Alex Brecher

@Elizabeth Anderson, Thanks for these notes on this important event! Obesity Week is always a great event for bringing the industry, researchers, and healthcare professionals together to discuss latest findings in obesity research and talk about As you mentioned, the list of speakers was quite impressive! Dr. Farooqi has published research papers on a variety of obesity-related topics, including effects of obesity on the brain and brain aging (not good!), and some of the genetic factors that are linked to obesity (yes, there is a big genetic component!). Dr. Brownell from the Sanford School of Public Policy at Duke University has done all sorts of research on obesity and the environmental factors that can cause it. He has worked on health policy such as food labeling, sales taxes, and other legislation that could affect the public’s likelihood of choosing healthier or less healthy foods. What an exciting speaker! Thanks for these notes. We look forward to your next update from the meeting!

Mark your calendar for October 30 to November 5. That’s when National Obesity Care Week is happening this year. As its name suggests, National Obesity Care Week is a campaign to improve care for obesity, since many obese patients do not receive the care they want or even the care they are entitled to. You may be one of them. National Obesity Care Week Background Fighting obesity successfully includes improving obesity treatment as part of regular healthcare. That sounds promising, but it has not yet panned out. To combat this, The Obesity Society (TOS), the Obesity Action Coalition (OAC), Strategies to Overcome and Prevent (STOP) Obesity Alliance, and the American Society for Metabolic and Bariatric Surgery (ASMBS) developed National Obesity Care Week. The event is aimed at raising awareness among patients, providers, and policy makers, and improving the quality of care obese patients receive. The first National Obesity Care Week happened in 2015. This year, the event runs from October 30 to November 5. Shortfalls in Obesity Care It would make sense for doctors to help their patients with weight management. But, as you may well know, many doctors do not. Primary care and other doctors may not set aside time during regular appointments to discuss your weight. If they do, they may not talk about strategies for managing it. This can be because there is not enough time, or they do not know much about the topic. Even if doctors do approach the subject of weight management with you, they may not have all the information they need, or they may not deliver it well. Doctors do not usually get much nutrition education, so how can they be expected to pass it on to you? They may also be guilty of “blaming the patient” and writing you off as a lost cause. After all, they may figure, it’s your fault you’re overweight, and it’s a choice you’ve made. They have no idea how ridiculous this assessment is! Even when doctors are genuinely interested in helping you, they may not have the resources at their fingertips. They may not know where to find meal planning and exercise materials to help you. They may not know which dietitians are in your health plan. They may not know when it’s time to consider weight loss surgery, or have a network of bariatric surgeons to refer you to. And finally, there’s the issue of money. Does your insurance cover obesity treatment, appointments with dietitians for meal planning and other support, and any mental health counseling that could address underlying causes of obesity? Does your insurance cover weight loss surgery at all, and is it the type you want to get? Probably not! Making Progress, Slowly Most of us in the weight loss surgery community have known that obesity is a disease for years. In 2013, the American Medical Association (AMA) finally made it official. Their reasoning was that obesity is so strongly linked to the development of other chronic diseases that it needs to be treated medically. Naming obesity as a disease increased awareness. Then, American Heart Association (AHA), The Obesity Society (TOS), and American College of Cardiology (ACC) published guidelines for treating obesity starting with the primary care doctor. They suggest a role of the doctor in assessing obesity and providing dietary counseling for the obese patient, along with monitoring weight and willingness to comply at each appointment. They also suggest considering bariatric surgery when other methods fail. But you may still run across many challenges to obesity care! Doctors are ignorant or insensitive. It’s too expensive. You do not know your options. Make the Most of Each Appointment Your doctor may not take the lead, but you can. Come to your next appointment with a list of questions and talking points. These can get a conversation started and help you take action. Let the doctor know what you are doing to lose weight, such as watching your diet or adding in some exercise. Show your doctor how your weight has changed over time. Bring in a few typical days’ worth of food logs and ask for comments. Explain to your doctor why you believe you are having trouble losing weight, and ask for help addressing those issues. Ask your doctor for a referral to a nutritionist or dietitian. If you are eligible and possibly interested in weight loss surgery, ask your doctor for a referral to a bariatric surgeon. Know Your Healthcare Plan Cost should not be a factor in your healthcare, but it is. Things are getting better, though. The Affordable Care Act requires all private insurance plans to cover screening and intensive behavioral counseling for obesity. However, in practice, counseling can range from telephone consults to in-person comprehensive programs. Weight loss surgery is covered only some states. It is becoming more commonplace, and your options are generally increasing. While only more established surgeries such as the adjustable gastric band and gastric bypass might have been likely to be covered previously, now some plans include the country’s most popular option, the vertical gastric sleeve (sleeve gastrectomy). You can do best for yourself by becoming familiar with your healthcare plan and exactly what it covers. So, as National Obesity Week happens, take some time to think about your own obesity care. Is it adequate? What is it lacking? How can you make a difference by being your own advocate and learning all you can about your options? Getting the care you need can be a fight, but it is a necessary and worthwhile one!

