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Obesity: How Prejudiced is the NHS?

serenity648 said:
My B12 investigation isnt about weight or diabetes, its about fatigue and breathlessness.
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Ok. I'll chase my status up. I'm sure I've been tested in the past but I think before kids, maybe. Just a gp request form, right?
 
CherryAA said:
Thanks for the info.

I hope the surgery worked for you?

I am intrigued by the way you mention sugar and fat together as causing dumping - I don't see anywhere in the literature I've read that suggests that fat follows anything like similar pathways as sugar , so its hard to see why fat would cause dumping which I've only really seen as being related to sugars. Have you been given any literature that explains the " fat " part of that comment ?
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Fat slows digestion but if you have gastroparatisis from nerve damage from diabetes it causes dumps/havoc. RH suffers may react differently to fat too?
 
CherryAA said:
I deliberately went for high fat, the result from high risk of heart disease according to the various categorisations to a cholesterol of 3.9 - which is apparently the cut off point where the Framlingham heart study opined that the statistics show that if your total cholesterol is 3.9 or under then you do not suffer a heart attack, FULL STOP. and it doesn't matter what the make up of that is in terms of the hdl, ldl or trigs. In fact measuring any of these independently would also give me the answer - heart healthy - which is a total turn around from high risk six months ago on a low fat diet!
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Mine is never over 4.4 but I'm being investigated for heart disease. Family history of fatal heart attacks early in life. (Just found out). I might benefit from a statin afterall. ;)
 
CherryAA said:
whichever way you look at it, its most likely that the operation is treated as pretty well permanent for the vast majority.
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My friend who had a band found that they stretch over time and she reverted to old eating habits.

If people who have had surgery are expected to eat only 1200 cals per day and from some of the US forums I believe they eat only 800 cals per day, there must come a time when they will need to consume more calories. Maybe that would require the reversal of the bypass. I don't know but having to eat many small meals becomes a pain in the backside for most of us.

The whole thing about calorie control is a bit of nightmare. In theory I need to eat 2700 cals a day to maintain my body weight, so my 1200 cals should in theory leave me with a deficit of 1500 cals per day, 10,500 cals per week and in theory be a 3 lb weight loss per week, only it doesn't work that way.

I'm in the fortunate position of having years of food diaries to verify my statements and it's why I believe that there's more to it than eat less and exercise more and why I don't think all overweight people sit on the backsides eating cake all day.

Even that program was going along with the idea that people just eat too much and although technically that's correct, your "too much", my "too much" and Joe Bloggs' "too much" are all different even if we were the same height, weight, age and gender (all used in calorie requirement calculations) and the current calorie calculations aren't robust enough to take this into account.

Whinge over.
 
DavidGrahamJones said:
My friend who had a band found that they stretch over time and she reverted to old eating habits.

If people who have had surgery are expected to eat only 1200 cals per day and from some of the US forums I believe they eat only 800 cals per day, there must come a time when they will need to consume more calories. Maybe that would require the reversal of the bypass. I don't know but having to eat many small meals becomes a pain in the backside for most of us.

The whole thing about calorie control is a bit of nightmare. In theory I need to eat 2700 cals a day to maintain my body weight, so my 1200 cals should in theory leave me with a deficit of 1500 cals per day, 10,500 cals per week and in theory be a 3 lb weight loss per week, only it doesn't work that way.

I'm in the fortunate position of having years of food diaries to verify my statements and it's why I believe that there's more to it than eat less and exercise more and why I don't think all overweight people sit on the backsides eating cake all day.

Even that program was going along with the idea that people just eat too much and although technically that's correct, your "too much", my "too much" and Joe Bloggs' "too much" are all different even if we were the same height, weight, age and gender (all used in calorie requirement calculations) and the current calorie calculations aren't robust enough to take this into account.

Whinge over.
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I agree with you, I have been eating an averge 1200 calories a day, weighing everything and have lost no weight in 3 months now, hence the blow out last night which added a kilo but I cant possibly have eaten more than about 1800 calories with that .

