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Showing content with the highest reputation since 10/16/2018 in Magazine Articles

  1. 4 points
    Alex Brecher

    New Year’s Resolutions

    Consider this: you can be 10 times more likely to achieve your goals if you make New Year’s resolutions than if you do not. That statistic may motivate you to take a little care in setting your goals for this year. So, here are a few tips for setting resolutions that you can keep. Make Them Realistic We all want to hit goal weight and stay there, but is that realistic for you? Probably not, if you are more than 70 to 100 lbs. overweight and have not yet had weight loss surgery. A more realistic resolution might be to schedule your surgery and then lose an average of 5 to 10 lbs. per month after surgery. These are some additional examples of unrealistic and realistic resolutions. Get to the gym every day. Work out at the gym or walk 5 days per week. Follow your diet perfectly. Get back on track within a day of losing control. Avoid all restaurants. Check the nutrition facts beforehand and make healthy choices when you order. Plan all meals and snacks ahead of time. Keep protein bars and other healthy protein snacks on hand for when you need them unexpectedly. Make Them Specific Yes, you want to lose weight for example. But how much do you want to lose? Your resolution might include the number of pounds you want to lose or the BMI you want to hit. It might be to lose back the pounds you regained after weight loss surgery a few years ago. Here are some other examples of specific resolutions to consider. Drink at least 64 ounces of water per day. Attend two support group meetings each month. Eat at least two servings of fish per week. Eat at least 65 grams of protein per day. When you make your goals specific, you know whether or not you are making progress towards them and when you hit them. That is motivating, and it keeps you honest with yourself. Consider the Process A goal is an endpoint. Your resolution might be to achieve those goals, but it should also include the process, or “how” you are planning to get there. If your resolution is to eat five servings of fruits and vegetables per day, your process might include storing canned and frozen vegetables so they are always available, keeping washed and cut fruits and vegetables in the fridge for snacks, and adding a half-cup of vegetables to your omelets. Here are some more examples of ways you can focus on the process. To hit your pre-op weight loss requirements, swap water for soda and side salads for fries. To get to the gym more often, lay out your clothes and shoes the night before, and figure out which workout you will do once you are at the gym. To move closer to your weight loss surgery, find out how to get approval for insurance reimbursement (or how you will finance your surgery) and which surgeons are your top choices. To get your blood sugar levels down, healthify your carb choices by identifying which are sugary and refined, and swapping them with high-fiber, unrefined whole grains, beans, and fruits. Stay Accountable Your resolutions are important to you, so make them a priority and hold yourself accountable. One way is to use the buddy system. You can either find a buddy with resolutions similar to yours, or just use a buddy who is willing to hold you accountable. Check in regularly with each other on your progress, encourage each other, and ask the tough questions if either of you are falling off track. Another way to hold yourself accountable is to use a log. Use an old-fashioned pencil and paper log, or opt for an online or smartphone app. Depending on your resolution, you can record thoughts, feelings, and progress, as well as food intake, weight, and exercise. Seeing your efforts in black and white can keep you honest and motivate you to keep going. Be Patient with Yourself Recognize that you won’t do it all at once, and that you will make mistakes. Set smaller incremental goals so that you can see progress in January, but keep the big picture in mind and realize that your resolutions are long-term. The big payoffs will come later in the year if you stick with your resolutions. Also, have a plan to forgive yourself, because things will go wrong. Dust yourself off and get back up, because you can achieve your goals!
  2. 4 points
    First off, I just want to say this very important thing, if you take nothing else away from this article, let it be this- People’s reactions to you are based on their relationship with themselves, not you. Always. Someone who is living at peace with themselves will have no need to harshly criticize, no desire to humiliate, and no feelings of unresolved jealousy. Sadly, once you understand this, you also realize how many people in your life are unhappy with themselves on some level. It makes it a little easier not to take things personally, but I would be lying if I said those things don’t hurt anymore. So how do you deal with friends and family members who are not living at peace with themselves? What practical steps can you take to be at peace with yourself so that you are able to reject those statements and hurtful judgments instead of internalizing them? Here’s the bottom line- You will always have people in your life who do not wish you well, who want to see you fail. If you do not learn to look past them and stay focused on you and your progress, and live at peace with yourself- you will experience re-gain. I love the words from Eleanor Roosevelt, “No one can make you feel inferior without your consent.” 1) Start with yourself- You need to be at peace with yourself. Who you are, what you weigh, your progress level, etc. Easier said than done, I know. But working towards that will allow you to bypass other’s opinions of you because you know who you are and where you’re going. A simple way to begin embracing yourself is positive self-talk. Start by looking into the mirror as often as you can, and saying things to yourself like, “I am a beautiful, peacefully person and I love me.” Say hello to yourself. “Hi Ash, you are a wonderful, beautiful person and I am SO proud of you.” It’s going to feel super painful and may trigger some emotions. Process those as they come, don’t shy away from the feelings that embracing yourself brings. If you need to cry, do so. If you smile, embrace it. Enjoy yourself. Changing that negative narrative in your head that so many of us carry around, is step one. 2) Be honest- When someone says something that’s offensive, it usually comes from one of 2 places: a poor relationship with themselves, or a lack of education. Use your best judgment to determine which it is. Keep in mind, there are a LOT of myths and misinformation surrounding bariatric surgery. Don’t assume people know more than they do. Think back to before you became an expert on Bariatric Surgery. How many questions you had, how many myths you thought were accurate. Seek to educate. But be honest, if someone makes a hurtful comment, let them know. Keep it simple, “Hey, that was uncalled for.” or “Please don’t say things like that to me.” Try to stay calm and in control. 3) Take a break- If you need a break, take one! Go for a walk, get out of the house, go listen to music alone. Don’t feel bad for needing a break. Family time can be stressful, don’t allow others to jeopardize your progress. When you’re stressed and anxious, you’re more prone to overeating which puts you back on that harmful cycle you’re working so hard to stay off of. Give yourself permission to stay home sometimes too, you don’t need to be at every single family gathering. It’s okay to opt out. People may get offended, they may try to make you feel guilty, but remember- it’s not about you. It’s all about how they feel about themselves. Those who are at peace with themselves will support you and do their best to understand where you’re coming from. 4) Stay focused- This is a tough one. Holidays pull our focus in so many directions, it’s easy for us to lose focus on our goals. Be proactive about making plans for yourself for food and exercising during the holidays. Being ahead of the game and staying on top of your plans will make you feel peaceful and accomplished. When you feel this way, your confidence is harder to shake and you will feel more secure. When you’re focused on a goal, it consumes your focus and the other things that pop up to derail you just fade into the background. Stick to your routine, take your supplements, and stay on track. You can do this! 5) Stay connected- Join a support group in-person or online, find an accountability buddy, hire a coach, or grab a friend who will keep you focused without judgment. Someone you can call, text or write to keep them updated so they can provide you with the encouragement you may not be getting from others this season. Having connection fills an emotional need that many try to fill with food. If you’re getting that need met, you won’t be as tempted to eat for comfort. Connection is something we all need, so make it a priority to have someone in your corner this holiday season. Remember, at the end of the day- this season is temporary. All the food, all the family, all the hustle and bustle. The things that can make or break this season. It’s all temporary. You are what you carry into the New Year. Your health journey is what lasts. Keep your sights on the long term. You can do this, I believe in you!
