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Tag Archives: bariatric center of excellence

Weight Loss…Simplified

Posted on January 20, 2020 by

The goal is to identify essential weight loss principles that you can use starting today for both medical and surgical patients. I’ll throw in a few “random thoughts” by Dr. Clark telling you my though process. One of my favorite quotes and favorite people, Albert Einstein, said “If you can’t explain it simply, then you don’t understand it well enough.” So, hopefully I can explain it simply.

It often seems like weight loss concepts and principles are significantly different between medical patients and surgical patients. Nothing could be further from the truth. The principles and concepts are exactly the same thing. The weight loss principles for a patient will be the same post weight loss surgery. They just have a slightly different anatomy. The essence of any weight loss plan will always be behavior modification. Change what you do, whether it’s nutritional or activity level. Change (weight loss) will not occur unless you change your behavior. Sometimes we’re waiting for the life around us to change or people around us the change. The reality is that’s never going to happen. If you don’t change, change will never occur. Don’t wait for someone else to change for you.

Energy storage is extremely important for survival. If we couldn’t store energy, we would have to eat continuously. We can store energy in 2 ways. We can store it as fat or we can store it as glycogen. Storing energy as fat is unlimited. We can store hundreds of pounds of fat. Even a thin persona has a lot of fat storage. Even a 200 pound male with 10% body fat has 70,000 available calories. That’s a lot of stored calories! We can’t store very much glycogen (sugar). We can only store about 2000 calories. Most of the glycogen is in the muscle. The muscle doesn’t like to give up any of this energy (it’s kinda selfish). The liver is unselfish. It will share sugar. What’s the problem with this?  The problem is just because you may have a tremendous amount of stored energy as fat does not mean that you have unrestricted access to it. Unfortunately it’s not very accessible.

What do we do here at The Center for Weight Loss Success? We have 2 comprehensive programs. We also have a full fitness center, nutritional store, clinical area, educational classroom, behavior modification classes, weekly live webinars, weight loss meds, Hormone Replacement Therapy, and more. We have a 6 month medical program referred to as “Weight Management University™.” We have a 12 month post-surgical program called, “Weight Management for Weight Loss Surgery™.” Both of these programs are very similar. A lot of the topics in the programs are interchangeable. The medical program has 14 different topics. The surgical program has 12 topics. The difference is how we present them. We put them in different order because they become pertinent at different times depending if you’ve had surgery or not.

The real question is:  how do you do it?? The dietary plan, activity plan, and behavior modification changes don’t take place immediately just because someone has undergone weight loss surgery. There should not be a “cloud of mystique” that surrounds someone who has had weight loss surgery. We didn’t change things by operating on you.

My job is to figure out why someone is overweight. Then, I have to figure out what are the right “things” to do for that individual. Finally, (the hard part), is how that individual implements those things and make them a lifestyle. Part of that is being willing and able to do those things in order to lose the weight. That’s a very important concept and mindset for anyone, especially with weight loss. Some people are just natural athletes. They may have never picked up a golf club. But when they do, they’re able to play pretty darn well. Other people might have to practice really hard but are mediocre at the sport. Is there a difference?  Maybe some of us will never be pro golfers. But if we practice and work at it we will get better. All weight loss surgery does is just exaggerate the “normal” weight loss curve. The normal weight loss curve is this: you go on a specific diet and lose weight. Then you’re weight is going to stabilize. You might regain a little bit. With weight loss surgery you lose weight much quicker, greater weight loss, and it lasts longer. Long term it’s still doing all the same things. One of the “downfalls” of WLS is….it works! Because WLS works so well, people often think they’re doing the right things. You’re going to lose weight the first few months no matter what you do, but if you don’t do all the right things long term you will find that you’re going to start struggling. You need to do all the right things. Weight loss is something we work on forever. It’s a process. You’ve got to do the right things. Are you willing and able to do the right things?

I’ll sometimes see people back in the office several years after having WLS. They’ve gained weight. Or, I see people who were successful in the Medical program but they return because they’ve gained weight back. No one gains weight due to a deficiency of surgery. Some people say they need surgery because they’re gaining weight. Likewise, no one gains weight due to a deficiency of phentermine or any other weight loss medication.  They gain weight because they are eating and/or doing the wrong things. As physicians sometimes we contribute to that. There are certain medications that physicians prescribe that cause weight gain.

The concept of eating is, “How little can I eat and be satisfied.” It’s not, “How much can I cram in there.” The difference between those two thought processes is about 20-25%.  It’s often the difference between losing weight and keeping it off, and gaining weight. Long-term the pattern of eating needs to be 3 meals a day +/- a planned snack. No one has ever starved in 3 hours. If your mind is telling you it’s time to eat something, but it’s not time to eat, drink some water or do something else. Meals should be small plate size. The best food has absolutely no labels. It’s eating green and clean.

The Basics

The “Basics” of the eating plan are calories, protein, and carbohydrates. Everyone has a calorie “ceiling.” If you go above it, you gain weight. It does not mean that if you stay below the calorie ceiling you will lose weight. You can’t survive without protein. Preserving lean body mass is key. We talk about this all the time. The best protein source is from food. Everyone has a carbohydrate “tipping point.” A certain level of carb intake makes insulin levels rise. Insulin turns on fat storage. Some people have a very high tipping point. They can eat just about whatever they want to and never gain a pound. They don’t have a better physiology. They have a more efficient physiology. If what you eat increases your insulin levels. It turns on fat storage. If you eat a mountain of lettuce and it makes your blood sugar go up, it will also make your insulin level go up. One thing you can do is get a blood sugar monitor and check your blood sugar after you eat.

I have a few things for you to “chew” on.  “Kinda” working on weight loss will never help.  You can’t, for example, do a good job during the week and then go crazy on the weekends. If you’re only going to do one thing, count your carbohydrate intake. Carbohydrate is not an essential nutrient and there is no such thing as carbohydrate deficiency. Carbohydrate influences insulin which is the “fat storage” hormone. If you don’t make insulin, you cannot store fat. One of the first symptoms of a Type I diabetic who does not make insulin is that they are losing weight like crazy. They can’t store fat. Two thirds of the population is “carb sensitive.” If they eat carbs they get large blood sugar swings. Large blood sugar swings cause 2 major problems:  symptoms (headaches, irritability, shaky, not thinking clearly) and weight gain.

What do blood sugar swings actually mean?

If your blood sugar level is 100, what does that actually mean? That’s at the higher end actually. We would rather that it be 80. Each of us has about 5 liters of blood in our body. When we say that your blood sugar is 100 mg/dl, that means there is 5 grams of sugar in your entire blood volume. There’s 1 gram in each of those liters. How much sugar is 1 gram? If you have just 5 grams of carbohydrate, in theory you will double your blood sugar. If it was 100, it will jump to 200 after eating 5 grams of carbohydrate.  Examples of 5 grams of sugar (1 tsp): ½ Oreo, 1 triscuit, 1/5 banana, ¼ apple, ¼ slice of bread. I often have patients come into the office and say, “Well I only had…” It only takes a little bit and you’ve doubled your blood sugar. The point of all this is that it doesn’t take much carbohydrate to give you tremendous blood sugar swings.

In review, the Basics of the eating plan include: a calorie ceiling, sufficient protein, and a carbohydrate tipping point. The trick is to figure out the numbers. If you’re a woman who’s had WLS, if you get about 1200 calories you’ll struggle. If you’re a man and get about 1500-1600 calories you’ll probably struggle. Protein is based on lean body mass. It almost always comes around 90-100grams/day. It depends on how big you are. A male with a much bigger frame is going to need more protein. We typically say less than 50 grams a day. Some patients are so sensitive they need to be in the 20-30 gram range to really see good weight loss. What about fat? I’m not concerned too much unless it drives your calories too high. You want to try and stick to the monounsaturated fats. There are good and bad fats. They do tend to influence calories. Fat does not affect the hormones the affect weight. Carbohydrate and protein do affect hormones that affect weight.

