Archive for the ‘The Sasse Guide™’ Category

Larry Whitler And Robin “Health First” Interview Experience

Tuesday, January 19th, 2010

Larry Whitler and Robin in the Daytona, Florida area, certainly have a great show and a great interaction on the air. They were gracious enough to have me as a guest on their program to discuss Life Changing Weight Loss, my newest book being released in January of 2010. Larry confessed that he is planning to lose weight as part of his own New Year’s resolution and the lively exchanged focused on the ways in which the book can help a person accomplish that mission.
The guest who followed my interview was Mike Huckabee, a person who knows quite a bit about losing weight. We also touched a bit on the problem of childhood obesity and what parents can do to help their children avoid the path toward adolescent and adulthood obesity.
Clearly as parents we all must set the best example possible. Our children need to see us making good food choices and exercising regularly and maintaining a healthy weight.
Thanks to Larry and Robin for a great show and the great dialogue they are providing on the air on Health Matters.

The Metabolic Miracle Explained

Thursday, December 10th, 2009

The metabolic miracle in truth describes the amazing, but predictable phenomenon that occurs when people with Type 2 diabetes lose weight. A high percentage of people in this situation will, by reducing their weight below the “diabetes threshold”, cure their Type 2 diabetes simply through weight loss. Because Type 2 diabetes results from weight gain in most cases, working very hard to reduce weight, pays big dividends in the form of reversing the development of the diabetes disease process. For each person the threshold weight at which their body is no longer able to properly handle and metabolize the blood sugar is different. And this threshold weight changes over time as we age. So what we find is that a variety of factors put us at risk for Type 2 diabetes, namely our own genes and our own intrinsic metabolism. But, then two powerful factors determine when and if we will actually develop diabetes and require medicines or insulin injections to maintain control of our blood sugar. These two factors are: chronological age, and weight. So pure and simple, as we age our risk of developing Type 2 diabetes goes up. Unfortunately there is really noting we can do about aging, at least until the anti-aging science develops some concrete solutions for us all! But, the even more powerful factor that determines when, and if we develop Type 2 diabetes is our weight. We do have tremendous control over our weight!
I have helped so many people who came to me with a story along the lines of this one: a patient named Judy had developed Type 2 diabetes after her weight increased and surpassed 240 pounds. She was forty-seven years old and found herself suddenly required to take two different types of oral medicines to control her blood sugar. After another year passed her doctor was increasing the doses and she was being told that she may soon need to move on to insulin injections to control her blood sugar. She was very discouraged and the combination of this depressing news, life stress, and a sore lower back all contributed to steady and increasing weight gain. Now she was 250 pounds and it seemed like her future was bleak. I helped Judy reorient her thinking about Type 2 diabetes and see that she could actually exert a lot of control. We talked about how taking extra medicines (one of which has as its chief side effect-you guessed it, weight gain!), along with finger sticks and checks of her blood sugar, and the possibility of injecting herself with insulin were all fairly “extreme” behaviors. She had previously viewed very intensive weight loss strategies as “ to extreme” and had therefore rejected them. I asked her to consider whether it really seemed all that extreme to follow a medically supervised, protein based meal replacement shake diet with very careful monitoring of her calories and blood sugar for fifty-two weeks, when compared to the extreme life changes she was forced to undergo to treat her diabetes. Over time Judy looked through what was involved in seriously embarking upon a medically based weight loss program and she changed her opinion about it. She realized that the sacrifice and pain and suffering involved in blending protein shakes and carefully monitoring her calories paled in comparison to the pain and suffering of taking more medication, seeing her health deteriorate and watching her blood sugar numbers rise. Once she made this mental leap, there was no turning back. Judy began losing weight and steadily, month by month lost more and more weight until the day arrived that her wight had dropped below 190 pounds. At that point she began having sustained normal blood sugar readings day, after day, after day even while reducing and finally eliminating her diabetes medicines altogether. Her primary care doctor was astonished to say the least. Now let’s be clear, not every single person with diabetes can experience the metabolic miracle and watch their diabetes melt away through a medically based weight loss system. For example: people with Type 1 diabetes generally will not expect to see this kind of result. And there are also a small percentage of people with Type 2 diabetes that has arisen because of their genetic make up and not because of weight gain. But, for the vast majority of people whose Type 2 diabetes does largely stem from weight gain, the metabolic miracle is waiting to happen. Given that 95 percent of diabetes in this country is Type 2 diabetes, and given that around 90 percent of those cases stem in significant part from weight gain, we are talking about tens of millions of people just in the United States alone and if you add the additional 70 million people with pre-diabetes whose blood sugars have begun to rise and whose metabolic machinery is well on the path toward full blown diabetes, you are talking about a rather sizable percentage of the overall population who stand to benefit right now from the approach outlined in this book to achieve the metabolic miracle of diabetes resolution.