  3. 3 points
    Try to see their side. You are asking them to see it from your perspective, so it is only fair that you try to see it from theirs. What are the reasons they may be against your Weight Loss Surgery, and how can you address them? In many cases, their concerns are legitimately about your well-being, and things you should consider if you have not already. They may worry that: You will not hit your goal weight this time since they’ve seen disappointment before. You will suffer complications from surgery. You will regret having a permanent Sometimes, their concerns are selfish but still worth discussing. They may worry that: You’ll stop feeling attracted to them. You will pressure them to give up their own favorite foods while you eat healthily. They will feel left out. You will not want to spend time with them. Reassure them. Address their concerns directly. Explain why you feel the surgery is safe, and how much research you have done to learn about it as well as find a surgeon. Tell them why you think Weight Loss Surgery will work for you even if previous diets have not. Let them know that you need to do this for yourself, not for them and that this will not change the way you feel about them – you will still love your SO, and respect your parents, for example. Tell them how you see yourself spending time with them after surgery, so they can be comfortable. Write it down and practice. Starting the conversation can be the scariest part of telling them. Before you bring up the subject, write down what you plan to say. This is a good exercise for you to do anyway since it encourages you to think through all of the doubts around Weight Loss Surgery. Writing it down and practicing can make it easier for the words to come when you decide to bring it up. Include them in your plans. Often, your spouse and parents, and others who care about you, just want to help. They may be afraid if they do not how to help. When you talk to them, let them know how important they are to you, both in life in general and in this important period of your life. If you tell them specifically what they can do to support you, they may feel more at ease with your decision and more confident in their roles. You might ask them to: Pick up your children from school when you are recovering from surgery. Go with you to the store to pick out protein powders and measuring cups and spoons. Ask you each night how you are doing. Cook healthy meals with you. Prepare for anything. The conversation may be as difficult and unfulfilling as you feared. Or, your SO, parents or other loved ones may be surprisingly supportive once they realize that you have done your research and are serious about making the lifestyle changes needed for success. They may even be interested in getting healthy with you and ask for your help and support in exchange for theirs. Stay strong and independent. As much as you long for your SO and other loved ones to support you wholeheartedly, it may not happen. Try not to let it get you down, though. If you are sure about what you want, go for it, with or without them. They will come around sooner or later, and if not, you may be better off without their negative influence. Letting them know that you have made up your mind regardless of their support may actually convince them to help you since there is no point in standing in your way. Stay independent in the sense that you realize that you do not need them. Your success does not depend on their approval, and you are not doomed to fail if they stand in your way. Get the support you need from others as you move forward.
  4. 3 points
    Louisa Latela

    Go With Your Gut!

