StephanieRR

I was was extremely prepared by my nutritionist. It took me 6 months to finish getting my financing together for the surgery. At first it was upsetting a little to have to wait so long. It ended up being a blessing in disguise!!! During those 6 months, my nutrtionist brought me in monthly, and made sure I was preparing myself mentally. She let me know it is not an easy fix. Every day will still have struggles between healthy lifestyle decisions or rather to fall back into old patterns. It was those 6 months that she was more like a psychologist.I firmly believe my mental changes prior to the surgery is what is making me a success. I strongly advise going to somewhere who specializes in these procedures rather than some doctor who just throws you into it. I believe it is the best tool I've ever had! ALONG with the mental preparation & encouragement. Your article was insightful since I always choose to try to keep things on a positive note. Next time I will think more about both sides of the coin.

Last night I attended the bariatric support group meeting of my local medical group. There were 35 people in the room including a staff nutritionist and the Procedure Scheduling Coordinator. The attendees fell mostly into three groups.


The first group were people going through the process of being approved for surgery. The second group had received surgery recently and were in the first few months of reducing. The third group were people who had surgery about a year ago and had lost a substantial amount of weight. And then there was me. I was the only one there who'd had WLS more than a year ago (2003 is certainly more than a year ago!).
As I listened to the discussion, what struck me was that the main voices in the room were those in the honeymoon period. Most speakers were less than a year out from their surgery, had lost a tremendous amount of weight and were very euphoric.
The theme that dominated the session was that it is smart for the prospective patient and those in the first few months post-surgery to surround themselves with people who have only positive things to say about their WLS, only read positive message boards and blogs, and keep away from any 'negative' perspectives.
I make a point of spending time on message boards where people are struggling with their weight-loss surgery. I need to be able to understand their challenges in addition to those I have personally faced. As a Life Coach I need to see why and how people struggle and how they get beyond it. In addition to benefiting me professionally, this helps me on my own journey to maintain my goal weight when my old thoughts and behavior patterns re-appear.
I spoke up to the group last night because I think it's important for all of us to focus not only on the positive, but also to acknowledge the land-mines that anyone can experience after weight-loss surgery. Otherwise, the opportunity is lost to learn from the struggles of others and avoid avoidable pit-falls.
Weight loss surgery is an amazing tool for change, but it isn't good for everyone. Attention to some peoples' bad post-surgical experiences is an opportunity to balance the information given (or not given) by the those with an economic incentive to sell surgery. For example, at last night's meeting there was a woman (who has been approved for surgery in November) talking about how she looked forward to the end surgery would bring to her desire to eat in stressful situations. The professionals in the room were silent.
I said to this woman, "Many weight-loss surgery patients still battle the tendency to eat when stressed." I told her that she shouldn't expect the surgery to eliminate the desire to eat when stressed and that it would be wise to begin to create strategies now for dealing with her stress after surgery.
I told her that in my experience and in the experience of many of my clients, the stressful situations that triggered the desire to eat in the past are still very present after weight-loss surgery. With the loss of food as an ally and a slimming body that can feel vulnerable and unprotected in the world many turn to drugs or alcohol or force unhealthy foods down their throats looking for a de-stressor or comfort.
Last night's discussion leads me to ask you, the BariatricPal veteran, the following questions:
What were you told prior to surgery about life after surgery that was not entirely true or was not the entire story?

What do you wish you had fully understood prior to surgery that you did not and what do you believe would have put you in the best possible position to succeed after surgery?

What information, if any, was missing in the lead-up to your surgery that gave you unreasonable expectations or that led to disappointment in the months or years since surgery?
I don't pose these questions to be negative, I want as many people as possible to succeed with their surgeries! I want to clear the air and "add to the record" about what weight-loss surgery does and what it will NEVER do.
So, those of you who have had surgery, what do you want those considering surgery to know?

Michelangelo was considered the greatest artist of his day. Even now he is considered to be one of the supreme artists of all time. His works in painting, sculpture, and architecture rank among the most famous in existence. His creations in every field during his life time was prodigious. The sheer volume of correspondence, sketches, and reminiscences that have survived to this day is also part of his legacy. He is the most documented artist of the 16th century.


He could take a piece of stone, say marble, look at it, study it and see what lay inside that piece of rock. He saw beauty in it and worked until that beauty was exposed. He would chip away at the stone little by little shaping it, molding it, working every angle of the rock to make sure that what he saw inside would come to life at his hands. He stood back and looked at his progress and wondered if he was getting the results he knew was inside. He measured, considered and chipped away until the piece was perfect in his mind.
Did he expect to find the beauty within the stone in two months? Or even a year? Maybe! Most likely not as his work was calculated and loved as he proceeded to get the most out of the marble that he was working with. His love and artistry has lasted down through the centuries and has awed many of us to this day. Some who dabble in the arts would long to be a fraction of the greatness attributed to Michel Angelo. He worked at it until it was the beautiful piece that he intended it to be. Did he give up! No! Did he question his thoughts and his fortitude to complete the work? Most likely. But without his hard work and seeing his art through to a finish, he would not have been the man everyone considers to be the ultimate artist of all time.
Are we like Michelangelo's in our journey to find the beauty within the shell that we are chipping away at bit by bit. Shaping and forming and rebuilding until we have the desired results needed to say our work is complete. Or do we continue to chip and chip away at ourselves with negative talk or expectations of more then what we can find in ourselves?
Do we want to go far beyond what is possible and put ourselves in a position where we will never be content and happy about who we have become. Or who we are meant to be for that matter. Do we long to look like we did at sixteen and therefore set ourselves up for failure! What is the goal here? Is it working to get healthy and improve our lives and well being! Yes most definitely!!!
We need to see ourselves as we are meant to be. Not what society dictates as normal today. Stick thin and then some! There is so much fat shaming out there and sadly it is accepted by many! If we buy into this thinking we will believe that our body type is not 'correct'. Therefore we may never see our true wonderful selves. The sacrifices we have made to change our lives such as changed personal and family relationships, even financial sacrifices. Not to mention the courage required to even take this step. Why should we allow society to dictate to us what we should look like.
When we decided to have weight loss surgery our goals were to lose the excess weight so that we could become more active and live a better, more fulfilled life. While some of us end up ten or even twenty pounds below what was expected there is another group that have gone well beyond this. Some have traveled this journey and have not taken care to find who they are inside. They have gone beyond what was suggested by their surgeon and nutritionist. Their health has suffered because they did not see the beauty of who they were inside the outside coating. New addictions surfaced by following a rigid former failed diet along with the pressure of wanting to be like others we have seen in movies, magazines, friends or even relatives. Some of us have pushed ourselves to the brink of unhealthiness.
Some keep carving and chipping away until there is nothing left to work with and the desired finish is not met. Going beyond what was necessary, to see just how small we can be or weigh can become the central point of our existence. Would it be possible to maintain this new life style? In most cases no. Setting ourselves up to fail again is not the answer to long lasting health benefits. Being balanced in everything will bring us good health. Not to mention the ability to do all the things we listed on that piece of paper stuck to the refrigerator or the goal weight we put down here in our profiles. When deep inside we thought we would never ever get to that goal. Right!?
Learning to retrain our brains to see food as a form of nourishment, rather then a reward or a comfort for troubled times. We must learn the best way to feed our bodies so that we will reach our proper weight level resulting in sound health.
So where does it end? When will we see ourselves as successful? When will we be able to say, “I finally got here and now I can maintenance it and enjoy the fruits of my labors.” When will it be okay to say, “I am happy with myself and proud of all I have accomplished?” We deserve to say it. We deserve to live it. We need to learn to enjoy the new us and look forward to what life has to offer us. So we can grab it, run with it and live it to the limit!
When Michelangelo grew older he started to feel and see his mortality. That was when he sculpted the Rondanini Pieta. This was likely his last sculpture. It was never to be completed because Michelangelo carved it until there was not enough stone left. The legs and a detached arm remain from a previous stage of the work. As it is, the sculpture has an abstracted quality, in keeping with the 20th-century concepts of sculpture.
So, may we never over sculpt our body's, suffering the results of it going far beyond who we were meant to be. Believing that there would never be a size that is right for us. We must find a place of contentment. Most of all we must see the beauty within ourselves as we travel this life as a successful weight loss surgery patient.

