liquids frequently throughout the day to avoid dehydration.

Dumping syndrome is caused by food emptying too quickly from the new stomach after gastric bypass surgery. Signs and symptoms include diarrhoea, nausea, cold sweats, and light-headedness. Avoid eating or drinking refined sugars and high-fat foods or drinks and wait for 30 minutes after finishing your meals before drinking.

After weight loss surgery you eat less food and fibre. To prevent constipation drink plenty of water, exercise daily, include fibre in your diet and we find taking a fibre supplement such as Benefiber or Fibresure is helpful. (found in large supermarkets near the vitamin aisle)

If you find it difficult to follow advice, whether that is due to poor motivation, poor understanding of nutrition/what is required, poor planning, lack of knowledge as to how to prepare meals/meet your dietary needs or emotional eating …. It is important to seek professional expert advice to avoid a poor result and future weight regain.

Weight loss surgery is just a tool, if long term dietary, exercise and mind set are not changed, weight regain is a real possibility. Find a bariatric provider who can expertly meet all of your individual needs.

What do you value most?

 

Values are the things in life that we most care about and consider important.

There might be values you think are important, and others that don’t matter so much to you.

Below is a little activity that I think is very interesting and can be quite insightful, to see what is most important to you and whether you are doing enough to meet your own personal values?

Values:

Below are some common values, read through them and consider what is important to you.

Then:

1.Write a few notes next to each value on the list below

 

  1. Give each value a score as to how important it is to you:

(0 = not important, 10 = very important).

 

  1. Give each area a rating according to how successfully you have lived your life in accordance with this value in the past month

(0 = not at all well, 10 = very well).

 

  1. Look at the rated scores for Number 2 compared to the rated scores for Number 3, are your values in sync?

 

When the scores for Number 2 and Number 3 match you are being true to yourself, to your personal values.

When your scores do not match up, how can you make changes in your life to even the scores out?

 

 

FAMILY:

What kind of family relationships do you want? What sort of brother / sister / mother / father / aunt / uncle / niece / nephew do you want to be? How do you want to be in those relationships?

 

PARTNER:

What kind of partner do you want to be? What kind of relationship do you want to be a part of? What sort of partnership do you want to build? What kind of person do you want to be in a relationship?

 

PARENT:

What sort of parent do you want to be? What qualities do you want your children to see in you? What kind of relationships do you want to build with them?

 

FRIENSHIP/SOCIAL LIFE:

What sort of friend do you want to be? What friendships are important to cultivate? How would you like to act towards your friends? What kind of social life matters to you?

 

EMPLOYMENT/CAREER:

What kind of work is valuable to you? What qualities do you want to bring as an employee? What kind of work relationships would you like to build? What kind of work matters to you?

 

EDUCATION/PERSONAL GROWTH AND DEVELOPMENT:

How would you like to grow as a person? What kind of skills would you like to develop? What matters to you about education and learning? What would you like to know more about?

 

RECREATION/FUN/LEISURE:

How would you like to enjoy yourself? What relaxes you? When are you most playful?

 

SPIRITUALITY:

What kind of relationship do you want with God / nature / the Earth?

 

COMMUNITY, ENVIRONMENT, CITIZENSHIP:

What kind of environment do you want to be a part of? How do you want to contribute to your community? What kind of citizen would you like to be?

 

PHYSICAL HEALTH AND WELLBEING:

What kind of values do you have regarding your physical wellbeing? How important to you is your health? How do you want to look after yourself?

 

VALUE              DESCRIPTION OF YOUR VALUE     IMPORTANCE        SUCCESS

 

Family

 

Marriage / Couple / Intimacy

 

Parenting

 

Friendships / Social life

 

Career / Employment

 

Education / Personal growth & development

 

Recreation / Fun / Leisure

 

Spirituality

 

Citizenship / Environment / Community

 

Health / Physical wellbeing

Diabetes Death Trap!

Diabetes is killing people across the globe. Type 2 Diabetes is a known co-morbidity of Obesity.

415 Million people worldwide have diabetes, worryingly almost half of those people do not know yet that they have the disease. It truly is a global epidemic.

It is estimated that by 2040 1 in 10 people will have diabetes.

 What are the risk factors of Type 2 Diabetes?

