- WWE wrestler Chyna appeared twice in Playboy.
- Pamela Anderson has appeared more than any one else on the cover of Playboy.
- Carnie Wilson was not on the cover of her voice.
1. Pamela Anderson. The blonde beauty was the playmate of the month in February of 1990 at 22 years old, although she appeared on the cover first in October of 1989. She has appeared on more covers of playboy than anyone else and owes much of her success to the Playboy dynasty.[1]
2. Anna Nicole Smith. Much like Pamela, she first appeared on the screen in March of 1992 credited as “Vickie Smith” and was Miss May 1992. In 1993 she was picked as playmate of the year at 26 years old.[2] This led to her gig as a Guess model and ultimately her E! Reality TV indicate. After her death, due to an overdose of prescription drugs, Playboy featured an deliver to her in May of 2007.[3]
3. Carmen Electra. Her first nude pictorial for Playboy was in May of 1996. She has been featured four more times since that date, including in January of 2009 for the 55th Anniversary edition. She was also the first woman to become a celebrity photographer for the Playboy cyber club.[4]
4. Jenny McCarthy. She was Miss October 1993, and later became Playmate of the year in 1994. This led to her job at MTV on the dating show “Singled Out” and various film and TV roles. McCarthy continued to appear in Playboy, including on the June 2005 cover and as a celebrity photographer. Her little sister Amy was “Cyber girl of the month” in January 2005.[5]
5. Latoya Jackson. She posed for Playboy at age 32 in March 1989 the first time. The notify was the best selling issue ever. She posed again in November 1991 and in 1994 appeared in a playboy video. In reaction to her act, the conservative, Jehovah Witness Jackson family appeared on television to publicly condemn her. [6]
6. Drew Barrymore. She appeared at in January 1995, at a worthy thinner 19 years old, in the magazine, while dating the guitarist of the band Hole, Eric Erlandson. During this period in Drew’s life she was somewhat of a wild child pulling pranks like flashing David Letterman her bare breast on his birthday.[7]
7. Denise Richards. She graced the December 2004 cloak a mere five months after giving birth to her daughter Sam. Richards was married to actor Charlie Sheen at the time. [8]
8. Sharon Stone. At the age of 32 years old she posed after appearing in the 1990 movie Total Recall unbiased one year before her breakout role in Basic Instinct. In 1999 Playboy named her among the 25 sexiest stars of the century. [9]
9. Carnie Wilson. A controversial playboy centerfold, she appeared in the August 2003 issue at 36 years old, and after undergoing gastric bypass surgery. Notably, Wilson did not appear on the cover, Jenna and Heidi two contestants from Survivor did.
10. Joanie Laurer aka Chyna. She is not your typical beauty at 5’10″ and 180 pounds by any standards but the muscle bound WWE wrestler appeared in November 200 and January 2002, after he departure from the WWE.[10]
[1] http://www.playboy.com/girls/playmates/directory/199002.html
[2] http://www.people.com/people/gallery/0,,20011426_5,00.html#20011249
[3] http://www.theinsider.com/news/119905_Anna_Nicole_Smith_on_Playboy_May_2007_issue_cover
[4] http://www.popcrunch.com/carmen-electra-playboy-magazine-january-2009-picture/
[5] http://www.superiorpics.com/jenny_mccarthy/
[6] http://www.superiorpics.com/latoya_jackson/
[7] http://www.youtube.com/watch? v=1LYV9AZNlFU
[8] http://www.askmen.com/celebs/entertainment-news/denise-richards/denise-richards-playboy-pose.html
[9] http://www.easybunnygirls.com/2009/02/01/sharon-stone-showed-her-basic-instinct-to-playboy-magazine/
[10] http://www.rotten.com/library/bio/sports/chyna/
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Filed under Gastric Bypass by on Jul 18th, 2011. 
- Recommended Daily intakes based on the USRDA
- How much sodium, bulky and calories from each food
- commentary on the ludicrousness of each “dish”
No one, who isn’t either insane or insanely stupid, thinks of fast food as “healthy.” Granted, people have tried to sue fast food companies for making them fat, but those cases inevitably get thrown out because, really, if you are that out of touch, you probably belong in an institution. By and large, people know it is something that you should have on occasion when you are in a hurry, or as a treat. Most of us didn’t need Super Size Me or Fast Food Nation to tell us fast food was abominable for us; nothing with that much salt meat and cheese can be good for you. Killjoys like these seem to be sending a message to the Fast Food Industry saying “You are killing us!”
Based on my findings, the fast food industry’s response is “Fuck you!”
But there are posthaste food joints out there that take this fact to a ridiculous extreme, producing foods that are almost immoral they are so poor for you. Do they all taste good? Would that I had the means to try all of them and give you first-hand results (wink-wink, nudge-nudge to any film makers out there, I will be your guinea pig). I happen to love fast food in all of its fat and sodium riddled glory.
I hold no illusions that it is anything other than a fast track to cardiac arrest and obesity, but I am half a step away from being an addict. Here is a rundown of what you SHOULD be putting into your body, based on the USRDA (information is from http://www.netrition.com/rdi_page.html)
Nutrient Unit of Measure Daily Values
Total Fat grams (g) 65
Sodium milligrams (mg) 2400
This will give you a benchmark when you see how atrociously bad for you these foods are. Just to reiterate, this is what they recommend you ingest in an entire day, with 3 square meals and occasional snacking and drinking. Based on the below list, the conscientious folks at your local snappily food joint want you to net all of your eating done for the day in one shot.
