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Tag Archives: weight loss hampton roads

Turkey Slider Lettuce Wraps

Posted on September 04, 2020 by

These tasty little burgers make a great appetizer or small plate meal!

Ingredients
1 lb ground turkey
1 tsp lemon zest
1 tsp lime zest
2 cloves garlic, minced
2 green onions, sliced thin
1 Tbls olive oil
1 head Bibb or Butter lettuce
Slivered carrot or herbs for garnish

Directions
1. Mix ground turkey, lemon and lime zest, garlic and onions together.
2. Shape into small 1 ½-2” patties.
3. Heat olive oil in heavy skillet over medium high heat. Place patties in hot oil and cook about 2 minutes or until browned. Flip over and repeat.
4. Serve on lettuce leaves.
5. I generally have small bowls of Sriracha sauce or mustard to add if desired.

Makes 16 sliders

Nutrition Facts:
Calories 60
Total Fat 4g
Total Carbohydrates 1g
Dietary Fiber 0g
Protein 8g

Print Recipe: Turkey Slider Lettuce Wraps

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

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Weight Loss…Simplified

Posted on January 20, 2020 by

The goal is to identify essential weight loss principles that you can use starting today for both medical and surgical patients. I’ll throw in a few “random thoughts” by Dr. Clark telling you my though process. One of my favorite quotes and favorite people, Albert Einstein, said “If you can’t explain it simply, then you don’t understand it well enough.” So, hopefully I can explain it simply.

It often seems like weight loss concepts and principles are significantly different between medical patients and surgical patients. Nothing could be further from the truth. The principles and concepts are exactly the same thing. The weight loss principles for a patient will be the same post weight loss surgery. They just have a slightly different anatomy. The essence of any weight loss plan will always be behavior modification. Change what you do, whether it’s nutritional or activity level. Change (weight loss) will not occur unless you change your behavior. Sometimes we’re waiting for the life around us to change or people around us the change. The reality is that’s never going to happen. If you don’t change, change will never occur. Don’t wait for someone else to change for you.

Energy storage is extremely important for survival. If we couldn’t store energy, we would have to eat continuously. We can store energy in 2 ways. We can store it as fat or we can store it as glycogen. Storing energy as fat is unlimited. We can store hundreds of pounds of fat. Even a thin persona has a lot of fat storage. Even a 200 pound male with 10% body fat has 70,000 available calories. That’s a lot of stored calories! We can’t store very much glycogen (sugar). We can only store about 2000 calories. Most of the glycogen is in the muscle. The muscle doesn’t like to give up any of this energy (it’s kinda selfish). The liver is unselfish. It will share sugar. What’s the problem with this?  The problem is just because you may have a tremendous amount of stored energy as fat does not mean that you have unrestricted access to it. Unfortunately it’s not very accessible.

What do we do here at The Center for Weight Loss Success? We have 2 comprehensive programs. We also have a full fitness center, nutritional store, clinical area, educational classroom, behavior modification classes, weekly live webinars, weight loss meds, Hormone Replacement Therapy, and more. We have a 6 month medical program referred to as “Weight Management University™.” We have a 12 month post-surgical program called, “Weight Management for Weight Loss Surgery™.” Both of these programs are very similar. A lot of the topics in the programs are interchangeable. The medical program has 14 different topics. The surgical program has 12 topics. The difference is how we present them. We put them in different order because they become pertinent at different times depending if you’ve had surgery or not.

The real question is:  how do you do it?? The dietary plan, activity plan, and behavior modification changes don’t take place immediately just because someone has undergone weight loss surgery. There should not be a “cloud of mystique” that surrounds someone who has had weight loss surgery. We didn’t change things by operating on you.

My job is to figure out why someone is overweight. Then, I have to figure out what are the right “things” to do for that individual. Finally, (the hard part), is how that individual implements those things and make them a lifestyle. Part of that is being willing and able to do those things in order to lose the weight. That’s a very important concept and mindset for anyone, especially with weight loss. Some people are just natural athletes. They may have never picked up a golf club. But when they do, they’re able to play pretty darn well. Other people might have to practice really hard but are mediocre at the sport. Is there a difference?  Maybe some of us will never be pro golfers. But if we practice and work at it we will get better. All weight loss surgery does is just exaggerate the “normal” weight loss curve. The normal weight loss curve is this: you go on a specific diet and lose weight. Then you’re weight is going to stabilize. You might regain a little bit. With weight loss surgery you lose weight much quicker, greater weight loss, and it lasts longer. Long term it’s still doing all the same things. One of the “downfalls” of WLS is….it works! Because WLS works so well, people often think they’re doing the right things. You’re going to lose weight the first few months no matter what you do, but if you don’t do all the right things long term you will find that you’re going to start struggling. You need to do all the right things. Weight loss is something we work on forever. It’s a process. You’ve got to do the right things. Are you willing and able to do the right things?

