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Category Archives: Weight Loss Surgery

Breaking Through a Weight Loss Plateau After Bariatric Surgery

Posted on April 22, 2019 by

Today we’re going to talk about those dreaded weight loss plateaus. What do we do about them?  What should you look for? We all dread them. They are going to happen. It doesn’t matter what we’re taught. You’re going to go through plateaus. What do you look for? What can you do to break through the plateaus? At some point you need to think about whether it’s your weight maintenance. That’s a slightly different topic. We’re not going there today. I’m going to just assume that you’re not where you want to be and not where you can be. So subsequently you’re at a weight loss plateau.

What is a weight loss plateau? Sometimes we look at the scale and it hasn’t budged in three days and therefore it’s a plateau. That’s not really a plateau. A weight loss plateau is when you’re doing the right things and your weight is stuck for a few weeks.  So, for two or three weeks nothing is happening. Subsequently then, yes, you can be in a weight loss plateau. Shorter than that means there can be just a lull in the action, so-to-speak. Your body adjusts. As it adjusts, it’s going to try and turn off weight loss. It doesn’t want you to lose weight. With any weight loss plan, your body is going to assume you’re in a state of deprivation. So, it doesn’t actually want you to lose weight. It wants to hang on to that energy source if you truly were in a famine.

We’re in a weight loss plateau. What is going on? What I usually do is give people questions to ask themselves about certain things. I’m going to give you this list of questions and we’re going to talk about what some of the solutions are.

Question #1—Have you actually cut your calories too low? Sometimes people do cut their calories down too low. If you cut them down too low, your body is going to go into starvation mode and you’re not going to lose weight very well. It’s hard to put an exact number on that. Potentially if you’re going lower than 1000 calories and you’re not in a medically supervised plan, that’s generally not the greatest thing. In the surgical plan right after surgery you’ll often be between 700-800 calories. Long-term that’s really not the right answer either. You want to make sure you haven’t cut calories too low.

Question #2—Are you getting enough water? This is probably one of the most common reasons I see initially in a weight loss plan and especially after surgery when things start slowing down. If you start to get a little behind in your water, the body will tend to hang on to everything-fat included. I encourage people to push the water.

Question #3-How many carbs are you really taking in? At The Center for Weight Loss Success we talk about restricting carbohydrates. Everyone is going to have a tipping point with carbohydrate. If you go above that tipping point you struggle with weight loss. Are you above your tipping point? If you don’t know what your tipping point is, it’s hard to know that answer. It is something we can figure out. It’s not necessarily easy to do.  You have to write it down! That goes along with one of our solutions-Journaling! Write these things down, especially carbohydrate. If you’re going to measure one thing, count your carbs. I don’t know how many times I’ve said that over the past couple of years.

Question #4-Are you getting enough protein? Carbohydrate influences insulin. You want to keep your insulin level as low as possible. Insulin is a hormone we can’t survive without. You’ve got to have some but you want to survive with the absolute smallest amount possible. Insulin can cause so many problems. Weight gain is just one of them. If you’re not getting in enough protein, your body will preferentially break down lean body mass, slowing your metabolism down. Protein manipulates other hormones too. Protein is more satisfying so you stay fuller for a longer period of time. It also increases growth hormone and glucagon. Glucagon is the opposite hormone of insulin. Insulin is telling your body to store fat. Glucagon is mobilizing the fat. As adults we don’t need that much growth hormone, but we make it because we can’t survive without it. If we can optimize what we do make, it’s going to help you preserve lean body mass, keeping your metabolism higher. So you want to make sure you’re getting in enough protein.

Question #5-Is your exercise too routine? Your body will get used to whatever exercise program you’re doing. When you’re body gets used to it, it doesn’t get the same out of it as it did originally. If your exercise gets too routine you don’t get as much out of it. The real trick with exercise is you want to preserve lean body mass to keep your metabolism as high as possible. Exercise alone typically doesn’t make you lose weight, but if you can preserve or build lean body mass you’re going to increase your metabolism and keep you on a weight loss track. The flip side to your exercise routine is whether you are exercising too hard? That can also slow down weight loss. Inherently that doesn’t make sense but it actually can do that because too much exercise can cause our stress hormone, cortisol, to go way up. When cortisol levels go up, it’s hard to lose weight. It makes us resistant to weight loss. This was a survival mechanism when we were stressed. Typically our biggest stress was not being able to find food. Stress typically makes us resistant to losing weight. It leads us into the next question.

Question # 6- Are you handling your stress alright? If you’re going through a stressful event, whether it be social, work, family, or medical, if you’re not handling stress well then it could turn on the plateau.

And, finally a couple things to look at as far as asking yourself about weight loss plateaus. What about caffeine and artificial sweeteners? Inherently both of those don’t make sense in a weight loss plan of turning off weight loss. But some people are sensitive to caffeine because it will increase your stress hormone because it’s a stimulant. Increasing stress hormones can make your resistant to losing weight. You want to be cutting back or getting rid of the caffeine. Caffeine can stimulate appetite which makes it harder to stick with the plan.

