All posts by Dee Anne Agonis

Tips and Tricks to Get Back on Track

Along your journey I’m sure you have all heard “weight loss surgery is just a tool”. This is such a common phrase because it is exactly that. The surgery itself is just one small piece in a very large and complex puzzle. Bariatric surgery will not be as effective if you don’t make health conscious decisions with your food, activity levels, and day-to-day lifestyle. Changing habits is not an easy thing to do and even when you begin to create those new healthy habits the old ones are always wanting to creep back into your life. Whether you are 2 months out, 6 months out, a year out, or five+ years out, falling off track can happen to anyone. What is important to do is to recognize that you are getting off track and find a way to get yourself back on the pathway to success. Here are 7 tips to get your life, health, and habits back in your control!

 

Be mindful of what you eat and drink.

It is very common to eat and drink without paying attention to how much we are actually consuming. Portion control is so important to your success. In fact, most people underestimate how much they eat in a day. If you have found that you are stalled at a certain weight or are regaining, a good start would be to track and log what you are eating over a week. There are many apps that make this fast and easy to do, we recommend using Baritastic. When you become aware of what you are consuming on a daily basis it is easier to make better healthier choices.

Are you eating enough protein?

 At the very center of the bariatric diet is protein. Protein helps you feel full longer, slows down digestion to make you feel more satisfied, maintains muscle as you lose fat, and much more. Overall, protein is an essential part of your weight loss success. This is the reason you should always eat your protein first before any other part of your meal. If you feel like you have been less focused on getting your daily protein intake try to center your mind back to having 60 – 80 grams of protein a day. Protein sources include: meat, eggs, low fat cheese, low fat or fat free yogurt, beans, fish/seafood, and poultry. For more details about how to get the right amount of protein per day call 913-677-6319 to schedule an appointment with one of our registered dietitians.

Are you drinking enough water and at the right time?

It is easy to replace water with other drinks during the day that are high in carbs including juices, coffee drinks, soda, and sweet tea, but that can be a main source of weight regain. Everyone, especially bariatric patients, need to drink at least 64 ounces of water to stay properly hydrated. In addition to drinking enough water you need to make sure you are not drinking water during/with your meals. When you drink with your meals the food gets flushed through your pouch so you have minimal satiety. This will make you hungry within a short period of time. Focus on drinking water when you wake up and between meals for best results.

You might not be getting enough physical activity.

Exercise plays a critical role in losing weight and also keeping it off. Getting enough physical activity will help you be successful in meeting your weight loss goal, improve your energy, improve your mood, and help you sleep better. If you are someone that struggles to get yourself to the gym or “hates working out”, we have a solution for you. There are so many different ways to get physical activity that “hating working out” can no longer be an excuse. You can take your dog on a walk, take a Zumba class, try water aerobics classes, do group fitness activities, do yoga, the list is endless. Focus on finding something you love and make small goals along the way until you reach your final end goal.

Are you getting enough sleep?

I think we can all agree that there’s not enough time in the day to get everything we want to get done. It is tough to balance working out, eating healthy, work, social life, sleep, family, etc. It is unrealistic to get 10 hours of sleep a night for most of us, but try to aim for 7-9 hours. Sleep impacts both your impulse control and decision making. When you have gotten a full night of sleep you are likely to be more active during the day and make healthy food choices. With sleep, exercise, and food all impacting one another and all being vital for weight loss success it is important to put an equal focus on all three.

Make sure you set realistic goals for yourself.

Sometimes looking at the big picture can be extremely overwhelming, but if you can break down your ultimate goal into small realistic goals the big picture looks much less frightening. Every time you reach a new goal you will be more driven to meet then next one. This can be a great cycle and habit to get into. Goals allow us to believe in ourselves, give us inspiration, and hold ourselves accountable.

Be active within the bariatric community.

 A great way to add to your support system is by attending support group meetings. Everyone there has been in your shoes and knows the experiences surrounding weight loss surgery. Each member has a different journey to share and understands the emotions involved and the dedication required for a successful bariatric surgery. Another way to get extra support is by being active in online support groups. There you can ask for support but also give your support to others, so it is the best of both worlds. The Bariatric Center of Kansas City has a closed support group on Facebook that in very interactive. Click here for the link to join: Support Group Link.

Most of you reading this are probably doing so because you’re ready to get your bariatric journey back on track.  We want you to know that our support is always here for you.  We hope that these tips and tricks will help you while you travel your pathway to success! If you have any specific questions related to this information provided or would like to make an appointment with us, feel free to contact The Bariatric Center of Kansas City, 913-677-6319. Our specialists can assist you with information and bariatric support. 

If you’re interested in starting a bariatric journey soon, sign up to attend a free informational seminar today by registering at:  https://www.eventbrite.com/o/the-bariatric-center-of-kansas-city-at-shawnee-mission-health-lenexa-ks-324917613

October 2nd, 2018 – Fad Diets: Are They Okay After Surgery?

Stephanie Wagner is a bariatric dietitian who has her own website and blog to assist bariatric patients before and after surgery achieve their goals. She came to address all the popular fad diets that folks are hearing about on social media sites and if they are effective or safe for patients after bariatric surgery.  Her website is www.foodcoach.me.

The latest diet programs most frequently mentioned on social media are:

  • Keto and Paleo
  • Weight Watchers
  • Vegan (several varieties)
  • Whole 30
  • Intermittent Fasting and Carb Cycling

When looking at any diet, the first two questions to ask are:

  1. Does it totally contradict your bariatric diet recommendations?
  2. Is it sustainable – in other words is it something you can maintain long term?

