All posts by Chris Nastav

Hydration Following Bariatric Surgery

Hydration After Bariatric Surgery

Leading up to surgery, your surgeon and dietitian have both stressed to you the importance of hydration. It is recommended that at least 64 oz of fluids are consumed each day to prevent dehydration, constipation, and kidney stones (1). However, following surgery, you may find it more difficult to reach this goal. Your taste may change, and water may no longer taste right. You also will have smaller stomach pouch, limiting the capacity to hold fluids (2). Yet, staying hydrated will remain of the utmost importance, as dehydration is the leading cause of re-hospitalization following bariatric surgery.

As you start to delve back into your normal daily routine and go back to work, you may find barriers to reaching 64 oz of fluids per day. Aside from simply forgetting to drink because you are sick or you are busy and focused on a task, other reasons may come into play. You may be out hiking or camping and have limited access to safe, clean water for drinking. Medical reasons such as diarrhea and vomiting, fever, excessive sweating, and increased urination may also lead to dehydration (3). Signs of dehydration include thirst, headaches, hard stools, less frequent urination, dark-colored urine, fatigue, dizziness, and confusion (1,3).

Dehydration Causing Headaches
Dehydration Causing Headaches

Dehydration comes with several serious risk factors. If you’re not staying well hydrated while being physically active or while outdoors in the heat, this could lead to heat injury, which can range from heat cramps, to heat exhaustion, to heat stroke. Dehydration can also cause urinary and kidney problems such as urinary tract infections, kidney stones, or even kidney failure. Seizures may occur due to electrolyte loss and imbalance. Finally, a lack of enough fluid intake can cause hypovolemic shock, in which a low blood volume will cause a drop in your blood pressure and a drop in the amount of oxygen in your body (3).

Healthy Drinking
Healthy Drinking

Immediately following surgery, with a small and swollen stomach pouch, you may not reach 64 oz of fluids per day. Continue to sip fluids throughout the day, however, to reach at least 30-40 oz of fluids. As you progress your diet following surgery, reaching 64 oz of fluids per day will become much easier, especially as the swelling and inflammation subsides. You will know if you are staying well hydrated by observing clear, light colored urine at least 5-10 times per day (1). If water itself no longer tastes right, try adding a squeeze of lemon or other citrus fruit to your water for a flavor boost. You may also try artificially sweetened beverages such as Crystal Light, Diet Ocean Spray, G2, Powerade Zero, decaffeinated coffee or tea, or even broth.

Hydrate Yourself Well
Hydrate Yourself Well

Staying hydrated obviously reaps many benefits to your health. It also will help keep you on track with your weight loss. Choose calorie-free fluids to stay hydrated. Anything high in sugar or calories could not only cause dehydration, but could also cause weight gain or dumping syndrome. Remember to avoid drinking with your meals. It is recommended for you to wait 30 minutes before meals and 30 minutes after meals to drink your fluids, so that you are not pushing the food out of your stomach. When your stomach is emptied too quickly, you will become hungry again and might take in too many extra calories by snacking before your next meal. This could lead to weight gain. Sipping your fluids frequently in between your meals will help to keep you full and avoid snacking.

Michelle Adams MS, RD, LD

References:

  1. ASMBS https://asmbs.org/patients/life-after-bariatric-surgery
  2. Obesity Help. http://www.obesityhelp.com/forums/nutrition/Hydration-and-Fluid-Options-after-Bariatric-Surgery-WD154.html
  3. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/dehydration/symptoms-causes/dxc-20261072

Becoming a Bariatric Athlete: Commit to Healthy Eating & an Active Lifestyle

5k-runners-kc-bariatric

What does it take to become a bariatric athlete?  High quality nutrition and regular physical exercise is where your training begins!

