ESA Central Jersey Bariatrics, LLC

CJB Blog

February 22, 2012

Central Jersey Bariatrics featured this weekend on News 12 NJ!

By Seun Sowemimo, MD, FACS

 I was able to sneak out of this office this morning to be a guest on News12’s “To Your Health”  program hosted by Dr. Derrick DeSilva. I was invited to talk about sleeve gastrectomy (gastric sleeve), a minimally invasive surgical weight loss procedure. Karen Fabiny, RN, my colleague at CentraState Medical Center and also my patient, joined me to share her firsthand experience with gastric sleeve (she has dropped more than 130 pounds!).

The team at News 12 could not have been more accommodating and I can say that Karen and I both had a great time. Let us know if you think we are ready for Hollywood!

Our program will air several times this weekend:

Saturday and Sunday
February 25 - 26, 2012
AM:  6:30, 9:00 - PM:  Noon, 1:30, 4:30
 

January 4, 2012

Published Greater Media Newspapers

Outsmart the unhealthy dangers of restaurant dining

By Dr. Ayotunde Adeyeri

It's one thing to eat a heart-healthy diet when you are home. But it can be more challenging when you are at a restaurant. Here are some tips for when you go to a restaurant, which may help you maintain your healthy diet:

• Buffets can be challenging because you can unnoticeably slip into the danger zone of losing track or overeating.
• Select dishes that are designated "heart-healthy," "low-fat" or "light." Today, many restaurants make a point of highlighting these healthy items on the menu.
• Don't be afraid to ask how dishes are prepared and if they can be prepared differently. Many restaurants will honor requests to serve foods the way you prefer. For example, ask to have fish grilled without butter or oil.
• Ask for dressing, sauces and gravy on the side, so you can use them sparingly. And ask your server if low-fat salad dressings are available.
• Avoid deep-fried foods. Instead, select foods that are broiled, baked, grilled, roasted, steamed, poached, lightly sautéed or stir-fried.
• If you order poultry or meat, trim off all the visible fat.
• Eat the same amount of food you would if you were at home. If the restaurant meal includes larger portions, set some of it aside and take it home.
• Choose pasta with a tomato-base rather than cream-based sauces.
• Order entrées with vegetables as key ingredients.
• Do not ask for a refill on the fresh baked breads and butter.
• Order beverages carefully because the calories you save in ordering sensibly will be more than lost with a bad order of a beverage.
• Choose between a high calorie beverage and a dessert. Get water with the meal and share a dessert.
• Plan your day's intake ahead of time when you are going out for dinner.
• Pay attention to what you eat before and after eating out and crank up your activity level.

Board certified and fellowship trained laparoscopic surgeon Ayotunde Adeyeri, M.D., is the medical director of the Institute for Weight Loss at Raritan Bay Medical Center. The Institute provides individualized medical and surgical solutions and support for individuals seeking weight loss, who have been unable to lose weight through conventional dieting, exercise or weight loss medication.

December 15, 2011

Join our CJ Bariatrics online support group at ObesityHelp.com!

Our own Julie Parrott, MA, LD, RD, offers a popular web-based support group for bariatric patients on ObesityHelp.com. It just takes a minute to register and join. Please stop by to share your experiences, ask questions and help others! http://www.obesityhelp.com/group/CJB/.

December 2, 2011

Revisional Bariatric Surgery Can Restart Your Weight Loss Journey

By Ayotunde Adeyeri, M.D.

With so many weight loss success stories and the increasing popularity of bariatric surgery, it begs the question--what happens if you've undergone a procedure and you have not achieved the desired results?

When performed improperly or when the patient is not counseled on post-surgery nutrition, those who have undergone bariatric procedures could experience complications and/or lack of desired significant weight loss. However, hope is not lost-there are several options for those who have undergone a previous bariatric procedure and require revisional bariatric surgery to finally achieve the desired weight loss goal.

