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Hey Doc – Could it be my Thyroid?

Posted on January 08, 2020 by

I routinely hear from patients in the office, “It couldn’t be my thyroid.” It could be. But usually that’s not the real blame for weight problems. It is something to try and understand. It’s commonly a problem, especially in women. When it gets treated people feel so much better.

I probably mention this on every Losing Weight USA Webinar; with all hormones, balance is absolutely key! If you balance one hormone, potentially you can throw off another hormone. You don’t want one working too well and the other not working well enough.  Hormones come from endocrine glands. There are lots of different endocrine glands. They all produce different hormones. The endocrine glands are found throughout the body.  There are lots of different glands in the body: pancreas, testis, ovaries, and more. A hormone is simply a chemical messenger. They communicate between one part of the body and another. The tissue that makes the hormone releases the hormone into the bloodstream. Subsequently the hormone goes throughout the body. The tissues that have receptors can receive the message. It’s that “Lock and Key” type of thing. It needs to fit well into the receptor in order to send the message. Hormones are one of the main tools your body uses to maintain homeostasis (balance).  Hormone balance is a key concept. It’s especially true with Thyroid Hormone.

The pituitary gland is a tiny gland the size of a berry sitting in the center of your head. It receives messages and sends messages. It works in concert with the hypothalamus. The hypothalamus often sends the message of what the pituitary gland should release. The pituitary gland releases all sorts of hormones. It releases prolactin, growth hormone, thyroid stimulating hormone, FSH, and more. Often it’s the pituitary gland that’s sending the message to the endocrine gland. Then the endocrine gland releases the hormone. The thyroid gland receives instruction from the pituitary gland. There are a lot of places where these hormones can be thrown out of whack.

The thyroid gland sits in your neck. It’s below the “Adam’s apple.” It’s one of the largest endocrine glands. The thyroid comes from the Greek word for shield. It’s protected and covered by some of the neck muscles. The parathyroid glands are adjacent to it. The parathyroid glands influence your bones but they don’t really influence your overall metabolism. They are adjacent to the thyroid glands. The function of the thyroid is directly related to metabolism (how your body uses energy). This is what drives your metabolism—whether it’s slow or fast. This is what overseas our metabolic rate. When someone talks about a slow or fast metabolism, they are alluding to their thyroid gland. If you looked under a microscope at a slice of your thyroid tissue you would see these open areas that have food in there. That’s the thyroid hormone. If this goes out of whack potentially you can get thyroid disease.

A balanced hormone means there’s good communication between different areas. The hypothalamus talks to your pituitary gland. The pituitary gland talks to the thyroid gland. Then the thyroid gland releases the thyroid hormone. There are multiple layers. They are like multiple feedback loops. One of these hormones in the loop feeds back on the other. So you don’t want to get too much of any one thing there. It’s also very dependent on appropriate iodine intake.  Iodine is essential for life. It’s utilized by every single cell in your body. The thyroid uses about 3 mg every single day. The breast tissue uses a couple milligrams every single day because the breast is very receptive to iodine. It’s very important in breast function. Iodine has been added to salt. The iodized salt is one of the only ways we get iodine.

Unfortunately the iodine that’s in the salt can vaporize. Once the iodized salt container has been opened the iodine can vaporize. We often don’t get enough iodine because it’s been released into the atmosphere. It’s very common that people don’t get enough, especially Americans. Iodine used to be added to a lot of different foods. It’s been taken out of a lot of foods and substituted with bromine. In Europe bromine is illegal. The receptors for bromine are very similar to iodine. So if you’re exposed to a lot of bromine eventually the iodine receptors get blocked and then, subsequently even with the iodine, you’re not utilizing as much as you could. Iodine is very important to the thyroid. If you don’t get enough it can lead to goiter. Cysts form because the tissue is trying to work but can’t due to lack of iodine. The cysts can turn into a goiter. They can be very noticeable or very small. Eventually the thyroid could have to be taken out.