    When we do not pay attention to our intuition there is a low level anxiety/energy that constantly runs in the background of our mind/body. And we consciously (or not so consciously) think things like “I know I should speak up for myself at work, but I don’t want to make waves.” “I really should have an omelet for breakfast but the donut looks good, I know I’ll feel sick afterwards, oh it doesn't matter, I'll eat better tomorrow.” “I never should have volunteered to do that project: I don't have the time, but I didn't want to disappoint my friend.” “I know my partner treats me disrespectfully, he doesn’t really mean it I know he wants to change. I’m gonna keep my mouth shut and hope he changes soon.” etc. Having all this background chatter is annoying. Guess What?? Overeating or eating foods that make you sleepy or foggy is a GREAT way to dull that noise. However if you want to lose weight and keep it off in a healthfully, you must learn to respond to your overeating triggers in positive, self nurturing way. If ignoring your intuition is one of your triggers here is a simple way to begin to notice your intuition. When you make a commitment to "playing around with this" you will undoubtedly begin to be more aware of your gut instincts in more important areas of your life: relationships, work, health. Once you start to trust your intuition you will continually be guided to people places and things that you support you in your quest to life a healthy joy-filled life! This comes from my Nurturing Nudge # 55 Go With Your Gut! Practice listening to and acting on your intuitive hunches. If this is a new concept for you, start out with small things like trusting your gut when it comes to getting in the fastest moving line at the bank, or finding a great parking spot. In these instances your intuitive hunch is the very first feeling/thought/inclination that comes up when you pose a question. For instance your intuitive hunch might be to get in a longer line at the bank, something your rational mind would argue. But I challenge you to go with your gut. More times than not I bet you find that your intuitive hunch was right. Another easy way to better trust your instincts is to call or email a friend when the thought of them pops up in you mind. Whenever I do this I usually find that my friend was just thinking about me or that he or she needed my support at the exact time I reached out to him/her. This is great practice for learning to live your life in connection with your Higher Power, your Intuitive Knowing, which will always guide you to act in ways that are loving and respectful to yourself and others; that support your Highest Good. Know this: You have all the wisdom and knowledge you will ever need inside you. Practice accessing, listening to, and acting on its promptings. When you do this you might be surprised to notice that you experience a feeling of lightness and increased energy, a greater sense of well being, and a sense of things flowing easily and effortlessly! It is soooo cool to follow your instincts and see that they were right on even when they made no logical sense! Kinda makes your heart giggle!! AFFIRMATIONS I trust my gut! My intuition guides my every action! The more I listen to my intuition the louder it speaks! My gut rocks! Live In Love 😘 Louisa If you've had weight loss surgery but found that you've regained some weight this group may be a valuable resource for getting back on track. https://www.eventbrite.com/e/lighten-up-tickets-53027486640?fbclid=IwAR3hCtIcVvH46SlVTyyOEN-vzTbBPc7OiMEoahTlWxokL1qHuOLAhOpIukg
  5. 1 point
    First off, what is a ketogenic diet? The ketogenic diet is a very low carbohydrate, very high fat, low-moderate protein diet. Historically, it has been used to control epilepsy in children. When you don’t give your body carbohydrates (your body’s preferred fuel source), it begins to use and break down body fat as a source of energy, which is called ketosis. The breakdown of fat leads to the production of ketones, and the ketones are what begin to fuel your body (instead of the carbohydrates you were feeding it before). This process can take a few days to achieve, and when done correctly, can be tested by measuring the ketones in your urine with a dipstick. If ketones are present, this means you’re in ketosis. What does the macronutrient profile look like? FAT – A ketogenic diet should include healthy fats such as fats from fish, seafood, eggs, nuts, vegetable oils, dairy, and some meats. There is a lot of poor information on the internet that encourages people to have the majority of their fats in the form of cream, lard, bacon, and fried foods, which are not good for our heart. CARBOHYDRATES – The ketogenic diet is described differently depending on the source, but on average it means limiting your carbohydrates to 5-10% of total daily calories. For bariatric patients eating around 1200, 1500, or 1800 calories/day, this works out to 22, 28, or 34 g of carbohydrates/day, respectively. That’s very little! Foods rich in carbohydrates that are limited/eliminated in a ketogenic diet include: grain products (e.g. pasta, rice, bread, etc.), fruit, many vegetables (e.g. potatoes, corn, carrots, squash, etc.), some dairy products (e.g. milk, yogurt), legumes (e.g. chickpeas, beans, lentils), and sweets and sweetened beverages (e.g. chocolate, ice cream, pastries, juice, soda, etc.). That’s a lot of food groups being restricted! PROTEIN – On a ketogenic diet, protein is considered low-moderate (depending on your protein requirement), or around 15-20% of total calories. For bariatric patients eating around 1200, 1500, or 1800 calories/day, this works out to 52, 65, or 78 g of protein/day, respectively. Are these protein targets in the range that your dietitian has recommended for you? For many of you, likely not. FIBRE – Fibre falls under the umbrella of carbohydrates. Because you now know that carbohydrates are very limited on a ketogenic diet, you can guess that fibre will also be very limited. A diet very low in grain products, fruits, most vegetables, and legumes means that constipation is going to be a real issue! I heard that a ketogenic diet leads to rapid weight loss. It’s true in the beginning, but the important factor here is to understand what kind of weight loss this is. Yes, it’s true that reducing carbohydrates leads to weight loss, however the weight that’s initially lost is mainly water weight, not fat. Here’s a behind the scenes look at what’s going on: Your body always wants to keep your blood sugar well controlled, so it stores some sugar (or glycogen) in your liver. When you’re sleeping, or fasting, your body uses this stored glycogen to send some sugar into your blood, to be sure that your blood sugar doesn’t drop too low. Glycogen is stored in your body by attaching glucose to water. So when we empty our glycogen stores, we’re actually losing a fair bit of water as well, and that’s the initial weight loss that you see. The weight loss that