All posts by Dee Anne Agonis

Is Your Scale Stuck?


Are you finding yourself STUCK? Are you wondering how to get back on track? Are you considering doing the liquid reset that is so popular in the Bariatric community? You don’t have to torture yourself anymore to get that “full” sooner feeling and to jump-start your weight loss again, all you need is a plan! You see, the original purpose of an all-liquid diet is to shrink the liver pre-op. It was never intended to be a go-to when you hit a weight plateau. Liquid diet “resets” can make us feel deprived therefore harder to stick with. It can also make you feel drained, which is rather discouraging because you are lacking proper nutrition during a liquid diet “reset”. Instead, our top option should be to go back to the basics of bariatric eating. You can eat real food and still get the result you intended with this and other plans. You can “reset” your eating and rid your body of sugar at the same time with proper nutrition. By the end of a “reset” you should be able to tell a big difference in how much you are able to eat and might even see that scale move!

If you feel you are truly having difficulties with your nutrition or have developed new food aversions and need more guidance, please feel free to call our office and set up an appointment with one of our Bariatric Registered Dietitians. They would be happy to help!

A Big “Thank you!” to Annie Epp, one of our dietitians here at The Bariatric Center of Kansas City for sending over this 7-day plan complete with recipes and grocery shopping list. It looks great!







Day 1

2 eggs, 1 slice deli turkey, low fat mozzarella cheese sautéed in skillet 

Leftover Ranch Pork Chops with sautéed ranch bell peppers

Baked salmon

Basil tomato tossed side salad

rice of choice

Day 2

Protein Pumpkin Pancakes with Greek yogurt topping

Left over Baked salmon

Basil tomato tossed side salad

 rice of choice

Pan Seared steak strips, Brussel sprouts sautéed with lemon and garlic

Day 3

2 eggs, 1 slice deli turkey, low fat mozzarella cheese sautéed in skillet 

Left over Pan Seared steak strips, Brussel sprouts sautéed with lemon and garlic

Pan Seared chicken breast with marinade of choice, steamed green beans, and baked apples

Day 4

Protein Pumpkin Pancakes with Greek yogurt topping

Left over Pan seared chicken breast with marinade of choice, steamed green beans, and baked apples

Tuna salad with sweet mini peppers

Day 5

2 eggs, 1 slice deli turkey, low fat mozzarella cheese sautéed in skillet 

Left over Tuna salad with sweet mini peppers

White Turkey chili

Day 6

Protein Pumpkin Pancakes with Greek yogurt topping

Leftover White Turkey Chili

Chunky Garden Italian Chicken with steamed broccoli

Day 7

2 eggs, 1 slice deli turkey, low fat mozzarella cheese sautéed in skillet 

Leftover Chunky Garden Italian Chicken with steamed broccoli and an apple

Ranch Pork Chops with sautéed ranch bell peppers



Protein Pumpkin Pancakes




1 scoop vanilla whey protein powder

1 tsp pumpkin pie spice

1 tsp ground cinnamon

1/2 tsp baking powder

1 egg

2 tbsp unsweetened almond milk


1/2 cup 0% fat, plain Greek yogurt

2 packets natural sweetner Ex: Truvia

1/2 tsp pumpkin pie spice


  1. Mix dry ingredients together: protein powder, pumpkin pie spice, cinnamon and baking powder.
  2. Add egg and mix together well. Add unsweet almond milk and mix batter together until smooth.
  3. Add to pre-heated griddle pan and let cook until slightly bubbly on top. Flip and cook about 30 seconds longer.
  4. Serve with light cool whip or plain Greek yogurt with pumpkin pie spice and sweetener.

Recipe Notes

This recipe makes 4 pancakes. Each pancake provides an estimated 9 g protein, 3 g carbs, 2 g fat.


Pan Roasted Sweet Peppers



Cook Time-10 MINUTES


1 lb sweet mini peppers

1 tsp olive oil

1/4 tsp sea salt


  1. Remove stems from peppers, cut in half lengthwise and remove seeds.
  2. Heat a non-stick skillet to medium-high heat. Add olive oil (or cooking spray).
  3. Add peppers to the pan. Season with sea salt and let cook 8-10 minutes, stirring occasionally, until starting to both blister and soften.

Recipe Notes

This recipe makes 4 servings. Each serving provides an estimated 43 calories, 1 gram protein, 7 grams carbohydrates and 1 gram fat.


Basil Tomato Tossed Side Salad



4 cups green leaf lettuce

3 tbsp fresh basil, torn

2 cups grape tomatoes, halved

2 oz shredded parmesan cheese

lemon vinagrette recipe linked above


  1. In a medium bowl, toss lettuce and basil. Top with tomatoes, parmesan cheese and lemon vinaigrette.
  2. Toss and serve.

Recipe Notes

This recipe makes 8 servings. Each serving provides an estimated 2 grams protein, 9 grams carbohydrate and 9 grams fat. Pair with a lean protein entree


White Turkey Chili



1 lb 93% lean ground turkey

1/2 cup chopped onion

1 clove garlic, pressed or minced

2 cups water

1 cup cannellini beans, rinsed

4 oz green chili peppers

2 cubes chicken bouillon

1 tsp ground cumin

1/4 tsp black pepper


  1. Brown the ground turkey with the garlic and onion; drain.
  2. Add all other ingredients to slow cooker. (This can also be made on the stove top!)
  3. Cook on high 3-4 hours or low 6-7 hours. Can top with shredded low-fat cheese…but I ate it plain! Yumz.

Recipe Notes

This recipe makes 4 servings. Each serving provides an estimated 25 grams protein, 12 grams carbohydrate and 7 grams fat. 


