For anyone deciding it’s time to grab onto a diet plan and hang on for dear life, there are plenty of diets out there. But which to choose?
Anything that fits in the “fad” category is probably not a good fit for you. “People think you can do a fad diet (successfully), but that’s not the case,” says Kristina Greene, registered dietitian and diabetic educator at Methodist Hospital in Crown Point, Ind. “I have some patients who have juiced and lost fifty to sixty pounds -- but they gained it all back. A diet of 500 to 600 calories per day cuts out whole food groups, and that’s not sustainable long term.”
And Lori Granich, registered dietitian (RD) with Franciscan St. Margaret Health in Dyer, Ind., cautions, “Eliminating food groups … puts you at risk for nutritional deficiencies.” Besides, “Eating a wide variety of healthy foods will keep you from being bored.”
So drop the fad notion and go natural. “Losing weight naturally is all about lifestyle changes and sticking to it for the rest of your life,” says Greene. That means, says Granich, “a balanced diet that promotes slow, steady weight loss” -- the kind that stays lost.
How dietitians help
Where to start? Granich explains for a diet tailored to individual needs, a registered dietitian can:
Make you aware of your eating patterns and suggest changes to aid in weight loss;
Identify “calorie creep”: areas of your diet that may be providing more calories than you realize;
Create realistic, attainable goals;
Help you change eating and lifestyle habits.
Design a diet specific to any medical issues.
Be aware the terms “registered dietitian” and “nutritionist” are not interchangeable, says Granich.
“Registered dietitians have met specific academic and professional practice requirements … In some states anyone can refer to themselves as a nutritionist,” with little or no nutrition education or training. You can call your local hospital for a registered dietitian or visit http://www.eatright.org/programs/rdfinder/. If you’ve decided to go it alone or with a structured plan, Jill Kilhefner, RD and certified diabetes educator at Porter Regional Hospital, notes that a recent US News And World Report named the DASH diet, Mediterranean diet and Weight Watchers as the highest recommended..
Kilhefner quashes a fond hope: “There are no magic foods. The proper formula for weight loss is simple: calories in, calories out.” From there, she says, educate yourself. If you’re not seeing an RD, utilize the Internet, free hospital support groups, RD’s cooking classes -- any good sources for information on the best food choices and portion sizes. “Don’t put yourself at risk physically nor nutritionally by trying to recreate the wheel.”
As for setting a goal, “I like to have them choose one activity goal and one dietary goal, and be specific and realistic: how many minutes of activity per week; drinking how much more water,” says Greene, who soon will also be a diet counselor at the Valparaiso YWCA. Keep in mind It takes about a month for a new behavior to become a habit. “Then choose a reward for when the goal is reached, one that will motivate you. Not candy,” she laughs. “Maybe some jewelry, or a trip.”
Ready, set, action
Before starting an exercise regimen, “Absolutely check in with your family physician,” says Kilhefner. Then, says Granich, “Start slowly and gradually increase your intensity and duration,” to avoid injury. Healthy adults can aim for 150 minutes of moderate exercise and two or more days of strength training per week. She suggests changing the routine to stay motivated, and find fun classes like Zumba.
Once you reach your goal weight, keep moving: “It will help you maintain your goal weight.”
And that’s exactly the point of losing weight naturally.
While weight loss surgery produces a new lease on life, one of the negative after-effects tends to be excessive loose neck and facial skin that gives the person an older, more tired look, says Sreek Cherukuri, M.D., a top board-certified facial plastic surgeon and Northwest Indiana’s leader in minimally-invasive cosmetic procedures of the face and neck.
That occurs because the skin and connective tissues in the face and neck stretch over time to accommodate layers of fat as they accumulate, he explains.
“Weight loss surgery makes people feel better and healthier, but they tend to look older. Losing the fat that was underneath the skin leaves the person with jowls as well as loose neck and facial skin,” he says. “Laugh lines and frown lines are more pronounced.”
The Weekend Lift provides a solution that returns the client’s face and neck to a more youthful, naturally-toned look and feel without more major surgery.
Introduced to the area in 2003 by Dr. Cherukuri, the Weekend Lift is mini-facelift that is an excellent alternative to a full facelift. It provides an overall lift to the neck and lower third of the face, whether clients have had weight loss surgery or would like to “freshen” their looks, he says.
“It focuses primarily on trouble spots such as the neck, jowls, mid-face and the lines around the nose and mouth. It is called the Weekend Lift because that is the approximate duration for post-operative recovery,” says Dr. Cherukuri, who performs this and other minimally-invasive cosmetic procedures at Carepointe Facial Plastic Surgery, 801 MacArthur Blvd., Suite 302 in Munster.
There are major advantages to the Weekend Lift compared with traditional full facelift surgery, he says.
• The procedure is performed with local anesthetic rather than under general anesthetic.
• It takes about one hour instead of the usual two to six hours for a traditional facelift.
• There are no major risks and minimal incisions. Incisions start at the hairline and go around the ears. There are no drains or big face bandages and no risk of nerve damage.
• Unlike a full facelift, the Weekend Lift has minimal bruising or swelling.
• Downtime from work or other activities is one to three days, instead of a month or more with traditional facelifts.
• The cost is about one-third of a full facelift.
The natural results of the Weekend Lift also make it a popular alternative to the “wind tunnel” look many celebrities such as Joan Rivers, Bruce Jenner and Kenny Rogers have from major facelifts, he says.
“One of my goals in facial plastic surgery is to produce results that appear as if the person were born with it”, explains Dr. Cherukuri. “In other words, people should not be able to tell if any cosmetic surgery has been performed because the results look so natural.”
For more information, call (219) 836-2201 or visit theweekendlift.com.
It’s tiny gland, but when our thyroids get out of whack, it’s big trouble. According to the American Thyroid Association, more than 12 percent of the U.S. population will develop a thyroid condition during their lifetime and an estimated 20 million Americans have some form of thyroid disease. Of those, up to 60 percent of those with thyroid disease are unaware of their condition.
“Thyroid diseases are generally more common in females than in males,” says Akbar Rahmani, M.D., board certified in internal medicine with a subspecialty in endocrinology with an office in Tinley Park who is on staff at Ingalls Health System. “People can have an overactive or underactive thyroid but underactive is more common.”
People with an underactive thyroids, also called hypothyroidism, tend to experience abnormal weight gain and difficulty losing weight until hormone levels stabilize, says Kristal Markovich, a registered dietitian at Methodist Hospitals.
