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Wednesday, May 31, 2006

WLS increases sixfold

I'm not usually a fan of Fox News, but the company's Web site has an interesting article on the increased popularity of surgical weight loss. The article attributes the increase to a fairly new procedure called adjustable gastric banding (LapBand), which is reversible and minimally invasive.
I'd love to hear your thoughts on the subject. Click on the link below to read the story: http://www.foxnews.com/story/0,2933,197531,00.html

Birth control pills may be effective after bypass

In talking with some post-op friends the other day, I realized that many of us had received conflicting information from our doctors regarding the use of birth control pills after gastric-bypass surgery.

As a Kaiser patient, I had been told that barrier methods and IUDs were the best options after surgery, and birth control pills were off-limits. Another woman was told nothing by her doctor about contraception and had continued taking the same oral contraceptives as before surgery. The third woman was told that our pouches lack the digestive acids to break down the pill so she chewed hers up every day to ensure absorption.

Contraception is a serious issue for post-op patients. In general, it is not safe to get pregnant within the first 18 months after gastric-bypass procedures. The high rate of weight loss, reduced caloric intake and frequent vitamin and electrolyte imbalances do not make for a body able to sustain a healthy pregnancy.

Those of us with pre-op infertility have to be even more careful. Most times, that infertility is caused by obesity-related hormonal imbalances. As the weight drops off, some women become super fertile at a time when pregnancy would be dangerous for both them and the fetuses they would carry.

Of course, birth control pills are not the only forms of contraception on the market, but they are among the most commonly covered by insurance companies. For instance, my new employer-provided insurance plan only covers oral contraception. That makes the Pill the cheapest form of contraception available to me, and it's important to know whether it’s a viable medical option.

After talking with these women, I decided to e-mail the medical director of my bariatric program to ask why we had been discouraged from taking the Pill. Her answer surprised me. It had nothing to do with malabsorption issues. She said the risk of blood clots after surgery was too high, and birth control pills would add to it. According to her, oral contraception is safe and reliable after the first month.

A quick Google search shows some Web sites still advocating against the Pill because of malabsorption concerns. When it comes down to it, contraception is not a decision that can be taken lightly by a post-op. After all, if a chosen method fails, the resulting pregnancy can be quite dangerous. I’m still on the fence about whether I’ll trust the Pill to protect myself from getting pregnant this year, but the decision is individual. The friends whom I mentioned in the beginning of this column will continue as they have before and expect the same level of success. Only time will tell.

Saturday, May 27, 2006

Starting a dialogue on childhood obesity

Originally published May 27, 2006, in Our Town for the Tracy Press.

Growing up overweight isn’t easy. I should know; I lived the experience firsthand. And having that history makes me incredibly passionate about the subject of childhood obesity and the epidemic it’s become in our nation.

But battling childhood obesity is not as simple as protecting in-school physical education requirements or teaching nutrition in elementary schools. Though children need to learn how to make better eating and lifestyle choices to ensure their own health, they need the support of their parents to make that happen. In their defense, parents do not intuitively know how to help their children lose weight or be healthy.

But now there is a children’s book on the market that addresses the subject in a manner that’s accessible to both kids and their parents. “It’s Not Your Fault That You’re Overweight” is written by Merilee A. Kern, a former marketing executive for eDiets.com who continues to write nutrition columns for the company. There are gender-specific paperback editions of the book and even coloring and activity e-books for children younger than 7. It’s available at www.notfault.com

The title alone is eye-catching. As someone who was obese as a child, my first question was who the author would choose to blame. Would it be parents for allowing their kids to be inactive and overeat? Would it be the fast-food industry for enticing children with their commercials and ads? Or would it be society as a whole for innumerable reasons?

The answer is both all and none of the above. Kern addresses the issues of children favoring video games over being active and the increase of eating in restaurants or on the run. However, the entire book is written in a nonthreatening tone. Her central message is that everyone — children and the adults in their lives — makes poor choices that promote being overweight. But instead of assigning blame, the author poses the issue to be one of ignorance. It’s not that kids or their parents are intentionally making bad food and lifestyle decisions; it’s that they don’t know any better.

The main characters (Patty or Matt, depending on which edition you purchase) and their parents don’t realize how serious it is for children to be overweight until a doctor’s appointment. The doctor educates the children and their parents about the medical consequences of obesity and offers advice that puts the children on the path to achieving a normal weight.

