lthueme

Great article! I am going to share with my non-Bariatric patient friend who was just asking me today about a diet plan she saw at Costco. I advised her to just focus on eating healthy and track everything. This will be good coming from another source

Great article! I am going to share with my non-Bariatric patient friend who was just asking me today about a diet plan she saw at Costco. I advised her to just focus on eating healthy and track everything. This will be good coming from another source

Great article! I am going to share with my non-Bariatric patient friend who was just asking me today about a diet plan she saw at Costco. I advised her to just focus on eating healthy and track everything. This will be good coming from another source

Do you fear the word “diet”?
Then why are we required to see “diet-icians”? I’ll tell you why, because the true definition of diet is a personal style of eating. Either you have a good diet, or you have a bad diet – but most think of it as being on a diet, as in eating horrible, boring food for a set period of time, only to go back to one’s old way of eating which sadly is usually not healthy.


The dietician teaches us a healthy – guess what word I’m going to use next – diet. It includes all of the basic food groups, proteins, fruits & vegetables, carbohydrates that are high in fiber and other nutrients our bodies need to survive, dairies, fats and let’s not forget WATER. There are other groups but are usually lumped into one of the major groups, such as legumes are considered either proteins or sometimes good carbs. Anyhow, you get what I’m saying I hope – that our diet is just that – our means of eating to survive.
Good diets… what can we do to avoid using the word diet without causing a panic? We should set our diet in a healthy way. Why? Because to see the word diet and understand that it is a lifestyle change to make our bodies healthy and happy is the only way. It’s for life, not in the temporary sense.
Choose meals with as close to clean and basic as possible. Lean proteins, keeping colorful and fresh fruits and vegetables around, carbohydrates that are high in fiber, dairies that are low in fat, and fats that are high in the Omegas and low in saturation.
Look on the internet or ask friends for good healthy recipes! This helps to keep the stigma of boring out of your vocabulary. I’ve had a fish meal in about a hundred different ways, and many different types of fish so I never get bored! It doesn’t always have to be baked and bland. Explore seasonings that are low in sodium and dress it up with some cook-able fruits and vegetables. You will be pleasantly surprised at how tasty a “boring diet” can be. It’s definitely something you can continue on forever and have a healthy diet.
Keep a log of what you are eating and if you notice that you are eating something too often, change it up. Keep it off your “To Cook” list for a few weeks. Boring diets can become a problem and make you crave foods that are not healthy for you. You don’t have to eat chicken breasts every day to be considered a good bariatric patient. There are many cuts of protein that you can make in a healthier way.
Which brings me to the next bullet point – you can basically eat any cut of meat you prefer. They all have B-12 which our bodies LOVE obviously. Not only that, beef is very high in iron, pork is considered the other white meat (just be sure to trim the fat!) and best of all most bariatric folks get fuller faster and stay satiated for a longer time on these cuts. Ensure you are chewing very well with these cuts and are far out enough from surgery to not get “stuck”. Not only that but eat slowly and judge each bite to recognize your full signal.
Always choose all different kinds of fruits and vegetables and get a minimum of 5 servings per day. A serving of fruit is one half of a medium sized fruit. Get plenty of vegetables of all varieties. Yes greens are awesome, but many other vegetables get ignored simply because they are of a different color, but yet they are packed full of vitamins that are hard for us to get otherwise. We will forever be bound to the supplement, but we shouldn’t ignore this group because we get it in a pill. They are very tasty too, some are sweeter and some are full of vigor but any will dress up a meal!
Drink plenty of water. I don’t think this is a shock to anyone! Water will make you feel energized and alive during the weight loss process. It does also constantly flush your body of toxins, sodium and water weight (I know it seems like it would be opposite but it’s not) which shows up nicely on the scale. As bariatric patients we no longer are able to get our H2O from foods we eat, because we simply don’t eat enough. I’m telling you that 64 Oz per day should be anyone’s goal. If you can get in more great, if you’re not getting that in – time yourself. 8 Oz every hour for 8 hours, or for myself I do one 16.9 Oz bottle every 2 hours.

Now for the evil bad diets…
Just don’t do it.
If you must have a snack that is not healthy, limit yourself. You never need more than one serving of anything bad. Bad is considered high in saturated fat, refined sugar, added sugar, high in sodium, and high in calories that might put you over your daily limit.
When partaking in eating non-nutritive foods, enjoy it! Sit in a quiet spot and truly taste your food you have chosen.
Do not mindlessly eat it; you will just keep going back for more to try to fulfill the desire. Sad to say it usually never registers.
Think about what you just ate, and judge it. Was it as delicious as you envisioned it in your mind? If so, what was good about it? If not, why did you eat it? Will you eat it again?
Do not allow non-nutritive foods become a regular part of your diet. They should be a treat, once in a while. Remember our stomachs can only hold so much nutrient dense food, but non-nutritive foods usually come without capacity. The further out from surgery we get the more “bad diet” we can fit in and if you don’t teach yourself limits this WILL become a problem.

