Alex Brecher

“Complete” But Lacking Essential Nutrients
What does a “complete” multivitamin contain? It could provide anything from all the essential nutrients to just a few. There is no legal definition for “complete.” In the case of Flintstones “Complete” multivitamin chewables, “complete” apparently means that it has all 13 vitamins, but only 6 of the more than 15 essential minerals that you need.
Quantity Is Critical
For bariatric surgery patients, it is not only important to get each of the necessary vitamins and minerals, but also to have the right amounts. You need high amounts of some of the vitamins and minerals, and Flintstones chewables simply do not deliver. For example, the American Society for Metabolic and Bariatric Surgery (ASMBS) suggests at least 12 mg thiamin (vitamin B1) per day, while a chewable has 1.5 mg.
You will also be short on:
Vitamin A Vitamin D Vitamin E Vitamin B12 Iron Calcium And more.
“Doubling Up” Does Not Work
If one tablet is not enough, can’t you just take two? Well, not really. First, getting twice as much as certain nutrients may still leave you short. For example, 2 Flintstones chewables provide 1,200 IU of vitamin D, while recommendations for post-op gastric bypass patients are to get 3,000 IU per day. And no matter how many chewables you take, you will never get enough of essential minerals such as selenium and chromium, since the chewables have none.
Multivitamin: What Is in a Name?
We usually refer to them as “multivitamins,” but most often, we really mean, “multivitamin and mineral supplements.” Sometimes, a “multivitamin” that you buy off the shelf really is literally a bunch of vitamins with few or no minerals. Do not get confused by the name when purchasing your supplement. Read the supplement facts label to see which nutrients are in the supplement, and how much there is.
Safe Choices, Your Way
To be sure that you are getting the right supplement for bariatric surgery post-op needs, you are best off choosing a bariatric supplement. It may be a tad more expensive, but it could prevent deficiency diseases such as anemia or peripheral neuropathy. The BariatricPal Store has Multivitamin One and a wide range of other multivitamin and minerals formulated according to ASMBS guidelines.
Choosing a bariatric surgery-targeted multivitamin instead of a kids’ supplement does not mean you have to choke down capsules if you cannot stand them. You can always opt for another form, such as Powder or a Soft Chew. BariatricPal Protein One has 28 essential vitamins and minerals, along with protein and fiber, in Unflavored powder or great-tasting shakes such as Chocolate, Vanilla, Cookies and Cream, Peanut Butter, Chicken Soup, and more.
For help figuring out which vitamin and mineral supplement may be right for you, you can look at the attached ASMBS guidelines or check out our Bariatric Vitamin Guide, which breaks down recommendations for each surgery type. Also, be sure to talk to your doctor about your individual needs before trying a supplement.
ASMBS-Nutritional-Guidelines-2016-Update.pdf

How you may wonder, can you make this the most wonderful time of the year if you cannot celebrate it with the same food, drink, and abandon that you may have before your WLS journey started? Keep your chin up! We’re not promising that these holidays will be the same as ever, but you can make them great. They may even be better! Here are our thoughts on loving the holidays while staying healthy.
We’re Not in Kansas Anymore!
As with the rest of your life, the success of the holidays can no longer best be measured by how much you ate. There is so much more to it than that! Now, pleasure from food contributes to “success,” but so do so many other things, including the activities you do, the quality of your time with loved ones, and the pride you have in yourself. Give up your former conceptions of what holiday happiness is, and you will have a lot to gain (but not weight).
Just Say, “No!” – But How?
There is no denying that a good deal of the holiday cheer – and the holiday struggle – revolves around food. Eat it with abandon, and you will set yourself back months. You are almost sure to be offered more than you should eat and foods that are not on your diet, so you will need to learn to say no. Be prepared with different ways to say, “No,” without hurting anyone’s feelings, and practice the before-hand so you are not caught off guard.
“No, thanks.” “No, thanks. I’m not hungry.” (If you’re in the middle of lunch so you cannot claim that you are not hungry:) “No, thanks. It’s not in my diet.” “I would love to, but my doctor said I cannot have that!” “Thank you! How kind! I will save it for later.” Later, give it to someone who will love it. Be Confident.
Be polite but firm when refusing food or insisting on getting in your afternoon walk. You may be surprised at how easily people accept your decisions. They may even make them easier once they see you are serious by, for example, offering to bring you a diet-friendly version of a treat or asking to come on your walk. If you waver initially, though, they may not take you seriously, and instead, keep prodding you to abandon your good intentions.
Be Proud of Yourself.
A barrier to success that is present year-round, but more intense during the holiday season, is the natural desire to help others – and this can come with a feeling of guilt if making your health a priority makes you worry that you are not giving your best to your family. Remember that you can give your best only when you are at your best, and to be at your best, you need to be healthy. You will have more energy, think more clearly, and even be happier when you are taking steps towards health, and all that will enable you to give more to others.
You Are Not Alone
The grass may seem greener on the other side of the fence, but is it really? It probably is not, even though you may feel that your holiday season is hard while others have it easy. The truth is that millions of others are facing the same challenges as you. Even people who appear not to have weight problems are sure to have major concerns in their lives. They may be fighting just as hard as you to avoid eating the whole pie, or they may have non-food challenges. You do not know, but what you can safely assume is that everyone has challenges. You will feel better about yourself if you always treat others with respect and not with jealousy.
Rather than feeling sorry for yourself, you might as well embrace the holidays for what they are worth: an opportunity to overcome hurdles and strengthen yourself; a magical time of year when people come together; and a chance to experience new feelings and participate in new activities that may not have been possible before you got serious about your health.

“Complete” But Lacking Essential Nutrients
What does a “complete” multivitamin contain? It could provide anything from all the essential nutrients to just a few. There is no legal definition for “complete.” In the case of Flintstones “Complete” multivitamin chewables, “complete” apparently means that it has all 13 vitamins, but only 6 of the more than 15 essential minerals that you need.
Quantity Is Critical
For bariatric surgery patients, it is not only important to get each of the necessary vitamins and minerals, but also to have the right amounts. You need high amounts of some of the vitamins and minerals, and Flintstones chewables simply do not deliver. For example, the American Society for Metabolic and Bariatric Surgery (ASMBS) suggests at least 12 mg thiamin (vitamin B1) per day, while a chewable has 1.5 mg.
You will also be short on:
Vitamin A Vitamin D Vitamin E Vitamin B12 Iron Calcium And more.
“Doubling Up” Does Not Work
If one tablet is not enough, can’t you just take two? Well, not really. First, getting twice as much as certain nutrients may still leave you short. For example, 2 Flintstones chewables provide 1,200 IU of vitamin D, while recommendations for post-op gastric bypass patients are to get 3,000 IU per day. And no matter how many chewables you take, you will never get enough of essential minerals such as selenium and chromium, since the chewables have none.
Multivitamin: What Is in a Name?
We usually refer to them as “multivitamins,” but most often, we really mean, “multivitamin and mineral supplements.” Sometimes, a “multivitamin” that you buy off the shelf really is literally a bunch of vitamins with few or no minerals. Do not get confused by the name when purchasing your supplement. Read the supplement facts label to see which nutrients are in the supplement, and how much there is.
Safe Choices, Your Way
To be sure that you are getting the right supplement for bariatric surgery post-op needs, you are best off choosing a bariatric supplement. It may be a tad more expensive, but it could prevent deficiency diseases such as anemia or peripheral neuropathy. The BariatricPal Store has Multivitamin One and a wide range of other multivitamin and minerals formulated according to ASMBS guidelines.
Choosing a bariatric surgery-targeted multivitamin instead of a kids’ supplement does not mean you have to choke down capsules if you cannot stand them. You can always opt for another form, such as Powder or a Soft Chew. BariatricPal Protein One has 28 essential vitamins and minerals, along with protein and fiber, in Unflavored powder or great-tasting shakes such as Chocolate, Vanilla, Cookies and Cream, Peanut Butter, Chicken Soup, and more.
For help figuring out which vitamin and mineral supplement may be right for you, you can look at the attached ASMBS guidelines or check out our Bariatric Vitamin Guide, which breaks down recommendations for each surgery type. Also, be sure to talk to your doctor about your individual needs before trying a supplement.
ASMBS-Nutritional-Guidelines-2016-Update.pdf