Making the decision to adopt a healthy lifestyle can come with many challenges, and it includes making lifelong lifestyle changes. Whether you are considering weight loss surgery in Kansas City, or you have already had surgery, it is important to note that committing to a physically active lifestyle while maintaining healthy eating is crucial for long-term success.  Following surgery, weight loss may seem effortless in the first year. However, without the incorporation of physical activity, weight may return within two to three years. While weight loss will be your primary objective initially, it is important to remember that the goal is not necessarily becoming thin, but rather becoming healthy and active for improved lifelong vitality.

When beginning your journey with physical activity, it is recommended that you start out slowly. Gradually progress by starting with increasing your daily activities such as washing dishes by hand, cleaning the house, parking farther away, etc., and work your way up to cardiovascular activities until you are up to 60 minutes per day for 6 days per week. Try aerobic exercises that are low to moderate intensity, which are best for weight loss. Focus more on increasing your duration rather than intensity. When you are ready to graduate to sports training, it is highly recommended that you begin working with a trainer or coach, who will assist you in maximizing your performance while teaching you to prevent injury from occurring.  

In time, you may feel the need to branch outside of your home or gym and begin to embrace more physical endurance activities such as 5Ks, triathlons, and marathons.  With these commitments you might find yourself asking, “How do I fuel my new body?” Learn to prioritize food as your fuel, and find sports nutrition products that are tolerable. Recognize that as a bariatric athlete, you will not be able to eat the same volume as a non-bariatric athlete. 

healthy-eating-kc-bariatricThe goal with fueling your new body for athletic training is not to significantly increase your calories or begin “carb-loading.” The timing of replenishing your body is important, and to maximize your energy, you will only need to “top-off” during the day rather than overloading, so as not to stretch your pouch with larger meals. For the most benefit in energy and muscle restoration, you should eat carbohydrates and protein within 20 minutes after finishing your workout. Choose carbohydrates that are nutritionally valuable as well as tolerable, such as fruits, beans, and quinoa. Sports nutrition products are typically high carbohydrate and made up of simple, concentrated sugars, which could trigger dumping syndrome. More tolerable products in bariatric athletes have shown to be those with maltodextrin and chia seeds.

hydrating-runner-kc-bariatric-athleteDehydration, cramping, and hyponatremia can occur when not enough fluids are consumed. In addition, a great amount of fluid can be lost from sweat alone while training. Leading up to your workout, it will be important to stay hydrated throughout the day so that you assure you are going into the workout well hydrated. Continue to take small sips of water or sports drink throughout your workout as well.

To prevent sodium loss from sweating, replenishing electrolytes during or after your workout is critical. Bariatric athletes need low sugar or sugar free sports drinks, such as G2 or sugar free Powerade. Salt tabs or electrolyte tabs may be used for electrolyte replenishment, but some bariatric athletes may be more sensitive to their effervescent effects.

healthy lifestyle tips - handwriting on a napkin with a cup of coffee

Adopting a physically active lifestyle and committing to an exercise program is the key to your weight loss success. Always remember that bariatric surgery is just a tool to help you maximize your weight loss. Maintaining your nutrition and activity will help you remain successful in achieving and maintaining your weight loss goals. Always follow the recommendations for nutrition and exercise that are provided to you by your surgeon and dietitian, and continue to monitor your exercise program to ensure continued success with your weight loss and maintenance.

References:

1. Weight-loss Surgery and Fitness: The Do’s and Don’ts for a Successful Exercise Program. Julia Karlstad, Med, CSCS. http://www.obesityaction.org/wp-content/uploads/WLS-and-Fitness.pdf

2. Nutrition for Bariatric Athletes: Part 1. Lea Crosetti Andes, RD, CSSD. http://wmdpg.org/wp-content/uploads/2014/11/Nutrition-for-Bariatric-Athletes-Part-1-Fall14.pdf

3. Emergence of the “Bariathlete.” Lea Crosetti, RD. http://www.obesityaction.org/educational-resources/resource-articles-2/weight-loss-surgery/emergence-of-the-bariathlete

4. Becoming a Bariatric Athlete: Maintaining Nutrition. Michelle Adams MS, RD, LD

Committing To Your Diet This Holiday Season

Happy Thanksgiving

The holiday season is almost here. This time of year can be especially tough for anyone trying to lose weight and get healthy. From office parties to family get-togethers, Halloween candy and Thanksgiving dinner, there is so much good tasting yet unhealthy food in abundance.