National Obesity Care Week Background Fighting obesity successfully includes improving obesity treatment as part of regular healthcare. That sounds promising, but it has not yet panned out. To combat this, The Obesity Society (TOS), the Obesity Action Coalition (OAC), Strategies to Overcome and Prevent (STOP) Obesity Alliance, and the American Society for Metabolic and Bariatric Surgery (ASMBS) developed National Obesity Care Week. The event is aimed at raising awareness among patients, providers, and policy makers, and improving the quality of care obese patients receive. The first National Obesity Care Week happened in 2015. This year, the event runs from October 30 to November 5. Shortfalls in Obesity Care It would make sense for doctors to help their patients with weight management. But, as you may well know, many doctors do not. Primary care and other doctors may not set aside time during regular appointments to discuss your weight. If they do, they may not talk about strategies for managing it. This can be because there is not enough time, or they do not know much about the topic. Even if doctors do approach the subject of weight management with you, they may not have all the information they need, or they may not deliver it well. Doctors do not usually get much nutrition education, so how can they be expected to pass it on to you? They may also be guilty of “blaming the patient” and writing you off as a lost cause. After all, they may figure, it’s your fault you’re overweight, and it’s a choice you’ve made. They have no idea how ridiculous this assessment is! Even when doctors are genuinely interested in helping you, they may not have the resources at their fingertips. They may not know where to find meal planning and exercise materials to help you. They may not know which dietitians are in your health plan. They may not know when it’s time to consider weight loss surgery, or have a network of bariatric surgeons to refer you to. And finally, there’s the issue of money. Does your insurance cover obesity treatment, appointments with dietitians for meal planning and other support, and any mental health counseling that could address underlying causes of obesity? Does your insurance cover weight loss surgery at all, and is it the type you want to get? Probably not! Making Progress, Slowly Most of us in the weight loss surgery community have known that obesity is a disease for years. In 2013, the American Medical Association (AMA) finally made it official. Their reasoning was that obesity is so strongly linked to the development of other chronic diseases that it needs to be treated medically. Naming obesity as a disease increased awareness. Then, American Heart Association (AHA), The Obesity Society (TOS), and American College of Cardiology (ACC) published guidelines for treating obesity starting with the primary care doctor. They suggest a role of the doctor in assessing obesity and providing dietary counseling for the obese patient, along with monitoring weight and willingness to comply at each appointment. They also suggest considering bariatric surgery when other methods fail. But you may still run across many challenges to obesity care! Doctors are ignorant or insensitive. It’s too expensive. You do not know your options. Make the Most of Each Appointment Your doctor may not take the lead, but you can. Come to your next appointment with a list of questions and talking points. These can get a conversation started and help you take action. Let the doctor know what you are doing to lose weight, such as watching your diet or adding in some exercise. Show your doctor how your weight has changed over time. Bring in a few typical days’ worth of food logs and ask for comments. Explain to your doctor why you believe you are having trouble losing weight, and ask for help addressing those issues. Ask your doctor for a referral to a nutritionist or dietitian. If you are eligible and possibly interested in weight loss surgery, ask your doctor for a referral to a bariatric surgeon. Know Your Healthcare Plan Cost should not be a factor in your healthcare, but it is. Things are getting better, though. The Affordable Care Act requires all private insurance plans to cover screening and intensive behavioral counseling for obesity. However, in practice, counseling can range from telephone consults to in-person comprehensive programs. Weight loss surgery is covered only some states. It is becoming more commonplace, and your options are generally increasing. While only more established surgeries such as the adjustable gastric band and gastric bypass might have been likely to be covered previously, now some plans include the country’s most popular option, the vertical gastric sleeve (sleeve gastrectomy). You can do best for yourself by becoming familiar with your healthcare plan and exactly what it covers. So, as National Obesity Week happens, take some time to think about your own obesity care. Is it adequate? What is it lacking? How can you make a difference by being your own advocate and learning all you can about your options? Getting the care you need can be a fight, but it is a necessary and worthwhile one!

I was recently approached about carrying Subtle Butt disposable gas neutralizers in the BariatricPal Store. Subtle Butt disposable gas neutralizers use activated carbon to eliminate bad odors and save you from the smell (or the embarrassment). These 5 saving graces (also affectionately known as fart pads or fart filters) effectively filter the odor caused by flatulence. Simply stick one to the inside of your underwear and you're good to go. I personally know many weight loss surgery patients that suffer from really bad flatulence after gastric bypass or duodenal switch weight loss surgery. We would start selling them if we were told that our members were interested in this product. Please let us know by voting in this poll!

