support group guidance please?

I want to pool the group for input on a project I'm working on.  

Here are the boring details.  The request is below.  I work for a large-ish national health insurance company in the corporate offices, and suffice it to say that my CEO takes weight issues very seriously. His opinion is that he makes a major investment in people who work here, and he wants them healthy and happy, and he's willing to put the company's money where is mouth is.  When I started here I weighed 495, and they pretty much immediately started helping me lose weight (I haven't weighed in a week but I was 372 last week, surgery is tomorrow).  We have a full time medical clinic on site.  I was assigned a nutritionist, exercise physiologist, therapist, and an RN - led disease management team to address not just my weight, but related issues like changing behaviors, diabetes, back/knee pain, etc. This is all done free to the employees.  In addition, we have a private subsidized gym and on-site restaurant that serves some things like burgers, but they specialize in healthy foods and adjust recipes to various dietary needs as well- every day there is a changing list of sub-400 calorie selections, small farmers market, etc. Our health plan covers all weight loss surgeries with only a $250 cost to employees, and requires support programs afterwards. 

That is the problem.  It requires these support programs, but we don't have one.  Our best option is an Overeaters Anonymous meeting about 4 miles away that meets bi-weekly. Quite honestly, I went to one and it was miserable, deflating, and counter-productive, not to mention somewhat pandering. I know we can do better. 

I've forwarded a suggestion to the employee health group that we start one. They like the idea. Nobody there has actually had any weight loss surgery, and so cannot really develop an effective program that isn't more theoretical / lecture in nature.  They asked me to put together a group syllabus for discussion, and they my ideas so far so far, but they want me to fle**** out more because they've been looking for ideas for another purpose already.  

Here's the request.  I'd like you to review the syllabus, and tell me where I'm missing items, things I haven't thought of, anything you wish you'd known or thought of before / after surgery. The company has committed to doing something based on the initial syllabus, and if it's good enough they want to  explore certifying it for not just our employees, but for all the members we serve (2+ million) as a benefit. 

I'd love to get the opinions of the people here- on both sides of the bench! 

·         Sharing real surgical & outcome experiences

·         Risks of surgery

·         Proper after care

·         Surgical alternatives

·         How to “work” your new GI system

o   Order of ingestion guidelines

o   Fluids while eating

o   Feeling full vs being full.  When you feel full- you’re over-full

·         Discussing surgery with family & friends

·         Unexpected consequences of weight loss

·         Dealing with increased attention after weight loss

·         Using [restaurants] effectively

·         Discussing head hunger vs physical hunger

·         Post-surgical diet goals (800/80/40 plan and similar) and real techniques to reach them

·         The financial ROI of weight loss

·         Recognizing common side effects of weight loss surgery

o   Hair loss

o   Cold

o   Skin sagging

o   Sensitivity to

§  Alcohol

§  Gluten

§  Lactose

o   Better self image

o   Improved physical capabilities

·         Cooking techniques for healthier living (and demonstrations- I have portable cooking equipment from catering we could use)

·         Tasting & trading sessions for meal supplements / protein powders / etc

·         Vitamins and their new role in post-surgical patients (in particular B12 and Calcium malabsorption is prevalent), why they are so critical now.

·         Shopping support for

o   Food

o   Vitamins

o   Physicians/providers

o   Exercise equipment

·         Support resources

·         Exercise techniques and guidelines targeted to post-surgical patients

·         Clothes trading session maybe (we go through A LOT of clothes as we lose weight)

·         Perhaps and exercise club?

·         Maybe a team for a 5K walk/run?

Oh, just one more thing- one of the reasons I'm pushing this is that I found out that in my building alone, about 2% of all staff have had this surgery, and another 4% are seriously contemplating it.  That's ALOT of people that need good advice and support.  This isn't just about me.  As I found co-wokers that have had one of the surgeries, they all made the same comment- the BEFORE is easy, the AFTER is where you're on your own.  I want to change that.  

A couple of suggestions - you may have covered most of these in your outline above.  All I can say is that I wish I worked for your company!

• How to read a nutritional label
• What surgery should I choose?
• Online support (Obesity Help, MyFitnessPal)
• Gadgets for Geeks (FitBit, Endomondo.com, heart rate monitors, etc.)  
• The importance of protein on body function
• Surgery myths (the magic bullet theory, losing all your hair, looking gaunt/sickly, losing 50 pounds the first month, the "easy way out", etc.)
• The danger of comparing your journey to others
• Depression after weight loss
• What is the "Carb Monster" and how do I avoid running into him?
• What is "head hunger" vs. real hunger?
• For RNY patients, what is dumping and how to prevent it
• Buddy systems - assign a "vet" to someone contemplating surgery to help walk them through the process
• What do I need in the hospital?  What should I make sure I have in the house after surgery?
• Am I a food addict?  
• The danger of cross addictions post-surgery (alcohol for example)

I also think a buddy program for those post-op could be a good way to help keep you accountable, on-track and focused. Shopping support for protein products would also be a plus.

Recognizing common side effects of weight loss surgery....

Another thing, and maybe the most important, is reduction or curing of things like high blood pressure, type 2 diabetes, lowering cholesterol, less pressure on your joints, etc...

Jane

I'm pre surgery too.  I think your ideas are great.  You are very blessed to work for a company with those kinds of benefits.  My insurance does cover the surgery and I'm blessed to be using a center of excellence here in Asheville NC.  I will be using the behavioral therapist and NUT after surgery.  God bless you on your Surgery, I will see the Surgeon next month.  Tomorrow is my last visit to the weight Doctor at the weight management center before surgery.  I'm very excited and I know you must be.  Merry Christmas.

I think you should also add transferring addictions from food to alcohol. Sex, gambling etc.....

Um, wow, I want to work for your company!! Looks like a great list.

I would suggest:

for "how to work your new GI system": actually knowing your capacity and undereating it

Maybe a discussion on goal selection including measures of health such as BMI and body fat percentage

I don't see anything pre-op on here - like how to prepare for surgery (physically and mentally) or what to expect directly after surgery.

My favorite part of my support group is going around the room and hearing from everyone each month.   Everyone gets a chance to say how they did for the month.  The group then provides guidance, support and attaboys.  I look forward to those cheers from the group.....