After a year’s long process, I was very gratified to receive the designation as a Fellow of the American Society of Colon and Rectal Surgeons.  The society has quite rigorous criteria and requires extensive training including fellowship residency training beyond general surgery training plus a passage of a series of board exams and an application process including review of colon and rectal surgical cases.

It is an honor to become a fellow in the society that sets such high standards for colon and rectal surgery.  My areas of expertise are particularly focused of laparoscopic and minimally invasive intestinal abdominal surgical procedures.  I was fortunate to receive extensive training in minimally invasive surgery for intestinal disorders and colorectal disease as well as other gastrointestinal and abdominal disorders.  And in the years since that training have been fortunate to be in a position to further refine the techniques for successful outcomes with less invasive surgical intervention.

Minimally invasive intestinal and colorectal procedures allow for people to return to work sooner and recover more quickly after surgical intervention.  I perform a high number of laparoscopic and minimally invasive intestinal surgical procedures for many abdominal and colorectal disorders including colorectal cancer, inflammatory bowel disease, Crohn’s disease, ulcerative colitis and a host of other abdominal conditions including gallbladder disease and hiatal hernias as well as, of course, bariatric surgery.

So my thanks to the society for designating me a fellow and I look forward to participation in the society in the future.

As I look over the summer calendar I am tempted to sign up for loads of running races. Fortunately, my work calendar and kid duties preclude such a silly idea, but I am selecting three or four races through the summer and fall in which I hope to participate. But, how many is too many? Or better stated, what is the right amount?

I know that races or special events do help me maintain some focus and motivation with training and regular exercise. And I know from talking to many of my peers who participate in bicycling, running, swimming, dancing and other activities, that events, races, competitions and performances help us all maintain focus and motivation. But there is probably a number that is an appropriate number of competitions every year. And there is probably a number that is too many. So how do we figure that out?

I don’t know the answer yet, but I do know that at least several per year is probably appropriate for most people, if for no other reason that is gives one focus for a period of time of weeks to a few months. If our only competition is six months or a year away we tend to put it out of our mind and not prepare for it, just like taking a final exam at the end of the year is not generally sufficient motivation for a student staring out in the fall. We need some shorter term goals to focus our energies.

So, practical realities of life prevent me from doing more than a handful of races a year so we will see how well that strategy works.

Here are a few thoughts about how we could make our fighting force more effective, more lethal and better able to protect the United States of America:

1. Set a new standard for fitness and actually enforce it. There is no reason why nearly every person in the United States Military could not maintain a body mass index of 25 or less. Going to 26 quadruples one’s risk of type 2 diabetes so this is not an arbitrary number chosen.

2. Actually create the environment on military bases to foster fitness instead of inculcating obesity as we do now. Yes, this means actually promoting the notion that our fighting forces need to be physically and mentally fit and prepared to defend the nation. This means creating a culture of regular exercise, a culture of modest calorie intake and a culture that eschews diets consisting of massive carbohydrate and calorie intake. This does not require a big brother technique on the base. It simply requires setting standards eliminating all the obvious places of abuse of the dietary requirements (starting with the deluge of high fructose corn syrup on the bases, the high carbohydrate, high calorie meals being served and replace these with some fantastic tasting, but very good for you protein based snacks and meals).

3. Change the culture by rewarding people for productivity instead of rewarding people for laziness. Yes I realize this will make me unpopular with all sorts of mid level bureaucrats in every sort of job in the country that implicates a culture of less and less activity, but think about it. Ask anyone in the military how to get ahead and they will begin explaining the politics to you. Getting ahead does not involve being more productive, working harder or doing better. It involves kissing the right asses, keeping your head down and creating the appearance of work at the proper moments. How do you change corporate culture? Well, there are dozens of great books on this, but let’s start by using the obvious levers such as rewards like pay, vacation time, and rank, all the obvious things that go the people who are the best schmoozers. Toss out this system of brown-nosing and replace it with one that attempts to recognize measurable productivity.

