Monthly Archives: July 2016

SlimlifeSolution’s Testimonials

I had the Sleeve Gastrectomy January 16, 2013. Prior to my surgery there was concern about whether surgery was possible due to abdominal scaring and adhesions I had from a birth defect. I appreciate Dr Eslami’s brutal honesty, even on the day of surgery, letting me know that even with all the tests and precautions he couldn’t promise I’d come out of surgery with what I wanted. In the end he was able to safely perform a sleeve. So far I’ve lost over 65 pounds. I can’t say the road has been easy but the support from Dr Eslami and his staff is always there. Lynette is awesome with helping you navigate insurance and pre-operative stuff. Amanda is very accessible to answer questions. I even texted her while at the grocery store comparing yogurt for my pre-operative diet. I can not say enough about Rondi, the bariatric nurse. She’s a wealth of knowledge and a wonderful cheerleader. She even came to check in on me at the hospital. All of Dr. Eslami’s team are down to earth awesome people & Weight loss California. Come to the classes and support group and you’ll get to know them even more. – Jen

After almost 20 years of yo-yo dieting, I would lose up to 80 pounds at a time to only gain most of it back, my doctor recommended that I get off the yo-yo track once and for all and introduced me to Dr. Eslami and his team. My highest weight ever was 260 and at the time of my gastric sleeve surgery in January 2013, I was 230 pounds, a weight I was stuck at for almost 2 years despite dieting and exercise. Eight months later and over 50 pounds lighter, I feel like a new woman. I have the freedom to eat what I want, within the healthy sleeve limitations. I have so much energy and am thrilled that while I’m still around 20 pounds from my ultimate goal, I’m fitting into clothes that I haven’t worn for years. I give Dr. Eslami, Rondi, Amanda, and Lynette my utmost appreciation and respect for helping me get to where I am today. Thank you! – John

In April 2012, I had Roux-eny Gastric Bypass surgery. Before I had my surgery I was unable to walk without the aid of a walker due to a crushed hip. I wasn’t eligible for hip surgery because I had diabetes, high blood pressure, high cholestrol, and my weight was too high& & Obesity California. After surgery, I no longer take any medication for the above ailments and was able to have hip surgery. I have never felt better in my life! I am in clothes sizes I have never been before and feel like a new person! – Tavizon

Slim Life Solutions – Check of the Medical weight loss California treatment such as Weight loss California, Gastric bypass California, sleeve gastrectomy, lapband surgery and laparoscopic surgery.

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Bariatric Surgeon California

Dr. Eslami earned his Doctor of Medicine degree from the University of Tehran in Iran. Upon graduation, Dr. Eslami completed two years of service in the military as a general practitioner. In 1999 he relocated to the United States and completed a residency program in General Surgery at the University of Maryland in Baltimore, and was awarded a chief residency completion in both surgical trauma and intensive care shock trauma. He then went on to the Baylor College of Medicine in Texas to complete his fellowship in Advanced Minimally Invasive and Bariatric Surgery. & Weight loss California.

In addition to his formal education, Dr. Eslami has been very involved with clinical research, and often presents his articles at various conferences around the country & Obesity California.

Dr Eslami is an active member of the medical staff at several Mercy Hospitals. He has obtained Board Certification in Surgery from the American Board of Surgery. He is a member of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) . Dr Eslami is designated as a Center of Excellence- Bariatric Surgeon through the American Society for Metabolic and Bariatric Surgery (ASMBS) of which he is an active member. Dr. Eslami is an avid runner, biker, and swimmer. He enjoys boating, spending time with friends and family, participating in cultural meetings, and reading history in his spare time.

