catnapper

I totally agree. I was (and am) diagnosed with an eating disorder. I have learned to retrain my brain over time. I gave the scale so much power...so much power....until I worked really hard at changing my relationship with it, with food, with almost everything. I certainly wasn't at this place even 6 years ago. We all have to find what works for us and if getting on the scale destroys you it can certainly be something to focus on. I finally reached the point where getting on the scale was just a number to an equation and I was responsible for the feedback I was receiving. Before I avoided it and suffered even more because I imagined it to be far worse than it was. Once I started weighing every day, my weight hasn't fluctuated more than 5 pounds in years because I can catch what I'm doing. I'd rather work on a few pounds than ten pounds.
Regarding cheating: I don't actually use that term because I don't eat food anymore that has no nutritional value and/or might wake up those cravings that have long been quieted. Some people Celebrate a cheat day and if you can stick to that day and not go overboard, that's awesome. Again 100% is easy and it's that 99% that can get some of us in trouble. Since I wrote that blog post I've gotten the M&M story 8 more times. We are all different but thinking can be rewired or even progress can be made to get to a place where we don't react the same way we did a few years ago.
Regarding exercise: I had to look it up because I didn't even know how many steps equaled a mile. I attempt to hit a goal for steps per day and I have learned to do my best. You could say no one should wear a pedometer because they will have to beat those numbers. For that very reason my apps that report my steps are only seen by me. I know if I see I'm below my friends that I will try to do way better and not for the right reasons.
The list was generated by hundreds of people who report to this registry and have kept their weight off for a long time. It's simply data compiled to see what things were "alike". I don't often talk about my abstinence from certain foods but it came up in the list. I also receive hundreds of emails from people who lose their way after doing so well for some time because they fell back into old habits. Old eating habits, old thinking habits. Every day I try my best to wake up grateful for all that I have instead of coveting things I don't have. It's about progress too....and certainly not perfection. Deep rooted disorders can be tough to change but for many change is achievable even if it takes a long time. Thank you and everyone for their comments. I appreciate your kindness and mostly your respectful way of expressing yourself.

Ever since this story aired on the evening news I haven’t been able to get it out of my mind. For years the National Weight Control Registry has been keeping records and documentation of those who have lost weight and kept it off for years. The term “Super Dieters” tends to turn me off a bit because we all know diets don’t work and no one should be called “Super” as if figuring out how to manage your weight somehow gives you magic powers. I’ve been a member for several years. The questions are extensive… they ask everything you eat, your activity, how much you weigh, did you gain, did you lose, etc.


Ok…. so they gave us six tips these people seem to have in common and I’m thinking most people won’t get past the first one. Just like knowing the sky is blue, this first tip will be just like being told it isn’t….but what if this nugget is really spot-on? Truth is it won’t apply to everyone but I’m going to attempt to explain why it might apply to way more than you think.

Let’s get the next part over with (the posting of the list) so we can go ahead and get done with the screaming after reading the first rule.

Rule No. 1. Don’t ever cheat. They never give themselves a break, not even on holidays or weekends.

Rule No. 2. Eat breakfast. The National Weight Control Registry shows that’s one of the most common traits of those who succeed in keeping those pounds off once and for all.

Rule No. 3. Get on a scale every day.

Rule No. 4. Put in the equivalent of a four-mile walk seven days a week.

Rule No. 5. Watch less than half as much TV as the overall population.

Rule No. 6. Eat 50 to 300 calories less than most people.

So rule 4,5, and 6 deal with the “stuff” we’ve heard forever….calories in/calories out. For years I never ate breakfast because every day for over three decades I woke up with the idea that I would go as long as possible without eating. Too bad no one was around to tell me in the 4th grade that I was destroying my metabolism. So check…Rule 2 is a given. Since finding out there are about approximately 2,000 steps in a mile, most days…Rule 4, check!

Rule 5 done. Sometimes I watch TV while I’m walking so I’m not sure exactly how that fits in.

Rule 3 is an absolute for me. “Hello scale” every morning…it just gives me feedback and it has no special monster powers. I’ll do a “part two” in order to cover this in another post because this one is for everyone still laying on the floor from a cold faint after reading Rule 1.

