Alex Brecher

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!

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!

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!

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.

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!

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.

Key Points
· Measuring your food helps you keep track of your nutrition.
· Tracking protein is difficult unless you know the portion size.
Measuring Spoons
· Stainless steel (heavier gage like 18/8 is more durable). Plastic measuring spoons are lightweight and can be put in a dishwasher.
· Aluminum is a metal that can bend easily and turns dull if washed in a dishwasher.
· Look for a set that has at least a ¼ teaspoon up to 1 tablespoon measures.
· Plastic sets are priced from about $1 to over $30. Stainless sets start around $6 and can be up to $50 for fancy, decorative sets.
Measuring Cups
· Stainless steel is most durable and dishwasher safe. Find a heavier gage weight like 18/8 if possible.
· Aluminum is less expensive than stainless steel. This metal is more easily bent and dented. Washing in the dishwasher will make them dull.
· Plastic measuring cups come in a variety of colors and styles. Check to see if the plastic measuring cups you want to buy are microwave safe. Most are usually dishwasher safe.
· Tempered glass is microwave and dishwasher safe. Brands include Pyrex and Anchor Hocking. Safe for microwave use.
· Measuring cups for dry ingredients are the ones that come in separate measures (1/8 cup to 1 cup).
· Measuring cups for liquids come in stainless steel, aluminum, plastic and tempered glass. Sizes are usually 1 cup, 2 cups and 4 cups (1 quart).
· Prices can range from a few dollars to $50.
Food Scales
· There are digital (requires batteries) or mechanical/dial types that look like what is in the produce section, but smaller for home use. With a mechanical/dial-type scale, avoid “high capacity.” These scales are meant to measure in pounds, rather than ounces. That makes it a challenge to measure accurately. Prices start around $8.
· Digital scales are easier to read when looking for how many ounces the food weighs. Prices start around $25.
· Scales that can zero out after you place your dish on top can measure each ingredient as it is added to the dish. Some allow you to use your own dish and some have a bowl you have to use.

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.

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.

Consider Macros
That is, “macronutrients,” or carbohydrates, fat, and protein. The news is bad on the surface since the average fast food meal has more carbs and less protein per calorie than the average home-cooked meal. You can work to turn this around, though.
Carbohydrates: Cut back on carbohydrates by skipping the starchy sides: French fries, potato chips, and hash browns, steamed, fried, or Mexican rice, and breadsticks. Try to go “green” (lettuce wrap) or “naked” (no wrap) with your burger, tortilla, or sandwich; if the fast food joint cannot honor your request, just eat the filling with a knife and fork, and throw away the bread, bun, tortilla, or taco shell (if you are feeling guilty because of starving children in third-world countries, make a donation. You’ll do more good than you would by adding starch to your hips).
Protein: How can you boost your protein intake at a fast food restaurant to be what you need? Skinless grilled or baked chicken, lean cold cuts, cheese, and beans can all up your totals, and yogurt is an increasingly common side option. Even a small burger patty can give you 10 to 15 grams of protein, although it comes with a few extra grams of fat.
A good protein goal for a meal is about 20-30 grams. You can get that for 200-300 calories with any of the following.
Burger King Double Cheeseburger, no bun; Grilled Chicken Garden Salad, no croutons; or Veggie Burger with cheese, no bun or mayo. McDonald’s Grilled Southwestern Chicken Salad, no cheese; or Grilled Chicken Sandwich, no bun or spread. Taco Bell 2 grilled or fresco steak soft tacos, no tortillas; chicken or steak Power Menu Bowl, no rice or cheese. KFC Grilled Chicken Drumstick plus green beans or side salad. Panda Express Grilled Teriyaki or Asian Chicken. Fats: Your first order of business is to avoid anything fried. You will be avoiding excess grease while also avoiding sneaky carbs in breading – did you know that the amounts of carbs in onion rings and fried chicken are comparable to the amounts in bread? Also, watch the fatty spreads – think mayonnaise – salad dressings, and dips.
Find the Vegetables
Protein and vegetables…does this sound familiar? It should, since your goals when eating at a fast food restaurant should be the same as when you eat at home. Vegetables help fill you up without filling you out, and it is best to eat as many of them as you can handle with your pouch or sleeve. It may take a little more digging to find vegetables at fast food restaurants than at home, but you can usually do it. Here are a few leads.
Ask for extra lettuce, tomatoes, and any other available vegetables on burgers and sandwiches. Order a side salad or baby carrots with your meal. Check for salads with grilled chicken as an entrée. Pile salsa and diced vegetables onto your naked burrito. When “Value” Isn’t
Besides the convenience, the deals are among the most tempting things about fast food. For pennies more, you can often add fries and a drink, or you could get a second burger or taco for half the price. Don’t do it!
“Value” depends on what you want and need; why would you pay extra, even if it is “only pennies more,” for extra fat, sugar, starch, and calories? A healthier definition of “value” might be to pay the least you can for a meal that is convenient, delicious, and healthy. Why include “oversized” in your definition?
For those times when fast food simply makes sense, go for it – just keep yourself on track by reading the menu carefully and staying focused. You can do it, no matter where you end up. You might as well enjoy it!