Revisional Bariatric Options

• An adjustable gastric band can be removed and converted to a gastric bypass procedure. This can help patients who have complications like severe heartburn or have been unable to lose significant weight since the original surgery was performed. This can be achieved laparoscopically.
• The sleeve is another less-invasive revisional technique. In this procedure, part of the stomach is removed altogether. You will experience reduced hunger and better general health, thanks to a decreased caloric intake and better nutritional choices.
• A previous gastric bypass can be redone if the pouch has stretched out from bad eating habits or if there is a complication such as an ulcer causing pain and/or bleeding. If your bariatric specialist has advanced expertise, this procedure may be performed laparoscopically.

Most importantly, make sure the bariatric surgeon you choose for your revisional procedure has extensive educational and clinical expertise performing these advanced surgical procedures. If you've experienced complications or have not been satisfied with your original bariatric procedure, I would be happy to consult with you about your current and future weight loss goals. I regularly perform many of these procedures both in emergency and non-emergency situations.

November 22, 2011

Weight loss surgery after childbearing can benefit the whole family

By Seun Sowemimo, MD, FACS

Weight gain during pregnancy is normal and healthy. Unfortunately, many find it difficult to lose this weight after the baby is born. For women who were considerably overweight before pregnancy, post-partum weight loss can be even more difficult to achieve. The reasons for this are both biological and environmental. For women with a BMI of 40+, keeping up with a new baby can be exhausting and frustrating.

For obese women who are severely with a BMI of 35 and greater, bariatric surgery can offer a safe and rapid solution to achieve a healthy weight and avoid obesity-related conditions such as diabetes, heart problems, sleep apnea and even elevated cancer risk.

And when Mom maintains a healthy weight, the whole family can benefit--a recent study shows that a family member who undergoes weight loss surgery may have a healthy effect on the whole family and help offset childhood obesity. The obesity rate in children of mothers who have had gastric bypass is 52 percent lower after surgery.

October 5, 2011 - Published by Greater Media News

Gastric sleeve is a less invasive surgical weight loss solution

By Ayotunde Adeyeri, M.D. and Seun Sowemimo, M.D.

Gastric sleeve resection is one of the newest and safest types of bariatric surgery. This surgery is also referred to as sleeve gastrectomy, vertical sleeve gastrectomy, tube gastrectomy or laparoscopic sleeve gastrectomy. The procedure is performed by removing approximately 85% of the stomach, resulting in a tube-like appearance resembling a “sleeve.” The reduced stomach (the remaining 15%) is then stapled closed.

The sleeve may be a recommended alternative to gastric banding for those who can’t make the frequent office visits required by other bariatric procedures. Since the surgically reduced stomach is considerably smaller after the procedure, hunger and food cravings subside allowing for reduced food intake without hunger. Another marked benefit of sleeve resection is that it is performed laparoscopically, requiring only very small incisions. Benefits of gastric sleeve resection are significant??shorter hospitalization, less scarring, and reduced post-operative pain.

The National Institutes of Health recommends a body mass index (BMI) greater than 40 for most bariatric surgeries (about 80-100 pounds overweight). However, those with a slightly lower BMI may also be approved if their obesity is causing common complications such as diabetes, high blood pressure, high cholesterol or sleep apnea. Gastric sleeve resection is also used as precursor to traditional gastric-bypass surgery for patients who may be very overweight or for whom gastric bypass may be too high risk.

Bariatric patient says goodbye to diabetes, high blood pressure, sleep apnea

Before George Peters of Toms River underwent gastric sleeve resection with us, he weighed 425 pounds and needed four insulin shots and 15 pills per day to control a long list of chronic diseases—ranging from sleep apnea to heart disease and type 2 diabetes.

But since his weight loss surgery earlier this year, his overall health has improved dramatically:

• Eliminated all insulin injections
• Eliminated all blood pressure medications
• No longer suffers from sleep apnea
• No longer controlled by the emotional roller coaster that comes with diabetes (due to blood sugar changes)
• George lifts weights and walks five days a week

Should you wish to pursue any kind of bariatric surgery, first, get the facts. Locate a board certified bariatric surgeon and meet with the doctor or attend an Information Seminar. Ask if the bariatric center or surgeon offers one-on-one pre- and post-surgical nutritional counseling with a nutritionist or licensed dietician. Finally, make sure they offer regular support group meetings that include other bariatric patients.