My surgery was nearly 13 years ago and I’ve learned many, many things. Some beliefs that were absolutes changed and Rule 1 was one of them. I’ve told this before and I’m telling it again. Early on I would allow myself my one guilty pleasure ONLY IF I was able to get 5 pounds below goal. (It was a Quarter Pounder with cheese – insert my self induced shame). I was somehow able to stick to that but what I noticed was on the days I couldn’t have it, I wanted it! Eventually it became harder and nearly impossible to get 5 pounds below goal and after some period of time I also realized that I was beginning to forget how my “crack” meal tasted. Then I totally forgot and I didn’t even crave it anymore. Because I stopped eating it I had successfully rewired my brain to lose the cravings. I was also acutely aware the cravings would come right back if I ate another one…even one bite. Um….duh. That’s sort of like quitting cigarettes and having one just for fun after 3 years. I’ll say this again too. For me, the idea of taking a bite of something to get past the craving equates to giving an alcoholic a sip of beer to stop the craving. SOME of us can take these bites but so many cannot.

If I had a quarter for every post-op that told me the M&M story, I could take a trip to Mexico. The M&M story you might ask? Maybe it’s because they are tiny…but the story always starts the same. “I was doing great for 2 years, 4 years, (sometimes even longer) and I ate one M&M. Really what could that hurt? Next it was two then three…then a small bag, a bigger bag.” Some call it testing the waters. They went such a long time without one single M&M and nobody died, they certainly didn’t miss out on anything of nutritional value and they were doing great until they decided they could try just one. In other words they never cheated during that time and most were at the weight they wanted to be or at least smaller than after they started the M&M’s. You CAN be abstinent from sugar and junk food and it is far easier if you have none instead of a little for those that struggle with not being able to stop.
Again let me repeat….IF you can “eat just one”, go for it. I’m beyond thrilled for you!!! If you find you are not losing or you are in the process of regain, you could always try stopping any food you don’t wish to crave. Try it for a month but approach it one day at a time. When I’m somewhere and there’s a bowl of M&M’s, I look at it as if it’s a bowl of cyanide. Sugar put me in the prison of an obese body and at the end I would have rather died than spend another day at my heaviest weight. And really….if you were a drug addict would you allow yourself a cheat snort once a week?

This is a great quote that applies. 100% is easy, 99% is a b***h. Not eating processed sugar and junk food 100% is so easy but 99% leaves a ton of wiggle room. It has became totally effortless for me to avoid these foods but please don’t misunderstand…..my journey is still something I work on every….single…day.

If you still think this is utterly ridiculous, file it away for later. My favorite quote:

There is a principle which is a bar against all information, which is proof against all arguments and which cannot fail to keep a man in everlasting ignorance — that principle is contempt prior to investigation. It means don’t knock it until you’ve tried it.

And just in case you might have missed this before… I’ll leave you with an oldie but goodie.. .

I agree The Biggest Loser is TV not reality. They are working out 6 hours a day with the best trainers in the world and do not have the distractions of a job, kids, husband, house cleaning, etc. But I like to see the last chance workouts with everybody moaning and groaning and sweating. I would DVR the show each week and get on my elliptical and workout while watching it pushed me at the same time Bob or Jillian were pushing the others. One of the posters above talked about how hard it is to start a workout routine. It can be but don't assume you have to get up at the crack of dawn and go to the gym. I actually do not like gyms at all. I started by walking outside (now jogging 3-4 miles, 3x per week). I also have dvds that challenge you with hand weights I mix it up and do a different one 1-2 times per week. There are also so many free on demand workouts on cable tv. Make it easy for yourself to start.

ok I fess up..lol...the 6 out of 7? I watch GADS of tv..lol..hundreds of hours probably..lol..love my tv and coffee..GUILTY AS CHARGED!!

Admitting an addiction doesn't absolve you of responsibility, it simply means that you have greater self awareness. I personally don't have a problem with "Certain Foods", I have a problem with ALL foods. Did it occur to you that those "7 Habits" were simply the tools they used to battle their addiction, much as an alcoholic will use a 12 step program to battle their addiction?
Besides, if having to have WLS and and your GE system altered (band, sleeve, GB) to finally gain some control over my excess weight doesn't classify me as a "food addict" then I don't know what does.

