Susan B. Dopart M.S., R.D.

This week’s LA Times article by Michael Hiltzik regarding the man who had gastric band surgery and died 3 days later was jarring.   A 6 foot 6 inch man who weighed 300 pounds sought out surgery thinking he could get a better job weighing less.  He was only 36 years old, a schoolteacher with 6 children who had his whole life to live.

I remember back to the initial days of being a clinical dietitian at UCLA and taking care of those who had had gastric bypass surgery.  More than a few had severe health problems and some died of complications related to the surgery.  These experiences in themselves biased me towards not being an advocate for weight loss surgeries.

Personally I feel the surgery is treating the symptom, not the cause.  Research shows many who lose weight regain the weight within a 5-10 year period of time.  Why?  They have not dealt with the underlying root cause of their weight issues.

Many individuals are genetically preprogrammed to be overweight or have a weight issues.  However, a healthy lifestyle of exercise/activity and an individualized eating plan can do wonders for weight management.  It may be hard work but no surgery is required.

The conferences I attend on how weight loss surgeries change appetite, hormones, and result in high amounts of weight in a short period of time do sound appealing.  However, both the short and long-term complications scare me.

A client of mine had bypass surgery and lost half her weight 6 years ago.  She bought a new wardrobe, and was thrilled with her new self.  However, since she had not dealt with the emotional issues that brought on the weight in the first place, she regained most of the weight within 5 years.  She found herself in my office distraught and needing lifestyle skills to manage her weight.

Another one of my clients who had lifelong issues with weight was considering bypass surgery and after speaking with someone who had it decided against it.  He realized if he set his mind to it he could lose weight.  He sought out my services and is losing weight at a good clip due to his efforts of mindful lifestyle eating and exercise.

There are several types of weight loss surgeries which all require eating a very small amount of food.  If one tries to overeat, there are physical consequences.  Why give the control of your body over to a “forced” control of food? 

If the emotional issues of eating are not dealt with, no amount of surgery will keep it off forever.  Most people find a way to eat around it.  Healing your relationship with food is hard work but instead of physical it requires emotional surgery but no knives are not required.

Seek out help from a qualified professional who can bring you on a safe journey of lifestyle intervention.  You’ll save yourself more than the physical scars and financial burdens – you might even safe yourself from death – fast or slow….

Remember, it’s prevention not prescription.

How do we lose weight?  This magic question seems to elude and allure us to weight loss programs and gimmicks.   Water cooler conversations focus on the person who lost weight – how they did it, what are they eating, how long did it take?

I’ve thought about and wrestled with both the question and answer to weight loss since I was a little girl, which is the reason I became a dietitian.  I was a little round as young as second grade and always wanting the second ding-dong or ho-ho after school (who knew what a trans fat was in the 70’s?).  Why was I was always hungrier and bigger than my skinny friends - was it just that I needed to eat less calories or exercise a bit more?

Both the Los Angeles and New York Times have written about restaurant calorie counts, begging the question whether counting calories is the answer.  Health writer Jeannie Stein from the LA Times wrote several informative articles last week, one which asked “Does menu labeling really alter Habits?” 

New York Times article “In the Obesity Epidemic, What’s One Cookie?” discussed Michelle Obama’s strategy of “small changes add up,” in which one eats either 100 calories less or burns 100 calories more.

Is that enough? The challenge of weight loss is unique in that we are genetically diverse as human beings with different metabolisms and lifestyles.  And our food supply and large restaurant portions does not play to our advantage.

It might be time to stop looking for a simple answer and come up with a solution tailor made to your needs.  Ask yourself:

1.  Where do I store my weight?  If you have a lot of belly fat you may be eating too many carbohydrates (processed and starchy) and need more lean protein and good fats to keep your appetite under control.

2.  Instead of focusing on calories, think about how much food your body requires to be NO LONGER HUNGRY versus full.  Studies show when we shift into mindful eating it actually starts re-wiring our brains to be satisfied with less food.

3.  Exercise and activity are not really an “option” if health and weight loss are your goals.  Make exercise like brushing your teeth every day– something you do to keep all the systems in your body – including your metabolism- working at full capacity.

Think about what will work for you and focus on the REWARDS of what you want rather than the limitations.  That is how I found my answer.  Although I needed to look like my job, my driving force was to feel comfortable and healthy in my body.  Finding the path and answer to your water cooler question becomes the recipe for weight loss. Your recipe is the key to prevention and not prescription.