Before and After Weight Loss

Before and After Weight Loss

A major focus of our practice is the treatment of morbid obesity. Morbid obesity is defined as having a body mass index (BMI) of atleast 30kg/m2. BMI is calculated by weight in kilograms divided by height in meters squared.

Today, obesity has reached epidemic levels in the United States, and also in developing countries. The cause of obesity is multifactorial and includes a complex interplay of energy-rich diets, limited physical activity, and hormonal, psychological, and genetic factors. There are many associated illnesses of obesity. These associated illnesses affect essentially every organ system.

The cardiovascular system is affected by high blood pressure, diabetes, ischemic heart disease and peripheral vascular disease, high cholesterol, strokes, and venous insufficiency. The respiratory system is affected by asthma, and obstructive sleep apnea. Gastroesophageal reflux, fatty liver disease, gallstones, and colorectal cancer affect the gastrointestinal system. The musculoskeletal system is affected by osteoarthritis, back pain, and disc disease. The neurologic system is impacted by pseudotumor cerebri, carpal tunnel syndrome, and depression. The reproductive system is affected by polycystic ovarian syndrome, fetal abnormalities, prostate, ovarian and breast cancer. With such an exhaustive list of various illnesses, one can clearly appreciate the fact that obese patients are at an increased risk of early death compared to their aged-matched control cohorts with normal body mass index. The treatment of morbid obesity therefore requires a multidisciplinary approach as well as, close follow-up and a willingness to adapt and combine treatment modalities.

In our practice, we employ surgical and nonsurgical options. Patients must demonstrate that they have failed diets and other weight-loss programs before we offer surgical options. Our pharmacologic treatments include Phentermine, Phendimetrazine, Qsymia®, Belviq®, Contrave®, and Saxenda®. Our endoscopic treatments include the gastric balloon and endoscopic plication. Surgical options are generally employed when less invasive modalities have failed to achieve significant weight loss. We offer the laparoscopic or robotic vertical sleeve gastrectomy, Roux-en-Y gastric bypass, and duodenal switch. Our patients are enrolled in a nationwide database, which provides valuable information that leads to best-practice standards. Our minimally invasive approach leads to a quicker recovery, less pain, less scarring, and improved cosmetic results when compared to the open approach.

We realize that such a recalcitrant disease requires vigilance and persistence at therapeutic interventions. Patients who initially lose at least 50% of their excess weight may regain a significant amount of weight loss. Without long-term monitoring, patients who initially were considered cured of their associated illnesses may redevelop their associated medical conditions. Revision surgery is an option for patients that are willing to accept the risks of reoperative surgery and pledge to adhere to a healthy lifestyle and behavior modification. Unfortunately, the perfect treatment option for all morbidly obese patients does not exist. Areas of research include hormones, bacterial flora of the colon, endoscopic devices to limit absorption of calories, medications that enhance energy expenditure and procedures to alter the digestive anatomy. At the Laparoscopic and Endoscopic Surgery Institute, we are dedicated to the treatment of morbid obesity using both surgical and nonsurgical options.

Atlanta Bariatrics Our surgeons at Laparoscopic & Endoscopic Surgery Institute, P.C. have over 25 years of experience in management of a wide array of bariatric and general surgical issues. They have both undergone extensive specialty training that has enabled them to incorporate cutting-edge technology and advanced minimally invasive techniques into their care for patients. Services offered include medical and surgical weight-loss options. Our general surgical services also cover a range of conditions, including gallbladder disease, acid reflux, hernias, small intestinal and large intestinal conditions, any lumps or bumps (e.g., lipomas, cysts) and more.

Laparoscopic & Endoscopic Surgery Institute • • (770) 500-3660

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Atlanta GastroPreviously, medical guidelines recommended regular screenings for colon cancer begin at age 50. However, new studies show a significant increase in colon cancer occurrences in younger adults. Because of this data, the American Cancer Society (ACS) updated its guidelines to reflect this trend and now recommends all average-risk adults—regardless of gender or ethnicity—start screening for colon cancer at age 45.

Colonoscopy: The Gold Standard 

While at-home screening tests have gained in popularity, not all screening methods are created equal. At-home tests have varying degrees of accuracy and can only detect colon cancer when it’s in advanced stages. During a colonoscopy, physicians can both locate and remove colon polyps (growths) before they have the opportunity to develop into colon cancer, making it the gold standard for colon cancer screening by physicians.


