Category Archives: Life After Weight Loss Surgery

February 2nd. Post Bariatric Surgery Support Group

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by | January 23, 2017 · 3:40 pm

Post Bariatric Surgery Support Group – August 2016

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by | July 19, 2016 · 4:11 pm

One Thing I have Never Heard a Patient Say…

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After listening to patients experiences with weight loss over the years, I can say one thing I have never heard:  “I re-gained weight, but have not changed my exercise and physical activity level”.  Never, not one patient that I can recall has reported this scenario.

Why?

Because the two tend to go hand in hand.  Lower activity level, increase weight.  I am pretty sure you know this first hand.

Now, exercise is not the magic bullet for weight loss.  Food habits have to be a main focus for weight loss success.   However, physical activity and exercise add a huge boost that is hard to beat:

1)” Wiggle room” in your food intake for the occasional slips and celebrations.

2) Maintaining metabolism, which lowers as one loses weight without doing strength training.

Certainly, a consistent activity level is not a 100%  guarantee that  you will maintain weight loss – but it is a pretty good bet.

Life, however, is not consistent.  How do we keep life from getting in the way?

  • Keep your exercise program sustainable: The quick-fix exercise programs may have great results, but if you cannot sustain it, the results will quickly fade. When setting up an exercise program ask yourself, Is this sustainable?
  • Plan A, Plan B…:  Have at least one back up plan if your scheduled exercise time is interrupted.  Schedule Plan A into your calendar.  If there is a conflict – don’t delete – reschedule to Plan B.   For example, you plan on exercising in the morning for 30 minutes, but hit the snooze one too many times.  Reschedule it to two 15 minute  bouts, one at lunchtime and one in the evening.
  • Use lifestyle activity to fill in the gaps:  Lifestyle activity is simply the amount of movement you do during your daily life.   Its about taking advantage of those moments when you can take a quick walk, dance for one song, sneak in some exercises.  It has been shown to work well for weight loss.  Tracking with an activity monitor is helpful here when your regular activity level is lowered for some reason,  such as a longer work meeting or caring for an ill relative.  Armed with the information from your activity monitor,  you can ensure you are burning about the same amount of calories by keeping your step level the same as when you are regularly exercising.
  • Use movement to manage stress:  With plenty of life stressors to go around, if exercise is your go-to remedy, you will have many reasons to keep moving.  In your body, movement is the antidote for the response to stress – so this strategy is a way to naturally work with your body to lower stress level.
  • Connect with your “why”:  Why do you want to lose weight? Keep physical activity connected to your real, bottom line reason, instead of just exercising to make the numbers on the scale go down.  Your “why” is your natural motivation.  When physical activity is connected to your own personal “why”, your natural motivation will remain.

So, while it is great to challenge yourself with fitness goals – one of the best ways to boost your odds for lifelong weight loss success is consistency with exercise.  Hows that for a challenge?

Keep Moving, Be Well,

Janet

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

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by | June 16, 2016 · 3:29 pm

May Post-Bariatric Surgery Support Group

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by | April 21, 2016 · 6:05 pm

Life After Weight Loss Surgery – Patient Perspective 2

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I weighed in at my heaviest just after graduating with my Master’s in Education. I knew it was time for a serious life change. I started with small changes and ended up dropping just over 30lbs. It was great and I felt better, but realized I didn’t want this to be like all my other yoyo diets. I needed another tool.

I had a vertical sleeve gastrectomy done in July of 2015. I’m just over six months out now. Lots of people knew but I didn’t widely publicize it. First let me start by saying, no I did not choose the easy way out, nothing about this process is easy. No one wakes up one day and says hey, let me just cut open my body and take out most of my stomach, that’ll be a quick fix. Seriously, no one does that.

I am a recovering binge eater who additionally had incredibly unhealthy habits that I am working hard to overcome. Having a tiny stomach helps, it’s one of the many tools in my box. Unfortunately, I still struggle with my eating disorder, I probably always will. However, I now know how incredibly painful it is to binge eat with a tiny tummy so I try to avoid that as much as possible.

