Understanding gastroparesis; how to lose weight safely

Q: My doctor told me that I have gastroparesis and that it is a result of my diabetes, which I have had for 15 years. What is it and how can I manage it? – Janice J., Lansing, Mich.

A: Gastroparesis is a digestive tract disease that results from nerve damage associated with chronically high glucose levels. People with obesity are 10 times more likely to report symptoms of gastroparesis, and about 30% of people with type 2 diabetes will develop the condition. That’s because excess blood sugar damages the vagus nerve, which starts on the brain stem and runs through the abdomen, carrying signals back and forth between your digestive system and the brain. When damage occurs, stomach acid flow is reduced and messages telling your stomach to move food into the intestines are missing. The food remains undigested in the abdomen, causing irregular glucose levels, making your diabetes even more difficult to control and exposing you to very high or low blood sugar levels. It also triggers abdominal pain, nausea, and vomiting.

If gastroparesis is unrelated to diabetes (but it usually is), it can result from Parkinson’s disease, acid reflux, viral infection, or kidney problems. To relieve symptoms, you should avoid raw and high fiber foods; fatty foods such as dairy products, fried foods, and red and processed meats; and carbonated drinks. Treatments that go beyond lifestyle adjustments and tight blood sugar controls may include surgery for those with a dysfunctional pyloric valve that acts as the “door” that separates stomach contents from the small intestine. Gastro-oral endoscopic myotomy, or G-POEM, can provide relief for up to a year. There are also many off-label or experimental drugs that are being studied. You and your doctor can go to https://repository.niddk.nih.gov/studies/gpcrc/ for clinical studies and more information about possible prescribing approaches. You should be able to find some relief from symptoms.

Q: I am on a weight loss diet and my friend keeps warning me about the risks I am taking. That seems crazy because being overweight is really risky. Are there any dangers in losing weight? – Benita F., Phoenix

A: Achieving and maintaining a normal weight is not risky – it is essential for improved health. But and there’s always a crash diet or yo-yo diet, that’s a whole different story. Weight loss should be achieved by adopting new habits for life, rather than extreme or rigid diets that practically guarantee failure.

Research on the “The Biggest Loser” candidates has shown that extreme diets slow your metabolism down much more and for longer than ever thought. And a meta-analysis of studies found that dieters regain more than half of what they lose in two years.

Crash dieters can lose muscle strength and develop slow heart rates, electrolyte imbalances, decreased oxygen use, impaired brain performance, and depression. They also throw their leptin (I’m full), ghrelin (I’m hungry), and insulin hormones off balance, which makes weight gain even more likely. In extreme cases, you may see hair loss, trouble sleeping and interruptions or complete suspension of the menstrual cycle.

As for the yo-yo diet, one study found it doubled the risk of heart attack, stroke, and death for people with heart disease. And repeated failure to achieve a weight goal is strongly linked to developing binge eating disorder.

Better choice: A slow, effective change in your diet and exercise patterns.

Avoid one unhealthy food per month for six months (permanently): soda one month, french fries the next, then red meat, high-fat dairy products, processed meats, and sugary foods and beverages. This gives you space for fatty fish, skinless poultry, five to nine servings of fruit and vegetables per day, 100% whole grain products and legumes.

Start walking, take 10,000 steps or the equivalent every day. Add aerobics, biking, swimming, and weight training two days a week. Just move it and move it often.

You can safely lose weight – with lasting benefits for your health and happiness.

Mehmet Oz, MD is hosting “The Dr. Oz Show,” and Mike Roizen, MD is the Cleveland Clinic’s Chief Wellness Officer Emeritus. To live the healthiest life, turn on “The Dr. Oz Show ”or visit sharecare.com.

(c) 2021 Michael Roizen, MD

and Mehmet Oz, MD

King Features Syndicate

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