Inner Surfer Girl

It's the ridiculous (in my opinion) fad where women/girls wear tight corsets to have an unnaturally narrow waist. Didn't we learn anything in the 19th century? Bring on the fainting couches.

Here is an overview including health risks.
http://news.health.com/2015/03/10/what-is-waist-training/

It's the ridiculous (in my opinion) fad where women/girls wear tight corsets to have an unnaturally narrow waist. Didn't we learn anything in the 19th century? Bring on the fainting couches.

Here is an overview including health risks.
http://news.health.com/2015/03/10/what-is-waist-training/

It's the ridiculous (in my opinion) fad where women/girls wear tight corsets to have an unnaturally narrow waist. Didn't we learn anything in the 19th century? Bring on the fainting couches.

Good observations.
One thing I have been thinking about lately, especially with many of the issues that are being brought to the surface because of the US political campaign is sexual abuse.
I know a large part of my obesity is the result of me building a literal wall against unwanted attention/pain.
Even though I never experienced overt sexual abuse, the memories of bullying, ostracism, ridicule, unwanted comments, catcalls, rejection, harassment, and discrimination are very vivid. Much of it because I am female, but more so because I am a fat female.

Good observations.
One thing I have been thinking about lately, especially with many of the issues that are being brought to the surface because of the US political campaign is sexual abuse.
I know a large part of my obesity is the result of me building a literal wall against unwanted attention/pain.
Even though I never experienced overt sexual abuse, the memories of bullying, ostracism, ridicule, unwanted comments, catcalls, rejection, harassment, and discrimination are very vivid. Much of it because I am female, but more so because I am a fat female.

Not yet but soon, sleep study Nov 3rd then full speed ahead. Incidentally the sizes were 36 lb and 36 inches tall on first birthday, this phone has a will of its own goes off on tangents at times
Sent from my S55 using the BariatricPal App

Good observations.
One thing I have been thinking about lately, especially with many of the issues that are being brought to the surface because of the US political campaign is sexual abuse.
I know a large part of my obesity is the result of me building a literal wall against unwanted attention/pain.
Even though I never experienced overt sexual abuse, the memories of bullying, ostracism, ridicule, unwanted comments, catcalls, rejection, harassment, and discrimination are very vivid. Much of it because I am female, but more so because I am a fat female.

Good observations.
One thing I have been thinking about lately, especially with many of the issues that are being brought to the surface because of the US political campaign is sexual abuse.
I know a large part of my obesity is the result of me building a literal wall against unwanted attention/pain.
Even though I never experienced overt sexual abuse, the memories of bullying, ostracism, ridicule, unwanted comments, catcalls, rejection, harassment, and discrimination are very vivid. Much of it because I am female, but more so because I am a fat female.

Good observations.
One thing I have been thinking about lately, especially with many of the issues that are being brought to the surface because of the US political campaign is sexual abuse.
I know a large part of my obesity is the result of me building a literal wall against unwanted attention/pain.
Even though I never experienced overt sexual abuse, the memories of bullying, ostracism, ridicule, unwanted comments, catcalls, rejection, harassment, and discrimination are very vivid. Much of it because I am female, but more so because I am a fat female.

Bariatric Dietitian Elizabeth Anderson didn't exactly love school but she has an odd fondness for it now as September approaches and she's had a great deal of quality time with her teenager!
Find out what she learned in all those nutrition science classes as she answers some common WLS questions in Protein 101.


Which foods have protein?
Protein is found in meat, fish and chicken. For vegetarians and those less keen on meat, there’s protein in cottage cheese, eggs, Greek yogurt, tofu, cheese sticks all the beans you might put in chili—except green beans.
There’s also protein in meat alternatives like products from Morningstar Farms and Boca. You can usually find these products in the frozen food section. Protein amounts vary so check the labels.
How much protein do I need?
I tell my clients aim for 60-80 grams per day. Anyone with kidney issues might need to be much lower so it’s important to work with a dietitian specializing in bariatrics and kidney disease to get the protein prescription right for you.
Can you get too much protein?
If you’re drinking more than a two protein drinks per day along with multiple servings of protein, it’s easy to get up to 90 grams per day or more.
There IS such a thing as too much protein and greater than 95-100 grams per day is starting to push healthy levels.
p.s. Did you know the body simply cannot absorb more than 30 grams of protein per meal? If any of your protein drinks or bars are promising more than this per serving, don’t be fooled into thinking you are giving your body that full amount.
Is protein really that important, anyway?
Oh yes my friends, it is. Here’s why. Your body needs protein for its daily operations—cell building, transportation and repair work-- just to name a few.
If you don’t feed it enough protein it will use the protein it has in storage (your muscles!!!) while stopping all fat burning activity. It does this because it senses that this is a crisis situation and perhaps a famine is ahead. Any body fat on hand has become more precious than a winning Powerball ticket and will be protected appropriately.
It’s a common myth that after WLS you can eat whatever you want because you can’t ‘overeat.’ My advice? For optimal weight loss, that you can sustain, pull a Goldilocks and strive to get the amount that’s not too low and not too high but just right.

