Feb 27

I’ve Quit Losing Weight After Weight Loss Surgery


Why has my weight loss stalled? © esolla Fotolia.com

Why has my weight loss stalled? © esolla Fotolia.com

You were losing weight at a fast clip when suddenly you stalled or plateaued. What the heck is going on?

Don’t freak out. We all go through this during our weight loss surgery journey. Some stall days after surgery, some weeks and some months.

Why Has My Weight Loss Stalled?

A weight loss stall is an extended stretch of time where your efforts are not resulting in weight loss.

When you lose weight rapidly chances are you are losing lean body mass (muscle) and fat. Your muscle plays a big part in the burning of calories by keeping your metabolic rate higher so you want to hold onto your muscle and even make more muscle, says Maureen Miletics, RN, BSN, MS, CBN and director of bariatric services with St. Lukes Bariatric Services

That means you’ve gotta support that muscle with high protein intake, 65-70 grams or more. Your metabolic rate determines how many calories the body burns at rest. Additionally, you want to support and build muscle so you’re able to exercise and burn even more calories.

You May Need to Eat More – Protein

The reason you’ve quit losing might not be overeating. Many of us stall because we’re not eating enough or eating the right foods. When we losing weight rapidly due to a drastic drop in food/calorie intake, our bodies slow down the metabolism to conserve energy. Because the body thinks it’s starving, it tries to hold onto every last calorie. Bam. Plateau. If you’re skipping meals or trying to eat salad instead of protein, change your ways. Don’t skip meals. Consider adding a protein shake to your daily routine. Focus on proteins first, always, before you take a bite of veggies or starch.

Now, if you’re eating well, the stall just might be too much food. Let’s face it we’re all food addicts and slipping into old ways is possible. Hit this head on. Be honest with yourself. You may need to start tracking your foods, revisit the eating guidelines your dietitian provided and use some great tools to keep you on track. I often use small (baby) utensils, portioned plates/dishes and the MyFitnessPal app to track everything your eat.

One last fact: lack of sleep can also be a problem. If you don’t sleep six to eight hours a night, Miletics says you’re at greater risk of increased ghrelin levels (a hormone that makes you hungry) and decreased leptin (a hormone that decreases hunger).

Put the Brakes on Your Weight Loss Plateau

  1. Increase proteins
  2. Sleep well
  3. Build muscle, and
  4. Assess your eating patters and food intake



Feb 26

Why Do I Still Look Fat When I Look in the Mirror?

I look in the mirror and still see myself as fat. © rolffimages Fotolia.com

I look in the mirror and still see myself as fat. © rolffimages Fotolia.com

I look in the mirror, what do I see? I see me at 243 (or 303 or 423).

When I stand on the scale, what do I see? I see I weigh just 123.

When I reach in the closet, what do I grab? Always the flowing, body-hiding outfit that looks like a bag.

The clothes no longer fit but hide my body’s faults, which eases my mind,

because I still see myself as fat.

I Still See Myself as Fat

One of the most common questions I get from weight loss surgery patients is, “Why do I still see myself as fat – when I look in the mirror, think about what to wear or just consider my body?”

The answer may sound a little scary. It’s body dysmorphia (Phantom Fat), a disorder that causes people to think they are fat, when they are not. Many victims of anorexia nervosa suffer from the disorder, even when they are severely gaunt. Weight loss surgery patients suffer too.

After years of being obese and trying to convince ourselves that we weren’t really that big, or convincing ourselves we looked normal sized, or conjuring other self-preservation thoughts, we’re suddenly faced with looking at our new bodies.

1.       We don’t see an accurate picture when we look in the mirror

2.       We’re hyper-judgmental of our new bodies

3.       We hate the sagging skin, and

4.       We might harbor many other negative thoughts

Unfortunately, doctors and clinics selling weight-loss surgery don’t adequately educate us about the negative feelings and disorder most of us face. Just educating us about the surgery and post-surgery processes is overwhelming.

Consequently, we’re left to deal with the disorder ourselves or via support groups often not led by medical or psychological experts.

The good news is, for many the body dysmorphia will reverse. The bad news, for many that takes a long time and it can be a son of a gun to deal with initially, even a few years post-surgery.

I had surgery in September 2013. The first time I looked in the mirror and said, “Wow, I look great. I’m skinny,” was yesterday (February 25, 2016).

Treating Body Dysmorphic Disorder aka Phantom Fat

If you don’t deal with your feelings you could engage in self-sabotage where food once again becomes the source of solace. If you can’t start to love your new self, your worst fears may be realized.

