Dental Insurrection.

I have a tooth that feels its not getting enough attention and has moved to assert it’s nerve-based primacy in my life. Blogging has been, and will be, slow for another few days. My apologies.

For the men – Robert Morgan’s 250 lb. Weight Loss

Happily for men, they lose weight a lot faster than we ladies do. However, even with that advantage, this is quite the story.

Robert Morgan was the 31 year old, 502 pound sports editor for the WC Messenger of Wise County, Texas. He knew he needed to lose weight and remembers feeling proud of himself when…

…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.

Life was tough at that size, even for a former football player. He’s married to a sweet woman, they have great kids and it’s the good life even if they don’t have lots of money.

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.

Then one day, a rude kid mouthed off and Robert was sent on a new journey:

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!”

He talks about the self-revulsion we all feel:

I thought about it all night, the next day, and for the next week. I wanted to change overnight before the next person made fun of me. I see it almost every day now that my eyes were opened by this one person. People look at me differently every day, it’s just I can’t read thought bubbles as they stare when I slowly pass by.

I realize now I have been hiding from my problem that just won’t go away. My negative feelings about my appearance prevented me from enjoying everyday life, like going to movies, going for walks at the park, visiting with family and friends and playing with my two small boys. I hide from cameras and I run from mirrors. I hated the way I looked, and worst of all, I hated myself.

Robert talked to his wife, his boss, even his photographer who had wrestled with weight:

After laying everything on the line, I decided it was time for drastic measures. I just could not take another minute of being this way. I wanted to change my life, not only for me but for my children. They need their father back.

I decided to have weight-loss surgery before the weight killed me.

He talks about the humiliation obese people endure:

Flying? That could have been the worst experience ever. I had to board the plane early so no one would see me squeeze into my seat-and-a-half while connecting a seatbelt extension. Thankfully, my wife traveled to California with me and I didn’t have to pay for two seats.

He talks about the fact that he didn’t eat that badly. If you’ve read through my blog, you know there are lots of reasons you put on weight other than sheer gluttony. This is what he says:

I didn’t ask to be this heavy, nor did I get this way because I wanted to be seen. I never went home at the end of the day and ate a large pizza with a side of ranch dressing while drinking a two-liter bottle of Pepsi, only later to chase it with a tub of ice cream. It’s disheartening that people actually believe those walking in my shoes live their life with food in their mouths 24 hours a day.

So, Robert decided to fight back and he lists his raison d’etre for doing so:

My weight problem came along because I ate wrong. I was eating the wrong foods at the wrong times. Too much eating on the run and not enough eating a home-cooked meal at the dinner table.

Now I’m fighting back. I’m going to succeed for five main reasons:

1. To be an example for those who think it’s not possible to lose 200 pounds that it can be done;

2. To show the heartless, disrespectful folks who have looked down at me these past few years that I am human;

3. To be the man my wife used to know;

4. To give my children the father they need;

5. Because I want my life back.

Robert did his research:

I spent many long nights and early mornings researching doctors in North Texas that specialize in Lap-Band surgery. I did my homework online and offline. I talked to people who had the surgery and discussed their doctors and I looked into past problems and how many of these operations they have performed.

I finally, found the man who would help me change my life – Dr. Curtis Mosier. After talking with former patients, his Lap-Band coordinator and Mosier himself, I was ready to take the leap.

If you’re in North Texas, here’s Dr. Mosier’s page.

For Robert, as for many of us, insurance didn’t cover his surgery. He came up with the $15,000 on his own, and he is glad he did. The series starts at the beginning of his journey and goes on for two years. I’d encourage to read the whole series. It’s quite a story.

Live Broadcast of a Lap Band Surgery

Okay, I’m queasy – there’s nothing I like less than watching surgery, but some of you might really enjoy this so I pass it along.

