The next few weeks will be peppered with discussions about the feelings that patients, families, and our culture have about bariatric surgery. Embarrassment over having the procedure is still rampant in a lot of patients, but this article by Shari Roan of the Los Angeles Times indicates that this uncomfortable feeling, although natural, is completely unnecessary.  With some new, less-invasive procedures becoming available, weight loss surgery is turning into a trendy choice for many patients who are simply overweight (not even obese!!!) and wanting a healthy change. It seems that the stigma is really getting worn out!

Here's a snippet from the article:

A Bariatric Boom? Advances in Weight-Loss Surgery Could Soon Target Even Slightly Overweight Patients

After spending most of her 48 years trying, and failing, to slim down, Veronica Mahaffey was still 50 pounds overweight - not morbidly obese by a long shot, but still far from the size she wanted.

Worried about her health, she called a San Diego weight-loss surgery clinic last spring and asked for help.

She was told no.

At 185 pounds and with a body mass index of 28, the Ramona, Calif., mother of four was not heavy enough to meet the medical guidelines - or insurance company qualifications - for weight-loss surgery. Those standards require a BMI of 40 or higher, or 35 or higher for people with a medical problem such as diabetes or sleep apnea.

"People would say, 'You look fine.' But I couldn't get into normal-size clothing.," Mahaffey said. "And then I was told I was going to have to gain weight to qualify for surgery. That doesn't make sense."

Ultimately, she got the surgery through a clinical trial for one of several new weight-loss procedures. Now 10 pounds from her goal weight of 135, she says she looks better, feels better and is confident she'll no longer have to fight her weight.

Her experience could soon be shared by thousands of Americans.

Usually reserved for the most obese people, weight-loss surgery is unlikely to be a last-ditch option much longer. Technological advancements are turning it into a one-hour, incisionless procedure - making it more attractive to moderately overweight adults, obese teenagers; and people with difficult-to-control diabetes.

Several new procedures are in human clinical trials.

 I recently read an article from USA Today about making your home a healthier environment for all and wanted to share some ideas!

1.       Think low-fat – Buy 1 % or skim milk, reduced fat cheeses, 2% cottage cheese, 2% shredded cheeses, etc.

2.       Make substitutions – Use lower-fat ground turkey instead of high-fat ground beef in tacos, meat loaf, chili, and other dishes.

3.       Push veggies – Place a bowl of vegetables such as broccoli, snap peas, cucumbers or carrot sticks on the table before meals.  Cut veggies into fun shapes; use crinkle cutters, etc.

4.       Shop alone – Go to the grocery alone so your kids don’t try to sway you to buy extra junk food!  Pack their lunches for school so they are making healthier choices.

5.       Buy wisely – Purchase low-fat yogurt with berries, sugar-free/fat-free snacks.  Get rid of most high-calorie, low-nutrition candies, soda, cookies, and chips.

6.       Make your own treats – Use whole grain cereals with nuts or sesame seeds.  Add carrots, apples, celery with lower sugar peanut butter, and hummus.

7.       Let kids help – Get your kids involved in making snacks and meals.  Find kid-friendly recipes and have your kids help you prepare the meals.  Teach your children basic kitchen survival skills along with how to make healthier choices!

8.       Tempt your kids to drink more water by using fun water bottles and adding sugar-free flavorings. (Crystal Light, etc.)

Enjoy a healthy spring with your kids!

It's been a week of articles about self-healing. Whether you're making the big choice to undergo bariatric surgery, trying to lose weight before weight loss surgery, or taking care of yourself post-op, you're making a commitment to healing yourself.  Sometimes, though, that commitment is tough to make. We get frustrated with ourselves over little slips, and there's a temptation to give in--to let ourselves go, to not fight it anymore.

So today, I thought we should focus on motivation. Namely, what is it, and how do we keep it going?

Paige Waehner, one of the exercise gurus at About.com (which reviews medical articles through their Medical Review Board, by the way) ponders this same subject in her article, "Getting Motivated to Exercise." Here are a few shiny nuggets from her article:

"Staying motivated to lose weight and exercise is tough. In fact, the hardest part, according to my latest unscientific testing (i.e., asking friends, clients and family), is usually getting started.

'I'm just not motivated,' my clients say.

"We make plans to exercise, but, when it comes time to do it, we find a hundred other things we suddenly must do (exercise while my sock drawer is in such chaos? Ridiculous!).

"So, why does exercise seem great until we actually have to do it? Perhaps you think it's lack of motivation that makes it so hard to get started. If that's true, maybe we need to figure out just what motivation is. Is it a feeling? An action? Or a little bit of both?

". . . The problem with motivation is that many of us believe it's something that will come to us if we wait long enough . . . that someday we'll wake up and finally want to exercise. Rather than believe in that fantasy, maybe we'd all be better off by realizing that motivation is something we create, not something we wait for."

Waehner then goes on to discuss the elements of motivation that we can create for ourselves.  Of course, setting a goal is the first step, but then she focuses on ways we can make the follow-through easier on ourselves: through preparation, which "means having what you need and getting it all ready" so that you don't have any excuses (I personally make my salad for work while I'm watching TV the night before--that way, I can't buy a greasy sandwich with the excuse of not having a lunch prepared.); through disclipline, a scary word, which she says really "has to do with routine and habits" (Can I make a lunchtime walk a new habit? Give me a week, and I could get used to that!); flexibility, which means PLANNING for mistakes with "back-up plans" to avoid the disappoint that causes us to just give up (Ate something on your "naughty list"? No biggie; make yourself do a fifteen-minute walk when you get home--and then move on); and commitment, which she says is something we have to do "every day"---and not just in the beginning. 

