Presented by Karen Donaldson of Excel Weight Loss Solutions
Karen Donaldson is a fitness and nutrition professional who lives in Idaho. She has presented numerous sessions this weekend on fitness, massage and aromatherapy. I had the opportunity today to sit in one of her fitness sessions using exercise balls.
Inflated exercise balls – also called Balance Balls – are commonly used in Pilates and yoga classes, but their usefulness doesn’t end there. I’ve exercised with them regularly for about five years, but mainly just to work my ab muscles. That’s the greatest thing about the balls – because they provide an unbalanced exercise surface, everything you do on them works out your core muscles. A word of warning, though: Sometimes you don’t realize how good of a workout you got until you try to get out of bed the next morning.
Today’s class was popular, with a few participants taking it for a second time. We started by getting a feel for the ball by doing hip rotations and figure-eights. This enabled everyone to get their balance and learn how they moved. Then we walked our feet our in front of us until our lower backs rested on the ball to do sit-ups. We laid across the ball to do push-ups. We laid on the ground and rested our legs on the ball to do pelvic raises. We even did leg raises and played catch using the ball – only we had to catch the ball with our legs.
The class was the fastest hour of my life. Everyone had a great time. The versatility of the ball meant that everyone – regardless of size or fitness level – was able to exercise with it. One man marveled that it was the first time in decades that he was able to do push-ups. Another woman was surprised that she could exercise her abs without having to lie on the floor and struggle with getting up. Others couldn’t believe how much fun it made exercise. As a testament to that, more time was spent laughing than talking, but we each broke a sweat and left feeling the effects of the exercises.
Sunday, August 13, 2006
Emotional Eating
Presented by Dr. Monica Ganz, director of events and support groups for OH
I decided to sit in on today’s emotional eating workshop, because it’s heavy on audience participation and I thought it would be useful to see if any new information would be presented today. If you want to read about the full, prepared presentation, check out Saturday’s post.
This is more of a compilation of notes and tidbits extrapolated from today’s session.
The basic theme of the session is that everyone struggles with emotional eating in some form or another, but the key is how you handle it that determines whether it will derail your success.
Monica is big proponent of finding out your emotional eating triggers and using that knowledge to substitute other behaviors for eating. If you eat because you’re stressed out, find ways to relax yourself (bubble baths, aromatherapy, exercise, etc.). Monica uses a sound machine that lets her feel like she’s near the ocean to have alone time, because she believes we each need time for solace. One participant said she finds crafting (scrapbooking, needlecrafts, etc.) to be relaxing. An added bonus is that it keeps her hands busy, and that means she doesn’t graze or snack. Other ways participants mentioned they relax included drinking a cup of tea, doing crossword puzzles, online chatting, swimming and sunbathing and playing cards.
Another woman brought up a recent “A-ha Moment”: She’s 18 months post-op and has found herself grazing at night. One evening, she got involved cleaning her bedroom and found that it was 11 p.m. and she hadn’t eaten since dinner. It was at that point that she realized that she needed to keep herself busy in the evening to stave off her urge to snack. She said it’s frustrating to have these thinks pop up just when she thinks she has everything figured out, but Monica points out that this is a lifelong process. We’ll always learn new things about ourselves, our triggers and our needs.
For me, I’ve recently discovered that working at home has triggered me to graze at night. I’ve always been the type of person to eat at my desk, and I’m a workaholic – the two habits don’t mesh. What I didn’t realize is that when I started working from home in the evenings a few months ago, my couch became my desk. And when that happened, the urge to snack went from being something that only happened at the office to something that I had almost around the clock – because I no longer felt like I was leaving the office. Monica, who has worked from home for the last 20-plus years, said setting boundaries is the key. She’s had similar issues, which is why she has a dedicated workspace in her home and sets specific work hours so that she officially leaves the office each day. Not a bad idea.
The lone man in the group is considering surgery. He said he has a habit of unwinding in front of the computer and often eats while chatting or playing games. After asking him a few questions, Monica drew from him a big picture of his basic day. He works 5 a.m. to 5 p.m. He said he typically eats breakfast at 10 a.m., lunch at noon, a snack (like a full sandwich) at 5 p.m., dinner at 7 p.m. and then grazes until 3 a.m. some nights.
Monica explained to him that by grouping some meals so close together and then having a huge gap between others leads him to severe highs and lows in his blood sugar. Planning his eating episodes to be equally spaced apart will enable him to keep his blood sugar level and also control his portions.
The subject then turned to cravings. One woman from the group talked about how sometimes her cravings for cake or sweets are so overpowering that she goes ahead and buys the cake, eats one bite and throws it away. She knows she’s spending hundreds of dollars on food that she tosses in the garbage, but it helps her stay on track. She also talked about occasionally getting something that she takes a bite of and then spits out without swallowing it. She enjoys the taste but doesn’t worry about the calories or after-effects of eating off-program foods.
I decided to sit in on today’s emotional eating workshop, because it’s heavy on audience participation and I thought it would be useful to see if any new information would be presented today. If you want to read about the full, prepared presentation, check out Saturday’s post.
This is more of a compilation of notes and tidbits extrapolated from today’s session.
The basic theme of the session is that everyone struggles with emotional eating in some form or another, but the key is how you handle it that determines whether it will derail your success.
Monica is big proponent of finding out your emotional eating triggers and using that knowledge to substitute other behaviors for eating. If you eat because you’re stressed out, find ways to relax yourself (bubble baths, aromatherapy, exercise, etc.). Monica uses a sound machine that lets her feel like she’s near the ocean to have alone time, because she believes we each need time for solace. One participant said she finds crafting (scrapbooking, needlecrafts, etc.) to be relaxing. An added bonus is that it keeps her hands busy, and that means she doesn’t graze or snack. Other ways participants mentioned they relax included drinking a cup of tea, doing crossword puzzles, online chatting, swimming and sunbathing and playing cards.
Another woman brought up a recent “A-ha Moment”: She’s 18 months post-op and has found herself grazing at night. One evening, she got involved cleaning her bedroom and found that it was 11 p.m. and she hadn’t eaten since dinner. It was at that point that she realized that she needed to keep herself busy in the evening to stave off her urge to snack. She said it’s frustrating to have these thinks pop up just when she thinks she has everything figured out, but Monica points out that this is a lifelong process. We’ll always learn new things about ourselves, our triggers and our needs.
For me, I’ve recently discovered that working at home has triggered me to graze at night. I’ve always been the type of person to eat at my desk, and I’m a workaholic – the two habits don’t mesh. What I didn’t realize is that when I started working from home in the evenings a few months ago, my couch became my desk. And when that happened, the urge to snack went from being something that only happened at the office to something that I had almost around the clock – because I no longer felt like I was leaving the office. Monica, who has worked from home for the last 20-plus years, said setting boundaries is the key. She’s had similar issues, which is why she has a dedicated workspace in her home and sets specific work hours so that she officially leaves the office each day. Not a bad idea.
The lone man in the group is considering surgery. He said he has a habit of unwinding in front of the computer and often eats while chatting or playing games. After asking him a few questions, Monica drew from him a big picture of his basic day. He works 5 a.m. to 5 p.m. He said he typically eats breakfast at 10 a.m., lunch at noon, a snack (like a full sandwich) at 5 p.m., dinner at 7 p.m. and then grazes until 3 a.m. some nights.
Monica explained to him that by grouping some meals so close together and then having a huge gap between others leads him to severe highs and lows in his blood sugar. Planning his eating episodes to be equally spaced apart will enable him to keep his blood sugar level and also control his portions.
The subject then turned to cravings. One woman from the group talked about how sometimes her cravings for cake or sweets are so overpowering that she goes ahead and buys the cake, eats one bite and throws it away. She knows she’s spending hundreds of dollars on food that she tosses in the garbage, but it helps her stay on track. She also talked about occasionally getting something that she takes a bite of and then spits out without swallowing it. She enjoys the taste but doesn’t worry about the calories or after-effects of eating off-program foods.
Changing the Paradigm
Presented by Seth Margolies of Weigh2Win
Seth had surgery in 2003 and lost 188 pounds. From the beginning, he said, he understood that there was a high failure rate because people fall into old habits. For him, failure was not an option.
His belief is that unless you create a partnership, you will not have long-term success. You have to change the way you look at your lifestyle. Surgery alone will not keep you thin or in shape, but most surgical facilities don’t offer a fitness component so it falls to the post-op to become accountable for their own success.
