Here’s the route I’ll be taking from California to Norway, where I’ll be learning about salmon fishing. I’m excited to learn about the ocean fishing practices  there, and also to hear my Norwegian last name pronounced by native speakers! Looking forward to fun and educational experience.

 

View Cheryl’s Route To Norway in a larger map

First the good news if you’re a candidate for weight-loss surgery: By having such a procedure, your odds of living longer than someone who doesn’t might be greatly increased.

A recent study released by researchers in Milan, Italy, found that patients with obesity who underwent some form of bariatric procedure reduced their odds of dying by almost half compared to their counterparts who did not have the surgery.

Researchers analyzed data from eight clinical trials involving more than 44,000 obese men and women. About 14,000 of the subjects actually had some form of bariatric surgery — either gastric bypass or stomach banding — and the rest served as control subjects for comparison. The trials included an average of 7.5 years of follow-up.

Of the roughly 3,300 deaths among all participants, 2.8 percent had had a bariatric procedure; 9.7 percent did not have surgery. Thus, patients who underwent bariatric surgery had 45 percent lower odds of dying. The team found a similar benefit when it looked specifically at heart-related deaths. Overall, death rates were comparable for the approximately 10,000 banding and 4,000 gastric bypass surgeries, although the protective effects on heart-related deaths differed: Compared to no surgery, banding provided 29 percent lower odds of heart-related death vs. a 52 percent risk reduction with bypass.

The risks

The message here is not that surgery is the only solution to obesity — which we know leads to all kinds of health problems and many preventable deaths. As is proven every season by the contestants on The Biggest Loser, invasive, risky and expensive surgery isn’t the only way to shed large amounts of fat. But for people with severe obesity who are unable to manage their diet and exercise, it is an option — one to be carefully considered with the help of a trusted doctor.

Bariatric surgery isn’t cheap — this procedure will set you back between $14,000 and $26,000. But that’s not the only cost: The potential for complications leading to severe health problems and even death can’t be overlooked. These risks include staple/suture ruptures resulting in stomach acid leaks into the body, as well as infections, hemorrhages, ulcers, bowel issues and nutritional deficiencies. The numbers are tough to pin down, but estimates for overall complication rates vary from seven percent to as much as 20 percent; mortality rate estimates range from less than one percent to as much as two percent, depending on the study. Again, not a procedure to be taken lightly!

Another important thing to consider is that many people actually have some type of bariatric surgery only to gain the weight back again later. That’s right — this surgery is not a fail-safe weight-loss solution. Some of the contestants on The Biggest Loser can attest to this fact. Recently I had a chance to sit down with Jessica Delfs, one of the BL10 contestants who had weight loss surgery prior to appearing on the show. (You can read our Q+A on the subject here.)

They don’t operate on your brain.

“The surgery, no matter how involved, is just a tool and doesn’t change your brain and/or relationship with food. That has to change for long-term success,” says Margaret Furtado, a clinical dietitian specialist at Johns Hopkins Bayview Medical Center who specializes in bariatric surgery. “There are certainly ways to sabotage the band, as well as gastric bypass, and, as I say every day to my patients both pre- and post-operative bariatric surgery, ‘They don’t operate on your brain!’”

The band actually has a high failure rate: Her statistics show that 50 percent of people who have adjustable gastric banding surgery fail to lose 30 percent of their excess weight. (30-50 percent is considered successful.) Gastric bypass statistics reveal that the average result is 60-70 percent of excess body weight loss and some weight regain — 5 to 10 percent is normal. The newer bariatric procedure, sleeve gastrectomy (aka “the sleeve”), is now gaining popularity, and excess weight loss is about 40 to 60 percent given five-year data in the U.S.

“In my 10 years or so working with gastric banding at Tufts, Mass General and now Hopkins, I have seen only a handful of patients lose all of their excess body weight,” says Furtado. “In my experience, corroborated by statistics and conference talks, people who are ‘volume eaters’ versus ‘grazers’ tend to do better with the band as a tool. It’s like a funnel, so snacks, liquid calories, etc. go right down without problems. The more fills/adjustments clients have, the more they can’t tolerate meat, chicken and vegetables, and so a too-tight band can cause people to eat only junk foods and/or liquid calories, unfortunately.”

