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The Impact of Fast Foods on Your Health

Learn more about weight loss surgery at Rocky Mountain Associated Physicians www.RMAP.com (801) 268-3800

Life is busy. It’s no secret or something new we haven’t heard before! When strapped for time or when a meal is needed to be quick or easy to feed a hungry family, many are guilty of driving through a drive-thru of a fast-food restaurant. It’s quick, accessible, and let’s be honest, someone else prepared the meal.

Even grabbing frozen meals from the grocery store to save on time is a no-no regarding your health. Frozen pre-packaged foods can sometimes be laden with sodium, added sugar, unhealthy fats, and preservatives.

What Are Fast foods?

Fast foods or “junk food” can be defined as food that is high in calories (or empty calories) with little to no nutritional value. Fast food can sometimes even be labeled as “cheap” or cheaper than healthy nutrition-dense foods, thus leading to weight gain and overweight conditions.

Over the last couple of decades, fast food has become increasingly popular. With this increase in fast food chains, obesity, and chronic diseases have never been higher. But fast food is not just the food in fast food restaurants. These foods can include chips, soda, cookies, candy, breakfast cereals, bars, French fries, burgers, pizza, white flour baked goods, and all other high-calorie, low-nutrient foods. These are processed foods and can be easily accessed. They don’t need to be prepared and easily go from a bag or box into the mouth.

Fast foods, or “hyper-palatable” foods, are specifically engineered to spark cravings, triggering brain responses that look surprisingly like the brain’s response to alcohol or even illicit drugs. They contain certain chemicals that can make us feel happy, but later depressed because they don’t contain any nutrients that our body truly needs. It can also cause digestive issues such as bloating, constipation, or even stomach pain.

Examples of a few typical fast-food items, not including drinks or sides:

McDonald’s Big Mac: 590 calories; 34 grams of total fat
Burger King Whopper: 670 calories; 37 grams of total fat
Wendy’s Bacon Deluxe Double: 920 calories; 62 grams of total fat
Taco Bell Nachos Bell Grande: 730 calories; 38 grams of total fat

Examples of sides:

McDonald’s Medium French Fries: 320 calories; 15 grams of total fat
Dairy Queen Onion Rings: 360 calories; 16 grams of total fat
Popeye’s Regular Cole Slaw: 220 calories; 15 grams of total fat

Examples of drinks:

Wendy’s Large Frosty: 407 calories; 11 grams of total fat
McDonald’s Large Sweet Tea: 210 calories; 0 grams of total fat
Dunkin Donuts Ice Caramel Latte: 230 calories; 6 grams of total fat

These popular food menu items are highly processed, and loaded with fat, sugar, calories, and sodium. According to the Dietary Guidelines for Americans, the recommended daily calorie intake varies depending on life stages, pregnancy, and activity level.

For bariatric patients in maintenance, the focus is still 70% protein, 30% vegetables, 3 meals a day, while slowly adding complex carbohydrates back into your diet while increasing your physical activity. Bariatric patients should never consume more than 1 cup (8 ounces) at any meal. You should be consuming 2-to-4-ounce meals. This should be measured in volume, not weight. If you have questions about what you should be eating and when, please review the big blue binder that was given to you at your surgery orientation class before your surgery. If you still have questions or are unsure, please call us at (801) 268-3800.

¼ cup = 2 ounces	½ cup = 4 ounces	1 cup = 8 ounces
4 tbsp. = 2 ounces	8 tbsp. = 4 ounces	16 tbsp. = 8 ounces

Effects of Eating Fast foods

Fast foods are high in calories and fats, which when eaten often or as a regular diet can lead you to feel sick or even get sick. Eating nutrition-dense foods can help your body feel good and perform daily tasks with natural energy.

The majority of fast-food meals come with a soda, which increases sugar content ten times as much. Some research has shown that the high fat and salt content in fast food may increase addictive actions.¹ Fast food advertising, restaurant, and menus all provide informational cues that could prompt addictive overeating.

71% of Americans are overweight or obese; which is a staggering 100 million individuals in America² and over 300 million worldwide. Obesity has now become a global epidemic. Obesity can lead to many other health problems, such as to name a few:

Heart or cardiovascular disease
Diabetes
Fatty liver disease
High blood pressure

Today, eating processed foods and fast foods may kill more people prematurely than cigarette smoking.³ A link may even exist between fast-food, processed food, commercial baked goods, and sweets, and the damage of brain cells to the decreasing of intelligence. Candy and sweetened baked goods can even sometimes stimulate the brain in an addictive way, which could then lead to more serious illnesses.⁴

Research tells us that a surplus of calories outside the daily recommendation can shorten a person’s natural life, while moderate caloric restriction has been shown to slow the aging process and protect the body and brain.⁵ Americans are notoriously known to consume more excess calories, and foods which have minimal to no nutritional value, than any other population.

Fast-Food Epidemic

So, is fast food the enemy? According to the Centers of Disease Control and Prevention (CDC), between 2013 and 2016 about 37%, or 84.8 million of US adults, consumed fast food on any given day.⁶ On average, adults in the United States consumed 11.3% of their total daily calories from fast food between 2007 and 2010. Also in the study, 44.9% of adults ages 20-39 said they consumed fast food on a given day, compared with 37.7% of adults 40-59, and 24.1% of adults 60 and older. It also showed that 31.7% of lower-income adults, 36.4% of middle-income, and 42% of higher-income said they had eaten fast food. Among those who had eaten fast food, 43.7% did so during lunch, 42% during dinner, 22.7% during breakfast, and 22.6% as snacks.

The study also said that more men (48.3%) than women (39.1%) said they ate fast food during lunch. However, more women (25.7%) than men (19.5%) said they had it as a snack. Among all adults, a higher percentage of men (37.9%) than women (35.4%) said they ate fast food on a given day. This data is based on about 10,000 people 20 and older from the CDC study 2013-2016.⁷

Community Efforts to Help

Let’s be honest, we can’t always avoid eating out, and we shouldn’t need to. On the rare occasion you might find yourself eating out with friends or family, remember these few tips for a healthier meal option:

Substitute the fries: Pick a side such as a salad, fruit, or yogurt.
Choose calorie-free drinks: Go for water or a sugar-free beverage instead of soda.
Grilled over fried: Grilled chicken is a healthier option instead of fried or breaded chicken.
Limit portions: Americans are notorious for serving huge portions! Cut your meal in half and save the rest for another meal.
Leave off the sauces: May and most other sauces can add a lot of calories to a sandwich or salad. Order your own plain or add salsa or a low-calorie dressing.

