Tuesday, October 21, 2014

Depression Meds & Fish: Potential to Improve Patient Response

The 5 Day Pouch Test: Express Study Guide

Weight loss surgery patients must always be concerned about dietary nutrition and how our surgically altered digestive systems are responding to and absorbing nutrients, vitamins and minerals, and medications. A new study, though not specific to WLS patients, finds in general people who take antidepressants (SSRI) and regularly include fatty fish in their diet have a better response to the medication than those who eat little or no fish. The findings were shared in a news release October 20, 2014 by European College of Neuropsychopharmacology. The following is an abstract of the study prepared by David McNamee and published on Medical News Today

Could eating more fish make antidepressants work better?

The participants who ate the least fish tended to have the weakest response to antidepressants, whereas patients who had the most fish in their diet had the strongest response.

New research finds that increasing fatty fish intake may be one way to improve the response rate among depressed patients who do not find antidepressants beneficial.

Up to half of patients with depression do not respond to selective serotonin reuptake inhibitor (SSRI) antidepressants.

Previous studies have suggested there may be an underlying genetic reason why up to 42% of cases do not respond to antidepressants. And in 2013, the journal Biological Psychiatry published an online risk calculator that estimated the likelihood of antidepressant response, based on the findings of a large antidepressant trial.

The researchers behind the new study were investigating factors that influence antidepressant non-response when they hit upon an association between improved effectiveness and fish intake. Lead researcher Roel Mocking explains the team's findings:
"We were looking for biological alterations that could explain depression and antidepressant non-response, so we combined two apparently unrelated measures: metabolism of fatty acids and stress hormone regulation. Interestingly, we saw that depressed patients had an altered metabolism of fatty acids, and that this changed metabolism was regulated in a different way by stress hormones."
The patients with depression were then administered a 20 mg dose of an SSRI every day for 6 weeks. Patients who did not respond to the SSRIs were provided with a gradually increased dose of up to 50 mg per day. Non-responding patients tended to have 'abnormal fatty acid metabolism'

Taking measurements of fatty acid and cortisol levels throughout the trial, the researchers found that the depressed patients who did not respond to the antidepressants tended to have abnormal fatty acid metabolism.

American Heart Association Fish Intake FAQ's

Because fatty fish is rich in fatty acids, such as omega-3 DHA, the researchers examined the fish intake in the diet of the participants. They found that the participants who ate the least fish tended to have the weakest response to antidepressants, whereas patients who had the most fish in their diet had the strongest response.

The team reports that participants who ate fatty fish at least once a week had a 75% chance of responding to antidepressants, while participants who never ate fatty fish had only a 23% chance of responding to them. "This means that the alterations in fatty acid metabolism (and their relationship with stress hormone regulation) were associated with future antidepressant response," says Mocking.

McNamee, David. "Could eating more fish make antidepressants work better?." Medical News Today. MediLexicon, Intl., 20 Oct. 2014. Web. 21 Oct. 2014. http://www.medicalnewstoday.com/articles/284102.php

It may be quite some time before a definitive study such as this is made of weight loss surgery patients. In the meantime we can actively increase our intake of omega-3 fatty acids by increasing our fish intake. At present the American Heart Association provides approved guidelines and suggestions for including fish in a healthy diet. See this article:  FAQ's: Fish and the Heart Healthy Diet. And check out this recipe: Mediterranean Sea Bass.

FAQ's: Fish and the Heart Healthy Diet

The 5 Day Pouch Test: Express Study Guide

The American Heart Association is a terrific source of dietary information for improved heart health. While keeping in mind the traditionally prescribed high protein diet for weight loss surgery patients we most certainly can benefit from the generalized information from the AHA. Here I've pulled some questions and answers regarding fish intake in the heart healthy diet:
"Enjoy fish baked or grilled, not fried.  Choose low-sodium, low-fat seasonings such as spices, herbs, lemon juice and other flavorings in cooking and at the table." AHA

How often should I eat fish?
The American Heart Association recommends that consumers without documented coronary heart disease (CHD) eat a variety of fish, preferably oily fish (salmon, tuna, mackerel, herring and trout), at least twice a week.

