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	<title>Comments on: Your comments and questions are welcome.</title>
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	<link>http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/</link>
	<description>A forum to discuss the documentary film, "My Big Fat Diet" , and the science of low carbohydrate diets.</description>
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		<title>By: Ardyth</title>
		<link>http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/comment-page-4/#comment-644</link>
		<dc:creator>Ardyth</dc:creator>
		<pubDate>Tue, 11 Jan 2011 18:34:01 +0000</pubDate>
		<guid isPermaLink="false">http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/#comment-644</guid>
		<description>Hello Jay:  Yes, diet time again.  I would appreciate your comments on 
a couple of low carb diets.  Last year my husband and I did the cleanse 
on the Hormone Diet.  A friend going through menopause, recommended
it and we found it surprisingly easy to implement.  We dropped our caffeine 
consumption, replaced white flour and sugar from our very busy kitchen, 
and eliminated alcohol, which crept back in with a vengeance, particularly 
over the Holiday season.  And that is the purpose of this post.  For decades
I have routinely eliminated alcohol for the month of January after the plethora
of dinner parties in December.  Thus, it is the perfect time to launch into 
another diet that incorporates further good lifestyle changes.  And brings the 
weight down.  As a First Nations woman, of a certain age, I worry about 
diabetes, having helped my dad deal (poorly) with the disease, I believe I need 
to do this now.  Also, as a serious amateur cook, who loves food, I have a 
vested interest in committing to a diet so I can continue to enjoy food.  The 
other diet my husband came across is the GI diet.  I have browsed through your
posts but haven’t noticed any mention of either of these diets.  I tried Atkins 
back in university days, but found it challenging to maintain in a dorm life. 
I am also intrigued with your comments on exercise, as I was bracing myself 
to venture out for a walk in the snow.  I am about to go to campus for a three weeks, where there is a gym and thought that I could us this as a springboard to a moderate exercise regime with the goal of participating in the Sun Run this spring. 

We have tons of canned salmon, smoked salmon, frozen sockeye fillets, (after the 
big run this year), plus free range chickens, and lots of venison, so I feel well equipped 
for the protein portion of a diet.  I struggle with winter veggies, especially as we 
live on a small island where produce isn’t always top notch.  

I would appreciate your thoughts on the diets, the exercise, and the veggies. 
With thanks and cheers, A

&lt;strong&gt;Dr Jay&#039;s Reply:&lt;/strong&gt;

Nice to hear from you!

One of the things I found with shifting to low-carb is that I had to figure out a bunch of new recipes. I am like you in that I like to cook. Some people need a lot of structure and for them I recommend the new Atkins book (see comments below) which provides lots of detailed advice and meal plans, etc. For others (people like me), who don&#039;t need that structure and who look at recipes, not as something to be rigidly followed, but as guidelines which can be altered, my advice is to simply learn what are the foods that contain starch and sugar and avoid them. I started using Atkins cookbooks to get some ideas and went from there. I found that one had to be careful in selecting low-carb cookbooks as a lot of them still used too much carb. The Atkins books tended to be reliable so I have no problem recommending them. You will find that there are a lot of wonderful dishes that have minimal carbs already and by eliminating them you still end up with tasty meals. If you are in a place where it is hard to get fresh vegetables out of season, it may be tempting to eat root vegetables as they store well. The problem is that they tend to be fairly starchy. Frozen vegetables are an option. I use frozen spinach, for instance. The big issue, however, is not so much the vegetables but the fat. Where are you going to get your fat? The meats and seafoods you describe will have some fat but probably not enough (unless you have access to oolichan grease). My recommendation is to eat lots of dairy fats in the form of cheese, cream and butter. Olive oil is good to stock up on, too. 

I am not familiar with the Hormone diet. I have heard stories, however, of women who found their menopausal symptoms improved greatly on low-carb so I suspect that our hormonal systems function better with a carb restricted diet. 

