Alex Brecher

Unicorns are symbols of healing and peaceful strength, but what kind of magic do you get from a Unicorn Frappuccino? It is not the magic you want as a weight loss surgery patient. Here is the truth about the drink that is less magical than it is terrifying. To set the stage, let us tell you that an actual health department warned consumers about the drink on its Facebook page!
Does This Drink Make My Butt Look Big?
Well, yeah, kinda. The standard 16-oz Grande Frappuccino with whole milk and whipped cream has 410 calories. That may be a third or more of your daily goal, and those calories are not from filling nutrients. Most of them are from simple sugars that spike your blood sugar levels and lead to hunger within an hour or two. Cave into your craving for the 24-oz Venti blend, and you are looking at 500 calories. they are not the filling kind.
Sugar for a Day…or Week
The real problem here is the sugar. The exceedingly high sugar content is no surprise when you consider that sugar is an ingredient in the drink’s combination of Frappuccino syrup, mango syrup, blue drizzle, and classic syrup. The default Grande with whole milk has 59 grams of sugar. To put this into perspective, that is about twice the maximum amount of added sugars you should have in a day according to experts including the World Health Organization and the American Heart Association.
Sugar has empty calories without essential nutrients; it bumps up your blood sugar and is linked to diabetes, and it makes weight loss even harder because it leads to more sugar and carb cravings. The lowest sugar version is an improvement, but still nothing to brag about. A tall 12-oz Unicorn Frappuccino made with almond milk has 33 grams of sugar, still more than your daily maximum goal.
Where Is the Protein?
As a weight loss surgery patient, you are probably aiming for at least 65 grams of filling protein per day. A simple rule of thumb when choosing your healthy foods and beverages is to make sure you get at least 2 grams of protein for every gram of sugar. A Unicorn Frappuccino is not going to help much! When you get a Grande, you are getting only 5 grams of protein – so you should limit sugar to 2.5 grams, not the 59 grams of sugar that are actually in the drink! You would really need some unicorn magic to help you justify that kind of choice
Beware Dumping Syndrome
Unicorn horns are reputed to be powerful antidotes to toxins, but this drink might put you in search of some magical healing powers! If you are prone to dumping syndrome, especially after gastric sleeve or gastric bypass surgery, beware the Unicorn Frappuccino. Besides weight loss and cravings, there is another reason your surgeon and nutritionist suggest limiting sugar intake: dumping syndrome. If you are prone, you might want to take your Frappuccino back home before you start drinking it, because you may want to be pretty close to a bathroom!
Delicious and Nutritious Alternatives
Weight loss-wise, you can do way better than a Unicorn Frappuccino without feeling deprived. If you want the taste of mango, try an Aloha Mango Smoothie. Blue Raspberry Protein Drink may do the trick if you want sweet and tart. Vanilla Cappuccino can give you the sweet, creamy flavor that can take you to a fantasy land. Each of these choices has 15 grams of protein and no more than 4 grams of protein. Now that is magic!

Unicorns are symbols of healing and peaceful strength, but what kind of magic do you get from a Unicorn Frappuccino? It is not the magic you want as a weight loss surgery patient. Here is the truth about the drink that is less magical than it is terrifying. To set the stage, let us tell you that an actual health department warned consumers about the drink on its Facebook page!
Does This Drink Make My Butt Look Big?
Well, yeah, kinda. The standard 16-oz Grande Frappuccino with whole milk and whipped cream has 410 calories. That may be a third or more of your daily goal, and those calories are not from filling nutrients. Most of them are from simple sugars that spike your blood sugar levels and lead to hunger within an hour or two. Cave into your craving for the 24-oz Venti blend, and you are looking at 500 calories. they are not the filling kind.
Sugar for a Day…or Week
The real problem here is the sugar. The exceedingly high sugar content is no surprise when you consider that sugar is an ingredient in the drink’s combination of Frappuccino syrup, mango syrup, blue drizzle, and classic syrup. The default Grande with whole milk has 59 grams of sugar. To put this into perspective, that is about twice the maximum amount of added sugars you should have in a day according to experts including the World Health Organization and the American Heart Association.
Sugar has empty calories without essential nutrients; it bumps up your blood sugar and is linked to diabetes, and it makes weight loss even harder because it leads to more sugar and carb cravings. The lowest sugar version is an improvement, but still nothing to brag about. A tall 12-oz Unicorn Frappuccino made with almond milk has 33 grams of sugar, still more than your daily maximum goal.
Where Is the Protein?
As a weight loss surgery patient, you are probably aiming for at least 65 grams of filling protein per day. A simple rule of thumb when choosing your healthy foods and beverages is to make sure you get at least 2 grams of protein for every gram of sugar. A Unicorn Frappuccino is not going to help much! When you get a Grande, you are getting only 5 grams of protein – so you should limit sugar to 2.5 grams, not the 59 grams of sugar that are actually in the drink! You would really need some unicorn magic to help you justify that kind of choice
Beware Dumping Syndrome
Unicorn horns are reputed to be powerful antidotes to toxins, but this drink might put you in search of some magical healing powers! If you are prone to dumping syndrome, especially after gastric sleeve or gastric bypass surgery, beware the Unicorn Frappuccino. Besides weight loss and cravings, there is another reason your surgeon and nutritionist suggest limiting sugar intake: dumping syndrome. If you are prone, you might want to take your Frappuccino back home before you start drinking it, because you may want to be pretty close to a bathroom!
Delicious and Nutritious Alternatives
Weight loss-wise, you can do way better than a Unicorn Frappuccino without feeling deprived. If you want the taste of mango, try an Aloha Mango Smoothie. Blue Raspberry Protein Drink may do the trick if you want sweet and tart. Vanilla Cappuccino can give you the sweet, creamy flavor that can take you to a fantasy land. Each of these choices has 15 grams of protein and no more than 4 grams of protein. Now that is magic!

Unicorns are symbols of healing and peaceful strength, but what kind of magic do you get from a Unicorn Frappuccino? It is not the magic you want as a weight loss surgery patient. Here is the truth about the drink that is less magical than it is terrifying. To set the stage, let us tell you that an actual health department warned consumers about the drink on its Facebook page!
Does This Drink Make My Butt Look Big?
Well, yeah, kinda. The standard 16-oz Grande Frappuccino with whole milk and whipped cream has 410 calories. That may be a third or more of your daily goal, and those calories are not from filling nutrients. Most of them are from simple sugars that spike your blood sugar levels and lead to hunger within an hour or two. Cave into your craving for the 24-oz Venti blend, and you are looking at 500 calories. they are not the filling kind.
Sugar for a Day…or Week
The real problem here is the sugar. The exceedingly high sugar content is no surprise when you consider that sugar is an ingredient in the drink’s combination of Frappuccino syrup, mango syrup, blue drizzle, and classic syrup. The default Grande with whole milk has 59 grams of sugar. To put this into perspective, that is about twice the maximum amount of added sugars you should have in a day according to experts including the World Health Organization and the American Heart Association.
Sugar has empty calories without essential nutrients; it bumps up your blood sugar and is linked to diabetes, and it makes weight loss even harder because it leads to more sugar and carb cravings. The lowest sugar version is an improvement, but still nothing to brag about. A tall 12-oz Unicorn Frappuccino made with almond milk has 33 grams of sugar, still more than your daily maximum goal.
Where Is the Protein?
As a weight loss surgery patient, you are probably aiming for at least 65 grams of filling protein per day. A simple rule of thumb when choosing your healthy foods and beverages is to make sure you get at least 2 grams of protein for every gram of sugar. A Unicorn Frappuccino is not going to help much! When you get a Grande, you are getting only 5 grams of protein – so you should limit sugar to 2.5 grams, not the 59 grams of sugar that are actually in the drink! You would really need some unicorn magic to help you justify that kind of choice
Beware Dumping Syndrome
Unicorn horns are reputed to be powerful antidotes to toxins, but this drink might put you in search of some magical healing powers! If you are prone to dumping syndrome, especially after gastric sleeve or gastric bypass surgery, beware the Unicorn Frappuccino. Besides weight loss and cravings, there is another reason your surgeon and nutritionist suggest limiting sugar intake: dumping syndrome. If you are prone, you might want to take your Frappuccino back home before you start drinking it, because you may want to be pretty close to a bathroom!
Delicious and Nutritious Alternatives
Weight loss-wise, you can do way better than a Unicorn Frappuccino without feeling deprived. If you want the taste of mango, try an Aloha Mango Smoothie. Blue Raspberry Protein Drink may do the trick if you want sweet and tart. Vanilla Cappuccino can give you the sweet, creamy flavor that can take you to a fantasy land. Each of these choices has 15 grams of protein and no more than 4 grams of protein. Now that is magic!