Summer is here and it is a hot a busy one! So many fun holidays, activities and family outings, one barely has time shop, let alone plan healthy meals. Luckily, many find that it is a bit easier to make better food choices in summertime, when heavy, high-calorie dishes seem less appealing. The best foods for weight loss in summer are


Summer is here and it is a hot a busy one! So many fun holidays, activities and family outings, one barely has time shop, let alone plan healthy meals. Luckily, many find that it is a bit easier to make better food choices in summertime, when heavy, high-calorie dishes seem less appealing. The best foods for weight loss in summer are light, refreshing and, most important, keep you out of the hot kitchen.
The single easiest way to trim calories from your summer diet, experts say, is to load up on nature’s bounty. Produce is at its peak in summer. Delicious fruits and vegetables abound at farmers' markets and in your local grocery. Besides being low in calories, produce is loaded with vitamins, minerals, antioxidants, and fiber.
With just a few WLS tweaks that I took the liberty of making, these top 6 summer foods for weight loss from Kathleen M. Zelman, MPH, RD, LD of www.webmd.com offer some great suggestions.
Best Summer Weight Loss Food No. 1: Chilled Soups
Chilled soups like gazpacho or cucumber-dill that contain lots of chunky vegetables are great choices as long as we add a protein source. Chicken or ground beef perhaps? We are often asked if soup and a liquid, how can I have soup when I can not drink with my meals? Well, be smart. Know your own body, your own nutritional needs and your own sense of satiety. Then make a good choice for yourself.
Best Summer Weight Loss Food No. 2: Watermelon
Who doesn’t love diving into a crisp, juicy slice of watermelon when it's hot outside? Half of the watermelon comes from water, they say. It’s a wonderful way to satisfy thirst and a yen for something sweet. Another great choice, cool, crisp, good for you and plentiful!
Best Summer Weight Loss Food No. 3: Grilled Veggies
For Dawn Jackson Blatner, RD, a plate of grilled vegetables is a summertime must-have. She recommends keeping a plate of grilled onions, bell peppers, zucchini, carrots, eggplant, asparagus, and garlic in your fridge. Once again, it is important for WLS patients to be mindful and deliberate about eating protein at every meal. Grilled veggies are great – along side your protein.
Best Summer Weight Loss Food No. 4: Salads
Salads make for quick, healthy meals -- with no recipes required.
"Just give the produce a quick rinse; slice, dice, toss fruits, vegetables, low-fat cheese, a handful of toasted nuts with some salad greens and a light raspberry or ginger vinaigrette, along with a whole-grain roll, and you have a meal in minutes," Add garbanzo or kidney beans, extra cheese and perhaps some chicken and you have the perfect summertime WLS meal. You might also flavor with lots of herbs so you can go light on the dressing.
Best Summer Weight Loss Food No. 5: Low- and No-Calorie Beverages
"Beverages can be the Achilles heel during summertime because we need to drink lots of liquids to stay cool, but liquids quench thirst and don’t usually impact our hunger," the article states. As always, WLS patients should avoid carbonated beverages but enjoy flavoring water with fresh fruit, mint leaves, and even vegetables like cucumbers. Also be mindful of even artificially sweetened beverages as you may find they too can activate your sweet tooth.
Best Summer Weight Loss Food No. 6: Fruit-Based Desserts
Or better yet, how about just fruit! I have long been a fan of whole fruit of all sorts, bananas, oranges, apples and pears, berries too are favorites. To add some interesting variety, try grilling, baking or freezing fruit. Frozen cherries and grapes are quick and easy and grilled pineapple and a sliced peach – well, a little summer heaven! One of my favorite afternoon pick me ups is simply frozen fruit (berries, pineapple, peaches, whatever I have on hand) a ½ cup of fat free, plain Greek yogurt and a bit of Stevia to sweeten. Blend it up for a cool, healthy treat.
Enjoy!

The holidays remind us of family get-togethers sharing food, laughter and bonding. If you are a food addict, the holidays may be one big guilt ridden binge. Food addicts think about food and have memories of food too, but they will most likely be linked with memories of hiding food, being punished by withdrawal of food, or being abandoned from loving relationships and using food for comfort. This is one reason the holidays are so stressful for people who struggle with food addictions. The frenzy and excitement brings stress, and food addicts comfort and calm their stress with food.


Most people gain 3 to 5 pounds over the holidays. After the holidays one of the reasons many people become depressed is due to their out of shape bodies. Waiting until the New Year to shed a few pounds usually finds you carrying the additional weight you gained during the holidays into spring. By planning your holidays to include exercise and healthy choices, you don’t have to gain weight and you can still have a wonderful holiday.
Why does overeating happen more during the holidays?
Variety brings back emotional memories, images and feelings.
The holidays come only once a year and are stressful…food is comforting for many.
When we are stressed, upset or feeling lonely sugar can give us a high.
Food is associated with good friends, parties and feeling connected.

How do you avoid overeating?
Before a party eat something hot. Things such as soup are wise choices so your tummy will be full.
Avoid over drinking…in most cases over drinking causes overeating in that order.
Make the holidays more about relationships than food.
Try a small variety of many things instead of eating a whole pan of one thing.
Exercise at least 10 minutes each day. This helps you relieve stress and is much healthier than food.
Eating won’t help you deal with a breakup, boredom, or isolation, but reaching out for a good friend will. Avoid going to parties alone and when you go with someone ask them to help you limit your intake.
Eat until you are comfortable and then stop. Overeating is hard on your heart, liver and stomach.
Journal your feelings so you won’t have to eat them.
Learn to say “NO” to someone who is pushing food on you.
Bring your lunch to work and limit yourself to one holiday goodie in the work kitchen.

Preparing yourself and your family to focus more attention on the meaning of the holidays and less on food served will strengthen your family’s communication and bring a deeper sense of gratitude for one another.
–Mary Jo Rapini

Millions of Americans will go away on vacation this year, and if you are lucky enough to be one of them, you need to know what to pack. Packing requires a little more thought than it did before weight loss surgery, when you did not have much to worry about besides your clothes and toiletries. After weight loss surgery, you need to be sure that you bring what you need to stay healthy and keep losing weight. That means adding a few extra items to your packing list. These are some essential additions to your suitcase when you are taking a trip after weight loss surgery.


