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Dana Goossens, 29, lives in Illinois and participated in a recent clinical trial for a weight loss device called the Obalon Balloon System. Here's her story:

Like many Americans, Ive tried all sorts of ways to lose weight . Thats been disheartening, especially since Ive always been an active person. I tried everything from diet pills to eating only 500 calories a day and getting hormone injections to Weight Watchersbut I was never successful at keeping off the weight over the long term. I was tired of yo-yo diets and medications that made me feel bad.

My mother, who is a registered nurse, would remind me not to be vain, but she knew how much my weight was bringing me down. She forwarded me an article about a new device called the Obalon Balloon System , which consists of inflatable balloons that expand in your stomach to help you lose weight. It sounded strange, but I was curious.

I sent emails to the doctors involved in the clinical trial and I was able to secure one of the last spots. I was nervous about explaining my decision to my friends and family. My boyfriend told me if it would make me happy to give it a try, then I should do it.

The procedure was surprisingly simple. During the first session, I swallowed a small capsule that was tied to a tiny micro-catheter. The doctor then inflated the balloon once it was in my stomachit gets to be about the size of an orangeand removed the catheter. The whole process took about 10 minutes. In the beginning, I could tell there was an object inside of me. At night it was a bit more uncomfortable as I could feel the balloon move a bit and squeak, but nothing I couldnt handle. Eventually, my body got used to the feeling and I didnt think about it during the day.

After one month, I went back to the doctor and swallowed the second balloon capsule, and two months after that, I swallowed the third and final balloon. Pretty soon after swallowing the second balloon, I started noticing the real weight loss. I was also seeing a nutritionist regularly, and I started doing cardio fitness about four times a week for 45 minutes. I learned how to listen to my body and understand when I'm hungry or full.

By the end of the six months, I lost close to 40 pounds and weighed 138 pounds. My friends and family were really impressed. What I liked about the balloon procedure was that I didnt have to undergo surgery, and I could keep the procedure discreet.

I also developed lifestyle changes that helped me lose the weight at a steady pace, and I am hopeful this weight loss is more sustainable. By the time the trial ended, I felt confident I could maintain my healthy lifestyle even after getting the balloons removed. And I've even lost more weight since then.

The balloons have now been approved by the FDA, costs $6,000 to $9,000, and isn't covered by insurance.

Link:
'I Swallowed a Balloon For Weight Loss and Lost 40 Lbs.' - TIME

I was glad to see Valter Longos Fasting-Mimicking diet in the news again this week. I have been enthusiastic about Longos work ever since he documented altruistic suicide of yeast cells for his PhD thesis in the 1990s. Programmed death in one-celled protists was considered an affront to evolutionary theory at the time, and he had a devil of a time getting his findingsinto print.

Longo discovered in 2002-2005 that fasting had a powerful benefit for cancer patients, and that in conjunction with either radiation or chemo, it greatly magnified the benefits while mitigating the side effects. Intermittent fasting had benefits, too, for the general population, independent of cancer. It seems to be a way to get the health benefits of caloric restriction and it is easier to stick to for many people than a consistently low calorie diet.

But Longo couldnt get either doctors or patients interested in the fasting program. Part of the problem was the toxic mix of capitalism with medicine: the US relies on testing and promotion by profit-making companies to push medical technology forward, and fasting isnt a product that anyone can make money on. There was also an emotional truth: cancer patients feel scared, beleaguered, emotionally drained. So much is dragging them way outside their comfort zone that it takes extraordinary strength not to fall back on food as one of lifes most reliable comforts.

So many medical researchers see their job as finding treatments, and leave the problem of adoption and compliance to someone else. But Longo set himself single-mindedly to the task of bringing the benefits of fasting to a wider swath of the population. The question that led to the Fasting-Mimicking Diet (FMD): What dietary regimen can provide the greater part of the benefits of a water fast while inducing less hunger and minimal disruption to concentration, vitality and the pace of life?

