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Monday, February 28, 2005


For me, it's the perfect food for my little system. High protein. Easy to chew and swallow. Full of flavor. This is the recipe I've been using for several years now from Cooking Light magazine. It is the Rolls-Royce of meatloaf because it has not one, but two cheeses. Give it a try!

Please note, the nutritional content is for a "normal" serving - we all know a WLS serving is significantly less, but I wanted to include so you have a good idea what you're getting. Give it a try and let me know if you like it! Email me!

Double-Cheese Meat Loaf

Cooking spray
1 cup chopped onion
6 tablespoons ketchup, divided
2 tablespoons Dijon mustard, divided
1 cup (4 ounces) shredded part-skim mozzarella cheese
1/2 cup Italian-seasoned breadcrumbs
1/4 cup chopped fresh parsley
2 tablespoons grated Parmesan cheese
1 teaspoon dried oregano
1/4 teaspoon black pepper
1 large egg, lightly beaten
1/2 pound lean ground beef
1/2 pound lean ground pork
1/2 pound lean ground veal

Preheat oven to 375°.
Place a medium nonstick skillet coated with cooking spray over medium-high heat. Add the chopped onion, and sauté for 3 minutes. Combine the onion, 1/4 cup ketchup, 1 tablespoon mustard, mozzarella, and next 6 ingredients (mozzarella through egg) in a large bowl. Crumble ground meats over cheese mixture; stir just until blended.

Pack mixture into an 8 x 4-inch loaf pan coated with cooking spray. Combine 2 tablespoons ketchup and 1 tablespoon mustard; spread over top of loaf. Bake at 375° for 1 hour or until meat thermometer registers 160°. Let meat loaf stand in pan 10 minutes.

Remove meat loaf from pan, and cut into 12 slices.

Note: Substitute lean ground beef for the ground veal and pork, if desired.

Yield: 6 servings (serving size: 2 slices)

CALORIES 329 (38% from fat); FAT 13.9g (satfat 5.6g, monofat 5.3g, polyfat 1.2g); PROTEIN 33.8g; CARBOHYDRATE 15.1g; FIBER 1g; CHOLESTEROL 133mg; IRON 2.4mg; SODIUM 801mg; CALCIUM 196mg;

Sunday, February 27, 2005

Is Snacking THAT Bad?

Snacking is the easiest of the four rules to break, and the worst possible thing you can do to yourself. Weight loss surgery patients who snack gain weight. Snackers risk severe swings in blood sugar levels and glucose overdose. Snackers are not moving forward to the healthy life that surgery makes possible. Snackers will be self-loathing because they know they are causing harm to their body and defeating the bariatric system.

After surgery there is no physiological reason for snacking. When a patient eats three protein-rich meals a day the body’s fuel requirements are met and satiation results. Hunger does not occur if water is sipped throughout the day. If a patient is taking vitamins regularly she will not be nutritionally wanting. Given that, patients who take to snacking are doing so out of habit; a habit that contributed to obesity.

Much has been written about the emotional connection to eating – we eat because we are unfulfilled, looking for comfort, loneliness, or suffering stress. We are bored, worried, angry or sad. Something is missing in our life and we are eating to fill the void. I say baloney! Before surgery I ate unchecked because I love food. Sweet, salty, smooth, sticky: I love it all! I ate when I wasn’t hungry because the food was there. That’s why I was fat.

It is true that eating is often connected to the emotions, but not necessarily negative emotions associated with the inability to cope with life. Think wedding – there’s the cake; think funeral – there’s the potluck; think Father’s Day – there’s the barbeque; think Christmas – there’s the feast. The media would have us believe that the obese are people whose only coping skill for life’s daily challenges is a doughnut in each hand. But I know of many overweight people who are highly regarded professionals – lawyers, engineers, teachers, chefs, physicians, and writers – all quite capable of coping with life’s emotional dilemmas. I suggest that very few obese people are as emotionally incompetent as popular wisdom would have us believe. Obese people are overweight because they love food, eat too much, live in a society where food is ever present, have a genetic tendency to store fat and have found it discouraging to incorporate exercise into their lives.

Pre-operative patients are screened for their mental health, specifically their ability to cope with life’s ups and downs. If you passed the screening to have surgery you are mentally sound and capable of dealing with little upsets without running to the refrigerator or bakery for comfort. The public at large has underestimated your power to survive and thrive.

Successful patients understand that snacking is bariatric purgatory. When they begin to snack weight loss will cease and weight gain will certainly result. Successful weight loss patients – those who maintain the weight loss years after surgery – do not snack.