Keep reading even if you’re one of the nearly half of Americans who are not going to travel this year. These tips can be just as helpful for staycationers as for vacationers, since the goals are the same. On vacation, you need to stick to your weight loss surgery diet, keep exercising, and be prepared for unexpected complications that can come up.
Water Bottle
Before surgery, hydration was a lot easier. You grabbed a bottle of water, a soda, or whatever else was around. If nothing was available at the moment, you just waited until the next opportunity to drink something. That doesn’t fly after weight loss surgery! You need to stay hydrated to keep your energy levels up and your hunger down, and you cannot afford the calories of sodas, juices, or sports drinks.
Another wrench is that you cannot drink beverages while you are eating solid food, so you need to be prepared to meet your fluid requirements within small windows of time. Take a reusable water bottle so that you can always have water available when you need it. A reusable water bottle is not necessary if you are certain that you will always be able to purchase a few bottles of water when you need one. Include a few packets of powdered sugar-free beverage mix if you do not like the taste of water.
Protein Powder
Getting enough protein was no problem before weight loss surgery. There was no way you couldn’t get enough each day. After weight loss surgery, though, your 60 to 85 grams of protein per day can be challenging. Being on the road can make the task much more difficult. You might not be able to check the nutritional information of a food before it is time to eat your meal, or you might find yourself at a restaurant that seems to have no high-protein options. If you are in a foreign country, a lot of the foods you eat may be unfamiliar, so you will not know the exact protein content.

You can still enjoy these exotic foods on your vacation, though. Stash some protein powder in your suitcase so that you never need to risk being without enough protein. A 1-lb canister of protein powder can provide 300 grams of protein, which should be enough to help you meet your needs when you combine it with the healthy foods you choose during your trip.
Healthy Snacks
Snacks and meals were easy before weight loss surgery. There is always some sort of food around, and when your stomach growled, you could hit the nearest vending machine, convenience store, or restaurant. After weight loss surgery, you need to eat healthy foods. If hunger strikes and you are unprepared, you are out of luck.

Bring a few healthy snacks to prevent diet disasters at the airport and throughout your trip, unless you are certain that you will be able to visit supermarkets with the healthy foods you need whenever necessary. These are some ideas.
Protein bars.
Nuts or peanuts.
Peanut butter.
Beef jerky.
Microwave popcorn.
Packets of instant oatmeal (use the coffee maker in your hotel room to heat water to make the oatmeal).

Emergency Contacts
Anything can happen at any time after weight loss surgery. Lap-band patients may get sick and need an unfill, and any weight loss surgery patient can need to see a surgeon for a variety of reasons. Be sure you know how to reach your surgeon, primary care doctor, your pharmacist, and a friend or family member who can act as your emergency contact. You likely already have their information in your cell phone, but write it down on paper, too. That way, you can easily make copies of the information. Include names, phone numbers, and email addresses.
Anti-Nausea Medications
You may have already been prone to motion sickness and nausea before weight loss surgery, but the risks associated with vomiting are more serious after weight loss surgery. Vomiting can displace the lap-band or rip the staples if you have the gastric bypass, sleeve plication, or sleeve gastrectomy. Pack an over-the-counter anti-nausea and anti-vomiting medication that your doctor approves of so that you can minimize vomiting as soon as possible if you happen to get food poisoning or fall ill on vacation.
Running Shoes
Take your running, walking, or other active shoes…because this year, you are going to participate instead of watching on the sidelines! Don’t forget other activewear, such as comfortable exercise clothes that are suitable for whatever you might encounter, whether that involves outdoor hikes or indoor group exercise classes on a cruise ship.
Food Journal
Calories and portion sizes count just as much on vacation as at home, and logging your food is just as important. Take a paper notebook so that you do not need to rely on having internet access to log your food. Or, if you are staying in the U.S. and are confident that you can keep logging your food on your mobile device like you always do, you can stick with your smartphone.
Nutritional Supplements
You don’t want to waste your vacation chasing down the assortment of vitamins and minerals that you are supposed to be taking. Some of the vitamins and minerals may not even be available over-the-counter in the doses you need if you are in a foreign country. Bring enough of each kind of supplement that you take to comfortably see you through your trip.

A recent study published in The Lancet highlights just how obese the world has become.
The study entitled, 'Global, regional, and national prevalence of overweight and obesity in children and adults during 1980—2013: a systematic analysis for the Global Burden of Disease Study 2013, claims that over the past thirty years the number of overweight and obese people worldwide has tripled from 857 million to 2.1 billion. Meaning that across the globe, nearly 1 out of every 3 people is currently overweight or obese.
Researchers examined data from 183 countries and found that over the past three decades not one single country has achieved success in reducing obesity rates.
The heaviest country was unsurprisingly the United States, which accounts for approximately 13 per cent of the world’s obese people, followed by China and India, which together represent 15 per cent.
The study also found that more than 50 per cent of the world's 600 plus million obese people live in only ten countries: the United States, China, Russia, Brazil, Mexico, Egypt, Germany, Pakistan and Indonesia.
The results prove that obesity is now a major public health problem across both the developed and the developing world. As health professionals know all too well, obesity puts people at increased risk of diabetes, osteoarthritis, heart disease and cancer, among many other things. And according to the researchers who led the study from the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, being overweight is estimated to cause 3.4 million deaths worldwide each year.
Other Key Findings from the Report
-Across the globe prevalence of obesity and being overweight rose by 28 per cent for adults, and 47 percent for children from 1980 and 2013.
-Over the past three decades the largest increase in obesity rates for women were in Egypt, Saudi Arabia, Oman, Honduras and Bahrain.
-Over the past three decades the largest increase in obesity rates for men were in New Zealand, Bahrain, Kuwait, Saudi Arabia and the United States.
-In Kuwait, Kiribati, the Federated States of Micronesia, Libya, Qatar and Samoa more than 50 per cent of the women are obese.
-In Tonga, more than half the population are obese.
-Rates of overweight and obese children worldwide rose by nearly 50 per cent between 1980 and 2013.
-In the developed world the highest increases in adult obesity were in the US (where approximately a third of the adult population are obese), Australia (29 per cent), and the UK (25 per cent).

