FAQs

The team at the Houston Methodist Weight Management Center is ready to help you on your journey to living a healthier, more active lifestyle. Below are commonly asked questions from patients who are interested in enrolling in or starting a weight loss program. Click on the section for the answers in the following areas:

Weight Management

Weight Loss Surgery

Medical Weight Management

Restarting the Medical Weight Management Program

Diabetes and Weight Management

Weight Management

What is the best way to get started on my weight loss journey?
The first step is to learn about all of the available options. One easy way to do this is to register for a free orientation session at Houston Methodist’s Weight Management Center to learn about our medical weight management programs and weight loss surgery options.

Weight Loss Surgery

What are the selection criteria for weight loss surgery?
To be a candidate for weight loss surgery, you must meet specific criteria:

  • You have a body mass index (BMI) of 40 or greater or BMI of 35 to 39.9 with a significant obesity-related condition, such as diabetes, high blood pressure, heart problems, sleep apnea or reflux disease
  • Prior attempts at weight loss, such as dieting, exercise, behavior modification or medications
  • Understand the possible risks, benefits and side effects of the procedure
  • No medical or psychiatric conditions for which surgery would not be recommended
  • Commitment and motivation with realistic expectations of post-surgery life
  • No other addictive behaviors, such as smoking, drinking and/or drug abuse
  • Willingness to undergo both psychological and nutritional evaluation prior to approval
What surgical weight loss procedures are available at Houston Methodist?
Several different surgical weight loss options are available at the Houston Methodist Weight Management Center. Two of the most well-known procedures, the LAP-BAND® and the roux-en-Y gastric bypass (RYGB), are performed by our surgeons. The LAP-BAND® is considered a restrictive surgery (meaning that weight loss occurs by strictly reducing daily food intake) and does not involve cutting or stapling of the stomach. The RYGB surgery restricts the amount of food ingested and causes malabsorption (less absorption of calories and nutrients) by surgically bypassing a portion of the intestinal tract. Our surgeons are also experts in performing the gastric sleeve procedure, which is a minimally invasive laparoscopic procedure in which two-thirds of the stomach is permanently removed.

How does the LAP-BAND work?
The LAP-BAND® is the least invasive weight loss surgery option. This procedure uses a silicone band that is fastened around the upper part of the stomach, greatly reducing the stomach’s capacity to hold food. The banded upper stomach makes you feel full when consuming small amounts of food. The band is adjustable, so tightening it further increases the patient’s sense of fullness and, over time, may continue to reduce daily caloric intake. To tighten the band, the inner surface is inflated by injecting a saline solution into a self-sealing access port located just under the skin. This allows the surgeon to increase or reduce the size of the band to better promote successful weight loss. Though not an intended option, the LAP-BAND® is removable and completely reversible.

How does the gastric sleeve procedure work?
The gastric sleeve, also known as sleeve gastrectomy, is a minimally invasive laparoscopic surgical procedure that promotes weight loss by permanently removing two-thirds of the stomach, while preserving the valve (called the pylorus) that regulates emptying the stomach so food slowly trickles out. Because the stomach is reduced in size, it only holds approximately two to five ounces of food. You feel full with smaller amounts of food and reduce your overall daily caloric intake.

During the procedure performed under local anesthesia, the large portion of the stomach along the curvature is removed. The open edges are then attached with staples to form a sleeve or tube. The entire surgery takes about an hour and involves only approximately five small incisions. Because there is no nasogastric tube or drain, patients return to work and daily activities approximately two weeks following the surgery.

How does the roux-en-Y gastric bypass work?
The roux-en-Y gastric bypass (RYGB) is both malabsorptive and restrictive. This surgery involves creating a small stomach pouch by stapling across the top portion of the stomach, dividing it from the rest of the stomach. The new pouch is about the size of an adult’s thumb and holds about one ounce (two tablespoons), which greatly reduces food portions able to be consumed at one time.

The intestine is surgically restructured so that the small pouch connects directly to the middle part of the intestine (the “roux limb” of the jejunum), therefore bypassing the majority of the stomach and upper intestine (duodenum). Normal digestion and absorption of nutrients are reduced due to the small stomach size and shortened intestine; this decreases absorption of calories and nutrients.

Failing to follow an appropriate diet soon after RYGB can cause a side effect called dumping syndrome. Dumping syndrome occurs when consuming foods or fluids (1) high in sugar and fat, (2) at the same time or (3) in larger amounts that triggers “dumping” or faster emptying from the stomach pouch directly into the intestine. Dumping syndrome can cause symptoms such as abdominal cramping, diarrhea, lightheadedness, sweating and heart palpitations.

What risks are involved with weight loss surgery?
Every surgical procedure has a certain degree of risk. While complications are extremely infrequent at Houston Methodist, possible risks include infection, gastric leaks, pneumonia, pulmonary embolism and, in very rare cases, death. The surgical risks will be discussed with you at length when you meet with our surgeons so you can carefully weigh your decision .

What should I expect after surgery?
Weight loss varies from patient to patient and depends on the procedure you have. Patients who undergo the LAP-BAND® procedure can expect weight loss of one to three pounds per week in the first year after surgery. Though weight loss is gradual, maintaining a structured diet and exercise regimen will promote long-term weight loss. Patients who have the gastric sleeve procedure can anticipate a weight loss of about 60 percent of excess weight. The size of the new sleeve can make a difference in your overall weight loss, as well as changes in your diet, exercise and lifestyle choices long term. Patients who have the RYGB procedure generally experience rapid weight loss that mostly occurs in the first six months to one year after surgery. Long-term, a person may maintain a weight loss of 50 to 60 percent of excess weight. It is important to remember, however, that your eating behaviors must change permanently after weight loss surgery. There is a potential for eventual weight regain if you do not adhere to a diet and exercise regimen or if you eat more than the recommended amounts or increase the frequency of meals.

Some patients may experience heightened anxiety or depression within the first years after surgery. This is usually not serious and can be managed over the phone. Monthly patient support groups at Houston Methodist are available, although they are not mandatory. These sessions are recommended for all weight loss surgery patients and are helpful in managing lifestyle changes and for ongoing social support.

What are the other benefits of surgery?
After surgery, it is common for patients to report a number of additional health improvements. Many patients, for example, are able to reduce or eliminate their previous medications for diabetes, hypertension, reflux and other conditions. In addition to the weight loss and decrease in or complete elimination of medication, many patients also enjoy increased energy and a greater interest in physical activity along with greater self-confidence.