How do you stay committed to your diet and weight loss goals when everyone else is piling the food on to their plates? The answer is mental toughness.

Here are 10 ways to do it.

Focus on the long term goal
It’s easy to get consumed into the short term satisfaction of all that great tasting food, yet you must be strong and resist the temptation. Focus on the long term pride of achieving world-class fitness and health which leads to a leaner and stronger body, more confidence, better sex and a better all around you.

Make it HappenRemember your ‘why’
When the going gets tough and you feel like you’re going to stray from your diet, remember your ‘why.’ Why am I doing this? Why do I want to really lose weight? Why do I want to get healthy? This will shock you back to reality and keep you motivated to stay on track.

Stop and think
Before you put anything in your mouth, stop and ask yourself one very important question: How is this piece of food or beverage going to impact my health? If the answer doesn’t foster good health and wellness, put it down and walk away.

Don’t eat for pleasure
We’ve come to associate the holiday season with great tasting foods, items that are usually high in fat, calories and sugar. Many people eat for pleasure this time of year. If you’re serious about your weight loss goals, this is the time to eat for health, not for pleasure.

Group SupportYou need accountability and support
If you’ve struggled with food your whole life, walking into Thanksgiving or Christmas dinner is no different than a recovering alcoholic walking into a bar. You need support and accountability to stay strong. Find someone you trust who has your best interest at heart. Ask them to be your support person and to help hold you accountable for your actions.

Seeing is believing
One of the best strategies for staying compliant to your weight loss plan this time of year is creating a vision board filled with pictures of lean, fit and sexy people. Hang the vision board in a very visible location. When you constantly see the person you want to become, it will reinforce your goals into your subconscious mind. If you feel like cheating on your diet or giving up, look at the vision board and it will remind you why you’re fighting.

Expect a ChallengeExpect a challenge
Be realistic and know that remaining compliant this time of year is going to be extra challenging. Expect to feel pain or suffer. Most people feel the pain or run into an obstacle and seek escape right away. Have a plan to push forward when this happens and don’t let it catch you off guard. If you’re not ready to suffer during adversity, you’re not going to be successful.

Get really clear about your weight loss goals
Don’t just say, “I want to lose weight.” Get specific and say, “By April 1, I want to lose 15 pounds. I’m going to eat well, exercise each day and get really committed to doing this once and for all. The holiday season isn’t going to stop me.” When you set a timeline and have specific goals, you’re going to avoid procrastination.

You can’t cheat and then start over
You can’t cheat whether it’s Halloween, Thanksgiving, Christmas or any other day. Stop telling yourself that you can just start over on Monday. Monday is never coming. This isn’t a game or a hobby; it’s your health. Until you’re at a healthy body weight, 99% compliance is failure. You wouldn’t cheat on your spouse in a committed relationship, so don’t cheat on something as important as your diet.

It's Up to YouIt’s up to you
The mantra of fit people is: I am responsible. If losing weight and getting healthy is something you want bad enough, it’s up to you to make it happen. Nobody else is coming to the rescue. The choice is yours. Your weight is your responsibility. How bad do you want it?

The holidays to the millions of dieters is like heroin to a recovering drug addict: it’s full of temptation and ultimately results in a negative outcome. It doesn’t take much to derail a diet and completely ruin the road to a healthier life.

Note: This blog post was written for the Huffington Post on October 20, 2016 by Steve Siebold (Author and expert in the field of critical thinking and mental toughness training).