Remember: Two Fish Meals a Week
When we talk about the advantages of eating fish, we’re talking about over the long term – which comes from eating it twice a week," said Alice Lichtenstein, D.Sc., former chair of the American Heart Association's Nutrition Committee. Remember the adage that an apple a day keeps the doctor away? “Eat fish twice a week” isn’t quite as catchy, but Dr. Lichtenstein believes it could have the same effect.“This is not new advice,” she adds. “The problem is people don’t seem to embrace it.” American Heart Association

Try This Recipe: Mediterranean Sea Bass

Are there differences in omega-3 fatty acid content between wild fish and farm-raised fish?
Some farmed fish can have higher levels of omega-3 fatty acid than wild fish, and vice versa.  The omega-3 fatty acid content of wild fish can vary by the temperature of their environment (i.e., higher during the summer than winter), while the omega-3 fatty acid content of farmed fish can vary based on what they are fed.

The American Heart Association recommends eating fish at least twice a week, especially species high in omega-3 fatty acid such as salmon, mackerel, herring and trout, regardless of whether they are wild or farmed.
If I eat fish at least twice a week, should I worry about contamination?
For middle-aged men and for post-menopausal women, the benefits of eating fish a few times per week far outweigh the potential risks.

As fish consumption increases, the number of fatal cardiovascular events decreases and the cardiovascular benefit increases.
Research has shown that omega-3 fatty acids may help decrease the risk of arrhythmias (irregular heartbeats) and may help slow the growth rate of artery-clogging plaque.  Scientific evidence shows that eating fish is associated with reduced cardiovascular risks and increased health.  Based on these benefits, and the fact that most people do not eat recommended amounts of fish, it seems reasonable to recommend that people eat more fish.

Pregnancy: For women who are or may become pregnant, nursing mothers and young children, the benefits of eating fish twice per week are also greater than the potential risks.  However, four specific fish species (shark, swordfish, king mackerel and tilefish) should be avoided to minimize exposure to mercury.  In addition, albacore tuna can be eaten but should be limited to six ounces (one average meal) per week.

The potential risks from other contaminants (such as PCBs or dioxins, which are also found in trace amounts in many foods) are exceedingly small relative to the benefits of eating fish, so you don’t need to be concerned about eating fish because of this potential issue.  (If you eat a lot of sports-caught freshwater fish from local waters, check your local advisories.)  Consumers should remove the skin and surface fat before cooking to reduce the risk of eating contaminants.

Should I take fish oil supplements?
Fish intake has been associated with a lower risk of heart disease.  The American Heart Association recommends that consumers without documented coronary heart disease (CHD) eat a variety of fish, preferably oily fish (salmon, tuna, mackerel, herring and trout), at least twice a week.  Consuming fish oil supplements should only be considered by people with heart disease or high levels of triglycerides who consult with their physicians.

People with documented CHD are advised to consume about 1 gram per day of the fish oils EPA and DHA (eicosapentaenoic and docosahexaenoic acids), preferably from oily fish, although EPA+DHA supplements could be considered in consultation with their physicians.

People who have elevated triglycerides may need two to four grams of EPA and DHA per day provided as capsules under a physician’s care.  Very high intake (greater than three grams of EPA+DHA per day) could theoretically cause excessive bleeding in some people.

For more healthy heart and lifestyle information visit AHA: Getting Healthy

Recipe: Mediterranean Sea Bass

The 5 Day Pouch Test: Express Study Guide

"By all accounts fish is good for us. In fact, the American Heart Association tells us to eat fish twice a week, particularly cold water fatty fish."  (See this post for FAQ's about fish and Omega-3 consumption by the AHA).

Weight loss surgery patients are instructed to eat a diet of rich lean protein cooked without frying or breading. Grilled fish fits that order with ease! And by all accounts fish is good for us. In fact, the American Heart Association tells us to eat fish twice a week, particularly cold water fatty fish. Fatty fish including mackerel, lake trout, herring, sardines, albacore tuna, salmon, and some shellfish are high in two kinds of omega-3 fatty acids. Omega-3 fatty acids are believed to help lower triglycerides and may also fight cancer and reduce inflammation. Additionally fish is rich in B vitamins including B12, Niacin, and B6. It is readily available fresh at the meat counter or flash-frozen in the freezer section of most major supermarkets.

Fish cooks quickly and should be tended closely to avoid overcooking. Fish is done when it turns opaque in the thickest portion and flakes into sections. Scallops, a shellfish, are done when they are opaque and another shellfish, shrimp, are done when they turn pink. When cooking over the direct heat of the grill turn steaks, whole fish, shrimp and scallops halfway through grilling time. Avoid moving the fish protein too much on the grill because it tends to break-up. Thin fillets generally do not need to be turned. Some frequent fish grillers find baskets made specifically to hold fish on the grill are useful.