I am familiar with the GI diet. I have mixed feelings about it. On the one hand, reducing the glycemic index of the carbohydrate foods in your diet is a good thing when it means eating less refined foods, fewer sugars, etc. There is research that shows people can benefit from the GI diet when compared to the standard American diet. There is also research, however, that shows that greater benefits are achieved on low-carb vs low-GI. The other concern I have about GI is that fructose flies under the radar of the glycemic index. Foods can be high in fructose and still register a relatively low GI score. Fructose is something we should all avoid. I am sure, for many people, moving to a GI diet would be a big improvement. For people who are manifesting signs of insulin resistance, I still think that low-carb is the best way to go. 

When it comes to alcohol, it is not counted as a carb when it is distilled and as long as it is not combined with a sugary mixer. Things like wine and beer bring carbs along with the alcohol so their consumption can be a problem. I avoid beer now but will drink a glass of wine with dinner. I find my desire to drink more than that has gone away. If I drink anything other than wine it is usually a fine Antiguan rum mixed with diet Coke with a squeeze of lime. One drink a day won&#039;t derail your dieting efforts. Too much will be a problem even if it is not accompanied by some carbs. 

I have expounded on exercise in other recent comments so have a look there for more. Bottom line: exercise is good but not necessarily for weight loss. If you do low-carb you can lose significant weight without exercising. You will get an energy boost from low-carb which will make you feel more like exercising and then my advice is to go for it!

I hope these observations are helpful. Good luck!

