Not a day goes by that I don’t read some nutrition tip or hear about some product for bariatric surgery and say to myself… are you kidding me…this is such nonsense. And then I really get frustrated because you, my community, are likely reading this baloney too and maybe believing it. Bariatric dietitian Isabel Maples joins me to cut thru the crap. We’re picking some of the worse offenders and setting the story straight so you can make smart decisions.Podcast Guest: Bariatric Dietitian Isabel Maples, RDBariatric CoordinatorUVA Health in Haymarket, VirginiaEmail: ggw5ud@uvahealth.org Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Check out my freebie for 10 protein tips that work dailyOne of the things that frustrates me most for our bariatric community is the crap nutrition information on the Internet promising all kinds of miracles and delivering zero. In my Facebook group, I answer a lot of questions about this baloney. I’m not talking baloney you eat either but the baloney or pseudo science you’re constantly feed online. So today, we take on at least six current pieces of baloney and deliver some science-smart information so you can make decisions baked on fact not hype.Topics we'll dig into include:keto dietintermittent fasting black castor oil for hair lossbiotin and hair losspermanently slow metabolism after WLScollagen powder

There’s something about a new year…a fresh start, a time to reboot or tweak areas of your life that need an adjustment or a redo. Any decision to change habits, especially nutrition and health ones, takes work, right? The bariatric lifestyle is no exception. There’s a lot to learn and to know how to deal with. So this year, my focus word is IMMERSE. Let’s use the word ‘immerse' an a mnemonic to look at seven powerful strategies you can put into place for a successful bariatric lifestyle.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%****Stop dumping syndrome from dumping on your day. FREEBIE Are you feeling a little worn out from the holidays? Has the scale ticked up a few pounds and you’re not happy about it? Did you over indulge a bit and feel frustrated with where you are right now? That’s ok. You’re definitely not alone. But let’s get past the things of last year that want to haunt you and hold you back from your potential NOW. I love a new year and today’s a new day. Let’s approach it with hope and openness as to what you can accomplish…your expectations. As I just mentioned, this year, my focus word is IMMERSE. It’s easy to remember so let’s use it as a mnemonic for seven strategies to make this YOUR year, to live a successful bariatric lifestyle. But let’s get past the things of last year that want to haunt you and hold you back from your potential NOW. Let’s approach it with hope and openness as to what you can accomplish…your expectations. As I just mentioned, this year, my focus word is IMMERSE. It’s easy to remember so let’s use it as a mnemonic for seven strategies to make this YOUR year, to live a successful bariatric lifestyle. In this episode we'll dive deep into IMMERSE: I: individualM: mix it up!M: morph over timeE: expectationsR: reality checkS: set up for successE: enough

Here we are…about to wrap up another year and embark on a new one. Where do you find yourself right now? Are you just talking the talk when it comes to living out your bariatric lifestyle, wishing you could walk the walk? Our focus word for next year is ‘immersion’. Immersing yourself in the life you really want after weight loss surgery. Bariatric psychologist Dr. Connie and I are going to help you do just that. Dr. Connie joins me to help you immerse yourself into the new year…where you truly walk the walk and don’t just talk about it. Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchers Mind Prep The Book: How To Prepare for Bariatric Surgery and Live as a Healthy Post-Op: Mind Prep: The BookBariAftercare Daily Progress Journal Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.*** Protein freebie with 10 tips that work every dayToday we’re preparing for the new year and helping you immerse yourself in the bariatric lifestyle where you truly walk the walk. There is so much more to this journey than just the surgical procedure. We want you to be successful now and long term.Although many people have heard these phrases, let’s get clear about what we mean when we say… talking the talk versus walking the walk. Listen in as we explain how to both talk the talk and walk the walk. We get specific with tips and ideas that work as you commit to the new year and new lifestyle. We also get specific about what doesn't work and why not. It's an in-depth discussion you don't want to miss today.

Can you believe that 2023 is almost a wrap? Maybe you’re feeling like you haven’t accomplished all that you’re capable of this year or that you missed learning things that could help you on your journey. Well this part I can help with. Below, I'm sharing with you the top 10 podcasts from 2023. Pick and choose the ones that will help you right now or have a binge night and listen to a bunch of them. Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%*** Dumping Syndrome Freebie ***Top 10 Podcast List:EP 130 covers 7 things to know about Wegovy and Ozempic for weight loss after surgery so you can ask smart questions. https://www.breakingdownnutrition.com/blog/130-7-things-to-know-about-wegovy-ozempic-for-weight-loss-after-wlsGrab your digital note pad before you listen to EP 132. You’ll want to add these 15 tasty bariatric-friendly carbs to your mealshttps://www.breakingdownnutrition.com/blog/132-15-bariatric-friendly-carbs-bariatric-nutrition-q-a How about some bariatric-friendly foods that will help you fill up, but not fill you out? Listen to EP 133 for foods and tips on feeling more satisfied. https://www.breakingdownnutrition.com/blog/133-bariatric-friendly-foods-that-fill-you-up-not-out Don’t miss EP 129. Bariatric psychologist Dr. Connie joins me to help you deal with imposter syndrome. https://www.breakingdownnutrition.com/blog/129-how-to-deal-with-imposter-syndrome-bariatric-mental-health-q-a Listen to EP 131 and get the details on what fatty liver is, what it means to you and how diet can change it. https://www.breakingdownnutrition.com/blog/131-does-weight-loss-surgery-help-with-fatty-liver Bariatric psychologist Dr. Connie joins me on EP 134 to explain why relationships change after surgery and how to handle these changes. https://www.breakingdownnutrition.com/blog/134-how-wls-affects-relationships-bariatric-mental-health-q-a Bariatric dietitians Gayle and Isabel join me on EP 140 to answer your questions and explain why it’s beneficial to follow the 30-30 rule and for how long. https://www.breakingdownnutrition.com/blog/140-do-you-really-need-to-follow-the-30-30-rule-bariatric-nutrition-q-aDoes turmeric have anti-inflammatory benefits for your body? What about in a supplement? Is it worth spending your money or not? EP 135 gives you the science-based facts on this popular spice. https://www.breakingdownnutrition.com/blog/135-can-turmeric-help-with-inflammationDr. Connie joins me on EP 138 to talk about compulsive eating and how to deal with those feelings of guilt and shame. https://www.breakingdownnutrition.com/blog/1-138-how-to-deal-with-guilt-and-shame-after-compulsive-eating-bariatric-mental-health-q-aDo you think you’re getting enough calcium and vitamin D since your surgery? How do you know? How much is enough? Bariatric dietitians Gayle and Isabel join me on EP 136 to make sense of it all, so you know what to do. https://www.breakingdownnutrition.com/blog/136-getting-enough-calcium-vit-d

Do you feel blocked up, you know, like there’s a cement block in your colon? What a pain, literally, constipation can be after bariatric surgery or any time. Bariatric dietitians Gayle and Isabel join me to share nutrition strategies that are specific to constipation to help prevent and relieve it…tips you don’t want to miss and can help you feel better.Podcast Guests: Bariatric Dietitian Isabel Maples, RDBariatric CoordinatorUVA Health in Haymarket, VirginiaEmail: ggw5ud@uvahealth.org Gayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianWeight Loss and Bariatric Surgery InstituteOrlando, FLEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Mentioned in this podcast: Episode 132 15 Bariatric Friendly CarbsTopics covered:Do you think constipation varies with the type of surgery…do you think sleeve gastrectomy and lap band have more issues or what do you typically see?Constipation can occur for a number of reasons. Run thru a checklist with me and ask yourself how many of these speak to you. Any or all of these items can increase the chance that you’re constipated.Looking at constipation from the nutrition perspective Gayle, typically when do you start to increase the consumption of higher fiber vegetables, beans and lentils and do you have favorites to help prevent constipation? Isabel, talk about the goal for fiber and what’s realistic. Plus secrets to help meet that fiber goal too.Gayle, what about adding fiber supplements or a laxative when you feel block up? I’m not a big fan for rushing into this, are you?Tip: start by adding high fiber foods slowly to avoid gas and bloating. As you add foods with fiber, increase your fluids…they are team mates. Spread fiber sources throughout the day versus loading up at one meal.Gayle, is your protocol similar? Do you use a stool softener like Colace or a gentle laxative like Miralax?

It’s here! The season of eatings, greetings and meetings. Kicking off with Thanksgiving. I can almost hear you moan as you say to me, “how do I survive Thanksgiving without weight regain? What do I eat without kicking in my cravings or imploding my nutrition plan that’s been working so well?” Ok, first thing. I hear you. Let’s change that word survive to thrive. You heard me right. I want you to thrive this Thanksgiving and the entire holiday season. I have 5 strategies to help you do just that…let’s get started.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Recipe Mentioned in Podcast:Chocolate Peanut Butter ClustersEP on AlcoholEP 30 Bariatric Surgery and Alcohol Buzz: What You Need to Know Today's episode covers:permission to eat treats and desserts...what this means for youa go-to dessert and whysleep and hunger; why a nap is so importanthow to prevent the hangry takeoveryour action plan for success

Wayne asked me to do a podcast on food, grief and transition. I bet you haven’t thought about these three going together.  But ask yourself, are you dealing with any grief that might be tied to your surgery?  Have you thought about how grief might be related to what you choose to eat and to the transition you’re going thru? Whether you’re preparing for surgery now or have already gone thru it, food, grief and transition typically get skipped over but taking a look at them can really be insightful to your success. Bariatric psychologist Dr. Connie joins me to dig into how grief is tied to food choices and to your transition. You don’t want to miss this.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchers Mind Prep The Book: How To Prepare for Bariatric Surgery and Live as a Healthy Post-Op: Mind Prep: The BookBariAftercare Daily Progress Journal Let me remind you to listen to EP 80, 3 benefits of the MIND Diet. Find out specifically what brain-health foods are so you can add them to your diet. EP 80: 3 benefits of the MIND DietTopics we cover in this episode:Why do you think that grief, transition and then the tie to stress eating and food, seem to be left out of the discussion…what are some of the reasons?Does everyone experience grief following surgery and I’m getting really specific here…grief as it relates to the loss of food, or certain foods, that they no longer or should no longer eat? I can see both sides for you may also be thrilled after surgery that you may no longer be as focused on food.Do you think feeling grief over the loss of food is a “normal” part of the process following bariatric surgery?When you say ‘label it’ do you mean call it out, call it grief and deal with it?Let’s talk thru the TRANSITION that takes place after surgery…there’s a lot to we don’t think about…a.   Physical… transformationb.   Biological … internally… hormones…c.   Emotional… confidence…d.   Social…e.   Spiritual for some peopleThis might sound like an odd question but is the transformation process usually a happy time or a difficult time for people?How long does this transition stage following surgery typically last?

I’m going to give you several hints and I want you to guess the vegetable…ready? It’s good for your immune system, fat free, low in calories, cholesterol free, gluten free, very low in sodium and may contain vitamin D depending on how it’s grown. What is it? What’s your guess? If you guessed the mighty mushroom, you’re right. There are at least seven big benefits to adding mushrooms to your bariatric-friendly lifestyle.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Be sure and try our recipe for Magic Mushroom Burgers Did you know that mushrooms are technically not vegetables? They’re included with vegetables in nutrition education but scientifically are classified as fungi. They have no leaves, roots or seeds and don’t need light to grow, so they are not a true vegetable. However, the United States Department of Agriculture or USDA considers mushrooms a vegetable when educating because they have so many of the same nutrition attributes as other veggies. So botanically they are a fungi and considered a vegetable for nutrition. To look at mushrooms, you wouldn’t necessarily think of them as a nutrition powerhouse but don’t be fooled. Let’s look at seven health benefits to your body of adding mushrooms to your diet. And I’m talking about all varieties such as white button, crimini, portabella, shiitake, maitake, lion’s mane and oyster.I'll cover topics including:UV light and Vitamin Dprebiotics, gut bacterianutritional benefitsvaluable nutrients including selenium and your immune systemsodium and blood pressureumami the fifth tastehow to prevent GI distress from mushroomsrecipe for Magic Mushroom Burgers

It’s the dawn of a new era. First it was Ozempic and Wegovy and now there are more new weight loss drugs. They may be even better at treating obesity and achieving weight loss while also helping manage other diseases such as diabetes and high blood pressure. With some clinical trials promising weight loss of 20%, interest in these medications has skyrocketed! Along with the excitement of these new medications as hybrid treatments with bariatric surgery, there are side effects and nutrition concerns that you should be aware of and know how to handle. Bariatric dietitians Gayle and Isabel join me to share nutrition strategies specific to weight loss medications and bariatric surgery that you don’t want to miss and can empower your success.Podcast Guests: Bariatric Dietitian Isabel Maples, RDBariatric CoordinatorUVA Health in Haymarket, VirginiaEmail: ggw5ud@uvahealth.org Gayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianWeight Loss and Bariatric Surgery InstituteOrlando, FLEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%We go in-depth on the podcast and look at 5 nutrition ‘must knows’ and how to deal with them:nausea and vomitingconstipationloss of appetiteprotecting your muscle massbariatric supplements to prevent malnutrition

Ok, what do you think? How many teaspoons of sugar does the average soda contain? What’s your guess? Try 8-12 teaspoons of sugar per soda. Shocking isn’t it? Just for the heck of it, grab your sugar bowl and a teaspoon. Measure out 8-12 teaspoons. Can you believe that one average soda has that pile of sugar in it? I want to share with you how to find all the added sugars in your food.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Freebie: I developed a tip sheet to help you find the added sugars in your food using some of the tips we talk about today. Here’s the link for you to grab your free copy https://bit.ly/36YvdfQ Did you know that added sugars are basically empty calories? What the heck is an empty calorie? It means that the sugar provides you only calories and zero…zilch when it comes to providing any nutrition benefit to the maintenance of the body. Typically, added sugars are used as flavor enhancers and preservatives. And, don’t miss this…their carbohydrate-dense nature makes them a trigger for dumping syndrome.Topics covered in this episode:Science 101 of carb basicsAdded sugars versus naturally occurring sugarsGlucose use in the body/brainHow to read the Nutrition Facts labelIngredient list, what to look forHow to convert grams of sugar to teaspoonsMany names for sugar

Do you worry and obsess about how you look? Over something in your appearance that bugs you, but yet to others, is minor or not even noticed? Does it bother you so much that you can’t stop thinking about it? Maybe you feel so anxious about it, that you even avoid social situations. Bariatric psychologist Dr. Connie joins me to explain the difference between a distorted body image and body dysmorphic disorder. You don’t want to miss this episode.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchers Mind Prep The Book: How To Prepare for Bariatric Surgery and Live as a Healthy Post-Op: Mind Prep: The BookBariAftercare Daily Progress Journal Questions that Dr. Connie and I discuss in this episode:People talk about having body dysmorphic disorder after bariatric surgery as they lose weight quickly and no longer recognize the person they see in the mirror. But is this an accurate description of what body dysmorphic disorder or BDD is?I want to focus on the words ‘imagined defects’. Other people don’t notice this issue while you totally obsess over it. This is specific to BDD, right?What are the main causes of BDD?Let’s look closely at some of the warning signs that you might have body dysmorphic disorder.Dr. Connie, what symptoms do you most frequently see in your practice?What about muscle dysmorphia in men?At the beginning of our chat, I mentioned that people lose weight quickly after WLS and often struggle to recognize their smaller body as their own. This is NOT body dysmorphic disorder. What do you call it?How would you describe the differences then between BDD and distorted body image?How does treatment vary between the two and what type of help should you seek?What important message do you want to leave us with? 

What are you doing right now? Are you looking thru the cabinets for something to snack on? Are you really hungry or is food your response to today’s stress, sadness or boredom? Mindless eating can really get you off track. Instead, let’s amplify your bariatric surgery journey with doable mindfulness strategies. Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Here's your freebie. I developed a tip sheet to help you remember these mindfulness strategies we talk about today. Do you ever come home and eat the first thing you see in the fridge? I want you to stop a second and ask yourself these questions. Answer yourself honestly. Ready? "Am I aware of what I reach for and eat? And how much I eat?” "Do I multitask (watch TV, scroll thru my phone, or work) while I eat?" "Do I eat fast?" "How long does it take me to finish a meal?" "Do I feel satisfied after my meal?" After bariatric surgery, you are working so hard to eat well and develop a healthy lifestyle. You’re reaching for good tasting, nutritious food that nourishes both your mind and body. But mindless eating can derail all of your best nutrition efforts. Instead of mindless eating I want you to amplify the success of your journey. How? By learning and practicing the opposite of mindless eating which if mindful eating or mindfulness. Mindfulness means to be present in the moment, aware of your surroundings and the food you eat. This method focuses more on how you engage in eating (such as how fast you eat, appreciation of your food, your personal responses to hunger). In other words, it's making conscious decisions about eating instead of eating because you're stressed, mad, sad or bored. Also, it’s NOT about willpower but rather listening to your body telling you when it's hungry and full. Let's talk about how to use these seven tips:Practice mindfulness when you're not eating.Look at your food.Eat more slowly.Enjoy your meal or snack distraction free.Listen to your cues.Find your satiety.Organize a mindful kitchen.

Are you considering bariatric surgery? It can be so confusing, right? And downright scary. How much will it cost you? Who’s the best surgeon for you? How do you know if the surgeon is any good? What about the right hospital or surgical center? What services should you look for? Bariatric dietitians Gayle and Isabel join me to share information to help you save time and money in your selection of the right surgeon and hospital or surgical center.Podcast Guests: Bariatric Dietitian Isabel Maples, RDBariatric CoordinatorUVA Health in Haymarket, VirginiaEmail: ggw5ud@uvahealth.org Gayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianWeight Loss and Bariatric Surgery InstituteOrlando, FLEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Resources:Common CPT codes for insurance:Sleeve - 43775Bypass - 43644Revision- 43659Band removal - 43774Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.There’s a lot to think about when you consider bariatric surgery. It can be so confusing and downright scary. There is a lot of information you need to find out before surgery. How much is this going to cost? Who’s paying for what? Who’s the best surgeon? What type of services should be included? We’re going to answer a lot of these questions and share things for you to think about. It’s so important to know up front what you can expect and what’s expected of you. Services and fees vary so you want to do homework to prevent any surprises and unexpected costs. Topics we discuss:One of the first things that comes to my mind is…..Do you have insurance coverage? If you do, find out if your insurance company has any specific requirements that your surgeon, hospital or surgical center must meet. Isabel, you spend quite a bit of time keeping up with insurance nuances. What questions should you be asking your insurance company?Discussion of bariatric procedure codes...listed above for use with your insurance companyCoverage for nutrition consults among insurance companies as of course, I think this is very important.Credentials matter. the MBSAQIP program and programs of distinctionWhat to look for in a well rounded programExperience, beside manner fees 

Becky asked if I would do a podcast on plant-based eating after bariatric surgery with tips on how to get in enough protein. Is a plant-based lifestyle appropriate or even doable after weight loss surgery? Let’s talk about various plant-based options and some smart strategies that can make a plant-based lifestyle work.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.Resources: EP 73 Slider FoodsEP 127 Can you really eat carbs?EP 132 15 Bariatric-Friendly Carbs: Bariatric Nutrition Q & ATopics covered in this podcast:6 plant-based options to consider if you want to have a plant-based lifestyle after WLS3 concerns over a strict vegan lifestyle after WLSSlider foodsCarbs and weight regainConsulting our bariatric dieititianChoosing a wide variety of plant proteinPlant-based shakesComplete protein/essential amino acidsSupplementsTracking your intake

When I say the words ‘self-sabotage’, what’s the first thing that comes to your mind? Emotional or comfort eating? Maybe negative self talk? What about fear of failure or even fear of success? You know, those self defeating behaviors that we do to ourselves. Self-sabotage can wreck your weight loss journey after surgery. Bariatric psychologist, Dr. Connie, is here to help you recognize self-sabotage and also to teach you how to overcome it so you can have a successful transformation. Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Guest: Connie Stapleton, PhDWebsite: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchers Mind Prep The Book: How To Prepare for Bariatric Surgery and Live as a Healthy Post-Op: Mind Prep: The BookBariAftercare Daily Progress Journal Please Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.Are you receiving my weekly newsletter, Breaking Down Nutrition? You’ll be the first to know about product specials, helpful tips, the latest podcast and upcoming interviews that you don’t want to miss like today with Dr. Connie. Sign up on my websiteQuestions we discuss in depth:To me, we have to recognize these behaviors that we’re doing and understand them before we can stop. Start us off Dr. Connie with how you see self-sabotage.What are some examples of self-sabotage specific to the weight journey?I think there are many reasons for self-sabotage. Share some of these with us AND do you see different reasons for self-sabotage tied specifically to the weight loss surgery?I think we give food way too much power in our lives. Just look at advertising and how food is all about reward or comfort or a party….over and over we hear this message. Your words about food have influence over your behaviors. Think about it…maybe you say, what a stressful day at work…I deserve some chocolate or i worked out today so now I can treat myself to what I want. When you continue to reinforce this reward mentality, you set yourself up for self sabotage or that self defeating behavior with food over and over where food is your go to especially when stressed. We don’t want to give that much power to food. It’s just food. Thoughts you want to add, Dr. Connie?OK Dr. Connie, let’s get specific. Succeeding beyond the first year after surgery is dependent on having a healthy mindset and continuing on with the changes you’ve made the first 12 months. After this 12 months, often called the honeymoon, it seems self-sabotage increases. How do you get out of your own way and overcome self-sabotage so you can continue these positive habits you have worked so hard to build?What are the most important take- home messages?

Want to grab some attention? Just combine the word ‘toxic” or ‘deadly’ with the words sugar substitute and that will do it. Low calorie and no calorie sweeteners are so popular but on the flip side, social media posts and other media headlines have created fear and uncertainty about using them. Are they dangerous or even toxic? It’s confusing and hard to decipher what is sound factual science against what is low quality science or even pseudo science. Award-winning dietitian Neva Cochran is back to cut thru the hype, share the sound science, and make sense of it all so you know what to do.Here are your resources:Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Guest: Neva Cochran, MS, RDN, LD, FANDTwitter: @NevaRDLDInstagram: @nevardld Facebook: https://www.facebook.com/NevaRDLD/LinkedIn YouTubeWebsite: www.NevaCochranRD.com EP 122 with guest Neva Cochran: Should You Use Sugar Substitutes after Weight Loss SurgeryEP107 Can You Have Erythritol after Bariatric Surgery? Neva and I cover a lot of helpful information in this podcast so you can make the right decision for your situation. Some of the many questions we talk about include:There are so many names for sugar substitutes including artificial sweeteners, sugar substitutes and low and no sugar sweeteners. They actually fall into different groups such as sugar alternatives, sugar alcohols, and artificial or non nutritive sweeteners. Would you go over what sugar alternative or no sugar sweeteners belong in which group?Recently, there were confusing headlines about sugar substitutes in general and another one specific to Sucralose. There is so much conflicting information in the news about sweeteners. Sometimes the information is accurate and reasonable and other times it’s unrealistic and even ridiculous in the real world. What is your take?Is one sugar substitute better than another? How much is safe to use? Do you feel it varies between sugar alcohols and no sugar sweeteners with zero calories, even down to one specific sweetener over another? Erythritol recently got some bad press too but there’s more to this story than the headline as well. Neva, why do some people prefer one sweetener over another?What else is in sweetener packets besides the low cal sweetener?Neva, what is your bottom line advice to my bariatric community about non sugar sweeteners? 

You’ve have weight loss surgery and now you find out that you need to follow some 30-30 rule. Are you surprised? Are you thinking to yourself…what the heck is a 30-30 rule? Why do I need to follow it? And…what if I get something stuck in my throat while I’m eating? Do I follow it forever? Actually, this 30-30 rule can help make your transformation and journey an even greater success. Bariatric dietitians Gayle and Isabel join me to answer your questions and explain why it’s beneficial to follow the 30-30 rule and for how long.Podcast Guests: Bariatric Dietitian Isabel Maples, RDBariatric CoordinatorUVA Health in Haymarket, VirginiaEmail: ggw5ud@uvahealth.org Gayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianWeight Loss and Bariatric Surgery InstituteOrlando, FLEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%I want to give a shout out to mdm232323. The 5-star Apple podcast review says “I had sleeve surgery in March and just happen to find your podcast. And what a blessing. I’m listening whenever I can to get through your library of past podcasts to educate myself.”"Thank you so much for posting this 5 star review. I’m glad the podcast has been a blessing and that you gain usable knowledge from them. Keep listening!" Questions about the 30-30 rules we discuss:The 30-30 rule. It’s also called the “30-minute rule” and actually, it’s very beneficial after surgery. What’s it all about? Isabel, what is this 30-30 rule and are there other names for it?Gayle, are most patients surprised when they hear about this rule?Does the rule apply to all bariatric surgical procedures Isabel?Gayle what about your surgical center?Isabel, here’s a question from my Facebook group. Do I really have to wait 30 minutes to have water/any liquid before and after my meal?Gayle, I’ve been asked in the Facebook group if this rule has to be followed forever. It’s somewhat debatable. In fact, it’s not just patients that want to know. You and I were talking about a question that you had from an ICU dietitian. Tell us more.Isabel, why is it so smart to follow the 30-30 rule? What are the benefits to the body after surgery?What happens to the body if you don’t follow this rule?

Did you know that one of the players in heart health is called nitric oxide, sometimes referred to as N-O? The N-O level tends to increase after weight loss surgery. Did you notice I said increases? You might be wondering if that a bad thing as when your cholesterol number goes up. Actually, it’s the opposite, you want an increase in nitric oxide. Grab your phone or pen and I’ll share 7 foods that will help increase this nitric oxide level naturally.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Resources:Rush Hour Ready BeetsThere are so many fabulous benefits that result from bariatric surgery. Several that come to mind are lower blood pressure, lower blood glucose, a lower c-reactive protein or CRP blood level which means less inflammation in the body, and an improved lipid profile, specifically cholesterol and LDL numbers which result in an overall improvement in cardiovascular or heart health.Nitric oxide is actually made by the body. It’s produced in the body as an end result of a process in which nitrates in food along with antioxidants like Vitamin C are turned into nitric oxide.Let’s take a look at 7 natural nitrate containing foods to add to your meals in the coming weeks. Listen for more information about each food:citrus, garlic, cabbage, carrots, broccoli, spinach, beets, dark chocolate

When was the last time you ate so much that you felt stuffed? Was it a big Thanksgiving meal or when you celebrated your best friend’s birthday with that ginormous cake and ice cream? Maybe after a bad day, you almost finished a half gallon of ice cream along with some cookies while watching TV. How did you feel afterward? Frustrated that you ate so much you made your stomach hurt or did you play the guilt and shame game? Overeating every once in a while is normal. However, in compulsive eating, food is often the way of coping with negative emotions. Then you feel guilty, ashamed or depressed. These are different feelings than when you just ate too much at Thanksgiving. Bariatric psychologist Dr. Connie joins me to talk about compulsive eating and how to deal with those feelings of guilt and shame.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Guest: Connie Stapleton, PhDWebsite: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchers Mind Prep The Book: How To Prepare for Bariatric Surgery and Live as a Healthy Post-Op: Mind Prep: The BookBariAftercare Daily Progress Journal Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.Listen now for a lively discussion. Here are the questions Dr. Connie and I discuss on today's episode:Let’s start by explaining the difference between compulsive eating and binge eating disorder also called BED.Today, our focus is on compulsive eating. I often see compulsive eating start as a result of diet restriction where foods are seen as either good or bad. When you don’t allow yourself certain foods, at some point it’s easy to say, forget it and eat way too much of that restricted food. Other times, it starts as a mindless habit like munching in front of TV instead of eating a meal of protein food and other macros on a regular schedule. From your perspective how does someone typically start compulsive eating? Are there underlying emotional issues or a negative body image? What stands in the way of asking for treatment for either compulsive overeating?How common is compulsive eating in the bariatric community?Before someone is cleared for surgery, do they need to be treated for compulsive eating first? Let’s get specific. How do you overcome guilt and shame? What are your best strategies?What haven’t you said that we need to know?

