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.”
Click here to view article

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
Click here to view article

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

Summertime Suppertime Salad


Don’t want a hot dinner in the summer Florida heat? No problem, have a salad. But what about if you need to get adequate protein after your gastric sleeve, gastric bypass, or lap band surgery? No problem, have this salad. You can get protein, legumes, vegetables, fruits, nuts, whole grains, and healthy fats all in this one salad.

And it tastes good, too.

Using leftover baked or rotisserie chicken is perfect in this recipe. It’s quick, it’s already cold, and it adds lots of protein. Each ounce you add gives an additional 8 grams of protein to your post bariatric surgery diet. Protein is important to prevent muscle wasting following gastric sleeve, gastric bypass, and lap band surgery. Adding whole grains, like quinoa, to your diet can be a great source of vitamins and minerals and fiber. Fiber is important for bowel regularity, but also for weight loss since it helps you feel fuller for longer. The nuts and apples add a nice crunch, which is satisfying as well as flavorful.

This summertime suppertime salad may be a hit with your family as well!

Kale and Chicken Dinner Salad

  • 4 cups fresh kale, chopped and destemmed
  • 2 cups cooked chicken, cooled
  • 1 cup cooked quinoa, cooled
  • 8 oz can garbanzo beans, drained
  • ¼ cup dried cranberries
  • ½ cup dry roasted cashews
  • 1 gala apple, cored and chopped


  • Juice from ½ lemon
  • 1 tbsp apple cider vinegar
  • 1 tbsp honey (local is preferable)
  • ½ tsp each salt and pepper


  • Place chopped kale in a large bowl.
  • In a separate bowl, whisk together all the ingredients for the dressing.
  • Don’t skip this important step: pour dressing over the leaves and massage them in. Using your hands, get in there and rub the dressing all over the leaves, and squeeze the leaves in in your palm and between your fingers. This 3-5 minute process will bruise the leaves and make them more tender and sweeter.
  • Add the remaining ingredients to the salad and toss to evenly distribute.
  • Enjoy!

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.

What is a Bodyweight Squat?


If you are new to exercising, it may seem like there’s a whole new language to learn. Carb, squat, HIIT, plyometrics, deadlift, and burpee are just a few terms that might make a newcomer’s head spin. Exercising is crucial to improving your health and promoting weight loss, and we want our gastric sleeve, gastric bypass, and gastric band patients to feel comfortable exercising and being around people who do exercise. Knowing some terms can help you feel more “in the know” and less likely to feel uncomfortable working out, whether it’s in the gym, outside, or in your living room.

What is a Bodyweight Squat?

A bodyweight squat is basically squatting down without holding any additional weight and getting back up again. It’s a position you may do every day, whether it’s picking something up off the floor or petting your cat, so it’s a functional exercise. Some squats call for adding weights, but bodyweight squats use just your own bodyweight.

How Do You Do a Bodyweight Squat?

  • Begin in a standing position. Feet a little more than shoulder width apart. Feet outward pointed approximately 5 to 15 degrees.
  • Bend your knees to a squatting position and reach your butt behind you toward a wall (an imaginary wall is fine)
  • Keep your chest upright. You can either clasp your hands chest high in front of you, hold them out in front of you level with the ground, or place your hands behind your head. It may help to keep your eyes fixed on a spot in front of you.
  • Keep your weight in your heels.
  • Maintain your knee position above your feet, do not bend them in.
  • Bend as low as your can, then push up through your heels to a standing position.

(Tip: watch a video online to make sure you understand what it should look like.)

What Are the Benefits of a Bodyweight Squat?

Bodyweight squats work several muscle groups at one time: glutes, hamstrings, quads, and hip extensions. This can lead to more clearly defined leg muscles. Squats also strengthen your joints, tendons, and ligaments. By holding your chest upright, you help strengthen your core and improve posture. If you do these squats in a high number of reps, you will raise your heartrate and get a good cardiovascular workout. One huge benefit to incorporating bodyweight squats into your workout routine to improve your health and encourage weight loss is that these can be done in the comfort of your own home or office. If you have a few spare minutes (maybe while a pot of water is boiling or you’re on hold on a phone call) you can do a few squats.

