Learn How To Manage The Scale In Your Life With These 6 Tips!

Khalili Center - Scale


1. For accuracy, take your weight at the same time and on the same scale weekly.

2. Avoid taking your weight more than one time per day, or at different times per day.

3. The scale measures total weight and does separate out other tissues such as muscle.

4. Fluid fluctuation day to day of 2-4 lbs can be normal based on foods consumed, hydration level, bathroom habits and hormones.

5. Do not “get stuck” in the fluctuations but rather focus on your weight trend from month to month.

6. To maximize weight loss results or long term weight loss maintenance focus on healthy eating, exercise and regular water intake FIRST, the scale number SECOND.


Orange Chicken – Bariatric Makeover!!

Khalili Center - Orange Chicken
We love this sweet, spicy and flavorful LIGHTER alternative to the popular Chinese fast food version because it is now bariatric friendly and it is quick and easy and so delicious!

For the Orange Sauce

  • 1/3 cup freshly-squeezed orange juice
  • 1/4 cup reduced sodium chicken broth
  • 2 tbsp soy sauce (Tamari for gluten-free)
  • 2 tbsp raw sugar
  • 1 tbsp Chinese rice wine
  • 1 tbsp sriracha, or more to taste
  • 1 tbsp rice vinegar
  • 1/4 teaspoon white pepper
  • 2 teaspoons corn starch

For the Chicken

  • 20 oz skinless, boneless chicken breast, cut into small cubes
  • kosher salt, to taste
  • 1 1/2 tbsp corn starch
  • 1 tbsp sesame oil
  • 4 cloves minced garlic
  • 1-inch grated ginger
  • 1 teaspoon grated orange zest
  • 2 tbsp chopped scallions
  • 1/2 tsp sesame seeds, for garnish


  • Mix the orange sauce ingredients and set aside.
  • Season the chicken lightly with salt and coat evenly with corn starch, set aside.
  • Heat a wok on high heat, add 1 teaspoon of sesame oil and add half of the chicken. *Cook 2 to 3 minutes on each side until well browned, set aside. Add 1 teaspoon of oil and chicken and repeat cooking 2 to 3 minutes on each side. Set aside with the rest of the chicken.
  • Add remaining teaspoon of oil and quickly stir-fry the minced garlic and ginger until fragrant, about 1 minute. Add the orange zest then return the chicken to the pan. *Quickly stir the chicken then add the orange sauce and cook until the sauce thickens, about 1 to 2 minutes. Divide between 4 plates and garnish with the scallion and sesame seeds.


  • Servings: 4, Size: generous 3/4 cup
  • Calories: 288
  • Protein: 32.5 grams
  • Carb: 18 grams
  • Fat: 9 grams


This recipe comes from skinnytaste.com


Weight loss surgery may result in permanent remission for obese diabetics, ‘remarkable’ research finds


New research is boosting hopes that weight-loss surgery can put some patients’ diabetes into remission for years and perhaps in some cases, for good.

Doctors on Monday gave longer results from a landmark study showing that stomach-reducing operations are better than medications for treating “diabesity,” the deadly duo of obesity and Type 2 diabetes. Millions of Americans have this and can’t make enough insulin or use what they do make to process food.

Many experts were skeptical that the benefits seen after a year would last.

Now, three-year results show an even greater advantage for surgery.

Blood-sugar levels were normal in 38% and 25% of two groups given surgery, but in only 5 percent of those treated with medications.

The results are “quite remarkable” and could revolutionize care, said one independent expert, Dr. Robert Siegel, a cardiologist at Cedars-Sinai Medical Center in Los Angeles.

“No one dreamed, at least I didn’t,” that obesity surgery could have such broad effects long before it caused patients to lose weight, he said. Some patients were able to stop using insulin a few days after surgery.

At three years, “more than 90% of the surgical patients required no insulin,” and nearly half had needed it at the start of the study, said its leader, Dr. Philip Schauer of the Cleveland Clinic. In contrast, insulin use rose in the medication group, from 52% at the start to 55 percent at three years.

The results were reported Monday at an American College of Cardiology conference in Washington. They also were published online by the New England Journal of Medicine.

Doctors are reluctant to call surgery a possible cure because they can’t guarantee diabetes won’t come back.

