This document provides information about life after bariatric surgery. It begins by outlining the benefits patients can expect, such as rapid weight loss, improved health, and learning healthy dietary changes. It then discusses America's obesity epidemic and related health problems like diabetes. The causes of obesity are explored, such as unhealthy eating habits, excessive weight, lack of exercise, and changes in diet over time with increased sugar and refined grain consumption. Bariatric surgery, especially gastric bypass, is presented as an effective treatment for weight loss and diabetes reversal. Post-surgery, patients must focus on nutritional deficiencies, establishing healthy eating patterns, adequate protein intake, and exercise to successfully maintain weight loss long-term.
2. First the Good News!
At the end of this presentation you will have a
clear understanding of the following:
You will lose excess weight in a healthy way and
reach your ideal weight fairly rapidly post-op
You will feel better than you have in a long time
You can do this through safe and effective
dietary changes
You will learn how to maintain your weight
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3. In this talk we will cover:
The Problem
The Causes
The Solution
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4. An example of the Good news!
• TJ 40 y/o F
• 5’ 2”
• 130 pounds overweight
• Size 18
• Frequent Headaches
• Nausea
• Insomnia
• Chronic Fatigue
• Diabetic
•6 months later
• 70 pounds loss
•Size 8
•headaches gone
•nausea gone
•Dizzy spells gone
•Diabetes cured
•Great sleep
•Lots of energy!
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5. Now the Bad News!
• When it comes to Dieting and Weight loss in the US,
We are confused
• Our current weight problem is not a result of lack of
effort by the American Public.
• With over 6000 diets available and the contradictory
“scientific evidence”, it would be a miracle if Americans
were not confused
• Following the wrong plan, no matter how hard you try,
will get poor results.
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6. The Problem
America is Overweight and Obese
According to the CDC 1 out of 4 people
Are either Pre-Diabetic or Diabetic?
Oct 2010 CDC Estimates
By 2050 up to a third of the population diabetic
57 Million Americans Pre-Diabetic.
24 Million Americans Diabetic.
7th cause of Death in 2007
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7. More Statistics
Over 400,000 Deaths from Obesity year.
74% of Adult Americans are
Overweight/Obese
Since 1980 number of Overweight
Americans has doubled
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8. The Epidemic
Over the next 24 hours
2200 diabetics will be diagnosed
512 diabetics will die
66 diabetics will go blind
77 diabetics will develop end stage kidney
disease
153 will have diabetes related amputations
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9. Overweight and Obesity
CancerStats in U.S.
90,000 Cancer Deaths
14% of all Male Cancer
20% of Female Cancers
American Cancer Society*
*estimates excess weight
contributes to 33-50% of
women!
Heart Disease in
U.S.
Since 1984 more female deaths,
than male.
512,000 female Deaths
447,000 male Deaths
10,000 women under 50
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10. Health Effects of Being Overweight/Obese
• Type II Diabetes
• Heart disease
• High B.P., Heart Attack
• Stroke, Arthritis
• Pancreatitis
• Infertility, Birth Defects
• Carpal T.S., Low Back Pain
• Impaired Immune Response
• Impaired Resp. Disorders
• Fatigue, Fatigue and more...
• Gall Bladder D., Gout
• Menstrual disorders
• Menopausal hot flashes
• Insomnia, Sleep Apnea
• Depression, Reflux
• Surgical Complications
• Pain, Urinary Incontinence
• Chronic Ven. Insufficiency
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11. Cancers and Obesity
Esophagus
Pancreas
Colon and rectum
Breast (after menopause)
Endometrium (lining of the uterus)
Kidney
Thyroid
Gallbladder
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12. These Statistics Represent:
Quantity & Quality of Human Life Severely
Diminished by this one condition
Meaning Quantity in Years Lost
Quality of Life 24 hours, 7 days a week
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13. Why is There an Epidemic of
Diabetes and Obesity?
Falsehoods Exposed
“Its in my genes – I am doomed to get it”
“It is out of my control”.
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14. Causes of Diabetes & Obesity
• Unhealthy Eating Habits
• Excessive Weight (Abdominal Fat)
• Lack of Adequate Nutrients
• Lack of Exercise
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15. Changes in Our Eating Habits
Sugar intake 1900, 2-4 lbs. of
Sugar/person/year
Sugar intake 1999, 158 lbs./person/year
Refined Grain intake from late 1970’s thru
2000 has increased by 60 lbs. per year
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16. French vs American Diet
Late 20th Century French Diet was
higher in fat, had equal amounts of
meat and fish, 4X's as much butter
and cheese, and they had 60% less
Heart Disease than the US.
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17. More About Fats
From the mid 1980’s to mid 1990’s, the % of daily
calories from Fat in the American Diet, decreased from
40% to 33%, while obesity in increased significantly
From 1910 to 1970, Heart Disease escalated from
almost non-existent to # 1 cause of death. During this
time the intake of Animal & Butter fat significantly
decreased, dietary cholesterol did not increase, while
sugar intake increased dramatically
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18. How do we Gain FAT?
Let’s look at the common scenario of fat
gaining that takes place, slowly but surely
over time, from too many carbs, too many
“empty calories”.
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19. When blood sugar exceeds a certain level
the body converts it to fat and stores it.
High Carb
Meal
Fat
Storage
Fat
Storage
Fat
Storage
Fat
Storage
Low Blood sugar
Symptoms
Next Carb Fix
Next Carb Fix
Next Carb Fix Next Carb Fix
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20. Insulin and Glucagon
Insulin
• lowers elevated blood sugar.
