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Importance of Counseling Counseling is a specialty that maintains a focus on facilitating personal and interpersonal functioning across the life span. This specialty pays particular attention to emotional, social, vocational, educational, health-related, developmental and organizational concerns. The weight loss process is not about being perfect but about loving and accepting yourself as an individual. With our coaching and/or counseling, we assist you with developing a sense of empowerment, defining your boundaries and developing and maintaining optimism with the greater appreciation for the ‘self’. In case of weight loss surgeries, counseling is a support process in which a counselor holds talks with patients on one to one, with families, with groups to help him/her to solve issues related to obesity. Counselor basically helps the patient and their family in the journey of weight loss till the goal is achieved successfully. Presently, prior to the weight loss surgery date being scheduled, the bariatric surgery patients are required to undergo pre-operative counseling. A weight loss surgery can cause ripple effects and change many areas of your life. A person will often experience changes in their emotional state in terms of their depression going away. The patients could also experience reduced levels of physical pain and fewer obstacles. There will be some changes in the following areas of your life: Career Relationships Marriage Friendships Spirituality
Tips to reduce and maintain healthy weight Do not skip meals Eat balanced diet. Include cereals , pulses, green leafy vegetables, other vegetables, moderate vegetable oil(un saturated), fruits, restricted sugar, skimmed milk and its products daily in proper quantities to meet the requirements of carbohydrates, protein, fat, vitamins, minerals and fibre by the body. Calorie reduction is the most important requirement for weight loss. Cut down of 100 calories per day leads to 4.5kg weight reduction per year.The total calories from food should be 25-30% from fat in the form of unsaturated fat, 15% from protein and 50-60% from carbohydrates in the form of complex carbohydrates like wholegrains, vegetables and fruits.Reduction of 500calories from Basal energy expenditure helps to reduce 9 kg weight per year. Go for whole cereals and pulses like wheat, ragi, jowar, millets rather than refined ones like maida and its products like bread, biscuits, refined noodles, pastries etc Don’t be over restrictive like avoiding one or two meals and replacing it with fruits or juices. Regular physical exercise(brisk walking for 45 minutes for 5 to 7 days a week) Physical activity contributes to weight loss, decreases abdominal fat, increases cardio respiratory fitness. Exercises like aerobic exercise, swimming, bicycling, jogging, dancing leads to these benefits. Brisk walking is one of the easiest ways applicable to almost all age groups. Weight lifting can also be helpful to loose weight. You should be more active everyday by doing routine work like climbing up stairs rather than taking elevator or walking somewhere rather than driving , engage yourself in gardening, household work rather than using electronic gadgets and this can help you to burn calories without much difficulty. Watch your food portion size Inclusion of liberal amount of fresh vegetables and fruits reduces hunger pans, maintains your blood sugar and prevent constipation because of its fibre content and it is abundant in phytochemicals , antioxidants which prevent against cancer Try to include fruits with skin because deskinning removes fibre. No fat or low fat dairy and its products can be used. Drink liberal amounts of water frequently like one glass of water once in two hours intervals. Get rid of deep fried items and calorie dense foods. Avoid fatty items like mutton, beef, pork, crab, prawns. Include fish or fish oil , soya and its products weekly twice because of its omega3fatty acid content. Eggwhite can be taken daily. Healios Obesity and Diabetes Center Nutritive sweeteners: White and brown table sugars, molasses, honey, syrups are nutritive sweeteners.In addition sugar alcohols derived from fruits (or) commercially made are also nutritive sweeteners.The most common sugar alcohols include sorbitol, mannitol, xylitol and maltitol.All nutritive Sweeteners provide calories to the body and may affect your blood glucose. Non nutritive sweeteners are the true artificial sweeteners. They do not provide calories and will not influence blood glucose. These include Saccharin, Neotame, Aspartame, Sucralose, Stevia Acesulfame Potassium(Ace-k)
Counselling Diabetes, obesity, and their treatments can take a lot out of a person. These are particularly challenging phases of your life and need to be treated as such. If you’re suffering from obesity or diabetes, and if especially you need medical treatment and surgery to help your health, then it will take a huge toll on your overall well-being. Having a surgery can be particularly stressful and counselling can lend a helping hand to pull you out of it. Diabetes counselling is recommended for those who are struggling with high blood sugar. Even if you don’t have to undergo any form of surgery, living with diabetes everyday is not easy, and you need all the professional help that you can get to help you through this. With the proper counselling, you can make the right changes in your diet, in your lifestyle, and in even in your outlook. Obesity is a disease that is almost always associated with diabetes. Obese people are more likely to get diabetes. Even if you haven’t yet contracted diabetes, you will need proper guidance to help you deal with and fight with other complications that are brought about due to obesity. Be it diabetes or obesity, or even post-surgical treatment, the benefits of counselling cannot be undermined. People who are about to undergo weight loss surgeries need to go through counselling sessions at Healios. Professionals may conduct one-on-one counselling sessions as well as group sessions, with either the patient’s family or with other patients, to ensure an improvement in their mental and emotional state prior to the surgery. Weight loss surgery will unquestionably bring about some changes in all aspects of your life. Be it your career, your personal relationships with your friends, family and spouses, and even your own individual well-being, a thorough counselling session will help you come to terms to the changes happening in your life. People who have undergone drastic weight loss through bariatric surgery require rigorous counselling sessions after surgery, to make them feel comfortable and confident in their new bodies. The post surgical counselling sessions will help them with re-building an identity and their self-esteem, align self image with their body image, defining goals in the post-surgical healing process, maintain the new body and new lifestyle, and deal with any emotional and psychological changes. With Healios’ Obesity counselling, you can gain back lost confidence and make psychological progress to be at par with the physical progress that you make through the obesity treatment packages. Healios also provides pre- and post-surgical counselling sessions to help you through all the stages of weight-loss surgery. Other than these counselling sessions, Helios also provides its patients with Lifestyle Management sessions, to assist them in improving their overall quality of life.
