Alex Brecher

Freedom from Medical Chains
Medical benefits are probably most closely related to weight loss, but they are still worth noting as a “side” benefit of Weight Loss Surgery. As you lose weight, you may have improvements in blood sugar control, blood pressure, and cholesterol levels. You may have less joint and back pain. You may have fewer trips to the doctor, and be able to take fewer medications.
Better Sleep
Never underestimate the power of sleep! Losing weight can help you sleep more deeply so you feel better all day, every day. Your sleep can improve as you feel more comfortable in bed, and if you had sleep apnea that goes away or diminishes with weight loss. Just think how good life could be if you did not have to did not have to use a CPAP machine!
New Food Finds
Strange but true…there is a whole food world aside from burgers, burritos, fries, and bagels. Who knew that you might end up loving to start your day with oatmeal cottage cheese protein pancakes? Your favorite snack could turn out to be kale chips with parmesan. Dinner might be roasted cauliflower with grilled salmon – something you might never have considered when your go-to was mac and cheese from a box.
Sure, you might miss a few foods, but you might notice that you are loving all kinds of new health foods, and the way they make you feel. On top of it, eating slowly can help you savor each bite and enjoy the textures and flavors more.
Saving Money
Saving money probably was not your main reason for considering weight loss surgery, especially if your insurance is not footing the bill. Still, Weight Loss Surgery could be a financial gain in the long run as you consider some potential savings.
Lower medical bills for doctors’ visits, prescription medications, and complications such as complications of diabetes. Fewer sick days taken from work. Lower food bills as you eat less and potentially eat more homemade food. Fewer “extras,” such as higher prices of plus-sized clothing or needing to reserve two seats on a plane. More Meaningful Relationships
Were your relationships built around food before Weight Loss Surgery? Did you consider your friends your best eating buddies, with each of your meetings at a restaurant or each other’s houses for a (unhealthy) meal? Weight loss surgery frees you up to explore other interests. Deepen your relationships with your friends as you walk together or meet at museums or other sights instead of depending on food to bring you together. And, if you do meet for a meal or snack, feel good knowing you can focus on the conversation as you eat slowly.
Confidence
Ultimately, weight loss surgery is for you, and you can benefit inside as you look better on the outside. You can gain confidence from your new looks, maybe as you fit into clothes you love, or you see a few muscles popping out. Confidence also comes from your achievements. If you can do something as hard as going through Weight Loss Surgery and sticking to all those healthy lifestyle changes, you can do pretty much anything you set your mind to.
Energy
Energy is a wonderful thing, but it may be in short supply when you are carrying around extra pounds. Lose a few, and you might feel your endurance explode. You can keep up with your kids, enjoy a day at the mall or beach, and go on vacations. Getting through the work day can be easier. Life is better all around when you have energy.
Bariatric surgery is a weight loss tool, and it is so much more. Use it properly, and you can make great gains in many areas of your life. Part 2 of the series – to be published soon – will discuss ways to get what you deserve – maximum gains from Weight Loss Surgery!

Freedom from Medical Chains
Medical benefits are probably most closely related to weight loss, but they are still worth noting as a “side” benefit of Weight Loss Surgery. As you lose weight, you may have improvements in blood sugar control, blood pressure, and cholesterol levels. You may have less joint and back pain. You may have fewer trips to the doctor, and be able to take fewer medications.
Better Sleep
Never underestimate the power of sleep! Losing weight can help you sleep more deeply so you feel better all day, every day. Your sleep can improve as you feel more comfortable in bed, and if you had sleep apnea that goes away or diminishes with weight loss. Just think how good life could be if you did not have to did not have to use a CPAP machine!
New Food Finds
Strange but true…there is a whole food world aside from burgers, burritos, fries, and bagels. Who knew that you might end up loving to start your day with oatmeal cottage cheese protein pancakes? Your favorite snack could turn out to be kale chips with parmesan. Dinner might be roasted cauliflower with grilled salmon – something you might never have considered when your go-to was mac and cheese from a box.
Sure, you might miss a few foods, but you might notice that you are loving all kinds of new health foods, and the way they make you feel. On top of it, eating slowly can help you savor each bite and enjoy the textures and flavors more.
Saving Money
Saving money probably was not your main reason for considering weight loss surgery, especially if your insurance is not footing the bill. Still, Weight Loss Surgery could be a financial gain in the long run as you consider some potential savings.
Lower medical bills for doctors’ visits, prescription medications, and complications such as complications of diabetes. Fewer sick days taken from work. Lower food bills as you eat less and potentially eat more homemade food. Fewer “extras,” such as higher prices of plus-sized clothing or needing to reserve two seats on a plane. More Meaningful Relationships
Were your relationships built around food before Weight Loss Surgery? Did you consider your friends your best eating buddies, with each of your meetings at a restaurant or each other’s houses for a (unhealthy) meal? Weight loss surgery frees you up to explore other interests. Deepen your relationships with your friends as you walk together or meet at museums or other sights instead of depending on food to bring you together. And, if you do meet for a meal or snack, feel good knowing you can focus on the conversation as you eat slowly.
Confidence
Ultimately, weight loss surgery is for you, and you can benefit inside as you look better on the outside. You can gain confidence from your new looks, maybe as you fit into clothes you love, or you see a few muscles popping out. Confidence also comes from your achievements. If you can do something as hard as going through Weight Loss Surgery and sticking to all those healthy lifestyle changes, you can do pretty much anything you set your mind to.
Energy
Energy is a wonderful thing, but it may be in short supply when you are carrying around extra pounds. Lose a few, and you might feel your endurance explode. You can keep up with your kids, enjoy a day at the mall or beach, and go on vacations. Getting through the work day can be easier. Life is better all around when you have energy.
Bariatric surgery is a weight loss tool, and it is so much more. Use it properly, and you can make great gains in many areas of your life. Part 2 of the series – to be published soon – will discuss ways to get what you deserve – maximum gains from Weight Loss Surgery!

Mindfulness basically just means paying attention to something - without judgment.
Mindful eating is paying attention to your food, and to your appetite cues - again, without judgment (that's the hard part!).
Dieting vs. Mindful Eating:
Diet =
Weight gain: 95% of people who diet will regain the weight they lost within 5 years. 2/3 of those people will regain more than they lost, ultimately resulting in overall weight gain. All about willpower and rigidity. Relies on external cues. Restrictive and depriving. Food & body are the enemy. Mindful Eating =
Weight loss: Studies show that mindful eating programs result in weight loss, fewer calories consumed, lower fat intake and increased self-confidence (Timmerman et al., 2012) All about trust and acceptance. Relies on internal appetite cues. Permissive and satisfying. Food & body are the ally. Which would you prefer? For me, I'd much rather give mindful eating a shot. Especially since dieting was what led up to most people having bariatric surgery in the first place.
Step-by-step how to eat mindfully:
Pick a calm and quiet place to sit down and eat. Check in with your hunger. Are you physically hungry? If not, wait until later when you are hungry. The food will be much more satisfying if you enter the experience hungry. Choose a food that will be satisfying. Give yourself permission to eat that food without judgment (toward the food or yourself) or guilt. Use all of your senses - look at the food, touch the food, smell the food, taste the food, feel it in your mouth, move it around and notice the way the texture and taste changes as you chew. Chew slowly and thoroughly. As you swallow, feel the food going down your esophagus and into your stomach. Notice how the food feels in your stomach. Ask yourself if you want more. If so, take another bite and repeat until you feel satisfied. At the end, take a moment to express gratitude for the experience, for the food, and for your body. Carry the awareness of mindful attention to other areas of your life - you'll be shocked at what a big difference this makes! Be patient with yourself. The practice of mindful eating is just that - a practice. Your mind and attention will wander, you will inevitably catch yourself judging yourself or the food. That's ok - it's normal. Just notice it, and return your attention to the experience.
Practice this as often as you are able. Of course, it's not possible to eat mindfully 100% of the time, so don't be rigid with it.
As you get more skilled at mindful eating, it will become more effortless and second nature.
See, I told you this wasn't just for hippies! Mindful eating is very doable for all of us. We just have to make the conscious decision to do it. Paying attention to our food and our bodies allows us to get infinite more pleasure out of life.
Give it a shot and let me know what you think. Share your experience in the comments below.
What was it like to pay close attention to the taste and texture of the food?
What was it like to refrain from judgment about yourself for eating the food?
What surprised you about mindful eating?

Freedom from Medical Chains
Medical benefits are probably most closely related to weight loss, but they are still worth noting as a “side” benefit of Weight Loss Surgery. As you lose weight, you may have improvements in blood sugar control, blood pressure, and cholesterol levels. You may have less joint and back pain. You may have fewer trips to the doctor, and be able to take fewer medications.
Better Sleep
Never underestimate the power of sleep! Losing weight can help you sleep more deeply so you feel better all day, every day. Your sleep can improve as you feel more comfortable in bed, and if you had sleep apnea that goes away or diminishes with weight loss. Just think how good life could be if you did not have to did not have to use a CPAP machine!
New Food Finds
Strange but true…there is a whole food world aside from burgers, burritos, fries, and bagels. Who knew that you might end up loving to start your day with oatmeal cottage cheese protein pancakes? Your favorite snack could turn out to be kale chips with parmesan. Dinner might be roasted cauliflower with grilled salmon – something you might never have considered when your go-to was mac and cheese from a box.
Sure, you might miss a few foods, but you might notice that you are loving all kinds of new health foods, and the way they make you feel. On top of it, eating slowly can help you savor each bite and enjoy the textures and flavors more.
Saving Money
Saving money probably was not your main reason for considering weight loss surgery, especially if your insurance is not footing the bill. Still, Weight Loss Surgery could be a financial gain in the long run as you consider some potential savings.
Lower medical bills for doctors’ visits, prescription medications, and complications such as complications of diabetes. Fewer sick days taken from work. Lower food bills as you eat less and potentially eat more homemade food. Fewer “extras,” such as higher prices of plus-sized clothing or needing to reserve two seats on a plane. More Meaningful Relationships
Were your relationships built around food before Weight Loss Surgery? Did you consider your friends your best eating buddies, with each of your meetings at a restaurant or each other’s houses for a (unhealthy) meal? Weight loss surgery frees you up to explore other interests. Deepen your relationships with your friends as you walk together or meet at museums or other sights instead of depending on food to bring you together. And, if you do meet for a meal or snack, feel good knowing you can focus on the conversation as you eat slowly.
Confidence
Ultimately, weight loss surgery is for you, and you can benefit inside as you look better on the outside. You can gain confidence from your new looks, maybe as you fit into clothes you love, or you see a few muscles popping out. Confidence also comes from your achievements. If you can do something as hard as going through Weight Loss Surgery and sticking to all those healthy lifestyle changes, you can do pretty much anything you set your mind to.
Energy
Energy is a wonderful thing, but it may be in short supply when you are carrying around extra pounds. Lose a few, and you might feel your endurance explode. You can keep up with your kids, enjoy a day at the mall or beach, and go on vacations. Getting through the work day can be easier. Life is better all around when you have energy.
Bariatric surgery is a weight loss tool, and it is so much more. Use it properly, and you can make great gains in many areas of your life. Part 2 of the series – to be published soon – will discuss ways to get what you deserve – maximum gains from Weight Loss Surgery!

