Dr. Adeyeri

Hitting a plateau or weight loss “stall” is common for just about everyone. While it’s certainly frustrating, it’s important to understand this is just temporary. The good news is weight loss plateaus usually happen after you have lost a significant amount of weight—so congratulations! During your post-op weight loss, the body will eventually need a ‘time out” to stabilize itself and adjust to your lower nutrition intake, smaller size and increased calorie burn due to exercise. It can happen at any time in your weight loss journey, but is particularly common 3-6 months after bariatric surgery. Generally, stalls can last anywhere from a few days to a few weeks, even though you’re staying on track. Expect from one to three plateaus in the first year following weight loss surgery. WHY DO WEIGHT LOSS STALLS HAPPEN? You can blame your body’s metabolism— When you lose weight rapidly, you are losing lean body mass (muscle) and fat. Muscle plays a big part in the burning of calories by keeping your metabolic rate high, so you want to hold onto muscle and strive to build more! (This is one of the reasons we ask you to take in so much protein). A weight-loss plateau usually occurs when your metabolism slows down. Now that you’re thinner, the activities you’re performing may not be resulting in as much caloric burning. An increased metabolic rate is not the only reason for keeping muscle. You want to keep muscle so you can use them to exercise and burn even more calories. Weak muscles make exercise more difficult, so build muscle with strength training and cardio workouts. EIGHT TIPS TO OVERCOME BARIATRIC WEIGHT LOSS PLATEAUS AND BOOST METABOLISM 1. Increase the intensity of your exercise. 2. Weigh yourself less often. 3. Keep food journaling to ensure there are no negative nutrition issues creeping in. 4. Eat all that protein to help retain muscle, even in shake form. 6. Drink 64 ounces every day. 7. Sleep eight hours nightly and keep a set schedule, even on weekends. 8. Talk to your bariatric team during the plateau for an added level of support and guidance. KEEP IN MIND… If you are weight training, consider that muscle weighs more than fat; while you are building muscle, you are still losing inches (girth) even though if it isn’t reflected in pounds lost. USE YOUR SUPPORT NETWORK Remember there are several layers of people supporting you during your road back to good health: Your doctor Bariatric dietitians and nutritionists Family Friends Colleagues Live and online support groups. (They understand more than anyone!) If a plateau lasts more than a few weeks and you haven't contacted your bariatric surgeon yet, make an appointment for an ASAP visit to rule out any issues. Meanwhile, stay positive and celebrate how far you have come in a short time. This is a very brief traffic jam on your highway to success.

The good news is weight loss plateaus usually happen after you have lost a significant amount of weight—so congratulations! During your post-op weight loss, the body will eventually need a ‘time out” to stabilize itself and adjust to your lower nutrition intake, smaller size and increased calorie burn due to exercise. It can happen at any time in your weight loss journey, but is particularly common 3-6 months after bariatric surgery. Generally, stalls can last anywhere from a few days to a few weeks, even though you’re staying on track. Expect from one to three plateaus in the first year following weight loss surgery. WHY DO WEIGHT LOSS STALLS HAPPEN? You can blame your body’s metabolism— When you lose weight rapidly, you are losing lean body mass (muscle) and fat. Muscle plays a big part in the burning of calories by keeping your metabolic rate high, so you want to hold onto muscle and strive to build more! (This is one of the reasons we ask you to take in so much protein). A weight-loss plateau usually occurs when your metabolism slows down. Now that you’re thinner, the activities you’re performing may not be resulting in as much caloric burning. An increased metabolic rate is not the only reason for keeping muscle. You want to keep muscle so you can use them to exercise and burn even more calories. Weak muscles make exercise more difficult, so build muscle with strength training and cardio workouts. EIGHT TIPS TO OVERCOME BARIATRIC WEIGHT LOSS PLATEAUS AND BOOST METABOLISM 1. Increase the intensity of your exercise. 2. Weigh yourself less often. 3. Keep food journaling to ensure there are no negative nutrition issues creeping in. 4. Eat all that protein to help retain muscle, even in shake form. 6. Drink 64 ounces every day. 7. Sleep eight hours nightly and keep a set schedule, even on weekends. 8. Talk to your bariatric team during the plateau for an added level of support and guidance. KEEP IN MIND… If you are weight training, consider that muscle weighs more than fat; while you are building muscle, you are still losing inches (girth) even though if it isn’t reflected in pounds lost. USE YOUR SUPPORT NETWORK Remember there are several layers of people supporting you during your road back to good health: Your doctor Bariatric dietitians and nutritionists Family Friends Colleagues Live and online support groups. (They understand more than anyone!) If a plateau lasts more than a few weeks and you haven't contacted your bariatric surgeon yet, make an appointment for an ASAP visit to rule out any issues. Meanwhile, stay positive and celebrate how far you have come in a short time. This is a very brief traffic jam on your highway to success.

