Examples, and then some!

Philip J. Goscienski, M.D.

September 2008

Surgeons recommend stomach stapling or banding, or some similar procedure, for persons who are morbidly obese (weigh 100 pounds more than their standard weight) and who have not been able to lose weight by diet and exercise.

The idea of living for decades with a stomach not much bigger than a hen's egg conjures up lifestyle changes that seem overwhelmingly difficult. Patients who undergo such bariatric surgery are put on the two-by-two feeding regimen: two ounces of protein every two hours, 8 times a day. Most of us could down those two ounces in about 4 swallows but these patients are told to spread it out over 15 minutes. One 17-year-old patient summed it up: "It (the surgery) called for drastic changes in eating habits."

The complications that sometimes follow this enormous lifestyle change include rampant tooth decay, osteoporosis, hair loss and irreversible memory loss.

Enter the weight-loss heroes, persons who have lost 100 pounds or more without surgery and who have kept it off for two years or longer. They also underwent lifestyle changes but instead of paying a price they reaped huge benefits.

Perhaps you have heard of Nick Yphantides, the San Diego physician who waddled from patient to patient at a less-than-inspiring 467 pounds. Instead of surgery he did cutting of another sort, removing more than 4,000 calories from his daily intake. For several months he lived on protein shakes and burned off calories with daily exercise. He lost more weight (270 pounds) than he weighs now. His current diet plan includes fruits, vegetables and whole-grain products; refined grains, rice and potatoes are only a memory.

Carrie Chatman, described in Prevention Magazine, September 2003, took a much less drastic approach in order to lose 176 pounds. Her lifestyle changes didn't go as far as Dr. Nick's 800-calories-per-day protein shakes. She started slowly with a daily 30-minute walk on the treadmill and gradually moved up to 4 miles a day. If there was pain and discomfort in giving up Pop-Tarts, Doritos and a nightly dish of ice cream she seems no worse for wear. This 20-year-old's full-sized stomach easily accommodates three fiber-rich meals a day that are nutritionally fulfilling.

Nick and Carrie are but two of the heroes whose stories fill my file folder labeled "Examples." Terri lost 120 pounds, Tom lost 76. Both gave up calorie-dense junk food and added one hour of exercise to their daily routine.

All my examples made challenging changes in their lifestyles with no risk and no pain — unless you consider exercise painful. They gained bone mass instead of losing it; their teeth remain whole. Instead of risking dementia they lowered the likelihood of it by exercising more and enjoying fish, fruits and vegetables — plenty of them. Their between-meal snacks, fruit, baked vegetable chips, a couple of dollops of peanut butter on whole wheat crackers, are bigger than those two-by-two "meals." And they probably taste better.

Without question, bariatric surgery is a life-extending measure for increasing numbers of people. It helps them to lower blood pressure, blood sugar and blood cholesterol. But what kind of lifestyle changes would you rather make to accomplish these things?

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.