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Formerly Overweight Nurse Loses Over 70 Lbs.: 'I Didn't Want to Be a Contradiction to My Patients' PEOPLE.com Megan McGee started gaining weight when she got involved in an unhealthy relationship. I stopped doing all the things I used to do like seeing friends and going to the gym, so I became quite isolated, the Middlesex, England-based nurse, 26, tells PEOPLE.

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How Half Their Size Weight-Loss Winners Stay Motivated Plus Healthy Tips From Dr. Travis Stork! PEOPLE.com Half Their Size's Christina Jordan, Ashley O'Reilly and Lindita Halimi lost nearly 400 lbs. total, but they are still as motivated as ever. If you're struggling with your weight, don't worry, you got this, says Jordan, a mother-of-three who lost over ... and more »

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How Half Their Size Weight-Loss Winners Stay Motivated Plus Healthy Tips From Dr. Travis Stork! - PEOPLE.com

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'This Is How I Lost Nearly 200 Pounds While Constantly Traveling For Work' Women's Health Things began shifting for me when I saw one of my coworkers from another office the day he started a weight loss program called Take Shape For Life. He was hungry, and we were all teasing him. When I went back to his office five months later, I didn't ...

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May 26, 2017 The four images indicate the degree of microbial diversity in the gut in normal patients as well as in obese patients before and after undergoing two types of weight-loss surgery.The normal human gut has a high degree of microbial diversity, considered important for the maintenance of health. Obese patients have lost much of this diversity and while laparascopic band surgery effectively leads to weight loss, the low microbial diversity condition remains.By contrast, gastric bypass surgery results in the restoration of microbial diversity in the gut, though the composition of microbes is distinct from both normal weight and obese patients. Credit: Jason Drees for the Biodesign Institute

Obesity, already a global epidemic, is on the rise. Over one third of the U.S. population is currently afflicted, according to the Centers for Disease Control and the monetary costs alone are approaching $150 billion dollars annually. Causes of the epidemic include changing diets and greater sedentism, though environmental factors may also contribute.

A new study compares the two most common surgical therapies for obesity, known as Roux-en-Y gastric bypass (RYGB), and laparoscopic adjustable gastric banding (LAGB). The results demonstrate that RYGBthe more aggressive of the two surgeries produces profound changes in the composition of microbial communities in the gut, with the resulting gut flora distinct from both obese and normal weight patients. The results are likely due to the dramatic reorganization of the gut caused by RYGB surgery, which increases microbial diversity. The new research paves the way for new diagnostics and therapies for obesity.

The gamut of adverse health effects associated with obesity is broad, including such devastating illnesses as type 2 diabetes, coronary artery disease, stroke and certain forms of cancer. Patients often suffer loss of mobility, social isolation and inability to work. Currently bariatric surgery is the most effective treatment for morbid obesity, in terms of significant and sustained weight loss.

In the new study, appearing in the current issue of the Nature Publishing Group journal International Society for Microbial Ecology (ISME), Zehra Esra Ilhan, Rosa Krajmalnik Brown and their colleagues at the Biodesign Institute at ASU, along with researchers from Mayo Clinic, and Pacific Northwest National Laboratory, explore microbial communities in the human gut following RYBG and LAGB surgeries.

The results confirmed their earlier research with a smaller sample size, showing that in the case of the more aggressive and irreversible RYGB surgery, microbial communities underwent a profound and permanent shift following weight loss. The resulting post-surgical composition of gut microbes observed for RYGB patients was distinct from both normal weight and obese patients, and displayed the high microbial diversity associated with a healthy gut.

The current study also applied the technique of nuclear magnetic resonance (NMR) to examine the metabolomea composite of the metabolites produced by the various microbes in the gut, again noting significant alterations as a result of the RYGB procedure. In the case of the alternate treatment, LAGB, changes in the gut microbiota were mild and accompanying weight loss was less pronounced.

"This is one of the first studies to show that anatomically different surgeries with different success rates have different microbiome and microbiome-related outcomes," notes Ilhan, lead author of the new paper. Further, the results indicate that correction of obesity tends to improve related metabolic conditions, including diabetes and high cholesterol.

"One of the key findings of the paper confirms what we had already observed in earlier research. RYGP gastric bypass had a huge effect on the microbial community structure," Krajmalnik-Brown says. This fact may have profound implications for both the understanding and management of obesity.

The body's personal assistants

The millions of bacterial microbes in the human gut perform a vast range of critical functions in the body and have even been implicated in mood and behavior. Among their critical responsibilities are the micro-management of nutrients in the food we digest, hence their central place in the regulation of body weight.

