1. Increased adipose tissue increases how much Angiotensin-converting enzyme 2 (ACE2) your body produces. This enzyme binds to the Covid virus and may therefore increase disease severity.
2. People with weight problems are more likely to have diabetes, high blood pressure, heart disease, respiratory disease (sleep apnoea, asthma, reflux-related lung disease), kidney disease and other conditions that increase risks of causing severe illness from Covid.
3. People with weight problems are harder to look after in ICU and are more prone to complications when on a ventilator for a prolonged time.
4. We now know that people carrying extra weight are also far more likely to die after a covid infection.

So, what can be done about this?

First up, it’s important not to let fear dominate our lives, as that gets in the way of living. It is possible however to use legitimate concerns as a “call to action” to improve not just our health as it relates to Covid but our health overall. Experts have a number of suggestions that will help.

• Get vaccinated. Any vaccine is ok for a very large number of people over the age of 20. The risks of the AZ vaccine that everyone is concerned about have been massively blown out of proportion, this has led to people taking bad advice which has led to preventable illness and death.
• • If we vaccinated the whole Australian population in 2 weeks with the AZ, we would get around 25 vaccine-related deaths and around 50-100 ICU admissions. In NSW alone we have had a tiny percentage of the population infected with COVID leading to many ICU admissions and an increasing death rate. It’s likely that almost all these ICU admissions and deaths would have been avoided had the people affected had the AZ vaccine.  
  • 25 people die every week crossing the road in Australia and about 60 people a week from suicide. Clearly, the risks of vaccination need to be understood in this context.
  • We should, as adults, be more concerned about our children’s welfare. Every time someone over the age of 50 has a Pfizer COVID vaccine they are effectively preventing a dose from being available for a child or adolescent, and it’s clear that they won’t get their schooling, friends and future opportunities back until they are vaccinated.

• Take social isolation and personal hygiene seriously and ensure that those around you do as well. Official government guidelines have been consistently accurate for the last few weeks, and they do a far better job to inform us of the steps we need to take than what may pop up from unofficial sources and armchair experts.

• Ensure your medical conditions are optimally controlled. Now is a perfect time to get in touch with your GP and get a check-up.

• Work on your fitness. This will improve respiratory health, reduce your blood pressure and help control your blood sugars.

• Eat well and avoid snacking. If you are eating more than 3 times a day you are highly likely to be gaining weight. Calorie containing drinks (milky coffee, alcohol, juice etc all count as snacks). Weight gain increases stress on all your body’s vital functions if you are overweight.

• Consider short or long-term weight management strategies. While many traditional weight management options are not available during this time there are things you can try that can work well. Losing 5-10% of your weight can have profound effects on many illnesses if you are carrying too many kgs.
  • Very Low-Calorie Diets (VLCD) such as Optifast ™. These high protein/low carbohydrate meal replacements can replace 1-2 meals a day to promote weight maintenance, or 2-3 meals a day for rapid and safe weight loss.
  • Intermittent fasting. The 5:2 diet whereby you fast 2 days a week or the 16:8 diet where you only eat or have calorie-containing liquids for 8 hours a day are options that may work while our new routine is in “lock-down”.
  • Medically supervised options. These are more complex and rely on a mix of exercise, dietary change and VLCD. There are also several new and very effective weight-loss medications available that can help people lose up to 15-20 kg (10-15% of starting weight).

While bariatric surgery has been proven to provide a sustained weight loss greater than 5-10 times what can be achieved with the methods above, there are many people who may not wish to do this during the Pandemic. Now however could be a good time to consider a long-term weight management plan that could help protect you from this and other dangerous health problems in the future. Our offices are open to offering medical advice to people with a weight problem or people who have had previous weight-loss surgery to help keep them safe during this time.

A/Prof Michael Talbot

Fresh Start Online includes a wide range of program elements and resources specifically designed to enhance your surgical experience and to help you to to create and sustain a new healthy lifestyle.

Fresh Start is brought to you by an experienced, qualified and professional coaching team, to help you to achieve long-lasting health and weight results. 

It’s designed to assist you in:

• Getting clear on exactly what you want to create in terms of your health and weight;
• Create a new supportive identity for yourself that will support your success;
• Break stubborn habits, such as emotional eating, and self-sabotage if they do come up;
• Learn smart strategies around stress management, nutrition and movement; and
• Feel confident and inspired about the future.

Want to know more? Watch the video below to find out more about the program:

This program is included in the surgical package of all new patients of Upper GI Surgery and past-patients can access it at a significantly reduced price. If you would like to find out more, check out our Fresh Start page or speak to our team today who will be able to help.