Find ways to add activity to your life beyond your structured exercise time:
-Throw away the remote and get up to change the TV
-Get up and walk during commercials
-Take the stairs
-Walk the dog
The American College of Sports Medicine recommends 30 minutes of cardio per day and two days a week of strength-training. Yet only 15% of the U.S. population follows this guideline. The health benefits of three 10-minute spurts is just as effective as one 30-minute session.Seth is a firm believer in strength training because it improves the overall appearance post-ops and can reduce the need for cosmetic surgery. Women who do an hour twice a week of resistance training have less abdominal fat. Strength-training also increases your metabolism and keeps it elevated for longer periods of time.
If you’re inactive after surgery, your ability to eat more food kicks in. And if you fall in that, then you’ll start gaining weight back and be right where you started.
“Surgery is not the end of your battle with obesity," he said. "It’s the beginning of you starting to deal with it. And if you’re lucky, you’ll go into remission.”
Exercise improves mental health.
A Duke study took two groups of clinically depressed patients, gave one batch antidepressants and the other exercised 30 minutes a day. At the end of the study, both groups had 60% of its participants no longer depressed.
Workout tips:
-Start slowly
-Slowly increase the time spent and the intensity
-Set realistic goals that are measurable
-Visualize what you’re going to do
Track your progress
-Wear comfortable clothes
Don’t forget to mix up your routine to curb boredom and also to help your body break through its natural instinct to plateau. Think about variety. Think outside of the box when it comes to exercise. It doesn’t have to be just about going to the gym or following a fitness tape. Some like going to the gym because it’s a social experience. Others hate it because they are embarrassed or overwhelmed. Most people hate exercise because it’s boring, but it doesn’t have to be. You can make a fitness program out of cleaning house, if you do it to music and don’t take breaks. You can walk to run your errands instead of driving.
Losing weight and maintaining weight loss is as simple as calories in vs. calories out. Each of us burns calories at a different rate. Seth says it takes him three hours of exercise to maintain his weight when eating 2,000 calories. Start looking at food in relation to the amount of time required to burn it off.
It’s important to find something you love doing and do that as your exercise. If you like bike riding, make that your routine. If you like skating, then make time to skate regularly. Take dance classes. If you’re having fun, you’re more apt to keep it up.
We’re never going to be perfect, but we each have to do the best that we can and accept that’s our version of success. Changing the paradigm is amount loving yourself enough to put yourself first. Love yourself enough to give your body a break when you need one. Eat nutritious foods, because the better the food is going in, the better your body will run. Love yourself to invest in high-quality food.
Support is important. Surround yourself with loving, supportive people. Don’t waste your time with those who are negative.
Seth had surgery in 2003 and lost 188 pounds. From the beginning, he said, he understood that there was a high failure rate because people fall into old habits. For him, failure was not an option.
His belief is that unless you create a partnership, you will not have long-term success. You have to change the way you look at your lifestyle. Surgery alone will not keep you thin or in shape, but most surgical facilities don’t offer a fitness component so it falls to the post-op to become accountable for their own success.
Find ways to add activity to your life beyond your structured exercise time:
-Throw away the remote and get up to change the TV
-Get up and walk during commercials
-Take the stairs
-Walk the dog
The American College of Sports Medicine recommends 30 minutes of cardio per day and two days a week of strength-training. Yet only 15% of the U.S. population follows this guideline. The health benefits of three 10-minute spurts is just as effective as one 30-minute session.Seth is a firm believer in strength training because it improves the overall appearance post-ops and can reduce the need for cosmetic surgery. Women who do an hour twice a week of resistance training have less abdominal fat. Strength-training also increases your metabolism and keeps it elevated for longer periods of time.
If you’re inactive after surgery, your ability to eat more food kicks in. And if you fall in that, then you’ll start gaining weight back and be right where you started.
“Surgery is not the end of your battle with obesity," he said. "It’s the beginning of you starting to deal with it. And if you’re lucky, you’ll go into remission.”
Exercise improves mental health.
A Duke study took two groups of clinically depressed patients, gave one batch antidepressants and the other exercised 30 minutes a day. At the end of the study, both groups had 60% of its participants no longer depressed.
Workout tips:
-Start slowly
-Slowly increase the time spent and the intensity
-Set realistic goals that are measurable
-Visualize what you’re going to do
Track your progress
-Wear comfortable clothes
Don’t forget to mix up your routine to curb boredom and also to help your body break through its natural instinct to plateau. Think about variety. Think outside of the box when it comes to exercise. It doesn’t have to be just about going to the gym or following a fitness tape. Some like going to the gym because it’s a social experience. Others hate it because they are embarrassed or overwhelmed. Most people hate exercise because it’s boring, but it doesn’t have to be. You can make a fitness program out of cleaning house, if you do it to music and don’t take breaks. You can walk to run your errands instead of driving.
Losing weight and maintaining weight loss is as simple as calories in vs. calories out. Each of us burns calories at a different rate. Seth says it takes him three hours of exercise to maintain his weight when eating 2,000 calories. Start looking at food in relation to the amount of time required to burn it off.
It’s important to find something you love doing and do that as your exercise. If you like bike riding, make that your routine. If you like skating, then make time to skate regularly. Take dance classes. If you’re having fun, you’re more apt to keep it up.
We’re never going to be perfect, but we each have to do the best that we can and accept that’s our version of success. Changing the paradigm is amount loving yourself enough to put yourself first. Love yourself enough to give your body a break when you need one. Eat nutritious foods, because the better the food is going in, the better your body will run. Love yourself to invest in high-quality food.
Support is important. Surround yourself with loving, supportive people. Don’t waste your time with those who are negative.
Saturday, August 12, 2006
Emotional Eating
Presented by Dr. Monica Ganz
Normal eating consists of eating when you’re hungry, eating until you’re satisfied, eating a wide variety of foods, not avoiding foods out of fear and being flexible and varied.
Emotional eating consists of eating in response to feelings instead of hunger, such as:
Stress
Anxiety
Loneliness
Boredom
Anger
Sadness
Depression
PMS
Rewarding yourself
Other ways to deal with emotions and food cravings:
Scrapbooking
Take a walk
Listen to music
Take a bath
Read
Shop
Call a friend
Drink water (dehydration causes hunger rather than thirst)
Avoid high-sugar, high-carb foods
Keep a journal of what you eat and when so you can figure out your triggers. This helps you to break the cycle of unconscious eating. Making a decision to eat also ensures you don’t feel guilty about what you eat.
Change is difficult, but it’s the only thing in life that is consistent. Adapting to change is necessary for success. Before surgery, we were eating ourselves into our graves. We have to change our behavior if we want to be successful. Monica says she still wants to eat everything in front of, but she chooses not to eat it. Surgery is a tool that enables her to stick with that commitment.
Cross-addiction
A lot of post-ops who don’t learn to cope with their emotions will turn to alcohol, sex or other destructive behaviors to replace their food addiction.
Emotional eating issues from attendees:
“Last Supper Syndrome”: Gorging as a pre-op in preparation for surgery. -This is common among pre-ops who fear they are never going to be able to eat their favorite foods again. The important thing is to recognize that it’s normal and just try to make the healthiest choices possible.
Fast food is taboo-Stay away from fast food. That’s a behavior that got us to a point that we’re morbidly obese. Surgery requires an entire lifestyle change, and part of that change requires staying away from the triggers from our pre-op life.
Anger associated with food intolerance-“Nobody warned me that I couldn’t have pasta or tolerate meat.”-“Nobody told me I’d have to eat tofu, but it’s all I can tolerate.”-It’ll take a period of mourning, but eventually you will accept your limitations
Interest from the opposite sex
“I’m the same person I was before but now that I’ve lost weight, everyone has a brother for me to meet. I’d rather just not date.”-You’ll start meeting people who didn’t know you when you were obese, and you’ll start off on different footing with them. Monica said she also doesn’t waste any time with people who didn’t have time for her when she was overweight.-Everyone has emotional baggage, but it’s up to us as individuals to decide whether we hang onto it.
Desire for food hasn’t gone away“I just wish I didn’t still want the food.”-Surgery is a tool that helps us walk away from the table without overeating.
Normal eating consists of eating when you’re hungry, eating until you’re satisfied, eating a wide variety of foods, not avoiding foods out of fear and being flexible and varied.
