Think Before you Drink! Alcohol after Bariatric Surgery

Most of us know that if you drink alcohol on an empty stomach, you tend to become inebriated more quickly than you would if you had a full stomach. After gastric bypass or gastric sleeve surgery, the same thing happens.

Alcohol sensitivity, (particularly if alcohol is consumed during the rapid weight-loss period), is increased after bariatric surgery so that the effects of alcohol are felt with fewer drinks than before surgery. When alcohol enters the stomach of someone with normal gut anatomy, some of it is metabolized in the stomach. Conditions that reduce gastric metabolism of alcohol increase blood alcohol levels and its effects. Studies find with certain bariatric procedures (such as the gastric bypass or sleeve gastrectomy) that drinking an alcoholic beverage increases blood alcohol to levels that are considerably higher than before surgery or in comparison to the alcohol levels of individuals who have not had a bariatric procedure.

Bariatric patients are advised to take certain precautions regarding alcohol:

  • Avoid alcoholic beverages during the rapid weight-loss period.
  • Be aware that even small amounts of alcohol can cause intoxication.
  • Avoid driving or operating heavy equipment after drinking any alcohol.
  • Seek help if drinking becomes a problem.


Plump and young woman tests a glass of red wineIf you feel the consumption of alcohol may be an issue for you after surgery, please contact your primary care physician or bariatric surgeon and discuss this further. They will be able to help you identify resources available to address any alcohol-related issues.

The effects of alcohol are stronger and faster after both gastric bypass and gastric sleeve surgery. Aside from the physical dangers of becoming more inebriated quicker than we expect to be, the health dangers may be more pronounced as well. Alcohol is a carbohydrate that has no nutritional benefit and could lead to weight gain. It is toxic to the body and especially hard on the liver. If you must drink, moderation is key.

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If you live in the Las Vegas area and are interested in finding out more about bariatric surgery, schedule an appointment with Dr. Heidi Ryan. She can answer any questions you have about bariatric surgery and your options.

Hydrate with Style! Jazz up your Water with these Ideas

You know it’s good for you, but let’s face it, water is not the most exciting drink choice around. However, from the stuff we drink and swim in, to the steam that eases congestion and the ice that reduces swelling, water is all around us and in us. Heck, it kind of is us. After all, water makes up about two thirds of who we are, and influences every process in our bodies. Drinking enough of it is imperative to good health.

Not everybody has a taste for water, but there are ways to make it more appealing. If you want to drink more water, but aren’t crazy about the taste, here are some tips that can make it more enjoyable:

  • Add fresh fruit.
    • Citrus fruits, such as lemons, limes, and oranges, are classic water enhancers.
    • Try crushing fresh raspberries or watermelon into your water, or adding strawberry slices.
    • Cucumber and fresh mint are refreshing flavors as well.
  • Make it bubbly.
    • Try a naturally effervescent mineral water — which will give you the added benefit of minerals.
    • Try bubbly seltzer, a carbonated water. You can add fresh fruit or natural juice flavors to your seltzer, as suggested above, or look for naturally flavored seltzers at your local market.
  • Drink tea.
    • Herbal, fruit, green, white, and red teas are generally considered to be better for you than black teas (or coffee, for that matter) because they contain little to no caffeine.
  • Try bouillons, broths, and consommés.
    • If your palate leans toward the savory, start sipping one of these hot and savory liquids instead.
    • Choose low-fat and low-sodium versions for maximum health benefits.
    • Soup is water-based, so a cup of hot soup will count toward your daily fluid consumption.
  • Add fast flavor.
    • Consider sugar-free drink mixes.

In addition to the fact that our bodies need water to function properly in every way, drinking water helps us eat less by making us feel full, and it may also boost metabolism. Are you drinking enough water?

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If you live in the Las Vegas area and are concerned about obesity and the health problems that often accompany it, schedule an appointment with Dr. Shawn Tsuda. He and his expert team can help you find the right treatment for you.Healthy detox water with fruit in mason jars isolated

No so Fast: You are Going to Want to Eat and Drink With Regularity

When someone is considering bariatric/weight-loss surgery, concerns are usually about
the difficulties of wanting to eat something and not being able. It’s not often considered that there may be times in life that one wants or needs to go a significant amount of time without food or water. For example many of the world’s religions require the faithful to fast at certain time of the year. How does that work after bariatric surgery?

Fasting for religious or lifestyle reasons might pose a challenge to people who have undergone fastingbariatric surgery. A total fast — abstaining from all forms of nourishment including liquids — could be quite harmful to the bariatric patient.

After weight-loss surgery one’s digestive tract is physically different and can no longer accommodate large amounts of food. However, it’s also problematic for one to consume too little nourishment. After bariatric surgery, it’s critical to have an adequate intake of fluids and nutrients.

