Center for Weight Loss Success

Call Now!

757-873-1880

success@cfwls.com

Watch a Weight Loss Surgery Webinar Now

FREE WEIGHT LOSS GUIDE!

Food Pyramid & Habit Guide for Weight Loss Success
Keys to Successful Weight Loss and Long-Term Weight Control

captcha
.

Tag Archives: Lean body mass

Will I be Able to Enjoy my Favorite Foods Again after Weight Loss Surgery?

Posted on May 14, 2018 by

you chooseLife after weight loss surgery is not all about deprivation.  In fact, life after surgery is quite the contrary.  It’s about having an extra reinforcement so that you are better equipped to lose weight and keep it off long term.  As we have said over and over, surgery is a tool but you really need to know how best to use this tool for optimal long-term results.  Our society is focused on the here and now.  You will have an excellent tool that will help you quickly in the here and now after surgery.  More importantly it will serve you well for the long haul so you can fully experience your life in a rewarding and active way.  I see dreams come true each and every day!

Sure, there will be changes and I would be lying if we said they were all going to be simple. I am not trying to be vague here but the answer to the question “Will I ever be able to enjoy my favorite foods again after weight loss surgery?” depends upon a number of things.  These include the type of surgery you have and what is included in your favorite food list.   Not knowing exactly what those favorite foods are, I will include those that you will need to avoid altogether or enjoy in small quantities (we always like to focus on what you can have rather than what you can’t have).

The first category you will want to avoid or enjoy in small quantities is sugary sweets.  This can be in solid (i.e. candy) or liquid form (i.e. sweet tea).  After weight loss surgery, you should avoid food with >8 grams of sugar (5 grams if you are diabetic) because they can cause a negative reaction in your system, particularly if you have had a gastric bypass.  These foods can cause what is commonly called “dumping syndrome”.  Dumping syndrome occurs when there is a rapid passage of food into the small intestines causing a shift of fluid to the small intestine.  This usually occurs when you ingest foods that are too high in sugar or fat.  Symptoms include diarrhea, sweating, nausea, cold/clammy skin, dizziness, weakness, flushed appearance, and occasionally headaches.  You will need to stop and rest until the symptoms subside.  Remember to remain hydrated (water is best).  Take note of the food/foods that caused these symptoms so that you can avoid them in the future.

The second category you will want to avoid is alcohol.  Alcohol is full of empty calories, dehydrates the body, and has negative effects on the kidneys and liver.  In addition, because of the small size of your new pouch and the fact that food/liquid now empties more rapidly into the intestines, alcohol will be more toxic and cause a higher blood alcohol level than before surgery.  For these reasons, ingestion of alcohol should be avoided after surgery.  If you choose to have weight loss surgery and then ingest alcohol, please be aware that a small amount can affect you to a MUCH greater degree than prior to surgery.

After you are a month or so out from surgery, you can begin to experiment more with various foods.  Introduce raw fruits and vegetables cautiously.  Although many people do just fine, certain foods may be difficult to tolerate because your digestive system cannot n handle them.  The following may cause problems for you and may need to be avoided:

  • Tough meats, especially hamburger. Even after grinding, the gristle in hamburger is hard to digest.
  • Membranes of oranges or grapefruit
  • Cores, seeds, or skins of fruits or vegetables
  • Fibrous vegetables such as corn and celery
  • Hulls, popcorn
  • Breads – Fresh breads “ball up” in your stomach and can block your pouch. Try to avoid breads/crackers/cereals as much as possible.
  • Fried foods
  • Milk – If you are lactose intolerant you may use “Lactaid” products or soybean milk
  • Rice – tends to expand further once in your stomach and can cause pain

This list may seem daunting but realize that the further you are out from surgery, the more tolerant your system tends to be.  However, it is very important that especially throughout the first year you participate in a comprehensive program which should be available with any experienced bariatric surgeon/center.  A comprehensive program should include:

  • Follow-up visits with your surgeon
  • Individualized coaching with a nutrition specialist who understands the needs of the weight loss surgery patient
  • Personal trainer/fitness center that eases you into appropriate exercise activities in a safe and comfortable environment
  • Access to delicious nutritional products that support your need for 90+ grams of protein each day
  • An ongoing support group for you and your family/significant others.

All of this is provided on-site or online at the Center for Weight Loss Success and truly impacts the short and long-term outcomes of our awesome patients.  For those that live farther away, most services are very effectively provided online, via Skype, via webinars and other engaging ways.  Short and long-term comprehensive support is essential for optimal success.

CFWLS-Rhonda-09-

 

Rhonda’s Opinion:  Absolutely!  I enjoy food in moderation even more than before because it tastes so much better when you slow down to enjoy it.

Why is Protein so Important After Weight Loss Surgery?

Posted on May 07, 2018 by

can-eat-blueberries-182x300Protein is essential with any weight loss plan.  Protein is essential for muscle and tissue growth and repair.  If you reduce your caloric intake without consuming the necessary amount of protein, your weight loss will be a combination of lean body mass and fat loss.  With adequate protein intake (and exercise), you should be able to preserve your muscle mass, allowing the majority of your weight loss to come from fat stores.  If, over time, you do not meet your daily protein needs, you may experience fatigue, loss of lean body mass, and possible hair loss.

