Friday, June 16, 2006

Failing to plan means planning to fail

My husband and I are getting ready for a weekend trip to Lake Tahoe for his family’s annual summer vacation. Of course, I haven’t really given the trip much thought until today – when we’re supposed to be leaving.

That’s not exactly true. I thought about doing laundry, washing dishes, taking out the trash and packing. I’ve spent all week figuring out what to pack for a weekend of hiking, dancing and lounging on the beach, but I didn’t think of much else. Why is this a problem? Well, as I write this, I realize I haven’t spent any time finding out what we’re eating this weekend.

My husband’s family rents cabins along Camp Richardson, and they plan big group gatherings at mealtimes. I’ve asked repeatedly what we’re eating, and I’ve been told, “Well, you know. A little of this, a little of that.” That’s not helpful. I do know that for Father’s Day, there’s a family barbecue that features grilled steak. Otherwise, I haven’t a clue. I wasn’t overly worried about my lack of knowledge, because I figured there was bound to be something I could eat.

Then I read the monthly rant at bariatriceating.com last night. Susan Maria Leach, the site administrator and author of the rant, wrote about a recent vacation with her husband to visit family. Having had surgery five years ago, she didn’t pack special food for herself because she knew she could find something to eat just about anywhere. Unfortunately for her, she was wrong. Most of the restaurants the family visited during her trip didn’t offer anything that wasn’t deep-fried or smothered in gravy. And a family cookout only offered maple baked beans, dried-out hamburgers, macaroni and cheese, macaroni salad and birthday cake. She spent most of one day not eating, because she didn’t want to risk getting sick in public, and to make matters worse, she had to deal with relatives noticing her lack of eating and the hurt feelings that seem to arise around food.

Talk about a rude awakening. I quickly thought back to most of my food experiences around my husband’s family. In general, I, too, can find something to eat anywhere, but there are foods that just will not go down no matter how hard I try: hamburger, sausage, any form of dried or overcooked meat, scrambled eggs, pasta, rice and anything made with whole milk or cream. And then there are the foods that I do eat in a pinch but tend to make me ill: bread, sweets, gravy, fried eggs and potatoes.

As I thought about this, I also thought about the meals I’ve heard the family talk about having at past vacations: Spaghetti and garlic bread, barbecued hamburgers and hot dogs, breakfast scrambles, tri tip, baked potatoes, etc. And suddenly, it became clear that I needed to pack food for myself to prevent me from being in a situation where my choice was to either not eat or eat food that I knew for a fact would make me sick.

So, I’ll spend some time today before we hit the road at the grocery store. I’ll pick up string cheese, lunchmeat, protein bars, and I’ll take along some of the protein powder samples I have on hand. I may not touch a single thing I pack, but that will be better than the alternative.

Wednesday, June 14, 2006

Obesity Help Regional Seminar in Fairfield

Obesity Help is preparing for its regional seminar in Fairfield on June 24. The all-day event, held at the Hilton Garden Inn, 2200 Gateway Court, will feature a vendor fair, lunchtime reception and lectures on topics related to weight loss.

Obesity Help is an Irvine-based corporation that serves the morbidly obese community through its extensive Web site and bi-monthly OH Magazine.

The June 24 conference will feature four speakers who are well known in the bariatric and weight loss community.

Dr. Monica Ganz has lost 320 pounds following gastric-bypass surgery and is the director of events and chapters for Obesity Help. Her lecture, "Learning to Think Thin" will address the need for post-ops to retrain their brains and go from "thinking fat to thinking thin."

Lori Cochrane is a behavior analyst, speaker, writer and mentor to bariatric patients who had Roux-en-Y gastric bypass about five years ago. Her topic, "Bariatric Behavior: Rules of the Road for Long-term Success," addresses how to replace old behaviors with successful ones and how to enjoy positive change.

Dr. J. Timothy Katzen is owner of Body By Katzen and specializes in post-bariatric plastic surgery. His lecture, "Plastic Surgery After Weight Loss," will address the various types of body-sculpting procedures most common after drastic weight loss.