How do you know whether weight loss surgery is for you? Will it be the weight control solution you have been searching for for years? Or will it be a decision you regret? Nobody can answer that for you, but here are some considerations as you think about whether weight loss surgery is for you.
The Qualifying Criteria
You are not a candidate for bariatric surgery unless you meet certain criteria set by your surgeon or, if applicable, your healthcare coverage plan. The standard criteria are:
Body Mass Index (BMI) over 40 or BMI 35 with an obesity-related comorbidity, such as type 2 diabetes, high cholesterol, or sleep apnea. Confirmation that your obesity is not caused by an underlying condition that would make weight loss surgery ineffective. A psychological exam to show that you are capable of sticking to the post-op diet and lifestyle changes that are necessary. Previous documented attempts at losing weight with diet and exercise. Ineffectiveness of Previous Efforts
Weight loss surgery is a last resort, not a first try at losing weight. It is for patients who have been obese for years and who have tried to lose weight using lifestyle changes, such as a modified diet plan and a formal exercise program. Many weight loss surgery patients try “every diet under the sun” before deciding that it is time for WLS. They may have had trouble losing any weight at all, or may have lost weight initially but been unable to keep it off.
Readiness to Change
Weight loss surgery is just the beginning. The way you eat after weight loss surgery determines how well you will be able to control your weight for the rest of your life. You need to be ready to change if you want to be successful with weight loss surgery. No longer will you be able to down a pizza or hit the drive-through on a whim.
Are you ready to possibly:
Give up coffee and regular and diet soda? Cut sugary treats and fried foods, especially with gastric bypass? Pass on the alcoholic offerings at home, parties, and restaurants? Count protein, slash carbs, and measure portions? Addressing Other Issues
Weight gain does not always take place in a vacuum, and weight loss does not solve other problems you might have in your life. First, identify why you became overweight in the first place, and what is keeping you from losing the weight. Is weight loss surgery the answer, or do you need to first deal with an abusive relationship or lack of self-confidence, for example?
Emotional eating is a common reason for weight gain. If you tend to eat your feelings away, you are best off figuring out other ways to handle your feelings before you get surgery. Can you use walking as a form of therapy? Maybe you can join an in-person or online support group to turn to when you feel sad, lonely, or angry.
If your emotional eating is related to a specific problem, such as stress at work, your best bet may be to handle the problem before getting WLS. That could mean finding a healthy coping mechanism, or it could mean getting counseling to help you work through the source of stress. It could even mean finding a new job, as scary as that sounds.
Consider Replacement Addictions
Replacement addictions are common after weight loss surgery. They happen when you give up food – which can be an addiction – for a different addiction. Instead of turning to food for comfort, entertainment, or companionship, some weight loss surgery patients turn to “replacement addictions” or “cross addictions” They may take up smoking, or start to abuse alcohol. Replacement addictions can also be healthier than eating; some weight loss surgery patients become gym rats or take up gardening, sewing, or other hobbies.
As you consider weight-loss surgery, think about the possibility of food addiction being replaced by replacement addictions. What role does food play in your life now? What do you see replacing that emotional or physical role after surgery?
The decision to get weight loss surgery requires a lot of soul searching for most candidates. These points can help you work through some of the doubts you may have as you try to decide what is best for yourself.

How do you know whether weight loss surgery is for you? Will it be the weight control solution you have been searching for for years? Or will it be a decision you regret? Nobody can answer that for you, but here are some considerations as you think about whether weight loss surgery is for you.
The Qualifying Criteria
You are not a candidate for bariatric surgery unless you meet certain criteria set by your surgeon or, if applicable, your healthcare coverage plan. The standard criteria are:
Body Mass Index (BMI) over 40 or BMI 35 with an obesity-related comorbidity, such as type 2 diabetes, high cholesterol, or sleep apnea. Confirmation that your obesity is not caused by an underlying condition that would make weight loss surgery ineffective. A psychological exam to show that you are capable of sticking to the post-op diet and lifestyle changes that are necessary. Previous documented attempts at losing weight with diet and exercise. Ineffectiveness of Previous Efforts
Weight loss surgery is a last resort, not a first try at losing weight. It is for patients who have been obese for years and who have tried to lose weight using lifestyle changes, such as a modified diet plan and a formal exercise program. Many weight loss surgery patients try “every diet under the sun” before deciding that it is time for WLS. They may have had trouble losing any weight at all, or may have lost weight initially but been unable to keep it off.
Readiness to Change
Weight loss surgery is just the beginning. The way you eat after weight loss surgery determines how well you will be able to control your weight for the rest of your life. You need to be ready to change if you want to be successful with weight loss surgery. No longer will you be able to down a pizza or hit the drive-through on a whim.
Are you ready to possibly:
Give up coffee and regular and diet soda? Cut sugary treats and fried foods, especially with gastric bypass? Pass on the alcoholic offerings at home, parties, and restaurants? Count protein, slash carbs, and measure portions? Addressing Other Issues
Weight gain does not always take place in a vacuum, and weight loss does not solve other problems you might have in your life. First, identify why you became overweight in the first place, and what is keeping you from losing the weight. Is weight loss surgery the answer, or do you need to first deal with an abusive relationship or lack of self-confidence, for example?
Emotional eating is a common reason for weight gain. If you tend to eat your feelings away, you are best off figuring out other ways to handle your feelings before you get surgery. Can you use walking as a form of therapy? Maybe you can join an in-person or online support group to turn to when you feel sad, lonely, or angry.
If your emotional eating is related to a specific problem, such as stress at work, your best bet may be to handle the problem before getting WLS. That could mean finding a healthy coping mechanism, or it could mean getting counseling to help you work through the source of stress. It could even mean finding a new job, as scary as that sounds.
Consider Replacement Addictions
Replacement addictions are common after weight loss surgery. They happen when you give up food – which can be an addiction – for a different addiction. Instead of turning to food for comfort, entertainment, or companionship, some weight loss surgery patients turn to “replacement addictions” or “cross addictions” They may take up smoking, or start to abuse alcohol. Replacement addictions can also be healthier than eating; some weight loss surgery patients become gym rats or take up gardening, sewing, or other hobbies.
As you consider weight-loss surgery, think about the possibility of food addiction being replaced by replacement addictions. What role does food play in your life now? What do you see replacing that emotional or physical role after surgery?
The decision to get weight loss surgery requires a lot of soul searching for most candidates. These points can help you work through some of the doubts you may have as you try to decide what is best for yourself.

Ask Questions
Your advocate should get the information you need. Ask your surgeon how you can best prepare for surgery, what you can do to recover faster, and which mistakes he or she sees most often so you can avoid them. Find out how to contact your surgeon for post-op questions, and learn where you can go for support group meetings.
You will need to ask plenty of other questions, too! As your own advocate, don’t be shy about asking anyone about anything. Read everything you can online and on BariatricPal, then use the forums to ask about anything you’re not sure about. You are sure to get all kinds of helpful hints that you never expected!
Provide for Your Needs
Life does throw curve balls, but your basic needs stay predictable. You know which foods and fluids you will need in any given day, so make sure you have them. Plan your menu for each day and go grocery shopping for the week so you are sure to always have the food you need around.
Always keep a stash of “extras” in case of unplanned circumstances. Have instant protein meals and other staples in your pantry for last-minute meals. Keep protein bars and nuts in your car, your gym bag, and at work. Have different flavors of protein powder for whenever you find yourself hungry and without other options.
You can also help yourself out by planning ahead. For example, if you’re going to a party, make sure you will have the foods that you will need for that time without needing to wait until after the party to eat or depending on the host to provide healthy proteins. Stick a protein bar or some nuts in your pocket or purse, or bring a healthy dish to share and nibble on yourself.
Be Your Own Planner
If you were taking care of a child with certain needs, you would schedule them in, make sure your child had the materials needed, and get your child to where he needed to go. If you have children, you may keep track of their homework, take them to after-school activities, and make sure they get the nutritious meals and proper sleep that they need. You would keep healthy foods around and provide them with the pencils and sports equipment that they need for school and extracurricular activities.
Why wouldn’t you be just as good to yourself? Provide the same level of self-care for yourself as you do for your family. Keep healthy foods on hand, and schedule your own exercise and meal planning in and keep your commitment just like it was school.
Prioritize your commitments, just like you would do for your children. Your meal prep and workout time is important, but so is relaxation time with your family or friends, or by yourself. Over the long term, balancing work and play can keep you on track but satisfied.
Speak up When Necessary
Keeping quiet can sometimes seem easier or more considerate to others, but keeping a low profile can work against you sometimes. Learn when it makes sense to speak up for yourself. For example, at restaurants, the server may be willing to bring you what you ask for (like a slab of plain chicken breast or the kids’ meal), but will not even know that is what you want (and need) if you do not say something out loud. You may find that you need to explain your weight loss surgery as a medical condition to get your server to honor your request.
These are some other times when you should not keep your mouth shut:
When someone pressures you to eat something that's not on your diet. When you do not understand your surgeon’s or nutritionist’s instructions. When you need help around the house or preparing your food. Learning to be your own best advocate can pay off in a big way, as you will always have someone looking out for your best interests. It is one more thing you can do to help yourself succeed in your WLS journey.

Ask Questions
Your advocate should get the information you need. Ask your surgeon how you can best prepare for surgery, what you can do to recover faster, and which mistakes he or she sees most often so you can avoid them. Find out how to contact your surgeon for post-op questions, and learn where you can go for support group meetings.
You will need to ask plenty of other questions, too! As your own advocate, don’t be shy about asking anyone about anything. Read everything you can online and on BariatricPal, then use the forums to ask about anything you’re not sure about. You are sure to get all kinds of helpful hints that you never expected!
Provide for Your Needs
Life does throw curve balls, but your basic needs stay predictable. You know which foods and fluids you will need in any given day, so make sure you have them. Plan your menu for each day and go grocery shopping for the week so you are sure to always have the food you need around.
Always keep a stash of “extras” in case of unplanned circumstances. Have instant protein meals and other staples in your pantry for last-minute meals. Keep protein bars and nuts in your car, your gym bag, and at work. Have different flavors of protein powder for whenever you find yourself hungry and without other options.
You can also help yourself out by planning ahead. For example, if you’re going to a party, make sure you will have the foods that you will need for that time without needing to wait until after the party to eat or depending on the host to provide healthy proteins. Stick a protein bar or some nuts in your pocket or purse, or bring a healthy dish to share and nibble on yourself.
Be Your Own Planner
If you were taking care of a child with certain needs, you would schedule them in, make sure your child had the materials needed, and get your child to where he needed to go. If you have children, you may keep track of their homework, take them to after-school activities, and make sure they get the nutritious meals and proper sleep that they need. You would keep healthy foods around and provide them with the pencils and sports equipment that they need for school and extracurricular activities.
Why wouldn’t you be just as good to yourself? Provide the same level of self-care for yourself as you do for your family. Keep healthy foods on hand, and schedule your own exercise and meal planning in and keep your commitment just like it was school.
Prioritize your commitments, just like you would do for your children. Your meal prep and workout time is important, but so is relaxation time with your family or friends, or by yourself. Over the long term, balancing work and play can keep you on track but satisfied.
Speak up When Necessary
Keeping quiet can sometimes seem easier or more considerate to others, but keeping a low profile can work against you sometimes. Learn when it makes sense to speak up for yourself. For example, at restaurants, the server may be willing to bring you what you ask for (like a slab of plain chicken breast or the kids’ meal), but will not even know that is what you want (and need) if you do not say something out loud. You may find that you need to explain your weight loss surgery as a medical condition to get your server to honor your request.
These are some other times when you should not keep your mouth shut:
When someone pressures you to eat something that's not on your diet. When you do not understand your surgeon’s or nutritionist’s instructions. When you need help around the house or preparing your food. Learning to be your own best advocate can pay off in a big way, as you will always have someone looking out for your best interests. It is one more thing you can do to help yourself succeed in your WLS journey.

