Alex Brecher

I'll pass your suggestion along to the folks that make these decisions

Absolutely! They'll ship out Monday.

With all the information out in the world about weight and health, you want to make sure you’re getting the facts. As you’re sorting through all of this information, how do you know whether or not what you’re hearing, reading and seeing every day is accurate? This is a common thought of many people who have struggled with their weight and health. To provide you with the best information, the Obesity Action Coalition (OAC) will be in Los Angeles on Saturday, November 7 to host YWMLocal – Los Angeles 2015, a FREE half-day educational event. YWMLocal – Los Angeles 2015 presents safe and proven effective weight management strategies led by the country’s leading experts in weight and health, such as: Cassie I. Story, RD, a dietitian and creator of the food blog www.WLSDailyPlate.com who has been working with bariatric patients for the past 11 years. Deborah Bade Horn, DO, MPH, FASBP, vice president of the American Society for Bariatric Physicians (ASBP), who will be speaking about non-surgical treatment options. Sajani N. Shah, MD, a surgeon and assistant professor at Tufts University School of Medicine who practices minimally invasive surgery, with a focus on bariatric procedures. Our experts will address a variety of topics, such as weight management options, helpful nutrition and dietary guidelines, exercise information and demonstrations, motivational and inspirational messages and more! This free event is open to anyone who wants to learn more about their weight and health, and do so with the guarantee that they’re receiving information driven by science and research. Are you in or near the greater Los Angeles area? Join the OAC on Saturday, November 7, from 8:00 am to noon at the Los Angeles Convention Center and hear from a variety of experts in the fields of weight, health and nutrition. CLICK HERE to register online for the FREE one-day event.

We didn't "officially" launch the BariatricPal Store yet. it's online now and we'll be shipping starting Monday morning. Let me know your (honest) thoughts, please! You can use the following coupon code for %15 off the entire site: GETMESOMEBP

We didn't "officially" launch the BariatricPal Store yet. it's online now and we'll be shipping starting Monday morning. Let me know your (honest) thoughts, please! You can use the following coupon code for %15 off the entire site: GETMESOMEBP

We're almost ready to launch the new BariatricPal store. Please take a look at http://Store.BariatricPal.com . I'd LOVE to get some feedback and recommendations from our members.

Check out this video for a good overview of the show and the Intragastric balloon: http://www.doctoroz.com/episode/stomach-balloon-weight-loss-what-you-need-know-now?video_id=4555309039001

