Live from Fairfield...

I attended today's ObesityHelp Regional Seminar in Fairfield. I can't even begin to describe how impressed I was by the all-day event. This seminar was small with a handful of vendors manning booths with lots of samples and a series of lectures delivered in the same room. There were about 200 people in attendance, some from as far away as Utah.

I apologize ahead of time for any typos; I blogged directly from the event and pushed each segment live without running spell check. If you find fewer than 10 typos, I think I did pretty well.

For those of you pressed for time or just not interested in wading through the details, let me sum up some of my favorite parts of the day:

Speakers
For the most part, I enjoyed all of the speakers. However, I was surprised by new information a few of them provided. I learned about a new bariatric procedure called vertical sleeve gastrectomy. A less invasive version of bariatric surgery, the vertical sleeve gastrectomy can be done more safely on high-risk patients and features a faster recovery time (see notes on Dr. Cirangle for more information). Another surprise was learning that peanut butter isn't considered a high-protein food. This is terrible news for the woman who often licks peanut butter from a spoon in the name of lunch. Not only is the fat content in peanut butter so high that it outweighs the protein benefit, but the protein in peanut butter isn't easily absorbed. There goes my favorite convenience food. The final, most profound, news I heard was that a runny nose, sneezing and hiccups after a meal are signs of overeating.

Lunch
The beauty of attending a bariatric seminar is that there is no anxiety when lunch time comes. I wasn’t worried that the menu wouldn’t be pouch-worthy. And boy, was I not disappointed.The only plates at the buffet were salad plates, which is important for me. I tend to be a member of the clean-your-plate club, and large-size dinner plates entice me to overeat. Salad plates ensure proper portion control. Lunch was a variety of salads: a curried chicken salad, tuna salad, a selection of cheeses, fruit and a mixed greens salad. Everything was tasty and perfect.

Interesting people
I talked to a few people who attended the seminar to get themselves back on track after regaining some of the weight they lost through surgery. One woman, four years after surgery, has put back on 45 pounds. Though she is still smaller than she was before surgery, she recognizes the fact that her previous size is just around the corner if she doesn’t gain control.

She says that her body tolerated junk food better than protein-rich foods, and she took to eating those more than good-quality foods. She stopped taking vitamins, stopped supplementing with protein, started drinking with her meals, etc.

She said one of her main mistakes was to start thinking of herself as “normal” and acting as if she was an average person. It’s taken her a long time to accept that she’s not normal and never will be. To get herself back on track, she’s started taking a doctor-prescribed appetite suppressant. She says it helps her use her tool the way it was created to be used.

“The big disappointment with weight loss surgery is that it doesn’t fix the daily struggle you fight each day.”

Another testament to it not being brain surgery.

Another interesting point that came up was how many of us blame so much of life’s challenges on being overweight and expect those challenges to disappear with weight loss. But that doesn’t happen. After surgery, your spouse may still belittle you, you’re still going to be insecure and you’re still going to face all of the same emotions you had before. The difference now is that you can’t eat to cope with those problems.

Vendor faire
The vendor faire, though small, offers some great information and features.

ObesityHelp.com has a sampling of products available at its online store. Everything from books to MedicAlert jewelry to hygiene helpers are showcased.Another booth offers a plethora of samples from Bariatric Advantage vitamins and Body Choice protein pudding (12g).

The Body by Katzen booth features numerous photo albums of work by Dr. J. Timothy Katzen, a Beverly Hills cosmetic surgeon who will also speak at today’s event. I even got the opportunity to see breast and buttock implants. The buttock implant is hard as a rock. Gives new meaning to the term “buns of steel.”

Dr. David Elliot of Healthy S.T.E.P.s Weight Loss Center, is a Santa Rosa bariatric surgeon who will also speak today. Dr. Elliot spent 20 years in the U.S. Army and was introduced to bariatrics while studying under another surgeon. He’s been performing gastric-bypass surgery on his own for the last six years.

Lauralyn Bellamy of Embody Success is a life coach who will also speak today. She’s a post-op who specializes in helping other post-ops adjust to life as thin people.

The most popular booth of the day is probably the one with Achiev One. Only available online, either through the company directly or through bariatric Web sites such as bariatriceating.com. Account Exec. Fernando Vasquez had samples of almost every flavor. He was missing my favorite – cappucino. Of course, I shouldn’t complain. After all, my pouch doesn’t even like decaf coffee, and the Achiev Ones do have a small amount of caffeine from the real coffee used as flavoring in them. The drinks are similar to store bought Starbucks Frappucinos, except that they offer 20 grams of protein in each 9.5-oz. bottle. I think they are yummy and have given numerous ones to post-ops I know with daily coffee habits. However, they are not for everyone. A woman behind me complains that they smell of beef jerky but don’t taste nearly as good.

Speakers
Lauralyn Bellamy – “The Key to Overcoming Self-Sabotage in Weight Loss and the Rest of Your Life
Lauralyn spent 51 years of her life on diets before having gastric-bypass surgery three years ago. According to her, “Sabotage is a misguided effort to protect yourself.” It may seem that there is nothing to protect oneself from, but the “reptilian brain” saves us from the unknown. Since many obese people cannot imagine themselves at a normal weight with a healthy, normal relationship with food, the brain considers that a danger zone and will sabotage efforts at weight loss.

Diets work for a short time, she says, because they distract us. Obsessing over food journals, counting calories or carbs or whatever, menu-planning, exercising, etc., keeps the brain from realizing what’s happening at first. Once the brain realizes what’s happened, it kicks in survival instincts and sabotages the weight loss.

Life coaching, Lauralyn’s specialty, is about making life-affirming changes. As she says, “This is not about using food as a reward, it’s about learning how to imagine the rest of your life.”

She goes on to say that it’s important to realize that your “sabotage voice loves you” and make it an ally in your efforts. The challenge is that nobody can dismantle his or her own defense mechanism, which is why therapists and life coaches are needed, she said. One example of a strong defense mechanism, she said, is forgetfulness. A third party can help to keep you conscious throughout the day and throughout your life. That's so important, she said, because surgery alone doesn't fix everything. It's not magic; it takes work.

Dr. J. Timothy Katzen – “Plastic Surgery After Weight Loss”
Dr. Katzen’s specialty has been post-weight loss plastic surgery for the past seven years. He’s certified by the American Board of Plastic Surgery and has offices in Beverly Hills, Santa Barbara and Hawaiian Gardens. Any surgeon can call him or herself a plastic surgeon, so it is very important to make sure surgeons are board certified.

Body contouring is the general term for the type of cosmetic surgery needed after drastic weight loss.

Why is it needed?
Weight loss leads to losing fat, shrinking muscles, buckling fascia (connective tissue). The skin attempts to recoil, but age, elasticity and overall health determines how well it can resume a normal shape.

Dr. Katzen explains what he calls the “Lamp Shade Analogy.” When a person gains weight, the body balloons out – body parts become spherical. When weight loss occurs, the body shrinks, leaving the appearance of a deflated balloon.Medically, reconstruction decreases and eliminates the occurrence of rashes, improves self-esteem, improves hygiene (a big issue when dealing with excessive folds of skin) and increases the ability to exercise.

Dr. Katzen suggests gastric-bypass patients consider cosmetic surgery once weight has stabilized, about 10 to 12 months after surgery and when you’re been at the same weight for about three months. Lap-Band patients, he said, should wait about 22 months after surgery.

He believes in doing reconstruction in a certain order: torso (abdomen and trunk), medial thighs, breasts and arms. Face work can be done at any time, he said. He recommends doing the torso first, because it’s the foundation of the body. He also does not believe in doing all of the needed reconstruction in one shot. He says it’s safer to do reconstruction in a series of procedures.

Another thing to remember, Dr. Katzen said, is that reconstructions are shape surgeries not weight surgeries. Patients should not expect to lose mass amounts of weight from cosmetic surgery, though having excess skin removed may give the appearance of major weight loss.

Cosmetic surgery is considered elective and is usually not covered by insurance companies. However, Dr. Katzen explains the necessity of documenting rashes, skin breakdown, back and neck pain and hernias, which help prove to some insurance companies that the reconstruction procedures are medically necessary.

Some terms to know
Panniculectomy: Removes apron of skin and the fat in it. No muscle tightening, no hernia correction. However, this surgery is the one most likely to be covered by insurance companies.

Abdominoplasty (tummy tuck): Removes skin and fat, tightens abdominal muscles, tightens fascia, allows for hernia repair. Incisions on women can vary from a high "french cut" to a low "hip-hugger" cut or anywhere in between. For men, the incision usually follows the underwear line.

Circumferential Body Lift: A continuation of the abdominoplasty incision that goes right around to the back. The procedure not only tightens the tummy but allows for lifting of the outer thighs, removing saddle bags, removing love handles and lifting buttocks. The incision is low in front, trails up over the hip and goes back down in the rear to help the scar be covered by insurance.

Buttock implants: Dr. Katzen says he’s a firm believer in implants to create a rounder back side. He doesn’t believe other procedures last. Saddle bag removal: Sometimes, body lifts don’t fully remove saddle bags and extra work is needed.

Thigh lift: Varying procedures that tighten and remove excess fat and skin from the legs. According to Dr. Katzen, Blue Cross of California no longer covers thigh procedures under any circumstances. He predicts this to be a trend with insurance companies. If you need a thigh lift, now is the time to try for one through your insurance company.

Breast surgeries: Includes augmentation, lift or a combo of both. Incisions can be in the shape of an anchor, T or lollipop. For women, augmentation is often needed. For men, the procedure is more about flattening the region and tightening the skin.

Arms: Minor problems an be treated with liposuction, medium problems can be treated with a lift that has a crescent-shape scar hidden in the armpit, severe problems require an incision from armpit to elbow.Dr. Katzen suggests people who want cosmetic surgery to quit smoking, exercise regularly and take vitamins as soon as possible before surgery.

Dr. David Elliot – “Protect Your Pouch: Maximizing Your ‘Window’ of Opportunity”
Dr. Elliot, a Santa Rosa bariatric surgeon, starts his session with an anatomy lesson of how Roux-En-Y gastric-bypass works. A one-ounce pouch (about the size of a golf ball) is created at the top of the football-sized stomach. The opening that connects the pouch to the intestine is about the size of a dime.

To protect the brand-new pouch, Dr. Elliot recommends the following the first month after surgery:
Slow progression of diet (food intolerances are common)
Hydration, between meals – not during
At mealtime, protein comes first!
Re-learning to eat (use a small plate, eat slowly)

The stoma (openings to and from the pouch) is swollen the first month, which means that dry foods will get stuck (inducing vomiting or gagging). Also, the divided stomach is hyper-sensitive to many foods, such as caffeine and dairy, among other things. He recommends protein supplements for the first three months in an effort to achieve 60 grams a day (my doctor recommends 80).

Common causes of vomiting:
Stomal stenosis or stricture – stoma closes, causing food and water to come up. Fixed by dilation

Eating too fast – most common reason; patient should spend 30 minutes eating

Excess mucus

Stomal ulcers
Bezoars – collections of undigested foodstuffs (think hairball) that have to be removed with an endoscope

One of Dr. Elliot’s key points is that surgery doesn’t equate to absolute success no matter what. Patients must exercise regularly, eat three meals a day (no snacking) that incorporate nutrient-rich foods to ensure their own long-term success.