Try to see their side.
You are asking them to see it from your perspective, so it is only fair that you try to see it from theirs. What are the reasons they may be against your Weight Loss Surgery, and how can you address them? In many cases, their concerns are legitimately about your well-being, and things you should consider if you have not already. They may worry that:
You will not hit your goal weight this time since they’ve seen disappointment before. You will suffer complications from surgery. You will regret having a permanent Sometimes, their concerns are selfish but still worth discussing. They may worry that:
You’ll stop feeling attracted to them. You will pressure them to give up their own favorite foods while you eat healthily. They will feel left out. You will not want to spend time with them. Reassure them.
Address their concerns directly. Explain why you feel the surgery is safe, and how much research you have done to learn about it as well as find a surgeon. Tell them why you think Weight Loss Surgery will work for you even if previous diets have not.
Let them know that you need to do this for yourself, not for them and that this will not change the way you feel about them – you will still love your SO, and respect your parents, for example. Tell them how you see yourself spending time with them after surgery, so they can be comfortable.
Write it down and practice.
Starting the conversation can be the scariest part of telling them. Before you bring up the subject, write down what you plan to say. This is a good exercise for you to do anyway since it encourages you to think through all of the doubts around Weight Loss Surgery. Writing it down and practicing can make it easier for the words to come when you decide to bring it up.
Include them in your plans.
Often, your spouse and parents, and others who care about you, just want to help. They may be afraid if they do not how to help. When you talk to them, let them know how important they are to you, both in life in general and in this important period of your life. If you tell them specifically what they can do to support you, they may feel more at ease with your decision and more confident in their roles.
You might ask them to:
Pick up your children from school when you are recovering from surgery. Go with you to the store to pick out protein powders and measuring cups and spoons. Ask you each night how you are doing. Cook healthy meals with you. Prepare for anything.
The conversation may be as difficult and unfulfilling as you feared. Or, your SO, parents or other loved ones may be surprisingly supportive once they realize that you have done your research and are serious about making the lifestyle changes needed for success. They may even be interested in getting healthy with you and ask for your help and support in exchange for theirs.
Stay strong and independent.
As much as you long for your SO and other loved ones to support you wholeheartedly, it may not happen. Try not to let it get you down, though. If you are sure about what you want, go for it, with or without them. They will come around sooner or later, and if not, you may be better off without their negative influence. Letting them know that you have made up your mind regardless of their support may actually convince them to help you since there is no point in standing in your way.
Stay independent in the sense that you realize that you do not need them. Your success does not depend on their approval, and you are not doomed to fail if they stand in your way. Get the support you need from others as you move forward.

1. Oatmeal. Despite its high carb count, oatmeal is one of the healthiest foods, even for weight loss surgery patients. It is a whole grain (gluten-free, if you are wondering), and is a source of soluble fiber. People who eat whole grains instead of refined ones have a lower risk of heart disease, diabetes, and weight gain.
Have oatmeal with nuts or peanut butter for a little extra healthy fat and protein, and add cinnamon for a sweet flavor without sugar. No law says oatmeal needs to be sweet. Turn it into a savory bowl with a poached or hard-boiled egg, some feta cheese, and sliced cooked mushrooms.
2. Pear. Pears have a lower glycemic index and glycemic load than many other fruits, so they do not spike your blood sugar as much. They have soluble fiber, which helps lower cholesterol and blood sugar. They also provide lignans, which are heart-healthy.

You can do way more with a pear than use it as a dessert or a side for cottage cheese, although those work, too! Try serving it with all-natural ham, or tossing it with mixed greens, walnuts, bell peppers, and cooked chicken breast. You can also turn it into a salsa to top fish or chicken along with diced onion, tomato, and cucumber, plus chopped cilantro and lime juice.
3. Beans. Beans are a starch you can love since they pack in the fiber and protein along with vitamins and minerals. They are linked to lower risk for certain cancers, as well. If they bother your stomach, try having small portions or using an enzyme product such as Bean-o.
Kidney, pinto, garbanzo, and black beans – they’re all good! Make hummus with garbanzos and olive oil, or try vegetarian chili with beans, tomatoes, other vegetables, and seasoning. Or, make a taco salad or naked burrito with fat-free refried beans.
4. Pumpkin. Pumpkin has a medium glycemic index, but so few carbohydrates that your body will barely realize that it is there. Aside from the potassium and fiber in pumpkin, you will find amazing amounts of vitamin A in the form of beta-carotene – and that can only be a good thing after weight loss surgery. Butternut and acorn squash have a few more carbohydrates but are also excellent choices.
Stir pumpkin and cinnamon into your oatmeal, or mix them into non-fat cream cheese for a flavorful, protein-packed spread or dip for apples. Add chunks of butternut squash to stew, or blend pumpkin into a soup to make it creamy.
5. Peas. Peas may have a bad reputation, but it is undeserved. Choose snow peas or sugar snap peas in the pod for a dose of vitamin C and fiber. Use them raw or lightly cooked to preserve their antioxidants and keep their glycemic load down.
Use them in salads along with lettuce, chicken, and chopped vegetables, or dip them into Greek yogurt-based dips. You can also use snow and sugar snap peas in stir fry – just be sure to keep them crunchy.

Why Weigh Yourself?
Yes, you weigh yourself to know how much you weigh. But what is the point if you are on your weight program and your doctor will weigh you at your next appointment? Weighing yourself can have some benefits.
It can help you lose more weight by keeping you accountable. Just like logging your food can make you think twice before taking that extra bite, knowing that you will face the scale can keep you from serving yourself another portion.
It can be motivating. When you see the number of the scale go down, you might be more eager to wake up early for your workout, or order a salad instead of a sandwich.
It can be empowering. Knowing your weight gives you another piece of information about your body, and embracing rather than avoiding yourself can empower you to do your best for yourself.
How Often?
You can weigh yourself as often as you like, but it does not make sense to take too many weigh-ins too seriously. For many people, a good rule of thumb is to do a weekly weigh-in. You can take this weight as your “official current weight.” Some people like to stay off of the scale between their weekly “official” weigh-ins, while others like to weigh themselves daily, or even more than once a day, just to see what is going on. That is fine, as long as you do not take each weigh-in too seriously and do not let it bother you.
How to Weigh Yourself
You may be a 10, 20, or 40-year veteran of weighing yourself, but there are better and, well, worse ways to do so. It may be worth reviewing or revising your weigh-in practices to get better results. Here are some guidelines for accurate weigh-ins.
Weigh yourself at the same time of the day for your weigh-in, usually first thing in the morning.
Choose the same day each week to weigh yourself.
Wear minimal or no clothing.
Use the same scale, and a trustworthy one, each time.
Mistakes to Avoid
In theory, weighing yourself is as simple as stepping on the scale. Not! Your weight can be deceptively high or low if you find yourself making any of these mistakes.
Weighing yourself after a heavy meal. While 1 lb. of lettuce has only 50 calories, it weighs…1 lb. If it is in your stomach, you will weigh an extra pound. Weighing yourself in the morning before you eat anything can help avoid the problem of extra weight inside your stomach.
Weighing yourself wearing shoes or clothes. Heavy shoes and a full set of clothes can weigh 5 or more lb. That is a big chunk of weight that is not yours!
Weighing yourself with too much salt in your system. With salty foods comes sodium, with sodium comes thirst, and with thirst comes extra water. Water is heavy. It can still be in your system the next morning, and show up on the scale.
Weighing yourself right after exercising. Exercise does help you lose body fat, but it also helps you lose body water through sweat. You can lose a few lb. of water in one workout, and your body weight might be artificially low right after.
Weighing in Monday morning. If your weekdays are picture-perfect in terms of eating, and your weekends progress from Friday night at the bar to Sunday afternoon in front of the TV, your Monday morning weight can be variable, and possibly high. Friday morning may be a better time for you to weigh in.
Getting inaccurate numbers can be bad in many ways.
You might get discouraged for no reason if your weight shows up as higher than it really is.
You could become confused about how what you eat affects your weight if there seems to be no correlation.
You might have trouble detecting regain, and not modify your diet until you have gained more than you wanted.
Choosing a Scale
On top of making sure you are ready for a good weigh-in, you need to make sure that your scale is also ready. Using a cheap scale can drive you crazy because it may not be accurate. It could be difficult to read, or it could vary within a few pounds even if you are the same weight.
There are many affordable Body Scales that are highly accurate. You can find features that help you read the scale easily, track your weight, and see other information. These are some features to consider.
Digital read-outs.
Bluetooth connectivity to your smartphone.
Memory of your recent weights.
Measurements such as body fat and lean muscle mass.
Use the scale to help you on your weight loss journey, and you can consider it another weapon in your weight loss arsenal. The more tools you have, the better your weight loss success can be!

