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Posted on February 14, 2016 at 9:50 AM Comments comments (3562)


TO: Chicago Image


RE: Bylined Article

DATE: November 11, 2004


by Michael S. Romberg, M.D., F.A.C.S.

     “I can’t do it!” Mary bursts out as she manages to take a breath. A slight jog is just too taxing for this 28-year-old mother of two whose intentions to lose weight always hit a dead end. Her frustration with her weight triggers her to indulge, and thus starts the vicious cycle all over again. Mary and 127 million other Americans are considered overweight, and one out of five adults is obese – 80-100+ pounds overweight. A staggering 300,000 deaths each year can be linked to obesity, and healthcare costs of American adults with obesity amount to approximately $100 billion.

     “Excuse me, passing through!” Tom exclaims as he pushes his way through the narrow aisles in the movie theatre. Beads of sweat are visible as he finally settles down in the not-so-comfortable movie chair. Tom, single, 32 years of age and 290 pounds, is a computer engineer who spends all day in front of the computer, eating out almost daily. Exercise and health issues have taken a back seat in this goal-oriented professional’s life. Like many of us, Tom thinks about weight control, but there just isn’t enough time in his busy day for diet and exercise.

     People turn heads and cock an ear to the commotion at an airport sales ticket window. “What do you mean I have to pay double?” Bridget argues defiantly with the ticket sales person. Bridget, 45 years of age, has never been able to fly the friendly skies without a hitch because of her weight – about 370 pounds. With limited space on airplanes, there are no special considerations given for people who are overweight. In fact, they are often required to pay double, as occupancy allows. One can only imagine the humiliation…people snickering and criticizing. One thing is for sure: weighing 200, 100 or even 50 pounds over your ideal weight just doesn’t feel right.

     Standards of daily living are very limited, even oppressing at times. You are at risk for numerous health problems because of obesity. This is not a simple condition of eating too much.

     Obesity is a serious, chronic disease. There are several different types of effective treatment options to manage weight including dietary therapy, physical activity, behavior therapy, drug therapy, and surgery.

     No one option is effective alone, but together in a comprehensive program, the pounds can be shed. Not only does the weight come off, but the side effects of obesity, such as diabetes, hypertension, sleep apnea, hyperlipidemia, and heart disease, also show significant improvement.

     With the promotion of realistic expectations, the emerging success of surgery has provided patients with the most effective procedures, therapies and programs for long-term weight loss, health and well-being. Results show more than “pounds lost,” but a brighter quality of life.

     Seek out a multi-faceted approach to weight loss that includes medically supervised interventions, education, behavioral modification strategies, and a comprehensive pre- and post-surgical program for nutritional, physical and psychological support to ensure long-term patient success.

     No one can guarantee weight loss.

     No one program will work for everyone.

     Millions of dollars have been spent in the hope of sustained weight loss.

     Surgery options are out there. Is this the right choice for you?

Michael S. Romberg, M.D., F.A.C.S., is a bariatric surgeon with the Centers for Obesity Related Illness (CORI; CORI has established weight loss Centers of Excellence in Illinois, Michigan, New York and Florida. ### 

Getting Enough Sleep

Posted on September 3, 2015 at 11:50 AM Comments comments (6259)


Everyone needs to get enough sleep. Sleep helps keep your mind and body healthy.


How much sleep do I need?

*Most adults need 7 to 8 hours of good quality sleep on a regular schedule each night. Make changes to your routine if you can't find enough time to sleep.


*Getting enough sleep isn’t only about total hours of sleep. It’s also important to:


*Go to sleep at about the same time every day

*Get good quality sleep so you feel rested when you wake up

*If you often have trouble sleeping – or if you don’t feel well rested after sleeping – talk with your doctor.


How much sleep do children need?

*Kids need even more sleep than adults.


*Teens need at least 9 hours of sleep each night.

*School-aged children need at least 10 hours of sleep each night.

*Preschoolers need to sleep between 11 and 12 hours a day.

*Newborns need to sleep between 16 and 18 hours a day.

*Why is getting enough sleep important?

