Written By: Carly Weeks

TUESDAY, May 8th 2012 (Globe and Mail)—-Nearly half of all Americans will be obese by 2030, according to a new U.S. government report. 

The U.S. Centers for Disease Control and Prevention report used factors such as the cost of healthy and unhealthy food, fuel prices and Internet access to make their predictions.

ABC News reports that if the report is accurate and 42 per cent of Americans are obese by 2030, it will result in an extra $550-billion dollars (U.S.) in health-care costs.

The report was released at the CDC’s Weight of the Nation conference on Monday, which is examining the impact of the obesity crisis.

Although obesity rates aren’t as bad in Canada as in the U.S. – a survey released last year by Statistics Canada and the CDC found one in four Canadian adults are clinically obese, compared to one in three in the U.S. – it’s likely obesity rates will continue to rise here.

The World Health Organization defines obesity as having a body mass index (BMI) of greater than 30.

Various solutions have been proposed for solving the obesity epidemic, from taxing pop and candy to mandating more exercise in schools.

But many experts in the field agree real change will only result from wholesale changes throughout society.

An Institute of Medicine report released Tuesday concludes that in order to make a difference, major changes need to occur, such as requiring at least 60 minutes of physical activity in school every day, improving the nutritional value of foods marketed to children and expanded wellness programs in the workplace.

“Each of us has this role. We can’t sit back and let the schools do it, or let a mayor do it or think somehow the federal government’s going to solve it,” report co-author William Purcell told the Associated Press.

Although quite slim as a child, she started to gain some weight in high school but it was manageable until after having children.  Then it started to become more problematic as the years went by. It started simply enough. Arlene wanted to lose weight for years and did so many times over.  However, the main problem she encountered was sustaining her weight loss. Like everyone else who have made multiple attempts in losing weight, she regained her weight over and over again, usually more than she had lost in her previous attempts. 

Then one day, Arlene suffered from life’s biggest blow —-a back injury that would bring her busy career and life to an abrupt halt.  There was however, some mercy in the fact that she did not know at the time that her injury was going to end up permanent.  In addition to emotional grief, Arlene also became physically limited. She was not able to do her daily routine and on many days, could barely move or stand.  She began gaining weight at a fast rate reaching close to the 200lbs mark. It was at this moment Arlene decided it was time to do something. 

Arlene had a friend (a nurse), who told her about the Lap-Band program at the Surgical Weight Loss Centre (SWLC), her experiences with the SWLC team, and her continuing success.  Arlene’s friend was happy and was satisfied with relatively small portions.  Arlene was not particularly an emotional eater, but consumed large portions during meals and was still hungry afterwards.

In September 2010, Arlene had her consultation with Lap-Band surgeon, Dr. Chris Cobourn. He was very helpful to her and took the time to answer all of her questions. Weighing at 200lbs, Arlene was scheduled for her Lap-Band procedure in December 2010. In preparation for the procedure, Arlene was prescribed two weeks of meal replacement. She found it difficult, but not impossible. She was primed and very motivated. She was nervous on the day of her surgery, primarily of the anesthetic. But all went well, her anesthesiologist was great at making her feel comfortable and safe.

A year and a half year later, Arlene is 15lbs shy from her target weight. She is still continuing to lose weight at a healthy rate and no longer indulges in large portions. She is completely satisfied after her meals. Arlene has learned to keep a food diary detailing what she consumes during the day to prevent her from consuming extra calories. She finds this process helpful and gives her control. Arlene knows that although weight loss will not cure her back injury, it will help ease the pain and slow down the expected deterioration process.

She is happy to know that by achieving sustained weight loss, she has minimized her risks of being diagnosed with heart disease, stroke and diabetes.

‘Spring’ on the other hand…screams rebirth, rejuvenation, energy, action and movement!  Now that the days are getting longer and warmer, most people are finding that not only are their moods starting to improve, but so too are their energy levels.

So what to do with all that excess energy??? 

We all know the positive benefits of regular exercise (combats health conditions or diseases, helps maintain weight loss, improves mood to name just a few).   We all know we should do it.  But HOW do we make ourselves move more? 

First and foremost, we need to remove the negative connotation associated with exercise and instead include it as part of our daily routine.  Just as brushing your teeth is a regular part of your day, so too must ‘movement’ be.  I don’t mean that you have to go to the gym every day.  But the best determining factor of how committed a person will be to exercise is whether or not they enjoy it.  So if you hate getting on the treadmill, don’t do it. 