Testimonials

Prior to gastric bypass surgery on 1/6/2011, I weighed 362 pounds. I was a size 28W and dropped to a size 12 and weighed in at 179 pounds. When I was asked what my goal weight was, I simply stated, “I wanna cross my legs and get on a roller coaster!” Not only have I went to Disneyland, Six Flags, Las Vegas, & Mexico, but I’ve gone horse back riding on the beach, jet skiing in the lakes, and 3 wheeling on the sand. I partied at all of the hottest clubs and wore my first dress! My life did a 360, Thanks to Dr. Eslami and all of his supportive staff. Without them, I would not be where I am today. 😉 – Perez

Dr. Eslami and his office saved my life. I was 100 plus pounds over weight and Type 2 diabetic. I had my monument and decided that WLS was the way I would have to go. I also knew better then most people because I am an RN. On May 1, 2013, I had the Sleeve Gastrectomy by the doctor and I have never looked back. I was 310 lbs at the start and as of Jan. 4, 2014 I hit my goal weight of 130 lbs lost. Dr. Eslami and his office have been with me every step of the way. The pre-operative and after care was the best. If you have a question they are right there to help. This surgery is not just a physical change its a mental and lifestyle change as well. I currently am off all medications for type 2 diabetes. My health is back and on top of it I look and feel better! I thank everyone at the office for their support and Dr. Eslami for his bedside manner and skill as a doctor. – Jessica

Slim Life Solutions – Check of the Medical weight loss California treatment such as Weight loss California, Gastric bypass California, sleeve gastrectomy, lapband surgery and laparoscopic surgery

Sleeve gastrectomy

Obesity is emerging as a health epidemic around the world. According to the Centers for Disease Control and Prevention, obesity is rapidly spreading across all regions and demographic groups.

Obesity is an excess of total body fat, which results from caloric intake that exceeds energy usage.

Follow the links below to learn more about obesity.

Laparoscopic Gastric Bypass

In Gastric Bypass procedure, a small stomach pouch is created to restrict food intake. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the lower stomach, the duodenum (the first segment of the small intestine), and the first portion of the jejunum (the second segment of the small intestine). This bypass reduces the absorption of nutrients and thereby reduces the calorie intake.

Laparoscopic Sleeve Gastrectomy

Sleeve Gastrectomy (Tube Gastrectomy) procedure involves removing the lateral 2/3rds of the stomach with a stapling device. It can be done laparoscopically ( keyhole surgery) but is not reversible. It basically leaves a stomach tube instead of a stomach sack.

Laparoscopic Adjustable Gastric Banding

In Adjustable gastric banding procedure, a hollow band made of special material is placed around the stomach near its upper end, creating a small pouch and a narrow passage into the larger remainder of the stomach. The band is then inflated with a salt solution. It can be tightened or loosened over time to change the size of the passage by increasing or decreasing the amount of salt solution & Weight loss California.

Laparoscopic Surgery

Laparoscopy is commonly performed procedure to Investigate and some key hole surgeries on abdominal and pelvic organs & Obesity California.

Laparoscopy is direct visualization of the abdominal cavity and intra-abdominal organs by using a laparoscopy. The laparoscope is a long thin instrument with a light source at its tip, to light up the inside of the abdomen or pelvis. Fibreoptic fibres carry images from a lens, also at the tip of the instrument, to a video monitor, which the surgeon and other theatre staff can view in real time.

Carbon dioxide (CO2) is put into the abdomen through a special needle that is inserted just above the navel. This gas helps to separate the organs inside the abdominal cavity, making it easier for the physician to see the the intra-abdominal organs during laparoscopy. The gas is removed at the end of the procedure.

Dr. Eslami earned his Doctor of Medicine degree from the University of Tehran in Iran. Upon graduation, Dr. Eslami completed two years of service in the military as a general practitioner. In 1999 he relocated to the United States and completed a residency program in General Surgery at the University of Maryland in Baltimore, and was awarded a chief residency completion in both surgical trauma and intensive care shock trauma. He then went on to the Baylor College of Medicine in Texas to complete his fellowship in Advanced Minimally Invasive and Bariatric Surgery.

Slim Life Solutions – Check of the Medical weight loss California treatment such as Weight loss California, Gastric bypass California, sleeve gastrectomy, lapband surgery and laparoscopic surgery.

Medical Weight Loss Surgery California

Dr. Eslami earned his Doctor of Medicine degree from the University of Tehran in Iran. Upon graduation, Dr. Eslami completed two years of service in the military as a general practitioner. In 1999 he relocated to the United States and completed a residency program in General Surgery at the University of Maryland in Baltimore, and was awarded a chief residency completion in both surgical trauma and intensive care shock trauma. He then went on to the Baylor College of Medicine in Texas to complete his fellowship in Advanced Minimally Invasive and Bariatric Surgery.

