Panniculectomy

A panniculectomy removes hanging fat and skin, typically after massive weight loss. It may be performed as a single procedure or combined with a tummy-tuck, depending on the patient's condition. Panniculectomy is different from abdominoplasty, in that abdominoplasty tightens the muscle as well as removes excess skin and fat, but a panniculectomy only removes excess skin and fat. A panniculectomy may also be performed with another abdominal surgery, such as a hysterectomy, or repair of the abdominal wall or hernia of the belly button.

The Best Candidate for Panniculectomy

Panniculectomy candidates typcially suffer from obesity, or have recently experienced significant weight loss, or suffer post-pregnancy issues with inordinate fat localized below the belly button.

Candidates may have fat extending as low as the knees, over the hips, and around the back. These conditions cause panniculectomy candidates to experience a host of health issues, including back problems, the breakdown of skin, rashes, ulcers, or skin disorders. These conditions may interfere with everyday life — walking, standing, or sitting may become very difficult.

The best candidates have stabilized their weight for at least one year. The candidate must be participating in a proper dietary and exercise plan. Candidates who have had the gastric bypass procedure should wait until one year after gastric bypass surgery or Lap-Band surgery, after the health problems associated with obesity have subsided.

The Panniculectomy Procedure

The panniculectomy is most often performed by a board-certified plastic surgeon. The location of the procedure is typically a hospital, although the procedure may be performed in an outpatient surgery center. Time in surgery may be several hours. The procedure is often performed under general anesthesia (while you are asleep) and requires a hospital stay, typically ranging from one day to one week.

An incision is made from the lower area of the sternum to the pubic bone. Another horizontal incision is made at the pubic area where the excess fat and skin can be delicately removed. The skin that remains is then pulled together and closed. Drains may be inserted that will require personal home care. Tape will be applied to the incision areas. Any essential repairs to the abdominal wall or hernia within the belly button can usually be made at the same time.

After Panniculectomy

Your surgeon will supply a complete postoperative instruction list to follow, to reduce the risk of complications. You will have to sponge bath. Your doctor may fit you with a medical garment to wear at all times (except during a sponge bath) until otherwise directed.

If drains were inserted, the drains will need to be emptied as instructed. Dressings will also need to be changed.

Pain, swelling and bruising can occur, which can be managed with medications and proper care. Keep in mind that normal activities cannot be resumed immediately. Restrictions include no exercise or lifting of 10 pounds or more. There cannot be any pressure placed on the abdominal area.

Complications and Risks

Complications are possible with any plastic surgery. The most common but infrequent panniculectomy complications include infection, bleeding, and excessive scarring. If these occur, notify your surgeon immediately.

Consult a Qualified Plastic Surgeon

A qualified plastic surgeon will help ensure that a panniculectomy is appropriate for your condition. The most qualified surgeons can also increase your odds of success and reduce the risk of complications.

It's important to choose a board-certified plastic surgeon from the American Board of Plastic Surgery who has extensive, specific panniculectomy experience, as well as expertise in all areas of abdominal plastic surgery. Board certification may not always guarantee the best results; however, board certification does require specific and rigorous surgical education and training, which can help you achieve a safe and successful outcome.

Here are some tips for consulting a plastic surgeon:

• Review the doctor's credentials, education, training, type of certification held, and number of times that the treatment has been performed in the practice.
• View before-and-after photos of patients with similar conditions who received a panniculectomy and alternative surgical options.
• Inquire about the method of the procedure and possible complications from surgery.
• Ask for a pre- and postoperative instruction checklist.

Costs

Panniculectomy costs include three fees: local or general anesthesia fees, facility fees, and surgeon's fees. Since the panniculectomy procedure is usually performed during an abdominoplasty, you only pay one anesthesia fee and one facility fee. Since your treatment will be customized to fit your needs, only an estimated range of costs can be given. Average total fees range from $8,500 to $10,000.

Insurance coverage for the cost of the panniculectomy varies. If the procedure is strictly for cosmetic reasons, insurance will not cover the procedure. However, the insurance carrier may cover all or a portion of the costs if medical conditions are correlated with excessive weight. For example, hernia is often present in panniculectomy patients. In this case, the insurance will often pay for the hernia repair, but not necessarily the panniculectomy. The doctor will help identify whether the panniculectomy is covered under your insurance plan.

Reduce Weight by Natural Ways

Obesity or overweight is a condition characterized by excessive deposition or storage of fat in adipose tissues. Over the years it has been a common problem all over the world.

Ayurveda describes eight types of bodies, which are considered bad. Out of the eight, the two that are widely explained are: very thin body and very fat body. It has been proved that out these two those who are very fat have most diseases and troubles. This is because the extra fat puts a strain on the heart, kidneys, liver and the joints such as the hips, knees and ankles. Over weight persons are susceptible to several diseases like high blood pressure, diabetes, arthritis, gout, liver and gall bladder disorders.

The chief cause of obesity or over-weight is often overeating, irregular eating habits and not following the rules of eating including improper mixing of food items in one meal.

HOME REMEDIES FOR LOSING WEIGHT

Fruits and green vegetables are low calorie foods, so over weight persons should use these more frequently.

• One should avoid intake of too much salt. Salt may be a factor for increasing the body weight.
  
  

• Milk products like cheese, butter should be avoided because these are rich in fat. Meat and non-vegetarian foods should also be avoided.
  
  

• Spices like dry ginger, cinnamon, black pepper etc. are good for loosing weight and can be used in a number of ways.
  
  

• Rice and potato which contain a lot of carbohydrates should be avoided among cereals wheat is good.

• Vegetables like bitter gourd (Karela), and bitter variety of drumstick are useful for loosing weight.
  