Bariatric Friendly Thanksgiving Recipes

Bariatric Friendly Recipes

Is it really November already? Thanksgiving is just around the corner, and we hope that everyone enjoys their time with their families and the comfort of holiday recipes. To help keep you on track with your Bariatric diet, we’ve gathered a few bariatric friendly recipes for you to try this Thanksgiving. 

Always remember . . .

  • Eat your protein foods first.
  • Avoid drinking with your meals.
  • Moderation is KEY! Eat from a small plate.
  • Take your time to finish your meal and enjoy your food.
Bariatric Friendly Turkey Recipe
Bariatric Friendly Turkey Recipe

By Michelle Adams MS, RD, LD 

Bariatric Friendly Recipe #1 – Roasted Turkey Breast

from: http://www.foodcoach.me/2014/11/10/test/

Ingredients

  • 1 whole bone-in turkey breast (6 lbs)
  • 1 tbsp minced fresh thyme leaves
  • Grated zest of 1 lemon
  • 1 small onion, cut into eighths
  • 2-4 sprigs of fresh thyme

Instructions

  1. Preheat oven to 325F.
  2. Combine 1 tbsp salt, minced thyme and lemon zest (save rest of lemon). Wash the turkey breast inside and out and drain it well, patting with paper towels to dry.
  3. Sprinkle the salt mixture all over the skin of the turkey. Place in a roasting pan with rack. Cut lemon into 4 wedges and tuck inside turkey breast along with onion and thyme sprigs.
  4. Bake for 2 to 2 1/2 hours (leave plenty of time in case it needs longer). Check with a thermometer that the internal temperature reads 165F.
  5. Slice turkey breast and set in a dish covered with foil. It can sit here for an hour and then be reheated as needed by placing back in the oven.

***Remember to remove the skin before enjoying!

 

Bariatric Friendly Recipe #2 – Green Bean Casserole

from: www.ghsbariatricsolutions.com

Ingredients

  • 2 tsp olive oil
  • 1 medium onion, thinly sliced
  • 1/4 cup finely chopped onion
  • 1 pound fresh green beans, trimmed and sliced into 1 ½-inch pieces
  • 1 clove garlic, finely chopped
  • 1 1/2 cups sliced cremini mushrooms
  • 1 tsp cornstarch
  • ¼ cup water
  • 1/2 tsp dried thyme
  • 1 1/2 cups nonfat milk
  • 1/3 cup fresh whole-grain bread crumbs

Instructions

  1. Heat oil on low heat in large skillet.
  2. Gently cook onion slices for 15-20 minutes, stirring frequently, until onions are golden.
  3. Remove onions from skillet and transfer to a plate.
  4. Meanwhile, steam or boil green beans for 5-6 minutes, then plunge in a bowl of cold water to keep the vibrant green color and stop the cooking process. Drain and set aside.
  5. Add finely chopped onion, garlic to skillet, cook for 2-3 minutes.
  6. Add mushrooms and cook for 5 minutes, until they release their juices.
  7. Combine cornstarch and water in a separate bowl, stir until cornstarch is dissolved, then stir into vegetables. Sprinkle thyme over vegetables.
  8. Gradually stir in nonfat milk.
  9. Increase heat to medium and stir constantly until sauce thickens.
  10. Season with a tsp of salt if desired and some freshly ground black pepper.
  11. Spread green beans in a 1 ½-2 quart casserole dish.
  12. Pour mushroom sauce over green beans. Top with onions and breadcrumbs.

 

Bariatric Friendly Recipe #3 – Pumpkin Mousse 

from: www.nationalbariatriclink.org

Ingredients

  • One pkg. instant sugar free vanilla pudding in the six serving size
  • Three cups skim milk
  • ½ cup solid packed canned pumpkin
  • One tsp. pumpkin pie spice
  • ½ cup Cool Whip Lite
  • One cup plain yogurt
  • One tsp. vanilla extract

Instructions

  1. In a large bowl, add pudding mix and skim milk, beating for approximately two minutes before folding in the rest of the ingredients above.
  2. Spoon into cups or stemmed glasses and garnish with a sprinkle of cinnamon and a dollop of Cool Whip Lite.