Emotional eating consists of eating in response to feelings instead of hunger, such as:
Stress
Anxiety
Loneliness
Boredom
Anger
Sadness
Depression
PMS
Rewarding yourself
Other ways to deal with emotions and food cravings:
Scrapbooking
Take a walk
Listen to music
Take a bath
Read
Shop
Call a friend
Drink water (dehydration causes hunger rather than thirst)
Avoid high-sugar, high-carb foods
Keep a journal of what you eat and when so you can figure out your triggers. This helps you to break the cycle of unconscious eating. Making a decision to eat also ensures you don’t feel guilty about what you eat.
Change is difficult, but it’s the only thing in life that is consistent. Adapting to change is necessary for success. Before surgery, we were eating ourselves into our graves. We have to change our behavior if we want to be successful. Monica says she still wants to eat everything in front of, but she chooses not to eat it. Surgery is a tool that enables her to stick with that commitment.
Cross-addiction
A lot of post-ops who don’t learn to cope with their emotions will turn to alcohol, sex or other destructive behaviors to replace their food addiction.
Emotional eating issues from attendees:
“Last Supper Syndrome”: Gorging as a pre-op in preparation for surgery. -This is common among pre-ops who fear they are never going to be able to eat their favorite foods again. The important thing is to recognize that it’s normal and just try to make the healthiest choices possible.
Fast food is taboo-Stay away from fast food. That’s a behavior that got us to a point that we’re morbidly obese. Surgery requires an entire lifestyle change, and part of that change requires staying away from the triggers from our pre-op life.
Anger associated with food intolerance-“Nobody warned me that I couldn’t have pasta or tolerate meat.”-“Nobody told me I’d have to eat tofu, but it’s all I can tolerate.”-It’ll take a period of mourning, but eventually you will accept your limitations
Interest from the opposite sex
“I’m the same person I was before but now that I’ve lost weight, everyone has a brother for me to meet. I’d rather just not date.”-You’ll start meeting people who didn’t know you when you were obese, and you’ll start off on different footing with them. Monica said she also doesn’t waste any time with people who didn’t have time for her when she was overweight.-Everyone has emotional baggage, but it’s up to us as individuals to decide whether we hang onto it.
Desire for food hasn’t gone away“I just wish I didn’t still want the food.”-Surgery is a tool that helps us walk away from the table without overeating.
Low-key lunch
One of my favorite things about the lunches offered at OH events is the fact that they are always bariatric friendly. Today's lunch was tuna salad, chicken salad, green salad, mixed fruit and fat-free Jell-O pudding snacks for dessert.
During lunch, I had the opportunity to meet Dean and Lori Banks, who are also from Tracy. Lori had RNY gastric bypass at Kaiser's Fremont facility three months ago. Since then, she's lost 47 pounds. She hasn't had any complications, and said she's pleased with her results so far. It was quite exciting to run into somebody from home who is on the same path as me.
During lunch, I had the opportunity to meet Dean and Lori Banks, who are also from Tracy. Lori had RNY gastric bypass at Kaiser's Fremont facility three months ago. Since then, she's lost 47 pounds. She hasn't had any complications, and said she's pleased with her results so far. It was quite exciting to run into somebody from home who is on the same path as me.
How our weight loss affects our children
Presented by Dr. Monica Ganz and Nicki Ganz
Nicki was 17 when Monica had RNY gastric-bypass surgery in 2002. Since then, Monica has lost well over 300 pounds.But it wasn’t until a holiday trip a few years ago that Monica realized how her drastic weight loss affected her daughter.
“She walked into the house and hugged my sister, and she hugged her for a long time,” she remembered. “When she was done, she said, ‘Now that’s a mommy hug; I don’t get those anymore.”
Monica says she went to the bathroom and cried and then realized that she had been morbidly obese her daughter’s entire life. And Nicki had to adjust to losing the mother she always knew.
“It took me a really long time be OK with mom sharing clothes with me,” Nicki says.
Monica jumps in saying, “It was so exhilarating to be able to wear my daughter’s clothes that it never occurred to me how it would affect her. It took my husband to say, ‘That’s Nicki’s; you may not wear that,’ for me to realize what I was doing.”
Nicki admits that she still doesn’t like sharing clothes with her mother, especially if she thinks they look better on her mom.“
She’s always bigger than me in my eyes,” Nicki says. “Having her buy clothes the same size as me can be devastating.”
Other changes
Mealtime has also changed for Monica’s family. Though she still cooks for the family, she doesn’t eat everything she makes. She also will often need to leave the dinner table to avoid overeating.
“It’s rare that we have a full-length dinner with the whole family anymore,” Nicki said. “It’s usually just me and my dad left at the table.”
Monica says you have to be careful about the speed in which you make changes for the children. You can’t abruptly limit everyone’s portions just because you’re eating differently. Food changes need to be gradual, especially if the children are older. Younger children are more resilient and accepting of change. You can’t take an older child who you’ve let snack on chips and junk food without oversight and then take it all away from them and expect them not to resist the change.
The whole point, Monica says, is that this process doesn’t only involve us. Many of us think it’s all about us, because surgery is the first thing we’ve done for ourselves. But it involves and affects our children, spouses, siblings, parents and friends.
“Find out what works for your family and stick with it,” Monica said.
She also cautions against over-informing children. Only give them the information they need; otherwise, you may scare them.
“Older children have a harder time with the transition,” Monica said. “When they are in their teens and 20s, you’ll face jealousy and other emotions. It’s very scary from their perspective. The image they’ve always had of their mom doesn’t match what they now see.”
Nicki mentions her trouble with picking her mom out in stores anymore.
“Before, I just looked for the biggest person around, and that was usually Mom,” she said. “Now, I have a hard time finding her.”
Many pre-ops fear lost relationships, which Monica addressed by saying, “You have to remember why you’re doing this.”
Keeping the line of communication open is very important. Don’t just talk about your weight loss, Monica said. Make sure you talk about other stuff.
Nicki also talks about the difficulty adjusting to her mom’s increased activity.
“I wish she’d come back to the family,” she said. “She used to always be at home or around if I needed her. Now, she’s always on the phone or working or away from home. I feel like this new passion has now come first, almost.”
Nicki was 17 when Monica had RNY gastric-bypass surgery in 2002. Since then, Monica has lost well over 300 pounds.But it wasn’t until a holiday trip a few years ago that Monica realized how her drastic weight loss affected her daughter.
“She walked into the house and hugged my sister, and she hugged her for a long time,” she remembered. “When she was done, she said, ‘Now that’s a mommy hug; I don’t get those anymore.”
Monica says she went to the bathroom and cried and then realized that she had been morbidly obese her daughter’s entire life. And Nicki had to adjust to losing the mother she always knew.
“It took me a really long time be OK with mom sharing clothes with me,” Nicki says.
Monica jumps in saying, “It was so exhilarating to be able to wear my daughter’s clothes that it never occurred to me how it would affect her. It took my husband to say, ‘That’s Nicki’s; you may not wear that,’ for me to realize what I was doing.”
Nicki admits that she still doesn’t like sharing clothes with her mother, especially if she thinks they look better on her mom.“
She’s always bigger than me in my eyes,” Nicki says. “Having her buy clothes the same size as me can be devastating.”
Other changes
Mealtime has also changed for Monica’s family. Though she still cooks for the family, she doesn’t eat everything she makes. She also will often need to leave the dinner table to avoid overeating.
“It’s rare that we have a full-length dinner with the whole family anymore,” Nicki said. “It’s usually just me and my dad left at the table.”
Monica says you have to be careful about the speed in which you make changes for the children. You can’t abruptly limit everyone’s portions just because you’re eating differently. Food changes need to be gradual, especially if the children are older. Younger children are more resilient and accepting of change. You can’t take an older child who you’ve let snack on chips and junk food without oversight and then take it all away from them and expect them not to resist the change.
The whole point, Monica says, is that this process doesn’t only involve us. Many of us think it’s all about us, because surgery is the first thing we’ve done for ourselves. But it involves and affects our children, spouses, siblings, parents and friends.
“Find out what works for your family and stick with it,” Monica said.
She also cautions against over-informing children. Only give them the information they need; otherwise, you may scare them.
