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Tag Archives: weight loss

Optimizing Weight and Health by Controlling Your Insulin Levels

Posted on March 25, 2019 by


Today I’m going to give you a talk about some of my thoughts about weight loss and also some of my thoughts optimizing health in the long term. My concept of this has evolved over a number of years. This discussion is pertinent for anybody looking to improve their health or looking to lose weight (whether or not you’ve had weight loss surgery).  This is not just about losing weight. This can pertain to anybody. Hopefully this discussion will help many people.

We’re talking about optimizing health and optimizing weight loss. It’s a new year, so all of us have that somewhere in out “to do” list somewhere.  The essence of any weight loss plan (of health plan) will always be behavior modification.  If we don’t change our behavior then literally nothing will change in our life. We have to do the changing. It can’t be that we’re waiting for everybody else to change for us and that will change our life. That just doesn’t work very well.  We have to change behavior. Change is not going to occur unless you change your behavior! It really is up to you. No matter how you look at it, it’s still a personal responsibility. That’s true for me. It’s true for everyone.

This is an overview. I also call it an Over Simplification. Controlling weight and health, I’ve become convinced, is controlling insulin levels. If we control insulin levels, we control weight and health.  Insulin is a hormone. Its main function is to control blood sugars. When blood sugar goes up, insulin goes up to help keep our blood sugars controlled.  Insulin causes a lot of other potential problems.  It causes the following: water retention, increases B/P, increases chol/TG’s, increases inflammation, increases heart risk, and turns on fat storage (weight gain). If we can control insulin weight and we can control health.  The real question is how do we control insulin??? It’s a hormone you can’t live without. I’m digressing a bit. But if you look back 100 years ago before insulin was available as a medication Type I diabetics (they make no insulin) were pretty much given a death sentence because it was a slowly wasting disease. We want the insulin numbers as low as possible because it worsens so many other health problems. We can control blood sugar somewhat by getting rid of anything that raises blood sugar; keeping calories low, keeping carbohydrates really low and a modest amount of protein.  Subsequently we can control the blood sugars ok without any insulin. Without insulin, you can’t store fat. So, 100 years ago, people with Type I diabetes would just keep losing weight.  Zero insulin is a bad number.

Controlling weight and health is controlling insulin levels.  How do you control insulin? There are 4 ways. There are actually two more that I’m not going to get into too much. We need to control stress and get quality sleep. When we are highly stressed and suffer from poor sleep, cortisol levels go up which results in higher insulin levels. Control stress through deep breathing, exercising, warm bath, or whatever.  But there are four main ways of controlling insulin. Number one is low calories. Insulin levels will come down if you lower your calories. The issue is, if we take calories too low, over time your metabolism will slow down significantly. Cutting calories way back long term isn’t necessarily a doable thing and might not lead to as much weight loss as we would like because of slowing of metabolism. Exercise can be very helpful. The more intense the exercise, the better it works. That’s where high intensity interval training and the weight training comes in. The more active you are, the more controlled your insulin will be. Anyone that has Type II Diabetes should absolutely be exercising. Low carb has got to be the cornerstone of an eating plan to control insulin levels. It’s carbs that influence insulin the most. If you ignore eating low carb, it’s going to be next to impossible to control insulin levels. How low is low? I’ll get into that later. But it is somewhat based on the individual. The fourth way to control insulin levels is intermittent fasting. It works the very best to control insulin levels.  Intermittent fasting means not eating. Two of the reasons it works is because it’s both low calorie and low carbohydrate. There are lots of other reasons it works too.

How do you actually implement these ways to control insulin levels?  Three out of the four have to do with eating.  You can say that diet trumps everything else. We still have to really work on our diet. Words to live by:  eat a small amount of good food slowly. Make that your mantra! If you do that you’ll typically be eating healthy. When I say “good” it doesn’t necessarily mean it tastes good like a candy bar. By good, I’m talking about quality food. Tape it to your refrigerator door or make it your screen saver.

Let’s talk about the “concept” of eating.  This is your overall thought process of eating.  “How little can I eat and be satisfied”, NOT “How much can I cram in there…”  The difference between those two statements is generally a good 20-25%. That’s the mindset. Then we need to look at the “pattern” of eating.  The pattern of eating is the simplest thing to change.  When we’re eating has nothing to do with what we’re eating. I like for people to have a good pattern of eating. That doesn’t necessarily mean it’s a regular pattern. It can actually be an irregular pattern. If you think about it, throughout history it typically has been an irregular pattern. For some individuals, it works really well eating every few hours. I assure you that’s not my patient population.  Forty to fifty years ago that was the norm. The pattern of eating was typically 3 meals a day. That was it. There weren’t a whole lot of snacks because you didn’t want to “ruin your appetite.” Obesity and these health issues weren’t nearly as prevalent. That also meant there were 12 hours after that 6:00 supper. Fasting was typically part of a normal eating pattern 50 years ago. Thousands of years ago fasting was a huge part of it because food wasn’t available. You were lucky if you got one or two meals a day!  It’s figuring out a pattern that’s good for you. Again, it doesn’t necessarily have to be a regular pattern. It might work well for you, but other people not so much. For the surgical patients we often tell them they should eat breakfast each day. There is some rationale to that. But for long term most people get beyond the surgery and feel good and it’s not necessary. But you need to get your protein and hydration in. It’s really hard to do right after surgery. It’s not hard to do long term. Eating when you’re not hungry is probably not such a great idea. Skipping meals is ok unless you just had surgery. Some people need a snack. Others don’t need a snack.