In my work, I find that one of the most common explanations people give for their struggle with diets and with obesity is “I’m a food addict.” When asked what this means, most people explain that their inability to maintain the weight lost from diets and the fact that most or all of the weight eventually returns is proof of their “food addiction.” Additional evidence they cite is that their eating is “all or nothing,” that they can completely avoid so-called “forbidden foods” or binge on them with regularity, but nothing in between.
This kind of reasoning is called reasoning from the converse. This is where you have a conclusion or an end state and you then go backwards to explain the cause and use the existence of the end state as proof of the cause. This invariably leads to circular logic that goes nowhere. Here’s how it works: “I am a food addict which explains why I cannot moderate my intake of certain foods, and my inability to moderate my intake of certain foods proves that I am addicted to them and am therefore an addict.” But does it? There is actually another, more accurate explanation.
There are three facts that must be considered:
1) 95% of people will regain most or all of the weight they have lost on a diet within five years.
2) Many, if not most diets teach avoidance of “forbidden foods,” not moderate consumption of them.
3) Very few diets or weight loss regimens are successfully maintained indefinitely.
These facts are very important to our discussion because they are true for almost EVERYONE who has tried to lose a significant amount of weight. Therefore, either everyone who has failed to keep their weight off following a diet or eventually resorts to eating “forbidden foods” is a “food addict” or there are other explanations for this phenomenon.
But why is it that so many of the people I meet are eager to call themselves “food addicts?” Most people are uncomfortable acknowledging that they are addicted to alcohol or illicit substances such as cocaine or heroin, so why is being a so-called “food addict” easier to acknowledge? I believe it is because the label “food addict” removes the feelings of guilt and shame that so many people experience when they regain weight after all of the work they expended in losing it. It is absolutely heartbreaking to lose the weight, have people notice that you’re thinner and then a year later you’ve regained the weight and everyone knows it. It would be very tempting to blame this on a disease called “addiction.” “It’s not my fault that I regained the weight and am obese again…I’m a food addict.” I can certainly understand the desire to be free from responsibility from your obesity or weight regain; however, it’s not necessary to fall back on the explanation that you are a “food addict.” Perhaps if we looked at the facts about weight loss, there would be no need for all of the guilt and shame and the resulting need to explain it away by calling it an addiction.
Review the facts that I mentioned earlier. The overwhelming majority of people regain the weight they have lost from a diet, very few diets teach moderate eating of “forbidden foods” (so you’re left with only knowing how to eat them or not eat them), and most people find it very difficult if not impossible to stay on a regimen of controlled eating for extended periods of time. These are the problems faced by almost all human beings who try to lose weight, not just those who are “food addicts!” So what is the explanation when someone actually succeeds in losing weight and keeping it off? Great question…and the answer is not that these rare souls are not “food addicts” or that they are “recovered food addicts.”
The National Weight Control Registry (NWCR) is an organization that keeps tracks of “successful weight losers” who have lost 30 pounds or more and have kept it off for at least one year. What should immediately catch your eye is that “success” is defined as losing 30 pounds and keeping it off for one year. So if losing 30 pounds and keeping it off for one year is considered “successful,” if you’re morbidly obese and manage to lose 100 pounds and keep that off for several years that would be incredibly successful! Extensive research has been done on these folks over the years and the most recent study has discovered 7 common habits which most of the 6,000 people studied have in common. 6,000 participants in a study is a strong number of people and one where the conclusions drawn are likely very robust.
Interestingly, the researchers noted that 90% of the folks in this study who finally lost the weight and kept if off had a previous history of losing weight and putting it back on. Therefore, the overwhelming majority of people were not successful on their first try. The seven habits of successful “losers” were: 1. Engaging in 200+ minutes of exercise of moderate intensity per week, 2. Limiting TV watching to less than 10 hours per week, 3. Eating a low-calorie, low-fat diet with less than 30% of calories from fat, 4. Consistency – relatively little food variety and the same daily pattern of eating, 5. Eating breakfast, 6. Avoiding emotional eating and binging and limiting consumption of fast food to less than once weekly and, 7. Monitoring yourself such as documenting calories and/or fat. Notice that every one of the seven habits is just that…a pattern of behavior. There is no mention of the characteristics of the 6000 people. It’s not about who they are, but rather what they did and continue to do.
So what do we make of this “food addiction?” Neuroscience is recognizing the difficulty human beings have in resisting certain foods that we can call “engineered foods” that are high in sugar, salt and other additives. These foods are designed by fast-food companies and food manufacturers to be irresistible because they cause certain reactions in the brain that make it hard for us to say no. But these are challenges for us all. In fact, mass consumption of these “engineered foods” is likely one of the great contributors to the obesity epidemic. They explain why we, as a society, are getting fatter. Perhaps we will discover that some individuals (for neurological or other reasons) have a more difficult time resisting these “engineered foods” enriched with sugar, salt and other additives, and that these individuals are the true “food addicts.” But what would knowing that you are one of these individuals change? What would a “food addict” do differently to lose weight and keep it off?
The addiction model says that the addict should completely abstain from using the substance or drug. Should “food addicts” avoid all food (impossible) or just the ones they are “addicted” to? And how would we know which ones those would be? The most commonly cited addictive “substance” in food is sugar, but we’re not at all certain. There is also another problem. Much of the research on binge eating indicates that designating certain foods as completely “forbidden” and avoiding them results in feelings of deprivation and their becoming even more desirable which often results in binging on them when you finally give into temptation.
Perhaps someday there will be treatments for true “food addicts” if “food addiction” actually exists. What is more likely however; is that these folks will simply have to work even harder than most of us to stick to the seven habits that are detailed above. In the meantime, consider giving up the label of “food addict” and instead, recognize that losing weight and keeping it off is a tremendous challenge, but an achievable one. If you’re thinking of beginning to address your own personal “battle of the bulge” either for the first time or the twentieth time, or if you’re feeling hopeless and thinking there is no point in even trying, fear not…most successful losers apparently made several unsuccessful attempts before they finally got it right. And if you are thinking of starting yet again…the seven habits detailed above are a great blueprint to follow.