Happy Halloween! And now, to the important part: candy! More specifically, how are you going to avoid it this year? It can be staring you in the face at home as you get ready for trick-or-treaters, and at work as your coworkers bring in their leftovers. How are you going to pass up the sweet stuff this year? Are thoughts of weight gain, dumping syndrome, and guilty feelings enough to keep you away? Or do you need some more tangible strategies? Maybe you hand out a type of candy that you do not like, or arm yourself with a stash of frozen grapes to satisfy your sweet tooth during the evening. What are your plans this Halloween, and how are you going to “be good?” And, just for fun…what did a typical Halloween look like before WLS?

Happy Halloween from BariatricPal!#subject#> body,div,dl,dt,dd,ul,ol,li,h1,h2,h3,h4,h5,h6,pre,form,fieldset,input,textarea,p,blockquote,th,td { margin:0; padding:0; } table { border-collapse:collapse; border-spacing:0; } fieldset,img { border:0; } address,caption,cite,code,dfn,th,var { font-style:normal; font-weight:normal; } caption,th { text-align:left; } h1,h2,h3,h4,h5,h6 { font-size:100%; font-weight:normal; } q:before,q:after { content:''; } abbr,acronym { border:0; } address{ display: inline; } html, body { background-color: #d8dde8; color: #5a5a5a; } body { font: normal 13px helvetica, arial, sans-serif; position: relative; } h3, strong { font-weight: bold; } em { font-style: italic; } img, .input_check, .input_radio { vertical-align: middle; } legend { display: none; } table { width: 100%; } td { padding: 3px; } a { color: #225985; text-decoration: none; } a:hover { color: #328586; } div.outer { margin: 0 auto; padding: 14px; } table.wrap { max-width: 800px; margin: 0 auto; } td.logo { background-color: #0f3854; padding: 8px; } td.content { background-color: #fff; font-size: 14px !important; color: black !important; line-height: 150% !important; padding: 8px; } ul { margin-left: 25px; } Hey BariatricPal Members! Happy Halloween! It’s time to enjoy a few scares and spooks and a lot of fun, but how is that possible when you are trying to lose weight? This newsletter has a few tips that can help you enjoy yourself this Halloween and in the coming months, and keep the results from showing up on the scale. Here’s what we have: Surviving Halloween as a Weight Loss Surgery Patient Scary Good Treats from The BariatricPal Store The Start of the Eating Season (Or Not) Thanks for reading the newsletter and being part of the BariatricPal community. Don’t forget to login to share your healthy Halloween tips and get some healthy inspiration when you need it, and have a safe and happy Halloween! Sincerely, Alex Brecher Founder, BariatricPal Surviving Halloween as a Weight Loss Surgery Patient Halloween is one of the hardest times for bariatric patients. You’re sure to see candy nearly everywhere, and you may not see much else. How are you supposed to pass up the sugar while still having fun and getting in your Protein? It may not be easy, but you can do it. Go with a Plan Plan ahead, just like you do in the rest of your post-op life. If you are going to a party, plan to drink ice Water for most of the time. Set yourself up far from the buffet table, and talk to everyone you can to keep your mind off of the food. Also, remember to fend for yourself instead of depending on the party far. Bring a dish or two to share to make sure you have something healthy to eat for when you are hungry. These are some fun Halloween ideas. String cheese Fingers with half-sticks of string cheese being the fingers, and grape tomato halves filling in as the fingernails. Drizzle tomato sauce for blood if you like. Candy Corn Fruit Plate with three layers: each representing a color of the traditional candy corn. The bottom of the triangle can be a yellow fruit such as pineapple chunks; the middle stripe can be an orange fruit such as orange wedges or cut cantaloupe; the white tip can be banana slices or even cottage cheese for dipping. You can also make this with veggies! Banana Ghosts using banana halves for the ghost and blueberries, peanuts, or pieces of Protein Cereal for the eyes and mouth. Tangerine Pumpkins using a peeled tangerine for the pumpkin body, and a piece of celery stuck in the center as the stem. Stay Busy without Eating If you are trick-or-treating, there are all kinds of ways you can stay busy without diving into the kids’ loot. Keep yourself busy by helping out any children who need it, whether they are yours or anyone else’s in the neighborhood. Fix their makeup and costumes, help them cross the street safely whenever necessary, and hold