Why Does It Matter?
Support during your Weight Loss Surgery journey can help you succeed. It is motivating to know that the people who love you are on your side. Through the long days of diet restrictions and dramatic lifestyle changes, your journey will be easier if your family members and friends pitch in however they can, whether with verbal encouragement or concrete changes such as avoiding eating off-limits foods in front of you.
Still, it is important to remember that you CAN succeed, whether or not you get the support you hope for.
Get to the Heart of the Matter
First, make sure you know why they are against your weight loss surgery. It is often because they are afraid for your safety. They may know people – or know people who know people who know people – who had complications from Weight Loss Surgery. You can talk to them about the real risks of surgery – using statistics rather than hearsay – compared to the risks of remaining overweight.
Still, do not assume that your safety is why they are negative about your decision. It is important to let them express their concerns and to address them directly. These are some other common reasons why your family and friends might have a negative gut reaction to your exciting news.

They may be worried that you won’t be able to stick to the Weight Loss Surgery diet, and that you’ll be disappointed with the results.
They may think you don’t need it. A lot of family members have trouble seeing how overweight you are, and understanding how much it interferes with your life and health.
They may feel insulted. Parents especially may feel as though they have failed if they see you, their child, opt for surgery.
They may feel threatened. Your significant other, for example, may be comfortable in the relationship you have had for years, and may worry that the way you feel about him/her will change as you lose weight.
They may not know what it means for them. Friends may worry that you won’t want to hang out with them anymore, especially if your time together tends to revolve around food or if they think of you as their dependable “fat friend.”

Whatever the true concern is, address it directly. Reassure your friends and family that you are doing this for you, and that you will not become a different person.
Offer Them a Role
Some friends and family members may feel overwhelmed by your news of Weight Loss Surgery, and that can lead to their negative response. Surprisingly, offering them ways to be more involved in the experience can actually help change their minds. They may feel better about your WLS once you tell them the details about the prep, procedure, and diet, and may even be grateful if you let them know specifically what they can do to help.
Address Meal Times Directly
Food is central to relationships at home and in social settings, so it is understandable if your loved ones are worried about how your upcoming Weight Loss Surgery will affect the time you spend together. If you think this may be a concern, discuss meals at home and in restaurants with your friends and family. Let them know that you will still be present at the table and interested in being good company, even if you are not eating as much as them or ordering the exact foods that they are. If you are comfortable with the situation, they are more likely to be.
Agree to Disagree
In most cases, family members mean well. It may be hard to remember or see in the heat of the moment, but they often do genuinely want the very best for you. If you have already tried your hardest to convince them to support your Weight Loss Surgery decision and they are not ready to do so, your next hope is to keep them as an ally in other aspects of your life.
Hopefully, you and they can agree to disagree about your Weight Loss Surgery. You can let them know that you respect their opinion and will not be pressuring them to support your WLS. In exchange, you can ask them to continue to be your friend regardless of whether you are a bariatric surgery patient.
Be Patient
Sometimes, it just takes time. Your own Weight Loss Surgery success may be the best argument for why your loved ones should support you. It may take weeks, months, or a year, but they may come around as they see how happy you are, and as they realize how much they miss you.
Bariatric surgery is a lot easier when everyone you love supports your decision, but that’s not always the case. Don’t let resistance from family members and friends get you down, though. They’re probably trying to act in your best interest, and in most cases, you can still get Weight Loss Surgery while keeping strong relationships with them.

Why Does It Matter?
Support during your Weight Loss Surgery journey can help you succeed. It is motivating to know that the people who love you are on your side. Through the long days of diet restrictions and dramatic lifestyle changes, your journey will be easier if your family members and friends pitch in however they can, whether with verbal encouragement or concrete changes such as avoiding eating off-limits foods in front of you.
Still, it is important to remember that you CAN succeed, whether or not you get the support you hope for.
Get to the Heart of the Matter
First, make sure you know why they are against your weight loss surgery. It is often because they are afraid for your safety. They may know people – or know people who know people who know people – who had complications from Weight Loss Surgery. You can talk to them about the real risks of surgery – using statistics rather than hearsay – compared to the risks of remaining overweight.
Still, do not assume that your safety is why they are negative about your decision. It is important to let them express their concerns and to address them directly. These are some other common reasons why your family and friends might have a negative gut reaction to your exciting news.

They may be worried that you won’t be able to stick to the Weight Loss Surgery diet, and that you’ll be disappointed with the results.
They may think you don’t need it. A lot of family members have trouble seeing how overweight you are, and understanding how much it interferes with your life and health.
They may feel insulted. Parents especially may feel as though they have failed if they see you, their child, opt for surgery.
They may feel threatened. Your significant other, for example, may be comfortable in the relationship you have had for years, and may worry that the way you feel about him/her will change as you lose weight.
They may not know what it means for them. Friends may worry that you won’t want to hang out with them anymore, especially if your time together tends to revolve around food or if they think of you as their dependable “fat friend.”

Whatever the true concern is, address it directly. Reassure your friends and family that you are doing this for you, and that you will not become a different person.
Offer Them a Role
Some friends and family members may feel overwhelmed by your news of Weight Loss Surgery, and that can lead to their negative response. Surprisingly, offering them ways to be more involved in the experience can actually help change their minds. They may feel better about your WLS once you tell them the details about the prep, procedure, and diet, and may even be grateful if you let them know specifically what they can do to help.
Address Meal Times Directly
Food is central to relationships at home and in social settings, so it is understandable if your loved ones are worried about how your upcoming Weight Loss Surgery will affect the time you spend together. If you think this may be a concern, discuss meals at home and in restaurants with your friends and family. Let them know that you will still be present at the table and interested in being good company, even if you are not eating as much as them or ordering the exact foods that they are. If you are comfortable with the situation, they are more likely to be.
Agree to Disagree
In most cases, family members mean well. It may be hard to remember or see in the heat of the moment, but they often do genuinely want the very best for you. If you have already tried your hardest to convince them to support your Weight Loss Surgery decision and they are not ready to do so, your next hope is to keep them as an ally in other aspects of your life.
Hopefully, you and they can agree to disagree about your Weight Loss Surgery. You can let them know that you respect their opinion and will not be pressuring them to support your WLS. In exchange, you can ask them to continue to be your friend regardless of whether you are a bariatric surgery patient.
Be Patient
Sometimes, it just takes time. Your own Weight Loss Surgery success may be the best argument for why your loved ones should support you. It may take weeks, months, or a year, but they may come around as they see how happy you are, and as they realize how much they miss you.
Bariatric surgery is a lot easier when everyone you love supports your decision, but that’s not always the case. Don’t let resistance from family members and friends get you down, though. They’re probably trying to act in your best interest, and in most cases, you can still get Weight Loss Surgery while keeping strong relationships with them.

I have worked as a psychologist, providing psychological evaluations prior to bariatric weight loss surgery for the past eight years. For the most part, people need a power tool to help them lose and keep off the weight they have lost over and over again in their lives. The gastric sleeve, bypass, and now balloon are those tools. However, every once in a while, I will encounter someone who believes these procedures are the magic bullet.
I can pick this up in five seconds when I learn that:
this person has no exercise plan to maintain their weight loss a barrage of excuses as to why they can't exercise anymore zero insight into why they are overweight ("I don't know why I am overweight, I just eat steamed vegetables and grilled chicken mostly.") a lack of motivation or understanding for why they also have to engage in behavioral modification in addition to the surgery "Why would you reveal all of this?" you ask. Aren't I giving away the keys to the kingdom to anyone who reads this and wants to pass a psychological evaluation? Perhaps- but who are you really cheating if you don't go within and face the real demons that got you here in the first place?
When I ask people about their eating styles, I tend to group them into four categories:
1) emotional eater- someone who uses food when they are bored, stressed, tired, lonely, sad, or even happy in addition to eating when they are hungry
2) skip and binger- someone who fails to think about food until it is too late, and when they are ravenous end up going for whatever is available which is usually some type of carb and calorie laden fast food
3) miscellaneous- someone who just recognizes that they eat too large of portion sizes and/or the wrong types of food
4) food addict- usually someone with a history of other addictions, trauma, and a significant amount of weight to lose. They usually have comorbid psychological diagnoses that have been unaddressed or ill-addressed.
Out of the four categories, the 4th is the most troubling for a psychologist. This particular person is most correlated with the patient who fails to address their core issues, eats "around the sleeve," or bypass, experiences dumping syndrome, comes back a year later and asks for the bypass, or a different procedure.
This is the person who, ironically, is usually the most resistant to my recommendation that they seek therapeutic support prior to the surgery. They want it done YESTERDAY. They want it NOW. It is this type of thinking that got them into trouble in the first place. The impulsivity and lack of emotional regulation.
I've witnessed people fail to address their maladaptive eating patterns and never quite get to their goal weight. I had a male that would buy a bag of pepperonis at the grocery store and snack on them all day and couldn't understand why he wasn't losing weight. This daily "snack," which was a mental security blanket, served as a veritable IV drip of fat and calories throughout the day.
I've had a woman who figured out how to ground up her favorite foods into a liquid form because she never quite let go of her attachment to "comfort foods." One of her most notable liquid concoctions consisted of chicken and Cheetos. I'll just leave that for you to chew...er swallow.
They say with drug and alcohol recovery- you "slay the dragon," but with food addiction recovery, you have to take it for a walk three times a day. If you don't fundamentally shift your relationship with this dragon, you're going to get burnt when you are walking it.
My number one tip for transforming your relationship with food is to start looking at eating the same way you do as brushing and flossing: You don't necessarily salivate at the idea of what type of toothpaste you will use, where you will do it, who you will do it with, right? You just do it twice a day because you don't want to lose your teeth and you want to maintain healthy gums.
Food has to be thought of in the same way. You fuel up. You don't use food as a place to define your quality of life. You don't use food to celebrate. You don't use food to demarcate the end of a long day. You don't use food to help you feel less alone. You figure out healthier coping alternatives to meet these needs.
Loneliness-call a friend for support
Celebrate- get a massage
Demarcate the end of a long day- start a tea ritual and use essential oils
Another reason you must say goodbye to comfort food is that it triggers the pleasure center of the brain, which ignites our dopamine, which perpetuates the addiction. Many people think we are just telling them to get rid of the comfort food because of the carbs or calories, but there are unique and harmful chemical consequences to ingesting these types of food we know are bad for us.
If you are ready to take a modern approach to weight loss and stop dieting for good- check out my wls/vsg psychological support course here for free.