Artificial sweeteners can turn off weight loss for a couple of reasons. They can make us want sweet things. We get used to the sweet taste. They tend to be so much sweeter (even 1000 times) than sugar. Artificial sweeteners have no calories but it trains us to want something sweet. It makes it harder to stick to the diet plan. Also, they can often increase insulin levels. Inherently that doesn’t make sense. The sweetness you’re tasting from the artificial sweetener make the body think that you’re getting something that has a lot of calories. It’s expecting those carbohydrate calories so the body releases insulin. Hunger and cravings will increase. Insulin tells your body to store fat. Artificial sweeteners can turn your body into fat storing mode even though there are no calories in it.

What do we actually do about this? These are questions to ask yourself once you’ve hit a plateau. What are we going to do about these things? Some of these answers I hit a little bit on during the questions themselves.  What can you do?

  1. Write it down. Go back to journaling. It is a basic thing. If you don’t write it down, you’ll never really figure out where the problem area it. You have to write down everything. I’m referring to what you’re eating, drinking, and how much activity.
  2. You need to make sure you’re counting the carbohydrate, protein, and water. You want to watch all those things. If they’re all good, then we have to figure out how we work with that. Push the water. Hydration!!
  3. Go back to the beginning. Many people do the Jump Start diet. It’s using some of the protein meal replacement shakes. It gives you a good protein source, controlled carbohydrate, calories will be fairly low, and it gives you exact numbers so that you know exactly what happens when you have X amount of calories, carbs, and protein.
  4. Look at the exercise. Is it routine? Now it’s time to change gears. You really want to make sure you’re doing plenty of resistance training. You can do body weight exercises (push-ups, pull-ups, sit-ups, squats). You don’t necessarily need weights to do it. The best exercise for weight loss is high intensity interval training (HIIT). The best piece of exercise equipment you can have is a heart rate monitor. You’re pushing your heart rate up to near max, back and forth. Potentially you’re going into the anaerobic training where you go up to your heart rate max. You’re crossing over into anaerobic metabolism which gives you the best fitness gains. You can’t do that if you’re just starting in fitness. But if you are into fitness and you’re good at that, this is something that can really get you going and get you back on that weight loss plan.
  5. Something I mentioned is ratchetting down that carbohydrate and lifting up that protein. You can do it with food. Again, you have to count it.
  6. We can start looking at over-the-counter products. There are a lot of different things out there. Green tea is actually one of the things that can be helpful. It can boost your metabolism about 4%. In a 2000 calorie diet that’s about 80 calories. If you’re on a 1000 calorie diet, it’s about 40 calories. It’s not really that much but enough that can help to get you back on the weight loss curve. Cayenne peppers as a supplement or eating the food can boost your metabolism. There’s some evidence that probiotics can change your intestinal flora. Often it can help with weight loss.
  7. Make sure you’re doing the basics. Are you taking your vitamins? We often think of B-vitamins as our energy vitamins. You can either do B-vitamin injections to potentially jump start a weight loss plan or a high dose of B-6. I would encourage doing an activated form of B-6. It can bump up your metabolism some. We’re talking about 50 or 100mgs. If you’re buying B-6 by itself it’s usually 1 or 2 tablets.
  8. It’s kind of like an amino acid. It helps mobilize fat molecules into the mitochondria. The fat molecules are what you’re trying to get rid of. The mitochondria are your energy furnace. That’s what is actually being burned for energy and truly converted to energy. By itself it’s not energy until it’s converted to ATP. That happens in your mitochondria. Carnitine helps mobilize fatty molecules into the mitochondria. It’s like a steam engine. You’ve got to get the fuel into the furnace. Carnitine gives you a bigger shovel so it’s easier to move the fuel into the furnace. Typical you may need to take 1-2 grams of carnitine. You can find it in most health food stores.

Those are some things you can do as far as working through some weight loss plateaus. We went through a lot of information. Weight loss plateaus are very common. It happens to everybody until their finally in maintenance. So it’s literally going to happen to everybody. You want to work through it. The last thing you want to do is throw in the towel. You can go through those questions as well as the solutions that I talked about. You can also use appetite suppressants. They are carefully regulated by the FDA. But if you’re in a medical or surgical weight loss plan and are stuck or have cravings, appetite suppressants can be very helpful. They just have to be monitored very carefully. Some people are not candidates for them.  Another thing that helps with cravings is chromium. It’s a mineral just like sodium and potassium. We need minerals in tiny amounts. If we take them in higher doses it can help with cravings. You can buy it at health food stores, pharmacies, and here at CFWLS. You do need to take it three times a day. It will say take one a day on the bottle. That doesn’t work. You usually need to take it three times a day.

There are lots of little solutions. Hopefully something there will help you with your weight loss plateau. Work through it. If you have questions please let us know. We’re here to help. If you want more information go to our corporate website which is www.cfwls.com  If you want to join me each week in a webinar, we talk about all kinds of different topics about weight and overall health. You can go to losing weight USA and sign up there.  The website is: www.losingweightusa.com    Sign up and you’ll get access to me plus recipes and tips every week. Thank you all for listening. If you have questions just give us a yell here at Center for Weight Loss Success. I will talk to you on the next podcast. Remember-it’s your life. Make it a healthy one!