#13 KFC: Extra Crispy Thigh
In a bucket of Kentucky Fried Chicken, there are 4 possible pieces:
Drumsticks: these are the parts that kids usually fight over both because they have a cool name and a convenient handle
Breasts: The breast is where people who actually want to get full go, it has the most meat, and for true KFC connoisseurs, the most skin.
Wings: Left overs. There is less meat in a KFC wing than a sheet of newspaper and more crunchy shit than the breast. They are for people who love fried battered food but don’t want to be bothered with the food
Thighs: the thighs are the “everything else” pieces. They are barely identifiable black meat that gets as much fat from the meat as they do from the fryer. Despite being one of the smaller pieces on average, they, ounce for ounce, are the most hideously unpleasant for you piece of food from a state that has “Fried” in its damn name.
How does it measure up?
Calories: 370
Fat: 28g
Sodium: 850mg
Compared to some of the monstrosities listed further down, this isn’t so bad. However, when one considers that no one ever fair eats one of these things, and one equals a fat third of your daily sodium intake and half your daily full, it becomes readily apparent why it is on the list. Chicken parts travel in groups, and this one is looking for your heart with the intent to beat it into submission.
#12 McDonald’s: Double Cheese Burger
For the last several years, these guys showed up as the first option on McDonald’s “Dollar Value Menu”. Why pay a buck ’98 for two cheeseburgers when you can have the equivalent for half the cost? All you are losing is some bun and a pickle, and really, who cares? It’s a pretty simple formula over at McDonald’s, you have a bun, a allotment of meat (despite what internet rumors would have you beget), a slice of cheese, some mulched up onions, a dollop of ketchup and a couple of pickle slices on a bun.
How unpleasant could that be?
How does it measure up?
Calories: 440
Fat: 23g
Sodium: 1150mg
Pretty terrible. You save a measly 5 grams of fat on the KFC thigh, and what do you get in return? More sodium which is arguably way worse for you) and more calories. How in hell it manages to have less fat but more calories is beyond me, its not even fried. I used to eat two of these at a time and wash them down with beer. It’s a wonder my entire digestive tract didn’t start a revolution on behalf of my circulatory system (Give them a rest you son of a bitch! We all need them!)
That was the soft stuff. From here on in we proceed into “regodamndiculousville”, where the food is so unbelievably bad for you that if it was fed to prisoners of war, it would be banned by the Geneva Convention. I’m not kidding.
#11 Hardee’s: Smoked Sausage Biscuit
I haven’t been around a Hardee’s since I was a kid, and even then I don’t remember ever having eaten there. However, there is an excuse for future gastric bypass hovering around there for breakfast, and it is the Smoked Sausage Biscuit. I honestly wish I knew more about this, but it looks pretty standard. While most snappily food places do their sausage in patty form, Hardee’s decided to go the link route and split a Hillshire Farm smoked sausage in half and stick that sucker on a biscuit.
You can’t go wrong with sausage and biscuits. Even if both are terrible, there is some law of nature that forces the two in concert to taste good. Stephen Hawking is working on a theory to explain it I think, and if not, he should.
How does it measure up?
Calories: 620
Fat: 46g
Sodium: 1637mg
You might be thinking “No shit? The sausage and biscuit beat the double cheese? But there is only one piece of meat (technically) and no cheese!” and if not, you should be. But that info comes from Hardee’s own website, and why in Hell would they lie about those numbers unless they were somehow far, far worse.
There is one thing I think when I explore at those numbers: that thing must taste like heaven on a biscuit.
#10 McDonald’s: Double Quarter Pounder with Cheese
You’d think that since someone took the time to make an entire documentary out of them that McDonald’s would have food appearing further down in the list, but alas, the worst thing they offer is the Double Quarter Pounder with cheese. Now, don’t get me wrong; this thing is as likely as the previous 3 to clog your arteries and make you look like Sanju Bhagat if you eat it any more than once every 6 months, but it is a far cry from the Cloverfield-sized beasts that come after it.
It follows the same format as the Double Cheeseburger, only larger and with Sesame Seeds!
How does it measure up?
Calories: 740
Fat: 42g
Sodium: 1380mg
Frighteningly for me and my burger/beer binges, the DQPwC is only slightly worse for you than the double cheese. Sure it has almost twice the fat, but it is “only” 300 more calories for double the beef and only 200 more milligrams of sodium. As far as death burgers go, the double quarter pounder with cheese is a wuss.
#9 Arby’s: Pecan Chicken Salad Sandwich
Nothing with “Chicken” or “Salad” in the title could be awful, could it? Oh wait, yeah it can. Really bad. Typically the “non-fried” chicken is the best thing on the menu for you, but not in Arby’s Pecan Chicken Salad Sandwich. Here is the list of ingredients:
Grilled Chicken
Apples
Grapes
Celery
Toasted Pecans
Mayo
All served on Honey Wheat bread with green leaf lettuce. Ostensibly, this should be healthy. Mayo is always a little iffy, but overall, that is a pretty decent looking meal. Fruit and meat isn’t really my thing, so it doesn’t sound too appetizing to me, but damn, should it really be ranked after the double quarter pounder with cheese?
