The True Size of the American Obesity Epidemic

To understand the true magnitude of the American obesity epidemic, we first need to understand what it really means to be overweight. Doctors and nutritionists classify people as either underweight, healthy weight, overweight, or obese. These different classifications are determined by body mass index (BMI), or a measure of body fat based on your height and weight.

To get a basic idea, this chart from the CDC approximates what that means for someone who is 5’9” tall.

Height Weight Range BMI Considered
Source: CDC      
5′ 9″ 124 lbs or less Below 18.5 Underweight
  125 lbs to 168 lbs 18.5 to 24.9 Healthy weight
  169 lbs to 202 lbs 25.0 to 29.9 Overweight
  203 lbs or more 30 or higher Obese

As for what is driving America’s chronic weight problem, there are no definite answers. Scientific studies often reach conflicting conclusions. Many theories are out there, but the preponderance of evidence points to the two causes most people already suspect: too much food and too little exercise.

Bigger portions, confusing “diet” for “nutrition,” and lack of exercise are a deadly combination. Today, each American puts away an average of 195lbs of meat every year, compared to just 138lbs in the 1950’s. Consumption of added fats also shot up by around two thirds over the same period, and grain consumption rose 45% since 1970.

Research published by the World Health Organization found that a rise in fast food sales correlated to a rise in body mass index, and Americans are notorious for their fast-food consumption. It is not just how much we eat, but what we eat.

The role of diet in the obesity epidemic is obviously major, but it’s also complex. Consumers are sent mixed messages when it comes to what to eat and how much. Larger portions, processed packaged food, and drive-thru meals are branded as almost classically American — fast, cheap, filling, and delicious, but yet we spend billions of dollars annually on weight loss schemes.

Lack of exercise is also a major culprit in the obesity epidemic. A far greater majority of us are sitting throughout our workday. According to one study, only 20% of today’s jobs require at least moderate physical activity, as opposed to 50% of jobs in 1960. Other research suggests Americans burn 120 to 140 fewer calories a day than they did 50 years ago. Add this to the higher number of calories we are packing in, and we get a perfect recipe for weight gain.

A number of other factors are thought to play a role in the obesity epidemic, such as the in- utero effects of smoking and excessive weight gain in pregnant mothers. Poor sleep, stress, and lower rates of breastfeeding are also thought to contribute to a child’s long-term obesity risk. Of course, these factors are not explicit or solitary causes of obesity, but they are reliable indicators of the kinds of systemic problems contributing to this crisis.

In the end, though, we can’t lose sight of the big picture. Over the past years, diet fads have come and gone, with people rushing to blame red meat, dairy, wheat, fat, sugar, etc. for making them fat, but in reality, the problem is much simpler. Genetics and age do strongly influence metabolism, but as the CDC points out, weight gain and loss is primarily a formula of total calories consumed versus total calories used.

If you are looking for answers to debilitating obesity and the health issues that often accompany the extra weight, contact VIP Surg at (702) 487-6006. We can help you find the right treatment for your unique situation.

A pair of female feet on a bathroom scale

Most Common Surgical Treatments for Clinically Severe Obesity

The obesity epidemic continues to grow in our country, and with obesity comes a whole host of additional health risks, like type 2 diabetes, heart disease, high blood pressure, osteoarthritis and stroke. Those looking to reduce these obesity-related health risks are turning to bariatric or medical weight-loss surgeries like gastric bypass.