The Duluth Clinic Weight Management Program in Duluth, MN, will broadcast a LAP-BAND® weight loss surgery, live on http://www.OR-Live.com Tuesday, March 4, 2008, at 6:30 p.m. The public will be able to watch as a surgeon uses minimally invasive techniques to fit a special band around the upper portion of the stomach, which helps patients to feel fuller, eat less, and lose weight.

Duluth Clinic weight loss surgeon, Walter Medlin, MD, will perform the live procedure. Members of the Duluth Clinic Weight Management Program will help explain the surgery and answer questions as they are e-mailed by viewers. A patient who had LAP-BAND® surgery almost a year ago will also share his experiences and respond to questions during the surgical webcast.

Maybe I should live blog it. 😉

Yeeeee-ouch! The Appeal Letter From Hell

I found this letter over at the now-defunct BandLandia.com while surfing around looking for more insurance standards. It’s to the right of the butterflies on the right side of the screen. Keep moving your bottom shuttle right.

I started to quote it here, but it’s just too long and too dense. She addresses who has turned down her request for surgery and questions their qualifications, she enumerates her attempts at dieting and failing, she explains why surgery is desirable, she discusses her BMI and what that means, how being obese handicaps her, and what the law requires. It’s powerful piece of writing. If you’re in a battle with an insurance company, I’d certainly take a loo.

YouTube interview with Dr. Ariel Ortiz

I just found a wonderful interview with, once again, Randy Alvarez’ Wellness Hour; only this is one is on YouTube so I can embed it here for you. Dr. Ortiz, his guest, has performed over 2000 lap band procedures. Interestingly, Dr. Ortiz refused to do the interview until Randy Alvarez agreed to come down his clinic and see the surgery first hand. What Randy witnessed was a very simple, very quick procedure and patients up walking around sometimes as quickly as 30 minutes. He says that he accepts patients ranging in age from thirteen to seventy, and says that in particular with the older women, the changes in their life are dramatic. Each clip is about 10 minutes long and has a fair amount of information.

In addition, Dr. Ortiz has written Lap-Band for Life which is currently available through Amazon. But there are only two of ’em right now, so you better grab it fast. 🙂

Fantastic Attorney Page For Insurance Lap Band Denials

The Northwest Weight Loss Surgery site has a link to one of the best pages ever – Obesity Law And Advocacy Center. Attorney Walter Lindstrom is founder, and he is specializing in laws and discrimination that impact the obese. Now, if you’re reading this page, you’re not planning on being obese for long so you may wonder how this impacts you!

Well, Mr. Lindstrom has a lot of advice on what you need to do to get your insurance to cover your lap band procedure. For starters, a lot of insurance companies mandate that you establish that you were on a supervised diet program and require that you provide them with notes. He has an entire paper on the importance of doing this. His basic point is that for many of us, getting insurance approval isn’t that quick anyway. Most doctors want you to lose 10 pounds or so before surgery to make the liver smaller anyway, so Mr. Lindstrom says “do it”. It will get you a little farther down the road while you work through the insurance issues, and will make you healthier for the surgery.

There are lots of articles and FAQ page as well. There were two questions that particularly caught my eye and I think will be relevant to many of you.

I’VE BEEN DENIED OBESITY SURGERY BY MY INSURANCE COMPANY BECAUSE CLAIM IT ISN’T MEDICALLY NECESSARY. CAN YOU HELP ME?

We are fortunate to be able to help most anyone in this position and have a success rate overturning denials based on “medical necessity” or failure to meet criteria for surgery that is in excess of 90%. We can be most effective if we get the case or claim right at the time of the first denial. If you wish to inquire about us advocating for you in that type of case, click here.

Oooo la la! A success rate of over 90%! That’s what I want to hear!!!!!

And then this:

MY INSURANCE COMPANY DENIED ME BASED ON A LACK OF DOCUMENTATION OF WEIGHT LOSS EFFORTS AND I DON’T HAVE ALOT OF THAT INFORMATION….CAN YOU HELP ME?