Bariatric patients should embrace both of these powerful tools to enjoy long term post surgery success, with food and lifestyle choices, that are faced with well into the future.



The Importance of Behavior Modification and the Role of Personal Accountability


As a bariatric patient care professional, I encourage the following mindset with patients from all surgery time frames and life situations:
Lifelong commitment to pursuing a healthier lifestyle,
Compliance to the recommendations of behavior modification, and
Addressing and grappling with the challenges that are life long

Self-awareness and personal accountability are two areas that are not so obvious when assessing one’s own role in the struggle with obesity. We are aware of genetics, family history, medical co-morbid conditions and life stress that impact each patient’s history of their own struggle with being obese. So how do patients obtain the necessary tools to support the physical presence of bariatric surgery? Through engaging in a solution to the past disappointments of weight loss efforts that are already so familiar.
Many patients report the path to insight and reflection often reveals mental justifications, old bargaining behaviors and frustrations that fuel negativity and inappropriate attachments to and uses of food. Although it is easy to lay blame for many things in life, self-deception only facilitates the repetitive cycle of anger and disappointment. In the professional arena, we often discuss the addictive quality of food and how food has a parallel function in the same manner that other behaviors do, i.e. shopping, drugs and alcohol, sex, gambling and the like. The need for emotional escape and mental distance can encourage us to use food as “anesthesia”, a way of shutting down and shutting out the world around us. We are careful to watch for those cross-addictive behaviors following bariatric surgery and recommend supportive resources across the board. These services provide a safe and secure way to investigate and discuss personal issues that are relevant and central to the patient’s path to success following surgery.
The role of a supportive aftercare program or community of patients, even individual therapy, is a vital component to future success and and be a valuable tool on the road to recovery, helping to smooth the transition and adaptation to new food related behaviors and lifestyle choices. The ability for patient’s to share a parallel experience and be able to “relate” to a certain stage of recovery, or a certain type of struggle with others, will provide an opportunity for engagement and bonding with others. On a therapeutic level, individual counseling can expand one’s degree of awareness and promote a greater sense of personal accountability, once the roots of old behaviors and attitudes have been identified and deciphered. A patient can then restructure their responses to daily challenges that may have been inadequate prior to surgery.
As patients walk the road of recovery from obesity, while engaging in physical as well as emotional healing, the element of discovery and pride is tangible and even contagious. Patients will enjoy improved health, greater energy and a strong positive attitude of self worth; what follows can be a heightened sense of calm, balance and overall peace of mind. Once personal discoveries have been made, individually or in a group setting, bariatric patients can feel a greater sense of control in planning the path in front of them. Commitment and compliance are two key elements that promote post surgery success. As patients employ newfound tools and wisdom on a consistent basis, quality of life can be infinitely better as well as profoundly rewarding.

