Healthy Steps Bariatric Surgery Testimonial 2

Meet a Healthy Steps couple and hear their testimony regarding bariatric surgery and how it was life changing!

See what they have to say about Dr. Robert Woodbury’s care as a surgeon and Santa Rosa Sutter’s medical team to take care of them in the hospital for surgery.


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Bariatric Surgery Testimonial of Healthy Steps Patient

Watch the video below!

Hear how you will be guided through the Healthy Steps Surgery Program with individual care to meet your specific needs and insurance requirements. The program is inclusive of visits to see our nurses, nutritionist, exercise physiologist and psychologist.

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Coconut Water


The Truth About Coconut Water

Author Fooducate
Coconut water is the clear liquid found inside the hollow center of a young, green coconut. It is not to be confused with coconut milk or cream, a liquid puree of the coconut meat. Coconut water is extracted from coconuts when the proportion of water to meat is highest. The drink is very popular in central and south America, the Pacific Islands, and other tropical regions. Fresh coconut water is served directly from the fruit by cracking a small hole on top for a straw.
Coconut water has caught on strongly in the US, and is viewed by many as a viable alternative to sports drinks. An 8 fluid ounce serving of coconut water has only 45 calories, mostly from 2.5 teaspoons of naturally occurring sugar. A big benefit is the high potassium content – 500mg (equivalent to the potassium in a banana).
Various brands of coconut water tout themselves as all-natural energy drinks. They list health benefits such as electrolyte replenishment, alkaline balance, kidney cleansing, and more. Whether all these health benefits are true or not, coconut water beats Gatorade and other sports drinks because it has less ingredients, less chemicals (colorings), and less sugar. However, water trumps them both. 
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Bottom Line
Water trumps all for hydration. If you want a somewhat exotic sweet treat, try coconut water.

Supermarket tips
When buying coconut water, choose a product that lists only coconut water as its ingredient. Avoid products with added juices or flavors as they will add more sugars and calories to your beverage.
Author Fooducate
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Bariatric Surgery Support Group — change of location this month

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Sharon McKenzie, Back On Track

It is that time again, we are taking sign-ups!!

Screen Shot 2014-04-16 at 9.34.59 AMSharon McKenzie is offering another Back On Track Class. This life changing series is something you won’t want to miss!

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Dr. Robert Woodbury Speaks – “Emerging Concepts in Obesity”

Check out upcoming events to hear Dr. Robert Woodbury speak on the topic of

“Emerging Concepts in Obesity”

Saturday, April 5th Northern California Medical Association Symposium

Friday, April 26th Grand Rounds @ Memorial Hospital

Here are just a few of the questions that  we should be asking and Dr. Woodbury will be answering, you won’t want to miss this!

  • Why does a patient suffering from gastric cancer undergo a gastrectomy and roux-enY reconstruction not lose massive amounts of weight from the surgery?
  • Why des a mammal force fed into a state of morbid obesity naturally return to a normal weight after the force feeding stops?
  • Why does a rodent fetus genetically designed to be immune from obesity, transplanted into a morbidly obese mother, become morbidly obese?
  • How does changing the gut microflora alter the genetic expression of GABA receptors in the brain and decrease anxiety?
  • Why do mammas subjected to bariatric surgery lose drastically more weight than a pair-mate mammal fed the same calorie restricted diet that the surgery animal ate?
  • If gluttony is simply due to a deficiency in will-power why do bariatric patients develop profound changes that immediately correct it?
  • If environment and family influences are to blame for obesity, then why do children born to mothers after bariatric surgery have less obesity, diabetes and cardiovascular risk than their sibling born before mom had bariatric surgery?
  • If restricting calories were a dominant mechanism for weight loss why did the old jaw wiring surgeries and non-metabolic gastrectomies fail to cause real sustained weight loss?

If you are interested in the science behind his talk, see below for the bibliography.