Protein is the most important nutrient for the gastric-bypass patient. One point that surprised me, though, is that peanut butter is not considered a high-protein food. He said that the protein is too low in comparison to overall calories and fat. Fish and eggs, however, are excellent protein sources that are often well-tolerated by newer post-ops. For vegetarians, tofu, beans and legumes are good choices.

Hunger tends to return about six months after surgery. The pouch capacity increases (3/4 of a cup), the stoma size increases (pouch empties in two hours instead of four), and weight loss slows dramatically. For people who want to continue losing weight after six months, Dr. Elliot recommends avoiding carbs (they cause cravings and cramping that might be confused as hunger), not snacking (remove temptation from home and work), don’t drink with meals and “water loading.” Water loading is drinking a half-glass of water right before meals to dilute the ghrelin (hunger hormone) in the pouch. This helps some patients be satisfied longer and with less food.

One important thing to protect your pouch from is ulceration. Factors that can lead to ulcers include:
Alcohol
Smoking
Nonsteroidal medicine (ibuprofen, naprosyn, aspirin)

Dr. Elliot recommends giving up alcohol for life because of the danger of ulceration, as well as the high number of calories. On special occasions, he recommends drinking no more than a half glass of wine after a full meal because post-ops are “cheap drunks” because of how fast alcohol is absorbed by the new digestive tract.

Some patients who think they are in menopause find that their menstrual cycles starts back after gastric bypass. This had to do with hormonal imbalances brought about by obesity. For those who want to conceive, he recommends waiting at least one year before getting pregnant.
Most common reasons for regaining weight:· Lack of exercise· Snacking or grazing· Stretching of pouch because of overeating

Long story short, Dr. Elliot says that falling back into old habits is the main reason that people regain the weight they lost during the honeymoon period. Taking advantage of the honeymoon period to learn and create new lifestyle habits is the key to making sure surgery is a successful tool to overcome obesity.

Dr. Paul Cirangle – Will discuss long-term issues that WLS patients need to be aware of forever and the insurance situation in California
Dr. Cirangle’s first topic of discussion was nutritional deficiencies after surgical weight loss.

Malabsorptive procedures (gastric bypass) lead to more long-term nutritional deficiencies than restrictive procedures (Lap-Band). There are varying degrees of malabsoptoion depending on bypass procedure. Duodenal Switch has the highest incidence of deficiencies. RNY is middle of the road.

Malabsorption is why vitamins are such a necessity for bypass patients. Part of the procedure that is gastric bypass actually bypasses the parts of the intestine that absorb vitamins. Dr. Cirangle cites research that shows that patients who didn’t take vitamins regularly in the first two years after surgery not only became deficient later on but also were less likely to be able to correct the deficiency once it occurred. He says the best vitamins are the ones that you’ll take forever.

“If you don’t like the taste, you won’t take it and that makes it a bad vitamin,” he said.

Other reasons patients develop deficiencies is because they had them before surgery and because of the drastically reduced nutrient intake. A scary point Dr. Cirangle made is that gastric-bypass surgery is a procedure that by its nature causes ulcers. He recommends post-ops take some form of acid-reducer daily for the rest of their lives.

Anemia is common and can be caused by anastomotic bleeding (very rare), marginal ulcers, B-12 deficiency and iron deficiency. A third of post-ops will develop it within two years. Supplementing with folate not only helps prevent anemia but also protects your heart, he said.

“Very occasionally, anemia becomes so profound that we have to reverse the procedure,” he said. “That occurs most commonly with the Duodenal Switch.”

Other possible complications that require reversal are protein deficiency and kidney stones. The good news is that he says anemia is 95 percent correctable with supplementation.

The normal human digestive system is so efficient at absorbing calcium that 90 percent of what most people eat is excreted through feces. But for gastric-bypass patients, calcium absorption is difficult because the part of the intestine that absorbs it is bypassed. Dr. Cirangle recommends taking 500 mg at a time (3x a day) with a protein source to improve absorption. He also said that he doesn’t believe that calcium citrate is the only way to go for gastric-bypass patients to absorb calcium.

“To me, the best calcium is the one you like,” he said. “If you like Viactiv, which is calcium carbonate, that’s fine by me.”

Dr. Cirangle mentioned a new procedure on the horizon called a vertical sleeve gastrectomy. It’s a restrictive procedure – no malabsorption – that uses no incisions and is safest for high-risk patients. His practice has done 500 of the procedures, and he said that for those who self-pay, it’s the most affordable option. The other perk is that it’s the safest option for high-risk patients.

Dr. Monica Ganz – “Learning to Think Thin”
Dr. Ganz, who has lost 320 pounds with the help of gastric-bypass surgery, understands the need for the formerly obese to figure out how to think thin. Thinking like a thin person is the key to long-term success, she says. She’s a high-energy speaker who jumps from topic to topic with rapid-fire speed.The first thing Dr. Ganz recommends is to get rid of too-large clothes. The advantage to doing that is that it’s a commitment to “never go back” to your previous size.

Old habits die hard, she says. Every single day is a battle with food demons, but it gets easier with time. The problem with time is that it’s also easier to lapse into old behaviors. Taking pictures each month is a necessary practice. Many post-ops develop body dysmorphic disorder, which means the brain perceives the body to look bigger than it really is. She says it takes the brain a lot longer to catch up with your appearance than it does to lose the weight. According to Dr. Ganz, it can take up to five years for the mind to adjust. Taking measurements regularly is another tool to help combat body dysmorphia.

Be wary of your relationship with the scale
The key to making this a success is it’s a lifestyle. People who use the scale to determine what they will eat that day (treats if they lost weight; depravation if they gained weight) are still on diets, and diets are proven not to work. A scale is only to be used as a tool to guide you; you can’t depend on it as a measure of your self worth.

Getting back to basics
It takes 21 days to form a new habit, but most people give up at 18 days. Get a food scale and measure your portions.· Read labels· Hydration – if you have trouble keeping it down, try Propel, or something similar· Chew your food down to baby-food consistency· Undigested carbohydrates or protein cause gas· Eat slowly – use a timer· Use smaller size items (mini pans, salad plates, baby spoons, etc.)· Sip water all day long until you get 64 ounces to 74 ounces a day· Stay away from fast food (too much of a trigger)

Dr. Ganz recommends eating about 100 grams of protein each day to account for malabsorption. Not all foods have protein that is easily absorbed. For example, she said that eggs have protein that is 99 percent available, where as peanuts are only 49 percent available. On top of that, gastric bypass patients have 25 percent of their nutrients bypassed, meaning they absorb even less. A good rule of thumb to determine whether you need more protein is if you’re tired or have noticed your weigh loss has stalled.

Some aids to help you on your journey· Lactaid or Lactaid milk· Molly McButter to replace butter· Beano to combat gas

After weight loss, many people don’t know how to dress for their new size and shape. Take advantage of personal shopping services at department stores, even if you don’t buy anything. Have your makeup professionally done; go to a salon and have a makeover. Look your best and you will feel your best.

Cooking with almond flour

I've spent a ton of time in the kitchen this week, trying to come up with summertime favorites that are bariatric friendly.

I'm working to perfect a cobbler recipe. My first attempt this week (with white and yellow peaches from the local farmers market) was tasty but too watery. It seems the butter in the recipe wasn't fully absorbed. This taught me an important lesson about the principles of using almond flour to cut down the carb content of foods.

According to Susan Maria Leach, author of "Before and After", which provides a hefty number of bariatric-friendly recipes that Leach modified herself, I made a few common beginners' errors.

When using almond flour, she recommends cutting the fat in a recipe in half because almonds provide a decent amount. Another thing she does is cut the liquid by a quarter, because almond flour doesn't absorb liquid the same way as all-purpose flour. She also recommends using Nature's Sweet, which is available for sale on her Web site, as a sweetener. A high-quality form of maltitol (a sugar alcohol), it behaves the same way as sugar when cooked. This is different from Splenda, which doesn't offer the same volume as sugar.

This information will come in handy next week when I try again after the farmers market. If it works, I'll post the recipe, too. If not, I'll try again the next week.

Recipes wanted

I'm looking for bariatric-friendly summertime recipes. Anything low-carb and high in protein is good. But even if you only have a regular recipe, post it anyway. Maybe we can figure out a way to make it friendly for WLS patients.

I'll start by posting my chicken salad recipe. I make it in single-serving batches, because my husband isn't a fan of chicken so the measurements are approximate for me.

3 oz. cubed chicken breast
1 tablespoon minced celery
1 teaspoon minced red onion
1 teaspoon dill
Marie's peppercorn ranch dressing
Craisins to taste (or other fruit -- apples and grapes are great)
Sprinkle of chopped nuts (pecans and pine nuts are my fave)

Mix first four ingredients in a bowl, add enough dressing to moisten chicken. Salad can be put in the fridge at this point for later. Right before serving, add Craisins and nuts. If you add them too early, the Craisins will bleed color on the chicken and the nuts will lose their crispenss. If necessary, you can add more dressing to keep the mixture moist.

Serve it on a pile of baby greens or atop a Ry-Krisp cracker. YUM!

Liquid calories count

I was talking with a friend today about my recent trip to Tahoe. I was telling her all about the fun I had and the yummy rum runners I discovered there. As I was telling her the ingredients of a rum runner, she commented that they seemed high in calories. I shrugged and said that I knew they were high in sugar, but that the calories were probably lower than she thought.
I looked up the calorie values online and was shocked to see that a basic rum runner is about 200 calories. That's a quarter of what I consume from food in a typical day! That got me to wondering how many calories I drank during my trip. After some simple math, the number 1,600 glared at me from my cell phone calculator. I consumed 1,600 calories in beverages over the course of three days! That's about two full days of food for me.
I'm not one to cry over spilt milk and I'm not losing sleep over this, but it does stop me in my tracks. I'll take more care in choosing my beverages in the future.

Seminar offers opportunity to meet experts, peers

Space is still available for the Obesity Help Regional Seminar in Fairfield, and I’m excited to announce that I will be in attendance. If everything goes according to plan, I will blog from the all-day seminar Saturday, June 24.

The event, which will be at the Hilton Garden Inn, 2200 Gateway Court, will feature speakers on subjects ranging from cosmetic surgery to behavior modification. For information on the scheduled speakers, check out my June 15 posting.

Great opportunity
I’m excited to attend this seminar for a number of reasons. It’s a great opportunity to meet nutritionists, psychologists, surgeons and other professionals who understand the journey I am on. After all, the OH national seminar series isn’t named “Making the Journey Together 2006” for nothing. I love meeting experts in the surgical weight loss field for both personal and professional reasons. The wider my network of experts, the better equipped I become to write about bariatric issues that go beyond the scope of my own experience. A broad network also helps me to better serve the members of the monthly surgical weight loss support group I lead here in Tracy.

But on a personal level, attending this seminar excites me because it will enable me to meet and connect with other gastric-bypass patients — people who have already experienced what I have, people who are at the same spot in their journey as I am and people who hope to one day soon be on the same path as me. People like Karen Robb of Concord.