Are you covered at age 45?
Because the ACS guidelines are new, make sure to verify your insurance benefits before scheduling a screening. Although many physicians and medical societies have adopted these new ACS guidelines, unfortunately, not all insurance companies have. Know your options; talk to your physician; and take charge of your health.


For more than 40 years, Atlanta Gastroenterology Associates has been dedicated to providing accessible, affordable, and compassionate digestive healthcare services to
communities throughout greater Atlanta. To make an appointment at a location near you, call 1.866.GO.TO.AGA [468.6242] or visit

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Men's Health Recipe By Scott D. Miller, MD

If you were to bake a cake and only used flour, you would have one disappointing dessert. In fact, not only does grandma’s baking require a whole array of ingredients, it demands the right quantities combined with the best timing and finesse. At this point, you’ve caught on—there is no secret ingredient when it comes to your health. If there was a cookbook for longevity, the recipe for men’s health would read as follows:


An ounce of prevention: Most men are not very reliable when it comes to seeing their primary care physician on a regular basis. Your doctor can often detect health concerns before they become symptomatic (or worse). Of course, receiving that “good bill of health” from your doctor does not give you free reign until next year. Rather, this office visit should reinforce practicing a healthy lifestyle on a daily basis.

Several pounds of exercise: Consistency always trumps intensity. Variety will help keep you coming back for second helpings. For instance, combine flexibility and strength training with varying intensities of aerobic exercise throughout the week.

Three cups of balanced meals: Countless fad diets come and go. Many of these dietary trends are not sustainable. The best eating habits are based on the appropriate number of daily calories of unprocessed foods that include a diversity of fruits, vegetables, healthy fats, complex carbohydrates, and lean proteins.

A pinch of this and a palmful of that: Much like yeast being needed for bread to rise, we require adequate sleep to function. When sleep-deprived, we are more susceptible to heart disease, a weakened immune system, and life-threatening accidents. Rest also helps us deal with the physical and emotional stressors in life. Embracing meaningful connections with family, friends, and co-workers will further allow us to manage this stress. So, grab a mixing bowl. Start with an eight-hour helping of sleep. Stir in some exercise to create the right consistency. Skim any stress that may have collected on the surface.

Dr. Scott Miller

Finally, add a balanced diet to taste. Then bake at 98.6 degrees for 80 years.

Look for my article on “Back to School: How Men Can Boost Their Family’s Health” in the next issue.

Scott D. Miller, MD, is the Medical Director of Robotic Surgery at WellStar North Fulton Hospital. He is a urologist with WellStar Urology in Roswell and has practiced in
Atlanta for over 20 years. WellStar North Fulton Hospital offers the Know Your Heart Screening that can determine your risk of heart disease, stroke and other serious conditions.

Call 770-956-STAR (7827) to learn more or schedule an appointment.

Scott D. Miller, MD WellStar North Fulton Hospital • (470) 956-4230 •

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SciaticaBy Kristen Willett, DO

If you have ever suffered from pain that radiates
from your lower back into the back of your leg or
foot, there is a good you were experiencing
sciatica. In fact, 40% of the population will
experience sciatica at some point in their life.

What is Sciatica?

Sciatica refers to the symptoms associated with compression or irritation of the sciatic nerve, the longest nerve in the body. The nerve is a collection of fibers from the lower lumbar and upper sacral areas that exits the spine and travels down into the muscles of the buttocks, through the back of the thigh and into the knee. Around the knee, it splits into the nerves that continue down into the calf and foot.

• Sciatica may feel sharp, achy, or burn and may radiate from the back or buttocks into the outside or back of one of the legs.
• It may intensify when standing up from a seated position, or when coughing or sneezing.
• In more severe cases, it may be accompanied by weakness or numbness in the affected leg that could extend as far as the foot.

What Causes Sciatica?

Several things can precipitate sciatica but the most common are:

• A herniated disc—the most common cause.
• Spinal stenosis—a narrowing of the nerve’s passageway that may be due to arthritis and degeneration of the discs.
• Spondylolisthesis—slippage of one vertebrae onto another, causing the nerve to be pinched as it exits the spine.
• Miscellaneous—things such as infection, tumors, and other disorders can very rarely disturb or compress the sciatic nerve.