What’s Wrong with Away-from-Home?
There is nothing wrong with eating outside the home – unless you are average. That is because the average restaurant meal has more calories, more fat, and more sugar than the average home-cooked meal. You can reverse this, though, with some awareness.
Classic Breakfast Sandwiches
The classic breakfast sandwich or burrito can have eggs, cheese, and meat. From there, the sandwich can vary widely. An egg white McMuffin from McDonald’s, for example, has 260 calories, while a Croissan‘wich with bacon and sausage from Burger King has 620 calories. Skip the butter and any fried potatoes, such as hash browns or shredded potatoes, and choose:
Ham instead of bacon or sausage. An English muffin (or nothing) instead of a bagel, biscuit, croissant, or tortilla. Egg whites instead of whole eggs. Café Choices
Coffee shops and bakery-café’s offer all kinds of fresh, tantalizing, and absolutely off-limits foods. Hint: you do not need a cinnamon roll with 50 grams of sugar to start your day. Stay away from the breakfast pastries and breakfast sandwiches on bagels. Instead, you may be best off with an “a la carte”-style breakfast. Look for items such as:
Plain oatmeal or oatmeal with nuts as an add-in. Fruit cups or whole fruit. Low-fat cream cheese – you can spread it on half of a whole-grain bagel. Smart Suggestions
Starbucks offers some hot breakfast options for under 300 calories – their egg white bites have only 170 calories – and Dunkin Donuts offers some DD Smart Wake Up Wraps for 160 to 240 calories. By the way, a Bismark donut has 490 calories. Subway offers egg whites, ham, and reduced-calorie cheese on 3-inch subs, so you can avoid too much bread.
Lunch for Breakfast
You may not need to depend on the breakfast menu if the restaurant serves lunch early in the morning. If that is the case, you may be able to get grilled chicken, turkey breast, and cheese on a salad.
Bring Your Own
There is a chance that you may not realize how easy and quick it can be to bring your own breakfast from home and avoid restaurants altogether. We understand if you have exactly zero seconds to dedicate to making your breakfast in the morning before you leave home. You can stash it in the car or fridge the night before.
If you have access to hot water before you have breakfast, these options can work:
Protein Oatmeal with an apple or some walnuts. Protein Muffins in flavors such as Blueberry, Double Chocolate, and Maple Pumpkin. Protein Hot Chocolate with milk for extra calcium or protein. If you are going to eat in the car or have no microwave at work, you’ll need something ready-to-eat. Consider:
Protein Cereal in Honey Nut, Chocolate, or other favorite flavors. Oatmeal Raisin Protein Cookies. Fruit and cottage cheese or yogurt. A Protein Bar. You can have the best of both worlds: a meal as quick and easy as a fast food meal, with nutrition that fits into your meal plan like a home-cooked meal. Way to start the day right!

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.