Symptoms can also include, changes in the menstrual cycle for women, constipation, depression, dry hair and hair loss, dry skin, fatigue, greater sensitivity to cold, slow heart rat and swelling of the thyroid gland.
“That’s why a healthy diet and exercise plan for long term weight loss and maintenance are essential,” she says noting that going on a severe calorie restriction may only leave a person more tired. “Choose lean protein, whole grains, fruits/vegetables and low fat dairy products and follow a healthy diet plan.”
Fortunately treating underactive thyroids is relatively straightforward says Rahmani.
“Underactive thyroids have many causes,” he says. “Someone can be born without a thyroid gland, and so it’s underactive from the get go. Sometimes patients have their thyroids surgically removed because of cancer or part of their thyroids were removed because of other types of surgery or use of radiation. The most common reason is people lose their thyroid function as they grow older or you could have been treated. We treat underactive thyroids with medicine--very simple and natural. You just take one pill a day and have your blood levels monitored regularly.”
Overactive thyroid symptoms include an inability to maintain proper weight and are less easy to treat. On the surface, that sounds like the way to go. After all, doesn’t it mean you can eat whatever you want? But in reality hyperthyroidism is a serious disease.
“Medical management is a must with hyperthyroidism,” says Woodruff who refers to the Mayo Clinic Website in suggesting that in cases of patients experiencing severe weight loss or muscle wasting, it may help to add extra protein at least until hyperthyroidism is under control.
Symptoms of hyperthyroidism include feeling nervous, moody, weak, or tired, fast heartbeat, shaky hands, difficulty concentrating and frequent bowel movements
Treatment is complex and requires consultation with an endocrinologist, a physician specializing in diagnosing and treating conditions that are related to the endocrine system.
“There are basically three treatments,” says Rahmani, “each with pros and cons since it’s a chronic disease. There are only a few types of medicine to treat overactive thyroids and they are not simple pills, they can damage the bone marrow and the liver, plus those pills controls rather than treat overactive thyroid, temporarily bring patient down to the right range.”
Other options are to mechanically destroy the thyroid by removing it through surgery or radiation says Rahmani.
“There’s medicine to take for a few years to control, a percentage of the thyroid can be surgically removed or there are pills containing radiation iodine that shrink the thyroid,” he says.
There are times, says Rahmani, when patients will insist they have an underactive thyroid which is the cause of their weight gain.
“If you’re obese from an underactive thyroid your obesity will decrease to a certain degree,” he says. “But if part of the obesity is due to underactivity and overeating, if you are 40 pounds overweight and ten pounds of that because of your thyroid, then ten pounds is what you’ll lose. One thing patients don’t always like is that after treatment, when their thyroid is back to normal, they still have the old habit of eating too much. So if the patient doesn’t watch the diet, they will gain weight.”
“Whether a person can be managed with or without medication depends on the type of diabetes the individual has,” says Irene Woodruff, MA, RD, CD, a renal dietitian at DSI Duneland – LaPorte and Knox. “Type I DM or diabetes mellitus is the insulin-dependent form and typically affects young people. Type I Diabetes develops as a result of a gradual loss of pancreatic function and insulin production. The person with this type of diabetes is typically dependent on insulin injections to maintain blood sugar control. They will need to balance their carbohydrate intake to the insulin they are taking.”
Type II DM, which results mainly from the loss of cell sensitivity to circulating insulin, commonly affects adults and has hereditary and lifestyle causes such as being overweight. And sadly, Type II, previously seen only in adults, is now seen more frequently in children and has been termed MODY--maturity onset diabetes in the young. It is the type of diabetes that may be managed with healthy lifestyle changes as well. That’s because food and nutrition has a profound impact diabetics because the body digests and absorbs different types of foods at different rates.
“Simple, processed carbohydrate foods eaten on their own are broken down rapidly and contribute to rapid rises in blood sugar,” says Woodruff. “The same simple carbohydrate food eaten as part of a meal containing protein, fat, and fiber, is processed less rapidly and contributes to a less dramatic rise in blood sugar.”
According to Lori Granich, Registered Dietitian at the Midwest Bariatric Institute at Franciscan St. Margaret Health in Dyer, carbohydrates have the largest impact on our blood sugars.
“People with diabetes should not avoid carbohydrates, but they should pick high-fiber carbohydrates and always practice moderation,” she says. “For an overall healthy diet, we should be limiting refined carbohydrates such as candy, soda and high processed snack foods. Instead, we should choose carbohydrates that are higher in fiber because they digest slower, which will prevent a spike in blood sugars. High fiber foods also keep you full and can aid in weight loss. Keeping a food log is a great way for patients to see how certain foods affect their glucose levels. It also gives patients more insight into their eating habits.”
When teaching people how to manage their diabetes, Terri Sakelaris, M.S., a registered dietitian and Certified Diabetes Educator at the Community Hospital Diabetes Center in Munster, talks about how to use carbohydrate counting to help keep blood glucose levels within a patient’s target range.
“Carb counting helps you to keep track of how much carbohydrate you are eating, she says, noting that the American Diabetes Association recommends setting a limit for the maximum amount of carbs to eat combined with the right balance of physical activity and medicine.
Sakelaris also gives her class a meal plan calculated on their weight and height which lets them know how many grams of carbs they get a day.
“Grams are like money,” she says. “It’s a way for people to see what it costs them in terms of what they eat so they can decide what to spend them on.”
Reducing blood sugar levels can be simpler than many diabetics realize.
“Ten minutes of walking can reduce sugar quite a bit,” says Sakelaris. “Drinking water versus beverages with a lot of carbs is also beneficial. Keeping hydrated is very important because if someone is dehydrated, their blood sugar goes up. And if you’re under a lot of stress, you release adrenaline which tells the body to release sugar.”
Julie Mantis, a nurse practitioner and diabetes educator who works with Sakelaris, says that even little things like standing up when a commercial comes on TV and stretching or lifting small weights can help.
“If it gets the heart rate going, that’s good,” she says.
According to Woodruff, the body digests and absorbs different types of foods at different rates. Simple, processed carbohydrate foods eaten on their own break down rapidly, contributing to rapid rises in blood sugar while the same simple carbohydrate food eaten as part of a meal containing protein, fat, and fiber, is processed less rapidly and contributes to a less dramatic rise in blood sugar.
Fiber intake is also important.