Remember that what we’re trying to do is control insulin levels. It doesn’t matter what you eat. Anything you eat will make insulin levels go up. You need to have time for insulin levels to go back down. If you’re eating every couple of hours, insulin levels never go back down. There is good evidence that the same size meal taken late in the evening versus earlier in the day will stimulate a much more dramatic insulin response.  A much more dramatic insulin response is going to turn on fat storage that much more. Literally the same calories eaten at a different time can affect us significantly. With the Mediterranean diet they have the big meal mid-day and typically light eating in the evening. In the US we have that backwards typically. We’re often having our latest meal later into the evening. If it’s really getting later into the evening you’re getting a much bigger insulin response which turns on fat storage and turns on all the other problems. The pattern of eating is something we have to figure out. It’s simple to change. You’re either eating or you’re not eating. When you make the decision to eat, there are so many other decisions that have to be made; what are you going to eat? How much? What’s the makeup of all this stuff?  The pattern of eating is the simplest to change. But simple doesn’t mean easy.

What should a meal be? A meal size should be a small plate size. It’s true whether you’ve had surgery or not. A small amount of good food slowly. The best food has no labels (non-processed food). That means we prepared it ourselves.  It’s the processing that causes a lot of these problems. Try to avoid processed foods. Purchase it yourself. Prepare it yourself. Get it from the edges of the supermarket.

So what am I going to eat? This is where we have lots of decision making and lots of shades of grey. The basics of any eating plan is looking at three things:  how many calories, how much protein, and how much carbohydrate you’ll be sensitive to. I didn’t say a whole lot about fat. Fat will influence your calories. Fat also has minimal influence on insulin. I don’t recommend “high protein” diet. High protein actually stimulates insulin levels significantly.  The trick is figuring out the numbers. There’s always a calorie ceiling. If we go above a certain number of calories (for every person it’s different-no matter what you’re eating) you’re not going to lose weight. There’s always a calorie ceiling.  No matter what we eat it will influence insulin levels.  But carbohydrate raises it the most. Just because you stay below that calorie ceiling doesn’t mean you’ll lose weight. It just means you’re not gaining weight. That’s all.

We can’t survive without protein. Your body is utilizing it second to second, day to day for everything that’s happening.  It’s used for heart beating, digestion, breathing, growing hair, etc.… If we don’t take in enough protein each day, your body is going to steal what it needs from your lean body mass. If you’re breaking down lean body mass, you’re slowing your metabolism down.  Lean body mass is what drives our overall metabolism. The more lean body mass you have, the higher your metabolism.  How many calories does a pound of muscle burn? It depends on how well trained it is. In an elite athlete, a pound of muscle is burning calories like crazy. World class athletes can eat 7-8000 calories a day.  Couch potato muscle doesn’t burn much! Muscle burns more calories than fat. The better trained the muscle mass, the higher your metabolism.

Everyone has a carbohydrate “tipping point.” That means that at a certain level of carbohydrates your insulin levels will jump up. When insulin levels go up, you retain water and store fat like crazy. It turns on fat storage. When you turn on fat storage you’re not going to lose weight. You can figure out what your tipping point is, but it’s not easy to do. The healthier the carbohydrate and less processed, your tipping point will be higher.  If you’re exercising your tipping point will be higher. If you’re not very carbohydrate sensitive you’re tipping point will be higher. There are people who aren’t carb sensitive who eat a lot of carbs and don’t gain weight.  They just have a more efficient physiology. If it only takes a tiny amount of insulin to make your blood sugar decent then you’re not going to turn on fat storage.

Here are some things to “chew” on. “Kinda” working on weight loss does not work. You need to be all in. If you’re only going to do one thing—count your carbohydrate intake. It gives you the most bang for your buck. There’s no such thing as carbohydrate deficiency. Since carbohydrate is not an essential nutrient and they do significantly influence insulin, try to get the carbs as low as possible. 2/3 of the population is carb sensitive.  Close to 95% of my patient population is carb sensitive. Many of those people are also insulin resistant. It’s like a stepping stone; Carbohydrate sensitivity to insulin resistance, to diabetes type II. This means when you eat just a little bit of carbohydrate you tend to get very large blood sugar swings. What should happen is the blood sugar goes up a little bit after eating carbs. The insulin levels only go up a little bit. If your carbohydrate sensitive, what tends to happen is a delay with the insulin.