Son prompts woman to focus on health
Karen, a 36-year-old mother of an active toddler, had gastric-bypass surgery almost two years ago. She has since lost more than 170 pounds, going from 325 to 152. I can identify with Karen’s story. Her beginning and current weights are similar to mine, we both were overweight as long as we could remember, and both of us decided to have bariatric surgery because of children. For her, it was the 10-month-old son she already had; for me, it was the children I hope to have in the future.

“I decided to have the surgery around Christmas of 2003,” Karen told me in an e-mail yesterday. “My son was, at the time, 10 months old. He wasn’t quite walking yet, but he was sure getting around! I was in constant pain from my knees, feet and hips. I could barely stand up, let alone chase a toddler around the house.”

Karen says she had a fairly easy time getting insurance approval for surgery, and she went under the knife Sept. 20, 2004, which was also my very last birthday as a morbidly obese woman. Karen’s “re-birthday,” as she calls it, just so happens to be on the same day as my actual birthday. Yet something else we have in common.

Nothing comes easy
However, Karen is quick to point out that it hasn’t been all peaches and roses on her journey.

“I started out only being able to eat saltine crackers, because everything else made me sick,” she said. “I was so tired for so long. It was at least three months until I started to feel awake again.”

Even now, a year and eight months since surgery, Karen struggles with eating issues and is far from considering herself perfect.

“I have to work every day to use my tool in the correct manner,” she said. “Some days I do good, and some days I revert back to the old ways that got me up to 325 pounds. I just try to take each day as it comes and not regret what I did the day before.”

“I realize now that each day I get to wake up alive and not in pain and each moment I get to spend with my son is a gift. I try not to spend my days regretting what I should have done but instead trying to do what is right today and in the future.”

Wise words, if you ask me. But Karen has a lot of wisdom to impart. She exercises regularly and loves the way she looks in clothing, though she wouldn’t mind a little nip and tuck if she were to win the lottery.

I do not believe for a second that Karen is the only amazing person I will meet this weekend, but even if she is, my trip to Fairfield will be well worth the price of gas.

Kentucky Fried Killer?

I don’t generally blog about items that appear in the Tracy Press, because I figure if you found my blog, you must have already waded through the rest of the site. Let’s be honest, few people wake up every morning with a burning urge to read my musings. Well, that’s not necessarily true, but the people who do are most likely related to me and don’t count in this instance (no offense, Mom; you know I love you).

But I just couldn’t ignore Stephen Chapman’s column in today’s online Voice section regarding a government lawsuit against KFC. Chapman, a Creators Syndicate columnist who also writes for the Chicago Tribune, is considered a Libertarian. In my world, that means that some days when I read his column, I throw the paper down and tell anyone within earshot that he’s off his rocker. Other days, I throw the paper down so I can shake my fist in agreement. Today is a fist-shaking day.

Frivolous lawsuit
Today, Chapman takes the people at the Center for Science in the Public Interest to task for sticking their noses where they don’t belong — in the business of KFC and its use of hydrogenated cooking oil. If you don’t have the energy to read the full column, let me sum the CSPI’s core issue: Hydrogenated oil contains trans fats, which cause heart disease, and KFC should be banned from using it. According to Chapman and some scientists, the jury is still out on how evil, awful or terrible trans fats are.

I’m usually the first person to promote anything that might help our country fight its increasing battle with obesity, but there is such a thing as going too far. Generally, I’m willing to jump on any bandwagon that blames the fast-food industry for the declining health of our country’s citizens. But I’m no Pollyanna. I know that the fast-food industry only provides us with products that are lucrative. We are as much at fault for eating the industry’s high-calorie, low-quality food as the restaurants are for offering mega-size value meals.

The root of all evil?
Do I think fast food is evil? Not necessarily, but I don’t think it’s healthy. I’ve watched “Super-size Me” more than once. I believe there is a correlation between the obesity epidemic and our country’s increased reliance on fast food as the meal-time rule instead of the exception it used to be a generation ago.

There are days, typically when I’m suffering from a serious Jack-in-the-Box craving, when I think all fast-food establishments should be razed and replaced with eateries specializing in convenient healthy foods. But it doesn’t take me long to return to reality.

The fact is that we as a society need to start fighting our own battles instead of having the government do it for us. If we don’t want foods with trans fats, we need to stop eating at places we know serves them. The guy who prompted the CSPI lawsuit claims he didn’t know KFC used hydrogenated oil. Chapman points out that if this guy cared that much about trans fats, he would have asked. If enough people decide the danger of trans fats is too much to bear, KFC will notice a reduction in sales and profits. And nothing makes a company act faster than a dwindling bottom line.

Not only is government action in this case ridiculous on principle, it just doesn’t make financial sense. I’d rather my taxes go toward programs educating the public on a wide range of health issues than to fighting one corporation on one arguably minor point. In my book, this is right up there with the lawsuit against McDonald’s for serving hot coffee.

Lazy day at the lake

It was difficult to wake up this morning. Not only were we out late last night and needing to recover from that, but I had muscles I didn't know I had hurting significantly from yesterday's walk.

While everyone spent most of the day at the beach, Beau and I stayed close to the cabin. We lounged in the sun, with the hopes of adding a little color to my pallid complexion.
As the weather turned cool, we headed down to the Beacon Bar & Grill with Beau's cousins to listen to the live band and enjoy a round of rum runners.

The Beacon is known for its rum runners, a frozen concoction of cranberry juice, orange juice, pineapple juice and rum with a float of dark rum added for good measure. Rum runners were a weakness of mine in my college days, and I haven't had one since. With all of the juice, the cocktails contain way more sugar than I typically allow myself in a sitting. However, I've been experimenting with the concept of enjoying off-program treats in moderation. I still believe that such behavior is better compartmentalized during vacations and not as an everyday habit.
The rum runner was tasty, and the band, AM/FM, was quite good. And we all enjoyed an hour of grown-up time without children in tow.

We left the bar and headed back to the cabins to start dinner. Tonight's family meal consisted of barbecued steak, steamed green beans, chili, garlic bread, au gratin potatoes and more cantaloupe. What can I say? The cantaloupe was quite tasty. I ate a couple of inches of my medium-rare steak, a dozen green beans (fresh from my 3-year-old niece's garden), and a half-cup of chili. It was a protein-rich dinner that sat very well in my pouch.

Because I had to work tonight, we left shortly after dinner as everyone else was getting ready to celebrate a birthday. Though I dislike cake, I was glad to leave before it was served. The whipped cream frosting looked way too tempting.

Historic Camp Richardson

Camp Richardson Resort sits on the southwest shore of Lake Tahoe, about 15 minutes from the casinos in Stateline, Nev.

The rustic collection of winter and summer cabins is not what typically comes to mind when I think of a resort, but that doesn't mean that the place isn't without its charm. A haven for vacationing families, the resort features numerous cabins that can be reserved for a day or a week. Some families have waited years for a spot to open up, and once it does, they return year after year.

My husband's family has been vacationing in Camp Richardson every June for the last six years. All together, the family rents four cabins within close proximity to one another. Some stay a whole week, while others -- like my husband and me -- just visit for a couple of days over the weekend.

Today, we arrived shortly after breakfast. My in-laws had spent last night in the cabin and were quick to show us their incredibly uncomfortable bed. After a quick tour of their cabin, we visited Beau's Aunt Ramona in her cabin. Ramona's cabin, aptly named the Cadillac, is by far the most modern and spacious cabin of anyone in the family. Then again, Ramona has the biggest family, so the cabin is still close quarters for her brood.

Beau's parents took us on a brief walk around to help us get acquainted with the area. We walked down the water. Fun fact: The temperature of Lake Tahoe doesn't vary more than a few degrees throughout the course of the year, because it's the direct result of snow runoff. Today, it was a tepid 32 degrees. Beau waded in after what his mom thought was a dollar bill on the lake floor. Beau discovered it was just a rock, but not before getting chilled to the bone after about five minutes in the water.

Tour of the estatesCamp Richardson is actually a trio of sites, but the cabins are in the Tallac Historic Site, which features the Pope, Baldwin and Valhalla estates.

After Beau's refreshing dip in Lake Tahoe, his parents took us on a brief tour of the estates. For more information on the estates, click on the link in the preceding paragraph.

We enjoyed a leisurely two-mile walk among the estates and trails with Beau's parents before they turned back to the cabin for a nap. We continued on, walking about five miles before heading back ourselves for a bit of lunch and a nap.

Meal time and sleepy time
At the cabin, we scarfed down a quick lunch of ham-and-cheese sandwiches and laid down on the aforementioned rock-hard bed for a siesta. More than two hours later, I woke up, feeling as if I'd slept the entire night. Beau didn't wake up for two more hours.

Shortly after he woke up, we joined the family for a communal dinner of hamburgers, hot dogs and Polish sausage with macaroni salad, chips and fruit. I ate about half a polish sausage, cantaloupe, a bite of macaroni salad and a few chips. I usually steer clear of pasta and potatoes, but I made an exception today for no good reason.

Fun downtown
We left Camp Richardson around 7 p.m. to meet some friends in town for fun at the casinos. Beau and I are notoriously terrible at gambling, so our cash was quickly played out at the slots in Harrah's and Harvey's. We then met our friends at the Cabo Wabo Cantina inside Harrah's. We hung out there for a few hours. The cantina was a fun atmosphere with a live band. It's said that one never knows when Sammy Hagar, proprietor of the Cabo Wabo Cantina and creator of the Cabo Wabo line of tequila, will walk in. The Red Rocker was nowhere to be found tonight, but that didn't stop us from having some fun on the dance floor.

Failing to plan means planning to fail

My husband and I are getting ready for a weekend trip to Lake Tahoe for his family’s annual summer vacation. Of course, I haven’t really given the trip much thought until today – when we’re supposed to be leaving.

That’s not exactly true. I thought about doing laundry, washing dishes, taking out the trash and packing. I’ve spent all week figuring out what to pack for a weekend of hiking, dancing and lounging on the beach, but I didn’t think of much else. Why is this a problem? Well, as I write this, I realize I haven’t spent any time finding out what we’re eating this weekend.

My husband’s family rents cabins along Camp Richardson, and they plan big group gatherings at mealtimes. I’ve asked repeatedly what we’re eating, and I’ve been told, “Well, you know. A little of this, a little of that.” That’s not helpful. I do know that for Father’s Day, there’s a family barbecue that features grilled steak. Otherwise, I haven’t a clue. I wasn’t overly worried about my lack of knowledge, because I figured there was bound to be something I could eat.

Then I read the monthly rant at bariatriceating.com last night. Susan Maria Leach, the site administrator and author of the rant, wrote about a recent vacation with her husband to visit family. Having had surgery five years ago, she didn’t pack special food for herself because she knew she could find something to eat just about anywhere. Unfortunately for her, she was wrong. Most of the restaurants the family visited during her trip didn’t offer anything that wasn’t deep-fried or smothered in gravy. And a family cookout only offered maple baked beans, dried-out hamburgers, macaroni and cheese, macaroni salad and birthday cake. She spent most of one day not eating, because she didn’t want to risk getting sick in public, and to make matters worse, she had to deal with relatives noticing her lack of eating and the hurt feelings that seem to arise around food.

