Alvin began working for Clarian Bariatrics in May 2008. His goal is to coach others through the process of changing their lifestyle for complete health and weight management through bariatric surgery. During his career he has worked at Riverview Hospital, Community Surgical Associates, Welborn Baptist Hospital and Purdue University. In addition, Alvin has earned two Bachelor of Science degrees from Purdue University in restaurant, hotel and institutional management and dietetics. He enjoys reading, cycling, cooking and is an avid Disney fan.Alvin began working for Clarian Bariatrics in May 2008. His goal is to coach others through the process of changing their lifestyle for complete health and weight management through bariatric surgery. During his career he has worked at Riverview Hospital, Community Surgical Associates, Welborn Baptist Hospital and Purdue University. In addition, Alvin has earned two Bachelor of Science degrees from Purdue University in restaurant, hotel and institutional management and dietetics. He enjoys reading, cycling, cooking and is an avid Disney fan.The Clarian Bariatrics' support group meeting for gastric band patients was held on Tuesday, August 18. Did you know that Clarian Bariatrics offers monthly support group for gastric lap band weight loss surgery patients on the third Tuesday of each month from 6 p.m. to 7p.m.? Please consider joining us at the next session.
The topic this month was "Why We Overeat?"
A few of the reasons we overeat are steeped misinformation and myth, but there are many with theories with scientific data to back it up. Some of the myths and truths include:
However, this is a very small list of reasons. Solutions to combat why we over eat include:
The topic this month was "Why We Overeat?"
A few of the reasons we overeat are steeped misinformation and myth, but there are many with theories with scientific data to back it up. Some of the myths and truths include:
- Emotional eating, which could include feeling like there is no hope or giving up.
- Foods affecting neurotransmitters in the brain including sensory cues like vision, smell and taste.
- Personal and family history and traditions.
- The ability to get food 24/7.
- Making our life "chaotic" through various commitments.
- Even the theory that the food and restaurant industry are manipulating fat, sugar, and salt content.
However, this is a very small list of reasons. Solutions to combat why we over eat include:
- Learning fact from myth.
- Creating structure in your life.
- Practice eating right by picking foods that satisfy not stimulate.
- Anticipate events in your life and seize control.
- Stop destructive thoughts as they happen not afterwards.
- Listen to yourself!
Below is the rest of patient Bob Cole's personal experience at this year's Indiana State Fair.
Corn!
Again, all carbs and not the best for you. But, if you can tolerate it, head up to the Indiana Popcorn Producers booth on the north side of the fair. They’re giving away 1-cup samples of fresh Indiana popcorn, hot air popped. Ask for it without salt. It’s a small serving, tasty, and absolutely FREE!
Now, I’m not suggesting you’re going to head out and eat ALL this stuff for lunch! I spent ALL day, two meals trying it out. Plus, I split it with my family so I got all the tastes I wanted without trying to eat it all myself.
And, my pedometer said I got in over seven miles of additional walking that day (not counting the two mile morning walk). Enough to easily walk off the delicious State Fair food!
Corn!
- I know, it’s a starchy vegetable and high in the carbs. But, the State Fair wouldn’t be right to me without an ear of wonderful roasted Indiana Sweet Corn.
- If you can tolerate it, try one out WITHOUT THE BUTTER. A good ear of corn doesn’t need butter, anyway! They’re happy to prepare one that way for you. No salt too, of course. A Hoosier delicacy!
- Now, this is where you can enjoy the fair AND get your health in, too. And, the booths are all right next to each other, too!
- Chicken on a stick - Low fat, tasty, but personally, not what I come to the fair for
- Pork - Head to the Indiana Pork booth and try the boneless pork chop sandwich. Then throw away the bread. Delicious, lean protein and good for you! It’s a six oz portion though.
- Lamb on a stick - Also reasonably low fat and very tasty. At $6 for a small kabob, a little pricy. Only about 4 oz.
- Beef! - Check out the grilled sirloin steak at the Cattle booth. Not the lowest fat cut of meat at the fair. But, really delicious. A big portion, 6-8 oz.
Again, all carbs and not the best for you. But, if you can tolerate it, head up to the Indiana Popcorn Producers booth on the north side of the fair. They’re giving away 1-cup samples of fresh Indiana popcorn, hot air popped. Ask for it without salt. It’s a small serving, tasty, and absolutely FREE!
Now, I’m not suggesting you’re going to head out and eat ALL this stuff for lunch! I spent ALL day, two meals trying it out. Plus, I split it with my family so I got all the tastes I wanted without trying to eat it all myself.
And, my pedometer said I got in over seven miles of additional walking that day (not counting the two mile morning walk). Enough to easily walk off the delicious State Fair food!
