Diane524

Whether you are pre-op, a recent post-op or already well on your way to weight loss, exercise plays a starring role in the speed and longevity of your overall weight management after bariatric surgery.


Even if you are preparing for bariatric surgery, you can start exercising (so long as you are cleared by your doctor) and lose a surprising number of pounds even before your gastric bypass, sleeve gastrectomy or revision bariatric surgery.
In addition, the better cardiovascular condition you are in before surgery, the fewer complications you’ll face during and after surgery.
Not sure where to start?
Here are instructions I offer to my own weight loss surgery patients here in Freehold, NJ:
Bariatric Preoperative Stage
Patients who start an exercise strategy before surgery have an easier time adjusting to exercising after surgery, according to the American Society for Metabolic and Bariatric Surgery (ASMBS).
But, admittedly, exercise is challenging for people who carry a lot of extra weight. For this reason, starting slow is imperative. If you are morbidly obese, talk with your bariatric surgeon about fitness guidelines for your current health situation.
Generally speaking, these are reasonable goals to target:
· Focus on cardiovascular exercise, even if it’s just a walk around the neighborhood for 10 to 30 minutes, depending on your health and doctor’s recommendation.
· Start walking for 10 minutes, twice a day and add 5 minutes each day, up to 30 minutes per day.
· Realize that empowerment that fitness gives you over your body and your overall health.
· Appreciate how good you feel after exercising—even for 10 minutes!
Weight Loss Surgery Postoperative Stage
For the first two weeks after surgery, focus on flexibility exercises, deep breathing and getting back into performing normal daily activities.
· At your first post-op visit with your surgeon, he or she will carefully go over your customized exercise plan based upon your health, age and the procedure you had.
· With your doctor’s approval, three weeks after your operation, begin to gradually incorporate low-intensity aerobic exercise (walking or swimming are my preferred choices at this stage).
· If you feel prolonged pain or discomfort, you are doing too much too soon.
· During the first six weeks after surgery, do not lift more than 15 pounds.
One Month and Beyond
Now your goal is to increase range of motion so you can easily take off your shoes and pick things up off the ground and move around more.
· Strength-training (light weights) exercises are rebuilding muscle.
· Work toward 30 minutes of continuous exercise five days per week.
· Avoid abdominal exercises for the first eight to 12 weeks (allow the incision to heal). This also helps to alleviate abdominal hernias near or around the incision.
· Change-up your workouts so your body is constantly challenged (walk around the park today, lift weights at the gym tomorrow and use the elliptical machine)
· Introduce a wider variety of bariatric fitness options: biking, yoga, dancing, aerobics, Pilates, kickboxing.
A year after weight loss surgery, you should be able to perform 45 minutes to an hour of exercise five times a week.
Exercise is Insurance Against Future Weight Gain
A lifelong exercise program is critical to a weight loss surgery patient’s long-term success. If a physically active lifestyle has not been adopted, weight gain will likely result. (Sadly, I have seen this firsthand on more than one occasion).
Exercise is insurance for long-term weight-loss. If you have a slip, an extra 5 to 10 minutes spent working out will ensure that your metabolism stays elevated and this extra effort will burn more calories.
Working out will not, however, save you if you overeat regularly—bariatric surgery or not. By sticking close to your daily calorie requirements most days, drinking plenty of Water and focusing on fitness, you’ll look great, feel even better and be the healthiest person you can be.
And that’s worth just 30 minutes out of your day, isn’t it?
Photo Credit: Woman Exercising by Witthaya Phonsawat -FreeDigitalPhotos.net

Our nutrition guidelines specifically mention incorporating skim or 1 percent milk when you do have milk. This is for milk that comes from cows. We get questions from our patients about what that really means.


Milk that has no fat is also called skimmed, fat-free, non-fat or 0 percent fat. The USDA National Nutrient Database uses the terms nonfat, fat-free and skim as descriptors for milk with no fat. The fat content of the milk refers to the percentage of weight that the fat contributes to the serving size. It does not refer to the percent of calories the fat contributes. Each 8-ounce cup of milk, no matter how much fat, will have 12 grams of carbohydrate as milk sugar.
Milk sugar is also called lactose. Each 8-ounce cup of milk will also have 8 grams of Protein. An 8-ounce cup of skim milk has 80 calories. Milk with 1 percent fat is also referred to as low-fat milk and has 100 calories and 2 grams fat. Milk with 2 percent fat is also referred to reduce- fat milk and has 120 calories and 5 grams fat. Whole milk is also called Vitamin D milk and has 150 calories and 8 grams fat.
Most of the fat in milk is saturated, which can contribute to elevated cholesterol. Increased fat also means increased calories and a potential for dumping issues. Along with protein, milk also packs in Calcium, potassium and Water. There are several lactose free milks on the market if you are lactose intolerant. For those that enjoy milk, you are getting a nutrition-packed Fluid. Next week’s tip will be an overview of the other milks on the market like almond and cashew milks. Stay tuned!

People who have undergone bariatric surgery know the weight loss battle does not end in the operating room. Months and even years after surgery, some weight can slowly creep back on. But this isn't a time to panic because now you have the tools to overcome a little setback and regain control of your weight.
This time, you are in charge.


One of the lessons you learn after weight loss surgery is that you are in charge of your health, diet and exercise program. The food no longer rules the roost--you do.
The truth of the matter is no matter what the scale says, 110 or 310, everyone puts on a few pounds now and then. As a bariatric surgeon in New Jersey for more than 10 years, one of the biggest anxiety triggers for patients is weight gain.
"That's it--it's over--I'm going to gain all the weight back."
Of course that's not true. To get back on pace, I’ve listed a few essential steps to help get you back on track to dropping the pounds once again:
• Go back to the beginning
Post-surgery, you probably followed your healthcare team’s advice to the letter. But as time passed, and you looked and felt healthier, you may have started to deviate from those dietary and exercise guidelines. Pull out your notes and review the program guidelines that brought you this far. Get back on the scale once a week and fire up your food journal again.
• Get thyself to the nearest support group ─ STAT
Weight loss is a personal journey, but it doesn’t have to be a lonely one. Online support groups on BariatricPal.com are great secondary resources to live weekly or monthly groups with your bariatric doctor or hospital. There is support all-around you, reach out and take it.
• Work it out
Are you using the ‘too tired’ reason for missing a trip to the gym or 30 minute fast walk around the neighborhood? If you need energy, you know how to get it—get up, get out and get moving. “Too busy,” you say? Remember, only you can prioritize your health and wellness. You matter—make time for your health every single day.
• Come to terms with the weight gain
This doesn’t mean blaming yourself. Rather, be forthright about how and why it happened and pat yourself on the back that you’ve recognized it now—not later.
There’s no need to beat yourself up. You have already done the hard part by recognizing some weight has crept back on. That in itself shows you are going to battle back. We encourage our patients at Sterling Surgicare to call us if they feel frustrated or defeated--everyone needs a pep talk now and then.
Remember there are many people supporting you 24/7 in this effort.
Life is filled with occasional side-steps and set-backs. It is part of making us who we are. Make a plan, regroup, recommit.
You can do this.

The weight loss surgery journey is easier for some than for others. That’s true not only mentally, but physically as well. Some patients are confident as they get the surgery, follow their prescribed diets, and lose weight until they approach their goal weights.
But most have doubts at some point. Those doubts can be strong especially in the first few weeks after surgery.


I see this lack of confidence time and time again in the forums. Weeks or a month after surgery, gastric sleeve, gastric bypass, lap-band, and other Weight Loss Surgery (WLS) patients start to wonder whether Weight Loss Surgery was the right choice. Most often, they are disappointing in the number of pounds they have lost, and they wonder, “Am I going to be the Weight Loss Surgery patient who fails?”
I can say this with confidence: If you follow the Weight Loss Surgery diet, you’ll lose weight.
“I’m Not Losing Weight Fast Enough!”
That’s a common post on BariatricPal. The poster is usually a week or a few weeks post-op, and worries their weight loss isn’t fast enough. They think their “slow” rate of weight loss means Weight Loss Surgery didn’t “work” for them. They think they will never be able to lose significant amounts of weight, since WLS was a last-ditch effort to lose weight and get healthy after years of dieting didn’t work.
But in most cases, these fears just aren’t true. Don’t misunderstand me. I’m not saying these fears are unreasonable. I understand them perfectly. I, and probably every Weight Loss Surgery patient, wondered whether it would work for me. And the answer for me, and for everyone who followed their Weight Loss Surgery diet, was “YES!”
The Perfect Storm for Frustration
So why the panic? I like to think of the first few weeks or even months after weight loss surgery as a perfect storm for generating doubts. It’s a time when the following are true.
You realize you have made a decision that led to a change to your body that is irreversible (in the case of sleeve gastrectomy) or meant to be permanent (in the case of the gastric bypass), or
You realize a lifetime commitment to changing your eating habits and lifestyle is a pretty big deal.
You have not eaten solid foods for weeks, or even more if you had a liquid diet for long before surgery, and it’s getting you down.
You are struggling in your daily life as you try to make time for exercise or you find your family members continue to eat junk food in front of you.

All that is enough to get anyone down before you even start thinking about the reason you got the surgery in the first place – to lose weight! If you doubt you’re losing weight “fast enough”, you might start wondering if you made the wrong decision when you got Weight Loss Surgery – and that’s a depressing thought.
Crunching the Numbers
Almost without fail, the BariatricPal member who posts about disappointing early weight loss is losing weight quite quickly. The only person who is disappointed in this number, typically, is the member him or herself. I’ve seen members post with concerns about losing “only” 20 pounds in the first month, or “only” 10 pounds in the first week. Guess what. That’s great!
Think about it. A general round number for great first-year weight loss after Weight Loss Surgery is 100 pounds. That’s an average of 2 pounds a week, or 8 pounds a month. If you lost 20 lbs in your first month, you’re doing fantastic! To hit 100 pounds in your first year, you won’t even lose a pound every three days! So don’t worry if the scale doesn’t plummet every single day. If you’re eating right, you’ll lose weight.
Try to keep yourself motivated by keeping it all in perspective. Another motivating thought is to consider how long it took you to gain the extra weight. 5 years? 10 years? Your whole life? And now you have a chance to lose it within 1 or 2 or 5 years? That’s a pretty good bargain, right?
Recovery Now for Weight Loss Later
Now, I know you’ve prepared for Weight Loss Surgery for a long time, and you’re eager to lose weight. But really, you’re not quite ready to focus on weight loss if you’re still recovering from surgery. It’s far more important to heal properly. That’ll help you lose weight faster later and avoid complications that’ll set you back, not to mention cause possibly serious health problems.
So, no matter how frustrated you are, stay positive, and focus on following your surgeon and nutritionist’s instructions to the letter. Continue to eat a liquid diet and then pureed foods without cheating and sneaking in solid foods. Use this time to establish a pattern for your long-term success. Learn to measure your food, and to set aside time for food prep and for exercise.
Weight loss surgery is a lifetime adventure, and that realization can really hit hard in the early days and weeks post-op. You can get through this tough period by focusing on one day at a time and not worrying about your rate of weight loss. Measure your success not by the scale number, but by how well you stick to your plan.