Try this simple flavorful recipe for grilled fish and I think you will be hooked!

Mediterranean Sea Bass

This Provence-style recipe infuses the clean flavor of olive oil with fresh herbs and garlic for a light and flavorful lean protein main dish. Keep it simple and enjoy. (Suitable fish substitutes: red snapper, striped bass, halibut.)

For the paste:
3 tablespoons extra-virgin olive oil
1 tablespoon finely chopped fresh basil
1 tablespoon finely chopped fresh thyme
2 teaspoons dried lavender
1 teaspoon minced garlic
1/2 teaspoon kosher salt
1/4 teaspoon freshly ground black pepper

4 skinless Chilean sea bass fillets, about 6 ounces each and 1 inch thick
Lemon or lime wedges (optional)

To make the paste: In a small bowl whisk together the paste ingredients. Spread the paste evenly on both sides of the fish fillets. Grill over Direct High heat until the flesh is opaque throughout and starting to flake, 5 to 7 minutes, turning once halfway through grilling time. Serve warm and garnish with lemon wedges, if desired.

Kaye Bailey (c) - All Rights Reserved
Article Source:  Make Grilled Fish a Healthy Part of Your Weight Loss Surgery Diet

Monday, October 20, 2014

Weight Regain: A fact, not a moral failure

The 5 Day Pouch Test: Express Study Guide

"A person is not good if they lose weight and bad if they gain weight. Gained weight is a symptom of the metabolic disorder called obesity. When weight is lost and managed the disease is in remission; when weight gain occurs the disease is in relapse." Kaye Bailey
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Lately the bulk of the email I have received is about weight regain: from people who have put on weight after losing it with surgery and people who are afraid they will gain weight after working so hard to lose it. As I think about it I have never met a WLS patient who is not concerned about the weight coming back. When you think about it, it makes sense. By the time we are morbidly obese we have probably lost and gained the same pounds many times over. We live in a world where being overweight and staying overweight is easy -- Losing weight is the opposite. Losing weight and keeping it off is akin to swimming upstream in a swift current.

There are a few things I hope you will remember about weight regain which may help you face it rationally with kind and gentle compassion:

Weight regain is not a moral issue. A person is not good if they lose weight and bad if they gain weight. Gained weight is a symptom of the metabolic disorder called obesity. When weight is lost and managed the disease is in remission; when weight gain occurs the disease is in relapse. Managing the disease is our responsibility and we are served well when seeking the support of others including our bariatric team, friends, family and WLS community. (Read: Four Truths About Weight Gain After WLS)

Knowledge is power. Not long ago I heard a bariatric surgeon say that patients regain weight because they were not fully educated before surgery. The fact is, life after surgery is quite overwhelming. I'm positive I retained only scant bits of information taught during my pre-op and early post-op recovery. What I know now is the pursuit of new information day in and day out is mandatory if I'm going to stay focused and enthused about weight management. The best place to learn about life after WLS is from other patients who are doing their best -- just like you -- to make this weight management experience healthy and effective.

It is never too late. If we have allowed our health problem to become a moral problem it is easy to suffer feelings of hopelessness. But it is never too late to make little changes which bring about a big difference in our life. Each new day, each new meal, each new step we take is an opportunity to nurture our body and being. It is never too late.

Last week's LivingAfterWLS Digest offered several resources addressing the topic of weight regain after surgery. Take a moment to find something meaningful to you, and pass the word on to a friend who may be feeling down and discouraged. Remember, we are all in this together!

And while you're in the retrospective mode please consider taking a moment to complete our LivingAfterWLS Personal Self-Assessment. This is a proven tool to help you stay on track with weight loss surgery. 

Express Study: Don't Leave Your 5DPT to Chance!

The 5 Day Pouch Test: Express Study Guide

Free Kindle Reader App for all computers and devices makes this $3.95 Guide a top bargain. Get the 5DPT plan and take it anywhere.

Are you starting the 5 Day Pouch Test today with only a little knowledge of the plan? Don't just wing it! Get our low-cost Express Study Guide eBook on Kindle and do the plan the right way! Get the best results possible for your effort. Learn more:

5 Day Pouch Test Owner’s Express Study Guide eBook, available exclusively through Amazon Kindle. This quick study provides the basics of the 5 Day Pouch Test plan to get you back on track with your weight loss or weight maintenance goals with weight loss surgery. What’s in it: The Express Study Guide includes the plan summary broken down by day; 32 Frequently Asked Questions and Answers about the plan; and 10 sample recipes to get you started.