Ask Questions
Your advocate should get the information you need. Ask your surgeon how you can best prepare for surgery, what you can do to recover faster, and which mistakes he or she sees most often so you can avoid them. Find out how to contact your surgeon for post-op questions, and learn where you can go for support group meetings.
You will need to ask plenty of other questions, too! As your own advocate, don’t be shy about asking anyone about anything. Read everything you can online and on BariatricPal, then use the forums to ask about anything you’re not sure about. You are sure to get all kinds of helpful hints that you never expected!
Provide for Your Needs
Life does throw curve balls, but your basic needs stay predictable. You know which foods and fluids you will need in any given day, so make sure you have them. Plan your menu for each day and go grocery shopping for the week so you are sure to always have the food you need around.
Always keep a stash of “extras” in case of unplanned circumstances. Have instant protein meals and other staples in your pantry for last-minute meals. Keep protein bars and nuts in your car, your gym bag, and at work. Have different flavors of protein powder for whenever you find yourself hungry and without other options.
You can also help yourself out by planning ahead. For example, if you’re going to a party, make sure you will have the foods that you will need for that time without needing to wait until after the party to eat or depending on the host to provide healthy proteins. Stick a protein bar or some nuts in your pocket or purse, or bring a healthy dish to share and nibble on yourself.
Be Your Own Planner
If you were taking care of a child with certain needs, you would schedule them in, make sure your child had the materials needed, and get your child to where he needed to go. If you have children, you may keep track of their homework, take them to after-school activities, and make sure they get the nutritious meals and proper sleep that they need. You would keep healthy foods around and provide them with the pencils and sports equipment that they need for school and extracurricular activities.
Why wouldn’t you be just as good to yourself? Provide the same level of self-care for yourself as you do for your family. Keep healthy foods on hand, and schedule your own exercise and meal planning in and keep your commitment just like it was school.
Prioritize your commitments, just like you would do for your children. Your meal prep and workout time is important, but so is relaxation time with your family or friends, or by yourself. Over the long term, balancing work and play can keep you on track but satisfied.
Speak up When Necessary
Keeping quiet can sometimes seem easier or more considerate to others, but keeping a low profile can work against you sometimes. Learn when it makes sense to speak up for yourself. For example, at restaurants, the server may be willing to bring you what you ask for (like a slab of plain chicken breast or the kids’ meal), but will not even know that is what you want (and need) if you do not say something out loud. You may find that you need to explain your weight loss surgery as a medical condition to get your server to honor your request.
These are some other times when you should not keep your mouth shut:
When someone pressures you to eat something that's not on your diet. When you do not understand your surgeon’s or nutritionist’s instructions. When you need help around the house or preparing your food. Learning to be your own best advocate can pay off in a big way, as you will always have someone looking out for your best interests. It is one more thing you can do to help yourself succeed in your WLS journey.

Ask Questions
Your advocate should get the information you need. Ask your surgeon how you can best prepare for surgery, what you can do to recover faster, and which mistakes he or she sees most often so you can avoid them. Find out how to contact your surgeon for post-op questions, and learn where you can go for support group meetings.
You will need to ask plenty of other questions, too! As your own advocate, don’t be shy about asking anyone about anything. Read everything you can online and on BariatricPal, then use the forums to ask about anything you’re not sure about. You are sure to get all kinds of helpful hints that you never expected!
Provide for Your Needs
Life does throw curve balls, but your basic needs stay predictable. You know which foods and fluids you will need in any given day, so make sure you have them. Plan your menu for each day and go grocery shopping for the week so you are sure to always have the food you need around.
Always keep a stash of “extras” in case of unplanned circumstances. Have instant protein meals and other staples in your pantry for last-minute meals. Keep protein bars and nuts in your car, your gym bag, and at work. Have different flavors of protein powder for whenever you find yourself hungry and without other options.
You can also help yourself out by planning ahead. For example, if you’re going to a party, make sure you will have the foods that you will need for that time without needing to wait until after the party to eat or depending on the host to provide healthy proteins. Stick a protein bar or some nuts in your pocket or purse, or bring a healthy dish to share and nibble on yourself.
Be Your Own Planner
If you were taking care of a child with certain needs, you would schedule them in, make sure your child had the materials needed, and get your child to where he needed to go. If you have children, you may keep track of their homework, take them to after-school activities, and make sure they get the nutritious meals and proper sleep that they need. You would keep healthy foods around and provide them with the pencils and sports equipment that they need for school and extracurricular activities.
Why wouldn’t you be just as good to yourself? Provide the same level of self-care for yourself as you do for your family. Keep healthy foods on hand, and schedule your own exercise and meal planning in and keep your commitment just like it was school.
Prioritize your commitments, just like you would do for your children. Your meal prep and workout time is important, but so is relaxation time with your family or friends, or by yourself. Over the long term, balancing work and play can keep you on track but satisfied.
Speak up When Necessary
Keeping quiet can sometimes seem easier or more considerate to others, but keeping a low profile can work against you sometimes. Learn when it makes sense to speak up for yourself. For example, at restaurants, the server may be willing to bring you what you ask for (like a slab of plain chicken breast or the kids’ meal), but will not even know that is what you want (and need) if you do not say something out loud. You may find that you need to explain your weight loss surgery as a medical condition to get your server to honor your request.
These are some other times when you should not keep your mouth shut:
When someone pressures you to eat something that's not on your diet. When you do not understand your surgeon’s or nutritionist’s instructions. When you need help around the house or preparing your food. Learning to be your own best advocate can pay off in a big way, as you will always have someone looking out for your best interests. It is one more thing you can do to help yourself succeed in your WLS journey.

Without a doubt, obesity is stigmatized. The unfair bias that you face may be a major factor in your decision to consider or get weight loss surgery. Unfortunately, you will probably find that the obesity discrimination continues even as you try to use weight loss surgery to get healthy. Obese patients are blamed for their conditions, healthcare providers are not always sympathetic, and coverage for weight loss surgery is not guaranteed.
Why Do Obese Patients Get So Much Blame?
People are increasingly sympathetic to diseases that used to be stigmatized. Examples include cancer, many mental health conditions, and sexually transmitted diseases such as HIV/AIDS and syphilis. Now, treatment for these and other conditions, such as diabetes, is widely accepted as normal and an entitlement. Each of these conditions is largely the result of lifestyle choices, such as diet, use of tobacco and/or alcohol, sexual behavior, and physical activity levels. More than 80% of cancers are likely the result of lifestyle choices.
Ironically, though, many people in our society remain unsympathetic to obese people. They are quick to blame obese people for having no self-control, for refusing to follow a diet, and for not wanting to be healthy. You know, though, that those accusations are far from the truth. If you are considering weight loss surgery, you are confident that you have the self-control for the weight loss surgery diet, that you have tried to follow numerous diets but none have worked for you, and that you desperately want to be healthy!
You Did Not Ask to Be Obese: Some Factors are Outside of Your Control
More than one-third of American adults are obese, and another third are overweight. That in itself should remind you – and the people who judge you harshly – that fighting obesity is hard! The food environment includes fast food, vending machines, restaurants, food-focused social gatherings, and inexpensive snack foods.
There are also biological and family factors that you cannot control. Skinny people have no idea that you may be feeling extreme hunger all day, every day, or that your metabolism may be slower. Your family might have raised to choose high-calorie, high-fat foods, or even driven you into unhealthy emotional eating.
Research shows that some obese patients’ brains even respond differently to food compared to lower-weight individuals. Obese individuals, for example, tend to get less pleasure out of food, meaning they need to eat more to get satisfied. Furthermore, high-calorie foods like sugar can be addicting, leading to the same brain responses as cocaine does. But nobody blames cocaine addicts for their situations! Instead, they encourage counseling and intensive program to help them overcome their addictions, not punish them.
Discrimination in Obesity Treatment: A Look at Weight Loss Surgery Versus Dialysis
Just as unfair is the fact that the healthcare system continues the discrimination against obesity. Compare weight loss surgery as an obesity treatment with dialysis as a treatment for kidney failure (end-stage renal failure).
Far from being blamed for their conditions, kidney failure patients who need dialysis are provided the respect that all people deserve and the medical care that they need. Dialysis patients of all ages in the United States are able to apply for Medicare, the government’s health insurance program normally reserved for older adults. Dialysis treatments can cost about $40,000 per year, not including This is not to mention human factors such as reduced quality of life (the vast majority of dialysis patients are too sick to work) and early death (the life expectancy of dialysis patients is about 5 years). In comparison, a typical weight loss surgery procedure in the United States can cost $20,000 to $40,000, although it can be less, and successful patients are healthier and have more energy than before surgery.
The irony increases. The fact is that kidney failure usually results as a complication of type 2 diabetes or high blood pressure (hypertension). Both of these conditions are often caused by obesity; losing weight after weight loss surgery can prevent, eliminate, or reduce these conditions. In addition, it takes years for kidney failure to develop once you have high blood pressure or diabetes – years during which patients are likely to be on costly medications and inconvenient treatments.
Targeting obesity through weight loss surgery could prevent cases of diabetes and high blood pressure, reduce their effects in people who already have them, and prevent kidney failure, the need for dialysis, and early death.
Searching for Fairness in the Medical Treatment of Obesity
Your first barrier in your path to weight loss surgery may be your primary care physican (PCP). Some PCPs do not know much about weight loss surgery, or may be against it because they think obesity is your fault. Some PCPs take a narrow view of obesity, and feel that the only way to lose weight is for patients to “decide they want it badly enough” and “just eat less.” You already know that doesn’t work, so don’t let your PCP discourage you from learning more weight loss surgery if you think it might be the solution to your obesity struggles.
Insurance coverage has improved for obesity treatments, especially for weight loss surgery. Medicare and many private healthcare coverage plans cover weight loss surgery if you meet their predetermined weight and/or health criteria. Some private insurance companies, though, take a short-term view because they want to make profits within 3 years. Since most weight loss surgeries do not pay for themselves within 3 years, some private insurers do not cover weight loss surgery despite the likelihood that they would pay for themselves within 5 or 10 years, and in addition improve your health and quality of life.
Chance of Reduced Discrimination in the Future?
The majority of Americans believe that health insurance should cover weight loss surgery, in addition to other obesity treatments such as dietetic and mental health counseling. The Affordable Care Act (“Obamacare”), though, is not the ultimate solution. In nearly half of states, obesity treatments are not required to be covered by plans sold on the health exchanges. This determination is based on the available competitive services in the region. Since the most obese states are the ones least likely to have competitive anti-obesity care, these states are also least likely to have obesity treatments covered under the Affordable Care Act.
Overcome the Discrimination
Discrimination is an unfair fact of life as an obese individual, and it unfortunately does not end when you decide to get healthy using weight loss surgery as a tool. These are some of the ways that you can keep going strong and overcome the barriers you encounter as you work to get healthy.
You have the right to a second opinion if your primary care physician recommends against weight loss surgery but you would like to find out more.
Do not take “no” for an answer from your insurance company if you know you are entitled to reimbursement for surgery.
Do not listen to negative family members or friends who do not understand your obesity or interest in weight loss surgery. It is your life and health.
Educate others as much as you can to try to reduce the discrimination. Chances are that they are only being discriminatory out of ignorance, not out of true mean-spiritedness.