To answer those questions, you need to first review the basics of the post-op bariatric diet:

  • Protein first – aiming for around 60 grams of protein a day
  • Non-starchy vegetables next
  • Limit fruits, and when eating fruits be sure to pair with protein
  • Limit heart healthy fats
  • Avoid high starch vegetables, sweets and saturated fat
  • Take small bites and eat slowly
  • Avoid drinking with meals; but aim for 64 – 96 ounces of sugar-free liquids a day

Let’s take a look at each of the fad diets individually:

  1. Ketogenic – the goal is to keep carbohydrates to a minimum and increase fat. It plans on having you get 60 – 75% of your calories from fat, from things like “fat bombs”  and “bullet-proof coffee”
    • It doesn’t completely contradict the bariatric diet, but it emphasizes fat instead of protein
    • Too much fat is very hard on the post-op GI system – it will have difficulty breaking down that much fat and can cause dumping syndrome
    • High fat is high calories, because 1 gm of fat = 9 calories, where 1 gm of protein or carbohydrate = 4 calories
    • Reaching your protein goals are very difficult on this diet, and at the end of the day, you need to take in less calories than you burn off
    • A way to modify this diet for post bariatric surgery is to keep your protein to fat ratio at 1 to 1 – 1 grams of protein to 1 gm of fat; and keep your carbs to under 30 grams a day
  1. Paleo (paleolithic, or caveman) – the goal is to eat only unprocessed foods that our ancestors would have had access to, such as leafy greens, pesticide-free veggies, nuts, fruits on occasion, grass-fed meat, pasture raised poultry, and wild-caught fish.
    • It is naturally low in carbohydrates because it eliminated processed foods, and still focuses on meats and protein, so it doesn’t contradict the bariatric diet
    • You need to watch the “paleo friendly” foods and desserts as they may have more carbohydrates than are recommended for after surgery
    • This diet is frequently paired with a high intensity workout program such as Crossfit
    • It calls for root vegetables, which tend to be very high in carbs, such as carrots, potatoes, sweet potatoes – those all convert to sugar very quickly, and then your body will burn those instead of burning fat
  1. Weight Watchers – this program has been around for a long time and frequently changes. It does require you to join in to get the full benefit.  The latest version is “Beyond the Scale” which started in 2017.
    • Uses a point system, and has over 200+ foods that have zero points so you don’t have to track
    • You track your points and can rollover points to another day to provide flexibility
    • The biggest benefit is the weekly weigh ins that help to hold you accountable every week
    • While it doesn’t contradict the bariatric diet, you need to be very mindful of zero-points foods, as those are more designed for patients who have not had surgery.  They also don’t prevent snacking, which does contradict the bariatric diet.
    • It is sustainable as long as you continue to get 60 – 70 points from protein, and get 3 meals a day
  1. Vegan – the goal is to eliminate all meat and products made from animal sources. There a lot of variations, but a strictly vegan diet severely limits protein sources to fruits and vegetables, beans, edamame (soy), tofu and textured vegetable protein.
    • While it doesn’t contradict the bariatric diet, it is difficult to sustain as it is very challenging for someone to stay full on a completely vegan diet, as non-meat protein sources leave the stomach much faster
    • This diet is usually one chosen by someone for ethical reasons, and is more about personal convictions than weight loss
  1. Whole 30 – This is a copyrighted program that focuses on eating only “real foods” – nothing processed.
    • Is designed to be used to eliminate certain foods for 30 days: no sugar (real or articial), no alcohol, no grains, no legumes (beans), no dairy, no baked foods, no junk foods or treats.
    • Is doesn’t contradict the bariatric diet, but is actually more restrictive
    • You need to have a plan to go to after those 30 days
  1. Intermittent Fasting – this is more of an eating PATTERN where you cycle between eating and fasting, but doesn’t tell you what to eat. There are several eating patterns you can use, but most commonly recommend you eat during an eight hour period each day, and then fast the other 16 hours a day, taking in only sugar-free liquids.  Some have you eat for 5 days, and then fast for 2 days. 
    • This does contradict the bariatric diet, which wants you eating 3 meals a day. While you can eat your 3 meals within the 8 hour period, our dietitians never recommend fasting beyond 48 hours. 
    • There isn’t a lot of scientific evidence to support this diet yet, and this can be hard on your metabolism, which wants to slow down when you are fasting.
    • If you have diabetes, you must be extremely mindful of your blood sugars; and this can increase your cravings for carbohydrates, so that when you stop fasting you eat a lot of carbs.
  1. Someone asked about Carb Cycling – this is designed more for people who work-out a lot and is more of a maintenance diet. You eat more carbs on one day, less on another, and it requires 5 meals a day, so it contradicts the bariatric diet. 

If you want to try any of the above programs, meet with one of the dietitians to help you modify them to be bariatric appropriate.  Good luck!

 

Shedding More Than Pounds

We all hear about inner beauty our whole life but most of us never really understand what that means until we discover our own inner beauty. This is the story of how I found mine.

