Permanent weight loss – here’s what I’ve learned from my patients
How to lose weight for good according to Dr. Lisa Lynn Sowder’s weight loss patients.
I am a bit of an expert on weight loss, not because I have ever had major weight loss, but because I know so many patients who have and have been able to maintain their weight loss. These are patients who come to me for body contouring procedures such as abdominoplasty, breast lift, upper arm lift, thigh lift, flank lift, lower body lift and so forth.
I always ask them how they managed to finally lose the weight and keep it off. I ask them to go into some detail. This is not because because I want to write the next “diet bestseller” and buy a small island in Greece (although that would be nice) but because I want to pass on their secrets of success to other patients who struggle.
About 40% of my weight loss patients have undergone weight loss surgery. That’s another blog. The other 60% have done it through life style changes. Here is what that 60% have told me:
Without exception, they have all sworn off sweets and refined carbohydrates.
Many have embraced a very low carb diet – think Adkins diet.
Almost all have maintained regular aerobic exercise – walking and biking are the most popular with my patients.
A few of my patients have been helped with nutritional guidance from a physician or nutritionist.
I cannot remember a patient who mentioned a prepackaged food or liquid diet system.
And here are a few patients I will never forget:
One gentleman lost 60 pounds when he quit drinking with the help of Alcoholics Anonymous.
One lady was able to stay 180 pounds overweight despite her gastric bypass through continuous and careful overeating. She finally dropped her weight 150 pounds when she addressed her emotional issues with a psychologist and the help of Overeaters Anonymous.
One lady lost over 100 pounds by jogging. She started really, really slow and got faster and faster as she lost weight. She became addicted to a runners high which I guess is better than most addictions.
Several of my patients were able to slim down only after leaving a dysfunctional relationship.
One teenager lost 40 pounds just by giving up soda.
One lady in her 60’s lost 100 pounds after having bilateral knee replacements. She had been very, very sendentary and once pain free, became more active.
So there you have it folks; Dr. Sowder’s Guide to Slow, Deliberate, Difficult, Soul Searching, Sweating, Hungry but Long Term Weight Loss. Just think, I could have written that best seller and here I am just giving it away.
Seattle Plastic Surgeon blogs about spitting stitches a.k.a stitch abscesses a.k.a. a real pain for both patient and surgeon
Healing after surgery in most cases is uneventful. (Uneventful is a good thing when it comes to surgery and flying.) But sometimes uneventful healing can be interrupted by a stitch abscess which always looks way worse than it actually is.
Spitting stitches can occur whenever stitches are left in after surgery. In plastic surgery, we often close incisions just under the surface of the skin with stitches that dissolve over several months. If one of these stitches is a little too close to the skin surface, or works its way up towards the surface, it can cause a stitch abscess which is the skin’s reaction to a foreign substance (in this case the stitch). This is a lot like having a splinter in your foot or finger. It won’t get better until the splinter is removed. The same for a stitch abscess. It won’t get better until the stitch is removed. If you have had surgery and have a little area like in the photo above, give your surgeon a call and make an appointment to be seen. In the meantime, put some warm, moist compresses on the area and don’t freak out! It will be okay!
In most cases, a gentle probing with some sterile tweezers locates the offending stitch and it can be easily removed and the abscess resolves quickly. Sometimes, I will put a patient on antibiotics for a week or so if the inflammation is pretty wide spread or the patient feels lousy and/or is running a fever.
Back in the old days when silk and cotton sutures were used in the deep layers, patients could spit a stitch decades after surgery. Fortunately that is really rare these days although I have had a few patients myself spit permanent stitches years after surgery. It’s just one of those things that can happen but once the suture is removed, healing occurs quickly. Learn more here.
Seattle Plastic Surgeon shares her dog toy wisdom.
My aussie/border collie/snapping turtle, Stella, just loves her Henrietta and Earl chew toys. Henrietta emits a high pitched squeal when chewed. Earl produces a realistic flatus-like sound. Stella, Henrietta and Earl make for some great hilarlity – for about 30 seconds.
Henrietta and Earl do, however, have some redeeming qualities in that they are very useful for obesity education.
Henrietta has a problem with external obestiy. Her excess fat is mostly external and distributed kind of all over – her hips, back, chest, upper thighs and tummy. This fat is unsightly but not much of a health issue.
Earl, on the other hand, has the dreaded internal belly fat. Earl, who has an inappropriately elevated level of self esteem, will say, “It’s muscle, not fat. Feel it, baby, it’s hard.” Well, it’s not muscle, Earl. It’s belly fat and it puts Earl at risk for diabetes, high blood pressure, stroke, heart attack, etc.