You bet your ass:
How does it measure up?
Calories: 769
Fat: 10g
Sodium: 1240mg
In internet lingo, WTF!? Okay, so it has less fleshy, but almost as much sodium and more calories? Jesus Christ on a cracker, what is the mayo made out of? I am thinking eggs, oil and the souls of un-baptized babies. I’m thinking of making my own “Super-Size Me” style documentary called “I ate something from Arby’s”. I mean really, when you think about “chicken salad”, you typically think “healthy alternative”, not “Worse option than a double cheeseburger”.
#8 Hardee’s: Big Chicken Fillet Sandwich
Okay, we are now past the freakishly unhealthy grilled chicken into territory where we at least know it will probably raze us. Again, I wish I lived near a Hardee’s because this thing looks damn tasty. Fried chicken sandwiches are one of the rare foods where the advertised image looks a hell of a lot like the real thing.
This thing is a mammoth of chickendom; at 351 grams it is over three quarters of a pound. Holy. Shit. That is a lot of fried chicken. Determined it comes with tomato and lettuce, and sure there are sesame seeds and mayo, but sweet Jesus, that is enough chicken to kill someone if you dropped it on them from a tall building.
How does it measure up?
Calories: 800
Fat: 37g
Sodium: 1890mg
Finally, we are into “meal land” where a single sandwich will mean that you should really not anything for another 6 hours, not to mention enough sodium to engage care of almost two thirds of your daily allowance. Make sure you drink a lot of water when you eat one. It will take care of your thirst, and has the added bonus of letting you actually survey yourself gain weight as you retain water on top of ingesting over half your daily intake of fleshy in one sitting.
#7 Arby’s: Roast Turkey Ranch & Bacon Sandwich
Good God, what is it with these people and poultry? With the possible exception of the disease you can catch if it isn’t prepared properly, poultry is widely regarded as way healthier for you than beef, and typically it is. By the looks of it though, fast food joints with possessive names are out to ruin that reputation, or consume it to kill you.
A roast turkey sandwich is another innocuous sounding meal; even with ranch dressing and bacon, it calm sounds more like an actual “salad” than anything bad for you. As you can probably tell by the progression of things so far, this thing is a smoky appetizing Darth Vader in disguise. It really makes me wonder how many people order this kind of food thinking that they are doing the right thing, eating a turkey sandwich instead of a greasy cheesy burger. I can only imagine they die with a look of surprise when their hearts explode like a grenade in their chest.
How does it measure up?
Calories: 818
Fat: 11g
Sodium: 2146mg
Again, with poultry, as long as it isn’t fried, the fat content isn’t too high, especially white meat. But we couldn’t let it drop too low, lest this thing no demolish people, so they added ranch dressing and bacon to round things out. There is also almost 100% your daily sodium intake in there; so ingesting this sandwich will cause you to actually lower the moisture issue in the air around you.
#6 Wendy’s: Baconator
Even the advertising for this one has Dave Thomas’ ghost lifting his middle finger and laughing evilly at your various bodily systems, vegans and vegetarians everywhere. The commercial brags that there is nothing remotely vegetable like on a Baconator. Hell, if they had figured out a way, even the bun would be meat. What it is: 6 strips of bacon, 2 quarter pound patties, two slices of cheese, mayo, ketchup and a barely audible cloud of circling demons, cackling at the raw death embodied by this sandwich.
Needless to say, the Baconator is a sublime eating experience.
How does it measure up?
Calories: 830
Fat: 51g
Sodium: 1880mg
Now we’re talkin’! Nearly half your daily caloric intake?
Check!
Almost all of your daily fat intake?
Check!
Two thirds your sodium intake?
Check! By the way, if you happen to eat one of these with anything other than a LOT of water, you wind up anticipating a fate similar to John Hurt’s in Alien, complete with the twitching.
#5 Arby’s: Sausage Gravy Biscuit
Wow, gone are the names that even imply they may be healthy for you. This thing takes Hardee’s Smoked Sausage biscuit out behind the barn and beats it senseless with a 2 by 4 covered in butter. Not happy to simply have a fatty biscuit with a mere sausage on it, Arby’s goes a step further and covers it in a word that can increase your BMI just by reading it: Gravy.
And we aren’t talking “Thanksgiving dinner, made from turkey” gravy; this is “made from sausage which is flavored fat with some meat added” gravy. Although, to be fair, once you see that stats, you may be convinced that this is, in reality, unbiased a block of salt on a bun.
How does it measure up?
Calories: 961
Fat: 31g
Sodium: 3755mg
No, you didn’t misread that. 3755 fucking milligrams of sodium. According to the USRDA, if you eat one of these at 8 in the morning, you can’t have another ounce of sodium until after dinner the next day. Now, I don’t support people suing companies for ingesting the crap they provide, but if you decided to sue Arby’s for one of these nearly killing you, you might have a case.
Seriously, food like this should arrive with a warning label.
