The Number One Secret to Staying in Those Skinny Jeans

The secret to staying in those skinny jeans is staying focused. Staying focused for the rest of your life.

Houston weight loss surgery

What it is like to fit into those skinny jeans needs to be an ever present thought. The two variables most responsible for our obesity are not likely to change – our genetics and our calorie rich environment.

What does staying focused look like? Allison had gastric bypass nine years ago and has keep her eighty-five pounds off. She has a small frame, so eighty-five pounds is a lot. She is gorgeous. She often gets compliments on her appearance.

Allison has faithfully kept all her doctor follow up appointments. If you find someone that had a gastric bypass or sleeve gastrectomy that has regained significant weight, ask them, “When was the last time you saw your bariatric surgeon?”

Almost always you will get a vague answer full of excuses.

We teach all patients that one of the best things they can do if they begin to regain significant weight is to start seeing their bariatric surgeon monthly until they are back on tract. The act of scheduling the appointment, arranging time to make the appointment, walking in and weighting, and sitting in the exam room keeps those inner voices actively thinking about weight loss.

Then we can focus our discussion about what part of the eating rules they are struggling with and what to do about it.

To learn more about Houston weight loss surgery options and how to know if you’re choosing the right surgeon check out our page on How to Chose a Surgeon That’s Right For You.

Go Additive Free and See How Your Body Responds

Exercise along with losing weight, and maintaining a healthy weight is very important to our long term quality of life.

Houston weight loss surgery


It makes us fit. Fit to enjoy life more fully. It improves our mental well-being and is excellent at relieving stress. Exercise is all about developing a habit.

I think it takes one to two years to develop a habit to the point that you no longer have to talk yourself into exercising.

Visualize yourself signing up for an expensive gym membership, then driving to the gym and then sitting in the car trying to talk yourself out of going in. Suddenly everything seems more important.

The same is true when we try to develop good eating habits. Visualize and remind yourself over and over the things you notice about yourself when you are exercising on a regular basis. Use that visualization to help you give up the resistance of doing the simple do-able thing like getting out of your car and walking into the gym. And give up equating sweating and intensity of exercise with weight loss.

If not, you will be disappointed and quit. Do not quit. Develop the habit and the intensity can come later.

The two most important tools for success is to find the time of day that is least likely to be interrupted and to build in some method of accountability. For some, doing a form of exercise first thing in the morning before the hectic day starts works. For others, finding a partner and agreeing to make each other accountable works. If they have an excuse to not show up, give them a hard time, every time.

How about those bathroom scales? I think they give more bad information than good. In a hospital setting we weigh patients often daily. It is not because we think they are metabolizing fat and muscle or gaining fat and muscle. It is because we want to know what their water balance is. If the weight increases over night we know they are retaining fluid/water for some reason, and the reverse is true as well.

They are useful at home however for the same reason. It tells us what our water balance is. I recommend only weighing if you feel as though you are retaining fluid. If your weight goes up overnight, you are. You did not grow fat, or muscle, or bone. It could be for hormonal reasons such as menstrual periods, some medical problem, or side effects of some medicine. Most likely it is because you have been eating salty food.

Most people are salt sensitive and will retain water after eating salty food They will gain water weight that can be seen on the scale and felt in the puffiness of their fingers.

Prove it to yourself, do the trial above. Eat salt free Monday to Friday, then eat salty food Friday and Saturday, and wake up Sunday and see how you feel. Then visualize how it felt Monday to Friday, and remember that feeling when thinking about eating salty food and ask yourself, is it worth it?

Learning the nutritional value of food, learning to count calories, learning about metabolic rates and glycemic indexes all are very good.

There are many books on the subject and I highly recommend one from a friend of mine, Robert Moore, called The Body of Knowledge System.

To learn more about Houston weight loss surgery options and how to know if you’re choosing the right surgeon check out our page on How to Chose a Surgeon That’s Right For You.

Sleeve, Bypass, Band or Duodenal Switch – How Do i Choose Which is The Right Procedure for Me?

Houston weight loss surgeryBarry Swartz, the author of The Paradox of Choice, points out that we live in a time of abundant choices, which often causes anxiety. He says one way to reduce anxiety is to have a clear picture of your goal and what you need to do in order to achieve your goal. He also says to be careful on choosing based on emotion.