I didn’t find the researchers’ results surprising. That is in large part because I have seen the studies before. Also, although my own personal experience was completely positive, I have seen many others who have struggled post-op. Here are some of the possible explanations I have heard of and believe are viable for increased risks of suicide attempts in bariatric surgery patients. An increased ability to commit or attempt suicide, similar to what can happen when depressed patients begin taking anti-depressants. A theory I have heard is that the risk of suicide increases when patients first begin taking anti-depressants, possibly because they now have the energy to think about taking action toward suicide. Maybe weight loss surgery patients gain the energy to think about suicide as they lose weight. Replacement addictions leading to drug overdose. Replacement addictions are common in weight loss surgery patients. They replace our former food addictions and can come in all kinds of forms, whether it is an addiction to alcohol, exercise, or drugs. Loss of use of food as an “outlet” for external stressors. We all handle stress in our own ways. Many of us used food to reduce stress before surgery. After surgery, that outlet is gone. If we do not develop a new healthier outlet, our new outlet may be drugs or alcohol, or we may not have an outlet. The outcome may be a suicide attempt. Realization that a high BMI was not the cause of the patient’s problems and mood. Some patients believe their problems will go away when they lose weight and their obesity-related health concerns diminish. Unfortunately, problems at work, relationship struggles, and self-worth issues do not automatically go away after weight loss surgery, and they may become more devastating because the patient realizes they are not a result of having a high BMI. Increased social pressures. These can begin as soon as the patient begins considering bariatric surgery and feels the need to defend her decision and explain that it is not the “easy out.” The defense can continue for life as friends and family continually make comments, whether positive or negative, about the patient’s weight, eating habits, and other personal matters. Changes in hormone levels. The JAMA researchers noted changes in neurohormones such as neuropeptide YY, which could be linked to depressive symptoms. Realization that it’s a lifelong change. Life is a really, really long time. Some patients may not realize quite how long until they are post-op and feeling the daily grind of their surgery. This may be especially true in malabsorptive or irreversible surgeries like the gastric sleeve. A strong support system is absolutely critical to prevent these tragedies! It needs to begin in the earliest pre-op stages, and continue possibly for life. It needs to include the medical side as well as the social side. Before approving patients for surgery, bariatric centers need to provide more than a cursory psychological evaluation. They need to really try to figure out whether their potential weight loss surgery patients have risk factors for depression and suicide attempts. I have met so many weight loss surgery patients who are on anti-depressants, yet depression is a contraindication for weight loss surgery! The bariatric center team needs to put the best interest of the potential patient first and try to determine whether the need to use anti-depressants is due to obesity-related factors and will go away post-op, or whether the patient has signs of depression unrelated to obesity. From approval through surgery, the patient should continue to meet with a qualified mental health professional to prepare themselves for life after surgery – going beyond behavior changes and reaching into likely changes in self-perception and personal and even professional relationships. After surgery, mental health support needs to continue. Patients need to have access to a professional should they need one. They should be educated on signs of depression and suicidal tendencies. They also need to be taught to expect certain new stressors, and they need to learn coping strategies to replace food. They should also go to support group sessions, both to receive education and to be able to share stories with and learn from other patients. These are all things that “should” happen. Unfortunately, they rarely do. It is not uncommon for the initial psychological evaluation to be the only contact they have with a mental health professional, and even then, the evaluation may be more of a formality than a true investigation into the patient’s mental health and likelihood of being a good candidate for surgery. Post-op follow-up is often little to non-existent. Not only might patients not be given the one-on-one attention they may need, but they may not even know which symptoms to look for should they develop depression. They may feel lost, which can be exacerbated if other post-op follow-up such as nutritional support is also lacking. In addition, follow-up support in in-person support groups may not be what it should. If meetings even are offered by a certain bariatric center, they may be at inconvenient times, or too far away, or too infrequent, to be of use. Or, patients simply may not attend. This is also where online support groups like BariatricPal can come in. I believe they serve many purposes. Let patients know they are not alone. Whatever feelings, situations, and relationship struggles they are facing, countless other weight loss surgery patients have gone through the same things. They can be anonymous. People do not always want to talk about their deepest fears and feelings face to face. An online setting can provide a forum for them to express themselves without fear of consequences. They are available 24/7. Possibly suicidal patients need help RIGHT NOW, not tomorrow, and not at the next available appointment. They are free. There’s no need to worry about whether insurance covers it, or how many minutes they have to work through their problems. They are positive. At least, BariatricPal is. I work very hard to enforce our zero-tolerance policy for rudeness.

The FDA recently approved two intragastric balloons, the Reshape and Orbera.

Good to know since I stocked up on every flavor (including pumpkin!) for the new BP Store we're launching in a few days. Guess we're gonna have to find some good alternatives.

I tested your ticker and couldn't replicate your issues. What problem are you having exactly?

Hey everyone, Just a quick note to say…We’ve lost 3 million pounds! That’s right! When you add up the pounds each member has lost since joining BariatricPal, we have a total loss of 3 million pounds! Congratulations to each of you on your loss. It’s a testament to your hard work, and to the strength of our community. The 3 million pounds lost reflects members’ pounds lost since we launched BariatricPal in 2013. Let’s not stop here, though. Keep adding your weight loss to our community total! When you change your weight in your user profile, your total pounds lost automatically get added to our total. The other way to add to the total is to log in to BariatricPal. Just under the community’s weight loss total (where it says, “Together, we have lost…”), just enter your starting weight and current weight. Select “Update your weight,” and your weight will add to our growing total! Congrats again, and thanks for proving once again what you mean to BariatricPal.

