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One of the primary responsibilities of the Long-term Care Ombudsman program is to bring awareness to people about the abuse and neglect of vulnerable adults which includes long-term care residents, the elderly and disabled adults.

"Our goal is to not only stop abuse and neglect that is happening now but also to help prevent it in the future," said Scott Harding, ombudsman program supervisor. "June 15, is World Elder Abuse Awareness Day. And while our efforts continue every day, we want to observe this day by being more aware of elder abuse, educating ourselves on the causes and effects and resolving to do more now and in the future to protect some of the most vulnerable individuals in our society."

Elder abuse takes many forms, including physical, sexual, verbal and psychological. In the State of Oklahoma, abuse is defined as causing or allowing infliction of physical pain, injury, sexual abuse, sexual exploitation, unreasonable restraint or confinement or mental anguish. It also includes depriving vulnerable adults of nutrition, clothing, shelter, health care or other services that can cause serious harm.

"While many people might consider physical and sexual abuse the most serious types of abuse, verbal and psychological are more prevalent and can often cause harm just as serious, and sometimes more so," said Harding.

Verbal abuse is defined as the use of words, sounds, gestures, actions, behaviors or other communication by a person responsible for providing services to a vulnerable adult that is likely to cause a reasonable person to experience humiliation, intimidation, fear, shame or degradation. While the outward signs of physical abuse may eventually heal, the scars and effects of verbal and psychological abuse may never fully heal, said Harding.

Another common form of abuse is financial exploitation which is defined as the improper use of a vulnerable adults financial, real or personal resources for the benefit of another person.

It is estimated that one in 10 older Americans is the victim of abuse and much of that abuse goes unreported. The various types of abuse can occur in the home, community and in long-term care facilities.

"The victims can be our loved ones, neighbors and friends. Often, the abusers are someone the victim knows well and may be their own family," said Harding.

Signs of abuse may include: unexplained injuries; drastic and sudden changes in behavior; unexplained weight loss; withdrawal from normal activities; fearfulness; depression; and more.

"Whether an advocate, loved one or just concerned citizen, everyone has a role to play in stopping and preventing elder abuse," said Harding. "If you observe or suspect abuse, report the abuse to Adult Protective Services and local law enforcement. Depending on the situation, the victim may need your care and support through such a difficult situation. If you have friends and family who are elderly or may be considered vulnerable, keep in touch with them and raise your awareness of any signs of abuse or neglect."

The APS Hotline is 800-522-3511. To find a local long-term care ombudsman, contact Scott Harding or Gina Elliott at the Area Agency on Aging, 918-682-7891. The state long-term care ombudsman office can be reached at 405-521-6734.

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Ombudsman program brings awareness of disabled adults | News - Tahlequah Daily Press

SAN CLEMENTE, CA / ACCESSWIRE / June 22, 2020 /ReShape Lifesciences Inc. (OTCQB:RSLS),a leading developer and distributor of minimally-invasive medical devices to treat obesity and metabolic diseases, today announced a partnership with inHealth Lifestyle Therapeutics (formerly inHealth Medical Services), a Lifestyle Therapeutics company, to launch the ReShapeCare virtual health coaching program this month. The new service is tailored to patients under treatment for obesity, those who may have lost continuity of care, and patients pursuing weight loss surgery and medically supervised weight loss programs. ReShapeCare will enable bariatric surgeons and physicians to optimize management of their patients' care by providing a turn-key, personalized service proven to improve treatment and health outcomes for obesity and associated chronic disease while reducing administrative encumbrances.

"At a time when providers are grappling with the impact of COVID-19 on their patients and practices, we are accelerating our plans to offer an outcomes-focused, high-touch virtual service that enhances patient engagement between required practice visits and is adaptable to their daily lives," said Bart Bandy, CEO and President, ReShape Lifesciences. "We selected inHealth as our chosen provider based on the high quality of their coaches, their exceptional telehealth-enabled platform with a unique reimbursement system for practices, and the strong body of clinical research that proves their method works. Emerging from the effects of this pandemic and recognizing how all of our lives may be changed moving forward, we are excited to introduce this progressive lifestyle centered program that will assist healthcare providers in empowering their patients throughout their weight loss journey."

ReShapeCare is a live, telehealth-based coaching program that provides online weight loss coaching and lifestyle therapy for patients affected by obesity and its associated comorbid conditions such as hypertension and diabetes. Through the service, patients are matched with a dedicated, certified health coach and enjoy one-on-one video sessions with exclusive access to validated educational resources. The service must be prescribed by a physician, can be customized to their practice, and is covered by most insurance plans.

Published clinical studies demonstrate that virtual health coaching leads to more adherent patients and more successful weight loss outcomes. In a 2017 study published in theJournal ofTelemedicine and Telecare[i], 69.2% of patients achieved weight loss with a 12-week telemedicine-based weight loss program versus just 8% in the control group that received initial instructions and recommendations although they also had access to the same virtual platform and devices throughout the 12 weeks.

Rashmi S. Mullur, MD, Chief of Telehealth at the VA Greater Los Angeles, endocrinologist at UCLA Health and an investigator on the study, said, "Our study demonstrated the clinical benefit of telehealth-based coaching for improved weight loss. We were able to increase patient access, via video visits, and elevate the level of care we can provide. Our model showed that this approach increases patient adherence and motivation, and allows for greater, shared decision-making responsibility between providers and their patients to reach their health goals."

ReShapeCare acts as a seamless extension of a healthcare provider's practice, driving new revenue at a time when many physicians are bracing for the opposite. The program can be customized to support existing programs of care and provides HIPAA-compliant dashboard reports for the individual medical supervision of enrolled patients. ReShapeCare will be available as a pre- and post-operative service and is appropriate for all bariatric surgery and medically supervised weight loss patients.

