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Am I Hungry? Mindful Eating for Bariatric Patients

We had a great support group meeting today and the topic was "Understanding the Desire to Eat" presented by Katie Mckenna, a specialist in both nutrition and psychology - her visits are always incredibly enlightening. http://www.mckennaco...om/default.html   Our nutritionist also shared a new resource that looks interesting that I will most likely check out - the paste is from the bariatric section of thier website. I am of the belief that one can never have too many resources to help us long the way on this journey.   http://www.amihungry...c-Surgery.shtml   Am I Hungry? Mindful Eating Program for Bariatric Surgery       The Am I Hungry? Mindful Eating Program for Bariatric Surgery helps resolve the mindless habits and emotional eating issues that lead to problems after bariatric surgery. It includes TWO books (both paperback)*: Am I Hungry? Mindful Eating Program for Bariatric Surgery Companion Workbook and Journal *
Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle
The award-winning book Eat What You Love, Love What You Eat is the foundation of this program; the Bariatric Surgery Companion Workbook and Awareness Journal shows you how to apply this life-changing approach after you've had bariatric surgery. (This program is appropriate for people who have had or are considering gastric bypass, the band, or the sleeve.) Each of the eight workshops in the Bariatric Surgery Companion Workbook and Awareness Journal helps you apply what you’ve read in Eat What You Love, Love What You Eat to your daily life and explore issues that are unique to people who have had bariatric surgery. Each of the eight workshops also has a special section called "Adjust" to guide you through the necessary skills to adjust to your "new normal." (See Dr. May's article below: It's STILL Not About the Food.) Download the Am I Hungry? Mindful Eating Program for Bariatric Surgery Companion Workbook and Journal table of contents and an excerpt from Workshop 8 listing the key concepts here. *Available only as a set because the Bariatric Surgery Workbook and Awareness Journal is a companion to Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle. It is not intended to be used alone. If you have already purchased Eat What You Love, Love What You Eat from us, you may email Orders@AmIHungry.com with your name so we can look it up (or you can email us a copy of your receipt). We are sorry for the inconvenience but it is very important that you use both books together!   Am I Hungry? Mindful Eating Program for Bariatric Surgery (set of two books) $39.90 Am I Hungry? Mindful Eating Workshops for Bariatric Surgery - Webinar   Participate in this workshop from the convenience and privacy of your own home! Facilitator: Jeff Butts (Read Jeff's personal story here) Dates: Wednesdays, March 6, 2013 - April 24, 2013 Time: 5:00 - 6:30 pm PST/6:00 - 7:30pm MST/7:00 - 8:30pm CST/8:00 - 9:30pm EST Investment: $199 Click Here to Register   Email training@AmIHungry.com to receive advanced notification of future webinar dates. Am I Hungry? Mindful Eating Workshops for Bariatric Surgery - Facilitator Training   Do you work with bariatric surgery patients? Now available: Facilitator Training to offer Am I Hungry? Mindful Eating Workshops for Bariatric Surgery in your bariatric center, office, or community! Please download the Facilitator Training information packet and contact us at 480 704-7811 or Training@AmIHungry.com to learn more. About the Author Michelle May, M.D.   Michelle May, M.D. is a recovered yoyo dieter and the founder of the Am I Hungry?® Mindful Eating Workshops and Facilitator Training Program (www.AmIHungry.com). She is the award-winning author of Eat What You Love, Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle that guides readers to eat fearlessly and mindfully. Eat What You Love, Love What You Eat received seven publishing awards including best book in the categories of health, best self-help, best nutrition, and mind-body-spirit and was named one of the Top 10 Diet Books in 2010 by Time.com (though Michelle insists that it is a how-not-to-diet book!). She is also the author of Eat What You Love, Love What You Eat with Diabetes. Margaret Furtado, M.S., R.D. served as a consultant on this project:   Margaret Furtado, M.S., R.D. has specialized in bariatric surgery at bariatric surgery centers of excellence for over a decade, including Tufts Medical Center, Massachusetts General Hospital, and The Johns Hopkins Center for Bariatric Surgery. She is currently a Bariatric Nutrition Specialist at The University of Maryland Medical Center, in Baltimore, Maryland. Margaret has co-authored 3 patient-centered books on bariatric surgery and nutrition, including her newly-revised Recipes for Life After Weight Loss Surgery and The Complete Idiot's Guide to Eating Well After Weight Loss Surgery. She was one of the authors of the 2008 bariatric nutrition guidelines published by the American Society of Metabolic and Bariatric Surgery. Margaret speaks internationally on bariatric surgery and nutrition. Bariatric Surgery: It's STILL Not About the Food!   Michelle May, M.D. writes about why mindful eating is so helpful for bariatric surgery patients:   Bariatric Surgery is Only a Tool   While bariatric surgery may be controversial, even bariatric surgeons agree that bariatric surgery is a tool, not a quick fix. This is a critical point because a tool can do nothing on its own; it requires skillful management by a knowledgeable user to work effectively. Therefore results following bariatric surgery depend on learning to use that tool optimally to develop and maintain a healthy lifestyle.   Adjusting to a New Normal   When people ask my opinion about bariatric surgery, I have to admit that it's a tough question because many people who decide to try surgery believe that they've tried everything else. Most have never even heard of intuitive or mindful eating.   