Imagine a fighting force in which the valuable administrators, the corporals, sergeants, lieutenants, captains and majors who make the whole system run were actually rewarded for getting their work done early and doing it well. They do not have to resort to tricks like leaving their lunch bag and hat on the desk with the light on so the colonel would think they are in the building when actually they are surfing the web at their apartment.

The United States taxpayers currently pay for something like half a million U.S. active duty service people deployed outside the United States at bases around the world. Those people could be representing America as the fittest, strongest, most vital people on the planet. But, it would take a culture change in the United States Military for this to take place. It would require recognition of the science of diabetes, health and nutrition- one that recognizes that cutting simple carbohydrates and overall calorie intake is critical to maintain fitness- emphasizes regular exercise and acknowledges the connection between mental and physical fitness and the ability to perform one’s job to the best level. This culture currently does not exist in our U.S. Military and in precious few places around the country. But I believe the U.S. Armed Forces represents an important area where a great difference could be made where great improvements in the health of the men and women who proudly serve could occur and where the national security could be improved. All it takes is leadership.

The Brescia Marathon is coming on. Brescia is a lovely town surrounding a medieval castle in Northern Italy. I pegged the date of the Brescia Marathon on my calendar beginning back in 2009 and stuck with it despite my lack of preparation and training. I wish I could say I have been training religiously and was well prepared to run a personal best, but that is not the case. The winter months and lots of work have left me just hoping I can finish in four hours. We’ll see. It will be fun and exciting and I will have to brush up on my Italian.

The day was cool, mildly overcast, probably in the low 50’s, but calm with no winds. The sun peaked out after around 9:00, which is perfect because in Italy marathons do not start at the ungodly ours of 5 and 6 A.M. No, instead they begin at the rather humane hour of 9:30 in the morning. So after an early morning check-in we crowded to the start and began.

My first half split was respectable enough, 1:48, but I developed some foot soreness on the back half and slowed to a crawl coming across the finish line well over four hours. But, happily enough, I have my eye on some future races and hope that with the weather being nicer I will do a better job of preparing and training. I am sticking to my goal of a sub-3:30 marathon in 2010. So we’ll see!

Joanie has a great health show on the radio in San Francisco called the Joanie Greggains Show and I had the great privilege of appearing as a guest on her show this morning on March 27, 2010. We talked about Life Changing Weight Loss, the book, Joanie has some great questions about the inner motivation and the need to except internal change as a foundation for losing weight and keeping it off. We also talked quite a bit about obesity prevention among children and what it takes to fight that battle.

I think one thing many people in the public don’t comprehend is that times have changed and the environment surrounding our children is quite different now than it was thirty years ago. It definitely requires a much more active battle plan to prevent our children from becoming overweight and obese. It’s not just going to happen automatically. The environment is too rich in calories and carbohydrates and the environment also deters exercise and activity to such a great extent that most children are heading toward a path to overweight and obesity as they progress to adulthood. So as parents we must take a tougher line. We must cut against the grain of the school environments, the neighborhood environments, what is going on television and at our friend’s houses. We have to eliminate sugar beverages from the household, toss out all the snacks, candies, cookies and ice cream in the pantry and freezer and make those kinds of treats special occasion treats a couple of times a month, but not an everyday or every meal occurrence. We have to encourage ways for our children to get regular exercise and this can take some creativity given the demands and time pressures that most young students face and also the safety concerns that most parents have about letting children run loose in the neighborhoods. The battle can be won it just requires determination and a real effort.

I had the great pleasure of talking on the air with Bill Dean on his program The Morning Brew that airs in Minnesota. Bill is a fantastic host and we got to discuss the importance of weight loss and maintaining a healthy weight as well as my recently released book, Life Changing Weight Loss. Bill also noted he himself was diagnosed with vitamin D deficiency, a surprisingly common finding for a great many of us. Usually the symptoms of vitamin D deficiency are fatigue and loss of energy so they can be very subtle. Most people don’t even realize they have it.
We also touched on a number of topics including childhood obesity.
Bill is a great host and I hope I have an opportunity to appear as a guest on his show again.