I would add to also have a clear picture of the amount of risk you are willing to take to achieve your goal. First off, dieting has never been proven by any long-term study to help a person lose 50 or more pounds long-term. It’s clear that diets are not the path for almost everyone carrying that much or more excess weight.

So which is the right surgical procedure for you?

It is the procedure that will give you long-term weight loss success with the least possible risk. One must also consider the risk of failing to achieve success. In other words, all those serious medical problems and day-to-day difficulties will not go away if you fail. And that has serious consequences.

The gastric bypass and duodenal switch are complex operations. The sleeve gastrectomy and the lap band are much less complex. The more complex, the more risk of complications. This is true even among the greatest of surgeons.

I will share the pros and cons of each of these procedures, but first I would like to share my story of why I now only perform the sleeve gastrectomy. I had to revise this chapter because in the first edition of this book, I was still performing all three procedures. I would educate the patient and then ask them to choose. Now I can’t justify the extra risk, including the risk of failure, from the other procedures.

It’s my belief that everyone is a genius in some way. They have a particular skill set that makes them good at something. Laparoscopic surgery started big time in 1990 with gallbladder surgery. I quickly found that laparoscopy fit my skill set and began doing advanced procedures much earlier than most. I attended a live tel-seminar where Dr. Kelvin Higa did a laparoscopic gastric bypass. I knew immediately that this was for me.

It fit my skill set, background and educational, as well as my love for GI surgery. So I traveled to Dr. Higa to learn from the master. I also did a mini fellowship at Southwestern Medical School in Dallas, Texas. I performed my first laparoscopic gastric bypass in January 2000.

I was amazed that patients would come in with this huge list of medications and almost immediately after surgery would no longer need them. There were a few complications along the way and they were challenging to treat. Regardless, it was clear that the benefits of the gastric bypass tremendously outweighed the risk of complications. So, I became a big fan of the laparoscopic gastric bypass. Around the beginning of 2002, I attended a masters conference on weight loss surgery. The room was full of the most experienced surgeons. After going over the pros and cons of bypass versus lap band, a question was asked of the audience,“Which procedure would you choose for yourself if you were the patient?”

One after another approached the microphone and said they would choose the lap band for themselves because it was least likely to have a complication and they could not afford to have a complication. I was amazed. To me, the band was just another version of past procedures that had too high of a failure rate. However, during the conference a light bulb went off. Patients, like these surgeons, should have a choice of how much risk they are willing to take. So I immediately started the training process, and became one of the first five in Texas to be approved by the FDA for the procedure. I performed my first lap band procedure in November of 2002. I did my last lap band in 2012.

During this time there were many surgeons that only performed lap band surgeries.. I felt they did not offer the bypass because it was too technically difficult for them. Without doubt, the bypass was a superior operation. It did a much better job resolving diabetes and hypertension and these were issues for most of our patients.

Patients chose the band more than the bypass because it was a safer operation. So over time, I was doing 60% bands and 40% bypasses. The bypass patients rarely had a surgical complication and the office follow up was easy as well. Patients just seemed to lose weight effortlessly and rarely had issues.

When a complication did occur it was a big deal for the patient, the family and for me. I also found that many patients did not lock in the eating habits required for long-term success and over time re-gained some weight, usually about 20% of what they lost. They would tell me they were eating right, but their friends would tell a different story. In 2003, I attended a conference on laparoscopic revisional weight loss surgery- the first one ever done. Michael Gagner talked about the first ten laparoscopic gastric sleeves performed. This is the story of the beginning of the laparoscopic sleeve gastrectomy.

He was doing a duodenal switch (sleeve plus malabsorption procedure) when anesthesia asked if he find a way to end the operation early. They were having a difficult time ventilating the patient. The patient was super obese, and the breathing machine was having difficulty keeping the patient adequately oxygenated. So, he decided to do the sleeve part and come back later and do the malabsorption part. The patient lost weight very well, so he decided to start staging the operation. He would do the sleeve, and later come back to do the malabsorption part whenever they were not losing adequate weight. He found that many patients did not need the second part of the surgery and that the sleeve was adequate.