#4 Burger King: Quad Stacker
Were you beginning to think that maybe we forgot BK? Or maybe their “Flame Broiling” somehow produced a “healthier” burger than the fried or microwaved gems that come from their major competitors Wendy’s and McDonald’s? Nope. They just didn’t have anything healthier that made the list.
The Quad Stacker is the King’s way of telling you to go fuck yourself. They clearly don’t care if you live to see the end of today, just eat this and die. It is FOUR pieces of beef, FOUR pieces of bacon and FOUR pieces of cheese. Plus stacker sauce and a bun, which after the previous list are really just ancillary things to make it a little more deadly, and slightly less messy.
How does it measure up?
Calories: 1010
Fat: 70g
Sodium: 1800mg
I am beginning to run out of expletives that can accurately relate the sheer awfulness of these things. I think I will just settle on a simple “Fuck” and be done with it. Half the calories, two thirds the sodium and 5 more grams of rotund than you should eat in a day. Some people have these for lunch, and don’t skip dinner.
#3 Jack in the Box: Sirloin Bacon and Cheeseburger
Finally, a fast food restaurant not named after somebody. If you remember the early 90s, Jack in the Box didn’t just try killing people with over-the-top food; they also weak bacteriological warfare in the form of E. coli. Needless to say, they would probably like to keep that chapter behind them, and probably could if random assholes on the internet would drop it already.
Their offering to this list switches up the normal naming convention in cheeseburger circles. Rather than a cheeseburger that happens to have bacon, they wanted you to know that this was first and foremost a sirloin burger, and they stuck some bacon and cheese on it for good measure. This sandwich is 427 grams… that is 15.06 ounces. For all you non-eggheads out there, that is 1 ounce stupefied of a full fucking pound. At that size, this burger should be classified as its own species.
How does it measure up?
Calories: 1136
Fat: 70.5g
Sodium: 2215mg
It doesn’t look too much worse than the quad stacker, does it? There is a major difference, though. The quad stacker has 4 pieces of beef, cheese and bacon. Jack in the box is 3 pieces of bacon, 1 piece of cheese and one god damn fraction of beef. ONE. I suggest there may be a special breed of cow engineered by Jack in the Box for the express purpose of turning the human heart into an explosive device. Is JITB speed by Al-Queda?
We may never know.
#2 Burger King: Triple Whopper with Cheese
Finally, a kill-burger that eschews bacon. Bacon is cheating in a way, being basically salted fat. However, BK’s second entry cheats in its own right by combining 3 massive quarter pound pieces of beef in a single sandwich. Jack in the Box can do it with one, but BK is the mercurial food equivalent of a guy who drives a great big natty wide truck but never does anything off road or for the construction business. That is to say, they over compensate for having a small penis.
How do I approach up with that? Come on… look at all that meat they stack up. On second thought, maybe it’s all just a enormous metaphor for homosexuality. Whatever the case, the Triple Whopper (with cheese) is stupidly bad for you.
How does it measure up?
Calories: 1240
Fat: 84g
Sodium: 1600mg
Another note about the 3 patties; odds are against any given triple whopper having all of its beef from one cow, meaning you could be dining on up to 3 separate animals in one shot. It is very likely that ordering one of these puts you on par with Hitler and Stalin in terms of acts of genocide. Enjoy the sesame seeds you Nazi.
#1 Hardee’s: 2/3 Lb Monster Thickburger
Ok, for starters, you know things can’t be pleasurable when the name sounds like a jubilant porn spin on the movie “Goodburger”. Secondly, this thing is #1 on the list. Being in the same room with it is nearly as healthy as having bacon grease and butter, slightly heated so as to be liquid, injected directly into your bloodstream where it coagulates on contact, causing you to have a massive body-wide stroke which kills the people standing next to you as well.
Or maybe not, but there is a reason this thing made number one.
How does it measure up?
Calories: 1420
Fat: 108g
Sodium: 2770mg
I am speechless. Hardee’s is very likely a front for Gozer worshippers who are trying to bring about the end of all times. Three quarters of your daily caloric intake, almost twice your stout, and just for the fun of it, almost 400 more milligrams of sodium than you should have in a day. If it weren’t for the existence of the Sausage and Gravy Biscuit, this would be the single unhealthiest thing on earth aside from plutonium and being crushed under an aircraft carrier in a volcano.
I hope no one has interpreted this as some sort of underhanded PETA propaganda meant to make you feel guilty about eating crappy food. Quite the opposite; I say eat this crap and revel in its sheer audacity to flip the bird at God and nature’s concept for your digestive tract. Just a few words of advice: eat this food with plenty of water, or, plenty off beer. With the beer, you don’t get as well hydrated, but you care a lot less.
Make sure there is a hospital near by, or at least a phone. You never know when a piece of bacon might get lodged in a ventricle and you could die from that.
Remember this: Moderation is the key to everything. It’s not like you can’t eat this garbage, just not all the time. And if you do, then quite frankly, you are an idiot, and you should file a lawsuit against your brain.
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Filed under Gastric Bypass by on Apr 26th, 2011.