When you hear someone say, I don’t diet – I am doing a lifestyle change, that’s really great. But all they are really saying and doing is changing their bad diet to a good one, permanently.

All people meet it at some point in their weight loss journey. It might come after you experience complications from surgery, or when you travel for vacation, or when you are unusually stressed at work. It might even come when you least expect it, when your diet and weight loss have been going smoothly for months. “It” is the dreaded plateau.


How Do You Know When You Hit a Plateau?
Simply enough, a plateau is when you stop losing weight even though you want to. It’s not just a day or two without weight loss. It’s a period of a few weeks or more when you keep trying to lose weight, but the scale does not budge. You think you are doing everything you can and should be doing to lose weight, but still you do not see results. That is a plateau. It can be frustrating and discouraging and seem to be unfair.
Stay Positive
Plateaus can be maddening, but the absolute worst thing you can do during a plateau is to give up. If you decide that your diet is not worth the effort, you are almost certainly going to gain weight. Going back to your old, pre-surgery diet habits, taking oversized portions, and eating high-fat, high-sugary foods will not just make you gain weight. These bad habits can erase your health gains. Worse, they could cause some of the weight loss surgery complications that you already know about, such as the following:
Stretching of the sleeve in vertical sleeve gastrectomy
Dumping syndrome in gastric bypass
Esophagitis with the adjustable gastric band (lap-band)
Feeling nauseous or having diarrhea

Another reason to stay positive is to keep up your motivation to continue all of the other healthy behaviors in your lifestyle. Don’t fall into the trap of “all-or-nothing,” in which you decide to give up all of your healthy efforts just because your weight loss isn’t quite what you want it to be. These include:
Taking your daily vitamin and mineral supplements
Getting enough protein and fluids each day
Following your regularly exercise routine

It Could Be Worse
And it will be worse if you give up. It may sound strange, but you can stay positive by thinking about how much better your weight is now than where it could be if you gave up trying. If your careful diet is not leading to the weight loss you had hoped for, it is still preventing weight gain. If you give up, you will gain weight, and probably be pretty disappointed in yourself.
Measure Success in Other Ways
Another way to stay positive is to stop focusing on the scale. Find other ways to measure your progress. Tracking your body measurements, for example, can let you know that you are shrinking and building muscle even if your total weight is not decreasing right now.
Tracking behaviors instead of measurements is another strategy. For example, you assess your success according to whether you eat well, such as hitting your protein goals or sticking to your planned menu. Other successful behaviors to be proud of yourself for are planning and preparing meals ahead of time and making sure you drink enough fluids at times other than meal times.
Be Honest and Go Back to the Basics
“Why me?”
That’s a natural question when you hit a plateau, but most people don’t ask it seriously. However, if you think seriously about what is causing the plateau and how you can fix it, this question can actually help you break through the barrier and get back to losing weight.
In many cases, you can figure out “why me” by asking yourself these questions.
“Am I logging every single bite that goes into my mouth?”
“Am I following the meal plan my nutritionist or surgeon gave me?”
“Am I measuring – not eyeballing – all of the foods I eat?”
“Am I exercising as much as I am supposed to be?”
“Am I getting in my protein each day?”
“Have I been too busy or preoccupied to plan my meals and snacks in advance?”

If you answer these questions honestly, you might discover that you have slipped up and are not keeping up your good habits quite as well as you thought you had. Go back to the basics of meal planning and nutritious eating, and you are almost sure to see the scale move again within weeks.
You’re in Charge!
Plateaus are frustrating and nobody wants to experience them at some point, but almost everyone does. These steps can help you when you notice that you are in a plateau.
Stay positive and keep up your healthy behaviors.
Focus on other measures of success besides the scale.
Assess your diet honestly.
Make any necessary changes.

You can get over your plateau, and you will be stronger for it! Just be patient and do what you know is right for your health.

Yes, I agree with your article @@Alex Brecher! We are all in this together, some just take different routes to arrive at the same place - a healthier you! It may be a good idea to add some of your comments to the welcome email. Thank you for writing about this topic, it is a good reminder and refresher for everyone who has been here for a little while or from the beginning.

This should be a must read upon signing up. Not allowed to post until acknowledging having read this.
Thanks, Alex.
It is funny some of us feel we have to fight the "normies" regarding WLS all the while fighting each other.

