High Protein Diet for Weight Management

When you are looking to gain lean muscle or lose weight, eating a high protein diet is very important and squeezing those meals into a busy schedule is quit challenging. On my journey to gain lean muscle and weight management, I have developed a quit meal that is high in protein and packed with carbohydrates (carbs) to keep you fueled throughout the day.

Fist & Broccoli Diet

Fish and broccoli is high in protein and easy to prepare. Photo by Natura Skin Clinic

Since I love fish and I need two easy meals at work, I eat fish and rice or broccoli at least twice while I am at work from Monday through Friday. I eat two pieces of salmon or tilapia with brown rice or broccoli on my first break, then another meal on my lunch break. These meals are great for me because each piece of fish has at least 21 grams of protein plus the brown rice or broccoli. When you calculate it, you are getting at least 50 grams of protein per meal. After work and during the weekends, I usually eat what I want to make my diet fun and not stressful.

If you don’t like fish or you get tired of it, you can substitute it with a chicken breast, which contains about 43 grams of protein per cup. You can also alternate your sides with a baked potato or a slice of wheat bread for carbs.

The good thing about these two meals is that they are quick and easy to prepare. They are also high in protein and delicious at the same time. With two protein shakes, you could easily have four meals per day and not be stressed about it. When you add a simple exercise routine with these meals, you will be able to maintain your weight while gaining lean muscle as well.

I have been on my diet and exercise plan for about two months now and I have already gained about 10 pounds of lean muscle. I also feel better and I have more energy at work.

For anyone who has a busy work schedule and cannot find the time to cook healthy meals, this easy fish diet will be a great start to maintaining a healthy weight and gaining lean muscle.

Leeman Taylor
Bachelor Degree in Criminal Justice
Real Estate Investor & Internet Marketer

Pasta May Be Good for Your Diet After All

Pasta has always been regarded as bad for you if you eat too much of it but a new Italian study says it may actually help you lose weight.

Pasta Diet

Pasta may help fight obesity and be a good diet choice after all, according to Italian study. Photo by Pasta For All

After analyzing data on thousands of Italians, eating pasta moderately looks to lower the risks of general and abdominal obesity. I love pasta but I try to eat it in moderation and make my meals as healthy as possible. For instance, I use whole grain noodles instead of regular noodles that have no nutritional value.

“Our data show that enjoying pasta according to individuals’ needs contributes to a healthy body mass index, lower waist circumference and better waist-hip ratio,” said George Pounis, first author of the study. Past studies would say that pasta is fattening and should be avoided if you are trying to lose weight so this finding is completely opposite.

“We have seen that consumption of pasta, contrary to what many think, is not associated with an increase in body weight, rather the opposite,” Pounis added in a journal news release.

Pasta is a part of the Mediterranean Diet, which emphasizes fruits, vegetables, beans, peas, olive oil, grains, fish and poultry. This is my type of diet and it is one that I can stick to so it has been working well for me lately.

Pounis and his colleagues at IRCCS Neuromed in Pozzilli, Italy, reviewed results of two large studies including more than 23,000 Italians. One was the Moli-sani Project, which involved citizens living in the Molise region — a little more than halfway down the boot. The other was the Italian Nutrition and Health Survey, which focuses on eating habits in all Italian regions.

The study did not mention how much pasta you can consume without getting fat. However, it did say that over eating pasta will make you fat.

“The obese population was older and at lower socioeconomic status, had higher waist and hip circumferences and waist-to-hip ratio, and consumed more pasta [grams per day] than normal or overweight participants,” wrote lead author Licia Iacoviello and colleagues, according to CNN.

After learning that eating pasta in moderation may actually help you lose weight, I believe that the Mediterranean diet is a good health choice for your diet.

Source: Pounis, G. “Association of pasta consumption with body mass index and waist-to-hip ratio: results from Moli-sani and INHES studies” Nutrition & Diabetes 4 July 2016

Leeman Taylor
Bachelor Degree in Criminal Justice
Real Estate Investor & Internet Marketer

When Summer Work Slows, Workout

Nearly each day, Sergio Perez walks to the supermarket from his Miami office to grab lunch, trekking about a mile each way. While the heat can be intense in summer months, Perez, who works 50 to 60 hours a week in financial services, says the routine is the easiest method to fit fitness into his work life balance. Working long hours weekly can be a hassle for weight loss, but you can find time in the summer when work slows down to exercise.