I have done about 9 cycles of the FMD over the past 1 years, including this week. In my personal experience, 5 days of the FMD is eminently tolerable once I begin, though I still face resistance when I think in advance about disrupting my comforting food routines. (Yoga, swimming and meditation have the same barriers for medifficult in the anticipation, enjoyable once I begin.) For me, FMD is not a weight loss program. I gain back all the weight Ive lost within a week after the 5-day program is finished. Others may have different experiences. People have used the 3-meal version of FMD (3 meals at 360 calories) as a medium-term weight-loss program, but the protein content is probably too low for those concerned about maintaining lean mass long term.

In his new study, 100 participants were randomized into two groups. The first group did three rounds of 5 days on FMD over three months. The second group did nothing special for three months, but were given an opportunity to try the same three rounds during the following three months. The average weight loss was 6 pounds for those who completed all three cycles; lean body mass was lost, in the same proportion as fat. Blood pressure, blood sugar, triglycerides all improved on average, and C-reactive protein (an inflammatory marker) went down as well.

The study included a range of healthy people as well as people who carried more weight and had higher risk factors. It was those with the higher inflammation and blood sugar who realized big benefits from the program, and the already-healthy were averaged in. There is a lot of evidence to indicate that intermittent fasting works, and that the FMD delivers similar benefits. But if youre already lean and healthy with low blood sugar, then its less clear whether there are substantial additional benefits from intermittent fasting.

Notable was a reduction in the hormone IGF-1, which I dont necessarily regard as a good thing. On the one hand, lower IGF-1 is characteristic of all caloric restriction models, in animals and humans, in which life span is increased. So it is an indication that the FMD was effective. But low IGF-1 has consistently been found to increase risk for all-cause mortality, and heart disease in particular [ref, ref, ref]. Benefits of higher IGF-1 include maintenance of muscle mass and growth of nerves that diminishes with age.

An additional benefit documented in the past is areset of the immune system. The white cell population is pruned during fasting, and the most-needed naive T-cells regrow after eating resumes.

Antidote to Obesity

Its the (large and increasing) population of unhealthy people that Longo is targeting. There is every reason to expect substantial benefits, but the big issue remainss: how many people can be motivated to take up the practice and stick to it? The question was touched on only peripherally in the current study, without discussion; of 48 subjects selected for the first round, 39 stuck it out for three FMD cycles over three months (81% compliance). Thats encouraging, but what we really want to know is: how many people will actually modify their eating rhythms for years at a time? Will they feel the benefits and will that motivate them to stick with it month after month, five days each month?

And will this translate into long-term weight loss? Sustaining weight loss is notoriously difficult for about 95% of the population. People can stick to a diet for a time, but the Siren song of food is with us everywhere, and sooner or later we succumb. Fortunately, theres good reason to hope that the FMD discipline offers benefits even if weight loss is not sustained.

How to do it

Longos own company, L-Nutra offers a packaged diet, called ProLon, availble through health care professionals. Its pricey and may be covered by insurance. LifeBox offers a non-prescription alternative that is not as much cheaper as it might be. For my own experimentation, I have preferred to use fresh, whole foods approximating the same macronutrient proportions as the ProLon package. It requires some time and attention in food prep, but it costs less than youre currently spending on the same meals, and you can fill yourself with satisfying portions of fresh vegetables for the same 360 calories. Here is my page of instructions and advice, with recipes designed by Enid Kassner.

For many of us, our relationship to food is central to our psychology. Shaking up food habits disrupts everything else as well. Its the main reason that food habits are so hard to change, but for me, its also a good thing. I enjoy the challenge and the self-awareness that come from a new frame of reference;fasting changes my perspective, my emotional baseline, and my mental state. For me, the first day is unfocused, low energy, but often a time of creative new ideas; the second day is distracted, obsessive, sometimes headache-y or otherwise uncomfortable, and beginning with the third day there is returning energy, along with a freedom that I didnt know I missed.

