Jann

I know not everyone wants to know how things work, it's enough to know that they do, but I found this series to be facinating! Jann http://health.howstuffworks.com/fat-cell.htm How Fat Cells Work by Craig Freudenrich, Ph.D. Freudenrich, Ph.D., Craig. "How Fat Cells Work." 27 October 2000. HowStuffWorks.com. <http://health.howstuffworks.com/fat-cell.htm> 06 October 2008. Inside this Article Introduction to How Fat Cells Work Body Fat Basics Fat Storage Breaking Down Fat Lots More Information See all Cells & Tissues articles What Are the Odds? Obesity A little more than half of the adults in the United States are overweight. Statistics show that an incredible 65.2 percent of the U.S. population is considered to be "overweight" or "obese." According to the Centers for Disease Control and Prevention (CDC), obesity and overweight status is determined in adults by finding a person's "Body Mass Index" or BMI. BMI is a calculation that takes into consideration both a person's body weight and height to determine whether they are underweight, overweight or at a healthy weight. An adult who is considered "overweight" has a BMI somewhere between 25 and 29.9. An adult with a BMI of at least 30 is considered "obese." This measurement is used because it's typically a good indicator of body fat. Whether due to concern for related health risks (high blood pressure, heart disease, diabetes, sleep apnea, respiratory problems, etc.), or just for sheer aesthetics, many Americans worry about fat. In fact, at this very moment, thousands of Americans are exercising or dieting to reduce their amount of body fat. But have you ever wondered what fat is? When a person "gets fat" -- gains weight -- what is actually happening inside the person's body? What are "fat cells" and how do they work? In this article, we will look at the world of the fat cell. We will examine where fat cells are located, how they store fat and how they get rid of it. Where's the Fat? Fat, or adipose tissue, is found in several places in your body. Generally, fat is found underneath your skin (subcutaneous fat). There's also some on top of each of your kidneys. In addition to fat tissue, some fat is stored in the liver, and an even smaller amount in muscle. Where fat is concentrated in your body depends upon whet her you are a man or woman: An adult man tends to carry body fat in his chest, abdomen and buttocks, producing an "apple" shape. An adult woman tends to carry fat in her breasts, hips, waist and buttocks, creating a "pear" shape. The difference in fat location comes from the sex hormones estrogen and testosterone. Fat cells are formed in the developing fetus during the third trimester of pregnancy, and later at the onset of puberty, when the sex hormones "kick in." It is during puberty that the differences in fat distribution between men and women begin to take form. One amazing fact is that fat cells generally do not generate after puberty -- as your body stores more fat, the number of fat cells remains the same. Each fat cell simply gets bigger! (There are two exceptions: the body might produce more fat cells if an adult gains a significant amount of weight or has liposuction performed.) Body Fat Basics The human body contains two types of fat tissue: White fat is important in energy metabolism, heat insulation and mechanical cushioning. Brown fat is found mostly in newborn babies, between the shoulders, and is important for thermogenesis (making heat). Since adult humans have little to no brown fat, we'll concentrate on white fat in this article. See the bottom of this page for more on brown fat. Fat tissue is made up of fat cells, which are a unique type of cell. You can think of a fat cell as a tiny plastic bag that holds a drop of fat. White fat cells are large cells that have very little cytoplasm, only 15 percent cell volume, a small nucleus and one large fat droplet that makes up 85 percent of cell volume. How Fat Enters Your Body When you eat food that contains fat, mostly triglycerides, it goes through your stomach and intestines. In the intestines, the following happens: Emulsification in Your Kitchen When you add water to a greasy skillet, the grease forms a layer on top of the water. If you squeeze one drop of dishwashing liquid into the center of the skillet, you'll see the large grease layer immediately break up into small droplets. Large fat droplets get mixed with bile salts from the gall bladder in a process called emulsification. The mixture breaks up the large droplets into several smaller droplets called micelles, increasing the fat's surface area. The pancreas secretes enzymes called lipases that attack the surface of each micelle and break the fats down into their parts, glycerol and fatty acids. These parts get absorbed into the cells lining the intestine. In the intestinal cell, the parts are reassembled into packages of fat molecules (triglycerides) with a protein coating called chylomicrons. The protein coating makes the fat dissolve more easily in water. The chylomicrons are released into the lymphatic system -- they do not go directly into the bloodstream because they are too big to pass through the wall of the capillary. The lymphatic system eventually merges with the veins, at which point the chylomicrons pass into the bloodstream. You might be wondering why fat molecules get broken down into glycerol and fatty acids if they're just going to be rebuilt. This is because fat molecules are too big to easily cross cell membranes. So when passing from the intestine through the intestinal cells into the lymph, or when crossing any cell barrier, the fats must be broken down. But, when fats are being transported in the lymph or blood, it is better to have a few, large fat molecules than many smaller fatty acids, because the larger fats do not "attract" as many excess water molecules by osmosis as many smaller molecules would. In the next section, we'll look at how fat is stored in your body. Brown Fat: Making Heat When you are first born, your body does not have much white fat to help insulate and retain body heat; although there are white fat cells, there is not much fat stored in them. Brown fat cells are somewhat smaller than white, are composed of several smaller fat droplets and are loaded with mitochondria, which can generate heat. A newborn baby produces heat (a process called thermogenesis) primarily by breaking down fat molecules into fatty acids in brown fat cells. Instead of those fatty acids leaving the brown fat cell, as happens in white fat cells, they get further broken down in the mitochondria and their energy is released directly as heat. This same process occurs in hibernating animals, which have more brown fat than humans. Once the newborn baby starts eating more, developing layers of white fat, the brown fat goes away. Adult humans have little or no brown fat. For the rest of the article go to the embedded website.

