I'm Hungry! or Am I?

By Joanne M. Moff

Joanne M. Moff, PA-C has been a practicing Physician Assistant for nine years. She received her training at Kettering College of Medical Arts in Kettering, Ohio. She has experience in both general and cardiothoracic surgery, and she recently changed her focus to bariatric surgery. She currently works with Dr. Rita Anderson at Kettering Medical Center.

OkayIve Gone Through Weight Loss Surgery, Now What Do I Do?! is truly a labor of love. This book actually evolved from a rather simple idea. During employee orientation at Kettering Medical Center, new hires were encouraged to find ways in which to make a difference in their patients lives in whatever way they could big or small. The inspiration to find your pickle was introduced. That began the process of seeking out some way to have an effect in bariatric patients lives. Within the first couple of weeks after starting with Dr. Rita Anderson in bariatric surgery, a pickle was discovered. Early recognition of the need for bariatric patients to have support following their surgery was made. In order for the patients to achieve success in the short term with their weight loss as well as in the long term with maintenance of their weight loss and an overall healthier lifestyle, support was seen as necessary. At first, simple ways to offer help were tossed around: a calendar, a mug, or a water bottle with tips, pointers and reminders on it listing how to live the new lifestyle as a bariatric patient. Then came the idea of a small booklet. The booklet would be interactive, allowing bariatric patients to offer their own helpful hints and suggestions, and there would be input from healthcare providers as well. As patients gave their contributions, research was being conducted and information was being gathered that would help to explain the whys of the new bariatric lifestyle as well as specific ways to incorporate those lifestyle changes. The booklet grew, going from five sections into eight chapters. It has continued to grow and expand into a full-fledged book covering the most important issues with which a bariatric patient will be faced. The pickle that started out as a simple, sweet gherkin has turned into an elaborate, giant dill pickle. What began as a way to help patients in the New Life Weight Loss Surgery Center succeed has turned into a crusade to help all patients who have gone through bariatric surgery succeed. Bariatric patients have seen enough failure in their lives with failed diets and recurrent weight gain. With the support of this book as well as support from family, friends, healthcare providers and other bariatric patients, failure will hopefully be a thing of the past.

• Language: English
• Publisher: Xlibris US
• Release date: Jan 27, 2010
• ISBN: 9781450020817

Book preview

Contents

Dedication

This book is dedicated to everyone who wants to learn more about and understand how his or her body works. It is also dedicated to everyone who wants to learn more about how to live a healthier lifestyle.

But it is mostly dedicated to those of you who are or who have been obese and to those who have had or are considering having bariatric surgery. You’ve struggled with eating and dieting, losing weight and gaining weight. Hopefully this book will help educate, enlighten, and entertain you as you travel down your path toward a happier and healthier life.

Disclaimer

The food and drink products listed in this book are meant to educate you on what is available, not to sway you to buy certain things. A sampling of what is available to you has been presented. When you run out of ideas on what to try, look to this book for some suggestions.

For those who prefer more natural ingredients and fewer artificial ingredients, examples are given. For those trying to find good-tasting, nutrient-dense, and protein-dense foods that may or may not contain artificial ingredients, examples are given.

My hope is to expose you to what is out there and let you come to your own conclusions about what is best for you.

Acknowledgments

Not to sound like a winner accepting an Oscar at the Academy Awards Ceremony, there are so many people I want to acknowledge, those who have been my support and inspiration for this book—and the last one too!

First of all, I want to thank my parents, Richard and Eleanor, for without them, I wouldn’t be here. I also want to thank my sisters, Carolyn, Diane, Kathy, Linda, Maria, and Sue. I want to thank my uncles and aunts and cousins. I want to thank my brothers-in-law, Ben, Bill, Doug, Jim, and Sam; my nieces and nephews, Jennifer, Andrew, Michael, Kevin, Celia, Amanda, Kimberly, Donald, Richard, Teresa, Lucy, Liza, Veronica, Christina, Ethan, Lucia, Danielle, Eleanor, Garret, and Isaac; and great niece, Regina. I hope I’ve made you proud!

To Rita, medical director of the New Life Weight Loss Surgery Center, not only were you open and supportive of my first book, but you’ve continued to encourage me on this second one. God has worked through you to take me some place I never in my life dreamed possible. Thank you! I love you!

To everyone at New Life Weight Loss Surgery Center and South Dayton Surgeons Inc., especially Susie, Jamie, and Nicci, I thank you and I love you! To everyone with Kettering Weight Loss at Kettering Medical Center and Sycamore Hospital, you guys are an awesome team!

To my best friend, David, thank you for being my cheerleader, shoulder, and partner. You can carry my bags anywhere! I love you!