Are you into working out and sports since your weight loss surgery? Wondering what to eat before and after your workouts, if you need more carbs, maybe calories too? Do you need a supplement for muscle gain? Bariatric sports dieititian Kim Tirapelle joins me to answer many of your questions and share the latest sports nutrition information.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM to save 15%Guest: Kim Tirapelle, MS, RD, CSSDWebsite: www.activebariatricnutrition.comPodcast: www.activebariatricnutrition.com/podcastInstagram: https://www.instagram.com/activebariatric/YouTube: https://www.youtube.com/channel/UC4QJLjJ5vSzbCiXTlR59TpwTikTok: @ActiveBariatricNutritionFacebook: https://www.facebook.com/ActiveBariatricJoining me in the studio is dietitian Kim Tirapelle. Kim is a certified specialist in sports dietetics who focus on bariatric sports nutrition. She’s worked with bariatric clients and athletes for the last 16 years and was also a collegiate sports dietitian for a Division I University. Kim now works 1:1 with her clients to optimize nutrition to meet exercise goals after weight loss surgery. You can also listen to Kim weekly on her podcast, the Active Bariatric Nutrition Podcast.When I found out you would be guest on the podcast, I put a poll in my FB group to see what questions they had about sports nutrition and they had a lot. So let’s jump right in and answer them. Questions I ask Kim, many of which come from my Facebook group:How far out from surgery should you be before you start heavier workouts and sports? Do I need more calories every day if i work out hard?How many calories should I add if I’m trying to gain muscle?Do I need more grams of protein daily for my workouts?How many grams of carbs do I need daily for my weight training? Should I eat more carbs if I’m exercising more?Is it normal to be hungrier some days and not others?Kim asked:I work out 5-6 times per week cardio and strength training. I can’t seem to lose this last 20-25 pounds. Could it be not enough water/liquids? I’m stumped!Karen wants to know: I had RNY Sept 2022. I am a regular CrossFitter and vegetarian. Always looking for more knowledge.Jason asked: I’d like to get back into running after bariatric surgery? Any tips to safely get back into running? What should I eat before/after a workout?Are supplements helpful for muscle gain? 

Do you think you’re getting enough calcium and vitamin D since your surgery? How do you know? How much is enough? Bariatric dietitians Gayle and Isabel join me to make sense of it all, so you know what to do.Podcast Guests: Bariatric Dietitian Isabel Maples, RDBariatric CoordinatorUVA Health in Haymarket, VirginiaEmail: ggw5ud@uvahealth.org Gayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianWeight Loss and Bariatric Surgery InstituteOrlando, FLEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! Questions we discuss on this episode:What exactly is calcium? Is it made in the body or must it come from food? Is there more than one form of calcium? Which is best for a supplement and why? Should you try to get calcium from food too?How much calcium do you need daily from supplements and food after surgery?Is a blood calcium test accurate?Are there other vitamins or minerals you should not mix calcium with?We often hear that milk is not fit for human consumption but yet goat milk is fine. Is this true or false? Is it bad to take my calcium citrate with coffee?Vitamin D and calcium go hand in hand as team mates in the body. Why is this?What is vitamin D and why do we need it? How much vitamin D do we need? Does the amount vary with surgery?What form of vitamin D is best or is there a best one?What are water miscible vitamins?

What condiments do you like on a hamburger? Did you say mustard? Do you buy the traditional bright yellow mustard? Guess what spice is in it? Turmeric. Does turmeric have anti-inflammatory benefits for your body? What about in a supplement? Is it worth spending your money or not? I want to give a shout out to Tracy who said: “I absolutely value the podcast. It's like a treasure chest of golden nuggets with so much information and tips.”Tracy, thank you. I love it …golden nuggets. The best part, though, is to hear that the information and tips bring value to you and your journey.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Speaking of information valuable for your journey, in two weeks your favorite bariatric dietitians Isabel and Gayle will join me to answer your questions on calcium and vitamin D.What's discussed about turmeric:What is inflammation?What is in turmeric that has an anti-inflammatory effect on your body?What is CRP?What type of blood test measures inflammation or CRP?How do anti inflammatory foods work in the body?Do you only need turmeric?What other foods and spices have an anti-inflammatory effect?Recipe for Golden Turmeric and Ginger LatteWhat about turmeric supplementsAre their side effects that could be dangerous?What is the typical dosage?

Do you feel like some of your relationships have changed since your weight loss surgery? And not necessarily for the better? Is this change in relationships common? Why does surgery affect these changes? Bariatric psychologist Dr. Connie joins me to explain why relationships change after surgery and how to handle these changes.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchers Mind Prep The Book: How To Prepare for Bariatric Surgery and Live as a Healthy Post-Op: Mind Prep: The BookBariAftercare Daily Progress Journal Relationship Webinar with Dr. Connie click and then copy/paste password: fN0G.7?* I want to give a shout out to Tracy who said: “Wow, so many golden nuggets in your podcast! I started at the beginning and I am implementing so so so many good things in my daily nutrition plan! Thank you”Thank you Tracy. I’m so happy you found the golden nuggets and impressively, have implemented them into you daily lifestyle.Recently there was conversation in my FB group about relationships with members asking especially about marriages and how they change after surgery. Is it true that a lot of married couples divorce after a one of them has bariatric surgery?Dr. Connie answers the above question and many others including: Do you agree with this research from what you see in your day to day practice?What do you see as the reasons for increases in new relationships and a higher instance of marriage after surgery?Whoa, wait a minute. Did you just say it’s not the amount of weight loss that is associated with marriage but better health? This really puts the focus on non scale victories over weight.Why are divorces happening after surgery? Biggest reasons?It seems to me that this issue of relationships needs to be addressed before surgery and hopefully it is. What can the bariatric team do to help patients understand how surgery might affect their relationships?What is a joint journey and why is it so important?What can you do now if you're experiencing these changes in a relationship?

Did you just have lunch? Are you still hungry? Have you noticed you’re hungry a lot lately and don’t feel satisfied? It’s true that some foods make you feel more full than others and this feeling of fullness is called satiety. How about some bariatric-friendly foods that will help you fill up, but not fill you out?Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Recipe and podcast mentioned in episode:Mediterranean salmon cakes EP 127 Can you really eat carbs? Speaking of information valuable for your journey, bariatric psychologist Dr. Connie joins me in two weeks to talk about relationships. You’ve asked in the facebook group and you want to know how relationships, especially marriages, change after surgery. We’ll dig into it.Why are you still hungry after a meal when you feel like you should be satisfied? Our wonderful bodies can be complicated and several factors can affect your hunger. The type of foods you select definitely affect how satisfied you feel and they also play another role in the production of hormones that affect hunger. In fact, the macronutrients protein and carbs affect the production of neurotransmitters or brain chemicals such as dopamine and serotonin that then affect appetite.This episode covers:Obesity as a diseaseGhrelin and leptin hormones and appetiteGLP-1 drugs: Wegovy and OzempicFoods that fill you upWhat do to now

Do you have concern, maybe even fear about eating carbs after bariatric surgery? You don’t want to regain weight from all of your hard work. Grab your digital note pad. You’ll want to add these 15 tasty bariatric-friendly carbs to your meals.Podcast Guests: Bariatric Dietitian Isabel Maples, RDBariatric CoordinatorUVA Health in Haymarket, VirginiaEmail: ggw5ud@uvahealth.org Gayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianWeight Loss and Bariatric Surgery InstituteOrlando, FLEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Resources:How to cut a mango:https://www.mango.org/how-to-cut-a-mango/Oh those carbs…the macro you love to hate. Actually we love carbs. Well, let me be a little pickier than that. We love smart carbs, those carbohydrates that are high in fiber and nutrition and low in sugar. In fact, if you missed it, go back and listen to episode #127Episode #127:Can you really eat carbs?Gayle, Isabel and I answer a lot of your questions. We share why you can eat them, and why it’s important to have carbs in your diet.Today, we’re getting even more specific and sharing 15 of our favorite carbs and how to prep or use them in your meals. Remember, we want to focus on smart carbs which are high in fiber and nutrition, and low in sugar.15 carbs we discuss:spaghetti squash noodlesplant based high protein pastaspiralized noodles or zoodlesflatbread pizzamushroomsoatmealbulgar wheatfreekahground flaxseedwheat germwhite navy beansblack beansEsquitesmedjool datesmango

What the heck is a fatty liver? Were you told you have a fatty liver before your weight loss surgery? What does this mean? Is it something that you should be concerned about? Does the surgery improve it? What about your diet? Does what you eat now and down the track affect fatty liver? Let’s get right to it and talk about how your surgery and your diet can affect a fatty liver.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%In two weeks I’ll be joined by your favorite bariatric dietitians Gayle and Isabel. We’ll share 15 of our favorite bariatric-friendly carbs that you can add to your meals so have that digital note pad ready.Topics covered in this episode:Liver 101NAFLD and NASHHow NAFLD is diagnosed; liver function testsWho gets NAFLDDoes WLS help fatty liver disease?What type of diet is recommended to keep your liver healthy?Are there medications to treat it?What about physical activity?

Is your weight regain since bariatric surgery more than you hoped it would be? Has your appetite significantly increased? Cravings too? Have friends mentioned or have you read that you might need a weight loss medication? How do you know if that’s a smart move for you?Let’s talk about seven things you should know about Wegovy and Ozempic for weight loss after weight loss surgery. I want you to be prepared so if you do decide to ask about it, you can have a knowledgeable discussion with your health care provider.Resources:Semaglutide Information Sheet: https://medlineplus.gov/druginfo/meds/a618008.htmlVisit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Are you receiving my weekly newsletter, Breaking Down Nutrition? If not, sign up today on my website You’ll be the first to know about giveways, product specials, helpful tips, the latest podcast and upcoming interviews that you don’t want to miss.Speaking of what you don’t want to miss, in two weeks I’ll be talking about non alcoholic fatty liver disease. You might have seen it abbreviated NAFLD. It often occurs together with weight gain. I want you to understand what it is and how you eat can change it.Wondering if Wegovy is right for you? Would it be another tool in your toolbox (notice I didn’t say THE tool)? Here are seven things to know and consider so should you decide, you can have an intelligent conversation with your health care provider. In this episode I cover:FDA approval and names for drugWhat Wegovy does in your body/how it worksLong term versus short term useComprehensive treatment plan and what it includesWeekly injections and chance of weight regainPrescribing criteriaSide effects to consider and cost

Someone in my Facebook group posted: " have imposter Syndrome with my weight loss accomplishments and I just feel like I don’t belong. Kind of like this isn’t real, and I don’t deserve it and that all this was just beginners luck."Do you feel this way too? Bariatric psychologist Dr. Connie joins me on the podcast to help you deal with imposter syndrome.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchers Mind Prep The Book: How To Prepare for Bariatric Surgery and Live as a Healthy Post-Op: Mind Prep: The BookBariAftercare Daily Progress Journal  Questions that Dr. Connie and I discuss:What is imposter syndrome and then how is it specific to our bariatric listeners? What type of things happen in life or what are the reasons that people experience imposter syndrome?I interviewed Wayne Davis in episode #113. Wayne is a member of my private Facebook group and he openly share his story with the scale, imposter syndrome and his victories after surgery. It’s a great episode: https://www.breakingdownnutrition.com/blog/113-beyond-the-scale-wayne-shares-his-victories-with-bariatric-surgeryBy the way, is imposter syndrome considered a mental health disorder? So what I’m hearing you say is that imposter syndrome can affect anyone but it affects those who’ve had bariatric surgery in specific ways to their situation…much like nutrition.Are there mental health issues associated with imposter syndrome? Let’s get to the nitty gritty of how can we deal with it? How can our listeners go about combatting imposter syndrome?Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

Do you have dreams and goals for your weight loss surgery transformation? Does your ‘but’ get in the way of your success? Not your ‘b-u-t-t’ butt or tooshie. I’m talking about the ‘b-u-t’ but that keeps you stuck in your rut and prevents you from moving ahead and reaching your transformation goals. Let’s have a mental boot camp and talk about how to deal with the ‘but’.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Do you feel overwhelmed since your weight loss surgery? Do you have dreams and goals for your weight loss surgery transformation but this transformation stuff is harder than you thought and takes a lot of work and change. Does your ‘but’ get in the way of your success? Not your ‘b-u-t-t’ butt or backside. I’m talking about the ‘b-u-t’ but that keeps you stuck in your rut and prevents you from moving ahead and reaching your transformation goals? You know the ‘but’…you would like to start walking or swimming ‘but' feel too exhausted or you want to prep your meals a couple of times a week ‘but’ feel overwhelmed and don’t know where to start or you really need to get more sleep ‘but’ your schedule is already jammed and it never seems to happen. Your attitude affects your journey, your weight and ultimately your success. When you are overwhelmed and stressed, it’s impossible to find the time to shop and prep food so you can eat well, exercise or do anything else for yourself…and you may feel guilty when you do. Bottom line, your WHY must be greater than your WHAT. Listen now for more on specific ways to deal with the 'but'.Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

I read a quote by Edith Lovejoy Pierce that said: “We will open the book. Its pages are blank. We are going to put words on them ourselves. The book is called Opportunity and its first chapter is New Year’s Day.” Did you wake up thinking… new year, same me? It’s time to set your intention for 2023 with these three steps.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.Bariatric psychologist Dr. Connie, episode #118 on negative self talkListen now to set your intention for 2023 with these 3 steps:Step 1 to set your intention: Reframe your outlook. Let go of comparing yourself to others. This is not easy but much needed so kick comparing yourself to the curb. Step 2 to set your intention. NO more self sabotage from negative self talk.Step 3 to set your intention. Put into practice a concept called 1% to infinity.

Can you really eat carbs? I see a lot of chatter about carbohydrate in my Facebook group. Some people think carbs are bad and try to never eat them, others fear carbs and still others love carbs… especially the less healthy ones. Are you confused and don’t know what to believe about carbs? Every friend tells you something different? To make it more confusing, some post surgery medical teams advise very little carbohydrate in the diet while others caution their patients not to cut carbs too low. This idea that carbs are bad for you is flat-out wrong diet information and can lead to unhealthful eating. Let’s get the carb facts you need. Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Podcast Guests: Bariatric Dietitian Isabel Maples, RDBariatric CoordinatorUVA Health in Haymarket, VirginiaEmail: ggw5ud@uvahealth.org Gayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianWeight Loss and Bariatric Surgery InstituteOrlando, FLEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  Obesity Action Coalition Dumping Syndrome Fact SheetPodcast #32 4 Ways to Prevent Dumping Syndrome from Dumping on Your Day https://www.breakingdownnutrition.com/blog/32-4-ways-to-prevent-dumping-syndrome-from-dumping-on-your-dayTopics Covered in PodcastIs it true that a carb is a carb is a carb and you don’t need it?It’s interesting that with all the fears and confusion surrounding carbs, most people in the US, UK and Australia eat way more carbs than we need for our weight. After bariatric surgery, the bottom line is what type of carbs and how much you eat. Do you agree Isabel?Gayle what about the term net carbs… do you look at this? Besides energy, high fiber smart carbs offer up a serving of health benefits…what are some of your favorites?Isabel, so much misinformation on Dr. Google about carbs, particularly sugar and other sweeteners such as honey and maple syrup but the body doesn’t see it that way. Why?Discussion of both early and late dumping syndromes Is there a range or recommendation for grams of carbs each day and does it vary with how far out from surgery you are?Favorite smart carbs

On your coworkers desk, tonight at your neighborhood party, tomorrow at the kid’s school, this weekend at your friend’s annual get-together…holiday foods and treats are everywhere you turn. Does all this food make you nervous, heck even anxious? What do you eat without kicking in your cravings or imploding your nutrition plan that’s working so well for you? Food is meant to nourish you and to be enjoyed, not to totally stress you out. I have five nutrition tips to help you destress about the food, enjoy the season and NOT feel defeated as you go into next year.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Go back and review episode #123 Podcast: How to Successfully Navigate the Holiday Food-a-Palooza after WLSNutrition tips discussed:Is chocolate ok to eat after WLS?What about dessert? Can you have dessert?How to stop that 'hangry' feelingThe best type of snack to eat before you go to a functionHow to feed your brain

Wayne told me that he use to have a disconnect between what he saw in the mirror and what he knew to be true from his scale and clothes. This disconnect is referred to in my Facebook group as ‘fat brain’. Do you feel it too? Your scales clearly show you have lost a lot of weight and you have changed clothing sizes BUT when you look in the mirror you still see your previous, heavier self. Wayne has worked thru this disconnect and today, we’re going to as well. Guest: Connie Stapleton, PhDWebsite: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchers Mind Prep The Book: How To Prepare for Bariatric Surgery and Live as a Healthy Post-Op Mind Prep: The BookBariAftercare Daily Progress Journal  Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Fat Brain Discussion: questions that Dr. Connie answersHave you heard of what my Facebook group calls 'fat brain'? What is it?What is body-image distortion and is it common after WLS?Is this similar to phantom fat?What causes this disconnect or feeling of fat brain/body image disturbances?Is it tied to the idea of 'never good enough'?What do you do if you have these kinds of thoughts and struggle with body image distortions?How to retrain your brain.Getting rid of stinky thinking.

The holiday season is in full swing. I’m curious. Does your schedule get more hectic or do you work hard to slow down and savor the season? As much as we want to slow down, I bet you’re saying…"are you kidding me, the stress of the holidays seems to rachet up my life everyday. And food is everywhere." I hear you. Amidst all the hustle and bustle, you CAN successfully navigate the holiday food scene and stay on your journey. Let’s talk about your plan.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Podcast Episodes Referred To:#30 Bariatric Surgery and Alcohol Buzz: What You Need to Know: #118 Negative Self Talk: Bariatric Mental Health Q & AThink about how far you have come. Let’s not let this annual food-a-palooza destroy your success. It all starts with a PLAN so let’s us the mnemonic P-L-A-N. Listen to devise your plan for the holiday season.P: power packL: love what you choose to eatA: assess the situationN: no negative self talk or guilt allowedWhat to do now...

Have you heard that sugar substitutes can increase your cravings and maybe cause you to regain the weight you’ve lost? Or, maybe you’ve heard that these no and low calorie sweeteners might cause diabetes? Is this information true and even accurate? Don’t go anywhere as award-winning dietitian Neva Cochran joins me on the Bariatric Surgery Success podcast to answer your questions and address your concerns.Guest: Neva Cochran, MS, RDN, LD, FANDTwitter: @NevaRDLDInstagram: @nevardld Facebook: https://www.facebook.com/NevaRDLD/LinkedIn: https://www.linkedin.com/in/neva-cochran-ms-rdn-ld-fand-a935225/ YouTube: http://www.youtube.com/user/nhcrdWebsite: www.NevaCochranRD.com Promotions:Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Joining me from Dallas, Texas, is award-winning registered dietitian nutritionist, Neva Cochran. She’s passionate about sharing fact-based food and nutrition information to help you “eat beyond those headlines” and enjoy your food. She blogs about trending food and nutrition topics on her “Eating Beyond the Headlines” blog. For 20 years, Neva was a researcher and writer for Woman’s World magazine and she brings her expertise to share with you today. Fat and sugar have both been demonized and right now there is a low sugar fad much like the low fat fad some years back. Low calorie and no calorie sweeteners are so popular but on the flip side, social media posts and other media headlines have created fear and uncertainly about using low calorie and no calorie sweeteners. Do they cause diabetes and/or weight gain? It’s confusing and hard to decipher what is sound science against what is pseudo science. There have been several questions posted in my FB group so let’s answer them and clear up the confusion so you know if it’s ok to use them and if so which ones. Questions we answer in this episode:**There are so many names for artificial sweeteners such as low and no sugar sweeteners. What are other names and are they all referring to the same thing? I recently did a podcast on erythritol, episode #107. Here's the link to listen: #107 Can You Have Erythritol after Bariatric Surgery? https://www.breakingdownnutrition.com/blog/107-can-you-have-erythritol-after-bariatric-surgery**Explain microbiome and specially the gut.**Should we be worried about these using these sugar substitutes? Diabetes in the bariatric community.**I’m in the grocery store and see box after box or container of various no and low calorie sweeteners. Is there a better choice among sugar substitutes?**Not everyone uses the same amount of these products. How much is too much and will it affect the gut? **Maybe you’ve heard that using no and low calorie sweeteners cause you to crave sweets more and gain weight. Is this accurate or unproven?**One member of my FB group was told not to drink Gatorade Zero, just water after surgery. Your thoughts?**What haven’t you told us that is important to know? The bottom line so to speak.

Have you wondered what life will look like two or more years down the road from your bariatric surgery? Maybe you’re there now, and wonder if others at the two year mark deal with the same things you do. Rob joins me on the Bariatric Surgery Success podcast to share what life is like two plus years down the track and what he faced along the way. It’s very insightful.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Guest Contact:Rob’s Instagram: https://www.instagram.com/my_weight_is_history/Rob is joining me today from New Jersey. We connected on Instagram where he openly shares his life since surgery almost two 1/2 years ago now. His posts let you see what he deals with day-to-day and how he’s handling it. Questions we discuss:Would you briefly share your back story, especially what was going on in your life that led you to have surgery over two years ago?First, how did you feel when you heard that? What concerns did you have about undergoing weight loss surgery?Did you have family and/or friend support?During the getting-ready for surgery stage- what was difficult? What helped?Fast forwarding…the dreaded scale. What has been your relationship with the scale since surgery? Is there a disconnect between what you see in the mirror and what you know from scale and clothes? Let’s talk about some of your non-scale victories..like weightlifting and other sportsRob, you’re a teacher. People look to you for all types of things. Talk about how surgery has affected others at school, both students and faculty, as they have watched your journey.Tell us how life is different today than two years ago…what does Rob’s day look like now?Rob, those are huge non-scale victories. So, how do you deal with down day…one that is just not working for you and what do you say to everyone listening when they are feeling like a failure?What are your health goals now and are they any challenges you still face that you want to conquer?

Are you feeling LESS restriction after weight loss surgery than you think you should feel? Does it vary with exercise and how hard you work out? Is this a big deal? Is it the surgery, your diet, what is it? Let’s talk about this feeling of LESS restriction.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Podcast Guests: Bariatric Dietitian Isabel Maples, RDBariatric CoordinatorUVA Health in Haymarket, VirginiaEmail: ggw5ud@uvahealth.orgGayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianWeight Loss and Bariatric Surgery InstituteOrlando, FLEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  I want to give a SHOUT OUT to Chef Henry who said:"I listen to a lot of podcasts but this is always the one I look forward to. Dr. Susan Mitchell provides a great service to the community with lots of information and support. Also her soothing way of communicating with the audience and her awesome guests are definitely a breath of fresh air."Chef Henry, I’m happy to hear that I’ve brought some fresh air to you and hopefully to others. There’s so much mis-information out there to wade thru, I’m glad to deliver information you can count on to be accurate. My facebook group is really supportive of each other and has a lot of discussion. One question recently asked was this “Do you feel your pouch has less restriction on days you train especially hard? Is it hunger that makes you feel less restriction? What’s going on?”Questions we did into during this episode:What is restriction and should you be concerned or not? What causes less restriction?From a medical nutrition therapy standpoint, what is important to know about restriction or less restriction?What is the body set point and will it return there after bariatric surgery?What about feeling full and learning satiety cues? Can you learn those even when you have never used them in the past? Can the body sense when it is full?What about calorie and macro needs when training hard? How does this affect restriction? Does everyone need the same increase in calories and macros?The role of carbs.

Feeling a little down, maybe even depressed since your bariatric surgery? Did you know that depression and anxiety are the most common mental health conditions in the world? What you choose to eat is more important than ever after surgery if you’re dealing with these feelings. Why? Because certain foods, like fish, can help. Let’s talk about fish as a brain multivitamin for mental health.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%What happens when you’re feeling depressed or anxious? Do you find that some of the things you always do for your self care particularly prepping and eating nutrition-packed foods kinda gets kicked to the curb? If you’re dealing with depression, what you choose to eat influences your mental health. And research has shown that seafood is brain food. What does this mean? Those feelings of anxiety and stress can be eased by regular consumption of fish.Today, I’m focusing on fish which is bariatric-friendly because of the evidence-based research pointing to benefits. Research indicates that the omega-3 fatty acids found in fish can reduce risk of depression along with arthritis and dementia.Discussion:How often and how much fish to eatWhat are omega-3 fats?DHA and EPAFish as a brain multivitaminWhich fish are rich in omega-3s

Ok, be honest with me. Do you talk to yourself? Do you say negative things to yourself, aka, negative self talk? Do you remember when and why you started talking negatively to yourself? Doesn’t make you feel so good, does it? Psychologist Dr. Connie Stapleton joins me today to help you get a better understanding of how negative self talk gets started and key steps you can take now to stop it.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Joining me in the studio is Atlanta-based psychologist Dr. Connie Stapleton. You know that Dr. Connie brings her vast experience in the mental health aspect of bariatrics to the table. She gets right to the core of the issues and always shares practical ways for you to improve your relationships with food, other people and most importantly with yourself. Today she’s doing that with negative self talk.Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchers Questions I ask Dr. Connie:In your experience what causes negative self talk? Are there triggers that kick it off and at what age does it tend to start or does age even matter?It seems like there would be a lot of negative consequences from engaging in consistent negative self-talkIs negative self talk as common among men or kids as it is women? How do we stop negative self-talk?Can you share some examples of how to change negative self-talk into something more positive? What last thought do you want to leave us with Dr. Connie?