It’s supposed to kick in but it doesn’t. Subsequently, you get a huge blood sugar swing. Then the blood sugar plummets. The insulin is chasing the blood sugar around all day. The blood sugar swings tend to cause symptoms: headaches, irritability, not thinking clearly, and weight gain. Weight gain comes from the blood sugar swing up which causes a big release of insulin. Insulin turns on the fat storage. The treatment is to not get the upswing. If you don’t get the rise up, you don’t get the fall. People who are fasting keep their blood sugars rock even. It’s only when you start eating that things get out of whack.

Many doctors, clinicians, and dieticians don’t understand this probably because they haven’t thought about it. The concept is very straight forward.  A blood glucose of 100 is the highest end of normal. Ideal range is 65-85. If your blood sugar is 100, what does that actually mean as far as how much sugar is in your blood? It’s only a tiny amount. We each have about 5 liters of blood in us. So if we say your blood sugar is 100, how much sugar is in your entire blood stream? The answer is 5 grams. That’s a miniscule amount. It’s the amount in a sugar cube. If you’re sensitive to carbohydrate, it only takes a tiny amount to get a blood sugar swing. 5 grams is ½ an Oreo, 1 Triscuit, 1/5 of a banana, ¼ apple, or ¼ slice of bread. If you have just one of those food items, you’re potentially doubling your blood sugar. A tiny thing can have major implications with your health. If your blood sugar is 80, that’s only 4 grams. If you eat ½ an Oreo, you’ve more than doubled your blood sugar. If you’re sensitive to carbohydrates (2/3 of the population is), it only takes tiny amounts to throw this out of whack. This turns on all those health problems.

The “core” of the eating plan is what you need to concentrate on.  The best food has not labels. We fix it ourselves. We get it from the perimeter of the grocery store. Eat just 3 things.  Number 1 is hydration. Water is the best thing to drink. Get rid of almost everything else. Number 2 is good protein sources. We would die without protein. The best sources are meat, seafood, cheese, and eggs. They are protein with no carbohydrates. This is considered adequate, not high protein. High protein will make insulin levels go up high. The whole concept is preserving lean body mass that keeps your metabolism decent. Number 3 is the vegetable/ salad stuff. It’s unprocessed food. No one ever gained 100 pounds eating too much broccoli. They’re low calorie, nutrient dense, and fairly low in carbohydrate. If it falls outside the “core”, don’t eat it! Easier said than done. The concept is simple but not easy to do.

The other end of the spectrum is the processed carbohydrates. This is the low carb diet simplified (LCDS). There are 3 things: the starches, the crumbly carbs and fruit. Fruit can be the downfall of many weight loss plans. It’s not because it’s not healthy, but it has a lot of sugar. It can turn off weight loss because it can affect insulin. Remember that eating healthy doesn’t correlate with weight loss. They’re two different things. The starches are potato, rice, pasta, bread, and corn. You really want to avoid the processed foods. The crumbly carbs (what I call the 6 “C”s). They are chips, cookies, crackers, cereal, cake, and candy. Get rid of them. Simple to understand, but not easy to do.

I’m going to give you the Basic Health Strategies that I encourage everybody to do. I try to do these things myself but I’m not perfect at it. I’m not willing to tell you to do something that I’m not willing to do.  The first is monitoring.  The scale is the best monitor we have. Weight yourself routinely. I encourage people to weigh themselves daily. I know everyone else out there from your dietician to your other physicians say not to weigh yourself every day because weight fluctuates up and down and you don’t want to be disappointed. The best time to weigh yourself is early in the morning. Get in the routine of weighing yourself every day. The reason is not to just look at the number, but you need to reflect on the past 24 hours. What happened or what did you do differently the past 24 hours that affected your weight? It’s relatively easy to look back on 24 hours. It might be as simple as you ate more salt the day before or you didn’t have a bowl movement. Very likely it could be too many carbohydrates which caused too much of an insulin response. The insulin caused you to retain water. It’s more difficult to reflect on a week or two.

The second basic health strategy is eating. Think “how little can I eat to stay satisfied”, not how much can I cram in there! Everyone has a carbohydrate tipping point where they struggle. The core of your eating plan is hydration (water or something that’s natural with no artificial sweeteners or flavors), protein, and veggies. Significant evidence has shown that diet sodas (even without carbs) will make you gain weight because there’s a significant insulin response. It’s not that it affects your calories or blood sugar necessarily, but what does it do to insulin? The insulin effect is the key.

Exercise absolutely helps with controlling insulin levels. The more intense, the better off you are. The biggest misconception is thinking that you need to exercise longer. But you need to increase intensity, not duration. You can get a tremendous workout in 20 minutes. There are a lot of examples out there. Nobody has to go to the fitness center for 1 ½ hours. This can be done at home in your own time.

Sleep is important because of cortisol levels. If you have poor quality of sleep, you’re typically going to struggle. Control stress. When it is out of control we struggle with our weight and health.