Does my diet after surgery need to change?
The diet after surgery usually starts with clear liquids and progresses gradually to a regular, low-fat diet. The diet progression promotes gastrointestinal tolerance, initial healing after surgery and reduction of potential complications.

Immediately following surgery, you will sip clear liquids (one to two ounces every hour). Clear liquids include water, broth, sugar-free fluids (e.g., diet fruit-flavored drinks like Crystal Light®) and decaffeinated, non-carbonated beverages. Over the course of the first month, the diet will slowly change to include low-fiber foods initially, semi-solid foods (blended), soft-textured foods and, finally, a regular diet. Foods should be low in fat and sugar. The portions at each stage of diet progression will gradually increase. Long term, the recommended average portion of food consumed in one setting is about eight ounces (equivalent to one cup).
Food tolerances vary among individuals. For example, a person may react differently to a specific food that may have been tolerated before surgery or that is tolerated by someone else who had the surgery.

Prior to surgery, you will meet with a clinical dietitian for comprehensive instruction with nutrition education regarding diet and recommended behavior changes following surgery.

What is my protein requirement after surgery?
Due to the limited portions, it is important to choose low-fat, high protein foods. The general goal is at least 70 grams of protein per day from food and fluids. Immediately after surgery, protein intake may be limited due to the overall volume restriction of foods and fluids. Eventually, as more solid foods are tolerated, you will be able to consume more protein and achieve your daily goal.

Good sources of protein include meat, poultry, fish, low-fat cheese, low-fat cottage cheese, low-fat tofu, light yogurt and beans/legumes. (Grains and vegetables contain protein in smaller amounts.)

Many people supplement meals with protein powders (e.g., 100 percent whey protein isolate, soy protein isolate or protein drinks like Isopure® and no sugar added Carnation Instant Breakfast®). Ask your dietitian if you have questions regarding protein supplements.

How will I drink fluids?
Foods and fluids cannot be consumed at the same time. Fluids should be consumed on a consistent basis between meals. You should wait at least 30 to 60 minutes before and after meals to drink fluids. Drinking right after meals may expand the stomach pouch or force foods through the intestine at a faster rate, causing uncomfortable side effects (e.g., dumping, vomiting).

Fluids include water, broth, sugar-free fluids (e.g., Crystal Light®), sugar-free gelatin, sugar-free popsicles (no fruit pieces), milk and soy milk. Carrying a water bottle during the day is recommended so that you always have fluids on hand. Take your time drinking.

Avoid caffeinated and carbonated beverages. Caffeine is an appetite stimulant, causing increased urination that may promote dehydration and can interfere with mineral absorption (e.g., calcium). Carbonated beverages can expand the pouch or cause discomfort. Avoid alcohol, which is considered empty calories and may not be well tolerated after surgery.

Will I need to take supplements?
Reduced calorie intake, poor digestion/absorption of nutrients and changes in food tolerances may lead to protein or vitamin/mineral deficiencies and poor nutrition. Possible side effects of deficiencies include hair thinning or loss, muscle loss, bone loss (long-term osteoporosis), low iron levels and fatigue.

After weight loss surgery, you are at risk for malnutrition. Daily vitamins and mineral supplementation is required. Your dietitian will recommend specific vitamin and mineral supplements that may include prescriptions from your physician.

Do you have basic guidelines I can follow?
We recommend a number of general diet tips for you to follow.

  • Choose sugar-free or low sugar fluids; you may use sugar-substitutes (e.g., Sweet-n-Low®, NutraSweet®, Splenda®).
  • Avoid beverages that contain caffeine, carbonation or alcohol.
  • Choose low-fat, high protein foods for good nutrition.
  • Meats must be lean and low in fat; try other healthy protein foods that include tofu or soy-based products, low fat yogurts/cheeses and beans.
  • Eat the meat or protein first at every meal.
  • Avoid high-fat foods and sugary desserts; monitor portion sizes closely to decrease daily calories.
  • Practice taking small bites (pencil eraser-sized bites) and chew foods thoroughly, approximately 30 chews per bite; stop eating when you are full.
  • Make mealtime last a minimum of 30 minutes.
  • Carry a water bottle during the day and sip fluids on a consistent basis between meals.
Will my insurance cover weight loss surgery?
Most insurance companies provide some coverage. Our staff can help you determine the coverage your insurance plan offers. Realizing the medical importance and lifesaving potential of weight loss surgery, we will act as your advocate and work directly with your insurance company to ensure that you receive all available coverage.

What if my insurance requires a pre-surgery diet program?
As part of your insurance criteria, you may be required to complete a three to six month program with a registered dietitian to qualify for weight loss surgery . This program is designed to prepare you for the surgery and the lifestyle changes that will follow. Throughout the program, you will work toward established goals that focus on exercise, healthy meal planning and behavior modification.

Our pre-surgery diet program is designed to provide helpful information to ensure the most successful outcome:

  • Assess your diet history and develop a personalized plan to improve your nutrition/behavior prior to surgery
  • Educate and prepare you for the nutrition and lifestyle changes required after surgery
  • Encourage taking responsibility for your diet and lifestyle by closely monitoring your progress
  • Require demonstrated nutrition and behavior changes at the end of the three- or six-month program
Your surgeon also may order a pre-surgery nutrition program if deemed necessary for a goal of weight loss prior to surgery. The timeframe and/or weight loss goal will be determined by the surgeon based upon your particular situation.

How should I select a physician and hospital for weight loss surgery?
The decision to have weight loss surgery is an important one, as is determining which physician and hospital is right for you. It is critical to select a center that provides a comprehensive multidisciplinary program. Houston Methodist Weight Management Center’s team of surgeons, physicians, nurses, dietitians and psychologists will care for you from start to finish.

Our surgeons are board-certified in general surgery and have significant abdominal and laparoscopic surgery experience. We are equipped with intensive care units (ICUs), diagnostic tools, such as CT scanners, 24-hour physician staffing and a full range of medical specialists on staff to help you in any way possible.

Can I have surgery at Houston Methodist if I am from a different city or state?
Our bariatric surgery team will assess the level of care available in your home community and will make every effort to assist you in coming to Houston Methodist for your surgery. Out-of-town surgery patients should expect a three- to seven-day stay in Houston.

How do I set an appointment for the pre-surgery visit?
Call Houston Methodist Weight Management Center to set up your comprehensive pre-surgical appointment. The appointment will take about two-and-a-half to three hours. The required nutritional and psychological evaluations will be performed at this time. You will also meet with the bariatric nurse for anthropometrics (body measurements) and a laboratory test as explained below.

If you are unable to keep your appointment, please call at least 24 hours in advance to cancel or reschedule. Due to busy schedules, we cannot guarantee that you will be seen if you arrive more than 20 minutes late for your scheduled appointment.