But some patients, like Heather Britton, have passed the five-year mark when some experts consider cure or prolonged remission a possibility. Before the study, she was taking drugs for diabetes, high blood pressure and high cholesterol; she takes none now.

“It’s a miracle,” said Britton, a 55-yeear-old computer programmer from suburban Cleveland.

“It saved my life. I have no doubt that I would have had serious complications from my diabetes” because the disease killed her mother and grandmothers at a young age, she said.

About 26 million Americans have diabetes, and two-thirds of them are overweight or obese. Diabetes is a leading cause of heart disease, strokes, kidney failure, eye trouble and other problems.

It’s treated with various drugs and insulin, and doctors urge weight loss and exercise, but few people can drop enough pounds to make a difference. Bariatric surgery currently is mostly a last resort for very obese people who have failed less drastic ways to lose weight.

It costs $15,000 to $25,000 and Medicare covers it for very obese people with diabetes. Gastric bypass is the most common type: Through “keyhole” surgery, doctors reduce the stomach to a small pouch and reconnect it to the small intestine. Another type is sleeve gastrectomy, in which the size of the stomach is reduced less drastically.

Schauer’s study tested these two operations versus medication alone in 150 mildly obese people with severe diabetes. Their A1c levels — a key blood-sugar measure — were over 9 on average at the start. A healthy A1c is 6 or below and the study aimed for that, even though the American Diabetes Association sets an easier target of 7.

After three years, researchers had follow-up on 91% of the original 150 patients. The medication group’s A1c averaged 8.4; the surgery groups were at 6.7 and 7, with gastric bypass being a little better.

The surgery groups also shed more pounds — 25% and 21% of their body weight versus 4% for the medication group.

Some cholesterol and other heart risk factors also improved in the surgery groups and they required fewer medicines for these than at the start.

Doctors don’t know how surgery produces these benefits, but food makes the gut produce hormones to spur insulin, and trimming away part of it affects many hormones and metabolism.

Four patients needed a second surgery within a year but none did after that. Out-of-control diabetes has complications, too — many patients lose limbs or wind up on dialysis when their kidneys fail, and some need transplants.

An obesity surgery equipment company sponsored the study, and some of the researchers are paid consultants; the federal government also gave grant support.

Dr. Robert Ratner, chief scientific and medical officer for the American Diabetes Association, said he was “very encouraged” that so many stayed in the study, and said it will remain important to follow participants longer, because many people who have weight-loss surgery regain substantial weight down the road.

“Any way you lose weight is beneficial” for curbing diabetes, he said, but “we need to be concerned about the cost and complications” of treatments. Diets cost less and have fewer side effects, Ratner said.

One other common type of obesity surgery, stomach banding, was not part of this study. Its use has declined in recent years as other types of surgery have shown long-term benefits for keeping weight off.


Get inspired to cook it lighter at Passover!

Khalili Center - Chicken Matzo Ball Soup

Bariatric Friendly Passover Food Tips

Chicken Matzo Ball Soup
For the matzo balls, replace half the eggs with egg whites or egg substitute. Use half the amount of fat the recipe calls for, and replace the rest with chicken broth .

Beef Brisket
Brown the onions and brisket in a minimum of oil (about 2 tablespoons per 5-pound brisket).

Replace half the eggs with egg whites or egg substitute (1/4 cup of substitute or 2 egg whites is equivalent to one whole egg). You can probably cut the amount of butter and sugar in half (the missing butter can be replaced with mashed potatoes, condensed chicken broth or a similar ingredient).

Passover Rolls
Replace half the eggs with egg whites or egg substitute. Cut the amount of vegetable oil called for can be cut in half and replace the rest with mashed potatoes or chicken broth.

Passover Apple Cake
Cut the amount of vegetable oil in half and replace it with fruit puree such as applesauce.

Passover Sponge Cake
Replace half the egg yolks with egg substitute (2 tablespoons per egg yolk).


This information comes from webmd.com


Researchers identify a mechanism linking bariatric surgery to health benefits

Khalili Center - Happy Woman


Bariatric surgery has positive effects not only on weight loss but also on diabetes and heart disease. Researchers at the Sahlgrenska Academy and University of Cincinnati have shown that the health benefits are not caused by a reduction in the stomach size but by increased levels of bile acids in the blood.