Intermittent fasting (IF) can be a tremendous addition to any health plan. Fasting is not starvation. They’re two different things. Starvation is something forced on us that we don’t choose to do and we don’t know where our next meal is coming from. Fasting is something we choose to do. We know when our next meal is coming, we just choose not to have it. Your body’s response is completely different. The hormonal changes that happen with IF actually work to improve health and decrease weight. Growth hormone goes up. The reality is we all fast when we go to sleep at night for about 8-10 hours. The world record for fasting is 382 days. The point is that it can be done safely and for an extended period of time. The question for each individual is how long to do it and how often. I can help you figure that out.

The final health strategy is personal responsibility. No one can do it for you. You have to decide you’re going to do this and then actually do it. It’s nice to talk about it and have support but you have to do it.

A few resources before I wind this down.  The Art and Science of Low Carbohydrate Living is a good book about how carbohydrate works.  It’s written by Stephen Phinney and Jeff Volek. Stephen is a physician and PhD. Jeff is a researcher and he’s at the University of Ohio. They’re very smart guys who live this stuff. Dr. Phinney has studied this for 30 or 40 years now! They have a second book called The Art and Science of Low Carbohydrate Performance. This book looks at how you can actually improve athletic performance with low carb. 15 years ago we talked about carb loading. But you don’t need to. You can improve athletic performance with low carbs. A very good book by Dr. Jason Fung is The Complete Guide to Fasting.  You can get them on Amazon.

If you think of questions, just pick up the phone and call the office (757-873-1880). Don’t hesitate to send us an e-mail. Our address is:  www.cfwls.com  If you’re contemplating surgery know that more occurs than just having a smaller stomach. There are hormonal changes. The ghrelin levels go down which helps with controlling insulin levels.

Our nutrition store is open to the public. Come by and see us. Thank you for listening. Hopefully this was helpful. I apologize for dragging on a lot longer than I thought I would. This is important stuff. This is an overview of weight and health. Controlling weight and health long-term is controlling insulin levels.  Thanks for listening. I’d love to hear from you. Take care. Have a good day.

Greek Chicken Salad

Posted on August 24, 2018 by

An abundance of flavor and beautiful too! 

Ingredients

Salad:
4 (1 lb) chicken breast halves – shredded or chopped
1 avocado – sliced
½ red onion – thinly sliced
½ cup kalamata olives – pitted and quartered
6 oz. jar (oil packed) sun dried tomatoes – drained & sliced
1/3 cup crumbled feta cheese
¼ cup pine nuts

Dressing:Greek Chicken Salad
1/3 cup olive oil
½ cup Greek yogurt – plain & 0% fat
¼ cup reduced fat mayo
½ tsp salt
¼ tsp black pepper
½ tsp garlic powder
1 tsp dried dill or ¼ cup fresh dill – chopped
1 Tbls white wine vinegar
Juice of 1 lemon

Directions

  1. Combine all dressing ingredients. Whisk well and set aside.
  2. Combine all salad ingredients in large bowl. Pour dressing over the top and toss well to combine. If preparing in advance, add avocado just prior to serving.

 

Makes 8 servings

Nutrition Facts:
Calories                                 316
Total Fat                                22g
Total Carbohydrates          7g
Dietary Fiber                        5g
Protein                  28g

Print Recipe Greek Chicken Salad

 

Adapted from Allrecipes.com

How Does Magnesium Help With Weight Loss?

Posted on July 23, 2018 by

Magnesium is a mineral and everyone needs it. Is it a “magic bullet?” Maybe not quite but just about everyone can benefit from taking it. Most people don’t get enough magnesium. It’s very likely that if you got your blood levels checked your magnesium would be normal.  It’s not your blood that needs magnesium.  You need it in your tissues. Magnesium plays an essential role in over 300 bodily functions.

-You can’t produce ATP (energy) without magnesium. It’s essential to build strong bones.
-It also helps the formation of insulin-like growth factor, which is very important in muscle growth.  So, we need it for growing muscles.
-It also helps improve stress hormones.
-It increases serotonin levels which helps with better sleep.
-It helps with overall relaxation and helps improve mood.
-It is very important for muscle relaxation. If you’re prone to muscle cramps or if you have a hard time going to sleep and can’t relax, magnesium can help.
-It’s also important in regulating blood sugar.
-It decreases inflammation, improves immune function, and improves and relieves constipation. -Magnesium is the working ingredient in Milk of Magnesia.

One of the things that can decrease your overall magnesium is caffeine.  Phosphoric acid decreases magnesium.  It’s in almost all sodas and steals magnesium so it’s not available in your tissues. Alcohol and chronic stress also steal magnesium.  Some things we can avoid but others we can’t completely avoid.

The bottom line is that almost everyone can benefit from extra magnesium. So, how much or what should someone take?  I encourage people to start with 500mgs a day. You may want to slowly increase that, especially if you’re prone to muscle cramps and tight muscles. You can take massive doses of magnesium as long as you have decent kidneys.  So if you have kidney problems or poor kidney function then you do have to be careful with magnesium.  If you don’t have kidney problems you can take big doses because your body will get rid of it if you get an excess.  The way it gets rid of it is—well it relieves constipation! If you do have constipation just start taking 500 mgs of  magnesium  a day and just start increasing that.