***Each cup holds only 106 calories, one gram of fat and seven grams of protein. Makes six servings.

 

Bariatric Friendly Pumpkin Recipe
Bariatric Friendly Pumpkin Pie Ramekins

Bariatric Friendly Recipe #4 – Pumpkin Pie Ramekins

from: www.ghsbariatricsolutions.com

Ingredients

  • 1  15 oz can of pumpkin
  • 1  12 oz can of evaporated fat-free milk
  • 1/2 cup egg whites or egg substitute
  • 3/4 cup Splenda (granulated)
  • 2 tsp pumpkin pie spice
  • 1 tsp cinnamon
  • 1/2 tsp ginger
  • 1/4 tsp nutmeg
  • 1/4 tsp allspice

Instructions

  1. Preheat oven to 425 degrees.
  2. Blend Splenda and spices in a bowl.
  3. Add egg whites and mix.
  4. Add pumpkin and evaporated milk and mix well.
  5. Spoon mixture into 8 ramekins.
  6. Place in pan with water halfway up sides of ramekins.
  7. Bake 10 minutes.
  8. Reduce temperature to 350 degrees and bake 30 minutes longer.
  9. Cool and remove ramekins from pan.

***Chill before serving. It tastes much better cold.

Bariatric Surgery And Fear Factors

Bariatric Surgery And Fear Factors

Did you know that it’s common for people to fear bariatric surgery more than obesity? How can that be? We all know the toll obesity takes on a person’s physical and emotional health, so why would a surgical remedy as part of a comprehensive bariatric health program be considered by some to be less desirable than living with the many negative impacts of obesity in everyday life?

In the February 2016 publication “Connect”, a news magazine published by the ASMBS (American Society for Metabolic and Bariatric Surgery), ASMBS President, Raul Rosenthal, M.D. shared that “Despite the scientific evidence and the millions of patients who have benefitted from bariatric surgery over the years, outsized fears and anxieties exist today among many patients, and even some doctors, about the “dangers,” “lack of effectiveness” and “extreme risks” of what some still call a “drastic procedure” that should only be considered a “last resort.”

It’s sad to consider that people who could really benefit by a gastric sleeve or gastric bypass in Kansas City hold back due to unfounded, irrational fears, much of which stems from misinformation! They may hold back from looking into surgical options to “play it safe”, while that decision alone can potentially lead them further down the road of obesity and deeper into a not so safe high risk medical state involving type 2 diabetes, hypertension, cardiovascular disease, stroke, sleep apnea, gallbladder disease, osteoarthritis, and depression. Clearly these conditions have a negative impact on an obese person’s quality of life and in fact lend themselves to reducing a person’s longevity over all. But many will choose to stay in this unhealthy, limiting state due to an unfounded fear factor!!

In Rosenthal’s article, he states: “In 2014, research from the Cleveland Clinic Bariatric and Metabolic Institute showed laparoscopic gastric bypass surgery in patients with type 2 diabetes carries a complication and mortality rate comparable to some of the safest and most commonly performed surgeries in America, including gallbladder surgery, appendectomy and total knee replacement.”

Unfortunately, many “patients may have formed views based on faulty information or atypical occurrences with friends, family or coworkers.” It’s much like the fear of flying, where an individual decides flying is too risky and chooses to never fly to get to a favorite destination. But statistically, the probability of your plane going down is around 1 in 5.4 million, with some reports putting the odds closer to 1 in 11 million (from Elite Daily article by John Haltiwanger on “Science Says”, “The Odds of a Plane Crash are One In 11 Million, Yet You’re Still Afraid.”) So air plane crashes do happen, but they are very rare when considering the number of flights that take place safely and successfully all around the world every day. Bariatric surgery is like that, too. You may hear of an occasional “horror story”, but when considering the number of bariatric surgeries performed successfully, and with great results, every year compared to a very small number of serious complications or deaths that occur, it’s easy to see that the negatives get more press and distort the reality that bariatric surgery is no more risky than other surgeries more commonly performed.