There are so many ways to increase your movement that doesn’t involve doing something you loathe.  Does the garden need tending?  The dog, no doubt, needs to be walked and if you have young kids they are always looking for someone to kick a ball around with.  Enlist a friend to go for walks. You will less likely to ‘skip it’ if someone is counting on you.  At work, take a five minute ‘movement break’ every hour.  Walk up and down a flight of stairs or around the office. Do some abdominal exercises while sitting in your chair.

Trust me, the more you start to move, the better your body will start to feel and the more you are going to want to ‘get physical’ on a daily basis!  There is nothing that your band will prevent you from doing. Don’t use this as an excuse.

So, I have to say it…I know it is a cliché…but let’s “Spring into Action” and get moving!

Yours in Health and Fitness,

Sue

Today is the end of Stress Awareness Month. I hope you were able to absorb some really great tips from our healthcare professionals.

I leave you with a few more “Lap-Band Life Lessons”.

Lesson #1: Don’t allow yourself to become too hungry. When you get hungry your blood sugar can drop which makes it very hard to think rationally. In this situation your dietary discipline may be affected and you are likely to make bad choices. Avoid skipping meals to prevent from getting into this situation.

Lesson #2: Always think about portions.  When we are stressed we increase the risk of eating too quickly and consuming greater than normal portions.  Try to be conscious of portion size and put aside the stress when eating.   

Lesson #3: Make healthy choices when it comes to snacks. The best snacks combine protein and carbohydrates. This combination is digested more slowly, allowing you to feel satisfied longer.  Avoid snacks high in fat and sugar.

Lesson #4: Think about what you’re eating. When people are really stressed, they think that paying attention to their diet will just lead to more stress.  In fact, if you make good choices you give your brain better fuel to deal with the stress and make it easier to cope.  High sugar and high fat food cause swings in blood sugar and affect your ability to focus.

Lesson #5: Deal with your stress. This may be easier said than done, but finding ways to manage your stress is essential to your overall health. Try yoga, tai chi, or meditation. Exercise regularly. Spend time with friends. Seek counseling. Reduce the number of stressors in your life.

Finding ways to minimize stress in your life and focusing on better food choices can break this cycle.

Stress may be a part of life, but it doesn’t have to lead to weight gain. Give these techniques a try!

Happy reading!

~CC

Don’t sit by me, you take up too much room. 

You can’t be a cheerleader, we don’t have a uniform to fit you. 

Do you need an extension belt?

If you have ever heard these comments and they were not meant for you, you probably would have laughed either in private or out loud, but if you were the focus of these comments, you probably would have had a different response.  This is the story of Sandra and how she became the “brunt” of these jokes and finally at 50 years of age, she no longer has that worry. 

Sandra had two things in her favour, in that, she realised at a very young age that she had an intelligent mind and a great sense of humor. These were the things she focused on so that people could relate to her as the smart girl or funny girl, rather than the “fat girl”.

When Sandra was younger, she remembered how her mother had difficulty clothing her, with brand names like Chubbies and Huskies ingrained her mind.   In her adult years, this advanced to the “nice” fat names like Above Average, Encore, Ladies Plus and a host of other labels. One thing Sandra always wanted was a pair of boots since she was 8 years old.  Back then, they were needed to keep out the snow, but later in life, it was a style necessity and exuded confidence in the beholder.  But Sandra gave up trying to fit in them.

At the age of 47, Sandra began to look at her life more seriously.  Her daughter was engaged and soon to be married. Sandra was unhappy in her marriage and had a really stressful job which required her to be travelling, attending trade shows and standing on her feet for hours on end.  She worked long hours and had to do a lot of eating out while on the road.  She was seriously overweight and both knees needed replacement due to degenerative arthritis and general wear and tear. 

Sandra was diabetic, had high blood pressure, reflux disease, and a general state of poor health.  She was taking 14 pills a day, unable to walk without extreme pain and discomfort and was losing self-confidence. She had a bout of depression and extreme anxiety which she managed to battle and come out the victor.  She knew she wanted to be around to see her grandchildren and she certainly was not through living.  Sandra wanted to have more fun and travel and….still really wanted a pair of high boots.

In the next couple of months, Sandra began researching online and heard of a procedure called the Lap-Band. During one of her business travel to Toronto, she saw an advertisement for the Surgical Weight Loss Centre and made the call.  This was the first step she needed to take control of her life. 

