Make Exercise a Priority – Succeeding after Bariatric Surgery

Exercise is key to achieving the body you want after bariatric surgery, but getting started on a gradual exercise and physical activity plan can be challenging. An exercise plan should begin before surgery and resume as soon as allowed by you doctor after bariatric surgery. Any exercise or activity plan should be closely supervised by a doctor.

A consistent exercise or activity plan aids in reaching and maintaining an optimal weight loss, as well as helping to:

  • Tone muscles
  • Increase energy
  • Boost metabolism
  • Tighten loose skin caused by rapid weight loss
  • Decrease risk of cardiac disease
  • Lower blood pressure
  • Improve mood

Physical activity is defined as activities in addition to normal daily activities such as working, shopping, or housekeeping. Try to get at least 30 minutes of physical activity each day. Walking is an excellent exercise that you can begin immediately after your surgery. It is also recommended to add strength training to build and maintain muscle mass while toning your body, but usually doctors don’t advise starting strength training until at least six weeks after your surgery. It is important to allow your incisions to heal first.

Tips for Developing an Exercise Plan:

  • Find an exercise partner. You are more likely to stick to your plan if someone else is counting on you to be their exercise partner.
  • Join an exercise club, gym, or class. Try all the classes they offer and find the ones you enjoy the most.
  • Use the stairs instead of the elevator.
  • Park your car as far from your destination as possible and walk.
  • Walk as often as you can.
  • Avoid using remote controls – get up and change the channel instead.
  • Be creative! Try mall walking, aerobics, dancing, or swimming.
  • If you have a dog, take your dog for a walk every day.
  • To look good and feel comfortable while exercising – wear comfortable workout clothes and shoes.
  • Pack a gym bag so you can head straight to the gym after work.
  • Adopt a weekly plan. Look at your schedule on Sundays, and plan how you are going to fit physical activity into your schedule every day.

Are you ready to change your life? Contact Dr. Shawn Tsuda for an appointment.

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From the Garden…

Zucchini: Gorge yourself of this Good-for-You Gourd

If you have a friend or neighbor with a garden, chances are they are often pushing zucchini in the spring and summer.   In the right conditions, zucchini plants are prolific producers, making cooks come up with ever-new and different recipes for using this delicious gourd.

Like most members of the squash family, zucchini has smooth skin, tender, crunchy flesh, small edible seeds, and high moisture content, so you can substitute zucchini in recipes that call for other fruits and vegetables that are similar. Of course you can use it in place of other squash in casseroles, but you can also use it as a substitute for things like pasta, cucumbers (if you like it raw), or even as a substitute for apples in this mock apple pie:


Servings -10 Yield-1 pie

  • 6 -8 cups zucchini (peel, cut lengthwise, remove seeds, slice 1/4-inch thick)
  • 3⁄4 cup granulated sugar
  • 1⁄2 cup brown sugar
  • 2 teaspoons cinnamon
  • 1⁄4 teaspoon fresh grated nutmeg
  • 1⁄4 teaspoon fresh ground cardamom
  • 1 1⁄2 teaspoons cream of tartar
  • 2 tablespoons cornstarch or 2 tablespoons flour
  • 1⁄2 teaspoon salt
  • 1 teaspoon vinegar
  • 1 tablespoon butter
  • 2 ready pie crusts, Pillsbury
  • 1⁄2 teaspoon sugar, for topping the crust


  1. Preheat oven to 425 degrees.
  2. Cook zucchini slices in boiling water until barely tender, about 2 minutes.
  3. Remove from stove and drain very well and cool. Remove as much moisture as you can with paper towels.
  4. In a bowl, toss zucchini with sugars, cinnamon, nutmeg, cardamom, cream of tartar, cornstarch or flour, and salt until well coated.
  5. Place lightly floured pastry in a 9-inch, pan.
  6. Fill with zucchini mixture.
  7. Dot with butter, drizzle with vinegar.
  8. Top with crust.
  9. Brush top crust lightly with water and sprinkle crust with sugar.
  10. Bake for 15 minutes at 425.
  11. Reduce heat to 350 and bake about 45 minutes.
  12. Serve hot with a scoop of vanilla ice cream.
  13. Or serve chilled.