follows from there is partly muscle loss if you’re not meeting your protein needs (which as discussed above, might be the case) and fat. While ketogenic diets have been shown to be better for weight loss than other low fat diets, the results are only true in the short term. In the long-term, there doesn’t appear to be any difference. You’re also more prone to rebound weight regain on a ketogenic diet once you re-introduce carbohydrates again (whether by choice, by cravings, or by obligation because you feel unwell without them). But I thought that the ketogenic diet was proven to be effective? The ketogenic diet isn’t a new diet at all. It’s actually been used for almost 100 years to treat children with severe epilepsy who don’t respond to medication. However, even these children don’t stay on the ketogenic diet their whole lives, they only do so for a temporary amount of time. These children are followed very closely by their doctor and dietitian to very slowly bring carbohydrates back into their diet. Despite what you dietitians say, I want to try the ketogenic diet! Ultimately, it’s entirely your decision to try what you want. We (as dietitians) are only here to guide you through the evidence that’s out there, and as of now, there’s no research on the ketogenic diet after bariatric surgery. There’s also not enough long-term research to know and understand if the ketogenic diet is safe for your heart in the long-term (i.e. more than 12 months of being on the diet). Three of our biggest concerns as dietitians are: 1) Are you meeting your protein needs? 2) Are you emphasizing healthy fats; 3) Are you just looking for a quick fix? If you’re using the ketogenic diet as a “reset” just like the last fad diet you tried, you’re only feeding the yo-yo dieting pattern (just playing devil’s advocate here!). Can I be on a ketogenic diet my whole life? The honest answer is we don’t know. We don’t have research on the long-term effects of following a ketogenic diet. It’s suspected that it may lead to higher cholesterol levels which may lead to heart disease, but more research is needed to conclude this. Does being on a ketogenic diet guarantee that I’ll keep the weight off? While more research is needed, one study showed that the participants who were very strict about following the ketogenic diet were able to keep off the initial weight loss for up to 56 weeks (or a little more than one year). We don’t have the research to say if in 10 or 20 years that their weight will still be stable or not. We do know however, that if you don’t find the ketogenic diet realistic for your lifestyle and you end up coming off of it, you will regain the weight (if not more), as with any temporary diet. Is the ketogenic diet safe? While it may be generally safe (meaning you’re not going to die) for most people, you should always check with your doctor, especially if you have heart disease, liver disease, and diabetes, as this diet may put your health at risk. The ketogenic diet is not considered safe for those who have chronic kidney disease. The ketogenic diet has received a lot of criticism because it’s a very restrictive diet, eliminating many foods and therefore many nutrients that are important for health. Following this diet puts you at high risk for micronutrient deficiencies. Make sure you discuss additional vitamin supplementation with your family doctor or dietitian. What are the benefits of a ketogenic diet? Aside from weight loss, following a ketogenic diet has been shown to improve blood sugar control in those with type 2 diabetes, lower triglycerides, lower LDL cholesterol (the ‘bad’ cholesterol), and raise HDL cholesterol (the ‘good’ cholesterol). Although these benefits sound attractive, know that other low fat diets have produced similar results, and would be safer in the long-term since they’ve been better studied and are less restrictive overall. What are the risks of following a ketogenic diet? Liver disease? – More research is needed, but several rat studies have shown an increased risk of developing liver disease. While results from rat studies don’t 100% translate into humans, animal studies often give an indication or at least a starting point for how something will affect the human body. More research is needed in human subjects. Muscle loss. – Another risk of following a ketogenic diet is muscle loss, because most patients aren’t able to meet their protein goals. Losing muscle may put you at risk of weight gain. Working with a dietitian while following a ketogenic diet can help you be sure you’re meeting your protein needs. Earlier death? – Like we’ve mentioned, there isn’t enough research yet on the long-term risks of following a ketogenic diet, but a recent study found that low carbohydrate diets (less than 40% of calories from carbohydrates) was linked to earlier death, compared to having a moderate-carbohydrate diet (50-55% of calories from carbohydrates). Remember that a ketogenic diet has around 5-10% of calories coming from carbohydrates. How did they explain this increased risk? The risk with a low carbohydrate diet seems to be because the carbohydrate calories are often replaced with more animal protein and unhealthy fats, rather than plant-based protein and healthy fats. Note that this study was not on bariatric patients, but again, the findings are interesting. What are the side effects of a ketogenic diet? Side effects during the adaptation period (i.e. in the beginning of following a ketogenic diet) include: brain fog, fatigue, headaches, nausea, strong smelling sweat and urine, constipation or diarrhea, and poorer exercise performance. Long-term side effects include: bad breath, micronutrient deficiencies, and muscle loss. What are common misconceptions of the ketogenic diet? Many people believe that it’s a carbohydrate-free diet, meaning no carbohydrates at all. This isn’t the case. You can have in the range of 20-50 g of carbohydrates per day (depending on how many calories you’re eating). If you don’t know what this looks like in terms of food, speak with your dietitian. Another misconception is that a ketogenic diet is high in protein. This also isn’t the case. A ketogenic diet is moderate in protein for the average person (who hasn’t had bariatric surgery), and is therefore typically low in protein for a bariatric patient. As you likely know, low protein puts you at risk of losing muscle which will affect your overall weight loss, and put you at higher risk of weight regain in the future. Other than muscle loss, what are other negative nutrition consequences of following a ketogenic diet after bariatric surgery? Low in fibre – The smaller food intake that you have after surgery already makes getting in enough fibre difficult. This partly explains why so many people are constipated after surgery. A ketogenic diet significantly limits most fibre-containing foods including fruit, most vegetables, grain products, and legumes, so your fibre intake decreases even more. Constipation is