The best foods have no labels

The best foods have no labels. Eat just 3 things. We would die without water. Water is the best thing to drink. Get rid of everything else. Good protein sources are meat, seafood, cheese and eggs. They have basically no carbohydrates. Eat colorful vegetables/salad stuff which is typically low calorie, nutrient dense, and fairly low carbohydrate. If it falls outside the “core,” then don’t eat it!

Dr. Clark’s low carb diet simplified (LCDS) is avoiding these three things: starches, “crumbly” carbs, and watching the fruit. Fruit can be the downfall of any weight loss plan. I’ve heard so many people say they eat healthy (including a lot of fruit). Fruit is healthy. There’s no doubt about that. However, it won’t help you lose weight. Healthy and losing weight are two different things. The main starches to avoid are potato, rice, pasta and bread. The “crumbly” carbs (6 “C”s) are chips, cookies, cereal, cake and candy. That includes hot cereal too. It’s simple to understand but NOT easy to do! Simple does not equate with easy.

A good weight loss plan includes a good diet/nutrition plan, activity/exercise plan, and behavior modification. There is no difference between surgical and medical weight loss patients trying to lose weight. The hard part is behavior modification.

We can help you get started! Call us at 757-873-1880 to schedule a free consultation if you are interested in a non-surgical program or watch our free weight loss surgery webinar.

Food Triggers & Dietary Disasters

Posted on January 13, 2020 by

A lot of times emotions can turn on that “feeding frenzy.” Or, sometimes situations will turn it on. Certain foods will call your name. We all seem to have our own triggers. We also have our own cravings. A trigger is something that sets in motion a course of events. Here we’re talking about eating when we don’t necessarily want to eat or should be eating. Eating triggers fall into 3 categories: trigger foods, trigger feelings, and trigger environments.

A trigger food is a specific food that sets off a course of overeating. Is there some food that you can only have a tiny bit and then you need to eat everything in sight? Control is often lost and excessive amounts of food may be consumed. Common trigger foods are usually highly refined foods such as sugar/fat combinations like ice cream. Another common trigger food is salty/starchy combination such as bread, chips, or crackers. I’m not a big fan of diet deprivation. I don’t believe in saying, “You can never eat this…” You’ll typically want it even more if you think you can never have it. If you want it even more it makes it harder to leave it alone. Can we be satisfied with a little bit? That’s what you want to strive for. If there truly is a food that causes you to eat the whole thing (whole bag of chips) then you probably should avoid that food. It’s the food, not the emotion that triggers the out of control eating. It’s not the situation.

Physiologic cravings are real. They tend to be most pronounced with high carb foods such as cookies, breads, pastries, and chips. They usually peak during the first few weeks of dieting. Then they fade. But you can experience true withdrawal symptoms. Carbohydrates are like a drug. If you have a little bit you’re going to want more. The symptoms are worsening cravings, headaches, fatigue, shakiness, and irritability. Once you get through the withdrawal symptoms it gets easier but that doesn’t make it easy. Many cravings are related to blood sugar swings. Every time the blood sugar comes down you’re going to want more because your body wants something to keep that blood sugar from dropping. Consequently you’re going to get a big swing up if you have more of that food. The big blood sugar swings make the cravings even worse. Appetite suppressants can help. Chromium can also help. It’s a mineral and can help smooth over blood sugar swings. You can get it just about anywhere. We sell it here in our nutrition store. On the bottle it will say take one a day as a supplement. Unfortunately that doesn’t work for cravings. Generally you need to take it 3 times a day. It’s very safe but you shouldn’t take a bottle every day!

A trigger feeling is an emotion (good or bad) which sets off a period of overeating. Examples are stress, anxiety, anger, sadness, or loneliness. It often sets off overeating of just about any food (salty, crunchy, sweet, doughy, etc.….). Identifying the emotion is key to controlling these triggers. Journaling is one of the best ways to sort this out. It’s not just writing down what you’re eating. It’s writing down why you’re eating. If you’re hungry and it’s time to eat then that’s a good reason. What if it’s not time to eat? If you’re not hungry, what are the reasons? Am I stressed? Am I excited? Am I depressed? You’ll see a pattern developing.

Trigger environments are specific situations or places that set off an episode of overeating (Movie Theater, buffet, sporting event, socializing with a specific group of friends).  The overeating is set off by the specific environment or situation. Usually you regret it the next day. To manage this you have to identify the specific location, people, or events. Avoidance works, but often that’s not possible. Are you really never going to the movies again? Are you really going to avoid your friends? It’s important to develop strategies to minimize the overeating in those environments. Plan ahead of time what you’re going to do. It’s hard to unlearn things but we have to.

We all have willpower even though we don’t think we do. Some of us need to take it up a notch. Cravings tend to fade with time. They can come back. The internal struggle with cravings leads to emotional pain. It’s often due to indecision. We really haven’t made up our mind. We literally make thousands of eating decisions every day. With fasting you get rid of a lot of decisions. Make the hard and fast decision that you won’t give in to the craving. To weaken the intensity and reduce the craving you must stop giving in to them. It’s easier said than done but it does work. Avoiding the indecision can be very helpful. Willpower is like a muscle. It can be strengthened with practice.

Your Strategies for Improving Willpower

There are strategies for improving willpower. The first strategy is Mindset Changing Techniques. You need to be truthful with yourself. Tell yourself it’s a craving, not true hunger. Is there another reason you’re eating (angry, lonely, tired, and stressed)? Don’t waiver in your commitment. It will get easier with time. We want to imagine the aftermath of giving in. Sometimes when we give in it feels good to eat that sugary food for a few minutes. You might even get a sugar high. But typically, a little later, you’re not going to feel so good. Replace the word can’t with won’t. You always have a choice.  Review your goals and remind yourself why you’re doing this. Why do you want to continue with this weight loss process? If you give in all the time, you’re always going to be at risk for gaining weight.

The second strategy for improving willpower is Habit Changing Techniques. You want to distance yourself from the food you crave. Remove the food or yourself from the scene. Remove the food or distance yourself from the scene. For example, don’t go to the movies for a while. When you go back, don’t revert back to the big tub of buttered popcorn, bring some protein snack along with you instead.  Drink something. Thirst is often confused with hunger. If you drink something you often realize you weren’t hungry. Your body will tell you that you need something. It could be just the water that it needs.  Try to change your mindset. Relax. Set a timer for 5 minutes and concentrate on breathing. Distract yourself: brush your teeth (how many people want to eat after they’ve brushed their teeth?), paint your nails, brisk walk, exercise, call a friend, shower, practice a musical instrument, or work in the yard. Do something that will distract you for a period of time and the cravings will fade away.

In summation, food trigger are all around you. Learn to recognize them for what they are. Develop the strategies to combat them. It will get you that much closer to your weight loss goals! If you need help, we offer counseling for anyone that’s struggling with that. The counselors will figure out a solution for you. Contact us at 757-873-1880 and set up a free consultation to figure out which program or plan fits your needs!

Avoiding Holiday Weight Gain

Posted on December 02, 2019 by

You don’t want to be standing on the scale after the holidays and wondering what happened.  We want to avoid that problem. Holiday weight gain: everyone thinks about and everyone fears it. Is it inevitable?  What can you do to avoid it? How do YOU make the best choices?

