Plateau Busters, courtesy of Spark... May 24, 2010 8:03 pm
Plateau Busters - Part 1
Eat the Right Nutrients at the Right Times
We hear it all the time—you changed your habits and lost weight steadily, but after awhile, that progress halted. You’ve been stuck at the same weight for days, weeks, or even months. There’s nothing more frustrating than trying your best, feeling like you are doing everything right, yet not making any progress towards your weight loss or fitness goals. Before you inhale a bag of cookies to console yourself, realize that weight loss takes work, and isn’t always perfect. But, there are plenty of ways you can re-energize your program (and motivation) to bust through your weight loss plateau. But…what is a plateau anyway? If you’ve been exercising and cutting calories for several weeks, and you’re no longer seeing the same results that you experienced in the beginning, then you’ve probably hit a plateau. This occurs when your progress comes to a standstill, and can be described as not making any “gains? (such as improving your fitness level or losing weight), but not necessarily moving backwards (losing endurance or gaining weight). Because every individual is unique, there’s no way to actually predict when a plateau might happen. However, the following principles of nutrition, rest, and variation will jumpstart your body, mind, and metabolism. (This article, part 1 in a series of 3, will focus on nutrition.) Incorporate some or all of the following suggestions to both prevent and overcome a weight loss plateau. With just a little tweaking, you’ll be in your skinny jeans in no time!
Eat the Right Nutrients at the Right Times
1. Make sure you are following your SparkPeople nutrition plan correctly. During set-up, did you accurately account for your level of activity? Or, if you are more or less active than when you started the program, have you changed this option in your set-up so that your caloric plan will be accurate for you? This is very important so that you don’t eat too little for your body’s needs, which can actually hinder your weight loss.
In addition, are you accurately tracking your foods in the Food Tracker daily, yet not reaching the minimum number of calories that is recommended? It’s common to think that cutting MORE calories will result in faster weight loss, but that’s not actually the case. You should never consume less than 1200 calories per day. Eating less than this (or too little in general) makes your body think it’s starving (known as “starvation mode?), so it holds onto every calorie, slowing your metabolism. Increase your calories to fit into your recommended range, and you’ll notice a difference.
2. Your body can only do so much with the tools that it has, so eat well. Aim for a wide variety of foods (instead of the same old thing day in and day out) from every basic food group. Try new fruits and vegetables, ethnic cuisines, and a wide range of lean proteins, including non-meat sources like tofu and legumes. All (or most) of your grains should come from whole, unrefined foods like whole-wheat breads and pasta, and brown rice.
These healthy foods, especially when eaten every three to four hours, will help raise and stabilize your metabolism (and energy) to optimal levels. With fewer ups and downs, your hunger will stay in check, and you’ll have plenty of energy to finish a tough workout.
3. After a workout, refuel with a balanced snack or meal within 30 minutes to 2 hours. Remember, “balanced? does not mean just protein. In fact, most individuals—and even athletes—need less than 10 grams of protein post-workout. Carbohydrates are actually more important, so try to eat an additional 30 to 60 grams at this time, when your body is primed to uptake glycogen into the cells to replace the energy you just used up during your workout.
4. Don’t overlook your huge need for water. Hydration is very important for stable energy levels. (You store 3 molecules of water for every glycogen molecule). Plus, hydration promotes muscle building (powering your metabolism), while dehydration promotes muscle breakdown. So drink up—before, during, and after your workout sessions. The standard “8 cups a day? might not be enough for you, especially if you are exercising regularly.