If you’ve been given a clean bill of health to start exercising after gastric sleeve, gastric bypass, or gastric band surgery, try incorporating bodyweight squats into your exercise routine. It may take you time to work on your form and body position, but once you do, squats can be a great exercise you can do in the privacy of your home or at the gym. If you master the bodyweight squat, there are a host of other variations of the squat that can help strengthen different muscle groups and add variety to your workout.

The above is offered by Dr. Shillingford, M.D., P.A., a Center of Excellence Surgeon specializing in gastric sleeve, gastric bypass, and lap band surgery. Dr. Shillingford’s reputation for excellent surgical skills and comfortable bedside manner attract patients from all over Florida, including Miami, Fort Lauderdale, Naples, Tampa, Orlando, and Jacksonville. His bariatric weight loss patients receive top notch care during their hospital stay at Northwest Medical Center’s Center for Excellence in Bariatric Surgery, where he serves as Medical Director, and during their follow up care in his Boca Raton office. But, it’s up to the patients themselves to incorporate exercise into their daily lives to make the most of their weight loss efforts.

3 Foods That Can Lower Cholesterol and Help You Lose Weight


High cholesterol (>200mg/dL) is often associated with a higher risk of heart disease and stroke. With dangerous levels of cholesterol flowing in the blood, some can deposit in the arteries, which can limit the flow of blood and lead to cardiovascular problems. High cholesterol has no obvious symptoms until it leads to problems, so it’s better to discuss getting a blood test with your doctor if you think you are at risk. Risk factors include: a diet high in saturated fat, obesity, large waist circumference, diabetes, lack of exercise, and smoking.

If you’ve been diagnosed with high cholesterol, follow your doctor’s advice, whether it’s for diet, exercise, medication, weight loss, or a combination of these. You can help complement your doctor’s advice by including foods in your diet that can help lower cholesterol also. Different foods can work in different ways to help lower cholesterol levels. For gastric sleeve, gastric bypass, and lap band patients who are also seeking to lose weight, choosing the right foods can be a little tricky. Care should be taken to ensure that adding foods to your diet does not increase your overall calories, or it could jeopardize your weight loss efforts.

We’ve researched three foods that can help lower cholesterol and can easily be incorporated into a weight loss diet for bariatric patients.

1. Whole Grains

Oats, barley, whole wheat, and brown rice are whole grains, meaning they have not been processed as much as their grain counterparts and are higher in soluble fiber. This dietary fiber actually can bond to the cholesterol in the blood and remove it before it gets absorbed. It can also help keep your bowel habits more regular, and can help you feel fuller for longer, which can also help with weight loss.

2. Fruits

Apples, grapes, strawberries, prunes, and blueberries are associated with cholesterol lowering properties. Some attribute their abilities to soluble fiber or pectin. These fruits (especially the prunes) do have a high sugar content, and should be eaten in healthy portions and used as part of a meal or snack for people seeking lower cholesterol and lose weight.

3. Beans

Beans and legumes (chickpeas, lentils, black, kidney, pinto, etc) are low in calories, a great source of fiber, and have a healthy dose of protein, making them ideal for weight loss in addition to their cholesterol lowering effects. They can be used to in conjunction with meat in recipes for extra protein (like chili and soups), as a dip (black bean dip, white bean and garlic dip), as a main or side dish (stewed lentils), or as a snack (crispy baked chickpeas). They are extremely versatile as well as inexpensive making them a great choice for everybody, not just those seeking weight loss and lower cholesterol.

The above suggestion is offered by Dr. Shillingford, M.D., P.A., a board certified surgeon specializing in laparoscopic, robotic, and weight loss 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 surgical skills also attract patients from as far away as Orlando, Jacksonville, Sarasota, Tampa, Fort Meyers, and Naples. His weight loss surgery patients are often have other factors influencing their health, such as high LDL cholesterol.