I just googled the word “immunity” and guess how many results popped up in 0.5 seconds? 1 billion, 400 million! Think people are concerned about their immune system? Are you? Are there foods that can help keep your immune system healthy? Yes, there are. I have a list to share that you can add into your diet.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Bariatric Surgery Success Episode #54 covering must-have vitamins and minerals including vitamin DYour immune system is a fascinating, intricate and very capable system made up of different organs, cells, and proteins that work together. It goes into action when some type of foreign invader such as bacteria, viruses, fungi and parasites tries to hack into your body, take over and make you sick. Does an Immune-Boosting Diet Really Exist?Some of the nutrients which are critical for the healthy functioning of immune cells include vitamins C, D and E, folate, zinc, selenium, iron, and copper.Foods discussed where you find these particular vitamins and minerals:Probiotic and prebiotic foodsCitrus foods like oranges, tangerines and grapefruitSalmon, tuna and sardines, egg yolksOysters, crab, shrimp and musselsBeef, ham, veal, sardines, mussels, oysters, chicken or turkeyNuts, seeds, avocado and spinach

Did you know? Your total cholesterol level and your triglyceride level may both improve, that is decrease, within six months of bariatric surgery. Can eating certain foods also help that cholesterol level lower? Yes they can. I have seven bariatric-friendly foods to share that you will want to add to your diet.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%You can share the message of hope, healing and transformation with your purchase from NewHopeGirls.com Use code TRANSFORM15 to save 15%Just a reminder, if you’re searching for a private facebook group where you can ask questions and talk about what’s on your mind, come join me. My group is called Bariatric Surgery Success with dietitian Dr. Susan Mitchell. I’ll put a link in the show notes or search by name on Facebook…again that’s Bariatric Surgery Success with dietitian Dr. Susan Mitchellhttps://www.facebook.com/groups/bariatricsurgerysuccesswithdrsusanmitchell Let’s talk about seven of my favorite bariatric-friendly cholesterol lowering foods and how they benefit cholesterol levels:AvocadosTeaNutsOatsBeansOlives and Olive OilDark Chocolate

Becky said that her weight is coming off very slowly since her bariatric surgery. It’s hard for her not to get frustrated seeing the massive weight loss that others are experiencing. Do you feel just like Becky? What is it with slow weight loss? Don’t go anywhere and let’s talk about slow losers after surgery.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Becky requested that we cover slow losers after surgery. She’s not alone. Slow weight loss has been brought up in the Facebook group before. I agree with Becky that when your weight is coming off very slowly while others seem to be losing so quickly, it’s hard not to get frustrated.Podcast Guests: Bariatric Dietitian Isabel Maples, RDBariatric CoordinatorUVA Health in Haymarket, VirginiaGayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  Weight Loss and Bariatric Surgery InstituteQuestions we discuss:Do you find that people lose differently after WLS? I’m not referring to weight itself specifically but rather how weight is lost over time and when this happens?Do the various surgeries differ in the amount of weight typically lost?Is what loss after surgery tied at all to your weight when you go into surgery?Does the amount of muscle mass you have before surgery affect weight loss after?Do you think the type of diet followed after surgery affects the speed of weight loss?You’re the dreaded slow loser and you hit a plateau. How do you jumpstart the loss again? What are your favorite strategies that work?What tips do you suggest to get that weight loss engine going again?New research in obesity: there seems to be a malfunction in these signals that the brain’s sending out. The gut/brain axis.By the way, if you’re searching for a private facebook group where you can ask questions and talk about what’s on your mind, come join me. My group is called Bariatric Surgery Success with dietitian Dr. Susan Mitchell. Search by name on Facebook…again that’s Bariatric Surgery Success with dietitian Dr. Susan Mitchell or use this link:https://www.facebook.com/groups/bariatricsurgerysuccesswithdrsusanmitchellBeautiful bags can be purchased at NewHopeGirls.com Women helping women in their transformations Use code TRANSFORM15 to receive 15% off your purchase

Do you sleep well? How many hours a night do you average? Five or less? Seven or more? Can getting the sleep your body craves keep you from feeling hungry? Could a good night’s sleep even affect your weight or and that dreaded weight regain after surgery? I have five benefits of a good night’s sleep to share that you don’t want to miss. You’re going to like them.By the way, if you’re searching for a private facebook group where you can ask questions and talk about what’s on your mind, come join me. My group is called Bariatric Surgery Success with dietitian Dr. Susan Mitchell. Search by name on Facebook…again that’s Bariatric Surgery Success with dietitian Dr. Susan Mitchell or use this link:https://www.facebook.com/groups/bariatricsurgerysuccesswithdrsusanmitchellVisit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%If you’re a short sleeper, you’re averaging five hours or less a night. This sleep pattern is tied to increased hunger and weight gain. Totally opposite of what happens when you sleep 7-9 hours a night.I'll talk about these five benefits to your body after surgery of a good night’s sleep…I’m talking 7 or more hours:Sleep improves food restraintSleep improves control over hunger and affects certain hormonesSleep improves control over portion sizesMore sleep means fewer eating occasionsSleep fights stress and stress eating

#113 Beyond the Scale: Wayne Shares his victories with Bariatric Surgery What was your relationship with the scale before you had bariatric surgery? Has it changed since surgery or does it still make you feel anxious? Wayne, a member of my private Facebook group, steps up to openly share his story with the scale and his victories after surgery. You don’t want to miss it.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Guest Wayne Davis: YouTube Channel Joining me today from Tuscaloosa, Alabama is Wayne Davis who is a pastor and a homeschool Dad. I met Wayne thru our private FaceBook group. When I asked Wayne how he felt about sharing his weight loss journey on the podcast, he said “Absolutely! I would love to tell my story. I struggled with telling people at first but the more I thought about it, I decided to be open and honest. It's the only way to help people.” Questions I ask Wayne and you don't want to miss his responses:Would you briefly share your story, especially what circumstances led you to consider surgery as an option?What concerns did you have about undergoing weight loss surgery?During the time that you were getting ready for surgery, what was the most difficult? And what helped you?What about after surgery? What were some of the toughest moments or issues you face?And now, the dreaded scale. What has been your relationship with the scale during this entire process? What is the disconnect between what you see in the mirror and what you know from scale and clothes? Is that changing as you grow into your new body?Your position as a pastor makes you up front and center with your congregation and the community. Plus, as a homeschool Dad, your children have seen your transformation. What has been the feedback from both your congregation and kids?It’s been nearly a year since surgery. Where are you today? Tell us about your biggest wins…your many non-scale victories. What routines have you developed that work for you?What challenges do you still face that you want to conquer? As you look back on your surgery and the success you’ve had, what is the number one thought you want to leave us with?

Have you ever been shamed because of your weight? How did it make you feel? Hurt, sad, angry, isolated? Maybe it made you feel you are unworthy of being loved. Shame can make it hard for you to have relationships with others and can lead to destructive behaviors. How can you deal with these feelings of shame? Psychologist Dr. Connie Stapleton and Caitlyn Scaggs join me today to help you get a better understanding of these feelings and to share proactive answers.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Beautiful bags can be purchased at NewHopeGirls.com Use code TRANSFORM15 to receive 15% off your purchaseConnie Stapleton, PhD:Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchersNew Hope Girls:Instagram: @Newhope.girlsFacebook: https://www.facebook.com/newhopegirlsLinkedIn: https://www.linkedin.com/company/nueva-esperanza--new-hope-girls-inc/Website: www.NewHopeGirls.comPodcast #64 about bullysQuestions answered in this episode by Dr. Connie and Caitlyn:What is the actual definition of shame and how is shame different from guilt?How do these feelings of shame show up in the girls and women you care for? Is shame connected to obesity and if so, how?How do you help girls and women in your care overcome shame?Is shame related to difficulties maintaining weight loss? If so, how?What do you think about the saying that you can't want healing more for someone than they want it for themselves? Is this true?What would you say to my bariatric community members listening who feel overcome with shame?

You’ve had weight loss surgery and now, your clothes don’t fit. And in another month, any new ones you get, likely won’t fit either. That’s a great thing, right, but also a potential budget buster. New clothes can certainly be a fun way to reinforce your journey and transformation but as you change sizes, this could get expensive. I’ve have some great ideas to build that new wardrobe, several times, without breaking the bankVisit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Clothing options to consider:Rental clothes: be sure and listen to the list of questions you want to ask before subscribingConsignment or resale shopThrift storeFacebook group: WLS Sisterhood of the Traveling Pants: https://www.facebook.com/groups/484642491937175/ FreeCycle or BuynothingClothing websites to check out:https://www.applesandpearsbox.com/ https://www.nuuly.comhttps://www.haverdash.comhttps://www.renttherunway.comhttps://www.joinwardrobe.comhttps://www.shopemeryrose.comhttps://thevolte.com Perth, AURental clothes for men:https://www.stitchfix.comhttps://www.renttherunway.comhttps://www.wantable.com 

Now that bariatric surgery is behind you, have you been considering plastic surgery? Do you have a lot of questions before you take this next step? Stay right where you are because plastic surgeon Dr. Omar Beidas is in the house answering your questions.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Today's Guest: Omar Beidas, MD, FACSIG: @drbodycontouring (Omar E. Beidas, MD, FACS (@drbodycontouring) • Instagram photos and videos)Orlando Health: Omar E. Beidas, MD, FACS (orlandohealth.com)Facebook: Omar E. Beidas, MD | FacebookRealSelf: Omar E. Beidas, MD Reviews, Before and After Photos, Answers - RealSelfDr. Omar Beidas is a board-certified plastic and reconstructive surgeon with the Orlando Health Aesthetic and Reconstructive Surgery Institute. He specializes in breast surgery and body contouring after weight loss. He also founded Orlando Health's "surgery after weight loss" program, the first of its kind in the southeastern United States. Dr. Beidas also works with bariatric dietitian Gayle Smith who joins me regularly on the podcast.Questions we discuss in today's episode:When you see a potential plastic surgery patient for the first time, what are the most common questions you are asked and how do you respond?How long after weight loss surgery should you wait to do skin removal? Is there an ideal body fat percentage where you should be before surgery?What is the recovery time on a tummy tuck? How much benefit is working out regularly (building muscle) before having plastic surgery?If you have your stomach skin removed, do you always have to repair muscle?I’ve heard that your inner thighs are very difficult to heal. Is there any truth to that?What is the difference between all the abdominal surgeries? Tummy tuck vs mommy makeover vs pa-nnic’ulectomy vs fleur-dis-lis? I chose the FDL for my first surgery in January but don’t really know what I’m choosing.How many skin removals can be done together (arms, legs, breasts)?How far apart should you schedule multiple surgeries?What takeaways do you want to leave us with that you always want your plastic surgery patients to know?Search to verify if your surgeon is certified by The American Board of Plastic Surgery (ABPS) https://www.abplasticsurgery.org/VerifyCert?section=SurgeonSearch

Sometimes you just get tired of drinking water and more water, right? Surely after weight loss surgery, there are other beverages that are bariatric friendly. You bet there are. Let’s talk about some of our favorite beverages and why they work well to hydrate you.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Guests: Bariatric Dietitian Isabel Maples, RDFauquier Health Weight Loss SurgeryEmail: weightloss@fauquierhealth.orgisabel.maples@fauquierhealth.org Gayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  Weight Loss and Bariatric Surgery InstituteStaying hydrated ranks right up there with taking the right vitamin and mineral supplements after surgery. Water, water and more water is constantly pushed but there’re other bariatric friendly drinks that are on the market that work. Before we get into specific beverages that are bariatric friendly, let’s clear up the confusion about coffee and tea since people wrongly think that they dehydrate you.Questions we cover:What is the correct information from the Institute of Medicine on caffeine and dehydration?What do each of your surgery centers suggest when it comes to caffeine after surgery and why?What are the signs and symptoms of dehydration?When do you need to call your dietitian or health care provider?What are some of the bariatric-friendly beverages you recommend?What apps or other ways are available to track or remind you to drink fluids?

You’ve had weight loss surgery and now you have Covid. What should you eat and drink? How does Covid affect your bariatric diet? Nutrition can play a definite roll in your recovery, support your immune system and have an anti-inflammatory effect but you want to be smart in how you care for yourself. I’ll share 5 nutrition strategies in this episode of the Bariatric Surgery Success podcast.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%New Hope Girls Giveaway:Our giveaway is a beautiful tote in the Slate Surface pattern valued at $62.You can register to win the tote in our random drawing by answering two questions and sending your name and email to contactus@breakingdownnutrition.com Questions:#1 What do you like best about the Bariatric Surgery Success podcast?#2 If you could change something about the podcast, what would it be? Look at and read about tote: https://bit.ly/3PPVORlOr use code Transform15 any time to save 15% on your orderDeadline to enter is midnight, August 12Private FB Group link: https://www.facebook.com/groups/bariatricsurgerysuccesswithdrsusanmitchellIf you’ve recently had surgery and are nauseated, vomiting, have diarrhea, short of breath…all factors that can affect what you eat and when, please check in with your health care team. See if they have someone on call to discuss your symptoms and how to manage them. Regardless of how far out you are from surgery, never hesitate to contact your health care provider if you have symptoms and know you need answers and care.5 strategies discussed in this episode:Foods for immune support and anti-inflammatory benefitsWhen to have full liquids and soft foods; what about proteinEating with a sore throat or shortness of breathCoping with changes in taste and smellWhat to do if food taste bitter or metallic

Do you ever feel confused with all the sweetener options? How do you know which ones to try and which ones to stay away from? Erythritol is a commonly used, very low calorie sugar alcohol and is a choice among many low or no calorie sweeteners. You’re going to see it on the ingredient labels of many food products with less sugar. Is it bariatric friendly or will it cause unfriendly symptoms you don’t want?Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Erythritol is a popular low calorie sweetener used in all types of food items from ice cream, to cookies and candy, beverages, and more. It belongs to a class of compounds known as sugar alcohols. What are sugar alcohols and erythritol and why do they matter in a bariatric diet?In this episode of Bariatric Surgery Success, Iet's talk about:What is a sugar alcohol?What is erythritol and does it matter in your bariatric diet?Do sugar alcohols contain alcohol?How many calories does erythritol have as compared to sugars or other sugar alcohols?Does erythritol cause digestive problems?How much of it can you use?Taking a look at ingredient labelsMore on sugar alcohols in podcast #89 https://www.breakingdownnutrition.com/blog/89-sugar-alcohols-and-bariatric-surgery-what-you-need-to-knowFollow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

Is your hunger coming from your head or your heart or your stomach? Do internal battles and food issues drive your appetite? Can you re-learn how to have a healthy relationship with food? You bet you can. Let’s go from head and heart hunger to transformation.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Today's Guests:Connie Stapleton, PhDWebsite: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchersNew Hope Girls:Bags can be purchased at NewHopeGirls.com Use code TRANSFORM15 to receive 15% off your purchase. This is our way of thanking you for being part of this community of healing and transformation!Instagram: @Newhope.girlsFacebook: https://www.facebook.com/newhopegirlsLinkedIn: https://www.linkedin.com/company/nueva-esperanza--new-hope-girls-inc/Website: www.NewHopeGirls.comCaitlyn Scaggs is the Executive Manager with New Hope Girls which is based in the Dominican Republic and fights trafficking, abuse and exploitation. Their mission to rescue girls and empower women. As their state-side representative, Caitlyn works to grow awareness of this mission. Much of her work supports the workshop component and as the demand for their beautiful bags grows, so does the need to hire more women.Atlanta-based psychologist Dr. Connie Stapleton. You know that Dr. Connie brings her vast experience in the mental health aspect of bariatrics to the table. She gets right to the core of the issues and always shares practical ways for you to improve your relationships with food, other people and most importantly with yourself. There’s a significant emotional connection to food and food choices. From stress to abuse to trauma, what goes on in the heart and head affects what happens with food. Topics, questions and answers discussed:Caitlyn, girls come into your care enter with significant trauma. How do you see this show up around meal times? Are there observable signs?Caitlyn, girls come into your care enter with significant trauma. How do you see this show up around meal times? Are there observable signs?Dr. Connie, how have you seen abuse, trauma, food insecurity, bullying etc affect relationships with food?Caitlyn, how do you help your girls identify where they are feeling hunger, ie in their stomach or their heart?Dr. Connie, when you recognize food issues brought on from prior life events, how do you start someone on the way to healing the past and healing their relationship to food?Caitlyn how does healing begin around food for the girls and women you work with?Dr. Connie you just shared some ways to get started but it’s often hard to stay focused and continue to move ahead. How do you continue to kick the cycle of returning old habits and hurts to the curb and replace with cycles of empowerment? My listeners, my community are going through their own transformation journey. It may not be the exact same type of "hard" as what your girls have experienced, but they certainly have been through a lot. Caitlyn, do you have any words you'd like to share with them?Dr. Connie, when you start to feel hopeless and like a failure, going back to head hunger, how do you stop that self talk and stay focused on the fact that you are created for more?I am all about empowering my community to know they are worth it and to learn how to use food and nutrition to be healthy and get out there and live life. Caitlyn, I love that New Hope Girls empowers women and provide places of refuge and transformation. Tell us about your workshop for adult women where they make your beautiful products.I am so pleased to be a partner with New Hope girls as your fabulous bags and other items enhance and support the transformation of my community who in turn can support the women in your community with hope to change their lives. I love that. If we want to support New Hope Girls by purchasing some of your beautiful bags - how exactly can they do that?Link to FaceBook Group: https://www.facebook.com/groups/bariatricsurgerysuccesswithdrsusanmitchell "I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

As you transition back to real food after bariatric surgery, should ghee be your fat of choice? Is it bariatric friendly? Let’s compare it to butter.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%I’d like to give a shout out this week to Sonia who said: "Thank you Dr. Mitchell, your podcasts are priceless. I'm learning so much about having the right mindset for a successful bariatric surgery.”Sonia, so happy to hear the podcast is helping you prepare for your surgery. I always believe that knowledge is power. Have you heard of ghee? It’s been popular for many years in the culinary word of the Middle East and India. But what is it? Ghee is cow’s milk butter heated at a low temperature of around 100 degrees Fahrenheit or 38 degrees Celsius, until the water all evaporates and leaves behind milk solids.These solids are then skimmed or strained leaving a clarified liquid fat known as ghee.In Science 101 of the podcast, let's talk about:the nutritional profile of ghee compared to butteris ghee dairy free?is the lactose a problem if you need to be lactose-free?smoke point for cooking as compared to butter or clarified butterbottom line

Drink water! Drink more fluids! How many times have you heard this since your weight loss surgery? Too many to count, right? But on the flip side, there are so many fabulous benefits to your health from drinking water. I’ll share seven in this episode of Bariatric Surgery Success.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Did you know that your body is 60% water? No wonder water is so important for your health especially after weight loss surgery. Even though they are times drinking enough water is a pain in the patootie, the benefits to your health make all the effort so worthwhile.Let’s talk about these seven benefits of drinking water:beats brain fogbanishes bad breathkeeps skin more elasticprotects your heartmood managerfight that dreaded weight regainfabulous foods that have high water content and other nutritional benefits

Do you ever feel that food is getting stuck in your throat or GI tract since you’ve had surgery? What can you do about this discomfort? Bariatric dietitians Gayle and Isabel join me with workable answers and tips on this episode of Bariatric Surgery Success.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Guests: Bariatric Dietitian Isabel Maples, RDFauquier Health Weight Loss SurgeryEmail: weightloss@fauquierhealth.orgisabel.maples@fauquierhealth.org Gayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  Weight Loss and Bariatric Surgery InstituteIt’s so uncomfortable when you feel like food is stuck in your throat or your gastrointestinal or GI track. After surgery, I imagine this feeling is even worse. In today's episode we talk about and answer a lot of questions and topics including:Why does food get stuck and does it vary with the type of surgery?The 3 spots that food seems to get stuck along the road from "bite to belly".Speed of eating and mindfulness for prevention.Three digestive comfort tips that work to ease this stuck feeling.Size of bitesPausesShould you use meat tenderizer to help?How to moisten food and with what?Practice before surgeryReflux meds

You have quite a few supplements to take after bariatric surgery and one of those is calcium. This question was posted in my Facebook group recently: “Is it bad to take my calcium citrate with coffee?” I have your answer in this episode of Bariatric Surgery Success.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%“Is it bad to take my calcium citrate with coffee?” The thinking use to be that caffeine is a drug that can prevent your body from absorbing calcium the way it should. When you drink coffee containing caffeine, less calcium is absorbed and more is excreted mainly thru urine. Other experts suggested to avoid caffeinated beverages a good 30 minutes before or after you eat or drink food sources with calcium or take your supplements. The estimate for calcium loss was 5 milligrams of calcium excreted in the urine for every 150 mg of caffeine which is about a cup of coffee. Others have suggested that 2-3 milligrams of calcium are lost per cup. But let's talk about the latest science:*Actual calcium loss and relationship to bone health*Study from The Cleveland Clinic*Changes in bone density of fracture risk*What YOU can do to offset any loss*Type of calcium to take and how much*Type of vitamin D to take and how muchFollow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

Christina said to me: “I’ve lost 147 pounds, down from my highest weight of 290. Surgery has transformed my life in so many ways.” In this episode of Bariatric Surgery Success, Christian doesn't hold back and shares her emotional and empowering story with us. Be sure and listen thru till the end as she has a lot to say as wrap up.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%My first article for ObesityHelp.com on 7 foods to fight inflammation after surgery. Check it out.Christina is one of the members of my Facebook group. From 290 pounds at 5 feet 2 inches plus diabetes and high blood pressure, Christina is now under 150 pounds. She joins me today to tell her story that started as an overweight child and obese adolescent but has a remarkable ending.Some of her story includes:her obesity as a child and adolescent and how that affected herwhat made her decide to have weight loss surgerydid she lose weight before surgery?why did she go to Mexico for surgery?what she feels is the difference between motivation and commitment for success long termsetting boundaries in relationshipswhat's next for herFollow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

This comment was part of a discussion in my facebook group: “I had bariatric surgery and now my food issues have become alcohol issues.” Well, this happens and it’s called transfer addiction. Psychologist Dr. Connie Stapleton, who specializes in bariatric surgery, is with me to explain transfer addiction, how you can prevent it and what to do if it happens. Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Dr. Connie's info:Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchersPodcast episode #30: Bariatric Surgery and Alcohol Buzz: What You Need to KnowTransfer addiction is a term most people even medical professionals have never heard of so let’s dive right in and start with the basics and then get a lot of your questions answered by Dr. Connie including:What exactly what is transfer addiction?How common is transfer addiction after weight loss surgery?Is the transfer addiction to alcohol common and what are some of the other common transfer addictions to know about?What makes a person more susceptible to transfer addiction?What can I do to prevent this from happening?What do I do if I realize there is a problem now?Takeaways to know."I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

Feeling overwhelmed today? Way too many things on your to-do list? Get in line, right? Wondering what you'll fix for dinner? I have an idea for you: sheet pan dinners that take 30 minutes or less. They're quick, easy and satisfying. And I have a freebie with 4 recipes for you too. Just what you need to make your day a little bit easier.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Link to my interview with Dr. Connie Stapleton on her BariAfterCare podcast Audio podcasthttps://www.youtube.com/watch?v=FDS7A0d2NeI Video versionSheet Pan DinnersA sheet pan dinner is when the majority of dinner is prepared on one pan…a sheet pan.You might be thinking. Why sheet pan dinners. Don’t knock it till you try it. There are lots of benefits to sheet pan dinners. Let's talk about four in today's episode plus I'll share my go-to sheet pan recipe for you to try.Get your FREEBIE: 4 sheet pan recipesJoin me in the Facebook private groupFollow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

Are you preparing for bariatric surgery or maybe you just had it recently. What questions are on your mind that you wished you had asked your surgeon? Bariatric surgeon Dr. Andre Teixeira is in the house answering your questions on this episode of Bariatric Surgery Success.Visit Procarenow.com for all of your vitamin, calcium and protein needs. Use Code: Susan10 to save 10%Guest: Dr. Andre TeixeiraInstagram: @bariatricdrteixeiraFacebook: https://www.facebook.com/bariatricdrteixeiraOrlando HealthBariatric and Laparoscopy Center89 Copeland Drive, 1st FloorOrlando, Fl 32806321-843-8900Dr. Andre Teixeira is a board-certified bariatric physician for Orlando Health Physicians Bariatric and Laparoscopy Center in Orlando Florida. And he also works with bariatric dietitian Gayle Smith whom you know and joins me regularly on the podcast. In fact I recently read a journal article in Obesity Surgery written by Dr. Teixeira, Gayle and two other professionals on low calorie sweeteners. Some of the questions he answers include:When you see a potential surgery patient for the first time, what are the most common questions you are asked?Will I stop losing weight at a certain point and gain back?I feel like I am a slow loser. How much weight is average loss post surgery?What is the % success (keeping the lost weight) after a sleeve on long term (5-10 years)?How much weight will I lose?I am 2 years post op and I have not lost as much weight as I would like, not at 100 pounds yet, no gains though. Will this change?Please write a review on Apple Podcasts"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

Weight loss surgery is in your rear view mirror and your moving forward. You’ve lost the weight you want to lose and now you want to stop the weight loss and stay where you are. How do you do this? How do you stop the drop? Your favorite bariatric dietitian experts, Gayle and Isabel have answers for you.For all of your vitamin, calcium and protein needs, visit Procarenow.com Use Code: Susan10 to save 10%Guests: Bariatric Dietitian Isabel Maples, RDFauquier Health Weight Loss SurgeryEmail: weightloss@fauquierhealth.orgisabel.maples@fauquierhealth.org Gayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  Weight Loss and Bariatric Surgery InstituteThe three of us all get asked this question: "Can I lose too much weight after surgery?" Can you eat too few calories? True, it’s not as common as slow weight loss or weight regain after surgery but it happens. So how low is low when it comes to weight and how do you stop the drop? In this episode we answer the questions:Can I lose too much weight after surgery?Can I eat too few calories?How do you stop the drop when you don't want to lose any more weight?Can you drink too much fluid?How many carb grams should you eat? Are carbs off limits?Do you have brain fog?What about reflux and other gastrointestinal issues that make it hard to eat?What should my weight goal be?When should I see my dietitian again?

Health claims promise that alkaline water will slow how fast you age, prevent cancer, give you more energy and regulate your body’s pH. Should you open your wallet after weight loss surgery and spend your hard earned money? Will it benefit you in any way? Find out three things you’ll want to know.For all of your vitamin, calcium and protein needs:Visit Procarenow.com Use Code: Susan10 to save 10%In today's episode we'll take about:science 101: what alkaline water is and it's benefits or lack ofwhat is pHwhere does alkaline water fall on the pH scaleis alkaline water naturally sourced or manmadea friend tells you to drink alkaline water for energy. Will it help?can alkaline water affect the medications you take?what about your stomach's pH and your digestioncan you change blood pHshould you drink alkaline water over spring water or tap water?

Beetroot juice is all the rage with marathoners, Olympians and football teams along with those hoping for improved heart health. And does beetroot juice, the juice from those big gnarly beets, have benefits to you after weight loss surgery? Yes, it does. Here are three you should know about.Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchaseYour science 101 on beets and beetroot juice also known as beet juice. Beets are a root vegetable packed with vitamins and nutrients like vitamin C, fiber, folate, manganese and potassium. You can find beets that are dark red, golden yellow, white and even rainbow colored. By the way, those green leaves that grow out of the beet are also edible and you can prepare them like you would Swiss chard.Topics and benefits covered in this episode: Why your pee and poop turned pink or redWhat's in beets/beet juice that makes it special for your health and blood pressureHow beets and beet juice can enhance your workoutsDo whole beets work as well as the powder or juice?Beets and anti-inflammatory effect in your bodyCarbs in a glass of beetroot powder plus waterHow beets can lower blood pressure"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

Are you eating a lot after dinner in the evening? Are you waking up during the night to eat, maybe several times? Is your sleep disrupted? Stay right where you are because psychologist Dr. Connie Stapleton, who specializes in bariatric surgery, is with me to talk about night eating syndrome. She gets right to it with the answers you need now.Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchaseGuest: Dr. Connie StapletonWebsite: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchersResources mentioned in the podcast:It's All about the Protein: The 5 Fast-Ways Guide to Add Protein to Your DietTired of cravings and night eating? Want to prevent weight regain after bariatric surgery? Let's add protein sources you actually eat and enjoyReady to boost your protein intake today? Grab the freebie, get started.https://bit.ly/3migTnU Dr. Connie and I cover a lot of questions about night eating syndrome which include:What is night eating syndrome all about?Are there symptoms to look for?Is night eating syndrome the same as binge eating disorder or a sleep disorder?How common is night eating syndrome and is it an issue after weight loss surgery?What causes it?Are hormones tied to night eating syndrome?How is it diagnosed?What are the health effects to the body?How is it treated?What is your best course of action?

What is coconut sugar? Is it bariatric friendly? A better choice than honey or maple syrup? Bottom line, is it good for you or just big BS?Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchase*** Freebie mentioned in podcast:Did you know that added sugars are basically empty calories with zero nutritional value? They're often added to food as flavor enhancers and preservatives under many different names. Their carbohydrate- dense nature makes them a trigger for dumping syndrome. Use these three tips to crack down on added sugars in your food. Get the freebie: https://bit.ly/36YvdfQ In this episode, I'll cover: What coconut sugar is and where it comes fromHow it's madeThe nutrition info for 1 teaspoon of coconut sugarGlycemic indexAmount of fructose compared to table sugar"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

You’ve made the decision to have weight loss surgery and now you find out you need to follow the liver shrinking diet first. Let’s reduce your stress by talking about what the Liver Shrinking diet is and why you may need it.Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchaseI want to give a shout out to Christina who said: “I listen to all your podcasts and it has helped me so much. I sought out podcasts and found yours. And it’s changed my life! Thank you for all you do!!!Christina, receiving wonderful comments like yours and getting to know people like you is what makes my work a joy. Thank you.You’ve made a huge decision. You’re going to have bariatric surgery. Then you find out it’s not quite that simple. There are numerous steps needed prior to the surgery itself. One of those steps may be to follow the Liver Shrinking or Liver Reduction diet. What the heck is this all about?In this episode we'll cover: What Non-Alcoholic Fatty Liver Disease (NAFLD) is and why it may be important for your surgeryHow the liver shrinking diet worksThe three options for the dietNumber of calories per day along with waterWhat to do if you have diabetes and/or high blood pressureWhat about constipation on the diet?

