Monday, January 31, 2011

The Four Rules of Surgical Weight Loss Success

by Kaye Bailey

Original article: http://www.livingafterwls.com/Library/Four%20Rules.html#featured

There's more to the gastric bypass and gastric lap-band surgeries than just rapid weight loss. Patients who undergo weight loss surgery (WLS) sign-up for a lifetime of rigid behaviors to guarantee their long-term weight loss success.

Just imagine: If you knew what those behaviors were, could you lose the weight and keep it off without surgery? Take a look at the four rules weight loss surgery patients live by:

Rule 1: Protein First:
The first rule for living after Weight Loss Surgery (WLS) is Protein First – that means eating protein for three daily meals, and protein must be 50 percent of food intake. Animal products are the most nutrient rich source of protein and include fish, poultry and meat. Dairy protein, including eggs, is another excellent source of protein. Nuts and legumes are also good sources of protein, but sometimes difficult for the bariatric patient to consume.

Science is proving that a protein rich diet will prompt weight loss and increase energy. The body contains over fifty-thousand different active proteins all made out of the same building blocks: amino acids. Amino acids are made of carbon, hydrogen, oxygen and nitrogen as well as sulfur, phosphorus and iron. Many diseases – including obesity – indicate an amino acid deficiency.

Weight loss surgery patients don't have a choice, they must eat lean protein or they will get sick, anemic, and weary. Weight loss will cease if they eat processed carbohydrates instead of lean protein. Dumping or vomiting may also result if patients do not eat lean protein for the first half of every meal.

The distinction must be made between high fat proteins and lean proteins. A gastric bypass patient cannot tolerate high fat proteins such as bacon, fatty beef or sausage products or greasy fried chicken: these foods cause nausea and vomiting. In addition, these high fat protein rich items are contributors to obesity and should be avoided by anyone wishing to control their weight.

Rule 2: Drink lots of water
Dieters are often told – drink water. Drink a minimum of 64 ounces a day – eight glasses a day. Gastric-bypass patients don't have a choice: they must drink lots water. Other beverages including coffee, tea, milk, soft drinks and alcohol are forbidden. Water is the essential fluid for living. Water is one of the most important nutrients the body needs to stay healthy, vibrant and energetic. A tell-tell sign of a gastric bypass patient is the ever-present water bottle.

The human body is a magnificent vessel full of water. The brain is more than 75 percent water and 80 percent of blood is water. In fact, water plays a critical role in every system of the human body. Water regulates body temperature, removes wastes, carries nutrients and oxygen to the cells, cushions the joints, prevents constipation, flushes toxins from the kidneys and liver and dissolves vitamins, minerals and other nutrients for the body's use.

Nutritionists say a precise measure of the body's need for water is to divide body weight (pounds) in half and drink that many ounces every day. That number could well exceed 200 ounces a day for morbidly obese people actively engaged in weight loss.

The body will panic if actual water intake is significantly less than required. Blood cannot flow, waste processes are disrupted and the electrolytes become imbalanced. Proper hydration prevents inflammation, promotes osmosis and moistens lung surfaces for gas diffusion. It helps the body regulate temperature, irrigate the cells and organs and promotes all functions of elimination. Certainly by drinking plenty of water many people could resolve inflammation and elimination problems that result from insufficient water intake. Adequate water facilitates weight loss.

Rule 3: No Snacking
Gastric bypass patients are instructed to avoid snacking. No exceptions.

Snacking is the worst possible thing a weight loss surgery patient can do. If patients snack they cease to lose weight and could possibly regain weight. In addition gastric bypass snackers risk severe swings in blood sugar levels and glucose overdose, they fail to move forward to the healthy life that surgery makes possible. They feel like failures when the WLS does not result in weight loss.

The nature of gastric bypass surgery gives patients an edge on beating the snacking habit. When a patient eats three protein-rich meals a day the body's fuel requirements are met and satiation results. Hunger does not occur if water is sipped throughout the day. If a patient is taking vitamins they will not be nutritionally wanting. Given that, patients who snack are doing so out of the very habit that contributed to obesity.
If a dieter must snack they must be mindful of their choices. Fruits, vegetables and lean proteins will contributed to wellness and weight loss. Processed carbohydrate convenience foods fail to meet nutritional needs or facilitate weight loss and should be avoided.

Successful weight loss surgery patients understand that snacking is bariatric purgatory. When they begin to snack weight loss will cease and weight gain will certainly result. Successful weight loss patients – those who maintain their weight loss years after surgery – do not snack. The same is true for all successful dieters regardless of the means by which they initially lost weight.

Rule 4: Exercise
The final rule, the one many weight loss surgery post-ops despise the most, patients must exercise every day.

Nothing is more disappointing than hearing a gastric bypass patient brag that they didn't have to exercise to lose weight. It's true; patients will lose weight without lifting a finger. But patients who do not use the time of rapid weight loss to incorporate exercise into their lifestyle are doing themselves a grave disservice.

Obesity cripples the body. Bone tissues are compromised, joints are swollen, the vascular system is inadequate and the skeleton overburdened. As weight is lost, the burden on the bones, joints and vascular system is decreased. However, the body is a magnificent machine. Given proper nutrition and physical motion it will rebuild its broken framework. The systems can become strong and vital.

The most effective way to heal the body from the ravages of obesity is to exercise. Exercise means moving the body: walking, stretching, bending, inhaling and exhaling. Exercise is the most effective, most enjoyable, most beneficial gift one can bestow on themselves in the recovery from life threatening, crippling morbid obesity. People who successfully maintain their weight exercise daily.

Conclusion:
Successful weight loss surgery patients will tell you these are the four rules they live by, that the gastric bypass is only a tool to facilitate mindful behavior for better health. They will confirm that weight control, even with surgery, takes a lifetime of diligent attention to their bodies and behavior. They will assure you it isn't easy, but the results are worth the effort.

Friday, January 28, 2011

Protein Coffee

Delicious mocha chino

1 scoop of Nectar Vanilla Bean 24 grams protein/100 cals
4oz soy milk 3 grams protein 45 cals
2oz of water
2 oz of milk
ice cubes
sugar free cocoa
1 tsp of instant coffee
Blend
--Caramel Da vinci sf syrups mmmmm goood


 

Frozen slushy coffee drinks Jeanne in North Dakota


 

Disolve a teaspoon of instant coffee in the bottom of a Magic Bullet blender cup
Add crushed ice to about half or three quarters of the way full
Add a scoup of protein powder, I use ESA soy protein from Walmart
Add a half box of ESA protein chocolate liquid
whirl on the Magic Bullet and enjoy!

--It has 20 grms of protein from the powder and about 8 or 9 grams from the liquid protein!

--great fruit smoothie by using frozen strawberries instead of the ice. Fill the cup with frozen fruit
add strawberrie ESA liquid and a scoup of the ESA powder, whirl in the magic bullet...YUMO!