therefore even more of an issue! High in unhealthy fats – Many people don’t follow a ketogenic diet correctly and include too much saturated fats (or unhealthy fats) in their diet. For example, they may choose bacon, sausages, and lard, over fish, nuts, and vegetable oils. A diet high in saturated fats has been linked to heart disease. Low in many micronutrients – A ketogenic diet is also low in important vitamins and minerals such as thiamine, folate, vitamin A, calcium, magnesium, iron, and potassium. While you’re prescribed vitamins and minerals supplements after bariatric surgery, these standard prescriptions don’t account for you following a ketogenic diet. If you do decide to follow a ketogenic diet, it’s important to have your doctor or dietitian re-assess your vitamin and mineral supplements and for you to continue doing blood work regularly. Will I be able to exercise just as much while on a ketogenic diet? The downside to following a ketogenic diet is that it may actually reduce your exercise performance (across anaerobic, aerobic, and strength related exercises) in the short-term. If you’re doing low intensity exercises such as walking or a leisure bike ride however, you shouldn’t notice a difference. More research is needed to understand how a ketogenic diet affects exercise performance, especially in the long-term. I’ve been having episodes of low blood sugar after bariatric surgery. Can I follow the ketogenic diet? If you’ve been experiencing low blood sugar after surgery, it’s not recommended to start a ketogenic diet. It’s important to understand why you are experiencing low blood sugar as soon as possible. Here are some of the most common reasons for low blood sugar after bariatric surgery: Dumping syndrome due to high sugar intake Going long periods of time without eating Not eating enough carbohydrates or not spacing your carbohydrates out during the day Excess exercise An overactive pancreas Diabetic medication that is not adjusted properly Speak with your dietitian to figure out why your blood sugar keeps dropping. I plan to try the ketogenic diet for a few weeks and then come off of it. If that’s the case, then don’t bother. The reason this diet works for weight loss is because you are in ketosis (which in itself takes a couple of days to achieve because you need to use up your glycogen stores). If you come out of ketosis, you will no longer see the effects, and thus begins the yo-yo dieting effect. Always remember – Temporary changes yield temporary results! I’m already on the ketogenic diet, how can I come off of it safely? If you’ve already started the diet, reintroducing carbohydrates can lead to bloating, unstable blood sugars, and weight regain. To minimize these effects, begin by including whole grain products, rather than refined processed carbohydrates (e.g. white bread, breakfast cereals, pretzels, etc.). Whole grain foods include quinoa, brown or wild rice, oatmeal, bulgur, and barley. Sweet potatoes would also be appropriate. Include 1 to 2 tablespoons at only one meal per day for up to one week. If you’re feeling okay, begin including one fruit at one snack for a few days, and then try reintroducing yogurt and milk. But aren’t there doctors and health gurus out there promoting the ketogenic diet? Yes, there are, but there also were doctors and health gurus promoting the Atkins diet, the Pritikin diet, and the Dukan diet back in the day. There will always be people out there trying to capitalize on the newest fad diet to sell you on the weight loss dream and to take your money. It’s easy to point fingers and put the blame on specific foods or food groups, but ultimately the only way of eating that has been proven effective time and time again, is moderation. As dietitians, we know very well that ‘moderation’ (which means something different for each of our clients) isn’t sexy, but it’s key to having a healthy long-term relationship with food. I’m pregnant and I want to follow a ketogenic diet. Following a ketogenic diet during pregnancy is not recommended. While your body can handle being in ketosis, the production of ketones is harmful to your baby’s development, particularly their brain development. SUMMARY… – A ketogenic diet is very low carbohydrate, very high fat, low-moderate protein diet. – A ketogenic diet should emphasize healthy fats, but many sources online emphasize online unhealthy fats (e.g. bacon, sausage, lard, cream, etc.). – A ketogenic diet is very low in carbohydrates. This means that it’s not only grain products that are limited (e.g. pasta, rice, bread, etc.), but also fruit, many vegetables, some dairy products, legumes, and sweets. – By default, a ketogenic diet is also low in fibre which results in constipation in many patients. – A ketogenic diet is considered low-moderate in protein. Most bariatric patients aren’t able to meet their protein needs on ketogenic diet which results in muscle loss. – We don’t know the effects of a very high fat diet on health long-term, but it likely isn’t good for heart health. – Many of the benefits of a ketogenic diet (e.g. weight loss, improved blood sugars, lower triglycerides, lower LDL cholesterol, increased HDL cholesterol, etc.), are similarly seen in low-fat diets (while being way less restrictive overall). – There are many unpleasant side effects to following a ketogenic diet including constipation, poorer exercise performance (at least short-term, no research on long-term performance), muscle loss, bad breath, and micronutrient deficiencies. – You likely need to take additional vitamin and mineral supplements while following a ketogenic diet. Regular blood tests are still very important. – A ketogenic diet is not recommended in a variety of health conditions, and is even considered dangerous for some (e.g. patients with chronic kidney disease and pregnant women). Always check with your family doctor and dietitian before making drastic changes to your diet. – The ketogenic diet has not been studied in people who have had bariatric surgery, so the short-term and long-term effects are unknown. – The ketogenic diet is very restrictive and is therefore not sustainable for the majority of people. Eating out and socializing around food become almost impossible. Our final thoughts… Many patients are quick to blame carbohydrates for weight regain. Instead of jumping to a ketogenic diet, we recommend reviewing the bariatric basics and booking an appointment with your bariatric dietitian. If you absolutely insist on trying a ketogenic diet, we suggest a “modified keto diet” that consists of more plant-based protein and healthy fats, with enough protein to be sure you’re maintaining your muscle mass. What are your thoughts on the ketogenic diet? Have you been tempted? Are you currently following a ketogenic diet? – Lisa & Monica, your bariatric dietitians P.S. For more tips on healthy living after bariatric surgery, follow us on Facebook (@bariatricsurgerynutrition) or check out our highly praised book HERE!