You know those days when it's just not happening? You need to go in the kitchen and prep meals but you can’t seem to even crawl in there. Whether you’re single or have a family to feed, the good news is that there are numerous meal options to check out. Gayle, Isabel and I all get this question frequently: "Are there prepared or semi prepared meals that work for me after surgery?" Yes. Let's take a close look at some of the most popular meals you can order. Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchaseGuests: Bariatric Dietitian Isabel Maples, RDFauquier Health Weight Loss SurgeryEmail: weightloss@fauquierhealth.orgisabel.maples@fauquierhealth.org Gayle Brazzi Smith MS, RDN, CSOWM, LDNRegistered & Licensed DietitianEmail: gayle.brazzismith@orlandohealth.comWebsite: OrlandoHealth.com/Bariatrics  Weight Loss and Bariatric Surgery InstituteIsabel, Gayle and I each critiqued 2 meal companies looking specifically at calories, grams of protein, carbs, and fiber plus portion sizes.We had specific nutrition criteria in mind so that the meals would work for you after surgery when you’re at the point to eat regular food again. Here are the criteria we looked for:Calories: 250 to 400 per mealProtein: 15 to 30 grams per mealCarbs can be 5 grams up to 15/20 grams per mealFiber can be 3 grams up to 10/15 grams per mealSodium can be 100 mg up to 300/400 mg per mealYou can use these same ranges to critique meal options you’re interested in too as they are many meal companies to consider.Companies we critiqued:Freshly https://www.freshly.comBistroMD https://www.bistromd.comHello Fresh at www.hellofresh.comHome Chef at www.HomeChef.comBariBox: https://www.baribox.orgTiny Tummyz https://www.tinytummyz.com.auRemember that we eat with our eyes so when you heat or prep your meal, be sure and put the food on a nice smaller plate or in a pretty smaller bowl. Set up a place mat and napkin. The meal will take on an entire new look and feel of enjoyment than if you heat and eat from a bag. When you eat from the bag or container, you won’t feel satisfied and it’s hard to practice mindful eating where you enjoy each delicious bite slowly. "I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

Hey men…have you thought about bariatric surgery but that’s where it ended? Gentlemen, I’m talking to you. In a world where a lot of men don’t talk about personal health issues, particularly bariatric surgery, Henry from my private FB group steps forward to share his story. You don’t want to miss it.Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchaseI’ve always felt that men are under represented in the bariatric surgery world. The stats for surgery skew heavily towards women even though there are equal rates of obesity among American men and women. Of the surgeries performed about 80% are women and 20% or less are men. Why is that? Stigma? Bullying? Are men not as aware of their health issues? Lack of support?Joining me today from California is Henry Baker, whom I met thru our private FaceBook group. When I read his story and his desire to share it and empower men to consider surgery if warranted, I asked him to join me today.In this episode we cover: Henry's weight loss surgery storyWhat held him back from having surgeryWhat was his as-ha moment that made him decide to have surgery/His recent skin removal and hernia surgeryHis Covid experienceHis lifestyle changes and mindsetWhere Henry is todayHis message for youGuest: Henry BakerInstagram: https://www.instagram.com/healthy_henry1118/ Facebook: Chitown Man"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

Are you trying to make sense of the bariatric diet now that you’ve had surgery? What are sugar alcohols? How are they different from sugars? Should you consume them or will it not be pretty if you do? Let's clarify the differences between added sugars and sugar alcohols and what that means for you. Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchaseResources Mentioned in the Podcast:I have a freebie to help you Sleuth Out Added Sugars on food labels so be sure and download it. Interactive Nutrition Facts food label that shows sugar alcohols:https://www.accessdata.fda.gov/scripts/InteractiveNutritionFactsLabel/sugar-alcohols.cfmThis podcast covers the difference between added sugars and sugar alcohols including:what sugar alcohols are and how they are madecalories and calories per gram compared to added sugarscommon sugar alcoholshow many grams of sugar alcohol can you use per mealwhat about Dumping Syndrome"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

Are you feeling anxious today? Has the COVID pandemic brought out anxiety you didn’t have before or increased any anxious feelings you did have? Psychologist Dr. Connie Stapleton, who specializes in bariatric surgery, is with me today on this episode of Bariatric Surgery Success and gets right to it with the answers you need now.Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchasePlease Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.Joining me is Atlanta-based psychologist Dr. Connie Stapleton. If you’re a regular listener, you know that Dr. Connie has vast experience in the mental health apect of bariatrics. She gets right to the core of the issues and today she’s doing that with anxiety and shares practical ways for you to improve your relationships with food, other people and most importantly with yourself.Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchersQuestions that I ask Dr. Connie today about anxiety: Explain what anxiety is from a mental health aspect and what triggers it?Is anxiety associated with other psychological/mental health or physical symptoms?What about the use of medications, especially benzodiazepines?How can you prevent or control anxiety in an anxiety producing situation like COVID?If anxiety goes uncontrolled, can it progress to other conditions?What is the tie between anxiety and binge eating, night eating syndrome or other over eating behaviors?Take away tips.

Ancient grains are often promoted as the fast track for weight loss and the answer to stabilize your blood sugar. What exactly are ancient grains and are they better for you than modern ones?*** Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchase ***Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.Here's the link to the recipe mentioned in this episode: Sorghum Super Salad The Whole Grains Council defines ancient grains as typically unchanged over the last several hundred years and largely intact as compared to grains that have been cross-bred more recently. So modern wheat, which is bred, would not be considered ‘ancient’ while spelt, buckwheat, farro, sorghum, amaranth, teff, millet, quinoa and others would be. This episode covers the many benefits to your body of various ancient grains including:protein to carbohydrate ratiowhich ones have the ability to lower cholesterolwhich ones are gluten freefiber and weight regainfiber and constipation

Who knew that the not-so-popular crudite’, celery, would hit celebrity food status. Celery juice ads serve up promises to treat everything from ADHD to the Epstein Barr virus, acid reflux, gas, acne, urinary track infections and much more. Does this health hack…drinking celery juice daily …really benefit your body?Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchaseDid you know that a case of 18 bottles of organic celery juice will set you back $120? That’s almost $7 per small bottle. From online sites to stores like Walmart and Target, everyone is selling it. Should you drop the $120 bucks for the juice or put your wallet away?In this episode I'll share and discuss five ways that celery juice can and cannot benefit you:  HydrationBlood pressureWeight lossVitamin and mineral content plus a note on Warfarin if you take itInflammationI'll also touch on celery allergies and what to look for.Please Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

The pouch reset after bariatric surgery. Should you do it? People swear by it. Or is just more pureed baby food? Your favorite bariatric dietitians Gayle and Isabel join me from their clinics to answer your questions about the pouch reset for weight gain.Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchaseA large percentage of people face unwanted weight regain after their weight loss surgery. Enter: the pouch reset diet. Touted as the way to dump this extra weight, reset the stomach to its original size after surgery and gain control of unhealthy eating habits, it’s become a darling of internet health hype. Many people swear by it, I don’t. I'll explain why later in the episode.Gayle, Isabel and I just attended a virtual continuing education webinar on all that’s new in bariatric surgery. We have a lot to share with you this episode:* What is the pouch reset diet?* What are the different stages?* Does it work?* What about hunger?* Does the size of your stomach affect your weight?* What about hormone changes after surgery and your appetite?* Are there new weight loss drugs?* Where's the leak?Please Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.Guest Bariatric Dietitians Bariatric Dietitian Isabel Maples, RDFauquier Health Weight Loss Surgeryweightloss@fauquierhealth.org  isabel.maples@fauquierhealth.org Gayle Brazzi Smith MS, RDN, CSOWM, LDNWebsite: OrlandoHealth.com/Bariatrics  gayle.brazzismith@orlandohealth.com

If you do a quick Dr. Google search, health claims promise that coconut oil will burn your bariatric belly fat and alter fat levels in your blood. Let’s separate facts based on science from fiction based on nothing but hype in this episode of the Bariatric Surgery Success podcast..Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchasePlease Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.How did you like my bariatric friendly Valentine's Day Dinner Recipes? If you haven’t checked them out, it’s a romantic yet super simple menu of One Pan Steak Fajitas and Chocolate Stuffed Raspberries. Download the freebie now so you'll be readyHere are the top things to know about coconut oil and what it can and can’t do for you in terms of weight. I talk in depth about:Coconut is a fruit, and the inside of the coconut is called the meat. Coconut oil is categorized into two main types - refined and virgin. I explain the difference and which is better and why.Science 101: understanding why coconut isn't the answer to your weight regain.Looking at MCT oil compared to coconut oil: the differences and why those differences matter for weight loss.Coconut oil statsOther oil choices with less saturated fat

“Ch-ch-ch-chia”? Do you remember that jingle? You know, those pets in a pot that grew grassy hair? Who knew those seeds would become a so-called superfood down the track? Let's take an up close look at chia seeds with one caveat that will surprise you.Visit Procarenow.com Use Code: Susan60 to get a free bag of protein powder with $60 purchaseRate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! This week the focus is on the bariatric friendly food chia seeds. What nutritional value do they possess and what do you need to be aware of if you eat them. Stay with me to the end of the episode as there’s one red flag I want you to know about if you’ve already had surgery. From chia pets to a so-called superfood, who knew chia would become so popular? By the way, as an FYI, the term superfood does’t have a regulated definition, but is used by marketing types to make you think a food has superpowers. Just remember, many foods are nutrition powerhouses and there is no one magic bullet. But the great news, there are many powerful foods to eat.In this episode you'll find out:The nutritional benefits in 1 teaspoon of chia seeds including protein and fiber.The type of omega 3 fats that chia seeds containIs chia a complete protein or is it missing some amino acids?The benefits to your body of soluble fiberWays to use chia seedsONE big word of cautionOther episodes mentioned: #41 Is Pea Protein a Smart Choice after Bariatric Surgery#44 How to Eat for the Long Haul after Bariatric Surgery, part 2. If you haven’t followed the podcast, be sure to Follow/Subscribe now so you never miss an episode.

Do you feel like you blew it over the holidays? Over indulged way too much? Maybe even told yourself you’re a failure and can’t stay on track. Wondering how in the heck to start this new year off with a positive focus on you and your mental health? Psychologist Dr. Connie Stapleton, who specializes in bariatric surgery, is with me today and gets right to it with the answers you need now.How are you feeling about this new year? Are you excited? I always look forward to a fresh start. My passion is to show you how to use food and nutrition to feel better every single day, so you can do what you want to do.Procarenow.com for free samples. Use Code: Susan10 to save 10% Dr. Connie's info:Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchersTopics Dr. Connie and I cover in this episode:If you overindulged during the holidays and feel like a failure, how do you deal with those feelings and stop that stinky feeling?How do you "Stay In Today"?Words to replace "I'm a failure" with.Addressing feelings of failure.What works better than resolutions for your mental health?Dr. Connie's Gotta Do Ems for 2022.Today's coping tip for anxiety, the topic we'll cover when Dr. Connie returns.

In my many years of practice, some topics like weight loss in the beginning of a new year, pop up over and over again. Adrenal Fatigue is one of those topics. That’s why I do what I do. I’m here to cut thru the hype and BS and share accurate, evidence-based nutrition information worthy of your time and efforts. Simple, step by step strategies that can change your life now. I want you to feel well every single day and get out there and do the things you want to do. That’s why I do this Bariatric Surgery Success podcast.Procarenow.com for free samples. Use Code: Susan10 to save 10% Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most about the podcast. Thank you for your time! If you haven't followed the podcast yet, be sure to Follow/Subscribe now so you never miss an episode.The term Adrenal Fatigue has been around at least 20 years and every year it pops up again and again like whack a mole. For giggles I did a google search on the words adrenal fatigue and in .60 seconds I got over 23 million results selling everything from home test kits to all types of nutrition supplements to treat it. In this episode I cover:Find out what adrenal fatigue is and isn'tWhere you adrenals are located and what they do in the bodyDo adrenal glands burn out and cause fatigue?What supplements, if any, do you need?Can supplements contain hormones that may be harmful to your body?

Did you know that the MIND Diet is tied to better brain function, particularly as you age? What is it about this diet that is also good for bariatric surgery? In this episode I'll share three benefits to you.Procarenow.com for free samples. Use Code: Susan10 to save 10%Thank you for giving your time to listen. Because you do listen, FeedSpot selected the Bariatric Surgery Success podcast as one of the BEST 35 Dietitian Podcasts in 2021. It was selected from thousands of podcasts on the web ranked by traffic, social media followers, domain authority & freshness. You helped make this happen and I’m very grateful.Wondering what brain-healthy foods the MIND diet focuses on? The foods include:Green leafy vegetablesAll other vegetables with a limit on starchy onesBerriesNutsOlive oilWhole GrainsFishBeans PoultryWhat makes the Mind Diet beneficial to bariatric surgery? Here are three benefits covered in detail:Better brain function over time.2. Brain-healthy foods boost your fiber intake.3. Brain-healthy foods are anti-inflammatory foods.Rate, Review & Follow on Apple Podcasts:"I love Dr. Susan and Bariatric Surgery Success." If this sounds like you, would you please rate and review my podcast? Click here. Then click on "Listen to Apple Podcasts" at the top. Scroll down to where you see Ratings & Reviews and tap on "Write a Review". Yes, I'd love a 5 star review! LOL Be sure and let me know what you love most. Thank you for your time.

Procarenow.com for free samples. Use Code: Susan10 to save 10% Bariatric Dietitian guests:Isabel Maples, RDFauquier Health Weight Loss SurgeryEmail weightloss@fauquierhealth.orgisabel.maples@fauquierhealth.org Gayle B.Smith:Website: OrlandoHealth.com/Bariatrics  gayle.brazzismith@orlandohealth.comI want to give a Shout Out to Marie from Australia. Thank you for your email to let me know that you listen to the podcast and find it fantastic. It’s feedback like yours that makes it all worthwhile.You requested and I’m happy to announce that Gayle and Isabel will be regulars on the podcast this year. You can expect to hear from them every 6 weeks. Do you have a question you want Isabel and Gayle to answer? Post it anytime if you’re in the private Facebook Group or join us Bariatric Surgery Success with Dietitian Dr. Susan Mitchell. Or go right to my website, Breaking Down Nutrition and there’s a contact us link at the top of the home page. Or hit reply to the weekly newsletter if you receive it. If not, why not? You can sign up for it on the home page of the website.As part of out new year kick off, Gayle, Isabel and I talk about proven tips that we believe in and have had success with over the years because they work in every day life.Listen to the episode to hear about exercise ideas and strategies, how to deal with guilt when you eat a 'bad' food and what you get for giving up something else. You don't want to miss these real-world strategies for a successful 2022.Choose one or two of these tips and put them into play now. Set aside 20 minutes for a walk or two several times a week. Put it in your calendar as a to-do. Remember our saying about guilt too. No guilt allowed in 2022. YOU are worth it.

Procarenow.com for free samples. Use Code: Susan10 to save 10% Do you make New Year’s resolutions that by mid January are already kaput? There’s got to be a better way, right? I want to share with you what I do now and what I’ve been doing the last few years. It’s called 1% to infinity and it actually works. You’ll want to try this for 2022.1% to InfinityI’m sitting at my desk taking a minute, actually a few minutes, to reflect on this past year. So much has changed due to Covid and the stress had been incredible. Not just world wide but for our personal lives too, right?A few years ago I attended a work conference and heard about a concept called 1% to infinity. This concept is what I use now and it works. In this episode of Bariatric Surgery Success, I'll explain what 1% to infinity means and how to put it to work in your life today.It’s tiny but it is mighty. As the year rolls to an end, it’s necessary to pause, take a minute or several for that matter and look back. Remember. Reflect. Ask yourself questions about your life…what you love, what needs a tweak here and there? Be honest with yourself. Reflection is one way we heal and move forward to a better self and life.I recently read a New York times Opinion piece by Tish Harrison Warren who said and I quote: “Reflection is how we make space to heal and grow, to receive God’s work in and through the raw material of our lives. It’s the time needed for the quiet seeds hidden in the hard soil of the past two years to begin to sprout.”We’re just days away from 2022. Be sure and sign up now for my weekly Breaking Down Nutrition newsletter. I want you to be the first to know about new freebies, upcoming courses, tips, product discounts and of course, the latest podcast episode. It’s super easy to sign up on my home page While you’re on the homepage, join me in the private FB group, the Bariatric Surgery Success community. You’ll see the JOIN button on the homepage.

Procarenow.com for free samples. Use Code: Susan10 to save 10%Every holiday season several of my friends and my husband ask…”Hey, are you going to make that chocolate peanut treat? I want some.” In this episode I’ll share my favorite, fast, go-to chocolate recipe. You won’t believe how easy it is.Did you already ask yourself…can I have chocolate? I hope you answered yourself YES and remembered when I’m down the track from surgery, according to Dr. Susan, I can have small amounts of the foods I love. Video on how to make Chocolate Peanut Butter Crunch ClustersHere’s what you need:1/2 cup natural peanut butter, creamy or crunchy2 cups dark chocolate chips or chunks2 cups unsalted or lightly salted, dry roasted peanuts Combine the peanut butter and the chocolate chips in a large microwavable bowl and microwave 30-40 seconds at a time on medium power until melted. Stir to blend the chocolate and the peanut butter.Stir in the chopped peanuts.Spoon the mixture onto parchment paper or wax paper about a tablespoon at a time. Chill in the fridge until firm. Listen to the episode for all the deets.Chocolate has health benefits. There are several you’ll be happy to know. The naturally found flavonoids in chocolate may improve blood flow, reduce blood pressure and lower lousy or LDL cholesterol. I bet you never thought that chocolate is a source of fiber. The undigested fiber in cocoa is broken down in the gut and can be combined with prebiotics to produce anti-inflammatory compounds. There’s a lot more information in episode #40 if you missed it: 3 Surprising Health Benefits of Chocolate. It goes in depth on dumping syndrome, ingredients you don’t want in your chocolate, etc.We’re just a few weeks away from a fresh new year. Be sure and sign up now for my weekly Breaking Down Nutrition newsletter. You’ll be the first to know about new freebies, upcoming courses, tips, product discounts and of course, the latest podcast episode. It’s super easy to sign up on my home page https://www.breakingdownnutrition.com While you’re on the homepage, join me in the private Facebook group, the Bariatric Surgery Success community. You’ll see the JOIN button on the homepage.If you need a festive meal plan for the holidays, go get this freebie. The meal plan comes complete with appetizer, entree, side and dessert plus the recipes and color photos of each recipe. It’s available now to the end of December and you can find it on my homepage too.

Procarenow.com for free samples. Use Code: Susan10 to save 10%Are you considering bariatric surgery? How do you prepare yourself mentally for this huge decision? Psychologist Dr. Connie Stapleton, who specializes in bariatric surgery, is with me to share 5 ways to help you get in the right mindset.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 76. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.Don’t forget to sign up for the weekly newsletter if you haven’t already. You’ll get helpful tips, hear about new freebies, info on the latest podcast episode, be the first to know about product specials, sales, new courses, basically whatever is going on. You can sign up today on my homepage.Joining me via Skype is Atlanta-based psychologist Dr. Connie Stapleton. Thanks to your requests, Dr. Connie has become a regular guest and she’s here about every six weeks answering your questions. You’ve heard her and know that she has vast experience in the field of weight loss surgery. More importantly, she’s here to help you with your relationship with yourself, family and friends. She teaches you better ways to deal with life’s stuff. You can find links in the show notes to Dr. Connie’s website complete with resources as well as her podcast called BariAftercare.Dr. Connie's Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchers}S: Welcome back to the podcast, Dr. Connie! Questions I asked her and she answers during the episode:People are eager to get bariatric surgery as they want to get rid of that stubborn weight they’ve struggled with for so long. But they’re often frustrated with the number of “hoops” as they call them to jump thru in order to be cleared for surgery. What do you, as a psychologist, want patients to know before they have surgery?Although the size of the stomach changes, the issues from a mental health/brain standpoint haven't changed. What do you see most frequently as issues that still raise their ugly heads? I have patients ask me: “How can a person regain weight after having bariatric surgery? Doesn’t the fact that they can eat much less food after surgery make it impossible to regain weight?” What are your top five mental health strategies to help find the right mindset and set you up for success in your upcoming weight loss surgery?If you have more questions you want Dr. Connie to answer the next time she’s here, please contact me thru my website. You’ll see 'contact us' at the top of the page. You can messenger me thru Facebook as well or reply to one of my newsletters. I read every email that comes in.Take care of you. You’re worth it!

Procarenow.com for free samples. Use Code: Susan10 to save 10% Festive Holiday Meal Plan Freebie: https://bit.ly/3nsxI1K Podcast #74 on sports nutrition: https://www.breakingdownnutrition.com/blog/74-seven-bariatric-sports-nutrition-strategies-to-improve-workoutsPodcast #30 on alcohol: https://www.breakingdownnutrition.com/blog/30-bariatric-surgery-and-alcohol-buzz-what-you-need-to-knowThe holidays are here with all their fun festivities, family and friends, and of course… food. Ok, let’s be real. There’s also a to-do list that’s way too long coupled with too little sleep, too many commitments, very little down time, food everywhere you turn and what did I leave out? It’s a recipe for feeling hangry and overwhelmed. Are you with me? Let’s kick that hangry feeling to the curb and stay on track the entire month of December. I have five tips to help you stay on track now and go into the New Year feeling strong.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 75. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.A fresh new year is just around the corner. Be sure and sign up for the Breaking Down Nutrition newsletter. It’s a quick way to find out first what’s going on in bariatric nutrition from new freebies, upcoming courses, tips, product discounts and the latest podcast episode. It’s super easy to sign up on my home page https://www.breakingdownnutrition.com   Liz asked me how to stay on track. I’m sharing from a nutrition and food viewpoint and I’ll have Dr. Connie bring tips from a mental health perspective to kick off your new year in January. So Liz, the first tip for staying on track is to stop that hangry feeling before it gets a hold of you. You know the word hangry. It means you're hungry and angry and they go together. You’re hungry and start to feel stressed, overwhelmed and angry or you’re angry and then remember you haven’t eaten all day or very little. This not-so-tasty recipe for hangry is a disaster for all of your hard work and best efforts. The key: we can’t let ourselves (and I count myself here too) get hungry, overly tired or angry.Because there’s so much to do, get your shopping done now…early this month. Make a mug of tea (decaf, if you’re feeling stressed), stay in your pj’s and shop online if the thought of fighting crowds sends you to the fridge for a snack. After the holidays, shop year round and put gifts away for those ‘need a gift at the last minute’ moments and to take the stress out of holiday shopping where you feel the need to buy everything for everyone in a couple of weeks. Maybe you cut back on gifts and do more things together making new memories. Don’t miss this one…come close and listen. What about a gift for you? You heard me. You? What brings you joy? Is it taking your dog for a long quiet walk? Watching Christmas movies cuddled under a blanket? Eating leftovers and playing games with your family or friends? Choose something just for you and plan it in your schedule right now…several times during this month. This is not selfish. It is self preservation. You are not selfish.2. To prevent that hangry takeover, plan meals and snacks ahead. What? Ahead? Yes, here’s why. If you wait until you are hangry, you aren’t going to plan anything much less eat well. You’re going to reach for whatever is in front of you or easy to obtain. Whatever will stop the hunger and stop the angry /tired /overwhelmed feelings. It’s not going to be broccoli either. The holidays don’t need to win at getting you off track. Start now. Stock up on your smart snacks. Then take a look at the week to come. How many and what type of events do you have? First, could you say ‘no’ to anything that feels like too much? If you can’t say no, how about preparing a yummy, yet healthier option to take along? Eat a snack (protein and high fiber carbs) before you go to cut down on cravings and hunger. What about meals for this coming week? Consider prepping an item or two on the weekend or one night to have during the week. Put portions in the freezer to pull out when you’re dragging. This is my go-to secret sauce that I’ve done for years and it works. My work is busy and life gets hectic and crazy. You with me? I look at our upcoming schedule every week and think about when and what meals we need so we can eat well and stay on track amidst the craziness. It’s the key to staying on track day to day, week to week, and long term.3. Eat protein first always UNLESS you’re an athlete who is working out a lot. You may need to tweak this a bit in terms of when you eat your carbs and how many grams you eat. If you missed episode 74 on sports nutrition, go back and listen. You can always find it on the website or on your favorite podcatcher. 4. Fill in with smart carbs: those non starchy veggies and fresh fruit along with a small amount of high fiber starchy carbs. Decide today that during the month, you’ll have food on hand that makes it easy to eat well. Choose items you love. What would that be? For me, it’s a good spinach salad with pistachios, avocado and kalamata olives. Make it quick to prepare so you will eat them. Eat lots of protein, then your smart carbs and drink water to stay full and stay off the sugar roller coaster.5. Treats. You thought I would forget these. Not a chance. If you deny yourself the treats you love at the holidays, what happens? You feel deprived and like you’re on a miserable diet that feels like drop the ’t’ and you’re going to die. Allow yourself to have small portions of the goodies you really want. No guilt here. Plan for them or else you will end up craving and possibly binging on way too much. Allow yourself to have it and enjoy it. No dumping syndrome allowed either. To help prevent this, eat your other food first so you feel satisfied and then have your small treat. Cuts down on dumping. Oh, let’s not forget alcohol. Remember that after surgery, alcohol will affect you very quickly and strongly and with a very small amount so be aware. Listen to episode 30 for a lot more info so you’re smart about it.The holidays are a wonderful time of year. Part of the celebration is taking care of yourself and being good to you…you’re worth it

Procarenow.com for free samples. Use Code: Susan10 to save 10% Are you a bariatric athlete? Working out to feel good now and to keep moving forward with your fitness level? Try theses seven strategies to get the most from your workouts.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 74. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.Have you signed up for the weekly Breaking Down Nutrition newsletter? It’s a quick way to find out first what’s going on in bariatric nutrition from new freebies, upcoming courses, tips, product discounts and the latest podcast episode. It’s super easy to sign up at the bottom of my home page https://www.breakingdownnutrition.com   Let’s talk sports nutrition and specifically bariatric sports nutrition which is a very new field of research. I want you to know this up front because there aren’t a lot of sports nutrition guidelines if you’ve had bariatric surgery and are involved in sports and workout. The guidelines currently available can vary a lot between different types of workouts such as endurance/distance running for half marathons and marathons for example, as compared to weight lifting. Since dietitians often specialize in an area of nutrition just like physicians in medicine, bariatric dietitians may or may not be up-to-date on sports nutrition and dietitians who specialize in sports nutrition might not know a lot about bariatric nutrition. Bottom line: Ask your dietitian specific questions about your workouts or sports. They may need to check with their contacts and resources. Read on your own and then ask more questions, and then add in some trial and error. Each of you is different and each of your surgeries and outcomes are too. The type of surgical procedure matters in how you tweak the diet for workouts. For example, a sleeve gastrectomy tends to be easier to adapt to than a Roux-en-Y procedure because it’s less invasive which typically means a smaller incision and less tissue trauma during surgery. I’m the kind of person that wants direct, specific answers. Are you? And often, it just doesn’t work that way in medicine or nutrition. It does’t mean there aren’t strategies that work, there are for sure. But it may take you some trials and tweaking to find what works for you. So let’s look deeper into what we know now.If you exercise for less than one hour, most likely you can continue with your daily bariatric diet or you may need a few more calories. Where the calories come from, meaning which macros, depends on what your workout is like. If you’re an athlete who exercises at higher intensity for longer than one hour at time, there are several things to think about. Remember, you’re unique and special so trial and error is the answer to find what foods and fluids you tolerate the best as you work out. Let’s look at seven things to consider:Have you heard the term ‘nutrition periodization’? It means that your diet or how much you eat should match the level of your activity. In a less intense workout, typically under an hour, your body will need less total carbs and calories than if you’re training longer and at a higher intensity. Your workouts that are lower intensity and less time (again, typically under an hour) usually work well with your normal daily intake or a few more additional calories as I mentioned just a minute ago. If you workout longer (one hour or more) and at a higher intensity, you may need to eat 5-6 smaller meals or snacks rather than 3 meals. These 5-6 smaller meals include both pre and post exercise meals and snacks. The volume of your meals and snacks will depend on your surgery type and personal tolerance as well as your training demand. Keep an eye on your weight so you prevent weight regain from eating more calories than you are burning in your activity. These pre and post workout meals and snacks should include both protein and whole food carbs such as fruit, whole grains or starchy veggie just like you eat when you’re not working out. What do you eat first? Your answer has always been protein, right? But here’s a potential conflict to think about. If you’re lifting weights, that protein first concept works but what if you’re walking/running/biking/swimming instead or training for a 5K, 10K, half marathon or marathon? You may not get the carbs you need for these types of events and could bonk. What is bonk? You’ll know if it happens. It’s where you feel a sudden loss of energy and a sudden fatigue which is caused by the depletion of glycogen stores in the liver and muscles. You don’t want this to happen and it’s why circling back with your bariatric dietitian to personalize your needs with your specific types of training is so important. You’ll need more carbs and may need to eat them first so this is an important discussion to have as it goes against what you’re always told to do.Let’s call this one food for thought. Intensive exercise is probably smarter after one-two years when your caloric intake can be higher and the macros tweaked. That does’t mean you don’t exercise. Not at all. The first six months, you’re healing and you’re just trying to move around more. Then you move on to walking, swimming, etc but the intensive workouts might be better initiated one to two years after your surgical procedure. Have this discussion with your team if you want to work out harder and longer and it’s still early in your recovery.If you’re down the track and desire to increase your workout, what does a pre workout meal look like? A couple of minutes ago we just talked about the need to include both protein and whole food carbs with the amounts of each based more on the type of workouts you do.Some general examples would be:An egg with 1/2-1 slice of whole grain toastDeli meat wrapped around a low-fat cheese stick and fruitCottage cheese with fruit: berries, grapes or bananaRemember, the protein or carb amount may need to be changed based on the type of exercise you’re doing. If you’re 3-4 hours out from your workout, a meal fits in fine. As you get closer to the time you plan to workout, reduce the amount of food and if it’s only 30 minutes - 1 hours before you get started, continue to hydrate only. Since you should know your event or training days, aim to pre-hydrate a bit more and increase your fluid intake 2-4 cups in the 1-2 days before your hard training or event. Then as usual, sip on fluids all day as well as during your workout. Continue to keep food and fluids separate by 30 or more minutes unless your dietitian has told you differently depending on how far out from surgery you are now. To help you stay hydrated, you can eat foods with a higher fluid/water content such as Greek yogurt, a protein shake, even veggies and fruit which have high water contents. Use your urine color as a way to monitor your hydration. What color should it be? That’s right, pale or light yellow. When it’s darker, it’s sending you the message to consume fluids.Don’t forget about dumping syndrome. Remember that if you consume foods high in refined carbohydrates you may experience bloating, abdominal pain, nausea, diarrhea, even low blood pressure or a change in your heart rate. Symptoms vary depending on whether you experience early or late dumping syndrome. This means that using sports drinks and gels may be a problem due to the high carbohydrate content. Remember if you exercise longer than one hour, consuming carbohydrates and electrolytes can help prevent that sudden loss of energy and fatigue. Recommendations suggest to consume somewhere in the range of 30-60 grams of carbohydrate per hour, in about 10 gram increments. But you don’t have to use sports drinks or gels. They don’t have magical powers, just convenience. Did you know you can eat a few raisins or other fruit and get your carbs and calories easily? You don’t want low blood sugar or fainting as you’re trying to get stronger thru your workouts. Also, not getting enough quality calories can show its ugly face in muscle wasting, poor performance, or trouble with recovery.Speaking of recovery, try to eat or drink your meal within 30 minutes to one hour after you’ve finished your workout. Shoot for a ratio of 2:1 carb to protein for a post-workout meal. I know…this is not the typically bariatric way which is why which carbs you choose to eat is important along with how much. Your dietitian may have a certain level/strategy for you.Be sure and take your bariatric supplements daily and let your dietitian know how much you train. Increased workouts and increased calorie burn can increase the need for some supplements such as iron for example.Sports nutrition is just as important after your surgery as it is for anyone who trains or works out. Try these strategies, discuss with your health care team. Find what works for you. Take care of yourself and be good to you…you’re worth it.