Who it’s for: The 5 Day Pouch Test Express Study Guide is for those who want to learn a little more about the plan without investing in the manual; for people anxious to do the 5DPT and want a quick overview; for those who know the plan and have used it successfully who want a quick reference at their fingertips; and for people who want to succeed long term with their weight loss surgery tool.

The 5 Day Pouch Test: Express Study Guide

Thursday, October 16, 2014

Trick or Treat, Sugar is Sweet, But what about my WLS?

FAQ's on Sugar

by Kaye Bailey
There is so much confusing and conflicting data available about the health benefits or damages of sugar. Let's take a look at some of the most commonly asked questions about sugar and try to answer them reasonably without the hype or fear mongering that is commonly associated with foods of questionable nutritional value. Taking the best information we have available and using our personal experience I believe we can make the best food decisions for ourselves -- and save the drama for another topic.

Is Sugar Addictive?

Sugar taps into a powerful human preference for sweet taste, says Marcia Pelchat, PhD, a scientist at the Monell Chemical Senses Center, a basic research institute in Philadelphia.  "We're born to like sugar," she says. Scientists aren't sure if people can become physically dependent on sugar, although some animal studies suggest that such a thing is possible, she says. "There are the same kinds of changes in brain dopamine, in these animals given intermittent access to sugar, as in drug addicts."

Are some type of sugar better than others?

Celebrities and high-profile chefs have touted the benefits of replacing refined white sugar with purportedly more natural, healthier sugars, such as honey, maple syrup, or molasses. But, according to Rachel K. Johnson, RD, MPH, PhD, a professor of nutrition at the University of Vermont and a spokeswoman for the American Heart Association (AHA) there's no truth to these common misconceptions,  "In terms of something being inherently better about those sweeteners as opposed to table sugar or sucrose -- no." The bottom line: All are simple sugars. "A calorie of sugar is a calorie of sugar, so whether you're getting it from white sugar or some other type of sweetener, you're still adding empty calories to your diet," Johnson says. 

However, there may be one redeeming quality, she says. "Some of those sweeteners -- like maple syrup, molasses, honey -- may have a stronger taste, so you might be able to get the sweetness that you want with less of it, using less calories."

Does sugar cause weight gain?

Several current studies suggest a relationship between sugar intake and weight gain. What the studies do not determine is if the sugar causes the weight gain or the extra calories sugary foods provide that cause the weight gain. Seems like a moot point to me. As people with obesity - in whatever stage we are in - we know what foods we ate that contributed to our personal weight gain. For me sweets and pasta were dietary staples at the height of my morbid obesity. What was on your menu when your disease was at its worst? I suspect we all blame our "sweet tooth" for a certain amount of weight gain. Studies on infants confirm that it is human nature to prefer sweets over foods like vegetables which are an acquired taste. According to registered dietician, Kathleen M. Zelman, "We love sweets because they not only taste good, but make us feel good. Consuming simple carbohydrates (like sweets) boosts the brain chemical serotonin, which can help improve mood. Stress reduces serotonin levels, which may help explain why some people reach for sweets when they're feeling stressed."

Simple Ways to Cut Sugar Calories

According to Zelman, the bottom line is that if you want to control calories, you should limit added sugars of all kinds, including high-fructose corn syrup. She suggests five simple ways to cut back on sugar calories:

  •     Drink fewer sweetened soft drinks.
  •     Satisfy your sweet tooth with naturally sweet fruits, fresh or canned in fruit juice.
  •     Buy only 100% fruit juice that is not sweetened.
  •     Instead of sweetened beverages, enjoy sparkling water with lime and/or a splash of fruit juice.
  •     Choose unsweetened, whole-grain cereals and cereal bar
WLS Patients: Sugar and Dumping Syndrome 

Artificial Sweeteners: What you need to know today!

The 5 Day Pouch Test: Express Study Guide

With Halloween just around the corner and the feasting holidays coming right behind now is a good time to look at sugar, artificial sweeteners and the role they play in our weight loss surgery diets. I am always nervous about the "sugar" issue because if there is one thing health conscious people have strong opinions about it is sweet foods and how they get to be sweet. There is so much information (and mis-information) about sweets in the American diet that we can find "studies" or "proof" to support just about any position we want to take. Today let's look at what the American Diabetes Association says about artificial sweeteners:

Artificial Sweeteners
Artificial SweetenersPublished with permission from American Diabetes Association
Are you struggling to control your sweet tooth?