With weight-loss surgery, your surgeon makes changes to your stomach or small intestine, or both. The procedure resolves diabetes 80 percent of the time, and patients lose an average of 70 percent of extra weight. However, gastric bypass isn’t the only choice. Learn about your options:

Laparoscopic Adjustable Gastric Band – The surgeon puts a small band around the top of your stomach. The band has a small balloon inside it that controls how tight or loose the band is. The band limits how much food can go into your stomach. This surgery is done using a laparoscope. Advantages include:

  • Minimally invasive with small incisions
  • Short hospital stay
  • Adjustable without additional surgery
  • Can support pregnancy
  • Removable at any time

Laparoscopic Gastric Sleeve – This surgery removes most of the stomach and leaves only a narrow section of the upper part of the stomach, called a gastric sleeve. The surgery may also curb the hunger hormone ghrelin, so you eat less. Advantages include:

  • No cutting, bypassing, or stapling of the intestine
  • Little concern about vitamin and calcium absorption
  • No adjustments or artificial devices put into place
  • Most foods are possible

Laparoscopic Roux-en-Y Gastric Bypass Surgery – The surgeon leaves only a very small part of the stomach (called the pouch). That pouch can’t hold a lot of food, so you eat less. The food you eat bypasses the rest of the stomach, going straight from the pouch to your small intestine. This surgery can often be done through several small incisions using a camera to see inside (laparoscope). Doctors can also perform a mini-gastric bypass, which is a similar procedure also done through a laparoscope. Advantages include:

  • Tiny incisions, resulting is less scarring and easier healing
  • Excellent cosmetic result
  • Little pain
  • Few wound complications
  • Fast recovery
  • Short hospital stay
  • Resuming physical activity soon
  • Little risk of hernia formation

Duodenal Switch- This is complicated surgery that removes most of the stomach and uses a gastric sleeve to bypass most of your small intestine. It limits how much you can eat. It also means your body doesn’t get as much of a chance to absorb nutrients from your food, which could mean you don’t get enough of the vitamins and minerals you need. Advantages include:

  • Results in greater weight loss than other methods, i.e. 60 – 70% percent excess weight loss or greater, at 5 year follow up
  • Allows patients to eventually eat near normal meals
  • Reduces the absorption of fat by 70 percent or more
  • Causes favorable changes in gut hormones to reduce appetite and improve satiety
  • Is the most effective against diabetes compared to other methods

If you’re considering bariatric surgery, schedule an appointment with Dr. Shawn Tsuda. He can help you decide which, if any, of these treatments is right for your unique situation.Fat man running

 

Does your Diet Support your Warm-Weather Exercise Regimen?

Spring is here, and you might be changing up your fitness routine with warm weather in mind. However, just taking your exercise outside and hydrating more might not cut it for your new regimen. You need to properly fuel your body for the exercise you are doing.

Whether you’re training for fat-loss, a race personal best or just fun, how you fuel your body around the clock – not just immediately before or after exercise – affects your workouts. Try to avoid starving and then feasting; just stay fed by regularly eating while you’re awake. By eating regularly throughout the day, you can largely eliminate the need to worry about dedicated pre- and post-workout meals. Just schedule your workout between your regular meals.

Americans are notorious for getting the bulk of their protein intake at dinner. However, 2014 research published in the Journal of Nutrition shows that simply distributing your regular protein intake more evenly throughout the day improves the body’s ability to build lean muscle. Whatever your sport or workout goal, having healthy levels of muscle will help you reach it. Eat at least 25 to 30 grams of protein per meal. And, remember, those meals should be frequent.

It is important to boost your hydration factor. Most of us are chronically dehydrated, which can take a toll on your ability to focus and concentrate when exercising, and it can impair your strength and power. Research in the Journal of Athletic Training also shows that dehydration can worsen post-exercise muscle soreness. During exercise, aim to drink 6 to 8 ounces of water every 15 to 30 minutes. Ideally, when you finish your workout, your weight should be no more than 2 percent less than your starting weight. Any additional losses in weight point to significant dehydration.

Cutting down on packaged foods and focusing on nature-made foods such as fruits, vegetables, whole grains, dairy and meats is also important. Put junk in, and you can expect to get junk out.

Whatever your exercise goals or routines, know that you can’t out-exercise a bad diet. After all, food is fuel. Without the right fuel in the tank, you’re not going to get where you want to go.