These findings, reported in Nature, indicate that bile acids could be a new target for treating obesity and diabetes.
Previous research from the Sahlgrenska Academy has demonstrated that obesity surgery is the only effective treatment for obesity and obesity-related diabetes.

However, the mechanisms that cause the positive effects have been unclear.

Professor Fredrik Bäckhed, in collaboration with Randy Seeley and coworkers from the University of Cincinnati in the US, has shown that the positive effects of bariatric surgery are likely caused by the surgery-induced increase in bile acids. The study, which is published online in the leading science journal Nature, focuses on a specific receptor called FXR, which is involved in bile acid signaling.

“Our study shows that signaling through FXR is essential for the beneficial effects of the surgery to be achieved. This is a major breakthrough in understanding how bariatric surgery affects metabolism and in the development of new treatment strategies”, says Fredrik Bäckhed.

Important future complement

The prevalence of obesity is increasing worldwide and it is not realistic to operate on all obese subjects. Furthermore, bariatric surgery is associated with a risk of complications. Treatment strategies based on the FXR receptor could therefore be an important future therapeutic approach.

Improves glucose metabolism

In this study, mice with or without the FXR gene underwent an operation termed vertical sleeve gastrectomy (VSG) in which approximately 80 percent of the stomach was removed. The surgical procedure is the same as that performed in humans.
The researchers observed that the operation promoted weight loss and improved glucose metabolism in mice with FXR while the operation had no effect in mice that lacked FXR.

Alters intestinal bacterial flora

This study also showed that VSG resulted in changes in the gut microbiota, a potentially important finding given that Fredrik Bäckhed’s research group has previously demonstrated that the intestinal bacterial flora is altered in obesity and diabetes.

These additional findings suggest that an altered gut flora together with signaling through FXR may contribute to improved metabolism. This means that future treatments based on the intestinal flora could help in the treatment of diabetes.

This article was printed from healthcanal.com


Cauliflower Fried “Rice”



You will LOVE this delicious recipe because it is so healthy with abundant vegetables and low in carbs and fat – the perfect bariatric meal! Throw in some chicken or shrimp for a complete and satisfying meal anytime!


  • 1 medium head (about 24 oz) cauliflower, rinsed
  • 1 tbsp sesame oil
  • 2 egg whites
  • 1 large egg
  • Pinch of salt
  • Cooking spray
  • 1/2 small onion, diced fine
  • 1/2 cup frozen peas and carrots
  • 2 garlic cloves, minced
  • 5 scallions, diced, whites and greens separated
  • 3 tbsp. soy sauce, or more to taste (Tamari for Gluten Free)



  • Remove the core and let the cauliflower dry completely. Coarsely chop into florets, then place half of the cauliflower in a food processor and pulse until the cauliflower is small and has the texture of rice or couscous – don’t over process or it will get mushy. Set aside and repeat with the remaining cauliflower.
  • Combine egg and egg whites in a small bowl and beat with a fork. Season with salt.
  • Heat a large saute pan or wok over medium heat and spray with oil. Add the eggs and cook, turning a few times until set; set aside.
  • Add the sesame oil and saute onions, scallion whites, peas and carrots and garlic about 3 to 4 minutes, or until soft.
  • Raise the heat to medium-high. Add the cauliflower “rice” to the saute pan along with soy sauce. Mix, cover and cook approximately 5 to 6 minutes, stirring frequently, until the cauliflower is slightly crispy on the outside but tender on the inside. Add the egg then remove from heat and mix in scallion greens.



  • Servings: 4, Size: heaping 1 1/3 cups
  • Calories: 108
  • Protein: 9 grams
  • Carbs: 14 grams
  • Fat: 3 grams


Recipe from skinnytaste.com


Man details 220-pound weight loss after bariatric surgery: Is now a triathlete

Khalili Center - Jim Blackburn


Bariatric surgery has soared in popularity as research confirms that surgery beats diet and exercise for producing dramatic weight loss and reversing diabetes and heart disease.

Celebrities like Al Roker, Rosie O’Donnell, Lisa Lampanelli, chef Graham Elliot and New Jersey Gov. Chris Christie have all described weight-loss surgery as “life-changing.”

In an exclusive interview, Jim Blackburn, an Atlanta IT executive, revealed how bariatric surgery helped him lose 220 pounds and transformed him from couch potato to marathon man.