The following was written by Bob Cole, one of our patients. I will post his great recap of time spent at the Indiana State Fair in two parts. Have you been out to the Fair yet? There are plenty of healthier options to eat and you'll exercise more than you realize!
"I was fortunate enough to enjoy an entire day at the Indiana State Fair last Saturday, meeting my personal goal of seeing absolutely everything there was to see, visiting every corner of the fair, and doing it all in just one day.
I started out by joining the our First Lady, Cheri Daniels, Erin Light and the rest of our Clarian Bariatrics team in the two-mile Heartland for Health Walk. It was a very pleasant walk at that time of the morning and I talked to a lot of other folks who are interested in getting themselves fit. Thanks to Mrs. Daniels and Clarian Cardiovascular for sponsoring the walk, and to Erin and the rest of Clarian Bariatrics for organizing the team.
But, I thought I’d share some reviews of ways to enjoy the fair WITHOUT drowning yourself in fried foods and sugar. As you know, being a post-bariatric patient, I don’t think my body would enjoy that deep-fried Snickers bar too much anymore! In fact, you would be happy to know that just the smell of an elephant ear made me queasy! What a change from a year ago!
Of course, my recommendations here depend on where you are in your post-surgery journey, and what foods you can personally tolerate. Don’t take chances. Talk to one of the dieticians if you have questions. I am almost 18 months post-surgery so I’m in a pretty good place.
Veggies!
"I was fortunate enough to enjoy an entire day at the Indiana State Fair last Saturday, meeting my personal goal of seeing absolutely everything there was to see, visiting every corner of the fair, and doing it all in just one day.
I started out by joining the our First Lady, Cheri Daniels, Erin Light and the rest of our Clarian Bariatrics team in the two-mile Heartland for Health Walk. It was a very pleasant walk at that time of the morning and I talked to a lot of other folks who are interested in getting themselves fit. Thanks to Mrs. Daniels and Clarian Cardiovascular for sponsoring the walk, and to Erin and the rest of Clarian Bariatrics for organizing the team.
But, I thought I’d share some reviews of ways to enjoy the fair WITHOUT drowning yourself in fried foods and sugar. As you know, being a post-bariatric patient, I don’t think my body would enjoy that deep-fried Snickers bar too much anymore! In fact, you would be happy to know that just the smell of an elephant ear made me queasy! What a change from a year ago!
Of course, my recommendations here depend on where you are in your post-surgery journey, and what foods you can personally tolerate. Don’t take chances. Talk to one of the dieticians if you have questions. I am almost 18 months post-surgery so I’m in a pretty good place.
Veggies!
- I know we’re all supposed to be getting our protein. But, there are some pretty good veggies at the fair! Just WALK PAST that Deep Fried Veggie booth on the main street!
- Ya Ya’s Tomato Balls - They’ve gotten a lot of press this year. Sounded tasty to me, so I checked them out. Breaded and deep-fried! DEFINITELY A PASS!
- Just past the deep-fried veggie booth you’ll find a sign for “Tomato Bob’s”. They serve very crisp and tasty veggie kabobs. But, at $3 a pop, a little expensive.
- However, that same booth has real nice salads, too. Look into it. Low fat and sugar-free dressings available.
Did you know that blueberries contain phytochemical’s anthocyanin, proanthocyanidins, flavonols and tannins, which inhibit mechanisms of cancer cell development and inflammation? Other studies have found that blueberry consumption lowered blood cholesterol and total 
blood lipid levels, which may decrease risk of heart disease.
Half a cup or 3 ½ ounces of blueberries contain 60 calories, a very small amount of fat and protein, 2.4 grams dietary fiber, and 10 mg vitamin C. Choose fresh blueberries over blueberry juice – juice is a concentrated sweet that may cause dumping in Roux-en-Y patients. Also, avoid the snack foods that contain blueberries (muffins, pie, etc) since those foods are high in calories.
Blueberries may not be a part of your meal plan depending on where you are at in the process of weight management. If you decide to incorporate fruit into your meal plan limit to ½ cup a day and discuss any questions or concerns with a dietitian.
blood lipid levels, which may decrease risk of heart disease. Half a cup or 3 ½ ounces of blueberries contain 60 calories, a very small amount of fat and protein, 2.4 grams dietary fiber, and 10 mg vitamin C. Choose fresh blueberries over blueberry juice – juice is a concentrated sweet that may cause dumping in Roux-en-Y patients. Also, avoid the snack foods that contain blueberries (muffins, pie, etc) since those foods are high in calories.
Blueberries may not be a part of your meal plan depending on where you are at in the process of weight management. If you decide to incorporate fruit into your meal plan limit to ½ cup a day and discuss any questions or concerns with a dietitian.