After bariatric surgery, many people begin losing weight at a rapid pace. Whether you have the gastric sleeve, gastric bypass, or change your lap band to another bariatric solution, your body is going to change inside and out. I’ve outlined some of the most important improvements you are going to experience during the transition to a healthy weight and lifestyle: Food will not rule your life Once obesity sets in, life is about food, first and foremost. But after bariatric surgery, you’ll see that food isn’t really your ‘best friend’ anymore; it just keeps you alive, nothing more. Get ready to say goodbye to the constant worry about your next snack, next meal or which drive-through you’re going to visit. Going forward, you will learn that food gives your mind and body fuel to perform at its highest level possible. Food is not a crutch or a protector from the challenges of daily life. You’re going to feel so much better Preparation is the number one key to weight loss success. Before surgery, you’ll work with our Bariatric Navigator to start the process of changing what you eat. Go ahead and dump the junk food, the sugar products and empty carbs now. Your body doesn’t need artificially processed foods (nor does your family). After about a week or two of excluding these foods from your diet, you’re going to feel the difference. Read articles, blogs, magazines and books about healthy living. Prepare your body and your mind to make changes toward living a healthier lifestyle. By utilizing all of the resources from our comprehensive bariatric weight loss program, you will have many levels of support and education available to you. You are not alone in this journey Through your surgeon or hospital's bariatric program, you are going to meet people at all stages of the bariatric process. You will garner the tools to live a healthier life and learn how to meet and overcome obstacles. There is strength in numbers so seek out both live and online support groups. Sign up for a few and build relationships with people. You will be as big a help to them as they will be for yo u! Only you can change your mindset about food, exercise and weight The struggle against obesity is not just physical. It’s also mental and emotional. Having the courage and dedication to have weight loss surgery is a strong statement about your regard for your value and self-worth. The battle against obesity is complicated; if you feel you need psychological counseling services, we’ll be happy to provide you with recommendations based upon our patients’ feedback. You will be amazed that you actually like to exercise Once you are eating solid foods again, you can incorporate exercise into your routine, in most cases. Many patients enthusiastically report that weight loss surgery gave them a new chance to reap the benefits from working out. After weight loss surgery, you call the shots about what happens next. How will you reclaim your body, redeem your health, and start a journey toward a healthier quality of life? Discover or re-discover activities that you enjoy—start with walking around the neighborhood; jog/walk on a treadmill while you watch your favorite TV show or play ball with your kids (they will be elated, I assure you). Have you always wanted to hike? Take a water aerobics class? Try Yoga or Zumba? Embrace the new life you are creating for yourself. Dive in, try everything! The battle against the disease of obesity is often in the mind. When you see the physical changes happening, your mental outlook will improve as well. Seize that momentum and go after your goals with everything you’ve got. It’s well worth the effort.

Food will not rule your life Once obesity sets in, life is about food, first and foremost. But after bariatric surgery, you’ll see that food isn’t really your ‘best friend’ anymore; it just keeps you alive, nothing more. Get ready to say goodbye to the constant worry about your next snack, next meal or which drive-through you’re going to visit. Going forward, you will learn that food gives your mind and body fuel to perform at its highest level possible. Food is not a crutch or a protector from the challenges of daily life. You’re going to feel so much better Preparation is the number one key to weight loss success. Before surgery, you’ll work with our Bariatric Navigator to start the process of changing what you eat. Go ahead and dump the junk food, the sugar products and empty carbs now. Your body doesn’t need artificially processed foods (nor does your family). After about a week or two of excluding these foods from your diet, you’re going to feel the difference. Read articles, blogs, magazines and books about healthy living. Prepare your body and your mind to make changes toward living a healthier lifestyle. By utilizing all of the resources from our comprehensive bariatric weight loss program, you will have many levels of support and education available to you. You are not alone in this journey Through your surgeon or hospital's bariatric program, you are going to meet people at all stages of the bariatric process. You will garner the tools to live a healthier life and learn how to meet and overcome obstacles. There is strength in numbers so seek out both live and online support groups. Sign up for a few and build relationships with people. You will be as big a help to them as they will be for yo u! Only you can change your mindset about food, exercise and weight The struggle against obesity is not just physical. It’s also mental and emotional. Having the courage and dedication to have weight loss surgery is a strong statement about your regard for your value and self-worth. The battle against obesity is complicated; if you feel you need psychological counseling services, we’ll be happy to provide you with recommendations based upon our patients’ feedback. You will be amazed that you actually like to exercise Once you are eating solid foods again, you can incorporate exercise into your routine, in most cases. Many patients enthusiastically report that weight loss surgery gave them a new chance to reap the benefits from working out. After weight loss surgery, you call the shots about what happens next. How will you reclaim your body, redeem your health, and start a journey toward a healthier quality of life? Discover or re-discover activities that you enjoy—start with walking around the neighborhood; jog/walk on a treadmill while you watch your favorite TV show or play ball with your kids (they will be elated, I assure you). Have you always wanted to hike? Take a water aerobics class? Try Yoga or Zumba? Embrace the new life you are creating for yourself. Dive in, try everything! The battle against the disease of obesity is often in the mind. When you see the physical changes happening, your mental outlook will improve as well. Seize that momentum and go after your goals with everything you’ve got. It’s well worth the effort.