When you have diabetes, including sweets in your diet requires careful planning. However, it can be hard to just save sweets for special occasions.

Curb Your Cravings
Foods and drinks that use artificial sweeteners are another option that may help curb your cravings for something sweet.

Sometimes artificial sweeteners are also called low-calorie sweeteners, sugar substitutes, or non-nutritive sweeteners. They can be used to sweeten food and drinks for less calories and carbohydrate when they replace sugar.

However, many foods containing artificial sweeteners still have calories and carbs, so be sure to check the nutrition facts label.

Their sweetening power is at least 100 times more intense than regular sugar, so only a small amount is needed when you use these sugar substitutes.

Also, with the exception of aspartame, all of the sweeteners listed below cannot be broken down by the body. They pass through our systems without being digested so they provide no extra calories.

FDA Approved
There are five artificial sweeteners that have been tested and approved by the U.S. Food and Drug Administration (FDA):
  • acesulfame potassium (Brand Names: Sunett, Sweet One)
  • aspartame (Brand Names: Nutrasweet, Equal)
  • saccharin (Brand Names: Sweet 'N Low, Sweet Twin, Sugar Twin:
  • sucralose (Brand Name: Splenda)
  • neotame (Brand Names: Best of All, A Sweet Leaf, Sun Crystals, Steviva, Truvia, PureVia)

These sweeteners are used by food companies to make diet drinks, baked goods, frozen desserts, candy, light yogurt, and chewing gum. You can buy them to use as table top sweeteners. Add them to coffee, tea, or sprinkle them on top of fruit. Some are also available in "granular" versions which can be used in cooking and baking.

What's The Deal With Stevia?
Stevia (sometimes called Rebaudioside A or rebiana) is now generally recognized as safe (GRAS) by the FDA as a food additive and table top sweetener. When something is generally recognized as safe by the FDA, it means that experts have agreed that it is safe for use by the public in appropriate amounts.

Stevia is several hundred times sweeter than sugar. It comes from the sweetest part of the stevia plant and is an ingredient in many foods that you can buy at the store.
Sugar Substitutes in the Store.

Wednesday, October 15, 2014

Are you due for a Post-WLS Check-up? Use this tool!

The 5 Day Pouch Test: Express Study Guide

The LivingAfterWLS Self-Assessment is a proven tool to enhance and motivate your ongoing efforts with WLS.
The LivingAfterWLS “Quarterly Personal Self-Assessment” tool is a worksheet of questions we can ask ourselves in a sincere effort to assess our present state and make an action plan for the next three months. This worksheet should be used as a private tool with the intent to keep your eye on the goal. It is a contract with yourself; a contract of honor and self-respect because you deserve to treat yourself well and engage in appropriate long-term behaviors in pursuit of your healthiest life. Please accept this invitation to join me in the Quarterly Personal Self-Assessment. Take some quiet time to evaluate where you are and where you are going. Put your WLS goal back in sight. Pre-ops, Newbies and Old-timers can all use this tool. You can do this.

First Step in Self-Compassion: The Self-Assessment Worksheet

Download Free LivingAfterWLS Self-Assessment

In our LivingAfterWLS Weekly Digest delivered yesterday to your email Inbox and available HERE in our archives we encouraged our community members to take some time to exercise self-compassion as a positive step toward improving our health and weight loss surgery experience. As part of your self-compassion we invited you to download and complete our LivingAfterWLS Self-Assessment worksheet. Stats from the  newsletter show that many of you clicked the link to the download worksheet! This is exciting because we know that the LivingAfterWLS Self-Assessment is a proven tool to enhance and motivate your ongoing efforts with WLS. It has been part of the LivingAfterWLS curriculum for over eight years and still one of our most requested documents.

Use this tool to recall your original goals, find out where you are today, and map a plan for the future. Do this every three months, make a date with yourself to pause and reflect. When you know where you come from and where you are, then defining where you want to go is invigorating.

You can find this worksheet and more free downloads on our website:
LivingAfterWLS Downloads  and also on our Project 2014 webpage.

Tuesday, October 14, 2014

The Carb Monster has a hold of me - HELP!

The 5 Day Pouch Test: Express Study Guide

Why can't I just quit carbs cold turkey?

And why does the 5DPT help me quit carbs?

This article excerpted with permission from the 5 Day Pouch Test Bulletin January 2014.