Practice positive self talk every day. Repeat the following affirmations everyday to promote long-term changes.
Define your boundaries by:
- I deserve to be happy and successful
- I have the power to change myself
- I can make my own choices and decisions
- I am free to choose to live as I wish and to give priority to my desires
- I can choose happiness whenever I wish no matter what my circumstances
- I am flexible and open to change in every aspect of my life
- It is enough to have done my best
- I deserve to be loved
- I will take responsibility for my actions
Define your boundaries by:
- Be assertive not pushy or nasty!
- Don't accept others putting you down; tell others you don't agree and that they are wrong about you!
- Be easier on yourself, and learn to forgive yourself.
- Do something to help others. You will feel happier and more satisfied.
- Talk to yourself in a positive way - if you hear that negative inner voice cut it off and disagree with it!
- Control what you can control!
The Clarian Bariatrics support group meeting for gastric lap band patients was held on Wednesday, May 20. This month's topic was "Developing a Positive Self Message."
Most self talk is negative. Negative self-talk may cause you to doubt yourself, create uncertainty, and perpetuate poor self esteem and poor self confidence. Since self-talk is mostly negative, this will work against you in the long run.
Change your self talk to positive self message. Changing to positive self-talk will give you a new message to help you overcome long-time fears and obstacles. You will become more confident around others and feel more in control. All you have to do is learn to talk to yourself and with a positive self message!
Create awareness of what and how you talk to yourself. Write down when you are self critical, negative, and judgmental. This will increase awareness when you becoming demeaning to yourself. Replace negative thoughts with positive and flexible messages.
Focus on what you can control!
Write down all negative self-messages and reword to make into positive self-message. For example - Negative self-message – “I will never be able to lose weight and keep the weight off.” Positive self-message – “I will take one day at a time and overcome difficulties the best that I can.”
Most self talk is negative. Negative self-talk may cause you to doubt yourself, create uncertainty, and perpetuate poor self esteem and poor self confidence. Since self-talk is mostly negative, this will work against you in the long run.
Change your self talk to positive self message. Changing to positive self-talk will give you a new message to help you overcome long-time fears and obstacles. You will become more confident around others and feel more in control. All you have to do is learn to talk to yourself and with a positive self message!
Create awareness of what and how you talk to yourself. Write down when you are self critical, negative, and judgmental. This will increase awareness when you becoming demeaning to yourself. Replace negative thoughts with positive and flexible messages.
Focus on what you can control!
Write down all negative self-messages and reword to make into positive self-message. For example - Negative self-message – “I will never be able to lose weight and keep the weight off.” Positive self-message – “I will take one day at a time and overcome difficulties the best that I can.”
Earlier in the week I discussed the request from many patients for cookbooks that could be used by weight loss surgery patients. Even though there is not specific cookbook for bariatric surgery, these include some great recipes.
The Art of Simple Food: Notes, Lessons, and Recipes from a Delicious Revolution. (ISBN-10: 0307336794 ISBN-13: 978-0307336798)
The author, Alice Waters, is credited with the organic food movement. This doesn’t mean you have to use 100 percent organic foods but her description and simplistic approach to cooking is the best attribute of this cookbook.
Martha Stewart's Cooking School: Lessons and Recipes for the Home Cook (ISBN-10: 0307396444 ISBN-13: 978-0307396440)
We all know Martha Stewart. This cookbook is visually one of the best books I have seen. The use of photographs to demonstrate technique is fantastic. In addition her explanation of basic kitchen tools – pots, pans, spices, herbs, etc is for anyone with no or very little culinary knowledge.
I'm Just Here for the Food: Version 2.0
(ISBN-10: 158479559X, ISBN-13: 978-1584795599)
Alton Brown, host of “Good Eats” on the Food Network has put into writing his special brand in the explanation of basic cooking techniques.
Don't forget to check out the recipes on this blog either!
One question that we (dietitian’s) hear at Clarian Bariatrics often is, “Give me recipes for the liver reduction diet or for post-operative weight loss surgery life.”
We often reply there are no exact cookbooks or recipes specifically written for the protein based diet that you must follow. You can adapt any recipe to meet the low carbohydrate-protein based diet guidelines.
Understanding basic cooking techniques, ingredient interaction, having the right equipment or utensil and most importantly not being afraid to experiment are keys for long term weight management.
This blog is full of recipes by dieticians and former patients that can help you add variety to your diet. Simply type in "Recipe" on the "Search this Blog" function to the right to view them all. Later in the week, I will post some cookbook recommendations!
We often reply there are no exact cookbooks or recipes specifically written for the protein based diet that you must follow. You can adapt any recipe to meet the low carbohydrate-protein based diet guidelines.