The book is not humorous, particularly if you identify with the characters as I do (luckily, my name doesn’t rhyme with “fat” or “fatty”). The author has a very clear understanding of what it means to be an overweight kid and does not sugarcoat the experience. Being teased and bullied are addressed in addition to the physical limitations that come with carrying too much weight on a child-size frame.

Personally, I think the book hits closer to home for those of us who have been there in regard to growing up obese. I think Kern also makes a concerted effort to make those who have never struggled with their own weight understand the difficulties overweight kids face. She also includes a section of talking points for parents to use in discussing the story with their kids to make the experience more interactive.

Will this book alone change the world and guide us out of the epidemic that is childhood obesity? Probably not. But it’s a good start.

Saturday, May 13, 2006

Rising to the head of the class

Originally published May 13, 2006, in Our Town for the Tracy Press.

I’ve never been what I would call a gym bunny. You know the type — the women who show up bedecked in spandex with a full face of makeup and perfectly coiffed hair. Thankfully, the trend of wearing thong leotards over spandex shorts went out of style sometime in the ’90s.

I am more of a gym rat, somebody who rolls out of bed in the morning, grabs the nearest T-shirt and lounge pants, fills up a water bottle and heads out the door. No makeup, no brushing of hair. Aside from the careless regard for appearance, I used to differentiate myself from the gym bunnies by what I did when I got to the health club. I favored cardio and weight machines. Gym bunnies took classes. I hate classes.

My first foray into group exercise was when I signed up for a beginner aerobics class in college. We did step aerobics — the going trend. I have never been blessed with coordination, but the routines were simple enough for me to figure out.

I enjoyed that class so much that my roommate and I joined a gym the following semester so we could take step aerobics together. I was shocked the first day of class to see a room full of gym bunnies wearing butt-floss leotards. The instructor was about seven months pregnant and looked too cute in her multicolor thong leotard ensemble.

At first, I thought I was doing well. I was keeping up with everyone else and felt like I had really accomplished something. And then the instructor announced that the warm-up was over. For the next 30 minutes, I got more of a workout from trying to figure out the choreography than I did from the exercises. I don’t think there is a way to feel worse about yourself than to have a very pregnant woman run circles around you in an exercise class. I never went back.

That is, I hadn’t visited another class until Tuesday.

My workout buddy, Marie, has been telling me about this class she found at In-Shape Sports Club on Tracy Boulevard called Straight-Up Strength. She loves it. She loves it so much she got rid of her personal trainer and takes the class twice a week for strength training. She raves about how powerful she feels, how wonderful the instructor is and how much weight she’s lost since she started it a few months ago.

Last week, Marie convinced me to try the class. I spent part of my weekend dreading it. I didn’t want to be the loser in the back of the room who couldn’t figure out the routines. But I promised Marie, and I keep my promises.

Straight-Up Strength, which is a high-energy total-body resistance class, requires a bit of set-up. Getting there early is important. Each person needs to grab a step (to use as a bench), mat, barbell, dumbbells and weight plates. As I was setting up my workspace, I took a look around the room. I was surprised to see a few familiar faces in the all-female crowd and not a single gym bunny. Sure, there was quite a bit of spandex, but I think that’s a pre-requisite for most people when it comes to workout wear.

The women ranged in size from very fit to moderately overweight, and you could tell that most of them were regulars. Some women were already drenched in sweat from the class that precedes Straight-Up Strength; others were like me and had just done a little cardio beforehand.

Loretta, the class instructor, is a fierce force to reckon with. At least that’s what the regulars say. She has the type of figure that I’m sure keeps many people coming to her classes in hopes their bodies will soon follow suit. But what I liked is she took time before each segment to explain the moves and modifications. She also walked around the room to correct form and movement, ensuring everyone got the most out of class.

The class was an amazing mix of squats, dead lifts, lunges, rows, triceps kickbacks, biceps curls and other exercises of which I don’t even know the names. We went from lower body to upper body to lower body and back to upper body, ending with a serious ab routine. In all, the choreography wasn’t that tough. I got mixed up quite a few times, but with Marie and Loretta, I didn’t stay off track for long.The workout was tough. My legs shook, and there were times I didn’t think I’d make it through, but I did. And when class was over, I knew I had been through the wringer and would be sore the next day. But as Marie says, it’s a good sore. The type of soreness that reminds you of how much you accomplished the day before and how strong you really are.

That soreness is so intoxicating that I went back for more, and I might just continue with the class twice a week. Who knows? Maybe in two months, I’ll be just like Marie, raving about it to everyone I know and dragging one of my reluctant friends to join us.