What occurs during the pre-surgery visit?
The psychological evaluation includes an interview with the psychotherapist, who will examine past psychiatric and psychosocial history, along with an assessment of coping skills, which is an important factor in dealing with lifestyle changes following weight loss surgery.

A nutritional evaluation involves meeting with the clinical dietitian to discuss past nutritional history, current eating and lifestyle habits, and post-surgery expectations. You will receive a bariatric surgery guide with nutritional parameters, as well as information for your pre-surgery diet program, if required by your insurance or physician. Also, you will be required to attend a 90-minute comprehensive nutrition class that covers diet after bariatric surgery. You will receive the class schedule at the evaluation session.

When do I come to the center after surgery?
Long-term maintenance and adherence to both a healthy diet and lifestyle are critical for success. In addition to a follow-up with your surgeon after surgery, it is highly recommended that you come back for nutritional consultation with your dietitian, emotional counseling with your psychotherapist and cardiac rehabilitation with your exercise physiologist or staff to recondition your body. General follow-up after surgery is recommended at one month, three months, six months, one year and annually thereafter.

Houston Methodist Weight Management Center holds regularly scheduled patient support group meetings . Our weight management staff attends these meetings and is always available to address any concerns you may have. These meetings are a great way to network and gain peer support for ongoing postoperative success.

Medical Weight Management Program

What are the eligibility requirements?
You must have a BMI of 30 or greater and be at least 18 years old to be considered for the program. Individuals who have certain conditions or are undergoing certain therapies listed below are not eligible for the medical weight management program.


Other medical situations may also prevent you from participating in the program. Please feel free to address any questions with our staff during the free orientation session.

How much should I weigh?
Most people have a particular weight goal in mind when they begin the program. Our staff will work with you to determine a reasonable, achievable and, more importantly, a healthy weight for you based on your personal needs. Regardless of your weight goal, you will begin to see improvements in your health very quickly, often within the first month. Ninety percent of the health benefits from weight loss are achieved with as little as a 10 percent loss of your initial weight.

How often do I need to visit the center?
You will have a clinic visit each week with your nurse and a group session focusing on either nutrition or behavior change. Both laboratory tests and visits with our medical director will take place once per month. Your total time commitment is approximately two hours per week (not including exercise or other weight-loss related activities performed on your own time). Treatment sessions are held at a number of Houston Methodist Weight Management Center locations.

What kind of diet will I be on?
The medical weight management program is comprised of a liquid fasting plan that gradually transitions to a healthy eating plan. You will use a low carbohydrate, high-protein meal replacement beverage for the first phase of the program and will slowly introduce other foods once this initial phase is complete.

How much weight will I lose?
The expected rate of weight loss is two pounds per week, but results vary greatly from person to person. Most people consistently lose between two and five pounds per week on average.

Can I just purchase the beverage?
Our medical weight management program is a medically screened and monitored program that includes not only the use of a meal replacement beverage, but a more important component: support in the form of nutrition education and behavior change. This is a complete program designed to help you make lifestyle changes for permanent weight loss. The meal replacement beverage is only a small portion of the overall process, and therefore is available only for purchase as part of the program.

What kind of diet will I be on when I have finished the fasting portion of the program?
Fasting works well for a limited period of time. Once you have completed the fasting phase (Phase 1) or you are at the point where you can no longer continue the fast, it is time to gradually transition to food (Phase 2). This is done in a controlled, step-wise fashion over several weeks. The meal replacement beverage will slowly be withdrawn and regular food and calories added back into your diet. Your caloric requirements are individual to you and are based on your gender, age, weight, height and level of physical activity. You will ultimately be on a full food diet incorporating a variety of menu items. The ultimate goal is to return you to normal eating with a food plan created just for you, based upon your personal needs and preferences.

Will my insurance cover this program?
Due to limited insurance coverage and a lengthy approval process, we do not accept insurance for our medical weight management program. Instead, we have created a flat rate that offers a significant discount on regular charges for individual services. The package includes the following services: weekly clinic visits with a nurse, dietitian and counselor; weekly group sessions and monthly labs and physician oversight. To learn more about package pricing, please join us for a free orientation session.

How long do I have to be in the maintenance phase?
The maintenance phase is the most difficult phase of the program. During this phase, you will put together all of the knowledge you have accumulated over the previous fasting and transition phases to develop independence in continuing your healthy lifestyle. Maintaining weight loss requires a serious commitment from you, so we highly recommend that you remain in Phase 3 for at least a year after you complete your initial weight loss treatment.

How do I get started?
If you are interested in the medical weight management program, please register to attend a free one-hour orientation session to learn more. This is an informational orientation and requires no obligation. Orientations are held at convenient locations in the Greater Houston area. Please call 832.667.LOSE (5673) to reserve your spot, or register online.

Restarting the Medical Weight Management Program

Can I re-enroll as a patient in Houston Methodist’s medical weight management program at any time?
Absolutely; however, you must meet the following criteria:
I have regained 20 pounds. What should I do if I am not sure if I want to go back on all beverage? How can I get back on track?
If you have regained some of the weight you lost, we invite you to try our programs designed to get you back on track. You can also call us anytime for a consultation to discuss your options, such as resuming the program, returning to an
  • Learn more about our Step LITESM program.
  • Attend a Living I.T. event.
Who do I contact if I have an outstanding bill or a question about my bill before I return?
Please call us for any billing questions you may have at 713.441.4984.

Diabetes and Weight Management

Patients who are obese and have issues with weight management have a greater prevalence for diabetes. Below is general information about the different types of diabetes, who is at risk and how to manage your diabetes while you manage your weight loss. Click here for more information about diabetes education and available support at Houston Methodist.

What is diabetes?
Diabetes occurs when the body is unable to properly use blood glucose (sugar) for energy and the glucose remains in the bloodstream. This causes blood sugar to become elevated. Blood sugar can remain too high for different reasons. The pancreas makes insulin, a hormone that helps the body’s cells use glucose for energy. Individuals with diabetes may stop making insulin or not make enough, or their insulin may not work well enough to properly lower blood sugar levels. Having consistently elevated blood sugar can cause a variety of health problems.

Are there different types of diabetes?
Type 1 and type 2 are the different types of diabetes, both described below in detail.