Freedom from Medical Chains
Medical benefits are probably most closely related to weight loss, but they are still worth noting as a “side” benefit of Weight Loss Surgery. As you lose weight, you may have improvements in blood sugar control, blood pressure, and cholesterol levels. You may have less joint and back pain. You may have fewer trips to the doctor, and be able to take fewer medications.
Better Sleep
Never underestimate the power of sleep! Losing weight can help you sleep more deeply so you feel better all day, every day. Your sleep can improve as you feel more comfortable in bed, and if you had sleep apnea that goes away or diminishes with weight loss. Just think how good life could be if you did not have to did not have to use a CPAP machine!
New Food Finds
Strange but true…there is a whole food world aside from burgers, burritos, fries, and bagels. Who knew that you might end up loving to start your day with oatmeal cottage cheese protein pancakes? Your favorite snack could turn out to be kale chips with parmesan. Dinner might be roasted cauliflower with grilled salmon – something you might never have considered when your go-to was mac and cheese from a box.
Sure, you might miss a few foods, but you might notice that you are loving all kinds of new health foods, and the way they make you feel. On top of it, eating slowly can help you savor each bite and enjoy the textures and flavors more.
Saving Money
Saving money probably was not your main reason for considering weight loss surgery, especially if your insurance is not footing the bill. Still, Weight Loss Surgery could be a financial gain in the long run as you consider some potential savings.
Lower medical bills for doctors’ visits, prescription medications, and complications such as complications of diabetes. Fewer sick days taken from work. Lower food bills as you eat less and potentially eat more homemade food. Fewer “extras,” such as higher prices of plus-sized clothing or needing to reserve two seats on a plane. More Meaningful Relationships
Were your relationships built around food before Weight Loss Surgery? Did you consider your friends your best eating buddies, with each of your meetings at a restaurant or each other’s houses for a (unhealthy) meal? Weight loss surgery frees you up to explore other interests. Deepen your relationships with your friends as you walk together or meet at museums or other sights instead of depending on food to bring you together. And, if you do meet for a meal or snack, feel good knowing you can focus on the conversation as you eat slowly.
Confidence
Ultimately, weight loss surgery is for you, and you can benefit inside as you look better on the outside. You can gain confidence from your new looks, maybe as you fit into clothes you love, or you see a few muscles popping out. Confidence also comes from your achievements. If you can do something as hard as going through Weight Loss Surgery and sticking to all those healthy lifestyle changes, you can do pretty much anything you set your mind to.
Energy
Energy is a wonderful thing, but it may be in short supply when you are carrying around extra pounds. Lose a few, and you might feel your endurance explode. You can keep up with your kids, enjoy a day at the mall or beach, and go on vacations. Getting through the work day can be easier. Life is better all around when you have energy.
Bariatric surgery is a weight loss tool, and it is so much more. Use it properly, and you can make great gains in many areas of your life. Part 2 of the series – to be published soon – will discuss ways to get what you deserve – maximum gains from Weight Loss Surgery!

Freedom from Medical Chains
Medical benefits are probably most closely related to weight loss, but they are still worth noting as a “side” benefit of Weight Loss Surgery. As you lose weight, you may have improvements in blood sugar control, blood pressure, and cholesterol levels. You may have less joint and back pain. You may have fewer trips to the doctor, and be able to take fewer medications.
Better Sleep
Never underestimate the power of sleep! Losing weight can help you sleep more deeply so you feel better all day, every day. Your sleep can improve as you feel more comfortable in bed, and if you had sleep apnea that goes away or diminishes with weight loss. Just think how good life could be if you did not have to did not have to use a CPAP machine!
New Food Finds
Strange but true…there is a whole food world aside from burgers, burritos, fries, and bagels. Who knew that you might end up loving to start your day with oatmeal cottage cheese protein pancakes? Your favorite snack could turn out to be kale chips with parmesan. Dinner might be roasted cauliflower with grilled salmon – something you might never have considered when your go-to was mac and cheese from a box.
Sure, you might miss a few foods, but you might notice that you are loving all kinds of new health foods, and the way they make you feel. On top of it, eating slowly can help you savor each bite and enjoy the textures and flavors more.
Saving Money
Saving money probably was not your main reason for considering weight loss surgery, especially if your insurance is not footing the bill. Still, Weight Loss Surgery could be a financial gain in the long run as you consider some potential savings.
Lower medical bills for doctors’ visits, prescription medications, and complications such as complications of diabetes. Fewer sick days taken from work. Lower food bills as you eat less and potentially eat more homemade food. Fewer “extras,” such as higher prices of plus-sized clothing or needing to reserve two seats on a plane. More Meaningful Relationships
Were your relationships built around food before Weight Loss Surgery? Did you consider your friends your best eating buddies, with each of your meetings at a restaurant or each other’s houses for a (unhealthy) meal? Weight loss surgery frees you up to explore other interests. Deepen your relationships with your friends as you walk together or meet at museums or other sights instead of depending on food to bring you together. And, if you do meet for a meal or snack, feel good knowing you can focus on the conversation as you eat slowly.
Confidence
Ultimately, weight loss surgery is for you, and you can benefit inside as you look better on the outside. You can gain confidence from your new looks, maybe as you fit into clothes you love, or you see a few muscles popping out. Confidence also comes from your achievements. If you can do something as hard as going through Weight Loss Surgery and sticking to all those healthy lifestyle changes, you can do pretty much anything you set your mind to.
Energy
Energy is a wonderful thing, but it may be in short supply when you are carrying around extra pounds. Lose a few, and you might feel your endurance explode. You can keep up with your kids, enjoy a day at the mall or beach, and go on vacations. Getting through the work day can be easier. Life is better all around when you have energy.
Bariatric surgery is a weight loss tool, and it is so much more. Use it properly, and you can make great gains in many areas of your life. Part 2 of the series – to be published soon – will discuss ways to get what you deserve – maximum gains from Weight Loss Surgery!

Besides sweating, we lose water from talking, exhaling, fever, infection, going to the bathroom, living in a dry climate, vomiting and diarrhea. Symptoms of dehydration include headaches, fatigue or sleepiness, difficulty concentrating, confusion, memory issues, tension, anxiety, lower energy, constipation, feeling hungry, darker urine, feeling dizzy or lightheaded and muscle cramps. Water can be flavored but needs to be free of caffeine, carbonation and calories. Even though protein shakes have calories, most of them are water, so that counts towards your hydration. Sugar-free gelatin and popsicles count as water. Ice chips can be a nice way to get water when it’s sultry outside. Infused waters provide some flavor but no calories. Infused waters can be made by simply slicing citrus fruits or veggies, crushing berries, or adding herbs for steeping in your water. Cucumber and mint make a refreshing flavor combination. You can buy water bottles that have a tube down the middle that you can fill with fruits, veggies and herbs to flavor your water. How much is enough water? We start calculating your hydration goal by dividing by 2 what your weight would be if your BMI is 25. More is added if you are outdoors or workout a lot. Keeping a water bottle with you at all times can help you remember to sip enough fluids. Tracking fluids throughout the day is another way to know whether you’ve had enough fluids for the day. Have you sipped enough today?

The Struggle Often Continues
For some patients, Weight Loss Surgery can lower your interest in food, so you are not constantly thinking about it. There’s no question Weight Loss Surgery can help you gain control of your eating, but it’s unlikely to eliminate your struggles with food disappear. A few lucky Weight Loss Surgery patients really do stop being tempted by food. The rest, who make up the vast majority of Weight Loss Surgery patients, continue to struggle.
You still may be hungry, enjoy salt, fat, starch, or sugar, or be tempted to use food as an emotional crutch. Your family members may continue to insist on keeping high-calorie foods in the house, or pressure you to eat things you shouldn’t. Your friends may still be going out to eat and inviting you to join them in ordering high-fat, high-sugar items.
“Why Me?” Isn’t Appropriate
It’s easy, even natural, to think of yourself as unlucky. Why should you have to struggle with food? Why should you have to monitor every bite you take, while some people don’t? The fact is, almost everyone does. Ask almost any skinny person how they stay skinny, and you’ll get some variation of the same answer: “I work hard for it.”
Just like you, they are aware of what goes into their bodies. They sometimes may be hungry; they sometimes may want to eat more than they should. But they, like you now, take responsibility for their decisions. They may:
Skimp on portions if they over ate at the previous meal.
Choose healthy foods first.
Have a strategy for dealing with emotions and boredom that doesn’t involve eating.
Have a support system that promotes healthy behaviors.
Accept It and Manage It

