Surgical procedures aren't for everyone, but we can help you determine whether you're a candidate based on your height, weight and medical history. In general, weight loss surgery eligibility is based on both Body Mass Index, or BMI, and any health conditions you have that are affected by obesity. Due to the medical benefits of weight loss surgery, we do accept most major insurance carriers at Fresno Bariatrics.

Using a layered approach is another great way to build a good veggie habit. For example, start with a food you already enjoy — say, pasta — and layer some veggies into your bowl. This can help you explore a new food with one you already love eating, and from there, you can try new ways to savor it. Take spinach, for instance. After trying it with pasta, you may want fold it into an omelet or another favorite food, or explore it on its own with different cooking techniques (sautéed or steamed) or different flavor additions (garlic or golden raisins). The possibilities are limitless!

Live It! This phase is a lifelong approach to diet and health. In this phase, you learn more about food choices, portion sizes, menu planning, physical activity, exercise and sticking to healthy habits. You may continue to see a steady weight loss of 1 to 2 pounds (0.5 to 1 kilogram) a week until you reach your goal weight. This phase can also help you maintain your goal weight permanently.
How else can we explain the overwhelming numbers of people who suffer from this? Those who workout yet still have saggy moobs problem or low sex drive? Usually if you look fat, it’s not going to be only about fat percentage. More often, it’s a combination of high fat percentage and not enough muscle mass. This doesn’t mean looking like a hulk, but you need some muscles if you want to look lean.
Trying to lose weight? Having trouble? Women often find it harder than men to shed excess pounds. In part that's because women's bodies have a tendency to "hold on" to a certain amount of fat. But in some cases the problem can be traced directly to certain habits and lifestyle traps - including many that can easily be remedied. Here are 10 weight-loss traps to watch out for:
The more you have to lose (obese / overweight), the more you will lose as your body has more fat to spare. Sure, changes to your diet and activity levels will be the base but the magic lies in the details. Most people weight loss journey is about the yo-yo effect. They lose a lot of water (and water weight), go on holiday and then coming back home feeling fat and full of guilt. The truth is, fat has nothing to do with it, because they haven’t lost much of it in the first place.

Americans are serial snackers—a habit researchers associate with the accumulation of belly fat. But you don’t have to go snackless to snack less. Just watch the clock. A study published in the Journal of the Academy of Nutrition and Dietetics found that mid-morning snackers tended to consume more throughout the day than afternoon snackers. Afternoon snackers, on the other hand, tend to choose healthy snacks. Afternoon munching was associated with a slightly higher intake of filling fiber and fruits and vegetables.
Although you do want to increase your walking over time, this doesn’t necessarily mean that you have to be working your way up to a more intensive form of cardio like swimming or running. “Moving on to new exercises is not something someone should feel they have to do unless their goals change and a new exercise is needed to support those goals,” says Gagliardi. “Walking alone can be progressed by changing the distance, speed, terrain, and by adding intervals.”

Fancy coffee drinks from trendy coffee joints often pack several hundred calories, thanks to whole milk, whipped cream, sugar, and sugary syrups. A cup of regular coffee with skim milk has just a small fraction of those calories. And when brewed with good beans, it tastes just as great. You can also try nonfat powdered milk in coffee. You’ll get the nutritional benefits of skim milk, which is high in calcium and low in calories. And, because the water has been removed, powdered milk doesn’t dilute the coffee the way skim milk does. Here are 11 metabolism myths you have to stop believing.


There’s a reason everyone harps on about protein: Not only does it help keep you full, but it’s also responsible for repairing the tiny tears caused by strength training in your muscles. This helps them grow bigger and stronger, nudging out body fat in the process. As a general rule of thumb, aim to get at least 70 grams of protein throughout the day, says Dr. Cheskin. (These high-protein foods can help you reach that goal.)
Suspect you have a sluggish metabolism? You might have hypothyroidism, or an underactive thyroid gland, which afflicts about 25 percent of American women — many of whom don't know they have the condition, according to the American Association of Clinical Endocrinologists. "The thyroid gland controls your body's metabolism, so one of the first signs that it may be off is an inability to lose weight," explains Pamela Peeke, M.D., professor of medicine at the University of Maryland and author of Fight Fat After Forty. Your doctor can determine if you're suffering from hypothyroidism by running a blood test. If you do have an underactive thyroid, you'll be treated with a synthetic thyroid supplement, which you will need to take for the rest of your life (it will return your metabolism to normal, so it should be easier to drop unwanted pounds).
Swapping out unhealthy foods for nutritious ones gives you benefits beyond just losing weight. "I cleaned up my diet, swapping deli sandwiches with high-sodium meat and mayo for Tupperware containers or big butter-lettuce salads topped with carrots, walnuts, feta, and homemade dressing," says Jennifer Lasher, who lost 75 pounds. "I found that ditching processed foods left me with more energy, a clear head, and better skin, too."

