PSANJ: New Jersey Top Plastic Surgeons: Cosmetic Surgery New Brunswick, Princeton,

#Areas We Serve:

  • Edison, NJ
  • East Brunswick, NJ
  • New Brunswick, NJ
  • Princeton, NJ

New Brunswick Plastic Surgery: 78 Easton Avenue New Brunswick New Jersey 08901
Princeton Plastic Surgery: 60 Mount Lucas Road Princeton, New Jersey 08540

If you re interested in aesthetic plastic surgery, our New Jersey offices are easily accessible from anywhere in the NY, NJ, CT tri-state area via car, bus, and train-lines. You can easily visit PSANJ from North Jersey, Central Jersey, South Jersey, New York, Pennsylvania, Staten Island or anywhere in the tri-state area and receive world-class care that only PSANJ can offer. With two convenient locations in New Brunswick and Princeton, NJ we welcome patients from all over the state including: Edison, East Brunswick, Manalapan, Marlboro, Piscataway, Somerset, and Flemington. Many patients have also come from Colts Neck, Freehold, Old Bridge, Sayreville, Hillsboro, Belle Mead, and more. No matter how you imagine yourself, or where you re coming from, Plastic Surgery Arts of New Jersey can help you reach your dreams.

About Plastic Surgery Arts of New Jersey:

PSANJ is one of New Jersey s leading cosmetic surgeon centers with two locations in New Brunswick, New Jersey and Princeton, New Jersey. Patients travel from all over the east coast to receive body contouring, breast enhancement surgery, facial aesthetic surgery, and men s cosmetic procedures at the hands of New Jersey s top surgeons.

In addition to the breast and the body, we also specialize in facial plastic surgery. The many procedures available for facial cosmetic surgery at Plastic Surgery Arts of New Jersey include facelifts. brow lifts. eyelid lifts. nose job (rhinoplasty). lip injections. or laser skin rejuvenation. In recent years, requests for men s plastic surgery have increased. If you re a male interested in plastic surgery, we have developed a men s cosmetic surgery program that focuses on natural, conservative results with quick recovery times.

For less invasive, non-surgical procedures we offer many non-surgical options to improve your appearance and youthful image with natural looking results. Plastic Surgery Arts of New Jersey offers BOTOX Cosmetic. dermal fillers Juvederm for lip enhancements or to smooth out wrinkles, chemical peels. HydraFacial/microdermabrasion. and Juv derm Voluma TM .

Getting plastic surgery is a major decision that could have incredible life-changing results. We want you to look and feel your best, therefore we offer flexible financial options for patients that would like plastic surgery or a non-surgical skin care procedure. If you are interested in any of our services, please visit our before and after photo gallery or request a consultation today. Our New Brunswick office is located near Rutgers University or UMDNJ, with our second office located in the beautiful and historical Princeton, New Jersey. At PSANJ we are proud to be home to some of New Jersey s best plastic surgeons. We would love to see you at our offices in New Brunswick or Princeton, New Jersey. — Locations | Geo Sitemap

Cosmetic surgery offers us the chance to perform life-changing procedures for our patients – from breast reconstruction to breast implants, to tummy tucks and more. We use minimally invasive techniques that speed along recovery times and offer natural-looking results. At Plastic Surgery Arts of New Jersey, we can help you imagine the possibilities. – Dr. Kevin Nini

At Plastic Surgery Arts of New Jersey we value our patients’ personal goals when performing cosmetic procedures such as facelifts, rhinoplasty, liposuction, mommy makeovers and more. Surgical artistry is all about precision and a commitment to perfecting the tiniest details. Visit us in New Brunswick or Princeton, New Jersey and experience our unparalleled results. – Dr. Philip Wey

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Programs for Weight Loss and Weight Management That Work #weight #management,


Ultimate Weight Management Programs

Weight Management Overview

The term weight management can encompass a wide range of issues, from eating disorders to overweight and obesity. With eating disorders addressed elsewhere on this site, this section will focus on overweight and obesity among adults.

First, it is important to understand that, as they are used here, the terms overweight and obese are neither subjective nor judgmental terms. From a medical perspective, an adult is considered to be overweight when his or her body mass index (BMI) is between 25 and 29.9. Obesity is defined as a body mass index of 30 or above.

It s hardly a secret that the United States has an obesity problem. In fact, it s not an overstatement to observe that this nation is in the midst of an overweight and obesity epidemic. Consider the following statistics from the U.S. Centers for Disease Control and Prevention (CDC):

  • Between 1960 and 1980, the adult obesity rate in the United States was about 15 percent.
  • Between 1980 and 2008, the obesity rate more than doubled (reaching 34 percent).
  • Today, only one state (Colorado, 19.4 percent) has an adult obesity rate below 20 percent.
  • Eight states have obesity rates above 30 percent, with Mississippi (33.8 percent) having the highest adult obesity rate in the United States
  • More than 32 of men in the United States are obese.
  • Among adult women, the obesity rate is 35.5 percent.
  • Approximately 73 million U.S. adults are obese.

The obesity crisis in the United States has had significant impact in terms of both health and finance.

Overweight and obesity have been associated with a wide range of health problems, including (but not limited to), hypertension, heart disease, diabetes, sleep apnea, and certain types of cancers. Experts with Stanford Hospital and Clinics estimate that overweight and obesity are responsible for 300,000 premature deaths every year, and the CDC has identified obesity as the top health risk in the United States.

The Stanford experts also estimate that Americans spend $150 billion annually on obesity-related health issues.