Here are a few statistics. It’s often stated that the average person gains 3-5 pounds during the holidays. But, this is not true.  The average American does gain about 1.1 lbs. during an entire year. So, it doesn’t take that many years to start getting into some problems. About 10% of the population gains greater than 5 pounds in a year. This is typically the population that I see.  One of the problems is that it’s not just the entire year. About 80% of the weight occurs during the 6 weeks between Thanksgiving and New Year’s. A significant proportion of people (my patient population) will gain a significant amount of weight during a year. And, most of this occurs over the holidays.

There are a lot of factors that lead to overeating during the holidays. There are a lot of social gatherings. We get together for social functions over the holidays with friends and family and it usually revolves around food. The holidays tend to bring about more stress (family, gift buying, decorating).  The stress can lead to exhaustion and we make poor food choices. There’s a lot more emotional eating during the holidays. We can be sad, depressed, or stressed. Cold weather causes us to desire comfort food. One of the issues is the food around the holidays tastes good! It’s very palatable and it’s everywhere! Cookies everywhere!  Plenty of temptation. Often there are treats that only come out during the holidays.

How do you avoid that holiday weight gain? I like to look at what I call the 3 basic pillars of weight management. The three pillars are: eating (home and at parties), exercise, and behavior modification. We’re going to look at these three things and how we can use them to help us.

Eating is the biggest one.  Don’t skip breakfast. A couple of good studies have shown when people don’t eat breakfast they tend to eat more by the end of the day then what they normally would. The exception is if your breakfast is going to be a high carbohydrate meal. You’re better off skipping breakfast. If you start off with a carbohydrate breakfast, you’re going to end up eating more during the day. If you have a good protein start to your day you’ll actually eat less during the day. Recruit family and friends to help you. Let them know you’re trying to lose weight and you need their support. Typically they will be supportive if they know about it. Hopefully they want try and sabotage you. You might need to avoid them for a period of time. At home you might need to have an “off limits” area for yourself. If you have treats in the house for other family members that could tempt you, place them in an “off limits” area. Make it a rule that you won’t go into that off limits area. If you don’t make that rule, it makes it harder to avoid temptation. Don’t purchase or make the things that tempt you the most. If you need to make holiday cookies for your child to take to school, make ones you don’t typically like. Use the “catch and release” program. If someone brings you cookies, try one, and they immediately give it away. Get it out of the house.

A different scenario is eating at parties/functions. They’re occurring all the time during that 6 week period over the holidays. Here are some things to do to help protect you. Don’t go hungry. The last thing you want to do is show up at a holiday party starving because then you’re going to eat everything. Eat something healthy before you go. Bring a healthy choice with you so you know you’re going to have something you can eat. Increase the water. Water loading makes us feel full. It doesn’t last very long but it can prevent over eating. Use small plates and small utensils. If you use smaller plates and smaller utensils you will eat less. This has been shown in multiple studies for multiple years.  Watch the alcohol for numerous reasons. It has a lot of calories in it. Also watch the high calorie drinks like egg nog. We tend to get that “drinking amnesia” where we forget that we had drinks and don’t consider all the calories involved. Alcohol releases inhibitions and we tend to eat more. Do the “walkabout” first. Look around at all the food and figure out what you’re going to have.  Choose the good protein sources and colorful veggies. Choose your poison carefully. You can choose some things you don’t get to eat often. Complete deprivation doesn’t work well. I’m not a big fan of deprivation diets. If you tell yourself you can never eat something, you’re going to fall off the wagon at some point and go crazy. Have the mindset that you can be happy with just a small portion of the food. Don’t stay in the room that has the food in it. Get your food and leave the room. Eat in another room. Keep your hands full (not food related). You’re less likely to eat if your hands are full. Hold your drink in your dominant hand. Most people don’t eat very well with their non-dominant hand. These little tricks can be very helpful in avoiding the dietary disasters of the holidays.

Exercise to avoid weight gain. In encourage people to schedule their workouts. This is the time to go more intense. You’ll boost your metabolism somewhat. You might get a little more leeway with your eating. Make sure you’re doing the weight training. After you’re done eating go for a brisk walk. Get out of the chair and move as opposed to just moving to the couch to watch TV. You could buy yourself an early Christmas present and purchase some personal training sessions. It will keep you accountable. It can help you into the New Year getting your exercise on track.

There are behavior aspects to avoid weight gain over the holidays. Plan! It’s especially important if you’re going to travel and visit family. Once we get out of our usual environment and have less control, it’s important to plan ahead.  A lot of these social things revolve around eating. It’s good to revise your recipes. Nowadays this is relatively easy to find online. You can find many recipes with lower carbohydrates. Remember why you are celebrating the holiday and what the main focus is. Focus on the socializing with friends and family. Keep healthy snacks close at hand. If you know you’re going to struggle, have the better choices readily available. Keep unhealthy things out of sight. Handling stress effectively is easier said than done.  You can take a brisk walk, practice deep breathing, warm bath, or whatever positive thing you can do to keep that stress under control. Finally, get your rest. If you get quality rest, you’re going to handle these situations better. If you do overindulge, get back on track immediately. Don’t let a few bad choices turn into days or weeks. You don’t want to lose the momentum. You have to be very careful. 98% of our patients are sensitive to carbohydrates. If they drift, they struggle. It doesn’t take a whole lot of drift to have a big struggle. It’s like a drug. If you have a little bit, you’re going to want more.

Holiday weight gain is NOT inevitable! You need to plan, socialize with family and friends, watch the alcohol, and bump up your exercise.  When you indulge, get right back on track. Yes, it is that important.

If you need help, let us know! Check out our non-surgical options or Back on Track After Weight Loss Surgery.

What You Need to Know About the Gastric Sleeve

Posted on November 20, 2019 by

The gastric sleeve, or sleeve gastrectomy, is the new kid on the block so to speak. It’s not a new operation. We used to do the surgeries for other reasons not including weight loss. About 15 years ago a hormone was discovered called ghrelin. It’s a hormone made by part of the stomach that makes you feel hungry. We thought if we took that part of the stomach out, we’ve actually done two things. First we’ve made you a smaller stomach so you can’t eat very much. Secondly, when you take that part of the stomach out, ghrelin levels go way down. Since ghrelin makes you feel hungry, hunger levels go way down in its absence. If you think about it, one of the potential downfalls of every single weight loss plan in the world is hunger. If we can control hunger it’s a lot easier to lose weight and keep the weight off. Sleeve gastrectomy is the fastest growing option out there. It is the most common operation for weight loss right now. Last year about 2/3 of all operations done for weight loss were sleeve gastrectomy in the US. It’s close to 95% of what I do these days because it works so well and we see a quick recovery with very low risk. It keeps your anatomy normal.

In the sleeve gastrectomy, we remove the greater curve of the stomach (stretchy part). If you eat a large meal the stomach fills and stretches way out as you eat. That’s how it can hold so much. When we remove the stretchy part it leaves you with a tubular part (or sleeve). Sometimes when people hear the term sleeve gastrectomy they mistakenly think we’re placing something around the stomach. We’re not placing anything around the stomach. It’s referred to as a sleeve gastrectomy because we’re changing the shape. Like the sleeve on a shirt, it’s tubular shaped. We’re making it into a tubular shape. Nothing is bypassed so there is no malabsorption.  Your anatomy remains normal. Food is going to enter the stomach and empty into the small intestine the same way it did before. The size of the stomach is about the size and shape of a medium banana. The part of the stomach that’s removed is the part that makes the hormone ghrelin. Ghrelin is decreased so hunger decreases. This doesn’t mean that you won’t get hungry. There are still good reasons to get hungry. Your hunger is just much easier to control. This surgery is increasingly popular and the fastest growing option out there. It’s literally close to 95% of what I do nowadays.