This is one of the areas we spend a great deal of time and have had very good success. While it is very, very important for patients to go back to their various medical providers to get whatever historical records are available, the fact is many people don’t have or cannot locate such records. That should not stop anyone from seeking surgery. First, you can always postpone the surgery until you comply with your company’s requirements, whether they are 6 months, 12 months, 18 months or more. However, we also understand that many of you have “been there, done that” and don’t want to wait anymore. We work successfully on a great many of those cases despite a client not having a great deal of documentation and we would urge you to give us a chance if this is the basis for denial you confront.

This was something I was wondering about. I live on a diet. I don’t think there are that many changes I could make to my diet that would allow me to lose weight. But after reading this site, tomorrow I’m going to be figuring out ways to get on a supervised diet, just in case I wind up with insurance coverage and use it for my surgery.

And in case you need help but you’re thinking you can’t afford Mr. Lindstrom, he says this:

ISN’T HIRING AN ADVOCATE GOING TO BE VERY EXPENSIVE?

Fear of professional fees are unfortunately one of the primary reasons why many Americans, in our opinion, are denied access to health care they require. Many people cannot afford costly fees and many attorneys and other types of advocates charge fees which are greater than the costs of the treatment being denied. Obviously, in that case, it would make no sense to hire such a person or firm.

Our office has worked very hard to make high quality services affordable to anyone who needs them. We have kept our overhead extremely low and have streamlined our file handling to maximize results for our clients. We’ll discuss our various fee options with you on an individual basis, but our current structure starts under $500, depending on what you require.

While it is important that this office charge and collect a fair fee for the work that we do, we have never allowed someone’s ability to pay fees to be the final deciding factor as to whether or not we can help them. We don’t want anyone to not contact us simply based on an erroneous assumption that hiring us is too expensive. We will work hard, if necessary, to create a payment plan which meets your personal situation.

And since most of you don’t live in California:

I DON’T LIVE IN CALIFORNIA – – – CAN YOU STILL HELP ME?

The answer to this question is generally “Yes,” but circumstances will differ from case to case. First of all, you must understand that you are retaining our services as a designated authorized “representative” to assist you with your appeal; we are not acting as an “attorney” on your behalf. In those instances, it is generally not necessary for us to be admitted to the bar for your state.

If we take on the matter as attorneys (rather than as lay advocates), we do have to be admitted to practice in the jurisdiction for that case. In those instances, we associate local counsel to assist with following the local rules and to sponsor our admission to that state’s bar for purposes of that particular case. That is called being admitted pro hac vice (for purposes of that case).

There are a few things to keep in mind. If you want us to help you with your appeal, you’re not going to be obligated to file any type of lawsuit or arbitration or other type of litigated solution to the dispute. You’re also never obligated to keep us as your attorneys if you wish to file such an action; in fact, we too retain the right to not move forward with a litigated case and, in some instances, we may be unable to take on that representation because we may be witnesses to the payer’s conduct.

So. yes, he might very well be able to help you even if you live out of state.

There is a lot of great stuff to read there, so I’d encourage you to spend some time at his site. He has an entire paper on getting your insurance carrier to approve you. I’m going to read that tomorrow and report back as well.

What Is The Process?

One of the other searches I’m seeing is people wondering how to determine if a Lap Band is appropriate for them, and what to do next if it is.

We’ll start at the beginning. You need your height and approximate weight to determine what your BMI is. You can do that here. Most surgeons and insurance companies want a minimum BMI of 35. Next you need to think about how you will pay for it. If you have health insurance, you need to find out if they cover lap band surgery and if so, what their standards are. The Centennial Center For The Treatment of Obesity in Nashville, provides the standards for a few dozen insurance companies. You’ll see that most of health care providers have very similar criteria. Also note that most physicians have staffs that are very sophisticated about getting insurance companies to approve treatment. Even if it looks like your insurance won’t cover it, you should go talk to your local Lap Band specialist and see what the staff has to say about it. The Northwest Weight Loss Surgery site has this fantastic page on what to do if your insurance doesn’t want to cover your surgery.