Weight loss surgery is difficult, to say the least. The operation takes place after years or a lifetime of being obese and after months of research and preparation. Recovery can be anywhere from “not too bad” to riddled with complications. Nearly every aspect of your lifestyle changes, from your diet to the way you look to your relationships to your mental state. The entire experience is long and challenging, no matter how rewarding.


BariatricPal recognizes the challenges of being in the weight loss surgery community. You need every bit of support and information you can get to choose the best surgery for yourself, prepare for surgery, lose weight, and get healthy for the long term. The peer-to-peer support that BariatricPal members provide can be among the most powerful tools you have to help you achieve your goals. So please, help build the community up instead of tearing it down.
Potential for a Powerful, Unified Community
Our weight loss surgery communities began as WLSBoards, with four separate forums: LapBandTalk, VerticalSleeveTalk, RNYTalk, and SleevePlicationTalk. Each forum was dedicated to a single type of weight loss surgery. Members could discuss surgeons, diets, complications, and anything else related to weight loss surgery in general or the specific type of weight loss surgery in particular.
Then we merged the four WLSBoards to create BariatricPal, which is geared toward all types of weight loss surgery. This decision was based on the following beliefs.
We are all in this together. We have the same goal of fighting obesity through weight loss surgery.
The surgery types share many common characteristics and BariatricPal members can therefore benefit from having more input on topics such as the post-surgery diet progression, choosing a surgeon, ways to get more protein, and dealing with head hunger.
As a single community, we have greater potential to be a unified and strong voice for weight loss surgery than we did as separate communities.
Some topics are surgery-specific, and there is a need for surgery-specific subforums for certain topics such as fills for lap-band patients, experience with protein shakes for sleeve patients who may not be able to eat enough on a regular basis, and dumping syndrome for gastric bypass patients.

Has BariatricPal Become a Divisive Arena?
Unfortunately, BariatricPal members have had some regrettable experiences that contradict these principles. Rather than being supported, encouraged, and assisted, some members have felt attacked or belittled by other members who do not believe in their choices, whether in regards to type of surgery, food choices, or other lifestyle choices. Rude behavior, while unacceptable in any circumstance, is especially damaging in our community.
It weakens our collective voice.
It prevents some weight loss surgery patients and potential patients from getting the information they need.
It discourages WLS patients from pursuing their healthy lifestyles.

Avoid Destructive Posts
Most BariatricPal members are polite, helpful, and encourage. Occasionally, though, members post inappropriate and potentially hurtful posts that put down one type of weight loss surgery or another individual’s choice. In general, a poor post is one that makes a person feel bad and does not offer any useful information. These are examples of unacceptable posts.
“I didn’t even know they offered the lap-band surgery anymore because it’s so dangerous.”
“Weight loss is easy with the gastric bypass surgery. The rest of us have to work harder.”
“You shouldn’t be asking if you can eat that. If you even are thinking about it, you shouldn’t have gotten WLS.”

It’s okay to offer your opinion, but do it kindly. If you’re not sure if your post is okay, think about it before your post. The rule of thumb is to always err on the side of caution. Think how you would act if you were face-to-face with a good friend who had an opinion with which you disagree. You would listen to his or her position, then acknowledge the reasoning for that opinion. Then you would state your opinion and explain why you feel that way. Remember that feelings are harder to convey in written online conversations, and gentle words of advice can be interpreted harshly.
What We Have to Gain (or Lose)
When we all support each other, regardless of type of weight loss surgery, we have a lot to gain.
Positive atmosphere where everyone feels welcome, so those who need it feel comfortable to come and ask questions
Unbelievable wealth of experience and knowledge…among people who are kind enough to share it
A place where open discussions can lead to brainstorming and generation of ideas and strategies for success
A sense of pride that we are all here, with the same goal through the same means. Let us celebrate!

When rudeness and disrespect take over, we have just as much to lose. Just think about what would happen if you had a question, asked it, and got told that your question is dumb or that you are doing something wrong in your weight loss journey. Maybe you would leave BariatricPal or, worse, you would be afraid to ask your question anywhere else because you didn’t feel comfortable anymore. Nobody deserves to be treated like that.
Take a moment when you are on BariatricPal to appreciate the warm community, and think about what it means to you. The next time you post, ask yourself: are you helping to build a stronger weight loss surgery community, or are you tearing it down?

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.. .