"Medical device innovators like ReShape Lifesciences understand that without proper outpatient care and support, a patient's health goals are at risk. To ensure that patients maintain their weight loss, and manage or reverse their chronic disease, we must treat the major underlying cause of that disease: their lifestyle," said Aubrey Jenkins, Co-Founder and President, inHealth Lifestyle Therapeutics. "Our Lifestyle Therapeutics are a perfect complement to the ReShape Lifesciences mission, extending the care their providers deliver and enveloping their patients with a whole health solution that works."

For those providers interested in learning more, please emailcustomerservice@reshapelifesci.com. For more information on ReShape Lifesciences visitwww.reshapelifesciences.com. For more information on inHealth and its work with private practices and corporate partners, visitwww.inhealthonline.com.

About inHealth Lifestyle Therapeutics

inHealth is a Lifestyle Therapeutics company with a mission to unlock the human potential for preventing and reversing chronic disease. Our clinically validated, virtual solutions are scientifically proven to activate and sustain long-term patient outcomes, and delivered by trained, certified health coaches. Our Lifestyle Therapeutics can be prescribed by physicians, covered by most insurance, and delivered through our partnerships with clinicians, health plans, employers, and medical devices and digital health innovators. Like our services, we are a virtual company with team members all over the U.S., and we are hiring. To learn more, visitwww.inhealthonline.com.

About ReShape Lifesciences Inc.

ReShape Lifesciences is a medical device company focused on technologies to treat obesity and metabolic diseases. The FDA-approved LAP-BAND Adjustable Gastric Banding System is designed to provide minimally invasive long-term treatment of severe obesity and is an alternative to more invasive surgical stapling procedures such as the gastric bypass or sleeve gastrectomy. The ReShape Vest System is an investigational, minimally invasive, laparoscopically implanted medical device that wraps around the stomach, emulating the gastric volume reduction effect of conventional weight-loss surgery, and is intended to enable rapid weight loss in obese and morbidly obese patients without permanently changing patient anatomy.

Forward-Looking Safe Harbor Statement:

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements generally can be identified by the use of words such as "expect," "plan," "anticipate," "could," "may," "intend," "will," "continue," "future," other words of similar meaning and the use of future dates. These forward-looking statements are based on the current expectations of our management and involve known and unknown risks and uncertainties that may cause our actual results, performance or achievements to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements. Such risks and uncertainties include, among others: risks related to the effects of the COVID-19 outbreak on our results of operations, financial condition or liquidity; risks and uncertainties related to our acquisition of the LAP-BAND system; our ability to continue as a going concern if we are unable to improve our operating results or obtain additional financing; risks related to ownership of our securities as a result of our delisting from the Nasdaq Capital Market; our proposed ReShape Vest product may not be successfully developed and commercialized; our limited history of operations; our losses since inception and for the foreseeable future; the competitive industry in which we operate; our dependence on third parties to initiate and perform our clinical trials; the need to obtain regulatory approval for our ReShape Vest and any modifications to our LAP-BAND system; physician adoption of our products; our ability to obtain third party coding, coverage or payment levels; ongoing regulatory compliance; our dependence on third party manufacturers and suppliers; the successful development of our sales and marketing capabilities; our ability to raise additional capital when needed; international commercialization and operation; our ability to attract and retain management and other personnel and to manage our growth effectively; potential product liability claims; the cost and management time of operating a public company; potential healthcare fraud and abuse claims; healthcare legislative reform; and our ability to obtain and maintain intellectual property protection for our technology and products. These and additional risks and uncertainties are described more fully in the Company's filings with the Securities and Exchange Commission, particularly those factors identified as "risk factors" in our annual report on Form 10-K filed April 30, 2020. We are providing this information as of the date of this press release and do not undertake any obligation to update any forward-looking statements contained in this document as a result of new information, future events or otherwise, except as required by law.

CONTACTS:

ReShape Lifesciences Investor Contact:Thomas StankovichChief Financial Officer949-276-6042ir@ReShapeLifesci.com

ReShape Lifesciences Marketing Contact:Diane Utzman-O'NeillSr. Director Marketing952-460-0171dutzman-oneill@reshapelifesci.com

inHealth Lifestyle Therapeutics Contact:Amanda GuisbondDirector of Marketing and CommunicationsinHealth Lifestyle Therapeuticsaguisbond@inhealthonline.com

[i] Alencar, M. et al.Journal of Telemedicine and Telecare. "The efficacy of a telemedicine-based weight loss program with video conference health coaching support." 6 November 2017. DOI: 10.1177/1357633X17745471

SOURCE:ReShape Lifesciences Inc.

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ReShape Lifesciences and inHealth Lifestyle Therapeutics Launch ReShapeCare(TM) Virtual Health Coaching for Patients with Obesity - BioSpace

In February, the month before the lockdown, 12.5 per cent of Sheridan Villas 142 residents had experienced a worsened depressive mood. That number increased to 15 per cent in March, 15.7 per cent in April and 17.5 per cent in May. The most recent provincial average for depression was 22.3 per cent, according to Sheridan documents.

During the lockdown in March, April and May, Sheridan had slight increases in the number of residents with unexpected weight loss, pressure ulcers and falls. Those changes may look minimal on a spreadsheet, but staff say they know the people behind the data, calling the increase of a percentage point or two deeply personal.

Data for so-called behaviours noted a 6.4 per cent increase from February (when it was at 8.6 per cent) to 15 per cent in May. The most recent provincial average for behaviours was 12.6 per cent, according to Sheridan. Behaviours is a traditional nursing-home term used to describe people, mostly with dementia, who walk constantly, shout or sometimes act aggressively. Advocates say these are reactions to a life that is sterile.