If you don’t have health insurance, then you need to think about whether you want to pay for it yourself and if so, what your requirements are. In the US, Lap Band surgery costs anywhere between $12,500 and $20,000. You may need to travel a bit to get the best price. You can also go to other countries. Mexico is working hard at getting US health care dollars and you can have it done there starting at $7k. Remember, Mexican surgeons were performing Lap Band procedures for a few years before American doctors were. There is a tremendous amount of expertise to be had south of the border.

Next, you need to talk to a local doctor who performs Lap Band surgeries. ObesityHelp.com has a page that provides referrals, credentials and feedback from patients on doctors through out the US. You can get a real sense of what your options are locally. You’ll find that a lot of doctors have help lines that are staffed by people who have lap bands and they’ll answer every question imaginable with personal authority. Then, go see the physician your prefer. Find out what they have to say about your insurance and if you’ll need help getting it through. If they can’t get it through or if you don’t have insurance, find out what their cash price is. Do they offer financing (most do!)? Can you put it on a credit card (not something I advocate, by the way)? In addition, you need to know what tests they need your primary care physician to perform. And if you don’t have a primary care physician, can they do them or do they have a referral for having them done? You need to ask about follow up – for a lot of people, the follow up is essential to losing weight well. You want to know what the provisions are.

If you settle on an out-of-town doctor, ask them what the process is for people who don’t live locally. They’ll tell you. Write it down so that there are no surprises later.

The best online page I’ve found as to what happens after you decide to have the surgery, and know how you’re going to pay for it and have it scheduled is from the Northwest Weight Loss Surgery Center. They go over what you can eat in the week before the surgery and what medicines you should avoid, what you should take with you to the hospital and what to expect in the days immediately following surgery. It’s all there. Your own physician will have his or her own list, but, in the meantime, this will give you a clear idea of what is ahead.

Lap Bands and Caffeine II

I’m getting a lot of traffic through here wondering whether caffeine is allowed after a lap band. I suspect the question is about drinking coffee, so we are dealing with three separate issues in this case:
1. coffee
2. caffeine
3. artificial sweetners

Some of the physician sites warn against drinking coffee because it is a diuretic and thus, causes your body to lose fluid. And because bandees are restricted in the amount they can consume, they must be careful to drink proper amounts of water. If your cup of coffee is flushing the fluids you do drink right back out, that’s bad for you especially if you’re getting just enough in the first place. Other physicians are fine with coffee but require you to drink it black or use sweeteners.

However, caffeine itself may well be a problem for people who want to lose weight. Researchers at Duke University have now documented that caffeine causes blood glucose level to spike (at least in Type 2 diabetics) after meals and that alone, my friend, will make it harder for you to lose weight – most likely whether you are diabetic or not (though the referenced study only deals with diabetics).

Sweetners are also problematic. A recent study by Lyn Steffen at the University of Minnesota found that people who consumed even one can of diet soda a day were more likely to develop metabolic syndrome –the collection of risk factors for cardiovascular disease and diabetes that include abdominal obesity, high cholesterol and blood glucose levels, and elevated blood pressure – than people who didn’t. What researchers suspect is that your body tasting something sweet, gears up for a big calorie dump. When it doesn’t get the calories it’s expecting, it responds by holding on even tighter to the next batch of calories it does get and you gain weight.

In short, there is not an accepted standard on the issue of caffeine consumption and lap bands. From the point of view of this coffee and tea with cream and sweetner lover, there is plenty of reason to avoid both caffeine and artificial sweetners if your goal is weight loss. What to do? What to do? Listen to your doctor, I guess.

How much do Lap Band surgeries cost in the US? Part 1.

