Rule #2 - Lots of Water

  LivingAfterWLS Weekly Digest February 2, 2011 

Rule #3 - No Snacking

LivingAfterWLS Weekly Digest February 9, 2011  

Rule #4 - Daily Exercise

LivingAfterWLS Weekly Digest February 18, 2011 

The Four Rules: Before surgery most of us were taught the Four Rules we must follow in order to achieve the best results with weight loss surgery - any procedure. Those rules (with minor variations from one bariatric surgeon to the next) are:

• Protein First
• Lots of Water
• No Snacking
• Daily Exercise  

In order to maintain weight loss and keep the obesity from which we suffer in remission we must follow these rules for life. If it has been a while since you have given consideration to the Four Rules I invite you today to spend a little time refreshing your knowledge and enthusiasm about the rules.

Understand the Four Rules of WLS Before Going Under the Knife 

Weight loss surgery is frequently perceived as an easy means to weight loss that requires little or no effort by the patient. However, patients who undergo bariatric surgery are prescribed Four Rules of dietary and lifestyle management that they will follow for the rest of their life if they wish to lose weight and maintain a healthy weight. Here is what you need to know about the Four Rules of weight loss surgery before going under the knife.

Link to Article  

Of the four lifestyle changes prescribed to bariatric patients following weight loss surgery Rule #4, Daily Exercise, is the most difficult for patients to incorporate in their weight loss program. Patients who undergo weight loss surgery are morbidly obese at the time of surgery and most often have been living a sedentary lifestyle due to mobility complications caused by their weight. The surgeon's advice to include daily exercise as part of a weight loss program can feel as daunting as the challenge to climb Mt. Everest. In addition to daily exercise weight loss surgery patients are prescribed a high protein diet, and they must drink lots of water and avoid snacking.

Patients are more likely to become physically active when they gently increase their Activities of Daily Living (ADLs) rather than a attempt a full-steam-ahead boot camp-style cardio and strength training regimen from the get-go. The well-known Duke Diet for healthy and lasting weight loss suggests that the first element of fitness is the ADLs which include everything from "waking up, getting out of bed, combing your hair, putting on your robe, stepping out to get the newspaper to doing household chores, taking care of the yard, and walking the dog." According to the Duke Diet program ADLs accumulate throughout the day and burn calories with little or no conscious effort.

During the early days and weeks of recovering from bariatric surgeries, including gastric bypass, adjustable gastric banding (lap-band), and gastric sleeve, patients are encouraged to walk short distances several times a day as part of their recovery program. As a person heals from surgery they can mindfully seek opportunities throughout the day to increase their ADLs in ways that morbid obesity had limited them before surgery and the resulting weight loss. Patients should avoid the mistake many have fallen to, that is "waiting until I lose the weight before I start exercising." Patients who wait to include exercise in their day or fail to increase their ADLs seldom achieve the desired goal weight or sustain the weight loss full term.

Consider these opportunities to increase Activities of Daily Living while recovering from gastric weight loss surgery:

Do moderate housework like vacuuming and sweeping more frequently and more energetically 

During TV commercial breaks stand and walk in place, do stretches, knee bends, or arm circles 

Take the dog for longer, more frequent walks 

Play actively with children and include brisk walking, bending, tossing or climbing movements at the park or playground 

Enthusiastically work in the garden mowing the lawn or raking leaves 

Use stairs instead of elevators or escalators going both up and down 

Take stretching breaks to loosen tight muscles during long working days at a desk or office job 

Stand for routine office tasks like sorting paperwork or filing and talking on the phone 

Do calf raises while standing on line or waiting for the bus 

Plan hometown walking tours for a leisurely afternoon and explore your neighborhood 

Bring groceries from the car into the house one bag at a time increasing steps, do arm curls with heavier items like canned goods before putting away 

Hand wash the car with a bucket of sudsy water and rinse with the garden hose instead of going to a drive through car wash to increase activity and save money

The benefits of increased Activities of Daily Living are twofold for weight loss surgery patients: the first benefit is that of increased physical mobility and stamina; the second benefit is enjoying activities which morbid obesity had prevented. As patients become stronger physically through increased ADLs and weight loss they can then, quite effectively, begin to add fitness-building activities to their healthy weight management routine.

Article Source: How to Increase Activities of Daily Living After Weight Loss Surgery

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I found this recipe in Prevention magazine and was intrigued by the addition of two eggs at the end of cooking. This method is similar to egg drop soup but I had never considered adding an egg to a more hearty soup. The result was a fresh and light chicken soup with a creamy texture thanks to the addition of eggs. Each 2-cup standard serving has 49g protein so a WLS portion of 1-cup has about 25g protein. Not too shabby when you balance that against the 16g of complex carbs you will enjoy when eating this hearty soup. Give the recipe a try - I think you will find it has everything you need for a best-nutrition meal and a comfort meal in one lovely warm bowl of soup.

Lemony Chicken Soup

Serves 4 (2-cup) Servings

Ingredients:

1 teaspoon olive oil

1 small clove garlic, minced

6 cups chicken broth, reduced sodium

1 rib celery, chopped

1 cup shredded carrots

1/2 teaspoon ground black pepper

1/4 teaspoon salt

1/2 cup orzo

2-1/2  cups frozen green peas or beans

3 cups chopped cooked chicken

2 large eggs

3-4 Tablespoons freshly squeezed lemon juice (1 large lemon)

Directions:

Heat olive oil in a Dutch oven over medium heat. Add garlic and cook until light brown, about 1 minute. Add broth, celery, carrots, pepper, and salt and bring to a boil over high heat. Add orzo and reduce heat to a simmer. Cook until orzo is tender, about 8 minutes.  Add peas and chicken and simmer 2 minutes. Meanwhile whick eggs and 3 tablespoons of the lemon juice in medium bowl. Temper egg mixutre by whisking in about 1 cup hot broth in a thin stream. Whisk egg mixture into soup and warm briefly over low heat, 2 minutes. Do not boil or eggs will curdle. Adjust seasoning as needed with more lemon juice, salt, or pepper and serve.

4 (2-cup) servings. Per serving: 424 calories, 49g protein, 10g fat, 32g carbohydrate and 4g dietary fiber. Remember, weight loss surgery patients should carefully measure a 1-cup serving, half of the normal suggested serving size, and avoid drinking liquids when eating meals. This helps us feel full longer and gives our body more time to digest and absorb nutrients.

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