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Back On Track Together - Back To The Basics

posted 1/7/09 12:07 am

Remember when we were preparing for surgery?  How many meetings, classes and such did we attend?  We were told the more prepared we were the better our chances were for success.  And they were right.
Go through the house, car and work place and get rid of trigger foods.  Stock up on foods that will keep you on track.

Get back to journaling.  This will help you identify when you feel like eating, stress factors and any triggers in your life.  Once you identify these factors, this will help you put tools in place to keep you from eating.  For example, if you find you are eating more at night, then sign up for a dance class or something fun you like to do.  Go for a walk, bike, and swim or come to OH and reach out to your friends in the Back On Track Together Group.
·    Go back to your old blogs and read them, make notes of what worked for you and what didn’t.
·    Journaling can be a powerful tool in recognizing your successes and emotional red flags. 
·    Track all your food.  Write it all down.  Even condiments contain calories and all the bites that you take have calories in them.  They add up fast.
·    Note how you are feeling during the day.  This will help you find out if a certain time of the day or event is a trigger making you eat.
Here is a list of some websites that will help you track your food, exercise and water;

ObesityHelp Health Tracker
iphone apps - Lose It, iFitness, ALowGIDiet and Tap & Track

Make a list of goals for yourself.  Make them realistic and small.  As Cathy pointed out, small steps are easier to reach than unrealistic ones.  For example, set your goals like being able to take in your belt one notch and then reward yourself with something non-food. This is realistic and you can make it happen, instead of a goal of losing 5 pounds in one week.  You are just setting yourself up for that Merry Go Round we don’t want to get on again.  Unrealistic goals, beating yourself up and saying the hell with it leads to emotional eating.  Let our rebel yell be NEVER AGAIN!

In general, a long term post-weight loss surgery eating plan includes foods that are high in protein, and low in fat, fiber, calories, and sugar. Important vitamins and minerals are provided as supplements.
General Dietary Rules
·    While this food plan includes all 5 food groups, it is best to start each meal with high-protein foods, like lean meats or LF milk.
·    Eat small, frequent meals throughout the day. This is essential as your stomach pouch is small.
·    Each meal or snack should be small.
·    Eat and drink slowly. Allow up to 20 to 30 minutes to finish your meals and snacks.
·    Take small bites and chew all food thoroughly.
·    Avoid extra liquids during meals.
·    Learn to read labels on food for fat content. Aim for no more than 35 grams of (good) fat per day.
·    Foods which are best avoided include:
- High-sugar carbs, including carbonated or regular beverages or sodas.
- Fried foods
- High-fat fast foods, including snack chips, candy, junk food, chocolate or cookies.
- Sugar foods like white/brown sugar, syrup, molasses, jelly, desserts, and jams.
- Alcohol.

Fat in Weight Loss Surgery Food Plan
To help with weight loss and to maintain your weight loss, limit your fat intake to no more than about 35 grams of fat/day and avoid the following high fat foods and beverages except in small amounts:
Olives, nuts, avocados, regular mayonnaise, sour cream, cream cheese, pie crust, whole milk, butter, margarine, peanut butter, granola, muffins, cole slaw, potato salad, whole milk cheese, snack crackers, ice cream, shortening, lard, regular salad dressings, sauces, fried foods, bacon, sausage, bologna, potato chips, doughnuts, all oils, gravy, regular sodas, Kool-Aid, etc.

Sugary Foods and Refined Carbohydrates in Weight Loss Surgery Food Plan
By sugary foods, we mean food like: candy, cookies, ice cream, milkshakes or slushes, soda pop, sweetened juices or gelatin, and most desserts. The weight loss surgery food plan is low in these sweet and sugary foods for a number of reasons. First, these foods are high in calories and fat. Even in small amounts, they can make weight loss difficult.   Finally, most sweet and sugary food options are "empty-calorie" foods - meaning, they provide calories but no nutrition. And since calories are so restricted on a long term weight loss surgery food plan, it is important that nutrient-dense foods become an eating priority.  (AS A GENERAL GUIDE, BE CAUTIOUS IN EATING AN ITEM THAT CONTAINS MORE THAN 15 GRAMS OF SUGAR.) 

The first rule for living after Weight Loss Surgery (WLS) is Protein First – that means eating protein for three daily meals and (PLANNED) snacks.  The overall guide is you take what you weigh and divide it in half for your general protein requirements up to 125-150 grams per day maximum.  Of course, your activity level can cause that to be higher if you have a physical job or do considerable weight training.  Animal products are the most nutrient rich source of protein and include fish, poultry and meat. Dairy protein, including eggs, is another excellent source of protein. Nuts and legumes are also good sources of protein, but sometimes difficult for bariatric people to consume. 

