LivingAfterWLS Weekly Digest
Obesity Reclassified
Obesity is a medical condition,
not a moral failure
June 21, 2013
In This Issue
June Theme
Obesity Defined
5Ls: Look, Listen, Learn, Live, Love
AMA: Obesity is a disease, not a choice
Food for Thought: I am me, I am not my disease
Recipe: Summer Fresh Skillet Meal
Petals of Light by Kaye Bailey

A Well-Reasoned Approach to the WLS Basics

Take the basic tenets of weight loss surgery, curate knowledge that supports your chosen dietary path, collaborate with others sharing your dietary circumstances, apply personal experience, and build a dietary health-management way-of-life that enables you to thrive.

This is the responsibility of every person who desires to live a healthy balanced well-managed life with WLS."
~ Kaye Bailey

"Obesity is a chronic, debilitating and potentially fatal disease."
American College of Gastroenterology - 2008

Refresher: Definitions
OBESITY: noun.
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health. It is defined by body mass index (BMI) and further evaluated in terms of fat distribution via the waist-hip ratio and total cardiovascular risk factors. BMI is closely related to both percentage body fat and total body fat.

Obesity - The specifics

~Any BMI ≥ 35 or 40 is severe obesity

~A BMI of ≥ 35 and experiencing obesity-related health conditions or ≥40-44.9 is morbid obesity

~A BMI of ≥ 45 or 50 is super obesity

Learn your BMI at the Centers for Disease Control website: Link Below.  
"A successful surgery does not make a successful patient." Your surgeon can only do his part in your success;
the rest is up to you."

Dr. Guillermo Alvarez
Successful Weight Loss with
The Gastric Sleeve (page 59)

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Obesity Defined

This article is shared, with permission,  from Wikipedia, the Free Encyclopedia. You can read the entire article here: Wikipedia Obesity. The information is supported with 199 citations of reputable studies and research from world leaders in the field of medicine and obesity treatment.

Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems.

People are considered obese when their body mass index (BMI), a measurement obtained by dividing a person's weight in kilograms by the square of the person's height in metres, exceeds 30 kg/m2.

Obesity increases the likelihood of various diseases, particularly heart disease, type 2 diabetes, obstructive sleep apnea, certain types of cancer, and osteoarthritis.[2] Obesity is most commonly caused by a combination of excessive food energy intake, lack of physical activity, and genetic susceptibility, although a few cases are caused primarily by genes, endocrine disorders, medications or psychiatric illness. Evidence to support the view that some obese people eat little yet gain weight due to a slow metabolism is limited; on average obese people have a greater energy expenditure than their thin counterparts due to the energy required to maintain an increased body mass.

Dieting and physical exercise are the mainstays of treatment for obesity. Diet quality can be improved by reducing the consumption of energy-dense foods such as those high in fat and sugars, and by increasing the intake of dietary fiber. Anti-obesity drugs may be taken to reduce appetite or inhibit fat absorption together with a suitable diet. If diet, exercise and medication are not effective, a gastric balloon may assist with weight loss, or surgery may be performed to reduce stomach volume and/or bowel length, leading to earlier satiation and reduced ability to absorb nutrients from food.

Obesity is a leading preventable cause of death worldwide, with increasing prevalence in adults and children, and authorities view it as one of the most serious public health problems of the 21st century. Obesity is stigmatized in much of the modern world (particularly in the Western world), though it was widely perceived as a symbol of wealth and fertility at other times in history, and still is in some parts of the world.

Link to Article.



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In the world of obesity treatment and weight management the news was big this week. The American Medical Association (AMA) declared that Obesity is a disease that requires medical intervention, treatments and preventative measures (see article below).  People who have undergone a bariatric procedure to treat their obesity have known this all along. If obesity were not a medical condition why-oh-why would we undergo major gastric surgery to treat it?

Actually, the AMA is behind many other respected organizations in classifying obesity a disease. The most commonly accepted definition of obesity comes from the World Health Organization (WHO) dating back to 1997. In 2000, WHO officially stated,

"Obesity is a complex and incompletely understood disease. Obesity is a chronic disease that requires long-term strategies for its effective prevention and management. It (obesity) is a global problem. Prevention and management strategies should be developed."

To our collective population the AMA reclassification indicates treatment and prevention of obesity will become more comprehensive to include medically supervised diet and exercise, pharmacotherapy intervention, psychological and social counseling, and surgical options. In addition, more insurance companies will be forced to step-up and cover treatment protocols for obesity.

