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the-brutal-reality-of-life-at-600-pounds

The Brutal Reality of Life At 600+ Pounds

we're going to react to another episode of 600 lb life again not a fan of the title but then the day I think even with episodes like this there are good takeaways that we can all learn [Music] from just watching her wake up in the morning you could tell she's having a difficult time with mobility and part of when we talk about helping patients lose weight is thinking about their quality of life so yes we want to decrease risks of cardiovascular disease development of metabolic disorders like diabetes but we also want to make them comfortable we want to make them be able to enjoy their day-to-day lives and as they get older we want to make sure that they're able to keep their independence when I wake up in the morning I start hurting cuz the pain is intense remember it's exponential the amount of weight you're carrying in your abdomen is going to be exponentially higher on your hips on your knees on your ankles the number one thing proven to help reduce osteoarthritic pain and other symptoms related to it is weight loss it hurts and it's hard to reach around my body it is hard but is very important because when you have excess uh adapost tissue skin tissue uh that's a place where bacteria can live fungi can live and therefore you can actually develop skin conditions that are not only dangerous but also very uncomfortable and painful once I get out the shower my daughter comes in and she'll clean out the back of my legs because my arms are too short to reach mom she tries to do everything she tries not to be lazy she tries to do a lot but she can't it's important to not just clean the area but also dry the area thoroughly because a moist environment again Harbors bacteria and fungi size was something that was seen as you know kind of a a Birthright in our family we love to eat there was like kind of a running joke that if you were big you were well culturally eating is so important to people that discussing one's diet needs to be done in a very thoughtful and careful way you never know what food means to somebody what their daily meals with their family means to somebody I've seen this happen in my clinic with those who are from the Latin American community and how important it is for them to have regular meals with their family that consist of rice tortilla some of these Foods when eating in excess can actually be harmful for the patient especially when they have metabolic conditions like diabetes I was gaining weight from a young age and by the time I was in Middle School I was already 250 lbs then I started having seizures every time I had a seizure it was while I was watching TV or a movie I wonder if that has something to do with an epilepsy condition that is triggered by FL flashing lights or perhaps sleep deprivation in fact when we have children that have had a seizure they come into our Inpatient service in the hospital where we actually put an EG cap on where we monitor their brain waves and we try to induce the seizure either through sleep deprivation flashing lights and when we do that we are able to have the seizure occur in a safe controlled medical setting but then we're able to see what parts of the brain is coming from and we could actually then medicate the individual get them in a place where they're seizure free and hopefully um are going to be safe to go back home at 28 there was a situation that occurred that I needed to take custody of three of my cousin's kids oh wow that's awesome that she did that for her family I didn't want to give up on having children of my own so I dated and got pregnant with my two youngest children I was too big to weigh on the the office scale so I had to go to the freight scale at that time I was about 480 and I spend all my time focused on taking care of everybody else instead of myself and I know some people say why were they even weighing her that doesn't seem like it was sensitive it's actually really important during pregnancy to monitor one's weight to make sure that there's no fluid accumulation that the baby is impacting the body in a certain way those who carry excess body weight to this degree not only have trouble with scales they have trouble in our offices with stools they have trouble fitting in MRI and cat scan machines so it's not an easy Life by any means my weight limits me so much so I want to lose the weight but when the Cravings come all I want to do is eat I'm sure this was filmed before the introduction of the glp1 medications like OIC and wovi the reason why those medications have become so successful is because they work metabolically to some degree but the biggest benefit that they give people is that it reduces Cravings it slows gastric emptying so it slows the process of the food through the digestive system making an individual feel full therefore experiencing less Cravings being a teacher requires being on your feet all day but when I get to work I can't even make it in the building into my classroom without stoy so I kind of map my route to where I know there are chairs that I can sit in yeah the fact that she's getting that shorter breath is concerning from a cardiovascular standpoint like is her heart being able to keep up with amount of body weight she has right now for her own safety you want to make sure that she's capable of walking around without posing a risk to her heart by the time I get to my room I'm so physically wiped out and I'm starving but I'm constantly around food and if I run out it's usually around lunchtime I do look at the food in front of me and say I don't need it but it's good so I just want to keep eating you know people talk about food addiction whether it's real or not if you're in a situation where you need food to this degree where you're overeating you hate that you want the food you know that your body doesn't need the food it's presenting other health hazards to your life whether or not a medical textbook says it's an addiction in layman's terms at least it feels like an addiction cythia is over 600 lb and it's quite remarkable that you can take care of five children at that weight it just shows how motivated she is to take care of those children cuzz it's difficult on her breathing it's difficult on her heart on her joints and yet she's still showing up day in and day out you're a mom and you have responsibility to your kids so from this point on we are