  • Type 1 diabetes, also referred to as insulin-dependent diabetes or juvenile diabetes, occurs when the immune system attacks cells in the pancreas, causing it to stop making insulin. Only 5 to 10 percent of people have type 1 diabetes. It usually occurs in children, teenagers and young adults, but it can also develop in older adults. Individuals with type 1 diabetes must take insulin daily for life.
  • Type 2 diabetes, also referred to as non–insulin-dependent diabetes or adult-onset diabetes, occurs when the pancreas makes insulin but not enough, or the insulin does not work well. About 90 to 95 percent of individuals with diabetes have type 2. It usually occurs in people 45 years of age or older, but there are growing numbers of children and teens that are also developing type 2 diabetes.
Risk factors for type 2 diabetes include the following:

  • Obesity
  • Family history of diabetes
  • History of gestational diabetes
  • Impaired glucose tolerance
  • Physical inactivity
  • Race and ethnicity (African Americans, Hispanics and Latinos, Native Americans, Asians, and Pacific Islanders are at greater risk for type 2 diabetes.)
  • Gestational Diabetesoccurs during pregnancy, occurring in about four percent of pregnancies. It usually develops around the 24th week of pregnancy. The development of gestational diabetes is usually related to the production of normal pregnancy hormones, which cause the body to not make enough insulin and prevents insulin from working as well. This results in elevated blood sugar levels. To keep mother and baby healthy, it is important to maintain good control of blood sugar levels during pregnancy. Gestational diabetes usually disappears during the postpartum phase. However, studies indicate that two-thirds of women with gestational diabetes develop type 2 diabetes later in life.
  • Prediabetesis a stage that develops prior to type 2 diabetes. Individuals with prediabetes have higher than normal blood sugar levels, but not high enough to result in a diagnosis of type 2 diabetes. More than 50 million American have prediabetes. Studies indicate that if people with prediabetes do not make healthy changes in their weight, eating habits and physical activity, they will likely develop diabetes within five years.
How do I know if I have diabetes?
The following are common signs of diabetes:

  • Feeling tired
  • Urinating often
  • Being very thirsty
  • Feeling very hungry
  • Blurry vision
  • An infection that does not heal readily
  • Wounds or sores that do not heal well
  • Possible weight loss
If your health care provider thinks you may be at risk for developing diabetes, he or she may perform one of these blood tests:

  • Afasting blood sugar testis done after fasting 8 to 10 hours.
  • Anoral glucose tolerance testmeasures how the body responds to sugar. The patient is given a drink with a very high sugar content, and blood is drawn every 60 minutes for up to 3 hours.
  • Arandom blood sugar testmeasures the amount of sugar in your blood at the moment it is drawn. It can be done at any time of the day with no regard to food.
What can I do if I know I have diabetes?
Finding out that you have diabetes can elicit many feelings about your health and questions about the disease. Each person with diabetes is unique, and a one-size-fits-all approach to disease management may not work for you. In addition, the more you know about diabetes and your health, the more you can preserve your quality of life and stave off future complications. Individuals living with diabetes should meet with a diabetes educator at least once a year to answer questions and learn how to gain control over the disease.
Until you are able to see a diabetes education specialist, you can help manage your health by practicing the four cornerstones of diabetes education: medication, monitoring, diet and exercise.

Take your medications
Your health care provider may have prescribed diabetes medication(s) that can help manage your blood sugar levels. Medications may be pills, insulin or other injectable drugs. To gain better control of your blood sugar levels, it is important to take your medications consistently and as prescribed. Please contact your health care provider's office if you have questions about your medication(s).

Self-monitor blood sugar levels
Blood sugar levels can be affected by what you eat as well as stress, exercise, illness and medications. Checking your blood sugar level is the best way to see how your treatment plan is working. Depending on your treatment plan, your health care provider may ask you to check blood sugar levels once a day or up to seven times a day. Do your best to check as recommended and bring this information with you when you see your health care provider or diabetes educator. This information will let you and your health care provider know how your medicine, food and exercise are working to control your blood sugar level.

Eat healthy
One of the most important ways to manage diabetes is by eating the right foods in the right amounts. Learning how to plan your meals and snacks is important in managing diabetes. You do not need special diet foods, and the foods that are good for you are also good for the entire family. A registered dietitian or certified diabetes educator can help personalize your eating plan.
Follow these basic guidelines for eating healthy:

  • Do not skip meals and try to eat at the same time each day. Eat three meals a day, along with one or two snacks.
  • Watch portion sizes.
  • Eat a variety of foods. Add color to your meals and snacks with fruits and vegetables. Choose foods high in fiber such as whole-grain breads, beans, bran cereals, whole grain pastas and brown rice.
  • Limit fat intake and avoid fried foods. Cut off visible fats when possible. Use smaller amounts or avoid gravies, creamy sauces, oil, margarine or butter and salad dressings.
  • Limit sodium intake. Choose fresh or frozen fruits and vegetables and limit processed foods.
  • Plan meals using the plate method to limit portion size and ensure you eat a variety of foods.
Be physically active
Being physically active does not mean that you have to join a gym or force yourself to doing something that you cannot tolerate. Increasing your physical activity means sitting less often and engaging in activities you enjoy, so you are more likely to maintain your new activity level. Being more physically active can positively impact your health in many ways:

  • Lower blood sugar levels
  • Help your body use insulin better
  • Help lose weight and keep it off
  • Make your heart and lungs work better
  • Lower blood pressure
  • Lower blood lipid levels
  • Make your muscles stronger
  • Lower stress levels
The American Diabetes Association recommends exercising for at least 150 minutes every week. This includes aerobic activity, such as walking, swimming, biking, dancing and water aerobics. Doing some exercise every day is ideal. If you cannot commit to 20 to 30 minutes at one time, try breaking it up into two sessions of 10 to 15 minutes during the day. Making small changes in your routine can make a big difference in your health. Try some of these ideas and discover which activities you enjoy:

  • Walk the dog or walk with a friend
  • Do housework
  • Work in the yard or garden
  • Play with the kids
  • Put the remote away or exercise while watching TV
  • Get dancing
  • Stretch to relax
  • Park farther away and walk to your destination
  • Take the stairs

The team at the Houston Methodist Weight Management Center is ready to help you on your journey to living a healthier, more active lifestyle. Below are commonly asked questions from patients who are interested in enrolling in or starting a weight loss program. Click on the section for the answers in the following areas:

Weight Management
Weight Loss Surgery
Medical Weight Management Program
Restarting the Medical Weight Management Program
Diabetes and Weight Management

Weight Management
What is the best way to get started on my weight loss journey ?
The first step is to learn about all of the available options. One easy way to do this is to register for a free orientation session at Houston Methodist’s Weight Management Center to learn about our medical weight management programs and weight loss surgery options. 