  6. 1 point
    Like pretty much everything else in your life, the holidays are a whole new ballgame after weight loss surgery. Your weight loss surgery diet is strict. It doesn’t include fatty foods and sugary desserts. Going off your weight loss surgery diet can stall weight loss and also cause complications. You could be prone to dumping syndrome if you have the gastric sleeve or gastric bypass, and lap-banders can face obstructions and acid reflux with the wrong foods or too much. If you let your guard down for the rest of November and December, you can find yourself slipping off of your diet and feeling pretty unhealthy. But by keeping your eyes open and planning ahead, you can keep yourself on track and get through the holiday season feeling proud of yourself. Watch Carefully to Avoid Extra Calories Calories show up everywhere at this time of year. Sometimes they don’t even seem that bad, but they add up quickly. Have a bite here and a handful there without paying much attention, and you might be disappointed when you weigh in on New Year’s Day. Don’t let calories slip into your diet. First, be aware of the extra calories that are around. They can include any of the following. Lunch or dinner out when a friend or family member comes to town. Chocolate truffles on the secretary’s desk or the break room at work. Cookies from well-meaning friends and family who want you to taste-test their creations. Sweetened, pumpkin-spice coffee instead of calorie-free regular coffee. Food court fare when you’re holiday shopping at the mall. Holiday parties, potlucks, and dinners. Stick to Your Good WLS Habits The first line of defense is to stick to your regular good everyday weight loss surgery habits. Log every bite of food you take to keep from getting in hundreds of extra calories from sneaking in a taste here and there. Even if you have to estimate the calories in some of your food, especially if you eat out or at a party, you can keep more discipline if you log your food. Also, think about your other healthy habits. Keep drinking water between meals. And, protein is still all-important. Make sure you have some at each meal and snack. Focusing on finding lean protein can keep you focused when you’re faced with all kinds of other unhealthy choices. Arm Yourself Against Temptation If you’re starving and you’re face-to-face with a basket of chocolate-covered pretzels, you might opt for the sugary, high-carb snack. Unless that is, you have your own weapon. Keep some high-protein and low-calorie choices with you at all times so you never need to go for the junk food in desperation. We have many health snack options at the BariatricPal Store! Take them with you to work, or in your car, purse, or pocket. You can have them if you’re stuck in traffic or at the mall at mealtimes. Almonds packed in 1-ounce portions. Beef jerky (not fatty beef sticks). Apples Cheese sticks Roasted soybeans or garbanzo beans Tuna pouch Work around Your Cravings You don’t need to deprive yourself completely at holiday time. If there’s a particular taste you want, there’s a good chance you can satisfy your craving with a healthier alternative. For example, you can have lean ham and turkey breast instead of brisket and turkey with the skin on it. Roast green beans with onions, rosemary, and balsamic vinegar instead of having green bean casserole, bake sweet potatoes instead of having candied ones, and puree cauliflower or carrot instead of making mashed potatoes. Use the same strategy for desserts. Go for sugar-free cocoa mix instead of chocolate fudge when you’re craving chocolate. Munch on plain popcorn while your friends are passing around the caramel corn. For breakfast, make high-protein oatmeal pumpkin pancakes instead of regular pumpkin pancakes. Plan for a Few Treats Almost everyone has a few holiday treats that are irresistible. There may be some family recipe that you’ve had at every Christmas for as long as you can remember, or maybe a coworker brings in her cinnamon rolls made from a secret recipe. Whatever it is, you feel as though the holidays are incomplete without it. There’s no reason not to plan for one or two key treats. Just be sure you plan for them and stick to a single serving. Savor it, and concentrate on the flavors and on the memories and feelings it brings up. Then get right back on your regular diet. There are a couple of reasons why some weight loss surgery patients might be better off skipping even the occasional special holiday treat. First, don’t start if you’re not sure you can stop. If you’re not confident that you can stick to a single serving, it’s best not to start eating. Second, some weight loss surgery patients can’t tolerate all kinds of junk food. Fried and doughy foods are risky for lap-band patients, since they can obstruct the band. Gastric bypass and vertical sleeve gastrectomy patients are at risk for dumping syndrome from eating too much sugar or fat at once. And, no weight loss surgery patient should eat too much, since that can stretch the pouch or sleeve. The holiday season is a happy time, but it’s a struggle if you’re trying to lose weight and get healthy. You can prevent it from sneaking up on you and interfering with your weight loss by staying alert and having a plan.
  7. 1 point
    Almost everyone needs protein supplements right after weight loss surgery. Protein shakes and powders give you the protein you need when you’re not allowed to eat solid foods. But which types should you choose? And should you keep using them when you’re eating solid foods and surgery is long behind you? Protein for the Liquid Phase of the Post Weight Loss Surgery Diet Progression After a day or two of sticking to clear liquids, you progress to a full liquid diet. You can be on this diet for a few days, if you’re a lap-band patient, or a couple of weeks, if you have the gastric sleeve or gastric bypass. Protein sources include the following. Non-fat milk, with 90 calories and 8 grams of protein per 8 ounces. Non-fat milk powder, with 100 calories and 10 grams of protein per ounce. Low-sugar protein powder, with 110 calories and 25 grams of protein per ounce. Low-sugar protein shakes, with 100 or more calories and 15 or more grams of protein per 8 ounces. Without supplementing your diet with protein shakes and powders, you’re not going to be able to hit your 60 to 80 grams of protein. Protein Powders and Shakes in the Pureed Foods Phase This phase is really a transition phase. You’re adding foods back into your diet, but aren’t yet ready to eat chewy, sticky, crunchy, or other solid foods. Protein foods include the following. Non-fat cottage cheese, with 12 grams of protein per half-cup. Non-fat ricotta cheese, with 5 grams of protein per half-cup. Egg whites, with 4 grams of protein per extra-large white. Non-fat Greek or regular yogurt, with 8 to 14 grams of protein per container. During this phase, your surgeon will probably have you start to decrease your use of protein shakes and powders, but will probably recommend keeping them in your diet to help you get to 60 to 80 grams of protein per day. You might need one or two shakes a day, plus powder in foods such as oatmeal, yogurt, or pureed potatoes. Be Wary of Protein Supplements in the Long-Term Protein shakes and powders can be convenient, but they’re not your best bet for long-term weight loss. As you progress from pureed foods to semi-solid and then solid foods, your surgeon will probably recommend that you stop drinking shakes and focus instead on solid sources of protein. They’re more substantial and satisfying than liquid shakes. They take longer to eat than drinking shakes. They’re easier to fit into a real-life eating plan. You won’t be “drinking your calories.” They have more natural nutrients than processed shakes and powders. Most