Today, I’m calling various cities around the US and finding out what the basic fees are. Here in Los Angeles, the going rate seems to be about $18,000. Next week, I’m going to tackle getting costs out of country. I know that a lot of people go to Mexico and India.

I started off with St. Louis because that’s my home town. I spoke with Karen at Dr. Van Wagner’s office. Their basic fee for out-patient surgery comes to $14,555 – that covers everything. If you need to stay overnight at the facility, that would put another $1000 onto your price tag. In addition, they have a program fee of $375 but they will refund part of that if you are a cash patient. if your primary care physician requires any other tests from you, that would be additional. That’s something you need to ask about.

Update Congrats to Dr. Wagner for running an office where smart people answer the phones and answer questions. I’ve been calling other cities and have been put on hold, shuffled into voice mail cul de sacs and haven’t actually spoken with another person yet. I have to run so I’m going to continue this post tomorrow. Or maybe I’ll write about something else entirely tonight.

Weight loss with lap band interview

I just found a wonderful interview online from Randy Alvarez’ Wellness Hour. He sits down and talks to Dr. Robert Powell who has offices here in California and in Texas.

The interview itself is about 20 – 30 minutes long. I wasn’t clocking it, so I’m not sure of the length. But he does a good job of covering the basics. Dr. Powell is obviously not a big fan of gastric bypasses, and believes that most people would choose the lap band given the choice. He says that his office looks for 8 – 13 pounds of weight loss per month which is not nearly as quick as gastric bypass – but of course, lap bands are far less invasive and reversible if necessary. He talks about how his patients become ambassadors for the procedure and that’s something I’ve experienced. As I’ve begun talking to people who have had lapbands, all of them are incredibly enthusiastic as to how much it has changed their life for the better.

Alvarez and Dr. Powell discuss hunger for a moment. Beth, one of Dr. Powell’s patients, is on the show, and she addresses the fact that she hasn’t felt hungry since she was banded. Dr. Powell talks about how the nerves that signal that you’re full are in the top of your stomach. The lap band, by creating a little pounch, stimulates those nerves after just a small amount of food and thus, an early feeling of satisfaction. They also discuss the need for follow up care and for counseling, and how the office teaches people to eat well. With the feeling of hunger no longer in overdrive, eating properly becomes a much easier proposition.

Anyway, I hope you enjoy the interview. Dr. Powell does a good job of telling the story in a fairly complete and succinct fashion.

Lap Band Blog

I was out cruising around the internet the other night, looking for new and interesting things to bring home, when I found this very elegantly written blog post by Dr. Sid Schwab. Read the whole post. It’s a beautifully written piece about lap bands. The Simpson’s story below is fun as well.

The parents of Matt Groening, creator of the Simpsons, were friends of my parents. It might interest his fans to know, if they don’t already, that his parents’ names are Homer and Marge. Several years ago, my mom got Marge Groening to finagle a favor from Matt: he sent our son, on his birthday, several items of wittily signed simpsonalia, along with a couple of original drawings of Bart offering greetings, relating, as I recall, to a cow. This does not keep me from criticizing Mr. Groening on surgical matters.

On the most recent Simpsons episode, which I watched with my usual devotion, Homer underwent weight-loss surgery. During the pre-operative meeting with the surgeon he was told about “gastric bypass surgery,” but the explanation, complete with diagram, was of placing a band around the stomach. There’s a lot of misunderstanding out there.

And in the comments, I found a link to the blog of Dr. Chris Oliver, an orthopedic surgeon in Scotland who is blogging his weightloss with a lap band. I particularly like this post with the before and after pictures. Read the comments as well. Like Sid Schwab’s post above, Oliver references the fact that he doesn’t really feel hungry anymore. How liberating must that be?

What’s going on with this blog?