Research reveals that a purely restrictive bariatric procedure, like gastric banding, doesn’t change genetic or physiological barriers keeping you to a certain weight range. What’s more, the brain “fights” the weight loss for up to one full year after weight loss from dieting or even the band, so regular physical activity and a healthy diet with protein at every meal are vital to help long-term success.

Bariatric surgery procedures like gastric bypass and the newer gastric sleeve are considered “metabolic” surgeries in that they help increase metabolism for about six months or so after surgery, and help send a message to the brain to go to a lower physiological set point or lower weight thermostat. However, it’s imperative that healthy eating, including protein at least three times a day, and regular exercise be a part of the prescription to help these tools work best. Adequate sleep and stress management are also key to long-term weight loss success.

It is of the utmost importance that people change their relationship with food and exercise to keep the weight off after weight-loss surgery of any kind.

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The opinions expressed in this article are in no way intended as a substitute for medical advice. Consult your doctor when considering this or any other medical procedure.

Jessica Delfs, one of the contestants on the tenth season of The Biggest Loser had weight loss surgery prior to appearing on the show. The surgery did not fix her fundamental problems, however, and that is why she chose to become a contestant on the show. Cheryl sat down with her recently to discuss her experience with the surgery.

Cheryl Forberg, RD: Why do you think your band/bypass failed?

Jessica Delfs: I don’t think my band was a complete failure. I had lost 100 pounds before the show and hadn’t gained any of it back; I was just stuck with 100 more pounds to lose and everything I was doing before wasn’t working anymore. I had plateaued at 285 pounds. I believe the lap band “tool” could only do so much before I needed to deal with the mental and emotional reasons I had gotten that big (which I hadn’t confronted before the show).

CF: Did your relationship with food change?

JD: During the show it became fuel and nothing else. I didn’t really look forward to eating because it wasn’t “fun,” it was just something I needed to do to be able to work out at my highest intensity but still keep my calories and sodium low. When I got back and was surrounded by “enjoyable” foods again, it was hard. I didn’t have the option of indulging while I was on the ranch, and I struggled with keeping the mindset of “fuel only” when I got home. But once I saw the effect that indulging (even in moderation) had on my weight loss, I went back to what I knew worked — the BL plan — eating clean, whole foods low in calories and sodium, and things went right back to normal. I can’t use food as something I look forward to “indulging” in, but rather something that prepares me for the next workout or activity.

CF: What did you learn from your failed weight loss surgery?

JD: When my weight plateaued for three years after my surgery I learned that there were reasons I had become that big. It wasn’t merely because I ate too much. There were emotional things I had never dealt with, and even with the surgery my body wasn’t going to let go of the other 100 lbs until I was honest with myself how I got there. Once I started talking about my emotions and things that had happened in my past that pushed me to use food for comfort, I started to see the weight fall off, and now it’s not about what foods got me that way, but what are the things and emotions that trigger me to want to eat that way? Loneliness, boredom, stress, anxiety? All things I used food for, and now it’s about finding healthy alternatives in those situations. Journaling, exercising, talk to friends, etc. My surgery wasn’t a complete failure, but it wasn’t the golden ticket people look at it as. There’s a lot of mental and emotional work that you still need to do to complete the process or maintain the end result.

Don’t miss our next Twitter chat, Tuesday, March 20 at 3 p.m. EST/ 12 p.m. PST — all about eggs. The Meal Makeover Moms, Janice Bissex, RD and Liz Weiss, RD, will be joining us for an egg-spiring discussion including the health benefits of eggs. We’ll also be sharing cooking tricks, tips and recipes, and giving you the secret to the perfect hardboiled egg — just in time for Easter (though eggs, of course, are delicious any time).