Some believe or hope that having bariatric surgery will solve all of their problems—but nothing could be further from the truth. For example, if you’re an “emotional eater,” the situations and emotions that triggered eating in the past are unlikely to disappear simply because you’ve chosen to have bariatric surgery. As one patient said, “They didn’t operate on my brain!”   Some discover that they “miss” their friend—food—leaving them with a feeling of loss. As one person told me, "I've cut out my coping skill!"   Others believe that after surgery they won’t need to think about their eating anymore. In fact, it is just the opposite. You need to become very thoughtful about eating in order to use this tool optimally. If you’re not mindful about your eating, this “tool” can cause you to experience uncomfortable, even serious consequences—and you’ll be far less likely to get the results you hoped for.   Bottom line: It breaks my heart to see people invest so much yet continue to struggle in their relationship with food. Bariatric Surgery and Mindful Eating   Since 1999, tens of thousands of people have used the Am I Hungry? Mindful Eating Program and/or read Eat What You Love, Love What You Eat, to resolve their difficult eating issues. There are often people in our workshops who have had also bariatric surgery. They explain that surgery did not fix their real problem and/or that they need additional skills to cope with their "new normal."   Mindfulness is beneficial because it teaches us to focus our attention and awareness on what is happening right now, which in turn, helps us disengage from habitual, unsatisfying, and unskillful habits and behaviors.   Specifically, mindful eating skills help resolve the mindless habits and emotional eating issues that lead to problems after bariatric surgery: Eating too quickly
Taking large bites
Not chewing thoroughly
Eating while distracted leading to overconsumption
Not savoring food and therefore having difficulty feeling satisfied with small volumes of food
Eating too much, leading to vomiting and/or distention of the pouch
Grazing throughout the day
Eating "slider" foods and high-calorie soft foods and liquids, often in response to emotional triggers
Not consuming enough protein or nutrient-rich foods
Feeling deprived or left-out in social situations
Struggling to establish consistent physical activity
Transfer addictions
And many other issues...
Further, most people who make the difficult decision to have bariatric surgery want to improve their health and energy so they can live the vibrant life they crave. Yet without the additional tool of mindful eating, bariatric surgery can feel like a permanent diet that continues to consume your life. One of the most meaningful changes that happens when you learn to eat mindfully (whether you've had surgery or not!) is that it allows you to think about eating when you need to and free up your energy and attention to focus on living in between. Am I Hungry? Mindful Eating Program for Bariatric Surgery   For all these reasons we felt that it was time to create a mindful eating program especially for people who have had (or who are considering) bariatric surgery. We have a brand new Bariatric Surgery Workbook and Awareness Journal and will also begin offering additional workshop training for Am I Hungry? Facilitators who work with bariatric surgery patients.   Am I Hungry? Mindful Eating Program for Bariatric Surgery (set of two books) $39.90   (For a sneak peek, download a pdf of the key concepts covered in this Am I Hungry? Mindful Eating program for Bariatric Surgery.)   I am personally very excited about bringing the life-changing concepts of intuitive and mindful eating to the many people who, despite having surgery, still find themselves stuck in an eat-repent-repeat cycle. After all, even after bariatric surgery, it still isn't really about the food.   Eat Mindfully, Live Vibrantly! Michelle May, M.D.
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Symptoms Of Insufficient Protein

Got this in my email this morning from Unjury - a good reminder to myself to keep on working on getting my protein and calorie numbers up after surgery.   SYMPTOMS OF INSUFFICIENT PROTEIN   Everything in your body is made with protein. There’s nothing in your body you can make with just carbohydrate and fat. Your hair, skin, muscles, brain, heart, organs, blood, bones...every cell is made with protein. What happens when you don’t get enough? A doctor we know works with patients who haven’t gotten enough protein in their diet for years. She said that after surgery on those patients and she is putting in the stitches, “It’s like trying to sew wet tissue paper”. What are the symptoms of insufficient protein ? 1. Fatigue and/or weakness. Not just the feeling that we didn’t get enough sleep last night, but deep fatigue...or weakness where it’s hard to get through the day. 2. Weight loss plateau. When we don’t get enough protein, medical research indicates that the body tries to store calories rather than burning them. 3. Hair loss. We believe it is often preventable with enough protein. 4. Surgical complications. Is there surgery in your future? For many, the answer is yes. The best single numerical predictor of how well a surgery will go is your protein status. And, your body will heal slowly, sometimes very slowly, if your protein status is low.   These symptoms can also be caused by other things, so it is always good to ask your doctor. You can get back on track. Here’s what one UNJURY customer wrote: “My protein levels were really low my first trip back to the doctor... It was at 6 or 8 when I went in August...At that time, I hadn't started using UNJURY. I was told to increase my protein to try and bring it up.... At the end of October and my (protein level) was normal and up to 18.9 ! look what (UNJURY’s) done for me.”