Slim Life Solutions – Check of the Medical weight loss treatment such as Obesity surgery, Gastric banding CaliforniaObesity surgery California, Sleeve gastrectomy California , lapband surgery and laparoscopic surgery.

In addition to his formal education, Dr. Eslami has been very involved with clinical research, and often presents his articles at various conferences around the country.

Dr Eslami is an active member of the medical staff at several Mercy Hospitals. He has obtained Board Certification in Surgery from the American Board of Surgery. He is a member of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) . Dr Eslami is designated as a Center of Excellence- Bariatric Surgeon through the American Society for Metabolic and Bariatric Surgery (ASMBS) of which he is an active member. Dr. Eslami is an avid runner, biker, and swimmer. He enjoys boating, spending time with friends and family, participating in cultural meetings, and reading history in his spare time.

Lynette Saldana

Bariatric Coordinator

As Bariatric coordinator Lynette brings 10 years of experience. She has assisted hundreds of patients through the process of pre surgical preparation. Given Lynette’s experience & passion for bariatric patients and knowing the issues that obese individuals face she gives our practice the personal touch that they deserve. Lynette is always available to answer any questions you might have about steps to achieve your dream of weight loss.

Mania Deldar Doucette

Counselor

Mania Deldar Doucette, MFTI, is a Registered Marriage Family Therapist Intern, Registration #73945, who is supervised by Leslie Baughman, LMFT Lic #41380. She received a Masters degree in Marriage, Family, and Child Counseling from California State University Sacramento and graduated with honors.  She has received high praise for her ability to connect with clients and help them to achieve their therapeutic goals. In addition to her academic coursework and practicum placement, Mania has completed internships at prestigious institutions such as UC Davis CAARE Center and Head Start.

Mania is experienced in working with individuals (children, teens and adults), couples, and families. She specializes in working with individuals who are overweight and/or compulsively overeat as well as their families.  Her clinical emphasis utilizes an integrated approach of therapeutic modalities with a strong emphasis on Cognitive Behavior Therapy (CBT).Mania is fluent in Farsi and is also Safe Zone Certified to work effectively with the Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) population.

Slim Life Solution

Dr. Eslami earned his Doctor of Medicine degree from the University of Tehran in Iran. Upon graduation, Dr. Eslami completed two years of service in the military as a general practitioner. In 1999 he relocated to the United States and completed a residency program in General Surgery at the University of Maryland in Baltimore, and was awarded a chief residency completion in both surgical trauma and intensive care shock trauma. He then went on to the Baylor College of Medicine in Texas to complete his fellowship in Advanced Minimally Invasive and Bariatric Surgery.

Slim Life Solutions – Check of the Weight loss California treatment such as Obesity California, Gastric bypass California, Weight loss surgery California, Weight loss, lapband surgery and laparoscopic surgery.

In addition to his formal education, Dr. Eslami has been very involved with clinical research, and often presents his articles at various conferences around the country.

Dr Eslami is an active member of the medical staff at several Mercy Hospitals. He has obtained Board Certification in Surgery from the American Board of Surgery. He is a member of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES). Dr Eslami is designated as a Center of Excellence- Bariatric Surgeon through the American Society for Metabolic and Bariatric Surgery (ASMBS) of which he is an active member. Dr. Eslami is an avid runner, biker, and swimmer. He enjoys boating, spending time with friends and family, participating in cultural meetings, and reading history in his spare time.

Ann Savatdy

Medical Assistant

As a member of the Slim Life Solution family and bariatric consultant, Ann provides excellent services and resolves all inquiries with the patients concerning bariatric processes and procedures. She has received compliments from patients because of her easy going, bubbly personality and caring characteristics.

With the knowledge, professional skills, and experience in office administration for more than twelve years and an Associates of Science in Medical Billing and Coding, she is eager to be involved and help assist in changing people’s lives.