The key to helping with overeating or eating out is to meal plan and meal prep. Think about your schedule in advance and plan your meals accordingly. On days when you are constantly on the run, plan for a quick and easy meal such as:

Salad with grilled chicken or a salad in a jar
Turkey wraps or lettuce wraps
Veggie rollups or sandwiches
Boiled eggs and sliced veggies

Knowing whether a food is healthy or not typically feels like common sense or an easy judgment call. Vegetables? Yes. Potato chips? No. But it’s not always as clear-cut as it seems. According to Lauren Black, RD, LDN, CHWC, a registered dietician at Ohio State Medical Center, avoiding these eight foods that “disguise” themselves as healthy can help:

Low-fat peanut butter: the fat that would be in the reduced-fat peanut butter spread is replaced with ingredients like corn syrup solids, sugar, and molasses, plus starchy fillers. Those add-ins boost the spread’s sugar content to 4 grams and its total carbs to 15 grams. Try natural peanut butter instead.
Low-fat or fat-free salad dressing: Salad dressing, like peanut butter, also has healthy fat in it. It will have fat that can help you absorb nutrients from the greens in your salad. Try Greek yogurt-based dressings instead, or a vinegarette with lemon instead.
Fake meat: Some of those products, even though they might contain high amounts of plant-based protein, may also contain unhealthy ingredients such as high amounts of sodium or unhealthy fats. Try eating lentils, beans, eggs, or nuts if you are vegetarian.
Fast-food smoothies: Fast-food or store-bought smoothies can be high in added sugar, plus lots of simple syrups get added as well. Try a homemade smoothie if you’re craving one instead.
Pre-packaged yogurt parfaits: Yogurt parfaits might seem like a good healthy choice, but unfortunately most are made with added sugar, refined carbs, and other high-fat or calorie ingredients. Try reaching for fresh fruit or make a parfait at home with plain Greek yogurt.
Frozen diet meals: Frozen meals can be notoriously high in sodium and saturated fat for a smaller portioned meal. Instead, try making protein and veggies at home that can be frozen and saved for reheating later.
Pretzels: Even though pretzels are low-fat, they are low in protein and fiber. They can also be high in sodium and carbs. Try eating nuts instead for a healthy snack.
Fiber bars: Yes, these bars might have a little bit of fiber, but many of these bars are processed and contain additives such as sugar, preservatives, or flavorings.

Growing food at home can help you develop a lifetime habit of eating better, too. Preparing your food gives you control of what’s on your plate. With good information, emotional support, increased food availability and food preparation instruction, we all could be more enthused and willing to work together for change.

www.RMAP.com
Rocky Mountain Associated Physicians
801-268-3800
1160 East 3900 South, Suite 4100
SLC, UT 84124

Resources:

Andrea K Garber, Robert H Lustig; “Is fast food addictive?”; 2011 Sep; 4 (3):146-62; https://pubmed.ncbi.nlm.nih.gov/21999689/
Centers for Disease Control and Prevention; Health, United States, 2016; 2016; https://www.cdc.gov/nchs/data/hus/hus16.pdf#053
US Burden of Disease Collaborators; “The State of US Health, 1990-2010: Burden of Diseases, Injuries, and Risk Factors”; JAMA 2013 Aug 14; 310(6):591-608; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436627/
Joel Fuhrman, MD; “The Hidden Dangers of Fast and Processed Food”; 2018 Apr 3: dio:10.1177/1559827618766483; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6146358/
Joel Fuhrman, MD; “The Hidden Dangers of Fast and Processed Food”; 2018 Apr 3: dio:10.1177/1559827618766483; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6146358/
Cheryl D. Fryar, MSPH, Jeffery P Hughes, MPH, Kirsten A Herrick, PhD, MSc, and Namanjeet Ahluwalia, PhD; “Fast Food Consumption Among Adults in the United States, 2013-2016”; Centers for Disease Control and Prevention; https://www.cdc.gov/nchs/products/databriefs/db322.htm
Cheryl D. Fryar, MSPH, Jeffery P Hughes, MPH, Kirsten A Herrick, PhD, MSc, and Namanjeet Ahluwalia, PhD; “Fast Food Consumption Among Adults in the United States, 2013-2016”; Centers for Disease Control and Prevention; https://www.cdc.gov/nchs/products/databriefs/db322.htm

Welcome Erika Reichard to the RMAP Team!

May 31 By rmap nurse

Help us welcome Erika to the Rocky Mountain Associated Physicians (RMAP) family as our virtual and in-person Support Groups Host! She will be the host for our emotional and weight regain support groups.

Erika graduated from Weber State University in December of 2014 with her bachelor’s degree in psychology. She went on to graduate with her Masters of Social Work degree from Walden University in November of 2021, obtaining her Certified Social Worker professional license in December of 2021. She served a one year AmeriCorps service term in 2020, working with individuals struggling with homelessness and housing insecurity.

Throughout her internships for her master’s program, as well as for several months after graduation, she worked with individuals struggling with substance abuse and dependence. She currently works as an outpatient behavioral health specialist at the Weight Treatment Center in St. Mark’s Hospital. She works with a variety of patients who come through the clinic, including those who are preoperative and postoperative from bariatric surgery. Having undergone gastric bypass surgery herself in 2018, she uses her personal experiences and passion to help others.

In her free time, she enjoys practicing and teaching yoga, walking, reading, and spending time with her husband and animals.”

Welcome Erika! We are excited to have you join the RMAP family!

www.RMAP.com
Rocky Mountain Associated Physicians
801-268-3800
1160 East 3900 South, Suite 4100
SLC, UT 84124

Habits Sabotaging Weight Loss

Mar 29 By rmap nurse

Learn more about weight loss surgery at Rocky Mountain Associated Physicians www.RMAP.com (801) 268-3800

Regardless of how well-intentioned you are about your weight loss goals, there may be certain habits preventing you from reaching those goals that you might not even realize. It’s important to identify these habits and have the appropriate information to support your decision to change your lifestyle. This can help to prevent being thrown off track for optimal and life-long success after bariatric surgery.