Weight loss surgery people don’t have a choice, they must eat lean protein or they will get sick, anemic, and weary. Weight loss will cease or increase if they eat processed carbohydrates instead of lean protein.
The distinction must be made between high fat proteins and lean proteins. A weight loss surgery person should not eat high fat proteins such as bacon, fatty beef or sausage products or greasy fried chicken.  In addition, these high fat protein rich items are contributors to obesity and should be avoided by anyone wishing to control their weight.

The average, Non-Weight loss surgery person in general has a 50% to 80% of malabsorption.  There are a few that may be at 50% but the rate for most of us is higher than that. 
·    To maintain nutrition eat more protein foods like:
·    - Skim or 1% milk (if tolerable for your pouch)
- Low-fat cottage cheese
- Low-fat or non-fat yogurt with artificial sweeteners
- Egg whites
- Low-fat cheese
- Oatmeal and cream of wheat made with skim milk
- Fish
- Chicken and turkey (poultry)
- Other lean meats (pork tenderloin, extra lean ground beef)
- Non-fat dry milk powder (added to casseroles, soups, hot cereals, etc.)

Water is our Best Friend.  We need to drink water. Drink a minimum of 64 ounces a day – eight glasses a day. Weight loss surgery people don’t have a choice: they must drink lots water. Other beverages including coffee, tea, LF milk, crystal light should be consumed after you have met your water requirements.  Soft drinks and alcohol are forbidden (yea, I know what you are saying on the alcohol one).  Water is the essential fluid for living. Water is one of the most important nutrients the body needs to stay healthy, vibrant and energetic. A tell-tell sign of a weight loss surgery person is the ever-present water bottle.

The human body is a magnificent vessel full of water. The brain is more than 75 percent water and 80 percent of blood is water. In fact, water plays a critical role in every system of the human body. Water regulates body temperature, removes wastes, carries nutrients and oxygen to the cells, cushions the joints, prevents constipation, flushes toxins from the kidneys and liver and dissolves vitamins, minerals and other nutrients for the body’s use. 

Nutritionists say a precise measure of the body’s need for water is to divide body weight (pounds) in half and drink that many ounces every day. That number could well exceed 200 ounces a day for morbidly obese people actively engaged in weight loss.

The body will panic if actual water intake is significantly less than required. Blood cannot flow, waste processes are disrupted and the electrolytes become imbalanced. Proper hydration prevents inflammation, promotes osmosis and moistens lung surfaces for gas diffusion. It helps the body regulate temperature, irrigate the cells and organs and promotes all functions of elimination. Certainly by drinking plenty of water many people could resolve inflammation and elimination problems that result from insufficient water intake. Adequate water facilitates weight loss.

Weight loss surgery people are instructed to avoid grazing. No exceptions.

Grazing is the worst possible thing a WLS person can do. If we graze we cease to lose weight and regain weight. In addition weight loss surgery grazers risk severe swings in blood sugar levels and glucose overdose, they fail to move forward to the healthy life that surgery makes possible.

The nature of weight loss surgery gives people an edge on beating the grazing habit. When a person eats 6 small protein-rich meals a day or 3 meals with planned snacks in between, the body’s fuel requirements are met with no bad grazing. Hunger does not occur if water is sipped throughout the day. If a person is taking vitamins they will not be nutritionally wanting. Given that, people who graze are doing so out of the very habit that contributed to obesity.

Successful WLS people understand that grazing is bariatric purgatory. When they begin to graze weight loss will cease and weight gain will certainly result. Successful weight loss people – those who maintain their weight loss years after surgery – do not graze.  The same is true for all successful weight losers regardless of the means by which they initially lost weight.  In our experience, we find that grazing is the number one cause for weight regain.
Last But Not Least – Exercise
Nothing is more disappointing than hearing a weight loss surgery person brag that they didn’t have to exercise to lose weight. It’s true; people will lose weight without lifting a finger. But people who do not use the time of rapid weight loss to incorporate exercise into their lifestyle are doing themselves a grave disservice.

Obesity cripples the body. Bone tissues are compromised, joints are swollen, the vascular system is inadequate and the skeleton overburdened. As weight is lost, the burden on the bones, joints and vascular system is decreased. However, the body is a magnificent machine. Given proper nutrition and physical motion it will rebuild its broken framework. The systems can become strong and vital.

The most effective way to heal the body from the ravages of obesity is to exercise. Exercise means moving the body: walking, stretching, bending, inhaling and exhaling. Exercise is the most effective, enjoyable, beneficial gift one can bestow on themselves in the recovery from life threatening, crippling morbid obesity.


Doc prepared by the BOTT Team, Cathy Wilson and Kathy S.

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