The surgery doesn’t take that long. It generally lasts about 45 minutes. 95% of the surgeries we do are outpatient. It’s pretty rare that someone needs to spend the night. Full recovery isn’t as fast as the adjustable bands but it’s a lot faster than gastric bypass. Most people are comfortable driving about 3-4 days after surgery. Generally in 2 weeks people can do most things. In a month you can do anything you want. Recovery tends to be really quick.

What are the risks?  The first 30 days is the same as the other surgeries. It’s just slightly different numbers. In theory the death rate and leak rate should be the same as gastric bypass. But we’re not seeing that. What we’re seeing is about 1:1000 for deaths and less than half a percent for leaks. Wound infections, DVT’s, PE’s and dehydration have fewer risks than gastric bypass because the surgery doesn’t last as long. But it’s not impossible for any of those things. One of the things I really like about this operation is that we’ve gotten rid a lot of the long term risks. You’ve got normal anatomy so once you’re healed, you’re healed. The thing we have to keep in mind is stenosis.   Stenosis means narrowing. Anywhere along the tubular stomach could get scarring and become too narrow. If that happened you would go see a gastroenterologist. They can look in there and take care of it. It would be very rare to need another surgery after the sleeve. In theory stenosis should be about 1%. I’ve done over 1600 of these surgeries. I’ve only seen 1 case of stenosis.

We basically see the same weight loss as we did with the gastric bypass. Average weight loss is 70% of what you were overweight. If you are 100 pounds overweight, your average weight loss will be 70 pounds. If you are 200 pounds overweight, your average weight loss will be 140 pounds. That’s average. Some will lose more and some will lose less. That is very good weight loss. Long-term we see about 10-20% regain most of their weight. With any of these operations you can gain your weight back. Your stomach is a little bigger than with the gastric bypass. So why do we see a similar result?  It’s because ghrelin levels go down. In the other operations, that part of the stomach is still there. We can control the hunger somewhat with appetite suppressants. But they’re not necessarily ideal. With the sleeve gastrectomy ghrelin levels go down and hunger is easier to control.

Overall, for most people considering weight loss surgery, the sleeve gastrectomy is the better option. One of the reasons is we keep the anatomy normal. There’s a lower risk with the procedure, a fairly quick recovery and very good weight loss. We also get rid of any concerns about having anatomic abnormalities or nutritional abnormalities (malabsorption). There’s no mechanical device. Finally, you haven’t burned a bridge. That means if you don’t get out of it what you wanted out of it your anatomy is at least still normal. If your anatomy is still normal you could still have any of the other surgeries done. You could have a band placed on it or converted to a bypass. This is much more difficult after any other the other weight loss surgeries. We haven’t revised these things. We’ve seen really good results with them.

How does CFWLS compare to the national average? Obviously we’re doing this for weight loss to improve medical problems and improve your life.  We’re doing the same thing as everyone else in the world but we’re seeing better weight loss. We have a 15.8% better average weight loss at 2 years. We have good education and weight loss.  We give you a full year afterward. And with that better weight loss we also see better reduction in medical problems:  Diabetes 78.6% vs 62.3%, HTN 62.5% vs 46.9%, lipids 70.7% vs 45.3%, sleep apnea 69.4% vs 56.6%, and GERD 74.3% vs 16.6%.  Some people think weight loss surgery shouldn’t be done on patients with GERD. But we’ve seen it get much better, not worse. Again, it’s not the operation. It’s what you do with the operation. If you do the right things it can fix these medical problems.

Why is the education and support so important? We have Weight Management University for Weight Loss Surgery™.  It’s a 12-month post-op program. It includes all kinds of thing including the following:  pre-op and post-op text books, monthly support group, 12 Weight Management University courses, access to Members Only portal, fitness classes, personal training and more.

View the online surgical webinar and then schedule a call with Cat Williamson to go over any further questions you may have.  You’ll get a copy of my best-selling book, Less Weight…More Life!

What You Need to Know About a Gastric Bypass

Posted on November 11, 2019 by

gastric bypassLet’s start with a few facts about the gastric bypass. It’s been around the longest period of time. If you know anyone who’s had gastric bypass, they lose weight fairly quickly. People are often very concerned about the speed of the weight loss. Speed of weight loss doesn’t matter. It’s all tied to  body composition.. If you’re losing weight quickly and it’s all fatty tissue, than the faster the better. On the other hand, if you’re losing weight quickly but it’s lean body mass, that’s not so great. You’re going to get more and more tired and weaker and weaker. You’re slowing your metabolism down which will make it much harder to lose weight and easier to gain weight. No matter what, if you have gastric bypass, you’re going to lose weight fast. We refer to gastric bypass as being restrictive and malabsorptive. Restrictive means we’re making your stomach smaller. If we make you a smaller stomach, you can’t eat very much. You’re going to lose weight. The concept is simple. We make your stomach about the size of an egg. People often wonder if their stomach is going to stretch out. The answer is yes. We know it’s going to stretch out and we want it too. We don’t want your stomach the size of an egg. What we’re shooting for long term with all these operations is meal size, that being a small plate. That’s where we want to go. But, we’re working with stretchy material just like your skin is stretchy. If we make your stomach meal size small plate it would stretch way out. A normal size stomach can hold about 2-3 liters. We have to make your stomach tiny to begin with knowing that it’s going to stretch out.

The second part is the malabsorptive part. That’s where the bypass comes in. We’re going to bypass the part of the stomach called the excluded portion.  We go to the very beginning of the small intestine and divide it and pull it up and hook it into that tiny stomach so that we bypass the rest of the stomach. Whenever we bypass any portion of the intestinal tract, you’re not going to absorb things perfectly. You don’t absorb all the calories that you eat. But, you also don’t absorb some of the vitamins, minerals, and micronutrients quite as well either, which can be problematic. The surgery itself doesn’t take that long. It’s about 1 hour and 40 minutes. It can be done laparoscopically now. What we do is use long instruments and cameras and make little incisions on you. Recovery is pretty quick. Hospital stay is pretty quick. Recovery can take a while because this is a big operation. Whenever we start rearranging your anatomy, that’s a big operation. Recovery can take a good 4-6 weeks. Sometimes it can take up to 8 weeks to feel back to normal.

There are risks with every operation in the world. This is a bigger operation so the risks are bigger. When I talk about risk, I divide it into two time-frames. This is not something I made up. This is a medical standard which is basically right around surgery (peri-operative). By medical definition this means the first 30 days. The second time-frame is long-term which, by medical definition, means longer than 30 days. What’s the worst thing that could happen in that first 30 days? Could you die?  The answer is yes it could happen. The risk of death is real when we start dividing your intestinal tract. It wouldn’t matter if I was talking about taking your appendix out or taking your colon out. When you look at national statistics, the risk is about 1: 200.  What we see is about 1:500.  Bottom line is that it may be rare, but not impossible. The things we worry about the most are infections. Some things are easy to treat such as urinary tract infections. Other infections aren’t so easy to treat such as pneumonia. They occur about 2% of the time after any surgery where you have to go to sleep for. You have to go to sleep for all these surgeries. It’s somewhat related to how long did the surgery take? The biggest fear as far as infections go is a leak on the inside. What if the pieces we took apart during surgery and put back together leaked?  There are literally trillions of bacteria that live in the intestinal tract. When we start dividing the intestinal tract some of those bacteria could potentially get out. If they set up a rip-roaring infection, potentially you’d have to have another surgery to fix that. Wound infection means on the skin. They’re more of a nuisance than dangerous. They have to be treated with antibiotics. DVT is a deep venous thrombosis. PE is a pulmonary embolism. These are blood clots. You can get a blood clot without having surgery. You can get it from being dehydrated. One of the most common ways to get a blood clot is traveling on a long plane ride. You can also get it from having a general anesthetic. Again, it’s somewhat related to how long the surgery takes. The longer the surgery takes, the higher the risk is. We do all kinds of things to prevent that during surgery. The blood clot risk is 1-2%. If you got a blood clot you have to be on a blood thinner to dissolve that blood clot. The first thing that happens to that tiny stomach is the tissue swells up. Just like if you sprained your ankle. Your ankle would swell up. Stuff just trickles through the stomach initially. If you’re not able to stay hydrated you have to come back to the hospital to get IV fluids. You have to rest for a few days.