Understanding basic cooking techniques, ingredient interaction, having the right equipment or utensil and most importantly not being afraid to experiment are keys for long term weight management.
This blog is full of recipes by dieticians and former patients that can help you add variety to your diet. Simply type in "Recipe" on the "Search this Blog" function to the right to view them all. Later in the week, I will post some cookbook recommendations!
Your goal is to have all aspects of life IN your life in the long run. You will be required to determine when a situation must be OUT of your life completely or must be AVOIDED. There is no right or wrong choice. Depending on the scenario, your goals, and state of mind, will determine the proper action. Most will be placed in the AVOID box moving back and forth to the IN or OUT box.
A few Examples of IN, OUT and AVOID are:
To help you with the process of deciding what is IN, OUT, or AVOID you must define your boundaries by communicating your expectations to your spouse, significant other, family members and coworkers. In addition, define your boundaries by:
Clarian Bariatrics offers supports group meetings the first and third Wednesday of each month and the fourth Friday of each month. In addition, we offer a gastric band patient only support group the third Wednesday of every month.
A few Examples of IN, OUT and AVOID are:
- IN – Daily physical activity, food journaling, 60-80 grams of protein, at least 64 ounces of water, vitamin therapy, follow-up appointments at Clarian Bariatrics.
- OUT – Carbonated beverages, dining out everyday
- AVOID – Work related eating functions, birthday events, meeting friends at the favorite gathering spot.
To help you with the process of deciding what is IN, OUT, or AVOID you must define your boundaries by communicating your expectations to your spouse, significant other, family members and coworkers. In addition, define your boundaries by:
- Not letting others put you down; tell others you don't agree and that they are wrong about you!
- Being easier on yourself, and learning to forgive and being kinder to yourself.
- Doing something to help others. You will feel happier and more satisfied. You will respect yourself more.
- Talk to yourself in a positive way - if you hear that negative inner voice cut it off and disagree with it!
Clarian Bariatrics offers supports group meetings the first and third Wednesday of each month and the fourth Friday of each month. In addition, we offer a gastric band patient only support group the third Wednesday of every month.
As you can see from Traci's blog post below, the Clarian Bariatric Support group meeting topic for March “Your Environment – The Toxic World Around Us.”
A recent report from Good Morning America said, “The average American is exposed to over 3,000 commercial messages each day.” It was agreed that this number could be more or less depending on where you live and that most of the advertising messages are for food, and beverages. We counted 10 logos or symbols for various products or companies in less than 10 seconds.
Marketing in the U.S. is a multi-billion dollar industry. Product placement in movies and grocery stores, billboards, internet ads, and 30 second Super Bowl ads that cost millions, demonstrates the effectiveness of marketing.
Each patient was challenged to count the number of times they were exposed to some type of food related marketing in the next 24 hours. This included restaurants you drive by, billboards, television commercials, product placement in your favorite movie or TV show, food discussion at work or at home, and anything that advertises food.
One key long term goal is to control the environment around you. The reality is dining out, the Food Network, food commercials, holiday’s, family events, etc. are here to stay. You must determine if these events are going to be IN your environment, OUT of your environment, or something you must AVOID.
A recent report from Good Morning America said, “The average American is exposed to over 3,000 commercial messages each day.” It was agreed that this number could be more or less depending on where you live and that most of the advertising messages are for food, and beverages. We counted 10 logos or symbols for various products or companies in less than 10 seconds.
Marketing in the U.S. is a multi-billion dollar industry. Product placement in movies and grocery stores, billboards, internet ads, and 30 second Super Bowl ads that cost millions, demonstrates the effectiveness of marketing.
Each patient was challenged to count the number of times they were exposed to some type of food related marketing in the next 24 hours. This included restaurants you drive by, billboards, television commercials, product placement in your favorite movie or TV show, food discussion at work or at home, and anything that advertises food.
IN OUT AVOID
One key long term goal is to control the environment around you. The reality is dining out, the Food Network, food commercials, holiday’s, family events, etc. are here to stay. You must determine if these events are going to be IN your environment, OUT of your environment, or something you must AVOID.
Here are few more recipe modification tips that were discussed at last month's gastric band support group. Please do not hesitate to contact me if you have additional questions about nutrition after weight loss surgery or bariatric weight loss surgery.
EGGS: The purpose of eggs in a recipe is to provide leavening, color, texture, flavor and richness, bind ingredients together and act as a thickener. Substitute two egg whites or 1/4 cup egg substitute for each whole egg.