the littlest ones’ hands if they get scared. Practice the One and Done Actually, practice it twice! For your first “one and done” trick, choose one piece of candy, assuming that you are up to eat solids foods on your post-op diet, and assuming you know that you can handle a sugary piece of candy without feeling sick or reaching for another 10 pieces. For your second “one and done,” remember that Halloween is one night. The leftover candy from what you handed out to trick-or-treaters or that your children collected needs to go on November 1. Otherwise, if you keep it around the house, you risk munching on it, well, possibly up until Thanksgiving! No, thanks! Donate the leftover candy to your local school or church. Throw unwanted leftovers away (really, the trash can wears the calories better than you do). If you allow your children to continue to eat their trick-or-treating loot, have them stash it away out of your eyesight so you are not tempted to eat it. Scary Good Treats from The BariatricPal Store Treats with a Little Trick Trick or treat! It’s fun to gather all kinds of candies, but you know the damage to your waistline. The calories pile on, the sugar leads to more carb cravings and possibly dumping syndrome, and the fat clogs your arteries. Who needs those kinds of effects when you can turn to treats from The BariatricPal Store? Our little trick is to change up the nutritionals to bump up the protein and dial down the calories, sugar, and fat. Instead of grabbing a candy bar next time, try one of these little treats: Caramel Coated Protein Puffs Snacks with 150 calories and 15 grams of protein. chocolate & Caramel Crispy Bites with 160 calories and 12 grams of protein. White Chocolate Dream Bar with 170 calories, 10 grams of protein, and 5 grams of Fiber. Peanut Butter and Smooth Caramel Crisp Bar with 140 calories, 15 grams of protein, and 10 grams of fiber. You may not even miss your favorite candy bar. Grab the Best Deals! We’re celebrating the 1-year anniversary of the opening of The BariatricPal Store, and you will come out the winner! We’re constantly increasing our inventory, so check our new products regularly. Are you new to our store? Just use coupon code BPNEWSLETTER10 when you check out for a 10% discount off your entire purchase cost! The Start of the Eating Season (or Not) On guard! Halloween marks the unofficial start to the holiday season. Festive though it may be, the holidays can mean trouble for your weight loss plan. Leftover Halloween candy in the home and office. Thanksgiving…a four-day eating marathon in itself. Christmas Cookies, fudge, fruitcakes, and candy canes. Holiday parties with friends, family, and coworkers. Christmas and New Year’s celebrations. And more… The bottom line is that there may be food wherever you turn, and you can’t give in each time if you want to stay on track with your weight loss goals. Here are a few tips to help you get through this time. Practice saying “no.” “No, thank you.” “No, thanks, my doctor says I can’t eat that.” “No, thanks, I’m not hungry right now.” Have your own healthy substitutes ready. You can save hundreds of calories by making yourself some Protein Cocoa instead of ordering it with your friend or coworkers at a coffee shop, or by munching on a Chocolate Wafer Protein Bar instead of a few squares of fudge. Eat regularly to keep cravings down. Instead of letting yourself get too hungry so that you risk overdoing it when it is time to eat, keep healthy and quick meals and snacks on hand. Canned tuna, washed and cut fruits and vegetables, nuts, yogurt, and protein bars are just a few ideas. Change your goals slightly to be more realistic. You may lose weight a little more slowly during these months, and that’s okay. Scour the table before serving yourself. Often, there is a high-protein choice that can work for you, such as roast beef or ham, even if it is not the healthiest in the world. Plan an occasional treat when you know something spectacular is coming up. It might be a cookie from your aunt’s annual Christmas delivery, or some cornbread stuffing. Plan to have a bite to satisfy yourself so you do not feel deprived or, on the other hand, go overboard. The holiday season is long for weight loss surgery patients, since temptations are everywhere and these are foods that you may have enjoyed in the past. Still, you can get through it right on track by being a little cautious and planning ahead whenever possible. Have a safe and healthy Halloween this year! Enjoy every minute of it, and come tell us about it on the boards at BariatricPal! · Unsubscribe from all BariatricPal E-Mail.