With obesity on the rise today, many are looking at surgery as a quick means to lose weight and to take care of health problems related to being overweight. Gastric bypass surgery, also known as bariatric surgery, is a drastic surgery done to encourage support obese people in weight loss. Since new technologies for this surgery has been developed, making it less painful, and cutting healing time in half, this surgery has increased in popularity. Surgery increases were 450% between 1998 and 2002, going from 12,775 to 70,256. In 2004 the number of surgeries were estimated to be about 171,200.
Gastric bypass surgery is done laproscopically, in most cases. The physician creates a small pouch at the top of the stomach and adds a bypass around a segment of your small intestines. Your stomach is then stabled across the top, sealing it off from the rest of your stomach. The end result of the recent stomach pouch is about that size of a walnut and can hold about an ounce of food.
This surgery is not for everyone, nor does everyone seeking this drastic surgery qualify. It is only for the extremely obese. There are certain criteria that a person must meet in order to get the gastric bypass surgery done. Some of the criteria for surgery are: 1. You must have a body mass index of 40. 2. You must have a body index of 30 or higher. 3. You must be 90 lbs overweight or more. 4. You have been obese for at least 5 years. 5. You have tried all other methods to lose weight.
There are advantages to having this surgery, the most distinct is losing weight and feeling healthy. Before many have the surgery they are usually plagued with a number of health issues from high blood pressure to diabetes. Many are on several medications to control these illnesses. After surgery many seek a major improvement with their health problems. 80% of patients, within 2-3 months after surgery, will develop normal cholesterol levels and lower blood pressures. 90% of patients, who had type-two diabetes, will obtain excellent results within a few days after surgery. Some patients will even become medication free.
There are health risks as well when having gastric bypass surgery. Lung problems can occur by lack of motion of the chest wall. Deep breathing and lung exercises can prevent this. Another risk would be leakage of bowel connections. This happens when the connection of the bowel to the unusual stomach does not form a complete seal. This can become a serious complication. Everyone takes a risk, but the outcome to be thinner and healthier outweighs the risk for most people.
I was able to interview Jennifer who under went gastric bypass surgery about a year ago and here is what she said:
Dawn: Have you always had weight problems?
Jennifer: I have been overweight since I was 7 years old. Got worse when I hit puberty and kept getting worse!
Dawn: What diets/pills have you tried? Did they ever work?
Jennifer: I was on Weight Watchers when I was in junior high and did ok on that. I also took phen/fen and lost weight with that but then it was pulled because of causing heart problems and I ended up with some problems from taking that. I also would go on Atkin’s Diet and would lose some, but not much.
Dawn: Did you have any medical problems before surgery that were directly related to weight?
Jennifer: Polycystic Ovarian Syndrome, Sleep Apnea, Hypertension, Edema in my feet and ankles, Infertility, Insufficient Aortic Valve, Mitral Valve Prolapse.
Dawn: How did you learn of gastric bypass surgery?
Jennifer: From the news on TV at first, then researched it on the Internet.
Dawn: Did you research the pros and cons of gastric by-pass?
Jennifer: I researched it on the Internet, through other people that had had it…I read a lot of online journals and joined some online support groups, and then did more research through my doctor.
Dawn: What finally lead you to the decision to pick up the surgery done?
Jennifer: It was getting harder and harder to maintain up with 2nd graders and I wasn’t as good of a teacher as I had been…didn’t have enough energy and my feet and ankles would swell everyday. I also want to have a baby and knew that I couldn’t get pregnant at that weight and wouldn’t be able to care for a baby at that weight…no energy.
Dawn: What emotions were you feeling the day of surgery?
Jennifer: I was very scared…it was my first surgery ever…never had a broken bone, stitches, or been in the hospital before, but I was a woman on a mission. When I look support on it, I was given strength by God, that is the only way I can explain it because I don’t view how I went through with it if God wasn’t there making it happen…if that makes sense.
Dawn: After your surgery did you have any complications? How long did it take you to heal?
Jennifer: After my surgery the worst thing that happened was a horrible period that lasted about a week…super painful…worst cramps ever, but since then, my periods have become less painful and a lot lighter and shorter. I haven’t really had any side effects. I can’t take aspirin, steroids, or anti inflammatories anymore so that is hard because I can’t take Advil when I was used to taking a lot of that. Those meds can cause stomach ulcers, which is why post ops can’t grasp those meds. It took about 7 days for my stomach to stop feeling tender. I still have scars where my incisions were, but no pain at all. I have to take vitamin supplements daily to help me with nutrition.
Dawn: What foods can you eat and not eat?
Jennifer: I have a hard time with bread because it is so soft. I also can’t eat a lot of sweets and ice cream makes me sick. Pecan pie on Thanksgiving made me extremely ill. Carbonated drinks make me feel yucky. I can drink sweet tea ok, but usually drink water. I had inconvenience with chicken for a while but now can eat that. I do well with soups, moist meat, fruit, vegetables, crackers, chips, beef, and seafood. I haven’t found anything that I can’t have impartial a small amount of it. I have done really well since the surgery.
Dawn: What was your starting weight before surgery?
Jennifer: 313 lbs
Dawn: How much weight have you lost?
Jennifer: 100 pounds
Dawn: What is your goal weight?
Jennifer: 150-ish
Dawn: Would you recommend this surgery to others?