Again, the thyroid system runs from the hypothalamus down to the pituitary, and up to the thyroid gland. The thyroid gland then makes the thyroid hormone. Iodine is important in all of this. It releases thyroid hormone into the bloodstream. The thyroid hormone will go to just about every cell in your body.  If the thyroid hormone is unbalanced, then that would be either hypothyroidism or hyperthyroidism. It’s very important for growth and development and overall metabolism.

Is your thyroid functioning normally? TSH is thyroid stimulating hormone. It’s made by your pituitary gland in your brain. The thyroid functioning test is a screening test telling. It doesn’t tell us how well your thyroid is working. If the pituitary gland makes a lot of TSH it basically means your pituitary gland is screaming at your thyroid to get it to work. It often means the thyroid is not working well. That’s a sign of hypothyroidism. If the pituitary gland doesn’t make much TSH that means the thyroid is working like crazy. You don’t need to tell it to work anymore. That’s often a sign of hyperthyroidism.  Again, the thyroid function test is really a poor test. What’s important is not what the brain is telling the thyroid to do. What’s important is what the thyroid is actually doing. To know what the thyroid is doing, we look at the thyroid hormone. The working thyroid hormone is T3. It’s called free T3. What this has to do with is how many iodine molecules are on that thyroid hormone? T4 is levothyroxine. T3 is missing an iodine. Synthroid is synthetic thyroid. The issue there is that if you’re taking synthroid, you’re not taking the working thyroid hormone, T3. Subsequently your body has to convert it to the T3. Some people don’t do that well. If you don’t do that well synthroid (levothyroxine) might not be a good choice.   The reason we would give you T4 and not just T3 is because the T4 is much longer acting. Therefore it’s just one dose a day. T3 is short acting and you have to take multiple doses. Most people will continue to take the T4 and convert it to T3. I want to know what your TSH is (for the thyroid function test). But I also want to know what the free T3 is because that’s the true working hormone. All the others are just working up the working hormone. The T3 is what’s telling all the cells in your body how to act. How do we look at the thyroid physically? We can do an ultrasound or radioactive iodine. Often an ultrasound is a better way to look at the thyroid.

The TSH is coming down from the brain and tells the thyroid gland to release thyroid hormone. The level will change depending on what it needs to tell the thyroid. If it’s telling the thyroid to release more, the volume goes up. If it’s telling the thyroid to release less, the volume goes down. The T4 is converted the T3, which then tells all the cells what to do. The T4 could actually make what’s called reverse T3. You don’t want to make this. It’s kind of a mirror image of T3. The mirror image of the T3 doesn’t function like the actual T3 does. Reverse T3 really doesn’t do you a lot of good. Some people take the T4, and instead of converting it to the T3, convert it reverse T3. Subsequently you’re thyroid doesn’t work well. But it may not show up on that TSH screening test.

Lots of thyroid symptoms go along with abnormality. The biggest thing we’re worried about is hypothyroidism. If you’re truly hyperthyroid you usually don’t have a weight problem. The symptoms with hypothyroidism are numerous and vague. That’s where the problem comes in. Because they are vague, we just don’t think about these things. For example, there are a lot of reasons to be tired.  You might lose some of your eyebrow hair. You might get a puffy face, enlarged thyroid gland, or be hot or cold all the time.  Cold intolerance is a symptom. You could be tired all the time, have dry skin, menstrual cycles are way off, weight gain, constipation, or brittle nails. Unfortunately a lot of these symptoms are very vague and don’t necessarily point at any one thing. It potentially can be hypothyroidism. There are some overlap symptoms that go with both hyper and hypothyroidism. Part of the problem is how we sort all these things out. Again, we look at those thyroid function tests.