Quit dancing around the subject and start using the STAPLE ingredient in the Recipe for Recovery: COMMITMENT. If you're guilty of doing the RECOVERY HOKEY POKEY, it's time to put your WHOLE SELF IN!


The Recovery Hokey Pokey
You put your right thigh in.
You put your right thigh out.
You put your right thigh in…
and it jiggles all about…
You do recovery hokey pokey and
it turns you inside out
Yhat’s what it’s all about!
Weight loss. There’s simply nothing like it. The pounds come off. You feel great. People notice how much “better” you look. The scale is showing numbers you haven’t seen since high school. And then…it stops. Everything stops. The great feeing…the compliments…the scale.
Maybe this “losing weight” thing isn’t all it’s cracked up to be after all. What happens when all the excitement fades? What happens to the motivation? What happens to that “high” you felt when you jumped out of bed to greet the day each morning at the beginning of the weight loss adventure? What happens to the excitement of doing exercises you’ve never been able to do before?
Oh – reality! Yes, reality and the ordinariness of life sets in and now you don’t feel so inspired to do the things you need to do to get what you say you want. You know – improved health and a better quality of life. Those are the reasons most people (initially) state as their reasons for having weight loss surgery.
“I don’t think I’ll work out today because…I’m tired and deserve to sleep-in.”
“Maybe I’ll workout tonight, after work, when the kids are asleep.”
“Gosh! I had a long day, and the kids are down…maybe I should get some sleep while I can. I’ll exercise in the morning.”
“You know, I haven’t eaten anything ‘bad’ in a long time; I ‘deserve’ a little treat for all of my hard work. I’ll just have a little bowl of something sweet.”
“I’m really hungry. Maybe I’ll just eat the other half.”
“Who brought the donuts? I wonder if there’s a “plain” one in there…that wouldn’t be so bad.”
Sound familiar? Your enthusiasm wanes, then your motivation flies out the window, and whammo! You’ve lost enthusiasm for the commitment you made to your healthy recovery. What happened? What is commitment, anyway?
A commitment is a promise you make to yourself to do something or to be loyal to someone or something. We love the definition of commitment from Urban Dictionary:
“Commitment is what transforms the promise into reality.
It is the words that speak boldly of your intentions.
And the actions which speak louder than the words.
It is making the time when there is none.
Coming through time after time after time, year after year after year.
Commitment is the stuff character is made of;
The power to change the face of things.
It is the daily triumph of integrity over skepticism.”
by Ashbash January 13, 2005
Your commitment to living a healthy lifestyle can be a promise you make to yourself, to your children, or to your entire family. Commitments that you write down and share with others are more likely to be maintained. Stating your commitment to your healthy lifestyle every day (out loud is best) will remind you of the promises you made to follow through with the behaviors that result in improved health and a better quality of life – the reasons you chose to have weight loss surgery.
SO – when you wake up each morning, maybe sing this version of the Recovery Hokey Pokey:
I put my whole self in.
I put my old habits out.
I put my best effort in…
And I get good results out!
I stop recovery hokey pokey –
And I get rid of all self-doubt!
THAT’s what it’s all about!
Are you singing the Blues or Happy Days in your Recovery? Tune into the June APODCast on June 17, and you just might hear The Doc might sing The Recovery Hokey Pokey.

Last month in our Members Only Facebook Support Group we asked members if they eat their meals at the table. This prompted some fascinating and insightful discussion!


Lots of people were eating away from the table on a regular basis, eating everywhere from in front of the TV to in bed. Of course there are occasions where this is completely appropriate, such as Breakfast in bed on Mother’s or Father’s Day, or pizza in front of the footy on grand final day. However, when this is happening more often than not, it is difficult to be mindful and eat in response to your body cues. Boundaries are merged and eating flows over into times not meant for eating. This can result in over eating and poor weight loss.
After reflecting on the comments from our members, we wanted to break the concept of mindful eating down to some basic ‘rules of engagement’ to help you improve your eating habits and achieve your goals.
So what do I do?
Over the next month, try following these ‘rules’. Like most rules there is room for flexibility; as an adult you know when a rule doesn’t work for you, or when it is time to bend it.
Aim to always eat while sitting down, ideally at a table or bench.
Avoid grazing while standing up, for example, when preparing meals, passing through the kitchen, ducking into the staff room, etc.
Put anything you want to eat on a plate so you can see your portion. Avoid eating straight from packets, grazing from platters, nibbling at buffets, etc.
Have eating free zones in your home, such as the bedrooms, study and bathroom.
Set a time to signal it is time to stop eating for the day. This will vary from person to person but it helps limit the amount of mindless evening eating that happens so often.
Only snack if physically hungry and when snacking, apply the above ‘rules’.

Remember, aim for progress not perfection. Good luck, and let us know how you go.
As always, be kind to yourself.

Okay, it sounds cute, but it’s a serious question. If you want to lose weight or keep it off and get healthy, you need a plan. The old saying, “Fail to plan, and you plan to fail” could have been intended specifically for weight loss surgery patients. Fail to plan after Weight Loss Surgery (WLS), and you’re planning for plateaus or regains and possible complications.
What should you be planning? You don’t want to become fixated on planning, but there are a few key areas to be aware of. These are some of the questions you might ask yourself to make sure you’re planning enough. Each question is followed by the pitfall you might fall into if you don’t think ahead.


Where are you shopping, and what are you buying?
Possible pitfall: Finding an empty fridge and opting for McDonald’s or pizza delivery, or going to the supermarket without a list and buying whatever looks good – which usually doesn’t include lettuce and chicken breast.
A solid answer identifies when you’ll shop, and it includes a list of Proteins and other essentials, such as vegetables, fruit, healthy starches, and healthy fats. Check the list to make sure it has enough healthy foods for the meals and Snacks that will get you through to the next shopping trip.
What are you having for Breakfast tomorrow?
Possible pitfall: Being so rushed you grab a pair of Pop-Tarts on your way out, get a bagel at the coffee place, or get to work so hungry you sneak in a doughnut from the reception area.
A solid answer is realistic, so if you know you’ll be in a rush, it doesn’t involve a lot of preparation. You may want to get your breakfast ready the night before, even if it’s as simple as putting some cottage cheese and a few slices of turkey in a portable container with a tight-fitting lid.
What are you ordering for lunch?
Possible pitfall: Going out with the gang and ordering what they do…anything from a burger and fries to Pasta primavera.
A solid answer considers where you’re likely to find yourself at lunch and what’s on the menu. Identify your source of Protein and a vegetable beforehand and stick to your pre-made decision when you order. If you end up going out unexpectedly, look for salads, grilled chicken and fish, and sides of vegetables and fruit.
What are you making for dinner?
Possible pitfall: Ordering in or getting take-out, or falling back on a high-calorie, low-nutrition quick fix such as macaroni and cheese or taco kits.
A solid answer identifies your source of protein and vegetables so you can figure out what you need to buy and how much preparation is necessary.
When, where, and what is today’s workout?
Possible pitfall: Running out of time if you haven’t scheduled it into your day, or chickening out of the workout if you haven’t quite made the commitment to a specific exercise.
A solid answer says when you’ll work out, whether you’ll do it at home, at the gym, or somewhere else, and what clothes, shoes, and other equipment you need to bring with you, if any. Your answer should also include what you’ll be doing, whether it’s 30 minutes of walking on the treadmill plus 15 minutes of lifting weights, going to a Zumba class, or pulling weeds and sweeping the driveway.
What will you snack on at the party?
Possible pitfall: Eating whatever happens to look good, and ending up with not enough protein, too many calories, too much fat and sugar, and possibly nausea or dumping syndrome.
A solid answer doesn’t depend on what the host may serve. Your plan may be to bring some hard-boiled eggs or beef Jerky for yourself, plus a large green salad, vegetable skewers, or fruit salad for you and the rest of the guests to enjoy.
How will you answer your mother when she offers you a freshly baked chocolate chip cookie (your favorite) or the entire batch?
Possible pitfall: Feeling guilty for refusing or being caught off guard, and accepting the cookie or batch.
A solid answer includes a polite refusal, possibly with an explanation, such as, “No, thank you. My doctor has advised me not to eat cookies.” If you can’t avoid taking the batch home as a “gift,” don’t be afraid to throw it out. Nobody likes to throw away food, but if you’re going to, better to throw it away in the trash can than in your body.
How are you going to feel at the end of the day?
Possible pitfall: Let doubt creep in, and you may be setting yourself up for bad decisions with eating and exercise.
A solid answer is positive and confident with no room for self-doubt. At the end of a day of good eating and a bit of exercise, you may be tired, but satisfied, proud, and a little lower in weight. Staying positive and optimistic sets you up for good decision making without even thinking about it.
You always hear about the importance of planning for weight loss surgery success, but that advice may seem confusing if you’re not a natural planner, or even if you’re just not used to thinking so much about your WLS-related habits. Know the answers to these questions, and your planning skills can help you lose more weight and stay healthy.

During the course of our lives, many of us will need some kind of GI (gastrointestinal) surgery—gallbladder or appendix removal, hernia repairs or more serious issues related to the colon. Special care should be heeded to patients who have previously undergone weight loss surgery due to anatomic changes as a result of the procedure.


It’s also important to note that bariatric surgeons specialize in performing most general and laparoscopic operations (unrelated to the weight loss surgery) in the torso region of the body.

I recently had a case where my bariatric patient had his gallbladder removed by a general surgeon who was not a bariatric surgeon. Why? He didn’t realize that I also perform gallbladder surgery at least 2-3 times per week. Unfortunately, this patient experienced post-op complications which I was able to address successfully.

This incident compelled me to ask other post-op patients what they would do if they needed an operation in the GI region.
“Really? I thought you only performed weight loss surgery,” many of my patients remarked. When one patient told me she would definitely ask me for a referral, I knew I needed to compose an article about this subject.

If you are facing an operation in the abdominal region, contact your metabolic and bariatric surgeon first, so long as you satisfied with their quality of care. They have been specially trained to successfully treat most medical issues safely and successfully. In addition, they are well versed in your new anatomy and how best to address the medical situation you are facing and oversee your post-op care.
Photo courtesy of FreeDigitalPhotos.net Staff Only Signs At Laboratory” by artur84

Is your weight loss history standing between you and your current success after weight loss surgery? If you’re not getting the results you want, there’s a good chance it is. In Part 1 of the series, we brought up the idea of learning from your past, not running from it. Now, we take a look at a few more ways your past might have brought you down, and what you might be able to about it.