Long-term means 30 days until forever. The most common long term physical problem is peptic ulcer. You can get an ulcer without having gastric bypass. But when you have the anatomy of gastric bypass, the risk of getting an ulcer goes up. The people who tend to get ulcers are smokers and people who take anti-inflammatory meds. Ulcers just need to be treated. Something that could require another surgery is a bowel obstruction. Adhesion means scar tissue. If you’ve had any surgery on your abdomen you’re going to have scar tissue, not only on the outside, but also on the inside. That scar tissue can potentially kink the intestine. Just like a kind in a hose, nothing is going through there. You then have to go back to the operating room. Hernias are another risk. You can get them without having surgery. Any place we make an incision there is potentially a weaker spot. Stenosis means narrowing. What we’re talking about is right where we take the stomach and hook the small intestine to it. A scar could potentially form and cause a narrowing. If this happened, stuff wouldn’t go through very well. We would send you to a gastroenterologist. They would take a look down there and can stretch it out. Typically it doesn’t need any surgery but it does need to be evaluated and treated. Vitamin and nutrient malnutrition is relatively common. You won’t be able to absorb things perfectly. You’re going to have to take some things long term in addition to taking a battery of tests every 6-12 months to make sure those things are staying where they should. That’s a forever thing. That doesn’t go away.

We see great results with gastric bypass. You’ll lose about 70% of what you were overweight.  If you were 100 pounds overweight you’ll lose 70 pounds. If you’re 200 pounds overweight, you’ll lose about 140 pounds. That’s the average. Some people lose more, some people lose less. About 40% of people with gastric bypass regain most of their weight back. Overall the long term anatomical and nutritional problems, with relatively poor weight maintenance, make it difficult for me to recommend gastric bypass for most people.

What should you do? You need to decide what’s best for your unique situation. There is no right or wrong here.  What I encourage you to do is give us a call and set up a 1:1 consultation to discuss the options.  Let’s you and I sit down and go over your situation. Everybody’s situation is different.  Give us a call at (757) 873-1880 or email us at success@cfwls.com.

I have some final thoughts for you. Weight loss is the most important step you can make to improve your health!! There are so many medical problems that are directly related to weight loss. If we can control weight, we can control medical problems. If we can control all these medical problems it gives you the best chance of living a long, healthy life.

Watch the online seminar and give us a call (757-873-1880) and set up your 1:1 appointment. If weight is contributing to your health problems let us help you.  I hope to see you very shortly here in the office.

What About Fasting?

Posted on October 28, 2019 by

Is fasting something that could be helpful to you? Could it help with your health? Could it help with your weight? The short answer is yes!

Fasting is a pattern of eating. It’s been around forever. Food was scarce. Now….not so much. People fasted all the time thousands of years ago because food wasn’t available. We have plenty of food available now. Is this something that can actually be helpful? Is it a form of “fad” diet or are there any health benefits and could it help with weight loss? Fasting versus starvation are two different things. Starvation is never really a good weight loss plan. Fasting is something we choose to do. Starvation is something forced on us. We don’t know where our next meal is coming from. With fasting we know where our next meal is coming from. It’s readily available. We’re just choosing not to have that meal. Your body’s response to those two things is completely different. There can be some health benefits or hormonal changes that occur with fasting. Not with starvation. In the early 1900’s fasting was one of the only ways to treat diabetes. They realized they could at least keep blood sugars decent and controlled.  I’m talking about type I diabetics.  They also found they could treat some medical problems with avoiding food completely. It fell by the wayside when some of the new medications came along, as well as all the marketing with the food companies. Fasting doesn’t make those huge corporations any money. The last thing they’re going to tell you is to fast and skip a few meals. No one was talking about fasting after that because it didn’t make the big corporations any money at all because it’s free.

Fasting came back into vogue in the 1960’s. In 1965 a 27-year-old Scotsman, at 456 pounds, saw his doctor who suggested he shouldn’t eat for a few days. So he didn’t eat for 382 days!! He lost 276 pounds. He was monitored very carefully by the physician, took vitamins, drank broth, and took extra sodium/potassium. He only regained 16 pounds in 5 years! The point of this is it can actually be done very safely and can show good results. We all fast. Every single night we go to bed we are fasting. That’s where the word breakfast came from. You are breaking the fast. In the 60’s and 70’s most people fasted for about 12 hours a day because you ate breakfast at 700am, lunch at noon, and dinner around 600pm. So most people fasted for a good 12 hours a day. That was pretty normal. Nowadays that’s not so true. The real question to figure out for any individual is how long to do it? It can be done for an extended period of time, and very safely. It should be monitored if you’re going to do it for an extended period.

Isn’t this just calorie restriction? Your body’s response between 0 calories to calorie restriction is different. Everybody knows that when you cut way back on calories you’re going to lose decent weight in a short period of time. And then it quits working. Your body’s response to just decreasing your calories is to slow your metabolism down. Many studies have shown that if you cut your calories back enough you can actually slow your metabolism down to 40%. That’s a big number. If you normally consume 2000 calories and you cut back to 1200 calories, that means you slow your metabolism down to 1200 calories as well. You’re not losing weight anymore. Calorie restriction is a little different because you will slow your metabolism down. With short term fasting, you actually increase your metabolism. Inherently it doesn’t make sense. Think about it this way. Fasting is just a short term acute stress. An acute stress is much different than chronic stress. Chronic stress is when you slow your metabolism down because of severe calorie restriction. Acute stress hormones will go way up. It’s like a Fight or Flight kind of response. Those same hormones come in to play. Growth hormone goes way up. Growth hormone secretes during the fasting. Growth hormone is one of the best hormones to help you lose weight. It’s a fat burning hormone. Studies have shown that with a 24 hour fast, GH will increase 130% in females and 200% in males. If we can boost up our growth hormone it will help us significantly. Fasting decreases fasting insulin levels. Insulin inhibits fat burning. It also improves insulin sensitivity. Fasting increases catecholamines, acute stress hormone (epinephrine and norepinephrine). They are sometimes called adrenaline/noradrenaline.  They both help mobilize fat. They both activate the hormone-sensitive Lipase. Lipase is an enzyme that helps break down fat.

Is it just calorie restriction? The answer is NO! It increases your metabolism short term.  The real question is when does acute stress turn into chronic stress? It’s hard for me to tell you that in any individual. At some point after so many days acute stress starts turning into chronic. For any individual you need to figure out how long to do it and how often to do it. I can’t actually tell you what the answer is. I can tell you different ways to do it, but you have to figure it out.

Fasting and calorie restriction are equally effective in decreasing body weight and fat mass, but fasting is more effective in retention of lean body mass.  You can do it for an extended period of time (382 days). Fasting can be very helpful for weight loss and breaking through plateaus. We’re going to talk about how you do it and how to get started in a few minutes.