To the OR staff of Kettering Medical Center, especially Marianne, Adanna, Melany, Jess, Krista, Bev, Lisa, Jennifer, Heather, Brenda, Todd, and Emily, you guys are amazing! To everyone I used to work with on the heart team, Sue, Maria, Erin, Trish, Curtis, Marsha, Jim, Kathy, Birgit, Andrea, Deanna, Diane, Roberta, Barb, and Chris, I miss working with all of you so much! When the going got tough, you carried me through! I love you!

To all the sales representatives with their latest and greatest gadgets and research, especially Debbie, Kyle, Norm, Eric, Dave, Cameron, and Chad, thanks for sharing in the excitement of my latest work.

To the anesthesia department at Kettering Medical Center, your support and cheers of encouragement have been overwhelming! Thanks!

To Kenny and Brian, if we ever need a perfusionist, you’ll be the first we call!

To the production department of Xlibris Corporation, thank you for working so quickly to make my book available to everyone. You made the process of publishing my book fun and easy!

To anyone whom I have not mentioned, please forgive my oversight. It was not intentional.

Introduction

As I listened to the questions and concerns of bariatric patients over the past year, I realized I could do more to educate them on how to transition into their new lives. While Okay . . . I’ve Gone through Weight Loss Surgery, Now What Do I Do?! covers the major issues bariatric patients face after surgery, including fluids, protein, vitamins, exercise, depression, complications, recipes, and advocacy, this book focuses primarily on eating.

The first two chapters are designed to focus on the when, how, and why we eat. Appetite, hunger, and satiety are discussed in detail, especially how chemicals in our bodies affect each of these things.

The next two chapters are geared toward further explaining exactly how to eat after surgery. Eating was the focal point of many bariatric patients before surgery, and it remains a focal point after surgery. Chapter 3 describes in so much detail how to eat that if you read it and follow the guidelines, you can’t go wrong! And if you’re running out of ideas for protein foods, powders, drinks, or bars, read Chapter 4. It’s full of suggestions!

The last chapter offers new information on already discussed topics from Okay . . . I’ve Gone through Weight Loss Surgery, Now What Do I Do?! Like all things in medicine, new products and new information are constantly being generated, and this chapter covers some of the latest discoveries.

Chapter 1

Causes of Obesity

People become overweight, obese, morbidly obese, supermorbidly obese, or super-supermorbidly obese from eating too much and exercising or moving around too little. Is this true or false? If you say true, you’re right. But there’s much more to this than meets the eye. There are medical, scientific, and environmental reasons for why people eat too much and become overweight or obese. The less well known and understood are medical and scientific reasons.

Why did you eat breakfast this morning? Duh! Because I was hungry, you utter to yourself. But how did you know you were hungry? Because signals were sent to your brain from somewhere else in your body to tell you, Feed me! Sometimes, though, these signals—which include polypeptides, proteins, hormones, and their receptors—send out the wrong message about whether or not to eat. Too much or too little of these signals may be produced. Signals can get crossed or misread altogether and send out the wrong message about whether or not to eat. This is beyond your control. Polypeptides, proteins, and hormones in your fat and gastrointestinal tract, glucose or sugar in your blood, and your body temperature send signals to your brain that tell you to increase your eating or decrease your eating.

Polypeptides, proteins, and hormones that stimulate or increase your appetite include the following:

• Agouti-related peptide

• Galanin

• Ghrelin

• Growth hormone

• Melanin-concentrating hormone (MCH)

• Melanocyte-stimulating hormone (MSH)

• Motilin

• Neuropeptide Y

• Orexin

Polypeptides, proteins, and hormones that decrease your appetite include the following:

• Bombesin

• Cholecystokinin

• Gastrin

• Gastrin-releasing peptide (GRP)

• Glucagon

• Glucagon-like peptide-1

• Leptin

• Peptide YY

• Secretin

• Somatostatin

In the next chapter, we’ll discuss in much more detail some of the polypeptides, proteins, and hormones involved in appetite, hunger, and satiety (or fullness).

So why do we overeat? Why do some of us become overweight and obese while others of us don’t? To understand this, let’s look at some of the science behind obesity.

• Genetics

If genetics teaches us one thing, it is that big people come from big parents and big families. It is pretty unusual to see a morbidly obese person with skinny parents. It is also unusual to see a skinny person with morbidly obese parents.

Genetics plays a much greater role in causing obesity than was once thought. It was believed to account for at least 25 percent of the causes of obesity. We now know that it is responsible for upward of 75 percent of the causes of obesity. There are two thousand genes that are considered to be related to obesity, and less than two hundred have been identified.

Genetics can influence your appetite and satiety, which is your sensation of feeling full. Your polypeptides, proteins, hormones, and their receptors affect how and when you need to eat. If you are born with a defect with any of these chemicals, your body may send to your brain the wrong signals about whether or not you need to eat.

Genetics affects your basal metabolic rate, abbreviated BMR. Your BMR is