This is good for society. But the best benefit from this reclassification is that it allows us, as individuals, to realize that we indeed have a medical disease, a metabolic disorder, that causes us to store excess fat and become overweight or obese. Knowing this we can work at releasing ourselves from the blame and self-loathing that come with being overweight. Obesity is not a moral failure, it is a disease. Being overweight is not a sign of weakness or lack of willpower; it is the manifestation of the metabolic disorder. Once we accept that we can intelligently and systematically work with our medical experts, mental health professionals, friends and family members in a deliberate effort to put the disease in remission.

In today's special edition of the Weekly Digest I invite you to reclassify your personal definition of obesity. Consider the 5Ls (Look, Listen, Learn, Live, Love). I know that my weight management efforts are more successful when I approach my obesity as a medical condition requiring daily effort to manage. It serves me well to remember that I am me, I am not my disease (see article below).

I hope you find this special edition useful in your ongoing efforts for improved health with weight loss surgery. Today marks the start of summer and I wish you the  very best of health  and wellness.  You have the power to make this your healthiest year ever - Let's do it together!


"I believe in you.
You deserve to be healthy.
 You deserve to be kind to yourself.
You deserve to achieve your greatest level of success with weight loss surgery when you harness your inner resources."
--Kaye Bailey
5 Day Pouch Test Owner's Manual

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LLLLL5Ls: Look, Listen, Learn, Live, Love
A considered approach to managing obesity   
by Kaye Bailey

These are my 5Ls - Look, Listen, Learn, Live, Love. They are my abiding principles that guide me through this crazy life and help me manage my disease - obesity - each day. In sharing them with you I hope you will find inspiration and empowerment to manage your own disease in the best manner possible.

Look: Take a moment to step outside of yourself and consider your obesity. Did you choose to have this disease? Think back to the classic grade school writing assignment, "What do you want to be when you grow up?" I would bet the farm not one of us wrote, "When I grow up I want to be morbidly obese." We did not ask for this condition any more than someone with cancer or heart disease asks for their ailment. It just happens to be our circumstance. If you have long blamed yourself for being overweight it is time to let go. Overweight is overweight, it is not failure. Acknowledging that obesity is a disease empowers us to manage it logically and consistently.

Listen: Pause and listen to your inner dialog. Are you defining yourself as fat or obese? Do you hear yourself saying, "I am fat" or "Look how fat I am?" You are you. You are not fat, you are not obese. You have a medical condition called obesity. Cancer patients do not define themselves as "I am cancer." They say "I have cancer" or "I survived cancer." Listen closely to your self-talk and interrupt thoughts that are degrading and irrelevant. Change the word "fat" to "fabulous" next time you speak-up to define yourself. Go ahead, say "I am fabulous!"  Now that feels much better!

Learn: Become a knowledge sponge. Unlike any other illness we have significant power to control our obesity and put it in remission. Prior to surgery WLS patients are knowledge hounds. The learning doesn't stop once the incisions are healed. Pursue knowledge that supports your healthy weight management and implement that knowledge to the best of your ability. Never ever stop learning. That's why you are here, reading this newsletter. You want to know more in order to live better. I love this about our WLS community.

Live: Don't forget to live. So many of us put our lives on hold because of the debilitating nature of obesity. Seize this moment to do the things you put off doing for so long. Live the life of your dreams. Truly thriving in life supports ongoing weight loss efforts because living makes the struggles feel worthwhile. Don't just write your bucket list - live it!

Love: Finally, fill yourself with love. When you have love in your heart there is no room for negative feelings of self-loathing or disdain. Nobody is perfect and nobody gets this WLS lifestyle right everyday - I know that from personal experience. But if you give it your best shot and strive for ongoing improvement you will thrive. Be kind to yourself. Fill your heart with love.

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AMAAMA: Obesity a disease, not a choice:
Reclassification will change treatment options

WASHINGTON (AP)  The American Medical Association (AMA) now considers obesity a disease that requires medical intervention, treatments and preventative measures.

The resolution to consider obesity a disease was passed on Tuesday at the association's annual meeting.

"The suggestion that obesity is not a disease but rather a consequence of a chosen lifestyle exemplified by overeating and/or inactivity is equivalent to suggesting that lung cancer is not a disease because it was brought about by individual choice to smoke cigarettes," reads one of the final paragraphs of the resolution (courtesy NPR's posting of the full document).

The AMA hopes the reclassification will change how doctors treat patients; that they will treat obesity as a disease rather than a lifestyle choice or condition.

"Recognizing obesity as a disease will help change the way the medical community tackles this complex issue that affects approximately one in three Americans," said AMA board member Patrice Harris, M.D. "The AMA is committed to improving health outcomes and is working to reduce the incidence of cardiovascular disease and type 2 diabetes, which are often linked to obesity."