Those who wish to observe a fast after they have had bariatric surgery face several challenges:

  • new eating and drinking habits are being established
  • can’t consume large amounts in one sitting, so sipping fluids throughout the day is imperative
  • a complete fast poses risk for dehydration and poor calorie and nutrient intake
  • inadequate intake of protein can reduce lean body mass and metabolic rate

Fasting for long periods of time could result in vomiting, compounding dehydration and poor nutritional intake. Add to this the fact that foods that are usually eaten at the end of a religious fast are sweets, laden with carbohydrates and fats, that can also put you at risk for dumping syndrome and other unpleasant and uncomfortable side effects. Plus, the small amount of space in the stomach may make it difficult to fit the proper amount of food, nutritional supplements, and medications at meal times after a fast.

Read more about dietary needs after bariatric surgery at:

If you live in the Las Vegas area and are considering bariatric surgery, schedule an appointment with Dr. Heidi Ryan. She can answer your questions and address all of your concerns regarding these potentially life-saving procedures

All Protein Supplements Are Not Created Equal

There is a large assortment of protein supplementation on the market; however, it is essential to recognize that some supplements are of higher quality than others. For weight-loss surgery (WLS) patients, it can be very confusing if you are not aware of what to look for when it comes to protein supplementation.

Proteins are a part of every cell, tissue, and organ in our bodies. These body proteins are constantly being broken down and replaced. The body does not store protein for later use, big tub of whey protein with pink shaker and cup of protein powdtherefore consuming adequate high quality protein is necessary, otherwise the body will inevitably suffer. When protein intake is not adequate, the body will break down lean body mass to compensate for poor oral intake. Loss of lean body mass is inevitable for WLS patients or individuals following a very low calorie diet. To minimize that loss, sufficient high-quality protein must be consumed.

Most WLS patients rely strictly on liquids during the early post-operative phase, and the majority of their calories consumed during that time are often from protein supplements. Liquid or powder protein supplements may also be used post-operatively when patients are unable to consume adequate protein from food alone. This may be due to volume restrictions or food intolerances to protein rich foods.

Commercial protein supplements are available in many flavors, textures, tastes, mix-ability and price; however, the product’s amino acid composition is of the most importance when choosing protein supplements. Amino acids are the building blocks of protein. There are nine indispensable (essential) amino acids (IAA) and 11 dispensable (nonessential) amino acids (DAA). The IAA must come from dietary intake because the body is incapable of producing these compounds.

During rapid weight-loss, when protein supplements are the main source of dietary protein intake, it is essential to choose products that:

  • contain all of the IAA.
  • have a score of 100 on the protein digestibility corrected amino acid score.

WLS patients are going to get the best value when they choose supplements made from whey or soy isolate and avoid whey concentrate and collagen-based products. It is also important to remember that the use of protein supplements are typically decreased or cease throughout time as the WLS patient is able to meet daily protein goals from food of high biological value.

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If you are in the Las Vegas area and are considering bariatric surgery, schedule an appointment with Dr. Shawn Tsuda. He and his team of experts can find the right treatment for you.


The Food of the Kings is Now Readily Available to Us Regular Folks!

Spring has arrived, and with the season comes a new crop of fresh produce. In-season vegetables and fruits usually reap the most nutritional value, and asparagus is one of the most delicious and nutrition-packed vegetables of this time of year.

Dubbed the “food of kings” by Louis XIV of France, asparagus are low in fat and high in folic acid, a good source of potassium, fiber, and vitamins A, B6, and C. These tender stalks are at their peak from March through June but can be purchased year-round. When shopping for asparagus, look for sturdy spears with tight heads; the cut ends should not look dried out, wrinkled or woody. Fresh asparagus should snap when bent. Buy the freshest you can find and plan to use it within a day or two.

Delicious roasted, grilled, or lightly sautéed in olive oil, these seasonal spears make a tasty addition to any meal. The following is a healthy recipe for Creamy Asparagus Pasta. Lemon zest ties all the flavors together in this light and creamy dish.

Makes: 4 servings, 1 1/2 cups each

Active Time: 35 minutes

Total Time: 35 minutes


  • 8 ounces whole-wheat penne pasta
  • 1 bunch asparagus, trimmed and cut into 3/4-inch pieces
  • 1 1/2 cups whole milk
  • 4 teaspoons whole-grain mustard
  • 4 teaspoons flour
  • 1/2 teaspoon salt
  • 1/2 teaspoon freshly ground pepper
  • 2 teaspoons extra-virgin olive oil
  • 3 tablespoons minced garlic
  • 2 teaspoons minced fresh tarragon, or 1/2 teaspoon dried
  • 1 teaspoon freshly grated lemon zest
  • 2 teaspoons lemon juice
  • 1/2 cup grated Parmesan cheese, divided