Fortunately, I am not now, nor have I ever been a coffee drinker. One less monkey on my back.

Fortunately, I am not now, nor have I ever been a coffee drinker. One less monkey on my back.

Fortunately, I am not now, nor have I ever been a coffee drinker. One less monkey on my back.

Fortunately, I am not now, nor have I ever been a coffee drinker. One less monkey on my back.

Fortunately, I am not now, nor have I ever been a coffee drinker. One less monkey on my back.

Fortunately, I am not now, nor have I ever been a coffee drinker. One less monkey on my back.

I also had to take it for six months. My surgeon said it greatly reduces the risk of gall bladder problems, but it doesn't completely eliminate it.

@Dr. Adeyeri,
Thanks for the reminder that the physical changes from surgery only take you so far, and your mind has to handle the rest. We’re told that WLS success is a long-term proposition and it depends our own choices, but don’t always realize that that means changing our mindset.
It sounds like you have a good idea explaining to patients that the surgery is only a small piece of the puzzle. It may give a patient the potential to control weight, but that’s all it does. The majority of long-term success and happiness depends on changes in mindset.
Thanks also for the great advice on ways to change the mindset. I love your suggestion to make sure you’re improving your quality of life in all kinds of ways as you lose weight, so that the weight loss journey isn’t strictly about weight loss per se, but about making life great. It is all too easy to focus so completely on weight loss that we don’t make the changes needed to enjoy life more, or we don’t realize that now the potential is there to enjoy life more!
Thanks for the insights and tips!

The bariatric operation will only take you so far. For many people battling weight issues, the biggest caveat in achieving sustained weight loss is the way you think about food. It's not easy to break habits that have been comfortably in place for years, even decades.
It's time to take your "old frame of mind" out of its comfort zone. Here's how to do it:

When new bariatric patients come to my practice, one of the first things we discuss is how unimportant the operation will be for them, in the big picture. Once they recover from the shock of that news, we explain that their mindset contributed to their weight problem, and their mindset will be the secret weapon to ultimately get the weight off.
Here’s the thing--we don't operate on your brain. Bariatric surgery will only take you so far. Long-term weight-loss success requires a firm commitment to living a healthy lifestyle—eating the right foods--and ignoring the others that made you feel bloated and too tired to do anything. You need to stay very well hydrated and discover an exercise (or two or three) that you perform about 4-5 times a week for about 30-40 minutes.
Take this stress and…
Then there’s the stress of everyday life—we all have it. The trick is to find ways to offset these unavoidable pressure points, so that you aren’t on a one-way road to the kitchen. Food is not the answer to your problems, it never was.
While you are improving your health, feed your brain with positive feelings by improving the quality of your life. Make the effort to become more social: Join a gym, catch a movie with a long-lost friend, invite the nice parents of your child’s best friend over for coffee.
Give a little, get a lot
One of the activities I recommend to every bariatric patient is to give back to their community. Want to feel better than any junk food could make you feel? Volunteer. If you look around, you’ll see that you’re far more fortunate than you may realize. Help out, make life better for someone else, even in a small way. Give your time, give your heart.
Everyone needs a little help
If you think you can’t go it alone, reach out to your bariatric or family doctor to ask for resources who can offer mental health support specifically for people with food/weight issues.
You are never in this battle alone, always remember that.

If you'd rather vacation in a desert greenhouse this summer than get your bloodwork done, you're obviously not a fan of WLS labs. Are all those labs really necessary? Bariatric Dietitian Elizabeth Anderson helps you decide if it's time to fast or pack the sunscreen.