Weight Loss Surgery
What are the selection criteria for weight loss surgery?
To be a candidate for weight loss surgery , you must meet specific criteria:

 

  • You have a body mass index (BMI) of 40 or greater or BMI of 35 to 39.9 with a significant obesity-related condition, such as diabetes , high blood pressure, heart problems, sleep apnea or reflux disease
  • Prior attempts at weight loss, such as dieting, exercise, behavior modification or medications
  • Understand the possible risks, benefits and side effects of the procedure
  • No medical or psychiatric conditions for which surgery would not be recommended
  • Commitment and motivation with realistic expectations of post-surgery life
  • No other addictive behaviors, such as smoking, drinking and/or drug abuse
  • Willingness to undergo both psychological and nutritional evaluation prior to approval

 

What surgical weight loss procedures are available at Houston Methodist?
Several different surgical weight loss options are available at the Houston Methodist Weight Management Center. Two of the most well-known procedures, the LAP-BAND® and the roux-en-Y gastric bypass (RYGB), are performed by our surgeons. The LAP-BAND® is considered a restrictive surgery (meaning that weight loss occurs by strictly reducing daily food intake) and does not involve cutting or stapling of the stomach. The RYGB surgery restricts the amount of food ingested and causes malabsorption (less absorption of calories and nutrients) by surgically bypassing a portion of the intestinal tract. Our surgeons are also experts in performing the gastric sleeve procedure, which is a minimally invasive laparoscopic procedure in which two-thirds of the stomach is permanently removed.

How does the LAP-BAND work?
The LAP-BAND® is the least invasive weight loss surgery option. This procedure uses a silicone band that is fastened around the upper part of the stomach, greatly reducing the stomach’s capacity to hold food. The banded upper stomach makes you feel full when consuming small amounts of food. The band is adjustable, so tightening it further increases the patient’s sense of fullness and, over time, may continue to reduce daily caloric intake. To tighten the band, the inner surface is inflated by injecting a saline solution into a self-sealing access port located just under the skin. This allows the surgeon to increase or reduce the size of the band to better promote successful weight loss. Though not an intended option, the LAP-BAND® is removable and completely reversible.

How does the gastric sleeve procedure work?
The gastric sleeve, also known as sleeve gastrectomy, is a minimally invasive laparoscopic surgical procedure that promotes weight loss by permanently removing two-thirds of the stomach, while preserving the valve (called the pylorus) that regulates emptying the stomach so food slowly trickles out. Because the stomach is reduced in size, it only holds approximately two to five ounces of food. You feel full with smaller amounts of food and reduce your overall daily caloric intake.


During the procedure performed under local anesthesia, the large portion of the stomach along the curvature is removed. The open edges are then attached with staples to form a sleeve or tube. The entire surgery takes about an hour and involves only approximately five small incisions. Because there is no nasogastric tube or drain, patients return to work and daily activities approximately two weeks following the surgery.

How does the roux-en-Y gastric bypass work?
The roux-en-Y gastric bypass (RYGB) is both malabsorptive and restrictive. This surgery involves creating a small stomach pouch by stapling across the top portion of the stomach, dividing it from the rest of the stomach. The new pouch is about the size of an adult’s thumb and holds about one ounce (two tablespoons), which greatly reduces food portions able to be consumed at one time.

The intestine is surgically restructured so that the small pouch connects directly to the middle part of the intestine (the “roux limb” of the jejunum), therefore bypassing the majority of the stomach and upper intestine (duodenum). Normal digestion and absorption of nutrients are reduced due to the small stomach size and shortened intestine; this decreases absorption of calories and nutrients.

Failing to follow an appropriate diet soon after RYGB can cause a side effect called dumping syndrome. Dumping syndrome occurs when consuming foods or fluids (1) high in sugar and fat, (2) at the same time or (3) in larger amounts that triggers “dumping” or faster emptying from the stomach pouch directly into the intestine. Dumping syndrome can cause symptoms such as abdominal cramping, diarrhea, lightheadedness, sweating and heart palpitations.

What risks are involved with weight loss surgery?
Every surgical procedure has a certain degree of risk. While complications are extremely infrequent at Houston Methodist, possible risks include infection, gastric leaks, pneumonia, pulmonary embolism and, in very rare cases, death. The surgical risks will be discussed with you at length when you meet with our surgeons so you can carefully weigh your decision .

What should I expect after surgery?
Weight loss varies from patient to patient and depends on the procedure you have. Patients who undergo the LAP-BAND® procedure can expect weight loss of one to three pounds per week in the first year after surgery. Though weight loss is gradual, maintaining a structured diet and exercise regimen will promote long-term weight loss. Patients who have the gastric sleeve procedure can anticipate a weight loss of about 60 percent of excess weight. The size of the new sleeve can make a difference in your overall weight loss, as well as changes in your diet, exercise and lifestyle choices long term. Patients who have the RYGB procedure generally experience rapid weight loss that mostly occurs in the first six months to one year after surgery. Long-term, a person may maintain a weight loss of 50 to 60 percent of excess weight. It is important to remember, however, that your eating behaviors must change permanently after weight loss surgery. There is a potential for eventual weight regain if you do not adhere to a diet and exercise regimen or if you eat more than the recommended amounts or increase the frequency of meals.


Some patients may experience heightened anxiety or depression within the first years after surgery. This is usually not serious and can be managed over the phone. Monthly patient support groups at Houston Methodist are available, although they are not mandatory. These sessions are recommended for all weight loss surgery patients and are helpful in managing lifestyle changes and for ongoing social support.

What are the other benefits of surgery?
After surgery, it is common for patients to report a number of additional health improvements. Many patients, for example, are able to reduce or eliminate their previous medications for diabetes, hypertension, reflux and other conditions. In addition to the weight loss and decrease in or complete elimination of medication, many patients also enjoy increased energy and a greater interest in physical activity along with greater self-confidence.

Does my diet after surgery need to change?
The diet after surgery usually starts with clear liquids and progresses gradually to a regular, low-fat diet. The diet progression promotes gastrointestinal tolerance, initial healing after surgery and reduction of potential complications.
 
Immediately following surgery, you will sip clear liquids (one to two ounces every hour). Clear liquids include water, broth, sugar-free fluids (e.g., diet fruit-flavored drinks like Crystal Light®) and decaffeinated, non-carbonated beverages. Over the course of the first month, the diet will slowly change to include low-fiber foods initially, semi-solid foods (blended), soft-textured foods and, finally, a regular diet. Foods should be low in fat and sugar. The portions at each stage of diet progression will gradually increase. Long term, the recommended average portion of food consumed in one setting is about eight ounces (equivalent to one cup).
Food tolerances vary among individuals. For example, a person may react differently to a specific food that may have been tolerated before surgery or that is tolerated by someone else who had the surgery.

