Nicholson Clinic Blog

Mississippi has kept its U.S. heavyweight title for a fifth straight year, among both adults and children.

The percentage of adults classified as obese went up in 23 states, but Mississippi, with 32.5 percent, stayed atop the latest annual rankings by the Robert Wood Johnson Foundation and the Trust for America’s Health. The same survey put the state’s adult obesity rate at 31.7 percent in 2008.

In addition, 44.4 percent of Mississippi children ages 10 to 17 are classified as overweight or obese, the study found.

Doctors have linked obesity to increased risks of a variety of conditions, including diabetes, hypertension, arthritis and heart disease. Wednesday’s study found the current U.S. economic slump could worsen the problem by putting more nutritious food out of the reach of struggling families.

Mississippi Tops US Obesity Rankings via CNN.com

If you’re either considering weight loss surgery or have just recently had surgery for obesity, you are most likely contemplating adding in exercise to your routine. Of course, exercise is the right solution to add to your lifestyle along with making healthier eating choices. However, not all exercises are created equally for all people. Exercises that work for people with normal Body Mass Indexes may not work well for individuals who are obese. You’ll need to tailor some exercise to obtain the positive benefits of exercise while being success at doing so at the same time.

First, here are concerns to consider:

• Some exercise machines are difficult to use and can cause back and knee problems.
• Swimming is a wonderful exercise program for obese individuals, but you may be self conscious in a swimsuit.
• Stationary bikes and weight benches are sound options at gyms, but the equipment may seem small and unsteady if you are obese.

These considerations aren’t a reason for NOT choosing these types of exercise programs, but they can be issues you want to review ahead of time. You can easily begin an exercise program by choosing inexpensive equipment in your own home (such as an exercise bike) and then changing out the seat for one you are more comfortable with, for example. Even when you meet your weight loss goals, you will likely find that the seat of your choosing is still more comfortable than the one the bike originally came with.

If you are self-conscious swimming in a public pool, consider whether you can ask a friend or family member with a backyard pool if you can begin using their pool when it is not in use so you can begin exercise programs private. If you are overwhelmed or uncomfortable with the various equipment and how to use the machines properly at a workout gym, consider hiring a personal trainer who can work with you on what can work best and then help show you the machines to use and the ones to avoid — at least initially.

Finally, consider choosing simple exercise programs such as walking and similar programs you can do in the privacy of your own home as a place to start. Once you begin to feel better about yourself and start losing weight, you can always alter your exercise program to change along with your fitness level. We have suggestions on exercise programs and ways to begin a healthier, more active lifestyle. Our staff is always glad to answer your questions, so please don’t ever hesitate to ask!

Fast food, processed foods are high in calories. But, at least according to the former Surgeon General, companies produce these foods specifically to induce craving for more — which ultimately alters brain circuitry to cause some heightened level of physiological need.

Few would take exception to the assertion that obesity is an enormous health problem in the United States. There is less agreement, however, on how to combat the problem. David Kessler’s new book, The End of Overeating: Taking Control of the Insatiable American Appetite offers a compelling case that to prevent overeating–and hence obesity–people should avoid processed foods as well as many popular chain restaurants such as Olive Garden and Chili’s. The advice is consistent with what many experts who treat or research obesity have been recommending, but not entirely for the same reason.

Many of us recommend avoiding fast food in particular, and eating out in general, because of the tremendous number of calories in many of the meals offered. Although some fast food restaurants, such as McDonalds, have recently started offering some healthier options, most of the menu items are high in fat and calories. A recent study found that the average lunchtime purchase from a fast food restaurant in New York City contained more than 800 calories–far more calories than most people should be eating at lunch.

Kessler argues not only will you consume too many calories by eating processed foods; they will also cause changes in your brain circuitry, making you crave them in the future.

Read The Real Reasons We Overeat at The Atlantic Food Channel

While weight-loss surgery has typically been targeted to obese adults who have not been able to lose weight through dieting or exercise, a growing number of teenagers are having lap band surgery to overcome obesity.

In addition to helping teenagers overcome problems associated with obesity such as diabetes, heart disease, high blood pressure and sleep apnea, the surgery also helps teens develop an improved self esteem. In recognition that solving problems related to obesity when a person is young improves health and lessens medical needs in the long run, more and more insurance companies are covering the procedure.

Having weight-loss surgery is still considered an option of last resort for teenager. The first recommendation is dieting combined with increased exercise. Certain medications can also be considered. But when weight-loss surgery is agreed to, the result can be life-altering for a teenager or young adult physically as well as emotionally, and start a path toward healthy eating and living.