 

Hot Chocolate Protein


4 oz Labrada Lean Body Chocolate ready to drink
4 oz Labrada Lean Body Vanilla ready to drink

*I have both flavors, but if you want to just get some chocolate, that would be fine. You may not wish to add anything else but just heat this up. I like mine thin.
1/2 to 1 oz of water (sometimes I use fat free Hood Calorie Countdown Milk) just to thin it out a tad. I don't like thick drinks.
Heat in microwave for approx 1 min 45 seconds, stir, heat an additional 15-20 seconds

--Labrada Lean Body (say that out loud, just rolls right off the tongue) is a great protein ready to drink. You can drink it cold, or hot. Many proteins clump or cook when you heat them up, or even add hot liquid to them. But Labrada does not! You can even reheat your drink if it gets cold.... it will not clump. I have even heated it on the stove in a saucepan when we moved as we didn't have a new microwave yet! The only thing that may happen is that a thin layer of dry film might cover the top when reheating several times. If so, just skim off the top with a spoon.


Protein coffee... There is a trick to this. But here is my favorite:

Brew your coffee, and in an empty cup, add:
-1/2 to 1 scoop of Nectar Cappuccino (or your favorite protein powder; I've used Elite Chocolate Mint, Champion Chocolate, Nectar Choc Truffle, and even vanilla before... use your fave)
-Add a packet of splenda if desired
Then here is the trick... add approx 1/2 to 1 oz of ROOM TEMP to cold liquid. Make sure you do not add warm or hot liquids to protein powder directly. Stir, making a paste. I tell folks to STIR, STIR, STIR, MASH, MASH, MASH, STIR, MASH, STIR, MASH. Stir the fire out of it until you know its creamy, smooth in consistency... (I like to add Labrada Lean Body choc or vanilla as I use them as coffee creamers too!)
-Then add a little bit of coffee, stir well, then fill your cup to the top with coffee, stir again.

Add your favorite sugar free coffee syrup at any time
Enjoy! Melsreturn

Thursday, January 27, 2011

Keeping Your Head in the Game: Why Support Groups are so Important

By B. Charles Ihrig, PhD

Original content: http://www.obesityaction.org/magazine/oacnews13/SupportGroups.pdf

Everything in our culture is centered around food. We are bombarded with advertisements, and restaurants are seldom more than a block away in the city or a five minute drive from anywhere. Eating is our social event and family time; it is how we celebrate, how we romance, and the one thing that consistently marks every significant event in our lives. If you made that decision to address your weight, you now no longer fit into this part of your culture. The good part is, with some sustained work, you will never fit into those big pants either. Those people around you may not understand your food choices. They may be supportive of your efforts, or they may resent that you do not celebrate food with them anymore. They may be your food police and monitor everything you eat and you may be the one to resent their "help."


 

Whether supported by family and friends or not, there is a place to turn – It's your local support group!


 

Support Groups and Long-term Success

Weight-loss support groups are key for long-term success. Throughout years of seeing individuals succeed and struggle, one thing that most of those seem to have in common is that they are not well connected to a support group. Simply, it is about "Keeping Your Head in the Game!" This line was a recent statement from a regular member of one of my aftercare groups as to why she continues to come, and I felt that sums up the whole point. No matter how you chose to lose weight, whether it was through non-surgical or surgical means, significant weight-loss produces dramatic changes in your life. However, no changes were made to your brain and how you think. No matter what, changes are difficult, but are not unique. Others who have gone through this can guide you through these changes.


 

Support Groups and Helping Your "Addiction"

The notion has been put forth that for many individuals struggling to lose weight, food was an addiction. While everyone's experience with obesity is a very personal one, this theme rings true for many. People feel isolated in their addiction and in their recovery. Support groups offer the companionship, accountability and healthy substitute for the prior unhealthy eating behaviors. For people with all types of addictions, meetings have been the solution. For example, alcoholics find solace and support in Alcoholics Anonymous meetings. Those addicted to drugs gain sobriety with the help of Narcotics Anonymous. Likewise, gamblers learn to spend time at Gamblers Anonymous meetings rather than at the horse track or in a casino. Those who have spent most of their lives in a battle against obesity are also in need of such support to conquer their addictions and change their behaviors. Support groups typically offer the same anonymity and acceptance found in 12-step experiences. Members share a similar history and unity in their weight-loss journey. The group offers an understanding not found in our homes, family and communities. Families are also welcomed in these support groups. They see the similarities in others and feel less alone. They also get support for themselves with the changes in their home when a loved one has changed their lifestyle and chosen to treat their obesity.


 

Exploring Your Weight Problems

Very uniquely, I lead aftercare groups at the Centennial Center for the Treatment of Obesity in Nashville, Tenn. I am a Clinical Psychologist and the groups are geared toward a more therapeutic approach. While most support groups are organized and led by patients in their communities and neighborhoods, professionally lead groups offer the opportunity for a more guided experience. This allows for exploration of some of the thoughts and behaviors that lead to their initial weight problems. Individuals are able to identify obstacles that may now stand in their way. Additionally, struggles during the weight-loss occur; patients share these struggles and are guided into identifying what may be behind this struggle. Stresses, depression, family problems and relationships all provide possible hurdles to the weight-loss and numbers take on new meaning, or old meanings haunt the numbers. For instance, a patient may be stuck at 85 pounds of weight-loss and they recall the last time they were at that particular weight. They were in high school and were rejected by their high school sweetheart who had commented negatively on their weight. Meanings and motivations can be explored in such formats. Although, this should not be seen as a substitute for individual counseling, which provides an opportunity to deal with issues too personal to discuss in the group format.


 

Peer-led Support Groups

Peer-led support groups often reach out beyond the group itself. They serve as small communities. Peer-led support groups form walking groups or advocate for obesity-related causes in their cities and towns. Also, they share recipes and cook weight-friendly foods for each other. As a group, they go to restaurants to patron those places which accommodate appropriate food choices and servings. Mostly they share experiences, triumphs and failures.


 

Conclusion

Regular attendance and involvement in support groups serves as a reminder of what you are supposed to be doing. Support groups keep you honest and accountable. You are reminded of the importance of portion control and exercise. You learn tips that work for others and how to incorporate them into your life and family. Also, you learn strategies and get advice, but most of all, you will not be in it alone. So, "Keep Your Head in the Game!" Go to your local support group, or start one in your area. Get online and join an online support group; whatever it takes, get connected to others and stay connected.