Like it or not, some discrimination remains as you go through your weight loss journey. You cannot prevent it, but you can change how you react to it. Expect it and respond as positively as you can, keeping your own health and goals in mind. Over time, as you and others prove that weight loss surgery can be a worthwhile treatment for obesity, discrimination by insurance companies, healthcare providers, and the public will decrease.

A Lifelong Struggle with Food
Some weight loss surgery patients have nothing but memories of being obese. Robanne did struggle with food her entire life, but her ordeals included battles with anorexia and bulimia as well as childhood obesity and morbid obesity as an adult. By the time she was 37, she had high blood pressure and diabetes, and had two trips to the ER. She was close to giving up. That was at a weight of 300 pounds.
The Decision and Her Surgery
Robanne knew her health was the result of her weight. She researched the various WLS possibilities and felt Roux-en-Y was the best option for her because of the long-term success rate. Also, she had a friend that had lost 100 lb. after RNY.
She got her surgery in 2009 with Dr. Brenda Cacucci at the St. Vincent Bariatric Center of Excellence, in Carmel, Indiana.
A Personal Decision with Family Support
The decision for Robanne was personal. She explains she had enough on her mind at the time of her surgery, and was not in a place to be able to justify her decision to friends and family. So, she only told them about the surgery after she got it done. She also did not want to deal with judgmental people, since she was scared and uncertain at the time.
Her friends and family were supportive when she told them. She says her children “were particularly excited that ‘mommy would be able to jump on the trampoline with them some day.’” Now she says she is “strong enough to believe in my path,” and her results show it. She lost 150 lbs. and now weighs 150.
Overcoming the Challenges and Becoming a Dancer
Robanne faced the same challenges many WLS patients can relate to. It was tough to get in her dietary supplements and drink her protein shakes. In the beginning, exercise was a serious challenge – so much so that she tried to convince herself she didn’t need to exercise.
Luckily, she went to a group exercise cardio class, which happened to be a hip-hop dance class. She was too embarrassed to quit, so she stayed in class…and says it was the best thing that could have happened! That class changed her life.
She loved it, and learned that exercise could be fun and not dreadful. But she took it much further. Robanne worked at it, and now teaches seven hip-hop classes a week. She leads group exercise classes for the Obesity Action Coalition's national conference. Look for her at their next conference in San Antonio in August!
Robanne’s also been selected as a national national spokesperson for the Y.. She’s appearing in a national commercial rolling out this year. It is currently on the air in Seattle, WA and starting to pop up across the country, and you can take a look on
.


Tips from the Top
Anyone who’s lost and been able to keep off half her body weight probably has a lot of good advice, and Robanne is very willing to share it. First, she says to try new things. If you’ve been sedentary and overweight for years, she says, how do you know what you like? So try everything!
Also, “keep it real.” You’re not in the best possible shape right after surgery, so just work up to the tougher workouts instead of jumping right in. You don’t want to get hurt, burned out, or discouraged. Fitness is about being strong and pursuing health, not about a single number on the scale.
Another piece of advice comes in the form of one of her favorite quotes. "Start by doing what is necessary, then do what is possible, and suddenly you are doing the impossible"--St. Francis of Assisi.
And finally, stay focused. Robanne says, “Every day, I recommit to do what it takes to stay successful.”
A Day in the Life
What does a typical day look like for 6-year WLS veteran who’s lost half her body weight?
Something like this, at least for Robanne.
Coffee...with cream.
Breakfast: 1-2 packets of plain, heart healthy instant oatmeal sweetened with Splenda.
First morning snack: Greek yogurt.
Late morning snack: 1-2 hard-boiled eggs
Lunch: some kind of chicken (usually grilled), on a bed of mixed vegetables (usually salad). She uses salsa for dressing.
First afternoon snack: something crunchy like Skinny Pop popcorn.
Second afternoon snack: a slice of cheese, and handful of turkey, or some kind of lean protein.
Dinner: lean protein, 1/3 cup brown rice and broccoli or a small salad.
Every other day: a protein shake.
Plenty of water.

Robanne says she’s a creature of habit and keeps eating what she likes. The key for her is snacking on protein instead of carbs for the most part. She splurges on occasion on something like a cookie or something chocolate. But, she says, eating too much sugar and refined carbs makes her feel less bad. She sticks to whole grain carbs instead of white.
And exercise? This hip hop instructor is no slouch! She teaches 6-7 classes a week, including 2 days with 2 classes each. She also does weight training to keep up her muscle mass. She has 2 days off each week.
More from Robanne
If you want to learn more about Robanne, take a look at her Get Your Strong On site. It details her work in motivational speaking, weight loss coaching, and promoting corporate and kids fitness. You can also check out her inspirational video called “
.”Robanne wrote her story in a book, “Half My Size,” which she’s offering at a discount for BariatricPal members. You can order yours for $10 each with free shipping! The book is her story along with the lessons she learned for overcoming obstacles.
And for more ways to connect with Robanne…check out her bariatric motivation page on Facebook and give her hip-hop workouts a try!

Bigger from Birth…And Then College Hit
Michele was always big. She was at the top of her height and weight charts from the time she was an infant. She remembers times in her childhood when she couldn’t or wouldn’t participate because she was so big. She didn’t like physical education or sports, and the other children teased her.
Food was a comfort. Michele describes the situation as a vicious cycle. The more kids teased her, the worse she felt. The worse she felt, the more she ate. The more she ate, the more she weighed. The more she weighed, the more she got teased.
College was a disaster in terms of her weight. Forget about the freshman 15. What about the freshman 40? And the sophomore 40? Add to that the junior 40, the senior 40, and, for good measure, the super-senior (fifth-year) 67, and you now know how Michele Elbertson got to be 427 pounds at the age of 22 years.
A Young Weight Loss Surgery Patient with New Relationships
Michele made the decision to get the lap-band on her own. She needed a tool to help her control how much she ate, but understood that it was up to her to control what she ate. She only told her parents about her decision after she was sure about it. They were supportive, and have been since then.
Michele has taken full advantage of and responsibility for the band. She has lost 260 pounds – 260 pounds! – in less than four years. As she says, she’s a determined person who will accomplish anything she sets her mind to.
Michele began to “eat to live” rather than “live to eat.” As her relationships with food and exercise changed, so did her relationships with some friends. She lost some friends whose relationships centered only on food. She gained many more, though, through her new activities. She says the friends she’s gained through running and fitness far outweigh those she lost by changing her lifestyle.
An Athlete Is Born
Michele ran her first 5k after losing 100 pounds – when she was still 327 pounds. She was hooked. She loved the training, the atmosphere of the race, and the accomplishment. She has never looked back. Since then, she has run countless other races, including 38 half-marathons, 6 marathons, and a 50-miler ultra-marathon. She has also competed in triathlons.
Now at an athletic 159 pounds, Michele has her sights on even greater challenges. In the near future, she wants to run a 100-miler and complete an Ironman. Both are feats that most people wouldn’t even dream of.
Marathons, Ultras, and Ironmans
Now, not everyone’s a distance runner or triathlete, so to understand Michele’s accomplishments, here are a few facts about these endurance sports.
A marathon is 26.2 miles. All marathons are 26.2 miles.
An ultra-marathon is anything over 26.2 miles. Michele’s recently completed ultra-marathon was 50 miles, and she is training for a 100-miler.
A triathlon includes swimming, biking, and running. An Ironman triathlon consists of a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile marathon.