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New Pinterest fad may fuel unhealthy fitness obsession

http://www.today.com...sion-6C10866502   Melissa Dahl TODAY 6 hours ago pinterest.com So you’re on the couch entering hour three of a Pinterest binge. This is a time when you probably could use a little motivation to get yourself to finally log off and drag your butt to the gym.   That’s essentially the point of “fitspiration” – a cutesy, Internetty term for images and slogans meant to inspire people to meet their fitness goals, hundreds of which are posted and pinned every day on image-heavy social media sites like Pinterest, Tumblr and Instagram. And a lot of “fitspo,” as it’s nicknamed, does a great job of doing what it’s intended to do: inspire people to get and stay fit, say body image experts and fitness bloggers. But mixed right into those healthy messages are also some sneakily harmful underlying themes. “A lot of these things are very reasonable -- they say things like ‘Just start,’” says David LaPorte, a psychologist at Indiana University of Pennsylvania who has studied body image and social media. “Or, I love this one: ‘Failure isn’t falling down; it’s refusing to get back up.’ “The trouble is when you surround all those good messages with images of people that are unattainable for most women, quite frankly,” he says. Because many of the “fitspo” images actually look a lot like “thinspiration” – and if you’re unaware of that term, do a quick search on Pinterest, Tumblr or Instagram. You’ll immediately find thousands of photos of heartbreakingly thin young women (and some guys, too, but mostly young women): It’s a lot of protruding hipbones, visible rib cages, “thigh gaps." Search for “fitspiration,” and you’ll see pages and pages of similar images -- it's usually a headless shot, zoomed in on a defined, flat set of sweaty abs. Here's a couple examples of these images from Tumblr:   “It sets up an equally unrealistic standard of beauty, but it’s under the guise of being healthy,” says Charlotte Hilton Anderson, a fitness blogger from Denver. On her blog, she’s called fitspo “thinspo in a sports bra,” and many body image experts say she’s exactly right. Recently, Tumblr and Pinterest responded to reports about the negative impact of “thinspo” or “thinspiration” by placing PSA-style language at the top of the results page when a user searches for those and other terms that may promote self-harm; Instagram banned both hashtags entirely. But fitspo has so far stayed mostly under the radar. Out of curiosity, LaPorte pulled up two Pinterest pages to look at them side-by-side: in one he’d searched for thinspiration and the other, fitspiration. “There are very, very subtle differences, but they look, for all intents and purposes, identical,” says Laporte, who was half-seriously designing a study as we spoke over the phone. (“We could pull them up and have people sort them out by fitspo or thinspo,” he mused. “I’m going to have to put an undergrad on this one.”) It’s worth noting the similarities because researchers who study body image and mental health have linked “thinspo” to some potentially damaging consequences. In 2010, LaPorte published a study that showed even when people with no history of eating disorders briefly looked at thinspo sites, it actually changed their eating patterns: On average, they ate about 3,000 fewer calories the next week. The participants only clicked around the thinspo sites for about 90 minutes at a time.   “Now imagine you’re a 16 or a 14 year old … and you go onto these websites for hours,” LaPorte says.   And a 2006 Italian study found that thinspo sites worsen some of the issues associated with eating disorders: specifically, asceticism, competition and obsession for control. Few academic studies have looked at thinspiration, and none have considered fitspiration. But psychologist Mia Holland, who specializes in treating patients with eating disorders, sees more than a few links between fitspo and compulsive exercise. While scrolling through a “fitspiration” tagstream on Pinterest, slogans like “Exercise til it hurts” and “Pain is only in your mind” particularly stood out to Holland. “Those are very unhealthy mottos to live by when exercising. If something hurts, STOP,” Holland said via email. “The body is a great barometer of its own tolerance. Yes, we do experience some discomfort when working out. … However, if the pain is unbearable, it is time to stop! “Slight discomfort can mean a muscle is working – full pain means we are pushing it too hard and need to stop,” she says. Holland reiterates that there really is some healthy, positive stuff under the fitspo and fitspiration hashtags, too, like healthful recipes or practical and safe workout tips. And if the fitspo online community is where you’re getting your encouragement to lace up your running shoes and head out the door – well, that’s wonderful, and you should keep it up! But be sure you're aware of some of the sneaky, negative messages hiding there. “(Fitspiration) does contain some good advice and healthy recipes, but that can veil the hidden negative and potentially harmful messages such as ‘Exercise til it hurts,’” Holland says. “If someone sees the positive information listed ... they will be swayed to think all of (fitspiration) is positive and helpful – when in fact, it is not.” Jodi Rubin, the creator of Destructively Fit, a training program to help fitness instructors spot eating disorders in their clients, offers this advice for people who want to participate in the online fitness community without becoming dangerously obsessive about it: Being active can and should be fun, she reminds. “I use that as a gauge often,” Rubin says. “Hopefully, exercise is fun for people. When it starts to become a drag, when it starts to feel like if I don’t go then I’m not going to feel good about myself” – that’s when it becomes a potential problem, she says.
