Should you have weight loss surgery?

[dontoearth]

NYT article about low and no carb diets and obesity.  

 

 

http://www.nytimes.com/2016/09/11/opinion/sunday/before-you-spend-26000-on-weight-loss-surgery-do-this.html?action=click&contentCollection=Politics&module=Trending&version=Full&region=Marginalia&pgtype=article

 

 

[robblok]

Seems so logical that you put people with diabetic and people who are insulin resistant on a low carb diet. However many people don't want that, one of my friends has a friend who is diabetic and still drinks sugary drinks and does not like to go low carb. Many people just feel its their right to stuff their face with whatever food they want.

 

The doctors of course see that there is far more money to be made from operations and then many new consultations then for advising people to go low carb. In other countries (non US) people are get advice to go low carb. In my country they see it as the first option and operation as the last.  

[wtaumme]

I can't say much, but I had heard that they don't suit all the patients. rather then going for surgery you must relay on natural methods and exercise for maintaining normal health and weight.

[Jingthing]

This seems as good a place as any to share this very informative article about bariatric surgery:

 

 

Quote

 

BARIATRIC SURGERY: THE SOLUTION TO OBESITY?

Diet and exercise alone rarely help people lose weight and keep it off. Are operations the answer?

 

 

http://www.newyorker.com/magazine/2016/09/26/bariatric-surgery-the-solution-to-obesity?mbid=synd_digg

 

 

But there is so more to the article.

 

More general topics about obesity, the endless questions about MORALITY, failure rates, prevention vs. cure, etc.

 

Just a taste. You really need to read the ENTIRE article:

 

Quote

From a medical point of view, obesity, like asthma, is something that happens to a person—a disease with many etiologies, not all of them well understood. Dietz went on, “Embedded in the stigmatization of obesity is the idea that this is something that people have done to themselves; that’s not the way to understand it.”

 

I highly recommend that all those interested in overweight and obesity read it.

 

Thank you. 

[dontoearth]

   Thanks for posting the article.  It has a lot of new and up to date information.  I had no idea they had gotten the safety rate up so high with the surgery.  I realized I last checked on this 22 years ago.  At that time the complication and death rate was 3 in 100 and it was a rare last resort measure.  It looks like it is much safer and much more effective today.  

   There does seem to be some real evidence that something is going wrong in the stomach with bacteria.   This is a pretty recent discovery and the first discovery that seems to overcome set point.  Of course doctors believed stomach ulcers were caused by worry decades ago and it took a long time to get to the truth that the stomach ulcers are a virus so I am not surprised we know so little about this part of our body and how it functions.

     I do think it looks like a good choice for those that are morbidly obese.   I am hoping they come up with something else for those of us in the overweight category.  I am an old fashioned chicken and avoid surgery as much as I can.

     Thanks again for such a great article.  And might I mention that the page has many other resource articles which are also very enlightening for those that will go over and spend a little time reading!  I favor science over ignorance and superstition summed up with arrogant opinion and a few old wives tales.  I am talking you...portion control and exercise crowd!  

[tominbkk]

On 9/12/2016 at 9:46 AM, robblok said:

Seems so logical that you put people with diabetic and people who are insulin resistant on a low carb diet. However many people don't want that, one of my friends has a friend who is diabetic and still drinks sugary drinks and does not like to go low carb. Many people just feel its their right to stuff their face with whatever food they want.

 

The doctors of course see that there is far more money to be made from operations and then many new consultations then for advising people to go low carb. In other countries (non US) people are get advice to go low carb. In my country they see it as the first option and operation as the last.  

It doesn't help that the ADA recommends a diet with somewhere between 250-300 carbs a day.  

[tominbkk]

55 minutes ago, dontoearth said:

   Thanks for posting the article.  It has a lot of new and up to date information.  I had no idea they had gotten the safety rate up so high with the surgery.  I realized I last checked on this 22 years ago.  At that time the complication and death rate was 3 in 100 and it was a rare last resort measure.  It looks like it is much safer and much more effective today.  

