Alex Brecher

leag78, UK Cathy is completely right…don’t even bother going down this path because you will drive yourself crazy. You might also end up discouraging yourself so much you decide to quit your good intentions. Besides that…I don’t even understand your disappointment! You said you lost 32 pounds in 6 weeks and you don’t know how some people lose 50-80 pounds in 3 months. Well, I have news for you. If you’re losing 32 pounds in 6 weeks, you’re on pace to lose 70 pounds in 3 months. FYI! And Djmohr is exactly right – when is the last time you lost weight so fast? Probably never. And how long did it take you to put on the weight? Probably a long time. So ENJOY this magical time – the fast weight loss, the changes in your body, the pride you get from knowing you are taking control of your weight and health, and the knowledge that you can do this…because you ARE doing this!

Jenifer, I am so sorry to hear this. I will be thinking about you and your husband. You are such an asset to this site. We will miss you, but I know you are going to be there 100% for your husband. Best of luck to you both.

AussieSam, Great topic and discussion! I agree with you – the laws of physics (or metabolism, or energy balance) still apply, even if they are “altered” during weight loss due to slowed metabolism. So, like you said, I believe you will lose weight if you are eating fewer calories than you burn. Your metabolism could slow way down (say to 700 calories, as in the example AussieSam gave), but you could lose weight by dropping to 500 calories/day (hypothetically – I’m not recommending it, and I doubt if your metabolism really slows to anywhere near as low as 700 calories!). That said, the scale doesn’t necessarily go down each day (or each week!) even if you are eating less than you burn. That could be because of things like Water retention even if you are burning fat. That could explain a “stall” if you are certain you are eating perfectly and you still aren’t losing weight. In most cases, though, I think stalls happen for a reason that’s under our control. At least, it’s true for me. Maybe I let a few “extras” creep into my diet, or don’t quite exercise as much for a while. Since I’m at goal weight, my “stall” is really a “regain,” and I need to nip it in the bud – as soon as I admit to myself that my habits have slipped. I agree not all body weight lost is always fat – it can be muscle when our bodies are starving. But to some degree, eating fewer calories than you expend leads to weight (body weight, not water weight) loss. Anyway, great conversation – thanks!

That's pretty impressive! Wish I could have this delivered weekly. (This counts as my 2nd response to your topics )[/quote What's your home address Alex? Just ignore those Internet safety rules in favor of some yummy food. It's totally safe to put your personal information on here. Nobody reads my boring posts anyway. I opened my freezer this morning and I think I saw evidence of lipstick lady lurking around.... ImageUploadedByBariatricPal1432920880.742239.jpg Ha! I just looked at the pic Very funny.

I will move it back but if Dr. Ortiz's office keeps sending shills to post on their behalf, I will have no choice but to lock this and all topics about Dr. Ortiz.

That's pretty impressive! Wish I could have this delivered weekly. (This counts as my 2nd response to your topics )

It is my Bariatric dream to have Alex respond to one of my posts. It's been a year now and no success. I'm kinda jealous. Oh wait, he's "liked" a few of my posts. But I want words..... Unsubscribing. I think my current GF wouldn't appreciate seeing 12 emails titled "My naked kitty! Pics inside!" when I boot up my computer in the AM I'm technically responding to your post. Sweet dreams

I knew this was your test post but regardless who could resist peeking at your naked kitty!!

I belive this is now fixed.