weight loss surgery patients can get enough protein just by choosing one or two high-protein foods for each meal. You’ll get 60 to 80 grams with the following foods. Breakfast: 2 scrambled egg whites with ½ light English muffin and some fruit. Lunch: ½ cup fat-free cottage cheese and a green salad with 3 ounces of canned light tuna. Dinner: 3 ounces of chicken breast and steamed spinach. Snack 1: 1 low-fat cheese stick. Snack 2: 1 6-ounce container of plain low-fat yogurt and ½ cup carrot sticks. When Protein Supplements Are Okay Still, some weight loss surgery patients may still need protein shakes and powders in the long term. That’s often the case for vertical sleeve patients if your sleeve fills up too quickly to allow you to eat enough solid protein throughout the day. Talk to your surgeon to find out whether you should still use shakes and powders. Your surgeon might suggest that you include one or two protein shakes a day as snacks or mix protein powder into your yogurt, cereal or other foods. Protein supplements can still come in handy even if you’re able to meet your protein requirements on your daily weight loss surgery diet. If your routine gets interrupted, you might come up short. Consider the protein you can miss if you need to change your regular plans for a meal or snack. 10 grams of protein if you run out the door without grabbing your yogurt in the morning. 22 grams of protein if you forget to pack your tuna for lunch. 26 grams of protein if you’re stuck in a meeting instead of cooking your chicken dinner at home. When you’re stuck in the car or too busy to plan ahead, protein shakes can be lifesavers. On vacation, you can take protein powder with you so you’re always sure to have a source when you need it. You could also try Unjury Protein’d Cheese Sauce on steamed vegetables for an extra 21 grams of protein. Read the Nutrition Facts Panel to Find Protein Content The Food and Drug Administration lets food manufacturers call a food “a good source of” protein if it has at least 5 grams of protein. If a serving has at least 10 grams of protein, a food can be labeled “high,” “rich in,” or “an excellent source of” protein. That doesn’t do you much good if you’re trying to find a shake or powder with at least 15 to 20 grams of protein per serving. Don’t rely on a claim on the front of the label when you’re looking for a protein supplement. You could end up with a “high-protein” shake with only 10 grams of protein! Instead, check the nutrition facts panel to see how many grams of protein the food or shake has per serving. Check the Label for Calories and Sugar Protein shakes and powders can be high in calories and sugar. A bottle of Special K Protein has only 10 grams of protein, but 190 calories and 18 grams of sugar. A Pure Protein Frosty Chocolate Shake has 15 grams of protein, but 190 calories and 25 grams of sugar. A can of Boost High Protein drink has 15 grams of protein, 240 calories and 27 grams of sugars. No matter which stage of your weight loss surgery diet you’re on, you can’t afford to eat too many calories or too much sugar. The only way to protect yourself is to read the labels. Protein supplements can be great choices for boosting your intake to 60 to 80 grams a day. Shakes and powders can get you through the liquid and pureed foods stages of the post-surgery diet progression, and they can have a place in your diet even when you reach your long-term weight loss surgery diet plan. Just make sure not to overuse them if your surgeon is concerned, and to choose low-sugar options.
  8. 1 point
    There are many options when it comes to paying for bariatric surgery. Let's explore them. Click on each hyperlink to learn more on the topic. Having health insurance does not mean that weight-loss surgery is covered in your policy. About one quarter of people seeking weight-loss surgery will be denied three times before they receive weight-loss surgery insurance approval. If you have insurance coverage for bariatric surgery and are denied, you have the right to contest the decision and write a bariatric surgery insurance appeal letter. Since many health insurance plans exclude weight loss surgery, this leaves people faced with the decision to self-pay for bariatric surgery or to forgo what could very well be a life-saving procedure given the devastating effects of obesity and obesity-related diseases on health. An option is to take out a medical loan for weight-loss surgery. However, bariatric surgery is expensive if health insurance will not cover the surgery. And many people seek bariatric surgery outside the U.S. and engage in the process of weight loss surgery medical tourism. Thousands of individuals head to Mexico for Bariatric Surgery to realize excellent quality care, fast wait times, and attractive prices. With the question of safety of weight loss surgery in Mexico being being top of mind, I turned to Alex Brecher founder of BariatricPal Hospital MX for further exploration. Alex Brecher opened the BariatricPal Hospital MX in 2017 after having run a Mexico medical tourism business for 10 years. As far as free bariatric surgery in the US, while it will no doubt be a challenge, free weight-loss surgery is within the realm of possibility. Free or reduced cost WLS grants and charity care are available. There also are bariatric surgery clinical trials for surgical weight-loss candidates. Use our Match to Clinical Trials in 60-seconds widget on the bottom right column of MyBariatricLife.org to locate a trial near you.
  9. 1 point
    “The secret of change is to focus all of your energy not on fighting the old, but on building the new.” - Socrates Everyone does well out of the gates. We all impress ourselves when we start, what we believe to be, a new lifestyle change. However, "out of the gates," can mean different things for different people; for some it is two months, for others (usually depending on how strong the addiction or habit is) it can be two minutes. But what do we do when we fall from grace? The research on relapse (with any addiction; food, drugs, alcohol) is that recidivism is the rule not the exception. So why do we get so down on ourselves when we fall short of our goals? Why is it so hard to get back on the horse with the same vigor we had when we started? And how do we give ourselves a renewed sense of hope and motivation for change once we've fallen? One magical ingredient in the secret sauce (and one of many concepts I talk about in my book and my wls courses) that is lifestyle change is the novelty effect. The new plan to quit something or change a bad habit is something unlike we have ever done before, so we hope that we can achieve something we have never done before. The problem is that the moment we slip, that novelty loses its magic - and each time we start over, it loses its power to give us hope. So the solution is to cultivate more novelty. Our ability to continually grow and change is largely limited by our creativity. The more creative we become, the easier it is to take a different approach to change. To open a window when life seems to shut the door. In other words- what I am telling you, is that the only secret to long term weight loss maintenance is the knowledge that there isn't only one secret. There is no ONE diet that will forever change someone. Eventually people get tired of eating bacon and eggs every meal on Atkins, or grapefruit, or cabbage soup- but the thread they all share is their novelty. This is why all of them can work initially. Even as powerful as weight loss surgery is- people still find that they start to plateau or even gain the weight back if they aren't simultaneously addressing the behavioral and psychological factors that got them there in the first place. They too, must also continuously be creative about renewing