After weight loss surgery, you need to plan your meals ahead of time. You always want a high-protein, low-calorie option to be available at meal time. You might find yourself carrying your own prepared food with you to be sure that you have the food you need. Sandwiches are good “go-to” option, but not just any old sandwich will do! This article can help you build sandwiches that are good fits for your meal plan.


What is Wrong with the Sandwiches You Used to Eat?
A typical workday might have started off with a trip through the drive-through for a breakfast burrito or sandwich, or a bagel and cream cheese sandwich at work. Lunch could have been a brown bag peanut butter and jelly sandwich or a trip to a nearby restaurant for a sandwich, burrito, or burger. Where might these options leave you?
Sausage, egg, and cheese croissant or biscuit from a drive-through (600 calories with 42 grams of fat)
Bagel with cream cheese (500 calories with 70 grams of carbohydrates)
Peanut butter and jelly sandwich (600 calories and 40 grams of sugar)
Club sandwich (1,000 calories and 2,500 milligrams of sodium)
Chicken patty sandwich (60 grams of carbohydrates and 1,100 milligrams of sodium)
Beef, bean, and cheese burrito (900 calories and 40 grams of fat)

Your breakfast and lunch sandwiches could have added up to over 1,500 calories. Add in beverages, sides (hash browns, fries or chips, anyone?), and snacks, and you could have been at 3,000 calories by lunchtime!
These Choices Don’t Work After Weight Loss Surgery!
Needless to say, these options do not fit into your weight loss surgery diet.

First, some of those sandwiches have more calories than you are supposed to be eating in a day, not to mention that some also contain more saturated fat, sodium, and sugar than you should have in a day.
Second, those sandwiches emphasize starchy breads and fatty condiments, not the lean proteins and nutritious vegetables you need to stay full and nourished after weight loss surgery.
Third, they can cause complications. Doughy bagels and fried chicken, for example, can cause obstructions in lap-band patients; fatty sausage and sugary jelly can cause dumping syndrome in gastric bypass patients; and these low-nutrient foods can fill you up and cause malnutrition.

Luckily, this does not mean that you need to give up the convenience of sandwiches and the pleasure you get from biting into one. There are plenty of ways to make sandwiches that are weight loss surgery-friendly: low-calorie, high-protein, convenient, and delicious!
Protein Fillings for WLS Sandwiches
Start by choosing a lean source of protein, just like you do when you plan all of your meals. These are some healthier options compared to what you might have chosen before weight loss surgery. Don’t forget to measure your portions if you are making your own sandwich, or eyeball your portions if you are ordering in a restaurant.
2 scrambled egg whites (30 calories)
2 ounces of canned light tuna (60 calories)
2 ounces of chicken breast, lean ham, turkey breast (80 calories)
2 ounces of fat-free cheese (90 calories)
½ cup cooked beans or 1 vegetarian burger (120 calories)
2 ounces of turkey or vegetarian bacon or breakfast sausage (130 calories)

Load up on Vegetables and Fruit
Vegetables and fruit are the next food groups to add to your meals. Vegetables especially are low-calorie, so add more if you want a bigger sandwich. Try classic combinations, or get creative. You can also experiment with herbs such as fresh cilantro, basil, and dill. These are some ideas.
Lettuce and tomatoes with meat and cheese
Grilled eggplant, zucchini, and/or bell peppers with beans
Cucumbers and sprouts with fat-free feta cheese
Diced celery, carrots, onions, and water chestnuts with tuna
Spinach and mushrooms with egg whites
Pear or apple with fat-free cheddar cheese
Cantaloupe with ham and/or fat-free cheese
Blueberries with egg whites