“Carbohydrates have the largest impact on our blood sugars,” says Granich. “People with diabetes should not avoid carbohydrates, but they should pick high-fiber carbohydrates and always practice moderation. For an overall healthy diet, we should be limiting refined carbohydrates such as candy, soda and high processed snack foods. Instead, we should choose carbohydrates that are higher in fiber because they digest slower, which will prevent a spike in blood sugars. High fiber foods also keep you full and can aid in weight loss. Keeping a food log is a great way for patients to see how certain foods affect their glucose levels. It also gives patients more insight into their eating habits.”
Fiber is very filling says Sakelaris as it slows down the digestive system and the release of blood sugar.
“Orange juice will spike the release of blood sugar,” she says by way of illustration. “An apple, because of its fiber, slows it down.”
Recent studies indicate that cinnamon may improves glucose and lipids of people with type 2 diabetes.
“Some research has shown that cinnamon reduces blood sugar levels, triglycerides and cholesterol,” says Granich. “Researchers believe that it is decreasing insulin resistance. It is not suggested that people use cinnamon instead of their diabetes medications. Research is still ongoing.”
What works best is simple.
“If you want to prevent diabetes, it is very important to consume a healthy diet and exercise regularly,” says Granich. “Exercise is important for weight loss and can improve insulin sensitivity. Healthy habits are even more important for those people who have a history of diabetes in their family.”
At a time when only one in five women know heart disease is their greatest health threat, the American Heart Association’s Go Red For Women campaign message is as important now as it was when the campaign first started ten years ago.
“So many women still consider heart disease a man‘s disease,” said Diane Kemp, the executive director of the American Heart Association’s Midwest Affiliate. “We have a long way to go, and so much more information we have to get out.”
February Go Red For Women events include launching a Porter County “Go Red” campaign Feb. 5 from 8 a.m. to 10 a.m. at the Harre Hall on the Valparaiso University campus. The event will include a heart-healthy breakfast, an awareness presentation and a keynote speaker.
February 7 is national Go Red for Women Day, Kemp said, and businesses and community organizations will be supporting the campaign.
“You’ll see various signs and posters throughout Lake and Porter county municipalities and businesses, and a portion of Lincoln Way in Porter County will have our banners,” she said. “We’re also reaching out to media outlets around the country.”
On Feb. 12, LaPorte County will launch their own initiative at the Pottawattomie Country Club, and the organization is also working with The Methodist Hospitals throughout Northwest Indiana to provide heart screenings, Kemp said.
Congenital heart defects are the number one birth defect for children, and on May 17, there will be the “Our Heart of Gold” fundraising event, which is a gala to celebrate funding for cardiovascular research for children. May 29th, there will be a Go Red For Women educational symposium.
In September, there will be a Heart Walk Sept. 13 in Lake County and Sept. 29 in Porter County, Kemp said.
The Go Red For Women campaign is designed to empower women to learn what the risks for heart disease and visit their doctors. They can go to the www.goredforwomen.org website, or visit www.heart.org , Kemp said, to help them learn the facts and take assessments.
Kemp said it is important to note that the symptoms for heart disease in women can be very different from symptoms in men. For example, symptoms for women include jaw line pain and neck and back pain, and aren’t just pressure in the chest and a pain or numbness in the arm.
“The symptoms are often misunderstood,” Kemp said. “They can be confused with stress-related symptoms, when stress is not the case.”
Since 1984, Kemp said, more women than man have died of heart disease. Heart disease kills one woman every 60 seconds, and that doesn’t have to happen, Kemp said.
“80 percent of heart disease is preventable by healthy lifestyle choices,” she said. “Make sure your numbers are where they need to be. The three main risk factors are cholesterol, blood pressure and BMI (Body Mass Index).”
It is also important to not smoke and to know your hereditary risks, she said.
Heart attacks are much harder on women’s bodies than men’s, Kemp said, because women’s bodies are smaller, their hormones work and react differently and have a smaller heart and overall cardiovascular system.
“We have to take action quickly, and reduce our risk, because often, for women the first incident is fatal,” she said.
In talking with hundreds of volunteers for the American Heart Association across the region, Kemp said one theme is heard repeatedly from survivors.
“They said, they just knew something wasn’t right. But they acted, and that’s what saved their lives,” she said. “If we are more aware of our bodies and understand when we’re feeling something we shouldn’t be feeling, we can respond quickly. The fact they responded quickly is what allowed them to have an incident on Wednesday and be back in the office by Monday.”
Since 1929, the American Heart Association has been the leader in funding for cardiovascular research, second only to funding from the federal government. The organization has funded research that has helped make critical advances, including with bypass surgeries, valve replacement and stents.
“Where we are today, in 2014, we have made amazing advancements for cardiovascular patients,” she said. “But we are at the tip for where we will be in the next decade. It’s important to continue the quest for research and education for this cause. We’re too close to being steps closer to a potential cure.”
Stroke is the fourth-leading cause of death in the United States, and if you’ve had heart issues in the past, you may be at greater risk.
A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked or bursts. This cuts off vital blood and oxygen to the brain and causes cells to die.
People who have had heart attacks may be at increased risk for stroke, which is also linked to hereditary factors and lifestyle choices. It is important to act quickly if you feel that you or someone else is experiencing a stroke.
“Time lost is brain lost,” says the slogan of the American Heart Association.
Be sure to make note of what time the symptoms start, as this information could be crucial to medical professionals.
The American Stroke Association wants people to remember the acronym FAST for situations involving a potential stroke. Read what each letter stands for below, and remember to always call 911 immediately if you see these signs and symptoms.
Face Drooping: If either side of the face is drooping or numb, it’s time to call 911. The American Stroke Association advises that if it is hard to display a straight smile, then face drooping is probably occurring.
Arm Weakness: Strokes can cause weakness or numbness in the arms, making it difficult to raise them. Don’t brush this issue off as common aches and pains, like so many stroke victims in the past have done.
Speech Difficulty: Slurred and hard-to-understand speech are definite warning signs of a stroke. If repeating a simple phrase like “How are you today?” is difficult, a stroke could be taking place. Don’t spend very much time assessing the situation, call 911 immediately.
Time to call 911: Even if any of the above symptoms go away, call 911 immediately if you think either you or someone else may be having a stroke.
Remembering the FAST acronym is a great place to start, but you should also be aware of other symptoms of strokes.
They include sudden numbness or weakness of the leg, sudden confusion, sudden difficulty seeing in one or both eyes, dizziness, loss of balance and severe headache with no known cause.
Do not wait for these symptoms to dispel; seek immediate medical attention.
The thought of undergoing any type of heart surgery can be overwhelming. Although you may be nervous, it is important to remember that doctors perform successful heart surgeries every day all over the world.
