Tag Archives: bariatric surgery

Tomato & Spinach Frittatas

Posted on July 27, 2020 by Dawn Olson

For breakfast, brunch or appetizers!

Ingredients
2 cups baby spinach
1 (15 oz) can diced tomatoes, drained
2 cloves garlic, minced
½ cup shredded cheddar cheese
10 eggs
¼ cup milk
Salt & pepper to taste

Directions

Preheat oven to 350 degrees F (175 degrees C). Spray muffin tin with cooking spray.
Divide spinach, tomatoes & cheese in the muffin cups.
Mix eggs, garlic, milk and salt & pepper in large bowl and whisk together.
Pour mixture evenly into each cup.
Bake for 25 minutes.

Makes 12 servings

Nutrition Facts:
Calories         82
Total Fat          5.4g
Total Carbohydrates 2.3g
Dietary Fiber       .6g
Protein           6.4g

Print Recipe: Tomato and Spinach Fritattas

Mentally Preparing for Weight Loss Surgery

Posted on March 02, 2020 by CFWLS

Getting your mind in the right place before undertaking any weight loss plan is a good idea but it is especially important when considering a surgical weight loss procedure. Awhile ago, I interviewed Dr. Dawn Reese for one of my podcasts. We’ve transcribed the recording to post for you today.

Dr. Clark: “Dr. Reese, tell us a little bit about your background and how you got involved with me.”

Dr. Reese: “Thanks for having me back. I love being here. I love talking with you. We’ve been together now about 10 years. I met you in the hospital and we talked about doing this. I have a PhD in clinical psychology. My specialty is behavioral health (health psychology). I try to help people live healthier lives and do more with their lives then what they want. When you and I first met we talked about what you wanted to do with these surgeries and medical weight loss program. That was right up my alley. We can help people live healthier and take better care of themselves. This is what we need to talk about today when getting ready for surgery or a medical program.”

Dr. Clark: “We have to change our mindset. What do we need to work most on when we start contemplating a weight loss plan or having surgery?”

Dr. Reese: “People have to take care of themselves first. That’s the biggest thing with all of this. That’s the umbrella that we’re going to put everything else under. You have to start taking care of yourself first and start thinking about yourself first. One of your goals for weight loss is to change your mindset. How are you going to view yourself differently? How are you going to view yourself as a priority?”

Dr. Clark: “That priority and that mindset are very important. Eighty five percent of my surgical clients are women. They’re often worried about taking care of everyone else first. They put themselves on the backburner. We need to start planning for shifting that mindset before surgery. Make yourself a priority.”

Dr. Reese: “We start people having a mind shift (fake it til you make it). For example, you start using the smaller plate. Join the gym. I had a patient come in to my office and tell me he was going to join the gym after surgery. I told him we were going to start tomorrow. You start doing these things now and behaving as if you’ve started your medical or surgical weight loss. Think about how you’re going to plan and cook differently. Get mentally and behaviorally prepared.”

Dr. Clark: “A huge part of this is planning. You alluded to this when talking about the person going to the gym. You need to start implementing that plan even if you’re not able to do much at the gym. Get comfortable with walking in the gym and walking by the class you would like to do. Watch it for a couple minutes. Setting that time aside makes it much more likely that it’s going to happen afterwards. We want to develop skillsets before and after surgery. It could be eating skills or activity skills.”

Dr. Reese: “Planning is going to be key. How are you going to live your life differently? What are you going to change every day in your life so that you make yourself a priority? Make a list of what your goals are for that day. Preparing people around you is important. If you’re the cook of the family, how is that going to change? Mentally prepare on how this is going to impact other people and how that will make you feel. We have a joke in psychology: it doesn’t take 20 days to create a habit. It takes a little longer than that. Getting mentally prepared and behaviorally implementing it is so very important. For anything, planning is the key.”

Dr. Clark: “If my norm is getting together with my best friend on Friday nights and going to a movie, that might also include getting a big bucket of popcorn or other snacks. That’s a great part of life. We want to keep doing it, but we have to change some of the aspects. It isn’t that simple to make that change.”