You will need to check with your surgeon, but we recommend that our patients take in at least 90-100 grams of protein every day.  As your weight loss continues, your body will still prefer using your lean muscle as a source of energy.  Therefore, consuming 90-100 grams of protein daily will be a goal throughout your weight loss journey, not just during the beginning phases.

Once your weight has stabilized and you are in a maintenance phase then protein requirements may decrease somewhat into the 60-90 range depending on your weight and overall muscle mass.  The higher your weight the more protein you may require in order to maintain Lean Body Mass.  Men typically require more protein due to their higher total Lean Body Mass.

People seeking medical or surgical weight loss often have many questions surrounding protein intake since it is important for both situations.  How many kinds of protein are there?  Where can I find it?  How much do I need?  What is the best time to have it?  Let’s try to give some straight forward answers to these questions.

The word protein is derived from the Greek word proteios, meaning “of the first quality”.  Protein is essential for life (i.e. we can NOT survive without it!!!) because it contains sulfur and nitrogen, two vital elements for every cell in your body.  Protein also helps produce enzymes and hormones, maintain fluid balance, and regulate numerous vital functions, from building antibodies to building muscle.  The body maintains roughly 50,000 different protein containing compounds, forming the building blocks of muscle, bone, cartilage, skin, hair and blood.

As far at your diet is concerned, there are numerous kinds of proteins, each with their own set of advantages.  The right kinds can make all the difference, especially if you are trying to lose weight and build muscle.  Some of the best protein comes from food. Meat has about 7 grams of protein/oz., large eggs about 7 grams of protein, and milk about 8 grams of protein/8oz.  In a weight loss plan, you have to watch all the extra calories (fat, carbs) that come with food sources of protein.

  • Whey Protein: Whey protein is derived from milk (remember Little Miss Muffet and her curds and whey?).  Many whey protein supplements have had most of the excess fat, cholesterol and lactose removed.  Whey proteins are undoubtedly the most commonly used and most popular protein used in sports nutrition and with good reason.  They are the highest quality protein available with an excellent balance of essential amino acids.  Whey proteins are very efficiently absorbed and this is extremely important but this is also a potential problem.  Because whey protein is so efficiently absorbed (i.e. absorbed quickly) it tends to not keep you feeling full or satisfied for any extended period of time.  For this reason, it also tends to work better if used in small doses (10-20 gms) taken multiple times throughout the day.  Your hunger can potentially return faster than with other proteins.  This brings us to Casein protein.
  • Casein Protein: Casein protein is also derived from milk (the curds part of curds and whey) and is essentially whey’s counterpart.  It also is a very high quality protein with all the essential amino acids.  While whey is absorbed very rapidly, casein forms a slow digesting gel in your stomach.  This in turn promotes a feeling of fullness that can stave off hunger for longer periods of time.  This steady stream of amino acids helps to protect against muscle breakdown.  A good casein based protein supplement made specifically for weight loss is Weight and Inches (29gm protein/serving) which can be obtained from CFWLS.
  • Egg Proteins: Egg proteins digest at a moderate pace.  Eggs are an excellent protein source and mimic the amino acid profile of muscle quite nicely.  Unfortunately, eggs do have a relatively high amount of cholesterol and also arachodonic acid (mainly in the yolks).  Some people are very sensitive to arachodonic acid worsening inflammatory processes.  Egg proteins in supplement form (usually as albumin) have had most of the cholesterol and arachodonic acid removed.
  • Soy Protein: Soy protein is also digested at a moderate pace.  Soy protein contains all of the essential amino acids, but since soy is a plant, it tends to not have quite as good of a ratio of essential amino acids as dairy or egg based protein.  Therefore, it does not tend to protect muscle mass quite as well.  It can still be a good alternative for those who do not tolerate dairy based proteins.

As far as timing goes, ideally you should use smaller doses of protein multiple times throughout the day.  This is especially important after weight loss surgery so even these recommendations will need to be altered somewhat during the phase immediately following surgery.  Starting the day off with a good dose is always a good idea (i.e. that protein shake in the morning).  An example would be 20-30 grams at breakfast, 20-30 grams at lunch and 20-30 grams at dinner.  Then add two 10-20 gram snacks, appropriately spaced between meals.  Positioning a protein snack prior to and immediately after strenuous exercise works extremely well to build/preserve muscle mass.

After surgery, your new stomach pouch will initially only be able to hold about 1-2 tablespoons (15-30cc) of fluid at a time.  This is approximately ½-1 medicine cup.  Your new stomach should eventually stretch to accommodate 6-8 ounces (3/4 to 1 cup) within the first 1-2 years after surgery.  Because your new stomach pouch is so small, you need to follow the guidelines provided by your surgeon to ensure the fluid/food you put in your stomach is the most nutritious possible and does not overfill your small stomach, causing you pain and/or nausea/vomiting.

For delicious recipes that provide adequate protein and are low carb, visit us on Pinterest at: CFWLSVA

What is My Expected Weight Loss After Surgery?

Posted on April 23, 2018 by

Expected weight loss after surgery varies depending upon the surgical procedure, your pre-operative weight and your commitment to following the diet/exercise recommendations after surgery.  On an average, people lose approximately 70% of what they were overweight. For example, if you were 100 pounds over your ideal body weight, you would lose an average of 70 pounds – if you were 200 pounds over your ideal body weight, you would lose an average of 140 pounds.

