Pouya Shafipour, MD
Los Angeles, CA
First the Good News!
At the end of this presentation you will have a
clear understanding of the following:
You will lose excess weight in a healthy way and
reach your ideal weight fairly rapidly post-op
You will feel better than you have in a long time
You can do this through safe and effective
You will learn how to maintain your weight
In this talk we will cover:
An example of the Good news!
• TJ 40 y/o F
• 5’ 2”
• 130 pounds overweight
• Size 18
• Frequent Headaches
• Chronic Fatigue
•6 months later
• 70 pounds loss
•Dizzy spells gone
•Lots of energy!
Now the Bad News!
• When it comes to Dieting and Weight loss in the US,
We are confused
• Our current weight problem is not a result of lack of
effort by the American Public.
• With over 6000 diets available and the contradictory
“scientific evidence”, it would be a miracle if Americans
were not confused
• Following the wrong plan, no matter how hard you try,
will get poor results.
America is Overweight and Obese
According to the CDC 1 out of 4 people
Are either Pre-Diabetic or Diabetic?
Oct 2010 CDC Estimates
By 2050 up to a third of the population diabetic
57 Million Americans Pre-Diabetic.
24 Million Americans Diabetic.
7th cause of Death in 2007
Over 400,000 Deaths from Obesity year.
74% of Adult Americans are
Since 1980 number of Overweight
Americans has doubled
Over the next 24 hours
2200 diabetics will be diagnosed
512 diabetics will die
66 diabetics will go blind
77 diabetics will develop end stage kidney
153 will have diabetes related amputations
Overweight and Obesity
CancerStats in U.S.
90,000 Cancer Deaths
14% of all Male Cancer
20% of Female Cancers
American Cancer Society*
*estimates excess weight
contributes to 33-50% of
Heart Disease in
Since 1984 more female deaths,
512,000 female Deaths
447,000 male Deaths
10,000 women under 50
Health Effects of Being Overweight/Obese
• Type II Diabetes
• Heart disease
• High B.P., Heart Attack
• Stroke, Arthritis
• Infertility, Birth Defects
• Carpal T.S., Low Back Pain
• Impaired Immune Response
• Impaired Resp. Disorders
• Fatigue, Fatigue and more...
• Gall Bladder D., Gout
• Menstrual disorders
• Menopausal hot flashes
• Insomnia, Sleep Apnea
• Depression, Reflux
• Surgical Complications
• Pain, Urinary Incontinence
• Chronic Ven. Insufficiency
Cancers and Obesity
Colon and rectum
Breast (after menopause)
Endometrium (lining of the uterus)
These Statistics Represent:
Quantity & Quality of Human Life Severely
Diminished by this one condition
Meaning Quantity in Years Lost
Quality of Life 24 hours, 7 days a week
Why is There an Epidemic of
Diabetes and Obesity?
“Its in my genes – I am doomed to get it”
“It is out of my control”.
Causes of Diabetes & Obesity
• Unhealthy Eating Habits
• Excessive Weight (Abdominal Fat)
• Lack of Adequate Nutrients
• Lack of Exercise
Changes in Our Eating Habits
Sugar intake 1900, 2-4 lbs. of
Sugar intake 1999, 158 lbs./person/year
Refined Grain intake from late 1970’s thru
2000 has increased by 60 lbs. per year
French vs American Diet
Late 20th Century French Diet was
higher in fat, had equal amounts of
meat and fish, 4X's as much butter
and cheese, and they had 60% less
Heart Disease than the US.
More About Fats
From the mid 1980’s to mid 1990’s, the % of daily
calories from Fat in the American Diet, decreased from
40% to 33%, while obesity in increased significantly
From 1910 to 1970, Heart Disease escalated from
almost non-existent to # 1 cause of death. During this
time the intake of Animal & Butter fat significantly
decreased, dietary cholesterol did not increase, while
sugar intake increased dramatically
How do we Gain FAT?
Let’s look at the common scenario of fat
gaining that takes place, slowly but surely
over time, from too many carbs, too many
When blood sugar exceeds a certain level
the body converts it to fat and stores it.
Low Blood sugar
Next Carb Fix
Next Carb Fix
Next Carb Fix Next Carb Fix
Insulin and Glucagon
• lowers elevated blood sugar.
• shifts our metabolism into
• removes dietary fat from blood
and transports it into fat cells.
