Weight Loss Surgery May Prevent Diabetes

Weight Loss Surgery May Prevent Diabetes

February 03, 2013

For people who are extremely overweight and likely to develop diabetes, surgery may be the best form of prevention.

weight loss surgery in florida

weight loss surgery in florida

A new study shows that weight-loss surgery not only produced sustained weight loss in obese men and women but substantially reduced their odds of developing Type 2 diabetes. Over the course of a roughly 15-year period, those who had one of three types of bariatric procedures were 80 percent less likely to develop the disease than people who tried losing weight with diet and exercise advice from their doctors.

In fact, those who had the worst blood sugar levels at the start of the study, putting them in a high-risk category called prediabetes, benefited the most from surgery. Their risk of becoming diabetic fell by nearly 90 percent.

“The message is that bariatric surgery works,” said Dr. Claude Bouchard, an author of the study and a professor at the Pennington Biomedical Research Center in Louisiana. “You can take people on their way to becoming diabetic, and you intervene with bariatric surgery and weight loss, and you have a very, very strong protective effect against Type 2 diabetes.”

The findings add to a growing body of literature supporting bariatric surgery as a means for combating diabetes. This year, two studies showed that for people who are obese and already have diabetes, weight-loss surgery was more effective than drugs, diet and exercise in causing a remission of the disease. The new report, published on Wednesday in The New England Journal of Medicine, is the first large study to show a long-term preventive effect of surgery in people who are not yet diabetic but well on their way.

Experts who were not involved in the research said it could have tremendous public health implications. Nationwide, more than 20 million Americans have diabetes, most of them Type 2, the form linked to obesity. But almost three times that number are prediabetic, with blood sugar levels that are higher than normal but not quite high enough for a diagnosis of diabetes. Prediabetes is also referred to as impaired fasting glucose.

“Prediabetics almost always develop diabetes, and this showed that surgical treatment could put them on a new pathway away from the disease,” said Dr. Philip Schauer, a professor of surgery at the Cleveland Clinic who led one of the earlier studies looking at bariatric surgery in diabetics. “An 80 percent risk reduction is huge, particularly in light of the fact that Type 2 diabetes is a very deadly disease.”

The new study had its genesis in the 1980s, when scientists in Sweden set out to study the long-term effects of bariatric surgery on health. For ethical reasons at the time, the researchers did not randomly assign people to undergo weight-loss surgery. Instead, they enrolled extremely overweight people who had chosen on their own to undergo it, and then matched them to a control group of obese people who wanted to lose weight through nonsurgical means, including standard exercise and dieting advice.

For both groups, the median body mass index was just above 40, indicating morbid obesity. But no one was diabetic when the study began.

The surgical group consisted of 1,658 people who had one of three kinds of bariatric surgery. Most underwent banding procedures that restrict food intake but do not interfere with the normal digestive process. About 10 percent had gastric bypass, a more radical operation that involves shrinking the stomach and rearranging the bowels.

After following the groups for up to 15 years, the researchers found that those who had surgery lost an average of about 45 pounds, while those in the control group lost significantly less.

By the end of the study, about 10 out of 13 patients in the surgery group managed to avoid a diagnosis of diabetes, about double the reduction in risk normally seen in obese prediabetics who rely on lifestyle changes to lose weight. Dr. Bouchard speculated that in some cases, the operations helped avert diabetes not just through weight loss, but also through anatomical changes in the gut, which affect the production of hormones that play a role in things like appetite and metabolism.

Most of the patients in the new study, however, underwent banding procedures, which, unlike gastric bypass, do not significantly alter the anatomy of the digestive tract, said Dr. Rudolph Leibel, co-director of the Naomi Berrie Diabetes Center at Columbia University Medical Center. He said it was more likely that the improvements seen in the surgical group, in this case, were a result of their significant and sustained weight loss, something that is hard for many people to achieve through diet and exercise.

“I would predict that if you got the same amount of weight loss with lifestyle interventions and you could sustain it,” he added, “you would see quite comparable results.”
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Sleeve Gastrectomy

Sleeve Gastrectomy or Gastric Sleeve Surgery Procedure

The gastric sleeve surgery involves the creation of a thin vertical sleeve within the stomach that is non reversible. Once the stomach is secured using a stapling device, the rest of the stomach is removed. The resulting stomach size is comparable to a banana which limits the amount of food one can eat. Gastric sleeve surgery differs from other weight loss surgeries because the nerves leading to the stomach and outlet valve are preserved. Since the gastric sleeve does not reroute the intestines; digestion and absorption remain normal.