In my family growing up, happiness was a costume we put on and love was conditional. We received love IF we wore our costumes well. This meant successfully hiding the trauma and sadness we endured daily. As you can imagine, this type of masking built me into a miserable, cold, confused shadow of a human being. My misery was suffocating me and the only way I could survive was by letting my misery out and putting it on others. I put my husband and children through a war of their own. It wasn’t until the tragic death of my father in 2010 when he lost his battle with depression that I was able to see that the promise I had made myself to make sure my family had a better life than I had experienced was being broken. It was this tragedy that would forever change my life.

 

After many years of medication, therapy, and relationship repairs, I was finally in a good place. I was happy and enjoying life and truly loving people, but even though my pictures contained a beautiful smile there was sadness still behind my eyes and you didn’t have to look very far to see it. Though I had knocked down many walls of protection caused from years of abuse and trauma, after peeling back layer after layer of sadness and misery, I still could not find true joy. I had learned to love others but still had no idea how to love myself. I could not see past all of the physical things I saw in the mirror reminding me of the past causing me to despise myself and be unable to know who I truly was.

In 2015, my cousin approached me with “the next big thing to battle weight loss”. The difference with this program was that it allowed me to take the focus off of my own insufficiencies and put it on to others. This company had a program in place to feed needy children for every 10lbs you were able to lose. I thought this would lead to my own personal success for sure, after all I care for others more than myself! I gave this program time, just like I had all the others, and though I was very successful initially and felt amazingly warm inside with all the help I was providing others, I had failed myself again. The sadness and misery began to start in again, and I could feel the walls building themselves back up slowly. I knew I had to do something drastic to change my path.

Out of nowhere, and like the miracle I now see it for, I was presented with a new job opportunity. In April, 2016, I accepted a position as Case Manager for The Bariatric Center of Kansas City. I figured even if I wasn’t skilled enough to lose my own weight or lucky enough to even qualify for weight loss surgery, I would be responsible in helping thousands of others do so.

After doing this position successfully for many months and learning so much about the disease of obesity, my mother experienced a heart attack. Since my mother is only 15 years older than me, I was terrified of my future with obesity. I approached Dr. Hoehn to discuss my desire to proceed with bariatric surgery. I was both excited and scared to learn that I was “an ideal candidate” for bariatric surgery. Am I being vain? What will people think? Will I fail again? After a lot of praying and communication with my husband and children, I realized I DESERVED this opportunity to obtain the most relevant tool of our time to fight my obesity. Within weeks, I cashed in my 401K from my previous employer and scheduled surgery. After all, what good is a 401K if you don’t survive long enough to need it.

I was “sleeved” on August 17, 2016. My starting weight was 243 lbs. At my highest weight I was over 265 lbs. I have lost 113 lbs. since surgery, and now weigh in around 130 lbs (my weight fluctuates up and down between 130 and 135). The two years following surgery has contained ups and downs. Since I didn’t disclose my decision to have surgery to anyone other than my husband and children, this road was very confusing and lonely. If it hadn’t been for the staff/my co-workers at The Bariatric Center of Kansas City, I would have been isolated. I am thankful every day for the dietitians and doctors here who helped me by answering all of my every day silly questions regarding what I can eat and what is going on with my belly when it makes all these silly digestion noises. I am especially thankful for the Dr. Sabapathy who, as my psychologist during this time, helped me figure out how to cope with emotional stress and every day problems without turning to food. I know it was because of this program that I was able to be successful and now have a healthy relationship with food.

As the case manager for revisional bariatric patients (repeat bariatric surgery patients) at the Bariatric Center of Kansas City, I am even more grateful that programs like ours exist to educate and equip patients in a way that allows them to learn to be successful long term. I can’t tell you how many repeat bariatric patients tell me that they wish a program like ours would have been available to them at the time of their first surgery so that they may have been more successful.

As the weight began coming off, I began to feel worthy of love, life, victory and joy. Since reaching my goal weight about 1 year after surgery, I have been seizing the day! Losing the weight has not made me a better or more successful person, it has only allowed me to shed all the ugliness that existed from my past, and open my eyes to the true inner beauty inside me. People tell me all the time now that I have a glow about me and I tell every single one of them that this is me allowing others to finally see my inner beauty. Living this life as me makes me truly happy. I am enjoying squeezing every drop of joy out of every single encounter. I have tried many new and exciting things along the way and hope even more to push the limits on my own personal boundaries of new experiences.

Another great blessing that has come from this life changing decision is that while I was improving my quality of life, I simultaneously impacted my close friends and family. I have renewed old friendships from high school and built strong lasting connections with new friends. My marriage of 24 years is experiencing the same glow of inner beauty. I can honestly say that though it took some adjustment and compromise on both sides, we are more in love than the day we met. My children finally know what it is like to have a mother who is beautiful inside and out and is aware of what she is worth so that she can help them to find their own beautiful selves and go after what they want in this life and make it possible to achieve it. My son has been working with a personal trainer for more than 6 months to lose over 30 pounds through the hard work of diet and exercise!

Additionally, after seeing my success, my younger brother, Adam, decided to have surgery in 2017 at The Bariatric Center of Kansas City as well. He has lost more than 120 pounds and has found greater power within himself to obtain the things in life he wants to achieve. He is finding happiness and self-worth in everything he does. While I still experience hardships of life, like we all do, knowing my decision has not only improved my life, but those closest to me makes those hardships that much easier to cope with.

I know that I will face adversity in the future and may fail from time to time, but I will continue to live my life by this quote from Albert Einstein “learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop questioning.” I will continue to ask myself, “can I do better? how can I be better? What other great gifts within me am I hiding from the world?”