</description>
		<content:encoded><![CDATA[<p>Hello Jay:  Yes, diet time again.  I would appreciate your comments on<br />
a couple of low carb diets.  Last year my husband and I did the cleanse<br />
on the Hormone Diet.  A friend going through menopause, recommended<br />
it and we found it surprisingly easy to implement.  We dropped our caffeine<br />
consumption, replaced white flour and sugar from our very busy kitchen,<br />
and eliminated alcohol, which crept back in with a vengeance, particularly<br />
over the Holiday season.  And that is the purpose of this post.  For decades<br />
I have routinely eliminated alcohol for the month of January after the plethora<br />
of dinner parties in December.  Thus, it is the perfect time to launch into<br />
another diet that incorporates further good lifestyle changes.  And brings the<br />
weight down.  As a First Nations woman, of a certain age, I worry about<br />
diabetes, having helped my dad deal (poorly) with the disease, I believe I need<br />
to do this now.  Also, as a serious amateur cook, who loves food, I have a<br />
vested interest in committing to a diet so I can continue to enjoy food.  The<br />
other diet my husband came across is the GI diet.  I have browsed through your<br />
posts but haven’t noticed any mention of either of these diets.  I tried Atkins<br />
back in university days, but found it challenging to maintain in a dorm life.<br />
I am also intrigued with your comments on exercise, as I was bracing myself<br />
to venture out for a walk in the snow.  I am about to go to campus for a three weeks, where there is a gym and thought that I could us this as a springboard to a moderate exercise regime with the goal of participating in the Sun Run this spring. </p>
<p>We have tons of canned salmon, smoked salmon, frozen sockeye fillets, (after the<br />
big run this year), plus free range chickens, and lots of venison, so I feel well equipped<br />
for the protein portion of a diet.  I struggle with winter veggies, especially as we<br />
live on a small island where produce isn’t always top notch.  </p>
<p>I would appreciate your thoughts on the diets, the exercise, and the veggies.<br />
With thanks and cheers, A</p>
<p><strong>Dr Jay&#8217;s Reply:</strong></p>
<p>Nice to hear from you!</p>
<p>One of the things I found with shifting to low-carb is that I had to figure out a bunch of new recipes. I am like you in that I like to cook. Some people need a lot of structure and for them I recommend the new Atkins book (see comments below) which provides lots of detailed advice and meal plans, etc. For others (people like me), who don&#8217;t need that structure and who look at recipes, not as something to be rigidly followed, but as guidelines which can be altered, my advice is to simply learn what are the foods that contain starch and sugar and avoid them. I started using Atkins cookbooks to get some ideas and went from there. I found that one had to be careful in selecting low-carb cookbooks as a lot of them still used too much carb. The Atkins books tended to be reliable so I have no problem recommending them. You will find that there are a lot of wonderful dishes that have minimal carbs already and by eliminating them you still end up with tasty meals. If you are in a place where it is hard to get fresh vegetables out of season, it may be tempting to eat root vegetables as they store well. The problem is that they tend to be fairly starchy. Frozen vegetables are an option. I use frozen spinach, for instance. The big issue, however, is not so much the vegetables but the fat. Where are you going to get your fat? The meats and seafoods you describe will have some fat but probably not enough (unless you have access to oolichan grease). My recommendation is to eat lots of dairy fats in the form of cheese, cream and butter. Olive oil is good to stock up on, too. </p>
<p>I am not familiar with the Hormone diet. I have heard stories, however, of women who found their menopausal symptoms improved greatly on low-carb so I suspect that our hormonal systems function better with a carb restricted diet. </p>
<p>I am familiar with the GI diet. I have mixed feelings about it. On the one hand, reducing the glycemic index of the carbohydrate foods in your diet is a good thing when it means eating less refined foods, fewer sugars, etc. There is research that shows people can benefit from the GI diet when compared to the standard American diet. There is also research, however, that shows that greater benefits are achieved on low-carb vs low-GI. The other concern I have about GI is that fructose flies under the radar of the glycemic index. Foods can be high in fructose and still register a relatively low GI score. Fructose is something we should all avoid. I am sure, for many people, moving to a GI diet would be a big improvement. For people who are manifesting signs of insulin resistance, I still think that low-carb is the best way to go. </p>
<p>When it comes to alcohol, it is not counted as a carb when it is distilled and as long as it is not combined with a sugary mixer. Things like wine and beer bring carbs along with the alcohol so their consumption can be a problem. I avoid beer now but will drink a glass of wine with dinner. I find my desire to drink more than that has gone away. If I drink anything other than wine it is usually a fine Antiguan rum mixed with diet Coke with a squeeze of lime. One drink a day won&#8217;t derail your dieting efforts. Too much will be a problem even if it is not accompanied by some carbs. </p>
<p>I have expounded on exercise in other recent comments so have a look there for more. Bottom line: exercise is good but not necessarily for weight loss. If you do low-carb you can lose significant weight without exercising. You will get an energy boost from low-carb which will make you feel more like exercising and then my advice is to go for it!</p>
<p>I hope these observations are helpful. Good luck!</p>
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		<title>By: Iceynative</title>
		<link>http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/comment-page-4/#comment-502</link>
		<dc:creator>Iceynative</dc:creator>
		<pubDate>Wed, 30 Jun 2010 17:56:19 +0000</pubDate>
		<guid isPermaLink="false">http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/#comment-502</guid>
		<description>Dr. Jay , I just have a question regarding your recipes. I see you recommend  using Splenda, should we not be using Maple syrup as it is real food and it is also native to our diet? Just a thought.

&lt;strong&gt;Dr Jay&#039;s Reply:&lt;/strong&gt;

