Colleen Cook from Bariatric Support Centers International was on Weight Loss Surgery Radio last week with Cher Ewing and Jeff Cadwell. She had weight loss surgery back in the late nineties and discovered that there was no real support system in place for the patients - so she created one. Anyway, they’ve done a close look at their client’s who successfully reach their goal weights and these are the principles they’ve found in common.

Success Habits of Weight Loss Surgery Patients

1. Personal Accountability
I recognize that I alone am responsible for my successes and my failures.

2. Portion Control
I understand the importance of satiety and listen to my body’s signals.

3. Proper Nutrition
I make good healthy food choices each day.

4. Fluid Intake
I drink the right amount of the right beverages at the right time each day.

5. Regular Exercise
I have adopted the habit of exercise as part of my lifestyle.

6. Vitamins and Supplements

I take good quality vitamins each day to ensure my good health.

I can’t find the first installment of this series, but it’s about Karen Miller, a 26 year old woman, in Bridgeport, Connecticut who had a Lap Band procedure performed by Dr. Timothy Ehrlich. Like most future Bandees, she had lots of different health problems - frightening when you’re only 26. Those have gone away, and now she’s feeling (as a friend of mine put it) down right evangelical.

She said she’s actually had to stop herself from suggesting the procedure to others, for fear of seeming rude.`I don’t want to offend anybody,” said Miller, a law student at Western New England College in Springfield, Mass. “But I want to let them know that this is an option. Before I had the surgery, I didn’t even know it was out there. I wish I had known sooner.”

And her health problems are now better:

Her enthusiasm is understandable, given her response to the surgery. Before the procedure, she weighed 247 pounds. She also had Polycystic Ovarian Syndrome, which led to a number of health problems, including high blood pressure, irregular glucose levels and irregular periods.

The syndrome also made it difficult for her to lose weight, even though doctors urged her to do so.

On the advice of a friend, Miller, who works in the medical records department at St. Vincent’s, decided to explore bariatric surgery. However, she wasn’t interested in the more highly publicized gastric bypass surgery. That surgery, made famous by high-profile patients such as “Today” show weatherman Al Roker, involves rerouting part of the intestine.

Unlike gastric bypass surgery, lap-band is minimally invasive with few risks. Gastric bypass surgery, on the other hand, is a more complicated surgery that carries more risks, including possible death. Another benefit to lap-band surgery is that, unlike the bypass, it’s reversible.

Miller was deemed a good candidate for the lap-band, which is most effective for patients aged 18 to 65 and having a Body Mass Index of 40 or higher. Before surgery, Miller’s BMI - measurement based on weight related to height - was 42. Her health problems also made her a good candidate for the surgery, so she signed up.

One year later, she’s lost 72 pounds.

Since the procedure, Miller has gone from 247 pounds to 175 pounds. That’s obviously garnered a lot of reaction — most of it positive — from friends, family, strangers.

And she finds herself being cheered on.

Throughout the past year, Miller’s life has changed in many ways, but the thing that surprises her most is how supportive everyone has been.

“People are getting more and more cutthroat these days,” she said. “But when people see me doing this, they’re just so encouraging. I’m very happy.

It’s a good story - always gratifying to see someone decent have things go well. In the last installment, she’s about 20 pounds away from her goal weight - and wouldn’t we all like to be there.

Becca has now lost 60 pounds since February, and she looks fantastic. This clip is about how much her life as changed as a result of having Lap Band surgery. She rides bikes without worrying about the tires deflating, she plays the piano without problems and she can even cross her legs now and yes, there are some before and after pictures.

Anyway, good work, Becca! Congratulations on your triumphs.

Cher Ewing and Jeff Cadwell are both weight loss surgery patients and Life Coaches. Cher has had a Lap Band and Jeff a gastric bypass. They do weekly 90 minute broadcasts about various issues of interest to weight loss surgery patients. I like what they do because they have first hand knowledge of what the process is and that’s incredibly valuable.