Prior to selecting your surgeon/bariatric center, ask them what the average weight loss is for their clients after surgery.  At the Center for Weight Loss Success, the average weight loss after weight loss surgery is 127 pounds.  That takes into account weight loss for patients who began with a BMI anywhere between 33 and 50+.

Optimal weight loss results can be attained if you do the following:

  • Attend your scheduled surgeon appointments before and after surgery
  • Attend monthly support group meetings usually provided through your surgeon’s office
  • Strictly follow the diet set forth by your surgeon and if he/she has made nutritional coaching and/or personal training visits available to you through their weight loss surgery program, participate fully and attend these sessions
  • Include your support person(s) in your appointments/classes/support group as appropriate so they fully understand what you need to be doing and how to support you for optimal success
  • Monitor not only your weight but your full body composition (hopefully a service provided at your weight loss surgeon’s office) as you progress post-operatively. You will want to make sure you are losing fat and not your lean body mass (muscle).
  • Be sure to get in enough quality protein (check with your surgeon but usually at least 90 grams per day). This will help with your overall ability to maintain your lean body mass (muscle) which drives your metabolism.  It is also important for healing and prevention of potential long term problems such as hair loss.
  • Incorporate fitness as soon as your surgeon indicates it is safe for you to do so. Walking is a great beginning routine but you will want to incorporate increased cardio training and resistance training with weights.  Your surgeon will likely either provide these services or provide you with an appropriate plan/resource.
  • Immediately after surgery your surgeon will likely be most concerned that you are staying hydrated. Water is very important so be sure to sip all day long and in the long run get approximately 64 ounces of water in every day.  In addition to proper hydration, you need to make sure you are ingesting appropriate amounts of protein as mentioned earlier.
  • Take your vitamins as recommended by your surgeon and make sure they are pharmaceutical grade for optimal quality.
  • Whenever you are trying to lose weight, you can improve your rate of success by journaling what you eat and drink. This also helps as you meet with your surgeon and/or the nutritional coach before and after surgery.
  • Surround yourself with positive people who support your decision to have weight loss surgery. SUCCESSFUL PEOPLE DO

We’re here to help you succeed!  View the Online Weight Loss Surgery webinar now and then schedule your call with my Surgical Coordinator, Cat Williamson: schedule now

How do I prepare for weight loss surgery?

Posted on April 16, 2018 by

sands of timeHow to best prepare for weight loss surgery is one of those questions that might not be on the top of your list, but will contribute to your overall level of success.  As you know, weight loss surgery is an important decision.  If you are adequately prepared, your level of anxiety will decrease and you will be better able to manage the changes required of you after surgery.  In addition, with preparation comes confidence.  This is a great trait to have as you embark upon this remarkable journey.

So how do you prepare for weight loss surgery?  You will want to ask questions.  You will want to make sure that your bariatric surgeon/center has a very thorough educational process in place prior to and after surgery that addresses nutrition, behavior modification and fitness.  These three components are critical to long term success.

You may only be thinking short term.  Let’s face it, you are really busy and have many obligations at home, at work, with school and with friends that take precedence over your needs.  It’s easy to tell yourself “I will figure this out” but it is a lot easier if you have a support system in place at home and with your bariatric surgeon/center prior to surgery so that you can better manage any surprises that may come along the way.

If you have already decided to have weight loss surgery, you will want to think about the positive changes you want to accomplish.  Often people view surgery from a number perspective (i.e. how many pounds they would like to lose).  Weight loss surgery is about so much more than that.  It is about enabling yourself to accomplish things that might not have been possible in the past.  It is about having an exciting life.  Life you can experience to the fullest extent.  It is very important to think about (and document) life goals related to your weight loss.  Then you can celebrate the positive changes transforming your life.  Some of the “dreams” that people have shared include:

  • Walking up the stairs or to the corner of their street without getting short of breath
  • Playing with their children or grandchildren
  • Crossing their legs
  • Painting their toenails
  • Stop worrying about being able to fit into a chair at a public place or worrying that it will break when they sit on it
  • Fitting in a bathtub and having water on both sides
  • Shopping in a store for regular sized people
  • Riding a bicycle
  • Returning to a productive lifestyle
  • Stop worrying about going to a restaurant that might only have booths or chairs with arms on them
  • Going to a movie and fitting into the seat

Take some time to identify your “wish list” and document it.  Then spend some time getting your mind and body ready.  In the weeks or days before surgery, you need to consider yourself in training.  Just as athletes prepare for a race, you can prepare yourself to be in top form for surgery.  When you actively get your body and mind ready you likely will:

  • Have fewer complications from anesthesia and surgery
  • Be able to cooperate with necessary treatments
  • Heal faster and feel better quicker
  • Have better control of your pain

There are some very specific things you need to do to be in the best shape possible.  You need to begin these things as soon as possible.  We know that the very worst time to try to learn things is right after surgery when you may feel foggy from anesthesia and uncomfortable from your operation.  Learn and practice these things now so that you will be able to help yourself after surgery.