Summer Workout

Working long hours weekly can be a hassle for weight loss, but you can find time in the summer when work slows down to exercise. Photo by Daily Mail

When I hear friends converse about exercising, they usually discuss boot camps, running marathons or joining cross-fit training classes.

However, fitness experts say that while those exercise programs are admirable, high performance exercise is more than needed to receive benefits. Also, they say summer is the best time to start routines like Perez’s that fit easily into your work-life and can improve your health.

“It’s not about who works out the hardest or longest. It’s just about doing something, most days of the week,” says Chira Cassel, co-founder and director of The Sacred Space Miami, a wellness center.

The American Heart Association recommends at least 30 minutes of moderate-intensity physical activity for adults each day. Walking with a friend is a great way to start and get motivated about weight loss. As Aaron E. Carroll, a professor of pediatrics at Indiana University School of Medicine, notes, walking briskly, at 3 to 4 miles per hour or so, qualifies. So does bicycling slower than 10 miles an hour, or swimming a few nights a week. Anything that gets your heart rate somewhere between 110 and 140 beats per minute is enough, he says.

According to the American Time Use Survey released Friday by the Bureau of Labor Statistics, people only exercised or participated in sports 18 minutes per day on average. Men were more likely than women to exercise on a given day, 23 percent compared with 18 percent.

Since the summer contains longer days, less intensive work hours and fewer childcare responsibilities, it is much easier to find time for exercise. I agree that a convenient routine is one you are more likely to stick to. I go to the gym after work for about 40 minutes each day and this is very convenient for me so I have been consistent. Working out with a partner is motivation and it will help the both of you to be consistent with your routines.

Mixing up your workout routine, and scheduling exercise on your calendar gives you a better chance of follow-through, says Raeah Braunschweiger, a health fitness specialist with the UHealth Fitness and Wellness Center in downtown Miami. She suggests trying new trends like barre fitness or belly-dancing: “Find something you find fun. People get stuck in a rut and then start to question why they are doing this.” I think that joining classes are fun and trying new routines will keep you from getting bored over periods of time.

Overall, there are many benefits of working out such as stress relief, minimizing serious health risks and not to mention, weight loss. Start today on your weight loss journey to get fit and become a healthier you.

Source: Goodman, C. Miami Herald www.miamiherald.com July 4, 2016

Leeman Taylor
Bachelor Degree in Criminal Justice
Real Estate Investor & Internet Marketer

‘Stomach Pump’ Weight Loss Device Approved by FDA

Obese people who are struggling to lose weight may have a new option, but it may seem very unusual for some.

Asire Assist Bariatrics

FDA approves new ‘stomach pump’ weight loss device to cut a third of your calories. Photo by CBS News

The FDA approved a new device known as the AspireAssist. You do not have to undergo major surgery and it works by removing some of what is inside your stomach through a tube after you eat, cutting about a third of your calories.

The device is made up of a surgically placed tube in the stomach that removes food in the stomach after you eat just before the food is digested. Patients drain about a third of what is in their stomach,” says Katherine Crothall, PhD, president and CEO of Aspire Bariatrics, Inc., the developer of the device. I think that is a good percentage of contents removed that could lead to more weight loss that regular digestion.

The trial included 111 patients who had counseling about nutrition and exercise with 60 people who got the counseling alone. After twelve months, those who used AspireAssist lost an average of 12 percent body weight, while the counseling-only group lost over 3 percent.

The good thing is that both groups showed a little improvement in obesity related health issues such as diabetes and high blood pressure.

The device is intended for adults who are obese with a BMI of 35 to 55, who have not lost weight or kept the pounds off through non-surgical treatments. It is recommended for individuals to receive counseling on exercise and healthy eating so they will make long term lifestyle changes.

The thing I like most about this device is that it is less invasive than weight loss surgery and possibly a lot less risky. Surgery does lead to more weight loss though, says Stacy Brethauer, MD, a staff bariatric surgeon at Cleveland Clinic. He is familiar with the device but has to relation to the company.

Side effects of the AspireAssist include nausea, indigestion, diarrhea, constipation and vomiting, according to the FDA.