*Getting enough sleep has many benefits. It can help you:


*Get sick less often

*Stay at a healthy weight

*Lower your risk of high blood pressure and diabetes

*Reduce stress and improve your mood

*Think more clearly and do better in school and at work

*Get along better with people

*Make good decisions and avoid injuries (For example, sleepy drivers cause thousands of car crashes every year.)

Does it matter when I sleep?

Yes. Your body sets your “biological clock” according to the pattern of daylight where you live. This helps you naturally get sleepy at night and stay alert during the day.


When people have to work at night and sleep during the day, they can have trouble getting enough sleep. When people travel to a different time zone, they can also have trouble sleeping.


Get sleep tips to help you:


Work the night shift

Deal with jet lag (trouble sleeping in a new time zone)

Why can’t I fall asleep?

Many things can make it harder for you to sleep, including:



Certain health conditions

Some medicines

Caffeine (usually from coffee, tea, and soda)

Alcohol and other drugs

Untreated sleep disorders, like sleep apnea or insomnia

If you are having trouble sleeping, make changes to your routine to get the sleep you need. For example, try to:


Follow a regular sleep schedule

Stay away from caffeine in the afternoon

Take a hot bath before bed to relax

How can I tell if I have a sleep disorder?

Signs of a sleep disorder can include:


Difficulty falling asleep

Trouble staying asleep

Sleepiness during the day that makes it difficult to do tasks like driving a car

Frequent loud snoring

Pauses in breathing or gasping while sleeping

Pain or itchy feelings in your legs or arms at night that feel better when you move or massage the area

If you have any of these signs, talk to a doctor or nurse. You may need to be tested or treated for a sleep disorder.


Read about common sleep disorders.

Take Action! 


Making small changes to your daily routine can help you get the sleep you need.


Change what you do during the day:


*Exercise earlier in the day, not right before you go to bed.

*Stay away from caffeine (including coffee, tea, and soda) late in the day.

*If you have trouble sleeping at night, limit daytime naps to 20 minutes or less.

*If you drink alcohol, drink only in moderation. This means no more than 1 drink a day for women and no more than 2 drinks a day for men. Alcohol can keep you from sleeping soundly.

*Don’t eat a big meal close to bedtime.

*Quit smoking. The nicotine in cigarettes can make it harder for you to sleep.

*Create a good sleep environment.

*Make sure your bedroom is dark. If there are street lights near your window, try putting up light-blocking curtains.

*Keep your bedroom quiet.

*Consider keeping electronic devices like TVs and computers out of the bedroom.

*Set a bedtime routine.


*Go to bed at the same time every night.

*Get the same amount of sleep each night.

*Avoid eating, talking on the phone, reading, or watching TV in bed.

*Try not to lie in bed worrying about things. Check out these tips to help manage stress.

*If you are still awake after staying in bed for more than 20 minutes, get up. Do something relaxing until you feel sleepy.


Check out these other tips on getting a good night’s sleep.


If you are concerned about your sleep, see a doctor.

Talk with a doctor or nurse if you have any of the following signs of a sleep disorder:


*Frequent, loud snoring

*Pauses in breathing during sleep

*Trouble waking up in the morning

*Pain or itchy feelings in your legs or arms at night that feel better when you move or massage the area

*Trouble staying awake during the day

*Even if you aren’t aware of problems like these, talk with a doctor if you feel like you often have trouble sleeping.


Keep a sleep diary for a week and share it with your doctor. A doctor can suggest different sleep routines or medicines to treat sleep disorders. Talk with a doctor before trying over-the-counter sleep medicine.


Posted on August 31, 2015 at 10:45 PM Comments comments (11826)

13 Ways to Prevent Diabetes

Simple Tips to Improve Your Health

By Fran Golden, Special to Lifescript

Published April 21, 2015

Reviewed by Edward C. Geehr, M.D., Lifescript Chief Medical Officer

About 25% of Americans are at risk for type 2 diabetes – and most of us have no idea. A poor diet, not exercising enough, even aging raise our likelihood. Fortunately, simple efforts to improve our health can make a big difference. Read on for 13 prevention tips...


How serious a health problem is type 2 diabetes, the most common form of this incurable disease?




About 24 million people in the U.S. have it, and by 2034, that number will jump to 44 million, says University of Chicago researchers in one study.


This disease, in addition to affecting our families, will strain the U.S. health system, costing $336 billion per year by 2034, they expect.