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When Your Mother Says She's Fat

http://www.stuff.co....r-says-shes-fat   Dear Mum,   I was seven when I discovered that you were fat, ugly and horrible. Up until that point I had believed that you were beautiful - in every sense of the word. I remember flicking through old photo albums and staring at pictures of you standing on the deck of a boat. Your white strapless bathing suit looked so glamorous, just like a movie star. Whenever I had the chance I'd pull out that wondrous white bathing suit hidden in your bottom drawer and imagine a time when I'd be big enough to wear it; when I'd be like you. But all of that changed when, one night, we were dressed up for a party and you said to me, ''Look at you, so thin, beautiful and lovely. And look at me, fat, ugly and horrible.'' At first I didn't understand what you meant. ''You're not fat,'' I said earnestly and innocently, and you replied, ''Yes I am, darling. I've always been fat; even as a child.''   In the days that followed I had some painful revelations that have shaped my whole life. I learned that: 1. You must be fat because mothers don't lie. 2. Fat is ugly and horrible. 3. When I grow up I'll look like you and therefore I will be fat, ugly and horrible too. Years later, I looked back on this conversation and the hundreds that followed and cursed you for feeling so unattractive, insecure and unworthy. Because, as my first and most influential role model, you taught me to believe the same thing about myself. With every grimace at your reflection in the mirror, every new wonder diet that was going to change your life, and every guilty spoon of ''Oh-I-really-shouldn't'', I learned that women must be thin to be valid and worthy. Girls must go without because their greatest contribution to the world is their physical beauty.   Just like you, I have spent my whole life feeling fat. When did fat become a feeling anyway? And because I believed I was fat, I knew I was no good. But now that I am older, and a mother myself, I know that blaming you for my body hatred is unhelpful and unfair. I now understand that you too are a product of a long and rich lineage of women who were taught to loathe themselves. Look at the example Nanna set for you. Despite being what could only be described as famine-victim chic, she dieted every day of her life until the day she died at 79 years of age. She used to put on make-up to walk to the letterbox for fear that somebody might see her unpainted face.   I remember her ''compassionate'' response when you announced that Dad had left you for another woman. Her first comment was, ''I don't understand why he'd leave you. You look after yourself, you wear lipstick. You're overweight - but not that much.'' Before Dad left, he provided no balm for your body-image torment either.   ''Jesus, Jan,'' I overheard him say to you. ''It's not that hard. Energy in versus energy out. If you want to lose weight you just have to eat less.'' That night at dinner I watched you implement Dad's ''Energy In, Energy Out: Jesus, Jan, Just Eat Less'' weight-loss cure. You served up chow mein for dinner. (Remember how in 1980s Australian suburbia, a combination of mince, cabbage, and soy sauce was considered the height of exotic gourmet?) Everyone else's food was on a dinner plate except yours. You served your chow mein on a tiny bread-and-butter plate. As you sat in front of that pathetic scoop of mince, silent tears streamed down your face. I said nothing. Not even when your shoulders started heaving from your distress. We all ate our dinner in silence. Nobody comforted you. Nobody told you to stop being ridiculous and get a proper plate. Nobody told you that you were already loved and already good enough. Your achievements and your worth - as a teacher of children with special needs and a devoted mother of three of your own - paled into insignificance when compared with the centimetres you couldn't lose from your waist.   It broke my heart to witness your despair and I'm sorry that I didn't rush to your defence. I'd already learned that it was your fault that you were fat. I'd even heard Dad describe losing weight as a ''simple'' process - yet one that you still couldn't come to grips with. The lesson: you didn't deserve any food and you certainly didn't deserve any sympathy.   But I was wrong, Mum. Now I understand what it's like to grow up in a society that tells women that their beauty matters most, and at the same time defines a standard of beauty that is perpetually out of our reach. I also know the pain of internalising these messages. We have become our own jailors and we inflict our own punishments for failing to measure up.   No one is crueler to us than we are to ourselves. But this madness has to stop, Mum. It stops with you, it stops with me and it stops now. We deserve better - better than to have our days brought to ruin by bad body thoughts, wishing we were otherwise.   And it's not just about you and me any more. It's also about Violet. Your granddaughter is only 3 and I do not want body hatred to take root inside her and strangle her happiness, her confidence and her potential. I don't want Violet to believe that her beauty is her most important asset; that it will define her worth in the world. When Violet looks to us to learn how to be a woman, we need to be the best role models we can. We need to show her with our words and our actions that women are good enough just the way they are. And for her to believe us, we need to believe it ourselves.   The older we get, the more loved ones we lose to accidents and illness. Their passing is always tragic and far too soon. I sometimes think about what these friends - and the people who love them - wouldn't give for more time in a body that was healthy. A body that would allow them to live just a little longer. The size of that body's thighs or the lines on its face wouldn't matter. It would be alive and therefore it would be perfect. Your body is perfect too. It allows you to disarm a room with your smile and infect everyone with your laugh. It gives you arms to wrap around Violet and squeeze her until she giggles. Every moment we spend worrying about our physical ''flaws'' is a moment wasted, a precious slice of life that we will never get back.   Let us honour and respect our bodies for what they do instead of despising them for how they appear. Focus on living healthy and active lives, let our weight fall where it may, and consign our body hatred in the past where it belongs. When I looked at that photo of you in the white bathing suit all those years ago, my innocent young eyes saw the truth. I saw unconditional love, beauty and wisdom. I saw my Mum. Love, Kasey xx   This is an excerpt from Dear Mum, a collection of letters from Australian sporting stars, musicians, models, cooks and authors revealing what they would like to say to their mothers before it's too late, or would have said if only they'd had the chance. All royalties go to the National Breast Cancer Foundation. Published by Random House and available now.