We all have an inherent need to help others before we help ourselves, particularly as adults when we take on the roles of spouse, partner or parent. But taking on the goal of losing a large amount of weight requires that you dedicate yourself 100 percent to the task at hand. Make time--no matter what obstacles try to block your path--to accomplish these tasks every day 24/7/365 (yes, even Christmas): · Shopping for fresh and healthy food · Preparing meals · Exercising daily · Relaxing · Planning for the next day These responsibilities can be challenging when you are so accustomed to helping everybody else before finally seeing to your own needs (if you are not too exhausted to do so). It’s all-too-easy for self-care activities to slide off the to-do list (I’ll start again tomorrow…) Undertaking the Herculean challenge of losing a large amount of weight and changing unhealthy lifestyle patterns in your life may be the battle of a lifetime for many of you. And you are worth it. But to accomplish this goal as quickly and effectively as possible, you have to prioritize “self-care.” Five ways to prioritize your needs during weight loss 1. Prepare and enjoy your meal before you cook for the family. 2. Set-up a kids’ activities car pool to lessen wasted time sitting idly in the car. 3. Set a daily reminder to take a 15-minute break every day to do something that you enjoy, even if you just sit with your eyes closed. 4. Feel free to say to detractors, “I have to devote a concerted effort toward my weight loss, which will make me healthier and happier.” 5. If you are put into a situation where you may eat for the wrong reasons, change plans or politely excuse yourself. (You are in a special situation, you are allowed). Like getting regular oil changes for your car, prioritizing your own needs is what allows you to run optimally and put your best foot forward toward achieving your weight loss goals. And you are very much worth it.

During weight loss, and eventually weight management, your long-term success will be contingent upon prioritizing time and effort to take care of your business of weight loss. We all have an inherent need to help others before we help ourselves, particularly as adults when we take on the roles of spouse, partner or parent. But taking on the goal of losing a large amount of weight requires that you dedicate yourself 100 percent to the task at hand. Make time--no matter what obstacles try to block your path--to accomplish these tasks every day 24/7/365 (yes, even Christmas): · Shopping for fresh and healthy food · Preparing meals · Exercising daily · Relaxing · Planning for the next day These responsibilities can be challenging when you are so accustomed to helping everybody else before finally seeing to your own needs (if you are not too exhausted to do so). It’s all-too-easy for self-care activities to slide off the to-do list (I’ll start again tomorrow…) Undertaking the Herculean challenge of losing a large amount of weight and changing unhealthy lifestyle patterns in your life may be the battle of a lifetime for many of you. And you are worth it. But to accomplish this goal as quickly and effectively as possible, you have to prioritize “self-care.” Five ways to prioritize your needs during weight loss 1. Prepare and enjoy your meal before you cook for the family. 2. Set-up a kids’ activities car pool to lessen wasted time sitting idly in the car. 3. Set a daily reminder to take a 15-minute break every day to do something that you enjoy, even if you just sit with your eyes closed. 4. Feel free to say to detractors, “I have to devote a concerted effort toward my weight loss, which will make me healthier and happier.” 5. If you are put into a situation where you may eat for the wrong reasons, change plans or politely excuse yourself. (You are in a special situation, you are allowed). Like getting regular oil changes for your car, prioritizing your own needs is what allows you to run optimally and put your best foot forward toward achieving your weight loss goals. And you are very much worth it.

The bariatric operation will only take you so far. For many people battling weight issues, the biggest caveat in achieving sustained weight loss is the way you think about food. It's not easy to break habits that have been comfortably in place for years, even decades. It's time to take your "old frame of mind" out of its comfort zone. Here's how to do it: When new bariatric patients come to my practice, one of the first things we discuss is how unimportant the operation will be for them, in the big picture. Once they recover from the shock of that news, we explain that their mindset contributed to their weight problem, and their mindset will be the secret weapon to ultimately get the weight off. Here’s the thing--we don't operate on your brain. Bariatric surgery will only take you so far. Long-term weight-loss success requires a firm commitment to living a healthy lifestyle—eating the right foods--and ignoring the others that made you feel bloated and too tired to do anything. You need to stay very well hydrated and discover an exercise (or two or three) that you perform about 4-5 times a week for about 30-40 minutes. Take this stress and… Then there’s the stress of everyday life—we all have it. The trick is to find ways to offset these unavoidable pressure points, so that you aren’t on a one-way road to the kitchen. Food is not the answer to your problems, it never was. While you are improving your health, feed your brain with positive feelings by improving the quality of your life. Make the effort to become more social: Join a gym, catch a movie with a long-lost friend, invite the nice parents of your child’s best friend over for coffee. Give a little, get a lot One of the activities I recommend to every bariatric patient is to give back to their community. Want to feel better than any junk food could make you feel? Volunteer. If you look around, you’ll see that you’re far more fortunate than you may realize. Help out, make life better for someone else, even in a small way. Give your time, give your heart. Everyone needs a little help If you think you can’t go it alone, reach out to your bariatric or family doctor to ask for resources who can offer mental health support specifically for people with food/weight issues. You are never in this battle alone, always remember that.