I am very excited to say that I am now officially down 100lbs from my heaviest weight back in May 2014!  I am NOT an expert; I just know what has helped me. Here are some of the many things that I have learned on my journey in no particular order.

  1. Make one small change at a time that you can live with, forever. Changing too many things at once was always a recipe for disaster.
  2. It has to be a lifestyle change or it will all come back, plus some… I did it many times.
  3. High protein, low carbs, low sugar. If you really want it, eat it. Moderation is key. If you are a binge eater and seriously can’t control yourself, know your triggers. I cannot keep cookies in my house. I WILL eat them, ALL of them.
  4. Measure your food; it’s amazing to see what a “portion” looks like. Be honest with yourself about what you are actually eating. Start a food journal, or use an app. You don’t have to share it with the world, but don’t lie to yourself. Write in EVERYTHING. Did you really need that entire box of chocolates? No, probably not. The difference is I don’t lie to myself about what I’m eating or drinking. I’m making a conscious decision about what I’m putting into my body.
  5. Meal prep with healthy things you like. Start small, you don’t need to plan your whole week. That’s overwhelming in the beginning.
  6. Have a somewhat boring diet. I don’t mean eat gross things that aren’t appealing. I eat basically the same thing all the time. I know what’s in it nutritionally and I enjoy it. Yes, I occasionally venture outside of my typical foods. However, I also know that if I don’t let myself have what I want then I will binge eat. I have learned my triggers.
  7. DO NOT reward yourself with food. You are not a dog. Find something else that makes you feel nice. This was incredibly important for me to learn. It was one of those major light bulb moments. Now I save money for fun experiences when I reach a certain goal.
  8. Don’t get on the scale constantly. It can have way too much control over your life. Focus on how clothes fit, and how your body feels. Don’t let the numbers control you, it’s way harder than it sounds. Who knew 3 little numbers had so much power? I wish I cared more about the numbers on in my bank account that that scale.
  9. Exercise. I know that word sounds terrible and scary, but it really just means move your body more. Start with small steps like parking further away, or going for a walk between episodes on TV… Find something you enjoy. If you don’t like it you won’t keep doing it. I started running. – I know, you can’t picture it. I couldn’t either – I also started strength training. I am so thankful to my coworker who suggested it.
  10. Know your support system. My family and friends have been incredibly supportive. I am forever thankful for their support. Also, build a supportive circle of people who you aren’t necessarily close to such as on social media. Family and friends can be a great support, but can also say things that don’t help but hurt. Having an outside network of supporters is incredibly helpful.
  11. Set realistic goals, you don’t need some daunting monster goal hanging over you. Lots of short small ones. You’ll feel accomplished and keep going. There is nothing worse than feeling as if you failed yourself.
  12. Don’t tell people what you’re doing. Suddenly everyone is an expert and trying to “help” you. Initially tell the people who mean the most to you, whom you feel would support you, or whose support you feel you need. Other than that, people don’t need to know until you feel like no one can stop the path you are on.
  13. Learn to say no. I promise it will help. No to yourself, no to others. No is a complete sentence and doesn’t require an explanation.
  14. Instead of saying I don’t have time, try telling yourself that it isn’t a priority. See how it makes you feel. Sometimes I’m OK with it. Other times I realize that I should be a priority and I need to make time. There is always something we can cut back on. Maybe it’s scrolling mindlessly through social media?
  15. Make sure you have a good reason, something that you are fighting for. If you keep that in mind then it makes it so much easier. Mine is that I want to be healthy enough to have children and raise them. I want to be around long enough to watch them have children. I’m going to do anything I can to be healthy for that possibility.
  16. If you post comparison pictures, try to brand them in some way. People will undoubtedly use them to sell their stuff. Yes, it has happened to me. On that same note, take lots of pictures. Don’t delete all the ones you don’t like how you look, you don’t need to show them to anyone. It’s helpful to look back and see the change when you are feeling like a failure for one reason or another. There have been plenty of days when I felt like I wasn’t making as much progress as I wanted, or as quickly as I wanted it. I look back at my pictures and am always shocked.
  17. Think about what you are scared of in the process. Is it failure? It could happen, but you could also succeed. Is it how much money you will spend being healthy? You might be surprised. Better food is more expensive. However, I eat less of it. I also pay significantly less medical bills because of how sick I used to get. Yes, clothing is expensive. Clothes tend to get cheaper the smaller you are, unless you are into name brands. Is it excess skin? Skin has some elasticity, but we are being real honest here… Yes, I have excess skin. Yes, it makes me somewhat uncomfortable. However, I can tell you that I am way more comfortable in my own skin than I have been in years. What is scaring you away from trying? Is that you might actually be successful and don’t know what to do when you are? I know, strange concept, but I was really scared of that. Take a leap of faith, you can do this.
  18. This one is important. I would say the most important – Love yourself and be proud of yourself at every stage of your journey. I can’t even begin to explain how important this part was for me.