Exercise Is Crucial for Weight-Loss Success Exercise after gastric bypass surgery is critical for effective weight loss. “When we lose weight rapidly, we lose muscle. Muscle gauges and controls our metabolism. Exercise is a safe and effective way of maintaining lean body mass, which maintains metabolism and will facilitate [healthy] weight loss. Exercise also shortens recovery time for bariatric surgery patients and reduces the risk of postsurgical complications We offer typical exercise program recommended to bariatric surgery patients. The exercises in class are prescribed and performed for various reasons including weight loss, strengthening muscles, improving the cardiovascular system and developing or maintaining physical skills like balance. HIGHLY QUALIFIED AND CERTIFIED EXPERTS Every person that is referred receives a detailed assessment on their first visit. A senior physiotherapist evaluates the patient thoroughly and puts him/her on a exercise program which will be taken over by a physiotherapist cum certified Pilates instructor for further evaluation and a course of exercise program.
Young Adulthood: “A Neglected Period That Requires Attention” The worldwide prevalence of obesity is rising dramatically.It was 5% for men and 8% for women in 1980 and has increased to 11% for men and 15% for women in 2014. There is also an increase in obesity in young adults. This increases the risk of diabetes, hypertension, joint pains, infertility, hypercholesterolemia and also some cancers at a later age. A study was conducted on US women from the Nurses Health Study and US men from the Health Professionals Follow-Up Study to evaluate the association of weight gain from early to middle adulthood with health outcomes later in life. The cohorts analyzed in this study included 92, 837 US women in the Nurses' Health Study (1976-June 30, 2012) and 25, 303 US men in the Health Professionals Follow-Up Study (1986-January 31, 2012). Participants recalled their weight at age 18 years (women) or age 21 years (men) and reported their current weight at age of 55 years. Mean weight gain was 12.6±12.3 kg over the course of 37 years in women and 9.7±9.7 kg over the course of 34 years in men. Participants were also followed from age 55 years for mortality and for development of type 2 diabetes, hypertension, cardiovascular disease, cancer, cholelithiasis, severe osteoarthritis, and cataracts.It was found that the strongest direct association of weight gain was with type 2 diabetes, followed by cholelithiasis and hypertension. Colorectal cancer was significantly associated with early adulthood obesity, with the greatest risk in men who were overweight during early adulthood and subsequently gained the most weight. Among women, but not in men, moderate weight gain was associated with cholelithiasis and severe osteoarthritis. Higher BMI in early adulthood and subsequent weight gain were independently associated with increased mortality later in life. The above study and its results make us realize that efforts are to be taken to prevent and control obesity in young adults and should be accorded a high priority.