Plateau Busters - Part 2
Include Adequate Rest in Your Exercise Program
We hear it all the time—you changed your habits and lost weight steadily, but after awhile, that progress halted. You’ve been stuck at the same weight for days, weeks, or even months. There’s nothing more frustrating than trying your best, feeling like you are doing everything right, yet not making any progress towards your weight loss or fitness goals. Before you inhale a bag of cookies to console yourself, realize that weight loss takes work, and isn’t always perfect. Luckily, there are plenty of ways you can re-energize your program (and motivation) to bust through your weight loss plateau. But…what is a plateau anyway? If you’ve been exercising and cutting calories for several weeks, and you’re no longer seeing the same results that you experienced in the beginning, then you’ve probably hit a plateau. This occurs when your progress comes to a standstill, and can be described as not making any “gains? (such as improving your fitness level or losing weight), but not necessarily moving backwards (losing endurance or gaining weight). Because every individual is unique, there’s no way to actually predict when a plateau might happen. However, the following principles of nutrition, rest, and variation will jumpstart your body, mind, and metabolism. (This article, part 2 in a series of 3, will focus on rest. Click here to read Part 1 first.) Incorporate some or all of the following suggestions to both prevent and overcome a weight loss plateau. With just a little tweaking, you’ll be in your skinny jeans in no time! Include Adequate Rest in Your Exercise Program
1. Always allow 1-2 days of rest between working muscle groups. During a strength training session, tiny tears occur in your muscle fibers, which cause that all-too-common muscle soreness that lasts about 1-2 days after lifting weights. In order for those tiny tears to repair themselves—rebuilding as stronger muscles than before—you MUST rest those muscles. For example, if you lifted arms on Monday, you should wait at least one day, preferably two, before overloading those muscles again (Wednesday or Thursday). If you don’t rest long enough for repair to occur, you will actually get weaker, which is the opposite of everyone’s goals, and a common plateau-causing culprit. (For an in-depth look at strength training, check out SparkPeople’s Reference Guide to Strength Exercise.)
(continued...) 2. Try active recovery. Research shows that engaging in lower intensity exercise after a strenuous workout session may be more beneficial than resting completely. There are two types of active recovery. The first is the typical cool down phase that you perform at the end of your workout. Properly cooling down has been shown to help your muscles recover faster, and reduce the levels of lactic acid in the muscles. The second type of active recovery involves exercising lightly in the days following a hard workout. So, rather than taking a day or two off from the gym, consider exercising at a lighter intensity level (go for an easy walk and follow up with some stretching, or try some gentle exercises such as yoga, for example). In addition to helping your muscles rebound, active recovery has also shown to enhance relaxation and psychological recovery.
3. Get plenty of sleep. While most people are familiar with the concepts of rest, not everyone equates resting with sleeping. However, a significant amount of muscle repair occurs during your slumber. In turn, inadequate amounts of shut-eye hinder your ability to recover from exercise, making plateaus more likely. While every individual’s needs for sleep are different, most experts recommend getting AT LEAST 8 hours per night. Make sure this sleep is consistent during the week and through the weekends. After all, there is no real way to play catch-up when it comes to sleeping. If you are exercising intensely (long workouts most days of the week, or training for events such as marathons), your need for sleep may be even higher—up to 10 hours a night or more!
Plateau Busters - Part 3
Add Variety to Your Workouts
We hear it all the time—you changed your habits and lost weight steadily, but after awhile, that progress halted. You’ve been stuck at the same weight for days, weeks, or even months. There’s nothing more frustrating than trying your best, feeling like you are doing everything right, yet not making any progress towards your weight loss or fitness goals.
Before you inhale a bag of cookies to console yourself, realize that weight loss takes work, and isn’t always perfect. But there are plenty of ways you can re-energize your program (and motivation) to bust through your weight loss plateau.
But…what is a plateau anyway?
If you’ve been exercising and cutting calories for several weeks, and you’re no longer seeing the same results that you experienced in the beginning, then you’ve probably hit a plateau. This occurs when your progress comes to a standstill, and can be described as not making any “gains? (such as improving your fitness level or losing weight), but not necessarily moving backward (losing endurance or gaining weight).
Because every individual is unique, there’s no way to actually predict when a plateau might happen. However, the following principles of nutrition, rest, and variation will jumpstart your body, mind, and metabolism. (This article, part 3 in a series of 3, will focus on exercise variety. Consider reading Part 1: Eat the Right Nutrients at the Right Times and Part 2: Include Adequate Rest in Your Exercise Program first.) Incorporate some or all of the following suggestions to both prevent and overcome a weight loss plateau. With just a little tweaking, you’ll be in your skinny jeans in no time!
Add Variety to Your Workouts
Incorporate variation into each workout. Variety is critical because your muscles become very efficient at the exercises they are accustomed to doing. Switching things up or doing something radically different during each workout session is more challenging to your muscles. This concept should be applied to both aerobic exercise and strength training.
An individual who always does the same exercises will usually plateau sooner than someone who continually makes changes. If you don’t feel comfortable doing a different workout each time you hit the gym, try to change your exercise routine at least every 6-8 weeks. Changing your routine is crucial to keeping your body/muscles surprised. They'll have to work harder, you'll be challenged, and you'll burn more calories and build more lean muscle in the process.