Causes of Overweight and Obesity

At its simplest, weight management problems such as overweight and obesity are a matter of taking in more calories than are expended (or, in other words, eating too much and exercising too little). And in many cases, adults who are overweight or obese have adopted relatedly sedentary lifestyles while eating high-fat diets.

However, given the epidemic levels of overweight and obesity in the United States, the problem isn t always quite as simple as this. Sociologists, doctors, and other experts have put forth a number of theories regarding the dramatic rise in overweight and obesity over the past three decades.

In some cases, overweight or obesity is the result of genetic issues such as abnormal physiology or a hormone problem. Also on the biological front, body metabolism the process by which the body fuels continued growth may be impaired or impacted in a way that makes it difficult for a person to maintain a healthy weight .

Health issues that can lead to overweight and obesity include hypothyroidism, polycystic ovarian syndrome (PCOS), and Cushings Syndrome.

External factors also contribute to overweight and obesity. For example, studies have indicated that individuals who live in impoverished areas may be more prone to becoming overweight or obese.

This connection between poor neighborhoods and overweight or obesity occurs on two fronts:

  • Poorer neighborhoods are less walkable meaning that it is more difficult for individuals in these areas to get regular exercise.
  • Poverty-stricken areas are less likely to be served by larger grocery stores (which have better selection of healthy foods such as fresh fruits and vegetables). Residents who do the majority of their shopping at convenience stores are more likely to purchase high-fat foods and other less healthy items.

Other issues that can lead to overweight and obesity include the taking of certain medications and the presence of depression or an inability to process stress and pressure in a productive manner. Many people use food as a way to elevate their mood or de-stress themselves, a practice which can quickly result in overweight or obesity.

Symptoms of Overweight and Obesity

As indicated elsewhere in this section, overweight and obesity are medical terms that correlate to specific body mass index (BMI) scores. Adults with a BMI of between 25 and 29.9 are classified as overweight, while those whose BMI is 30 or larger are considered to be obese.

Normal weight is defined as a BMI of between 18.5 and 24.9, while a BMI of 18.4 and below is considered underweight. (These classifications are for adults only. Determining whether a child or teen is underweight, normal weight, overweight, or obese involves determining where the young person s BMI falls on a percentile chart.

BMI is calculated according to the following formula: (Weight in lbs. x 703) / (height in inches) squared

Using metric measurements, BMI is calculated as follows: Weight in kb / (height in meters) squared

For those who prefer not to perform these calculations themselves, a number of online BMI calculators are available. Most online BMI calculators simply require you to input your height and weight, and the software does the rest.

Thought not necessarily symptoms of being overweight or obese, the following health conditions have been associated with overweight and obesity. As rates of overweight and obesity have risen in the United States, many of the following conditions have also become more common:

  • Type 2 Diabetes (Type 2 Diabetes was formerly known as adult-onset diabetes. The name change is due to the fact that more children are being diagnosed with this condition a development that many attribute to rising rates of childhood obesity)
  • Hypertension (high blood pressure)
  • Heart disease
  • Certain cancers (including cancers of the breast, colon, uterus, gallbladder and prostate)
  • Respiratory problems (including sleep apnea)
  • Liver and gallbladder disease
  • Gynecological problems
  • Osteoarthritis (a problem affecting joint cartilage and bone)

Treatment For Weight Management

Treatment for overweight and obese individuals will vary depending upon the causes of the weight management problems; the age, gender, and weight of the overweight or obese client; and the presence of any health problems that may have led to or been exacerbated by the overweight or obesity.

For cases where the overweight or obesity is the result of a sedentary lifestyle, poor diet, or a combination of the two, treatment often involves nutrition education and a medically appropriate exercise plan. (Because overweight or obese individuals may be at increased risk for health problems such as heart disease, hypertension, and respiratory problems, it is important that they get the advice and approval of a healthcare professional before beginning an exercise regimen.)

For individuals whose overweight or obesity may have resulted from an emotional condition or mental health disorder (for example, those who suffer from binge eating disorder, or who have fallen into the habit of emotional eating as a way of coping with stress), therapy and counseling may be necessary in order to reprogram the client s food-related attitudes and behaviors.

In cases where counseling or therapy is called for, options may include any or all of the following:

Of course, if the overweight or obese individual has also been struggling with any physical health problems, these issues must be addressed as part of the person s overall health plan.

In some cases, losing weight may diminish a related health problem (for example, hypertension and joint pain may be lessened as one moves toward a healthy weight). In other situations, addressing a related medical condition such as an improperly functioning thyroid gland may lead to significant improvements in weight.

Regardless of the degree to which a person is overweight or obese, it is important to consult with a healthcare provider or weight management expert to ensure that one s efforts to achieve and maintain a healthy weight are done in a safe and sustainable manner.

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Weight Loss Surgery, Gastric Bypass in Austin, Texas – Dr #weight


Nilesh A. Patel, MD, FACS

Serving patients seeking bariatric surgery, including Lap-Band, sleeve gastrectomy, gastric bypass and revision surgery in Austin and the surrounding area

These pictures provide examples of weight loss
surgery performed by Texas Bariatric Specialists.
To pause, move your mouse over the slide show.