Prior to surgery, you will meet with a clinical dietitian for comprehensive instruction with nutrition education regarding diet and recommended behavior changes following surgery.

What is my protein requirement after surgery?
Due to the limited portions, it is important to choose low-fat, high protein foods. The general goal is at least 70 grams of protein per day from food and fluids. Immediately after surgery, protein intake may be limited due to the overall volume restriction of foods and fluids. Eventually, as more solid foods are tolerated, you will be able to consume more protein and achieve your daily goal.

Good sources of protein include meat, poultry, fish, low-fat cheese, low-fat cottage cheese, low-fat tofu, light yogurt and beans/legumes. (Grains and vegetables contain protein in smaller amounts.)

Many people supplement meals with protein powders (e.g., 100 percent whey protein isolate, soy protein isolate or protein drinks like Isopure® and no sugar added Carnation Instant Breakfast®). Ask your dietitian if you have questions regarding protein supplements.

How will I drink fluids?
Foods and fluids cannot be consumed at the same time. Fluids should be consumed on a consistent basis between meals. You should wait at least 30 to 60 minutes before and after meals to drink fluids. Drinking right after meals may expand the stomach pouch or force foods through the intestine at a faster rate, causing uncomfortable side effects (e.g., dumping, vomiting).

Fluids include water, broth, sugar-free fluids (e.g., Crystal Light®), sugar-free gelatin, sugar-free popsicles (no fruit pieces), milk and soy milk. Carrying a water bottle during the day is recommended so that you always have fluids on hand. Take your time drinking.
Avoid caffeinated and carbonated beverages. Caffeine is an appetite stimulant, causing increased urination that may promote dehydration and can interfere with mineral absorption (e.g., calcium). Carbonated beverages can expand the pouch or cause discomfort. Avoid alcohol, which is considered empty calories and may not be well tolerated after surgery.
 
Will I need to take supplements?
Reduced calorie intake, poor digestion/absorption of nutrients and changes in food tolerances may lead to protein or vitamin/mineral deficiencies and poor nutrition. Possible side effects of deficiencies include hair thinning or loss, muscle loss, bone loss (long-term osteoporosis), low iron levels and fatigue.


After weight loss surgery, you are at risk for malnutrition. Daily vitamins and mineral supplementation is required. Your dietitian will recommend specific vitamin and mineral supplements that may include prescriptions from your physician.

Do you have basic guidelines I can follow?
We recommend a number of general diet tips for you to follow.

 

  • Choose sugar-free or low sugar fluids; you may use sugar-substitutes (e.g., Sweet-n-Low®, NutraSweet®, Splenda®).
  • Avoid beverages that contain caffeine, carbonation or alcohol.
  • Choose low-fat, high protein foods for good nutrition.
  • Meats must be lean and low in fat; try other healthy protein foods that include tofu or soy-based products, low fat yogurts/cheeses and beans.
  • Eat the meat or protein first at every meal.
  • Avoid high-fat foods and sugary desserts; monitor portion sizes closely to decrease daily calories.
  • Practice taking small bites (pencil eraser-sized bites) and chew foods thoroughly, approximately 30 chews per bite; stop eating when you are full.
  • Make mealtime last a minimum of 30 minutes.
  • Carry a water bottle during the day and sip fluids on a consistent basis between meals.

 

Will my insurance cover weight loss surgery?
Most insurance companies provide some coverage. Our staff can help you determine the coverage your insurance plan offers. Realizing the medical importance and lifesaving potential of weight loss surgery, we will act as your advocate and work directly with your insurance company to ensure that you receive all available coverage.
 
What if my insurance requires a pre-surgery diet program?
As part of your insurance criteria, you may be required to complete a three to six month program with a registered dietitian to qualify for weight loss surgery . This program is designed to prepare you for the surgery and the lifestyle changes that will follow. Throughout the program, you will work toward established goals that focus on exercise, healthy meal planning and behavior modification.

Our pre-surgery diet program is designed to provide helpful information to ensure the most successful outcome: 

 

  • Assess your diet history and develop a personalized plan to improve your nutrition/behavior prior to surgery
  • Educate and prepare you for the nutrition and lifestyle changes required after surgery
  • Encourage taking responsibility for your diet and lifestyle by closely monitoring your progress
  • Require demonstrated nutrition and behavior changes at the end of the three- or six-month program

 

Your surgeon also may order a pre-surgery nutrition program if deemed necessary for a goal of weight loss prior to surgery. The timeframe and/or weight loss goal will be determined by the surgeon based upon your particular situation.

How should I select a physician and hospital for weight loss surgery?
The decision to have weight loss surgery is an important one, as is determining which physician and hospital is right for you. It is critical to select a center that provides a comprehensive multidisciplinary program. Houston Methodist Weight Management Center’s team of surgeons, physicians, nurses, dietitians and psychologists will care for you from start to finish.
Our surgeons are board-certified in general surgery and have significant abdominal and laparoscopic surgery experience. In addition, Houston Methodist’s Weight Management Center has been designated a level-1 bariatric surgery facility by the Bariatric Surgery Center Network (BCSN) Accreditation Program. We are also licensed by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). We are equipped with intensive care units (ICUs), diagnostic tools, such as CT scanners, 24-hour physician staffing and a full range of medical specialists on staff to help you in any way possible.

Can I have surgery at Houston Methodist if I am from a different city or state?
Our bariatric surgery team will assess the level of care available in your home community and will make every effort to assist you in coming to Houston Methodist for your surgery. Out-of-town surgery patients should expect a three- to seven-day stay in Houston.

How do I set an appointment for the pre-surgery visit?
Call Houston Methodist Weight Management Center to set up your comprehensive pre-surgical appointment. The appointment will take about two-and-a-half to three hours. The required nutritional and psychological evaluations will be performed at this time. You will also meet with the bariatric nurse for anthropometrics (body measurements) and a laboratory test as explained below.

If you are unable to keep your appointment, please call at least 24 hours in advance to cancel or reschedule. Due to busy schedules, we cannot guarantee that you will be seen if you arrive more than 20 minutes late for your scheduled appointment.

What occurs during the pre-surgery visit?
The psychological evaluation includes an interview with the psychotherapist, who will examine past psychiatric and psychosocial history, along with an assessment of coping skills, which is an important factor in dealing with lifestyle changes following weight loss surgery.
A nutritional evaluation involves meeting with the clinical dietitian to discuss past nutritional history, current eating and lifestyle habits, and post-surgery expectations. You will receive a bariatric surgery guide with nutritional parameters, as well as information for your pre-surgery diet program, if required by your insurance or physician. Also, you will be required to attend a 90-minute comprehensive nutrition class that covers diet after bariatric surgery. You will receive the class schedule at the evaluation session.