going to make changes in your eating habit this is a very old school way of doctoring where you tell a patient that you have children you need to do better for them and you try and lecture a patient but in most instances the way that you get a patient to where they want to be is by asking them the question and getting them to a place where they say I need to do this for my kids just the fact that they vocalized it rather than you did will already go further in their success rate you know how the homework goes you need to stick with the low carb diet and eat only three time a day and no sing this will be a 1,00 calorie a day diet I don't know how they expect her to go from eating what she's eating to a 1,200 calorie diet three times a day I just feel like you're setting up a person for fair failure on that she's going to have massive Cravings especially with the difficulties of her job it's going to make her sad it's going to make her uncomfortable what is your ability to do exercise and walk and you want her to exercise and walk with 1,00 calories I mean it's just completely unreasonable I really don't do a lot of walking how much you can walk before you feel tired and give up maybe like from here to your waiting room she should really be working with a nutritionist to figure out what she's already consuming and make changes from there as opposed to getting a cookie cut or 12200 calorie recommendation and telling her to exercise when she's never exercised before it's just going to be a major shock to the system I think even the most well-intentioned patient is going to struggle with that if we stick with this diet you should be able to lose 30 lb in one month and if you can make these changes weight loss surgery it could be an option for you down the road okay I get why they're trying to get her to lose 5% of her body fat to make sure that once the surgery is complete that there will be a level of success but doing it in the way that he prescribed it it just doesn't seem like you're setting up someone for success and also he didn't tell her what to eat didn't give any recommendations as far as macronutrients look I get you don't want to confuse and overload a patient but like encourage protein intake those foods that she's eating are Ultra processed and that they're going to make her not feel full they're going to make her want to overeat but if you just make recommendations about the types of foods to consume that's going to make it easier for her to stick to some sort of plan Yukaya has been offering to take walks with me and help me stay on track yeah social workouts go a long way in helping people stay consistent when you have uh another person that goes to the gym with you or goes with you to do some sort of physical activity the odds are that one of you wants to skip and then the other one encourages the other one to go so you're kind of doubling your chances of getting a workout in you're making good progress and I think you got to be good candidate for weight loss surgery okay but you still have a BMI close to 100 so I'm going to send you to the hospital so we can run some test on you make sure you are safe for anesthesia if all those tests are good I'll approve you for surgery I hate that he says it as if like he needs to approve we'll send you for to the hospital for some special tests to make sure it's safe for you to go for the surgery not for me to decide if youd save you're not deciding the tests are deciding whether or not it's safe for the patient it's in their best interest it's not you gatekeeping it the surgery will help to prevent her from turning to food but if she doesn't deal with some of her deeper issues is only a matter of time before she turns back to it I wonder uh what the rates of bariatric surgery are going to be now that we have these glp1 medications with a newer generation of gp1 medications coming out soon it's been a week since my surgery I was discharged yesterday and I'm recovering in the hotel right now I've lost all cravings for food how's your mindset now I mean you got the surgery finally I think my feelings are numb because I've been through so much yeah at that point it's hard to know long-term prognosis so it's hard to know what it'll be like two weeks from then today is your 10day after surgery huh yep all right how's everything coming along great how is your pain and discomfort don't have any wow look at that change in just a few days you have lost 100 lb so far that's exting any different I do but I'm arranging for you to start seeing a therapist in Oklahoma City I like that because I wanted to start discussing some things with them so you can be successful in the long term usually we do that before the surgery as well I wonder if this is just [Music] outdated wow that's a huge weight loss this has been a hard couple of months so I'm trying to keep my mind off of food as much as possible I've been going out to exercise and stay motivated see that's the tricky thing about overeating and overc consumption of food when someone's like hey quit cigarettes or quit alcohol cuz they're bad for you a person can say okay I'm never going to touch that again but food you have to consume no matter what but overc consumption can become a problem it's like imagine how difficult it is if everyone that had an alcohol addiction instead of trying to get them to quit completely we had to get them to to a place where they would only have a few drinks see how complicated that would be I've decided to stop trying to live up to everyone's expectations of me including Dr Nails I appreciate all the help he's given me but I've decided if he's pushing me for therapy I don't need to see him right now I'm working as hard as I can and I thought the surgery will fix everything but it didn't when it comes to surgeries they rarely heal everything they can get you a jump start especially when it comes to bariatric surgery it's still going to take a lot of work even with glp1 medications if you want to get in good shape you still have to exercise you still have to watch what you're eating change the amount of protein you're consuming otherwise you'd lose muscle as much as you are fat so it's not an easy Road just because there is something to help you one of the most important things you can do to keep a healthy metabolism is get good sleep here are my sleep tips here click here check that out and as always stay happy and healthy

Dr.

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