Snacking allows a patient to return to a caloric rich diet in spite of the tinny tummy system. One patient found her system tolerated graham crackers and they satisfied her life-long habit: the after school (work) snack. So, for a time, after work each day she would nibble on a graham cracker. Then it was two crackers, and within weeks she was having 8 graham crackers – about 1000 empty calories every afternoon. She added a cup of coffee to her "after school snack" and her weight loss stopped – in fact, she started gaining weight. The graham crackers and coffee was a perfect combination to defeat the system. She was making a slurry in her tiny tummy that passed through the stoma quickly so she didn’t ever feel full and could continue to eat the crackers with abandon. When, at the advice of her bariatric counselor, she stopped this behavior her weight loss resumed.

(Update: 4/11/05 - - a reader commented that 8 graham crackers is about 240 calories. Graham crackers are in sheets of 4-crackers, so two sheets is a serving of 8 crackers- about 240 calories. I should have specified that my friend was eating 8 sheets of graham crackers - 32 crackers or 4 servings - roughly 1,000 empty calories. Thank you, reader, for pointing this out.)

Almost every patient, in the adolescent phase, will find a way to trick the bariatric system. This is because our dieting history has conditioned us to a diet/splurge cycle – we follow the rules for so long, then we splurge because we’ve been so good. You know what I’m talking about. But weight loss surgery is for life; it is not a diet but a lifestyle.

With practice we can give the diet/splurge cycle new meaning: how about a success and reward cycle. As we succeed at living after weight loss surgery we reward ourselves with tangibles – a new outfit, a new haircut, a trip to the theatre and the intangibles – more energy, improved wellness, better sex!

Saturday, February 26, 2005


Who is this person I’ve become?

The words I read made me so angry I could have spit bullets. There it was, in black and white, the story of a fussy baby who was spoon fed ice cream to keep her quiet. Trained at six-months old to cry until she was fed ice cream. Cool, clean smooth, high-fat sugar saturated vanilla ice cream. I was reading a baby book and that baby was me!

I was indignant – how dare my parents comfort me – at six months old – with ice cream? No damn wonder I grew up to be a fat adult addicted to high fat sugary sweets. I was a fat baby and I became a fat child, a fat teen and a fat adult. All because at six months the solution for my tears was ice cream.

My mother had unearthed the dusky smelling baby book from parts unknown and sent it to me parcel post about the time I reached my weight loss goal. It was a sentimental gesture on her behalf, yet it unleashed my anger that had been building since the good doctor cut up my God-given stomach and deprived me of every comfort I’d ever known.

The surgery and resulting weight loss uncovered a terrible family lie: I wasn’t big boned after all. Until that moment of truth I believed the lie they’d told me: that I was big boned, not fat. In fact my weight loss exposed a small skeleton that is almost fragile. Without my fleshy camouflage some today call me petite. Another lie was betrayed as well: I did not have childhood arthritis as they told me, I had growing bones that were over taxed from carrying twice the normal weight of a child: that’s why they hurt. It had all been a lie that started with the first spoonful of vanilla ice cream fed to a pudgy baby in her high chair.

I was mad as hell, and I was blaming them – my parents – for twenty-five years of obesity. Twenty-five years of suffering and self-loathing. Twenty-five years of social inferiority because I was fat. It was their fault! A normally docile person, I was livid. I was enraged. I was heartbroken. There is so much pain associated with obesity, particularly for children and adolescents, how dare they – they who gave me life – put me in harm’s way by making me fat? How dare they?

Both of my parents are fat. They are morbidly obese. My dad says he’s fat because of a heart condition he says prevents him from exercise. My mom says she’s fat because her Swedish roots have decreed it so. They both eat too much high fat, calorie rich processed food and they exist in a sedentary world. They are unhealthy, lifeless, sad and tired.

And that’s what happened to their fussy baby. I grew up fat, unhealthy, lifeless, sad and tired. I learned to make excuses very early for my fatness and to blame others, mostly dead relatives who passed along the trait of thunder thighs. But I learned to blame myself too, to be self-loathing.

I harbored my anger for weeks: I refused their calls. I wrote angry letters which I never mailed. I prepared angry rants which I never delivered. Night after angry night I stayed awake, the memories of my fat life tormenting me. Every mean comment, every embarrassing moment played over and over until the momentum of my anger took a life of it’s own. I was no longer in control of my thoughts because I had surrendered to the anger. My face became a flush of acne, my hair started falling out again, my tolerance of daily life was short and I was just plain crabby. Here I should have been at the most exciting moment of my adult life for I had become the new me, yet I was a bitter angry unhappy thin person.

