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Dear Friends and Family of LapSF and The Surgical Weight Loss Center of Hawaii,

Happy Spring! Everyone at Laparoscopic Associates of San Francisco hope this finds everyone healthy and happy. We need ideas for the support group that would benefit you! Please let Nicole know what changes and/or additions would be beneficial. You can call the office or email her at Thank you to the Maui patients that came out last Friday night for the first-ever seminar and support group.

Image Plastic Surgeons to Speak at the Petaluma Support Group this Saturday on March 15th!

We are pleased to have Dr. Stan Poulos and Dr. Ingvar Hvistendahal from Plastic Surgery Specialists join us during the second hour support group to discuss various plastic surgery options following drastic weight loss.

Where: Sheraton Sonoma County Petaluma, 745 Baywood Drive
Details: The first hour will be an informational seminar for pre-op patients, the second hour dedicated to post-op patients.

Calendar of Events

Monterey Support Group on Monday, March 17th

ImageDon't forget!

When: 3/17/2008 from 7pm-9pm
Where: Hyatt Regency Monterey, 1 Old Golf Course Road

Our new therapist Tara will be leading the support group! Bring your questions and ideas for future topics.

Calendar of events

Support Group Changes & San Luis Obispo clinic

The March 17th seminar and support group in Walnut Creek is cancelled this month due to hotel renovation.

Just a reminder: We have a clinic day in San Luis Obispo on Monday, March 24th. We would love to start up a seminar and support group if there is enough interest.

SLO office:
2280 Sunset Drive, Suite D
Los Osos, CA 93402

Calendar of Events


ImageCelebrations, spending time with the family watching a favorite show, cookouts on warm evenings… eating and events are social activities that have long been tied together, and you shouldn’t have to give them up. But, after bariatric surgery and with new healthy habits, you won’t want to eat as much as you used to and, most likely, you won’t be able to.

These situations can present challenges. Sometimes even the most well-meaning family and friends may try to push food on you or may have difficulty supporting you. They may be unaware that certain comments they make or things they do are unsupportive.

Maybe you are frustrated because a family member continues to bring home high-calorie foods, even though you are trying to avoid them. Or, maybe you are upset because a friend who only knows the myths of bariatric surgery thinks it is the easy way out.


· It may be as simple as talking with your family members or friends. Be honest and calmly let them know what your goals are, what you need in the way of support, and, specifically, what comments or behaviors are not helpful.

· You may want to offer to bring them to a support group or information session at your bariatric program.

· Provide them with the information you used while making your decision.

· Politely change the subject if eating or bariatric surgery comes up.

· If they’re unable to change their behavior, you may consider limiting the amount of time you spend with them.

Adapted from

If you need support or ideas on how to deal with family and friends, give Tara a call

Image Walking buddies wanted!

I have had several patients ask me if there are any patients that are looking for a walking partner. If anyone is interested, please email me at

Go to and track your diet and exercise

Nutrition News by Jeannette Kotrys, RD

ImageSugar Alcohols

Sugar alcohols: Sorbitol, mannitol, erythritol, inulin, HSH (hydrolyzed starch hydrolysate), xylitol, lactitol, maltitol, galactitol, inositol, ribitol, dithioerythritol, dithiothreitol, and glycerol.

Sugar alcohols, also known as polyols, are ingredients used as sweeteners and bulking agents. They occur naturally in food and come from plant products such as fruits or berries. Sugar alcohols are a carbohydrate with a chemical structure that partially resembles alcohol and sugar. There is no ethanol in them so they are not an alcohol. Many foods labeled "sugar-free" contain sugar alcohols –so be careful. They offer fewer calories (1/2 to 1/3 less) than regular sugar, however still contain calories and will still stimulate the release of insulin in the body potentially leading to fat storage and decreased weight loss. There is less than 1.0 gram of CHO per 1 gram of sugar alcohol. Sugar alcohols = 2.6 calories per gram. BOTTOM LINE - they are NOT considered a "free food".

Sugar alcohols should be consumed very cautiously by the bariatric and/or diabetic patient. Blood sugar levels can rise, but in an amount less than ingesting a true sugar. It is important to keep in mind that we are all individuals, and our bodies will react differently to these products.

Additional Potential Problems:

Consuming more than 50 grams of sugar alcohols a day can induce diarrhea, gas, and/or bloating. Sugar alcohols are incompletely absorbed from the small intestine into the blood. Over consumption may produce a laxative effect.

More importantly, sugar alcohols may act as "trigger foods" causing carbohydrate cravings, binges and drastic increases in caloric intake. Please always look carefully at food labels for the presence of sugar alcohols to prevent an unpleasant surprise.

Call Jeannette if you have questions!


Dr. Gregg Jossart ~ Dr. Paul Cirangle
Laparoscopic Associates of San Francisco
2100 Webster Street, Suite 110
San Francisco, CA 94115
(415) 561-1310/(415) 561-1713 fax

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Laparoscopic Associates
2100 Webster Street, Suite 110
San Francisco, California 94115

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