So, here I am with a blog that says it’s about life and weight loss with a lap band and there is very little about lap bands here. The truth of the matter is that I want it to be larger than that – I want it to be about the whole ugly truth of weight loss. I want to provide a really three dimensional presentation of why weight loss is so difficult and unlikely and if, in the process, I can get a few people to leave their guilt behind, hallelujah.

I’m going to begin doing my interviews this week finally. I’m looking forward to getting started on that part. They should be fairly easy and quick for me to get up, so you’ll be seeing them by next weekend. In the meantime, I’m going to continue providing information on the literally Sisyphean task which is weight loss and weight loss maintenence.

Set Points and Weight Loss Surgery

One of the things I’ve been reading a lot about is set points. Basically, your body has a set weight that it likes and it’ll do everything it can to keep you there. You can lose about 10% – 15% of your excess weight, and if you work hard enough, your body will probably go along with that. Much more than that, and your body goes to war with your diet. Judy Forman, in a Boston Globe article, says this:

If you’re talking merely 10 to 20 pounds – and nobody knows the actual figure – you probably can diet and exercise your way to a svelter self and stay there, provided you stick with your weight control program rigorously. Forever.

Depressing, but you know it’s true. Dr. Lee Kaplan, in the same article continues:

Only about 1 to 2 percent of obese people can permanently lose weight through diet and exercise alone, said Dr. Lee Kaplan , director of the weight center at Massachusetts General Hospital.

And then he sets us all free:

“Dieting is like holding your breath,” he said. “You can do it, but not for long. Your body is stronger than your willpower.”

Uh huh. Now this is what all those “diet and exercise” types never tell you. Some of ’em don’t know and some of ’em can’t make money off you if they tell:

One famous study conducted at the University of Minnesota during World War II illustrates the ineffectiveness of severe dieting. The researchers put 36 physically and emotionally healthy young men of normal weight on a strict diet, allowing them only half the calories they were used to. The men lost weight, but became psychological wrecks, obsessing about food, bingeing, and, even after the diet was over, eating way too much, often 8,000 to 10,000 calories a day until they regained the weight, recounted New York Times science writer Gina Kolata in her recent book, “Re-thinking Thin.”

In another classic study in the 1950s, researchers at Rockefeller University in New York City recruited obese people who were so desperate to lose weight that they agreed to live in the hospital for eight months, including a four-month period in which they subsisted on only 600 calories a day of liquid formula. They lost weight, Kolata noted. But, to the dismay of subjects and researchers, they all quickly regained the weight.

Here’s what happens:

When a very fat person loses a lot of weight by diet and exercise, the brain goes into panic mode, reading a complex array of chemical signals as proof of impending starvation. Metabolism slows. The body hangs on to every calorie it can get. The chemical signals that trigger appetite soar, creating a drive to eat so powerful you can’t resist. From the standpoint of evolution, this makes sense: Our DNA was built when we were hunter-gatherers to protect us against starvation, not obesity.

So after you go on a diet, not only is your body slowing your metabolism, it’s also flooding you with hormones and chemicals that trigger hunger. So if you were happy with a Quarter Pounder and a small order of fries before your diet, after your diet, you’re gonna need to super-size everything to feel an equivalent level of satisfaction. That isn’t you being undisciplined. It’s you responding quite normally to your body.

They don’t why it happens yet, but here’s their best current guess:

Consider one of the best-studied weight control hormones, leptin, which is made in fat cells and is designed to tell the brain: “Stop eating. I’m full.”

“Obese people usually have high levels of leptin because they have so many fat cells making it,” said Dr. Eleftheria Maratos-Flier, an obesity researcher and associate professor of medicine at Beth Israel Deaconess Medical Center. “The heavier you are, the higher the circulating leptin.” In theory, being fat should mean that the brain would be flooded with “stop eating” signals.

But when people go on severe diets, “they lose more leptin than you would expect. So the brain thinks there is less fat than there ought to be,” which makes people eat more, she said.

