Research shows that lifestyle factors – beyond food and activity habits – contribute to obesity. Shift workers getting too little sleep at the wrong time of day may be increasing their risk of diabetes and obesity, according to new research showing that changes in normal sleep patterns can cause the body to struggle with controlling its sugar levels and slows metabolism. Previous studies have shown that shift workers and people who consistently do not get enough sleep have high levels of fat in their blood. Research has also shown that people with altered sleep patterns or who don’t regularly get enough sleep are more likely to be obese and develop diabetes or metabolic syndrome (a cluster of conditions that are associated with increased risk of heart disease).

For the study, researchers from Brigham and Women’s Hospital and Harvard Medical School recruited 21 healthy adults to stay in their laboratory while they adjusted their sleeping patterns and recorded changes in their bodies. The study lasted 6 weeks, beginning with an initial period of normal sleep (10 hours nightly). After the normal sleep, the participants underwent three weeks of restricted sleep, (less than six hours per 24-hour cycle). Their sleep patterns were also disrupted similar to that of a shift worker. Lastly, they underwent a recovery period, with nine days of normal sleeping.

The researchers found that during the sleep deprivation and body clock disruption period, the participants’ resting metabolic rate slowed and their post-meal blood sugar levels increased, at times high enough to be considered pre-diabetic. The slowing in metabolism was enough to add 10 pounds to an individual over the course of a year. However, after the final recovery period, the researchers found that these metabolic abnormalities returned to normal. “This study shows that you can control your own destiny in some way by disordering your own sleep. People could make beneficial or harmful modifications that might affect their own metabolism,” commented Dr. Loren Wissner Greene, a clinical associate professor of medicine at NYU Langone Medical Center.

Getting adequate sleep, proper nutrition, and physical activity are important for good health and weight loss. You can learn more about The N.E.W. Program’s comprehensive approach to weight loss here.

Losing 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, taking a few supplements, and being active.  Although supplementation is vital following bariatric surgery, most nutrition should come from real food.  Whole foods contain many micronutrients (vitamins and minerals) that work together to provide the human body with maximum benefits.  This synergy is unique to whole foods and cannot be replaced by supplements.  When a person is eating smaller amounts of food, their body’s nutritional requirements simply demand good food choices.

Foods often lose their nutrients when they are processed.  When choosing what to eat, it is therefore important to choose foods that have been minimally processed: fresh eggs, fish, meat, vegetables, and fruits retain their nutritive value.  It’s also worth knowing that frozen meats and produce are as nutrient-rich as their fresh counterpart.  Unfortunately, the reality is that, in this age of industrially prepared foods and hectic lifestyles, processed foods are hard to avoid entirely.  When selecting processed foods, look at the list of ingredients: the shorter the list, the less processed the food, the healthier for you.  Ingredients are listed by weight: the most abundant ingredient is listed first.

What’s good to eat, then?  High-protein foods are the cornerstone of any healthy eating strategy.  Eggs, for example, contain one of the most complete and digestible proteins available.  The biological value of egg whites is so high that egg protein is the reference protein against which all other forms of protein are measured.   Eggs are also a source of B vitamins, including B12.  Fish is also a great source of protein and offers many other benefits:  wild salmon is rich in heart-healthy omega-3 fatty acids; tuna provides B12 and thiamine.   Broiled, baked, seared, poached, or steamed, fish should not be overcooked to retain most of the vitamins.

A key fact to remember for healthy eating is that whole protein foods have the advantage of being digested slowly, resulting in a feeling of fullness and satiety that lasts for hours.  Whole protein, natural foods are also packed with flavor.  These foods should be part of your N.E.W. nutrition strategy, not as weight loss tools, but as great tasting sources of nutrition with maximum health benefits.

This entrée is quick, easy and nutritionally appealing. With just one serving your getting 23 g of protein and a recipe that will keep you satisfied.