Not only will you have a new way to use zucchini, but you can enjoy these health benefits of zucchini:)

  • Zucchini is one of the very low calorie vegetables; with only 17 calories per 100 g. It contains no saturated fats or cholesterol. Its peel is good source of dietary fiber that helps reduce constipation and offers some protection against colon cancers.
  • Zucchinis have anti-oxidant value.
  • Zucchinis are rich in flavonoid poly-phenolic antioxidants such as carotenes, lutein and zea-xanthin. These compounds help scavenge harmful oxygen-derived free radicals and reactive oxygen species (ROS) from the body that play a role in aging and various disease processes.
  • It is a very good source of potassium, an important intra-cellular electrolyte. Potassium is a heart-friendly electrolyte and helps reduce blood pressure and heart rates by countering pressure-effects of sodium.

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Tipping the Scale in your Favor after Bariatric Surgery

Weight loss surgery can be a rewarding experience for individuals and their families, and of course, Dr. Tsuda and his expert team provide help and advice on maintaining your health. Ultimately, however, the patient must be willing to follow doctor’s orders and actively participate in living a new lifestyle. Here are many simple tips that can help reduce pain, increase energy, and improve weight loss:

  • Eat nutrient-rich foods: fresh fruit, vegetables, and lean meats. You can only intake so many calories after surgery, so make sure what you do eat counts.
  • Take a multivitamin every day: It’s best to get your vitamins and minerals from food rather than supplements, but because you’re just acclimating to the new you a multivitamin is a good idea.
  • Understand the limitations of a reduced-quantity diet: It won’t be possible to eat as much food after surgery; make sure the food you do eat is healthy.
  • Finish your course of antibiotics after surgery: This will help reduce the risk of infection.
  • Understand the limitations of surgery: While surgery can reduce appetite, it will not be able to eliminate it entirely. It’s up to you to maintain a healthy lifestyle and change your diet.
  • Chew, chew, chew: After gastric sleeve surgery bigger pieces of food might get caught in your digestive tract and end up being quite painful. It’s also important to thoroughly chew all of your food to reduce the chances of vomiting and/or nausea.
  • Skip cocktails: Your body is more sensitive to alcohol after weight loss surgery, and if you consume too much you can be more at risk to stomach ulcers. Alcohol also provides some of the least nutritious calories you can intake, so it will not help you stay on track of your new diet.
  • Don’t lose motivation: Losing weight takes time; take each day as a small step towards success.

If you are considering bariatric surgery, contact Dr. Shawn Tsuda. His knowledge and experience can help you turn your life around and show you how to be successful on your weight-loss journey.
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Can Weight-loss Surgery Cure Type 2 Diabetes?

According to the American Society for Metabolic and Bariatric Surgery (ASMBS), the U.S. is in the midst of twin epidemics – obesity and diabetes. Obesity is a major risk factor for developing diabetes, and more than 90 percent of Type 2 diabetics are overweight or obese, according to the ASMBS.

An estimated 25 million Americans are currently affected by Type 2 diabetes. Because such a large percentage of our population is affected or at risk, novel treatments with the potential to lower the incidence of diabetes have captured the attention of clinicians, hospital administrators, researchers, and patients.

For overweight and obese patients, bariatric surgery has long been considered an effective option for significant weight loss that can also reduce sleep apnea and heart disease. However, some researchers have asked whether bariatric surgery can also cure diabetes. Some obese people who have weight-loss surgery see their diabetes disappear. Their blood sugar normalizes, and they no longer need medication to control it. Whether the diabetes-free benefit lasts forever, though, remains to be seen.