I am frequently asked about whether certain foods should be completely avoided or if it is essential to learn to eat all foods responsibly. Individuals who believe they are “addicted” to certain foods (like sweets) or certain ingredients of food (like sugar) commonly ask this question, and it’s a great question. The most common method of dealing with addiction to substances such as nicotine, alcohol and cocaine is complete avoidance of the substance, referred to as abstinence. Abstinence from these types of substances, while difficult to achieve, is far easier than the alternative of trying to moderate one’s intake of the substance. In the case of nicotine, heroin, cocaine and “hard drugs,” nobody challenges this approach because there is no benefit in continuing to use them. These substances are just plain bad for you so abstinence is completely rational. Alcohol has often been shown to be healthy when consumed in moderation, but for people who have battled with alcohol abuse and dependence it’s just not worth it and once again, abstinence is the preferred approach. In the case of specific foods or certain food ingredients, the story can become much more complicated.
There is an ongoing battle as to whether or not certain foods or food ingredients are “addicting.” Is sugar an addictive substance in the same way as nicotine, cocaine and alcohol? Can someone actually be “addicted” to sweets or carbohydrates? The jury is still out, but a definitive answer may not be necessary. What’s important is for you to consider how you plan to change your behavior given that the environment seems to be making little effort to eliminate the availability of these foods.
Almost everyone has one or more foods that they are prone to eat compulsively, whether they consider themselves to be “addicted” to them or not. Often these foods include sweets that are high in sugar (like cake, cookies, or ice cream); however, many people struggle to control their intake of a variety of foods like deli meat, pizza, peanut butter, nuts or even beef jerky. For many people, sugar isn’t the big problem.
What is interesting to consider is that most people have trouble controlling their intake of foods that they believe they shouldn’t be eating. Over and over I hear stories of people who binge on exactly the foods that they were told they couldn’t have as a child. These are often called “forbidden foods.” Whether it is peanut butter, ice cream, potato chips, cookies, pizza, or cheese doodles, it may be their “forbidden-ness” that makes us eat them compulsively and not their content of sugar or other ingredients that’s the problem. The literature on binge eating lends some support to this hypothesis as a very high percentage of binge eaters describe a history of restrictive dieting and/or deprivation. Indeed, a overwhelming number of patients I have seen over the years who describe themselves as binge eaters describe histories of either chronic over-restrictive dieting or having grown up in homes where their parents or others denied their access to certain foods. Some patients jokingly referred to one or both their parents as the “food police.” Once they were free from such restrictions (either by moving out to live on their own or by going “off” the diet) their consumption of these foods seemingly became uncontrollable. It seems that avoidance or total abstinence from such foods might actually be causing the binge eating. There is an all-or-nothing quality to this behavior. One possible explanation for this pattern is that the individual has never actually had the opportunity to eat these foods in moderation but rather to be forced to avoid them or eat them like there was no tomorrow. They were never allowed to eat them, so when they were finally available, they overindulged. So again I ask: “Is this type of compulsive eating or bingeing due to an “addiction” or to over-restriction, and what should you do about it in either case?” Should you continue to avoid certain foods or food ingredients or try to learn alter your behavior?
The answer really depends on your personal philosophy and how much distress the whole matter is causing you. Do you want to learn to eat certain foods more responsibly or would you rather continue to try to avoid them? Does it cause you great distress to think of a life without your favorite foods? Does it cause you great distress to make constant efforts to avoid certain people, places and events because your “trigger foods” will be available? If you decide that you would like to learn to eat certain foods more responsibly, you need to accept that this will take some work. To be successful, you need to become a bit of a scientist and experiment with different approaches.
Perhaps you are experiencing anxiety about the proposition of trying to learn to eat your “trigger foods” responsibly because you have never had the ability to do. This is completely understandable. Also, consider that if the foods you find to be triggers are inherently unhealthy (like “junk food),” maybe abstinence isn’t such a bad idea. After all, like heroin and cocaine, it’s hard to make the argument that chocolate covered cheesecake is good for you. You could try to learn to eat chocolate covered cheesecake responsibly, but life will continue even if you permanently take it off the menu. However, many people believe that they shouldn’t have to live the rest of their lives without chocolate, peanut butter, cashews and other foods or perhaps they just don’t want to. They are aware that most people do not need to resort to such levels of restriction. If you think in this way, then you need to learn how to eat these foods responsibly. You have to practice a new way of eating to get better at it and strengthen your ability to do so just like you would any other skill.
One approach to strengthen new eating skills is to eat certain foods in a limited number of circumstances and in a different manner. For example, if you believe that cashews are a “trigger food” and you have no history of eating cashews responsibly, it would be silly to continue to buy the one-pound jar of cashews from the bulk food store. You know how that story is going to end. Similarly, it may not be wise to bring a gallon-sized container of ice cream into your home if ice cream is a “trigger food.” However, it may be possible for you to learn to eat a responsible amount of cashews or a single serving of ice cream if you buy a small container of either when you’re at a convenience store. This is a good way to learn with a much smaller chance of bingeing. You don’t have to completely avoid cashews or ice cream for the rest of your life. Just don’t buy them in large quantities and bring them home for the time being. Many people adopt this approach. They’re not averse to eating these foods and don’t avoid them completely; they just don’t bring large quantities of them into their home. Many a patient has told me a similar story about pizza. When they want pizza, they go to the pizza parlor and buy a slice or two. They just don’t have a whole pizza delivered to their home. These are examples of altering behavior rather than avoiding certain foods altogether. This is how you learn to eat responsibly…you practice.
Another approach gaining a great deal of attention is called “mindful eating.” There is a growing literature on the merits and effectiveness of mindful eating in the treatment of binge eating as well as for those who simply want to learn better eating habits even if they don’t have concerns about their weight or eating behavior. Mindful eating is an approach where one learns to be more present-focused while eating, and can be especially helpful when eating “trigger foods.” A primary objective of mindful eating is to learn to develop an ability to control one’s eating behavior. Mindful eating involves slowing down and focusing on the thoughts, feelings and sensations you are experiencing while eating to be in better control of your behavior. Mindful eating is the antithesis of avoidance. Much has been written about mindful eating, so do some research if you’re interested in learning a powerful method to alter your eating behavior so that you may be able to develop the ability to enjoy eating certain foods without experiencing distress and anxiety or leaving them off the menu completely.

How often are you seduced by your thoughts to overeat? You’ve gone ahead and made the commitment to have weight loss surgery; you are not physically hungry, so why are you still eating? The simple answer is that your thoughts create feelings that drive your unconscious behaviors.


Many of us have thoughts that seduce us into doing things that are not in line with our goals. At the onset of a craving, the thoughts of seduction are telling you, “You deserve it. You’re special. You've been good all week. Go ahead and eat whatever you want. You are going to be strict tomorrow. Eat all the foods you love because you will never be able to eat them again.” How many of you remember that last thought before you had surgery? How many of you are now eating those exact foods those thoughts told you that you would never eat again? Take a moment to reflect on this next question, as it is imperative that you become aware of your internal dialogue. What seducing thoughts are currently controlling you?
The conscious decision to have surgery and achieve and maintain a healthy weight is just that: a conscious decision. Where many of us lack awareness is the understanding that the subconscious part of the brain is controlling and ruling our behaviors 70 percent or more of the time. So, that leaves you with the question of how do you get your subconscious on board with your conscious decision to reach and maintain a healthy weight?
What is the secret to working with the subconscious mind, the boss of decision making? Drum roll, please! The secret is meditation and guided imagery; you communicate and work with the subconscious through images and visuals. Below, I will walk you through a meditation that I do when I am craving certain foods and I am not physically hungry.
Craving Meditation
Read through the meditation a few times before actually going through the process. Before you begin the meditation, think about the food(s) you are craving and rate the intensity of the feeling on a scale of 1 to 10, with 1 being low and 10 being high.
1. Close your eyes. Imagine a large auditorium.
2. Silently ask your inner voices of seduction to enter the stadium.
3. Take a moment to listen to what they have to say.
4. Take a microphone and acknowledge that you have heard what they have said.
5. Then, tell the voices that you do not need them anymore as you are taking charge.
6. Open the doors and have all the voices in the stadium leave. Bolt and lock the doors after they leave.
7. Now, imagine those same foods you were craving and notice the difference in the intensity of the feeling and the mind chatter you had about the foods.
The next time you are experiencing a craving, a thought-feeling state, take a moment to do this meditation. This is a wonderful technique for creating new responses to your desires. I would love to hear from you. What did you notice after doing the meditation? If you have a technique that has helped you work through your cravings, please, pay it forward and share!