  • Focus on healthy eating. The better nourished you are, the more quickly your tissues will heal.  Healing is WORK for your body.  Good nutrition helps you tolerate the stresses on your body and to offset limits on food and fluids right after surgery.  Weight loss prior to your surgery can decrease your risk and improve recovery time after surgery.  This is why you should incorporate your new eating plan and individualized weight loss counseling prior to surgery as a part of your overall plan.  Consult your bariatric surgeon for specific options for weight loss prior to surgery.
  • If you are a smoker – QUIT! Even a few weeks of not smoking increases the safety of anesthesia.  You will not be allowed to smoke while hospitalized.  You will need all your oxygen for healing.
  • Build your exercise tolerance. Toning your muscles and building your strength will help you bounce back quicker.  Walking is a perfect exercise for you prior to surgery.  It is normal to feel a little weak after surgery, but you can reduce this by toning up with daily exercise.
  • Exercise your lungs! Practice your deep breathing.  After surgery you will be encouraged to do this.  Expanding your lungs helps your system get rid of anesthesia drugs quickly, helps prevent pneumonia, and speeds oxygen to your tissues to help you heal quickly.  You will also FEEL better.
  • Move your legs to prevent blood clots!!!! After an operation, the best exercise to help your circulation and reduce your chance of blood clots will be walking!  The nurses in the hospital will get you up after a brief recovery period following surgery.  Once you go home, follow the specific discharge instructions set forth  by your surgeon.  In general, you should rest as needed but also get up and walk around as much as tolerated.  You can do these exercises in bed or sitting in a chair during any rest periods.
    • Lying on your back in bed, “walk” your feet toward your body until your knees are fully bent. Tighten your abdominal muscles while you do this.  Now let your legs slide gently back to the flat position and repeat this four more times.
    • Lying in bed or sitting up, point your toes as if you were trying to bend your foot backwards. Hold for the count of five and relax.  You should feel a “pull” on the muscles in the front of your legs.  Next point your heels away from your body, tightening your leg muscles.  Hold for the count of five and relax.  You should feel this pull in the back of your legs.  Repeat the pointing exercises 5-10 times.

If you have decided to have surgery, you also need to focus your mind on a good outcome.  You are the most important player in this team effort, and much will depend on your ability to fully participate.  Your feelings and thoughts will play a very big part in your recovery.  Reassure yourself that the best people, equipment and techniques are supporting you during surgery.

Finally, if you have decided to have surgery, a good way to prepare is to use the power of your relationships to gather a support group.  Enlist family and friends to help you keep your spirits up.  Let friends and neighbors help with chores and meals.  We all do better when we know we are supported by people who care about us and are cheering us on. Don’t underestimate the power of your emotions.  Positive thinking is the biggest help you can give yourself.  Think hopeful, optimistic thoughts about the experience ahead, and start NOW!

If you do all of these things, you will be best prepared for a positive experience and outcome.

We’re ready to help you achieve your dream – view our online Weight Loss Surgery Webinar or schedule the next

 

 

Is Weight Loss Surgery Reversible?

Posted on March 26, 2018 by

chance or choiceIs weight loss surgery reversible? The answer is “yes” and “no” depending upon the type of weight loss surgery procedure that is performed.  Again, the purpose here is not to create confusion, but the bottom line is that you should not go into weight loss surgery with the mindset that it is reversible.  First time (primary) weight loss procedures have risk.  Secondary operations have a much higher risk primarily due to potential scar tissue, potential hernia formation and the fact that your anatomy has already been altered to a certain degree depending upon the type of primary operation performed.

Weight loss surgery may be reversible for the adjustable gastric banding procedure since the device can be removed.  With the gastric bypass, it is anatomically reversible since the parts of the stomach and small intestine can technically be put together again, but it is not recommended and carries a higher degree of risk.  For the sleeve gastrectomy, this procedure is not reversible since the portion of the stomach that is removed in order to create your new “medium banana sized” pouch cannot be replaced.

You have to go back to your need, your desire and your motivation for surgery.  It’s a commitment that can reap benefits beyond your imagination.  Fear is natural and you have to make sure you have done your research and you are as comfortable as possible with your decision.  A certain amount of anxiety is actually desirable.  It usually means that you realize you are making an important decision that will require a behavioral change (which is scary) but if you choose carefully and surround yourself with supportive people and proactively prepare for the potential obstacles, success will follow.

View our free Weight Loss Webinar now – or reserve your spot at our next on-site Weight Loss Seminar!

CFWLS-Rhonda-13-

 

 

 

 

Rhonda’s Opinion:  I don’t want to ruin a great thing!

Is Weight Loss Surgery Right for Me?

Posted on March 12, 2018 by

kevin

As you have read, weight loss surgery is a decision that requires research (like you are doing here), a risk/benefit comparison, an evaluation by an experienced bariatric surgeon and soul searching on your part to make sure you are committed to long term changes.  These changes can drastically improve your health, your ability to live your life to the fullest and potentially extend your lifespan.  This may seem overwhelming but the important thing for you to know is that you are not alone.

There is a delay with regards to documented statistics, but here are the clear trends:

  • About 15 million adults in the U.S. have morbid obesity which is associated with more than 30 other diseases and conditions including type 2 diabetes, heart disease, sleep apnea, hypertension, asthma, cancer, joint problems and infertility.  The direct and indirect costs to the health care system associated with obesity are about $117 billion annually.5
  • In the United States, the number of people who qualify for weight loss surgery is increasing as the incidence of obesity and morbid obesity is on the rise.
  • In the United States, the number of weight loss procedures performed each year continues to rise with an estimated 177,600 procedures performed in 2006 (an increase from about 16,000 in the early 1990’s).5 In 2008 the number of weight loss procedures was up to 220,000 and remained there in 2009.  Numbers for subsequent years have not been published as of this publication.