As he told the story I don’t think any of us thought this would eventually become the most commonly performed procedure. We just thought of it as another option. I started doing the sleeve in 2008. Very few knew how powerful this operation was at that time. From 2008 to 2009 very few patients chose the sleeve. First off, I did not know how powerful the operation was and many insurance companies did not approve it. By 2010, I had done enough of them that I could see the contrast between the sleeve, bypass and band.

The patients were losing weight and finding it easy to lock in and follow the eating rules required for long-term success. To this day, with more than 500 procedures performed, we have had no significant or serious complications. There are many chemicals and chemical pathways in our bodies that drive us towards bad food. It seems that once our body becomes obese, these chemicals work very hard to keep us from losing the weight and keeping it off.

Once we gain it, our body does not want to let it go. We knew that these chemicals were associated with the bypass procedure, but we had no idea that they effected the sleeve procedure as well. By 2010, we realized it. Research has shown it to be primarily related to changes in a chemical called Ghrelin, however there are many more than have yet to be discovered. The bottom line is that, by cutting out about two third of the stomach and leaving the upper third in a tube shape, our metabolism seems to normalize closer to what it was like before weight gain. We are able to get most patients off insulin and hypertensive medications the night of surgery, before weight loss has occurred due to these massive chemical changes.

I did many lap bands from 2002 to 2010 and it was like pulling teeth to get about 40% of those patients to follow the required eating rules. Subsequently, they would struggle with weight loss. Often they had mechanical issues with the band causing severe reflux esophagitis and vomiting. The typical patient that did well with the band was very good at following rules in their everyday life. They would learn the eating rules, get full on a small volume of food, and did great if no mechanical issues occurred. Because the lap band did not have the chemical changes like the sleeve and bypass, patients did not get off insulin and high blood pressure medications until they had lost significant weight.

Before the sleeve was an option, when patients were having problems, the only choice was the gastric bypass. Many patients did not want to take that risk. Now the patients can convert their band to a sleeve with relatively low risk. I quit offering the lap band and the bypass once I realized that the sleeve was low risk, had excellent weight loss, got most the patients off their medications the night of surgery, and the patients found it easy to lock in the important eating rules required for long-term success.

One of the hospitals that I use in Houston, Texas does more bariatric procedures per month than any other Houston hospital about 100 per month. Lap bands are no longer seen on the schedule at all. There are still bypasses, as some surgeons still feel that it is superior, and an occasional duodenal switch but mostly sleeves.

I think the story that I was a big fan of the bypass, did the band because it was safer, and now only do the sleeve is an important story that might help you understand why I think the sleeve is the right procedure for most patients. For those patients who do not achieve adequate weight loss with the sleeve, then the duodenal switch is a good option. The beauty is that half of the operation has already been done, and the next operation will be safer because of the weight loss achieved with the sleeve.

For most patients, the laparoscopic sleeve gastrectomy is the right choice.

For more information about what makes our Houston weight loss surgery experience different from all the rest, click here.

Tune Into Your Body And Observe How it Responds

Many years ago I read a book called The Food Chronology by James Trager. It takes our earliest knowledge of early man and what evidence there is about what he ate.

Houston weight loss surgery


The book then marches through historical events up to present time. It matches historical events with what was going on in relation to food at the time.

Skimming through the book you can get a tremendous sense of how we have arrived where we are today. And it brings us back to learning from our mistakes.

When farming became a trade, wheat and grains were the main crop. Then came the major plagues that killed millions of people because rodents ate the stock piled grains, multiplied rapidly and spread disease. The naturopathic doctors have brought into the spotlight how common gluten sensitivity is and how it adversely affects our health.

Gastroenterologist missed the boat when it comes to gluten sensitivity. They focused on celiac disease which is the severe form of gluten sensitivity, and ignored what the more minor effects gluten sensitivity may be causing in terms of intestinal symptoms such as cramps, constipation, diarrhea, and bloating to name a few, as well as skin rashes, migraines, nasal congestion and autoimmune disease.