Have you ever had a particularly bad snacking day only to find yourself the next morning promising to give-up snacky-carbs for good, cold turkey, right now. And by noon that will-power is forgotten as you reach for the snack of choice. And then the self-blame begins: "Why am so weak? Why am I a failure? Why don't I have will-power?"  I've lived this scenario more times than I care to admit and I know I'm not alone.

But it turns out we aren't just a bunch of weak-bellied carb-addicts. There is a biological reason that motivates the reach for the snack: our body has become accustomed to digesting and using processed carbs as it's primary source of fuel. Withdrawing them cold turkey puts the metabolic process in panic and serotonin levels drop. "You may be powerless to resist baked goods, pasta, and their carb cousins," according to Wurtman and Marquis in "The Serotonin Power Diet. "The reason for this specific, very tough-to-ignore craving for carbohydrates is that your brain is forcing you to yearn for them so that it can produce serotonin."

With the 5 Day Pouch Test we methodically transition from fatty non-nutritional processed carbs to healthy complex carbohydrates found in grains, vegetables, and fruits. The body still produces serotonin from these carbs while benefiting from the healthy nutrients and fiber missing from processed carbs. While some cravings for carbs are experienced the biological trauma is not as severe as when processed carbs are withdrawn cold turkey without providing a similar replacement fuel.

Below, from the 5 Day Pouch Test Owner's Manual page 49:

Carbohydrate withdrawal:
When any heavily consumed food is withdrawn from the diet the body is likely to experience symptoms of withdrawal that may include headache, dizziness, cramping, and nausea. This is not unique to our WLS body; this is a simple fact of biology.  On the 5DPT when processed carbs are withdrawn many people report symptoms of "carbohydrate withdrawal." Do not suffer through this.  If you notice symptoms of carbohydrate withdrawal eat a small piece of melon, some berries, an apple or an orange. Any low-glycemic fruit or vegetable will reduce the symptoms of carbohydrate withdrawal.

You may also try a serving of Emergen-C® energy booster fizzy drink mix, which is known to reduce the symptoms and discomfort of carbohydrate withdrawal. In addition, Emergen-C® provides B vitamins for energy and C vitamins for immunity along with many other vitamins and minerals. You can count a serving of Emergen-C® as part of your daily intake of water. Do not be put off by the 5 or 6 grams carbohydrate per serving: these are beneficial nutrient dense big-bang-for-your-buck carbs. Enjoy!
For nausea, try sipping freshly brewed warm green tea or ginger herbal tea. You can add fresh ginger juice to further ease the symptoms of stomach distress and nausea. If you made the Fennel & Celery Soup (page 36) for a grumpy pouch and have some left then enjoy a 1-cup serving of this soup. It is a known remedy to digestive discomfort and distress resulting from dietary change.

Helpful Article:
Nearly a quarter-million people in the United States will undergo weight loss surgery this year to arrest their morbid obesity and lose weight. In spite of the drastic nature of gastric surgeries not all patients will reach a healthy weight and some may eventually regain weight they lost initially with surgery. Link to Article


You deserve to be your very best:
Obesity be damned for getting in the way!
This article excerpted with permission from the 5 Day Pouch Test Bulletin January 2014.

Ebola: Facts and Knowledge

Health Headlines:
Ebola: Facts and Knowledge

The headlines about the ebola outbreak in West Africa and now spreading to various regions in the world, including the United States, are frightening. And while ebola does not target weight loss surgery patients specifically, I know that our group is curious and proactive as we pursue better health and improved quality of life with bariatric surgery. To that end I'm sharing two reliable sources of ebola information that go beyond the scary headlines to inform and educate us on the facts of this deadly virus.
Please follow these links to learn more:
CDC Infographic: Facts About Ebola in the US

World Health Organization: Ebola Virus Disease Fact Sheet

Weekly Digest: Self-Compassion Leads to Weight Loss

The 5 Day Pouch Test: Express Study Guide

The LivingAfterWLS Weekly Digest is out: Check your email Inbox or go directly to online archive to read the weekly newsletter: Digest October 14, 2014

"We didn't ask for obesity and we didn't ask for the fight of a lifetime to keep it under control. Treat yourself kindly. Find your personal hell-bent determination. You already know how courageous and powerful you are: you learned that when you underwent bariatric surgery. The 5 Day Pouch Test will help you find that place again through the course of five days focused on your mental and physical wellness. Pull out your strength and reserves and let's do this together.." 
~Kaye Bailey page 21,
5 Day Pouch Test Manual

Thank you for joining me in this week's LivingAfterWLS Digest, I know your time is valuable and appreciate you spending some of it with me. Today I address the issue of self-compassion and kindness and the role it plays in our health and weight management after surgery. As a group we are generous with our kindness and caring for others, but oh-so-hard on ourselves. Not a day goes by where I don't receive an email full of self-loathing and disappointment when WLS has not gone text book perfect as planned. Words like "failure" "disappointed" "angry" "depressed" and "hopeless" are used to describe setbacks that are perceived as personal weakness. Yet if we were to listen to a friend talk this way about herself we wouldn't allow it - we would build on her strengths and abilities and buoy her spirits with encouragement and praise.

