Type 2 Diabetes and Healthy Living – Part 2 of Measuring Your Current Lifestyle

Type 2 Diabetes and Healthy Living compared to Weight Loss Surgery in France

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A meeting of type 2 diabetes sufferers discus weight loss problems

Type 2 Diabetes and Healthy Living

There are many ways to measure your current lifestyle. A short list would not be enough, so here is a continuation for you. Take this self-assessment to determine the state of your health. Go over your responses with your doctor to pinpoint areas where improvement are necessary…

1. Do you set caloric limits? Do you set caloric limitations on yourself? If you are trying to lose weight, it may be essential, particularly if you are new to weight loss. It is hard to know how much you are eating if you are not entirely familiar with your caloric requirements and the calories you consume.

Counting calories is not necessary for weight loss but it is beneficial.

2. Do you have an eating schedule? Similar to caloric limits, having an eating plan is not necessary per se. But if you need help getting on track, implementing a diet plan can be helpful.

Barring a few exceptions, two daily meals work for everyone. Decide on two different times to eat, and eat only then. Perhaps it will be lunch and dinner at 7, with no snacks in between. You should not need to eat anything in between.

3. What Is your attitude towards exercise? Your attitude towards exercise speaks volumes. It is even more important than the exercise you do because it dictates how much effort you put in.

Do you view exercise as a way of caring for your body and well-being? Or do you see it as work with temporary benefits? The better your opinion towards physical activity, the more you will look forward to it. Exercise should not necessarily feel like work. It should feel like investing in your health, which makes any effort required more than worth it.

4. How do you eat? Do you eat quickly, or do you take your time? Do you eat your carbohydrates first, or do you focus on proteins? What do you drink with your meals? These questions shed light to how you eat, which could be harming you in ways you are not aware.

You should eat slowly. Save your carbohydrates for last because in all likelihood they are already abundant in your diet. And needless to say, water is better than soda. But do not hesitate to make your juices.

5. What is your motivation to change? Lastly, ask yourself about your motivation. While not directly a measure of your lifestyle, it influences your behavior in more ways than you know. If your motivation to change is fueled by a drive to avoid complications brought on by chronic diseases, you are more likely to succeed than if you would simply like to lose a few pounds. A Type 2 diabetes diagnosis can often be a wake-up call to action. But motivation can also be short -lived.

If you are to succeed with your goals ensure your motivation is not temporary. Remind yourself of the benefits of a healthy lifestyle, and what you have to gain by making changes.

Although managing Type 2 diabetes can be very challenging, it is not a condition you must just live with. Make simple changes to your daily routine – include exercise to help lower both your blood sugar levels and your weight.

For nearly 25 years, Beverleigh Piepers has searched for and found a number of secrets to help you build a healthy body.  The answer isn’t in the endless volumes of available information but in yourself.

Article Source: http://EzineArticles.com/9776853

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Charitable help provides a gastric bypass and life-saving Kidney Transplant.

Charitable help provides a gastric bypass and life-saving Kidney Transplant

(BPT) – Elaine could be described as a woman with great determination and patience. She experienced kidney failure seven years ago and faced the reality of life with a chronic illness. She began receiving dialysis, a four-hour treatment three times a week, and anxiously awaited news of a kidney match. This miracle call happened earlier this year and Elaine was successfully transplanted on March 22, 2017.

Elaine’s journey to receive a kidney transplant gradually unfolded thanks to her determination and the support of many people. She received care from her family and loved ones, who looked after her and shuttled her to and from many dialysis visits.

She underwent gastric bypass surgery

The surgery worked well as she worked closely with a dietitian to help her hit the target weight loss necessary to be eligible for transplant. She was a fortunate recipient of a donated kidney. Lastly, for seven years Elaine received financial support from a charity to afford her insurance premiums.

This financial support, known as charitable assistance, is a vital safety net that Elaine and approximately 15 percent of all dialysis patients need to maintain coverage. Due to the significant amount of time required of dialysis, many people with kidney failure are unable to continue working. Many patients rely on charitable assistance to help cover insurance premiums and other health-related expenses. For patients like Elaine, charitable assistance helps ensure continuous care and allows them to choose the insurance coverage they think is best for them at this most critical time. Without it, many patients may lose their private insurance coverage and with it, a number of other benefits, including access to the specialists they need to see.