If you find you still have a rocky relationship with food after weight loss surgery, don’t conclude that WLS didn’t work for you. Instead, accept that you will need to fight the cravings and urges for months, years, or life, and start making a plan. Don’t be afraid to ask for help in developing strategies – whether you ask other BariatricPal members or an always-thin person you admire!
Persist in Order to Get the Answers You Need
We all want to be able to trust our doctors. You want to believe your surgeon takes care of all aspects of your Weight Loss Surgery, including your post-op, long-term nutrition. But it doesn’t always happen like that. Nutritional counseling may not be part of your surgery package, or you may only get a limited amount of generic information.
Or, your surgeon may simply not know how to help you nutritionally. Remember that many doctors have no more than an hour of nutrition education in medical school. To become a weight loss surgeon, doctors need to learn surgery. There is no dietary education requirement.
If you need help finding strategies to satisfy hunger – physical or head hunger – and your surgeon and primary care doctor are not able to help, keep looking. A session with a nutritionist may be more affordable than you think, and worth every penny.
Your Emotional Support System and Your Relationship with Food
The support system you built so carefully can come in handy right about now. Take advantage of your ability to talk to a therapist or psychologist if you have one to bring up your concerns. Discussing your ongoing struggles with portion sizes, food choices, and over-frequent nibbling with a mental health professional can help you come up with some strategies that work for you.
Group sessions are also appropriate forums to talk about food struggles and strategies. Though it may feel embarrassing at first to admit you’re still thinking about food a lot, you will find nearly everyone in that room did or does have that same experience.
Most Weight Loss Surgery patients do not find their surgery instantly eliminates their food struggles. You can take months or years to come to terms with a food addiction, and it may be something you need to learn to live with for life, but in a healthier manner than before Weight Loss Surgery. Be honest with yourself and those around you, and be open to suggestions, and you can figure out strategies that work for you. Do not assume WLS did not work for you!

So why is it so hard to keep the weight off, and what can you do about it? It can be harder to keep the weight off than lose it in the first place because:
You might gradually be less strict with your food choices as the occasional treat becomes more frequent and bigger.
Your restriction may not feel as, well, restrictive as it did right after surgery.
Your metabolism is slower and you don’t need as many calories as you did before.
You don’t have the motivation that comes from seeing the scale go down as a reward for your good eating habits.

But a little challenge doesn’t have to get you down! After all, you’re a WLS patient, and you’re in it for the long haul! Here are some things to think about as you are losing weight, approaching goal weight, or even working on maintaining your goal weight. This is just Part 1 of the two-part series, so stay tuned for Part 2!
I Hate Counting Calories!
Yes, logging your food can be tedious. Some people even find that counting calories makes them anxious or causes them to fixate on food. Maybe immediately post-op you could skip the calorie counting and still lose weight because you had so much restriction. Maybe, in the beginning, you forced yourself to log foods for a few weeks or months.
What if, when you’re at or near goal weight, you can’t face the thought of counting calories? You still have a few options that can work.
Go back to the meal plan you got from your surgeon or nutritionist and stick to it. If it says ½ cup of oatmeal, it doesn’t matter whether you know how many calories that half-cup contains. You can be certain that if you follow the plan, your total daily calories will add up to the amount in the plan.
Log once a week. This can help you stay on track as you make sure your portion sizes are still working out for you and you are choosing the low-calorie, high-protein foods you think you are.
Focus on another nutrient, such as protein. If you hit your target grams of protein, stick to small portions, and make sure all of your protein and other foods are the nutritious ones you’re supposed to be eating – think lean proteins, vegetables, and healthy fats, for starters – you have a good start towards eating the way you should.

Carbs Are the Devil!
Maybe it’s carbs, maybe it’s sugar, maybe it’s pizza, or tacos, or ice cream that you avoid in your weight loss efforts. Whatever it is, there’s a good chance you’re trying to avoid it as you lose weight. Weight loss surgery patients can be tempted to go low-carb, paleo, or sugar-free. That’s fine, as long as you can keep it up long-term.
If you can’t, you’re setting yourself up for a rough time. What happens when you hit goal weight and you flip a mental switch in your head? What if you go from low-carb to letting cookies, bread, and pasta back into your diet? What if you go off paleo and find all sorts of processed foods that are delicious and convenient? What happens next time you come face to face with an order of chicken wings and dipping sauce for the table?
You may be better off planning for a diet that will work long term. While you are still losing weight or while you are early in the maintenance phase, take inventory of your feelings. Be honest about what you can and cannot live without, and develop a plan to address it. Then practice!
These are some possible ways to approach your food fears.
Think “healthy, portion-controlled carb” instead of “low-carb.” Aim to get in healthy carbs such as oatmeal, lentils, fruit, sweet potatoes, and yogurt rather than avoiding all carbs.
Consider the good and bad of the paleo diet. While the guidelines to avoid processed foods and refined sugars can’t hurt, it really necessary to avoid nutrient powerhouses such as beans (think: protein, fiber, and potassium)? And is it really possible to avoid all processed foods for the rest of your life? What happens if you run short on time? A good strategy may be to get in the habit of reading labels so you develop your ability to choose healthy (or at least, “healthier”) packaged meal helpers.
Make up your mind about trigger foods. Are you the type who can be satisfied with one potato chip when you get a craving? Or are you best off avoiding the chips altogether? Is there a similar substitute, such as kale chips, that can work for you? If you’re not sure, experiment so you know how best to handle cravings.

Maintenance has its share of challenges, but you can overcome them to be able to experience all the joys of hitting that goal weight you dreamed about for so long. Just like you did when you were getting ready for weight loss surgery and losing weight, you can take a carefully planned approach to maintenance that considers your own preferences. Stay tuned to Part 2 of the two-part series!

Reversibility
Each Weight Loss Surgery (WLS) type is designed to be permanent. However, the Adjustable Gastric Band (AGB) is fully reversible if necessary since the surgeon can remove the band from around your stomach. The Gastric Bypass (RNY) can be reversed, although the procedure is more complicated. The Gastric Sleeve (VSG) is absolutely irreversible since it involves removing most of your stomach from your body. Because of its reversibility, the AGB may be the choice for some younger patients or for those who do not want to take a dramatic step that affects their actual body parts.
Invasiveness and Recovery
The AGB is least invasive and has the shortest recovery time. It can even be an outpatient procedure, and you could get back to work in a week. This might be the only realistic option if you have very little sick leave available or you do not want to tell work colleagues about your surgery. The RNY and VSG are inpatient and require longer recovery times
Safety: Complications and Side Effects
Some risks of the AGB are band slippage or leakage, or erosion of the band. You could have vomiting or reflux if your band is displaced or filled too tight. Since the band can be removed, most of the complications can be stopped by emptying or removing the band.
The VSG has a higher rate of complications than the band. They can include leakage at the suture site. Nearly a quarter of RNY patients have complications of some sort, with more serious ones including staple line separation or leaks. You might opt for the AGB if you have a lower BMI without many health issues, or you might be more willing to take on RNY risks if your BMI is higher and you are more concerned about obesity-related issues such as diabetes.
The risk for nutritional deficiencies is higher with RNY and VSG. You can greatly lower your risk by taking the appropriate nutritional supplements, but you need to be prepared to take your bariatric vitamins for life. The effects of vitamin and mineral deficiencies can include osteoporosis, anemia, and nerve damage.
A Sweet Tooth and Dumping Syndrome
What are you looking to get out of your WLS? If all you need is help with portion control, AGB may be for you. It only helps with portion control, and it is up to you to make healthy food choices. On the other hand, the gastric bypass is best if you are looking for a tool to help you avoid sweets. That is because of the malabsorptive nature of RNY.
With RNY, your food passes through the lower part of your small intestine with less digestion than it would before surgery. Sugars that get to your small intestine can give you symptoms of dumping syndrome, including weakness, extreme fullness, diarrhea, nausea, and vomiting. Foods that cause dumping syndrome tend to be sugary and high-carb foods, such as candy, soft drinks, cakes, and pastries. Dairy and alcohol can also cause problems.
Most patients who get RNY have dumping syndrome at some point. Dumping syndrome can be beneficial because it gives you extra motivation to eat right – you know that if you grab that brownie, you may be headed for hours of misery! That can be a good reason to choose RNY. However, if the thought of dumping syndrome scares you, RNY is not for you!
There are many factors to consider as you choose your WLS type, but keep in mind that the decision is individual. You need to choose the WLS type that will work for you, even if it is not the one that worked for someone else. The decision is something to make after one or more serious conversations with your surgeon.

Reversibility
Each Weight Loss Surgery (WLS) type is designed to be permanent. However, the Adjustable Gastric Band (AGB) is fully reversible if necessary since the surgeon can remove the band from around your stomach. The Gastric Bypass (RNY) can be reversed, although the procedure is more complicated. The Gastric Sleeve (VSG) is absolutely irreversible since it involves removing most of your stomach from your body. Because of its reversibility, the AGB may be the choice for some younger patients or for those who do not want to take a dramatic step that affects their actual body parts.
Invasiveness and Recovery
The AGB is least invasive and has the shortest recovery time. It can even be an outpatient procedure, and you could get back to work in a week. This might be the only realistic option if you have very little sick leave available or you do not want to tell work colleagues about your surgery. The RNY and VSG are inpatient and require longer recovery times
Safety: Complications and Side Effects
Some risks of the AGB are band slippage or leakage, or erosion of the band. You could have vomiting or reflux if your band is displaced or filled too tight. Since the band can be removed, most of the complications can be stopped by emptying or removing the band.
The VSG has a higher rate of complications than the band. They can include leakage at the suture site. Nearly a quarter of RNY patients have complications of some sort, with more serious ones including staple line separation or leaks. You might opt for the AGB if you have a lower BMI without many health issues, or you might be more willing to take on RNY risks if your BMI is higher and you are more concerned about obesity-related issues such as diabetes.
The risk for nutritional deficiencies is higher with RNY and VSG. You can greatly lower your risk by taking the appropriate nutritional supplements, but you need to be prepared to take your bariatric vitamins for life. The effects of vitamin and mineral deficiencies can include osteoporosis, anemia, and nerve damage.
A Sweet Tooth and Dumping Syndrome
What are you looking to get out of your WLS? If all you need is help with portion control, AGB may be for you. It only helps with portion control, and it is up to you to make healthy food choices. On the other hand, the gastric bypass is best if you are looking for a tool to help you avoid sweets. That is because of the malabsorptive nature of RNY.
With RNY, your food passes through the lower part of your small intestine with less digestion than it would before surgery. Sugars that get to your small intestine can give you symptoms of dumping syndrome, including weakness, extreme fullness, diarrhea, nausea, and vomiting. Foods that cause dumping syndrome tend to be sugary and high-carb foods, such as candy, soft drinks, cakes, and pastries. Dairy and alcohol can also cause problems.
Most patients who get RNY have dumping syndrome at some point. Dumping syndrome can be beneficial because it gives you extra motivation to eat right – you know that if you grab that brownie, you may be headed for hours of misery! That can be a good reason to choose RNY. However, if the thought of dumping syndrome scares you, RNY is not for you!
There are many factors to consider as you choose your WLS type, but keep in mind that the decision is individual. You need to choose the WLS type that will work for you, even if it is not the one that worked for someone else. The decision is something to make after one or more serious conversations with your surgeon.

