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. 

The group began with a mindfulness exercise called Eating Raisins. Each person was given some raisins and was asked to eat one raisin as they normally would and then were guided to eat the other raisins in a mindful way. Each person was asked to use all 5 senses (touch, smell, hearing, taste and sight) before eating the raisin, which included placing the raisin in the mouth rolling it around and feeling it before chewing and swallowing it. This exercise allowed each person to increase their awareness and experience of eating and become more mindful.

We then talked about experiences of mindless eating. Mindless eating is not driven by genuine hunger or a biologically driven need of our body. Rather it is driven by cues in our environment both externally and internally. Patients in the group were able to give their own experiences of mindless eating such as eating in front of the TV, walking to the fridge when sitting on the couch at night looking for food, eating at the movies, eating when bored, eating when stressed, eating at social events and many more. This mindless eating is what causes us to gain weight. We need to engage in mindful eating to be able to maintain a healthy weight range.

What is Mindful Eating? – Mindfulness involves paying attention, on purpose, with an attitude of curiosity. Mindfulness helps you enjoy your food. You notice more about flavours, smells and textures when you pay attention. Mindfulness assists you to make better food choices.

Our support group learnt about the Seven Skills of the Mindful Eater

• Awareness – the calm and focussed attention when eating by tuning into your senses.

• Observation – seeing the situation from a distance, observe your body, feelings and thoughts before wanting to eat

• Being in the moment – when you engage in mindful eating, you act consciously not out of habit.

• Being Mindful of the Environment – be conscious of your environment, notice any triggers and manage them.

• Non-judgment – you need to learn to be compassionate and empathetic when learning how to engage in mindful eating. As you stop judging yourself you learn how to be more present and aware of what you are doing.

• Letting go – letting go of “what should be”, letting go of being perfect, acknowledge imperfections and move on.

• Acceptance – this means being okay with the way things are.

Lastly we discussed Physical Hunger vs Emotional/Habit Hunger – learning the difference. Is hunger arising from your physical body or from your heart and habits.

If you would like to attend our next support group on the 22nd of May then please call our office on 02 9553 1120 to book your space.

Today we will provide you with some insight on what was discussed during this support group meeting, which is helpful information for anybody considering plastic surgery following weight loss.

What is body contouring surgery?

Body contouring surgery is a form of plastic surgery that involves removing loose skin after weight loss or fat that is resistant to diet and exercise. It has to be noted that body contouring is only performed if you have reached your stable goal body weight, and you have to be nutritionally fit to tolerate the considerable duration of this surgery and recovery period. For example when multiple body areas need to be addressed, the treatment will be split into different operations in order to limit the duration of the surgery as well as make recovery from surgery more manageable.

Different types of body contouring surgery for weight loss patients

Body Lift/Belt Lipectomy – two separate operations. A belt lipectomy is similar to an abdominoplasty in that the loose skin of the lower abdomen is trimmed into an incision at the bikini line. With a body lift the incision line is continued around the back and above the buttocks, to gather the skin collecting at the ‘muffin top’ or ‘love handle’ areas, pulling the supportive tissues of the hips/buttocks down on the supportive tissues of the abdomen and back, creating a firm and more desirable body contour.

Brachioplasty – this is essentially an ‘arm lift’. This involves gathering the loose skin that hangs down from the upper arms, a patients ‘wings’ of skin. Although this surgery may seem desirable, the scars are long and can be obvious (extending from the armpit to the elbow at the inner aspect of the arm), so this surgery should be carefully considered.

Thigh lift – this in fact falls into two procedures, one that addresses the inner thigh loose skin (a medial thigh lift) and the outer thigh loose skin is addressed with a body lift procedure. A medial lift removes excess skin and fat from the inner thigh area, and the body lift helps reduce the amount of skin on the outer thigh.

Breast lift – or also known as mastopexy, reshapes and lifts the breast tissue, which can often be ‘droopy’ after weight loss. This is a procedure that both women and men benefit from, although they are different operations depending on your gender, but both equally satisfying.

How can I pay for body contouring surgery following weight loss?

You can often use your private health insurance for body contouring surgery if you have experienced a significant weight loss and consequently your loose skin has become debilitating. This can often cover hospital and operating costs including the post-operative stay. Medicare and your private health insurance can also contribute to your doctors’ bills, check with your insurance provider to see if you would be eligible. This surgery is also available to private patients wishing to fund the surgery themselves.

Bariatric surgery is one of the tools to help you lose your excess weight and allowing you to start living a healthier lifestyle, but some patients are disappointed with the appearance of their body afterwards, despite the hard work it takes to achieve such as weight loss. This is why many consider plastic surgery following weight loss and we felt it was important to address with our support group.

For more information on the body contouring services that Dr Amira Sanki and the team at Southern Aesthetic Plastic Surgery offer you can visit their website. For more information on bariatric surgery please contact us on 02 9553 1120 or submit an enquiry to us online.