If you calculate the treatment, including the device placement, monitoring, lifestyle counseling and follow-up, you could be expected to pay anywhere from $8,000 to $13,000 in the first year. This is not so bad compared to the cost of weight-loss surgery, which could range from $30,000 to $35,000, says John Morton, MD, immediate past president of the American Society for Metabolic and Bariatric Surgery. Insurance may cover the cost for patients who qualify which is a great idea in my opinion.

It is hard to tell how big of a role this device can play in weight loss, but if patients use the device properly and stay dedicated, then there is no doubt they will lose weight.

Source: www.fda.gov “FDA approves AspireAssist obesity device” June 14, 2016

 

Leeman Taylor
Bachelor Degree in Criminal Justice
Real Estate Investor & Internet Marketer

Weight-Loss Surgery May Boost Survival

Weight loss surgery may greatly reduce obese people’s risk of premature death, a new study says.

Gastric Bypass Weight Loss Surgery

Weight loss surgery may boost survival for obese, says study. Photo by Healthy Hippie

Nearly five years after surgery, the death rate was over one percent for the individuals who had weight loss surgery and four percent for those in the non-surgical group, according to researchers.

The study was led by Christina Persson from the University of Gothenburg in Sweden, who analyzed data from almost 49,000 obese people in Sweden. They were between 18 and 74 years of age.

Over 22,000 people had weight-loss surgery between 2000 and 2011. About 93 percent of the people in the surgery group had the procedure known as gastric bypass. The study compared them with approximately 26,000 people who did not have surgery.

According to the research, the overall death rate was reduced by 57 percent in the surgery group, compared to the non-surgery group. This number remained consistent after researchers adjusted for age and other previous diseases such as diabetes, cancer and heart disease.

Heart disease, cancer, suicide and accidents were the most common causes of death among those who did not have the surgery.

Cancer and heart disease accounted for most of the major difference in mortality rates between obese people who underwent weight-loss surgery and those who did not, says researchers.

Losing weight is not easy for anyone overweight so undergoing weight loss surgery should be recommended by doctors or health care providers. A death rate that is decreased by about 60 percent is amazing and I believe more obese people should consider having gastric bypass surgery to increase his or her survival.

According to the CDC, over one-third of adults in the U.S. are obese, so this is a very serious issue. There is no overnight success or magic pill that will make you lose weight so it really does take hard work and dedication.

The study was set to be presented Thursday at the European Obesity Summit. Findings presented at meetings are usually viewed as preliminary until they have been published in peer-reviewed journals.

Leeman Taylor
Bachelor Degree in Criminal Justice
Real Estate Investor & Internet Marketer
Source: European Obesity Summit, news release, June 2, 2016

‘Biggest Loser’ Study Reveals Struggle After Weight Loss

Everyone knows how difficult it is to lose weight if you have ever been on a diet. More important, once you do have weight loss success, keeping the weight off is another struggle. A recent study involving contestants from TV show “The Biggest Loser” demonstrates what really happens after weight loss.

Biggest Loser - Weight Loss

‘Biggest Loser’ study shows how difficult it is to keep the weight off, years later. Photo by Reality Tea

In the study, all but one contestant had regained at least some of the weight lost after six years, during the 30-week TV competition, according to Obesity.  The participants had regained about 90 pounds or 70 percent of the weight they lost. This just demonstrates how hard it is to fight obesity and maintain a healthy weight, even with a competition that has incentives.

There is no magic pill or formula for fat loss but here are a few answers to questions for people who are struggling with weight loss:

If you lose weight slowly, are you more likely to maintain weight loss?

Although many dieters get this advice, studies have shown otherwise including a recent Australian study. In this study, 204 obese people were instructed on live on 450 to 800 calories a day for 3 months, or limit themselves to 400 to 500 calories a day for 36 weeks. The overall goal was a 15 percent weight loss. After three years, almost everyone regained the weight they had lost, regardless of the counseling on diet and exercise. There was no change in the levels of the two hormones, ghrelin and leptin, which increases hunger. More individuals in the rapid weight loss group did lose at least 12 percent of their weight (80 percent, compared to 50 percent in the slow loss group) and fewer called it quits (3 percent, compared to 18 percent).

Will you maintain a higher metabolism if you build muscle through exercise, such as weight lifting?