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.

well, i must say i am lucky with my hub and my WLS. he totally committed to him and i eating better period...he himself has lost 25 pounds and his BP has dropped since we stopped with the high processed snack foods and every day take out.
a WLS patient to me does not have to turn the entire house hold upside down because someone had WLS...better choices/options can be made....and sometimes we just have to say no and learn to say no or eat just a small amount..
this is a lifestyle...learned slowed, accepted as a life long change...eating better quality foods is a trait that can be (learned) but it also must be done for success and better health...we can say we want to lose weight and be healthy but the hardest part is to do..
hub and his friends/family still come over and eat foods....(the yummies stuff) and i can either eat a bit here and there and not fret so much or just eat something else (which is what i do)....and i also prepare more healthy options for everyone..sometimes they notice and sometimes they don't..
great post alex

I do find some adjustments have an easy fix....
For example, when I cook a meal that I serve over rice, I cook white rice and brown rice. Same as with pasta, I cook regular pasta and whole wheat pasta. When I bake potatoes, I bake a few sweet potatoes for me and my husband, and baking potatoes for everyone else. As far as "junk" food, I never bought a lot of it before, so I still don't buy it on a regular basis now. For occasions where I serve chips and dip or guacamole, I now serve Beanitos (ground bean chips) and whole wheat crackers along with the regular chips for my guest. If the kids ever want ice cream, we take them out to get a scoup... That way we don't have a half gallon container in the freezer. We gave up carbonated drinks a year ago. The kids now drink tea or lemonade. While on the road and in need of fast food, we only stop at Wendy's, where I can get a great salad or a cup of chili. The kids can get their burger/French fry fix there at the same time. I thank God I don't have a sabottaging spouse or demanding type kids. My husband joined the gym eight months ago with me, eats whatever I prepare for myself, and benefitted from the changes because he took off 40 pounds this year as a bonus !!!!!

Your diet can be hard after weight loss surgery. You have to give up most junk food and monitor every bite that goes in your mouth. Although many patients have smaller appetites and fill up faster on less food, you can still struggle to make the dietary changes. You can be tempted to slip up, especially when food is around. And that is can be problem with family.
Family food dynamics before surgery might have been a lot easier. You ate the same food, went out together, and did not think much about which foods came into the house. After surgery, you have no choice but to restrict your diet. That is why family diet dynamics change after weight loss surgery.
Food Can Strain Your Family Dynamics
You can have the most loving family in the world, but they may not be your best dieting buddies. They may still want to buy their favorite foods, store them at home, and eat them when they want – even if it means eating them in front of you. These are some of the risks.
Caving in to these off-limit foods – and derailing your weight loss.
Becoming angry at your loved one(s) – and letting food hurt your relationship.
Banning all non-WLS foods from your home – and causing your loved one to be resentful.

How can you avoid these losing situations?
Everyone Needs to Compromise
The answer is compromise. You just went through a life-changing surgery because you struggled with obesity – and food – for years. You are on a strict diet, and cannot afford to have your hard work undone because your family continues to tempt you with high-calorie food. On the other hand, members of your family may feel that they have the right to eat whatever they want, whenever and wherever they want.
You can all compromise and come up with some new household rules. The following suggestions might work for your household, or you can come up with the rules that are best for your situation.
Family members are permitted to eat fast food meals inside the house, but cannot store leftovers.
Family members can keep certain wrapped snacks at home only if they keep them hidden from you and eat them outside the house, such as at school or work.
Everyone must wrap up and put away leftover foods so that you are not tempted to grab them
Everyone must respect your need to have your kitchen scale, measuring cups and spoons, and storage containers handy and available, not shoved deep into a back closet.