I’ll sometimes see people back in the office several years after having WLS. They’ve gained weight. Or, I see people who were successful in the Medical program but they return because they’ve gained weight back. No one gains weight due to a deficiency of surgery. Some people say they need surgery because they’re gaining weight. Likewise, no one gains weight due to a deficiency of phentermine or any other weight loss medication.  They gain weight because they are eating and/or doing the wrong things. As physicians sometimes we contribute to that. There are certain medications that physicians prescribe that cause weight gain.

The concept of eating is, “How little can I eat and be satisfied.” It’s not, “How much can I cram in there.” The difference between those two thought processes is about 20-25%.  It’s often the difference between losing weight and keeping it off, and gaining weight. Long-term the pattern of eating needs to be 3 meals a day +/- a planned snack. No one has ever starved in 3 hours. If your mind is telling you it’s time to eat something, but it’s not time to eat, drink some water or do something else. Meals should be small plate size. The best food has absolutely no labels. It’s eating green and clean.

The Basics

The “Basics” of the eating plan are calories, protein, and carbohydrates. Everyone has a calorie “ceiling.” If you go above it, you gain weight. It does not mean that if you stay below the calorie ceiling you will lose weight. You can’t survive without protein. Preserving lean body mass is key. We talk about this all the time. The best protein source is from food. Everyone has a carbohydrate “tipping point.” A certain level of carb intake makes insulin levels rise. Insulin turns on fat storage. Some people have a very high tipping point. They can eat just about whatever they want to and never gain a pound. They don’t have a better physiology. They have a more efficient physiology. If what you eat increases your insulin levels. It turns on fat storage. If you eat a mountain of lettuce and it makes your blood sugar go up, it will also make your insulin level go up. One thing you can do is get a blood sugar monitor and check your blood sugar after you eat.

I have a few things for you to “chew” on.  “Kinda” working on weight loss will never help.  You can’t, for example, do a good job during the week and then go crazy on the weekends. If you’re only going to do one thing, count your carbohydrate intake. Carbohydrate is not an essential nutrient and there is no such thing as carbohydrate deficiency. Carbohydrate influences insulin which is the “fat storage” hormone. If you don’t make insulin, you cannot store fat. One of the first symptoms of a Type I diabetic who does not make insulin is that they are losing weight like crazy. They can’t store fat. Two thirds of the population is “carb sensitive.” If they eat carbs they get large blood sugar swings. Large blood sugar swings cause 2 major problems:  symptoms (headaches, irritability, shaky, not thinking clearly) and weight gain.

What do blood sugar swings actually mean?

If your blood sugar level is 100, what does that actually mean? That’s at the higher end actually. We would rather that it be 80. Each of us has about 5 liters of blood in our body. When we say that your blood sugar is 100 mg/dl, that means there is 5 grams of sugar in your entire blood volume. There’s 1 gram in each of those liters. How much sugar is 1 gram? If you have just 5 grams of carbohydrate, in theory you will double your blood sugar. If it was 100, it will jump to 200 after eating 5 grams of carbohydrate.  Examples of 5 grams of sugar (1 tsp): ½ Oreo, 1 triscuit, 1/5 banana, ¼ apple, ¼ slice of bread. I often have patients come into the office and say, “Well I only had…” It only takes a little bit and you’ve doubled your blood sugar. The point of all this is that it doesn’t take much carbohydrate to give you tremendous blood sugar swings.

In review, the Basics of the eating plan include: a calorie ceiling, sufficient protein, and a carbohydrate tipping point. The trick is to figure out the numbers. If you’re a woman who’s had WLS, if you get about 1200 calories you’ll struggle. If you’re a man and get about 1500-1600 calories you’ll probably struggle. Protein is based on lean body mass. It almost always comes around 90-100grams/day. It depends on how big you are. A male with a much bigger frame is going to need more protein. We typically say less than 50 grams a day. Some patients are so sensitive they need to be in the 20-30 gram range to really see good weight loss. What about fat? I’m not concerned too much unless it drives your calories too high. You want to try and stick to the monounsaturated fats. There are good and bad fats. They do tend to influence calories. Fat does not affect the hormones the affect weight. Carbohydrate and protein do affect hormones that affect weight.

