That's a good question. I'm not sure what is the answer to your question. I'll do some research and get back to you if I discover an anything. You should email the people at Medifast as they probably could assist you..

Your right about one thing. Health care providers really don't seem to know how to deal with us. In some cases they would rather not...

In my opinion, this problem seems so obvious to me. The problem lies with expectations. People tend to trust and put a little.

Faith.

In their primary care provider, (which doesn't seem unreasonable). We trust our doctors to care for us when we are sick, check us out when we arn't feeling right, and refer us for tests and get us to the right specialists. All very normal to expect, but where we go wrong is that we also expect them to be our health care directors. And that responsiblity is actually in our own hands unfortunately. And I say unfortunately because I feel like the general population is grossly uneducated about their own health as well as what their options are to do about it. If you asked me how is my health, I could give you a vague answer, but honestly I wish I had more details.

Then and only then we won't be sitting around asking the "why didn't I know" questions...

I am with Callie. And again, the pre-op consult is NOT a psychiatric diagnostic consult. If you think you have any sort of brain-based disorder or have simply found life to be a struggle from way back, you need to tell somebody so you can get help. Providers are not mind readers. And for all of you who resonate with Jerry's concerns, I suggest you read anything written by Daniel Amen on ADD and other brain issues so you know how to have that conversation with a provider...

Callie & bhm,.

Your point about being our own "health care directors/advocate" is well taken and I strongly agree! We cannot be 'doctors' but often we must take responsibility for educating ourselves enough to ask to right questions of the right professionals. That directly leads to better outcomes. This is no small point - I believe it is critical - and not just with respect to ADHD but to the whole of our health care. Significantly, nowhere is your point more true than in a field like adult ADHD and obesity that is both rapidly changing and subject to strong misconceptions,- reinforced by undesirable attitudes - among health care providers..

Treatment of ADHD is multi-modal - i.e. you don't just treat it with meds but with a combination of meds,.

Exercise.

,.

Behavior modification.

,.

Counseling.

, nutrition, coaching, etc. For more, see:.

Http://www.healthcentral.com/adhd/t....

But by far (and closely tied to the point you make), ADHD patients are urged to make educating themselves and their families a very high priority from the start. Self-education is seen as key to the kind of multi-modal treatment recommended by Hallowell, Amen, Fleming, and many others..

It has quite interesting to see how the multi-modal approach to ADHD fits 'hand-in-glove' with the multi-modal approach required for weight loss.

Surgery.

Patients. They overlap in many areas - diet,.

Exercise.

, etc. And because of the close link between obesity and ADHD, this should surprise no one..

The following 3.

Books.

Are among my personal favorites:.

"Driven To Distraction" by Edward M. Hallowell.

Http://tinyurl.com/adhd-edhallowell-1.

Considered by many to be THE book..

"Delivered From Distraction" by Edward M. Hallowell.

Http://tinyurl.com/adhd-edhallowell-2.

Sequel to the original with lots of updated information. These two Hallowell.

Books.

Together form the basis for an excellent core understanding..

"ADD-Friendly Ways to Organize Your Life" by Judith Kolberg and Kathleen Nadeau.

Http://tinyurl.com/adhd-kolberg-1.

This book spends no time with the basics of ADHD, meds, treatments, etc. - it assumes you know the basic. It focuses instead on providing a lot of practical advice for day-to-day living. Great tips and techniques for working WITH your ADHD rather than against it...

A recent study showed that adults treated for obesity who also had ADHD have significantly more problems achieving weight reduction as well as a worse outcome in standard treatment programs..

If one modifies the diagnostic criteria of ADHD and defines the age of onset of ADHD symptoms at 12 (instead of 7 years), then ADHD is very frequent among obese individuals. 27.4% of all patients with obesity also had ADHD. Severe obesity (BMI over 40) had an even higher frequency of ADHD (42.6% of this treatment group). These patients with both obesity and ADHD had more hospitalisation and longer treatments with lower response rates..

Up to now, very little systematic.

Research.

Is available and only few psychotherapists or doctors will do an evaluation for ADHD in this group of patients with eating disorder..

Source:.

Http://web4health.info/pl/adhd-como.....

I suspect these attitudes held by many health care professionals are simply a reflection of attitudes in the general population and are linked to the strong repulsion response known as the "Uncanny Valley". I first wrote about the Uncanny Valley and why it is important here:.

