Center for Bariatric Nutrition
About the Beta Tester Application

References

Thank you for visiting the Center for Bariatric Nutrition. At present we are accepting applications to participate in our Beta-test program starting immediately. If you would like to participate please follow this <link>.

Dear friends,

As you know I was banded on 2/2/06. Over the course of the last 15 months I have lost 100 pounds of excess body weight. However, around 6 months into the program I found that I wasn't keeping up with my nutritional needs. Also around this time I became annoyed and weary with finding time to take off from work and having to drive to a nutritional counseling sessions. Especially working with people who had never had weight issues or experienced the process of Bariatric surgery and all that it entails to make it work.

Even of bigger impact towards my motivation, my mother went on a weight-loss program losing 196 pounds in a year. She looked great and countless people praised her determination and new self. The only problem was she didn't get enough nutrition and ended up dieing as a result. If I can be a catalyst for educating and helping bariatric patients be healthier and live longer it is done in my mothers name.

Knowing that Bariatric success is largely due to diligent oversight of my nutritional needs and being aware of why and how I eat. I developed a software product that allowed me to track everything I ate, how I was feeling at the time, how and what type of exercise I was doing and tracking of my weight loss and BMI. More important I was able to print out my meals, exercise, weight tracking, BMI tracking, overall progress and emotional state when I ate to share with my doctors, NP and Nutritionist!

I did some further research and found that despite the many positive Bariatric surgery outcomes reported in the literature, it is imperative that one be aware of possible vitamin/mineral deficiencies. Studies have documented an increased risk for specific vitamin/mineral deficiencies after Bariatric surgery.[6-21] Nutrient deficiency is proportional to the length of the absorptive area and to the percentage of weight loss,[6,7] with commonly reported deficiencies including iron,[7-10,13-15] calcium,[7,16-19] Vitamin D,[7,16-19] Vitamin B12,[7-14] and folic acid.[8-11] The risk for these deficiencies vastly increases when malabsorptive procedures, such as biliopancreatic diversion, are performed, and may also predispose the patient to fat-soluble vitamin deficiencies and/or protein malnutrition.[22-24] Although not as common, vitamin and/or mineral deficiencies have also been reported among gastric banding patients, including negative bone remodeling balance characterized by bone resorption[25] and a rare case of Wernicke's encephalopathy,[26] which is more commonly seen in gastric bypass and biliopancreatic diversion procedures.

Nutritional counseling for Bariatric patients has been found to reinforce mindful eating and help with the behavior modification process. Weekly nutritional assessments may provide valuable information to the rest of your Bariatric team (Doctors, NP, Psychiatrist, Primary Care Physicians and other health care providers you may be working with towards success.). Our dietitian's relationship with us is vital in order to encourage both pre- and postoperative weight loss, to educate each of us regarding dietary changes and nutritional risks after surgery, and encourage us to a lifetime of healthy eating habits. And this is the very reason why I have created CFBN V1 Beta! (I'm working on a better name, suggestions welcomed!).

Over the course of the last year I developed my application into an online interactive software product  based on my original pc based program. Called CFBN V1 Beta. This software application is designed specifically and only for Bariatric patients as a way to make sure all nutritional and behavior changes are being met.

As I developed and designed it myself I am seeking volunteers to "beta test" the program. What this entails is using the application daily. Giving me your honest feedback, sharing it with you healthcare providers, giving me their feedback, reporting bugs and completing weekly online forms about the applications ease of use among other questions.

I am the ONLY employee (employment opportunities) all of your information and anything you share will only be viewable by me (unless you choose to share with anyone else.). Down the road if you are invited to be a beta tester for our Gold and Platinum packages you may work with a license nutritionist and they will be able to see your information. But only if you agree to such.

You either heard about the beta program from me or through a friend of mine. You are invited to apply to be a participant. All participants will receive one free year of the silver package product. You may even be invited to beta test my Gold and Platinum packages at no cost to you.

With your help we can make this software into a useful product that will potential helps thousands of Bariatric patients world wide!

Become a Beta Tester <click here>

Much peace and happy losing,

Eileen Conway
Director Internet Strategies
Center for Bariatric Nutrition
(617) 596-1970