It is time we turn the table and exercise self-compassion and self-kindness. Doing so is the first step in taking positive action to manage our weight and health using the surgical tool we so desperately needed. Our featured article, "Encouraging self-compassion for a positive body image" is a good starting place to launch your campaign for self-kindness. Follow that with some "me time" spent on the LivingAfterWLS Personal Self Assessment, your quarterly review of your goals, progress, and plans. Download the worksheet for free: Self-Assessment Worksheet.

Other features in today's Digest include some fact-filled links on the big health headline: Ebola Virus Disease; updates from the new and improved LiviingAfterWLS Blog; a great recipe for Beef with Soba Noodles; and a quick study on the health benefits of walking.
I hope you find this digest useful in your ongoing efforts for improved health with weight loss surgery. You have the power to make this your healthiest season ever! Let's do it together!

Link to Digest in our Archive

Monday, October 13, 2014

Shout-Out to Eggface: Terrific Egg Recipes

As a follow-up to our post on World Egg Day I direct you to Shelly's "The World According to Eggface" blog where she posted eight terrific egg recipes suitable for the healthy weight management high protein diet of weight loss surgery. Check out her recipes here:

It's World Egg Day! 8 Eggceptional Recipes

 Shelly's Ham, Cheese, Triple Onion Egg Bites


Test Your Hunger with a Carrot!

The 5 Day Pouch Test: Express Study Guide

I came across this terrific hunger test on the well respected website: Lap Band Doctors. The concept is a simple self-question to determine the true nature of feelings of hunger in the moment we are feeling "hunger." We all feel hungry at times, sometimes physical, sometimes emotional. In an effort to remove the confusion between emotional hunger and physical hunger try this simple question and answer test as presented here by Dr. Ron Hekier:

By Dr. Ron Hekier October 11, 2014
"We’re all victims to emotional eating.  No one is immune to emotional desires that encourage eating.

Myself, I find that I’m most likely to make a poor food choice and eat snacks and junk food that I normally don’t when I’m under stress or feeling negative emotions.

In my experience, a significant amount of people have weight issues because of an emotional connection to food together with a rational detachment from food.

I want to share with you a great tip I just learned of while listening to a podcast about changing one’s state of mind. It can help you avoid snacking and reduce eating by incorporating a habit to change your frame of mind.

I’ll call it the carrot test.
Next time you are hungry and about to eat something outside ask yourself the following question: “Would I eat a carrot right now?”

That simple question “Am I hungry enough that I would eat a carrot now?” makes us mindful eaters.

I just learned this technique but I think it has the potential to work very well. If every time we’re about to eat a snack we ask ourselves if a carrot stick will satisfy us it makes us mindful eaters.

Before you grab any junk food or snack if you take a moment to ask yourself  “I’m hungry.  Would I eat carrot sticks now to satisfy my hunger?”

If the answer is no, then you aren’t hungry, but instead there is some emotional trigger driving you eat."
More Tips and Advice from Lap Band Doctors


Carrots Are Good!

If you are truly hungry have a carrot stick or two! Carrots are the leading source of beta carotene in the American diet. They also contain flavonoids, phytochemicals that function as antioxidants. A 1-cup serving of raw carrots provides 52 calories, 4 grams fiber, 1 gram protein, 686% of your Vitamin A Daily Value, 18% Vitamin C Daily Value and 13% potassium Daily Value. Carrots are an economic treasure at just .80 cents/pound. They keep well in the refrigerator and are easy to take on the run. On the Glycemic Index carrots score a 41 which is low-glycemic, making them a good addition to low-glucose-impact diet.