5 Tips for Long Term Weight Loss Success

Posted on April 02, 2019 by

Commit to a lifestyle change

Long-term weight loss is achieved through permanent changes in your lifestyle and food choices, not through fad quick fix diets or pills. Before beginning on your weight loss journey, make a commitment to your health and stick with it!

Keep moving

Regular exercise is a critical component of permanent weight loss. We recommend a minimum of five 30-minute sessions per week. Read our exercise tips on this blog for ideas on how to stay motivated and enjoy your exercise routines.

Go slowly and keep your expectations realistic

Remember that drastic weight loss in a short amount of time is not healthy, and it is more likely the loss is coming from water and muscle, not fat. Fat loss is best achieved when weight is lost slowly. Strive for a weight loss of no more than 1-2 pounds per week.

Tracking your foods & fitness

Tracking in an app or keeping a weight loss journal can be very helpful for long-term weight loss and keeping you focused on your goals. Each day, record what you have eaten, how much, and your mood and emotions. A journal not only keeps you accountable for your food choices, but can also help you identify any behaviors or emotions that trigger overeating. (We recommend an app like Baritastic to track daily)

Don’t go it alone

An important factor of long-term weight loss is the support and encouragement from others, whether it’s from your doctor, nutritionist, family or friends. Connecting with others helps you stay motivated, learn tips and techniques, and keep focused on your weight loss goals.

If you’re not already a part of our private Weight Loss Surgery Support Group on Facebook, request to join now!  Any patient that is 2 weeks or more post-op will be approved to participate – it’s a fantastic group of people!

What If Your Doctor Doesn’t Agree with Weight Loss Surgery?

Posted on March 19, 2019 by

Has your doctor mentioned weight loss as a solution for your ailments, aches and complaints? If obesity related diseases are problematic or your body mass index exceeds a healthy range, your doctor may refer you to a weight loss specialist or nutritionist.  You, like the majority of people with weight issues have tried numerous diet plans, most resulting in failure at long-term results. You’ve possibly even considered weight loss surgery. Do you know if your doctor is on board with surgical weight loss options?  We receive patient referrals from many practices but not all doctors are in favor of the surgical option. Their bias may be based on lack of research or experience with patients who have had successful weight loss procedures. Seeking a second opinion is common-place in the medical field. Don’t be afraid to keep looking.

At CFWLS, we encourage people considering weight loss surgery to be their own best advocate for personal health. Gather the information necessary to have an educated discussion with your doctor. Watch our Weight Loss Surgery WebClass or attend one of our free Weight Loss Surgery Seminars  to get started.

The medications that are prescribed to combat high cholesterol, diabetes, hyper-tension and other conditions often simply mask the symptoms while failing to get to the heart of the problem. Losing weight and keeping it off may result in eliminating these medications from your daily routine! The benefits don’t stop there, you may notice less joint pain, more energy, better sleep and a host of other positive outcomes!

Finding an experienced, board-certified Bariatric Surgeon who can answer your questions and explain your options to you is imperative. A comprehensive post-surgical follow-up plan will provide your best possible long-term outcome. Your search may be over. Dr. Thomas W. Clark is double board certified as a surgeon and Bariatrician. He has performed over 5,000 weight loss procedures and has dedicated almost 25 years to helping people lose weight and learn how to keep it off for life. His experienced staff will guide you and help you enjoy the process along the way!

Having a supportive doctor is important, but ultimately, it’s your body and Weight Loss Surgery is a personal choice. Do your research and obtain all pertinent information. Weigh the risks versus the benefits. Make an informed decision. Schedule a call with our office manager, Cat Williamson, to discuss your next step.

Phentermine – Could it Help You Lose Weight?

Posted on February 21, 2019 by

I’d like to talk to you about Phentermine. Phentermine is an appetite suppressant. It’s been around for a long time. Appetite suppressants are really carefully regulated by the FDA, so there are some hoops to jump through for those people utilizing them, but it’s very doable.  Potentially it can be helpful from a weight perspective, but also from a hunger/craving perspective.  It works very well for cravings.

A lot of appetite suppressants have come and gone.  There have been a number of them over the last 20 years or so. They got approved by the FDA, were around for a few years, and then gone.  One of the reasons is because the drugs were causing other problems.  There are a couple of newer ones in the last few years.  None of them really work any better than phentermine.  The new ones can be really expensive.  Phentermine has been around for about 60 years now. It can be very helpful.  And it’s very safe. We’ll talk about the risks, which are something we do have to keep an eye on. It can help with any medical weight loss plan. You have to be doing the right things. Phentermine will not make up for a bad eating and exercise plan.  It’s very closely monitored by the FDA. Part of that is because back in the 90’s they had phen-phen. It was a combination medication of phentermine and also phenfluramine. They put two medications together and it worked wonderfully. Unfortunately, the phenfluramine ended up causing heart problems. It was taken off the market.  Because phentermine was associated with it, it’s very closely regulated. Overall, it’s a very safe medication.  It has stood the test of time.  It can actually be used long-term but it needs to be monitored.  There can be some potential side effects. You do have to watch blood pressure. It’s rare but not impossible.