Http://tinyurl.com/uncanny-valley-post.

For many people, the obese fall into the uncanny valley. Health care professionals are people too - not immune from the uncanny valley response. All the more reason to be our own best advocates...

ABC/ GMA. A new analysis of U.S. health data links children's attention-deficit disorder with exposure to common pesticides used on fruits and vegetables..

Great! Now eating healthy snacks puts kids at greater risk!..

Bari,.

Had seen this a few days ago. As a general philosophy, I whole-heartedly support efforts to improve the quality and safety of our Medifast food supply - from production to table. This includes scientific.

Research.

Into any potential dangers. We won't know about risks if we don't look. Seems like a no-brainer. Also, minimizing our exposure to pesticides just makes sense in so many ways..

In my initial.

Research.

Into ADHD, one thing I had to constantly keep in mind was the very important distiction between CAUSE and CORRELATION. Understanding the difference is an important tool for evaluating any evidence we are presented with. From my original ADHD post:.

...is the huge difference between CAUSE and CORRELATION. The rule is: "Correlation does not imply causation" - i.e two things can be somewhat correlated ('linked in some way') but that does not mean one 'causes' the other - there may be an infinite number of explanations. This is no small distinction. As non-professionals researching ADD/ADHD, we often want to ask the question "Is there a link between X and Y?" That depends on the definition of the word 'link' and we quickly find ourselves in that foggy "shades of gray area" when what we really want are clear cut and solid answers. More on the differences between cause and correlation can be found at:.

Http://en.wikipedia.org/wiki/Correl....

There are many shades of gray associated with ADD/ADHD in general - and particularly when it comes to undiagnosed ADD/ADHD in adults. These shades of gray lead some people to conclude, erroneously I beleive, that ADD/ADHD is not real..

....

For example, I've learned that people with ADD/ADHD are more likely to smoke than the general population. I used to smoke many years ago but thankfully gave that up. Did I smoke because of my ADD/ADHD? In short I don't know. Could it have been a contributing factor? Possibly. But I've stopped demanding a yes or no answer..

Src:.

Http://tinyurl.com/gbs-adhd.

"It A Kids World After All".

(Page 3, Reply #24 ).

As another example, I've learned that there is a "link" between ADHD and mothers who smoked during pregnancy. My mother smoked during the time she carried me. Did this cause my ADHD? Did it 'contribute' towrads. Who knows. But it doesn't matter. Even if that were true, I would not trade my mother for all the gold in the universe.



But should this "link" cause us to look deeper. Yes, perhaps so...

BTW, Here's a link to a Time article on that study:.

Http://tinyurl.com/adhd-pesticide..

Why, if ADHD is so highly prevalant among severely obese people, is this potential not taken more seriously - particularly in candidates for weight loss.

Surgery.

? One possible factor is found in the attitudes of the health care providers themselves:.

Quote.

Many clinicians are still unaware that ADHD is a problem among millions of adults in the United States or they may not see ADHD as a valid diagnosis for adults, and consequently, many adults are not diagnosed with the disorder. The problem of acknowledged diagnostic legitimacy is shared by patients with several other medical disorders, such as obesity and fibromyalgia, both of which are now being found in a relatively large proportion of adults with ADHD..

The patient with both ADHD and obesity is in a particularly difficult situation. For example, a 2009 analysis[1] of studies on attitudes toward the obese by Puhl and Heuer found a significant percentage of physicians expressed negative attitudes; in 1 study included in this analysis, more than 50% of primary care doctors said obese patients were unattractive, ugly, and awkward, and one third said obese patients were lazy, sloppy, and weak-willed; in another study, 30% of general practitioners said obese and overweight patients were more self-indulgent and lazier than others and 60% said a lack of motivation was the most common issue in treating patients with weight problems. In a survey of 250 internal medicine, psychiatry, and pediatrics specialists by Jay and colleagues,[2] more than 40% of the doctors reported negative reactions to obese patients..

Yet treatment of both ADHD and obesity can provide considerable relief....

Source:.

"ADHD in Adults With Medical Comorbidities : Provider Attitudes and Medical Comorbidities".

Http://cme.medscape.com/viewarticle....

(Access requires free registration)..

Jerr,.