 

About the Author:

Charles Ihrig, PhD, is a licensed clinical psychologist and the owner and founder of Athena Consulting and PsychologicalServices, LLC. His company has been offering pre-surgical evaluations and follow-up psychotherapy for surgical groups in the middle Tennessee region for the last seven years

Wednesday, January 26, 2011

Food Addiction and the Weight-loss Surgery Patient

By Katie Jay, MSW

Original content: http://www.obesityaction.org/magazine/oacnews6/Food Addiction.pdf

For people with food addiction, the decision to overeat is not a conscious one, at least not in the early days of your addiction. You do not wake up and think, "Rise and shine! Let's get crackin'. Eat a box of donuts and lose some of that self esteem!" No, it's usually more like, "I'm going to be so good today… is that an OREO?"


 

Food addiction is a daily struggle for many weight-loss surgery (WLS) patients. It may be a week, a month, a year after surgery; but for about 70 percent of those who undergo weight-loss surgery, it happens. Of course, having the smaller stomach and/or rerouted intestines that come with WLS can be a great tool to help control your eating, but if you had trouble with food before surgery, there is high risk of eating compulsively, overeating or even just obsessing about food after surgery.


 

What exactly is food addiction?

Addiction is a loaded word that unfortunately holds a negative connotation for many people. That is why I prefer the term eating disorder, but even that term is viewed negatively by some. The truth is, though, that food addiction is a complex problem for which there is no one cause and no simple solution. No matter what you call it, food addiction or an eating disorder, the basic definition is the same: an unhealthy relationship with food. Sure, there are more clinical definitions, but it all boils down to one's relationship with food – how you think about it, how you use it, why you use it and what your behavior with food does to you (obesity, shame, preoccupation, illness, depression, etc.). In fact, shame and self loathing are such major factors in obesity and food addiction that I feel compelled to remind you that a food addiction is not a moral issue. It is not an affliction of weak-willed, lazy people. It is something

that occurs in people of all ages, income levels, races and sexes. It has a strong genetic component, a relationship to brain chemistry and a cultural component (can you say, "Supersize me?"). You do not set out to be addicted to food, or to be obese. Food addictions can develop over time, and are not always obvious in the early stages.


 

How do you know for sure you are "addicted" to food?

Food addiction is a vicious cycle of unhealthy eating, which brings on a sense of being hopelessly out of control, which brings on a desire to eat more food to numb the uncomfortable feelings. The amount of food eaten, the types of food and the manner in which the unhealthy eating occurs varies from person to person. Some people drive through a fast food restaurant and eat "in private" in their car. While others will get up at night to eat when no one else will observe them and criticize their behavior. Still, others hide food to sneak when the opportunity presents itself. Some people binge by eating as much food as possible in a short period of time. Others will eat more food than normal over the course of the day but never eat a large quantity at one sitting. Some people obsess about certain foods, like sugary, salty, fatty or refined foods. Many people who use food in an addictive manner also obsess about their body and/or their weight. You do not have to search far on the Internet to find a list of food addiction symptoms. Numerous quizzes exist to help a person determine whether or not they have a food addiction (see sample quiz on the previous day post).


 

What if you are a food addict?

As trite as it may sound, if you self diagnose a food addiction, you have taken an important first step. After all, if you do not know what your problem is, it is pretty hard to fix it. Research shows the number one reason people do not seek help with an addiction is they do not believe they can stop their self-destructive behavior. I see that dynamic in my coaching practice every day. The number one reason most of my coaching clients avoided seeking help for so long is they did not believe they could stop obsessing about their eating, body and/or weight. They had such a track record of failure with weight-loss and weight control they felt absolutely hopeless. If you feel hopelessly trapped by addictive behavior and you have decided not to seek help, remember that time and time again people who struggle with food addiction turn a corner and make real, permanent changes. It happens every day. The secret to healing from food addiction is to not keep it a secret. If deep down you know you have a food addiction, you will find relief when you start to talk about

it. You must seek help. Many people who struggle with their weight never lose obsessive thoughts about food, but that is partly because they are not seeking help, trying strategies to find what will work for them and living in the solution. The people most successful at breaking free from the burden of unhealthy eating have transitioned from being rebellious (reactive) to responsible (proactive). They stop looking for whose fault their food addiction is to whose responsibility it is. Many factors will affect the treatment of your food addiction. I encourage you to leave no stone unturned as you search for

solutions to your problem.

You may have an undiagnosed and untreated depression or anxiety disorder that, if left untreated, makes your food addiction much harder to deal with. There may be foods you could avoid that trigger you to overeat or obsess about food. Maybe you have not learned how to nurture yourself in healing ways so that you do not use food to manage your emotions. Food addiction is very common and nothing to be ashamed of. But, it is hard to get rid of it in isolation. Get help if you are struggling. And keep in mind, any addiction left untreated absolutely will control your life.


 

About the Author: Katie Jay, MSW, is a nationally recognized expert on weight-loss and weight loss surgery, CTA Certified Life Coach, and the director

of the National Association for Weight-loss Surgery and author of Dying to Change: My Really Heavy Life Story, How Weight-loss Surgery Gave Me Hope for Living.

Tuesday, January 25, 2011

How to Pick Great Protein Shakes!

Weight loss surgery makes protein shakes essential

Original content http://www.personal-nutrition-guide.com/protein-shakes.html

Whether you're considering bariatric surgery or have already had it, getting your protein is going to be a very important part of your life. However, it may be hard for you to get all the protein you need from "regular" foods for a variety of reasons. That's where and why protein shakes/protein powders come in to the picture. There are so many brands and types of protein powder and shakes out there I can't count them with all my fingers and toes! That's why you need to know and understand the differences so you can pick one that's best for you. Not all products are created equally and knowing what to look for and what to avoid is the difference between enjoying your shake...and spending time in the bathroom trying to recover from it. Whether you choose a ready-to-drink bariatric protein shake, or want to whip up your own shake, you need to know about the different types of protein and which you'll likely tolerate the best.

Let's get on the same page with our terminology. I use the terms protein powder and protein shake interchangeably. Although it is possible to buy unflavored protein powders that taste horrible, most are flavored, and can be mixed with water or milk and translate into a nice protein "shake."

Q: What's The Difference Between Protein Shakes?

Answers:

  1. The kind of protein
  2. How much protein per serving
  3. How much sugar is added
  4. How much fat is added
  5. How much "other stuff" is added (like food coloring, artificial sweeteners, etc.)

The Kinds of Protein

The source of protein in your shake can be derived from a variety of foods. Read the list of ingredients on the food label to determine the source. It will be one of the following:

Animal Sources

Note that there are 2 kinds of whey protein:

Products can have one or the other, or a combination of the two. If you're lactose intolerant, you may tolerate products with whey protein isolate, but not whey protein concentrate.

Plant Sources

The most popular shakes are made from whey protein concentrate, whey protein isolate, soy protein or even some combination of whey and soy.

Which protein source is right for you?

I suggest trying whey first, then soy or egg, and then any of the other plant sources named above. You'll get the most protein for the least calories from whey, egg, and soy. I recommend your shakes fall in the 150-250 calorie range.