“Older children have a harder time with the transition,” Monica said. “When they are in their teens and 20s, you’ll face jealousy and other emotions. It’s very scary from their perspective. The image they’ve always had of their mom doesn’t match what they now see.”
Nicki mentions her trouble with picking her mom out in stores anymore.
“Before, I just looked for the biggest person around, and that was usually Mom,” she said. “Now, I have a hard time finding her.”
Many pre-ops fear lost relationships, which Monica addressed by saying, “You have to remember why you’re doing this.”
Keeping the line of communication open is very important. Don’t just talk about your weight loss, Monica said. Make sure you talk about other stuff.
Nicki also talks about the difficulty adjusting to her mom’s increased activity.
“I wish she’d come back to the family,” she said. “She used to always be at home or around if I needed her. Now, she’s always on the phone or working or away from home. I feel like this new passion has now come first, almost.”
One Year+ Post-op: Now what?
Presented by Dr. Monica Ganz, director of events and support groups for OH
Losing weight after the weight loss stops
When you first have surgery, your pouch is about the size of your thumb – mainly because of swelling and irritation from the procedure. The pouch takes a year to 18 months to heal, and healing allows increased food intake.
Another cause of post-op weight gain is that some people start to be less diligent with exercise after a year. It’s typical to consume more a year after surgery. You have more foods available to you, because you’ve spent the first year experimenting with new foods and now know what you can and can’t tolerate. Some people think they are hungrier, which is unlikely if there is decreased activity. Also, many post-ops never experienced true hunger before surgery because they were eating all the time. Monica says they were never truly hungry yet never truly satisfied either. Eating more nutrient-dense foods also leads to eating more calories.
Statistically, 50% of WLS patients will gain back more than 50% of the excess weight lost by five years. Twenty percent will gain back 20% of their weight loss immediately upon reaching their goal weight.
Calories in minus calories out equal a change in weight: When you take in the same number of calories you expend, your weight stays the same; when you eat more calories than you expend, you gain weight; and if you eat fewer calories than you expend, you lose weight.
Inadequate Weight Loss
Calorie intake too high/hunger: Are you planning your meals and spacing them apart appropriately? Are you making good food choices? The surgery doesn’t fail the patient; the patient fails the surgery.
Metabolism too low/hypoglycemia: Are you eating frequently enough? Are you making sure you eat protein-rich foods? You should have six planned eating events per day. That includes meals and protein supplements. Micronutrient deficiencies can also affect metabolism. Skin can be very sensitive to tape two years after surgery because of micronutrient deficiencies.
Why do we stop losing?
Again, it’s about calories in vs. calories out. Each of us has set weight that our body prefers. Not everyone is meant to be a size 4 after surgery. It can be done, but some post-ops find that the sacrifices required to keep body weight that low isn’t worth it in the long run.Eliminate excess or empty calories. Look for ways to cut out unnecessary fat and calories without compromising your nutrition. That means, cut out simple carbohydrates not protein. Don’t go crazy counting calories; realize that you need to improve your lifestyle, you are not on a diet. Pay attention to the glycemic index and pick foods that score lower.
All calories are NOT created equal
Energy density, water content, fiber content, absorption, processing and storage all contribute to the effects of calories on the body.Fruits and veggies are high in fiber and water and low in calories. Crackers, cheese and fatty meats contain a lot of calories relative to how heavy they are.
Foods that have a high water and/or fiber content add bulk to your meals, so you’ll feel satisfied without eating more calories. For example, a quarter-cup of raisins has the same calories as 1.75 cups of grapes, but the grapes will be more filling. 100 calories: 23 M&Ms, quarter-cup of raisins, 5 oz. Jell-O or 2.25 cups of strawberries. Obviously, the strawberries are the best option as a filling food. McDonalds large fries is 540 calories, which is equal to 22 cups of raw broccoli, 135 baby carrots, 17.5 oz. chicken breast or 4.5 whole sweet potatoes.
Soft carbohydrate syndrome
Soft carbs are the arch enemy of WLS patients and are the cause of weight gain or plateau in the majority of patients. If you can crush it, and it crumbles, stay away from it. That’s a sure sign of simple carbohydrates, which travel through the pouch easily and offer very little nutritional value or satisfaction.
Losing weight after the weight loss stops
When you first have surgery, your pouch is about the size of your thumb – mainly because of swelling and irritation from the procedure. The pouch takes a year to 18 months to heal, and healing allows increased food intake.
Another cause of post-op weight gain is that some people start to be less diligent with exercise after a year. It’s typical to consume more a year after surgery. You have more foods available to you, because you’ve spent the first year experimenting with new foods and now know what you can and can’t tolerate. Some people think they are hungrier, which is unlikely if there is decreased activity. Also, many post-ops never experienced true hunger before surgery because they were eating all the time. Monica says they were never truly hungry yet never truly satisfied either. Eating more nutrient-dense foods also leads to eating more calories.
Statistically, 50% of WLS patients will gain back more than 50% of the excess weight lost by five years. Twenty percent will gain back 20% of their weight loss immediately upon reaching their goal weight.
Calories in minus calories out equal a change in weight: When you take in the same number of calories you expend, your weight stays the same; when you eat more calories than you expend, you gain weight; and if you eat fewer calories than you expend, you lose weight.
Inadequate Weight Loss
Calorie intake too high/hunger: Are you planning your meals and spacing them apart appropriately? Are you making good food choices? The surgery doesn’t fail the patient; the patient fails the surgery.
Metabolism too low/hypoglycemia: Are you eating frequently enough? Are you making sure you eat protein-rich foods? You should have six planned eating events per day. That includes meals and protein supplements. Micronutrient deficiencies can also affect metabolism. Skin can be very sensitive to tape two years after surgery because of micronutrient deficiencies.
Why do we stop losing?
Again, it’s about calories in vs. calories out. Each of us has set weight that our body prefers. Not everyone is meant to be a size 4 after surgery. It can be done, but some post-ops find that the sacrifices required to keep body weight that low isn’t worth it in the long run.Eliminate excess or empty calories. Look for ways to cut out unnecessary fat and calories without compromising your nutrition. That means, cut out simple carbohydrates not protein. Don’t go crazy counting calories; realize that you need to improve your lifestyle, you are not on a diet. Pay attention to the glycemic index and pick foods that score lower.
All calories are NOT created equal
Energy density, water content, fiber content, absorption, processing and storage all contribute to the effects of calories on the body.Fruits and veggies are high in fiber and water and low in calories. Crackers, cheese and fatty meats contain a lot of calories relative to how heavy they are.
Foods that have a high water and/or fiber content add bulk to your meals, so you’ll feel satisfied without eating more calories. For example, a quarter-cup of raisins has the same calories as 1.75 cups of grapes, but the grapes will be more filling. 100 calories: 23 M&Ms, quarter-cup of raisins, 5 oz. Jell-O or 2.25 cups of strawberries. Obviously, the strawberries are the best option as a filling food. McDonalds large fries is 540 calories, which is equal to 22 cups of raw broccoli, 135 baby carrots, 17.5 oz. chicken breast or 4.5 whole sweet potatoes.
Soft carbohydrate syndrome
Soft carbs are the arch enemy of WLS patients and are the cause of weight gain or plateau in the majority of patients. If you can crush it, and it crumbles, stay away from it. That’s a sure sign of simple carbohydrates, which travel through the pouch easily and offer very little nutritional value or satisfaction.
Vendor fair
There are about a handful of vendors at today's session, peddling everything from fitness videos and equipment to nutritional supplements and vitamins.
I'll be spending a few minutes with the vendors -- many of whom are leading workshops this weekend -- today and tomorrow to get a little more information on the products they represent and what has led them to make a career out of serving the obese and morbidly obese population.
Bariatric Advantage
Seth Felix is the Bariatric Advantage sales rep attending this weekend’s event. The son of a bariatric surgeon, Seth says he grew up with knowledge and interest in both bariatrics and obesity-related issues. He’s been with Bariatric Advantage for a little less than a year, but is an avid proponent of the products and confesses to snacking on some of the food items at work.
I used Bariatric Advantage vitamins – all of which are chewable – from three months before surgery to about a year afterward. I only switched brands because I was tired of the flavors. I’m happy to see the company debuting new flavors of vitamins and branching out beyond just vitamin and mineral supplements.