Losing Weight “Smart”

Thursday, December 3rd, 2009

On a recent radio interview, the host asked me about fat diets and crash diets as opposed to losing weight “smart.” I thought that was a very appropriate term to describe our philosophy at iMetabolic. If weight loss isn’t achieved with a smart plan it is often very transience; the person who drops pounds quickly with a crash diet is often subject to rebound weight gain.
What is losing weight smart? It is really a process that focuses on your goals, both short and long term. It takes into account the science and the experience derived from the successes and failures of weight loss centers around the world. (Take a look at my recently released book Doctor’s Orders, a 101 Medically Proven Tips for losing weight for a good accounting of the lessons that have been learned in clinical research and medically based weight loss programs). Losing weight smart involves a change of attitude and a change in the way that a person looks at how they eat and drink. How they focus on long term goals and sustain weight loss.
Losing weight smart also means reducing the glycemic index of your calorie consumption every single day. It means making this change, not as a “diet”, but as a change in the way you live. A change in who you are. It is no less satisfying in life to eat lower glycemic index foods, but it does take some getting used to. There is a sense of depravation at not being able to have some treats and sweets, snacks and other simple carbohydrates, but you get over that quickly. It is more than replaced by more powerful enduring feelings of feeling healthier, fitter and more energetic.
Losing weight smart also means taking full and total responsibility for your weight and your health and not being blown by the winds of peer pressure, fads and cravings. Losing weight smart also means having the right help and having the right tools to be able to lose the weight successfully and keep it off.

The Melbourne Marathon Experience (Part 3 of 3)

Wednesday, December 2nd, 2009

An aid station came along, and I took a good long walk to hydrate, slurp down some carbs, and take it all in. I smiled like a kid whose just been told a secret, and ran on under the Melbourne sun. In my mind I still thought I was ahead of the Conejo and might have a shot at finishing in the 3:30s, way ahead of any goal I could have set before this race. It felt good to think of goals; at our best we to challenge ourselves the way I challenge these kids and their parents to do something they had not thought possible.

In the last 10K I had the impression I was kicking it up a notch because I began passing runners at the rate of over a hundred every kilometer. I also heard their breathing more loudly and watched their slumping heads and shoulders. I felt not the slightest twinge of pain in the knee that had plagued me in training when I’d pushed up the mileage a few months earlier. The forced reduction in mileage due to my work and the advice of my orthopedist to abandon any further hills training seemed to have done the trick. Oh, and I had popped a few ibuprofen at around the halfway point just as a precaution. At 43 years of age, I figure running a marathon without ibuprofen is like summiting K2 without oxygen; no thanks.

Around 36K, I knew this would be my best race yet, and I just wanted the experience to last. By the time my iPod hit the Jane’s Addiction set I love, I had strains of electric guitar and a runner’s high spurring me onward. We turned and headed back into downtown, and the crowds grew louder and larger. I even reeled in the lioness and Bruiser, passed them in sequence and moved on, heading through the Gate C Tunnel that leads into downtown, lots of gas in my tank.