Dr. Adeyeri and Dr. Sowemimo (Dr. Seun) are board certified, fellowship-trained, advanced laparoscopic, bariatric and general surgeons and medical directors of Central Jersey Bariatrics located in Freehold, Holmdel and Old Bridge. They are on staff at CentraState Medical Center, Bayshore Community Hospital and Raritan Bay Medical Center where Dr. Adeyeri serves as medical director of the Institute for Weight Loss. For more information or to attend a weight loss surgery Informational Seminar, visit centraljerseybariatrics.com or call (732) 761 – 1740.

September 23, 2011

Three pieces to the dietary supplement puzzle for bariatric patients

By Julie Parrot, MS, RD, LD, Central Jersey Bariatrics

As a weight loss surgery patient, you know that the numerous forms of dietary supplements, tablets, capsules, chewables and powders, as well as drinks and energy bars can be overwhelming. How do you know which choices are the best for you? Imagine a puzzle with only three pieces. Let's put the three pieces of the puzzle together:

Which supplements do I need?

One of the primary goals of weight loss surgery is to restrict the quantity of food you eat at one time. This affects your ability to eat a variety of nutritious foods within your first six weeks after surgery. Your individual history and prior eating patterns may also leave you susceptible to developing specific nutrient deficiencies. At Central Jersey Bariatrics, we monitor your nutrient levels before and after surgery to prevent nutritional deficiencies from developing or worsening.

According to the most recent research guidelines, all weight loss surgery patients should be taking:

• a multivitamin and mineral supplement
• calcium citrate with vitamin D

Additionally, we recommend that you take vitamin B12 and iron each day if you had the sleeve gastrectomy or the gastric bypass (we discuss supplement and dose at pre-operative and post-operative visits).

After your first six weeks of surgery, you may also be taking specific supplement(s) based on your particular surgery or nutrient deficiency (recommended to you by your primary care practitioner or surgeon's office). These supplements may include protein supplements and specific vitamins such as vitamin B12 or vitamin C; minerals like iron or magnesium; herbs such as garlic; and specialty products like glucosamine chondroiton, probiotics, and omega 3 fatty acids.

What form or type of vitamin should I take?

We recommend that you take a chewable, powder or liquid form of supplement for the first four weeks after surgery. You should be able to tolerate most capsules or tablets after this time. The newer gummy vitamins may taste great, but they do NOT contain all the vitamins and minerals you need as a bariatric patient. In fact, many of the gummy vitamins do not contain the recommended 100% Daily Value for many nutrients, particularly thiamine (vitamin B1), so forego this option. The recommended daily amount (100% DV) for adults is 1.5 mg per day.

Why is thiamine so important?

Thiamine (vitamin B1) is an important nutrient for taking energy from food and turning it into energy for your brain, nerves and heart. It is needed by the body to process carbohydrates, fats, and proteins.

What happens if I don't get enough thiamine?

Your body stores very little thiamine, so deficiency can happen very quickly - especially if you are not eating much or if you are vomiting for any reason. When you don't get enough thiamine, you may have difficulty concentrating, weakness, changes in memory, burning feet and loss of balance among other symptoms.

Where can I get thiamine?

Thiamine is found in fortified cereals, beans/peas, nuts and pork, foods difficult for a weight loss surgery patient to obtain in the first six weeks after surgery. Some beverages, like coffee, black tea and alcohol, can also inhibit thiamine absorption. 

How much do I take?

When it comes to supplements, there is no "one size fits all". What you need depends on your particular situation, and the staff at Central Jersey Bariatrics will help you identify the dosage that's optimal for you.