Milligan said the behavioural changes are likely the result of resident confusion after provincial rules required isolation in rooms. She said many, particularly those with cognitive decline, are feeling rejected because they can no longer hug staff or hold hands.

They are also feeling a profound sense of abandonment because many do not understand why their families no longer visit, she said.

The Ontario government banned family visits in mid-March when the virus began its surge through homes.

On June 18, the Ministry of Long-Term Care began allowing one family member one outdoor visit each week. Unlike staff, who do not need regular COVID testing, families must test negative for COVID every two weeks. The demand for swabbing is onerous, particularly for fragile older spouses.

It took a deadly virus, but the long-term care industry is starting to understand the need for transformation that elevates emotion-focused care, said Laura Tamblyn Watts, CEO of CanAge, a seniors advocacy group.

Social isolation syndrome, as we are calling it, is a combination of low mood, loss of physical mobility and a loss of connection with people, Watts said. Weve seen it in Canada and around the world.

Having homes share the impact of isolation really brings to light how important it is to move to emotion-focused care in long-term care homes in Canada, Watts added. Only through tracking things like mood, things like social connection, can we take care of the whole person, not just their physical well-being.

Theres a new willingness in the industry to explore the programs and approaches that offer seniors vibrant lives, she said, not just medical care and meals.

What we are seeing now is associations and industry in long-term care are really understanding the importance of this model in a new way.

In traditional homes, where the task-focused system rules, isolation is pervasive. If there is a chance for real change, industry insiders say the government must ensure that homes provide individualized care that offers purpose and activities that connect with each person not the typical activities, like sitting in a circle tossing balls to each other.

I look at long-term care as being a pyramid and at the top of it is the resident, said Chris Brockington, a 20-year consultant in the nursing and retirement home industry.

With every decision, it has to be framed with, Will this be good for the resident? Staff has to say, If Im in their shoes, is this something I would like for my mother or father? Its the simple understanding of, how do we build a culture that cares?

To me that is the starting point. I think we can get on that really, really quick. Maybe we need to start thinking of (residents) as the customer. They are paying for the service. What do they get for it? Do they deserve to be awakened at 7 oclock when they really dont want to be awakened at 7 a.m.?

Brockington consults with for-profit and not-for-profit homes along with service providers such as pharmaceutical or medical device companies. After the public outrage over flaws exposed by the pandemic, he believes many operators are willing to change the old culture that put the needs of residents behind efficiencies and scheduling.

They are going to be open to anything right now because they know the onslaught that is coming toward them, he said. Culture in long-term care for the most part is not great. We do need to move it away from, say, an ivory-tower approach of We know best for your home.

Ask Doris Grinspun, CEO of the Registered Nurses Association of Ontario about Premier Doug Fords promise for transformation and shell say theres a good chance hell bring legitimate change.

I believe the premier takes this to heart, Grinspun said. And this is indeed a matter that we need to solve with heart, not only with the numbers, the budget. And we need to put the budget where the heart is.

Grinspun is pushing the government to commit to a minimum of four hours of direct nursing and personal care for each resident, each day. Currently, the RNAO says the average resident gets roughly 2.7 hours of direct daily care.

The estimated cost of the additional staffing, a mix of registered nurses, registered practical nurses and personal support workers, is $1.75 billion, according to RNAO reports. In its June 2020 report on staffing, the RNAO said the additional cost to bring staffing up to a new standard is truly an investment, not an expenditure, as it will save us from enormous costs in the future. It also said the cost is not large relative to the $63.8 billion health budget.

The pandemic exposed the staffing shortage in long-term care although the problems have existed for years, with residents sitting in filthy briefs, going hungry or left alone for hours. It was the report written by the Canadian Armed Forces, whose staff worked in homes with the most COVID infections, that got Fords attention.

Grinspun wants the government to commit to the staffing formula, saying it would help residents get the time and individual attention they need. She doesnt believe the industrys problems need to be studied again. The upcoming commission into long-term care, promised to begin in July, will produce yet another report, she said. Her staff recently counted 35 long-term care reports in the last 20 years. None led to lasting change.

Give us a plan, she said. Give us a two-year plan. But dont put this on an election platform.

The industry has never had the hiring power or the cachet of hospitals even though nursing home residents share the same conditions as acute care hospital patients, said Brockington, the consultant.

Part of it is, we are not portraying the sector as being a thought leader, he said.

Weve been left behind for so many years in terms of innovation. With innovation, you think of acute care, not long-term care. So, we are playing catch up, for years, trying to bring in new ideas. Because it is slow, the (nursing home) culture is make my life easy.

We need to make it a place where our educational system is actually promoting it as innovative, as fair, as doing something that is thought-provoking, that is compassionate.

Susan Veenstra is a registered nurse who spent two decades in long-term care, working in administrator and director of care roles. She now works as a consultant, often with Brockingtons company, In Initiatives Inc.

Veenstra agrees with the assessment that theres a culture of fear in many homes, with top-down decisions leaving staff and families afraid to speak up.

The ones who have done the best are probably with the most open communication, she said.

The industry is ready for a shakeup, eradicating the old task-focused system and replacing it with individualized care that allows frontline workers and residents to engage, she said. But that wont happen unless the upcoming commission into long-term care brings in new people with fresh ideas.

At the end of the day, they dont need to have the same old, same old, sitting at the table thinking that they are going to make things better if the same people are at the table.

Its like the definition of insanity: doing the same thing every time and expecting a different result.

For Derek Hoare, who left a 32-year career in private and not-for-profit long-term care management to run a restaurant on Prince Edward Island, the instrument of change is always the homes leader.