If you're lactose intolerant (or become lactose intolerant, which is likely to happen after gastric bypass) choose shakes/powders made from only whey protein isolate (label will usually say "lactose free"), or soy protein. Avoid whey protein concentrate.

Protein Shake/Protein Powders: How much protein do they provide?

This varies depending on the brand. First of all, read the serving size! A serving is typically "one scoop" but occasionally it will be "two scoops."

Then read the label for the number of grams of protein per serving. Choose a product with at least 15 grams of protein.

How much daily protein you need varies but generally is in the 60-80g/day range. (Be sure to follow the recommendations of your physician.) If you have two shakes per day with 15 grams protein each, you'll get half your daily requirement by drinking 2 shakes.

If you mix protein powder that has 15 grams of protein with 1 cup skim milk/lactaid milk your resulting shake will be even higher in protein: 23 grams. Then 2 shakes provide 46 grams per day.

Added Sugar

The amount of added sugar varies brand to brand. A protein powder with lots of sugar will taste really yummy but can cause dumping syndrome after gastric bypass surgery.

Choose a brand with the least amount of sugar possible: Ideally less than 5g, but if you must...no more than 15 grams.

You can use unflavored (i.e., unsweetened) protein powder to make a shake and use fruit and/or artificial sweetener to make it taste better while keeping the calories down.

Be sure to follow your doctor's recommendations as opinions vary. I've worked with one physician who likes his patients to choose shakes with less than 5 grams of sugar.

Know that 4 grams of sugar = 1 teaspoon.

Added Fat

This also varies brand to brand. Too much fat can cause dumping syndrome in the same way too much sugar can, and it also supplies excess calories.

Read the label for the number of grams of total fat and choose a brand with 5 grams or less.

Other Ingredients

Beside protein, sugar, and fat, protein shakes and powders can have added sodium, food dyes, artificial sweeteners and added vitamins and minerals.

Sometimes it's all that added stuff that upsets your stomach. Yellow #5 in a banana flavored shake or Red #40 and/or Blue #1 in a "berry" shake could cause you distress (plus these chemicals are just not healthy for you and some even may pose a health risk!). Also, while added vitamins and minerals sound good, the forms in protein powder are often cheap and hard to digest and may therefore upset your stomach.

Be sure to read the entire ingredient list. If the list of ingredients is really long and it looks like it belongs in a chemistry class, it's probably not the healthiest choice and you may have trouble tolerating it.

Summary: The Best Protein Shakes/Protein Powders Have:

These are my favorite brands and the ones I regularly recommend to my clients. See my protein shakes recipes to get some yummy ideas of how to mix them.

http://www.personal-nutrition-guide.com/protein-shakes.html

Friday, January 21, 2011

Food Addiction Questionnaire

Do you see yourself in some of these questions?


 

By Katie Jay, MSW

http://www.obesityaction.org/magazine/oacnews6/Food Addiction.pdf

1. Has anyone expressed concern about your thoughts and/or behavior around your eating, body or weight?

2. Do you think or obsess about food, your eating, your body and/or your weight much of the time?

3. Do you binge on a regular basis, eating a relatively large quantity of food at one sitting?

4. Do you eat to relieve unpleasant emotions?

5. Do you eat when you are not hungry?

6. Do you hide food for yourself or eat in secret?

7. Can you stop eating without difficulty after one or two bites of a snack food or sweets?

8. Do you often eat more than you originally planned to eat?

9. Do you have feelings of guilt, shame or embarrassment when you eat – or afterwards? 10. Do you spend a lot of time calculating the calories you ate

and the calories you burned?

11. Do you feel anxious about your weight, body or eating?

12. Are you fearful of gaining weight?

13. Do you tell yourself you'll be happy when you achieve a certain weight?

14. Do you feel like your whole life is a struggle with food and your weight?

15. Do you feel hopeless about your behavior with food, and/or your obsession with your body and weight?

16. Do you entertain yourself with thoughts of food and what you are going to eat next?

17. Do you weigh yourself once, twice or more daily?

18. Do you exercise excessively to control your weight?

19. Do you avoid eating or severely limit the amount of food you will eat?

20. Being totally honest with yourself, do you think you have a problem with food?

Thursday, January 20, 2011

A Food Addiction is an Unhealthy Relationship with Food

By Katie Jay, MSW

http://www.obesityaction.org/magazine/oacnews6/Food Addiction.pdf


 

A healthy relationship with food includes:

• Eating when you are hungry

• Stopping when you are full

• Eating without shame

• Eating to live (rather than living to eat)

• Not obsessing about food

• Not feeling guilty about eating

• Not eating secretively


 

An unhealthy relationship with food, or a food addiction, includes:

• Compulsive eating

• Overeating

• Obsession with food

• Secretive eating

• The feeling of being out of control with your eating

• Eating when you're not hungry

• Eating to numb emotions

• Eating past full, etc.

Action Steps for those Suffering from Food Addiction:

--Get help

--Seek counseling with an experienced eating disorder specialist of some kind

--Find an experienced life coach

--Attend support groups that focus on food addiction

--Do whatever you have to do to make the necessary changes in you and your environment

Wednesday, January 19, 2011

Mindful eating is…

eating with intention and attention.


 

Eating with Intention

Be purposeful when you eat:

• Eat when you are truly hungry.

• Eat to meet your body's needs for fuel and nourishment.

• Eat with the goal of feeling better when you finish.


 

Eat with Attention

Devote your full attention to eating:

• Eliminate or minimize distractions.

• Tune into the ambiance, flavors, smells, temperature and texture of the food.

• Listen to your body's cues of hunger and fullness.


 

Excerpt from Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle by Michelle May, MD(Greenleaf Book Group, October, 2009).

Original content found at: http://www.obesityaction.org/magazine/oacnews15/Mindful%20Eating.pdf

Tuesday, January 18, 2011

How Mindful Eating Helps Break Your Eat-Repent-Repeat Cycle

By Michelle May, MD


 

Original article found at: http://www.obesityaction.org/magazine/oacnews15/Mindful%20Eating.pdf


 

Most of us have attempted weight-loss numerous times. We counted calories, exchanges and points. We ate pre-packaged food or meal replacements. We followed rigid meal plans that restricted fat or carbohydrates – or solid food altogether. From an energy balance perspective, any of these tactics should work, and some do – short-term. From my perspective, the reason they do not work long-term is that they change what and how much we eat, without changing why and how we eat. Th ose two issues are critical because people who struggle with their weight are often disconnected from their signals of hunger and satiety. Overeating occurs in response to hundreds of environmental and emotional triggers such as free food, stress or boredom. Overeating also occurs unconsciously. For example, eating quickly or while distracted watching television or driving.