Bibliography for Article and Presentation

“Emerging Concepts in Obesity”  by Robert Woodbury, MD  April, 2014


Centers for Disease Control. Obesity trends 2010

Ryan, Woods, and Seeley “Central nervous system mechanisms linking consumption of palatable high-fat diets to the defense of greater adiposity” Cell Metab. 2012 Feb 8;15(2) 137-149.

Seeley et al “Behavioral, endocrine, and hypothalamic responses to involuntary overfeeding.” Am J. PHysiology, Sept 1996 vol 271. 819-823.

Williams Trust Case Control Consortium. “Genomic-wade association study of 14,000 cases of seven common diseases and 3000 shared controls”. Nature 2007; 447: 661-678

Frayling et al.  “A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity”.  Science 2007. 316. 889-894

Cecil JE.  “An obesity associated FTO gene variant and increased energy intake in children”  NEJM 2008: 359: 2558-2566

Diva, C. “Variation in the FTO contributes to childhood obesity and severe adult obesity”.  Nat. Genet. 2007: 39; 724-726

Andreasen, CH.  “Low physical activity accentuates the effect of the FTO rs9939609 polymorphism on body fat accumulation”.  Diabetes 2008; 57: 95-101

Hunt, SC. “Association of the FTO gene with BMI”.  Obesity Apr 2008 16(4) 902

Karra et al. “A link between FTO, ghrelin, and impaired brain food-cue responsivity.”  J. Clin. Inv. Aug 2013 123(8) 3539-3551

Tamashiro et al.  “Cloned mice have an obese phenotype not transmitted to their offspring.”  Nat Medicine Mar 2002 8(3)

Smith, Marceau, et al.  “Effects of maternal surgical weight loss in mothers on the intergenerational transmission of obesity”.  J. Clin Endocrinol Metab. 2009 94(11) 4275

Kral, Marceau et al.  “Large maternal weight loss from obesity surgery prevents transmission of obesity to children who were followed for 2 to 18 years”.  Pediatric 2006 Dec 118 (6) e1644

Woodard, Morton, et al.  “Probiotics improve outcomes after Roux-en-Y Gastric Bypass surgery: A prospective randomized trial. “  J. Gastrointest Surgery 2009 13:1198-1204

Lio, Kaplan et al. “Conserved shifts in gut microbiome due to gastric bypass reduce host weight and adiposity”.  Sci Transl Med 2013 5:178

Molinaro et al. “Probiotics, prebiotics, energy balance, and obesity”.  Gastroenterol Clin N Am 2012 (41)843-854

Jumperts  “Energy balance studies reveal associations between gut microbes, caloric load, and nutrient absorption in humans. “  Am J Clin Nutr Jul 2011 94(1):58-65

Jayasena et al  “Role of gut hormones in obesity”.  Endocrinology and Metabolism Clinics of N AM 2008 37: 769-787

Mikalakis and le Roux  “Gut hormones and leptin: Impact on energy control and changes after bariatric surgery – what the future holds. “  Obes Surg 2012 22: 1648-1657

Gallwitz and Schmidt  “GLP-1 receptor knock-out causes glucose intolerance but no alterations of eating behavior”.  Z Gastroenterolgy 1997; 35: 655

Cohen et al.  “Effect of gastric bypass surgery in patients with type 2 diabetes and only mild obesity”.  Diabetes Care 2012; 35(7) 1420-1428

Sumithran et al.  “Long term persistence of hormonal adaptations to weight loss”.  NEJM 2011 365(17) 1597-1604

ORourke,Robert OHSU. Presentation at ASMBS 2012. Based on his article.  O’Rourke “Inflammation in obesity-related disease. Surgery 2009 March; 145(3) 255-259

Speaker and Fleshner. “Interleukin-1 Beta: a potential link between stress and the development of visceral obesity. BMC Physiology 2012 12:8

Ahima et al.  “Brain regulation of appetite and satiety”.  Endocrin Metab Clinics N. Am. 2008 (37)811