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When Science Meets the Biggest Loser

I have watched every minute of all 14 season of The Biggest Loser. There are some pretty intresting findings from the study.   When Science Met The Biggest Loser   http://health.usnews.com/health-news/blogs/eat-run/2013/01/23/when-science-met-the-biggest-loser   By Yoni Freedhoff January 23, 2013   Yoni Freedhoff It's NBC's Monday night television juggernaut and the guilty pleasure of over 7 million viewers. Now in its 14th season, The Biggest Loser is a an industry unto itself, with a 2009 estimate by the New York Times pegging its worth at $100 million in annual revenue. Viewers tuning in week after week can watch as Americans with severe obesity are routinely yelled at, exercised until they vomit, injured, weighed nearly naked on a giant scale, and seemingly taught that the numbers on that scale measure not only their weight, but also their self-worth and represent the only true value of their health and success.   [see Are You Exercising for the Right Reasons?] Consequent perhaps to the show's immense popularity and polarizing approach, The Biggest Loser has led to the publication of a number of peer-reviewed medical studies that look at its impact on both the participants and the viewers. Their results are anything but pretty. Two studies have been conducted that examine how watching The Biggest Loser affects viewers' attitudes towards those with obesity. Perhaps not surprisingly, given the apparent tenor of the show—that obesity is a consequence of personal laziness and gluttony—the first study, published in the journal Obesity, showed that watching even a single episode of The Biggest Loser led viewers to dramatically increase their own hateful and negative biases towards those with obesity.   [see How to Spot and Stop Bullying] This result may be explicable on the basis of the second study, published in the journal Health Communication, which found that watching The Biggest Loser led viewers to be much more likely to believe that weight is well within an individual's locus of personal control. And, of course, that message echoes the show's­—that if you just want it badly enough, you can make it happen.The corollary is that if you don't make it happen, you must simply be lazy, which in turn may explain the increase seen in viewers' weight biases.   [see We're Not Fat Because We're Lazy] Interestingly, those same viewers who, consequent to the show, might attribute being overweight to laziness, were reported to be less inclined (go figure) to want to exercise or expect it to be enjoyable after watching a 7.5 minute workout on the show, according to a study published this month in the American Journal of Health Behavior. "People are screaming and crying and throwing up, and if you’re not a regular exerciser you might think this is what exercise is—that it’s this horrible experience where you have to push yourself to the extremes and the limits, which is completely wrong," said the study's lead author Tanya Berry of the University of Alberta. And what of the participants? Will being on The Biggest Loser change their lives forever? According to a paper published in the Journal of Clinical Endocrinology and Metabolism, the answer is yes, but perhaps for the worse. The researchers, including the show's own Robert Huizenga, looked at the metabolisms of participants following the completion of their first seven months with The Biggest Loser. As expected, due to weight loss and an effect broadly referred to as "metabolic adaptation," the participants' burned fewer calories at rest following their massive weight losses. What wasn't expected was the the magnitude of that decrease; researchers found that participants metabolisms slowed by an average of 504 more calories than would have been expected simply as a consequence of losing weight. In other words, participants' metabolisms slowed down to a much greater degree than was predicted. In turn, this suggests that the show's approach to weight loss may have risks unto itself and led the researchers to state: "Unfortunately, fat free mass preservation did not prevent the slowing of metabolic rate during active weight loss, which may predispose to weight regain unless the participants maintain high levels of physical activity or significant caloric restriction." This may explain why, when I interviewed three alumni of the TV show, they reported that 85 to 90 percent of participants regain most, if not all, of the weight that they lose, and that those who keep it off are generally the participants who have turned their losses into careers as personal trainers or motivational speakers. Ultimately the current state of the evidence on the phenomenon known as The Biggest Loser is far from flattering. It suggests that the show may be detrimental to both viewers and participants in that its combination of derision, personal blame, and extremes of exercise and dieting fuel societal weight bias while simultaneously discouraging people from exercising. Meanwhile, for participants, it seems to disproportionately slow down their metabolisms to the point where they're burning a full meal fewer calories than would be expected by their losses.   [see Why We're So Fat: What's Behind the Latest Obesity Rates] If you're a regular viewer here's my suggestion. Instead of spending two hours a week watching The Biggest Loser, why not use that same amount of time to ensure you pack your lunch for work each and every day and take three 20-minute walks a week with a friend or a loved one. No doubt the impact of those behaviors will be far more valuable and positive to your mental and physical well-being than watching a show that science suggests may be doing more harm than good.   [see 7 Mind-Blowing Benefits of Exercise]   Yoni Freedhoff, MD, is an assistant professor of family medicine at the University of Ottawa, where he's the founder and medical director of the Bariatric Medical Institute—dedicated to non-surgical weight management since 2004. Dr. Freedhoff sounds off daily on his award-winning blog, Weighty Matters, and is also easily reachable on Twitter. Dr. Freedhoff's latest book Why Diets Fail and How to Make Yours Work will be published by Random House’s Crown/Harmony in 2014.
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Feeling Great After One Year Post Op Appointment

I've just had my one year post op check up appointment this morning and I feel very positive after receiving wonderful feedback from my provider. Although my losses have slowed dramatically these last two months, Adam told me that I am 100% successful and ahead of the curve in terms of my success with the surgery. My husband and I have really been focusing on getting more activity and my daily calories are in the range of 800-1200 a day - with protein first as always. I met with a trainer last week who has set up a program of simple strength training and cardio to help me get to my goal, which is a healthy BMI <25 - at 5'3" that is 140.   Hubby, who also had a VSG two weeks prior to my own, is essentially at goal and is focused on building muscle. I am statistically right where Adam projected me to be (175) though the number has been back and forth between 175- 178 these past weeks. Just about all of my co-morbidities are resolved - though osteo-arthritis does not have a resolution but rather is managed, my pain and mobility is astronomically better than it used to be.   Adam said that even if I do not lose another pound I am absolutely healthy - and that I have completely turned my health around from what it was 3 years ago. It feels great to know that I have made such great strides - finally, I am getting this monster under control. I showed him the alternate height/weight chart that factors in age and he said that absolutely as we get older it is fine if those numbers are a bit higher - it is still considered healthy.   I have a tendency to rip myself to shreds and to look upon myself as a failure, a history of depression, anxiety, and disordered thinking can tend to do that and I had started to do the same thing with my weight loss progress, beating myself up mentally because I had not yet achieved my ultimate goal - feeling like a failure and forgetting to celebrate the magnificent successes I have achieved. Feeling down because of all of the excess skin, the terrible toll so many years of carrying so many excess lbs. does to one's body - feeling guilt that I had done this to myself, defeated. Feeling that I would never have ultimate success - it was a bit of a reboot to know that I am already a success in the eyes of this medical practitioner who was with me every step of the way with my surgery, the hematocrit levels that dropped to 19, the internal bleeding that followed, the multiple blood transfusions, the incisions that opened up at home when they finally let me return home from the hospital after a week - and sent me back to the ER. I was miserable for about 8 weeks after my surgery - it certainly took me a bit to recover.   I feel wonderful now, and am close to goal. I need to cherish the journey and recognize the incredible positive changes that my family and I have made over the past few years. It certainly takes a bit of practice to treat oneself well - just like this ongoing physical metamorphosis, it is a process, and there is no finish line. I will get to that goal eventually
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Getting To The Other Side...

