Alex Brecher

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Your diet has almost certainly changed since weight loss surgery. A good portion of the change is because of doctor’s orders: you may not be allowed to eat or drink soft drinks, sweets, fried foods, white bread, and other calorie-dense, nutrient-poor choices. Some of the changes in your diet may be because of changes in your digestive system after weight loss surgery. With the gastric sleeve and bypass, you might have trouble tolerating sweets, starchy foods, and fatty or greasy foods. This can be helpful for weight loss and may even be a reason why you chose that type of weight loss surgery. Some of the foods you cannot tolerate anymore may be surprises or disappointments. For example, you might no longer be able to take red meat or poultry, even though you are trying to get more low-carb, high-protein foods. Salads are often a problem after all types of bariatric surgery, and stringy veggies can be off-limits for lap-band patients. Needing to avoid high-fiber, low-calorie foods such as celery and popcorn can be frustrating when you are trying to eat healthy and lose weight. So, which foods are you unable to tolerate now after weight loss surgery? Are they what you expected? Are you glad you cannot have them because skipping them helps you lose weight, or are you disappointed? Are there any healthy foods that you can’t have anymore? If you’re pre-op, which foods are you most worried about not being able to eat? Are there any foods you are hoping you won’t be able to eat so that you can lose more weight?

We are proud to announce that Dr. Illan has been accepted as an international member of the American Society of Metabolic and Bariatric Surgery (ASMBS)! We are so proud of him. Stay tuned for some really exciting updates on BariatricPal MX coming shortly.

Breakfast: Protein pancakes and a banana, plus some walnuts Lunch: Tuna salad with light mayo on whole wheat mini bagel, grape tomatoes, baby carrots. Planned: Dinner: Veggie stir fry mix with tilapia and teriyaki sauce. Maybe brown rice. Snack: cauliflower and broccoli florets with guacamole and salsa Let us know your Sunday fare and remember – if you post your menu each day this week (Monday through Sunday), you will be entered into a drawing to win a $50 gift card to The BariatricPal Store! Don’t worry, you can still be entered into the drawing if you go back and post your earlier menus if you missed them already!

Breakfast: Scrambled eggs with spinach, ham, and cheese. Lunch: Greek salad with leftover chicken; balsamic vinaigrette. Dinner: Baked sweet potato topped with a mixture of ground turkey in tomato sauce plus cheddar cheese, along with brussels sprouts. Snacks: Fruit all day! Melon and berries. Share your Saturday meals (planned and/or actual) and remember – if you post your menu each day this week (Monday through Sunday), you will be entered into a drawing to win a $50 gift card to The BariatricPal Store! Don’t worry, you can still be entered into the drawing if you go back and post your earlier menus if you missed them already!

Breakfast: Banana split! Sort of. Another great one for the kids. Think about a banana split, but with cottage cheese instead of ice cream, and berries instead of fudge topping. Of course the kids can make them with chocolate chips and cereal. Lunch: I wanted a big burger, and settled for a sort of bunless double burger. Portabello mushroom with a turkey burger and the works: ketchup, mustard, pickle, lettuce, tomato, and onion. I didn’t have potato chips (well, maybe just a couple) or a bun. It was a knife and fork kind of burger, plus baby carrots. Dinner: I made chili because it’s easy and it will give me leftovers for the coming week. Oh, and because I had the ingredients already, especially the ground turkey. Ground turkey, chili seasoning packet (yes, I take shortcuts!), canned tomatoes, and onions and celery. I had a big bowl with cheddar cheese for dinner. It’s good plain or next week I will probably have it as a topping on a sweet potato, or mixed with lettuce for a sort of warm salad. A good day for eating, both for nutrition and for enjoyment. It was nice to have some time to make healthier and fun dishes for once. How did your weekend end? How is your week looking?

Eating on the go Friday, but I think I’m ready. Here is what I am planning to have. Breakfast: Greek yogurt with strawberries and a whole wheat mini bagel Lunch: Probably Subway. I’ll probably go for a salad with turkey breast and provolone. I’ll bring my own apple. Dinner: Looking like dinner with some friends, probably at an American restaurant (nothing exotic). Hopefully I’ll just find a chicken salad with light dressing or get some chicken or fish with veggies. Let’s have a little Friday fun and remember – if you post your menu each day this week (Monday through Sunday), you will be entered into a drawing to win a $50 gift card to The BariatricPal Store! Don’t worry, you can still be entered into the drawing if you go back and post your earlier menus if you missed them already!