The best foods have no labels

The best foods have no labels. Eat just 3 things. We would die without water. Water is the best thing to drink. Get rid of everything else. Good protein sources are meat, seafood, cheese and eggs. They have basically no carbohydrates. Eat colorful vegetables/salad stuff which is typically low calorie, nutrient dense, and fairly low carbohydrate. If it falls outside the “core,” then don’t eat it!

Dr. Clark’s low carb diet simplified (LCDS) is avoiding these three things: starches, “crumbly” carbs, and watching the fruit. Fruit can be the downfall of any weight loss plan. I’ve heard so many people say they eat healthy (including a lot of fruit). Fruit is healthy. There’s no doubt about that. However, it won’t help you lose weight. Healthy and losing weight are two different things. The main starches to avoid are potato, rice, pasta and bread. The “crumbly” carbs (6 “C”s) are chips, cookies, cereal, cake and candy. That includes hot cereal too. It’s simple to understand but NOT easy to do! Simple does not equate with easy.

A good weight loss plan includes a good diet/nutrition plan, activity/exercise plan, and behavior modification. There is no difference between surgical and medical weight loss patients trying to lose weight. The hard part is behavior modification.

We can help you get started! Call us at 757-873-1880 to schedule a free consultation if you are interested in a non-surgical program or watch our free weight loss surgery webinar.

Food Triggers & Dietary Disasters

Posted on January 13, 2020 by

A lot of times emotions can turn on that “feeding frenzy.” Or, sometimes situations will turn it on. Certain foods will call your name. We all seem to have our own triggers. We also have our own cravings. A trigger is something that sets in motion a course of events. Here we’re talking about eating when we don’t necessarily want to eat or should be eating. Eating triggers fall into 3 categories: trigger foods, trigger feelings, and trigger environments.

A trigger food is a specific food that sets off a course of overeating. Is there some food that you can only have a tiny bit and then you need to eat everything in sight? Control is often lost and excessive amounts of food may be consumed. Common trigger foods are usually highly refined foods such as sugar/fat combinations like ice cream. Another common trigger food is salty/starchy combination such as bread, chips, or crackers. I’m not a big fan of diet deprivation. I don’t believe in saying, “You can never eat this…” You’ll typically want it even more if you think you can never have it. If you want it even more it makes it harder to leave it alone. Can we be satisfied with a little bit? That’s what you want to strive for. If there truly is a food that causes you to eat the whole thing (whole bag of chips) then you probably should avoid that food. It’s the food, not the emotion that triggers the out of control eating. It’s not the situation.

Physiologic cravings are real. They tend to be most pronounced with high carb foods such as cookies, breads, pastries, and chips. They usually peak during the first few weeks of dieting. Then they fade. But you can experience true withdrawal symptoms. Carbohydrates are like a drug. If you have a little bit you’re going to want more. The symptoms are worsening cravings, headaches, fatigue, shakiness, and irritability. Once you get through the withdrawal symptoms it gets easier but that doesn’t make it easy. Many cravings are related to blood sugar swings. Every time the blood sugar comes down you’re going to want more because your body wants something to keep that blood sugar from dropping. Consequently you’re going to get a big swing up if you have more of that food. The big blood sugar swings make the cravings even worse. Appetite suppressants can help. Chromium can also help. It’s a mineral and can help smooth over blood sugar swings. You can get it just about anywhere. We sell it here in our nutrition store. On the bottle it will say take one a day as a supplement. Unfortunately that doesn’t work for cravings. Generally you need to take it 3 times a day. It’s very safe but you shouldn’t take a bottle every day!

A trigger feeling is an emotion (good or bad) which sets off a period of overeating. Examples are stress, anxiety, anger, sadness, or loneliness. It often sets off overeating of just about any food (salty, crunchy, sweet, doughy, etc.….). Identifying the emotion is key to controlling these triggers. Journaling is one of the best ways to sort this out. It’s not just writing down what you’re eating. It’s writing down why you’re eating. If you’re hungry and it’s time to eat then that’s a good reason. What if it’s not time to eat? If you’re not hungry, what are the reasons? Am I stressed? Am I excited? Am I depressed? You’ll see a pattern developing.