How is Sciatica Diagnosed?

When symptoms fail to resolve, see your doctor or healthcare professional. They will discuss your symptoms and history, as well as perform a physical exam to help determine your diagnosis. He or she may take X-rays to help with the evaluation. If necessary, advanced imaging studies such as a computed tomography (CT) or magnetic resonance imaging (MRI) may be ordered.

How is Sciatica Treated?

Most cases of sciatica will resolve on their own or with a few simple treatments. Those treatment options may include:

• Anti-inflammatories, such as ibuprofen, when appropriate.
• A physical therapy program may be beneficial to create a customized core strengthening and stretching program, as well as to utilize other modalities that may decrease pain and increase function and range of motion.
• Alternative treatments such as acupuncture and chiropractic care may be appropriate in some cases.

Cases of sciatica that do not rectify with conservative measures such as those listed above may benefit from epidural steroid injections to directly reduce the inflammation around the nerve itself. For those individuals that do not respond well to these treatments or for those who have intractable pain or unresolved neurological symptoms, surgery may be recommended.

How Can Sciatica Be Prevented?

The best way to avoid spine issues, when possible, is to develop a strong exercise program for your core and to maintain flexibility with a stretching routine. It is also beneficial to sustain a healthy weight and to focus on low-impact exercise.

Resurgens Spine Center • Non-surgical & Surgical Spine Care • 24 Convenient Atlanta Locations •

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Dry NeedlingDo you ever wish you could push the “reset” button on your aching muscles? 

A technique being utilized by BenchMark Physical Therapy and specially trained therapists across the nation is doing just that, moving the needle on pain.

Dry needling, a new physical therapy treatment, may be the best choice for your injuries, aches, and pains. This method has gained a popular reputation as an effective treatment for pain relief, stiffness, and improving range of motion and flexibility. It is often used to treat sports and orthopedic injuries, but can also be successful for treating chronic pain and fibromyalgia. For years, dry needling was performed in Europe before becoming mainstream in the United States.

Dry needling, often called “trigger point dry needling” or “intramuscular stimulation,” involves inserting a very thin filament needle into a “trigger point” or muscle spasm that sends pain to a specific area of the body. A trained therapist penetrates the ultrafine needle through all layers of the skin to reach the muscle, striking a “trigger point.” A trigger point is a taut band in the muscle that is often painful and can restrict range of motion and adequate blood flow to the area. The needle helps the therapist target tissues that cannot be reached with just the hands alone. The needle is “dry” because nothing is being injected, as in a flu vaccine needle or cortisone injection. With dry needling, the sterile needle is very thin and solid.

The goals of the treatment are to promote healing and improve blood flow. Benefits also include increased muscle flexibility, decreased muscle tension, and the deactivating of painful trigger points. Dry needling can also improve the brain’s ability to activate muscles, inhibit pain and improve function, often providing immediate and significant relief of symptoms.

To perform dry needling, a physical therapist must be certified, and have at least a year of experience. Typically, dry needling is conservative to start with to see how the patient responds. Over time, the technique can become increasingly aggressive. Making sure patients know what to expect from dry needling prior to their first treatment and making them feel comfortable is important. The procedure is rarely used in isolation. It is frequently used in conjunction with manual therapy, exercise, stretching, and an alternating regimen of heat and ice.

If you would like to try dry needling, talk to your physician or physical therapist, and see if the procedure can be part of an overall treatment plan that can get you back to feeling better, with the stroke of a needle.

Dry Needling Commonly Treated Conditions: 

• Tendonitis and muscle strain
• Low back pain & sciatica
• Carpal tunnel syndrome
• Tennis elbow
• Neck pain & tension headache
• Piriformis syndrome
• Plantar fasciitis
• Fibromyalgia
• Rotator cuff injuries
• Athletic and sports-related injuries

 BenchMark Rehab Partners is a family of physical therapists, occupational therapists, and hand therapists committed to inspiring and empowering people to reach their full potential. Its providers know that connecting with patients on a personal level helps to build trust. This trust is crucial in allowing patients and therapists to work together to make the best use of advanced certifications and refined techniques. A focus on proven methods and a hands-on approach help the BenchMark team achieve the goals of the patient in a safe and effective manner.