We agree with Dr. Rosenthal when he says, “Risks do exist and bariatric surgery is a serious operation. But unexplained risks or risks without context are a lot scarier than risks explained and fears addressed.” The Bariatric Center of Kansas City is a high volume, national leader in bariatric surgery and aftercare, providing gastric sleeve and gastric bypass in Kansas City. Our expertise and experience have led to shorter OR surgery times, shorter hospital stays and low complication rates, with our performance statistics falling well below the already low national averages! If considering bariatric surgery in Kansas City, do yourself a favor and get the facts on the bariatric surgery fear factor. Bariatric surgery is not as risky as some make it seem, and improved quality of life can be yours!

Read Dr. Rosenthal’s full article by clicking on the link below:

http://connect.asmbs.org/february-2016-president-rosenthal-message.html

Photo from original article: http://connect.asmbs.org/february-2016-president-rosenthal-message.html

March 26, 2016 – Cortisol and How it Affects You

Bariatric Support Group
Date: March 26, 2015
Facilitator:  Laura Hernandez, MBA, RD, LD

Laura spoke about cortisol, the “fight or flight” hormone that is released by the adrenal glands when we are stressed.  Normally when we get into a stressful situation or become afraid, our adrenal glands produce cortisol and adrenaline.  The cortisol helps to prepare your body for “fight or flight” by sending energy to the parts of the body that deal with the stress.   It shuts down your digestive system and appetite, and increases your blood sugar and blood pressure.    When the stress is over, your body increases your appetite to bring your body into normal balance after the “fight”.

She discussed different cortisol patterns that affect people throughout the day:

  • High early morning cortisol
  • High cortisol throughout the day
  • High evening cortisol
  • Low cortisol throughout the day.

She discussed ways to bring your cortisol into balance:

  1. Nutrition supplementation with Omega 3’s, Vitamin C, Vitamin B5 (the anti-stress vitamin), and Phosphatidylserine.
  2. Certain herbs can help relieve stress and restore cortisol levels to normal: Rhodiola rosea, Ginseng, and Ginkgo biloba.
  3. Stay hydrated!
  4. Relaxation practices, such as meditation, yoga, music therapy (look for these in the coming months)
  5. Exercise: best to do 15 minutes daily of both 1) anaerobic exercise (strength training), and 15 minutes of aerobic exercise (jogging, cycling, walking) in mid-morning or mid-afternoon.
  6. Sleep helps to restore cortisol balance, and disrupted sleep increases cortisol levels

Along those lines, we have 4 upcoming support groups to help with that.  April 7th we will be doing meditation, yoga, music therapy, and physical exercise.  Please don’t miss them!

March 3, 2016 – Protein & Macro-nutrients

Bariatric Support Group
Date: March 3, 2016
Facilitator: Laura Hernandez, RD, LD

Laura talked about one of the major building blocks of our bodies – protein.  She discussed how proteins are large molecules that are made up of smaller units called “amino acids” that are linked together.  She discussed the primary functions of proteins and the difference categories of proteins.  One of the primary reasons we stress to eat enough protein is that it is needed to build your lean muscle mass.  If you lose lean muscle mass, your metabolism will slow.  The more lean muscle mass you have, the higher your metabolism will be and the more fatty tissue you will lose.

Laura talked about how protein has the same caloric value as carbohydrate:  4 calories per gram.  That is why your diet should have the same number of carbs as it has protein.  If you are eating something that contains 10 gms of protein, you need to make sure that the total carbs are no more than 10 gms.