@@surfhudson, I don’t think there is anything wrong with snacking as long as you count it towards your daily totals and make up for it by having smaller meals. I mean, if you’re going to have 1,400 calories, for example, it doesn’t matter much whether you have three meals of 400, 500, and 500 calories, or three meals of 350 calories PLUS two Snacks each with 175 calories. As for what to have…think Protein, then Fiber, and of course filling! I always like to think about easy snacks, too, because I tend to grab whatever’s around. If nothing healthy is on hand, I am more likely to go for easy junk like chips. You might start with a protein, like hard-boiled eggs, Greek yogurt, low-fat string cheese, tuna, or Peanut Butter. Then think about adding some fiber, usually from fruit or vegetables. Have cottage cheese with fruit or veggies, dip cucumbers in Greek yogurt, pair celery or apples with peanut butter, or dip carrots into hummus. Beans and soybeans make a nice two-fer – they have protein and fiber! You can have roasted chickpeas or soybeans, or have a half-cup of fat-free refried beans or low-sodium canned beans. For something sweet, you can always do low-sugar flavored yogurt, or a Protein Bar, or fruit with ricotta cheese or non-fat cream cheese.

@@itzbrittaanyx3, You’ve gotten a lot of good answers here. It can be helpful to remind yourself of why you are on this journey. The more you practice, the better you will become at automatically remembering your reasons for passing up your family’s food. You will barely need to make an effort to remember; it will become natural if you keep practicing. Another strategy is to make sure you are loving what you eat. Just because you are eating Soup does not mean you cannot enjoy your meal. Yes, it can be tough if you are still on the liquid diet and are stuck with broth – but that is a temporary situation. As you progress, you can make sure that everything you put into your mouth is something that tastes very good and that you want to eat. You can also practice asking yourself what the point of eating the steak or cutlet would be. Would the five minutes of pleasure really be worth setting yourself back? Probably not! Distract yourself by focusing on your soup and on the conversation – because really, sitting down to eat as a family is a privilege that you can hopefully enjoy. It gets easier. Really, it does. But only if you practice it. Good luck!

@@itzbrittaanyx3, Yep, it’s tough! Welcome to the rest of your life! Still, it’s wonderful that they said they would stop eating because of your surgery. They may not have meant it, and of course they should have been more considerate than to start eating that stuff in front of you, but at least it shows they care about you and are aware of your challenges. On the positive side, it’s a good opportunity to remember that Burger King and so many other places have options you can go for. There are the grilled chicken and side salads, a veggie burger patty or beef burger patty without the bun, and a flame-grilled chicken burger without the bun at Burger King. You can do it. Coming here to vent and think about it is a very good way to cope!

@@hmvjoyce, Congratulations on your surgery! Thanks for keeping us posted on how it went. I am so glad it went okay. The nausea can be tough, but it will go away. Good idea to stay hydrated. It can be so difficult to get those fluids down and get enough of them in you, but it is so well worth it. Good luck as you recover and continue in this journey.

@@john925, Some good points here! In many cases, I think the blanket statements (“eat lots of Protein,” or “skip the carbs at breakfast”) from members come from their own post-op instructions, which are either general guidelines that work for most WLS patients, or are instructions designed specifically for them. In general, I don’t think most BariatricPal members are kidney disease patients, and may not be thinking about those and analogous populations when giving advice. I definitely agree with you to seek medical advice rather than blindly follow anonymous posters’ advice on the boards, regardless of whether you have a specific additional medical condition that could affect your WLS or diet. I think there are also some different kinds of advice. As @@PorkChopExpress said, some members come here because they need ANY kind of information, because their surgeon gave them none. Others who have some information but may have a medical condition such as diabetes really need to depend on their doctors for safe advice. And no, kidney disease, diabetes, or not, you probably should not be asking if you can eat ice cream a day after surgery.

@@Tierra T Tij, This is always a difficult situation. First, try to remember that they are all on your side in the sense that they want what is best for you. Unfortunately, they do not agree what is best for you. Your grandmother may not be able to perceive that her grand-daughter is overweight. Your friend may just see you as YOU and not as YOU plus extra weight. And your doctor may be among the many, many primary care doctors who have no idea how to approach obesity, or who do not have a clue what weight loss surgery is, or they feel that it is your fault that you are overweight. Do you really need your doctor to be behind your RNY? If yes, then you may need to find a more supportive doctor. However, I suspect you do not need your primary care doctor to support your RNY; it’s a surgeon who will do the surgery, not your doctor. As for going to Mexico, it is extremely scary when people first hear about it. We hear so much about crime and poverty there, but we do not hear much about the great things it has to offer, like weight loss surgery at prices you can actually afford with quality of care and surgery as good as in the U.S. Maybe once you explain to them how the process works and why you are sure it is safe, and maybe even invite one of them to be your companion when you go for your procedure. Is there anyone else who can provide the support you need? A different friend or family member? If not, can you join a local bariatric surgery support group and see if you hit it off with anyone there? So, you have to do what is best for you. Consider the reasoning behind why your grandmother, friend, and doctor are against your RNY, and decide whether they are right or whether you still want the surgery. Then do what’s best for you! Good luck.

@@ML573663, You’re getting some good news on this thread. Yes, it is possible to lose over 100 pounds your first year after getting the sleeve! It does not happen to everyone, but it can happen to you if things fall into place. First, you need surgery to go well. You can get a good start by choosing a good surgeon and by following all of the pre-op instructions you are given and losing whatever weight you can before surgery. That helps surgery be safer, so you have a lower chance of complications, and it helps you have fewer side effects, so you can get focused on losing weight after surgery as soon as possible. The main factor in how much you lose in the first year is…you. You will lose a lot more if you follow all your post-op diet instructions as you progress to the solid foods diet. If you rush the liquid and pureed stages or you do not get enough Protein or fluids, you’re more likely to have complications or to have trouble transitioning to solid foods. After you get to solid foods, you can lose a lot more if you follow the diet instructions, including what to eat and how much to eat. You can also help yourself out by exercising. If you are one of those patients who is just itching to “progress” back to whatever got you into trouble in the first place, such as drinking alcohol or eating brownies or wings, you will probably not lose weight as fast. Good luck!