Dr. Reese: “What you’re talking about is really important in terms of mentally rehearsing. You can imagine yourself at the movies but not having that popcorn. How is that going to look? How is that going to feel? When we are preparing athletes for an event, we have them imagine themselves in their role. If you’re an offensive lineman in football we have you imagine doing what you’ll be doing on the field before you even go on the field. That’s a great thing we can do here. How is it going to be Friday night at the movies? What is that going to look like? Mentally rehearsing is wonderful.”

Dr. Clark: “You have to mentally walk yourself through daily situations. Most of us have a routine we go through. I have a routine. I get up in the morning and shower and shave. I can literally write it out. What I find is that if my routine gets thrown off, my whole day starts to fall apart. I might have just told a patient who just had surgery to change their routine. You then have to think about how that will change everything else in your day. A lot of times people don’t think about a disruption or change in schedule. Then, when their routine changes (which causes stress) they revert back to old comfort levels. What does a person do?”

Dr. Reese: “You’re absolutely right. It’s stressful when we don’t have a normal routine. When people get stressed, we’re going to fall back into old patterns. We go back to things that are comfortable to us. We have to start planning. We need to think about what it is that we’re going to do even if we get stressed. How can I not fall back into that pattern and admit to ourselves that it happens? It’s not bad. It’s not good. It’s not anything. It’s just what happens. It’s not a failure. If you plan for it, you’re less likely to fall back into old patterns. You’re more likely to be able to get a new routine going.”

Dr. Clark: “You want to practice these things ahead of time so you’re ready for surgery. It sounds good and you have your plan in place. However, sometimes things don’t work out quite like we want them to. What you do is discuss how to handle things at this point. A major part of what you do is help people figure some of this out. What do we do? How do we change? It really still goes back to the mindset. This is a lot of what you do, right?”

Dr. Reese: “Absolutely! We want you to be successful. If you’re going to start a behavior change, especially weight loss, we don’t want you to be a failure.”

Dr. Clark: “The big message here is changing that mindset. We want to plan for it and practice it ahead of time. It doesn’t matter whether we’re talking about having surgery or starting on your weight loss plan. Things have to change. Change will never occur if you don’t actually change. You can’t wait for change to happen to you. You’ve got to be an active part of all this. Typically the change that happens to us is usually not a good change. We would like to be an active participant. We really want you to think about that message.”

Weight Loss…Simplified

Posted on January 20, 2020 by CFWLS

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 CFWLS

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!

What You Need to Know About the Gastric Sleeve

Posted on November 20, 2019 by CFWLS

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 CFWLS

Let’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 Are the Options for Weight Loss Surgery?

Posted on November 04, 2019 by CFWLS

What are the options for weight loss surgery? The most common options done worldwide are: gastric bypass, Laparoscopic Adjustable Gastric Banding (LAGB), and sleeve gastrectomy. I’m going to give you the basics on all of these. You can also watch our complete online webinar on Weight Loss Surgery Options.

Gastric bypass has been around for a long period of time. The first gastric bypass was done in 1955. It’s been around for over 60 years. It’s a well-studied operation. We know what happens to people who have gastric bypass. We know the problems that arise and what to do about the problems. It’s a very well-studied operation.

Adjustable gastric bands have been around in the US since 2001. Worldwide they’ve been around since the early 1990’s. Why do you care how long an operation has been around? We talk about long-term problems and long term results. By medical definition, long-term means 10 years long. That wouldn’t matter if I was talking about brain surgery, heart surgery, or knee surgery. It doesn’t matter. With weight loss we’re going to be talking about things that literally can last 20, 30 or 40 years. If you’re fairly young it could be 50 or 60 years. Looking at the long-term issues is very important and how it impacts your health for your lifetime.

The sleeve gastrectomy is the new kid on the block. 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 the sleeve gastrectomy in the US. It’s over 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.

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: preop and postop text books, monthly support group, 12 WMU4WLS courses, access to a private membership site via CFWLS.com, “Losing Weight USA” (weekly live webinars with access to Dr. Clark), and a private Facebook support group.