Trigger environments are specific situations or places that set off an episode of overeating (Movie Theater, buffet, sporting event, socializing with a specific group of friends).  The overeating is set off by the specific environment or situation. Usually you regret it the next day. To manage this you have to identify the specific location, people, or events. Avoidance works, but often that’s not possible. Are you really never going to the movies again? Are you really going to avoid your friends? It’s important to develop strategies to minimize the overeating in those environments. Plan ahead of time what you’re going to do. It’s hard to unlearn things but we have to.

We all have willpower even though we don’t think we do. Some of us need to take it up a notch. Cravings tend to fade with time. They can come back. The internal struggle with cravings leads to emotional pain. It’s often due to indecision. We really haven’t made up our mind. We literally make thousands of eating decisions every day. With fasting you get rid of a lot of decisions. Make the hard and fast decision that you won’t give in to the craving. To weaken the intensity and reduce the craving you must stop giving in to them. It’s easier said than done but it does work. Avoiding the indecision can be very helpful. Willpower is like a muscle. It can be strengthened with practice.

Your Strategies for Improving Willpower

There are strategies for improving willpower. The first strategy is Mindset Changing Techniques. You need to be truthful with yourself. Tell yourself it’s a craving, not true hunger. Is there another reason you’re eating (angry, lonely, tired, and stressed)? Don’t waiver in your commitment. It will get easier with time. We want to imagine the aftermath of giving in. Sometimes when we give in it feels good to eat that sugary food for a few minutes. You might even get a sugar high. But typically, a little later, you’re not going to feel so good. Replace the word can’t with won’t. You always have a choice.  Review your goals and remind yourself why you’re doing this. Why do you want to continue with this weight loss process? If you give in all the time, you’re always going to be at risk for gaining weight.

The second strategy for improving willpower is Habit Changing Techniques. You want to distance yourself from the food you crave. Remove the food or yourself from the scene. Remove the food or distance yourself from the scene. For example, don’t go to the movies for a while. When you go back, don’t revert back to the big tub of buttered popcorn, bring some protein snack along with you instead.  Drink something. Thirst is often confused with hunger. If you drink something you often realize you weren’t hungry. Your body will tell you that you need something. It could be just the water that it needs.  Try to change your mindset. Relax. Set a timer for 5 minutes and concentrate on breathing. Distract yourself: brush your teeth (how many people want to eat after they’ve brushed their teeth?), paint your nails, brisk walk, exercise, call a friend, shower, practice a musical instrument, or work in the yard. Do something that will distract you for a period of time and the cravings will fade away.

In summation, food trigger are all around you. Learn to recognize them for what they are. Develop the strategies to combat them. It will get you that much closer to your weight loss goals! If you need help, we offer counseling for anyone that’s struggling with that. The counselors will figure out a solution for you. Contact us at 757-873-1880 and set up a free consultation to figure out which program or plan fits your needs!

Sabotage Behaviors

Posted on December 16, 2019 by

We’re talking about sabotage behaviors. Often it’s self-sabotage. We are our own worst enemy.  But sometimes it’s others who are sabotaging us.  Eat to live, NOT live to eat. If it were only this easy! Often you “know” what to do, but doing the right thing can be difficult. Why is that? Often sabotage behavior can derail the best intentions.

Sabotage is “the act of hampering, deliberately subverting or hurting the efforts of another.” Another definition is “the deliberate action to destroy property or equipment.” What about the self-sabotaging behavior? Here are some things to think about. Are your goals realistic? If they become unrealistic, typically it becomes easy to sabotage yourself. You might be trying to do too much too soon. For example, if you overdo it with the exercising you could be so sore you can’t move. Now you have to stop working out for several days. That “all or none” mentality does not work. The reality is, we all make mistakes. We need to be able to forgive ourselves as well. There’s the “excuse for every occasion” type of thinking. For example, “I only have a birthday once a year.” There’s always going to be a birthday or festival or something. Relying solely on willpower is another example of self-sabotage. I assure you that doesn’t work very well. Listening to how you feel will help you counteract this, as well as journaling. Thinking about it ahead of time will help you make better decisions. Another good way is writing it down. Journaling is one of the best ways to control what we do. It’s a great way to keep track of what we eat and keep track of what we’re doing. Writing your emotions down can be very helpful. You can ask yourself things like, “Am I truly hungry?” “Why is it I’m hungry?” “Am I angry?”

How do you combat this self-sabotage behavior?