Before you scarf down meal number one, get moving: Working out first thing in the morning can help you lose 20 percent more fat than exercising after breakfast, according to a 2013 study in the British Journal of Nutrition. For a quick sweat session, try this fat-burning HIIT workout that includes challenging moves like squat jumps and lunges, but can still be done in the comfort of your living room. The best part? It takes just 10 minutes to complete.
For years, research has supported the fact that Weight Watchers is one of the best weight-loss diets. Thanks to its flexibility, easy-to-understand food tracking system, and group support, Weight Watchers consistently ranks number one for "best weight loss diet" and "best commercial diet" in the U.S. News & World Report rankings. (Oprah's endorsement probably didn't hurt either!) They recently revamped their program and changed their name to WW to signify a focus on overall wellness—not just weight-loss—so that users who aren't focusing on weight can also use the program to eat better, work out more, or develop a more body-positive mindset.
Even if you have specific health or weight loss goals, you may have no idea what type of program will yield the results you're looking for, especially if certain diet programs have failed you in the past. For this reason, we were specifically interested in the motivational aspects of each service. Programs that provide more motivation through the community, weight loss challenges, tools and tips scored higher than programs that didn't offer these features. The number of tools and motivational features also helped us determine whether or not the price of membership was warranted. While we didn't score programs based on their membership fees, we did note whether or not they were on the costlier side of the spectrum.
There’s mounting evidence that our body’s natural internal clocks, or circadian rhythms, drive a lot of our biological processes, including weight maintenance. They tend to sync up with daylight. That could be why studies have shown that shift workers tend to have a higher rate of obesity and weight gain—their body clocks are out of sync. One study even found that a third of people who experienced an interrupted sleep cycle for less than two weeks became prediabetic; all of the poor sleepers saw markers for the risk of obesity and type two diabetes climb.
For example, you might not realize just how much you eat when you go out to happy hour with friends. But if you take the split second to take a step back and make yourself aware of that fact, you’re more able to make a healthy decision. “The awareness and then planning and coming up with strategies for what else I can be doing—that might give me the same benefit of eating those comfort foods that make me feel better,” says Gagliardi.
We are leading a life that is full of junk food loaded with unhealthy calories. Because we are always on the run, being able to manage healthy eating is not possible for most of us. So, what is it that we end up doing? Eating packaged food or junk that is conveniently available. As a result of this, we earn excessive fat and uncounted calories which go unburnt!
Do you know that stressed livers will not be able to metabolize the fat effectively and that gets deposited around your stomach? Thus, in order to detox the liver, you could make use of lemon water. Lemon water enhances the enzymes helping detoxify your liver and carry out the fundamental functions very efficiently. The following is an easy recipe using lemon juice mixed warm water:
Rather than training hungry, drink a protein shake before you go. One scoop, or about 20 grams, is sufficient. Whey is a great choice because it's easy on the stomach, quickly absorbed, and has an enormous list of additional benefits. Numerous studies have shown that ingesting more high-quality protein leads to both increases in muscle mass and decreases in fat mass.[8]
I am so glad I came back to this page and read it again. I started out doing this 17 days ago..I lost 11 pounds first 5 days, 14 pounds my 9th day and now 21 pounds in 16 days..it is 3am the 17th days hasn’t even started..lol..I was doing really good and then I started having 2 gutter coffees every morning, basically because I bought a French press and .1 the coffee was so delicious and 2. because I would make a whole pitcher full so i would feel like I had to drink it…I started making butter covered shrimp scampi on butter covered zuchinni noodles, I had a big salad with an avacado and olive oil, garlic dressing with 3 over easy eggs on top…I know..right? That is just part of my addiction to food..it is my only vice, but i am seeing my mistakes now a lot quicker than I would have before…and I am putting on the brakes..skreeeeeeeech…I have been IFing since day 2 and have not stopped that, which is good and probably why i still have been losing…but i have been really restless with all of the caffeine in the coffee and some of the tea I drink..I have been an insomniac this last week. So..now I know, once again, black coffee in the morning followed by water and some green tea..maybe broth at 1pm..2 eggs scrambled with a handful of kale lightly tossed in just to warm it at 2-3pm and then 3 oz piece of fish or chicken with a large salad or medium salad with asparagus or brussel sprouts roasted…no more cheese on everything…yeah, I’ve been sprinkling on the cheese too..water and decaf tea until bedtime..I just needed a refresher course…and I find that is I write or type all this out, it stays in my brain better than opposed to reading it and saying,” yep, that’s the way to do it…lol” Thanks so much and I know I am babbling on and on..It is nice to have a place where I can let all of this out. Thanks again and let ya know3 in a week if it kick starts me right back into losing smooth and fast <3 ya both, Katy

