Hi there. Congrats! I'm from Newark and just found a new ob/gyn who came highly recommended. She has a great bedside manner and is very easy to talk to. Her name is Dr. Chantel Imran. Her office is on Kirkwood Hwy near Friendly's if you are familiar with the area. Oh and she's accepting new patients. I hope to use her for my Ob if all goes as planned, even though I just relocated to the beach. I liked her so much that I'd gladly travel over an hour for my appt's. The office number is 454-1222. All the best! 

World-renown Dr. Arya Sharma is the keynote speaker at our 2013 ObesityHelp National Conference on October 4-5, 2013.  Below is a post from Dr. Sharma. 

Just a couple of our own takeaways from the post below:
1.  Don't graze!!
2.  ObesityHelp provides us, as OH members, the ".....support patients towards a long-term goal of healthy and appropriate dietary choices with active monitoring (journaling) - via OH's Health Tracker. 
3.  Stay on track!  If you find yourself off track, jump right back on!

Thanks to ObesityHelp for our OH community and to Dr. Sharma for sharing his expertise online and at our Conference.

Post-Surgery Weight Regain: Nutritional Factors

Posted: 12 Sep 2013 06:00 AM PDT

One of the key reasons why bariatric surgery is so much more effective for treating severe obesity than non-surgical approaches, is because of its profound effect on food intake.

Thus, bariatric surgery significantly affects hunger and satiety and may even have important effects on “wanting” and “liking” of high-caloric foods.

However, this effect on ingestive behaviour is neither “guaranteed” not are these effects consistent between individuals.

As I tell my patients, “The surgeons operate on your gut, not your brain”.

Thus, it can only be expected that a certain proportion of patients will struggle to control their food intake despite surgery, thereby either losing less weight than expected or putting the weight back on.

In an article, published in Obesity Surgery, we systematically reviewed the published evidence on the role of dietary factors in this issue.

As may be expected, patients reporting “loss of control” of eating behaviour post-surgery lost less weight or had a higher risk of gaining back any weight they may have initially lost. Thus, individuals with self-reported “high-adherence” scores tended to lose and sustain greater weight loss than those who did not.

Given that bariatric surgery may limit the amount of food that can be eaten at a single meal, some patients resorted to grazing behaviours (defined as consumption of smaller amounts of foods over extended periods of time) leading to subsequent weight regain. In addition, it was reported that poor diet quality, characterized by an excessive intake of calories, snacks and sweets, as well as oils and fatty foods, was statistically higher in patients experiencing weight regain.

Interestingly, even short-term dietary “indiscretion” (or falling off) can result in very rapid weight regain. This is not surprising as, in this regard there is little difference between someone who has lost weight through surgery or simply through diet and exercise. Irrespective of how the weight is lost, the body appears to retain its ability to rapidly regain lost weight if allowed to do so.

Thus, as we discuss in our article,

“The existing literature strongly suggests that nutritional and lifestyle compliance is crucial to weight management post- bariatric surgery.”

“Comprehensive weight management programs must therefore provide improved patient education and promote adherence to post-bariatric surgery diets in order to ensure success. These programs must take action to support patients towards a long-term goal of healthy and appropriate dietary choices with active monitoring (journaling) and reinforcement (review of food records) strategies provided by a multidisciplinary health care team.”

As I have discussed previously, although bariatric surgery increases the chances of success, it is no magic bullet or easy way out – all patients have to work hard at learning to use their surgery as a tool to help them better control their food intake and will likely do better, the more they understand and comply with the post-surgical nutrition recommendations.

On the other hand, there may be very good reasons why certain individuals, despite best efforts, struggle to meet these recommendations.

I will discuss how neurohormanal and metabolic factors can make dietary compliance difficult in my next post.

@DrSharma
Edmonton, Alberta

Karmali S, Brar B, Shi X, Sharma AM, de Gara C, & Birch DW (2013). Weight Recidivism Post-Bariatric Surgery: A Systematic Review. Obesity surgery PMID: 23996349

When was your last period? *IF* hypothetically, you conceived last wednesday, it would be too soon for a home pregnancy test to give accurate results, so I wouldn't worry about testing just yet. Depo is a pretty reliable form of birth control on its own, so I would say that you probably don't need to worry about it, but taking a test right now is a waste of time and money. I would wait to see if you get your period on time, or if you don't have periods on Depo, I would wait at least 2 weeks from when the condom fell off before testing.

If it does end up that you're pregnant, I know it wouldn't be ideal but you will more than likely be just fine. I was only 5 months post op from my RNY when I found myself unexpectedly pregnant with my now healthy 10 month old son. My pregnancy was perfectly healthy and uncomplicated. I am also currently pregnant again due in January. Again, unplanned.

Hi,

I am almost 7 months post-op (VSG) and was told to use two forms of birth control after surgery.  I am 42 years old and have been on the Depo-Provera injections since I was 24.  My husband and I have been using condoms as our backup.  The other day, I believe it was Wednesday, the condom fell off and we didn't realize it (tried a new position).  I am afraid that I might be pregnant because of this.  My husband is buying a pregnancy test kit on his way home from work for me, tomorrow morning.  I am going to be up all night, worrying, though.  I have no way to get it on my own, as I don't drive due to bad knees (I am waiting to lose enough weight to have a right knee replacement, at least).  The only "symptoms" that I am showing is a big appetite, but I don't think it could be from pregnancy, as it'd be too soon.  Also, I have been under a lot of stress due to finances and school, so it could just be head hunger.  Anyway, I would appreciate anyone's experience with this or even opinion.  I have never been pregnant in my life and do not want to have a baby at my age!  Please help!

Thanks in advance,

Tina

oh my friend, you are so brave and so honest. i  commend you for having the courage to leave him. it CAN'T be easy for anyone but especially a mother of 2 and one on the way!! i wish i lived near by so that i could be of some help. if you ever need to talk i'm here for you!!! thank you for being an amazing mommy and aunt and standing up for whats right. i'm very sorry you have to deal with any of this. its horrible. please keep posting. i look fwd to all your posts.