Why is life expectancy in America lagging?

Part of the answer is certainly cultural. Advertising, parties, lunch and dinner meetings often reinforce consumption of food that is designed to beaddictivefor the sake of corporate profits. In America, we are surrounded by overweight people, but France and Italy have much lower obesity rates, and you can walk all day around the cities of Japan or China without encountering anyone who is seriously overweight. Even in America, the problem has grown way out of proportion only in the last 40 years. This and income disparity are the main reasons that life expectancy in America is at the bottom of the developed world. Our unaffordable, dysfunctional healthcare system provides many additional reasons. Meanwhile, life expectancy in Asia is climbing at an exemplary pace.

Longos FMD is designed to address thismostaccessible factor in the diseases of late life for a large swath of people who find they cannot lose weight. His research is based not just on effectiveness but equally important on tolerability. How many people will adopt it and reap the benefits? This will be an important question for public health going forward. But you are a unique individual, not astatistical median. I encourage you to experiment with FMD, seewhat you learn about yourself, and decide if it can be a valuable part of your health program in the long term.

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More:
Fasting-Mimicking Diet: Can You Make it a Habit? - ScienceBlog.com (blog)

Men's Fitness

Full-scale 'intervention' makes long-term weight loss even more successful Men's Fitness The real test comes when you've reached your goal weightor get close enoughand you start backsliding, stopping for fast food again, or slacking off at the gym. In fact, only one out of six overweight dieters achieves long-term weight loss, a ...

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Full-scale 'intervention' makes long-term weight loss even more successful - Men's Fitness

From waist trainers to "flat tummy tea," theKardashianshave used several questionable methods to slim down. Here's another one to add to the list:Kim Kardashian Westworkingout in a plastic trash bag-like suit to sweat away the rest of her baby weight.

The reality star worethe strange getup during a workoutwith trainer Donamatrixon Tuesday morning. "Im wearing a full sweat suit cause I gotta lose this extra, like, 7 pounds," she told her Snapchatfollowers. Kardashian West gave birth to her son, Saint, 16 months ago, and said in October that she'd dropped almost 70 pounds. She now says on Snapchat that losing 7 pounds will bring her down to her 115-pound goal.

Kardashian West isn't the only member of her family who's been spotted wearing a so-called "sauna suit."Khloe Kardashian has worn one as well. "I like wearing the sauna suit during cardio, but you burn more calories and break a sweat faster even if you're lifting weights," she said on her app.

To see if there's merit behind this Kardashian-approved weight loss trick, we reached out to Tom Holland, an exercise physiologist and author of Beat the Gym. The answer: a hard no.

"This is so old school and so horrible," HollandtellsHealth. Thismethod provides no long-term weight loss results, he says, and will only help Kardashian Westdropwater weight.

The sauna suit trick was widely used in the 1950s, says Holland, when boxers and wrestlers needed to weigh in for their sport and had to ensure they made a certain weight class. After weighing in and re-hydrating, these athletes would immediately gain the lost weight back, in a matter of a few hours.

"If all you care about is the number on the scale, then sure, this method will temporarily change that," Holland says."But you're also putting on a suit that doesn't breathe so it's potentially dangerous and the worst case scenario is death." Wearing a sauna suit mimics the effects of heat stroke because it depletes your hydration and electrolyte levels and raises your core temperature and heart rate to scary new levels. Organ failure is possible as wellifyou use the suit for too long.

Hollandsays that women who want to slim down should steer clearsweat suits and other fast fixes. Instead, highintensity interval training (HIIT) is the most effective way to drop pounds quickly. "With HIIT, you're going to burn abdominal fat, which is the last few pounds of a weight loss goal for many people," he says. "Plus, youcan potentially continue to burn calories after the workout with HIIT."

It's important to remember that thenumber on the scale is an arbitrary measurement. Losing 7 pounds may be important to KardashianWest, but she looksjust as great in her body-hugging dresses at her current weight. Holland says it best: "Body composition is more important than the number on the scale. Your body will find the way it's supposed to look. You may need to weigh a little more, but youll be strong and healthy."