What do you do if your thyroid is not quite abnormal enough to be on thyroid medication? One thing is iodine. It can help. Most Americans don’t get enough Iodine. There are some thyroid support supplements. We have them here is our store. You can also find them in health food stores. They usually have some B vitamins in them. They also have extra zinc, selenium and some herbal things as well. Typically there are some things you can do for supporting the thyroid.  Again, we can’t live without iodine.

Iodine supplements can be purchase in the CFWLS Nutrition Store or online.

 

 

 

 

Thyroid Support Pack also available in store or online!

Avoiding Holiday Weight Gain

Posted on December 02, 2019 by

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

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

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

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

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

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

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

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

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

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

What You Need to Know About the Gastric Sleeve

Posted on November 20, 2019 by

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

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

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

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

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

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

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

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

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

What You Need to Know About a Gastric Bypass

Posted on November 11, 2019 by

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

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

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

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

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

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

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

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

What Are the Options for Weight Loss Surgery?

Posted on November 04, 2019 by

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.

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:  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.

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.

Overeating…How Common Is It?

Posted on October 28, 2019 by

We’re all guilty of overeating. Overeating is eating more than what’s on your diet plan. Or, it can be just eating more than what you had planned. It’s also when you continue to finish your meal even though you feel full partway through it. Binge eating is different. It’s an extreme form of overeating. It’s eating an abnormally large amount. For someone who has a normal size stomach and hasn’t had weight loss surgery, that would be consuming around 5000 calories.  It means you are feeling out of control and you should see a mental health professional. If you have a small stomach from weight loss surgery then you can’t really ever binge eat, right?! The issue isn’t the amount. It’s the feeling out of control with your eating. If that is the case you need to seek professional help. It’s out of the scope of this discussion.

Sometimes we “justify” overeating. When you go out to eat, you want to get what you’ve paid for. Maybe you’re celebrating a birthday or anniversary.  When you go on vacation and let loose. Someone might be urging you to eat. Another justification is that the food is free.  When this happens we often get into the mentality of, “Since I’ve strayed, I might as well just keep eating.” “I fell off the wagon and ate the candy bar. I might as well eat the whole bag of candy bars.” We discourage that type of “all or nothing” thinking.

There are lots of different causes of overeating. Some of the common causes are: stress, irritation, frustration, habit, boredom, overwork, and worry. Often it has to do with some type of emotion. We’re going to go over 10 common “triggers” for overeating and also what you can do about them.

The first common “trigger” for overeating is boredom. It leads you to TV watching (TV commercials) which leads you to the refrigerator/pantry. What can you do? You can watch commercial free TV and prepare healthy snacks to keep on hand (cut up veggies are a good choice).

The second “trigger” is feeling deprived. This tends to come about by completely avoiding certain foods. We talk a lot here about avoiding simple carbohydrates and processed foods. We’re trying to avoid a whole category of foods. It’s easier said than done. It’s difficult for an extended period of time. I’m not a big fan of true “deprivation diets.” It’s the thinking that, “I can never have this again because I’m on a low-carb diet.” “I can never have ice cream.” You want to focus on a balanced diet and healthy eating and exercise habits.  We also need to have that portion control. “I’m just going to have this little bit…” Deprivation doesn’t work very well. There is an exception to that. The exception is if you have a true trigger food. That means if you have one piece of that trigger food I’m going to eat the whole bag. You need to avoid those foods.

The next trigger for overeating is feeling self-disgust or hating your body. What you’re really doing is focusing on what’s wrong with your body and some societal ideals. We often see the societal ideals on TV. Realize your body is only a portion of who you are. Your body is just a part of you. It’s not all of you. If this is a significant problem you should seek professional help.  I see this in many patients who have lost a lot of weight. They still see themselves as who they were, not who they are.  It usually fixes itself over time.

Carbohydrate sensitivity or glucose intolerance are the next common trigger. This means you’re prone to big blood sugar swings. This is a true physiologic trigger. Blood sugar swings lead to insulin swings resulting in hunger/cravings. It’s really hard to ignore this. If it comes from blood sugar swings, the answer is to avoid blood sugar swings. Avoid simple carbs and increase your protein intake. If you’re having carbs they should come from vegetables. Chromium is a mineral that helps with blood sugar swings. Usually you need to take it three times a day for the blood sugar swings.