Chunky Garden Italian Chicken


Cook Time 20 MINUTES


1 lb chicken breast tenderloins

6-8 mini sweet bell peppers, seeded and sliced

1/2 cup yellow onion, diced

1 clove garlic, minced or pressed

1 cup mushrooms, sliced

2 tsp Italian seasoning

1 (14.5 oz) can diced tomatoes


  1. Heat a large nonstick skillet to medium high heat. Spray with olive oil or cooking spray.
  2. Sprinkle all sides of chicken breast with salt and pepper. Place chicken in heated skillet and cook 4 minutes per side or until internal temperature reaches 165F. Work in batches as

needed. Remove chicken from pan and return pan to heat.

  1. Add the bell peppers, onions and garlic to the pan. Saute for three minutes and add mushrooms and Italian seasoning. Cook another 5 minutes or until mushrooms are softened.
  2. Add can of tomatoes and cook 2 minutes or until mixture is heated through. Add chicken back to pan just to re-warm. Remove chicken to plates and top with chunky garden vegetable


Recipe Notes

This recipe makes 4 servings. Each serving provides an estimated 27 grams protein, 11 grams carbohydrate and 2 grams fat. 


Ranch Pork Chops


Cook Time-20 MINUTES


4 (4 oz) boneless pork chops                                      

1 packet dry ranch seasoning

1 tsp ground black pepper

1/3 cup dijon must


  1. Heat oven to 375F.
  2. Mix together ranch and mustard. Rub all over pork chops.
  3. Place in the bottom of a casserole dish.
  4. Bake for 20 minutes or until internal temperature reaches 145F.

Recipe Notes

This recipe makes 4 servings. Each serving provides an estimated 23 grams protein, 4 grams carbohydrate and 7 grams fat.


Sautéed Ranch Bell Peppers



2 green peppers, cut into strips

2 tbsp ranch seasoning

1/4 tsp sea salt

1/4 tsp black pepper


  1. Heat a nonstick skillet to medium high heat. Spray with light cooking spray or olive oil.
  2. Add bell peppers and cook, stirring occasionally, until tender. About 10 minutes. Remove from heat to medium bowl.
  3. Add ranch seasoning, salt and pepper. Toss together and serve.

Recipe Notes

This recipe makes 4 servings. Each serving provides an estimated 0 grams protein, 3 grams carbohydrates and 3 grams fat







Thrift Shopping During Your Weight Loss Journey

One of the more exciting non-scale victories that come with weight loss is updating your closet. Well-fitting clothes make all the difference in before and after photos, and they can help you feel more confident, as well as show off your progress. It may be tempting to replace your entire closet with designer brands and clothes that fit now, but it’s important to realize that your weight loss journey is ongoing and fluid, so it might be smart to hold off on dropping your next paycheck on brand new clothes. One way around this is to explore the process of shopping at thrift stores. Thrift stores are a great source of gently-used clothes that you can enjoy temporarily or even long-term.


    Gina, one of our case managers here at the Bariatric Center of KC, has some great tips when it comes to thrift shopping for clothes as you embark on your weight loss journey.

“Find something that catches your eye, and throw it in your cart! Be sure to try it on before you purchase it so you know what it looks like on you.”

Gina says she’s managed to snag several name brand items of clothing for just a few dollars, and some still even had the tags on them.

She recommends shopping at thrift stores because an item might fit one day, and might be much too big the next. So, you’re only out a few dollars as opposed to what you would spend on a brand new item of clothing.


Thrift stores carry everything from dresses to work out clothes, so there’s a good chance you’ll find an outfit for a date night, a day in the garden, and one for work too.

We recommend washing any purchased clothes prior to wear in order to give them a “new” feel, and we recommend buying clothes that are in season, as there is no way to know what your size will be several months down the road.

What advice do you have for clothes shopping after weight loss surgery?

Share them with us on our Facebook page and support group!

April 20, 2019 – Alternatives to NSAIDs

Chris first talked about different types of pain – acute and chronic; mechanical, thermal or chemical, and nociceptive or neuropathic pain.

The 3 main types of pathophysiology of chronic pain are:

1. Nociceptive – this is pain that results from tissue damage, such as seen with rheumatoid arthritis
2. Neuropathic – this results from pain that originates from the actual nerves
3. Hypersensitivity – results from over stimulation of nerves over a large area such as with fibromyalgia

Typical treatments of pain include:

  • Analgesics – medications designed to relieve pain, such as opioids, aspirin, etc.
  • Steroids – which decrease inflammation, but also have serious side effects
  • NSAIDS – which also reduce inflammation
  • Cold and heat therapy
  • Physical therapy – helps to repair the damage

How NSAIDs work:
When there is an injury your body releases chemicals called prostaglandins. The chemicals are sent to site of injury and produce pain, fever, inflammation, support platelets to decrease bleeding, and help protect the lining of the stomach.

When you take an NSAID, it reduces the inflammation, pain and fever. However, they prevent platelets from clotting and can promote bleeding, and also prevent the protection of the stomach lining, so you are more prone to ulcers, which is why our patients cannot take them right before and after surgery.

Complementary and alternative therapies are frequently used by people to reduce pain, and while these exist outside normal health care practices, many have been found to help decrease pain.

The ones most highly rated are:

  • Acupuncture – when used by an experienced practitioner, this can been a very effective way to manage pain
  • Massage – is very effective for fibromyalgia and low back pain – works best for muscle related pain
  • Tai Chi – the slow movements can be highly effective for osteoarthritis and degenerative joint disease
  • Yoga – is very effective for low back pain, as it stretches out the nerves and can be modified as needed
  • Chiropractics – depends on the practitioner, but can be helpful for musculoskeletal issues
  • Relaxation – promising for fibromyalgia and low back pain (we have a relaxation CD that is available for those who want a way to do head to toe relaxation)

Therapies that have not been found to be as effective are aromatherapy, meditation, biofeedback, copper braclets and magnets, craniosacral therapy, hypnotherapy, imagery, Qigong, and reflexology. While many people practice these above and report relief, there is no science behind them It is recommended to try them a couple of times a week for a couple of months and if not relief, move on.

