Weight loss surgery for children and teens struggling with obesity – Harvard Health Blog


Right now, one in 12 children and adolescents in the US are severely obese. If that isn’t startling enough, consider this: among 12-to-15-year-olds, that number jumps to one in 10 — and among 16-to-19-year-olds, it is one in seven. According to the American Academy of Pediatrics (AAP), the best hope for many of these youths may be bariatric surgery. Bariatric surgery is surgery that helps with weight loss by making the stomach smaller and making other changes in the digestive system.

It’s jarring to think about doing irreversible surgery on an adolescent — or a child, as the AAP discourages age limits for bariatric surgery. But the reality is that obesity, with all of its risks, can be equally irreversible.

In children and teenagers, obesity is defined as a body mass index (BMI) greater than or equal to the 95th percentile for age and sex. If you are obese by the time you are 12, research suggests you have a 98% chance of being obese as an adult. Those are not good odds — and they are made more alarming by the complications of obesity. Diabetes, high blood pressure, fatty liver disease, and obstructive sleep apnea (which can lead to further problems, including heart disease) are the most common complications among younger people. In adults, the list expands to include even more problems, such as stroke, arthritis, and cancer.

Clearly, this is not a problem we can ignore.

When obesity isn’t severe, lifestyle changes such as eating a healthy diet and getting more exercise are absolutely the go-to methods of care. But once you get into severe obesity — usually a BMI of 35 or higher — lifestyle changes just don’t do the trick. (Severe obesity is a BMI greater than or equal to 120% of the 95th percentile for age and sex.) If lifestyle changes are all we suggest for children with severe obesity, we are condemning them to obesity and all of its complications. It’s that simple.

What does research on bariatric surgery tell us?

In the longest study of the effectiveness of bariatric surgery in youths, which followed patients for eight years on average, those that had surgery lowered their BMI by 29%. Those that didn’t have surgery? Their BMI went up by an average of 3.3 points.

Of course, the idea of surgery raises concerns. Yet bariatric surgery is actually safe and effective if done by experienced surgeons working in a high-quality center, with a strong multidisciplinary team that can give patients and families the ongoing education and support they will need, including psychological support. Surgical complications are infrequent and usually minor. The most common complication is micronutrient deficiencies, such as iron deficiency. While these can be prevented by taking supplements regularly, the reality is that adolescents are not always great about taking anything regularly. That’s why it’s important that the surgery be done at a center that offers a team approach and follow-up care in years to come.

Which children might benefit from weight loss surgery?

According to the AAP, parents and pediatricians can consider bariatric surgery if a child or teen

  • has a BMI greater than or equal to 35 and one or more complications of obesity
  • has a BMI greater than or equal to 40 whether or not they have complications.

Not everyone who falls into those groups should have surgery, though. It is not recommended for youths who

  • have untreated or poorly controlled substance abuse problems
  • have eating disorders
  • are pregnant or planning pregnancy.

It is also not recommended for those who can’t follow all the post-operative recommendations, including all the lifestyle and eating changes that are mandatory after surgery. Anyone who has had bariatric surgery needs to be very careful and thoughtful about what they eat, not just in the weeks and months after surgery, but for the rest of their lives. They’ll also need to take supplements every day.

The bottom line

While bariatric surgery is clearly not a decision to be taken lightly, it’s not a decision we should be avoiding, either. If we want to give severely obese youth their best chance of a healthy life, we have to get over our fear of surgery — and the common bias that obesity is just a matter of personal responsibility (think willpower) and not the medical problem that it is. Our children deserve better.



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Thousands of ‘Penis Fish’ Have Washed Up on a California Beach


After an influx of dark and stormy weather, residents in California’s Bay Area awoke to find their local beach awash with what appeared to be hundreds and hundreds of pulsating pink penises.

 

“I had no idea what they might be… it went on for two miles,” resident David Ford told Vice.

“I walked for another half hour and they were scattered everywhere. There were seagulls lined up the beach the whole way having eaten so much they could barely stand.”

Baffled by what he was seeing on Drake’s Beach, Ford reached out to a biologist at Bay Nature, who explained that yes, while these pink and swollen logs totally look like a bunch of dicks, they are in fact a strange species of marine worm known as the “fat innkeeper” (Urechis caupo) – or, more colloquially, the penis fish.

“Yes, the physical design of the fat innkeeper worm has some explaining to do,” wrote biologist Ivan Parr on the Bay Nature website.

 

“But the fat innkeeper is perfectly shaped for a life spent underground.”

It just so happens that ‘perfect’ shape also looks an awful lot like the most prominent part of male external genitalia, with a pink tip and everything.