During the course of our lives, many of us will need some kind of GI (gastrointestinal) surgery—gallbladder or appendix removal, hernia repairs or more serious issues related to the colon. Special care should be heeded to patients who have previously undergone weight loss surgery due to anatomic changes as a result of the procedure. It’s also important to note that bariatric surgeons specialize in performing most general and laparoscopic operations (unrelated to the weight loss surgery) in the torso region of the body. I recently had a case where my bariatric patient had his gallbladder removed by a general surgeon who was not a bariatric surgeon. Why? He didn’t realize that I also perform gallbladder surgery at least 2-3 times per week. Unfortunately, this patient experienced post-op complications which I was able to address successfully. This incident compelled me to ask other post-op patients what they would do if they needed an operation in the GI region. “Really? I thought you only performed weight loss surgery,” many of my patients remarked. When one patient told me she would definitely ask me for a referral, I knew I needed to compose an article about this subject. If you are facing an operation in the abdominal region, contact your metabolic and bariatric surgeon first, so long as you satisfied with their quality of care. They have been specially trained to successfully treat most medical issues safely and successfully. In addition, they are well versed in your new anatomy and how best to address the medical situation you are facing and oversee your post-op care. Photo courtesy of FreeDigitalPhotos.net Staff Only Signs At Laboratory” by artur84

When new bariatric patients come to my practice, one of the first things we discuss is how unimportant the operation will be for them, in the big picture. Once they recover from the shock of that news, we explain that their mindset contributed to their weight problem, and their mindset will be the secret weapon to ultimately get the weight off. Here’s the thing--we don't operate on your brain. Bariatric surgery will only take you so far. Long-term weight-loss success requires a firm commitment to living a healthy lifestyle—eating the right foods--and ignoring the others that made you feel bloated and too tired to do anything. You need to stay very well hydrated and discover an exercise (or two or three) that you perform about 4-5 times a week for about 30-40 minutes. Take this stress and… Then there’s the stress of everyday life—we all have it. The trick is to find ways to offset these unavoidable pressure points, so that you aren’t on a one-way road to the kitchen. Food is not the answer to your problems, it never was. While you are improving your health, feed your brain with positive feelings by improving the quality of your life. Make the effort to become more social: Join a gym, catch a movie with a long-lost friend, invite the nice parents of your child’s best friend over for coffee. Give a little, get a lot One of the activities I recommend to every bariatric patient is to give back to their community. Want to feel better than any junk food could make you feel? Volunteer. If you look around, you’ll see that you’re far more fortunate than you may realize. Help out, make life better for someone else, even in a small way. Give your time, give your heart. Everyone needs a little help If you think you can’t go it alone, reach out to your bariatric or family doctor to ask for resources who can offer mental health support specifically for people with food/weight issues. You are never in this battle alone, always remember that.

Whether you’re young in age or young-at-heart, there are a few key steps you can take to keep your metabolism motor humming so you are blasting away calories at the highest rate possible. As you age, your metabolism slows down. Older people also tend to have less muscle mass than younger people, which also reduces metabolic rate. This is why we encourage older patients to add light weight-bearing exercise to their fitness routines. So how do you keep that furnace burning in order to burn calories, even if you’re already achieved your goal weight? There are many simple tools to accomplish this task. I’ve outlined my favorites below: Exercise This weapon is key to maintaining and increasing metabolism. Seniors, take note−The Centers for Disease Control and Prevention (CDC) recommends people 65 and older get 2.5 hours of moderate-intensity aerobic activity every week and perform weight-bearing exercises on all the body’s major muscle groups at least twice a week. At any age, indoctrinate a 30-minute daily work-out, just like brushing your teeth and eating lunch, into your daily routine. Sleep To increase the chances of boosting metabolism, adults should get seven to nine hours of sleep each night. Getting too little shut-eye can significantly alter your body’s processes enough to predispose you to gain weight. (Do you ever feel hungry for no reason when you’re exhausted and then reach for the wrong foods to boot?) De-Stress When you’re tense, your body releases cortisol, a hormone produced by the adrenal system that is linked to weight gain. It can also significantly weaken your immune system and open the door to acute and chronic illnesses. Turn to regular physical activity, deep breathing, a quiet evening stroll, or professional help from a psychologist or counselor if you are experiencing chronic stress. Eat and Drink (First and foremost, follow your bariatric practice's instructions on post-op nutrition.) Eating the right foods−clean proteins, fruits and vegetables−fuels your metabolism firing on all cylinders. As soon as you awaken, charge-up those calorie burners by feeding them a protein and a fruit (think omelette with feta cheese, spinach and veggies and a cup of berries). Eat small meals throughout the day but stop by around 7 p.m. Staying hydrated is key to maintaining good health. Keep a glass or refillable water bottle with you throughout the day. You are properly hydrated if your urine is nearly clear. Other than choosing the right foods to eat and finding spiritual solace in your life, these tools serve as a roadmap to good health, including maintaining a healthy weight. Best of all, once you’ve adopted these tips, you will look and feel better--sooner than you think.

As you age, your metabolism slows down. Older people also tend to have less muscle mass than younger people, which also reduces metabolic rate. This is why we encourage older patients to add light weight-bearing exercise to their fitness routines. So how do you keep that furnace burning in order to burn calories, even if you’re already achieved your goal weight? There are many simple tools to accomplish this task. I’ve outlined my favorites below: Exercise This weapon is key to maintaining and increasing metabolism. Seniors, take note−The Centers for Disease Control and Prevention (CDC) recommends people 65 and older get 2.5 hours of moderate-intensity aerobic activity every week and perform weight-bearing exercises on all the body’s major muscle groups at least twice a week. At any age, indoctrinate a 30-minute daily work-out, just like brushing your teeth and eating lunch, into your daily routine. Sleep To increase the chances of boosting metabolism, adults should get seven to nine hours of sleep each night. Getting too little shut-eye can significantly alter your body’s processes enough to predispose you to gain weight. (Do you ever feel hungry for no reason when you’re exhausted and then reach for the wrong foods to boot?) De-Stress When you’re tense, your body releases cortisol, a hormone produced by the adrenal system that is linked to weight gain. It can also significantly weaken your immune system and open the door to acute and chronic illnesses. Turn to regular physical activity, deep breathing, a quiet evening stroll, or professional help from a psychologist or counselor if you are experiencing chronic stress. Eat and Drink (First and foremost, follow your bariatric practice's instructions on post-op nutrition.) Eating the right foods−clean proteins, fruits and vegetables−fuels your metabolism firing on all cylinders. As soon as you awaken, charge-up those calorie burners by feeding them a protein and a fruit (think omelette with feta cheese, spinach and veggies and a cup of berries). Eat small meals throughout the day but stop by around 7 p.m. Staying hydrated is key to maintaining good health. Keep a glass or refillable water bottle with you throughout the day. You are properly hydrated if your urine is nearly clear. Other than choosing the right foods to eat and finding spiritual solace in your life, these tools serve as a roadmap to good health, including maintaining a healthy weight. Best of all, once you’ve adopted these tips, you will look and feel better--sooner than you think.

