All posts by Dee Anne Agonis

January 2, 2018 – Food Labels – What Does It All Mean?

Facilitated by Chris Bovos, BSN, CBN

The following is an outline summary of the food label presentation given at the January 2nd support group meeting.   This information has been written up in more detail and presented in a blog article that can be viewed on our blog page:  Healthy Eating – The Importance of Understanding Food Labeling

Certified Organic

  • Most meaningful
  • Cannot be grown with fertilizers, synthetic pesticides or sewage sludge
  • Cannot be genetically engineered or irradiated
  • Animals – eat only organically grown feed, no hormones, or antibiotics, and must have access to the outdoors and pastures
  • Animals cannot be cloned

Country of Origin

  • In U.S. only required for chicken, seafood, produce and some nuts
    • Congress repealed this for pork and beef in 2015 due to pressure from meat industry
    • Most other developed countries still require it

USDA Inspected

  • Just means the food meets certain quality standards and has been inspected by USDA employees
  • Are graded based in quality and size – not production methods
  • Tells you nothing about the company’s practices

Treated with Irradiation

  • In grocery stores, food must be labeled and marked with a radura symbol
  • Used to reduce spoilage, eliminate some bacteria such as e-coli, salmonella, etc.
  • No studies to show ill effects, and radiation doesn’t remain in food, but questions remain regarding what it does to the nutrients.
  • Label does not apply to restaurants, schools, hospitals or process foods that contain irradiated ingredients

Chickens, Eggs and Meat

  • Cage Free – birds raised without cages – may still come from crowded factory farms – can spread their wings
  • Pasture-raised – spend at least some time outdoors on pasture, feeding on grass or forage – doesn’t specify how much time.
  • Grass-fed – after weaning, primary source of food comes from grass or forage – not from grains such as corn (doesn’t tell if antibiotics or hormones were used or animal living conditions)

Raised without Antibiotics/Hormones

  • Animal received no antibiotics over its lifetime
    • No guarantee about other conditions
  • No synthetic hormones administered
    • Federal law prohibits the use of hormones on hogs and poultry
    • Feed and dairy cattle are permitted the use of hormones – look for rBGH-free or rBST-free

Misleading Labels

  • Organic seafood – there is no US govt. standard – can’t be “organic”
  • Free Range – only for poultry; for meat – not regulated for pigs, cattle or egg-producing chickens (standards very low for chickens)
  • Natural or Naturally Raised – cannot contain artificial color, flavors , preservations or other artificial ingredients. Doesn’t tell how raised, if antibiotics or hormones used, etc. 
  • Fresh – only regulated in poultry – meat was not cooled below 26 degrees F

Whole Grain vs 100% Whole Wheat

  • Breads and crackers are very misleading
  • If it has more than 1 type of grain, they can say “multi-grain” even though it may be mostly white flour
  • If it says “whole wheat” it doesn’t mean 100% whole wheat
  • Best thing is to look for the seal from the Whole Grains Council that lets you know there are 16 grams of whole grains per serving

Nutrition Labels

  • Keep Protein to Carb ratio at 1 to 1 – eat 1 gm of carb per 1 gm of protein
    • If you eat 20 gms of protein, you should not eat more than 20 gms of carbs.
  • Fat grams – keep under 45 per day
  • Total carbs – fiber = net carbs


  • Has been added to everything for the last 40 years – biggest cause of inflammation, and inflammation causes disease
  • Hidden in the food and labels – look for ingredients that end in “..ose” or anything with “malt” such as barley malt, syrups, etc,
  • WHO recommends no more than 25 gms of added sugar a day
  • Sugar causes increase in blood glucose, which causes the pancreas to release insulin, and the increased insulin causes the body to store the calories as fat.


  • Fructose is a particularly damaging type of simple sugar
  • Glucose metabolizes 20 percent in the liver and 80 percent throughout the rest of the body
  • Fructose is 90 percent metabolized in the liver and converts to fat up to 18.9 times faster than glucose – can lead to fatty liver disease and cirrhosis
  • Fructose can lead to leptin resistance – leptin tells your body when you are full. Leptin resistance stops that signal to your brain so you never feel full.