Breads and Alternatives
Most bread is high in carbohydrates and low in protein – clearly not what you need for your nutritious weight loss surgery diet. Besides adding calories and carbs, bread can cause obstructions in lap-band patients and make gastric bypass patients sick or overly full. When possible, skip the regular bread.
Bagels
Tortillas
Subs
Croissants
Biscuits
Regular sliced bread

Instead, choose whole-grain, high-fiber, low-calorie breads, and consider open-faced sandwiches, with the filling on 1 slice of bread, instead of regular 2-slice sandwiches. These are some good options.
Reduced-calorie bread (45 or fewer calories per slice)
Light English muffin (50 calories per half)
Mini whole grain bagel (60 calories per half)
Low-carb tortilla (50 calories per small tortilla)
High-fiber, light wrap (90 calories per wrap)
Also, look for creative, non-bread alternatives.
Lettuce leaves to make lettuce wraps or cups
Egg roll or wonton wrappers
Sheets of dried seaweed
Grilled eggplant
Your fork (skip the bread and just eat the filling)

Keeping Condiments Under Control
The condiments that you add can make or break your sandwich, both in terms of nutrition and taste. Skip the full-fat mayonnaise, dressings, dips, sour cream, and butter, and be wary of high-sugar jam, barbecue sauce, and honey mustard. Instead, consider the following condiments.
Salsa
Fat-free mayo, dressing, dip, or sour cream
Regular mustard
Plain, non-fat Greek yogurt
Hot sauce
Shredded fat-free parmesan cheese
Reduced-calorie, trans fat-free margarine

Some Breakfast Sandwich Ideas to Start Your Day Off Right
Egg whites scrambled with spinach, mushrooms, and fat-free feta cheese on ½ English muffin
Cottage cheese and strawberries wrapped in lettuce leaves
Shredded fat-free cheese and lean ham toasted on a slice of reduced-calorie, whole-wheat bread and topped with salsa and tomatoes
Egg whites cooked with turkey bacon and broccoli in a small, high-fiber wrap
½ whole-grain mini bagel spread with fat-free cream cheese and topped with canned salmon with diced celery and water chestnuts

Lunch Sandwiches
Lettuce wrap filled with diced chicken breast, bean sprouts, mushrooms, and bell peppers, and soy sauce or light Asian dressing
Dried seaweed sheet rolled around tuna salad made with fat-free mayo, chives, and celery
Pinwheels made by layering slices of turkey breast, lean ham, and fat-free cheese slices, spreading them with mustard, and rolling them
Bean burrito with black beans, fat-free cheddar cheese, salsa, and fat-free sour cream on a small, high-fiber tortilla
Chicken breast with sliced apple and light vinaigrette between slices of grilled eggplant
Tomato sauce, fat-free mozzarella cheese, and mushrooms on a light English muffin
Toasted Rueben sandwich with low-fat Swiss cheese, shredded cabbage or sauerkraut, lean corned beef, and fat-free Thousand Island dressing on a light English muffin

Are You Ready for Some Sandwiches?
You can eat these sandwiches at home, or make them ahead of time and carry them with you in a reusable container. As a weight loss surgery patient, you should own plenty of reusable containers with tight-fitting lids. If you do not already have some, they are worth the investment so that you can carry healthy foods with you wherever you go.
We hope that you enjoy these sandwich ideas and that you are inspired to make some of your own healthy, high-protein sandwiches!

You know that you will never hit your goal weight if you intentionally try to cheat on your diet by sneaking bites or deciding not to log certain foods. But what if you think you are doing everything right and are still not losing the weight you expect? Hidden calories may be to blame. Figure out the sources of hidden calories in your diet, and you just may have a weight loss breakthrough!


Overeating is Possible after WLS

You got WLS so that you could lose weight, but it is important to remember that WLS is only a tool. To lose weight, you need to use that tool properly. If you fall into the trap of thinking that WLS automatically leads to weight loss, you might never hit goal weight. As a reminder, these are how the lap-band, vertical sleeve gastrectomy (VSG), and gastric bypass can help you lose weight.
Lap-band: The lap-band creates a small pouch, or stoma, to help you fill up faster so that you eat less.
Vertical sleeve gastrectomy (VSG): The surgery removes most of your stomach and creates a small sleeve out of the remaining portion. The gastric sleeve restricts the volume of food you can eat and it reduces hunger by reducing the amount of ghrelin, which is a hunger hormone.
Roux-en-Y gastric bypass: The surgery restricts food intake by creating a small pouch, and reduces nutrient absorption by having food from your stomach bypass much of your small intestine.