I loved maple syrup. My wife is from northern Quebec and we used to have boxes of it sent to us. No more, I&#039;m afraid. It is actually not that different from plain old sugar in terms of its carbohydrate content and its effect on your metabolism. Sorry to break it to you but it is not compatible with the low-carb diet especially for people who have insulin resistance. </description>
		<content:encoded><![CDATA[<p>Dr. Jay , I just have a question regarding your recipes. I see you recommend  using Splenda, should we not be using Maple syrup as it is real food and it is also native to our diet? Just a thought.</p>
<p><strong>Dr Jay&#8217;s Reply:</strong></p>
<p>I loved maple syrup. My wife is from northern Quebec and we used to have boxes of it sent to us. No more, I&#8217;m afraid. It is actually not that different from plain old sugar in terms of its carbohydrate content and its effect on your metabolism. Sorry to break it to you but it is not compatible with the low-carb diet especially for people who have insulin resistance.</p>
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		<title>By: Kylie Batt</title>
		<link>http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/comment-page-4/#comment-473</link>
		<dc:creator>Kylie Batt</dc:creator>
		<pubDate>Mon, 03 May 2010 22:42:37 +0000</pubDate>
		<guid isPermaLink="false">http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/#comment-473</guid>
		<description>&lt;strong&gt;? ???? ???-?? ????. ?????? ? ????? ?????, ??????? ??????? ?? ??????????....&lt;/strong&gt;

&lt;a href=&quot;http://cv-personal.ru/?p=121&quot; rel=&quot;nofollow&quot;&gt; ???????? ?? ?????? ????????? &lt;/a&gt; Please feel free to ask questions or post comments about the documentary film, &#8220;My Big Fat Diet&#8221;, or anything you see on this site or its links.....</description>
		<content:encoded><![CDATA[<p><strong>? ???? ???-?? ????. ?????? ? ????? ?????, ??????? ??????? ?? ??????????&#8230;.</strong></p>
<p><a href="http://cv-personal.ru/?p=121" rel="nofollow"> ???????? ?? ?????? ????????? </a> Please feel free to ask questions or post comments about the documentary film, &#8220;My Big Fat Diet&#8221;, or anything you see on this site or its links&#8230;..</p>
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		<title>By: Kylie BattName</title>
		<link>http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/comment-page-4/#comment-466</link>
		<dc:creator>Kylie BattName</dc:creator>
		<pubDate>Mon, 12 Apr 2010 06:37:12 +0000</pubDate>
		<guid isPermaLink="false">http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/#comment-466</guid>
		<description>&lt;strong&gt;?????????!!! ??? ??? ???????????!!!))))...&lt;/strong&gt;

&lt;a href=&quot;http://kiopersona.ru/?p=58&quot; rel=&quot;nofollow&quot;&gt;???????? ?? ?????? ????????????&lt;/a&gt; Please feel free to ask questions or post comments about the documentary film, &#8220;My Big Fat Diet&#8221;, or anything you see on this site or its links.....</description>
		<content:encoded><![CDATA[<p><strong>?????????!!! ??? ??? ???????????!!!))))&#8230;</strong></p>
<p><a href="http://kiopersona.ru/?p=58" rel="nofollow">???????? ?? ?????? ????????????</a> Please feel free to ask questions or post comments about the documentary film, &#8220;My Big Fat Diet&#8221;, or anything you see on this site or its links&#8230;..</p>
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		<title>By: ed the grocer</title>
		<link>http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/comment-page-4/#comment-450</link>
		<dc:creator>ed the grocer</dc:creator>
		<pubDate>Mon, 15 Feb 2010 07:36:33 +0000</pubDate>
		<guid isPermaLink="false">http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/#comment-450</guid>
		<description>I am a grocer and the only book I sell/give away is the Taubes book. I also send as many as I can to your site. Enough praise. I also push Vit D - a given. Vit C - if glucose supplants vit C and vit C is needed for healthy connective tissue, then, there would be a less trouble with VLDL and LDL. Iodine, ( a suprise ) our food comes from the same old fields, the dairy no longer uses it for cleaning and the Dr. tells us not to use salt (iodized). The solution for a sluggish thyroid is to supercharge the gland even when there is no iodine to work with. Magnesium, selenium, chromium.   And last, Q10/ALA , if q10 declines with age and the heavy demand gets all the q10, then what happens (no one says ) to the less muscular demanding parts of our system? colin, skin, eyes...</description>
		<content:encoded><![CDATA[<p>I am a grocer and the only book I sell/give away is the Taubes book. I also send as many as I can to your site. Enough praise. I also push Vit D &#8211; a given. Vit C &#8211; if glucose supplants vit C and vit C is needed for healthy connective tissue, then, there would be a less trouble with VLDL and LDL. Iodine, ( a suprise ) our food comes from the same old fields, the dairy no longer uses it for cleaning and the Dr. tells us not to use salt (iodized). The solution for a sluggish thyroid is to supercharge the gland even when there is no iodine to work with. Magnesium, selenium, chromium.   And last, Q10/ALA , if q10 declines with age and the heavy demand gets all the q10, then what happens (no one says ) to the less muscular demanding parts of our system? colin, skin, eyes&#8230;</p>
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		<title>By: shar</title>
		<link>http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/comment-page-4/#comment-417</link>
		<dc:creator>shar</dc:creator>
		<pubDate>Sat, 31 Oct 2009 14:41:28 +0000</pubDate>
		<guid isPermaLink="false">http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/#comment-417</guid>
		<description>Dr Jay I just wanted to thank you for the referral to atkins. I read about your big fat diet and tried to find as much info as possible, your science made sense to me. When I couldn&#039;t find enough info to follow the diet I read your advice to others to try atkins. Lost 9lbs in 4 days! Gotta say thank you so much for the advice!