Bariatric surgery is a life-long decision and commitment. It is a tool only given to you by your surgeon. Maintaining the lifestyle of a bariatric patient is up to you, and only you. You will need to be willing and able to follow the long-term plan your surgeon and bariatric clinic have provided and taught you to achieve weight loss success for your lifetime.

Sabotaging Habits

Even though some of your natural habits may seem good intentioned or harmless enough, here are eight habits to consider that you may be doing to sabotage your optimal weight loss:

Not Having a Meal Plan: Keeping to a meal plan will help you stay focused and meet the goals you have set. Not all meal plans work for everyone; i.e. nutritional needs and requirements, food sensitivities, different tastes and budgets, etc. So be sure to work with one that works best for you. If you need to, meet with a nutritionist or dietician to help you.

A meal plan can also help with meal preparation and having a shopping list to keep you from impulse buying or eating out.

Not Understanding Nutrition: There are so many different types of food out in the world nowadays. Some may claim to be “healthy” or “low” on certain ingredients, but are usually higher in sodium or sugar to make up the difference. Understanding the value of nutrition and the foods that fuel your body is beneficial to ensure a healthy and successful weight loss journey.

Not Switching Up Your Meals: After bariatric surgery, your meals don’t need to be bland or boring! Repeating the same foods could lead to boredom and you could end up reaching for something savory or sugary to cure that boredom. Add colorful veggies and different spices to your foods. Try different cooking methods to switch up your meals and create fun new recipes!

Not Getting Enough Sleep: Past studies show that individuals who get less than six hours of sleep at night are more likely to be diagnosed as obese¹. Thus, sleep-deprived people tend to choose foods that are high in calories and carbohydrates². Ensuring a good night’s rest and getting between 7-8+ hours of sleep each night can balance your hunger hormones.

Not Exercising: Physical exercise can be one of the best things you can do for your body. It is essential and necessary to maintain weight loss and your overall health. The current physical activity guidelines for Americans states that adults need at least 150 minutes each week of moderate-intensity of physical exercise³.

Not Considering Your Stress Levels: Not only can stress affect your physical health, but it can impact your emotional and psychological health as well. Stress can lead to the release of the cortisol hormone, which stimulates your fat and carbohydrate metabolism, increasing your appetite⁴. Not taking the time to take care of your physical and mental health can impact your overall health.

Not Counting Snacking: Even though “true” hunger should be the main motivation for snacking, some people don’t think of snacks as “food,” and don’t take them into account when counting meals. Snacking when appetizing food is nearby happens more often that admitted, even if the individual isn’t even hungry.

Not Focusing on What You’re Eating: The habit of eating in front of the TV or while playing on your phone can lead to overeating. You might not be noticing when you have had enough food and are full. Not eating enough during the day due to busy daily schedules or work could also lead you to being so hungry right before bed. This could lead to overeating due to extreme hunger. It may be hard to keep track of your daily intake, but it’s important that you are eating throughout the day while expending your energy⁵. If you find yourself hungry right before bed, try eating a handful of nuts.

It might seem impossible to reset and rewire our brains to change these sabotaging habits, but if you stay consistent and focused, you can start to see your mindset and life start to change, too. It is possible! Your health, inside and out, are the most important things during your lifetime, don’t forget to take care of YOU, too.

www.RMAP.com
Rocky Mountain Associated Physicians
801-268-3800
1160 East 3900 South, Suite 4100
SLC, UT 84124

Resources

Yili Wu, Long Zhai, Dongfeng Zhang, “Sleep Duration and Obesity Among Adults: A Meta-analysis of Prospective Studies”, Sleep Med, 2014 Dec; 15 (12):1256-62, doi: 10.1016/j.sleep.2014.07.018, https://pubmed.ncbi.nlm.nih.gov/25450058/
Stephanie M Greer, Andrea N Goldstein, Matthew P Walker, “The Impact of Sleep Deprivation on Food Desire in the Human Brain”, Nat Commun, 2013;4:2259, doi: 10.1038/ncomms3259, https://pubmed.ncbi.nlm.nih.gov/23922121/
S. Department of Health and Human Services; https://health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines
William Shaw, PhD; Susan Labott-Smith, PhD, ABPP; Matthew M. Burg, PhD; Camelia Hostinar, PhD; Nicholas Alen, BA; Miranda A.L. van Tilburg, PhD; Gary G. Berntson, Phd; Steven M. Tovian, PhD, ABPP, FAClinP, FAClinHP; and Malina Spirito, PsyD, Med, “Stress effects on the body”, American Psychological Association; 2018 Nov 1, https://www.apa.org/topics/stress/body
“5 Mistakes That Will Sabotage a Healthy Diet”, April 19,2021; Harvard Health Publishing; https://www.health.harvard.edu/staying-healthy/5-mistakes-that-will-sabotage-a-healthy-diet

Mindset Over Weight: Resetting Your Brain

Mar 15 By rmap nurse

Learn more about weight loss surgery at Rocky Mountain Associated Physicians www.RMAP.com (801) 268-3800

“Watch your thoughts, they become your words; watch your words, they become your actions; watch your actions, they become your habits; watch your habits, they become your character; watch your character, it becomes your destiny.” – Lao Tzu

Who else feels like their emotions sometimes seem to come out of nowhere and have a mind of their own? Even though it may seem as though we have no control over our emotions, we do! We have more control than what we sometimes like to acknowledge. It’s important and necessary to think where our emotions come from. Our thoughts—and emotions—both positive and negative, become our beliefs and feelings that affect our habits and daily life.

The Power of Words

You have probably heard the saying, “Sticks and stones may break my bones, but words shall never hurt me.” For some, no matter how hard they try, words and thoughts can be just as powerful and harmful as physical hurt. More often than not, it’s our own words and thoughts discouraging ourselves about ourselves. What we think and tell ourselves matters.