Lauralyn Bellamy had gastric-bypass surgery three years ago and has created Embody Success! Coaching, to teach others the tools that helped her achieve success. Her topic, "The Key to Overcoming Self-Sabotage in Weight Loss and the Rest of Your Life," is self-explanatory.

Keep checking back for more information on the Fairfield conference and other upcoming OH events. If you're interested in attending the Fairfield event, sign up soon; space is limited.

Step by step: Losses add up

The LA Times is following a brother and sister who tipped the scales at close to 600 pounds each before having Lap-Band surgery last year.

Lap-Band is an adjustable gastric band (think of a bicycle inner tube) that cinches the stomach to limit the amount of food eaten at one time and the speed of which it is digested. Lap-Band patients tend to lose weigh more slowly than gastric-bypass patients and the procedure is considered minimally invasive and is also reversible.

Sheila and Cyrus Tehrani refinanced their childhood home to pay for their procedures. After losing about 150 pounds in the last year, Sheila needed to have a panniculectomy -- or excess belly skin removed -- to help keep her active. The hanging apron of skin was impairing her ability to walk. During the procedure, doctors removed almost 50 pounds of excess skin and repaired a hernia Sheila didn't even know she had.

To read the entire article click here: http://www.latimes.com/news/local/la-me-superobese6jun06,1,7135581.story?page=1&coll=la-headlines-california

Practicing what I preach

I've spent the last half-hour in my kitchen trying to figure out what to eat for breakfast and pack for lunch and dinner in preparation for a long night at work.

It's been over a week since I went grocery shopping. Though I bought a bunch of food, I didn't plan very well and didn't stock up on convenient, portable meal options for myself. I have lots of cheese, but no cold cuts to use as lower-fat protein sources. No cottage cheese, ricotta cheese or even low-fat cream cheese.

Here I've been blogging about re-evaluating my eating habits and being more diligent and I forgot the most important thing -- making sure my fridge and pantry are stocked with options conducive to staying on my eating plan.

It took some time, but I've found a few cans of tuna, which will be perfect to take to work today. I have a freezer full of chicken that I just need to thaw and cook up. I can cut up chicken breasts to add to a salad or mix up a batch of chicken salad. I also have my protein powder -- I just need to move it from the cupboard to the counter so I don't forget about it.

More now than I ever, I need to be diligent about planning and making sure I eat good-quality meals and not just what sounds easy on the fly. Now excuse me, I have tuna salad to make before I go to work.

Tuesday, June 13, 2006

Evaluating eating habits

As I mentioned a couple of days ago, I'm nearing the end of my weight loss honeymoon period. In an effort to make the most of the next three months, I'm spending some time evaluating my eating, exercise and lifestyle habits to see where I can make improvements.

I've already recognized that I need to keep a tighter rein on my consumption of fat. This week, I'm paying attention to my portion sizes and how fast I eat. I definitely eat too fast, and eating too fast leads to eating too much.

Though I limit my carbohydrate intake, I enjoy Ry-Krisp crackers. Two crackers offer 3 grams of fiber, 1 gram of protein and no fat. Spreading a half-ounce of cheese on top provides a protein-rich, filling meal. The problem is that when I don't take my time eating, I feel like I have room for two crackers and eat them easily. But then a hour goes by and my pouch starts aching. I sense that it's being stretched by too much food. The feeling is painful and encourages me not to make the same mistake again. Now, I know that my limit is one cracker -- eaten slowly.

As for exercise, I need to work on consistency. I know it's better to work out regularly twice a week than to hit the gym five days one week, two the next and then skip it for three weeks. But my perfectionist attitude, which helped get me to 335 pounds in the first place, prevents me from setting and maintaining realistic goals sometimes.

Monday, June 12, 2006

Fighting against the grain

When I weighed 300 pounds, nobody even blinked when I chose my meals carefully. The same was true when I was 200 pounds. Now that I'm under 160, many people -- particularly those who knew me at my highest weight -- think I need to ease up on my vigilance.