Speed and Amount of Weight Loss
The gastric bypass (RNY) and gastric sleeve (VSG) lead to faster weight loss. The expected weight loss with VSG is 50 to 70% of excess weight within two years; RNY leads to excess weight loss of about 80% within 18 months. Usually, heavier patients look towards the VSG and RNY, while the Adjustable Gastric Band (AGB) is sometimes used for lower BMI patients. Expected excess weight loss with AGB is 50% over two years.
The VSG can be the surgery of choice for heavier patients because the actual operation is a safer procedure than the RNY. However, the RNY could be better for you if you have diabetes since many patients have much better blood sugar control after the surgery.
Long Term Results
You may have a lower chance of keeping the weight off long-term with AGB compared to other surgeries, but that depends on several factors. You can keep the weight off if your band stays in place and if you make the commitment to continue to follow your WLS diet once you hit goal weight. The RNY has good long-term results for many patients who keep a good amount of weight off for 10 or more years. The VSG is a newer procedure and the jury is out on long-term results.
How It Works: Restriction, Malabsorption, and Hormones
All weight loss surgeries are “restrictive.” They restrict the amount of food you eat by making your stomach smaller so it fills up faster, with less food. The AGB does this by creating a small pouch that is separated from the larger portion of your stomach. The AGB is only restrictive, but it is the least invasive surgery type.
The RNY involves the surgeon separating the lower stomach, which is restrictive because it leaves you with only the upper stomach to hold food. The RNY is also malabsorptive because it leads to nutrient malabsorption. The surgeon connects the upper portion of your stomach to the lower part of your small intestine. After RNY, food “bypasses” the upper part of your small intestine which is where a good amount of digestion and absorption typically occur. That way, less of the food you eat is absorbed, so you get fewer calories. This is a benefit if you are looking for faster weight loss.
In the VSG, the surgeon removes about 75% of your stomach, leaving you with only a small tube-like “sleeve.” This is how it is restrictive. The VSG also helps you lose weight because it affects your hormones. Your stomach naturally produces a hormone called ghrelin that makes you hungry. When the surgeon takes out most of your stomach, you have less ghrelin and less hunger. The VSG may be for you if you always feel hungry.
Reversibility and Flexibility versus Implanted Devices
The AGB is an implanted device. That means you will have a foreign object in your body for good. Some patients do not mind this and prefer the AGB because it does not rearrange their insides.
Others prefer the RNY or VSG because there is no foreign object left inside your body. However, these options involve changes to your body. The RNY rearranges your digestive system, while the VSG removes most of your stomach.
Adjustability
The AGB is the only WLS option that is adjustable. You can tighten (or “fill”) the band to make it more restrictive and lose more weight, or loosen it to make it more comfortable. Loosening the band can also be helpful if you need to eat more food, such as if you become pregnant, or when you approach goal weight.
You are in the “green zone” when the band is tight enough for you to feel full between meals and lose weight, but not so tight that you feel side effects such as regurgitation, trouble eating solid foods, or coughing.
A drawback to the adjustability of the AGB is that you need to get it adjusted in a surgeon’s office. This can be inconvenient since you need to get it filled a few weeks after surgery, and may need to adjust it a few times before you get it right. It can also be difficult to find a surgeon who can do the adjustment for you.
You should always know the location of the nearest surgeon to fill or unfill your band if needed, whether pre-scheduled or in an emergency. This can be difficult if you get your band inserted far from home or even in another country.
There is a lot to consider when choosing a Weight Loss Surgery type, and we will look at even more factors in Part 2 of this series!

Speed and Amount of Weight Loss
The gastric bypass (RNY) and gastric sleeve (VSG) lead to faster weight loss. The expected weight loss with VSG is 50 to 70% of excess weight within two years; RNY leads to excess weight loss of about 80% within 18 months. Usually, heavier patients look towards the VSG and RNY, while the Adjustable Gastric Band (AGB) is sometimes used for lower BMI patients. Expected excess weight loss with AGB is 50% over two years.
The VSG can be the surgery of choice for heavier patients because the actual operation is a safer procedure than the RNY. However, the RNY could be better for you if you have diabetes since many patients have much better blood sugar control after the surgery.
Long Term Results
You may have a lower chance of keeping the weight off long-term with AGB compared to other surgeries, but that depends on several factors. You can keep the weight off if your band stays in place and if you make the commitment to continue to follow your WLS diet once you hit goal weight. The RNY has good long-term results for many patients who keep a good amount of weight off for 10 or more years. The VSG is a newer procedure and the jury is out on long-term results.
How It Works: Restriction, Malabsorption, and Hormones
All weight loss surgeries are “restrictive.” They restrict the amount of food you eat by making your stomach smaller so it fills up faster, with less food. The AGB does this by creating a small pouch that is separated from the larger portion of your stomach. The AGB is only restrictive, but it is the least invasive surgery type.
The RNY involves the surgeon separating the lower stomach, which is restrictive because it leaves you with only the upper stomach to hold food. The RNY is also malabsorptive because it leads to nutrient malabsorption. The surgeon connects the upper portion of your stomach to the lower part of your small intestine. After RNY, food “bypasses” the upper part of your small intestine which is where a good amount of digestion and absorption typically occur. That way, less of the food you eat is absorbed, so you get fewer calories. This is a benefit if you are looking for faster weight loss.
In the VSG, the surgeon removes about 75% of your stomach, leaving you with only a small tube-like “sleeve.” This is how it is restrictive. The VSG also helps you lose weight because it affects your hormones. Your stomach naturally produces a hormone called ghrelin that makes you hungry. When the surgeon takes out most of your stomach, you have less ghrelin and less hunger. The VSG may be for you if you always feel hungry.
Reversibility and Flexibility versus Implanted Devices
The AGB is an implanted device. That means you will have a foreign object in your body for good. Some patients do not mind this and prefer the AGB because it does not rearrange their insides.
Others prefer the RNY or VSG because there is no foreign object left inside your body. However, these options involve changes to your body. The RNY rearranges your digestive system, while the VSG removes most of your stomach.
Adjustability
The AGB is the only WLS option that is adjustable. You can tighten (or “fill”) the band to make it more restrictive and lose more weight, or loosen it to make it more comfortable. Loosening the band can also be helpful if you need to eat more food, such as if you become pregnant, or when you approach goal weight.
You are in the “green zone” when the band is tight enough for you to feel full between meals and lose weight, but not so tight that you feel side effects such as regurgitation, trouble eating solid foods, or coughing.
A drawback to the adjustability of the AGB is that you need to get it adjusted in a surgeon’s office. This can be inconvenient since you need to get it filled a few weeks after surgery, and may need to adjust it a few times before you get it right. It can also be difficult to find a surgeon who can do the adjustment for you.
You should always know the location of the nearest surgeon to fill or unfill your band if needed, whether pre-scheduled or in an emergency. This can be difficult if you get your band inserted far from home or even in another country.
There is a lot to consider when choosing a Weight Loss Surgery type, and we will look at even more factors in Part 2 of this series!

Equipment
The essentials are sturdy shoes and comfortable clothes. These may be easy for an exercise pro, but where do you start if you are a beginner? Comfortable clothes can be very simple; an old t-shirt and sweatpants will suffice. If you feel better when you feel stylish, try yoga pants or capris and a top with sweat-wicking fiber.
For shoes, beginners are probably best off going to a specialty running and walking store for expert advice and help with fitting. You will pay more at a specialty store than you would online, but the extra money is worth it, at least the first time, to make sure the shoes are right for you. You can always save money later by ordering online or going to a discount sporting goods store once you are confident you know which shoes you want. A word of wisdom: when it comes to shoes focus on function, not fashion!
Any other equipment you need depends on what activity you are planning to do. A gym usually has everything you need for its activities. If you need to get specialty equipment such as a yoga mat or boxing gloves, ask a friend or another seasoned activity buddy to help you find one that fits your needs and your budget.
A Backup Plan
Things go wrong quite often, so you had better have a backup plan if you want to have a chance of keeping up your exercise intentions. Here are a few examples.
· Plan to walk in the mall if there is a rainstorm when you are supposed to meet a friend in the park.
· Keep a pair of shoes in the trunk of the car so you can walk at lunch even if you forget to bring your workout shoes to work.
· Keep a protein bar and a protein shake with you so you can work out without a grumbling stomach on a busy day.
· Keep your phone charged so you can walk when your friend calls out of the blue and you chat for several minutes.
Fun Times
Dance if you love to dance. Stay off the treadmill if it is boring. Go swimming if you are a fish in the water. Skip the spinning classes if you hate loud music. Play basketball if you love shooting hoops.
Get the picture?
Do what you love, and skip what you hate. Exercise should be fun for you to be able to keep it up for years, and the great news is that it can be. Here are some tips for
Plan your entertainment, whether it is an upbeat playlist while hiking or an episode of your favorite TV show to watch while on the bike at home. Get social, whether by phoning a friend while you are walking in the park, or meeting up with friends to walk or hold your own boot camp. Prevent boredom by including different activities regularly. You could walk Mondays and Fridays, life weights Wednesdays, and show off the results of your training during your Saturday tennis matches. Walk with a friend to a cafe for some low-calorie decaf coffee as a post-walk treat. Make your workout something you enjoy, and you are way more likely to keep doing it.
Planning
Just like with your food, you are more likely to stick to your exercise intentions when you plan. It can be as simple as setting aside the time, such as 30 minutes in the morning. You may be more likely to follow through when you are more specific in your planning, such as a 15-minute walk followed by 15 minutes on the stationary bike. Planning helps you set aside the time and set aside any doubts about what you will do during that time.
Rewards
Give yourself some well-planned rewards, and your mind and body will start to associate exercise with positive things. Your rewards can be tangible, such as a massage every time you work out five times in a week. They can also be emotional, such as taking five minutes to thank yourself after a workout and think about how good you feel.
You can get or stay fit, no matter your experience with exercise. It starts with an intention and continues with some hard work and great rewards.

