Low Carb Freedom

If you choose gatric bypass...

Please, please, please read all these posts first and remember to take all of your supplements. Here is one documented case where a gastric bypass patient went almost blind, but the vision was able to be restored.

Cautionary Tales for Gastric Bypass Patients

I have always told people who come to this site to give low carb a good try before resorting to gastric bypass or lap band or Roux-en-Y gastric bypass (RYGB). Why? Because you will be on a low carb high protein diet after you have the surgery. In addition, it seems that you will also be in the hospital a lot more than you would if you didn't have the surgery. So says the latest study out of the Journal of American Medicine: Hospitalization Before and After Gastric Bypass Surgery.

Now, it only covers 1 to 3 years after the surgery, but everyone who is considering the operation should read this article. I also recommend the gastric bypass surgery blog, Living After WLS.

Low Carb Ice Cream (with no cream) that is Good for You: Alpine Ice from Mountain Herbal Foods

While I have been disappointed by many low carb foods in the past, new "good for you" foods that taste great are coming down the pipeline, and Alpine Ice certainly fits the bill. Not only does it have lower carbs, but it also has no dairy, no soy, no gluten or eggs. It is also certified Vegan and low fat. (Not that I care about these last facts.) You can give this to just about anyone on any type of diet. I bet this ice cream (with no cream) would be great for people who have had gastric bypass or lap band surgery too.

It wasn't developed for low carbers; we just happen to be a lucky ancillary market. It was developed for cancer patients and is suitable for diabetics.

The Zone doctor, Dr. Barry Sears, was an advisor, and even has a great quote on their website:

I feel that Mountain Herbal Foods ushers in a new era of "guiltless pleasures."

These are foods that you believe you should feel guilty about eating because they have such great taste, yet they are manufactured to deliver incredibly high level of nutrients known to improve health and wellness. 

Life can't get much better than that.

I tried this at a local ice cream store in Marblehead, MA -- Terry's Ice Cream Shop on School Street. Terry's has two flavors: Lavender Sunrise and Green Tee Herbena. I tried both of them with a mini teaspoon and decided to get a bowl of the Lavender Sunrise. For some reason, this dessert seemed like it should come from the Orient and not "handmade in small batches in the Berkshires of New England." The taste was light and refreshing, and it was further enhanced by the knowledge that this stuff truly was good for you AND ONLY 45 calories! About half an apple! (Read here why calories do count.)

Besides lots of herbs, teas, etc., Alpine ice contains inulin and erythritol instead of maltitol, and long-time readers of this site know that these ingredients are the best ingredients to have in a product.

Distribution is limited at this moment, but I'm sure if there is demand, something can be done. I suggest printing out this page and bringing it to your local health food/low carb market. Many low carb stores also cater to the gluten-free and dairy-free customers, and this certainly fits the bill.

If you look at the label, the fact that this is low carb doesn't jump out at you because they haven't broken out the sugar alcohols. (I think they should, of course.) Mountain Herbal clarified the sugar alcohol content and trans fat in an email, so the complete nutritional label should be as follows:

	Alpine Ice Lavender Sunrise
Serving Size	1/2 cup (about 80 grams)
Calories	45
Total Fat	0g
Saturated Fat	0g
Trans Fat	0g
Cholesterol	0mg
Sodium	10mg
Total Carbohydrates	20g
Dietary Fiber	8g
Sugar	3g
Sugar Alcohol	6.6g
Protein	0g
Ingredients	Ingredients: Tea (Water, Lavender*, Green Tea*, Blue Malva*, Chamomile*, Lemon Balm*, Peppermint Leaves*), Harmony Infusion (Water, Elderflower*, Raspberry Leaf*, Green Tea*, Peppermint*, Nettle Leaf*, Dandelion*, Lemon Balm*, Orange Peel*), Inulin, Erythritol, Lemon Juice, Fructose, Maltodextrin*, Gum Acacia, Glycerine, Tara Gum, Guar Gum

Now, according to the folks at Mountain Herbal, I really should try the Bolder Berry, which is available now, and with the ingredient list filled with berries, I can't wait to try it.