However, there are a few tips that will help you:

• Read the Supplement Facts. All products labeled as dietary supplements carry a Supplement Facts panel that lists the contents, amount of active ingredients per serving, and other added ingredients (like fillers, binders, and flavorings).
• Pay attention to how a "serving size" is defined. Different products define a serving size differently. For instance, do you need to take six capsules, two chewable tablets or just a single chewable to provide the percent daily value (% DV) listed on the Supplement Facts?
• Who is the supplement intended for? An adult? A child? Pregnant and Lactating woman? An adult who had weight loss surgery?
• Look for a seal of approval. The dietary supplement or dietary ingredient manufacturer is responsible for ensuring that a dietary supplement or ingredient is safe before it is marketed. FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market. The FDA has established standards for dietary supplements (ensuring identify, purity, strength, composition-in short, that you are getting what the manufacturer claims you are getting). Also, several independent organizations (like U.S. Pharmacopeia, ConsumerLab.com, NSF International) offer quality testing and allow products that pass these tests to display their seals of approval.
• Keep track of all your supplements. Because vitamins and minerals are present in many different supplements, it's very important to keep a list of all the supplements you take. The U.S. Office of Dietary Supplements (ODS) has created a handy (and free!) mobile app for consumers called My Dietary Supplements (MyDS). Simply enter the names and amounts of your dietary supplements, and they'll be stored on your iPhone or iPad for your use anytime, anywhere-for example, when seeing your doctor or shopping. MyDS is available from the iTune store. http://itunes.apple.com/us/app/myds/id399053073?mt=8 Download MyDS. MyDS gives you:
• An easy way to keep track of the vitamins, minerals, herbs, and other products you take-right in the palm of your hand.
• Access to science-based, reliable information on dietary supplements.

Use Reliable Sources

Not all information on dietary supplements is accurate or useful. In fact, there is quite a lot of misinformation out there. We recommend to patients a wealth of reliable information available at the following government websites:

• http://ods.od.nih.gov/ The Office of Dietary Supplements provides accurate and up-to-date scientific information about dietary supplements.
• http://nccam.nih.gov/ National Center for Complementary and Alternative Medicine Clearinghouse: 1-888-644-6226
• http://www.ncbi.nlm.nih.gov/pubmed/ National Library of Medicine, PubMed
• http://health.nih.gov/ NATIONAL INSTITUTES OF HEALTH. The National Institutes of Health supports research on dietary supplements.
• http://www.fda.gov/Food/DietarySupplements/default.htm U.S. FOOD AND DRUG ADMINISTRATION issues rules and regulations and provides oversight of dietary supplement labeling, marketing, and safety.

About the Author

Julie Parrot, MS, RD, LD, is the lead dietician/nutritional counselor at Central Jersey Bariatrics. She has worked in the field of nutrition for more than 20 years including working as a clinical research study coordinator and clinical monitor for the Lap Band FDA trials for the BioEnterics/Inamed LAGB Device. Julie served as the founding Bariatric Surgery Sub-units Coordinator for the American Dietetic Association and Weight Management Dietetic Practice Group Sub-unit Director.

She is an active member of the ASMBS Integrated Health (IH) Executive Council and IH Clinical Issues and Guidelines committee. She co-authored the ASMBS Nutrition Guidelines for the Surgical Weight Loss Patient and continues to serve as an Allied Health Editor for the journal, Surgery for Obesity and Related Disorders (SOARD). 

To learn more about weight loss surgery and the nutritional support programs at Central Jersey Bariatrics, we invite you to attend our next Informational Seminar, located at a hospital near you, or call (732) 761-1740 for more information.

September 16, 2011

DR. OZ SUPPORTS BARIATRIC SURGERY IN THIS MONTH'S ISSUE OF PREVENTION MAGAZINE

In the September issue of Prevention Magazine, Dr. Oz supports gastric bypass as a means to battle obesity:

"I really do think we can get ahead of obesity. It's easier to cure than cancer and drives most of the heart disease and a good amount of the autoimmune issues we have. I also think gastric bypass surgery will play a big role. We probably do only 1% of the gastric bypass surgeries we should do."

Published August 31, 2011 in NJToday.com.