5http://asmbs.org/benefits-of-bariatric-surgery/

Telling you that you are not alone and sharing these sobering statistics doesn’t solve the problem for you or the general population.  There has to be a need (and clearly there is a need), there has to be a want (which usually results from the pain endured as a result of being obese or morbidly obese) a viable solution (in this case, surgical weight loss with an experienced bariatric surgeon who is passionate not just about surgery but your long term success).  Sounds like a recipe for success but there is an ingredient that is missing.  You can have a need and a want and a viable solution but if you don’t have the commitment and motivation to follow through and create lasting change for yourself, you may never experience the optimal success you deserve.

If you decide that you have the want, the need and the commitment, you are a great candidate for weight loss surgery.  Now you just need to explore the rest of the questions in this book and get started on your path to success.

View our free Weight Loss Surgery webinar now and then click to schedule your conversation with Cat Williamson, our Surgical Coordinator.

How do I know if I qualify for weight loss surgery?

Posted on March 05, 2018 by

gastric sleeve sleeve gastrectomy GeorgiaIf you are at least 50 pounds over your ideal body weight and have been unsuccessful with other methods of weight loss, you may be a candidate for weight loss surgery.  However, most insurance companies additionally require a BMI of 40 or greater or a BMI of 35-40 with other potentially life threatening health problems such as diabetes, high blood pressure and/or sleep apnea.  Your BMI is your weight in relation to your height.  So how do you calculate your BMI?  You need to take your weight in kilograms and divide by the square of your height (meters).  For example, If your weight is 80 kilograms and your height is 1.8 meters, you would square your height (1.82=3.24) and then divide it into your weight (80 divided by 3.24 = a BMI of 24.69).  Or you can simply enter your information online for quick results with a BMI calculator.4

General BMI classification guidelines include:

BMIClassificationHealth Risk
Under 18.5UnderweightMinimal
18.5-24.9Normal WeightMinimal
25-29.9OverweightIncreased
30-34.9ObeseHigh
35-39.9Severely ObeseVery High
40 and OverMorbidly ObeseExtremely High

The decision as to whether or not weight loss surgery is right for you is ideally made by you and your surgeon after careful consideration of your weight, your past medical/surgical history and your current health problems or co-morbidities.  However, there are general guidelines that most surgeons and insurance companies adhere to when choosing who an appropriate candidate for weight loss surgery is as noted below:

General Guidelines for Weight Loss Surgery Candidates3:

  • BMI of 40 or greater
  • Comorbidity: You have a life-shortening disease process, heart disease, diabetes or obstructive sleep apnea that can be improved by losing weight.
  • For at least two years, you have attempted to lose weight.
  • You have been obese for an extended period of time, at least three to five years.
  • You are able to effectively care for yourself and follow a physician’s instructions.
  • You are motivated to lose weight and maintain a healthful lifestyle.
  • You do not abuse drugs or alcohol.
  • You are a nonsmoker or have quit smoking.
  • You are an adult under the age of 65.

These guidelines vary by insurance carrier and your individual policy.  Your insurance policy is an agreement between you and your insurance provider.  However, if you are working with an experienced bariatric surgeon/center, they can easily help you navigate through your particular insurance requirements and efficiently submit your information for surgery authorization. This topic is covered in Chapter 6 of the book, Less Weight…More Life! Is Weight Loss Surgery Right for You?

As with any general guidelines, there are caveats that cannot be ignored. Some of the ones we find most important include age, motivation and mindset.  With regards to age, you can see by the general guidelines listed previously that it is recommended that an adult be under the age of 65.  At the Center for Weight Loss Success (www.cfwls.com) we do not put a cap on age for good reason.  Age is just a number.  You likely know someone who is over 65 years of age yet physically, emotionally and intellectually they are really more like a 40 year old.  Conversely, you likely know someone around 40 who walks, talks and acts as if they should be 80+ years old.  In terms of lower age restrictions, although there are a few centers in the United States performing weight loss procedures on patients under the age of 18, most surgeons prefer to wait until you are 18 years of age or older and able to better decide and commit to such a life changing procedure.

Of great importance is your motivation and mindset.  If you are considering weight loss surgery, you need to be motivated and an active participant throughout your entire pre-operative and post-operative phases.  This is how you will experience the best results.  Weight loss surgery is something you need to do for yourself, not someone else.  You need to prepare yourself physically and mentally prior to surgery and proactively plan for your post-operative phase.  If you believe surgery is a “quick fix” or the “easy way out” you likely should not pursue weight loss surgery.  With this mindset, you may not fully commit to the lifestyle changes that result in the rewarding outcomes that will transform your life in so many positive ways.  However, if you do commit, get ready for an amazing journey.  Try not to get overwhelmed here.  An experienced bariatric surgeon/center will provide a comprehensive process to help guide you through these considerations.

Finally, it is important to note that some people are actually too obese to qualify for weight loss surgery.  If you are too heavy, you will usually be instructed to lose weight before your surgeon can proceed with weight loss surgery.  Once again, an experienced bariatric surgeon/center will guide you through this process and help you optimize your physical and emotional health prior to surgery and beyond.

