Alex Brecher

Attached is the ASMBS Metabolic and Bariatric Surgery Numbers Estimation for 2017. No surprises here but definitely very interesting numbers.

Stalls Happen Your surgeon will probably tell you about your likely weight loss. You might hear numbers such as 70 to 100 lb. in the first year, or up to 10 to 20 lb. in the first couple of months. Those might be realistic and turn out to be accurate for you, but what might also be true, that your doctor did not tell you, is that weight loss may not be steady. You might lose 75 lb. in a year, which is an average 1.5 lb. per week, but you are not going to lose 1.5 lb. every week for a year straight. You may lose 5 lb. in one week, 3 lb. in another, 0 lb. in another, and, some weeks, even gain weight. You are almost sure to encounter stalls, or plateaus, or periods of weeks or even a month when you do not lose weight, even if you are eating right. Your doctor may not tell you about stalls ahead of time, but you can handle them better if you are prepared right out of the gate. Your Metabolism May Plummet As you lose weight, you need fewer calories to sustain your basic body functions. Furthermore, when you exercise at a lower body weight, you burn fewer calories doing the same workout at the same intensity than you did when you were heavier. On top of that, your body may go into starvation mode and use even fewer calories as it becomes more efficient at using what you give it. While there is little that you can do to prevent a slower metabolism, you can at least be aware of it. Also, you can take heart knowing that you are likely to be able to exercise longer and at a higher intensity to offset some of the reduced body weight. It’s Freezing! Brrr…! Remember the days when you were the hottest one in the room, and all you wanted was to stop sweating? Those may be in the past. Part of the slowed metabolism can be due to your body’s new mechanism to save energy, which means turning down the thermostat. Another possibly surprising side effect of weight loss is that having less cushioning (body fat), so sitting in chairs or lying in bed can be less comfortable. People Can Still Hurt You You probably know that Weight Loss Surgery does not change who you are, but your doctor may forget to tell you that it does not change other people, either. You may no longer get flack for being overweight, but people can still be hurtful. They can tell you… You took the easy way out with Weight Loss Surgery. You have not lost much weight. Clearly, Weight Loss Surgery did not work. You lost so much weight that you look sick. All you care about now is your diet and exercise plan. Your Social Life May Change Some friends will stick by you. Others may desert you. If some of your friends have just been “eating buddies,” or people you go out with to the bar or restaurants, you may need to exercise self-control at the bar or restaurant, find new activities to do with those friends or find new friends. You stand to gain wonderful new friends who share your new interests, such as walking, going to the gym, or cooking healthy fun foods. The Skin Stays Losing body fat will not give you a movie star’s appearance. It may not even be all that you need to lose. You may have loose skin that flaps, chafes, and interferes. There is a chance that you will want to get skin removal surgery for cosmetic, comfort, or medical reasons. Beware Replacement Addictions You may have been addicted to food. It may have provided comfort, entertainment, and companionship. Give it up, and you are likely to find something to replace it. Alcohol is a common replacement addiction, but you can do better! Stay aware of your emotional and physical needs, and you can be mindful of what replaces food in your life. Exercise, within reason, is a common choice; another healthy option is to make some great friends who are supportive and make you feel good. Your doctor will tell you a lot about what to expect after weight loss surgery, but she may leave out several important items. Go in with open eyes, and you can prepare better and come out farther ahead.

I wish that was possible. The taste would be very difficult to mask for a bariatric level multivitamin.

Bariatric Spray Vitamins are one of the most exciting breakthroughs in the delivery of nutrients to the body since pills were invented nearly a thousand years ago. Taking supplements orally is the fastest, most efficient and convenient way to take your daily dosage. Oral sprays deliver the purest form of supplements by sending them directly into your bloodstream. When you spray into your mouth, the micro-sized droplets are instantly absorbed through the capillaries and the nutrients are absorbed within seconds without stress to the organs. Sprays overcome the absorption problems accompanied by traditional nutritional supplements and are ideal for weight loss surgery patients, older patients and those suffering from any digestive complaint such as Crohn’s Disease, Colitis, Gastritis, and IBS. Check them out at the BariatricPal Store

You can support BariatricPal by purchasing PatchMD products from the BariatricPal Store. I can’t promise that we have all the answers. I can assure you that we have awesome 24/7 customer service and support.

