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Duodenal Switch Patients
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  1. Like
    jessgnc reacted to Alex Brecher for a magazine article, Starbucks Unicorn Frappuccino: Not the Magic You Want!   
    Unicorns are symbols of healing and peaceful strength, but what kind of magic do you get from a Unicorn Frappuccino? It is not the magic you want as a weight loss surgery patient. Here is the truth about the drink that is less magical than it is terrifying. To set the stage, let us tell you that an actual health department warned consumers about the drink on its Facebook page!
    Does This Drink Make My Butt Look Big?
    Well, yeah, kinda. The standard 16-oz Grande Frappuccino with whole milk and whipped cream has 410 calories. That may be a third or more of your daily goal, and those calories are not from filling nutrients. Most of them are from simple sugars that spike your blood sugar levels and lead to hunger within an hour or two. Cave into your craving for the 24-oz Venti blend, and you are looking at 500 calories. they are not the filling kind.
    Sugar for a Day…or Week
    The real problem here is the sugar. The exceedingly high sugar content is no surprise when you consider that sugar is an ingredient in the drink’s combination of Frappuccino syrup, mango syrup, blue drizzle, and classic syrup. The default Grande with whole milk has 59 grams of sugar. To put this into perspective, that is about twice the maximum amount of added sugars you should have in a day according to experts including the World Health Organization and the American Heart Association.
    Sugar has empty calories without essential nutrients; it bumps up your blood sugar and is linked to diabetes, and it makes weight loss even harder because it leads to more sugar and carb cravings. The lowest sugar version is an improvement, but still nothing to brag about. A tall 12-oz Unicorn Frappuccino made with almond milk has 33 grams of sugar, still more than your daily maximum goal.
    Where Is the Protein?
    As a weight loss surgery patient, you are probably aiming for at least 65 grams of filling protein per day. A simple rule of thumb when choosing your healthy foods and beverages is to make sure you get at least 2 grams of protein for every gram of sugar. A Unicorn Frappuccino is not going to help much! When you get a Grande, you are getting only 5 grams of protein – so you should limit sugar to 2.5 grams, not the 59 grams of sugar that are actually in the drink! You would really need some unicorn magic to help you justify that kind of choice
    Beware Dumping Syndrome
    Unicorn horns are reputed to be powerful antidotes to toxins, but this drink might put you in search of some magical healing powers! If you are prone to dumping syndrome, especially after gastric sleeve or gastric bypass surgery, beware the Unicorn Frappuccino. Besides weight loss and cravings, there is another reason your surgeon and nutritionist suggest limiting sugar intake: dumping syndrome. If you are prone, you might want to take your Frappuccino back home before you start drinking it, because you may want to be pretty close to a bathroom!
    Delicious and Nutritious Alternatives
    Weight loss-wise, you can do way better than a Unicorn Frappuccino without feeling deprived. If you want the taste of mango, try an Aloha Mango Smoothie. Blue Raspberry Protein Drink may do the trick if you want sweet and tart. Vanilla Cappuccino can give you the sweet, creamy flavor that can take you to a fantasy land. Each of these choices has 15 grams of protein and no more than 4 grams of protein. Now that is magic!
  2. Like
    jessgnc reacted to Dr. Colleen Long for a magazine article, Don't be the Chicken & Cheetos Lady   
    I have worked as a psychologist, providing psychological evaluations prior to bariatric weight loss surgery for the past eight years. For the most part, people need a power tool to help them lose and keep off the weight they have lost over and over again in their lives. The gastric sleeve, bypass, and now balloon are those tools. However, every once in a while, I will encounter someone who believes these procedures are the magic bullet.
    I can pick this up in five seconds when I learn that:
    this person has no exercise plan to maintain their weight loss a barrage of excuses as to why they can't exercise anymore zero insight into why they are overweight ("I don't know why I am overweight, I just eat steamed vegetables and grilled chicken mostly.") a lack of motivation or understanding for why they also have to engage in behavioral modification in addition to the surgery "Why would you reveal all of this?" you ask. Aren't I giving away the keys to the kingdom to anyone who reads this and wants to pass a psychological evaluation? Perhaps- but who are you really cheating if you don't go within and face the real demons that got you here in the first place?
    When I ask people about their eating styles, I tend to group them into four categories:
    1) emotional eater- someone who uses food when they are bored, stressed, tired, lonely, sad, or even happy in addition to eating when they are hungry
    2) skip and binger- someone who fails to think about food until it is too late, and when they are ravenous end up going for whatever is available which is usually some type of carb and calorie laden fast food
    3) miscellaneous- someone who just recognizes that they eat too large of portion sizes and/or the wrong types of food
    4) food addict- usually someone with a history of other addictions, trauma, and a significant amount of weight to lose. They usually have comorbid psychological diagnoses that have been unaddressed or ill-addressed.
    Out of the four categories, the 4th is the most troubling for a psychologist. This particular person is most correlated with the patient who fails to address their core issues, eats "around the sleeve," or bypass, experiences dumping syndrome, comes back a year later and asks for the bypass, or a different procedure.
    This is the person who, ironically, is usually the most resistant to my recommendation that they seek therapeutic support prior to the surgery. They want it done YESTERDAY. They want it NOW. It is this type of thinking that got them into trouble in the first place. The impulsivity and lack of emotional regulation.