3 Bariatric Surgery for Severe Obesity. Consumer Information Sheet. National Institute of Diabetes and Digestive and Kidney Diseases. March 2008. http:// http://win.niddk.nih.gov/publications/gastric.htm

4http://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html

If you don’t qualify for weight loss surgery under your insurance provider, contact my Surgical Coordinator, Cat Williamson at CFWLS to discuss your options.

What are the best weight loss surgery options available today?

Posted on February 27, 2018 by

Weight loss surgery has certainly evolved…thank goodness!  Don’t get me wrong, it is not without any risk but the procedures available today are much safer and more effective than procedures of the past.

This overview includes the three primary surgical procedures performed within the United States as of the publication of this book along with the advantages, risks and typical results/outcomes for each.  These three procedures are the Sleeve Gastrectomy (also referred to as the Gastric Sleeve), the Laparoscopic Adjustable Gastric Banding (also referred to as LapBand® or Realize Band®) and the Laparoscopic Gastric Bypass. 

Sleeve Gastrectomy:

sleeve GastrectomyThe Sleeve Gastrectomy is a newer laparoscopic weight loss surgical procedure in which a small “sleeve-shaped” stomach is created.  Approximately 75% of the “stretchy” portion of the stomach is removed. This also removes the portion of the stomach that makes the hormone ghrelin. Ghrelin is a hormone which makes you feel hungry. The remaining “sleeve” of the stomach is about the size and shape of a medium banana.   Because anatomy remains normal, this procedure can be considered for people with less weight to lose (50-60 lbs. overweight).

Advantages:

  • The portion of the stomach that produces ghrelin (a hormone that stimulates hunger) is removed.
  • The stomach is reduced in volume, but otherwise tends to function normally.
  • No “Dumping Syndrome” since the pylorus is preserved.
  • No intestine is bypassed so there is little chance of nutritional deficiencies.
  • No implanted device that requires adjusting.
  • Procedure is performed laparoscopically most of the time.
  • Usually done as an outpatient.

This procedure tends to work due to 2 major reasons:

  1. You have a much smaller stomach and will feel full with eating only a small amount.
  2. There is a decrease in the hormone ghrelin so that hunger is much better controlled.

The sleeve gastrectomy was originally developed as the 1st stage of a 2 stage procedure (patients would undergo a conversion of the sleeve gastrectomy to a bypass procedure).  However, it was found to work so well on its own that most patients did not need (or want) to go through with the next stage. This surgery cannot be reversed (i.e. once that part of the stomach is gone…it’s gone).

Risks:

Obesity, age, and other diseases increase your risks from any surgery.  Below are identified risks related to surgery and the sleeve gastrectomy procedure based upon national averages? :

  • Risk of death is 1:500-1,000
  • Leaks (1-2%)
  • Infection (2%)
  • Blood Clot/Pulmonary Embolus (1%)
  • Nausea/vomiting
  • Peptic ulcer disease
  • Formation of gallstones due to rapid weight loss
  • Stricture (1%)

Some of these problems may require further surgical intervention

Typical Results and Outcomes:

Weight loss outcomes are tracked closely at the Center for Weight Loss Success.  We are proud that outcomes here generally out-perform national averages.  The average best weight loss for this procedure is 65-70% of a client’s excess body weight (i.e. if someone is 100 lbs. over their ideal body weight, average weight loss outcomes would be 65-70 lbs.).

A weight loss of only about 40% of excess body weight will often show significant improvement in many other medical problems:

  • Many Type 2 diabetics will get off of their medications
  • Hypertensive clients will have improvement or resolution of their hypertension
  • Sleep apnea almost always improves
  • Cholesterol improvement in most clients
  • Arthritic symptoms improve

Laparoscopic Adjustable Gastric Banding (LapBand® or Realize Band®):

The FDA approved adjustable gastric banding surgery in June, 2001.  However, it was developed in the 1980’s and has been used in Europe since 1993.  In terms of surgical procedures for weight loss, this is the least invasive procedure.

LAP-BANDLaparoscopic adjustable gastric banding involves applying a band around the upper part of the stomach.  As a result, this creates a small gastric pouch at the top of the stomach, with a small opening to the rest of the stomach.  The band is made of an inflatable silastic ring that controls the flow of food from the small pouch to the rest of your digestive system.  With this surgery, there is no cutting or stapling required dividing the stomach.

In addition to the band, a small port is connected by tubing to the inflatable ring around the stomach.

The port is secured just beneath the skin where fluid can be injected or withdrawn to inflate or deflate (adjust) the band.  This results in increasing or decreasing the size of the opening between the upper small gastric pouch and the lower portion of the stomach.  The need for an adjustment is determined by the surgeon based upon weight loss and symptoms related to eating.

Like any tool, it can be used correctly or incorrectly.  Used incorrectly (such as drinking high calorie liquids) you will have relatively poor weight loss or even weight gain.  It is still diet, exercise, and behavior change which produce weight loss.  Thus, following your surgeon’s recommendations is crucial to your overall success.