Weight Loss Surgery Options

Posted on October 15, 2019 by CFWLS

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

Get your free digital copy of my best-selling book too! (Details here)

The Top 10 Dieting Mistakes

Posted on October 07, 2019 by CFWLS

We all make mistakes, especially when we’re trying new things like weight loss. With weight loss people have typically tried many things. These are going to be some of the more common mistakes. You need to see it as an opportunity to change, and hopefully for the better.

Mistake #1 is “kinda” working on weight loss. Kinda working on weight loss does not work! We often want that quick fix. We have to learn the skills over a period of time. If you’re just going to “kinda” work on it, it isn’t going to work. Skills have to be learned. Then, they have to be ingrained and become habit. They have to be practiced over and over and over again so they can become lifelong habits. Think about a serious athlete trying to make the Olympics. They can’t just “kinda” work on it. Commitment is absolutely essential. You can’t expect perfection. We’re going to make mistakes.

Mistake #2 is making weight loss too complicated. Yes, weight loss is hard, but you really need to stick to the basics. The basics are: dietary changes, behavior/habit modification, and increased activity and fitness. Those are the basic concepts. It sounds easy, but obviously it’s not so easy. I put together a webinar about a month ago that went over some really important concepts about controlling weight. It really boiled down to controlling insulin levels. It was about all the things you need to do to control insulin levels. Diet has to be the cornerstone of all that. Slowly work on all the basics and you will continue to make progress. With any type of change you need to ask yourself two questions: Can I do it? Is it worth it? If you can’t answer yes to those two questions you’re going to struggle and not make that long term change.

Mistake #3 is not exercising! Exercise does not make you lose weight faster. So many people come in and say they’d be losing weight faster if they were exercising. It’s probably not true, but it’s still very important. It’s absolutely essential to preserve lean body mass. The natural part of aging is losing lean body mass at a rate of 1% a year. LBM is what drives your overall metabolism. Simplistically speaking, a pound of muscle burns a lot more calories than a pound of fat. It’s actually a pound of well-trained muscle (think of the Olympic athlete) burns calories like crazy versus a pound of fat. You want to have a fuel-burning machine. Muscle does that. Our overall metabolism is dependent on how much lean body mass we have. The better trained the lean body mass, the higher the metabolism will be. You can increase your metabolism with better trained muscle. It burns a lot more calories than untrained muscle. So exercise is extremely important. It doesn’t make you lose weight faster. It makes you lose weight longer and makes it so much easier to keep that weight off.

Mistake #4 is avoiding the scale. I’ve said many times that the scale is the best monitor we have. Patients often say they don’t weight themselves routinely. They only weigh when they come into the office. Why would you think that’s a good idea??! I’ve said many times that you need to stand on the scale every day. The best time to weigh yourself is early in the morning. It’s the most accurate. If you forget to weigh yourself in the morning, just wait until the next day. Your weight will go up during the day. Make that part of your morning routine. The reason is to reflect on the previous 24 hours. What was different about that previous 24 hours? You’ll figure out the little things that matter. It may be as simple as you had to much salt or you didn’t have a bowel movement. Those little things that we typically eat really matter and will show up on the scale. Once a week doesn’t work. How many of us can look back on a week and figure out what we did differently during that week versus the previous week? Literally two days I can’t remember what I did differently. Looking back on 24 hours is relatively simple. What worked? What didn’t work? You’ll figure those little things out that affect day to day weight.

Mistake #5 is believing that genetics is responsible for your weight. Genetics does influence our weight. But if we are using genetics as a reason for our weight that’s just an excuse. When you really look closely at that thought process, weight is more likely contagious than it is inherited. We tend to do the things we surround ourselves with. If everyone in your family is overweight it is slightly genetics but it’s very likely what they’re eating and doing. It tends to be contagious. We do the things that the people we hang around do. That’s true in our family and social life. It’s going to be a very rare situation where genetics is truly the reason. Weight is more likely contagious rather than inherited.