, an Australian network created to “provide a strong voice and support for people living with and affected by obesity”. WIN actively seeks participation in their surveys from people affected by obesity, and then share their findings with the public. All of this information comes from members and volunteers who choose to participate. 

We have reached out via our blogs, newsletters and social media to encourage those that follow us to participate and join WIN, as we believe the work they are doing is making a difference. WIN recently released their 2020 Report – The Personal Costs of Weight Issues in Australia. 

This important report highlights the perspectives of those who are living with the challenges of overweight and obesity. Obesity is much more complex than “eat less and move more” or a simple matter of lifestyle choices. This report is designed to help raise awareness of not only the complexities of obesity but challenges around weight stigma, the impact of the environment and navigating the Australian health system. 

Summary of WIN Report Recommendations

• Weight stigma needs to stop. The lived experience and perspectives of those living with overweight or obesity to be included in the development of plans and strategies, the design of treatment paths and research, and debates on weight issues in a person-centred approach.
• Improve clarity and reduce barriers to better health. Making obesity training mandatory in areas such as health and social care service education. Making effective, evidence-based treatment options affordable and accessible across Australia.
• More supportive environments in society. Government making healthy food cheaper and easier to access, particularly in low income and remote areas. Investing in green spaces, education and a regulation in terms of ‘junk food’ marketing, particularly to children and younger people.

In the coming months we will explain each of these areas in more detail in a series of blogs, but in the meantime if you would like to read or download the full report you can here.

WIN – “Weight Issues Network” is an advocacy group initiated by Australians living with, or caring for those living with obesity, with the aim of reducing weight-related stigma and provide the consumer voice in issues related to overweight and obesity. The WIN community aims to provide a place to access quality information and peer support, as well as to advocate on important weight issues in Australia. 

How has the COVID-19 pandemic impacted those suffering from obesity

WIN is interested in understanding the impact that the COVID-19 crisis is having on those with the lived experience of obesity. In order to do this, they have set up a quick and easy anonymous survey that they would like those that are living with weight problems to participate in. 

Your input in this survey will help them to raise the common key issues of concern and highlight them to decision-makers, organisations, healthcare providers and stakeholders who work in the area of obesity here in Australia. 

If you would like to participate in the survey click here. This simple questionnaire should take no more than a couple of minutes of your time but will be a big help in understanding the impact that this epidemic has had on our community. 

How do I become a WIN-NER? 

If you would like to continue to help WIN give you a voice in issues related to overweight and obesity, they have made it as easy as possible for you to sign up to become a member! 

• Complete the membership form online at www.auswin.org.au. 
• Send an email to info@auswin.org.au
• Post the membership form to PO BOX 3004, Rosemeadow, NSW 2560. 

If you would like to know more visit the WIN website today. 

Understanding food labels

Food labels can be very tricky and confusing to understand. Today we will explain how to understand food labels to make shopping for healthier food a whole lot easier, which will in turn, further assist with weight loss and management following bariatric surgery. 

Let’s start with what seems like the obvious: serving size. When you’re looking at a food label make sure that you understand how many servings are included, and be conscious that suggested serving sizes are not always appropriate for post-bariatric surgery patients. The 100g column is useful to compare different brands of food but is often not the serving size, so also bear this in mind. Our guides below for you refer to the 100g measurement to make this easier. 

Here are some basic guidelines to follow when you’re checking out the nutritional content: 

Total Fat – choose foods with less than 10g fat/100g. 

Saturated Fat – less than 2g/100g is best. 

Total carbohydrates (includes Starch, Sugar & Fibre)

• Sugars – less than 10-15g/100g

Sodium – less than 400mg/100g is good; less than 120mg/100g is best. 

How much protein do I need

You probably noticed we didn’t mention protein in our guide above. Protein is a crucial part of a post-bariatric surgery diet. Why? 

• Protein keeps you full for longer as it’s digested more slowly. 
• Adequate protein during weight loss is important to reduce muscle wastage. 
• A higher protein (30% of energy from protein), more nutrient-dense diet long term helps to control weight and reduce cravings that are often experienced when the diet is high in processed carbohydrates. 

Depending on what stage you are at with your weight loss journey will dictate the protein requirements in your diet, please see the chart below provided by our dietitian:

Getting enough protein long term

Finally, the last part of the Support Group meeting discussed different ways of increasing protein intake particularly during the earlier part of the day. There are now many new high protein products available in the supermarkets that can help set you up for the day with a protein-packed breakfast boost. Check them out below: 

Our Support Group Meetings are run quarterly from our practice in Kogarah, Sydney. Our bariatric surgery patients find attending these Support Groups greatly aids their long-term weight loss results as well as ensuring they keep on the right track. If you would like to join us for our next Support Group Meeting on the 6th of November give us a call on (02) 9553 1120.