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 nicole@lapsf.com what changes and/or additions would be beneficial. Thank you to the Maui patients that came out last Friday night for the first-ever seminar and support group.

Don't forget the Petaluma seminar and support group this Saturday! When: February 16th, 9-11am 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.

REMINDER: Professional Photographer Coming to the Sacramento Support Group, Plastic Surgeons Coming to the Sacramento and Stockton Support Groups February 23rd! LapSF knows how hard our patients have worked and would like to chronicle our patients' success! We have hired a professional photographer at no cost to the patients to come out to the DoubleTree to take "after" pictures on 2/23/2008 at 11am. You will be provided one 8x10, or 2 5x7's or 4 4x6's. A tip on what to wear from the photographer: Solid, bold colors, without too much pattern or any at all looks best in pictures. Deep blues, reds, earth tones also look great. Shirts that don't have writing in the front, so it won't be so distracting. Please call or email Nicole to reserve your spot or for more information: (415) 561-1310 nicole@lapsf.com Also don't forget Dr. Stan Poulos and Dr. Ingvar Hvistendahal from Plastic Surgery Specialists will be joining us during the second hour support group to discuss various plastic surgery options following drastic weight loss. Calendar of Events

Nutrition News by Jeannette Kotrys, RD HAIR LOSS! Telogen effluvium (rapid hair shedding) can occur as a result of rapid weight loss. Many patients suffer from increased hair loss during the first six months after surgery. However, this never leads to baldness and normal hair growth will eventually return. Nutritional deficiencies can contribute to increased hair shedding by weakening hair shafts that cause breakage to the hair and slow regrowth. Principal nutrients that are involved include vitamin A, certain B vitamins, biotin, vitamin C, copper, iron, zinc, and protein--all of which are malabsorbed to some degree by gastric bypass patients. Surgery and anesthesia can also result in temporary hair loss. With time, adequate protein, and vitamin supplements, hair loss will subside. Below is a list of supplements we recommend to slow or deter hair loss: SUPPLEMENT NAME DOSAGE Biotin 1-3 mg per day Co-Enzyme Q10 50 mg per day Fish Oil 2,000 mg per day Primrose Oil 500 mg per day Zinc 80 mg per day Call Jeannette if you have questions!

Another Study Confirms Weight Loss Surgery Resolves Type 2 Diabetes Recently a landmark article was published in the Journal of the American Medical Association (JAMA) documenting the effectiveness of adjustable gastric banding (Lap-Band and REALIZE) both in regards to weight loss as well as resolving Type 2 Diabetes (adult onset diabetes usually related to obesity). In the study, 60 obese patients who were recently diagnosed with diabetes were entered into the study and broken up into 2 groups randomly - those treated medically with diet, exercise and medications, and those treated with surgery (placement of an adjustable gastric band). Both groups were followed for 2 years. The results were very enlightening - the individuals who were treated with a medical regimen faired much more poorly losing on average 1.7% of their weight compared to the surgical group who lost on average more than 20% of their body weight. More enlightening was the resolution of Diabetes - 73% in the surgical group vs. only 13% in the medically treated patients. In summary, this unequivocally supports the effectiveness of either the Lap-Band or the REALIZE band both in weight loss as well as resolving Diabetes in overweight individuals. These results are similar to what we see with Gastric bypass and other weight loss surgeries. Read the entire JAMA article

First-Ever Maui Seminar and Support Group! The Surgical Weight Loss Center of Hawaii is excited to announce the addition of a Maui seminar and support group. When: March 7th, 6-8pm Where: Maui Beach Hotel 170 Kaahumanu Avenue, Kahului, HI 96732 Details: The first hour will be an informational seminar for pre-op patients, the second hour dedicated to post-op patients. Free parking. Please email Nicole at nicole@lapsf.com for ideas or topic suggestions Calendar

Sincerely,

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
www.LapSF.com
weightloss@lapsf.com