- Change your cardio activity:
- Change the type of exercise you usually do. The possibilities of aerobic exercise are endless. If you walk, try cycling. If you take kickboxing, try the elliptical. Consider adding some of these possibilities to your routine: running, jogging, walking, elliptical machine, swimming, cycling, indoor exercise, outdoor exercise, hiking, fitness videos/DVDS, group fitness classes like kickboxing, aerobics, spinning, stair steppers, etc.—anything, just change it up!
- Change the duration of your workouts. Try to increase your minutes as you become fitter, and occasionally, try a shorter (but more intense) workout.
- Change the intensity of your workouts. This is something you can play with on a daily basis. This includes working at an incline or harder level, sprint work, distance work, maintaining intensity, or interval work (shifting between fast/hard and easy/recovery intervals).
- Change your Strength Training Routine:
- Change the mode of exercise. If you are using machines, move to free weights. If you are using body weight, try resistance bands. If you are doing free weights, add a stability element like a BOSU ball or stability ball. Try doing exercises while balancing on one foot or switch between any and all of these.
- Change the exercises you actually do. If you have been doing chest press, change to a chest fly or use the pec deck machine. Think of an alternative exercise for each muscle group and you’ll have an entirely new workout! Check out SparkPeople's Exercise Demonstrations for more ideas.
- Change your resistance level and/or number of repetitions. Be sure to increase your weight regularly. Make sure you are lifting to fatigue with each set. If you typically lift 12-15 reps, try doing 8-10 (with a higher weight) or vice versa. Play with your weight and reps in each set. Try lifting (as an example) 25 pounds for 15 reps, then 30 pounds for 12, then 35 pounds for 10 reps on your third set. You can also do it backwards, starting with high weight/low reps and working the weight down.
There are lots of ways to add variety to your workouts—and it's SO important that you do to continue losing weight and improving your fitness level. By always challenging yourself, you will avoid hitting a plateau in the first place, and overcome the one you're stuck in now.
The principles of nutrition, rest and variation all work closely together. When not followed properly, they can instigate a negative snowball effect: Repeating the same exercises can cause overtraining, which leads to plateaus and an inability to sleep. Lack of rest hinders you progress, making recovery take much longer, especially if you are not well-nourished and hydrated.
The human body is amazingly adaptable. By making a few changes in these areas, you can jumpstart your routine and see those positive results in no time. | Leave a comment.
Diets high in added sugar raise heart... April 21, 2010 12:07 am
A study says daily sugar intake can alter important blood fats. Whether the source is sugar cane or high fructose corn syrup, the ‘sugar effect’ persists.
April 20, 2010 |By Karen Kaplan, Los Angeles Times
Feeding a sweet tooth won't just lead to weight gain and a mouthful of cavities. A new study suggests that diets high in added sugars can alter levels of important blood fats and increase the risk of cardiovascular disease.
The study, published in the Wednesday edition of the Journal of the American Medical Assn., found that people who got at least 25% of their daily calories from added sugars of any kind were 3.1 times more likely to have low levels of so-called good cholesterol in their bloodstream than people who got less than 5% of their calories from added sweeteners.
Additionally, those who consumed more than 17.5% of their calories from the sugars — be it ordinary table sugar derived from sugar cane or sugar beets, high fructose corn syrup or any other caloric sweetener — were 20% to 30% more likely to have high levels of blood fats called triglycerides than people with the low-sugar diets, the study found.
The association between sugar intake and blood lipids was independent of the harmful effects of other components of sugary processed foods, such as fat and cholesterol. The link also persisted when researchers took into account smoking and drinking habits and levels of physical activity.
"There is a specific added-sugar effect," said Dr. Miriam Vos, a pediatric gastroenterologist at Emory University in Atlanta who led the study.
The findings support guidelines released last year by the American Heart Assn. recommending that men eat no more than 150 calories of added sugars each day and that women limit themselves to 100 calories. That works out to about 5% of daily intake.
That's far less than the 25% limit suggested in 2005 by the Institute of Medicine, which advises the government on health matters. The World Health Organization endorses a limit of 10%, an amount that didn't appear to harm blood lipid levels in the new analysis.
To reach their conclusions, Vos and her colleagues at Emory and the Centers for Disease Control and Prevention examined data from 6,113 American adults who participated in the CDC's National Health and Nutrition Examination Survey between 1999 and 2006. Survey workers took measurements of height, weight and blood pressure, drew blood samples and asked participants detailed questions about everything they ate in a 24-hour period.