This journey has been a crazy one, and my lifestyle has completely changed. I eat healthy, and honestly unhealthy food doesn’t even sound that appealing to me anymore. I do active things for fun now and am looking forward to doing so many more. I feel healthy and have energy at the end of the day now. I wouldn’t change it for anything. I may look different and lead a different lifestyle but, I’m still 100% me, sarcasm and all. Just a lighter, healthier version of me. I am still very much a work in progress, but that will never change.

Thank you to the patient who submitted this post – if you would like to share your perspective after weight loss surgery, email me janet.huehls@umassmemorial.org

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

Keep Moving, Be Well

Janet

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by | April 13, 2016 · 3:40 pm

Life After Weight Loss Surgery – Exercise Part I

Mannus

Achieved his dream of skiing with his son, not just because he lost weight, but because he was STRONG enough to do it!

There is great celebration at the scale when a patient sees weight loss here at the Weight Center.

The celebration can only start when we understand WHAT was lost!

If a patient has been doing strength training – Whoo hoo! Let the celebrating begin! However…

About 30% of weight lost without strength training is muscle.

 Muscle = metabolism!

Muscle = strength, balance, bone strength. 

Muscle = being  able to do the things you want to do at your goal weight.

The myths that muscle weighs more than fat, that we will get big bulky muscles, that cardio is best for weight loss makes many avoid strength training when trying to lose weight.

Cardiovascular exercise such as walking, running, cycling, swimming -does not prevent this loss of muscle with weight loss.

See this blog on strength training   if you are not doing strength training and have had weight loss surgery. 

Since the weight loss is rapid after weight loss surgery, muscle loss is more likely.

For true success after weight loss surgery – regular strength training is key.

If you have questions, please contact me.

Keep Moving, Be Well

Janet

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

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by | March 24, 2016 · 7:50 pm

Follow-up After Weight Loss Surgery

roadWeight loss is a journey. And bariatric surgery is a milestone in that journey. Surgery marks a whole new chapter, a beginning of a new journey within that weight loss journey. Sure, it’s a faster, smoother ride after, than before surgery. It’s like getting onto a highway after driving for miles on bumpy, traffic light-filled roads. The appetite restriction makes it much easier to feel full with smaller meals. The quick weight loss in the initial months after surgery opens up a whole new world of possibilities for exercise. With your joints carrying less weight than before, moving becomes much less painful, and the increase in physical activity leads to further weight loss.

But even highways can be fraught with traffic jams and lane closures at times. The journey after surgery may be easier than before, but no one said it would be perfect. The stomach is an elastic bag, after all. And everyone is different. Some people experience appetite restriction for a longer time than others. Different people experience different levels of “hunger” at different points during their journey.

• Not eating 6 small meals a day, and sometimes skipping a few of those small meals, is one factor that can slow down weight loss, as it can lead to intense hunger, which can lead to eating fast and too much, which, in turn, can lead to stretching of the stomach. Skipping meals can also slow down the metabolism and cause weight re-gain.
• Not getting enough protein can be another factor, as protein helps with feelings of fullness and with preserving muscle mass that boosts metabolism.
• Usually consuming too little protein can lead to consuming too many carbohydrates – starchy foods such as bread, crackers, rice, etc. – which can cause weight re-gain. Starches are not only higher in calories, they are also notorious for causing “cravings,” as they spike blood sugar levels, sending hunger signals to the brain.
• Sometimes people can get off track with exercise, especially during the winter months. And, after not moving for a few days or weeks, they lose all motivation to get back on track because they have feelings of guilt and “failure.”