Mistake #6 is giving in to saboteurs. Friends, family, and acquaintances will all try and sabotage you. They will say the following: “You deserve this.” “A little won’t hurt.” “It’s the holidays!” There will be saboteurs. Be prepared to say, “No thank you” in multiple different ways. Deflect the comments by changing the subject. Explain to them the importance of this and that you want to recruit them to help. Tell them you value their support. You want them to help you rather than hinder you. Sometimes they don’t realize they’re sabotaging your progress.

Mistake #7 is being inconsistent. It’s that mentality of, “I’ve been good all week. I’m going to take the weekend off.” “I deserve this vacation because I’ve been so good.” Consistency goes along with commitment. Ask yourself those questions: “Can I do it?” “Is it worth it?” A bad weekend can undo 2 weeks of hard work. You tell yourself that you can slide just a little bit. You’ll find that you’ll slide a lot. It’s really easy to gain weight. It’s incredibly easy to gain weight. Write down your motivations for weight loss and review them often. “Why am I doing this?” “Where do I want to go with this?” Hopefully you’ll realize being consistent is worth it.

Mistake #8 is not eating enough. The common thinking is less is better. The reality is starvation has never been a good weight loss plan. Starvation is cutting way back but history has shown that it isn’t successful for weight loss. Fifty to sixty years ago some semi-starvation experiments were done. Around WW II there were contentious objectors. These people refused to join the military so they were asked to help by being put on semi-starvation diets. They found that if you cut those calories in half of what someone normally would be eating, people didn’t actually lose weight. They lost weight for a while but their metabolism slowed way down to make up for the calorie deficit. Part of the problem with just decreasing calories, and to continue to decrease calories, is that it only tends to work for a short period of time. Your body adjusts fairly quickly and it will slow your metabolism way down. It can slow it down to almost 50%. That is your body’s survival mechanism which is good if there truly is a famine. However, most of us aren’t living in a famine. Part of the issue with the semi-starvation diets is they cut their protein way back. If you’re getting sufficient protein, typically your calories will be decent. Weight loss will become more difficult. It will also become really easy to regain weight.

I had written that mistake #9 was skipping meals. It’s actually not such a bad thing because intermittent fasting works really well. Intermittent fasting is just skipping meals. I do encourage people to eat breakfast for a couple of reasons. There are also reasons to skip breakfast. There isn’t a right and a wrong here. I’ve become convinced about that. Some of it depends on what you’re eating for breakfast. If you tend to eat a high carbohydrate breakfast, studies show you’re going to be eating 300-400 calories a day extra because you tend to be hungrier. If you’re going to eat a high protein breakfast you tend to stay full longer and you eat about 200 calories less a day. Most people don’t wake up starving. For certain individuals, skipping meals can actually work nicely. Skipping meals can actually be a good thing.

The NEW Mistake #9 is thinking that meal “timing” doesn’t matter. It DOES matter. The same meal late in the evening has a greater insulin response. If you eat that meal earlier it will have a different insulin response. This goes along with skipping meals. Some people do much better with eating 2 meals a day. We already talked about intermittent fasting. It works. There’s no doubt about it. Insulin is key to weight control. The longer time you can spend with lower insulin levels, the easier it is to lose weight. The concept of eating multiple small times throughout the day will never work well. If you’re sensitive to carbohydrates or somewhat insulin resistant, the small meals throughout the day will never work for you. The reason is that, no matter what, whatever we eat will raise insulin levels. Carbohydrate just does it the most. You want to spend as much time as possible with low insulin levels. Skipping meals will give you more time with lower insulin levels. Eating the same amount of calories but spreading it out throughout the day is asking your body to stimulate insulin levels multiple times throughout the day. That concept doesn’t have a whole lot to do with how many calories you’re eating. It’s just a pattern of eating. Timing matters. It’s a really rare person that controls their weight well by eating a little bit multiple times throughout the day. That’s just not my patient population. That’s not who I see. There are some individuals who aren’t that sensitive to carbohydrates. Those people will be fine eating small meals throughout the day.

