Gastric Bypass and Gastric Banding surgeries have become common and highly successful surgical procedures for the treatment of morbid obesity, where weight excess is greater than 100 pounds over ideal body weight. Many stories have been presented in the print, radio and television media. These features tend to focus on the sheer numbers; 100 to 300 pound weight losses are, indeed, impressive. At the N.E.W. Program at Newport Beach we prefer to look at aspects of weight loss that do not get the same hype: quality of life issues.
True, losing 100 pounds or more is no small accomplishment. It improves the patient’s self-image, confidence and energy. A typical patient has a number of medical conditions that are made worse by the condition of obesity. Sleep apnea, high blood pressure, diabetes. weight-bearing joint disease, elevated lipids and disrupted liver function, plus many other maladies are exacerbated by the mere presence of obesity. How does this affect the patient? Sleep apnea is an excellent example. An obese patient with this condition NEVER gets a restful night’s sleep. Even when treated with an apparatus that aids in breathing during sleep, patients tested are proven to get less than adequate REM sleep when compared with normal individuals. This will lead to daytime sleepiness, and worse, drowsiness when alertness counts the most – when driving. Patients with this condition are constantly dragging through each day, fighting off dozing and often failing to do so. Diabetes is also prevalent in obese patients. At treatments costs which often exceed $50,000 per year, this debilitating disease causes early death and significant loss of function in daily activities. The neuropathy that accompanies diabetes leads to pain in the feet and legs, limited mobility and ultimately can result in skin ulcers and even amputation of the limb. Both of these conditions are cured or resolved in over 90% of all patients undergoing bariatric procedures.
Ask any patient who has “crossed over” into the healthy quality of life that ensues following weight loss surgery, and they will tell you “I wish I’d done this ten years ago”. Canes and walkers often are discarded when the arthritic conditions associated with obesity gradually fade away. Women unable to conceive children due to hormonal imbalances return to the clinic to show off their progeny; overjoyed by the realization of an event they had given up on as impossible before. Patients who have been on as many as 10-15 medications per day for high blood pressure, diabetes, high cholesterol, fluid retention and asthma (to name a few) often eliminate ALL of these medications, replaced with multivitamins, calcium, iron and B vitamins. A very fair trade, most would admit.
Ironically, you would expect the monthly spending budget for this new, thinner person to be much better – it isn’t for all expenses. While the cost of groceries and dining out is reduced significantly, this saving is more than offset by the new passion the patient now has: shopping for clothes. Since weight and inches are lost quickly, a person may only be able to wear a new article of clothing for a few times before it becomes too large for them. Some savvy shoppers have taken to second-hand clothing outlets to buy their “interim” apparel, while others are overjoyed to shop in “normal-sized” boutiques for the first time in their lives. Once again, consensus would be that this is a very fair trade, indeed.
Article by Patrick Sawyer, PA-C
By Brian Quebbemann, M.D. and Justin Braverman, M.D.
The N.E.W. Program
The world may be getting smaller, but it’s people are getting bigger . . . and bigger . . . and bigger.
Back in 1963, when the boats that carry customers through Disneyland’s “It’s a Small World” ride were first designed, an adult’s height was roughly the same as today, but the average adult weighed far less than 200 pounds. Not anymore. Today, the boats at Disneyland’s famous ride frequently “bottom out”, overloaded with today’s overweight passengers.
The “Small World” ride has been handicapped by a “Big Rider” problem. Instead of carrying mainly healthy-weight patrons, the ride must now accommodate adults who often weigh much more than 200 pounds. Increasingly, over-weighted boats get to certain points in the ride and become stuck on the bottom of the pool. In an attempt to avoid this problem, Disneyland employees have been trained to leave empty seats on many boats to compensate for hefty patrons, but this routinely upsets the hundreds of other paying customers waiting in line. When a boat does bottom out, the long line of boats backs up behind it, their passengers becoming upset while listening to the ride’s theme song over and over. The ride monitors must then find the stuck boat and attempt to tactfully help a heavy rider, or two, to an exit at one of the emergency platforms. To make things even more uncomfortable, some of the embarrassed, overweight riders do not deal with this situation graciously.