Hehe! Me too! I'm the queen of cigarette avoidance now! Course, hubby isn't appreciating me spraying OUST in his general direction every time he lights a smoke!

You are the rock star I said you'd be girl! Hugs!

Again, take a really deep breath and ask yourself why you went through banding surgery and what it means to you. One of the things that I found when I had to force myself to gain weight after August's non related surgery was that I lost my internal compass in that process. I was in the hospital for tantamount to a month and stoned on morphine for the same amount of time. (They took my tubes, ovaries and some colon) I forgot some major rules of banding which confused me. What I'm saying is that if you don't know or remember exactly what it is that you are supposed to be doing you can't succeed. Knowledge is power. I was clearly lost (even having lived a good band-life from June to August) and had to sit down and re-read my WLS books and get my act back together and sounds to me that you have to sit down and re-read all your band-life materials. The band isn't the end all be all, you have to do a lot of the work on your own, the band is just there to give you a swat now and again. If you read every single forum on banding on the internet there is one absolute, you really don't ease into band restriction until the third or fourth fill. It's a slow behaviour modification process designed to help change your thinking about how you eat. You need to dig in deep and get some self control. For me it was the thought of hurting my investment (the band) and myself. For you that doesn't appear to be the trigger. You have to find what works for you whether that's painful joints, limited mobility, limited lifestyle, difficulty breathing, arms length relationships, shut-in lifestyle, early death -- whatever pushes your buttons, only you know what that is. We can be one your supports but we can't do your work for you and neither can the band. Can you see the hard point I'm making? At the end of the day it's all on each of us to manage our bands, our choices and our lives. Please don't misunderstand that I'm being mean to you. I'm not, I'm just really concerned. You need to find the tools that will work for you to get you started down the right path. Is there a band group in your area? Does your medical provider have a WL group you can join? Is there a counsellor that you can speak to about emotional eating if that's something that plagues you? If you are visual make a list of everything you know you are doing wrong and everything you know you are doing right. If you are not sure if it's right or wrong ask. People on this forum do care and they will respond. Maybe create a goal sheet with a series of mini goals and once a month or every two weeks a bigger goal to work towards and celebrate that success, whatever works for you but structure a program for yourself that keeps you accountable. For me having to write down what I eat and a graph of my WL keeps me on track. For a very successful bandster, MamaMichelle, it was taking photos of herself and having goal clothing. Everyone has a different way of getting there. Find what works for you! I find as added incentive that I seek out the before and after photos that are all over the internet. Look at all of our own success stories -- go into the gallery here. It totally reinforces the choices I make! I don't mean to sound preachy, that's not my intent and I'm hardly perfect but your post scares me. Pizza day two? You've put yourself at risk and in harm's way, hun. You are NOT destined to be fat -- you just need to re-educate yourself and keep your eye on the prize -- your health and your new life. Godspeed!