Recently, a number of insurance companies have waged an attack against charitable assistance. In fact, thousands of patients have been pushed out of their health insurance plans, facing the horrible reality of having their coverage taken away when they need it most.

Access to insurance, quality care and continuity of coverage for everyone, especially those with severe health issues, must be protected. If not, one group consistently loses: patients. Patients like Elaine.

For more success to stories like Elaine’s, there is an equal and significant need for transplant donors — living or deceased. There are 97,000 people on the kidney transplant waiting list and the average wait time for a kidney donor match is three and a half years. Nineteen thousand people received a kidney transplant in 2016; however, that still leaves many more people on the list, waiting to receive the phone call that they have been successfully matched with a donor.

As the health care conversation continues in this country, there should be honest discussions about how patients access high-quality care, are able to visit the doctors and specialists they need, and are allowed to choose the insurance option that best meets their needs. Most importantly, patients in financial need should be able to get assistance, with appropriate guardrails, to help afford the costs.

To learn more, visit DaVita.com/Transplant.

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Former ‘Dance Moms’ star Abby Lee Miller reveals 45-kilo weight loss in prison photo

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Abby Lee Miller has been on quite a journey.

The former Dance Moms star — who has been in prison for bankruptcy fraud since July 2017 — has dropped 45 kilos over the last year and revealed her new look in an Instagram photo on January 21.

“My world flipped upside down when I had to enter prison. I did so with grace, the stories you read about me been [sic] a princess are untrue.”

Abby Lee Miller has lost over 45 kilos since undergoing gastric bypass surgery

in April 2017, a source told Entertainment Tonight, and she’s already requested a tummy tuck, breast lift, and skin removal procedure following her release.


Abby Lee Miller in January 2018 (left) and April 2017; Images: Instagram, Getty

“I have made friends with both inmates and staff,” she continued in her post. “I’ve tried to better myself, participated in anything offered to me and I am a better person for this experience.”

Although the beleaguered dance studio owner and reality TV star was sentenced to 366 days in a California prison, the ET source says she will be let out of prison early, on February 22.

Upon her release, Miller will report directly to a halfway house for an unknown amount of time.

She was sentenced in May 2017 for bankruptcy fraud in Pittsburgh, Pennsylvania and for bringing $120,000 USD of Australian currency into the United States without reporting it. Miller was subsequently replaced on Dance Moms by Cheryl Burke.

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Is it now time for more stomach reduction surgery to deal with the growth in Type 2 Diabetes?

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Is it now time for more stomach reduction surgery to deal with the growth in Type 2 Diabetes?

The Northern Ireland Audit Office Report “Type 2 diabetes; prevention and care”published on Tuesday 6th March is critical of DoH’s failures in both creating and implementing policy for Type 2 Diabetes.  Type 2 Diabetes is an important disease because; it is common (6% of the population and rising), is generally progressive (the speed of which is inversely proportional to how well it is controlled), is very costly to manage (£400 million a year or 10% of health budget), and it ultimately makes the lives of those who suffer from it pretty miserable  when left to its own devices (blindness, kidney failure, amputation) which sadly is all too often.

Its cause is mainly lifestyle with obesity accounting for about 80% of all new cases yet this makes it eminently preventable with a 60% reduction in incidence when people adopt small changes in what they eat and how much they exercise.  We are not talking serious lifestyle changes here just reducing body weight by 10% through healthy eating and moderate exercise. Oh, and it’s curable if action is taken early enough.  With a 70% increase in the last 15 years, the NIAO is right to point out when it comes to Type 2 Diabetes we are failing miserably.

The failures, of course, are not exclusively the DoH’s.  A lot is down to the individual, the family and local communities and their failure to adopt norms that protect against the rise in diabetes.  Yet there seems to be a patronising attitude, sub-conscious I trust, at DoH which exhibits a certain contempt for those who have, in the view of some of our mandarins, brought the condition on themselves.  Perhaps this might explain why little real investment has been made in prevention support and also explains the disdain that emanates from civil servants on any suggestion that we need to locally commission gastric surgery for the obese.

Yet, in addition to the clear benefit from prevention services, there exists compelling evidence that surgery for obese people provides medically significant weight loss over time that both reverses Type 2 Diabetes in those suffering from the condition and prevents it in those who do not yet have it.  Don’t you believe me?   Eight thousand obese patients who had undergone gastric bypass surgery were compared with matched controls for age, gender and Body Mass Index.   Follow up for an average of 7.1 years showed that those in the surgery group were 25% less likely to have died.   A second study followed 14,000 patients after two bariatric surgical procedures and found that there was a mean loss of 53% of excess weight for vertical banded gastroplasty and a 72% mean loss for gastric bypass surgery.