Anger is a common emotion

I understand now that this phase of anger is common for the recovering morbidly obese person, and in fact, common to many people recovering from life-threatening debilitating illnesses. Most of our anger is about how obesity caused us to be self-loathing: about learning to hate ourselves – since childhood – because of our obesity. We are angry for blaming ourselves for lack of control that caused obesity, we are angry at others who blamed us.

We are angry at the people who have belittled us for being fat, then belittled us as “weak” for taking the easy way out – surgery – to lose weight. We are angry at doctors who’ve told us to lose weight, but didn’t tell us how. We are angry at the media that bombards us with pictures of rail thin skeleton models sending the message that unhealthy anorexic behavior is fashionable and obesity is loathsome. That is the same media that advertises thin people joyously eating heaping portions of unhealthy processed fat laden food. We are angry at employers who fail to promote the obese and who make us work twice as hard to prove that obese does not equal stupid.

We are angry at the diet industry that has taken billions of our dollars when we fell for their promise of “instant weight loss guaranteed”. We are angry at every person who said, “You have such a pretty face, if you could just lose the weight.” We are angry at a society that deems it politically incorrect to insult people for their race, religion or sexual preference, but leaves the field wide open to defame and humiliate the obese.

I am angry at my parents for raising me obese. But I am more angry that they are unwilling to take control of their own health and treat their obesity. I am angry because they are selfish and depriving themselves healthy and active relationships with their children and grandchildren. I am angry because I will have to watch them die slow tormented deaths from the co-morbidities associated with obesity.

The recovering obese are very angry. And finally, after years of stuffing angry feelings inside, the anger erupts when we lose weight and discover our new selves. And that makes us angry too! Why did we have to lose weight in order to allow ourselves to be angry?

We are entitled to be angry. As a class of people we are subject to the most tolerated form of socially accepted bigotry: it is in our home and social lives, in the workplace, in our leisure activities. We live in a society where half the people are obese – half of those morbidly obese – yet that same society condemns the obese as today’s untouchables. We are entitled to be angry.

But I learned that as I lay awake night after night becoming more angry, growing more pimples and losing more hair, that my anger was destroying me. My parents weren’t hurt by it, the media was not affected, my employer didn’t suffer, the comedians continued their fat jokes. I was suffering alone.

Anger leads us down a path of blaming – that’s a well-traveled path in today’s litigious society. We want to blame someone or something for our suffering. It’s true, not one single fat person has chosen to be fat. Cancer patients don’t chose to have cancer, victims of heart attack don’t chose that fate, people maimed in accidents don’t make that choice. Obesity is not a choice. We want to blame someone else because for most of our lives we have blamed ourselves: that’s what fat people learn to do – we hate ourselves for a choice we did not make.

Friday, February 25, 2005

Iron Deficiency

I’ve been feeling a tired and slow lately. Just don’t have my usual get-up and go. Naturally, I blame the gastric bypass – it gets the blame whenever I don’t feel well. After careful assessment I realized I have forgotten to take my vitamin for almost three weeks now. I am probably iron deficient – a risk all gastric bypass patients face.

We’ve all heard of anemia – a dangerous iron deficiency disease. In fact, iron-deficiency anemia is second only to obesity as a nation-wide health problem in the United States. Nine out of ten women in this country do not get their RDI of 18 milligrams of iron a day. That means their heart, brain and all other tissues are not receiving enough oxygen – iron is the chemical element in the red blood cell hemoglobin that delivers oxygen throughout the body.
If a person is short on iron they suffer a loss of energy, low-level fatigue – the blahs!
Brain activity, breathing, cellular respiration and every activity of the body depend on iron in the blood. Rosy cheeks and a glowing complexion indicate iron needs are met. Energy levels are up and an overall sense of wellness pervades.

Gastric bypass patients are at risk of iron deficiency because iron found in meat, poultry and fish is normally absorbed by the duodenum and small intestines. The nature of the bypassed system prevents adequate iron from foods from being absorbed. In addition, patients cannot physically eat enough food to meet the Daily Reference Intake (DRI).

To avoid iron deficiency and the resulting loss of energy patients must take an iron supplement daily.

Iron supplements: ferrous fumarate, ferrous gluconate or ferrous sulfate are recommended for all weight loss surgery patients. The body more readily absorbs iron when it is taken with vitamin C or a glass of orange juice. Your bariatric center may recommend a specific iron supplement for you. I take Puritan’s Pride® Easy Iron; a capsule that contains 28 milligrams of iron glycinate, a gentle form of iron that is highly absorbable and well tolerated. It also contains Vitamin C, Folic Acid and Vitamin B-12 to further aid iron absorption by the body. I take it by itself between meals with water. Iron can interfere with zinc and calcium so I do not take my other supplements at the same time.