Fitting It All in Every Day
Michele works out 6 days a week. Currently, she’s training for an ulta-marathon and is running 5 days a week and lifting weights 3 times. She also does Zumba classes. She takes a rest day once a week.
Michele has built her life to be able to accommodate her training schedule. She recently quit her teaching career to focus instead on helping others achieve their fitness and health goals. She is a personal trainer and group fitness instructor. Working at a gym is pure genius – it leaves her with no excuse not to get her workout in!
Eating Like a Bariathlete
How do you have energy to train like an athlete and work full-time while losing over 200 pounds in 4 years? Ask Michele. Here’s how she eats and works out in a typical day.
7:00 a.m. breakfast: almonds and yogurt or eggs/romaine lettuce
9:00 a.m. snack: protein bar
Workout, such as running, lifting, or group fitness class, such as Zumba or bokwa
Noon. lunch: soup or salad, usually the largest meal of the day
2:00 p.m. snack: cheese and crackers or something small, equivalent to 200 calories (may include a fruit or vegetable)
4:00 p.m. snack: hot tea
6:00 p.m. dinner; lean protein, veggie, possibly a carb
7:30 p.m. snack: lemon water/hot tea.

The number of calories Michele eats during a day is 1,800 (her resting metabolic rate) plus half of the calories she burns through exercise. So, if she runs 10 miles and burns 1,200 calories in exercise, she’ll eat 1,800 plus 600 calories, or 2,400 calories. She allows herself an occasional treat meal with junk food, but still counts those calories.
The Accolades
Michele is more than your typical bariatric patient, and she’s been getting the recognition she deserves for her extraordinary achievements. These are a few recent examples.
Runner’s World magazine Cover Contest Finalist.
Makeover on the Rachel Ray Show.
Local feature on 6ABC Action News in Philadelphia.

Dealing with Negativity – Don’t Worry About It
One of the most striking things about Michele is her drive. She has worked very, very hard to get where she’s at today. She’s lost 60 percent of her body weight through being very disciplined every day. And, she has run marathons. Anyone who has run a marathon can tell you that it is was harder than they had ever imagined. Anyone who hasn’t run a marathon cannot imagine how difficult it is.
But with all the publicity, Michele has receive a lot of nasty comments. How is she supposed to react when people slam her? They say she hasn’t accomplished anything, that the band has done it all. In fact, they basically say what a lot of weight loss surgery patients hear all the time from people who don’t know any better.
So how does Michele react to negativity? She doesn’t want to respond directly and add “fuel to the fire.” She knows they don’t know anything about her, and she’s probably done more exercise and worked harder than they ever have. So, she just goes about her business.
Leading by Example
Michele says she hopes her successes and story will give others hope. She describes herself as a “real person” and “very down-to-earth,” and she hopes others will see that they can accomplish what she has. In the future, she would like to travel to seminars as a motivational speaker. In the meantime, we congratulate her on her amazing story and wish her well in her 100-miler this spring!

How do you know whether weight loss surgery is for you? Will it be the weight control solution you have been searching for for years? Or will it be a decision you regret? Nobody can answer that for you, but here are some considerations as you think about whether weight loss surgery is for you.
The Qualifying Criteria
You are not a candidate for bariatric surgery unless you meet certain criteria set by your surgeon or, if applicable, your healthcare coverage plan. The standard criteria are:
Body Mass Index (BMI) over 40 or BMI 35 with an obesity-related comorbidity, such as type 2 diabetes, high cholesterol, or sleep apnea. Confirmation that your obesity is not caused by an underlying condition that would make weight loss surgery ineffective. A psychological exam to show that you are capable of sticking to the post-op diet and lifestyle changes that are necessary. Previous documented attempts at losing weight with diet and exercise. Ineffectiveness of Previous Efforts
Weight loss surgery is a last resort, not a first try at losing weight. It is for patients who have been obese for years and who have tried to lose weight using lifestyle changes, such as a modified diet plan and a formal exercise program. Many weight loss surgery patients try “every diet under the sun” before deciding that it is time for WLS. They may have had trouble losing any weight at all, or may have lost weight initially but been unable to keep it off.
Readiness to Change
Weight loss surgery is just the beginning. The way you eat after weight loss surgery determines how well you will be able to control your weight for the rest of your life. You need to be ready to change if you want to be successful with weight loss surgery. No longer will you be able to down a pizza or hit the drive-through on a whim.
Are you ready to possibly:
Give up coffee and regular and diet soda? Cut sugary treats and fried foods, especially with gastric bypass? Pass on the alcoholic offerings at home, parties, and restaurants? Count protein, slash carbs, and measure portions? Addressing Other Issues
Weight gain does not always take place in a vacuum, and weight loss does not solve other problems you might have in your life. First, identify why you became overweight in the first place, and what is keeping you from losing the weight. Is weight loss surgery the answer, or do you need to first deal with an abusive relationship or lack of self-confidence, for example?
Emotional eating is a common reason for weight gain. If you tend to eat your feelings away, you are best off figuring out other ways to handle your feelings before you get surgery. Can you use walking as a form of therapy? Maybe you can join an in-person or online support group to turn to when you feel sad, lonely, or angry.
If your emotional eating is related to a specific problem, such as stress at work, your best bet may be to handle the problem before getting WLS. That could mean finding a healthy coping mechanism, or it could mean getting counseling to help you work through the source of stress. It could even mean finding a new job, as scary as that sounds.
Consider Replacement Addictions
Replacement addictions are common after weight loss surgery. They happen when you give up food – which can be an addiction – for a different addiction. Instead of turning to food for comfort, entertainment, or companionship, some weight loss surgery patients turn to “replacement addictions” or “cross addictions” They may take up smoking, or start to abuse alcohol. Replacement addictions can also be healthier than eating; some weight loss surgery patients become gym rats or take up gardening, sewing, or other hobbies.
As you consider weight-loss surgery, think about the possibility of food addiction being replaced by replacement addictions. What role does food play in your life now? What do you see replacing that emotional or physical role after surgery?
The decision to get weight loss surgery requires a lot of soul searching for most candidates. These points can help you work through some of the doubts you may have as you try to decide what is best for yourself.

Clients who regain weight after bariatric/weight loss surgery often ask us about the ‘5 day pouch test’. This much debated ‘test’ promises to ‘reset’ your stomach and help you lose more weight. It’s so popular in fact, it has its own acronym – the ‘5DPT’. So what’s the deal, is it too good to be true?

Let’s start with a bit of background
The pouch test was ‘created’ in 2007 by a fellow gastric bypass-er named Kaye. She struggled, like many, with discouraging and disheartening weight regain after bariatric/weight loss surgery. In an attempt to recreate that ‘tight newbie feeling’ again, she developed the pouch test.

To start off the 5 day pouch test, she instructs you to ‘get back to the basics’. Or in other words, she wants you to return to the post-op liquid phase that is required in the first few days after surgery. She then recommends that you progress slowly from soft/puree protein, to firm protein and then lastly to solid protein (what’s the difference between firm and solid protein? We don’t know either...). Following this, you are supposed to feel a renewed sense of self.

MYTH...
The 5 day pouch test WILL NOT...
- shrink your stomach
- reduce hunger and increase satiety (feeling of fullness)
- ‘reset’ your body
- cut your cravings for carbs and sweet/salty foods

FACT...
We do however agree with some of Kaye’s suggestions.

1. Always delay your fluids from your solids foods.
--> Stop drinking 15 minutes before your meals/snacks and wait at least 30 minutes after eating to start drinking again. WHY? - Drinking and eating at the same time ‘flushes’ the food out of your stomach too quickly. This causes you to feel hungry soon after eating.

2. Take your time to eat.
--> Eating slowly and savouring your food without distractions increases satiety at meal times. WHY? - This gives your brain time to process that you are eating and lets you get the flavor fix you’re looking for.

3. Ask yourself if liquid protein snacks (aka ‘slider foods’) keep you full long enough (Ex. milk, yogurt, soft cheeses, cereal).
--> While these foods are nutritious and provide good quality protein, they may not help you feel as full as you felt in the first few months after surgery. WHY? - These liquid foods spend less time in your stomach which is why you maybe feel hungry soon after eating.

4. Include a high protein food at every meal and snack.
--> WHY? – High protein foods help keep you full longer.

In our opinion, the ‘5 day pouch test’ is just another diet in disguise. Anything that promises to ‘reset your system’, ‘boost your weight loss’, ‘cut cravings’, ‘kick start your metabolism’, ‘burn fat’, etc. is unfortunately wishful thinking.

There are no short cuts to healthy eating and lasting weight loss. There is only you, your pouch (i.e. your little stomach) and knowing how to use it!

How do I know if my pouch is still small?
Believe it or not, the majority of weight regain after bariatric/weight loss surgery is NOT related to having stretched your stomach. This is good news! In our experience, weight regain is more related to what you eat, the timing of your meals and snacks, and how you are eating. For example, if you feel comfortably full for 2-3 hours after eating the amount of food that fits on a bread plate, which includes a combination of protein, a small amount of grains, and some vegetables, your pouch is likely perfectly fine.

We even asked one of our favourite bariatric/weight loss surgeons about the 5 day pouch test! Here is what he said:
Need help?
If you are looking to get back on track with your weight loss and healthy eating, sign up for our Get Me Back on Track package. Whatever the cause of your weight gain, we will give you realistic strategies and tips to tackle your triggers and barriers to healthy eating. Even simple changes to your home and office environments can make a big difference.