As far as supplements, the one used most extensively in Europe and is said to decrease or eliminate the used of NSAIDS after a few weeks is ASU – Avocado Soybean Unsoponifiables. Because Europeans use considerably less pain medication than in this county, they tend to use more natural sources. This is said to be as effective as NSAIDS when taken twice a day, although it takes a couple of weeks to get the best relief. It is available on Amazon.

Other frequently used supplements for joint pain are glucosamine and chondroitin. These supplements slow the progression of osteoarthritis and improve joint function. They are said to be as effective as Celebrex at doses of 800 – 1200 mg a day.

Fish oil supplements, which provide omega 3 fatty acids help to block inflammatory cytokines, or chemicals that are released with inflammation. Even rheumatologists have recommended OMAX 3, which is especially pure fish oil that decreases inflammation in rheumatoid arthritis. Flaxseed is high in linoleic acid, which is a type of Omega 3, but should be used with caution as it can act as a blood thinner.

The spice Ginger has an effect similar to a class of NSAIDS called Cox 2 inhibitors. It is taken in doses of 2 gm/day in food.

Indian Frankincense (300 – 400 mg a day_ slows cartilage damage and is a strong anti-inflammatory and analgesic.

Sam-e is a supplement that is used as a effective anti-inflammatory and analgesic that works well with B Vitamins. It has been studies and is said to work as well as Celebrex. It should be monitored by a PCP.

Any supplements should be cleared with a physician first to insure they do not counteract other prescription medication you are taking.

Another supplement that has gotten a great deal of press lately is CBD Oil – it is made from HEMP and is a major constituent of cannabis, or marijuana. However, CBD oil is supposed to have less than 0.3% THC, which is the substance that causes a “high” when ingesting or smoking marijuana. The only FDA approved form of CBD oil is Epidiolex, which is approved for use in seizure disorders in children. There have been many CBD oil shops pop up around the country, and it is important to know that 70% of the oil sold did not contain the amount stated on the label, and many had more THC than they are supposed to, which can lead to altered senses or depression.

As far as topicals, the best, which is by prescription only, is Voltaren gel. It does have to be used several times a day, and needs to be used regularly for best results. Capsaicin is made from the pepper family, and provides warmth to the affected area. Always wash hands after using. Aspercream, and Bengay are aspirin based creams and provide some relief, as do Lidoderm patches. There are helpful in the short term, but don’t work as well for chronic pain.

There are dietary modifications that can dramatically help prevent inflammation.

The main foods to avoid are:

  • Sugar
  • Saturated and trans fats
  • Omega 6’s – corn oil, safflower, sunflower grapeseed, soy and peanut oil
  • Aspartame
  • Refined carbohydrates like donuts, white breads, white rice and pasta
  • Limit alcohol
  • Nightshade vegetables (for some people) – tomatoes, peppers, eggplant, etc.

The best anti-inflammatory diet is to follow the Mediterranean diet, as most of the foods contain anti-inflammatories and antioxidants:

  • Fish- especially cold water fatty fish – sardine, mackeral, salmon
  • Veggies – broccoli, sweet potatoes, onion, kale and peas
  • Olive oil and safflower oil
  • Nuts – walnuts are the best
  • Green tea

How to Prepare for Weight Loss Surgery

how to prepare for weight loss surgery in kansas city

Bariatric surgery is a life changing decision that takes many people years to make.
It is the most effective way to lose weight long-term and will drastically change your life physically, mentally, and emotionally. In order to prepare for the changes you will face along your journey, there are many essential steps you can take. Knowing that your commitment begins well before surgery will help you be that much more successful!

With the help of our past patients we gathered 10 ways you can start preparing for weight loss surgery in Kansas City today:



1. Research: Visit our website, read books and articles, come to our support group meetings, join our closed support group on Facebook and ask questions to our past patients. Our community of patients online can help answer questions you may have and they will give you real, honest, experienced feedback.

  • Talked with others that had the surgery, asked about their ups and downs. -Jessica
  • Tried to find WLS patients and their success stories on social media. – Nicole
  • I also watched a ton of youtube videos from patients on what their experience was like (warning: this can be good and bad). – Kristen **be careful as not all information is valid
  • I attended the support group meetings prior to surgery and it helped me SO much. – Amanda
  • Research went to several seminars on the subject and picked bariatric center because they had the best presentation and all the surgeons were there my first night visiting I was so impressed with them. – Rexanna
  • I join the Facebook group and asked questions to patients that already had surgery. That was really helpful. – Karla
  • I looked up stories of others that have had the surgery and saw their before and afters. – Shawn
  • The monthly group support classes at the Bariatric Center help. – Peggy
  • I researched it and talked to my physician about it…. Was given 3 recommendations and checked them all out…. Attended seminar and just confirmed KC Bariatrics was the place to go -Don

2. Make Changes to your Diet: Try to minimize snacking and focus on getting three protein centered meals throughout the day. You can also reduce or eliminate high carbohydrate foods, fast foods, carbonation, caffeine, and sugar.

  •  I ate clean and lean, cut out processed sugars, soda and coffee. -Chane
  • I immediately changed my eating habits so I could be strong for the recovery. -Jessica
  • We started eating (mostly) like we would afterward, cutting way down on carbs, eating protein first. I made sure we had plenty of protein shakes, Jell-O, sugar free Popsicles and Bomb Pops, broth, and other phase-appropriate foods so I wouldn’t have to worry about getting them later. – Roger
  • I focused on getting in enough protein. -Lisa
  • Cleaned out my kitchen! – Stephanie
  • I stopped sugar the year before and stopped eating a lot of carbs. – Rexanna

3. Understand your Insurance Policy: While we are in network with most major insurance plans, not all insurance plans cover weight loss surgery and the pre- and post-operative clinic visits. Insurance companies can have requirements for BMI, comorbities associated with weight, completion of a supervised diet, and more.