Another trigger is Habits. It’s what “you’ve always done.” It’s like when you go to the movies and always have a tub of popcorn. Try to engage your mind and hands in some type of new activity. It could be as simple as reading a book or playing an instrument. You need to break the habits or break the routine.

Next is depression and/or lack of energy. You often turn to food as that “pick me up.” Yes sugar is an energy source. Your body has plenty of energy. You just need to access that energy that’s there, meaning the fatty tissue. In order to accomplish this, the carbohydrates need to be low. The food gives you a pick me up but it’s not a long-term answer. Try to identify those low energy times of your day and take a brisk walk. Don’t ignore depression. It can happen frequently in a weight loss plan. Don’t ignore it. It tends to be relatively fleeting. It’s very real for someone who’s losing weight fairly quickly that they get a chemical imbalance. Seek professional help.

Needing comfort is the next trigger for overeating. There are pressures at work and home. There’s lack of appreciation. Everyone tends to have their favorite comfort foods. Baked potato to pizza to ice cream. How do you beat it? Take some time out for yourself. Go get a massage for pedicure/manicure. Make sure you schedule “me” time.

Feeling overwhelmed can be a trigger. It happens sometimes a couples times a day for me. You have too much to do and not enough time to do it in. Realize you can only do so much. To get a project done we have to make the first step. The 2nd and 3rd steps will be easier. We all have a lot to do and can’t get it all done. It’s often prioritizing.

More common trigger: being emotional. Emotions tend to bring on eating; being upset, hurt, anxious, stressed, sadness, or happiness. Go outside for that quick walk. Remove yourself from the situation if it’s a negative emotion.  Deep breathe/stretch.  Exercise is a great stress reliever.

Lack of willpower is a common trigger for overeating.  Willpower is like a muscle. We can train ourselves to use and slowly improve on it. Exercise your will power. It will get stronger.  How many times have I heard, “Gee I don’t have any willpower?” Everybody has willpower, it’s just how much.  Every Wednesday I was fasting. I did some videos on fasting. It works. After a while you get used to it. Anything we practice we get better at. Fasting got easier for me as time went on. If you think about it, we make thousands of food decisions just about every day. When to eat? How much to eat? What to eat? Is it time to eat yet? Fasting frees up a lot of time and energy. There’s no thinking about food because it’s not happening. You just have to figure out what the best times are for you to do those things. I did videos on Losing Weight USA as well as our YouTube site. It can be very helpful with weight loss. Time yourself. I assure you no one has ever starved in a few hours.

Here are some tips to avoid overeating. These are things we should ask ourselves all the time.

Get in the habit of asking yourself 2 questions: why am I eating and am I still hungry? Part of it may be that it’s time for lunch. Maybe you haven’t eaten all day. Literally bite-to-bite you can ask yourself, “Am I still hungry?” You want to stop when you feel satisfied. Make sure you’re avoiding the “overeating” foods; simple carbs. If you’re going to overeat, have more protein.  The simple carbs are like a drug. If you have a little bit, you’re going to want more. You’ll crave more. One of my favorite eating rules is eat only when seated at a table. The other eating rule is always use utensils and a plate. That’s gets away from wandering through the pantry and grabbing something or eating something over the kitchen sink. It doesn’t necessarily mean it will change what you’re eating. It will change what you’re eating if you have to be seated at a table and use utensils and a plate, it gets rid of a lot of the eating on the fly. There are a lot of decisions that have to be made when you eat that way.  For example, if you grab a handful of M & M’s. You put them on a plate, get a spoon and you sit down at a table to eat them. By the time you actually do that, you may not even eat them. If you just walk by and grab a handful, you’re likely to eat more because you’re eating them “on the fly.” It’s an eating rule that is very simple but effective.