Thanksgiving is just around the corner and we’re already in the throes of preparing for the holiday season ahead. The holidays mean one thing—food, drinks--and more food. As an obesity expert and surgeon who performs weight loss surgery, I can tell you most of us gain weight from here until the end of the year—and more than just a pound or two. Whether you’re maintaining your weight or trying to lose those last few pounds before Thanksgiving, I’d like to share my thoughts on how to manage your weight the same way you would manage a project at work, school or home. In the real world, it’s admittedly difficult to prep healthy food in advance and squeeze in a trip to the gym between commuting to work, dealing with home projects, driving kids to football or dance and trying to get to bed by 11 p.m. every night. Add in the additional responsibilities of holiday activities and—no surprise here--watching your weight plummets on the priority scale. But you can do it nonetheless, it just takes a little planning. My most successful patients, who face losing hundreds of pounds after bariatric surgery, organize their lives to put nutrition, exercise and other healthy endeavors on equal ground with the other aspects of daily life—no matter what. Here are some of my favorite tips and tools to plan a more organized strategy that will support your path to a healthier holiday season: 1. Figure Out What Needs Fixing Everyone has periods of time when eating right and exercising goes off kilter. Take a few minutes to figure out when and why this happens. Are you running out of healthy foods too often? Are you stressed at night dealing with the kids and eating to calm down? Are you so exhausted you can’t be bothered with working out? Once you identify these triggers, you can create a plan to overcome these challenges. 2. Organize Your Surroundings Without a doubt, living or working in a chaotic environment is stressful. If the kitchen is a mess, there is no food in the house and you can never find your favorite sneakers, you’re putting yourself at an unnecessary disadvantage. Get your home and office back under control; start with the most disorganized space and clean it up. (This can usually be accomplished in less time than you think and the results will make you feel five pounds lighter). 3. Schedule Your Workouts the Same Way You Schedule a Meeting Pick a specific time during the weekend to review your calendar for the days ahead and schedule your workouts accordingly. And then actually go—no matter what. 4. Plan Meals, Grocery Shopping and Cooking Once a Week Reviewing your schedule for the week will help figure out where and when you’ll be eating meals, what foods you’ll need, and how much time you need to cook. Look at the weekly grocery store circular and stock up on healthy items that are on sale. Planning saves money. 5. Go to Bed—No Excuses Sleep deprivation interferes with weight loss by confusing hormones that signal hunger and fullness levels. Research shows that people who stay up late consume more calories than those who go to sleep at about the same time each night. When you're tired, your willpower wanes. Even as adults, you still need to aim for eight hours of quality sleep per night. Managing your weight during the holidays is like taking medicine—you train yourself to do it every day, just like brushing your teeth and eating lunch. Which areas of your life could reap the biggest improvement if they were just a little more organized? Start there. In a few short weeks, you are going to realize the positive impact on your life—and your waistline. When January rolls around, you’ll be starting a new year looking and feeling your best. Now that’s the way to welcome 2016.

Your dietitian and bariatric support team will prescribe some foods and drinks that you will consume just about every day so it makes sense to buy these items in volume. I love Facebook. It’s a way I can stay in touch with my patients (and their families) here in New Jersey between office visits and once they are on maintenance after reaching goal weight. I recently posted a query asking my post-op patients what healthy staple items they buy from the big warehouse stores—BJ’s, Costco, Sam’s Club--and I received many helpful responses that I’d like to share with you. Armed with these terrific recommendations below, you’ll eat healthier, save time, money and require fewer trips to the grocery store during your weight loss journey. “What "go-to" items do you purchase from warehouse stores since weight loss surgery?” · Premier protein shakes · Protein bars · Sam’s chicken sausage with mozzarella · Muscle Milk · Liter bottles of water · Optimum Nutrition protein powders · Frozen Mahi Mahi filets · Cranberry almond chicken salad in 4 oz. cups. · Chicken breasts and ground turkey · Baby Bell light cheese · Frozen veggies · Veggie burgers · Salmon fillets · Fresh spinach · Probiotic 10 and Fiber Gummies · Ready-to-eat veggie tray · Gold Standard Whey, Kirkland Fiber Caps, Opti-Fiber, Kirkland Calcium Citrate · Mini cucumbers · Bagged chopped kale salad · Kirkland plain Greek yogurt · Kirkland citrus green tea, Crystal Light · Figgy Pops, Healthy Choice fudge bars · Quinoa · Chia seeds If you are a member of these clubs, take an hour or two and really peruse the aisles in search of healthy products that support your nutrition plan. Keep in mind, many food items can be frozen and thawed when you need it to avoid spoilage. Ask your IWL dietitian for more ideas or bring in a sample of a food or drink you’re not sure of (take a screen shot of the nutrition label before you buy it). If you’d like to friend me on Facebook, I can be found here.