I wanted to tell you guys thank you for the kind thoughts this past week - which has been bar none -probably the most hellish week of my life.   My VSG surgery was last Monday afternoon (May 21, 2012) My husband had this same surgery done on Tuesday, May 9th and sailed through it - we brought him home the next morning. Unfortunately I have not experienced the same kind of luck with my own recovery.   In a nutshell, I was supposed to go home on Tuesday morning, but I became tachardic (heart rate off the charts) and my red blood cells counts dropped so low that I was about as white as the sheet on my bed, as it turns out I was bleeding internally. Over the next few days I was given two blood transfusions, the first showed little improvement, then slowly the red blood cells started to return after the 4th unit of blood on the second transfusion.   I was finally released on Friday morning - only to come home and have one of the 6 incisions on my belly rupture after I was home for about an hour - bleeding so profusely that it was like I had been hit by a shotgun blast.We ended up back in the ER once again that evening, having soaked through all of the towels, ratty clothes, and absorptive things in the house lol.   They took yet another CBC (complete blood count) - which makes about 17 blood draws on someone who has teeny tiny veins, and can barely swallow .5 ounce of water - they were threatening to insert a central line and go back in to find the bleeding - Good news is that the numbers are looking better, so they did not need to. I was also 20 lbs. higher than my surgery day weight from blood pooling in the tummy and the insane amount of fluids they pushed all week. Right before I left the hospital they gave me a shot of lasix and put a Dulcolax suppository in the bum - lets just say I we had to stop a coule of times on the way home - we are not even that far from the hospital.   6 days out and it is the first day that I have actually start to feel okay. Now my stomach looks like a giant black and blue sack of potatoes - its has assumed shapes I have never known it could. Gotta get a picture of it before it goes away - it really is quite a spectacle.   After the process I have gone through this past year with the nutrition, psych, and medical counseling and then having the surgery - it is in no way the easy route - merely the most successful in helping people as obese as myself hope to live a bit longer. Yesterday I was able to start getting all of my vitamins in, and am working hard to get my protein and fluids - it really is true, your tastes can really change after surgery. The only things that taste okay now are melted sugar free popsicles, protein chicken soup broth (strained), proti-diet protein drinks and powerade zero.   I am very grateful to be feeling better for the moment - it think it might be a while before I have much energy. Frankly I am just glad to be alive - thank you guys for your enduring love and friendship.
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My 'Naked' Truth by Robin Korth

http://www.huffingtonpost.com/robin-korth/sex-over-50_b_5563576.html     Naked, I stood at the closet doors with the lights on and made myself ready. I took a deep breath and positioned the mirrors so I could see all of me. I consciously worked to remove my self-believed inner image. I opened my eyes and looked very carefully at my body. And my heart lurched at the truth: I am not a young woman anymore. I am a woman well-lived. My body tells of all the years she has carried my spirit through life. I am a 59-year-old woman in great health and in good physical shape. I stand five-feet, nine-inches tall and weigh 135 pounds. I wear a size six in both jeans and panties, and my breasts are nowhere near my navel. In fact, they still struggle to make it full-up in a B-cup bra. My thighs are no longer velvet and my buttocks have dimples. My upper arms wobble a bit and my skin shows the marks of the sun. There is a softness around my waist that is no longer perfectly taut, and the pout of my abdomen attests to a c-section that took its bikini flatness -- but gave me a son.   Why this brutal scrutiny of myself? It was time to counter the damage of my culture, my own soft-held fear and to pour warm love on my own soul. It was time to claim every mark and not-perfect inch of my own body -- a body that had been called "too wrinkled" by a man who was fetched by my energy and my mind, but did not like the bare truth of me. His name was Dave and he was 55 years old.   We met on a dating site. Dave was interesting, gentlemanly and bright. He held my hand and toured with me on long bicycle rides. He drove many miles to come to my door. He made meals for us both and ruffled my dog's happy head. I was enticed and longed for the full knowing of this man. And so, we planned a weekend together. That's when things got confusing, unspoken and just-not-quite there. We went to bed in a couple's way -- unclothed and touching -- all parts near. Kisses were shared and sleep came in hugs. I attempted more intimacy throughout the weekend and was deterred each time.   On Monday evening over the phone, I asked this man who had shared my bed for three nights running why we had not made love. "Your body is too wrinkly," he said without a pause. "I have spoiled myself over the years with young women. I just can't get excited with you. I love your energy and your laughter. I like your head and your heart. But, I just can't deal with your body."   I was stunned. The hurt would come later. I asked him slowly and carefully if he found my body hard to look at. He said yes. "So, this means seeing me naked was troublesome to you?" I asked. He told me he had just looked away. And when the lights were out, he pretended my body was younger -- that I was younger. My breath came deep and full as I processed this information. My face blazed as I felt embarrassed and shamed by memories of my easy nakedness with him in days just passed.   