In the last kilometers, two more aid stations popped up, and I dutifully slowed to a walk and took in fluids at each, staying true to my plan. At the last one, my engines were revving and I could not walk more than 15 seconds before the sight of the runners passing me spurred me to toss the second cup of water and rejoin the run.

In a gorgeously designed finish, the runners find a long lead up a central boulevard and then a turn across the picturesque William Barak Bridge affording every runner a stunning view of the iconic Melbourne architecture, its cultural landmarks and the river. A gentle down slope before entering the Melbourne Cricket Grounds and then a magnificent stadium finish, complete with the sounds of a cheering crowd that overcame the music in my earphones. For a moment I thought I glimpsed the Conejo across the stadium, at the finish line already before my last lap, but no matter, just a look-alike I hoped.

I took in the majesty of the stadium finish, the crowd noise, the feel of the infield grass under my feet, and the sense that I have completed this marathon and could turn around and run halfway back at this point. I saw families in the stands cheering, including some profoundly overweight kids who I hoped saw something inspiring today. Yes, you can be out here or wherever you want to be one day soon, with some new thoughts in your head and a little encouragement.

As I rounded the last turn and headed for the finish line, I squinted to make out the numbers on the first and only timer I had seen during the race. Exhilarated and a little disappointed all at once, I saw in red numerals 3:42 with the seconds counting quickly upward toward sixty. The Conejo had slipped past me! No matter, I was pleased to finish in this time, and most importantly, feeling this strong. I’d never even seen the monster this day, nor heard a single of his approaching footsteps. I raised my arms in victory for the finish photo.
Dr. Sasse finishes the 2009 melbourne marathon

Weight Loss Tip: Avoid Temptation when “Family” Means “Food”

Thursday, November 19th, 2009

Weight Loss Tip #90 Avoid temptation when “family” means “food”

From Doctors Orders: 101 Medically Proven Tips for Losing Weight

Being a guest can be difficult. Being a guest on a diet can be even more difficult. But being a guest for family functions is sometimes the hardest test of all. Everyone in the family thinks they know you, what you like to eat and how much. When you start making changes it will confuse and possibly alarm them. They’ll wan the old you back. They’ll want to feed the old you.

Wether your family meets once a year for a major holiday or every Sunday for a traditional family dinner, you need to take control of what you’re going to eat. Try to mentally preoare before going. Know ahead of time if you’re going to be facing dietary choices, like potatoes for vegetables for breaded meats for the main course, and look for ways to lessen the caloric hit, from taking smaller portions to planning the workouts to make up for it. You might want to try a mini-fast that night, or curtail your calories for the cext couple of days.

In addition, if you’ve made dessert a special occasion rather than a nightly expectation, this is no time to change. Even if you ‘ve anticipated your father’s breaded shrimp or your mother-in-law’s potatoes au gratin, you don’t have to eat the unexpected seven-layer German chocolate cake. Skipping dessert isn’t that unusual anymore. You might even have other family members joining you.

For more information on Doctors Order: 101 Medically Proven Tips for Weight Loss Click Here, and don’t miss out on our Twitter and Facebook Contest happening through November 31’st.

Weight Loss Tip: Use A Pedometer

Tuesday, November 17th, 2009

Weight Loss Tip #38 Use a Pedometer

From Doctors Orders: 101 Medically Proven Tips for Losing Weight

Buy a pedometer. Wear it daily. Keep track of the number of steps you’re walking every day.

At Western Bariatric Institute, we started giving out pedometers to patients and staff alike. The enthusiasm was contagious, and, in no time, people were competing against each other, checking in to see who had done how many steps the day before, competing to do more the next day.

Use a pedometer to count the number of steps you take every day. Set a goal for a minimum number of steps. Once you’ve started achieving your goal you’ll find you’re ready to push further. You’ll find yourself parking farther away from where you’re going and taking the stairs rather than the elevator just so you can count more steps. Good for you! This is a behavioral change for the better. When you’re trying to hit a goal every day, you feel better; when you hit or exceed that goal, you feel better still. And instead of letting your mind drift and find ways of being lazier – shortcuts and escalators and driving from one store in the same parking lot to the next – your brain is working competitively, adding steps beating goals.