When fat loss is the goal, planning a good mix of workouts is key. Gary suggests incorporating a combination of strength training, high- and moderate-intensity cardio and something to help relax the muscles. “I’ll train my clients hard on the strength training and high-intensity cardio side of things, then suggest they get to a good yoga or pilates class and fit in a run or sign up for a spin class,” he says.


You can’t skimp on sleep. Losing weight for good calls for a total lifestyle change -- and that includes getting more Zs. Missing the recommended seven to nine hours of shut-eye has been linked repeatedly with increased obesity rates. “When you don’t sleep enough, it certainly affects your brain,” explained Dr. Arad. “What we’ve learned is that people who don’t sleep well are making poor choices — eating more unhealthy diets, and they are obviously more fatigued, so they become less physically active.” In fact, people who sleep six hours or fewer per night on average consume about 300 extra calories the following day.

“Nuts like pistachios aid in fat loss because they’re a good source of protein and fiber, says Tammy Lakatos Shames, RDN, CDN, CFT, co-author of The Nutrition Twins’ Veggie Cure. “These nutrients stave off hunger and ward off energy crashes that lead to sugar cravings and binges. Plus, they’re one of the lowest-calorie nuts. I suggest opting for the in-shell variety. Seeing the leftover shells is a visual reminder of how much you’ve already eaten, which can potentially curb your intake,” she adds.

Subcutaneous fat is the vast majority of fat found on your body. It's the fat that lies right under the skin and creates the pinchable inch -- or more -- that creates a muffin-top appearance. Because it's more metabolically active, visceral fat tends to respond faster than subcutaneous fat to efforts to lose it. Subcutaneous fat is notoriously stubborn, so you may notice the circumference of your belly reduce relatively expediently, but your muffin top or pinchable fat on your abs hangs on for longer.

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Make sure that everything you're eating is whole — as in nothing processed or packaged. Since salt is a preservative, these are the foods that are highest in sodium — something to keep in mind when planning your meals. Plan on making sure that all items you choose are fresh. That means filling up on fresh fruits and veggies, whole grains, low-fat dairy, and lean protein.
Taking in simple carbs (sugars) right after weight training replenishes muscle and liver glycogen stores, but excess sugar consumed at other times will be stored as fat. Satisfy your sweet tooth occasionally, but try limiting your intake of sugar to fresh fruit. Replace sugary beverages like soft drinks and juice with water, coffee, tea, or diet soda.
As women age, weight creeps up too, with the average women gaining about one pound per year in their 40s and 50s, resulting in an added 10 to 15 pounds. The drop in estrogen levels during this time of perimenopause (the years leading up to menopause) contributes to weight gain and can change the way you distribute fat. You may gain weight in your belly more readily than you did in younger years.
Fiber expands in your stomach and also takes time to digest, both of which help keep you feeling full for longer. Good sources include whole grains, veggies, and whole fruit (not juiced). Healthy fats like olive and nut oils—in moderation—improve flavor, give you energy, and help your body use certain nutrients. Alexandra Shipper added healthy fats, such as avocado, to protein sources like eggs and fish on her way to dropping 55 pounds.
Women who ate low-fat dairy products, such as non-fat yogurt and low-fat cheese three to four times a day lost 70 percent more fat than low-dairy dieters, according to a study published in the journal Obesity Research. "Calcium serves as a switch that tells your body to burn excess fat faster," explains study author Michael Zemel, M.D., director of the Nutrition Institute at the University of Tennessee in Knoxville. Sorry, but you won't reap the same benefits from calcium-fortified O.J. Research shows that you get the best results from dairy products themselves, not fortified foods. Aim for 1,200 mg, which includes about three servings of dairy a day.
If you have Celiac disease, of course you can and should eat gluten-free foods. But for those who choose gluten-free options because they think it’s healthier, think again. “As alternative grains are more bitter than their wheat-, barley-,  and rye- gluten-containing counterparts, the most common means to mask bitterness is…wait for it…by adding high levels of sugar,” says Alvin Berger, MS, PhD, nutritionist, lipid biochemist and co-founder of Life Sense Products. “The sugar is added in its plethora of alternative forms and names, to provide cover. The bottom line is that many gluten-free foods are higher in total sugars and high glycemic-carbs than their gluten-containing counterparts.”
It’s bad for every part of your body.  Your body is actually breaking down, your relationships suffer, your brain doesn’t work right, your joints hurt, you lose muscle, and you just don’t look good in the mirror.  Conventional wisdom says you should start cutting fat and calories and run on a treadmill for an hour a day. Then you’re made to feel as if it’s your fault because their advice doesn’t work.
Here’s a thought: Take a 10-minute break from your busy day of present wrapping or online shopping to walk up and down the stairs in your house or apartment—you’ll say goodbye to about 100 calories, says Donavanik. You’ll also feel less tense and cramped up. Want to maximize your calorie burning potential? Run up and down those stairs instead and you’ll zap the same number of calories in half the time. 
Be realistic about the type of exercise you can do when starting a new program. If you are hoping to lose weight and keep it off, you will have to do more than a condensed fitness program. The best way to get into exercising is by picking exercises that you are actually going to do and, hopefully, enjoy. If you hate running, don’t make it your main form of exercise—you will need much more motivation each day than if you picked an exercise that you actually enjoy. Instead, try out different exercises until you find a few that you really love, like swimming, biking, or even Zumba.