Throughout our lifetime we are conditioned, and soon our thought process becomes so automatic that we don’t even realize we’re thinking in a certain way! Our thoughts become feelings, and feelings seem to come out of nowhere, which then tends to turn into actions. Before you know it, our thoughts have become so habitual that it takes continual training to stop and recognize the negative thoughts we have, priming our feelings and emotions to take action. Whether it be us getting irrationally angry, anxious, depressed, sad—we develop habits, healthy or destructive, to cope with our emotions.

Negativity of Harmful Thoughts

Emotions such as fear, sadness, and anger are a basic part of life, and everyone will experience them at one point in life. For most individuals, it can be a struggle dealing with these emotions successfully. We usually react to these emotions in the heat of the moment instead of pausing to think on how to act. According to Mental Health America, here are a few ways people might deal with negative emotions:

Denial: Sometimes a person might not be able to accept a certain emotion or truth, and denial is used as a defense mechanism against situations and circumstances that are painful and overwhelming.
Withdrawal: This is a coping mechanism used when a person no longer wants to be around or participate in events and activities with others. It’s a self-protective measure for when people are experiencing emotions that might make them uncomfortable. They might be feeling shame, guilt, anger, and fear. Withdrawal can lead to extreme loneliness, depression, anxiety, and anger.
Bullying: An unwanted, aggressive behavior, such as bullying, involves a real or alleged power imbalance. Both those who bully or are bullied could have potential lasting difficulties.
Self-harm: If a person feels as though they have no control over their emotional pain, sometimes they will turn to self-harm. This can be in the form of causing themselves physical pain instead, self-imposed starvation, bouts of overeating and self-induced vomiting, or putting themselves in unsafe situations or demonstrate dangerous behavior.
Substance Abuse: A person might use alcohol and/or other drugs to aid the emotions they feel. It could be to make them feel better or “numb” painful situations.

The good news is that with time and coaching, we can learn to identify and challenge our automatic negative thoughts. We can train our minds to identify our triggers, feelings, and thoughts. Although it may seem overwhelming at first, it’s very important to identify the motivation for changing one’s habits. You need to find and recognize your “Why?”

Retrain Your Brain

It may seem impossible, but when you feel yourself start to engage in negative self-talk or thinking, try to remember a few of these tools listed below to curb the negativity:

Turn Negativity into Positivity: When negative thoughts start to pop in your brain, we might start to accept the thought process and allow it to control our mindset and mood. However, according to research by Mayo Clinic, positive thinking improves our psychological well-being and can lower levels of depress and distress.¹ Ask yourself if the negative thought is really true, or is it helpful in any way? Would you say it to a friend you cared about? This can help change your focus and challenge your negative thought.
Become a Morning Person: I know what you’re thinking, you can’t even begin to function without your cup of coffee (which should be de-caffeinated for weight loss surgery patients)! But hear me out, your thoughts begin to take form the instant you wake up, so it’s important to develop a morning routine that helps you take control of those thought patterns.

: Let some natural light in
: Exercise
: Drink a full glass of water
: Meditate
: Avoid scrolling social media

National Alliance of Mental Illness (NAMI) says that doing a constructive morning routine can help to increase your energy, productivity, and positivity.²

Learn What Triggers You: Certain people, places, things, and events in life can set in motion a stream of negative thoughts. This brings about the “Act, don’t react.” Take a few breaths, remember your questions to ask yourself, and steer your thoughts into a different direction. If you need to, remove yourself from the situation completely. Do what you need to do to clear your thoughts and bring yourself to feel comfortable.
Be Mindful of Your Thoughts: To be aware of your negative thoughts is simply knowing that they do exist, and you will have them. Remember that your thoughts are just that…thoughts. Practicing mindfulness daily can help us become aware of what we are feeling and what our bodies truly need. Yes, our bodies do listen to our thoughts! It will believe anything and everything our minds tell it. Being mindful of your thoughts can help re-direct negative thoughts and thinking. Even though you won’t be able to always stop your mind from having negative thoughts, that’s okay, because thoughts are just thoughts.

: To learn more about practicing mindfulness exercises, click here.

Ask for Help: Whether it’s a friend, family member, or a professional, do not feel ashamed by needing to ask for help. Therapy with a psychologist or counselor, or even meeting with a nutritionist or dietician can be very beneficial! There, they can provide exercises and tools to help change thinking patterns from negative to positive in a healthy way.

Changing our mindset on our bodies, weight, self-image, worth, and habits is possible! We can learn to rewire our brains to change habits, and in turn make healthier choices and think more positive thoughts. Our brains are very complex and one of the most difficult to understand. As your mindset changes, your life will, too.

www.RMAP.com
Rocky Mountain Associated Physicians
801-268-3800
1160 East 3900 South, Suite 4100
SLC, UT 84124

Resources

Mayo Clinic Staff, “Stress Management”, Mayo Clinic, 2022, https://www.mayoclinic.org/health-lifestyle/stress-management/in-depth/positive-thinking/art-20043950
Luna Greenstein, “The Power of a Morning Routine”, National Alliance on Mental Illness, 9 Aug. 2017, https://www.nami.org/blogs/nami-blog/august-2017/the-power-of-a-morning-routine

The Connection Between Sleep and Weight

Mar 1 By rmap nurse

Learn more about weight loss surgery at Rocky Mountain Associated Physicians www.RMAP.com (801) 268-3800

It is well known that losing weight—or regain after bariatric surgery—is hard. Keeping weight off and maintaining can be just as challenging. There are few studies out there in the medical community still trying to straighten out the connections between sleep and weight, but there are some which emphasize the potential weight loss benefits of a good night’s sleep and negative health impacts of sleep deprivation.

New research suggests that adults who are better rested consume significantly fewer calories than those who are chronically sleep-deprived. A study published by JAMA Internal Medicine finds that people who sleep less consume more calories and foods that are high in calories. This is compared with people who sleep for longer periods.¹

The study concludes with the participants who slept an hour longer each night consumed an average of 270 fewer calories each day and lost about a pound compared to control group participants, who gained just under a pound on average.