Shoua Moua

Medical Assistant

Shoua Moua was born in Fresno, CA. She moved from Fresno to Sacramento and graduated in 2011.While attending college she pursued in Medical Assistant program and received her certificate in 2014. She extern at Sacramento Surgical and three months later was hired as a Medical Assistant for both wonderful surgeons; Dr. Eslami and Dr.Amirikia. Ongoing two years, her position was changed from Medical Assistant to Bariatric Coordinator. Loving to help others, she is now a helping hand to candidates with their goals of weight loss and a better life style before and after surgery. On her spare time, she loves to spend time with family and friends and help them in ways she can.

 

Medical Weight Loss Surgery

Dr. Eslami earned his Doctor of Medicine degree from the University of Tehran in Iran. Upon graduation, Dr. Eslami completed two years of service in the military as a general practitioner. In 1999 he relocated to the United States and completed a residency program in General Surgery at the University of Maryland in Baltimore, and was awarded a chief residency completion in both surgical trauma and intensive care shock trauma. He then went on to the Baylor College of Medicine in Texas to complete his fellowship in Advanced Minimally Invasive and Bariatric Surgery.

Slim Life Solutions – Check of the Weight loss surgery treatment such as Gastric banding, Gastric bypass, Medical weight loss California, Sleeve gastrectomy, lapband surgery and laparoscopic surgery.

In addition to his formal education, Dr. Eslami has been very involved with clinical research, and often presents his articles at various conferences around the country.

Dr Eslami is an active member of the medical staff at several Mercy Hospitals. He has obtained Board Certification in Surgery from the American Board of Surgery. He is a member of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES). Dr Eslami is designated as a Center of Excellence- Bariatric Surgeon through the American Society for Metabolic and Bariatric Surgery (ASMBS) of which he is an active member. Dr. Eslami is an avid runner, biker, and swimmer. He enjoys boating, spending time with friends and family, participating in cultural meetings, and reading history in his spare time.

Morbid Obesity is typically defined as beeing 100 lbs or more over ideal body weight, or having a BMI (Body Mass Index) of 40 or higher. Morbid Obesity reaches a point of significantly increasing the risk of co-Morbidities that result in either significant physical disability or even death. Morbid Obesity is a serious and chronic disease. Treatment is available, and surgery is an extremely viable option for you.

Like every operation, there is a risk. Because our patients already have health-related problems, there is an increased risk of complications. However, our team makes sure the thoroughly screen you to make sure that there are no surprises on the operating table. If we feel that it is not safe to operate on you, we will not proceed. However we will gladly work with you in order for you to be eligible for the operation. Your team will be behind you 100% before, during, and after the surgery.

This really depends on your job. If you work in a low-impact office, you may be able to go back to work after 3 weeks. If you are a construction worker, you may be able to go back after 6 weeks. Each patient heals on their own time, so everyone will recover on their own time.

Afshin Eslami, M.D. Bariatric Surgeons

Dr. Eslami earned his Doctor of Medicine degree from the University of Tehran in Iran. Upon graduation, Dr. Eslami completed two years of service in the military as a general practitioner. In 1999 he relocated to the United States and completed a residency program in General Surgery at the University of Maryland in Baltimore, and was awarded a chief residency completion in both surgical trauma and intensive care shock trauma. He then went on to the Baylor College of Medicine in Texas to complete his fellowship in Advanced Minimally Invasive and Bariatric Surgery.

Slim Life Solutions – Check of the Medical weight loss treatment such as Obesity surgery, Gastric banding California,  Obesity surgery California, Sleeve gastrectomy California , lapband surgery and laparoscopic surgery.

Dr Eslami is an active member of the medical staff at several Mercy Hospitals. He has obtained Board Certification in Surgery from the American Board of Surgery. He is a member of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) . Dr Eslami is designated as a Center of Excellence- Bariatric Surgeon through the American Society for Metabolic and Bariatric Surgery (ASMBS) of which he is an active member. Dr. Eslami is an avid runner, biker, and swimmer. He enjoys boating, spending time with friends and family, participating in cultural meetings, and reading history in his spare time.

Lynette Saldana
Bariatric Coordinator

As Bariatric coordinator Lynette brings 10 years of experience. She has assisted hundreds of patients through the process of pre surgical preparation. Given Lynette’s experience & passion for bariatric patients and knowing the issues that obese individuals face she gives our practice the personal touch that they deserve. Lynette is always available to answer any questions you might have about steps to achieve your dream of weight loss.

