LivingAfterWLS Weekly Digest
More than calories or grams:
Nutrient Intake Most Important After WLS

October 2014
In This Issue
October Theme
Health Headlines: B12 News
Your Body Perception Matters
Meds not working? Eat This:
LivingAfterWLS Blog Links
Recipe: Crispy Tilapia & Slaw
LivingAfterWLS
What if today we were just grateful for everything?


October Theme 
Compassion Starts Within

"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 

"Clinically, the study suggests a potential benefit to pre-operative weight bias screening. Identifying an opportunity to provide coping strategies, including counseling and peer support group participation, may help to foster long-term weight loss surgery success."
-- Internal Weight Bias Study


"If we continue to eat the things that led to our obesity in the first place, we will continue to be obese. If the behavior does not change, the result will not change."
~Kaye Bailey page 69
 Day 6: Beyond 5DPT


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"Obesity is a chronic, debilitating and potentially fatal disease."
American College of Gastroenterology - 2008

Check out our special edition Digest: Obesity is a Medical Condition, Not a Moral Failure
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Walk Your Way through Autumn





"
"Step for step, mile for mile, walking is the best cardiovascular activity you can include as part of your weight loss surgery success story. Walking is easy, accessible, inexpensive, individual and effective. It is the gold-star sport for real people with real lives. Formerly stigmatized as cheap transportation and a senior citizens' sport it is now a credible and fashionable form of exercise. And it's been around for a long time - anthropoids stood upright and put one foot in front of the other thousands of years ago and we haven't looked back since."
  • The RIGHT way to Stretch:
  • Relax into the stretch
  • Never force the stretch, and never bounce
  • Hold the stretch 5-10 seconds, ease off the stretch, then relax into the stretch once again for another 5-10 seconds
  • Take a relaxing breath as you start each stretch. Inhale through the nose, exhale slowly through the mouth
  • Keep your shoulders relaxed at all times

Most injuries during stretching occur due to improper stretching technique. Remember to be gentle, relax, and never force a stretch.

How is your walking program going this week?

 

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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 our nutritional needs following weight loss surgery. So often, due to our epic dieting history, we focus on counting calories or fat grams or most recently protein grams as measure of food intake. While these measures are important to our success with WLS, they are not the only things with which we must be concerned. We need to pay close attention to our nutritional intake: vitamins, minerals, phytochemicals, fiber, flavonoids, and all those things that keep the body running. Quite honestly, with WLS we not only want to lose weight, we want to feel fabulous and full of life when the pounds are gone. In order to achieve and maintain this euphoria of living we must feed our bodies well.

There is a goodly amount of new information coming out about nutrients and how our body absorbs them. One of the key findings in the last 10 years is that we need healthy monounsaturated fat in our diet because it delivers nutrients throughout the body. Nutritionists are now encouraging us to avoid fat-free products in favor of healthy oils including olive oil, canola oil, and the omega 3 fatty acid found in cold water fish. Today we look at why these healthy fats make a difference in our health and weight management, and how to effectively and appropriately include them in our post WLS diet. Fish and Healthy Fats.

Another commonly known factor in our battle against obesity is self-perception: how we view our body. Take a look at this revealing feature about the role of body image in our weight management: Your Body Perception Matters.   And finally, wrap things up with a terrific easy and affordable weeknight recipe: Crispy Cajun Tilapia and Slaw. So good!

I hope you find this digest useful in your ongoing efforts for improved health with weight loss surgery. You have the power and knowledge to make this your healthiest season ever! Let's do it together!
 
CHEERS!
Kaye


 
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Health Headlines:
Easy new blood test to determine Vitamin B deficiency

A new test for Vitamin B12 Deficiency may soon be beneficial to weight loss surgery patients who are at risk of vitamin b deficiency due to compromised nutrient absorption and low dietary intake. A study out of the University of British Columbia identifies Vitamin B deficiency with a simple blood drop test. In a report released today researchers indicate large portions of the population may benefit from this simple test.


 

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bodyHow people view their own weight influences bariatric success 

Medical News Today
Negative feelings about one's own weight, known as internalized weight bias, influence the success people have after undergoing weight loss surgery, according to research appearing in the journal Obesity Surgery, published by Springer. The study, from the Geisinger Health System in the US, is considered the first and only study to examine internalized weight bias in relation to post-surgical weight loss success in adults.

Internalized weight bias adversely affects many overweight people. Studies have shown that weight bias stems from personal perception or societal views that overweight people are personally accountable and at fault for their body weight. These overweight individuals feel - or think others feel - they lack the willpower, discipline and treatment needed to lose weight. In addition, people who are highly vulnerable to negative feelings about their own weight are more likely to experience low self-esteem and depression.

In this study, the researchers measured the degree to which participants internalized weight bias by developing negative self-attributions as a result of these biases. They leveraged Geisinger's electronic health record and its existing bariatric surgery database along with psychological surveys. The result: As ratings of internalized weight bias before surgery increased, weight loss success twelve months after surgery decreased.

The researchers found no differences in ratings of bias between participants' race or geographic location (urban or rural) but identified high levels of internal negative thoughts and feelings in about 40 percent of preoperative participants. In addition, greater weight bias was associated with greater depression. On average, most participants were white females with a preoperative mean BMI of 47.8 kg/m² and a postoperative BMI of 32.5±6.1 kg/m² twelve months after surgery.

Clinically, the study suggests a potential benefit to pre-operative weight bias screening. Identifying an opportunity to provide coping strategies, including counseling and peer support group participation, may help to foster long-term weight loss surgery success.