  • Calling my insurance really cleared things up for me. I felt more informed about the costs and, more importantly, why I was paying certain costs. -Megan
  • I called my insurance because I wanted to know more about the BMI requirements. – Dan

4. If you smoke or use tobacco/nicotine products, quit: Smoking and the use of tobacco and nicotine products affects how the body handles surgery. It has also been proven to dramatically increase the risk of complications during and after bariatric surgery. Additionally, smoking makes it harder for your body to heal after surgery because it decreases the amount of oxygen available to your cells.

  • When I found out that smoking can increase my chance of a complication I quit right away, it was one of the hardest things I’ve had to do, but I am so glad I did. -James

5. Begin tracking your food and water: Keeping a record of your food and water intake can be very eye opening and give you a better understanding of your current eating habits. This will hold you accountable and help you reach your goals. There are many phone apps out there that can help you do this.

  • I already downloaded the Baritastic app (love that app!) and started tracking my food. – Nicole

6. Drink more water: This is something many patients struggle with after surgery. Focus on trying to drink 64 ounces of water every day and make sure you aren’t drinking empty calories. Limit high calorie beverages, alcohol, juice, and energy drinks. Eliminate caffeinated and carbonated beverages. Stop drinking liquids with your meals and wait 30 minutes after a meal before drinking.

  • I bought an insulated water bottle to keep my water nice and cold and made sure it was big enough too. I don’t like warm water and knew if I had to refill it a lot I would struggle with drinking my daily intake. – Eli
  • I was not a regular water drinker prior to surgery, so I really tried to drink 64 ounces of water everyday before dinner. – Sam
  • I cut out all soda and sugar and cut back on caffeine. – Stephanie

7. Find an exercise plan that works for you: If you don’t currently exercise, start small and create a workout routine that works with your level of fitness and physical ability. You can take a walk, walk up and down your stairs at home, do chair exercises, do arm workouts while watching tv, etc. The most important thing is to find something you enjoy doing and stay consistent.

  • I went on a walk every day and worked my way up to 3 miles. -Chase
  • I took walks with my dog 5 days a week. – David
  • I started going to the gym every day to get into the habit. – Becky

8. Commit to not gaining additional weight: Some of our past patients have expressed that they overate before their surgery. They knew they were getting the weight loss surgery but didn’t try to lose or maintain before their operation. Try to avoid binge eating and eating bad unhealthy foods “for the last time.”

  • Learn from my mistake – I overate in the months prior to my surgery because my insurance didn’t require any supervised dieting. I now know how unhealthy that was and wish I would have started my healthy eating habits before my surgery. – Carris 

9. Change your relationship with food: Learn to stop eating your feelings, do not think of food as a reward or a punishment. Think of eating as fuel for your body. Our body needs nutritious wholesome food in order to have enough energy to do day-to-day tasks. Make sure to eat mindfully and focus on eating slowly and chewing your food. 

  • I sat down with the foods and had put me in the poor condition I was in and told them it was time to say goodbye. I made a small ceremony of it. It had to be official. I also made a point to make my kitchen more accommodating for healthier eating (got rid of large dishes and made a permanent spot for my new scale). I cleaned out my entire food supply and stocked it with things that are within the new dietary guidelines. – Eli
  • I started to ask myself “why?”. Why am I eating this to feel better? Why do I eat desserts when I am sad? Why am I not eating food that is fueling my body? -Cynthia
  • I had the 6 mo insurance approval time , so I implemented almost all my post OP rules (lifestyle) preop. I lost 50# prior to surgery! I also replaced 1hr of TV time with walking. – Wendy

10. Focus on your mental and emotional health: Make sure you are emotionally and mentally ready to make this change in your life. Ask yourself why you want to have weight loss surgery or what factors have contributed to your weight? You may also want to create a support system for yourself that will help you make positive healthy decisions. Find new hobbies that you enjoy that don’t involve food – check out this blog: “Fork Free Hobbies“. Set some goals for yourself and remember – small steps lead to big victories! 

  • I also limited myself from negative people I knew against having surgery. While I appreciated all feedback in the end I’m the only one walking in my shoes not them. – Chane
  • Found support in (close) family members and friends that I knew who would understand why I needed to take the journey. PRAYED, A LOT, for strength and understanding. – Jessica
  • Mentally visualized my goals and wrote down why I was doing this. – Amanda
  • Saw an eating disorders therapist, practiced chewing a lot and following the drinking around meals rules. – Deena
  • Therapy! I saw Dr. Coker like 4 times and then I saw a therapist from February- November of 2018. Surgery was in July 2018. It helped me manage my emotions before and after.
  • It really came down to wiping out everything I knew that caused this weight issue and taking in new habits that made my new lifestyle easy to maintain. -Eli
  • I shared with friends and family my plan for Bariatric surgery. That gave me extra support and accountability. – Stephanie

If you are ready to take the next step toward the future you click here to sign up for our free informational weight loss seminar! If you would like to speak to someone about our program please call 913-676-8492 and Katie will be able to answer any questions you may have. 



April 2nd, 2019 – Carbohydrates Explained

One of our dietitians, Annie Epp, RD, spoke about Carbohydrates.  With all the information about low carbohydrate diets out there, she wanted to explain the difference between types of carbohydrates and which are the healthiest. She started with the actual building blocks of carbohydrates. 


The most simple building block of carbs are monosaccharides, which she described as a single pearl on a pearl necklace.  The are a 5 or 6 carbon rings bonded to oxygen and hydrogen. 

  • The monosaccharides are:
    • Glucose
    • Fructose (the sweetest form)
    • Galactose (the carb in milk)

Two monosaccharides joined together are a disaccharide.