During my graduating year in High School (1977) I got the biggest kick out of the TV commercial featuring the winners of the Publishers Clearinghouse Sweepstakes. The two mild mannered, plainly dressed, farm folk declared (with more drawl and twang than Gomer Pile) “What luck! We Mays are in luck. We have just won a million dollars! Our lives will never be the same!”
Yep, they are lucky, I thought. I am a May too, so how come I’m not so lucky? Though many spend a considerable amount of time, effort, and energy entering sweepstakes – hoping to get ‘lucky,’ I have adopted a different philosophy. “The harder you work the luckier you get!” Time and time again that has proven to be the case.
Following my weight-loss surgery in 1995, I recall mustering up the nerve to call a few of my friends to tell them what I had done. The first call I made was to a long time nurse friend. I will forever remember her immediate reply after I told her where I was and that I had just had a gastric bypass. “You are so lucky!” she exclaimed. “Lucky?” I replied. “What do you mean lucky?” I have spent my entire life fighting my weight and finally, finally, I had the courage to make this gigantic commitment. It took great thought, planning, preparation, prayer, not to mention a support of my family, and a 2nd mortgage to do this. Luck had nothing to do with it!”
The first year was a dream come true. The weight seemed to fall off. I lost 125 pounds. No complications, no bumps, and very little effort on my part. Wow was I lucky! I would find myself eating something I shouldn’t. Or skipping a few days of exercise only to weigh in to find that I lost another pound! “Dodged a bullet this week; Man I am so lucky!” I thought. And then…. I found that the next month, was not so lucky. I learned by experience that I was not invincible, and that maintaining my weight loss requires much more than luck. It requires dedication, commitment, thought, focus, and constant effort. Indeed I found, that in weight issues too, the harder I work, the luckier I am.
It has been over 19 years now and my weight continues to fluctuate up and down 20 pounds or so. Interesting, when I work hard at it, I lose - when I don’t, I gain. Go figure.
It seems that this weight management thing will always require effort. Throughout your journey, you too, will have ups and downs, good days and bad days. We have a remarkable tool, but we will always reap what we sow. As you work to reach and maintain your weight-loss goals, remember to stay committed to your Success Habits, stay in tune with your body, work hard; and oh, good luck!

I loved this article! It gave me a chuckle and a sense that I am not alone. Do you know how many times I have asked myself "Why did I just do that?", knowing exactly what all I know??!! Every single diet I ever tried had one of those moments... I am only 3 months out so I am still on the more strict side. However it pleases me to see others out there are leading a life of somewhat "normal" eating behavior and getting right back on track. This is extra encouragement for me. Thank you!

Thanks for your comments, So glad you found this helpful. I am nearly 20 years post op - and still learning to make good choices consistently. All my best!

I loved this article! It gave me a chuckle and a sense that I am not alone. Do you know how many times I have asked myself "Why did I just do that?", knowing exactly what all I know??!! Every single diet I ever tried had one of those moments... I am only 3 months out so I am still on the more strict side. However it pleases me to see others out there are leading a life of somewhat "normal" eating behavior and getting right back on track. This is extra encouragement for me. Thank you!

Just after Easter, I posted this photo of my morning ‘snack’ of carrots, celery jelly beans and chocolate eggs with a caption, “Does this make sense to anyone?” The responses were funny, truthful, and understanding. Some quickly identified the beans and eggs as protein and together with the carrots and celery some said that made a very healthy snack! Others noted that there were so few, it didn’t matter. One commented,


Just after Easter, I posted this photo of my morning ‘snack’ of carrots, celery jelly beans and chocolate eggs with a caption, “Does this make sense to anyone?” The responses were funny, truthful, and understanding. Some quickly identified the beans and eggs as protein and together with the carrots and celery some said that made a very healthy snack! Others noted that there were so few, it didn’t matter. One commented, “Living on the edge – just don’t overdo it!” Yes, I laughed out loud.
And don’t we all have times when we live on the edge, test fate, and throw caution to the wind? I suppose we do. I just always wonder why. Why do we do what we do, when we know what we know? For myself, sugar is a real challenge for me and something I need to avoid (see Sugar Free Me! article) Yet, still I ate the jelly beans and chocolate eggs on a plate with vegetables, as if that would make it ok, or that the vegetables would counter act the sugar. Yeah, right. Knowing that so many can relate, I thought I would give a shot at perhaps a few reasons why I think we do what we do when we know what we know.
We Want To Feel Normal – Sometimes we simply don’t’ want to have to worry about it! We are under the impression that eating whatever one wants is ‘normal.’ It might appear that our thin friends and relatives can, but it always comes down to calories in- calories out; for everyone! We are normal and like most people will always need to be careful and mindful about our choices, but sometimes, we just want our actions to have no consequences. (But they do)
Others Do It. In support groups, sometimes patients share how they are able to get away with eating “forbidden foods” and how they are still doing great with their weight loss. Well, more often than not I have found that these people are either ‘honeymooners’ or their metabolism is different than mine or they are great exercisers. Eating what others eat hasn’t worked well for most of us. We each need to know for ourselves EXACTLY what our own bodies need – and what works and what doesn’t work for us to maintain our weight loss goals.
Reckless Abandon – My favorite definition of reckless abandon is: “to abandon all sense of responsibility or consequence.” Sometimes we do because we are either too busy to pay attention, or too stressed to care. It is unfortunate that all too often our lives are out of control and when we are too busy, we put ourselves last! The commitment we have made to ourselves must be strong enough to endure ‘come what may’ we must stay focused on our Success Habits. No matter what! It is too easy to get out of control and off track and find ourselves somewhere we swore we would never be again.
A Little Won’t Hurt – That may be true for some but honestly, this is one of my greatest challenges. Some people can do just a little, but for others like me, have trouble stopping at just a little. It’s not that I binge eat or eat too much at once, it’s just that once I have a little, my body starts to crave more, and more and soon I am a slave to my food choices day after day. For me, a little does hurt.
Will I make the choice to eat jelly beans & chocolate again? Absolutely! Will I enjoy it? Yes! Will I stop, and get back to my routine habits as soon as possible? Yes! Why? Because I know what I know.

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.

When the snow melts and the sun comes out after a long winter, spring cleaning is a natural ritual for most of us. Almost all of us feel more energized when the air is fresh, new leaves appear, and birds are chirping. Spring cleaning your house lets you get rid of the dustiness of winter and give you the feeling of a new start. Did you realize that whether you are before or after weight loss surgery, your health and weight can benefit from cleaning your house? And what if you could apply your spring-time energy to cleaning up other aspects of your life, and in doing so, improve your weight loss?