Come with your questions about boiling, poaching, scrambling, baking or otherwise preparing egg-citing meals (OK, we’ll stop now). Feel free to leave any questions or comments you may have in the comment section here.

Please the hashtag #eatwell during the chat so we are sure to see your question or comment.

#eatwell Twitter Chat with @cherylforbergrd
Hosted by Cheryl Forberg, RD and Meal Makeover Moms
Time: 12 pm PST/3 pm EST
Date: Tuesday March 20

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Follow @MealMakeovrMoms

Follow @janicebissex

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Cheryl recently spoke with Toby Amidor of The Food Network’s Healthy Eats blog about being both a chef and nutritionist and her seven years working with the contestants on NBC’s The Biggest Loser.

Toby brought up the subject of maintenance:

Q: The contestants on the show have a lot of help from a registered dietitian and trainers, what tools are they provided with so they can continue to get healthy or maintain once they leave the show?

The trainers certainly teach them a variety of different cardio and strength training options. It’s important to find an exercise you really love or you’re not going to stick with it. The gym at the Ranch has state-of-the-art equipment and the trainers are always teaching new things in and out of the gym to keep everyone interested, engaged and ideally increasing their muscle mass while shedding pounds.

I introduced them to a new way of shopping, cooking and eating. I also taught them how to weigh, measure and journal their food intake while at the Ranch. One of the many things you didn’t see was that I reviewed every contestant’s food journal every single day which was an incredible teaching tool for learning about portion sizes, meal timing and accountability. I still get calls from contestants I haven’t seen in years. They tell me when the pounds start to come back the first thing they do is pull out their food journals again.

And later on in the interview Cheryl revealed that she is working with a number of former Biggest Loser Contestants who have done just that.

Though I still want to share my weight loss expertise with a large audience, I’d also like to focus more on that slippery slope we call maintenance and show people that eating well and staying there are not mutually exclusive.

I’m currently coaching a group of former Biggest Loser cast members about maintenance weight — how to get and stay there.

As Cheryl has explained in the past, we — almost all of us — tend to to eat more than we think we do, and food journaling can play a big part in getting back on track (as can the help and assistance of a nutrition professional).

In this video, made backstage during preparations for The Biggest Loser Season 5, Cheryl talks more about the importance of food journaling.

Join us on Thursday, February, 9 at 3 p.m. EST/ 12 p.m. PST for a chat on Twitter. This month we’ll be chatting with chef and author Suvir Saran. In his most recent cookbook Masala Farm, Suvir shares seasonal recipes inspired by his organic farm in upstate New York and calling on his years as an accomplished chef working with Indian flavors. Suvir and Cheryl will be talking about international flavors, with each of them offering their own takes on how you can spice up your meals.

Suvir and Cheryl will be ready to answer any questions you may have about their recipes, cooking with different spices, and eating well. Feel free to leave any questions or comments you may have in the comment section here.

Follow @suvirsaran

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#eatwell Twitter Chat
Hosted by Cheryl Forberg, RD (@cherylforbergrd) and Suvir Saran(@suvirsaran).
Thursday, February, 9 at 3 p.m. EST/ 12 p.m. PST
Use the hashtag #eatwell on your questions and comments

Tweet #eatwell

Diet co-authored by Cheryl Forberg, RD ranked No. 2 for weight loss, and No.1 for diabetics

U.S. News and World Report ranked The Biggest Loser Diet among the top diets for weight loss on its annual list of The Best Diets. The Biggest Loser Diet ranked No. 2 among all tested diets for weight loss, and was named the No. 1 diet for fighting and managing diabetes by the prestigious magazine.

Cheryl Forberg — a Registered Dietitian, James Beard award-winning chef, New York Times best-selling author, and Nutritionist for The Biggest Loser for 12 seasons, co-authored the diet and since the show’s debut in 2004 to season 12 2011, she individually counseled each of The Biggest Loser’s 250 contestants on how to transform their eating and cooking habits — consequently helping to change their lives.