  

• Taking of honey is an excellent home remedy for obesity. It mobilizes the extra deposited fat in the body and puts it into circulation, which is utilized as energy for normal functions. One should start with small quantity of about 10 GMs. or a tablespoonful to be taken with hot water. It is good to take it in early morning. A teaspoonful of fresh lemon juice may also be added.
  
  

• Fasting on honey and lime juice is highly beneficial in the treatment of obesity without the loss of energy and appetite. In this mode of treatment, one teaspoonful of fresh honey should be mixed with a juice of half a lime in a glass of lukewarm water. It can be taken several times in a day at regular intervals.

• Cabbage is considered to be an effective remedy for loosing weight. This vegetable inhibits the conversion of sugar and other carbohydrates into fat. Hence, it is of great value in weight reduction. It can be taken raw or cooked.

• Exercise is an important part of weight reduction plan. It helps to use up calories stored in body as fat. In addition, it also relieves tension and tones up the muscles of the body. Walking is the best exercise to begin with and may be followed by running, swimming, rowing.

• Lime juice is excellent for weight reduction. Juice of a lime mixed in a glass of warm water and sweetened with honey should be taken every morning on an empty stomach.
  
  

• Measure the portions of your food every meal and make sure that the portions are small. For example one portion of rice should not be more than the quantity which can fit in your fist. Smaller meals at a regular interval of 4 to 5 hours will keep your metabolism high and prevent your body from converting the food you intake into fat. You must also include regular exercise in your daily routine to help enhance weight reduction.

Yoga Vs Weight Loss

oga exercises are widely practiced by many to reduce weight. Along with the weight reducing diet yoga helps shed excess weight effectively.

We must exercise our lungs, as often as we can, by Yoga techniques with the emphasis on deep breathing, to enable them to come alive. Yoga exercises are not strenuous. Breathing and relaxation are inseparable function with the exercises the body does. Almost all exercises, involve every part of the body - the spine, the limbs, the chest and the abdomen. There is no spot reducing exercises as in others.

Though there are more than seventy postures in yoga; a few of which when practised regularly give good results in reducing weight. A few such exercises that stimulate the endocrine glands are beneficial for obesity. These are easy to practise daily at a fixed time. You must keep in mind that a natural diet will be more suitable for these exercises.

1. Dhanurasana Method:

• Lie on the stomach and keep both the legs together.
• Fold the legs slowly by bending the knees.
• Breathe slowly in the normal way and lift your head.
• Arch the back and hold both the legs with your hands near the ankles.
• Stretch the legs held by the hand a little further to assume a bow's posture. Look up.
• Remain for a few seconds in this posture Time can be increased after a few days when you are perfect.
• Release the legs and lower them to the ground.Rest your head down and place the arms on your sides and relax a while and repeat the exercise two or three times.

This exercise stimulates all the endocrine glands from the thyroid in the neck to the sex glands in the pelvic region. The abdominal muscles stretch and enable good digestion. It cures obesity if practised very regularly. It also removes fatigue and lethargy. It is helpful in all irregularities of menses and obesity caused during menopause in women.

This exercise should not be practised by people suffering from hernia, people with spinal injuries and fractures and those suffering from stomach ulcers.

2. Yoga mudra Method:

• Assume the posture of Padmasana - sitting cross-legged, placing the legs on the thighs of the opposite side, the heels touching the abdomen.
• Sit erect and hold your right wrist with left hand at the back. Slowly bend forward and touch the ground.
• While bending forward it is essential to exhale first and then bend, likewise while bending backward it is necessary to inhale first and then bend, because bending forward causes the compression of the abdomen and extension of the spine. If this breathing pattern is mastered, bending exercises will not cause any cramps, pains and other discomforts or giddiness and headache.
• After sitting cross-legged, hands folded at the back, exhale and slowly bend forward and touch the floor.
• Stay thus for a few seconds and gradually come back to the original position by inhaling deeply and lifting the head from the ground. Repeat a few more times. Relax and unfold the legs.
• If sitting in Padmasana causes too much pain, the asana can be started with sitting on Siddhasana, i.e. crossing just one leg on the thigh opposite to it.

Lap Band Surgery Diet

After Lap-Band surgery the stomach can not hold more than 4 to 6 ounces per meal. Therefore, one should be particular about nutritional value of the food with every bite.

Certain foods which cannot be allowed ever for a patient of Lap-Band are tough meats such as steak and pork chops and hamburger. Oranges and grapefruits need the skin to be removed before eating. For this matter, the fruits and vegetables need deseeding, de-skinning beforehand.

Food which need to be avoided are high fiber vegetables like celery and sweet potatoes, spicy foods, fried foods, spices like cinnamon, pepper, or onion or garlic salt. If one is unable to tolerate milk, then calcium and protein rich foods such as cottage cheese and dry milk can be added to foods for added protein.

Why protein

Lap-Band patients should take fifty to sixty grams of protein every day to avoid protein deficiency.
Lack of protein causes hair loss, edema, fatigue, muscle weakness, and a delay in wound healing. It also causes depression, anxiety, irritability, apathy, as well as gallstones, colds, headaches, low blood pressure, anemia, irregular hear rates, and, some times death too. The amount of protein can be monitored by a serum albumin blood test.

How to eat food

One should eat slowly by making tiny bites. The new stomach is a baby stomach. It requires to take protein shakes and relearning of eating skills like a new baby learns to eat. Adding new foods should be slow in process.

The patient needs to make a habit to chew foods well. It will do the patient a world of good to cut the food items to small pieces and then chew it thoroughly. Otherwise complications will happen such as vomiting, stomach irritation and swelling and stoma obstruction.

One should go back to liquid diet if solid foods cause nausea and vomiting. Drinking of 6-8 cups of water per day between meals will keep one hydrated throughout the day. Three small meals a day with adequate nutrients is to be eaten.The stomach can only hold about 1/4 cup of food at a time. Easting has to be stopped when the hunger is gone.