Nilesh A. Patel, MD, FACS, is a board-certified general surgeon who performs weight loss surgery. He has successfully performed thousands of bariatric surgeries and his practice was recently featured in Newsweek magazine’s showcase section as one of the top bariatric programs in the state. Dr. Patel serves as a national instructor for gastric bypass surgery. He and Texas Bariatric Specialists were also recently featured on the cover of MD News and NSIDE magazine in Austin. Texas Bariatric Specialists have also been recognized as “Best of the Best” in Corpus Christi by the Caller Times. Dr. Patel has served as a guest editor of the Medical Clinics of North America and the Surgical Clinics of North America journals. In addition, he has made guest appearances on several media outlets and programs, including WOAI-TV’s “San Antonio Living,” KSAT-12 San Antonio, KRIS-TV Corpus Christi and KVUE-TV Austin. Dr. Patel has also been featured in the San Antonio Business Journal .

Texas Bariatric Specialists focus on minimally invasive bariatric surgery, including laparoscopic Lap-Band surgery, an adjustable, reversible procedure. For gastric bypass patients, they use the advanced laparoscopic Roux-en-Y technique. Dr. Patel’s expertise has earned him the honor of being selected as national preceptor with Covidian, a world leader in surgical stapling devices. As a preceptor, he has trained members of the Society of American Gastrointestinal and Endoscopic Surgeons on advanced surgical techniques for weight loss surgery.

The surgeons of Texas Bariatric Specialists are among the few weight loss specialists in south Texas who offer the single incision laparoscopic sleeve gastrectomy. This technique requires only a single incision around the belly button and a separate mini-incision near the bottom of the breast bone. Dr. Patel’s team also specializes in all types of revision and reconstructive surgery, which requires advanced surgical expertise.

Texas Bariatric Specialists provides a comprehensive weight loss program to help patients learn healthy habits that will improve their lives. Dr. Patel and his team emphasize long-term support and a team approach to wellness, providing services of a dedicated nutritionist, insurance specialists, a psychologist, as well as free support groups, complimentary on-line support groups, an on-site nutritional resources store and pre- and post-surgical classes. The talented team of Texas Bariatric Specialists boasts a success record better than the national average due to their personalized care and dedication to long-term success.

Click on the images above to see what
these patients had to say about Texas Bariatric Specialists.

What Do Patients Say About the Surgeons of Texas Bariatric Specialists?

“My first impression of Dr. Patel was that he was a very knowledgeable and personable doctor. From day one I felt really comfortable with Dr. Patel, and that’s a positive in my book. I hold Dr. Patel in the utmost esteem. Dr. Patel has the finest staff and recovery facility I have ever seen. The clinic, if you can call it that, as it looks more like a hospital, was clean and very modern. The post-operative treatment was of the highest caliber; no need or concern went unanswered. Words cannot describe how truly indebted I am to Dr. Patel and his staff.” Harold

“Dr. Patel is such a wonderful physician. From the very beginning he was very knowledgeable about his center. He answered all my questions, and his staff was just excellent. Dr. Patel has a great bedside manner and he made me feel comfortable when he came by for visits. He is superb in his follow-up care. If I had any friends that needed surgery, I would definitively refer them to Dr. Patel. If I ever get sick, I would want Dr. Patel and his staff to take care of me. He is such a great person. Who could ask for anything more?” Peggy

More About Nilesh Patel, MD, FACS

Dr. Patel is a member
of the ASMBS.

Nilesh Patel, MD, FACS. completed a medical degree at the Robert Wood Johnson Medical School in Pittsburgh. He then performed a residency and fellowship at the Allegheny General Hospital. Dr. Patel is one of the few surgeons in south Texas who have completed a full-year fellowship dedicated to minimally invasive weight loss surgery. Dr. Patel has written many articles that have been published in surgical journals and has presented his research at national and international bariatric surgery conventions. He is a member of the advisory board of the health website and serves as the Associate Director of Bariatric Surgery and Clinical Assistant Professor in the Department of Surgery at the University Texas Health Science Center in San Antonio. In addition, Dr. Patel is a member of several medical organizations, including the American Society for Metabolic and Bariatric Surgery and the Texas Medical Association.

You Can Email Texas Bariatric Specialists Here:

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Consumer Guide to Weight Loss Surgery is a registered trademark of Ceatus Media Group.

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Herbal Supplements for Weight Loss – Which Ones Work? #herbal #products


Herbal Supplements for Weight Loss

Updated March 06, 2015

Have you considered taking an herbal supplement for weight loss? There is no shortage of products that promise to melt fat or blast away pounds. But they don t always deliver the results that you expect. So it s important to gather the most current information about herbal supplements to lose weight safely and more effectively.

Herbal Weight Loss Supplements – The Basics

There are different types of dietary supplements.

Herbal supplements for weight loss are those that come from plant sources and claim to help you lose weight. Sometimes they are also called botanicals or phytomedicines. Herbal supplements often have a label that says they are natural and often have healthy-sounding names. But just because a product is natural doesn t mean it is safe. And just because a supplement is healthy doesn t mean it is effective.

Several recent studies conducted on dietary supplements found that consumers who buy herbal supplements may not get the product that is advertised on the label. Unfortunately this is a trend that doesn t just happen with online vendors or shady back-alley dealers. The State of New York recently cited several large retailers including Walgreens and GNC, for selling products that were not as advertised. Legislators in New York are pushing for stronger laws to protect consumers who buy herbal supplements for weight loss and for other health concerns.

Healthy Eating

Get nutrition tips and advice to make healthy eating easier.

Popular Herbal Supplements for Weight Loss

If you choose to supplement your weight loss program with an herbal product, you ll probably find that popular products in stores and online contain one or more of these herbal ingredients.