A tell-tale indicator of pathology in obese patients has been found in the gut, where a markedly lower diversity of microbial communities is observed. As Krajmalnik-Brown explains, diversity of gut microbes is essential to good health. "Diversity is good because of what we call functional redundancy," she says. "If you have 10 workers that can do the same job, when one of them gets sick, the job still gets done."

Low microbial diversity in the gut, by contrast, is associated not only with obesity but a range of ailments including inflammatory bowel disease, ulcerative colitis and autism. (Earlier research by Krajmalnik-Brown and her colleagues demonstrated diminished diversity in the gut microbiome of autistic children and in a more recent study, improvement in the symptoms of autism was demonstrated following transplantation of beneficial microbes.)

Competition in diverse microbial networks in the gut helps provide a system of checks and balances. Should diversity fall, a delicate democracy can be shattered and tyranny may prevail, as populations of microbes like Salmonella or Clostridium difficileusually subsisting at low levels in the gut expand and take over.

The study sought to explore long-term changes in the gut in patients who had undergone either of the two surgeries at least 9 months prior, comparing them with normal weight and pre-bariatric obese patients. While the reasons for the sharp disparity of results between RYGB and gastric banding are not entirely clear, the results indicate that simply reducing the size of the stomach through gastric banding is not sufficient to induce the large changes in microbial communities observed for the RYGB group.

Operation weight loss

One hypothesis the authors put forward is that RYGB alters the physiology of the gut to such a degree that microbes formerly unable to survive conditions in the obese gut are able to flourish in their surgically-modified surroundings. "One of the things we observe from the literature is that the oral microbiome community composition is very similar to the colon microbiome composition after bariatric surgery," Ilhan says. "You're giving new microbes a chance to make it. Most of the species are acid sensitive, which supports the idea that changes in stomach pH levels may permit these microbes to survive and make it to the colon."

According to John DiBaise, a gastroenterologist at Mayo Clinic, Scottsdale and co-author of the new study, "These new data on microbial community structure and function significantly expand our knowledge on how the microbiome is associated with weight loss following bariatric surgery."

While it seems clear that RYGB surgery produced permanent changes in bacterial communities in the gut, the resulting microbial community may also act to help maintain weight loss over the long term. Experiments have shown that transplantation of beneficial microbes from mice that have undergone RYGB surgery into obese mice induces dramatic weight loss. While these results have yet to be replicated in humans, the findings open the door to the eventual use of healthy microbial communities to treat obesity.

Weighing future research

Although the RYGB surgery has been quite successful for many patients suffering from morbid obesity, it is a serious, invasive procedure that is not without risks. Further, some patients are not successful and regain the weight they have lost post-surgery, perhaps because they lack the favorable microbes necessary for permanent weight loss. As Ilhan says, "a probiotic that would replace surgery would be great. Another positive outcome would be if we can find a microbial biomarker that will identify the best candidates for surgery and sustained weight loss."

Explore further: Metabolic benefit same with similar weight loss after surgery

More information: Distinctive microbiomes and metabolites linked with weight loss after gastric bypass, but not gastric banding, International Society for Microbial Ecology, 2017

(HealthDay)Early metabolic differences following laparoscopic adjustable gastric banding (LAGB) and Roux-en-Y gastric bypass (RYGB) in obese individuals with type 2 diabetes mellitus (T2DM) disappear when weight loss reaches ...

One in five patients who undergo one of the most popular weight-loss surgical procedures is likely to develop problems with alcohol, with symptoms sometimes not appearing until years after their surgery, according to one ...

Obese patients who underwent Roux-en-Y gastric bypass (RYGB) lost much more weight than those who did not and were able to sustain most of this weight loss 10 years after surgery, according to a study published online by ...

(HealthDay)For obese patients without diabetes, bariatric surgery improves insulin sensitivity (IS), with more pronounced improvements for Roux-en-Y gastric bypass (RYGB) than for laparoscopic adjustable gastric banding ...

(HealthDay)Roux-en-Y gastric bypass surgery (RYGB) strongly predicts insulin cessation after surgery in insulin-treated type 2 diabetes (I-T2D) patients, independent of weight loss, according to a study published online ...

Among obese participants with type 2 diabetes mellitus, bariatric surgery with 2 years of a low-level lifestyle intervention resulted in more disease remission than did lifestyle intervention alone, according to a study published ...

Obesity, already a global epidemic, is on the rise. Over one third of the U.S. population is currently afflicted, according to the Centers for Disease Control and the monetary costs alone are approaching $150 billion dollars ...

Changing the natural electrical signaling that exists in cells outside the nervous system can improve resistance to life-threatening bacterial infections, according to new research from Tufts University biologists. The researchers ...

(Medical Xpress)A team of researchers with the Icahn School of Medicine at Mount Sinai in New York has found that giving a certain antibody to menopausal mice resulted in less weight gain and reduced bone loss. In their ...