Having Medicine

Swallowing pills of aspirin-size or larger, or capsules or irregular-shaped pills will be difficult, so it is better to make the pills into half like the blood pressure pill. It may be required that the tri-estrogen capsules are changed to a cream form, and taking liquid antibiotics and painkillers for an infection.

Diet immediately after surgery

The first 3 to 4 days following the Lap-Band surgery patients must follow a liquid only diet. It is so important to stick to this diet that unless one has it, there will be complications like band erosion or slippage that will require additional surgery.

No caffeine is permitted for the first three months after surgery. Carbonated beverages are restricted to avoid gas, bloating, and increase in stomach size caused by carbonation and in fact are prohibited for life.

Diet immediately after two months of surgery

The second phase diet consists of a modified liquid diet (food shredded in a food processor) along with a high protein intake. The patient is required to consume two ounces of a protein every hour for ten to twelve hours a day. Two ounces of other liquids such as soup, baby food, or sugar-free gelatin three times a day is also required. So the basic foods are meat, protein, vegetables, and salads. But high carbohydrate and starchy food like bread and potatoes are avoided.

Risks of Lap Band Surgery

Mechanism behind a Lap band surgery

A Lap Band is a silicone belt that goes around the top of the stomach. Lap Band surgery is one in which such a band is placed dividing the stomach into two parts with the upper part forming a pouch connected to the lower part through anarrow passage. It is a weight loss surgery like gastric bypass surgery.

The pouch gets filled up with a mall amount of time. The food which gets deposited in the pouch, takes time to empty into the stomach thereby reducing the craving for food.

Who are the clients of Lap band surgery?

If the body mass index (BMI), is between 35 and 39, then there are several associated medical problems like diabetes, hypertension, or high cholesterol. These are called the co-morbid conditions which make the patient an ideal case to go for the Lap Band.

Weight loss history is recorded by many insurance companies with varying stringent measures.

How the surgery is done?

With the help of a small camera, called a laparoscope, the gas band is placed around the stomach, with the pipe emptying into a port, the port being placed below the abdomen. This takes just an overnight stay.

When saline is injected more into the gas band, the narrow passage becomes still narrow further restricting the food flow.

After Lap Band Surgery: Aftercare

One needs to follow a nutrition plan including vitamin supplements prescribed by the surgeon or nutritionist. The nutrition plan may be of liquid diet for some weeks, until soft foods can be tolerated and solid foods ultimately.

A specific exercise program, may also be taken up.

The surgeon has to check the patient many times to properly adjust or his/her band. As times go, a patient requires six to eight such adjustments during the first 18 months of the surgery.
Patients typically lose 50% to 60% of their excess body weight within two years after the procedure. Additional plastic surgery may be indicated, depending on how much weight is lost.

Lap Band Complications

Slippage of band: This can occur as weight loss happens. When the stomach goes above the band, heartburn and vomiting may happen. This has to be laparoscopically fixed.

Erosion of band: Sometimes the band can erode into the inside of the stomach.

Deflation of the band: The band can have leakage which can deflate it which can happen on the band, the port, or the tube connecting both. As a result the stomach pouch can get enlarged defeating the purpose of having the pouch.

Blockage of the stoma: The narrow passage can get blocked at times because of its being too narrow.

Consult a Qualified Surgeon

Losing weight without being malnourished is something which needs qualified guidance. This is critical to the success of having the surgery. One can avoid complications, and weight loss can be achieved according to one’s desire.

It is good that the surgeon verifies the number of procedures undertaken by him, and to increase one’s own knowledge about further examination so that office support in case of emergency can be requisitioned.

Successful Lap Band Surgery Examples

Some successful doctors

Case 1

Dr. Rumbaut and his team at San José, the most prestigious Private University Affiliated Facility in Northern Mexico, have performed about 1800 Lap-Band procedure without a single case of death.

The mean excess weight loss after 18 months in this case is approximately 67%, other complications with the slippage and erosion of lap band are less then 1%. Infection, bleeding, pneumonia, etc. all less than 2% and all patients were discharged before one week.

Case 2

Dr. Franco Favretti, and Dr. Gianni Segato, two of the most experienced Lap-Band Surgeons in Europe at Saint-Pierre Hospital in Brussels have performed well over 1,700 Lap-Band cases. They have the distinction of performing this surgery along with two other team members namely Dr. Cadiere and Dr. Himpens, in October 1992.

The treatment requires 5 to 6 days stay in Italy which starts meeting the patients at Venice International Airport on Thursday. The patients get admitted to the hospital on Friday Morning for pre-op tests, undergo surgery on Saturday and get discharged from the hospital on Monday.

After surgery, the patients are requested to stay a few more days to make sure about their recovery. After that they are taken for sightseeing to nearby Venice.

By Friday the patients can go back home and can resume work.

Case 3

According to the records of Dr. Cadière and Dr. Himpens, who have done 3000 cases already, not many patients received reimbursement from their insurance.

One patient mortality that in their case was due to over-eating, and esophageal perforation when death occurred some 4 weeks after surgery. The erosion rate is 1%, Pouch dilatation rate is 6 % and band-removal rate 3% after 3.6 years.

Case 4

Dr. Andreas Osterwalder is one of the most experienced Lap-Band Surgeons in Europe at the Ars Medica Clinic near Lugano.

The patients are required to bring the reports of the basic tests like lab/chest x-ray and ECG which prove the fitness to stand general anesthesia for at least 2 hrs, a sonography of the upper abdomen (to exclude gallstones). They are also required to bring reports of a gastroscopy as proof against any gastric disease.

The patient can fly to Zürich, and then to Lugano Airport in Agno to be picked up from there. One should go prepared for a stay of 2-3 days in a hotel room.