Today, they have, as their guest, Colleen Cook who is a weight loss surgery patient and founder of Bariatric Support Centers International. From the press release on the show:

Join Cher & Jeff as they talk with Colleen Cook about her story. Colleen is a weight-loss surgery patient from 1995.

She is the founder of Bariatric Support Centers International, an extraordinary company that specializes in providing long-term education and support services for weight-loss surgery patients. She is also the founder and former chair of the National Support Group Network for Allied Health Sciences, a committee of the American Society for Bariatric Surgery.

Colleen is a sought after speaker & former host of her radio show, “Obesity’s Surgical Solution”. She is the author of the internationally acclaimed “Success Habits of Weight Loss Surgery Patients“. She has an extensive background in group organization, meeting facilitation, and leadership training. Known as Ms. Enthusiasm, Colleen helps men and women from all walks of life recognize their extraordinary potential and then inspires them to aspire even higher.

Her book, which I linked from my bookstore, is out of print and ridiculously expensive secondhand (not her doing). So, I’m going to spend some time at Ms. Cook’s website and see what kind of things I can learn. We do know, as I remind you so endlessly, that people who have weight loss surgery and attend support groups lose more weight than those who don’t. And this is all about the weight loss.

By the way, Jeff and Cher maintain podcasts of all their shows, so even if you miss one, you can catch up again later.

It’s a beautiful day in Southern California and I have got a lot of running around to do. So, I’m gonna put on my running around clothes and go do it. It even smells good today. The flowers are blooming mad.

Hmmmm, here’s something I’ve never read before. Dr. Rachael Keilin is talking about how fills impact a bandee’s hunger, and how the impact of the fill isn’t necessarily immediate.

There is also a phenomenon we see fairly often, but really can’t explain well. Some people will have a delay in the “tightness” of a fill by as much as two weeks. This is why we won’t fill one day and then fill again three days later. Because there is sometimes a lag in the perception of hunger after a fill (and remember: it’s hunger control we’re aiming for, not bulimia!), we don’t want to end up over-filling patients, especially if they live out of town. Spitting into a cup is just not fun. You’re meant to have gradual weight loss with the Lap Band from eating less. You’re not meant to be on a liquid diet or pureed food diet. We want to eat more or less a regular diet, just eat a smaller amount of food so that you can lose weight.

Interesting. Now, that I’ve checked out Dr. Keilin’s site, I have to go find out what “Smart Lipo” is. Inquiring minds want to know.

It’s always easier for men to lose weight, we know. This is a video from True Results with their patient Andrew S. He’s being interviewed while a make up artist is getting him ready for a photo shoot. Anyway, take a look, guys. At the end of the video, you can see how trim he is now.

And for those of you who haven’t clicked on Robert Morgan’s 250 Pound Weight Loss story, do it now. He’s a sports writer, who weighed over 500 pounds when he finally had a Lap Band procedure.

And I got that way by following the standard American diet. With a busy family and a job that keeps me constantly on the move into the evenings on most nights, I ate a lot on the run – McDonald’s, Chicken Express, Wendy’s and other such food.

I remember there was a time when we ate out more than we did at home. And I remember thinking at one point that I was getting healthier because I switched to Taco Bell. At that point I was getting burritos with lettuce and cheese rather than quarter-pounders. And boy, I thought that was a huge improvement.

But deep inside I knew better. I could not stand the pain shooting up the heel of my foot or that I was out of breath walking back to the car after a football game. Better yet, I knew I was in trouble last April when I was at Odessa’s Ratliff Stadium for the regional track meet. This massive, college-size stadium has no elevator and hauling a wide load up 50 flights of stairs several times a day about gave me heart failure.

I felt doomed to die of a heart attack by the age of 32, but I didn’t know what to do. I don’t overeat so I figured eventually it would all go away. I was certain that putting on a few extra pounds was something that happens to everyone when they hit their 30s.