The Link Between the Stomach and Your Appetite

True or false: Your appetite is linked to your stomach. Answer: False. Your appetite is actually controlled by the neurotransmitter’s ghrelin and leptin, not your stomach. The hormone ghrelin promotes hunger and increases appetite. The hormone leptin contributes to the sensation of feeling full. The body will naturally increase and decrease the levels of these neurotransmitters throughout the day, signaling the need to consume calories.²

Obesity and Sleep Deprivation

Depending on the cause, chronic sleep disruptions increase the risk of high blood pressure, heart attack, stroke, and irregular heartbeats.³

Past studies show that people who get less than 6 hours of sleep at night are more likely to be diagnosed as obese, though it’s difficult for these studies to determine cause and effect.⁴ Obesity in itself can cause an increase risk of developing conditions that interfere with sleep, such as sleep apnea. Though it’s unclear if not getting enough sleep is the cause of obesity, and/or if obesity is causing people to sleep less. Commonly, sleep-deprived individuals tend to choose foods that are high in calories and carbohydrates.⁵

Sleep and Losing Weight

Research shows that not getting enough sleep while trying to lose weight can sabotage the amount of weight lost and encourage the tendency to overeat.⁶ When treating obesity in adults, medical experts encourage improving sleep quality.

Sleep and Physical Activity

When you aren’t getting enough sleep, it can result in having less energy for exercise and physical activity. Exercise is essential and necessary to maintain weight loss and overall health. For example: walking, running, weightlifting, dancing, swimming, sports, etc. Listen to your body to see what time of day works best for you when working out in response to how well you sleep. For some individuals, exercising too late in the day can interfere with how well they rest at night.

Ways to Help Improve Sleep

It’s important to try and get adequate sleep, as well as quality sleep, as part of a healthy weight plan. Here we have put together some tips and suggestions that could help improve your sleep:

Keep to a regular sleep schedule
Sleep in a dark room; purchasing blackout curtains can help with blocking out light and noise
Don’t eat right before bed
Reduce stress
Become an early bird
Keep a sleep log
Monitor sleep times with wrist actigraphy devises such as smartwatches
Limit use of electronic devises at least 1 hour before bed
Turn temperature to a comfortable number
Exercise regularly

Healthy Looks Different for Everyone

Remember that good health and healthy looks and feels different for everyone. Health is a lifelong journey that includes not only healthy habits and eating nutritious foods, but by also having a healthy relationship with your body. Work closely with your doctor’s guidance, as well as keeping your own personal decisions in mind.

www.RMAP.com
Rocky Mountain Associated Physicians
801-268-3800
1160 East 3900 South, Suite 4100
SLC, UT 84124

Resources

Esra Tasali, MD, Kristen Wroblewski, MS, Eva Kahn, MS, et al Jennifer Kilkus, MS, RDN, Dale A. Schoeller, PhD, “Effect of Sleep Extension on Objectively Assessed Energy Intake Among Adults with Overweight in Real-life Settings”, JAMA Intern Med., 2022; 182(4):365-374. Doi:10.1001/jamainternmed.2021.8098, https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2788694
Karine Spiegel, Esra Tasali, Plamen Penev, Eve Van Cauter, “Brief Communication: Sleep Curtailment in Healthy Young Men is Associated with Decreased Leptin Levels, Elevated Ghrelin Levels, and Increased Hunger and Appetite”, Ann Intern Med., 2004 Dec 7; 141(11):846-50, doi: 10.7326/0003-4819-141-11-200412070-00008, https://pubmed.ncbi.nlm.nih.gov/15583226/
“Losing Weight, Especially in the Belly, Improves Sleep Quality, According to a John Hopkins Study”, https://www.hopkinsmedicine.org/news/media/releases/losing_weight_especially_in_the_belly_improves_sleep_quality_according_to_a_johns_hopkins_study
Yili Wu, Long Zhai, Dongfeng Zhang, “Sleep Duration and Obesity Among Adults: A Meta-analysis of Prospective Studies”, Sleep Med, 2014 Dec; 15 (12):1256-62, doi: 10.1016/j.sleep.2014.07.018, https://pubmed.ncbi.nlm.nih.gov/25450058/
Stephanie M Greer, Andrea N Goldstein, Matthew P Walker, “The Impact of Sleep Deprivation on Food Desire in the Human Brain”, Nat Commun, 2013;4:2259, doi: 10.1038/ncomms3259, https://pubmed.ncbi.nlm.nih.gov/23922121/
Marie-Pierre St-Onge, Andrew McReynolds, Zalak B Trivedi, Amy L Roberts, Melissa Sy, Joy Hirsch, “Sleep Restriction Leads to Increased Activation of Brain Regions Sensitive to Food Stimuli”, Am J Clin Nutr, 2012 Apr;95(4):818-24, doi: 10.3945/ajcn.111.027383, https://pubmed.ncbi.nlm.nih.gov/22357722/

Daniel R.’s Gastric Bypass Story

Feb 8 By rmap nurse

My journey started earlier in the year when I ended up at the ER for high blood pressure. I wasn’t feeling good and went to urgent care, and my blood pressure was at 299, so they sent me to the ER where I spent the night. After that, I set up an appointment to establish a regular doctor.

On the first visit, the doctor said with my weight, sleep apnea, prediabetes, and high blood pressure, that he recommended weight loss surgery. I told him I had already considered that and was looking into going to Mexico to do it. He told me that a lot of insurances cover [weight loss surgery] if it was medically necessary, and so I put in my paperwork with his recommendation. Part of that was to lose weight on my own first, which I lost 40-ish pounds in about a month. I saw a dietician and psychologist at St. Mark’s and then I got approved. I was super excited and nervous. I wanted to better my health so I can be around longer for my son, Daniel Cruz.

I finally got my surgery date, and a week before, my wife and I found out we were expecting a second child! That just backed up my decision even more that I was doing the right thing.

The week right after surgery, I ended up at the ER twice because my blood pressure dropped down to 43 and got severely dehydrated. I tried my hardest to stay hydrated, but it is very difficult to consume water for the first few weeks. It gradually got easier. At that point, I got taken off all my medicine and no longer needed my sleep apnea machine to sleep. I no longer snore while sleeping either! I only take my multivitamins and calcium chews!

I quickly started losing lots of weight and dropping sizes in clothes. Before I knew it, I went from using 5XL shirts and size 50 jeans to my current L-XL shirts and size 34 jeans. I can sit and put one leg on top of the other, which I had not done for over 20 years!