Cost of Lap banding surgery

On an average, the cost of Lap Band surgery comes from $17,000 to $30,000 that includes treatment and travel.

Reimbursement from insurance companies

Although there was no provision from the insurance companies to reimburse the cost of Lap Band surgery (mainly because it was mistaken as cosmetic surgery), slowly the life risk aspect of the surgery is being realized which is why they are paying for most part of it certified by the doctor according to the NIH standards.

Expense overheads borne by the hospitals

The arrangements are such that the patients are received from the airport to the hotel where a stay of 4-5 days is arranged. The hospital stay is just for one night.

The out-of-town patients get scheduled within three weeks. Most patients can go back to work within 5 days and can start their exercise regime within 10 days. All required Pre-Operative Exams are done on the day prior to surgery.

What is Lap Band Surgery?

Why lap band surgery is needed?

When there is a craze for food after exceeding the permissible weight limit, then usually dieting is prescribed. But eating less amount of food does not satisfy the food craving, in most of the cases, so an alternative is to besearched for that.

The alternative that one can think of is to reduce the stomach size so that one feels full after eating a certain amount. That is exactly what is done with lap band surgery, wherein a small pouch in the upper part of the stomach is created.

The idea is to fill up the smaller upper pouch of the stomach to give a filled up feeling because it fills quickly with less food. Because of the narrow opening it takes longer to empty into the lower part of the stomach, which means that the next pang of hunger is delayed.

Placing the Lap Band

The procedure involves placing a silicone band around the upper portion of the stomach, so that the stomach gets divided into two with the upper part being a small pouch with a narrow opening to the bigger lower part.

A gastric band device is introduced in the abdomen through a tiny incision of 1 cm. The operation is performed under general anesthesia and takes about 30 minutes to one hour to complete.
The band is a hollow cylinder itself. It can be inflated if further constriction is required, and can be deflated if vomiting, obstruction, oesophagal enlargement, etc. happens.

The band can be inflated by a reservoir of saline solution positioned under the skin at the upper abdomen connected by a tube. Normally six to ten band adjustments during the first year is required for a patient.

Apprehensions and facts about Lap Band

Lap Band involves no major surgery of the stomach and no inside stapling. Adjustments can be done without further operation. When the objective is achieved, the laparoscopic removal of the band is possible.

The Lap Band reduces the size of a normal stomach of 1000 cc’s by 15 to 30 cc's which is about the size of an egg.

Weight loss is slower in case of Lap Band, than in gastric bypass. One can lose only 38 percent of excess body weight during the first two years after which the weight becomes static.

Weight loss is a journey. A journey is meant to help one through. This procedure involves less pain, less risk leading to effective treatment of the weight.

Who qualify for the operation

Though the intake of less food helps the patient continually lose weight, not everybody qualifies for the procedure. People who are obese and require controlling their weights from gaining dangerously exponential proportions are the ones who are normally given this treatment. Although the band can be placed permanently, still it is possible to remove at any time.

Apart from achieving a good weight loss curve, the operation is taken up in case of patients who continuously vomit making intake of solid foods impossible.

To gain an insight about weight-loss needs, the BMI Calculator can be used to determine the current Body Mass Index.

Post operation care

Advantage of the operation is that the stoma size can be adjusted post-operatively without any further surgery.

All surgical weight-loss operations require the patients to consume less than 800 calories of food per day during the first 18 months and up to 1200 calories per day after 36 months.

How to reduce Belly fat?

Reduce Belly Fat

Abdominal fat, also known as visceral fat, stomach fat or belly fat, is not just a matter of vanity anymore. Doctors are increasingly sounding the alarm about the health dangers of belly fat, as more Americans are diagnosed daily with obesity, diabetes, and high cholesterol.

Scientists in Sweden have reported that patients taking conjugated linoleic acid, or CLA for short, lose fat- especially abdominal or belly fat. CLA is a special type of fatty acid, and is available in the U.S. without prescription.

In a 2001 trial, people taking 4 grams of CLA a day lost nearly 4% of their body fat and reduced their tummy fat over 12 weeks, with no other dietary or exercise changes.

Another Swedish study in 2004 found that CLA “might slightly decrease body fat in humans, particularly abdominal fat,” without changing body mass index. No harmful side effects were reported.

A 2004 review study on weight loss supplements from Creighton University Medical Center reported that “results for conjugated linoleic acid were positive in three clinical studies, with few adverse effects.”

A 4% reduction of fat may not sound like much, but its importance for your health can be profound. Doctors at Laval University in Quebec, who specialize in the study of abdominal fat, say that even a 5% to 10% reduction in belly fat can reduce your risk of diabetes and heart disease by as much as 60%.

While CLA may not be the cure for belly fat all by itself, it is certainly one way to target belly fat loss. In combination with some (or all) of the other powerful, proven methods I will share with you in this series, it could make a profound difference for your waistline- and your health.

America's Fattest and Fittest Cities - A Survey

Top 25 Fittest 1. Albuquerque, N.M.
2. Seattle, Wash.
3. Colorado Springs, Colo.
4. Minneapolis
5. Tucson, Ariz.
6. Denver
7. San Francisco
8. Baltimore
9. Portland, Ore.
10. Honolulu
11. Washington, D.C.
12. Omaha, Neb.
13. Tulsa, Okla.
14. Boston
15. Virginia Beach, Va.
16. Milwaukee
17. Sacramento
18. Louisville-Jefferson, Ky.
19. Columbus, Ohio
20. Philadelphia
21. Austin, Tx.
22. Nashville-Davidson
23. Charlotte
24. Atlanta
25. Oakland, Calf.
Top 25 Fattest 1. Las Vegas
2. San Antonio
3. Miami
4. Mesa, Ariz.
5. Los Angeles
6. Houston
7. Dallas
8. El Paso
9. Detroit
10. San Jose
11. Long Beach, Calf.
12. Memphis
13. Chicago 14. Arlington, Texas
15. Oklahoma City
16. Indianapolis
17. Forth Worth
18. New York
19. Fresno, Calif.
20. Wichita, Kan.
21. San Diego
22. Phoenix
23. Jacksonville, Fla.
24. Kansas City
25. Cleveland

nnovative Ways To tackle People With Bad Health Habits

reduce weight immediately

For lunch, Joy Hesemann loved to dive into a platter of deep-fried, crunchy chicken tenders with a side of ranch dressing. At night, she'd fry up ground beef for Hamburger Helper or another boxed meal for her family's dinner. Later, she'd plop in front of the TV or computer screen and rip into a bag of Oreos or potato chips.