Talk about a rude awakening. I quickly thought back to most of my food experiences around my husband’s family. In general, I, too, can find something to eat anywhere, but there are foods that just will not go down no matter how hard I try: hamburger, sausage, any form of dried or overcooked meat, scrambled eggs, pasta, rice and anything made with whole milk or cream. And then there are the foods that I do eat in a pinch but tend to make me ill: bread, sweets, gravy, fried eggs and potatoes.

As I thought about this, I also thought about the meals I’ve heard the family talk about having at past vacations: Spaghetti and garlic bread, barbecued hamburgers and hot dogs, breakfast scrambles, tri tip, baked potatoes, etc. And suddenly, it became clear that I needed to pack food for myself to prevent me from being in a situation where my choice was to either not eat or eat food that I knew for a fact would make me sick.

So, I’ll spend some time today before we hit the road at the grocery store. I’ll pick up string cheese, lunchmeat, protein bars, and I’ll take along some of the protein powder samples I have on hand. I may not touch a single thing I pack, but that will be better than the alternative.

Obesity Help Regional Seminar in Fairfield

Obesity Help is preparing for its regional seminar in Fairfield on June 24. The all-day event, held at the Hilton Garden Inn, 2200 Gateway Court, will feature a vendor fair, lunchtime reception and lectures on topics related to weight loss.

Obesity Help is an Irvine-based corporation that serves the morbidly obese community through its extensive Web site and bi-monthly OH Magazine.

The June 24 conference will feature four speakers who are well known in the bariatric and weight loss community.

Dr. Monica Ganz has lost 320 pounds following gastric-bypass surgery and is the director of events and chapters for Obesity Help. Her lecture, "Learning to Think Thin" will address the need for post-ops to retrain their brains and go from "thinking fat to thinking thin."

Lori Cochrane is a behavior analyst, speaker, writer and mentor to bariatric patients who had Roux-en-Y gastric bypass about five years ago. Her topic, "Bariatric Behavior: Rules of the Road for Long-term Success," addresses how to replace old behaviors with successful ones and how to enjoy positive change.

Dr. J. Timothy Katzen is owner of Body By Katzen and specializes in post-bariatric plastic surgery. His lecture, "Plastic Surgery After Weight Loss," will address the various types of body-sculpting procedures most common after drastic weight loss.

Lauralyn Bellamy had gastric-bypass surgery three years ago and has created Embody Success! Coaching, to teach others the tools that helped her achieve success. Her topic, "The Key to Overcoming Self-Sabotage in Weight Loss and the Rest of Your Life," is self-explanatory.

Keep checking back for more information on the Fairfield conference and other upcoming OH events. If you're interested in attending the Fairfield event, sign up soon; space is limited.

Step by step: Losses add up

The LA Times is following a brother and sister who tipped the scales at close to 600 pounds each before having Lap-Band surgery last year.

Lap-Band is an adjustable gastric band (think of a bicycle inner tube) that cinches the stomach to limit the amount of food eaten at one time and the speed of which it is digested. Lap-Band patients tend to lose weigh more slowly than gastric-bypass patients and the procedure is considered minimally invasive and is also reversible.

Sheila and Cyrus Tehrani refinanced their childhood home to pay for their procedures. After losing about 150 pounds in the last year, Sheila needed to have a panniculectomy -- or excess belly skin removed -- to help keep her active. The hanging apron of skin was impairing her ability to walk. During the procedure, doctors removed almost 50 pounds of excess skin and repaired a hernia Sheila didn't even know she had.

To read the entire article click here: http://www.latimes.com/news/local/la-me-superobese6jun06,1,7135581.story?page=1&coll=la-headlines-california

Practicing what I preach

I've spent the last half-hour in my kitchen trying to figure out what to eat for breakfast and pack for lunch and dinner in preparation for a long night at work.

It's been over a week since I went grocery shopping. Though I bought a bunch of food, I didn't plan very well and didn't stock up on convenient, portable meal options for myself. I have lots of cheese, but no cold cuts to use as lower-fat protein sources. No cottage cheese, ricotta cheese or even low-fat cream cheese.

Here I've been blogging about re-evaluating my eating habits and being more diligent and I forgot the most important thing -- making sure my fridge and pantry are stocked with options conducive to staying on my eating plan.

It took some time, but I've found a few cans of tuna, which will be perfect to take to work today. I have a freezer full of chicken that I just need to thaw and cook up. I can cut up chicken breasts to add to a salad or mix up a batch of chicken salad. I also have my protein powder -- I just need to move it from the cupboard to the counter so I don't forget about it.

More now than I ever, I need to be diligent about planning and making sure I eat good-quality meals and not just what sounds easy on the fly. Now excuse me, I have tuna salad to make before I go to work.

Evaluating eating habits

As I mentioned a couple of days ago, I'm nearing the end of my weight loss honeymoon period. In an effort to make the most of the next three months, I'm spending some time evaluating my eating, exercise and lifestyle habits to see where I can make improvements.

I've already recognized that I need to keep a tighter rein on my consumption of fat. This week, I'm paying attention to my portion sizes and how fast I eat. I definitely eat too fast, and eating too fast leads to eating too much.

Though I limit my carbohydrate intake, I enjoy Ry-Krisp crackers. Two crackers offer 3 grams of fiber, 1 gram of protein and no fat. Spreading a half-ounce of cheese on top provides a protein-rich, filling meal. The problem is that when I don't take my time eating, I feel like I have room for two crackers and eat them easily. But then a hour goes by and my pouch starts aching. I sense that it's being stretched by too much food. The feeling is painful and encourages me not to make the same mistake again. Now, I know that my limit is one cracker -- eaten slowly.

As for exercise, I need to work on consistency. I know it's better to work out regularly twice a week than to hit the gym five days one week, two the next and then skip it for three weeks. But my perfectionist attitude, which helped get me to 335 pounds in the first place, prevents me from setting and maintaining realistic goals sometimes.

Fighting against the grain

When I weighed 300 pounds, nobody even blinked when I chose my meals carefully. The same was true when I was 200 pounds. Now that I'm under 160, many people -- particularly those who knew me at my highest weight -- think I need to ease up on my vigilance.

"You should treat yourself," "You deserve a freebie," "Don't you ever just let go?" are comments I get a lot. I try to laugh off such comments, and that often works. But then there are times when such comments lead into evaluations about my current weight. A few well-meaning people have told me that they think I've lost enough weight and that I should stop now. And they use that opinion as justification of why I should have a slice of cheesecake or sample some ice cream.

I don't do so well when people feel the need to tell me how much I should weigh. One would argue that I should be able to tell people that my weight is none of their business. However, I have a hard time drawing such lines in the sand. After all, writing my column and this blog puts me in the spotlight. If I'm going to put myself out there publicly, I don't feel like I get to tell people to mind their own business. I realize this is untrue. I can make myself as private or public as I wish, but it's still hard for me to do.

Instead, I point out to people that with BMI of 28, I'm still considered overweight. I need to lose about 20 pounds before I'm even on the high end of normal. Of course, that usually leads to sideway glance, during which the person tries to picture me smaller than I am now. Then the person typically crinkles his or her forehead and says, "Wow...but that would make you too skinny. You don't want to do that, do you?" Usually, I shrug and say I'm undecided.

That's the truth; I am undecided. I'm very happy at my present weight. I'm healthy; I feel good; life is amazingly easy for me. And I don't feel like I have to work that hard to maintain this weight. But I also know that the more weight I lose within the next three months, the more I'll be likely to keep off forever. And that makes me want to maximize the remainder of my honeymoon period.

Is the honeymoon over?

I've given a lot of thought to Friday's entry about cheese, not because I typically dwell over such things or because I mourn the need to limit my consumption of it. I've been thinking of it because the "honeymoon period" that follows gastric-bypass surgery is nearly over for me.

The honeymoon period is the 18-month window following gastric-bypass surgery in which the patient loses the bulk of his or her excess weight. After the honeymoon period, the gastric-bypass patient becomes more like the average person trying to lose weight. Watching the amount and type of food consumed becomes increasingly important, as does maintaining the positive lifestyle changes made in the preceding months.

One of the challenges is that as the honeymoon period nears an end, it's common to slip into old habits without even realizing it. And it becomes even more important to be vigilant about following the prescribed post-operative eating plan.

But the other challenge is that nearing the honeymoon period also means the post-op has lost a massive amount of weight and is nearing his or goal (assuming the weight loss went according to plan). Why is that a challenge? It's a challenge because our society seems to view weight management as a finite task. People understand the concept of losing weight, especially when morbidly obese people do it. But when a person goes from losing weight to maintaining the loss, people act as if the hard part is over. And if the hard part is over, that must mean that the easy part has begun. Nothing could be further from the truth.

Suited for success

Originally published June 10, in Our Town for the Tracy Press.

This is my first summer at a normal weight. To celebrate, I promised my husband I would buy a swimsuit. He’s a water baby and has pouted for years that I won’t go swimming with him or hang out at our friends’ houseboats. I’ve never even gone on his family’s annual summer vacation at Lake Tahoe.

I can think of few things I dread more than wearing a swimsuit, but I’m pretty sure trying suits on in store dressing rooms is worse. I haven’t bought a suit in seven years. The only reason I bought one then was because I was visiting a relative in Hawaii, and she told me she’d leave me at the airport if I didn’t have a swimsuit in my suitcase.

I’m a planner, and as such, I’ve spent the last four or five months scouting swimsuit styles to see what’s out there and what might look good on me. Weight loss has changed my body into a bit of a pear shape, which makes standard one-piece suits not exactly suitable. The tankini was my greatest discovery. The suits can offer the coverage of a one-piece but the separate pieces can be mixed to offer the perfect fit.

I decided to take advantage of my favorite department store’s Memorial Day sale last week and blocked out a few hours in search of the perfect suit, or at least one that didn’t make me cringe to wear in public. Having already decided I wanted a tankini, I gravitated toward that section.
I fell in love with a selection of suits with brown bottoms and teal-and-brown tops. I was disappointed to see that the store was out of full-coverage bottoms, though. The only brown bottoms were swim skirts and low-rise bottoms, but I grabbed one of each, just in case. After all, the tops were that cute. Then I went to the black suit section and found a modest black set with full-coverage bottoms and top.

In all, I took about a dozen pieces into the dressing room. I set aside my favorite styles to try on. Two of the brown-and-teal tops were awesome. They were both halter-style, which experts say will emphasize the bust line and help balance a narrow upper body with a wider lower body. I also found the halter styles to be more supportive than standard swim tops.

Once I found what I thought was the perfect top, I tried on the bottoms. I went for the low-rise bottoms first, knowing ahead of time that they would probably be a no-go. I was right. I may be less than half the woman I used to be, but that does not mean my navel needs to be seen in public.

Next I tried on the skirt. The tag said swim skirts were good to “slim and hide hips and thighs.” Such skirts may cover the hips and upper thigh, but I strongly disagree that they function to “slim” or “hide” anything. The skirt wasn’t long enough to cover what I consider the most problematic part of my thighs. If anything, having the hemline fall at the widest part of my thighs just seemed to make me look even wider. And, as I remember from the bathing suit I bought seven years ago, when wet, swim skirts cling in all the wrong ways. The skirt was definitely out.