You may already know that you should think about the quantifiable aspects: think numbers. You want to know how much weight that surgeon’s patients tend to lose, what kind of complication rates does the surgeon see and which types of complications do they tend to be, and how much experience the surgeon has in terms of lifetime surgeries and current number of surgeries they performed per month.
But what about the rest? What about “bedside manner” and all the things it includes? Finding a surgeon with great statistics may not be enough to guarantee that you have found the best surgeon for yourself. There are some less definable characteristics to think about.
Explains well
Your surgeon should be able to explain everything you want to know in terms you can understand. If you are the type of person who needs to question every detail, you need a surgeon who is willing to take the time to explain everything you want to know at the level of detail you are requesting. Don’t accept “because I said so” as an answer.
Even if you are not the type to ask many questions, you still need to be able to communicate with your surgeon. You need to understand basics such as your surgery options, what to expect in the hospital, and your pre-op and post-op instructions. Keep looking for another surgeon if the one you’re considering now cannot explain well. It is the surgeon’s responsibility to do so; you are not “dumb” for not understanding.
Treats You with Respect
Basic respect can make your entire experience more pleasant, safer, and more successful. “Respect” is complicated, but it can include some of the following.
Treating you as an individual rather than giving you cookie cutter treatment. Taking your concerns seriously. Giving you information to help you make decisions, rather than forcing decisions on you. Discusses risks and expected weight loss seriously with you, and does not make unrealistic promises about surgery safety and impossibly fast weight loss. Is Accessible
There may be times when you have a question or concern that cannot wait until your next appointment. Is your surgeon accessible? If not, does your surgeon have someone else you can call at any time? Find out what happens if you need to contact your surgeon, or a nurse or the nutritionist, during or after business hours. You want to be sure you are in good hands at all times.
Focuses on the Future
You’ve heard over and over that weight loss surgery gives you a tool, and that the rest is up to you. You’ve also heard that this is a change for life, not a quick fix for a few months or a year. Your surgeon should be giving you that same message.
Stay clear of any surgeon who does not discuss the future with you. Be wary if the surgeon seems to believe that his surgery will be enough to get you to the weight you want. As much as you may want to believe it, it is not true. You will need to eat right and work hard for years to get your weight under control, and you need a surgeon who will support you every step of the way.
Gives You Confidence
No matter what happens in your life, which decisions you make about surgery, and what triumphs and challenges your weight loss surgery journey includes, things will be better if you feel positively about them. Your surgeon can help by giving you confidence that:
He or She will take care of you no matter what. He or She believes in you. You are making the right decisions for yourself. This can be difficult to judge, but see how you feel after walking out of the surgeon’s office. Do you feel excited and hopeful? Or do you feel overwhelmed and daunted? A few nerves are normal, but you should also feel that you can do this. If not, find a surgeon who does let you feel self-confident.
Fantastic surgeons are out there, and you deserve one, but you may need to put in some effort to find one. After checking out the statistics, you may need to depend on your gut to help you make the right decision. You can go into surgery with more confidence when your surgeon is communicative, respectful, and positive.

Success is not always about the number on the scale!

We know you guys hate it when we say this, but it’s the truth… and we are about to show you the PERFECT example.

Check this out – http://people.com/bodies/fit-mom-looks-drastically-different-2-lb-weight-loss/

Adrienne’s transformation is truly incredible! Despite losing a measly 2 lbs, a quick look at her before and after picture clearly shows a dramatic change in her body composition.

What do we mean by ‘body composition’? Body composition refers to what proportion of our body is fat, muscle, bone and water. Since the weight of our bones and water stay relatively stable, it is the percentage of our fat and muscle that change when we gain weight, lose weight and, in the case of Adrienne, also when we exercise.

Unfortunately, what we measure on our home scales is simply the total weight of all of these (i.e. fat + muscle + bone + water). This means when we gain muscle and lose fat, which is what happens in the case of exercising and weight lifting regularly, our scale is not able to express these shifts in body composition.

Moral of the story: the scale does not always dictate your progress. If you are sweating your butt off in the gym, you are definitely changing your body.

It breaks our hearts when we see clients who are healthy, super fit and 3-5 dress sizes smaller, but they are still not happy with their ‘success’ because of the number on the scale. Sadly, in some of these cases, the clients were so desperate to lose more weight that they stopped their weight training to intentionally lose muscle. Crazy right? All just to see the number on the scale go down.

Remember: Success looks different on everyone.

Weighing yourself is only one measure of progress. Ask yourself the following questions if you are exercising regularly but not seeing results on the scale. If you answer yes to any one of these questions, you are most likely changing the composition of your body for the better (i.e. gaining muscle and losing fat).

- Do your clothes fit slightly looser?
- Are you less out of breath when walking?
- Are you using a smaller hole on your belt?
- Do you feel powerful at the gym?
- Is there more definition to your arms and legs?
- Do you feel stronger?

Although Adrienne’s story does not involve bariatric surgery / weight loss surgery, she is a perfect example of how you can dramatically change your body while being ‘plateaued’ or ‘stalled’ in terms of your weight.

What are your favourite non-scale victories? Post below in the comments!

You may already know that you should think about the quantifiable aspects: think numbers. You want to know how much weight that surgeon’s patients tend to lose, what kind of complication rates does the surgeon see and which types of complications do they tend to be, and how much experience the surgeon has in terms of lifetime surgeries and current number of surgeries they performed per month.
But what about the rest? What about “bedside manner” and all the things it includes? Finding a surgeon with great statistics may not be enough to guarantee that you have found the best surgeon for yourself. There are some less definable characteristics to think about.
Explains well
Your surgeon should be able to explain everything you want to know in terms you can understand. If you are the type of person who needs to question every detail, you need a surgeon who is willing to take the time to explain everything you want to know at the level of detail you are requesting. Don’t accept “because I said so” as an answer.
Even if you are not the type to ask many questions, you still need to be able to communicate with your surgeon. You need to understand basics such as your surgery options, what to expect in the hospital, and your pre-op and post-op instructions. Keep looking for another surgeon if the one you’re considering now cannot explain well. It is the surgeon’s responsibility to do so; you are not “dumb” for not understanding.
Treats You with Respect
Basic respect can make your entire experience more pleasant, safer, and more successful. “Respect” is complicated, but it can include some of the following.
Treating you as an individual rather than giving you cookie cutter treatment. Taking your concerns seriously. Giving you information to help you make decisions, rather than forcing decisions on you. Discusses risks and expected weight loss seriously with you, and does not make unrealistic promises about surgery safety and impossibly fast weight loss. Is Accessible
There may be times when you have a question or concern that cannot wait until your next appointment. Is your surgeon accessible? If not, does your surgeon have someone else you can call at any time? Find out what happens if you need to contact your surgeon, or a nurse or the nutritionist, during or after business hours. You want to be sure you are in good hands at all times.
Focuses on the Future
You’ve heard over and over that weight loss surgery gives you a tool, and that the rest is up to you. You’ve also heard that this is a change for life, not a quick fix for a few months or a year. Your surgeon should be giving you that same message.
Stay clear of any surgeon who does not discuss the future with you. Be wary if the surgeon seems to believe that his surgery will be enough to get you to the weight you want. As much as you may want to believe it, it is not true. You will need to eat right and work hard for years to get your weight under control, and you need a surgeon who will support you every step of the way.
Gives You Confidence
No matter what happens in your life, which decisions you make about surgery, and what triumphs and challenges your weight loss surgery journey includes, things will be better if you feel positively about them. Your surgeon can help by giving you confidence that:
He or She will take care of you no matter what. He or She believes in you. You are making the right decisions for yourself. This can be difficult to judge, but see how you feel after walking out of the surgeon’s office. Do you feel excited and hopeful? Or do you feel overwhelmed and daunted? A few nerves are normal, but you should also feel that you can do this. If not, find a surgeon who does let you feel self-confident.
Fantastic surgeons are out there, and you deserve one, but you may need to put in some effort to find one. After checking out the statistics, you may need to depend on your gut to help you make the right decision. You can go into surgery with more confidence when your surgeon is communicative, respectful, and positive.

Bigger from Birth…And Then College Hit
Michele was always big. She was at the top of her height and weight charts from the time she was an infant. She remembers times in her childhood when she couldn’t or wouldn’t participate because she was so big. She didn’t like physical education or sports, and the other children teased her.
Food was a comfort. Michele describes the situation as a vicious cycle. The more kids teased her, the worse she felt. The worse she felt, the more she ate. The more she ate, the more she weighed. The more she weighed, the more she got teased.
College was a disaster in terms of her weight. Forget about the freshman 15. What about the freshman 40? And the sophomore 40? Add to that the junior 40, the senior 40, and, for good measure, the super-senior (fifth-year) 67, and you now know how Michele Elbertson got to be 427 pounds at the age of 22 years.
A Young Weight Loss Surgery Patient with New Relationships
Michele made the decision to get the lap-band on her own. She needed a tool to help her control how much she ate, but understood that it was up to her to control what she ate. She only told her parents about her decision after she was sure about it. They were supportive, and have been since then.
Michele has taken full advantage of and responsibility for the band. She has lost 260 pounds – 260 pounds! – in less than four years. As she says, she’s a determined person who will accomplish anything she sets her mind to.
Michele began to “eat to live” rather than “live to eat.” As her relationships with food and exercise changed, so did her relationships with some friends. She lost some friends whose relationships centered only on food. She gained many more, though, through her new activities. She says the friends she’s gained through running and fitness far outweigh those she lost by changing her lifestyle.
An Athlete Is Born
Michele ran her first 5k after losing 100 pounds – when she was still 327 pounds. She was hooked. She loved the training, the atmosphere of the race, and the accomplishment. She has never looked back. Since then, she has run countless other races, including 38 half-marathons, 6 marathons, and a 50-miler ultra-marathon. She has also competed in triathlons.
Now at an athletic 159 pounds, Michele has her sights on even greater challenges. In the near future, she wants to run a 100-miler and complete an Ironman. Both are feats that most people wouldn’t even dream of.
Marathons, Ultras, and Ironmans
Now, not everyone’s a distance runner or triathlete, so to understand Michele’s accomplishments, here are a few facts about these endurance sports.
A marathon is 26.2 miles. All marathons are 26.2 miles.
An ultra-marathon is anything over 26.2 miles. Michele’s recently completed ultra-marathon was 50 miles, and she is training for a 100-miler.
A triathlon includes swimming, biking, and running. An Ironman triathlon consists of a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile marathon.