"You should treat yourself," "You deserve a freebie," "Don't you ever just let go?" are comments I get a lot. I try to laugh off such comments, and that often works. But then there are times when such comments lead into evaluations about my current weight. A few well-meaning people have told me that they think I've lost enough weight and that I should stop now. And they use that opinion as justification of why I should have a slice of cheesecake or sample some ice cream.

I don't do so well when people feel the need to tell me how much I should weigh. One would argue that I should be able to tell people that my weight is none of their business. However, I have a hard time drawing such lines in the sand. After all, writing my column and this blog puts me in the spotlight. If I'm going to put myself out there publicly, I don't feel like I get to tell people to mind their own business. I realize this is untrue. I can make myself as private or public as I wish, but it's still hard for me to do.

Instead, I point out to people that with BMI of 28, I'm still considered overweight. I need to lose about 20 pounds before I'm even on the high end of normal. Of course, that usually leads to sideway glance, during which the person tries to picture me smaller than I am now. Then the person typically crinkles his or her forehead and says, "Wow...but that would make you too skinny. You don't want to do that, do you?" Usually, I shrug and say I'm undecided.

That's the truth; I am undecided. I'm very happy at my present weight. I'm healthy; I feel good; life is amazingly easy for me. And I don't feel like I have to work that hard to maintain this weight. But I also know that the more weight I lose within the next three months, the more I'll be likely to keep off forever. And that makes me want to maximize the remainder of my honeymoon period.

Sunday, June 11, 2006

Is the honeymoon over?

I've given a lot of thought to Friday's entry about cheese, not because I typically dwell over such things or because I mourn the need to limit my consumption of it. I've been thinking of it because the "honeymoon period" that follows gastric-bypass surgery is nearly over for me.

The honeymoon period is the 18-month window following gastric-bypass surgery in which the patient loses the bulk of his or her excess weight. After the honeymoon period, the gastric-bypass patient becomes more like the average person trying to lose weight. Watching the amount and type of food consumed becomes increasingly important, as does maintaining the positive lifestyle changes made in the preceding months.

One of the challenges is that as the honeymoon period nears an end, it's common to slip into old habits without even realizing it. And it becomes even more important to be vigilant about following the prescribed post-operative eating plan.

But the other challenge is that nearing the honeymoon period also means the post-op has lost a massive amount of weight and is nearing his or goal (assuming the weight loss went according to plan). Why is that a challenge? It's a challenge because our society seems to view weight management as a finite task. People understand the concept of losing weight, especially when morbidly obese people do it. But when a person goes from losing weight to maintaining the loss, people act as if the hard part is over. And if the hard part is over, that must mean that the easy part has begun. Nothing could be further from the truth.

Saturday, June 10, 2006

Suited for success

Originally published June 10, in Our Town for the Tracy Press.

This is my first summer at a normal weight. To celebrate, I promised my husband I would buy a swimsuit. He’s a water baby and has pouted for years that I won’t go swimming with him or hang out at our friends’ houseboats. I’ve never even gone on his family’s annual summer vacation at Lake Tahoe.

I can think of few things I dread more than wearing a swimsuit, but I’m pretty sure trying suits on in store dressing rooms is worse. I haven’t bought a suit in seven years. The only reason I bought one then was because I was visiting a relative in Hawaii, and she told me she’d leave me at the airport if I didn’t have a swimsuit in my suitcase.

I’m a planner, and as such, I’ve spent the last four or five months scouting swimsuit styles to see what’s out there and what might look good on me. Weight loss has changed my body into a bit of a pear shape, which makes standard one-piece suits not exactly suitable. The tankini was my greatest discovery. The suits can offer the coverage of a one-piece but the separate pieces can be mixed to offer the perfect fit.

I decided to take advantage of my favorite department store’s Memorial Day sale last week and blocked out a few hours in search of the perfect suit, or at least one that didn’t make me cringe to wear in public. Having already decided I wanted a tankini, I gravitated toward that section.
I fell in love with a selection of suits with brown bottoms and teal-and-brown tops. I was disappointed to see that the store was out of full-coverage bottoms, though. The only brown bottoms were swim skirts and low-rise bottoms, but I grabbed one of each, just in case. After all, the tops were that cute. Then I went to the black suit section and found a modest black set with full-coverage bottoms and top.