The clinical indications for using phentermine are a BMI over 30 or BMI over 28 with medicals problems.  It’s similar to having weight loss surgery.  Generally what they’re talking about mostly are sleep apnea and diabetes.  Chemically, phentermine looks like amphetamine. Because amphetamine can cause all kinds of problems, and can be addicting, it was thought that phentermine was in the same class as amphetamine, and therefore just as dangerous. It was more regulated by the FDA. A lot of those theoretical problems really never panned out.

I’ve been utilizing phentermine in the patient population for about 15 years now. Just like surgery, it’s a good tool. It’s just another tool in the toolbox. There’s nothing magic about it. It can be a good additive tool along with the surgery. All it really does is takes the edge off hunger.  It really takes the edge off cravings. It won’t prevent you from eating. It can also help with carbohydrate withdrawal. Most of our patients are very sensitive to carbohydrates. If they fall off the wagon and start eating too many carbs and then try to cut them back again they’ll go through withdrawal. Carbohydrates are like a drug. The phentermine can help with the carbohydrate withdrawal symptoms.  We have found that phentermine can give you 8-12 pounds of extra weight loss. It’s the same with our surgical patients. If they feel like they’ve stalled out, the phentermine can give them some more weight loss.

If you are keeping your carbohydrates down while utilizing phentermine, you can lose a tremendous amount of weight. The weight loss from phentermine will vary from person-to-person depending on age, genetics, sex, and other health problems.

There are potential side effects. You absolutely need to have an EKG done prior to starting phentermine. You want to document that your heart is fine. It’s not going to cause a heart problem. But if you’ve already got a heart problem, it can worsen the problem.  Almost everyone starting phentermine gets a dry mouth. Make sure you’re drinking a lot of water. It can make you feel slightly jittery. It’s kind of like having a few cups of coffee. They typically fade away in about 7-14 days. It’s a side effect. It’s not how the medication works.  I tell people that if it makes you jittery and it bothers you, then quit taking it. The medication will be out of your system within 12 hours. One of the uncommon side effects of phentermine is insomnia. If you take it too late in the day you might have a hard time going to sleep. But that typically over time goes away. Other uncommon side effects are tremors, dizziness, and high blood pressure. It’s really rare for blood pressure to go up, but that’s one of the reasons why we have to monitor it. Theoretical potential problems (which are related back to the phen-phen) are heart problems and addiction/withdrawal. You can get used to the medication, but that’s not necessarily addiction. You can build up a tolerance to the medication where it stops working as well. But you can’t go through withdrawals.  You don’t have to wean off the medication. You can just stop taking it.

There are some real reasons to avoid phentermine. If you have an allergic reaction to it, obviously you shouldn’t take it. If you have a history of heart problems (no matter what it is), I would discourage you from taking it. You shouldn’t take it if you have high blood pressure that’s poorly controlled.  You can take it if your blood pressure is well controlled. Theoretically you should avoid phentermine if you’re taking antidepressants. Because of the chemical make up of phentermine, there was a thought that there would be a cross over, and some antidepressants would make this exacerbate heart problems. It would make antidepressants not work as well or the antidepressant would make it exacerbate heart problems. But it’s absolutely fine to take it with antidepressants. There is actually some antidepressant affect with phentermine.

Legally I have to have a discussion about the” art” of taking phentermine to a patient if they’re going to be taking it. I have to talk about the potential side effects as well as the” art” of using the medication. It tends to last for 10-12 hours. So, since most people don’t wake up starving, don’t take it first thing in the morning.  There’s no sense in taking it then.  Take it mid to late morning.  Play with the timing. If you find you’re having a hard time getting to sleep, then take it earlier. If you have a lot of hunger and cravings right before bed then you need to take it later.  It’s one of those medications that work if you take it.  It doesn’t work if you don’t take it. You don’t have to build up to it or wean off of it.  Therefore you can use it intermittently. It’s fine to use it certain days of the week. We typically write it as a daily dose but there’s no reason you need to take it every day.  Take it as you need it. It can be used long term. It originally was written in the PDR to be used for only 8-10 weeks. They originally said that because the original studies were only done for 8-10 weeks.  It was then approved by the FDA but never approved for long term use.  It has been used for long term use for many years the PDR has never been changed. So most physicians only prescribe it for a few months. It’s kind of silly to think we can fix something in a couple months. I’ve had people on phentermine for 10-12 years. It just has to be monitored. We’re making sure there aren’t any blood pressure problems, ensuring it’s still helping, and make sure there are not side effects bothering you. If it’s not helping, you shouldn’t be taking it anymore. There is evidence that if a person is taking it long term that if they stop it every few months for 7-10 days, and then it tends to work better.