In June 2008, Sandra had her consultation. From the first call, she was treated with respect.  The staff was wonderful right from the first contact.   The surgeon who called to speak with Sandra a couple of days later was gentle but blunt.  He very calmly told her that the path she was on would certainly lead to serious health problems and that she was currently in excess of 160 lbs. Sandra spoke with her family doctor in Nova Scotia and helped make the arrangements for the required tests for her procedure.   She was given a surgery date, further instructions regarding diet prior to surgery and financial planning options. 

Then came the big day! Her brother, the health nut, drove Sandra to the clinic and left her in the capable hands of the staff at the Surgical Weight Loss Centre.  She was consulted, weighed and then took the walk to surgery in flannelette booties.  After a very brief time in recovery she was given back to her brother and headed back home.  The next day the staff at the Surgical Weight Loss Centre phoned Sandra’s brother to check up on her and made sure all was well.

Now three and a half years later, Sandra no longer has to use the handicapped washroom in public, require a belt extension on an airplane and the tray fits down as well.   She saved her knees and now takes only one and half pills a day.   Her blood sugar is under control.  Grocery bill is cut in half. She can cross her legs. And yes, she now owns seven pairs of high boots.

Sandra has gone from a size 26 to a 14 and has an abundant amount of energy. 

When asked how she would justify the cost? Her answer: her life, her happiness, her quality of living.

Written by: Megan Ogilvie

TUESDAY, April 24th 2012 (Toronto Star) — More than 1 million Ontarians have diabetes and the Greater Toronto Area is home to approximately one half of all cases, a massive new study has found.

Brampton, parts of Mississauga, Etobicoke, Rexdale and Scarborough have some of the highest rates in the province — with the exception of First Nations communities, where as many as one in three people have diabetes.

The report released Tuesday by the Institute for Clinical Evaluative Sciences (ICES), for the first time maps diabetes rates cross Ontario. It also plots rates of diabetes complications, painting a picture of who in the province is more likely to receive help in managing their disease.

Previous reports have shown some communities in the GTA have higher than average rates of diabetes. But the new data reveals rates in several areas are even higher than some experts anticipated.

In Brampton, Malton and Rexdale, for example, between 12 and 22 of every 100 adults have diabetes. The provincial average is about 9 cases for every 100 adults.

“It’s definitely an increase from previous numbers,” Dr. Sanjeev Goel, the diabetes primary care lead for the Central West Local Health Integration Network, said of the rates in Brampton, Malton and Rexdale. “It is surprising they are that high. That means, in some parts of those communities, one in five people have diabetes.”

The goal of the ICES study is to provide a baseline look at patterns of diabetes in Ontario to help policy makers and healthcare practitioners better target diabetes prevention and management strategies to communities that need them most.

Although the data in the report did not differentiate between type 1 and type 2 diabetes, the majority of people with diabetes — about 90 to 95 per cent — are thought to have type 2, said the study’s lead author, Dr. Gillian Booth, an adjunct scientist at ICES and a scientist at the Centre for Research on Inner City Health at St. Michael’s Hospital. 

Type 1 diabetes, which most often appears when the patient is a child or teenagers, should not be confused with type 2 diabetes, in which the body does not produce enough insulin or uses insulin efficiently. Type 2 diabetes, which is closely tied to obesity, is a chronic disease that comes with myriad health complications, including stroke, heart disease, blindness and kidney disease.

Experts say the soaring rate of type 2 diabetes in Ontario — and across much of the world — is due in part to an aging population and to rising rates of obesity, spurred on by unhealthy eating habits and sedentary lifestyles.

But socioeconomic status and ethnic background also play a part in who will get diabetes and who is at risk for developing the disease.

Booth said diabetes is more common in certain ethnic groups, including people of Aboriginal, South Asian, African and Hispanic descent. These groups are more likely to get type 2 diabetes — and at an earlier age — due to a variety of genetic factors, including a propensity to gain weight and the likelihood that extra body fat will induce insulin resistance.

Booth said the pattern revealed by the report fits with where these at-risk communities live in the province.

“There is more ethnic diversity in the GTA, so we do see higher rates of diabetes as well,” she said. “Amongst recent immigrants, South Asians have among the highest rates of diabetes. We do see communities around the GTA, such as Brampton and Mississauga, having high rates of diabetes where we know a lot of South Asian immigrants are settling.”

Zacky Ahsan, 58, has had type 2 diabetes for 13 years. The Brampton resident of South Asian descent admits he did not manage his diabetes as well as he could after his diagnosis. In April 2011, Ahsan suffered a diabetes-related stroke and spent two months recovering in hospital.