Iron is a key element in the body’s energy-producing system. As you lose weight and become more active you will thrive with bounding energy. Be sure to maintain it by supplying your body with the iron it needs. In your annual blood test your serum ferritin level will measure your iron level and the nutritionist at your bariatric center will make the appropriate recommendations for supplementation.

It should be noted that iron RDI’s are different for men and pre-menopausal women. Men over 19 years old should intake 8 milligrams of iron a day, preferably from food sources; women aged 19 to 51 should intake 18 milligrams, supplementation is suggested. After menopause women need intake only 8 milligrams to meet iron needs.

Always assess your nutritional intake if you lack energy. There’s probably something you are missing, that once you get it back in your system you’ll be feeling prime and proper in no time! If you don't know what vitamins & minerals you should be taking see your bariatric center.

As for me, I've got my vitamin supplement set out for the day and I'll return to my routine of taking them daily for better health and energy!

Thursday, February 24, 2005

I dumped again last night

Well - I went down that frightful dumping highway again last night. The cause, 3 pre-processed chicken wings and 1/4 cup deli potato salad.

Deadly combination.

It took 25 minutes for the disorientation and hot-flash-sweats to begin. Rode that out until the freezing cold hit. Then I laid on the bed like a lump. I felt sorry for myself and worthless. I didn't accomplish anything. It really sucked.

The sad part? I've dumped on processed wings before. I knew better.

Today's a new day. Let's do better.

Have you dumped lateley? Tell me all about it.

Wednesday, February 23, 2005

Why Protein?

The first rule for living after weight loss surgery is Protein First – that means eating protein at all three daily meals, and protein must be 50 percent of food intake. Animal products are the most nutrient rich source of protein and include fish, poultry and meat. Dairy, including eggs, is another excellent source of animal protein. Nuts and legumes are also good sources of protein, but sometimes difficult for the bariatric patient to consume.

Protein is essential in the weeks immediately following surgery because it facilitates the body’s healing process. Surgery invades and injures to the body. Muscles and tissues are damaged by surgery, even the minimally invasive laparoscopic surgeries. When body tissues are damaged the body responds by increasing protein production from the dietary amino acids found in animal protein. To do so, the body requires an abundant supply of amino acids. One of the first foods allowed a post-operative patient is gelatin: it contains protein from the bone, skin and connective tissues of animals. Gelatin is a cool, smooth healing tonic for the injured body. Studies show that patients who eat adequate protein will heal better and faster than patients who are protein deficient.

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

In spite of the by-passed nature of the bariatric system, patients will metabolize proteins normally. Amino acids from food are not broken down in digestion or the small bowel. Instead they are absorbed directly through the bowel wall into the bloodstream. A diet rich in lean protein is the most efficient way for patients to heal their body, boost energy and avoid protein deficiency. A diet of lean protein guarantees weight loss.

The distinction must be made between high fat proteins and lean proteins. A bariatric system will not tolerate high fat proteins such as bacon, fatty beef or sausage products or greasy fried chicken skin. In fact, many patients report repulsion or nausea when presented high fat protein options. Meat with fat and poultry with skin contain a great deal of saturated fat and cholesterol, both of which increase the risks of cardiovascular disease. Milk and cheese are also significant sources of saturated fat. For many patients, intolerance of milk products prevents them from eating too much saturated dairy fat.

Before surgery, like most Americans, we ate too much high fat protein. In fact, protein deficiency is very rare in this country. Fortunately, there is an abundance of low-fat, high protein options. The advice varies from doctor to doctor, but generally patients should try to eat 20 to 50 grams of lean protein each day after their weight loss has stabilized. In the early weeks and months following surgery the protein intake will be much less, sometimes only 15 to 20 grams a day. See the specific guidelines from your surgical center to determine a timeline for protein intake.

Monday, February 21, 2005

Kashi Chewy Granola Bars

Have you tried the new bariatric friendly Kashi Chewy Granola Bars?

I grabbed a box of 18 at Sam’s Club for around $9 (roughly $0.50/bar). The box included three varieties: Honey Almond Flax, Trail Mix and Peanut Peanut Butter. Each provides about 140 calories with a whopping 5 grams protein and scant 6 grams of sugar – a WLS patient’s worst enemy. I’ve found I can tolerate about 12g of sugar without dumping, so these seem safe enough for me. Be sure to know your sugar tolerance. Another bonus, 4 grams of fiber per serving! Don’t all of us WLS people need a little more fiber to keep things moving?