The Right Mindset for Smart Decisions
It is no surprise that you are at your best when you are rested, relaxed, and confident. That goes for almost every aspect of your life, and it holds true for weight loss. Thinking clearly lets you “weigh” the consequences of the hard-boiled egg versus the French fries for a snack so you can see the benefits of choosing the egg for weight loss outweigh the benefits of choosing the fries for a few minutes of pleasure.
Self-confidence also lets you make the right choices. When you are confident, you know that you have the power to choose. You realize that are not a victim of circumstances, and you do not need to eat something just because it is available to you. You know that you have the power to say no to the things you should not eat, and the power to find the things you should.
Better Sleep, Better Choices
Sleep is not just a luxury to feel guilty about. Adequate sleep may be the missing key to your weight loss program. When you get enough sleep, you have lower levels of a hormone called ghrelin. Ghrelin makes you hungry, and less ghrelin helps keep hunger in check. Getting enough sleep also lowers carb and sugar cravings and gives you the strength to make rational decisions. Think protein and veggies, not potato chips and cookies.
Stress, Hormones, and Your Weight
In addition to your daily choices, there are behind-the-scenes factors that can cause weight gain when you are stressed. Hormones affect your metabolism and can cause weight gain when they are not balanced. Too much stress, for example, raises levels of a hormone called cortisol. Cortisol increases raise your hunger levels, which can lead to you overeat. It also affects your fat storage. You might gain more fat in your abdominal area, which is a health risk for diabetes, heart disease, and more.
Tips for Chilling Out
The first trick for relaxing is to get over your guilt. It is not only okay to kick back, but it is healthy. It may be surprisingly tough when you are out of practice, though. Here are some ideas for stepping back from your busy life and giving your mind a chance to recover for a healthier body.
Set aside 10 minutes for yourself every day. Meditate, take a bath, read, or do something else that is just for you. Get more sleep if you find yourself waking up tired or struggling to get through the day. Exercise most days. A quiet stroll on the beach or a hike may seem like out-of-reach dreams, but any exercise helps clear your mind. Restorative yoga, a cycling class, and home exercise DVDs all do the trick. Stretch. It loosens your muscles and gives you a chance to think through your day. Weight loss surgery success takes a lot of hard work, but there are some ways to get more bang for your buck without working harder. Take a chill pill, and you might find that the extra relaxation gives you the strength and stamina to lose more weight.

Why?
Schedules and meal times tend to be more lenient. The kids are off school and in full on vacation mode. The social calendar is fuller than ever. Even weeknights are no longer off limits. Nostalgic summer foods and refreshing drinks seem to be everywhere and oh so tempting!
We want you to enjoy summer just like everyone else, but if your goal is weight maintenance or if you are still within 1 year postop, it is important to stay mindful.


Here are some of our TOP TIPS...


BBQs & BACKYARD PARTIES! - Hamburgers, hot dogs and ribs, oh my!

If you’re the host, prepare marinated chicken and vegetable skewers. Skewers make perfect postop portions, but at the same time are an appropriate option for your other guests.

Have you recently had surgery? There is a high likelihood that overcooked barbecue meats may be difficult for you to tolerate (i.e. causing a “stuck” feeling along with a lot of discomfort). Untoasted buns and bread may do the same. If this is the case, prepare a ‘safe food’ for the event. This means bringing a food that you know you tolerate well. Don’t just wing it! There is nothing worse than feeling sick or vomiting at a party.

Examples of safe foods for those of you who are recently postop:

Legume/bean salad Barbecue ready aluminum foil packets filled with marinated fish or chicken and vegetables. Encasing your foods in foil packets traps in the moisture making your foods tenderer. Tuna or egg salad served with crackers Hard shell tacos Skewers of watermelon + bocconcini cheese + basil or mint leaves, drizzled with balsamic vinegar Homemade smoothie popsicles (great option if you are only days postop!)
ICE CREAM! - Tis the season!

We are often asked by our patients “How often can I have ice cream?” and “How much ice cream can I have?”

Remember that all foods fit after surgery. Ice cream is no different. We recommend our patients simply be mindful of their portions and indulge every now and then as opposed to daily.

Sugar is addictive. The more you have, the more you want. If you had difficulty limiting sweets before surgery, consider limiting sweets after surgery to avoid falling back into the old habits. For example, instead of having a whole tub of ice cream in your freezer (which may be too tempting), allow yourself to have a child-sized cone once a week in town with friends.

Another important consideration is: Did you have a gastric bypass (Roux-en-Y)?
If yes, you are at risk of experiencing dumping syndrome with sweet foods like ice cream. Limit your portions of ice cream to simply tastings (ex. ¼ cup portions) or try these lower sugar options…

Opt for fresh seasonal fruits + a spoonful of CoolWhip Invest in a homemade ice cream maker (Ex.https://www.bedbathandbeyond.ca/store/product/cuisinart-reg-ice-cream-frozen-yogurt-maker-in-white/3251572 ). For an instant cool treat, add in 1 full-sized container of vanilla yogurt + fresh seasonal fruit. Delicious! Try one of the many savory balsamic strawberry recipes on the internet for something different. Ex - https://www.acouplecooks.com/video-strawberries-with-balsamic-greek-yogurt-and-mint/
ALCOHOL!

Alcohol is absorbed much faster into your bloodstream after surgery. For this reason, the effects can be intense. It is often said that 1 drink after surgery is equivalent to the feeling of 4-6 drinks before surgery! Patients often laugh about this statistic, but it is no joke.

We recommend our patients limit themselves to one standard drink per evening and to serve it in ½ portions (Ex. ½ glass of wine + ice cubes).

Never drive after drinking, regardless of the amount! Even one standard drink can raise your blood alcohol concentration above the legal driving limit.

Remember that beer is also carbonated. Carbonated drinks (Ex. soda and fizzy water) are generally discouraged after surgery because it is suspected that they can stretch out your stomach with regular consumption. Whether or not this is actually the case has yet to be proven, but carbonation aside, beer and carbonated mixed drinks contain calories, and a lot of them!

Patients often ask, “But what the heck am I supposed to drink this summer if I can’t have soda, beer, mixed drinks, fizzy water or more than 1 glass of wine!”

This is a valid question. We admit that the alternatives are not super exciting.

We recommend:
Fruit-infused water Flavoured ice cubes (Ex. http://www.marthastewart.com/356419/flavored-ice-cube-ideas ) Homemade iced tea – Apparently Davids Tea’s ‘La vie en Rosé’ is refreshingly close to a true rosé wine! Similarly, Teavana has a fun mixology theme to their summer ice teas this year. Flavours include Beach Bellini, Strawberry Daiquiri, Mandarin Mimosa and Pina Colada!

What are your favourite summer tips? Post below in the comments!

Wishing you all a great start to your summer!

“ The wound is where the light enters you.”
- Rumi



When I work with pre and post-op bariatric surgery patients, I consistently go over this idea of being "full from within." Many people question, "what does that mean for me? What does that look like?"
My response is that for one to be truly full, we must first clear out the old toxicity, wounds, and hurtful schemas we've picked up throughout the years. How does one get over a hurt? There is not "getting over." You go through it. You have to feel it to heal it.
If you have underwent gastric sleeve, bypass, or balloon surgery and still feel like there is a missing piece- it is likely that there are some deeper psychological toxicities that need to be cleared. The first step to doing so is sitting still, sitting with the feelings, and it is in stillness that our heart finally starts to answer the questions our mind has failed to thus far.
Yet so many have been taught not to feel. That there must be an easier way- a shortcut. 1 in every 8 Americans is on some form of psychotropic medication. 1 In his book, Anatomy of an Epidemic, science journalist Robert Whitaker states that since 1987, the percentage of the population receiving federal disability payment for mental illness has tripled; among children under the age of 18, the percentage has grown by a factor of 35.1

While Whitaker recognized that in the short-term, these medications help people to feel better, he started to realize that over time- drugs make many patients sicker than they would have been if they had never been medicated. 1 He does not make the argument that all people should stop their meds. He believes in the utility of them, just more sparingly than they are currently utilized.

However, throughout my years in the practice of therapy- I have noticed a trend of moving people away from feeling. Crying is actually a symptom in the DSM-V. We have pathologized a human feeling! When psychiatrists and therapists witness a patient tearful too many times in session, their next conclusion is that something must be wrong and they must be medicated.

This frustrates me so much as a clinician and as a person who has done her share of work in her own personal therapy. When we are broken, we are broken open. Being broken is a starting point, not a symptom that something has gone awry.

It is at the point of our deepest pain and grief that we have the greatest opportunity for growth. I find myself telling patients over and over- “you can’t “get over” it, you must “go through” it.” Yet, so many of us have been indoctrinated to think that if we spend more than a day being sad, we must have depression, or if we feel nervous a little bit longer than we’d like to- we must have an anxiety disorder. We definitely “are Bipolar” if we have a mood swing.