In all, I took about a dozen pieces into the dressing room. I set aside my favorite styles to try on. Two of the brown-and-teal tops were awesome. They were both halter-style, which experts say will emphasize the bust line and help balance a narrow upper body with a wider lower body. I also found the halter styles to be more supportive than standard swim tops.

Once I found what I thought was the perfect top, I tried on the bottoms. I went for the low-rise bottoms first, knowing ahead of time that they would probably be a no-go. I was right. I may be less than half the woman I used to be, but that does not mean my navel needs to be seen in public.

Next I tried on the skirt. The tag said swim skirts were good to “slim and hide hips and thighs.” Such skirts may cover the hips and upper thigh, but I strongly disagree that they function to “slim” or “hide” anything. The skirt wasn’t long enough to cover what I consider the most problematic part of my thighs. If anything, having the hemline fall at the widest part of my thighs just seemed to make me look even wider. And, as I remember from the bathing suit I bought seven years ago, when wet, swim skirts cling in all the wrong ways. The skirt was definitely out.

That left me with the lone black suit. I liked the bottoms on. They were basic and showed my entire thigh, but I figured I could wear a sarong if I didn’t want to be so exposed. The top, sadly, was not a halter-style. But it was flattering and supportive, and after waffling back and forth for a solid 10 minutes, I decided to go with it. I bought the top in a size 10 and the bottoms in a 12.
I have yet to wear it, but that family vacation in Tahoe is next week, and the suit is already packed.

Friday, June 09, 2006

Cutting the cheese

It's been almost 15 months since I had gastric-bypass surgery. In that time, I've gone from being able to consume 1 to 2 oz. of food in one sitting to comfortably accommodating 4 to 6 oz., depending on the type of food and time of day.

As I'm able to eat a larger quantity of food, I'm also beginning to realize the increased need to pay attention to the food I eat. Shortly after surgery, I focused mainly on getting in protein -- paying little to no attention to fat content. If alfredo sauce or butter helped chicken or fish slide into my pouch with great ease, then that's what I used. I also started favoring cheese as a quick, convenient protein source.

Many days, breakfast would consist of an ounce of cheese. I'd pack some cheese in my purse if I planned to be out all day and wasn't sure about where I'd be at meal times. An ounce of cheese is about 100 calories and offers 7 to 10 grams of protein. It was a wise choice for portable meals. However, I need to watch my consumption more closely. Reaching for cheese wasn't a problem when an ounce was all I could eat. Now that I can eat 4 ounces in a sitting, what used to be a 100-calorie meal could now be a 400-calorie meal if it only includes cheese. And fat is also an issue. One ounce of cheese has about 8 grams of fat. Four ounces of cheese would push me well over my day's fat limit.

Cheese isn't a new favorite of mine. Growing up in Hilmar, home of the popular Hilmar Cheese Co., my love for cheese began early in life (if you get the chance to visit Hilmar Cheese, I recommend sampling the Squeakers). I don't think it would be exaggerating to say that we go through five pounds of cheese a month in my house. Of course, I'm not the only one eating it. My husband loves snacking on quesadillas, grilled cheese sandwiches and cheese and crackers. He loves ham-and-cheese omelets for breakfast and always adds a couple extra cups of shredded cheese when he bakes a frozen pizza. I prefer to eat cheese out of hand or with a couple of Ry-Krisp crackers.

Now that I'm limiting my cheese consumption, I have to find other quick snacks. Cottage cheese and ricotta cheese are low-fat options that I may start using once again. I got my fill of both in the first weeks after surgery and lost my taste for them, but it's time to try them again. Protein drinks are another fast fix at meal time. And lunch meat still remains a great choice -- though it's another food I've grown weary of over the last few months.