Family Members of All Ages Contribute to the Diet Dynamics
Your weight loss surgery affects everyone in your household in a different way, and everyone from young children to teenagers to your spouse contributes to the household’s diet dynamics. Modify your approach to be appropriate for each family member.
Young children – They do not necessarily understand your weight loss surgery or the reasons behind it, and they are unlikely to fully understand why the household’s diet is changing. Luckily, young children are likely to eat what you offer. Offer them the same healthy foods – lean proteins, fruits, vegetables, and nutritious starches – that you make for yourself, and you may be surprised how well they accept them, especially when you are cheerful and positive about it. In addition to serving healthy foods at home and in sack lunches, you can pack a treat for lunch so that they can enjoy it and you are not tempted to eat it.
Teenagers – Teenagers want to be independent. On principle, many of them automatically seem to reject anything that you do. The truth is, though, that they often just don’t want their friends to think that they’re different. If you have teenaged children, keep plenty of healthy snacks on hand and serve healthy foods at meal times. You may be surprised at just how often they choose to “sneak in” the healthy choice instead of opting for junk food! Don’t make a big deal out of it, or the teens will go right back to choosing junk foods. To further allow teens their sense of independence,
An important consideration with teenagers is that they may have their own weight concerns. They may already be overweight, or they may worry that they will one day struggle with their weight just like you did. That’s why it’s important now to allow them to develop healthy eating habits without putting pressure or rigid restrictions on them.
Spouse – You spouse is happiest when you are happy. You would do anything for your spouse. So why can weight loss surgery – which you went through to help you become healthier, happier, and a more capable person – lead to so much tension? Your spouse might not completely support your surgery, especially if he or she has never had a serious weight problem. Also, your spouse may be jealous of your resolve and new lifestyle.
On top of everything else, your spouse might be afraid that of losing the foods that he or she loves, either because you won’t allow them or because he or she eventually will need to accept and confront his or her own weight problem.
You need to have serious discussions of all of these issues and come to an agreement, just like you do in all other parts of your relationship. Let your spouse know that you aren’t changing as a person, but that you are becoming healthier. Let your spouse know that becoming thinner and more energetic will only deepen your love. And, discuss the food. Is your spouse willing to eat what you eat? Are there some treats that your spouse can eat in front of you that you are confident that you will not eat?
Family Meals Post-Weight Loss Surgery
You can have pleasant, healthy family meals even after weight loss surgery. One way is to prepare and eat your own food, while serving the rest of your family what they normally eat. You can all eat together. Even though you are eating less, you will take as long to eat as they will because you need to focus on chewing thoroughly and eating slowly. These are some other suggestions for family meals.
If you’re the one who makes the meals, you don’t have to make two every night. Once a week, cook your own food and refrigerate or freeze single-serving portions. Eat those at family meals, and cook for your family as usual.
Have a salad bar or other serve-yourself-style meal, such as a burger bar or pasta bar. Include WLS-friendly options as well as everyone’s favorites. Everyone can choose what they want to eat. For example, at a pasta bar, you serve yourself spaghetti squash, grilled chicken, tomato sauce, and salad, while others might choose spaghetti, meat sauce, and breadsticks.
Have a family treat night – can you decide that for one night, they can order in or eat junk, and you will stick to your diet? You might even be able to schedule your family’s treat night on an evening when you work late or you go out with friends so you don’t have to be around the tempting foods.
Make something that’s healthy for everyone, and just serve yourself a little less or skip the starch. You have learned to love lean proteins and veggies, and your family can, too.

Weight loss surgery changes a lot, from your body and mind to everything else in your life. Family diet dynamics are no different. With all of the other stress surrounding your new lifestyle, the environment surrounding food in your household can become tenser. With some understanding, communication, and compromise, you can keep everyone happy as you stay on track with your weight loss…and your family just might become healthier in the end!

Living with an adjustable gastric band is a partnership; it takes effort, compliance and conviction to live in a successful "team" effort.


You’ve made a commitment to adjustable gastric banding surgery, because you need to improve your overall present and future health. Sounds manageable, shouldn’t be too difficult; the results following bariatric surgery, 1 year, 3 years and so on, will be worth it. So, you have the surgery and, for awhile, it seems like magic, weight is coming off slowly but surely and you are working hard to move toward greater health goals day by day. If all goes well, you will have few bumps in the road, right? Well, that’s the hope, not always the reality.
I can tell you this; you are not alone on this journey and you will probably experience a good degree of success with your adjustable gastric band even if you are faced with a struggle from time to time. The challenges and rewards of surgery go hand in hand. The challenges of all patients remain virtually the same: how do we combine all the team professionals, support services, along with family and friends, to make this surgery work for you? It may help to look at the big picture for a moment and remind ourselves of the common issues that weight loss surgery patients may be facing along the way.
Here are some common challenges that bariatric patients may encounter at any point in the post-operative journey:
YOUR HABITS ARE TOUGH TO BREAK: You are human and make mistakes; you have habits and memories of the way food is woven into your life over the years.
YOU ARE BECOMING COMPLACENT: You are very motivated as a surgery patient at the beginning, then become complacent and lose motivation over time, after losing a large amount of weight.
YOU'RE OFF TRACK: You experience daily life stress that distracts you from your post surgery lifestyle priorities and commitment to better health.
YOU ARE AFRAID TO BE JUDGED: You have gained weight back now that you are 3 or more years post surgery but are embarrassed to reconnect with your surgeon and supports in your bariatric community, patients and professionals alike.

In addition to team professional support from your bariatric surgery program here are a few things to consider:
CONVICTION: Support and encouragement from family, friends and mentors. Those who have a vested interest in you and your success are the key people who help you post surgery and beyond. Try not to hear all or nothing of what others may say; seek what is helpful to you and leave the rest. Time and education help reassure those around you that your decision to have surgery is a sound one.
CONSISTENCY: Staying on a regular schedule with the surgeon’s office consists of regular lap band fills every 6 weeks or more, follow up visits with the nutritionist, regular blood work and support group attendance are ways to promote best results with your adjustable gastric band.
SHARING AND RECEIVING: Many patients find the use of individual therapy helpful or a group setting to reinforce continuous learning and lifestyle improvements. This would be recommended in addition to program support group attendance.
ONLINE SUPPORT SYSTEMS: Online resources are very helpful as an addition to program as well as personal support.