style="margin:0;padding:0;background-color:#d8dde8;color:#5a5a5a;font:normal 13px helvetica, arial, sans-serif;position:relative;"> Hey BariatricPal Members! For most of us, this is a good time to focus on weight loss and health. Summer vacation is long over, and the hectic holiday season hasn’t yet started. If you need a little motivation to buckle down and get to work, you just may be able to find it in the newsletter and on BariatricPal. So here’s the run-down of this month’s newsletter. On the Boards: Update Your Weight Loss! Member Spotlight: Meet OKCPirate! On the Boards: Join the Fun! Don’t forget: BariatricPal is your community, and it couldn’t exist without your support. I always want to hear your feedback and suggestions to make BariatricPal an even better source of support for you. Thanks, and don’t forget to share your great accomplishments this month! Sincerely, Alex Brecher Founder, BariatricPal Update Your Weight Loss! We’ve lost a lot of weight as a community. How much? Over 3 million pounds! Check out the counter on the right side of almost any page on BariatricPal. Don’t forget to add your weight loss to the total! There are two ways you can do this. Way 1: Log in to BariatricPal. Just under the community’s weight loss total (where it says, “Together, we have lost…”), just enter your starting weight and current weight. Select “Update your weight,” and your weight will add to our growing total! Way 2: Log in to BariatricPal and go to the Surgery Information section in your User Control Panel settings. You can get there from here. Type in your starting weight and current weight, then select “Save Changes” near the bottom of the page. You get to choose – Way 1 or Way 2. Either way, make sure we count your weight loss in our total! It’s just another way of celebrating your hard work and the progress you’re making in your weight loss surgery journey. Member Spotlight – Meet OKCPirate This week, we’re delighted to feature OKCPirate from Oklahoma City in our newsletter. His wakeup call came in January of 2015, when he started seeing strange lights out of the side of his eyes. His doctor told him that was a warning sign, and things would get more serious if he didn’t lose weight. His highest weight was 305 lbs. Taking a closer look, OKCPirate realized he was spending over $2000 per year on his CPAP machine, blood pressure medication, and gout medication. Beyond that, there were effects such as a painful knee, higher clothing costs, and trouble getting a date. OKCPirate tried Weight Watchers and had some success, but yo-yo dieted Traveling for work made it harder to keep off the weight. Things changed when he heard a podcast on the obesity crisis. The presenters stated that behavioral change results in 8% chance of long term success, but bariatric surgery offers 80% chance. He didn’t believe it at first, but looked it up and sure enough, those statistics were accurate. He decided to go for the gastric sleeve in Mexico, where it is less expensive. OKC used BariatricPal as he was planning his surgery to get advice and encouragement, as well as to learn what to expect. He started to get in shape, practiced eating slower, and worked with a therapist on mental changes. OKCPirate credits his easier recovery with his careful preparation, including following the pre-op diet to the letter. The hardest parts for him, in fact, were the comments from some friends who disagreed with his decision to get the surgery. He also felt nervous wondering which foods he would and would not be able to tolerate. Since getting the surgery in November of 2014, OKCPirate has dropped 89 lbs, from 272 to 216 lbs. He says life is easier now. He doesn’t need to worry ahead of time about cutting his toenails, sitting in a booth at a restaurant, and using his laptop on a plane. His knee doesn’t hurt, and he’s off his CPAP and blood pressure medications. He loves being more intimate with his girlfriend, wearing the same size pants he wore in college, and giving away his old clothes. OKCPirate continues to visit BariatricPal to encourage others and to learn from “pioneers who have cleared a great trail for me to follow.” For those who are struggling with their weight loss, he says you are fighting against your hormones. A $5000 investment, he says, can help you win the battle. Thanks, OKCPirate, for sharing your story and advice. You look fantastic, and deserve to feel as good as you to! To see a photo of OKCPirate running a road race, go to his profile