Anti-Obesity Drugs Unlikely to Provide... March 30, 2010 8:16 am
Anti-Obesity Drugs Unlikely to Provide Lasting Benefit, According to Scientists
ScienceDaily (Mar. 18, 2010) — Scientists at the University of Liverpool argue that anti-obesity drugs fail to provide lasting benefits for health and wellbeing because they tackle the biological consequences of obesity, and not the important psychological causes of overconsumption and weight gain.
Dr Jason Halford, Reader in Appetite and Obesity at the University of Liverpool, points out that anti-obesity drug developers focus primarily on weight loss as their end goal, and do not take into consideration the motivational and behavioural factors that most commonly cause obesity. Obesity typically results from eating too much food combined with too sedentary a lifestyle. However, obese people may also have a complicated psychological relationship with food that makes it difficult for them to control their appetite sufficiently to manage their weight.
Obesity is one of the most serious public health problems of the 21st century and, according to Government predictions, is set to affect half of all men and more than a third of all women in the UK by 2025. Obesity is not only associated with a number of serious health problems, including type 2 diabetes, heart disease and reduced life expectancy, but also has a knock-on effect for the health service, industry, education and government -- with a multi-billion pound cost to the economy.
Dr Halford said, "Anti-obesity drugs haven't successfully tackled the wider issues of obesity because they've been focused predominantly on weight loss. Obesity is the result of many motivational factors that have evolved to encourage us to eat, not least our susceptibility to the attractions of food and the pleasures of eating energy rich foods -- factors which are, of course, all too effectively exploited by food manufacturers.
"As psychological factors are critical to the development of obesity, drug companies should take them into consideration when designing new drug therapies. We've learned a great deal about the neurochemical systems that govern processes like the wanting and liking of food, and it's time to exploit that knowledge to help people manage their eating behaviour."
Anti-obesity drugs can work in different ways; for example, by suppressing appetite, altering metabolism or inhibiting the absorption of calories. There have, however, been serious concerns over the safety of the most commonly prescribed drugs, leading to the recent withdrawal of the European market leaders Sibutramine (Reductil, Meridia) and Rimonabant (Accomplia). As a consequence of these setbacks, there are few anti-obesity drugs in development.
Dr Halford and his co-authors explain that there are motivational, emotional and behavioural traits which are common to the obese. Typically, obese people have a heightened desire to eat, which is easily provoked by environmental factors such as food adverts. They display a pre-occupation with food and have a heightened preference for high fat and high sugar foods. Obese people also tend to eating faster and take larger mouthfuls which together result in them eating bigger meals.
However, despite eating larger than normal portions, obese people are less likely to feel full after eating, partly because of the energy-dense foods they prefer have a reduced impact on gastrointestinal hormone signals that help promote feelings of satisfaction and fullness. Consequently, there are a number of reasons why obese people have enduring, and easily provoked, feelings of excessive hunger which culminate in overconsumption.
Professor Tim Kirkham, an authority on the biopsychology of appetite at the University of Liverpool, said: "Novel, effective anti-obesity treatments must address these different factors. We need to identify drugs that can selectively affect the desire to eat, the enjoyment of eating, fullness and satisfaction. Interventions designed specifically to modulate these processes could help reduce the aversive experience of dieting, and maximize an individual's capacity to successfully gain control over their appetite. Currently, we know little about the behavioural effects of anti-obesity drugs under development, and so we have little indication whether these new treatment address the underlying causes of obesity."
The research is published in Nature Reviews Endocrinology.
Story Source:
Adapted from materials provided by University of Liverpool, via EurekAlert!, a service of AAAS. | Leave a comment.
100 Reasons To Exercise March 8, 2010 10:24 pm
I borrowed this from the same source Annielou used for her post this morning. Victoria bariatric surgery. I am printing this for my own use. I challenge everyone to pick one or two of the reasons for yourself for today and get out there and just do the exercise. Today I p-ick numbers 19 and 21. What numbers or reasons are you going to pick for today. Go burn some calories with me. Hugs
100 Reasons To Exercise
A recent survey showed that people could find more reasons NOT to exercise, quicker than they could find reasons TO exercise. Now you have NO excuses!
Here are 100 good reasons to exercise. Make a list of the ones that you would like to achieve and use these reasons as your own personal motivators.