 

Changing Why and How You Eat

Mindful eating was one of the keys to breaking my eat repent- repeat cycle. One definition of mindfulness is paying attention, on purpose and without judgment, to the internal and external world in the present moment. I describe it as eating with intention and attention.


 

Benefits of Mindful Eating

Eating is a natural, healthy and pleasurable activity when you are eating to satisfy hunger and meet your needs for nourishment and enjoyment. Mindfulness helps you identify the difference between physical hunger and head hunger. Further, learning to savor food makes eating more pleasurable, leading to a paradoxical decrease in the quantity of food you need to feel satisfied. Mindfulness also makes it possible for you to notice the difference between physical satisfaction and the discomfort of fullness, allowing you to self-regulate the quantity of food you eat.


 

The Practice of Mindful Eating

Admittedly, if you are used to eating on autopilot, learning to eat mindfully may feel awkward at fi rst; however, like any new skill, it becomes natural with practice. During our Am I Hungry? workshops, we have a Mindful Eating potluck or go out to dinner together; you too can practice the following steps by yourself or with a friend.


 

Step 1 Before a single bite of food passes your lips, it is important to recognize why you are eating since the reason(s) impacts every other decision downstream. Whenever you feel like eating, first ask yourself, "Am I hungry?" This simple, but powerful, question helps you recognize whether the desire to eat was caused by your body's need for fuel or some other trigger. It may be helpful to close your eyes and do a mind-body scan, looking for signals of hunger. These may include hunger pangs, growling stomach, low energy, shakiness, headache or other symptoms that indicate that your stomach is empty and your blood glucose is low. Recognize that these are all physical symptoms, not cravings or thoughts, such as "That looks good," or "I better eat now while I have the chance."


 

Step 2 Decide what to eat, honoring your preferences by asking yourself, "What do I want?" and honoring your health by asking, "What do I need?" If you are preparing your own food, view it not as a chore, but an opportunity to become an integral part of the process. Connect with all of your senses as you touch, smell and combine the ingredients.


 

Step 3 Create a pleasant ambiance. Even when you are preparing food for yourself, make it attractive by setting the table, turning on music and perhaps even lighting candles. Minimize distractions so you can give the food and your body's signals full attention. If you eat while you are distracted by watching television, driving, working or talking on the telephone, you may end up feeling full, but not satisfied. Do not eat while standing over the sink, peering into the refrigerator or sitting in bed. Instead, choose one or two places at home and at work for eating.


 

Step 4 Before serving yourself or ordering, set your intention for how full you want to be at the end of eating. This intention guides you in deciding how much food to purchase, prepare or serve. Once you have the amount of food you think you will need, physically divide it in half on your plate to remind yourself to stop halfway and check in again. This little "speed bump" slows you down and serves as a reminder to reconnect if you lost your focus.


 

Step 5 Take a few deep breaths to calm and center yourself before you begin eating. Reflect on all that went in to bringing this food to your plate. Express gratitude for the nourishment, the people with whom you are sharing the meal, or simply the fact that you are giving yourself time to sit down and enjoy eating.


 

It is Time to Eat Mindfully

Make eating a multi-sensory experience. Look at your food and appreciate the colors, textures and arrangement. Decide which food looks the most appetizing and start by eating one or two bites of it while your taste buds are the most sensitive. If you save the best until last, you may want to eat it even if you're full. Take small bites since large bites are wasted on the roof of your mouth, teeth and cheeks where you have very few taste buds. In addition, much of what you perceive as taste actually comes from smell. When you slowly chew a small bite of food, the aromas are carried from the back of your throat to your nose, enhancing the flavors.

Put your fork down after each bite. When you are loading your next forkful, you cannot pay attention to the one in your mouth. When you are always paying attention to the next bite you will keep eating until there are no more bites left.


 

Recognize Fullness

Pause in the middle of eating. When you get to your speed bump, stop eating for a couple of minutes. Estimate how much more food it will take to fill you to comfortable satiety, keeping in mind that there is a delay in the fullness signal reaching the brain. Notice when your taste buds become less sensitive to the taste of food; that is a sign that your body has had enough. Push your plate forward or get up from the table. The desire to continue eating will pass quickly, so distract yourself for a few minutes if necessary. Keep in mind that your intention was to feel better when you were done and that you will eat again when you are hungry.


 

Complete the Mindful Eating Process

When you're finished eating, notice how you feel. If you over-ate, do not judge or punish yourself. Instead, be aware of the physical and/or emotional discomfort caused by being overly full and create a plan to decrease the likelihood that you will overeat next time. Once you experience the pleasure of eating mindfully, you

may be motivated to become more mindful during other activities too. Use intention and attention in your personal relationships and during routine activities like showering or exercising. Living fully in each moment increases your enjoyment and effectiveness in everything you do.


 

About the Author: Michelle May, MD, is a recovered yo-yo dieter and the founder of the "Am I Hungry? Mindful Eating and Weight Management Program." Download the fi rst chapter of her new book, Eat What You Love, Love What You Eat: How to Break the Eat-Repent-Repeat Cycle from www.amihungry.com.

Thursday, January 13, 2011

No sugar No flour Cookie Recipe

Submitted by Norma Becker

3 apples, peeled & chopped

Pecans, almonds or walnuts (handful or to taste) chopped

2 heaping cups of oats

1/3 cup ground flaxseed

2 eggs

2 Tbsp olive oil

2 Tbsp honey

2 tsp vanilla

2 heaping tsp cinnamon

1 tsp apple or pumpkin pie spice

1 tsp baking soda

Handful of chopped prunes


 

Mix all together. Drop by spoonful on baking sheet.

Bake at 350' for 15 minutes


 

Great snack or breakfast

Wednesday, January 12, 2011

How to Maintain Relationships After Weight Loss Surgery

--Dr. Margaret Berton, Physiologist, www.drberton.com, discussed this at our last support group

Article written by an eHow Contributor

Original content: http://www.ehow.com/how_2100493_maintain-relationships-after-weight-loss.html

Losing weight after weight loss surgery is a great accomplishment. Although the impact of the patient's weight loss may be dramatic, their relationships may also be affected. The spouse, friends and family may begin to mourn the person they knew before weight loss surgery. Learn to maintain your relationships after weight loss surgery while enjoying the benefits of a trimmer body.


1. Be considerate of your spouse, friends and family. They may have supported the surgery, but are unsure of how to react to a more confident and outgoing you. Accept the compliments initially, but try not to dwell on them.

2. Keep conversations diverse. Show concern and enthusiasm for what's going on with friends, family and the spouse. Don't talk to much about your weight loss success, as they may view it as being self-centered. Inquire about their interests and goals.

3. Include the spouse in new activities. When you were overweight, you probably were leery of new activities in the past. Now that you're willing to try new things, solicit fun activities from the spouse. Take turns at picking the next adventure.