You can! Keep reading to find out how you can live a cleaner lifestyle and give yourself a boost in the meantime. A bit of tidying up can help keep your weight loss on track, or help you break a plateau if you’ve been stuck for a while.
Spring Clean Your House
A large part of having cleaner home is about peace of mind and lower stress levels. Having less stress helps reduce hunger and lets you make better diet decisions. Beyond this, a clean home lets you be more efficient because you know where things are and you do not have to wade through piles of useless things. Housecleaning also burns calories, so it’s a good thing for weight loss! Sweeping, raking, washing windows and floors, and scrubbing counters all get you moving and promote weight loss.
As you clean, don’t forget to clean your closets. It is an excellent time to get rid of the oversized clothes that you plan to never be able to wear again. Seeing your progress can be extremely motivating, and removing these clothes makes room for new, smaller sizes that you will need to buy as you continue to lose weight.
Spring Clean Your Diet
You lose weight fastest when your diet is spic and span, and part of your spring cleaning should focus on your diet. Look carefully at whether your diet is as clean as it needs to be to stay healthy and lose weight. Are you measuring each bite? Are you choosing protein and vegetables first, and avoiding sugary foods that will make you sick?
It’s far easier to follow your weight loss surgery diet plan when your kitchen is set up well. Get rid of any tempting junk foods that have snuck into your pantry and refrigerator, and stock up on healthy foods, such as tuna, vegetables, turkey, chicken breast, fruit and eggs. Dig out your food scale and measuring spoons from under the clutter, and use them consistently.
Spring Clean Your Commute
A nice side benefit of cleaning up your lifestyle is being able to help the environment. You can reduce air pollution and noise pollution by walking or biking whenever you can. If you are lucky enough to live near to your workplace, you may be able to walk or bike to work. If that’s not practical for you, you can still walk more and drive less. Take a healthy lunch to work instead of driving to pick something up from a restaurant at lunch time. On weekends, challenge yourself to drive less. Park further away from destinations, and walk the final few blocks instead of driving.
Driving is so ingrained in us that sometimes we don’t even realize that we could walk. Try to get in the habit of asking yourself whether you can walk from your home. If not, consider whether you can park in a central location and do several nearby errands on foot. You might be able to park in a supermarket parking lot to do your food shopping, and walk to the library, post office, or other stores without moving the car. Each half-mile that you walk burns about 50 calories.
Of course, if you do take the car to drop off and pick up your children, turn the engine off to reduce air pollution. Then get out of the car and give yourself a workout by walking until your children are ready to come home.
Spring Clean Your Schedule
Lack of time is a common excuse for all sorts of unhealthy behaviors. You might opt for fast food because you have no time to purchase and prepare healthy foods. You might not get enough protein during the day because you are too busy preparing your children’s lunch to focus on yourself in the morning. Maybe you regularly skip workouts because you do not have time to exercise. You may overeat because you do not have time to measure portions. And, whether or not you realize it, you may be cranky because you are too busy.
That stops now. Take a hard look at your daily and weekly schedule, and clean it up if necessary. There may be several ways to tidy up your schedule so that you can fit in the healthy behaviors that will help you lose weight.
Search your daily schedule for wasted minutes. They add up! How much time do you spend texting your family and friends and updating your social media profiles online? We’re not suggesting that you stop these activities, but being aware of them can help you weed out the non-essential parts.
Skip the television occasionally. Instead of watching a 30-minute television program, go for a walk. Or, instead of walking it from the couch, hit the treadmill or do some calisthenics while you watch.
Multi-task to save time. For example, you don’t have to sit down to talk to your children about their days. Talk to them while you’re in the kitchen making dinner together or you’re taking a walk.
Get better sleep. Sleep in a dark, quiet, cool room to get better sleep and wake up more refreshed after less time.

Spring is a time of new chances, and this spring, you can clean up your entire lifestyle to feel better and lose more weight. All it takes is a close examination of some of the different areas of your life, and you will feel better about your weight loss surgery journey.

Protein-containing foods help us feel satisfied for longer after eating, which is helpful in managing our weight.


In a previous article I introduced the concept of getting the most from what you are eating, in particular, feeling satisfied after eating. Whilst the purpose of weight loss surgery is to help you feel satisfied on a smaller amount of food, the type of foods you choose is important to help maximise this. There are two key ingredients in helping you to feel satisfied after eating:
1. High fibre, low glycemic index carbohydrate-containing foods
2. Protein-containing foods.
The previous article explored the glycemic index, or GI. This article focuses on protein. Protein-containing foods help us feel satisfied for longer after eating, which is helpful in managing our weight.
Protein is also involved in many bodily functions including:
building and repairing body cells such as bone, hair, skin, nail and muscle
producing hormones to help us burn stored energy, including body fat
making enzymes to help digest food
helping to protect our body against colds, hair loss, muscle weakness, and fatigue.

Not eating enough protein can result in:
a weaker immune system
muscle loss
hair loss
inadequate weight loss.

Why am I at risk of inadequate protein intake after weight loss surgery?
As indicated in the protein counter (on my website), meat products contain the most protein per serve.
An Australian study from The St George Upper GI Clinic in Sydney, Australia, found that those with a gastric band often find red and white meat difficult to tolerate whilst fish was tolerated more easily. Some people who have had sleeve gastrectomy and gastric bypass also reported difficulty eating these foods but it was far less common than it was among those with a gastric band.
Red meat and chicken breast can be more difficult to eat if they are dry, overcooked, stringy, or if they have been reheated. Any meat can be difficult to tolerate if you are not using the correct eating technique. Some people will then avoid these foods, when working on improving eating technique may allow them to eat these foods comfortably.
Food tolerance varies from person to person and is found by trial and error. Tolerance of all foods can be improved by following the correct eating technique as I have discussed previously.
Following all surgeries, you will be eating smaller amounts of food. A reduced intake of food causes a decrease in protein intake. In the early stages following surgery, people who have had a sleeve gastrectomy or gastric bypass are likely to tolerate only very small quantities of food. When you eat your meals, eat the protein-containing food first to ensure you have room for this important nutrient.
How much protein do I need?
There is no one exact recommended protein intake following weight loss surgery. A range of 60-120g has been suggested, however your individual protein needs will vary depending on your age, gender and your particular stage of recovery. It is best to speak to your dietitian about your protein needs. You can then use the protein counter below to see how you can achieve this.
It is easy to confuse the weight of food with the protein content. For example, some may assume 100g of meat provides 100g of protein. This is not the case. Head to my website for a simple table on the protein content of common foods.
Lean protein foods are the best choices, as they are lower in fat, particularly saturated fat. Meat should be trimmed of fat and chicken should have skin removed. Low fat milk, yoghurt and reduced fat cheeses are recommended.

Do you feel like you are doing all the right things with your diet, but still not losing weight? Are you trying to buy all the right foods, but still struggling to see results? Maybe you are being tricked by the Healthy Food Frauds.
Last week we appeared in a segment on Today Tonight Adelaide featuring Healthy Food Frauds. You can see the segment
. Healthy Food Frauds are foods or drinks that sound healthy, but contain hidden fats and sugars. Food marketing is big business and food packaging is premium marketing space. Those packages need to convince you a product is going to be appealing – whether that is in the way it makes you feel, or how it nourishes your body. Think of words like natural, whole, earth, vitamin and baked - they all make a product sound as if it is going to be good for you. Unfortunately this is not always the case!
As you will see in the segment, we poured a decent serve of muesli and showed it contained 10 teaspoons of sugar and four teaspoons of fat! This bowl held about one and a half cups of muesli. Whilst this may be greater than many of you would even contemplate after weight loss surgery, the sugar and fat hiding in there is surprising nonetheless. What may surprise you even more is that eating this bowl of muesli would be like sitting down and eating nine slices of bread!
In researching this segment we investigated a lot more foods than were actually shown.
Here are some other common Healthy Food Frauds we like to expose:
- Fruit juice may contain up to 13 teaspoons of sugar in a 600ml bottle you grab at the service station or deli, including the “no added sugar” varieties.
- Muesli bars may contain two teaspoons of sugar and two teaspoons of fat in a small bar.
- Low fat yoghurt may contain up to 6 teaspoons of sugar per 175g tub.
- Juice bar smoothies: can easily contain six teaspoons of sugar and 2 teaspoons of fat.
- A bottle of vitamin water can contain 7 teaspoons of sugar.
- A small, 250 ml coconut water contains 3 teaspoons of sugar.
- A small box of dried fruit, easy to throw in the kid’s lunchbox can contain up to six teaspoons of sugar.
Check out the segment to see more Healthy Food Frauds exposed, it only takes a few minutes.
Making small changes to our daily food and drink choices can make a big difference - the difference between gaining weight and losing weight. By reducing five teaspoons of fat per day, or 10 teaspoons of sugar per day (or a combination of both), you can lose about one kilogram per month. Whilst you may think this seems small, over a year that is 12 kilograms! It really adds up!