Here’s the scenario. You’re obese or morbidly obese, maybe 100 or 200 or 300 pounds overweight. You haven’t been able to lose weight on your own with diet and exercise. You don’t respect yourself. You’re looking at a future with joint pain, heart disease, diabetes, and sleep apnea, or maybe you already have some obesity-related health conditions. What do you do? Weight loss surgery? Or going “Biggest Loser” style? In the first part of the series, we looked at a recent study comparing results of weight loss with NBC’s “Biggest Loser” to weight loss with weight loss surgery. At least in the short term, weight loss was similar, with Biggest Loser contestants coming out ahead at 7 months with the gap narrowing by 12 months. Some articles and research are available, but wouldn’t it be nice if there were a way to compare Biggest Loser and bariatric surgery side by side? Here’s our summary of how the groups lost weight and what the results were. Methods In case you’re not aware, the “Biggest Loser” is a reality television show that is a weight loss competition. Morbidly obese contestant compete on the Biggest Loser ranch to lose the most weight. Every 7 to 10 days for 13 weeks, a contestant is voted off and eliminated from the competition. From week 13 to 30, the remaining contestants go home and return for the finale, where the contestant who has lost the most weight is crowned the Biggest Loser winner. They lose weight with intense exercise and a restricted diet. This study compared roux-en-Y gastric bypass (RYGB) patients. They lose weight because their smaller stomach forces them to eat smaller meals. In addition, they need to limit sweets and fatty foods to avoid gastrointestinal symptoms. Diet Biggest Loser contestants ate similar amounts of to RYGB patients. In the Biggest Loser, contestants ate at least 70 percent of their baseline needs, calculated by a formula based on their fat-free mass. A contestant who weighs 220 pounds and has 50 percent body fat would be asked to eat at least 1,000 calories per day. The diet includes lean protein, fruits, and vegetables, and restricts processed foods. In comparison, RYGB patients often eat a similar number of calories. They too focus on protein, followed by vegetables and fruits. Also, they limit sugary and fatty processed foods. Exercise Here’s the big difference. Four hours of exercise a day, anyone? Biggest Loser contestants exercise 90 minutes per day six days a week with the trainers, plus up to 3 hours daily on their own. That adds up to up to 31.5 hours a week – basically a job! Weight loss surgery patients are asked to exercise, but to work up to it. They may have goals such as working up to 20 or 30 minutes daily, and getting up to 60 to 90 minutes most days over the long run. The Logistics: Support and Cost Biggest Loser contestants have a lot of support. On the show, they see a trainer six days a week. They have a doctor – Dr. Huizenga – to monitor their health and progress. In contrast, most RYGB are on their own – they don’t have the luxury of a trainer each day. They tend to follow-up with their surgeon once or a few times over the months following surgery. They may have support groups to help. Bariatric surgery is expensive, no question. The procedure, plus pre-op workups and post-op appointments, can be thousands or tens of thousands of dollars. Biggest Loser? Diet and exercise sound inexpensive, but can you afford to exercise for 31.5 hours a week? Can you afford to see a doctor whenever you want? What about the cost of benefits provided to contestants, such as having room and board at a weight loss resort for several weeks? The list price for a guest at a Biggest Loser Resort is about $2,500 weekly. For 13 weeks, as on the Biggest Loser, that’s a cost of $32,500. Makes RYGB seem cheap! Weight Loss What about the important thing – weight loss? Turns out the results are pretty similar…at least in the beginning. After 7 months, the Biggest Loser group lost an average of 108 pounds, while RYGB patients were at an average of 78 pounds down. By 12 months, RYGB patients were down by 89 lb. on average. And Biggest Loser patients? They were no longer being followed – who knows what happened after their season of the show ended? It stays a little cloudy later on, too. Biggest Loser hasn’t published statistics on the long-term success of its contestants. In contrast, RYGB has been shown to be successful in studies that have tracked patients for 5 or even 10 years. Health Effects Both groups had improvements in some measurements of health. Blood pressure, blood sugar, chronic inflammation, and “good” HDL cholesterol improved. Strangely enough, Biggest Loser contestants had an average increase of total cholesterol from 168 to 192, and of “bad” LDL cholesterol from 105 to 126. Also curious was the decrease in metabolic rate – or the number of calories burned at rest. Biggest Loser contestants’ metabolisms dropped more the RYGB patients’, even though Biggest Loser contestants maintained more of their lean tissue while dropping more fat. Okay, so what’s the take-home message? One might be that the way that is best for you to lose weight depends on your individual situation. If you have the time and money to train Biggest Loser-style, maybe you would prefer that to going under the knife. If you need a permanent tool for long-term assistance with losing weight, and maybe even if your health insurance will chip in, weight loss surgery may be for you. What do you think?