That left me with the lone black suit. I liked the bottoms on. They were basic and showed my entire thigh, but I figured I could wear a sarong if I didn’t want to be so exposed. The top, sadly, was not a halter-style. But it was flattering and supportive, and after waffling back and forth for a solid 10 minutes, I decided to go with it. I bought the top in a size 10 and the bottoms in a 12.
I have yet to wear it, but that family vacation in Tahoe is next week, and the suit is already packed.

Cutting the cheese

It's been almost 15 months since I had gastric-bypass surgery. In that time, I've gone from being able to consume 1 to 2 oz. of food in one sitting to comfortably accommodating 4 to 6 oz., depending on the type of food and time of day.

As I'm able to eat a larger quantity of food, I'm also beginning to realize the increased need to pay attention to the food I eat. Shortly after surgery, I focused mainly on getting in protein -- paying little to no attention to fat content. If alfredo sauce or butter helped chicken or fish slide into my pouch with great ease, then that's what I used. I also started favoring cheese as a quick, convenient protein source.

Many days, breakfast would consist of an ounce of cheese. I'd pack some cheese in my purse if I planned to be out all day and wasn't sure about where I'd be at meal times. An ounce of cheese is about 100 calories and offers 7 to 10 grams of protein. It was a wise choice for portable meals. However, I need to watch my consumption more closely. Reaching for cheese wasn't a problem when an ounce was all I could eat. Now that I can eat 4 ounces in a sitting, what used to be a 100-calorie meal could now be a 400-calorie meal if it only includes cheese. And fat is also an issue. One ounce of cheese has about 8 grams of fat. Four ounces of cheese would push me well over my day's fat limit.

Cheese isn't a new favorite of mine. Growing up in Hilmar, home of the popular Hilmar Cheese Co., my love for cheese began early in life (if you get the chance to visit Hilmar Cheese, I recommend sampling the Squeakers). I don't think it would be exaggerating to say that we go through five pounds of cheese a month in my house. Of course, I'm not the only one eating it. My husband loves snacking on quesadillas, grilled cheese sandwiches and cheese and crackers. He loves ham-and-cheese omelets for breakfast and always adds a couple extra cups of shredded cheese when he bakes a frozen pizza. I prefer to eat cheese out of hand or with a couple of Ry-Krisp crackers.

Now that I'm limiting my cheese consumption, I have to find other quick snacks. Cottage cheese and ricotta cheese are low-fat options that I may start using once again. I got my fill of both in the first weeks after surgery and lost my taste for them, but it's time to try them again. Protein drinks are another fast fix at meal time. And lunch meat still remains a great choice -- though it's another food I've grown weary of over the last few months.

I think I'll be writing more over the next few days about the way I'm altering my way of eating and how I view different foods. As always, I welcome any ideas, questions or feedback on the topic. This is yet another new phase in my life, and it's one I'm learning to embrace.

Concert in the park

For those in the Tracy area, tonight is the first installment of the weekly Performances in the Park at Lincoln Park. Tonight's performer, Megan Slankard is someone of whom I'm quite fond. Not only was she raised in Vernalis -- the community I called home when I first moved to this area -- but she began coming into her own as a performer when I was entertainment editor for the Tracy Press. And her younger sister, Lauren, was my very first intern.

My husband and I enjoy the weekly summer concert series, and like the local farmers market, it's an event we work hard not to miss. Not only is it a free way to have fun, but it feels good to spend a few hours on a Thursday evening out in the open air. Tonight, we've invited some friend from out of town to join us for a picnic dinner during the show. We hope they enjoy it as much as we do.

Personally, I look forward to comparing tonight's experience with last year's series. Last year was the first time we checked out the concert series, because my weight loss had finally reached a point where I could handle sitting on the ground and getting back up. Some challenges I experienced were my newly emerging tailbone getting sore and numb from sitting on the hard earth and the embarassment of everyone behind me getting a great view of my underwear because my pants were always slipping down. I remember I still got winded walking the four to five blocks from the park to where we had to leave our car. But by the end of the series, Beau no longer had to drop me off at the park before parking the car. I was physically able to walk the few blocks in both directions.

Since the last concert in late July, I have lost about 80 pounds. Last year at this time, I was wearing a size 20. Today, I wear a 10/12. I'm packing a sweatshirt in case the evening air turns chilly, an old comforter to provide a little more padding beneath my rear and a selection of cold appetizers and maybe even a little wine just to add to the experience.

I hope to see you there.

Obesity in the news

I just Googled "obesity" and found a selection of interesting news stories that I'd like to share:

• The Urban League of Greater Chattanooga announced a health initiative today aimed at combating obesity among black women throughout the city. Read the story at: http://www.tfponline.com/absolutenm/templates/breaking.aspx?articleid=1786&zoneid=41

• The BlueCross BlueShield of Tennessee Health Foundation has awarded $40,000 to the Tennessee Pediatric Society Foundation in support of its Impacting Childhood Obesity Treatment & Prevention Program. Read the story at: http://nashville.bizjournals.com/nashville/stories/2006/06/05/daily34.html

• London - British children as young as 5 are working out in "kid gyms" as fears about childhood obesity grow. Read the story at: http://news.monstersandcritics.com/lifestyle/consumerhealth/article_1171082.php/British_children_seek_to_beat_obesity_in_kid_gyms

• ALBANY - As experts say childhood weight problems are increasing, two Assembly Democrats Wednesday called on schools to test for obesity and fast-food restaurants to detail nutritional information on menus. Read the story at: http://www.pressconnects.com/apps/pbcs.dll/article?AID=/20060608/NEWS01/606080343/1006

• As Americans keep getting bigger, hospitals are revamping themselves to accommodate an influx of obese patients. Read the story at: http://english.people.com.cn/200606/08/eng20060608_272044.html

• The federal government says 64 percent of Americans are overweight and 30 percent are obese. That has prompted the Food and Drug Administration, the F.D.A., to issue a report urging restaurants to help control obesity. Read the story at: http://www.voanews.com/english/2006-06-07-voa24.cfm

Strict parenting linked to overweight kids

Finally, there's a study that has proven what I've known all along: "Clean you plate!" admonishments lead to kids becoming overweight.
The study of 872 families was conducted by Boston University School of Medicine and published in the June issue of Pediatrics, released Monday. Researchers studied the effects of parenting styles on children's weight and found that authoritarian parents were more likely to have obese kids than authoritative parents.
Though none of us can undo the damage done by our parents at the dinner table, we can heed the advice of researchers and break the cycle with our own children by offering flexibility within a firm set of boundaries.
Read an Associated Press article on the study and view video footage at http://news.yahoo.com/s/ap/20060605/ap_on_he_me/diet_parenting_2

The sweet smell of successful marketing

Candy makers are seeing the power of marketing on consumers.

It's been years since miniature versions of full-size candy bars have been on the market. I still remember when Hershey's Kisses and Miniatures were first advertised on TV, and I begged my mom to buy some. As a child, I was enthralled by the idea of trying three or four types of candy instead of having to choose only one to take home from the store. The fact is that most candy consumers are like me. We buy the miniatures because we want variety -- and they fit so great in a candy dish. But that also means that those bite-size treats don't last long once the bag is opened.

But a new day has dawned in the snack food/candy market. Consumers now flock to portion-controlled packaging. Nabisco’s 100-Calorie Packs are all the rage around my office. Nobody feels guilty about a treat when they know exactly how it affects their calorie consumption.

According to a Reuters article, published Wednesday, Hershey Co. and Nestle unveiled similar concepts earlier this week at the All Candy Expo in Chicago. Both companies promoted low-calorie stick versions of their full-size candy bars. Other portion-controlled concepts debuted at the show included 100-calorie packages of Sunkist fruit chews and other low-calorie or sugar-free candies.

The most profound observation comes from Daniel Azzara, Hershey's vice president for global innovation and quality. He told Reuters that this isn't really innovative for the company.

"What's interesting to me is the idea that (now) it's actually labeled "100 calorie" on the front of the package and consumers see that as portion controlled," Azzara said. "In reality, we've had a lot of snack size and Kisses and small pieces of chocolate for a long time."

Azzara's words speak volumes to me. After all, if I couldn't stop at just one Kiss, what would make me think one stick would be enough? Is it because the nutritional information is more clearly displayed? Is my subconscious really that easily fooled? Or is it just that the packaging is more complete? The wrappers are a bit more difficult to open than simply unfoiling a Kiss.
I'm not sure that this marketing ploy will have much effect on how much candy people actually consume, but I do think there will be a lot less guilt surrounding the consumption.

Read the full article on CNN.com here: http://www.cnn.com/2006/HEALTH/diet.fitness/06/06/diet.candy.reut/index.html

Pamphlet released on obesity

The Obesity Action Coalition has released the first in a series of pamphlets on obesity. "Understanding Obesity" offers readers an in-depth look into obesity and morbid obesity, as well as addressing who it affects, health risks and treatment options.“The OAC recognized that there wasn’t an educational brochure available to patients and the public that really looked at obesity as a whole." said Joseph Nadglowski Jr., OAC president and CEO, in a press release announcing the pamphlet. "Often times, people overlook the many facets of living with obesity or morbid obesity, such as the diminished quality of life, the negative stigma associated with it, the lack of the ability for individuals to access safe and effective care and much more."According to the nonprofit, future pamphlets will address childhood obesity and further examine treatment options

Appropriate use of protein bars

I was visiting one of my favorite message boards this evening and came upon a post about protein bars that reminded me of how there can be too much of a good thing.

Protein bars can be a convenient, healthy meal replacement in a pinch. However, when used as a snack, they are rarely any better than a Snickers bar. I see too many people who think of protein bars as a replacement for candy. They think of the bars as a healthy treat.
Sure, protein bars offer anywhere from 10 to 40 grams of protein (depending on brand), but they also can be very high in calories. Many that I have are around 300 calories.

As a WLS patient, I can only eat about a third to half of a bar in one sitting. But there are some people who eat two or three a day as a snack. And they wonder why they aren't losing weight.
So, take my advice. If you eat protein bars frequently, make sure you're paying attention to the calories you're taking in and compensating accordingly

Obesity boosts risk of breast cancer

WebMD has an article on a study linking postmenopausal obesity to breast cancer.
Read it in its entirety here:
http://www.webmd.com/content/Article/122/114754.htm?pagenumber=1

WLS increases sixfold

I'm not usually a fan of Fox News, but the company's Web site has an interesting article on the increased popularity of surgical weight loss. The article attributes the increase to a fairly new procedure called adjustable gastric banding (LapBand), which is reversible and minimally invasive.
I'd love to hear your thoughts on the subject. Click on the link below to read the story: http://www.foxnews.com/story/0,2933,197531,00.html

Birth control pills may be effective after bypass

In talking with some post-op friends the other day, I realized that many of us had received conflicting information from our doctors regarding the use of birth control pills after gastric-bypass surgery.

As a Kaiser patient, I had been told that barrier methods and IUDs were the best options after surgery, and birth control pills were off-limits. Another woman was told nothing by her doctor about contraception and had continued taking the same oral contraceptives as before surgery. The third woman was told that our pouches lack the digestive acids to break down the pill so she chewed hers up every day to ensure absorption.

Contraception is a serious issue for post-op patients. In general, it is not safe to get pregnant within the first 18 months after gastric-bypass procedures. The high rate of weight loss, reduced caloric intake and frequent vitamin and electrolyte imbalances do not make for a body able to sustain a healthy pregnancy.