“I learned my lesson,” said Ahsan, who immediately quit smoking and is now vigilant in monitoring his blood-sugar levels, taking his medications and keeping to an appropriate diet. He also volunteers with the Canadian Diabetes Association to educate as many people as possible in his community about ways to manage the disease to prevent complications.

“The majority of people are not aware of what will happen,” he said. “This is the only disease that affects the whole body — the renal system, the pancreas, the eyes, the limbs.”

Mimi Lowi-Young, CEO for the Central West Local Health Integration Network (LHIN), said the LHIN has known about the high rates of diabetes within its boundaries since being alerted by the 2006 Canada Census.

“We know we’ve got a very fast-growing population, especially of the South Asian population; we also have an aging population and we have a population who has increased obesity,” she said. “You put that all together and those are some of the factors that cause us to have a higher rate of diabetes.”

To help the thousands of residents with diabetes, the LHIN has 11 diabetes education programs scattered across the region and has opened a Centre for Complex Diabetes Care at Brampton Civic Hospital, which Lowi-Young said provides individuals with diabetes “a single point of access to help slow the process of their disease.”

Key findings

 • More than two-thirds of Ontarians with diabetes live in major urban centres.

 • In northern and rural First Nations communities, diabetes prevalence among adults is as high as 32 per cent.

 • Rates of chronic complications of diabetes, which include end-stage kidney disease, amputation and cardiovascular problems, were highest in northern Ontario and in rural areas in southern parts of the province. Rates for those communities were about three times higher than in urban areas.

 • Rates of acute complications, which include severe high or low blood sugar levels, varied four-fold across the province. Rates for these complications were highest in smaller, rural communities in southern and northern areas of Ontario.

 • People in urban areas had greatest access to diabetes programs and services.

 • More than half of Ontarians with diabetes had an additional chronic medical condition.

Written by: Horatia Harrod and Fred Mitting

MONDAY, April 16th 2012 (The Windsor Star)—United States (70.8 per cent overweight) A study from Yale University has found five per cent of Americans would rather lose a limb than be obese. The majority, however, don’t appear to have a choice, and the country is becoming increasingly adept at making life comfortable for them.

On March 22^nd, the Today Show aired an interview with singer Carnie Wilson to discuss her continuing battle with obesity through another form of bariatric surgery called the Lap-Band procedure. Interestingly enough, Wilson’s decision to have the revision operation was a result of her weight regain after gastric bypass surgery. According to Wilson, she attributes her weight gain to the effect of two pregnancies after her gastric bypass. 

It’s interesting that her weight gain occurred after two pregnancies which fit with our findings. The Surgical Weight Loss Centre currently has a research paper in the prestigious surgical journal – Annals of Surgery – which discusses the issues of pouch dilatation after Lap-Band surgery.  Pouch dilatation occurs when the small pouch created at the time of surgery above the Lap-Band can stretch up over time. Pouch dilatation can occur in about 2% of our patients. Our research suggests that although the risk of it occurring is low, it may be more common in pre menopausal women and women who have completed pregnancy.  

The interesting implication of our research is that the creation of a small pouch is a common feature of all bariatric surgical procedures including gastric bypass, Lap-Band and the gastric sleeve.  As such it is probable that pouch dilatation is common to all of these bariatric operations in this group of patients.  The implications of pouch dilatation however, are very different for each procedure.

Pouch dilatation after Lap-Band may cause symptoms of heartburn and regurgitation.  If this does not resolve with loosening of the band, then it may require repositioning of the band which is a simple outpatient procedure.  Pouch dilatation after gastric bypass or gastric sleeve may lead to regain of some or all of the weight that had been lost after the surgery.  Unfortunately, gastric bypass and gastric sleeve are not adjustable, or reversible, and thus treatment of the weight regain will likely require conversion to a different procedure such as the Lap-Band. 

The Surgical Weight Loss Centre has extensive experience with the conversion of other weight loss procedures to the Lap Band since 2005. For more information on the Lap-Band program offered at the Surgical Weight Loss Centre visit http://bit.ly/o81y20.

Link to article: http://todayhealth.today.msnbc.msn.com/_news/2012/03/22/10799250-trying-to-hold-on-to-weight-loss-carnie-wilson-discusses-second-surgery

Happy reading!

~CC

Life is busy and stress comes out at us from many directions: family commitments, work commitments, health concerns, financial concerns, the list is endless. 

How do we deal with the stresses in which bombards us and negatively affect our physical and emotional health every day? Well, we’ve all heard the saying “stressed spelled backwards is desserts” which goes hand in hand with the golden oldie “a moment on the lips is forever on the hips”. 