"I knew I was constantly overeating and eating the wrong things, and I wasn't exercising," admitted Hesemann, 27, an administrative assistant from Streamwood, Ill. "I wanted to change, but I needed some motivation."

That came in the form of a new research study at Northwestern University investigating innovative ways to rehabilitate people with lousy health habits. The prerequisites: a chummy relationship with saturated fat but no acquaintance with fruits and vegetables; leisure time spent gazing at a TV or computer screen, along with an "allergy" to exercise.

In other words, a typical American lifestyle.

"That was me," Hesemann said. She signed up.

The study was designed by Bonnie Spring, a professor of preventive medicine at Northwestern's Feinberg School of Medicine, to make change as easy as possible.

Spring knows it's overwhelming for someone with a raft of unhealthy habits to overhaul an entire lifestyle. So she wants them to just change two unhealthy behaviors to see if the others will tag along. Sort of a buy two, get two free sale. Her method is based on the Behavioral Economics Theory used by Nobel Prize winner Daniel Kahneman.

She's also helping these fat-food-loving couch dwellers flip their lifestyles with an arsenal of high-tech tools including a specially programmed Palm Pilot to monitor eating and exercise; virtual visits with a personal coach and an accelerometer which straps around the waist to record the intensity of their movements. (You call that a brisk walk")

Participants are assigned to eat more veggies and fruits or cut down on saturated fat; and cut back on "screen" time or increase exercise.

"We're trying to figure out which two behavior changes give you the maximum healthy bang for your buck on all unhealthy behaviors that we're trying to modify," Spring said.

"The new behaviors come along for the ride in one of two ways -- a complementary behavior or a substitute behavior," Spring explained. "If watching TV means you also snack when you watch, then eating and snacking are complementary behaviors for you. If I can get you to cut down on your TV, you'll probably automatically cut down on your snacking. I make your life simpler by just asking you to change one. The complementary behavior is a bonus that comes along for the ride."

"A substitute behavior replaces or crowds out another behavior," Spring said. An example would be eating more fruits and vegetables, so you would nibble strawberries instead of being elbow-deep in a bag of Cheetos.

Hesemann's assignment for the four-month study was to slash most saturated fat from her diet and break a sweat for an hour a day. She also got a crash course on healthier eating and strategies to inject more physical activity into her day such as taking the stairs instead of the elevator.

She recorded every bite of food and minute of exercise in the ever-present Palm Pilot, which had software to monitor her daily progress. With each entry, an image of a thermometer with a rising "temperature" showed her intake of saturated fat so far that day (she was allowed 20 grams) and her minutes of exercise.

"It was dreadful to have to write it down," Hesemann said about logging in her food. She learned her favorite fried chicken tenders lunch soared past her fat quota as did her beloved Italian sausages. "I said 'Oh, my god. I'm never eating those again!' I hated seeing that thermometer rise."

At the end of each day she'd download the data into her computer and send it to her personal coach. The coach would zip Hesemann encouraging e-mails ("You're doing a great job!") or friendly reminders to get off the couch ("You need 30 minutes more of activity each day.")

As with all participants, Hesemann's recordings in the Palm Pilot and contact with the personal coach gradually tapered off over the four-month period of the study. This latter period is when it gets interesting for Spring. She's waiting to see who falls off the wagon.

"It's really hard to maintain a new healthier lifestyle," Spring said. "At first it's novel and exciting and then the novelty wears off. You tend to revert back to the old habits. There's kind of an inertia that pulls you back."

Spring is anxious to see which two behavior changes best helped people maintain their healthier habits. But she won't know the results until the study ends in 2008.

In the meantime, Joy Hesemann now races up and down the stairs at work instead of punching elevator buttons and hits the gym three days a week. She bakes skinless chicken for dinner and nibbles strawberries for dessert. She's lost 40 pounds and dropped three dress sizes. She's even eliminated high fat foods from her 6-year-old daughter's meals. Six month after the study, Hesemann's new healthy ways show no sign of abating.

"This program made me more conscious of the foods I'm eating. And the exercise is a blast. I still have my fallbacks, but if I go to McDonald's I'll get the grilled chicken sandwich instead of the comforting, nasty foods. For me this is a new way of life. "

High Salt Diet may lead To Ulcers

Hight salt diet = ulcers

Bethesda, Md--Scientists from the Uniformed Services University of the Health Sciences (USU) have discovered that diets high in salt may increase the virulence of the pathogen Helicobacter pylori (H. pylori), which is the most common cause of ulcers in the stomach and duodenum.

"Apparently the stomach pathogen H. pylori closely monitors the diets of those people whom it infects. Epidemiological evidence has long implied that there is a connection between H. pylori and the composition of the human diet. This is especially true for diets rich in salt," says Hanan Gancz, Ph.D., of the Uniformed Services University of the Health Sciences in Bethesda, Maryland, who presented the research May 22, 2007 at the 107th General Meeting of the American Society for Microbiology in Toronto. The research was conducted in the USU laboratory of D. Scott Merrell, Ph.D., assistant professor of microbiology and immunology. High concentrations of salt in the stomach appear to induce gene activity in H. pylori, making it more virulent and increasing the likelihood of an infected person developing a severe gastric disease.