Being obese, being inactive, a family history of diabetes, high blood pressure and being aged 45 and over.

What are the symptoms of Diabetes?

Frequent urination, excessive thirst, very hungry, fatigue, dry skin, slow healing wounds and leg or foot pain.

Long term risks of diabetes:

Increased blood pressure

Nerve damage

Kidney disease

Eye problems which can lead to blindness

Serious sores on the skin and feet which can lead to amputation.

 

If you are worried about the risk of diabetes see your GP and request a HbA1c blood test. This blood test gauges your average blood sugar level for the last 2-3 months.

If you are diabetic it is important to take your medications as prescribed by your doctor, to monitor your blood sugar levels, to reduce/eliminate sugar from your diet, eat a healthy balanced diet as advised by your doctor and to increase your exercise and REDUCE YOUR WEIGHT!

If your BMI is above 30, Bariatric surgery may well be an effective option for you.

Bariatric surgery can trigger physiological changes, hormones are changed which stabilise blood sugar……… all without the use of drugs!

Aftercare makes all the difference…

 

Surgical weight loss specialists all know for sure that bariatric surgery is a tool to help you lose weight. It is without any doubt the most effective proven weight loss method, but it still is not a miracle cure. Weight regain can and does happen.

Permanent dietary and activity changes need to be made and often for this to happen we need to get rid of old habits and change our mindset.

A good aftercare programme needs to support you medically, nutritionally and emotionally through the early days, weeks, months and possibly years following surgery….

 

Things to consider in the early weeks

What is normal, what are the physical warning signs? Who do I contact?

What should I be eating and drinking? What amount should I be eating? What texture of food should I be eating?

When can I go back to work? What activities can I do? Are my wounds ok?

 

And months later…………………………

My relationships are changing, some people are helpful, others not so much! How best to deal with this?

After a lifetime of an unhealthy relationship with food, how do I turn it into a new healthy relationship?

How do I deal with cravings? What’s triggering my cravings? How do I eat the ‘right’ things when I’m craving the ‘wrong’ foods?

How do I change a lifetime of habits? How do I make my new habits stick?

I used to use food to feel calmer after a stressful day at work, it used to lift my mood, ease my anxiety, what should I do now?

How do I recognise the signs of stress, depression, anxiety? What help can I get for this?

How can I change my negative thoughts?

I’m losing my motivation now a few months have passed how can I get it back?

Will I get loose skin? What can I do to help myself with this as I’m losing weight?

 

Check with your provider who will guide and support you along your journey……

Help my relationship is changing!

 

After weight loss surgery your lifestyle changes, your habits change, your body shape is decreasing, your energy is increasing, and your health is often improving.

These things can often have a positive effect on your personal relationships, especially when your partner or significant others are understanding and supportive of the changes. Often their quality of life can improve too!

These changes can be very positive although at times relationship difficulties can arise.

The people in your life can react differently towards you, such as trying to consciously (or unconsciously/not realise they are doing it) sabotage your efforts,

They might not have faith in the fact that you can stick to your new lifestyle.

There could be jealousy, jealous of your successful weight loss and your courage at having done something positive to improve the quality of your life and your health.

Sometimes there is insecurity, they may worry that now you may want to find a different partner, friends might find the new you ‘boring’

Try to speak to your partner/the important people in your life as to how they can support you, explain what you have had done and the changes this will mean to your life long term, placing emphasis on all the positive gains… better health, improved energy, encourage them to voice their fears and openly discuss the changes.

For long term success following bariatric surgery and to avoid the real risk of future weight gain, it is essential that permanent behaviour changes are made, and emotional needs are understood and met in a healthier way.

Post-Surgery Blues

 

I hear it often, when calling our patients after their discharge from hospital………… their feelings of regret …. sometimes saying they feel guilty at not having been able to lose weight on their own without having had to resort to weight loss surgery, plus the added post-operative discomfort and pain, pain and discomfort that they ‘chose’ to have this procedure.

Feeling low after an anaesthetic is common, we reassure our patients that these feelings are perfectly normal and do pass very quickly. We often then talk about the reasons why they chose to have surgery in the first places and remind them that losing weight ‘eating less and exercising more’ is easier said than done and that there are often biological, metabolic, behavioural and psychological reasons all playing their part. We want our patients to relax and stop being so hard on themselves!