Procarenow.com for free samples. Use Code: Susan10 to save 10%Ahhh slider foods…so tasty and so easy to eat copious amounts without ever feeling full or uncomfortable.Bariatric dietitians Gayle Smith and Isabel Maples join me to talk about what slider foods are and how they can cause a weight plateau and weigh regain.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 73. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.Do you need a festive meal plan for the holidays? Check out my new freebie, a festive meal plan complete with appetizer, entree, side and dessert plus the recipes and color photos of each recipe. It’s available now to the end of December.Also, do you have a question you want Gayle, Isabel and myself to answer? You can post it anytime if you’re in the Facebook Group Bariatric Surgery Success with Dietitian Dr. Susan Mitchell.Joining me via Skype are bariatric dietitians Isabel Maples and Gayle Smith. If you’re a regular listener, you know that both Isabel and Gayle join me on these bariatric nutrition Q & A episodes to answer your questions.They both have boots on the group every day in their clinics. Isabel is a registered dietitian and bariatric coordinator with Fauquier Health in Warrenton Virginia. Gayle is the bariatric dietitian at the Weight Loss and Bariatric Surgery Institute in Orlando, Florida.Bariatric Dietitian Isabel Maples, RDFauquier Health Weight Loss SurgeryEmail:  isabel.maples@fauquierhealth.org Bariatric Dietitian Gayle Brazzi Smith:OrlandoHealth.com/Bariatrics  gayle.brazzismith@orlandohealth.comQuestions we discuss today:What is a slider food and why do we love them so?Why are slider foods so popular and easy to reach for?What about the stress component to slider foods?How are slider foods tied to a weight loss plateau and weight regain?How can you be slider food savvy?Remember, if you’re looking for the latest freebie, ProCare supplements, portion control dinnerware, the newsletter and other resources, just go right my resource pageTake care of yourself. You’re worth it!

Procarenow.com for free samples. Use Code: Susan10 to save 10%You know the smell of nail polish remover? That familiar smell is very similar to keto breath. Along with that smell might come a metallic taste in your mouth. Keto breath…yes, it’s a thing. Let’s talk about what keto breath is and what you can do about it if you have it.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 72. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.In the newsletter this week is a link to my new holiday freebie, a festive meal plan complete with appetizer, entree, side and dessert plus the recipes and color photos of the recipes. It will be available now to the end of December. If you’re not receiving the weekly Breaking Down Nutrition newsletter, it’s a quick way to find out first what’s going on in bariatric nutrition from new freebies, upcoming courses, tips, product discounts and the latest podcast episode. Be sure and sign up at the bottom of my home page https://www.breakingdownnutrition.com   Have you recently had bariatric surgery and now you have a terrible metallic taste in my mouth? Does brushing your teeth help for a little while and then the bad taste returns? Does your breath smell like nail polish remover? You may have keto breath.The good news right up front is that it will go away.Here’s what you need to know now about keto breath.The most common causes of bad breath are dehydration, ketosis from rapid weight loss, dental issues, and food not emptying your pouch well. Let’s start with dehydration as it’s a big factor in bad breath. It's easy to cut back on fluids after surgery when you don’t mean to because you’re having to take smaller sips and there’s less fluid in your mouth keeping it fresh. So for many reasons, and bad breath being just one, take note of how much water and other fluids you drink each day. Just as a reminder, you’ll slowly be working your way up to 8-12 cups/day or two to almost three liters of water and other liquids. You’ll start with small sips every 15 minutes as tolerated and build from there. Did you know that dehydration is the main reason for re-hospitalization after bariatric surgery? That’s why fluids are so important to start your journey off right and keep it on the right track. Sometimes bad breath can be resolved just by making sure you drink enough.If you think there’s any chance you might have tooth decay, gum disease, or any other dental issues, visit your dentist to rule it out. These types of issues can be an underlying cause of bad breath. Try to brush and even floss after each meal or snack whether it’s liquid or solid. Even brush your tongue as bacteria and food particles can build up on the surface and cause bad breath.Now let’s get to keto breath as a cause of bad breath. What is keto breath? Basically when you reduce carbohydrates to a very low level, the lack of carbs fueling your cell metabolism [meaning there’s a lack of energy to your cells], your body will turn to stored fat as an energy source and break it down it. When your body breaks down fat for energy instead of carbs, it converts the fatty acids into chemicals called ketones. The body has numerous self-regulating processes whose goal is to maintain a balance of it’s internal environment. With the increased production of ketones, the body gets rid of the them through both your breath/respiration and urine. One type of ketone, acetone, is an ingredient in some nail polish removers, which is why your breath may smell like it. So when you hear the words, keto breath, they refer to the release of ketones, which is the breakdown of stored fat in your body when there is a lack of carbohydrate for fuel. It also can give you a metallic taste in your mouth.Keto breath can happen to anyone who loses weight, but is more noticeable after weight loss surgery because of how fast the weight comes off. How do you get rid of it? As you move along your journey and start to add more carbs back to your food intake, keto breath should go away. Speak to your bariatric dietitian about it. Sometimes adding back as few as 5 grams of carbs can make a difference. Eating foods that increase saliva production, like parsley, celery and lemon or grapefruit can help a little too with bad breath.A less common problem but one I want to mention is that bad breath after lap band or gastric sleeve surgery can be caused by food that isn’t emptying the stomach pouch as it should. The result is likely a build-up of digestive fluids such as acid in the stomach pouch. This build up can put you at an increased risk for acid reflux, which often shows up as heartburn or regurgitation. The main reasons that food becomes stuck in the pouch is eating foods that are not recommended after weight loss surgery or eating too quickly. If you’re drinking plenty of fluids every day, have good oral hygiene and slowly adding carbs as allowed to diminish keto breath and you still have bad breath issues, talk to your health care team.I hear you. Keto breath is not fun to deal with when you’re trying to make many other changes after surgery. But it will go away. Remember that it’s the very low carb diet that causes it so as you start to add even small amounts of carbs back to your diet, it should correct itself. Take care of yourself and be good to you…you’re worth it.

Procarenow.com for free samples. Use Code: Susan10 to save 10%Related: 5 Surprising Foods that Contain Powerful PrebioticsFrom neck and face creams to waters, cold brew coffee, almond butter and supplements, probiotics are being added to everything. Plus, there are also natural probiotic food sources such as yogurt, kefir, and sourdough bread. Do these probiotics help with weight loss? Three things to know about probiotics in the episode of Bariatric Surgery Success.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 71. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.Are you receiving the weekly Breaking Down Nutrition newsletter? It’s a quick way to find out first what’s going on in bariatric nutrition from new freebies, upcoming courses, tips, product discounts and the latest podcast episode. Be sure and sign up at the bottom of my home page . It’s also an easy way to communicate with me. Just hit replay to the newsletter. I read all the emails.  Probiotics are bacteria that offer a health benefit to your body. Bacteria can be a good thing as probiotics may help prevent or treat certain illnesses. It’s no wonder probiotics are often nicknamed “the good bacteria”! Why does this matter to you? Your gastrointestinal tract or GI tract contains many species of bacteria that make up what’s known as the intestinal flora. It’s a balancing act going on in the GI tract between good and bad bacteria. Think of it this way. Medications, diseases, even some environmental issues can alter this balance. This flora can “get out of whack” when you take antibiotics or other medications, and can be effected by various illness. Diarrhea is one of the most common symptoms that reveals something abnormal is going on. This is where probiotics may be helpful. Certain probiotic strains may help digestive health, positively influence cardiovascular risk factors, reduce inflammation, support your immune system, and even help fight depression and anxiety.Probiotics are live bacteria that occur naturally in foods that you can include in your daily diet such as yogurt, kefir, kombucha, tempeh, kimchi, sauerkraut, sourdough bread, even pickles and traditional buttermilk. These different foods provide a variety of probiotic bacteria strains in modest amounts and are beneficial to the intestinal flora. Probiotics can also be purchased as supplements and when taken in larger amounts or doses are considered a therapeutic treatment more like a medication. But not all probiotics survive and thrive. What does that mean? For you to derive health benefits, these good bacteria must survive the manufacturing process and storage along with the trip through the gastrointestinal tract once you take them. Since they are live bacteria, all of these factors matter, along with prescribing the right ones for the health benefit needed.Don’t miss this. It’s the bottom line for therapeutic treatment which we’ll tie to weight loss in just a moment. When using probiotics for disease-specific prevention and treatment which means a therapeutic use, it calls for the precise probiotic species that has been shown to confer health benefits for that specific medical condition. Probiotics must be identified by the genus, species and strain. For instance, with Lactobacillus rhamnosus GG, the genus is Lactobacillus, the species is rhamnosus, and the strain is GG. If the treatment calls for this probiotic and another is used, the benefit is missed.Plus the supplement must provides an amount that works. An adult probiotic should be alive, typically provide at least 1 billion colony forming units daily (also called CFUs) and given in the correct dose and frequency. This is why consulting a professional is so important when it comes to using them for treatment.What about probiotics in weight loss before and after bariatric surgery? Research studies indicate that someone who is a moderate weight has different bacteria in the gastrointestinal or GI tract than someone who is overweight or obese. Also interesting is that there tends to be less diverse bacteria in someone who is obese. Less diverse GI bacteria appears to be tied to more weight gain than in folks who have more diverse GI bacteria. The issue is figuring out the methods by which probiotics affect this GI bacteria, body weight and belly fat. This is currently not well understood. Probiotics may help the battle with weight loss in several ways including the release of appetite-regulating hormones like glucagon-like peptide-1 (GLP-1) and peptide YY (PYY) which may then help burn calories and fat. There is also the thought that probiotics increase levels of fat-regulating proteins that could lead to reduced fat storage. Obesity has also been linked to inflammation in the body. If the health of the GI track is improved with probiotics, overall inflammation may be reduced which may then help with weight loss. Several strains of probiotics in both the Lactobacillus and Bifidobacterium family have been shown to potentially reduce weight and belly fat with more research needed to determine use, dosage, etc. However, when participants in studies stopped taking the probiotic, they gained back all of the belly fat. So will this mean that probiotics are needed daily and ongoing? This is why we need research studies first.One important word of caution. Probiotics aren’t for everyone. For example, if your immune system is impaired due to disease or treatment such as cancer chemotherapy, taking probiotics is not a good idea and may make your situation worse. If you’re pregnant or elderly you want to talk to your health care provider before taking probiotics.Until we have more specific research on weight loss and probiotics, remember probiotics in foods such as yogurt, kefir, sourdough bread, tempeh and sauerkraut may improve your digestive health and risk factors associated with cardiovascular disease, reduce inflammation, and even help fight depression and anxiety.Take care of yourself and be good to you…you’re worth it.

Procarenow.com for free samples. Use Code: Susan10 to save 10% Nick asked this question in my Facebook group. What psychological tools could we use to avoid relapse into disordered eating? Stay right where you are because psychologist Dr. Connie Stapleton, who specializes in bariatric surgery, is with me today to give you answers.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 70. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.Don’t forget to sign up for the weekly newsletter if you haven’t already. You’ll get a weekly tip, hear about new freebies, info on the latest podcast episode, be the first to know about product specials, sales, new course, whatever is going on. You can sign up today on my homepage.Joining me today via Skype is Atlanta-based psychologist Dr. Connie Stapleton. If you’re a regular listener, then you’ve already heard Dr. Connie on the podcast before talking about your relationship with food or how to handle a bully. She has vast experience in the field of bariatrics and shares practical skills for improving your post op relationships with food, other people and most importantly your relationship with yourself. She teaches you better ways to deal with life’s stuff.Dr. Connie's Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchersWelcome back to the podcast, Dr. Connie! What are you working on in Atlanta?You heard the question at the beginning from Nick. He wants to know what psychological tools could we use to avoid relapse into disordered eating? From many years of practice, I understand and appreciate the tight interface between my work as a dietitian and yours as a psychologist. Our work goes hand in hand. You can have a fabulous diet but emotions can derail your best efforts. Talk a little about psychology and then start with some of the top tools you use and suggest to avoid relapse into disordered eating.Listen to the podcast for the 20 minute discussion.If you have more questions you want Dr. Connie to answer the next time she’s here, let me know. You can messenger me thru Facebook or reply to one of my newsletters. I read every email that comes in. Take care of you. You're worth it.

Procarenow.com for free samples. Use Code: Susan10 to save 10%Drink more fluids, stay hydrated. These words probably run thru your mind many times a day especially after weight loss surgery. Where does tea fit in your fluid count? Is it smart for you to drink it? You’re going to like these five benefits of tea after surgery.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 69. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.Joining me today via Skype is Texas-based registered dietitian nutritionist Neva Cochran. Neva is a nutrition communications consultant to a variety of food, nutrition and agricultural organizations. She’s passionate about promoting fact-based food and nutrition information to help you eat beyond the headlines and enjoy a variety of nutrient-rich foods. Contact information for dietitian Neva Cochran:Twitter: https://twitter.com/NevaRDLDInstagram: https://www.instagram.com/nevardld/Facebook: https://www.facebook.com/NevaRDLD/YouTube: http://www.youtube.com/user/nhcrdWelcome Neva. Listen as Neva talks about the many benefits of tea.She addresses how tea counts in your daily fluid intake, caffeine amounts in tea versus coffee, tea and depression, tea and diabetes/blood glucose and if tea dehydrates you.

Procarenow.com for free samples. Use Code: Susan10 to save 10% When I say the word probiotics, what’s the first food that comes to your mind? Yogurt maybe? But what about the word prebiotics? How are they different from probiotics? After all, they’re spelled almost the same. Stick around and let’s talk about five surprising foods that contain powerful prebiotics and the benefits to your body.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 68. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.I want to give a shout out to Ann who posted in the FB group: "I love having this facebook group and the podcast for support." Hey Ann, thanks for taking time to tell me. My go is for the Facebook group and podcast to work together so you listen to new information and have a place to talk about it. So glad you’ve joined in.Remember, if you want to join us in the facebook group, please do. You can find answers and support day-to-day or just vent if you need to. On facebook, search groups for bariatric surgery success with dietitian dr susan mitchell and ask to join. The link: https://www.facebook.com/groups/bariatricsurgerysuccesswithdrsusanmitchellBack to probiotics and prebiotics. You hear these words commonly tossed about in the supplement and food world but what do they mean anyway? Probiotics are bacteria that offer a health benefit to the body. This is a case where the word ‘bacteria’ is a good thing as probiotics may help prevent or treat certain illnesses. Its no wonder probiotics are often nicknamed “the good bacteria”. In your body, it’s a balancing act between good and bad bacteria. Think of it this way. Medications, diseases, even some environmental issues can alter this balance which is where probiotics may be helpful. Probiotics are live bacteria that occur naturally in foods such as yogurt, sauerkraut, sourdough bread, and other fermented foods.But what about prebiotics? Prebiotics are a type of fiber. Think of them as fiber that acts kind of like fertilizer for the good bacteria in your body. Probiotic bacteria feed on prebiotics. Prebiotics may also support your immune system, increase how much calcium your body absorbs, reduce symptoms of irritable bowel syndrome or IBS and decrease your cholesterol level. Plus, you can’t forget the one thing that TV ads have been heavily promoting which ishelp with the ‘go’ or a way to help prevent constipation.Prebiotics or prebiotic fiber is found naturally in quite a few foods which may surprise you. We’ll talk about these in just a minute. They’re also added to food products like cereals, breakfast bars, and breads in a form called inulin that you’ll likely see on the ingredient list. You can also find prebiotic fiber such as inulin in pill or powdered supplements. Sometimes, prebiotics are combined with probiotics to create what I call a tag-team approach or symbiotic relationship. Remember, prebiotic fibers help enhance the work of probiotic bacteria.You might have heard that prebiotic fiber can cause gas and bloating. It can. This can happen from prebiotic food sources and especially prebiotic supplements if you take a large dose. Typically a large prebiotic supplement dose is about 15 grams but a much lesser amount could cause issues if you’ve been dealing with any gas and bloating following surgery. It’s a good time to run this by your bariatric dietitian or health care provider before you add any prebiotics in supplement form. If you ever take a prebiotic supplement it’s better to start with a small dose of 2-5 grams and assess your tolerance before adding more. Because prebiotics are classified as fiber, they count toward the daily fiber recommendations of 25-30 grams. Here’s the nice surprise I mentioned. You’ve probably been consuming prebiotic fiber every day and didn’t know it. I love this about eating real food. Prebiotic fiber occurs naturally in many foods that you probably eat now if you’re six months to a year down the track from surgery. These 5 food sources may surprise you: apples, bananas, onions, garlic, and asparagus. You probably never associated them with prebiotics. Remember we said that the prebiotic fiber in these foods acts kind of like fertilizer for the good bacteria or probiotics in the digestive tract. So every time you add onions or garlic to a dish, you’re adding a source of prebiotics. Asparagus is a low carb vegetable that also brings prebiotics to the table. Apples and bananas, so common right, but oh so good for you. The good news about eating these whole food sources like onions, garlic, asparagus, bananas and apples for the prebiotic fiber is that these foods also contain beneficial vitamins and minerals. It’s a win-win all the way around. And typically less of a bloating and gas issue too…can’t forget that, right? The next time you slice an apple, think of all the healthy goodness it’s bringing to your body.Other foods that contain prebiotic fiber include artichokes, barley, berries, flaxseed, leeks, legumes, and oats. These will be beneficial to your body as well as you add back foods into your daily diet. Take care of yourself and be good to you…you’re worth it.

Procarenow.com for free samples. Use Code: Susan10 to save 10% I bet you’ve wondered this too. Olga posted, "Would you please make an episode on how to deal with the common cold after gastric bypass? What cold medications are allowed, what to avoid? Is it ok to get Theraflu?"Bariatric dietitians Gayle Smith and Isabel Maples join me to answer your questions.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 67. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.Before I jump in with Isabel and Gayle, don’t forget, if you’re looking for the latest freebie, ProCare supplements, portion control dinnerware, the newsletter and other resources, just go right my resource page: Also, do you have a question you want us to answer? You can post it anytime if you’re in the Facebook Group, Bariatric Surgery Success with Dietitian Dr. Susan Mitchell. Or go right to my website and there’s a contact us link at the top of the home page. You can also hit reply to the weekly newsletter if you receive it. If not, why not? You can sign up for it on the home page of the website too.This week joining me via Skype are bariatric dietitians Isabel Maples and Gayle Smith. If you’re a regular listener, you know that both Isabel and Gayle join me on these bariatric nutrition Q & A episodes to answer your questions.They both have boots on the group every day in their clinics. Isabel is a registered dietitian and bariatric coordinator with Fauquier Health in Warrenton Virginia. Gayle is the bariatric dietitian at the Weight Loss and Bariatric Surgery Institute in Orlando, Florida. Isabel’s and Gayle’s contact information: Bariatric Dietitian Isabel Maples, MEd, RDFauquier Health Weight Loss Surgeryisabel.maples@fauquierhealth.org Bariatric Dietitian Gayle Brazzi Smith, MS, RDN, CSOWM, LDNOrlandoHealth.com/Bariatrics  gayle.brazzismith@orlandohealth.com

Procarenow.com for free samples. Use Code: Susan10 to save 10% Has someone told you to take vitamin B-12 for brain fog after bariatric surgery? B-12 helps to keep your brain healthy and even helps to prevent Alzheimer’s disease as you age.  Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 66. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.I want to give a shout out to Brittany who posted in the FB group: I love your podcasts! Brittany I love you right back for taking time to say so and share with the group. If you want to join us in the facebook group, please do. It’s an active group where you can find answers and support day-to-day or just vent if you need to. There’s a lot to deal with after surgery, right? On facebook, search groups for bariatric surgery success with dietitian dr susan mitchell and ask to join. Click for the direct link.Has someone told you to take vitamin B-12 for brain fog after bariatric surgery? First let’s take a broad look at the brain, then vitamin B-12 and it’s tie to your brain and finally bring it home to bariatric surgery. Your brain has a lot of demands. It needs both calories and nutrients or vitamins and minerals. Don’t miss this fact. The brain uses 20% of your calories. Did you have any idea it was that high? B-vitamins, folate, zinc and other vitamins and minerals all join in to keep the brain healthy. A deficiency of these can cause depression type symptoms, poor memory, problems with attention, learning, fatigue, mood and appetite or what just feels like brain fog or brain impairment. This is one of the big reasons that follow up lab work after your surgery is so very important. If you listen to some of my other podcasts, you know I talk about many vitamins and minerals working together as a team. B-vitamins, folate, zinc and other vitamins and minerals such as thiamin all work like an effective basketball team in your brain. Deficiencies in these or even too few carbs can all cause brain fog but today the focus is on your brain and B-12 also known as cobalamin.A B-12 deficiency after weight loss surgery is very common but did you know that B-12 deficiency increases with age too? This happens for a couple of reasons. Often as you get older, you tend to eat less, which decreases the amount of B12 in your diet. Also up to 1/3 of people who are 50+ don’t absorb B-12 from their food because they don’t produce enough stomach acid. This is the same thing happening after bariatric surgery but for a different reason. You have surgical changes which affect absorption. Less B12 is released in the stomach as much of the stomach is bypassed or removed. Add age to the picture and a low vitamin B-12 blood level is tied to what feels like brain fog or brain impairment and could also be tied to dementia including Alzheimer’s disease. Maybe you’ve heard the word homocysteine. A high homocysteine level is not something you want. It’s an amino acid in the blood and elevated levels have been linked to dementia, heart disease, stroke. The good news is that homocysteine can be lowered with the B vitamins B6, B12, and folic acid which seem to slow down the loss of brainpower.Let’s review the science in today’s Science 101 on Vitamin B-12 specific to bariatric surgery. The absorption of B-12 can be affected due to changes in acid production and reduced availability of what’s called the intrinsic factor. This intrinsic factor helps the B-12 to be absorbed and used by the body. When it’s not there or insufficient, B-12 doesn’t get absorbed and used as it should. You could experience brain fog symptoms and feel like your coordination is off plus numbness and tingling of your arms, legs. This is a prime reason why routine screenings are so important and typically done every six months or so. These screenings help your health care provider pick up on a possible deficiency hopefully before it becomes a problem. Two other tips to keep in mind. First, are you taking proton-pump inhibitors (PPIs) like Prilosec, Nexium or Prevacid? These meds reduce stomach acid and stomach acid is necessary to absorb B-12. Even meds such as Zantac or Pepcid can increase the risk for B-12 deficiency. Number two. Alcohol. It inhibits the absorption of B vitamins such as B12 and thiamine. Even without alcohol, you may already be struggling to get enough of these vitamins due to surgery so be aware. Go back and listen to podcast #30 on Bariatric Surgery and Alcohol Buzz for more in depth info. As a reminder. Do you recall what foods contain B12?B12 is found in protein foods like meat, eggs, cheese, fish, chicken, milk, and fortified breakfast cereals meaning it was added to the cereal. You want these in your diet but the amount needed is higher than typically what food can provide. How much vitamin B-12 do you need after surgery? The dose is 250-500 micrograms (ug) a day with most suggestions in the 350-500 microgram range daily or 1000 mcg every other day. The dose depends on your surgery, your lab results and the route of administration meaning under the tongue, injection, etc. Sometimes an intramuscular injection of B12 or a nasal spray will be ordered by health care team. You can take B12 at any time or with any other supplements. It’s likely that your multi will have enough B-12 in it so check the label before you buy additional. Be sure and discuss your lab screenings with your health care team before you decide to take any extra.PS Check out the Supplement Facts on a number of products to see what you like best. As I’ve shared before I’m a fan of and partner with ProCare Health.