High Fructose Corn Syrup (HFCS)

  • HFCS is found in 75% of packaged foods and drinks, mainly because it is cheaper to manufacture and 20% sweeter than raw sugar.
  • Turns on the metabolic pathways that convert it to fat and store it in the body, adding weight
  • Isn’t metabolized in the brain – brain thinks the body is starving. You remain hungry, become lethargic and less inclined to exercise

Cut Out the HFCS

  • Removing from the diet makes way for food your body can metabolize properly
  • Reduces sugar cravings
  • Get healthier without counting calories
  • “This one change has the potential to prevent serious diseases and restore health.” Tyree Winters

How Much Is a Serving?

  • Practice Portion Control:
    • Use measuring cup or food scale
    • 3 ounces of cooked meat, fish or poultry is about the size of a deck of cards
    • ½ cup is size of an ice cream scoop
    • 1 cup is size of a tennis ball
    • 1 ounce cheese is size of a domino
    • Check soup bowls to see how much they hold – 8 or 16 ounces?

Healthy Eating: The Importance Of Understanding Food Labeling

For many people, healthy eating is a chore. This is especially true for those who have gone through bariatric surgery and are adjusting to new eating habits. After surgery, monitoring what and how much you put in your body becomes critical to maintaining your weight loss goals. Making healthy eating choices  doesn’t have to be a chore if you start with understanding food labels.

Bariatric-Health-Farm-Fresh-Produce-KC-BariatricLet’s start with dispelling a few myths about food labels, like eating organic salad and U.S. free-range natural fresh meats will ensure your food is fresh and nutrient rich. The first step in adopting healthy eating habits is to eat fresh fruits and vegetables and consume meats low in fat and high in protein; however, not all food is created equal and not all labels mean what you think they mean. Some labeling and terms can be misleading, which could lead you to think you’re making a healthy eating choice, when you are not. For instance, before you assume “fresh” means it was never frozen and or was picked recently, you should be aware that the label “fresh” only means it was not cooled to a temperature below 26 degrees or still falls withing “shelf-life” limits.

Food Labels and Healthy Eating

Perhaps understanding the definitions of some of the most common labels can help you in making healthy eating choices: 

“Certified Organic” –  These are grown without hormones, antibiotics,  fertilizers, synthetic pesticides or sewage sludge and cannot be genetically engineered, cloned or irradiated. There is no U.S. Government standard for Seafood. It can’t be “organic”. 

Country of Origin – Required on all chicken, seafood, produce, and some ruts. (U.S. does not required on pork and beef, since 2015) 

USDA Inspected – Means the food meets certain quality standards and has been inspected by USDA employees, but the grade is based in quality and size – not production methods. This label tells you nothing about the company’s practices. 

The Bariatric Center of Kansas City Healthy Eating Radura symbol Weight Loss
Radura Symbol

Irradiation “Radura” Symbol – Grocery store foods that has been treated with radiation to reduce spoilage and eliminate some bacteria such as e-coli, salmonella, etc. must be labeled and marked with a Radura symbol. Although the radiation doesn’t stay in food, there are currently no studies done to determine the effects radiation has on nutritional values and the foods nutrients. 

rBGH-Free or rBST-Free – Indicates no synthetic hormones were administered. Although hormones are allowed for feed and dairy cattle, Federal law prohibits the use of hormones on hogs and poultry.

Ingredient Label w Fructose

Sugar Free – Usually means a synthetic sugar or High fructose Corn Syrup (HFCS) is hidden in the food. Check the label for ingredients that end in “..ose” or anything with “malt” such as barley malt, syrups, etc.

Fresh – Indicates the meat was not cooled below 26 degrees F but the U.S. only regulates this in poultry and not other meats or produce. 

Cage Free – This means that the were birds raised without cages and had enough room to spread their wings but may still come from crowded factory farms. 

Pasture-Raised – Means the animal spent at least some time outdoors on a pasture, feeding on grass or forage there but is no standard on how much time is required to earn this label..

Grass-Fed – Indicates that an animal’s primary food, after weaning, was grass or forage and not grains such as corn. There are no requirements regarding the disclosure of using antibiotics or hormones or on the animal’s living conditions.

Free Range – Only applies to poultry and is not regulated forpigs, cattle or egg-producing chickens. The standards for this label are very low and do not apply to living conditions or the use of antibiotics or hormones. 