Skinny Starters
There is sure to be food out from the second you arrive at the party. Munch on chips and dip for the minutes or hours as soon as you get there, and you will probably down more carbs and calories than you should have in a day. Instead, try munching on Protein Chips, Cheese Crisps, or any kind of cut, raw vegetables. You can up the gourmet factor by making open-faced bruschetta-like appetizers with tomatoes and feta or mozzarella on Protein Rusk Bread.
Skinnier Side: Purple Cabbage Salad
Try making a red, white, and blue salad using shredded purple cabbage as your “blue” base. The red can come from strawberries, and you can dot it with white pieces of tofu. Dress your coleslaw with lite Asian vinaigrette, and each serving will have over 100 calories less than regular coleslaw.
High-Protein Semi-Soft Foods Side: Egg Salad WLS-Style
If cabbage is a little beyond where you are after WLS, opt instead for a low-calorie version of egg salad. Use hard-boiled eggs or egg whites and the usual seasonings such as paprika, lemon juice, pepper, hot sauce, or mustard. Then, save over 100 calories per portion by using Calorie-Free Mayo instead of regular. It even comes in flavors such as Chipotle, Honey Mustard, and Ranch.
Protein Centerpiece: Sugar-Free Barbeque
A barbecue has the potential to yield the ideal WLS-friendly main course if you get a lean protein, but a grilling occasion can go terribly wrong, too. Consider barbecue ribs with nearly 1,000 calories, or beef patties with over half their calories from fat. Instead, try chicken breast, shrimp, or fish with calorie-free, sugar-free BBQ Sauce for a punch that is nearly pure protein. Of course, skip the bun to save more calories and carbs.
Instead of buttery grilled corn, almost any grilled vegetable makes a better choice. Try eggplant, zucchini, bell peppers, asparagus tips, or mushrooms. If you want to marinate them first, use a low-fat, sugar-free option, such as balsamic vinegar or Cajun seasoning.
Red, White, and Blue Dessert
Aren’t those July 4 cakes decorated to look like an American flag beautiful? Here’s an idea: keep the cake intact and get your red, white, and blue dessert from a more healthful source. Try strawberries or raspberries and blueberries in creamy Vanilla Protein Pudding to get a satisfying dose of antioxidants, fiber, and protein without any added sugar.
Your Independence Day barbecue can be just as celebratory as ever, but a lot healthier this year with some planning. Look for the high-protein, low-carb choices, but make sure they have the flavors you love, because loving life is part of being healthy!

With restaurants, fast food, and other prepared foods being such a big part of our culture, you may not be able to, or even want to, stop eating out. That is okay, even after WLS. You will just need to be a savvy customer to be sure that wherever you are, you get a meal that fits into your meal plan. Take heart: it is almost always possible.
The Trouble with Eating Out
Research has been clear on the differences between eating out and preparing food at home. Restaurant meals tend to be bigger and higher in calories. Beyond that, they are higher in sodium and saturated fat, and lower in fiber.
That does not bode well for weight loss, but you are not doomed. Most restaurants are willing and able to accommodate you. You may be pleasantly surprised at the choices.
Do Your Homework (Or Procrastinate)
Most restaurants have their menus posted online. Many have their nutritional facts online. Check before you go to the restaurant, and decide on your meal before you get there. When it comes time to order, you need not browse the menu for temptations.
Or Procrastinate
It is not always possible to check beforehand, and that is okay. Just keep your goal in mind:
Some lean protein, such as eggs, chicken, or fish.
A vegetable.
A small amount of a healthy starch and/or healthy fat.
Build that meal from the items you see on the menu.
The Customer Is Always Right
If you need another expression to drive home the point, what about, “He who pays the piper calls the tune?” You are perfectly entitled to ask for no sauce, dressing on the side, or no bun.
A surprising number of joints allow substitutions or modifications for no extra cost, although some may charge. The cost is usually minimal, and worth it. Examples include getting grilled instead of fried chicken or fish, or swapping a side salad or steamed vegetables for a side of rice, pasta, or potatoes.
Best Bets for Breakfast, Lunch, and Dinner
You can go to a restaurant with some ideas of what they might have for each meal, and search for those.
Breakfast
Eggs: in an omelet or scrambled. Look for egg whites if you can, and choose vegetable toppings. Cheese and turkey can also be good additions. Skip bacon and other fatty meats in your eggs.
Oatmeal: plain, regular or steel-cut, without add-ons such as dried fruit or brown sugar. Nuts are okay. Steer clear of granola.
Breakfast sandwich: English muffin (you can eat half) with egg and/or cheese and/or ham – no bacon, sausage, croissant, or biscuit.
Create a meal from sides or add-ons, such as cottage cheese, an egg, fresh fruit, or turkey sausage.
Lunch
Green salad with any of grilled chicken, cheese, nuts, vegetables such as tomatoes and cucumbers, and light dressing. Skip regular dressing (or order it on the side), croutons and chow mein noodles, and dried fruit.
Chicken, fish, turkey breast, a veggie burger patty, a hamburger patty, or taco beef. Skip the bread, tortilla, bun, or taco shell, and steer away from breaded and fried.
Side salad, carrot sticks, yogurt, or sliced apples.
Dinner
Shrimp cocktail or broth-based soup for starters. Avoid dips, chips, bread and breadsticks, and fried starters.
Grilled, baked, or roasted plain chicken or fish. Avoid fried choices, fatty meats, and creamy or buttery sauces.
Steamed vegetables or a side salad. Avoid fries, pasta, rice, and mashed potatoes.
The Final Filter: You
No matter what lands on your plate or your to-go box, the ultimate decision about what goes into your mouth is made by…you. You can turn a potentially disastrous order into a not-so-bad or even good meal with some smart choices.
Decide how much you will eat and pack away the rest before you take your first bite.
Scoop out the filling from sandwiches and burritos, while leaving the bread and tortillas.
Eat the proteins and vegetables from your plate, while leaving the fries and fatty sauces.
Scrape off any breading and eat only the chicken or fish inside.
Weight loss surgery is to help you lose weight, but it is also to help you live a better life. If the good life for you includes eating out, you can do it. Just be careful. Keep your weight loss surgery diet plan in mind as you order and eat, and you can lose weight as you live your normal life.

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

With restaurants, fast food, and other prepared foods being such a big part of our culture, you may not be able to, or even want to, stop eating out. That is okay, even after WLS. You will just need to be a savvy customer to be sure that wherever you are, you get a meal that fits into your meal plan. Take heart: it is almost always possible.
The Trouble with Eating Out
Research has been clear on the differences between eating out and preparing food at home. Restaurant meals tend to be bigger and higher in calories. Beyond that, they are higher in sodium and saturated fat, and lower in fiber.
That does not bode well for weight loss, but you are not doomed. Most restaurants are willing and able to accommodate you. You may be pleasantly surprised at the choices.
Do Your Homework (Or Procrastinate)
Most restaurants have their menus posted online. Many have their nutritional facts online. Check before you go to the restaurant, and decide on your meal before you get there. When it comes time to order, you need not browse the menu for temptations.
Or Procrastinate
It is not always possible to check beforehand, and that is okay. Just keep your goal in mind:
Some lean protein, such as eggs, chicken, or fish.
A vegetable.
A small amount of a healthy starch and/or healthy fat.
Build that meal from the items you see on the menu.
The Customer Is Always Right
If you need another expression to drive home the point, what about, “He who pays the piper calls the tune?” You are perfectly entitled to ask for no sauce, dressing on the side, or no bun.
A surprising number of joints allow substitutions or modifications for no extra cost, although some may charge. The cost is usually minimal, and worth it. Examples include getting grilled instead of fried chicken or fish, or swapping a side salad or steamed vegetables for a side of rice, pasta, or potatoes.
Best Bets for Breakfast, Lunch, and Dinner
You can go to a restaurant with some ideas of what they might have for each meal, and search for those.
Breakfast
Eggs: in an omelet or scrambled. Look for egg whites if you can, and choose vegetable toppings. Cheese and turkey can also be good additions. Skip bacon and other fatty meats in your eggs.
Oatmeal: plain, regular or steel-cut, without add-ons such as dried fruit or brown sugar. Nuts are okay. Steer clear of granola.
Breakfast sandwich: English muffin (you can eat half) with egg and/or cheese and/or ham – no bacon, sausage, croissant, or biscuit.
Create a meal from sides or add-ons, such as cottage cheese, an egg, fresh fruit, or turkey sausage.
Lunch
Green salad with any of grilled chicken, cheese, nuts, vegetables such as tomatoes and cucumbers, and light dressing. Skip regular dressing (or order it on the side), croutons and chow mein noodles, and dried fruit.
Chicken, fish, turkey breast, a veggie burger patty, a hamburger patty, or taco beef. Skip the bread, tortilla, bun, or taco shell, and steer away from breaded and fried.
Side salad, carrot sticks, yogurt, or sliced apples.
Dinner
Shrimp cocktail or broth-based soup for starters. Avoid dips, chips, bread and breadsticks, and fried starters.
Grilled, baked, or roasted plain chicken or fish. Avoid fried choices, fatty meats, and creamy or buttery sauces.
Steamed vegetables or a side salad. Avoid fries, pasta, rice, and mashed potatoes.
The Final Filter: You
No matter what lands on your plate or your to-go box, the ultimate decision about what goes into your mouth is made by…you. You can turn a potentially disastrous order into a not-so-bad or even good meal with some smart choices.
Decide how much you will eat and pack away the rest before you take your first bite.
Scoop out the filling from sandwiches and burritos, while leaving the bread and tortillas.
Eat the proteins and vegetables from your plate, while leaving the fries and fatty sauces.
Scrape off any breading and eat only the chicken or fish inside.
Weight loss surgery is to help you lose weight, but it is also to help you live a better life. If the good life for you includes eating out, you can do it. Just be careful. Keep your weight loss surgery diet plan in mind as you order and eat, and you can lose weight as you live your normal life.