Hoping for a better Thursday…Here’s the plan! Breakfast: Peanut butter and banana on toast. Lunch: Going to brown bag it. Hard-boiled eggs, string cheese, an apple, and a protein bar. Dinner: Probably pick up something quick on the way home, maybe steamed chicken and veggies with the sauce on the side plus brown rice from a Chinese place. How is your Thursday shaping up? What did it look like? Share your Thursday menu and remember – if you post your menu each day this week (Monday through Sunday), you will be entered into a drawing to win a $50 gift card to The BariatricPal Store! Don’t worry, you can still be entered into the drawing if you go back and post your earlier menus on the appropriate threads if you missed them already!

Hoping to get the week off to a good start, but a busy day coming up. Here’s my plan for tomorrow: Breakfast: Greek yogurt with strawberries and a whole wheat mini bagel Lunch: Whole wheat pita Dinner: Snacks along the way: hard-boiled eggs (made a batch today) and grapes. What is your plan for Monday? Or, how is your Monday going? Post your Monday Menu here, and remember – if you post your menu each day this week (Monday through Sunday), you will be entered into a drawing to win a $50 gift card to The BariatricPal Store!

Yesterday was…okay. I kept the cookies in check! Here’s the goal today. Breakfast: Whole wheat mini bagel with peanut butter and blueberries Lunch: From a Greek place nearby. Fast, easy, and healthy. Roasted chicken, salad (just a side salad, probably don’t need the feta cheese in a Greek salad), hummus. Dinner: Turkey cheeseburger, high-fiber bun, and the works: ketchup, pickles, lettuce, tomato. Cooked spinach, because there’s some in my fridge. Maybe an orange. Snacks: Protein bar (chocolate almond) What is your Wednesday looking like (or how did it go?) and remember – if you post your menu each day this week (Monday through Sunday), you will be entered into a drawing to win a $50 gift card to The BariatricPal Store! Don’t worry, you can still be entered into the drawing if you go back and post your earlier menus if you missed them already!

Yesterday was good…hopefully today will be, too! Here is my goal for today. Breakfast: Oatmeal cookies with non-fat cream cheese. The cookies have 10 grams of protein per serving. Strawberries. Lunch: Going out with work colleagues (a business lunch). I don’t know where we’re going. It might be Olive Garden (herbed salmon!). An apple for afterwards if needed. Dinner: Hopefully I can make up for whatever damage lunch will do. The plan here is chicken breast with a lemon pepper sauce/marinade, broccoli, and rice. Snacks: Probably oatmeal protein cookies. I made a batch with Protein Oatmeal Cookie Baking Mix and they are tempting! I’ll probably freeze some so they’re around for other times, too. Let us know your planned or actual Tuesday menu, and remember – if you post your menu each day this week (Monday through Sunday), you will be entered into a drawing to win a $50 gift card to The BariatricPal Store! Don’t worry, you can still be entered into the drawing if you go back and post your earlier menus if you missed them already!

Breakfast: Oatmeal pancakes with oats and pancake mix. Good for the kids! Plus cantaloupe. No pancake syrup for me. Is maple syrup good for weight loss? It’s natural, right? Lunch: coleslaw with shredded cabbage mix and walnuts and Asian dressing and feta cheese. Actually, it was good! Dinner: When in Rome, do as the Romans do…actually, never mind. When in a Chinese restaurant, don’t order the egg rolls, white rice, and sweet and sour chicken. Order Broccoli Chicken. And I did! The fortune cookie could not have done too much damage, and I am sure it would have been bad luck to pass it up. So I didn’t. How did your day go? Good start to the weekend?