Jennifer: YES! And I would recommend my doctor…Dr. JK Champion at the Videoscopic Institute of Atlanta. He does surgery at Emory Dunwoody Hospital.
Dawn: If you had to do it again, would you?
Jennifer: In a heartbeat!
If you are thinking of getting gastric bypass surgery, understand the pros and cons of having it done. Research and weigh the risks. Talk to others who have had it done as well as a bariatric surgeon. In the end it’s up to the individual and what is going to make them happy and healthy.
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Filed under Bariatric Surgery by on Feb 8th, 2011.
A large piece of the American population either is overweight, or in some cases, may be obese. There are many ways in which a person can fight obesity, but there are only a few successful treatments that help someone achieve a healthy weight in a relatively short time. These treatments are bariatric surgeries, and they are specific procedures that treat obese individuals. One such procedure is called Gastric Bypass. The goal of this surgery is to form weight loss by limiting the amount of food a person is pleasurable of though-provoking. There are many negative aspects of Gastric Bypass, which include the cost, bad side effects, and postoperative hospitalizations; however, tremendous weight loss, the impact on other diseases, and a higher self-esteem are all positive results that Gastric Bypass can have.
In the Gastric Bypass procedure, a small pouch of the stomach is created by separating it from the rest of the stomach. This is done by using staples. After surgery when the patient eats, the small pouch acts as the patient’s whole stomach (Steinbrook 1075). Since the pouch is microscopic, the amount of food the patient is able to eat is small. The patient will then be eating less food after the surgery which helps to produce weight loss.
One of the downsides to this operation is the cost. Typically, gastric bypass surgeries range from about $20,000 to $50,000, depending on the type of health care company that the patient has (Steinbrook 1075). A major factor that depends on if a health insurance company will conceal the surgery is the patient’s medical condition. If the patient has many other health risks and problems besides obesity, than the patient’s chance of getting approved for the operation is low. Frequently, obese patients do have more than one type of health scrape, so this limits the accessibility of gastric bypass to certain patients.
Another downside to this operation is linked to the experience of the surgeon. Within the past decade, Gastric Bypass procedures have seen an annual increase from 16,000 to more than 100,000 performed in the United States (Steinbrook 1075). Certainly, the risks and complications that occur after the surgery are associated with the experience of the surgeon performing it. If the doctor has performed many Gastric Bypass surgeries, then the risk of problems during or after the surgery is performed is low. However, the opposite is true; if the surgeon is quite new to the operation and has done very little training in performing the surgery, then the risks increase (Steinbrook 1076).
One negative aspect that follows the surgery is the restrictive diet. For twenty-four hours immediately following the operation, Louis Martin reports, a meal plan aloof of “a clear liquid diet not to exceed 60mL per hour” is imposed. If that is successful, the person can then move to a diet that is detached restrictive and involves sugarless, high protein, pureed food and drinks. Because this diet is so restrictive, the intake of vitamin and protein tablets is required. Complications can occur if the patient fails to continue to take the vitamins for various reasons, thus leading to nutritional deficiencies (Martin 265). Complications can also occur if the patient fails to adhere to the diet altogether.
Other risks that one has following the operation are gastrointestinal leaks and internal hemorrhaging. Gastrointestinal leaks are contents and liquids that escape from the puny pouch. According to Benjamin Schneider et al, this usually occurs along the stomach line where the staples have been placed (248). The leaks may occur because of staple failure, and also from the lack of experience that the surgeon may have. Following the surgeon’s performance of the first hundred gastric bypass surgeries, the risk of gastrointestinal leaks is reduced by about 1.6% (250). Also, as mentioned before, internal hemorrhaging can also occur. In fact, much of the mortality rate involving the gastric bypass map can be linked to either internal hemorrhaging or leaks from the staple line (247).
Post-operative hospitalizations are also approved in patients undergoing gastric bypass surgery. In their explore of patients, Zingmond, McGory, and Ko report that “20.2% were readmitted in the year after RYGB [Gastric Bypass],18.4% in the second year after RYGB, and 14.9% in the thirdyear after RYGB” (1918). Readmittance to the hospitals can, and probably does occur following that three year period. Most of the occurrences happen because of surgical complications like infections or gastrointestinal leaks (1918). However, the chances of hospitalizations following the surgery decrease with each passing year.
Another common side effect of gastric bypass surgery is a sickness called the dumping syndrome. The dumping syndrome is essentially a severe case of influenza, and is caused by the patient’s intake of sugar. The syndrome is often associated with profuse sweating, nausea, tremors, diarrhea, and a high fever. This negative side effect, however, can possibly be viewed as a positive one, because it reinforces the sugarless diet that the patient is supposed to adhere to (Martin 264).
Just as there are many negative outcomes of gastric bypass surgery, it is also important to focus on the positive outcomes of this surgery. An overall significant lifestyle change for the better and an improvement of the patient’s health is possible for those who undergo this operation. In Flancobaum and Choban’s research, the patients that they studied reported that the amount of their physical activity increased after the surgery. Other conditions, such as diabetes, hypertension, and sleep apnea improved remarkably in these patients (229).