Seth told me the company will introduce two new flavors of its already-popular 400mg calcium supplement lozenge. BA already has mint, cinnamon – the top seller – and chocolate. Within the next two months, lemon and sour cherry will also be for sale. Seth excitedly tells me that they taste like Sweet Tarts and will offer a nice change for those who are tired of the original flavors.
BA’s No. 1 selling product, according to Seth, is the orange-flavored multivitamin for gastric-bypass patients. Like me, this is the BA product most bariatric patients start with, because all surgeons recommend a good multivitamin.
Bariatric Advantage also offers a multivitamin for LapBand patients that is called VitaBand. Because Bandsters don’t have to worry about malabsorption, their vitamin and mineral needs are different than bypass patients. Seth says the main difference is that VitaBand has iron included, and it’s the only BA vitamin that comes in watermelon flavor.“
We’re starting to get a lot of complaints from people who want our other multivitamin to be offered in watermelon as well,” he said.
Seth also spent a little time telling me about the company’s new products, such as their food supplements. BA is now offering food items for early post-ops, such as protein supplements and cereal. Packaged for easy travel, the products come in smaller, bariatric-friendly portions. He says the chocolate cereal reminds him of Cocoa Crispies. The cereal comes in chocolate, vanilla and banana – which can be exciting for post-ops sick of just chocolate and vanilla.
Another new product is the Promend AGB, which Seth says can work for bariatric patients but is actually geared toward post-ops who have cosmetic surgery. It’s a drink powder that provides 10g of protein and various herbal supplements to promote healing after cosmetic surgery.“And it tastes just like lemonade,” he said.
Excel Weight Loss Solutions
Karen Donaldson of Pocatello, Idaho, has been in the fitness industry for more than 20 years. As the founder of Excel Weight Loss Solutions, she works with people on nutrition, exercise and weight management.Karen started in the fitness industry focused on the disabled and those of limited mobility, which led to her eventual exposure to the obese and morbidly obese population.
“I’ve never been interested in working with jocks,” Karen said. “Those people will work out no matter what. I’d rather serve the rest of the population. It’s about real life.”
Dr. Monica Ganz, director of events and support groups for ObesityHelp, is a strong supporter of Karen and her program. Monica invited Karen to attend an OH event about 2.5 years ago because she was impressed by the workout video she produced.
“The nice thing about it is that anybody can do it – regardless of their fitness level,” Monica said. “And the videos feature normal-size and overweight models, which is important to me.
That fact has not been lost on Karen.
“Nobody is motivated by seeing somebody prance around in a thong leotard,” Karen said. “But if you look at someone who looks normal or is close to your size, then you believe you can do it; and you’re much more motivated.”
The other reason Monica is a big fan of Karen’s is that her exercise programs use resistance bands and exercise balls.
“This is something that everyone can do,” Monica said. “When I had surgery, it never occurred to me that I could exercise while sitting down. At that time, I couldn’t even walk.”
Also, as someone who travels more than 100 days each year, Monica favors the portability of the resistance bands. They don’t take up much space in the suitcase and are easy to do in hotel rooms.
“This keeps me on track,” she said. “I would never use the hotel gym, but I can use these in the privacy of my own room on my own time.”
Karen, who is presenting workshops this weekend on insulin resistance and strength training and on using exercise balls, also has her own line of aromatherapy products.Monica favors the aromatherapy locket with a piece of felt anointed with Appetite Balance, which helps curb cravings.
I'll be spending a few minutes with the vendors -- many of whom are leading workshops this weekend -- today and tomorrow to get a little more information on the products they represent and what has led them to make a career out of serving the obese and morbidly obese population.
Bariatric Advantage
Seth Felix is the Bariatric Advantage sales rep attending this weekend’s event. The son of a bariatric surgeon, Seth says he grew up with knowledge and interest in both bariatrics and obesity-related issues. He’s been with Bariatric Advantage for a little less than a year, but is an avid proponent of the products and confesses to snacking on some of the food items at work.
I used Bariatric Advantage vitamins – all of which are chewable – from three months before surgery to about a year afterward. I only switched brands because I was tired of the flavors. I’m happy to see the company debuting new flavors of vitamins and branching out beyond just vitamin and mineral supplements.
Seth told me the company will introduce two new flavors of its already-popular 400mg calcium supplement lozenge. BA already has mint, cinnamon – the top seller – and chocolate. Within the next two months, lemon and sour cherry will also be for sale. Seth excitedly tells me that they taste like Sweet Tarts and will offer a nice change for those who are tired of the original flavors.
BA’s No. 1 selling product, according to Seth, is the orange-flavored multivitamin for gastric-bypass patients. Like me, this is the BA product most bariatric patients start with, because all surgeons recommend a good multivitamin.
Bariatric Advantage also offers a multivitamin for LapBand patients that is called VitaBand. Because Bandsters don’t have to worry about malabsorption, their vitamin and mineral needs are different than bypass patients. Seth says the main difference is that VitaBand has iron included, and it’s the only BA vitamin that comes in watermelon flavor.“
We’re starting to get a lot of complaints from people who want our other multivitamin to be offered in watermelon as well,” he said.
Seth also spent a little time telling me about the company’s new products, such as their food supplements. BA is now offering food items for early post-ops, such as protein supplements and cereal. Packaged for easy travel, the products come in smaller, bariatric-friendly portions. He says the chocolate cereal reminds him of Cocoa Crispies. The cereal comes in chocolate, vanilla and banana – which can be exciting for post-ops sick of just chocolate and vanilla.
Another new product is the Promend AGB, which Seth says can work for bariatric patients but is actually geared toward post-ops who have cosmetic surgery. It’s a drink powder that provides 10g of protein and various herbal supplements to promote healing after cosmetic surgery.“And it tastes just like lemonade,” he said.
Excel Weight Loss Solutions
Karen Donaldson of Pocatello, Idaho, has been in the fitness industry for more than 20 years. As the founder of Excel Weight Loss Solutions, she works with people on nutrition, exercise and weight management.Karen started in the fitness industry focused on the disabled and those of limited mobility, which led to her eventual exposure to the obese and morbidly obese population.
“I’ve never been interested in working with jocks,” Karen said. “Those people will work out no matter what. I’d rather serve the rest of the population. It’s about real life.”
Dr. Monica Ganz, director of events and support groups for ObesityHelp, is a strong supporter of Karen and her program. Monica invited Karen to attend an OH event about 2.5 years ago because she was impressed by the workout video she produced.
“The nice thing about it is that anybody can do it – regardless of their fitness level,” Monica said. “And the videos feature normal-size and overweight models, which is important to me.
That fact has not been lost on Karen.
“Nobody is motivated by seeing somebody prance around in a thong leotard,” Karen said. “But if you look at someone who looks normal or is close to your size, then you believe you can do it; and you’re much more motivated.”
The other reason Monica is a big fan of Karen’s is that her exercise programs use resistance bands and exercise balls.
“This is something that everyone can do,” Monica said. “When I had surgery, it never occurred to me that I could exercise while sitting down. At that time, I couldn’t even walk.”
Also, as someone who travels more than 100 days each year, Monica favors the portability of the resistance bands. They don’t take up much space in the suitcase and are easy to do in hotel rooms.
“This keeps me on track,” she said. “I would never use the hotel gym, but I can use these in the privacy of my own room on my own time.”
Karen, who is presenting workshops this weekend on insulin resistance and strength training and on using exercise balls, also has her own line of aromatherapy products.Monica favors the aromatherapy locket with a piece of felt anointed with Appetite Balance, which helps curb cravings.
OH Visalia Conference -- Day 2
I have a few minutes between getting ready and eating breakfast to jot down a few thoughts before heading out to today's session.
I learned something interesting about ObesityHelp during dinner last night. OH does not pay its speakers a dime, which explains why its conferences are so affordable. After all, how many 2.5-day conferences have you attended that only cost about $100? Dr. Monica Ganz, the organization's director of events and support groups, says it's important to her that every penny from events goes toward making the events rewarding for attendees -- not to line the pockets of speakers.
That also explains why some sessions can be a crap shoot. When I was at the Fairfield conference in June, I overheard some attendees complain that certain speakers delivered nothing more than an infomercial for their services or products. I would say that's a gross exaggeration, but I did notice bits of self-promotion here and there during sessions. Knowing that the speakers were not paid in any way explains that, however. You can't expect them to travel to a conference unpaid without hope of some sort of remuneration or exposure to their target market.