The once 420-pound Jim underwent gastric-bypass surgery in 2010, and lost 174 pounds over the next 12 months. Shortly afterward, Blackburn began running, and recently completed his first marathon. He’s now training for his first triathlon.

On April 5, Blackburn will speak at an event sponsored by WLSFA, (Weight Loss Surgery Foundation of America), a non-profit charity that funds surgeries for people who can’t afford them. Jim will appear alongside WLSFA ambassadors Carnie Wilson and Lisa Lampanelli.

Jim said bariatric surgery completely changed his life and revealed how his struggles have shaped his never-say-quit attitude.

Question: It has almost been four years since you got gastric bypass surgery. Why did you decide to get the surgery?

“Yes, four years April 5, 2014 – my surgiversary. About two years before my surgery, my primary care doctor and good friend suggested that I needed to consider some type of surgical intervention. This was due to mounting medical problems and co-morbidities that came with being severely overweight. At the time, I did not consider surgery to be an option and pretty much ignored the possibility of surgery being a solution that I would consider.

A little over a year prior to my surgery a family member came to me and said that she had done a lot of research on weight loss surgery and programs and said that she and her husband had decided to undergo RnY gastric bypass. This sparked my interest and I was drawn into the process because I took on somewhat of a support role for both of them and was exposed to the educational process as well as what the day of surgery was like and the recovery. Seeing their results increased my interest.

Along with this, another family member, who needed the surgery desperately, was on the fence as to whether surgery was right for her so together we sort of banded together, made the decision to have the surgery, and then progressed through the educational process, the testing process, the day of surgery, and then the recovery.

For both of us the surgery was a success at varying levels but it was this push, or being able to push her, that cemented my decision to have the surgery. In addition to this, there were many of the other typical factors that contributed to my decision such as my mortality, getting older, turning 50, and wanting to live to experience and be a part of my grown children’s lives as the father that walks his daughter down the aisle or helped his son with his first house purchase – all of the things that I wanted to do was clouded in my severe and morbid obesity that I dealt with each and every day.

My health, aching bones, shortness of breath all were decision making factors along with high blood pressure, gout, sleep apnea, fatty liver, and the beginning stages of diabetes.”
Question: You’ve lost 220 pounds to date and look incredible. How did you make the staggering 180-degree transformation from couch potato to marathon runner/triathlete?

“I lost 174 pounds my first year and was basically doing the minimal amount of exercise, which consisted of mostly walking. During this year I kept in contact with my surgeon and would send progress pictures to him often. I remember in one of his response emails that he complemented me on my progress and then he said that my skin was starting to look saggy and that I needed to get into the gym. Since he was commenting on a picture I had sent that only showed my face the message for some reason resonated very loud with me.

Looking back, I can also remember my primary care physician having the ‘talk’ with me about having to have a second surgery to remove excess skin and skin flaps. My comment to him was that there was absolutely no way I was having another surgery and that I would do whatever was necessary to get my skin to tighten up.

Both of these interactions, with two different doctors, stuck with me and were the catalyst to my initial efforts to get into the gym and start a routine and serious workout program. The very next day, after my surgeon’s email, I joined the YMCA and started a workout regimen that lasted for almost a year straight.

The regimen was simple: Monday/Wednesday/Friday, 5:00am-6:00am, alternate treadmill and machine weights. I did not do anything too complicated and relied heavily on music and technology to help get me through the very hard first three months. Five-minute walks on the treadmill turned into five/one-minute walk/jogs and then I gradually moved into longer and faster runs until I was doing a constant hour on the treadmill. Along with this I lifted weights with multiple sets of high repetitions. At first I either ran or lifted but not both but soon I was able to do both in one workout session and from there things snowballed into group exercise class and then graduating to running on the street.

Parallel to the efforts in the gym I took a greater interest in social media and learned that it is possible to hold one’s self accountable by setting goals in a social media setting. While I cannot pinpoint the exact reason why this worked for me I can speculate that since I failed so many times throughout my life at losing weight that I was not willing to fail once committed to a goal.