&lt;strong&gt;Dr Jay&#039;s Reply&lt;/strong&gt;:

Thanks for sharing your story. I hope you have continued success.</description>
		<content:encoded><![CDATA[<p>Dr Jay I just wanted to thank you for the referral to atkins. I read about your big fat diet and tried to find as much info as possible, your science made sense to me. When I couldn&#8217;t find enough info to follow the diet I read your advice to others to try atkins. Lost 9lbs in 4 days! Gotta say thank you so much for the advice!</p>
<p><strong>Dr Jay&#8217;s Reply</strong>:</p>
<p>Thanks for sharing your story. I hope you have continued success.</p>
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		<title>By: PHolloway</title>
		<link>http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/comment-page-4/#comment-387</link>
		<dc:creator>PHolloway</dc:creator>
		<pubDate>Sat, 29 Aug 2009 02:59:45 +0000</pubDate>
		<guid isPermaLink="false">http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/#comment-387</guid>
		<description>Thanks for your input, Helen. However, my daughter&#039;s father (not my husband anymore, for reasons that may become clear in this diatribe) has diabetes in his family and his health is a nightmare. My kids report that for him, breakfast is a handful of m&amp;ms. He has always believed in low-fat, low-carb in spite of the terrible consequences on his family and, himself. He has always had memory and concentration issues very much like my son, and borders on paranoia, obsessive/compulsive disorder, etc. He has had major health problems that I won&#039;t go into here, but they almost defy belief.  His weight yo-yo&#039;.s When I first started dating him, he weighed 230 pounds and he gained even more when he was in medical school and stopped competing in college sports. When he feels like he is overweight, he goes on a starvation diet. He has horrible emotional mood swings and some real cognitive impairment. (I am amazied that he continues to practice medicine, although he mostly works as medical expert on worker&#039;s comp cases rather than seeing patients) So, no, I don&#039;t think low-fat, high-carb is appropriate for him!</description>
		<content:encoded><![CDATA[<p>Thanks for your input, Helen. However, my daughter&#8217;s father (not my husband anymore, for reasons that may become clear in this diatribe) has diabetes in his family and his health is a nightmare. My kids report that for him, breakfast is a handful of m&amp;ms. He has always believed in low-fat, low-carb in spite of the terrible consequences on his family and, himself. He has always had memory and concentration issues very much like my son, and borders on paranoia, obsessive/compulsive disorder, etc. He has had major health problems that I won&#8217;t go into here, but they almost defy belief.  His weight yo-yo&#8217;.s When I first started dating him, he weighed 230 pounds and he gained even more when he was in medical school and stopped competing in college sports. When he feels like he is overweight, he goes on a starvation diet. He has horrible emotional mood swings and some real cognitive impairment. (I am amazied that he continues to practice medicine, although he mostly works as medical expert on worker&#8217;s comp cases rather than seeing patients) So, no, I don&#8217;t think low-fat, high-carb is appropriate for him!</p>
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		<title>By: Helen</title>
		<link>http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/comment-page-4/#comment-386</link>
		<dc:creator>Helen</dc:creator>
		<pubDate>Fri, 28 Aug 2009 17:51:23 +0000</pubDate>
		<guid isPermaLink="false">http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/#comment-386</guid>
		<description>Hi PHolloway:

Thank you for your response to my previous post. I am now posting in the other string as I think Dr. Jay wanted to divert comments there.
From I read, yes extra fat cells are created as we become obese. Those who lose the weight retain the original fat cells, which sits there like empty sacs and thus the excess skin and subcutaneous tissue. After my childhood as a obese person, then two babies, I am fairly lean but retain those belly rolls of extra skin.
It sounds like your husband has perfect insulin sensitivity, and does not produce so much of it when exposed to carbs, so that eating carbs does not get away on him. For people like that, it seems a low-fat, high-carb eating style works fine.
Helen</description>
		<content:encoded><![CDATA[<p>Hi PHolloway:</p>
<p>Thank you for your response to my previous post. I am now posting in the other string as I think Dr. Jay wanted to divert comments there.<br />
From I read, yes extra fat cells are created as we become obese. Those who lose the weight retain the original fat cells, which sits there like empty sacs and thus the excess skin and subcutaneous tissue. After my childhood as a obese person, then two babies, I am fairly lean but retain those belly rolls of extra skin.<br />
It sounds like your husband has perfect insulin sensitivity, and does not produce so much of it when exposed to carbs, so that eating carbs does not get away on him. For people like that, it seems a low-fat, high-carb eating style works fine.<br />
Helen</p>
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		<title>By: PHolloway</title>
		<link>http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/comment-page-4/#comment-384</link>
		<dc:creator>PHolloway</dc:creator>
		<pubDate>Fri, 28 Aug 2009 16:28:36 +0000</pubDate>
		<guid isPermaLink="false">http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/#comment-384</guid>
		<description>Oops - I said her insurance WOULD pay - when it should read that the insurance WOULD NOT pay.</description>
		<content:encoded><![CDATA[<p>Oops &#8211; I said her insurance WOULD pay &#8211; when it should read that the insurance WOULD NOT pay.</p>
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		<title>By: PHolloway</title>
		<link>http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/comment-page-4/#comment-383</link>
		<dc:creator>PHolloway</dc:creator>
		<pubDate>Fri, 28 Aug 2009 16:27:12 +0000</pubDate>
		<guid isPermaLink="false">http://www.drjaywortman.com/blog/wordpress/2008/03/09/your-comments-and-questions-are-welcome/#comment-383</guid>
		<description>Another comment:
As I read more of this blog, I am more and more interested in the postings here and feel compelled to respond. I just read the question about bariatric surgery, and, as always, really appreciate Dr. Jay&#039;s reply. My daughter, who weighed 320 pounds at her &quot;peak&#039; at age 16, lost about 150 over several years with diet (modified low-carb - she prefers to be vegetarian but eventually became resigned to the fact that her heredity would make that difficult) and intense exercise. What a marvelous accomplishment for a young woman! However, by the time she graduated from college, she had massive amounts of loose skin everywhere. That is a side-effect of major weight gain/loss that few people mention. I have an acquaintance that suffered the same fate after bariatric surgery. My daughter commented once that &quot;I worked so hard to lose weight and I&#039;m still a freak.&quot; It was so tragic, especially since she is a talented actress in a society that demands physical beauty for performers of her age group. She visited a plastic surgeon and arranged for surgery, only to discover that her insurance would pay for it. My acquaintance, on the other hand, had the same procedures and her insurance covered it because it was the result of the bariatric procedure. (Dr. Jay, being from Canada, might be interested in that little detail, especially as we debate public health care in the US) Fortunately, between my mother and me, we came up with the $15,000 plus for the operations and my brave daughter endured the pain and rehabilitation of two stints of operations (abdomen and under-arms performed in two separate &quot;bouts&quot;).  She is much more comfortable now and has a slim midriff and torso, but is left literally and emotionally &quot;scarred for life.&quot; She is convinced that she will never have the career she wants because of the visible scars. She still has some extra skin on her thighs that leaves them looking heavy, but really can&#039;t afford the cost and trauma of more surgery. 
