This week doctors and staff from Khalili Center for Bariatric Care paid a visit to the Sunrise Elementary School. It was our second visit to Sunrise this year and part of our ongoing community outreach to help educate students about proper nutrition and the importance of maintaining a healthy diet.
On this week’s visit to Sunrise we educated students on the four food groups, how to differentiate healthy foods from unhealthy foods, and how food affects our bodies in general. We also focused on the importance of exercise and even gave the kids pedometers, let them run around the track and count how many steps they took. To get the students excited and engaged about exercise, we set up a challenge in which at the end of the school year, we will award a prize to the class that racks up the most steps.
Geile’s story is an all too common one, with many professional football players, linemen in particular, encouraged to “eat to play,” in order to maintain the heavy weights the game demands. Upon retiring, many players discover that they’re unable to shed this excess weight. Far too many retired players find themselves with obese bodies, poor eating habits, and a litany of injuries that make shedding their excess pounds difficult.
The rise of obesity in the NFL has coincided with the rise of the problem in the overall population. Back in 1970, there was only one player in the NFL over 300 pounds. By 1990, there were about 70 NFL players weighing more than 300 pounds. Currently, the number of NFL players exceeding 300 pounds has ballooned to over 500 players.
Khalili Center surgeons have performed weight loss surgery on numerous athletes, including former college football player, James Hardy, who has since successfully lost over 200 pounds.
The Khalili Center is a one-of-a-kind medical practice offering a comprehensive approach to weight loss surgery, with tools and support to help people transform their lives. Dr. Kai Nishi, a surgeon at the Center was named by HealthTap (http://www.healthtap.com) as the “Top Bariatrician in the Nation” for the Summer 2013 Top Doctor Competition.
The Center’s surgeons, Dr. Theodore Khalili, Dr. G. Kai Nishi, and Dr. Eraj Basseri, have successfully performed over 5,000 weight loss surgery procedures, including Gastric Bypass, Gastric Banding, and Sleeve Gastrectomy. The Khalili Center is located at 9033 Wilshire Blvd., Suite 200, in Beverly Hills.
Here’s a development to keep your eye on: Bariatric surgery performed on a small group of morbidly obese type 1s led to considerable weight loss, improved glycemic control, and improved metabolic profiles up to three years later.
The surgeries, performed by doctors at the Cleveland Clinic in Ohio on 10 patients, led to an average body mass index reduction of 27 percent and A1c’s that dropped from 10% to 8.9%. The average BMI of the participating patients was 41.6 before surgery. A BMI of 35 is considered the threshold for obesity.
Other statistical markers derived from the study included:
• The nine women and one man (average age 46) involved in the study had been diagnosed with type 1 for an average of 22 years and suffered from various comorbidities, including cardiovascular disease, gastroesophageal reflux, hypertension, hyperlipidemia, and sleep apnea,.
• The patients underwent one of three bypass approaches: laparoscopic Roux-en-Y gastric bypass (seven patients); adjustable gastric banding (two patients), and sleeve gastrectomy (one patient).
• At a follow-up almost 37 months after the procedure, nine of the patients had lost more than 60 percent of their weight–a stunning reduction. Their average daily insulin intake dropped from 0.74 to 0.40 U/kg.
The doctors, who published their findings in Diabetes Care, were careful to say that their patient sample was too small to draw broad conclusions from, and called for much larger studies to establish bariatric surgery as a therapy for treating obese type 1 patients.
Bariatric, or gastric bypass surgery works by reducing the size of a patient’s stomach. The result is considerably reduced appetite and food intake, almost always leading to significant weight loss.
The surgery has become an increasingly used approach to treating obese type 2 patients. Originally intended to address weight, years of data show that many type 2s who have undergone the procedure have had often dramatic reversals of their diabetes symptoms. In some cases, with great caution, doctors have declared total remission of type 2 diabetes in some patients.
The Cleveland doctors say that while the results of their small experiment show encouraging effects on type 1s, they don’t think that bariatric surgery could ever be considered a cure or near-cure for type 1 diabetes. It, however, could be a means of improving the metabolic profiles of type 1s by significantly reducing their weight and blood glucose levels.
Combat unexpected hair loss, which can be common for weight loss surgery patients for a short time post-surgery!
- Eat 80-100grams high quality protein daily.
- Ensure adequate iron intake with food and supplements and get your labs, including a full vitamin panel and thyroid, checked!
- Eat fish 2-3 times weekly for valuable essential fatty acids.
- Take your vitamins, including a full spectrum multivitamin daily.
- Eat 1-2 servings of dark green vegetables daily.
- Eat 1-2 servings of deep orange, yellow or red vegetables daily.