Weight loss, the main goal of the surgery, is a tremendous outcome for those people that follow the doctor’s orders. Martin says that during the first month following the gastric bypass surgery, the loss of five to fifteen percent of the total body weight can be expected (164). Additionally, Schneider et al reports that in their case studies of patients in the twelve months following gastric bypass, excess weight loss of sixty-eight percent occurred (251). The amount of weight and fat loss that follows the surgery is a fantastic result for those patients. In fact, over eighty percent of the cases that adhere to the restrictions, diet, and orders from the doctor are successful (Martin 352).
There are also several diseases that will be improved, or be cured, as a result of the surgery. They include type two diabetes, coronary artery disease, and gout. Type two diabetes is mainly caused by obesity; therefore, the surgery will more than likely reverse the disease. In fact, the findings of Schneider et al confirm this: type two diabetes in obese patients is completely reversed in eighty-two to ninety-eight percent of the cases studied (253). Because insulin levels fall rapidly after the surgery, and in most cases, stay at a normal level, patients are not required to have insulin injections (Martin 354). Coronary artery disease and gout also improve following the surgery. In his book Obesity Surgery, Louis Martin tells us that the American College of Cardiology’s findings are that significant weight loss reduces the risk of coronary artery disease (356). Therefore, the weight loss produced through gastric bypass will prevent those people from being at risk for this disease. The other infection, gout, involves the over-production of uric acid levels and is worsened by obesity in patients. Weight loss can control the amount of the effects that gout has, making the surgery a positive outcome for this disease also (356).
Another important effect that gastric bypass surgery has on patients is the execute on their self-esteem. Frequently, obese people are looked down upon and sometimes seen as inferior or incapable of being successful. This usually leads to low self-esteem, feelings of worthlessness, and sometimes severe depression as well. After the surgery and weight loss has been induced, “depression caused by obesity is cured by weight loss” (Martin 359). The patient should no longer have any reason to feel shame because he or she is obese. Indeed, if he or she loses body fat then that should give him or her more reason to feel proud and be confident.
Both the negative effects and the definite effects of gastric bypass surgery have been indicated. Clearly there is a substantial amount of evidence for both sides. The cost of the surgery, restrictive diet following it, and all of the complications that can come from the surgery certainly can discourage a person from pursuing this type of treatment. However, after reviewing the many positive side effects that can result from gastric bypass surgery, it is clear that pursuing the surgery would be not only beneficial but also vital to one’s well being. One has to consider the following: What are the possible positive outcomes for me in this type of operation, and are the certain results worth having the negative side effects?
Works Cited
Flancobaum, Louis, and Choban, Patricia. “Surgical Implications of Obesity.” Annual Review of Medicine. 1998: 215 Academic Search Premier. EBSCO. Paul Laurence Dunbar Lib., Wright State U. 22 January 2006. (http://epnet.com/).
Martin, Louis F. Obesity Surgery. New York: McGraw-Hill: Medical Publishing Division, 2004.
Schneider, Benjamin, et al. “Laparoscopic Gastric Bypass Surgery: Outcomes.” Journal Of Laparoendoscopic and Advanced Surgical Techniques. Aug 2003: 247-255. Academic Search Premier. EBSCO. Paul Laurence Dunbar Lib., Wright State U. 22 January 2006. (http://epnet.com/).
Solomon, Caren, and Dluhy, Robert. “Bariatric Surgery- Quick Fix or Long Term Solution.” The New England Journal of Medicine. 23 December 2004. Academic Search Premier. EBSCO. Paul Laurence Dunbar Lib., Wright Site U. 22 January 2006. (http://epnet.com/).
Steinbrook, Robert. “Surgery for Severe Obesity.” New England Journal of Medicine. 11 March 2004: 1075-1079. Academic Search Premier. EBSCO. Paul Laurence Dunbar Lib., Wright State U. 22 January 2006. (http://epnet.com/).
Zingmond, David, Marcia McGory, and Clifford Ko. “Hospitalization Before and After Gastric Bypass Surgery.” The Journal of the American Medical Association. 19 Oct 2005. Academic Search Premier. EBSCO. Paul Laurence Dunbar Lib., Wright Space U. 19 January 2006. (http://epnet.com/).
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Filed under Bariatric Surgery by on Jan 23rd, 2011.
Roux-en-Y (often abbreviated as RNY) is generally considered the “gold standard” for weight loss surgery and has been performed in various forms for over 40 years. The surgery process usually begins 2 weeks before your surgery date with a prescribed liquid diet. These 2 weeks leading up to your surgery date will be both mentally and physically challenging. The week after your surgery will be challenging simply because you’re healing from major surgery and the 2nd week after surgery is challenging because you’re learning a new way of eating which can be very difficult.
I’ll go into more detail about each of these 3 stages based on my own experience during the first month of my gastric bypass life. I had laparoscopic Roux-en-Y gastric bypass surgery on November 13, 2007 and in the first month (2 weeks pre-op plus 2 weeks post-op) I lost 27 pounds.