Avoid “family style” eating. This means bringing all the food to the table and passes it around until it’s all gone. You need to leave the food in the other room, make your plate, and go sit down and eat it. You can still get more but you have to physically get up, go into the other room, stand there and figure out what you’re going to put on your plate, and walk back to the table and eat. This is better than having a person pass you the food dishes at the table. Little things might be what the difference is between being successful and unsuccessful. Use small plates and small utensils. Remember propinquity. It’s about shaping our environment for success. Measure your portions. You will likely be at least 30% off when “eyeballing.” We all tend to drift with portion sizes. Eat slowly. Chew slowly and set your utensils down between bites. Give your body time to tell your mind that you’re done.  Wait 10-15 minutes before you get more. Ask yourself, “Why do I need more?”

For cravings use distractions. You need to use that willpower muscle. Change your activity. Distract yourself until the cravings go away. Chromium can help. You usually have to take it 3 times a day. Practice! Always leave a little food on your plate. If you’re out at a restaurant and you leave some food on our plate, typically people aren’t going to be bugging you about bringing you more food. Finally, a carb blocker can be helpful. Also an appetite suppressant, especially for cravings.  The FDA regulates appetite suppressants very carefully.  So there are a number of hoops to jump through, but they’re all very doable.

Remember, you do NOT have to be a member of the “Clean Plate Club.” It’s really not going to help any starving children anywhere!

Questions? “What’s a good snack food to avoid blood sugar swings?” Well anything that has carbohydrates will typically cause blood sugar swings. Simple carbs are much worse than complex carbs. It depends on what you tend to drift toward. The snack should be low-carb. That can be meat, cheese, or eggs. A lot of that is snack-worthy. Nuts are OK as long as you limit them. Be careful there. Cut up veggies are good. The flip side is that any food potentially can cause a blood sugar swing, even something with 0 sugars in it. I see this all the time with diabetics drinking why protein shakes. Typically 95% of my surgical patients are really sensitive to carbohydrates. Whey is efficiently absorbed. If you drink a whey protein shake that’s filled with amino acids and your body doesn’t need all those amino acids at that one time, your body will just convert it to sugar. Your body is good at doing that. Protein with any carbohydrate will smooth out the blood sugar somewhat too.

If you think of other things, just give us a yell 757-873-1880. Stop by and get your body comp done. Remember!  It’s your life. Make it a healthy one! Have a good evening everyone. Take care!

What About Fasting?

Posted on October 28, 2019 by

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

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

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

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

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

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

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

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

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

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

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

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

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

Sleep Deeply~

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

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

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

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

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

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

You can do extended fasting.

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

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

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

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

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

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

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

Chicken Diablo

Posted on August 13, 2019 by

You can make it as spicy as you want – I like it hot!

Ingredients
2 chicken breast halves, cut into 1-2” chunks
1 red or yellow bell pepper, diced
1 can black beans, rinsed and drained
1 cup Mexican cheese blend, shredded
1 package frozen riced cauliflower
10 oz can of Rotel (any style you like) or 1 cup salsa
1 pkg of creamy chicken protein soup mix
½ cup hot water

Directions

  1. Thaw cauliflower and spread in the bottom of casserole dish.
  2. Top with chunks of chicken, pepper and black beans.
  3. Stir soup mix with hot water until mixed and add tomatoes/salsa (not drained).
  4. Pour over entire casserole.
  5. Sprinkle with cheese and bake at 350 degrees for 45 minutes.
  6. Serve with sour cream if desired.

Makes 6 servings

Nutrition Facts:
Calories                                 135
Total Fat                                  3g
Total Carbohydrates             7.5g
Dietary Fiber                        1.5g
Protein                                  18g

Note: Try using green beans in place of riced cauliflower for a bit of variation!