- Eat 2 servings of citrus fruits, berries daily.
- Get 7-9 hours of steady sleep.
- Limit caffeine intake 1-2 cups daily.
We love this recipe for you breakfast-skippers! You know who you are. Breakfast (or anytime) this yummy recipe is perfect for the bariatric patient or anyone! Oooh, stuff scrambled eggs with ham, pepper, onion and top it with reduced fat cheddar cheese…delish!!
2 medium russet potatoes
Olive oil spray
2 large eggs
3 egg whites
2 tbsp fat free milk
2 thin slices lean ham, chopped
2 tbsp chopped onion
1/2 cup bell pepper, chopped
Salt and fresh pepper
4 tbsp reduced fat cheddar cheese
*Pierce potato with a fork a few times all around. Place in microwave and cook about 5 minutes per potato. When finished, allow to cool enough to handle. Cut potatoes in half horizontally. Scoop out potatoes leaving about 1/4 inch thick wall or thinner for less carbs. (Skins weigh 2.5 oz after scooped)
*In a large bowl, whisk eggs, milk, salt and pepper. Add onion, pepper and ham and mix well. Spray a medium nonstick skillet with olive oil spray and cook the eggs, mixing often.
*Heat oven to 450°. Lightly spray potato skins on both sides with oil. Season both sides with salt and pepper. Fill with eggs and top each one with 1 tbsp cheese. Place on a baking sheet and bake 5-10 minutes or until cheese is melted.
Servings: 2, Serving Size: 2 skins
Protein: 23.8 grams
Carb: 35.1 grams
Fat: 7.6 grams
Incorporate these healthy tips into your daily life in order to ‘live well’ after weight loss surgery!
- SCHEDULE. Eat three small meals plus one healthy snack a day.
- STOP & THINK. Eat slowly and chew thoroughly.
- PROTEIN FIRST. Always.
- PUT THE FORK DOWN. Always stop eating as soon as you feel satisfied.
- USE THE 30 MINUTE RULE. Do not drink before or during meals.
- NO GRAZING. Limit eating between meals – stick to your meal plan of 3 meals and 1 snack a day.
- BECOME A GOURMET. Eat only good-quality, nutritious food.
- HYDRATE. Drink enough fluids during the day…and be sure to only drink low-calorie liquids.
- WORK IT OUT. Keep moving. And, then move some more!
Carbs are cheap food, and it’s no surprise that poorer children and families must live on these less quality calories to get by and survive.
The result of public schools squeezed by budget cuts, having to eliminate physical education and shorten recess combined with poverty and fewer healthy options, has resulted in a growing trend all over the USA: Heavier kids who become sick with adult onset diabetes far too early in life, and who are destined for a life of debilitating weight gain and early death.
You would think a surgeon who makes his living doing gastric bypass and other weight loss surgeries wouldn’t care about this, but the Khalili Center Foundation, staffed with some amazing physicians, is hoping to change at-risk kids’ future by educating through hands-on immersion and involvement.
The Khalili Center is one of the country’s premier bariatric surgery programs, located in Los Angeles. One of its partners, Dr. Kai Nishi, was named HealthTap’s Top Bariatrician in the Nation for the Summer 2013 Top Doctor Competition.
The three partners of The Khalili Center started the original minimally invasive bariatric program at noted LA hospital Cedars-Sinai, and then left there to form the Khalili Center for Bariatric Care, knowing they would be more free to dispense a broader, more patient-centric style of care on their own.
Part of their philosophy is that they’d far rather see the youth of Los Angeles learn to lead a fit life at a very early age, than to see them end up on their operating tables for bariatric surgery as adults.
The doctors literally walk that talk with their youth education programs. They go out to LAUSD schools and teach kids how to do jumping jacks, simple exercises and jog, and teach about the importance of good nutrition. They make it fun to learn.
The day before the upcoming L.A. Marathon, The Khalili Foundation, their organization that strives to end the cycle of obesity, conducts and promotes its own 5K walk within the official LABIG5K event. The KC is an event sponsor charity. Their efforts are in force right now to attract youth to participate along with their family members. The foundation sponsors 50 children from intercity schools to walk the 5K with the doctors.
Imagine if other doctors and medical groups took such a proactive stance and hands-on involvement with children in schools less served by wealth, if every business in the city would do half of what the Khalili Center does just for this one event. The message of how to live a fit and healthy life would be accomplished and the childhood rates for obesity would begin to plummet.
Dr. Kai Nishi and his partners who are so driven to help the youth of Los Angeles will have a booth at the 5K event on Saturday, March 8. They encourage all who are interested to join them.