Try to see their side.
You are asking them to see it from your perspective, so it is only fair that you try to see it from theirs. What are the reasons they may be against your Weight Loss Surgery, and how can you address them? In many cases, their concerns are legitimately about your well-being, and things you should consider if you have not already. They may worry that:
You will not hit your goal weight this time since they’ve seen disappointment before. You will suffer complications from surgery. You will regret having a permanent Sometimes, their concerns are selfish but still worth discussing. They may worry that:
You’ll stop feeling attracted to them. You will pressure them to give up their own favorite foods while you eat healthily. They will feel left out. You will not want to spend time with them. Reassure them.
Address their concerns directly. Explain why you feel the surgery is safe, and how much research you have done to learn about it as well as find a surgeon. Tell them why you think Weight Loss Surgery will work for you even if previous diets have not.
Let them know that you need to do this for yourself, not for them and that this will not change the way you feel about them – you will still love your SO, and respect your parents, for example. Tell them how you see yourself spending time with them after surgery, so they can be comfortable.
Write it down and practice.
Starting the conversation can be the scariest part of telling them. Before you bring up the subject, write down what you plan to say. This is a good exercise for you to do anyway since it encourages you to think through all of the doubts around Weight Loss Surgery. Writing it down and practicing can make it easier for the words to come when you decide to bring it up.
Include them in your plans.
Often, your spouse and parents, and others who care about you, just want to help. They may be afraid if they do not how to help. When you talk to them, let them know how important they are to you, both in life in general and in this important period of your life. If you tell them specifically what they can do to support you, they may feel more at ease with your decision and more confident in their roles.
You might ask them to:
Pick up your children from school when you are recovering from surgery. Go with you to the store to pick out protein powders and measuring cups and spoons. Ask you each night how you are doing. Cook healthy meals with you. Prepare for anything.
The conversation may be as difficult and unfulfilling as you feared. Or, your SO, parents or other loved ones may be surprisingly supportive once they realize that you have done your research and are serious about making the lifestyle changes needed for success. They may even be interested in getting healthy with you and ask for your help and support in exchange for theirs.
Stay strong and independent.
As much as you long for your SO and other loved ones to support you wholeheartedly, it may not happen. Try not to let it get you down, though. If you are sure about what you want, go for it, with or without them. They will come around sooner or later, and if not, you may be better off without their negative influence. Letting them know that you have made up your mind regardless of their support may actually convince them to help you since there is no point in standing in your way.
Stay independent in the sense that you realize that you do not need them. Your success does not depend on their approval, and you are not doomed to fail if they stand in your way. Get the support you need from others as you move forward.

Almost everyone needs protein supplements right after weight loss surgery. Protein shakes and powders give you the protein you need when you’re not allowed to eat solid foods. But which types should you choose? And should you keep using them when you’re eating solid foods and surgery is long behind you?
Protein for the Liquid Phase of the Post Weight Loss Surgery Diet Progression
After a day or two of sticking to clear liquids, you progress to a full liquid diet. You can be on this diet for a few days, if you’re a lap-band patient, or a couple of weeks, if you have the gastric sleeve or gastric bypass. Protein sources include the following. Non-fat milk, with 90 calories and 8 grams of protein per 8 ounces. Non-fat milk powder, with 100 calories and 10 grams of protein per ounce. Low-sugar protein powder, with 110 calories and 25 grams of protein per ounce. Low-sugar protein shakes, with 100 or more calories and 15 or more grams of protein per 8 ounces. Without supplementing your diet with protein shakes and powders, you’re not going to be able to hit your 60 to 80 grams of protein.
Protein Powders and Shakes in the Pureed Foods Phase
This phase is really a transition phase. You’re adding foods back into your diet, but aren’t yet ready to eat chewy, sticky, crunchy, or other solid foods. Protein foods include the following.
Non-fat cottage cheese, with 12 grams of protein per half-cup. Non-fat ricotta cheese, with 5 grams of protein per half-cup. Egg whites, with 4 grams of protein per extra-large white. Non-fat Greek or regular yogurt, with 8 to 14 grams of protein per container. During this phase, your surgeon will probably have you start to decrease your use of protein shakes and powders, but will probably recommend keeping them in your diet to help you get to 60 to 80 grams of protein per day. You might need one or two shakes a day, plus powder in foods such as oatmeal, yogurt, or pureed potatoes.
Be Wary of Protein Supplements in the Long-Term
Protein shakes and powders can be convenient, but they’re not your best bet for long-term weight loss. As you progress from pureed foods to semi-solid and then solid foods, your surgeon will probably recommend that you stop drinking shakes and focus instead on solid sources of protein.
They’re more substantial and satisfying than liquid shakes. They take longer to eat than drinking shakes. They’re easier to fit into a real-life eating plan. You won’t be “drinking your calories.” They have more natural nutrients than processed shakes and powders. Most weight loss surgery patients can get enough protein just by choosing one or two high-protein foods for each meal. You’ll get 60 to 80 grams with the following foods.
Breakfast: 2 scrambled egg whites with ½ light English muffin and some fruit. Lunch: ½ cup fat-free cottage cheese and a green salad with 3 ounces of canned light tuna. Dinner: 3 ounces of chicken breast and steamed spinach. Snack 1: 1 low-fat cheese stick. Snack 2: 1 6-ounce container of plain low-fat yogurt and ½ cup carrot sticks. When Protein Supplements Are Okay
Still, some weight loss surgery patients may still need protein shakes and powders in the long term. That’s often the case for vertical sleeve patients if your sleeve fills up too quickly to allow you to eat enough solid protein throughout the day. Talk to your surgeon to find out whether you should still use shakes and powders. Your surgeon might suggest that you include one or two protein shakes a day as snacks or mix protein powder into your yogurt, cereal or other foods.
Protein supplements can still come in handy even if you’re able to meet your protein requirements on your daily weight loss surgery diet. If your routine gets interrupted, you might come up short. Consider the protein you can miss if you need to change your regular plans for a meal or snack.
10 grams of protein if you run out the door without grabbing your yogurt in the morning. 22 grams of protein if you forget to pack your tuna for lunch. 26 grams of protein if you’re stuck in a meeting instead of cooking your chicken dinner at home. When you’re stuck in the car or too busy to plan ahead, protein shakes can be lifesavers. On vacation, you can take protein powder with you so you’re always sure to have a source when you need it. You could also try Unjury Protein’d Cheese Sauce on steamed vegetables for an extra 21 grams of protein.
Read the Nutrition Facts Panel to Find Protein Content
The Food and Drug Administration lets food manufacturers call a food “a good source of” protein if it has at least 5 grams of protein. If a serving has at least 10 grams of protein, a food can be labeled “high,” “rich in,” or “an excellent source of” protein. That doesn’t do you much good if you’re trying to find a shake or powder with at least 15 to 20 grams of protein per serving.
Don’t rely on a claim on the front of the label when you’re looking for a protein supplement. You could end up with a “high-protein” shake with only 10 grams of protein! Instead, check the nutrition facts panel to see how many grams of protein the food or shake has per serving.
Check the Label for Calories and Sugar
Protein shakes and powders can be high in calories and sugar. A bottle of Special K Protein has only 10 grams of protein, but 190 calories and 18 grams of sugar. A Pure Protein Frosty Chocolate Shake has 15 grams of protein, but 190 calories and 25 grams of sugar. A can of Boost High Protein drink has 15 grams of protein, 240 calories and 27 grams of sugars.
No matter which stage of your weight loss surgery diet you’re on, you can’t afford to eat too many calories or too much sugar. The only way to protect yourself is to read the labels.
Protein supplements can be great choices for boosting your intake to 60 to 80 grams a day. Shakes and powders can get you through the liquid and pureed foods stages of the post-surgery diet progression, and they can have a place in your diet even when you reach your long-term weight loss surgery diet plan. Just make sure not to overuse them if your surgeon is concerned, and to choose low-sugar options.