Why Does It Matter?
There is an expression that goes, “Shoot for the stars and you’ll hit the moon.” The idea is that if you set your sights high but fall short, you will still achieve something great. The theory may sound good, but it may neglect to consider reality.
The truth is that for many of us, another saying is truer: “Success breeds success.” That is, when you hit one goal, you are motivated to keep working towards your next one. You build momentum as you hit goal after goal, and those goals then act like stepping stones to those proverbial stars.
The Trap of “Too Much, Too Fast”
There is a common tendency overshoot when it comes to weight loss goals. These are some reasons why.
We want to lose weight so badly that we think only of the dream goal.
Most of us tend to think of ourselves as above average – so we set our weight loss goals at higher than average.
We set deadlines that are too short because we are so focused on getting there that we forget to recognize how wonderful the journey is.
We set our goals based on what someone else lost.
Classic Failure: “All or Nothing”
One of the surest ways to set yourself up for failure is to set your weight loss goal to be too many pounds within too little time. It is comparable to the “all-or-nothing” mentality that so often comes with dieting: you are doing fine until you eat a cookie, and then you figure that the day is wasted, so you might as well finish the bag of cookies, skip your workout, and order pizza and breadsticks for dinner.
The same mentality after weight loss surgery can get you into the same trouble. If you aim for an unrealistic 20 or 30 lb. in your first month and instead hit a respectable 5 to 10 lb., the “disappointment” can discourage you so you do not try as hard.
Realistic Weight Loss
The amount of weight you can realistically expect to lose depends on your procedure, how much you have to lose, and your own drive and other individual characteristics. An average gastric bypass or sleeve patient might lose about 50% of excess weight. For example, Someone who is 5’4” tall and weighs 245 lb. has about 100 lb. of “excess” body weight and might set a goal to lose about 50 lb.
Another way to look at it is to take a rough estimate of average weight loss with your procedure for your surgeon’s patients. You might use that number as the basis for your own weight loss goal. You could also look at your final goal – say, 100 lb. down – and divide that by 1 to 2 years – in this case, a seemingly modest 1 to 2 lb. per week.
Setting Realistic Goals
For weight loss or any other goal, you can follow certain guidelines for realistic goal-setting. Set your goal to:
Include a realistic amount of weight loss.
Leave yourself enough time to achieve that amount.
Include interim goals that you can celebrate and use as motivation.
Provide for rewards as you progress, so you stay motivated.
Allow enough time for plateaus and setbacks. They will come.
Keep It in Perspective
Strange but true…weight loss is only one of many reasons to get weight loss surgery and follow a healthier lifestyle. What about…?
Gaining energy?
Getting healthier?
Feeling more confident?
Participating in more of life?
Along with setting weight loss goals, you can set other goals for healthy eating, working out, and trying new things. You will always have something to chase after and you will be able to see more progress every day.

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.