SALT: The purpose of salt in recipes is preservation, texture aid, binder, color, fermentation control and flavor enhancer. Great substitutes for salt are seasonings which are ingredients added to food to intensify or improve its flavor. Most commonly used seasonings herbs, such as oregano, rosemary and basil; the fragrant leaves of any of various annual or perennial plants and do not have woody stems and spices, such as cinnamon, nutmeg, cloves and allspice; the is pungent or aromatic seasonings obtained from the bark, buds, fruit, roots, seeds or stems of various plants and trees. You should also consider using various vinegars and peppers.
SUGAR: The purpose of sugar in recipes is complex and is difficult to replace. Sugar adds volume, tenderness, texture, acts as a preservative, golden or caramel color and flavor. So a substitution for sugar is difficult but most recipes sugar can be reduced by at least one-third without changing the taste and texture. A great alternative is a use sugar substitute. If possible add sugar substitutes after cooking process – heat may cause a bitter after taste. Your ultimate goal is to avoid the foods that require sugar, such as cakes, pies, cookies, etc.
Clarian Bariatrics will provide monthly support group for gastric band weight loss surgery patients on the third Wednesday of each month from 6 p.m. to 7:30 p.m. Patients may bring family and/or support members to the meetings. The next meeting is Wednesday, March 18 at our Indianapolis location.
EGGS: The purpose of eggs in a recipe is to provide leavening, color, texture, flavor and richness, bind ingredients together and act as a thickener. Substitute two egg whites or 1/4 cup egg substitute for each whole egg.
SALT: The purpose of salt in recipes is preservation, texture aid, binder, color, fermentation control and flavor enhancer. Great substitutes for salt are seasonings which are ingredients added to food to intensify or improve its flavor. Most commonly used seasonings herbs, such as oregano, rosemary and basil; the fragrant leaves of any of various annual or perennial plants and do not have woody stems and spices, such as cinnamon, nutmeg, cloves and allspice; the is pungent or aromatic seasonings obtained from the bark, buds, fruit, roots, seeds or stems of various plants and trees. You should also consider using various vinegars and peppers.
SUGAR: The purpose of sugar in recipes is complex and is difficult to replace. Sugar adds volume, tenderness, texture, acts as a preservative, golden or caramel color and flavor. So a substitution for sugar is difficult but most recipes sugar can be reduced by at least one-third without changing the taste and texture. A great alternative is a use sugar substitute. If possible add sugar substitutes after cooking process – heat may cause a bitter after taste. Your ultimate goal is to avoid the foods that require sugar, such as cakes, pies, cookies, etc.
Clarian Bariatrics will provide monthly support group for gastric band weight loss surgery patients on the third Wednesday of each month from 6 p.m. to 7:30 p.m. Patients may bring family and/or support members to the meetings. The next meeting is Wednesday, March 18 at our Indianapolis location.
Clarian Bariatrics held a support group meeting for gastric band patients was on Wednesday, February 18. This month's topic was recipe modification.
The goal of recipe modifications are to reduce calories, fat content, added sugar content and sodium content while maintaining flavor, texture, and appearance.
Making small changes such as reducing, removing or using a substitute ingredient or changing the cooking methods will result big changes. Most changes focus on reduction fat or oil, sugar, and salt but may not reduced calories. Here are a few examples:
A. Fat and oils in recipes provide leavening ability, texture, structure, color, and flavor. A few fat substitutions are:
Look for a few more tips early next week!
The goal of recipe modifications are to reduce calories, fat content, added sugar content and sodium content while maintaining flavor, texture, and appearance.
Making small changes such as reducing, removing or using a substitute ingredient or changing the cooking methods will result big changes. Most changes focus on reduction fat or oil, sugar, and salt but may not reduced calories. Here are a few examples:
A. Fat and oils in recipes provide leavening ability, texture, structure, color, and flavor. A few fat substitutions are:
- One Whole Egg = Two egg whites or 1/4 cup egg substitute (such as Egg Beaters)
- Light Cream = Combine equal parts 1% milk and evaporated skim milk
- Whipped Cream = evaporated skim milk (note: the milk and the beaters must be very cold, but not frozen, before whipping).
- 1 cup Oil = 1 cup Pureed Prunes or Applesauce
Look for a few more tips early next week!
The following blog post was written by my colleague, Jill Beadles, who works with one of Clarian Health's CPAP Education Centers. She will occassionally be submitting posts as a way to educated our weight loss surgery patients on common sleep disorders and other causes of obesity.
Obstructive Sleep Apnea (OSA) is a very serious health condition that affects millions of Americans. OSA occurs when the airway becomes obstructed during sleep. These obstructions can cause a person's heart rate to vary more than usual in sleep, blood oxygen levels to drop and cause severe side effects while asleep and during waking hours if left untreated.