Quick! Obesity is killing you! You need to drop weight and get your life back. What do you do? Do you exercise four hours a day? Or do you go for weight loss surgery? Dr. Huizenga of the Biggest Loser and colleagues asked exactly that question – and you can bet what they concluded. The first two articles in this series looked at their research. It compared Biggest Loser methods to bariatric surgery and reported findings on weight loss and other effects. As it turns out (spoiler alert if you haven’t read the previous articles in this series!), weight loss is faster among Biggest Loser contestants, at least for the first 7 months. And then? Who knows? The gastric bypass patients in the study continued to lose weight through 12 months, while the Biggest Loser contestants…weren’t even tracked. Who knows what they weighed at 12 months and beyond? The research raises a lot of other questions for me. Here are the ones I would like to ask Dr. Huizenga, with each question followed by an explanation of what I am curious about. Cost is obviously an important factor for almost everyone. Can you please explain your reasoning in saying a program like the Biggest Loser is more cost-effective than weight loss surgery? Exercise for four hours a day – cheap, right? In theory, sure. Just join a gym for $60 a month and work out as much as you want. But is it really that simple? Not really, if you’re an average human being. Take a look at the Biggest Loser contestants’ program. They didn’t just have access to a gym. They had trainers 6 days a week, a room away from real-world worries and temptations, and all the healthy foods they could dream of, not to mention medical care as needed. Value? Well, at a value of $2,500 per week (as listed on the Biggest Loser Resort website), contestants who were on the ranch for 13 weeks received a package valued at $32,500. That doesn’t include any additional support, like contact with trainers after the show was over. There’s no getting around the fact that weight loss surgery has a big price tag of $5,000 or $10,000 or $25,000. But that’s only if you’re paying out of pocket, and it’s still less than the first 13 weeks of a Biggest Loser style weight loss program. Get some insurance reimbursement, and you could get surgery for free or for a reduced cost. Plus, you don’t need to leave your job for a few months to live at the ranch – another cost in itself. Why do you believe slowed metabolism is more significant in weight loss surgery patients compared to Biggest Loser contestants? You found a slowed metabolism in Biggest Loser contestants compared to gastric bypass patients at 7 months. You attributed the slow to contestants losing weight for the show’s finale…but the weight loss surgery patients in your study were also still losing weight at that time? One of the reasons you promote intense exercise over weight loss surgery is because patients maintain more lean muscle mass and metabolism when they work out…but this didn’t seem to be a huge benefit in your study! Can you please provide a sample day that includes four hours of daily exercise and that individuals could follow on a long-term basis to lose weight? Okay, Dr. Huizenga says exercise can come out of television time, but I’m having trouble thinking of a daily schedule that includes four hours of exercise and still lets someone take care of the family and work. Here’s how I see it: wake up at 4:30, work out from 5:00 to 7:00 (thus missing your kids waking up), take kids to school, go to work by 8:30, walk on your lunch hour (that’s your hour 3 of exercise), get off work at 5, pick up kids, run errands, and get home by 6, have dinner at 6:30, work out from 7 to 8 (thus missing family time), put kids to bed, go to bed at 8:30 for a solid 8 hours of sleep. Fun life! (Not!). Maybe you can drop some of your duties for a few weeks, but for the months or years it takes to hit goal weight? That’s just not realistic. And how much exercise is necessary for maintenance? I guess the study didn’t say…because it didn’t follow the Biggest Loser contestants for more than 7 months. People aren’t supervised on a daily basis like they are on Biggest Loser. Is it safe to exercise for 4 hours a day, especially when we’re talking about people who may not have this kind of background? Most people don’t have access to trainers and medical support the way Biggest Loser contestants do. And, people who are 100 or 200 lb. overweight aren’t generally used to exercising for hours a day (let’s face it: except for athletes, most people aren’t). How do they know what to do? How can they prevent injuries? Are there any health risks associated with exercising to the extreme? How do you explain these health values? Most of the health values improved with weight loss, but some of the Biggest Loser contestants’ values got worse. Why do you think “bad” LDL cholesterol increased by about 20 percent, and total cholesterol also increased significantly? What are the long-term results in Biggest Loser contestants? The show has been airing since 2004, and it has just completed Season 16. You must be in touch with some of these contestants and have the ability to contact others. What are their long-term results? Have they kept the weight off? There are plenty of studies on long-term effectiveness of weight loss surgery. Most find that bariatric surgery is generally effective for weight control and improvements in health conditions such as diabetes, arthritic pain, and sleep apnea, for example. Many studies conclude that among people who are eligible for weight loss surgery, the ones who get surgery do better than the ones who don’t. Is it really justified to say exercise is better than weight loss surgery when there is no evidence supporting that?