Fitting It All in Every Day
Michele works out 6 days a week. Currently, she’s training for an ulta-marathon and is running 5 days a week and lifting weights 3 times. She also does Zumba classes. She takes a rest day once a week.
Michele has built her life to be able to accommodate her training schedule. She recently quit her teaching career to focus instead on helping others achieve their fitness and health goals. She is a personal trainer and group fitness instructor. Working at a gym is pure genius – it leaves her with no excuse not to get her workout in!
Eating Like a Bariathlete
How do you have energy to train like an athlete and work full-time while losing over 200 pounds in 4 years? Ask Michele. Here’s how she eats and works out in a typical day.
7:00 a.m. breakfast: almonds and yogurt or eggs/romaine lettuce
9:00 a.m. snack: protein bar
Workout, such as running, lifting, or group fitness class, such as Zumba or bokwa
Noon. lunch: soup or salad, usually the largest meal of the day
2:00 p.m. snack: cheese and crackers or something small, equivalent to 200 calories (may include a fruit or vegetable)
4:00 p.m. snack: hot tea
6:00 p.m. dinner; lean protein, veggie, possibly a carb
7:30 p.m. snack: lemon water/hot tea.

The number of calories Michele eats during a day is 1,800 (her resting metabolic rate) plus half of the calories she burns through exercise. So, if she runs 10 miles and burns 1,200 calories in exercise, she’ll eat 1,800 plus 600 calories, or 2,400 calories. She allows herself an occasional treat meal with junk food, but still counts those calories.
The Accolades
Michele is more than your typical bariatric patient, and she’s been getting the recognition she deserves for her extraordinary achievements. These are a few recent examples.
Runner’s World magazine Cover Contest Finalist.
Makeover on the Rachel Ray Show.
Local feature on 6ABC Action News in Philadelphia.

Dealing with Negativity – Don’t Worry About It
One of the most striking things about Michele is her drive. She has worked very, very hard to get where she’s at today. She’s lost 60 percent of her body weight through being very disciplined every day. And, she has run marathons. Anyone who has run a marathon can tell you that it is was harder than they had ever imagined. Anyone who hasn’t run a marathon cannot imagine how difficult it is.
But with all the publicity, Michele has receive a lot of nasty comments. How is she supposed to react when people slam her? They say she hasn’t accomplished anything, that the band has done it all. In fact, they basically say what a lot of weight loss surgery patients hear all the time from people who don’t know any better.
So how does Michele react to negativity? She doesn’t want to respond directly and add “fuel to the fire.” She knows they don’t know anything about her, and she’s probably done more exercise and worked harder than they ever have. So, she just goes about her business.
Leading by Example
Michele says she hopes her successes and story will give others hope. She describes herself as a “real person” and “very down-to-earth,” and she hopes others will see that they can accomplish what she has. In the future, she would like to travel to seminars as a motivational speaker. In the meantime, we congratulate her on her amazing story and wish her well in her 100-miler this spring!

Food will not rule your life
Once obesity sets in, life is about food, first and foremost. But after bariatric surgery, you’ll see that food isn’t really your ‘best friend’ anymore; it just keeps you alive, nothing more. Get ready to say goodbye to the constant worry about your next snack, next meal or which drive-through you’re going to visit.
Going forward, you will learn that food gives your mind and body fuel to perform at its highest level possible. Food is not a crutch or a protector from the challenges of daily life.
You’re going to feel so much better
Preparation is the number one key to weight loss success. Before surgery, you’ll work with our Bariatric Navigator to start the process of changing what you eat. Go ahead and dump the junk food, the sugar products and empty carbs now. Your body doesn’t need artificially processed foods (nor does your family). After about a week or two of excluding these foods from your diet, you’re going to feel the difference.
Read articles, blogs, magazines and books about healthy living. Prepare your body and your mind to make changes toward living a healthier lifestyle. By utilizing all of the resources from our comprehensive bariatric weight loss program, you will have many levels of support and education available to you.
You are not alone in this journey
Through your surgeon or hospital's bariatric program, you are going to meet people at all stages of the bariatric process. You will garner the tools to live a healthier life and learn how to meet and overcome obstacles. There is strength in numbers so seek out both live and online support groups. Sign up for a few and build relationships with people. You will be as big a help to them as they will be for yo u!
Only you can change your mindset about food, exercise and weight
The struggle against obesity is not just physical. It’s also mental and emotional. Having the courage and dedication to have weight loss surgery is a strong statement about your regard for your value and self-worth. The battle against obesity is complicated; if you feel you need psychological counseling services, we’ll be happy to provide you with recommendations based upon our patients’ feedback.
You will be amazed that you actually like to exercise
Once you are eating solid foods again, you can incorporate exercise into your routine, in most cases. Many patients enthusiastically report that weight loss surgery gave them a new chance to reap the benefits from working out.
After weight loss surgery, you call the shots about what happens next.
How will you reclaim your body, redeem your health, and start a journey toward a healthier quality of life?
Discover or re-discover activities that you enjoy—start with walking around the neighborhood; jog/walk on a treadmill while you watch your favorite TV show or play ball with your kids (they will be elated, I assure you). Have you always wanted to hike? Take a water aerobics class? Try Yoga or Zumba? Embrace the new life you are creating for yourself. Dive in, try everything!
The battle against the disease of obesity is often in the mind. When you see the physical changes happening, your mental outlook will improve as well.
Seize that momentum and go after your goals with everything you’ve got. It’s well worth the effort.

Having a smaller stomach pouch after surgery makes it a challenge to get in more veggies. Veggies you can sip instead of chewing to applesauce will make it easier to get in your vegetables. Think about blending veggies with protein powder to help increase your protein intake. Focus on non-starchy veggies. There are several ways you can sip your veggies.
One way is to experiment with blended smoothies. A blended smoothie has 3 main parts: fresh or frozen produce, ice cubes, and a base. The base can be water, milk or yogurt. For bariatric patients, a base can also be protein powder or ready to drink protein shakes. You’ll need a good blending machine like NutriBullet, Ninja or Vitamix. Look for a blender with at least 1000 Watts for best results. Next time you make a protein smoothie, throw in a handful of raw spinach or kale, cucumbers, shredded purple cabbage, frozen veggie blend, fresh herbs or something from your garden. Fruits are often a part of a smoothie, but you will need to calculate the carbs to stay in your carbohydrate goal.
Another idea is to make a non-alcoholic Bloody Mary. Stir a tablespoon of unflavored protein powder into 6 ounces low sodium V8 vegetable juice. This V8 is a blend of several vegetable juices. Throw in dashes of lemon juice and Worcestershire sauce, stir again and the pour over ice. Unflavored protein powder can be added to vegetable soups. Sprout’s has unflavored whey protein powder in the bulk bins, which is a way you can test taste this protein without buying a large canister. One tablespoon provides 10 grams of protein. If you use whey protein isolate, remember to keep it under 140o F. to prevent the protein from curdling. Healthy sipping!

It takes a lot of work for you prepare for and recover from weight loss surgery, and to continue to lose weight and get healthy. With all that focus on yourself, it sounds strange that you could be neglecting yourself, but it often happens. If you do not work on strengthening your self-respect, self-confidence, and self-love, you may not be as successful in your weight loss surgery journey. Here are some easy tips for building a little rapport with the most important person in your life: you.
Recognize Your Greatness
You would do everything you could to recognize the good things about someone else if you were building a relationship with them, and you can do the same for yourself to build your relationship with yourself. It can take some practice to get into the habit of recognizing your good qualities and your good choices, so get started! Don’t forget to appreciate:
Every milestone, whether a weight loss milestone or a non-scale victory. Each good decision you make, such as packing a lunch instead of leaving it to chance. How energized and proud you feel after eating right and exercising. Your new inner strength for recognizing what’s important – your health – and setting aside what’s not – a few moments of short-lived gratification when you visit the drive-through. Your efforts and resolution – because what you are doing is not easy! Reward yourself when you deserve it
Little gifts can make your appreciation seem sincerer, and motivate you to keep up the good work. Give yourself treats regularly to reward yourself for any progress you made, or “just because.” A night curled up with a box of pizza is no longer an option, but there are plenty of far better ways to show yourself “I love me!”
A massage or spa treatment. New workout clothes or other new clothes. A new app or fitness monitor to motivate you and show your progress. A morning sleeping in. Getting your house cleaned. A makeover or parts of one, such as a new haircut or different color nail polish. Be Your Biggest Supporter
Consider what a supporter does, and figure out how you can be your own biggest one. It can take some effort, such as planning ahead to pave the way for healthier choices, such as packing breakfast the night before so you do not go through the drive-through, keeping a pair of walking shoes in the car so you can grab a walk anywhere whenever you have time, and putting each of your surgeon appointments and support group meetings on your calendar so you cannot forget.
A supporter is also your biggest advocate. Speak up for yourself when needed, whether it is to tell the server at the restaurant that you need smaller portions and you would like the sauce on the side, or whether it is to tell your mother that you are doing this surgery for yourself because you need to. Your advocacy may include being firm with the surgeon about your preference for the surgery type you want.
Don’t Deprive Yourself
Telling yourself “no” constantly is no way to build a loving relationship! Grow the love by giving yourself treats. Just make sure they are on your diet. You might end the day with some Protein Cocoa or Chocolate Caramel Crispy Bites, sneak in some BBQ Zippers for an afternoon crunch, or greet the weekend with Protein Pancakes and a Protein Omelet. There are plenty of recipes online for healthy alternatives to favorite comfort foods from pizza and fried chicken to ice cream and brownies.
Balance Tough Love with Forgiveness
Honesty is the foundation for any strong relationship, including this one. Call yourself out when you make a decision you’re not proud of or you find yourself slipping into a slump where the scale starts creeping up or sweets start sneaking their way into your diet.
At the same time, realize that you will not be perfect, and accept that fact. Develop a plan for when you catch yourself off track. Your plan will probably include recognizing your mistakes, forgiving yourself forb them, considering what led you to make them, and resolving to fix them.
Build a stronger relationship with yourself, and you are setting yourself up for better success in the short and long terms. It takes some practice, but the results are well worth it.