The Lap Band.... A good solution?

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Ask your medical question here. : MD STAT is an educational service. We do not prescribe medication. We do not enter into a doctor-patient relationship with you. We explain, educate, clarify, and suggest possible solutions to your medical questions. Thank you for your interest.

I am an obese woman, 45 years old, who has tried a variety of diets and I'm considering the lap-band procedure. I am 5'3" and weigh 260 pounds. The best I ever did in the last ten years was on weight watchers and I got to 190 over 6 months but I put it all back on over the next year. I am strongly considering the procedure. Do you have any opinion on this for me?
Gender: Female
How old are you?: 45
How long has this been going on?: More than a year
Check all symptoms you are currently experiencing:
Psychiatric

Describe associated symptoms not listed above: I am depressed about the way I look.

I am "borderline diabetic" but otherwise quite active and healthy.
 

Check all conditions present in your immediate family... :
Cardiac Disease
Diabetes

Please list any medication allergies that you have : : None
Please list any medications you are currently taking (and dosage if known) :: None
When was your last menstrual cycle?: 3 weeks ago
Are you currently using or do you have a history of tobacco use?: No
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Occasionally  

 

Summary:

 

What is the reality of the long term success with the lap band? Will I stop the yo-yo cycle? Are there any risks associated with the surgery aside from the normal surgical risks?

Sleep, Circadian Rhythms, and Weight Loss

I AGREE TO USE MD STAT FOR EDUCATIONAL PURPOSES ONLY, THAT NO DOCTOR PATIENT RELATIONSHIP IS FORMED BY MY PARTICIPATION IN THIS EXCHANGE, AND I UNDERSTAND THAT MY QUESTION AND ANSWER(S) WILL BE POSTED ON THE WEBSITE AND WILL BE VIEWABLE BY VISITORS TO THE SITE.: Yes, I agree.

Is there a standard amount of sleep folks need?  I typically sleep 5.5-6 hours per night and have for years.  I do feel better with more but do not noticeably function better (may just be years of kidding myself).  


It does seem easier to lose weight when sleeping more (diet and exercise staying constant).  Does this make any sense or is it my imagination?

Gender: Male

How old are you?: 46


Check all symptoms you are currently experiencing:
None of these
No medications

Are you currently using or do you have a history of tobacco use?: Yes
Are you currently using or do you have a history of illegal drug use?: No
Please describe your alcohol consumption :: Weekly

TOP THREE QUESTIONS:

typical need for sleep
short term impact of lack of sleep
recovery from lack of sleep (1 nights good rest, more?)
__________________________

So Joe,

Your question is very complex. The issue about 'how much sleep is enough' does tend to vary from individual to individual and we are not sure why. First, let me point you to THIS SITE, which is, at least, an interesting read.

Two highlights from this site....

"
Though scientists are still learning about the concept of basal sleep need, one thing sleep research certainly has shown is that sleeping too little can not only inhibit your productivity and ability to remember and consolidate information, but lack of sleep can also lead to serious health consequences and jeopardize your safety and the safety of individuals around you.

For example, short sleep duration is linked with:

Increased risk of motor vehicle accidents
Increase in body mass index – a greater likelihood of obesity due to an increased appetite caused by sleep deprivation
Increased risk of diabetes and heart problems
Increased risk for psychiatric conditions including depression and substance abuse
Decreased ability to pay attention, react to signals or remember new information

According to researchers Michael H. Bonnet and Donna L. Arand, "There is strong evidence that sufficient shortening or disturbance of the sleep process compromises mood, performance and alertness and can result in injury or death. In this light, the most common-sense 'do no injury' medical advice would be to avoid sleep deprivation.
"

And on the other hand....

"
 ...some research has found that long sleep durations (nine hours or more) are also associated with increased morbidity (illness, accidents) and mortality (death). Researchers describe this relationship as a "U-shaped" curve (see illustration) where both sleeping too little and sleeping too much may put you at risk. This research found that variables such as low socioeconomic status and depression were significantly associated with long sleep. Some researchers argue that these other variables might be the cause of the longer sleep: the fact that individuals with low socioeconomic status are more likely to have undiagnosed illnesses because of poor medical care explains the relationship between low socioeconomic status, long sleep and morbidity/mortality. Researchers caution that there is not a definitive conclusion that getting more than nine hours of sleep per night is consistently linked with health problems and/or mortality in adults, while short sleep has been linked to both these consequences in numerous studies.
"

And as to the weight and sleep part of your question, well, that's a rat's nest indeed, but, as you may guess, there does appear to be a link between not-enough sleep, and obesity. THIS LINK here is pretty in depth and gets all doctor-y, but you will get the idea.

And to open another can of worms, there is a raft of medical evidence out there on CIRCDADIAN DISRUPTION... jet lag if you will.... rotating shift work.... Bottom line. It sucks. In fact, it's probably the main reason that I will pay to get out of night shifts in the ER.

More to follow.... this is hard to do on an Iphone.

Weight Loss Question

Hello Docs,

I am having trouble losing weight. I tend to yo-yo on the weight thing. I have tried Weight-Watchers and Nutri Systems, but I get so hungry I eventually binge and end up back where I started. What are options for me besides surgery? I am female and 40 years old. I am 5' 4'' and weigh 260 pounds. I have no other medical problems. I have had a recent complete physical including a thyroid check. I'm healthy but fat! What to do?

Thanks,

Cynthia

Dear Cynthia,

Thanks Cynthia for your question. There are as many ways to approach weight loss these days as there are people trying to lose weight. Weight Watchers and Nutri-System are great programs, but when it comes down to the essentials it takes two things to lose weight: good diet and regular exercise. The reason that most diets fail is because there is (believe it or not) too much self-reliance or (worse) reliance on friends to be a support structure for continued success.
You've done a good job by getting a primary physician to see you and get some routine lab work. However, the usual amount of time your primary provider has to devote to you (especially if you are an established patient) is going to be about 15 minutes. In my practice, I have found that it takes about 30-45minutes of time just to get a good history from the patient to make a plan about any further diagnostic testing or a treatment plan.
If you are ok physically, then you need to get a strong team together to help you succeed. A physician or other provider can often be a good source for accountability by following up at regular intervals. A dietitian can help you get on the right track instead of trying to wade through a sea of diet books and philosophies. Lastly, a good personal trainer can often be your best cheerleader. You might even consider a psychologist or psychiatrist if you think that there are issues that may be hindering your success.
Sometimes weight loss medication can help get you from the bad habits to the good habits. I often tell my patients that weight loss medication can help you lose weight even if you sit on the cough, but they are BETTER used as a means of helping you make a transition to a healthier lifestyle. Otherwise, they will be a miserable failure.
I would recommend that you seek the guidance of a physician who practices "bariatric medicine" (notice that I didn't say "bariatric surgeon"). If you look on the website for the American Society of Bariatric Medicine for a listing of physicians in your area that specialize in this expertise, then you may find the perfect partner in your weight loss goal. The website is www.asbp.org. Good luck to you!!! _DOC2