So here are the essential issues of bariatric living:
Your consistent awareness of these issues will increase the effectiveness of your weight loss “tool” so you can maintain a long and happy partnership with it.
It is an emotional adjustment at times and requires perseverance.
You will bicker, even fight at times (with your band) and say things you will regret.

Just remember, the band can be very flexible at times and allow you make mistakes but it cannot help you if you do not help yourself. That’s what life partners are supposed to do, right? They provide consistent support through all the ups and downs of life, through good times and bad.
You will have a long and prosperous relationship with your gastric band if you work as a team; isn’t that really the goal, after all?

Jean, another great article. The above is true for any restrictive weight loss surgery. If you don't change your eating habits and physical activity, you may lose for awhile but not get great results. Weight loss surgery is not a magic pill or wand. It is a tool to assist and still takes work to be successful.

Restriction is a myth, and it’s time to stop believing in it. The adjustable gastric band isn’t all about restriction after all. It’s all about satiety.


I tend to talk about satiety a lot. Why? Because recognizing satiety is absolutely crucial to our weight loss success and good health, no matter what bariatric surgery we have. Satiety is the sensation of having eaten enough food. Understanding satiety is so important to weight loss success that I’m dividing up what I have to say into three Satiety 101 articles. This is the first of the three.

Let’s start by asking an important question: do you think that your properly-adjusted band will restrict how much you can eat, so you take in fewer calories and lose weight? I realize that someone – perhaps more than one person (perhaps even your very own bariatric surgeon) may have told you that the adjustable gastric band works by creating a small stomach pouch that restricts how much you can eat. But I’m here to tell you, it’s a lot more complicated than that, and to go on thinking of the band as a “restrictive” method does bariatric patients a disservice.

The notion of restriction is a myth, a holdover from earlier times, before the band’s function and effects were fully understood. Now, after nearly 30 years of clinical use and studies, band manufacturers and bariatric surgeons are beginning to see that the old idea of the band’s “restrictive” mechanism is not only incorrect, but can cause a host of unpleasant and sometimes dangerous side effects and complications (such as band slips, esophageal dilation and achalasia, pouch dilation, and disappointing weight loss), and some of those complications can cause permanent damage.

If you swallow a few bites of barium-coated food (doesn’t that sound yummy?), fluoroscopy will show that food passes through the upper stomach pouch, right past the band, and into the lower stomach pouch within in minutes of each swallow you take, so that you can go on eating just like you did as a pre-op: fast and furious (when food doesn’t make that trip a quick one, it may mean that the band is too tight and needs fluid removed from it). That quick trip also means that you can eat far more food than you need, just like you did as a pre-op. Finally, the bariatric medical community is beginning to see that instead of being restrictive, the band works by reducing physical hunger (the need to eat) and appetite (the desire to eat), and by creating early and prolonged satiety, so that the patient, not the band, can reduce her/his food intake.

Now, let me re-state that from the point of view of someone who lived with a Lap-Band® for five wonderful years. It’s up to you, not your band, to make the band work for you. Your band is an inert, expensive piece of plastic that doesn’t limit how much you eat. It doesn’t know your name or that you hate broccoli. It’s not going to leap out of your mouth and throw your forkful of food on the floor when it’s time for you to stop eating. It’s not going to sound an alarm or start flashing red lights. It’s not going to shout, “Jean McMillan! Stop eating right this minute!” (Yeesh! In that last scenario, the band sounded an awful lot like my mom!)

Seriously, though. One of your jobs as a successful bandster is to learn when and how to stop eating, all by yourself. The “how” to stop is a big topic, not just for WLS patients but for every human trying to lose weight and avoid wasting precious resources like food, and far beyond the scope of this article. So for now, let’s concentrate on the “when” to stop eating part. We’ll do that in the second article in the Satiety 101 series: Satiated vs Stuffed, so stay tuned!

This is the first in the Satiety 101 series of articles.

Are you still searching for the feeling we call “full”?
Not once in my life before my band surgery did I ever feel I had eaten enough food. Day after day, meal after meal, I searched for the feeling of “full”. I had no idea what it felt like, for many reasons. Some were emotional, some spiritual, some physical. Researchers now theorize that the internal message system in obese people doesn’t function properly, so that we don’t receive or comprehend “full” messages. Whatever the reason(s), I ate as if I was shoveling food into a bottomless pit that no amount of food could ever fill.