Doing your part to be prepared for the operation can go a long way in calming your nerves. Talk early and often to your physician about the procedure and focus your thoughts on the end goal: to have a healthier, stronger heart.
Before the Surgery
You will most likely arrive to the hospital the day before your surgery, depending on whether you are undergoing an emergency or planned procedure.
Be ready for potential X-rays, blood tests and continuous monitoring as your surgical team gathers all pertinent patient information.
Be sure to ask any questions you may have regarding the operation, hospital facilities or potential effects after surgery.
During the Surgery
You will be given anesthesia to cause deep sleep and freedom from pain, which generally means you will remember nothing of the operation.
Depending on the scope, heart surgeries usually take three to five hours, according to American Heart Association. Family members and friends are usually allowed to stay in the waiting room, and can be notified shorty after your surgery.
After the operation, you will be transported to the intensive care or recovery unit to begin your rehabilitation from surgery.
After the Surgery
Depending on what type of surgery you have, the road to recovery can be filled with certain challenges, especially if you’re used to exerting yourself physically.
You will most likely be under strict doctor’s orders to rest and avoid even moderate exercise while your heart and body heal from surgery.
Again, remember your end goal. You have made it through all of the preparation, as well as the actual surgery, and must be cautious not to take on extra physical or mental stress. Doing so can set back your recovery time and even cause complications.
You know the risk factors associated with heart disease: high blood pressure, high cholesterol and high blood glucose.
But how do you know which risk factors you have? Enter heart health screenings. All regular cardiovascular screening tests should begin at age 20, according to American Heart Association.
The frequency of follow-up will depend on you risk levels and the strategy your physician recommends.
Regular screening can help you detect risk factors in their earliest stages, allowing plenty of time for lifestyle changes or medication that can reduce the chance for heart disease. Check the list below to see what screenings you should be taking.
High blood pressure generally has no symptoms and cannot be found without measurement. That’s why it is labeled the silent killer.
Sixty-eight million Americans (one in three) have high blood pressure, according to the Centers for Disease Control and Prevention, and it is important to monitor because of its link to an increased risk for heart disease and stroke.
The American Heart Association recommends that you undergo fasting lipoprotein testing every five years starting at age 20. This blood test measures total cholesterol – both bad and good – and triglycerides.
Men over 45 and women over 50 may need to be tested more frequently, as could people with other cardiovascular risk factors. Things like high blood pressure, cholesterol and triglycerides can be improved through changes to diet, exercise and medication.
High blood glucose levels put people at a greater risk of developing Type 2 diabetes, which can increase the chance of heart disease and stroke.
Check with your doctor about undergoing a blood glucose test, especially if you are 45 or older. The American Heart Association urges people to have their level checked at least every three years.
For the first time, the American Heart Association has defined what it means to have ideal cardiovascular health.
Its goal comes from the heart. The organization is focused on improving heart health of all Americans by 20 percent while reducing deaths from cardiovascular disease – all by the year 2020.
The Seven Factors
Don’t Smoke: Cigarette smoking greatly increases your risk for heart disease. Talk to your doctor about quitting or encourage someone who smokes to stop as soon as possible.
Maintain Healthy Weight: Doctors often calculate body mass index (BMI) to determine if a person’s weight is within a healthy range. It is a good number to know because being overweight or obese can increase your risk for heart disease.
Exercise: And not just for a few minutes each day. The Surgeon General recommends that adults engage in moderate-intensity exercise for at least 30 minutes of most days of the week. This regular activity can help you maintain a healthy weight and lower your cholesterol and blood pressure.
Healthy Diet: Mixing in plenty of vegetables and fruits in into your diet can help you avoid heart disease. Opt for foods low in saturated fat, trans fat and cholesterol for optimum health.
Manage Blood Pressure: Keep an eye on your blood pressure regularly. You can check it at a pharmacy, a doctor’s office or even at home. Doing so can help you stay heart-healthy.
Cholesterol: The Centers for Disease Control and Prevention urges adults to have their cholesterol checked at least every five years. It is a simple blood test that can help alert your doctor of any increased risk factors for heart disease.
Glucose Levels: Especially for people with diabetes, it is crucial that blood sugar levels are kept in check. Talk with your doctor about how to best monitor your levels and reduce your risk for heart disease.
February doesn’t devote only one day to the heart anymore. Yes, you can still spoil your sweetie on Valentine’s Day, but medical professionals are hoping that a month-long campaign of awareness will convince you to help your own heart, too.
American Heart Month is sponsored by the American Heart Association, which devotes February to community outreach, marketing initiatives and educational programs – all aimed at bringing attention to American heart health.
National Wear Red Day
American Heart Month kicks off on Feb. 1 with National Wear Red Day, an initiative designed to pay tribute to men and women affected by heart disease.
Wearing red is also a symbol of recognizing dedicated health care professionals and honoring researchers working toward uncovering medical innovations.
The color also symbolizes you and your personal effort toward ensuring your optimum health, and the health of those around you.
The American Heart Association and its partners spend a lot of energy in February explaining the simple steps that Americans can take to improve their heart health.
Their message is clear: Heart disease is the leading cause of death in the U.S. but is highly preventable.
Healthy choices and proper management of health conditions can go a long way to reducing heart disease, as can an informed public dedicated to helping their fellow Americans reach peak heart health.
Spread the Word
You can do your part to help American Heart Association in its efforts. Do a little research on heart health and spread the message with your friends and family members.
You can also take your voice to social media by tweeting, posting and broadcasting heart-healthy tips and tricks.
The U.S. Department of Health and Human Services’ website, HealthFinder.gov, features an American Heart Month toolkit full of sample tweets and informational resources that can help you share the message.
Maintaining a healthy blood pressure is a constant battle for some people, but it is a fight that they shouldn’t have to face on their own.
There are a network of professionals, family members and friends all ready to help you reach and sustain your health goals.
Two minds are often better than one when trying to tackle any major issue. The same is true for anyone seeking expert medical advice related to keeping their blood pressure at a safe level.
The U.S. Preventive Services Task Force recommends a team-based care approach for blood pressure control, meaning a physician supported by a pharmacist, dietician, nurse and/or a community health worker.
This multi-faceted approach, the task force suggests, improves the management of major cardiovascular risk factors in outpatients, as opposed to a single physician alone.
Talk to Your Physician
Your physician is a wealth of information when it comes to finding ways to beat high blood pressure. He or she can provide diet and exercise tips that are customized to your body and medical history.