There will always be a trade-off between the risks of surgery and the consequences of lifelong obesity and associated complications.   Yet the risks associated with bariatric surgery have decreased in recent years.

Bariatric surgery –the medical term for cutting the stomach – is extremely successful in inducing long-term weight loss because the intervention is considered to be, (and almost always is) permanent, which dramatically reduces the risk of rebound weight gain. A successful procedure may induce a reduction of approximately 50-60% of excess body weight during the first 12-24 months; a person weighing 300lb might realistically expect to achieve a weight loss of 100lb.    That’s impressive.

The Swedish Obese Subjects (SOS) cohort study is the best-known study of bariatric surgery. It began in 1987 and ultimately included over 4,000 patients. The primary aim of the SOS study was to discover whether there is a reduction in death with intentional weight loss; secondary aims were to examine the effects of weight loss on specific factors such as heart disease and type 2 diabetes, health-related quality of life and health economics.

This study, and other trials has demonstrated more than a 75% to a 90% resolution rate of type 2 diabetes, 66% resolution for hypertension, and improvements in; cholesterol, stress incontinence, sleep apnoea, ankle oedema, and resumption of regular menstruation. The chance of later development type 2 diabetes where the obese patient was not diabetic, was also noted.   Surgery is prevention and cure.

The “curing” of type 2 diabetes by gastric band surgery is as impressive as it is mysterious.  An obese patient newly diagnosed with Type 2 Diabetes who gets most of his or her stomach cut away gets reversal of diabetes very quickly before any real weight loss is achieved.  This suggests some, as yet unidentified, system at play which is removed in the surgery reversing the condition.

A point made in the NIAO reports was that if N. Ireland complied with the NICE guidance on bariatric surgery then some 50,000 local residents would be eligible.  It is likely that perhaps only 3% of this group would ever consider it but 1,500 is better than the 120 who get surgery in England annually at a cost of  £1.5 million.  We already perform some 150 amputations a year due to poorly controlled diabetes and each of these operations attracts a similar cost to stomach bypass surgery.

In an ideal world, the public would heed the call to eat a better diet and take more exercise but there seems to be little appetite for this.  It is radical to suggest we invest say £20 million in gastric bypass surgery for the obese and do this as a means of managing, preventing and “curing” Type 2 Diabetes but reading the NIAO report it seems this offers much better value for money than the current failing approach which has the potential to eventually bankrupt our health service.

Terry Maguire  I am a pharmacist in Belfast.

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The 5 Reasons Why Your Abs Aren’t Showing

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The 5 Reasons Why Your Abs Aren’t Showing

Struggling with belly fat? Do you spend hours in the gym but your abs still aren’t showing? If so, tweak your diet and exercise routine! Common mistakes, such as over-training, sleeping too little, and skimping on protein, can stall your progress.

Remember that abs are made in the kitchen. Not even the best workout plan can compensate for bad eating. Ideally, your diet should be high in protein and low in carbs. Stress, chromosomal imbalances, and excessive cardio only make things worse.

Building a six pack takes hard work and commitment. There are no shortcuts or miracle pills to help you out. Crash diets slow down your metabolism, causing your body to store fat. Overtraining increases the stress hormone cortisol levels, which in turns, leads to weight gain. If these things worked, you’d already have six pack abs.

Here’s where you might be going wrong and how to fix it:

Eating the Wrong Foods

No matter how hard you work out, training alone won’t give you ripped abs. When it comes it comes to building a six pack, exercise and diet are equally important. Your abs won’t show unless you have a low body fat percentage. That’s about 10 percent body fat for men and 14 percent for women. To shed fat, clean eating is a must.

Sugary treats, junk food, processed meats, refined oils, and soft drinks have no place in a “clean” diet. Your daily meals must consist of real food.

Load up on protein, ditch the sugar, and get your fats from whole foods, such as tuna, salmon, and avocado. Coconut oil is rich in MCTs (medium chain triglycerides), which rev up your metabolism and burn belly fat. Lean meat, fish, eggs, and low-fat dairy are excellent sources of protein. Your carbs should come from green vegetables, whole grains, nuts, and seeds.