Part of it is setting realistic goals. If the bar is set too  high there’s no way we’re going to get over it. It would be nice to lose 100 pounds. Is that realistic? Can you do it in a year? The goal is going to be different for every individual. Some of it is where we are trying to get in the long run. Secondly, throw away the excuses. Just decide what you’re going to do and do it. Don’t be in a hurry. You don’t have to do it all at once. We all make mistakes. We all fall off the wagon. You need to forgive yourself. Be realistic. This didn’t happen overnight.

Try not to overbuy. We talked recently about the “Costco effect” where we can get some great deals on everything in bulk. That’s wonderful except whenever we buy things in bulk we tend to eat it quicker. This is true with everything.  When you have a lot of it, you tend to overuse it.  When we have only a little bit of something we tend to conserve it. This is true with food too. Overbuying tends to lead to overeating.

Pre-plan your day or week, including meals and activity. Review them frequently. Review at night to see what you could have done better that day. Wake up in the morning and figure out what your plan for the day is. Keep track of your steps daily.

Replace the negative thinking wit what you’re doing right. We tend to beat ourselves up. Negative thinking is never helpful. Realize you made a mistake and do things differently. Most things in our life are recurring themes.

Finally, journaling is one of the most powerful tools there is. Writing things down helps you figure out what works well for you. Without writing it down you’ll never really know where the problem areas are, especially the eating and activity aspect. We often have the concept of thinking we’re doing everything just right. But if you actually right it down you can find areas of improvement. We can all improve. I can assure you of that.

Other people can sabotage your efforts. Some do it purposefully and others do it unconsciously. Unconscious saboteurs appear to be supportive and believe they are being helpful, but they actually knock you off track by acting out of habit. The conscious saboteurs are more obvious. They know you’re trying to lose weight but they try to entice you. “Just one won’t hurt.” “This is the best cookie ever.”  Some people ask you to do something else when they know it’s your fitness time. “Let’s stop by the bar and have a beverage and some food. “ Other people just have a constant discussion about food. I could never understand why someone who’s trying to lose weight would watch the Food channel. Turn it off. Why do you want to torture yourself?! You can be a foodie I guess, but it makes it really hard. When we talk about food, we get hungry.

How do you combat saboteurs?

Recruit people to help with weight loss. Communicate with friends and family assertively. Have responses ready. When someone encourages  you to eat some cake, just say, “No thank you.”  You don’t have to have a big explanation.  Place trigger foods out of sight. I’m not a big fan of saying you can never eat a particular food. The exception to that is for people who have trigger foods. If you’re someone who can’t eat just one potato chip and has to eat the whole bag, then you should avoid that trigger food. Stop being so polite.  “Ok I’ll have a little of this….” “I’ll skip my exercise because I know we haven’t seen each other in a long time.” Try to recruit your saboteur as a support person. If you can’t recruit them, it’s time to spend less time with them.

There are certain situations and events that are saboteurs. The big three are vacations, office life, and holidays. The reality is we’re all going to be part of these things. You can’t just ignore them. Everybody needs a vacation. You should have fun when you go on vacation. Incorporate activity into your vacation. Try some new foods. Search for new protein sources. Keep alcohol in check. There’s a lot of calories alcohol and it turns to sugar very quickly. It also decreases inhibitions so you tend to eat more. Plan your splurges. For example, be careful during the day because you want to go to a certain restaurant at night. Enjoy the splurges and then get right back on track. Deprivation diets don’t work very well.

Office life can be a saboteur. We obviously have to go to work. We have to socialize. You don’t want to hide what you’re doing. If you’re losing weight, people are going to know what you’re doing. If you talk about what you’re doing then you can get support. Everyone is going to have an opinion so you want to be a little careful who you’re sharing things with. Don’t listen to everything they say. Take a walk during your break. Keep healthy snack available. Plan your eating times. There are also unplanned eating times. There should be periods of time when you’re not eating.

During the holidays plan for events and don’t go hungry. Have a plan to socialize away from the food. Take a look at the spread of food so you can “pick your poison.” Keep it to a minimum. Watch the alcohol. It’s a good time to schedule a personal trainer during the holidays. Have someone that is going to hold you accountable and to push you. Don’t go it alone. Find a weight loss buddy. You can support each other.

Here are some tips for success.