After an intense weight workout, your body needs carbs and starches to replenish blood-sugar levels and stop the breakdown of muscle. This is also the time when your insulin sensitivity and metabolism are at their highest. Enjoying your biggest meal when your body is craving energy and cutting back on the rest of your meals throughout the day will minimize any unwanted fat gains.
Illescas-Zarate, D., Espinosa-Montero, J., Flores, M., & Barquera, S. (2015, April 19). Plain water consumption is associated with lower intake of caloric beverage: Cross-sectional study in Mexican adults with low socioeconomic status. BMC Public Health, 15, 405. Retrieved from https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-015-1699-0
So, if you are serious about fat loss you have to cut down on your daily carbohydrate intake. Now have you ever noticed that your body feels full for a longer period of time when you eat chapati than when you eat rice? Well, this is because we have been used to eating whole wheat chapati and white rice. Where whole wheat chapati is a whole grain, a complex carbohydrate. On the other hand, white rice is a simple carbohydrate which is nothing but the refined version of brown rice.
People who get enough sleep tend to weigh less than those who don't. Additionally, researchers found that well-rested dieters lost more fat than those who were sleep deprived, who lost more muscle. "Whenever I don't sleep enough, I'm ravenous the next day," says Weil. To keep her hunger in check and help her maintain her slim figure, she tries to get at least 8 hours of sleep every night.
Choose Liquid Calories Wisely. Sweetened drinks pile on the calories, but don't reduce hunger like solid foods do. Satisfy your thirst with water, sparkling water with citrus, skim or low-fat milk, or small portions of 100% fruit juice. Try a glass of nutritious and low-calorie vegetable juice to hold you over if you get hungry between meals. Be careful of alcohol calories, which add up quickly. If you tend to drink a glass or two of wine or a cocktail on most days, limiting alcohol to the weekends can be a huge calorie saver.
Picking healthy foods is not as simple as finding a “healthy” brand and sticking to it. Every restaurant and every brand has some dishes and products that are healthier than others. It’s key to look beyond advertised health claims on the front of the box. In fact, research from Washington State University shows that reading food labels can improve weight loss.
One study from the University of Adelaide in Australia suggests you may lose more weight when you work out towards the end of your menstrual cycle, as opposed to right when a new one begins. That’s because the hormones estrogen and progesterone tell your body to use fat as an energy source. "Women burned about 30 percent more fat for the two weeks following ovulation to about two days before menstruation," study author Leanne Redman says.

Fresno Bariatrics, located in Fresno, California, is one of the most experienced weight loss surgery programs in the country. On both the state and national levels, we are a step above most other weight loss surgery programs. Our superb clinical outcomes have earned HealthGrades' five-star ratings and a Bariatric Excellence Award™ 6 years in a row, putting our program in the top five of all California hospitals.