We have been taught to not feel the yin, only the yang of our emotions. It’s societally acceptable to talk about how happy your weekend was, or how much fun you had on vacation- but watch the uncomfortable shifting in chairs that takes place when you open up about how you just haven’t felt like yourself lately.

In our world of quick fixes, where we can have a conference across the world, over a computer, communicate a message in two seconds via text, or post a picture that all of our family can see instantly- we also want instant relief for our suffering. Yet, suffering is part of the human condition. It is through experiencing our deepest sorrows, we are able to appreciate our greatest joys. But we must first be willing to sit in the muck.

"Out of the mud, grows the lotus." -Thich Nhat Hanh

Part and parcel of any addiction (food, drugs, alcohol, etc.) is that the addict is particularly uncomfortable with being uncomfortable. However, the cure is right there for the taking.

“So what does this look like in real life?” you ask. “How do I open the wound, bring in the light, and clear out the infection that started all of this in the first place?” You start with presence. You start with a still and open heart. You start with a spiritual vulnerability that allows you to be at peace with not knowing what will happen next. You sit broken open and wait for the light to enter over time.

The most important piece in all of this is being able to create a consistent forum where you hold the space. This could be a therapist’s office, it could be a weekly walk with a friend, a journal practice, or it could be as simple as a prayer every night.

You set the priority to hold the space and to sit in the muck. Maybe it starts with emotions that have no words? Maybe it starts with visceral, physical feelings, that you have to simply sit with for a while? Maybe you are lucky enough to immediately put in words where your wound all started and its just floating around in your thoughts, waiting to be articulated? Perhaps it starts with a behavior you tend to do all of the time that you know comes from a place of pain?

Case Study:

I had a client who continuously posted on social media sites. She had a constant need to feel recognized and admired. She knew there was something behind it and wanted to get to the bottom of where this was coming from.

Session over session, we sat with that need. We talked about what she wanted to get from each of those posts and why she was still “on E,” left with an empty psychological tank.

The short story of Narcissus goes that he disdained people who loved him. After Nemesis noticed this he lured him to a pool that cast his own reflection. Narcissus fell in love with this pool, not realizing it was merely an image. Unable to leave the beauty of his reflection, he lost his will to live. He stared at this reflection until he died. 59

Growing up, this client never quite got the love and admiration we all need from our parents. When we love something so much and don’t get that back- it is that unrequited love that leaves a narcissistic wound. It doesn’t necessarily always start with parents. It can be a formative romantic relationship, but it usually starts with parents.

When we are flying from couch to couch saying “look at me mommy I’m superman!” and our mom says “get off that couch now!” instead of “look at how strong and powerful you are,” we begin forming the wound. Unfortunately, without recognizing this- many people will go throughout their life trying to heal it through other people or other things instead of within themselves. (recall the wizard of oz’s moral of the story).

It was up to this client to stop the instinctual need to post and each time she had this inclination to look within for what she needed. Eventually, she developed a muscle for self validation, and the posting behavior stopped.

The lesson in this case study is to hopefully help guide you to your wound. If we have a food addiction and feel out of control, you can bet we have a wound. Instead of distracting through bad habits, addictions, unhealthy relationships, or external wants- it is time to finally create a place of presence to start the healing process.

Mind Meal: Sit in silence for at least 15 minutes. Visualize in your mind’s eye your heart with a bridge of white light to your head. What does it say? Where is the pain? Where is the wound? How might you start filling yourself up for good?

Want to learn more about how to be truly full from within. Check out Dr. Colleen's latest book aimed at helping one focus on why they eat vs. what they eat, and stop the "diet yo-yo" for good. You can also sign up for her free course : Full From Within, here.
1 Retrieved: June 2, 2017 https://www.madinamerica.com/author/rwhitaker/

You can cook just about anything on the grill. Choose foods that are in your post-surgery diet phase. Find a recipe you like and then start grilling. Veggies can be grilled either on skewers or in a vegetable grill pan. Grill enough for leftovers during the week. Use a marinade for flavor and moisture. You can make your own marinade or use a low-fat dressing. A foil packet dinner is a great way to combine a protein, veggies and seasoning all wrapped up in foil makes for a quick clean up. Each person can customize the seasonings for individual preferences. Foil packet dinners are quite a trend right now and you’ll find many recipes on the internet. These leftovers are great to have for another meal, or 2 or 3 . . . Making a kebob is another quick and easy way to grill small portions of protein and vegetables. Protein sources can be chicken, turkey, fish, shellfish, pork or beef. You may want to grill veggies on a separate skewer since these take longer to cook. What about fruit kebobs or grilling fruit right on the hot grill surface? A mango and shrimp kebob is a great combination. You can also pair grilled fruit with light yogurt or use in a fruit salsa to top grilled meat. The possibilities are endless. For some easy grilling ideas, check out this website: https://www.readyseteat.com/recipes/easy-grilling-recipes
Choose the recipes that suit your bariatric eating plan. What’s going to be on your grill?

In the first part of the series, we looked at a recent study comparing results of weight loss with NBC’s “Biggest Loser” to weight loss with weight loss surgery. At least in the short term, weight loss was similar, with Biggest Loser contestants coming out ahead at 7 months with the gap narrowing by 12 months.
Some articles and research are available, but wouldn’t it be nice if there were a way to compare Biggest Loser and bariatric surgery side by side? Here’s our summary of how the groups lost weight and what the results were.
Methods
In case you’re not aware, the “Biggest Loser” is a reality television show that is a weight loss competition. Morbidly obese contestant compete on the Biggest Loser ranch to lose the most weight. Every 7 to 10 days for 13 weeks, a contestant is voted off and eliminated from the competition. From week 13 to 30, the remaining contestants go home and return for the finale, where the contestant who has lost the most weight is crowned the Biggest Loser winner. They lose weight with intense exercise and a restricted diet.
This study compared roux-en-Y gastric bypass (RYGB) patients. They lose weight because their smaller stomach forces them to eat smaller meals. In addition, they need to limit sweets and fatty foods to avoid gastrointestinal symptoms.
Diet
Biggest Loser contestants ate similar amounts of to RYGB patients. In the Biggest Loser, contestants ate at least 70 percent of their baseline needs, calculated by a formula based on their fat-free mass. A contestant who weighs 220 pounds and has 50 percent body fat would be asked to eat at least 1,000 calories per day. The diet includes lean protein, fruits, and vegetables, and restricts processed foods.
In comparison, RYGB patients often eat a similar number of calories. They too focus on protein, followed by vegetables and fruits. Also, they limit sugary and fatty processed foods.
Exercise
Here’s the big difference. Four hours of exercise a day, anyone? Biggest Loser contestants exercise 90 minutes per day six days a week with the trainers, plus up to 3 hours daily on their own. That adds up to up to 31.5 hours a week – basically a job!
Weight loss surgery patients are asked to exercise, but to work up to it. They may have goals such as working up to 20 or 30 minutes daily, and getting up to 60 to 90 minutes most days over the long run.
The Logistics: Support and Cost
Biggest Loser contestants have a lot of support. On the show, they see a trainer six days a week. They have a doctor – Dr. Huizenga – to monitor their health and progress. In contrast, most RYGB are on their own – they don’t have the luxury of a trainer each day. They tend to follow-up with their surgeon once or a few times over the months following surgery. They may have support groups to help.
Bariatric surgery is expensive, no question. The procedure, plus pre-op workups and post-op appointments, can be thousands or tens of thousands of dollars. Biggest Loser? Diet and exercise sound inexpensive, but can you afford to exercise for 31.5 hours a week? Can you afford to see a doctor whenever you want?
What about the cost of benefits provided to contestants, such as having room and board at a weight loss resort for several weeks? The list price for a guest at a Biggest Loser Resort is about $2,500 weekly. For 13 weeks, as on the Biggest Loser, that’s a cost of $32,500. Makes RYGB seem cheap!
Weight Loss
What about the important thing – weight loss? Turns out the results are pretty similar…at least in the beginning. After 7 months, the Biggest Loser group lost an average of 108 pounds, while RYGB patients were at an average of 78 pounds down. By 12 months, RYGB patients were down by 89 lb. on average. And Biggest Loser patients? They were no longer being followed – who knows what happened after their season of the show ended?
It stays a little cloudy later on, too. Biggest Loser hasn’t published statistics on the long-term success of its contestants. In contrast, RYGB has been shown to be successful in studies that have tracked patients for 5 or even 10 years.
Health Effects
Both groups had improvements in some measurements of health. Blood pressure, blood sugar, chronic inflammation, and “good” HDL cholesterol improved. Strangely enough, Biggest Loser contestants had an average increase of total cholesterol from 168 to 192, and of “bad” LDL cholesterol from 105 to 126.
Also curious was the decrease in metabolic rate – or the number of calories burned at rest. Biggest Loser contestants’ metabolisms dropped more the RYGB patients’, even though Biggest Loser contestants maintained more of their lean tissue while dropping more fat.
Okay, so what’s the take-home message? One might be that the way that is best for you to lose weight depends on your individual situation. If you have the time and money to train Biggest Loser-style, maybe you would prefer that to going under the knife. If you need a permanent tool for long-term assistance with losing weight, and maybe even if your health insurance will chip in, weight loss surgery may be for you. What do you think?