Why the increase? Blame the rise in obesity.


“Women who are overweight or obese are more at risk,” says Josefina Diaz, M.D., former chief of endocrinology at Saint Joseph Hospital in Chicago.


Aging, especially after 45, and being physically inactive are other major factors.


You can’t be cured of diabetes, but you can make lifestyle changes to help prevent diabetes. That’s good news for the more than 57 million people in the U.S. who have prediabetes (higher than normal blood sugar levels that could lead to the disease), according to the U.S. Department of Health and Human Services.


Will changing your routine really make a difference? Yes!


In fact, major diet and exercise changes reduced risk for 58% of people with prediabetes, according to a 10-year Diabetes Prevention Program (DPP) by the National Institutes of Health.


To stay safe, first learn how this disorder works: With type 2 diabetes, the body doesn’t produce enough insulin (a hormone that regulates blood sugar), or your cells ignore it.


We need insulin to change food into energy. Without it, sugar stays in the bloodstream and, at high levels, causes diabetes, which can then turn into other problems.


“It can lead to heart attack and stroke, dementia, Alzheimer's disease, many types of cancers and complications including blindness, kidney failure and limb amputation,” says Fred Vagnini, M.D., medical director of The Heart, Weight Loss and Diabetes Center in New York and author of The Weight Loss Plan for Beating Diabetes (Fair Winds Press).


Learn more about these head-to-toe diabetes complications.


Read on for the latest studies and expert-recommended guidelines on how to stop this disease before it starts...


1. Get moving

Physical activity lowers blood sugar and boosts your sensitivity to insulin. Research shows both aerobic exercise and resistance training can help control diabetes, but you’ll get the best benefits if you do various types of exercise, according to the American Diabetes Association (ADA).


The ADA recommends a half-hour of mild aerobic activity (like dancing or tennis) five times per week, based on results from a landmark, 16-year study by the Harvard School of Public Health. That study found that even brisk daily walking reduces risk of type 2 diabetes by 30%.


Why resistance training? Because muscle is a good absorber of blood sugar (which gets it out of the bloodstream).


Do a full-body workout – engaging chest, back, butt and legs – for 30 minutes twice a week, says Melina Jampolis, M.D., a member of the CNN Health team.


For resistance exercises, click here.


If that doesn’t fit your schedule, exercise for 10 minutes each day, varying your routine.


“You need to challenge yourself and change things up to keep getting a benefit from it,” she says.


You don’t have to hit the gym, adds Howard Shapiro, M.D., author of Eat and Beat Diabetes With Picture-Perfect Weight Loss (Harlequin).He says activities such as cleaning the house and carrying groceries help too.


2. Go for whole grains

White bread, white rice and potatoes aren’t just bad for our waistlines: They all have a high glycemic index, which can cause spikes in blood sugar and insulin levels.


“There’s no question that refined carbs, like white flour and sugar, increase your risk of diabetes,” Dr. Jampolis says.


Find out if a low-glycemic diet is right for you.


Studies, including the large Shanghai Women’s Health Study in China (that followed 75,000 women), found that women whose diets had the highest glycemic index had a 21% higher risk of developing type 2 diabetes compared with those whose diets had a low glycemic index.


Counting carbs and switching to whole grains can help.


Whole-grain bread, pasta and cereals – but not the sugary kind – are all good when it comes to diabetes prevention, because they slow down carb absorption.


Studying 160,000 nurses in two studies, Harvard School of Public Health researchers found those who averaged 2-3 servings of whole grains a day were 30% less likely to develop type 2 diabetes than those who rarely ate whole grains.


You may also want to take a fiber supplement, such as Metamucil (but again, choose sugar free).


Can’t give up carbs? Read on…


3. Pour a spoonful of vinegar

Two tablespoons of apple cider vinegar a day lowers the blood sugar surge you get eating from eating carbs, thereby lowering your blood sugar, according to a series of studies by Carol Johnston, Ph.D., professor and director of the Nutrition Program at Arizona State University.


Johnston recommends making a vinaigrette with 2 parts vinegar to 1 part olive oil (avoid bottled dressings, which have the opposite ratio) and starting your dinner with vinaigrette-dressed salad or steamed vegetables.