• shifts our metabolism into
storage mode
• removes dietary fat from blood
and transports it into fat cells.
• Increases body's production of
cholesterol
• causes the kidneys to retain
fluid
• stimulates the release of
eicosanoids. (proinflammatory
Signaling Molecules)
Glucagon
• shifts metabolism into burning
mode
• turns fat into blood sugar for
energy use.
• Decreases body’s production
of cholesterol
• causes the kidneys to release
excess fluid.
• stimulates the release of
eicosanoids. (antiinflammatory
signaling molecules)
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25. Out of Control Portion Size
Hamburger 2.8oz – 4.30oz 50% inc in calories
French Fries 2.4oz – 7.00oz, 10x inc in calories
Chocolate Bar 2.0oz – 7.00oz, 3x inc in calories
Coca Cola 6.5oz – 16.0oz, 2x inc in calories
Popcorn 3cups – 21cups, 10x inc in calories
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28. “If there is one thing that could
bankrupt America, it’s health care.
And it’s out of control!”
David Walker, GAO – Presidential Forum on Aging
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31. So, How do We
Solve this Problem?
The Bad News is:
There is No Magic Pill to solve
this problem.
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32. What Does not Work
• Natural Stimulants”, i.e. Ephedra and the
many other “Fat Blockers”, “Carb
Blockers”, “sleep your way to weight Loss,
dont change your lifestyle” products.
• Prescription Medications for Weight Loss,
remember Fen, Phen?
• Lastly,“it is not the fault of your Genes”.
When we take care of the body in the way it
is designed to be cared for, it performs
wonderfully and loses weight steadily.
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33. Really Good News
Gastric Bypass Cures Diabetes and most
diseases associated with Obesity
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34. This Challenge is:
Following a plan that focuses on:
Fat Loss
Preservation and increase in muscle mass
Long-term sustainable weight loss and
avoids weight regain.
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35. It is not about a Diet
It is about a system!
A System Structured for
Success
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36. What a typical diet lacks:
Proper nutrients.
Proper protein content.
Adequate unsaturated “good” fat
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37. Long term Post-op Program
• Abdominal Fat Loss
• Develop Healthy Food Habits
• Nutritional Deficiencies Supported
• Exercise
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38. Abdominal Fat Reversal
Establish a Bio-chemical State to Target:
ABDOMINAL FAT
Abdominal Fat = Development of Insulin
Resistance & Tumor Formation
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39. Abdominal Fat Study
Excess body weight in combination with
physical inactivity is a major determinant
for the development of insulin resistance
with associated hyperglycaemia and
hyperinsulinaemia and further leads to
tumour development.”
Arch Physiol Biochem. 2009 May;115(2):86-96. Obesity related
hyperinsulinaemia and hyperglycaemia and cancer development.
Becker S, Dossus L, Kaaks R.
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40. Healthy Food Habits
• Understand Food Habit Impact on Blood
Sugar
• Make the 20/80 Flip
• Minimize Foods that Induce
Allergies/Sensitivities
• Ensure Adequate Intake of Protein with Meals
(60 grams/day minimum)
• Maintain 3 Meals a Day – Never Miss Breakfast
• Healthy Snack Between Meals
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41. Nutritional Deficiencies
• Typical post-op Mineral and Vitamin
Deficiencies
• Chromium, Magnesium, Zinc, EFA,
Selenium, CoQ-10, alpha lipoic
acid, calcium with vitamin D, iron
and vitamin B12
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42. Exercise
• Daily 30 minutes of movement for
Heart Health
• 60 minutes of exercise for weight
maintenance
• Family Exercise very important to
prevent childhood obesity
• Non-Exercise Activity Thermogenesis
(NEAT)
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43. Summary
• Gastric Bypass is an effective procedure to
cure diabetes and cause dramatic weight
loss.
• Caloric intake, nutritional deficiencies and
Protein intake need to be monitored post-
operatively and for the rest of one’s life.
• 60-80 grams of Protein/day is necessary to
avoid muscle loss and maintain one’s weight.
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44. Conclusion
Have 4-6 small meals a day. You can
not eat large amounts of food and
your meals will not last as long as they
did before, so eat more frequently.
Drink at least 64 ounces of water daily.
Drink at least 30 minutes before eating.
This "water loading" will make you feel
fuller before you eat.
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45. Simple Action Steps
Chew your food very well- 20 times before swallowing. It
slows down your eating and also breaks down the food to
allow the food to go down easier
Keep a food diary and plan your meals. If you fail to plan,
you plan to fail.
Don't rely on what is nearby for food. Fast food will slow
you down. Never skip breakfast. Eat like a queen for
breakfast, princess for lunch and pauper for dinner.
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46. Simple Actions
Avoid foods high in sugar (more than 20
grams per serving) or high in fat (more 30%).
Bread does not grow on Trees! So Avoid
Carbohydrates as much as possible
Be careful with liquids like juices, smoothies, or lattes. These
have calories and you will not have the feedback or solids
telling you that you are full.
Avoid snacking. Grazing on food will add weight. Stick to your
set meal times.
47. Concluding Remarks
Don't give up. Weight loss and weight
maintenance is a life long process. If you
over indulge one day, make up for it the
next day. Keep working to make yourself
better each in every day in each and
every way.
Find time for yourself. If you are stressed at
work or home your body will know it and
not like it. Take care of yourself or you
can't take care of others.
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48. For more information please visit us at
www.WellesleyMD.com
Or Call us at (310) 400-5565