“Do you think I should keep taking my sublingual B12, Elizabeth?” Roxanne* is 3 years post op from her gastric sleeve and is wondering if the expense of the meltable supplement is worth it.
“I’m not sure, what does your latest B12 lab show?” I respond.
“Uh…..I haven’t had labs done in, well...years,” Roxanne admits.
And she’s not alone. Scores and scores of WLS clients intend to keep up with the required post op labs but life gets in the way.
People, I am here to tell you, if it has been a long, LONG since you’ve had your specific bariatric lab work done, run, don’t walk, to your nearest phlebotomist.
Every few years, the Obesity Society (TOS), the American Society of Metabolic and Bariatric Surgery (ASMBS) and the American Association of Clinical Endocrinologists (AACE) update medical guidelines for bariatric surgery patients. They have a list of labs that need to be done at 3 and 6 months and those that need to be done annually. Yes, every-single-year, after surgery.
Why? Believe it or not, vitamin and mineral deficiencies increase over time—regardless of your WLS procedure.
I know many PCPs push back against ordering these regular labs--whether it’s the cost to their practice, the patient or both, many providers don’t understand the necessity for the work-up.
What concerns me the most is that the damage from some vitamin and mineral deficiencies cannot be undone or corrected. The damage is permanent.
A psychiatrist speaker at a recent convention I attended, talked about patients he’s seen that were 6-10 years post op that were suffering from mental health issues--sometimes incapacitating problems.
When he looked at their lab work, he was shocked to see that for some patients, vitamin and mineral deficiencies were the sole cause.
If your provider pushes back against these labs, I’m happy to provide you with the link to the scientific paper citing which labs need to be done and when. You can share this with your provider and insurer.
Roxanne is off having her B12 checked as we speak. Armed with those results, we’ll be able to determine the most affordable and healthful path forward, specifically for her.
You deserve the same so make that appointment today. I thank you.
*names of clients have been changed

For me, I have truly come to see obesity as a disease. Especially in that it is not a moral failing or a defect of character. It is a physical disease.

In this series of articles Dr. Krainin will explore the complex relationship between weight, weight loss through bariatric surgery, and sleep disorders.


Many people on the journey to a healthy weight first encounter the field of sleep medicine due to a requirement from their surgeon or health care insurance company to get tested for sleep apnea. Let's explore the origination of this rule.
Obstructive sleep apnea is an extraordinarily common medical condition that is characterized by the repetitive closure of the upper airway during sleep. The cartoon below depicts what happens in the back of the throat when people have sleep apnea:

The Sleep Apnea-Weight Relationship
Being overweight or obese is a major risk factor for sleep apnea. In fact, a 1998 study found that 20-40% of people with a BMI ≥ 32 had sleep apnea. What's the connection? Fat accumulates everywhere in our bodies - even in the tongue! As the tissues in our mouths and throats get bigger, and our necks get thicker, there is less space available in the posterior airway to allow us to breathe. When our breathing goes on "autopilot" during sleep, muscle tone in our bodies goes down and our upper airways are more prone to collapse, creating a recipe for disaster.
Additionally, obese patients are at risk for another form of sleep disordered breathing called "obsesity-hypoventilation syndrome." The basic mechanism of this condition is that, when patients carry excessive weight on their chest and abdomen region, the muscles that operate the lungs can tire out, leading to sustained low oxygen and high carbon dioxide levels, both of which are harmful for the body.
Physiological Effects
During each abnormal breathing episode, our body experiences many negative physiological effects. Oxygen levels can drop precipitously, blood pressure goes through the roof, stress hormones are secreted into our bloodstream leading to blood sugar elevation, pressure in the brain skyrockets. Over time, these effects take a toll on the body. Sleep apnea is associated with numerous medical conditions including heart attack, irregular heart rhythms, stroke, hypertension, type 2 diabetes, headaches and acid reflux, to name a few.
The Surgery Connection
Medical research clearly shows that patients with significant sleep apnea are at an increased risk for "perioperative morbidity." This means that patients with sleep apnea are more likely to experience a complication after surgery if they have untreated sleep apnea. Research studies show that these complications include increased risk of death, irregular heart rhythms, need to be transferred to ICU and difficulty with extubation (removal of the breathing tube after surgery). One study showed that patients with sleep apnea were 2.25 times more likely to have a complication that required a prolonged hospital stay after gastric bypass surgery than those without the disorder. For these reasons, bariatric surgery teams now take sleep apnea very seriously when planning surgical interventions.
Next column: Sleep Apnea Testing & Treatment in the Bariatric Surgery Patient

For me, I have truly come to see obesity as a disease. Especially in that it is not a moral failing or a defect of character. It is a physical disease.