Procarenow.com for free samples. Use Code: Susan10 to save 10% Ever noticed that when you don’t sleep well, you’re more hungry than usual? If you don’t get enough sleep over time, what happens? Your weight starts to creep up, right? Is there a tie between sleep and weight regain?Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 65. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.By the way, if you’re searching for a private facebook group where you can ask questions and talk about what’s on your mind, come join me. The group is called Bariatric Surgery Success with dietitian Dr. Susan Mitchell. Link to private Facebook group: https://www.facebook.com/groups/bariatricsurgerysuccesswithdrsusanmitchellWhat’s going on with your right now? Do you find yourself sleeping less and less? How many hours of sleep a night do you average? Seven? Six? Five? Less than that? Are you dragging during the day? Feeling irritable?On average, we're sleeping an hour an a half less a night than 20 years ago. The saying you snooze, you lose definitely takes on a new meaning when you’re talking weight regain.Sound science says that sleep deprivation, defined as under six hours of sleep a night, results in the increased production of the hunger hormone ghrelin. Too little sleep also kicks up your stress level by increasing the stress hormone cortisol which then increases your appetite. What if you’re trying to get more sleep yet have a lot of stress in your life? Does stress affect your sleep? So here’s the question. Is it stress that makes you have trouble sleeping, eat more and regain weight or is it too little sleep that makes you more stressed, eat more and gain?Plus do you notice that when you don’t get enough sleep, you’re not only hungry, but you have an attitude? Call it angry and hungry or maybe you’ve heard the word for both anger and hunger. You’re hangry. Bottom line: the less sleep you get, the more it fuels hunger with reports of eating up to 1000 calories more per day and a bad attitude.A better night’s sleep potentially means less weight regain and more productive days. THE GOOD NEWS: When you increase the amount of sleep you get and average 7-8 hours per night, hunger hormones and hunger itself seem to return to normal.Try these tips to help you get that solid 7-8 hours of shut eye:1. Most important: make the decision that you’re going to get more sleep. Then set a reminder, start a get-ready-for-bed routine, whatever it takes and then go to bed at the same time each night so your body learns a routine and starts to tell you that it’s bedtime. 2. Unplug for 30 minutes before bed: research shows that the bright lights from your favorite devices including cell phones, TV, computers and tablets decrease the body’s production of melatonin, a hormone whose job it is to help make you feel tired and ready to fall asleep. 3. Keep your room cool and dark so your body wants to sleep.4. Listen to relaxing music or meditations or sounds that de-stress you like ocean waves or rain. 5. Stressed and you know it? Actually set a worry time, think about your issues, journal your thoughts if you want and then let them go for the night.Sleep is like nutrition for your brain. You’ve got to have it. Speaking of nutrition to help you sleep. Try these two tips. Include bananas, fish, oats, and chickpeas in your diet. These foods contain vitamin B6, which helps the body produce melatonin, the sleep-inducing hormone.As you can tolerate them, eat tart cherries (they can be dried, fresh or frozen) and nuts regularly as they contain melatonin.Recipe for Chocolate Cherry Bread. The recipe calls for tart cherries, walnuts and banana. It’s scrumptious. Spread almond or peanut butter on a slice or half slice depending on your portion needs for a snack.Remember, better sleep and more sleep begins with you making the decision that you’ll go to bed and increase the hours you sleep. Tweak your diet with the melatonin and B-6 rich foods. Try some of the sleep tips. Let me know how they work for you.Stay focused on your journey, you're worth it.

Procarenow.com for free samples. Use Code: Susan10 to save 10% I received this question for Dr. Connie: I was bullied and I hate the way it made me feel. I attended a group exercise class and was verbally bullied in front of everyone by another girl in the class. She made very mean remarks about my weight and why I was even there. Please, tell me, how do I handle these bullies? Don’t go anywhere because Dr. Connie's back! Psychologist Dr. Connie Stapleton, who specializes in bariatric surgery is here to tell you how to handle a bully.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 64. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.Joining me today via Skype is Atlanta-based psychologist Dr. Connie Stapleton. If you’ve been lucky enough to already hear Dr. Connie on the podcast, you know she has vast experience in the field of bariatrics and shares practical skills for improving your post op relationships with food, other people and most importantly your relationship with yourself. She teaches you better ways to deal with life’s stuff. This week she’s taking on the bullies.Dr. Connie's Information Website: http://www.conniestapletonphd.comBariAftercare: The Podcast; available on phone podcast apps, Apple podcasts and most other podcatchers My resources for you: https://BreakingDownNutrition.com/resources S: Welcome back to the podcast, Dr. Connie!S: You heard the question at the beginning about the woman who attended a group exercise class and was verbally bullied in front of everyone by another girl in the class. She made mean remarks about her weight and why this person even showed up. Today I want to dig deep on bullying as it’s a big problem for anyone dealing with weight issues.Questions we discuss. One of the best episodes yet with spot on information and strategies.1. Dr. Connie, what makes someone bully another person whether it’s over weight or any issue?2. When you’re bullied in a public venue, like this exercise class, how do you handle it?3. What about when you’re cyber bullied?4. Bullying also happens one on one. How do you stop it? 5. How do you personally cope, heal and then move forward from being bullied?Dr Connie, such good information. Any last thought to leave us with?I hope today’s episode has given you insight, knowledge and strategies to handle any bully you may encounter. If you have more questions you want Dr. Connie to answer the next time she’s here, please contact me thru my website. You can also messenger me thru Facebook or reply to one of my newsletters. I read every email that comes in. Take care of you. You’re worth it! 

Procarenow.com for free samples. Use Code: Susan10 to save 10% Are you into juicing? Maybe you’ve even considered replacing your coffee with a green drink. Is there a best way to juice if you’ve had bariatric surgery? You bet there is.Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 63. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening.If you’re looking for a private facebook group where you can ask questions and talk about what’s on your mind, please join me in Bariatric Surgery Success with dietitian Dr. Susan Mitchell. Juicing breaks down fruits and vegetables into liquid form generally by separating the juice from the pulp. But it‘s the method of juicing that makes all the difference when you’ve had weight loss surgery.Juicing can be a good option to increase your nutrient intake meaning vitamins, minerals, fiber and naturally occurring plant nutrients or what’s called phytonutrients. It’s also an easy way to incorporate additional vegetables and fruits into the diet, particularly less popular ones like kale or spinach. Ideally juicing should supplement the vegetables and fruits that you eat in whole form.  Instead juicing often replaces these whole fruits and veggies.There are two methods of juicing. First is traditional juicing, the type most common in juice bars, airports and hotels, where a fruit or vegetable is pressed or shredded. All of the pulp (another name for fiber) is removed using either a cold press or centrifuge juice extractor leaving only the juice.But for anyone and especially if you’ve had bariatric surgery, you miss out on the benefits of fiber and they’re valuable. A few benefits include helping with digestion, reducing inflammation and increasing satiety or how full you feel. Do you remember in episode #47 on fighting inflammation with food, we talked about fiber. It’s digestible by gut bacteria making short chain fatty acids. What was that fatty acid in the gut called? Butyrate. What we love about butyrate is that it provides valuable health effects such as inhibiting the growth of bad bacteria, reducing inflammation and increasing mineral absorption.Don’t forget, fiber also helps prevent constipation but sometimes it causes potential gas and bloating. Your juicing tip: start with a small portion, maybe 1/4 of a cup and see how it goes. It may be too bulky and filling to drink very much of it at a time.So we don’t want to give up fiber easily. Besides, juice with no pulp or fiber packs more calories and carbs, mostly coming from the natural sugar found in fruit in a more concentrated form. For example, a cup of pineapple is about 80 calories, but a cup of pineapple juice is about 120. Juice is the most calorie-dense part of plant foods.Did you know that the calories in a juice drink can range from 100 to 800, depending on the type of fruits and vegetables you add and the amounts? Remember that fruits tend to have more calories than vegetables so opt for more veggies and less fruit to keep calories reasonable. A good ratio is 75% veggies and 25% fruit or 3/4 veggies and 1/4 fruit. Portion size is always key too.Here’s where the second method of juicing called whole juicing is superior. Whole juice is the result of blending vegetables and fruits into a drinkable liquid without removing the fiber. Whole juicing requires a high-powered blender instead of a juicer. You may be familiar with brands for home use such as a Blendtec, NutriBullet or Vitamix. When whole juicing, whole fruits and vegetables go in the blender with extra water, and a powerful motor pulverizes them into a smooth juice with the fiber included.A study in the European Journal of Nutrition compared the effects of whole apples to apple juice in regard to the effects on blood lipids such as cholesterol. The results suggest that the fiber component found in the skin of apples is needed for the cholesterol-lowering effect and that clear apple juice is not a suitable substitute for the whole fruit. When the entire apple is used in whole juicing the benefits of the skin remain in the juice.Your take aways:1. Juicing can work for you after bariatric surgery as long as it’s whole juicing which retains the fiber and all of its benefits.2. Aim for 3/4 veggies and 1/4 fruit to keep calories and carbs lower.3. Always eat protein-packed foods first as that’s bariatric gold then have the juice.4. Portion size is always key. Start small with 1/4 cup and see how you tolerate it. Any issues with bloating or gas?Stay focused on your journey, you’re worth it.

Want a strong and heathy immune system? Who doesn’t right? The foods you eat and the vitamins and minerals they contain play a starring role in keeping your immune system in top form. Let’s talk about 5 vitamins and minerals that are among the top contenders for supporting immunity and then, where you find them in food. Procarenow.com for free samples. Use Code: Susan10 to save 10% Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 62. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. During the covid pandemic we hear a lot about immunity and compromised immune systems. What is your immune system? Think of it like the Internet and an intricate broadband network where you have to be on guard for hackers. Your immune system is also an intricate system that goes into action when it determines that some type of foreign invader has tried to hack into your body in the form of bacteria, viruses and parasites. Your body needs numerous vitamins and minerals in order to keep your immune system strong and alert. Think of it like training for the Olympics. It takes time, practice and focus to succeed in your sport. It’s the same with your immunity. The goal is to focus on eating foods loaded with vitamins and minerals day after day over time so that when your immunity is challenged by illness, it’s optimized and ready to respond. Let’s focus on 5 vitamins and minerals important in supporting immunity along with what they do and where to find them in food. 1. Vitamin C: known for its role in the healing process and the ability to fight infection and potentially shorten how long an infection lasts. What food first comes to your mind when you think of Vitamin C? Citrus, like oranges, tangerines and grapefruit? They’re great sources but don’t forget about papaya, spinach, broccoli, bell peppers and berries like blackberries and strawberries and kiwi. It’s rare that you need extra vitamin C supplements as it’s easy to find in so many foods. 2. Vitamin D: you may have heard vitamin D mentioned a lot in the Covid conversation. It’s one one of the most powerful vitamins for your immunity. However, there are not a lot of food sources. Salmon, tuna and sardines, egg yolks and some mushrooms contain vitamin D and also fortified products like orange juice, milk and various cereals. What does fortified mean? Fortified means that the food item did not originally contain vitamin D so it was added to it similar to adding vitamin D to a multi vitamin supplement but in food. Vitamin D is one of those vitamins that you will likely need from both food and supplements in order to reach the blood level needed. Go back and listen to podcast #54 It covers the must have vitamin and mineral supplements after bariatric surgery. Part 2 covers vitamin  D more in depth and the benefits of vitamin D3. 3. Zinc: found mainly in animal foods, zinc helps the body make new immune system cells.  Oysters, crab, shrimp and mussels along with lean meats and poultry are all sources but you can find zinc in legumes, like chickpeas, lentils and beans. Don’t forget milk, cheese and nuts such as peanuts, cashews and almonds. Lots of choices for zinc so it's rare that you need extra beyond what will be in your food and daily bariatric multi. 4. Iron: your body uses iron to help carry oxygen to cells and is active in many immune processes. In other episodes we’ve talked about how important iron is after bariatric surgery and that it’s one of the minerals you’re likely to be low in. As a reminder, the body more easily absorbs and uses iron from animal products called heme iron. Plants can also be sources of iron too but it’s not absorbed and used as well by the body. Think about adding various beans such as black or kidney along with kale and broccoli to your diet. 5. Vitamin E: also helps regulate immune functions. Some food sources of vitamin E include nuts, seeds, avocado and spinach. What did you notice about nuts and spinach? They’ve  been mentioned already for their zinc and vitamin C content. This is the beauty of food. Foods are typically not just a one-vitamin wonder, but supply a team of nutrients working together for your benefit. That’s why food first is a smart focus followed by supplements rounding out what you need more of due to your surgery. So remember, vitamins C, D and E along with zinc and iron help support your immunity. Be sure and choose some of the foods we talked about for your daily diet to keep your immunity system healthy. Stay focused on your journey, you’re worth it.

Procarenow.com for free samples. Use Code: Susan10 to save 10% Mohsen asks: I  have chocolates and ice cream sweetened with Stevia or Monk fruit. Is Stevia low GI and will it cause dumping? Or should it be avoided all together? Today, we’ll answer the questions on your mind. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 61. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. Before I jump in with Isabel, let me remind you that if you’re looking for the latest freebie, supplements, portion control dinnerware, the newsletter and other resources, check out my resource page This week joining me via Skype is bariatric dietitian Isabel Maples. If you’re in the private facebook group, you might have seen her comments as she shares her expertise. Isabel is a registered dietitian and bariatric coordinator with Fauquier Health in Warrenton Virginia. She helps her patients navigate the weight loss surgery process to maximize success. Her focus is to help you relearn body cues for hunger/satiety, tame trigger foods, and discover the joy of movement. Guest: Bariatric Dietitian Isabel Maples, RD Fauquier Health Weight Loss Surgery Facebook: Isabel Maples RD Welcome Isabel! Thanks for joining me today. Lots of good questions today starting with first one: I started running, using the Couch Potato to 5k Program!  I'm on week 2 and I find that the last few times I finished my run, I am EXHAUSTED! I’ve been sleeping well. I drink plenty of fluids. I have a protein drink before I go and then I eat lunch about an hour after I get home. I drink plenty of water in the afternoon. What am I missing? Is it my nutrition? Do you have any advice on what I should I eat before and after I run? Q2: I have a question about portion. I’m 4 weeks post surgery and have lost around 14 kg's or almost 31 pounds since the surgery which I’m very happy about. I expected to not be able to eat more than 1/2 cup, however, I found that If I chew my food well ( during the minced diet) I could easily eat 1 full cup. Is this normal? Q3: Mohsen wants to know: I have a question regarding Stevia. I  have chocolates and ice cream sweetened with Stevia or Monk fruit. Is Stevia low GI and will it cause dumping? Or should it be avoided all together? Any last thoughts Isabel? Have a question you want answered? Contact me thru the website https://BreakingDownNutrition.com or if you receive the weekly newsletter, hit reply and send it to me that way. And remember, take care of yourself. You’re worth it!

Procarenow.com for free samples. Use Code: Susan10 to save 10% Did you remember to download the new freebie I mentioned last week? Go get the freebie and try the three tips to help you cut down on added sugars in your food. Freebie: 3 Ways to Crack Down on Added Sugars  Podcast: Liz posted this question: “I see a lot of protein drinks that are casein-based advertised as Non-Dairy. How can they do that when casein is dairy?” I’ll explain the labeling which is confusing. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 60. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. Today I want to give a shout out to Jill who posted on Facebook: “I love supporting anyone who has had surgery. It’s a tricky road to navigate. I love listening to your podcasts.” Right back at your Jill. Your kindness caught my eye right away. In a world of bullies and mean-spirited words, we need more of your attitude. And thank you for listening to the podcast. Ok, let’s get back to Liz’s question about protein drinks that are casein-based advertising as Non-Dairy. The rest of her question was: “How can they do that when casein is dairy? They always say with an asterisk that casein is dairy, but really, it’s not just a tiny amount, it’s the main source of protein for the drink.” There are a lot of us dietitians who feel your pain and frustration. Actually there are two terms for us to look at closely. Dairy-Free is one, and Non-Dairy is the other. You’ll see both of these terms on food packaging and labels. One point to put in memory right now: the terms don’t tell the whole story. What does? The ingredient label. And remember, the ingredient label in the United States lists the ingredients from most to least. In order to get clear on these terms, let’s talk about what they mean on a label. Starting with Dairy-Free. This one might shock you. There is NO regulatory definition for the term Dairy-Free. What that means is the Food & Drug Administration or FDA has not set rules or regulations for the use of the term Dairy-Free on labels. Bottom line, no definition means that food labeled Dairy-Free may or may not be free of milk proteins. So you and I become the label sleuths I talk about regularly. We need to go from the package label to the ingredients and see what’s what. Where this really matters from a health standpoint is if you’re allergic to milk. If you are truly allergic, please go straight to the ingredients. If the product contains milk derivatives like whey or casein, often in the forms called caseinates, they’re a potential problem for milk allergies. Hold on, I’m climbing on my soap box. This term Dairy-Free reminds me of the term "natural", which also has no legal definition. Basically “natural” means anything you want it to mean. So you can see why the term “Dairy-Free” should turn on a light bulb and send you straight to the ingredient label if you have a health concern. Switching to the term “Non-Dairy”. The FDA does have an older regulatory definition for the term Non-Dairy. But, the interesting, ok frustrating, part is that the definition allows the presence of the milk protein, casein. The term, Non-Dairy, is commonly used on coffee creamers made from caseinate, a milk protein, rather than milk or cream, but now you see the term “Non-Dairy” on labels for protein drinks. This feels like misleading advertising when casein, which is a milk protein and a milk allergen, is the main ingredient. However it is currently allowed, but the term caseinate must be followed by an explanation with wording such as milk derivative. Non-Dairy definitely does not mean that the product is milk-free so if you have a true dairy allergy, you need to read the ingredient label carefully for this term too. Stay focused on your journey, you’re worth it.

Listed as a top-10 celebrity diet, the lectin-free diet has been promoted for weight loss. Should you try it after bariatric surgery to prevent that dreaded weight regain? Before I just in, I want to welcome our new podcast sponsor ProCare Health whose ad you just heard by the way. I’m proud to have them on board and know you’ll find their products helpful in your journey. Procarenow.com for free samples. Use Code: Susan10 to save 10% Also I have a new freebie for you: 3 Ways to Crack Down on Added Sugars. Did you know that added sugars are basically empty calories with zero nutritional value? They're often added to food as flavor enhancers and preservatives. Their carbohydrate-dense nature makes them a trigger for dumping syndrome. So grab the freebie and use the three tips to help you crack down on added sugars in your food. Freebie 3 Ways to Crack Down on Added Sugars One of my wonderful podcast listeners, Mohsen, sent me an email saying there’s a bit of information out there in regards to lectins and what they do to the lining of your intestines and bacteria in your gut. Dr. Steve Gundry is the big advocate against lectins and I am not sure whether I should listen to him or not. I think legumes are a really nutritious food and I love having them for my snacks including small cans of Edamame. What is your opinion? Very glad you asked Mohsen. The internet is full of lectin pseudo-science as I call it. You may have also read about celebrity Kelly Clarkson losing 37 pounds or 17 kilos on the lectin-free diet. This kind of weight loss alway creates a buzz, healthy or not. Trying to cut out lectins means cutting out grains, beans and legumes, fruits, veggies such as tomatoes and eggplant and more. First of all, what the heck is a lectin? Found in almost all food, it’s a protein that binds to carbs such as sugars and has important functions in both plants and humans. It seems that the sugar-binding activity of this lectin protein may be necessary for normal digestion and absorption of foods. In other words, according to scientists following a lectin-free diet may alter normal nutrient absorption. Let me stop right here and bring it home. Is there a downside to a lectin-free diet for you? Put on your science 101 cap. Think about this. Why would it matter to you if normal nutrient absorption is altered? It matters because going thru bariatric surgery already alters nutrient absorption. Why would you want to add insult to injury meaning add on additional issues you don’t need? There is so much research now on the benefits of consuming plants, specifically fruits and vegetables, which include supporting your immunity, fighting inflammation in the body, and just living a long life. For example, lycopene which gives tomatoes their red color, has a role in cancer prevention and heart health. This lectin-free advice is so controversial and goes against current recommendations from science-based groups including the American Cancer Society and the American Heart Association. Ok, but you heard that lectins are toxic. This is true and you hear about the toxic lectin in raw or undercooked kidney beans. Eating raw kidney beans can cause you to vomit along with other ugly gastrointestinal symptoms. Bottom line: do not eat raw beans. Fully cook them to reduce the lectins. Lectins are found in beans but when you cook the beans, the lectins are basically wiped out and don’t affect the body. But why the weight loss with this diet? I would suspect it has much more to do with cutting out carb-heavy processed foods, typically high glycemic, which also significantly cuts calories. Your take away: restricting foods with another pseudo science diet doesn’t help your journey or transformation. Restriction is not a positive lifestyle change. And lectins are not something you need to worry about. Your diet needs to be individualized for you after surgery which includes a lot of high quality protein, small amounts of high fiber complex carbs such as legumes (which includes beans, peas and lentils), vegetables, whole grains and fruit. Focus on you. Follow your bariatric-specific plan and take your bariatric supplements. Forget lectins. You have enough to focus on and you’re worth it.  

Recently someone posted this question in my Facebook group: how do I stop fighting my brain over tempting food? Well, stay right where you are. She’s back! Psychologist Dr. Connie Stapleton, who specializes in bariatric surgery and helps you deal with life’s stuff, is here to answer questions about your relationship with food. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 58. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. Joining me today via Skype is Atlanta-based psychologist Dr. Connie Stapleton. Dr. Connie uses her vast experience to share practical skills for improving your post op relationships with food, other people and most importantly your relationship with yourself. Basically, as I mentioned at the beginning of the podcast, she teaches you better ways to deal with life’s stuff Dr. Connie's Contact Info: Website: http://www.conniestapletonphd.com BariAftercare: The Podcast; available on Apple podcasts and most other podcatchers Dr. Stapleton’s hosts "Fair and Firm" retreats for bariatric patients. At each retreat, participants address struggles in their relationship with food, issues related to regain, and the frustration related to emotional eating and food addiction. It’s time to sign up for the next retreat, scheduled for September 1st – September 5th. Arrive on the evening of the 1st, meet your fellow retreat attendees, relax and get a good night’s sleep. The next three days are filled with education, activities, movement, relaxation (to include a massage if you would like one), discussion and laughter. Learn more about yourself, your relationship with food and how to move through barriers related to eating that keep you from fully engaging in the life you want to live. Depart on Sunday, early afternoon and take home new information about yourself and a host of skills for relaxation, mindfulness, avoiding emotional eating, and dealing with food addiction. Each participant has a full size bed. All bath and hair products, to include hair dryers are provided, although participants are welcome to bring their own products. All meals and snacks are provided and are bariatric-specific. Special food needs will be accommodated. For more information, email Connie@conniestapletonphd.com S: Welcome back to the podcast, Dr. Connie! S: When you were here three or four weeks ago, my listeners loved your information and have a lot more questions so we’re going to get right to it. In my opinion, today’s media messages feed us unrealistic expectations of how we should look and what we should eat which then can be a part of unhealthy relationship with food. At the beginning I mentioned that this question was posted to my Facebook Group: how do I stop fighting my brain over tempting food? Dr. Connie, a lot of people refer to having a relationship with food but I don’t think the concept is well understood.. Would you talk about fighting with the brain and explain what having a relationship with food means? Q2: My relationship with food seems to flow with my relationship with my significant other. When he and I are at a good place in our relationship, I seem to be better able to stay away from sweets for the most part. When he and I argue, it seems I have a really hard time not wanting to eat chocolate, candy or ice cream. What are your thoughts about that? Q3: I do well in terms of following my food plan during the day but when I come home, I struggle to maintain that healthy daytime relationship with food throughout the evening. Do you have any suggestions? Q4: I developed an unhealthy relationship with food when I was around ten years old. I started coming home from school to any empty house. I was scared, lonely and often bored at home by myself. If I ate, I was distracted from those feelings. I recognize I am an emotional eater, but I still struggle to not turn to food any time I feel even close to how I felt when I was alone after school as a kid. How can I overcome this? S: Whether you’ve had surgery or not, these questions can apply across the board to so many of us. Take time to think about the thoughts Dr. Connie shared and how they can apply to your daily life. Decide what works best for you. You’re worth it!

My hair is falling out atrociously since my surgery. What can I do to stop it? Are you experiencing this too and have the same question? I have three things to share about hair loss and nutrition after weight loss surgery. You’ll be glad you listened. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 57. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. Let me put your mind at rest. The good news is, hair loss is very common, not permanent, and your hair should  grow back. I know it seems terrifying but it’s totally normal to lose 5-15% of your hair from bariatric surgery and the rapid weight loss that follows. Typically it does’t last more than 6 months then it grows back. It’s just a pain in your patootie to go thru. You might be wondering why this hair loss happens. There are many causes that include stress, thyroid issues, extreme diet changes, too little protein, too few calories, hormonal imbalance and iron or zinc deficiency. Even medication like a beta-blocker or too much vitamin A can cause hair loss. So think about your situation. You’ve had surgery, cut your calories very low, possible too little protein, maybe an under active thyroid. Sprinkle in low levels of iron, zinc, biotin or folate and you have a recipe for hair loss. Your science 101 for today: there are three stages in hair follicles known as anagen or growth phase, catagen or the transition or degradation phase and telogen or dormant, hair loss phase. Any guess which phase bariatric hair loss is tied to? You got that right, telogen or the dormant and hair loss phase. It seems the hair follicles are pushed into this dormant phase which typically lasts 3-6 months and then the hair falls out. Are you within this window? To be even more specific, hair loss is more common with gastric bypass and gastric sleeve because you tend to experience a more rapid weight loss and increased chance of vitamin / mineral deficiencies. The physiological stress of surgery and rapid weight loss can cause the body to focus vitamins and minerals on the heart, brain and other functions instead of hair growth. This is when you see the growth phase end and the telogen or dormant phase start. The dormant or telogen phase kicks in causing hair loss to occur. As your body adjusts to the changes, the hair loss slows and then stops. The caveat: your hair should grow back normally if there are no vitamin and mineral deficiencies and you are consuming adequate protein. So, the three important things to know and act on: 1. Follow up with your health care team for blood work to make sure there are no underlying health issues such as hypothyroid that would affect hair growth and loss. At the same time, lab work can check for vitamin and mineral deficiencies such as iron or zinc. 2. Take your bariatric-specific vitamin and mineral supplements daily or as your product recommends. It should contain iron, zinc, biotin, copper and other nutrients tied to healthy hair. Don’t miss this…if you do not have a deficiency, taking more of these supplements will not make your hair grow back any faster and excessive levels of vitamin A and zinc for example can be potentially harmful. If you’re wondering if you take the correct bariatric supplements that your body needs after surgery, listen to podcasts #53 & #54. Links to the podcast, newsletter, private Facebook group, etc on my resource page. Besides your recommended supplements, food choices can make a difference in your hair too. Sweet potatoes, spinach and tomatoes all contain vitamin A plus spinach is also a source of iron and vitamin C. Nice trifecta, right? Oysters contain zinc and eggs may surprise you but are a source of biotin. Beef contains very absorbable heme iron while lentils and black beans also contain iron and when eaten with a vitamin C rich food like red peppers or tomatoes, will help it to be absorbed better. These are just a few foods that you can pick from to give your diet a boost in the hair department. 3. Be sure you consume 60-90 grams of high quality animal, soy or dairy based protein and protein powders every single day. Lack of protein causes your hair to become thin and fall out which you don’t need if surgery has already pushed your hair into the dormant stage. I hear you. This hair loss isn’t fun with all of the other changes you face in your journey but it will end and sooner than you think. Time has a way of passing by quickly. Focus on you. Take your proper supplements, plan your protein daily, check in with our health care team if something seems amiss. You’re worth it.