The most common and effective treatment for OSA is Continuous Positive Airway Pressure (CPAP). If a patient is diagnosed with OSA and the treatment path he or she chooses to take includes CPAP, it is extremely important to continue the therapy until re-evaluated by a physician. Some patients will wear CPAP to keep their airway open at night for the rest of their lives. Others may find that after significant amounts of weight loss, they may not need the CPAP machine anymore. Either way, the decision to stop or continue to wear CPAP, is one that you and your physician need to make together.
Patients that have had, or plan to have bariatric surgery, may be prescribed CPAP therapy as obesity is a corollary to OSA. This is a good thing! It is going to help keep you healthy, help you sleep better, and aid you through your weight loss. Just remember, that right after surgery when you start losing weight to continue to wear your CPAP. You are probably feeling better, having more energy, and may even think you don't need the CPAP. This may not be true!
You may need to be re-evaluated but the adverse side effects from not wearing your CPAP can still be happening even though you are starting to feel better. Continue to wear your mask and CPAP machine until you talk with your bariatric physician or your family physician and they decide it is safe to discontinue treatment.
If you need a new mask, your machine is acting up, or you think the pressure needs to be adjusted, help is right around the corner. The Clarian CPAP Education Centers are located around the city and are staffed by respiratory therapists that can re-fit your mask, answer questions, and get your therapy back on track.
Clarian currently has CPAP Education Centers at the following locations; IU Hospital, Methodist Hospital, Clarian West, Clarian North, Bedford Regional Medical Center, Clarian Arnett, and La Porte Hospital. We can help you with all of this regardless of your current home care provider. Please feel free to call 317-962-2433 if you need an appointment at any of these locations.
Obstructive Sleep Apnea (OSA) is a very serious health condition that affects millions of Americans. OSA occurs when the airway becomes obstructed during sleep. These obstructions can cause a person's heart rate to vary more than usual in sleep, blood oxygen levels to drop and cause severe side effects while asleep and during waking hours if left untreated.
The most common and effective treatment for OSA is Continuous Positive Airway Pressure (CPAP). If a patient is diagnosed with OSA and the treatment path he or she chooses to take includes CPAP, it is extremely important to continue the therapy until re-evaluated by a physician. Some patients will wear CPAP to keep their airway open at night for the rest of their lives. Others may find that after significant amounts of weight loss, they may not need the CPAP machine anymore. Either way, the decision to stop or continue to wear CPAP, is one that you and your physician need to make together.
Patients that have had, or plan to have bariatric surgery, may be prescribed CPAP therapy as obesity is a corollary to OSA. This is a good thing! It is going to help keep you healthy, help you sleep better, and aid you through your weight loss. Just remember, that right after surgery when you start losing weight to continue to wear your CPAP. You are probably feeling better, having more energy, and may even think you don't need the CPAP. This may not be true!
You may need to be re-evaluated but the adverse side effects from not wearing your CPAP can still be happening even though you are starting to feel better. Continue to wear your mask and CPAP machine until you talk with your bariatric physician or your family physician and they decide it is safe to discontinue treatment.
If you need a new mask, your machine is acting up, or you think the pressure needs to be adjusted, help is right around the corner. The Clarian CPAP Education Centers are located around the city and are staffed by respiratory therapists that can re-fit your mask, answer questions, and get your therapy back on track.
Clarian currently has CPAP Education Centers at the following locations; IU Hospital, Methodist Hospital, Clarian West, Clarian North, Bedford Regional Medical Center, Clarian Arnett, and La Porte Hospital. We can help you with all of this regardless of your current home care provider. Please feel free to call 317-962-2433 if you need an appointment at any of these locations.
There are several types of protein used in supplements. The most common types of protein used are milk based, soy based and collagen based.
Milk Based Protein
There are two types: whey and casein type.
There are two types of soy based protein: isolate and concentrate.
Collagen Based Protein is incomplete protein missing the essential amino acid, tryptophan. Commonly used protein supplements called “protein shots,” brand names New Whey Protein, Profect, etc. This type of supplement should be avoided by weight loss surgery patients. It is only useful if essential amino acids are obtained from diet, but patients require higher levels of protein for positive nitrogen balance.
Clarian Bariatrics will provide a monthly support group for Gastric Band weight loss surgery patients on the third Wednesday of each month from 6:00 to 7:30 p.m. Patients may bring family and/or support members to the meetings.
Milk Based Protein
There are two types: whey and casein type.
- Whey proteins are soluble which allows faster stomach emptying. There are three types of whey protein: isolates-90-98% protein by weight, concentrates-29-89% protein by weight, less expensive and better tasting and hydrolysates-predigested, easily absorbed, expensive.