Muscle does burn more calories than fat, so you may think that the more muscle you have, the faster you will burn calories. In fact, a study showed that building muscle has nearly no effect on resting metabolism, which is the amount of calories a person burns while at rest. According to the study, the muscle we build is small compared to the total amount of skeletal muscle on our body. This muscle is at rest most of the time and no one can go around and flex their muscles all day.

Should you avoid snacks to maintain weight loss?

Even though it seems that snacking packs on the extra pounds, studies that randomly assigned individuals to snack or not have not confirmed this, and even studies that observed people have not found that snacks undermine fat loss.

Is there a certain type of diet that keeps weight off?

Many individuals are convinced that low fat or low carb diets are the best for weight loss. However, Dr. Lee Kaplan, an obesity researcher at Harvard, says that there is no weight loss program or diet that is guaranteed to work but that individuals can often keep a loss of 5 percent of their weight, which comes with many health benefits. He tells his patients to try different weight loss programs until they find one that works for them.

Will doing vigorous cardiovascular exercises after weight loss speed up your body’s slowed metabolism?

As long as you are not consuming more calories than you burn you are okay. Although this sounds like a simple task, “this is not as easy a proposition as it sounds,” says Dr. Michael Rosenbaum, a doctor and obesity researcher at Columbia University. The brain controls your hunger and your food cravings, and it is very easy to accidentally consume more calories than you burned exercising. That is a major reason studies that use exercise alone to help individuals lose weight have usually failed to find an effect. Did you know that after you lose 10 percent of your weight by diet alone, your muscles begin using genes that make them more efficient? They actually burn 20 to 30 percent fewer calories for the exact exercise.

Is there hope for weight maintenance?

Do not let this Obesity study discourage you if you are currently overweight or obese. This research is just to show you that anyone can be treated if they seek help sooner and start now. Weight loss is a lifelong process that includes proper dieting, daily physical activity, counseling, medication or even surgery. The best option is to consult with your physician about a weight loss plan that fits you and start your journey for a healthier life today!

Leeman Taylor
Bachelor Degree in Criminal Justice
Real Estate Investor & Internet Marketer

Source: Fothergill, E., Guo, J., Howard, L., Kerns, J. C., Knuth, N. D., Brychta, R., Chen, K. Y., Skarulis, M. C., Walter, M., Walter, P. J. and Hall, K. D. (2016), “Persistent metabolic adaptation 6 years after “The Biggest Loser” competition. Obesity. doi: 10.1002/oby.21538 May 2 2016  http://onlinelibrary.wiley.com/doi/10.1002/oby.21538/full

Kolata, G. “Short Questions to Hard Answers about Weight Loss” The New York Times May 4 2016 www.nytimes.com

Beans, Chickpeas May Aid Weight Loss

Beans, peas, lentils and chickpeas may be great for weight loss, according to a new Canadian research study.

Beans, Chickpeas Aid Weight Loss

Beans, chickpeas or also known as “pulses”, help you feel full to lose weight. Photo by the Globe and Mail

Data from 21 clinical trials that was analyzed on foods known as “pulses”, found that they can help people on a diet feel full and lose unhealthy weight. Beans, peas and other legumes are some of my favorite foods in my diet so this is good news for me as well. I could eat beans almost every day with rice and not get tired of it. Consuming these pulses on a regular basis means I am maintaining my weight while eating something I enjoy at the same time.

“Though the weight loss was small, our findings suggest that simply including pulses in your diet may help you lose weight, and we think more importantly, prevent you from gaining it back after you lose it,” study lead author Russell de Souza, a researcher at St. Michael’s Hospital in Toronto, said during a hospital news release.

These foods are high in fiber, protein, vitamins and minerals so there is no question how they help you lose weight or lower cholesterol levels if consumed regularly.

The new analysis in the trial included a total of 940 adults who began eating one serving (3/4) cup of pulses each day. They lost 0.75 pounds on average over a six week period without making any extra effort to stay away from other kinds of foods, said researchers. This may not seem like a lot of weight loss but the fact that pulses suppress appetite is the main point. When you feel full, you eat less. The Canadian team also noted that pulses have a “low glycemic index” — meaning that they break down slowly in the digestive tract.

Prior research has found that one serving of legumes makes individuals feel fuller. Each time I eat a few good servings of beans or peas I always have a low appetite and feel less hungry later.