Teens considering weight-loss surgery should receive counseling as well as nutritional guidance about eating choices and how their food consumption and sedentary lifestyle will need to change after a surgery in order to keep the weight off for the rest of their lifetime.

Teens and their parents are invited to attend one of our upcoming free seminars to learn more about the procedures and whether weight-loss surgery is something worth considering.

If I choose to undergo weight loss surgery, will I still be able to smoke?
Patients who smoke cigarettes are asked to quit six to eight weeks prior to LAP-BAND/REALIZE Band or gastric bypass weight loss surgery.

Why is exercise important after weight loss surgery?
Not only does exercise burn calories, it also helps to build and preserve muscle. If you don’t exercise daily, your body will consume your unused muscle as you lose weight. This will cause you to lose muscle mass and strength. For this reason, patients are encouraged to begin exercising soon after LAP-BAND/REALIZE Band or gastric bypass surgery. Visit our practice to discuss which type of exercise is appropriate following surgery.

FAQ: Plastic Surgery & Alcohol

FAQ: Expectations, Reversible, & Guidelines

FAQ: Insurance Coverage & Letter of Medical Necessity

13% of American adults have it, and 40% of them don’t know it.

Diabetes is sometimes called the gateway disease because it can lead to so many other health complications. Here’s a look at the effect diabetes, left unchecked, can have on your body:

• Brain – Depression strikes 15% to 20% of people with diabetes, making it difficult to follow the healthy-living recommendations that help keep the condition well-managed.
• Eyes – High blood glucose levels (and high blood pressure, common in people with diabetes) can damage the tiny sensitive blood vessels in the eyes, leading to vision loss and blindness.
• Heart – People with diabetes are twice as likely to develop heart disease and stroke than those without diabetes. They also tend to develop these problems at younger ages than other people.
• Stomach – Poorly controlled diabetes can lead to damage in the nerves that help control digestion. Gastroparesis occurs when food lingers in the stomach longer than it should, causing heartburn, bloating, nausea, and vomiting.
• Digestive System – Nerve problems caused by diabetes can cause changes in digestion, bowel and bladder function, as well as urinary tract infections.
• Kidneys – Diabetes is the most common cause of kidney failure, responsible for 44% of cases. With kidney failure, the body can not rid itself of waste. While kidney failure builds gradually over many years, ultimately people need either dialysis or a kidney transplant to treat it.
• Sexual Organs – Both men and women with diabetes may see changes in their sexual response, and between 35% and 50% of men with diabetes develop erectile dysfunction.
• Legs – Diabetic nerve damage can lead to pain in the thighs, hips, and buttocks and cause weakness in the legs.
• Hands and Feet – About 60% to 70% of people with diabetes develop nerve damage, most commonly in the hands and feet, causing pain or loss of sensation, the latter of which can result in open sores, ulcers and infections of which the patient is unaware.

Dr. Nick Nicholson says that “it’s not uncommon for people to be off all diabetes medications within three months after weight loss surgery. Some people don’t need medication less than a week after bypass surgery.” He goes on to say that “The bottom line is, as things stand right now, the only effective treatment we have for diabetes in obese patients is weight loss surgery.”

Fourth of July is quickly approaching, and weather forecasts indicate we can expect hot (but not too hot) and clear skies — the making of a perfect celebration. Many families celebrate with a day at the lake or backyard pool, culminating with the watching of a spectacular fireworks display. Of course, throughout all the day’s celebrations will be food, and typically an overabundance of it!

If you’ve had weight loss surgery and are watching what you eat, or are just trying to not overdo it on this day, you won’t be surprised that many people consume enough calories on a single day for what is recommended for two or three days — sometimes even more! What might surprise you, however, is which foods have the greatest calories.

Grilling is a traditional favorite for 4th of July celebrations — and the spread may include steaks, ribs, chicken, and pork — sometimes a combination of them all. But grilling is the healthiest approach for eating meats, and as long as you don’t overdo quantities, meats can provide a great nutritional benefit and not overdo the calories. It’s the fattening side dishes, appetizers, and ice cream that can you your diet in, however.

Salads are often made with fattening mayonnaise, dripping with oils, cheese, breads, and more, and you’re often so busy socializing with friends and family that you may not realize how much you’ve consumed. Chips and dips can also pack on the pounds as can cobblers, pies and cakes. And alcoholic drinks, especially those made in a blender, can sometimes be a whopping 500-700 calories each! (Remember, we recommend refraining from alcohol consumption the first year after weight-loss surgery anyway!)