Today the majority of weight loss sleeve gastrectomies use laparocropic techniques. This allows for a minimally invasive procedure leading to shorter hospital stays, smaller incisions, faster recoveries, and less pain compared to open surgical procedures.


· Fewer diet restrictions

· Diminished hunger

· Less chance of malnutrition compared to other procedures

· Suitable for high risk patients

· Less invasive than gastric bypass

· Fewer follow up visits

· Can be performed laparoscopically


Sleeve gastrectomy is an option for those looking to overcome morbid obesity. Per most insurance plans, the National Insititues of Health requires a body mass index greater than 40 as an indicator for the sleeve procedure to be covered. In terms of weight, this is equivalent to 100 pounds overweight for males and 80 pounds overweight for females. If other obesity-related illnesses present themselves (hypertension, high cholesterol, diabetes), people with body mass indexes 35 to 39 may also be candidates per various insurance companies. For BMIs 30 to 35, cases are considered on a case by case basis and may very well not be covered by major medical plans.


Gastric sleeve surgery is an inpatient procedure that is performed under general anesthesia. Hospital stay will generally last between one to two days. Total recovery may involve a sore abdomen for a few days and re-adjustment to eating solid foods. Six months to a year after surgery, most people who undergo sleeve gastrectomy tend to lose 50 to 80 percent of their excess body weight. Health improvements in diabetes, hypertension, and cholesterol have also been shown within one to two years after surgery.

You may call today for a consultation with Dr. Kahlil Shillingford who is an expert in sleeve gastrectomy surgery in South Florida. Total inclusive rate for a self pay client is affordably priced at $10,500. Call (561) 483-8840
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Significant Reductions in Binge Eating Occur After Weight Loss Surgery

Significant Reductions in Binge Eating Occur After Weight Loss Surgery

Binge Eating Disorder is the most common eating disorder in the United States and is prevalent in up to 30% of those seeking weight loss treatment. Its prevalence in the population at large is eight percent. It can have an exclusive night eating or nocturnal component for some patients. It generally leads to obesity and can have a genetic component and also tends to be more common in women. Childhood obesity can be a risk factor. Usually the foods eaten are “comfort” foods. It is important to note that bingeing episodes can lead to a lack of proper nutrition; many of the “comfort” foods involved in binging can be high in fat, sugar, and/or salt, but low in vitamins and minerals.


Signs of binge eating disorder may include: Loss of control over eating during a binge, Eating large amounts of food and quickly, Eating when depressed, lonely or bored and Experiencing shame after binge eating. Currently, the DSM-IV (Psychiatric Manual) categorizes it under Eating Disorder Not Otherwise Specified. It is included as a diagnostic category for further study in DSM IV to have more specific diagnostic criteria.


Treatment options include: psychotherapy, overeaters anonymous meetings and other support modalities. Supportive and cognitive behavioral therapy can be very helpful, therapy in particular helps people track their feelings and behaviors towards food. Developing alternatives to stop emotional overeating is key to success such as: Exercise, reaching out to friends for support, recreational games, reading, listening to music and various other hobbies.


In addition helpful tips to stop overeating include:

-Slow down, and pause in between bites. The slower you eat, the more time your body has to catch up and tell you that you are full.

-Set your utensil down in between bites. Allow yourself to fully chew your food.

-Make it a habit to sit at a table and eat.

-Don’t eat while cooking. Tasting foods can add a lot of extra calories.

-Drink plenty of water.


For many patients who are obese after weight loss surgery can be a viable option to help. Bariatric surgery is effective in producing weight loss and abstinence in severely obese binge eating disorder, significant reductions in binge eating usually occur after obesity surgery in patients. In one study, binge eating was eliminated in all of 22 patients classified presurgically as binge eaters at a four-month-follow-up- post surgery.


Whether obesity leads to psychopathology, perhaps through discrimination and isolation or psychopathology leads to obesity the etiologies are multifaceted and are not clear. We need more research to learn about binge eating disorder and ways to help patients cope better with emotional stress, loneliness and boredom. Obesity is a national crisis and various treatment options including weight loss surgery can help.


Resource: Weight Loss Surgery

5 “Go-To” High Protein Snacks


Healthy, protein rich snacks will need to fill in the gaps of your post op gastric sleeve diet when you’ve reached the final stage at one year post op. When you no longer rely on protein supplement drinks to help you meet your nutrition and protein requirements, you will need to make wise food choices that provide you with vitamins, minerals, fiber, and protein without adding too many calories that could hinder weight loss (or even promote weight gain).