Because of the reach of social media, I felt accountable to those who I am connected with which included my family, close friends, acquaintances, and total strangers. Since I was very public with the decision to have weight loss surgery, a part of me did not want to fail. The perception of a failure to me and to so many people would somehow diminish my major decision to have weight loss surgery with the number one hurdle in the process was that I had never set foot in a hospital in my life for any type of medical treatment.

Media attention to my success fueled my desire to succeed as well. Through media channels at my weight loss surgical center, a health reporter for a local Atlanta station picked up my story and reported on my success, my surgery, and I was on TV. Suddenly I thought to myself I will be able to watch this story five years from now. My grandkids will be able to watch this story 20 years from now. This was exciting but also surreal in that media attention is the ultimate form of accountability. The media attention snowballed and I did a promotional spot for Emory in Atlanta (see video above).

Then came my running and staying healthy and active so I started out slow and ran my first 5k road race. The feelings I experienced before, during, and after were amazing. I can remember the second I crossed the first start line and the tears I had that quickly turned into sweat. I can remember crossing the finish line and the feeling of accomplishment. My motto going forward from that point was/is: ‘I won’t be first, I won’t be last, but I will finish and I will finish strong.’

Every race I have done after this I have carried this motto and those same emotions with me. The 5k distance went to a 10k distance and once I knew I could do it – again, failure is not an option – I decided to enter the lottery for the world’s largest 10k, the Peachtree Road Race – I got in. Again, media picked up on this and two local Atlanta new stations did stories on my road to the Peachtree and again my goal was out there, to the world, and therefore failure was not an option. Regaining weight was not an option. Stopping my healthy lifestyle was not an option.

So, with a half marathon and full marathon completed, I will participate in my first triathlon this spring, I will run my 3rd Peachtree Road Race this July, and then I will, as part of the Push America team, run the 2014 Marine Corps Marathon in Washington, D.C.”
Question: What is your daily diet like now? What about your workout routine?

“The type of surgery that I had was the Roux-en-Y Gastric Bypass that left me with a tiny new stomach – often called a ‘pouch’ that is surgically constructed to hold roughly 1 to 2 ounces of food. Over time, the size of my pouch changed and at about two years was considered to be ‘mature’ and can hold approximately 6 to 9 ounces of food. The average person can hold approximately 30 ounces of food in their stomach.

Today my diet is driven by my workout routine and my need to consume the correct energy packed foods. Quantity of food and liquid per meal is limited so my daily diet consists of multiple meals throughout the day with three to four hour intervals.

I graze a lot and make choices to eat fruit, whole grain snacks, yogurt, and similar snacks to keep my engine fueled. I do have the standard ‘big’ meals with my wife and family but keep a home cooked or restaurant cooked multi-course meal to eating a single course at a time – in very small portions – and chewing well.

As far as foods I can and cannot tolerate, there are not many. I can eat sugar (candy) of just about any type in very small quantities, can have the occasional one doughnut, and enjoy a lot of liberty with my pouch and bypass that typically is not tolerated in other surgery recipients.

Acidic fruits and high fiber foods give me some GI distress and I have to limit meat (poultry, chicken, and red meat) to small, moist, and well cooked (and well chewed) portions. Another important point about my diet is that my tastes changed after surgery and continue to resonate between various types of foods. For example, eggs and grits were a big deal for me pre-op but after my surgery both of these foods tasted terrible for the first three years post-op. At four years, I can tolerate these but only in small quantities.
My workout routine varies depending on what I am training for. Since my neighbor is a nationally ranked runner and multi-Ironman finisher, he has taken me under his wing and is my official coach and is programming my workouts very carefully to balance training stress with healing and nutritional needs. Currently I am getting ready for three big events coming up in the next 6 months which include a triathlon, a 10k road race, and a marathon.

My coach uses a training tool by Training Peaks. This week’s training schedule is segmented into three areas: swim, bike and run. Each workout has drills mixed in to improve both my technique and aerobic capacity. Getting to this point has been a long and hard road but doing this keeps me focused on getting better from week to week and while I am not trying to set a record or win any races I do get the ultimate satisfaction of being able to participate and complete athletic events that as of four years ago were not possible.”
Question: What are some common misconceptions people have about weight-loss surgery that you’d like to clear up?

“Weight-loss surgery is not:
• the easy way out.
• not cheating.
• not accessible to all that need it
• a get-it-and-forget-it solution.

