At this month’s support group meeting our focus was on one thing – EXERCISE.  Why should we exercise?  How should we exercise?  What are the best ways to exercise?  How often and how long should we exercise for?  The questions are endless.  To help us get a grip on all things exercise we invited Monica O’Reilly, owner of Fit for Life Fitness Center, to help answer these questions.  Here is a breakdown of what we learned:

• In order to reach your goals you CANNOT continue with the same eating, the same exercise, and the same physical activity behaviors.  You must change these behaviors through self discipline. 
• Physical activity does not discriminate.  Adults of all ages, shapes and sizes will gain health and fitness benefits through physical activity.
• Sitting for prolonged periods of time hurts your body.  How?  It turns off most of the abdominal muscles, over-works the back muscles, over-stretches the spinal ligaments, stresses the back portion of the discs and shortens the psoas, calf and hamstring muscles.  If you have a desk job make sure you get up and stretch every 20 – 30 minutes.
• Sarcopenia is to blame for weight gain in the majority of adults.  Sarcopenia is the gradual decrease in muscle tissue that occurs with age and begins for most people around the age of thirty.  The average adult will lose 1% of musle each year after the age of 40.  Men and women who do NOT strength train will lose 5 – 7 pounds of muscle for each decade of adult life due to disuse atrophy. 
• Lean muscle loss = slower metabolism!  A slower metabolism leads to lower energy requirements for your body to function. Fewer calories are being used so more calories are being stored as fat.  Without a reduction in food intake (calories), this process results in 15 – 17 pounds more body fat for each decade of adult life.
• Keep your muscles!  To replace muscle and raise your metabolism, strength training must be done on a regular basis.  Research reveals that by adding just 3 pounds of muscle you can raise your resting metabolism by about 7 percent. 
• Muscle loss = fat gain.  How do we fix this?  Eat sensibly.  The average person should do cardio exercise at least 3-5 times a week for a period of 25-30 minutes.  Strength train at least 2-3 times a week non-consecutively.  Work the major muscle groups of the body which include the legs, hips, chest, back, abdomen, shoulders and arms.
• Kick off your exercise program gradually.  If you are new to exercise start off with a 10 minute exercise session then increase to 2o minutes and then to 30 minutes.  When strength training start off with 1 set of 8-15 repetitions per exercise.  Progress to 2 to 3 sets over time.
• Make healthy lifestyle changes.  Know your BMI and your waist measurment.  Be aware of how many calories you are consuming.  The more calories you eat the more exercise you have to do in order to burn those calories because what your body doesn’t use will get stored as fat.  Weigh yourself weekly and if you’re goal is to lose weight, aim to lose 1/2 pound to 2 pounds per week. 

Joan Wilson before and after weight loss surgery.

As recently as 2009, Joan Wilson was one of the 17 million Americans with diabetes.  At 5-feet-tall and 217 pounds, she was a common Type 2 candidate, obese and physically inactive.  Type 2 diabetes can cause heart disease, stroke, blindness, kidney failure and leg and foot amputations.  If Joan, now 70, didn’t make some changes, she ran a huge risk of suffering from any of these afflictions, or worse, becoming one of the over 200,000 people who die from diabetes related complications each year.

Joan did not want to be a statistic.  She was tired of people looking down on her, tired of being unhealthy and tired of having no energy.  But Joan wasn’t tired enough to go down without a fight, refusing to allow poor health to rob her of her senior years.

After months of researching, Joan took the first step toward positive change and met with Dr. Timothy Hipp at North Florida Regional Healthcare’s Center for Obesity Surgery and Treatment.  After discussing her options, Joan elected to have the least invasive form of bariatric surgery, adjustable gastric banding.

Dr. Hipp performed Joan’s surgery in December of 2009 at North Florida Regional Medical Center.  By November 2010, she was 52 pounds lighter with plans to lose 20 more.  She is off of her diabetes and blood pressure medications.

“My life has changed so much,” Joan says.  “I feel like I have more energy.  I love shopping for smaller size clothes, and my health has improved so much.  I love life now.”

Not one to sit still, Joan is taking full advantage of her heightened energy, fulfilling her two passions of working and helping people.  She works part-time as a bookkeeper for a CPA and serves as treasurer for two community groups – Lake City Newcomers and Marion Place Homeowners Association.  No matter what, she makes time for exercise, and nearly every day she walks or rides her stationary bike. 

“I’ve never been happier,” she says.  “I’m proud of myself.”

Her advice to those considering weight loss surgery is to learn their options.  A decision to have the procedure must be followed by sticking to the program carefully.  More than anything, it’s key to remember gastric banding is a tool for losing weight and still involves commitment and work.

Today we are encouring everyone to pull out their dusty pair of sneakers and hit the pavement for it is National Start! Walking Day.  Here are a few ideas to help you get involved!

1. Take your dog for a walk.  It’s great exercise for you and your furry friend.
2. Take an evening stroll with a friend or family member.
3. Choose to take the stairs whenever you can. 
4. Park your car further away from the entrance at work or when shopping.
5. Squeeze in a quick stroll around the office during your lunch break.

Jill had gastric bypass surgery at the Center for Obesity Surgery and Treatment.