This surgery has changed my life, changed my husband’s life, and has changed my children’s life and I will forever be thankful for that. Surgery can be a scary thought, but just remember “ultimately, know deeply that on the other side of every fear lies freedom!” *Mary Ferguson

Eggcellent Ways To Add Flavor To Your Eggs

Eggs are among the most nutritious foods on the plant. They are packed with vitamins, minerals, high-quality protein, and good healthy fats. Eggs are also rich in two very important antioxidants, lutein and zeaxanthin, that help protect the eyes. Also, one large egg has only 5 grams of fat, 6 grams of protein, and zero carbs. This is a perfect super-food that is both weight-loss friendly and inexpensive. Additionally, because eggs are high in protein they will keep you full throughout the day. Eggs are very versatile in the way you can prepare them making them a great meal at any time of the day. If anyone is thinking breakfast-for-dinner….so are we! Because eggs will be such a large part of your daily diet, we want to give you all additional ways to cook them and add in additional flavor!

Tips for Scrambled Eggs:

  • For added protein and creamier eggs – add ¼ cup of cottage cheese for every four eggs. Click here for recipe. 
  • For big fluffy eggs – add 1/4 tsp. of baking powder to egg mixture for every four eggs. Click here for recipe. 
  • For tangier and creamier eggs – add 1/2 tbsp. of plain Greek yogurt to egg mixture for every three eggs. Click here for recipe.

Tips for Added Flavor:

  • For added flavor – add chopped onions, peppers, mushrooms, spinach, or tomatoes to egg mixture before cooking.
  • For added protein and flavor – add black beans to egg mixture while cooking or add refried beans on top after completely scrambled.
  • For added protein and flavor – add salsa and cheese on top after completely scrambled.
  • For added flavor – add pesto into the scrambled egg mixture while cooking.
  • For added healthy fat and flavor – top with avocado chunks after eggs are completely scrambled.
  • For enhanced flavor – add salt and pepper to egg mixture before you start cooking.
  • For added flavor – saute spinach and pour egg mixture on top to cook.
  • For added flavor – add any fresh herb such as dill or thyme to egg mixture before cooking.
  • For spicy flavor – add curry powder to your egg mixture before cooking.
  • For added protein – add some cooked quinoa to your egg scramble after the egg mixture is cooked.
  • For extra spicy flavor – saute diced jalapenos and pour egg mixture on top or simply top with sriracha once cooked.

Convenient ways to make eggs:

Overall eggs are very rich in nutrients, versatile in your daily diet, and full of protein. They are an eggcellent and inexpensive way to ensure you are getting your daily recommended amount of nutrients and protein. If you have any specific questions related to this information provided or would like to make an appointment with one of our registered dietitians feel free to contact The Bariatric Center of Kansas City, 913-677-6319. Our specialists can assist you with information and bariatric support. 

If you’re interested in starting a bariatric journey soon, sign up to attend a free informational seminar today by registering at:  https://www.eventbrite.com/o/the-bariatric-center-of-kansas-city-at-shawnee-mission-health-lenexa-ks-324917613

September 18th, 2018 – Mind Over Body Image

 

Dr. Sabapathy started by defining body image as “…the perception of how we see ourselves or are taught to see ourselves.”  It is linked to our self-esteem and shaped by our experiences.  It is not gender based, and is usually either positive or negative. 

We tend to see the following characteristics with a positive self image:

  • Confidence
  • Trust in ourselves
  • Respect for our bodies and what they can do
  • Freedom of expression
  • Not weight dependent

With a negative self image, we tend to see:

  • Focus on physical appearance
  • Feel it is being scrutinized
  • Comparing self with others
  • Shame or embarrassment
  • Focus on external things

A lot of how we see ourselves as adults has to do with what we were taught to see ourselves during our childhood.  If we constantly heard negative comments at home, at school or others we were around, we tend to see ourselves negatively.  We internalize those negative comments and we come to expect people to react negatively to us.  If we remain around those people with negative comments, it becomes difficult to overcome a negative self-image.  As children, we don’t have much control over our environment or how adults talk to us.  As adults we can begin to manage our expectations. By being consciously aware of those situations where you know to expect negativity, you can prepare for that negativity, tell yourself positive thoughts, and limit the time and place to be in those situations. 

Some of the audience mentioned that they had a different group of friends now who were more positive. You may need to change your environment – do you live with negative people, do you need to spend less time with negative family members?  Do you need a different work environment?  That’s why support groups are great – they surround you with people who support you and give you positive reinforcement for all you’ve done. 

Dr. Sabapathy  talked about how some days we feel positively and other days negatively about ourselves.  Some of the emotions that can lead to negativity are:

  • Frustration – when we feel stress or barriers to what we are trying to accomplish, we become frustrated. Frustration can build up and accumulate. This leads not only to negativity but to anger as well  
  • Loneliness – this is a state of mind, and can occur whether you are alone or around others. Can lead to binge eating as a way to alleviate it.  Make a list of other things you can do rather than eating when feeling alone
  • Anger – this can result from a build up of frustration or when trying to hold in sadness. When you are craving something salty and crunchy, it is frequently because of anger.
  • Boredom – this happens most often during the evenings and on weekends so plan something during those times to help prevent it. It is okay to be bored sometimes.  It can lead to creativity and allow you some “down time” to relax and think of how far you’ve come.

