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

Reason You Need to Strength Train for Weight Loss


If you are trying to lose weight (and keep it off), you know that exercise is key.  Most people consider cardio workouts to be crucial for weight loss.  And they are.  But, strength training is also important for weight loss.  Gastric sleeve, gastric bypass, and lap band patients should consider adding strength training to their workout routine to help them lose weight.

Strength training involves strengthening and toning your muscles by making them work against a resisting force.  Images of giant metal weight machines might creep into your head, but strength training can be as simple as using your body weight, medicine balls, resistance bands, or dumbbells.  

Strength training is highly beneficial to the body.  It tones and defines muscles.  It can help improve bone density and reduce the risk of fractures.  Strength training can help improve your balance and coordination, which can help prevent falls as you get older.  It can even be as effective as medication for reducing arthritis pain.  Working out your muscles can also boost your mood and give you an energy boost.

But, how does strengthening and toning your muscles contribute to weight loss?  

When you strength train your muscles, you build more lean muscle.  Your muscles grow and get toned.  Yes, this may make the needle on the scale move up, but lean muscle also helps you burn calories.  For every 3 pounds of muscle you gain, you can expect to burn 120 more calories a day without doing anything extra.  The simple fact of having more lean muscle means you burn more calories, even when the muscle is at rest.

If gastric sleeve, gastric bypass, and lap band patients have started an exercise regime after surgery, but haven’t incorporated strength training, starting slow is the best.  Give your muscles time to recover before working them out again.  Strength training can easily be done at home (think push ups, squats, planks, and lunges) using apps or videos.  But, consider consulting a trainer to make sure you are using proper body mechanics to prevent an injury.  

If you are trying to lose weight and haven’t been successful despite diet and exercise, bariatric surgery may be an option.  Dr. Shillingford, MD, PA has performed over 4,000 bariatric procedures, including gastric sleeve, gastric bypass, and lap band surgery.  His weight loss surgery patients come from all over Florida, including Boca Raton, Miami, Fort Lauderdale, Naples, Orlando, and Jacksonville, to have their weight loss surgery performed by the Director of Bariatric Surgery at a hospital with a designated Bariatric Center of Excellence.  To find out if you are a candidate for gastric sleeve, gastric bypass, or gastric band surgery, call Dr. Shillingford at (561) 483-8840 today.

Hydration: 5 Simple Ways to Fit it All In After Gastric Sleeve Surgery


64 ounces. That’s how much water and low or no calorie liquids you should be drinking each day after your gastric sleeve surgery. Does it sound like a lot? That may be because you weren’t drinking enough water before your bariatric surgery. Perhaps you were drinking other fluids like soda and juice in place of water. Now that you’ve had gastric sleeve surgery and are following a low calorie diet to lose weight and keep it off, water and other noncaloric fluids are essential.

After gastric sleeve surgery, your doctor and dietitian will recommend that your fluids be consumed in between meals instead of with meals. This is to ensure that you are getting enough protein, vitamins, and nutrition from your food intake rather than filling up on water when you should be eating. If drinking in between meals is a change for you, it may take some getting used to.

Not getting enough water can be very dangerous. 64 ounces of water and noncaloric fluids is a good rule of thumb for most people after gastric sleeve surgery, but, as hydration is dependent on many things (including body weight, medical diagnoses, medications, activity levels, etc), always follow your doctor’s orders for proper hydration. Dehydration is among the top reasons for readmission to the hospital following bariatric surgery. It can lead to dry skin, headaches, rapid heartbeat, constipation, lightheadedness, irritability, confusion, low blood pressure, and fever. But, careful monitoring of your fluid intake can help prevent dehydration in many instances.

Use these 5 tips to ensure you are getting 64 ounces of liquids each day:

  • Keep Track
    Keep track of your fluid intake to ensure you are getting enough. Since you will likely only be drinking small amounts of fluids at a time, you will have to drink often, and may easily forget how much you’ve had. Jot down how many ounces you consume and when. Start early and periodically add it up during the day to make sure you are on track to fitting in all 64 ounces. If not, consider setting up a schedule and setting an alarm on your phone to help you keep track of when you should be drinking.
  • Bring it Everywhere
    Bring a drink everywhere you go. Bring water with you in the car, at the grocery store, while you take the dog for a walk, everywhere. If you have it with you, you can drink it. If you don’t bring it, you can’t drink it. It’s that simple.
  • Keep Your Eye on It
    Use a see through water jug that displays ounces on it. If you fill a 24 ounce water jug in the morning, it should be easy enough to figure out how many ounces you’ve had before lunch by looking at the level. No guesswork needed. If you use an opaque water jug or one without the ounces labeled, it won’t be obvious if you’re not drinking enough and you may miscalculate your fluid intake.
  • Plan Alternate Fluids
    Include non caloric or low calorie liquids as a snack or treat. Sugar free jello or popsicles can make a good dessert as they provide very few calories, count as a liquid, and satisfy a sweet tooth. Even low sodium broth can be a good afternoon snack that can satisfy a savory craving and provide liquids at the same time.
  • Make Your Water Tasty
    Infuse your water with some flavor to entice you to drink. A slice of lemon, lime, orange, or cucumber can give your water some flavor with negligible calories. Or use a zero calorie sweetener to make your water more flavorful without adding calories. If it tastes good, you may be more likely to drink 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 bariatric surgery patients to pay particular attention to their water and fluid intake in order to prevent dehydration and its complications.