Found along the west coast of Northern America, this approximately 25 centimetre-long creature (10 inches) builds its home in sand or mud, burrowing into a nice, safe U-shaped tunnel with an entrance that looks sort of like a “chimney“.

penis worm house chimney(Rebecca Johnson/iNaturalist/CC BY 4.0) “When the tide is in, the worm slides up to the chimney of its burrow and exudes a sticky mucous net from a ring of glands,” explains Parr.

“Sometimes you can see these mucous nets, looking like decaying jellyfish, draped around the burrow entrance.”

As the worm digs deeper into its burrow, this creature secretes a slimy net, which slides all the way from the entrance into its mouth.

Using its three layers of muscles, the worm then pumps a bunch of water into its hole, sucking plankton, bacteria and other yumminess into its net, before slurping it all back like a shot.

It’s name, the innkeeper, comes from all the freeloading worms, crabs, goby and shrimp who enter its burrow and eat along with it. But building your house out of sand inevitably comes with its risks.

“Strong storms – especially during El Niño years – are perfectly capable of laying siege to the intertidal zone, breaking apart the sediments, and leaving their contents stranded on shore,” explains Parr.

Hence a beach full of dicks.

 





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Black Patients May Not Benefit On Low-Dose Aspirin


By EJ Mundell
HealthDay Reporter


WEDNESDAY, Dec. 11, 2019 (HealthDay News) — The daily use of low-dose aspirin against heart disease may have taken another knock.

New research shows that the practice may not provide black Americans with any lowering of their heart attack risk.

Researchers analyzed 11 years of data from more than 65,000 people, ages 40-79, living in the American Southeast. More than two-thirds of the participants were black, and about two-thirds were at high risk for heart attack or stroke at the start of the study period.

Taking low-dose aspirin was associated with a reduced risk of a fatal heart attack in whites, particularly in white women, but it did not appear to lower the risk among blacks, even among those with the highest risk of heart disease, the research found.

The reasons for the “race gap” in aspirin effectiveness are unclear, but “we think the reason aspirin use did not have a beneficial effect for African Americans could involve a different genetic response to aspirin therapy and poor control of other risk factors,” said study lead author Dr. Rodrigo Fernandez-Jimenez. He’s a cardiologist and researcher at National Center for Cardiovascular Research in Madrid, Spain.

The researchers stressed that the study wasn’t designed to prove cause and effect, only showing associations between aspirin use and heart health. The findings were published Dec. 11 in the Journal of the American Heart Association.

While millions of aging Americans take a daily low-dose (81 milligrams) aspirin in hopes of reducing their odds for heart attack and cancer, new data has emerged casting the practice in doubt.

In fact, earlier this year, the American Heart Association and the American College of Cardiology issued a joint statement that — at least in older people at low risk for heart disease — daily aspirin use was probably not worth it, given the added risk for bleeding tied to the drug.

Dr. Benjamin Hirsh directs preventive cardiology at Northwell Health’s Sandra Atlas Bass Heart Hospital in Manhasset, N.Y. He reviewed the study and agreed that “physicians are accustomed to prescribing aspirin to patients with lower risk of heart disease, but the findings of this study and others are changing this practice.”


Continued

Also, most of the previous research on aspirin’s usefulness against heart trouble was based on data from white patients, Fernandez-Jimenez noted.

“Most available data shows that African Americans have a higher risk of having a heart attack, stroke or other heart diseases compared to whites; however, previous studies didn’t include enough black participants to determine if taking a low-dose aspirin for primary prevention of heart disease was useful for this group of people,” he said in a journal news release.

Dr. Satjit Bhusri is a cardiologist at Lenox Hill Hospital in New York City. He stressed that aspirin is still being recommended for people at high risk of a heart attack, such as those who’ve already had an attack.

So why didn’t that benefit seem to extend to black patients? “There may be an underlying genetic, compliance or socioeconomic play here,” said Bhusri, who wasn’t involved in the new study.

In the meantime, informed decisions as to who is “high-risk,” regardless of race, are easily made, Hirsh said.

“We now have multiple tools including imaging scans, such as coronary calcium scores, which help identify individual risk to guide the recommendation for aspirin,” Hirsh explained. “We need to individualize our patients’ risk of heart disease in order to determine who will be most likely to benefit from aspirin.”

That’s in keeping with American Heart Association guidelines, which now advise that decisions about aspirin use must be based on a patient’s specific health status, in consultation with their physician.



