Most people tend to think of the period after WLS where you have reached your goal weight as “maintenance”, but lately I’ve been starting to look at it in terms of something else; prevention. It’s something that’s been bouncing around in my head for a few weeks now, and I touched on it briefly during my talk at the NW WeightLoss Conference over the weekend.

See, in some ways, I am still a fat dude. I’ve lost a lot of the weight, but I’ve been slowly coming to terms with the fact that maintaining that loss may not be enough. I need to prevent becoming becoming … not so much obese, but rather prevent becoming unhealthy in the ways I was before.

Semantics? Possibly. But I think the two may have some subtle, yet important differences. See, I’m about 25 pounds up from my lowest point of about 18 months ago, but the majority of that has been muscle mass. And, at my current weight I am just a few pounds away from falling in to the “obese” category on the BMI charts. Yea, that means that I am “overweight”. Even at my lowest weight I was still about 12 pounds from even cracking in to the upper limit of “healthy”.

It can be a tough struggle against that label, against those numbers. It can be very hard at times to not become frustrated that after everything I’ve gone through, after everything I’ve done to be healthier, to look at that chart and realise how close I am to still being classified as obese… No matter how good everyone tells me I look, no matter how many accolades I get from family, friends, my doctors and nurses. Those feelings are still there, ebbing and flowing like the tide… they recede for awhile but they also continue to find their way back.

I haven’t talked about this much yet, because we’re still in the formative stages, but I’m working with some folks from my bariatric center at Unity Hospital and we’ve basically formed the Unity Obesity Advocacy Group. I am going to (hopefully) be arranging some meetings with my state reps in the coming weeks to tell them about myself, my struggle with my weight, some things about obesity and bariatric surgery in the hopes of building a relationship with them and educating them on some of the things facing those fighting obesity. Then ideally, as legislative issues come before them in their work that they have a face to put to the stories, information and knowledge to help them make a more informed decision and maybe even someone they can turn to when they need more information.

One of the key points we eventually hope to make that while all the talk these days about obesity prevention is great… there also needs to be some focus on treatment. I’ll get in to this more later, but it’s sort of what got me thinking about what I’m trying to say here.

I didn’t do so hot on the prevention side, in fact I failed at it. So I needed treatment. Bariatric surgery, in my case gastric bypass, has been an effective treatment for me, very effective. So now what?

If you look at the definition of “maintain” and it’s basically about staying at a certain place, a certain level. But my treatment has had effects on more than just my weight, it’s improved my health in so many other ways. And I’m not just talking about my physical health either, I’m talking mental and emotional health as well. On the other hand, “prevent” is about keeping something from happening.

So the more I have been thinking about it, the more I have to wonder why I would want to stay … to maintain where I am now. Cause I don’t. I want to continue to grow in the areas of my mental and emotional health. As far as my physical health, even if I couldn’t do much to further improve that, it’s not so much about maintaining my current health as it is preventing going back to being unhealthy. I’m sure my weight will continue to fluctuate, be it from changes in my muscle mass or even some fat here and there. And I’m (mostly) ok with that. What I’m not ok with is going back to being unhealthy, no matter what the number on the scale says.

I am NOT the same person I was 3 years ago. I am NOT the same person I was 160-170 pounds ago. I don’t want to be. So does maintenance presume that I will stay who I am today even if those numbers remain the same? I would hope not, but I simply do not want to continue to be who I am right now. I want to continue down this path I’ve been on when it comes to my mental and emotional as well as physical health.

Maintaining my weight isn’t as important to me as preventing becoming unhealthy again. And I can pretty much say the same thing when it comes  to my mental and emotional health as well.

Ok, yea, I suppose I could say I’m at the point where I am looking to maintain a healthy weight, but again, that is only part of the picture. I am not my weight. I am not my surgery. These things are parts of a whole. I dunno, this is sort of something that has just been creeping in to my consciousness and I maybe I still need to spend some time considering it, but right now I have the feeling that a slight shift from a maintenance mentality to one of prevention is worth exploring.

I’d be interested in hearing your thoughts.

Maintaining a consistent exercise routine is tough. It’s tough for just about everybody, not just weight loss surgery patients. Finding time to exercise in our busy lives can be a challenge. I roll out of bed at 5 a.m. to fit my routine in my schedule. I know others spend their lunch hours or late evenings at the gym. Beyond scheduling, maintaining interest in exercising is probably the next most difficult challenge we face in staying fit. Once boredom sets in, it’s only a matter of time until our visits to the gym or time on the treadmill becomes less frequent and finally non-existent.

Two summers ago, one year out of my Lapband surgery, I was itching to vary my workout routine. The monotony of the treadmill and stationary bike for the past year was overwhelming. I searched for an alternative. With the onset of spring, I had begun regularly walking the neighborhood and remained unsatisfied. I took a look at my bike hanging from the garage ceiling and decided to take it down for a spin. Later that week, I set out for an eight mile ride on a popular local trail. I was hooked and knew I found my niche.