Are you confused and don’t know what to believe about eating carbs? One friend tells you carbs are evil, don’t eat them and another friend loves carbs and says you need them too. Who’s right? Maybe you fear carbs and think if you do eat them, you’ll regain weight. Let’s cut thru the carb confusion together. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 56. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. The message that carbs are bad or evil, something to fear and to avoid at all costs is flat out incorrect. To add to this confusion, carb advice varies from one bariatric office to another. Should you be fearful or concerned about eating carbs? No, they’re not evil, not at all when put in the proper perspective. Carbs are one of the three main macronutrients including protein and fat needed by your body. Carbs provide energy to your body and brain and without them, you’ll feel like you’re crawling the carpet? You know what I’m talking about. During the digestive process, carbs are broken into glucose for energy and are the perfect source for your brain. So if you’re foggy or forgetful, I ask you, have you cut out carbs? The brain is only 2% of body weight but it gobbles up glucose. So a restriction on carb can result in muscle break down to feed the brain. Repeat after me: carbs are an excellent fuel source for the body and brain. If you’ve been avoiding carbs, here’s how to add them back. And the 50-million dollar question. How many grams of carbs should you eat? As we’ve talked about before, your number one focus is on your protein selection first then add high fiber complex carbs and fat choices. You might be thinking, no way! You want me to count grams of protein now carbs too. Do I really have to do this from now on? No, you don’t. More on this in a minute. But first, start by choosing high fiber complex carbs that I often refer to as ‘smart’ carbs. Your total grams per day should be somewhere in the 90-130 range depending on how far out from surgery you are right now. Often at 6 months out, the carb suggestion will be around 90 grams a day working up to 130 grams 1 year or so down the track. However this can vary with the surgery so a carb discussion with your dietitian is one to put on your list. As I mention every week, your body, your hormones, and your genetic makeup is different from someone else who had surgery the same day as you did. Include 1/2 -1 carb serving per meal or snack. This may vary as you may need more if you work out daily. 1 carb serving is 15 grams. If you have a can of beans or refried beans, go grab them so we can be label sleuths together. Look at the Nutrition Facts label here in the US or check the label you have in your country to see what it says. I have a can of refried beans and it says the serving size is 1/2 cup and under Total Carbohydrate there are 23 grams of carbs in that 1/2 cup. If 15 grams is equal to one carb serving, you know that 23 is equal to about 1 & 1/2  carb servings. If you’re trying to stay at 1 carb serving of 15 grams, you would want to cut the portion back from 1/2 cup to 1/4 cup or so. But look a little closer at the label. What makes this a smart carb? Notice fiber listed under total carbohydrate. There are 5 grams in this 1/2 cup serving. That’s significant. This fiber slows how fast the beans are digested, makes you feel full and is good for your microbiome. Benefits galore. This is why I call it a smart carb. What is a smart carb? Smart carbs are the carbs that best fuel your body and brain. This mean vegetables, fruit, whole grains, ancient grains like faro and quinoa, beans and lentils. All of these contain fiber and are referred to as complex carbohydrates because they take longer to break down and are more satisfying.  When consuming these smart complex carbs, you tend to lose more weight too since they contain fiber and help you to feel full similar to protein. Plus these complex carbs contain a who’s who list of vitamins and minerals along with naturally occurring phytonutrients that help fight inflammation in the body. But what about those refined or empty-calories carbs which have no nutritional benefit for you? You know the ones. Those goodies we love to hate but reach for when stressed such as candy, cakes, cookies, soda, etc. Never say never. Why? Because when you avoid them totally, you want them more than ever, right? And your desire for a cookie becomes a desire for five or six cookies. Your favorite treats need to be just that…treats. Instead of reaching for treats as an outlet to stress or overeating them because you deprived yourself, plan to have a small portion as part of your menu for that day such as your favorite dark chocolate or birthday cake or dessert on Thanksgiving. If you deny yourself totally, it only leads to deprivation and then potentially overeating and that’s not a win for your transformation. Just remember, less is more when it comes to refined carbs and your health so portion size is super important. Here’s where the light bulb should go off. Basically you differentiate between healthy and less healthy carbs or treats by the added sugars. How do you know? You got this. You’re a label sleuth. Remember, look at the Nutrition Facts label every time you can in the US or your particular label in another country. Again, look at the serving size such as 1/2 cup, then total the carbohydrate in grams in that 1/2 cup. Look below carbohydrate to see if there is fiber and then look for those added sugars. The added sugars will be listed in grams as well and remember that four grams is equal to one teaspoon of sugar. By the way, coconut sugar, brown sugar, raw sugar, honey, agave, and maple syrup all act the same in the body so don’t be mislead to think one is better. It’s a personal choice. If the added sugars says 16 grams for example, how many teaspoons of sugar is that? Right, four. Now, look at the ingredients and see what type of sugar is added. Remember the ingredients go in descending order from most to least. If there are zero added sugars on the label, then the carbs are coming from natural sugars like lactose in milk and fructose in fruit. Remember that too many carbs or the wrong type of carbs at a meal or snack can cause havoc in your gastrointestinal track or let’s just say your gut. This havoc is known as dumping syndrome which is rapid emptying of food from the stomach into the intestines and results in very unpleasant symptoms. If you suspect this is an issue for you, go back and listen to podcast #34 on 4 Ways to Prevent Dumping Syndrome from Dumping on your Day. Check out my new resource page with links to many of the items we talk about like podcasts, newsletter, freebies. Big question, don’t miss this. Do you always have to count carb grams or add up calories? No. What was that? No! But it’s a win-win for you if you learn about carbs, grams of carb per serving, what the serving size is and what that serving size looks like. Once you cement this into that glucose-eating brain, it will be easy for you to choose and eat healthier carbs in the right portions as you live life whether you’re preparing food or eating out or eating with other friends or family in their homes. The more you know the more successful your journey and transformation. Learn to pick and choose your carbs well. You’re worth it.  

The questions are listed here but the actual Q & A is in the podcast audio. Q1Liz asked: How much protein is too much protein? And Debra wants to know: I'm working out now, running and weight lifting, on a regular basis. Should I increase my protein? Today, we’ll answer the questions on your mind. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 55. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. Joining me via SKYPE is bariatric dietitian Gayle Brazzi Smith. Gayle has a heart-felt passion for helping people with their weight loss journey. You’ll see her posts in our private Facebook Group: Bariatric Surgery Success with Dietitian Dr. Susan Mitchell. Gayle is also certified in Obesity and Weight Management and is the bariatric dietitian at the Weight Loss and Bariatric Surgery Institute in Orlando, Florida where’s she been for seven years. Their website is OrlandoHealth.com/Bariatrics S: Let’s get right to our questions starting with: Liz asked: How much protein is too much protein? Leads us right into Q2 from Debra: I'm now working out now, running and weight lifting, on a regular basis. Should I increase my protein? We can’t wrap up without a mention of the current darling collagen powder. Yes, it’s super popular right now but it does not contain the essential amino acid tryptophan and is low in both the amino acids cysteine and methionine making it an incomplete protein source with a lower PDCAA score and not a great choice for after bariatric surgery regardless of the Internet hype. Podcast #50 discusses pea, whey and collagen protein powders Q3: it’s a long one so come in close…Jeanette asked: I have a huge list of foods called "caution foods" to avoid after surgery, including high fat cheeses, creamy sauces, spicy foods, sugar alcohols, and bread (including pita, tortillas, rolls, pastries, etc.). My diet plan does allow for me to start having small amounts of whole grain bread after 6 months. My question is about recipes that call for "breading" like all-purpose flour or whole wheat flour. If I am not allowed to eat bread, should I be substituting things like coconut flour, almond flour, chickpea flour or quinoa flour in recipes? And are things like panko breadcrumbs and cornstarch off limits, too? Finally, again thinking of recipes, if a recipe calls for "cream cheese," would I be able to still make the recipe if I substitute Neufchatel cheese?

Do you need to buy a separate vitamin D supplement if it’s in your multi? What about iron? Do you need another supplement for it too? The right supplementation is so important to your success after bariatric surgery. This is part 2 of the 6 Must-Have Vitamin & Mineral Supplements after Bariatric Surgery. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 54. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. Remember in part one we talked about when you have weight loss surgery, vitamin and mineral supplementation is one of those items that will be on your daily to-do list from now on. The right supplements are part of your new lifelong strategy for success. So which supplements do you need? Let’s dig into more general suggestions for bariatric surgery remembering that your health care team may tweak these some based on your lab work and surgical procedure. In part 1, we looked in-depth at multivitamin and mineral supplements which give you good A-Z coverage and then we covered vitamin B-12.  If you missed it, the podcast is #53. Today in part 2, we’ll discuss iron, calcium and vitamin D, and thiamine. The iron in your multivitamin mineral supplement may be sufficient and you won’t need to purchase a separate one. You can find doses of iron in multis ranging from 18mg up to 36, 45, 60mg or even more but these are typical. Your dose will depend on your lab work, if you’re female and still have your period, hope to get pregnant or if you’re anemic whether male or female. Your iron need is a good one to discuss with your bariatric dietitian. Here’s a smart strategy for you: Take Vitamin C or consume a vitamin C rich food at the same time as you take your iron to increase iron absorption. If both C and iron are in your multi, you’re good to go. If you’re eating an iron rich food such as black beans for example, also eating food containing vitamin C such as a tangerine will boost the iron absorption. Don’t miss this tip: Whether your multi contains iron which it usually does or you take it separately, be sure and take your calcium at a different time, about 2 hours later or the calcium will not be absorbed well by your body. Speaking of calcium, Calcium Citrate is better absorbed than other types such as calcium carbonate. Recommended daily dose will be somewhere from 600 mg per day up to 1,200-1,500 mg per day. We just said that calcium should not be taken with iron. The other important strategy for calcium is to take it in divided doses of 500-600 mg at a time. Why? That’s the maximum amount your body can absorb at one time and you don’t want to waste it. Calcium is often sold in combination with vitamin D which helps increase the absorption of calcium from the intestine. You can take vitamin D with your calcium or get your vitamin D in your multi. How much Vitamin D do you need? The general recommendation is to take 3,000 International Units (IU) of Vitamin D3 per day. Your dose may be higher depending on your blood test. Be sure and look at the Supplement Facts on the multi or the calcium/vitamin D product and see if the vitamin D is D3, how much is in the supplement and the percent Daily Value. Remember the Supplement Facts label is on the back of products. This Supplement Facts label is specific to the US and I realize that if you’re listening from another country things will be different. The label tells you the serving size. Plus you’ll see each vitamin and mineral listed with the amount of each one and the percent Daily Value or the percentage of your daily needs. What about Thiamin AKA vitamin B1: at least 12 mg should be included in your daily multi to prevent a deficiency so again check the label before you purchase. However, a thiamin deficiency can occur with rapid weight loss, persistent vomiting, or not getting enough thru diet and you may be treated more quickly with higher doses than found in a supplement. Also very important to have your screening for thiamine deficiency. It can make you quite sick. Check out various supplement companies. Try samples if they offer them. I partner with ProCare Health. Plus if you receive my Breaking Down Nutrition newsletter, there will be a 10% off code in there again this week too. If you don’t receive the newsletter, you can sign up for it on the home page of my website Breaking Down Nutrition. Remember, take your supplements on schedule. It m makes a huge difference in your success. You’re worth it!

Did you know that vitamin & mineral supplementation typically begins at the time of discharge from the hospital, usually 2–4 days after surgery? Any idea what the must-have vitamins and minerals are for your body? What about when to take them and how much to take? The right supplementation is so important to your success. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 53. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. Let’s get right to it… Vitamin and mineral supplementation is a lifelong part of bariatric surgery. When you have weight loss surgery, vitamin and mineral supplementation is one of those items that will be on your daily to-do list from now on. Call it a behavior modification, lifestyle change or a tweak to your daily routine. However you look at it, supplements are part of your new lifelong strategy for success. Nutritional deficiencies are common after weight loss surgery and the type of surgery performed does make a difference. For example, vitamin and mineral deficiencies are more common after procedures like Roux-en-Y gastric bypass or biliopancreatic diversion as compared to sleeve gastrectomy and adjustable gastric banding. That’s why you always hear me say to circle back with your health care team for clarity if you’re unsure about which supplements they recommend for your procedure. Recommendations vary between surgical centers and even professionals groups so don’t be surprised if your supplements suggestions are different from someone else you know who’s had surgery. Let’s start with three important tips to keep in mind: 1. As I mentioned at the start of the podcast, vitamin & mineral supplementation usually begins when you go home from the hospital which is typically 2–4 days after surgery. So if you’ve had surgery and are home now, you should have started on supplements. We’ll talk about which ones in a minute. 2. Your body has changed in it’s ability to absorb vitamins and minerals. How much it’s changed depends on the surgical procedure. When selecting your products, chewable or suckable pills, or liquids are a really good idea the first 3-6 months. Then if you choose and your health care provider doesn’t have you on any specific regimen, you can switch to capsules or tablets. 3. Routine vitamin and mineral screenings/lab tests should be part of your care from your health care team. How often and what they screen for will vary with your procedure. A lot has changed in the vitamin-mineral world. In the not-to-distant past, bariatric-specific supplements weren’t common so we combined various over-the-counter products to get what we needed. Today, many companies provide a wide variety of bariatric supplements. In fact, there so many to choose from, it’s easy to become overwhelmed or unclear about which ones to take. You’ll need to do some label sleuthing and I’ll show you how. So which supplements do you need? Let’s dig into the general suggestions for bariatric surgery knowing that your health care team may tweak these. Today, in part 1, we’ll talk about multivitamin and mineral supplements along with vitamin B-12.  In part 2, we’ll cover iron, calcium and vitamin D and thiamine. First on the list. Take a complete multivitamin plus mineral supplement that is bariatric specific. What the heck does that mean? Complete means it contains the typical A-Z formulation of vitamins and minerals similar to what you find in an adult supplement but in amounts recommended for bariatric surgery. Make sure it includes both vitamins and minerals and specifically check for vitamins A, D, E, K, folic acid and thiamin along with the minerals iron, zinc, selenium and copper. If it’s a good quality bariatric supplement it will contain all of these and more. Here’s a need to know: you can find a multi both with and without iron. It’s fine to take your iron in the multi as long as you haven’t been put on a higher dose.  Also, the numbers of multis you take everyday will vary based on the brand. Typically the dose will be one or two tablets, capsules or chewables per day. How do you know? Label sleuth time. This is what I want to show you. Do you have a vitamin container near by? Go get one. Now take a look at the Supplement Facts label which you’ll find on the back of most products. This Supplement Facts label is what you’ll find in the US and I realize that if you’re listening from another country, you’ll have a different label. At the top of the label you’ll see the serving size such as 1 chewable tablet. Then you’ll see listed each vitamin and mineral along with the amount per serving and the percent Daily Value. Percent daily value or DV is the percentage that chew provides of your daily needs for each of the vitamins and minerals listed.  You’ll want to see 100-200% Daily Value for most every vitamin and mineral but there will likely be a few that are higher such as thiamine, vitamin B12 or even iron. Don’t miss this tip: Sometimes you need more iron than what’s in your supplement and we’ll talk about that in part two but if you multi contains iron which it usually does, be sure and take your calcium separately, wait about 2 hours or more from the time you take the multi or the calcium will not be absorbed well by your body. Vitamin B-12 aka cobalamin: the dose is 250-500 micrograms (ug) a day with most suggestions in the 350-500 microgram range daily or 1000 mcg every other day.  The dose depends on your surgery, your lab results and the route of administration…meaning under the tongue, you swallow it, etc. Sometimes an intramuscular injection of B12 or a nasal spray will be ordered by health care team. You can take B12 at any time or with any other supplements. It’s likely that your multi will have enough B-12 in it so check the label before you buy additional. Be sure and discuss your lab screenings with your health care team before you decide to take any extra. Today’s Science 101 on Vitamin B-12. The absorption of B-12 can be affected by bariatric surgery due to changes in acid production and reduced availability of what’s called the intrinsic factor. This intrinsic factor helps the B-12 to be absorbed and used by the body. When it’s not there or insufficient, B-12 doesn’t get absorbed and used as it should. You could experience neurological symptoms which include numbness and tingling of your arms, legs and skin plus feel like your coordination is off. This is a prime reason why routine screenings are so important and typically done every six months or so. These screenings help your health care provider pick up on a possible deficiency hopefully before it becomes a problem. Check out the Supplement Facts on a number of products to see what you like best. As I’ve shared before I partner with ProCare Health Plus if you receive my Breaking Down Nutrition newsletter, there will be a 10% off code in there this week too. If you don’t receive the newsletter, you can sign up for it on the home page of my website Breaking Down Nutrition. Decide what works best for you. Ask questions if you’re not sure. You’re worth it!  

Hey, what’s for dessert? I grew up in Tennessee and this was a common question. Still is. And, I have to admit, I love dessert. Always have. But wait, I’m a dietitian. But first I’m a person who loves food and good dessert. How about you? You’ve had bariatric surgery but I bet you’ve asked yourself this question too, right? Can you have dessert or do you have to deny yourself now? Can dessert be good for you? Is dessert off the menu or what does dessert look like post surgery? Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 52. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. I’d like to give a shout out this week to Christine who said this on Facebook: “Listening to your podcast every week helps keep me on track! I’m also excited about Dr. Connie joining the show.” Thank you Christine. Happy to know that the podcast helps you stay on track week to week. And yes, Dr. Connie’s spot on when it comes to mental health issues, isn’t she?  If you missed guest psychologist Dr. Connie, the episode is #51 called Bariatric Mental Health Q & A: Your Questions Answered. Listen to it on the website or your favorite podcatcher like Apple or Google podcasts. Let’s get right to it…dessert or no dessert? Basically whether we’re talking about treats or goodies or desserts we’re talking about the same thing. You may eat them at different times but they all fall in the same category. Bottom line, it’s all in your smart strategy. First, the replay. Remember that your body is unique as is your surgery. So as I always mention, circle back to your surgical team to make sure certain changes will work for you. Let’s be honest with each other. How long can you eat plain ol’ chicken or fish and brown rice or broccoli? Answer: not that long. Sure, you want to continue with your wins and successes but skipping a treat or a dessert that you really want can set you up to want more of it. Can I get an Amen? Remember prior to the COVID pandemic, when you worked in an office and someone had that cool candy bowl always filled with M & M peanuts? Did you grab a few and feel satisfied or did you deny yourself? Did you then try to ignore them all day but those M & M’s kept calling your name? Denise, Peggy. What happened then? If you denied yourself long enough, did you go in there and grab a big handful or maybe even look in the drawer for the bag? Denial leads to feelings of being deprived, and ultimately, cravings and over eating. If you’d just had a few peanut M & M’s when you really wanted them, it’s likely you would have been satisfied and moved on.  You’ve made terrific progress up to now and want to continue but can you fit a favorite dessert into your eating plan? You bet you can. It’s all about a smart strategy. By that I mean, think of the food choices you’ve made since surgery. I’m assuming you’re almost a year or more out now from surgery to be talking desserts or treats. You eat high protein foods, watch your processed carbs, choose healthy fats. When it comes to treats or dessert, whether you buy them or make them, try to meet those goals we just mentioned: include protein, keep the sugar low, and emphasize healthy fats. And sure, calories should be lower so you don’t ruin all your efforts with weight regain. However, before we talk more on how to do this, there will be times during special occasions, like a birthday or anniversary, when nothing but a certain dessert that you love will do. You know exactly what I mean? What is that treat for you? So, what to do? You plan your healthy meal with your normal goals, portions and foods in mind, but then allow yourself a small portion of the item you love and enjoy every single bite. The operative word here is a small portion planned as part of your day so that your favorite treat doesn’t turn into a stomach ache, dumping syndrome, or other gastrointestinal issues from too much sugar or fat. Enjoying something special should not affect your long term plan and success. It’s that denial that comes back to haunt you with cravings and overindulgence that’s the issue. What about bariatric treats and desserts made with protein rich foods, low sugar, etc? Yes please. There are lots of bariatric recipes online but not all are good ones so what should you think about when selecting one? Jeanette asked this question: “I know desserts will always need to be kept to a minimum, but for special occasions I hope I can still make desserts that will be "bariatric friendly," such as using almond flour and splenda, stevia or monkfruit in a berry or peach crumble. But I have heard that one reason why white bread and pastas and sugar free angle food cake are forbidden is that they can ball up and clog my intestines. Sugar free angel food cake is spongy. Does this mean I should find something else to use instead of sugar free angel food cake? I don't want something to clog my intestines!” Jeanette’s question is spot on in that it affects many items you would make at home. There are two schools of thought on dessert and sweeteners. Some people hate sugar free sweeteners or don't tolerate them well or both. They would prefer to plan in a small portion of the real item. In a lot of desserts, the sugar free sweeteners don't bake well. In others they work great. It can be trial and error but they do better when used in fresh fruit items or in a pudding. Angel food cake, whether made with sugar or a sugar-free sweetener is like white bread, white pita or white pasta in that it is highly refined and has no fiber. It's the lack of fiber that is the issue and why you hear people say they get clogged up. Clogged up refers to the lack of fiber to help move the digestive process along. So you could use an angel food cake make with real sugar (just use a little less than the recipe calls for). Have a small portion with fruit to add fiber. Or, you could substitute the angel food cake for a pound cake made with almond flour. Almond flour has fewer carbs and more fat with the emphasis on healthy fat as the majority is monounsaturated. You could also find cookies made with almond flour and crumble them up.  The process is to ask yourself a few questions when you’re baking at home: 1. Can I cut the amount of sugar without affecting the recipe? Most of the time the answer is yes, try it cutting back by 1/4 and go from there. FYI: 4 grams of sugar is equal to 1 teaspoon. 2. Would a sugar free sweetener work? 3. Can the all purpose flour be partially or fully replaced with an alternative like white whole wheat, almond flour, quinoa flour, or even chickpea flour, which contains both fiber and protein? 4.Can I alter the fat from butter or shortening to an oil or butter/oil combo? I cook a lot and always tweak recipes to better meet the needs of my family. And remember, it also comes down to the portion you eat. You can make yourself totally stressed, that’s not the goal. So make smart substitutions and serve yourself the appropriate portion. It's really important to be able to make recipes that you and family will eat and enjoy. Use these ideas, pre-plan and you can do just that. Decide what works best for you. You’re worth it!

Lynn asks, “How do I deal with feeling self conscious about my loose hanging skin and new found wrinkles after surgery?” And Liz wants to know, “What are ways to get yourself to enjoy exercise?” Don’t go anywhere, psychologist Dr. Connie Stapleton, who specializes in bariatric surgery and helps you deal with life’s stuff, joins me today to answer your questions. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 51. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. I’d like to give a shout out this week to Jen who made this comment on Facebook: “I am pre-op right now. I love listening to your podcast. You provide awesome insight!” Thank you Jen. I think you’re pretty awesome for taking time to tell me. I hope to continue to provide lots of insight for your journey and can’t wait to hear about your success. Joining me today via Skype is Atlanta-based psychologist Dr. Connie Stapleton. Dr. Connie uses her vast experience to share practical skills for improving your post op relationships with food, other people and most importantly your relationship with yourself. Basically, as I mentioned at the beginning of the podcast, she teaches you better ways to deal with life’s stuff. Resources: Website: Psychologist Dr. Connie Stapleton http://www.conniestapletonphd.com BariAftercare: The Podcast; available on Apple podcasts and most other podcatchers

Resources From Today's Episode: Bariatric Surgery Success with Dr. Susan Mitchell Private Facebook Group FREEBIE: 5 Tips to Packing in Protein Free Samples: ProCare Health FREE Samples Podcasts Mentioned: #31 Does Protein Help Prevent Weight Regain? #29 Should You Go Keto after Bariatric Surgery? #48 Is Pea Protein a Smart Choice After Bariatric Surgery? Protein, protein, protein! Do you feel like your head may explode if you hear that word one more time? I bet you do, for I admit, I talk about it a lot as do most dietitians. There are so many protein powders on the market…egg, soy, whey, pea, collagen. Which is the best one for you after surgery? There are days when no matter what you do, you can’t consume enough protein thru food, right? Maybe it’s a bad day and you’re just not feeling well. Maybe your day was interrupted unexpectedly and the meal plans you had just didn’t work out. Protein powder is an excellent way to help hit your daily protein target when eating enough protein thru food is just not happening. Let’s take a quick look at the most common ones. Soy, eggs, whey, and casein are all complete proteins with a high PDCAA score. The highest score is 100 which all of these have. If you’ve listened to some of the other podcasts where I’m talking about protein, you may recall that PDCAA means Protein Digestibility Corrected Amino Acid score which measures quality of protein. A complete protein contains all nine essential amino acids. It isn’t missing, or low in any one of the nine. Essential amino acid means that it cannot be made by your body and must be taken in thru food. Soy protein, made from ground soybeans is a quality complete protein. It’s a good choice if you prefer a plant based protein. Soy, egg, whey and casein all taste a little different so it comes down to your personal preference. Egg protein comes from the egg white or albumen. It’s also a high quality complete protein and is popular with people who can’t have dairy or just want to change it up. I’m going to spend most of our time together on whey protein powder as it’s so popular. It’s often called the gold standard of protein powders. But remember what we just said…egg and soy protein as equally as good just not as popular. The protein in milk is 80% casein and 20% whey. Whey is a complete protein containing all nine essential amino acids and is digested faster than casein. Just like egg or soy protein powder, it isn’t missing or low in any one of the nine essential amino acids. Science 101 for this week. Whey powder comes in several forms: whey concentrates, whey isolates and whey hydrolysates. In whey concentrate the water has been removed but the remaining product usually still contains lactose, fat and cholesterol which are naturally found in whey. Whey protein isolates usually have a little more protein but less of lactose, fat and cholesterol than whey concentrates. Whey hydrolysates are pre-digested and assimilate into the body more quickly. Isolates and hydrolysates are typically more costly due to processing. Most containers just say whey protein on the front. How do you know what’s what? Look at the ingredient label. The ingredients go in descending order most to least. The first words should be whey protein concentrate or whey protein isolate, the two most common forms. It’s up to you which you purchase. Because whey comes from milk, anyone who is truly allergic to milk proteins should avoid whey. A milk allergy is not the same as lactose intolerance. They’re two different things. Because the lactose level is low in whey concentrate and lower in whey isolate, they often work for lactose intolerance. Casein is also a complete protein in milk. Studies suggest that since casein is absorbed more slowly than whey and releases amino acids over time, it may be beneficial to consume before bed. This will supply protein through the night. A combination of whey and casein works well too. Make sure your whey protein doesn’t have a lot of other added ingredients that you probably don’t need, like  herbs, coffee or guarana, and particularly vitamins and minerals which typically are not added in the amounts specific to bariatric surgery. Generally the fewer ingredients the lower the cost too. There are so many brands to choose from. I partner with ProCare Health because many of their products are tested by a third party, are made in the US, and meet or exceed current ASMBS guidelines. That’s important to me and for your care. If you want FREE samples, see the link above in the resources and you can try them out. Let’s move on to pea protein which is an environmentally friendly plant-based option that’s easily digested and most people are not allergic to it. It’s dairy-free for vegans and people with a true dairy allergy. For a lengthy explanation of pea protein be sure and listen to podcast #48 Is Pea Protein a Smart Choice After Bariatric Surgery. The link is above in the resource list. A plant-based protein powder like pea may have all nine of the essential amino acids but be limiting in one or more. Remember this means that the level is not high enough to meet the body’s requirement. Because you had bariatric surgery and your body needs high quality complete protein. Pea protein has a limiting amino acid or one in a very low amount which is methionine. You can add the amino acid methionine to your diet by eating foods such as brown rice, sunflower and pumpkin seeds. Adding these to your diet increases the carb and fat grams too. Some pea protein products add sunflower or pumpkins seeds directly to the pea powder which then pushes up the total calories along with carb grams of a serving of that powder to around 8 grams compared to 1 or 2 in whey protein. When you have a gold standard protein like whey, egg or soy, you can save those carb and fat grams and use them on real food. This is so important to the enjoyment of food when your portions and calories are limited. I’m a fan of protein powder, it certainly mets a need but I’m a bigger fan of eating real food and maximizing the benefits to the body. We can’t wrap up without a mention of the current darling collagen powder. Yes, it’s super popular right now but it does not contain the essential amino acid tryptophan and is low in both the amino acids cysteine and methionine making it an incomplete protein source with a lower PDCAA score and not a great choice for after bariatric surgery regardless of the Internet hype. The nice thing about protein powder is that it can be mixed with water, juice, milk or other beverages. Most protein powder mixes best in warm liquid so mix your powder with a small amount of warm water or other warm beverage and then mix into your cold beverage if that’s what you’re having. Or, do you have a frother? This tool works really well for blending in protein powder. Combined with a warm liquid it’s a win-win. So cut thru all the hype and go straight to the ingredient label to see what’s what. Find a protein powder without all the unnecessary added ingredients that you don’t need and push the price up. Whey protein concentrate is whey protein concentrate. It doesn’t need a bunch of added items. Compare prices and the label and look beyond the hype. Save money. It’s all part of taking care of yourself. Decide what works best for you. You’re worth it!  