EXERCISE….
1 Helps to reduce bodyfat
2 Helps lower blood pressure
3 Increases efficiency of heart and lungs
4 Promotes increased flexibility
5 Increases overall fitness level
6 Burns loads of calories
7 Improves blood circulation
8 Strengthens muscles
9 Increases bone density
10 Helps to prevent osteoporosis
11 Slims the body
12 Improves posture
13 Helps you look younger
14 Slows down the aging process
15 Improves your sex life!!!!
16 Reduces risk of back pain
17 Helps improve the look of cellulite
18 Helps you relax and unwind
19 Boosts metabolic rate which helps weight loss
20 Increases energy levels
21 Promotes a natural high
22 Helps reduce your appetite
23 Reduces risk of heart disease
24 Reduces risk of cancer
25 Keeps skin clear
26 Reduces stress
27 Gives your body more definition
28 Encourages you to eat healthy foods
29 Stimulates your mind
30 Can prevent diabetes (Type 2 only)
31 Encourages a healthier lifestyle
32 Helps you enjoy life to the full
33 Increases confidence
34 Improves assertiveness
35 Can help to ease period cramps
36 Helps you feel better during PMT
37 Can act as a natural remedy for some ailments
38 Increases self-esteem
39 Reduces the risk of breast cancer
40 Encourages you to become more socially interactive
41 Tones inner thighs
42 Acts as an anti-depressant
43 Lifts and firms buttocks
44 Helps you to unwind
45 Improves balance
46 Improves co-ordination
47 Can dramatically improve your body shape
48 Promotes a good night’s sleep
49 Reduces cholesterol
50 Improves discipline
51 Increases motivation
52 Combats fatigue
53 Tones back of the arms
54 Promotes therapeutic benefits
55 Gets rid of headaches
56 Increases a new zest for life
57 Firms chest muscles
58 Helps make your hair shinier and healthier
59 Increases body’s immunity system
60 Helps fight against colds and flus
61 Strengthens joints
62 Can naturally provide the same benefits as HRT
63 Can help prevent injury to muscles and joints
64 Gives face a nice, healthy glow
65 Reduces bodyfat from hips
66 Helps the body to become more curvaceous
67 Allows you to eat a little bit more
68 Burns calories that would normally lie as fat
69 Gyms/Fitness Classes can improve your social life
70 Helps you to be more content with yourself
71 Helps you deal with life’s problems more effectively
72 Helps you think more rationally about life
73 Increases your happiness
74 Promotes well-being
75 Increases strength in legs
76 Prevents children from gaining weight
77 Encourages confidence in children
78 Helps build up a natural defence system
79 Fights off sickness and infection
80 Combats boredom
81 Helps prevent varicose veins
82 Maintains joint flexibility
83 Increases mobility in joints
84 Gives you more energy
85 Can help with arthritis in joints
86 Helps strengthen lungs (in the case of asthma)
87 Gives you a more positive outlook on life
88 Promotes a positive self-image
89 Maintains muscle tone and fitness during pregnancy
90 Helps you cope better during labour
91 Acts as an outlet for tension and stress
92 Can aid in the rehabilitation of muscle injury
93 Helps you lose weight off your abdominals
94 Helps you look and feel ten times better
95 Helps you lose weight off the right places
96 Assists the internal organs to function smoothly and effectively
97 Is a healthy way for you and your family to spend quality time
98 Helps you let off steam
99 Sends oxygen to the part of the brain which prevents depression
100 Finally, EXERCISE is FUN, FUN, FUN!!!
Long term weight loss and... March 8, 2010 10:05 pm
Thanks Annielou for the article.
Long term weight loss and maintenance after Gastric Bypass
This page is sort of a "user's manual" for the stomach pouch created in the Roux-en-Y Gastric Bypass. The guide is targeted to patients who underwent GBP more than 6 months previously, but the best results are achieved by patients who begin to live by these guidelines even before the procedure. Thanks go to Latham Flanagan, MD. Many of the concepts and many of the terms used in this outline have been learned from him. Dr. Flanagan practices bariatric surgery in Eugene, OR.
The first year after gastric bypass is usually very rewarding, but this time can also be confusing, frustrating and frightening. The function of the stomach pouch "tool" changes almost continuously over the first six months, and continues to change periodically over the year or so. Just when the patient feels they have begun to understand the stomach pouch/tool and how to use it, things change all over again.