  • These combinations may be one of the following:
    • Maltose – which is 2 glucose monosaccharides joined together (alcoholic beverages, barley)
    • Sucrose – which is 1 glucose and 1 fructose joined together (table sugar)
    • Lactose – which is 1 glucose and 1 galactose joined together (carb in milk)
    • High Fructose Corn Syrup (HFCS) – this is glucose combined with a fructose, but artificially processed – this is not a natural carbohydrate – cheaper to process than real cane or beet sugar, and became popular in food industry as a cheap and easy way to sweeten foods. The introduction of HFCS is when the obesity epidemic began, and it is suggested that this is part of the cause.

The monosaccharides and disaccharides are the simplest form of carbohydrate and therefore are absorbed very quickly, which causes the blood sugar to spike and fall quickly.  This is NOT a good source of energy for sustained period.  You find these in table sugar, candy, desserts, and sugary drinks.  The only simple carb that is okay is dairy products, because of the protein that they also provide, and this helps to prevent the extreme blood sugar spikes.

Refined Carbohydrates and Sugars:

These are grains that have been processed to remove the bran and germ of the grain. This gives the grain a finer texture for baking, but also removes the fiber, iron and B vitamins.  These should be avoided. Examples are white bread, pasta and rice, sweets and candy, gas station snack foods, sugary drinks. 

Sugar Alcohols are a form of carb that isn’t completed digested. These include xylitol, sorbitol and mannitol.


These are many monosaccharides linked together, and the 3 types are:

  • Starch – the storage form of carbs in plants, like corn, peas, potatoes and wheat
  • Glycogen – the storage form of carbs in animals (including humans) in liver and muscle
  • Fiber – dietary fiber found naturally in whole grains, fruits, vegetables, nuts and seeds, and beans and legumes.

Some fiber is absorbed (soluble fiber) and some cannot be absorbed and passes out of the body.

Complex carbohydrates do not cause the big spikes in blood sugars, which is important because when blood sugar is high, it results in insulin allowing glucose to enter a fat cell increasing the overall fat mass.


When reading a nutrition label, the “sugar” listed is the total amount of carbs from the mono and disaccharides, or the simple carbs.  These you want to avoid.

The Total Carbohydrates = the total Sugars, Starches and Fiber.  Ignore the term “Net Carbs” because this is just a marketing tool to make you think it is lower in carbs.  The only one to really count is the Total Carbhydrates.

Meal Composition after you heal from surgery should be the following:

  • 3 oz. solid protein 3 meals a day (50 – 60 gm of protein/day)
  • 1/3 cup non-starchy vegetables with 2 meals a day
  • 1/3 cup of fruit or whole grains with 2 meals a day

This should give you approximately the following composition:

                30-45 grams of total carbs per day

                10-15 grams of total carbs PER MEAL if eating carbs with 2 meals a day

                5 – 10 grams of total carbs PER MEAL if eating carbs with 3 meals a day

Annie then showed us a few examples of good and poor choices in individual frozen meals you can buy:

Good Choices Included:

  • Smartmade Chicken Fried Cauliflower Rice Bowl – 18 gm protein/16 gm carbs
  • Bariatric Pal Vegetable Chili – 15 gm protein/9 gm carbs

Bad Choices included:

  • Smartmade Roasted Turkey and Vegetables – 20 gm protein/36 gm carbs
  • SmartOnes Santa Fe Rice & Beans – 11 gm protein/39 gm carbs

Just as you try to get in 60 grams of protein a day, try to keep your carbs to no more than 60 grams, so you are matching carbs/protein 1 to 1, and you will be doing well!






March 19th, 2019 – Benefits of Exercise Beyond Weight Loss


While we are all aware that exercise increases weight loss, there are many other benefits to becoming more active.

Improving our body’s structure:

  • Retaining our muscles and bones is crucial to helping us to stay healthy as we age
  • Women over the age of 50 and men over the age of 70 are at a much higher risk for osteoporosis resulting in increases in fractures
  • We reach our peak bone mass at age 30. Beyond that, our rate of new bone formation slows and we are losing bone mass faster than we retain it
  • It is crucial for bones to be “stressed” through weight bearing exercises to retain mass. It is also important for your body to take in enough calcium to keep bones strong
  • The fractures most commonly seen as you age are hips, spines, and wrists
  • Our muscles are made of protein, so protein intake becomes increasingly important as we age to prevent injury and maintain balance. Remember: your heart is a muscle

Exercise helps maintain flexibility:

  • If you are more flexible, you will have better balance. This helps to prevent injury, particularly as you age
  • Stretching exercises help a great deal with improving flexibility – especially things like yoga.

Exercise helps to decrease disease:

  • Helps to keep blood sugar levels lower, preventing diabetes
  • Decreases blood pressure and heart disease

Improves mental health and energy:

  • 1 in 5 adults have anxiety and/or depression. Those who exercise have 45% less anxiety and depression than those who are sedentary
  • You need 150 minutes a week of moderate activity to reduce health disorders
  • Between 30 and 60 minutes of exercises are required for the release of “endorphins” which are hormones released by the brain that make you feel happy and reduce pain

Additional Tips:

  • You need to exercise at a level that is “a little uncomfortable” for you. You need to keep track of your exercise so as you are able, you can increase it a little every week. Over time you will be able to look back and see how much you’ve improved.
  • People tend to push themselves more when they participate in a class or team
  • Increased strength and energy help you as you perform you daily activities of living
  • Improves the quality and duration of sleep
  • The most effective exercise program is one where you combine cardio and strength training.
  • You need the cardio training for endurance – need to get your heart rate up to release the endorphins
  • Strength or weight training can be done with fitness resistance bands instead of weights (Kim got hers at Target and there are also lots on Amazon)
  • High Intensity Interval Training done once a week is the best type of exercise for anti-aging and longevity

Remember any kind of exercise is better than not doing anything!