If I didn’t have a sense of humor, I could never have survived 60 years of living, including 2+ decades of morbid obesity and the 6+ years of my WLS journey. Don’t get me wrong – I took my band (and later, my sleeve) surgery very seriously because I felt that this was my very last chance to get healthy – but laughter is part of what makes my life happy, and makes it much easier to bear my ridiculous fear of starving to death.


Today’s episode is: I’M GONNA STARVE! That title is exactly what I thought in the beginning about my post-op life – Deprivation! Suffering! Starvation! I know I’m not alone in this because through the years I’ve seen so many posts on the “When will this get easier?” theme.
To reach the easier part of my WLS journey, I had to do some mental, emotional and spiritual fine-tuning. The idea of a middle-class woman living in a rich and obese country like the USA actually starving to death was and is absurd. Absurdity is ideal material for a comic strip. I hope you’ll get a laugh or two from I’M GONNA STARVE.

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.

If you are anything like me, discipline or strong willpower is not something that comes natural. I have been developing mental toughness throughout the years when it comes to maintaining a healthy weight. Does your mind race with thoughts of eating a smorgasbord of different foods? Is every food going through your mind a carbohydrate loaded with sugar or salt? Do you think, “Let me just eat or drink what I want today, and I will get back on track tomorrow?” Do you go through a plethora of different feelings? You may not even know what you are feeling. All you know is that you are consumed with this urge to eat or drink, many times when you are not physically hungry.


Man, did I feel like that today. I just wanted to check out and lose myself in literally stuffing my face with junk food. I was consumed with thoughts of pizza, nachos and cheese, gummy bears and Ben & Jerry’s New York City super chunk ice cream. Oh, and let’s not forget the peanut butter cup candy. Maybe your favorite question is, “Wine, anyone?” Maybe your choice of food to emotionally zone out is different, but is any of this resonating with you?
So what do I do when this pattern pops up in me? This is where developing mental toughness will get you the desired results you deserve. Below, I am going to walk you through four quick steps that have worked wonders for me in developing mental toughness, and I know they can work wonders for you!
4 quick steps to developing mental toughness:
1. First, realize your pattern of internal dialogue and foods when you are getting ready to emotionally eat or start binge eating. Once you begin to pay attention, you will notice that you crave the same foods every time and that there is an impulse or urge to eat right away. You will have the same automatic dialogue of eating and watching TV or telling yourself you’ll just eat this one time and start fresh tomorrow, etc.
2. Stop and realize you are trying to avoid or escape a bad feeling. We automatically want to feel good. Tell yourself that having a bad feeling is not the end of the world; you are not dying. Take a moment to identify the feeling, where it is in your body and what is it trying to tell you. If you cannot find it, that is okay. Just continue to tell yourself that it is okay to feel bad. Allow yourself to just sit with it.
3. Remember to breathe. Through this time, take deep breathes, letting go with every exhale.
4. Have the mantra: “There is no tomorrow. I only have this moment. What I do right now is the only thing that matters. What I do right now is creating my future.” Repeat this over and over again as you breathe.
You will notice that as you go through this process, the feelings that were leading the desire to eat will lesson; as they lesson, your desire to eat will lesson.
The key to developing mental toughness is to become aware of your automatic behaviors to escape bad feelings. If you follow these four steps every time you have an impulse to emotionally eat, you will create a new pattern of reacting to your feelings. When you have a plan to decrease the number of times you emotionally eat, you will be amazed at how quickly you begin to see results in weight loss!

It just seems so obvious to me that this is a site of support and helpful tips. I can't imagine why anyone would want to subject negativity to this community. I personally feel better hoping that something I may have posted or commented on may have helped encourage someone.
I agree with PdxMan! People should read this first. It's a shame there's usually a bad apple in every basket.
Thank you Alex for bringing such a diverse group who all share a common healthy goal together. I think it's a wonderful source of support and info!!

Clients often tell me one of their biggest challenges after weight loss surgery is eating slowly.


Clients often tell me one of their biggest challenges after weight loss surgery is eating slowly. Eating too quickly means that you are unlikely to chew foods properly. This can cause discomfort, pain and in some cases, regurgitation.
To be able to eat a variety of foods comfortably after weight loss surgery, you really need to concentrate while you are eating. The following tips may help you do this:
Set aside time for meals and avoid doing other things whilst you are eating.
Sit up straight and avoid slouching. Sit at the table rather than the couch. Avoid eating whilst preparing food.
Move away from the television or computer. You cannot focus on what you are eating if you are immersed in something else.
Avoid playing with your mobile phone or other electronic devices.
Avoid getting really hungry. The hungrier you are when you start a meal, the more likely you are to eat quickly, take big bites and not chew properly.
Avoid eating with your hands as you will tend to take bigger bites. Use cutlery to cut food into small pieces. The more pieces you need to cut the longer it will take to eat.
Avoid eating on the run, or in the car.
Put your cutlery down between mouthfuls. Wait until you have swallowed your food before cutting the next piece. Avoid having that next mouthful loaded on your fork ready to go.
If you really struggle to slow down, use your cutlery in the opposite hand until the pace of eating feels more natural.
Choose a relaxing environment to eat. If the staff room at work is too distracting, head outside to a nearby park. Opt for a quiet café rather than a noisy food court, where you may be tempted to rush.
Be especially careful when eating socially, as during conversation it is very easy to become distracted. Eat during a break in conversation.
Avoid the tendency to want to keep pace when eating with others.

Take notice when you do slow down your eating. Do you feel more satisfied? Do you enjoy your food more? Many people report they enjoy food more after surgery as they eat more slowly, allowing them to really taste the food and savour the flavours.
Get in the habit of eating slowly. It could take up to 20 minutes to eat a small meal – between 10 and 20 minutes is a good goal. If there is food left on your plate after this time, discard it. There is a risk of eating too slowly which can turn a meal into grazing, which defeats the purpose of weight loss surgery.
Time how long it takes you to eat your next meal. It may just surprise you!

Recently I have found myself spending a lot of time talking with my weight loss surgery clients about getting the most from what they are eating, in particular, feeling satisfied after eating. Whilst the purpose of weight loss surgery is to help you feel satisfied on a smaller amount of food, the type of foods you choose is important to help maximise this.


Recently I have found myself spending a lot of time talking with my weight loss surgery clients about getting the most from what they are eating, in particular, feeling satisfied after eating. Whilst the purpose of weight loss surgery is to help you feel satisfied on a smaller amount of food, the type of foods you choose is important to help maximise this.