Try to see their side.
You are asking them to see it from your perspective, so it is only fair that you try to see it from theirs. What are the reasons they may be against your Weight Loss Surgery, and how can you address them? In many cases, their concerns are legitimately about your well-being, and things you should consider if you have not already. They may worry that:
You will not hit your goal weight this time since they’ve seen disappointment before. You will suffer complications from surgery. You will regret having a permanent Sometimes, their concerns are selfish but still worth discussing. They may worry that:
You’ll stop feeling attracted to them. You will pressure them to give up their own favorite foods while you eat healthily. They will feel left out. You will not want to spend time with them. Reassure them.
Address their concerns directly. Explain why you feel the surgery is safe, and how much research you have done to learn about it as well as find a surgeon. Tell them why you think Weight Loss Surgery will work for you even if previous diets have not.
Let them know that you need to do this for yourself, not for them and that this will not change the way you feel about them – you will still love your SO, and respect your parents, for example. Tell them how you see yourself spending time with them after surgery, so they can be comfortable.
Write it down and practice.
Starting the conversation can be the scariest part of telling them. Before you bring up the subject, write down what you plan to say. This is a good exercise for you to do anyway since it encourages you to think through all of the doubts around Weight Loss Surgery. Writing it down and practicing can make it easier for the words to come when you decide to bring it up.
Include them in your plans.
Often, your spouse and parents, and others who care about you, just want to help. They may be afraid if they do not how to help. When you talk to them, let them know how important they are to you, both in life in general and in this important period of your life. If you tell them specifically what they can do to support you, they may feel more at ease with your decision and more confident in their roles.
You might ask them to:
Pick up your children from school when you are recovering from surgery. Go with you to the store to pick out protein powders and measuring cups and spoons. Ask you each night how you are doing. Cook healthy meals with you. Prepare for anything.
The conversation may be as difficult and unfulfilling as you feared. Or, your SO, parents or other loved ones may be surprisingly supportive once they realize that you have done your research and are serious about making the lifestyle changes needed for success. They may even be interested in getting healthy with you and ask for your help and support in exchange for theirs.
Stay strong and independent.
As much as you long for your SO and other loved ones to support you wholeheartedly, it may not happen. Try not to let it get you down, though. If you are sure about what you want, go for it, with or without them. They will come around sooner or later, and if not, you may be better off without their negative influence. Letting them know that you have made up your mind regardless of their support may actually convince them to help you since there is no point in standing in your way.
Stay independent in the sense that you realize that you do not need them. Your success does not depend on their approval, and you are not doomed to fail if they stand in your way. Get the support you need from others as you move forward.

With restaurants, fast food, and other prepared foods being such a big part of our culture, you may not be able to, or even want to, stop eating out. That is okay, even after WLS. You will just need to be a savvy customer to be sure that wherever you are, you get a meal that fits into your meal plan. Take heart: it is almost always possible.
The Trouble with Eating Out
Research has been clear on the differences between eating out and preparing food at home. Restaurant meals tend to be bigger and higher in calories. Beyond that, they are higher in sodium and saturated fat, and lower in fiber.
That does not bode well for weight loss, but you are not doomed. Most restaurants are willing and able to accommodate you. You may be pleasantly surprised at the choices.
Do Your Homework (Or Procrastinate)
Most restaurants have their menus posted online. Many have their nutritional facts online. Check before you go to the restaurant, and decide on your meal before you get there. When it comes time to order, you need not browse the menu for temptations.
Or Procrastinate
It is not always possible to check beforehand, and that is okay. Just keep your goal in mind:
Some lean protein, such as eggs, chicken, or fish.
A vegetable.
A small amount of a healthy starch and/or healthy fat.
Build that meal from the items you see on the menu.
The Customer Is Always Right
If you need another expression to drive home the point, what about, “He who pays the piper calls the tune?” You are perfectly entitled to ask for no sauce, dressing on the side, or no bun.
A surprising number of joints allow substitutions or modifications for no extra cost, although some may charge. The cost is usually minimal, and worth it. Examples include getting grilled instead of fried chicken or fish, or swapping a side salad or steamed vegetables for a side of rice, pasta, or potatoes.
Best Bets for Breakfast, Lunch, and Dinner
You can go to a restaurant with some ideas of what they might have for each meal, and search for those.
Breakfast
Eggs: in an omelet or scrambled. Look for egg whites if you can, and choose vegetable toppings. Cheese and turkey can also be good additions. Skip bacon and other fatty meats in your eggs.
Oatmeal: plain, regular or steel-cut, without add-ons such as dried fruit or brown sugar. Nuts are okay. Steer clear of granola.
Breakfast sandwich: English muffin (you can eat half) with egg and/or cheese and/or ham – no bacon, sausage, croissant, or biscuit.
Create a meal from sides or add-ons, such as cottage cheese, an egg, fresh fruit, or turkey sausage.
Lunch
Green salad with any of grilled chicken, cheese, nuts, vegetables such as tomatoes and cucumbers, and light dressing. Skip regular dressing (or order it on the side), croutons and chow mein noodles, and dried fruit.
Chicken, fish, turkey breast, a veggie burger patty, a hamburger patty, or taco beef. Skip the bread, tortilla, bun, or taco shell, and steer away from breaded and fried.
Side salad, carrot sticks, yogurt, or sliced apples.
Dinner
Shrimp cocktail or broth-based soup for starters. Avoid dips, chips, bread and breadsticks, and fried starters.
Grilled, baked, or roasted plain chicken or fish. Avoid fried choices, fatty meats, and creamy or buttery sauces.
Steamed vegetables or a side salad. Avoid fries, pasta, rice, and mashed potatoes.
The Final Filter: You
No matter what lands on your plate or your to-go box, the ultimate decision about what goes into your mouth is made by…you. You can turn a potentially disastrous order into a not-so-bad or even good meal with some smart choices.
Decide how much you will eat and pack away the rest before you take your first bite.
Scoop out the filling from sandwiches and burritos, while leaving the bread and tortillas.
Eat the proteins and vegetables from your plate, while leaving the fries and fatty sauces.
Scrape off any breading and eat only the chicken or fish inside.
Weight loss surgery is to help you lose weight, but it is also to help you live a better life. If the good life for you includes eating out, you can do it. Just be careful. Keep your weight loss surgery diet plan in mind as you order and eat, and you can lose weight as you live your normal life.

“Complete” But Lacking Essential Nutrients
What does a “complete” multivitamin contain? It could provide anything from all the essential nutrients to just a few. There is no legal definition for “complete.” In the case of Flintstones “Complete” multivitamin chewables, “complete” apparently means that it has all 13 vitamins, but only 6 of the more than 15 essential minerals that you need.
Quantity Is Critical
For bariatric surgery patients, it is not only important to get each of the necessary vitamins and minerals, but also to have the right amounts. You need high amounts of some of the vitamins and minerals, and Flintstones chewables simply do not deliver. For example, the American Society for Metabolic and Bariatric Surgery (ASMBS) suggests at least 12 mg thiamin (vitamin B1) per day, while a chewable has 1.5 mg.
You will also be short on:
Vitamin A Vitamin D Vitamin E Vitamin B12 Iron Calcium And more.
“Doubling Up” Does Not Work
If one tablet is not enough, can’t you just take two? Well, not really. First, getting twice as much as certain nutrients may still leave you short. For example, 2 Flintstones chewables provide 1,200 IU of vitamin D, while recommendations for post-op gastric bypass patients are to get 3,000 IU per day. And no matter how many chewables you take, you will never get enough of essential minerals such as selenium and chromium, since the chewables have none.
Multivitamin: What Is in a Name?
We usually refer to them as “multivitamins,” but most often, we really mean, “multivitamin and mineral supplements.” Sometimes, a “multivitamin” that you buy off the shelf really is literally a bunch of vitamins with few or no minerals. Do not get confused by the name when purchasing your supplement. Read the supplement facts label to see which nutrients are in the supplement, and how much there is.
Safe Choices, Your Way
To be sure that you are getting the right supplement for bariatric surgery post-op needs, you are best off choosing a bariatric supplement. It may be a tad more expensive, but it could prevent deficiency diseases such as anemia or peripheral neuropathy. The BariatricPal Store has Multivitamin One and a wide range of other multivitamin and minerals formulated according to ASMBS guidelines.
Choosing a bariatric surgery-targeted multivitamin instead of a kids’ supplement does not mean you have to choke down capsules if you cannot stand them. You can always opt for another form, such as Powder or a Soft Chew. BariatricPal Protein One has 28 essential vitamins and minerals, along with protein and fiber, in Unflavored powder or great-tasting shakes such as Chocolate, Vanilla, Cookies and Cream, Peanut Butter, Chicken Soup, and more.
For help figuring out which vitamin and mineral supplement may be right for you, you can look at the attached ASMBS guidelines or check out our Bariatric Vitamin Guide, which breaks down recommendations for each surgery type. Also, be sure to talk to your doctor about your individual needs before trying a supplement.
ASMBS-Nutritional-Guidelines-2016-Update.pdf