Problem: Depending on Others
This one’s not always so obvious, but it may be keeping you from reaching your full potential in weight loss and, frankly, in life. Of course, it’s normal and healthy to depend on others for some things. Maybe you rely on your spouse to pick up the kids from school, and you depend on your parents to parents to take care of your house when you’re on vacation.
But what about the important things? What about your health? Do you take full responsibility for it? Or do you do what you did as a kid – depend on someone to make sure you had the food you needed and expect your parents or the doctor would make you better if you got sick or hurt?
You’re still living in the past if you have not taken control of your health. You are the one who needs to purchase and prepare healthy food; set aside time to work out; eat the right foods to avoid complications from surgery. Others can help, but you need to be in charge.
Problem: Looking for the Quick Fix
If you look for a quick fix, you’ll probably find one. You can lose weight quickly using any number of strategies, and you’ve probably used them all from juicing to low-carb to low-fat. The problem with quick fixes is they’re quick to break, as you’ve found out when you went off the diets and gained the weight back. After WLS, don’t look for the quick fix. Be patient, and know you’re in it for the long haul.
Looking for the quick fix can be something obvious that you recognize in yourself, but it is not always. Looking for the quick fix can be as subtle as subconsciously thinking of what and how much you eat as a temporary diet or thinking of your exercise program as something with a start and finish.
You may be subconsciously looking for the quick fix if you’re unwilling to sign up for a long-term gym membership, or to invest in a kitchen scale or bariatric surgery recipe book. If you feel these things aren’t worthwhile, think about why. Is it because you don’t honestly see yourself needing them for long because you’re not really invested long-term into weight loss surgery success?
Problem: Not Building Your Support System
Many obese people struggle with late-night eating. Even if they are able to make it through the rest of the day eating reasonably healthy, night-time binges can strike furiously. If you weren’t able to overcome them previously, it may have been because you did not build enough of a support system.
This time, don’t underestimate the power of your support system. Include people, such as friends and family, as well as alternate plans. You can set up many layers of protection against late-night overeating. Don’t store junk food at home, and don’t drive home past trigger spots like drive-through burger joints. Have two or three friends or family members whom you can call or talk to if you’re about to make a bad choice, and choose a pre-determined activity to do before eating, whether you decide to blog, sew, or take a walk. Also, have plenty of ready-to-eat healthy food around so it’s easier to grab than any junk.
Problem: Lack of Self-Confidence
Have you ever heard of a self-fulfilling prophecy? You think something will happen a certain way, so you act as though it will happen that way, and then it does.
For weight loss, that can be a bad thing if you let it. “I know my diet’s going to fail, so I’m not going to bother weighing my food.” Then, guess what – you don’t lose weight! “I knew I wouldn’t lose weight.”
But self-fulfilling prophecies can be just as positive as they can negative, especially if you have self-confidence. “I know WLS will work for me, so I’m going to hit my Protein goals and weigh my portions every meal.” When you don’t even let doubt creep in, you can be more empowered to follow the behaviors that lead to success.
Weight loss surgery can be a fantastic tool for weight loss, but it’s only as good as you make it. To make it more powerful, don’t run from your personal history. Recognize your past, identify what went wrong, and fix it. Make sure this time really is different.

You’re considering weight loss surgery, you’ve scheduled it, or you’ve already gotten it. Are you going to be successful with it?
Historically speaking, the answer is “No.” Maybe that’s not what you wanted to hear, but it’s true. Just take a look at your past. You haven´t been able to lose weight and keep it off. It you had, you wouldn’t be looking at Weight Loss Surgery.
But that’s no matter. Your past does not need to determine your future. Replace old habits and attitudes and look forward instead of back. That’s how you will be able to get the results you want instead of the disappointments you used to get.
In this first article of the two-part series, we’ll take a look at some of the problems from the past that could stand in your way. Part 2 of the series will have a few more.


Problem: Childhood Habits
No joke. It’s hard to shake off the behaviors you learned while growing up. Maybe your family traditions were something like making pancakes and sausage on Saturday mornings, ordering pizza on Wednesday nights, and watching Sunday afternoon football while eating the usual unhealthy Snacks. Maybe your “habits” were actually lack of habits – maybe you didn’t grow up walking to school or playing outdoors every day.
Do you see yourself clinging to the old traditions, whether or not purposefully? Give yourself permission to let go of the old ones, and maybe even create some new ones. You don’t need to plop down in front of the TV after dinner just because you always have. Maybe you could take a walk. You don’t need to meet your parents at a favorite Italian restaurant every week. Maybe you could meet for coffee. Or, you could meet at the Italian restaurant, but change your usual order of spaghetti and meatballs to a salad.< /p>
It’s time to stop letting your childhood dominate your current life and health. And here’s food for thought: if you’re old enough to get weight loss surgery, you’re old enough to make your own traditions.
Problem: Mistaking “Food” for “Love”
This can be one of the biggest obstacles for weight loss surgery patients because it can lead to conflict between them and their families. Maybe it’s the Jewish or Italian mother who guilts you into eating, the Asian culture that requires you to clean your plate, the Latin American family that solves problems at the dinner table, or the African American community known for soul food.
Which of these or other food-centric cultures you were raised in doesn’t matter; the point is somehow food got confused with showing love. Somehow, eating for reasons other than hunger – for celebration, comfort, courtesy, expression of love – became cultural norms.
Your personal history may be weighing you down if you are eating to make other people happy. This won’t work for you. It can stall weight loss and continue to make you feel dependent on others. Instead, make the decision now to eat for yourself – to nourish yourself, to fuel yourself, to be able to enjoy life. There are many ways to give and receive love besides eating food that is literally killing you slowly.
Problem: Devaluing Yourself
You wake up before dawn to clean the house. Then you get the rest of the family up and ready, and make, serve, and clean up from Breakfast. You drop the kids off at school on the way to work, then pick them up on your way home. You help them with homework, make and eat dinner, and put the kids to bed. After a few minutes with your spouse, you hit the sack yourself. The day is over, and you haven’t had one second to yourself.
Sound familiar? If this – or something like it – has been your life for years, you’re setting yourself up for weight loss underachievement because you’re undervaluing yourself. Where’s the you time in this day? You deserve it, and it's up’to you to take it. It’s not something you should feel guilty about, but if you do, consider this: doing your best for yourself puts you in the position to do your best for others, too.
Problem: Hanging with the Wrong People
It’s true. The people you hang out with affect your weight just as much as your genes do. If your friends are obese, they may be setting you up for much bigger struggle than necessary against obesity. That’s because you are likely to make the same choices they make. You sit on the couch with them and order unhealthy dishes with them. In contrast, skinny friends may influence you to eat healthier and be more active.
If you notice your friends dragging you down, feel free to say something. You can politely ask to get together to shoot hoops instead of drink beer. Catch up at the park or over coffee, not over nachos. Collect and test healthy recipes instead of decadent Desserts. Changing those age-old habits may not be that hard.
If your friends refuse to change their activities and you still want to spend time with them, you can. Just be aware of how their choices can affect yours, and make sure it doesn’t happen.
Do any of the above sound familiar? If they do, think about how you can avoid making the same mistakes this time around. Some of the smallest changes in attitudes can lead to big changes in results. Stay tuned for Part 2 of the series for more!

Making the decision to have weight loss surgery is a very big deal. It seems obvious to say that when someone agrees to weight-loss surgery they're desperate for help to change the way they're living, or not fully living their lives. Everyone goes into the procedure ready and willing to surgically alter their anatomy hoping for a better future.


So why is it that so many will fall short of losing the optimal amount of weight for their health and will actually regain within 3 years much if not all of the weight they lost? Some studies say 1/3 of patients will regain most of their weight post-surgery. I think the number is actually higher because many people who regain simply fall out of contact with their bariatric surgeon and support staff because they feel ashamed, so the statistics do not include these people. So, why do most people regain the weight? What can you do to help insure that you will be one of the successful long-term losers of your excess weight? By examining why people fail you can create a plan for how you will succeed.
The government agency, National Institutes for Health (NIH) defines weight-loss surgery as "merely a tool that helps people get a new start toward maintaining long-term good health. The surgery alone will not help someone lose weight and keep it off. Together with a reduced-calorie and low-fat diet and daily exercise, surgery will help an individual lose weight and maintain the weight loss.” Please read that a few times. That is how important this quote is! The surgery alone will not help someone lose weight and keep it off.
We as weight-loss surgery patients have a history of seeking comfort, happiness and pleasure through food. We wouldn't be here if that weren't true. Me included. The process of surgically altering our anatomies does nothing to remove from us the tendency to seek comfort in familiar ways but assures there will be physical suffering if we do. Post-surgery we will still have the same brain that is used to comforting us with food, and we will still have the fingers and the arms that are used to lifting food to the same mouth to find comfort and pleasure. It is critically important that the WLS patient seek out new ways to soothe, comfort, and find pleasure in their world other than by eating.
ONE main reason patients regain their weight is they search for ways to get around the surgery, still thinking of food as primarily a source of pleasure, not a source of fuel that can be pleasurable. This is often done relying on liquid calories, which may pass more easily, like high calorie coffee or juice bar drinks or alcohol. This is also done post-operatively by trying to maintain the presence of “trigger foods” in their lives. “Trigger foods” are often foods from the patient's past that helped cause obesity, do not satisfy hunger but instead create a craving. Many are high-calorie and highly processed, not nutritious. Trigger foods can include chocolate, chips, crackers, bread, Cookies, ice cream, pudding, lattes, frapuccinos and alcoholic beverages. Really, any food can be a “trigger food” if there is so much pleasure in the “mouth-feel” or taste that repeating the pleasurable experience takes on more importance than actually feeding hunger. Very successful patients cultivate a mostly trigger-free post- surgical life. Bariatric surgeons and the NIH know the most common reason for regain and the most common post- surgical complication is “noncompliance.” Non-compliance is a fancy word that means the patient is not eating and exercising the way he/she agreed to before surgery. These people “talk the talk.” The successful patient “walks the walk” after surgery and changes how they eat and move.
A SECOND reason people often regain beginning in the second or third year post-op is that the “honeymoon” is over. The “honeymoon” generally encompasses the first 12 to 18 months post- surgery. During this time many patients will say, "I could eat all the chocolate and ice cream I wanted and still lose weight. I didn't have to try and the weight just came off.” This is often true because the body has been through such a shock after surgery that it takes months for the body to reset itself and learn to function with its' new physiology. Patients who regain their weight often believe that this “honeymoon period” is the new way that it will always be and don't adopt healthy eating patterns. So when their “honeymoon period” ends as it will they believe that the surgery has somehow failed them. In reality they have failed their surgery! During the first 12-18 months post-op it is essential to develop healthy patterns around food and exercise. This is the time when it is actually easiest to do and to not do so wastes a once-in-a-lifetime opportunity to begin a great new life with positive momentum.
A THIRD reason many patients regain much of their lost weight is a lack of support. Humans are social animals and we desire and need the support of each other throughout our lives. For thousands, if not tens of thousands, of years people coming together as a family or a community over food has been a way we connect with each other. Post-surgery, when the patient isn't able to eat what others are eating or in the quantities others are eating, or others are eating their 'trigger foods”, life can feel very stressful and lonely. This can be compounded by being around unsupportive people or people who want to be supportive but don't know how. Patients fail by not surrounding themselves with supportive people in a safe environment where they also must be accountable for their actions and behavior with food and their bodies. It is key to have a community of professionals and non-professionals who understand the challenges and hardships faced by those carving a new life with a new anatomical structure. There are online and in-person support groups. Even patients who've gone abroad for weight loss surgery can often use the support services available with their local medical group's Bariatric department. Creating relationships that support and assist you in becoming a healthier person and that hold you accountable for making healthy choices are key.
These are my top three. What would you add to this list? What plan will you create to deal with the items you add to this list? Who will support you on this journey of your life.....for your life?