on BariatricPal. If there’s anyone you would like to see featured in the spotlight, let us know on the Member Spotlight forum on BariatricPal. You can also PM Alex Brecher. Don’t forget you can nominate yourself, too. We want to know your story! Insure Nutrition We are always thrilled to welcome a new newsletter sponsor into the BariatricPal family, and this month, Insure Nutrition is giving us the pleasure of doing just that. Our latest sponsor, Insure Nutrition, is an online company that specializes in getting health insurance coverage for nutritional supplements. Its Post-Bariatric Surgery Nutrition products includes Premier Protein shakes in chocolate, vanilla, and strawberry flavors and OptiSource High Protein drinks in caramel and strawberry flavors. Checking if you are eligible is easy. Insure Nutrition encourages you to use its online form to find out if you qualify. Our sponsors help make BariatricPal newsletters and other services possible. We encourage you show your thanks by considering them first for your bariatric needs. Unjury and Opurity BariatricPal is proud and excited to announce two new sponsors for our newsletters. The new sponsors are Unjury, a supplier of wonderful tasting, highest quality protein supplements, and Opurity (from the makers of UNJURY), highest purity vitamin supplements for bariatric surgery patients. Their support lets us keep BariatricPal newsletters coming to you each month. Unjury was founded by a master’s degree dietitian who has been helping patients since 1974. It is committed your health. You know the importance of getting enough protein after weight loss surgery, but you also know that meeting your protein goals can be challenging. Unjury makes your task not just easier but actually enjoyable. Product flavors include Chocolate Splendor, Chocolate Classic, Vanilla, Strawberry Sorbet, Chicken Soup Flavor, and Unflavored. These ready-to-use protein powders come in single-serve and multi-serve containers, and contain high-quality whey protein to keep you full and nourished. Launched in 2007, Opurity is dedicated to using the purest ingredients in its supplements. Opurity Bariatric Multivitamins have two unique big advantages: First, each multivitamin requires only one tablet per day*. Second, Opurity is so dedicated to quality that it is unique in using no ingredients from China. Choose from chewable orange-berry multivitamins for gastric bypass and gastric sleeve patients or for lap-band patients.Opurity also sells chewable calcium, vitamin D and folic acid/vitamin B-12 chewables. All supplements come with a 100% satisfaction guaranteed. They return policy is: “Yes you can return it.” Support from Unjury and Opurity helps us continue to bring you the services you enjoy on BariatricPal, so please support these two brands! When looking for your bariatric surgery supplements, first visit Unjury.com and Opurity.com. Purchasing from these companies helps support BariatricPal. Thanks to Unjury and Opurity for your generous sponsorship, and thanks to BariatricPal members who support our partnership! *You still need calcium and sublingual B-12. Around the Boards…Join the Fun! BariatricPal is the place to be if you’re looking for encouragement, advice, or ideas, or just some good old company. We’ve got something for everyone, whether you’re asking for help, sharing advice, or doing a bit of both. Recipes… Whether you’re pre-op, post-op, or in maintenance, the recipes are what it’s all about, right? Almost all of us could use a good new recipe here and there, and BariatricPal is about the best place you can go to exchange them. Check out a discussion on the pre-op liquid diet, how to get through the pureed foods diet, or the 411 on post-op expectations. …And More Once you’ve got your meal plan under control, don’t forget to make yourself at home on one of the specific weight loss surgery boards, such as the lap-band, gastric bypass, or gastric sleeve forum. And, take a look at what else is hot. Find out what to do if you hate exercising (or share your ideas!), talk about bariatric surgery do’s and dont’s, or share your bariatric surgery nightmare or fear. If it’s got to do with weight loss surgery, it’s on BariatricPal…and if it’s not, just start a conversation yourself! Thanks for reading the newsletter and for being a member of the BariatricPal community. Here’s to a month of seeing you make great progress towards your goals…and sharing every step of the journey with us on BariatricPal!