As a result of this growing inconvenience, Disney was forced to close down the “It’s a Small World” ride for an entire year in order to complete a massive renovation in which the boats will be redesigned, and the flume deepened, to accommodate their patron’s additional poundage. Unfortunately, this problem is not just isolated to Mickey Mouse’s home town.
Although America is well known to have an obesity epidemic, the problem is not confined to American shores. Even Mediterranean countries, touted for their heart-healthy diets, are being faced with expanding waistlines. In Italy, 42 percent of adults are overweight and 9 percent are obese, according to the World Health Organization. In France, 41 percent of adults are overweight and 11 percent are obese.
Though some experts blame America’s obesity problem on soft drinks or the use of high-fructose corn syrup as a sweetener, the problem goes much deeper. We live in a culture that encourages lifestyle patterns that include frequent overeating and minimal physical activity. Unfortunately, if obesity trends continue, researchers at Johns Hopkins University estimate that 75 percent of American adults will be overweight or obese in just eight years and 41 percent will in fact be obese.
Because obesity has been linked to at least 53 diseases, including diabetes, heart disease, stroke and cancer, and because the costs of obesity on society have become so huge, governments are now being forced to take action. In countries like Mexico, Brazil and China, the health costs of excess weight are rapidly becoming a big part of their budget. As a result, governments from Scotland to China are already debating how to tackle this issue. Planned maneuvers include taxing sodas and sugary drinks, revamping agricultural subsidies to make fruits and vegetables cheaper, banning junk-food ads on children’s television, and demanding equal advertising time for healthy food.
However, no matter what government initiatives are applied, the first steps to rectify this epidemic need to be made on an individual level. People must make positive changes in their lifestyle, especially eating habits, not just to lose their excess weight, but to avoid becoming overweight in the first place. It’s a sad day in our society, when instead of being able to successfully address the underlying issue of obesity, we are forced to tear down a famous ride and rebuild it in order to accommodate our unhealthy way of life.

Edamame is a popular snack food, but the wonders of this bean have only recently become evident in the United States. The combination of great taste, ease of preparation and excellent nutrient value is making it popular with people of all ages.
Edamame’s many health benefits is also something worth noting. The soybean is a complete protein containing all of the amino acid building blocks. It also provides an antioxidant boost from plant chemicals called isoflavones.
Fresh green soybeans are picked while they are still young. It is common for fields of soybeans to be picked when they mature to a dried form, however, the edamame bean is not allowed to mature and therefore is picked while still in the green pod.
High in protein, edamame beans provide a tender textured bean that can be served instead of other types of bean such as fava or lima beans. As a vegetable dish, the edamame bean is served steamed in the shell. It is also commonly cooked in salted water and then served like peanuts to be eaten out of hand. edamame tastes similar to nuts that are boiled, providing a chewy and nutty flavor. They can be stored refrigerated and should be eaten in several days. For recipe ideas, see Edamame three ways blog entry below.
Nutritional value of 1/2 cup cooked edamame*
127 calories
11 g protein
12 g carbohydrate
5 g fat (0.6 g saturated fat)
3.2 g dietary fiber
93 mg calcium
*Source: USDA Nutrient Database
Losing lots and lots of weight after bariatric surgery is the goal that all patients seek, but gaining permanent control of your weight-health is the true prize to achieve. Long-term success depends on a few simple steps: eating well, avoiding dieting, taking a few
and maybe a daily protein-packed supplement, and being active.
Although supplementation is vital following bariatric surgery, most nutrition should come from natural real foods. Whole foods contain many micronutrients (vitamins and minerals) that work together to provide the human body with maximum benefits. Whole foods are also highly satisfying because they often have high water content, are bulky, have tons of flavor, and require a lot of chewing. These characteristics of whole foods are hard to be copied or replaced by supplements and are almost never present in highly processed foods. When a person is eating smaller amounts of food, their body’s nutritional and hunger requirements will simply demand good food choices.
The professionals at The N.E.W. Program emphasize these healthy eating patterns for all of their clients, not just weight loss surgery patients, and work with all of their clients on an individual basis to help achieve the best long-term success.
The N.E.W. Program’s weekly workshop series continues Tuesday with a focus on balanced nutrition, food choices and compliancy. “Dr Q’s Three-S Rule” will be presented at 5:30 p.m., Tuesday, March 9 at our Newport Beach location.