It hit me like a ton of bricks this year, and I have one immature, rude, disrespectful Decatur High School student to thank for it. I was at my first volleyball game of the season in late August when I walked by the student body section. I noticed in my peripheral vision as I approached the group that one boy in particular kept staring at me. Just as my family and I passed, he quickly turned to two of his buddies and said, “Did you see how fat that dude was? What a freak!”

Well, that would definitely be a wake up call. I got one of my own the other night. A young friend came by and saw a photo on the wall that my husband had taken about ten years ago. It’s a black and white shot of barefooted me in a long dress and denim jacket sitting on a stone bench. My hair is long and fluffy at the time. My hands are folded in my lap and my legs crossed. He looked at it for a second and said, “Wow, that could almost be you only much younger”. Ouch. Ouch. Ouch.

Savin’ mah pennies. Savin’ mah pennies.

on the right side of the page, is filling up nicely. If you haven’t had a chance to do so, I’d encourage you to spend a few minutes today looking through. There is a tremendous amount of wisdom packed into the various blogs as to what the process of losing weight with a Lap Band is like.

For those of us here in the US, today is Memorial Day when we remember those whom we lost in war. To all of you who have lost someone in war, my kind thoughts go out to you today.

Oooooooh, this is sooooo interesting. One of the things I really want to do after I get my Lap Band is go diving. I’ve never been SCUBA diving in my life, and living so close to the beautiful waters of Mexico, I really want to at least once. Just once. Maybe twice. Anyway, I found this fascinating article about bariatric surgery and diving. It covers all of the weight loss surgery techniques and the risks to divers from each.

The news for bandees is good:

Adjustable Banded Gastroplasty or “Lap Band” isanother more restrictive procedure which reduces the size of the stomach. Following the surgery, the patient’s stomach may only hold 1-2 tablespoons in volume. This method drastically reduces the amount of food the patient can consume at any one time; digestion continues normally; and nutritional problems such as anemia and osteoporosisare almost nonexistent. The patient does not require as much ongoing medical supervision or dietary supplements.

Patients choosing this procedure must be very selective about the food they eat: since absorption is not altered, any foods high in calories, sugars and fat will have the same affect on the body as they did before the surgery. If a patient consumes too much food or large pieces of food, vomiting can result.

After surgery, some patients experience chronic acid reflux. Reflux and regurgitation of fluid and gastric liquid can present problems for a diver in the “head down” position, such as during descent. Divers can manage problems of regurgitation or vomiting through proper dietary considerations and possibly medications.

The estimation of “1-2 tablespoons in volume” is pretty extreme. In truth, you’ll be eating 6 to 8 ounces of food per meal - or a “half glass” of food as Dr. Paul O’Brien likes to put it. In the real world, that’s the equivalent of a McDonald’s Double Cheeseburger and a small order of McDonald’s Fries. Of course, you won’t be eating at McDonald’s if you want to lose weight, but you can see where a meal of that size would be perfectly satisfying emotionally. And of course, with the Lap Band, you’ll be quite full as well.

So, for me, it’s to Mexico for my Lap Band surgery, and then hopefully, one year later, back for a SCUBA trip. I can’t wait. Palancar Gardens - here I come!

This is a clip from National Health Journal with Dr. David Davtyan of the Beverly Hills Weight Loss Clinic. It has good animations - at least one of which I have seen before - including an animation of how the inner ring fills up to make the band adjustable. Dr. Davtyan is a Lap Band patient as well, and feels like that has really helped him to understand how the adjustability works best.

I’ve been working on a project with a friend’s daughter. She’s graduating from high school and chose to make a short film as her senior project. My husband edits motion pictures and we see a lot of student films - either he’s hired to put them back in order, or people ask me to take a look at them to tell me what I think. I have to say that most of them that I see are from college students who have some formal training as filmmaker and very few of them - even the ones from USC’s vaunted graduate filmmaking department - are as good as what my young friend has conjured up. Seriously. And that’s always a stunning thing to witness.