There are a lot of models of pedometers out there. I recommend starting with a simple version. If you end up hooked (and hopefully will) you can always upgrade to a fancy pedometer that will help you convert the length of your stride into mileage and preform other functions such as operating like a stopwatch.

For more information on Doctors Order: 101 Medically Proven Tips for Weight Loss Click Here, and don’t miss out on our Twitter and Facebook Contest happening through November 31’st.

Surgical Weight Loss For Lower BMI Patients

Sunday, November 15th, 2009

For people in the Body Mass Index range of 28 to 35, up until recently there have been few options available for weight loss surgery. However, as weight loss surgery has become less and less invasive and associated with fewer and fewer risks, the notion of weight loss surgery for people in a lower BMI category has increasingly appeared to make good sense. After all, like with any surgery or other health treatments intervention, one should always think about and then balance the risks and benefits. On the risk side, laparoscopic or minimally invasive weight loss surgery has become increasingly safe with fewer and fewer risks. This is evidenced by the shift towards the outpatient arena. Laparoscopic adjustable gastric banding surgery (LAGB, Lap-Band and REALIZE band) has proven to be an even less invasive procedure. The complications or problems with surgery have become increasingly rare and are also less severe or acute, meaning that they are typically the kinds of problems that can be solved over time with office visits with the doctor and/or strategic re-operations, if necessary. It is becoming exceedingly rare to require any sort of emergency intervention. So the risk side has fallen to such degree that broadening this option for more people would make great sense if the evidence was also there to show its effectiveness or benefit to people in this lower BMI category. So what does the evidence show?

I have reviewed a number of studies that demonstrate a great, high level of effectiveness for people in this Body Mass Index category undergoing weight loss surgery and specifically Lap-Band surgery. These studies show that people undergoing Lap-Band surgery lose weight with a similar high rate of success, and they also improve their health by resolving health conditions including:

  • Breathing difficulties
  • Diabetes
  • Obstructive sleep apnea
  • High blood pressure
  • High cholesterol
  • Bone and joint degenerative pain and diseases and many others

Furthermore, it appears that these people also prevent these same conditions from developing if they have not already done so. For example, less people are likely to progress from prediabetes (or impaired glucose tolerance) on to full diabetes if they undergo Lap-Band surgery.

So the evidence to date would indicate that the benefits exist. A program with Lap-Band surgery will have a high likelihood of resulting in lower weight, better health, resolution of health conditions, longer life and better quality of life. The lower invasiveness of the procedure reduces the risks down to very small ones which pale in comparison to the health risks associated with ongoing overweight and obesity. So why has this not become more widely available?

The reasons that Lap-Band surgery has not become more widely available for people in this low BMI group have to do with several factors and several interests that slow down the process. For starters, the medical devices have been approved for use in people with a Body Mass Index over 35 who have obesity related health conditions, or for people with a BMI over 40 regardless of those specific identified health conditions. This means that the FDA has not approved the device for placement in people with a Body Mass Index under 35 yet. It is always important to bear in mind that many medical devices are approved for one fairly narrow indication, but are then used and placed by physicians for patients in many other more broad circumstances. Certainly, the Lap-Band is one example of this as there are now many studies showing its effectiveness in lower Body Mass Index patients. This was referred to as “off label” use of a medical device. The same thing is true for medications. Oftentimes, the pharmaceutical companies, just like medical device companies, obtain FDA approval for an indication but then over time physicians will prescribe the medication for a broader set of clinical circumstances when it is proven effective. Part of this is because there is enormous expense and time involved in obtaining an officially sanctioned, more broadened indication from the FDA and part of it is because there may be a long lag time of years before the FDA catches up with the medical science about a particular topic, medical device or drug.