The bariatric program nurse will check blood pressure and anthropometrics (e.g., weight, height). Also, an H. pylori breath test, if requested by the surgeon, will be performed. H. pylori are bacteria that can cause stomach and small intestine ulcers in some individuals; it has also been linked to certain stomach cancers. This is a critical test to perform prior to having gastric bypass surgery; once the stomach is stapled shut, H. pylori is difficult to treat. The breath test requires that you have nothing to eat or drink (including water and chewing gum) for one hour prior to the test. Please notify the nurse ahead of your appointment if you have taken any of the following drugs:

   
  • Antibiotics
  • Aciphex
  • Prevacid
  • Protonix
  • Nexium
  • Prilosec
  • Prilosec OTC
  • Pepto Bismol

 

A pre-surgery photograph will also be taken at this appointment.

When do I come to the center after surgery?
Long-term maintenance and adherence to both a healthy diet and lifestyle are critical for success. In addition to a follow-up with your surgeon after surgery, it is highly recommended that you come back for nutritional consultation with your dietitian, emotional counseling with your psychotherapist and cardiac rehabilitation with your exercise physiologist or staff to recondition your body. General follow-up after surgery is recommended at one month, three months, six months, one year and annually thereafter.

Houston Methodist Weight Management Center holds regularly scheduled patient support group meetings . Our weight management staff attends these meetings and is always available to address any concerns you may have. These meetings are a great way to network and gain peer support for ongoing postoperative success.
Medical Weight Management Program

What are the eligibility requirements?
You must have a BMI of 30 or greater and be at least 18 years old to be considered for the program. Individuals who have certain conditions or are undergoing certain therapies listed below are not eligible for the medical weight management program. 
   

 

Other medical situations may also prevent you from participating in the program. Please feel free to address any questions with our staff during the free orientation session.

How much should I weigh?
Most people have a particular weight goal in mind when they begin the program. Our staff will work with you to determine a reasonable, achievable and, more importantly, a healthy weight for you based on your personal needs. Regardless of your weight goal, you will begin to see improvements in your health very quickly, often within the first month. Ninety percent of the health benefits from weight loss are achieved with as little as a 10 percent loss of your initial weight.

How often do I need to visit the center?
You will have a clinic visit each week with your nurse and a group session focusing on either nutrition or behavior change. Both laboratory tests and visits with our medical director will take place once per month. Your total time commitment is approximately two hours per week (not including exercise or other weight-loss related activities performed on your own time). Treatment sessions are held at a number of Houston Methodist Weight Management Center locations.

What kind of diet will I be on?
The medical weight management program is comprised of a liquid fasting plan that gradually transitions to a healthy eating plan. You will use a low carbohydrate, high-protein meal replacement beverage for the first phase of the program and will slowly introduce other foods once this initial phase is complete.

How much weight will I lose?
The expected rate of weight loss is two pounds per week, but results vary greatly from person to person. Most people consistently lose between two and five pounds per week on average.

Can I just purchase the beverage?
Our medical weight management program is a medically screened and monitored program that includes not only the use of a meal replacement beverage, but a more important component: support in the form of nutrition education and behavior change. This is a complete program designed to help you make lifestyle changes for permanent weight loss. The meal replacement beverage is only a small portion of the overall process, and therefore is available only for purchase as part of the program.

What kind of diet will I be on when I have finished the fasting portion of the program?
Fasting works well for a limited period of time. Once you have completed the fasting phase (Phase 1) or you are at the point where you can no longer continue the fast, it is time to gradually transition to food (Phase 2). This is done in a controlled, step-wise fashion over several weeks. The meal replacement beverage will slowly be withdrawn and regular food and calories added back into your diet. Your caloric requirements are individual to you and are based on your gender, age, weight, height and level of physical activity. You will ultimately be on a full food diet incorporating a variety of menu items. The ultimate goal is to return you to normal eating with a food plan created just for you, based upon your personal needs and preferences.

Will my insurance cover this program?
Due to limited insurance coverage and a lengthy approval process, we do not accept insurance for our medical weight management program. Instead, we have created a flat rate that offers a significant discount on regular charges for individual services. The package includes the following services: weekly clinic visits with a nurse, dietitian and counselor; weekly group sessions and monthly labs and physician oversight. To learn more about package pricing, please join us for a free orientation session .

How long do I have to be in the maintenance phase?
The maintenance phase is the most difficult phase of the program. During this phase, you will put together all of the knowledge you have accumulated over the previous fasting and transition phases to develop independence in continuing your healthy lifestyle. The maintenance phase (Phase 3) is offered in 16-week blocks. Maintaining weight loss requires a serious commitment from you, so we highly recommend that you remain in Phase 3 for at least a year after you complete your initial weight loss treatment.

How do I get started?
If you are interested in the medical weight management program, please register to attend a free one-hour orientation session to learn more. This is an informational orientation and requires no obligation. Orientations are held at convenient locations in the Greater Houston area. Please call 832.667.LOSE (5673) to reserve your spot, or register online.

Restarting the Medical Weight Management Program
Can I re-enroll as a patient in Houston Methodist’s medical weight management program at any time?
Absolutely; however, you must meet the following criteria:

 

  • BMI of 30 or greater
  • Discharged from the New Beginning (fasting phase) for at least three months

 

I have regained 20 pounds. What should I do if I am not sure if I want to go back on all beverage? How can I get back on track?
If you have regained some of the weight you lost, we invite you to try our programs designed to get you back on track. You can also call us anytime for a consultation to discuss your options, such as resuming the program, returning to an all-beverage diet or attending supportive meetings or events. 

 

  • Learn more about our Step LITESM program.
  • Attend a Living I.T. event.

 

Who do I contact if I have an outstanding bill or a question about my bill before I return?
Please call us for any billing questions you may have at 832.667.LOSE (5673) .

Diabetes and Weight Management
Patients who are obese and have issues with weight management have a greater prevalence for diabetes. Below is general information about the different types of diabetes, who is at risk and how to manage your diabetes while you manage your weight loss. Click here for more information about diabetes education and available support at Houston Methodist.