There are some cautions about phentermine. Sometimes it may work so well that you don’t eat. We’ve talked about intermittent fasting and how that works.  The problem with skipping meals and intermittent fasting are two different things. If you’re just skipping means, then it was unintentional. Fasting is intentional. You don’t want to be skipping meals all the time. If you’re doing intermittent fasting for a day or two, you can take phentermine. It’s another tool in the tool box. Starvation has never been a good weight loss plan. Phentermine won’t stop you from eating. If you’re eating for many reasons (not hunger), then it’s not going to help you. You need to take a good look at the behavior side of things.  Why are you actually eating? Work on solving those problems. Without a good nutritional and exercise plan, any weight loss with the phentermine will likely be temporary.

In summary, phentermine has been around for a long time. It has stood the test of time. It can be very safe. It can be very helpful, especially for cravings. But it still needs to be used with a good diet and exercise plan. It doesn’t work to fix a poor life plan. You need to have a normal EKG. We have to monitor your blood pressure as well as side effects.

Come in and get your body composition done.  Make sure your losing body fat and not lean body mass. You should be receiving the health tips and weekly recipes. Tune in each Tuesday at 6pm for the next webinar. Watch your e-mail for the invite and link! Remember it’s your life! Make it a healthy one!  Take care everyone.

What If I Can’t Find a Qualified Bariatric Surgeon or Comprehensive Follow-up Program in My Area?

Posted on July 16, 2018 by

2017-03-29_16.59.40_smallerIf you cannot find a qualified bariatric surgeon or comprehensive follow up program in your area, you will have to either compromise what you want/ need or continue your search until you find the surgeon/program that will meet and/or exceed your expectations.

A few experienced surgeons offer a travel program for surgery.  At the Center for Weight Loss Success, we offer such a program for appropriate surgical candidates.  Not only does the program include surgery with arguably the most experience bariatric surgeon in the United States who has performed over 5,000 weight loss procedures, but it also includes our comprehensive Weight Management University for Weight Loss Surgery™ program.  In addition, it is one of the most affordable options available in the United States.  You can learn more about it at www.cfwls.com

The bottom line is that you have to be comfortable with your choice.  We are fortunate to have many excellent bariatric surgeons in the United States.  Your long-term success is the most important thing under consideration here.  I hope this book has helped to inspire you, answer your questions and better prepare you for an amazing journey.  Only you know if this journey is something that is right for you.  If we can be of further assistance in any way, please let us know at success@cfwls.com.  If you desire additional information and would like to view helpful videos that address each of these questions, please visit our main website at www.cfwls.com or at www.myweightlosssurgerysuccess.com.

CFWLS-Rhonda-09-

Rhonda’s Opinion:  Travel to the surgeon/program of your choice – it’s all worth it!

How Do I Find a Qualified Weight Loss Surgeon?

Posted on July 09, 2018 by

NEVER UNDERESTIMATEThe search for a qualified weight loss surgeon can be completed in a number of ways.  Some of the more common methods include:

  1. Personal referral from someone you know
  2. Referral from your primary care practitioner
  3. Online search
  4. Author/Expert Publication such as a journal or the book you are reading
  5. Local marketing (i.e. radio, billboard, TV, newspaper or other publication)

Remember to ask the questions reviewed in my previous blog.  Evaluate the available options and select the surgeon, staff and program that will best fit you and your needs.  This is a decision that requires careful consideration.  Talking to someone who has already had surgery with the surgeon you are considering is often very helpful.

You will want to attend an on-site seminar with the surgeon (not just his/her assistant or office staff).  This is a great way to get to know the surgeon, learn about the various procedures he/she performs, their particular outcomes, the comprehensive program they offer, get to meet their staff and learn more about your options.  If you are unable to attend an on-site seminar, many surgeons also offer a comprehensive online webinar such as the one on our website at www.cfwls.com.

kevin

What Questions Should I Discuss with My Primary Care Doctor?

Posted on July 02, 2018 by

shaking-hands1-1024x586Particularly if you have a number of medical problems, your primary care doctor and your bariatric surgeon will need to communicate openly throughout your pre-operative and post-operative phases of weight loss surgery.  In addition, some insurance carriers require a letter from your primary care physician indicating that you are an appropriate candidate for weight loss surgery and/or “cleared” for surgery.  If this is the case, the staff at your bariatric surgeon’s office will be able to help you facilitate receiving such information prior to authorization for surgery.

Amazingly a number of people do not have a primary care provider.  If this is the case for you, your surgeon will likely recommend that you find one.  He/she will want to communicate your progress and have someone to refer you to in the event you have a medical problem unrelated to surgery and/or necessary medication changes as you lose weight following surgery.

Some questions you will want to discuss with your primary care provider include:

  1. Are there any medical reasons that would prevent me from being an appropriate candidate for weight loss surgery?
  2. Do you recommend any particular weight loss surgeon and the reason(s) why?
  3. Are you able to provide my surgeon with any necessary documentation or clearance that might be required?

Most primary care practitioners are comfortable answering these questions and used to working closely with an experienced local bariatric surgeon.  Some may be limited in terms of who they are able to recommend due to required referral patterns within health systems.  However, this is not generally the norm and the final decision is yours.