If you’re in the Las Vegas area and are interested in weight-loss surgery, schedule an appointment with Dr. Shawn Tsuda. He can help you find the perfect treatment for your situation.Screen Shot 2017-04-10 at 11.19.07 AM

What you Need to Know about Protein

You probably know you need to eat protein, but what is it and where exactly do you find it? The answer is – everywhere – if you’re talking about the body. Proteins make up about 42% of the dry weight of our bodies. The protein collagen—which holds our skin, tendons, muscles, and bones together—makes up about a quarter of the body’s total protein. Protein builds, maintains, and replaces the tissues in your body. Your muscles, your organs, and your immune system are made up mostly of protein. All of our cells and even blood are packed with protein molecules.

Proteins, along with fats and carbohydrates, are the macronutrients that form the basis of our diets. Once consumed, some people associate protein only with helping to build muscle, but keep in mind that’s not all it does for us. In our bodies, protein performs a range of duties, from building new cells to regulating metabolism to helping cells communicate. Proteins help shuttle oxygen throughout the body in the form of hemoglobin, as well as build muscle.

When you eat foods that contain protein, the digestive juices in your stomach and intestine go to work. They break down the protein in food into basic units, called amino acids. The amino acids then can be reused to make the proteins your body needs to maintain muscles, bones, blood, and body organs.

Amino acids are the building blocks of proteins. Our DNA directs the body to join various combinations of amino acids into a variety of sequences and three-dimensional shapes for an arsenal of over 2 million different proteins, each serving a unique function. Our bodies can make some of these amino acids, but there are nine that are considered “essential amino acids” because we must consume these through our diet.

Many foods contain protein, but the best sources are:

  • Beef
  • Poultry
  • Fish
  • Eggs
  • dairy products
  • Nuts
  • Seeds
  • legumes like black beans and lentils

While our bodies can store fats and carbohydrates to draw on when needed, we do not have a storage pool of amino acids. We need a fresh source each day in order to build the body proteins we need. If the body is missing a particular amino acid to form the protein it needs, it will pull that amino acid by breaking down existing muscle protein. If we consistently lack certain amino acids we will lose muscle weight, energy and, eventually, fundamental functions.

The amount of protein you need depends on your weight and health. The Recommended Daily Allowance (RDA) for protein for the healthy individual is 0.8 grams of protein per kilogram of body weight or 3 to 4 grams per 10 pounds, and two to three servings of protein-rich food will meet the daily needs of most adults. Athlete’s protein intake recommendations may be higher.

The good news is that you don’t have to eat all the essential amino acids in every meal. As long as you have a variety of protein sources throughout the day, your body will grab what it needs from each meal.

You can look at a food label to find out how many protein grams are in a serving, but if you’re eating a balanced diet, you don’t need to keep track of it. It’s pretty easy to get enough protein.

*Dr. Shawn Tsuda is a General Surgeon specializing in robotic bariatric surgery. Schedule a consultation to learn more.
gabel mit verschieden Proteinen

Heartburn or GERD – It makes a Difference

Acid reflux occurs when stomach contents moves backward into the esophagus. It’s also called acid regurgitation or gastroesophageal reflux (GERD). Acid reflux is a common digestive condition. According to the American College of Gastroenterology, more than 60 million Americans experience acid reflux at least once a month. More than 15 million Americans experience it every day.

Acid reflux usually causes a burning sensation in the chest. The sensation radiates up from the stomach to the mid-chest or throat. This is also known as heartburn. When symptoms that seem like heartburn persist, it could be a disease with more serious consequences. Chronic reflux can sometimes lead to difficulty swallowing and in some cases it can even cause breathing problems like asthma.

Acid reflux is caused when the muscle at the end of the esophagus, the lower esophageal sphincter (LES) is faulty or weak. The LES is a one-way valve that normally opens for limited amounts of time when you swallow. Acid reflux occurs when the LES doesn’t close properly or tightly enough. A faulty or weakened LES allows digestive juices and stomach contents to rise back up into the esophagus.