As I'm blogging from the sessions today, I'll try my best to make it clear who offers products or services for sale so readers can make the most informed decisions regarding whether to believe the opinions of the speakers.
Oh, and keep reading throughout the weekend for my review of the numerous samples given out throughout the conference. For example, attendees last night received full-size samples of AchievOne coffee-flavored protein drinks, Power Crunch protein bars, and various other bariatric-friendly snacks.
I learned something interesting about ObesityHelp during dinner last night. OH does not pay its speakers a dime, which explains why its conferences are so affordable. After all, how many 2.5-day conferences have you attended that only cost about $100? Dr. Monica Ganz, the organization's director of events and support groups, says it's important to her that every penny from events goes toward making the events rewarding for attendees -- not to line the pockets of speakers.
That also explains why some sessions can be a crap shoot. When I was at the Fairfield conference in June, I overheard some attendees complain that certain speakers delivered nothing more than an infomercial for their services or products. I would say that's a gross exaggeration, but I did notice bits of self-promotion here and there during sessions. Knowing that the speakers were not paid in any way explains that, however. You can't expect them to travel to a conference unpaid without hope of some sort of remuneration or exposure to their target market.
As I'm blogging from the sessions today, I'll try my best to make it clear who offers products or services for sale so readers can make the most informed decisions regarding whether to believe the opinions of the speakers.
Oh, and keep reading throughout the weekend for my review of the numerous samples given out throughout the conference. For example, attendees last night received full-size samples of AchievOne coffee-flavored protein drinks, Power Crunch protein bars, and various other bariatric-friendly snacks.
Friday, August 11, 2006
Changing places
Because of hacking issues associated with Movable Type (the program used for this blog), the Tracy Press will stop hosting blogs. Instead, the Press will link to external blogs.
The good news is that anyone within the Tracy Press circulation area may now ask to have their blog linked from our Web site (E-mail tluiz@tracypress.com to make such a request).
The bad news is that my blog address will change this week. As far as I know, the plan is to keep all previously posted entries up as read-only files until I'm able to move all postings over to the new site. However, I'm not sure how long it'll take me to complete my transition. In the interest of serving readers best, I'll start uploading my oldest entries to the new site first. I won't publish new material until the transition is complete.
Click here to view and bookmark my new blog site. I'm hope that using Blogger will make this column more user-friendly to visitors. Please let me know what you think.
The good news is that anyone within the Tracy Press circulation area may now ask to have their blog linked from our Web site (E-mail tluiz@tracypress.com to make such a request).
The bad news is that my blog address will change this week. As far as I know, the plan is to keep all previously posted entries up as read-only files until I'm able to move all postings over to the new site. However, I'm not sure how long it'll take me to complete my transition. In the interest of serving readers best, I'll start uploading my oldest entries to the new site first. I won't publish new material until the transition is complete.
Click here to view and bookmark my new blog site. I'm hope that using Blogger will make this column more user-friendly to visitors. Please let me know what you think.
Movie Night -- "Super Size Me"
Tonight's session ends with a screening of "Super Size Me," the now famous documentary by Morgan Spurlock. Spurlock spent 30 days eating nothing but McDonalds food. During that time, he gained about 30 pounds and suffered serious health problems.
This is the third time I've seen the movie. The first time was a year before my gastric-bypass surgery, and it was then that I swore off McDonalds. I had it at home to watch the day I was released from the hospital. It helped strengthen my resolve as my mother and husband sat on either side of me eating Jack in the Box for dinner.
It's a film I highly recommend watching, if for no other reason than to understand why this country has more than 60% of its population who are considered obese.
This is the third time I've seen the movie. The first time was a year before my gastric-bypass surgery, and it was then that I swore off McDonalds. I had it at home to watch the day I was released from the hospital. It helped strengthen my resolve as my mother and husband sat on either side of me eating Jack in the Box for dinner.
It's a film I highly recommend watching, if for no other reason than to understand why this country has more than 60% of its population who are considered obese.
Importance of Vitamins and Minerals after Gastric Bypass Surgery
Led by Dr. Monica Ganz
People who’ve had malabsorptive procedures (Roux En Y and duodenal switch) are in danger of vitamin and mineral deficiencies because certain vitamins and minerals cannot be absorbed by the new digestive tract through ingestion.
Vitamins are essential for the release of energy from carbohydrates, fats and proteins. B-12, for example, is a vitamin that can’t be replenished once a person has become truly deficient in it.
Minerals don’t furnish energy but are vital in many other physiologic functions. The body stores and reuses minerals so deficiencies aren’t easily detected.
Many post-ops become deficient in iron and calcium.
Iron
Iron deficiency occurs because the pouch empties too quickly for iron to be absorbed and because RNY and DDS patients have their duodenum – where 50% of iron absorption takes place – bypassed. Symptoms of iron deficiency include fatigue, feeling cold, pica (compulsive eating of non-food items), tongue fissuring and pagophagia (compulsive eating of ice).
Supplements should be in the form of 18mg of ferrous fumerate or amino-iron, which is most absorbable. Taking iron with vitamin C (such as diluted orange juice or even a chewable vitamin C) to help its absorption. Food sources of iron include liver, oysters, shellfish, organ meats, lean meats, poultry and fish (best meat sources), dried beans and vegetables (best plant sources), egg yolk, dried fruits, dark molasses, whole grains and enriched breads and cereals.
Calcium
Calcium deficiency occurs because post-ops can’t eat enough of calcium-rich foods, and the mineral is absorbed in the duodenum. Symptoms of calcium deficiency include fragile bones and hypertension.Supplements should include 1200mg of calcium citrate (plus vitamin D) per day, four servings of dairy products per day. For each missed serving of dairy products, supplement with an additional 500mg of calcium citrate. This is why many post-ops are encouraged to take up to 2400mg per day.Another problem is that calcium deficiency is hard to detect because the body will leach the necessary calcium from the bones. Dexa bone-density tests are the best way to find out whether a post-op’s body is leaching calcium from the bones. Some people also notice teeth problems, such as a loss of enamel.
Vitamins most commonly found deficient in post-ops are vitamin B1 (Thiamin), vitamin B-12 and folic acid.
Thiamin
Thiamin is necessary for the breakdown of glucose for energy, nerve function, good digestion, normal appetite and good mental outlook. Deficiency is rare in the U.S., except in alcoholics. Symptoms include beri beri, fatigue, poor appetite, constipation, depression, etc. Supplementation is as easy as taking a chewable multivitamin (Bariatric Advantage, Optisource, etc.).
Vitamin B-12
Vitamin B-12 aids in the formation of mature red blood cells, synthesis of DNA, stimulates appetite, promotes growth and releases energy. Food sources include liver, kidney, dairy products, fish, clams, oysters, salmon and sardines.Gastric bypass post-ops MUST supplement with B-12 because the pouch doesn’t supply the intrinsic factor required for absorption. Signs of deficiency include pernicious anemia, tiredness and neurological disorders.Supplements can be by mouth, injection or nasal spray. Monthly injections are the safest best.
Folic acid
Folic acid is necessary for formation of red blood cells. Deficiency happens because of poor dietary intake, low iron and alcoholism. Symptoms of deficiency include rapid heartbeat, fatigue, anorexia, pale skin, paranoia, or sore, inflamed tongue. Food sources include soy, leafy greens, organ meats, mushrooms, oatmeal, red beans and wheat. Supplementation is usually as easy as taking a good multivitamin.
People who’ve had malabsorptive procedures (Roux En Y and duodenal switch) are in danger of vitamin and mineral deficiencies because certain vitamins and minerals cannot be absorbed by the new digestive tract through ingestion.
Vitamins are essential for the release of energy from carbohydrates, fats and proteins. B-12, for example, is a vitamin that can’t be replenished once a person has become truly deficient in it.
Minerals don’t furnish energy but are vital in many other physiologic functions. The body stores and reuses minerals so deficiencies aren’t easily detected.
Many post-ops become deficient in iron and calcium.
Iron
Iron deficiency occurs because the pouch empties too quickly for iron to be absorbed and because RNY and DDS patients have their duodenum – where 50% of iron absorption takes place – bypassed. Symptoms of iron deficiency include fatigue, feeling cold, pica (compulsive eating of non-food items), tongue fissuring and pagophagia (compulsive eating of ice).