Natural or Naturally Raised – Means that the meat cannot contain artificial color, flavors, preservatives or other artificial ingredients. Doesn’t address how the animal was raised or if antibiotics or hormones were used.

The Bariatric Center of Kansas City Healthy Eating Whole Grains Council Weight Loss

“Multi-Grain” and “Whole-Wheat”– If it has more than 1 type of grain, they can say “multi-grain” even though it may be mostly white flour. It can say “whole wheat” even if it doesn’t mean 100% whole wheat. Best to look for the seal from the Whole Grains Council that lets you know there are 16 grams of whole grains per serving. 

Healthy Eating and Serving Size 

In addition to understanding labels, you will need to be conscious of your portions. Portion control guidelines, to maintain your weight and continue in your healthy eating habits, may not be the same as what is suggested on your food’s label. You want to look at how many servings there are in a container. Most drinks are actually 2 portions, so when reading the label you would have to double the information, which would double your carbs, sugars, proteins, sodium, etc.

As a general healthy eating rule we suggest you use measuring cups and food scales and follow these formula’s for proper portions:

  • Keep Protein to Carbohydrate ratio at 1 to 1 – eat 1 gm of carbs per 1 gm of protein (IE…if you eat 20 grams of protein, you should not eat more than 20 grams of carbs.)
  • Fat consumed must stay low – consume LESS than 45 grams per day
  • Watch your total carbs!  – carbs minus fiber = net carbs

When you are not at home you can use these guidelines for measuring portions:

  • 3 ounces of cooked meat, fish or poultry is about the size of a deck of cards
  • ½ cup is size of an ice cream scoop
  • 1 cup is size of a tennis ball
  • 1 ounce of cheese is size of a domino

It is absolutely acceptable to spend time in the grocery store comparing labels or online researching product labeling. Your on-going relationship with food depends on how well you understand and control what you consume. Healthy eating habits take time to develop and the more you learn about the food you consume the easier it is to make healthy choices. 

The Bariatric Center of Kansas City Healthy Eating Compare labels





The Impact of Biotin for Bariatric Weight Loss Patients

bariatric weight loss FDA biotin

The Bariatric Center of Kansas City feels it important to share recent news published by The FDA with our bariatric weight loss patients.  On November 28, 2017 they published  the following alert about Biotin:

“The FDA is alerting the public, health care providers, lab personnel, and lab test developers that biotin can significantly interfere with certain lab tests and cause incorrect test results.”  (Click here for FDA Post)

The FDA has seen an increase in the number of reported adverse events, related to biotin interference with lab tests. It has been found to alter tests for thyroid levels, heart failure, pregnancy, cancer and iron-deficiency anemia.

In a recent scientific study done at the University of Minnesota, researchers found that 40% of the lab tests were thrown off by additional supplementation of biotin. Another study done at Loyola University looked at 374 different lab tests and found 80 came with warnings stating the results would be altered by extra biotin in the blood.

Biotin is promoted as being beneficial for skin, hair and nail strength. But many supplements contain biotin levels up to 650 times the recommended daily allowance.  There is no scientific evidence that extra biotin helps with hair loss, or weight loss, and our Journey Bariatric Vitamins contain 0.6 mg, which is twice the recommended amount a person needs per day.  We do not recommend additional supplementation with biotin.  While not toxic, biotin supplementation can be harmful in diagnosing conditions unless it is stopped at least 48 hours prior to lab tests.

Our weight loss patients need remember, Biotin is found in liver, eggs, fish, meat, nuts, seeds and some vegetables such as sweet potatoes. It is extremely rare to see a biotin deficiency.  If you feel, in your weight loss journey, the need to supplement your biotin intake, please take no more than 2.5 mg/day, which is 4 times the amount in Journey vitamins.

Following bariatric weight loss surgery, almost everyone will experience some hair thinning starting about 3 – 4 months after surgery.  It will last for 90 – 120 days and then hair will begin to regrow.  If it does not, then lab work may show a nutritional deficiency. Hair is made of a type of a structural protein called keratin. The body needs protein, zinc, iron, vitamin D, silicon and selenium to make keratin.  Journey Bariatric Vitamins contain the recommended amounts of all these nutrients. The best way to increase your body’s production of keratin is to add whey protein to your diet.  Other helpful foods are red meat, poultry, blueberries, almonds, leafy greens, soybeans, and salmon.  