Why Weigh Yourself?
Yes, you weigh yourself to know how much you weigh. But what is the point if you are on your weight program and your doctor will weigh you at your next appointment? Weighing yourself can have some benefits.
It can help you lose more weight by keeping you accountable. Just like logging your food can make you think twice before taking that extra bite, knowing that you will face the scale can keep you from serving yourself another portion.
It can be motivating. When you see the number of the scale go down, you might be more eager to wake up early for your workout, or order a salad instead of a sandwich.
It can be empowering. Knowing your weight gives you another piece of information about your body, and embracing rather than avoiding yourself can empower you to do your best for yourself.
How Often?
You can weigh yourself as often as you like, but it does not make sense to take too many weigh-ins too seriously. For many people, a good rule of thumb is to do a weekly weigh-in. You can take this weight as your “official current weight.” Some people like to stay off of the scale between their weekly “official” weigh-ins, while others like to weigh themselves daily, or even more than once a day, just to see what is going on. That is fine, as long as you do not take each weigh-in too seriously and do not let it bother you.
How to Weigh Yourself
You may be a 10, 20, or 40-year veteran of weighing yourself, but there are better and, well, worse ways to do so. It may be worth reviewing or revising your weigh-in practices to get better results. Here are some guidelines for accurate weigh-ins.
Weigh yourself at the same time of the day for your weigh-in, usually first thing in the morning.
Choose the same day each week to weigh yourself.
Wear minimal or no clothing.
Use the same scale, and a trustworthy one, each time.
Mistakes to Avoid
In theory, weighing yourself is as simple as stepping on the scale. Not! Your weight can be deceptively high or low if you find yourself making any of these mistakes.
Weighing yourself after a heavy meal. While 1 lb. of lettuce has only 50 calories, it weighs…1 lb. If it is in your stomach, you will weigh an extra pound. Weighing yourself in the morning before you eat anything can help avoid the problem of extra weight inside your stomach.
Weighing yourself wearing shoes or clothes. Heavy shoes and a full set of clothes can weigh 5 or more lb. That is a big chunk of weight that is not yours!
Weighing yourself with too much salt in your system. With salty foods comes sodium, with sodium comes thirst, and with thirst comes extra water. Water is heavy. It can still be in your system the next morning, and show up on the scale.
Weighing yourself right after exercising. Exercise does help you lose body fat, but it also helps you lose body water through sweat. You can lose a few lb. of water in one workout, and your body weight might be artificially low right after.
Weighing in Monday morning. If your weekdays are picture-perfect in terms of eating, and your weekends progress from Friday night at the bar to Sunday afternoon in front of the TV, your Monday morning weight can be variable, and possibly high. Friday morning may be a better time for you to weigh in.
Getting inaccurate numbers can be bad in many ways.
You might get discouraged for no reason if your weight shows up as higher than it really is.
You could become confused about how what you eat affects your weight if there seems to be no correlation.
You might have trouble detecting regain, and not modify your diet until you have gained more than you wanted.
Choosing a Scale
On top of making sure you are ready for a good weigh-in, you need to make sure that your scale is also ready. Using a cheap scale can drive you crazy because it may not be accurate. It could be difficult to read, or it could vary within a few pounds even if you are the same weight.
There are many affordable Body Scales that are highly accurate. You can find features that help you read the scale easily, track your weight, and see other information. These are some features to consider.
Digital read-outs.
Bluetooth connectivity to your smartphone.
Memory of your recent weights.
Measurements such as body fat and lean muscle mass.
Use the scale to help you on your weight loss journey, and you can consider it another weapon in your weight loss arsenal. The more tools you have, the better your weight loss success can be!

Equipment
The essentials are sturdy shoes and comfortable clothes. These may be easy for an exercise pro, but where do you start if you are a beginner? Comfortable clothes can be very simple; an old t-shirt and sweatpants will suffice. If you feel better when you feel stylish, try yoga pants or capris and a top with sweat-wicking fiber.
For shoes, beginners are probably best off going to a specialty running and walking store for expert advice and help with fitting. You will pay more at a specialty store than you would online, but the extra money is worth it, at least the first time, to make sure the shoes are right for you. You can always save money later by ordering online or going to a discount sporting goods store once you are confident you know which shoes you want. A word of wisdom: when it comes to shoes focus on function, not fashion!
Any other equipment you need depends on what activity you are planning to do. A gym usually has everything you need for its activities. If you need to get specialty equipment such as a yoga mat or boxing gloves, ask a friend or another seasoned activity buddy to help you find one that fits your needs and your budget.
A Backup Plan
Things go wrong quite often, so you had better have a backup plan if you want to have a chance of keeping up your exercise intentions. Here are a few examples.
· Plan to walk in the mall if there is a rainstorm when you are supposed to meet a friend in the park.
· Keep a pair of shoes in the trunk of the car so you can walk at lunch even if you forget to bring your workout shoes to work.
· Keep a protein bar and a protein shake with you so you can work out without a grumbling stomach on a busy day.
· Keep your phone charged so you can walk when your friend calls out of the blue and you chat for several minutes.
Fun Times
Dance if you love to dance. Stay off the treadmill if it is boring. Go swimming if you are a fish in the water. Skip the spinning classes if you hate loud music. Play basketball if you love shooting hoops.
Get the picture?
Do what you love, and skip what you hate. Exercise should be fun for you to be able to keep it up for years, and the great news is that it can be. Here are some tips for
Plan your entertainment, whether it is an upbeat playlist while hiking or an episode of your favorite TV show to watch while on the bike at home. Get social, whether by phoning a friend while you are walking in the park, or meeting up with friends to walk or hold your own boot camp. Prevent boredom by including different activities regularly. You could walk Mondays and Fridays, life weights Wednesdays, and show off the results of your training during your Saturday tennis matches. Walk with a friend to a cafe for some low-calorie decaf coffee as a post-walk treat. Make your workout something you enjoy, and you are way more likely to keep doing it.
Planning
Just like with your food, you are more likely to stick to your exercise intentions when you plan. It can be as simple as setting aside the time, such as 30 minutes in the morning. You may be more likely to follow through when you are more specific in your planning, such as a 15-minute walk followed by 15 minutes on the stationary bike. Planning helps you set aside the time and set aside any doubts about what you will do during that time.
Rewards
Give yourself some well-planned rewards, and your mind and body will start to associate exercise with positive things. Your rewards can be tangible, such as a massage every time you work out five times in a week. They can also be emotional, such as taking five minutes to thank yourself after a workout and think about how good you feel.
You can get or stay fit, no matter your experience with exercise. It starts with an intention and continues with some hard work and great rewards.

Chocolate
A small square of dark chocolate may be good for your heart, but the 50 grams of sugar and 20 grams of fat in a 400-calorie slice of frosted chocolate cake far outweigh any heart-healthy benefits in dark chocolate. A serving of Double Chocolate Protein Cake with 120 calories and less than 6 grams of sugar and 5 grams of fat can satisfy the craving while also providing 12 grams of protein. Or, you could try a Chocolate Dream Bar with 10 grams protein and 160 calories. Imagine pulling that out after a workout and showing your friends how you lose weight!
Mac and Cheese
Ahh…nothing like plopping down in front of your TV with a bowl of mac and cheese after a tough day, and then feeling oh so bad about the carb coma you just put yourself in. Keep the mac and cheese, and skip the coma, with a smart swap. Opt for cooked cauliflower chunks, shirataki noodles, or Protein Fusilli instead of regular macaroni, and a sauce with non-fat cream cheese and low-fat cheddar instead of full-fat cheeses.
Mashed Potatoes
Mashed potatoes and gravy are the ultimate comfort food and the opposite of the weight loss surgery diet ideal. Put another way, they’re a load of carbs, fat, and calories, and devoid of protein. Instead, make pureed cauliflower with almond milk, parmesan cheese, nutmeg, and pepper, or try pureed turnip or carrot. Turn it into an entire meal by topping your potatoes with Protein Gravy, which adds 10 grams of protein and 3 grams of fiber for only 65 calories.
Chips…
A little crunch can be quite the welcome afternoon companion, but oftentimes, your crunch indulgence sticks on your hips instead of leaving at the end of the afternoon. A few handfuls of potato or tortilla chips can cost you 500 calories before even talking about the fat and calories from a creamy dip. If all you are looking for is some mindless munching, try celery (if you can handle the strings), cucumber sticks, bell pepper strips, or snow peas. An entire cup has less than 50 calories, and it can fill up your pouch or sleeve pretty fast. Or, if what you really want is the entire chip experience, go for Protein Chips in flavors such as ranch, salt and vinegar, BBQ, and more.
…And Dip
The ranch, French onion, or spinach and artichoke dip you love may be giving you more than a meals’ worth of calories, without the protein you need to keep full. Keep the calories down with salsa, or get yourself some nutrients by making a dip with a base of non-fat sour cream, cream cheese, or Greek yogurt.
Chinese Takeout
It was so easy and delicious to order fried rice, chow mein, or sweet and sour chicken, but was it really worth a thousand calories? Make your own Asian inspired dishes with ingredients such as Protein Fettuccine instead of chow mein noodles, low-carb Asian flavor sauce, and riced cauliflower, along with lean proteins such as shrimp and chicken, and plenty of veggies. When you are stuck for time or want a ready-made meal, the veggies, rice, and chicken in Spicy Chicken Oriental with 230 calories and13 grams of protein can be on your plate in less time than delivery.
Grilled Cheese and Tomato Soup
It is classic but so far-fetched on a high-protein bariatric diet…until now. Get your grill on by toasting low-fat cheese on Protein Bread with 2 grams net carbs per slice. Pair your open-faced grilled cheese sandwich with Protein Tomato Soup, and you could easily get more than 20 grams of protein in a filling meal with under 200 calories.
Dessert
No explanation is necessary. Fruity, chocolatey, nutty, or caramel-y; crunchy, chewy, or spoon-y, dessert tastes good. Keep the good without the guilt or dumping syndrome with any number of high-protein choices. Stash Protein Bars, Protein Pudding, and Protein Cookies in your favorite hiding spots so you can grab a low-sugar treat whenever you need a lift. Whether you are craving lemon, cranberry, coconut, peanut, toffee, or s’mores, there is a choice for you.
Cravings can hit hard, but that’s okay! With a little thought, you can make smart choices to satisfy your craving without missing a beat in your weight loss.