My male freind who lost 26 kilos easily in 4 months , as always been very sceptical of this - thinking - calories in and out most be the key somehow - then he put a kilo n during a three day fast - he's starting to have a rethink !
 
CherryAA said:
I agree with you, I have been eating an averge 1200 calories a day, weighing everything and have lost no weight in 3 months now, hence the blow out last night which added a kilo but I cant possibly have eaten more than about 1800 calories with that .

My male freind who lost 26 kilos easily in 4 months , as always been very sceptical of this - thinking - calories in and out most be the key somehow - then he put a kilo n during a three day fast - he's starting to have a rethink !
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A lot of that could be water weight as the carbs you ate.. pappadoms.. naughty naughty may have caused some water retention. So far as I know that's why a higher carb meal than usual can cause more than expected weight gain. A bit like muscle retaining more water when exercising although my reading on that is still a bit sketchy..
 
CherryAA said:
Have you got the split of HDL.LDL and trig? and where these have moved over time ?

http://heartriskonline.com/CholesterolChart.htm
http://www.onlineconversion.com/cholesterol.htm
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I'll have to post them later. In 2 places and kids are off school and hubby away. No free time, other than posting inbetween their cartoons. ( I must remember too thou!) I know when I read them they are inkeeping. Thyroid problem keeps my cholesterol down, always has. Its common with thyroid complaints. Not sure if a safety mechanism of the body?
Maybe I need to give myself a safety net of less than 3.9 thou.
Not obesity related I feel. Any thyroid sufferer would have same dilemma.
I will be thoroughly interested to see how my body is going to react to less weigh. Less insulin resistance and I'm praying for to be able to dump my high blood pressure tablets. And of course no insulin injects, goes without saying. I can only tolerate metformin, sometimes at mo. I'munsure how well the op will benefit me. II've heard fantastic stories.
You don't get nothing for nothing. Yes eating ice cube worth of food is the exchange. I'm not that bothered about food at the moment anyway. It doesn't make me happy and financies deem not many meals out. I cannot see the economy of the uk being healthier again for at least 5-6yrs and that is being optomistic. I'm doing this at the right time for me and my circumstances.
I just want to skip down the road again!
 
bulkbiker said:
A lot of that could be water weight as the carbs you ate.. pappadoms.. naughty naughty may have caused some water retention. So far as I know that's why a higher carb meal than usual can cause more than expected weight gain. A bit like muscle retaining more water when exercising although my reading on that is still a bit sketchy..
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Self experimental is your only answer as not enough proof. We are all different but metabolism has been explored in 'normal' circumstances and obesity but not with all other interferring factors. Its on going.
 
It is probable not the case for you ickyhun, your heart is probably struggling to get rid of water but will likely resolve itself when you lose weight due weight loss surgery. This will ease the pressure on the heart. Usually it is sodium/salt causing water retension in the sodium sensitive. regards D.

ickihun said:
Self experimental is your only answer as not enough proof. We are all different but metabolism has been explored in 'normal' circumstances and obesity but not with all other interferring factors. Its on going.
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CherryAA said:
then he put a kilo n during a three day fast - he's starting to have a rethink !
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You really would be surprised at how much difference water makes. Although when you think a litre of water weighs a kilo, maybe it's easier to accept. I'm always a bit concerned when I hear of people being told to consume huge amounts of water, because if it were me it would end up around my ankles and my shoes wouldn't fit, but maybe just me.

The other interesting thing is that when we lose weight we actually breath it out, not pass it.
 
DavidGrahamJones said:
You really would be surprised at how much difference water makes. Although when you think a litre of water weighs a kilo, maybe it's easier to accept. I'm always a bit concerned when I hear of people being told to consume huge amounts of water, because if it were me it would end up around my ankles and my shoes wouldn't fit, but maybe just me.