There is an especially frightening change that takes place around 6-9 months after the surgery. The stomach pouch softens and expands slightly so that a patient regains a regular appetite and can "suddenly" tolerate a significantly larger amount of food. Patients frequently worry that something has pulled apart or broken on the inside, though this is rarely the case. This increased interest in food and increased capacity for food is a very natural and appropriate part of the recovery process after gastric bypass surgery. The reason it frightens patients so much is that they had previously felt they had control of their weight for the first time in their lives, and the renewed appetite threatens that they are losing control once again.
This page is about how to gain control of your weight using the stomach pouch "tool" and to keep control of the weight for life. The first thing to realize is that for the first six months or so after gastric bypass you did NOT have control of your weight. The pounds were going to come off almost no matter what you did. The stomach pouch could not handle enough calories to maintain weight for the first few months - we call this the "honeymoon" period after gastric bypass. The return of appetite and the increase in food capacity signal an end to the honeymoon period and a transition to the rest of life.
Your surgeon has created a stomach pouch that will be your tool to use to control your weight for life. We describe the stomach pouch as a tool so that patients understand the necessity that you learn how to use it, and stick with the "rules of the tool" over time. Patients who are aiming for the best long term success begin using these concepts and rules immediately after the gastric bypass. The time to really choose your new habits is during the early recovery after surgery - this is when your motivation is highest, and the rest of your life has been thrown out of kilter by the surgery anyway. Use this early recovery period to choose your new exerciseand diet habits. And even though patients lose weight "no matter what" for the first few months, use of the concepts outlined below will also maximize the weight loss during the honeymoon period - take advantage of this time so that when appetite and capacity return there is not so much further to go in achieving a weight goal.
The "Rules of the Tool"
OK, here are the magic "rules of the tool" (are you ready?): Diet and Exercise. Seriously. The good news is that diet and exercise, supported by your pouch/tool, can help you achieve your goal weight with excellent energy and without uncomfortable hunger. The specific guidelines are below:
Exercise keys
Regular exercise is at least as important to success as following the diet recommendations outlined below. In this context, regular exercise means some kind of vigorous aerobic activity, at least 45 minutes in duration, at least 5 days per week. Patients who achieve this goal can reliably expect to have improved energy and improved weight loss.
Hibernation mode and Hunting mode
It appears easiest to understand these benefits by thinking back to the evolution of our ancestors. Back in "cave man days" starvation was a constant threat, and our bodies were evolved to store any extra calories in preparation for the lean times. During lean times, the body is programmed to do everything possible to hold onto the calorie stores. So the first response of the body when faced with starvation (during a drought for our ancestors, or after gastric bypass surgery for us) is to conserve all possible energy by turning down the "metabolic thermostat." This means that fewer calories are burned and the person feels like sleeping and being away from activity - they are easily fatigued. Some call this the "hibernation mode," and it is as if the long winter has come and the best adaptation is to go way back into the cave and wait until the weather (and the hunting) improve. (Note that the hibernation response can also lead to depression and difficulty interacting with others.)
The role of exercise in this situation can be thought of as "fooling" the body into a different mode called "hunting mode." If the body is treated to regular vigorous physical activity during starvation, its interpretation may be that the person is foraging or hunting. The body (from an evolutionary standpoint) would be in favor of hunting because it could lead to more calorie intake, so it provides more energy to facilitate the acquisition offood - it turns up the "metabolic thermostat". This upregulation means that more calories are burned throughout the 24 hour period (besides the extra calories burned during the exercise) and the person has a significantly increased feeling of energy. Note that this discussion about hibernation mode and hunting mode is written as a way of understanding the observed effects of exercise after gastric bypass - these are not scientifically established physiologic events.
The best time to begin your exercise program is before the gastric bypass. Again we're serious. Success in gastric bypass is all about choosing the right habits, with the support of the surgery to improve your success. If you exercise and diet before the surgery, you will have a strong impact on reducing your surgical risk. You will also benefit from having your plan in place, so you don't have to figure it out during the confused recovery phase after surgery. If exercise is not begun before surgery, then it should be started as soon as possible after surgery. Discuss details with your surgeon, but generally we advise patients to maximize their physical activity from the outset.