Friday, October 10, 2014

Quick Recipe: Ham and Egg Breakfast Bowl

The 5 Day Pouch Test: Express Study Guide

In celebration of World Egg Day I share this recipe, with permission, from the American Egg Baord: Incredible Edible Egg. Check out Incredible Egg for great recipes and tips for including eggs in your high protein WLS diet.
"Is your breakfast incredible? If not, then start your morning with eggs. They are all-natural and contain high-quality protein to keep you fuller longer and energized all day long. Plus, with 64 percent more Vitamin D and 14 percent less cholesterol than previously thought—eating delicious eggs for breakfast is a no brainer." ~ Incredible Edible Egg - American Egg Board

1-Minute Ham & Egg Breakfast Bowl

Eggs, ham and cheese join forces in a three ingredient breakfast bowl that's fast and mess-free.
Prep Time: 15 seconds
Cook Time: 45-60 seconds
Servings: 1 serving

1 thin slice deli ham (1 ounce)
1 EGG, beaten
Shredded Cheddar cheese

Step 1     LINE the bottom of 8-oz ramekin or custard cup with ham slice, folding ham in half, if necessary. POUR egg over ham.

Step 2     MICROWAVE on HIGH 30 seconds; stir.  MICROWAVE until egg is almost set, 15 to 30 seconds longer.

Step 3     TOP with cheese.  SERVE immediately.


Don't overcook.  Scrambled eggs will continue to cook and firm up after removed from microwave.

Microwave ovens vary. Cook time may need to be adjusted.

It's World Egg Day! Yes - How eggcellent is that?

The 5 Day Pouch Test: Express Study Guide

"World Egg Day is a unique opportunity to help raise awareness of the benefits of eggs and is celebrated in countries all around the world. The International Egg Commission has proclaimed the second Friday in October as World Egg Day. Countries throughout the world will be joining in the celebration of the egg." International Egg Commission

In honor of World Egg Day I share this article with permission from Medical News Today by James McIntosh.

"Eggs are a common food source and have been eaten by humans across the world for thousands of years. Eggs are produced by the female animals of many different species, but by far and away the most common choice for consumption is the egg of the chicken.

The US is regarded as the world's largest exporter of eggs1 and it is estimated that in 2014, 256 eggs will be produced for each member of the population - the highest rate of production in the past 8 years.

Eggs are considered to be one of the best sources of protein available. One medium-sized egg weighing 44 g typically contains 5.53 g of protein. Nutritionists often use eggs as a point of comparison when assessing whether another food is a good source of protein or not. Around 12.6% of the edible portion of an egg is protein.

A medium-sized egg typically contains 5.53 g of protein and only 63 Calories. Around 9% of an egg's content is fat, found almost exclusively in the egg's yolk.

The majority of fat in an egg is that which is generally regarded to be the most healthy; approximately 38% is monounsaturated and 16% is polyunsaturated, with only 28% being saturated.

Eggs are also a rich supply of long-chain omega-3 fatty acids. These are predominantly in the form of docosahexaenoic acid (DHA) which helps with the maintenance of brain function and normal vision.

These fatty acids are most commonly found in oily fish and so eggs provide an alternative source for people that are unable to eat fish.

Possible health benefits

As suggested by their wide nutritional content, there are several health benefits that can be derived from eggs:

  •     Strong muscles: the protein within eggs helps keep muscles working well while slowing the rate at which they are lost.
  •     A healthy brain: eggs contain vitamins and minerals that are needed for the regular functioning of cells, including the brain, nervous system, memory and the metabolism.
  •     Good energy production: eggs contain all the daily vitamins and minerals that are needed to produce energy in all the cells of the body.
  •     A healthy immune system: likewise, vitamin A, vitamin B12 and selenium are all key to keeping the immune system healthy.
  •     Lower risk of heart disease: having a healthy immune system helps. Choline plays an important part in breaking down the amino acid called homocysteine, which is associated with the development of heart disease.
  •     Healthy baby development during pregnancy: nutrients within eggs help to prevent birth defects such as spina bifida.
  •     Healthy eyesight: lutein and zeaxanthin help to prevent macular degeneration, an eye condition which is the leading cause of age-related blindness. Other vitamins also promote healthy vision.
  •     Weight loss and maintenance: the high quality of protein within eggs has been found by researchers to keep people energized and feeling fuller for longer. Feeling full prevents unhealthy snacking and reduces overall calorie intake.
  •     A healthy appearance: some vitamins and minerals within eggs help promote healthy skin and work to prevent the breakdown of body tissues. A strong immune system also contributes to a healthy look overall.

McIntosh, J. (2014, October 10). "What are the health benefits of eggs?." Medical News Today. Retrieved from