Happy Father's Day from BariatricPal! #outlook a {padding:0;} body{width:100% !important; -webkit-text-size-adjust:100%; -ms-text-size-adjust:100%; margin:0; padding:0;} .ExternalClass {width:100%;} .ExternalClass, .ExternalClass p, .ExternalClass span, .ExternalClass font, .ExternalClass td, .ExternalClass div {line-height: 100%;} #backgroundTable {margin:0; padding:0; width:100% !important; line-height: 100% !important;} img {outline:none; text-decoration:none; -ms-interpolation-mode: bicubic;} a img {border:none;} .image_fix {display:block;} p {margin: 1em 0;} h1 { color: white !important; } h2, h3, h4, h5, h6 {color: #333333 !important;} h1 a:active, h2 a:active, h3 a:active, h4 a:active, h5 a:active, h6 a:active { color: red !important; } h1 a:visited, h2 a:visited, h3 a:visited, h4 a:visited, h5 a:visited, h6 a:visited { color: purple !important; } table td {border-collapse: collapse;} table { border-collapse:collapse; mso-table-lspace:0pt; mso-table-rspace:0pt; } a {color: #4a8aca;} /* Unhides cells that we set to hide in the HTML in case the client doesn't support style properly */ *[class~=hidePhone] { display : block !important; width : auto !important; max-height: inherit !important; overflow : visible !important; float : none !important; } *[class~=hidePhone][width="30"] { width: 30px !important; } *[class~=hidePhone][width="40"] { width: 40px !important; } td[class~=hidePhone] { display: table-cell !important; } @media only screen and (max-device-width: 480px) { a[href^="tel"], a[href^="sms"] { text-decoration: none; color: blue; pointer-events: none; cursor: default; } .mobile_link a[href^="tel"], .mobile_link a[href^="sms"] { text-decoration: default; color: orange !important; pointer-events: auto; cursor: default; } #userPhoto, .hidePhone, *[class~=hidePhone], td[class~=hidePhone] { display: none !important; } .responsive_table > tr > td, .responsive_table > tbody > tr > td, .responsive_table > tr, .responsive_table > tbody > tr { display: block; text-align: left; } html[dir="rtl"] .responsive_table > tr > td, html[dir="rtl"] .responsive_table > tbody > tr > td, html[dir="rtl"] .responsive_table > tr, html[dir="rtl"] .responsive_table > tbody > tr { text-align: right; } .responsive_row { margin-bottom: 10px; } .responsive_fullwidth { width: 100% !important; } } @media only screen and (min-device-width: 768px) and (max-device-width: 1024px) { a[href^="tel"], a[href^="sms"] { text-decoration: none; color: blue; pointer-events: none; cursor: default; } .mobile_link a[href^="tel"], .mobile_link a[href^="sms"] { text-decoration: default; color: orange !important; pointer-events: auto; cursor: default; } Store Forums Magazine Activity Hey BariatricPal Members! You can get your quality time with Dad if you keep him company while he grills up a healthy dessert in the form of peaches, pineapple, or watermelon. Slice the fruit and grill it plain or with a bit of cinnamon or balsamic vinaigrette. You can put a small amount of goat cheese or another soft cheese on the fruit before serving it. Guy Bonus: The grill! By letting Dad make dessert, you help him feel useful and in control, and that’s what dads are for, right? • Your Hearty and Healthy Menu to Say, “Thanks, Dad!” • Weight Loss Surgery: A Guy Thing or Not? • Get Motivated with Some Together Time Use the newsletter as a start for some inspiration and ideas, and keep the journey to health going as you stop by the BariatricPal Forums. Have a wonderful Father’s Day and remember what’s important. Thanks for all of your support! Sincerely, Alex Brecher Founder, BariatricPal Hearty and Healthy Menu to Say, “Thanks, Dad!” What does Dad want? If he’s the stereotypical guy, he’s pretty simple when it comes to food. Some comfort food can be the most direct way to letting him know how much you love and appreciate him, but you are not doing him any favors by serving up high-fat, high-carb, high-calorie fare. These great-tasting ideas can help you get a Father’s Day meal on the table fast while keeping your weight loss surgery diet in mind. In the Center: Steak A fatty steak can be a diet breaker, but Tender Flank Steak is not. It is a savory and satisfying dish. Preparation only takes minutes; just remember to leave four hours to marinate the meat. Double the recipe, using two pounds of beef, and you will have 8 total servings, each with 26 grams of protein and less than 1 gram of carbohydrates. Guy Bonus: Leftovers! A big steak can do double or triple duty in