Nope!

@Matt Z My apologies. You're right. I was having a rough start to my week and took it out on you.

Imagine if cheese puffs were about the healthiest snack you could eat. Well...now they are! Shrewd Food protein crisps have texture taste and that's remarkably similar to national snack brands, but are packed with easy to absorb protein. This snack is high in taste and protein and low in calories, fat, carbs, and sugar. Check them out at the BariatricPal Store!

You're very welcome. Nobody was ignoring you. We prioritize our responses and it can take us a few days to respond to topics that aren't urgent.

Nobody is "supposed" to monitor these forums. We don't work for you We respond when we are able and generally our members are usually able to assist other members. If you used the search feature, you'd find the answer to your question instantly. I just entered the words "member ranks" in the search bar and came up with 3 links: and Here is the information, again:

Check out https://Store.BariatricPal.com for popular choices of protein powder and bariatric vitamins. You can sort products by popularity to get a better idea of what's used most often.

WOW! These look awesome!! I just reached out to them so we can add their entire line to the BariatricPal Store. Thanks!

I'm not sure how much sugar this gummy has but I've seen RAP gummies with 16g of sugar. Make sure you look closely at the nutrition facts.

We have TONS of sample sizes available! Check us out at https://Store.BariatricPal.com.

There's not enough protein in any pill you're going to take. You'd need to swallow an entire bottle to meet your daily goals.

The BariatricPal "Divine" 15g protein & fiber bars have arrived at the BariatricPal Store! They're available in 3 delicious flavors: Caramel and Sea Salt Peanut Butter Vanilla Too much of a good thing? We don’t believe so. BariatricPal Divine Protein Bars have a chewy core, with a creamy coating. BariatricPal High Protein & Fiber Bars deliver on delicious taste, optimal convenience, and bariatric nutrition. You can’t predict what might happen in your busy life, but you can always be prepared. Keep protein bars in your office, backpack, car, and gym bag so you’re always able to satisfy hunger no matter where you are. A good snack has enough protein to tide you over until the next meal, but not too many calories or carbs. BariatricPal Divine Divine Protein Bars provide 15 grams of protein and only 140 calories. Plus, they have 5 grams of filling fiber to help you stay on track with your weight loss diet. 15 grams of protein 140 calories 5 grams of fiber 0 grams trans fat Suitable for the Solid Foods and Maintenance diets Suitable for gastric sleeve, gastric bypass, duodenal switch and gastric band patients On-the-go snack or breakfast Aspartame free Gluten free Caffeine free 7 Bars Per Box

In this video, Kimberly H. shares her thoughts on the BariatricPal Box of the Month Club. **USE CODE KIMH20 TO GET $20 OFF YOUR FIRST BOX** https://store.bariatricpal.com/pages/bariatricpal-box-of-the-month-club

