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.

Advantages

· 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

Candidates

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.

Recovery

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

Kale and Sweet Potato Frittata

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This Kale and Sweet Potato Frittata works on so many levels. By incorporating two superfoods (kale and sweet potatoes) you know it’s packed with nutrients like vitamin A, vitamin C, folate, vitamin K, manganese, and copper as well as a long list of other nutrients. The eggs provide high quality, easily tolerated protein, which is ideal for gastric sleeve, gastric bypass, and lap band patients. The fiber from the kale and sweet potato can even help you feel fuller for longer, which is great for promoting weight loss. It cooks up quickly, making it a good choice even for a busy weeknight dinner. Add a pretty salad and it can even be fancy enough for company. It works for breakfast, lunch, or dinner. It’s full of protein, fiber, and antioxidants. It’s easy to fit into a post bariatric surgery diet and promote weight loss. What more can you ask for? Make it today!

Kale and Sweet Potato Frittata

  • 8 large eggs
  • 3 tbsp parmesan cheese
  • 2 tbsp olive oil
  • 1 medium red onion, chopped
  • 1 bunch kale, washed, destemmed and chopped
  • 1 medium sweet potato
  • 1 clove minced garlic
  • ¼ tsp sea salt
  • ¼ tsp freshly ground pepper

Directions:

  • Wash and dry sweet potato. Poke holes in the skin using the tines of a fork. Microwave until soft, about 5 minutes, turning over halfway. Peel and dice into small pieces when cool.
  • Whisk together eggs and half the cheese in a separate bowl.
  • Using a non-stick broiler proof skillet, heat olive oil over medium heat, add onion and saute until soft (about 5 minutes). Add minced garlic and saute one more minute.
  • Once onion is soft, add a handful of chopped kale to the hot pan, once wilted, stir and add another handful until it’s all added and cooked. Season with salt and pepper. Add sweet potatoes and saute for 1-2 minutes.
  • Add eggs and stir to distribute vegetables evenly with the eggs. Reduce heat and cover. Cook until eggs are almost set, about 4 minutes. Remove lid. Sprinkle with remaining cheese.
  • Place pan in preheated broiler until eggs are completely set and the top begins to brown (about 1-3 minutes). Enjoy!

This recipe is offered by Dr. Shillingford, MD, PA, a board certified surgeon specializing in advanced laparoscopic and weight loss surgery. Dr. Shillingford, a Center of Excellence surgeon, offers gastric sleeve, gastric bypass, and lap band surgery to his patients seeking to lose weight safely and effectively. Overweight and obese patients who have tried losing weight and have been unsuccessful have turned their lives around after weight loss surgery with Dr. Shillingford. Many have lost over a hundred pounds, lost several inches off their waistline, improved their blood pressure and improved or cured their type 2 diabetes, and have finally been able to keep up with an active lifestyle. Don’t wait, call Dr. Shillingford today at (561) 483-8840 and get your life back!

Greek Yogurt Chicken

Greek Yogurt Chicken

There seems to be an infinite number of chicken recipes on the internet, and for good reason. Chicken is inexpensive, has a mild flavor that a majority of adults and children enjoy, and is usually readily available at the store. But, for gastric sleeve, gastric bypass, and lap band patients, chicken is also one of the most easily tolerated meats following bariatric surgery.

The beauty of this recipe is that is quick, easy, and you likely will have everything you need on hand. What’s more is that it tastes good and makes a juicy, not dry chicken. By incorporating plain greek yogurt, you also get an extra dose of protein, which is important for bariatric patients who struggle to meet their daily protein requirements.

For gastric sleeve, gastric bypass, or lap band patients who eat meals with a partner who doesn’t follow a lower calorie or bariatric diet for weight loss, this chicken dish can easily work for both. You can adjust your side dishes to either reduce or add to your calories and carbohydrates as needed, but the chicken is versatile enough to work with either meal. Dr. Shillingford’s weight loss surgery patients can stick to small portions of lower carbohydrate sides (such as tomato and avocado salad, grilled asparagus, or even a small baked sweet potato) to make a satisfying and delicious dinner that can easily fit into a post bariatric surgery lifestyle.

  • 2 skinless, boneless chicken breasts
  • ½ cup plain greek yogurt
  • ¼ cup grated Parmesan cheese
  • ½ tsp garlic powder
  • ¼ tsp onion powder
  • Salt and pepper to taste

Directions:

  1. 1. Mix yogurt, parmesan cheese, and spices in a bowl.
  2. 2. Place the chicken breasts in a pan.
  3. 3. Divide the mixture evenly and spread on top of each chicken breast.
  4. 4. Bake at 375 degrees for about 45 minutes or until cooked thoroughly.

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. His weight loss surgery patients are often seeking advice on how to get enough protein after bariatric surgery.

3 Grocery Store Tips to Buying Better Food

3 Grocery Store Tips to Buying Better Food

For bariatric patients and anyone trying eat healthier and lose weight, cooking your own food instead of buying take out is an enormous first step. It stands to reason that if we buy healthier foods, we will eat better foods. But, how do we buy better food?

We’ve got 3 tips for our gastric sleeve, gastric bypass, and lap band patients who are trying change their lifestyles and to eat healthier:

1. Shop with a list

This is huge. In order to not get distracted by flashy sales and new products, you must shop with a list. Plan out the next few days worth of meals and write down all the ingredients you will need. You should even plan out some snacks since healthy snacking is crucial to meet your protein requirements after bariatric surgery.

2. Read the labels

You may think all items, such as yogurts, are similar but that’s far from the truth. Read the Nutrition Facts labels of several different products before selecting the one that’s best for you. Look for serving size, calories, carbohydrates, trans fats, fiber, and names of ingredients. You may think you’ve found a great product only to realize that it has two servings in the container and now you have to double the calories. If the label lists trans fats, look for a different product. Trans fats have been linked to increased risk of cardiovascular disease. See if you can recognize and can pronounce all of the ingredients. Natural ingredients are generally better than those created in a laboratory. Look for products containing dietary fiber, not only does fiber help create a feeling of fullness, but it helps lower blood cholesterol. Plus, you don’t digest fiber, so even though grams of fiber count as carbohydrates, your body doesn’t actually absorb those calories.

3. Buy mostly from the perimeter of the store

Most supermarkets are designed to house the fresh and refrigerated foods along the perimeter walls, with the processed and shelf stable foods in the middle aisles. Aim to buy most of your foods from the perimeter, which will include fresh fruits and vegetables, meats, poultry, and fish, and dairy products like milk, eggs, yogurts, and cheese. Good choices can also be found in the middle aisles (like nuts, beans, olives, and canned tuna), but be mindful to stick to your prepared list and don’t go for impulse buys.

You may find the first few trips to the grocery store take longer than you’re used to, but once you’ve found your go-to products, your shopping time will decrease. You may even find that you like grocery shopping even better when you shop off a list instead of browsing through every shelf to search for meal ideas. The goal is to break bad food buying habits (like buying foods just because they’re on sale) and learn a better way to shop for healthy foods. If your refrigerator and pantry are stocked with fresh, low calorie, high protein, and high fiber choices instead of high calorie, high carbohydrate, highly processed choices, you’ll have no choice but to eat healthier!

These tips 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. His weight loss surgery patients are often seeking advice on how to form healthier eating habits, and it starts with buying better food.

5 “Go-To” High Protein Snacks

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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

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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.

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