Take 5 minutes to learn how to talk obesity with your patients, family or friends. Good communication is essential for a successful patient-provider relationship, but not all doctors talk to their patients about obesity. The topic can be embarrassing, or doctors may not know what to say, or they may assume the patient “is choosing” to be overweight and therefore does not need or want to talk about it. Wrong! If you’re a patient, you can start the conversation whenever you’re ready. If you’re a provider, it may be worth your while to take a few minutes to learn how to talk obesity with your patients. Here are a few ways. Ask your colleagues how they start a conversation with their overweight patients. They may have some good opening lines that relieve tension and do not sound accusatory. Identify a few patients who have successfully lost weight. Ask them how they did it, what role their healthcare providers played, and what they liked and did not like about how their doctors handled the situation. Remind yourself that obesity is a disease. You would not treat a cancer patient as though cancer were their fault; do not treat obese patients as though they chose to be obese. Learn to be sensitive. Talk to a few overweight patients to ask them about their preferences for how doctors approach them. Remember that each patient is an individual. Any obesity treatment that will be successful needs to fit into their lifestyle. Their obesity occurs in the context of their lives, their food habits, and their family and friends. Ask 5 questions to start a conversation. Patient or provider, you can get the convo started by asking some questions. Patient: Here is how I usually eat in a day. Can you make any suggestions to help me lose weight? My knees and back have been hurting, and I think it may be related to my weight. Do you have any suggestions for me? What kind of weight loss counseling can you refer me to? I have been trying to lose weight for years, and it hasn’t worked. Can you please explain how weight loss surgery might help? What are the options for weight loss surgery, and where can I go for more information? Provider: Your BMI is in the obese range. How do you feel about that? I noticed that you gained/lost weight since I saw you last. Why do you think that happened, and how do you feel about it? Do you know some of the health effects of being overweight, and do they make you want to lose weight? What have been some of the reasons you feel you have not been able to lose as much weight as you wanted? What do you feel I can do to help you lose weight? Know 5 reasons to address obesity. There are unlimited reasons to address obesity, but healthcare provider or patient, having them in mind can keep them on your priority list. Here are five out of many possible reasons. It kills. Obesity raises the risk for leading causes of death including certain cancers, heart disease, stroke, and diabetes. It hurts. Knee pain, hip pain, low back pain, and arthritis are just some of the painful conditions that can make obese patients suffer every day. It’s embarrassing. Obese individuals can go through life feeling the stigma of their disease. Others often judge them unfairly based on their appearance. It’s expensive. How much do patients and providers spend on medications and obesity-related treatments? Employers even discriminate based on obesity, even though it is technically illegal. It’s limiting. Obesity can make patients miss out on family vacations, and even trips to the movies or a restaurant if they cannot fit in the seat. It’s treatable – so there is no reason to ignore it! Any amount of weight from a little to the amount expected with weight loss surgery can improve health, life expectancy, quality of life, and self-confidence. Engage in 5 reasons to inspire action. What’s in it for you? Why should you inspire action? What are the benefits of improving obesity care? Provider or patient, being healthy lowers costs – think about money saved on prescription medications, doctor’s appointments, and treatment for diabetes complications, strokes, and heart attacks. Better care leads to better weight loss. Improving obesity care can lead to better overall care when patients and providers form a partnership. Better coverage for obesity care increases access so patients can be sure they and their families will get the care they need and deserve. Patient or provider, you can win when other providers get the message and work together to solve obesity. So spread the word! Pass this challenge on to five of your friends or colleagues. Why stop at five, and why stop at friends or colleagues? Tell everyone you know about National Obesity Care Week and how they can help raise awareness to improve obesity care. So, are you up to the challenge? Healthcare provider, patient, or obesity care advocate, you can be part of it this year. Share in the comments how you’re spreading the word about obesity care and working to improve care for everyone!

