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Understanding the Negative Health Effects of Obesity

Currently, obesity rates in America are among the highest they have ever been. Delaware itself has one of the highest rates of obesity in the nation, with more than 1/3 of all adults being classified as overweight or obese. Body mass index (BMI) is a measure used to classify weight status. It is a ratio of height and weight. A body mass index greater than 30 is indicative of obesity. Excess body weight has been linked to a number of negative health effects.

There is a strong association between obesity and diabetes. Studies show that 85% of those who have Type II diabetes are overweight or obese.  Those with uncontrolled blood glucose (blood sugar) can develop other negative health risks including kidney disease, cardiovascular disease, vision impairment, or amputation.

Joint Pain
Joint pain is another common condition associated with obesity. Excess weight puts tension and pressure on your body and this typically results in pain or discomfort in certain joints and muscles. Joint pain can often be alleviated when there is a decrease in excess body weight, even in small amounts.

Obstructive Sleep Apnea
Sleep apnea is a disorder where breathing stops for several seconds multiple times per night while you are asleep. When this happens, there isn’t adequate oxygen being delivered throughout the body. Sleep apnea leads to daytime sleepiness which can affect quality of life as well as energy levels. Untreated sleep apnea is a risk factor for heart disease and accidents.

Increased Cancer Risk
Long-term obesity can lead to an increased risk for many different types of cancers, including colon cancer, kidney cancer, and breast cancer. The National Cancer Institute states that the relationship between obesity and cancer is complex, but more is being researched regarding possible causes. Excess fatty tissue and excess inflammation have both been deemed risk factors for certain cancers.

Nanticoke Weight Loss and General Surgery

While there are harmful conditions associated with obesity, there has been a tremendous advancement in obesity management and treatment. Obesity is now classified as a disease but can be modified or improved.

There are a variety of non-surgical and surgical options to address obesity. If you suffer from any of these health conditions or are struggling to maintain a healthy weight, contact Nanticoke Weight Loss and General Surgery, located in Seaford, Delaware.


Hydration and Bariatric Surgery: The Basics

When you think of weight loss surgery, a lot of the focus is placed on the eating habits that will have to change after the surgery. What you may not think about, however, is the drinking habits that are associated with weight loss surgery and how important they become.

Weight loss surgeries such as bariatric surgery restrict your stomach, which is designed to help you cope with hunger. This also means not being able to hold as much fluid in your stomach. Without a plan in place, this can pose a serious hydration problem.

Below are some basic tips for staying hydrated after bariatric surgery.

Stick To Water

While it may be tempting to drink juice and soda, they do not hydrate you the way water does; and with limited space in your stomach, you want to make sure all the liquid you take in is hydrating you to the fullest.

Keep A Water Bottle On You At All Times

After bariatric surgery, you will not be able to drink a whole bottle of water at a time to catch up if you haven’t been drinking water throughout the day. Instead, you will need to constantly take small sips of water. The best way to ensure you are doing this is to have a bottle of water with you at all times. This will serve as a reminder to continue drinking throughout the day.

Use Cups Of Ice

It can be difficult to get used to drinking small sips at a time after bariatric surgery, especially if you’re used to drinking large amounts of water at a time. One way to train yourself to take small sips is to fill a large cup with ice and drink the water as it melts. This will ensure you are only drinking small portions at a time and will also make you drink water regularly throughout the day.

Utilize Technology

Just like food and exercise tracking, you can download a water tracking app. Not only will this track the amount of water you are drinking per day, it will also give you regular reminders if you fall behind your scheduled goal.

Bariatric surgery is designed to allow you to lose weight and lead a healthy life; however, it does require you to make lifestyle changes. Hydration is an important part of that lifestyle change.

If you’re interested in weight loss surgery options such as bariatric surgery, contact us at Nanticoke Weight Loss and General Surgery.