www.centerforbariatricnutrition.com

PO Box 2159
Boston
, MA 02101

REFERENCES
1. Herpertz S, Kielmann R, Wolf AM, et al. Does obesity surgery improve psychological functioning? A Systematic Review. J Obes 2003;27:1300�14.
2. Dixon JB, Dixon ME, O'Brien PE. Quality of life after lap-band placement: influence of time, weight loss, and comorbidities. Obes Res 2001;9:713�21.
3. Vallis TM, Butler GS, Perey B, et al. The role of psychological functioning in morbid obesity and its treatment with gastroplasty. Obes Surg 2001;11:716�25.
4. Sjostrom L, Lindroos A, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med;351:2683�92.
5. Halverson JD, Koehler RE. Gastric bypass: analysis of weight loss and factors determining success. Surgery 1981;90:446�55.
6. Brolin RE, LaMarca LB, Kenler HA, Cody RP. Malabsorptive Gastric Bypass in Patients with Superobesity. J Gast Surg 2002;6:195�203.
7. Alvarez-Leite JI. Nutrient deficiencies secondary to bariatric surgery. Curr Opin Clin Nutr Metab Care;7:569�75.
8. Brolin RE, Gorman RC, Milgrim LM, et al. Multivitamin prophylaxis in prevention of post-gastric bypass vitamin and mineral deficiencies. Int J Obes 1991:15:661�7.
9. Halverson JD. Micronutrient deficiencies after gastric bypass for morbid obesity. American Surgeon 1986: 594�8.
10. Amaral JF, Thompson WR, Caldwell MD, et al. Prospective Hematologic evaluation of gastric exclusion surgery for morbid obesity. Ann Surg 1984:186�93.
11. Boylan LM, Sugerman HJ, Driskell JA. Vitamin E, vitamin B6, vitamin B12, and folate status of gastric bypass surgery patients. J Am Diet Assoc 1988;5:579�85.
12. Haverson JD. Metabolic risk of obesity surgery and long-term follow-up. Am J Clin Nutr 1992;55:602S�5S.
13. Avinoah E, Ovnat A, Charuzi I. Nutritional status seven years after Roux-En-Y gastric bypass surgery. Surgery 1992;171:137�42.
14. Simon SR, Zemel R, Betancourt S, et al. Hematologic complications of gastric bypass for morbid obesity. South Med J 1989;9:360�2.
15. Updegraff TA, Neufeld NJ. Protein, iron, and folate status of patients prior to and following surgery for morbid obesity. J Am Diet Assoc 1981;78:135�40.
16. Goode LR, Brolin RE, Chowdhury HA, et al. Bone and gastric bypass surgery: effects of dietary calcium and vitamin D. Obes Res 2004;1:40�7.
17. Coates PS, Fernstrom JD, Fernstrom MH, et al. Gastric bypass surgery for morbid obesity leads to an increase in bone turnover and a decrease in bone mass. J Clin Endocrinol Metab 2004;3:1061�5.
18. Ott MT, Fanti P, Malluche HH, et al. Biochemical evidence of metabolic bone disease in women following Roux-Y gastric bypass for morbid obesity. Obes Surg 1992;4:341�8.
19. Hamoui N, Anthone G, Crookes PF. Calcium metabolism in the morbidly obese. Obes Surg 2004;14:9�12.
20. Salal-Salvado J, Garcia-Lorda P, Cuatrecasas G, et al. Wernicke's syndrome after bariatric surgery. Clin Nutr 2000;5:371�3.
21. Chang CG, Adams-Huet B, Provost DA. Acute post-gastric reduction surgery (APGARS) neuropathy. Obes Surg 2004;182�9.
22. Slater GH, Ren CJ, Siegel N, et al. Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsorptive bariatric surgery. J Gastrointest Surg 2004;8:48�55.
23. Chapin BL, LeMar HJ, Knodel DH, et al. Secondary hyperparathyroidism following biliopancreatic diversion. Arch Surg 1996;10:1048�52.
24. Kushner RK. Managing the obese patient after bariatric surgery: a case report of sever malnutrition and review of the literature. JPEN 2000;2:126�32.
25. Pugnale N, Giusti V, Suter M, et al. Bone metabolism and risk of secondary hyperparathyroidism 12 months after gastric banding in obese pre-menopausal women. Int J Obes 2003;27:110�6.
26. Bozbora A, Coskun H, Ozarmagan S, et al. A rare complication of adjustable gastric banding: Wernicke's Encephalopathy. Obes Surg 2000;10:274�5.
27. Stevens VJ, Corrigan SA, Obarzenek E, et al. Weight loss intervention in phase 1 of the trials of hypertension prevention. Arch Int Med 1993;153:849�58.
28. Kelley D. Effects of weight loss on glucose homeostasis in NIDDM. Diabetes Reviews 1995;3:366�77.
29. Busetto L, Tregnaghi A, De Marchi F, et al. Liver volume and visceral obesity in women with hepatic steatosis undergoing gastric banding. Obes Res 2002;10:5:408�11.
30. Kral JG. Surgical treatment of obesity. Med Clin N Am 1989;1:251�64.
31. Froom P, Melamed S, Benbassat J. Smoking cessation and weight gain. J Family Practice 1998;466:460�4.
32. Marcus BH, Albrecht AE, King TK, et al. The efficacy of exercise as an aid for smoking cessation in women: a randomized controlled trial. Arch Int Med 1999;159:1229�34.
33. Kawachi I, Troisi RJ, Rotnitzky AG, et al. Can physical activity minimize weight gain in women after smoking cessation? Am J Publ Health 1996;7:999�1004.
34. Jonsdottir D, Jonsdottir H. Does physical exercise in addition to a multicomponent smoking cessation program increase abstinence rate and suppress weight gain? An intervention study. Scand J Caring Sci 2001;15:275�82.
35. Ussher M, West R, McEwen A, et al. Efficacy of exercise counseling as an aid for smoking cessation: a randomized controlled trial. Addiction 2003;98:4:523�32.
36. Miller, W. Rollnick. S, (Eds). Motivational Interviewing. Guilford Press; 1991.
37. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 1983;51(3):390�5.


CenterforBariatricNutrition.com
Copyright © 2004 - 2007 [Center for Bariatric Nutrition]. All rights reserved.
Revised: 07/09/07

You are visitor 779
Page
Revised: 07/09/07