Forberg has long touted The Biggest Loser Diet’s benefits to diabetics. In fact, one-in-four contestants have diabetes when they report The Ranch: But they all leave without it.

 
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If you are interested in contacting Cheryl about speaking or endorsement opportunities or are a member of the media interested in Flavor First, please contact us at Media@FlavorFirst.com.

Cheryl is also available for private consultation.

Do you want to keep your New Year’s resolutions beyond January? Of course you do, and we want to help you do it!

Join us on Wednesday, January, 18 at 4 p.m. EST/ 1 p.m. PST for a chat on Twitter all about what you can do to stick to your New Year’s resolutions, and have a fitter, healthier and happier 2012. My fellow nutritionist Greg Hottinger, MPH, RD and exercise physiologist Michael Scholtz, MA, co-authors of the new book Coach Yourself Thin, will be joining me to answer all of your questions and provide guidance and expert advice.

During the chat you will also have a chance to win a copy of “Coach Yourself Thin” and an opportunity to get free access to Greg and Michael’s next “Coach Yourself Thin” Webinar.

Follow @novowellness

Follow @cherylforbergrd

#eatwell Twitter Chat
Hosted by Cheryl Forberg, RD (@cherylforbergrd) and Greg Hottinger, MPH, RD and exercise physiologist Michael Scholtz, MA (@novowellness)
Wednesday, January, 18 at 4 p.m. EST/ 1 p.m. PST – 5 p.m. EST/ 2 p.m. PST
Use the hashtag #eatwell on your questions and comments

Tweet #eatwell

We all know by now that drinking and dieting don’t mix too well, but during the holiday season for many of us a few cocktails with friends here and there are inevitable. At one such gathering, where a friend served his delicious homemade egg nog, I stopped to think about what was in the drink I was enjoying. Now, nobody labors under the misconception that egg nog is good for them, but I wondered exactly how many calories were in our glasses.

He shared the recipe and I took it home for some statistical analysis. Made with whole cream, eggs, sugar (many store bought brands are loaded with corn syrup and may be even higher in calories), and rum and brandy the drink weighed in at a whopping 400 calories per 8 ounce glass.

That’s, of course, not anything someone who’s on a calorie budget to lose weight would want to drink, but it’s important for all of us to stop and think about what we’re putting in our bodies and how it might fit into (or not fit into) our diets.

For instance: Each New Year’s toast has 150 calories per 6 ounce flute of bubbly. 

Alcohol is already high in calories: a single ounce of gin,rum, vodka, whisky or tequila has between 50 and 90 calories, while liqueurs (such as Cointreau or Kahlua) may have more than 180 calories an ounce (and the average cocktail contains two ounces of alcohol).

Add in sugary soft drinks and other mixers and the calories start to pile up quickly.

When we are drinking egg nog or hot buttered rum at a party, we’re likely not kidding ourselves that it’s low in calories. But there are even times when we might think we’ve chosen the lighter option when we’re really imbibing a calorie bomb.

Case in point: Did you know that tonic water contains a ton of sugar? In fact, 8 ounces of tonic water has 94 calories and 22 grams of sugar (the equivalent of two heaping tablespoons of sugar).  This can easily double the amount of calories in your cocktail. So, next time you think you’ll have a “light” G & T, you might want to swap the tonic out for soda water (which has zero calories and no sugar) and a twist of lemon.

My friends, fellow nutritionist Greg Hottinger, MPH, RD and exercise physiologist Michael Scholtz, MA, co-authored the new book Coach Yourself Thin, all about what you can do to overcome the things stopping you from reaching your weightloss goals.

On Tuesday, December 20, the day the book hits stores (pre-order here), Greg and Michael will be offering two free live 60-minute webinars all about how you can coach yourself thin. In addition, Greg and Michael are giving away five copies of the book (at random) to my fans and followers who sign up to participate in the discussion. So, what are you waiting for? Sign up for one of the webinars below!

Tuesday, December 20th, 1pm-2pm EST – Register!

Tuesday, December 20th, 8pm-9pm EST – Register!