Ive given this a lot of thought, Hoare said. When I look at the homes on the list of the ones that had greater (COVID) fatalities than the other ones, I would hazard a guess that the homes that did better had a much stronger employer-employee relationship and a much more common goal relationship where they worked toward the common good and developed programs for residents collaboratively.

That is what Ive seen, and that is what I have found has worked. It is not autocratic leadership but one that has involvement.

Most long-term care managers dont call attention to negative outcomes, but Sheridan Villa administrator, Marianne Klein, said the declines in her homes data, particularly in worsening mood category, prove that homes need creative approaches moving forward.

Klein said Sheridans emotion-focused program, Meaningful Care Matters (formerly Butterfly) gave staff an edge when, for example, they tried to get a man, declining with COVID, to eat. He had been refusing food and drink.

His registered practical nurse, Darryl Hawtin, knew the man well and remembered that he liked Polish sausage. Hawtin spoke to Sheridans dietitian who bought a package of Polish sausages at the grocery store. Culinary staff cooked the meat the next day. The resident ate the sausage and later asked for ice cream. Hes been eating well ever since, Klein said.

If we know the people we are caring about, if we understand them, what their needs are and what their strengths and limitations are, we are able to provide care that meets their needs, Klein said.

If we dont do that, we treat people like a piece of data and thats not what this is all about.

Moira Welsh is an investigative reporter based in Toronto.

Excerpt from:
The brutal blow that pandemic isolation has dealt residents of long-term care residences - mississauga.com

More Americans than ever are living with obesity. The number of adults with the condition has skyrocketed 200 percent over the past 40 years. Obesity continues to contribute to a number of public health concerns such as its associated comorbidities and healthcare costs in addition to legitimate concerns about overall population health in the face of novel health threats like COVID-19.

However, as the number of Americans struggling to manage their weight continues to grow 72 percent of the country lives with overweight or obesity so has our clinical understanding of this complex but treatable condition. We know that there are hormonal and metabolic differences between people who live with obesity and those who do not. We know that there is a range of effective treatment options for obesity, and while it certainly includes behavior modification and cognitive therapies, we can also explore pharmacological and surgical interventions. We also know that there are limitations to the effectiveness of physical activity on weight loss and obesity management.

Given all that we now know about obesity, it is vital that clinicians and other healthcare professionals make it a priority to educate themselves on best practices for effectively integrating physical activity into obesity treatment plans.

We need to re-examine the role of physical activity in obesity management. Heres why.

The notion that people can win the fight against obesity simply through dieting and exercise was taken to a new level with the introduction of The Biggest Loser to the cultural landscape. Contestants experienced dramatic weight loss while appearing on the show just as we might expect to happen when patients with obesity are prescribed high levels of physical activity along with around-the-clock monitoring but maintaining highly intense exercise regimes is unsustainable for most people with overweight and obesity. Additionally, a key insight from a long-term study of Biggest Loser contestants tells us that physical activity plays a larger role in maintaining weight loss than it does in catalyzing it.

Certainly, that doesnt mean that physical activity plays no role in the weight loss journey. But it does mean that we should exercise caution in thinking about physical activity in terms of isolated exercise not only is it an ineffective weight loss treatment for patients with obesity, but it reflects an outdated understanding of the metabolic mechanisms behind weight loss.

We know that sitting for long periods of time can negatively impact insulin resistance, but breaking up those periods with short walks can reduce insulin and glucose responses. With that in mind, a more effective and sustainable approach would dispense with eat less, move more and instead encourage patients to sit less, walk more.

What healthcare professionals need to know about incorporating physical activity into obesity treatment.

Heres what we do know about physical activity it can power a number of positive health outcomes. Exercise can improve lipoprotein levels, blood pressure, insulin resistance, mood and brain function and cardiovascular health in patients with obesity.

Healthcare professionals should keep the following best practices in mind when collaborating with patients on obesity treatment plans:

Keep patients grounded: Create realistic expectations of weight loss results, if any, based on individual patient activity programs. Help patients start to take a longer-term view of the weight loss journey to stave off feelings of burnout or frustration with the process. And level-set about the risk of sore muscles after starting a new exercise program.

Slow and steady wins the race: Patients often begin the treatment process with a great deal of enthusiasm which can inspire positive behavior changes, but it can also create the risk of exercise-related injury from doing too much, too fast. Help patients learn their individual exercise level and collaborate on finding ways to support and gradually increase the intensity.

Get things going: Starting a new exercise program can be a major hurdle to overcome. Help patients make the first step by connecting them with an easy-to-follow, actionable regimen that incorporates physical activity into their everyday lives. An easy place to start is by advising patients to walk a certain number of steps each day and gradually increase that footprint over time.

Reframe it: As discussed, physical activity delivers a number of health benefits beyond weight loss. Keep the myriad positive outcomes of physical activity top of mind for patients and help them to understand that exercise is just one part of a broader plan of care to improve their overall health. This insight can make it easier for patients to prioritize physical activity everyday.

Grow your obesity medicine knowledge: Healthcare professionals can better meet the needs of this rapidly growing segment of Americans by deepening their understanding of obesity medicine. The Obesity Medicine Association (OMA) provides a number of resources to encourage this endeavor, including The Obesity Algorithm, Obesity Treatment Proficiency Badges, ABOM certification preparation materials and more. OMA is also hosting a series of virtual courses on the fundamentals of obesity treatment an informative primer on evidence-based approaches for evaluating, diagnosing and treating obesity.

The number of Americans struggling with obesity may be growing but so is our knowledge of how to effectively treat the condition. Healthcare professionals who bring this knowledge into their practice areas can play a more active role in guiding patients with obesity to better health outcomes.