How Setting Boundaries Can Help With Weight Loss

When it comes to weight loss, many people find that the difficulty is not losing the weight, but rather keeping the weight off. There are many reasons for this, but a lot of it comes from not setting proper boundaries regarding lifestyle habits. It can be very difficult to completely change or alter routines that you have had in place for years prior to losing weight. If you don’t set the proper boundaries, it is very easy to slip right back into your old routine.

Below are three boundaries you should set for yourself to ensure you follow through with weight loss goals and maintain a healthy lifestyle.


While we all understand how important exercise is, it can be difficult to stick to an exercise regiment if you do not set certain boundaries. The first is choosing a place to work out. It can be a gym, a friends house or your own home, but establishing where you will exercise is the first boundary you should set to ensure you stick with it. Next, you will want to set a schedule to make sure you have a specific time you will be working out. This will allow you to make sure you are free to work out and are not constantly skipping workouts.


In order to set proper snacking boundaries, you will need to be honest with yourself. Can you handle having snacks in the house? Are you able to limit snacks to small portions once or twice a week? If you are not able to do these things, you need to have an honest conversation with those around you about getting snack foods out of the house. If you cannot resist the temptation to snack in your home, making your home a “snack-free” zone is the best idea for you.

Eating Out

Depending on your lifestyle, this can be a very difficult boundary to set, especially if you are in a relationship with someone that enjoys going out. If you are serious about your weight loss goals, you will have to limit your exposure to eating out, as restaurant food typically contains added sugar and salt. Setting boundaries regarding the number of times you eat out, as well as what restaurants to go to will help keep you on track with your weight loss goals.

A weight loss regiment takes a lot of dedication. In order to truly realize all of your weight loss goals, you should set boundaries that are clear and definitive to make sure you stay on task.                   

For more weight loss tips, contact us at Nanticoke Weight Loss and General Surgery.

Dieting Without a Support System? Here’s How You Can Still Achieve Your Weight Loss Goals

About one out of every three adults in the U.S. is considered to be obese. That being said, it isn’t always easy to start and stick to a diet that requires immense lifestyle changes. If you’re fortunate, you’ll have your friends and family cheering you on and providing emotional support every step of the way. But if not, that’s okay. Although difficult, it’s still possible to achieve your medical weight loss goals on your own. Here are just a few tips to keep in mind for those who are on their dietary journeys without emotional support from friends or family members.

Avoid tempting situations.

Many people hear the words ‘lack of emotional support’ and automatically assume that this means friends and family members are talking negatively about their weight loss goals. But the fact is, emotional support, or lack thereof, comes in many forms, and one of the most common signs of lack of support is when friends or family members try to tempt you with food in spite of your dietary goals. If you’ve made your weight loss goals clear to friends and family and they still pressure you to have ‘just one bite,’ it’s probably a better idea to start declining invitations to these kinds of food-based gatherings altogether.

“Loved ones may offer unhealthy foods, invite you to eat out often, or bring unhealthy foods into the house. If you are a people-pleaser you will likely find it more difficult to say no. Learn to politely decline offers, and realize this does not make you a bad person,” writes MyFoodDiary. It is important to set boundaries with others to protect your health and wellbeing. You may meet resistance at first, but in time people will respect your decisions.

Take time to self-reflect.

It can be understandably difficult to process your emotions about your ongoing weight loss journey without the listening ear of a friend or family member. In these cases, it’s always a good idea to channel your emotions in a healthy way. Treating your emotions with foods, drinks, or candy is not a healthy coping mechanism. Having a healthy way to express yourself will help to process your emotions and guide you further along your weight loss journey.

Dieting without emotional support is certainly challenging, but these tips can help you get started. For more information about finding the right weight loss program, contact Nanticoke Weight Loss and General Surgery at 302-536-5395.