As a new bandster, it took me a long while to even begin to pay attention to my eating, never mind figure out when to stop eating. And no wonder. For over 50 years, I had eaten mindlessly, greedily, endlessly. Every single day, every meal, every moment, I ate and ate to reach what I call Thanksgiving Dinner Full. I loved to cook (and still do). I loved to eat (and still do). My business travels took me all over the world, so that in each country I was able to enjoy a huge variety of different and delicious food. Occasionally the food was very strange – I can’t recommend eating the lightly grilled, still wriggling sea slug I sampled in Taiwan – but I was always game for a culinary adventure.
It’s very ironic that during those overseas travels, I witnessed true hunger, deprivation, and near-starvation firsthand. What I ate in one day then could probably feed a whole family for a week. In Southeast Asia I once met a new business associate for the first time. We talked business for a while. Then he said something startling, seemingly out of the blue: “Your family must be very wealthy.”
I said, “Uh, not especially.”
He smiled at my modesty, gestured at my size 24 body and said, “But it is true, because I can see that you eat very well.”
That encounter was mortifying on several levels, as I’m sure you can imagine. When I left that business career and coincidentally began dealing with my weight and eating issues, I also began to feel shame for my eating behavior, for the waste of all the food I’d gobbled up in my perpetual quest for TDF (Thanksgiving Dinner Full). But how on earth could I end that quest? How could I ever learn to stop eating before I reached the TDF level?
I was extremely fortunate to start my weight loss surgery journey a short while later, and even more fortunate that my Lap-Band® eventually became such an effective tool in helping me eat less and lose weight. Although I felt I’d done a lot of research as a pre-op, I have to smile every time I think of a bandster friend who told me, “I had no idea how much work this was going to be.” I had no idea either. Every bite of food, every sensation in my body before, during, and after I ate, became a big project.
If you’re a new post-op, or even a further-out post-op, are you too discovering how much work is involved in living with and succeeding with your band? Perhaps wondering, “What have I gotten myself into?” If so, that’s OK. Remember that you’re not alone, and that you can succeed even if feels like getting there is taking forever and a day.
So, c’mon, Jean. Get to the point. Tell us: how do you know when to stop eating? Do you eat until you're full? What is “full” supposed to feel like now?
My answer to the first question is no. As a WLS patient, you don't eat until you’re full. You should never again eat that way, not just because that’s how you became obese enough to qualify for bariatric surgery but because eating that way will hinder your weight loss and can cause some nasty side effects and complications. So you’re going to have to figure out a new stopping point. And that stopping point is the satiety point.
Satiety is not quite the same as being full. For a bandster, full means that you have overeaten again and will soon be so uncomfortable you’ll have to take a few breaths before you go on to clean that plate like a good kid. (Which, by the way, is another practice you’ll have to give up sooner or later). Full means your upper stomach has reached its maximum capacity and that at any moment, that food is going to back up into your throat and make an ungraceful exit all over you, the table, and your dining companions. Full means that you sped right past your satiety point. Full means that it’s time to start paying much closer attention to how you feel as you eat.
Satiety happens on your way to being full. With a properly adjusted band, you will be comfortable if you stop eating when you're satiated, but will experience discomfort if you eat until you're full. If you eat to the TDF point, you won’t have that old faithful full-belly sensation that made you loosen your belt while waiting for Mom to bring you a big piece of pumpkin pie.
Instead, you’ll probably feel pressure, even pain, in your upper abdomen and chest. You’ll produce enough excess saliva to make you drool. You’ll think you’re about to power barf. You’ll be very sorry you overate. You’ll promise God and your bariatric surgeon (who are not actually the same person, by the way) that if you can feel relief right now, you’ll never overeat again. You’ll need to learn some strategies to prevent another episode of overeating. In article #3 of the Satiety 101 series, “Recognizing Satiety,” we’ll take a look at some common signals our bodies give us when we’re closing in on the satiety point.

Do you know when to stop eating? To learn the when, you must pay attention to your “stop eating” signals.
How do you know when to stop eating? Do you eat until you're full? No, you don't. You should never again try to eat until you feel full, not just because that’s how you became obese enough to qualify for bariatric surgery but because if you’re like me, your stomach (or soul) is an endless void that no amount of food will ever fill. You’re going to have to figure out a new stopping point.