What Questions Should I Ask When Trying to Find a Qualified Bariatric Surgeon?

Posted on June 25, 2018 by

American College of SurgeonsIf you are considering weight loss surgery, you are likely quite savvy in your research and know what you are looking for.  In fact most people research weight loss surgery for at least one year prior to deciding to have surgery and choosing which qualified bariatric surgeon will perform their procedure.  This is actually refreshing to me and my professional  team at the Center for Weight Loss Success. I welcome any and all questions and actually worry a bit if there are no questions. I will answer your questions with sincerity and honesty.  This is very important because your relationship with your surgeon is for life and ongoing support is critical to long-term success.

Below is a basic list of questions you should ask any bariatric surgeon under consideration.  Although most are a standard part of your initial meeting and individualized consultation, they are important to know.  You will likely have others so be sure to add them to the list prior to your individual consultation appointment.

  • How many years have you been a bariatric surgeon?
  • How many and what types of weight loss procedures have you performed and do you perform each year?
  • Are you a board-certified surgeon?
  • Are you a member of ASMBS (American Society for Metabolic & Bariatric Surgery)?
  • Based on my personal health and weight, what surgery do you recommend for me?
  • What are the advantages/disadvantages/risks of this procedure?
  • Do you perform the surgery laparoscopically or open?
  • Will you perform the procedure, or an assistant?
  • Where will the surgery be performed?
  • Is the hospital or clinic a Center of Excellence?
  • What pre-op testing will be done?
  • What post-op testing will be done?
  • Do you have a comprehensive pre-operative and post-operative program including nutritional coaching, fitness, ongoing support groups, ongoing education and availability of a psychologist?
  • What changes will I be expected to make with regards to diet and exercise?
  • Do you have an insurance and/or financial coordinator available to patients?
  • Do you have a dietician or nutritionist available to patients?
  • Do you have a psychologist available to patients?
  • Do you have a support group for patients?
  • How are questions during non-office hours handled?
  • What should my expected weight loss be?
  • Ask for specific statistics regarding complications and outcomes with your particular type of surgery. They should be willing to provide the information and not try to hide any negative results.
  • Do you have patients who are willing to share their experiences with me?

If you can find a bariatric surgeon who is also experienced and/or board certified in bariatric medicine, that is an added bonus since they will also be equipped to assist you in losing weight prior to surgery.  They also understand medical weight loss methodology that helps the further out you are from surgery.  There are only a select few bariatric surgeons who are also board certified in bariatric medicine.  I have chosen this route because it is my passion and I feel it provides me with the added knowledge to assist patients with or without surgery and also enhance their long-term success.

Your individualized consultation with your prospective surgeon should be thorough and informative.  In addition to your surgeon, you will want to feel comfortable with the office staff and overall customer service experience.  You are becoming a new member of their weight loss surgery family when you choose to have surgery.  Your surgeon and his/her staff are your extended support system.  They should also provide you with the opportunity to include your significant other each step of the way so they can also understand what to expect before, during and after surgery.

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Rhonda’s Opinion:  This is different for everyone.  I looked at the experience and program offerings of the physician.  With Dr. Clark it seemed like a no-brainer.

How Do I Guarantee My Results After Weight Loss Surgery?

Posted on June 18, 2018 by

everydayThis is a great question and one that isn’t asked often enough.  Understandably, your initial focus is usually on researching the available surgical options.  After that, your next focus tends to be who will perform your surgery, where your surgery will be performed and how much it will cost.  Unfortunately, the focus doesn’t usually turn to one of the most important considerations – what you need to do to guarantee your results after weight loss surgery.

The reality is that everyone loses weight after weight  loss surgery (particularly with the gastric bypass and sleeve gastrectomy procedures).  It’s exciting!  It’s rewarding!  It’s awesome!  But…eventually…your weight loss slows down and you will plateau.  Don’t despair, with proper support and guidance, you can get through plateaus and the final plateau will ideally be somewhere just above your ideal body weight.

This occurs, especially if you use the time after surgery (particularly the first year) to not only lose weight, but learn how to modify your mindset and your lifestyle habits…for good!  If you do this, your potential for true long-term success is exponentially increased.  Remember, weight loss surgery is a tool to lose weight.  If you don’t fully understand how to properly use your tool, your results can be compromised.  Instead, why not optimize your results?  This is where your post-operative comprehensive program comes in.  Don’t skip this important aspect of your research process prior to surgery.

This may be disheartening to hear because you might think of weight loss surgery as a guarantee.  Don’t get me wrong, I see success each and every day and it is truly amazing!  However, weight loss surgery is not a magic bullet.  Long term success requires long-term changes.  Don’t worry though.  With proper comprehensive support, this process is not only rewarding and fulfilling, it is actually fun!

So…What should you do after weight loss surgery to guarantee your results?  This was reviewed somewhat in Chapter 10 but I am going to expand this explanation.  I will begin with identifying the most common things you should be doing and then I will take a slightly different approach and share with you the five most common culprits to poor/slower weight loss or eventual weight re-gain.