Guide To Preparing For Gastric Bypass Surgery (Part 2)

In the last post, we discussed some of the most essential steps for properly preparing for weight loss and bariatric surgery such as gastric bypass. Taking the right steps all the way up until the day of your procedure is the best way to maximize weight loss potential and results. Here’s part two of our guide that will address some more steps to prepare for gastric bypass surgery.

Medications up to One Week Before Surgery

At the one week mark, most experts recommend avoiding aspirin and other aspirin products. This also applies to blood thinners. The best measure is to talk to your doctor before taking any medications, whether they’re prescription or over the counter. This is especially true when it comes to the week before your surgery, since some medications may react with the anesthesia.

Your Diet One to Seven Days Before Surgery

The week before your surgery, you should be consuming a full liquid diet. This is reviewed with you by the surgeon. This is a necessary step to prepare you for your bariatric procedure. For a specific list of appropriate liquids or if you are unsure about your dietary restrictions, talk to your weight loss doctor. It’s also a good idea to take some time to care for your emotional health; you may feel nervous or uneasy about the surgery, which is completely natural.

“Begin thinking about what factors have contributed to your weight and what has been in the way of making changes in your life… Consider starting a list or journal of healthy and motivating lifestyle changes you are making. Develop a support network of positive, caring people. Find alternative ways of coping with emotional eating. Remember that making lifestyle changes is a process that takes time — take small steps, set realistic goals and stay positive,” says UWHealth.

In a study funded by the U.S. Department of Health and Human Services, patients who had gastric bypass surgery lost an average of 64.8 pounds and those who had gastric sleeve surgery lost about 55 pounds within one year. Taking the right steps before your weight loss surgery can help you maintain a healthy lifestyle after the procedure.  In fact, those that tend to practice healthier habits prior to their surgery can far exceed the national average for weight loss statistics. For more information about medical weight loss surgery options, contact Nanticoke Weight Loss and General Surgery at (302) 536-5395.

Nanticoke Weight Loss Recognized for Quality in Bariatric Surgery

Highmark Blue Cross Blue Shield (BCBS) Delaware has recognized Nanticoke Weight Loss & General Surgery with a Blue Distinction® Center for Bariatric Surgery designation as part of the Blue Distinction Specialty Care program. Blue Distinction Centers are nationally designated hospitals that show expertise in delivering improved patient safety and better health outcomes, based on objective measures that were developed with input from the medical community.

To receive a Blue Distinction Center for Bariatric Surgery designation, a health care facility must demonstrate success in meeting patient safety measures as well as bariatric-specific quality measures, including complication and readmission rate for laparoscopic procedures in sleeve gastrectomy, gastric bypass and adjustable gastric band. A health care facility must also be nationally accredited at both the facility and bariatric program-specific levels.

In 2017, the Blue Distinction Centers for Bariatric Surgery program expanded to include not only the type of service provided, but also the site of care. Health care facilities were evaluated as either a comprehensive center or as an ambulatory surgery center.

Nanticoke Weight Loss & General Surgery is proud to be recognized by Highmark BCBS Delaware for meeting the rigorous Blue Distinction Center quality selection criteria for bariatric surgery set by the Blue Distinction Specialty Care program.

Bariatric surgeries are among the most common elective surgeries in the U.S., which provides significant opportunity to improve quality within the health care system. There were 196,000 bariatric surgeries performed in 2015, according to the American Society of Metabolic and Bariatric Surgery (ASMBS), and the average cost is more than $28,000 per episode, according to the Journal of the American Medical Association. Furthermore, it is estimated that nearly 36.5 percent of U.S. adults and 17 percent of youth are obese and impacted by obesity-related health conditions, according to the Centers for Disease Control and Prevention (CDC). The estimated annual health care costs of obesity-related conditions are nearly $210 billion per year in the U.S., according to the Journal of Health Economics. On average, health care costs were reduced by 29 percent within five years following bariatric surgery, due to the reduction or elimination of obesity-related conditions, according to ASMBS.