Weight-loss surgery:
• requires commitment
• is just one component of success
• changes lives
• improves quality of life

Surgical intervention is used because we as humans have made great strides in medical care over the past 100 years. Medicine saves lives and obesity, a disease, should be treated as any other disease.

Often a person’s life hangs in the balance and whether their obesity is psychological or a result of an underlying medical condition the access to the proper care and compassion is critical, just as critical as it is to those with heart disease, diabetes, or cancer.

I was fortunate because I was able to borrow the $30,000 to have my weight loss surgery. My insurance did not consider my obesity and associated co-morbidities to be “life threatening” enough to cover weight loss surgery. For others, weight loss surgery is not an option because of the lack of or no insurance coverage and no ability to borrow funds for the surgery.”
Question: Do you have any advice for others who are considering weight-loss surgery?

“First and foremost a person who has exhausted all avenues of weight loss, has a very high BMI, and is facing one or more multiple co-morbidities should weigh the surgical option very seriously but very carefully and thoroughly. They should not kid themselves or enter the process with a closed mind. Each component/step leading up to the day of surgery should be followed completely.

Compliance and sticking to the program does not end after surgery — it begins and the changes necessary to be successful must continue for life. Weight loss surgery is a lifelong commitment and the decision to have the surgery should be treated as such.

A patient must do the psychological evaluation honestly and thoroughly. Education provided by the weight loss center, including nutritional counseling, should be embraced and taken seriously. A patient must embed themselves in their weight loss centers program and follow the program to the letter.

While there are many very valuable experienced based resources on the Internet including forums, blogs, and social media outlets, it is critical — CRITICAL — that advice from the resources do not override or take the place of the teachings and ongoing advice of the chosen surgical weight loss center, the surgeon, the primary care physician, the nutritionist, or the psychiatrist.”


To learn more about Jim Blackburn’s triathlon training and weight-loss journey, follow him on Twitter at @JmbAtlanta.


This article was republished from examiner.com


How does obesity surgery do all that?

Khalili Center - Weight Loss Surgery


Scientists and physicians who study the treatment of obesity have been puzzled for some years over bariatric surgery and its benefits.”Stomach stapling” surgery was long seen as a “plumbing adjustment” that prompts weight loss by restricting the stomach’s capacity. But mounting evidence demonstrates that it does much more than that. Bariatric surgery appears to set in motion a host of physiological and psychological changes beyond weight loss, in many cases resolving type 2 diabetes, righting problematic cholesterol readings, and not just curbing, but changing, appetites.

How it does all that, however, has remained a mystery that researchers are just beginning to pry open. In a series of experiments conducted on mice and reported this week in the journal Nature, new research suggests that a newly popular bariatric procedure called vertical sleeve gastrectomy sets in motion a cascade of signaling changes in the gut and elsewhere. Those changes, in turn, reshape the mix of gut bacteria in ways that appear to turn up metabolic function, lipid metabolism and signals that tell the brain it’s time to stop eating.

In vertical sleeve gastrectomy, the surgeon staples off roughly four-fifths of the stomach to create a banana-shaped tube where once a large pouch existed. The procedure accomplishes much of what the more complicated Roux-en-Y gastric bypass operation does, but does so more simply. For that reason — and because gastric banding is increasingly seen as less effective in promoting weight loss — surgeons are performing more sleeve gastrectomies in bariatric practices around the United States.

Researchers have already observed that certain bile acids circulate more copiously in the guts and blood of patients in the wake of bariatric surgery, but could only guess at why. They also have observed that the community of bacteria colonizing the guts of obese patients changes in the wake of bariatric surgery. But they could only guess at how.

A team of researchers from Sweden, Denmark and the University of Cincinnati in Ohio found that one link between these two changes is a genetic “switch,” or transcription factor, called FXR. Increased bile acid unlocks FXR, which improves metabolic function directly. But improved FXR signaling also promotes the growth of gut bacteria that help regulate fat metabolism, and suppresses gut bacteria that is linked to weight gain and metabolic disturbance, the group showed.

In their experiments, mice specially bred to lack the FXR genetic switch (and fed enough to make them obese) initially ate less and lost weight after they got a vertical sleeve gastrectomy. But within a week, their appetites rebounded, they showed a preference for consuming fat, and they quickly regained the weight.