The Key Points:
The main key is the power of the motor. The more powerful the motor, the faster the blades rotate. A motor that is 900 watts will mix much better than a motor that is 300 watts. An evenly smooth texture is more likely with more powerful blenders and mixers. The products listed are ones our patients use more frequently. Look for a blender that is in your budget, works well for what you want to use it for and how easy it is to clean. Keep in mind how much space you have in your kitchen, too. Some of the blenders/mixers can only pulse and may list a time limit on how long to pulse. Products listed are for making protein shakes or smoothies only. Shaker Cups
Widely available in many retail stores and in the BariatricPal Store. Prices range from $6-$20. Made to mix protein powders with fluids. Easy to carry with you. Great for traveling. Sometimes it’s more difficult to mix the protein powder completely in a shaker cup. PROMiXX (original) and version 2.0 Vortex Mixer Original lists for about $30 on Amazon. Needs regular batteries. The 2.0 has a rechargeable, lithium battery that requires a USB port. Starts about $50 on Amazon. Great for mixing protein powders and liquid. Great for traveling or when you are just on the go. Although this is not dishwasher safe, it is easy to clean. Vitamix Systems
The product has been around since 1949. Prices range from $400-$720. Can make smoothies. An extended warranty is available. Ninja Systems
Ninja Fit 16 oz. Blender – Comes with two blender cups. Motor is 700 watts. One speed. Starts around $60. Nutri Ninja Pro 24-Oz. Blender – This is just for blending shakes. Motor is 900 W. Comes with 18 oz. and 24 oz. blender jars. One speed only. Starts around $100. Nutri Professional 3-Speed Blender – Comes with 72 oz. pitcher and 16 oz. cup. Price starts around $140. Ninja Auto-iQ Blender – There are several models that have the Auto-iQ cycle. This pauses through the cycle to allow food to fall towards the blades. These will have different speeds and may have both automatic and manual settings. Designed to make blended (“extracted”) smoothies using vegetables, seeds, nuts and fruits. Prices range from $120-$160. Magic Bullet/NutriBullet Systems
Magic Bullet is the original product in the line. The original can blend protein powders and fluids to create smooth protein shakes. Does a fairly good job pureeing soft, fresh fruit, canned or frozen fruit that has been thawed. Don’t expect the Magic Bullet to provide a completely smooth texture for blended or extracted smoothies. Motor is 250 watts. Starts at $40. Check to make sure whether you are buying a new or refurbished machine. NutriBullet Series comes in several models. Check websites and advertisements to find discounted prices. Most come with recipes. Check to see if parts are hand wash or dishwasher safe. NutriBullet (Original) – Eight or 12 Piece Sets. Starts around $80. Motor is 600 watts. NutriBullet Pro 900 – Nine to 15 piece sets. Starts around $100. Motor is 900 watts. NutriBulletRx – 10 piece set. Starts around $180. Motor is 1,700 watts. Has an extra heating feature to make soups or warm beverages. Could use other NutriBullets and heat product in microwave. This is larger than the original and Pro 900 machines. Other Smoothie Blenders:
Look for other personal blenders by Oster, Farberware and Elite. Immersion Blenders are hand-held blenders that you immerse in your cup or glass to blend. These can also be used to puree soft cooked vegetables and soups. More Options
Consider using a hand-held mixer to mix your protein powders and fluid together. Get a work out by using a whisk to blend the protein powder and fluid together.

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.

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.

What’s Wrong with Away-from-Home?
There is nothing wrong with eating outside the home – unless you are average. That is because the average restaurant meal has more calories, more fat, and more sugar than the average home-cooked meal. You can reverse this, though, with some awareness.
Classic Breakfast Sandwiches
The classic breakfast sandwich or burrito can have eggs, cheese, and meat. From there, the sandwich can vary widely. An egg white McMuffin from McDonald’s, for example, has 260 calories, while a Croissan‘wich with bacon and sausage from Burger King has 620 calories. Skip the butter and any fried potatoes, such as hash browns or shredded potatoes, and choose:
Ham instead of bacon or sausage. An English muffin (or nothing) instead of a bagel, biscuit, croissant, or tortilla. Egg whites instead of whole eggs. Café Choices
Coffee shops and bakery-café’s offer all kinds of fresh, tantalizing, and absolutely off-limits foods. Hint: you do not need a cinnamon roll with 50 grams of sugar to start your day. Stay away from the breakfast pastries and breakfast sandwiches on bagels. Instead, you may be best off with an “a la carte”-style breakfast. Look for items such as:
Plain oatmeal or oatmeal with nuts as an add-in. Fruit cups or whole fruit. Low-fat cream cheese – you can spread it on half of a whole-grain bagel. Smart Suggestions
Starbucks offers some hot breakfast options for under 300 calories – their egg white bites have only 170 calories – and Dunkin Donuts offers some DD Smart Wake Up Wraps for 160 to 240 calories. By the way, a Bismark donut has 490 calories. Subway offers egg whites, ham, and reduced-calorie cheese on 3-inch subs, so you can avoid too much bread.
Lunch for Breakfast
You may not need to depend on the breakfast menu if the restaurant serves lunch early in the morning. If that is the case, you may be able to get grilled chicken, turkey breast, and cheese on a salad.
Bring Your Own
There is a chance that you may not realize how easy and quick it can be to bring your own breakfast from home and avoid restaurants altogether. We understand if you have exactly zero seconds to dedicate to making your breakfast in the morning before you leave home. You can stash it in the car or fridge the night before.
If you have access to hot water before you have breakfast, these options can work:
Protein Oatmeal with an apple or some walnuts. Protein Muffins in flavors such as Blueberry, Double Chocolate, and Maple Pumpkin. Protein Hot Chocolate with milk for extra calcium or protein. If you are going to eat in the car or have no microwave at work, you’ll need something ready-to-eat. Consider:
Protein Cereal in Honey Nut, Chocolate, or other favorite flavors. Oatmeal Raisin Protein Cookies. Fruit and cottage cheese or yogurt. A Protein Bar. You can have the best of both worlds: a meal as quick and easy as a fast food meal, with nutrition that fits into your meal plan like a home-cooked meal. Way to start the day right!

