What is Your BMI?

Obesity_and_BMIThese days when you go to your doctor, the topic of weight is often discussed in terms of body mass index (BMI) rather than pounds alone. BMI is a measure of body fat based on one’s height and weight. BMI is a fairly reliable indicator of body fatness for most people. BMI does not measure body fat directly, but can be considered an alternative for direct measures of body fat. Additionally, BMI is an inexpensive and easy-to-perform method of screening for weight categories that may lead to health problems.

For adults 20 years old and older, BMI is interpreted using standard weight status categories that are the same for all ages and for both men and women. For children and teens, on the other hand, the interpretation of BMI is both age- and sex-specific.

The standard weight status categories associated with BMI ranges for adults are shown in the following table:

BMI Weight Status

Below 18.5 Underweight

18.5 – 24.9 Normal

25.0 – 29.9 Overweight

30.0 and Above Obese

It is important to remember that BMI is only one factor related to risk for disease. For assessing someone’s likelihood of developing overweight- or obesity-related diseases, the National Heart, Lung, and Blood Institute guidelines recommend looking at two other predictors:

* The individual’s waist circumference (because abdominal fat is a predictor of risk for obesity-related diseases).

* Other risk factors the individual has for diseases and conditions associated with obesity (for example, high blood pressure or physical inactivity).

If you are trying to lose weight, BMI is one of the ways to track your progress, but you can get a clearer picture of your body composition if you use that number along with weighing yourself on a reliable bathroom scale and using a tape measure to track your waist circumference.

Consult with Dr. Shawn Tsuda to see what weight-loss options are available for you.

Read more about this topic online at: http://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

Guide To Weight-Loss Surgery

If you are obese and suffer from any of the dangerous health problems associated with obesity, you may be considering bariatric (weight-loss) surgery to help you lose weight and get on the road to better health. Even if you and your doctors have decided that this is a good option for you, choosing which bariatric procedure can be a bit overwhelming. Learning about them can help calm confusion and fear.

Bariatric Surgery Types

Bariatric surgery contributes to weight loss in two ways:

* Restriction – surgery that physically restricts the amount of food your stomach can hold, which limits the amount of calories you can eat.

* Malabsorption – surgery that shortens or bypasses part of the small intestine, reducing the amount of calories and nutrients the body absorbs.

Two surgery types that work through restriction:

* Adjustable Gastric Banding – a band with an inflatable balloon in it is placed around the upper part of the stomach restricting the amount of food/calories the stomach can hold.

* Sleeve Gastrectomy – a large part of the stomach is actually removed from the body, forming a new, smaller stomach restricting the amount of food/calories and causing less production of the hormone that causes hunger.

Two surgery types that work through malabsorption:

* Roux-en-Y Gastric Bypass – a small pouch is created at the top of the stomach, drastically reducing the amount one can comfortably eat. Part of the small intestine is cut and attached to the new pouch. Because food now bypasses part of the small intestine, less calories and nutrients are absorbed.

* Duodenal Switch with Biliopancreatic Diversion – this procedure begins with the surgeon removing a large part of the stomach. The valve that releases food to the small intestine is left, along with duodenum. The middle section of the intestine is closed off and the last part is attached directly to the duodenum. The separated section of the intestine isn’t removed; it’s reattached to the end of the intestine, allowing bile and pancreatic digestive juices to flow into this part of the intestine. Food therefore bypasses most of the small intestine, limiting the absorption of calories and nutrients.

If you are considering weight-loss surgery, contact Dr. Shawn Tsuda for a consultation. Read more online at: http://www.mayoclinic.org/tests-procedures/bariatric-surgery/in-depth/weight-loss-surgery/ART-20045334?pg=2

Love after Losing Weight: Handling Intimacy after Bariatric Surgery

Valentine's DayIntimacy can be difficult for even those with the best self-image. After perhaps a lifetime of a less-than-stellar body image, obese people who undergo bariatric surgery often have problems establishing or reestablishing intimacy within relationships. Existing partners are often afraid of hurting their loved ones both physically and emotionally, and the one who is losing the weight isn’t yet comfortable in his or her new, changing body. There are things one can do, however, to help ease the transition and kick-start a new, exciting, and sensual life.

1. Exercise: It’s what you are supposed to do anyway, and believe it or not, exercise can help with more than the weight loss. Physical activity sends blood to important large muscles including the pelvis. Ultimately, better circulation make things happen.

2. Eat right: Following a bariatric diet low in fat and sugar can help lower high blood pressure and blood sugar, helping to turn around a low sex drive in you and your partner.

3. Think about sex: If stressors like bills, job, and other responsibilities are keeping your mind tied up, it might be hard to spark libido. The book Fifty Shades of Gray is popular for a reason. Make time for yourself. Whether reading a romance novel or something more explicit, focusing on sex can boost desire and drive.

Making the decision to have bariatric surgery is an intensely private and personal matter. You’ve made that difficult decision already, so now take the next step toward making your life what you have always wished it could be. This year on February 14th, whether you are in a relationship or not, love yourself. For some, getting physical problems under control is all it takes to increase libido. Don’t let the years of negative thinking and poor self-image haunt you. Don’t buy into society’s messages about the perfect sexual body, be your own sexual person inside the body you have. Happy Valentine’s Day from Dr. Shawn Tsuda!

Bariatric Surgery: STAMPEDE your way to a Healthy You

STAMPEDEBlogWhile not the first study to find that bariatric surgery may help reverse type 2 diabetes, a trial conducted by the Cleveland Clinic and published in the New England Journal of Medicine (NEJM), the STAMPEDE (Surgical Therapy and Medications Potentially Eradicate Diabetes Efficiently) trial, is the largest randomized trial to date.

For the study, which was also presented at the Annual Scientific Session of the American College of Cardiology in Washington, D.C., a third of patients underwent gastric bypass surgery with medications. Another third of patients in the study had a sleeve gastrectomy, and then took medications. The remaining third received only medications and psychological counseling.

Results showed that after three years, 37.5 percent of patients who had gastric bypass surgery were able to stabilize their blood sugar to healthy levels without medication; 24.5 percent of patients who underwent the sleeve gastrectomy were able to control their blood sugar without medications; while just five percent of patients who received only medication and counseling were able to successfully control their diabetes.

The researchers also found that participants who had bariatric surgery showed significant reduction in conditions associated with metabolic syndrome (a group of risk factors associated with obesity) including high blood pressure and poor kidney function. Only 5 to 10 percent of bariatric patients needed cardiovascular and glucose lowering medication, compared with 55 percent who only received medication and counseling.

The STAMPEDE trial was first published in the NEJM in 2012, but as this new data shows, the results have stood the test of 3 years’ time. No surgery is without risks, but for people with type 2 diabetes and metabolic syndrome, the benefits appear to be worth it.

If you are considering weight-loss surgery, contact Dr. Shawn Tsuda for a consultation.

Read more online at: https://weightloss.clevelandclinic.org/ClinicalTrials.aspx?MenuType=2