Mikalakis and leRoux.  “Gut hormones and leptin: Impact on energy control and changes after bariatric surgery, what the future holds.” Obes Surg 2012 22:1648-1657

Seeley and Kaplan. Presentation at Metabolic Applied Research Strategy Conference June 2010

Kaplan. “Effect of surgical and non-surgical weight loss on energy expenditure”. Presentation at Metabolic Applied Research Strategy, June 2012.  Based on much of his own unpublished and published work including: Mirshahi et al “The MC4R Allele is associated with better metabolic status and more weight loss after gastric bypass surgery. J Clin Endocrin Metab Dec 2011; 96(12) E2088-E2096

Hatoum et al.  “Melanocortin-4 receptor signaling is required for weight loss after gastric bypass surgery” J. Clin Endocrinolgy Metab 2012

Periera, et al. “Effects of a low glycemic load diet on resting energy expenditure and heart disease risk factors during weight loss. JAMA. Nov 24, 2004. vol 292 #20

Stylopoulous et al  “Roux-en-Y gastric bypass enhances energy expenditure and extend lifespan in diet-induced obese rats”.  Obesity 2009; 17(10): 1839-1847

Shin et al.  “Longitudinal assessment of food intake, fecal energy loss, and energy expenditure after roux-en-y gastric bypass surgery in high fat fed obese rats.”  Obesity surg Apr 2013; 23(4) 531-540

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How to Choose A Pickle

(Article from Fooducate)

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Are you a pickle lover?

Addicted to the crunch of a tasty dill pickle?

Although pickles are super easy to make at home, most people buy commercial jars, not fully knowing what’s really inside. Lets take a look at Vlasic Original Dills, for example, to see what goes into industrial pickles these days. Here is the ingredient list:

Cucumbers, Water, Distilled Vinegar, Salt, Calcium Chloride, Polysorbate 80, Natural Flavors, Potassium Metabisulfite (Preservative), Yellow 5.

The first four ingredients make sense. They make pickles too, at home. That’s how your grandmother used to make pickles, except she also added lots of dill, which is surprisingly missing from this ingredient list. Now on to the “bonus ingredients”.

Calcium Chloride is a preservative that doubles as a food preservative. It adds to the salty flavor without the added sodium. Although on its own, calcium chloride is an irritant, it is safe when part of a food.

Polysorbate 80 is an emulsifier used in ice creams to keep them texture smooth. It is also used as a solubilizer, helping to dissolving ingredients that would not otherwise do so. We’re not sure why it is needed in pickles. Perhaps to dissolve massive amounts of calcium chloride and salt.

Natural flavors can be anything that improves the taste of the pickle, so long as it comes from nature, not a lab. Be sure that a lab creates the natural flavor from a varied source of “natural ingredients”, but the manufacturer is not obliged to disclose the exact formulation. It is a trade secret.

Potassium Metabisulfite is an additive that inhibits the growth of mold.

Yellow 5 is an artificial food coloring that is being phased out in European countries, as some studies have shown it to cause hyperactivity in children. Unfortunately, it makes the pickles look brighter and thus fools people to believe they are tastier.

Bottom Line

Here we’ve got a dill pickle without any dill, but on the bright side – it glows in the dark.


Supermarket Tips

If you want to take a stab at making your own pickles, here is our very own easy recipe.

If you are buying pickles, read the ingredient list and avoid products with artificial colorings and other ingredients you can’t find in your own kitchen.

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Jill Temkin – See what we have in store for you!

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Culinary Class April 8th

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Quest Bars…we want your feedback


We’d like YOUR opinion!

We are thinking about carrying QUEST bars for patients who desire a low carb bar option!

Perks to the bar:

Low carb

High protein (bioavailable)

Low sugar

Gluten free

High fiber


*Most QUEST bars are as low as about 5 net carbs and 20 grams of protein.

Let us know if you would like to see the bars in our office. What flavors have you liked or disliked? 

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