As someone with Bipolar issues, I can tell you that providers are not more sensitive to behavioral symptoms of disease than the geheral populus, nor are attorneys. I tell them ahead about it, but it never fails, if I respond angrily, they completely forget that that is why I am there in the first place!.

On another note, I have been.

Reading.

Your volumes of ADHD entries with moderate interest, and then the funniest thing happened. I had bought a book on ADHD to read and take an online test for CEU credit. I always take the pre-test, where you are lucky to make 30%. I made an 80% on the pre-test and automatically got my certificate. You never know...Keep the good info coming, I am also.

Learning.

A lot about my son's ADHD as a new manager, and often share your posts with him...{:>}..

Thanks. One thing I'm finding helpful - a way to keep perspective - is a a bit of self-deprecating.

Humor.

My latest favorite joke:.

Q: How many ADHD adults does it take to screw in a lightbulb?.

A: Wanna go bike riding?.

I find this hilarious (and also highly applicable to myself), but its.

Humor.

Is generally not readily evident to those not familiar with ADHD. As with any joke, if you have to explain it, it loses much in translation.....

I was delighted to run across this - a recent article in the Wall Street Journal that actual does a fairly decent job of informing people about ADHD in adults:.

Http://tinyurl.com/adhd-wsj.

"It's extremely hard for me to sit my butt in a chair. I get fidgety. I want to get up," says Linda Hensens, 46, a medical transcriptionist in Clayton, N.C., who discovered she has ADHD when a bariatric surgeon asked about her working habits. "I'll think of the wash that needs to be done and clothes that need to be folded and dusting that needs to be done and, Oh my god, I promised my nephew I'd make a cheese cake, and I've got Easter dinner to plan. My mind is going like that all the time.".

(Note from Jerry: ADHD among WLS candidates? Apparently, some bariatric surgeons are giving ADHD more serious consideration in WLS candidates.).

.....

ADHD frequently goes hand in hand with depression, anxiety and bipolar disorder, and it can be difficult to untangle which came first. "It's very common for someone to be treated for depression or anxiety for years, and have the therapist not notice the ADHD," says Mary Solanto, director of the AD/HD Center at the Mount Sinai Medical Center in New York City. But adults whose ADHD is left untreated face a high incidence of substance abuse, automobile accidents, difficultly staying employed and maintaining relationships..

....

Adults more typically have trouble with paying attention, focusing and prioritizing. Managing time and money are particularly difficult..

....

But adults whose ADHD is left untreated face a high incidence of substance abuse, automobile accidents, difficultly staying employed and maintaining relationships..

That said, some adults with ADHD are highly intelligent, energetic, charismatic and creative.....

In the end, diagnosis is like a big dart board with a lot of pharmacy invented names that treat thi,s that and the other thing. Professionals have their favorite diagnoses and treatments, and there is a better than even chance that's what they'll see. If you only have a hammer, everything looks like a nail..

Mis-diagnosis of eating disorders are another whole topic, but believe me, since nobody really knows how to fix it, there's no investment in diagnosing it, so the vast number of compulsive and binge pattern eaters are never diagnosed. Imagine trying to throw ADHD in the mix?.

The last thing doctors and patients in the midst of launching a weight loss.

Surgery.

Shuttle, that may have the odd rusty O-Ring, want to hear is about addiction, or ADHD, or anything else that might add stress or time to the procedure..

SO, you just tuck the ball and sprint for the goal... Some folks, like me, would rather deal with as many issues as possible on this side of the blade, but that's just me. You never had the choice, but I'll bet a few years to deal with this ADHD thing would have been nice, once you realized how it was impacting your future...Good for you that you are holding out and not letting others tell you how to feel or what to think..

Things like ADHD, and Addiction, and Depression are off topic to a lot of people, except those who have these challenges. God forbid a real psychological should encumber the process with information people need to know to make the decision to have the.

Surgery.

, and have a plan to deal with it on the other side...That's so...clinical..

Do I know which is better in the long run? Hell, I don't even have statistics for the procedure I am planning to have. I only know that if you don't want to complicate an existing disorder that is not being treated..

Stress, pain, drugs. and major rearrangement of one's entrails can exacerbate the situation and potentially put the patient at risk of severe illness, mortality or, "worst of all," regain...IMHO..