Print Recipe: Chicken Diablo

Artificial Sweeteners – Pros, Cons and Weight Loss

Posted on June 19, 2019 by

Can they actually help with weight loss? Can they potentially hinder weight loss? So those are some real questions and we will get to them as we go.

Here’s an overview of artificial sweeteners. What role does sugar play in your diet? We will talk about nutritive vs. non-nutritive sweeteners. There is a difference there.  We’ll talk about sugar alcohols and which ones have been around for a while.  Then we’ll discuss saccharin, aspartame, sucralose, and more.  Finally, we will talk about artificial sweeteners and weight gain.

Things have changed over many, many years.  A couple hundred years ago 1800-average consumption of sugar was 25 pounds a year.  By the year 2000, average sugar consumption was 146 pounds a year!  We have an innate desire for sweet things. As we’ve talked about in the past, your body requires NO sugar/carbohydrate to survive. In order to reduce the consumption of sugar other sources of “sweetness” have been developed in hopes that it will be better to have no so much sugar. This came about because we realized that maybe all this sugar isn’t good for us.

We divide sweeteners into nutritive vs. non-nutritive.  Anything that is going to provide us with true nutrition or nourishment is considered a nutritive sweetener.  Foods from food groups (grains, vegetables, fruits, dairy, meat, and oils) provide nourishment and calories so they are considered nutritive.  Products that are added to foods and do not provide any nourishment are considered non-nutritive. FDA places sweeteners under the “GRAS” (generally regarded as safe) list or as “food additives” or “dietary supplements.” It’s thought that they’re safe. We don’t know it absolutely. There may not be a way to study it completely. They can be listed under different things under the FDA. It will depend on what they’re made up of.  Since 1999 at least 10,000 new products containing sweeteners have been launched.  It’s probably close to 15,000 now.

Sugar alcohols are technically a nutritive sweetener because they provide calories (1.5-3 cal/gram). We see a lot of marketing out there. They can be labeled as sugar free. Sugar free doesn’t necessarily mean carbohydrate free.  And, it doesn’t necessarily mean calorie free. Sugar alcohols are neither sugar nor alcohol, but are carbohydrates. Sugar alcohols occur naturally in many fruits and vegetables. That can be the reason why there is some sweetness to some fruits and vegetables. Some of them contain fructose. It’s actually sweeter than other types of sweeteners. Typically sugar alcohols aren’t as sweet as table sugar. Sweetness varies from 25%-100% as table sugar (sucrose).  That means that often a lot more is added to mimic the sweetness. There are lots of examples out there like sugar free gum.  But it’s not carbohydrate free.  The following are sugar alcohols: sorbitol, mannitol, xylitol, erythritol, maltitol, lactitol, and isomalt.  They provide fewer calories than sugar since they are not completely absorbed. Carbohydrate provides 4 calories per gram. Sugar alcohols are typically about 1 ½ -3 calories per gram.  Sugar alcohols have less sugar, but that doesn’t mean they can’t raise your blood sugar. The carbohydrate will eventually be broken down into sugar. They can cause the following side effects: gas, bloating, and diarrhea. Some people are very sensitive to sugar alcohols. Remember: they are NOT calorie free and since not as sweet, you often will eat more.

Saccharin has been around for a long period of time: sweet n’low, Sugar Twin, Necta Sweet.  It’s been around for over 100 years. It was discovered in the 1800’s by researchers working on coal tar derivatives.  It’s calorie free but it does have 200-700 times the sweetness of table sugar. Most of these artificial sweeteners we’re talking about have tremendous amounts more sweetness than table sugar. It tends to have a bitter aftertaste. Originally there was a concern of “bladder tumors in rats” (no increased risk in humans). The researchers gave rats 100X more than any of them could ever actually eat in a day. There’s no way anyone can ever eat this much sugar. When they re-did the study, they found that there were rats that were pre-disposed to getting bladder tumors anyway!  So, the tumors probably had nothing to do with the saccharin. It’s never been shown to cause tumors in humans. If you’re allergic to sulfa medications, potentially you could have an allergic reaction.  It’s very rare, but not impossible.