“The Blue Distinction program gives Highmark BCBS Delaware members the ability to choose their Providers based upon reliable quality and safety information. It also provides a pathway for exceptional Providers to demonstrate their value, and delivers the kind of transparency necessary for members to make informed value-driven health care decisions. We congratulate our Blue Distinction Specialty Care Providers on their accomplishment and thank our members for choosing Highmark BCBS Delaware,” said Dr. Charles DeShazer, Vice President and Executive Medical Director, Clinical Services, Medical Policy & Quality.

BCBS companies across the nation have recognized more than 550 health care facilities as Blue Distinction Centers for Bariatric Surgery. Health care facilities recognized with this designation are assessed using a combination of publicly available quality information and cost measures derived from BCBS companies’ medical claims.

Since 2006, the Blue Distinction Specialty Care program has helped patients find quality specialty care in the areas of bariatric surgery, cancer care, cardiac care, maternity care, knee and hip replacements, spine surgery, and transplants, while encouraging health care professionals to improve the care they deliver. Research shows that, compared to other health care facilities, those designated as Blue Distinction Centers demonstrate better quality and improved outcomes for patients.

For more information about the Blue Distinction program and for a complete listing of the designated facilities, please visit To learn more about services provided by Nanticoke Weight Loss & General Surgery, visit

About Highmark Blue Cross Blue Shield Delaware

Highmark Blue Cross Blue Shield Delaware serves approximately 440,000 members through the company’s health care benefits business and hundreds of thousands of additional members through the Blue Card program. Headquartered in Wilmington, it employs more than 600 people. Highmark Delaware is an independent licensee of the Blue Cross and Blue Shield Association. For more information, visit

About Blue Cross Blue Shield Association

The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide health care coverage for one in three Americans. BCBSA provides health care insights through The Health of America Report series and the national BCBS Health Index. For more information on BCBSA and its member companies, please visit We also encourage you to connect with us on Facebook, check out our videos on YouTube, follow us on Twitter and check out our blog.

About Blue Distinction Centers

Blue Distinction Centers (BDC) met overall quality measures for patient safety and outcomes, developed with input from the medical community. A Local Blue Plan may require additional criteria for providers located in its own service area; for details, contact your Local Blue Plan. Blue Distinction Centers+ (BDC+) also met cost measures that address consumers’ need for affordable health care. Each provider’s cost of care is evaluated using data from its Local Blue Plan. Providers in CA, ID, NY, PA, and WA may lie in two Local Blue Plans’ areas, resulting in two evaluations for cost of care; and their own Local Blue Plans decide whether one or both cost of care evaluation(s) must meet BDC+ national criteria. National criteria for BDC and BDC+ are displayed on Individual outcomes may vary. For details on a provider’s in-network status or your own policy’s coverage, contact your Local Blue Plan and ask your provider before making an appointment. Neither Blue Cross and Blue Shield Association nor any Blue Plans are responsible for non-covered charges or other losses or damages resulting from Blue Distinction or other provider finder information or care received from Blue Distinction or other providers.

What to Consider When Choosing a Weight Loss Procedure

Struggling with weight is something that almost everyone has experienced at some point throughout their lifetime. In fact, in the United States alone, approximately one out of three adults meet the threshold for obesity. However, despite how incredibly common obesity is in the United States, there is still a social stigma that affects overweight individuals.

We know that dieting can be extremely difficult. The majority of people who go on a diet find it too difficult to stick to and have a hard time losing weight on their own. Having a healthy lifestyle can feel un-achievable, but with weight loss surgery, it can become a reality.

There are a variety of FDA approved weight loss surgery options out there, but it can be difficult to determine which one is right for you. There are several things to consider when choosing a weight loss surgery route, a decision that should be made in consultation with your physician or doctor supervised weight loss center. Here are just a few questions to ask yourself when trying to choose a weight loss procedure, given to us by the Obesity Action Coalition.

How Much Weight Do You Want to Lose?

