Friday, July 26, 2013

The Shame of Shaming

It's amazing but, in this day and age, there are still people who believe we can socially stigmatize our way to a reduction in obesity. Those of us involved in weight loss surgery, and those of us who are dealing with weight issues understand one fact that people who are not intimately involved with weight issues might never come to understand: eating is nothing like smoking or drug use.

It's true that a certain amount of social stigma has been helpful in combating such substance addictions as cigarette smoking and perhaps alcoholism too. However, there is one major and glaringly obvious difference between these addictions and chronic overeating -- you can theoretically stop overeating, but you can't stop eating entirely. Moreover, without treatment, the urges only get stronger as you lose weight. No surprise then that a new study published in the journal, PLoS ONE, shows that the more obese people feel discriminated against for their weight, the more likely they are to remain obese.

The reason treatments like sleeve gastrectomy surgery have become necessary is that overeating might be similar to an addiction, but it simply can't be dealt with in the same way. We're all "addicted" to food in the sense that we need it to live and our body is constantly driving us to eat. What appears to be happening is that overweight people seem to have more persistent, harder to resist signals being sent to them.

Even here in looks-conscious Los Angeles, even the most well-off, and well-motivated, obese celebrity with access to the best trainers and nutritionists in the world might find weight loss next to impossible without a lap band in Beverly Hills. Clearly, then, shaming and discrimination is not what obese people need to help them lose weight. Most of them have plenty of that already. What overweight people need to lose weight is pretty simple: help.

Monday, July 15, 2013

New Dishes Target Post-Bariatric Surgery Consumers

The team at Dr. Feiz & Associates, leaders in surgery for weight loss in Los Angeles, remembers news stories from two years about about if the color of your plate can benefit weight loss. While we think the science is not clear on that issue, we have read recently about portion-control plates designed for patients who have gotten bariatric surgery. Any tool to help patients lose weight, we have to support, especially in instances where portion control was an issue before a bariatric surgery.

Here's one we found that marks portion size for protein, vegetables, and starch. It's a neat idea, and great for patients who are learning how to convert the sometimes confusing measurements (oz., cups, and Tbs.) into what they actually look like on the plate. We do wonder how long somebody would use this after a gastric sleeve, bypass, or lap-band, once they have gotten acclimated to portion sizes. However, if this plate works for somebody, that's all that matters. We think it'd be a great addition for a household where one person has had weight loss surgery and the rest haven't to encourage proper portioning.
We also found this product from a company called BariWare. It's not exactly a plate, but it does have different compartments that only hold 1 oz. of food, making measurements easy. One reviewer online said it was even great for stews and she applauded the silverware, which encourages slow eating. It doesn't necessarily tell you what to put in each compartment, but the staff at Dr. Feiz & Associates does our best to educate our patients on which foods make satisfying and healthful meals.

We can't help but think that the portable portion-control plate is the more convenient and helpful, especially on the go. However, everybody's weight loss journey is different and these plates might not be helpful for everybody. Here at Dr. Feiz & Associates, our bariatric surgeon, nutritionist, and support staff keep strong tabs on our patients, monitoring their diet and exercise and, yes, even discussing issues like portion-control plates. All of these products retail for about $15 to $20, so they're a great investment if you think they'd be a long-term help.

If you're considering a weight loss surgery or have a question about any of the products mentioned above, please call Dr. Feiz & Associates at 310-817-6911 or contact us online.

Friday, July 12, 2013

It's Not Any One Thing

The press coverage of the recent Purdue University study regarding diet sodas and health may say a lot more about how people think about the topic of weight than it actually does about diet sodas.  Many of the stories treated the fact that diet drinks don't directly lead to large weight losses as if it were a gigantic shock.

The fact of the matter is that pretty much the first thing a person who is serious about weight loss in Los Angeles or anywhere else should do is cut out sugary sodas. These products have almost no nutritional value and don't make us feel particularly full, while adding far more calories to our diet than most soda drinkers realize. While they may be much sometimes be much healthier in terms of nutrients, most sweet fruit juices have similar issues.

Ideally, we would substitute mainly water for sodas, which have some non-sugar ingredients that might not be particularly healthy.  Even at their best, diet sodas are a compromise for people who complain they get bored drinking water -- ideally, they would be just an occasional change of pace, not a habit. However, it's  hard to imagine how they, by themselves, can increase weight gains though, of course, they can have their own health issues. (Excessive cola and diet cola drinkers alike really do seem to be more prone to kidney stones.) Moreover, it's possible there's something about diet sodas that causes people to eat more over time than they would if the were just drinking water, though that's far from proven.

All that being said, the breathless tone of the aritlces seemed to somehow equate consuming diet drinks with a serious weight loss approach, such as, say, weight loss surgery. It's hard for us to imagine why anyone who has even the slight familiarity with the difficulty of weight loss would imagine that simply drinking diet sodas would, by itself, cause significant weight loss in most people. The vast majority of obese people didn't simply Big Gulp their way to being overweight. While removing one source of additional calories is important, the human body and brain will find to persuade a person who is trying to lower their caloric intake to obtain the calories in some other form.

Frankly, if losing weight were as easy as simply cutting out sugary sodas or, for that matter, donuts or bacon, there would be no need for procedures like gastric sleeve surgery. The dynamics of weight gain are far too complex to be boiled down to one very particular dietary bad habit. It would be nice if journalists -- who are, as far as we know, as prone to weight issues as people in any other profession -- would be a bit more aware of the complexities of the situation.

Friday, July 5, 2013

A Walk in Their Shoes

It was inevitable that, at least in certain corners, the decision by the American Medical Association (AMA) to label obesity disease would be politicized in certain quarters. To be specific, writer Michael Tanner opined in the very conservative National Review yesterday about how the decision is really nothing much more, in his mind, than an attempt by doctors and others to persuade the government to pay for the poor lifestyle choices of patients, presumably by forcing the government to subsidize weight loss surgery and other treatments.

All we can say is that it's pretty evident that Mr. Tanner has never had to seriously struggle with his own weight and that he's woefully unaware that the decision is far from unprecedented. While we can spend all day defining what a disease is, the fact of the matter is that the AMA declared alcoholism an illness in 1956, possibly well before Mr. Tanner was even born. Anyone who has ever dealt with weight issues knows that it's very much like an addiction but with one diabolical additional problem: You can give up alcohol completely; you can never smoke a cigarette again and be much healthier for it; you can't stop eating completely. No wonder that so many people find permanent, healthy weight loss in Los Angeles or anywhere else to be next to impossible.

While we understand that not everyone agrees with classifying any addiction as a disease, the entire weight of medical thinking about these issues holds that it is. It's also clear to most people that addiction to overeating is far tougher to end that just about any other addiction because our need to eat it so utterly basic. That's why such outstanding procedures as gastric sleeve surgery are becoming more routine every day.

The problem here, of course, is that people who have no personal experience of addictive problems, and who have bothered to learn much about them, are unaware of what it feels like from the inside. They have no idea that the brain, which is a bodily organ like any other, is constantly sending very strong signals that the desired substance -- whether it's a, a double sized martini, or a cream filled donut -- must be obtained immediately, just to feel normal. For a non-addicted person, the decision to have a cocktail or a donut is an act of volition. They may even remember occasions -- often in their youth -- when they, more or less on purpose, decided to overindulge in food or drink for fun, maybe suffered some short term consequences, and moved on. They may think that addicts are doing the same thing, but on a daily basis. If only it were that simple.

We suppose it's inevitable that political types who have no experience of medical issues will misunderstand decisions made by doctors. We'd like to suggest that they exercise their capacity for empathy, but that's not always a strong suit.