Supplements should be in the form of 18mg of ferrous fumerate or amino-iron, which is most absorbable. Taking iron with vitamin C (such as diluted orange juice or even a chewable vitamin C) to help its absorption. Food sources of iron include liver, oysters, shellfish, organ meats, lean meats, poultry and fish (best meat sources), dried beans and vegetables (best plant sources), egg yolk, dried fruits, dark molasses, whole grains and enriched breads and cereals.
Calcium
Calcium deficiency occurs because post-ops can’t eat enough of calcium-rich foods, and the mineral is absorbed in the duodenum. Symptoms of calcium deficiency include fragile bones and hypertension.Supplements should include 1200mg of calcium citrate (plus vitamin D) per day, four servings of dairy products per day. For each missed serving of dairy products, supplement with an additional 500mg of calcium citrate. This is why many post-ops are encouraged to take up to 2400mg per day.Another problem is that calcium deficiency is hard to detect because the body will leach the necessary calcium from the bones. Dexa bone-density tests are the best way to find out whether a post-op’s body is leaching calcium from the bones. Some people also notice teeth problems, such as a loss of enamel.
Vitamins most commonly found deficient in post-ops are vitamin B1 (Thiamin), vitamin B-12 and folic acid.
Thiamin
Thiamin is necessary for the breakdown of glucose for energy, nerve function, good digestion, normal appetite and good mental outlook. Deficiency is rare in the U.S., except in alcoholics. Symptoms include beri beri, fatigue, poor appetite, constipation, depression, etc. Supplementation is as easy as taking a chewable multivitamin (Bariatric Advantage, Optisource, etc.).
Vitamin B-12
Vitamin B-12 aids in the formation of mature red blood cells, synthesis of DNA, stimulates appetite, promotes growth and releases energy. Food sources include liver, kidney, dairy products, fish, clams, oysters, salmon and sardines.Gastric bypass post-ops MUST supplement with B-12 because the pouch doesn’t supply the intrinsic factor required for absorption. Signs of deficiency include pernicious anemia, tiredness and neurological disorders.Supplements can be by mouth, injection or nasal spray. Monthly injections are the safest best.
Folic acid
Folic acid is necessary for formation of red blood cells. Deficiency happens because of poor dietary intake, low iron and alcoholism. Symptoms of deficiency include rapid heartbeat, fatigue, anorexia, pale skin, paranoia, or sore, inflamed tongue. Food sources include soy, leafy greens, organ meats, mushrooms, oatmeal, red beans and wheat. Supplementation is usually as easy as taking a good multivitamin.
Dining among peers
We just got back from dinner. There are about 10 people at tonight’s session, which makes for a close, intimate experience. I’ve gotten the chance to truly get to know each woman here. Two women have come from out of state for the conference – one from as far as Minnesota. The rest are from up and down the state.Our introductory session was just that, an introduction to the weekend’s activities. We’ve had numerous opportunities to ask whatever we want and get in-depth answers from Dr. Monica Ganz, director of events and support groups for ObesityHelp.The best thing, though, for me has been the experience of eating with other bariatric post-ops. In my daily life, I tend to eat with non-ops and can forget myself when eating. Sitting around a dinner table with post-ops was amazing, because we had a lot of similar habits. Many of us ordered soup for dinner. There were lots of offers to share food. And everyone ate at a similar speed. I didn’t have to worry about being the slow poke who held everyone up or having anybody comment on how much I ate (or didn’t, for that matter).
In Central CA for OH Conference
I've arrived safe and sound for the ObesityHelp Regional Conference in Visalia.
The conference begins today and lasts through Sunday. According to the OH Web site, 70 tickets are still available for the weekend. Visalia is only about 2.5 hours from Tracy if you take I-5 down and cut through Los Banos. However, there is some construction along Highway 152 in Los Banos. If you decide to drive that way, pack plenty of patience.
I'm staying in Tulare, at the Charter Inn & Suites. About 15 minutes from the Presidian Hotel where the conference is held, the hotel I'm at offers me a nice break from all the excitement that is often found at convention sites. And I happen to really like the staff here.
Today's session begins at 3 p.m. with registration and a vendor fair until 4 p.m.
Dr. Monica Ganz will host a Q&A session from 3:30 to 5 p.m. Monica is a social psychologist who had gastric-bypass surgery in 2002. She has since lost more than 320 pounds and now works for ObesityHelp. Monica is someone whom I greatly admire. Her warmth and compassion are effusive in her discussions, yet she never sugar coats the situation either. Her honesty is appreciated and accepted because it's always tempered with the compassion that comes from someone who has been morbidly obese and changed her life.
Dinner is from 5 to 7 p.m., during which time I'll try to find some place yummy to eat and also take some time to update my blog.
After dinner, the evening sessions will begin and last until 9 p.m.
Check back later today for more updates.
The conference begins today and lasts through Sunday. According to the OH Web site, 70 tickets are still available for the weekend. Visalia is only about 2.5 hours from Tracy if you take I-5 down and cut through Los Banos. However, there is some construction along Highway 152 in Los Banos. If you decide to drive that way, pack plenty of patience.
I'm staying in Tulare, at the Charter Inn & Suites. About 15 minutes from the Presidian Hotel where the conference is held, the hotel I'm at offers me a nice break from all the excitement that is often found at convention sites. And I happen to really like the staff here.
Today's session begins at 3 p.m. with registration and a vendor fair until 4 p.m.
Dr. Monica Ganz will host a Q&A session from 3:30 to 5 p.m. Monica is a social psychologist who had gastric-bypass surgery in 2002. She has since lost more than 320 pounds and now works for ObesityHelp. Monica is someone whom I greatly admire. Her warmth and compassion are effusive in her discussions, yet she never sugar coats the situation either. Her honesty is appreciated and accepted because it's always tempered with the compassion that comes from someone who has been morbidly obese and changed her life.
Dinner is from 5 to 7 p.m., during which time I'll try to find some place yummy to eat and also take some time to update my blog.
After dinner, the evening sessions will begin and last until 9 p.m.
Check back later today for more updates.
Thursday, August 03, 2006
Perks of the flu
There's a line in "The Devil Wears Prada" where a characters says, "I'm just a stomach flu away from my goal weight." In my former life as a morbidly obese person, I would never have understood how true that could be.
But as a "normal-size" person, I smirk at the truth of such a comment. I'm just getting over my first nasty illness since having gastric-bypass surgery almost 18 months ago. After taking a week off work and spending almost two weeks subsisting just on liquids, I'm finally on the road to recovery from what had to be the most aggressive stomach virus known to man -- or at least to me.
The week before I came down with this bug, I weighed myself at home and found I was holding steady at 158 pounds as I had for the last few months. When I went to the doctor for my stomach ailment, I weighed 158 on his office scale. I thought that was odd. After all, doctor's office scales tend to weigh on the heavy side because they get jostled so much. But I figured the scale must have been recently calibrated. But after five days of struggling to get in 300 calories a day, I noticed my clothes were getting baggy. I hopped on the scale one morning and was surprised to see it register at 150. I didn't think much of it, figuring I'd put at least some of the weight back on when I started eating solid food again.
But here I am, a week into eating solids, and not only have I not put the weight back on, but I've managed to drop another couple of pounds. And believe me, at this size, 12 pounds is really noticeable. My size 10 pants are loose, and I've gotten tons of recent remarks about looking thinner. And to think, I have the stomach flu to thank for it all.
But as a "normal-size" person, I smirk at the truth of such a comment. I'm just getting over my first nasty illness since having gastric-bypass surgery almost 18 months ago. After taking a week off work and spending almost two weeks subsisting just on liquids, I'm finally on the road to recovery from what had to be the most aggressive stomach virus known to man -- or at least to me.
The week before I came down with this bug, I weighed myself at home and found I was holding steady at 158 pounds as I had for the last few months. When I went to the doctor for my stomach ailment, I weighed 158 on his office scale. I thought that was odd. After all, doctor's office scales tend to weigh on the heavy side because they get jostled so much. But I figured the scale must have been recently calibrated. But after five days of struggling to get in 300 calories a day, I noticed my clothes were getting baggy. I hopped on the scale one morning and was surprised to see it register at 150. I didn't think much of it, figuring I'd put at least some of the weight back on when I started eating solid food again.