So it appears to most experts in the field that we are currently living in this window of time where the medical science demonstrates the benefit of placement of laparoscopic adjustable gastric band in people with lower Body Mass Index, bu the indication from the FDA has not yet caught up with the science. This situation is likely to change because the science is so overwhelming and the medical device manufacturers will soon enough get this data a fair hearing at the FDA and it will undoubtedly be approved at some point in the future.

One of the other reasons that this highly effective procedure is not more available for people with lower Body Mass Index is the cost associated with it for the insurance plans. While the insurance plans can look at data showing overall reduction of health expenditures and cost effectiveness over a one and a half to three year time frame for weight loss surgery, they tend to focus on the short-term costs and the perceived increase in cash outlay if a much greater number of people take advantage of Lap-Band surgery for their weight loss goals. This is too bad because it represents a short-term, short sighted thinking. But nonetheless, it is very unlikely that commercial health insurance plans are going to approve laparoscopic adjustable gastric banding surgery for lower BMI individuals any time in the near future. That will likely take years and will only occur after it is approved by Medicare and other government sponsored plans, in my opinion.

It’s possible though that the same data from numerous studies that will be put before the FDA can also be put before insurance plans who do have a better longer term, more forward thinking outlook. Because they do stand to save money with reduced expenditures covering diseases like obstructive sleep apnea, high blood pressure, heart disease and diabetes after people undergo weight loss surgery. Also, employers who increasingly decide the specific coverage’s that they will approve in their health care plans, may also wish to examine this data because they tend to have a more forward thinking approach than the insurance plans. They realize that they will enjoy less medical absenteeism and less health expenditures, Worker’s Compensation claims and future health insurance premium increases if their workforce can become healthier, fitter and suffer less from obesity.

But in today’s environment, it is unlikely that the insurance carriers are covering it and it forces many people to obtain financing to cover the cost of the procedure or find resources to cover the cost of the procedure.

Examining costs and the potential risks of complications and further costs:

Comparing apples to apples

LAGB is a low risk, low invasiveness intervention. I have performed many LAGB procedures in people with this lower BMI category under our research protocol, whereas our protocol has not included laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass surgery. In the future, this may change, but right now the risk/benefit analysis in my view favors making available the less invasive weight loss surgical option for this low BMI group of 28 to 35.

It is important that any price that you ultimately decide to pay includes some protection against hidden costs or the costs of further procedures due to complications. Our study has taken this into account and provides a coverage for complications that might arise. While no coverage is absolutely perfect, this coverage was designed to cover 95% of the potential events which may occur as complications to the band including unexpected hospitalization and reoperation for the most commonly identified problems such as band slippage and port dislodgement or dysfunction.

The low BMI research study
Approved by the institutional review board in our region, the study for laparoscopic adjustable gastric banding in moderately obese subjects continues to accrue study participants.

Each study subject receives a thorough evaluation and must be approved as a candidate by the principal investigator, Dr. Sasse.

Subjects are all given educational materials and offered the opportunity to attend support groups and receive ongoing band adjustments in an effort to optimize weight loss success. These groups can be a valuable weight loss tool as they can help motivate you to reach a better level of fitness and lose weight in the process.

Weight Loss Tip: Fight Back When the Day Gets Crazy

Thursday, November 12th, 2009

Weight Loss Tip# 6 Fight Back When the Day Gets Crazy

From Doctors Orders: 101 Medically Proven Tips for Losing Weight

Some days just don’t fall into line, no matter how well you plan. The day turns crazy. The kids need something. A crisis happens at work. Unexpected events cancel your well-planned lunch and dinner regime.

What can you do to avoid the binge that can happen if you go too long without feeding the beast?

Keep some low-carb snacks available. Some of the protein bars don’t hold up well in the car in the summer heat, but others do. Experiment and try stashing a box of the kind that are not covered in chocolate somewhere in your car.

Then think of some other snacks that work for you: beef jerky, cheese sticks and other low-carb snacks, keep them available for when the day falls apart, you’re out running errands and there is no way to have an organized meal.

For more information on Doctors Order: 101 Medically Proven Tips for Weight Loss Click Here, and don’t miss out on our Twitter and Facebook Contest happening through November 31’st.