There are some other health benefits to fasting. A natural response to illness is often fasting. We’re not hungry when we feel bad. Hippocrates said, “To eat when you are sick is to feed your illness.”  Plutarch said, “Instead of using medicine, fast a day.” This has been around for a long period of time. Physicians realized that it actually could be helpful.

Fasting could help with cancer. Rats who had breast cancer lived longer when they fasted. Fasting seems to protect normal cells and “starves” cancer cells. It starves cancer cells.  Many cancers survive on sugar.  If we take the sugar away and your body is utilizing your fat to give yourself energy, the cancer cells can’t utilize the fat as an energy source. The cancer cells can die. There are some studies that are looking at brain cancers where very low carbohydrate can kill the cancer.

A study was done on mice and longevity. The mice fasted every other day. They kept the calories the same but they kept the food away from them every other day. The mice that fasted lived almost twice as long! The short (acute) stress may be better than chronic stress.

I want to go back to weight again. I’m going to give you an example. Let’s say you’re trying to be on a 1000 calorie a day diet. That’s a really low calorie diet. That’s 7000 calories a week. What if you did a 1200 calorie a day diet? That could be much easier to tolerate. It probably won’t slow your metabolism down because it’s not so calorie restrictive.  You could fast one day a week. The numbers come out about the same. It’s still 7000 calories a week. The 1200 calories a day is much more tolerable and you get the hormonal benefits of fasting.

Fasting increases Neuronal Autophagy. That means the breakdown products around the neurons which have to be removed. Subsequently fasting helps do this. It also increases Brain Derived Neurotrophic Factor (BDNF). This helps regulate memory, learning, and cognitive function. Your brain uses ketones wonderfully. Fasting increases ketones. You don’t need sugar for your brain! Keystones actually work better. They’re made from B-hydroxybutyrate which is neuro-protective. There’s some good evidence that is can protect your brain long term and make it less likely to get Alzheimer’s.

What about exercise? We tell you all the time to eat your protein to improve exercise benefits. How could fasting possibly help? First of all, don’t even consider fasting and training if you’re not going to hydrate well, sleep well, and become fat adapted (low carb diet).  There is good evidence that well-trained athletes who live in ketosis actually perform better once they adapt to it. Most people don’t take the time to get adapted to ketosis.  Fasting likely improves your adaption to exercise by forcing you to train in a less optimal state, which can boost performance down the line. It likely won’t improve your performance right then, but you’re working in a stress condition.  It can actually could benefit exercise.

So how do you do this? Implementation is the only way that any of the theoretical benefits will help you! Extended fasting can be done for long periods. If weight loss is your main goal, I don’t recommend doing multiple extended fasts. You don’t want to transition from acute stress to chronic stress. Typically it’s going to be in that 2-3 day range. Again, you’d have to play with that. See how you feel and how you do. You don’t want to lose those acute stress benefits. Again, it can be done indefinitely.

Sleep Deeply~

A couple of rules apply. You want to make sure you get quality sleep. Sleep counts as fasting hours. Fasting doesn’t make up for a poor eating plan. You have to have a good eating plan. If you don’t eat well, no method of fasting is helpful besides possibly a few less calories. Fasting is always easier to do on a low carb diet (controls blood sugar swings and cravings). When you first start fasting, I assure you that you will have hunger and cravings. Hunger tends to go away. It doesn’t just keep increasing. It comes in waves. Most people notice after the 2nd day that hunger goes away. It’s much easier to get there with a low carb diet.

There are a lot of different ways to do fasting. There’s one that’s fairly popular. A lot of people talk about it. It’s referred to as Leangains. (16/8). In a 24 hour period you fast for 16 hours and there’s an 8 hour window when you eat. For 16 hours you push non caloric fluids. It can include tea and black coffee. If you’re going to fast, I encourage you to avoid anything that’s artificial (flavors, sweeteners and colors).  The best way to break the fast and get results is after a workout. People often do this every day. Some people narrow the window down. That means a 20 hour fast and a 4 hour window. There are a few people out there that do 1 meal a day.

Another way to fast is Eat-Stop-Eat. Once to twice a week you don’t eat for 24 hours (you pick the time). There is good evidence that the later you have your dinner, the bigger the insulin response. The same meal you eat at lunch is going to have a different insulin response than the one eaten at dinner.  Having your main meal earlier is a good thing.

The 5:2 Diet is not a true fast. It’s eating healthy for 5 days a week. For 2 non-consecutive  days you cut the calories down to 400-500 calories. That adds up to about 1 day of a fast. Some people find this a lot easier to do. You can drink protein shakes for your meal.

Feast, then fast is eating one big meal a day then fast the remainder of the 24 hours.

Alternate day (often used in research) can work really nicely. You eat normally one day, then don’t eat the next day. Some people will do that with a true 36 hour fast. You can do this 1-2X a week. It’s hard to start. Once you get used to it, it’s very doable.

You can do extended fasting.

There are a few questions that always come up. Won’t you lose lean body mass? It works best when you’re keto-adapted; burning fat as energy. You actually don’t lose lean body mass. There’s been a good study that looked at alternate day fasting for two months. The people lost no lean body mass. It was all fat. Can you exercise during a fast? It really depends on your response to the exercise. You might want to cut your exercise back a little bit. You want to stay active because “slugs” tend to dwell on food. Stay busy so you’re not thinking about food. How often should you fast? You can do it daily and have that window (leangains). You can do it 1-2 times a week. Or you can do it for an extended period of time. You have to figure it out. I’d love to be able to tell you what the right answer is but I can’t. You need to figure out how long to do it and how often. Should you take your vitamins on fasting days? It depends on how well you tolerate them on an empty stomach. You can skip those days if you’re not able to tolerate them. No one ever got vitamin deficient by missing one day of vitamins. Vitamin deficiency is a long term issue, not a 1 day issue. Who shouldn’t fast? The following people should not fast: if you’re under high stress, over-training, chronic poor sleep habits, eating the standard American diet, underweight, pregnant, breastfeeding , or if you’re a child (if you’re still growing).

What are the advantages of Intermittent Fasting? It’s available immediately to anyone! It’s simple, effective, no skill needed, and it will work. It’s free and will save you money! Fasting is convenient and saves time! We make thousands of food decisions every single day (What am I going to eat? Where am I going to eat? How much am I going to eat?). If you’re not eating, you’ve gotten rid of all the anxiety about what where and when? It’s flexible and you can add it to any diet. You can do it wherever and whenever you want. It gives you unlimited power. You decide how long and how often. You’re in control.

Do not use intermittent fasting as self-punishment for “bad” eating or to “make up” for a generally poor diet. For any individual you need to determine how long to fast and how often to fast. No one can figure that out for you! What do I do?? I’ve been fasting for years.  I typically fast one day a week. I have my last meal on Tuesday. I will fast until Thursday morning. I push the water like crazy. I typically exercise the way I always do. If I get a little worn out, I cut it short. I try to keep the rest of my routine fairly normal. I stay busy. It works with my schedule. When I first started fasting, it was incredibly difficult. It was hard, but it’s very doable. I originally was going to fast for 24 hours (Tuesday evening to Wednesday evening). Here’s my problem: typically you’re hungry in evening. So if you’re going to break your fast in the evening, it’s a lot harder to break it gently than to just have a normal amount of food. I found that if I could just get through those few hours in the evening and go to bed, I could wake up the next morning not hungry. Most of us don’t wake up hungry. I found it easier to do a 36 hour fast than 24 hour. I routinely do it once a week. If I have some kind of event like a birthday celebration, I don’t fast. I change the day. Nothing is written in stone. You get to make the rules. That works well for me. That doesn’t necessarily mean it’s right for you. But, it can be.