She discussed the way our bodies digest protein, starting in the stomach where acids and enzymes are produced.  The pancreas also secretes some digesting enzymes, and then the small intestine is the major site for protein digestion and absorption.  We discussed some of the reasons you need to increase your protein, such as surgery, infection, poor protein intake, loss of blood.  In those cases, your protein requirements go up and you need to be sure to eat more protein.  Proteins are hard to digest, so some of the ways to make it easier for your body to digest is to marinate meat with an acidic or salt marinade, tenderize meat or beat eggs before cooking.

You want to watch for signs for poor protein intake, such as muscle wasting, weight plateau, frequent infections, hair loss and severe edema (swollen ankles or legs). We diagnose protein malnutrition by check your levels of Pre-albumin when we do your lab work.  You want to eat between 60 – 120 gms of protein/day based on your age, physical activity, and physical diagnosis.  That needs to be individualized by the dietitian.

Protein will either be animal based, which are complete proteins, or vegetable based, which are incomplete proteins.  When eating vegetable proteins, you will need to combine them with other sources, such as beans with rice or grains.  Fruits also have some protein in them, but not a lot.  She shared some sample menus of things that would be a good way to get your protein in during a day once you are able to eat most foods.  She talked about dairy products and the difference between whey isolate and hydrolyzed, or pre-digested, whey protein.

The main points to remember are that protein supports weight loss by improving metabolism and increasing lean muscle mass.  It also helps to manage your appetite.  Too little or too much protein can result in a weight plateau, so it is important to eat enough but not go overboard with protein, unless you are an athlete and doing heavy exercise.

February 18, 2016 – Excess Skin & Body Magic

Bariatric Support Group
Date: February 18, 2016
Facilitator: Stephanie McCain & Chris Bovos

Chris announced that anyone who has a CPAP or BiPAP at home that they no longer need following their weight loss can donate it to the program. We will have them cleaned and sterilized, put new tubing and hoses on them and give them to patients who need them but cannot afford them. Just bring them to support group, just like you do your clothing.

We are done accepting winter clothing, and you will see the spring/summer clothing out in March. As a reminder, please don’t bring clothing larger then 3X, and just bring the clothing you have that is in very good condition, no stains, holes, and appropriate for someone to wear to work. We do also have some workout clothing, and nice jeans. Please don’t bring everything you have – please select the nicest pieces. We get so many clothes now that we donating some to thrift shops, organizations that help single mothers, and veterans.

Stephanie McCain, a patient who had surgery 2 years ago and has lost a total of 72 pounds, did a presentation showing a product called Body Magic. It is a compression garment that was originally designed by plastic surgeons to use on patients after tummy tucks and other surgery. It is wonderfully designed and extremely well made. It can be washed in cold water on delicate and then line dried. There are a number of different garments, from t-shirts to eliminate tummy rolls, to a full body garment that goes from mid-thigh to above the breasts. Stephanie has not had a tummy tuck and showed how her clothes fit without the garment and how it looks after putting it on. The different is quite obvious. A number of our patients have purchased them over the last few years and have dropped several sizes. She is currently offering them to our patients at a big discount. Next month the cost will go up. She needs to measure each person to ensure the best fit, and likes to help you put it on the first time. Her husband, Robert, also wears the men’s t-shirt to eliminate tummy rolls following his weight loss surgery. The compression does help with ongoing weight loss and some of the remaining fatty tissue is “rearranged” with consistent use of the garment. You can go to her website to read more about the garment and order one, or you can call her directly. Her contact information is:
www.Ardyss.net/McCain (then click on reshaping link). Her cell phone is 630-297-3253. She is a very busy lady working full time and going to school at night, so be patient and she will get back to you!

February 4, 2016 – Your Appetite Regulation System

Bariatric Support Group
Date: February 4, 2016

The group listened to an informative talk about how our body manages the energy balance in our body, the complex appetite regulation system, and how in obesity those regulation systems become increasing more unregulated as we continue to gain weight.