  • Glucomannan . This natural fiber product comes from the konjac plant. While diet supplements that contain glucomannan say it is effective for weight loss, a recent 8-week study found that the herbal supplement did not promote weight loss.
  • Chitosan. This product actually comes from fish but it is frequently listed as an herbal supplement to help you lose weight. People who are allergic to shellfish should not take this product. Even if you are not allergic, recent studies have found not found it to be effective for weight loss.
  • Bitter orange. After ephedra was banned, some herbal supplement manufacturers started using bitter orange instead. Bitter orange may help you burn more calories, but researchers are not sure. Scientists have substantial concerns about the safety of the stimulant. Users of bitter orange have reported chest pain, anxiety, and increased blood pressure and heart rate.
  • Green tea extract. This herbal supplement is found on almost every drugstore shelf and many vendors sell the pills online. Unfortunately, many of the research studies that investigated the extract s effectiveness have not been high quality. The NIH suggests that green tea may provide a modest weight loss benefit.
  • Raspberry ketone . You ll see raspberry-related products in many herbal supplements for weight loss. But there have been no high quality studies to demonstrate it s effectiveness as a diet aid in humans.
  • Forskolin. This extract from the Coleus plant has not been studied enough to determine if it is effective for weight loss. And some medical experts believe the herbal supplement may have dangerous side effects.
  • Aegeline. While this product should no longer be available, you may still be able to find it online or in stores. Aegeline (included in OxyElite Pro ) was removed from the market and banned by the FDA after several cases of death and severe injury were reported. The ingredient was included in popular fat burning supplements and body building products.

Should I Take an Herbal Supplement to Lose Weight?

Before you take any supplement, be sure to consult your health care provider to make sure that the product is safe for you to use. Many products can be safe for some people but dangerous to others when combined with a medication, vitamin or health condition. So be absolutely sure that you tell your doctor about all of the supplements, pills, and herbal products that you take or plan to take.

While you re at your doctor s office, you may also want to ask if there have been recent scientific studies about the effectiveness of the product you re considering. It s best to get this information from an unbiased source, like your doctor. You can also check the database provided by the National Institutes of Health (NIH) or the NIH Office of Dietary Supplements Fact Sheets. According to the NIH, most supplements have been found to be ineffective for weight loss.

There are some products that have been shown in limited situations to have some weight loss benefit, but you re not likely to slim down if you rely on the supplement alone. You re more likely to see results if you focus on proven methods such as a calorie-controlled healthy diet and regular exercise. Then add a supplement only if it is recommended by your physician.

Herbal remedies and supplements for weight loss. Medline Plus. U.S. National Library of Medicine from the National Institutes of Health. Accessed: February 17, 2015.

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Industrial standby generator #1mw #generator, #1000kw #generator, #turbine #engine, #emergency #generator,


Turbine Marine (TM) Compact Series Portable Generators

For dependable power in a compact, lightweight, easy-to-maintain unit

1.1 MW Turbine-powered Portable Standby Generator

Turbine Marine Inc. has developed the Compact Series 1.1 MW turbine-powered portable standby generator . It is emergency industrial equipment that is so small and lightweight it can be easily towed with a standard size pick-up truck, or airlifted by helicopter as its weight is approximately 8500 lbs. and its overall dimensions are 12 L x 5 W x 7.5 H. Its enclosure is sleek and aerodynamic to reduce drag while in tow or flight. The Compact Series 1.1 Megawatt generator (1,100 Kilowatts) is powered by military Lycoming T-53, 1,475 Hp turbine engines. It has the capability of using multiple fuels including, but not limited to; jet, diesel, gasoline and bio-fuels, without any changes to the unit by the user. A natural gas version is also available.

See what Distributed Energy Magazine had to say about our portable turbine generators

See the Advantages of using the Compact Series portable turbine generators.

The COMPACT SERIES is an emergency power generator manufactured using only the highest industry standard components, such as Stamford NewAge Generators (alternators) and Woodward Electrical controls for engine management and electrical current monitoring. The unit has a full digital control panel that is also capable of synchronizing multiple generator units. The 1.1 MW generator assemblies can be ordered in any Hz or voltage configuration that the application may demand.

The high-tech carbon fiber composite, fully weatherproofed enclosure, houses a self monitoring safety and engine shut down system. The enclosure also incorporates a dust / saltwater mist air filtration system for both the engine and alternator. This filtration system will allow proper operation in any conditions land or sea. The emergency back up generator assembly is trailer-mounted for easy mobility. The trailer is a quick- mount system that can be removed in minutes if a skid version is needed.

850 KW Turbine-powered Portable Standby Generator

Turbine Marine Inc. also reveals its Compact Series 850KW turbine-powered portable standby generator . This unit has the same features as the 1.1MW Series. It is also lightweight, portable, multi-fuel capable and is built with the best industry quality components.

All of our generators are easily serviceable throughout the world.


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Lap Band Surgery Procedure, Advantages and Results #lap #band, #gastric #band,gastric


Northwest Weight Loss Surgery, the leading center for the Lap-Band. Gastric Bypass. Sleeve Gastrectomy. for weight loss surgery

Special Offers


About Lap Band Surgery

The Lap Band surgery (also known as Laparoscopic Adjustable Gastric Band Surgery) was approved by the FDA in June 2001. Prior to that, it was the number one weight loss operation being performed in Europe and Australia. Over 550,000 Lapbands have been placed world-wide since 1993. Multiple long-term studies have shown average excess weight loss to be greater than 55% in the majority of patients. Current studies have shown the band to be a highly effective operation with the lowest risk.