Henrietta’s fat is best addressed with weight loss but it can also be addressed with breast and body contouring surgery. Earl’s fat on the other hand can only be addressed with weight loss. Surgery cannot remove Earl’s internal fat although Stella is doing her best to chew it off.
Thanks for reading! Easily asmused Seattle Plastic Surgeon, Dr. Lisa Lynn Sowder
An article in the Seattle Times today confirmed that Seattle has had one of the wettest, coldest springs in recorded history. My Vitamin D level is probably undetectable. But……..
I still love it here and here is why. Earlier this week I was at the annual meeting of the American Society for Aesthetic Plastic Surgery (www.surgery.org) and got a little taste of what patients in some other parts of the country want in the way of plastic surgery. When it comes to breast implants, it’s “go big or go home”. Ditto for buttocks. Ditto for lips. With liposuction, it is the six pack look for women. Some of these patients after surgery reminded me of some comic book heroines.
I love having patients who have a healthy and realistic idea of what the beautiful human form ought to look like. Almost all my patients share my idea that it would be nice to come out of surgery looking like it could have – on a very good day – occurred in nature.
Maybe my low Vitamin D is just making me cranky, but I just don’t like that totally fake look and (as further proof of an ever loving God), neither to 99% of my patients.
Seattle Plastic Surgeon Reveals Some Very Shady Before and After Photos.
I get buried in advertisements for the newest, latest, greatest, you gotta have it, gizmos that are supposed to make my practice and my results and my life in general even better that they already are. Of course, these gizmos average about $100,000 and – this is what really fries me – they are rarely available for demo prior to purchase. This is sort of like buying a fancy new car without a test drive.
Another thing that fries me is some of the very, very misleading advertisements that many of the manufacturers try to pass off as real results. Here is an example. This is from an ad for a non-invasive fat removal system that uses energy that passes through the skin and is directed at the fat layer. Wow, what a difference until you look carefully. (Plastic surgeons are trained to look carefully.) In the photo on the right, Mr. Sixpack is pinching a fat roll that starts above his bellybutton and in the photo on the right, he’s pinching a fat roll that starts below his bellybutton. So obviously the more fat pinched, the thicker the roll. I can do this myself – big fat roll and little fat roll. I bet you can do it too!
Okay, and just one more thing that fries me, and then I’ll stop, at least until my next blog entry: Most of these new technologies are marketed heavily to non-plastic surgeons. The family practice doc or gynecologist or even (I’m not making this us) ophthalmologist who may want a little piece of the cosmetic surgery action may see this ad and go, “Wow, I must have one of these!” These docs are not experienced with liposuction or other body contouring and may not look at these photos as carefully as a real plastic surgeon. So these non-plastic surgeons buy one, it doesn’t work very well but they have to keep promoting it and using it and in some cases, giving patients a really raw deal because they have already dropped $100,000 on it and they can’t sell it because after a while, everyone knows it doesn’t work very well. So beware of non-plastic surgeons using the “latest technology”. They likely just don’t know any better.
Seattle Plastic Surgeon discusses possible hazards of removal of superficial fat.
The Wall Street Journal recently ran an article about non-surgical fat removal using two different devices. One freezes the fat under the skin and the other zaps the fat with a laser than is focused under the skin. These two procedures basically kill the fat cells, they leak out all their fat and then the body removes the fat droplets, metabolizes and excretes the fat. Over weeks to months, the treated areas slim down.
Does that sound sweet or what??? But stop and think about it…………
The fat treated this way and with other techniques like liposuction, tummy tucks and body lifts is subcutaneous fat. It’s just the fat that resides under the skin and is harmless as far as overall health is concerned. Yeah, it’s unsightly and can get in the way but it’s harmless.
Visceral fat, on the other hand is bad news. This is the fat that is internal and encases and infiltrates the internal organs. This is the fat that causes the “beer belly” in many men and in some women. This is the fat that makes one an “apple” as opposed to hip and thigh fat that makes one a “pear”. Visceral fat produces all sorts of bad substances that lead to metabolic and cardiovascular disease and cancer.
Stay with me here. If subcutaneous fat cells are removed using fat removal methods and the patient gains weight, those fat cells are not around to enlarge and store the excess fat. Soooo….the amount of visceral fat may increase instead. A person may have slimmer hips or thighs or their love handles may be smaller, but their “beer belly” and all the health issues that go with a “beer belly” may increase.
It always bears repeating what I have been telling prospective patients for years. Liposuction and body contouring such as tummy tuck and lower body lifts is for patients that are at a healthy and stable weight. These procedures are not to be used as a substitute for diet and exercise. They are only for the left over, stubborn bulges and/or lax skin. Using these procedures as a weight loss tool will leave many patients disappointed and, if patients gain weight after surgery, at increased risk for obesity related diseases.
@lisalynnsowder