If you have issues keeping your numbers down through healthy diet and physical activity, your physician can prescribe specific medicines targeted at mitigating high rates.
It is important to be transparent with your doctor about your eating, smoking and drinking habits if you want effective results. The more they know, the more they can help you stay healthy.
Keep a Journal
We all need help remembering things sometimes. Medication schedules, blood pressure measurements and doctor’s appointments, for example, can be hard to keep track of when you’re busy with daily life.
A journal can help you keep notes on all of these important items and more.
It can also be a valuable tool in sharing your medical history and concerns with your doctor, providing a solid source of crucial, up-to-date information.
Eat nutritious foods. It’s a simple statement, indeed, but not always easy to live by.
As the obesity rate in America continues to bulge, doctors and researchers plug along at educating the masses about the link between bad diet and heart disease – the No. 1 killer in the United States.
A study published in the American Journal of Clinical Nutrition found that the quantity of fruit and vegetables in diets was more important than the variety.
Researchers followed 120,000 people for more than 20 years, during which about 6,000 developed heart disease. The people who ate the most fruits and vegetables had a 17 percent lower risk, particularly the people who added more citrus fruit and green leafy vegetables.
The chart below with recommendations from the American Heart Association offers a global glance into what you should – and shouldn’t – be eating to help your chances of avoiding heart disease.
Fruits and Vegetables: At least four-and-a-half cups per day
Fish (preferably oily fish): At least two three-and-a-half-ounce servings a week
Fiber-rich Whole Grains: At least three one-ounce-equivalent servings a day
Sodium: Less than 1,500 mg a day
Sugar-sweetened Beverages: No more than 450 calories (36 ounces) a week
Nuts, Legumes and Seeds: At least four servings a week
Processed Meats: No more than two servings a week
Saturated Fat: Less than seven percent of total energy intake
Dr. Gerald Cahill’s bariatric patients are making strides to best health.
“The transformation is amazing.”
“I can do things now that I never before thought possible.”
These are the voices of patients who have had bariatric surgery for weight loss at Franciscan Midwest Bariatric Institute. Danny Gronendyke knows first-hand how life-changing significant weight loss can be. He had a gastric bypass June 27, 2012. “I call it my new birthday.”
His weight was at 314; now, it’s 185. “Every day is amazing; I can do things now that I never before thought possible. A group of us do 10K runs!”
Millie Sasaki, RN, and Lori Granich, RD, are the support group facilitators for this group.
Lori Granich is the programs lead registered dietitian. “I have been moved to tears watching this group’s determination. Watching them cross the finish in in their first 5K represented just one of many achievements in their journey to better health.”
“Our program’s support group is an excellent resource and support network for our patients. We are so pleased to see our patients forming such positive, active lifestyle changes, such as this running group.” says Sasaki, who is a certified support group instructor.
“I’m excited to be part of a program that supports its patients before, during and after their weight loss surgery.” says Kathy O’Donnell, RN. “Our post-operative support group is truly unique. I think it’s rare to find a bariatric program that is not only willing to partner with you throughout your weight loss journey, but for the rest of your life as well.”
This team, led by Dr. Gerald Cahill, takes patients challenged by weight through the entire process of losing weight through surgery, including evaluation, preparation, the surgical procedure, and post-operative support.
Weight loss can have a significant, positive impact on an individual’s health -- including a decreased risk for cardiovascular disease, sleep apnea, diabetes, and even infertility. When there is a lot of weight to lose, the challenge can be great. The caring, professional team at Franciscan Alliance understands this, and can help you choose the bariatric service best suited to your need, along with medically supervised programs proven to help people live better, healthier and longer lives.
Franciscan Midwest Bariatric Institute, designated a Bariatric Surgery Center of Excellence by the American Society for Metabolic and Bariatric Surgery, has a proven record of success. Says Dr. Cahill, who is the program’s medical director and surgeon, “"My goal is to provide excellent, personalized, safe care for patients desiring weight-loss surgery. I strive to assist patients in achieving a positive attitude about their health and an overall improved lifestyle.”
Please visit sites.franciscanalliance.org/StMargaret/Weightloss for more information about this outstanding program
An estimated 50 million adults in the United States suffer from some form of arthritis. In fact, there are more than 100 different types of arthritis, which causes painful inflammation of the joints.
Experts say, however, there are steps sufferers can take to help minimize and manage arthritis pain. These steps can range from something as simple as a diet change to in extreme circumstances, surgery.
Before learning what steps someone with arthritis should take to manage pain, it is important to diagnose the type of arthritis and determine a treatment plan, says Dr. Tania Ghosh, a member of Porter Physician Group and a Geriatrician and internal medicine specialist with Glendale Primary Care in Valparaiso.
"The diagnosis is made starting with history," Ghosh says. "Most of the time, the way in which the arthritis started, the duration of the problem, the course of its progression, and other associated symptoms and physical findings noted upon examination guide the physician toward the probably diagnosis."
That diagnosis is often then confirmed with the help of radiological testing like X-rays and MRIs, as well as blood work.
"The underlying cause for the arthritis determines the modality of treatment," Ghosh says.
Overall health can have a direct impact on the amount of pain associated with arthritis, Ghosh says.
"If it is related to weight, the most important lifestyle change is diet, exercise and weight loss," she says.
Arthritis related to Gout - a complex form of arthritis that can be extremely painful - could benefit from dietary modifications as well, Ghosh says.
The Physicians Committee for Responsible Medicine recommends avoiding dairy products, citrus fruits, sugar, fats, caffeine and nightshade plants - tomatoes and eggplant, for example.
Studies have shown other changes, like adding polyunsaturated oils and omega-3 supplements to a diet, can have mild, beneficial effects.
Vegan diets - because of their low-fat and high in antioxidant qualities - have shown to be beneficial to managing the inflammation associated with arthritis as well, according to the organization.
If lifestyle changes don't minimize the pain, Ghosh says mediation is a possible course of action physicians may prescribe.
Ultimately, she says, treatment is determined by the cause of the arthritis.
"That could vary from different types and strengths of pain pills, oral medications that help in reducing the inflammation in the joint, injections into the affected joints, and medications that are used to treat any systemic problems that might be causing the arthritis," she says.
If there is significant damage to the joint, which is not benefiting from medical management, surgery is sometimes required, she says.
Examples include finger and hand surgeries to correct joint problems in the hand, arthroscopy that removes debris or inflamed tissue in a joint through a small lighted instrument, and arthroplasty to replace part or all of a joint in the hip or knee.