   There does seem to be some real evidence that something is going wrong in the stomach with bacteria.   This is a pretty recent discovery and the first discovery that seems to overcome set point.  Of course doctors believed stomach ulcers were caused by worry decades ago and it took a long time to get to the truth that the stomach ulcers are a virus so I am not surprised we know so little about this part of our body and how it functions.

     I do think it looks like a good choice for those that are morbidly obese.   I am hoping they come up with something else for those of us in the overweight category.  I am an old fashioned chicken and avoid surgery as much as I can.

     Thanks again for such a great article.  And might I mention that the page has many other resource articles which are also very enlightening for those that will go over and spend a little time reading!  I favor science over ignorance and superstition summed up with arrogant opinion and a few old wives tales.  I am talking you...portion control and exercise crowd!  

 

Amazing things happen when you go keto and get fat-burning adapted.  Your hormones re-regulate themselves and you actually start being able to know when you are hungry and not, and eating to satiety only.  Weight flies off, fat first.  Even when fasting, when fat adapted, you do not burn your muscle, you burn your own fat reserves.  The science is in folks!  Look at The Art and Science of Low Carb Living or Jason Fung's book on Ketogenic Diet.  The science they discuss is irrefutable. Just up to people to read up and learn.

[robblok]

On 24-9-2016 at 9:38 AM, tominbkk said:

 

Amazing things happen when you go keto and get fat-burning adapted.  Your hormones re-regulate themselves and you actually start being able to know when you are hungry and not, and eating to satiety only.  Weight flies off, fat first.  Even when fasting, when fat adapted, you do not burn your muscle, you burn your own fat reserves.  The science is in folks!  Look at The Art and Science of Low Carb Living or Jason Fung's book on Ketogenic Diet.  The science they discuss is irrefutable. Just up to people to read up and learn.

You just have to keep your protein high like 1,5 gram per kg otherwise you WILL loose muscle. Plenty of studies done about that and ketose is no guarantee that it wont happen.  (I think high protein is not much of a problem if you go low carb given you you just cut out carbs and need to eat something besides fat)

[tominbkk]

2 minutes ago, robblok said:

You just have to keep your protein high like 1,5 gram per kg otherwise you WILL loose muscle. Plenty of studies done about that and ketose is no guarantee that it wont happen.  (I think high protein is not much of a problem if you go low carb given you you just cut out carbs and need to eat something besides fat)

For sure - I keep my macros 75% fat, and 25% protein....the carbs are only a few % usually.  I take in between 80-100 grams protein.  If I dip below that, especially after exercise, I can feel it.

[Strange]

2 minutes ago, robblok said:

You just have to keep your protein high like 1,5 gram per kg otherwise you WILL loose muscle. Plenty of studies done about that and ketose is no guarantee that it wont happen.  (I think high protein is not much of a problem if you go low carb given you you just cut out carbs and need to eat something besides fat)

 

Would you still go 1.5 grams of protein per kg regardless of a persons body fat? 

 

100 kg person with 30% body fat gets 1.5 grams per kg? 

 

I always went with 1 gram per pound of lean body mass, regardless of body fat percentage.

[tominbkk]

2 minutes ago, Strange said:

 

Would you still go 1.5 grams of protein per kg regardless of a persons body fat? 

 

100 kg person with 30% body fat gets 1.5 grams per kg? 

 

I always went with 1 gram per pound of lean body mass, regardless of body fat percentage.

Yeah that's what I shoot for.  

[robblok]

2 minutes ago, Strange said:

 

Would you still go 1.5 grams of protein per kg regardless of a persons body fat? 

 

100 kg person with 30% body fat gets 1.5 grams per kg? 

 

I always went with 1 gram per pound of lean body mass, regardless of body fat percentage.

I seen the research on conserving muscle when dieting, so yes I would keep it at 1,5 gram. I take it that in the research the people were overweight. But just look at it this way 10kg less is just 15 grams of protein.. that is nothing. Its not hard to get 150 grams of protein a day (if you eat right)

[robblok]

1 minute ago, tominbkk said:

Yeah that's what I shoot for.  