As you begin the process of weight loss by changing what you eat, you’ll quickly feel better (and lighter). For example, look at the difference in what you now purchase at the grocery store since your operation--you see much more ‘real food’ and far fewer pre-packaged items in the grocery cart now, that's for sure. But fruits, vegetables, protein drinks and lean cuts of meat cost more than pre-packaged junk food, which can be attributed to one of the reasons some lower income people lose the battle with obesity. Since you’ve made a decision to change your life, including what you eat, you’re going to be buying several of these healthier options in bulk, as they will serve as the new staples in your nutrition plan. Your dietitian and bariatric support team will prescribe some foods and drinks that you will consume just about every day so it makes sense to buy these items in volume. I love Facebook. It’s a way I can stay in touch with my patients (and their families) here in New Jersey between office visits and once they are on maintenance after reaching goal weight. I recently posted a query asking my post-op patients what healthy staple items they buy from the big warehouse stores—BJ’s, Costco, Sam’s Club--and I received many helpful responses that I’d like to share with you. Armed with these terrific recommendations below, you’ll eat healthier, save time, money and require fewer trips to the grocery store during your weight loss journey. “What "go-to" items do you purchase from warehouse stores since weight loss surgery?” · Premier protein shakes · Protein bars · Sam’s chicken sausage with mozzarella · Muscle Milk · Liter bottles of water · Optimum Nutrition protein powders · Frozen Mahi Mahi filets · Cranberry almond chicken salad in 4 oz. cups. · Chicken breasts and ground turkey · Baby Bell light cheese · Frozen veggies · Veggie burgers · Salmon fillets · Fresh spinach · Probiotic 10 and Fiber Gummies · Ready-to-eat veggie tray · Gold Standard Whey, Kirkland Fiber Caps, Opti-Fiber, Kirkland Calcium Citrate · Mini cucumbers · Bagged chopped kale salad · Kirkland plain Greek yogurt · Kirkland citrus green tea, Crystal Light · Figgy Pops, Healthy Choice fudge bars · Quinoa · Chia seeds If you are a member of these clubs, take an hour or two and really peruse the aisles in search of healthy products that support your nutrition plan. Keep in mind, many food items can be frozen and thawed when you need it to avoid spoilage. Ask your IWL dietitian for more ideas or bring in a sample of a food or drink you’re not sure of (take a screen shot of the nutrition label before you buy it). If you’d like to friend me on Facebook, I can be found here.

Whether you’re maintaining your weight or trying to lose those last few pounds before Thanksgiving, I’d like to share my thoughts on how to manage your weight the same way you would manage a project at work, school or home. In the real world, it’s admittedly difficult to prep healthy food in advance and squeeze in a trip to the gym between commuting to work, dealing with home projects, driving kids to football or dance and trying to get to bed by 11 p.m. every night. Add in the additional responsibilities of holiday activities and—no surprise here--watching your weight plummets on the priority scale. But you can do it nonetheless, it just takes a little planning. My most successful patients, who face losing hundreds of pounds after bariatric surgery, organize their lives to put nutrition, exercise and other healthy endeavors on equal ground with the other aspects of daily life—no matter what. Here are some of my favorite tips and tools to plan a more organized strategy that will support your path to a healthier holiday season: 1. Figure Out What Needs Fixing Everyone has periods of time when eating right and exercising goes off kilter. Take a few minutes to figure out when and why this happens. Are you running out of healthy foods too often? Are you stressed at night dealing with the kids and eating to calm down? Are you so exhausted you can’t be bothered with working out? Once you identify these triggers, you can create a plan to overcome these challenges. 2. Organize Your Surroundings Without a doubt, living or working in a chaotic environment is stressful. If the kitchen is a mess, there is no food in the house and you can never find your favorite sneakers, you’re putting yourself at an unnecessary disadvantage. Get your home and office back under control; start with the most disorganized space and clean it up. (This can usually be accomplished in less time than you think and the results will make you feel five pounds lighter). 3. Schedule Your Workouts the Same Way You Schedule a Meeting Pick a specific time during the weekend to review your calendar for the days ahead and schedule your workouts accordingly. And then actually go—no matter what. 4. Plan Meals, Grocery Shopping and Cooking Once a Week Reviewing your schedule for the week will help figure out where and when you’ll be eating meals, what foods you’ll need, and how much time you need to cook. Look at the weekly grocery store circular and stock up on healthy items that are on sale. Planning saves money. 5. Go to Bed—No Excuses Sleep deprivation interferes with weight loss by confusing hormones that signal hunger and fullness levels. Research shows that people who stay up late consume more calories than those who go to sleep at about the same time each night. When you're tired, your willpower wanes. Even as adults, you still need to aim for eight hours of quality sleep per night. Managing your weight during the holidays is like taking medicine—you train yourself to do it every day, just like brushing your teeth and eating lunch. Which areas of your life could reap the biggest improvement if they were just a little more organized? Start there. In a few short weeks, you are going to realize the positive impact on your life—and your waistline. When January rolls around, you’ll be starting a new year looking and feeling your best. Now that’s the way to welcome 2016.