In addition to the actions described in Chapter 10, your post weight loss surgery steps to success should include:

  1. Don’t miss your post-operative visits with your surgeon. It is important for him/her to monitor your recovery and progress.  Sometimes people avoid their visits because either they are feeling so great, they don’t think they need to be seen or they are struggling and too embarrassed to see their surgeon due to a perceived sense of failure.  Unfortunately, this is the time you REALLY need to come in for your visits.  If you feel great, you can confirm your progress and celebrate even more.  If you are doing well, your surgeon WANTS to see you and celebrate with you as well.  If you are struggling, your surgeon WANTS to see you to help you identify the reason(s) why you are struggling.  It is best if this occurs as early as possible so you can take necessary actions to get back on track as soon as possible. You are not alone and recommendations can usually be determined quickly.  You can leave with a plan in hand and the confidence you need to master the use of your new tool and get back on your path to success.
  2. Don’t miss any scheduled visits with your primary care provider. This is particularly important if you are on any medications that need to be adjusted as you lose weight (i.e. hypertension and diabetes medications).
  3. Don’t miss any scheduled visits with your team of weight loss coaches. Included in comprehensive programs such as the one offered at the Center for Weight Loss Success, you will also be coached by a dietician, weight loss coach and/or personal trainer.  These professionals help you navigate the specific barriers or situations that may impede your optimal progress.  They will also keep you on track and guide you through this life changing experience.  In addition, your team loves to help you celebrate your success and assist you to avoid pitfalls and create new habits that keep you headed in the right direction.
  4. Make the most of the educational materials provided to you before and after surgery. At the WMU4WLS hardcover 2018 whiteCenter for Weight Loss Success, you receive a comprehensive  pre-operative and post-operative learning series called Weight Management University for Weight Loss Surgery™.  This program is reviewed at your office visits guides you each step of the way for the first 12 months after surgery.  Each monthly module explains what to expect that month, what to expect the next month, success stories, recipes and educational materials explaining what you need to know.  They also include information regarding nutrition, metabolism, fitness and other topics that assist you to attain your optimal success.  The modules are supported videos in your membership site and homework assignments that help put it all together.  This comprehensive system is well received by patients.  By the end of your first year after surgery, you will feel as if you have earned a new degree in weight loss surgery!  No matter what learning method you prefer, all bases are covered so dive on in and enjoy!
  5. Attend the support group provided by your experienced surgeon/center. These are generally offered in a group setting and often supplemented with online support as well.
  6. Surround yourself with positive and supportive people who have healthy behaviors. Beware of saboteurs.  There will usually be someone at work or at home who intentionally or unintentionally attempts to sabotage your new way of life.  Sabotage comes in many forms.  Here are a few strategies for dealing with the most common types:
    • Self-Sabotage: Hard to admit, but sometimes we are our own worst enemies. Do you have an internal dialogue that sounds like a tug of war between something you want to do and a rationalization as to why you can’t possibly do that today (better known as excuses)? It all starts with a realistic goal, a realistic plan and realizing that you are in control of your own behavior.  Try replacing the word “can’t” with the word “won’t” the next time that happens and your “self-talk” will begin to change!
    • Family/Friends: You like to think they are all supportive but the reality is that those we count on the most for support are often the ones encouraging a “treat”, “celebration”, “one more bite” or those trigger foods that you can’t say no to. The truth is that you are vulnerable right now and they need to understand your dedication to your goal.  You may need to have a “heart-to-heart” asking for their support. Be assertive, keep your goals handy, put treats out of site or give them away, focus on activities rather than food events.  At parties, focus on conversation and go in with a plan of attack you know you can stick to.
    • Vacations: Time away should be a time to enjoy and relax. However, be careful about your sabotaging thoughts to “let loose”, “do nothing” or “blow it out for the week”.  You can have fun in moderation, incorporate a new sport or activity, enjoy new foods (focus on protein, new vegetables or fruit) and feel great by working in a long walk, run or visit to the fitness center at that great resort!
    • Office Life:  Why is it that your office has to celebrate every event with cakes, cookies & donuts?  Let your co-workers know you are trying to get healthier and welcome them to join you.  Start a new office healthy thinking initiative. Avoid trips to the snack-laden break room and take your break outside.  Make a point not to eat at your desk or if you have to, only bring things you know fit into your plan. Keep a stretch band or small weights at your desk to use.  You could use eight different muscle groups in an eight-hour day!
    • Holidays/Parties: We need to celebrate life!  It can be done though without all of the focus being on food and/or alcohol (which diminishes our sense of control).  Plan for the event ahead of time and don’t go hungry.  You will be less tempted. Plan on picking one or two special food items, giving yourself permission to sample what is there…you don’t want to feel deprived.  Keep your alcohol consumption absent or to a minimum and stay hydrated with water with a twist of lemon or lime.  Hold your drink in your dominant hand to avoid picking at food and talk to others…it’s harder to eat while you are talking.