Those of us with pre-op infertility have to be even more careful. Most times, that infertility is caused by obesity-related hormonal imbalances. As the weight drops off, some women become super fertile at a time when pregnancy would be dangerous for both them and the fetuses they would carry.

Of course, birth control pills are not the only forms of contraception on the market, but they are among the most commonly covered by insurance companies. For instance, my new employer-provided insurance plan only covers oral contraception. That makes the Pill the cheapest form of contraception available to me, and it's important to know whether it’s a viable medical option.

After talking with these women, I decided to e-mail the medical director of my bariatric program to ask why we had been discouraged from taking the Pill. Her answer surprised me. It had nothing to do with malabsorption issues. She said the risk of blood clots after surgery was too high, and birth control pills would add to it. According to her, oral contraception is safe and reliable after the first month.

A quick Google search shows some Web sites still advocating against the Pill because of malabsorption concerns. When it comes down to it, contraception is not a decision that can be taken lightly by a post-op. After all, if a chosen method fails, the resulting pregnancy can be quite dangerous. I’m still on the fence about whether I’ll trust the Pill to protect myself from getting pregnant this year, but the decision is individual. The friends whom I mentioned in the beginning of this column will continue as they have before and expect the same level of success. Only time will tell.

Starting a dialogue on childhood obesity

Originally published May 27, 2006, in Our Town for the Tracy Press.

Growing up overweight isn’t easy. I should know; I lived the experience firsthand. And having that history makes me incredibly passionate about the subject of childhood obesity and the epidemic it’s become in our nation.

But battling childhood obesity is not as simple as protecting in-school physical education requirements or teaching nutrition in elementary schools. Though children need to learn how to make better eating and lifestyle choices to ensure their own health, they need the support of their parents to make that happen. In their defense, parents do not intuitively know how to help their children lose weight or be healthy.

But now there is a children’s book on the market that addresses the subject in a manner that’s accessible to both kids and their parents. “It’s Not Your Fault That You’re Overweight” is written by Merilee A. Kern, a former marketing executive for eDiets.com who continues to write nutrition columns for the company. There are gender-specific paperback editions of the book and even coloring and activity e-books for children younger than 7. It’s available at www.notfault.com

The title alone is eye-catching. As someone who was obese as a child, my first question was who the author would choose to blame. Would it be parents for allowing their kids to be inactive and overeat? Would it be the fast-food industry for enticing children with their commercials and ads? Or would it be society as a whole for innumerable reasons?

The answer is both all and none of the above. Kern addresses the issues of children favoring video games over being active and the increase of eating in restaurants or on the run. However, the entire book is written in a nonthreatening tone. Her central message is that everyone — children and the adults in their lives — makes poor choices that promote being overweight. But instead of assigning blame, the author poses the issue to be one of ignorance. It’s not that kids or their parents are intentionally making bad food and lifestyle decisions; it’s that they don’t know any better.

The main characters (Patty or Matt, depending on which edition you purchase) and their parents don’t realize how serious it is for children to be overweight until a doctor’s appointment. The doctor educates the children and their parents about the medical consequences of obesity and offers advice that puts the children on the path to achieving a normal weight.

The book is not humorous, particularly if you identify with the characters as I do (luckily, my name doesn’t rhyme with “fat” or “fatty”). The author has a very clear understanding of what it means to be an overweight kid and does not sugarcoat the experience. Being teased and bullied are addressed in addition to the physical limitations that come with carrying too much weight on a child-size frame.

Personally, I think the book hits closer to home for those of us who have been there in regard to growing up obese. I think Kern also makes a concerted effort to make those who have never struggled with their own weight understand the difficulties overweight kids face. She also includes a section of talking points for parents to use in discussing the story with their kids to make the experience more interactive.

Will this book alone change the world and guide us out of the epidemic that is childhood obesity? Probably not. But it’s a good start.

Rising to the head of the class

Originally published May 13, 2006, in Our Town for the Tracy Press.

I’ve never been what I would call a gym bunny. You know the type — the women who show up bedecked in spandex with a full face of makeup and perfectly coiffed hair. Thankfully, the trend of wearing thong leotards over spandex shorts went out of style sometime in the ’90s.

I am more of a gym rat, somebody who rolls out of bed in the morning, grabs the nearest T-shirt and lounge pants, fills up a water bottle and heads out the door. No makeup, no brushing of hair. Aside from the careless regard for appearance, I used to differentiate myself from the gym bunnies by what I did when I got to the health club. I favored cardio and weight machines. Gym bunnies took classes. I hate classes.

My first foray into group exercise was when I signed up for a beginner aerobics class in college. We did step aerobics — the going trend. I have never been blessed with coordination, but the routines were simple enough for me to figure out.

I enjoyed that class so much that my roommate and I joined a gym the following semester so we could take step aerobics together. I was shocked the first day of class to see a room full of gym bunnies wearing butt-floss leotards. The instructor was about seven months pregnant and looked too cute in her multicolor thong leotard ensemble.

At first, I thought I was doing well. I was keeping up with everyone else and felt like I had really accomplished something. And then the instructor announced that the warm-up was over. For the next 30 minutes, I got more of a workout from trying to figure out the choreography than I did from the exercises. I don’t think there is a way to feel worse about yourself than to have a very pregnant woman run circles around you in an exercise class. I never went back.

That is, I hadn’t visited another class until Tuesday.

My workout buddy, Marie, has been telling me about this class she found at In-Shape Sports Club on Tracy Boulevard called Straight-Up Strength. She loves it. She loves it so much she got rid of her personal trainer and takes the class twice a week for strength training. She raves about how powerful she feels, how wonderful the instructor is and how much weight she’s lost since she started it a few months ago.

Last week, Marie convinced me to try the class. I spent part of my weekend dreading it. I didn’t want to be the loser in the back of the room who couldn’t figure out the routines. But I promised Marie, and I keep my promises.

Straight-Up Strength, which is a high-energy total-body resistance class, requires a bit of set-up. Getting there early is important. Each person needs to grab a step (to use as a bench), mat, barbell, dumbbells and weight plates. As I was setting up my workspace, I took a look around the room. I was surprised to see a few familiar faces in the all-female crowd and not a single gym bunny. Sure, there was quite a bit of spandex, but I think that’s a pre-requisite for most people when it comes to workout wear.

The women ranged in size from very fit to moderately overweight, and you could tell that most of them were regulars. Some women were already drenched in sweat from the class that precedes Straight-Up Strength; others were like me and had just done a little cardio beforehand.

Loretta, the class instructor, is a fierce force to reckon with. At least that’s what the regulars say. She has the type of figure that I’m sure keeps many people coming to her classes in hopes their bodies will soon follow suit. But what I liked is she took time before each segment to explain the moves and modifications. She also walked around the room to correct form and movement, ensuring everyone got the most out of class.

The class was an amazing mix of squats, dead lifts, lunges, rows, triceps kickbacks, biceps curls and other exercises of which I don’t even know the names. We went from lower body to upper body to lower body and back to upper body, ending with a serious ab routine. In all, the choreography wasn’t that tough. I got mixed up quite a few times, but with Marie and Loretta, I didn’t stay off track for long.The workout was tough. My legs shook, and there were times I didn’t think I’d make it through, but I did. And when class was over, I knew I had been through the wringer and would be sore the next day. But as Marie says, it’s a good sore. The type of soreness that reminds you of how much you accomplished the day before and how strong you really are.

That soreness is so intoxicating that I went back for more, and I might just continue with the class twice a week. Who knows? Maybe in two months, I’ll be just like Marie, raving about it to everyone I know and dragging one of my reluctant friends to join us.

Life as a skinny girl

Originally published April 29, 2006, in Our Town for the Tracy Press.

As a rule, I don’t leave Tracy much. I grew up in a small community, and the mall is enough to keep me in town on weekends. Having a Trader Joe’s or a Whole Foods would almost guarantee I’d never leave, but such decisions are not for me to make.

Because I stick close to home, I don’t meet many people who don’t already know about me, either through this column or mutual friends. At the least, strangers know I’ve lost a significant amount of weight; at the most, they know I’ve had gastric-bypass surgery.

My recent trip to Virginia was the first time I was able to interact with people who had no clue of my history. It was a trip, in more ways than one.

My cousin (pictured above with me), who has been my biggest fan my whole life, treated me as she always has. She just kept pointing out all the things we were doing that we never would have done before, like trekking for miles around Washington, D.C., in the pouring rain without having to stop for me to catch my breath.

For her, my visit was profound because the rest of the world could see me for the person she had always seen hidden within a fortress of fat. She commented on my emerging confidence, my posture, my openness. And we spent a lot of time discussing my interactions with others.

Despite losing 175 pounds, I still have the emotional core of someone who is morbidly obese. I’ve always identified myself as a “big girl” with all the positives and negatives that accompany that label. It took 48 hours for me on this trip to realize how my perception of myself is quite different from that of others.

What was my first clue? Somebody made fun of fat people in front of me. Yup. You read that right; somebody actually made a rude comment about overweight people in my presence. I was so shocked that I couldn’t even speak.

At first, I got hot in face with embarrassment and rage. How dare somebody say such a thing to me and laugh? Did they have any idea who they were dealing with? And then the truth hit me like a ton of bricks: No, they didn’t. I looked down at myself and the people who had joined us for lunch and realized no one had any reason to see me as being different. Size-wise, I was average. There were a couple of people a little bigger than me, a couple of people about the same size as me and a couple smaller than me.

Looking at me, they couldn’t tell I used to be morbidly obese. They had no idea how offensive such a comment was to me. And, I’m ashamed to admit, I had no idea how to bring it up. I thought about a simple, “Uhh … that’s not cool,” comment, but what if the response was, “Why do you care? You’re not fat”? Should I say, “Yeah, well, I used to be, and comments like that still offend me”? Maybe, but I didn’t think I needed to be that blunt. The fact is that my past wasn’t their business. In hindsight, an appropriate response to such a challenge could have been, “Yeah, well I’m not black either, but racist jokes still offend me.”

I tried to shrug off the comment. It was a five-word sentence at most. And it was more a thoughtless comment than an outright insult. Thinking back, the rudeness was more inferred than implied. A woman made a comment about “fat chicks” being attracted to her husband and made an “uggh” sound to show her displeasure. But the fact is that if I had sat at that table a year ago, she never would have uttered the sentence.

The worst of it is that I’ve spent more time thinking about the comment than anybody else, particularly the speaker. Did I let it ruin my good time? No. But I did let it make me feel bad about myself. And I did because I have a secret fear. I am afraid that I will get so caught up in the new me and the positive attention this new body brings that I’ll forget who I used to be.

Those who have read my column from its inception know that I did not have gastric-bypass because I wanted to be thin. There were health problems that required drastic weight loss; if I thought there was another solution to those problems, I might have chosen a different path. Spending two decades dealing with morbid obesity shaped my character. As much as I cringe when I think of all the teasing and discrimination I suffered back then, those experiences are what led me to become the compassionate person I am today. For the most part, I like her. Sure, I’d like her to be a little more confident, maybe show a little more backbone at times, but she’s an all-around great person — imperfections and all.

I don’t ever want to lose my connection to my past, and my inability to speak on my own behalf at lunch that day made me feel it was slipping away.