In the first part of the series, we looked at a recent study comparing results of weight loss with NBC’s “Biggest Loser” to weight loss with weight loss surgery. At least in the short term, weight loss was similar, with Biggest Loser contestants coming out ahead at 7 months with the gap narrowing by 12 months.
Some articles and research are available, but wouldn’t it be nice if there were a way to compare Biggest Loser and bariatric surgery side by side? Here’s our summary of how the groups lost weight and what the results were.
Methods
In case you’re not aware, the “Biggest Loser” is a reality television show that is a weight loss competition. Morbidly obese contestant compete on the Biggest Loser ranch to lose the most weight. Every 7 to 10 days for 13 weeks, a contestant is voted off and eliminated from the competition. From week 13 to 30, the remaining contestants go home and return for the finale, where the contestant who has lost the most weight is crowned the Biggest Loser winner. They lose weight with intense exercise and a restricted diet.
This study compared roux-en-Y gastric bypass (RYGB) patients. They lose weight because their smaller stomach forces them to eat smaller meals. In addition, they need to limit sweets and fatty foods to avoid gastrointestinal symptoms.
Diet
Biggest Loser contestants ate similar amounts of to RYGB patients. In the Biggest Loser, contestants ate at least 70 percent of their baseline needs, calculated by a formula based on their fat-free mass. A contestant who weighs 220 pounds and has 50 percent body fat would be asked to eat at least 1,000 calories per day. The diet includes lean protein, fruits, and vegetables, and restricts processed foods.
In comparison, RYGB patients often eat a similar number of calories. They too focus on protein, followed by vegetables and fruits. Also, they limit sugary and fatty processed foods.
Exercise
Here’s the big difference. Four hours of exercise a day, anyone? Biggest Loser contestants exercise 90 minutes per day six days a week with the trainers, plus up to 3 hours daily on their own. That adds up to up to 31.5 hours a week – basically a job!
Weight loss surgery patients are asked to exercise, but to work up to it. They may have goals such as working up to 20 or 30 minutes daily, and getting up to 60 to 90 minutes most days over the long run.
The Logistics: Support and Cost
Biggest Loser contestants have a lot of support. On the show, they see a trainer six days a week. They have a doctor – Dr. Huizenga – to monitor their health and progress. In contrast, most RYGB are on their own – they don’t have the luxury of a trainer each day. They tend to follow-up with their surgeon once or a few times over the months following surgery. They may have support groups to help.
Bariatric surgery is expensive, no question. The procedure, plus pre-op workups and post-op appointments, can be thousands or tens of thousands of dollars. Biggest Loser? Diet and exercise sound inexpensive, but can you afford to exercise for 31.5 hours a week? Can you afford to see a doctor whenever you want?
What about the cost of benefits provided to contestants, such as having room and board at a weight loss resort for several weeks? The list price for a guest at a Biggest Loser Resort is about $2,500 weekly. For 13 weeks, as on the Biggest Loser, that’s a cost of $32,500. Makes RYGB seem cheap!
Weight Loss
What about the important thing – weight loss? Turns out the results are pretty similar…at least in the beginning. After 7 months, the Biggest Loser group lost an average of 108 pounds, while RYGB patients were at an average of 78 pounds down. By 12 months, RYGB patients were down by 89 lb. on average. And Biggest Loser patients? They were no longer being followed – who knows what happened after their season of the show ended?
It stays a little cloudy later on, too. Biggest Loser hasn’t published statistics on the long-term success of its contestants. In contrast, RYGB has been shown to be successful in studies that have tracked patients for 5 or even 10 years.
Health Effects
Both groups had improvements in some measurements of health. Blood pressure, blood sugar, chronic inflammation, and “good” HDL cholesterol improved. Strangely enough, Biggest Loser contestants had an average increase of total cholesterol from 168 to 192, and of “bad” LDL cholesterol from 105 to 126.
Also curious was the decrease in metabolic rate – or the number of calories burned at rest. Biggest Loser contestants’ metabolisms dropped more the RYGB patients’, even though Biggest Loser contestants maintained more of their lean tissue while dropping more fat.
Okay, so what’s the take-home message? One might be that the way that is best for you to lose weight depends on your individual situation. If you have the time and money to train Biggest Loser-style, maybe you would prefer that to going under the knife. If you need a permanent tool for long-term assistance with losing weight, and maybe even if your health insurance will chip in, weight loss surgery may be for you. What do you think?

Choose the right surgeon.
If weight loss surgery is the tool, your bariatric surgeon is the one who makes the tool and gives it to you. You want a tool that is made precisely, ready to do the job, and built to last. Your surgeon needs to make the right cuts and place the band properly or make a tight, solid sleeve or pouch. So, look for a surgeon who is experienced and has a good track record of successful patients and low complication rates – don’t be afraid to ask!
There’s more to choosing a surgeon than technical skills. Also, consider what else the surgeon will do for you. The right surgeon for you is willing to discuss your options and the procedure with you in a way that you can understand. You’re setting yourself up for extra challenges if you’re afraid to talk to your surgeon or your surgeon is unavailable.
Get the scoop on the diet.
Your diet is central to every part of the weight loss surgery journey. You may be told to lose some weight before surgery as a test to make sure you’ll follow the rules post-op. Then there’s the pre-op liquid diet to shrink your liver for a safer surgery. Next, for faster healing and fewer side effects, you need to follow the post-op progression from liquids to pureed foods to solid foods. Finally, there’s the nutrient-dense, low-calorie diet to help you hit goal weight and stay there.
At best, you will have a surgeon or a nutritionist who gives you plenty of information. Since that’s not always the case, you may need to take steps to figure out the diet for yourself. You can look online, and may need to shell out the money for a few appointments with a nutritionist. Not knowing the right foods to eat can set you up for surgery complications and disappointing weight loss.
Take responsibility.
It’s nice to depend on a stellar surgeon and complete healthcare team to walk you through surgery and beyond step by step. Ideally, your trusted surgeon would explain your options to you and recommend the best surgery for you, whether it’s the sleeve, band, bypass, or another choice. You’d go back for follow-up appointments and ongoing nutritional and psychological counseling.
That doesn’t always happen in the real world, but that’s no excuse to give up. You can take responsibility for finding out the information you need to know about what to expect, how to prepare, and what comes next. Be persistent and do your research in all kinds of places, and you’re more likely to succeed.
Face the facts.
Weight loss surgery isn’t all fun and games. You don’t leave the operating room skinny. Weight loss isn’t steady. It may take you longer to get to goal weight than you hoped. Recognize the real possibilities to avoid being disappointed and possibly even giving up.
These are some other possibilities to consider, so you can be prepared if they happen to you.
You may still love sugar, salt, fat, and/or starch.
You may still be hungry.
Others may not notice your weight loss, or may not be impressed.
Others may be jealous of your weight loss or say you didn’t earn it.
You may have loose skin when you are finished losing weight.
Weight loss surgery doesn’t solve psychological problems.

Be Open-Minded
If you want to lose weight and get healthy, you’ve got to change your diet. Whatever eating habits got you to this point are not going to get you to goal weight!
That may mean you need to be open-minded. Maybe you hated vegetables, or can’t stand the thought of downing protein shakes for 2 weeks on the pre-op liquid diet and up to 4 weeks on the post-op liquid and mushies diets.
It’s time to re-evaluate. Can you sneak some veggies into your diet? Can you retrain your brain to love them? Can you force down those protein shakes for a few weeks in exchange for a lifetime’s worth of better health?
Learn to see the good.
There will be disappointments - guaranteed. The scale may not cooperate, or you may make a poor eating choice, or you might skip your morning workout because you didn’t make sleep a priority the night before. Focus on the negative, and you just may talk yourself out of continuing the hard work and good progress.
Instead, learn to appreciate yourself and see the positive sides of things. Maybe you didn’t lose weight this week, but did you eat right? Maybe you downed a piece of pepperoni pizza without thinking about it, but did you pass up the breadsticks and soda that you would have had before surgery? Maybe you didn’t work out this morning, but did you make it to the gym more this month than you did last month?
See yourself as a strong, powerful person, and you will act like one. You can build on the positive behaviors you see in yourself so they eventually overshadow the mistakes.
You have control over your own destiny. Success with weight loss surgery depends on planning and hard work. The more you are involved and the more responsibility you take throughout the process, the better you can do.

Weight shaming is nothing new. I would beg to guess that most children who’ve struggled with weight have been victims of weight-based bullying. I can remember, as a shy elementary school kid, rapidly gaining weight and being different from the other children in my class. This impacted my self-image as I grew up, and my school days were rampant with daily bullying. The damage this did to my self-esteem carried over into many aspects of my life.
As a therapist, I had to confront those ideas I had about my value in therapy as a graduate student. I had to stop blaming those kids, and instead, change my thinking to change my life. Today, in the first few days after my 20th High School Reunion, I realize I had to fully let it go. The children and young adults that once ignored me or superficially friended me were not completely at fault for their behaviors in grade school, I was at fault for carrying their bad behavior with me and perpetuating those negative comments in my daily life.
It has always been my belief and a widely accepted professional self-care philosophy that you must work on your own issues actively to be able to help others. To do the real work on your own issues, it is essential to identify where those issues originated. How you got to that place of brokenness often brings back memories of humiliation, shame, mocking, and criticism from people you’ve known throughout your life. I had to actively challenge myself to overcome those negative memories of grade school and not shy away from attending like I did my 10-year reunion, so I got involved. I challenged myself to head up the 20-year reunion effort by rallying the troupes. I put myself in a position that gave me no way out by researching venues and getting the committee together.
I conquered my anxiety about what those people would think about me now. And you know what, I enjoyed my time at the reunion. It helps that I also weigh at least 150 pounds less, but as I’m sure many of you know, anxiety doesn’t go away automatically when you lose weight. To conquer my anxiety, I confronted it— using all those coping skills learned in years of therapy. What did I learn? I wasn’t the only one questioning whether or not I should go because I wasn’t sure how I would be accepted. In the days after the reunion, another attendee posted concerns about how she felt she hadn’t gotten to a place in life that she was proud of yet and worried what people would think. My reaction was genuinely heartfelt and profoundly appropriate for anyone struggling with their place in this world:
Be unapologetically you. Love your life and the place you've arrived without regrets or envy of others. The positivity you put out into the world will reflect back into your life a thousand times, just as negativity does the same. If you wallow in shame, blame, hurt, and pain those emotions intensify as you carry them around, they are heavy and burdensome. Let them go, smile more, take care of your whole self: mind, body, heart, and soul through your thoughts, words, actions, and emotions.
We often shy away from connecting with people who can be supportive of our goals and ambitions because we may lack confidence ourselves or hang on to past impressions people have made on us. If I learned anything from this experience, it’s that I had a lot of smart, talented people around me growing up. We've done some incredible things with our lives. There’s no reason feel like an outcast anymore. They were people I perceived to judge me in school who probably didn't understand the impact of their actions, and my perception was screwed because I didn't like myself back then. I love myself now and want to share the joy and be supportive by connecting, encouraging, and promoting a better mindset to attain happiness. If we continue to hang on to the negative, we never provide an opportunity to establish the positives. Forgiveness is an asset in your ability to cope. Shutting people out and never affording them the opportunity to do better will promote those negative memories rather than turning them around to make positive relationships.

