CindyZee

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


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

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

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

During weight loss, and eventually weight management, your long-term success will be contingent upon prioritizing time and effort to take care of your business of weight loss.


We all have an inherent need to help others before we help ourselves, particularly as adults when we take on the roles of spouse, partner or parent.
But taking on the goal of losing a large amount of weight requires that you dedicate yourself 100 percent to the task at hand. Make time--no matter what obstacles try to block your path--to accomplish these tasks every day 24/7/365 (yes, even Christmas):
· Shopping for fresh and healthy food
· Preparing meals
· Exercising daily
· Relaxing
· Planning for the next day
These responsibilities can be challenging when you are so accustomed to helping everybody else before finally seeing to your own needs (if you are not too exhausted to do so). It’s all-too-easy for self-care activities to slide off the to-do list (I’ll start again tomorrow…)
Undertaking the Herculean challenge of losing a large amount of weight and changing unhealthy lifestyle patterns in your life may be the battle of a lifetime for many of you.
And you are worth it.
But to accomplish this goal as quickly and effectively as possible, you have to prioritize “self-care.”
Five ways to prioritize your needs during weight loss
1. Prepare and enjoy your meal before you cook for the family.
2. Set-up a kids’ activities car pool to lessen wasted time sitting idly in the car.
3. Set a daily reminder to take a 15-minute break every day to do something that you enjoy, even if you just sit with your eyes closed.
4. Feel free to say to detractors, “I have to devote a concerted effort toward my weight loss, which will make me healthier and happier.”
5. If you are put into a situation where you may eat for the wrong reasons, change plans or politely excuse yourself. (You are in a special situation, you are allowed).
Like getting regular oil changes for your car, prioritizing your own needs is what allows you to run optimally and put your best foot forward toward achieving your weight loss goals.
And you are very much worth it.

Of course!
And it's so easy. You just toss everything and and let it simmer.
1 pack of thin slices chicken cutlet ( family size)
1 tbsp of butter ( I used light)
2 tbsp of Dijon mustard
1 cup or more of white wine
Sprinkle of parsley
1 lemon squeezed
2 packs of scallions chopped
1 chicken boullion
I take the chicken with some of the sauce and purée it and it's amazing!!! The chicken really breaks apart easily.
Enjoy!
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Anytime!
I forgot to add 2 tbsp of light olive oil.
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Hi Zephra. I was sleeved by Dr. Nick Nicholson on 07/27/10. He is absolutely great. Forgot to mention: my incisions are healing super well, I haven't thrown up even once, etc. so everything else is great. I was just worried that it was too much pain. I keep forgetting that it's only been two weeks and "DUH", it is major surgery!

Wow! I'm very ignorant about WLS approvals (though very familiar with dealing with health insurance for long-term disabilities) so forgive me for speculating but it seems strange they would hold an application submitted in 2016 to standards that were not in effect until 2017. Maybe they held onto it so they could deny it for that reason... or maybe I am just skeptical of insco's! I hope you get a good result from the P2P with your doctor.

you're what we in the bariatric community call a "lightweight" (I don't know what the actual weight requirements are to be considered a "lightweight", but I'd say under 250 lbs). Lightweights lose slower than us heavier folks because they have a lot less to lose. I know you read about people losing 30 lbs the first month, but those folks are few and far between and usually weigh over 300 lbs.
Your body's going to lose at the rate it wants to lose. The only control you have is to stick to your program. I was a "slow loser", and I have lost 227 lbs. It'll come off, whether fast or slow, if you stick to your program.

I'm leaving the 10th for my surgery on the 11th with Dr Cabrera in Mexico. Please keep us updated on how you're doing

Does anyone else think it's really weird how the WLS industry and doctors don't have an agreed upon recovery plans for patients? I've read on here that some people can eat soft foods one week out and others are on liquids for three weeks post op. I know medical care is like this for a variety of different surgeries but it seems weird that the plans vary so much.
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I agree. I'm having surgery done 1/11 and starting to get nervous. But this group is helpful.
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I wanted to make a little post , to say thank you to all your guys support and replies I have never met a group of people that are so warm and actually responds to posts..
I'm barely starting my journey and seriously you guys rock !!!
You calm my nerves and make it not so bad knowing I have a long ways to go.. cause of all the encouragement and tips !!
I wish everyone a Happy New Year and keep being awesome!!
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Today I woke up hopeful because I know it will happen!!!!! New Year New Me !!!!!!
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I was really frustrated at first cause I wanted done immediately and now that I have completed everything and waiting for insurance approval I feel like I just can't wait anymore after the hoops and hurdles I'm ready!
progress starts in the mind
I also started spending more time on here just educating myself on all there is to know and all kind of differnt personal experiences people have...it helps
progress starts in the mind

The closer I'm getting the more excited I am, so just give it some time. I just have a sleep study left and that is scheduled for the 18th. Just try every day to research and start making better food choices-during the last couple months I've had ups and downs, but now I have a good meal plan and exercise routine so I hit my surgery weight and get in better shape for when I recover.
You got this!

Thank you all for your responses. As you know it is always helpful to know you are not alone and that others have gone through the same thing and been fine.
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Had my surgery yesterday and I am on the way home now.
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It's just as bad lol gas and more gas Sent from my HTC6525LVW using the BariatricPal App

Mine is a cabbage Soup diet on day 3 already lost 10 pounds surgery is Monday
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I just got approved for December 13th for surgery in the morning. Feeling excited and anxious to take this on. Have to break up with Starbucks.

I am having so much trouble choking down Protein drinks. It smells like the tube feeding I put in my patients and the taste makes me want to vomit. I tried the double shot espresso from CLICK last night and it's the first shake that didn't make me sick. It comes in lots of flavors but make sure you can have caffeine. My boss is having surgery with a different surgeon and she's not allowed caffeine. I have variety packs from 3 different companies to try, and I'll keep you posted if I find anything that I can tolerate.
FYI: I'm have surgery in 3 weeks with Dr Ortiz in Mexico at OCC

I put myself on pre-op diet to test my 'will power' 6 days ago. Its ruff, believe me I understand! But I just keep saying to myself... "mind over matter". You're likely fighting a food addiction as am I. Are you going to let it win? Ask yourself, how bad do I really want this? You can do this!!! Dont give up on yourself... Get back in there and fight for your life!!!!
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I think I've gained about that much too. I have been going to weight management and trying to complete all the requirements for surgery since April so I think part of it is losing patience and kinda being over the waiting game. And though 24 days Isn't forever it still just feels too damn far away lol. I really need to get on mostly liquids next week to prepare. What drinks do you use?
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I'm literally never sure if I'm hungry or bored. Or if I'm full. It's like I have no sense of anything? Does anyone else feel this way? And how do you determine if you're hungry or bored? Help please
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Reached my goal.... so very happy and grateful for the opportunity I have had and the hard work I have put in.
Heres to skin Surgery in January.. bring it on !!
A very thankful Kate