Consider Macros
That is, “macronutrients,” or carbohydrates, fat, and protein. The news is bad on the surface since the average fast food meal has more carbs and less protein per calorie than the average home-cooked meal. You can work to turn this around, though.
Carbohydrates: Cut back on carbohydrates by skipping the starchy sides: French fries, potato chips, and hash browns, steamed, fried, or Mexican rice, and breadsticks. Try to go “green” (lettuce wrap) or “naked” (no wrap) with your burger, tortilla, or sandwich; if the fast food joint cannot honor your request, just eat the filling with a knife and fork, and throw away the bread, bun, tortilla, or taco shell (if you are feeling guilty because of starving children in third-world countries, make a donation. You’ll do more good than you would by adding starch to your hips).
Protein: How can you boost your protein intake at a fast food restaurant to be what you need? Skinless grilled or baked chicken, lean cold cuts, cheese, and beans can all up your totals, and yogurt is an increasingly common side option. Even a small burger patty can give you 10 to 15 grams of protein, although it comes with a few extra grams of fat.
A good protein goal for a meal is about 20-30 grams. You can get that for 200-300 calories with any of the following.
Burger King Double Cheeseburger, no bun; Grilled Chicken Garden Salad, no croutons; or Veggie Burger with cheese, no bun or mayo. McDonald’s Grilled Southwestern Chicken Salad, no cheese; or Grilled Chicken Sandwich, no bun or spread. Taco Bell 2 grilled or fresco steak soft tacos, no tortillas; chicken or steak Power Menu Bowl, no rice or cheese. KFC Grilled Chicken Drumstick plus green beans or side salad. Panda Express Grilled Teriyaki or Asian Chicken. Fats: Your first order of business is to avoid anything fried. You will be avoiding excess grease while also avoiding sneaky carbs in breading – did you know that the amounts of carbs in onion rings and fried chicken are comparable to the amounts in bread? Also, watch the fatty spreads – think mayonnaise – salad dressings, and dips.
Find the Vegetables
Protein and vegetables…does this sound familiar? It should, since your goals when eating at a fast food restaurant should be the same as when you eat at home. Vegetables help fill you up without filling you out, and it is best to eat as many of them as you can handle with your pouch or sleeve. It may take a little more digging to find vegetables at fast food restaurants than at home, but you can usually do it. Here are a few leads.
Ask for extra lettuce, tomatoes, and any other available vegetables on burgers and sandwiches. Order a side salad or baby carrots with your meal. Check for salads with grilled chicken as an entrée. Pile salsa and diced vegetables onto your naked burrito. When “Value” Isn’t
Besides the convenience, the deals are among the most tempting things about fast food. For pennies more, you can often add fries and a drink, or you could get a second burger or taco for half the price. Don’t do it!
“Value” depends on what you want and need; why would you pay extra, even if it is “only pennies more,” for extra fat, sugar, starch, and calories? A healthier definition of “value” might be to pay the least you can for a meal that is convenient, delicious, and healthy. Why include “oversized” in your definition?
For those times when fast food simply makes sense, go for it – just keep yourself on track by reading the menu carefully and staying focused. You can do it, no matter where you end up. You might as well enjoy it!