"How an individual internalizes weight bias relates to depression before surgery as well as overall weight loss success twelve months following bariatric surgery," says Michelle R. Lent, Ph.D., Investigator and Clinical Psychologist at Geisinger's Obesity Institute. "Future studies should assess the impact of early weight bias screening and intervention to promote better psychological health and weight loss results."


Media, Springer Science+Business. "How people view their own weight influences bariatric surgery success." Medical News Today. MediLexicon, Intl., 24 Oct. 2014. Web.
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Value Price: $3.95
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 WLS. The Express Study Guide includes the plan summary broken down by day; 32 FAQs and Answers about the plan; and 10 recipes to get you started.
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This complete collection of 5 Day Pouch Test approved recipes is a handy companion for getting back to the basics of weight loss surgery using the 5DPT as a tool.What's in it: A summary review of the 5 Day Pouch Test and review of the basic tenets of weight loss surgery, 60 tried and tested 5DPT approved recipes, and numerous informational tips to promote your successful weight loss and weight management with WLS.
Approx. 85 pages
$5.95 Instant digital download
Don't have a Kindle? No problem. The Kindle eReader app is available in your APP store or the Kindle Store for free. Benefit: manage your entire digital library in one place, your library transfers when you upgrade your device and may also be viewed on tablet, laptop or computer. Brilliant!
Apple ~ Android ~ Blackberry ~ Windows

depressDepression Meds & Fish:
Potential to Improve Patient Response

From LivingAfterWLS Blog October 21, 2014

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.

Link: 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.
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In response to our reader survey we are increasing the number of posts each week to our award winning LivingAfterWLS Blog. Now in it's 10th year we commit to continued quality and timely content intended to benefit and support your healthy weight management with weight loss surgery. Check out a few of our recent posts and bookmark LivingAfterWLS.blogspot.com to stay current with our postings. Thanks for being a part of the LivingAfterWLS community!



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So our task, once we have adjusted to the high protein diet, is to include plant carbohydrates as ingredients in our meal preparations; snacks when appropriate, and side dishes when possible. Don't miss the cool Infographic with this post!

Including veggies and fruit as part of a diet that involves low-volume capacity (tiny stomach don't ya know?) is challenging. I've pulled some of our top recipes from this blog for you to use in meal planning and as examples to spark ideas for including fruit and veggies on your plate. Take a look at some of these favorites!
Healthyhttp://livingafterwls.blogspot.com/2014/10/on-fridays-livingafterwls-blog-we.html

Are you eating enough protein to lose weight?
"We need protein at all stages of life, for a variety of bodily functions. It's the major component of all cells, including muscle and bone. It's needed for growth, development, and immunity to fight off infections and protect the body."

High Protein Energy Breakfast
I just found this great recipe from the American Egg Board: Mini Breakfast Pizzas. What a great way to start your day and what a healthy way to send the kids off to school.

Warm Soup: Perfect for Autumn Supper
"When post-WLS patients discover soup it often becomes their go-to comfort food. Soup is a very effective tool for calming carb cravings and satisfying our emotional need for comfort with food."

5DPT: Soups for Liquids - Refresher Course
We get a lot of questions about the soups for the 5 Day Pouch Test. Here is an explanation directly from our book: The 5 Day Pouch Test Owner's Manual. Many who have done the 5DPT and used the soups swear by them. Another question that I get frequently is, "Can I have the soups when I'm not doing the 5DPT?" The answer is a big resounding YES!

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recipeRecipe: Crispy Tilapia & Slaw
Quick and satisfying weeknight meal

This featured recipe is published with permission from page 103, Cooking with Kaye: Methods to Meals. Enjoy it tonight!

 

Cajun-Seasoned Crispy Tilapia

Indy Chef, quick cooking, loads of lean protein and healthy omega 3 fats 


Tilapia is readily available fresh or frozen. The lean flesh of tilapia is white, slightly tinged with pink, sweet and fine-textured. It's suitable for pan-frying, baking, broiling, grilling, and steaming.

Ingredients:
1 cup panko Japanese bread crumbs
½ cup cornmeal
2 teaspoons Cajun seasoning, salt-free
¼ teaspoon pepper
1 (1-pound) package tilapia fillets, fresh or frozen, thawed if frozen
1 tablespoon canola oil
1 tablespoon butter

Directions: On a shallow plate combine panko, cornmeal, Cajun seasoning, and pepper. Rinse fillets under cold running water; while still wet dredge in panko and cornmeal crumb mixture pressing to adhere crumbs to fillets. In a large, 12-inch high-sided skillet heat canola oil and butter over medium-high heat until hot. Add 3 or 4 fillets to hot skillet and cook 5 minutes on each side until fish flakes easily when tested with a fork; remove and keep warm. Repeat until all fillets are cooked. Serve warm with Yogurt Tartar Sauce, page 96, and Quick Cajun Coleslaw, recipe below.

Nutrition: Serves 4. Each serving provides 256 calories, 25 grams protein, 6 grams fat, 14 grams carbohydrate, 1 gram dietary fiber.

Try This: Cajun seasoning blends are widely available flavored from mild and sweet to spicy and hot. Most blends are built on a foundation of flavors that include garlic, onion, chiles, black pepper, mustard, and celery. Try several to find your favorite.

Quick Cajun Coleslaw: In a medium bowl whisk 1 cup reduced calorie ranch dressing, with 1 to 2 teaspoons Cajun seasoning blend. Add 4 green onions, chopped, and 1 (10-ounce) package ready-to-eat coleslaw salad mix. Toss together; serve chilled with Crispy Tilapia.

 

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The health content in the LivingAfterWLS website is intended to inform, not prescribe, and is not meant to be a substitute for the advice and care of a qualified health-care professional.

 

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Kaye Bailey, Founder
Evanston, Wyoming 82931