I am even a bit higher in my protein per kg i shoot for 1,5 to 2 grams. But I am quite muscular and lean now. So I do believe in relation to my body-weight I need more protein. But protein is used for many different things not just muscle, in reality just a small part goes to muscle growth and maintenance. Renewing your skin for instance is done with the amino acids from proteins. 

[dontoearth]

1 minute ago, robblok said:

I seen the research on conserving muscle when dieting, so yes I would keep it at 1,5 gram. I take it that in the research the people were overweight. But just look at it this way 10kg less is just 15 grams of protein.. that is nothing. Its not hard to get 150 grams of protein a day (if you eat right)

     Is there any scientific research with acceptable medical measurements in humans that shows we burn muscle when we diet?   The blood and urine samples of fasting patients does not show this and I am not aware of other studies.  The only muscle wasting I have seen is from youtube where some people fasted down to dangerous body weights.  The number there was under 4% body fat left on the body and at that point serious damage occurs.  The video did not explain why anyone would do this seemed to be nutty vegans in some remote village that celebrated fasting with a religious cult.  Anyway, that is not science!

[Strange]

Just now, robblok said:

I seen the research on conserving muscle when dieting, so yes I would keep it at 1,5 gram. I take it that in the research the people were overweight. But just look at it this way 10kg less is just 15 grams of protein.. that is nothing. Its not hard to get 150 grams of protein a day (if you eat right)

 

Yeah, I'm close to 200lbs though and around 15%. I get constipated as hell when I'm around 200g/day and its hard to eat that much chicken (I know I know there are more sources... Chicken is easy and I hate fish) so I supplement with ON Whey. 

 

Read research too and seems to make sense to consume for LBM, plus I can take a normal dump. 

[robblok]

9 minutes ago, dontoearth said:

     Is there any scientific research with acceptable medical measurements in humans that shows we burn muscle when we diet?   The blood and urine samples of fasting patients does not show this and I am not aware of other studies.  The only muscle wasting I have seen is from youtube where some people fasted down to dangerous body weights.  The number there was under 4% body fat left on the body and at that point serious damage occurs.  The video did not explain why anyone would do this seemed to be nutty vegans in some remote village that celebrated fasting with a religious cult.  Anyway, that is not science!

There are quite a few studies that shown it muscle wasting happens a lot and often people who diet lose a lot of muscle during the diet. You should just look for it the research is there. Just a study i found real fast and there are more.  Second one shows more

 

http://www.webmd.com/diet/news/20140529/fast-weight-loss-may-mean-muscle-loss

https://examine.com/nutrition/how-does-protein-affect-weight-loss/

[dontoearth]

1 minute ago, robblok said:

There are quite a few studies that shown it muscle wasting happens a lot and often people who diet lose a lot of muscle during the diet. You should just look for it the research is there. 

     That is what I am saying!  I have not found any medical and scientific proof.  You can find 'soft fluffy' articles all day long that swear this is happening.  Medical?  Scientific?  I just can't find them.   I am talking actual real measurements in a lab, hospital setting!  

     Remember just because you have read something hundreds of times and everyone has repeated it faithfully that doesn't make it true.  I have only seen documented muscle wasting in dying cancer patients, etc!  I haven't seen anything from dieting at all.

[robblok]

I just added one more just look at my studies  second one is also based on research. Here now a third and a fourth

 

http://www.ncbi.nlm.nih.gov/pubmed/16469983

 

http://advances.nutrition.org/content/3/2/119.full

[dontoearth]

@robblok,

      From the first reference...this is what I call academic SLOP:

          

However, the authors also pointed out in a meeting news release that muscle loss among people in the very-low-calorie diet was likely overestimated immediately after they completed the diet, compared with four weeks later.

This is likely because they had a larger loss of water and glycogen (a natural form of sugar in the body) when they had just completed the diet than four weeks later, the researchers explained.