- Casein Protein, which clots in acidic environment, delays stomach emptying but results in slower release of protein. This is the best source for patients with lactose intolerance due to low lactose content.
There are two types of soy based protein: isolate and concentrate.
- Protein Isolate is a refined, or purified, form of soy protein with a minimum protein content of 90%. It contains very little non-protein components, fats and carbohydrates.
- Soy Protein Concentrate is about 70% soy protein. Soybeans are considered a complete protein source because all the essential amino acids are provided.
Collagen Based Protein is incomplete protein missing the essential amino acid, tryptophan. Commonly used protein supplements called “protein shots,” brand names New Whey Protein, Profect, etc. This type of supplement should be avoided by weight loss surgery patients. It is only useful if essential amino acids are obtained from diet, but patients require higher levels of protein for positive nitrogen balance.
Clarian Bariatrics will provide a monthly support group for Gastric Band weight loss surgery patients on the third Wednesday of each month from 6:00 to 7:30 p.m. Patients may bring family and/or support members to the meetings.
The Clarian Bariatric's support group meeting for gastric lap band patients was on Wednesday, January 21. This month's topic was protein. We discussed why it was a good food source, an explanation of why protein is important, the best protein source in supplements, how much do you need and can you eat too much protein.
Proteins in our diet are made up of building blocks called amino acids. There are 20 amino acids. Ten are “essential” meaning they cannot be made by the body and must come from our diet. There also 10 non-essential amino acids, which can be created by the body.
These amino acids are used by the body to make specific proteins such as enzymes, hormones, skin, hair, muscles and transport protein, etc. Every function in the body requires some type of protein. Animal based foods are the best food source and are called “Good Quality Protein” because they provide all essential amino acids.
Plant based foods typically lack one or more essential amino acids therefore are not considered good quality protein. Therefore, the best way to obtain protein from diet are from all types of meat, cheese (2 percent, low fat or fat free) or egg and adding in plant based foods.
Look for more tips later in the week, and feel free to ask me any questions you have related to bariatric weight loss, weight loss surgery or nutrition after lap band surgery.
Many patients will ask, “How much will I lose with the gastric band?” The amount of weight that you will lose is dependent on multiple factors. You will need to be committed to your new lifestyle. Making good food choices with emphasis on protein foods (lean meats, dairy products, eggs, etc) and vegetables over starchy foods (breads, pasta, rice, etc), snack foods and any foods that are liquid or liquid when swallowed.
Daily activity is critical for both short and long term weight management. Following all of the rules related to gastric band placement, e.g. no liquids with meals, eating slowly, chewing at least 20-25 times before swallowing, etc.
Lap Band System reports 61 percent of patients lost at least 25 percent of excess body weight, 52 percent of patients lost at least 33 percent of excess body weight, and 32 percent lost greater than 50 percent of excess body weight.
In addition, two percent of patients gained some weight and five percent maintained their weight. The average weight loss will be about one to two pounds per week depending your food choices, activity level and ability to follow the 10 rules for gastric band patients.
Do you have an additional question about Lap Band surgery, other types of weight loss surgery or bariatric weight loss in general? Then feel free to ask me a question by clicking on comment below.
Happy New Year! I just wanted to follow-up with the second part of my "Solutions for Maladaptive Eating" post from last week. Please do not hesitate to contact me if you have any questions about bariatric weight loss or after weight loss surgery maintenance.
Solutions:
How to prevent maladaptive eating?
The lap band is a tool. It will help adapt to new methods of eating but you must make changes and practice these skills at every meal:
Follow all of rules no matter how inconvenient. Practicing positive behaviors and changing the old behaviors is the only way to have success with weight loss surgery regardless at which Indiana hospitals the procedure performed.
Solutions:
How to prevent maladaptive eating?
- Have a routine!
- “Don’t buy it” and “Don’t bring it in the house.”
- Healthy eating is for the entire family– variety or foods from all food groups(long term) and potion control, avoiding deep fried foods, eliminating or changing the type of foods you eat.
- Don’t eat fast – best way to prevent over stuffing the pouch.
- Chew!
The lap band is a tool. It will help adapt to new methods of eating but you must make changes and practice these skills at every meal:
- Create a routine
- Slow down and chew.
- Portion control – limit to 1 to 1 ½ cups per meal
- Always have a food source with fiber at every meal. e.g. vegetables at lunch and dinner and fruit at breakfast.
- Understanding that a little hunger is okay. If you are “starving,” ask yourself if you are following all of the rules?! Develop a new relationship with food.
Follow all of rules no matter how inconvenient. Practicing positive behaviors and changing the old behaviors is the only way to have success with weight loss surgery regardless at which Indiana hospitals the procedure performed.