Mountain Herbal Foods LLC
217 humphrey street
marblehead, ma 01945
t: 781.639.1192    f: 781.639.4356
info@mtnherbal.com

Living After WLS Launches a Newsletter

You know that I highly recommend Kaye's Blog, Living After WLS, to everyone who either has had weight loss surgery or is considering weight loss surgery. Go in with your eyes open and read about her and other peoples' experiences.

Anyhow, Kaye has started a newsletter. To subscribe, click here and then type in your email address in the subscription box.

And don't forget to subscribe to my Low Carb Freedom weekly newsletter as well.

Watch a Gastric Bypass Procedure On the Web and Ask the Doctors Questions

OK, OK, if you haven't tried a low carb diet yet, try it, because if you have a gastric operation, you will be on a low carb diet later. If you are seriously thinking of an operation, find out as much about it as you can. Read the good, the bad, and the ugly here: Surgery: Gastric Bypass & Lap Band.

And why not actually view the procedure as well? At this website, you can see a preview of the weight loss surgery to check to see if you will be able to view it, and also send in questions to the doctors beforehand. This is cutting edge marketing of medicine here folks, and I can't say that it is a bad thing. This is what they will perform:

The Roux-en-Y procedure, which Dr. Naaman will perform, combines the two main principles of bariatric surgery - restriction and malabsorption. The surgeon divides the stomach, creating a small pouch that greatly restricts the amount of food the patient can eat. The procedure also reroutes and shortens the small intestine, decreasing the amount of food energy absorbed by the body. The bypassed stomach and intestine segments are reattached below the pouch, so the fluids and enzymes provided by those organs can drain into the intestines and facilitate digestion.

Lap Band versus Gastric Bypass

Here is a good article summing up how lap band works. It also quotes stats as to the complication rate:

The low risk is why Dr. Svein Holsaeter and Dr. Tim Eldridge started performing the surgeries. Holsaeter said he is one of a number of physicians who were looking for a safer way to help patients lose weight.

"The risk of dying from bypass surgery is one in 200," Holsaeter said. "The risk of having a fatal event from this is one in 2000.

"We don't make big incisions. We make incisions that vary from about an inch down to one-eighth of an inch."

Eldridge explained the procedure with the analogy of a pouch. He said that the band actually restricts the amount of food that can enter the stomach, which means the patient has to make some changes to his or her lifestyle.

As always, try the low carb diet first, because after any type of weight-loss surgery, you will be on a low carb diet afterwards. And for the best description of the aftermath around, read Living After WLS .

After gastric bypass, what to do about clothes?

Folks, this is a good problem to have, clothes sizes getting smaller way too quickly....

With the recommendation that weight loss surgeries take place in large centers that do lots of operations, this program should be emulated:

This is a clothing swap for bariatric patients sponsored by bariatric patients. There is no money exchanged,” said Billie Terrill, office liaison for the institute, who also was a gastric bypass patient. “This is a great way for people to get nice clothes when they’re transitioning so quickly.”

.

Terrill said an average patient will drop a size every six weeks. With clothing costs high, many of the patients shop at the Goodwill Store. But the monthly support group came up with the idea to swap clothing among themselves. Members volunteered to sort and arrange the clothes, and orchestrate the morning’s swap.

Read the  whole thing here.

       

Physician's Guide to Pharmalogical (Drug) and Surgery for Obesity Patients

The Annals of Internal Medicine has come out with new guidelines, or, rather, codified guidelines, for the treatment of obesity. Diet and Exercise is the number one method, but it isn't covered extensively, at least in this paper. There are five recommendations:

Recommendation 1: Clinicians should counsel all obese patients (defined as those with a BMI 30 kg/m ² ) on lifestyle and behavioral modifications such as appropriate diet and exercise, and the patient's goals for weight loss should be individually determined (these goals may encompass not only weight loss but also other parameters, such as decreasing blood pressure or fasting blood glucose levels).