The good news is that most spreads are balanced with healthier foods along with the fattening ones, and you can pick and choose carefully so that you can still enjoy the outing without making a big deal over your selections. Most outdoor celebrations include fresh veggies and fruit (just stay away from the fattening dips like Ranch dressing and heavy whipped creams), and low-fat salads. Another good reason to stay away from potato salads, slaws, and the like? Those salads have ingredients that can quickly spoil when out in the heat, leading to food poisoning or at the very least, upset stomachs.

And while you’re celebrating America’s Independence Day, you can also celebrate the new, slimmer and healthier, you!

Losing the weight doesn’t always shed a person’s large self-image, according to a study conducted by a psychologist who studies body image and counsels obese people undergoing bariatric surgery.

Although people who have weight-loss surgery and then lose significant weight may look great on the outside — especially as compared to their former self — in their minds they are still obese. The notion of being unable to embrace a new self-image is called a phantom fat phenomenon.

Body-image consultants and psychologists agree that it can take time and sometimes even counseling to help individuals who have lost weight to truly accept their new image. Some experts believe that it may happen because the brain hasn’t “caught up” with the new body, especially for people who have been obese for significant time and then suddenly begin to experience steady weight loss. Another reason for the possible phantom fat image is because weight loss doesn’t necessarily mean that the perfect body comes with it. Depending on a person’s age and overall condition before surgery, the individual may still have cellulite, excess skin, or a so-called “lumpy body.”

Our staff at Nicholson Clinic understands that weight-loss surgery is a lifestyle change that doesn’t start or stop with the weight loss surgery itself. Our staff is here to support you along the way to a healthier and fit lifestyle before, during and after the surgery you determine is right for you. We’ll be there to help you to feel more comfortable with the surgery and confident about yourself, and will answer questions or concerns to help you achieve your weight loss goals.

We have three free seminars scheduled in July to help you learn more about weight loss surgery and the various options that may be available to you.

If you’re considering lap band surgery as an option to lose weight and to meet your goal of improved fitness, recovery time is one of the first questions typically asked. The answer? It depends on the individual person, of course, but in general recovery time is between and four and eight days to be back to feeling your best.

While you can technically be back at work as soon as the day after surgery, we highly recommend that you don’t. You may or not feel like it, first of all, but even if you do, your body needs an opportunity to rest and recover. No matter how minor, any type of surgery has an effect on your body. If possible, allow for a leisurely recovery time, and then you can always return to work earlier if you feel good.

Time off to relax and recover is important for many reasons. First, relaxation allows your incision an ample opportunity to heal. Second, you may feel discomfort initially and then soreness for a few days after, although the amount may vary greatly from person to person. Some people don’t feel discomfort at all, while others need a longer recovery time to feel better at the incision site. Third, you may feel week from dietary limitations both before surgery and after surgery. And finally, we ask for you to not shower for a day or so to minimize the possibility of an infection at the incision site. Not showering gives you some extra time to recover and just “chill,” so plan to take full advantage of it!

Once you do return to work, make sure you take it easy and slow and allow your body some additional time to heal fully. Don’t overextend yourself or engage in physical activity during this time. In about two or three weeks, your body should be recovered to the point that all normal activities can be resumed.

Will I need to undergo plastic surgery to eliminate excess skin? Will it be covered by insurance?

After losing weight, many patients find that they are left with large amounts of excess, saggy skin on their bodies. To remove this skin, some patients choose to undergo plastic surgery. Since this is considered cosmetic surgery, it is typically not covered by insurance. Therefore, patients who think they might like to have plastic surgery to remove excess skin should save money for it as soon as they decide to undergo LAP BAND surgery or gastric bypass weight loss surgery at our practice.

Can I drink alcohol after undergoing weight loss surgery?

After undergoing gastric bypass weight loss surgery, you will find that even small amounts of alcohol will affect you quickly. For the first year, it is suggested that you completely refrain from drinking alcohol. After that, you may have small amounts of alcohol with your doctor’s approval. Patients who undergo LAP-BAND/REALIZE Band surgery or gastric bypass surgery should avoid alcoholic drinks because they tend to be high in calories and can hamper weight loss.

Check out our blog post “Why Alcohol and Weight Loss Don’t Go Together” and “Long Island Iced Tea – How Many Calories?“