Each day you can slowly go up. You’ll get to a level that keeps things regular for you. If you take too much, you’ll get loose bowl movements but that’s about it. I take about 1000 mgs of magnesium every day. If I stop taking it for a few days or I miss a few days I’m really prone to muscle cramps. If you’re prone to muscle cramps you know what I’m talking about.  It’s misery! Magnesium probably isn’t the cure-all but it does help with better sleep, better mood, lowers stress, improves energy, improves flexibility, and prevents cramps.  What’s not to like!?

And yes, we carry it in the Nutritional Store here at CFWLS!  You can pick it up the next time you’re here or order it at: Mag-Potassium Aspartate – 100 Tabs

What If I Can’t Find a Qualified Bariatric Surgeon or Comprehensive Follow-up Program in My Area?

Posted on July 16, 2018 by

2017-03-29_16.59.40_smallerIf you cannot find a qualified bariatric surgeon or comprehensive follow up program in your area, you will have to either compromise what you want/ need or continue your search until you find the surgeon/program that will meet and/or exceed your expectations.

A few experienced surgeons offer a travel program for surgery.  At the Center for Weight Loss Success, we offer such a program for appropriate surgical candidates.  Not only does the program include surgery with arguably the most experience bariatric surgeon in the United States who has performed over 5,000 weight loss procedures, but it also includes our comprehensive Weight Management University for Weight Loss Surgery™ program.  In addition, it is one of the most affordable options available in the United States.  You can learn more about it at www.cfwls.com

The bottom line is that you have to be comfortable with your choice.  We are fortunate to have many excellent bariatric surgeons in the United States.  Your long-term success is the most important thing under consideration here.  I hope this book has helped to inspire you, answer your questions and better prepare you for an amazing journey.  Only you know if this journey is something that is right for you.  If we can be of further assistance in any way, please let us know at success@cfwls.com.  If you desire additional information and would like to view helpful videos that address each of these questions, please visit our main website at www.cfwls.com or at www.myweightlosssurgerysuccess.com.

CFWLS-Rhonda-09-

Rhonda’s Opinion:  Travel to the surgeon/program of your choice – it’s all worth it!

How Do I Find a Qualified Weight Loss Surgeon?

Posted on July 09, 2018 by

NEVER UNDERESTIMATEThe search for a qualified weight loss surgeon can be completed in a number of ways.  Some of the more common methods include:

  1. Personal referral from someone you know
  2. Referral from your primary care practitioner
  3. Online search
  4. Author/Expert Publication such as a journal or the book you are reading
  5. Local marketing (i.e. radio, billboard, TV, newspaper or other publication)

Remember to ask the questions reviewed in my previous blog.  Evaluate the available options and select the surgeon, staff and program that will best fit you and your needs.  This is a decision that requires careful consideration.  Talking to someone who has already had surgery with the surgeon you are considering is often very helpful.

You will want to attend an on-site seminar with the surgeon (not just his/her assistant or office staff).  This is a great way to get to know the surgeon, learn about the various procedures he/she performs, their particular outcomes, the comprehensive program they offer, get to meet their staff and learn more about your options.  If you are unable to attend an on-site seminar, many surgeons also offer a comprehensive online webinar such as the one on our website at www.cfwls.com.

kevin

What Questions Should I Discuss with My Primary Care Doctor?

Posted on July 02, 2018 by

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

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

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

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

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

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

Posted on June 25, 2018 by

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

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

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

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

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

CFWLS-Rhonda-09-

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

How Do I Guarantee My Results After Weight Loss Surgery?

Posted on June 18, 2018 by

everydayThis is a great question and one that isn’t asked often enough.  Understandably, your initial focus is usually on researching the available surgical options.  After that, your next focus tends to be who will perform your surgery, where your surgery will be performed and how much it will cost.  Unfortunately, the focus doesn’t usually turn to one of the most important considerations – what you need to do to guarantee your results after weight loss surgery.

The reality is that everyone loses weight after weight  loss surgery (particularly with the gastric bypass and sleeve gastrectomy procedures).  It’s exciting!  It’s rewarding!  It’s awesome!  But…eventually…your weight loss slows down and you will plateau.  Don’t despair, with proper support and guidance, you can get through plateaus and the final plateau will ideally be somewhere just above your ideal body weight.

This occurs, especially if you use the time after surgery (particularly the first year) to not only lose weight, but learn how to modify your mindset and your lifestyle habits…for good!  If you do this, your potential for true long-term success is exponentially increased.  Remember, weight loss surgery is a tool to lose weight.  If you don’t fully understand how to properly use your tool, your results can be compromised.  Instead, why not optimize your results?  This is where your post-operative comprehensive program comes in.  Don’t skip this important aspect of your research process prior to surgery.