Valarie Kane, RD
Registered Dietitian/Nutritionist

Valarie Kane is a Registered Dietitian and earned her Bachelors of Science in Dietetics from California State University of Sacramento. While completing her dietetic internship at Oregon Health & Science University, Valarie acquired extensive experience in both adults and pediatrics working in an inpatient hospital setting, as well as with various outpatient clinics. She is a member of the Academy of Nutrition and Dietetics and the California Dietetics Association. She continues her education at various conferences and seminars throughout the country. Valarie has a special interest in gastrointestinal diseases, food allergies, and weight management.

Valarie is currently working towards becoming a certified specialist in Adult Weight Management as well as Child & Adolescent Weight Management.

She enjoys traveling, new adventures, and spending time with family and friends. She enjoys teaching nutrition education and helping people achieve their goals through behavior change, diet modification and creating a healthy lifestyle overall.

Bariatric Surgeon

Afshin Eslami, M.D.

Dr. Eslami earned his Doctor of Medicine degree from the University of Tehran in Iran. Upon graduation, Dr. Eslami completed two years of service in the military as a general practitioner. In 1999 he relocated to the United States and completed a residency program in General Surgery at the University of Maryland in Baltimore, and was awarded a chief residency completion in both surgical trauma and intensive care shock trauma. He then went on to the Baylor College of Medicine in Texas to complete his fellowship in Advanced Minimally Invasive and Bariatric Surgery.

Slim Life Solutions – Check of the Weight loss California treatment such as Obesity California, Gastric bypass California, Weight loss surgery California, Weight loss, lapband surgery and laparoscopic surgery.

Dr Eslami is an active member of the medical staff at several Mercy Hospitals. He has obtained Board Certification in Surgery from the American Board of Surgery. He is a member of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) . Dr Eslami is designated as a Center of Excellence- Bariatric Surgeon through the American Society for Metabolic and Bariatric Surgery (ASMBS) of which he is an active member. Dr. Eslami is an avid runner, biker, and swimmer. He enjoys boating, spending time with friends and family, participating in cultural meetings, and reading history in his spare time.

Mania Deldar Doucette
Counselor

Mania Deldar Doucette, MFTI, is a Registered Marriage Family Therapist Intern, Registration #73945, who is supervised by Leslie Baughman, LMFT Lic #41380. She received a Master’s degree in Marriage, Family, and Child Counseling from California State University Sacramento and graduated with honors.  She has received high praise for her ability to connect with clients and help them to achieve their therapeutic goals. In addition to her academic coursework and practicum placement, Mania has completed internships at prestigious institutions such as UC Davis CAARE Center and Head Start.

Mania is experienced in working with individuals (children, teens and adults), couples, and families. She specializes in working with individuals who are overweight and/or compulsively overeat as well as their families.  Her clinical emphasis utilizes an integrated approach of therapeutic modalities with a strong emphasis on Cognitive Behavior Therapy (CBT).Mania is fluent in Farsi and is also Safe Zone Certified to work effectively with the Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) population.

Shoua Moua
Medical Assistant

Shoua Moua was born in Fresno, CA. She moved from Fresno to Sacramento and graduated in 2011.While attending college she pursued in Medical Assistant program and received her certificate in 2014. She extern at Sacramento Surgical and three months later was hired as a Medical Assistant for both wonderful surgeons; Dr. Eslami and Dr.Amirikia. Ongoing two years, her position was changed from Medical Assistant to Bariatric Coordinator. Loving to help others, she is now a helping hand to candidates with their goals of weight loss and a better life style before and after surgery. On her spare time, she loves to spend time with family and friends and help them in ways she can.

Bariatric Surgeon Afshin Eslami, M.D.

Dr. Eslami earned his Doctor of Medicine degree from the University of Tehran in Iran. Upon graduation, Dr. Eslami completed two years of service in the military as a general practitioner. In 1999 he relocated to the United States and completed a residency program in General Surgery at the University of Maryland in Baltimore, and was awarded a chief residency completion in both surgical trauma and intensive care shock trauma. He then went on to the Baylor College of Medicine in Texas to complete his fellowship in Advanced Minimally Invasive and Bariatric Surgery.