4. Compliment your spouse. Let him know how much his support is appreciated or tell him how his encouragement helped during depressing times. Take the focus off you and put it on the spouse who may need reassurance.

5. Do something special. Buy that hard to find CD that the hubby's been talking about, purchase concert tickets to your wife's favorite artist or plan a romantic weekend away. The point is to do something that will make the spouse feel special, especially when there is no occasion to do so. Your new personality may make the spouse insecure about the relationship and small gestures like these are reassuring.

6. Listen. When friends and family express concerns about personality changes, listen to them and don't take offense. They may have valid points that are being overlooked. Changes are to be expected, but make sure the changes are positive.

7. Express empathy. The bottom line is that losing weight feels great, but the response from loved ones can be unpredictable. Go easy on them and gradually reveal your new personality over time. A little empathy will help maintain relationships after weight loss surgery.

Tips & Warnings


 

Tuesday, January 11, 2011

7 Steps to Improving Emotional Adjustments Post-Surgery

By Lynne Routsong-Wiechers, MSW, LISW

Original content: http://www.obesityaction.org/magazine/oacnews4/Emotional Issues.pdf


 

1--Follow your doctor's orders and recommendations. This means following the dietary changes from the start. Get lots of rest and take care of your physical needs.


 

2--Journal. I know what you are thinking. Journaling is boring and tedious and we don't like it, right? By keeping track of the foods you eat and how you feel will truly help you feel more in control emotionally and physically. This is especially helpful if you find that you are emotionally eating.


 

3--Set realistic goals and expectations. For many, goals may be getting off their medication(s), walking without getting winded or the ability to cross their legs. So whatever your goals are make sure that you write them down and modify them as needed.


 

4--Reflect on the past. Although it is important to move on, it's also important for patients to remember the moment when they decided to have weight-loss surgery. It's sort of like we have to hit our "low or bottom" to realize that we have to change.


 

5--Take lots of pictures, measurements and keep your pants. It is important that we take pre-op pictures and post-op pictures regularly. This reminds us about our success. Measurements and pre-op clothing are important especially during the dreaded plateaus. We may be losing inches and it's important that we have visual aids to help us realize our success. Although you may be a smaller size, It's important to have a visual reference point to remind us that we are losing weight.


 

6--Seek help. It is important to ask for help if you find that you are having difficulty adjusting to the many changes after surgery. Seek support via support groups, family, friends and/or professional counseling. Support groups and counseling are especially rewarding and helpful because we realize that many patients often experience the same adjustment issues and it makes us feel less isolated and alone while we travel our journey.


 

7--Live life to the fullest. You deserve to be healthy, happy and have fun! Enjoy and savor every moment of your weight-loss journey. You deserve it.

Monday, January 10, 2011

Baby Steps: Emotional Adjustments after Weight-Loss Surgery

By Lynne Routsong-Wiechers, MSW, LISW

Original content: http://www.obesityaction.org/magazine/oacnews4/Emotional Issues.pdf


 

I look in the mirror (if I get the nerve up) and see somewhat of a familiar face, but unsure as to whom is looking back.

I look at my body and wonder how on earth I allowed myself to get this way… I then cry.

I see the disappointment in my children's faces when they ask me to play with them, but I just don't have the energy nor the will to move.

I wake up in the morning and dread putting my feet on the ground because of the pain that I know is coming.

I avoid public places and gatherings with friends because I fear the stares and the comments that may come.

I look at my closet, and realize that the majority of my closet consists of blue and black stretch pants and wide slip on shoes.

I dread traveling far distances, especially by plane, for fear that my luggage gets lost and I can't find clothes in my size at the stores and the fact that I can no longer comfortably sit in a seat.

I pretend that my seatbelt fits on an airplane because I don't want to ask for an extension.

I go grocery shopping at night so I am not judged by what I put in my cart.

I am convinced that my arms are becoming shorter because my bathroom habits are becoming difficult.

I notice that walking even short distances feels like I have run a marathon.

I am always hot and sweating even when it's cold outside.

I no longer feel attractive towards my significant other.

I feel like I have lost all sense of myself.

I am scared that today may be my last.

These are the thoughts that race through an obese person's mind daily. Obesity is something that you go to sleep and wake up with. You can't get away from it. It becomes your identity. There is so much shame and guilt that is associated with being overweight. Having weight-loss surgery causes a ripple effect and many other areas of your life will change. A person will often experience changes in their emotional state; for example, depression may often times go away. Patients also could experience less physical pain and obstacles. Some changes that could occur include: Career RelationshipsMarriage

Friendships Spirituality. Currently, I no longer suffer with the physical co-morbidities. I am able to walk and even sometimes run around the yard with my children. I even got on a bike! I no longer suffer from depression and my energy level is off the charts. After having undergone my surgery, I realized that many people don't truly understand what its like to be obese unless they walked in our shoes. Obese patients need a voice and they need to be heard. I decided to open up a counseling practice specifically for gastric bypass patients and obesity-related issues. I see the relief in my patients' eyes when they see my pre-surgery picture and realize that, "I have walked in their shoes." There is so much shame and guilt that is associated with being overweight. I try to encourage my patients to let the guilt go and focus on the reality that they will lead a very different life after surgery.


 

The Changes: This is Not the Easy Way out.

We dream about it. We think about it. We almost become obsessed with the thoughts of being a healthy person. It sometimes keeps us up a night. We finally see the light at the end of the tunnel and realize that we will get there. We wait for weeks sometimes months for that "letter." You know which one I am talking about - the letter from the insurance company. Then one day you go to the mailbox and there it is. You realize that it's now a reality! All of the preparation has paid off, but now the reality of what is about to happen sets in. Getting patients to realize that weight-loss surgery is not the easy way out is essential in successful weight-loss. Regardless of what we hear in the media and from society, this is not easy. Deciding to have this surgery

is difficult, but living as a weight-loss surgery patient is not always easy.


 

Fear of the Unknown: "Baby Steps"

Although we are looking for a change in our lives, change can be scary and unknown. Many of us fear change, but at the same time look forward to it. I

can't tell you how many times patients, including myself, ask themselves, "why did I do this," right after surgery. Most often this emotion is short lived,

but it's an example of how change can affect us. I realized that I was no longer going to allow food to control me. Food issues become an addiction and we must learn that we no longer live to eat, but instead we eat to live. In addition, we all go through a phase where you have a difficult time realizing the new you. For example, although patients may reach their goal weight, they may look in the mirror and ask themselves, "who is that thin person?" Losing a massive amount of weight can make a person feel vulnerable and afraid. Remember, obese individuals like to "blend in" with the crowd, but all of a sudden we are now the focus of attention. People are watching us. They are now watching what we eat, asking us how much we have lost and even giving us compliments. This can make us feel uncomfortable. I call it taking "baby steps." We are re-learning who we are in life. In relation to baby steps, we have to re-learn how to eat according to our surgery. We have to adjust to eating smaller portions, chewing food to a pulp, not drinking while eating, avoiding high sugar and fatty foods and changing our eating behaviors for good. Food is a central part of our life. If you're an alcoholic, the cure for alcoholism is to stop drinking. Unfortunately, we need food for survival. Food issues become an addiction and we must learn that we no longer live to

eat, but instead we eat to live. It took me a long time to understand this concept. There were so many things in my life related around food. I realized that I was no longer going to allow food to control me.