H. pylori is a spiral-shaped bacterium that can live in the acidic environment of the stomach and duodenum which is the section of intestine below the stomach. It is the most common cause of ulcers of the stomach and duodenum, accounting for up to 90% of duodenal ulcers and up to 80% of gastric ulcers.

Infection with H. pylori also causes gastritis, and infected persons also have a 2- to 6-fold increased risk of developing mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer compared with uninfected counterparts.

H. pylori infection is common in the United States and is most often found in persons from lower income groups and older adults. About 20% of persons less than 40 years of age and about 50% of persons over 60 years of age are infected. Most infected people do not have symptoms and only a small percentage go on to develop disease.

Previous research has focused on the affects diet has on the stomach environment where H. pylori resides, but until now scientists have overlooked the response of the microorganism specifically to these dietary queues. Working from the epidemiological evidence that H. pylori infection combined with a high-salt diet results in an increased incidence of severe gastric maladies, Gancz and colleagues decided to look at the direct effect a high concentration of salt had on both the growth and gene expression of the bacterium.

"We noted that H. pylori growth rate shows a sharp decline at high salt concentrations. Moreover, bacterial cells exposed to increased salt exhibited striking morphological changes: cells became elongated and formed long chains," says Gancz. "We conclude that H. pylori exposed to high levels of salt in vitro exhibit a defect in cell division."

They also discovered transcription of two genes responsible for the virulence of the bacterium was increased during high-salt conditions.

"The altered expression patterns of some virulence genes may partially explain the increased disease risk that is associated with a high salt diet in H. pylori infected individuals," says Gancz.

The Uniformed Services University of the Health Sciences is located on the grounds of the National Naval Medical Center in Bethesda, Md. The University provides military and public health-relevant education, research, service and consultation to the nation and the world. USU is a typical academic health center with a unique focus on health promotion and disease prevention and the specialized mission of educating health care practitioners to deal with peace and wartime casualties, natural disasters, emerging infectious diseases and other public health emergencies.

This work was supported by a grant from the U.S. National Institutes of Health.

Weight Loss Surgery can Brain Damage

Weight Loss Surgery Risk

Weight Loss Surgery Side Effect

After weight loss surgery, some patients risk brain damage from vitamin B-1 deficiency, researchers report.

Too little vitamin B-1 -- thiamine -- causes a syndrome called Wernicke's encephalopathy. It's most often seen in malnourished alcoholics.

If treated right away with vitamin B-1 shots, patients quickly recover. But if the syndrome isn't recognized quickly, it can result in permanent brain damage.

And that can be a problem, says Wake Forest University researcher Sonal Singh, MD. Singh and Abhay Kumar, MD, of the University of Iowa, found 32 reports of Wernicke's encephalopathy in weight loss surgery patients.

"Early diagnosis is essential," Singh tells WebMD. "Yes, thiamine shots are helpful. But you get full recovery only when it is given early. Once [advanced symptoms] develop, there is going to be neurological damage."

Singh and Kumar report their findings in the March 13 issue of the journal Neurology.

Tricky Symptoms

Wernicke's encephalopathy has three classic symptoms: jerky, uncoordinated movement; uncontrollable eye movements; and mental confusion.

That sounds easy to recognize. But not all weight loss surgery patients who develop the syndrome get all three symptoms. And some patients have unusual symptoms, such as hearing loss, weakness, convulsions, and tingling or numbness in the arms and legs.

Symptoms of Wernicke's encephalopathy most often occurred four to 12 weeks after weight loss surgery. However, one case began a year after surgery, and another started only two weeks after surgery.

There's one major warning sign for weight loss surgery patients: frequent vomiting. Twenty-five of the 32 reported patients were vomiting after their surgery.

However, not all the patients had this symptom. And many developed vitamin B-1 deficiency even though they were taking oral thiamine supplements, suggesting that deficiencies in other nutrients may also play a role.

How often do weight loss surgery patients get Wernicke's encephalopathy? That isn't yet known. Singh says it's an issue that clearly needs study.

"Maybe giving shots of thiamine after surgery would prevent this," Singh says. "We might do it preventively rather than waiting for symptoms to appear. That, too, needs to be studied."

Bariatric surgeon Ioannis Raftopoulos, MD, assistant professor of surgery at the University of Pittsburgh, says he regularly monitors thiamine levels in his patients and routinely gives his patients thiamine supplements, either orally or by monthly injections.

The result: Raftopoulos says he has never had a patient develop Wernicke's encephalopathy.

"This kind of thing only happens when a patient has been vomiting for weeks," Raftopoulos tells WebMD. "That kind of neurological impairment means a patient has had a lot of problems for a long time. That is why the key here is patient follow-up. All my patients have my personal beeper number so they can contact me immediately, before there is a serious problem."

Singh says patients should immediately call a doctor if, after weight loss surgery, they have coordination problems -- especially changes in their gait -- or any changes in their hearing or vision.

Top 10 antioxidants for Weight Loss

1. Blackberries
5,75 millimoles per 100g serving

This wonderfully delectable summer fruit came out tops. Blackberries give an antioxidant kick of 5,75 millimoles per serving.

Blackberries are also fat-free, and a source of folic acid and vitamin C, so there's no holding back. Whip them into smoothies, make a wicked fruit coulis to serve with desserts, or simply have them fresh.

You can freeze blackberries and use them all year round. This can be done by coating the berries with a mixture of sugar and ascorbic acid (ask your pharmacist), but it is generally better to freeze lightly boiled berries to which sugar has been added.

2. Walnuts
3,72 millimoles per 100g serving

Nuts are great health foods – they're cholesterol-free, generally low in sodium and a great source of vitamins and minerals. But in terms of antioxidant content, walnuts seem to beat the rest of the nut family with 3,72 millimoles per serving.