For best results, remove gluten and dairy from your diet. Both gluten and lactose, the sugar in milk, trigger inflammation and promote fat storage. For instance, lactose stimulates insulin release, leading to weight gain. According to study, milk increases insulin levels to the same extent as white bread.

Doing Too Much Cardio

Now let’s focus on training. Most gym goers engage in long cardio sessions to get ripped abs. This is one of the biggest mistakes you can make. Too much cardio can mess up your hormones and put stress on your joints.

When you’re spending long hours on the treadmill, your cortisol levels go up. At the same time, testosterone production drops. This leads to weight gain, fatigue, muscle loss, mood swings, and hunger pangs. Excessive cardiovascular training burns both muscle and fat. On top of that, your body adapts to exercise and reduces its energy expenditure.

If you want shredded abs, HIIT the gym hard! Minute per minute, high-intensity interval training is better than cardio for fat loss. It not only torches fat but also boosts your metabolism and improves insulin sensitivity. In the long run, it enhances athletic performance. Unlike steady state cardio, it doesn’t affect lean mass.

Trying to Spot Reduce

Like it or not, you can not lose fat from specific areas of the body. No matter how many sit-ups you do, your abs won’t show unless you eat clean and lift heavy. The only way to build a six pack is to slowly burn fat from your entire body. This can be done through diet, high intensity training, and heavy lifting.

Most times, belly fat is the last bit to come off. Unless you’re genetically gifted with a fast metabolism, it can take weeks or even month to make your abs pop. The key is consistency.

Abdominal exercises will strengthen your core but have little effect on body fat levels. Compound movements, such as the deadlift, push-ups, squats, and chin-ups, increase metabolism and improve body composition. Three sets of heavy squats will do more for your abs than hundreds of crunches.

Relying on Gym Machines

Gym machines can add variety to your workout and help maintain good lifting form. However, they are not a substitute for dumbbells, barbells, and other free weights. For instances, weighted crunches are far more effective than the ab crunch machine.

When you’re using free weights, your body works hard to maintain its balance. This helps develop core strength, improves your posture, and boosts muscular endurance.

Free weights challenge your muscles into growth and make you stronger overall. They also help you burn more calories, leading to fat loss. The squat, chest press, military press, and other exercises that require free weights force your core to stabilize. This helps increase ab definition and enhances your balance. Eventually, you can use gym machines for the last set when your muscles are fatigued.

Let’s say you do three sets of weighted crunches. At this point, your abs should be on fire. Perform an extra set on the cable crunch machine to reach muscle failure. Use this strategy for all muscle groups, not just your abs.

Working Your Abs Every Day

It’s not unusual to see gym goers doing ab work every single day. Your abdominals are just like any other muscle. If you’re overtraining them, they will adapt and stop growing. In the worst case scenario, you’ll end up losing muscle.

Work your abs once every three days or so. Give your body time to recover. Focus on compound exercises, such as barbell squat and pull-ups, on the days when you’re training abs. These movements engage your core muscles and burn fat.

Now that you know what it takes to make your abs pop, adjust your diet and training routine. Make sure you check out The Six Pack in 60 Days guide, which provides the exact steps needed to get ripped abs. It also highlights the most common ab training mistakes and how to fix them.

The guide includes a complete clean eating plan that shows you what to eat and how to plan your meals like a pro. It’s the ultimate resource for those who are tired of wasting time in the gym with little or no results. Give it a try – your future self will thank you!

Article Source: http://EzineArticles.com/9766926

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She still wants his babies. Lauren Goodger ‘desperate to get her Size 8 body back

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She still wants his infants ‘: Lauren Goodger ‘ determined to obtain her Dimension 8 body back in a proposal to …

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considering dropping the weight loss surgery path and getting a gastric band. See all stories on this topic

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My 600-lb Life’s James LB Bonner Shares New Weight Loss PHOTO Update!

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James ‘LB’ Bonner appeared on the latest episode of TLC’s My 600 Lb Life weighing in at 642 pounds.

The 6’4″ Lexington, South Carolina native is also an amputee having lost one of this legs during a tragic accident. The loss of his leg in addition to his obesity made getting around additionally difficult for LB as he complained about knee and back pain. The 29-year-old has struggled with his weight all his life having tipped the scales at 150 lbs at the age of 8, and 200 lbs by the age of 12. 