Advantages:

The advantages cited in the literature are outlined below:

  • Risk of death is approximately 1:1000
  • There is no division or re-routing of intestinal tract
  • Minimal risk of malnutrition
  • The procedure is considered reversible since the Band can be removed with minimally invasive technique if needed

The band is adjustable:

  • Often performed under fluoroscopic guidance
  • May require 4-6 adjustments during the first year (or more)
  • Adjustments need to be checked yearly – forever

The band is effective with the following considerations:

  • Weight loss success is directly related to:
    • close clinical follow-up
    • appropriate adjustments
    • exercise
    • diet and behavior modification

The potential disadvantages of laparoscopic adjustable gastric banding are as follows:

  • Weight loss is typically slower when compared to other weight loss surgeries
  • Adjustments are required throughout your lifetime
  • Problems can develop secondary to the mechanical device (see Risks)

Risks:

Obesity, age, and other diseases increase your risks from any surgery.  Below are identified risks related to surgery and the laparoscopic adjustable gastric banding procedure based upon national averages.

  • Risk of death is 1:1000
  • Infection (<1%)
  • Blood Clot/Pulmonary Embolus (1%)
  • Gastric pouch dilation potentially requiring further surgery (5%)
  • Band slippage or migration often requiring further surgery (5%)
  • Band erosion requiring further surgery for band removal (1%)
  • Access port problem or tubing leak requiring further surgery
  • Nausea/vomiting
  • Peptic ulcer disease
  • Formation of gallstones due to rapid weight loss

Some of these problems may require further surgical intervention

Typical Results and Outcomes:                       

Following are expected results and outcomes based upon national averages:

  • Average weight loss is 45-50% of excess body weight, but with aggressive diet and exercise changes you can lose almost all of your excess weight.
  • A weight loss of only about 40% of excess body weight will often show significant improvement in many other medical problems:
    • Many of Type 2 diabetics will get off of medications
    • Hypertensive clients will have improvement or resolution of their hypertension
    • Sleep apnea almost always improves
    • Cholesterol improvement in most clients
    • Arthritic symptoms improve

 

Laparoscopic Gastric Bypass Surgery

Laparoscopic Roux-en-Y Gastric Bypass was first originated by a group of Bariatric surgeons in California in 1994.  This procedure is considered a combination procedure.  It works by both restricting the amount of food consumed and also by providing some malabsorption.   The surgical outcomes of this procedure seem to indicate that the weight loss results are similar to the traditional “open” procedure as long as the procedures are performed the same way.

The procedure begins by dividing the stomach to create a “pouch” that limits the amount of food that can be eaten.  The pouch is about the size of one’s thumb and can hold about 20cc or 2-3 tablespoons of food.  The larger excluded stomach, known as the gastric remnant, is stapled closed and separated from the pouch.  This portion no longer receives food but has a normal blood supply thereby keeping it healthy.

The second step of the procedure involves taking a portion of the small intestine and creating a “bypass” or “Roux” limb that is connected to the new pouch to provide an outlet for food.  This part of the procedure is what creates a slight malabsorption of nutrients to assist in weight loss.

The malabsorptive portion of the procedure also contributes to weight loss by causing a condition known as “Dumping Syndrome”.  Most sugar consumed is normally absorbed in the first 1-2 feet of small intestine in normal situations.  After the Gastric Bypass procedure sugar passes directly from the pouch into the lower small intestine.  The unabsorbed sugar pulls fluid into the small intestine resulting in distension, increased motility (activity), cramping and a neurologic response that may cause an increase in heart rate, sweating, diarrhea, nausea, and even vomiting.  Most patients will experience this at least once and will learn to avoid foods containing high sugar content, thus improving the chance for long-term weight loss success.

The following is a diagram of the described procedure: gastric bypass

Risks:

  • Possible conversion to an open procedure due to limited access and visibility
  • There may be an increased risk for bowel obstruction in the long term
  • Death (1:500-1,000)
  • Pouch leaks – (1%)
  • Deep venous thrombosis (1-2%)
  • Pulmonary emboli (1%)
  • Abdominal wall hernia (1%)
  • Peptic ulcer disease (3-5%)
  • Stricture (narrowing) at gastric pouch (1-2%)
  • Small bowel obstruction (1-2%)

Typical Results and Outcomes:

The average best weight loss for this procedure is 70% of a person’s excess body weight (i.e. if someone is 100 lbs. over their ideal body weight, average weight loss outcomes would be 70 lbs.).

A weight loss of only about 40% of excess body weight will often show significant improvement in many other medical problems:

  • Many Type 2 diabetics will get off of their medications
  • Hypertensive clients will have improvement or resolution of their hypertension
  • Sleep apnea almost always improves
  • Cholesterol improvement in most clients
  • Arthritic symptoms improve

Determining which procedure is right for you will require an evaluation with your surgeon and discussion about your specific situation.  As you meet with him/her you will want to find out what their opinion is regarding the preferred weight loss procedure based upon your medical history as well as the number of procedures he/she has performed and their individual outcomes.

We invite you to view our Weight Loss Surgery webinar to learn more and decide if weight loss surgery is right for you:  Weight Loss Surgery Webinar

CFWLS-Rhonda-04

Rhonda’s Opinion:  The decision has to be yours but I am REALLY happy with the sleeve gastrectomy!

Walk Your Way Healthy

Posted on October 16, 2017 by

So often people want to exercise, but they don’t know where to start. Walking is a great place to start. Walking is typically easy on the joints, can be done anywhere, and all you need is a comfy pair of shoes.