And now we’re back to diet and exercise and why it doesn’t work:

Put differently, some researchers believe that one reason weight loss programs ultimately fail is that diet and exercise do not change the body’s “set point,” the thermostat-like mechanism in the hypothalamus and other parts of the brain that keep weight fairly constant.

And that brings us round to weight loss surgery. The article goes on to talk about gastric bypass, but there’s no evidence that all patients need to go that far. We know that patients who have had lap band surgeries lose as much weight as patients who have had gastric bypass, and they keep off as effectively as well. Though there are reasons for some to choose other types of weight loss surgery over lap bands, for most of us, the less invasive the surgery the better.

And here’s the conclusion about long term weight loss from the Medical Journal of Australia. LAGB being Gastric Banding:

All bariatric procedures have been able to achieve loss of more than 50% of excess weight.24,27-29 The ASERNIP-S systematic review showed greater weight loss after RYGB than LAGB during the first 2 years after the procedure, but the difference in weight loss was not significant at 3 and 4 years.24 In a recent review,23 we extended the data of the ASERNIP-S review by including all studies that included at least 50 patients, reported up to March 2004 (Box 5). This showed a substantial weight loss after both procedures, with an initial greater weight loss after RYGB but similar effectiveness for both procedures at 4, 5 and 6 years.

So, there ya’ have it – the big reason why diet and exercise do not work as we have been taught to believe they do.

Life Delays And Caffeine

Isn’t this how it always goes? You get really jazzed about a project and something in your life stops you cold. Car problems put my interviews on hold. I’ve decided the thing to do is just buckle down and write about what it is I’m learning.

I read a really interesting article a couple weeks ago about caffeine and blood glucose levels. Dr. James Lane, a psychologist at Duke University (where they have been working for a very long time on obesity issues) discovered that patients with Type 2 diabetes experienced rising blood sugar levels just from consuming caffeine. Tiny little monitors were placed under the patient’s skin, and recorded the rising levels after meals.

The findings, appearing in the February issue of Diabetes Care, add more weight to a growing body of research suggesting that eliminating caffeine from the diet might be a good way to manage blood sugar levels.

Lane studied 10 patients with established type 2 diabetes and who drank at least two cups of coffee every day and who were trying to manage their disease through diet, exercise and oral medications, but no extra insulin. Each had a tiny glucose monitor embedded under their abdominal skin that continuously monitored their glucose levels over a 72-hour period.

Participants took capsules containing caffeine equal to about four cups of coffee on one day and then identical capsules that contained a placebo on another day. Everyone had the same nutrition drink for breakfast, but were free to eat whatever they liked for lunch and dinner.

The researchers found that when the participants consumed caffeine, their average daily sugar levels went up 8 per cent. Caffeine also exaggerated the rise in glucose after meals: increasing by 9 percent after breakfast, 15 percent after lunch and 26 per cent after dinner.

For those of us who have experimented with Atkins, this may answer a mystery that Dr. Atkins wrestled with. From the very beginning, he stated that you could not drink coffee on his diet. He didn’t know why, but he knew his patients didn’t lose weight unless they cut the caffeine out. His suspicion was that it triggered hunger and we’d eat more than we should. Well, I knew that wasn’t the case with me, but I didn’t lose weight until I cut the coffee out.

I wrestle with a lot of guilt (as I’m sure most of you do as well) and it’s gratifying to discover that many of the problems with weight loss really have nothing to do with self-discipline. I do a lot of work at my computer and it’s so comfy in the morning to sit here quietly, typing away, and when I pause to collect my thoughts, to have a sip of a nice, hot cup of coffee with a little cream (okay, a lot of cream – I’ve given up) and sweetner. In the summertime, for me, it’s Diet Coke in the morning. I love the bubbles and the acidic bite against my tongue.

So, now, what do I do? It will be several more months before I can afford surgery. Do I give up caffeine? Or do I wait it out?