There are a lot of foods you can’t have regularly after WLS, at least when you make them the traditional way. Think pizza, fried chicken, Pasta salad, brownies…the list goes on. Do you still crave those foods after weight loss surgery? Which foods are most tempting to you? If you still crave these junk foods, how do you satisfy your cravings? Do you completely avoid these foods because you know they’re trigger foods? Do you have a small bite and leave the rest alone? Do you have recipe swaps that make the foods healthier but still satisfying? One of my favorite recipe swaps is for lasagna. Now, I can make it with sliced zucchini or eggplant for the noodles, extra chunky tomato sauce with tomatoes, red peppers, and mushrooms, and low-fat mozzarella and parmesan cheese. Veggie lasagna does the trick for me, but you can also make it with lean ground turkey or soy crumbles for extra Protein.

Tons of questions and concerns come up before and after weight loss surgery. When should I start my pre-op diet? Can I eat this brand of Protein powder? What happens if I feel nauseous? When can I start lifting weights again? Some of the questions aren’t urgent, but sometimes you feel like you need an answer ASAP. If you’re wondering whether a particular brand of Protein shake is okay for dinner, you want an answer fast. Same with a medical concern, like low blood pressure or shakiness, since you don’t know if it’s something serious to worry about. So, who’s on your call list? Whom do you go to when you have urgent questions? Is it your surgeon? Your primary care doctor? A friend who’s had weight loss surgery? BariatricPal? Does your answer change if it’s a weekend versus a weekday? Where do you go for help and information when you need it?

Thanks everyone for these recipes and resources! There are some pretty neat food swaps around! These are some of my favorites – maybe not too original, but they’re still good. -Portabello pizzas. Use the mushroom as the crust instead of a regular crust. You can go wild on the low-carb toppings, too, from cheese and veggies to chicken, anchovies, and olives. -Spaghetti squash. Definitely not an original, but I find this endlessly fascinating as a substitute for spaghetti. Maybe I like the idea of it because it’s so easy and natural. -“pasta” or “potato” salad made with hard-boiled eggs, cooked cauliflower (instead of pasta/potatoes), and Greek yogurt. To Lexuskela: Good for you for being really strict and sticking to your meal plan! I agree with some of the others, though, who have mentioned that not all carbs are bad. Maybe when you get more comfortable with your diet you might think about some of the healthy starches, like oatmeal and other whole grains, and sweet potatoes.

The Vet's forum is now back online and available here.

I appreciate everyone's feedback! We will add back the Vet forums in a few days.

Once you choose your surgeon, you should be confident that you’re in good hands. Still, your surgeon is only partly responsible for your weight loss surgery success. YOU have the greatest share of responsibility. Here’s what you can do before surgery to make surgery safer, make recovery easier, and lose weight faster – and it’s not just sitting back and waiting for your surgery date to arrive! Pre-Op Diet The pre-op diet has a few purposes. The critical one is to shrink your liver so it’s not blocking your surgeon’s view of your insides during surgery. That makes your operation easier and safer. The pre-op diet also helps you lose weight. That may be surprising since you’re expecting to start your weight loss after surgery, but it’s actually a good idea to start losing weight beforehand. In fact, the more you lose before surgery, the safer surgery will be, and the better you’ll feel afterwards. Different surgeons suggest different pre-op diets. The diet has about 1,000 calories. It could depend on lean proteins and other nutrient-rich foods, or it could be a liquid diet with protein shakes. Or, it could be a combination of the two, with each day including two protein shakes as meal replacements plus one meal with vegetables and protein. The pre-op diet can last from a few days to several weeks or even months. In general, the longer you’re on it, the better. You’ll lose more weight, shrink your liver more, and gain confidence that you’ll be able to continue a strict eating program long-term after surgery. Get in Shape Why exercise before surgery? One reason is that, like with a good diet, it can make surgery safer. In this case, it’s because exercising can strengthen your heart, lungs, and blood vessels. Of course, exercise also burns calories and can help you lose a little extra weight before surgery. Another reason to get in shape before surgery is because it will make recovery easier. Many weight loss surgery patients find that walking around the house and then the neighborhood is their best tool for fighting post-op pain. If you’re used to being active before surgery, you’ll have an easier time walking after surgery. You don’t need to go crazy on your pre-op exercise regimen. If you’re not used to exercising, start small. As long as your doctor approves you to be active, just find a few minutes each day to walk at a comfortable pace. Clean and Stock the Kitchen Fact: you can’t eat food that’s not there. So, clean out your kitchen. Get rid of sugary desserts, starchy snacks, and fatty meats and cheeses. Anything you know you shouldn’t be eating shouldn’t be in your kitchen. Get rid of it before surgery because for weeks after surgery, you won’t be physically able to carry out heavy trash bags filled with forbidden foods. Once your kitchen is cleaned out, stock it up! At least get the protein shakes and powders you’ll need for weeks or more after surgery. Consider getting some flavored water in case you’re unable to tolerate water post-op. You can also stock up on non-perishable staples, such as canned chicken and tuna, frozen fruit and vegetables, and instant oatmeal packets. Take Your Nutritional Supplements You know you’ll be taking nutritional supplements post-op. If you have the sleeve or bypass, you’ll be taking them for life. With the band, you’ll need supplements for months, years, or life. Did you know you shouldn’t wait until after surgery to start taking your supplements? At a minimum, take a multivitamin beginning when you start your pre-op diet. Even if you’re eating a balanced diet, the supplement helps make sure your body has the nutrients it needs to heal your surgery wound. Also, it’s an insurance policy so that if you have trouble eating and swallowing supplements for a few weeks after surgery, your body will still have a good store of nutrients in reserve. Practice Your Healthy Eating Habits Consider the pre-op period practice for the post-op diet. That includes eating slowly, measuring portions, and choosing nutrient-dense instead of processed, high-calorie foods. Also consider making exercise a habit now, so it’s easier to get back to it after surgery. You cannot guarantee an easy surgery, but you can certainly do a few things to improve your chances. Use these tips to take control of your pre-op prep as soon as you’re ready to lose weight and get healthy!