Some ways to counter those emotions are:

  • Cultivating non-judgmental awareness of yourself, others, and those things that are out of our control. You cannot change anyone else, but you can change how you respond to them.
  • Mindfulness is being present in those moments and finding something positive in the situation
  • Change our expectations when we have to be in those situations that can be negative and prepare for them
  • When we are tired, our ability to shift to positivity is worn down, so avoid those situations when you are tired.

When our body image is stuck on how we used to see ourselves and want to change it, especially regarding seeing how far you’ve come in your weight loss journey, try noticing how you sit in a seat – a restaurant seat, a theater seat, an airline seat.  Notice how much more room is available, how much loser a seat belt is, how clothes fit you.

Take photos of yourself during your journey – and especially take them in a door frame. Then always take them in that same door frame so you can see how you fit in that door frame as time goes on. 

Broaden your definition of success – it is more than the number on the scale.  It is how much farther you can walk, taking less medication, feeling better overall, able to do things like cross your legs, ride a roller-coaster, etc.  and remember why you did this in the first place.  

How to Live and Maintain a Health Life

 

Living a healthier lifestyle and bariatric surgery go hand in hand in improving your quality of life. A healthy lifestyle is going to mean something different for each person, so it is important to get an understanding of what that means for you individually. Being “healthy” is not just about eating good and exercising, it is about a positive self-image, positive thinking, and surrounding yourself with the right people. We’ve highlighted four techniques that we think are vital to maintaining a healthy mind and a healthy life and followed that up with a list of 43 more ways to maintain that lifestyle!

 

1) Purge negativity from your life.
 Negativity can come at us from many angles, including yourself, your friends, your job, your family, and even your significant other. What we would like to focus on is ways to get rid of some of those negative thoughts and negative energies. First, let’s start with our self. It is important to understand that negative thinking can be a habit of mind. The only way to break a bad habit is to replace it with a good one, so let’s talk about a few strategies for negative thinking.

  • Simply talk your thoughts out with a supportive friend or family member
  • Write your thoughts down to get an understanding of what is triggering the them
  •  Calm your thoughts by taking some deep breaths so you can reset your mind
  • Find something you enjoy to do and when you start having negative thoughts you can go and do that thing. Ex: Read a book, go for a walk, go to an exercise class.
  • A personal favorite, create a positive go-to statement that you can say to yourself when you are hearing that negative voice in your head

Next is tackling when friends and family are bringing negativity into your life. Unfortunately, with bariatric surgery it is common to have unsupportive friends and family before and after surgery. Some may think you don’t need it, some may think you are taking the easy way out, some may be threatened or jealous, and some may simply be worried about your safety. Whatever the concern may be, it is best to address it directly. This can be a challenge for some patients to address because the people you love most and the people that should be happy for your success are the ones who are bringing you down and the ones you need to address directly. Here is how we divert negativity from friends:

  •  Try to change the subject
  • Limit your time together
  • Avoid conversations that have led down a negative path in the past
  • Find new friends that have similar interests as you

Now how do we deal with negative family members? Well we all know that we, sadly, cannot choose our family. What you do have the power to do is decide how much time you want to spend with them and how much you let them affect you. You can also set boundaries or where you draw the line when certain family members are being negative and let them know when they are crossing that line. Sometimes it is best to limit certain topics and discussions with family if you know they are going to go down a negative route. This can be a challenge for some, but family might not even be the best audience to talk to about bariatric related things, so remember we are always a resource for you to use along your journey.

2) Get enough sleep
Getting enough sleep is very important for your overall health and well-being. Sleep is correlated to weight, productivity, metabolism, immune function and so much more. A deficiency in sleep is an all too common occurrence in the United States. As part of a health survey for the Centers for Disease Control and Prevention, an estimated 50-70 million Americas have chronic (ongoing) sleep disorders. According to the National Heart, Lung, and Blood Institute, this is a problem because “sleep deficiency is linked to many chronic problems including, heart disease, kidney disease, high blood pressure, diabetes, stoke, obesity, and depression”. At a high-level sleep is necessary for healthy brain function, emotional well-being, and physical health. It is so important to be getting between 7 – 9 hours of sleep each night to function your best.

3) Find something you love or have a passion for
If you are someone that has been struggling to find their passion, finding something you love and investing it that will give you a feeling of purpose and fulfillment. For some, that purpose is blatantly clear, but for others, it isn’t as easy to identify. I am going to list a few tips that Jack Canfield, originator of the Chicken Soup for the Soul series and New York Times bestselling author, says will help you find your life passion and true purpose. (“10 Life Purpose Tips to Help you Find Your Passion”, Jack Canfield).

  • Explore the things you love to do and what comes easy to you
  • Ask yourself what qualities you enjoy expressing the most in the world
  • Create a life purpose statement
  • Follow your inner guidance (what is your heart telling you to do)
  • Be clear about your life purpose
  • Conduct a passion test – https://thepassiontest.com/
  • Think about the times you’ve experienced the greatest joy in your life
  • Ask yourself, when have I felt most fulfilled?
  • Align your goals with your life purpose and passions
  • Lean into your true-life purpose

By using and focusing on some of these tips and tricks you will be able to start living your everyday life with purpose!

4) Drink enough water
As we all know and are often told water intake is vital to our overall health. Drinking water is important, but most of us aren’t drinking enough water every day. It is needed to regulate our weight and body temperature, remove waste, and carry nutrients and oxygen around our body. Make sure you are drinking enough to keep you hydrated through out the day. Signs of dehydration include dark yellow urine, dry lips, dry mouth, and little urination. If you are someone that struggles with getting your daily water intake or struggles with the taste of water, here is a few things you can do to help.