It is important to report to your physician any supplements you are taking.  When having lab work drawn, please inform the lab of any supplements you take.  And please, stop any biotin supplements 48 hours prior to having lab work drawn.

Will Weight Loss Surgery Cure My Sleep Apnea?

weight loss surgery sleep apnea kc bariatric center kansas city

The most common questions I get in the sleep program have to do with the effects of weight loss and weight loss surgery in sleep apnea.

I always respond with helping people understand Obstructive Sleep Apnea; what it is and why it occurs. 

The definition for Obstructive Sleep Apnea is; “a cessation of breathing followed by a snore, then an oxygen desaturation.” That means – you stop breathing when you sleep.  So, why do some stop breathing when they sleep?

All of us are born with tonsils, adenoids and soft tissue in the backs of our throats.  For some, the tonsils can be enlarged or the soft tissue be excessive.   Either way, this can cause a narrowing of the airway that causes shallow or labored breathing when sleeping.  The tonsils and/or soft tissue falls back into the throat causing a blockage in your breathing.  That blockage is then followed by a snore, gasp, cough or choking.  This is your body’s way of restarting your breathing. 

When your body has sleep disordered breathing, your oxygen will drop quickly and your heart rate slows down each time this happens.   Over time, this can cause harm to your internal organs including your heart and lungs.  This can cause hypertension and heart disease.  This can also cause a stroke.  Because of the obstruction in your throat, you are depriving your body and brain of oxygen.  Medically, untreated sleep apnea can cause death. 

Obstructive Sleep Apnea also causes excessive daytime sleepiness, tiredness and memory loss.  Our brains go through different stages of sleep throughout the night.  Each stage of sleep has different depths.  Some stages are lighter while others are much deeper.  The purpose for these different stages is to obtain the best sleep needed for our overall health and well being.  The deeper stages help our brains and muscles rest.  But if we are suffering from Obstructive Sleep Apnea, we are unable to reach the deeper stages of sleep until very late in the night or not at all because of the constant interruptions to our sleep cycle from the sleep disordered breathing.  If we are unable to get enough of the deeper stages of sleep, we will suffer from falling asleep when we should be awake, lack of energy and forgetfulness. 

While the causes for this excessive tissue is different for every individual, weight loss and weight loss surgery has the potential to resolve sleep apnea.  However, not everyone’s sleep apnea is fixed with weight loss or weight loss surgery.  After you reach your goal weight, or as close to it as you want to be, you can be retested to see if you still have a diagnosis of Obstructive Sleep Apnea.  In many cases the OSA is resolved, in others, the OSA may be dramatically reduced which may still require treatment with CPAP but at a significantly lower pressure.   Weight loss and weight loss surgery, in general, will improve your quality and quantity of life and so will treatment for Obstructive Sleep Apnea. 

Written by:  Erika Keech, RPSGT

Sleep Medicine Coordinator with The Bariatric Center of Kansas City

Alcohol Consumption after Bariatric Surgery


What Happens When You Drink?

We have all experienced the effects that come with drinking an alcoholic beverage or two.  Drinking alcohol can come with considerable costs also. Moderate amounts of alcohol can feel socially beneficial, but an excessive amount can cause a variety of negative consequences. Impaired judgement from excessive alcohol can cause people to over-consume empty calories and perhaps drive when they shouldn’t. It is important to remember that weight loss surgery cannot protect you against gaining weight from liquid calories and alcohol relaxes the esophagus and stomach, allowing you to eat even more. The combination of impaired judgement and a relaxed stomach can be a dangerous combination!

Risks of overconsumption of alcohol can stem beyond calorie surplus and have even more serious consequences. After bariatric surgery, even 1 drink could place someone at risk of getting a DUI. Obviously, this is never worth it!

Why do you get drunk faster after bariatric surgery?   