Identify sabotaging behaviors you or others might have. It’s very important to figure these things out. The situations are not going away. They are going to be there forever. Review the tools for combating saboteurs and risky situations. Separate yourself from risky situations as necessary. There are a couple of good resource both written by Judith Beck. She’s a psychologist/behaviorist. The first is “The Diet Trap Solution” which is an older book. It’s a really good book about how to change your behavior with eating. The other is “The Beck Diet Solution.”

Right now we have 2 specials running to help you with your weight loss goals.  The first is our 28 Day Weight Loss Plan and the second is our Weight Loss Surgery Reset.  Check them out!

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.

Why is Your Protein to Carb Ratio So Important?

Posted on November 25, 2019 by

Baja Chicken Bowl

Why is the protein to carb ratio so important? Why do we harp on this stuff? If you’ve come into my office to see me you’ve heard me talk about the protein to carb ratio. The protein part is important for a number of different reasons.

Protein tends to be more satisfying. So, you tend to stay full for a longer period of time. It’s also harder to digest. Digestion is work your body has to do. Eating protein increases your metabolism.  Protein increases a couple of hormones that help with weight loss. Those hormones are glucagon and growth hormone, and are stimulated by protein. Protein is really important after surgery because we want to make sure as you’re losing weight you are preserving lean body mass. It’s the combination of the protein and the exercise that helps do that.

The carb part is the antithesis of the protein side. The carbohydrate typically works against weight loss. It stimulates the hormone insulin. Insulin has multiple jobs. Its main job is trying to keep blood sugars normal. It also tells your body to store fat. In a weight loss program you want to be mobilizing fat. You want to keep insulin levels way down. One of the nice things about insulin is that it’s a hormone you have some control over. Most hormones you don’t have any control over. Insulin only goes up in response to blood sugar levels going up. You want to keep your carbohydrate lower and protein higher. Both of those things have nothing to do with calories. It doesn’t mean calories aren’t important. In a weight loss plan you need to be in a calorie deficit. But if we can manipulate hormones, sometimes that’s going to help with weight loss even more.

Creamy Tuscan Shrimp

I’ve seen thousands of patients throughout my surgical career.  You tend to figure out a few things. One thing I see the best weight loss occurs when people get their protein in the 90-100 gram range. It’s typically higher for men (120). With carbohydrate we see the best weight loss when carbs are below 50 grams a day. That’s where we get the protein to carb ratio of 2-1. Protein should be about twice as much as your carbohydrate. We typically see the best weight loss in that ratio. For any one individual the protein could be a little higher or lower. There is a limit to how much protein you should take in because at some point it drives your calories too high. There isn’t any limit to how low your carbohydrate should go. The lower the better. It’s just harder. There’s carbohydrate in lots of foods. The best foods that will keep those carbs as low as possible are generally going to be the colorful vegetables and salad stuff. Both of those are very low in carbohydrate. We literally don’t need to eat any carbohydrate. Your body actually does need some carbohydrate, but it can make the carbs. You don’t have to eat it. The lower your carb intake, the lower your insulin levels, and the easier it is to lose weight.

Every individual has what I call a “tipping point” with their carbohydrate. Most of our surgical patients are very sensitive to carbs. Often times when they drift up and get into that 70-80 gram range I see them start to struggle. Some of them have to be as low as 30 grams a day. Most of them do very well if they can keep it below 50 grams a day.

If you’re looking to lose weight and need some help, we offer the most comprehensive surgical and non-surgical programs anywhere.

If you’re interested in weight loss surgery, watch our online seminar.
Watch a virtual consultation for our non-surgical programs here.

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.

Pumpkin Sausage Soup

Posted on November 01, 2019 by

Perfect for a chilly Fall evening!

Ingredients
1 lb. pork sausage
1 medium white onion, chopped
1 clove garlic, minced
4 cups chicken broth
1 (15 oz) can pumpkin puree
¼ cup half & half
Salt & pepper to taste

 

Directions

  1. Brown sausage with onion and garlic. Drain excess fat and set aside.
  2. In medium saucepan, whisk together chicken broth and pumpkin puree.
  3. Add sausage mixture and stir. Heat over medium high heat until hot and turn down heat to simmer. Add half & half and season to taste.
  4. Garnish with pepitas or toasted pumpkin seeds.

Makes 6 servings

Nutrition Facts:
Calories                       224
Total Fat                       12g
Total Carbohydrates       9g
Dietary Fiber                   3g
Protein                          20g

Print Recipe: Pumpkin Sausage Soup

Note: You may substitute turkey sausage for the pork.

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!