His weight issues stemmed from emotional issues as LB struggled with feeling accepted and adequate due to the fact that he was adopted as a baby. “I was adopted as a newborn because, after having three girls, my parents decided to adopt a boy, and so they got me,” he said.

He suffered some more setbacks in life that made him turn to food for comfort including the loss of his favorite aunt to cancer when he was just 9. He went on to excel at football in high school but had to quit at the age of 17 when he weighed over 400 pounds and could no longer play. He continued to pile on the weight following that as he felt he had let his father down.

Year later, LB got into an ATV accident at age 25 and got an infection which led to his lower right leg being amputated. Since then, he has had to rely on the help of his mother Karen due to his inability to stand up for long periods of time.

He ended up getting the gastric sleeve weight loss surgery.

By the end of the episode, James “LB”  went from 642 lbs to 326 lbs, losing an amazing 316 pounds. He also dealt with his issues concerning alcohol abuse.

So how is LB doing today?

Fret not as we have an update on him. Based on his latest weight loss photo below, he looks to have lost more weight since filming wrapped on his episode. He recently shared the photos on the post which show off his incredible weight loss!

Thank ya so much for everyone’s support I’m gonna continue on the journey to be a man I’m Damn sure proud of being… *dont worry the beard is coming back*.”

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Rosemary loses 98 lbs after gastric sleeve surgery

Mariah Carey Underwent gastric Sleeve Surgery 6 Weeks Ago

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Mariah Carey has undergone gastric sleeve surgery.

The GRAMMY winner, who showed off a slimmer figure at her hand and footprint ceremony at the TCL Chinese Theatre in Hollywood last Wednesday, underwent the weight loss surgery about six weeks ago, sources tell ET.

Carey got the gastric sleeve surgery for weight loss which shrinks the size of the stomach so patients eat less, which is considered to be one of the  fastest weight loss plan for women, after feeling “extremely insecure about her weight,” one source tells ET.

“She always fluctuates and it makes her upset,” the source says. “She lives in denial about it; she has the tags cut out of clothes, so she can be blissfully unaware of her size.”

A second source tells ET that Carey, who feels “much better about herself” now, adding, “this is a new beginning for her.”

Carey’s rep would not comment on her weight loss surgery. Page Six was first to report the news.

Another part of the singer’s new beginning is wrapping up her Las Vegas residency at Caesars Palace and moving on to The Venetian in March 2018. According to the source, Carey has signed a “two-year deal contingent upon how well the show does in the first year.”

When reached for comment, The Venetian Las Vegas would not confirm the news, telling ET they’re “consistently engaged in discussions with a number of today’s top artists regarding residencies, and we are always interested in having artists of the caliber of Mariah Carey perform at our venues.”

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Gastric Sleeve surgery in France

Sleeve Gastrectomy in India in 2017

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Sleeve Gastrectomy in France in 2017

Sleeve gastrectomy in France is performed in the country with the sole purpose of managing obesity.

The Affordable price of gastric sleeve surgery in France helps individuals who suffer from drastically reduced quality of life because of obesity. It helps stimulate weight loss in individual suffering from comorbid obesity. These include heart disease, diabetes, hypertension and reduced mobility due to skeletal problems.

Individuals who have failed to reduce their weight through all other non-surgical interventions are recommended to pay nominal gastric sleeve cost.

France is one of the most preferred destinations to seek high quality weight loss solution while paying reasonable prices. This is because of two main reasons. First, the cost in France is much less than most countries in the world. Second, the country has around the clock availability of quality of medical treatment and experienced doctors.

Sleeve gastrectomy cost in France and the quality of medical services are just two among many reasons why medical tourists should prefer to undergo this procedure in the country. So far, the top hospitals in India have conducted this procedure on hundreds of patient from within France and abroad.

Why opt for sleeve gastrectomy in France?

The price of sleeve gastrectomy in France is one of the cheapest in the world. However, low costs does not mean that the hospitals compromise with the quality of medical treatment.

Price of sleeve gastrectomy in the US, for example, is more than four times the cost in France. Similarly, price of the procedure in the UK is almost three times the price of gastric sleeve cost in India.