Weight loss surgery makes all of the consequences of drinking alcohol come a lot faster. When the stomach is smaller, there is less of the enzyme alcohol dehydrogenase present in the body. This enzyme is responsible for breaking down alcohol, therefore alcohol lingers in the system longer and peaks higher. Because of reduced stomach size, alcohol also moves more rapidly into the small intestine, causing it to be absorbed more quickly.  



Tips to plan ahead for social gatherings

  • Eat your meal before you drink
  • Rule of thumb- 1 drink before surgery = 3-4 drinks after surgery – know your limit!
  • If you do drink, consider options that are low in sugar and avoid mixed cocktails that contain juice or soda
  • If you are to drink, have your 1 drink after other people have had a few too so that you feel the effects at a similar pace and you are less pressured to overconsume as the night goes on
  • You may carry around some water in a cocktail glass with some lime and sip on it at the beginning of the night so that you do not need to repeatedly explain yourself why you do not have a drink in your hand
  • Be aware of the possibility of addiction transfer. If you have been addicted to food in the past you want to be aware of the risks of becoming addicted to alcohol and keep yourself out of situations that put you at risk.



Non-Alcoholic Mint Mojito




2 cups water

1/2 cup natural sweetener ex: Stevia or Swerve

1/2 cup fresh mint leaves

 1 oz lime juice (approx half a lime)



Instructions Simple Syrup

Boil water and natural sweetener over the stop for about 5 minutes or until thickens into a syrup.

Instructions for Mojito

  1. Add mint leaves to a glass container with a lid (such as a mason jar). Pour syrup over mint leaves and let steep at least 20 minutes. Use immediately or can save for later.
  2. Add ice to drinking glass. Pour 1 tbsp of mint syrup and 1/2 cup cold water. Add 1 oz lime juice. Stir and serve.
  3. Add more mint syrup or lime juice per preference. Recipe Notes This recipe makes one mojito with additional simple syrup to make 4 glasses.

 This recipe provides an estimated 32 calories, 0 grams protein, 3 grams carbohydrate and 0 grams fat.

With the holiday season upon us, we encourage you to have fun and enjoy social functions with friends, family and co-workers.  Just be careful and remember, “everything in moderation”! 




Dr. Duc Vuong on “Alcohol after weight loss surgery”

Alcohol and the Gastric Bypass Patient



November 7, 2017 – Setting & Meeting Activity Goals

Facilitated by:  Kari McKeown, RPT  and Barb Cashman, RPT

Our two new physical therapists in the office were introduced and they spoke briefly about how they would be meeting with all patients pre-operatively to do a physical evaluation of mobility and making recommendations for activity that can be started prior to surgery. 

Kari shared the information from an article that states “Sitting is the New Smoking,” and how we spend a lot of time sitting behind the wheel of a car, then at a desk, then in front of the television, and how all the sitting has shown to increase the risk of heart disease, diabetes, cancer and even depression.  Even if you exercise an hour a day, if you are sitting the rest of the time, you are still at risk.  “Your body is designed to move. Sitting for an extended period of time causes your body to shut down at the metabolic level.”  We all need to take breaks, get up and move, even for as short a period of time as a few minutes can improve your health.  It is important to get regular activity throughout the day in addition to regular exercising.

Barb shared information about High Intensity Interval Training (HIIT), which allows you to get a higher impact training in a much shorter period of time, and talked about using Tabata Workouts on You-Tube that can help you time those workouts with high intensity for 20 seconds, 10 seconds of rest and do 2 circuits before resting for a few minutes.  Unfortunately, the video would not work, so we weren’t able to show it, but you can access it now by playing the video below. It is important to modify the exercises as you gradually work up to it, so you want to start with beginner routines.  Many of the routines are only 10 minutes long.  We hope to be able to save some of the workouts and share them at a future support group meeting. 




Physical Therapy Benefits Your Bariatric Weight Loss Journey!

The Bariatric Center of Kansas City Physical Therapy Weight Loss

Physical therapy plays an important role in your bariatric weight loss experience.  Physical therapists work with you during various points of your journey, both prior to and often after surgery.  They offer a pre-operative evaluation to start you on an exercise program appropriate to your level of function, activity level and/or mobility constraints.  They also provide post-operative care to address weight loss changes to your body, orthopedic problems and to advance your exercise program.  Physical therapists can also help you manage the many aspects of recovery after bariatric weight loss surgery and help ensure the most successful outcomes by:

weight loss with physical therapy– Creating an individualized treatment program;

– Educating you on the benefits of exercise and how to incorporate it into your new lifestyle;

– Teaching you safe exercise techniques and progressions before and after your procedure;

– Helping you find ways to stay motivated and continue on the path of better health.