Aspartame was discovered in 1965 by scientists working on “ulcer drugs.” For some reason they licked their fingers and discovered how sweet it was. It’s now found in over 6000 foods.  Aspartame is Nutrasweet, Equal, and Sugar Twin. They made this by connecting 2 amino acids (aspartic acid and phenylalanine).  These 2 amino acids together have a very sweet taste. Technically it will have calories, but since it’s 200X sweeter than sugar, this amount of calories is miniscule. People with phenylketonuria (PKU) can’t break down phenylalanine. There have been reports of headaches. There are numerous websites that rail against its use. This is the most controversial sweetener. But there’s never been a study that showed that this is a problem. Because it’s just 2 amino acids, there really shouldn’t be a reason for any problems.

Sucralose is Splenda. It was discovered while trying to make a new insecticide. The name is somewhat confusing because it sounds a lot like sucrose. Sucrose is table sugar. They’re two completely different things. Splenda is about 600X the sweetness of sugar.  It can be used for cooking and baking. It’s made from sugar, but it’s nothing like sugar. They chemically altered the sugar and put a chlorine molecule on the sugar, therefore rendering it unable to be absorbed. It’s like a backward or left-handed sugar. You get the taste of sugar, but you don’t get the calories. They added a filler to Splenda called dextrose or maltodextrin to provide bulk and volume.  It’s a marketing ploy that sucralose has not calories but the fillers do have calories. A serving size has not calories which is technically right. However, a serving is less than a teaspoon. A cup actually has about 96 calories and 32 grams of carbs! A cup of sugar has about 768 calories and 192 grams of carbs. So it’s all a marketing ploy with regards to it having no calories.

Acesulfame K (Ace K) was approved in 1988. The K is potassium. It’s 200X sweeter than sugar. It’s often used as a “flavor enhancer.” It’s often put together with another type of sweetener because it tends to make it more palatable. It makes for a synergistic effect. That’s what is used in many of the “zero” sodas. It’s often listed in ingredients as: acesulfame K, acesulfame potassium, ace-k, Sunett, Sweet One, Swiss, Sweet. It does contain a carcinogen called methylene chloride. However, the amounts are so tiny that it’s never really a thought of it causing any problems. It’s been linked to headaches, depression, and nausea. There are minimal studies done to fully evaluate. They’re generally regarded as safe.

Neotame has been FDA approved since 2002 (brand name Newtame). It’s a newer version of Aspartame without the phenylalanine dangers to PKU patients. It’s about 10,000X sweeter than sugar. It’s often used as a “flavor enhancer.” A newer one out there similar to neotame is altitame. It’s amino acids put together: aspartic acid and alanine. It’s 2000X sweeter than sugar.  It’s not been approved in the US yet as far as I know. It very likely will get approved.

Advantame is the cousin to Aspartame. The FDA approved it in May, 2014 (6th one approved). It’s 20,000X sweeter than sugar. It dissolves in water. It doesn’t break down in heat so it can be used in cooking. It does have miniscule amounts of phenylalanine. The “safe” consumption level is >40,000 packets/day. Well good luck with eating 40,000 packets a day! Very unlikely it’s going to cause any problems.

Stevia/Rebiana is one you hear about more and more often. There are many of them out there. They’re all based on the stevia plant. It’s a plant native to South America (Stevia rebaudiana).  They’re starting to grow it more and more places. It’s now being cultivated for harvesting its sweet leaves. The natives used to just pick the leaves and chew on them.  There’s some evidence that potentially it can actually help control blood sugar. It’s 200-300X sweeter than sugar. The working molecule from the plant is called Rebaudioside A. By itself is available as a sweetener labeled as: Only Sweet, Truvia, PureVia, Reb-A, Rebiana, and SweetLeaf. Stevia can be sold as a “dietary supplement.” It’s truly not an artificial sweetener because it comes from a plant. Just because it comes from a plant doesn’t mean it’s necessarily a good thing.  A lot of poisons come from plants too. It doesn’t have any obvious harmful effects. There is a question as to whether it can help with controlling blood sugar. This is probably one of the potentially safer ones out there. There just aren’t a whole lot of studies being done. It’s already approved so who’s going to go back and start doing studies?