WebMD News from HealthDay


Sources

SOURCES: Satjit Bhusri, M.D., cardiologist, Lenox Hill Hospital, New York City; Benjamin Hirsh, M.D., director, preventive cardiology, Northwell Health Sandra Atlas Bass Heart Hospital, Manhasset, N.Y.;Journal of the American Heart Association, news release, Dec. 11, 2019




Copyright © 2013-2018 HealthDay. All rights reserved.





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Europe’s XMM-Newton Telescope Celebrates 20 Years of X-Ray Astronomy


A European Space Agency telescope celebrated 20 years of exploring the secrets of the X-ray universe this week.

The XMM-Newton telescope, which launched on Dec. 10, 1999, has made contributions in various fields of science and astronomy, and has observed objects ranging from galaxy clusters to star flares. But in a press release celebrating the anniversary, scientists zeroed in on the observatory’s black hole discoveries.





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Behavior Change Agents: How Health Coaches Help Clients Change


I want to share with you some of the behavior change techniques that I use to help my clients shift their health behaviors.

How do health coaches help people change their behavior? Check out this article from health coach Will Welch to find out. #healthylifestyle #changeagent #kresserinstitute

How Do Coaches Help People with Behavior Change?

Those of us who choose health coaching as a career and those of you who are interested in becoming health coaches share an essential characteristic: we want to help people find their best health and their best life. So what’s the best way we can do that?

Is it by giving people information or telling them what health behaviors they should start and stop? Or is it by helping them explore what matters to them, determine what changes they’re ready for, experiment with behavior changes, and connect their goals to their long-term vision of health and well-being? I’m sure you can guess which of these two approaches I use as a coach.

I’ve always found value in the proverb, “If you give a man a fish, you feed him for a day, but if you teach a man to fish, you feed him for a lifetime.” As a health coach, I don’t teach my clients or give them “the answer.” Instead, I help them learn how to build habits and set goals. I’ve found that distinction to be key to my success as a health coach.

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Becoming a “Change Agent”

Health coaching is a growing field, but it’s still the Wild West—at present, anyone can call themselves a health coach, and anyone can share what they read in a book or heard on a podcast. People who want to improve their health benefit most from working with a certified health coach who has been trained to facilitate behavior change, not just regurgitate nutrition, exercise, and lifestyle information. As a coach, if you want to help people improve their health, enroll in a health coaching certification program and learn how to become a “change agent.”

Becoming a change agent takes a lot of practice to master. The ADAPT Health Coach Training Program offers world-class coaching training, and it is the only program with a curriculum that integrates Functional and ancestral health along with the art and practice of coaching. It has more hands-on training with experienced Mentor Coaches than any program available, which gives you the practice and feedback you need to help your clients in the best way possible.

My ADAPT training, as well as my experience as a health coach, has taught me several things about helping people change their behavior. Here are some tips and takeaways.

Being a Change Agent Means Building a Foundation for Change

Coaches don’t just snap their fingers and see their clients’ behavior change, nor do they tell their clients to change and expect them to comply. The stage is set for change when coaches and clients build a foundation of rapport and trust, coaches meet clients “where they are,” and clients are open to coaching.

Rapport

Client behavior change starts with establishing rapport. For me, rapport building begins from the moment I meet a client:

  • Am I present?
  • Am I warm and responsive?
  • Do I listen to and understand what they are saying?
  • Have I checked my biases, judgments, and agenda at the door?

If I can answer “yes” to all these questions in the first few minutes of a coaching session, then it’s likely that I’m laying down the foundational elements of rapport and trust with my client.

Credibility

Credibility is also crucial for building trust. As a certified health coach, I have the practical skills that an effective coach brings to the client-coach relationship and the education to understand the health problems of my clients, I know where to turn for useful resources, and I can spot and refer out “red flags” when they arise. Demonstrating these skills helps further foster trust with my clients.

Earning credible certifications also fosters trust with clients, potential employers, and the general public. The ADAPT Health Coach Training Program offers the ADAPT-Certified Functional Health Coach (A-CFHC) certification. Becoming an A-CFHC means demonstrating the knowledge, skills, and behaviors that are necessary to act safely and effectively as a Functional Health coach. Becoming a board-certified health coach through the National Board for Health & Wellness Coaching (NBHWC) also demonstrates a commitment to the profession and furthers your credibility.

The American Medical Association is also beginning to recognize the value of credentialed, credible health coaches in their creation of CPT codes for coaching services. See this press release for more information on what this decision means for health coaches.

Meeting Clients Where They Are

Have you ever heard the phrase, “when all you have is a hammer, everything looks like a nail”? Coaches can’t operate with a one-size-fits-all, hammer-and-nails approach to clients. In order to be effective, we have to meet clients where they are.