While they don’t taste like the traditional super-sweet granola bars they do pack a wholesome and satisfying crunch. Don’t you get tired of soft foods all the time? Me too! I think I’ll stash some in my car’s glove compartment, handbag and desk at work for those times when I need a safe snack. (I know, snacking is against the four rules, but damnit! Sometimes I simply need a bite to eat between meals. You probably do too.)

Give them a try and let me know how you like them. Email me!

Rock Bottom: Was WLS a huge mistake?

Halfway through the phase of rapid weight loss – six months out – I hit rock bottom. No matter what I ate I threw-up or dumped. I was tired, depressed and discouraged. I felt victimized by my damned tiny tummy. I felt punished by my obesity and punished by the treatment I’d carefully selected. Life just didn’t seem fair. There was no light at the end of the tunnel.

So I attended a support group meeting, the first in several weeks. The meeting forum that night was an open discussion for post-operative patients. I was determined to find someone to identify with, someone who was as much a victim as I.

I found my peer in the third woman who took the floor. She was still very heavy, but said she had lost 75 pounds since surgery more than a year ago. Her weight loss had stopped. Her hair was brittle and thin; her skin sagged and was deathly pallor, her eyes cloudy. And she was in a very bad mood. She was angry that so many patients thought they should follow a regimen – the four rules – after surgery. Thumping a chubby hand on her cottage cheese thighs she rallied her troops: “We did not have surgery so we could spend the rest of our lives following strict diet and exercise programs – we didn’t like that before surgery, and we don’t like it now!”

Surprisingly, we applauded her because we all hated eating bland protein, not snacking, exercising and drinking water: it felt like a punishment. She continued, “I’m thinner than I ever was and that’s good enough! I’ve lost 50 percent of my excess weight and the bariatric profession considers me a success, so this is where I’m staying! I’ll continue to eat what I want as often as I want, I will not follow a regimen!!” Again, applause filled the room. We were victims when we were obese, now we were victims of the very surgery we fought to have!

And I bought her story – just maybe halfway was good enough for me too. Perhaps I had set my goals too high, I was expecting too much of the Little Fat Girl. Maybe if I just accepted that this was all the weight I would lose I could get on with my life and not constantly fret about following the four rules. Maybe by accepting “good enough” I’d stop torturing myself with over eating and eating the wrong things. Maybe 50 percent was good enough.

The meeting continued after a short recess during which we congratulated one another for our 50 percent successes. The first speaker up was a slim perky woman, her skin was flawless, and her body seemed tight and compact. She was a picture of fitness: could she have ever been obese? She spoke with quiet confidence. She was not a victim.

“There was a time when I, too, felt angry and punished by my weight loss surgery,” she began. “But one day I realized, weight loss surgery is part of a new lifestyle, not a regimen and not a punishment.” She explained that as a morbidly obese person (she had lost 130 pounds) she was a slave to the poor health, poor habits and low self-esteem that perpetuated her obesity. She said the day she realized she was no longer a slave to the shackles of obesity she was able to liberate herself.

She embraced her new lifestyle, not as a regimen or punishment, but as a means to better everyday living. We were skeptical, and we didn’t applaud. But then she made her final pitch. “If we suffered from a life-threatening illness – and morbid obesity is life-threatening – and medical science said I will give you a tool to help you treat your life-threatening disease, but you are responsible to use that tool to achieve total success – would you settle for 50 percent as good enough?”

We sat there in stunned silence. Not one person nodded that 50 percent would be good enough, not even the thigh-thumping rebel.

So here I was at the fork in the road. I could accept that 50 percent was good enough and continue to mistreat my body nutritionally and physically. Or I could adopt and new lifestyle that would encompass the health, nutrition and wellness that goes beyond the four rules. I could push my weight loss to the maximum achievable results and experience health and wellness surpassing my wildest dreams.

It was my choice.

Sunday, February 20, 2005

The Truth About Dumping

Dumping is a very effective tool your new system uses to alert you of inappropriate eating. Dumping syndrome is described as a shock-like state when small, easily absorbed food particles rapidly dump into the digestive system. This results in a very unpleasant feeling with symptoms such as a cold clammy sweat, pallor, butterflies in the stomach and a pounding pulse. These symptoms may be followed by cramps and diarrhea. This state can last for 30-60 minutes and is quite uncomfortable.

That was the clinical description of dumping.