“This new study fits well with our previous work, which found that pulses increased the feeling of fullness by 31 percent, which may indeed result in less food intake,” Russell de Souza, the study’s lead author and researcher with the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, said in a statement.

I love the fact of adding foods to your diet instead of removing them to lose weight and most diets fail according to research. It excites me even more that eating beans and peas has been shown to lower bad cholesterol while lowering the risk of heart disease at the same time.

To say the least, if you love beans, chickpeas or other legumes like I do, you should eat them more often to lose weight and improve your health for the future.

Leeman Taylor
Bachelor Degree in Criminal Justice
Real Estate Investor & Internet Marketer

Source: Souza et al. “Effects of dietary pulse consumption on body weight: a systematic review and meta-analysis of randomized controlled trials” Am J Clin Nutr ajcn124677First published online March 30, 2016.doi:10.3945/ajcn.115.124677

Small Weight Loss Has Big Health Benefits

Obese people who lose just 5 percent of their body weight can reduce the risk of heart disease and Type 2 diabetes and increase their metabolic function, says a new study.

Small Weight Loss

Losing 5 percent of your body weight has reasonable health benefits, study says. Photo by New Pittsburgh Courier

There are many current treatment guidelines that recommend patients lose about 5 to 10 percent of their body weight in order to receive health benefits, but the recommendations were focused on prior studies that did not differentiate between individuals who lost only 5 percent of their body weight and those who lost more weight.

In this study, 40 obese individuals with signs of insulin resistance were randomized to either go on a low calorie diet to lose 5, 10 or 15 percent of their body weight or just maintain their body weight. According to the journal Cell Metabolism, the study found that 5 percent weight loss was enough to lower multiple risk factors for heart disease and type 2 diabetes. To put this in perspective, a 200-pound individual could lose just 10 pounds to improve their health profile. This is more encouraging in my opinion because it’s a realistic goal and it is much easier to achieve than losing 10 percent of that 200 pounds.

“Even though five percent weight loss may not have dramatic cosmetic benefits, it does have significant health benefits,” said the study’s author, Dr. Samuel Klein, director of the Center for Human Nutrition at Washington University School of Medicine. “You’re much healthier on the inside, and it’s a really reasonable and legitimate target for people with obesity.”

This study should be a reminder to obese people that a 5 percent weight loss is really a success and not a failure. Diet and exercise can be difficult for any individual overweight and when you do not see any immediate physical changes, you may feel discouraged. This study is a good example to remind you that you are actually fighting diseases and improving your overall health by losing a little weight.

Obesity is a major risk factor for chronic health conditions, such as diabetes, cancer and heart disease. Taking short walks and making small changes to your diet is a good way to start weight loss to improve your health today.

“Our findings show that even a small amount of weight loss has important health benefits for multiple organ systems,” Klein said. “We hope that these findings will encourage obese people to take reasonable steps to watch what they eat and increase their physical activity, because this will translate into a lower risk for diabetes and heart disease.”

To say the least, some weight loss is better than no weight loss at all or even making an honest effort. Just because you don’t see instant physical results it does not mean you are not becoming healthier inside. Losing just 5 percent of your body weight is really a success so this should be encouragement to keep losing weight and receiving the nice health benefits that come along with it.

Leeman Taylor
Bachelor Degree in Criminal Justice
Real Estate Investor & Internet Marketer

Source: Magkos, Faidon et al. “Effects of Moderate and Subsequent Progressive Weight Loss on Metabolic Function and Adipose Tissue Biology in Humans with Obesity” Cell Metabolism 22 February 2016

Exercise Alone May Not Lead to Weight Loss

Many of us tend to believe that more exercise is better for burning calories and weight loss. However, this is not the case according to a new study published in Current Biology.

Exercise May Not Lead to Weight Loss

Exercising more than average may not help you lose weight, according to new study. Photo by Women’s Health Magazine

According to researchers, when we increase our exercise regimen our bodies adapt to the energy expenditure which causes us to reach a plateau. This means there is a limit to the amount of calories we can burn through exercise. This study is not to discourage exercise which is essential to keeping your mind and body healthy, but to shed light on how important dieting is for losing weight.