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.

Why Does It Matter?
There is an expression that goes, “Shoot for the stars and you’ll hit the moon.” The idea is that if you set your sights high but fall short, you will still achieve something great. The theory may sound good, but it may neglect to consider reality.
The truth is that for many of us, another saying is truer: “Success breeds success.” That is, when you hit one goal, you are motivated to keep working towards your next one. You build momentum as you hit goal after goal, and those goals then act like stepping stones to those proverbial stars.
The Trap of “Too Much, Too Fast”
There is a common tendency overshoot when it comes to weight loss goals. These are some reasons why.
We want to lose weight so badly that we think only of the dream goal.
Most of us tend to think of ourselves as above average – so we set our weight loss goals at higher than average.
We set deadlines that are too short because we are so focused on getting there that we forget to recognize how wonderful the journey is.
We set our goals based on what someone else lost.
Classic Failure: “All or Nothing”
One of the surest ways to set yourself up for failure is to set your weight loss goal to be too many pounds within too little time. It is comparable to the “all-or-nothing” mentality that so often comes with dieting: you are doing fine until you eat a cookie, and then you figure that the day is wasted, so you might as well finish the bag of cookies, skip your workout, and order pizza and breadsticks for dinner.
The same mentality after weight loss surgery can get you into the same trouble. If you aim for an unrealistic 20 or 30 lb. in your first month and instead hit a respectable 5 to 10 lb., the “disappointment” can discourage you so you do not try as hard.
Realistic Weight Loss
The amount of weight you can realistically expect to lose depends on your procedure, how much you have to lose, and your own drive and other individual characteristics. An average gastric bypass or sleeve patient might lose about 50% of excess weight. For example, Someone who is 5’4” tall and weighs 245 lb. has about 100 lb. of “excess” body weight and might set a goal to lose about 50 lb.
Another way to look at it is to take a rough estimate of average weight loss with your procedure for your surgeon’s patients. You might use that number as the basis for your own weight loss goal. You could also look at your final goal – say, 100 lb. down – and divide that by 1 to 2 years – in this case, a seemingly modest 1 to 2 lb. per week.
Setting Realistic Goals
For weight loss or any other goal, you can follow certain guidelines for realistic goal-setting. Set your goal to:
Include a realistic amount of weight loss.
Leave yourself enough time to achieve that amount.
Include interim goals that you can celebrate and use as motivation.
Provide for rewards as you progress, so you stay motivated.
Allow enough time for plateaus and setbacks. They will come.
Keep It in Perspective
Strange but true…weight loss is only one of many reasons to get weight loss surgery and follow a healthier lifestyle. What about…?
Gaining energy?
Getting healthier?
Feeling more confident?
Participating in more of life?
Along with setting weight loss goals, you can set other goals for healthy eating, working out, and trying new things. You will always have something to chase after and you will be able to see more progress every day.