This is what I experience when I dump: shortly after eating a food I don’t tolerate (sugar, milk, sugary milk products or starchy carbs) I begin to feel a bit disoriented, maybe dizzy and then an overall sense of confusion or panic takes over my mind and body. This is a mild state of delirium. Then I begin sweating. Profuse sweating that can completely soak my hair, my clothes; it drips and glistens on my skin. During this state of sweaty panic I feel like I’m out of my mind! A few times during extremely dramatic dumping episodes I literally thought I was dying, the state of distress was that severe.

At this point during a dumping episode I have learned it is best to lie down on my side and let it nature take its course. The body is efficiently, albeit painfully, correcting a chemical imbalance in the cell system. It takes great presence of mind to calm myself and lay down, but even in a state of near-delirium I now know this is the only action to be taken. I know the event is passing when the sense of panic is replaced by exhaustion and cold chills instead of sweating. Occasionally I have suffered diarrhea at this point. If I have the luxury I’ll try to take a nap or go to bed after dumping. If it is in the evening I’ll sleep through the night, and wake feeling like I’ve been run over by a truck.

The mild delirium associated with dumping is the result of an interruption of nerve impulses affecting cerebral metabolism. The interruptions are caused by metabolic disturbances such as fluid or electrolyte imbalance. When the incorrect foods are consumed and dumped into the digestive system the electrolytes get out of balance. Dehydration will also cause an electrolyte imbalance. This mild delirium is characterized by a reduced ability to maintain attention to surroundings or disorganized thinking. The daily routine can become confusing. In extreme cases a person who is dumping may experience rambling, irrelevant or incoherent speech.

After the dump passes the interrogation begins: what caused that dump? I have dumped on yogurt, sugar cookies, lobster bisque and blackberry sorbet. I have dumped after one margarita. A particularly impressive dump followed a love-fest with a piece of pecan pie. Salty potato chips that should have never crossed my lips knocked me flat quicker than a prize-winning boxer could have. I have dumped a few times for which I never determined a cause. I believe stress has caused me to dump. I’m certain dumping is not exclusive to food intake, that it can be triggered by the body’s physiological reaction to stress. However, in most cases eating the inappropriate food for my short-circuited system is the culprit. Through trial and error I can predict most things that make me dump and I avoid them contemptuously.

The most efficient way to avoid dumping is to maintain the strict regimen practiced during bariatric infancy: follow the four rules. Eat protein first making sure it comprises one-half of every meal. Avoid snacking. Avoid all sources of simple sugar; and yes, this includes cookies, cakes, candy, sodas, ice cream and sorbet. Sip water throughout the day. When you practice this eating behavior your blood sugar will not fluctuate and you will not dump. Most patients, who crave a taste of something sweet, have learned they can tolerate a bite of fruit at the end of the meal. Proceed with caution and discover what works for you.

The first reaction when dumping begins is to try and make it stop. There is a feeling of helplessness – like trying to stop an earthquake. I have tried eating myself out of it. I have tried flushing it away by drinking water. I have tried physical motion – pacing – to get myself out of it. I have not successfully stopped a dumping episode. I don’t know anyone who can successfully halt a dumping episode. Sipping a sports drink like Gatorade will relieve my symptoms, although my surgical weight loss specialists do not recommended this practice. If you find something to bring relief during a dump, and it causes no further harm, then do it.

It is important to note that the dumping experience is different for every person. Some will always have extreme dumps and others more mild episodes. Individuals will notice dumping episodes will vary by incident. No two people dump the same and no two dumps are alike.

Dumping is a bittersweet fact of life after bariatric surgery. Because we must fuel our bodies by eating we will experience dumping. Adherence to the four rules will prevent dumping in most cases. However, every now and again we will be blindsided by a dump caused by a food never suspected. Keeping a list of poorly tolerated foods will help you avoid them. The acutely dramatic event of dumping is a convincing motivator to follow the rules and avoid the foods that have trigged a dumping episode.

Being people who love food, we may now and then, willfully break the rules fully aware of the consequences. We are all vulnerable to the desires of the flesh. Not long ago I was quite certain I could not go on living without a taste of ice cream – I’d been an ice cream celibate for over three years. So carefully I selected my tasty treat, settled myself in the safety of home, and I savored a totally decadent half-cup serving of vanilla ice cream. I accepted that a dumping episode would follow. As expected my body entered the shock-like delirium complete with profuse sweating then clammy chills. No matter how good that ice cream tasted, that momentary pleasure was not worth the price. It is a mistake I won’t soon repeat.

Saturday, February 19, 2005

It's Only a Tool

Let’s face it. By the time we resort to weight loss surgery most of us are in the big leagues when it comes to dieting – we are dieting professionals! Like many of you, my amateur career in dieting began when I was a pre-teen. Actually – my first attempt to lose weight wasn’t a diet. Not even close. In the darkness of night when I was twelve years old I stole away into my mother’s kitchen – not for my usual midnight rendezvous with chocolate chip cookies and cold glass of Ovaltine. This time, my prey was the box of plastic wrap.