Finally, she adds that "fun" has to be a part of any motivational plan: we have to remind ourselves that some of our self-healing tasks can actually be fun, whether it's dancing during our work outs or getting creative with a new recipe in the kitchen.  Of course, she also counsels us to "reward" ourselves with the things we love after all our hard work. And who doesn't like to work for a reward?  (Psst! I love shoes!)

With all these elements in mind, it might be a good idea sometime today to stop and evaluate the goals you have in mind and incorporate these motivating elements. Map things out on paper if you have to. You'll get farther with your goals--and have more fun along the way.

Lastly, remember this bit of wisdom:

"It does not matter how slowly you go, so long as you do not stop." - Confucius (551 BC - 479 BC)

Lyn isn't associated in any way with Clarian North, or Clarian Health, so I might get in trouble for posting her story (blame this ignorance on me being an intern and a huge supporter of personal blogs).  But, she's an award-winning blogger---who is also a mom fighting obesity.  She's got grit, she's real, and she's working really, really hard to make herself healthy. That alone should give her words the right to be reposted here for you to read them.

In her controversial March 3rd post entitled, "Why Not Stay Fat?" she shared her most powerful motivation for losing the weight:

"Every so often, I get an email or a comment from a distraught reader who believes that the key to my happiness lies in accepting my body as it is right now, and not trying to lose anymore weight. 'Stop dieting!' they say. 'You are beautiful just the way you are!'

"They're right, in part. I *am* beautiful just the way I am. Oh, I have my days where I look at my naked thighs and feel disappointed that I let myself get this way; naked obesity is not always pretty to ME. I can see the beauty in my body when I am bathing or getting dressed; the Rubenesque curves, the womanly softness. I like it. But this is not about looks for me. It is about quality of life. It is about as far from vanity as you can get.

"About a year ago, I wrote a post on Fat Acceptance explaining why I am trying to lose weight. I wrote about how, at 278 pounds and 38 years old, I was barely able to walk to the mailbox and back. How I couldn't even bring laundry upstairs to fold it and had to get my kids to carry everything up and downstairs. I've described the horror of watching my toddler daughter run, laughing, towards a busy street as I tried desperately to catch up to her but was unable to do more than hobble and stumble, screaming to a stranger to please grab her just before she got to the road. I've talked about how for years I did not go downstairs to kiss my children goodnight because, frankly, I couldn't. I was getting very close to having to use a wheelchair before I lost weight. And then, at 214 pounds, I climbed a mountain. What a huge difference a 64-pound loss made in my life!

"And yet, over the past year and a half I have struggled to stay around 225-230 pounds. And so I am asked, 'You're so much better off now. Why not just stay 230 pounds? You are eating so healthy, exercising, living a healthy lifestyle. Why not just accept your body as it is? Surely you are healthy enough now.'

"And I respond: I do not want to lose my mobility. I do not want to be like my mother, hobbling around with a cane by the time I am 50. And my orthopedic surgeon has said that I need to get more weight off these knees or I will be crippled EARLIER than my mother was. Maybe I will still need total knee replacements EVEN IF I lose all the excess weight. But maybe not. I am *so much* more mobile now than I was 50 pounds heavier that I have to believe losing another 50 will benefit me even more.

"I am in pain on a daily basis. When I don't eat sugar, the pain is FAR less severe. I take supplements, I do exercises. And the best thing I can do to improve my quality of life is to lose weight.

"...You can't know whether any one person would be happier, sadder, healthier, or sicker if they gained or lost weight. It is PERSONAL. Every person gets to decide what they want to do about their body and whether or not they are satisfied with their weight and health.

"Yes, I am healthier after eating the way I have for the last two and a half years. Yes, I am fitter after biking, walking, and strength training as I have. Yes, I am wiser in my choices. And yes, I am still too fat for my own health, comfort, and happiness.

"And that, I believe, is about to change."

To read more of Lyn's amazingly honest blog, go here.
 

After bariatric surgery, eating and drinking can be challenge for a few days, and for some, a few weeks. Preventing foodborne illness or food poisoning is critical. Symptoms of food poisonings--vomiting and diarrhea--increase the risk of dehydration and damage to your newly-formed pouch or the placement of the gastric band.

You can prevent food poisoning from bacteria and viruses by following four simple steps when you prepare food:

1.  Clean: Wash your hands and clean surfaces that touch food often.
2.  Separate: Do not cross-contaminate food by using the same cutting boards, knives, stirring spoons, etc. for raw meats and vegetables.
   3. Cook Thoroughly: Cook your food to proper preparation temperature. Go to FoodSafety.gov for recommended cooking temperatures of food.
   4. Chill: Refrigerate any leftovers immediately after each meal.

The goal after weight loss surgery is to  have a safe recovery, which includes being able to drink enough liquids to prevent dehydration, to eat enough protein, to take your vitamins, and to get back on your feet as quickly as possible. Safe food handling will eliminate one potential problem that may slow down recovery after surgery.