Recommendation 2: Pharmacologic therapy can be offered to obese patients who have failed to achieve their weight loss goals through diet and exercise alone. However, there needs to be a doctor–patient discussion of the drugs' side effects, the lack of long-term safety data, and the temporary nature of the weight loss achieved with medications before initiating therapy.

Recommendation 3: For obese patients who choose to use adjunctive drug therapy, options include sibutramine, orlistat, phentermine, diethylpropion, fluoxetine, and bupropion. The choice of agent will depend on the side effects profile of each drug and the patient's tolerance of those side effects.

Recommendation 4: Surgery should be considered as a treatment option for patients with a BMI of 40 kg/m ² or greater who instituted but failed an adequate exercise and diet program (with or without adjunctive drug therapy) and who present with obesity-related comorbid conditions, such as hypertension, impaired glucose tolerance, diabetes mellitus, hyperlipidemia, and obstructive sleep apnea. A doctor–patient discussion of surgical options should include the long-term side effects, such as possible need for reoperation, gall bladder disease, and malabsorption.

Recommendation 5: Patients should be referred to high-volume centers with surgeons experienced in bariatric surgery.

Basically, there is a loop that always leads back to diet and exercise as you go down the choices. If, step 1, diet and exercise don't work, then, in step 2, offer weight loss drug therapy, but tell everyone the side effects and temporary nature of the weight loss. Step 3 talks about specific weight loss drugs.

If weight loss drugs don't work, then move to step 4, and offer them weight loss surgery, with all the precautions and potential problems. If weight loss surgery is the solution, then, in step 5, help them choose a high volume surgery center.

Seems like common sense. Further in the recommendation is this paragraph:

Lifestyle modification through diet and exercise should always be recommended for all obese patients. In addition, patients need to be continuously educated regarding diet and exercise, and it should be clear that after a surgical procedure patients cannot resume their previous eating habits. There is no evidence at present to answer the question of whether one procedure is better than another. In addition, weight loss through surgery has not been shown to reduce cardiovascular morbidity or mortality. (emphasis mine)

Basically, after weight loss surgery, you have to go on a low carb diet. So, for those who are thinking about weight loss surgery, why not try it out on a voluntary basis first before going through the surgery. As I have said before, there is a great blog, Living After WLS , that talks about many of the side effects.

An Interesting Weight Loss Surgery Blog

I have come across a great weight loss surgery blog. Now, I haven't had weight loss surgery and I don't intend to, but the reason I mention it so often on my site is because after weight loss surgery you WILL be on what is essentially a low carb diet. Why not give the low carb diet a shot to see if it works before making that decision. If it doesn't work for you then you are back to where you started, but a little wiser as to what life will be like after the surgery.

Weight loss surgery also has a lot of potential complications, but the best person to describe what life is like after the surgery is someone who has gone through it. Kaye Bailey writes eloquently and forcefully on the subject.

If you are contemplating the operation or have had the operation, please give Living After WLS a try.

Weight Loss Surgery & Pregnancy

An excellent article on what you have to watch out for if you are a woman and have weight loss surgery and you want to or could potentially get pregnant. Some important points from the article:

1. The pill might not work:

But birth control can be tricky, since you may not be able to absorb enough of the Pill to make it effective, and diaphragms need continual readjustment as you lose weight. That's why Dr Nease urges patients to use at least two forms of birth control during the first 18 months after surgery.

2. That horrible gestational diabetes test could be a real problem for women who have had weight loss surgery.

Having your weight-loss surgeon on your side also helps you avoid problems your OB/GYN might not know about. For instance, taking the standard glucose tolerance test for gestational diabetes, for instance, can bring on a full spate of "dumping" symptoms for gastric bypass patients: nausea, sweating, abdominal cramps, diarrhea, heart palpitations and other symptoms, says Dr Nease. Ask your OB/GYN to check for gestational diabetes by testing your fasting blood sugar. Similarly, your doctor might prescribe a standard prenatal vitamin, but there are also vitamins created for gastric bypass surgery patients that might be more effective.

Read the whole thing.