Mistake #10 is having that “All or None” mentality. It’s feeling that you’re either doing everything great, but if you make a mistake you’re all done and throwing in the towel. This is a learning process. We’re human and we won’t be perfect every day. Accept the mistakes and move on. You didn’t gain the weight overnight. It didn’t happen with just one meal or one bad day. When you have that bad day, chalk it up to a learning experience. Figure out what you’re going to do differently when you’re in that same situation next time. Figure out those tools you can utilize to prevent you from falling off the deep end and get back on track for the next meal. Don’t beat yourself up.

In summary, to err is human but it does not define your destiny. Don’t let mistakes derail your weight loss plan. Dust yourself off and keep going. At CFWLS this is what we do. We’re here to help you. If you need some help just give us a yell. If you have any questions give us a yell here at CFWLS. Call, send an email, or walk in the door. You should be checking your body comp. Make sure you’re losing fat not lean body mass.

If you would like weekly weight loss tips and recipes and a chance to ask me questions, subscribe to Losing Weight USA! Remember it’s your life! Make it a healthy one! Have a good evening everyone. Take care!

Gluten Sensitivity – Part 1

Posted on September 23, 2019 by CFWLS

I want to start out with some humor. It’s a cartoon. The doctor is talking to the patient and says, “The high carb diet I put you on 20 years ago gave you diabetes, high blood pressure and heart disease. Oops.” How true is that?!

I have a graph that shows what’s happened over the last 20 years or so. It’s the year versus the number of diabetics. The number of diabetics was fairly stable in the early 80’s into the 90’s. As the population grew, it went up a little bit. It was stable at about 6-7 million. Then in 1992 the US Government endorsed a high-carb, low fat diet. The American Diabetic Association and the American Heart Association followed suit with similar recommendations in 1994. Then in 1994 the graph started going up. From the early 90’s at 6 million diabetics to the 2000’s and now it’s over 20 million. That’s a huge increase in a short period of time. Coincidence??? I don’t think so.

Gluten has been around for a long period of time. It’s a Latin word that means glue. It’s a large water soluble protein found mainly in grains. Wheat is the biggest culprit. It gives elasticity to dough. It helps it rise and keep its shape. There are a lot of disorders that can be related to gluten. We call them gluten related disorders. It’s an umbrella term of any disease that is triggered by gluten. This includes Celiac Disease (the one that you hear about most), gluten sensitivity, and wheat allergy. You sometimes hear the term gluten intolerance. The real term is gluten sensitivity. Intolerance means you don’t tolerate it well. All of these are immune related disorders. Your immune system is responding to the exposure of gluten. For some people it can be a life threatening problem. If they get even close to gluten they have all kinds of problems.

Celiac disease affects about 1-2% of the population. The prevalence of this is going up and up. We’ll talk about why later. There’s something different now about the wheat than there was years ago. Unfortunately it’s never been tested to see if it’s a safe thing. Some of the symptoms are chronic diarrhea, abdominal pain, and malabsorption. It’s a true anti-inflammatory response in the intestinal tract. The diagnosis is made by endoscopes. A biopsy is taken. The treatment is a gluten free diet. There’s no other treatment.

Non Celiac Gluten Sensitivity means you don’t have the full blown disease. These people feel there are certain problems that arise when they eat gluten. You may or may not have any intestinal complaints. Multiple symptoms are improved when gluten is removed. This is much more common (30-40% of the population).The percentage of the population continues to go up.

A true Wheat Allergy is like an anaphylaxis. It’s like someone allergic to peanuts eats one by mistake, they go into anaphylaxis. This is a very quick onset. The others have a slow onset. A wheat allergy is much rarer.