Back in my room by the light of the desk lamp I wrapped my naked thighs, belly and butt with the plastic. And I did a great job shrouding myself in a plastic smelter I was sure would deliver me from the evil of fatness. I was positive, beyond any doubt, that by sunrise I’d have reduced my little fat body to a state of near-goddess like beauty and I could go to the end of school swimming party in a teeny bikini. I envisioned the looks of awe on the faces of my cruel classmates as they beheld my star-like figure. Those name-calling bullies would line up to apologize for their words that had in fact hurt me. And I would triumph gloriously in my body by Saranwrap.

Imagine my surprise, and tremendous disappointment, when I woke a slick sweaty mess suffering from an unfortunate galling. Worst of all, my body had not shrunk, not one iota.

The plastic wrap magic trick didn’t work. Neither did the countless other miracle plans, programs or pills I attempted over the years. You name the diet, I’ve been there, done that. And so have you. You, like me, were a long-time professional dieter.

But guess what? By having weight loss surgery you have retired from the diet game. You will lose weight with bariatric surgery. Guaranteed. At first it will seem effortless. You won’t feel hungry – in fact, sometimes you won’t even feel like eating. You don’t have to count points, stir powder into drinks, eat special packaged foods, take enemas, or wrap yourself in plastic. It’s not even called a diet.

But in spite of the comparative ease with which the weight is lost, it essential that patients actively engage in radical behavior modification to become healthier and sustain long-term weight loss.

You cannot simply let the bariatric system to do the work for you and hope for the best – you must take responsibility to ensure your own health and wellness. Every bariatric surgeon will tell you that the bypassed and malabsorption system is only part of treating morbid obesity – it is only a tool.

Many patients believe that after surgery they can eat anything they want until their pouch is full, and there is no need to pay attention to nutrition. Some believe that they need to snack frequently throughout the day, that it is impossible to eat just three tiny meals a day without snacking in-between. Some patients believe they can continue to drink anything but water and lose weight. Some patients are content to lose weight without adding exercise to their life.

These patients are sadly mistaken.

Patients who want to use weight loss surgery as a means to a healthier life will engage in radical behavior modification every day for the rest of their lives.

It is incomprehensible that a person would undergo weight loss surgery and not make the necessary behavior changes to ensure success and wellness.

When a person fails to uphold their end of the bargain they show a grave lack of self-respect. The bariatric system is surgically achieved willpower. The unpleasant side effects of unchecked behavior – dumping and vomiting – are reminders to respect your body. It behooves every patient to learn the four rules and engage daily in pursing a healthier, happier more self-respecting life.

    Protein First
    No Snacking
    Daily Exercise
    Drink Lots of Water

Ask Kaye

Dear Kaye:

Help! My hair is falling out by the hands full. Is there anything I can do?

Blonde & Balding

Dear Blonde & Balding:

Surprisingly, hair loss is one of the reasons female pre-operative patients sit on the fence before deciding to have surgery. Obese people, particularly obese women, often have lush gorgeous hair. Of course they do – it’s well fed and nourished! How many of us have been described as the woman with “beautiful hair and a pretty face”? What person in their right mind would give up one of their beautiful features?

Hair loss usually occurs in the fourth of fifth month of bariatric infancy. During the phase of rapid weight loss, caloric intake is marginal. This puts your body in a state of panic called starvation. Think about the pictures of prisoners of war. Most victims of this atrocity are without hair because they are literally starving to death. A healthy body normally sheds ten percent of hair follicles at any given time. When a body is starving roughly thirty to forty percent of hair follicles are sacrificed as the body channels nutrition to more vital areas. During this phase hair loss is dramatic, often patients finds clumps of hair on the shower floor. Remaining hair becomes drab and lifeless.

I knew hair loss was a potential effect of weight loss surgery, but because I’m a “cup-half-full” person, I didn’t believe that hair loss would happen to me! That just happens to other people I told myself! Imagine my surprise when my blonde locks were littering the bathroom floor like hair saloon. I shed some tears over that.