Think you don’t have time to commit to losing weight and getting healthy? Think nobody has a less healthy relationship with food than you do? Then you haven’t met Robanne Robin. She’s a mother of 3, a motivational speaker, a diabetes prevention educator, and a weight loss and fitness coach for kids and adults. She’s also a Roux-en-Y gastric bypass patient.


A Lifelong Struggle with Food
Some weight loss surgery patients have nothing but memories of being obese. Robanne did struggle with food her entire life, but her ordeals included battles with anorexia and bulimia as well as childhood obesity and morbid obesity as an adult. By the time she was 37, she had high blood pressure and diabetes, and had two trips to the ER. She was close to giving up. That was at a weight of 300 pounds.
The Decision and Her Surgery
Robanne knew her health was the result of her weight. She researched the various WLS possibilities and felt Roux-en-Y was the best option for her because of the long-term success rate. Also, she had a friend that had lost 100 lb. after RNY.
She got her surgery in 2009 with Dr. Brenda Cacucci at the St. Vincent Bariatric Center of Excellence, in Carmel, Indiana.
A Personal Decision with Family Support
The decision for Robanne was personal. She explains she had enough on her mind at the time of her surgery, and was not in a place to be able to justify her decision to friends and family. So, she only told them about the surgery after she got it done. She also did not want to deal with judgmental people, since she was scared and uncertain at the time.
Her friends and family were supportive when she told them. She says her children “were particularly excited that ‘mommy would be able to jump on the trampoline with them some day.’” Now she says she is “strong enough to believe in my path,” and her results show it. She lost 150 lbs. and now weighs 150.
Overcoming the Challenges and Becoming a Dancer
Robanne faced the same challenges many WLS patients can relate to. It was tough to get in her dietary supplements and drink her Protein Shakes. In the beginning, exercise was a serious challenge – so much so that she tried to convince herself she didn’t need to exercise.
Luckily, she went to a group exercise cardio class, which happened to be a hip-hop dance class. She was too embarrassed to quit, so she stayed in class…and says it was the best thing that could have happened! That class changed her life.
She loved it, and learned that exercise could be fun and not dreadful. But she took it much further. Robanne worked at it, and now teaches seven hip-hop classes a week. She leads group exercise classes for the Obesity Action Coalition's national conference. Look for her at their next conference in San Antonio in August!
Robanne’s also been selected as a national national spokesperson for the Y.. She’s appearing in a national commercial rolling out this year. It is currently on the air in Seattle, WA and starting to pop up across the country, and you can take a look on
.


Tips from the Top
Anyone who’s lost and been able to keep off half her body weight probably has a lot of good advice, and Robanne is very willing to share it. First, she says to try new things. If you’ve been sedentary and overweight for years, she says, how do you know what you like? So try everything!
Also, “keep it real.” You’re not in the best possible shape right after surgery, so just work up to the tougher workouts instead of jumping right in. You don’t want to get hurt, burned out, or discouraged. Fitness is about being strong and pursuing health, not about a single number on the scale.< /p>
Another piece of advice comes in the form of one of her favorite quotes. "Start by doing what is necessary, then do what is possible, and suddenly you are doing the impossible"--St. Francis of Assisi.
And finally, stay focused. Robanne says, “Every day, I recommit to do what it takes to stay successful.”
A Day in the Life
What does a typical day look like for 6-year WLS veteran who’s lost half her body weight?
Something like this, at least for Robanne.
Coffee...with cream.
Breakfast: 1-2 packets of plain, heart healthy instant oatmeal sweetened with Splenda.
First morning snack: Greek yogurt.
Late morning snack: 1-2 hard-boiled eggs
Lunch: some kind of chicken (usually grilled), on a bed of mixed vegetables (usually salad). She uses salsa for dressing.
First afternoon snack: something crunchy like Skinny Pop popcorn.< br> Second afternoon snack: a slice of cheese, and handful of turkey, or some kind of lean Protein.< br> Dinner: lean protein, 1/3 cup brown rice and broccoli or a small salad.< br> Every other day: a Protein Shake.< br> Plenty of Water.< br>
Robanne says she’s a creature of habit and keeps eating what she likes. The key for her is snacking on protein instead of carbs for the most part. She splurges on occasion on something like a cookie or something chocolate. But, she says, eating too much sugar and refined carbs makes her feel less bad. She sticks to whole grain carbs instead of white.
And exercise? This hip hop instructor is no slouch! She teaches 6-7 classes a week, including 2 days with 2 classes each. She also does weight training to keep up her muscle mass. She has 2 days off each week.
More from Robanne
If you want to learn more about Robanne, take a look at her Get Your Strong On site. It details her work in motivational speaking, weight loss coaching, and promoting corporate and kids fitness. You can also check out her inspirational video called “
.”Robanne wrote her story in a book, “Half My Size,” which she’s offering at a discount for BariatricPal members. You can order yours for $10 each with free shipping! The book is her story along with the lessons she learned for overcoming obstacles.
And for more ways to connect with Robanne…check out her bariatric motivation page on Facebook and give her hip-hop workouts a try!

An important aspect of learning to love the new you in the mirror is creating a personal style that flatters the woman you are becoming! While experimenting with new styles and fashions is fun, the time and money you will need to create and maintain a wardrobe over a 100 major weight loss period can be daunting!


To help you avoid making the same mistakes I did, here is a brief list of pot holes to avoid.
1) Not making adjustments to the size clothing you wear early in your weight loss- Clothing that is too loose or badly fitting can exaggerate rather than slim the body's silhouette. As little as 15 pounds can determine whether a garment will eye-catchingly drape or unappealingly droop on your frame. Selecting styles which will adjust to a changing figure can stretch the period over which clothing can be worn.
2) Selecting unflattering and/or dark colors - We have all heard that wearing dark colors, particularly black, will make us appear thinner. The truth is that the silhouette, proportion and fit of a garment all make more difference than the color ever will. Simply put, there is no one size fits all and everyone does not look good in black. Most people look better in a set of colors which complement their individual skin, hair and eye undertones and which typically does not include black. Once that color scheme is identified you can confidently purchase clothing which will look beautiful on you individually.
3) Wearing clothing inappropriate to your age, thinking that age appropriate clothes will appear frumpy-I personally know how bad an idea that can be! I gained weight in my early 40's and as I lost weight in my 50s I was attracted to particular skirt styles and dress types both in lengths which were more appropriate to how I had dressed in my30's, the age at which I had been able to wear them last. Because I had worn large sized unfashionable clothing during the period in my life when I likely would have been adjusting to a more grown up wardrobe, I was unaware that wearing those earlier styles made me look as if I were trying to look 30 again. Dressing age appropriately does not mean you have to look frumpy, it is possible to find clothing which will be attractive and alluring on a more mature woman.
4) Buying clothes inconsistent with your current lifestyle - by the time I reached by goal I held a responsible position in a financial institution with a conservative (unpublished, but implicit) dress code. Some of the clothing I selected, because I both liked it and found I could wear it, was brightly-colored or ultra-feminine and not always appropriate to my workplace. While it is okay to have some 'fun' clothes which are either more alluring or casual, you should dress for work in a style consistent with your place of business, and save the casual wear for extracurricular events.
5) Waiting until the end of your weight loss to discard clothing which is now too big. There were numerous times during the two years it took me to reach my goal where every little bit of positive reinforcement I could get was needed to keep me on the straight and narrow path. Being able to toss out the old clothes can symbolize a 'no going back' mentality and reinforce the behaviors necessary to ensure that your reach your goal.
6) Spending too much money on your transition clothing - it is not necessary to build an entire wardrobe from scratch each time you go down one size or to spend a fortune on designer clothing at each stage of your weight loss. Nor should you limit your purchases to Target and KMart until you reach your goal weight. There are a number of ways to manage the expense of maintaining a stylish, well-fitting wardrobe during your weight loss period.
I made all these mistakes and more. By the time I’d reached my goal weight, I had spent a lot of money and wasted countless hours buying clothing and accessories! I had no idea how to create my own, personal style. That was a luxury I never allowed myself when I was overweight. I had to learn the basics of building an image using fit, color, proportion, and style from square one.
At that point, I decided to call in a professional, and I hired my first image consultant; she changed everything. She taught me ways to reduce the time, effort and expense of creating my new look.
She helped me match my outside self to the way I felt on the inside.
I loved how simply wearing the right clothes and accessories made me feel. It really helped me acknowledge my own, personal transformation, and encouraged me to dig deeper and work harder on me.
I loved the process of working with an image consultant so much that I decided to become one!
I believe style is more than the just the way you look on the outside. It’s also the way you feel and think on the inside. Your personal style is a statement about who you are, what you think, and how you live. It’s the energy you project to others and should reflect how you to live in the world.
Every day, I have the privilege of helping women just like you create and communicate their personal style—through the beginning, middle and end of their transformations.
Are you ready to emerge as the woman you truly are, inside and out? Then don’t wait another second. Call me and set up a time to discuss how I can help you create your new look, and your new life.

A fair number of bariatric patients end up with lactose intolerance after surgery. Lactose is the sugar found in milk.