[dontoearth]

@robblok,

        Are they really saying they aren't sure and don't know and excess protein might even have caused it:

However, the underlying physiological mechanisms contributing to the loss of skeletal muscle during energy deprivation are not well described. Recent studies have demonstrated that consuming dietary protein at levels above the current recommended dietary allowance (0.8 g·kg⁻¹·d⁻¹) may attenuate the loss of skeletal muscle mass by affecting the intracellular regulation of muscle anabolism and proteolysis. However, the specific mechanism by which increased dietary protein spares skeletal muscle through enhanced molecular control of muscle protein metabolism has not been elucidated

[thaibeachlovers]

Surgery should always be a last ditch solution for non life threatening problems.

IMO, if someone REALLY wants to lose weight they will, by eating less and exercising more.

IMO, just taking the surgical route only makes surgeons rich, and doesn't prevent the patient continuing to eat bad food, leading to bad health, like diabetes.

Sugar is the number one culprit in weight gain and is the curse of modern times. Unfortunately, sugar is in most processed food, so is difficult to avoid.

 

[tominbkk]

37 minutes ago, dontoearth said:

     Is there any scientific research with acceptable medical measurements in humans that shows we burn muscle when we diet?   The blood and urine samples of fasting patients does not show this and I am not aware of other studies.  The only muscle wasting I have seen is from youtube where some people fasted down to dangerous body weights.  The number there was under 4% body fat left on the body and at that point serious damage occurs.  The video did not explain why anyone would do this seemed to be nutty vegans in some remote village that celebrated fasting with a religious cult.  Anyway, that is not science!

What I've learned is if you are fat adapted, then your body will utilize your fat stores for energy when it needs it.  So what Don said, if you get really low on fat stores it will go to use the muscle.

[dontoearth]

27 minutes ago, robblok said:

I just added one more just look at my studies  second one is also based on research. Here now a third and a fourth

 

http://www.ncbi.nlm.nih.gov/pubmed/16469983

 

http://advances.nutrition.org/content/3/2/119.full

     Last sentence in the results says.......

         No significant effects of protein intake on loss of either body mass or fat mass were observed.

      And in their conclusion they recommend high protein low carb diet anyway.  

      Gosh I wish I were a young researcher once again and could publish any crap I wanted too....with any data and then recommend any results I felt like recommending.

       Which by the way is how we got the LOW FAT diets....People made recommendations that were not supported by the data.  They just felt comfortable in doing so...because everybody knew....and everyone agreed...and so there...

[tominbkk]

38 minutes ago, Strange said:

 

Yeah, I'm close to 200lbs though and around 15%. I get constipated as hell when I'm around 200g/day and its hard to eat that much chicken (I know I know there are more sources... Chicken is easy and I hate fish) so I supplement with ON Whey. 

 

Read research too and seems to make sense to consume for LBM, plus I can take a normal dump. 

Get some good Fiber supplement.  I bought some at the New Image place Central Rama 9 when I went to get some ketone testing strips (I wanted to try them, interesting).  It's called FibreMax and has inulin, psyllium, oat bran, and also some probiotics for gut health.  I haven't been so regular even though I eat lots of broccoli, cauliflower, green beans, lettuces and such.  Took a dose Friday night and another Saturday morning.  By Saturday night, well, without sounding gross, let's just say I had the most perfect bowel movement.  And then again this morning.  The Fiber was 1200 Baht but is enough to last for about two months.  Definitely something I will buy again.  

[robblok]

Just now, dontoearth said:

     Last sentence in the results says.......

         No significant effects of protein intake on loss of either body mass or fat mass were observed.

      And in their conclusion they recommend high protein low carb diet anyway.  

      Gosh I wish I were a young researcher once again and could publish any crap I wanted too....with any data and then recommend any results I felt like recommending.

       Which by the way is how we got the LOW FAT diets....People made recommendations that were not supported by the data.  They just felt comfortable in doing so...because everybody knew....and everyone agreed...and so there...

Other parts show that there is quite a bit of muscle lost. Just read all the other reports too. 

 

Protein intakes of >1.05 g/kg were associated with 0.60 kg additional fat-free mass retention compared with diets with protein intakes < or =1.05 g/kg. In studies conducted for >12 wk, this difference increased to 1.21 kg. No significant effects of protein intake on loss of either body mass or fat mass were observed.