For more obesity medicine resources, or to become an OMA member, please visit: http://www.obesitymedicine.org.

Angela Fitch, MD, FACP, FOMA is the Associate Director of the Massachusetts General Hospital Weight Center and faculty at the Harvard Medical School. She is board certified in obesity medicine, internal medicine and pediatrics. Dr. Fitch serves as Vice President of the Obesity Medicine Association and previously served as Secretary-Treasurer.

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Why we need to rethink treating obesity with physical activity - Medical Economics

Each week the Reckon Women newsletter includes a column from an Alabama woman, in collaboration with See Jane Write. Click here to sign up for the newsletter. Click here to sign up for the Reckon Women Facebook page.

By: Millie Jackson

A few weeks ago, I was having a socially distanced visit with a friend. She quipped, Ive gained the Covid 19. Ill have to buy new clothes. I just shrugged. I knew that I had probably gained a few pounds during the time I have been at home, but I was no longer obsessing about it or particularly worried. I dont even own a scale anymore.

It hasnt always been the case. My weight has cycled up and down much of my life. My first diet was in junior high when I was considered chubby. I was rewarded with pretty clothes for losing weight. The message that thin was good and fat is bad had been reinforced and I learned it well.

The language of diet culture reinforces that we are supposed to hate our bodies, that we should be at war with fat, and that we should do anything possible to achieve an ideal that is not possible for many women. The $70 billion-dollar weight loss industry needs to feed us these messages to sustain itself. I have seen this language most of my life, but it has only been recently that I have really thought about what it is telling me.

At the beginning of the quarantine period there were many warnings about gaining weight while we were unable to live our normal lives, unable to exercise or go to the gym, unable to even go to the grocery store. Over the past few months I have read and seen many weight shaming postings and articles. There is really nothing new in the language, but I think it is more noticeable right now.

Weight can be a factor in health, but it isnt the only one. What it means to be healthy is multi-faceted and needs to take multiple factors into consideration. Reinforcing shame doesnt help anyone lose weight or improve their health.

I yo-yo dieted for decades, which was much more harmful to my health than maintaining a weight. A decade ago, I hit a high on the scale and looked for the most efficient way to make progress. What I found, a 1,000 calorie a day diet of bars and shakes, nearly destroyed my health and led to multiple injuries despite a 150 pound weight loss in a year.

I had done some crazy things before this Optifast, long term fasts, and the ever-present Weight Watchers, but nothing as drastic as that diet. Id like to claim that was my last diet, but it wasnt. But over the past decade I have been educating myself more about health and nutrition. Ive explored a number of the popular programs and diets. Some have benefits but some that appear positive send just as harmful of a message as the diet industry.

What I ultimately learned was that cooking real food, moving my body regularly through exercise that helped me rather than punished me, and not obsessing about a number on a scale served me better than any diet I had ever tried.

Over the past year I have settled into accepting and appreciating my body more. Im not always perfect and neither is it. It doesnt mean that I dont want to change some things but that isnt my constant focus. I have regained much of the weight I had lost because sustaining a 1,000 calorie a day diet along side a crazy exercise schedule is simply impossible. Im working on listening to my body more and what it needs. I have rediscovered exercise like walking which helps me move but also gets me outside more often.

Releasing much of the moral judgement about food and about my body has led me to be more content than I was when I focused on weighing, measuring and tracking every ounce of food I ate and every move I made. Losing weight was supposed to solve all my problems but in reality, it compounded some of my health problems. Rather than fight a battle with my body, I am now learning what matters to me being at peace with who I am right now.

Millie Jackson is a writer, coach, storyteller, and yoga teacher. You can learn more about her at http://www.millieljackson.com

Link:
The pandemic, body image, and what matters most - al.com

Adults at high risk for type 2 diabetes who had received eitherlifestyle intervention or metformin in the 3-year Diabetes Prevention Program (DPP) and continued in the Diabetes Prevention Program Outcomes Study (DPPOS) were less likely to develop diabetes than patients in theplacebo group over an average 22-year follow-up.

DPPOS chair David M. Nathan, MD, and other study investigators presented findings last week during the virtual American Diabetes Association (ADA) 80th Scientific Sessions.

At the end of the DPP, conducted in 1996-2001, patients in the lifestyle-intervention or metformin groupwere 58% and 31% less likely to have incident diabetes, respectively, than patients in the placebo group.

Now, 22 years after they enrolled in the DPP, patients were on average 72 years old and those in the original lifestyle intervention or metformin group were 25% and 18% less likely to have diabetes, respectively.

And participants who did not develop diabetes had significantly lower rates of eye, kidney, and major cardiovascular disease, at 57%, 37%, and 39%, respectively, according to a statement from the ADA.

"What we have shown is that diabetes prevention is possible," Nathan, from Massachusetts General Hospital and Harvard Medical School, Boston, told Medscape Medical News in an interview.

The DPP participants were at very high risk for diabetes, Nathan stressed.

"Their glucose levels were rising. They were overweight, if not obese, and we also overrecruited in ethnic and racial groups that are at particularly high risk African Americans, Hispanic Americans, American Indians, and Asian Americans."

This unique, long-term study showed "a pretty remarkable and not unexpected, some may say reduction in eye disease, kidney disease, and major cardiovascular disease in people who did not develop diabetes," he noted.

"I think it is important for providers and patients with prediabetes to know that even after 22 years, adults at high risk for diabetes have continued to benefit from metformin or prior intensive lifestyle modification in preventing or delaying" diabetes, Christine Lee, MD, told Medscape Medical News in an email.