  • Add fruit such as lemons and berries to your water to take away that bland taste
  • Set a timer on your phone to make sure you are drinking throughout the day
  • Always have a water bottle near by
  • Eat vegetables high in water content
  • Invest in a smart bottle that syncs to a hydration app and glows when you need to drink more water, link below.

As we mentioned before, these are just four tips of the many you can use to maintain a healthy lifestyle. Your four may be different, so here are 43 more ways to live out that healthy day-to-day life.

1. Drink more water
2. Get enough sleep
3. Meditate
4. Exercise
5. Pick exercises you enjoy
6. Work out different parts of your body
7. Eat fruits
8. Eat vegetables
9. Eat fermentable fibers
10. Pick different-colored fruits/veggies
11. Get your macro-nutrients
12. Get you micro-nutrients
13. Cut down on processed food
14. Choose white meat over red meat
15. Go for healthy fats
16. Love yourself
17. Go walking/running
18. Purge negativity from your life.
19. Avoid trigger foods
20. Breathe. Deeply.
21. Improve your posture
22. Address emotional eating issues
23. Eat small meals
24. Stop eating when you feel full
25. Live a life of purpose
26. Avoid deep-fired foods
27. Avoid sugary food/drinks
28. Don’t drink alcohol
29. Watch out on glycemic index
30. Go organic
31. Prepare your meals
32. Learn to say no
33. Bring a water bottle when you go out
34. Eat only what your body needs
35. Stop smoking
36. If you are going to snack, eat healthy snacks
37. Go for routine check ups
38. Enrich your diet
39. Experiment with new and different foods
40. Get out of the house more often
41. Exercise good dental hygiene
42. Join social interact fitness classes
43. Hang out with healthy people

The Bariatric Center of Kansas City wants to encourage and challenge you to focus on a few of the items on the list each week and over time you will see an improvement in YOUR personal version of a healthy lifestyle!

For more information on bariatric weight loss surgery, feel free to contact The Bariatric Center of Kansas City, 913-677-6319. Our specialists can assist you with information and bariatric support. 

If you’re interested in starting a bariatric journey soon, sign up to attend a free informational seminar today by registering at:  https://www.eventbrite.com/o/the-bariatric-center-of-kansas-city-at-shawnee-mission-health-lenexa-ks-324917613

Chua, C. (2018, August 23). 45 Tips to Live a Healthier Life. Retrieved from https://personalexcellence.co/blog/healthy-living/

Sleep Deprivation and Deficiency. (n.d.). Retrieved from https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency

10 Life Purpose Tips to Help You Find Your Passion. (2018, May 03). Retrieved from http://jackcanfield.com/blog/finding-life-purpose/

September 4th, 2018 – Rachelle Vigna’s Journey and the Susan G. Komen Event

Rachelle is one of our patients who had a gastric sleeve surgery about 2 years ago.  She came to share her journey and her experience with walking 60 miles in 3 days only 3 months after surgery.

Rachelle had a lap band placed elsewhere a number of years ago, and had problem with vomiting after eating for years.  She eventually came to us and had the band removed.  During the months after her band removal, she decided to come to some support groups to hear about the sleeve, and became friends with Kelly, another patient who had the sleeve a year before.  Kelly told her about the Susan G. Komen 60 mile walk in 3 days in San Diego.  Rachelle had a grandmother, mom, and niece who had previously had breast cancer, and her niece had died at the age of 29 from an aggressive breast cancer.  Rachelle decided she needed to do this in remembrance of her family members, and Kelly agreed to do it with her.  They started a 6 month training session shortly after she had her band removed.  3 months after her sleeve surgery, she and Kelly flew to San Diego for the walk.

Rachelle shared many of the pictures and stories from the 3 days, talking about the physical and emotional experience.  They finished the 3 day walk and met a lot of wonderful folks who were there either as survivors, or in remembrance of those lost to breast cancer.  It is the largest walk in the US, with around 2500 walkers going 20 miles a day along the coast.  You can walk as part of a group or team or on your own, but it is very well organized and there are many volunteers – including the San Diego police depart.  Everyone dresses up and the town is bathed in pink for that weekend.  The best part was the camaraderie everyone felt being together for a common cause.  There is food and water all along the route, there are vans to take those that can’t make it up to the next stop, you can camp out every night or stay in a hotel along the route, and when you reach the end of the walk, there are remembrance tents where you can go in and truly remember the person you are walking for, which is quite an emotional and spiritual experience.  Rachelle talked about how everyone helped encourage everyone else, and even pushed someone up the hill to Torrey Pines in a wheelchair.  She said she had a great sense of accomplishment and was so inspired by the time she was there.  I think everyone in support group was ready to go by the time she finished talking about it.  For more information, you can go online to the Susuan G. Komen Website. There are walks in 7 cities, but the largest by far is in San Diego.

Rachelle answered a few questions afterward, and shared that she had regained 10 lbs while going through a recent divorce.  During that time she stopped exercising daily and was eating things she knew weren’t on her diet.  She is now ready to get back on track, and was heading to the gym when she left. 

We are here to help so if you have any questions, comments, or concerns feel free to call our direct line at 913-677-6319. 

