Tag Archives: weight loss center of excellence

Creamy Shrimp with Mushrooms and Spinach

Posted on January 31, 2020 by CFWLS

It doesn’t get much better than this!

Ingredients
1 lb raw shrimp, peeled & deveined
8 oz baby bell mushrooms
3 oz baby spinach
2 Tbls butter
3 cloves garlic, minced
1 tsp dried basil
½ cup chicken broth
½ cup half & half
2 tsp arrowroot powder (or cornstarch)
Salt & pepper to taste
1/2 cup parmesan cheese

Directions
1. Toss shrimp with salt & pepper, sprinkle with basil.
2. Melt 1 Tbls butter in skillet and cook shrimp over medium heat until pink, turning to cook evenly on both sides. Remove from skillet.
3. Melt remaining butter in skillet and add garlic. Saute and add chicken broth and spinach.
4. Combine half & half with arrowroot powder and pour over wilted spinach. Stir mixture until it starts to thicken.
5. Stir in parmesan cheese and cook until cheese is melted.
6. Toss in shrimp and stir to coat.
7. Sprinkle with basil and serve.

Makes 4 servings

Nutrition Facts:
Calories 276
Total Fat 13g
Total Carbohydrates 8g
Dietary Fiber 1g
Protein 32g

Print recipe: creamy shrimp with mushrooms and spinach

Avoiding Holiday Weight Gain

Posted on December 02, 2019 by CFWLS

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 CFWLS

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

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

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

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

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

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

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

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

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

Thanks to Dr. Clark...