Lee is program director of the Division of Diabetes, Endocrinology, and Metabolic Diseases, at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

In the DPP, 3234 patients at high risk of developing diabetes were randomized to receive placebo or metformin (850 mg twice a day) or an intensive lifestyle counseling program that aimed for 7% weight loss and 150 minutes of moderate exercise per week.

At the end of the DPP, 88% of participants (including those who had developed diabetes) entered the DPPOS; those who were taking metformin stayed on it and all three groups received less intensive lifestyle counseling.

As reported earlier, 15 years after enrolling in the DPP, 55% of participants in the lifestyle group and 56% of those in the metformin group had developed diabetes, compared with 62% of those in the placebo group.

At 22 years, 75% of patients from the DPP who were still alive were still participating in the DPPOS.

"The new findings did not show that taking metformin can prevent cancer, cardiovascular disease, or diseases of the eyes and kidney caused by diabetes," Lee pointed out.

However, "the data suggest that there may be some preventive effects of metformin for these outcomes in adults younger than 45 years [eg, a trend to less stroke], but these outcomes were more infrequent in this younger age group and further studies are needed before conclusions can be made for this age group."

"Conversely, there appeared to be a greater risk for kidney disease with metformin in older adults," she continued.

Therefore, "when balancing that risk [from metformin]" with prior, and newer, results that respectively show lifestyle modification works better than metformin for preventing diabetes in older adults, and can also decrease the risk of frailty in this same group, "patients ages 60 and older at high risk for diabetes should focus on intensive lifestyle modification for diabetes prevention," according to Lee.

Metformin is not approved for diabetes prevention in the United States, and it is unlikely that any of the several manufacturers of generic metformin would file a new drug application for this use with the US Food and Drug Administration, according to Nathan.

In the United States, an estimated 30 million people have diabetes (mostly type 2), including about 7 million not yet diagnosed, Nathen said, and another 90 million have prediabetes.

More research is needed to be able to identify which patients with prediabetes are most vulnerable to developing diabetes and would benefit most from prevention interventions, he stated.

Similarly, Lee said that the current findings "highlight the importance of trying to further understand differences in how metformin or lifestyle modification work in adults at high risk for diabetes."

"Research to better identify who can benefit most from metformin or lifestyle will help providers offer patient-centered approaches for diabetes prevention," she said.

In the meantime, and as previously reported, the US Preventive Services Task Force and the ADA recommend screening and lifestyle counseling to achieve weight loss and reduce diabetes risk in high-risk adults, and diabetes prevention programs are covered by Medicare, many commercial health plans, and some Medicaid and state employee health plans.

About 2 years ago, the Center for Medicare and Medicaid Servicesbegan funding the diabetes prevention lifestyle program for qualifying Medicare beneficiaries at high risk of diabetes, said Nathan, and the program is available in many US communities.

And as previously reported, the turnkey lifestyle program to prevent diabetes by the US Centers for Disease Control and Prevention (CDC) replicates the DPP intervention and is offered by 244 YMCAs at more than 1100 locations.

Patients receive coaching from trained individuals about making long-term dietary changes, increasing physical activity, and overcoming challenges to maintaining weight loss and a healthy lifestyle. Counseling is given in 22 sessions over 1 year.

However, few physicians are referring patients with prediabetes to the program. According to a 2019 CDC study, only 5% of individuals with prediabetes and 0.4% of those with an elevated risk of diabetes had been told by their physician to participate in a diabetes prevention program (JAMA Netw Open. 2019;2:E193160).

DPPOS is supported by the NIDDK, National Cancer Institute, National Heart, Lung, and Blood Institute, National Institute on Aging, National Eye Institute, Office of Research on Women's Health, and CDC. Merck supplied the metformin.

ADA 2020 Scientific Sessions. June 16, 2020.

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DPPOS at 22 Years: 'Diabetes Prevention Is Possible' Long Term - Medscape

The comprehensive research and analysis report comes out as an incredible and a must-have resource for global Weight Loss Stomach Pump Implants industry players to gain a competitive edge over their opponents. It includes reliable and verified industry size, CAGR, production, consumption, and sales forecasts for the global Weight Loss Stomach Pump Implants industry. It also provides industry revenue and volume estimates for years up to 2026. Readers of the report can easily become aware of ongoing and future trends, key opportunities, challenges, and growth drivers of the global Weight Loss Stomach Pump Implants industry.

The report offers highly detailed competitive analysis of the global Weight Loss Stomach Pump Implants industry, where the business and industry growth of leading companies are thoroughly evaluated on the basis of production, product portfolio, recent developments, technology, geographical footprint, and various other factors. The authors of the report have also provided information on future changes in the competitive landscape and the expected nature of competition in the global Weight Loss Stomach Pump Implants industry. This will help players to prepare themselves well for any unforeseen situations in the industry competition and give a tough competition to other players in the global Weight Loss Stomach Pump Implants industry.

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In the regional analysis section, the report offers in-depth analysis of top geographies and their drivers along with accurate forecasts for their growth rate, industry size, and other factors. The report also includes recommendations and suggestions for players to ensure long-term growth in the global Weight Loss Stomach Pump industry.