As her mother, I am laden with guilt that her life was so severely impacted by my mistaken belief in feeding my family a low-fat, high-carb diet. I have no doubt she suffered malnutrition and near starvation that lead her to have disordered eating as a child. She still is prone to bulimia when under stress. I write this so that anyone considering massive weight loss be warned that there are some side effects - especially if the weight is gained or lost quickly. Also, for parents with metabolic syndrome and insulin-resistance in the family, to feed your children a low-grain, low-sugar, low-processed food diet from the beginning and not to listen to the medical establishment. The saddest part of this is that her father is an MD in internal medicine and sports medicine and still believes in low-fat, low calorie diets. His health is a disaster!</description>
		<content:encoded><![CDATA[<p>Another comment:<br />
As I read more of this blog, I am more and more interested in the postings here and feel compelled to respond. I just read the question about bariatric surgery, and, as always, really appreciate Dr. Jay&#8217;s reply. My daughter, who weighed 320 pounds at her &#8220;peak&#8217; at age 16, lost about 150 over several years with diet (modified low-carb &#8211; she prefers to be vegetarian but eventually became resigned to the fact that her heredity would make that difficult) and intense exercise. What a marvelous accomplishment for a young woman! However, by the time she graduated from college, she had massive amounts of loose skin everywhere. That is a side-effect of major weight gain/loss that few people mention. I have an acquaintance that suffered the same fate after bariatric surgery. My daughter commented once that &#8220;I worked so hard to lose weight and I&#8217;m still a freak.&#8221; It was so tragic, especially since she is a talented actress in a society that demands physical beauty for performers of her age group. She visited a plastic surgeon and arranged for surgery, only to discover that her insurance would pay for it. My acquaintance, on the other hand, had the same procedures and her insurance covered it because it was the result of the bariatric procedure. (Dr. Jay, being from Canada, might be interested in that little detail, especially as we debate public health care in the US) Fortunately, between my mother and me, we came up with the $15,000 plus for the operations and my brave daughter endured the pain and rehabilitation of two stints of operations (abdomen and under-arms performed in two separate &#8220;bouts&#8221;).  She is much more comfortable now and has a slim midriff and torso, but is left literally and emotionally &#8220;scarred for life.&#8221; She is convinced that she will never have the career she wants because of the visible scars. She still has some extra skin on her thighs that leaves them looking heavy, but really can&#8217;t afford the cost and trauma of more surgery.<br />
As her mother, I am laden with guilt that her life was so severely impacted by my mistaken belief in feeding my family a low-fat, high-carb diet. I have no doubt she suffered malnutrition and near starvation that lead her to have disordered eating as a child. She still is prone to bulimia when under stress. I write this so that anyone considering massive weight loss be warned that there are some side effects &#8211; especially if the weight is gained or lost quickly. Also, for parents with metabolic syndrome and insulin-resistance in the family, to feed your children a low-grain, low-sugar, low-processed food diet from the beginning and not to listen to the medical establishment. The saddest part of this is that her father is an MD in internal medicine and sports medicine and still believes in low-fat, low calorie diets. His health is a disaster!</p>
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