 

What's in my Toolbox: "Surgery as a Tool"

Weight-loss surgery is a great tool. This means that it is not the fix all, but if you correctly use the tool then you will have increased chances of success. If you choose to misuse the tool, then chances are you will have less success. This surgery will enable you to only eat small portions and feel a sense of fullness. Although this sounds so "simple" it can be difficult. In addition, we go through phases where we long for food. This is also known as "food grief." It is as if we long for our "friend" of food. We turn to food in times of celebration, sadness, for reward and for comfort. When a person can no longer turn to food to fill the void, they must find other ways. Many of my patients, including myself, find other hobbies or activities. In addition, this is when bariatric support groups become so helpful and beneficial.


 

About the Author: Lynne Routsong-Wiechers, MSW, LISW, has worked in private practice counseling since 1996. She underwent gastric bypass in 2003 and has dedicated her practice to working with gastric bypass and obesity patients. She is currently a Bariatric Psychotherapist in Dayton, Ohio, providing consultation to medical professionals and speaking to the public regarding gastric bypass.

Friday, January 7, 2011

Why have Bariatric Surgery

Before deciding to have weight loss surgery, it is important for you, the patient to understand what's involved and what lifestyle changes you must make. Success of long term weight loss is up to you. Bariatric (weight loss) surgery can provide long-term, consistent weight loss if you exercise and eat a healthy diet. Bariatric surgery isn't for everyone. This is an elective major procedure that has risks and side effects and requires permanent changes in your lifestyle. Weight-loss (bariatric) surgeries change your digestive system, often limiting the amount of food you can eat. These surgeries help you lose weight and can lower your risk of medical problems associated with obesity.


 

Weight loss surgery is for people who are unable to achieve or maintain a healthy weight through diet and exercise, are severely overweight, and who have health problems as a result. Surgery may be an option for you if:

  • Your body mass index (BMI) is 40 or higher (extreme obesity)
  • Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problem, such as diabetes or high blood pressure


     

Weight loss surgery is not a quick fix and doesn't replace the need for following a healthy diet and getting exercise. Long term success of the surgery depends in part on your commitment to following the guidelines given to you about diet and exercise.


 

Before you have weight loss surgery, you'll go through an extensive screening process. Not everyone who wants Bariatric surgery is psychologically or medically ready for the surgical procedure.

Why have Bariatric Surgery

Before deciding to have weight loss surgery, it is important for you, the patient to understand what's involved and what lifestyle changes you must make. Success of long term weight loss is up to you. Bariatric (weight loss) surgery can provide long-term, consistent weight loss if you exercise and eat a healthy diet. Bariatric surgery isn't for everyone. This is an elective major procedure that has risks and side effects and requires permanent changes in your lifestyle. Weight-loss (bariatric) surgeries change your digestive system, often limiting the amount of food you can eat. These surgeries help you lose weight and can lower your risk of medical problems associated with obesity.


 

Weight loss surgery is for people who are unable to achieve or maintain a healthy weight through diet and exercise, are severely overweight, and who have health problems as a result. Surgery may be an option for you if:

  • Your body mass index (BMI) is 40 or higher (extreme obesity)
  • Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problem, such as diabetes or high blood pressure


     

Weight loss surgery is not a quick fix and doesn't replace the need for following a healthy diet and getting exercise. Long term success of the surgery depends in part on your commitment to following the guidelines given to you about diet and exercise.


 

Before you have weight loss surgery, you'll go through an extensive screening process. Not everyone who wants Bariatric surgery is psychologically or medically ready for the surgical procedure.

Thursday, January 6, 2011

Support Group Tonight

Come out and join us for the Evening Support Group
At the Gateway Club on Lackland AFB

6:30pm to 8:00pm (1830-2000)

No appointment needed - just show up!
**Reminder each patient must attend one meeting before surgery

Many pre and post surgical patients attend
Bariatric Surgeons will be there
Guest Speaker will be Dr. Burton, Psychologist


Directions to Gateway Club
Enter Lackland AFB at Main gate (Visitor Center) off Military Dr
Go straight from gate to stop sign club will be catty-corner to you
Questions call (210) 292-4303 during duty hours

Wednesday, January 5, 2011

Choosing the "Right" Weight-loss Surgery Procedure

by Lloyd Stegemann, MD, FASMBS

for original article go to: http://www.obesityaction.org/magazine/oacnews16/choosingtherightweightlosssurgeryprocedure.php

Weight-loss surgery has been shown to be very effective at producing significant and sustained weight-loss. There are several different weight-loss operations that are currently available that can lead to this desired result. Because of this, one of the most frequent questions I get from patients considering weight-loss surgery is,
"How do I decide which procedure is right for me?"

Effectiveness of Weight-loss Surgery Operations

It is my opinion that EACH of the most common weight-loss operations done today (gastric bypass, adjustable gastric banding and sleeve gastrectomy) are effective when:

  • They are performed by a competent surgeon
  • They are done in a center that offers an aftercare program that focuses on dietary, behavioral and exercise changes
  • And most importantly, they are done on a patient willing to work WITH their operation

No matter what procedure a patient chooses, the key to weight-loss surgery is getting the patient to use their weight-loss operation to implement lifestyle change. Each of the available surgeries truly is a "tool" that will help to control hunger and portion size, but that's it! The rest is up to the patient.

Having said that, there are some differences between the available "tools." Here are some of the things a patient should consider when deciding which surgery is right for them.

Considerations When Choosing a Surgery Type

Expected Weight-loss

In general, gastric bypass patients will lose around 70 percent of their excess weight, sleeve gastrectomy patients will lose around 60 percent, and gastric banding patients will lose around 50 percent.

All of this depends, however, on how well a patient follows up and if the patient works on all the necessary lifestyle changes that must occur to make them successful over the long-term. I think it is important to keep in mind that even though gastric banding patients tend to lose less weight, they still see significant improvement in their health and quality of life.

Reliability of Weight-loss

Gastric bypass and sleeve gastrectomy patients almost always achieve the expected weight-loss outlined above. I do not worry about these patients losing weight; I worry about them regaining it down the road. This will occur if they do not make the necessary lifestyle changes in the first year after their weight-loss operation.