Here are a few tips if you’re thinking about it. You want to drink lots of water. Stay busy. I certainly wouldn’t sit around in the kitchen.  Ride out “hunger waves.” Hunger is not something that keeps escalating. It goes away. I would encourage you to not tell everybody that you’re doing this, especially those who aren’t supportive. They’re just going to look at you like you’re crazy. You want to avoid high stress time. If you’re in the middle of a move or you have a big project going at work it will be a lot harder.  Try practicing. Give yourself some time. Try it for a month. Just try it intermittently. Just like everything we practice, it gets easier.  Follow a low carb diet between fasting periods. This reduces hunger and makes fasting easier. Don’t binge after fasting. Break the fast gently. Fit fasting into your own life. Don’t change your life to fit your fasting schedule. Change your fasting schedule to fit your life!

Mark Twain said, “A little starvation can really do more for the average sick man than the best medicines and the best doctors.” There’s probably a lot of truth to that statement.

If you have questions, don’t hesitate to give us a call or text us at The Center for Weight Loss Success 757-873-1880.  You should be stopping by to get your body composition done. Fasting can help you preserve that lean body mass!

Remember!  It’s your life. Make it a healthy one! Have a good evening everyone! Take care!

Weight Loss Surgery Options

Posted on October 15, 2019 by

Let’s talk about the problem of obesity and what you can do about it. I will preview the operative procedures and the risks of having surgery, as well as the results. I’ll give you my opinion. For most people I think the sleeve gastrectomy is the better option! I see all the nutritional problems that arise and abnormal anatomy problems with the bypass. And I see the device problems with the adjustable bands. There’s relatively poor weight loss with the bands. The sleeve gastrectomy is a fairly low risk procedure.  It’s a quick recovery and we see really good weight loss with it. And, you keep your anatomy normal. I’ve become convinced over the years that keeping the anatomy normal is probably a good thing.

Weight loss is hard. Surgery is an extension of an overall medical weight loss plan. Weight doesn’t magically fall off just because you have surgery. It’s still diet, exercise, and behavior modification. Surgery is a “tool” to assist you with weight loss. That’s all it is. A tool can either be used correctly, or it can be used incorrectly. If used correctly it can be very powerful. If used incorrectly it doesn’t work well and you can get into some real problems. Long term weight control is still very hard. Some people think they’ve had the surgery and lost the weight so they don’t have to worry about it anymore. YES YOU DO! You can regain your weight. It doesn’t matter what operation we’re talking about. You need to do the right thing. You have to know what the right things to do are. Then, how do you implement those things? Sometimes the concepts are really straight forward but you have to know what they are. Implementing the concepts is the hard thing. We have the expertise and support here. We can help you with how you do this in your life. Sometimes life tends to get in the way. Surgery combined with a Medical Weight Loss program gives you the best chance for long term success. It’s not that we’re doing better or different operations but we see better weight loss than other places. We see better weight loss because it’s the education and support side of this whole thing that really gets people optimizing weight loss and then keeping that weight off long term. That’s absolutely key.

Lots of different medical problems go along with weight. Every single one I’ve listed on the slide is directly related to weight. When weight goes up, they get worse. As weight comes down, they get better. Some of them completely go away with weight loss. If they don’t go away, at least they get under control. Some of them are very significant: diabetes, high blood pressure, heart disease, and more. These things can potentially be life threatening. Weight loss treats them all. If I could boil it down to the biggest problem it’s the risk of dying. It goes way up. For someone who is 75-100 pounds overweight, on average, you’re going to die about 10-15 years before someone who’s not overweight. That’s the issue. We want you to live a long, healthy life and die of old age. Last thing you want is that premature death. By treating the weight, we can treat all those other problems.

To learn more about your weight loss surgery options, check out our informative webinar: Weight Loss Surgery Webinar

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What You Need to Know About Antioxidants

Posted on May 13, 2019 by

Let’s talk about antioxidants. You hear about them in the media. Are these miracle workers or is this just marketing?

The antioxidants kick out the free radicals. These are superheroes!  It’s the epic story of good vs evil. They are the fearless defenders of basically everything.  They can cure cancer, prevent aging, and supercharge your immune system. They basically can do it all, right?! Are these miraculous disease fighting nutrients or over-hyped marketing gimmicks?

What we’re trying to address is the oxidative challenge of life. A paradox of metabolism is that the majority of complex organisms (humans) require oxygen.  Oxygen is a highly reactive molecule that not only sustains life but also produces reactive oxygen species: hydroxyl radical (OH) and super-oxide anion (O2-). They are free radicals. These free radicals are by-products of our energy producing process (cellular respiration). Cellular respiration is how the cells produce energy and sustain life. We can’t live without this happening on a cellular level. The trick is to keep these highly reactive free radicals under control to prevent cellular damage. These free radicals can cause cellular damage. It’s thought that this cellular damage done by the oxygen-free radicals can cause a lot of health problems. We want to keep them under control. Antioxidants can potentially help us here.

Are you getting “rusty?” I wanted to find a simplified version to think about this. Oxygen and iron produce rust. You can actually do it without the oxygen.   In order for rust to form we have to have oxygen available. Are these oxygen free radicals causing some damage within our body? That’s the real question.  Just like the Tin-Man got squeaky in the Wizard of Oz, potentially we may need to be oiled up a little bit. What are the ways we can prevent this damage from occurring?

What are antioxidants? The oxidants are producing damage. Antioxidants may be able to prevent that.  They are molecules that are capable of inhibiting the oxidation of other molecules. If you’re inhibiting the oxidation of other molecules, we’re preventing the rust. Oxidation is a chemical reaction that transfers electrons from one substance to another. They’re just moving electrons around. Part of this is that oxidation reactions are crucial for life (respiration and production of energy). If we’re not doing this, we are dead. We can’t live without it, but we want to prevent the damage. When we’re breathing in and out oxygen is travelling throughout our body. Every single cell in our body needs it because oxidation reactions are crucial for life. We want to limit the by-products that can cause damage. So, the oxidation can produce these free radicals. These oxygen free radicals can lead to chain reactions that cause cell damage and cell death. These oxygen free radicals are even more reactive than oxygen is. They can cause damage. We don’t want to cause damage to the DNA. When the cells re-produce and there’s damage to the DNA, potentially you’ve cause damage that will keep on going. Tumor cells can come from normal cells. There’s DNA damage and all of a sudden they’re growing out of control. Antioxidants can stop some of these chain reactions. It does this by removing the free radical intermediates. It’s done by giving up electrons. Then it can stop these reactions by occurring.

We can think of antioxidants in two different ways. They’re either Hydrophilic or Hydrophobic. Hydro means water.  Phyllic means loves water. Hydrophobic means fear of water. Some work well with water and others do not work well with water. There are different types of antioxidants and they’ll do different things in different parts of your cell. They specifically can do different things for different reactions. They want to neutralize these free radicals.

Where do these free radicals come from? Typically they come from different things in our life.  It could come from the following things: ultraviolet rays, atmospheric pollution, stress, and poor nutrition. All these things affect all of our cells. They can cause free radicals. If these free radicals occur they can cause cellular damage. We want to protect these cells with antioxidants.

How does an antioxidant work? For an oxygen free radical to form, the molecule has to lose an electron. Then it becomes unstable, thus becoming the “free radical.” They want to steal an electron from somewhere. They try to steal it from some nearby molecule. This causes a chain reaction. It can go all through the cell and cause cellular damage. An antioxidant is an electron donor. It can donate an electron and still remain stable. It has to be able to donate an electron to these free radicals and still remain stable. This stops the damage.  The antioxidants bind to the free radicals to form stable molecules. Stable molecules will prevent the damage. It’s a relatively simple concept. It’s not quite that simple in chemistry.