I also started being able to go on long walks and not be suffocating trying to catch my breath. I have been implementing better behaviors for my son as well.

I really enjoy playing with my children and being able to do more activities with them that I was not able to before. It’s always crazy and fun seeing people I had not seen for a long time, and seeing their reaction to my drastic changes.

For me, the only complications I had was the first week post-surgery, like I mentioned before. Besides that, I have been very blessed and lucky with my results. My goal the first year was to lose 150 pounds, and I hit that goal. This year, I am trying to lose another 30-50 pounds so that I can do skin removal surgery, then I want to get back into bodybuilding like I did when I was fresh out of high school!

There are times when I feel like I don’t recognize the person I see in the mirror, but inside, I am the same person, but better and healthier than before my surgery.

–Daniel R.
Surgeon: Dr. Rodrick D. McKinlay
Surgery: Gastric Bypass Roux-en-Y
Surgery Date: 12/13/21
HW: 433
SW: 397
CW: 253
TWL: 144

Stress and Weight Gain

Feb 8 By rmap nurse

Learn more about weight loss surgery at Rocky Mountain Associated Physicians www.RMAP.com (801) 268-3800

Stress brought on by challenges or demands that lead you to feel worried, frustrated, anxious, or upset can cause the body to react in a negative way. Not only can stress affect your physical health, it can impact your emotional and psychological health as well.

You could be familiar with the terms “emotional eating,” “stress eating,” “head hunger,” or “emotional hunger.” Any of these terms can affect your weight loss. When people stress-eat, they often keep eating even though they are no longer hungry. It could be hard not to mindlessly eat, not paying attention to how much or what they eat.

Eating in response to unpleasant or uncomfortable emotions most often means turning to “comfort” foods, such as ice cream, chocolate, cookies, cakes, potato chips, and fried foods to name a few. When people are in emotional turmoil, hardly are salads, veggies, or a type of protein-packed snack reached for. When foods are high in calories and low in nutrition, it is a recipe for some type of weight gain.

It’s no secret that life is stressful. How often have you found yourself saying, “life just happened,” or “I’m dealing with a lot of stress right now.” If you turn to food to make yourself feel better, feel like food makes you feel safe, or a quick fix to heartache or loneliness, these are indications that it could be from an emotional-eating standpoint and not actual physical hunger.

The bottom line is that stress can lead to the release of hormones such as cortisol, which stimulates your fat and carbohydrate metabolism, creating a surge of energy in your body, increasing your appetite. Elevated cortisol levels can cause cravings for sweet, fatty, and salty foods.¹

Ways to Help Manage Stress

Identifying how you feel, recognizing what you need, and choosing what to do instead of grabbing for unhealthy food options is an imperative habit to form to help avoid stress-eating. You could be thinking that’s easier said than done, but with committed effort and resilient determination, you can develop this new habit over time and keep up with your weight loss, too!

Practice Relaxation: This can be done through mindfulness meditation, yoga, or deep breathing. These options can help bring hormones down to normal levels.

Consume High-Quality Foods: Even though you might be having cravings or want a “quick fix,” try to aim for whole, plant-based foods. These foods will be turned into energy instead of being converted into fat and stored by the body.

Exercise: Getting out for a daily walk, run, or getting into the gym is an excellent way to manage stress hormones. Any type of movement, such as dancing, swimming, sports, hiking, etc. is considered exercising. So, make it fun and enjoyable to do!

Getting Enough Sleep: Following a regular sleep routine calms and restores the body. Sleep also decreases cortisol levels, which if you remember, cortisol is accountable for your fight or flight reaction to danger, increasing your heart rate in anticipation of a fight. Is has been studied that getting less than five hours of sleep a night has been linked to cortisol-related issues, such as high blood pressure.² Try to get at least 7-9 hours of sleep each night to avoid the rise in hormone levels.

Support Groups: Participating in groups provide an excellent opportunity to be surrounded by others who likely know and understand similar situations you could be experiencing. It is a judge-free zone where you can talk openly and honestly. You can express your feelings while getting feedback from fellow patients who can share their experience, and can give helpful tips which could work for you too. Rocky Mountain Associated Physicians (RMAP) believes it very beneficial to our patients to provide group therapy for all patients who wish to be supported in this way.

For more information on our support groups and how to join them, please visit here.

It is imperative to take care of yourself and prioritize yourself, which means taking the time to do things that help you live well and improve both your physical and mental health. These are just a few examples to help you begin implementing healthy habits into your daily life.

Don’t forget the most important thing during your life time…which is YOU!

www.RMAP.com
Rocky Mountain Associated Physicians
801-268-3800
1160 East 3900 South, Suite 4100
SLC, UT 84124

Resources

William Shaw, PhD; Susan Labott-Smith, PhD, ABPP; Matthew M. Burg, PhD; Camelia Hostinar, PhD; Nicholas Alen, BA; Miranda A.L. van Tilburg, PhD; Gary G. Berntson, Phd; Steven M. Tovian, PhD, ABPP, FAClinP, FAClinHP; and Malina Spirito, PsyD, Med, “Stress effects on the body”, American Psychological Association; 2018 Nov 1, https://www.apa.org/topics/stress/body
Leproult, G. Copinschi, O. Buxton, E Van Cauter, “Sleep loss results in an elevation of cortisol levels the next evening”, 1997 Oct; 20(10):865-70, https://pubmed.ncbi.nlm.nih.gov/9415946

The Negativity of Weight Stigma and Bias

Jan 25 By rmap nurse

Learn more about weight loss surgery at Rocky Mountain Associated Physicians www.RMAP.com (801) 268-3800

Have you ever been judged by others for your weight, and/or for your bariatric surgery? If so, you know firsthand the negative and harmful effects of weight stigma and bias.

The World of Obesity Federation defines weight stigma as “the discriminatory acts and ideologies targeted towards individuals because of their weight and size. Weight stigma is a result of weight bias. Weight bias refers to the negative ideologies associated with obesity.”

Weight stigma can result in devastating emotional responses such as depression, low self-esteem and anxiety, which can lead to even more potential consequences. However, weight stigma can affect more than the emotional health, but also on social and physical health. Some individuals have reported to intentionally avoid social gatherings or settings in order to remain isolated away from fear of being criticized.