A fair number of bariatric patients end up with lactose intolerance after surgery. Lactose is the sugar found in milk. During the rapid weight loss phase, you do lose some muscle mass. The digestive system is a muscle. When the digestive system loses a little of its muscle mass, it loses the ability to digest lactose, because we quit producing lactase, the enzyme that breaks down lactose.
Lactose is the type of sugar found in milk. Fluid milk and foods made from this can contain lactose. Examples of these kinds of foods include ice cream, a glass of milk, instant hot cocoa and pudding.Yogurt and cheese go through a fermentation process that actually breaks down some of the lactose. That’s why people with lactose intolerance can eat some yogurt and cheese.
Lactose can also be found in milk based Protein supplements whether it’s the ready to drink or the protein powders. Milk based protein supplements will have the words whey, casein or milk in the ingredient list. Some protein supplements will actually state “Lactose Free” on the label.
Lactose can also be found in a protein product when the milk-based protein is from a “concentrate” form of whey, casein or milk. The protein is the concentrated form of whey, casein or milk. However, the protein is not isolated from the lactose. For example, whey protein isolate may have up to 1 percent of its weight as lactose. Whey concentrate may have up to 52 percent of its weight as lactose.
You can look at the Nutrition Facts Label to see if the protein product you choose has any sugar in it. If a type of milk or milk protein is listed on the ingredients, it could mean there is some lactose. A product that has 2 grams of sugar or less per serving are often safe to drink. If you are lactose intolerance, you’ve now got information to start looking for lactose in all the right places.

You may think of weight loss surgery as a bit of a trade-off: you get to lose weight, improve your health, and enjoy more activities. In exchange, you need to be careful with your diet. But don’t mistake “caution” for “deprivation.” You can still eat at restaurants after weight loss surgery.


Before weight loss surgery, a night out with friends or family may have meant thousands of calories and way too much fat and carbs. If you’re started to look some of the numbers up, you know those old patterns are history for you. You can’t afford the fried appetizers, the chips and dip, the plates of Pasta, the burgers and fries, or the hot fudge sundaes anymore.
But so what? You’d be hard-pressed to find a restaurant that doesn’t offer a meal that you can eat. Some restaurants are a little tougher than others, and you may need to use a little restraint, but weight loss surgery definitely doesn’t mean the end of your social life and fun times.
Do Your Homework Beforehand
It’s always wise to do your homework beforehand when you can. If you know ahead of time you’ll be going out to eat, check the menu online. When you check the menu at home, you’re in a relaxed environment instead of the high-pressure situation of being in the restaurant with your friends waiting for you to order. Many restaurants even have nutrition information available so you can figure out exactly what to ask for. If possible, know what you are going to order before you enter the restaurant. That way, you don’t even need to look at the menu, so the off-limits options don’t tempt you.
Ordering from the Menu – Or Not!
It’s not the end of the world if you need to take a look at the menu, though. Just change your attitude a little compared to the way you looked at menus before Weight loss surgery. Instead of looking for what sounds delicious, look for what sounds healthy. That’s lean Protein and vegetables.
In general, look for Proteins such as turkey burger, grilled chicken breast, and fish or seafood. Have them on a green salad or ask for vegetables on the side, and you’re good to go! If you don’t see what you need listed in the Entrees, see if there’s a menu section dedicated to low-carb or low-calorie items, and also check out the appetizers and salads – shrimp cocktail and salad with tofu are perfect examples of high-protein, low-calorie possibilities.
When you order, ask your server to leave the troublemakers off your plate, or at least serve them on the side. That includes creamy sauces, salad dressings, bread, pasta, potatoes, and rice. You can also ask for smaller portions of everything (except vegetables).
Don’t panic if you don’t see an entrée that meets your needs. The restaurant certainly has ingredients in the kitchen that are on your diet! Describe your diet to your server, and make suggestions. For example, you can ask your server if it might be possible for you to get a green salad with Beans, tuna, or chicken, cottage cheese with fruit, egg whites made with vegetables and ham, or a veggie burger or ground turkey patty with a lettuce wrap. Otherwise, ask if your server will just bring you one or more of the following staples for your meal.
Hard-boiled eggs
Cottage cheese
Chicken breast
A green salad
Slices of ham, turkey, or chicken breast
Fresh fruit
Raw or steamed vegetables

When your meal comes, pause for a second. Push any suspect ingredients over to the side of your plate – like an extra pat of butter, or the garlic bread you know you don’t need. Then ask your server for a doggy bag and pack up the portion you know you shouldn’t eat. Finally, enjoy your food!
Enjoy Yourself and Half the Meal
Why are you at the restaurant? Sure, part of it is for the food. But really, why are you there? It’s for the occasion, maybe to catch up with friends, relax with family, or Celebrate a birthday or anniversary. That has nothing to do with food, and nothing to do with Weight loss surgery. So enjoy it 100%. You can probably enjoy the occasion even more without focusing on a big plate of nachos in front of you!
During the meal, eat slowly, savor each bite, and be part of the conversation. The more you talk, the less you can eat. When you’re finished, make it clear. Put your napkin on your plate and push your plate away. You can even announce that you’re finished so you’re too self-conscious to start eating again.
So life goes on after weight loss surgery goes on, and you don’t need to hide from your old social life. You can be just as excited about going out to eat as everyone else. Just let your fun depend on the people you’re with and don’t even worry about the junk food you’re not eating. Weight loss surgery is about getting your life back, and part of life is hanging out with the people you love.

Jaime “Pandora” Williams has not had anything handed to her. She has worked hard for everything she has, including every pound of her 250-lb weight loss. From weight loss surgery and overcoming food addiction to figuring out how to deal with her father’s death to paying for training for a new career, Pandora has kept moving forward and earned her spot as one of our weight loss surgery heroes.


Jaime “Pandora” Williams has not had anything handed to her. She has worked hard for everything she has, including every pound of her 250-lb weight loss. From weight loss surgery and overcoming food addiction to figuring out how to deal with her father’s death to paying for training for a new career, Pandora has kept moving forward and earned her spot as one of our weight loss surgery heroes.
Throughout it all, she has kept her determination to help others. She has shared every step of her journey on her Desperately Seeking Slender blog, and has made a career as a weight loss and wellness coach. Find out how Pandora Williams, who was “Desperately Seeking Slender,” turned her life around and is helping others do the same!
Struggling with Weight from Childhood to Early Adulthood
Pandora comes from a family that did not eat healthy. They ate fast food often, and home cooked meals were likely to be tacos, pot roast and potatoes, and other high-calorie foods. She remembers father loving his sweets, and her mother struggled with weight gain and obesity after quitting smoking.
With a diet of cheeseburgers and chicken nuggets, not surprisingly, Pandora had been overweight since childhood. She hit the 400-lb. mark 4 years after graduating high school, and also had chronic depression, diabetes, and sleep apnea. Atkins and intense exercise helped her get down to 225 lbs. before getting married, but the weight came back after marriage.
Weight Loss Surgery and a New Lifestyle
Pandora wanted weight loss surgery, but put it off for a few years because she couldn’t afford it. She got serious when her health insurance began to cover it, and got the Roux-en-Y gastric bypass in 2010. She chronicled her entire weight loss journey on her blog. She lost 100 pounds by December of 2010, 200 pounds six months later in June of 2011, and entered “Onederland” (under 200 pounds) in October of 2011. Now, she maintains a weight of 165 lb. – quite a difference from her highest BMI of 69.9!
Needless to say, she threw away the old habits of eating a half-gallon of ice cream or a dozen tacos. She worked hard to overcome her food addiction. Portion Control and measuring were new behaviors she had to follow. Now, five years post-op, she is able to get away without writing down every bite when things are going right.
Still, she keeps herself on track by food journaling and calorie counting the second she is unsure of herself, whether because of a jump on the scale or a high-sodium day. Pandora follows a carb cycling plan where she eats higher and lower amounts of carbs on alternating days. She’s an exercise addict, and that also helps her keep her weight in check.
Body Image and Reconstructive Surgery
Despite maintaining a healthy weight and feeling more confident in overcoming her food addiction, Pandora says her body image is a bit of a struggle. She has had 6 rounds of reconstructive surgery, and still has trouble accepting the mistakes she made in the past with her body and health.
A Life-Changing Letter to Chris Powell!
By August of 2012, Pandora’s weight was well under control, but she was not satisfied with that. She wanted to help others do the same. She knew she had the “the passion, desire to help, and love” for people who were struggling with their weight, because she knew exactly what they were struggling with. What she needed was help figuring out how to help them, and she just couldn’t get in touch with someone who could guide her.
Then, in August of 2012, Pandora wrote a letter to Chris Powell, the celebrity trainer on “Extreme Makeover.” After some persistence, she managed to get her letter to him, and she received a reply! He posted an encouraging message on Facebook, and that was enough to keep her motivated. Since then, she has had a couple more interactions with him on social media – including an encouraging message when she was feeling down – and was able to meet him in Hollywood at the Extreme Makeover Finale. She considers him and his wife Heidi an inspiration.
A Day in the Life
Between taking care of herself and helping others be the best they can be, Pandora is very busy! Here is a typical day in her life.
8:00 a.m. Wake up, food prep, get ready for work. coffee, coffee, coffee!
9:30 a.m. Arrive at the gym. May do a 4 to 5-mile run or take a group exercise class like yoga before work.
10:30 a.m. Breakfast: Quest Protein Bar.< /p>
11:00 a.m. Start work - working the front desk and doing either one-on-one training or weight loss/wellness coaching sessions.
12:30 p.m. Lunch: Veggies (cucumber slices, cherry tomatoes, baby carrots): about five of each and either some low-sodium turkey breast with low-fat Swiss cheese or some hard-boiled egg whites filled with chicken salad made with a Greek yogurt base and green onions.
2:30 p.m. Snack: Usually a container of Greek yogurt or some homemade steel cut oats from home.
3:00 p.m. Leads a weight loss boot camp group training session with light weights and cardio – usually works out with the group.
5:00 p.m. Snack: Usually a piece of fruit like an apple or an orange, or a banana on higher-mileage days.
7:00 p.m. Leads a weight loss boot camp group training session with light weights and cardio – usually works out with the group.
8:30 p.m. Finishes running for the day if she didn’t get in an early morning run or get more than 5 miles already that day.
10:00 p.m. Home/Shower/Dinner: usually a lean Protein like baked chicken or turkey and steamed veggies. Uses spices and changes the vegetables a lot for variety. Includes a serving of brown rice, couscous, quinoa or whole wheat Pasta on days she eats carbs.
11:00 p.m. Snack: Usually Greek yogurt, no sugar added ice cream sandwich, a frozen protein bar, or an extra-thick Protein Shake.< /p>
12:00 a.m. Bedtime
Pandora tries to run longer distances after work if she doesn’t get to work out during her weight loss boot camp classes. Her days off on Sundays and some Thursdays may include an extra kickboxing class, a spin class, or a run over 10 miles.
New Lifestyle, New Career, and Paying It Forward.
As a morbidly obese high school graduate, Pandora had been limited in her career options. She made a living working from home at jobs such as customer support and data entry. Since losing weight and getting healthy, she has thrown herself into something she is passionate about – helping others get and stay healthy through lifestyle. Now, Pandora works as a weight loss and wellness coach at a ladies-only fitness facility gym, and has earned multiple certifications in the fitness and coaching industry.
She also pays it forward as a weight loss surgery advocate. She has spoken at the Obesity Action Coalition and Weight Loss Surgery Foundation of America (WLSFA), as well as at other bariatric support clinics and groups. She publishes articles regularly, including here on BariatricPal!
You can follow Pandora on Desperately Seeking Slender and on Facebook and Twitter @SeekingSlender.