http://video.about.com/weightloss/Tummy-Tuck.htm A very good video in cartoon format of exactly what a tummy tuck is! http://video.about.com/weightloss/Laparosc...ric-Banding.htm A very good high over-view video in cartoon format of exactly what the lapband is and it's purpose! Jann

Top 5 Emotional Eating Triggers By Jennifer R. Scott, About.com About.com Health's Disease and Condition content is reviewed by our Medical Review Board Filed In:Weight LossThese questions will help you to learn more about your emotional eating triggers and plan alternative behaviors. Stress & Anxiety When stress rears its ugly head, do you soothe yourself with comfort food? Does a pint of ice cream quell those butterflies in your tummy? Loneliness Does a Saturday afternoon home alone lead you to eating more than your share? Do you reach for the fridge when you feel a twinge of loneliness? Anger Do you get the urge to over-eat when you are mad at someone, annoyed or frustrated with yourself? PMS Do cravings coincide with your monthly cycle? Are you constantly hungry during your period? Sadness & Depression When you have the blues, does it seem you can never feel full? Do you feel so bad that only binge eating reduces the sadness? http://weightloss.about.com/od/emotionaleating/index_a.htm contains some good information if you click on the link -- Jann

How do I get rid of loose skin after weight loss? By Paige Waehner, About.com Updated: September 25, 2008 About.com Health's Disease and Condition content is reviewed by our Medical Review Board Question: How do I get rid of loose skin after weight loss? Answer: Loose or saggy skin can be a common problem after losing a large amount of weight (more than about 50-100 lbs) in a short period of time. In time, you may see improvements in your skin's elasticity, but some people may require surgery to remove excess skin. According to Plastic Surgery Guide Natalie Kita, the main factors involved in your skin's elasticity include: Age: As you get older, your skin becomes less elastic. Genetics: Genes influence how much firmness your skin retains as you get older. How much weight you lose: When you lose a large of amount of weight in a short time, such as with weight loss surgery, your skin doesn't have time to shrink along with your body and may be permanently stretched if you're overweight for a long period of time. Sun exposure: Your past, present and future exposure to the sun can damage your skin. Nutrition and water intake: Your skin may not be as healthy or firm if you aren't getting balanced nutrition, vitamins and minerals (especially Vitamins C & E) and staying hydrated. Smoking: Smoking can speed up the normal aging process of your skin. What You Can Do About It Because we're all different, each person will have a different response after losing weight. Some people may bounce back quickly while others may need to consider body contouring surgery to get rid of extra skin. Natalie recommends waiting at least a year after weight loss before considering plastic surgery to allow your weight to stabilize. Remember that body contouring surgery is an expensive and serious surgery requiring a long recovery time. You may be able to make a difference with other options, such as exercise and a healthy diet. A basic cardio and strength training program can help you reduce body fat while building muscle. When you add muscle, you can improve how the skin looks and may be able to reduce some sagging. Avoiding Loose Skin The best way to avoid loose skin is to lose weight slowly, about 1-2 pounds per week. Slow weight loss allows you to maintain muscle mass while losing fat and it also allows your skin to adjust as you lose weight.

You are not "just Heidi", you are "Heidi!" there is a difference! It's time to make it all about you (never discluding the children of course). I wish you luck and love on your new journey. Jann

Unless something changed very recently Dr. Botha doesn't take Mexican patients. A couple of months ago he was looking into legal liability issues to maybe change that. Dunno about Mitchell. Dr. Descouteax hasn't stopped doing fills, he just isn't taking on new patients right now. Jann

I'm sorry to hear about all your stress, Flan. I have to say however you are stunning! I hope all is well in your world now. Hugs, Jann

