Smoking and Bariatric Surgery

Tobacco use continues to be the leading cause of preventable death in the United States and the world. According to the Centers for Disease Control and Prevention, the prevalence of tobacco use among bariatric surgery candidates is similar to, if not greater than, the general population. However, tobacco use is a well-documented surgical risk factor.

Substantial research has examined the impact of tobacco use on bariatric surgery in particular. For instance, while the mortality risk associated with bariatric surgery is generally low (less than 1%), death is twice as likely for active tobacco users.

A history of and/or active smoking has also been shown to increase the risk of developing postoperative complications among bariatric surgery patients. Patients who smoked within one year of having bariatric surgery, compared to their nonsmoking counterparts, were 1.5 times more likely to develop any surgery-related problem within one month of having surgery.

Smoking can potentially disrupt breathing capacity and lung function in patients. Research reveals an association between tobacco use and respiratory complications following bariatric surgery. Patients who smoked cigarettes within one year of having bariatric surgery were at increased risk for developing pneumonia.

Smoking, defined as smoking one or more cigarettes per day, was shown to increase the likelihood of developing marginal ulcers and wound rupture postoperatively. A history of or active tobacco use was also shown to predict not only the development but also recurrence of marginal ulcers up to 12 months after bariatric surgery. In addition, slower rates of wound healing and infection have been noted more generally among surgery candidates who use tobacco. With higher complication rates during and after surgery, the potential for prolonged hospitalization also increases. Preliminary research suggests patients who smoke within a month of surgery may also require higher dosing of opioid medication for postoperative pain management.

In the face of these and other potential risks, many bariatric surgery-related guidelines exist for addressing tobacco use. The latest evidence-based bariatric surgery guidelines recommend advising tobacco users to quit tobacco at least six weeks prior to bariatric surgery, as well as, provide tobacco users with the necessary support for maintaining long-term abstinence.

If you are considering bariatric surgery, contact VIPSurg for a consultation. If you are a smoker, he can get you the help and support you need to quit so that you can have surgery and become a healthier you!

Quitting smoking concept. Hand is refusing cigarette offer.

Healthy Strategies for the Holiday Party Season

Holiday parties may seem exciting enough to forgo healthy eating, but they aren’t as exciting as sticking to your eating plan and living a longer, healthier life. Work these tips into your party routine so that you can stick to your plan without missing a thing (other than calories you don’t need! Wink, wink).

There are plenty of party foods that are naturally low in calories and seem equally merry. Go for crudités, lean deli meats, chicken kebabs, salsa (instead of using chips, spoon up thicker salsa straight from your plate or with a piece of chicken), steamed asparagus, boiled shrimp, and grapes. On a cheese tray, go for lower-calorie selections such as soft goat cheese and feta, and consider skipping the crackers when eating hard cheeses.

It’s a good idea to have a strategy:

  • Eat your calories: An easy way to cut calories without thinking is just to watch the liquid calories. Each glass of wine can be over 100 calories, and that’s not to mention the spiced or chocolate drinks you may be tempted with on the side. Determine exactly how many glasses you want to enjoy before heading into the party so that you can plan accordingly. A pre-party workout can help you counterbalance a glass or two with little to no damage.
  • Balance is key: Try to balance out your plate with enough vegetables, protein, and whole grains. It helps to load the veggies on your plate first, then protein, so that you’re guaranteed to get enough nutrients without splurging on the first plate of carbohydrates you see. Remember that you can always go back for more.
  • Slow down: Holiday parties can actually help slow the pace of your eating because of all the excitement going on. Think about enjoying the flavors as well as your company with every bite.
  • Don’t save up: A lot of people out there will save their appetite before big nights so that they can enjoy more of the delicious food that’s being offered. Waiting too long to eat will not only send your body into starvation mode, but it will also shrink your stomach so that you feel full sooner when you do start to indulge. Eating throughout the day will maintain insulin levels and combat a possible dinner binge, so try to digest something every three hours.

If you are considering bariatric surgery, schedule an appointment at VIP Surg. Their expert team can help you find the perfect solution for you.

Celebrating vegan party at home

What Does Moderation Mean to You?

“Everything in moderation,” says a friend who drinks one glass of wine every day.

“Everything in moderation,” says the personal trainer at the gym as she munches on dry carrot sticks. 

What is moderation? If the concept of moderation confuses you, you’re not alone. Everyone defines it differently. Eating in moderation is a subjective term, meaning something slightly different depending on your perspective. While it’s seemingly a simple question, individual perceptions of reasonable limits would provide a multitude of answers.

At one end of the spectrum, there are those who don’t put much thought into eating a healthy and well-balanced diet. Convenience and taste are the main factors influencing their dietary decisions.

At the opposite end, one may find those who label food as either wholesome and pure or downright evil, with seldom anything in between. Typical “bad” foods such as sugar, carbs, dairy, and processed or refined foods are avoided at all costs.