Read more:
Kim Kardashian West Loves This Plastic Weight Loss Suit, But Does It Really Work? - Health.com

On any given day, just over 1 in 5 American adults are actively trying to lose weight. An additional 50% have tried dieting for some length of time, but have retreatedto old routines while mounting the will to try again.

Results will be mixed, ensuring the nations sprawling diet industry a steady flow of revenue. According to Marketdata Enterprises, which tracks the weight-loss industry, we spend more than $60 billion a year on diet foods, books, coaching, meetings, mobile apps and meal plans to help with weight loss.

Thoughdieters may be deadly serious in their objectives,roughly 4 in 5 shun expert guidance infavor of a do-it-yourself approach, according to Marketdata. These homemade strategies are based ondiet plans touted by celebrities or trumpeted in bookstores, online or on TV.

Fads come and go. Confusion reigns. And failure is common.

Physicians generally arentmuch help. Under the Affordable Care Act, whose future is uncertain, primary care doctors are expected to advise all obese patients to lose weight and counsel them on how to do so. Research tells us a doctors recommendation can be a powerful spur to weight loss. But few are equipped to lead patients to the specific plan that will work best for them.

It doesnt help that the science of what works is filled with gaps and contradictions, or that the diet plan that works for one person may not work well for another.

Its simple to say that to lose weight, calories out must exceed calories in and that to reverse obesity, just continue the process. But experts say that losing weight, and maintaining that loss, is vastly more complex.

Its a matter of evolution adaptations tofamine and drought have helped design the human body to abhor the loss of weight. As researchers demonstrated in a study of people who lost about 14% of their starting weight with a very-low-calorie diet, the body undergoes a host of changes to ensure that the weight is regained.

Metabolic rate drops, allowing the post-diet body to do more with fewer calories. Myriad hormonal signals shift in ways that boost appetite. Those changes endure for at least a year after weight is lost, the researchers found. Even after weight comes back, many of those changes persist, ensuring further weight gain.

These findings, which have been replicated by other studies, helpexplain why95% of dieters will regain all the weight they lost within five years, and most will gain a few extra pounds as well.

Resultslike that have fueleda growing expert consensus that dieting temporary adherence to a regimen of eating that causes weight loss is a fools errand. When weight must be lost, experts say, it should be with strategies and eating patterns that can be maintained over the long haul.

Those strategies should be flexible enough to withstand the plateaus of weight loss. They should be sustainable enough to support long-term health and nutrition while helping prevent Type 2 diabetes and other diseases linked to obesity. And they should be tolerable enough to stick with through a weight loss maintenance period that may last a lifetime.

In short, diets must become a way of life, not a painful interlude,says Dr. Louis J. Aronne , a weight-loss specialist at Weill Cornell Medical College in New York City who has developed an online program called BMIQ to guide physicians and obese patients on their choices.

The diet that people find easiest to comply with is the one that works best for them, Aronne says.

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Trying to lose weight? The key is to diet for the long term - Los Angeles Times

To find out, English researchers compared stress levels and body weight of more than 2,500 men and women over age 54 who participated in the English Longitudinal Study of Ageing.

"We found levels of cortisol in the hair to be positively and significantly correlated to larger waist circumference and higher body mass index or BMI," said lead author Sarah Jackson, a research associate at the Institute of Epidemiology and Health at University College London."These results provide consistent evidence that chronic stress is associated with higher levels of obesity."

Cortisol is a hormone produced in the adrenal glands that is released into the bloodstream in times of stress. In addition to suppressing inflammation and regulating blood pressure, cortisol helps maintain steady supplies of blood sugar and gives an energy boost to handle emergencies.

"It's providing glucose to the brain, keeping things going during a stressful event," Jackson said. "It also plays a huge role in metabolism, body composition and the accumulation of body fat."