The following manufacturers are covered:Aspire BariatricsApollo Endosurgery

Segment by RegionsNorth AmericaEuropeChinaJapan

Segment by TypeBulimiaOthers

Segment by ApplicationHospitalsClinicsNursing HomesOthers

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Table of Content Covered in the Weight Loss Stomach Pump Market Report:

1 Study Coverage

1.1 Weight Loss Stomach Pump Product Introduction

1.2 Key Market Segments in This Study

1.3 Key Manufacturers Covered: Ranking of Global Top Weight Loss Stomach Pump Manufacturers by Revenue in 2019

1.4 Market by Type

1.4.1 Global Weight Loss Stomach Pump Market Size Growth Rate by Type

1.5 Market by Application

1.6 Coronavirus Disease 2019 (Covid-19): Weight Loss Stomach Pump Industry Impact

1.6.1 How the Covid-19 is Affecting the Weight Loss Stomach Pump Industry

1.6.1.1 Weight Loss Stomach Pump Business Impact Assessment Covid-19

1.6.1.2 Supply Chain Challenges

1.6.2 Market Trends and Weight Loss Stomach Pump Potential Opportunities in the COVID-19 Landscape

1.6.3 Measures / Proposal against Covid-19

1.6.3.1 Government Measures to Combat Covid-19 Impact

1.6.3.2 Proposal for Weight Loss Stomach Pump Players to Combat Covid-19 Impact

1.7 Study Objectives

1.8 Years Considered

2 Executive Summary

2.1 Global Weight Loss Stomach Pump Market Size Estimates and Forecasts

2.1.1 Global Weight Loss Stomach Pump Revenue Estimates and Forecasts 2015-2026

2.1.2 Global Weight Loss Stomach Pump Production Capacity Estimates and Forecasts 2015-2026

2.1.3 Global Weight Loss Stomach Pump Production Estimates and Forecasts 2015-2026

2.2 Global Weight Loss Stomach Pump Market Size by Producing Regions: 2015 VS 2020 VS 2026

2.3 Analysis of Competitive Landscape

2.3.1 Manufacturers Market Concentration Ratio (CR5 and HHI)

2.3.2 Global Weight Loss Stomach Pump Market Share by Company Type (Tier 1, Tier 2 and Tier 3)

2.3.3 Global Weight Loss Stomach Pump Manufacturers Geographical Distribution

2.4 Key Trends for Weight Loss Stomach Pump Markets & Products

2.5 Primary Interviews with Key Weight Loss Stomach Pump Players (Opinion Leaders)

3 Market Size by Manufacturers

3.1 Global Top Weight Loss Stomach Pump Manufacturers by Production Capacity

3.1.1 Global Top Weight Loss Stomach Pump Manufacturers by Production Capacity (2015-2020)

3.1.2 Global Top Weight Loss Stomach Pump Manufacturers by Production (2015-2020)

3.1.3 Global Top Weight Loss Stomach Pump Manufacturers Market Share by Production

3.2 Global Top Weight Loss Stomach Pump Manufacturers by Revenue

3.2.1 Global Top Weight Loss Stomach Pump Manufacturers by Revenue (2015-2020)

3.2.2 Global Top Weight Loss Stomach Pump Manufacturers Market Share by Revenue (2015-2020)

3.2.3 Global Top 10 and Top 5 Companies by Weight Loss Stomach Pump Revenue in 2019

3.3 Global Weight Loss Stomach Pump Price by Manufacturers

3.4 Mergers & Acquisitions, Expansion Plans

4 Weight Loss Stomach Pump Production by Regions

4.1 Global Weight Loss Stomach Pump Historic Market Facts & Figures by Regions

4.1.1 Global Top Weight Loss Stomach Pump Regions by Production (2015-2020)

4.1.2 Global Top Weight Loss Stomach Pump Regions by Revenue (2015-2020)

4.2 North America

4.2.1 North America Weight Loss Stomach Pump Production (2015-2020)

4.2.2 North America Weight Loss Stomach Pump Revenue (2015-2020)

4.2.3 Key Players in North America

4.2.4 North America Weight Loss Stomach Pump Import & Export (2015-2020)

4.3 Europe

4.3.1 Europe Weight Loss Stomach Pump Production (2015-2020)

4.3.2 Europe Weight Loss Stomach Pump Revenue (2015-2020)

4.3.3 Key Players in Europe

4.3.4 Europe Weight Loss Stomach Pump Import & Export (2015-2020)

4.4 China

4.4.1 China Weight Loss Stomach Pump Production (2015-2020)

4.4.2 China Weight Loss Stomach Pump Revenue (2015-2020)

4.4.3 Key Players in China

4.4.4 China Weight Loss Stomach Pump Import & Export (2015-2020)

4.5 Japan

4.5.1 Japan Weight Loss Stomach Pump Production (2015-2020)

4.5.2 Japan Weight Loss Stomach Pump Revenue (2015-2020)

4.5.3 Key Players in Japan

4.5.4 Japan Weight Loss Stomach Pump Import & Export (2015-2020)

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Coronavirus threat to global Weight Loss Stomach Pump Market Future Need Assessment 2027 - Personal Injury Bureau UK

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Physical exercise is an indispensable component of any health plan. With choices like jogging, running, swimming and cycling, theres something for everyones taste and preference. Even when it comes to exercises for the upkeep of mental health, there are many practices to choose from.

The age-old practice of yoga has witnessed unprecedented popularity in the recent years because of how wonderfully it integrates exercises to promote the well-being of the mind and body. Amidst the buzz around International Yoga Day, Id like to dwell some more on this holistic form of exercise. The theme for International Yoga Day this year was Yoga for Health Yoga for Home. Like with all things special in our lives, just one day of the year to honour the practice of yoga certainly falls short.

One outstanding feature of yoga practice is that it requires very little in terms of financial investment. In an earlier piece, Dont Pay For Good Health, I talk about the investments that we can make for health that dont cost much, but are of high tremendous value. Yoga fits this description very well.

With a low-cost and high-impact strategy to boost well-being, yoga requires no special equipment other than a modest mat. The only other thing you need is a little bit of space (indoor or outdoor) to stretch. However, this does not mean that the practice requires no other commitment. To reap its benefits, the commitment of consistency over a period of time is essential. The benefits that accrue from yoga are akin to financial investments there are some short-term gains, but the real magic happens in the long term.