Ingredients

• 8 tilapia fillets (4 ounces each)
• 1/4 teaspoon salt
• 1/4 teaspoon pepper
• 1/4 cup plain yogurt
• 2 tablespoons butter, softened
• 1 tablespoon lime juice
• 1 small red onion, finely chopped
• 1/2 cup pitted Greek olives
• 1 teaspoon dill weed
• 1/2 teaspoon paprika
• 1/4 teaspoon garlic powder
• 1/2 cup crumbled feta cheese

Poor dietary habits cause nutritional deficiencies in the majority of people with obesity. When starting on a serious weight loss program, whether it’s a medical or a surgical program, nutritional deficiencies should resolve. The goal is not just to eat fewer calories, but to eat better quality food overall. The N.E.W. Program provides comprehensive follow-up appointments with physicians that specialize in weight loss and nutrition. We follow very careful patient management protocols and measure our long-term results.  Better nutrition includes healthy hydration, a healthy diet, and vitamin and mineral supplementation when appropriate. For in-person, or over-the-phone nutrition coaching and dietary advice please call our office.

Orthopedic surgeons, rheumatologists and physicians specializing in rehabilitation medicine know that the knee joint has to support the force of three to six times one’s weight.  The impact of extra weight is also multiplied on other joints, including those of the back, hips and ankles.  The results of this increased wear and tear are impressive; for example, men who are just 40 pounds over their ideal body weight have a five-fold increase in osteoarthritis (1).  This close link between obesity and osteoarthritis is well documented (2).  Of course, the incidence of severe osteoarthritis in people that are one hundred or more pounds overweight is exponentially higher, and the age of onset is much earlier.  As always in medicine, unless patients and their doctors attack the root cause of their disease, in this case arthritis, medications and other therapy will only temporarily alleviate the pain and allow for permanent injury to the bone and cartilage.

For patients who do not yet require surgery to replace damaged joints, substantial weight loss has been shown to alleviate the debilitating symptoms of osteoarthritis.  Schauer, et al, documented that seventy percent of patients that were taking medications for joint pain had no pain and were off all arthritis medications after weight loss surgery (3).  Another published study documented that 58 percent of patients undergoing weight loss surgery complained of chronic low back pain, but this number decreased to only 20 percent after surgery (4).

Unfortunately, not everyone will have resolution of his or her knee pain after weight loss since joint cartilage lost after years of obesity will never regenerate.  This damage may result in the need for surgery to repair or replace the damaged joint.  Of course, recovery from joint replacement is more difficult in obese patients and many orthopedic surgeons will not perform joint replacement surgery in severely obese patients because of the significantly higher risk of complications.  A patient who is unable to undergo joint replacement due to excess weight is a prime example of a person who needs surgical weight loss.

To evaluate the impact of surgical weight loss on patients requiring joint replacement therapy, the Mayo Clinic followed 20 patients who had hip and knee replacements after weight loss from gastric bypass.   This recent study found a significant improvement in physical rehabilitation after joint replacement in patients who had previous weight loss due to gastric bypass.   In fact, not only did the recovery from joint replacement improve, the re-operation rate due to complications after surgery was dramatically lower (5).

Everyone is aware that osteoarthritis will often improve with good weight control.  For those people who are severely obese and are suffering from chronic joint pain, surgery for permanent weight control may be the best option to help your physician or surgeon improve your treatment results.

1- Annals of Rheumatic Disease; Felson, 1996,  2- Amer. Jour. of Public Health; Sahyoun, 1999, 3- Schauer 20004, 4- Melissas, 2004, 5- Parvizi, 2000

Type II Diabetes is a disease in which the body cannot effectively use insulin and the level of sugar in their blood stream reaches dangerously high levels causing multiple medical complications.  Although there are treatments available, most patients are on lifelong medication and many develop numerous medical complications from this disease.   As the incidence of diabetes has increased dramatically over the last 10 years, it has become clear that this increase is caused by the increase in weight of the average person in America.

Unfortunately, this combination of obesity and diabetes is deadly.  Every year more than 300,000 people die in the United States as a direct result of obesity-induced illnesses, and diabetes is a main culprit.  Diabetes alone is the 6^th leading cause of preventable death in America.  Not only that, but diabetes is the leading cause of blindness, non-traumatic amputations and kidney failure in American adults.