Every WLS patient experiences some very minimal weight gain, a normal part of the process. However, untreated dismay and body dysmorphic disorder can lead to substantial weight gain.

Regardless of the cause, avoiding intensely critical examinations of our bodies is a step toward self-acceptance.

Treatments for body dysmorphic disorder include:

·         Psychotherapy, individual counseling to change thinking and behavior;

·         Anti-depressant medications; and

·         Family or group therapy that helps the family/group identify symptoms and learn how to react to them

Here are two more suggestions that work with just about every WLS patient I talk to about the disorder and even tough self judgement

  • Rock your clothes every day
    • Get rid of your tent clothing – except for at-home lounging
    • Dress up, not down
    • Wear fitted clothes
    • Tuck in shirts and blouses
  • Force yourself to see your body as it is; and take and post those selfies.

Mayo Clinic Defines Body Dysmorphic Disorder

Body dysmorphic disorder is a type of chronic mental illness in which you can’t stop thinking about a flaw in your appearance — a flaw that is either minor or imagined. But to you, your appearance seems so shameful that you don’t want to be seen by anyone.

When you have body dysmorphic disorder, you intensely obsess over your appearance and body image, often for many hours a day. Your perceived flaw causes you significant distress, and your obsession impacts your ability to function in your daily life. You may seek out numerous cosmetic procedures or excessively exercise to try to “fix” your perceived flaw, but you’re never satisfied. Body dysmorphic disorder is also known as dysmorphophobia, the fear of having a deformity.


More Information on Body Dysmorphic Disorder from WebMD



Jan 26

Satiety. Huh? Reduce Calorie Intake by Managing Hunger

During my morning research session today, I came across a word I didn’t know — satiety. Huh? What the heck is that?

It was used in a description of a recipe that used protein powder as a replacement for other ingredients. You know the gig — gotta have that protein.

Further exploration revealed satiety is a buzzword in the diet and nutrition universe. A word we weight-loss- and weight-management-minded folks might, and perhaps should, hear often.

Foods high on the satiety index

Foods that fill us up and greatly help us manage hunger.



Ok, let’s make this easier, sa-TIE-atee, according to WebMD.com. It’s the state of feeling full. So, when we say something increases the satiety, it increases the feeling of fullness.

What Foods Fill Us Up?

Dr. Susanna Holt and her associates at the University of Sydney, Australia, developed the “Satiety Index.” It tells us what foods have the highest ability to satisfy hunger over a short period of time, two hours. Using 240-calorie portions of popular foods, Dr. Holt ranks the test foods according to how they compare with a slice of white bread, which carries a rank of 100.

The following foods are rated by how much food people ate after consuming the foods to satisfy their hunger.

Boiled potatoes ranked highest at 323 on the index, while candy and cake came in below 70, and the lowly croissant scored 47.

By eating foods that are higher on the index, more satisfying, we can assist in managing our hunger.

How the Satiety Index Helps Weight-Loss Surgery Patients

The axiom is, if you are satisfied longer you will eat less (in the long run). That’s great for those wanting to lose weight. Great also for those of us who eat often (every three to four hours). The index can help us make some good decisions, think creatively when we make menu selections and combine foods.

That’s what started this whole thread — trying to be creative by substituting protein powder for flour.

But, it’s important to understand a 240-calorie portion of fruit is a huge serving we would not be able to handle.

In addition, many of the high satiety foods are not on our bariatric radar. So, the key is to see what’s high and what’s not and figure out how to balance those foods to our benefit.

In a report on the index by David Mendosa, he quotes Dr. Holt as saying, “Many ‘health-conscious’ dieters will eat a meal based on several pieces of fruit and some rice cakes (in Australia anyway) and then wonder why they feel ravenous a few hours later. These kinds of extremely low-fat, high-carb meals do not keep hunger at bay because they are not based on slowly-digested carbs and probably don’t contain enough protein. A dieter would be better off eating a wholesome salad sandwich on wholegrain bread with some lean protein like tuna or beef and an apple. This kind of meal can keep hunger at bay for a very long time.”

Foods that satisfy hunger are rated using the Fullness Factor formula.

FF values range from 0 to 5. Foods with high FF’s are more likely to satisfy hunger with fewer calories. Foods with low FF’s are less likely to satisfy your hunger.

Expanded List, the Fullness Factor

Ron and Lori Johnson, who developed NutritionData.com, took the Satiety Index further. They reviewed additional studies and published observations to expand the scope of the index and create their Fullness Factor (FF) formula. FF values fall within the range of 0 to 5. Foods with high FF’s are more likely to satisfy your hunger with fewer Calories. Foods with low FF’s are less likely to satisfy your hunger.