BariatricPal is establishing a new program called BariatricPal Local Chapters. This program is part of BariatricPal’s mission to support weight loss surgery patients in their pursuit of achieving weight loss and following a healthy lifestyle. The purpose, structure, values, and guidelines for this program are described below. I. Purpose The leaders of BariatricPal Local Chapter have established the following objectives. Promote weight loss and healthy lifestyles among potential and post-op weight loss surgery patients. Provide a structured program for weight loss surgery patients to meet each other face-to-face in safe environments. Promote the ability of weight loss surgery patients to make healthy lifestyle choices through increased knowledge. Increase self-confidence and a sense of community through positive social interactions. II. Organizational Structure Management BariatricPal Local Chapters is under the direction of Alex Brecher, founder of BariatricPal. Alex has the final say in all decisions regarding BariatricPal Local Chapters. Others involved in the governance of BariatricPal Local Chapters include the advising and managerial team at BariatricPal. Local Leaders Local leaders are essential to the success of BariatricPal Local Chapters. Duties include: Communicating remotely with local members to inform them of upcoming meeting schedules and agendas. Leading each local meeting or event. Making all meeting attendees feel comfortable and welcome Encouraging local members to attend meetings. Communicating with BariatricPal Local Chapters management to provide updates on local meetings and to gather information on upcoming events. Recruiting local experts to share their knowledge at meetings. To carry out these duties, leaders must: Be committed to the success of their local chapters as well as the overall program. Be able to prevent personal conflicts and address them when they arise. Be available for scheduled meetings. Be able to interact with diverse groups of people. Stakeholders All BariatricPal members in good standing are invited to participate in BariatricPal Local Chapters. Local Experts Local experts, such as bariatric surgeons, nutritionists, mental health professionals, cosmetic surgeons, and others who work with weight loss surgery patients, can be invited to BariatricPal Local Chapters meetings. They can provide their expertise in the form of lectures, demonstrations, and question-and-answer sessions. III. Core Values These are the core values of BariatricPal Local Chapters. Acceptance: The program is based on the understanding the individual differences exist and are to be celebrated. Encouragement: Participants can expect a positive environment in which their efforts to lead healthier lives are supported through peer encouragement and increased knowledge of how to make healthier choices. Respect: All participants in BariatricPal Local Chapters deserve, and are entitled to, respect. No participant may deride another for their choices. Consideration: Participants are expected to show common courtesy, such as allowing other members to speak in turn, attending meetings when they have committed to doing so, and lending a hand, when appropriate, in setting up and cleaning up meeting facilities. Health: BariatricPal Local Chapters supports all aspects of health from the physical to the emotional and psychosocial. IV. Protocols Meetings BariatricPal Local Chapters meetings will take place on a monthly or quarterly basis. Meetings can fit into any of the following categories. Standard meetings (described below) Group walks or other physical activity sessions at a level that can include participants of all capabilities Group outings, such as to restaurants or grocery stores Standard meetings follow this general structure, which will be further detailed in other program documents. Greetings: introductions and greetings led by the leader. Follow-up: discussion of any necessary follow-up items from the previous meeting, and discussion of progress toward goals stated at the previous meeting. Main event: this can be a lecture led by the leader with guidance from a BariatricPal lesson plan (to be provided), a cooking or other demonstration, or a lecture or discussion led by a weight loss surgery expert. Question and answer session. Goals to work on before the next meeting Closing comments, such as the planned time and activity for the next meeting and any necessary reminders, such as special materials or locations. Other Events The overall BariatricPal Local Chapters program may periodically sponsor regional or national activities. These may include workshops, casual meet-ups, or group excursions. Details will be provided as developments occur. V. Resources Needed and Potential Obstacles BariatricPal Local Chapters will require sites where meetings can be held. Leaders are encouraged to seek sites, such as local schools, public parks, church and other religious organization buildings, and other sites where meetings are commonly held. Facilities should have tables and chairs for all participants, as well as necessary resources such as a large screen. Items such as paper, pens, and other supplies may also be needed for certain meetings. There are several expected obstacles for BariatricPal Local Chapters, but they can be overcome. Personal commitments interfering with the ability to lead or attend meetings. Transportation barriers. Slow growth in overall participation or leadership. VI. Changes to the Charter Changes to the Charter can be made by BariatricPal Local Chapters’ founder, Alex Brecher. Requests for changes can be submitted to Alex Brecher for consideration and approval.