What I found that first summer of cycling was that exercise can actually be enjoyable. I loved being outside. I met new people as I explored bike paths and trails around Northeast Ohio. I actually became skilled in a sport; something that I had never been in my whole life. I was more fit and healthy from this cycling. I was achieving better results than I had by running on the treadmill where I was bored to death.

Beyond breaking the monotony of exercise, I developed self confidence, a desire to compete, and a thirst for new challenges. I see these as victories similar to our weight loss surgery non-scale victories. These attributes are not about pounds lost or muscles gained. They are about changes in my self that made me a different person. I used exercise as a tool to become a new Tom; a Tom who strives to be active and savor the excitement of a sport and the completion that comes with it.

This coming week I am about to embark on the greatest challenge in my life. Days before my third weight loss surgiversary I will complete a 1o day bicycling tour with my best weight loss cycling pal Chuck. We will cycle almost 400 miles from Pittsburgh, Pennsylvania to Annapolis, Maryland camping along the trail. It is definitely stretching the envelope for me. There will be a lot of unknowns and most likely some pretty trying days. I know the rewards are there for the taking. I know I had to meet this challenge to continue my journey to become an experienced cyclist and stronger person.

I am painfully aware that the monotony of exercise can set in at any time. I plan on varying my exercise routine using the self confidence and strength I gained from my cycling as a tool to break free from monotony. As summer wanes, I plan on giving yoga a try. I hope to find a gym where I can work with a personal trainer on developing a routine that I enjoy. I know I need to step up the variety of my exercise routine or it will become history.

I am not a personal trainer or a person who is capable of recommending an exercise routine for you. I am a person who knows the value of exercise and have experienced a very positive change in my life by including it in my life. If you have abandoned exercise at this point in your weight loss journey, I want you to give something new a try. Ride a bike; take a hike; enroll in a yoga class; or give kick-boxing a try. Variety is the spice of life and also a powerful tool to break free from the monotony of exercise. There is no reason to not have a good time when you are exercising.

Tom from beariatric.com

Note: You can follow my cycling journey at Crossing Mountains, Chasing Rivers (http://crossingmountains.com/). Subscribe to my real time updates from the trail by entering your email address and clicking on Subscribe under Follow our Footsteps in the right border.

Living in your comfort zone can be either a good or a bad thing. If you have been working hard to transform your life and reach a level of change, it’s good to stay in a well earned comfort zone. Change is mentally and physically challenging. When you achieve that change, your body deserves a time to recharge and reap the benefits. The bad side of a comfort zone is when we move in and stay too long. A little too much comfort breeds complacency that can unravel that hard-worked-for transformation.

One can choose to go back toward safety or forward toward growth. Growth must be chosen again and again; fear must be overcome again and again. – Abraham Maslow, founder of humanistic psychology

It’s good to remind ourselves of what athletes refer to as “being in the zone”. It’s that place where an athlete wants to be. They are performing at their peak with everything going perfectly and without much thought. These experienced athletes know that to stay in that zone they need both challenge and nourish their bodies. That balance between testing their limits and being happy performing at their current levels is what makes them grow and expand beyond their current boundaries.

The athlete’s well thought-out balance translates well to a bariatric patient’s weight loss journey. It is where emotional health and physical health come together to assure continued success in a sustainable weight management program. There is no standard template on how to live in the zone. It varies by the individual. It starts with knowing ourselves. We need to understand when a comfort zone helps us reach our full potential and when it hinders our march forward. Here are a few helpful hints to help you define your comfort zone and how to live your post-op bariatric life in and out of the zone.

1. Discover the real you. — I spent considerable time developing my personal wellness vision that identified what success and happiness means to me.
2. Know your habits, both bad and good. – Habits are very hard to break. Your long term success will be greatly improved the more you understand your habits and how they impact your life.
3. You are #1. – This is difficult for most of us. Our work life, home life, and relationships put this to a test. Recognizing that YOU are the most important part of these is a must do.
4. Baby steps are good. — Remember the ancient Chinese proverb: A journey of a thousand miles must begin with a single step.
5. Be adventurous. – Test the boundaries of your comfort zone often. Testing is how you expand the limits and grow beyond the limits.
6. Enjoy life on the beach. – Above all, enjoy your time in the zone and reap those benefits, baby!

Tom @ Beariatric.com

Last week I linked to an article on The Huffington Post that was pretty negative regarding agave nectar and presented a bunch of info to back a claim on how it is worse for you than high fructose corn syrup (HFCS).