Toss these nuts into salads, mix them into muesli, or include them in rice pudding or apple tart.

Just make sure that you have no more than a handful of walnuts per day. If you're overweight, cut this amount to a handful no more than three times per week.

3. Strawberries
3,58 millimoles per 100g serving

Strawberries are sexy, fun and – best of all – so low in calories that you can eat as much as you like without giving your weight a second thought.

These fruits should also form part of your diet for another reason: they're packed with antioxidants and clock in at 3,58 millimoles of these health-boosting components per 100g serving.

There's no need to tell you that strawberries are a great addition to desserts, smoothies, salads, and even cocktails – just make sure you eat them as fresh as possible.

4. Artichokes, cooked
3,56 millimoles per 100g serving

The humble artichoke also made the top-10 list. Apart from the 3,56 millimole/100g antioxidant punch, artichokes are a good source of iron.

These veggies also help to reduce bowel upsets and help to let good bacteria flourish in your gut.

Cook artichokes for 20 minutes with a slice or two of lemon, a bay leaf and salt. The leaves and the heart can then be eaten.

5. Cranberries
3,13 millimoles per 100g serving

The cranberry really is a super-food. Numerous studies have shown that the anti-inflammatory properties of this fruit can help to prevent and treat urinary tract, and possibly other, infections.

One reason why cranberries are so healthy, is because of their high antioxidant content (3,13 millimoles per 100g).

As cranberries are generally too tart to eat fresh, go for the canned varieties and use these in both sweet and savoury dishes.

6. Raspberries
2,87 millimoles per 100g serving

Raspberries have a long history of being used to treat conditions ranging from tonsillitis to stomach aches and also to strengthening the womb in pregnancy.

Now we know that these berries are not only a good source of antioxidants (2,87 millimoles per 100g serving), but are also high in vitamin C.

Ask your grocery store if they stock fresh or frozen raspberries, and use them in fruit salads, deserts or eat them with yoghurt for breakfast.

7. Blueberries
2,68 millimoles per 100g serving

Another berry, this time the blueberry, made the list. This only goes to show that berries really are super foods.

Apart from the high antioxidant content (2,68 millimoles per serving) there is also preliminary evidence that berries can thwart cholesterol and help prevent liver cancer.

Blueberries are not sour and can be eaten raw. This will preserve their vitamin C content.

8. Cloves, ground
2,64 millimoles per 100g serving

Who would have thought that cloves, a great addition to anything from chicken dishes to Christmas mince pies, could have magic health-boosting properties?

Well, this spice made the top 10 antioxidant list – and with good reason. It contains 2,64 millimoles of antioxidants per 100g serving.

While it's more difficult to get your daily antioxidant injection from this spice – simply because we generally use it in small quantities – you should still try to incorporate it in your diet.

9. Grape juice
2,56 millimoles per 100g serving

You already know that a daily glass of wine can kick-start your health. But plain old grape juice seems to be even better – at least when it comes to levels of antioxidants (2,56 millimoles per serving).

Research shows that red grape juice can improve cholesterol levels and inflammatory markers associated with heart disease. This action has been linked to the antioxidant content of the juice.

But be warned: grape juice has a high sugar content and can add quite a few calories to your diet. Don't drink more than one glass of juice, diluted with water, per day.

10. Cranberry juice
2,47 millimoles per 100g serving

As mentioned above, cranberries have strong anti-inflammatory effects and are particularly useful in preventing urinary tract infections.

As fresh, raw cranberries are too tart to eat, cranberry juice is the ideal way to tap the benefits of this fruit.

Try to drink a small glass of cranberry juice every day – especially if you're prone to urinary tract infections. Or combine cranberry juice with iced Rooibos tea for a refreshing summer drink.

Is the weight loss program that you have chosen safe?

Since the awareness about obesity has increased widely. There is also mushrooming of weight loss solution companies .It has become an industry owing to the inquisitiveness of people to turn slim overnight .Even those who are little obese are also joining the bandwagon. But caution must be employed while choosing the weight loss solutions Read on.This article covers

• Why people join weight loss programs?
• What all are the options available for them?
• Which is the best weight loss program?

With the percentage of obesity and overweight rising in the world, especially drastically in the United States, it comes as no surprise that people have started to opt for one or the other weight loss solutions available today.

Many people gain weight due to stresses in lives and very little exercise combined with a high-fat and on-the-go diet. However, whatever the reason may be, it is always good and healthy to lose weight and with so many options available today, losing weight has become easier than never. However, be aware of any program or supplement which promises magical results to you.

Weight Watchers

One of the most common and fast weight loss solutions available on the market today is Weight Watchers. Weight Watchers offer individuals looking for weight loss, a complete range of weight loss solutions, along with corporate solutions as well, which can be tailored according to requirements of any company, or individual. You can sign up for Weight Watcher's online program, attend their meetings, or find about other e-tools which the company offers. By subscribing to their web site, you can also receive their newsletter and low-fat recipes. The program never claims that it is possible to lose weight by simply a magical solution and stresses the importance of a healthy lifestyle in order to lose weight. Weight Watchers has been established for quite some time now and has proved to many customers about the efficiency of their weight loss solutions.