More than a headache gone bad, migraines, those excruciating headings whose symptoms include throbbing pain, pulsing sensations, nausea, vomiting and an extreme sensitivity to lights and sounds, are a neurological disease.
Migraines are caused by the activation of the trigeminovascular system, which then stimulates pain stimulating neurons causing the severe headaches associated with migraines says Sanjeev Maniar, MD, a board certified Clinical Neurophysiologist and Neurologist at Methodist Hospitals.
According to Maniar, there are two types of migraines—aura migraines whch come with such warning signs as photophobia or sensitivity to light, numbness and sleep difficulties and migraines without auras that start without any warning signs.
Ranked in the top 20 of the world's most disabling medical illnesses, according to the Migraine Research Council, more than 10% of the population including children suffers from migraine and nearly 1 in 4 U.S. households includes someone with migraine. For some, the pain is so intense, that they retreat to a dark and quiet room while waiting for the pain to subside.
But despite their prevalence, migraines aren’t easy to diagnose since some of their symptoms are similar to headaches including those caused by sinus infections.
Dr. Sreekant Cherukuri an otolaryngologist at Community Hospital in Munster, says that it isn’t unusual for people to confuse sinus headaches with migraines.
“Their symptoms, such as pain and pressure in the sinuses, nasal congestion, watery eyes, are similar,” he says, “because both occur with migraines and sinus infections.”.
Diagnosis can also be difficult because the symptoms can change from episode to episode.
“Migraines can be devastating in terms of how they impact people,” says Dr. Crystal Tuncay, an internal medicine physician with the Porter Physician Group. “Some of the more severe symptoms mimic strokes and can include temporary blindness and weakness on one side or the other of the body.”
The first step to treatment is an accurate diagnosis.
“When people come to my office, I ask if they, in addition to their sinus symptoms also have a moderate-to-severe headache, nausea and sensitivity to light,” says Cherukur noting that true sinus headaches are, usually occurring because of a sinus infection. Symptoms of sinus infections include fevers as well as thick nasal secretions which are yellow, green, or blood-tinged. Treating a sinus infection should make the sinus headache go away.
There are different theories of what causes migraine headaches says Tuncay.
“Sinus or tension headaches can overlap with migraines and with women hormonal cycles can impact migraines,” she says.
Studies show, reports the Migraine Research Council that more than 27 million adult women suffer from migraine in the United States which is three times more than adult men. Interesting, in childhood, boys are affected more than girls, but after adolescence the headaches increase more rapidly in girls than in boys.
“Foods with gluten or MSG, coffee and chocolate can be associated with migraine says Maniar who also recommends that those prone to migraines get eight hours of sleep and avoid skipping any meals.
Family history plays a big part as a large percentage of people experiencing migraines come from a family who have experience migraines. If one or both parents suffer from migraines that increases the odds you will too.
“People who have migraines usually start at a young age,” says Tuncay noting that is another way to determine whether a headache is a migraine. “If someone reports migraine like symptoms for the first time after age 55 we look for other causes and maybe do imagining and a normal neurological exam. Many headaches are usually caused by tension, poor posture and sinus.”
“Taking a history also is important in determining whether a person has migraines,” says Cherukuri.
There are more than 100 prescription medications available for treating migraines. According to Maniar, there are several kinds of medications for migraines. For those who have four or more a month, preventative medications like Depakote and Topamax can be effective. Abortive medications, like Imitrex, work well for those with less frequent headaches and can be taken with the onset of symptoms. For those with chronic migraines—15 or so a month—Maniar says that Botox has show to be a preventative.
Cherukuri says that many people start with over the counter medication. Prescription medications providing acute treatment can be taken at the onset of a migraine and for those with frequent attacks, preventive treatment includes drugs taken daily.
“Some people say acupuncture helps and there is some evidence that magnesium supplements might help,” says Tuncay. “Also exercise and good sleep hygiene are important. For those who take over the counter medications, one of the big problems is overuse.”
Tuncay also suggests that migraine patients keep a journal listing what you ate, what stresses you were under, activities you participated in, environmental changes and anything else that might help you pinpoint what causes your migraines.
Journaling can also help you beginning learning triggers—sensory warnings like flashes of light, blind spots or a tingling in arms or legs that precede a migraine.
Finding the right medication can help reduce the frequency and severity of migraine headaches though it may take some trial and error to find the right one. Meds are more effective with lifestyle changes such as good eating habits.
“Importantly, if you’re over 55 and the worse headache you ever had just came on, proceed to the Emergency Room,” says Tuncay. “Don’t put it off.”
With the cold weather and the holidays approaching, local health experts suggest now is the time to start lowering your body mass index and improving your health.
Doing so will not only make you healthier, it might also affect the insurance premiums you pay.
Edward G. Klein, director of compensation and benefits for the Human Resources Department at Methodist Hospitals, says many employers are introducing wellness programs, or population health management programs, that require employees to complete a number of healthy lifestyle activities in order to obtain access to the health plan, or obtain a less costly plan, or obtain a plan with higher benefit levels or avoid surcharges.
“There are many different plan designs in wellness, all meant to better match the culture of the employer’s environment,” he says.
The goals of the healthy living initiatives are to help employees and their covered spouses discover problems before they become critical or emergent health events, like screening programs. Some ensure those identified with chronic conditions are following the medical best practices to maintain their health.
Many of the screening programs are manditorily covered under health plans, the goal being to remove the cost barrier from the employee’s consideration in seeking care.
“The whole point is to maintain employees and their covered spouses health at the lowest risk level that can be obtained,” he says. “Regular physician visits and supporting screenings are considerably less expensive than an emergency room visit and hospitalization on both claims costs and human emotions.”
Lori Granich, clinical dietician with Midwest Bariatric Institute at Franciscan St. Margaret Health, says many healthcare providers use the body mass index (BMI) as a calculation to assess a patient’s health risk.
The BMI is a calculation used to assess a person’s weight status based on their height and weight.
A normal BMI is a value between 18.5 and 25. A BMI less than 18.5 suggests a person is underweight, and over 25 suggests a person is overweight. A BMI over 30 suggests a person is obese, she says.
Those with a BMI over 25 are at a greater risk of developing high blood pressure, diabetes, heart disease and certain types of cancers.
“BMI does have its limitations in that it can overestimate body fat in those with a muscular build and investigate body fat in those who have lost muscle,” she says.
Methodist Hospitals Diabetic Center’s dietician Kristina Greene says BMI shouldn’t be exclusively used as a diagnostic tool.