Trudy, seriously quit beating yourself up so violently! You regressed and you know it clearly. Take a deep cleansing breath and start again. Try journaling it and see if you can source out what triggered you self sabotaging, the why goes deeper and requires a ton of introspection. Maybe you are a visual girl and that will help. Go back and read the guidelines and get back on track. Being on the run is a convenience lifestyle and you have to adapt band-living to that convenience as LisaL suggested but it's going to take some upfront work on your part. You are going to be okay, just jump out of this negative cycle and re-commit. You can do this, you know you can! Jann

How cool is that?! Gratz!!!! Jann

Welcome!! Jann

I expect I'll get slammed for this answer but if you can make the decision to drastically change your life with the band smoking can't be that far behind, can it? I've smoked a pack a day for over 25 years and I quit before I went into the hospital in August. I haven't smoked since. My issue is my hands out of habit reach for the package, my body doesn't want the nicotine the behaviour of smoking wants attention if that makes any sense. I take the tools I've learned through banding and apply it to not smoking. I change my focus, do not have cigarettes anywhere near me (hubby still smokes) and removed all ashtrays from my vicinity. So far so good ... Jann

WOW! I pay $100.00 a fill at the PLC and Alberta Health pays as a normal part of health care for the rest should something be a problem with the band. A thousand a year seems a bit steep? Jann

I found this on the system -- http://www.lapbandforum.com/index.php?showtopic=6560. Also Andrew Gaffney, Med Info was very helpful to me when I decided to get my band. He hooked me up with Dr. D. Try giving him a shout. I cannot find his email address -- anyone? Lori at OCC should know how to get in touch with him? Lori??Jann

Sweetie, not to make light of how you feel, you are certainly entitled to it -- good Lord! This too shall pass and you will come out of it stronger and even more determined. I know it doesn't feel like that right now but wait for it, it will happen. Since I can't do my full program I've decided that when I take the time to watch TV, for example, I'll keep some five pound weights behind the sofa and do some upper body workouts. Last night I did some stretching from the hips up. At least that way I feel like I'm still accomplishing something. Just keep seeing that healthy thinner girl in your mind's eye and it will all come together for you! Warm hugs! Jann

Thank you Kitty! It's all good now. Jann

That is absolutely wrong on every level. I'm finding generally speaking more and more that fill doctors do not tend to be warm and fuzzy, have very little dialogue and there are definitely prejudices with Mexican patients. It's more like poke and pay. If you can find a group like Julie outlined you are truly blessed. Clearly they are out there! If I hadn't done all my own homework along the way I would be absolutely clueless about band-life. I'm sorry you had to go through that. My first fill hurt like hell I'm told because of the scar tissue but the second one was way easier. Depending where you go for fills they tend to go small for the first two or three fills to see how your body adapts. I'm at a comfortable fill level right now at 1.8 cc in a 4 cc. I hope your next fill experience is a better one!

Beyond a shadow of a doubt the band was the best decision I ever made but it's a learning process for sure. I went from 2XL to medium. I can't even remember the time prior to this that I was that size. I feel good, my joints feel good, my clothes no longer have that stuffed sausage feel (in fact they are too big again). For the first time in years I can tuck my blouse in and wear a belt! (Also a medium! YAY!) I've been lucky and I have no hanging skin due no doubt to the slow process weight loss with the band. Everything is coming together beautifully as far as I can tell. It's very weird to catch your own reflection in the windows at the mall and have to take a moment to connect that it's you! I don't know if any of that helps but I really am happy I went with the band and despite the assembly line approach and lack of communication at OCC I would absolutely go back to TJ to have the surgery done. Please make sure you do your homework and set up your aftercare program locally even if you do choose to go back to OCC for fills if you use them. Read Julie's posts for good arguments on having a local back-up plan. Good luck with your decision! Jann

OMG, you are my hero! Nice work!!! Jann

Excellent post! Thanks for that. Jann

LOOK at you GO! Well done! That's impressive! Jann

The initial outlay for protein shakes and vitamins was about the most expensive. My food costs have definitely reduced significantly!

I have 1.8 cc in a 4 cc band over two fills and I haven't had an issue. I have heard however that air sometimes does get into the band and dissipates. I would check with your next fill, if there is a loss then I'd be concerned.