 

The last part only means that eating more protein did not help losing more bodymass.. It did help to retain muscle.. you should read it again.

[robblok]

7 minutes ago, tominbkk said:

What I've learned is if you are fat adapted, then your body will utilize your fat stores for energy when it needs it.  So what Don said, if you get really low on fat stores it will go to use the muscle.

 

Its a pipe dream Tom.. to think if you are low protein that you wont lose muscle you can be fat adapted all you want but go to low in protein and your at risk. Its real hard not to lose muscle when dieting. Its not logical but the body also protects the fat. If not we would always burn 100% fat.. just not the case. 

[tominbkk]

7 minutes ago, robblok said:

 

Its a pipe dream Tom.. to think if you are low protein that you wont lose muscle you can be fat adapted all you want but go to low in protein and your at risk. Its real hard not to lose muscle when dieting. Its not logical but the body also protects the fat. If not we would always burn 100% fat.. just not the case. 

I guess I should say I'm not low protein, I'm just not high protein.  Also, you need to take into account how many carbs you are eating, and effects of hormones, insulin etc in the process. And if you eat too much protein you can get Gluconeogenesis, where the body converts excess protein into glucose which the body needs to take care of, kicking you out of ketosis.  

 

Whatever you are doing seems to be working for you :)  I am quite confident that for me 80-100 grams of protein is good.  I ams still in ketosis, I still feel strong when I exercise, and I recover quickly.  If I felt week or sore all the time I would think about upping my protein 15-20 grams at a time till that changed.

 

[robblok]

2 minutes ago, tominbkk said:

I guess I should say I'm not low protein, I'm just not high protein.  Also, you need to take into account how many carbs you are eating, and effects of hormones, insulin etc in the process. And if you eat too much protein you can get Gluconeogenesis, where the body converts excess protein into glucose which the body needs to take care of, kicking you out of ketosis.  

 

Whatever you are doing seems to be working for you :)  I am quite confident that for me 80-100 grams of protein is good.  I ams still in ketosis, I still feel strong when I exercise, and I recover quickly.  If I felt week or sore all the time I would think about upping my protein 15-20 grams at a time till that changed.

 

I am happy I am not you.. You must be eating tons of fat ?

 

100 grams of protein 400 cals cars low say 50 grams 200 cals... rest calories from fat ? (personally I think your either higher in proteins or high in carbs then you think)

 

To be honest I never found that upping protein had ANY noticeable influence on muscle soreness. For me it depends on how hard I exercise or if I include new movements. 

 

What is working for me is HRT in combination with diet (keeps my test levels normal even on a low cal diet and test also help not to lose muscle and aid recovery). Currently also trying bromcriptine and it seems to work (still early) but breaking new limits again. Its supposed to work on the same receptors as leptine does making sure that your metabolic rate does not slowdown during diet.

 

Leptine responds on how much you eat and how much bodyfat you have and changes your metabolic rate accordingly. Though what I have read that 40% less metabolic rate has been noticed in people who diet.. but after correction for lost weight it seems only 15% can be attributed to leptine slowing you down.

[robblok]

@Tominbkk

 

I am not one of those persons that thinks only my way works.. you lost quite a lot already so your way works for you too. I just don't really believe in fat loss without any muscle loss. (its real hard unless chemically aided). The body just does not like to burn all its fat. Its how we are evolved there are so many mechanisms that work against us when we want to lose fat that its crazy to assume that when we finally lose weight is all fat (also because research shows this is often not the case). Bodybuilders are often an exception because they are chemically aided and can go against the normal laws of weight loss. 

[tominbkk]

I am happy I am not you.. You must be eating tons of fat ?

100 grams of protein 400 cals cars low say 50 grams 200 cals... rest calories from fat ? (personally I think your either higher in proteins or high in carbs then you

Hey there

I take in less than 25 g of carbs a day. I meticulously log everything into my online food counter. I take about 80 to 100 g of protein and 120 to 150 g of fat per day. Sometimes a little less fat and a little more protein, but the carbs are always the same. Welcome to the keto diet!

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