I hope that everyone had a Merry Christmas, and enjoyed some time with friends and loved ones. Last week, I posted some tips on managing maladaptive eating that was discussed at the December gastric band support group. I wanted to expand on that posting with some solutions for maladaptive eating, which are beneficial to weight loss surgery patients.
Changing maladaptive eating behavior requires a commitment. Some solutions to the most common types of maladaptive eating are:
1. Relying only on gastric band adjustments for fullness.
Solutions:
2. Eating too much!
Solutions:
3. Making inappropriate food choices or eating the wrong type of food, examples are:
It is sometimes difficult for bariatric weight loss surgery patients to adjust to this new lifestyle and way of eating, but it is absolutely essential to control maladaptive eating to have long term success. Look for part two tomorrow!
Changing maladaptive eating behavior requires a commitment. Some solutions to the most common types of maladaptive eating are:
1. Relying only on gastric band adjustments for fullness.
Solutions:
- Goal: Limit to three meals per day – avoid snacking
- Limit to 1 to 1 ½ cups of food at meals – 4 ounces of protein and ½ cup fruit at breakfast, and 4 ounces of protein and 1 cup of vegetables at lunch and dinner.
- No liquids 30 minutes before, eat for 30 minutes, and no liquids for 60 minutes afterward.
2. Eating too much!
Solutions:
- Limit to 1 to 1 ½ cups of food at meals – 4 ounces of protein and ½ cup fruit a breakfast, and 4 ounces of protein and 1 cup of vegetables at lunch and dinner.
- Understanding and accepting a little hunger is okay.
- Understanding and accepting that stomach growling is okay.
3. Making inappropriate food choices or eating the wrong type of food, examples are:
- Choosing foods that are liquid or liquid when swallowed, e.g. ice cream, shakes, sweets.
- Using the choking as an "EXCUSE" to eat sweets and ice cream.
- Using children and family members as reasons for having ice cream, shakes, and sweets.
- Choosing a specific food due to the texture of food to accommodate eating.
It is sometimes difficult for bariatric weight loss surgery patients to adjust to this new lifestyle and way of eating, but it is absolutely essential to control maladaptive eating to have long term success. Look for part two tomorrow!
Yesterday, I posted some information from our gastric bypass surgery support group from December. We had an important discussion on maladaptive eating, which should be controlled in order for weight loss surgery success. Below are a few tips to overcome one of the many causes of obesity:
Band adjustments are key for fullness but just as important is making good food choices and understanding a little hunger is okay and part of weight management. Three potential zones for fullness:
1. Yellow Zone – Gastric band is too loose. You are hungry, both portion and total meal size are getting larger, small meals do not satisfy you, and weight loss is below expected level.
2. Green Zone – Ideal area in which small meals are satisfying and provide fullness. Vomiting and heartburn are rare. Staying in this zone requires you to follow dietary guidelines and rules.
3. Red Zone – Gastric band is too tight and may cause difficulty with eating, swallowing, vomiting, heartburn, and food choices are more liquid e.g. ice cream, shakes, candy, chocolate bars, rather than solid.
Key reasons that lead to maladaptive eating:
1. Relying only on adjustments for fullness
2. Eating too much resulting in discomfort
3. Making inappropriate food choices or eating the wrong type of food,
4. Improperly chewing foods resulting in choking or vomiting
5. Want versus Need
Remember, Clarian Bariatrics will provide monthly support group for gastric bypass weight loss surgery patients on the third Wednesday of each month from 6:00 to 7:30 p.m. Patients may bring family and/or support members to the meetings.
Band adjustments are key for fullness but just as important is making good food choices and understanding a little hunger is okay and part of weight management. Three potential zones for fullness:
1. Yellow Zone – Gastric band is too loose. You are hungry, both portion and total meal size are getting larger, small meals do not satisfy you, and weight loss is below expected level.
2. Green Zone – Ideal area in which small meals are satisfying and provide fullness. Vomiting and heartburn are rare. Staying in this zone requires you to follow dietary guidelines and rules.
3. Red Zone – Gastric band is too tight and may cause difficulty with eating, swallowing, vomiting, heartburn, and food choices are more liquid e.g. ice cream, shakes, candy, chocolate bars, rather than solid.
Key reasons that lead to maladaptive eating:
1. Relying only on adjustments for fullness
2. Eating too much resulting in discomfort
3. Making inappropriate food choices or eating the wrong type of food,
4. Improperly chewing foods resulting in choking or vomiting
5. Want versus Need
Remember, Clarian Bariatrics will provide monthly support group for gastric bypass weight loss surgery patients on the third Wednesday of each month from 6:00 to 7:30 p.m. Patients may bring family and/or support members to the meetings.
Powered by Compendium Blogware