A longer lasting and more effective way of dealing with our daily stresses is in the form of exercise (I heard that collective groan, but listen up it’s not so bad). Exercise has been proven to decrease the ‘stress hormones’ like cortisol which cause us (and often your band) to tighten up, and increase the ‘feel-good’ chemicals called endorphins which give you a natural mood boost.  The more you exercise the better you will feel and the less stress you will experience!

TIP #1: Safety first. Before beginning a fitness program always consult with your health care professional first.

TIP #2: Don’t set the bar too high. How many of us have decided Dec 31^st around 11:59 p.m. to join the gym only to find that goal a little daunting and after a couple of weeks we never darken the door again?

If you are new to exercise, start with baby steps and work your way up.  Excitement about a new program can lead to overdoing it and possibly even injury. If you begin your program slowly, chances are, you’ll stick with it. If you’re new to exercise, aim for about 20 to 30 minutes of exercise, three to four days a week and increase gradually. This does not all have to be at one time, as long as you are doing it. It is also extremely beneficial to incorporate some strength training exercises at least twice a week.

TIP #3: Choose something you like to do. Pretty much any form of exercise or movement can increase your fitness level while decreasing your stress. The most important thing is to pick an activity that you like to do. 

If you love to walk, invest in a good pair of shoes and find your inner Forrest Gump.  If you groove to “Flash Dance”, plug in your iPod, lock the bedroom door and bust some moves.  Don your gardening gloves and “Get Physical” in your garden. The more you enjoy an activity, the more likely you are to do it and I GUARANTEE your stress will start to melt away.

TIP #4: And finally set aside some “me time” and stop feeling guilty.  This is not a luxury and it is not being selfish.  It is a necessity and just as you would schedule in an important breakfast meeting or your children’s soccer game, set aside some time to get active and de-stress.

They say it takes 30 days to break a habit and 30 days to make a habit.  Why not take The 30 Day Challenge!  Commit yourself to doing some form of physical activity daily.

Anything you like to do and commit to at least 10 minutes every day for 30 days. Allow yourself to quit after 10 minutes if you are not enjoying yourself.  Chances are you will find yourself extending those minutes, feeling energized, sleeping more soundly and handling life’s stresses more effectively. 

Yours in Health and Fitness,

Sue

Most people will think of particular circumstances or symptoms, for example: you sleep through your alarm clock, are late getting the kids to school, hit the highway just in time to get stuck in bumper-to-bumper traffic and then realize your gas light is on, so your heart starts to race and you break a sweat! 

It’s important to remember that stress can also be generated from positive moments and is especially prominent when we are unsure of how to handle said situation.  Since stress can impact mental, emotional and physical wellbeing, management is an absolute priority.  Therefore, it’s incredibly important to learn how to deal with stress in a positive and productive way!

Emotional and Stress Eating

 Many individuals turn to food for comfort, enjoyment or for celebration; therefore, it’s important to realize when you feel tense as a trigger and deprogram what might feel like an automatic response to reach for doughnuts, ice cream, and other high-fat or sugary foods, eat irregularly throughout the day and consume fewer fruit and vegetables. Not surprising, then, that stress eaters are more apt to gain weight.

Coping Strategies

1. Build a good nutritional foundation. Ensure to participate in the SWLC education sessions, interact with your SWLC care team on a regular basis and access the numerous resources that SWLC offers in order to prepare your home, mind and body in advance and better handle stress when it happens.

2. Be mindful. Don’t allow intakes of foods and beverages to sneak under your radar due to mindless eating such as walking past the candy dish and picking up a few to munch on or tasting food as it cooks. Mindful eating encourages you to be present during your intakes so that you select nutrient-dense, high quality items.

3. Enjoy complex carbs! Look for high fiber, minimally processed carbohydrates such as steel cut oats, bran buds, brown rice, whole-grain pasta, vegetables, legumes, fruits and non-fat milk to fuel your brain and body so that you are better equipped to handle stress.

4. Substitute for cravings. When you find yourself craving salty chips, opt for some pickles instead. If pickles don’t satisfy your palette, how about trying fresh fruits, or something crunchy like baby carrots. Skim milk low calorie pudding is also delish when craving for something smooth and creamy.

5. Have a backup plan. Stress induced eating can have a fast onset, so aim to always be prepared. Keep healthy snacks on hand at all times.

6. Reflect. Recognize what’s happening when stressful events  or thoughts ensue. Stop and evaluate. Ask questions like where’s your hunger rooted—mind or stomach? How hungry are you? When was the last time you ate or drank something?

Margeaux, RD