TWO WEEKS PRE-OP - Most surgeons now require patients to follow a strict 2 week liquid diet before gastric bypass surgery. Not all bariatric programs have this requirement, but more and more surgeons are adding this requirement. Many ask why such a strict diet. The reasons are twofold. First this strict diet will help the patient lose weight before surgery. Any weight you can lose before surgery will make you that much healthier and allow for a safer surgery. Secondly a liquid diet will shrink your liver. Your liver is located right in front of your stomach and in morbidly obese patients it is often enlarged due to overeating of complex carbohydrates. By losing weight and restricting food intake to a basic liquid protein diet, the liver will shrink and be less cumbersome for the surgeon. This will help to reduce the risk of complications or a “nicked liver” during the surgery. During the 2 weeks before my surgery, I lost 15 pounds.
Although I haven’t read this next reason in any medical research, my own experience proves it to be upright. This strict liquid diet is to launch to train our brain to eat in a different way. I was limited to 3 small protein shakes, 1 cup of broth/soup and 1 fiber drink per day with the addition of 64 ounces of water. The first three days were brutal and I had more cravings for food than I ever opinion possible. I believe I was dealing with sugar and carb withdrawals. The fourth day seemed to begin the easier phase of the diet, after my body became accustomed to the fact that I could survive on so few calories while still getting the nutrients I needed. Even though the food cravings were still there, I was able to deal with them mentally and emotionally during those first 2 weeks. Because I was able to face the craving demons before surgery, I believe it has made my post-op eating easier to adjust to.
THE WEEK OF SURGERY – For most Roux-en-Y gastric bypass patients the hospital discontinue is 2 to 4 days. People who have their surgery laprascopically they can expect 2 to 3 days. People who have an originate incision may be in the hospital an extra day. While in the hospital your surgeon will have you taking damage medication to minimize any discomfort you may feel. If the pain medication you are given is not working properly or is making you nauseous, be sure to let your doctor know so they can make an adjustment. This happened to me while I was in the hospital. I was given a morphine pump to control my injure, however, the morphine made me sick to my stomach. So my pain medication was quickly changed to Nortab and I was given anti-nausea medicine to decide my stomach.
The first day – the day of your surgery – you will likely not be able to drink anything including ice chips. This will allow time for your new stomach/pouch to heal. The following morning you will be taken for your “swallow test” to check to see if there are any leaks in your newly formed digestive system. This involves swallowing some barium and having x-rays taken of your abdomen. The hardest part of this test was standing fair and peaceful for the 5 or 10 minutes the test takes. Once you pass this test you’ll be given water or Crystal Light to sip. Usually it is served in a 1 ounce medicine cup and you’ll need to sip that water for 15 minutes, then refill the cup and start over. This will help to boom you to take very tiny sips of liquid and take your time drinking. Later that day you may graduate to a larger variety of liquids like gelatin, broth, hot tea or protein shakes. You’ll remain on a liquid diet while in the hospital.
Once you get home from the hospital you will probably remain on a liquid diet for the remainder of the first week. Some programs require patients to remain on a clear liquid diet for the first week of gastric bypass surgery. Some programs allow patients to include “tubby liquids” such as yogurt, cream soups and cottage cheese. When I came home from the hospital I was on full liquids and was required to drink 3 protein shakes per day. I was also required to take in 64 ounces of water each day. Even though it is expected that in the first week or two it will be nearly impossible to meet the water and protein goals – you are expected to try your best during this time. You’ll be eating about 1 to 2 ounces of food (full liquids) at one setting during this early stage.
TWO WEEKS POST-OP - I was amazed at how well I felt after just the first week of recovery. I was able to net around just fine and was healing expeditiously. But the eating share of the recovery process was still a challenge. Depending on your surgeon’s requirements and nutritionist guidelines, you may continue to be eating full liquids one week after your gastric bypass surgery. Some patient progress to soft foods at this point. No matter what your guidelines are, be distinct to follow what your doctor mandates. They have developed your nutritional program based on years of experience and helping hundreds or thousands of other post-op patients. By now you’ll be eating about 1 to 3 ounces of food (full liquids) at one setting.
I was on full liquids this second week after surgery until I had my follow-up appointment with my surgeon. Because of scheduling conflicts, my normal 2-week follow up appointment ended up happening just 8 days after my surgery (which also happened to be the day before Thanksgiving). At this appointment I was told to inaugurate the next phase of my eating plan which included soft foods such as egg salad, pate`, hummus, peanut butter, refried beans and soft or melted cheese. I was also allowed to add up to 1 tablespoon of a “side item” which included either vegetables or a grain (from a very limited list that was basically crackers). This allowed me a little bit more of a variety of choices at Thanksgiving.
The biggest challenge during these first couple weeks after surgery is the struggle to adapt to your new way of eating and figuring out a schedule for meals, snacks, protein shakes and water intake. Not to mention trying to figure out when to occupy your medications, vitamins and supplements in between all the meals and water. Instead of being obsessed with food, I quickly became obsessed with watching the clock and trying to stay on schedule with my eating. Because at this early stage we don’t have true hunger pangs, you need to rely on the clock to ensure you’re eating enough to withhold your body nourished.
Other people who have gone through this journey before me keep saying that the first month is the hardest fraction of the whole RNY gastric bypass surgery process. Once you pass the 6 week price, things get easier and the variety of food you’re allowed is worthy greater. So hold on during these first weeks and know it’s going to glean better soon.
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Filed under Bariatric Surgery by on Nov 29th, 2010.