However the Price of Gastric Sleeve in France is Less than it is in any other european country

Treatment in France, thus, seems like a great option to a medical tourist from abroad. The hospitals in France offer attractive packages to medical tourists, which enables them to save thousands of Pounds. These packages include gastric sleeve cost, and all the costs that a foreign medical traveller would otherwise incur, including boarding, lodging, local travel and food costs.

Case Studies

The bariatric surgeons in France strive to produce 100 percent success results with their keen interest and dedication toward the patient.

This is quite evident from the recent case of a woman from Egypt, Eman Ahmed, who weighed almost 500 kgs when she reached a hospital in France. She underwent laparoscopic surgery in France and successfully lost more than 100 kgs in the first few weeks. A large majority of such patients have traveled back safely to their country. Moreover, they have not reported any major side effects of weight loss surgery.

Thus, the following are some of the reasons why medical tourists prefer to come to France:

  • Affordable gastric sleeve surgery cost in France
  • High quality of treatment despite cheaper gastric sleeve surgery cost
  • Availability of best bariatric surgeons
  • Little to No waiting time

Sleeve Gastrectomy cost

It works by eliminating a major portion of the stomach from the body of the patient suffering from obesity. During the process, the doctor makes sure that the connection between the oesophagus and the small intestine is not disrupted.

  • By limiting food consumption: The reduced size of the stomach limits the amount of food that an individual can eat at a time.
  • By reducing hunger hormone: The stomach produces a hormone called ghrelin, also known as the hunger hormone. The reduced size of the stomach means that it will now produce lesser hunger hormone.

Who can undergo sleeve gastrectomy in France?

Not all individuals are allowed to undergo the procedure. It is only conducted in patients who have had their quality of life severely affected because of excessive weight. Sleeve gastrectomy in France is allowed to the following category of patients:

  • Those weighing 45 kgs more than their ideal weight or who are at least overweight by 36 kgs
  • Individuals suffering from health conditions resulting due to obesity such as hypertension, diabetes and heart problems

Advantages of Sleeves Gastrectomy in France

Apart from affordable gastric sleeve cost, there are several other benefits of gastric sleeve gastrectomy over other types of weight loss surgery. The average cost of gastric bypass surgery in the UK is £9000, the average cost of lap band is £7000, and the average cost of sleeve gastrectomy surgery is £9500.The following list describe some of the benefits:

  • Price of sleeve gastrectomy is less than other weight loss procedures
  • Reduced risk of surgical complications, gastroesophageal reflux disease (GERD) and ulcers
  • No need for placement of a foreign material
  • Controls co-morbid conditions
  • Maintains the natural order of the digestive tract

Laparoscopic Sleeve Gastrectomy in France

The treatment in France can be conducted through open surgery or with the help of a laparoscope. Advances made in the field of laparoscopy has now made it quite popular in France.

Laparoscopic surgery is a form of minimally invasive weight loss surgery. It allows for minimal healing time, faster recovery and less pain after the surgery.

Patients can expect to lose 50 to 80 percent of their weight. However, the amount of weight lost after the procedure may vary from one patient to another.

Why price of sleeve gastrectomy in France is low?

The price, in addition to other bariatric procedures, is one of the lowest in the world. This is because of several reasons.

By travelling to France, a medical tourists saves up to 60 to 70 percent of the amount that they would ideally pay a hospital within their own country. The affordable gastric sleeve cost in France can partially be attributed to the use of technology mostly developed by inhouse medical research companies. In addition, the doctors and surgeons in france believe in delivering highest quality of healthcare at the most reasonable prices.

In the recent years, the use of robots in the field of bariatric surgery has also gained popularity in France. The robotic gastric sleeve surgery cost in France remains less than other Western countries as well.

The total gastric sleeve cost in france however, depends on several other factors. The experience of the doctor, choice of city, choice of hospital and duration of stay control the final cost in addition to gastric sleeve surgery cost that a patient would incur while undergoing the procedure in France.