If you have ever felt that obesity care is not as good as it could be, now is your chance to make a difference! The Obesity Society (TOS), the Obesity Action Coalition (OAC), Strategies to Overcome and Prevent (STOP) Obesity Alliance, and the American Society for Metabolic and Bariatric Surgery (ASMBS) are sponsoring National Obesity Care Week this October 30 through November 5, and you can be involved! Join BariatricPal and other weight loss surgery and anti-obesity advocates this year as we fight obesity through better healthcare. One initiative you can take part in is TAKE5. This challenge lets healthcare providers work with patients to fight obesity and improve health. Here are the 5 parts to the challenge! They are directed towards doctors, but patients can play a major role, too. Take 5 minutes to learn how to talk obesity with your patients, family or friends. Good communication is essential for a successful patient-provider relationship, but not all doctors talk to their patients about obesity. The topic can be embarrassing, or doctors may not know what to say, or they may assume the patient “is choosing” to be overweight and therefore does not need or want to talk about it. Wrong! If you’re a patient, you can start the conversation whenever you’re ready. If you’re a provider, it may be worth your while to take a few minutes to learn how to talk obesity with your patients. Here are a few ways. Ask your colleagues how they start a conversation with their overweight patients. They may have some good opening lines that relieve tension and do not sound accusatory. Identify a few patients who have successfully lost weight. Ask them how they did it, what role their healthcare providers played, and what they liked and did not like about how their doctors handled the situation. Remind yourself that obesity is a disease. You would not treat a cancer patient as though cancer were their fault; do not treat obese patients as though they chose to be obese. Learn to be sensitive. Talk to a few overweight patients to ask them about their preferences for how doctors approach them. Remember that each patient is an individual. Any obesity treatment that will be successful needs to fit into their lifestyle. Their obesity occurs in the context of their lives, their food habits, and their family and friends. Ask 5 questions to start a conversation. Patient or provider, you can get the convo started by asking some questions. Patient: Here is how I usually eat in a day. Can you make any suggestions to help me lose weight? My knees and back have been hurting, and I think it may be related to my weight. Do you have any suggestions for me? What kind of weight loss counseling can you refer me to? I have been trying to lose weight for years, and it hasn’t worked. Can you please explain how weight loss surgery might help? What are the options for weight loss surgery, and where can I go for more information? Provider: Your BMI is in the obese range. How do you feel about that? I noticed that you gained/lost weight since I saw you last. Why do you think that happened, and how do you feel about it? Do you know some of the health effects of being overweight, and do they make you want to lose weight? What have been some of the reasons you feel you have not been able to lose as much weight as you wanted? What do you feel I can do to help you lose weight? Know 5 reasons to address obesity. There are unlimited reasons to address obesity, but healthcare provider or patient, having them in mind can keep them on your priority list. Here are five out of many possible reasons. It kills. Obesity raises the risk for leading causes of death including certain cancers, heart disease, stroke, and diabetes. It hurts. Knee pain, hip pain, low back pain, and arthritis are just some of the painful conditions that can make obese patients suffer every day. It’s embarrassing. Obese individuals can go through life feeling the stigma of their disease. Others often judge them unfairly based on their appearance. It’s expensive. How much do patients and providers spend on medications and obesity-related treatments? Employers even discriminate based on obesity, even though it is technically illegal. It’s limiting. Obesity can make patients miss out on family vacations, and even trips to the movies or a restaurant if they cannot fit in the seat. It’s treatable – so there is no reason to ignore it! Any amount of weight from a little to the amount expected with weight loss surgery can improve health, life expectancy, quality of life, and self-confidence. Engage in 5 reasons to inspire action. What’s in it for you? Why should you inspire action? What are the benefits of improving obesity care? Provider or patient, being healthy lowers costs – think about money saved on prescription medications, doctor’s appointments, and treatment for diabetes complications, strokes, and heart attacks. Better care leads to better weight loss. Improving obesity care can lead to better overall care when patients and providers form a partnership. Better coverage for obesity care increases access so patients can be sure they and their families will get the care they need and deserve. Patient or provider, you can win when other providers get the message and work together to solve obesity. So spread the word! Pass this challenge on to five of your friends or colleagues. Why stop at five, and why stop at friends or colleagues? Tell everyone you know about National Obesity Care Week and how they can help raise awareness to improve obesity care. So, are you up to the challenge? Healthcare provider, patient, or obesity care advocate, you can be part of it this year. Share in the comments how you’re spreading the word about obesity care and working to improve care for everyone!

Weight loss surgery is all about the food! Okay, maybe not all about the food, but a good amount! You focus on food from the moment you first learning about the post-op diet and the diet you will follow for the rest of your life. You learn about portions, about which foods you should and should not eat, and about hunger, fullness, head hunger. Your diet post-op is far different than what you may have eaten in the years leading up to surgery. You may not have known which foods are right to eat. Maybe you did not know that Protein can be satisfying, or the exact size of a proper portion, or that you were doing yourself more damage than eating fried chicken or pizza when you ordered a dressing-laden salad from a restaurant. Did you learn a few things when preparing for WLS? Or, are you more like me in that you basically knew what you should be doing, but you weren’t able to do it consistently for long periods of time? I more or less knew that eating a balanced diet was the best way to go, but I still put myself on some crazy diets because I thought maybe they would work. So, how has your understanding of nutrition changed, if at all? Share what you learned as you went through weight loss surgery!