The release of cortisol, she says, is triggered by receptors that are densely located in visceral fat tissue, the type that surrounds our organs, which may explain its association with weight gain and loss.

Cortisol is usually tested via blood, urine or saliva, but that captures only a snapshot in time.

"Cortisol levels fluctuate throughout the day depending on time of day, what you eat, sudden stressful situations, even illness," Jackson said. "That why blood, urine and saliva tests are not good measures for long-term stress."

The results suggest that "chronic high-level cortisol exposure may play a role in the maintenance of obesity," but Jackson adds that because the study was not longitudinal, researchers could not establish a true cause and effect.

Susan Fried, a professor and director of translational adipose biology and obesity at the Diabetes Metabolism Obesity Institute, said the results are consistent with research associating high cortisol levels and obesity. However, she agreed that there is no evidence of causation.

"As indicated in the paper, measurements of hair cortisol reflect exposure over the past several months," Fried, who was not involved in the study, wrote in an email. "But the obesity in the people studied likely developed many years earlier. Thus, these high hair cortisol values may simply reflect social or biological stress associated with being obese.

"It is possible, for example, that the social stigma that people with obesity often endure may cause mental stress and hence high cortisol levels.

It is also possible that stress over the past few months may also be due to medical conditions caused by obesity, for example it may be difficult and painful for people with obesity to walk."

The researchers will "continue to weigh and measure our study participants every four years to determine the ways stress affects body mass over time," Jackson said.

In the meantime, she suggests that people under chronic stress look to ways other than eating to ease their tensions, such as meditation, yoga and mindfulness.

"There's a lot of evidence that cortisol influences appetite and even our preference for high-calorie comfort foods," Jackson said. "So I know that's tough. But it's best to look for better ways to manage stress and avoid using food as a crutch."

Read more:
Long-term stress might make you fat, study says - CNN

CHARLESTON, WV--(Marketwired - February 24, 2017) - The Sirtfood Diet focuses on consuming foods which may interact with a type of protein called, Sirtuins. The primary foods that contain this protein include chocolate, red wine, kale, blueberries, citrus, prawns, and salmon as well as green juices. The diet itself is limited to 1000 calories for each of the first three days, then the diet increases to 1500 calories per day. Dr. Nishant Rao -- Medical Director of Diet Doc's national medical weight loss program advises dieters who are looking to lose weight on the Sirtfood Diet that, "Most of the initial weight loss during the first three days is going to be glycogen weight (stored carbohydrates + water), not actual fat loss." Dr. Rao continues, "Also, there is very little research on the actual impact that these foods have on weight loss when you take their calorie counts out of the equation."

Dr. Rao also takes issue with the way that the Sirtfood Diet's research has been conducted, "The research that was put forth by the author of the book used paid participants and were also under the guidance of a personal trainer and nutritional expert." This again blurs the lines between weight loss that would occur regardless, and any additional benefits of the sirtfoods. Ironically, sirtuins themselves are also produced via caloric restriction and exercise! While experts may disagree on whether sirtfoods actually cause weight loss, the fact that the creators of the diet enlisted personal trainers and nutritional experts does point to the fact that a combination of doctor supervision, diet planning and nutritional guidance and support plays a significant role in helping individuals reach their ideal weight. Diet Doc Medical Weight Loss offers unlimited guidance from certified doctors and nutritionists to clients nationwide and customizes the nutritional criteria for each of their clients based on their unique health history, body composition and current weight loss struggles.

New Diet Doc patients can call or easily and effortlessly visit https://www.dietdoc.com to complete an initial comprehensive, yet simple, health questionnaire and schedule an immediate personal, no-cost consultation. Diet Doc Physicians all received specialized training in nutritional science and fast weight loss. Diet Doc reviews each patient's health history to create a personalized diet plan geared for fast weight loss, or that addresses life-long issues causing weight loss to slow down or stop. Nutritionists work personally with each patient and use their own algorithm to craft meal and snack plans that are compatible with each patient's age, gender, activity level, food preferences, nutritional needs and medical conditions. They combine these state of the art diet plans with pure, prescription diet products that enable their patients to resist the temptation to reach for sugary snacks, eliminate fatigue and curb the appetite. Over 97% of Diet Doc patients report incredible weight loss results with the majority losing 20 or more pounds per month.

