5 Steps to prevent Heart Disease

Friday, July 8, 2016

Overeaters Anonymous  

I went back to an Overeaters Anonymous meeting last night.

My last meeting was more than 20 years ago.  

I never lost weight while in that group but I gained benefit from it.  

Now that I am in a reduced obese state at 220 lbs from my highest weight of 280 lbs in 206 lbs I was very curious to find out if I could get anything out of the program again. 

I was a little concerned that I would be viewed as an interloper as I am now certified in the American Board of Obesity Medicine and I have just opened an Obesity clinic.  I worried as I would be viewed as an opportunist trolling for future patients. 

My hope lay in the fact that the organization is anonymous. 

I only had to share my first name and my personal story. 

How I lost weight and how I tried to maintain weight loss is accepted by the group. 
 Maybe not by individuals. That is for outside the meeting.

There is not supposed to be cross talk and when talking a person is talking to the group not to other individuals.  No one is to interrupt while a person is sharing.  A person notifies they are done talking by stating they pass.  

Last night reminded me what I like about this group.  
As a Doctor, I need to go and learn to listen. 

My six medicines have allowed me to get down to 220 pounds while eating ad libitum Atkins and walking 20- 40 minutes a day.  I also drink alcohol. 
 I call it the Bon Vivant diet.  

I only shared two of the medicines I take with the group.  Invokana and Victoza.  
These folks, I suspect are mostly doing the white knuckle method. 

They spoke of one person who has lost 200 pounds and maintained the weight loss for 20 years.  I wanted to interrupt and explain the waterfall effect on results of diet trials.  Some do very well.  

I want to get on my soapbox and teach them about the Sponge theory and how they are doomed because of their low leptin levels.  It's not a food addiction. 

Or is it?

Could this be a group of Binge Eating Disorder (BED)?

In preparation to taking my Obesity Boards in Dec. 2015 I was taught:

BED is most common eating disorder.
20% in bariatric surgery
50% of severely obese

1- Not a food addiction but behavior addiction like gambling or sex.

2- First approach: Cognitive Behavior Therapy

 3-Vyvanase is a CNS stimulant indicated for BED. 

 (Topiramine, Bupropion may help)

4- Criteria:
Lack of control
Eat rapidly
One time a week for 3 months
Not associated with purging.  

Patients are not allowed to undergo Bariatric surgery if they have Binge Eating Disorder. 

They have to undergo Cognitive Behavior Therapy first. 

Here are waterfall results from surgery.

 Bariatric surgery cannot overcome M&M's.



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