Slim Life Solutions – Check of the Weight loss surgery treatment such as Gastric banding, Gastric bypass, Medical weight loss California, Sleeve gastrectomy, lapband surgery and laparoscopic surgery.

Dr Eslami is an active member of the medical staff at several Mercy Hospitals. He has obtained Board Certification in Surgery from the American Board of Surgery. He is a member of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES). Dr Eslami is designated as a Center of Excellence- Bariatric Surgeon through the American Society for Metabolic and Bariatric Surgery (ASMBS) of which he is an active member. Dr. Eslami is an avid runner, biker, and swimmer. He enjoys boating, spending time with friends and family, participating in cultural meetings, and reading history in his spare time.

Ann Savatdy

Medical Assistant

As a member of the Slim Life Solution family and bariatric consultant, Ann provides excellent services and resolves all inquiries with the patients concerning bariatric processes and procedures. She has received compliments from patients because of her easy going, bubbly personality and caring characteristics.

With the knowledge, professional skills, and experience in office administration for more than twelve years and an Associates of Science in Medical Billing and Coding, she is eager to be involved and help assist in changing people’s lives.

Valarie Kane, RD

Registered Dietitian/Nutritionist

Valarie Kane is a Registered Dietitian and earned her Bachelors of Science in Dietetics from California State University of Sacramento. While completing her dietetic internship at Oregon Health & Science University, Valarie acquired extensive experience in both adults and pediatrics working in an inpatient hospital setting, as well as with various outpatient clinics. She is a member of the Academy of Nutrition and Dietetics and the California Dietetics Association. She continues her education at various conferences and seminars throughout the country. Valarie has a special interest in gastrointestinal diseases, food allergies, and weight management.

Valarie is currently working towards becoming a certified specialist in Adult Weight Management as well as Child & Adolescent Weight Management.

She enjoys traveling, new adventures, and spending time with family and friends. She enjoys teaching nutrition education and helping people achieve their goals through behavior change, diet modification and creating a healthy lifestyle overall.

Medical specialists California

Dr. Eslami earned his Doctor of Medicine degree from the University of Tehran in Iran. Upon graduation, Dr. Eslami completed two years of service in the military as a general practitioner. In 1999 he relocated to the United States and completed a residency program in General Surgery at the University of Maryland in Baltimore, and was awarded a chief residency completion in both surgical trauma and intensive care shock trauma. He then went on to the Baylor College of Medicine in Texas to complete his fellowship in Advanced Minimally Invasive and Bariatric Surgery.

Before seeing any medical specialist, it is always preferable to talk to your own family doctor, who can discuss your condition with you and advise on whether any specialist care is appropriate. If it is, he or she can help you to choose the specialist best suited to your needs. Your family doctor can help the specialist to care for you better by providing relevant information about your health. Communicating with the specialist will also enable your family doctor to care for you better during and after your specialist treatment & Obesity California.

Most medical specialists will accept only referred patients. This is partly to try to ensure that the specialist you are seeing is appropriate for you and your condition, and also because Medicare pays higher rebates for specialist services if you have been referred & Weight loss California.

Your medical file is handled with the utmost respect for your privacy. Our staff are bound by strict confidentiality requirements as a condition of employment regarding your medical records. Ordinarily we will not release the contents of your medical file without your consent.

During your initial visit, the doctor will explain the specific test or procedure you want, help you visualize the results and go over the risks. He may do a physical examination and ask you a bunch of questions. Once you go and have the test done then he will decide what your diagnosis and appropriate treatment.

Apart from medicare and your insurance information

  • Drivers License or a valid ID
  • Insurance information
  • Referral Letter (if required)
  • Reports, X-rays, MRI’s, CT scans etc and any other relevant information
  • List of medications (if any)

Your body needs to receive the proper vitamins in order to survive. We have created our own special vitamins for you to take after the operation. Your doctor will also go over with you any medicines you need to take. Most patients actually stop taking their medication from pre-surgery because they are healthy!

Slim Life Solutions – Check of the Medical weight loss California treatment such as Weight loss California, Gastric bypass California, sleeve gastrectomy, lapband surgery and laparoscopic surgery.