Why Does It Matter?
There is an expression that goes, “Shoot for the stars and you’ll hit the moon.” The idea is that if you set your sights high but fall short, you will still achieve something great. The theory may sound good, but it may neglect to consider reality.
The truth is that for many of us, another saying is truer: “Success breeds success.” That is, when you hit one goal, you are motivated to keep working towards your next one. You build momentum as you hit goal after goal, and those goals then act like stepping stones to those proverbial stars.
The Trap of “Too Much, Too Fast”
There is a common tendency overshoot when it comes to weight loss goals. These are some reasons why.
We want to lose weight so badly that we think only of the dream goal.
Most of us tend to think of ourselves as above average – so we set our weight loss goals at higher than average.
We set deadlines that are too short because we are so focused on getting there that we forget to recognize how wonderful the journey is.
We set our goals based on what someone else lost.
Classic Failure: “All or Nothing”
One of the surest ways to set yourself up for failure is to set your weight loss goal to be too many pounds within too little time. It is comparable to the “all-or-nothing” mentality that so often comes with dieting: you are doing fine until you eat a cookie, and then you figure that the day is wasted, so you might as well finish the bag of cookies, skip your workout, and order pizza and breadsticks for dinner.
The same mentality after weight loss surgery can get you into the same trouble. If you aim for an unrealistic 20 or 30 lb. in your first month and instead hit a respectable 5 to 10 lb., the “disappointment” can discourage you so you do not try as hard.
Realistic Weight Loss
The amount of weight you can realistically expect to lose depends on your procedure, how much you have to lose, and your own drive and other individual characteristics. An average gastric bypass or sleeve patient might lose about 50% of excess weight. For example, Someone who is 5’4” tall and weighs 245 lb. has about 100 lb. of “excess” body weight and might set a goal to lose about 50 lb.
Another way to look at it is to take a rough estimate of average weight loss with your procedure for your surgeon’s patients. You might use that number as the basis for your own weight loss goal. You could also look at your final goal – say, 100 lb. down – and divide that by 1 to 2 years – in this case, a seemingly modest 1 to 2 lb. per week.
Setting Realistic Goals
For weight loss or any other goal, you can follow certain guidelines for realistic goal-setting. Set your goal to:
Include a realistic amount of weight loss.
Leave yourself enough time to achieve that amount.
Include interim goals that you can celebrate and use as motivation.
Provide for rewards as you progress, so you stay motivated.
Allow enough time for plateaus and setbacks. They will come.
Keep It in Perspective
Strange but true…weight loss is only one of many reasons to get weight loss surgery and follow a healthier lifestyle. What about…?
Gaining energy?
Getting healthier?
Feeling more confident?
Participating in more of life?
Along with setting weight loss goals, you can set other goals for healthy eating, working out, and trying new things. You will always have something to chase after and you will be able to see more progress every day.

Consider Macros
That is, “macronutrients,” or carbohydrates, fat, and protein. The news is bad on the surface since the average fast food meal has more carbs and less protein per calorie than the average home-cooked meal. You can work to turn this around, though.
Carbohydrates: Cut back on carbohydrates by skipping the starchy sides: French fries, potato chips, and hash browns, steamed, fried, or Mexican rice, and breadsticks. Try to go “green” (lettuce wrap) or “naked” (no wrap) with your burger, tortilla, or sandwich; if the fast food joint cannot honor your request, just eat the filling with a knife and fork, and throw away the bread, bun, tortilla, or taco shell (if you are feeling guilty because of starving children in third-world countries, make a donation. You’ll do more good than you would by adding starch to your hips).
Protein: How can you boost your protein intake at a fast food restaurant to be what you need? Skinless grilled or baked chicken, lean cold cuts, cheese, and beans can all up your totals, and yogurt is an increasingly common side option. Even a small burger patty can give you 10 to 15 grams of protein, although it comes with a few extra grams of fat.
A good protein goal for a meal is about 20-30 grams. You can get that for 200-300 calories with any of the following.
Burger King Double Cheeseburger, no bun; Grilled Chicken Garden Salad, no croutons; or Veggie Burger with cheese, no bun or mayo. McDonald’s Grilled Southwestern Chicken Salad, no cheese; or Grilled Chicken Sandwich, no bun or spread. Taco Bell 2 grilled or fresco steak soft tacos, no tortillas; chicken or steak Power Menu Bowl, no rice or cheese. KFC Grilled Chicken Drumstick plus green beans or side salad. Panda Express Grilled Teriyaki or Asian Chicken. Fats: Your first order of business is to avoid anything fried. You will be avoiding excess grease while also avoiding sneaky carbs in breading – did you know that the amounts of carbs in onion rings and fried chicken are comparable to the amounts in bread? Also, watch the fatty spreads – think mayonnaise – salad dressings, and dips.
Find the Vegetables
Protein and vegetables…does this sound familiar? It should, since your goals when eating at a fast food restaurant should be the same as when you eat at home. Vegetables help fill you up without filling you out, and it is best to eat as many of them as you can handle with your pouch or sleeve. It may take a little more digging to find vegetables at fast food restaurants than at home, but you can usually do it. Here are a few leads.
Ask for extra lettuce, tomatoes, and any other available vegetables on burgers and sandwiches. Order a side salad or baby carrots with your meal. Check for salads with grilled chicken as an entrée. Pile salsa and diced vegetables onto your naked burrito. When “Value” Isn’t
Besides the convenience, the deals are among the most tempting things about fast food. For pennies more, you can often add fries and a drink, or you could get a second burger or taco for half the price. Don’t do it!
“Value” depends on what you want and need; why would you pay extra, even if it is “only pennies more,” for extra fat, sugar, starch, and calories? A healthier definition of “value” might be to pay the least you can for a meal that is convenient, delicious, and healthy. Why include “oversized” in your definition?
For those times when fast food simply makes sense, go for it – just keep yourself on track by reading the menu carefully and staying focused. You can do it, no matter where you end up. You might as well enjoy it!