At Diet Doc, all patients gain unlimited access to the best minds in the business. Their staff of doctors, nurses, nutritionists and coaches are available 6 days per week to answer questions, offer suggestions, address concerns and lend their professional guidance and support. Because of this, more and more people are turning to Diet Doc for their weight management needs. Diet plans are tailored to be specific to the needs of those of any age, gender, shape or size and for those who are struggling to lose that final 10-20 pounds to those who must lose 100 pounds or more. Call today to request a private, confidential, no-cost online consultation.

About the Company:

Diet Doc Weight Loss is the nation's leader in medical, weight loss offering a full line of prescription medication, doctor, nurse and nutritional coaching support. For over a decade, Diet Doc has produced a sophisticated, doctor designed weight loss program that addresses each individual specific health need to promote fast, safe and long term weight loss.

Twitter: https://twitter.com/DietDocMedical

Facebook: https://www.facebook.com/DietDocMedicalWeightLoss/

Linkedin: https://www.linkedin.com/company/diet-doc-weight-loss?trk=biz-brand-tree-co-logo

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Dr. Nishant Rao of Diet Doc Finds Unexpected Similarities Between the Sirtfood Diet and Doctor-Supervised Weight Loss - Marketwired (press release)

CNN

Maintenance Interventions Key in Long-Term Weight Loss Endocrinology Advisor Post-diet coaching sessions have been found to improve the maintenance of long-term weight loss in dieters. HealthDay News Successful weight maintenance may be more likely with a series of post-diet coaching sessions conducted mostly by phone, ... Long-Term Weight Loss Improved by Maintenance InterventionThe Cardiology Advisor (registration) 4 Ways to Maintain Weight LossConsumerReports.org New study suggests strategies for keeping off poundsCNN Science Daily -CBS News -HealthCanal.com (press release) (blog) all 23 news articles »

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Maintenance Interventions Key in Long-Term Weight Loss - Endocrinology Advisor

By John Mecenas, MD, Special to the Journal 6:49 p.m. ET Feb. 22, 2017

Dr. John Mecenas is a board certified general surgeon with advanced training in minimally invasive surgery and bariatric surgery.(Photo: Provided photo)

For adults and adolescents diagnosed with clinically severe obesity, bariatric surgery offers an effective, safe solution for weight loss that also reduces risks for developing diabetes and other illnesses.

Years of research has shown obesity is a complex disease and bariatric surgery, while highly effective, is just one component of a successful treatment plan. The Cayuga Center for Metabolic and Bariatric Surgery at Cayuga Wellness Center has developed a program that links patients to specialists who manage health issues related to obesity as well as diet, nutrition, exercise and lifestyle modification for effective, long-term weight loss. Obesity treatment is undergoing a shift on when surgery is recommended. Earlier surgical care, when combined with other treatments, prevents many patients from developing other obesity-related illnesses.

Who should consider bariatric (weight-loss) surgery?

Bariatric surgery is considered for people with a body mass index (BMI) of greater than 40. However, you should also consider surgery if your BMI is equal to or greater than 35 and you have other obesity-related illnesses such as diabetes, high blood pressure, elevated cholesterol, heart disease, sleep apnea, debilitating joint problems and some types of cancers.

Why is weight-loss surgery, rather than dieting, recommended for people with clinically severe obesity?

Many studies show patients with extreme obesity are more successful in weight reduction with surgical treatment than with dieting or exercise alone. Numerous medical groups from the American Diabetes Association and the American Heart Association to federal health agencies including the National Institutes of Health and the Centers for Medicare & Medicaid Services recommend bariatric surgery for effective weight loss in cases of severe obesity.