“For example, a person may have a high BMI. However, to determine if excess weight is a health risk, a healthcare provider would need to perform further assessments,” she says. “These assessments might include skin fold thickness measurements, evaluations of diet, physical activity, family history and other appropriate health screenings.”
Granich suggests losing weight to lower your BMI by consistently eating a healthy diet filled with fruit, vegetables, lean proteins, whole grains and low fat dairy.
She also suggested drinking plenty of water and having a consistent exercise routine.
“Walking, swimming and biking are great ways to increase your heart rate and burn calories,” she says. “Even losing a small amount of weight can help lower the risk of developing the diseases associated with being overweight.”
In addition to lowering your BMI, Debi Pillarella, manager at Fitness Pointe, says it is important to discuss with your doctor which health screenings are right for you and why and when you should have them. Or, start with the Mayo Clinic website at www.mayoclinic.com/hScreening to get a customized recommendation for screenings.
There are a variety of screenings that are appropriate at varying times.
Blood pressure should be checked at least every two years, or more often if your blood pressure tends to run higher.
Cholesterol should be checked regularly for women starting at age 45, and men should have theirs checked every five years beginning at 35.
Colorectal cancer tests should begin starting at age 50, or based on your doctor’s recommendation.
Diabetes should be screened for regularly, not only a fasting glucose test, but also a test called A1C.
Women also need mammograms beginning about age 40, and osteoporosis tests starting at age 65, or when a doctor recommends it. Women should have Pap smears every one to three years.
“The ‘one size fits all’ approach to health screenings does not consider your gender, age or family history,” she says. “Screenings can help detect health problems, which is part of the key to receiving successful treatments. Tests including mammograms, Pap smears and colorectal cancer tests can find diseases and conditions early when they are easier to treat.”
Pillarella says it is important to maintain activity, even during the busy holiday months and when the weather is cooler.
She recommends standing as often as possible, and trying not to become sedentary.
“Get active during every commercial break,” she says. “Walk around the house or go to the kitchen for a drink of water.”
Even using household items like towels, paper plates and brooms can provide inspiration for fitness.
“Purchase or rent a beginner’s workout DVD,” she says. “Or use household items as exercise props and turn boring housework into workouts that keep you fit.”
"One of the fundamental things in any discussion of food allergies is to separate food intolerance versus true food allergies,” says Cynthia Lerner, MD, who specializes in pediatric and adult allergies. “There’s mass misinformation and confusion to the terminology of food allergies.”
As an example, Lerner notes that celiac disease is not a food allergy, it’s a gastrointestinal intolerance to wheat.
“A person who is allergic to wheat, who gets hives, vomits, collapses is far different than the individual who has celiac disease,” says Lerner, an assistant professor of pediatrics, Northwestern University, Feinberg School of Medicine with private practices in Munster, Tinley Park, Illinois and at the Ann and Robert Lurie Children’s Hospital of Chicago New Lenox Outreach Clinic. “People might say, 'I’m allergic to milk,' but really what they have is a lactose intolerance.”
According to Lerner, peanuts and cow’s milk lead the list of most common food allergies followed by tree nuts, soy, wheat, finfish and shellfish.
“On the more unusual side celery is seen as benign,” she says, “but some people have an allergic reactions to it.”
A May report from the federal Centers for Disease Control and Prevention notes a 50 percent rise from 1997 to 2011 in the number of U.S. children who have food allergies. According to a 2010 study, peanut allergies among children appear to have tripled between 1997 and 2008.
“Food allergies do appear to be on the rise and people are becoming more aware of them,” says Carol Bliznik, a registered dietitian with Franciscan St. Anthony Health-Crown Point.
“Symptoms can be relatively mild such as a minor rash or itching, mild such as hives, intestinal problems and mild diarrhea or can be severe requiring immediate hospitalization or result in rapid death,” says Michael S. LaPointe Ph.D., Associate Professor of Biology at Indiana University Northwest. “Most individuals do not know they have a food allergy until they first encounter the food. Severe allergies may result in hives the first time an individual eats it. Eating the food a second time can cause a severe reaction and death.”
LaPointe notes the different levels of allergic reactions to food.
“Mild allergies leading to a rash, itching or hives can usually be treated by an antihistamine such as Benadryl, or topical creams to relieve the itching,” he says. “Eating of peanuts and shellfish can lead to a severe drop in blood pressure – hypotension -- and closure of the airways, so a person cannot breathe. Individuals that know they have these will typically carry an epi pen, containing the hormone epinephrine, also known as adrenaline. Epinephrine increases the heart rate and blood pressure and causes the airways to open.”
Responding to the rise in food allergies in school age children, the U.S. House of Representatives recently passed a bill, which President Obama signed, expanding access to epinephrine auto injectors in schools.
“The most important concern to the public at this point is not esoteric sensationalism of allergies but the treatment,” says Lerner. “The new Auvi-Q is an epinephrine auto‑injector that talks you through the injection process during a severe allergic reaction.”
Both Lerner and LaPointe recommend anyone with a moderate to severe food allergy always carry at least one epi pen with them.
“Both parents and kids need to be prepared and need to check so they’re not carrying around expired adrenaline,” Lerner. “And everyone should have at least two on them. They come in two for a reason. The mantra is epi everywhere – on the parents, on the child, in the glove box of your car. If someone is experiencing anaphylaxis, a severe life-threatening allergic reaction, those around them should use the epi, call 911 and later you can address the cause of the problem.”
Lerner also is an advocate of wearing a bracelet with information about a person’s medical conditions.
“Don’t put a card in your wallet,” she says. “People won’t find it in time.”
“The best way to avoid foods causing any allergic reactions is to read food labels and ask question when you’re in a restaurant or out some place,” says Bliznik noting that many restaurants now have dishes for those with food allergies.
But it is important to be aware of cross-contamination.
“There have been cases where someone had died from exposure to minuet traces of peanuts,” says LaPointe. “For example, food cooked in pots that previously contained peanut oil, or kissing someone that had eaten a peanut butter sandwich. “
What’s causing this increase in allergies is unknown at this point. The previous paradigm that pregnant women should not eat certain foods during pregnancy and particularly in the last trimester, is now considered ineffective.
“They really have gone away from avoidance during the pregnancy and the last trimester,” says Lerner. “In the past, we delayed introduction to what we considered allergenic food to infants. In the years I was having kids we didn’t introduce eggs before age one and peanuts until age two. Now that we are having this incredible rise in allergies across the world, the new paradigm is introducing the new foods much earlier one at a time.”