• Increases body's production of
• causes the kidneys to retain
• stimulates the release of
• shifts metabolism into burning
• turns fat into blood sugar for
• Decreases body’s production
• causes the kidneys to release
• stimulates the release of
Out of Control Portion Size
Hamburger 2.8oz – 4.30oz 50% inc in calories
French Fries 2.4oz – 7.00oz, 10x inc in calories
Chocolate Bar 2.0oz – 7.00oz, 3x inc in calories
Coca Cola 6.5oz – 16.0oz, 2x inc in calories
Popcorn 3cups – 21cups, 10x inc in calories
The Status Quo
33% Diabetic - CDC!
So, How do We
Solve this Problem?
The Bad News is:
There is No Magic Pill to solve
What Does not Work
• Natural Stimulants”, i.e. Ephedra and the
many other “Fat Blockers”, “Carb
Blockers”, “sleep your way to weight Loss,
dont change your lifestyle” products.
• Prescription Medications for Weight Loss,
remember Fen, Phen?
• Lastly,“it is not the fault of your Genes”.
When we take care of the body in the way it
is designed to be cared for, it performs
wonderfully and loses weight steadily.
Really Good News
Gastric Bypass Cures Diabetes and most
diseases associated with Obesity
This Challenge is:
Following a plan that focuses on:
Preservation and increase in muscle mass
Long-term sustainable weight loss and
avoids weight regain.
It is not about a Diet
It is about a system!
A System Structured for
What a typical diet lacks:
Proper protein content.
Adequate unsaturated “good” fat
Long term Post-op Program
• Abdominal Fat Loss
• Develop Healthy Food Habits
• Nutritional Deficiencies Supported
Abdominal Fat Reversal
Establish a Bio-chemical State to Target:
Abdominal Fat = Development of Insulin
Resistance & Tumor Formation
Abdominal Fat Study
Excess body weight in combination with
physical inactivity is a major determinant
for the development of insulin resistance
with associated hyperglycaemia and
hyperinsulinaemia and further leads to
Arch Physiol Biochem. 2009 May;115(2):86-96. Obesity related
hyperinsulinaemia and hyperglycaemia and cancer development.
Becker S, Dossus L, Kaaks R.
Healthy Food Habits
• Understand Food Habit Impact on Blood
• Make the 20/80 Flip
• Minimize Foods that Induce
• Ensure Adequate Intake of Protein with Meals
(60 grams/day minimum)
• Maintain 3 Meals a Day – Never Miss Breakfast
• Healthy Snack Between Meals
• Typical post-op Mineral and Vitamin
• Chromium, Magnesium, Zinc, EFA,
Selenium, CoQ-10, alpha lipoic
acid, calcium with vitamin D, iron
and vitamin B12
• Daily 30 minutes of movement for
• 60 minutes of exercise for weight
• Family Exercise very important to
prevent childhood obesity
• Non-Exercise Activity Thermogenesis
• Gastric Bypass is an effective procedure to
cure diabetes and cause dramatic weight
• Caloric intake, nutritional deficiencies and
Protein intake need to be monitored post-
operatively and for the rest of one’s life.
• 60-80 grams of Protein/day is necessary to
avoid muscle loss and maintain one’s weight.
Have 4-6 small meals a day. You can
not eat large amounts of food and
your meals will not last as long as they
did before, so eat more frequently.
Drink at least 64 ounces of water daily.
Drink at least 30 minutes before eating.
This "water loading" will make you feel
fuller before you eat.
Simple Action Steps
Chew your food very well- 20 times before swallowing. It
slows down your eating and also breaks down the food to
allow the food to go down easier
Keep a food diary and plan your meals. If you fail to plan,
you plan to fail.
Don't rely on what is nearby for food. Fast food will slow
you down. Never skip breakfast. Eat like a queen for
breakfast, princess for lunch and pauper for dinner.
Avoid foods high in sugar (more than 20
grams per serving) or high in fat (more 30%).
Bread does not grow on Trees! So Avoid
Carbohydrates as much as possible
Be careful with liquids like juices, smoothies, or lattes. These
have calories and you will not have the feedback or solids
telling you that you are full.
Avoid snacking. Grazing on food will add weight. Stick to your
set meal times.
Don't give up. Weight loss and weight
maintenance is a life long process. If you
over indulge one day, make up for it the
next day. Keep working to make yourself
better each in every day in each and
Find time for yourself. If you are stressed at
work or home your body will know it and
not like it. Take care of yourself or you
can't take care of others.
For more information please visit us at
Or Call us at (310) 400-5565