Your weight loss surgery will not work for you if you cheat in these ways.
You eat more frequently – and take in more calories – than your surgeon suggests without feeling the restrictive effects of the adjustable gastric band.
You eat sugary, fatty high-calorie foods. The lap-band, especially, is unlikely to cause you to develop dumping syndrome. That is good because you will not get the unpleasant symptoms, but it is bad because it does not prevent you from eating sugar, starch or fat. Even with a stoma size of just 4 ounces, or a meager 1/2 cup, you could fit in 400 calories’ worth of M&M’s in with room to spare.
You drink fluids when you are eating solids so that you are able to consume more at a single meal or snack. Drinking fluids while eating solid foods can also cause your stomach, sleeve or pouch to empty faster so that you get hungrier sooner.
You sip on beverages that provide calories but do not fill you up.

How Hidden Calories Might Be Throwing You Off

What if you think you are following your weight loss surgery diet diligently? You measure your food whenever you can, you use your dietitian’s food list when you go grocery shopping, and you order chicken and vegetables when you go out to eat. You get protein at every meal, and you drink plenty of water each day.

Hidden calories are the ones that creep into your diet. You might not know you are eating them, or you might think that you eat so few “extra” calories that they don’t matter in your diet. But, they do impact your weight loss. An extra 20, 50, or 100 calories here or there really affects your weight loss. Remember that a pound of body fat equals 3,500 calories. That’s an average of 500 calories per day to lose a pound a week. If you are getting hundreds of hidden calories a day, that could easily be a pound a week that you’re not losing.

Where Are the Hidden Calories?

Good question! They can be almost anywhere.
Starches are not necessarily unhealthy, but they should only be part of your meal after you eat your protein and vegetable or fruit.
Protein is the first thing you should eat at each meal and snack, but it is also a source of calories. Fatty meats and poultry with the skin can have 100 or more extra calories per 3-ounce portion compared to lean meats and chicken or turkey breast.
Healthy foods can be high-calorie. A handful of nuts or dried fruit or a big spoonful of peanut butter can have 200 to 300 calories.
Condiments can wreck your diet. A tablespoon of mayonnaise has 100 calories, a tablespoon of jam has 50 calories, and a tablespoon of salad dressing has 80 calories. Ketchup, teriyaki sauce, and marinades can have 15 to 20 calories per tablespoon.
Restaurant foods can be tricky. Vegetables that you think are steamed can have butter in them, and chicken, fish and other proteins that you think are good choices can come in sauces with 100 or 200 calories per serving. Portion sizes can be several times what you need: a 12-ounce steak is 4 to 6 WLS-sized portions, and a 3-cup plate of pasta is 6 to 8 WLS-sized portions.

o Examples of each of the below. Carbs: toast, crackers. Eat celery. Smaller pasta, more protein meatballs.
o Protein. It’s a nutrient, but it’s also a source of calories. Esp. if with sugar/carbs in supplements, or hi-fat protein foods. Bacon
o Healthy hi-cal foods: nuts, pb, dried fruit (fresh). Portion sizes. Avocado.
o Condiments. Fatty dressings (choose low-fat), use less (use herbs), sugary
o Portion sizes. MEASURE. Nibbling without measuring, eyeballing. You get 60 extra calories every time you take a piece of cheese that is the size of your thumb (1.5 ounces) instead of weighing it to make sure that it is only 1 ounce.
o beverages
o Restaurants: salads, fat added to “grilled” foods or steamed vegetables, beverages, “healthy” bagel instead of low-cal doughnut
o Eating too frequently. Tips for if you’re starving (protein, no fluid with meal); tips to make meal smaller (if you’re eating so many meals, don’t need to be big)

The Good News
The good news is that small changes add up to big calorie savings.
Have an ounce of low-fat cheese instead of full-fat, and save 50 calories.
Have a quart of regular or sparkling water instead of a quart of a sports drink, and save 200 calories.
Skip the bite of cookie dough after you finish baking for your children, and save 100 calories.
Have 3 ounces of 95% lean ground beef instead of 85% lean ground beef, and save 70 calories.
Rinse the spoon instead of licking it after you serve yourself peanut butter, and save 30 calories.
Spread peanut butter or tuna on 3 large celery stalks instead of 6 triscuit crackers, and save 90 calories.
Have one-third of a cup of pasta with your meatballs instead of a full cup, and save 120 calories.