the coming days. Leave Dad with some large lettuce leaves (instead of bread) and sliced avocados for steak wraps for tomorrow’s lunch. On the Side: Pureed Cauliflower If you’re a meat and potatoes guy, you have to have your potatoes…unless you have Mock Mashed Potatoes. You can make it with frozen cauliflower, or try a blend of cauliflower and cooked carrots, parsnips, or turnips. This is another great recipe to double. Serve it with Instant Chicken Gravy made Cream of Chicken Protein Soup. Guy Bonus: Midnight noshing! When Dad has the late-night munchies, he won’t do much damage by finishing up the “mashed potatoes” and gravy. For Dessert: Grilled Fruit You can get your quality time with Dad if you keep him company while he grills up a healthy dessert in the form of peaches, pineapple, or watermelon. Slice the fruit and grill it plain or with a bit of cinnamon or balsamic vinaigrette. You can put a small amount of goat cheese or another soft cheese on the fruit before serving it. Guy Bonus: The grill! By letting Dad make dessert, you’re help him feel useful and in control, and that’s what dads are for, right? Weight Loss Surgery: A Guy Thing or Not? If you are a weight loss surgery patient or you have been looking into weight loss surgery, you may have noticed something: there seem to be a lot of women! It is not your imagination. About 80 percent, or four out of every five, WLS patients are women. Why the Difference? Why are men so much less likely to get WLS? It is not because men are skinnier; obesity rates are almost the same between men and women. Reasons for the WLS gap may include: • Differences in perception of health, as women may recognize health risks earlier than men. • Cultural factors, as women tend to feel more pressure to lose weight than men. • Perception of need, as men may be more likely to feel that they can do it without surgery than women. More than women, men may feel that WLS is the easy way out, or they may be embarrassed at the rapid weight loss that their acquaintances may notice. They may also feel more out of place ordering WLS friendly fare at restaurants or eating “diet foods” in public. Should You Break the Trend? Male or female, the same factors should determine whether WLS is for you. • Have you tried multiple diet and exercise programs? • Do your BMI and health status make you a good candidate? • Are you ready to commit to a lifetime of healthier choices? If your WLS goes well and you embrace the changes, you can expect the benefits that can make life better. You can lose weight and get back your energy. Better yet, you can spend more time with your kids now and in the future. Get Motivated with Some Together Time At the end of the day what matters are the people you love. For Father’s Day, whether or not you are with your dad, honor the ones you love while you promote healthy behaviors together. Cook Up a Storm Dad may not truly dislike cooking. He may just not know how to cook, especially when it comes to WLS friendly foods. Whether it is father or grown-up child who is the WLS patient, both of you can benefit from preparing some high-protein, low-carb quick fixes as you spend quality time together. • Layer yogurt with Protein Cereal and berries to make an elegant breakfast parfait. • Transform an infamous doughnut burger from a heart attack on a plate into a weight loss special by swapping Protein Pancakes for the doughnut and turkey burger for ground beef. • Toss Protein Pasta with Low-Carb Sauce and spinach or cooked broccoli or other vegetables. Get Active Now and Forever One reason to get WLS is to be able to keep up with the family. To keep up the motivation, try scheduling a family hike or other activity, such as a trip to the beach. Notice how good it feels when you spend the time being active together – or think about how good it would feel if you could all keep up together. It’s a good time to remind each other why the hard work is worth it. Whether you are a dad, a future dad, or a product of a great dad or father figure, we want to wish you a Happy Father’s Day! We hope this newsletter got you a little more inspired to be healthy for yourself and for your family, and we look forward to spending some time with you on the boards when you get a chance! Stop paying for nutritional supplements! Check your insurance eligibility now! If you no longer wish to receive this newsletter, please click *|unsubscribe|* or to unsubscribe from ALL BariatricPal E-Mail Click Here.