HOW TO GET 10,000 STEPS A DAYfeet on sidewalk
Everyone knows movement is good for the body. The hardest part is often finding the time, especially if you have an office job. However, 9-5 is a long time to be sitting at a desk. But don’t worry, anything is possible with a little bit of change.

Walking is the best way to start adding movement into your day. Walking is typically easy on the joints, can be added in small time frames, and needs no fancy equipment.

If you have the option, I highly recommend an activity tracker. While pedometers and activity trackers are in no way a necessity, seeing your steps add up can motivate and inspire you to keep moving. Seeing your steps also adds accountability. You may think you are getting an adequate amount of movement, but having a concrete number to track will help you ensure you are hitting your goals.

If you are new to walking try to hit 10,000 steps a day at first. That may seem daunting, but think of reaching 10,000 steps in smaller goals. Set a small goal to hit 250 steps/hour or 100 steps/30 minutes throughout the day. Newer activity trackers can often be set to alert you at different times of the day or a well-placed post-it note can sometimes be all it takes to keep your mind focused on your goal. Also start to recognize what activities equal 100 steps. You’ll be more motivated to continue changing your habits if you can see a concrete benefit that results.

If you are at a desk for the majority of the day there are great ways to sneak in steps throughout your day:

1. First, stepping side-to-side does count! Stand and pace as you read your emails in the morning. Are you brainstorming with colleagues? Don’t be afraid to stand and move as you think. The fun thing about counting steps is every step counts! Even if you’re not walking anywhere.

2. Park in the back of the parking lot. This advice is nothing new. But it still stands as good advice. I bet walking into work in the morning from the last spot in the lot can easily get you 100 steps.

3. Do you take an elevator? Change to taking the stairs. If you are new to stairs don’t feel like you have to conquer them all at once. Simply walk one flight up and then take the elevator the rest of the way. Add in the extra flights as you get stronger. Fitness success is about making a lot of little changes over a long period of time. It’s not about making a lot of changes all at once.

4. Rather than emailing or calling a coworker, walk over to their cubicle.

5. Walk the longest path to the bathroom, printer, scanner, fax, kitchen, water cooler, etc.

6. Take a short walk during your lunch break. Instead of spending your time driving to and from a restaurant, pack your lunch and then squeeze in a short walk with the time you saved.

7. Dress for success! Keep a change of shoes, socks, undershirt, etc. in your car during warmer weather for your longer lunchtime walks. In the winter, keep mittens, hat, and a scarf handy.

8. If it’s still too cold in the winter or too hot in the summer you can head to your nearest mall. Walking end to end one time is sure to add up!

9. Be the one who walks the dog, gets the mail, takes out the trash, and picks up the house before bed

10. Make time with your family count. Take a walk after dinner. Start playing Pokemon Go with your kids. Dance in the kitchen as you cook. Start a new hobby like bird watching, golfing, or hiking. Free time is when you’ll really rack up the steps.

Once you start tracking your steps you’ll be motivated to squeeze in more steps and set new goals. More importantly, you;ll be finding more ways to live a happy and long life. Steps don’t just result in better physical health. Walking will give you more opportunities to de-stress and clear your mind. Innovative ways of hitting your step goals will create new hobbies and create family memories. The more you get moving the more life you’ll have in each step.

Day_34_group

Join the CFWLS Steps for Success and add your daily steps to our group walks!  It’s easy – just log into World Walking and join the group.  It’s fun and a great way to stay inspired.

If you would like more advice on reaching 10,000 steps a day contact a CFWLS personal trainer or lifestyle coach today.

Spring Teller croppedContributed by Spring Teller, CPT, Group Instructor

The Best Weigh In Routine – Part 2

Posted on October 02, 2017 by

Dr C with tie croppedI want to complete the video I made last week which was about routine weighing. Should you weigh yourself routinely or not?  My inclination is, yes, people ought to weigh themselves regularly. I think people should weigh themselves daily.

I want to talk about what the real reason is for weighing yourself daily. Especially if you’re in a weight loss program, whether you’ve had surgery or you’re in the middle of a weight loss plan, I encourage people to weigh themselves daily. During the weight loss program, you’re not just weighing yourself to watch the pounds come off. The real reason to weigh daily is to get in the habit of weighing yourself routinely for maintenance.

Maintenance is hard.  It’s actually harder than weight loss. So, you want to get in the habit of weighing yourself routinely during the weight loss plan so that you’re doing it for maintenance. If you weight yourself daily during maintenance you’ll notice little fluctuations.  If you notice little fluctuations you can look back on that 24 hours and figure out, “What did I do differently during those 24 hours that would affect today’s weight?”  Typically there is going to be something. You’ll be able to figure that out a lot easier if you’re weighing yourself routinely (daily).  If you try to look back a week’s period of time you really have no idea what you did differently. So, this is the reason you want to weigh yourself routinely so you can have those little fluctuations under control.

Maintenance, as I mentioned, is harder than weight loss. It’s easier to make little modifications by looking back over the past 24 hours to figure out what you did differently and then modify what you’re doing.  You can change that fairly easily. So that’s why you should weigh yourself daily.  It’s so that you can be in the habit of doing it for maintenance.

Stop in anytime to check your BCA – and don’t forget to add those pounds to the total on our home page!