Breakfast means breaking the fast. If you fast too long, your body starts breaking down muscle mass for energy.


A common meal pattern seen with new patients is skipping breakfast. The most common reasons include lack of time and not being hungry. Once a patient starts eating breakfast, the lament is “I’m so hungry about an hour after breakfast!”
You are likely experiencing physiological hunger. If you go too long without eating, your body will start breaking down your muscle to convert to blood sugars. When you lose muscle mass, you burn fewer calories. Your muscle mass is like the idle on a car. When the idle is set high, the engine burns more energy. When the idle is set low, the engine needs less energy to run. Good muscle health is like having a higher idle set point for your body.
Skipping breakfast to lose weight backfires for two reasons. The first problem is that you lose muscle mass, which decreases your ability to burn calories. The second problem is that you will get too hungry by the next meal which leads to overeating. Eating too many calories at one time leads to storing fat. Research shows that starting your day with a high Protein meal leads to eating fewer calories throughout the day. A high protein breakfast can be eggs, light Greek style yogurt, low fat or fat free cottage cheese, string cheese or other low fat cheese, a high Protein Shake or high protein Cereal like Special K Protein or Kashi Go Lean with skim or low fat milk. Start eating a high protein breakfast within an hour after waking to get your metabolism started.

Weight loss surgery can be a godsend. Getting the surgery could be the best decision you ever make. It can give you your life back and help you become healthier than you have been in years – or ever before. But what you need to do to stick to your new lifestyle isn’t so different from what other healthy people need to do. If you want to be thin and fit, you need to think and act like a thin and fit person.


Bariatric Surgery: Necessary But Not Sufficient
Weight loss surgery is a significant part of the solution to surgery. If you can’t lose weight without it, it’s necessary. But, on its own, it’s not sufficient for weight loss. As every weight loss surgery patient knows, weight loss surgery only works when you add other components, like a healthier lifestyle, to lose weight permanently.
Don’t Give Up
It’s easy to start feeling sorry for yourself when regular diets don’t work for you. You may feel that your doctor’s recommendation to get weight loss surgery is official recognition that your obesity is out of your control. After weight loss surgery, it can seem like you’re still working harder than the “skinny” people, and you may feel like giving up. There’s no point in feeling doomed to obesity. Don’t bother resenting your “bad luck” with obesity. The truth is that most fit and healthy people need to work hard at it, just like you do.
Have a Plan
Don’t leave things up to chance. Skinny people may not have as many dietary restrictions and requirements as you, but you can bet many of them think carefully about what they eat. They plan what they’ll order at a restaurant, and you should, too. They’ll also compensate for oversized meals by exercising a little extra or eating a little less at the next meal.
Be Honest
Are you really acting like a skinny person? Their behaviors are the same as many of the rules you’re supposed to be following on your weight loss diet. If you’re not losing weight like you think you should be, look carefully at your habits.
Are you ending your meal when you’re barely full, or eating for another reason, such as eating to keep everyone else company while they eat?
Are you driving straight home, or passing through the drive-thru?
Are you drinking only Water between planned meals and Snacks, or are you getting in calories from juice and sweetened coffee drinks?
Are you eating only at the table, or are you nibbling while standing?

Watch your skinny coworkers and even housemates carefully, and you may start to notice some of their good habits. They may be lucky enough have those habits formed naturally while you need to work a little harder on them, but you can do it.
Ask Away
Yes, you’ll see a lot of skinny people doing a lot of things you wouldn’t dare try because you’d be afraid of gaining weight. They may pack away a hot dog, an ice cream sandwich, and a few beers at a baseball game, or munch their way through a bag of potato chips with dip while watching television.
Ask them how they get away with it if it’s your friend or someone in your family and you feel comfortable enough. You may get a frustrating answer (“I eat whatever I want and don’t worry about it.”), but you may get something helpful (“I eat very carefully six days a week so I can veg out and eat chips on Sunday” or “I knew I wanted to relax and enjoy myself at the game, so I worked out for an extra hour this morning to burn a few extra calories”).
These tips can reinforce the strategies you already know and add to your collection of strategies. They can also help you realize that everyone works hard at staying fit and thin – weight loss surgery or not. You may not be allowed to eat an ice cream sandwich and drink beer on your weight loss surgery diet, but you can exercise ahead of time as a strategy against
If You Can’t Beat ‘Em, Join ‘Em
Until you hit goal weight, you may be most self-conscious about your weight when you’re at the gym. You’re likely to be surrounded by fit people with strong-looking and lean bodies. Don’t just think of these people as another species. Instead, use them to your advantage.
Strike up a conversation with them, being careful not to interrupt their workouts. Catch them while you’re both on the elliptical, bike, or treadmill, or when they’re done with their workout.
Some people will let you know that they’re not interested in making friends at the gym. Don’t take it personally – it has nothing to do with your fitness level, weight, or personality. Some people just go to the gym because they want to feel alone.
Other people will be delighted to talk to you. Most people love talking about themselves, including their workout schedule and goals. They’ll be happy to give you pointers. You can learn what they do to stay in shape, and how often they hit the gym. Possibly most inspirational of all is what you’ll learn about their dedication to their health. They had to get up just as early as you, they’re just as busy as you, and they worry about their diets just as much as you – and they make it a priority to get to the gym almost every day.
It Comes Down to Attitude
So much of your weight loss journey success depends on your attitude. When you feel like you’re working harder than everyone else, you may be tempted to stop trying. Once you realize that everyone needs to work hard to be fit and healthy, you’re more likely to stay committed. Act skinny, and you’ll hit your goal weight.

Nutritional deficiencies are a major concern after weight loss surgery.
You eat less food, so you eat fewer nutrients.
Sleeve and bypass patients absorb fewer nutrients.
You eat less fat, which makes it harder to absorb fat-soluble nutrients like Vitamin A.< br>
Some bariatric surgery patients take one or two multivitamins, plus an entire barrage of high-dose Vitamin and mineral supplements. Others barely take any supplements. Which should you be taking? How do you even know whether you need a supplement? Can you prevent deficiencies just by eating a better diet?


VITAMIN A – Vision, immunity, and healthy red blood cells
Risk for Deficiency
Nutrient malabsorption procedures: Roux-en-Y gastric bypass, gastric sleeve, BPD-DS
Very low-fat diet

Food Sources
Orange fruits (mango, cantaloupe)
Orange vegetables (carrots, sweet potatoes,
Green vegetables (kale, spinach)
Liver

Deficiency Information
Blood test: serum retinol (vitamin A)
Consequences of deficiency: impaired vision; changes in Iron metabolism

Supplement Notes
High doses can be toxic – take only if your doctor prescribes them.

VITAMIN D – Calcium metabolism and bone health, affects immune function and heart health
Risk for Deficiency
Nutrient malabsorption procedures: Roux-en-Y gastric bypass, gastric sleeve, BPD-DS
Very low-fat diet
Little skin exposure to sun, live in northern climate, or older age

Food Sources
Fatty fish (salmon, herring, mackerel)
Fortified milk
Egg yolks (if you are a bariatric surgery patient, you might mostly be eating egg whites)
Some fortified cereals

Deficiency Information
Blood test: 25-hydroxyvitamin D
Consequences of deficiency: osteoporosis (low bone mineral density and higher risk for fractures); possible higher risk for heart disease

Supplement Notes
High doses can be toxic – take only if your doctor prescribes them.
Need for supplementation is very common.

VITAMIN B12 – Healthy red blood cells, homocysteine metabolism (important in heart health)
Risk for Deficiency
WLS that reduces nutrient absorption: gastric bypass, gastric sleeve, BPD-DS.
Plant-based diet.
Heavy bleeding: e.g., complication after WLS)
Older age

Food Sources
Animal-based foods: meat, fish, poultry, dairy products, eggs
Some fortified cereals

Deficiency Information
Blood test: vitamin B12
Blood test: CBC (complete blood count)
Consequences of deficiency: risk of heart disease; megaloblastic anemia; permanent neurological damage; osteoporosis; depression

Supplement Notes
High doses not likely to be toxic.
Supplements may be necessary if you are on antacids such as proton pump inhibitors

FOLIC ACID – Healthy red blood cells, homocysteine metabolism (important in heart health), prevention of neural tube defects (for pregnant women)
Risk for Deficiency
Nutrient malabsorption procedures: Roux-en-Y gastric bypass, gastric sleeve, BPD-DS
Low dietary intake – especially when grain intake is low after weight loss surgery

Food Sources
Fortified grains (most grains in the U.S.): including spaghetti, bread, cereal
Lentils
Asparagus
Orange juice
Spinach
Lima beans

Deficiency Information
Blood test: serum folate
Blood test: homocysteine
Consequences of deficiency: cognitive dysfunction; neural tube defects; megaloblastic anemia

Supplement Notes
High doses can hide vitamin B12 deficiencies.

CALCIUM – Bone health, muscle function
Risk for Deficiency
Nutrient malabsorption procedures: Roux-en-Y, gastric bypass, BPD-DS
Diet low in dairy products – either because of lactose intolerance or other reasons (such as avoiding milk because of the calories).