I think I'll be writing more over the next few days about the way I'm altering my way of eating and how I view different foods. As always, I welcome any ideas, questions or feedback on the topic. This is yet another new phase in my life, and it's one I'm learning to embrace.

Thursday, June 08, 2006

Concert in the park

For those in the Tracy area, tonight is the first installment of the weekly Performances in the Park at Lincoln Park. Tonight's performer, Megan Slankard is someone of whom I'm quite fond. Not only was she raised in Vernalis -- the community I called home when I first moved to this area -- but she began coming into her own as a performer when I was entertainment editor for the Tracy Press. And her younger sister, Lauren, was my very first intern.

My husband and I enjoy the weekly summer concert series, and like the local farmers market, it's an event we work hard not to miss. Not only is it a free way to have fun, but it feels good to spend a few hours on a Thursday evening out in the open air. Tonight, we've invited some friend from out of town to join us for a picnic dinner during the show. We hope they enjoy it as much as we do.

Personally, I look forward to comparing tonight's experience with last year's series. Last year was the first time we checked out the concert series, because my weight loss had finally reached a point where I could handle sitting on the ground and getting back up. Some challenges I experienced were my newly emerging tailbone getting sore and numb from sitting on the hard earth and the embarassment of everyone behind me getting a great view of my underwear because my pants were always slipping down. I remember I still got winded walking the four to five blocks from the park to where we had to leave our car. But by the end of the series, Beau no longer had to drop me off at the park before parking the car. I was physically able to walk the few blocks in both directions.

Since the last concert in late July, I have lost about 80 pounds. Last year at this time, I was wearing a size 20. Today, I wear a 10/12. I'm packing a sweatshirt in case the evening air turns chilly, an old comforter to provide a little more padding beneath my rear and a selection of cold appetizers and maybe even a little wine just to add to the experience.

I hope to see you there.

Obesity in the news

I just Googled "obesity" and found a selection of interesting news stories that I'd like to share:

• The Urban League of Greater Chattanooga announced a health initiative today aimed at combating obesity among black women throughout the city. Read the story at: http://www.tfponline.com/absolutenm/templates/breaking.aspx?articleid=1786&zoneid=41

• The BlueCross BlueShield of Tennessee Health Foundation has awarded $40,000 to the Tennessee Pediatric Society Foundation in support of its Impacting Childhood Obesity Treatment & Prevention Program. Read the story at: http://nashville.bizjournals.com/nashville/stories/2006/06/05/daily34.html

• London - British children as young as 5 are working out in "kid gyms" as fears about childhood obesity grow. Read the story at: http://news.monstersandcritics.com/lifestyle/consumerhealth/article_1171082.php/British_children_seek_to_beat_obesity_in_kid_gyms

• ALBANY - As experts say childhood weight problems are increasing, two Assembly Democrats Wednesday called on schools to test for obesity and fast-food restaurants to detail nutritional information on menus. Read the story at: http://www.pressconnects.com/apps/pbcs.dll/article?AID=/20060608/NEWS01/606080343/1006

• As Americans keep getting bigger, hospitals are revamping themselves to accommodate an influx of obese patients. Read the story at: http://english.people.com.cn/200606/08/eng20060608_272044.html

• The federal government says 64 percent of Americans are overweight and 30 percent are obese. That has prompted the Food and Drug Administration, the F.D.A., to issue a report urging restaurants to help control obesity. Read the story at: http://www.voanews.com/english/2006-06-07-voa24.cfm

Wednesday, June 07, 2006

Strict parenting linked to overweight kids

Finally, there's a study that has proven what I've known all along: "Clean you plate!" admonishments lead to kids becoming overweight.
The study of 872 families was conducted by Boston University School of Medicine and published in the June issue of Pediatrics, released Monday. Researchers studied the effects of parenting styles on children's weight and found that authoritarian parents were more likely to have obese kids than authoritative parents.
Though none of us can undo the damage done by our parents at the dinner table, we can heed the advice of researchers and break the cycle with our own children by offering flexibility within a firm set of boundaries.
Read an Associated Press article on the study and view video footage at http://news.yahoo.com/s/ap/20060605/ap_on_he_me/diet_parenting_2

The sweet smell of successful marketing

Candy makers are seeing the power of marketing on consumers.