Julia is a seventeen year old girl who decided to make a movie. She’s an actress and was in our last film - she got about 4 days work out of it. And she’s been in a couple student films. In addition, we spent a day filming a one man stage show for a local actor and she was the boom operator for us. That is the sum total of her filmmaking experience. Anyway, I say all this, because this seventeen year old showed up with a script that was really, really good - by any objective standard. It concerns a teenage girl who involves herself in radical environmental activities and decides to desecrate a grave. I read the script and was pretty stunned at what she’d put together. A lot of it takes place at night time though and I told her she needed a real director of photograhy - this wasn’t something I had the equipment or the skills to light. She called up the DP we’d used on the film she’d been in, he read the script and told her he’d do it. Unbelievable. So this seventeen year old kid has a first rate script, a world class DP with a ten ton truck with all sorts of goodies, great locations and it’s turned into a wonderful project. My husband has been the camera operator and filled in a bit of the directing. But she did the writing, the casting and it is still her vision through and through. She’ll edit it for her final grade. Once that’s done though, I think she and my husband will sit down together for a polish.

It’s been an amazing thing to watch. She’s made interesting choices through and through. Anyway, tonight is the final night of shooting and I’ll have some posts for you tomorrow.

Well, this is good news. Maybe it will help knock down a few more insurance walls for Lap Bands here in the US. Maybe it’ll help reduce the cost as well.

WASHINGTON (Reuters) - The U.S. Medicare program may expand reimbursement for bariatric surgery for the obese, in light of a study that found the treatment can help reverse diabetes, the agency said on Monday.

Recent research found the surgery can completely reverse type 2 diabetes, a metabolic condition spurred by weight gain and suffered by millions of Americans.

Medicare, the government health plan for the nation’s 44 million elderly, “will assess the nature of the scientific evidence supporting surgery for the treatment of diabetes,” the agency said on its Web site.

The agency will decide whether to set a “national coverage decision,” that would set reimbursement policy for all Medicare recipients. It could also decide to not cover the weight-loss surgery for diabetes alone.

The government already pays for the surgery in certain patients, generally those classified as “morbidly obese.”

Both my mother, and my grandfather had diabetes and died at the age of 64 from heart attacks. Neither of them were obese and both of them were quite active. My grandfather was a rodeo photograher - not a job for the unfit. He was taking down storm windows from his home when he died. My mother was digging a ditch and I’m guessing the combination of the diabetes, the smoking and the Arkansas summer heat took her. Still, 64 is awfully young. Here’s hoping that we help keep parents, grandparents and aunts and uncles around longer.

Wow, Skinny Biddy has some interesting photos of a Lap Band at various stages of being filled. I’ve never seen these photos before. Check it out.

There’s a blog post that I’m sure a lot of people who are researching Lap Bands right now are seeing in which a young woman is telling her tale of getting Lap Band surgery in Mexico four years ago. At that point in time, surgeons weren’t doing fills for the patients of other surgeons, so she had to fly to Mexico everytime she needed a fill - a situation that has now changed. Anyway, she expresses the idea that had she not needed to fly to Mexico for a fill, she would have had fills several times a month, rather than over the course of several months. This isn’t accurate - you wouldn’t have fills several times a month. According to Dr. Paul O’Brien, who is the Director of The Centre For Obesity Research and Education at Monash University in Australia, you’ll have your first adjustment 4 weeks post op. At that point, you’ll have adjustments every two weeks or so, until you hit what he calls “the green zone”. It takes about a week to determine how the particular fill is affecting you and most physicians prefer to have a little more data before they proceed again. Once you hit the green zone, the time between adjustments stretches out from four weeks, to six weeks to three months, to six months. It just depends. I’ve talked to a few people who have lost all of their weight with four or five adjustments. Some people require more.

For those of you who are new to this - the port is located somewhere just to the side of your belly button. Fills are simple and painless. You lay down a table, put your hands behind your head and life your legs slightly. That causes your tummy muscles to tighten up and the physician feels for the port. Once found, they swab the area to clean it, spray a local anesthetic on it (no shot) and do a quick injection. They withdraw all the saline from your Lap Band so that they are sure how much is already there, and then inject the full new amount. It’s all over in under two minutes.