You’re Starving, or Not For some WLS patients, hunger goes away. For others, hunger is reduced enough so that you can keep it in check, even if you were constantly hungry before WLS. Some patients, though, still need to fight hunger. It is still a struggle to pass up certain foods and to keep portions small. Your Head Gets Hungry “Head hunger” is when you think you are hungry, but you are really just bored, the food looks good, or you feel like eating for some other reason. It is important to learn to recognize head hunger so that you know when it is not time to eat, but it is also important to realize that it may not be time to eat every time you are physically hungry. That is because you are losing weight, which means you are eating less than you burn, which means…your body is hungry. Pizza and Ice Cream Taste Great Often, your sense of taste changes after weight loss surgery. You may be one of the lucky patients who stops loving junk food. Pizza and French fries may be too greasy and salty for your new taste buds, and ice cream and muffins may be too sweet. On the other hand, your taste buds may be just as enamored with the food groups of sweet, salty, starchy, and greasy. You may need to work just as hard as you did pre-op to keep pizza, ice cream, fried chicken, and bagels from overwhelming your diet. Salads May Not Work Your game plan for weight loss may include a huge salad once or twice a day. It is filling, healthy, and low-calorie – the perfect weight loss combo. The problem is that many weight loss surgery patients can no longer stomach salads for months or longer after surgery. Instead of lettuce, a protein, and some dressing, consider building your meals with cooked vegetables, a protein, and a small amount of healthy fat such as avocado or peanut butter. Creativity Is the Name of the Game Many other healthy foods may be off-limits because your tastes change or they are too stringy or they make you sick. You will have to be flexible to find healthy substitutes for them. Here are some common trouble foods and some alternatives. Popcorn: try Protein Cereal as a quick snack. Celery: opt for Bean Crisps Lean beef and poultry: try fish, veggie burgers and other soy and bean products, and lentils. Cheese: try peanut butter or hummus. The good news is that most WLS patients tend not to develop aversions to vegetables, so pile your plate high! What Happened to Water? Water is the one calorie-free and free from cost food that is actually a nutrient…and it may have tasted great before surgery. Afterwards, not so much. Some patients have trouble drinking plain water after surgery. It just does not taste good anymore. Now that diet soft drinks and carbonated flavored water are off limits, you have fewer choices for hydration – but they are there. Flavored water without bubbles. Decaffeinated low-acid coffee and tea. Ice water with lemon or lime. Malnutrition Happens Malnourishment may be far from your mind when your goal is weight loss, but it happens quite often. It can be a deficiency of protein, but also of vitamins and minerals. You will have to get enough protein every day and take your nutritional supplements every day, probably for life. Sit Near the Bathroom You just never know when you may need one when you sit down to eat a meal. Dumping syndrome strikes fast and without warning. By the way, you also cannot predict how full you will get and when you will be able to finish your entire plate. You can make your weight loss surgery journey a tad easier by aware of what to expect, and there may be a few things your doctor does not tell you about.

What’s Wrong with Away-from-Home? There is nothing wrong with eating outside the home – unless you are average. That is because the average restaurant meal has more calories, more fat, and more sugar than the average home-cooked meal. You can reverse this, though, with some awareness. Classic Breakfast Sandwiches The classic breakfast sandwich or burrito can have eggs, cheese, and meat. From there, the sandwich can vary widely. An egg white McMuffin from McDonald’s, for example, has 260 calories, while a Croissan‘wich with bacon and sausage from Burger King has 620 calories. Skip the butter and any fried potatoes, such as hash browns or shredded potatoes, and choose: Ham instead of bacon or sausage. An English muffin (or nothing) instead of a bagel, biscuit, croissant, or tortilla. Egg whites instead of whole eggs. Café Choices Coffee shops and bakery-café’s offer all kinds of fresh, tantalizing, and absolutely off-limits foods. Hint: you do not need a cinnamon roll with 50 grams of sugar to start your day. Stay away from the breakfast pastries and breakfast sandwiches on bagels. Instead, you may be best off with an “a la carte”-style breakfast. Look for items such as: Plain oatmeal or oatmeal with nuts as an add-in. Fruit cups or whole fruit. Low-fat cream cheese – you can spread it on half of a whole-grain bagel. Smart Suggestions Starbucks offers some hot breakfast options for under 300 calories – their egg white bites have only 170 calories – and Dunkin Donuts offers some DD Smart Wake Up Wraps for 160 to 240 calories. By the way, a Bismark donut has 490 calories. Subway offers egg whites, ham, and reduced-calorie cheese on 3-inch subs, so you can avoid too much bread. Lunch for Breakfast You may not need to depend on the breakfast menu if the restaurant serves lunch early in the morning. If that is the case, you may be able to get grilled chicken, turkey breast, and cheese on a salad. Bring Your Own There is a chance that you may not realize how easy and quick it can be to bring your own breakfast from home and avoid restaurants altogether. We understand if you have exactly zero seconds to dedicate to making your breakfast in the morning before you leave home. You can stash it in the car or fridge the night before. If you have access to hot water before you have breakfast, these options can work: Protein Oatmeal with an apple or some walnuts. Protein Muffins in flavors such as Blueberry, Double Chocolate, and Maple Pumpkin. Protein Hot Chocolate with milk for extra calcium or protein. If you are going to eat in the car or have no microwave at work, you’ll need something ready-to-eat. Consider: Protein Cereal in Honey Nut, Chocolate, or other favorite flavors. Oatmeal Raisin Protein Cookies. Fruit and cottage cheese or yogurt. A Protein Bar. You can have the best of both worlds: a meal as quick and easy as a fast food meal, with nutrition that fits into your meal plan like a home-cooked meal. Way to start the day right!