  1. Bring a large pot of water to a boil. Add pasta and cook for 3 minutes less than the package directions. Add asparagus and continue cooking until the pasta and Norasit's Gallery (NorGal)asparagus are just tender, 3 minutes more. Drain and return to the pot.
  2. Meanwhile, whisk milk, mustard, flour, salt and pepper in a medium bowl. Heat oil in a medium saucepan over medium-high heat. Add garlic and cook, stirring, until fragrant and lightly browned, 30 seconds to 1 minute. Whisk in the milk mixture. Bring to a simmer, stirring constantly, and cook until thickened, 1 to 2 minutes. Stir in tarragon, lemon zest and juice.
  3. Stir the sauce into the pasta-asparagus mixture. Cook over medium-high heat, stirring, until the sauce is thick, creamy and coats the pasta, 1 to 2 minutes. Stir in 1/4 cup Parmesan. Divide the pasta among 4 bowls and top with the remaining 1/4 cup Parmesan.


Per serving: 359 calories; 10 g fat (4 g sat, 4 g mono); 18 mg cholesterol; 55 g carbohydrates; 18 g protein;7 g fiber; 602 mg sodium; 467 mg potassium.

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If you live in the Las Vegas area and are considering bariatric surgery, schedule an appointment with Dr. Heidi Ryan. She and her team of experts can help find the right treatment for you.

Tracking Your Journey to a Healthy You

Today, many people wear a wrist band commonly called a fitness tracker to report statistics on personal activity levels. The general opinion seems to be that one either likes them or not, and many agree they can be amusing for the short term. These devices replace and expand on the idea of the pedometer, and they do a lot more. They can track other body beats, too. Some people even wear their device to bed to tell them about their sleeping habits and movements as well. However, it seems to be up to the individual user as to whether thExercise tracking device Dollarphotoclub_101019544 (2)ey truly help with weight loss.

The equation for losing weight is fairly simple: burn more calories than you consume. If you want to lose weight, you must understand and pay attention to both calories taken in and calories burned. It stands to reason then that tracking what you are burning could help you monitor what you consume.

A fitness tracker can also be an interesting and worthwhile fitness motivator. These devices are extremely useful at making us aware of habits we often don’t think about and helping us change them. Depending on personal use, it may be worth the price tag if it motivates you to move more and improve your health.

Wearable devices and smartphone apps could help you in your weight-loss efforts. They can tell you whether you’ve covered the distance you’ve set as your goal and help you track the calories you consume. The weight-loss equation may be simple, but losing weight is hard. Consider trying a wearable device and smartphone to measure your progress, make exercise a consistent habit, and celebrate your daily successes.

How many steps do you think you walked today?

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If you are obese and have tried to lose weight through conventional means to no avail, schedule an appointment with Dr. Shawn Tsuda to see if you are a good candidate for bariatric surgery. He and his team of experts can help you find the right treatment for your unique case.



Cancer and Obesity: The Links Explored

Most people know that being significantly overweight is detrimental to one’s health, regardless of age or fitness level, but did you know that obesity will soon become the Cancer Blue Markernumber one risk factor for cancer, even surpassing tobacco use? Research shows that being a healthy body weight may cut your risk of getting certain kinds of cancer.

During the last two decades, there has been a dramatic increase in obesity in the United States, and rates remain high. According to the U.S. Centers for Disease Control and Prevention, nearly 35 percent of adults and approximately 17 percent of children and adolescents aged 2 years to 19 years are obese. The rate is highest in people older than age 40.

Researchers are exploring several ideas for how extra body fat may increase a person’s cancer risk. The answer appears to be slightly different for each type of cancer, but the bottom line is that obesity seems to cause chronic inflammation, which in turn may promote cancer development. Does that mean if you achieve a normal body weight you won’t get cancer? Unfortunately no. However, the key scientific findings do show that a healthy body weight can minimize risk.

Some types of cancer appear to be closely linked to carrying extra weight:

  • Breast (in women who have been through menopause)
  • Colon and rectal
  • Uterine
  • Kidney
  • Esophageal
  • Pancreatic
  • Endometrial
  • Thyroid
  • Gallbladder

Obesity-related pain or irregular hormone levels can disguise some of the early warning signs of some cancers. Fatty tissue may also make it difficult for doctors to see smaller tumors on imaging scans. A later-stage diagnosis often means a lower chance for survival or could necessitate more invasive therapy. Additionally, surgery, radiation, chemotherapy and other treatments may be challenged by a patient’s size. If the patient needs an operation, excess fat can put them at higher risk of complications because there is greater physical difficulty in performing the procedure if the anatomy is obscured by fatty tissue or difficult to recognize. In addition, poorer circulation and oxygen supply to excess fatty tissue impairs healing. Obesity associated medical conditions — sleep apnea, diabetes and a propensity to form blood clots — may also interfere with recovery.

Read more on this topic online at:

If you live in the Las Vegas area and are considering bariatric surgery to help you get to a healthy weight for you, schedule a consultation with Dr. Heidi Ryan. She and her team of experts can help you find the best treatment for you.