Meeting clients where they are includes being able to act as an effective coach with a large variety of clients. These are clients who are having success with behavior change and want additional support as well as clients who are very sick and just beginning to contemplate change. For clients in either circumstance or anywhere in between, coaches must establish foundational information by asking questions such as:

  • What’s the big vision that the client has for their health?
  • What is the client’s current health challenge?
  • What’s the first step the client could take toward their goals?

The answers will be different for each client, even if the questions are similar.

Fit and Coachability

Not every coach-client partnership is a fit or successful. Assessing fit and coachability are other critical early steps that coaches can take to build a foundation for change. Does your client want to change their behavior and do the work, or do they merely want you to give them the answers? Is mental illness a concern and something that will get in the way of a client’s ability to change? Are you and the client just not a good fit? Sometimes, the answer to these questions is “yes,” and that’s okay.

When the client isn’t coachable or the fit isn’t there, the right thing to do is end the coaching engagement or work with the client on a referral to another coach or health professional. Sometimes, the best way to help someone change is not to be their coach and to connect them with the help that they need instead.

Change Agents Are Good at Facilitation and Use Education Sparingly and Wisely

The amount of health information available these days is staggering. I love a good podcast, blog article, or eBook, and these sources of information are a great supplement to my education and experience. But I don’t use this information to get my clients to change their behavior. Information can be a part of the change process, but alone, it does not get people to change.

Consider that, in 2019, there are over 50,000 health and fitness books on Amazon.com. That’s a lot of information. (1) But, at the same time, six out of 10 U.S. adults have one chronic illness, and four out of 10 have two or more. The availability of information is not translating to a healthier population. (2)

What Role Does Information Sharing Play in Behavior Change?

So what role does information play in behavior change, and when can information sharing be helpful? I find it interesting that the NBHWC says that 75 percent of each coaching session required for the National Board Certification exam “must be devoted to coaching facilitation and not education.” (3) This 75 percent requirement means not only that 25 percent of each session can include education and information sharing, but also that the NBHWC sees it as potentially part of a successful coaching session.

Information sharing can help clients with behavior change in a variety of scenarios. It can be empowering for clients to independently research their health challenges and spend time outside of coaching sessions, reading and contemplating new ideas about health and wellness. But when information can advance the exploration of a topic during a session, it may be a better fit for the coach to provide relevant information in the session rather than interrupt a fruitful discussion, have clients research the topic, and then pick up the conversation in a later session.

Information sharing may also be warranted when clients don’t understand the information that they are researching or want more resources on a topic. In these circumstances, coaches can share information on a topic in a way that clients can more easily digest or refer the client to other helpful resources on that topic. Following your clients’ lead on the topic and type of information they’re looking for, rather than sending them information that you think they should read, is the key to doing this successfully.

Sharing Information Using Elicit-Provide-Elicit

One excellent method for sharing information with clients comes from motivational interviewing, and it’s called Elicit-Provide-Elicit. (4) When coaches determine that information sharing will support clients’ behavior change, they should follow three steps:

  1. Elicit: Ask clients what they already know, what they would like to know, and whether they would like more information on the topic.
  2. Provide: Share information that clients want to know, be clear (no jargon), offer little bits of information and time to reflect, and acknowledge clients’ freedom to ignore the information or disagree with it.
  3. Elicit: Ask for clients’ responses.

I’ve successfully used this method for sharing information with clients many times. It aligns the information that I’m sharing with my clients’ goals and interests, gives them time and space to reflect on it, and creates a dialogue around the information that furthers exploration into their behaviors, goals, and vision of health. When done successfully, this method of information sharing supports behavior change by adding clarity and awareness to clients’ understanding of their health challenges and providing them with additional paths to explore.

Change Agents Assess Readiness for Change and Match Their Coaching Techniques to Client Readiness

When I start working with clients, I am always curious about what changes they’re ready for and where they want to start the coaching process. Not every client is prepared to eliminate foods from their diet, sign up for a gym membership, or wear blue light-blocking glasses. For some clients, actual behavior change may be weeks away, they are ambivalent about it, or they are just starting to contemplate taking those first steps. Far from being “uncoachable,” these clients can make incredible progress toward their health goals if coaches know what to listen for and what questions to ask.

The Transtheoretical Model of Change

Both during my training and in my coaching practice, I’ve found that the Transtheoretical Model (TTM) of change is a useful framework for assessing clients’ readiness for change and finding the right approaches to target various levels of client “readiness.” (5) The model outlines different stages of change and suggests different techniques for coaches to help clients progress from one stage to the next.