This question is very important to ask yourself when considering weight loss surgery. What is the magic number that will make you feel like you are back to the healthy lifestyle? For example, gastric bypass surgery patients are expected to lose up to 70% of their excess body weight. The expected weight loss percentage is different for every type of surgery. However, while this is an important question, remember that there really isn’t a magic number. Weight loss isn’t about hitting a number; it’s about making healthy changes for the better.

How Quickly Do You Expect to Lose the Weight?

Most people who get weight loss surgery think that the weight will magically fall off immediately. Unfortunately, this is not the case. The weight loss rate of each type of surgery varies, and every human body is unique. For example, gastric sleeve surgery patients usually lose 10lbs per month on average for the first 6 months. While this can sound like a quick process, it still typically takes over a year for the patient to meet their expected goal weight.

Will You Be Able to Follow Through With the Lifestyle Change?

Many people go into weight loss surgery knowing that they have little willpower over their eating and/or exercising habits. If you can diet like a champ, then there is little to worry about. Some procedures lead to dangerous consequences when the diet is broken, while others do not. As such, talk to your weight loss specialist about the kind of diet that will be possible after the surgery is complete.

If you are thinking about getting weight loss surgery, consider these three factors to help you choose the best procedure for you.

Vitamins and Bariatric Surgery: What To Know

Bariatric surgery is a weight loss procedure that works by limiting the amount of food the stomach can hold, causing malabsorption of nutrients or a combination of both. While these procedures will cause the weight to be lost, they are not a cure for obesity. In order for the weight loss to be successful over the long-term, a patient will need to follow diet guidelines, as well as adhere to lifestyle changes.

One of the postoperative requirements is daily vitamins. Below are some of the most important vitamins for long-term weight loss success after a bariatric weight loss procedure.


Following bariatric surgery, you will need to take a multivitamin for the rest of your life. This multivitamin should include iron, folic acid, selenium, copper and zinc. In the months directly following the surgery, these multivitamins will be chewable.


The daily calcium intake post-bariatric surgery will help to prevent bone disease and calcium deficiency. In some cases, the calcium doses will need to be spread throughout the day to enhance the absorption. The daily calcium intake will need to be between 1,200 and 2,000 mg, so breaking this into 500 or 600 mg doses can be helpful.

Vitamin D

The recommended daily dosage of Vitamin D for post-bariatric surgery patients is 800 to 1,000 international units. This should be split into two daily doses and should be taken with the calcium daily. You may also substitute a calcium-vitamin D supplement to avoid multiple pills everyday.

Iron and Folic Acid

Your dietitian may also recommend additional iron and folic acid supplements. For females that are still menstruating, it is particularly popular for a dietitian to suggest this additional vitamin intake.

Vitamin B12

One very common deficiency following bariatric surgery is vitamin B12. For this reason, it is recommended to have a B12 injection every other month following bariatric surgery to ensure adequate vitamin levels.

The goal of the daily vitamins is to prevent nutrient deficiencies. While bariatric surgery will cause weight loss, sticking to the postoperative regiment suggested by your dietitian is the best way to ensure the weight stays off.

If you are interested in learning more about bariatric surgery, contact us at Nanticoke Weight Loss and General Surgery.

Sneaky Ways to Lose Weight Without Even Trying

For many, losing weight is easier said than done. There are so many different diets available that it can be hard for the 66% of Americans who are on a diet to choose which one works the best for them.

However, to achieve their weight loss goals, it is crucial for dieters to adopt a healthy lifestyle instead of only a change in diet. This is because the best way you to lose weight sustainably is to make a complete lifestyle change, rather than a temporary switch (like eliminating fatty food from your diet for a few months or so).