Fortunately, diabetes can be controlled, and sometimes even resolved completely, with gastric bypass.  Recent media attention, on CBS 60 Minutes™ and numerous other news outlets, has reported the dramatic resolution seen in diabetes after the gastric bypass operation.  This incredible success is not seen with other weight loss operations such as the gastric band procedure.

As a result, The N.E.W. Program is now offering modified gastric bypass as a treatment for Type-2 Diabetes in patients who are overweight but have a body mass index below the standard criteria required for traditional bariatric surgery.  The expectation is for patients who have diabetes that is difficult to treat to be able to finally gain effective control of this devastating disease, and hopefully even resolve diabetes completely.

Interested physicians and patients may call for more information at The N.E.W. Program or email info@thenewprogram.com

My disgust with the TV show the “Biggest Loser” is something that I’ve been open about for years. As a physician dedicated to helping people win their battles with obesity, using legitimate interventions, healthy support and positive advice, I have always found it appalling that a TV show that belittles obese people is so popular. Why would we tolerate this?! Would we send our child, if they were struggling in school, to a camp called the “Smartest Idiot??” Of course not, so why would society find it acceptable to gawk at severely overweight people that want nothing more than to be healthy?

In response to this The N.E.W. Program decided to launch a positive initiative. In contrast to the Biggest Loser show, this program uses realistic and constructive training methods to find an active lifestyle that you can maintain. It’s up and running, its healthy, it’s fun, and it works.

With this exciting exercise challenge, working out has never been so much fun! Participants have full access to results-driven fitness programs and expertise from our team of trainers. When it comes to permanent weight loss, the experts from The N.E.W. Program know what works, and what doesn’t. We provide a competitive but positive training environment.

Prizes are awarded, but more importantly, you’ll enjoy the camaraderie of working together as a team and the personal satisfaction of taking control of your health through exercise. The competition combines the muscle toning benefits of “boot camp” at the gym with calorie burning aerobic outdoor field trips throughout Southern California.

The next competition starts January 10th!  To learn more and SIGN UP for The Smallest Winner Competition CLICK HERE.

Article written by: Dr. Brian Quebbemann

A recent study found that bariatric surgery is a cost-effective weightloss option for people in most obesity categories–ranging from mildly to severely obese. The study found that people who have bariatric surgery are more likely to keep weight off in the long-run than people who shed pounds through other methods. Additionally, they suffer fewer health problems related to being obese. Because of these findings, the research team from Washington University in St. Louis concluded that weight loss surgery is a good value, in economic terms. Moreover, they found that for the most severely obese people, bariatric surgery ultimately saves money, in the form of healthcare dollars saved.

The research team looked at over 150 studies, and examined the effectiveness of weight loss surgery. They estimated the life expectancies and quality of life of people who had bariatric surgery in comparison with people who did not undergo surgery. Findings indicated that life expectancy for those who received weight loss surgery was an average of 5-6 years longer.

The study determined the cost-effectiveness of bariatric surgery using a metric called the quality-adjusted life year (QALY), which measures the value of medical treatment in terms of an individual’s quality and length of life. In our country, it is presumed that an individual would be willing to pay up to $50,000 for an extra year of a healthy life. Therefore, a cost less than $50,000 is considered cost-effective. The researchers found that for those with a BMI of 50 or more, the cost per QALY is negative, meaning that the cost of weight loss surgery is less than the medical costs associated with not having the surgery. For people with a BMI of 40-50, the cost per QALY ranges from $1,900 to $3,800, while for those with a BMI of 35-40, the cost per QALY ranges from $2,400 to $3,900, all well below the limit of $50,000.

Dr. Marina Kurian of NYU explained that this is an important study because it “helps to identify the benefits of weight loss surgery a cross Body Mass Index (BMI) categories and adds credence to the FDA approval of the lap band in lower BMI patients.”

You can find more information about The N.E.W. Program’s financing options here.