What types of bariatric surgery are available at Cayuga Medical Center?

Three types of minimally invasive, laparoscopic surgeries are used at Cayuga Medical Center.

Sleeve gastrectomy is among the most common bariatric surgeries used locally and nationally. During a sleeve procedure, the surgeon removes a section of the stomach. That creates a stomach shaped like a sleeve, which reduces stomach volume and induces weight loss.

Gastric bypass surgery, also called Roux-en-Y gastric bypass, is still considered the standard bariatric procedure by many surgeons. The surgery includes two parts. First, the surgeon staples your stomach, creating a small pouch in the upper section. That procedure makes the stomach smaller, so you eat less to feel full. Next, the intestine is re-routed to bypass the majority of the stomach and part of the small intestine. The bypass reduces the absorption of food.

Both gastric bypass surgery and sleeve gastrectomy produce other physiologic and metabolic changes in the body that can increase weight loss and control obesity associated illnesses.

A third procedure called adjustable gastric banding is less frequently used than the other two bariatric surgeries. In gastric banding, a ring with an inner inflatable band is placed around the top of your stomach to create a small pouch. This makes you feel full after eating a small amount of food. After surgery, the surgeon can adjust the size of the opening from the pouch to the rest of your stomach.

How long do the surgeries take, how many days would I be hospitalized and is the surgery covered by insurance?

Depending on the type of surgery, the procedure takes one to two hours and the hospital stay may be one to two nights, but sometimes not require an over-night stay. The three surgeries offered are covered by Medicare and most private insurance plans.

How does a patient prepare for bariatric surgery?

Discussing your concerns with your primary care provider is always a good first step. Your primary physician can help by referring you to a surgeon. The surgeon will advise you on tests needed prior to surgery and precautions to make in the days preceding the operation. In addition, starting and following a weight loss and exercise program for several months prior to surgery may increase weight loss and improve patient outcomes.

What should a patient look for in a bariatric surgery program?

First, find an experienced, board certified surgeon who has specialized training in laparoscopic bariatric surgery. Patients should look for a program that links various aspects of their care. A team approach is the best way to treat obesity because the causes and consequences of the disease are so varied. Patients should look for a program that links various aspects of their care. The program at the Cayuga Center for Metabolic and Bariatric Surgery works to include a patients primary care physician, board certified laparoscopic surgeons and a certified bariatrician, who is a medical doctor specializing in obesity treatment. The program also involves nurses, health educators, dieticians and exercise physiologists. Developing that continuum of care is the goal of the Cayuga Center for Metabolic and Bariatric Surgery and the Cayuga Center for Healthy Living.

Following surgery many patients benefit from joining a weight-loss surgery support group. Regular meetings for bariatric surgery patients are held at Cayuga Medical Center.

Dr. Mecenas is a board certified general surgeon with advanced training in minimally invasive surgery and bariatric surgery. He began the Weight-loss Surgery Program at Cayuga Medical Center in 2002 and is now the director of the Cayuga Center for Metabolic and Bariatric Surgery. For additional information on bariatric surgery, go to cayugamed.org or call the bariatric services line at (607) 252-3555.

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Health Watch: Weight loss surgery reduces major health risks - Ithaca Journal

For 10 years, Ive been the force behind MyBodyTutor.com, which simplifies the weight-loss process into practical, sustainable behaviors that help you lose weight and actually keep it off. It hasnt always been easy, but I believed enough in my program to quit my comfortable job for it. Ive since made a career out of working with clients who have "tried everything" but just havent managed to keep the weight off. One client had attempted 16 different programs before finding success with me.

The truth is, you can lose weight with almost any program, but sustaining that weight loss is a different story altogether. My program has been a success because clients can fly the nest after acquiring the necessary skillsI dont want anyone to come back as repeat business. Here the top weight-loss strategies that make my clients so successful.