We’ve rounded up 5 “go-to” snacks that you can count on to fill you up in between your meals.

  • Hummus and fresh veggies
    You can make it yourself or buy it prepackaged, but either way hummus can make a great snack. Since it’s made from chickpeas, you get the complex carbohydrates, protein, and fiber from the legume. Add in celery sticks, red pepper rings, cucumber rounds, or carrot sticks and you’ve got a fiber filled, crunchy snack that can satisfy.

  • Cottage cheese and fruit
    Cottage cheese has a reputation as a diet staple for a reason: it’s high in protein, low in calories, and fills you up. Add in some sliced strawberr ies, diced cantaloupe, or blueberries for a boost of vitamin C and fiber.

  • Nuts
    Having a variety of nuts handy is a great choice for gastric sleeve, gastric bypass, and lap band patients. The salty crunch of nuts can very satisfying in between meals. Nuts, including pistachios, walnuts, almonds, cashews, and peanuts, can be a healthy, vitamin, mineral, and fiber filled snack. Just be wary of how many you snack on as the calories can add up quickly.

  • Cheese and grapes
    Whether you cut it off a block or unwrap it, cheese can be a great snack choice. Dairy naturally has carbohydrates, but it also has protein and calcium. Add some fresh grapes to temper the richness of the cheese and add some fiber.

  • Roll Ups
    Turkey and swiss, ham and american, roast beef and provolone, chicken and cheddar, or any combination you like can make a quick and easy snack. If you want to get fancy, you can add an apple slice for a sweet crunch, microgreens for a fresh taste, or olives for a savory addition.

These suggestions are offered by Dr. Shillingford, M.D., P.A., a Center of Excellence surgeon specializing in advanced laparoscopic and weight loss surgery. Dr. Shillingford’s gastric sleeve, gastric bypass, and gastric band patients come from all over Florida and the country, including Boca Raton, Miami, Orlando, New York, Detroit, and Houston, for his surgical skills, compassionate care, and reputation for affordable obesity surgery. Healthy snacking is crucial to eating enough protein for bariatric patients and these 5 snack choices can help you meet your protein requirements while still contributing to successful weight loss.

Food Highlight: Scallops


Scallops seem to be an enigma of the fish world with some people not realizing the scallop is actually a form of shellfish. In fact, typing ‘scallop’ into Google shows that people often ask if scallops are vegan. A quick reminder of what a scallop shell looks like will often lead to a forehead slap.

Indeed, the white, round, fleshy delicacy is the bivalve mollusk that opens and closes the beautifully ridged shells. In the United States, the most common kinds of scallops are the Atlantic deep sea scallop and the bay scallop. Though they are often labeled as such, you can also tell by size with the sea scallop measuring about one and a half inches in diameter and the bay scallop being much smaller at about a half inch wide.

Scallops make a wise choice for gastric sleeve, gastric bypass, and lap band patients for several reasons. They are low in calories and high in protein, which helps aid weight loss. A 2 oz portion of scallops provides 60 calories and 12 grams of protein along with 3 grams of carbohydrates and about 1 gram of healthy fat. That same 2 oz portion of scallops also provides about half the Daily Value of vitamin B-12.

Because of their small size, it is easy to control your portions with scallops, which is ideal for gastric sleeve, gastric bypass, and gastric band patients. It is easy to cook only a few for a dinner for one, or if cooking dinner for a group it’s easy to take just enough scallops to fill your smaller stomach without taking too many.

Consuming seafood has many benefits that do not only pertain to bariatric patients. Eating fish one to three times a month can reduce the risk of ischemic stroke by nearly 10%. That number increases with the frequency of eating fish. Consuming fish, especially fish high in omega 3 fatty acids like scallops, reduces the risk of coronary artery disease. Scallops in particular are an excellent source of B12, and a good source of magnesium and potassium, which all have heart healthy benefits. Another benefit to scallops is they are low in mercury, so you can eat them frequently without worrying about mercury poisoning.

Scallops are very perishable, so care should be taken when buying them fresh. You will often find fresh scallops shelled, washed, and either frozen or packed on ice. They can also be purchased frozen from the grocery store or warehouse store. Scallops cook quickly, just a few minutes on each side and they’re done. If your scallops are frozen, they will need to be defrosted before cooking to avoid overcooking. To defrost frozen scallops, place in a covered bowl the refrigerator for 24 hours or thaw under cold running water.

