Weight-loss menu
September 8, 2004
By Marcia Ames
Weight loss menu from counting calories to stomach surgery
Do you dream of being photographed someday standing inside one leg of your megasize trousers?
Or do you simply want to lose 10 or 20 pounds in a hurry?
More than one in two people across the country might be tempted by such goals - about 57 percent of all adults were overweight as of four years ago, according to the U.S. health department.
Two years ago for Maryland adults, the percentage was 58 and represented an upward trend.
Before such people go hoping for amazing results from a fad diet program, however, St. Agnes Hospital dietician Kerry Miller recommends caution.
"I think it's false hope," said Miller, who oversees the meal selections for all St. Agnes in-patients.
At six months, dieters using one well-known program may have lost more weight, but at one year?
No difference, she said.
In addition, some fad diets prove unhealthy in the long run by not providing enough calories or nutrients. Diets too low in calories, for example, could lead to fatal complications, according to the federally supported Weight-control Information Network (WIN).
Following a basic rule of eating foods from each of the major food groups - fruits; vegetables; grains; milk, yogurt and cheese; meat, poultry, fish, dry beans, eggs and nuts - and exercising regularly tends to work better in the long run for most people, Miller said.
That, plus making sure you eat enough calories - but not too many.
"It's what you take in and put out," she said, simplifying a formula most adults should know by heart.
Calories count
Whether dieters understand the biochemistry involved doesn't matter, so long as they know foods have calories and calories are used to operate the body. Excess calories are stored and contribute to weight gain.
Apparently, many people today either don't know or don't care how much they eat, Miller has observed.
"You see it every day - people walking through the mall with their 24-ounce sodas and their ice cream cones," she said.
In some cases - including ones she deals with at the hospital - people don't realize how much they eat. In keeping a food diary, for example, they will fail to record beverages such as coffees made with whipping cream or fruit shakes made with yogurt or ice cream.
"They're loaded with calories," Miller said.
In addition to the cosmetic downside of carrying around too many pounds, the potential consequences include heart disease, stroke, diabetes, certain cancers, gallbladder disease, difficulty breathing during sleep and joint damage, according to the National Center for Chronic Disease Prevention and Health Promotion.
"We see so many diabetic patients - the type II diabetes that comes from being overweight," said Miller, referring to the most common form of the disease.
Unlike type I, in which patients can't produce the insulin needed to maintain a normal blood sugar level, type II renders them unresponsive to this vital hormone.
Measuring metabolism
Exactly how many calories the body needs depends on the individual, a fact that has prompted one Catonsville fitness center to offer metabolic testing.
Simple and painless, the test requires only that a client relax and breathe naturally into a machine that measures oxygen consumption.
"This shows us how many calories they would burn if all they did was sit home watching TV," said Margaret Northrop of the Catonsville R.O.M. Works center.
Because the machine also estimates how regular exercise would affect that number, clients can calculate a realistic diet plan - enough calories, but not too many - Northrop said.
Even the best laid plans lead to failure for some overweight people, however.
The surgery option
"If diet and exercise alone would have done it, there is no reason why I wouldn't have lost weight - and kept it off," said St. Agnes nurse Cathy Carr, recalling the years leading up to her November 1999 gastric bypass surgery.
Now happy and healthy with about 160 pounds on her 5-foot-4 frame, Carr said, she believes genetics plays a role in some cases.
Not much overweight as a child, she started taking on pounds in her 20s and eventually discovered that dieting wasn't the answer, in her case.
"With every diet, I gained more weight," she said.
"I dieted my way up to almost 340 pounds."
With a body mass index of 58 - a number indicating how much fat she was carrying - Carr qualified as morbidly obese, she said.
"I was a big lady."
In addition, she suffered from diabetes, borderline hypertension, difficulty breathing during sleep, general shortness of breath and joint pain.
Almost five years ago, at age 37, she underwent the surgery and her life was changed as "from night to day."
Unable to exercise by the time she topped 300 pounds, Carr said she had been willing to risk such a drastic measure to become an active mother to her child again. Within 15 months of the surgery she had lost almost half her weight.
'I started living'
Today, she feels like a teenager.
"I started living again in November 1999 - that's when I got my life back," she said.
"Most importantly, all the medical conditions I had before my surgery have been resolved."
Wanting to help other obese patients achieve the same satisfaction, she has coordinated St. Agnes' bariatric surgery (a.k.a. gastric by-pass) program since it was initiated in 2001. More than 600 patients have gone through the program, including many from southwest Baltimore County.
"The doctors go in and they do the surgery laporoscopically, through small incisions," she said, describing a technique that has been refined in the years since she acquired her 7-inch scar.
"They staple and divide the upper portion of the stomach to create a new stomach we call the pouch," she said.
Connecting a portion of the small intestine directly to the egg-size pouch completes the two-and-a-half-hour procedure, allowing nutrients to bypass absorption in the rest of the stomach and part of the upper intestine.
Patients who qualify generally have a body mass index of 40 or higher (or 35, with a significant medical condition) and a history of failed diets, Carr said.
They must also pass a psychological evaluation.
Carr invites anyone interested in learning more about the program to attend one of the hospital's free support group meetings, held on the first and third Thursday of each month at 7 p.m., in the hospital auditorium, 900 Caton Ave.
Source:http://news.mywebpal.com
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