“The Fullness Factor can be used in conjunction with nearly any type of diet or approved food list,” reports NutritionData.com. “By simply selecting foods with higher Fullness Factors, you’ll improve your chances of consuming fewer Calories, while simultaneously minimizing your hunger.”





Jan 24

Weight-Loss Surgery Victories – Best When Shared

I savored many victories as I lost weight and my body shrank after surgery.  Victories such as fitting into the back seat of a car, flying comfortably in a center airplane seat, or shopping at a regular store rather than the big-and-tall outlet.  Most who have faced the battle of being a large person in a normal-sized world (and possibly some who are not obese) understand these events and the joy of the experiences. These are the public victories and are oh so sweet.

clothes_binOther small and important victories experienced along my journey are known by only me.  My favorite of these events occurred about a year into my weight loss.

My friend Jo called the experience “Shopping in your closet.” You may know what we’re talking about — rummaging through a storage bin of clothes stowed after they no longer fit — stored in hopes the items might see the light of day again.

Blessed to have been successful in my gastric-bypass, weight-loss journey, my old, too-small clothes did see the light of day again. I morphed from a size 54 pant to 34 and a 5XL shirt to a large or even a medium. A medium!

Private Victory

man wearing a loose Tshirt post weight-loss surgery

The often private and emotional victories post weight-loss surgery are even better when shared.

My greatest joy, as I scavenged, came when I found an old T-shirt at the bottom of the bin. I recalled how much I loved wearing it with a pair of jeans and tennis shoes on a Saturday afternoon, long ago, before my weight gain.

I slipped my arms into the the arm holes and raised the T above my head to draw the shirt down. What happened next was overwhelming.

The tee shirt, pulled only by gravity, simply fluttered as it descended over my head, down my chest and past my stomach, until totally unfurled. It hadn’t been held up by a distended stomach. No pull or stretch across a wide expanse of body was required. The T just rode the pocket of air between itself and my body. I deeply savored the success of my journey and the simple but poignant reward.

Victory Shared

We all experience victories, some big and public others private. But, perhaps the most joyous times of all are when we share our victories with each other. Until today, my fluttering T-shirt experience was known only to me. I hope sharing my joy brings encouragement, satisfaction or a smile. These little moments are what make every step of the journey worth taking.


What are some of your favorite moments of victory?






Guest Blogger William H. Streetman Bill is a writer/blogger and frequent speaker on the topic of living healthfully after gastric bypass. Following his surgery in Oct. 2010, he successfully lost over 200 pounds, has kept it off for nearly four years, and enthusiastically shares the story of his new life with others. Visit Bill’s website, www.WHS-NewLife.com



Jan 13

Lack of Protein, Vitamins and Minerals Cause Issues for Weight Loss Surgery Patients

Vitamins Minerals and Protein Critical for Weight Loss Surgery Patients

Focus on feeling great.

My hair is falling out. I’m exhausted. I’m getting leg cramps. I bruise so easily.

These challenges aren’t faced only by weight-loss-surgery (WLS) patients. However, we WLS patients have a higher risk of facing these challenges due to our small amount of food intake and malabsorption.

So, we’ve gotta focus. Focus on protein and a hard-core commitment to taking our supplements.

I know:

♦  Argh, I too hate taking my supplements. But, oh they help me feel good and stay on track

♦  Argh, I too am tested daily to take in enough protein. But, oh how it helps me feel good and keep from getting hungry too quickly

♦  Argh, there is so much to learn about this lifestyle. But, education is our sword of health, success and thus increased happiness

How To Get the Protein, Vitamins and Minerals You Need

The simple solution is follow doctor’s orders to a T — which translates to, “Take your supplements every day and track your food intake and nutrition.”

That’s all well and good. But, what do they say about good intentions?

The better question might be, what symptoms could indicate a deficiency? The American Society of Metabolic and Bariatric Surgery provides this list.

Protein Deficiency Signs and Symptoms

  • Hair loss
  • Fatigue
  • Leg swelling

Vitamin and Mineral Deficiency Signs and Symptoms

  • Calcium: bone pain
  • Iron: fatigue
  • Zinc: brittle nails
  • Vitamin A: inability to see in the dark
  • Vitamin E: poor wound healing
  • Vitamin K: easy bruising
  • Vitamin B1 (Thiamin): numbness and tingling in the hands and feet
  • Vitamin B12 (Methylcobalamin): fatigue

Before making changes in diet, vitamins and medications, be sure to consult your physician.



More Resources on Vitamin, Mineral and Protein Deficiencies — Articles, Charts and More



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