Happy Memorial Day!#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; } Dear BariatricPal Members, Happy Memorial Day from BariatricPal! Everyone loves this holiday because it kicks of the summer vacation season. As a weight loss surgery patient, you can use this holiday to kick off a new phase of weight loss and health, whether you’re getting ready for surgery or you’re working on losing weight or keeping it off. Here’s what we have for you in this newsletter. Use Memorial Day to Inspire Your Next WLS Victory Red, White, and Blue: Your Memorial Day WLS Treats! Healthy Barbecue for Memorial Day and Summer Enjoy the newsletter, then use your day off to spend time with your family and friends. Don’t forget to burn a few extra calories and put together some healthy meals for the rest of the week! Sincerely, Alex Brecher Founder BariatricPal.com Use Memorial Day to Inspire Your Next WLS Victory Memorial Day is the national holiday that honors the men and women who have died while serving in the United States’ armed forces. This could include members if your immediate family or your former friends, or maybe your family tells stories of ancestors who went off to fight in long-ago wars such as World War I. Most of us know one or more family members or friends who currently serve in the armed forces, and this holiday offers the perfect chance to thank them for their service. Memorial Day can also offer the opportunity to become inspired again in your WLS journey. Maybe you can dedicate the next phase in your journey to a vet, an active duty solider, or a current member of the reserves. Knowing how proud you can make this person can give you the energy to put in an extra 10 minutes on the treadmill when you feel like quitting, or the strength of mind to say no to dessert. Hit your goals as your inspiration is fighting for the country, and the two of you can make each other proud. Red, White, and Blue: Your Memorial Day WLS Treats! If you’re going to a Memorial Day party or just trying to enjoy the time for your family, there’s nothing more appropriate than bringing or making something red, white, and blue to serve. Decorated cupcakes and berry pie with ice cream are tempting and simple options, but you can do better. Here are some fun and healthier ideas. A veggie tray with purple and white cauliflower, red grape tomatoes and bell pepper strips, and white yogurt-based dip. Sugar-free strawberry jell-o topping with sugar-free whipped topping and blueberries. Sliced blackberries and strawberries in cottage or ricotta cheese optionally sweetened with low-calorie sweetener. Sliced figs and red pears served with white low-fat feta or goat cheese. With a little creativity, you can make an attractive and healthy treat to share. Healthy Barbecue for Memorial Day and Summer Memorial Day is the unofficial start of summer. That means it’s grilling season! Whether it’s a party at the park or a backyard barbecue, you’re the one who gets to decide how well you’re going to stick to your WLS diet. Remember your pre-WLS days? A meal at a barbecue might have looked something like this. Chili dog and bun or barbecue ribs (500 calories) Cole slaw or pasta salad (300 calories) Baked beans (200 calories) Iced brownie (200 calories) Can of soda (150 calories) 1 beer (150 calories) That’s 1,500 calories, in case you lost count. Healthy Grilling Hot dogs, cheeseburgers, ribs…who needs ‘em? You sure don’t! With all the healthy possibilities out there, you have no reason to worry about a barbecue! For a healthy, tasty burger, grill a mixture of lean ground turkey, Worcestershire sauce, Italian seasonings, and crumbled fat-free feta or grated parmesan cheese. Or, if you’re not in the mood for much food prep, just throw some lean ground turkey, veggie burgers, chicken breasts, or shrimp on the grill. They’re all high-protein, low-calorie choices. Instead of serving your protein on buns or rolls, serve them with lettuce leaves. You may be able to get your family to try these healthy swaps. You could even challenge them to see who can come up with the best healthy burger or other recipe for the grill. If not, you know the drill. Throw their hot dogs and beef burgers on the grill, and let them have their treats as you enjoy your lighter, high-protein, low-carb food. Guess who’ll feel better after the meal! Smart Summer Sides after WLS If you’re still hungry and don’t feel like more protein, try grilling up a portabella mushroom or some sliced eggplants for something to chew on. For a side, almost any vegetable is a great grill choice: zucchini, asparagus, artichokes, onions, and even cabbage. Just brush them with a little olive oil, not butter, and flavor them with herbs, bouillon, or teriyaki sauce. The cold sides can be killers at a barbecue, so plan ahead for healthier options. Skip the baked beans and biscuits, and don’t even think about mayo-laden pasta or potato salad. If your grilled protein wasn’t enough to fill you up, think about the following. Use Greek yogurt instead of mayo when making prepared salads. Make prepared salads based on veggies or proteins, not carbs. So, make slaw with shredded cabbage or broccoli, or make tuna salad or egg white salad with ham. Always have a big green salad available. It’s something to fill up your plate and keep you busy when you’re not truly hungry but still feel like eating while everyone else is. Sweet Endings…No Regrets Red, white, and blue cupcakes...American chocolate chip cookies…a flag-decorated sheet-cake…you don’t have to blow your diet to show your patriotism! Fresh red strawberries, white peaches, and blue blueberries or purple grapes are just as patriotic, just as popular, and way healthier. Sugar-free ice pops work, too! Your Memorial Day celebration and every other barbecue this summer can be even more fun because you know you’re doing the right thing for your weight loss. You can make your meal high-protein and low-calorie while keeping it delicious and simple. Have a great Memorial Day! Remember to keep it healthy, active, and fun! After all, that’s what life and your WLS journey are for, right?

Jean, Thanks for yet another bit of your wisdom. Yes, weight loss surgery helped me lose almost a whole person, both in weight and in personality, as in eating too much and sitting on the couch instead of being active and really living. And you are right that “person” is not necessarily entirely lost all the time. Now, well over 10 years post-op, the healthy behaviors are pretty much habitual, but the old devils are still calling. Sometimes they call louder than other times. Hearing them, and occasionally giving in to them, reminds me where I came from and why I don’t want to go back.