For example, when clients are just starting to contemplate a health behavior change, I spend more time talking with them about the pros and cons of change. For clients who are beginning to take action, they already understand these pros and cons, and we spend more time discussing how to manage obstacles and potential slip-ups.

In each of these scenarios, I may work with clients who have the same goal but who are talking about that goal in different ways. One may say, “I would like to stop eating sugar, but I like ice cream too much,” whereas the other might say, “I stopped eating sugar, but I’m going to a birthday party soon, and I’m worried about being tempted by ice cream.” The goal is the same, to stop eating sugar, but these clients have different challenges. Our ability in a coach-client partnership to continue the client’s progress toward their goals depends on my listening to these differences and helping them find actions that solve their current challenges and get them to the next stage.

Listening for Ambivalence

One thing that you’ll notice in both of the examples above is that these clients aren’t overwhelmingly positive and optimistic about behavior change. Instead, they are ambivalent. Feeling two (or more) ways about something is common—for example, a client might want to change, but may also feel much more comfortable in the short term to keep eating ice cream or to give in to the social pressure at a party and eat ice cream when they planned not to. These example clients are expressing their mixed emotions around these challenges, which is a perfectly normal part of any behavior change. 

Being a change agent as a coach often comes from acknowledging this ambivalence in a coaching session and allowing clients to talk themselves into changing. One of the best things that I can do as a coach is to tell a client that I hear ambivalence from them about the change and then be silent. Clients will often then describe their mixed emotions about the change and verbally process their discomfort in a way that brings clarity to their situation and suggests possible next steps for them to take.

Change Agents Support the Change Process and Help Create the Conditions for Change

One of my coaching colleagues recently shared this useful Albert Einstein quote with me: “I never teach my pupils, I only attempt to provide the conditions in which they can learn.” Great coaches create the conditions for their clients to change behavior. These coaches:

  • Encourage clients to experiment with action steps
  • Help clients create targeted goals tied to a long-term vision of health
  • Help clients forecast challenges
  • Provide clients with accountability

Coaching as a “Messy” Process: The Role of Experimentation

I like to think of coaching sessions as a sandbox. In a sandbox, you can experiment with building sandcastles or just sit there and feel the sand between your toes. And nothing is permanent in a sandbox. You can start over with a new sandcastle if you don’t like the first one.

Similarly, clients can experiment with actions, and if those actions don’t work or clients want to try something else, then they get to start over the next week with a new action. Clients can also spend a week thinking about what a change would mean to them or why they want to change. In other words, there are no right answers or right next steps, and sometimes change is not a change in behavior, but a change in mindset.

When there are no right answers, the value in coaching comes from the experience of trying something different and the discovery of what works well and what doesn’t. For example, a client might have planned to go to the gym seven days next week, but they get busy and only go once. After that one workout, they find going to the gym easier than they thought, and then go to the gym all seven days the following week. In another scenario, they might go to the gym all seven days the first week, find that they’re too tired, and try four days of exercise the following week.

In each of these examples of behavior change, the objective “success” in that first week is different, but the client learns something about themselves and makes an adjustment the following week. Change happens in both examples, and as you can see, there are many possible paths to successful behavior change.

Setting SMART Goals to Support Behavior Change

The more targeted a goal is, and the more relevant it is to a client’s long-term health vision, the more likely the client will change their behavior and accomplish the goal. SMART goals are a great way to structure goals and make them easier for a client to complete them.

SMART goals create a framework for clients that helps them articulate and understand their goals. The acronym SMART stands for:

  • Specific: Make the goal as specific as possible (e.g., “I want to lose 5 percent of my body fat” rather than “I want to lose weight”).
  • Measurable: As the saying goes, you can’t manage what you don’t measure. Knowing that you’re progressing toward your goals because you have the numbers to show your progress allows you to track success.
  • Attainable: Is this goal achievable and action-oriented? Set yourself up for success by selecting a goal with one specific action that you can accomplish.
  • Relevant: Do you care about this goal? Is it part of your long-term health vision? If you’re trying to reverse diabetes, then running a marathon might not be as relevant as restructuring your diet.
  • Time-bound: When will you complete your goal? Open-ended goals are less likely to be completed than those that have a completion date. This date helps provide accountability.

Doing the work in coaching is never easy, but SMART goals make the work more straightforward because they outline clear parameters for clients’ goals and successful completion.

To take SMART goals to the next level, coaches can help clients link these goals to clients’ long-term health vision. This linkage sets up SMART goals as defined building blocks for clients along a path to their vision.

The Role of Accountability in Behavior Change

I’ve had clients tell me that just knowing they were going to have another session made them follow through on their weekly goal. This sense of being accountable to another person can be a powerful motivator for behavior change.