But here I am, a week into eating solids, and not only have I not put the weight back on, but I've managed to drop another couple of pounds. And believe me, at this size, 12 pounds is really noticeable. My size 10 pants are loose, and I've gotten tons of recent remarks about looking thinner. And to think, I have the stomach flu to thank for it all.
Tuesday, August 01, 2006
OH Conference in Visalia, CA
Obesity Help will have its last Northern Californai regional conference from Aug. 11 through 13 in Visalia.
I'm looking forward to attending and blogging from the event as I did at the Fairfield conference in June. The Visalia event promises to be even bigger and better. Tickets are still available and can be purchased by clicking the above link.
I hope to see you there.
I'm looking forward to attending and blogging from the event as I did at the Fairfield conference in June. The Visalia event promises to be even bigger and better. Tickets are still available and can be purchased by clicking the above link.
I hope to see you there.
Saturday, July 01, 2006
Risks of dying from obesity higher than that of bariatric surgery
Researchers from the Hospital of Saint Raphael in New Haven, Conn., report that the risk of dying from morbid obesity is 50 to 85 percent higher than the risk of dying from bariatric surgery.Scientists announced the study findings at the 23rd Annual Meeting of the American Society for Bariatric Surgery in San Francisco this past week.
“Morbid obesity is a killer disease that requires intervention,” said Dr. Randolph B. Reinhold, lead author and chairman of Saint Raphael’s surgery department, in a prepared statement. “This study puts into perspective that for some people, the risk of not having surgery is higher than having surgery.”
According to a press release from the society, the study evaluated 1,185 morbidly obese patients from 1997 to 2004. Of those people, 908 had bariatric surgery and 112 did not. The remainder were not available for the study. Over the course of the study, 2.9 percent of the surgery recipients died compared to 14.3 of those who did not have surgery.
“Bariatric surgery has been proven to be effective in achieving sustainable weight loss in people with morbid obesity and reducing or eliminating obesity-related diseases,” Reinhold said.
“Morbid obesity is a killer disease that requires intervention,” said Dr. Randolph B. Reinhold, lead author and chairman of Saint Raphael’s surgery department, in a prepared statement. “This study puts into perspective that for some people, the risk of not having surgery is higher than having surgery.”
According to a press release from the society, the study evaluated 1,185 morbidly obese patients from 1997 to 2004. Of those people, 908 had bariatric surgery and 112 did not. The remainder were not available for the study. Over the course of the study, 2.9 percent of the surgery recipients died compared to 14.3 of those who did not have surgery.
“Bariatric surgery has been proven to be effective in achieving sustainable weight loss in people with morbid obesity and reducing or eliminating obesity-related diseases,” Reinhold said.
Friday, June 30, 2006
Peach Cobbler Recipe
I believe I have perfected my cobbler recipe. Beau says it's a keeper...we'll see what his parents say when I serve it for dessert tomorrow. I would rather use Nature's Sweet instead of Splenda, but since I didn't have any, this is what I went with:
Tonya' s version of Grandma's Peach Cobbler
1/4 cup butter (1/2 stick)
1/2 cup almond flour
1/2 cup flour
1-1/2 teaspoons baking powder
1/2 teaspoon salt
1 cup Splenda
3/4 cup milk
3 cups peeled and sliced fresh peaches, with their juices
Preheat oven to 350°F.
Put the butter in a 9x13-inch Pyrex baking dish and put the dish in the preheating oven. While the butter is melting, mix up the batter by combining the flour, baking powder, salt, sugar and milk.
When the butter is completely melted, remove the pan and pour the batter into the melted butter. Then, carefully spoon the peaches and juice evenly over the batter. Return dish to the oven and bake for 45 minutes to an hour.
Tonya' s version of Grandma's Peach Cobbler
1/4 cup butter (1/2 stick)
1/2 cup almond flour
1/2 cup flour
1-1/2 teaspoons baking powder
1/2 teaspoon salt
1 cup Splenda
3/4 cup milk
3 cups peeled and sliced fresh peaches, with their juices
Preheat oven to 350°F.
Put the butter in a 9x13-inch Pyrex baking dish and put the dish in the preheating oven. While the butter is melting, mix up the batter by combining the flour, baking powder, salt, sugar and milk.
When the butter is completely melted, remove the pan and pour the batter into the melted butter. Then, carefully spoon the peaches and juice evenly over the batter. Return dish to the oven and bake for 45 minutes to an hour.
Thursday, June 29, 2006
Settling in
Just got in from the American Society of Bariatric Surgeons' Annual Convention in San Francisco.
"Information Overload" are the two best words to describe how I feel right now, but I learned some amazing information. I learned about new procedures in the field of bariatrics, saw various vitamin and protein supplements.
I saw Carnie Wilson! She's absolutely beautiful. Celebrity Fit Club must have been a success for her, because she's now at her goal weight.
I'll report more over the next several days.
"Information Overload" are the two best words to describe how I feel right now, but I learned some amazing information. I learned about new procedures in the field of bariatrics, saw various vitamin and protein supplements.
I saw Carnie Wilson! She's absolutely beautiful. Celebrity Fit Club must have been a success for her, because she's now at her goal weight.
I'll report more over the next several days.
Tuesday, June 27, 2006
Study suggests 10 new obesity causes
A study found obesity may not just be about eating and lifestyle.
Check out this article:http://www.cbsnews.com/stories/2006/06/27/health/webmd/main1757772.shtml
Check out this article:http://www.cbsnews.com/stories/2006/06/27/health/webmd/main1757772.shtml
Monday, June 26, 2006
Samples-o-rama
I've been busy trying all of the yummy samples I picked up at Saturday's OH seminar.
Some quick notes:
Body Choice Premium High Protein Pudding
I was not impressed by this protein pudding. First, I don't consider 14 grams of protein to be that high. I tried the chocolate flavor, and it was gelatinous and a bit grainy. There was a distinct protein aftertaste, and I didn't like the feeling on my tongue after eating it. Personally, I much prefer Snack & Slim pudding, which provides a creamy 20 grams of protein in a 5 oz. serving and has no icky aftertaste.
Bariatric Advantage Vitamins
BA has reformulated its vitamins, which means fewer are necessary each day. The taste of the chewables is just as good as before, except the flavor of the iron has improved dramatically (I love the new passion fruit flavor).
Achiev One
As I've said before, my pouch can't handle the coffee in these 20-gram protein mocha-style drinks. But my husband thoroughly enjoyed the hazelnut version I brought back with me. He said it's even better than Starbucks Frappucinos.
Some quick notes:
Body Choice Premium High Protein Pudding
I was not impressed by this protein pudding. First, I don't consider 14 grams of protein to be that high. I tried the chocolate flavor, and it was gelatinous and a bit grainy. There was a distinct protein aftertaste, and I didn't like the feeling on my tongue after eating it. Personally, I much prefer Snack & Slim pudding, which provides a creamy 20 grams of protein in a 5 oz. serving and has no icky aftertaste.
Bariatric Advantage Vitamins
BA has reformulated its vitamins, which means fewer are necessary each day. The taste of the chewables is just as good as before, except the flavor of the iron has improved dramatically (I love the new passion fruit flavor).
Achiev One
As I've said before, my pouch can't handle the coffee in these 20-gram protein mocha-style drinks. But my husband thoroughly enjoyed the hazelnut version I brought back with me. He said it's even better than Starbucks Frappucinos.
Sunday, June 25, 2006
ASBS Annual Convention
The American Society of Bariatric Surgeons is gathering in San Francisco this week for its national convention. The convention includes lots of classes for surgeons to learn new surgical techniques as well as other things related to bariatrics. But the highlight of the event is the exhibitors trade show that is from Wednesday through Friday. Day passes for the trade show can be purchased by the general public for $100. I can't wait to check it out myself. I'll be there Thursday.
Saturday, June 24, 2006
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.
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.
Friday, June 23, 2006
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.
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.
Thursday, June 22, 2006
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!
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!
Wednesday, June 21, 2006
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.
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.
Tuesday, June 20, 2006
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.
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.
Monday, June 19, 2006
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.
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.
Sunday, June 18, 2006
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.
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.
Saturday, June 17, 2006
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.
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.
Friday, June 16, 2006
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.
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.
Wednesday, June 14, 2006
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.
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
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.
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.
Tuesday, June 13, 2006
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.
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.
Monday, June 12, 2006
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.
"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.
Sunday, June 11, 2006
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.
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.
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