Weight-Loss Resolution for Men (Part 3 of 3)

Wednesday, November 11th, 2009

Here is the third and final post in the series of blog posts I have written specifically for men looking to loose weight, but women can benefit from many of the tips mentioned in this series posts as well.  We have previously covered some simple medically proven weight loss tips for when your at work and weight loss tips for after work. In this post I want to briefly touch on some ideas about dinner and beyond.  All of these weight loss tips and many more can be found in my book Doctor’s Orders: 101 Medically Proven Tips for Losing Weight.

So if you have read the earlier blog posts you already have some very powerful, yet simple things you can do at work and after work to help you lose weight and maintain a healthy weight.

In today’s busy world most of us have a hard time even shopping for groceries, let alone preparing and sitting down to eat a healthy meal. But if you’re serious about losing weight this year and keeping it off, this is an important step. Invite your friends or roommates, or if you’re married find a way to connect schedules so you can sit down together for a good meal. It’s healthier than eating out, and you can control portion size and ingredients. So let’s talk about some more helpful weight loss tips to help you make this happen.

Dinner and Beyond

  1. Plan meals ahead of time. That way you’re not surprised when dinnertime rolls around again and don’t head for fast food or packaged meals.
  2. Serve yourself on a smaller plate. For most of us, smaller portions than what we’re used to will satisfy. Serving smaller portions on a smaller plate make those portions look less lonely.
  3. Serve yourself only once.
  4. Serve from the kitchen, and put away any leftovers before sitting down to eat. If they’re not there to snack on while you’re cleaning up after dinner, you won’t be tempted. If getting seconds is difficult, you might not bother.
  5. Pay attention to what you eat, how you feel and when you become satisfied, so you can stop rather than overeating. Whatever you were taught as a child, you do not have to finish everything on your plate. In fact, I suggest you always leave something there.
  6. Skip dessert and take a walk. Dessert should be for special occasions, not every night; otherwise, what makes it special? And if you’re married with children, think of the wonderful example you’re setting when you all head out for that walk.
  7. Eat by 7 p.m. and then stop for the day. Studies show that the body tends to hold on to calories consumed late at night and burns calories eaten early in the day.
  8. Get enough sleep. Studies also show not getting enough sleep can increase appetite.

Then get up tomorrow, and know that you have taken steps to live a healthier life and win the battle of weight loss. Good luck!

Weight Loss Tip: Have A Cup Of Tea

Tuesday, November 10th, 2009

Weight Loss Tip #64 Have a Cup of Tea

From Doctors Orders: 101 Medically Proven Tips for Losing Weight

Tea is a great drink, nutritious and full of health benefits, especially green tea. Studies have shown that green tea may prevent or improve obesity and possibly reduce the risk of associated diseases, including diabetes and coronary heart disease.

Green tea may not be the proven wonder-drink its proponents might like us to believe, but there is at least enough theoretical backing to support its health benefits to give it a try. That doesn’t mean that you can add sugar or cream or other calories to your tea or drink it in large amounts; and this isn’t a permission slip for calorie-rich, if delicious, drinks like Thai iced tea (high-calorie, sweet, dessert-like milky and delicious tea). But go ahead and have a cup of tea, enjoy the relaxation, take the time to decompress and reduce stress. But use only zero-calorie sweeteners.

For more information on Doctors Order: 101 Medically Proven Tips for Weight Loss Click Here, and don’t miss out on our Twitter and Facebook Contest happening through November 31’st.

Dr. Kent Sasse, Medical Director | 75 Pringle Way Suite 804 Reno, NV 89502 | Phone: 775-829-7999

Dr. Kent Sasse serves the entire city of Reno and all the surrounding areas. Dr. Sasse is one of the nation's foremost medical weight loss and bariatric surgical experts.
Dr. Sasse has educated patients about food nutrition and weight loss for many years.

Copyright © 2007-2010 Kent Sasse, M.D. All Rights Reserved.

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