Yoga, like many other forms of exercise, decreases the risk of illness. This includes gains in terms of cardiac health, diabetes, blood pressure, weight management, anxiety and depression, among many other conditions. I commonly find that when trying to motivate people to exercise, wellness or immunity rarely work as an incentive, but weight loss does. Finding an effective incentive to exercise regularly is sometimes all it takes.

Once you make yoga practice a regular feature, it will surely enable you to maintain healthy practices in other spheres of your life. After all, the practice of yoga is very holistic in nature. Its physical component (asanas) improves flexibility, coordination and body strength. Pranayama, which is the breathing component, helps to diminish anxiety and induce a state of calm.

Yoga is a way of life, just like what a diet was originally meant to be (the word diet is derived from the Greek word diata, which means a way of life).

Yoga and dietetics both believe in a holistic way of life. Food is nourishment for the body and mind, as is yoga. At a time like this, we ought to do what we can to maintain physical and mental strength.

Neelanjana Singh

Nutrition Therapist & Wellness Consultant

View original post here:
The Pricelessness of Exercise - The New Indian Express

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Between all the trendy diets like low-carb, keto, and intermittent fasting, it can be hard to keep track and figure out what might actually work for you. What's more, plenty of these diets have led to all sorts of spin-offs and other versions, including this buzzy one: fat fasting.

While the name sounds a little counterintuitive, this diet involves upping your fat intake, but only for a short period of time. Read on for a full breakdown of the diet, with input from a registered dietitian.

Fat fasting is a very short-term high-fat, low-carb meal plan, usually lasting just three to five days, according to New Jersey-based dietitian Erin Palinski-Wade, RD, CDE, author of Belly Fat Diet For Dummies. Although this is not an actual fast, it is referred to as one since the body forced into a state of ketosis (when you're burning fat for energy) due to the high-fat, low-carbohydrate intake, explains Palinski-Wade.

While it sounds a little bit like a quickie keto diet, it's not the exact same thing. Unlike the keto diet, your calories are restricted to 1,000 to 1,200 per day with 80 to 90 percent coming from fat, which is slightly higher in fat and significantly lower in calories than the standard keto diet. But it's similar in that the focus is on increasing fat intake to achieve ketosis.

Yes, it can. However, any fat loss will likely not be sustainable. As mentioned, the fat fast forces the body into ketosis, which is the process your body uses to convert fat into energy when the body is starved of glucose, explains Palinski-Wade. Your body no longer uses glucose (which is produced from carbs) for fuel when you've been fasting, or when carbohydrate intake is very low, she adds.

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The very low carbohydrate content and low calorie level of the fat fast quickly forces the body into ketosis, Palinski-Wade explains. "[The method] has been touted as a way to break through weight loss plateaus, or for individuals on a ketogenic diet to get back into a state of ketosis after a cheat day, she notes.

Remember: The goal is to keep calories between 1,000 to 1,200 per day and consume 80 to 90 percent of your total calories from fat.

So, foods high in fat with few to no carbohydrates are the ideal choice for this diet, says Palinski-Wade. These can include both animal- and plant-based foods, such as:

Foods you'd want to avoid while fat fasting include:

Due to the extremely low calorie intake and very restricted meal plan choices, it would be next to impossible to meet your daily nutrient goals while following a fat fast, says Palinski-Wade.

This plan is promoted to only last three to five days as a jump start [to weight loss or fat burning], but restrictive diets such as these are unsustainable long term and generally result in binges after such periods of restriction, she explains. The very low calorie and carbohydrate intake of this fast may result in reduced energy, changes in mood, reduced endurance, and nausea and headaches.

For people with diabetes or those on blood glucose-lowering medication, this type of meal plan may also significantly increase the risk of hypoglycemia, she adds. This form of fasting may also negatively impact athletes and those with intensive exercise routines.

Palinski-Wade notes that she generally would not recommend this diet for, well, anyone. However, if someone did try this diet plan, they should be sure to discontinue it within three to five days to prevent nutrient deficiencies, she adds.

Generally crash diets like this plan result in rebound eating behaviors, yo-yo dieting, and unsustainable weight loss, she says. People with diabetes definitely should avoid this form of diet (or consult their medical team before starting) to prevent episodes of hypoglycemia.

The bottom line: Fat fasting may help you burn fat or get through a weight loss plateau temporarily, but the weight loss will likely not be sustainable and may lead to nutritional deficienciesand Palinski-Wade does not recommend this technique.

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What Is Fat FastingAnd Is It Good For Weight Loss? An RD Weighs In - Women's Health

Metformin, a low-cost diabetes drug that has been dubbed a "miracle" because of its potential anti-aging properties, could also play a role in preventing the worst effects of the coronavirus, according to a preprint study from the University of Minnesota.

The study, which was one of the largest observational studies of coronavirus risk factors so far, found that obesity and diabetes were two big risks for COVID-19-related death, the Minnesota Star Tribune reported.

Tignanelli said metformin may help with COVID-19 infections because it reduces inflammation and lessens the body's immune system response. In some cases, people with COVID-19 have an overreactive immune response to the virus, which can result in death.

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An April 2019 study published in the journal Annals of Internal Medicine found metformin could help people lose weight for the long term.

"Taking a pill a day is a lot easier than going to diet and exercise for 15 years. Almost no one can achieve it," Dr. Kishore M. Gadde, the lead study author, previously told Insider.

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A 'miracle drug' used for diabetes and weight loss maintenance may play a role in reducing coronavirus deaths - Business Insider India

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