This works for exercise, too. Every little bit helps. When you walk for just an extra half-mile, or about 10 minutes, you burn 50 extra calories.
Start to think about where extra calories may be coming into your diet, and see what you can do to limit them. You’ll be happier with your weight loss results!

Sleeve gastrectomy surgery reduces the size of the stomach by stapling along its length to form a long tube that looks similar to a banana. The majority of the stomach is then removed and discarded. The new banana shaped stomach is long and thin hence is often referred to as a ‘sleeve’.


Sleeve gastrectomy surgery reduces the size of the stomach by stapling along its length to form a long tube that looks similar to a banana. The majority of the stomach is then removed and discarded. The new banana shaped stomach is long and thin hence is often referred to as a ‘sleeve’.
About 80-90% of the stomach is removed making it much smaller, hence it holds much less food than it did previously. This smaller stomach helps you feel satisfied after eating a small amount of food. In addition, the part of the stomach that is removed is the part that secretes much of the hormone called ghrelin, which is involved in stimulating appetite. It is thought that producing less ghrelin further helps to reduce hunger after surgery. Although ghrelin levels start to rise again after surgery, they don’t seem to return to their previous levels and so hunger is more easily satisfied.
Unlike the adjustable gastric band the sleeve gastrectomy is not reversible. The stomach may stretch, or adapt to fit a little more food, but it cannot grow back. A sleeve gastrectomy therefore is a commitment for life.
As you will be eating less after sleeve gastrectomy, making the most of your food choices is important to help you obtain all the nutrients required for good health.
Following a sleeve gastrectomy most people will lose most of their excess weight in the first year. After this time weight loss often stabilises, so make the most of this period by making good food choices and regular physical activity a habit for life. After the first year, your ongoing success will depend on your efforts to change your lifestyle and maintain these habits in the long term.
Whilst the size of the stomach changes after surgery, the type of foods that can be eaten does not. Choosing high-energy (calorie or kilojoule) foods regularly will hinder your progress. As with other types of weight loss surgery, snacking or grazing, lack of physical activity and poor food choices can lead to weight regain. Positive, lifelong changes to eating and physical activity will ensure your long-term success.
Poor food choices can also cause dumping syndrome. Dumping syndrome had been thought to occur only following gastric bypass surgery, however it has been seen following sleeve gastrectomy surgery. Avoiding fatty or sugary foods will help prevent dumping syndrome. We will discuss dumping syndrome in a coming edition of the newsletter, but for now you can see a simple explanation here. Avoiding fatty or sugary foods will help prevent dumping syndrome.
A 2011 study found that those who had regular follow up after sleeve gastrectomy achieved better weight loss, health improvement, quality of life and food tolerance, than those who did not. Your support team is there to guide you to acheive the best results following surgery, so make the most of the team and keep in touch! They have all sorts of hints and tips to help you achieve success on your weight loss journey.

What prompted me to write this article is a conversation I was having with a fellow sleever a few weeks ago. Shortly after her surgery she started having symptoms that her doctor diagnosed as a gluten intolerance. Around the same time, I began having similar symptoms - I began getting a rash on my legs and arms, I started getting stuck in my weight and having bloating, even began getting canker sores at odd times. As it turns out, I also now have a gluten sensitivity. Over the course of the last couple of weeks, I've spoken with several other sleever friends that have also had similar problems. So I did a Google search and found this article and several others on just this subject. I also did a quick check on Web MD and read the book Wheat Belly. With this information in hand, along with a diagnosis from my daughter's endocrinologist that she may have a gluten sensitivity as well, I put myself and my daughter on a gluten-free diet (her's was doctor recommended). My rash, canker sores, and bloating have all disappeared, and some of my daughter's issues are also starting to dissipate.

I am curious as to how many others have developed gluten sensitivities after WLS? Have any of you? I'd love to hear your stories!