We wanted to let our members know that ORBERA is going to be featured on Dr. Oz. The segment is scheduled for Tuesday, October 6 October 13. Looks to be a good segment! Please, let me know if you were able to watch and what your thoughts were on the show.

You get a food list after WLS of the foods you can and cannot eat. In most cases, once you get to the full solids diet and have a chance to add a bunch of foods back to your diet, you can have a pretty full range of foods, including meats, fish, dairy products, vegetables, fruit, healthy fats, and whole grains. There are a lot of foods you CAN have, but they can look pretty boring when you see them in a list. So how do you get from a foods list to a meal plan? Do you just keep it simple, like have a quarter-cup of cottage cheese and a half-cup of cooked green Beans? Or do you try to develop recipes, like making low-fat, high-Protein green bean casserole? How do you approach your recipes, and what are some of your favorite recipe sites and online resources?

I’ve seen this come up a few times recently, so I figured I’d post about it. It’s hard enough to find a surgeon whom you like and trust, and to choose which type of weight loss surgery you want, but it’s even harder to get them both at the same time. For example, let’s say you do your research and decide on the lap-band. Then you meet a few surgeons, and the one you happen to like the best tells you you should get the bypass. What do you do? Do you put yourself entirely in the surgeon’s hands? Do you find another surgeon?

Elode, That’s hilarious…anything you can do to annoy a teenager is a good victory. Just kidding. Congrats on yet another milestone. You are getting so close to goal weight!!

Lexuskela, Good question! I think everyone’s different in terms of post-op working out. A lot depends on how much you were working out before surgery – what is your body used to? Don’t push yourself too much. If you’re a beginner and your doctor says okay, just walk for a few times a week, and then increase the length and number of times, and add variety, like swimming or Zumba or weights. About working out slowing your weight loss due to muscle gain…I wouldn’t worry too much about it. First, it’s hard to gain muscle. You’re going to be gaining a huge amount like several pounds or anything. Second (and I know this one’s a little bit of a tougher pill to swallow)…so what? If you are eating right and working out so you’re fit and healthy, that’s better than “just” eating right without working out and being fit. And yes, a pound is a pound. To be technically accurate, muscle is DENSER (not HEAVIER) than fat – the same volume of muscle weighs more than the same volume of fat. So you can lose inches without losing pounds if you gain muscle while losing fat.

Dub, Thanks for the update…yes, you are right that it has been a lot of activity! Good for you for being persistent and focused despite the whirlwind of insurance hassles and finally giving up on insurance! If you trust your surgeon, it’s fine to go with whatever he says – if he thinks sleeve, you can go with sleeve if you think he’s giving you the best advice for YOU. But you should feel comfortable discussing your options with him, and not feeling pressured AT ALL into anything. You can always get a second or third or fourth opinion if you’re not absolutely sure. You get one shot at this. Well done on your weight loss so far – you’re showing that you can be committed and you’re more likely to be successful. Good luck to you! Keep us posted on everything.