FAULTY “BRAIN SWITCH” DETERMINES OBESITY Obesity is considered as a disease in this New World. It has become a pandemic affecting every Nation. According to data collected in 2014 from the World Health Organization, more than 600 million adults around the world are obese and 41 million children younger than 5 years old are overweight. This in turn results in diabetes, high blood pressure, coronary artery disease, obstructive sleep apnea, joint pains and infertility. A team of researchers from the Biomedicine Discovery Institute at Monash University in Melbourne, Australia, has recently conducted a study striving to gain a better understanding of the brain mechanisms that contribute to weight gain and loss. They have identified the mechanism through which brain controls the amount of fat that is burned after a meal. They concluded that “Faulty signals” from the brain can promote obesity. Researchers revealed the existence of a "switch" that tells the body what to do with the fat gained after food intake. If the switch is faulty, then the body is likely to store more fat, thus becoming predisposed to obesity. They have found a link between food intake and the process whereby white fat turns into brown fat. In the body, fat is stored in adipocytes or fat cells that make up the adipose tissue. These fat cells can convert from "white" (storing energy) into "brown" (releasing energy). The study found that the brain normally "instructs" the white fat cells to turn into brown fat cells after eating. This happens in response to insulin released from pancreas into the blood in larger quantities as blood sugar levels increase. On the other hand, brown fat cells are turned back into white energy storing fat cells after a period of gap during which no food is consumed. When this mechanism functions normally, it allows the body to stabilize its weight. This mechanism is akin to a switch, "reading" the insulin signals and flipping on and off as appropriate. In the case of people predisposed to excess weight gain, this switch malfunctions, becoming stuck in the "on" position. As a result of this browning is turned off all the time and energy expenditure is decreased all the time, so when you eat, you do not see a increase in energy expenditure - and that promotes weight gain. Bariatric surgery will result in increased levels of GLP 1 and PYY hormones and decreased levels of hormone called ghrelin. This in turn results in stimulation of satiety center in the brain and inhibition of hunger center. Post bariatric surgery, patients feel less hungry and so they eat less. They do not feel tired also. This results in weight loss and resolution of obesity associated comorbid conditions like diabetes, high blood pressure etc.
Abdominoplasty is a commonly performed body-contouring procedure to improve the shape and tone of your abdomen. This operation is often referred to as a ‘tummy tuck’. The operation is suitable for people with loose abdominal skin following pregnancy or significant weight loss, or if you have fatty bulges in the lower tummy that you just can’t get rid of with exercise. An abdominoplasty removes any excess skin and fat as well as improving the abdominal contour by tightening the muscle layer. Liposuction is often performed at the same time to optimise the result. The surgery results in a firmer abdomen with a more flattering contour. It is not a weight loss surgery (Bariatric Surgery). PRE OPERATIVE ASSESSMENT It is important for you to tell your surgeon the specific areas that concern you. These may include loose skin, stretch marks, fatty bulges, loose abdominal wall muscle tone and also other medical problems which can affect wound healing, such as smoking and diabetes, as well as risk factors for deep venous thrombosis (DVT or leg vein clots). People contemplating future pregnancies or significant weight loss are best to defer surgery. The expected scars, as well as the other risks of the operation will be explained. THE SURGERY Abdominoplasty is performed under a general anaesthesia. The surgical scar is at the lower most part of the abdomen thus hiding the scar. There are many variations on the procedure ranging from a mini-abdominoplasty with laparoscopic abdominal wall tightening to a full abdominoplasty involving removal of excess skin and fat, tightening of the abdominal wall muscles and repositioning of the umbilicus (belly button). AFTER THE SURGERY After the operation your abdomen or stomach will feel very tight and you may have a slightly flexed posture for a couple of weeks. This means you will be slightly bent over, not able to stand up completely straight. Most patients stay in Hospital for 2-4 days. Recovery times vary with most people being able to return to work in two to four weeks, with no sport or heavy lifting for 6-8 weeks.
ABOUT PILATES Untitled-31 Pilates is a rigorous form of exercise which emphasizes core strength and improvement in posture. During the Bariatric surgery journey, it is important to take up a form of exercise that you feel committed and passionate about. When you’ve lost sufficient weight after bariatric surgery, more intense exercise such as Pilates will be easier for you to try. Pilates is an excellent form of physical fitness to help keep you in shape for long term weight loss surgery results. Benefits of Pilates post Bariatric surgery include: Strengthen your back and abdominal muscles Improve your alignment and posture Develop muscle balance to help prevent injuries Increase your flexibility Improve your circulation Develop a long, lean and strong body Enjoy more energy ITS NOT JUST A EXERCISE PROGRAM, ITS AN EDUCATION. We just don’t exercise you, we educate you about your own body. Many conditions are managed by educating the patient about posture or ways to reduce strain on the body. Particularly relevant with work related problems. Our physiotherapists are experts in prescribing the right exercises to resolve various problems. eg : low back pain, early arthritis, etc DO NOT PUNISH YOURSELF AT GYM Most of the people fight their bodies at gym after weight loss surgery or any other surgery, but gym is not the right place for you. You need an medical expert to guide.
Banded Sleeve: It has been found and reported that 30 to 60% of patients with a sleeve gastrectomy will have progressive weight regain after two years of follow up. There are many causes for weight regain following sleeve gastrectomy such as overeating, irregular follow up etc. This results in dilatation of the sleeve with increase in the gastric reservoir and increased calorie intake. In this operation, staples are applied and a sleeve gastrectomy operation is performed.Then at about 4-5 cms below the esophagus a ring is applied around the sleeved stomach and fixed with stitches to the stomach. In our patients who have undergone this procedure, we have found that laparoscopic banded sleeve gastrectomy results in greater weight loss and also helps in maintaince of lost weight.