A newer one is called Nectresse which is “from the makers of Splenda.” It’s made from Monkfruit, molasses, and erythritol. Monk fruit is about 150X sweeter than sugar. It’s said to have “zero calories” in a packet. Again, that’s somewhat of a marketing ploy. One little packet technically can be called zero calories. That’s not really true because if you’re using it in a large amount (baking) the calories would be there. It’s about 1/3 the calories of table sugar. It’s not technically calorie free because it’s mixed with molasses and monk fruit.

Are artificial sweeteners helpful or a hindrance to weight gain? Research is showing both possibilities. Can we see weight gain or weight loss? It could be both. It may depend on the individual. If you’re taking in fewer calories and using an artificial sweetener it could potentially help you with weight loss. The flip side is it can work against you because artificial sweeteners are so much sweeter than sugar is. They train us to like really sweet things. They may even increase sugar cravings. Sometimes when people are trying to stop sugar cravings they eat other things too that have more sugar and drives the calories up. So it might help with actually keeping the sugar amount lower, but it could cause you to eat more. Also when you get something sweet in your mouth, your body thinks it’s getting sugar. Your body prepares for the sugar coming into the intestinal tract by raising insulin. Potentially artificial sweeteners can raise insulin levels. Insulin is the hormone that tells your body to store fat. Much higher sweetness trains you to prefer sweeter things. It depends what you’re doing with the artificial sweetener. My belief is that if you’re going to use them, use the smallest amount possible. There’s no nutritional value of any artificial sweetener. I would encourage you to experiment. Cut them out and see what happens. If you’ve hit a plateau and can’t figure out what’s going on, artificial sweeteners could be part of your solution.

Any sweeteners are not essential nutrients. They exist to nurture your sweet tooth not your body! Our innate desire for sweetness may be interfering with our ability to judge “good” from “bad.” As a general rule you don’t get something for nothing! I would recommend trying to avoid sugar and artificial sweeteners as much as possible.

If you have questions don’t hesitate to contact us here at The Center for Weight Loss Success.  You can bring your questions when you come in. Stop by and get your free body composition analysis done. You want to preserve lean body mass and get rid of the fat. You should be receiving the weight loss tips and weekly recipes. Subscribe to my weekly webinar each Tuesday at 6pm.Remember it’s your life. Make it a healthy one. Have a good evening everyone. Take care.

Parmesan & Garlic Protein Orzo

Posted on June 05, 2019 by

A perfect meatless entrée for your busy nights! 

Ingredients
1 tsp olive oil
2 packets of protein orzo
2 cloves garlic, minced
1 lg shallot or 3 green onions, sliced
2 cups chicken broth
½ cup milk
¼ tsp salt
¼ tsp fresh ground pepper
¾ cup Parmesan cheese, grated
2 cups fresh baby spinach

Directions

  1. Heat oil in skillet and add orzo (uncooked). Stir until slightly browned.
  2. Add garlic and shallots and cook until softened.
  3. Add ½ cup chicken broth until absorbed, then add another ½ cup of broth. Continue until all the broth is absorbed.
  4. Add ½ cup milk and cook until almost absorbed.
  5. Toss in the spinach, salt & pepper. Stir until wilted.
  6. Add ½ cup Parmesan and allow to start to melt.
  7. Divide into bowls and top with remaining cheese.

Makes 2 servings

Nutrition Facts:
Calories                                 355
Total Fat                                 10g
Total Carbohydrates               13g
Dietary Fiber                           3g
Protein                                   41g

Print Recipe: parmesan garlic protein orzo