By comparison, when the obese mice with a functioning FXR signaling system got the sleeve gastrectomy, they consistently ate less, showed a marked preference for consuming protein and carbohydrates over fat, lost weight and kept it off.

Finally, researchers conducted a census of the bacteria living in the mice’s gastrointestinal tracts. They found that compared to obese mice who got no sleeve gastrectomy, or got it but had been bred to lack the FXR switch, those who got the surgery and had an intact FXR signaling pathway had smaller populations of Bacteroides in their guts (a change that other studies have linked to fat loss and improved glucose control). Those mice also had more gut bacteria in the Porphyromonidaceae,Roseburia, Lactobacillus and Lactococcus families (all of which have been linked to better metabolic function).

“I really like this study,” said Dr. Jonathan Q. Purnell, an endocrinologist at Oregon Health & Sciences University who was not involved in the study. The authors, he said, have found one key link — there are probably more, Purnell added — between the increased bile acids and the enhanced gut microbiomes seen in bariatric surgery patients. Other studies have found that bariatric surgery effects changes in the appetite hormone ghrelin and activates other transcription factors that turn genes on and off, Purnell said.

The discovery that FXR signaling is key to bariatric surgery’s positive effects does several things, said study co-author Randy K. Seeley, professor of endocrinology at University of Cincinnati’s College of Medicine: it lays to rest any lingering belief that bariatric procedures induce weight loss only by shrinking the stomach’s capacity, Seeley said; it undermines any argument that metabolic improvements seen in bariatric surgery patients are simply a consequence of weight loss; and it bolsters the growing belief that gut bacteria may hold the key to weight control and healthy metabolic function.

The discovery also gives researchers a handle on how the broad benefits of bariatric surgery might be attained without the cost or risk of surgery, said Seeley.

“We need to figure out other ways you can do this,” Seeley said. Only 1% of patients who might benefit from such surgery are currently getting it, and that number is unlikely to ever get above 4%, experts estimate. As a result, Seeley said, scientists need to find ways to mimic bariatric surgery’s molecular effects in the body with a pill, a genetic “switching” device or by manipulating the bacteriological community in patients’ guts.


This article was reprinted from the LATimes.com


Kick-Start Your Metabolism with These 7 Real Tips

Khalili Center - Metabolism

Everyone has times when they feel like they are plateauing in their weight loss surgery journey, so here are some tips to overcome the hurdles!


1. Do you have room for improvement?
When your nutrition habits have room for improvement irrelevant of your weight, you may lose weight!

2. Do you bounce back fast?
Get back on track with your healthy habits at the next meal rather than the next day!

3. Do you treat yourself or trigger yourself?
Everyone needs a treat from time to time but be savvy and never choose a “trigger” food, that is a food that you can’t stop eating and you feel out of control with!

4. Do you need to just do a liquid diet?
No. Solid food is slower to digest and your body and brain feels more satisfied!

5. Do you chew slow?
Chewing your food a lot produces more satisfaction chemicals in your brain that consuming the same amount with less chewing!

6. Are you replacing your water with coffee, tea or soda?
Stop and get the water in; to increase your energy, change your mood, and metabolize fat!

7. Do you coach yourself to success?
Learn to coach yourself with positive self observation; criticism rarely creates successful long term weight control!


Weight-Loss Surgery Can Reverse Diabetes, But Cure Is Elusive

Khalili Center - Diabetes and Weight Loss Surgery on NPR


Bariatric surgery can help obese people lose weight, and excess weight is a big risk factor for Type 2 diabetes. So it makes sense to try to figure out whether the surgery could help control diabetes, too.

So far the answer is yes, at least for some people and for three years. But surgery doesn’t work for everyone, and the long-term implications remain unclear.

More than one-third of the people who had gastric bypass surgery met glycemic control targets three years out, compared with 24 percent who had a different type of bariatric surgery called sleeve gastrectomy. And just 5 percent of people in a group treated with medication alone were able to meet that standard.

It’s one of the first randomized controlled trials to look at bariatric surgery as a treatment for Type 2 diabetes, which affects 23 million adults.

Click here to read the entire article on NPR.org

The information presented in the blog pages of Khalili Center is for educational and informational purposes only and should not considered personal medical advice. Consult with your personal physician/care giver regarding your own personal medical care.