Who cares what obesity is?
You might wonder whether it matters whether obesity is a “disease” or not, especially if doctors have not managed to help you lose weight, except, possibly, your bariatric surgeon. But, the name actually does make a difference.
It gives obesity and obesity treatment more attention. It can help remove the stigma surrounding obesity. It gives doctors a mandate to treat you. It could lead to increased medical insurance coverage for obesity treatment, from diet programs to bariatric surgery. Here is why obesity is a “disease.”
Obesity meets a definition of disease comprising three criteria:
"an impairment of the normal functioning of some aspect of the body;" (changes in organ function, for example) "characteristic signs and symptoms" (excess body weight, for example) "harm or morbidity” (obesity-related complications, such as diabetes and arthritis, for example) The American Medical Association, the American Heart Association, the American College of Cardiology, and The Obesity Society are among the respected organizations who agree that obesity is a disease.
Obesity is not only a disease but an epidemic based on the number of people it affects. It affects 35% of American adults, not including the other 30% who are overweight and at risk for obesity. Nearly one out of five children are obese.
Healthcare providers can take charge.
One point of calling obesity a disease is to allow and even require, healthcare providers to treat it. No longer should they simply tell you to lose weight, or, worse, ignore the “condition” in the first place. Instead, they should provide care for obesity, including developing treatment plans and following up with you to discuss progress.
Now there is a roadmap.
Now that obesity treatment is in the realm of medical professionals, there needs to be a standard approach to treating it. The American Heart Association, along with the American College of Cardiology and The Obesity Society, have published clear guidelines for treating obesity.
Identify at-risk patients and patients with obesity using BMI, and monitor them at each appointment. Enroll patients with BMI of 30 or over in a medically-supervised weight loss program (note: this is not the same as your doctor telling you to eat less and lose weight on your own!) Keep weight loss surgery in mind for patients with extreme obesity and an obesity-related condition). Weight loss surgery is a recognized treatment for obesity.
The third prong of the roadmap is especially important if you are considering weight loss surgery. The recommendation to consider it when treating high-risk patients has a few effects.
It reduces stigma, from primary care physicians and your other regular doctors, surrounding WLS. It increases the number of patients who may have WLS covered by insurance. It encourages patients and professionals alike to learn about WLS. No longer is weight loss surgery considered to be an extreme or fringe approach. The ASMBS states that experts who agree that bariatric surgery has a role in obesity treatment also include the American Association of Clinical Endocrinologists, the American Diabetes Association, Centers for Medicare & Medicaid Services (CMS), and the National Institutes of Health (NIH).
Further progress is needed.
There is still much to be done in the medical arena. Healthcare professionals aside from bariatric specialists are often still in the dark about recognizing obesity and treating it. Worse, many still have stigma or bias against overweight patients, and still, engage in patient-blaming.
Obesity almost certainly has genetic components along with lifestyle factors. While it may be a disease, it is also a disease that you can work to treat. Now that it has officially been recognized as a disease, let us hope that patients and healthcare professionals can work hand-in-hand, each doing their part to fight obesity.