What is diabetes?
Diabetes occurs when the body is unable to properly use blood glucose (sugar) for energy and the glucose remains in the bloodstream. This causes blood sugar to become elevated. Blood sugar can remain too high for different reasons. The pancreas makes insulin, a hormone that helps the body’s cells use glucose for energy. Individuals with diabetes may stop making insulin or not make enough, or their insulin may not work well enough to properly lower blood sugar levels. Having consistently elevated blood sugar can cause a variety of health problems.

Are there different types of diabetes?
Type 1 and type 2 are the different types of diabetes, both described below in detail.

  • Type 1 diabetes, also referred to as insulin-dependent diabetes or juvenile diabetes, occurs when the immune system attacks cells in the pancreas, causing it to stop making insulin. Only 5 to 10 percent of people have type 1 diabetes. It usually occurs in children, teenagers and young adults, but it can also develop in older adults. Individuals with type 1 diabetes must take insulin daily for life.
  • Type 2 diabetes, also referred to as non–insulin-dependent diabetes or adult-onset diabetes, occurs when the pancreas makes insulin but not enough, or the insulin does not work well. About 90 to 95 percent of individuals with diabetes have type 2. It usually occurs in people 45 years of age or older, but there are growing numbers of children and teens that are also developing type 2 diabetes.

Risk factors for type 2 diabetes include the following:

 

  •  Obesity
  • Family history of diabetes
  • History of gestational diabetes
  • Impaired glucose tolerance
  • Physical inactivity
  • Race and ethnicity (African Americans, Hispanics and Latinos, Native Americans, Asians, and Pacific Islanders are at greater risk for type 2 diabetes.)

 

  • Gestational Diabetes occurs during pregnancy, occurring in about four percent of pregnancies. It usually develops around the 24th week of pregnancy. The development of gestational diabetes is usually related to the production of normal pregnancy hormones, which cause the body to not make enough insulin and prevents insulin from working as well. This results in elevated blood sugar levels. To keep mother and baby healthy, it is important to maintain good control of blood sugar levels during pregnancy. Gestational diabetes usually disappears during the postpartum phase. However, studies indicate that two-thirds of women with gestational diabetes develop type 2 diabetes later in life.
  • Prediabetes is a stage that develops prior to type 2 diabetes. Individuals with prediabetes have higher than normal blood sugar levels, but not high enough to result in a diagnosis of type 2 diabetes. More than 50 million American have prediabetes. Studies indicate that if people with prediabetes do not make healthy changes in their weight, eating habits and physical activity, they will likely develop diabetes within five years.

 

How do I know if I have diabetes?
The following are common signs of diabetes:

 

  • Feeling tired
  • Urinating often
  • Being very thirsty
  • Feeling very hungry
  • Blurry vision
  • An infection that does not heal readily
  • Wounds or sores that do not heal well
  • Possible weight loss

 

If your health care provider thinks you may be at risk for developing diabetes, he or she may perform one of these blood tests:

 

  • A fasting blood sugar test is done after fasting 8 to 10 hours.
  • An oral glucose tolerance test measures how the body responds to sugar. The patient is given a drink with a very high sugar content, and blood is drawn every 60 minutes for up to 3 hours.
  • A random blood sugar test measures the amount of sugar in your blood at the moment it is drawn. It can be done at any time of the day with no regard to food.

 

What can I do if I know I have diabetes?
Finding out that you have diabetes can elicit many feelings about your health and questions about the disease. Each person with diabetes is unique, and a one-size-fits-all approach to disease management may not work for you. In addition, the more you know about diabetes and your health, the more you can preserve your quality of life and stave off future complications. Individuals living with diabetes should meet with a diabetes educator at least once a year to answer questions and learn how to gain control over the disease.
Until you are able to see a diabetes education specialist, you can help manage your health by practicing the four cornerstones of diabetes education: medication, monitoring, diet and exercise.

 
Take your medications
Your health care provider may have prescribed diabetes medication(s) that can help manage your blood sugar levels. Medications may be pills, insulin or other injectable drugs. To gain better control of your blood sugar levels, it is important to take your medications consistently and as prescribed. Please contact your health care provider's office if you have questions about your medication(s).

 

Self-monitor blood sugar levels
Blood sugar levels can be affected by what you eat as well as stress, exercise, illness and medications. Checking your blood sugar level is the best way to see how your treatment plan is working. Depending on your treatment plan, your health care provider may ask you to check blood sugar levels once a day or up to seven times a day. Do your best to check as recommended and bring this information with you when you see your health care provider or diabetes educator. This information will let you and your health care provider know how your medicine, food and exercise are working to control your blood sugar level.

 

Eat healthy
One of the most important ways to manage diabetes is by eating the right foods in the right amounts. Learning how to plan your meals and snacks is important in managing diabetes. You do not need special diet foods, and the foods that are good for you are also good for the entire family. A registered dietitian or certified diabetes educator can help personalize your eating plan.
Follow these basic guidelines for eating healthy:
 

  • Do not skip meals and try to eat at the same time each day. Eat three meals a day, along with one or two snacks.
  • Watch portion sizes.
  • Eat a variety of foods. Add color to your meals and snacks with fruits and vegetables. Choose foods high in fiber such as whole-grain breads, beans, bran cereals, whole grain pastas and brown rice.
  • Limit fat intake and avoid fried foods. Cut off visible fats when possible. Use smaller amounts or avoid gravies, creamy sauces, oil, margarine or butter and salad dressings.
  • Limit sodium intake. Choose fresh or frozen fruits and vegetables and limit processed foods.
  • Plan meals using the plate method to limit portion size and ensure you eat a variety of foods.

 

Be physically active
Being physically active does not mean that you have to join a gym or force yourself to doing something that you cannot tolerate. Increasing your physical activity means sitting less often and engaging in activities you enjoy, so you are more likely to maintain your new activity level. Being more physically active can positively impact your health in many ways:

 

  • Lower blood sugar levels
  • Help your body use insulin better
  • Help lose weight and keep it off
  • Make your heart and lungs work better
  • Lower blood pressure
  • Lower blood lipid levels
  • Make your muscles stronger
  • Lower stress levels

 

The American Diabetes Association recommends exercising for at least 150 minutes every week. This includes aerobic activity, such as walking, swimming, biking, dancing and water aerobics. Doing some exercise every day is ideal. If you cannot commit to 20 to 30 minutes at one time, try breaking it up into two sessions of 10 to 15 minutes during the day. Making small changes in your routine can make a big difference in your health. Try some of these ideas and discover which activities you enjoy:

  • Walk the dog or walk with a friend
  • Do housework
  • Work in the yard or garden
  • Play with the kids
  • Put the remote away or exercise while watching TV
  • Get dancing
  • Stretch to relax
  • Park farther away and walk to your destination
  • Take the stairs