Jan. 6, 2023 - Weight Loss Surgery in Delaware: Intermittent Fasting

For Bariatric Friday today, Kemal Erkan, Chairman of American Surgery Center, is with Dr. Isaias Irgau, President of Christiana Institute of Advanced Surgery (CHRIAS) to discuss intermittent fasting. Dr. Irgau specializes in weight loss surgery, also known as bariatric surgery, and has for over 20 years. This is the most effective way to treat morbid obesity and the illnesses that come along with it including high blood pressure, type 2 diabetes, and sleep apnea. Morbid obesity is defined as being 100 pounds over one’s ideal body weight. “It is critically important that we educate our patients that bariatric surgery is a very powerful tool,” Dr. Irgau explains, “nevertheless a tool which means patients’ attitude towards eating and physical activity has to fundamentally change for them to be successful… we want obesity to become history in the life of the patient”.

Intermittent fasting, as described by Dr. Irgau, involves a time for eating and a time for not eating. Currently, in society, humans will eat when they are awake, and that could mean eating all day throughout a period of 24 hours. However, our digestive system has not evolved to manage that method of eating. Food is so prevalent in society that it can often be difficult to not gravitate toward snacks and small extra meals, especially when it is directly offered.

Erkan was introduced to intermittent fasting a few years ago by Dr. Irgau through a study that was being done on this type of diet. The study originally was focused on how the diet affects aging, but they came to realize weight loss was occurring in tandem. Dr. Irgau explains that a majority of patients are receptive to this type of diet because there are a variety of regimens. Dr. Irgau states, “once the body has used up the calories that it needs for energy expenditure, what is it going to do with the excess calories in the body, it is trained to just store that excess calories as fat.” Dr. Irgau continues to explain, “every time we are taking in some type of calorie, what we do is increase the insulin level in our blood… what insulin does is it prevents the fat cells from releasing fat… insulin really is a weight gaining hormone.” Intermittent fasting aims to interrupt that process, so the body’s insulin level remains low for a longer period of time.

The pair mention a study that was done regarding hunger and productivity. “From an evolutionary point of view, we evolved to survive hunger, our body is a machine that was built to be able to seek food at times in which food is not available, which means your brain has to be at its best when you are hungry, so you are more alert,” Dr. Irgau states. He adds, “but the other thing also that is very interesting is that when we digest food, we expend a lot of calories, in fact digesting food is one of the most energy consuming processes… that’s why you feel so sluggish because a lot of your energy is going into processing all that food you have eaten.” Fasting will give the brain much more availability of energy because it is not competing for energy with the digestive system.

For people who have diabetes and high blood pressure, they should be monitored by a physician when utilizing intermittent fasting. As a society, the parameters of intermittent fasting can immensely help weight loss. When it is not the window to eat, food refusal in a social situation is much more accepted and respected by peers. This diet can also prevent overeating. Stomachs are a certain size, so once the time window for eating is restricted, one can only consume so much in a small period of time. Discipline is very important with this method of eating. By following a schedule, one becomes stronger mentally. Erkan closes by saying, “we are going to continue to be the voice of patients who are suffering from morbid obesity… this is

the most efficient way to deal with the disease, and this is the best treatment, and we want to make sure that more people are educated, and more people take advantage of this.”