BenchMark Rehab Partners •• 1-866-577-7342

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By Paul E. Cox, MD, MS


What is concierge medicine?
The concierge medical healthcare model allows for a patient-centered approach. You and your physician have the time to develop a personalized blueprint for preventive medicine that creates a long-term plan for your heath and wellness. The concierge model allows the doctor to make their relationship with you a priority, to personalize your health plan and to no longer only be a resource when you are ill. You have 24/7 access to your doctor, you have greater access to innovative labs and testing, and greater access to a physician who can help track your healthcare goals with you.


How does it compare to traditional medicine?
A concierge physician sees about 10% of the number of patients the average U.S. physician is seeing. A typical appointment in our concierge practice lasts a minimum of 30 minutes and can be up to an hour with the doctor. We feel this is necessary for optimizing your customized health plan, but in most cases, this would not be allowed in a typical practice, where insurance only allows for a very brief 10-minute appointment.


Why should I consider concierge medicine?
If you feel your doctor visits are over before they begin, you are not alone. For people seeking a better understanding of their health and increased vitality, the current healthcare system is stacked against them. In fact, the medical professional has a label for those patients more interested in health and vitality. They are called the “worried well.” Most doctors gloss over our observations with platitudes and prescriptions. At Vital Living Healthcare, we seek out the “worried well” because we understand they have legitimate questions and observations.


We want the patients who are dedicated to the pursuit of a healthy, happy, and vital life. If you are considering concierge medicine, we would encourage you to come in for a complimentary mini consult with Paul E. Cox, MD, MS, and see if it is the right fit for you.


Paul E. Cox MD

Paul E. Cox MD

Board certified in anti-aging and family medicine, Paul E. Cox, MD, MS, is an expert at turning back time. Firmly rooted in a scientific approach, Vital Living Healthcare focuses on early detection, prevention, and innovative treatments to reverse age-related decline. By using state-of-the-art equipment and techniques, along with focusing on all aspects of your health (mind, body, spirit, and surroundings), Dr. Cox will create a comprehensive and personalized design for maintaining or reclaiming your health and vitality. Experience the healthcare you deserve and schedule your complimentary consultation with Dr. Cox today.


Paul Cox, M.D. • Vital Living Healthcare • (404) 843-3636 •

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hiiiiiiiiTiago Kulaif, 40, epitomizes how life can be optimized at any age by making health and exercise a priority. As the director of fitness at Windy Hill Athletic Club, Tiago shares how he stays in shape and his approach to training.

“There’s a method to the madness. Through my years in the fitness industry, as an athlete and as a coach, I’ve come to understand how important cross-training is to enhance the human body on many levels,” says Tiago. “I believe in an all-inclusive, systematic, and well-rounded model that trains the body how it’s designed to move in real life. In other words, I use various methods, such as weight training, cardiovascular training, and mobility training to keep my muscles and movement strong, and be fit for life!”
Tiago is currently busy kicking off Windy Hill Athletic Club’s newest fitness program, EverybodyFights®, which you can find out more about below. And when Tiago isn’t hitting it hard in the gym and working, he balances life by spending quality time with his wife and daughters.


Developed by George Foreman III, EverybodyFights® is designed to help everyone train like a fighter in a group class environment. Whatever your experience level, this program has a class that fits your needs and a certified trainer who’s there to support your fight.


BAGSXBODY by EverybodyFights® provides a full-body strength and conditioning workout, incorporating various bodyweight exercises within boxing rounds to create a high-intensity boxing fitness experience.


Windy Hill Athletic Club •

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Bleeding Gums

Bleeding Gums


Bacterial plaque is the main factor contributing to bleeding gums. If we don’t practice good dental hygiene techniques, bacteria forms plaque around the teeth. Over time, these bacteria will result in inflamed, bleeding, and swollen gums. Bleeding and inflamed gums can also be a sign of gingivitis or periodontitis (loss of supporting bone, if left untreated, results in tooth loss).



What can I do to prevent my gums from bleeding?

• Step up your dental hygiene home care.

• Make sure to use a soft-bristled toothbrush.

• Electric toothbrushes will help with better control of plaque (e.g. Sonicare) in some patients.

• Floss at least once per day to prevent plaque from adhering to the teeth.

• Maintain a diet that is low in sugar.

• Check your medications. Aspirin and other pain relievers can cause gums to bleed more easily.