Food Sources
Dairy products: milk, cheese, yogurt (choose fat-free)
Fortified milk substitutes (almond milk, soy milk)
Fortified orange juice
Canned bony fish (salmon, sardines)
Green leafy vegetables (absorption is poor)
Some fortified cereals
Tofu

Deficiency Information
Blood test: calcium levels – note: this is not a good test for adequate calcium! You can have normal test results and still not have enough calcium in your diet!
Dietary intake analysis: see if you get at least 1,200 to 1,500 milligrams per day from your diet.
Rough estimate of dietary intake: at least 4 servings of high-calcium foods each day
Consequences of deficiency: decreased bone mineral density (osteoporosis and higher risk for bone fractures)

Supplement Notes
Taking too much calcium can cause kidney stones and be bad for the heart.
Ask your doctor how much calcium you should take in a Multivitamin and as a calcium (or calcium and Vitamin D or calcium and magnesium) supplement.
Don’t take your calcium supplement at the same time as iron because you will interfere with absorption

IRON – Healthy red blood cells, energy and other metabolism
Risk for Deficiency
Nutrient malabsorption procedures: Roux-en-Y, gastric bypass, BPD-DS
Vegetarian or vegan (plant-based) diet
Adolescents and women of child-bearing age.
Individuals with excessive bleeding (such as with a post-op complication)

Food Sources
Fortified grains (most grains in the U.S.): including spaghetti, bread, cereal
Meat, seafood, and poultry (animal-based sources have a more absorbable form of iron)
Beans and lentils
Green vegetables, such as spinach, kale, broccoli
Potatoes
Raisins
Deficiency Information
Blood test: serum iron/Fe
Blood test: ferritin
Blood test: total iron binding capacity (TIBC) (high value means low iron status)
Blood test: hemoglobin and hematocrit

Supplement Notes
Iron supplements can be toxic even if your dose is not that high. Don’t take them unless your doctor prescribes them.
That includes iron in multivitamins.
Don’t take iron supplements at the together with calcium supplements.
Try to take supplements with Vitamin C (in food or as a supplement) to increase absorption.

THE OTHERS
The above deficiencies are most common among weight loss surgery patients, but other deficiencies are possible. You are at risk because of your low food intake as you restrict calories. Malabsorptive procedures, such as gastric bypass and gastric sleeve, also put you at risk. Ask your doctor if you are concerned about any of the following Vitamins and minerals. Often, a simple blood test or even a run-through of your daily diet can help you figure out if you need an additional supplement over your daily multivitamin and mineral supplement.
B vitamins: B1 (thiamin), B2 (riboflavin), B3 (niacin)
Vitamin C
Vitamin K
Magnesium
Zinc

The Bottom Line
Nutritional deficiencies are a big risk after weight loss surgery, but they depend on a few different factors.
Type of weight loss surgery – sleeve and bypass patients are more prone to nutrient deficiencies than lap-band patients.
Your diet – eat Protein first and choose nutritious foods to lower your risk of deficiencies.
Genetics and other uncontrollable factors – women are more likely to need iron supplements, for example, than men.

Megadoses of vitamin and minerals can be toxic, so don’t prescribe them for yourself. Instead, contact your surgeon or regular doctor. Simple tests can often let you know your nutrient status so you can know which nutrients to supplement.

Protein’s importance is widely recognized in bariatric surgery because requirements are at least as high after surgery as before, yet stomachs are so much smaller.
So how much Protein do we need and can we get enough at each meal without only eating meat?


Protein’s importance is widely recognized in bariatric surgery because requirements are at least as high after surgery as before, yet stomachs are so much smaller.
Emerging research is suggesting that the distribution of our protein intake throughout the day can be just as important for maintaining muscle mass as the total quantity. One study found that consuming more than 30g of protein at a time provided no additional benefit, with the maximum benefit achieved at 30g.
Eating enough protein is essential for building and maintaining muscle mass and function. The older we get the faster our body breaks down our muscle after building it, to the point where we can almost pump ourselves up at the gym and slowly start deflating as we walk out the door. Muscle has an important impact on our metabolic rate, or how many calories our body burns in the day. Our calorie burning ability influences how easy it is to gain, lose or maintain weight.
So how much protein do we need and can we get enough at each meal without only eating meat?
There are varying recommendations for protein intake following bariatric surgery ( gastric bypass, sleeve gastrectomy and gastric band ) . The recommendations fall within the range of 50 – 80g of protein per day for most people. Taller individuals with higher muscle mass fall towards the top of this range and may even have needs that exceed 80g per day.
If this protein intake is spaced out between three periods in the day, then this would suggest that 16 – 26g would be ideal within each period, with a maximum of 30g in any period. If a period includes a meal and a snack, then we can divide the day into Breakfast plus morning snack, lunch plus afternoon snack and dinner plus supper snack.
My assessment of the usual intakes down the track after surgery is that dinner would usually provide an easy opportunity to consume sufficient protein via intake of meat, poultry, fish, egg dishes or legumes such as black Beans or lentils. Breakfast and lunch are the riskier times, where haste and convenience can influence intake.
Let’s review the protein content of some common breakfast meals that equate to approx. 200 Cals:

1 slice of toast + ½ cup baked beans + coffee with milk = 10g
½ cup high protein Cereal + 3 oz milk + ¼ cup fruit = 14g
1 cup yoghurt + ¼ cup fruit = 14g
Smoothie with 150 ml fat free milk + 2 Tbsp yoghurt + ¼ cup fruit = 8g
Omelette made with 1 large egg + 1 oz grated cheese + vegetables = 15g So, it seems it is not so easy to achieve the maximum of 30g or even 1/3 of the total requirement at breakfast after bariatric surgery, being 16-26g.
This means that what we eat at the morning snack is going to make or break a well-proportioned daily protein intake.
Let’s look at some options that can make up the difference and equate to approx. 100 Cals:

½ cup cottage cheese + 6 carrot or celery sticks = 21g
0.7 oz peanuts = 5g
2 Tbsp Pepitas = 6g
8 oz fat free milk based coffee eg Cappuccino = 6g
1 slice cheese with Tomato and cucumber = 7g
7 oz natural yoghurt = 10g
Small granola bar = 2g
½ Quest Protein Bar or shake = 10g Morning snack options of approx 100 Cals that would not have contributed to achieving the protein target would be:

1 piece of fruit = 2g
0.7g mixed fruit and nuts = 2g
6 carrot sticks and 1/2 cup salsa = 2g
2.3 oz yoghurt = 2g
1 cup popcorn = 1g
2 fruit Cookies = 2g You can see that it would take a little planning but it is achievable. I think the take home message is that mid morning is the time to incorporate a protein based snack such as a half serve of a Protein Shake or bar and that cottage cheese is your friend.
A similar assessment of lunches reveals:

1 slice bread + 40g meat + salad = 15g
1.5 cups meat or legume based Soup = 10g
90g chicken + salad = 21g
burger pattie + salad = 21g This places less reliance on the protein content of the snack as the amount of meat consumed at lunch approaches a 100g serve.
Evening meals planned around the bariatric plate model will result in greater than 20g protein where half the plate is filled with meat, poultry or fish.
Problems arise where meat is not well tolerated, such as commonly reported in gastric banding and also in other surgeries due to reduced stomach acid from the smaller stomach size or from long-term use of anti reflux medications.

The most successful "bariatric warriors" have learned to manage their weight loss using the same management tools they need to complete a project at work.


In other words, they’ve re-organized their lives in order to make nutrition, exercise and other healthy lifestyle endeavors gain equal ground with the other aspects of daily life.
It’s extraordinarily difficult to prep healthy food, squeeze in a trip to the gym (between work, home and kids) and get to bed by 11 every night if you don’t have an organized schedule to fit it all in. It’s easy to feel overwhelmed and discouraged before you even begin trying to get your life more organized.
If this subject is resonating with you, here are five small steps you can take to better organize your day while regaining control of your health.
5 Steps to Organize and Manage Your Weight Loss
With these five steps, essentially, you’ll be organizing and managing your weight loss in the same way you might manage a project at work or school.
1. Sit down and think hard about what’s not working.
It’s hard to concentrate on cultivating healthy habits when your brain is constantly on overload. Successful weight loss requires time, planning and focus. If you’re also listening to a harsh inner voice filled with criticism, pessimism and negative messages, your chances of success will be diminished.
As much as you need to organize your time and environment, you will also need to organize your mindset.
2. Organize your surroundings.
Without a doubt, living or working in a chaotic environment is stressful.
When you can’t find the keys, you’ll be late for appointments. Likewise, if the kitchen is a mess, there is no food in the house and you can never find your favorite sneakers, you’re putting yourself at an unnecessary disadvantage.
Start with the most disorganized space and tame it. (This can usually be accomplished in less time than you think and the results will make you feel five pounds lighter).
3. Schedule your workouts the same way you schedule a meeting.
Pick a specific time each week to review your calendar for the days ahead and schedule your workouts accordingly. Treat them as you would an important meeting or appointment. And then get there — no matter what.
4. Plan meals, grocery shopping and cooking once a week.
Reviewing your schedule for the week will help figure out where and when you’ll be eating meals, what foods you’ll need, and how much time you’ll need to cook. Look at the weekly grocery store circular and buy the healthy items which are on sale and stock up for the future. Planning ahead saves money.
5. Go to bed (no excuses).
sleep deprivation interferes with weight loss by confusing hormones that signal hunger and fullness levels.
Research shows that people who stay up late consume more calories than those who go to sleep at about the same time each night. When you’re tired, your willpower wanes. Even as an adult, you still need to aim for eight hours of quality sleep per night.
Where do I start?
Which areas of your life could see the biggest improvement if they were just a little more organized? Start there.
In just a few short weeks, you’re going to see the positive impact that “project managing” your weight loss has on your life — and your waistline.
Need more help? Give us a call or shoot us an email and we'll be happy to offer advise or direction.
We ARE in this TOGETHER!
Photo Courtesy of FreeDigitalPhotos.net.

Regardless of where you live, occasionally bad weather requires you to be home bound. If you are in the throes of post-bariatric weight loss, this can be a tricky time as you can't get to the gym or grocery store. Here are some tips and tricks to keep your weight loss on course--no matter how high the snow piles up or how hard the wind blows.


For those of you in the midst of post-op bariatric weight loss, you've probably designed your own schedule that focuses on a nutrition and exercise routine that works for your lifestyle.
And then something unexpected happens--like bad weather--with a forecast of snow, hurricane or torrential rains for the next several days...
Not if, but when, you find the weather trying to take control of your weight loss journey, don't let it derail your efforts.
My team and I recently offered these tips to our patients here in New Jersey, just before two feet of snow was predicted:
1. Plan ahead — have healthy foods and drinks on hand.
If the roads are still safe, make a special trip to the grocery with the main goal of stocking up mainly on your own personal healthy go-to meal and beverage items needed for the week. If you have the right foods at hand, you are set!
2. The snow and cold offers different ways to exercise.
If you lose power or your gym is closed, there are a plethora of ways to exercise! For example, if you are faced with snow, make lemonade out of lemons:
Get out and play — run, jump and toss a few snowballs. Remember why snow can be fun!

Shovel your driveway (or help a neighbor shovel theirs). This can be a great form of exercise. (If you are over age 40 and/or have heart problems, consult with your physician before attempting to shovel snow.)

Take a walk in heavy winter boots for an excellent cardio work-out.