Lap band surgery involves implanting an adjustable gastric band designed to help you lose weight, improve weight-related health conditions and enhance quality of life. It reduces the stomach capacity and restricts the amount of food that can be consumed at one time. The Lapband is a silicone ring designed to be placed around the upper part of the stomach and filled with saline on its inner surface. This creates a new, smaller stomach pouch that can hold only a small amount of food. The Lapband also controls the stoma (stomach outlet) between the new upper pouch and the lower part of the stomach. When the stomach is smaller, you feel full faster, while the food moves more slowly between your upper and lower stomach as it is digested. As a result, you eat less and lose weight. Click here for an animated video on the lap band procedure.

The Minimally Invasive Procedure

During the procedure, surgeons usually use laparoscopic techniques (making tiny incisions rather than a large incision and inserting long-shafted instruments through ports ), to wrap the lap band around the patient s stomach. A narrow camera is passed through a port so the surgeon can view the operative site on a nearby video monitor. Like a wristwatch, the Lapband is fastened around the upper stomach to create the new stomach pouch that limits and controls the amount of food you eat. The band is then locked securely in a ring around the stomach. Since there is no stomach cutting, stapling, or gastrointestinal re-routing involved in the lap band procedure, it is considered the safest, least invasive, and least traumatic of all weight-loss surgeries. The laparoscopic approach to the surgery also has the advantages of reduced post-operative pain, shortened hospital stay, and quicker recovery. If for any reason the Lap-Band device needs to be removed, the stomach generally returns to its original form.

Adjustable Weight Loss

Once placed around the stomach, tubing connects the lapband to an access port fixed beneath the skin of your abdomen. This allows the surgeon to change the stoma size by adding or subtracting saline or salt water, inside the inner balloon through the access port. This adjustment process helps determine the rate of weight loss. If the band is too loose and weight loss is inadequate, adding more saline can reduce the size of the stoma to further restrict the amount of food that can move through it. If the band is too tight, the surgeon will remove some saline to loosen the band and reduce the amount of restriction. The diameter of the band can be modified to meet your individual needs, which can change as you lose weight. For example, pregnant patients can expand their band to accommodate a growing fetus, while patients who aren t experiencing significant weight loss can have their bands tightened.

The lapBand procedure is the only adjustable weight-loss surgery available in the United States to help maintain restriction and keep the weight off long-term.

Advantages of Lap Band Surgery

  • Least invasive surgical option
  • No intestinal re-routing
  • No cutting or stapling of the stomach wall or bowel
  • Small incisions and minimal scarring
  • Reduced patient pain, length of hospital stay and recovery period

Fewer Risks and Side Effects

  • 10 times less operative and short-term mortality than gastric bypass 1
  • Low risk of nutritional deficiencies associated with gastric bypass
  • Reduced risk of hair loss
  • No dumping syndrome related to dietary intake restrictions

Adjustable and Reversible

  • Allows individualized degree of restriction for ideal rate of weight-loss
  • Adjustments performed without additional surgery
  • Supports pregnancy by allowing stomach outlet size to be opened to accommodate increased nutritional needs
  • Only surgical option designed to help maintain long-term weight loss
  • Removable at any time
  • Stomach and other anatomy are generally restored to their original forms and functions

Effective Long-Term Weight Loss

  • More than 550,000 Lap-band devices placed worldwide
  • Standard of care for hundreds of surgeons around the world
  • #1 selling adjustable gastric band for weight loss
  • Academic publications with up to 10 years of follow-up

Diet and Exercise After Weight Loss Surgery

Weight loss gives you more energy, makes you feel better about yourself and motivates you to continue the changes that have made you successful. The success of any weight loss operation must begin with realistic goals; once established, your motivation will ultimately determine the amount of weight you lose. Weight loss surgery works with you, not by itself. It creates a situation where a small amount of food makes you full and less hungry, reducing the number of calories eaten in a day. If you take advantage of this situation, you will lose weight.

Exercise adds to this by increasing the number of calories burned. When you exercise, you build muscle, which increases your metabolic rate, which burns more calories. We strongly encourage the addition of exercise to weight loss surgery, as the combination of eating fewer calories and burning more calories is very powerful for successful weight loss.

There are patients who go through the trouble of having weight loss surgery and do not lose much weight because they expect the lapband surgery to do the work for them. Becoming a thinner person requires change. You must be more active and make wise food choices. An example is a patient who eats a large quantity of high-calorie liquids such as milkshakes or sugary sweets. Sugar is an unnecessary source of calories that you must burn off with exercise. We strongly recommend not eating sweets after weight loss surgery (unless it s your birthday). Try sugar-free foods. Other patients sabotage their success by grazing or emotional eating — eating small amounts of food throughout the day. After weight loss surgery, if you avoid sugar, high-calorie liquids and emotional grazing, you will increase your success rate. The best way to lose weight is to eat less and exercise more.

Northwest Weight Loss Surgery has developed a comprehensive after care program to better prepare you for the lifelong changes after surgery. We encourage you to attend our monthly support groups where we discuss many topics relating to the weight loss journey. For patient success stories click here .

Motivation is the Key to Weight Loss

Most patients who’ve had lapband surgery found it to be the only thing that allowed them to keep the weight off long-term. We hear people say things like “weight loss surgery gave me my life back and I wish I would have done this sooner . We have many successful patients. but it is incorrect to think that you do not have to put any effort into losing weight. Your surgeon will educate you on your responsibilities as a weight loss surgery patient. These include new eating patterns and a new lifestyle.