This may be disheartening to hear because you might think of weight loss surgery as a guarantee.  Don’t get me wrong, I see success each and every day and it is truly amazing!  However, weight loss surgery is not a magic bullet.  Long term success requires long-term changes.  Don’t worry though.  With proper comprehensive support, this process is not only rewarding and fulfilling, it is actually fun!

So…What should you do after weight loss surgery to guarantee your results?  This was reviewed somewhat in Chapter 10 but I am going to expand this explanation.  I will begin with identifying the most common things you should be doing and then I will take a slightly different approach and share with you the five most common culprits to poor/slower weight loss or eventual weight re-gain.

In addition to the actions described in Chapter 10, your post weight loss surgery steps to success should include:

  1. Don’t miss your post-operative visits with your surgeon. It is important for him/her to monitor your recovery and progress.  Sometimes people avoid their visits because either they are feeling so great, they don’t think they need to be seen or they are struggling and too embarrassed to see their surgeon due to a perceived sense of failure.  Unfortunately, this is the time you REALLY need to come in for your visits.  If you feel great, you can confirm your progress and celebrate even more.  If you are doing well, your surgeon WANTS to see you and celebrate with you as well.  If you are struggling, your surgeon WANTS to see you to help you identify the reason(s) why you are struggling.  It is best if this occurs as early as possible so you can take necessary actions to get back on track as soon as possible. You are not alone and recommendations can usually be determined quickly.  You can leave with a plan in hand and the confidence you need to master the use of your new tool and get back on your path to success.
  2. Don’t miss any scheduled visits with your primary care provider. This is particularly important if you are on any medications that need to be adjusted as you lose weight (i.e. hypertension and diabetes medications).
  3. Don’t miss any scheduled visits with your team of weight loss coaches. Included in comprehensive programs such as the one offered at the Center for Weight Loss Success, you will also be coached by a dietician, weight loss coach and/or personal trainer.  These professionals help you navigate the specific barriers or situations that may impede your optimal progress.  They will also keep you on track and guide you through this life changing experience.  In addition, your team loves to help you celebrate your success and assist you to avoid pitfalls and create new habits that keep you headed in the right direction.
  4. Make the most of the educational materials provided to you before and after surgery. At the WMU4WLS hardcover 2018 whiteCenter for Weight Loss Success, you receive a comprehensive  pre-operative and post-operative learning series called Weight Management University for Weight Loss Surgery™.  This program is reviewed at your office visits guides you each step of the way for the first 12 months after surgery.  Each monthly module explains what to expect that month, what to expect the next month, success stories, recipes and educational materials explaining what you need to know.  They also include information regarding nutrition, metabolism, fitness and other topics that assist you to attain your optimal success.  The modules are supported videos in your membership site and homework assignments that help put it all together.  This comprehensive system is well received by patients.  By the end of your first year after surgery, you will feel as if you have earned a new degree in weight loss surgery!  No matter what learning method you prefer, all bases are covered so dive on in and enjoy!
  5. Attend the support group provided by your experienced surgeon/center. These are generally offered in a group setting and often supplemented with online support as well.
  6. Surround yourself with positive and supportive people who have healthy behaviors. Beware of saboteurs.  There will usually be someone at work or at home who intentionally or unintentionally attempts to sabotage your new way of life.  Sabotage comes in many forms.  Here are a few strategies for dealing with the most common types:
    • Self-Sabotage: Hard to admit, but sometimes we are our own worst enemies. Do you have an internal dialogue that sounds like a tug of war between something you want to do and a rationalization as to why you can’t possibly do that today (better known as excuses)? It all starts with a realistic goal, a realistic plan and realizing that you are in control of your own behavior.  Try replacing the word “can’t” with the word “won’t” the next time that happens and your “self-talk” will begin to change!
    • Family/Friends: You like to think they are all supportive but the reality is that those we count on the most for support are often the ones encouraging a “treat”, “celebration”, “one more bite” or those trigger foods that you can’t say no to. The truth is that you are vulnerable right now and they need to understand your dedication to your goal.  You may need to have a “heart-to-heart” asking for their support. Be assertive, keep your goals handy, put treats out of site or give them away, focus on activities rather than food events.  At parties, focus on conversation and go in with a plan of attack you know you can stick to.
    • Vacations: Time away should be a time to enjoy and relax. However, be careful about your sabotaging thoughts to “let loose”, “do nothing” or “blow it out for the week”.  You can have fun in moderation, incorporate a new sport or activity, enjoy new foods (focus on protein, new vegetables or fruit) and feel great by working in a long walk, run or visit to the fitness center at that great resort!
    • Office Life:  Why is it that your office has to celebrate every event with cakes, cookies & donuts?  Let your co-workers know you are trying to get healthier and welcome them to join you.  Start a new office healthy thinking initiative. Avoid trips to the snack-laden break room and take your break outside.  Make a point not to eat at your desk or if you have to, only bring things you know fit into your plan. Keep a stretch band or small weights at your desk to use.  You could use eight different muscle groups in an eight-hour day!
    • Holidays/Parties: We need to celebrate life!  It can be done though without all of the focus being on food and/or alcohol (which diminishes our sense of control).  Plan for the event ahead of time and don’t go hungry.  You will be less tempted. Plan on picking one or two special food items, giving yourself permission to sample what is there…you don’t want to feel deprived.  Keep your alcohol consumption absent or to a minimum and stay hydrated with water with a twist of lemon or lime.  Hold your drink in your dominant hand to avoid picking at food and talk to others…it’s harder to eat while you are talking.