Effects of Stigma on Physical Health

We know some of the emotional effects stigma can cause, but what about physical health?

Treatment: Some might avoid medical care for problems they are experiencing. This will cause barriers to the treatment and strategic prevention of obesity for the patient.

Eating Behaviors: According to Canadian Medical Association (CMA), weight stigma and shaming can actually cause eating disorders, such as binge eating, emotional eating, restrictive eating, weight cycling, and eating anxiety.¹

Stress: It has been studied and shown by the research of the American Psychological Association (APA) that stigma correlates with increased stress hormone levels. Stress, long-term or chronic, can have serious effects on our bodies, including the musculoskeletal, respiratory, cardiovascular, endocrine, gastrointestinal, nervous, and even the reproductive systems.²

Self-Harm or Suicide: In some instances, weight stigma is so severe that it has led to self-harm or suicidal ideations and acts. Although no studies to date have investigated the topic of body weight and suicide ideation, the prevalence of both obesity and suicide ideation has risen in the last several decades suggesting that obesity may increase the risk of suicide ideation.³

Places Stigma Can Take Place

The environment can also play a part in weight stigma—the chairs at the movie theaters, restaurants, and airlines are not designed to accommodate people with obesity. Medical tables and gowns are also sometimes unable to accommodate patients with obesity.

Schools and Educational Environments: According to Obesity Action Coalition (OAC), bullying has become an epidemic. In a national survey of overweight sixth-graders, 24% of the boys and 30% of the girls experienced daily teasing, bullying or rejection because of their size.⁴ But not only are students victimized, teachers can also commonly be victimized by their peers. For more information on bullying, please visit the following web sites:
- Education.com
  www.education.com/topic/school-bullying-teasing
- National Institute of Health
  nih.gov/news/health/sep2010/nichd-21.htm
- Centers for Disease Control
  cdc.gov/ncipc/dvp/electronic_aggression.htm

Workplace: It has been shown that employees who are obese or who carry excess weight are frequently treated poor or unfairly in the workplace.⁵ This can include unfair hiring practices, lower wages (women affected by obesity earn 6% lesser, and men earn 3% lesser, for work identically performed), harsher discipline from employees, wrongful termination, and negative stereotypes (for example: laziness, less competent, undisciplined, less ambitious, less productive).The article continues with some employers beginning to impose financial penalties, such as charging employees who are obese more in healthcare costs until they are able to reduce their body mass index (BMI).

Personal Relationships: This topic could by far be argued to be the most harmful to people affected by obesity. Being criticized by spouses/partners, parents, siblings and children, are the most common source of stigma comments, and can be the most damaging comments made, intentionally or not.

Healthcare and Medical Settings: Research done with support from the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) have shown that many healthcare providers strongly regard people with obesity with negative attitudes and stereotypes.⁶ This way of thinking can influence judgment, interpersonal behavior and decision-making, as well as person perceptions, and can then impact the care they provide to patients with obesity. Some healthcare providers can view obesity as an avoidable risk factor that hinders their ability to treat and prevent disease.

Social Media: Weight discrimination has increased significantly in the United States, as much as 66% between 1995 and 2006, and 71% of adolescents reported being bullied about their weight in the past year.⁷ Social media, such as Facebook, Instagram, Tik Tok, or Twitter could have both negative and positive influences on weight stigma. It has a potentially notorious role in both worsening and reducing weight stigma. In a study of college-age women at Utah State University, exposure to “thin-ideal” magazines and sites provoked higher body dissatisfaction, negative effect, eating disorder symptoms, and decreased self-esteem.⁸

Combating Weight Bias

Tackling weight stigma and bias requires a united effort from everyone. There are many ways to help prevent bias and get involved with the movement. This can be done starting with individual actions in your daily life, and ranges all the way down to speaking out for those who might think their voice doesn’t matter, or are being bullied or teased.

Use respectful language when talking to or about people affected by obesity. “Fat jokes” and certain vocabulary words are harmful and support society’s stigma. Modeling respectful language is a way to influence others to do the same.

Educate yourself and others to help understand that obesity is a disease with compound causes. This can also help harmful weight-based stereotypes and bullying in any setting.

The Obesity Action Coalition (OAC) have a Weight Bias Task Force that will take on any social media platform which displays weight stigma and bias in the media. You can contact them if you see any examples of weight-based stereotypes by going here.

We here at Rocky Mountain Associated Physicians (RMAP) encourage you to get involved, become educated, and help to make a difference in lessening weight stigma and bias. Use your voice, stand up for others, and help reduce the negative stigma associated with the disease of obesity.

If you or someone you know needs help, please contact the 988 Suicide and Crisis Lifeline. If you are experiencing mental health-related distress or are worried about a loved one who may need crisis support, please don’t wait or hesitate to reach out.

Call or text 988
Chat at 988lifeline.org

www.RMAP.com
Rocky Mountain Associated Physicians
801-268-3800
1160 East 3900 South, Suite 4100
SLC, UT 84124

Resources

Lauren Vogel, “Fat Shaming is Making People Sicker and Heavier”, Canadian Medical Association, v.191 (23); 2019 Jun 10, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565398/
William Shaw, PhD; Susan Labott-Smith, PhD, ABPP; Matthew M. Burg, PhD; Camelia Hostinar, PhD; Nicholas Alen, BA; Miranda A.L. van Tilburg, PhD; Gary G. Berntson, PhD; Steven M. Tovian, PhD, ABPP, FAClinP, FAClinHP; and Malina Spirito, PsyD, Med, “Stress Effects on the Body”, American Psychological Associated (APA), https://www.apa.org/topics/stress/body
Carlyn Graham, Michelle Frisco, “The Relationship Between Obesity and Suicide Ideation Among Young Adults in the United States”, SSM Popul Health, 2022, Jun, 18: 101106, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9079098/#:~:text=Obesity%20is%20highly%20stigmatized%20in,suicide%20ideation%20among%20young%20adults
JoAnn Stevelos, MS, MPH, “Bullying, Bullycide and Childhood Obesity”, Obesity Action Coalition, Winter 2011, https://www.obesityaction.org/resources/bullying-bullycide-and-childhood-obesity/
“Weight Bias in the Workplace”, Obesity Action Coalition, 2015, https://www.obesityaction.org/wp-content/uploads/Weight-Bias-in-the-Workplace.pdf
SM Phelan, DJ Burgess, MW Yeazel, WL Hellerstedt, JM Griffin, M van Ryn, “Impact of Weight Bias and Stigma on Quality of Care and Outcomes for Patients with Obesity”, National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), 2015 Apr; 16(4): 319-326, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381543/
Olivia Clark, Matthew M. Lee, Muksha Luxmi Jingree, Erin O’Dwyer, Yiyang Yue, Abrania Marrero, Martha Tamez, Shilpa N. Bhupathiraju, Josiemer Mattei, “Weight Stigma and Social Media: Evidence and Public Health Solutions”, 2021 Nov 12; 8: 739056, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8632711/
Nicole Hawkins, P Scott Richards, H Mac Granley, David M Stein, “The Impact of Exposure to the Thin-Deal Media Image on Women”, 2004 Spring; 12(1):35-50, https://pubmed.ncbi.nlm.nih.gov/16864303/