Obesity has been linked to risk increases for heart disease, Type 2 diabetes, stroke, liver disease, sleep apnea, breathing problems, osteoarthritis and joint pain, infertility, sexual side effects and cancers of the breast, colon, esophagus, pancreas and kidneys. A recent cancer study also found a rise in obesity-related cancers over the last thirty years.

This new position on obesity could have a "tremendous impact on [obesity] legislation in Washington [and] with insurance companies," Dr. Louis Aronne, an obesity specialist at New York-Presbyterian Hospital in New York City, said on "CBS This Morning" Wednesday.

It is also possible that bariatric surgeries including Lap-band procedures or gastric bypass surgeries would now be covered by more insurers based on the AMA's reclassification, he told CBS.

While the AMA's recognition of obesity as a disease is not legally binding, the decision by the largest association of physicians in the country could have far reaching implications.

"The American Medical Association's recognition that obesity is a disease carries a lot of clout," Dr. Samuel Klein, director of the Center for Human Nutrition at Washington University School of Medicine in St. Louis, said to USA Today . "The most important aspect of the AMA decision is that the AMA is a respected representative of American medicine. Their opinion can influence policy makers who are in a position to do more to support interventions and research to prevent and treat obesity."


notdisease Food for Thought:
I am me, I am not my disease

Published with permission from the 5 Day Pouch Test Owner's Manual, 2nd Edition by Kaye Bailey, page 18. Copyright (C) LivingAfterWLS, LLC - All Rights Reserved.

An affirmation: I was born with the disease obesity and by the time I was out of college it had advanced to morbid obesity. At age 33 my disease was treated with gastric bypass surgery which affected a loss of weight that put my disease, morbid obesity, in remission. Three years later I suffered a relapse of my disease with a weight gain of 30 pounds. Through dietary and lifestyle compliance and working with my tool and following the rules prescribed by my bariatric surgeon, I was able to put my disease, obesity, back in remission. I will always have the disease of morbid obesity and I am fortunate that I was able, at a young age, to be treated with the best medically available option.

The Facts: 
Obesity is a disease.

Weight loss puts the disease in remission.

Weight gain puts the disease in relapse.

As with most diseases, those who suffer obesity are responsible to make dietary and lifestyle changes that work in tandem with medical treatment to keep our disease in remission.

Like most diseases, relapse occurs: obesity manifests relapse in weight gain.

We are never limited in the number of times we can actively affect behaviors to put obesity in remission:  we always have another chance.

Most importantly, I am not the disease, I have the disease.

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 Kaye Bailey: I am me, I am not my disease

Video Summary: Kaye discusses the importance of our language and how we define ourselves.


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Summer Fresh Skillet Meal
Cooking with Kaye: Methods to Meals
Reprinted with permission from
Cooking with Kaye: Methods to Meals.
Page 125.
Sweet Italian Turkey Sausage
with Veggies and Pasta  
Freeway Chef, colorful variety, succulent sausage flavor

This is a good recipe for learning to enjoy pasta as an ingredient in our meal rather than the main course. The sausage and vegetables play the lead role providing most of the volume while pasta makes an appearance as supporting cast. Learn more about including pasta in your Protein First diet on Page 165.

1˝-cup garden rotini corkscrew pasta
1 (19-ounce) package Jennie-OŽ Lean Sweet Italian Turkey Sausage
2 tablespoons canola oil
1 medium red onion, thinly sliced
1 yellow sweet bell pepper, seeded, chopped
2 cloves garlic, minced
2 green zucchini, halved lengthwise, cut into 1/2-inch pieces
1 pint cherry tomatoes, rinsed and drained
1 cup barbecue sauce, any flavor

Directions: Cook pasta according to package directions, drain and set aside. Slice sausage links into 1-inch pieces; set aside. Prepare all vegetables. In large high-sided skillet heat canola oil over high heat; add turkey sausage and cook and stir until sausage is lightly browned and fragrant. Add onion, bell pepper, garlic, and zucchini. Continue to cook and stir over high heat until vegetables become tender but not overly soft. Add cherry tomatoes and cooked pasta and cook another 2 minutes. Stir in barbecue sauce and ˝ cup water; toss to coat all vegetables and sausage; adjust with more barbecue sauce or water to preferred consistency. Serve warm.

Nutrition: Serves 4 to 6. Each 2-cup serving provides 322 calories, 21 grams protein, 9 grams fat, 44 grams carbohydrate, 8 grams dietary fiber.

Try This: Vary the vegetables with the season and use frozen vegetable blends when fresh vegetables are in short supply. ~ Chilled leftovers of this skillet meal make an easy on-the-go lunch. Serve leftovers chilled, or gently reheated in the microwave.  

Page 125, Cooking with Kaye: Methods to Meals

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