    I've witnessed people fail to address their maladaptive eating patterns and never quite get to their goal weight. I had a male that would buy a bag of pepperonis at the grocery store and snack on them all day and couldn't understand why he wasn't losing weight. This daily "snack," which was a mental security blanket, served as a veritable IV drip of fat and calories throughout the day.
    I've had a woman who figured out how to ground up her favorite foods into a liquid form because she never quite let go of her attachment to "comfort foods." One of her most notable liquid concoctions consisted of chicken and Cheetos. I'll just leave that for you to chew...er swallow.
    They say with drug and alcohol recovery- you "slay the dragon," but with food addiction recovery, you have to take it for a walk three times a day. If you don't fundamentally shift your relationship with this dragon, you're going to get burnt when you are walking it.
    My number one tip for transforming your relationship with food is to start looking at eating the same way you do as brushing and flossing: You don't necessarily salivate at the idea of what type of toothpaste you will use, where you will do it, who you will do it with, right? You just do it twice a day because you don't want to lose your teeth and you want to maintain healthy gums.
    Food has to be thought of in the same way. You fuel up. You don't use food as a place to define your quality of life. You don't use food to celebrate. You don't use food to demarcate the end of a long day. You don't use food to help you feel less alone. You figure out healthier coping alternatives to meet these needs.
    Loneliness-call a friend for support
    Celebrate- get a massage
    Demarcate the end of a long day- start a tea ritual and use essential oils
    Another reason you must say goodbye to comfort food is that it triggers the pleasure center of the brain, which ignites our dopamine, which perpetuates the addiction. Many people think we are just telling them to get rid of the comfort food because of the carbs or calories, but there are unique and harmful chemical consequences to ingesting these types of food we know are bad for us.
    If you are ready to take a modern approach to weight loss and stop dieting for good- check out my wls/vsg psychological support course here for free.

  3. Like
    jessgnc reacted to Alex Brecher for a magazine article, Is Weight Loss Surgery for Me?   
    How do you know whether weight loss surgery is for you? Will it be the weight control solution you have been searching for for years? Or will it be a decision you regret? Nobody can answer that for you, but here are some considerations as you think about whether weight loss surgery is for you.
    The Qualifying Criteria
    You are not a candidate for bariatric surgery unless you meet certain criteria set by your surgeon or, if applicable, your healthcare coverage plan. The standard criteria are:
    Body Mass Index (BMI) over 40 or BMI 35 with an obesity-related comorbidity, such as type 2 diabetes, high cholesterol, or sleep apnea. Confirmation that your obesity is not caused by an underlying condition that would make weight loss surgery ineffective. A psychological exam to show that you are capable of sticking to the post-op diet and lifestyle changes that are necessary. Previous documented attempts at losing weight with diet and exercise. Ineffectiveness of Previous Efforts
    Weight loss surgery is a last resort, not a first try at losing weight. It is for patients who have been obese for years and who have tried to lose weight using lifestyle changes, such as a modified diet plan and a formal exercise program. Many weight loss surgery patients try “every diet under the sun” before deciding that it is time for WLS. They may have had trouble losing any weight at all, or may have lost weight initially but been unable to keep it off.
    Readiness to Change
    Weight loss surgery is just the beginning. The way you eat after weight loss surgery determines how well you will be able to control your weight for the rest of your life. You need to be ready to change if you want to be successful with weight loss surgery. No longer will you be able to down a pizza or hit the drive-through on a whim.
    Are you ready to possibly:
    Give up coffee and regular and diet soda? Cut sugary treats and fried foods, especially with gastric bypass? Pass on the alcoholic offerings at home, parties, and restaurants? Count protein, slash carbs, and measure portions? Addressing Other Issues
    Weight gain does not always take place in a vacuum, and weight loss does not solve other problems you might have in your life. First, identify why you became overweight in the first place, and what is keeping you from losing the weight. Is weight loss surgery the answer, or do you need to first deal with an abusive relationship or lack of self-confidence, for example?
    Emotional eating is a common reason for weight gain. If you tend to eat your feelings away, you are best off figuring out other ways to handle your feelings before you get surgery. Can you use walking as a form of therapy? Maybe you can join an in-person or online support group to turn to when you feel sad, lonely, or angry.
    If your emotional eating is related to a specific problem, such as stress at work, your best bet may be to handle the problem before getting WLS. That could mean finding a healthy coping mechanism, or it could mean getting counseling to help you work through the source of stress. It could even mean finding a new job, as scary as that sounds.
    Consider Replacement Addictions
    Replacement addictions are common after weight loss surgery. They happen when you give up food – which can be an addiction – for a different addiction. Instead of turning to food for comfort, entertainment, or companionship, some weight loss surgery patients turn to “replacement addictions” or “cross addictions” They may take up smoking, or start to abuse alcohol. Replacement addictions can also be healthier than eating; some weight loss surgery patients become gym rats or take up gardening, sewing, or other hobbies.
    As you consider weight-loss surgery, think about the possibility of food addiction being replaced by replacement addictions. What role does food play in your life now? What do you see replacing that emotional or physical role after surgery?
    The decision to get weight loss surgery requires a lot of soul searching for most candidates. These points can help you work through some of the doubts you may have as you try to decide what is best for yourself.