The first time I met George Peters, I knew he would be a record holder, I just didn't realize to what extent! He had been sufficiently frightened by several chronic health issues he was living with as a result of his weight. And I knew he was ready to defeat the fear and fight back. While George didn't look like it outwardly, he weighed more than 400 pounds. With the full support of his family, his took his obesity challenge by the horns (and then some). George recently shared his personal weight loss journey on Facebook as a way to show where he had been--and where he is today. He kindly permitted us to share his remarkable story below: Why Weight Loss Surgery By George Peters (shared with permission) It's one month until my first Ironman in Mont-Tremblant, Quebec and I'm sharing my story of ‪#‎whyweightlosssurgery: In 2010, I weighed 425 pounds. I was visiting my primary care physician, and he stated that I would need surgery to have an insulin pump inserted into me to control my diabetes. My realization was that I would probably be dead by age 50, if I didn’t get my diabetes under control. Weight-related Health Issues My diabetes, high blood pressure, respiratory problems and circulatory problems were out of control. I had tried numerous diets to control my weight and health problems, and they always started off with success only to surrender any weight loss, to an eventual failure, and an additional weight gain. I decided that I would have bariatric surgery for weight loss in January 2011. I had gastric sleeve surgery performed by Dr. Ayotunde Adeyeri at Bayshore Community Hospital in Holmdel. Sleeve Gastrectomy Success I lost 125 pounds and started to control my health problems. My weight loss stalled in 2013 and my fear of my health problems returning scared me. I hadn’t reached my goal weight of 240 pounds. I started running in the fall of 2013 when my daughters convinced my wife and me to have our family run in a turkey trot (5K). A New Passion for Fitness, Strength and Endurance I started running and found the workouts to be rewarding. I started cycling again soon after. I hadn’t ridden a bicycle since I was a teenager because I was too big to ride a bike. Soon after my first 10 mile bike ride, I decided to sign up for my first sprint triathlon, in the spring 2014. During the 2014 year, my performance in three of my four triathlons was affected due to gall bladder problems that eventually led to my gall bladder being removed 5 days after the New Jersey State Triathlon. Losing Nearly 200 Pounds Sends George to His First Ironman Competition 2015 has been a year of setting goals and working to achieve them: My goal for this year is to finish an Ironman. I scheduled multiple smaller events to help me prepare for the Ironman. I finished the NYC half marathon in March. My training continued, and I finished the Raleigh Ironman 70.3 in 9 hours 3 minutes. In August, I will complete my first full Ironman triathlon in Mont Tremblant, Quebec, Canada. Ironman and Triathlon have given me a bright outlook for the future. I now have a goal of being in Kona by the age of fifty.

Having a job where I can share these outstanding success stories is an honor!

There are times when a patient needs to change from one bariatric procedure to another for various reasons--complications with the original procedure or the volume of anticipated weight loss was not achieved. In this case, a more complex, but highly successful procedure called a duodenal switch (DS) procedure may be the solution to achieve the desired goal weight. It is a more advanced procedure, but also offers the patient the greatest volume of potential weight loss, in many cases. Duodenal switch surgery is a combination of a gastric sleeve and gastric bypass surgery, in simple terms. It decreases both the quantity of food that can be accommodated by the stomach and the number of calories that can be absorbed and used by the body. It is considered one of the more specialized weight loss surgery procedures and is only performed by bariatric surgeons who have successfully undergone procedure-specific training to perform it. WHO IS APPROPRIATE FOR DUODENAL SWITCH SURGERY? Duodenal switch revisional bariatric surgery is sometimes performed as a secondary procedure after a gastric band or sleeve gastrectomy surgery did not achieve the desired overall weight loss the patient hoped to achieve. This lesser know procedure actually offers the patient the highest opportunity to lose the highest volume of weight loss. DUODENAL SWITCH KEY FACTS: *It may reduce hunger significantly. *You may have nutritional deficiencies and must take multi-vitamins daily *You will not experience dumping syndrome if you consume sugar. *You will carefully monitor your diet to ensure you are consuming enough healthy foods. Duodenal Switches involve stapling about 70 percent of the stomach off and leaving the rest of the stomach connected to the first part of the intestine (the duodenum) which is then re-attached at a lower area of the intestine. This procedure prevents bile and digestive juices from processing food further down the intestine which results in less caloric absorption. Because of this longer period between eating and digestion of food, the food passes to the colon faster, and the patient doesn't process the full amount of calories he or she normally would have. The positives and negatives of DS Surgery Duodenal switch surgery has excellent results, with the average patient losing 70 to 80 percent of excess weight in the two years that follow the procedure. However, patients who choose this type of surgery are at higher risk for nutritional deficiencies than with other types of weight loss surgery. Nutritional supplements, including vitamins and minerals, will be necessary for the lifetime of the patient. If you are still considering your bariatric options, talk with your surgeon about the viability of this weight loss surgical option for you.