None of these things are easy – eating 6 small meals, getting enough protein, watching the carbs, exercising regularly. They take a lot of planning, time and effort. And, it is only natural to get off track with them after surgery, just as it is pre-surgery. Yet, a lot of people mistakenly think that once they have had surgery, there are “no room for mistakes.” People think, “I have invested a lot in surgery, I better not get off track ever again.” But holding yourself to such high standards, putting that kind of pressure on yourself, can actually backfire because it is self-defeating and leads to discouragement. Humans are not perfect, and neither is life. Even after surgery, you will still have good days and bad days, holidays and sick days, stressful days and vacations.

If you start the journey thinking “I cannot afford to fail,” then if things do go wrong, you are bound to chalk it up to “your fault” instead of examining what led to it.
Sometimes we spend so much energy beating ourselves up that we don’t see the complete picture, we don’t focus on the things that led to the lapse – some of which could well be out of our control.

For example, overeating could be the result of not drinking enough liquids or skipping meals, but we get too caught up thinking, “oh no, I’m back to my old ways” instead of back-tracking to see what led to it. Not exercising for a week or two could lead to a loss of motivation – but only if you had assumed in the first place that you were supposed to be perfect and not miss a single day.

Moral of the story? Success with weight loss isn’t defined by how many weeks, months, or years you can go without breaking down and indulging, overeating or not exercising. Rather, it is defined by how soon you can get back on track after a day, week, month, or even year of being off track. It is never too late to get back on track – ever. And the secret to getting back on track as soon as possible is having a curious, compassionate, non-judgmental attitude towards yourself. “It’s okay.” “I’m only human.” “What led to that?” “What can I do differently next time?” “What’s the lesson here?” This is the right way to talk to yourself, instead of “I’m so lazy” or “I failed” or “I’m back to my old ways.” Don’t forget about all of the pounds you lost before you start focusing on the pounds you gained.

Of course, all this is easier said than done. We humans are hard-wired to be our own worst critics. It is so much easier to offer hope and empathy to our friends than to ourselves! That’s precisely why you need the objective, non-judgmental perspective of your provider. You could be unnecessarily scolding yourself when all you needed to do was make some small changes to your meal or exercise routine. You could be avoiding a follow-up visit with your doctor or dietitian because you are thinking, “How can I face them after having gained this weight?” when in reality, you are the only one judging yourself.

Here’s another reason to stay in touch with your surgeon, dietitian and exercise physiologist:
• Your nutritional needs – calories, vitamins, etc. can change through the years after surgery based on your medical conditions, deficiencies, and general health status.
• Your exercise plan, too, can need alterations based on your fitness level.

It is difficult to try guessing these changes yourself. Regular appointments and blood tests make it so much easier to always have an accurate sense of your needs and to make it possible to update your diet and exercise plan at regular intervals. So, regular check-ins with your healthcare providers are extremely important for permanent weight loss success after bariatric surgery.

Remember, no one said that weight loss is supposed to be easy after surgery forever, or that you are expected to be 100% prefect with eating healthy and with exercise. It is still a journey with traffic jams and bumps in the road. Support makes that journey easier, whether it is from your family and friends or from your professional and compassionate healthcare providers.

Special Thanks to Narmin Virani RD for writing, Kayla Scally NP for editing, and Robin Mason NP for reviewing this blog.  

Please share these posts with anyone you know interested in losing weight with or without weight loss surgery.  Click here to learn more about the UMass Memorial Weight Center

These weekly blogs are general guidelines. These guidelines apply to patients who are cleared by a physician for the type of exercise described. Please contact your physician with any concerns or questions. Always report any symptoms associated with exercise, such as pain, irregular heartbeats, and dizziness or fainting, to your physician.

 

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