Tension relief is one of the top reasons we overeat and make poor food choices. When something causes us to feel tense, we seek to alleviate that feeling often with overly indulgent food and drinks. As we get older, we make less time for fun, which leads to burnout.

What defines fun for you? Consider signing up for art classes, salsa lessons, volunteering, board games, meditation, yoga, even cooking healthier spins on your favorite foods. Focusing on fun might sound trite, but there's a good reason my most successful clients create time for it: The more fun we have, the less we'll rely on food and drink to create it for us.

...what youre craving is avoidance. When we indulge, were after the experience of eatingthe escape and distraction. So when you want to eat an entire pint of ice cream, what youre really after is that sense of reward. But food wont give you what you're truly looking for, so when youre craving something that will hamper your goals, ask yourself: "If I could use a magic button to change something in my life right now, what would I use it for?" This will help you identify whats really bothering you. For example, if youre unhappy with your career, or youre seeking a better relationship with your partner, identifying these issues will help you map out a plan of action instead of covering up a desire with temporary relief in the form of dessert.

You know how some people can work their butts off in the gymeven with a trainerand they dont end up looking any different? You can't out-exercise a poor diet; what you do between exercise matters most. While exercise is the key to energy and a better mood, diet is the key to weight loss.

We often have to battle between our short-term, irrational mind and our long-term, rational mind. When were hungry, stressed, or tired, its harder to make good choices. Besides, when was the last time you were "in the mood" for grilled chicken and vegetables when you felt ravenous? Sure, you might not always follow through with your healthy-eating plans, but the chances youll do so increase dramatically when you actually have a plan in the first place. You dont get any bonus points for using heroic willpower rather than simple planning, so why not make it easier on yourself? My most successful clients always have healthy food ready to go in the fridgethis just makes good choices easier.

This might sound like common sense, but its not common practice. You cant expect to stick with a planthat wont work in the long run, but people keep attempting absurd fad diets. Forget about them! You can only follow a cookie, shake, grapefruit, cabbage, no-carb, and no-fun diet for so longand my most successful clients avoid these diets. Before you start any weight-loss program, ask yourself, "Can I see myself eating like this in five years from now?" If the answer is no, then the diet youre thinking about starting isnt going to work. Give yourself a chance to succeed from the start.

One of the top reasons people are overweight is because they eat when they're emotionally hungry, not physically hungry. Physical hunger comes on gradually and can be satisfied with any food. It passes what I call the "Broccoli Test."

Emotional hunger comes on suddenly. It feels urgentand is marked by specific food cravings. You can have snack after snack, and nothing hits the spot. This is because you're not hungry for foodyou're hungry for something else. So when youre about to eat, pause and ask yourself, "Am I hungry or am I eating to change the way I feel?" This will allow you to catch yourself if you're about to eat for emotional reasons, not out of true hunger.

Ill never forget when a client told me that before starting one of her many failed diet attempts, she was told to sign a contract stating shed never indulge in any of her favorite desserts again. If only it were that easythats like saying "Dont be sad" to someone whos depressed. Its ridiculous. Never indulging again isnt sustainable... or even desirable.

You should eat treats when theyre special to you. My rule is that your special indulgence should pass the "Will I remember this in two weeks?" test. Most of the indulgences we eat arent remarkabletheyre bags of chips or boxes of stale-tasting cookies from a convenience store. The idea is to make the most of routine meals and indulge when its truly worth your while. Wait for a memorable treat like a high-quality pastry from your favorite shop.

The real secret to sustainable weight loss is that there is no secret. It's about eating well, exercising and doing these consistently. Understanding what gets in the way of consistencyand how to be more steady in your effortsis the only way to stick with a plan and get the results you really want.

Adam Gilbert is the founder of MyBodyTutor.com, an online program that solves the lack of consistency faced by chronic dieters.You can follow Adam on hisblog,Instagram, andTwitter.

Read more:
I've Spent 10 Years Helping People Lose Weight Here Are My Best Tips - Greatist

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