Large meals that cause the stomach to stretch a lot can temporarily loosen the LES. Other factors associated with reflux include:

  • obesity
  • stress
  • hiatal hernia (when part of the stomach pushes up through the diaphragm)
  • consuming particular foods (particularly carbonated beverages, coffee, and chocolate)

Most people experience occasional acid reflux or GERD. However, in some cases the digestive condition is chronic.

Acid reflux can affect infants and children as well as adults. Children under 12 usually don’t experience heartburn. Instead they have alternative symptoms like:

  • trouble swallowing
  • dry cough
  • asthma
  • laryngitis (loss of voice)

These alternative symptoms can also appear in adults.

Gastroesophageal Reflux Disease (GERD) is a chronic digestive disease. It’s the more serious form of GERD and can eventually cause more serious health problems if left untreated. Acid reflux that occurs more than twice a week and causes inflammation of the esophagus is considered to be GERD.

Most people with GERD experience symptoms such as:

  • heartburn
  • regurgitation
  • trouble swallowing
  • a feeling of excessive fullness

Living with acid reflux is inconvenient. Fortunately, symptoms can generally be controlled through:

  • stopping smoking
  • reducing alcohol consumption
  • eating less fat
  • avoiding foods that set off attacks
  • losing weight
  • sleeping in different positions
  • antacids
  • anti-reflux medication
  • surgery

Most people with reflux will not have long-term health problems. However, GERD can increase the risk of Barrett’s esophagus. This is a permanent change in the lining of the esophagus which increases the risk of esophageal cancer.

If you suffer from GERD that isn’t responding to treatment, schedule an appointment with Dr. Shawn Tsuda to learn about LINX http://www.linxforlife.com/. This could be the answer you’ve been searching for.

Stethoscope on notebook and pencil with GERD (Gastroesophageal R

 

Weight-loss Surgery Myths – Setting the Record Straight

If you are considering bariatric surgery, you’ve probably heard many of the popular myths. These run the gamut from horror stories to fairy tales. In reality, these procedures are neither as awful nor as fantastic as they’re made out to be. Here are some facts to help set the record straight about weight-loss surgery (WLS).

Myth: All bariatric surgery involves stomach stapling.

  • There are many different types of gastrointestinal procedures for weight loss, some of which reduce the functioning size of the stomach and others that bypass parts of the digestive tract, reducing absorption of calories and nutrients. Different types of surgeries offer different results, and some are more suitable for particular people than others.

Myth: People who get weight-loss surgery don’t have willpower.

  • Many bariatric surgery patients have struggled for years, pushing themselves to extremes to lose weight and keep it off. They understand that surgery is a final option when everything else has failed. The surgery, recovery and lifestyle changes that accompany WLS require both courage and determination on the part of the patient.

Myth:  Bariatric surgery is only for the morbidly obese.

  • Obesity is only one of the criteria that qualify patients for surgery. Overweight patients may also be candidates if they have one or more health problems that might be reduced or alleviated by weight loss such as diabetes, sleep apnea, hypertension, arthritis, and high cholesterol.

Myth: Bariatric surgery is extremely dangerous.

  • Any type of surgery has associated risks, such as complications or even death. However, a number of recent advances have helped to minimize risks. Surgeries are usually done laparoscopically with mini-incisions that result in faster healing, less pain, and less scarring.

Myth: You will finally be skinny after bariatric surgery.

  • Losing just 50% of excess weight and keeping it off is considered a success story. That’s still going to be overweight in the eyes of most people. Plus, your skin isn’t necessarily going to tone up and be free of drooping after weight loss. However, the health benefits in reducing weight-related problems like sleep apnea often occur even in patients who don’t lose all the weight they would like.

Myth: Weight loss from bariatric surgery is permanent.