Cooking scallops can be super quick, depending on your recipe. They can easily be pan seared, baked, broiled, or grilled. Because they have a mild flavor, the ingredients you add will be important. Sauteing scallops with garlic is always a hit, or try them with lime and cilantro, or grill on a skewer with peppers, pineapple, mushrooms, and a cherry tomato. Your flavor options are wide open thanks to the naturally mild sweetness of scallops.

The above Food Highlight is offered by Dr. Shillingford, M.D., P.A., a board certified surgeon specializing in advanced laparoscopic and bariatric surgery. Dr. Shillingford’s gastric sleeve, lap band, and gastric bypass patients come to his Boca Raton office from both South Florida and Northern Florida, as well as Georgia, Texas, Ohio, New York, New Jersey, and Michigan. His weight loss surgery patients are often looking to explore new and different foods, and for many patients scallops may be a new food. Since scallops are low in calories, high in protein, taste good, cook quickly, are easy to portion control, and a heart healthy they can make a great addition to a bariatric weight loss diet.

Go Green this St. Patrick’s Day


Did you know that Corned Beef and Cabbage is not a traditional meal on St. Patrick’s Day in Ireland? Traditionally, the Irish eat lamb or bacon to mark the occasion. If the calorie laden meal of corned beef, cabbage, and potatoes isn’t even an Irish custom, then gastric sleeve, gastric bypass, and lap band patients don’t have to feel guilty for skipping it. So, forget the heavy corned beef and cabbage this year, and celebrate St. Patrick’s day by going green. And by green, we mean the color green.

Green foods tend to be quite healthy (green bagels, gummy bears, Skittles, M&M’s, and the like excluded). Think kale, spinach, cucumbers, avocados, peas, mint, peppers, and arugula just to name a few. In fact, try to think of a naturally green food that isn’t good for you. Their natural goodness makes it incredibly easier to incorporate green foods into a post bariatric surgery diet than greasy corned beef.

Corned beef, cabbage, and potatoes isn’t exactly a meal that encourages weight loss. So, this St. Patrick’s Day, go green and go healthy. We’ve gathered some green inspired cuisine ideas. They may not be Irish, but that’s alright since corned beef and cabbage isn’t either.

The above suggestions are offered by Dr. Shillingford, M.D., P.A., a board certified surgeon specializing in laparoscopic, robotic, and bariatric surgery. Dr. Shillingford performs gastric sleeve, gastric bypass, and gastric band surgery at one of South Florida’s few hospitals designated as a Center of Excellence for Bariatric Surgery by the American Society for Bariatric Surgery. Some of his patients come from local areas, such as Miami and Fort Lauderdale, but his reputation and skill also attract patients from as far away as Orlando, Jacksonville, Sarasota, Tampa, Fort Meyers, and Naples.

10 Ways to Get Up More and Sit Less

10 Ways to Get Up More and Sit Less

When we are sitting, we’re barely burning any calories compared to when we get up and move. Unfortunately, many of us do a lot of sitting. If you work at a desk, in an office job, or commute to work, sitting is hard to avoid.

If you are trying to incorporate more activity into your life, you have to get up and move. For gastric sleeve, gastric bypass, and gastric band patients, increasing physical activity is crucial to weight loss. For those new to physical activity, you may have to work your way up to a full workout, but adding little bursts of activity throughout the day can help get your body used to the additional movement. And for those who do exercise but could use a little more calorie burning activities in your day to help boost your weight loss, adding in a few extra moves a day can help, too.

Are you ready to take on the challenge to get up more and sit less? Great! To help get you started, we’ve brainstormed a few ideas to get you up and moving during your day:

  1. 1. Organize your home or work space so things are less convenient. Separate your printer from your computer. Keep the TV remote far enough away from the TV so you have to get up from the couch.
  2. 2. Bring your lunch to work, but leave it in the car. You’ll have to walk out to your car and back at lunchtime. You could even park far away or go for a little walk after eating if you have time.
  3. 3. When you have to talk on the phone, get up and walk around your home or office.
  4. 4. Use a small glass or water bottle instead of a big one. This will encourage you to get up and refill it often.
  5. 5. Drink a lot of water. You should be drinking 64 ounces of water each day after bariatric surgery. This should necessitate multiple trips to the bathroom.
  6. 6. At work, choose a bathroom that is further down the hall or on a different floor and take the stairs.
  7. 7. Don’t use a drive-thru. Whether it’s for food, coffee, or prescription pick ups forgo the drive thru and walk into the store.
  8. 8. If you’re watching TV, get up between each episode or if there’s a commercial, get up then too. Put something away, go to the bathroom, refill your water cup, do something that gets you up off the couch for a few minutes and gets you moving.
  9. 9. Set a timer in the kitchen (or on your phone) to remind you to get up. This is really helpful for when social media seems to make you fall through a black hole of time. Set the timer for 10 or 15 minutes, get up from your phone or computer to go do something productive, then come back. Just remember to set the time again when you sit down.
  10. 10. When you absolutely can’t get up (when you’re stuck in traffic or in a meeting), you can still engage your muscles. Try Kegel exercises or tighten and relax your abdominal muscles. Try doing thirty repetitions at a time and you’ll begin to feel it.

The above suggestions are offered by Dr. Shillingford, MD, PA, a Center of Excellence surgeon specializing in advanced laparoscopic and bariatric surgery. Dr. Shillingford performs gastric sleeve, gastric bypass, and lap band surgery for patients using insurance and those who choose to pay the affordable out of pocket price. Dr. Shillingford’s surgical skills, excellent reputation, and affordable prices attract patients from near and far, including Miami, Orlando, Jacksonville, Tampa, Georgia, New York, Michigan, Ohio, and Texas. Dr. Shillingford encourages all of his patients to incorporate physical activity into their bariatric lifestyle as it is essential for our bodies and minds in addition to weight loss.

The Call of the Meatball

The Call of the Meatball

Do you hear it’s call?
If you listen carefully, you may hear “Make me, cook me, eat me, I’m delicious!”
That’s the call, the call of the meatball.
The perfectly portioned, easy to make, easy to freeze, customizable, and very versatile little ball of goodness is just waiting to be made and enjoyed in so many ways!

For gastric sleeve, gastric bypass, and gastric band patients the meatball can be the perfect package. It can be made from ground beef, turkey, chicken, pork, or any combination that works for you and you tolerate well after weight loss surgery. Between the meat and the eggs, it’s high in protein. They can be baked (not fried) to lower the calories from fat. They can be made into small portions to help you control how many ounces you eat per meal. Their mild flavor makes them easy to incorporate into a variety of meals and flavor profiles (meaning you won’t get bored of them).

Meatballs can easily be worked into a low calorie diet to help you lose weight after bariatric surgery. In case all you can think of is pasta and meatballs, we’ve brainstormed some creative meals that use meatballs:

  • Place a meatball and a cube of mozzarella cheese on a toothpick and dip in marinara sauce
  • Top with tzatziki sauce and eat in a lettuce cup or pita bread
  • In a bowl of vegetable or minestrone soup
  • Mixed in with sauteed cabbage and a dash of tomato sauce
  • Skewered with pineapple and peppers with a sweet and sour sauce on the side
  • Turn it into a slider
  • Alongside of mashed cauliflower
  • Work it into a taco salad
  • With buffalo sauce and celery sticks
  • Make zucchini noodles with meatballs, or a zucchini lasagna with meatballs

If that didn’t make you ready to make meatballs, nothing will. While you can buy frozen meatballs, making them yourself is not much more effort and is a whole lot better. Any basic meatball recipe will work, but if you’ve never made meatballs before a good, classic style recipe can be found here. If you have extra meatballs, place them on a sheet pan and freeze them. After they are completely frozen, pop them into a freezer bag for more convenient storage. It should be easy to pull out a one, two, or a few the next time you need a quick meal.

The above suggestions are offered by Dr. Shillingford, M.D., P.A., a Center of Excellence surgeon specializing in advanced laparoscopic and bariatric surgery. Dr. Shillingford’s gastric sleeve, lap band, and gastric bypass patients come to his Boca Raton office from both several Florida locations such as Miami, Tampa, Sarasota, Orlando, and Jacksonville, as well as other states like Georgia, Texas, Michigan, Ohio, New York, New Jersey, and Hawaii. His weight loss surgery patients are often looking to explore new and different foods and flavor combinations that are consistent with their low calorie, high protein post bariatric surgery diet. Meatballs can easily and deliciously be incorporated into meals or snacks to add extra protein in a post gastric sleeve, gastric bypass, or lap band diet.

American Society of Bariatric Physicians ObesityHelp making the journey together ASMBS Realize University Of Michigan American Medical Association Society of Laparpendoscopic Surgeons American Associantion Of Physicians of Indian Origin