Paisley Prescriptions - March 2020

Serious as a Heart Attack: Minimize Your Rish for Stroke & High Blood Pressure


March 2020 Issue
Paisley Prescriptions

If you’re overweight, you’re not alone. More than one-third of Americans are obese, and two-thirds are either obese or overweight. All 50 states in the US now have at least a 20 percent obesity rate, with five states at more than 35 percent of their population being obese (South Carolina is not one of them). Just two decades ago, not one state in our nation had over a 15 percents obesity rate. Being overweight and obese is an epidemic, one far more scary and imminent than headline viruses. Obesity is linked to 60 chronic illnesses, and has now surpassed smoking as the No. 1 preventable cause of death. The reason: We are eating more. Way more! We are consuming 23 percent more calories on a daily basis than we did in the 1970s. What that looks like in numbers is a standard 2,000 calorie per day consumption has increased to an average of almost 2,500 calories per day, all while physical activity has decreased. The result: We have become an unhealthy, sick country. Everyone knows losing weight is one of the hardest tasks to conquer. Sometimes we feel defeated before we even start. The good news is, if you are overweight or obese, losing even five percent of your current weight helps reduce your risks for disease. Many wonder where to start. It’s OK to ask for help, and that’s why we went to the experts to really talk about the ins and outs of weight loss and fat reduction, and what the difference is.

Sources:; CDC

PYRX 0320 TsaiJ. William Tsai, M.D., FACS

What are the dangers
of losing weight too fast?
What is a healthy pace of weight loss?

Losing weight too fast can cause malnutrition, hypotension, dizziness and general fatigue. Significant weight loss in a short amount of time can also alter the effect of medications on the body. It is important to know how many calories you should take in for safe weight loss. Generally, losing one pound per week for an obese patient is safe, but you should always consult your physician before undergoing any weight loss program.

I’ve tried every diet.
How does the bariatric or gastric sleeve work?

The sleeve gastrectomy, also known as the gastric sleeve, physically reduces the size of the stomach. The size of the pouch is approximately eight ounces, which therefore reduces the amount of food and drink one can consume. Secondarily, the sleeve removes the part of the stomach that controls hormones that makes you feel hungry. Surgery is only a tool combined with lifestyle changes, such as a healthy diet and exercise, that makes weight loss successful after this procedure.

J. William Tsai, M.D., FACS, a board-certified surgeon with Southeast Georgia Physician Associates-General & Vascular Surgery. Learn more at or 912.265.5125.

PYRX 0320 BowenDiane G. Bowen, M.D.

What factors could be preventing
my weight loss?

Over the years, I’ve had many patients complain about not being able to lose weight, even after making lifestyle changes to eat healthier and get exercise. They feel they’ve exhausted every option, yet when we dig a little deeper, we often find a root cause for their weight loss resistance to be either nutritional deficiencies, hormone imbalances or both.  

In general, Americans have been overfed and undernourished. While that might sound contradictory, an abundance of calories doesn’t necessarily deliver the right nutrients that your body needs. In fact, overeating can create nutrient deficiencies. Low nutrients equal poorly functioning metabolism. American diets fall short of nutrients like magnesium, vitamins C, B12 and A. Being nutritionally deficient may be caused by medications that deplete key nutrients, poor digestion and foods low in important nutrients. These nutrients are important to help reduce inflammation, control blood sugar levels and are building blocks and cofactors to help hormones work better.  

If you find the weight loss journey stressful, and you are already under stress, then your body may be responding by making more cortisol which then causes your body to hold on to the very weight that is bothering you—a Catch 22. If your weight does not quickly respond to simple steps like increased exercising or better food choices, then it may be time to have a comprehensive nutritional assessment completed to determine your nutrient levels and provide insight into what your body is missing in order to accomplish weight loss.

Often the key to losing unwanted belly fat, gaining energy, clarity, and a better mood lies with your hormones. Hormones such as Cortisol and Leptin, in addition to Estrogen and Testosterone, may be out of whack, causing resistance to weight loss regardless of all the your efforts. Hormone testing is important to see what your levels are in order to determine what may be the underlying root cause.  Once you are nutritionally and hormonally balanced not only will you lose weight, you will gain more energy and be in a better, more balanced mood.

When is cosmetic surgery
like liposuction
or a tummy
tuck an option?
Liposuction is a cosmetic reshaping procedure used to remove excess fat deposits often around the abdomen, thighs and buttocks. Other areas can benefit from recontouring including the chest, arms and face or neck. Sometimes liposuction fat can be recycled for use in fat grafting, taking from an undesired area of fullness like abdomen and grafting it to the breast. It can be combined with a tummy tuck or abdominoplasty, which is a surgical procedure to remove excess loose or sagging skin in the abdomen area. None of these procedures are designed to be a weight loss tool. For your best result, it is helpful for you to be at a stable weight with a goal of reshaping those areas that are out of balance.   
A comprehensive consultation with a plastic surgeon is suggested in order to determine if Liposuction or a tummy tuck is the best course of action for you to achieve your desired outcome.  

Diane G. Bowen, M.D., is owner of Golden Isles Center for Plastic Surgery, PC – 1015 Arthur J. Moore Dr., SSI., with a full medical spa and on-site plastic surgery suite. 912.634.1993. Dr. Bowen is also founder and director of Centered on Wellness, at the same location.

PYRX 0320 KentHarold L. Kent, M.D.

What are the key benefits of Coolsculpting as a consideration
in weight loss?
What are typical results and timelines?

When a patient has significant weight loss, there can be residual pockets of fat that become noticeable bulges--think “love handles”, “bra fat” and other unattractive areas. Coolsculpting is meant to reduce the size of these bulges by using cold to kill fat cells. While Coolsculpting is not a weight loss treatment, it can kill up to 20 percent of fat cells within the treated area. Most treatments take about 35 minutes and results can be noticed with three weeks although the best results are seen in 90 days. For better results, some areas need to be treated twice and the “Treat to Complete” method involves treating adjacent areas as well. Some results are subtle, so we use the Styku device to take multiple body measurements before and after treatment. Styku also measures body weight and percentage of body fat.

What are some key indicators for weight loss surgery?
Should I consider lap band surgery?

Currently, the main indications for bariatric surgery include assessment of co-morbid illnesses and measurement of Body Mass Index (BMI). Weight loss surgery is indicated for patients with a BMI of 40 or more and patients with a BMI of 35 to 40 with a significant co-morbid illness, such as hypertension, diabetes, sleep apnea and certain other conditions.

The Lap Band is FDA approved for patients with a BMI above 30, who also have a co-morbid illness. Lap Bands are implanted laparoscopically, mostly on an outpatient basis. The band restricts the flow of food to the lower part of the stomach, resulting in dilation of the pouch above the band. Current thinking is the stretch of the pouch induces contractions to expel food into the lower portion of the stomach, and that the force of the contraction is communicated to the brain resulting in a feeling of satiety.

Lap Band patients require regular and ongoing follow up to be successful in their weight loss. Some surgeons aren’t inclined to do follow up after implanting a Lap Band, so other surgical options are currently more popular. Whatever path a patient chooses to lose weight, they must commit to a permanent lifestyle change in order to be successful.

Harold L. Kent, M.D., Bariatric & General Surgery, is owner of Georgia Coast Surgical Med Spa & More; 3226-F Hampton Avenue, Brunswick, Ga. You can reach him at 912-264-9724 or, Facebook: Georgia Coast Surgical & Med Spa.  

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