What are common antioxidants? There are a lot of them out there but many vitamins are antioxidants. Vitamin C is one of the best out there. Vitamin A and the carotenoids are antioxidants.  Those are found in the following: carrots, squash, broccoli, sweet potatoes, tomatoes, kale, collards, cantaloupe, peaches, apricots (bright colored fruits and veggies).  You’ll find that many of these antioxidants occur naturally in bright colored fruits and vegetables.  Vitamin C is found in citrus fruits, green peppers, broccoli, leafy veggies, strawberries and tomatoes. I don’t encourage people to eat a lot of fruit, especially if they’re sensitive to carbohydrates. Vitamin E is a fat-soluble vitamin found in nuts and seeds, green leafy veggies, vegetable oil, and liver oil. It’s in a lot of things that we typically eat. We talked about selenium with thyroid. It’s very important for thyroid function. It’s found in the following: fish, shellfish, red meat, grains, eggs, chicken, and garlic. There are a lot of vitamin-like antioxidants. You’ll sometimes see these sold as antioxidants. Coenzyme Q10 is very important. It can be helpful if you’re on a cholesterol medication (statin). If you’re on a statin you ought to be taking Coenzyme Q10 because there’s a lot of damage that occurs in the cells with statins. Coenzyme Q can offset that. It’s an important carrier in mitochondria during energy synthesis. Glutathione is often sold in health food stores because it’s a good antioxidant. The problem is that it’s digested in the intestinal track so you don’t just absorb it. You have to eat the precursors that can make the glutathione. It’s an electron donor and can be increased by supplementing with ALA, melatonin, and milk thistle. Flavonoids/Polyphenols are in a lot of whole foods. They are found in soy, red wine, purple grapes, pomegranate, cranberries, and tea. You’ll often see on the labels, “high in flavonoids.” Lycopene you’ll see on every ketchup bottle in the world. It’s in tomato and tomato products, pink grapefruit, and watermelon. Lutein is found in dark green veggies such as kale, broccoli, kiwi, brussel sprouts, and spinach. Lignan is in flaxseed, oatmeal, barley, and rye.

There are antioxidant enzymes made by the body. These enzymes can help produce the antioxidants. Superoxide Dismutase (SOD) stabilizes that superoxide anion. It can donate electrons. Catalase is another enzyme that converts H202 (hydrogen peroxide) to O2 (oxygen) and H2O.  Glutathione peroxidase also breaks down H2O2 to O2 to H2O. The simplified definition of an antioxidant is they are electron donors. They stabilize potentially damaging molecules. Are there health benefits? Yes!

Where are the best antioxidants? Not necessarily in a pill form. Just like when we talked about fiber. The best fiber comes from food. The best antioxidants come from food. It’s the bright colored veggies and fruits (be careful if you’re carb sensitive) that are very high in antioxidants.

You’ll often see what’s called anti-aging antioxidants. It’s a lot of marketing but there’s something to it.   I think a lot of the damage of aging is these oxygen free radicals. They can cause damage to the cells, specifically the DNA, and then cause aging. Can we prevent that by taking antioxidants? Most things that have antioxidants in them are very healthy. I encourage you to eat these foods but they’re not necessarily going to stop the aging process. These foods are: acai berry, pomegranate, passion fruit, blueberries, kiwi, cranberries, apricots, prunes, and more. If they’re whole foods, they will typically contain antioxidants. Dark chocolate contains antioxidants. Just a little though…

There are a lot of common myths about antioxidants. Part of that is free radicals must be destroyed! Again, as we mentioned at the beginning, free radicals are actually normal byproducts of normal metabolism. If we stop that, we’d be dead. We can’t stop that and we don’t want to stop that. We want to do it in a controlled manner.  Another myth is that all antioxidants are created equal. All these different foods have different antioxidants in them. They have different jobs. You want to get your antioxidants from a broad variety of foods. Another myth is that all antioxidants come from fruits and veggies. That’s not true because you can find them in meat, dairy, and eggs. Typically whole foods are a good source. The next myth is antioxidant fortified foods are healthier. There’s no evidence of this. You can get the antioxidants from whole foods. Adding more antioxidants to those foods has never been shown to be healthier. The last myth was a theoretical concept a few years ago. The myth is if I exercise and take antioxidants I will become super fit. However, the way muscle function improves is to have some stress on the muscle in order for function to improve. That’s why when we exercise we get sore.  A little bit of soreness is good.  A lot of soreness is not so good. The way we improve from a fitness standpoint is that you need to have some muscle growth there. Part of the way a muscle grows is by undergoing stress. To improve muscle function it is some of the result of this oxidative stress. If we prevent the oxidative stress during exercise you could potentially doing yourself more harm than good. You need to stress the muscle. Just be careful. You don’t want to injure yourself. Some of the best fitness gains occur during the aerobic into the anaerobic energy systems. By taking antioxidants, it may be harder for that to happen.

Here are a few tips for success! Eat your colorful veggies! The evidence is mixed about whether taking antioxidant supplements is beneficial. There’s never been a big study that’s shown that it’s really helpful. Eat the whole foods.  Most of what you see is marketing! The “Basics” is always important: eat right, exercise daily, take your vitamins, get plenty of rest, and handle stress. You have to do these things right. Throwing some supplements on top of that is not doing a whole lot to help. Adding antioxidants to the “Basics” potentially will be helpful. I will encourage you to go the whole food route.

If you have any questions don’t hesitate to leave a message below or email them to Success@CFWLS.com. Also if you think of some once we’re all done, give us a yell and we’ll answer them. Stop by the Center for Weight Loss Success and get your Body Composition Analysis done. You need to make sure you’re losing fat and preserving lean body mass.

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!

The Skinny on Ketosis and Low Carb Diets

Posted on April 15, 2019 by

Low Carbohydrate diets actually have a lot of misconceptions. So we’re going to go through a bunch of them. Let’s start out with the first two I hear most commonly.

The first misconception: Ketosis is dangerous.

The second misconception: Low carb diets make you lose bone mass and are bad for your kidneys.

Ketosis just means you have ketones in your bloodstream. We have ketones in our bloodstream all the time. It’s just the level of ketones.  Ketones are really just an energy source. They come from the breakdown of fat. Isn’t that what you want in a weight loss plan? You want to have some ketones in your bloodstream so you can use them as an energy source. Ketosis is often confused with diabetic ketoacidosis, and that’s a completely different thing. That occurs when the ketones get about 10 times the level of what would happen in a low carbohydrate diet. Ketosis by itself is not dangerous at all. It’s just an energy source.

Initially in low carb diets we saw that there was some extra calcium in the urine. But long-term we found that we actually absorb more calcium. So for a little bit of calcium that’s lost in the urine, there’s still a positive calcium there. We don’t actually lose bone mass. We can actually improve bone mass. Kidney failure doesn’t happen. There’s a difference between kidneys that can have low carb diets and kidneys that shouldn’t have low carb diets. What I mean is, with kidneys that are normal, there’s no problem with having a low carbohydrate diet. Kidneys that are abnormal should not be on a low carbohydrate diet. Typically, on a low carbohydrate diet, you’re going to have a little more protein, and it’s the protein that’s the problem.  It’s the extra nitrogen in protein that kidneys can’t handle if you’ve got bad kidneys. If you have normal kidneys, it could actually improve kidney function.

Remember-it’s your life. Make it a healthy one!