We love these delicious and moist high protein meatballs because they are rich in the two most filling nutrients…protein and fiber! By adding spinach to meatballs you can eat the same amount of meatballs for fewer calories! There’s nothing like being able to eat a tasty bariatric meal!
1 lb 93% lean ground beef
1 tbsp olive oil
10 oz frozen chopped spinach, thawed and drained of all liquid
2 slices whole wheat Weight Watchers bread (or any half point bread)
1 large egg
1 clove garlic, minced
2 tbsp fresh parsley
1/2 cup Pecorino Romano cheese (or your favorite Parmesan Cheese)
Salt and pepper
1 tsp olive oil
3 cloves smashed garlic
28 oz can Tuttorosso crushed tomatoes (my favorite)
1/2 onion (don’t chop)
Salt and pepper
*Wet bread with water then mash up with your hands. Add to large bowl and combine with chopped beef, chopped spinach, egg, garlic, parsley, grated cheese, salt and pepper. Mix all ingredients well until thoroughly combined. Using a 1/4 cup measuring cup, measure meat, then divide in two so that each meatball is 1/8th of a cup. Roll into little meatballs.
*In a large pot, add olive oil and heat on medium. When hot, add smashed garlic. When garlic is golden brown, add tomatoes, onion, salt and pepper and cover, reduce heat to low.
*Meanwhile, in a large nonstick skillet, add 1 tbsp olive oil on low heat. When oil is hot add as many meatballs that will fit, cook on low, turning often so that all side get browned. Cook until the centers are cooked through.
*When finished, place on a dish lined with paper towels to blot any excess oil. Drop meatballs into sauce and continue cooking the remaining meatballs, repeating the process. When all meatballs are in the sauce, simmer for an additional 15-20 minutes. Discard onion and serve.
Servings: 6, Serving Size: 5 meatballs with 4.5 oz sauce
Protein: 17.4 grams
Carb: 14.3 grams
Fat: 9.8 grams
The benefits of weight loss surgery extend beyond the shedding of excess pounds to encompass financial, lifestyle and other health-associated advantages.
But still less than 1 percent of patients eligible for weight loss surgeries, including gastric bypass, undergo the procedures each year in the United States, according to the American Society for Metabolic and Bariatric Surgery.
Dr. Donovan Teel II, medical director of bariatrics for Premier Health Network, that operates Atrium Medical Center in Middletown, said he and a second physician perform about 400 bariatric surgeries each year. He said the leading reason why only 1 percent of eligible patients undergo the surgeries is “access and insurance coverage.”
“Obesity isn’t treated as an equal disease; there’s a bias against it,” Teel said, including companies adding extra co-pays for the procedure.
Weight loss surgeries are recommended for adults with a body mass index — amount of excessive body fat — of 40 or higher, or those with a BMI of 35 with obesity-related comorbidities such as high cholesterol, sleep apnea and diabetes, according to Dr. Joe Northup, a bariatric surgeon with the Mercy Health network in Fairfield. A normal BMI ranges from 18 to 25.
“Surgery is a declaration you will be successful and live a healthy lifestyle,” Northup said. “Most have already tried different ways to lose weight. Weight loss surgery is a tool to make diet and exercise successful.”
The American Society for Metabolic and Bariatric Surgery estimates between 150,000 and 160,000 Americans undergo bariatric surgery each year.
More than a third of U.S. adults are obese, and more than 8 percent of the U.S. population — 25.8 million people — have diabetes. The total costs of diagnosed diabetes in 2012 in the U.S. was $245 billion, according to American Diabetes Association.
“Patients are not aware of their BMI and who qualifies for surgery,” Northup said.
Northup and his partner, Dr. Mohamed Dahman, perform about 300 bariatric surgeries each year at Mercy’s Fairfield and Jewish hospitals. Northup said once a person hits a BMI of 40 or higher, it’s very difficult to have “successful sustained weight loss.”
Bariatric surgeries include three types: gastric bypass (creating a small stomach pouch that bypasses the rest of the stomach and a short section of intestine); sleeve gastrectomy (removing a large portion of the stomach to create a small stomach); and adjustable gastric band (creating a narrow area to slow food intake and reduce some hunger).
Weight loss surgeries have the ability to improve or reverse a patient’s comorbidities, including Type II diabetes, high blood pressure, heart disease and arthritis. Northup said Type II diabetes is resolved in 85 percent of his patients.
Michael Lacombe, 47, of Hamilton, has lost about 130 pounds since undergoing gastric bypass surgery by Dr. Northup in September 2013. At an original weight of 386 pounds, Lacombe said he’s lost between five and 10 pounds each week. His goal is to reach 200 pounds.