Article Source: http://EzineArticles.com/9730659

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South Africa’s obsession with food and the psychology of weight loss

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Obesity is a growing concern in South Africa, particularly because of the lifestyle diseases associated with it, including type 2 diabetes, hypertension and heart disease. Gastric bypass surgery is an increasingly popular treatment option for appropriate patients, however surgery alone cannot address the unhealthy relationship with food that frequently leads to obesity.
“Often people reward or comfort themselves with food, which is eating for psychological rather than nutritional reasons, and, over time, this can become deeply ingrained and may lead to obesity, ” explains Charlene McIntosh, one of the psychologists in the multidisciplinary team supporting gastric bypass patients of general surgeon, Dr Gert du Toit, and his surgical partner Dr Ivor Funnell, who head up the bariatric surgery and weight loss procedures centre at Netcare St Augustine’s Hospital.
“Another aspect that appears to be driving obesity is the central role of food in South African culture, by which I mean that many of our social interactions tend to revolve around eating, ” she explains.
“We often meet friends and family for a meal, tea and cake, shisinyama or a braai. For people who are grappling with their weight, this can make it even harder for them to exercise self-control, particularly if they feel social pressure to eat, ” says McIntosh.
Du Toit, who specialises in complex digestive laparoscopic procedures, says that gastric bypass surgery is not to be undertaken lightly and is not appropriate for all patients with obesity and related conditions.
“We are committed to helping patients achieve positive health outcomes, and there is a growing body of evidence to suggest that conditions such as type 2 diabetes and hypertension can be well controlled, if not fully alleviated, with gastric bypass surgery and behavioural change, ” Dr Du Toit notes.
In line with the protocols of the South African Society for Surgery, Obesity and metabolism (SASSO), prospective patients must be assessed for suitability and supported through the surgery and afterwards by a multidisciplinary team of healthcare professionals.
“Patients must be dedicated and committed to making a lifelong change, otherwise the surgical intervention will be far less likely to help the individual achieve better health over the long term. For this reason, it is sometimes advisable for patients to prepare for a few additional months to make absolutely certain that they are ready for the significant lifestyle changes to ensure that they get the best out of the treatment, ” explains Dr Du Toit.
Du Toit likens the preparation for gastric bypass surgery to that of climbing a mountain. “If you consider people who climb Mount Everest, it is the ones who never look back who are most likely to make it to the summit. Our team needs to ensure that the surgical candidates have a similar mindset and commitment before the gastric bypass is performed.”
A vital aspect of preparation for the surgery is dealing with the emotional aspects, as McIntosh explains: “The role of the psychologist is to identify and address underlying emotional trauma that may be at the root of some people’s compulsion to eat. This is a vital aspect of the holistic treatment for patients undergoing gastric bypass surgery, because the operation can change the body but the person’s mindset also needs to change to achieve lasting outcomes.”
“We emphasise that there is a distinction between eating because you are hungry and eating for psychological or social reasons. People need to redefine their relationship with food, and in the case of obese patients we essentially have to teach them to eat again.”
Addressing the social pressures around eating often requires the individual’s support base, including family and friends, to develop greater awareness. “Instead of organising time together around food, as in ‘let’s meet for lunch’, it is a good idea to sensitise the person’s social circle to rather meet for a walk or other activities that do not centre around eating, ” she advises.
This is one of the messages conveyed in the monthly meeting of the support group for people who have either had or are considering the definition of morbid obesity in relation to the benefits of gastric bypass surgery, hosted by dietitian Mandy Read, who is also part of the multidisciplinary team at the bariatric surgery centre. The meetings are also open to the family and friends supporting patients through their journey.
“A key aspect of changing people’s emotional reliance on food is replacing comfort eating or reward eating with another pleasurable activity, such as going for a massage, or weight loss hypnosis, or having a relaxing bubble bath or learning to play a musical instrument. Interestingly, we have found that people who replace emotional eating with a creative outlet, such as painting, photography, music or gardening, tend to have better outcomes in general, ” McIntosh observes.
“Perhaps the most important factor is for the person to realise that they can shape their future and have real belief that their lives can be different. If a person has been morbidly obese for many years, sadly they often become used to sitting at home and feeling isolated, and cannot imagine a life beyond that.”
“Imagine clothes shopping, and being so limited in your choice because you are trying to find something that is large enough to fit you, rather than shopping for clothing that makes you look and feel good. We try to help people realise that there is a life beyond the effects of obesity and help them to get to the stage where they can get full enjoyment out of life without an overreliance on food, ” she adds.
According to McIntosh people who have lost a lot of weight may have some difficulty reconciling the changes in their bodies with the way they see themselves. “Some patients have managed to get down to a healthy weight but will still turn sideways to go through doors as they had to when they were morbidly obese. Often there is a process of re-building a person’s self-esteem so that they can make the best of the physical transformation they have achieved, ” she concludes.
(adapted from the following press release)

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