March 5th, 2019 – Plastic Surgery After Weight Loss Surgery

Dr. Korentager is the Chair of the Department of Plastic Surgery at The University of Kansas Hospital. He and his associate Dr. De Souza both do cosmetic surgery, reconstructive and breast reconstruction for patients needing excess skin removed following weight loss surgery.

Dr. Korentager began by explaining that the words plastic surgery is from the Greek work plastikos, which means “to mold or shape.”  This is their focus and involves looking at the whole person, and not just removing skin but helping to contour the whole body.

He pointed out the massive weight loss can leave changes in the body that can at times be debilitating, such as a large abdominal panniculus (pannus) that hangs down below the pubis and can affect walking and exercising.  Excess skin can also affect a person’s body image if it alters their appearance and the way they see themselves.

The primary sites for excess skin following weight loss are the breasts, arms, abdomen and thighs.  Secondary sites are the sides and back, under the chin and face. 

This excess skin is a combination of residual fatty tissue and skin laxity that occurs after a long period of being stretched.  We lose elasticity in our skin with age, and there are no products which will reverse or improve the results of aging.  To assist in healing, the most important points to remember are the following:

  • Do not smoke, vape or chew nicotine products, and do not smoke marijuana. These decrease the circulation to the tissue and prevent proper healing.
  • A diet high in protein is essential for rebuilding tissue and zinc is also very helpful

Dr. DeSouza showed slides with before and after pictures of the following surgeries and questions were answered about each:

  • Abdominoplasty – this is where the abdominal wall muscle is pulled together both horizontally and vertically to add strength, and the excess skin is removed and the area contoured using liposuction and different techniques to get the most pleasing scar.
    • A panniculectomy is just where they remove the excess skin, but there is no muscle tightening or liposuction done for contouring
    • The cost is about $6 – 7,000 for private pay
    • Insurance will pay if you have documentation for 4-6 months of sores and rashes that do not respond to treatment, back pain, and difficulty exercising
    • They recommend coming in for a consult after your weight has been stable for 6 months, and about 3 months before you are ready, as the planning process is important.
    • They do have some programs to help defray costs.
    • There is no age limit, but more importantly they want patients to be healthy.
  • For a thigh lift, it is a longer surgery, and there is a scar that runs down the inner leg to at least the knee and sometimes lower, depending on where the excess skin drapes.
    • This surgery is not usually covered by insurance
    • Cost for this surgery runs between $7 – 8,000
  • Breast reconstruction/augmentation can leave the following:
    • Sagging and loss of volume
    • Asymmetry with nipples not being at the same height
    • Grooves and pain or numbness in shoulders
    • Rashes under breasts
    • Insurance may pay if there is good documentation of medical problems for 4 – 6 months prior (more likely for breast reduction with back and shoulder pain)
    • They prefer not to use implants if they can give someone enough volume using extra tissue with a breast lift. If they do use implants, the 2 they prefer using are:
      • Ideal Saline implants – these last longer and if they rupture it is easy to repair
      • Non-textured silicone gel implants – these should be replaced every 10 – 15 years
      • They DO NOT recommend textured implants as these have been associated with an increase in a type of lymphoma called ALCL
    • For a breast lift or reduction, the cost is around $6,000. If implants are used, a pair runs between $800 – 1200, and the implants come with a lifetime warranty.
  • Bachioplasty is surgery done to remove the excess skin under the arm.
    • In order to prevent tightening as the scar heals, they create a small zig-zag incision in the arm pit and also at the elbow.
    • The scars are always going to be long – there is no way around it
    • They can combine this surgery with breast surgery, and move some of the fatty tissue from under the arm to the breast to increase fullness.
    • Insurance will not pay for this surgery.
  • Facelift:
    • A full facelift which includes under the chin is around $6,000.
    • For just under the chin, they can do an outpatient procedure under local for about $2500.

Some of the other general information they shared included:

  • The two biggest complications are bleeding and blood clots. The longer the surgery, the greater the risk of both, which is why they don’t combine any of the procedures except the breast and under arm.  They always believe in safety first
  • There isn’t anything that will make your skin more elastic. Once the elastin fibers are broken, they don’t come back. 
  • They are unable to donate the skin removed for the burn unit because it isn’t a high enough quality of skin.
  • If they need to remove skin above the belly button, they save and replace the belly button. However, that doesn’t always heal well if there has been a lot of other abdominal surgery, and the blood supply to it may not be as good.  They can make a “new” one if a patient wants one. 
  • Your skin is the largest and most important organ of your body. In order to take good care of it, they recommend preventing sun damage. 
    • They do feel the best topical pharmaceutical to preserve your skin is Vitamin C
    • If you try other skin protocols, the key is consistency. You must use it every day for long periods of time.  Too many people buy a product and when they don’t see a difference in a week or two, they stop using it.  Be consistent.
  • If you are having difficulty paying for plastic surgery, they have a Resident Training program for some of the simpler procedures. There is always a board certified plastic surgeon in the room, but the resident is doing the procedure, and there is a discount.

To contact the plastic surgery clinic at KU Hospital, call 913-588-1227 or go to  and type in your question or request for a consult, and they will get right back to you. 



How To Prepare For Your First 5K

5K Run Walk Post Weight Loss Surgery Kansas City

Walking or running a 5K — 3.1 miles — can be a fun and rewarding experience, especially if it’s your first time. But even though this is the shortest distance for running races, it still requires adequate training and preparation. Depending on your level of fitness and your goal, the type of training plan you follow will vary. Many beginners have the goal of just finishing the race, while experienced runners may have a certain goal time in mind. Either way, training properly is important.