Hey BariatricPal Members, Want to win a $50 gift card for The BariatricPal Store? We're holding a drawing! All you have to do to enter is post your menu every day in the coming week (Monday, June 19, through Sunday, June 25). Each day I will start a separate thread with my planned menu. Then you can post your own planned or actual menu for that day. Every BariatricPal member who posts their menu each day for the 7 days will be entered into the drawing for a $50 gift card to The BariatricPal Store! So...let us know what you're eating each day, and good luck in the drawing!

Have you tasted New Whey Protein yet? We used to carry it in our store but stopped because we had complaints about taste. I'm curious if things have improved taste wise.

BariatricPal is proud to be the exclusive sponsor of Bariatric Foodie's new weekly live Facebook show ! Tune in tonight, when hosts Nik and Shannon will review BariatricPal protein chips, and find out how you can win some yourself!

Don't forget to enter Bariatric Foodie's giveaway to win BariatriPal protein chips! Entry is open until Sunday, June 18, 11:59 p.m. EST. Good luck! Link: www.bariatricfoodie.com/foodiechips

Thanks so much, Nanette! So many people had less-than-ideal experiences in high school and have memories of being teased or ostracized or even just feeling bad because of our weight. Your approach is a brave and clever one to heal the ones. It is also a generous one, because there are probably classmates of yours who feel bad about how they treated you and to whom you gave the chance to feel better when they saw that you are not holding grudges. You are also right that it helps to be 150 lbs lighter and feel self-confident when going bad to the reunion - maybe that can be extra motivation to get healthy! Thanks for your great article.

Summer officially starts next week. It is a great time to think about what you will do over the next few months to move forward on your weight loss surgery journey. You are a deserving person, and you can think of your efforts as a way to honor yourself. What can you do so that come Labor Day and the end of summer, you will look back on Summer 2017 and be proud of yourself? Will this be the summer that you… Get weight loss surgery? Train for a 5k walk? Try a new healthy recipe each week? Spend 5 minutes a day planning and logging meals? Share how you plan to celebrate yourself and get healthier this summer! It would also be great to know what you are using for motivation.

Happy Friday! I hope it was a good one for you! Breakfast: oatmeal with frozen blueberries, and walnuts. Again. Am I stuck in a rut? At least it’s healthy. Lunch: Knowing dinner may not be the best…A Greek salad with chicken breast. I added some raspberries. Dinner: Sometimes you have to have fun and go out with friends, but I still made an effort. Italian. Minestrone soup and 2 slices of thin crust pizza with chicken, artichokes, and parmesan. A freshly baked breadstick. How can you resist? At least I didn’t have a bowl of pasta! A small piece of chocolate cake – we split it three ways. This day wasn’t the best, but I think I did well under the circumstances. The chocolate cake probably wasn’t necessary. It was good, but not that good. Probably not worth it. How did your weekend start? Share your Friday menu!

This was my day. How did yours go? Breakfast: Oatmeal, frozen blueberries, and walnuts. Lunch: 2 chicken soft tacos, yes, from a chain that you might be able to guess! With refried beans, double salsa, sour cream, and cheese. I only ate one of the tortillas. They’re not bad, though – not too many carbs! I looked them up online afterwards. Dinner: Chicken breast with lemon pepper marinade. Microwaved frozen brussels sprouts on the side. I’m not always much of a chef, but at least I got my protein and veggies in at this meal. Dessert: It happens, and I don’t fight it. It was ice cream time, and I savored every spoonful of the full-fat stuff. Okay, maybe not the healthiest day, but not too bad considering the cravings I satisfied!

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The day went…okay! Here’s the run-down. Breakfast: 2 slices of whole wheat toast with scrambled eggs. Lunch: Caught empty-handed with no great options. I settled for packaged convenience food, which actually wasn’t too bad. I had a yogurt, an ounce of beef jerky, an orange, and a little tray of baby carrots and grape tomatoes. Dinner: Starving from busy afternoon with no snack, and no time to cook. Huge salad with romaine lettuce (pre-cut bag – easier!), grape tomatoes, and a scoop of tuna. Honey mustard dressing. 1 slice whole wheat toast with peanut butter. Snack: blue cheese. Why? I don’t know. I felt like it. My meals were not gourmet, but they were pretty healthy. How did your day go? What were the good and bad?