How to Dine Out Post Weight Loss Surgery

For many bariatric patients the thought of going out to eat after surgery is intimidating and frightening. Thoughts of  “I can’t eat anything on here”, “nothing on the menu is healthy” or “what if the way this is prepared makes me get sick” are all common concerns. Going out to dinner does not have to be something you dread, there just has to be a change in your mindset. Many day-to-day events and social activities revolve around going out to eat, so if it’s occasionally a part of your lifestyle that’s okay. We are going to help ease any anxiety that dining out brings by covering a few simple tips and tricks.

According to registered dietitian, Megan Moran, in her article “Dining Out Made Simple“, if you are specific with ordering, creative with portion sizes, and smart about your restaurant choice “you can regain the joy of dining out by following” these three painless tips.

Keep Things Specific and Simple
The first step is sticking to foods that you have tolerated post weight loss surgery. It is best to avoid trying new foods as “your favorite pre-weight loss surgery meals may no longer be tolerated, and you may not even like them [because your] tastes may have changed following surgery.” Now let’s think simplicity, your primary focus should be on a moist and soft protein that will be easy to digest. Good protein options include but are not limited to: boneless baked fish, dark chicken meat, beans, tofu-based dishes, and meats in soups. Here is Megan’s example of a properly ordered meal, “may I have a moist piece of fish: baked, not fried, and a side of steamed cauliflower with no added oils, butter, sugar, or salt.” While being specific may be intimidating, it is important to know exactly what you are eating. Most restaurants will accommodate your request and best of all, if they do fulfill your order you can frequent that restaurant knowing they adhere to your dietary needs.

Know Your Portion Size
With restaurant portion sizes continuing to increase in size, controlling and knowing the correct portion size for each food group is very important. The Bariatric Center of Kansas City’s registered dietitian, Annie Epp, says that “building the perfect plate at a restaurant would include 15-20g of protein equaling about 3oz (or a deck of cards), 1/3 cup of non-starchy vegetables, and no more than 1/3 cup of carbohydrates.” In order to achieve this “perfect plate” you can request a half portion of your meal for a reduced rate and if the restaurant seems hesitant offer to show them your special menu request cards and see if they will accommodate after that. If they choose not to grant your request, you could ask to be served half of the meal and have the remaining half boxed up. An additional option would be to share your meal with someone in your dinner party. No matter what option you choose, just focus on the correct portion size so you do not overeat.

Choose a Quality Restaurant
While some fast food restaurants may have smart choices and accommodate to your dietary needs, the best option is to select a restaurant that offers good quality food. Once you select a restaurant, it may ease some of that menu anxiety if you call ahead and ask if they will cater to your needs. In fact, Rick Sampson, President and CEO of New York State Restaurant Association, “encourages people to request smaller entrees or portions and emphasizes that customers should not feel obligated to explain why they need this request. Restaurants cater to individuals with other medical needs, such as heart disease and diabetes, so requesting needs in food preparation for weight loss surgery should be no different.”

Overall, by focusing on a simple protein-centric meal, understanding the proper portion size, and choosing an accommodating restaurant, dining out will become an enjoyable experience again. To summarize, our registered dietitian, Annie, lists a few basic tips surrounding the post weight loss surgery dining out experience.

  •  Focus on 15-20g of protein per meal (3oz = deck of cards)
  • Eat 1/3 cup non-starchy vegetables with 2 of your 3 daily meals
    • Green beans, asparagus, broccoli, cauliflower, brussels sprouts, etc.
  • No more than 1/3 cup carbohydrate with 2 of your 3 daily meals
  • Ask for salad dressing or sauce on the side
  • Expect to need a to-go box
  • Order foods that keep well since you will likely be taking it home (example: chili)
  • Do not be afraid to ask for what you want or tolerate even if you do not see it on the menu- most restaurants are happy to accommodate you.
  • Enjoy the experience and company of dining out and don’t just focus on the food

 

Moran, M. (2007). “Dining Out Made Simple.” Obesityhelp.com. Available at: http://www.obesityhelp.com/magazine/restaurantcard.html/mode,pcontent/cmsID,11385/ [Accessed 13 Sep. 2018]

August 25th, 2018 – Sleep Apnea: When Will It Go Away?

Facilitated by: Dr. Eveloff, Sleep Medicine

Dr. Eveloff is a sleep medicine physician and works with patients who have obstructive sleep apnea (OSA).  He said that  most explanations of sleep apnea are incorrectly saying that a person stops breathing at night while asleep.  It isn’t that you stop breathing, but that you have an episode where your airway closes down and narrows to the point where it decreases your oxygen flow.  OSA can increase your risk of high blood pressure, diabetes, coronary artery disease putting you at a higher risk for a heart attack or stroke.  It can also cause you to awaken a lot at night.  Many people wake up to urinate a lot at night and think it is because their bladder is full, when in fact it is due to sleep apnea.

The main risk factor is excess weight or obesity.  It is one of the co-morbidities that qualifies a person for bariatric surgery.  Patients with OSA are at a higher risk for anesthesia, as OSA can lead to and increase  complications following surgery.  The more severe the sleep apnea, the more severe the complications.  This is why it is so important for everyone to be screened for sleep apnea prior to surgery, and if they are at risk for OSA to get a home sleep study. If a sleep study shows the OSA is moderate or severe, they need to have CPAP, or continuous positive airway pressure.  Without it, the patient will not be getting adequate oxygen during the night which can lead to daytime sleepiness and even weight gain as it can cause an increase in one of the hormones that makes you hungry. 