The hair loss is a transient effect of your bariatric surgery and will be resolved when your nutrition and weight stabilize. When my hair began falling out, my husband, who has been a proponent of vitamin supplements all his life, found a vitamin specifically formulated for building strong healthy hair. The vitamin I take for healthy hair and nails is Silica Complex by Puritan’s Pride. It contains calcium, magnesium, zinc, boron, betaine and horsetail extract. Consumption of this supplement almost immediately retarded my hair loss and renewed my dull lifeless hair. I will continue taking this supplement throughout my life. Five years after surgery my hair is long, full and lustrous – one would never know I had suffered significant hair loss. In hindsight, I would certainly begin taking this supplement prior to my surgery. In the very least I would begin taking it soon after surgery before the signs of hair loss were apparent.

Do you have a question about Living After Weight Loss Surgery?

Email Kaye Bailey

The Rest of Your Life

I found out I was fat on the first day of kindergarten when the little girl sitting next to me on the floor pointed at my chubby knees and told me I was fat. I didn’t even know what fat was but I could tell it was bad and I didn’t want to be fat. Until that day I had been unaware I was different. But there I was, a five-year-old girl sitting cross-legged on the floor in my pretty red first-day-of-school dress learning a new word that would define me for twenty-five years.

Then I had gastric bypass surgery and my world turned around. After a lifetime of unsuccessful dieting the pounds melted away and I became a thin, fit, healthy person! The decision to have surgery took courage, nerve, and a little bit of plain old faith. It was my last hope, my last resort, the end of the road for a thirty-year-old fat woman sitting on the kindergarten floor.

And it WORKED!

On the one-year anniversary of my surgery I walked into an upscale dress shop and the clerk looked me over and she said the most glorious words I had ever heard, “You’re a size six, right?”

Absolutely! Size Six! That’s me! (I did have enough self-control not to hug her!)
Every gastric-bypass patient knows how the story of the little fat girl begins. Most of us started our lives heavy and in spite of countless valiant efforts we have never won the battle to become trim and healthy. Each of us could fill a large binder with stories of shame, humiliation, fear and outright embarrassment because of our obesity. Sure, we’ve had those fleeting weight loss successes only to have our hearts broken when the pendulum swings from weight loss to weight gain. I can’t count the nights in my lifetime I spent awake wishing and dreaming to wake up thin and fit and beautiful. I prayed to every God I’d ever heard about for a miracle. I suppose every overweight person prays for a miracle.

If you are reading Living After WLS you have studied and consulted, discussed and prayed about your decision for weight loss surgery. You have chosen surgery as your miracle. Congratulations! You have shown great courage! You have the spirit to take action in the face of great fear! You have made a decision you will never regret! You are about to start the adventure of your lifetime. Now you are at the crossroad where you stop dreaming and begin living the miracle!

During the first few months after surgery you will experience wonderful changes as your body drops the pounds, seemingly without effort on your behalf! This time truly is a window of opportunity where a patient discovers the person who has been hiding inside for so long. Suddenly your face will have structure; you might lose a chin (or two!) Your body will shrink so fast that clothes that fit one day will be hanging off your incredible shrinking figure the next!

While it may appear to onlookers that you are losing the weight without personal struggle or effort, this really isn’t true. Physically the pounds are melting away. But inside there are struggles every day and issues to overcome. Some patients report symptoms of depression during this phase of rapid weight loss – so much changing so fast! Others report extreme highs and elation as they see their new healthy self magically appear in the mirror. People surrounding the rapidly diminishing patient may de-value the effort it takes for person to accomplish massive weight loss. They may not understand the physical and mental toll this rapid weight loss is taking. This surgery requires a complete retraining of your body. Nothing you have done in the past to feed your body will you be able to continue doing. How many people would call a complete body overhaul easy?

There are people in our world, fat and thin alike, who see weight loss surgery as a magic pill – the easy way out of the big bodies we are lugging around. We’ve all heard, and been hurt by their comments, “just quit eating all that food and exercise – it’s easy to lose weight.” Easy to lose weight? Not damn hardly! If that were true then a third of our population wouldn’t be struggling with obesity. Losing weight and keeping it off is never easy. Not before surgery. Not after surgery. Never-ever-never.

But the good news: with weight loss surgery you will be armed with the most powerful, the most effective tool ever in the history of weight control! There is no other pill, program or plan in existence that has the enduring proven success of weight loss surgery. You will have this tool for the rest of your life. Unless you deliberately have it reversed it can never be taken from you.

Congratulations! Enjoy your gastric-bypass experience!

It’s for the rest of your life!

Tuesday, February 01, 2005

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On June 1 LivingAfterWLS launched an exciting new monthly newsletter “You Have Arrived”. The premier edition newsletter was warmly received by our readers and I look forward to creating and sending future issues full of exclusive content, helpful hints and inspiration for our growing community LivingAfterWLS.

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Best Wishes,
Kaye Bailey