Why Do Onions Make Us Cry?


We’ve all experienced it: the burning feeling and tears in our eyes when we chop, dice, or mince our favorite bulb to add to our meal. Why do onions make us cry?

The cells of the onion’s bulb have a chemical called propanethial S-oxide, or otherwise known as Lachrymatory Factor (LF). When the onion is whole, the chemical is safely tucked inside the cell walls. When we start cutting into the onion, we slice open the cells releasing allinase, starting a chemical chain reaction which leads to the production of LF. When the LF comes into contact with our eye, our brain gets signalled that an irritant is present and blinking and tears are initiated.

This phenomenon may seem like a cruel trick, but it’s actually the onion’s way of protecting its energy-storing bulb from predatory insects or creatures. This advanced chemistry is an onion’s self defense.

Should we heed the onion’s warning and stay away? No! Just be prepared for the coming tears or turn your head away to help reduce them. Onions have vitamin C and chemicals linked to growth inhibition of cancer cells. Plus, onions give our food tons of flavor and add very little calories (only 4 calories in a tablespoon). That is a major benefit to assist with weight loss, especially for gastric sleeve, gastric bypass, and lap band patients.

Dr. Shillingford, MD, PA, encourages his gastric sleeve, gastric bypass, and lap band patients to choose healthy foods, and onions are a great choice for their flavor as well as their small caloric content. Dr. Shillingford’s bariatric patients come from all over Florida, including Boca Raton, Miami, Orlando, Tampa, and Jacksonville, for his reputation as a Center of Excellence Surgeon and his compassionate bedside manner. To schedule a surgical evaluation with Dr. Shillingford or to attend one of his free informational sessions, please call his Boca Raton office at (561) 483-8840.

Lemon Water: Miracle or Mediocre?

Lemon Water: Miracle or Mediocre?

Celebrities swear by it. Clean living advocates advocate for it. Detox diets are based on it. It’s supposed to make your skin look radiant, flush toxins out of your body, and suppress appetite. All by adding the juice and possibly some rind to your water.

Sound too good to be true? Then it probably is.

But, the claims are likely based in some truth. First, lemons are high in vitamin C. The juice from half a lemon has 25% RDI of vitamin C, a powerful antioxidant. This may very well help improve the look of your skin. As an antioxidant, vitamin C helps protect your body against free radicals, which if left to their own devices, can be harmful to your body.

Drinking water can help reduce appetite, but is lemon water any better at it? Probably not, unless the lemon taste makes you drink more water than you would otherwise drink. And that varies from person to person and their taste preference. If you replace lemon water for a high calorie drink, such as soda or juice, it can reduce your overall caloric intake and lead to weight loss. Also, don’t doubt the benefit of the placebo effect. If drinking lemon water makes you feel like you are living healthier, you may be less likely choose unhealthy foods. Improved hydration may help your workouts. You may be able to exercise for longer, or with greater frequency as you may feel less tired while you are properly hydrated. Combine that with eating healthier and it’s a recipe for weight loss.

For sleeve gastrectomy, gastric bypass, or lap band patients, hydration is of utmost importance. Not getting enough water is one of the top reasons for rehospitalization following bariatric surgery. Proper hydration is also key to bowel regularity. If you’ve ever been constipated, you know it can make you feel down, sluggish, and cranky. It can be prevented with proper hydration, like from drinking lemon water. Is drinking lemon water a miracle cure? Probably not. But it’s more than mediocre, mostly because it’s water. If the addition of lemon juice or a lemon wedge helps gastric sleeve, gastric bypass, or lap band patients easily meet their goal of drinking at least 64 ounces of water each day, then it’s more like a manna, or unexpected aid to success.

The above is offered by Dr. Shillingford, M.D, P.A., a board certified surgeon specializing in laparoscopic 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 in 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.

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