A big thank you to Rob Kingsbury for serving as such an interesting and enthusiastic host. I was fortunate enough to appear as a guest on his radio program and Rob, perhaps more than any other radio host, put me through the paces on everything from personal weight loss strategies to personal responsibility failures to national policy. Childhood obesity, vitamin deficiencies and personal motivation were topics that Rob explored in depth. He is not one to shy away from controversy and I really enjoyed the opportunity to be on his program.

Weight loss surgery is highly effective as a tool or method for losing weight and changing ones life.  But it is only a tool.

One of the toughest things for people to begin to understand is that they themselves are the true instrument of change.  The surgery is a highly effective component in that change journey, but ultimately the person who makes the decision to lose the weight and undergo weight loss surgery is, in fact, the most important element that will insure long-term success weight loss.

When I meet with individuals who are pursuing weight loss surgery, I begin emphasizing this point very early on, beginning in fact with our informational seminar.  I think that our group emphasizes this point so much because over time we have come to appreciate more about what it takes to succeed beyond one year or two years and we have begun to explore how to insure success beyond ten years, twenty years and for a lifetime.  Today estimates are that between 10 and 20% of people regain their weight years down the road after Roux-en-Y gastric bypass surgery, though the statistics on this are a little murky.  How then, does one avoid becoming one of those statistics?  We believe the answer lies in adopting a new outlook and a new way of viewing the problem of weight loss and health.  The people who do succeed and keep it off for a lifetime accept total and complete responsibility for their weight loss journey. They begin looking, not outward, but inward for solutions to the long-term problems of poor health and weight gain.  They adopt the “battle” mentality against excess calories, desserts, treats, and snacks.

They adopt the attitude of life change that is crucial to success in this battle.

After some delays, we have received the shipment of my newly released book: Life Changing Weight Loss. In these times, everyone could use a guide to real, successful weight loss.

In radio interviews on stations around the country, I have been so pleased at the reception the book has received so far. One of the common threads I hear is that media people are inundated at this time of year with weight loss books and information, most of which has very little basis in the practical science of what truly works. Much of it is based on wishful thinking, marketing plans or fanciful obsessions with obscure root extracts and proprietary blends of unregulated secret, magical herbs. The truth about successful weight loss is much simpler and yet, also much more complicated.

At the end of the day, to solve a weight problem and keep the pounds off, we must find a successful strategy to consume less calories every single day, burn more calories every single day, and find satisfaction and contentment despite this. Many of us can muster the motivation on a short term basis to consume less calories and burn more calories, but we feel like we are starving ourselves or doing the impossible. That won’t work for the long term. Long term success lies in mustering that motivation, but making an internal life change, a new look at how we view ourselves, our weight, our diet and our activity. Only then does the “light switch” flip on, only then do we successfully lose the weight and keep it off for the long term.

Larry Whitler and Robin in the Daytona, Florida area, certainly have a great show and a great interaction on the air. They were gracious enough to have me as a guest on their program to discuss Life Changing Weight Loss, my newest book being released in January of 2010. Larry confessed that he is planning to lose weight as part of his own New Year’s resolution and the lively exchanged focused on the ways in which the book can help a person accomplish that mission.
The guest who followed my interview was Mike Huckabee, a person who knows quite a bit about losing weight. We also touched a bit on the problem of childhood obesity and what parents can do to help their children avoid the path toward adolescent and adulthood obesity.
Clearly as parents we all must set the best example possible. Our children need to see us making good food choices and exercising regularly and maintaining a healthy weight.
Thanks to Larry and Robin for a great show and the great dialogue they are providing on the air on Health Matters.