CherieRyde

I recently posted an article titled “The Biggest Loser:” Irresponsible Weight Loss Surgery Comments? . We received many fantastic comments from our concerned members. I've decided to follow up our article with an Open Letter to Dr. Robert Huizenga or Dr. H as he's known on the show. The letter will also be sent to the shows producers and staff members.


Dear Dr. Huizenga,
I am the founder of BariatricPal, the world’s largest online community for weight loss surgery patients and potential patients.
I am writing to you today regarding your role as an expert on “The Biggest Loser.” I am asking you to please stop publicly portraying weight loss surgery in a negative light without any explanation. Most recently, during the Season 16 Finale, you stated that losing weight using methods used on the show were far healthier than turning to weight loss surgery. The implication was that bariatric surgery is under no circumstances the best choice for individuals struggling with obesity.
I am asking you to stop making comments like this. You and “The Biggest Loser” have a significant amount of influence on America. The season finale attracted 5.4 million live viewers, with untold millions watching the show at a later time. Given that one-third of American adults are obese, it is almost certain that many viewers have obesity.
“The Biggest Loser” reaches out to this audience throughout the show. Contestants, trainers, and health experts like yourself directly address viewers who need to lose weight, offering encouragement and tips. As you know, positive gestures like this can motivate people to change their lives.
Unfortunately, the derogatory comments about bariatric surgery can have just as much impact, but in a negative way. Your statement at the Season 16 finale of “The Biggest Loser” and similar ones make weight loss surgery sound like a shameful, dangerous, and ineffective choice in all cases, with no further explanation.
According to the Weight-Control Information Network (WIN), 4% of men and 8% of women in the U.S. have extreme obesity (BMI over 40). That translates to about 20 million American adults who are potentially eligible for weight loss surgery. This figure does not include the approximately 60 million Americans whose BMIs are between 30 and 40, and who might be eligible for surgery due to the existence of a co-morbidity.
Not all of these individuals are eligible for and interested in weight loss surgery, but many are. BariatricPal alone, for example, has a quarter-million members who are weight loss surgery patients or who are considering surgery.
For weight loss surgery patients, your comments can be hurtful. Weight loss surgery is not the “easy way out.” It is a tool to help control food intake. Eligibility criteria include a requirement that patients be committed to the strict dietary changes necessary to lose weight after bariatric surgery. I and millions of other weight loss surgery patients who have successfully used weight loss surgery as a tool against obesity worked hard to get where we are today. We do not deserve for you and your colleagues to suggest that we have cheated to lose weight.
Comments that groundlessly condemn weight loss surgery can harm potential patients just as much if not more. Eligible candidates might decide not to get the surgery in part because of your position. First, your comments can lead to a feeling of shame for even considering bariatric surgery to fight obesity. This is unjust, since the post-surgery diet is strict and requires a lifetime of attention, just as “The Biggest Loser” contestants must modify their own diets for the rest of their lives to maintain weight loss.
Secondly, your comments on the show seem to imply weight loss surgery does not work. While there are patients who do not respond to surgery, and complications are always a threat, the scientific literature overwhelmingly agrees that weight loss surgery is a viable option for the treatment of morbid obesity.
Furthermore, the scientific community largely agrees that weight loss surgery can improve health and metabolic parameters. To varying degrees, methods such as gastric bypass, adjustable gastric band, and gastric sleeve have been linked to improvements in diabetes and other obesity-related conditions, such as hypertension, sleep apnea, and dyslipidemia. The UK’s healthcare system, known as the National Health System or NHS, is so convinced of bariatric surgery’s effectiveness, safety, and cost savings potential it covers bariatric surgery procedures.
Unconditionally stating that weight loss surgery is the wrong choice is particularly unfair given that “The Biggest Loser” contestants do not always achieve or maintain their goal weights. An article on Today.com, which is owned by NBC, looked at initial, finale, and current weights of selected contestants from the first 11 seasons of the show. Of the 56 contestants they highlighted, 20 were within 10 pounds of their finale weights, and 8 had gained back at least 40 pounds since the finale.
These results are impressive but not perfect. And, “The Biggest Loser” is not for everyone. So far, only hundreds of individuals have been lucky enough to have the opportunity to lose weight on the show. For a few others, losing weight at one of the Biggest Loser resorts is an option – but not a practical one for most people. At $3,000 per week, it could take $50,000 or $100,000 or more to reach goal weight, not including time out from work and life.
Weight loss surgery may be the only practical choice for people who have work and family obligations, and who live within a budget. People struggling with obesity do not choose weight loss surgery because they think it will be easy. They choose it because they have no other choice. Nothing else has worked for them. For me and hundreds of thousands of other weight loss surgery patients, it worked.
Because of this, I ask you again to please stop publicly attacking weight loss surgery without explanation. You and I and everyone else who is connected to obesity knows what a terrible disease it is. We should join forces in fighting it. Let’s work together to get the greatest possible number of people healthy, and not work against each other with derogatory and divisive comments.
Thank you for all of your hard work and commitment to fighting obesity. You have established yourself as one of the most influential health experts in obesity, and I hope you will use your voice in a positive way. Thank you for considering this.
Sincerely,
Alex Brecher
Founder, BariatricPal

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!