The other interesting thing is that when we lose weight we actually breath it out, not pass it.
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Yes the water thing is interesting - Prof Tim Noakes was the guy who told athletes to stop drinking " excess " water when running . I have a tendency to forget to drink water, though with food I get thirsty so I am sure that my own water gain is a bit of a double whammy- it will still take days for the effect to wear off though.
 
lindisfel said:
It is probable not the case for you ickyhun, your heart is probably struggling to get rid of water but will likely resolve itself when you lose weight due weight loss surgery. This will ease the pressure on the heart. Usually it is sodium/salt causing water retension in the sodium sensitive. regards D.
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I take a diuretic but as the day wears on pop! It comes accumulating again. Water tummy is what causes most of my breathlessness. It pushes up my lungs.
I keep seeing...' huge amounts of insulin cause odema'. Maybe that is why my meds are getting changed to loss insulin to be injected?
I guess that would make sense as as the day wears on more fluid retention from more injection fluid
I drink water regularly but don't flood my system. I drink when I'm thirsty. Good bgs keep my body's cravings in check, even for water. @CherryAA .
 
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BarbaraG said:
The ND is 800 calories per day, comprising 600 calls in optifast shakes and another 200 calls worth of non-starchy veg. Without going into the nutritional data too much, it's probably not far off 100g carb per day, so the chances are they are not in ketosis.
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I feel it is important to give an alternative view of this....
Having participated in a medically supervised Newcastle diet, six years ago, (GP in consultation with the Newcastle /Taylor team) using a total food replacement method, Lipotrim in place of the unavailable Optifast, I was monitored for weightloss and ketosis, at least weekly. Sometimes twice a week. Had I not had ketones in the urine tested I would have had to stop the diet, as the supervising medics would have believed this meant I was cheating by consuming foods other than the prescribed meal replacement drinks. Although the meal replacements were high carb, it was the severe calorie restriction that caused the ketosis.
Ketosis is achievable with carbs as long as total calories consumed are very low.
 
Pipp said:
Ketosis is achievable with carbs as long as total calories consumed are very low.
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I didn't know that, thank you.

It makes sense, though. According to none other than Ted Naiman (via a question on Twitter), the trigger for ketosis is the hormonal milieu, mainly low insulin. Have a low food intake for long enough and insulin levels will have to fall.


Re an earlier question about why the band is not as effective as bypass or sleeve, my suggestion is that it lacks the effect on gut hormones of the other procedures. It relies solely on restricting the amount you can eat at once..... but obesity is a hormonal, not an energy balance problem. Or, rather, the energy balance is consequence, not cause.
 
BarbaraG said:
On BBC2 right now - a programme arguing that many more surgeries for weight loss should be carried out, and that prejudice against obese people is a barrier.

First patient they showed is T2D, and the morning after surgery his BG was between 5 and 6 (they didn't tell us what it was before). He was told he could stop his meds there and then.

Watching with interest to see what they say about diet.
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It made me cry at the end when they showed that poor man three weeks after his surgery, having lost a stone and a half, mashing up a boiled potato into some white fish in sauce. Why was he eating potato? Why not two pieces of fish and some mashed up broccoli. What are they told to eat afterwards? Surely not more carbs? If they can only eat tiny amounts it needs to be nutritionally dense. I think gastric bypass is just malnutrition on the NHS. I would love to get my hands on the info they are given about what to eat afterwards. I cried for the poor man
 
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Ellie3919 said:
It made me cry at the end when they showed that poor man three weeks after his surgery, having lost a stone and a half, mashing up a boiled potato into some white fish in sauce. Why was he eating potato? Why not two pieces of fish and some mashed up broccoli. What are they told to eat afterwards? Surely not more bloody carbs? If they can only eat tiny amounts it needs to be nutritionally dense. I think gastric bypass is just malnutrition on the NHS. I would love to get my hands on the info they are given about what to eat afterwards. I cried for the poor man
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I doubt you'll suffer malnutrition three weeks after a gastric bypass.
 
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CherryAA said:
then he put a kilo n during a three day fast
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Constipation even slower transit times plus fluid retention (most of what we eat is water e.g. steak - 75% water) can make a huge difference to our weight. In the old days I weighed once a week like the dieticians tell you but I only realised how our weight is so affected by things other than eating too many calories (or too little) when I started to weigh every day. At least if I see a 1 kg increase overnight, I know it's not eating too much food, it's mainly water and slow transit times.
 
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