As scary as this may sound, LaPointe notes that some children grow out of their allergies. And Lerner says true food allergies are much less common than positive skin tests might indicate.
"We have a lot of people who test positive and maybe are sensitized but could eat peanuts or other foods,” she says. “And sometimes people are over diagnosed which causes a lot of anxiety. Though 1 percent of the population has peanut allergies, only about a tenth are severely anaphylactic while the other 90 percent may just have symptoms like a rash, wheezing or gastrointestinal upset.”
Committing to Weightloss: Bariatric surgery is not just about an easy fix, it's about a lifestyle change
For many, bariatric or weight loss surgery isn’t a cosmetic choice but a medical necessity.
“Our culture with so many fast food options and hurried schedules as well as lack of time to cook, feeds into the continuing and rapid rise of overweight Americans,” says General and Bariatric Surgeon, Dr. Paul Stanish, M.D., F.A.C.S., who is the Medical Director for the Healthy 4 Life program at Community Hospital in Munster and St. Mary Medical Center in Hobart.
According to Dr. Larry Brewerton, PhD, a professor of psychology at Indiana University Northwest who also has a part time private clinical practice, though our ancestors ate just enough to survive with a little to keep going in the winter when food was scarcer, now our eating patterns have definitely changed and not for the best.
“Food is too readily available,” he says. “Soda used to be a treat, when I was growing up nobody drank it every day.”
Not so in the era of Big Gulps, all-you-can-eat-buffets and supersized meals – an overload of unhealthy calories that translates into an obesity epidemic. Current estimates indicate that nearly one-third of the adult American population or about 60 million people. Those with clinically severe obesity, generally considered to be 100 pounds above a person’s ideal weight, are at a high risk of developing such life threatening medical conditions as heart disease, high blood pressure and diabetes. Annually, there are more than 300,000 excess deaths in the U.S. due to obesity and the resulting healthcare costs amount to approximately $100 billion.
According to Stanish, several studies show that bariatric surgery can reverse the Type 2 diabetes better than just medication. Other medical pluses, besides significant weight loss, include improvement in cardiovascular risk factors along with a reduction in mortality ranging from 23 percent to 40 percent.
“There are basic criteria that insurance companies look for in determining if a patient is a candidate for bariatric surgery,” says Lori Granich, Bariatric Dietitian at the Midwest Bariatric Institute in Dyer. “The most popular parameters are having a BMI greater than 40 or having a BMI over 35 with two co-morbidities such as hypertension, diabetes or sleep apnea. Patients have typically failed previous attempts at weight loss. Patient’s eligibility will also depend on meetings with the surgeon, nursing staff, psychologist and dietitian.”
Healthy 4 Life’s website features an easy to use tool for measuring body mass index (BMI). Plug in your height and weight (no fibbing please) and the site can calculate your BMI.
The surgery first became available in the 1950s but has vastly improved since then.
“Most bariatric surgeries these days are minimally invasive or laparoscopic and can be categorized into restrictive or malabsorptive procedures,” says Granich RD. “A restrictive procedure, such as the lap-band or sleeve gastrectomy, reduces the size of the stomach to decrease the amount of food it can hold. Malabsorptive procedures, such as the Roux-En-Y Gastric Bypass, restricts food intake while limiting absorption of calories. This results in large amounts of weight loss.”
But it isn’t a free pass to a future of endless desserts and no weight gain (sigh!). Indeed Stanish says that after surgery if big time sweet eaters don’t cut back it significantly, the undigested sugar in their intestines can make them sick and cause something unpleasantly known as dumping syndrome.
“Bariatric surgery should be taken as a last resort,” says Kim Kramer, a wellness dietitian at Ingalls Hospital and the Illinois Dietetic Association’s media spokeswoman. “It is not a quick fix, it’s very hard work. People should try every other option before making this choice whether it’s going on a weight loss plan or adding more exercise to your day.”
Stanish says that when they first started their weight loss program, it was surgical.
“Then we recognized we needed a non-surgical program,” he says. “So now usually when patients come to us we say we’re going to get to the surgery later, let’s work on this first so by the time we get them into surgery the patient is probably 15 to 20 pounds lighter and in much better shape for the surgery. But even with surgery, if patients don’t make the therapeutic changes in their way of life, they will gain some of it back. These changes include healthy eating and an increase in physical activity.”
Besides their pre-surgery program, Healthy 4 Life also provides customized weight loss options with ongoing medical and personal support as patients adjust to their new – and healthy -- life habits. This includes their Weight No More support group designed for on-going participation enabling patients to continue practicing the skills necessary for a lifetime of continued health and weight management.
“Our Therapeutic Lifestyle Changes (TLC) teaches patients about eating the right foods and increasing physical activity," says Stanish, adding that he avoids the dreaded “e” word – exercise.
“Bariatric surgery is a life-changing procedure,” says Granich. “It is imperative that patients are willing to commit to the lifestyle changes needed for post-operative success. Some insurance companies implement a time frame up to six months for medically supervised weight loss before they will approve surgery. The surgeon may require additional testing based on the patients past medical history or age. A medically supervised program will help patients change their eating habits, quit smoking, lose weight and start exercising before surgery. When these changes are made preoperatively, patients adapt better to life after surgery.”
Kramer, who conducts preparatory classes for people considering the surgery as well as weight management programs, says that the life changes include smaller portions, at times not being able to eat solids and fluids together and a commitment to exercise and healthy eating.
“We offer healthy cooking demonstrations and discuss general nutrition,” she says. “We prepare people for what to expect after surgery. A lot of times people take vitamins afterwards based on what surgeries they’re having.”
In order to get ready for surgery, Kramer says people need to start exercising before surgery.
“Bariatric surgery is a huge step,” says Brewerton. “For those who are considering it, they should talk to someone who has had the surgery and find out would they do it again if they had the choice and why or why not.”
Besides the physical component, weight loss surgery also has a psychological aspect too.
“Many people use food when they’re feeling badly, sad, angry or anxious,” says Brewer. “It becomes a way of dealing with their feelings.”
But ultimately, stuffing ourselves harms our health and, if we gain too much weight, our self-esteem, sometimes increasing the feeling we’re trying to stymie through food.
Brewerton suggests learning to express our feelings by talking to a therapist or joining a supportive weight lose group like Weight Watchers is one way to handle negative emotions in a positive way.
“Stress management is also important so that we don’t eat as a stress reliever,” says Kramer. “There’s a lot of emotion in why we eat what we do.”