Why Weight Loss Surgery By George Peters (shared with permission) It's one month until my first Ironman in Mont-Tremblant, Quebec and I'm sharing my story of ‪#‎whyweightlosssurgery: In 2010, I weighed 425 pounds. I was visiting my primary care physician, and he stated that I would need surgery to have an insulin pump inserted into me to control my diabetes. My realization was that I would probably be dead by age 50, if I didn’t get my diabetes under control. Weight-related Health Issues My diabetes, high blood pressure, respiratory problems and circulatory problems were out of control. I had tried numerous diets to control my weight and health problems, and they always started off with success only to surrender any weight loss, to an eventual failure, and an additional weight gain. I decided that I would have bariatric surgery for weight loss in January 2011. I had gastric sleeve surgery performed by Dr. Ayotunde Adeyeri at Bayshore Community Hospital in Holmdel. Sleeve Gastrectomy Success I lost 125 pounds and started to control my health problems. My weight loss stalled in 2013 and my fear of my health problems returning scared me. I hadn’t reached my goal weight of 240 pounds. I started running in the fall of 2013 when my daughters convinced my wife and me to have our family run in a turkey trot (5K). A New Passion for Fitness, Strength and Endurance I started running and found the workouts to be rewarding. I started cycling again soon after. I hadn’t ridden a bicycle since I was a teenager because I was too big to ride a bike. Soon after my first 10 mile bike ride, I decided to sign up for my first sprint triathlon, in the spring 2014. During the 2014 year, my performance in three of my four triathlons was affected due to gall bladder problems that eventually led to my gall bladder being removed 5 days after the New Jersey State Triathlon. Losing Nearly 200 Pounds Sends George to His First Ironman Competition 2015 has been a year of setting goals and working to achieve them: My goal for this year is to finish an Ironman. I scheduled multiple smaller events to help me prepare for the Ironman. I finished the NYC half marathon in March. My training continued, and I finished the Raleigh Ironman 70.3 in 9 hours 3 minutes. In August, I will complete my first full Ironman triathlon in Mont Tremblant, Quebec, Canada. Ironman and Triathlon have given me a bright outlook for the future. I now have a goal of being in Kona by the age of fifty.

It’s also important to note that bariatric surgeons specialize in performing most general and laparoscopic operations (unrelated to the weight loss surgery) in the torso region of the body. I recently had a case where my bariatric patient had his gallbladder removed by a general surgeon who was not a bariatric surgeon. Why? He didn’t realize that I also perform gallbladder surgery at least 2-3 times per week. Unfortunately, this patient experienced post-op complications which I was able to address successfully. This incident compelled me to ask other post-op patients what they would do if they needed an operation in the GI region. “Really? I thought you only performed weight loss surgery,” many of my patients remarked. When one patient told me she would definitely ask me for a referral, I knew I needed to compose an article about this subject. If you are facing an operation in the abdominal region, contact your metabolic and bariatric surgeon first, so long as you satisfied with their quality of care. They have been specially trained to successfully treat most medical issues safely and successfully. In addition, they are well versed in your new anatomy and how best to address the medical situation you are facing and oversee your post-op care. Photo courtesy of FreeDigitalPhotos.net Staff Only Signs At Laboratory” by artur84

People who have undergone bariatric surgery know the weight loss battle does not end in the operating room. Months and even years after surgery, some weight can slowly creep back on. But this isn't a time to panic because now you have the tools to overcome a little setback and regain control of your weight. This time, you are in charge. One of the lessons you learn after weight loss surgery is that you are in charge of your health, diet and exercise program. The food no longer rules the roost--you do. The truth of the matter is no matter what the scale says, 110 or 310, everyone puts on a few pounds now and then. As a bariatric surgeon in New Jersey for more than 10 years, one of the biggest anxiety triggers for patients is weight gain. "That's it--it's over--I'm going to gain all the weight back." Of course that's not true. To get back on pace, I’ve listed a few essential steps to help get you back on track to dropping the pounds once again: • Go back to the beginning Post-surgery, you probably followed your healthcare team’s advice to the letter. But as time passed, and you looked and felt healthier, you may have started to deviate from those dietary and exercise guidelines. Pull out your notes and review the program guidelines that brought you this far. Get back on the scale once a week and fire up your food journal again. • Get thyself to the nearest support group ─ STAT Weight loss is a personal journey, but it doesn’t have to be a lonely one. Online support groups on BariatricPal.com are great secondary resources to live weekly or monthly groups with your bariatric doctor or hospital. There is support all-around you, reach out and take it. • Work it out Are you using the ‘too tired’ reason for missing a trip to the gym or 30 minute fast walk around the neighborhood? If you need energy, you know how to get it—get up, get out and get moving. “Too busy,” you say? Remember, only you can prioritize your health and wellness. You matter—make time for your health every single day. • Come to terms with the weight gain This doesn’t mean blaming yourself. Rather, be forthright about how and why it happened and pat yourself on the back that you’ve recognized it now—not later. There’s no need to beat yourself up. You have already done the hard part by recognizing some weight has crept back on. That in itself shows you are going to battle back. We encourage our patients at Sterling Surgicare to call us if they feel frustrated or defeated--everyone needs a pep talk now and then. Remember there are many people supporting you 24/7 in this effort. Life is filled with occasional side-steps and set-backs. It is part of making us who we are. Make a plan, regroup, recommit. You can do this.

Thank you Lisa! How are you doing in week one? It will get easier, I promise! All the best on your journey back to good health! Dr. Adeyeri.