Well, Andy over at Small Bites has another opinion on the matter. And honestly, his opinions have been ones I’ve come to respect and trust… and he really does back up what he talks about.

Since I started Small Bites, I have always said that, as far as I am concerned, “sugar is sugar is sugar”.  All sweeteners offer 4 grams of sugar (16 calories) per teaspoon.  The best thing you can do is limit all added sugars — whether it’s white sugar, brown sugar, maple syrup, honey, or agave.

That said, I don’t see the need to demonize agave, which brings us to this post.

Honestly, I was hesitant to present the original article because I do have reservations about The Huffington Post in general… but it seemed a worthy enough article that I figured I would move past my own prejudice and share it. Do I regret doing so? No, not really, but I think you are doing yourself a grave disservice if you don’t also read Andy’s article as well.

You Ask, I Answer: Agave Is The New Enemy? [Small Bites]

Thanks to Darya over at Summer Tomato for the link to this Huffington Post article by Dr. Joseph Mercola that gives some frank info on agave nectar and comes to conclusion that it’s probably not any better, and maybe worse for you than high fructose corn syrup (HFCS).

Unfortunately, masterful marketing has resulted in the astronomical popularity of agave syrup among people who believe they are doing their health a favor by avoiding refined sugars like high fructose corn syrup, and dangerous artificial sweeteners.

And if you’re diabetic, you’ve been especially targeted and told this is simply the best thing for you since locally grown organic lettuce, that it’s “diabetic friendly,” has a “low glycemic index” and doesn’t spike your blood sugar.

While agave syrup does have a low-glycemic index, so does antifreeze — that doesn’t mean it’s good for you.

Most agave syrup has a higher fructose content than any commercial sweetener — ranging from 55 to 97 percent, depending on the brand, which is FAR HIGHER than high fructose corn syrup (HFCS), which averages 55 percent.

This makes agave actually WORSE than HFCS.

I hear voices in my head.

Our bodies generally know how they’re supposed to be, how they’re supposed to operate, and when something isn’t quite right with them… they tell us.

We just need to be willing to listen.

Ok, fine… they’re not literal voices like when we think to ourselves, but everything from a twinge of pain when we lift something wrong to that constant pain in our knee because we’re carrying around a couple hundred extra pounds are messages from our body that something just ain’t right.

Some messages require an interpreter in the form of a medical diagnoses, maybe for high blood pressure, or high cholesterol. But they’re all messages that our body is trying to get us to pay attention to.

And all too often we ignore them… or maybe worse yet we pop pills, get shots, or do other things that simply drown out that voice instead of taking the time to listen to what it’s trying to tell us.

I was that way. Advil for the knee pain. Sure, I could blame genetics for a bit of it, but being 380 pounds sure didn’t that chronic condition any better. Then there was Rolaids for the heartburn. And I was on meds for the hypertension. And some messages are easy to just plain ignore. Sleep apnea; I knew I had it. But heck, it only happened when I was asleep… so I didn’t have to deal with it.

These were all things I knew would at least get better, if not go away entirely if I just lost some weight.

I know that because every time I did lose some weight things would get a bit better. But those pounds I lost would find me again, bringing back buddies with them and all those things I knew where wrong but had been trying my hardest to ignore would get worse again.

Pre-op I lost over 50 pounds and by the time I had my surgery I had stopped taking the meds for acid-reflux. Just after surgery I took my last pill for my blood pressure. And while I haven’t been tested yet, I believe my sleep apnea is all but gone. Know how I know this? I listened to my body… and it was dreaming. I rarely hit that deep REM sleep before surgery, but within a few months after I was having vivid dreams again… which means I was sleeping… and sleeping pretty damn good.

Yea, I got pretty damn good at ignoring that voice in my head, but just because I’m a former fat dude now doesn’t mean I can continue to ignore it. Post-op it’s probably even more important to really listen.

In the weeks and months after surgery you really, really, really need to pay attention. You just had major surgery, a traumatizing event for your body. It’s going to be giving you constant messages about how you’re doing.

Try to do too much too soon, don’t get your fluids in, ignore your protein needs, try to eat something you probably shouldn’t; these are all things your body will be keenly aware of and it will let you know about in no uncertain terms. Dizziness, nausea, weird pains, acute tiredness, bloating, fevers and more. These are messages from your body that you’ve got to listen to.

A week after surgery I was just plain wiped out, and spent most the day in bed sleeping. By mid-afternoon I was running a fever of 101, and still I slept. By evening it was nearing 103. After paging my surgeon and letting him know what’s up… I got a bit of a chastising. Yea, my body was needing rest. I listened that message. But the fever… well, that was likely another message telling me…

“Hey! You can’t drink while you sleep dummy! Now I’m kinda parched here!”

I spent most the night taking sips of water every 10 minutes trying to get my body re-hydrated. By the next afternoon I was out walking again and even took my first post-op trip to the store and later made it to a support group meeting.