Thanks for this next ingredient in the recipe for success in the Journey to Recovery! Attitude is so important. You provide such great examples of how it can affect our own journeys and the people around us. I think it’s also important to recognize each situation can have more than one “best” attitude. Or example, you could also be “GENEROUS” to your sister-in-law by waiting until the two of you are alone, and then offering any help she might want in getting healthy. One thing that’s great about attitude is the control we each have over our own. We cannot control other people and things but we can control our own attitudes and reactions, and that in turn affects what happens next. When confronted by an unexpected or new situation, it never hurts to take a few seconds to think about the best way to respond to get the best results. Having a good attitude and healthy reactions to different situations become habit when we practice it. Thanks for this help!

Dr. Huberman, Thank you for this fabulous article! Every part of it is spot on! I really appreciate how you classify emotional eating as a habit, just like eating in other situations when we’re not hungry is a habit. Each of your suggestions for preventing emotional eating is so helpful. It is unbelievable how effective it can be to simply train yourself to delay eating for 30 seconds. If you can delay 30 seconds, you may be able to delay for a minute, and then 5, and then 30, until the urge passes or it really is time to eat. Or in those 30 seconds, you might be able to talk yourself out of it, or find something more productive to do, like prepare for that meeting! It is also amazing how little we actually do allow ourselves to feel emotions sometimes, often without even realizing we’re suppressing or avoiding our feelings. Getting to know what they feel like can be scary at first, but so worthwhile because we can become accustomed to feeling them and dealing with them instead of hiding with food (even if it is subconscious, not deliberate, suppression). Thank you again for these great explanations and suggestions.

Amoreno, Your profile says you’re 54…that’s not old when you consider the risks and benefits of the surgery. As you said, you’re facing serious problems already. If you continue to postpone surgery, your window of opportunity may eventually close if you develop a serious obesity-related complication that makes surgery too risky. Good luck with your surgery this summer! I hope you can get it done and be well on your way to recovery and serious weight loss by the time school starts again in the fall.

I think we all at some point hope it’ll be quicker (and easier!) than it actually is, whether we get bypass, sleeve, or, in my case, lap-band. It’s really hard, but you have to keep it in perspective, at least if you want to stay sane and positive. Compare how long it took to gain all that weight (years? Decades?) and how long it’ll take you to get to goal weight (Months? A year? A couple of years?). In your case, you are on track to hit goal weight within months…and that’s exciting!

Wishfull.shrinking, Best of luck to you on Tuesday! Can’t wait for you to tell us how it went and keep us posted on the rest of your weight loss surgery journey! Congratulations so far on all your hard work to make it to this point.

LiberalinAZ, I agree with your point of view: you can lose weight without cutting all starches. It’s about calories. Knowing that you can still lose weight even if you is a great thing. It’s also wonderful that you logged it, because you are being honest with yourself and also figuring out what works for you and can work for you long-term. Do you have a choice of nutritionists? Is there any chance you can work with a different one? It seems really counterproductive to me to work with one who disapproves of your choices and refuses to work with you. Even the fact that you’re considering not logging your “poor” food choices anymore seems sad, because it’s such a good habit to get into. As for the cost of post-op eating, I don’t think it should be too expensive. You mentioned you can eat Beans, which are pretty cheap! You can easily get a can of about 15 ounces or 350 calories for $1 or, if you’re willing to cook your own, you can pay a lot less for dried beans. I’m not sure how much you were hoping to spend, but you might save money by eating a lot less than you were before, and also by being healthier.

What don’t I dislike about the fashion industry? That would be a little quicker… But okay, a few of the problems I have: I would have a lot more options if I were taller. Sorry, I’m only 5’7.” Does that mean I don’t deserve to wear clothes that fit? Sizes are inconsistent between brands. I have no idea how big or small something will be without trying it on, and I don’t like clothes shopping. Shapes, and proportions…apparently mine aren’t the same as the clothes’.

I tried! Any other suggestions?

Done! Hope everyone has an awesome weekend

Great article(s)! Almost fell off my chair when I got to #10!

Great suggestion! I'll try to get this implemented asap!!

Was a pleasure meeting you!

I'm very surprised your surgeon revised you to a gastric sleeve after band removal due to acid reflux. Acid reflux is a contraindication for gastric sleeve surgery. They should have gone right to the gastric bypass or the Mini gastric bypass. Good luck on your Pandescopy and surgery! Please keep us updated.