Here’s a video of a Lap Band fill being done:

Here’s Love My Lap Band Interviewee Lorraine Kay talking about her fill (among a few other things). Now, Lorraine’s experience involves a barrium X-ray so they can check things out a little more thoroughly, and that’s more likely to happen with someone whose procedure is being covered by insurance. Still, she makes the point quite well that it’s quick and simple.

And here is Becca getting a Lap Band fill in her physician’s office:

Fill Centers USA has 30 locations around the nation and has an entire post-operative support program. They handle fills, and provide the post-surgical support helping you learn to use your Lap Band to the most positive end possible. One of the things we know, is that people who have post-surgical support lose more weight, and have an all around happier experience. So, if you’re contemplating surgery in Mexico, this is an option you should consider.

If you’re just investigating Lap Band surgery, I’d encourage to read Dr. Paul O’Brien’s book THE LAP BAND SOLUTION. He covers all of the basic information in a clear, concise, easy-to-read manual. He’s one of the premier experts on Lap Bands in the world, and has been formally researching their efficacy since the early nineties.

Dr. Paul O’Brien is right! We do get to have our glass of red wine with a Lap Band! Not that I’m much of a drinker, but I would like to live longer. Being an American with no health insurance, I get scared sometimes.

I was googling “weight loss” + genetics + fat and found this study from researchers at Oregon State University, the Massachusetts Institute of Technology and the University of Ottawa about SIRT-1 - a gene which can reduce the development of new fat cells and increase metabolism. Ooooo la la! Well, it seems this gene’s activities can be increased by resveratrol, a compound found in grape skins.

The study was done with mice as a research model, and a remaining challenge will be to see if the same results are observed in a higher vertebrate model, including humans.
The research outlined the processes of fat formation and usage at a cellular and genetic level. It also analyzed the metabolic function of resveratrol, a polyphenol and antioxidant found at high levels in grape skins.

“When cells were exposed to resveratrol, our studies showed a pretty dramatic reduction in the conversion to fat cells and a lesser but still significant increase in the mobilization of existing fat, or the rate at which the cells metabolized stored fat,” said Mark Leid, a professor of pharmacology in the OSU College of Pharmacy. “This clearly could be one of the explanations for the health benefits that some researchers believe can be linked to moderate red wine consumption.”

And…

n trying to determine the molecular basis for this genetic link to longevity, the new study found that SIRT1 increases the use of fat and reduces the formation of new fat cells – apparently it represses one or more fat-regulating proteins and other genes that drive fat storage following calorie restriction. This may have been an evolutionary adaptation for the body to sense short term famine and counter it by increasing the burning of stored body fat, researchers say.

So, there ya go - I get to have a glass of red wine while I’m blogging and you get to have a glass of red wine while you’re reading my blog.

One more in my series Why You Can’t (Or Don’t) Lose Weight and Keep It Off. I’ve got more to report comin’ up in the next few days.

Nice blog update. Jaime, of Jaime’s Journey, went to the doctor the other day and has officially lost 50 pounds! She started off at 350 and her doctor is now teasing her that she’s just melting away. She has before and after pictures up as well - pre-surgery, 1 month post and 2 months post.

Lise the Loser came back from her weekend at Langley, Washington to discover that she has officially lost 30 pounds and now weighs - dun da da da! - 199. She is in Onederland to stay!

Achieving Me has bought herself a fabulous black ruffled dress (it is dreamy) for the Winter Ball she will be attending this July! She got it in a size 8 (12 for our Aussie friends) so that it fits in a few months.

Lastly, I think Gwen has some new photos up of herself in her photo carousel.

Happy Mother’s Day to all. A documentary I co-produced a couple years ago on the training of opera singers is being screened for the board of the organization we worked for tomorrow night. I’m excited about that. My darling 29 year old son may, or may not, be aware of Mother’s Day but you know, a mother’s hope springs eternal.