Both extremes can have detrimental effects on health. Eating calorie-dense foods high in sugar, fat, and salt on a regular basis, combined with a sedentary lifestyle increases the risk of chronic diseases like heart disease, obesity, and diabetes.

However, cutting out entire food groups without replacing missing nutrients can also pose problems. While “clean eating” might come in an attractive package, severe restrictions can lead to cycles of binge eating, feelings of guilt and shame, and further restriction.

Toward which end of the spectrum do you tend to lean? Where is the fine middle ground?

Eating in moderation means you do not consume more calories than your body needs to function properly. A person who does not eat a moderate number of calories gains weight, risking obesity and its associated illnesses.

The quality of the food is also an important factor when talking about eating in moderation. Consuming food your body does not need or want, such as excess sugar and fat has a detrimental effect on your body.

Eating in moderation means consuming nutritionally dense food so your body gets all the vitamins and minerals it needs without harmful or needless substances. According to the MyPlate scheme from the USDA, a healthy dinner plate contains lean protein, whole-grain foods, fruits and vegetables.

Plan your plate to ensure you are eating the proper foods in moderation. Draw an imaginary line down the middle of your plate. Fill the left half your plate with fruits and vegetables. Draw another imaginary line to cut the right half of your plate into two quarters. Fill one section with lean meat and put whole-grain products in the other section.

Moderation is about a healthy relationship with food – balancing the pleasure of eating with our basic need for sustenance. It is realizing that eating one piece of cake a week probably won’t kill you, but that doing so everyday just might.

If you are fighting obesity and metabolic disease, schedule a consultation at VIPSURG. Dr. Tsuda and his team of experts can help you find the right treatment for your unique situation.

Healthy eating habits with fruit

Give Thanks with a Healthy Lifestyle

If you’re trying to live healthily by exercising and eating right, the up-coming holiday season can pose some serious challenges. During any holiday—especially Thanksgiving—people have a lot of food put in front of them. Many times, it is way too much food for even the best of metabolisms to handle without putting on a few pounds. The question is, how do you enjoy the holidays without derailing your health goals?

During Thanksgiving, it’s easy to go overboard with the calories and consumption. Temptations of gooey pecan pie and dense sweet potatoes topped with crackly marshmallows make it seem impossible to be disciplined.

Here’s the thing — eating healthfully on Thanksgiving doesn’t mean you have to skip all your favorite foods. If you’ve got your eating under control most of the time, go ahead and have a piece of pie — just don’t lose control entirely.

These tips can help you keep your willpower and your wits about you this Thanksgiving:

  • Stick to healthy portions. Fill up half your plate with vegetables, fruit, and a whole wheat roll, a quarter of it with mashed potatoes or sweet potatoes, and a quarter of it with turkey or ham. The more colorful your plate, the better – so get lots of leafy greens, carrots, bell peppers, and beets in your veggie selection. If you fill up on those lower caloric density and higher nutrition things, you’re going to feel full, but not bloated and tired.

It’s a holiday, so indulge a bit if your diet allows it. If you’re going to eat dessert, make sure you allot for the calories elsewhere – don’t go back for that second helping of marshmallow sweet potatoes; instead opt for the cranberry salad.

  • Eat before you indulge. Don’t starve yourself during the early part of Thanksgiving Day thinking that you’re saving room or that this will make it okay for you to overeat later. 

If you’re going to a Thanksgiving lunch, be sure to eat breakfast before. If you’re going to a dinner, be sure you eat lunch or have a snack in the afternoon. You should have your normal meals because whenever we get overly hungry, we tend to overeat.

  • Substitute healthy ingredients for unhealthy ones. There are plenty of ways to make Thanksgiving fare healthier. For mashed potatoes, consider mixing in chicken broth, herbs, or roasted garlic to perk up the flavor instead of adding in butter. For green bean casserole, swap out fried onions with toasted almonds for a less-fatty alternative, and instead of having cranberry sauce, opt instead to make a cranberry salad. 
  • Drink lots of water and take a walk after eating. Many times, when people think they are hungry, they are just thirsty. By drinking lots of water throughout the day, you’ll lower the risk of overeating. Keep in mind that alcohol not only has lots of calories, but it’s effects can also lower your willpower for keeping to your healthy lifestyle choices.

It’s also a good idea to take a walk after eating to get your metabolism going instead of lazing on the couch. Ultimately, you’ll sleep much better that night if you do a little exercise after eating rather that falling into a food coma.

All of us at VIPSurg wish you and yours a happy, healthy, and safe Thanksgiving! We are here to help with your bariatric and general surgery needs.

Whole Homemade Thanksgiving Turkey

Could Bariatric Surgery Be the Right Choice for You?

Invest in your health advice on blackboard

Weight-loss surgery is a major, permanent life change. Most people don’t even consider it if they haven’t exhausted all other options. As a matter of fact, many people research weight-loss surgery for years and never act. Whether it is fear of a drastic life change or fear of failure, making this choice could be a matter of life and death.