In truth, I never would have been successful at losing weight over the last year if I had not changed. But it’s important to me that the “new Tonya” is a combination of the best parts of super-size Tonya and normal-size Tonya. I like to call it the “new normal,” in a whole new world.

Busy weekend

My week of R&R is shaping up to be quite busy. I may not have as much time to post here as I had planned.

Tonight is pretty open, but we're leaving for D.C. at 4 a.m. tomorrow to go to the Cherry Blossom Festival. We're driving to meet up with some friends in Maryland, and then we plan to take the Metro into D.C. After a day of blossom fanfare (grand parade, good eats and lots of music), we're hoping to catch a few winks before checking out nightlife in the city. On Sunday, we're going to see the landmarks and then drive back to Virginia. On Monday, we're going to check out Busch Gardens and other sights in Williamsburg. And I hope to get a few winks before flying out early Tuesday.

Bon voyage

Flying is definitely easier as a normal size person. It's not that I thought it would be otherwise, but part of me just thought flying was a pain for everyone.

After spending a day at airports (from San Jose to Dallas to Norfolk, Va.), I can categorically say the trip was like none I've ever experienced.

Though I could ramble on about differences noted throughout my journey, I think the most remarkable changes were felt on the plane. Not only did I have ample legroom in the coach cabin, but I had at least two inches of room on either side of me to spare in the seat. I didn't have the arm rests cutting into my hips. I didn't need to worry about crowding the passenger next to me.

Not needing a seat-belt extender made this trip so much more pleasant than my last. There is nothing more embarassing than having to ask a flight attendant for one and wait -- patiently -- while one is tracked down while nearby passengers glare at you for delaying takeoff.

Ooh...and let's not forget the tray table. Not only did it fully lower, it did so without touching my belly or thighs. I could actually cross my legs beneath it!

What to eat
The only real challenge was food. Most airlines no longer provide in-flight meals. That's not so bad for the average passenger. The sandwiches sold in airport cafes for $9 each are probably immensely better than what used to pass for food on the flight. But for someone who's had WLS, planning is essential.

I talked to other post-ops who are frequent flyers to get tips, and I must say I benefitted from their expertise. Everyone I spoke with agreed that the most important thing to do is pack protein-rich foods. Such foods would provide the necessary energy for a day of traveling, but also help keep me on track. After all, I wouldn't want to arrive at my destination too weak to have any fun.

I packed two cans of Snack & Slim pudding (each has 20g of protein and is sugar free), three sticks of string cheese (8g of protein each), two EAS AdvantEdge Carb Control protein bars (21g of protein each), one EAS AdvantEdge Carb Control RTD (15g of protein) and a scoop of IsoFruit protein cocktail mixed in 28 oz of water (21g of protein).

Traveling messes with my internal clock, and I wasn't sure what to make of my intermittent feelings of hunger. At some points, I felt like I was eating too much, others not enough. But in the end, I did OK. Unfortunately, I didn't pack enough for the return trip.

By midnight Wednesday, I had eaten one of the puddings, three cheese sticks, the EAS drink, one protein bar (eaten in two intervals) and about half of the IsoFruit cocktail (the cantaloupe-melon flavor is quite tasty). That accounted for about 90 grams of protein and roughly 650 calories.

Feeling parched
The one thing I didn't do well with is drinking water. Including the IsoFruit drink, I packed 60 oz of water. I'm supposed to drink 80 oz a day, but I thought 60 would be good enough. The problem is that I don't like to use the restroom on airplanes, and that encourages me to drink less water than I should. By the end of the day, I had only consumed about 30 oz of fluid...not good.

Ready to fly

In just a little more than 24 hours, I'll be boarding a plane for the first time in five years. I'm looking forward to noticing the differences between traveling by air as a plus-sized woman and traveling in my new body.

I wouldn't exactly say I'm ready for the experience. I haven't packed yet. In fact, I still have to do a load of laundry before I can consider packing, and I have two more hours of work before I can even consider heading home. But once I'm on the plane, I'm sure it'll all be worth it.

Check back here periodically over the next few days; I plan to blog during my trip. Maybe I'll even figure out how to use a digital camera and post pictures of the sights I take in.

Who you callin' skinny?

Originally published April 1, 2006, in Our Town for the Tracy Press

Lately, a few well-meaning friends and acquaintances have taken it upon themselves to tell me that I should be done losing weight. Take the janitor at my office. About a month or so ago, she exclaimed that I was too skinny.

“You have no legs,” she cried when she saw me, and then she asked if I was going to lose any more weight. I told her that I would, that I was still considered overweight. “Your doctor can say what he wants, but doctors don’t know everything,” she said. “To me, you are too skinny and you need to stop losing weight.”

This is funny, because according to the body-mass index, I’m at the high end of being overweight. I would have to lose more than 30 more pounds to be at the high end of normal. I mentioned this to my doctor when I was trying to pin her down on a goal weight for me last week at my one-year follow-up.

Aside from refusing to give me a magic number — “I’d rather you settle into a healthy permanent lifestyle and let your weight stabilize from there” — she pondered what makes people feel they can butt into the business of others.

“You know, nobody ever goes up to an obese person and says, ‘Whoa, you’re too fat; you must lose weight.’”

She’s right. What is it that makes the average, polite, tactful person say rude, insensitive things to those who are nearing their weight-loss goals? Or is the person doing the losing just too thin-skinned? I think there are a variety of answers to the questions, but what I think isn’t always correct, so I posed the question in an e-mail to some people I know in the surgical weight-loss community to see what they thought on the subject.

Theresa White of West Virginia had Roux-En-Y gastric bypass in 2003, and she remembers getting the same type of comments when she was about 30 pounds from goal.

“It was usually people who weighed about 120, and sometimes, I wondered if they were just jealous or afraid I would get smaller than they were,” she wrote back. “I just tried not to let it bother me. But it did bother me. It made me wonder how they could think I was so small, yet I still had several pounds to go.”

But Theresa was quick to point out that these hurtful comments didn’t deter her from her goal. Instead, they just made her think a little differently about it.

“Goal for me was no longer a number; it was to be healthy and look healthy.”

Rhonda Velasquez of Tennessee is waiting for weight-loss surgery, but she wrote that she’s experienced the same attitudes from people when she’s lost weight in the past.

“Men never told me I was too skinny, but I noticed women had no trouble discussing my size or weight.”

I have to admit that, like Rhonda, I’m not getting “too skinny” comments from men. Only other women say such things. But I wonder if they are really malicious.

The more I think about it, the more I realize that nobody in my life has ever seen me as thin as I am today. I have always been obese. If I had lost 167 pounds over the course of two or three years, those around me would have had more time to adjust to the new me. And for those who don’t see me every day, the new me can be truly shocking compared to the me of a year ago or more.

To be honest, being called skinny is something I could get used to. It’s a novelty to me, and I believe most people who say it know that and do it to make me feel good. But it also reminds me to pay attention. I don’t want to get so enamored of being thin that I go into dangerous territory and risk my health.

What is perfection?

I spent some time this weekend on one of my favorite WLS message boards. A few of us on the board complimented the site administrator and others for setting such good examples for the rest of us.

The administrator was quick to post that she is far from perfect. She mentioned that she occasionally indulges in a bite or three of some of her old favorite foods that aren't WLS-friendly, such as pizza. Her strategy is to take a bite (or two or three) of the food as it's presented before picking it apart. So, she'll nibble a little of the pizza as is, and then just eat the toppings before trashing the crust.

This works for her, because eating just a bit of the food as is keeps her from feeling deprived.
To me, this sounds like perfection for a WLS patient. Why? Because if I try that same method, I end up eating the topping and then nibbling on the crust. And if I'm not careful, I'd eat the whole slice before realizing it.

I'm just not the three-bite type. Fear enables this trick to work for me when trying cheesecake or chocolate mousse. But for whatever reason, pizza is a weakness -- and three bites is never enough. And that's why this woman is perfect in my book.

WLS and blood pressure

A Reuters story reports that a recent study found a significant reduction in high blood pressure after gastric-bypass surgery.

According to the story, published Monday, March 20: "Patients who had not been taking drugs to treat their hypertension prior to surgery saw a significant easing of their blood pressure afterward, and some of those on anti-hypertension drugs were able to stop taking them, according to a study published in the Archives of Surgery."

So far, I have not been as fortunate as the group studied. My blood pressure, though significantly lower than before I had weight loss surgery, still hovers around 140/100.
Click here to read the whole story.

V-Day indulgence while staying on track

Originally published Feb. 11, 2006, in Our Town for the Tracy Press.

Valentine’s Day is just around the corner, and I’m very excited. Before having gastric-bypass surgery, V-Day excited me because it meant a gold box of See’s Candies truffles, a dozen red roses and dinner at Fabio’s, with the restaurant’s famed chocolate mousse cake for dessert. Cliché, yes, but I loved every bite of it. Roses are still a favorite, but See’s Candies is no longer in the game plan. I’ve become vigilant about avoiding sugar and staying on the straight and narrow path when it comes to eating.

Since moving into a condo a month ago, I’ve also become more domestic. I spend a lot more time in the kitchen, at least. All this time in the kitchen has been good: I eat better, and I’ve had lots of fun experimenting with bariatric-friendly recipes. So it’s no surprise that, when planning a romantic Valentine’s dinner for my husband, I would dig out my dog-eared copy of “Before and After: Living & Eating Well After Weight Loss Surgery” by Susan Maria Leach for inspiration.
I settled on Shrimp Creole, which I’ll serve over rice for my husband and over steamed zucchini for me. Dessert will be chocolate genoise — a very moist cake made with little flour.

The further out I get from surgery, the more I realize that my day-to-day battle with food doesn’t differ much from anyone else’s. I can eat more now than I could six months ago, and that means I now have to carefully watch my portions to avoid overeating. I also have to watch the amount of fat I eat and limit snacking so I don’t go overboard on calorie consumption.

I think a lot of New Year’s resolutions go out the window around Valentine’s Day because people decide to give themselves a free day of eating and never get back on track. Soon, they stop going to the gym, stop caring about what they eat and end up exactly where they were the previous year.

That’s why a recent e-mail from a Weight Watchers representative caught my eye. Instead of admonishing people to steer clear of holiday decadence, WW spokeswoman Wendy Yellin offered tips for building planned indulgence into a weight-loss plan.

“If you avoid things that you love (like chocolate), you set yourself up for failure and bingeing,” Yellin wrote. “We want to teach folks about portion control and how to enjoy life while they are losing weight.”

Yellin has two different ideas of what people could do to prevent Valentine’s Day from getting them off track.The first is about common sense: Exercising a little extra each day for a week can help negate the effects of one day’s indulgence, as can scaling back the calories. If you typically enjoy a 16-ounce Starbucks Coffee mocha, you can save between 300 and 400 calories for each day you abstain. If you skipped Starbucks all next week, you could build up a bank of almost 2,000 calories to allow for any Valentine’s indiscretions.

Yellin’s other idea is to make lower-calorie versions of decadent desserts so you can indulge without shame.The recipes she shares — all available at www.weightwatchers.com — are not bariatric-friendly, but they do look yummy, and I’d love to hear from any readers who test them.