There is a connection between the breathing center of the brain and the muscles of the pharynx  or throat.  Because our pharyngeal muscles are used for many things, they are collapsible.  Obesity can increase the pressure on those muscles making them collapse more easily.  Weight loss can help resolve the sleep apnea, but it is impossible to know if the sleep apnea has resolved without repeating a home sleep study.     

Conditions that may worsen sleep apnea are nasal congestion, sedatives for sleep, and pain medication.  If you have nasal congestion, that needs to be treated in addition to the sleep apnea. Some signs that may indicate you should be retested are if you stop snoring, you are no longer tired during the day, you no longer wake up at night, and you have lost 20% of your body weight.  Retesting is the ONLY way to be sure you no longer have sleep apnea.  

Dr. Eveloff answered a number of questions from the group:

  • Are self-cleaners for machines important?
    • If you wash it with soap and water weekly, or once a month with vinegar, you should be fine.  You don’t need those cleaners.
  • Does snoring always mean you have sleep apnea?
    • No it doesn’t, but those with OSA usually do snore.
  • My CPAP causes nasal congestion.
    • If using the CPAP causes nasal congestion, you need to treat the nasal congestion first, and then the sleep apnea.
    • No one mask is better than another for this, and it may be that the pressure in the machine is too high and needs to be adjusted.
  • What is the difference between a home study and one done in a sleep lab?
    • The home study is checking for 3 different variables and the one in a sleep lab is checking for 14. For most people, the home sleep study is just fine. 
    • There are conditions that require a more comprehensive test, but for our purposes, a home study works well.
  • What is central sleep apnea or clear airway apnea?
    • This is a completely different type of sleep apnea where the person literally stops breathing. This can be due to taking a lot of opioids.
  • If you don’t wake up at night, does that mean you don’t have sleep apnea?
    • No, you may not be aware of waking up, and still have it. The only way to know for sure is to be tested.

The Benefits of Weight Loss Surgery Over Traditional Dieting Explained!

 

Society tends to blame the failure to lose weight on lack of willpower, but the truth is much more complicated than that. In New York Times article, “Why Weight Loss Surgery Works When Diets Don’t”, Dr. Twells, a clinical epidemiologist, explains that “the overwhelming majority of patients who undergo bariatric surgery have spent many years trying – and failing – to lose weight and keep it off.  And the reason is not lack of willpower.” The only consistently successful weight-loss method for morbidly obese people (those with a BMI over 40) has been bariatric surgery. Without undergoing surgery morbid obesity is very difficult to cure.

Dr. Twells goes on to elaborate that traditional dieters “have lost hundreds of pounds over and over again. The weight that it takes them one year to lose is typically back in two months.” The reason for this is because “a body with longstanding obesity defends itself against weight loss by drastically reducing its metabolic rate” an effect not seen after bariatric surgery. Helen Leahey, journalist for The Washington Post, concurs that “attributing the cure to personal responsibility is inaccurate and ineffective.” (“Resolving to Lose Weight this Year? Willpower isn’t your biggest obstacle.”)

 

There are multiple studies that prove weight loss surgery has long lasting effective results. In fact, Dr. Twells reviewed a study that followed patients from five to twenty-five years after weight-loss surgery and found the surgery had positive impacts on the patients’ health and quality of life. These patients rated themselves as “healthier and less likely to report problems with mobility, pain, daily activities, social interactions, and feelings of depression and anxiety.”

While weight loss can be the ultimate goal for some patients, let’s talk about the metabolic benefits. “For the two most popular surgical techniques – the gastric bypass and the gastric sleeve – the metabolic benefits are independent of weight loss.” Moreover, according to findings at the Cleveland Clinic, for the small percentage of patients who lose less weight than most after surgery, significant metabolic benefits persist. Benefits include increased blood circulation, reduced toxins in the body, a more positive mood, and an increase in overall energy.  Even more importantly, studies are now showing  an extremely positive impact for patients with Type II diabetes, with weight loss surgery often leading to a significant reduction in insulin requirements, or better yet, a complete cure!

To conclude, Dr. Jon C. Gould, a surgeon at the Medical College of Wisconsin in Milwaukee, stated that “bariatric surgery is vastly underutilized, less than 1 percent [of people] who would qualify for bariatric surgery are actually getting it.”  There is a perception that bariatric surgery is dangerous and doesn’t work, but this is countered by extensive research on long term results following surgery. While many experts would agree that money would be better spent of prevention than treatment, Dr. Twells pointed out that “we have yet to find a way to prevent obesity, and people whose health is compromised by their weight deserve to be treated by the most effective method we have.” Bariatric surgery is not a cop out and failure to lose weight is not lack of willpower. Bariatric surgery is an effective means to end your struggle to lose weight.

For more information on bariatric weight loss surgery, feel free to contact The Bariatric Center of Kansas City, 913-677-6319. Our specialists can assist you with information and bariatric support. 

If you’re interested in starting a bariatric journey soon, sign up to attend a free informational seminar today by registering at:  https://www.eventbrite.com/o/the-bariatric-center-of-kansas-city-at-shawnee-mission-health-lenexa-ks-324917613

Leahey, Helen.”Resolving to Lose Weight This Year? Willpower Isn’t Your Biggest Obstacle.” The Washington Post, January 1, 2015.

Brody, Jane. “Why Weight Loss Surgery Works When Diets Don’t” The New York Times, February 13, 2017.