1. Executive summary: Laparoscopic adjustable gastric banding for the treatment of obesity (Update and Re-appraisal). The Australian Safety and Efficacy Register of New Interventional Procedures – Surgical (ASERNIPS) 2002; 1. (Laparoscopic adjustable gastric banding surgery, like the LAGB surgery, is associated with a mean short-term mortality rate of around 0.05% compared to 0.50% for Gastric Bypass and 0.31% for Vertical Banded Gastroplasty.)
As with any surgery, there are specific risks and possible complications associated with the LAGB surgery. Talk to your doctor to determine if you are a candidate for the LAGB procedure.
M898-10 06/07

Northwest Weight Loss Surgery offers options for weight loss surgery; Gastric Bypass, Sleeve Gastrectomy, Lap Band Surgery, Plication, Botox, Juvederm, Facial Peels and Medical Grade skin care products. for Washington State, servicing the entire country including Seattle, Bellevue, Redmond, Tacoma, Spokane, and the Tri cities areas as well as Nationwide. We also offer weight loss surgery for patients from Canada and other countries outside of the U.S.A.

* Please note – Results and individual symptoms may vary.


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Do TNF inhibitors make you put on weight? #humira #weight #gain


Do TNF inhibitors make you put on weight?

My patient emailed me last week, distressed.

Her rheumatoid isn’t the issue and hasn’t been, even since she commenced TNF-inhibitor therapy.

The problem – Weight gain.

About 10 kg since the commencement, over a period of a couple of years.

She couldn’t be happier with the joint disease and for all intents and purposes, the rheumatoid arthritis is in remission. She was a little overweight beforehand and the hope was that she could exercise and be much more active once disease was controlled.

She’s been really compliant. With our clinic’s connected care approach, she has diligently worked on mindful eating with our dieticians, and she’s had her exercise program designed, reviewed and modified a number of times. She has joined the gym and actually attended, faithfully following guidance.

And yet, the weight has increased.

I can only imagine how demoralising this is.

We even swapped the medication to a different TNF-inhibitor. No improvement in weight. And there’s no other obvious cause.

Please let me reassure you that this is a rare situation but it does occur. All of us treating patients with TNF-inhibitor therapy have noticed this phenomenon in a very few patients.

I haven’t heard a satisfactory explanation. It’s been argued that having active inflammatory disease is a catabolic state. When inflammation is suppressed effectively, this state of excessive use of energy reverses and the patient puts on weight.

Hmmm….doesn’t happen with the vast majority of patients.

Anyway, I’m going to swap her to a different class of biologic agents. Fingers crossed that the disease doesn’t flare. And it becomes easier to lose the weight.

As a patient, have you any experience with this?

Any of you rheumatologists reading this have any knowledge to share?


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Preparing for Weight Loss Surgery – Robin F #preparing #for #weight


Preparing for Weight Loss Surgery

Robin F. Apple, James Lock, and Rebecka Peebles

  • -Part of the successful TreatmentsThatWork series
  • -First book of its kind exclusively for mental health professionals working with pre-operative weight loss surgery patients
  • -Treatment program outlined is based on cognitive-behavioral techniques proven to be effective with overweight and obese individuals

Preparing for Weight Loss Surgery

Robin F. Apple, James Lock, and Rebecka Peebles


Obesity has quickly become an American epidemic. People suffering from significant overweight often have to contend with a lifetime of significant comorbidities, social stigma, and lower quality of life. Recently, more and more people are undergoing weight loss surgery as a way to resolve these issues.

If you are working with pre- or post-operative bariatric surgery patients, your goal is to teach them the skills they need to ensure themselves a successful surgical outcome. After surgery, patients are required to adhere to a strict diet and the very specific recommendations of their surgical “team.” Without a high level of commitment from the patient to follow these recommendations, the potential for maintained weight loss after surgery is very limited.

Preparing for Your Weight Loss Surgery, Therapist Guide contains a series of scientifically tested cognitive-behavioral techniques to help you prepare your patient for the post-operative challenges of creating radically changed eating and lifestyle habits. It provides instructions for teaching your patient basic problem-solving and cognitive restructuring methods that will change their negative thoughts and attitudes about food. Interactive forms including food records and checklists, body image journals, and homework assignments found in the corresponding patient workbook round out this comprehensive treatment package.

TreatmentsThatWorkTM represents the gold standard of behavioral healthcare interventions!

BL All programs have been rigorously tested in clinical trials and are backed by years of research
BL A prestigious scientific advisory board, led by series Editor-In-Chief David H. Barlow, reviews and evaluates each intervention to ensure that it meets the highest standard of evidence so you can be confident that you are using the most effective treatment available to date
BL Our books are reliable and effective and make it easy for you to provide your clients with the best care available
BL Our corresponding workbooks contain psychoeducational information, forms and worksheets, and homework assignments to keep clients engaged and motivated
BL A companion website ( offers downloadable clinical tools and helpful resources
BL Continuing Education (CE) Credits are now available on select titles in collaboration with PsychoEducational Resources, Inc. (PER)

Preparing for Weight Loss Surgery

Robin F. Apple, James Lock, and Rebecka Peebles

Table of Contents

Introductory Information for Therapists.
2. Understanding Your Patient’s Eating Behavior
3. Helping Your Patient Keep Track of Their Eating
4. Educating Your Patient About Weighing Behaviors
5. Pleasurable Alternative Activities
6. Challenging Eating Situations: People, Places and Food
7. Teaching Your Patient About Problem Solving and Cognitive Restructuring
8. Working With Your Patient on Body Image Issues
9. Congratulations! Your Patient is on the Way to the O.R.
10. “What Happens After Surgery?”
About the Authors.