Uses for Homemade Pasta Sauce Besides Pasta


When you think of homemade pasta sauce, you may think about a grandma standing over a pot all day stirring. But, really, making your own tomato sauce can be easy and not all that time consuming.

In under an hour and with only a handful of ingredients, you can make your own pasta sauce. You may think this is crazy because opening a jar of sauce only takes a few seconds, but making your own has many benefits, especially for bariatric surgery patients.

First, you have control over your own ingredients and can flavor it how you like it. Adding vegetables is a good way to boost the vitamin and mineral content without adding a lot of calories. Spinach, kale, carrots, and mushrooms can make great additions. Also, you can adjust the spices to your preference- basil, oregano, bay leaves, savory, or thyme. Or, if you like it spicy, go heavy on the red pepper flakes. It’s up to you. Cheese, like ricotta, romano, or parmesan, may also be a welcomed addition for extra protein.

Second, your homemade sauce will have no added sugars. Many people don’t realize that jarred pasta sauce can have added sugars to increase its sweetness and palatability. By making your own, you can eliminate another source of added sugars from your post gastric sleeve, gastric bypass, or lap band diet.

Third, you get to skip most of the ingredients you can’t pronounce. Aside from what’s in your tomato paste, you’ll know all of your ingredients and can avoid things like firming agents and preservatives.

Fourth, by making your own sauce, you can opt to freeze some for future use. Let’s face it, gastric sleeve, gastric bypass, and lap band patients tend not to eat a lot at one time, so jars of sauce can go uneaten and wasted. But, when you cook up a batch of your own sauce, it’s easy to freeze it for future use. Try using ice cube trays to make small batches that will reheat quickly.

Making tomato sauce doesn’t mean you have to eat pasta. Although you can fit pasta into a gastric sleeve, gastric bypass, or lap band diet, the traditional huge plate of pasta and sauce is certainly not your best choice anymore. But there are make more uses for tomato sauce than just for pasta.

Try these ideas when you’re craving tomato sauce:

  • Spoon a dollop on top of an egg omelet filled with onions and spinach
  • Use it on chicken, turkey, or beef meatballs
  • Use it as a dip for boneless, skinless roasted chicken pieces
  • Add it to green beans or okra for extra flavor
  • Use as a poaching sauce for cod
  • Use as a dip for mozzarella cheese
  • Make Zucchini Pizza Rounds
  • Add a small amount into a soup for extra richness (this works well with beef vegetable soup, minestrone, or lentil)

If you can think of more uses for your homemade tomato sauce in your post bariatric surgery diet, let us know! Dr. Shillingford’s gastric sleeve, gastric bypass, and lap band patients are always looking for new, healthy, low sugar ways to add nutrition and variety to their weight loss surgery diets, and would welcome suggestions!

Dr. Shillingford performs gastric sleeve, gastric bypass, and lap band surgeries at Northwest Medical Center’s Center of Excellence in Bariatric Surgery. Over the course of his career, Dr. Shillingford has performed over 4,000 bariatric procedures, but most of his gastric sleeve, gastric bypass, and lap band patients come from Florida cities, including Boca Raton, Miami, Fort Lauderdale, Orlando, Jacksonville, and Tampa, as well as areas like Ohio, Texas, New York, and New Jersey.

Rainy Day Dinner


Rain has taken over South Florida of late. If the stormy weather has given you a chill, warm up with a Summertime Minestrone. Featuring fresh summer vegetables, beans, and some pasta, this soup can fill your belly without filling your waistline. The soup can be a perfect accompaniment to chicken or turkey, or even a sliced summer sausage. By adding in plenty of fresh vegetables and fat free broth or stock, you can keep this soup low in calories without compromising on flavor. The beans and pasta will add some protein, which is ideal for gastric sleeve and gastric bypass patients. To include extra protein, sprinkle fresh grated parmesan cheese on top.