McDonald’s, Burger King, and the Other Burger Joints
Burger joints are the epitome of fast food, but they can be surprisingly diet-friendly if you are careful. Plain, kid-sized burger patties, grilled chicken, and salads without bacon, croutons, and other unhealthy additions are all easy to fit into your weight loss plan. Choose a side salad instead of fries or onion rings, and you can have a filling and healthy meal.
Skip: buns, mayo, shakes, and crispy chicken.
Panda Express
The premise is great – choose a dish with protein and vegetables, skip the fried rice and chow mein noodles, and feel good about a high-protein, high-fiber meal. This is actually possible when you avoid breaded and sugary choices, such as Orange Chicken and Honey Walnut Shrimp, in favor of Mushroom Chicken, String Bean Chicken Breast, and Broccoli Beef. If you are still hungry, add a side of Mixed Vegetables for 80 calories. Skip the appetizers – all of them!
To put things into perspective, an order of Broccoli Beef plus a side of Mixed Vegetables has 230 calories, while an order of Orange Chicken plus a side of Chow Mein plus an order of Cream Cheese Rangoons had 1,080 calories.
Skip: rice, noodles, breaded chicken, beef, fish, or shrimp, and rangoons and egg and spring rolls.
KFC and Other Chicken Places
Choose “grilled” instead of “fried,” “crispy,” “original,” or “breaded,” and you will be well on your way to a high-protein, low-carb meal. Get pieces instead of a sandwich, and be wary of sugary or fatty dipping sauces. Green beans and corn – no butter – can round out your meal, but stay away from the other sides, such as
Skip: fried and popcorn chicken, biscuits, baked beans, coleslaw, mashed potatoes and gravy, and mac and cheese, and creamy dipping sauces.
Pizza Hut and Other Pizza Places
As at any restaurant, moderation is your best bet at pizza places, too. You will not go too far wrong if you can stick to a slice of thin-crust pizza with light cheese, ham or chicken instead of pepperoni or sausage, and any vegetables that you want to pile on. Other promising choices are baked wings (5 grams protein, 60 calories each) and a salad with grilled chicken.
Skip: thick-crust pizza, too many slices, pasta bowls, breadsticks, and dessert pizzas.
Taco Bell and Chipotle
So many of the components can be healthy for you, but somehow, they can come together to create an unhealthy disaster. Protect yourself by ordering from the bottom up. Choose chicken or grilled steak; as many vegetables as you can find, and some cheese or avocado. Add a few beans if you want, plus a generous scoop of salsa, and your Mexican-style meal can keep your waistline happy.
Skip: tortilla chips and shells, tortillas, rice, nacho cheese sauce, fatty ground beef, sour cream, creamy sauces, and quesadillas.
Panera and Other Cafes
Many cafes promise fresh ingredients, but do not mistake “quality” for “waist-friendly.” Look for green salads with vegetables, grilled chicken or feta, and nuts or avocado. You can also get a good bet when you see broth-based soups, such as chicken noodle or vegetable, and lean turkey or ham. For breakfast, look for egg whites, plain oatmeal, and fresh fruit.
Skip: pastries and sugary beverages, bread, large quantities of salad dressing, mayo-based spreads, fatty meats, and add-ons such as croutons and chow mein noodles.
You can find a healthy meal at almost any place you end up at, and often, you can plan your order ahead of time. Just look for the menu online so you can see your options and the nutrition information. Then let someone else do the cooking and cleaning up, and enjoy your tasty meal.

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

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

With restaurants, fast food, and other prepared foods being such a big part of our culture, you may not be able to, or even want to, stop eating out. That is okay, even after WLS. You will just need to be a savvy customer to be sure that wherever you are, you get a meal that fits into your meal plan. Take heart: it is almost always possible.
The Trouble with Eating Out
Research has been clear on the differences between eating out and preparing food at home. Restaurant meals tend to be bigger and higher in calories. Beyond that, they are higher in sodium and saturated fat, and lower in fiber.
That does not bode well for weight loss, but you are not doomed. Most restaurants are willing and able to accommodate you. You may be pleasantly surprised at the choices.
Do Your Homework (Or Procrastinate)
Most restaurants have their menus posted online. Many have their nutritional facts online. Check before you go to the restaurant, and decide on your meal before you get there. When it comes time to order, you need not browse the menu for temptations.
Or Procrastinate
It is not always possible to check beforehand, and that is okay. Just keep your goal in mind:
Some lean protein, such as eggs, chicken, or fish.
A vegetable.
A small amount of a healthy starch and/or healthy fat.
Build that meal from the items you see on the menu.
The Customer Is Always Right
If you need another expression to drive home the point, what about, “He who pays the piper calls the tune?” You are perfectly entitled to ask for no sauce, dressing on the side, or no bun.
A surprising number of joints allow substitutions or modifications for no extra cost, although some may charge. The cost is usually minimal, and worth it. Examples include getting grilled instead of fried chicken or fish, or swapping a side salad or steamed vegetables for a side of rice, pasta, or potatoes.
Best Bets for Breakfast, Lunch, and Dinner
You can go to a restaurant with some ideas of what they might have for each meal, and search for those.
Breakfast
Eggs: in an omelet or scrambled. Look for egg whites if you can, and choose vegetable toppings. Cheese and turkey can also be good additions. Skip bacon and other fatty meats in your eggs.
Oatmeal: plain, regular or steel-cut, without add-ons such as dried fruit or brown sugar. Nuts are okay. Steer clear of granola.
Breakfast sandwich: English muffin (you can eat half) with egg and/or cheese and/or ham – no bacon, sausage, croissant, or biscuit.
Create a meal from sides or add-ons, such as cottage cheese, an egg, fresh fruit, or turkey sausage.
Lunch
Green salad with any of grilled chicken, cheese, nuts, vegetables such as tomatoes and cucumbers, and light dressing. Skip regular dressing (or order it on the side), croutons and chow mein noodles, and dried fruit.
Chicken, fish, turkey breast, a veggie burger patty, a hamburger patty, or taco beef. Skip the bread, tortilla, bun, or taco shell, and steer away from breaded and fried.
Side salad, carrot sticks, yogurt, or sliced apples.
Dinner
Shrimp cocktail or broth-based soup for starters. Avoid dips, chips, bread and breadsticks, and fried starters.
Grilled, baked, or roasted plain chicken or fish. Avoid fried choices, fatty meats, and creamy or buttery sauces.
Steamed vegetables or a side salad. Avoid fries, pasta, rice, and mashed potatoes.
The Final Filter: You
No matter what lands on your plate or your to-go box, the ultimate decision about what goes into your mouth is made by…you. You can turn a potentially disastrous order into a not-so-bad or even good meal with some smart choices.
Decide how much you will eat and pack away the rest before you take your first bite.
Scoop out the filling from sandwiches and burritos, while leaving the bread and tortillas.
Eat the proteins and vegetables from your plate, while leaving the fries and fatty sauces.
Scrape off any breading and eat only the chicken or fish inside.
Weight loss surgery is to help you lose weight, but it is also to help you live a better life. If the good life for you includes eating out, you can do it. Just be careful. Keep your weight loss surgery diet plan in mind as you order and eat, and you can lose weight as you live your normal life.