Choose the right surgeon.
If weight loss surgery is the tool, your bariatric surgeon is the one who makes the tool and gives it to you. You want a tool that is made precisely, ready to do the job, and built to last. Your surgeon needs to make the right cuts and place the band properly or make a tight, solid sleeve or pouch. So, look for a surgeon who is experienced and has a good track record of successful patients and low complication rates – don’t be afraid to ask!
There’s more to choosing a surgeon than technical skills. Also, consider what else the surgeon will do for you. The right surgeon for you is willing to discuss your options and the procedure with you in a way that you can understand. You’re setting yourself up for extra challenges if you’re afraid to talk to your surgeon or your surgeon is unavailable.
Get the scoop on the diet.
Your diet is central to every part of the weight loss surgery journey. You may be told to lose some weight before surgery as a test to make sure you’ll follow the rules post-op. Then there’s the pre-op liquid diet to shrink your liver for a safer surgery. Next, for faster healing and fewer side effects, you need to follow the post-op progression from liquids to pureed foods to solid foods. Finally, there’s the nutrient-dense, low-calorie diet to help you hit goal weight and stay there.
At best, you will have a surgeon or a nutritionist who gives you plenty of information. Since that’s not always the case, you may need to take steps to figure out the diet for yourself. You can look online, and may need to shell out the money for a few appointments with a nutritionist. Not knowing the right foods to eat can set you up for surgery complications and disappointing weight loss.
Take responsibility.
It’s nice to depend on a stellar surgeon and complete healthcare team to walk you through surgery and beyond step by step. Ideally, your trusted surgeon would explain your options to you and recommend the best surgery for you, whether it’s the sleeve, band, bypass, or another choice. You’d go back for follow-up appointments and ongoing nutritional and psychological counseling.
That doesn’t always happen in the real world, but that’s no excuse to give up. You can take responsibility for finding out the information you need to know about what to expect, how to prepare, and what comes next. Be persistent and do your research in all kinds of places, and you’re more likely to succeed.
Face the facts.
Weight loss surgery isn’t all fun and games. You don’t leave the operating room skinny. Weight loss isn’t steady. It may take you longer to get to goal weight than you hoped. Recognize the real possibilities to avoid being disappointed and possibly even giving up.
These are some other possibilities to consider, so you can be prepared if they happen to you.
You may still love sugar, salt, fat, and/or starch.
You may still be hungry.
Others may not notice your weight loss, or may not be impressed.
Others may be jealous of your weight loss or say you didn’t earn it.
You may have loose skin when you are finished losing weight.
Weight loss surgery doesn’t solve psychological problems.

Be Open-Minded
If you want to lose weight and get healthy, you’ve got to change your diet. Whatever eating habits got you to this point are not going to get you to goal weight!
That may mean you need to be open-minded. Maybe you hated vegetables, or can’t stand the thought of downing protein shakes for 2 weeks on the pre-op liquid diet and up to 4 weeks on the post-op liquid and mushies diets.
It’s time to re-evaluate. Can you sneak some veggies into your diet? Can you retrain your brain to love them? Can you force down those protein shakes for a few weeks in exchange for a lifetime’s worth of better health?
Learn to see the good.
There will be disappointments - guaranteed. The scale may not cooperate, or you may make a poor eating choice, or you might skip your morning workout because you didn’t make sleep a priority the night before. Focus on the negative, and you just may talk yourself out of continuing the hard work and good progress.
Instead, learn to appreciate yourself and see the positive sides of things. Maybe you didn’t lose weight this week, but did you eat right? Maybe you downed a piece of pepperoni pizza without thinking about it, but did you pass up the breadsticks and soda that you would have had before surgery? Maybe you didn’t work out this morning, but did you make it to the gym more this month than you did last month?
See yourself as a strong, powerful person, and you will act like one. You can build on the positive behaviors you see in yourself so they eventually overshadow the mistakes.
You have control over your own destiny. Success with weight loss surgery depends on planning and hard work. The more you are involved and the more responsibility you take throughout the process, the better you can do.

Get the Go-Ahead
Step 1: get your doctor’s approval! This can give you confidence that you are on the right track and that you are going to be safe while exercising. Find out whether you have any exercise restrictions such as type of exercise or a safe heart rate. Once your doctor gives you the okay, you have no more excuses!
Walk, Swim, or Bike
The first goals of an exercise program for beginners are often to get your heart rate up and burn a few calories. Walking, swimming, and stationary biking can be the safest and most comfortable options for many weight loss surgery patients.
Start at a slow, easy pace without pushing yourself before you are ready. Only go for a few minutes at the beginning, and work up gradually as you get into better shape. Focus on yourself, and don’t compete with others’ paces or workout lengths. Stay positive, since it gets easier as time goes on! Pump Some Iron
Walk into a co-ed gym, and you are likely to see two groups. The men are lifting weights, while the women are focused on cardio and tied to machines such as ellipticals, treadmills, and bikes. Which group should you be in?
Both! While cardio, or aerobic exercise, burns calories and helps your heart, blood sugar, and other health measures, strength training has its own benefits. It helps you lose weight by building muscles, which burn more calories all day, and it improves your bone health. Strength training does not bulk you up; it makes you toned and lean. You have all kinds of options.
Lifting dumbbells or barbells. Using weight machines at the gym. Pulling on resistance bands. Trying exercises that use your own body weight as resistance. Work on each of your major muscle groups, including biceps (front of arms), triceps (back of arms), shoulders, chest, back, hips, quadriceps (front of thighs), hamstrings (back of thighs), calves, and core – your abs and obliques. The ultimate goal is to work each muscle group at least two days per week, making it tired but not straining.
You might want to ask a trainer or an experienced friend for help with ideas for exercises, as well as for demonstrations on proper form. You do not want to get injured!
Do a Full Workout
What is the difference between a workout and a full workout, you ask? The workout is the main part of your exercise, such as a brisk walk and/or a weight lifting session. A full workout starts earlier and ends later because it includes:
A 5 to 10-minute warmup such as slow walking or easy cycling to gradually get your heart up from its resting rate to its workout rate. Your main workout, such as brisk walking, an aerobics class, or a tennis match. A 5 to 10-minute cool-down, such as slow walking on the treadmill or in the pool. 5 to 10 minutes of stretching to keep your muscles loose. The full workout takes a little longer, but keeps your injury risk down and lets you get more out of your workout and entire exercise program.
Be Realistic
Some exercises may not be comfortable or feasible when you are carrying around extra weight. Do not fight with yourself or get down on yourself. Just be patient. Do what you can, and you will gain new skills as you get in better shape.
Exercise can be one of your greatest gifts to yourself on the weight loss surgery journey. It is hard and getting started is hard, but the rewards are well worth it. Good luck!

Get the Go-Ahead
Step 1: get your doctor’s approval! This can give you confidence that you are on the right track and that you are going to be safe while exercising. Find out whether you have any exercise restrictions such as type of exercise or a safe heart rate. Once your doctor gives you the okay, you have no more excuses!
Walk, Swim, or Bike
The first goals of an exercise program for beginners are often to get your heart rate up and burn a few calories. Walking, swimming, and stationary biking can be the safest and most comfortable options for many weight loss surgery patients.
Start at a slow, easy pace without pushing yourself before you are ready. Only go for a few minutes at the beginning, and work up gradually as you get into better shape. Focus on yourself, and don’t compete with others’ paces or workout lengths. Stay positive, since it gets easier as time goes on! Pump Some Iron
Walk into a co-ed gym, and you are likely to see two groups. The men are lifting weights, while the women are focused on cardio and tied to machines such as ellipticals, treadmills, and bikes. Which group should you be in?
Both! While cardio, or aerobic exercise, burns calories and helps your heart, blood sugar, and other health measures, strength training has its own benefits. It helps you lose weight by building muscles, which burn more calories all day, and it improves your bone health. Strength training does not bulk you up; it makes you toned and lean. You have all kinds of options.
Lifting dumbbells or barbells. Using weight machines at the gym. Pulling on resistance bands. Trying exercises that use your own body weight as resistance. Work on each of your major muscle groups, including biceps (front of arms), triceps (back of arms), shoulders, chest, back, hips, quadriceps (front of thighs), hamstrings (back of thighs), calves, and core – your abs and obliques. The ultimate goal is to work each muscle group at least two days per week, making it tired but not straining.
You might want to ask a trainer or an experienced friend for help with ideas for exercises, as well as for demonstrations on proper form. You do not want to get injured!
Do a Full Workout
What is the difference between a workout and a full workout, you ask? The workout is the main part of your exercise, such as a brisk walk and/or a weight lifting session. A full workout starts earlier and ends later because it includes:
A 5 to 10-minute warmup such as slow walking or easy cycling to gradually get your heart up from its resting rate to its workout rate. Your main workout, such as brisk walking, an aerobics class, or a tennis match. A 5 to 10-minute cool-down, such as slow walking on the treadmill or in the pool. 5 to 10 minutes of stretching to keep your muscles loose. The full workout takes a little longer, but keeps your injury risk down and lets you get more out of your workout and entire exercise program.
Be Realistic
Some exercises may not be comfortable or feasible when you are carrying around extra weight. Do not fight with yourself or get down on yourself. Just be patient. Do what you can, and you will gain new skills as you get in better shape.
Exercise can be one of your greatest gifts to yourself on the weight loss surgery journey. It is hard and getting started is hard, but the rewards are well worth it. Good luck!