The truth is, bariatric treatment could drastically improve the health, happiness, and lifespan for millions of Americans who currently qualify for it. If you are one of them, and you’re hesitating to have the surgery, here are some things to think about:

Why are you considering bariatric surgery? 

  • Obesity-related health problems
  • Depression
  • Out of breath quickly
  • Obesity discrimination
  • Relationship problems
  • Poor self-image
  • Failed diet and exercise programs

If you and your bariatric doctors decide that surgery makes sense for you, be prepared to do a lot of work both before surgery and for the rest of your life. Bariatric surgery should be thought of as one of the most effective tools available, but in order to succeed you must be ready to completely change your life.

According to the National Institutes of Health guidelines, you could be a good candidate for bariatric treatment if one of the following applies…

  • You have a body mass index (BMI) of 40 or more (“morbidly obese” or “super obese”)

OR

  • Your BMI is between 35 and 39.9 (“severely obese”), and you have a serious obesity-related health problem.

As mentioned above, bariatric treatment may be the best tool to make you happier and healthier, but that’s all it is — a tool. You will be the key to making it successful.

If you would like to talk to a doctor to see if bariatric surgery is a good option for you, schedule a consultation at VIPSurg. Their team of experts can help you make the right decision for your unique situation.

 

The Complexity of Obesity

People generally assume that obesity is strictly the product of bad choices about physical activity and diet. That kind of thinking gets in the way of dealing with obesity as a health condition.

Obesity is a very complicated condition. About 50 to 70% of one’s risk of obesity is genetically determined. You can make choices that make it better or worse, but that’s just like any other chronic disease. When the blame and shame that is so common gets in the way, it makes it hard to improve the health of people living with obesity.

A lot of health plans have broad, blanket exclusions for obesity, thinking that it is a cosmetic condition. However, the rise in the prevalence of obesity over the last 3 decades has made it clear that it’s creating a burden of chronic disease ranging from cardiovascular disease to diabetes to many cancers.

Because weight-based stereotypes and prejudice so often come from thinking that obesity is caused and sustained by personal characteristics such as laziness or lack of willpower, there is a need for increased public awareness and education about the complex biology of obesity and the significant obstacles present in efforts to achieve sustainable weight loss. The prevailing societal and media messages that reinforce blame on obese persons need to be replaced with messages that obesity is a chronic disease with a complex etiology. Obesity is a lifelong condition for most people who are overweight or obese.

Several studies have consistently demonstrated that experiencing weight stigma increases the likelihood of engaging in unhealthy eating behaviors and lower levels of physical activity, both of which exacerbate obesity and weight gain. Among youths, studies have demonstrated that overweight children who experience weight-based teasing are more likely to engage in binge eating and unhealthy weight-control behaviors compared with overweight peers who are not teased, even after control for variables such as BMI and socioeconomic status. 

Other research has consistently documented a positive association between weight-based victimization and eating disorder symptoms and bulimia. Weight-based victimization among overweight youths has been linked to lower levels of physical activity, negative attitudes about sports, and lower participation in physical activity among overweight students.

If you’re looking for treatment for this very real, physical disease, contact VipSurg for an appointment. Our expert team understands the complexity of obesity and all the issues that come with it. We can help find the right treatment for you.

Doctor writing word OBESITY with marker, Medical concept

Obesity’s Link to COPD

According to estimates, 6% of American adults have chronic obstructive pulmonary disease (COPD), and 35% of those COPD patients are considered obese. In addition to being common among COPD patients, studies have also suggested that obesity leads to a higher risk of acute exacerbations, indicating that obesity may be a risk factor. 

Now a U.S. study suggests that obese people with COPD who get weight loss surgery may go to the hospital less often with acute breathing problems after their operations. The study found that among obese adults with COPD, those who had bariatric surgery to lose weight, needed to go to the emergency room or have inpatient care half as often as before surgery.

The researchers examined data on 481 obese adults aged 40 to 65 who had COPD and underwent bariatric surgery in California, Florida, and Nebraska. They followed patients from 2005 through 2011 to see how hospital and emergency room visits for COPD in the two years before weight loss surgery compared to the two years afterwards.

At the start of the study, when patients were 13 to 24 months away from getting their operations, 28% of them had an emergency department (ED) or hospital visit for acute COPD symptoms. During the second year of the study, the 12 months right before surgery, these rates didn’t change much, but compared with that first year of the study, the chances of an ED or hospital visit dropped by 65% in the first year after bariatric surgery. 

Just 12% of patients had a COPD visit during that time. During the last year of the study, 13 to 24 months after surgery, the odds of an ED or hospital visit were 61% lower than in the first year of the study. These findings suggest that benefits of bariatric surgery may extend beyond remission of chronic health problems associated with obesity to include COPD and other respiratory conditions.

If you are considering bariatric surgery, schedule a consultation at VIP SURG. Their expert team can help you find the right treatment for your unique situation.

Elderlay woman with oxygen suplement (COPD)