Go sledding or make a snowman with your kids.

Go ice skating. Find a nearby ice rink and get an inexpensive pair of ice skates from a local sporting goods store, or rent a pair.

3. If you’re stuck inside, discover some new health recipes to try.
Make good use of the day/s that work and school is closed. Enjoy a big mug of green tea and go through cookbooks or check online (assuming you have power) and find some new ways to prepare and enjoy Protein, fruits and vegetables.
4. Get inspired by other bariatric weight loss success stories.
Whether you are thinking about a surgical weight loss solution, pre-op, post-op or you’ve achieved your goal weight, a little inspiration never hurts. I’m a big fan of BariatricPal.com as an objective and reliable resource for information, client-to-client support, questions and sharing personal challenges and victories.
5. Make a special “Storm” food journal.
If you’re working with a nutritionist or dietitian, chronicle everything you eat and drink during the inclement weather. Add in your daily exercise (walking up and down the stairs and running the vacuum at home counts!) and how many eight ounce glasses of Water you drink per day. Knowing you are going to show the journal to your doctor or nutritionist can keep you on track.
Final thoughts…
During any major bad weather, first and foremost be safe and secure. Secondly, use the unusual “down time” to think about your obesity battle (or success) and strategize about what’s working and what you’d like to improve.
Make the best out of the short-term challenge so that by the time the sun is shining again, you’ll feeling strong, powerful and in charge of your weight loss goal.

I am. You are. He is over there… and she is too. Everyone reading this article is a success. Being a success has nothing to do with how much weight you have lost. It isn’t determined by your tape measure. It’s not proclaimed by everyone on your buddy list. You are a success as long as you wake up trying and go to bed planning to fight tomorrow.


Who is a “Success Story”? I’ll tell you…

I am. You are. He is over there… and she is too. Everyone reading this article is a success. Being a success has nothing to do with how much weight you have lost. It isn’t determined by your tape measure. It’s not proclaimed by everyone on your buddy list. You are a success as long as you wake up trying and go to bed planning to fight tomorrow.

I just realized it at this very moment. I mean, I’ve always known… but it never really hit me in my gut (no pun intended) until right now. What I have been searching for, for so long – ten years now to be exact. That is when I really started getting into the health and fitness community. It was when I was diagnosed with high blood pressure and I was scared enough to change my life. I’d recently lost an Uncle when I was diagnosed, due to complications (many tormenting and painful years of it) of this horrible disease also known as “The Silent Killer”. And from there I was set to change my life, forever.

Fast Forward many years to 2011. That was the height of my health and fitness and going into 2012 until I blew out my knees. I created a thread here called “Bariatric Surgery Do’s and Don’ts”. In case you have not seen this thread yet, here’s the link: http://www.bariatricpal.com/topic/194624-bariatric-surgery-dos-and-donts/

Well, little did I know at the time of creating that thread that today it would become the Top Most Liked Post here at BariatricPal.com – now you might be wondering what the heck that thread has to do with this magazine article? Well, here it is: what you do today will someday have a profound effect toward your distant future. Have you heard of the “Butterfly Effect”? Well it’s exactly the same idea. Tomorrow you may not even notice the results of yesterday’s decision make, but one of these days – maybe next week, maybe not until 5 years from now but you will realize the finality of your decision.

That’s not all though, back in 2007 I finally realized that I needed help. I started to research Weight Loss Surgery on Google. Well those searches lead me here. I mean, back then it was called LapBandTalk. My, my… has it grown since then! Since that time I have had 2 revision surgeries due to complications but I know there is absolutely no way I wouldn’t have gotten through all of it without the support of this website. I am forever grateful to the Site Owner, he (Alex) has been a true blessing for me.

In that time I have become somewhat of a Bariatric Community leader, both here and abroad. It’s special to me because making that tiny Google Search was the first flutter of my wings to now. Even being a Global Moderator here and writing my very own magazine articles. I am so thankful for the opportunity to express myself the way I believe I am meant to.

Even though I am fluttering all over sharing my story, I always know where my home is.

Life is not all wonderful however; you have to be just as prepared for the results of your bad decisions too. If you’re choosing to binge for several days your result will show up on your next weigh-in. Just like if you chose not to make your house payment for a few months, you can scar your credit report for maybe an entire decade of your life... it’s the same idea.

So again, if you woke up this morning with the idea that you are going to at least try… then you are a success. Your results may take time to catch up to this truth (you just need to have faith and practice patience) but it will come about.

I've been at goal weight for years, I am 11 years post-WLS and food is often still a struggle. Although my weight doesn't fluctuate more than 5 or so pounds from goal weight, which I maintain, it is always a struggle.
I was on a cruise last week and the buffet was like a mermaid singing her siren's song enticing me to shipwreck myself on her fattening rocks. So tempting. And for the entire week she never shut-up!

What I'm beginning to accept is that I will ALWAYS be a food addict and need to remain vigilant at all times. I won't be permanently free of this addiction and there will always be struggle involved.
It seems my only choice is whether I struggle at a healthy weight able to participate in active sporting and life endeavors or whether I will struggle while I return to morbid obesity at 333 pounds and live out my days sitting in a chair in front of the tv gorging myself.

I choose to struggle while healthy and active. I have tools and support for continuing to choose the healthy, active path.
Maybe that's as good as it gets...and that's enough!

A Post-Op & A Doc (Cari De La Cruz and Connie Stapleton, Ph.D.) have officially designated 2015 as the Year of Recovery. There are just six, basic ingredients, which, if added to your life, can help you reach and manage your goals to lose weight and keep it off.
The good news is:
1) You already have everything you need to begin following the recipe.
2) It doesn’t involve shellfish, peanuts or milk, so you can’t possibly be allergic to it,
3) There is no baking, cooking, sautéing or mixing required, because the Recipe for Recovery doesn’t involve food, but does involve eating.


We like to say that obesity is “all about the food, but it isn’t about the food” (which makes you wonder why we’re talking about a recipe and ingredients). Well, let’s start here: Do you eat when you’re upset, stressed or worried? What are you eating to avoid? Are you eating to avoid a person? a situation? a feeling? By following the Recipe for Recovery, you can learn to deal directly with any upset, stress or worry related to any “what” or “who” so you don’t need to turn to food for a short-term “high” or “fix.” Here’s another one: Do you eat when you’re bored? What do you need when you’re bored? Are you in need of a hobby? Companionship? What are you doing to find a healthy hobby or seek healthy companionship so you don’t automatically turn to food? These are some of the important questions you’ll begin to ask yourself as you learn follow the Recipe for Recovery.
We know these are tough things to think about – especially when we’re busy plotting our next snack or obsessing about the box of donuts in the break room at work – fortunately, you don’t need to answer these questions BEFORE you can begin choosing to live in Recovery From Obesity. In other words, you don’t have to know what, where, or why in order to stop the destructive eating behaviors.
Basically, food is often a SYMPTOM of a problem – not THE PROBLEM. For example, you might have a problem with interpersonal relationships or issues at work, or perhaps a battle within yourself – like an “emotional storm” -- where you say really mean, negative, unpleasant things TO yourself ABOUT yourself. Rather than addressing the problem, you turn to food, so food becomes the focus rather than the actual problem! Unfortunately, food is a temporary (very temporary) reprieve from unpleasant feelings, memories, or thoughts and though it provides a chemically induced euphoria…it’s short-lived. What is true for the alcoholic is also true for people who abuse themselves with food, which means the problem will still be there when the food is gone…. and then you have the hangover to deal with -- usually in the form of self-brutality by way of horrendously abusive self-talk. Yikes!
We created the Recipe for Recovery from Obesity to help you learn to deal with the real issues (stress, worry, boredom, frustration, fear) in healthy ways (and to hopefully avoid the self-destructive eating and subsequent emotional hangovers).
Here are the six ingredients that make up the Recipe for Recovery:
1. AWARENESS: Awareness is always the first step in change, which is why we refer to it as the essential ingredient to weight loss and weight-management. It’s pretty hard to change something you’re not aware of. You might know that you’re obese, but are you aware of how you are contributing to the problem? Maybe you’re stuck in your weight loss journey, or you’re regaining, or you never made it to your “goal” – you’re aware that there’s a problem – but you don’t know what to do next. Becoming AWARE of your issues is the place to start.
2. ACCEPTANCE: This is often an overlooked ingredient in weight loss/management. If you don’t accept that weight and the associated issues are ongoing problems in your life, then it’ll be pretty difficult to make the necessary changes to lose that weight and keep it off! The truth is, there are many things we need to accept in our journeys of weight loss/management that you may not have ever considered, such as the fact that you’ll have to eat right and exercise regularly, and will probably have to forego (or greatly limit) some of the foods you really love. The process of acceptance may include having some anger, fear and even mourning. Accept it – and get on with the process!
3. ATTITUDE: We call this the flavorful ingredient (and for some of us, this one is pretty spicy!) We all have different “tastes” when it comes to food… and life, which means that we don’t all like the same things or do the same things in exactly the same ways! Variety is the spice of life? Well, we think attitude is the FLAVOR of recovery! Focusing on attitude and having a positive one can make all the difference in your Recovery results!
4. COMMITMENT: You’ll use this staple ingredient at least once (and sometimes several times) each day in your Recovery journey, especially when you inevitably develop a case of the “I-don’t-wannas” – you know, those moments when you just “don’t wanna…” workout…log your food…manage your portions, pass on the Cookies, etc. Adding a dash or a splash of commitment to your life helps you make the next wise choice. Every wise choice moves you toward your desired goals – a healthier self and a better quality of life.
5. ACCOUNTABILITY: Often quite underused, Accountability is an ingredient to help ensure the recipe is prepared as directed. We know it can be tempting to try to do things your own way, and we also know how that’s worked in the past! That’s where accountability really brings the Recipe for Recovery to life! Use accountability to do what you said you’d do when you began your weight loss journey. Whether you chose surgery, medically supervised weight loss, or another structured program, you agreed to do certain things, so this ingredient really matters. Hold yourself accountable for following through with doing the things you said you would do to get the weight off and keep the weight off.
6. EFFORT: The sixth (and key) ingredient in the Recipe for Recovery is Effort. Without ongoing, consistent, “use-it-whether-you-feel-like-it-or-not” – continual effort, the recipe will NOT turn out the way you want. Let us repeat: Your Recovery will NOT be successful if you do NOT use this key ingredient. When you put forth effort, you see results in the direction you are working toward. When you withhold efforts, you also see results – but not the ones you want! And, guess what? You can’t overuse this ingredient, so add it liberally and realize the fullness of a life in Recovery!
It may sound like a lot of work, but if you want what you say you want (a healthy life in Recovery From Obesity) -- these ingredients really add up to a winning result!