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After weight loss surgery, you are best off if you drink, and drink, and drink. Getting enough Fluid can help you recover faster from surgery. After surgery and as you get further out, drinking enough Water can help you feel fuller and lose more weight. Unfortunately, it can be difficult to get in your 64 or more ounces every day. The rule to separate liquids from meal times, and the fact that you can feel overly full especially right after surgery, can make it hard to get enough to drink. It is also common that your tastes change. You may not like the taste of plain water, or you may find flavored water too sweet. With all these challenges, how do you make sure to get in enough fluid each day? What is your beverage of choice – do you go for plain water, or use flavored water, or get in some broth along the way?

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food advertising is everywhere! Nearly a third of the time a typical television show takes is dedicated to commercials, and a good portion of those commercials are for food – and not usually for healthy food! Watch TV for a few minutes, and you are sure to see ads for soft drinks, burgers, pizza, potato and tortilla chips, candy bars, and beer. and all-you-can-eat buffets with fried chicken and Pasta. The internet can be even worse! There you are, browsing the net, and you see tempting offers for food delivery. All you have to do is click on the ad, choose your order, and answer the door a few minutes later! It’s hard to avoid food advertising, so how do you deal with it? Does it ever remind you of some forbidden foods that used to be staples before you starting on your WLS journey? Do you get cravings for those off-limits foods? How do you handle the ads? Are you able to limit their effects on you? How do you keep from picking up the phone and calling Domino’s, or driving your car right into McDonald’s drive-through when you see a billboard showing their latest irresistibly tasty and affordable deal? Share your tips – because a lot of us find that the ads trigger some dangerous behaviors for weight control.

Caffeine is a hot topic for weight loss surgery patients! It can delay healing of your wounds from surgery, and it is a trigger for heartburn. It can also interfere with nutrient absorption at a time when your body is already struggling to stay nourished. Still, as many as 96% of Americans use caffeine, and 85% use it daily. The average daily intake for Americans is 165 mg – about the amount in 1 to 2 cups of coffee or 3 to 4 cans of a caffeinated soft drink (such as Coke, Pepsi, or Mountain Dew). If you’re among the majority who depend on caffeine to wake up and stay sharp, weight loss surgery can put a damper on your style. Some surgeons suggest staying away from caffeine for life, while others require a 30-day caffeine-free post-op period before letting you try a little to see if you can tolerate it. Some potential weight loss surgery patients delay or even decide against surgery because they cannot face the possibility of life without their coffee. If you loved your soda and coffee before WLS, how are you coping now? How much coffee, tea, and soda did you used to drink, and how much do you have now? Did you cut it out cold turkey before surgery? Share your pre-op and post-op caffeine experiences here!

@@kenya1129, You are doing so well! A 6-week liquid diet is a LONG diet, and you are almost there! Just another 2 weeks to go. You have every right to be irritable and to complain. And underneath it, be proud of how well you are doing. Most WLS patients do not need to go nearly that long on a liquid diet, so you have a bigger challenge than most.

@@markiealex, Congratulations on your surgery! In the short term, try to remember that you are at the point post-op when it’s very easy to feel regrets. You’re tired, you’re in pain, and you’re feeling deprived. In the longer term, yes, you have given up a very big source of comfort by giving up the ability to eat as much of whatever kind of food you want. You cannot deny it! Instead, you can try to face it and figure out how to replace the comfort you found in food with comfort from something else. For some WLS patients, using food for comfort is a habit that you can get over with practice. You are practicing right now by sticking to your post-op diet! You might just find that one day, you do not feel a hole or emptiness anymore. For other WLS patients, you can get over using food for comfort by finding a substitute activity to do instead of eating. When you feel like eating for comfort and not for hunger, you might, for example, take a walk, phone a friend, clean the house, or work on a new or old hobby such as gardening or knitting or playing an instrument. For other WLS patients, you may need counseling or other professional help so you can figure out why you turn to food, whether you have any emotional issues to work on, and what you can do instead of eat. It is great that you are recognizing this and reaching out for help. Good luck and keep us posted as you find a solution!

@, Good question! And good concerns – they are real “problems” with weight loss! One thing I thought I would miss about being obese would be having an excuse. Obesity can be a bit of a protective wall. If you choose, you can use it as an excuse for not being popular, for not taking care of yourself, for not getting things done, and for any sort of failure. I was afraid that I would lose my “built-in” excuse, and would not know how to handle things. I was dead wrong. I am more confident. And when I fail at something, I am happy to own up to my mistakes and move on. So, I hope all of your fears either don’t come to pass, or are far outweighed by everything you gain when you lose weight!