Preparing for Weight Loss Surgery

Robin F. Apple, James Lock, and Rebecka Peebles

Reviews and Awards

“These volumes are an extremely useful addition to the field. Psychological and behavioral preparation is a critical part of the bariatric surgery process, yet it has been sorely underemphasized in the literature up to this point. These volumes give this important topic the attention it deserves.”– Scott Crow, M.D. Professor of Psychiatry, University of Minnesota

“Very little has been available for mental health professionals who work with bariatric surgery patients preparing them for surgery, despite the fact that many important issues need to be discussed before this life changing procedure. Preparing for Weight Loss Surgery Therapist Guide and Workbook by Apple, Lock and Peebles provides a very important, practical and user-friendly work which nicely fills this void. Therapists working with this group of patients can use these materials with confidence, knowing that the texts are informed by the latest research in the area and are both pragmatic and clinically informed. These materials represent a major step forward in the care of patients who will be undergoing bariatric surgery.”– James E. Mitchell, M.D. Christoferson Professor and Chair, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences

“The recent surge in the use of bariatric surgery, because of its effectiveness in the treatment of obesity, has outpaced the development of methods to prepare individuals, before and after surgery, for the behavior changes that need to occur in relation to food. These manuals therefore, fill an urgent need to prepare patients, both adolescents and adults, for bariatric surgery and provide sensible guidelines for the patient (and therapist) for the management of potential post-operative problems.” Stewart Agras, M.D. Professor of Psychiatry, Stanford University School of Medicine


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GASTRIC BYPASS SURGERY- Information on cost, expected weight loss and risk


Gastric Bypass and Gastric Sleeve Diet

Immediately after your gastric bypass or gastric sleeve surgery, you won’t be able to eat for one to two days. After a couple of days, you will be able to eat some very specific foods according to a diet progression. The purpose of the gastric bypass diet progression is to help you in the healing process, minimize stress on surgical areas and allow time for your body to adjust to new eating patterns.

Common phases in the gastric bypass and gastric sleeve diet:

Phase I – Liquids – foods and fluids that are liquid or semi-liquid at room temperature and contain mostly water, such as broth, juice, milk, strained cream soup and cooked cereal. In most cases, you stay on a liquid diet for one to two days.

Phase II – Pureed foods – foods with a consistency of a smooth paste or a thick liquid. Pureed foods contain no distinct pieces. The pureed diet is generally followed for three to four weeks, or as recommended by your dietitian or doctor.

Phase III – Soft foods – foods that are tender and easy to chew, such as ground or finely diced meats, canned or soft, fresh fruit, and cooked vegetables. You usually eat soft foods for eight weeks before progressing to eating foods of regular consistency with firmer texture as recommended by your dietitian or doctor.

During the diet progression, you eat many small meals each day and sip liquids slowly throughout the day (but not at the same time you eat). You may start with six small meals a day, then progress to four meals and then finally, when following a regular diet, decrease to three meals a day. Typically, each meal will include protein-rich foods, such as lean meat, low-fat dairy products (yogurt, cheese) or eggs. Protein is important for maintaining and repairing your body after surgery.

How quickly you move from one step to the next depends on how fast your body adjusts to the change in eating patterns and the texture and consistency of food. People usually start eating regular foods with a firmer texture three months after surgery, but it can occur sooner.

You may drink anything that is clear and liquid at room temperature. Avoid caffeine and carbonated drinks.

  • Water with ice chips
  • Sugar free popsicles
  • Crystal Light
  • Decaf tea
  • Sugar Free Jell-O
  • Diet V8 Splash

Do not drink from straws or sports top bottles as this can cause air bubbles and may cause discomfort. Water may be difficult at first. Try adding lemon and adjusting the temperature. Please follow your doctors’ recommendations on how long to follow each diet.

  • Mashed potatoes
  • Bananas
  • Malt-O Meal
  • Scrambled Eggs
  • Baked Fish
  • Low Fat cottage cheese
  • Sugar free yogurt or pudding
  • Applesauce with no sugar added
  • Soft cooked vegetables
  • Avoid eating fats and sugar for the time being as these may be difficult for the body to digest in this stage.
  • Chew your food very well – eat slowly.
  • If you feel full – STOP EATING

  • Protein is needed by the body to build and repair the body’s cells and tissues.
  • Protein plays a vital role in immunity.
  • Choose lean meats such as:
  • Fish, shellfish, poultry, lean beef, lamb, pork, veal, and 95% fat free deli meat.
  • Avoid high fat cooking methods like frying with oil. void high fat meats such as bacon, sausage, pepperoni or salami.
  • A limited amount of fat is needed in the diet.
  • Fats can be found in baked goods (cakes, muffins, cookies), greasy or fried foods, oils and butter.
  • Fat may be difficult to digest after gastric bypass surgery.
  • Too much fat may cause reflux (heartburn).
  • Excess fat may cause diarrhea, nausea and discomfort.
  • Avoid high fat choices like regular salad dressing, butter, cream cheese and mayonnaise.
  • Choose low fat options such as fat free / low fat salad dressing, mayonnaise, nonstick cooking spray and olive oil.

