Dr. Marc Bessler is assistant professor of surgery at Columbia University College of Physicians and Surgeons, and director of the Columbia University Center for Metabolic and Weight Loss Surgery. He is also the director of the Minimal Access Surgery Center at New York-Presbyterian Hospital/Columbia University Medical Center. A fellow of the American College of Surgeons, Dr. Bessler's clinical specialties include surgical management of morbid obesity, gastroesophageal reflux disease, laparoscopic surgery of the stomach, esophagus and hernia surgery, and natural orifice surgery. His research interests focus on hormonal, oncologic, and immune responses in laparoscopy.
He earned his medical degree from New York University School of Medicine, and completed his residency in general surgery and his fellowship in surgical endoscopy at the Columbia University College of Physicians and Surgeons and the Presbyterian Hospital in New York City.
Question: What is an appropriate diet for an adult male?
Marc Bessler: You know it’s really hard, it varies from individual to individual so much. If I don’t eat protein with a meal personally, I start to get hungry. But if I don’t eat carbs, I get a headache. So I have to eat a certain amount of carbs in my diets. Some people can go on an Atkins diet, pure protein and be fine and that’s just not comfortable for me. I find I fill up very quickly with a little bit of fats. Other people, you know, eat fats, they’re not full and they take in a lot more calories because of that. Research seems to show that a high protein diet is very effective for weight loss, a pure protein diet is almost impossible to maintain and not healthy in the long run, so a sort of Atkins diet, and a low Glycemic index has been shown to work. That means carbohydrates that are metabolized more slowly than processed foods like white bread and rice, not so good, pastas etc. But steel cut oats, sweet potatoes instead of regular potatoes, these are low Glycemic index foods that don’t get broken down in your system that quickly, those help. I mentioned already proteins help, the right fats, in the right amounts is important because you need fats in your diet. So olive oil, omega 3s, nut oils and things like that have been shown to be somewhat helpful and then you have to mix that up in proper proportions and that again is vary from individual to individual. But I think a diet that includes a significant proportion of calories from protein, low Glycemic index carbohydrates and proper fats is the right one to do. Then the question is for weight loss, what’s a good diet and I think that cutting back calories is critical that it’s really the only way to have significant weight loss. Everybody’s metabolic rate’s a little different but most people don’t live on much less than 2000 calories a day, for normal and therefore you have to cut back by 500 or 800 calories a day in order to get a good weight loss. A pound of fat, a pound of anything in your body is 3500 calories. So roughly a pound of fat, 3500 calories, 500 calories a day for 7 days should be a pound. So if you cut back 500 calories a day then it’s simple, one less Snapple, one less bag of chips, add the two together that’s about 500 calories. If you do that every day for a week you should lose a pound. Now you can’t keep doing that forever because your body’s metabolism’s gonna slow down and you’re not gonna continue to lose a pound a week.
Question: Do men and women have different dietary needs?
Marc Bessler: The amount of calories that women need versus that men need does differ for a man the same height and weight as a woman, it might differ, probably not dramatically as you would think, it has something to do with muscle mass, men tend to have a little bit more muscle mass but again it’s individual. So a woman with the same height and weight and the same muscle mass as a man probably not dramatically different. But most women are a little smaller height wise, a little less muscle mass per that same weight and therefore their metabolic rate tends to be a little lower, they need few calories. So might be 2500 calories for a man and 2000 calories for a woman, it’s very individual though.
Question: How can parents encourage good dietary habits?
Marc Bessler: That’s a whole other area, really adolescence and it’s not my specialty but adolescents, really it’s the same equation, I think the important thing about adolescents and kids is they’re at a time when they’re still developing their behaviors, it’s much easier to change behaviors. So that you can encourage more activity, get that involved in their life, you can encourage the healthy eating habits, volume control. On the other hand it’s very, very difficult when a child is hungry to hold back food from them, so giving them the right foods is really important and I don’t think actually eliminating certain foods that are the wrong foods is the answer either because you can get that counter intuitive response of “It’s held back from me for so long, I just want more of it” and so there has to be that proper balance and it depends on the child’s personality and the parents parenting style, it’s really hard. But again cutting back calories a little bit has been shown to be the most effective way to do this. On the other hand in kids that are growing, cutting back calories too much can actually impair ultimately growth and it’s been shown that cutting back calories actually shortens children’s ultimate height. Now I think it’s much better to be an inch shorter than 50 pounds heavier and it’s a worthwhile trade off as long as it’s done carefully.
Recorded on: 6/16/08