one self throughout their lifetime. So the following is for all of you who are struggling today. Those that feel they have lost their way and perhaps feel disenchanted or disappointed. Below is a recovery "map" I created a long time ago for my clients, some struggling with substance abuse, others with food. It all works the same. Print it out, or copy and paste it in the notes section of your phone and take 20 minutes to fill it out with the things that are personally meaningful for you. This is not THE answer to long term recovery from addiction, but it is a fresh approach for many who feel stale at the moment: Baptism - Some ceremony to signal a renewed sense of hope and a fresh start. One client trying to recover from substance abuse, buried all of his wine and liquor bottles in his yard. Another client had a "garbage party" with her kiddos, and they loved smashing all the processed foods they had in their pantry and throwing them in the trash. Associations/triggers list all of the things that get you into trouble (being at a bbq, wanting to celebrate something, holidays, 7-10pm at night, date night, etc) Coping Skills (what gets you through the crave waves) These are the behaviors that you do INSTEAD of the addictive behavior. Extra credit if you are able to make a coping skill for each trigger listed above. Higher Desires/Vision of Self when you let go of your attachment to food and all the self loathing, mental, and physical heaviness it brings- what are you freeing your life up for? will you write a book? will you do more outdoor activities with your kids? do you want to resume an activity you once loved as a child? Is there a role model that inspires you that has done what you want to do? Cons Why are you doing this in the first place? These are the things that are hard to keep in mind when our reptilian mid brain (see last article) is at the wheel. What is personally meaningful? Does it age you? Does it make you feel out of control? Do you dread going on airplanes because you know you'll need an extender? does it prevent you from going to amusement parks with your kiddos? Spirituality (religion gets us into heaven, spirituality gets us out of hell) All addiction is what disconnects us from our deeper self and edges us further and further away from God (or whatever you like to call it) and our deeper spirituality. Spirituality is what allows us to move into the unknown, be comfortable with discomfort, and have faith that everything will be ok. It can include a gratitude practice, volunteering, play, aligning one self with nature, connecting with a spiritual e newsletter (mind body green, daily om, etc), generosity, etc. Daily Recovery Ritual (symbolic gesture to self every day that we are consciously devoting time to our recovery) What are the things you can do daily to symbolize to yourself that today is a new day? Keep it realistic or you won't do it. Vitamins, meditation, lemon water, supplements, self care, reaching out to a loved one, exercise, etc. Reward System What will you do for yourself if there is a certain period of time reached where you meet your goals? Will you get a massage at the end of every month? Will you plan a vacation after three months of solid goal hitting? Will you reward yourself with one day per week of going to the movies in the middle of the day and playing hooky if you're on the straight and narrow for five days? Strategy This is your "what." What are you doing daily to ensure that you are in alignment with your goals? Are you reading something fresh all the time? Do you make a timeline of your addiction and how it has affected your life? Do you go to local support meetings each week? Do you keep in touch with an online community? Do you make sure to give yourself small breaks while with the kids every day? Do you have a self care space set up in your house? Do you talk to a partner about how to change behaviors of theirs that might be hindering your efforts? can they get a mini fridge? Do you do acupuncture to balance your chi? Do you do yoga to manage your depression? Do you find a therapist? Recovery Resources (try to hit one each morning) what resources are in your pocket when you are feeling weak? bariatricpal.com? WLS journeys on Instagram? The Fix, Reddit, unique blogs documenting their weight loss journey, wls and vsg searches on Pinterest, etc. Good luck on your fresh start!
  10. 1 point
    We are going to take our Vows again and freshen up on our agreement we took to one another two decades ago. Sometimes a “fresh start” rekindles those words spoken when they first occurred can remind us exactly what they meant to us. But what about the Vows we took when we first took the plunge to seriously consider Weight Loss Surgery? Do you remember what you told yourself you would do way back when? Be truthful with yourself, are you still bound to these vows? I remember mine, and the most distinct one for me was that I would NEVER go back to the old me. The obese me, the one who had no hope, who was miserable and feeling lost and scared of my own future. There were several others such as, I promise to work out and become fit for a stronger body. Even telling myself that no matter what, I would not let the scale dictate to me how amazing or awful a person I am. For the most part the scale often told me I was quite amazing (Ha!). I suppose maybe I did listen to the scale back then because it was fun to watch the weight melt away. During those times when the scale didn’t cooperate I used other means of measuring how well I was doing. I checked to see how my clothes were fitting; I kept a running measurement of every part of my body – even my neck and my wrist! Even a quarter inch loss in those areas made me feel better. Then there are the awesome side-by-side photos. Pictures don’t lie! They never did, and that’s probably why a lot of us hid from the cameras Pre-Op. As the years go by Post-Op it really does become easier and easier to forget how we got to our goals and how we have maintained. It becomes easier to tell ourselves that indulging more and more is acceptable and before you know it the pounds creep back up. You will blink your eye and all of a sudden your clothes become tight and you notice a little comfortableness about yourself. I personally have made a Re-commitment to myself not so long ago. I am 50 (and 1) Days into a No Sugar eating plan and I am back to regular routine workouts. Another agreement that I am re-committing to myself is that I will never again ignore the scale. Yes, it’s true I don’t allow the scale to make me feel bad about myself but it is a necessary tool to remind me that I need to make sure I don’t keep going up, or I will be like the mountain climber on The Price Is Right and yodel my way right off the chart cliff. Let’s just say my Re-commitment has done me well and I am more than on my way back to the champion I was a year or so ago. It feels good to take back the control and be reminded that my life depends on me keeping my promises. I needed this in order to take my future health serious. Every day is Day 1, until you successfully make it to Day 2. What were your most outstanding Vows that you recall? Are you still following them, or can you Re-commit to them? If you find yourself needing to Re-Commit, don’t wait! Take this moment to truly reflect on just how well you really are doing. Can you make some new commitments even? This time write them all out on a piece of paper and make a contract with yourself to uphold the Vows of health and fitness with yourself, and sign it and date it. Read it aloud and if necessary show someone that you trust. Read it out to them and be upfront to them about what you are doing. Of course only you can ensure that you are upholding your end of the bargain to the healthy person inside.