A new study has uncovered a molecular mechanism in the prion protein, a protein responsible for neurodegenerative diseases, which may explain why nerve cells degenerate in these disorders.

(Medical Xpress)A European team of researchers working at Sweden's Karolinska Institutet has found evidence that suggests that humans have an olfactory defense against contagious diseases. In their paper published in Proceedings ...

A 12-month study mapping bacterial diversity within a hospitalwith a focus on the flow of microbes between patients, staff and surfacesshould help hospitals worldwide better understand how to encourage beneficial microbial ...

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A physical therapists tips for active and safe outdoor workouts

By Dan Corsetti

Published: May 26, 2017

Performing a variety of exercises is better than focusing on a singular sport since it trains the body to handle various loads, resistances and stressors, says Dan Corsetti.

Now that the weathers warmer and the days are longer, were taking our workouts outside, enjoying al fresco walks, runs, hikes and team sports. While physical activity and fresh air are a wonderful combination, its important to stay safe while youre being active especially if youve been sedentary all winter.

Many people tend to hibernate in the wintertime, hunkering down inside during the short, cold, dark days. If youre not the type to do cold weather workouts outside (skiing, ice skating, winter walks), hopefully, youve stayed active inside at the gym, on the treadmill or using workout videos.

Getting back into an outdoor routine safely means ramping up slowly. Dont expect to run 10 miles on your first day out, especially if you havent kept up with your running routine all winter. And dont panic about the approach of bathing suit season, thinking you need to immediately drop 40 pounds. Understanding and respecting your body is the key to being healthy and active in any season.

A fit, active lifestyle requires strength, stamina and flexibility - and a well-balanced workout routine. Use these tips to stay safe this spring:

Ease into it: Most of us have experienced DOMS (delayed onset muscle soreness) in our lifetime. DOMS happens when we jump into an activity after a prolonged period of rest or inactivity. It usually presents as three to five days of achiness that improves with activity and increases with prolonged rest.

Although DOMS itself is not damaging (even though it can feel severe at times!), its an indicator that you may have done too much, too soon. Ease back into your outdoor workout and dont try to play multiple soccer or tennis games on the first warm, sunny day. If youve already overdone it and are experiencing sore muscles, decrease your activity level, which will allow your body to adapt to the stressors youre placing on it. Modify the duration, frequency and/or the intensity of the activity to allow your body to adapt. Generally 12 to 24 hours of soreness after a new (or harder than usual) activity is normal and expected.

Warm up properly: Before any physical activity, a proper warm-up is important to prepare your body. In general, an active warm-up is more beneficial than a passive stretch prior to activity. Research has shown dynamic stretching is more effective at improving performance than static stretching. Active/dynamic warm-ups include: high knees, monster walks, grapevines, toe taps, lunges, squatting and barn doors.

Mix it up: Do you focus only on one activity, like running? Cardio is great, but strength training is just as important for weight loss, maintaining bone density and building stronger muscles and joints. And increase your flexibility through stretching, yoga and Pilates. Theres a well-documented difference between strength, endurance, power and mobility, so incorporate each component into your exercise program to ensure its well-rounded.

Part of becoming strong and healthy is training your body to handle various loads, resistances and stressors under varying conditions. This is why were seeing so many injuries in young athletes who specialize in a single sport. This singular focus and lack of variety contributes to their risk for overuse injuries. As an added benefit, variety also prevents boredom, making you more likely to maintain your workouts long-term.

Increase the length/intensity of your workouts safely: The most effective way to avoid injuries is a gradual, progressive exposure program to an activity. Instead of running 10 miles on your first day out, start off running a shorter distance for a short time period and increase distance and/or time gradually by 10 percent each week.

Avoid overuse injuries: Many springtime activities like running or tennis use repetitive motions, which can lead to overuse injuries. Change up your routine, doing different activities each day. Vary your surfaces (between blacktop, track, treadmill and trail) to decrease stress on your body. Most runners will sustain an injury in their lifetime not because running is bad for us, but because its a repetitive activity.

Runners/walkers: alternate your route, so youre not pounding up and down the same hills every day, which can impact your hips and knees. Add a comprehensive strengthening program in addition to your cardio activities to help reduce many different types of injuries.

Work with a physical therapist: A physical therapist can help you create a customized workout routine that considers your fitness level, previous injuries and personal goals. Additionally, a physical therapist will demonstrate proper form, analyze your movements and provide advice to help you get fitter and stronger - while staying safe.

Dr. Daniel R Corsetti III of Sport & Spine Physical Therapy Inc. in Portsmouth, can be reached at 603-431-9700 or through nhsportandspine.com.Performing a variety of exercises is better than focusing on a singular sport since it trains the body to handle various loads, resistances and stressors, says Dan Corsetti.

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