In 2012, two studies demonstrated that 95% of patients saw their diabetes improve or disappear two years after undergoing a lap band, biliopancreatic diversion, or gastric bypass surgery for weight loss. Researchers found that in obese patients with uncontrolled type 2 diabetes, 12 months of medical therapy plus bariatric surgery achieved glycemic control in significantly more patients than medical therapy alone.

No one can be sure how surgery will impact the future of diabetes care. More comparisons between bariatric surgeries and medical therapy are needed before anyone in the industry can arrive at a firm conclusion. However, in 2011, the FDA expanded bariatric surgery eligibility requirements to include patients with lower BMI and at least one obesity-related risk factor, such as diabetes. This change will likely encourage continued research on the link between weight loss surgeries and lasting diabetes remission.

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Sneaking Exercise into your Vacation

All too often, along with family vacation fun comes lots of extra calories, thanks to dining out and indulging in treats that aren’t normally included in one’s daily diet. However, if you keep moving during your vacation, you can still enjoy a few indulgences without taking home souvenir pounds!

  • Opt for walking tours. Not only is this less expensive than most bus tours, it also gives you flexibility to customize your vacation the way your family wants to spend it.
  • Choose active activities. Since the goal of family vacations is to have fun, knowing that you don’t have to take extra time for family fitness can take the guilt out of letting loose. When you plan accordingly, excursions like hiking, snorkeling, or simply splashing around in the hotel pool can burn calories without putting a damper on your good times.
  • Walk along the beach. Instead of just lounging on the beach, try to sneak in a little family fitness while taking in the sunshine. Whether you take a family jog or walk, toss a Frisbee or football around, or chase your kiddos around in the surf, your body works a little harder when trying to keep stable on the sand’s soft surface. That helps you and your brood burn off those vacation pounds long before you head home. vacation exercise image
  • Get active after meals. You don’t have to go overboard with exercise while on vacation, but engaging in a little physical activity aids in digestion and helps you burn off those extra calories you indulged in for dessert. Take a family stroll downtown, do a little shopping after lunch, or walk back to your hotel after your meal instead of catching a cab — it all counts as family fitness when you’re on vacation.

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Dr. Tsuda wishes you and your family happy, healthy travels this summer!

Weighing your Options:

Questions to Ask when Considering Bariatric Surgery

Before you head to a bariatric surgeon’s office, there are a few things to think about. Bariatric surgery isn’t for everyone. There are risks to weigh, financial considerations to mull over, and medical issues to take into account. Ask yourself these questions to begin the process of considering weight-loss surgery:

  • What is your BMI? If you don’t know your body mass index (BMI), you can use this online calculator to figure it out, or have it evaluated in your health care provider’s office.
    • If your BMI is greater than 40, weight loss surgery could be a reasonable option if you are healthy enough to sustain the procedure.
    • If your BMI is 35 or over, you may be a good candidate for surgery if you have at least one obesity-related medical condition.
    • If your BMI is over 30 and your health is also compromised by diabetes or metabolic syndrome you may want to speak to your physician about bariatric surgery.
  • Have you tried other weight loss programs? Some insurance companies will only cover the expense of the procedure if you have tried traditional methods of weight loss for at least six months.
  • Are you ready to change your lifestyle? Patients who have the greatest success with bariatric surgery adopt moderate eating and exercise habits to maintain their weight loss over a long period of time.
  • Have you investigated the different types of surgery available in your area? There are several different procedures available for patients who choose weight loss surgery. Three common types of bariatric surgery are:
    • Roux-en-Y gastric bypass
    • laproscopic adjustable gastric banding
    • laproscopic sleeve gastrectomy

Each procedure has different risks and benefits.

  • Will insurance cover my expense? According to one report, 25% of patients considering surgery were denied coverage three times before finally getting approval.

Use these questions as a starting point for considering the weight loss surgery option, and schedule an appointment with Dr. Heidi Ryan. She can help you discover your options for becoming a new, healthier you.
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