Lead researcher Herman Pontzer, PhD, a professor of anthropology at City University of New York, and Edward L Melanson, PhD, an associated professor in the division of endocrinology, metabolism, and diabetes at the University of Colorado Anschutz Medical Campus, Auroro measured the daily activity of more than 300 men and women. They came from the U.S., Africa and Jamaica. People in some of those countries are usually more active physically than many Americans.

Although they did not track whether the people lost weight or gained, they had a record of their body mass index (BMI) and calculated their calorie burning for 7 days. As people got more exercise, the calories burned did not rise very much. People who had average physical activity lost about 200 more calories than those who were inactive. Unfortunately, those who exercised more than the average saw no change in the amount of calories burned.

According to Pontzer, moderate exercisers are active “but not serious athletes”. For example, someone who rides a bike to work or walks a couple of miles each day. Although this study did not focus on the role of exercise in weight loss, Pontzer does mention that diet and exercise work together as an effective fat loss strategy.

This study seems to point out that the obesity epidemic may be caused by overeating rather than inactivity. I have always heard the saying that “abs start in the kitchen” so I understand how important diet is already. I also understand how over working out at the gym is not effective as well. Pontzer says that our body adapts to our exercise routine if we are more active which creates an energy expenditure plateau. This is why many people wonder why they workout at the gym for hours every day and see no weight loss results.

The researchers believe that our body has a “sweet spot”, a point at which the calories burned during workouts peak. The way to find it is to pay attention to your body, Pontzer says. If you feel worn out and need more time to recover from exercise, you may be over doing it and need to work out less.

To say the least, diet should be the first step in weight loss but exercise must be included as well for preventing diabetes, stress, high blood pressure and heart disease.

Leeman Taylor
Bachelor Degree in Criminal Justice
Real Estate Investor & Internet Marketer

Source: Pontzer, Herman et al. “Constrained Total Energy Expenditure and Metabolic Adaptation to Physical Activity in Adult Humans” Current Biology 28 January 2016

Side Effects from This Weight Loss Method

Although the majority of individuals who have a type of weight loss surgery say their overall health has gotten better, a large number of side effects and visits to the hospital are reported as well, says a new study.

Weight Loss Surgery

Side effects from one weight loss surgery include stomach pain and fatigue, says study authors. Photo by Massey Medical

Gastric bypass is a surgery that helps you lose weight by altering the way your stomach and small intestines handle food according the U.S. National Library of Medicine. Your stomach will be smaller after surgery and you will feel full with less food. You still have to eat right and be physical after surgery to stay healthy and keep the weight off so keep that in mind.

Over 1,400 individuals completed surveys who underwent gastric bypass surgery in Denmark between the years of 2006 and 2011. It showed that only 7 percent revealed decreased health after they underwent the surgery but a shocking 89 percent experienced side effects. About 5 years after surgery, side effects such as fatigue and stomach pain were reported while 29 percent were hospitalized.

About 70 percent of the patients sought medical care for their problems and the most common rationale for seeking medical attention was fatigue (34 percent), abdominal pain (34 percent), anemia (28 percent), and gallstones (16 percent), say authors.

Women, those under the age of 35, smokers and the unemployed were those most likely to have side effects after surgery. Patients who also had the most symptoms had an overall lower quality of life which could lead to depression.

Health care providers should focus on quality of life between patients who are having several symptoms to help them prevent depression. “Focus on the [quality of life] among patients with many symptoms may be required since such patients are at risk of depression. Development of new weight-loss treatments with less risk of subsequent symptoms should be a high priority,” study leader Dr. Sigrid Bjerge Gribsholt, from Aarhus University Hospital in Denmark, and colleagues wrote.

There are already new alternatives to weight loss surgery being developed such as the balloon pill and other devices that aid fat loss. Technology is always advancing so there will be more developments to come to help individuals lose weight fast.

Weight loss can be difficult for anyone especially if you are morbidly obese so gastric bypass surgery may be a better option for you. Diet and exercise is most important so consulting with your physician about a plan to lose weight should be a priority.

If your New Year’s Resolution is to lose weight and stay fit, talk with your doctor today about a weight loss plan that is right for you.

Leeman Taylor
Bachelor Degree in Criminal Justice
Real Estate Investor & Internet Marketer

Source: Gribsholt SB, Pedersen AM, Svensson E, Thomsen RW, Richelsen B. Prevalence of Self-reported Symptoms After Gastric Bypass Surgery for Obesity. JAMA Surg. 2016.