  • Unfortunately, even this one is not true. In fact, some regain is likely. Part of this is simply the body adjusting and learning to store fat even on a very restricted diet. At other times, a patient’s failure to adhere to the post-surgery lifestyle recommendations plays a role.

Myth: You should only have WLS if you are done having kids.

  • It isn’t safe to get pregnant in the first year or two after bariatric surgery. You simply won’t be getting enough nutrients to support a growing fetus. After you are done losing weight (if you are taking all your supplements and monitoring your health carefully), getting pregnant should be okay. This is something to discuss with your bariatric surgeon.

Myth: After bariatric surgery, you won’t be able to eat anything that tastes good.

  • Patients who undergo gastric bypass may need to avoid very sweet foods because it can cause side effects like dizziness and nausea. Patients who have a duodenal switch typically need to keep fatty foods to a minimum. However, many patients can and do eat their favorite foods after they recover from surgery. They just eat very small portions.

Myth: You can never be far from a bathroom after WLS.

  • In the aftermath of surgery, you may find yourself having some “emergency” bathroom visits. However, symptoms like diarrhea and vomiting should subside over time as you get a better handle on how your altered digestive system responds to food.

Myth: Bariatric surgery is reversible.

  • Gastric banding is usually reversible. That’s because the stomach and intestines are not cut or stapled with this surgery. Gastric bypass may be reversible, but this is a very involved surgery. It’s more difficult to put everything back where it was, and there is a risk that the revision won’t restore normal function. Sleeve gastrectomy and duodenal switch entail actual removal of part of the stomach without reattaching it lower on the intestine. This type of surgery is not reversible.

Surgery for weight reduction is not a miracle procedure. Weight loss surgery is designed to assist the morbidly obese in developing a healthier lifestyle. A surgical weight loss operation is a useful tool for weight loss, but it is a surgical procedure that requires a substantial lifelong commitment. The surgery alone will not help someone lose weight and keep it off. The patient must change eating and exercise habits. Without changes to the daily pattern of eating and activity, the patient is likely to regain the weight over time.

 

Gastric Bypass for a Longer Life

According to research by the Geisinger Health System, one of the largest health service organizations in the U.S., patients with severe obesity who have gastric bypass surgery reduce their risk of dying from obesity and other diseases by 48% up to 10 years after surgery, compared to similar patients who do not undergo the procedure. This is significant considering that the American Society for Metabolic and Bariatric Surgery estimates about 24 million Americans have severe obesity, which would mean a BMI of 35 or more with an obesity-related condition like diabetes or a BMI of 40.

Researchers from the Geisinger Health System followed nearly 2,700 patients who had gastric bypass at the system’s nationally accredited bariatric surgery center between 2004 and 2014. Mortality benefits began to emerge within two years after surgery and were significant within four years. The biggest reduction in risk occurred in patients 60 years or older at the time of surgery and in patients who had diabetes before surgery.

“The long-term survival benefits these older patients and those with diabetes experience likely relate to improvements in long-term metabolic and cardiovascular health, among other risk factors,” said Michelle R. Lent, Ph.D., a Geisinger Obesity Institute researcher. “While this study did not evaluate specific-cause mortality, as expected, we did find significant improvements or remission in diabetes and high blood pressure.”

In the study, more than 60 percent of patients with diabetes before surgery experienced diabetes remission about five years after surgery. Previous studies have shown death from heart disease and even certain cancers are lower in gastric bypass patients than patients with severe obesity who do not have the operation.

People with obesity and severe obesity have higher rates of heart disease, diabetes, some cancers, arthritis, sleep apnea, high blood pressure and dozens of other diseases and conditions. Studies have shown individuals with a BMI greater than 30 have a 50 to 100 percent greater risk of premature death compared to healthy weight individuals.Live Longer

If you live in the Las Vegas area and are interested in learning what bariatric surgery can do for you, schedule an appointment with Dr. Shawn Tsuda. He and his team of experts can help you choose the best treatment for your unique situation.