Fresh Summertime Minestrone

  • 1 Tbsp olive oil
  • 1/2 onion, diced
  • 1 leek, cleaned and sliced (white and light green parts only)
  • 1 stalk celery, diced
  • ½ red or orange bell pepper, diced
  • 3 cloves garlic, minced
  • 6 cups fat free chicken or vegetable stock
  • 1 bay leaf
  • 1/4 teaspoon each dried thyme and basil
  • 1 teaspoon sea salt
  • 2 medium to large zucchinis or yellow squash, diced
  • 1 cup fresh green beans, trimmed and cut into 1-inch lengths
  • 2 roma tomatoes, diced
  • 1 cup fresh spinach, chopped
  • 1 15 oz can cannellini beans, rinsed and drained
  • 1 8 oz can garbanzo beans, rinsed and drained
  • 1/2 cup dry ditalini or other small pasta
  • Grated Parmesan cheese (optional)


  • Heat oil in a pot over medium heat. Add onion, leeks, celery, and pepper, and saute until they begin to soften, about 8-10 minutes. Add minced garlic and cook an additional minute.
  • Add stock, seasonings, beans, and remaining vegetables and bring to a boil by increasing the heat.
  • Once boiling, add pasta and cook until al dente. Note that ditalini will take longer than many other smaller pastas.

This soup is quick, easy, and filling. It would make a great lunch or dinner, especially in rainy weather. Don’t let rain get you down, use this stormy weather to cook up some fresh, hot soup that can fit into your post bariatric surgery diet.

The above recipe is suggested by Dr. Shillingford, M.D., P.A., a Center of Excellence surgeon specializing in laparoscopic and weight loss surgery. Dr. Shillingford is proud to perform gastric sleeve, gastric bypass, and lap band surgeries in Northwest Medical Center’s Center of Excellence for Bariatric Surgery, where patients are taken care of by staff specially trained in the field of bariatrics. This prestigious designation attracts patients from all over Florida, including Miami, Boca Raton, Orlando, Wellington, and Jacksonville. Dr. Shillingford’s weight loss surgery patients often ask for recipes that easy to prepare, taste great, and are protein rich to fit into their post bariatric surgery diet.

Gift Ideas for a Healthier Father’s Day


June 18th is Father’s Day. If you haven’t gotten the father in your life a gift yet, this may be one blog to read or share with friends or family.

Instead of a traditional tie, why not choose a gift that lets him know you love him and want him in your life for as long as possible. Gifts that are thoughtful, but also health promoting, can be a good choice. Some of these gift ideas can work for any father in your life- you father, husband, son, brother, grandfather, uncle, or even a father figure. Consider his needs and tailor the gift to help him achieve his goals quicker or with a bigger smile on his face.

If eating better is a priority for him, consider a gift that encourages better ingredients or more healthful ways of cooking. If getting out and exercising more is something he talks about, help him out with a gift that encourages sports or activities. If the dad in your life is doing a great job of eating healthy, losing weight, and improving his fitness levels, reward him with something to complement his new lifestyle and lets him know that his hard work is being noticed.

We’ve gathered a few ideas that may encourage exercise, fitness, healthy eating, weight loss, and an overall healthy lifestyle. Even if these ideas won’t work, they may help you brainstorm other ideas that can be just as thoughtful for the father in your life.

  • Grill
  • Grill accessories (such as a skewer set, grilling basket for vegetables, or a cookbook)
  • Golf day
  • Golf clothes or equipment (new golf bag, golf clubs, monogrammed golf balls or tees)
  • Snorkel set
  • Gym membership or personal training gift certificate
  • Cruising bike
  • Roller blades
  • Fishing rod or tackle box
  • Gift certificate to a gourmet market or his favorite healthy food establishment
  • Swim shirt with sun protection
  • Lunch box or bento box
  • Sushi-making kit
  • New sneakers
  • Smaller sized clothing or belt
  • Fruit tree or herb garden
  • Activity monitoring watch
  • Paddleboard or kayak

For the dad who has everything or you’re not sure which size to buy, consider giving the gift of an “experience.” A day of rock climbing, or a day on a deep sea fishing boat, or even an afternoon of playing laser tag with the family can create a fun and lasting memory of a fantastic Father’s Day celebration.

These Father’s Day ideas are offered by Dr. Shillingford, MD, PA, a board certified surgeon specializing in advanced laparoscopic and obesity surgery. Dr. Shillingford encourages a healthy lifestyle for his gastric sleeve, gastric bypass, and lap band patients, which includes healthier eating and incorporating exercise into our regular routines. Many of Dr. Shillingford’s weight loss surgery patients come from Miami, Fort Lauderdale, Boca Raton, Orlando, Naples, and Jacksonville, where the weather frequently encourages getting outdoors for exercise and sports. Whatever you get for the dad in your life this Father’s Day, the most important gift may just be your love and support.

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