As mentioned in Satiated vs Stuffed, satiety is not quite the same as being full. Full means your upper stomach has reached its maximum capacity: that you have overeaten again – an old habit that made you obese enough to qualify for weight loss surgery. Satiety happens on your way to being full. With a properly adjusted band, you will be comfortable if you stop eating when you're satiated, but you’ll experience discomfort if you eat until you're full.
This third article in the Satiety 101 series discusses the signals your body gives to tell you you’re satiated, but that’s only half the battle. The other half involves heeding instead of ignoring those signals. That subject could fill a book (which that I might write some day). Today we’ll focus on recognizing your own unique Stop Eating Signals.
Because of its anatomical position (near your diaphragm, and pressing on the vagus nerve at the top of your stomach), the band’s presence (but not your band itself – which we must remember is an inert piece of plastic without any magic at all inside) can give you quick feedback about your eating behavior. The feedback is written in a language issued and understood by your brain, with assistance from your endocrine and digestive systems. Even if you were lousy in your high school French class, you will have to learn how to get directions in that language, so you won’t end up on Weight Gain Road instead op Weight Loss Avenue. Those directions come in the form of what I call Soft Stop and Hard Stop signals.
To understand those directions, you’ll need to slow down and pay attention while you eat. It takes 15 to 20 minutes for satiety signals to reach your brain and to be broadcast to the rest of you. If you usually eat with a crowd (family, friends, coworkers), you might need to try eating by yourself for a few meals so you won't be distracted. Stop signals can be subtle and they can come from unexpected parts of your body. It's better to heed a gentle reminder than wait for a hammer to hit you on the head.
SOFT STOPS are your early warning system, gentle reminders from your body that it's time to stop eating. Because they don't hurt much, they're easy to ignore. They include:
· Mild queasiness (an icky, but not about-to-vomit, feeling)
· Fullness or pressure in the back of the throat
· Pressure in the chest or just below the breastbone
· Throat clearing
· Some difficulty swallowing
· Burping (or the urge to burp)
· Taking a deep breath
· Mild coughing
· A sigh
· Hiccups
· Watering eyes
· Runny nose
· Left shoulder pain
· A sneeze
· More saliva in the mouth than usual
· A sudden distaste for the food you were enjoying a moment before
As soon as you notice one of these signs, stop eating! I don't care if your stubborn mind is insisting that it's okay to continue (because it thinks you have room for just one more bite, or the food tastes good, or you haven't cleaned your plate, or you deserve the food, or whatever's going on in there). If you go on eating past this point, you won't be changing your eating behavior and you're likely to get into trouble…that is, a hard stop.
HARD STOPS are the equivalent of running into a brick wall. They can happen without any apparent warning, but usually you have sped heedlessly past a soft stop before you hit the wall. Hard stops are the painful and sometimes embarrassing reminders that you have eaten too much, too fast, in bites that were too big, without chewing enough. They include:
· Chest pain and/or painful pressure or tightness in the chest
· Feeling like you have a rock in the back of your throat
· A burning sensation in the throat
· A “stuck” feeling, as if the food you’ve eaten has nowhere to go
· Productive burps (PB's) – regurgitation of food, kind of like the way a baby erps up milk
· Sliming (excess saliva and mucus that's so profuse, you have to spit it out)
When you experience a hard stop, STOP EATING! It's not at all a good idea to keep eating after you experience a hard stop, even if the discomfort goes away and your plate of food still looks appealing. You may feel fine and may in fact be able to eat some more, but you should not eat more. The hard stop has irritated your upper gastrointestinal system. Continuing to eat will just perpetuate the problem, getting you into a never-ending cycle of eat-hard stop-pain-eat-hard stop-pain. Cycles like that tend to turn into complications like band slips and esophageal and stomach dilation. That’s the reason for my next piece of advice: follow a liquid diet for 24 hours after a hard stop episode, then transition carefully back to pureed then soft then solid food.
If you’re like me, you did not have WLS in order to live on liquids for the rest of your life. That’s yet another reason to learn how to prevent hard stops in the first place, so that you can eat and enjoy real food at every meal.
Now here’s one last chunk of information before the bell rings and today’s class ends. You may not experience any or all of these stop signals any or all of the time. At breakfast you might get one signal and at lunch, an entirely different one. At dinner, you may notice no stop signal at all. As time goes on and you lose weight and the amount of saline in your band changes, your stop signals may change as well.
All that can be frustrating, but it will force you to go on eating slowly and carefully for the rest of your life, and that’s actually a good practice for anyone, banded or not. That plate of food before you is a blessing that some people in this world can only dream of. Those small portions may look puny to you, but would be a feast to someone else. So treat your food, and your body, with the care they deserve.
Learning to recognize satiety over and over again is an ongoing process because our bodies are not statues made of marble. We are all marvelous, unique, and complex creatures who change by the minute, every day of our lives. Click here to read about how those changes can affect soft and hard stop signals. http://www.bariatricpal.com/page/articles.html/_/support/post-op-support/restriction-riddles-r93

This is the third and final article in the Satiety 101 series of articles.