Let’s focus on the positive…. following the post-operative recovery, you will notice your physical hunger level is less, sometimes non-existent! Your energy levels will begin to increase, your quality of sleep usually improves, and your body shape will gradually start to change.

However, sometimes difficulties can appear and there are several reasons for this. Everyone is an individual, with different sets of circumstances yet we do see some common themes.

Sometimes we hear that patients feel as if they are losing not being able to socialise or eat with family and friends as you did before surgery due to your post-operative dietary restrictions.

Be reassured that as the next few months pass, textures of foods will increase, and portion sizes will not be quite as restrictive. You will still be able to eat with others, just less.

Sometimes after a few weeks or even months, it becomes clear with some patients that, before surgery, food was used as a way of managing feelings and thoughts. It can feel as if you have lost your method of coping with these uncomfortable emotions and thoughts. It is important to find a healthier way of dealing with these unwanted feelings and thoughts to avoid self-sabotage (finding ways to work against your surgery/not following advice) or cross addiction (using alcohol or drugs in the situations you used to use food as a coping method).

Find an aftercare programme that provides expert emotional support and advice to help you deal with areas such as anxiety, low mood, stress, self-esteem and confidence.

 

Are you prepared to make the long-term changes to achieve a long-term good result?

 

Don’t kid yourself, Bariatric Surgery is not a quick fix. Yes, you are more than likely to lose weight in the early weeks and maybe months after surgery, but that weight can and often is regained.

For long term success you certainly must change your dietary and lifestyle habits and become more physically active, but have you considered that bariatric surgery can only help with your physical hunger but not your emotional hunger?

Have you used food as a means of coping with your emotions in the past? For example, eating when you feel low in mood, anxious or stressed?

You are going to need to learn different healthier means of dealing with your emotions. Who is going to guide and support you? If you can no longer self soothe or calm yourself with food, how will you manage with these emotions?

Choose a Bariatric provider who offers an after-care package that will fulfil your potential needs. Check out the experience and specialty of each member of the team, not just the Surgeon! Of course, when you are looking for a provider, check out the experience and safety record of your bariatric surgeon. The National Bariatric Surgical Register (NBSR) gives information on every bariatric surgeons’ statistics.

Your Aftercare programme, does it cover dietary, lifestyle and psychological support? Are the team Weight loss surgery specialists? Not simply an aesthetic clinic adding on weight loss surgery procedures. Bariatric Surgery is a real specialty which should be managed by experts in the field.

 

Surgery Overview.

Your bariatric team should discuss the differences between the different procedures, the pros and cons of each procedure before you decide.

It is vital to understand that bariatric surgery is only a tool to help you lose weight. You will have to make life long changes: dietary changes, lifestyle, activity and mindset changes. Otherwise you most likely will get poor results and/or regain weight.

I will explain how the different weight loss operations work and what lifestyle changes needed to achieve and maintain a good weight loss result.

THE GASTRIC BAND:

The gastric band works by restricting the amount of food eaten and reduces your portion sizes, but only when used correctly. It is quite easy to cheat the gastric band by eating the wrong texture of food.

An adjustable Silicone band is placed around the top of the stomach which creates a small stomach pouch. The band has tubing attached which leads to a port, which is placed underneath the skin. The band is adjusted by a needle entering the port, injecting fluid in or out to the port to increase or decrease the level of restriction felt. Only health professionals trained in this procedure can do band adjustments.

On average patients lose approximately 40-50% of their excess weight loss in the first two years after surgery, when they work with the band correctly.

The gastric band is reversible, it can be removed if problems happen. Long term risks are things such as: Band slippage, erosion, problems with the port or tubing, band infection and esophageal dilation.

 

Gastric Band rules to live by..

Once you have moved through the post-operative dietary stages:

  1. Eat dry Textured food (except for the early weeks following surgery and following gastric band adjustments) Wet mushy foods will slide through the band and you will feel very little restriction.
  2. Do not eat and drink together
  3. Keep calories in drinks low
  4. Take only small bites of morsels of food
  5. Chew thoroughly, approximately 20 times for each morsel of food
  6. Wait a minute after you have swallowed your food before putting more food into the mouth.
  7. No snacking between meals.
  8. Mindful eating to a avoid vomiting and stretching the stomach pouch above the band
  9. Multi vitamin and mineral supplement for life.