Upcoming Educational Seminars for February 2023

Jan 25 By rmap nurse

Learn more about weight loss surgery at Rocky Mountain Associated Physicians www.RMAP.com (801) 268-3800

If you or someone you know is considering weight loss surgery, we invite you to attend a free educational seminar.

Here you will learn from our education team, including one of our bariatric surgeons, information specific to Gastric Bypass, Gastric Sleeve and Duodenal Switch (DS) surgery. In this seminar we discuss benefits, risks and expected outcomes of weight loss surgery. You will also have a chance to ask the surgeon your specific weight loss surgery questions.

Hear more about weight loss surgery from each of our surgeons.

Dr. Steven C. Simper
Dr. Rodrick D. McKinlay
Dr. Nicholas J. Paulk
Dr. Douglas C. Greer

Upcoming Seminars:
– *Due to Tuesday, February 14th being a holiday, this seminar date has been canceled*
– Tuesday, February 28th @ 5:30 PM

In-person space is limited so give us a call today at (801) 268-3800, or join us virtually via WEb-Ex by signing up here.

www.RMAP.com
Rocky Mountain Associated Physicians
801-268-3800
1160 East 3900 South, Suite 4100
SLC, UT 84124

Bariatric Surgery Aftercare

Jan 11 By rmap nurse

Learn more about weight loss surgery at Rocky Mountain Associated Physicians www.RMAP.com (801) 268-3800

The surgeons and staff here at Rocky Mountain Associated Physicians (RMAP) want to see our patients achieve their goals, as well as have a lifetime of success with their new tool and healthy behaviors we have educated them on. We seek to be a partner in your journey for health, not just for the first year of weight loss, but for life. This could be means of annual bloodwork, support groups, continuing education of the bariatric world, and annual follow-ups. We want to help keep you on track and provide a place for you, our patients, for when you feel overwhelmed. Bariatric surgery is life changing, and it will change your way of living for the rest of your life!

Your follow-up care with us is important! It is to help us monitor your health and weight status, but also assist you in establishing patient-selected incremental goals as well as long-term goals.

There are numerous reasons as to why you should continue to follow-up with your surgeon and bariatric clinic after weight loss surgery. Here we have listed three of the top reasons why:

Annual Bloodwork: Bloodwork is important after bariatric surgery so that we can monitor your vitamin levels and overall health. We can see if anything looks amiss, causing unusual symptoms you might be experiencing, any deficiencies developing, or the reason why some unexplained or unwanted weight loss or gain could be happening.

We have our patients do annual bloodwork every year after surgery. Your family physician or our office can order them once to two weeks before your annual visit. The tests you need are:

Comprehensive Metabolic Panel
Lipid Profile
CBC with diff
Vitamin B-12 level
Thiamine (Vitamin B1) level
Folate
Hemoglobin A1c

***You must be fasting 6 hours prior to blood draw.

Duodenal Switch patients
Get all of the labs listed above PLUS

Vitamin A level
Vitamin D level
Protime

Mail or fax a copy of these tests to our office. The tests will be reviewed by your surgeon and placed in your chart. Fax number: (801) 268-3997.

Keeping You on Track: After the weight loss stage, it can be easy to lose focus of the guidelines and education materials we have provided for you. Understanding that the necessary adjustments to your present behaviors are yours to make, we are here to help in any way we can! Having someone else following your achievements and setbacks could help you stay on track with your weight loss results and maintenance goals. We could provide education and our professional advice if you find yourself straying, getting off track, or becoming overwhelmed with the anatomy changes of weight loss surgery.

Your Overall Health: In addition to getting bloodwork done annually, our surgeons and medical staff members like to follow our patients to continue monitoring their health in general; the positives—no more CPAP, remission of diabetes, doing activities you were unable to do before—but also the complications that can occur after surgery—vitamin deficiencies, gas, diarrhea, bowel blockage, hernias, excess skin. Additional testing could be necessary after surgery, so keeping your follow-up appointments with us is essential.

Post-Op Visits

You should schedule an appointment to see your surgeon/assistant for follow-up visits at:

3-4 weeks (scheduled at the time of your surgery orientation class)
2 months
4 months
6-8 months
1 year or additionally as requested by your surgeon
Annually thereafter

Bariatric surgery is undoubtedly a major lifestyle change, and it takes strong determination and commitment to have long-term success. Your surgeon, nurses, and health staff are your unified team with your best interests in mind. We want you to reach improved health and experience an enriched quality of life. We want to be a partner in your health and along for your weight loss journey.

Keep in contact with us, and attend the weekly support groups we provide for our patients regularly.

www.RMAP.com
Rocky Mountain Associated Physicians
801-268-3800
1160 East 3900 South, Suite 4100
SLC, UT 84124

The Impact of Fast Foods on Your Health

Welcome Erika Reichard to the RMAP Team!

Habits Sabotaging Weight Loss

Mindset Over Weight: Resetting Your Brain

The Connection Between Sleep and Weight

Daniel R.’s Gastric Bypass Story

Stress and Weight Gain

The Negativity of Weight Stigma and Bias

Upcoming Educational Seminars for February 2023

Bariatric Surgery Aftercare

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