Shrimp Creole
Serves four

Bariatric ½ portion: 117 calories, 3g fat, 7g carbs, 15g protein

1 tablespoon olive oil
½ cup chopped onions
½ cup chopped celery
½ cup diced green bell peppers
2 garlic cloves, chopped
1 16-ounce can diced tomatoes with juice
1 8-ounce can tomato sauce
1 tablespoon Worcestershire sauce
1 teaspoon Creole seasoning blend, such as Tony Chachere’s
2 teaspoons Tabasco sauce, plus extra to taste
1 teaspoon cornstarch
Kosher salt and freshly ground pepper
1½ lbs. large shrimp, peeled and deveined

Saute the onions, celery, peppers and garlic in the olive oil in a covered nonstick skillet over medium heat until the vegetables are softened. Add the tomatoes, tomato sauce, Worcestershire, Creole seasoning and Tabasco. Cover the pan, reduce the heat and simmer for 45 minutes, or until the vegetables are tender. Blend the cornstarch with 1 tablespoon water, stir into the sauce and cook until the mixture thickens. Season with salt, pepper and extra Tabasco to taste. Add the shrimp, cover and simmer four to five minutes, until the shrimp is pink and just cooked through.
Copyright: “Before and After: Living & Eating Well After Weight Loss Surgery” by Susan Maria Leach

Chocolate Genoise
Serves 10

Full portion: 107 calories, 7g fat, 7.5g carbs, 5.2g protein

Take this basic chocolate layer cake over the top by making it into a sugar-free black forest torte. Spoon a little sugar-free pie filling over a wedge of chocolate genoise, dust the edge with confectioners’ sugar and top it with Splenda-sweetened whipped cream. This cake must be refrigerated after the first 24 hours because Splenda is not a preservative.

Vegetable oil cooking spray
½ cup all-purpose flour
½ cup Dutch-processed cocoa (Droste is an excellent brand)
6 large eggs, at room temperature
1 cup Splenda Granular
1 teaspoon vanilla extract
2 tablespoons salted butter, melted

Preheat the oven to 350 degrees Fahrenheit. Spray the bottom and sides of a 9-inch round cake pan with cooking spray, line the bottom with a round of wax paper and spray again.Sift the flour and cocoa together into a large bowl using a fine mesh strainer and set aside.
Combine the eggs and Splenda in a glass bowl, beating with an electric mixer on high until double in volume, about five minutes. Set the bowl over a pan of simmering water to slightly warm the egg mixture and continue beating for another five to seven minutes, until the mixture is the consistency of softly whipped cream. Beat in the vanilla.
Lightly fold the flour and cocoa into the eggs, about one-third at a time, using a large rubber scraper and cutting through the batter, being careful not to deflate the mixture too much. Fold in the butter until just incorporated and pour into the prepared pan.
Bake for 15 minutes, or until a toothpick inserted in the center comes out clean. Cool for 10 minutes, turn out onto a cake rack and carefully peel off the paper.
Copyright: “Before and After: Living & Eating Well After Weight Loss Surgery” by Susan Maria Leach

Chocolate Chip Peanut Butter Pie
Serves 10

7 POINTS* per slice

½ cup reduced-fat peanut butter
4 ounces light cream cheese
4 ounces fat-free cream cheese
12 ounces fat-free sweetened condensed milk
2 tablespoons fresh lemon juice
1 cup light whipped topping, thawed
5 tablespoons mini chocolate chips, divided
6 ounce pie crust

In a large bowl, using an electric mixer, beat together peanut butter and both types of cream cheese until smooth. Gradually beat in milk and lemon juice; fold in whipped topping and 4 tablespoons of mini chocolate chips. Spoon peanut butter mixture into prepared pie crust; sprinkle remaining 1 tablespoon of chocolate chips over top. Cover with plastic wrap and chill in refrigerator at least 4 hours. Chill overnight if you prefer a firmer pie texture.
Copyright: Weightwatchers.com

Chocolate Turtle Cookies
Serves 24

2 POINTS* per cookie

1 cup all-purpose flour
1/3 cup unsweetened cocoa
2/3 cup sugar
¼ cup reduced-calorie margarine
¼ cup fat-free cream cheese
1 large egg white(s)
2 tablespoons fat-free skim milk
1 tsp vanilla extract
1 spray cooking spray
24 pieces caramel candies
24 pieces pecan halves

Combine flour and cocoa in a small bowl; set aside. Beat together sugar, margarine, cream cheese, egg whites, milk and vanilla extract in a large bowl; add flour mixture and blend well. Chill dough at least 30 minutes, or until firm. Preheat oven to 350 degrees Fahrenheit. Lightly coat two baking sheets with cooking spray.Shape dough into 1-inch balls; place on baking sheets about 1 to 2 inches apart. Press a caramel into each cookie and flatten; top each caramel with a pecan half. Bake for 10 minutes. Allow cookies to cool on baking sheets and then remove to a wire rack to cool completely.
Copyright: Weightwatchers.com

Breaking through a plateau

Originally published Jan. 28, 2006, in Our Town for the Tracy Press.

After three long months of hovering around 180, I’ve finally overcome my first plateau since having gastric-bypass surgery. Though I expected my weight loss to stall and knew it was normal, that didn’t make it any easier to deal with.The first month, I was OK with the slowdown. I knew my body needed to catch up and figure out how it wanted to distribute my weight. I welcomed the occasion as a milestone. After the second month of no movement on the scale, I got nervous. Now, I knew I was at a plateau for sure. I started to wonder whether I would lose any more weight at all and how I felt about that. Though I felt great at 180, I decided that I deserved to find out whether losing another 20 or 30 pounds would make me feel even better.

Once I decided I wasn’t ready to stop losing weight, I read up on weight-loss plateaus and how to go about breaking through them. My friends in the surgical weight-loss community suggested logging my food intake and weighing my portions to make sure I wasn’t getting lax on my eating program. They also suggested I go back to eating on a schedule to prevent snacking. I hadn’t been that cautious about my fat intake throughout this process, figuring that I wasn’t eating large enough portions to matter. But I started paying close attention and logging my meals on fitday.com to see my daily nutrient totals. Still, the scale didn’t budge.

I reread all my fitness magazines that had articles on the subject. Most of them had tips similar to my friends’ suggestions. A few suggested changing up my workout routine, saying a plateau is often a sign that the body has gotten used to its fitness demands. I was nonplussed; I had already tried that. But one of the articles had an interesting tip tacked on at the end. It suggested that if all else failed, taking a two-week break from exercise might do the trick. Sometimes, the body just needs a break, it concluded.

That seemed a little too out there for me, but I inadvertently put the tip to the test when I took two weeks off from working out. One week, I was overwhelmed with juggling work and personal commitments and decided to take the gym out of the equation. I had to take the second week off after I pulled a muscle in my back. I hadn’t weighed myself since Dec. 24, because I was too frustrated with the standstill. But I pulled it out last weekend after deciding that I was finally ready to face it. That, and my jeans were starting to get baggy, which made me think there was a good chance the scale would show movement.

Imagine my delight when I stepped on the scale and it registered 171 pounds. Progress, at last. It’ll be interesting to see what happens next. Some bypass patients don’t lose much weight after their first anniversary. Others drop another 40 to 60 pounds. I don’t want to lose 60 pounds; I know that for sure. But I wouldn’t mind seeing another 30 or 35 go bye-bye. Time will tell, that I know. For now, I’ll enjoy going to clothing stores in search of size 12 pants that I can zip up.

There has to be at least one pair out there.

Manufacturers catch up to their supersized consumers

Originally published Jan. 14, 2006, in Our Town for the Tracy Press.

Ever since I can remember, there has been a quiet denial in our society of those who don’t fit within acceptable size standards.I remember desperately wanting a Jockey bra-and-panty set when I was in the fifth grade. All of my friends had them, and they were enviably cute. Not only did the cotton set match, they had the coolest elastic bands that went around the rib cage on the bra and the waist on the panties in contrasting colors. Sadly, Jockey did not make these sets for an almost-200-pound girl. These lingerie sets were more about style than function.

Looking back, I imagine they were created for pre-pubescent girls to emulate their older sisters and moms. But when I was 10, I needed support, and that didn’t come in a stylish manner. I remember begrudgingly nodding when my mom would point out various styles of Playtex’s 18-Hour bras. As if the lace was supposed to make me feel as cool as the other girls at school. I didn’t throw a temper tantrum about not getting what I wanted. I wasn’t a naïve kid. I knew my size limited my choices and that I needed to be happy with what I got.

As I grew up, I became bitter at the industries that seemed to ignore consumers of my size. By the time I was in college, I realized that I had a choice. As a consumer, I could use the power of my dollar to make a statement by supporting size-friendly businesses. An added bonus was that it was less embarrassing to tell my friends I only bought clothes at Lane Bryant because I liked how the store empowered plus-size women to be fashionable instead of admitting that I couldn’t find clothes in regular stores that fit me.

After working in the casual-dining industry, I discovered that most restaurants kept armless chairs handy for larger customers. Before being seated, I would often ask for a table with those chairs. Occasionally, I’d get a blank look from a hostess, but I would stand my ground to prevent the embarrassment of a companion not being able to fit in a booth or wedge herself into a standard-size chair.

Little did I know that manufacturers were starting to take notice of the expanding girth of their consumers.

I bought a brand-new Mitsubishi in 2003. To be honest, I didn’t want another Mitsubishi. I had just totaled a Mirage. It seemed to be a courtship with disaster to replace it with similar car. But when I researched cars, I came upon a startling fact: The 2003 Mitsubishi Lancer had seats a few inches wider than any other car in its class. Not only that, but the seat belts were six inches longer, and there was an extra inch or two of head and leg room. The Lancer became a desired car because it would comfortably accommodate both me and my tall, skinny husband.

Two weeks ago, USA Today reported that other automakers have followed suit. Honda’s 2006 Civic offers front seats almost an inch wider than its 2005 model, according to an article published Jan. 3. Mercedes-Benz and Subaru have done the same in some of their models marketed to U.S. customers.

And it’s not just automakers who’ve noticed their consumer base growing in width. Scripps Howard News Service reports that coffin-makers are increasing the size of their caskets to meet the needs of larger people. It’s a lucrative move, if you believe the Trust for America’s Health study that blames obesity for 400,000 American deaths each year.

Caskets used to be built with a standard interior width of 22 to 24 inches, according to the article published last April. Southern Heritage Casket Co., in Oxford, Ala., offers a line of oversize caskets up to 44 inches wide. Batesville Casket Co. of Indiana offers 13 oversize models under its Dimensions brand.Indiana’s Goliath Casket Co. gives new meaning to the term “supersize.”

The company now offers a 52-inch casket — which is a little bit wider than a standard pickup, according to the company’s owner.

“The 44-inch, 48-inch, 52-inch are for body weights between 650 and 1,200 pounds,” owner Keith Davis said in the SHNS article. “There are extra supports to make sure the weight doesn’t cause the casket to break.”

On one hand, I’m happy to see manufacturers finally realize that our society is not the same size as the celebrities it covets. On the other, I find this trend depressing.I think we should all be accepted for whatever size we are, but the fact that there is a market out there for coffins that support corpses between 650 and 1,200 pounds proves that obesity is truly epidemic — and we pay for it with our lives.