And as you progress further and further from surgery, there are other important messages you have to learn to listen for… feelings of hunger and fullness. As you start eating more (or less in the case of bandsters), you need to do like they all say… chew your food well, don’t drink, take your time, and pay attention to what you eat.

Just remember, your body knows you pretty well… learn to listen to it and work with it, it’ll thank you in the long run.

image credit: wake apparel

As a WLSer, we are given a tool to help us lose weight. Along with that tool our surgeons give us a set of guidelines on how to maximize the effective use of that tool in our lives. If you follow those guidelines, you are all but guaranteed that your surgery will work, and you will not only lose weight but keep it off.

There’s just one problem. We’re human.

For many of us, rules are meant to be broken. We get complacent. We get lazy. We get… Whatever it is, there’s going to come a time where we “break the rules”.

And ya know what? That’s ok.

Well, it’s ok as long as you don’t kid yourself about it and start thinking it’s ok to do so again and again and again.

Every decision you make about following your surgeons guidelines are going to have consequences, consequences YOU have to live with. If you make good decisions, you’ll be rewarded with good things. You lose the weight, you get healthy, you keep the weight off.

If you make bad decisions, you’ll likely lose weight more slowly than you otherwise would have (and likely not as much), you’ll end up with vitamin deficiencies, you’ll dump, you’ll regain the weight you lost…

Every decision you make will have consequences. The key thing to keep in mind, the thing to ask yourself is, are they consequences you can live with?

I’ve gone back and forth about posting things here on FFD that are just links to other sites, news articles, etc… when I find things of interest, I like to try and summarize how they are relevant to someone looking in to or has had WLS. But, I don’t always have the time to do so… and I figure why not start sharing these things I come across anyways?  So…  I’m starting up the “newsroom” category to use for when I post links to outside stories.

I have a couple to share real quick, one was posted by someone on twitter this morning and another from someone over on the BTV forums.

Confidence rises in weight loss surgery – at first I thought this was going to be about how the patient confidence rises, but it’s more about how WLS is increasingly becoming accepted as a treatment for morbid obesity.

Weight-Loss Surgery Pays For Itself After 2 Years, Study Shows – This is an older item, from September of 2008, but even then studies were showing how WLS would pay back in spades, not just from a health perspective, but also money wise.

While I would much rather you spent all of your free time reading what I have to offer here at formerfatdudes.com, I can’t keep up with writing enough stuff to keep you properly entertained and informed. Especially when I spend a good chunk of my time reading other sites myself.

Sites like Small Bites.

Small Bites is kept up by Andy Bellatti who working on becoming a Registered Dietitian and also has a degree in journalism. His mission for the site is summed up as follows…

Andy Bellatti’s Small Bites blog aims to deliver information on a variety of nutrition topics in a straightforward fashion free of hype, magic bullets, and quackery.

In these times of information overload and self-appointed gurus who lack basic nutrition science concepts, Small Bites delivers precise and scientifically sound advice to help you achieve your health goals.

A couple of articles he put up recently really caught my eye and I thought I’d share them…

A lot of post-ops use flax seed for things like the infamous “Muffing in a Minute” and other cooking as a way to get some baked goods while minimizing their flour intake. I also use flax seed meal as an egg substitute in some of the baking I’ve done. One of the big deals people make about flax seed is the whole omega-3 fatty acids thing… which I know nothing about, but which Andy actually explains pretty well.

Bottom line is that there are three types of these omega-3 things, and we need them all. Flax seed is great for one of them, not the best source of the other two, so you either need to keep some fish in your diet or use supplements to round things out.

And in case you needed yet another reason to look in to WLS, or incentive to keep the weight off that you’ve lost, here he talks a bit about about the Numbers Game and how excess weight has been shown to be the MAIN factor in over 70% of all cases of heart disease and over 50% of strokes.

Both of these posts are good examples of the straight forward, no-nonsense style in which Andy presents some great information on a wide range of nutrition and health related topics.

Happy Thanksgiving everyone!

It was roughly 13 months ago that I started down the path to WLS by getting a referral from my doctor to the bariatric clinic.

One year and two days ago I met with the nutritionist and was put on a 1500 calorie a day meal plan to lose the required pre-op weight. Yea, I kinda cheated a bit on Thanksgiving… and Christmas. But I made the commitment and did a lot better than I had the year before.

Now here it is a year, and bout 185 pounds later, and I am truly thankful I made the decision to have this surgery.

I have no doubt I will be here for many many more Thankgivings to come than I otherwise would have been…. years I’ll be able to further enjoy the other many things I’m thankful for, such as my friends and family… and also thanks to the surgery I can truly add good health to the list of things I am thankful for.

Enjoy your day everyone.