• Stop smoking.


What if I still have bleeding gums after taking these steps? If changing your habits, diet, and medications doesn’t stop your gums from bleeding, seeing your dentist should be your next step. An X-ray of the teeth and gums may be needed to determine if more treatment or a deeper cleaning may be necessary to return your gums to health.


What causes periodontal disease? Predominantly gram-negative anaerobic bacteria, smoking and diabetes are well-established risk factors for periodontal disease. It is lined to an increase susceptibility to systemic disease (e.g. heart attacks, strokes,premature births, etc.).


Kimche & Presley Cosmetic & Sports Dentistry

Kimche & Presley Cosmetic & Sports Dentistry

Dr. Kimche was born and raised in Washington, DC. As a sports fanatic, she attended Tulane University in New Orleans, LA on a basketball scholarship, where she received a Bachelor of Science in Physical Education. Dr. Kimche graduated from Indiana University School of Dentistry and completed her residency in general dentistry at Emory University. She has built her own practice in Atlanta serving over 15,000 patients since 1989.


Dr. Presley received his Bachelor of Science degree from the University of Georgia. After graduating from the Nova Southeastern University College of Dental Medicine, he continued on to complete a General Practice Residency at Columbia University/Harlem Hospital Center. He has been practicing dentistry in the Atlanta area for over 13 years. Dr. Presley is a member of the American Dental Association, the Georgia Dental Association, and the Academy of General Dentistry. 

Details:, 404.262. 0806. 
2921 Piedmont Rd. NE., Ste. E., Atlanta, Ga, 30305.




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Screen Shot 2019-05-30 at 6.41.08 PMMarking 15 years of Bob Steele Salon ownership this year, Amanda Hair’s ambitious vision for the business continually comes to fruition, including expanding from one location to five. She draws on the excellent organizational practices she learned early in her career and strives to apply those high standards to the salon while creating a fun environment for Atlanta’s top talent.

Q: What tips do you have for choosing a hairstylist?

A: The great thing about Bob Steele Salon is that our stylists perform both cut and color in one appointment, which saves you time. Selecting a stylist can be overwhelming and it’s important to have a connection. At our salons, we have over 95 of Atlanta’s top hairstylists to choose from and you can pick who you want right from your phone. First, visit and then select from our five metro locations. From there, you will be able to read the bios of all of our stylists and find the right fit for you. You can even book online right from our website.

Q: Where are you located?

A: We have five metro Atlanta locations for you to choose from. Our flagship location is in North Atlanta, where Buckhead meets Vinings, and houses over 30 stylists. East Cobb is located at the intersection of Sandy Plains and Shallowford roads. Alpharetta is nestled in Liberty Village off Old Milton, next to Avalon. Smyrna is located in the heart of Downtown Smyrna in the Smyrna Market Village, and the Roswell location is located off Highway 92 at the intersection of King Road.

Details: (404) 262-9499

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Screen Shot 2019-05-30 at 6.26.21 PMMaggie is the owner/operator of Opulence Spray Tan Studio. Since 2013, she has maintained her success as Atlanta’s premier mobile spray tan studio by providing convenience, personal attention to detail, and nurturing amazing relationships with her clients.

Q: What makes the Opulence tanning formula different?

A: Maggie Teall created an organic, all-natural solution made with beets and brown sugar that guarantees a warm undertone with subtle hints of reds and browns. From the fairest skin to the darkest complexions and every freckle in between, Opulence Spray Tan Club will enhance your natural beauty and ensure an even, authentic-looking tan every time! Its masterfully crafted blend promises the appearance of a natural tan that lasts for 7 to 10 days when used with the Opulence Spray Tan aftercare products. The team at Opulence values each client’s time and offers a four-hour rapid solution option for those who may be on a time crunch and need to shower before the traditional processing time of 8 to 10 hours.

Q: How do I book a spray tan?

A: The Opulence team understands that for most of their clients, time is money. So in addition to offering mobile tanning, starting in August 2019, the company will welcome all customers to the grand opening of its brick-and-mortar studio in the chic suburb of Chamblee. Maggie and her team are excited to continue serving their mobile clientele as well as offer walk-in services for all customers at the brand-new studio. Go to and click “request appointment now.”

Details: 678-480-6742 5211. Peachtree Blvd., Ste. 900, Atlanta

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