Coaches can provide accountability in a variety of ways. It’s always a best practice to ask clients if and how they would like to be held accountable. Some may want to check in and update you on their progress. Others may want to spend a couple of minutes at the beginning of the next session talking about their struggles, successes, and lessons learned. As with other areas of coaching, there are no right or wrong answers, and what the client thinks will be helpful is usually the best method to use.

Coaches can also provide accountability by reminding clients of their goals and health vision. This is especially true when the client is doing things that seem at odds with what the client has said they want in previous sessions. For coaches, it can be easy to judge clients for acting in a way that appears inconsistent with their goals. However, I’ve found that merely reflecting back to them their current actions and their stated goals and asking them what they think can be a powerful way to provide awareness to clients.

For example, I could say to a client, “You mentioned that you ate ice cream every night last week. You’ve also told me that your goal is to remove sugar from your diet because it makes you feel lousy. Tell me about that.” I’m putting both things out for the client to reflect on without making them wrong. They may have cut all sugar out of their diet except ice cream and tell me they feel successful, or they may pause to think about it and tell me that they didn’t realize how hard a week they’d had and how ice cream was their comfort food. In the latter scenario, my asking the client to tell me about it may help them find their triggers for stress and identify other methods for coping besides eating ice cream.

Coaches have a wealth of tools to facilitate their clients’ behavior change. Becoming a change agent requires that all of us in the coaching profession build rapport with our clients, meet them where they are, share information wisely, and create the conditions for change. You can learn all these skills in the ADAPT Health Coach Training Program.





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Why Volcanologists Didn’t Predict New Zealand’s Deadly Eruption


On Monday, at 2:11 pm local time, New Zealand’s White Island volcano unexpectedly erupted, blasting a superheated plume of ash, sulfur gas, and steam 12,000 feet in the air and blanketing the crater’s floor in powdered rock and debris. At the time, dozens of people were visiting the popular tourist destination, also known by its Maori name, Whakaari. Officials confirmed Tuesday afternoon that the death toll has now risen to six, with 30 injured and eight more missing and presumed dead.

“The scale of this tragedy is devastating,” New Zealand Prime Minister Jacinda Arden said Tuesday during an address to Parliament. Her government is already launching investigations, the New York Times reported, into why people were allowed onto the privately owned island, despite warnings from scientists that its volcano had grown increasingly restless in recent weeks.

White Island is one of several volcanoes in New Zealand that can produce explosive, steam-driven eruptions at any time, making monitoring them a huge challenge. Data from the well-instrumented island had suggested an increased likelihood of an eruption, but nothing in the days and hours leading up to Monday afternoon had signaled one was imminent. The fatal episode underscores the sobering fact that even in the age of high-tech sensors and big data-crunching algorithms, some forces of nature still elude prediction.

Smoke and ash rises from a volcano on White Island early in the morning on December 9, 2019 in Whakatane, New Zealand.

Photograph: John Boren/Getty Images

“An eruption at the scale of what we saw yesterday can occur suddenly, as it did yesterday, with virtually no immediate precursor signals,” GNS Science senior volcanologist Graham Leonard told reporters Tuesday. The government-owned company is responsible for monitoring the Pacific Rim nation’s many geological hazards, including earthquakes, tsunamis, and landslides. It also issues periodic hazard bulletins for a dozen volcanoes in the region, of which White Island is considered the most active.

An 80-minute boat ride across the Bay of Plenty from New Zealand’s mainland, White Island rises like a barnacle. Every year more than 13,000 tourists visit to snap selfies in front of the blurping mud pots and sulfurous vents of its horseshoe-shaped crater, the tip of a massive undersea volcano. Its magma reservoirs sit very close to the surface, feeding heat and gas into a shallow aquifer above it, superheating any water trapped in the rock, and pressurizing the surrounding sediment. Any external shock to the system—an earthquake, a surge of gas from deeper in the magma, or changes to the aquifer water level—can release the built-up pressure, often to violent effect. At those temperatures, water expands into steam at supersonic speeds, with enough energy to shatter solid rock. The resulting explosion is called a hydrothermal or phreatic eruption.



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Abdominal Massage for Constipation: Benefits & Directions


Abdominal massage used to be the go-to treatment for constipation. It’s a safe and natural way to ease that stopped up feeling, and the gas and bloating that often go with it. When you massage your stomach in the right way, you induce peristalsis — the wave-like motions of your intestines that push everything through. This means that it takes less time for waste to get out of your body.

The great news? You can massage your own abdomen, have your partner do it, or find a therapist who specializes in abdominal massages.