Maintain Your Ideal Weight, Enjoy Healthy Foods for Good Health

By Dr. Ayotunde Adeyeri
Partner, Central Jersey Bariatrics
Director, The Institute for Weight Loss, Raritan Bay Medical Center

Maintaining your ideal weight and enjoying a balanced, healthy diet is an important part of your well-being and can significantly reduce the risk for chronic diseases, including: diabetes, heart disease, stroke and certain cancers. Know your body mass index, or BMI, and waist measurement compared to your height, so you can track how you are doing. Regular exercise is a must; be sure to get 30 minutes of aerobic exercise most days of the week plus some form of resistance training or weight lifting and stretching.

Proper nutrition is also very important. Enjoy a balanced diet with plenty of whole grains, vegetables and fruits, low-fat dairy products, proteins low in saturated fat and switch to water instead of sugary drinks.

The following guidelines can help you select nutritious foods for you and your family:

Limit your saturated fats and avoid trans fats: butter, some margarines; vegetable shortening; foods containing “hydrogenated or partially hydrogenated vegetable oil,” such as cookies, crackers, pastries, microwave popcorn, and some frozen meals; deep-fried foods, such as doughnuts, french fries, and fast foods; cheese; butter; fatty meats, such as hamburger, steak, and prime rib; cold cuts; poultry skin; whole milk and whole-milk products, such as ice cream and cream; and tropical oils, such as palm kernel or coconut.

Increase your intake of good fats (monounsaturated and polyunsaturated): olive oil; canola oil; peanut oil; flax seeds and flaxseed oil; wheat germ; nuts, including almonds, cashews, filberts, macadamias, pecans, pistachios, walnuts, and peanuts; avocados; peanut butter (look for all-natural brands) and other nut butters, such as almond butter and cashew butter; corn, soy bean, safflower, and sunflower oils; sunflower seeds; fish, including herring, bluefish, salmon, pollack, flounder, lake trout, tuna, and sardines; fish-oil pills with EPA and DHA (500 to 1,000 milligrams per day).>

Dr. Ayotunde Adeyeri is a board certified, fellowship-trained, advanced laparoscopic surgeon, partner at Central Jersey Bariatrics, Freehold; medical director of the Institute for Weight Loss at Raritan Bay Medical Center; and medical director at Sterling Surgicare, located in Holmdel and Old Bridge. For more information or to make an appointment with Dr. Adeyeri, call (732) 761 – 1740.

December, 2010

IC BANDING – One of the least invasive FDA-approved bariatric procedures

By Seun Sowemimo, M.D.
Partner, Central Jersey Bariatrics
Medical Director, Prime Surgicare

Laparoscopic gastric banding is the safest and least invasive weight loss surgery. Not surprisingly, it is the second most common weight loss surgery after more complex gastric bypass surgery. The adjustable gastric band provides a safe and effective way to achieve substantial weight loss—without cutting or stapling your stomach. The band limits the amount of food you can eat at one time. As a result, you feel full sooner and stay satisfied longer. That makes it easier to stick with healthy eating and lifestyle habits.

How will it help me lose weight?

During the minimally invasive gastric band procedure, a band is placed around the upper part of the stomach, dividing it into two parts?a small upper pouch and a lower stomach.

The upper pouch can hold only about 4 ounces (1/2 cup) of food. As a result, you eat less food at one time, feel full sooner and satisfied longer. Unlike gastric bypass surgery, your stomach is not stapled or removed during surgery, and your intestines are not rerouted. As a result, you will continue to absorb valuable nutrients from the food you consume.

This band can be adjusted over time, as necessary. After an adjustment, you’ll be satisfied with less food, so you can keep losing weight. The degree of band tightness affects how much food you can eat during a meal and the length of time it takes for food to empty from the upper pouch. When the band is adjusted to the proper tightness, you’ll feel full sooner and stay fuller longer. Best of all, quick and easy band adjustments can be safely performed right in our office. In most cases, you can return to your normal activities the same day.

How can I learn more?
Please call Dr. Sowemimo at (732) 761-1740 to schedule an appointment.