Weight-loss with adjustable gastric banding is much more variable. Some patients will lose 70-90 percent of their excess weight (remember, 50 percent is expected), but some will lose almost no weight. You see, with a band, if patients are not following-up and working on lifestyle change IMMEDIATELY, they just will not lose weight. The good news is that when a gastric banding patient loses weight, they almost always keep it off because they had to make lifestyle changes to take off the weight and that is what keeps it off for ANY weight-loss operation.

Fast or Slow

Gastric bypass and sleeve patients will typically lose five to seven pounds a week early on and will reach their expected weight-loss 12-15 months after their operation. Some patients say, "I am having this operation to lose weight and I want it off NOW!" That is more of a gastric bypass/sleeve type of weight-loss.

On the other hand, gastric banding patients tend to see a slower, steadier weight-loss (losing one to two pounds per week) but will see this continue until they reach their expected weight-loss around two years after their operation.

Fear of the Unknown

There are good studies looking at the long-term effects of gastric bypass and adjustable gastric banding. It appears that both of these operations are safe, lead to significant weight-loss and improvement in weight related medical problems, and most importantly, maintenance of the weight-loss.

The same cannot be said for the sleeve gastrectomy at this point. Certainly the studies currently available show this operation to be safe and effective, but because the operation is so new, we do not yet know what is going to happen to patients 5 or 10 years after this operation. Will they see weight regain? Will there be problems due to removing so much stomach? We just do not know the answer to these questions yet.

Ability to Follow-up

In order to get an adjustable gastric band to be effective, it HAS to be adjusted. In the first year after surgery, gastric banding patients are typically seen more frequently than gastric bypass or sleeve patients, so it is important that a gastric banding patient be able to make these follow-up appointments in order to achieve maximum weight-loss.

If your employer makes it very difficult for you to get to your doctor appointments or if you live a great distance from your surgeon (more than 2 hours), you are less likely to follow-up and therefore less likely to do well with your band.

Fear of Needles

In order to "fill" the band, a needle must be used. The needle is small and fills do not really cause much pain, but if you are afraid of needles it does not matter if the needle is small.

I will never forget a patient that I inherited after he went to Mexico to have his band placed. I went to fill his band for the first-time and he said, "You have to use a needle? Dr. Stegemann, I am deathly afraid of needles!" As I put the needle into his port, he passed out. Needless to say, he really should have thought about that before he had a band.

Punishment Factor

Gastric bypass patients will very likely experience "dumping" if they eat foods containing sugars. After eating a sugary food, their heart starts racing, they start sweating and then they get severe abdominal pain, dizziness and oftentimes diarrhea. This really helps them stay away from those foods that may have caused them problems in the past.

Some patients like the idea of knowing that if they "cheat" on their operation the operation will punish them for it. There is no dumping with gastric banding and sleeve patients so they need to be more disciplined in their food choices when it comes to sweets.

Foreign Body Fear

Gastric band patients need to be VERY comfortable with having the band in you for the rest of your life. We do not take the band out when patients reach a healthy weight. Please do not be like one of my band patients who called two weeks after surgery and said, "Dr. Stegemann, you have to take this out. I can't sleep knowing it is inside of me."

Reversibility

Some patients choose to have a band because they believe that if the "cure" for obesity is found or they develop some other "problem," they can have it taken out. While it is true that taking out a band is pretty straightforward, there are few reasons why a surgeon would remove a band.
And, despite what you may have heard, a gastric bypass is also reversible. Certainly it is more challenging to reverse a bypass than it is to remove a band, but it can be done. A sleeve gastrectomy, however, cannot be reversed. If a band is removed or a bypass is reversed, a patient almost always begins regaining weight as they no longer have the "tool" that controlled their hunger and portion size.

Fear Factor

Many patients fear a gastric bypass or a sleeve gastrectomy because they feel it is "more invasive" and therefore more dangerous.  While it is true that a gastric bypass and a sleeve gastrectomy are bigger operations, when we look at the complication rates of all three operations, they are the same: 10-15 percent of patients will experience a complication related to their operation at some point. I think it is also important to keep in mind that weight-loss surgery has NEVER been safer than it is today.

What NOT to Consider When Choosing a Surgery
When deciding which surgery is right for you, I would suggest that you NOT consider the following:

Loose Skin

Loose skin is a reflection of significant weight-loss and it does not seem to matter if the weight-loss is slow or fast. If a gastric band patient, a sleeve patient and a gastric bypass patient all lose 150 lbs, they will ALL have some degree of loose skin.

Cost

In most markets, gastric bypass and sleeve gastrectomy are more expensive than adjustable gastric banding. While this is not important if insurance is paying for your surgery, it is important to those that have to pay for their surgery themselves. I always encourage my "cash pay" patients to choose their operation first and THEN figure out how they are going to pay for it.

Conclusion
There is no study that your surgeon can do that will tell him or her what is the "best" operation for you. If you are a good candidate for surgery, then very likely you could do well with ANY weight-loss operation. Ultimately it comes down to you knowing you, and I am convinced that patients are the best decision makers on which operation is right for them. Go with your gut, no pun intended. The operation YOU feel is right for you is very likely the right one for you!

About the Author:
Lloyd Stegemann, MD, FASMBS, is a private practice bariatric surgeon with New Dimensions Weight Loss Surgery in San Antonio, TX. He is the driving force behind the Texas Weight Loss Surgery Summit and the formation of the Texas Association of Bariatric Surgeons. Dr. Stegemann is a member of the American Society for Metabolic and Bariatric Surgery and the OAC Advisory Board.

Monday, January 3, 2011

Tips & Reminders: food

  1. Do not skip meals.
  2. Consume meals slowly. Stop if you feel full or nauseated. Resume when the feeling subsides.
  3. Take small bites and chew well! Chew 10-20 times per bit once you begin solid foods.
  4. A protein shake (8 oz) may be substituted for a meal if you have a problem tolerating solid food. Stage 1 (Sugar free Clear liquid) diet is your "fall back" stage if your stomach pouch is upset.
  5. Eat a balanced diet. The amounts of food eaten at each meal will be small, it is important that they be of high nutritional value.
  6. Avoid grazing or snacking through-out the day. "Grazing" is encouraged with non-calorie fluids, but is discouraged with solid foods. Grazing can lead to overeating and negatively impact weight loss.
  7. Freeze foods in ice cube trays and store in Zip Lock bags. When ready to eat, microwave frozen cubes.
  8. Use spices to flavor foods. Be careful with hot spices such as cayenne pepper and hot sauce because it may upset your stomach. Hot spices are OK, if you tolerate them.
  9. Blending your food. (Pureed- Stage 3)
    1. Cut foods into small pieces about the size of your thumbnail.
    2. Place food in blender. Add enough liquid to cover the blades (broth, juice, water, milk)
    3. Blend until smooth like applesauce.
    4. Strain out lumps, seeds, or pieces of food.