“I was having pain in my lower back and went to a chiropractor,” says Angie E. from Portland, Oregon. “Turns out, I had gas bubbles all through my intestines. He sent me to a massage therapist, who — much to my relief (and also embarrassment) — was able to work them out.”

Abdominal massage doesn’t take very long and is an excellent natural remedy for mild gastrointestinal stoppage or gas. “I experienced near-instant relief when the gas was massaged from me,” says Angie. “While I haven’t experienced pains like that since, if I am feeling particularly bloated, I will sometimes use self-massage to gain similar results.”

Abdominal Massage Breakdown

Giving yourself a stomach massage is an easy way to encourage bowel movements and get your system moving again. It works safely and effectively for both occasional and chronic constipation.[1, 2] With this simple at-home method, you can work away bloating, cramping, and pressure that constipation causes.[3, 4]

Learn the easiest protocol for abdominal massages that will relieve constipation, cramping, and more!

In a nutshell, you use tiny clockwise motions with your massaging hand, slowly moving that hand around your abdomen, also in a clockwise direction. The clockwise motion follows the natural movement of your intestines. Here’s how it works.

  1. Find a peaceful spot where you can relax. Lie flat or elevate your legs if it is more comfortable.

  2. Start on the right side of your stomach by the pelvic bone. Using gentle pressure, rub in tiny clockwise circular motions, working your way up to your right rib cage. Continue the circular motions as you move across to your left side, then down the left side to your hip bone. Keep up the circular massage while moving inward, toward your belly button.

  3. Continue this for three minutes. You may feel a hard lump in your belly. This massage will help move that lump along. Be gentle but firm.

  4. After three minutes, use a little more pressure, continuing the circular movements. Take one minute to move up from your right pelvic bone to your right rib cage, one minute over to your left rib cage, and one minute down to your left pelvic bone. Then, one minute to move upward to your belly button.

  5. Continue massaging for 10 minutes. Keep moving in a clockwise motion. You should not feel pain.

Abdominal Massage Tips

Once you have the movements down, you can give yourself an abdominal massage as needed. Here are a few tips.

  • For constipation, abdominal massage works best when done about an hour after eating, first thing in the morning, or before bed.

  • To reduce bloating, abdominal massage works best right after you eat. Use a lighter touch.

  • Limit abdominal massage to once or twice per day.

  • Lighten up your pressure if you feel any pain.

Avoid this technique if you’ve recently had abdominal surgery or if you have a bowel obstruction.

Other Benefits of an Abdominal Massage

Abdominal massage helps whether you’ve had constipation for a short time or an extended period.[1] As mentioned, it can also help if you have a bloated, gassy stomach and may even help with lymphatic drainage and reduce excess fluid accumulation.[5, 6]

Beyond digestion, abdominal massage has many health benefits, including the following:

  • To ease cramps, try five minutes of abdominal massage every day the week before your period.[7]

  • Abdominal massage improves blood circulation. This brings more oxygen and nutrients not just to the abdominal cavity and intestinal tract, but to all of your internal organs. That will improve organ function, as well.

  • Massage naturally detoxifies your body by moving lymph around. Abdominal massage can also help remove fecal material stuck on your intestinal walls.

  • Like any massage, massaging the abdomen can also improve mood and ease emotional tension.[8]

What Else Can I Do For Gut Relief?

Abdominal massage is a great way to relieve constipation and bowel movements, but it will not repair any gut conditions, like irritable bowel syndrome (IBS). Below are the top ways to get gut relief.

Nourish Your Body

One of the best ways to help a gut condition is to change unhealthy eating patterns. Eliminate processed foods, gluten, dairy, or other foods that cause digestive issues.

Probiotic-rich foods provide a powerful kick for your gut health. Not only do they have a pretty long shelf life, but they’re also full of healthy bacteria and live cultures you need for a flourishing gut biome. Eating these foods boosts your vitamin levels, promotes heart health, and increases your body’s probiotic bacteria, which stimulate digestion.[9] Try these probiotic-rich foods:

  • Alternative-milk yogurt (almond, coconut, oat)

  • Kefir

  • Kombucha

  • Sauerkraut

  • Kimchee

  • Pickles

  • Lassi

  • Fermented vegetables

Try a Colon Cleanse

You can power-up the digestion process and boost colon health by performing a colon cleanse. Even better, do them regularly.

A gut cleanse resets your colon and digestive tract to restore normal processes. Afterward, your gut will process and digest food more efficiently. For most people, it results in more regular and consistent bowel movements.