Gluten is made up of glutenin and gliadin. There’s also water which gives the dough its elasticity. It tends to be everywhere! That’s where the problems come in. Many grains and products have gluten in them. Where is it hidden? The obvious one is wheat. Anything that has wheat in it is going to have gluten. It’s also found in barley, bulgur, cous cous, matzo, rye, spelt, and more. There are grains that don’t have any gluten in them. Some of those grains are relatively rare. Some of them are common like potato, corn, rice and millet. I’ve made a list of things you wouldn’t guess have gluten in them: baked beans, beer, blue cheese, bouillon, most cereals, chocolate milk, energy bars, egg substitutes, hot dogs, fruit fillings, ice cream, imitation crab meat, ketchup, vinegar, mayonnaise and meat balls, Gluten is added to a lot of things you wouldn’t really expect. Oats may or may not have gluten. French fries are made out of potato. But before they’re frozen they are actually sprinkled with wheat flour so they don’t stick to each other. A lot of cosmetics have gluten. Medications, play dough, some shampoos, some vitamin supplements have gluten. There are a lot of things that are code words for gluten. Sometimes they’ll put it as the genus species of the actual plant. There will be hidden gluten. Keep in mind that gluten free does not mean low carb. It could actually mean high carb.

Gluten sensitivity can cause all kinds of symptoms. From a GI standpoint, they can be somewhat similar symptoms as true celiac disease but not quite as dramatic. The GI symptoms are: abdominal pain, bloating, diarrhea, constipation, nausea, GERD, gas, stomatitis, and mouth ulcers. There are also symptoms of gluten sensitivity that have nothing to do with the GI system such as: migraines, brain fog, fatigue, fibromyalgia, joint/muscle pain, numbness, eczema, skin rashes, depression, anxiety, anemia, folate deficiency, asthma, rhinitis, and eating disorders. There are neurologic symptoms. Gluten can set off schizophrenia. It could be a factor in autism, peripheral neuropathy, ataxia, ADD, and ADHD. We see this diagnosed all the time nowadays. It actually could be a gluten problem.

There are some antibody tests to diagnose for gluten sensitivity. However, they’re going to miss a lot of people. The only good way is a diagnosis of exclusion. You remove gluten from your diet for at least a month and then try and reintroduce it. If your symptoms come back, it’s probably due to gluten. It’s not the most scientific thing in the world to do but it actually works pretty well. It’s like an elimination diet. The treatment is a gluten free diet. Those with gluten sensitivity often have the false impression that “cutting back” is helpful, but really need to avoid all gluten. I want everyone to keep in mind that if you eliminate gluten, no nutritional deficiency will occur.

It’s really amazing some of the symptoms that can be related to gluten sensitivity. I already mentioned a lot of them. Some other symptoms are: autoimmune disorders (rheumatoid arthritis, diabetes, Hashimoto’s), bone pain, cancer, heart disease, infertility, dental problems, skin problems, and more. Gluten sensitivity can have a lot of things to do with things you never expect. The only way to know is getting rid of the gluten. Obviously we think of gastrointestinal problems associated with gluten sensitivity.

Unfortunately there are no real standards for testing gluten intolerance. The simple way to do it is to get rid of the gluten. We can measure anti-gliadin antibody (IgA) in the blood or stool. If you measured everyone’s blood, 12% have antibodies to anti-gliadin. There are 30% in the stool. It can cause an immune reaction. If something causes an immune reaction there can be damage. The reaction is usually an inflammatory reaction. Cytokines develop and are released. The Gold Standard is gluten free for 1 month, then re-introduce. If symptoms pop up, then you are sensitive to gluten.

Gluten-free should not mean eating all the junk/processed food that is labeled as gluten free. It doesn’t correlate with low carb. The “Core Diet” is just 3 things: hydration (water), good protein sources, and salad stuff. That’s what you should eat. Get rid of most everything else. Do I agree with trying to keep a gluten-free diet??? Absolutely!

I have more to say about gluten and I’ll post another article next week. We’ll delve into this more and look at all the major body organs that can be affected by gluten sensitivity. I’ll go into a little more detail with that.

If you think of questions, don’t hesitate to call (757-873-1880), text or stop by. This is something that’s really common. I think this is something that’s going to become more and more important. Part of the problem is that the wheat that’s being grown now is not the same wheat that was grown 100 years ago. It was genetically modified (GMO’s). You hear about GMO’s all the time. The problem with GMO’s is whether they’ve been tested for safety.

Remember to stop by and get your body comp checked.

Remember, it’s your life. Make it a healthy one.

Thanks to Dr. Clark...

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