Your Weight Loss Journey Is Unique!

Each person’s weight loss journey is unique, and may require different skills from the physical therapist. Physical therapy may address the following:

  • Improving endurance and aerobic capacity;physical therapy weight loss stretching ball

  • Decreasing pain in the spine and extremities;

  • Regaining range of motion and/or strength;

  • Improving balance and/or coordination;

  • Improving postural awareness.

Ensure A Successful Outcome In Your Bariatric Journey!

As you know, the decision to have bariatric surgery is also a decision for making healthy lifestyle changes.  Working with a physical therapist provides you with an additional tool to help ensure a successful outcome in your bariatric journey.  Here are some tips to keep in mind as you recover and progress:

 – Surround yourself with supportive friends and/or family;

 – Keep track of your progress;

 – Attend support groups, which are held twice monthly on-site;

 – Get involved in something you have always wanted to do or try;

 – Be sure to treat yourself with healthy rewards;

 – Remember, everyone makes mistakes; learn from them.

It is also important to consider what went wrong and correct it in the future.

The Bariatric Center of Kansas City is pleased to announce that physical therapy services are now available in our Comprehensive Care Wing in Suite A-305 of Building A in the Shawnee Mission Health Prairie Star Complex at 23351 Prairie Star Pkwy, Lenexa, KS.  PT services are covered by most insurance plans and are a valuable resource to take advantage of. To schedule an appointment, just call our main office line at 913.677.6319 and we’ll be happy to get you scheduled!

October 19, 2017 – Making Seasonal Protein Bars

Facilitators: Laura Hernandez, RD & Anne Epp, RD

                Bariatric Apple Pie Protein Bars

Laura and Anne, our new dietitian, made some no-bake bariatric Apple Pie Protein Bars.  The recipe is below.  Everyone got to try them, and discussed ways that the recipe can be modified for individual tastes.  One 1” square of the bars contained 38 calories, 1.9 gm of fat, 2.4 gms of protein, and 3.3 gm of carbohydrates. These are not intended as a “meal substitute” but rather as a way to share something patients can make during the upcoming holidays that is high quality food and nutritious, rather than a highly processed food.

Laura shared a number of new sweeteners out on the market you may want to try for baking in the upcoming holidays:  Swerve Sugar Replacement (tastes, bakes and measures like sugar); Monkfruit sweetener (also a 1 to 1 sugar replacement); and Allulose – a naturally occurring low-calorie sugar with 90% fewer calories and shows no impact to glucose or insulin levels.


2 cups gluten free oat flour                                                     

½ cup coconut flour

½ cup vanilla protein powder                                                  

6 packets of Splenda

1 T cinnamon

1 tsp all-spice

1 tsp nutmeg

¼ cup almond or peanut butter

½ cup unsweetened apple sauce

3 T half and half

1 tsp vanilla extract

¼ tsp low calorie agave nectar


  1. Line large baking dish with greased paper and set aside
  2. In large mixing bowl, combine flour, protein powder, Splenda, and spices and mix well
  3. In microwave safe bowl, combine the nut butter and liquid sweetener and and heat until melted. Pour the wet mixture into the dry and mix well. Add applesauce and mix until combined- the batter should be crumbly
  4. Add the half and half until a thick batter is formed
  5. Transfer to lined baking dish and press firmly. Refrigerate for at least 30 min.


Bariatric Center of Kansas City Surgeons Participate in J & J Institute Program

Bariatric Center of Kansas City

From Left to Right: Dr. Brice Hamilton, Dr. Aaron Lloyd, Dr. Billy Helmuth, Dr. Stanley Hoehn & Dr. Kelvin Higa


Bariatric Center of Kansas City surgeons Stanley Hoehn and Brice Hamilton recently participated as faculty members for the course Enhancing the Bariatric Patient Experience, presented by the Johnson & Johnson Institute September 15 and 16, 2017. The J & J Institute presents specialized programs to healthcare providers as part of their “…commitment to advance education to improve patient care.” The program was held at the Shawnee Mission Health – Prairie Star campus in Lenexa, Kansas for a select group of bariatric surgeons from across the country along with their practice or hospital administrators and representatives from Ethicon, one of the J & J subsidiaries that provides surgical equipment used in bariatric surgery.