This starts with walking on the same day as surgery, and should progress to more vigorous activity as the months go by. People who put off regular exercise until they feel "all recovered" or who try to start exercising when they realize they are not on course to reach their goal weight generally do not achieve or keep the new habit. Patients who work hard on exercise early after the surgery find it very rewarding. As the weight falls off, the capacity for exercise improves dramatically, with significant improvements on a week-by-week basis. Two objections to the exercise program that we frequently hear are that the patient is too heavy, or too fatigued. The first of these is unfortunately valid in many of our patients who are extremely heavy - people with a BMI of 70 or more frequently cannot engage in routine exercise. The good news is that people with extreme weights burn a large number of calories by simply walking. The amount of physical work done (which translates into calories burned) comes from how much mass is moved and how far it goes.
The message here is that the benefits of exercise can be realized in many ways - just work as hard as you can and do it frequently. Fatigue is the second objection. Patients sometimes tell us that they can't imagine walking to the door and back, especially in the first few months after surgery. Our answer is to do your best to exercise anyway. This complaint is likely to be a manifestation of hibernation syndrome, which can be shaken off by exercise.
Diet Keys
The goals of the long term gastric bypass diet are:
- consume minimal calories (promote weight loss)
- consume adequate nutrition (achieve excellent long term health)
- achieve the two goals above without undue hunger or cravings
These goals can all be achieved by using the pouch/tool with the right kinds of food, at the right intervals, and with appropriate management of fluids. The first thing to understand is that when the pouch is filled with food it sends signals to the brain that say that hunger is satisfied - no additional food is needed. This feeling is called "satiety." Any time a mature pouch is stretched by stuff inside it, the pouch will send a satiety signal to the brain, and (here's the cool part) the satiety signal will continue as long as the stuff is still in the pouch! Therefore, keeping in mind the goals above, a patient should do the
following:
- Eat no more than three meals per day, with NO nibbling between meals. This will limit the volume of food and naturally limit the number of calories. One of these meals should definitely include breakfast - it has been shown that absence of nutrient intake causes the appetite center to "gear up" or become more sensitive, resulting in greater overall calorie intake through the day. This may work by means of an "ileal satiety feedback receptor" which (when exposed to nutrients several hours after they are taken in) may help suppress appetite. Use solid protein (chicken, fish, etc) as the basis for each meal. It is OK to use some vegetables for variety. The solid protein will meet your nutritional needs, and it is the best food to "hang around" in the pouch to give a longer feeling of satiety. Many patients learn early on that they cannot hold nearly as much chicken as they can mashed potatoes - this is a GOOD effect. The effect exists because solid proteins do not pass out of the pouch too easily, resulting in less volume consumed. Simple carbohydrates (potatoes, pasta, rice, bread) should also be minimized because of their effect on blood sugar. Simple carbohydrates are close relatives of sugar, so that the calories in these foods are rather easily absorbed and they tend to "rush" into the system and drive the blood sugar up quickly. Because the amount of carbohydrate consumed was not very large the blood sugar soon begins to fall, but by this time the pancreas is pumping out large amounts of insulin (a hormone which pushes blood sugar down) and this combination causes the blood sugar to drop too low. At this point the patient is experiencing hypoglycemia, and the deep urge to consume food - if they consume a simple carbohydrate (such as juice, or a bit of potato) they will be back on the blood sugar roller coaster. A cycle of blood sugar highs and lows such as this leads to consumption of way too many calories, and the calories have no nutritional benefit. On the other hand, proteins take a while to digest, and so they are absorbed slowly. This provides a longer term steadier energy source for your body, avoiding the high/crash cycle.
- Don't drink liquids with meals, and don't drink for at least two hours after your meal. Liquids taken after a meal will wash the food out of the pouch, releasing the tension on the walls of the pouch, and losing the feeling of satiety. In other words, consumption of liquids (with a mature pouch/tool) may be followed by a feeling of emptiness or hunger. Note that soup is a particularly poor food choice, because it is just like drinking with your meal. The liquefied food will pass quickly through the pouch, which allows more calories to be consumed and leaves the pouch empty. Note also that this part of the plan is not appropriate to begin practicing in the first three months or so after gastric bypass - in the early period after surgery it is enough of a struggle to get in adequate liquid (and hunger is not a huge challenge) that it is appropriate to begin drinking liquids about 30 minutes after you eat.
It's a good idea to re-read this set of instructions each month until you've really "got it." It takes a lot of effort, determination, and practice to use your pouch/tool in the best way - the good news is that the results are worth it!
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