Eating and

Weight Management

  • Weight Loss Surgery

    Obese patients often fail to lose weight or lose and then quickly regain their weight. When repeated weight loss attempts fail, surgical procedures are considered. Surgical interventions have many benefits and have become increasingly popular to rescue obese patients. A number of bariatric surgical procedures have been used to decrease stomach size. The surgeries usually reserved for obese patients (BMI ≥40), are sleeve gastrectomy and gastric bypass.

    Two randomized trials of bariatric surgery have reported 5-year outcomes — both in obese patients with type 2 diabetes — most recently the Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently (STAMPEDE) trial. In these studies, sleeve gastrectomy, RYGB, and BPD reduced the burden of glucose-lowering medication and produced diabetes remission in up to 50% of patients.[i]

  • About 65% to 70% of bariatric-surgery procedures today in the United States are sleeve gastrectomies, It is a safe operation. A statement issued at the meeting, the American Society for Metabolic and Bariatric Surgery explained that last year sleeve gastrectomy, where surgeons remove about 80% of the stomach, emerged as the most popular method of weight-loss surgery in America, surpassing laparoscopic gastric bypass, which had been the most common procedure for decades. In 2013 in the United States, sleeve gastrectomy accounted for 42.1% of the 179 000 bariatric procedures performed, followed by gastric bypass (34.2%), gastric band (14%), and biliopancreatic diversion with duodenal switch (1%).

  • Two weight-loss procedures, Roux-en-Y gastric bypass (GB) and sleeve gastrectomy (SG) alter postprandial glucose pattern and enhance gut hormone secretion immediately after surgery before significant weight loss. This weight-loss independent glycemic effects of GB has been attributed to an accelerated nutrient transit from stomach pouch to the gut and enhanced secretion of insulinotropic gut factors; in particular, glucagon-like peptide-1 (GLP-1). Meal-induced GLP-1 secretion is as much as tenfold higher in patients after GB compared to non-surgical individuals and inhibition of GLP-1 action during meals reduces postprandial hyperinsulinemia after GB two to three times more than that in persons without surgery. Moreover, in a subgroup of patients with the late complication of postprandial hyperinsulinemic hypoglycemia after GB, GLP1R blockade reverses hypoglycemia by reducing meal stimulated insulin secretion. The role of enteroinsular axis activity after SG, an increasingly popular alternative to GB, is less understood but, similar to GB, SG accelerates nutrient delivery to the intestine, improves glucose tolerance, and increases postprandial GLP-1 secretion. [ii]

  • Following RYGB or sleeve mastectomy, most people report subjective changes in appetite, taste and food preference, with decreased high-fat preference most commonly reported. Objective post surgery changes in taste and olfactory acuity occur. A new phenomenon, ‘meal-size aversion’, may contribute to reduced postoperative energy intake. Recent studies provide evidence for peptide YY3–36, glucagon-like peptide-1, ghrelin, neurotensin and oleoylethanolamide as mediators of postoperative eating behavior changes. Factors modulating these changes include sex, type 2 diabetes status, genetics and bariatric procedure. New studies implicate central dopaminergic and opioid receptor signaling as key neural mediators driving altered eating behavior. Brain neuroimaging studies show that obesity-associated changes in food-cue responses, brain connectivity and structural abnormalities are normalized following bariatric surgery.[iii]
    Gastric banding is a procedure done through an endoscope and has many advocates: Jenkins summarized a study report from Centre for Obesity Research and Education in Clayton, Australia. She wrote:” A new study of the use of laparoscopic gastric-band surgery in overweight rather than obese patients with type 2 diabetes showed it is a powerful therapy associated with sustained weight loss for at least 5 years and significant improvements in blood glucose, HDL cholesterol, and quality of life. The five-year outcomes from the randomized trial in patients with type 2 diabetes showed an average weight loss of 12.2% in moderately overweight patients who underwent the procedure vs 1.8% in overweight patients who received medical care alone. In addition, 23% of patients in the gastric-band group had diabetes remission at 5 years compared with 9% in the medical-care-only.” [iv]

  • The authors reported: “In the current study, 51 patients with a BMI of 25 to 30 kg/m2 and type 2 diabetes were enrolled between 2009 and 2011 and randomized to gastric band combined with medical care or medical care alone. A total of 45 patients were followed to 5 years, including 22 patients randomized to surgery plus medical care and 23 to medical care alone. At 5 years, five patients (23%) in the gastric-band group had diabetes remission compared with two patients (9%) in the medical-care-only group. Remission was defined as fasting glucose less than 7.0 mmol/L and 2-hour glucose less than 11.1 mmol/L after a 75-g oral challenge.[v]
    [i] Miriam E Tucker. Laparoscopic Sleeve Gastrectomy: Good Operation, With Limits Medscape November 09, 2017
    [ii] Altered glucose metabolism after bariatric surgery: What's GLP-1 got to do with it? Metabolism: clinical and experimental. 2017, DOI: 10.1016/j.metabol.2017.10.014
    [iii] Current Opinion in Endocrinology & Diabetes and Obesity. 2017/11/07
    [iv] Kristin Jenkins. Gastric Bands Help Overweight Patients With Diabetes. Medscape March03,2017
    [v] Wentworth JM et al. Five-Year Outcomes of a Randomized Trial of Gastric Band Surgery in Overweight but Not Obese People With Type 2 Diabetes. Diabetes Care. February 17, 2017

  • The Book Eating and Weight Management teaches rational food selection, appetite control, weight management. Read this book and use the Alpha Nutrition Program to resolve food-related symptoms, restore more normal appetite regulation and build optimal disease-preventing nutrition. The book reveals the basic concepts of weight management and emphasizes aspects of the Alpha Nutrition Program that are most useful in achieving normal eating behaviors and weight management. Your efforts are first directed toward changing food selection, eating behaviors and increasing physical activity. The Alpha Nutrition Program is a set of instructions and nutrient tools designed to resolve disease through diet revision. The program is nutritional therapy, a personal technology of health restoration and health maintenance. The books is available in a print version and as an inexpensive eBook for download. 148 Pages.

    Download eBook version, Eating and Weight Management

  • Eating & Weight Starter Pack Help understanding and managing overweight, obesity, and compulsive eating disorders. Includes Alpha ENF, Alpha Nutrition Program, and the book Eating and Weight Management.

    No one should claim that weight loss is easy, but weight management can be pursued in a rational manner with an expectation of success. First, you have to understand that the goal is not really weight loss. The goal is to become a smaller, leaner person and stay that way. The key phrase is "stay that way". A permanent change in food selection and eating behaviors is required for a permanent change in body weight. We like to think that successful weight management is a natural by-product of new healthy habits. A healthy lifestyle means that you feel and act well, you eat well, you exercise, stay in shape, and seek mind-body balance.

  • Order Eating & Weight Rescue Starter Pack

    Alpha ENF is the principle meal replacement formula. Alpha PMX is a fat free version of Alpha ENF can be used as food replacement. Alpha DMX is used instead of Alpha ENF for diabetes 2.

    Printed books are available from Alpha Online. Click the add to cart button on the left to begin an order for printed books. Click the download buttons on the right for eBook downloads. eBooks are available fro download at low cost - a good way to begin if you need more information.

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