  • Carbohydrates including grains and starches are the bodies main source of energy.
  • They provide energy, B Vitamins, Fiber, and Minerals
  • Complex carbohydrates provide nutrients and make you feel full.
  • Look for foods with whole grain or 100% wheat flour.
  • Examples of complex carbohydrates:
  • Wheat bread, low fat crackers, cereals with low sugar such as Special K, Cheerios, Raisin Bran, rice and pasta
  • VEGETABLES provide fiber, energy, Vitamin A and Vitamin C
  • Choose a variety of vegetables for your diet
  • Avoid using high fat cooking methods such as added butter or oil, or adding high fat sauces such as creams, cheese or gravy
  • Remember to incorporate vegetables back into your diet slowly and start with soft consistencies.
  • FRUIT provides complex carbohydrates, fiber, energy and Vitamin C.
  • Incorporate them into your daily routine; fruit makes great snacks.
  • Choose a variety of fruits
  • Remember to incorporate fruits back into your diet slowly and start with soft consistencies.


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Cerebral Palsy #cp, #cerebral #palsy, #wheelchair, #crutches, #congenital #disorder, #birth #defect,


Cerebral Palsy

Maybe someone at your school has cerebral palsy — or perhaps you have it and you’ve been dealing with it your whole life. As we become more aware of appearance and body image. it can be tough to be in a wheelchair or to have people tease you about the way you walk. But lots of teens with CP don’t let it hold them back. They do just what everyone else does.

What Is Cerebral Palsy?

Cerebral palsy (CP) is a disorder of the brain. Normally, the brain tells the rest of the body exactly what to do and when to do it. Because of how CP affects the brain, a person might not be able to walk, talk, eat, or move the way most people do.

CP affects a person’s muscle tone and ability to coordinate body movements. People with CP have trouble controlling their muscles. How a person is affected all depends on what part of the brain is involved.

How Does Cerebral Palsy Affect People?

The three types of cerebral palsy are:

  1. Spastic (pronounced: SPASS-tik) CP is the most common type of CP. People with spastic CP can’t relax their muscles or the muscles may be stiff.
  2. Athetoid (pronounced: ATH-uh-toid) CP affects the ability to control the muscles of the body. A person’s arms or legs may flutter and move suddenly.
  3. Ataxic (pronounced: ay-TAK-sik). People with ataxic CP have problems with balance and coordination. Their movements may seem shaky.

People with CP can have mild cases or more severe cases. It all depends on how much of the brain is affected and which parts of the body that section of the brain controls. If CP affects both arms and both legs, a person might need to use a wheelchair. If CP only affects the legs, someone may walk in an unsteady way or have to wear braces or use crutches.

If CP affects the part of the brain that controls speech, a person with CP might have trouble talking clearly or not be able to speak at all. Some people with CP also have learning disabilities or behavior problems, though many don’t have these issues. Others can have medical problems like seizures or epilepsy. or hearing impairment.

What Causes It?

In most cases, doctors don’t know exactly what causes CP. They do know that it’s the result of damage to the brain — either while a baby is in the womb or in the first few months or years after the baby is born.

Babies have a higher chance of having CP if they are born early or if they’re very underweight at birth. Babies who don’t get enough oxygen during or right after birth also have a higher chance of having CP. So do babies who need to be on a ventilator (a machine to help with breathing) for several weeks or more after birth.

CP is not contagious, so people can’t catch it from other people. Even a mother with CP can’t pass it on to her unborn baby.

What Do Doctors Do?

Doctors diagnose CP when kids are young, so by the time people reach their teens, they usually know they have CP and are used to living with it.

With CP, the problem with the brain will not get any worse as people get older. For example, someone who has CP that affects only the legs won’t develop CP in the arms or have problems with speech later on.

Although CP doesn’t get worse over time, how it affects someone’s body can change as the person grows or develops. For example, some teens with CP may develop dislocated hips (when the bones that meet at the hips move out of their normal position) or scoliosis (curvature of the spine).

Because CP affects people differently, there are lots of ways to treat and manage it. Some teens have only mild problems with movement. Others need crutches or wheelchairs to get around. Doctors, parents, teachers, therapists, and the person with CP all work together to develop the best treatment plan.

Teens with CP may work with these experts:

  • a pediatric orthopedist
  • a developmental pediatrician who looks at how the person is growing or developing compared with other teens
  • a pediatric physiatrist (or rehabilitation physician), who helps kids with disabilities of many kinds
  • therapists, like physical therapists to help with movement, occupational therapists to help with skills like handwriting, and speech therapists

Some teens with CP take medicines to relax their muscles (in the case of spastic CP) or to help control seizures. And some might have special surgeries to keep their arms or legs straighter and more flexible.

Coping With Cerebral Palsy

Puberty can be especially challenging for people with CP. Rapid growth can cause weight gain and clumsiness in any teen, but can make it even more difficult for someone with CP to move around. A person’s muscles can become tighter as the bones grow, which can restrict movement even more.

If you have CP, what you’ll do depends on your CP. One thing you can do is to get more involved in your medical care wherever possible. Keep up with your appointments, including any physical or other therapy visits. This is a time when your medical team will want to keep an eye on you and adapt your treatment or therapy as you grow.

Many guys and girls with CP can do the same sorts of things that other teens do, like enjoying extracurricular activities, listening to or playing music, hanging out with friends, reading, going to the mall, and dating, to name just a few.

Helping a Friend Who Has CP

If you know someone who has CP and you’re wondering how to help, just treat that person the way you would anyone else. Some people with CP might need extra assistance once in a while, like when reaching for something. Help out — just as you would with anyone else — without making a big deal about it. If you can’t understand what a person with CP is saying or if it takes longer to do things, give him or her extra time to speak or move.

And don’t be afraid to talk to a friend about what it’s like to live with CP. Everyone wants to fit in, and being in a wheelchair or having other physical problems can make someone self-conscious or feel left out. So if you know someone with CP, try to be welcoming and include him or her in what you’re doing.

Date reviewed: August 2015


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