Training Time

As with any fitness program, training for a 5K should be done gradually. It is important to build up a level of cardiovascular endurance as well as muscular strength and endurance in order to allow your body to adapt safely. Depending on your level of fitness before starting a 5K training plan, you should allow eight to 10 weeks to build up to running for 30 minutes or walking for 45 minutes, which is the approximate time it will take a beginner to complete a 5K.

Base Building for Running

When first starting a 5K-training program, you should be able to walk at a brisk pace — 15 minutes per mile — for 30 minutes. If you cannot, you should build your walking distance first. Once you are ready to add running to your workout, do so gradually with a mix of walking and running.

Training Plan

Varying your training throughout the week is the key to a successful 5K training plan. We advise walking or running at least three days a week. On the other days, we recommend that you rest in order to allow your muscles to recover or cross train. We also recommend a gradual increase in your walking/running distance over the course of eight to ten weeks. Below are links to three different 5K training plans for varying fitness levels.   

Training Plan – Walking

Training Plan – Running

Run Your First 5K

Training Plan – 6 Week Beginners Walking

The Bariatric Center of Kansas City 5K

We are hosting our very own 5K Fun Walk/Run right here at our facility on May 5th, 2019 at 9:00am! Participants will have the choice to run, trot, or walk the 5K. The course is designed to accommodate the fitness goals and levels of runners, and walkers of all ages. This is a non-profit event meant to get our wonderful community of patients together to celebrate all the successful journeys we have been able to be a part of since 2002! We welcome those who have had weight loss surgery in Kansas City, as well as friends and family. You do not have to be a bariatric patient to register or attend. To sign up click here.

We will have:

  • morning refreshments

  • post-run snacks and refreshments

  • swag bags

  • event t-shirts

  • giveaways and raffles

  • tours of our facility, clinic, and patient rooms

  • and MORE!

If you have any additional walking/running questions please feel free to call 913-677-6319 and ask speak with Kari or Barb, our physical therapists. They are very experienced and can answer any questions or concerns you may have! For more information on bariatric surgery click here.

February 5th, 2019 – HALT Emotional Eating

 One of the triggers for eating is our emotions.  We use food to soothe ourselves in many stressful situations, but it can be controlled with some awareness.  Dr. Coker talked about a simple way to clarify why we are eating called HALT:

            H – Hungry:     Do I need something physically or emotionally?  Find what will fill you.

            A – Angry:        What is causing me to feel this way?  Express yourself.

            L – Lonely:       Am I having difficulty connecting with others? Tell someone.

            T – Tired:         When was the last time I took a break? Breathe and slow down.


When you find yourself eating when you are not hungry, you need to stop and ask yourself if you are really experiencing one of the above feelings.  If you continue to eat during those times, you will find yourself on an emotional eating merry-go-round:

emotional wheel weight loss surgery kansas city

The problem with soothing ourselves with food is that that good feeling only lasts a moment, and then is replaced with guilt causing more stress and continuing the cycle.  Some common reasons for emotional eating are:

  • The feel good fix 
  • Prolong pleasure
  • Habit
  • Impulsive
  • Ignoring internal cues
  • Stress and effort to re-balance
  • Accessibility – it’s there
  • Sheer boredom
  • Distraction                                

In order to change our behavior we have to look at the steps involved in changing habits:

  1. Pre-contemplation – think about what you want to change and why
  2. Contemplation – figure out what you want to do instead
  3. Preparation – get yourself mentally ready and geared up to make the change; talk to someone about it, get support for making the change
  4. Action – make the change
  5. Maintenance – continue to work on keeping the change by rewarding yourself with non-food rewards.

In order to make the change, learn to “be” more aware of what is going on with you:

  1. SIT with your feelings. When you want to go eat, first do the following:
    • Stop –  just stop for a moment
    • Inspect – inspect your feelings and why your may be feeling hungry
      • (are you Hungry, Angry, Lonely or Tired)
    • Take a breath – once you have let the moment pass, address the real feeling you are having.
  1. Recognize your own negative self-talk. We have a lot of negative things we say to ourselves over and over. 
    • Name the critical voice – who is talking to you (is it something your mom, husband, friends says to you)
    • Be curious, not critical – why are they saying it
    • Is it true? – probably not
    • Distance yourself from the thought and shift the negative talk to how you wish to feel
    • You can begin to soothe yourself with positive self-talk
  1. Eat Mindfully. When you do eat, sit down, slowly chew, sense and savor the food, and smile!
  2. Consciously choose distraction during those trigger moments. Write down and keep handy:
    • 5 people to call
    • 5 ways to relax
    • 5 places to go calm down
    • 5 encouraging statements to tell yourself
    • 5 activities that will keep you otherwise busy and distracted

Food is not the enemy. Anger, sadness, regret and lack of self love are. 

Watch the TED Talk video on breaking habits at:



Why Take Journey Bariatric Multivitamins?

Many vitamins and minerals are essential for complete and balanced nutritional health. Even if you eat a balanced, whole-food diet, you may still be missing vital nutrients. Additionally, after weight loss surgery you are at higher risk for nutritional deficiencies. You require more vitamins than someone who has not had surgery due to less consumption of food and changes in your anatomy.

That is why taking a bariatric specific multi-vitamin is so important pre and post-surgery to ensure you are getting all essential nutrients. We have designed a bariatric multi-vitamin that is specifically formulated for weight loss surgery patients. Our Journey Multivitamin is easy to digest because we use ingredients that are highly absorbable. It is gentle on the stomach and is less likely to cause nausea and constipation due to specific ingredient selection.

Often, we get asked “Why can’t I just take a normal multi-vitamin?”. That is because each vitamin and mineral have specific daily values that need to be met and often your typical drug store multi-vitamin will not have the necessary amounts, leading you to buy additional supplements on top of your multi-vitamin. Our Journey Multi-vitamin is designed to ensure complete and balanced nutritional health for the bariatric patient because it includes the necessary vitamins and minerals, in the correct amounts, required for good nutrition.       