You can overcome these problem areas!  Make sure you identify what is risky for you so you can have a game plan to combat the situation(s).  Don’t prevent yourself from enjoying life but sometimes (especially early on in your weight loss until new habits are developed) it is easiest to limit exposure, make small strides, build your confidence and then celebrate your success!

Another way to look at how to achieve long-term success is to know and understand the most common reasons you might not get the results you desire and what to do about them.  Below are the five most common culprits to poor/slower weight loss or eventual weight re-gain:

  1. Depression – Emotional health is as important as physical health.  Although depression is not a problem for most after surgery, it can be a significant deterrent to optimal weight loss.  It is important to identify depression (admit that it is ok) and seek appropriate treatment so you can move on with your weight loss journey.
  2. Not Exercising – We require each of you to complete a fitness evaluation with a personal trainer which is included with the program.  The reason for this is because we believe some form of consistent exercise is essential for optimal success.  You should determine what form of exercise is right for you and begin your exercise plan before surgery.  We cannot over-emphasize the importance of this factor.  Although most find it difficult to begin an exercise plan, those that take that plunge never regret it.  It can only enhance your weight loss experience and progress.
  3. Drinking High Calorie Liquids – Many do not realize the excessive amount of sugar and calories contained in some liquids (i.e. Gatorade, Juice, Soda).  As a result, you may “waste” calories on such liquids.  This can significantly impede your weight loss.  It is better to choose water, water with lemon, Fruit2O, Crystal Light or other low or no calorie drink options.
  4. “Grazing” – After the first 2 months or so, you should have progressed to three meals per day with some higher protein snacks in between.  If not, you may develop the habit of “grazing” or eating throughout the day.  If this is the case, you tend to take in a significantly higher amount of calories throughout the day (more than what your body needs).  This will slow down your weight loss and can potentially cause weight re-gain.  Please guard yourself against such habits.
  5. Eating and Drinking at the Same Time – When you eat and drink at the same time, the food is “washed through” the stomach quickly.  It is important to hydrate yourself by drinking a low/no calorie beverage approximately 30 minutes prior to eating.  In this way, your hunger will be decreased.  When you eat, you should not drink at the same time.  As a result, your “pouch” will remain fuller for a longer period of time.  Thus, you will remain satisfied for a longer period of time.  Be sure to stop eating before you truly feel “full”.  It is a slow communication from your stomach to your brain to indicate a feeling of fullness.  Thus, you may overeat and realize it too late.  This can be a very uncomfortable feeling.

So although you may be focusing on the surgery itself, you will be doing yourself a big favor by not neglecting your post-operative plan.  Use these tips and don’t forget to enjoy this journey of self-discovery.

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Rhonda’s Opinion:  Make yourself a priority and it will work.

Will I Need to Take Vitamins and Supplements After Weight Loss Surgery?

Posted on June 11, 2018 by

I Can & I WillYes, you will need to take vitamins.  Supplements are helpful but not a requirement.  Actually, whether or not you have weight loss surgery, you should be taking vitamins.  Supplements can be helpful as well, especially if you are trying to lose weight.  You should also make sure your vitamins/supplements are pharmaceutical grade so that the quality of their content is monitored and guaranteed.  The nutritional store at the Center for Weight Loss Success only carries such vitamins and supplements and our patients love them.  (www.cfwls.com)

The common vitamins that will likely be recommended for you (may vary depending upon the surgeon) include the following:

Multivitamins: Taking vitamins will be a lifelong commitment for all patients who have had weight loss surgery.  In the beginning, you should take two chewable complete multivitamins each day.  At one month after surgery, you may be able to progress to taking two regular vitamins daily.  We recommend two vitamins each day during the first year when your weight loss is most rapid.  After the first year, you should continue to take one multivitamin a day.  Women may want to consider a prenatal vitamin if pre-menopausal.

B-Complex: Usually around 1 month after surgery, we recommend that you also add one B-Complex vitamin each day (or even 2 per day).  The B vitamins assist in muscle and nerve functioning and have been shown to increase a person’s energy level over time.  You cannot overdose on B vitamins.  If you take in more than you need, you will simply rid yourself of any excess through your urine.  It is common for B vitamins to cause your urine to be darker or a brighter yellow.  This is normal.  If you prefer, B-Complex is also available as an injection at the office as appropriate.

Essential Fatty Acids (EFA’s):  Take them – they’re just good for you.  By taking fish oil supplements, Omega-3 fatty acids are ingested in their biologically active form.  They can be directly used to support cardiovascular, brain, nervous system, and immune function.  The mini-soft gels are smaller and have a natural lemon flavor to prevent a “fishy” after taste.  Our product is ultra-filtered to guarantee removal of mercury and other possible contaminants.  Most people should take 2-4 soft gels per day.  They are also helpful to prevent constipation.

Magnesium-Potassium: During weight loss your body will tend to waste both magnesium and potassium.  Both of these minerals are essential to normal muscular and cardiovascular function.  Magnesium is involved in over 300 biological reactions throughout the body.  It can help prevent/treat fatigue.  If you are prone to muscle cramps – you need to add this supplement.  Typical doses are 1-4 tablets daily with food.