You can overcome these problem areas!  Make sure you identify what is risky for you so you can have a game plan to combat the situation(s).  Don’t prevent yourself from enjoying life but sometimes (especially early on in your weight loss until new habits are developed) it is easiest to limit exposure, make small strides, build your confidence and then celebrate your success!

Another way to look at how to achieve long-term success is to know and understand the most common reasons you might not get the results you desire and what to do about them.  Below are the five most common culprits to poor/slower weight loss or eventual weight re-gain:

  1. Depression – Emotional health is as important as physical health.  Although depression is not a problem for most after surgery, it can be a significant deterrent to optimal weight loss.  It is important to identify depression (admit that it is ok) and seek appropriate treatment so you can move on with your weight loss journey.
  2. Not Exercising – We require each of you to complete a fitness evaluation with a personal trainer which is included with the program.  The reason for this is because we believe some form of consistent exercise is essential for optimal success.  You should determine what form of exercise is right for you and begin your exercise plan before surgery.  We cannot over-emphasize the importance of this factor.  Although most find it difficult to begin an exercise plan, those that take that plunge never regret it.  It can only enhance your weight loss experience and progress.
  3. Drinking High Calorie Liquids – Many do not realize the excessive amount of sugar and calories contained in some liquids (i.e. Gatorade, Juice, Soda).  As a result, you may “waste” calories on such liquids.  This can significantly impede your weight loss.  It is better to choose water, water with lemon, Fruit2O, Crystal Light or other low or no calorie drink options.
  4. “Grazing” – After the first 2 months or so, you should have progressed to three meals per day with some higher protein snacks in between.  If not, you may develop the habit of “grazing” or eating throughout the day.  If this is the case, you tend to take in a significantly higher amount of calories throughout the day (more than what your body needs).  This will slow down your weight loss and can potentially cause weight re-gain.  Please guard yourself against such habits.
  5. Eating and Drinking at the Same Time – When you eat and drink at the same time, the food is “washed through” the stomach quickly.  It is important to hydrate yourself by drinking a low/no calorie beverage approximately 30 minutes prior to eating.  In this way, your hunger will be decreased.  When you eat, you should not drink at the same time.  As a result, your “pouch” will remain fuller for a longer period of time.  Thus, you will remain satisfied for a longer period of time.  Be sure to stop eating before you truly feel “full”.  It is a slow communication from your stomach to your brain to indicate a feeling of fullness.  Thus, you may overeat and realize it too late.  This can be a very uncomfortable feeling.

So although you may be focusing on the surgery itself, you will be doing yourself a big favor by not neglecting your post-operative plan.  Use these tips and don’t forget to enjoy this journey of self-discovery.

CFWLS-Rhonda-13- 

Rhonda’s Opinion:  Make yourself a priority and it will work.

Will I Need to Take Vitamins and Supplements After Weight Loss Surgery?

Posted on June 11, 2018 by

I Can & I WillYes, you will need to take vitamins.  Supplements are helpful but not a requirement.  Actually, whether or not you have weight loss surgery, you should be taking vitamins.  Supplements can be helpful as well, especially if you are trying to lose weight.  You should also make sure your vitamins/supplements are pharmaceutical grade so that the quality of their content is monitored and guaranteed.  The nutritional store at the Center for Weight Loss Success only carries such vitamins and supplements and our patients love them.  (www.cfwls.com)

The common vitamins that will likely be recommended for you (may vary depending upon the surgeon) include the following:

Multivitamins: Taking vitamins will be a lifelong commitment for all patients who have had weight loss surgery.  In the beginning, you should take two chewable complete multivitamins each day.  At one month after surgery, you may be able to progress to taking two regular vitamins daily.  We recommend two vitamins each day during the first year when your weight loss is most rapid.  After the first year, you should continue to take one multivitamin a day.  Women may want to consider a prenatal vitamin if pre-menopausal.

B-Complex: Usually around 1 month after surgery, we recommend that you also add one B-Complex vitamin each day (or even 2 per day).  The B vitamins assist in muscle and nerve functioning and have been shown to increase a person’s energy level over time.  You cannot overdose on B vitamins.  If you take in more than you need, you will simply rid yourself of any excess through your urine.  It is common for B vitamins to cause your urine to be darker or a brighter yellow.  This is normal.  If you prefer, B-Complex is also available as an injection at the office as appropriate.