Global Healing Center’s 6-Day Colon Cleanse Program will help you eliminate accumulated toxins and waste material that are messing up your system. It’s one of the best things you can do for your personal wellness and the secret to true health. Disease begins in the colon, and health does too!

Create a Wellness Routine

A proper wellness routine is essential to a happy and healthy lifestyle — and it can boost your gut health. Getting one started isn’t the hard part. Maintaining it and making it a habit can be tricky, though.

It can help to create a daily wellness journal. In it, track the following activities to make sure you’re sticking to it. It can help to pick just one or two you want to add to your routine. Once you’ve gotten those habits to stick, add more, as desired. As a bonus, creating a regular wellness routine generally improves quality of life!

  • Drink enough water. Buy a reusable water bottle that tracks how much you’re drinking based on the time of day. That way, you ensure you’re getting enough throughout the week to be properly hydrated.

  • Get enough sleep. You may have noticed after a colon cleanse that you sleep better. This is because the gut microbiome is linked to sleep regulation.[10] Most cellphones have a sleep tracker on them now — use it to make sure you’re getting plenty of good sleep. But keep the phone away from your bed at night!

  • Start exercising. Working out regularly helps your immune system, digestion, and mood, so get in the gym. Try downloading and using a fitness app, or watch YouTube videos and follow along. Just get moving!

  • Reduce your stress. Alleviating stress can improve digestion issues. A good probiotic supplement, in addition to probiotic foods, can help out here. Not only do they aid digestion, but they also support a positive mood.[11] For other stress reduction techniques, practice deep breathing, meditation, or yoga. Anything that calms your nerves will help you maintain a healthy digestive system.

  • Eat a balanced diet. This is by far the best method for maintaining proper gut health. Leafy greens and vegetables should be your new best friends. Track what you’re eating in a journal or a fitness app to make sure you’ve got a variety of healthy foods in your diet.

Points to Remember

Abdominal massage is an easy, at-home way to help treat constipation. It only takes a few minutes of massaging in circular motions to get things moving again. Abdominal massage works by stimulating a wave-like effect in your intestines that helps push everything through.

Only do stomach massage once or twice a day. If it causes pain, lighten your pressure, or stop altogether.

For other, more general gut relief, make sure you’re nourishing your body with fermented and probiotic-rich foods. Starting a wellness routine is another ideal solution. That means getting enough sleep, exercising, drinking enough water, and eating healthier.

Anytime you feel you need a complete reset, do a colon cleanse to get your digestion back to normal. In fact, doing them regularly will keep your gut happy!

Have you tried abdominal massage for constipation relief or any other purpose? What was your experience? Share in the comments below!

References (11)
  1. Lämås K, et al. Effects of abdominal massage in management of constipation–a randomized controlled trial. Int J Nurs Stud. 2009 Jun;46(6):759-767.

  2. Sinclair M. The use of abdominal massage to treat chronic constipation. J Bodyw Mov Ther. 2011 Oct;15(4):436-445.

  3. O’Neill T. Abdominal Self Massage. University of Michigan Health System. Updated Sep 2014. Accessed 15 Oct 2019.

  4. Harrington KL, Haskvitz EM. Managing a patient’s constipation with physical therapy. Phys Ther. 2006 Nov;86(11):1511-1519.

  5. Wang TJ, et al. The effect of abdominal massage in reducing malignant ascites symptoms. Res Nurs Health. 2015 Feb;38(1):51-59.

  6. Vairo GL, et al. Systematic review of efficacy for manual lymphatic drainage techniques in sports medicine and rehabilitation: an evidence-based practice approach. J Man Manip Ther. 2009;17(3):e80-e89.

  7. Kim JS, et al. The effects of abdominal meridian massage on menstrual cramps and dysmenorrhea in full-time employed women. Taehan Kanho Hakhoe Chi. 2005 Dec;35(7):1325-1332.

  8. 6 Things To Know About Massage Therapy for Health Purposes. National Center for Complementary and Integrative Health, National Institutes of Health. Updated 9 Oct 2019. Accessed 22 Nov 2019.

  9. Rezac S, et al. Fermented foods as a dietary source of live organisms. Front Microbiol. 2018 Aug 24;9:1785.

  10. Li Y, et al. The role of microbiome in insomnia, circadian disturbance and depression. Front Psychiatry. 2018 Dec 5;9:669.

  11. Clapp M, et al. Gut microbiota’s effect on mental health: The gut-brain axis. Clin Pract. 2017 Sep 15;7(4):987.

†Results may vary. Information and statements made are for education purposes and are not intended to replace the advice of your doctor. If you have a severe medical condition or health concern, see your physician.