Jill Johnson is a great dieter.  Numerous times, she lost 100 pounds on a single diet and exercise plan.  While she had little problem losing the weight, she struggled to keep the weight off.  Within a year or so, she would manage to gain back all those hard-shed pounds.  At her heaviest, 5-foot-7-inch Jill was 273 pounds and wore a plus-size 24.

After a lifetime of a wild roller coaster ride of gaining and losing, Jill had enough.

“I finally admitted it to myself,” Jill says.  “I was incapable of losing weight and sustaining the weight loss with diet and exercise alone.”

As an advanced nurse practitioner, Jill realized that weight loss surgery, coupled with diet and exercise, would offer her the best chance of losing the weight and keeping it off.

In September 2007, Dr. Timothy Hipp performed gastric bypass surgery for Jill.  At the time of her surgery, she weighed 230 pounds.  Post-surgery, Jill reached a normal, healthy weight with ease.  But more importantly, she has not regained any of the weight.  In January 2011, Jill weighed 130 pounds.  Now a size 4, she has dropped more than 20 sizes from her heaviest.

Beyond her improved health and newfound energy, weight loss surgery has affected her love life.  She was single for 30 years prior to having surgery.

“I had resigned myself to the fact that I would probably live out the rest of my life with no partner,” Jill explains.  “This was because I had such a poor self image due to the constant fluctuation in my body size and the resultant changes in my appearance.”

In one of her most dramatic life changes yet, Jill started dating after her three-decade-long relationship hiatus.  She met Brian, discovering that it was possible for her to be in a loving and lasting relationship.

Although she appears to be younger, Jill is now 62 years old and has retired.  Ironically, she now how more energy than ever before.  Her son and daughter-in-law are avid cyclists, so despite the fact that Jill hadn’t been on a bike in 50 years, she bought a bicycle.  She and Brian, both fresh-air junkies, spend their free time in the great outdoors.

Jill’s advice to those considering weight loss surgery is to take action now.  Weight loss surgery is not a magical solution, she says, but it does make what was once impossible become possible.

For those patients who choose a Gastric banding procedure, adjustments will be necessary. As you may remember, the gastric band is “empty” when it is originally placed around your stomach. By “empty” we mean that there is not any saline in the portion of the bag that can change size and taper the upper portion of your stomach.

When you go in for adjustments, saline will be inserted into the gastric band through the port in your abdomen. The saline fills the expandable portion of the gastric band and changes the size of the upper portion of your stomach, thereby helping you to control your food intake. You will be scheduled to come in for your first gastric band adjustment four weeks after your surgery, unless your doctor tells you otherwise. In general, gastric band adjustments will be performed when you come on for a checkup with us. You will have multiple adjustments over the first year or two, until we work together to target the best fit for your body. Do not worry: the process is fast, easy and pain free. Our experienced staff performs gastric band adjustments regularly so you are in good hands.

After an adjustment you will need to expect some things. Nothing major, just guidelines that you will need to follow to stay on track.

Diet

Immediately after an adjustment you will have to follow a specific diet. It will remind you of the diet you followed initially after surgery, but it will move much faster from a time standpoint. Follow this diet exactly so that your body has time to adjust to the change in the size of your gastric band.

• Liquid Diet (first two days)- This stage begins immediately after your adjustment. For the first few hours (or up to a day) you will want to drink clear liquids. Soon you will be back to your favorite bariatric liquids until the end of this stage. Remember to drink 64 ounces a day and to include your proteins. Skim milk and doctor approved protein shakes are great choices.
• Soft Foods ( days 3 and 4)- The next stage puts you back on soft foods. You will be eating three meals a day and still drinking your 64 ounces of liquid in between meals. Remember to include protein, so have a shake if you need to. Try some tasty soft foods like:
  • Avocado
  • Sweet Potato
  • Egg Whites
  • Cottage Cheese
  • Skinless Steamed Veggies

Keep in mind that your stomach may still be adjusting in general. Stick to foods that you know agree with you. If you want to try a new food, we suggest adding the new food into your diet slowly. We also suggest that you wait until in between adjustments to expand your diet; you do not want to give your stomach too much change all at the same time.

Make Sure the Adjustment was Correct

Once the band is adjusted, you will need to pay attention to ensure a good fit. A band that is too tight can make you uncomfortable. Come back and see us for a readjustment if you are experiencing:

• Difficulty swallowing
• Regular heart burn
• Regurgitation
• Coughing fits that wake you up

Most often the adjustments you will receive are correct. Keep in mind that band adjustments are a process that takes time and communication between you and your medical staff. Every person is a little different, and as a result every adjustment is, too. With time and communication, your doctor will find the right saline levels for your comfort and weight loss goals.

Time for Another Adjustment

After your adjustment you will need to watch for some changes that tell you it is time for another. When you see these signs, you are in the “Green Zone” as we like to call it.

• Feeling hungry in between 3 balanced meals even though you are still drinking 64 ounces of fluids a day
• Increased ability to eat larger quantities of food without feeling full
• You stop gradual weight loss of 1 to 2 pounds a week

If you have any questions about maintaining weight loss after your bariatric surgery or if you would like to find out more about the procedures and how they can help you visit us.

Sources:
University of California San Diego Medical Center
Lap Band Surgery Site.com

Related Posts:
Maintaining Weight Loss
Avoiding Unexpected Sickness after Surgery
Signs You May Need a Gastric Band Adjustment