“I went from a high dosage of medications to none within two to three weeks,” Lacombe said. “My energy is up and I owe my life to Dr. Northup.”
Prior to surgery, Lacombe had high cholesterol, high blood pressure, and for the past 11 years, Type II diabetes being treated with insulin and pills. He saves about $300 a month on medications — money he says now “goes to my kids.”
Since having the surgery, Lacombe’s energy levels have increased and he spends more time with his family, wife Jennifer and children Nicholas, 12, and Meagan, 8.
“It’s easier to get out of bed in the morning; I don’t feel the stress on my knees anymore,” Lacombe said. “I can find clothing in my size now.”
Lacombe said through the help of dietitians at Mercy Health he’s been able to make significant changes to his diet, including eating lots of green vegetables and cutting out hamburgers and two two-liters of soda each night.
“You don’t have those urges anymore; I force myself to eat because I’m not hungry,” Lacombe said. “The hardest thing has been not eating hamburgers.”
Dr. Angela Fitch, medical director of medical weight loss programs at the UC Health Weight Loss Center in West Chester Twp., said in order for weight loss surgery to be successful, the patient still has to follow lifestyle recommendations, including 150 minutes of physical activity per week and eating 60 to 90 grams of protein each day.
“You have to develop a different relationship with food,” Fitch said.
One of the most important aspects of a bariatric diet is incorporating protein into your meals!
READ FOOD LABELS
- Look for the number of servings per container.
- Compare the amount being eaten to the serving size per container.
- Look for the grams of protein per serving.
COUNT THE GRAMS OF PROTEIN IN YOUR PROTEIN SUPPLEMENT
ESTIMATE HOW MUCH PROTEIN IS IN FOODS EATEN
- For example: 1 ounce of chicken, fish, beef, turkey = 7 grams protein
FOODS OF HIGH PROTEIN CONTENT
MEAT, FISH, POULTRY
|Lean ground sirloin||3 oz||21.0 gm||230|
|Roast||3 oz||19.0 gm||200|
|Corned Beef||3 oz||23 gm||215|
|Pork chop||3.5 oz||21.4 gm||150|
|Red snapper||1 cup||39.0 gm||100|
|Shrimp, boiled||3 oz||21.0 gm||85|
|Tuna, in water||½ cup||28.0 gm||90|
|Salmon||3 oz||20 gm||125|
|Perch||3 oz||22.5 gm||100|
|Flounder||3 oz||32.0 gm||100|
|Lobster||1 cup||19.5 gm||85|
|Haddock||3 oz||16.5 gm||95|
|Baked ham||3 oz||26.0 gm||130|
|Chicken, dark||3.5 oz||30.0 gm||175|
|Chicken, white||3.5 oz||33.0 gm||160|
|Turkey||3 oz||25.0 gm||120|
|Peanut Butter||2 tbsp||8.5 gm||190|
|Mashed potatoes||½ cup||2.0 gm||100|
|Fat free refried beans||½ cup||9.0 gm||135|
|Baked potato, no skin||1 small potato||3.0 gm||130|
|Barley||1 cup||4.0 gm||193|
|Baked beans||½ cup||6.0 gm||133|
|Kidney beans||½ cup||7.0 gm||107|
|Broth||½ cup||1.5 gm||25|
|Low fat creamed soup||1 cup||6.0-9.0 gm||90|
|Chicken noodle soup||1 cup||7.0 gm||110|
|Bean, Pea, or Lentil soup||1 cup||9.0 gm||230|
|Minestrone soup||1 cup||5.0 gm||90|
MILK, CHEESE, YOGURT
|Cottage cheese||½ cup||14.0 gm||90|
|Skim mozzarella||1 oz||6.0 gm||80|
|Fat free American cheese||1 slice||7.0 gm||35|
|Fat free cheddar, shredded||¼ cup||9.0 gm||35|
|Skim milk||1 cup / 8oz||8.0 gm||90|
|Non fat dry milk||1 oz||8.0 gm||90|
|Yogurt, light||1 cup||8.0 gm||90|
|Whole egg, large size||1 egg||7.0 gm||80|
|Egg white||1 egg white||4.0 gm||25|
|Egg substitute||¼ cup||7.0 gm||30|
|Edamame||1 cup prepared||17.0 gm||189|
1 oz = 2 tablespoons 2 oz = ¼ cup 3 oz = 1/3 cup 4 oz = ½ cup 8 oz = 1 cup
The information presented in the blog pages of Khalili Center is for educational and informational purposes only and should not considered personal medical advice. Consult with your personal physician/care giver regarding your own personal medical care.