It's been years since miniature versions of full-size candy bars have been on the market. I still remember when Hershey's Kisses and Miniatures were first advertised on TV, and I begged my mom to buy some. As a child, I was enthralled by the idea of trying three or four types of candy instead of having to choose only one to take home from the store. The fact is that most candy consumers are like me. We buy the miniatures because we want variety -- and they fit so great in a candy dish. But that also means that those bite-size treats don't last long once the bag is opened.

But a new day has dawned in the snack food/candy market. Consumers now flock to portion-controlled packaging. Nabisco’s 100-Calorie Packs are all the rage around my office. Nobody feels guilty about a treat when they know exactly how it affects their calorie consumption.

According to a Reuters article, published Wednesday, Hershey Co. and Nestle unveiled similar concepts earlier this week at the All Candy Expo in Chicago. Both companies promoted low-calorie stick versions of their full-size candy bars. Other portion-controlled concepts debuted at the show included 100-calorie packages of Sunkist fruit chews and other low-calorie or sugar-free candies.

The most profound observation comes from Daniel Azzara, Hershey's vice president for global innovation and quality. He told Reuters that this isn't really innovative for the company.

"What's interesting to me is the idea that (now) it's actually labeled "100 calorie" on the front of the package and consumers see that as portion controlled," Azzara said. "In reality, we've had a lot of snack size and Kisses and small pieces of chocolate for a long time."

Azzara's words speak volumes to me. After all, if I couldn't stop at just one Kiss, what would make me think one stick would be enough? Is it because the nutritional information is more clearly displayed? Is my subconscious really that easily fooled? Or is it just that the packaging is more complete? The wrappers are a bit more difficult to open than simply unfoiling a Kiss.
I'm not sure that this marketing ploy will have much effect on how much candy people actually consume, but I do think there will be a lot less guilt surrounding the consumption.

Read the full article on CNN.com here: http://www.cnn.com/2006/HEALTH/diet.fitness/06/06/diet.candy.reut/index.html

Tuesday, June 06, 2006

Pamphlet released on obesity

The Obesity Action Coalition has released the first in a series of pamphlets on obesity. "Understanding Obesity" offers readers an in-depth look into obesity and morbid obesity, as well as addressing who it affects, health risks and treatment options.“The OAC recognized that there wasn’t an educational brochure available to patients and the public that really looked at obesity as a whole." said Joseph Nadglowski Jr., OAC president and CEO, in a press release announcing the pamphlet. "Often times, people overlook the many facets of living with obesity or morbid obesity, such as the diminished quality of life, the negative stigma associated with it, the lack of the ability for individuals to access safe and effective care and much more."According to the nonprofit, future pamphlets will address childhood obesity and further examine treatment options

Sunday, June 04, 2006

Appropriate use of protein bars

I was visiting one of my favorite message boards this evening and came upon a post about protein bars that reminded me of how there can be too much of a good thing.

Protein bars can be a convenient, healthy meal replacement in a pinch. However, when used as a snack, they are rarely any better than a Snickers bar. I see too many people who think of protein bars as a replacement for candy. They think of the bars as a healthy treat.
Sure, protein bars offer anywhere from 10 to 40 grams of protein (depending on brand), but they also can be very high in calories. Many that I have are around 300 calories.

As a WLS patient, I can only eat about a third to half of a bar in one sitting. But there are some people who eat two or three a day as a snack. And they wonder why they aren't losing weight.
So, take my advice. If you eat protein bars frequently, make sure you're paying attention to the calories you're taking in and compensating accordingly

Thursday, June 01, 2006

Obesity boosts risk of breast cancer

WebMD has an article on a study linking postmenopausal obesity to breast cancer.
Read it in its entirety here:
http://www.webmd.com/content/Article/122/114754.htm?pagenumber=1

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.