4. Spice it up

In an often-quoted 2003 study, Pakistani researchers along with Richard Anderson, a scientist with the U.S. Department of Agriculture, found even 1 gram of cinnamon daily reduces blood sugar.


Subsequent U.S. studies haven’t confirmed the benefits of the spice or cinnamon supplements, but diabetes experts still recommend adding it to your diet.


“It can’t hurt, sprinkled on toast or whatever,” Johnston says.


5. Drink more coffee

Hold on to your mugs: An 18-year, 125,000-participant study (84,276 were women) by the Harvard School of Public Health showed that women who drank six or more cups of coffee per day reduced the risk of type 2 diabetes by nearly 30% – although that much coffee can pose other health risks. Coffee has lots of antioxidants, including chlorogenic acid and magnesium (which can improve sensitivity to insulin), and was found to be better than decaffeinated coffee, though decaf also had some positive effects.


6. Eat your veggies

Experts differ on the best diet to keep diabetes at bay, but all agree you should eat vegetables – and some fruits, beans, nuts and seeds too.


Dr. Jampolis suggests following an anti-inflammatory diet – whole grains, fruits and vegetables – and avoiding trans fats, chemicals and processed foods.


Dr. Vagnini proposes a low-carb, low-salt version of the Mediterranean diet, which is rich in fish, healthy fats like olive oil and spices.


The ADA recommends a nutrient-dense diet (high in vitamins, minerals and fiber, and low in saturated and trans fats) that promotes weight control.


7. Trade meat for soy

If red meat is your main source of protein, replace some of your standbys with soy-based foods, like these 10 tofu dishes and soy burgers.


If that’s hard to swallow, consider this: A major study evaluating more than 37,000 women, conducted by Brigham and Women’s Hospital in Boston, found that eating red meat increases risk of type 2 diabetes in women. Processed meats like hot dogs were found to further increase risk in the 8.8-year study.


By contrast, soy has major benefits.


“Soy protein helps regulate glucose and insulin levels, promotes weight loss because it’s low calorie, has no saturated fat and lowers high cholesterol,” Dr. Shapiro says. He recommends 25-40 grams of soy products daily.


8. Skip the sweet drinks

Drinking large quantities of sugar in a few quick gulps creates a blast your body may not be able to handle.


In a Harvard study following 90,000 female nurses over eight years, those who had one or more servings a day of sugar-sweetened soft drinks or fruit punch were twice as likely to develop diabetes. (Weight gain from the drinks was a factor too.)


Diet soda can make you hungrier and leave you craving sugar, Dr. Vagnini says.


9. Reduce stress

Although research is underway to determine if stress raises blood sugars, many experts believe it does, including Richard Surwit, Ph.D., the chief of medical psychology at the Duke University School of Medicine, who wrote a book about managing emotions to control blood sugar, The Mind-Body Diabetes Revolution (Da Capo Press).


What helps?


“I encourage prayer, meditation, yoga and any kind of emotional healing,” Dr. Vagnini says.


These 9 stress-reducing exercises also help.


10. Soak up some sun

Vitamin D, which we get from sun exposure, plays a role in insulin sensitivity and secretion, leading researchers at Loyola University Chicago to conclude it may prevent or delay the onset of diabetes – and reduce complications for those already diagnosed. If you’re reducing sun time, other good sources are low-fat dairy, milk and fish.


Or take vitamin D supplements.


Dr. Vagnini recommends 5,000 units per day in tablet form to his patients, but consult your doctor to find the right dose for you.


11. Get your zzz’s

Not getting enough sleep increases hunger, which leads to weight gain and, you guessed it, raises your risk of getting diabetes.


Women need at least seven hours of sleep per night, according to Dr. Diaz.


Click here for 12 sleep tips.


12. Toss your cigs

Smokers are about 50% more likely to develop diabetes than nonsmokers – and heavy smokers have an even higher risk, according to the landmark Harvard School of Public Health study.


Are you ready to quit smoking?


13. Check your levels

The ADA recommends blood glucose screening for everyone 45 and older. Generally, this testing is repeated every three years. But if you have known risk factors (like high blood pressure or obesity), discuss them with your doctor – she may want to test you earlier or more frequently.


Visit our Type 2 Diabetes Health Center for more information.