Generally, patients who tend to eat large savoury meals and do not have a particularly sweet tooth can be suitable for a gastric band.

Sometimes a patient may choose a gastric band as they feel the other surgical options are too drastic.

The gastric band requires a strong commitment to attending clinical follow up for gastric band adjustments appointments and to a strong commitment to following the rules of how to work with the band.

 

GASTRIC SLEEVE:

Approximately 75% of the stomach is removed. This reduces the amount of food that you can eat. Ghrelin (The hunger hormone) is reduced which reduces your appetite. On average patients lose approximately 70% of their excess weight lost in first two years following surgery. Generally, there are less long-term problems in comparison to the gastric band. However acid reflux can occur and if you over eat, over time the new stomach can stretch

Gastric Sleeve rules to live by..

Once you have moved through the post-operative dietary stages:

  1. Normal balanced healthy diet
  2. Separate eating and drinking (Do not drink and eat food together, wait 30 mins after finishing food, before having a drink)
  3. Keep calories in drinks low
  4. Mindful eating to avoid stretching the pouch long term
  5. No snacking between meals
  6. Multi vitamin and mineral supplement daily for life
  7. Vitamin B12 injection every three months for life

 

GASTRIC BYPASS (Roux en Y):

The gastric bypass restricts your portion size and not all the calories you eat are absorbed. Your appetite is reduced. A small stomach pouch is made (approx. size of a golf ball) which is connected to a loop of the small bowel (The duodenum is bypassed). The remaining stomach and small bowel are reconnected further downstream where all the digestive juices from the stomach, liver and pancreas mix with food and allow some of it to be absorbed.

On average patients lose approximately 80% of their excess weight in the first two years after surgery. The gastric bypass can put type two diabetes into remission. Many patients tell us that their likes and dislikes of food have changed for the better. Dumping Syndrome is common, especially during the first year after a bypass. Nutritional deficiencies can occur as not all nutrients are absorbed. You can stretch the pouch by repeatedly over eating.

 

Gastric Bypass rules to live by..

Once you have moved through the post-operative dietary stages:

  1. Separate eating and drinking (Do not drink and eat food together, wait 30 mins after finishing food, before having a drink.)
  2. Keep calories in drinks low.
  3. Mindful eating to avoid stretching the pouch long term.
  4. Avoid snacking between meals.
  5. Multi vitamin and mineral supplement daily for life.
  6. Vitamin B12 injection every three months for life.

Rise in obesity sees 20 people a month go under the knife for life-saving surgery

People in Nottingham are twice as likely to be admitted to hospital with obesity related problems – higher than anywhere else in England.

One city clinic has also revealed that around 20 overweight patients a month are opting to have weight-loss surgery which can include having three-quarters of their stomach removed.

But Nottingham nutrition coach Susan Hart says gastric surgery should be “a last resort”.

Recent statistics show that obesity-related admissions are up by a third in the last year.

Gastric Sleeve surgery Nottingham

Private clinic Gateway Health says there has been a significant increase in the last year of people wanting gastric surgery – seeing 20 clients a month, 17 of whom will be suitable for treatment.

Surgery includes fitting gastric bands, which restricts the amount of food the stomach can hold by placing an inflatable silicone band around the upper part of the organ and gastric sleeves, which removes a large portion of the stomach.

Andrew Kemp, chief executive of the clinic, told the Post: “We have seen a significant increase since the middle of last year and we are not marketing or doing anything different than before.

“I wish I did know why. The trend across the country is pretty flat but in our area it seems to be more prolific.

He predicts that instead of being used as treatment, such surgery will become preventative. “Ten to fifteen years from now we will be doing gastric bands to stop people from gaining massive amounts of weight.

“We can see there is a significant benefit for them, why wait till people are really sick to have them. It is a bit like a smoker with a nicotine patch. It does not stop you smoking but it takes away the craving.

“The gastric band will help take away some of those cravings for food.”

He said the private clinic used to see on average 10 patients a month, but that had now doubled. The surgery is usually undertaken on someone who has a body mass index (BMI) of 35 and over.

Mr Kemp believes the food we eat has not become any fatter, but that people are exercising less than they did in the 1950s.

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