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Tag Archives: board certified surgeon

The Top 10 Dieting Mistakes

Posted on October 07, 2019 by

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 2

Posted on September 30, 2019 by

Wheat flour-why are you everywhere?!!  There are a couple of good books that I mentioned in the article. One is “Wheat Belly” by Dr. William Davis. Also a good book is “Grain Brain” by Dr. David Perlmutter.

A quote from Dr. William Davis:  “The world’s most popular grain is also the world’s most destructive ingredient.” A quote from Dr. David Perlmutter:  “gluten is our generation’s tobacco-addicting and potentially causing long term problems.” I think there’s some real truth to both of those statements.

Wheat has fed the world. It’s been around for a while. The proliferation of wheat products parallels the expansion of our waists. What truly raises blood sugar the most?? White sugar? Snickers bar? Banana? Whole wheat bread?  The answer is whole wheat bread. It raises blood sugar more than anything else out there. Wheat is the dominant source of gluten. It’s found in everything (cosmetics, shampoo, and more).  Wheat constitutes about 20% of all calories consumed worldwide.  How many aisles in the grocery store are actually dedicated to wheat/grain products at the grocery store? There’s the bread aisle, baking aisle, snack aisle, cereal aisle, pastry aisle.. Wheat is almost everything. You have to “let go” of a few myths:  Low fat, high carb diet is good. And, cholesterol is bad.

Wheat was first cultivated @330 BC and was Einkorn wheat. Wheat has dramatically changed over the past 50 years. It’s been over 2000 plus years now. Hybridized and crossbred to make it resistant to disease and drought is one reason it has changed. It means we can grow a lot more wheat. But it also means an increase in yield (10X from 50 years ago). It’s a good thing we can feed people. The problem is that modern wheat has been so modified that today’s strain could not survive in the wild without the fertilization/pest control. Unfortunately with all this modification it really hasn’t been tested that much to see if it’s actually safe. It’s just assumed that the new strains are going to be safe.  But there are a lot of assumptions out there that don’t prove to be correct.  So we don’t know if it’s true or not. We just assume these hybrids of wheat really are safe. Wheat gluten has undergone significant structural change with the hybridization. It’s a different thing now than when it was 2000 years ago.

I s wheat addictive? Obviously a lot of drugs are addictive. Exogenous drugs can supercharge or hijack the CNS. Examples of these drugs are: cocaine, tobacco, and heroin.  The endogenous opiod-like products are endorphins.  Endorphins give us some of those “highs” (exercise highs).  There are other exogenous opiod-like peptides that are found in wheat (gluten exorphins and gliadorphins-prominent part of the wheat). So there is some kind of “feel good” property when we first eat these things. It’s more than just a blood sugar rush. There are other things that are actually occurring.  Can they actually make you crave “another hit?” Certain people may be more susceptible just as people who are more susceptible to alcohol or heroine.

Wheat/carbs lead to increase blood sugar swings which then increases insulin levels. Insulin is the hormone that turns on fat storage, especially in the abdominal area. Wheat also increases inflammatory markers. When inflammatory markers go up we also tend to gain weight in the abdominal area. Also, it reduces the production of Adiponectin (heart protective and aids in weight loss). If we reduce adiponectin, we’re going to have a harder time losing weight.

People with celiac disease have to avoid all aspects of gluten. It is a major problem.  Antibodies to wheat gliadin are found in the blood. It causes inflammation of the intestinal tract. Gluten also affects Irritable Bowel Syndrome and Gastroesophageal reflux disease.  Reflux is probably one of the biggest problems that I see that wheat can cause.  Get rid of the grains. Gluten can cause bloating, cramping, gas, constipation ,diarrhea and more.

Wheat can increase blood sugar easier than most everything else. Diabetes was unseen in the hunter/gatherer societies until the introduction of cultivating wheat/grain. Wheat consumption parallels diabetes and obesity. The average weight consumption is about 133 pounds a year.

Does wheat make you age faster?? Wheat, carbs, and fructose all increase Advanced Glycation End-products (AGE). It causes stiff arteries, increases cataracts and slows neuronal connections (dementia).  So….wheat free is (potentially) anti-aging!

LDL is often referred to as “bad cholesterol.”  Actually only parts of LDL are bad. Diet influences this. Carbs/wheat will increase VLDL and triglyceride formation, and subsequently increase small LDL’s. Gluten can potentially make heart disease worse. Insulin turns on lipogenesis in the liver, therefore increasing production of small LDL and triglycerides.

AGE (advanced glycation end-products) causes the loss of skin elasticity (wrinkles). Wheat can cause acne. Foods that increase blood sugar and insulin will also increase acne.  Wheat definitely causes dermatitis herpetiformis (uncomfortable and unsightly patches on the skin). Wheat can also cause mouth ulcers, acanthosis nigricans (darkening of the skin), psoriasis, pyoderma gangrenosum (hair problems) and hair loss.

Thomas Edison said, “The chief function of the body is to carry the brain around.” There’s a lot of truth to that statement. Dr. David Perlmutter said, “The origin of brain diseases is in many cases predominately dietary. Although several factors play into the genesis and progression of brain disorders, to a large extent numerous neurological afflictions often reflect the mistake of consuming too many carbs and too few healthy fats.” Our ancestors didn’t have sugar and wheat as available to them. Their diet consisted of 5% carbs, 20% protein, and 75% fat. The USDA diet is 60% carbs, 20% protein, and 20% fat. That’s a lot different. The problems with our health have evolved very quickly over the last 40 years with this recommended diet. Maybe we need to re-think this. Almost all degenerative conditions are associated with inflammation and the biggest instigators of inflammation are  carbohydrate and often gluten (both increase production of cytokines).   The assault on the brain is much harder to recognize until it’s too late. It’s also harder to measure. The real question is, “What if we are all sensitive to gluten from the perspective of the brain:” (Dr. David Perlmutter). If we got rid of gluten would we have a lot less brain disorders?

I already talked about the exorphins which are temporary. But inflammation affects everything including the brain. The following can be affected by wheat: worsening ataxia, peripheral neuropathy, worsening migraines, brain fog, and mood swings.

The bottom line is wheat is everywhere and it’s probably not helping you. What do you do? Going gluten free doesn’t mean eating gluten free! Many things that are labeled gluten free are just substituting one starch for another. Eating gluten free is not a bad idea but it doesn’t mean you need to eat the foods that are labeled as gluten free. Remember the “core” of your eating plan: hydration (water is best),  good protein sources, and colorful vegetable and salad. The best foods have no labels on them. There is no such thing as carbohydrate or wheat deficiency!

You can get those books just about anywhere. Wheat Belly is by Dr. William Davis and Grain Brain is by Dr. David Perlmutter.

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

Posted on March 19, 2019 by

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

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

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

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

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

What Questions Should I Discuss with My Primary Care Doctor?

Posted on July 02, 2018 by

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

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

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

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

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

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

Posted on June 25, 2018 by

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

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

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

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

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

CFWLS-Rhonda-09-

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