NutriSystem

Another popular weight loss solution is NutriSystem. A commercial weight loss program, NutriSystem also provides a host of services for people who are looking for weight loss solutions. Similar to Weight Watchers, NutriSystem also provides consultation online, through meetings, and other e-tools which are available on their website. NutriSystem focuses on the consumption of a low-caloric diet which stresses the importance of balanced nutrition. The diet follows the Food Guide Pyramid and follows the basic 60% carbohydrates, 20% fat, and 20% protein diet theory. However, NutriSystem also focuses on the "glycemic index". This index measures the quality of carbohydrates and divides them as good or bad carbohydrates. For an individual who is following the NutriSystem weight loss solution, the program will stress on the consumption of their pre-packaged meals which are supposedly containing food in the correct portion size. However, the drawback being that once the program ends, dieters usually have no idea about which food items to take or how to prepare low-caloric food items. The dependency on packaged food increases drastically. NutriSystem does not claim to be a fast healthy weight loss solution and emphasizes a healthy lifestyle along with a regular workout session.

eDiets

eDiets is an online weight loss program which promotes itself as a program which understands that every person requires a different dietary program, and the site sells customized eating plans to people who are willing to invest. With very reasonable prices for their eating plans, eDiets also offers information on caloric consumption, food items to eat and not to be eaten, lifestyle changes required, and also informs individuals about various types of exercises which are good for weight loss.

LAP BAND SURGERY - SOLUTIONS

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Diet and Nutrition

Nutrients That Aid Weight Loss: Calcium

There are certain foods and nutrients that have been shown to help those trying to lose weight. In a study published in the Journal of the American College of Nutrition, women with the highest consumption of dairy calcium lost the most weight and fat over two years, regardless of how much or how little they exercised.

According to research, calcium appears to suppress a process of the body in which fat is deposited, so intake of calcium may actually promote metabolism and reduction of fat. Though it is better to get calcium from nutritious foods, calcium supplements are also effective. Many women's daily calcium intake is far below the recommended 1200-1500 milligrams per day, so there is typically room for improvement in this area.

Foods High in Fiber and Water Content Help Weight Loss

Fiber is a substance that is not digestible, so it adds bulk to foods without adding significant calories. Consuming high fiber foods is beneficial for health in general, but also aids weight loss by giving a feeling of fullness without extra calories.

Similarly, eating food with high water content also give a feeling of fullness, but water has no calories. Foods that contain a lot of water include most fruits and vegetables, eggs, fish, and soups.

HEALTHY TECHNIQUES to LOOSE WEIGHT

Healthy Lifestyle Leads to Healthy Weight Loss

For many people, healthy weight loss does not involve quick fixes, but rather employing life long strategies and changes for an overall healthier lifestyle. Introducing healthy habits, such as regular exercise, and replacing processed, high calorie, high fat foods with healthy foods, are often necessary for successfully managing weight over the long term.

Healthy Weight Loss Better, Even If Results Are Modest

Achieving and maintaining a healthy weight is important for overall health and quality of life, but studies show that even modest weight loss for those who are overweight - losing as little as 5% weight - can reduce risks for a variety of health problems and diseases. Losing weight in an unhealthy way, such as crash dieting, employing extreme dietary restrictions, or using unsafe diet aids, can actually backfire and cause other health problems. Losing a small amount of excess weight in a healthy manner is typically more beneficial than losing a lot of weight in an unsafe way, because healthy weight loss methods are more likely to improve overall health.

Herbs for Weight Loss

Herbs That Increase Metabolism for Weight Loss

Some herbs act on digestion, metabolism, or appetite to impact weight loss. Certain substances can increase thermogenesis, or metabolism, which may lead to weight loss.

Certain thermogenic, or stimulant, herbs have a reputation for aiding weight loss, but according to the FDA should be avoided due to serious or possibly fatal side effects. Weight loss herbs to avoid include: ephedra (or products containing ephedra), which can have dangerous cardiac side effects, herbal laxatives such as cascara sagrada or senna, which can cause serious intestinal problems.
Herbs which may safely aid weight loss include the following:

» Cayenne contains a substance called capsaicin, which may stimulate digestion and increase metabolism and fat burning.
» Green tea contains caffeine and antioxidants that appear to stimulate metabolism.
» Seaweed, or kelp, is a natural thyroid stimulant, which may boost metabolism.
» Nettle is considered to be a thermogenic herb.
» Ginseng helps to boost energy and metabolism.

Anyone with problems or health conditions related to any of these herbs or their actions should not use them.
Hoodia Gordonii: "New" Herb for Weight Loss

The herb Hoodia gordonii (or just "Hoodia") has gained recent attention as an aid for weight loss, due to its appetite suppressing actions. The plant grows in African desert regions, and has been used by the Kalahari San Bushmen for many hundreds of years.

Studies at Brown University indicate that Hoodia appears to work by interrupting or stopping the hunger mechanism in the brain. There is almost no research on the effectiveness of Hoodia as an herbal weight loss supplement, and no substantial information on its safety.

Diabetics should probably avoid Hoodia, because this herb "tricks" the brain into thinking that the body has sufficient blood sugar levels, which may interfere with the function of normal physiological processes that indicate when blood sugar is becoming dangerously low.
Fiber to Suppress Appetite

Taking soluble fiber supplements adds bulk and makes one feel full, but without any added calories. It is imperative to drink adequate water when using fiber supplements to avoid constipation and digestive problems, and fiber supplements should be taken under supervision of a health care professional. Foods high in soluble fiber include apples, oatmeal, beans, and pears.

How Does Hypnosis Work on Weight Loss

Considerable controversy swirls around the mechanisms by which hypnosis actually contributes to weight loss. Leon (1976) suggested that hypnosis can help obese people team new healthier eating patterns and retain them. One author remarked that the hypnotic state is characterized by heightened concentration, suggestibility, and relaxation (Mott, 1982). Certain individuals are thought to be capable of achieving this state more readily than others. A so-called hypnotic "induction" whereby a hypnotist using certain procedures to bring an individual into the hypnotic state is not a prerequisite for achieving the state (Mott, 1982). Hypnosis, contrary to the claims of some intemet advertisers cannot magically reprogram people's minds. In short, methods of hypnosis run the gamut from simple relaxation techniques to formal inductions administered by hypnotists, but should not be considered supernatural in its effects.