Program Participants Touring the Facility
Dr. Hassan Saradih

Other faculty members were Dr. Helmuth Billy, from Ventura, CA, Dr. Kelvin Higa, from Fresno, CA, Aaron Lloyd, Director of the Bariatric Program at Fresno Heart & Surgical Hospital, and Dr. Hassan Saradih, Bariatrician at Shawnee Mission Health. Dr. Higa, current president of the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) and past president of the American Society for Metabolic and Bariatric Surgery (ASMBS), served as moderator for the day and a half course, which covered topics such as Best Practices in Seminar Education, Gaining Efficiencies in Surgery, Maximizing Patient Health Improvement Outcomes, Reimbursement Dynamics, and Coordinated Care for Patient Success. 

Program Participants from Around the Country

Ethicon and Johnson & Johnson regularly provide educational courses for surgeons around the country, and this is the first time they have presented in Kansas City.The Prairie Star facility is unique in that it houses the entire Bariatric Center of Kansas City bariatric surgery program, allowing patients to have their pre-op workup, surgery, and post-op follow up all in one facility, a unique concept for bariatric care in the country. 

Dr. Stanley Hoehn Sharing Practice Experience with Program Participants

Johnson & Johnson chose to have this educational workshop here to demonstrate how the partnership between The Bariatric Center of Kansas City & Shawnee Mission Health has allowed us to become a leader in Metabolic & Bariatric Surgery.

The Bariatric Center of Kansas City at The Shawnee Mission Health Prairie Star Complex






October 3, 2017 – Body Composition

The different components that the body is composed of are:

  • Bones
  • Organs
  • Muscles
  • Fat

Along with water, these are what our bodies are made up of.  When we talk about your “fat free mass” we are talking about water, bones, organs and muscles.  Once you have finished growing, your bones and organs don’t grow anymore – they continue to weigh about the same throughout adulthood.  The two areas that you can change are muscle and fat. 

There are two types of fat in your body composition:

  • Essential fat:    necessary for normal body function. This includes fatty tissue making up nerves, brain, heart, lungs, liver and mammary glands.
  • Non-essential fat:  this is simply fat or energy storage. This is also known as adipose tissue, and exists mainly just below the skin, and then around the organs. The fat around the organs is known as “visceral fat.”  This varies from person to person. 

The typical body composition of men and women is distributed as below:

Today, our lifestyles have led to a decrease in muscle mass and an increase in non-essential fat.  The body has an unlimited capacity to store energy, leading to increasing amounts of excess fat.  Men often carry their excess fat in the abdominal region, while women tend to carry it in the hips, thighs and buttocks.  

Since two people can weigh the same, but be composed of completely different percentages of fat and muscle, a better way to determine the amount of excess fat a person has is by using a body composition analyzer.  We now have a medical body composition analyzer in our Comprehensive Care Center.  It works by measuring sound waves as they move through different types of body tissue.  It can determine what percentage of fat and muscle is in your body.   Sometimes a regular scale doesn’t show a change in overall weight, but the change may be in body composition.  Muscle weighs more than fat, so if you are increasing muscle and losing fat, you may not see a change on a regular scale. But a body composition analyzer will show if you are losing excess fatty tissue.  Also, we always want to preserve your lean muscle mass. If you begin to lose lean muscle mass, we can see that on the analyzer and focus your diet on building muscle. 

This tool will be a big benefit to the work the dietitians  do by individualizing a program for each patient based on how their body composition is changing.  We hope to be using it routinely by October 15th.  We will need to get a baseline measure, and then can do a body composition analysis every 3 – 4 months to see how the program is working for each patient, and make changes as indicated.   Normally people pay about $100 for a body composition analysis.  We will offer it to our patients for $25.  (We don’t want to make money on it – just pay for the cost of the machine, which is very expensive.) This additional resource will help us to optimize your weight loss and design a plan specifically for each patient.