RNY and Exercise

I thought this article was excellent and read every word because I think it does apply to the Sleeve as well.  Another great reason to just get out there and exercise!

Prior to WLS I was on Cholesterol Meds.  I came off them but everything went way up again.  I have hereditary cholesterol.  My parents were both 120 pounds, my brother 6' and 175.  All on Meds.  I got tested yesterday and for the first time in decades, I am in normal ranges.  My good cholesterol >45 is actually 75.  I eat a lot of red meat, full fat cheese, half and half in my coffee.  I don't buy any low fat products because I watch carbs not fat.  I totally credit my first great cholesterol report on my exercise.  Once I was healed enough post plastics I took back to walking and for the last month, intensive hiking.  I figure that as long as I'm out of work, I'll get strong.  It's working!!

This is reposted from a yahoo bariatric group that I'm on.
***********************************************************************************************

Medical News: Exercise Saves Lean Body Mass After Gastric Bypass

 

Tue May 29, 2012 11:16 am (PDT)

http://www.medpaget oday.com/ MeetingCoverage/ AACE/32948? utm_source= cardiodaily& utm_medium= email&utm_ content=aha& utm_campaign= 05-29-12& eun=gd3r& userid=325714& email=steve. goldstein@ cox.net&mu_ id=5319799

Exercise Saves Lean Body Mass After Gastric Bypass

By Chris Kaiser, Cardiology Editor, MedPage Today
Published: May 29, 2012

Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Action Points

PHILADELPHIA -- Obese patients who undergo bariatric bypass surgery lose more lean muscle mass early in recovery compared with gastric banding patients, but an intense exercise program can mitigate the muscle loss, researchers found.

=+=+=+=+=+=+ =+=+=+=

At 1 year post operation, the bypass surgery patients lost a mean of 19.62 lbs. of lean body mass compared with 12.41 lbs. in the laparoscopic adjustable gastric banding group, according to Ted Okerson, MD, from the University of California at Irvine, and Helmuth Billy, MD, from Ventura Advance Surgical Associates in Los Angeles.

The greatest reduction in lean body mass occurred within the first 3 months after the procedure (10.15% versus 4.95%), Okerson told attendees here at the American Association of Clinical Endocrinologists meeting.

However, on a per-pound basis, the loss of lean body mass was the same for both groups, which Okerson attributed to an intense resistance training and protein supplement program.

"For each group, 21% of their weight loss was lean body mass," Okerson told MedPage Today.

"Despite a loss of fat and lean body mass in both groups at 1 year, the bypass patients lost 52% of their lean body mass in the first 3 months," he emphasized. It may prove clinically meaningful in the long run in determining whether patients can sustain their weight loss, he said.

But the important factor, he said, is that it is possible to stanch the loss of lean body mass with resistance training and high protein intake.

"Bypass patients can essentially lose the same amount of lean body mass as those who undergo gastric banding, but they have to really work at it," Okerson said. "It's an intense exercise program."

Besides the addition of resistance training to aerobic exercise, patients supplemented their diet with 80 to 90 g of protein per day, which is more than the recommended 15 to 70 g per day, he said.

The researchers are continuing to follow these patients to see if they are able to maintain the protein, exercise, and vitamin supplementation over the longer term, and whether it results in sustained weight loss.

"Clinicians need to determine which procedure is best for their patients based upon these lifestyle changes," Okerson told MedPage Today.

He said that gastric banding patients have to eat slower and wait between bites, while bypass patients tend to eat less because they feel full quickly. Also, if Roux-en-Y bypass surgery patients overeat or eat the wrong foods, they can have nausea, vomiting, or rapid stomach emptying.

For the study, researchers retrospectively examined records from a surgical database of patients who underwent gastric bypass or gastric banding from 2007 to 2009.

Of the 480 patients in the study (188 bypass, 292 banding), the baseline body mass index (BMI) and percentage of body fat were not significantly different. There also were no differences in lean body mass, percentage of lean body mass, or basal metabolic rate.

At 1 year after the procedure, the bypass patients had a greater reduction in BMI (-17.10 versus -7.69 kg/m2) and excess weight loss compared with the gastric banding patients (78.35% versus 48.04%). But it came at the expense of greater loss of lean body mass early in recovery, Okerson reported.

Also at 1 year, bypass patients had a greater mean reduction in basal metabolic rate compared with those who had gastric banding (200.21 kcal/d versus 108.53 kcal/d).

"It's up to the clinician to understand the data and help patients choose the procedure that best fits their lifestyle," Okerson said. "The bottom line is we want them to be successful with their weight loss and, hopefully, with remission of comorbidities. "

Funding for the study was provided by Allergan.

Okerson reported a conflict of interest with Allergan, as did his co-author.

From the American Heart Association:

Bariatric Surgery and Cardiovascular Risk Factors
Primary source: American Association of Clinical Endocrinologists
Source reference:
Okerson T, et al "Changes in body composition following gastric bypass or gastric banding" AACE 2012; Abstract 1315.

 

thanks, Jody.  that 3 month window has past for me and I know I lost strenth and muscle along with fat but I can keep building and get my strength back. 

Lee...thanks for sharing!

Lee

I just got back from an appt with my doc.  I lost more weight (Yikes!) but the doc credits how good I look to all of the strength training I have done.  Apparently I don't look nearly as thin as I am, and we joked about my abs of steel.   There was also a discussion that the exercise and strength training have reset my metabolism to a much higher level, which has an impact on weight loss.

And yes, since my appt last week, I lost another 3 lbs.  I'm now within 3 lbs of being officially underweight. 

Lee, thanks for sharing.  This is very interesting.  Hopefully some of the doctors/NUTS will read this and climb on board to the higher protein levels.

I do the protein and the aerobic exercise(Zumba& Running), but have not done the strength training.  I really need to start this.  I do not have nearly the strength I used to have or maybe it is I don't have the weight to put behind it-LOL!!

Linda

Thanks, Lee, that validates what I thought (with no empirical evidence!).

Those who say "But I'm doing fine losing weight with no exercise" really don't get what's happening in their bodies!

 While we are all past that initial post op period, I want the newbies to know that exercise can make a big difference in the end results.  I know that my hiking is building my big muscle groups and that it is allowing me more healthy food in my plan.

Exercise, including strength training, is the key to keeping our metabolism functioning. I wouldn't be where I am at today, without the strength training. It is my cornerstone of fitness and everything revolves around the weight training. Muscle mass is crucial.


gail