I now recommend to any patient having any type of GI problems to do a brief trial of a gluten free diet and I am amazed how many people report back that they are significantly improved. If you don’t believe me – try it. Ask your friends that are having some of the above problems to do the gluten free diet and have them report back how they feel. You will be amazed.

Back to the topic of wheat, it is widely touted that grains are very healthy, that we should eat oatmeal, wheat bread and cereals. But they cause many people to have problems.

So if you go through a gluten free trial and find that in many ways you feel better, then step back and observe the abundance of information there has been that wheat is healthy. You might be getting the idea that much of the advice we get as far as what to eat is not as solid as we think.

We learned that we need a lot of fiber in our diet. We thought that because wheat has a lot of fiber it must be good for us. For many it is not. Individuals need to see how they respond to wheat and if they don’t respond well to avoid it. Tune in to your body and observe how it responds.

Remember there is a lot of fiber in whole foods.

I believe we have too many chemicals in our diets. Food additives are chemicals and all have a side effect profile just like medicines.

Just like medicine they affect some and not others. The problem is that there are so many of them laced in our packaged food products that it is difficult to separate those that you can and cannot tolerate.

Intuitively it makes sense that some may be causing problems.

Get a one on one Houston weight loss surgery consultation by requesting an appointment with one of the best surgeons, Dr. Clifton Thomas!

For more information about what makes our Houston weight loss surgery experience different from all the rest, click here.

Lap Band Failure – Tiffany Explains Why She Switched to the Sleeve Gastrectomy

In this video interview, Tiffany explains why she switched from a Lap Band to a Sleeve Gastrectomy. Tiffany discusses the problems that she went through as a result of the band and the process she went through to have it changed over to a Sleeve.

To learn more about this process, visit our Converting Band to Sleeve page here.

For more information about what makes our Houston weight loss surgery experience different from all the rest, click here.

New Audio Report – Your Complete Guide to Weight Loss Surgery

My new audio report “Your Complete Guide to Weight Loss Surgery” is now up on our website.

weight loss surgery Houston

This is audio report is a series of interviews I’ve done in the past, and they answer a wide array of questions that pertain to weight loss surgery. Specifically, you’ll learn:

  • The Top Questions Asked About Weight Loss Surgery
  • What Life if Like After Weight Loss Surgery
  • 5 Reasons You Should Not Have Lap Band Surgery
  • 5 Tips to Prepare for Weight Loss Surgery
  • 5 Ways to Know if You’re a Candidate for Weight Loss Surgery

You can grab this report by visiting and entering your name and email. The email list is for updates only. We won’t  put your name on any list or send spam.

For more information on what to look for when researching Houston weight loss surgery options, check out our page on “choosing the right surgeon” here.

Exciting News for the “Skinny Jeans” Brand

Many of you may be familiar with my Amazon bestselling book Skinny Jeans…at Last! Since writing this book almost two years ago, my desire has been to build a brand off the Skinny Jeans…at Last! ™ name. Recently I was able to secure the trademark for the name, and we now have a dedicated site launched in preparation for the latest edition which will be ready for publication soon.

weight loss surgery Houston

You can visit the new site at and check out some of the reviews and excerpts.

We will be adding more free content – blog articles and videos over the coming weeks; and eventually create an online community forum for members to interact, sharing their own experiences and support with one another.

Can a Sleeve Gastrectomy Help Someone Who Is a Diabetic?

In this video, Tim shares his experience as a diabetic the benefits he’s seen since having a Sleeve Gastrectomy. Before surgery, Tim was taking 100 units of insulin plus pills.

After surgery, Tim is down to just 10 units! A huge decrease. Part of this of course can be attributed to a 28 lb weight loss since surgery; but another part is directly related to the chemical change that has taken place in Tim’s body since the Sleeve Gastrectomy.

To learn more about Houston weight loss surgery options and how to know if you’re choosing the right surgeon check out our page on How to Chose a Surgeon That’s Right For You.

New Year, New Beginnings

It’s the start of a new year, and that means New Year resolutions are in full force. If you still need some extra motivation for staying on track, Dr. Thomas offers some helpful advice.

Disclaimer: Please note that there's no guarantee of getting the same results as each of these patients. Specific results vary by individual patient.