Consider Macros That is, “macronutrients,” or carbohydrates, fat, and protein. The news is bad on the surface since the average fast food meal has more carbs and less protein per calorie than the average home-cooked meal. You can work to turn this around, though. Carbohydrates: Cut back on carbohydrates by skipping the starchy sides: French fries, potato chips, and hash browns, steamed, fried, or Mexican rice, and breadsticks. Try to go “green” (lettuce wrap) or “naked” (no wrap) with your burger, tortilla, or sandwich; if the fast food joint cannot honor your request, just eat the filling with a knife and fork, and throw away the bread, bun, tortilla, or taco shell (if you are feeling guilty because of starving children in third-world countries, make a donation. You’ll do more good than you would by adding starch to your hips). Protein: How can you boost your protein intake at a fast food restaurant to be what you need? Skinless grilled or baked chicken, lean cold cuts, cheese, and beans can all up your totals, and yogurt is an increasingly common side option. Even a small burger patty can give you 10 to 15 grams of protein, although it comes with a few extra grams of fat. A good protein goal for a meal is about 20-30 grams. You can get that for 200-300 calories with any of the following. Burger King Double Cheeseburger, no bun; Grilled Chicken Garden Salad, no croutons; or Veggie Burger with cheese, no bun or mayo. McDonald’s Grilled Southwestern Chicken Salad, no cheese; or Grilled Chicken Sandwich, no bun or spread. Taco Bell 2 grilled or fresco steak soft tacos, no tortillas; chicken or steak Power Menu Bowl, no rice or cheese. KFC Grilled Chicken Drumstick plus green beans or side salad. Panda Express Grilled Teriyaki or Asian Chicken. Fats: Your first order of business is to avoid anything fried. You will be avoiding excess grease while also avoiding sneaky carbs in breading – did you know that the amounts of carbs in onion rings and fried chicken are comparable to the amounts in bread? Also, watch the fatty spreads – think mayonnaise – salad dressings, and dips. Find the Vegetables Protein and vegetables…does this sound familiar? It should, since your goals when eating at a fast food restaurant should be the same as when you eat at home. Vegetables help fill you up without filling you out, and it is best to eat as many of them as you can handle with your pouch or sleeve. It may take a little more digging to find vegetables at fast food restaurants than at home, but you can usually do it. Here are a few leads. Ask for extra lettuce, tomatoes, and any other available vegetables on burgers and sandwiches. Order a side salad or baby carrots with your meal. Check for salads with grilled chicken as an entrée. Pile salsa and diced vegetables onto your naked burrito. When “Value” Isn’t Besides the convenience, the deals are among the most tempting things about fast food. For pennies more, you can often add fries and a drink, or you could get a second burger or taco for half the price. Don’t do it! “Value” depends on what you want and need; why would you pay extra, even if it is “only pennies more,” for extra fat, sugar, starch, and calories? A healthier definition of “value” might be to pay the least you can for a meal that is convenient, delicious, and healthy. Why include “oversized” in your definition? For those times when fast food simply makes sense, go for it – just keep yourself on track by reading the menu carefully and staying focused. You can do it, no matter where you end up. You might as well enjoy it!

Good suggestion. We had this back in the day. I will see what we can do to add it back.

This Sunday, we'll be welcoming Lisa Kaouk, a Dietition & Nutritionist as well as Co-author of "The Complete Guide to Weight Loss Surgery: Your Questions Finally Answered". The event will begin at 6PM Eastern, 5PM Central, 3PM Pacific, 11PM GMT time. Join us in the BariatricPal Community FaceBook group at https://www.facebook.com/groups/BariatricPal/ if you're not already a member.

It’s called forum spam. Please use the report post feature.

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