But some dieters are apprehensive to make an overhaul in their lifestyle. They often believe this dramatic change is just too hard to maintain. This is simply untrue. It’s a lot easier to accomplish than you might think. These tips and tricks will help you lose weight in no time at all:

    • Try to get moving as often as possible
      No, we don’t necessarily mean get up and run a marathon every day. Instead, just try to fit in a couple extra “healthy steps” – whether it is parking your car farther away from a building entrance, walking in place during television commercials, or taking a walk around the block on your lunch break. Everything counts! Soon, it will become a habit for you and you won’t even notice all the extra activity.


    • Keep the food away from the television
      It is all too easy to overeat when you’re doing a mindless activity like watching TV or scrolling on your laptop. If you’re going to eat while you watch or scroll, then make sure to measure out your portions before you sit down. Ideally, you should make meals your main activity, rather than using your food as a way to accompany other things.


    • Keep your goals short term
      If you concentrate too much on one large goal, it can be all too easy to give up when you aren’t seeing results right away. So keep your goals simple and reset them every six months to amp up your inspiration. Instead of setting goals that feel out of reach, set smaller, realistic ones that will give you a sense of accomplishment and will encourage you to keep moving forward.


  • Don’t concentrate on fad diets
    As we mentioned before, the only way to have a truly healthy lifestyle is to combine healthy foods and exercise to meet your goals. This means you should stay away from fad diets that promise results right away. You will need something that is much more sustainable and designed to benefit you in the long run.

Nanticoke Weight Loss provides several useful tips and tricks to help you achieve a healthy lifestyle. Keep an eye out for our next blog which will give you more inspiration!

Listening to Your Gut Feeling: The Scoop on Fiber

While most know that fiber is beneficial for healthy digestion, many often miss the other benefits of fiber and why it is such an important part of a healthy diet. How is it that something that we don’t even digest can help to keep us healthy? Let’s take a look.

Fiber is actually the part of the plant that we cannot break down, digest, and use for energy. There are lots of different types of fiber, many of which you might have heard of. Starch, bulk, roughage, pectins, and others are often used interchangeably with the word fiber. However, all of the different types of fibers can be classified into two groups: soluble and insoluble. Soluble fibers dissolve in water (hence the soluble part) and form a gel. Insoluble fibers do not do this. Instead they aid in the movement of materials through the intestinal tract. Both are an important part of our intestinal and overall health.

Fiber is primarily found in plants, therefore fruits, vegetables, grains, and beans are great sources. Other foods such as meats, dairy, refined grains, and many processed foods are low in fiber. Look on the Nutrition Facts Panel to see just how much fiber your foods contain. It is recommended that men get 30-38 grams of fiber per day and women get 21-25 grams of fiber. There are fiber supplements, but these are mostly soluble fibers only. Check out the label to make sure you know what’s in your supplement.

Fiber is best known for keeping us all regular. Regular bowel movements are of course a healthy part of life, but fiber is more helpful than that! A high fiber diet can help manage irritable bowel disease and some studies have shown a relationship between high fiber and lower risks of certain cancers. Did you know that fiber helps us feel full, so we’re less likely to overeat during and in between meals? It does this by slowing down contents in our intestines so we feel fuller for a longer period of time.  Fiber has also been shown to better control blood sugar in those with diabetes. Better blood sugar control can mean less insulin and fewer long term consequences of diabetes. Fiber also helps to protect against heart disease, which is the #1 cause of the most fatalities in the United States. Soluble fiber binds to cholesterol (in the form of bile) and carries it out of the body, therefore reducing the amount of overall cholesterol.

In order to keep our intestines happy and our bodies healthy, include fiber into each meal of your day. Remember to start slowly and include adequate fluids throughout the day. Eating a lot of fiber without enough fluids can actually cause more stomach upset than relief. It is best to start slowly by adding a few new high fiber foods per day. Start adding small portions of things like fresh fruits or nuts or seeds to your meals. Then take a look at your cereals, pastas, and other packaged products and make sure they have at least 3-4 grams of fiber per serving. Before you know it, you’ll reach your daily recommendation of fiber.  Trust your gut!