Essential Fatty Acids (EFA’s):  Take them – they’re just good for you.  By taking fish oil supplements, Omega-3 fatty acids are ingested in their biologically active form.  They can be directly used to support cardiovascular, brain, nervous system, and immune function.  The mini-soft gels are smaller and have a natural lemon flavor to prevent a “fishy” after taste.  Our product is ultra-filtered to guarantee removal of mercury and other possible contaminants.  Most people should take 2-4 soft gels per day.  They are also helpful to prevent constipation.

Magnesium-Potassium: During weight loss your body will tend to waste both magnesium and potassium.  Both of these minerals are essential to normal muscular and cardiovascular function.  Magnesium is involved in over 300 biological reactions throughout the body.  It can help prevent/treat fatigue.  If you are prone to muscle cramps – you need to add this supplement.  Typical doses are 1-4 tablets daily with food.

Will I Have to Exercise After Weight Loss Surgery?

Posted on June 04, 2018 by

fit for lifeThe short answer is “Yes”.  Exercise is extremely important following weight loss surgery because you will be losing weight at a rapid pace.  Your body will try to fight this weight loss by attempting to store fat for this perceived starvation.  Your body does this by burning muscle mass and storing fat.  This is undesirable.  To combat this effect, it is important to exercise regularly so that your metabolism is increased and your body burns fat rather than muscle mass.

If you decide to have weight loss surgery, you should seize this opportunity after surgery and integrate activity/exercise into your daily routine. This will not only help you through any plateaus, it will help you build muscle, enhance your metabolism and overall energy, and greatly influence your overall success.

I encourage walking beginning the day of surgery to improve circulation.  Early walking forces the heart to pump blood throughout the body and prevents it from pooling in your legs which could cause clots that are potentially life threatening.    The more walking you can do, the better.  We ask that you avoid lifting heavy weights or doing sit-ups/abdominal crunches until you are at least 4 weeks from your surgery.  Prior to that time, you may ride an exercise bike, or swim (not until 2 weeks from your surgery).  When you choose your particular exercise program, make sure it incorporates weight training along with some form of aerobic/cardiovascular exercise.

Most everyone knows the benefits of exercise – it’s just doing it that is difficult.  We all can find excuses (not enough time, not enjoyable/boring, inconvenient, lack of resources, don’t know how, etc…).  The bottom line is that you must make time for exercise and make it a priority.  This is easy to say, but hard to do.

The benefits of exercise are many.  Some of these benefits include:

  • Decreased appetite
  • Decreased blood pressure
  • Decreased stress level
  • Reduced risk for development of heart disease
  • Reduced risk for colon and other cancers
  • Reduced depression and anxiety
  • Improved balance and independent living
  • Improved digestion
  • Improved self-esteem
  • Improved flexibility
  • Improved energy levels
  • Improved sleep pattern
  • Improved sexual satisfaction
  • Improved overall quality of life

So you may logically understand the benefits of exercise.  If you still choose not to exercise, you must ask yourself “why?”  Determine your roadblocks to exercise and then identify solutions to the roadblock.  Once you “get the fever” for exercise after doing some form on a regular basis, you will wonder why you didn’t do it earlier.  If you choose weight loss surgery, you are making a life changing decision.  Maximize the benefits of this decision and commit to a regular exercise program.  You will not regret it.  Your weight loss will be enhanced and your overall quality of life improved.

It does take time and effort to get started.  In addition, after you have had surgery, you may have some feelings of fatigue for the first one to three months after surgery.  Until you can begin a more vigorous exercise program (4 weeks after surgery), walk as much as possible.  If you are unable to walk due to a health problem/disability, perform as much upper body exercise as you can tolerate using light weights (until 4 weeks after surgery).  If you have cardiac/respiratory problems, be sure to obtain clearance for starting an exercise program from your primary care physician and/or specialist.

Choose a fitness program that will work for you.  It should be tailored to your specific needs, abilities, preferences and activities that you will enjoy.  Otherwise, you will be tempted to quit.

Remember that at the Center for Weight Loss Success, we love making fitness fun and specialize in starting wherever you are.  We work privately with our patients and offer three personal training sessions as a part of their Weight Management University for Weight Loss Surgery™ program.  Our certified trainers love working with clients at all levels of fitness.  You can also participate in our Group Fitness classes as a part of your program.  Remember, you are not alone.  Please use these resources available with your experienced bariatric surgeon/center to enhance your weight loss and improve your overall health and metabolism.

walking_feetWhen starting a workout program, take it easy.  Be sure to gradually work up to at least 30 minutes of vigorous exercise three or more times a week.  Stick to it and strive to make exercise a habit (usually considered a habit once performed regularly for at least three months)!  You won’t see dramatic changes overnight but you will see dramatic changes over time.

When you exercise, be sure to warm-up prior to the activity and cool down/stretch after the activity.  Do not lift too much weight (increase weight gradually), and remain hydrated – be sure to drink water before and after your workout.