Taking Supplements After Bariatric Surgery

After bariatric surgery you will be consuming a much lower volume of food than pre-surgery, therefore the risk of nutrient deficiencies increases. Some surgery, such as gastric bypass surgery, alter the way your digestive system works and requires lifelong supplementation. If you fail to take the vitamin and mineral supplements recommended to you by your doctor then you are at an even higher risk of nutrient deficiency. If you have had gastric bypass surgery then you are at even higher risk of nutrient deficiencies due to the way this operation alters the way your digestive system works.

Our most recent support group meeting involved discussion on the main nutrients that patients may become deficient in following bariatric surgery and why each of these nutrients are important as well as which foods they are found in as well as the best ways to prevent deficiencies.

Common Nutrient Deficiencies Following Bariatric Surgery

The main nutrients that patients become deficient in following bariatric surgery include:

Iron  – this is the most common nutritional deficiency in the Western world, and the risk is particularly high following weight loss surgery. Iron is digested by in your stomach via the stomach acid and absorbed into the body. As the size of your stomach has been reduced following surgery the stomach produces less acid, meaning less absorbable iron. Iron is essential for the transfer of oxygen around your body. It is difficult to get sufficient iron from the food you consume alone which makes taking your iron supplements even more important

Vitamin B12 – this is most common in patients who have had a sleeve gastrectomy or a gastric bypass. Again this is as a result of a decreased production of stomach acid your body can no longer absorb vitamin B12 as efficiently as it should. Also eating smaller portions of food rich in B12 can also cause a deficiency.

Vitamin D/Calcium – vitamin D deficiency is extremely common. Vitamin D is needed to absorb sufficient calcium, so can have a knock on effect. A deficiency in calcium can lead to metabolic bone disease and osteoporosis, increased bone pain and risk of of fractures. Ensuring that you take supplements for each will help maintain a healthy bone structure.

These deficiencies don’t develop overnight, but over time can affect your health or quality of life so it is important to get into a routine of regularly taking your vitamin supplements, especially in the months following surgery.

How thoughts can impact our eating habits

The focus of February’s support group meeting was a discussion on how thoughts may impact eating habits and it was run by our resident psychologist Fiona Tzouramanis. Here’s a summary of what was discussed during the support group.

This topic explored how our thoughts can influence our feelings, and then in turn impact on our actions (behaviours). When we experience unhelpful thought patterns, we then tend to experience unhelpful feelings. Our actions are then based on alleviating those unhelpful feelings which at times can then be detrimental to our weight loss and/or weight maintenance goals.

Emotions that can trigger this negative behaviour could be feeling stressed, anxious, tired, guilty, frustrated and so on. The actions following these emotions could be to choose to eat take away food, eating whatever food available, eating junk food or not eating at all.

After we engage in these actions we often then have feelings of guilt or are disappointed in ourselves. This then leads to self-doubt and unhelpful thought patterns. This negative cycle of thoughts, feelings and behaviours will continue unless we intervene.

How we can take positive steps to controlling our negative behaviour

Fortunately there are positive actions that we can take in two areas of this negative cycle.

Thought Stage – at the thought stage we can challenge our thoughts and come up with more rational type thinking that is not going to cause any distressing and unhelpful feelings. In turn the rational thoughts will help create helpful feelings and helpful actions.

Behaviour Stage – at the behaviour/action stage we can choose to accept our unhelpful thoughts and feelings, however still choose a positive action that is working towards our weight loss journey. Choosing a positive action will then have a positive influence on our thought patterns, therefore creating positive feelings.

Being mindful of our thoughts and understanding the impact on our feelings and actions is the key to a positive change. Making changes to the way we think isn’t necessarily easy but with practice this can be of huge benefit in the long run.

Each support group talks about different topics with different guest speakers. It gives attendees the opportunity to ask any questions and address any of their own issues, as well as being able to openly discuss their experience with other participants who are on the same journey. Click here to read reviews of our past support groups. 

If you would like to attend our next support group then please call our team on 02 9553 1120 and they will be able to reserve you a place. Our next support group takes place on Wednesday the 9th of May and our guest speaker is Dr Amira Sanki who will be discussing plastic surgery options for weight loss surgery patients.

At each support group we discuss topics that deal with different issues patients may face following surgery and help deal with these situations correctly.

On Wednesday 29^th November we had our last Bariatric Support Meeting for 2017 and Tania Chaanine our Dietitian was guest speaker, she spoke about “The Bariatric Diet”.

After weight loss surgery, it is important to consume adequate amounts of protein; this not only helps us feel more satiated after a meal but it supports many important functions in our body.

Inadequate amounts especially after bariatric surgery can lead to muscle wasting, hair loss, fatigue, poor weight loss and poor weight maintenance long term.

In our support group we discussed the importance of adequate protein intake without compromising on a fairly balanced diet.

Getting enough protein from food sources was the emphasis of our discussion.

Our next support group meetings can be viewed here: Bariatric Patient Support. Please reserve your place for our Support Groups at least one week in advance of the meeting. If you would like to reserve your place please call us on (02) 9553 1120.