I am a 58 yr old 5’6″ and was at 230 after a serious ATV accident which is mending well. This happened 3 weeks ago so with a fractured L10 and 3 broken ribs, it’s going to take a bit. I purchased the weight loss plan about 4 months ago and started but fell off. I started again after the accident and have been delving into as much info and reading everything you sent in your wonderful package. What I am not seeing is a recommendation for the number of carbs, fats, etc. a day. I am down to 220.2 after only 6 days having added water as the only “liquid” right now because of the metabolism increase I read about with one of your friends. I am going to start adding the shakes in a day or 2 but am doing pretty well with your list from the program. There is so much to eat on there, it gives great variety. My body also seems to be craving the veggies and clean foods, probably because it’s working so hard t heal itself. I have tried looking on the internet for these numbers and have found other peoples recommendations, but would rather have them from you to stay more strictly in your program. I am going to send before and after pics and am being successful! Thank you for the wonderful support even after purchasing and the loving coaching you both give. You guys are awesome! PS – The superfood cookies are delicious!!!
“One of the best ways to build endurance, strength and burn fat during a workout is through high-intensity treadmill power training,” says Jimmy Minardi of Minardi Training. Here’s how: Start the treadmill speed at a slow jog, and once you’re warm, gradually increase the incline to 15%, keeping the speed the same, explains Minardi. After 45 seconds at 15%, start lowering the treadmill and continue to run until it’s completely flat. Do five intervals with a 3 to 5 minute rest in between each, or until your heart rate has returned to normal.

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Losing weight isn’t necessarily a matter of meat vs. plants or carbs vs. fats. Repeatedly, studies suggest you can lose weight with a number of different approaches, including the ketogenic diet, intermittent fasting, and WW (formerly known as Weight Watchers). Truth be told, losing weight is much easier than keeping it off. The last decade of research on weight loss points to the fact that once you lose weight, your body is in a battle with biology. It’s an unfortunate irony, but studies show that as you drop pounds, your levels of “I’m hungry” hormones increase, while your “I’m full” hormones decrease. At the same time, your body physically needs less fuel to operate your smaller size. It’s not an easy battle, but it isn’t impossible; you can march on. Here’s what we’ve learned about weight loss, and what you can do to take charge of your weight this year.
When you’re trying to flatten your stomach, reducing your intake of artificial sweeteners, sugar alcohols and sugar substitutes can help, notes Shay Kostabi, Master Trainer and Creative Director for ReXist360 Resistance Training Systems. “These sneaky devils can wreak havoc on your whole digestive system, which can cause weight gain and bloating. To nix bloating in the long run, Kostabi suggests eliminating the sweeteners altogether. They can be hiding in everything from protein bars to gum, so be sure to read labels carefully. For immediate deflation, she suggests increasing your water intake. Though any H20 will get the job done, she’s a big fan of Essentia, an electrolyte-enhanced water that comes in a BPA-free bottle.
In a new study, Stanford University researchers put more than 600 overweight adults on either a healthy low-fat or low-carb diet. It turns out, participants had similar levels of weight loss success on each plan. Researchers looked for clues (such as insulin levels and gene patterns) to see if there are any factors that might make someone more successful on either diet, but after combing through the data, they were not able to make any connections. Since it may take years before scientists discover individual traits that could lead to more success on one plan compared to another, for now, we can learn a lot — and lose a lot! — by recognizing the dieting advice that all experts agree on.
A healthy GI tract is teeming with beneficial bacteria, and scientists are uncovering just how important those microbes are for keeping your weight under control. They’ve discovered that the strains of bacteria in the guts of thin people differ from those in obese folks, and there’s evidence that certain types of probiotics may help aid weight loss by assisting with the regulation of appetite, fat storage, and other related metabolic functions. You can get probiotics from live culture yogurt and certain supplements. While popping a pill or eating yogurt won’t magically shrink your waist, warns Ginger Hultin, RD, gut health is important. Read more about the weight loss benefits of probiotics.
Nighttime snacking may be even worse than we thought. When researchers fed rats the same number and kind of calories but varied whether they ate them over an eight- to ten-hour period or a 15- to 24-hour span, the late night diners became obese while the rats who noshed only during the day lost weight. While they haven’t identified exactly why this occurred, they believe it has something to do with eating in line with circadian rhythms, or our bodies’ natural internal clocks, which can be triggered by environmental conditions such as sunlight. When researchers repeated the study with humans they got similar results—seems like a good idea to quit eating at sundown.

A muffin top and large belly don't just affect your wardrobe choices. This fat is dangerous to your health as well as deleterious to your appearance. All the situps in the world won't reduce your waist circumference or rid you of a muffin top. Only a comprehensive exercise plan and a sensible, low-calorie diet can help you slim this area. These strategies take time but make it more likely you'll get lasting results. Know that shrinking your belly's overall girth may prove easier than trimming the last bit of pinchable fat on your tummy.
A trim midsection is good for many things, like fitting into your favorite jeans or walking the beach in a swimsuit with confidence. But there are even better reasons to work off extra baggage around your stomach. That baggage, known as visceral fat, isn’t just the most annoying kind — it’s also the most dangerous. As it forms between your organs, deep within your abdominal cavity, it secretes proteins that can trigger chronic inflammation, putting you at risk for heart disease, diabetes, and even cancer.
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