We talked for some time more, my head reeling at the content of the conversation. He spoke of special stockings and clothing that would "hide" my years. He blithely told me he loved "little black dresses" and strappy shoes. He said my hair was not long and flowing as he preferred, but that was okay because it was "cool looking." I felt like a Barbie Doll on acid as I listened to this man. He was totally oblivious to the viciousness of his words. He had turned me into an object to be dressed and positioned to provide satisfaction for his ideas of what female sexual perfection should be. He explained that now that I knew what was required, we could have a great time in the bedroom. I told him no. I would not hide from my own body. I would not wear outfits to make my body more "tolerable." I would not undress in the dark or shower with the bathroom door closed. I would not diminish myself for him -- or for anyone. My body is beautiful and it goes along with my mind and my heart.   When I told Dave that I never wanted to see or hear from him again, he was confused and complained that I was making a big deal out of nothing. He whined that I had taken a small part of our relationship and made it a major event. I didn't even want to try to explain the hurt and the horror that he had inflicted upon me. I actually felt sickly sorry for this man as I hung up the phone. It was after this call that I went to the bedroom and gently stripped off my clothes. As I looked in the mirror -- clear-eyed and brave -- I claimed every inch of my body with love, honor and deep care. This body is me. She has held my soul and carried my heart for all of my days. Each wrinkle and imperfection is a badge of my living and of my giving of life. With tears in my eyes, I hugged myself close. I said thank you to God for the gift of my body and my life. And I said thank you to a sad man named Dave for reminding me of how precious it all is.   Robin Korth enjoys interactions with her readers. Feel free to contact her at info@robininyourface.com or on Facebook. To learn about her new book, "Soul on the Run," go to: www.SoulOnTheRun.com You can also download her "Robin In Your Face" free daily motivational app by going to www.robininyourface.com/whats-new/
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Ten Mistakes That Weight Loss Post-Ops Make

This is reposted from another WL forum - thought it could be useful to add to a blog post to remember~     Ten Mistakes that Weight Loss Postops Make   1st Mistake: Not Taking Vitamins, Supplements, or Minerals Every WLS patient has specific nutritional needs depending on the type of surgery you have had. Not only is it a good idea to ask your surgeon for guidelines, but also consult with an experienced WLS nutritionist.   Understand there is not a standard practice that all surgeons and nutritionists follow in guiding WLS patients. So, it is important to do your own research, get your lab tests done regularly, and learn how to read the results.   Some conditions and symptoms that can occur when you are deficient in vitamins, supplements, or minerals include: Osteoporosis; pernicious anemia; muscle spasms; high blood pressure; burning tongue; fatigue; loss of appetite; weakness; constipation and diarrhea; numbness and tingling in the hands and feet; being tired, lethargic, or dizzy; forgetfulness, and lowered immune functioning. Keep in mind, too, that some conditions caused by not taking your vitamins, supplements, or minerals are irreversible. For example, a vitamin B-1 deficiency can result in permanent neurological deficits, including the loss of the ability to walk.   2nd Mistake: Assuming You Have Been Cured of Your Obesity A "pink cloud" or honeymoon experience is common following WLS. When you are feeling better than you have in years, and the weight is coming off easily, it's hard to imagine you will ever struggle again. But unfortunately, it is very common for WLS patients to not lose to their goal weight or to regain some of their weight back.   A small weight regain may be normal, but huge gains usually can be avoided with support, education, effort, and careful attention to living a healthy WLS lifestyle. For most WLSers, if you don't change what you've always done, you're going to keep getting what you've always gotten -- even after weight loss surgery.   3rd Mistake: Drinking with Meals Yes, it's hard for some people to avoid drinking with meals, but the tool of not drinking with meals is a critical key to long-term success. If you drink while you eat, your food washes out of your stomach much more quickly, you can eat more, you get hungry sooner, and you are at more risk for snacking. Being too hungry is much more likely to lead to poor food choices and/or overeating.   4th Mistake: Not Eating Right Of course everyone should eat right, but in this society eating right is a challenge. You have to make it as easy on yourself as possible. Eat all your meals--don't skip. Don't keep unhealthy food in sight where it will call to you all the time. Try to feed yourself at regular intervals so that you aren't as tempted to make a poor choice.   And consider having a couple of absolutes: for example, avoid fried foods completely, avoid sugary foods, always use low-fat options, or only eat in a restaurant once a week. Choose your "absolutes" based on your trigger foods and your self knowledge about what foods and/or situations are problematic for you.   5th Mistake: Not Drinking Enough Water Most WLS patients are at risk for dehydration. Drinking a minimum of 64 oz. of water per day will help you avoid this risk. Adequate water intake will also help you flush out your system as you lose weight and avoid kidney stones. Drinking enough water helps with your weight loss, too.   6th Mistake: Grazing Many people who have had WLS regret that they ever started grazing, which is nibbling small amounts here and there over the course of the day. It's one thing to eat the three to five small meals you and your doctor agree you need. It's something else altogether when you start to graze, eating any number of unplanned snacks. Grazing can easily make your weight creep up.   Eating enough at meal time, and eating planned snacks when necessary, will help you resist grazing. Make a plan for what you will do when you crave food, but are not truly hungry. For example, take up a hobby to keep your hands busy or call on someone in your support group for encouragement.   