Energy balance is measured in calories. When the energy in, exceed energy out, then we gain weight. What is supposed to happen at that point is that our body makes us less hungry and increases our metabolism in order to rebalance our energy. However, if the energy in consistently exceeds the energy out, our body begins to become unregulated and that balance is lost. In addition, not all body tissue has the same rate of metabolism. Fat has a much lower metabolic rate, and lean muscle has a much higher metabolic rate, so the more lean muscle you have, the easier it is for you to balance your energy because you have a higher metabolism.

The regulation of our appetite is extremely complex. It is regulated by over hormones that are secreted in the stomach, intestines, pancreas, and even in fatty tissue itself. These hormones signal us to feel hungry or to be satisfied. As we gain weight, those signals become unregulated, and the result is that our body tells us we are always hungry, and no matter what we eat we are never satisfied. This begins a vicious cycle that keeps us gaining more and more weight. Because this system is so complex, just trying to balance our energy in with energy out becomes almost impossible. The saying that you just need to “Eat less and move more” doesn’t work.

We also each have a “metabolic set point” which is mostly genetic and extremely difficult to change. If we diet and lose weight, our metabolic set point causes us to become hungry in order to regain the weight in an effort to try and pull us back up to that set point. What happens when you have surgery, is that the metabolic set point is reset to a lower point, which now allows you to lose the weight and keep it off, because the body is no long trying to pull you back up to the higher set point. While current research has not shown us exactly how the surgery does that, we know that is does. Now you have a fighting chance to get the weight off and keep it off.

January 23, 2016 – Cooking for One

Bariatric Support Group
Date: January 23, 2016 11 am
Facilitator:  Laura Hernandez, RD, LD; Chris Bovos, RN, CBN

Laura and Chris cooked today using cauliflower instead of pasta or rice.  Chris made a pizza crust from riced cauliflower which she cooked and then cooled before putting pizza sauce and cheese on top.  It probably should have been cooked a little longer than it was to make it as crispy in the middle as it was on the edges, and while you can’t pick it up and eat it with your fingers, it still tasted a lot like pizza.  To rice cauliflower, just put the flowerets in the food processor or chopper and chop until it is uniform size – about the size of a grain of rice.  It can be a great substitute for rice and adds a lot of vitamin C and other nutrients to your diet.  Like its cousin, broccoli, it is a wonderful antioxidant and powerful anticancer food, especially if used with turmeric.  It has anti-inflammatory properties as well, making it a wonderful superfood!

Cauliflower Pizza Crust:
2 lbs cauliflower florets – riced to make 6 cups
1 egg beaten
1/3 cup soft goat cheese
1 tsp dried oregano
1 clove crushed garlic
2 TBL grated parmesan
1 tsp paprika

Fill large pot with 1 inch of water, bring to boil, add “rice” and cover cooking 5 minutes.  Drain and transfer to clean towel – squeeze out all moisture. In large bowl  mix strained rice, beaten egg, goat cheese, spices and mix well (use hands). Press onto baking sheet lined with PARCHMENT (not waxed) paper.  Make crust about 1/3 in thick with edges slightly higher.  Bake for 35 – 40  minutes at 400 degrees until light brown. Add your toppings and return to the oven and bake 5 – 10 minutes until cheese is bubbly.  (let crust cool to prevent tomato sauce from soaking into the crust, or put cheese on first to prevent this)

Then Laura made stir fry replacing the rice with riced-cauliflower. Eveyone was amazed at how it tasted just like regular stir fry!

In a large fry pan over med-high heat, put some sesame oil in the pan and add chopped onion, garlic, carrots and peas.  When the onions are clear, add 2 – 3 beaten eggs and stir.  Lastly, add the riced cauliflower and soy sauce to taste.  One medium head of cauliflower makes about 4 – 6 cups of riced cauliflower.  You can also add some chicken which has been previously cooked and chopped, to make it into chicken fried rice!