Try to see their side.
You are asking them to see it from your perspective, so it is only fair that you try to see it from theirs. What are the reasons they may be against your Weight Loss Surgery, and how can you address them? In many cases, their concerns are legitimately about your well-being, and things you should consider if you have not already. They may worry that:
You will not hit your goal weight this time since they’ve seen disappointment before. You will suffer complications from surgery. You will regret having a permanent Sometimes, their concerns are selfish but still worth discussing. They may worry that:
You’ll stop feeling attracted to them. You will pressure them to give up their own favorite foods while you eat healthily. They will feel left out. You will not want to spend time with them. Reassure them.
Address their concerns directly. Explain why you feel the surgery is safe, and how much research you have done to learn about it as well as find a surgeon. Tell them why you think Weight Loss Surgery will work for you even if previous diets have not.
Let them know that you need to do this for yourself, not for them and that this will not change the way you feel about them – you will still love your SO, and respect your parents, for example. Tell them how you see yourself spending time with them after surgery, so they can be comfortable.
Write it down and practice.
Starting the conversation can be the scariest part of telling them. Before you bring up the subject, write down what you plan to say. This is a good exercise for you to do anyway since it encourages you to think through all of the doubts around Weight Loss Surgery. Writing it down and practicing can make it easier for the words to come when you decide to bring it up.
Include them in your plans.
Often, your spouse and parents, and others who care about you, just want to help. They may be afraid if they do not how to help. When you talk to them, let them know how important they are to you, both in life in general and in this important period of your life. If you tell them specifically what they can do to support you, they may feel more at ease with your decision and more confident in their roles.
You might ask them to:
Pick up your children from school when you are recovering from surgery. Go with you to the store to pick out protein powders and measuring cups and spoons. Ask you each night how you are doing. Cook healthy meals with you. Prepare for anything.
The conversation may be as difficult and unfulfilling as you feared. Or, your SO, parents or other loved ones may be surprisingly supportive once they realize that you have done your research and are serious about making the lifestyle changes needed for success. They may even be interested in getting healthy with you and ask for your help and support in exchange for theirs.
Stay strong and independent.
As much as you long for your SO and other loved ones to support you wholeheartedly, it may not happen. Try not to let it get you down, though. If you are sure about what you want, go for it, with or without them. They will come around sooner or later, and if not, you may be better off without their negative influence. Letting them know that you have made up your mind regardless of their support may actually convince them to help you since there is no point in standing in your way.
Stay independent in the sense that you realize that you do not need them. Your success does not depend on their approval, and you are not doomed to fail if they stand in your way. Get the support you need from others as you move forward.

Legal Trouble for Premier Protein

Premier Protein sells all kinds of protein shakes. The ones whose labels state that they have 30 grams of protein per serving are the ones in the settlement. Analysis has found that they have 26 to 29 grams. The flavors that are in the settlement are Vanilla, Chocolate, Strawberries & Cream, Banana & Cream, Peaches & Cream, Cookies & Cream, Mixed Berry, Organic Chocolate, Organic Vanilla, and Caramel.

While the company is not admitting wrongdoing or ceasing the sale of these products, there is a class action settlement. You may be eligible for a cash payout if you purchased any of the misleading shakes in the past 7 years, since 2011. Pre-op or post-op, you need to know how much protein is in your shakes.

Not Best for Bariatric Patients

Every gram of protein counts, but the deception in amount of protein per serving is not the only problem. Even if you are willing to overlook the shortfall in the amount of protein, Premier Protein has a problem with type of protein.

Read the ingredients carefully, and you will see that less than 1% of the product is “whey protein concentrate.” Whey protein is the type of protein that you should be looking for because it absorbs more quickly than casein. Whey protein has been shown to increase weight loss and body fat loss in bariatric surgery patients.

Another glance at the list of ingredients of Premier Protein shows that “milk protein concentrate” and “casein” are the major sources of protein. Casein is slow-acting. If you had a bariatric surgery type, such as gastric bypass, that interferes with absorption, you may not get all the benefits from casein.

What’s Better?

We know that you need a protein supplement, so what can you find that has the amount and type of protein you need and the great taste that will encourage you to take care of your needs? BariatricPal Protein One gets our vote.
27 grams of whey protein. 28 vitamins and minerals. Great-tasting French Vanilla, Cinnamon Swirl, and Double Chocolate Fudge. It has a few more advantages over Premier Protein.
Over twice as much dietary fiber for fullness and digestive health. Choose from convenient single-serving packets or multi-serving tubs. Comes in powder so you can add water or your favorite beverage. Has an “unflavored” option so you can add it to anything, from soup to smoothies. When it comes to bariatric products, quality counts. Any purchase you make should be from a trusted source because there are a lot of poor-quality or misleading products out there. The few grams of difference between Premier Protein’s claims and reality may not be a lot, but along with the poor choice of casein instead of whey as the main protein source, you might want to seek another source for your protein. Look for a trusted vendor and name brand as you make your choice. What you put in your body really does matter.

The scale can be one of your most important tools on your weight loss journey, but only if you use it right. Surprisingly enough, using the scale right can take more than a bit of planning, just like many other aspects of your weight loss surgery journey. The number you see can jump around and start to drive you crazy if you do not know the reasons behind the blips.
These are some reasons for some ups and downs on the scale, and how to prevent or at least accept them. Hint: It is probably not yet panic time!
Up: Salt (Sodium)
Did you have a salty meal last night? Did you snack on pickles, top your chicken with salsa, season your turkey burger with soy sauce or another salty condiment, or help yourself to a big salad with fat-free dressing? Those are all great choices for weight loss, but not for today’s weight.
Are you confused? Here is the explanation. Sodium, which we mainly get from salt in foods, has no calories and is one way to add flavor without fat or sugar to food so you can keep calories down for weight loss, But, sodium attracts water. Eat a high-sodium meal or snack, and your body can retain water. You may feel bloated and notice your ankles or fingers swelling. That water inside of you is heavy, and the scale will tell you so.
Tip: Do not eat a high-sodium or salty meal or snack the day before your weigh-in, or keep in mind that you did.
Up: Stress
Long-term, stress eating can add fat to your hips and pounds to the scale. Short-term stress can bump up your weight, too, without overeating. Stress hormones lead to water retention and (see above) water is heavy.
Tip: Don’t stress out! Easier said than done, but being aware of stress can help. So can exercising, laughing with friends, and meditating.
Up: Big Meal, Day, or Weekend
Remember the part about how sodium attracts water? So do extra sugar and carbohydrates. It takes an extra 3,500 calories to gain a pound of body fat, but y you are likely to see your weight jump if you eat a big meal, or have a cheat day, or get out of control on the weekend. That sodium and those carbs can add up more quickly than you expect.
A single restaurant meal with rolls or breadsticks, a burger and fries, and a small dessert can have over 5,000 mg of sodium and 200 grams of carbohydrates. That amount may “only” include 2,000 calories (barely over ½-lb’s worth of body fat), but it is enough to bump the scale up as much as a few pounds the next day.
Tip: Do not eat too much! If you do have a cheat meal or day, do not weigh in after it. Most people consider Mondays to be a bad day for a weigh-in because weekend diets are often less strict than weekday eating patterns.
Up: Lack of Sleep
Do you ever feel groggy and heavy when you do not get enough sleep? The scale will confirm that it is not your imagination. You can retain water due to hormonal shifts when you do not sleep enough. Over the longer term, sleep deprivation can make you gain “real” weight (body fat) because lack of sleep:
Increases ghrelin, which is a hormone that makes you feel hungry.
Increases cravings for sugar and carbohydrates.
Reduces your ability to resist cravings.
Tip: Get enough sleep. It is not a luxury that is beyond your control. It is an important part of your weight loss lifestyle, so make it a priority.
Down: Dehydration
Weight loss is one motivation to exercise, but losing too much weight with a single workout just means you are dehydrated, not that you burned off pounds of fat in an hour or so. The scale can show you a low number because you sweated a lot. It can be motivating, but it is not healthy. Dehydration can lead to fatigue and to later water retention – and a bump up on the scale!
Tip: drink 8 oz. of water every 20 minutes while you are exercising intensely. Weigh yourself before and after your workout, and drink 16 ounces of water for each pound that you lost during your workout.
Down: Sudden weight loss
Have you ever started a diet and seen the pounds come off quickly at first before the weight loss tapered off? It may have even happened after WLS if you were one of those patients who lost 10 or 20 lb. within the first weeks.
A good portion of that weight was water weight. It happens when your body shifts from gaining weight (or being stable) to losing weight. What happens is that your body loses carbohydrates that were stored in the form of glycogen. Glycogen holds water. When you lose the glycogen suddenly by going low-carb or low-calorie, you lose water, too. So, your scale weight drops fast.
Tip: Celebrate those first pounds lost, but keep working hard. Stick to your diet and stay hydrated so the pounds keep coming off for weeks and months to come.
Now that you know that the scale can be fickle, you can concentrate on finding the balance between trusting the scale and trusting your diet. If you stay on track with your eating and workout program, and take care of the “little things” such as getting enough sleep and managing stress, you can outlast any bumps on the scale and come out stronger and lighter than ever.