There are two key ingredients in helping you to feel satisfied after eating:
1. High fibre, low glycemic index carbohydrate-containing foods

2. Protein-containing foods.


This post will demystify the glycemic index, or GI. Protein will be the focus of a later post.


The GI is a measure of the effect that different carbohydrate-containing foods have on blood glucose (blood sugar) levels. It describes the way our body digests and absorbs these foods. Carbohydrate-containing foods include:
breads, cereals, rice, pasta and noodles
starchy vegetables including potato, sweet potato and corn
legumes including baked beans, kidney beans, chickpeas and lentils
fruits and fruit juices
milks, yoghurts, custards and ice cream
any food containing flour or sugar.

Some carbohydrate-containing foods are broken down and absorbed quickly, so they raise our blood glucose level faster and higher. These are high GI foods. Other carbohydrate-containing foods are digested and absorbed more gradually, causing a slower, longer lasting rise in blood glucose levels. These are low GI foods. Low GI foods keep us feeling satisfied for longer after eating.



Often people experience a 'honeymoon' period following weight loss surgery, where weight loss seems automatic. Unfortunately this may not last forever and weight regain can occur with all surgeries. Maximising the satisfaction you get from the food you eat is crucial to keep losing weight and maintain that lost weight. A lower GI eating pattern also helps us feel satisfied for longer after eating, which can help with losing weight. For example, if you eat high GI foods at your meals, you are likely to become hungry sooner after the meal than if you eat low GI foods. This can make you more likely to snack and if you have not planned for this, you may be forced to grab something from the biscuit barrel or vending machine. 
 


Appetite control is not the only benefit of a lower GI diet. Research has shown that people eating a lower GI diet can reduce their average blood glucose levels, which is particularly important for people with diabetes. Lower GI foods are often also higher in fibre. A high fibre diet helps prevent constipation, decreases the risk of heart disease as soluble fibres can help remove cholesterol from the body and helps protect against bowel cancer, haemorrhoids, irritable bowel syndrome and diverticulitis.



Foods are classified as low, moderate or high GI.



To follow a low GI diet, try to choose one low GI food at each meal. Eat high GI foods in small amounts, or less often. 

Head to my website to see a simple table of low, moderate and high GI foods.
Go to www.glycemicindex.com for further information.

In talking with clients I am constantly reminded of the dietary myths that circulate to leave people confused about weight management. Here I bust some of my favourite weight management myths.


Myth 1: Don’t eat after 7pm (or 7:30pm or 8pm, etc)
Our body doesn’t switch off at night. Our metabolism continues ticking over as our heart pumps blood, our lungs breathe, our muscle tissue repairs, etc. This happens all day and all night. In fact, we burn calories when we are sleeping, just as we do when we are awake. Our metabolism does not shut down at 7pm, so there is no reason to stop eating at any one particular time.
It is important however not to leave all of our eating until the evening. We should fuel our body regularly throughout the day so that it can perform at its best. This is even more important following weight loss surgery, as you can no longer eat the size of meals you once did. Therefore, you can’t skip your meals during the day and expect to meet your nutritional needs at night. Regular meals throughout the day are also important to control your hunger. Being ravenous at the end of the day is another trigger for overeating late at night.
Some people find rules that they should not eat after a particular time at night appealing, as this is when they tend to overeat. Overeating at night can act as a ‘reward’ for getting through the day, or as a way to relax and wind down. It may be habit as we watch TV or a movie. This is when night eating is problematic, as it is not eating for hunger. Do you eat for reasons other than hunger at night? What else could you do to relax? Could you sort through those photo albums that are overflowing, have a bubble bath or phone a friend you haven’t spoken to for sometime. What about a jigsaw puzzle, a crossword, scrapbooking, sketching or even an evening walk? The options are endless.
Myth 2: There are good foods and bad foods
Food is neither good or bad, it is what we do with it that counts. Of course, some foods are high in energy (calories/kilojoules) and have little nutrition, so these should be eaten in small amounts. However, food itself is morally neutral. We assign it the ‘good’ or ‘bad’ label, or define it as ‘allowed’ or ‘not allowed’. By labeling food in this way, we are then ‘good’ or ‘bad’ if we eat it.
A better view of food is one where all food is morally neutral. You have permission to eat any foods you choose, you can choose eat those that are more nourishing, most of the time. I often say to clients that there are 21 meals in a week, if one or two are not perfect nutritionally, it is not a problem. If the balance is reversed however and only one or two are nutritious, then this is not going to help you achieve good health.
Some foods that provide little nutrition may provide much enjoyment, so may play a very valuable role in your diet in other ways. You can and should include foods that give you pleasure, it is managing the amounts of these foods that are important in achieving good health.
Myth 3: Carbs are fattening
Nothing is fattening in isolation. Anything can be fattening if you eat too much of it. Food is made up of combinations of carbohydrate, protein, fat, vitamins, minerals, fibre and water. Carbohydrate, protein and fat provide energy, the other nutrients do not.
If we look at the nutrients that provide us with energy in their most simple form:
• Carbohydrate contains 4 calories per gram
• Protein contains 4 calories per gram
• Fat contains 9 calories per gram.
Whilst not a food, alcohol contains 7 calories per gram
As you can see, carbohydrate itself is quite low in calories. So why does carbohydrate have such a bad reputation?
The problem with carbohydrate containing foods is the way we have come to serve and eat them. We heap rice, pasta and noodles on our plates, leaving very little room for protein foods but more importantly, vegetables and salads.
Low glycemic index, carbohydrate-containing foods can be quite nutritious and when eaten regularly, in appropriate amounts, help us manage our hunger through the day. We just need to look at how we serve them. For example, rather than serving spaghetti bolognaise as a plate or bowl of pasta topped with a little meat sauce, serve equal amounts of meat sauce and pasta on half the plate with a side salad on the other.
Myth 4: You can do some extra exercise to compensate for eating ‘bad food’
The problem with this myth is that is feeds into the ‘good food’ and ‘bad food’ myth. If exercise is something we do when we eat ‘bad food’, exercise is seen as a punishment. Exercise can help you feel good, help you sleep better, give you more energy and help you become healthier. It should be enjoyed for these benefits.
Myth 5: You need to eat every 3 hours to keep your metabolism up
Every body is programmed differently and will have a slightly different metabolic rate. Some bodies will need to be fed more frequently than others. If we set a basic meal pattern, our body will let us know how much we need to eat.
If we provide our body with appropriate fuel three times a day, it will then let us know if we need to eat more often, we just need to tune into the signals. If we start the day with breakfast, our body is given the signal we are starting the day and can help regulate how much we need to eat through the day.
You may have heard a ‘rule’ after weight loss surgery to eat only three (or less) meals per day. I strongly believe that there is no one rule that fits every person. The only way you can tell if you need to eat between meals is to tune in to your hunger and satiety signals. If you are genuinely, physically hungry between meals it may be fine to have a small snack. If you are eating as you feel bored/tired/frustrated/lonely or simply watching the clock, then you need to work on another solution.
Myth busting your way to success
Whilst the internet has brought a whole world of information to our fingertips and can help share dietary fact, it has also perpetuated lots of dietary fiction. Think about some of the food facts you have come to believe over time. Write them all down and take them along to the dietitian in your weight loss surgery team. They will help you sort the fact from fallacy.