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Tag Archives: Center for Weight Loss Success

Meal Planning Tips and Menu Ideas

Posted on March 24, 2020 by

Now, more than ever, it’s important to plan your meals and snacks.  If you’re working from home, the kitchen & pantry are just too close for comfort! Really, the last thing you want to get out of your time in quarantine is a larger waistline.

Take the time you’re saving by not commuting and plan your next week or 2 of meals and snacks.  It’s easier than you may think.  Use this handy template or create your own on a whiteboard – whatever works for you!  CFWLS Weekly Meal Planner

Where to start?

  1. Consider how much protein you need for your day.  What is your carbohydrate cap? These are the first 2 things you need to think about.
  2. Make a list of all of the proteins and vegetables in your freezer, refrigerator & pantry. These are things you won’t need to add to your grocery list and a good start for your menu plan.
  3. Find recipes that use the primary ingredients that you have on hand. A great place to start is our Blog page or our Pinterest page. Pick out 4 or 5 to try this week. Most of them are quick & easy and use ingredients that you have on hand or are easy to find. The nutritional information is included but you may need to adjust for serving size if you’re eating less than indicated.
  4. You will want to use the perishables first so look at the proteins & veggies you found in the frig. They will be the key additions to your meals and snacks the early part of your week. I find it easiest to start with dinner (or the main meal of the day) and work from there. Pencil in those meals and you’ve begun!
  5. Fill in the remaining main meals with recipes that contain the items that you found in your freezer and add any missing ingredients to your shopping list.
  6. Breakfasts don’t have to be complicated. Protein shakes, Greek yogurt, cottage cheese and the like can be quick and satisfying options. Stay away from any starchy items in your pantry as they tend to lead you toward a slippery slope when it comes to carbs later in the day. Pencil in your week with healthy options that you have and add any missing things to your list.
  7. I leave lunches until last because it’s a great place to use the leftovers from any previous meals. Figure out what you will have left over and slip it into your lunches for the week.  Keep in mind that the end of the week dinners may slip into next week’s plan.
  8. Snacks will be used to make up the rest of your protein target.  Keep in mind that many of these sources will also have carbohydrates so choose wisely.  Here’s our handy ‘Sack Lunch and Snack Ideas Trifold‘ handout for reference.
  9. Now, before you forget, order those missing items from your local grocery store.  Online shopping has made it easy but keep in mind that the wait time right now is longer than normal. You may need to plan on picking up your items (or having them delivered) will be 2 or 3 days out and some items may be out of stock. (plan for allowances) You can refer to our Low Carb Shopping List for more ideas to keep on hand for next week.

Additional resources:
Low Carb Substitutions for Cooking & Baking
Tips on Cooking and Low-Carb Eating
Baritastic Tips – A Great Tracking Tool!
CFWLS Monthly Menu Planner – for long range planning
Kids lunch and snack handout
Menu planner – 3 weeks – these are done for you but you can switch it up a bit!

Enjoy! This can truly be a fun and rewarding experience and is a great teaching tool for family members. Get the kids involved – they catch on quickly.

Reach out to me with any questions! Dawn@CFWLS.com

Cauliflower Cheese Soup

Posted on March 13, 2020 by

Wholesome goodness – substantial enough on it’s own or serve it with a salad 😊

Ingredients
1 small head cauliflower, broken into flowerets
1 cup shredded carrot
1 stalk celery, diced fine
1 small onion, diced fine
2 cloves garlic, minced
1 cup water
½ cup chicken broth
1 packet protein Cheese Dip mix
½ cup half and half
½ cup shredded cheddar cheese
Bacon bits for garnish
Green onion for garnish

Directions

  1. Cook cauliflower, carrots, celery, onion & garlic in 1 cup of water until cauliflower is tender. Remove from heat and mash with potato masher.
  2. Prepare Cheese Dip mix according to directions for soup. Add to cauliflower mixture.
  3. Add chicken broth and half & half. Return to heat and bring to a simmer. Stir in ½ cup shredded cheddar cheese.
  4. Serve with bacon bits and green onion garnish (if desired).

Makes 4 servings

Nutrition Facts:
Calories                                  165
Total Fat                                   9g
Total Carbohydrates               11g
Dietary Fiber                            3g
Protein                                    11g

Print Recipe: Cauliflower Cheese Soup

Look for this new product in the store!

Chicken Crust Pizza

Posted on March 09, 2020 by

Wow! The protein is in the crust so dress it any way you like it 😊

Ingredients
Crust:
8 ounces chicken breast, cooked and shredded fine
1 egg
1 clove garlic, minced
½ cup shredded Parmesan

Topping: (nutritional info for toppings used here)
2 Tablespoons pesto sauce
¼ cup sliced red pepper
½ cup packed baby spinach
¼ cup shredded Parmesan

Directions

  1. Preheat oven to 400 degrees. Place baking stone on center rack.
  2. Cook chicken and shred or finely chop. You could use canned chicken breast as well.
  3. Mix chicken with egg, garlic and ½ cup parmesan cheese.
  4. Press chicken mixture onto parchment paper (on baking sheet or pizza peal), making it about 1/4 inch thick. Slide paper into oven and directly onto hot baking stone. Bake for 18-20 minutes or until crust starts to brown.
  5. Remove from oven and add toppings. Return and bake until hot and cheese is melted.

Makes 3 servings

Nutrition Facts:
Calories                                 253
Total Fat                                14g
Total Carbohydrates              4.5g
Dietary Fiber                            1g
Protein                                   28g

Print Recipe: Chicken Crust Pizza

Note: This recipe is easily doubled. You can add whatever toppings you like and substitute mozzarella cheese for the Parmesan as a topping. Nutrition values will vary with toppings.

Mentally Preparing for Weight Loss Surgery

Posted on March 02, 2020 by

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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!