7th Mistake: Not Exercising Regularly Exercise is one of the best weapons a WLS patient has to fight weight regain. Not only does exercise boost your spirits, it is a great way to keep your metabolism running strong. When you exercise, you build muscle. The more muscle you have, the more calories your body will burn, even at rest!   8th Mistake: Eating the Wrong Carbs (or Eating Too Much) Let's face it, refined carbohydrates are addictive. If you eat refined carbohydrates they will make you crave more refined carbohydrates. There are plenty of complex carbohydrates to choose from, which have beneficial vitamins. For example, if you can handle pastas, try whole grain Kamut pasta--in moderation, of course. (Kamut pasta doesn't have the flavor some people find unpleasant in the whole wheat pastas.) Try using your complex carbohydrates as "condiments," rather than as the center point of your meal. Try sprinkling a tablespoon of brown rice on your stir-fried meat and veggies.   9th Mistake: Going Back to Drinking Soda Drinking soda is controversial in WLS circles. Some people claim soda stretches your stomach or pouch. What we know it does is keep you from getting the hydration your body requires after WLS--because when you're drinking soda, you're not drinking water! In addition, diet soda has been connected to weight gain in the general population. The best thing you can do is find other, healthier drinks to fall in love with. They are out there.   10th Mistake: Drinking Alcohol If you drank alcohol before surgery, you are likely to want to resume drinking alcohol following surgery. Most surgeons recommend waiting one year after surgery. And it is in your best interest to understand the consequences of drinking alcohol before you do it.   Alcohol is connected with weight regain, because alcohol has 7 calories per gram, while protein and vegetables have 4 calories per gram. Also, some people develop an addiction to alcohol after WLS, so be very cautious.   Depending on your type of WLS, you may get drunker, quicker after surgery, which can cause health problems and put you in dangerous situations. If you think you have a drinking problem, get help right away. Putting off stopping drinking doesn't make it any easier, and could make you a lot sicker.
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Words of Wisdom

I am currently reading 703: How I Lost More Than a Quarter Ton and Gained a Life by Nancy Makin. It is a well written memoir about her struggle with obesity. I Googled her this morning and came across an excerpt from an old blog post of hers that resonated with me. This same struggle will be one I deal with for as long as I am alive, hopefully I can continue on this path with honesty and grace. http://www.amazon.co...-1&keywords=703     http://nancymakin.wordpress.com/   Your plan may be vastly different. Small steps make for big changes down the road. If you can’t do a lot, do what you can; excuses are just that… excuses for not moving forward. If you do this, you are sabotaging your future. If you act like a victim, you’ll always be a victim. If you want change, change the things you can, however insignificant they seem right now. Each positive act will bring results, just as surely as negative ones do…. they will change what you think, about you, your capabilities and about the world around you. Do it for yourself, because you are valuable. Exercise, ie: activity, is only one aspect of a human being’s life. We are a mixture of body, mind and spirit. Neglecting any one of the “whole” causes the disconnect that leaves us faltering, unsure and feeling incomplete. Give your love and time to someone else today in any way you can and watch the magic that’s released. You will begin to treat yourself as you treat others… Little gestures move mountains.   Believe.
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Eight Signs Of Emotional Eating

A pal from my WL support group shared this one~   Eight Signs of Emotional Eating   A lot of people ask, "How do I know if I am over eating for emotional reasons?" If any of the following statements sound like they could apply to you, then it's likely you are struggling with emotional eating.     1. My hunger comes on suddenly. Physical hunger comes on slowly. Hunger from emotional eating often comes on quickly and suddenly.   2. I crave specific foods-generally not carrot sticks or steamed broccoli. Cravings for specific foods usually unhealthy foods are signs of emotional eating. Often people like the rush they get from satisfying their cravings. The rush is fulfilling emotional hunger.　   3. My hunger feels urgent- I need a particular food right away and I am willing to walk out of my way, or get in your car late at night, or raid my kids Halloween candy to get it. Physical hunger, unless you haven’t eaten for a long time, is usually pretty patient. It will wait for food. Emotional hunger demands to be satisfied immediately.   4. My hunger is often paired with an upsetting emotion- if I backtrack a few hours or a few days I’ll usually find an upsetting event and feeling that triggered the urge. Hunger thats comnnected to an upsetting emotion or situation is definately emotional hunger. Physical hunger is not typically triggered by emotions.   5. My eating habits involve unconscious eating-all of a sudden I’m eating ice cream and I find the whole contianer is gone.   6. I don’t stop eating in response to being full- I keep wanting more of the taste of the food. Physical hunger doesn’t need to be stuffed in order to be satisfied. Emotional hunger on the other hand often demands more and more food to feel satisfied.   7. My hunger isn’t located in the belly- I crave the taste of a certain food in my mouth or I can’t stop thinking of a certan food. Feeling hungry in this way is usually a sign of emotional hunger or binging. Physical hunger is happy to get what it can, while emotional hunger usually focuses on specific tastes and textures.   8. After I satisfy my hunger, I am often filled with a sense of regret or guilt.Feeding your body what it needs is not something to feel guilty about. If you feel guilty after you eat, it’s likely because part of you knows you’re not eating just to satisfy physical hunger.   When you’re eating for phyiscal reasons, you are usually mindful of what you’re doing. If you catch yourself eating, “just because”, then its likely you’re eating for emotional reasons.
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