We also get asked, “What is the difference between your bariatric multivitamin and another bariatric brand?”. Our Journey multivitamin is the only bariatric multivitamin that has a probiotic in it. This aids in weight loss and gut healing. Additionally, many other bariatric multivitamins do not meet the standard amounts set by the American Society for Metabolic and Bariatric Surgery (ASMBS). This is the governing body of weight loss surgery in the US and implements quality control measures. Keep in mind that just because it says “bariatric” does not mean it meets the ASMBS standards. If you have questions about brands other than Journey please call us at 913-677-6319 and one of our dietitians will be able to answer any questions you have.

Below shows what you would need to buy to equal what is provided in the Journey Multivitamin:

**Costs are based upon Walmart’s Vitamin Selection.

Overall, our vitamins are more cost effective than purchasing vitamins at Walmart/Target/CVS/etc. Journey vitamins will also help you be more compliant with your vitamin regimen because you will be taking 2 pills verses 8 pills.  

Nutrition is the primary environmental trigger to a healthy weight, so that is why bariatric patients must take vitamins for the rest of their life. You will no longer be able to prevent nutritional deficiencies with food alone. Vitamins and minerals are essential factors in many biological processes that regulate appetite, hunger, nutrient absorption, metabolic rate, fat and carbohydrate metabolism, energy storage, and glucose balance. After weight loss surgery in Kansas City, there is a high risk of vitamin and mineral deficiency due to malabsorption and/or incomplete digestion of foods related to small amounts of gastric acid produced and dietary intake.

Here is a look at the most common deficiencies and how you can supplement your vitamin regimen with nutrient rich food sources.

Copper:  Copper is an essential mineral required by the body for bone and connective tissue production, and for coding specific enzymes that range in function from eliminating free radicals to producing melanin. A deficiency in copper can lead to osteoporosis, joint pain, lowered immunity, and since copper is essential for the absorption of iron, anemia.

DV: 2mg

  • Seafood 
  • Kale
  • Mushrooms
  • Seeds 
  • Nuts 
  • Beans 
  • Avocado
  • Goat cheese
  • Dried Fruit

Zinc/Folate: Zinc is a mineral that’s essential for good health. It’s required for the functions of over 300 enzymes and involved in many important processes in your body. It metabolizes nutrients, maintains your immune system and grows and repairs body tissues.

DV: Men: 11mg – Women: 8mg


  • Meat
  • Oysters
  • Crab
  • Lobster
  • Whole Grains
  • Legumes
  • Seeds
  • Nuts
  • Dairy

Iron: Iron Is Essential for Metabolism, Muscles, and Normal Bodily Functions. Iron gets used by the body to help make the hemoglobin in red blood cells, which then carry oxygen throughout the body, from our lungs to our muscles and other organs. It’s not a nutrient that you want to be lacking in. Not getting enough iron, a condition termed iron deficiency anemia (or just anemia), makes it difficult for your blood cells to deliver the oxygen your tissues and organs need.

DV: Men and Women Over 50: 8mg / Women 19 – 50: 18mg


  • Red Meat, pork, and poultry
  • Dark green, leafy vegetables – spinach and kale
  • Dried fruits – raisins and apricots
  • Peas, beans, and other pulses
  • Seafood
  • Seeds and Nuts
  • Egg Yolks
  • Poultry

Vitamin D: Vitamin D is important for good overall health and strong and healthy bones. It’s also an important factor in making sure your muscles, heart, lungs and brain work well and that your body can fight infection. Your body can make its own vitamin D from sunlight. You can also get vitamin D from supplements and a very small amount comes from a few foods you eat.

DV: 600 IU


  • Salmon
  • Canned Tuna
  • Mushrooms
  • Fortified Milk
  • Orange Juice
  • Fortified Yogurt
  • Swordfish
  • Eggs
  • Sardines

Potassium: High-potassium foods are an essential part of any balanced diet. The mineral helps regulate your body’s fluid levels, aids in muscular function and waste removal, and keeps your nervous system functioning properly.

DV: 4,700mg


  • Potatoes
  • Tomato
  • Kidney Beans
  • Fresh Fruit
  • Avocado
  • Fish
  • Acorn Squash
  • Dairy 
  • Dark Leafy Greens
  • Dried Fruit

Calcium: Calcium is a vital mineral. Your body uses it to build strong bones and teeth. Calcium is also needed for your heart and other muscles to function properly.

DV:  19-50: 1,000mg / 50 and Up: 1,200mg


  • Seeds 
  • Cheese 
  • Yogurt
  • Sardines and Canned Salmon
  • Beans and Lentils
  • Almonds
  • Whey Protein
  • Leafy Greens 
  • Edamame and Tofu
  • Milk
  • Figs

Magnesium: Magnesium is a nutrient that the body needs to stay healthy. Magnesium is important for many processes in the body, including regulating muscle and nerve function, blood sugar levels, and blood pressure and making protein, bone, and DNA.

DV: 400mg


  • Dark chocolate
  • Avocados
  • Nuts
  • Legumes
  • Tofu
  • Seeds 
  • Whole grains 
  • Fatty fish
  • Bananas
  • Leafy Greens 

Vitamin B12: Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy and helps make DNA, the genetic material in all cells. Vitamin B12 also helps prevent a type of anemia called megaloblastic anemia that makes people tired and weak.

DV: 2.4 mcg


  • Clams
  • Sardines
  • Beef
  • Tuna
  • Fortified Nutritional Yeast
  • Trout
  • Salmon
  • Fortified Nondairy Milk
  • Milk
  • Yogurt
  • Cheese
  • Eggs


For additional nutritional information please feel free to call 913-677-6319 to schedule an appointment with one of our dietitians.