You’ve had bariatric surgery and know that protein plays a major role in your recovery. But what about fat. Can you have some or is it taboo? Let’s talk about the macro we love to hate…fat. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 49. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. If you haven’t joined me in the private Facebook group, what’s holding you back? It’s called Bariatric Surgery Success with Dr. Susan Mitchell. Lately we’ve talked about pea protein versus whey protein and how many grams of carbs you need after surgery. Lots of questions and feedback so if you need a safe place to ask, join us. Fat and carbs are two words that make many of us cringe. But they shouldn’t. Both are needed by the body to be healthy and both add to the enjoyment of food. Let’s focus on fat today and how much you need after surgery. So much confusion and so little time. Let’s get right to the big issues. Fat is a macronutrient just like protein and carbohydrate. You might find this hard to believe but fat plays numerous positive roles in your body as it acts as an energy source, protects your organs, regulates body temperature and helps to absorb vitamins A, D, E and K which are known as the fat-soluble vitamins. Fat also increases your feeling of fullness or satiety. And we surely can’t forget that fat improves the taste and mouth feel of so many foods. The big question is how much fat should you eat after surgery? The broad answer 25-30% of your total calories per day. Let’s dig deeper. Put your math hat on. Let’s say that you’re eating 1200 calories per day. Use 25% fat calories in this example. So 25% of 1200 calories is 300 calories. If you like to log calories fine but more about that in a minute. If you’re more into grams and prefer to keep an eye on them, then do you recall how many calories per gram are in fat? Nine. To convert those 300 fat calories into fat grams divide by 9 and you get about 33.5 grams. To review once more, if you’re consuming 1200 calories a day and want to eat about 25% of those calories from fat then 25% of 1200 is 300 calories. To convert to fat grams, divide by 9 and your have 33+ grams. The math changes as your total calories change and the amount of fat you desire changes. For example, if you’re eating 1400 calories per day and 30% fat, then 30% of 1400 is 420 calories. Divide by 9 calories per gram and you have about 47 grams of fat per day. Notice there is not one and only one answer. Why? Your body varies from your friend’s as perhaps your surgery does too. You also may eat more or less grams of protein per day in the range of 60-120. And then you have carb grams of up to 130. Each macronutrient takes up part of the total calories per day so your individual needs juggle within these ranges. Beside the calories and fat grams per day, the type of fat you eat is equally important. Your focus: unsaturated fat instead of saturated. If you listen to the podcast, you’ve heard me say that saturated fat can raise your total cholesterol level as well as the lousy LDL cholesterol. Unsaturated fat which includes monounsaturated and polyunsaturated fats are found in foods such as nuts, seeds, olives, fish, avocado, and oils from these foods such as olive oil, peanut oil, etc. Unsaturated fats tend to be more health protective especially when it comes to your cholesterol level and heart health. Plus some of these foods such as fish, avocado and nuts have anti-inflammatory effects too. Another bonus. A few minutes ago I mentioned you can track fat grams or calories if you want. You can easily become frustrated if you try to track everything and will want to give up. Eating and food are meant to be enjoyed not be a pain in your patootie every day. What to do? Let’s go back to the main focus macro. Protein. If you track or count your protein intake for the day and then just make smart fat choices with your focus on unsaturated fat and realistic, smaller portions and do the same with high fiber carbs, things fall into place without feeling overwhelmed and saying forget about it. And remember, this sanity with your daily calories and macros is part of taking care of yourself. Decide what works best for you. You’re worth it!

Does pea protein contain the nine essential amino acids? And if so, is this a good source of protein after bariatric surgery? Let’s look closely at popular pea protein. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 48. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. If you haven’t joined me in the private Facebook group yet, what are you waiting for? It’s called Bariatric Surgery Success with Dr. Susan Mitchell. There is good conversation happening in there. Lots of questions and feedback going on. With so many protein supplements on the market, how do you know what to choose? Plus you’ve had bariatric surgery so do all protein supplements provide what your body needs to thrive? Recently in our private Facebook group, someone asked if pea protein contains the nine essential amino acids and if so, is this a good source of protein after bariatric surgery. In this podcast, I’m not covering vegetarian or vegan diets as they’re more difficult to follow after surgery due to the limits on carbs and calories. After bariatric surgery, the big focus is and continues to be on protein, high quality protein which comes from animals or soy. So let’s talk a minute about whey protein. In a whey protein powder for example, it's typically just whey protein and not a lot of other added items you probably don’t need. Plus whey protein tends to contain a few more grams of protein per serving than pea protein. It’s a complete protein with the correct proportions of those nine essential amino acids needed by the body. It isn’t missing or low in any one of the nine. Essential amino acid means that it cannot be made by your body and must be taken in thru food. You probably know of amino acids for their role in making and repairing muscle. But these aminos do a lot more in the body from hormone production and the absorption of calcium to roles in immune function, sleep-wake cycles and sexual function. Science 101 today: One of the reasons why animal protein which includes whey protein works so well after bariatric surgery is that it has a high protein digestibility corrected amino acid score known as the PDCAA. Basically it measures protein quality. Why does that matter to you? The highest PDCAA score is 100. Milk (whey/casein), eggs, and soy all have a score of 100 and are all complete proteins. Also important is the quantity of leucine found in protein. It’s one of the nine essential amino acids which helps maintain lean tissue and the amount varies widely in products. Animal products including whey protein and soy products are very good sources of leucine. Let’s look at pea protein closer. What exactly is it? Pea protein powders or supplements are made by extracting protein from yellow peas making it naturally vegan and also gluten-free and dairy free. Both whey and pea proteins are relatively low in carbs, fat, fiber, and sugar when nothing else is added to it. Plus pea doesn’t contain any of the top food allergens such as fish, shellfish, eggs, and soy. So it’s very popular with those following a vegetarian or vegan way of life. It’s also a good source of iron from the peas. Pea protein powder is good quality and works for many people but not as well as animal protein specifically in the case of bariatric surgery. It's does contain the nine essential amino acids but here is where we dig a bit deeper. Quality matters.  A product may have all nine of the essential amino acids but be limiting in one or more. This means that the level is not high enough to meet the body’s requirement. Pea protein has a limiting amino acid or one in a very low amount which is methionine. You can add methionine to the diet by eating foods such as brown rice, sunflower and pumpkin seeds. Here’s where the issue is specific to weight loss surgery. Some pea protein powders contain just pea protein. Then brown rice or seeds need to be added to the diet to boost the methionine level. What happens, the carb and fat grams get a boost up too. Other products add sunflower or pumpkins seeds directly to the pea powder which then affects the total calories along with carb and fat grams in a serving of that powder. This addition often pushes up the total carb level in a serving of pea protein powder to around eight grams compared to one or two in whey protein. I would prefer you to have the choice of those grams of carbs and fat and to use them on real foods that you love since you have to watch carbs and fat each day. Other pea protein products also contain various vitamins and minerals but not in amounts appropriate or specific to bariatric surgery. A specific bariatric vitamin-mineral supplement would better meet your needs than those added to a product not designed for weight loss surgery. Bottom line, in this case, it’s all about the very specific needs of bariatric surgery and choosing protein powder that leads to the best outcome. Pea protein is a good protein but not the best choice for post surgery. And remember, it’s all about taking care of yourself. You’re worth it!  

What do black beans, bing cherries, avocado and nuts have in common? These foods fight inflammation in the body. But isn’t Inflammation a good thing or is it a not so good thing? Let’s talk about the type of inflammation you don’t want in your body and how you can fight it with food. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 47. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. I want to give a big shout out and say thank you this week to lilurameshi. I so appreciate your 5 star review on Apple podcasts which says: “Awesome…great podcast for bariatric nutrition. It’s a quick podcast that is packed full of information. Have a pen and paper handy to write down some of the great tips.” Well, I’m glad to know that I’m not the only one who takes notes these days and happy you like the quick format. Thank you for taking time to post the review. 210 million! That’s the number of results that came up on Google when I searched the words inflammation and diet. Inflammation can be good thing or a not so good thing. Inflammation is good if it’s short term such as when cut yourself and your immune system sends in white blood cells to jump start the healing process. Inflammation is not so good when it becomes chronic or on-going inflammation in your body. This type of inflammation, which is invisible to your eye, gets all the media attention because it’s been implicated as an underlying cause of many common diseases from heart disease and autoimmune illness like lupus or rheumatoid arthritis to some cancers, diabetes, and even stroke. Chronic inflammation can damage your blood vessels, which increases your risk for heart problems. In cancer, inflammation can damage your genes or increase the development of blood vessels that let’s cancer cells spread and grow. Did you know that chronic inflammation and obesity are linked too? Recent studies have shown that obesity may be causing chronic inflammation which in-turn causes insulin resistance. Insulin is a hormone that helps your cells take up sugar. If your body becomes resistant to insulin, your blood glucose or blood sugar remains high. Insulin resistance could be a factor in both diabetes and weight gain. These effects make obesity and inflammation like a case of the chicken and the egg. Which comes first? Obesity causes inflammation and chronic inflammation can eventually lead to obesity. This inflammation in the body raises the level of a marker known as C-reactive protein or CRP for short. The liver produces this CRP during periods of inflammation so it makes sense that if the body has chronic inflammation going on, the CRP level will be elevated. Doctors measure this level of general inflammation in the body with a blood test called high-sensitivity C-reactive protein or hs-CRP. Numerous foods are touted to single handedly fight inflammation. But that’s just not how it works. For your diet to have an anti-inflammatory effect the key is not to focus on a single food or food component. The ultimate success of the anti inflammatory diet approach is based on synergy. Think of your favorite team, basketball, soccer, football, whatever it is. To win and to continue to win, the team must work closely together. In the same way, the synergistic effect of nutrients and bioactive compounds consumed together from a variety of healthy foods provides the best anti-inflammatory outcome. The good news is that inflammation can be reduced with a diet that includes lots of anti-inflammatory foods. Remember these foods are for after surgery when you’ve progressed thru the various diet phases and now eat a regular diet.  Let’s talk about seven of these anti inflammatory foods and food components. 1. Garlic, herbs and spices. These contain various anti-inflammatory phytochemicals or naturally occurring plant nutrients. Until exact amounts are determined, you can include garlic, turmeric, ginger, oregano, rosemary, thyme and pepper as part of your daily diet. Note: Did you try the Golden Turmeric and Ginger Latte that my intern Pitchaya created? It’s great day for a cozy day. Also find it on the website under recipes. 2. This one may surprise you. Fiber ranks as one of the most anti-inflammatory components. Fiber is a type of carbohydrate that is not absorbed by your body so it helps to keep you full without adding extra calories. Foods rich in fiber include whole grains (oatmeal, quinoa, whole wheat), nuts, fruits, and vegetables. What about beans such as black, kidney or garbanzo and lentils? Also a good source of fiber and low on the glycemic index, they help keep your blood sugar in check. And when you eat more beans and lentils you tend to crave and eat less processed or foods that have zero nutrition such as cookies, cakes, chips and pastries which by the way can make your blood sugar level spike and have been tied to inflammation. Science 101: beans and whole grains contain fermentable fiber, which may be particularly helpful to the microbiota of the colon. This fermentable fiber produces butyrate, a fatty acid that assists in maintaining the intestinal wall and protecting from substances that could increase inflammatory reactions. Bottom line: when you are choosing the carbs for your day, choose smart ones that will make a difference in your health after surgery. 3. Vegetables and fruit. For best benefits, a wide variety of fruits and vegetables is the goal due to the powerful assortment of naturally occurring phytochemical or plant nutrients found in them.  One easy tip: choose a colorful combination of fruits and vegetables to know you are eating a variety. You still need to limit the portions to the amounts that fit into your plan for the day. Spinach, blueberries, raspberries and strawberries are all good examples. Don’t forget Bing cherries and tart cherries. The Agricultural Research Service has conducted studies on Bing cherries and found that regular consumption lowers the CRP inflammation marker in the body. Anthocyanins are one of the natural phytonutrients in tart cherries that give them their bright red color. These phytonutrients are linked to reduced inflammation. 4. Seafood such as tuna, salmon and sardines which are rich in omega-3 fats that play various beneficial roles in the body such as suppressing inflammation. Eating fish once or twice a week is a smart goal. 5. Flaxseeds, algae, walnuts and pumpkin seeds which are plant sources of omega-3 fats. The plant source is called alpha-linolenic acid or ALA and converts in the body to omega-3 fats but the conversion rate is low, about 10-15%. 6 and 7. Avocados and nuts: both are rich in monounsaturated fats, the more heart healthy type of fat and both contain anti-inflammatory components. Eating these also helps you to cut down on saturated fat as which can raise the lousy LDL cholesterol level and promote inflammation. Bonus: both are filling so help you feel satisfied. Your big take away today is that the secret to the success of the anti inflammatory diet is the synergistic effect from a variety of foods such as beans and lentils, herbs and spices, fruits and vegetables, nuts, avocado and fish…all rich in various vitamins, minerals, healthy fats and bioactive compounds.

Jenna asked, “Does the tea I drink need to be decaf?” And Shelly wants to know, “When can I start drinking diet soda again?” Today, we’ll answer your burning questions. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 46. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to you. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your entire journey. So happy you’ve connected with me. You’re in the right place and I’m glad you’re listening. I want to give a shout out and say thank you this week to Christine for her comment on Facebook. She said: “I love this podcast, it’s quick yet packed full of information.” Christine, my goal is to not waste your time and get right to it with information you can use. Glad you like the short format too. This week joining me on the podcast is bariatric dietitian Isabel Maples. If you’re in the private facebook group, you may have seen her comments as she shares her expertise. Isabel is a registered dietitian and bariatric coordinator with Fauquier Health in Warrenton Virginia. She helps her patients navigate the weight loss surgery process to maximize success. Her focus is on making food fun again by relearning body cues for hunger/satiety, taming trigger foods, and discovering the joy of movement. Guest: Bariatric Dietitian Isabel Maples, RD Fauquier Health Weight Loss Surgery Facebook: Isabel Maples RD Welcome Isabel! Thanks for joining me today. Questions we answer: 1. Jenna asked, “Does the tea I drink need to be decaf?” Reference: Podcast Episode #34: The Buzz on Bariatric  Surgery and Caffeine 2. Shelly wants to know, “When can I start drinking diet soda again?” 3. What about sugar free jello and sugar free pudding? Reference: LiquaCel liquid protein Thanks so much for joining me today Isabel. And remember, take care of yourself. You’re worth it!  

Move over latte. People want cold-brew. It’s trendy and continues to grow in popularity. Is it just a fancy name for traditional iced coffee or how is it different? Does it affect your cholesterol level? What cold-brew is, how it’s made and what you need to know about your cholesterol in this week's podcast. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 45. Most of my career I’ve worked in some type of media, particularly radio where I did morning drive nutrition spots for over 18 years. That’s what lead me to start podcasting and ultimately to this podcast. I created Bariatric Surgery Success to provide you with life-changing information based on science along with simple strategies and tools to help you be successful in your transformation and your journey. You’re in the right place and I’m glad you’re listening. I want to give a shout out and say thank you this week to Jo for her comment on Facebook. She said: “Thank you for this podcast, it’s the best one out there xx”.  And I say, you made my day Jo. Have you ever taken coffee that’s been sitting around too long and added ice to make your version of iced coffee? Traditional iced coffee is regular coffee brewed hot and then cooled down.  But cold-brew coffee is just the opposite. You use water that is room-temp or chilled and then the coffee steeps slowly over time usually 20-24 hours to get the caffeine and the flavor. Cold-brew needs more ground coffee to get the flavor than traditional brewed coffee. Usually it’s concentrated and then diluted with milk, cream or water. When it comes to taste, cold-brew is milder and less acidic since cold water doesn’t dissolve coffee as well as hot water. Traditional coffee can be bitter from the heat which oxidizes the coffee oils and acids. If you have heartburn, you may find cold-brew easier to tolerate. So you might be thinking. Is the caffeine content different? This answer isn’t straightforward. According to Coffeechemistry.com cold-brew coffee uses a higher coffee-to-water ratio than traditional coffee. So even though the cold-brew method extracts less caffeine, the higher amount of coffee used in the brew process likely compensates for the difference in solubility. Other factors such as time, temperature and grind size, can also affect the amount of caffeine. Just a quick review if you’ve had bariatric surgery, the current science, which has been out for a while now, says that caffeinated fluids are as good as other fluids for keeping you hydrated. In fact the American Society for Metabolic and Bariatric Surgery who makes many recommendations for care after surgery suggests avoiding caffeine for at least the first thirty days after surgery while your body is still sensitive and healing and then checking in with your bariatric dietitian or surgeon if you want to add caffeine back to your diet. If you add caffeinated coffee back to your day, you may want to start with a caffeine-decaf mix. See how the caffeine affects you and then gradually work your way to full throttle on the caffeine. You can also go back and listen to podcast #34: The Buzz on Bariatric Surgery and Caffeine. What about your cholesterol level? You may have heard that some coffee brewing methods push cholesterol up. Remember that coffee doesn’t contain cholesterol but might affect how the body produces it. A review of studies looking at coffee consumption and blood lipids or blood fats, particularly cholesterol, found that filtered coffee had very little effect on the cholesterol level. Now consumption of unfiltered coffee can increase both your total cholesterol number and the lousy LDL cholesterol but remember, unfiltered coffee is a different method of brewing. It’s not cold brew. Cold brew typically uses a filter. Coffee contains substances called diterpenes that are tied to increased cholesterol. The use of paper filters will trap most of these. So if the coffee has been filtered, there’s little effect on the cholesterol level. These diterpenes are strongest in coffee where the grounds have the longest contact with the water during brewing and no filtering. So the best thing to do is to use a filter. Here’s a fun spin on cold brew to try if you like more of a latte. Take a cup of cold brew and add a splash of milk, some protein powder and a dash or two of cinnamon and blend like crazy. Remember, wait a good 30 days after surgery before you add back caffeine or coffee, discuss with your medical team and get the go ahead. Add it back slowly. Be sure and sign up for the Breaking Down Nutrition newsletter on our website, BreakingDownNutrition.com. Also, I have a new partnership with ProCare Health. You may already know their line of bariatric multivitamins, calcium and protein products. The newsletter is where you’ll find discount coupon codes. Have a question or comment for me? Contact me thru the website or hit reply to my newsletter with your question. Be good to yourself. You’re worth it.

Did you know that not all protein sources are alike? Some are better choices than others if you’ve had  bariatric surgery. In part two of eating for the long haul after bariatric surgery, let’s talk about five more specific tips that can make a difference in the success of your journey. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 44. In part one of eating for the long haul, we talked about focusing on small bites, eating only until comfortably full versus stuffed, dividing your meals and total calories, keeping yourself accountable and eating protein first. Did you notice that a number of our tips in part one deal with being mindful and paying attention to details you may have ignored before? These tips work for everyone, not just if you’ve had surgery, even your family members. They’re strategies for building and keeping a healthy lifestyle. And remember, don’t think of the way you eat as a diet. It’s really a bariatric lifestyle of making behavior changes and tweaks in what you choose to eat so that you prevent weight regain, eat good food that the whole family can enjoy and make sure you don’t feel deprived. Real food, not diet food.  Tip #6 Let’s do a deeper dive on protein. Not all protein sources are alike. Protein is made up of amino acids which are often called the building blocks of protein. There are nine essential amino acids we need from food. After bariatric surgery, your primary goal is to get high quality protein sources with these nine amino acids so that you meet your nutritional needs. Your need for quality protein is and always will be high while your need for calories is lower. There are many good protein sources from plants but because of your need for high quality protein with all nine amino acids and with lower calories and less carbs, animal-based proteins such as seafood and fish, poultry, beef, pork, eggs and dairy along with plant-based soy protein are better choices. These high quality protein sources are known as complete proteins because they contain all nine of the essential amino acids your body needs in the right amounts. Don’t miss those last four words…in the right amounts. Plant-based proteins such as lentils, split peas, beans including pinto, black or kidney and nuts and seeds are considered to be incomplete proteins, as they lack one or more of the essential amino acids that your body needs. Yes, they contain protein but are higher in carbs although they do contain the type of carbs you want called complex carbs with fiber. Nuts and seeds are high in fat, but heart healthy fat typically. What to do? You can still work them in your diet as they are so nutritious but with a close eye on portion size and grams of carbs. Think of the protein in them as a bonus to the complex carb and fiber. Tip # 7: For every 100 calories you eat, a minimum of 10 grams or 10% should come from lean, high quality protein sources. For example, let’s say you drink a protein shake with 200 calories. It should contain how many grams of protein? 20 at a minimum or 10 grams per 100 calories. So if the drink has 25 grams of protein, you would be in good shape. Tip #8: Ditch the grazing. You know what I mean. Picking up food to munch on it just because. Because it’s a bad day, someone was a jerk at work and made you mad, your favorite TV show is on, or some person made a rude remark that upset you. Unfortunately in this world, these things probably won’t stop happening so how you respond becomes much more important. What matters is you and your success…period. The problem with grazing for all of us (or emotional eating as I call it) is that we tend to feel even worse after we eat to cover our emotions. Plus what do you typically graze on? Not lean chicken or tuna but more likely chips or ice cream or some type of candy. Finding another outlet that doesn’t involve food is critical. Read a book, take a shower, walk, call a friend, just don’t graze or emotionally eat. Tip #9: Choose smart carbs and limit the total grams per day to 90-130 depending on how far out from surgery you are and what your dietitian suggests. Often at six months out, the carb suggestion will be around 90 grams a day working up to 130 grams over one year down the track. However this can vary with the surgery so a carb discussion with your dietitian is one to put on your list. Smart carbs mean vegetables, fruit, whole grains, beans and lentils that contain fiber and are referred to as complex carbs versus refined or empty-calories carbs that we mentioned above in grazing. You know the ones, the goodies we tend to reach for under stress.  Tip #10 Focus on fluids to stay hydrated and to help prevent constipation. Do you remember your fluid needs? At least eight cups 64 ounces or 2 liters. And when? Before and after meals, not at the same time. I know this seems like a lot to learn but you’ll get it in no time. Think of it for what it is…healthy eating with a bariatric spin on it to go the long haul. Be good to yourself. You’re worth it.

Have you been thinking: “I made it thru these 6-8 weeks after bariatric surgery but I’m not so sure I want to go back to a so-called regular diet of real food. I don’t want to regain weight.” I hear you and I have 10 helpful tips. Let’s talk about five of them today in part one. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 43. This week, I want to give a thank you shout-out to Lyolka. She gave the Bariatric Surgery Success podcast a 5-star review on Apple Podcasts and said: “Thank you for the very helpful tips! I’m getting ready to have surgery and your podcast really helps me to learn more! Great format, not too lengthy, straight to the point. Love the energy and enthusiasm in your voice!” These reviews mean a lot to me. Your feedback is exactly why I do the podcast. If I’m not helping you, then I don’t need to be doing it. I so appreciate your time to share your thoughts. And speaking of getting to the point, let’s go. Over the last 6-8 weeks your diet has morphed a lot starting with clear liquids and progressing to a soft diet. You did it. Now you are ready to think about how you’re going to eat for the long haul. Your decision to have bariatric surgery was a big deal. It’s not over after the first weeks of healing and constant tweaks in what you eat and drink. You’ve progressed and are now ready at this point to transition to a regular, healthy, balanced and let’s not forget tasty way of eating. I mention tasty because food nourishes the body from a nutrition standpoint but food also nourishes the soul and is about enjoyment of life, the time and tasty meals shared with family and friends. Moving on from soft foods to regular foods is so important. You’ve had surgery, yes, and you will eat less because of it, true, but you will still eat regular nutritious foods that help provide your body with A-Z nutrition and satiety or that feeling of fullness.You want to move forward from liquid meals and only soft foods. Why? Regular foods help prevent the weight regain you are worried about. How? Regular food, especially those foods that contain protein and fiber are more filling and satisfying than liquids so you feel full on less. You feel full on less food. Also and equally important is that we’re talking about the rest of your life here. Diets don’t work and never have. Learning to eat well and make smart choices does. A bariatric diet is not a diet from the viewpoint of drop the “t” and you feel like you’re going to die. Instead, it should be a bariatric lifestyle of behavior changes and tweaks in what you choose to eat so that you prevent weight regain, eat real food that the rest of the family can and will eat, and you don’t feel deprived. Real food, not diet food. At the risk of sounding like a message on replay, remember that your surgeon or surgery center may have their own nutritional regimen for you to follow depending on your surgery so check in with them if you have any issues. This week in part one, let’s look at the five of the 10 tips to eat for the long haul. Tip #1: It’s so easy to take big bites of food and a habit most of us could benefit from changing. As you start to practice mindful eating, be aware of your bites and make them small. Chew them well, especially since liquids are consumed when? 15-30 minutes before a meal or 30 minutes after. This is easier to do if you sit down, relax and enjoy your food versus a gulp and go. Tip #2: Stop eating when you’re comfortably full not stuffed. It’s a hard habit to change as we are use to eating until we feel stuffed. Feeling stuffed won’t make you feel good and can have a negative effect on your surgical outcome. This tip will also require you to begin to pay closer attention and listen to your body. More mindful eating techniques. If you retrain yourself to eat slowly, you’ll start to become more aware of when you’ve had enough. Tip #3: Divide your food into three meals and one or two snacks which will total somewhere between 900-1000-1200 calories per day. This calorie level will depend on your physical activity level, sex, age, surgery progress and what your bariatric dietitian feels is right for you based on your personal health parameters. Tip #4: Decide how you want to monitor and keep yourself on track for success. In order words, some dietitians suggest you track what you eat daily so you know the calories you’ve consumed, others suggest count grams of macros, particularly protein and carbs, other say weigh and measure your food or use portion containers and forget the rest. I’ve found thru the years that what works is the method you prefer and will actually do. All of these can be successful as well as a mix. You can use small plates and bowls or products that are marked to help you know and see the portion size. You can track only fluid and protein intake on an app. Decide what is best for you and put it into action. Why? Personal accountability works. Also get into my private Facebook group. It’s called Bariatric Surgery Success with dietitian Dr. Susan Mitchell We’re all about accountability and helping each other. Tip #5: Eat your protein food sources first. Long term success and the health of your body depend on an adequate intake of protein today, tomorrow and each day down the track. One big reason to reach your protein intake each day is that protein supports your metabolism. The more muscle you have on your body, the higher your metabolism rate will be and the more calories your body will burn. Aiming for that 60-90 grams of protein per day will provide the amino acids in the protein to your muscle mass and the myriad of other body processes where protein plays a role such as the formation of hormones, enzymes, and immune system antibodies to help your body function as it should. Remember you are dividing this total amount of protein over the day. To help you plan, 60, 80 and 90 grams of protein are equal to 240, 320 and 360 calories out of your daily total of somewhere around 1000 calories. When you have protein food sources at every meal and snack, you’ll start to notice that you’re not as hungry and feel comfortably full on less food. You might be wondering about high-protein liquid supplement drinks or powders. I recommend meeting your protein needs with food when possible for the reasons we just talked about, feeling satisfied particularly. But I also know on some days it can be difficult to get the grams of protein your body needs without a protein drink as they’re so convenient and make a good snack or backup meal plan. They will help meet your protein needs for sure but you may not feel satisfied enough. Pay attention and see. By the way, I have a freebie guide on how to add protein to your diet. You can download it from the my homepage BreakingDownNutrition.com Remember mindfulness. Pay attention to how you feel as you eat. Listen to your body. This may be totally new and that’s ok. Most of us haven’t listened to our bodies as we should but it’s never too late. In part two, we’ll talk about why all protein sources are not alike and 5 more tips to eat for the long haul. Be good to yourself. You’re worth it.  

You’ve had bariatric surgery and your new journey has begun. It’s an exciting time, isn’t it, but can also be a time of confusion and uncertainly. What do you eat now? Next week? Next month and down the track? I have tips for you to try and suggested recommendations for the best outcome in these first 6-8 weeks. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 42. I like to give a shout out to Nick, who had this to say about the podcast: “Have enjoyed listening to your podcasts - really great to have information directly relevant to bariatric surgery related eating” Thank you, Nick. I often hear that after surgery it’s so confusing as to which direction to go. I’m glad to help and to know that the information is relevant. Thank you for listening Nick and thank each of you for listening and sharing with your friends. Your diet is going to morph a lot in the next days, weeks and months as your body heals from the surgery. What you eat will change as the days and weeks pass by. Let’s focus on the initial six-eight weeks following your surgery. Remember that every surgeon or surgery center may have their own nutritional regimen for you to follow depending on your surgery. Today’s information will work in tandem with that information but if you have any questions specific to your case, always circle back to your surgery center or office. Think of your next six-eight weeks as a gradual progression in terms of food texture and consistency. Immediately following your surgery, your diet will be room temperature clear liquids or basically anything you can see thru for 24-48 hours up to 4 days. You will slowly be working your way to up to 8-12 cups/day or about 2 to almost 3 liters of water and other liquids. You’ll start with small sips every 15 minutes as tolerated and build from there. Did you know that dehydration is the main reason for re-hospitalization after bariatric surgery? That’s why fluids are so important to start your journey off right. Clear liquids don’t include carbonated beverages as they tend to introduce air and cause discomfort…something you do not want right now. Water, diluted fruit juice, protein water, broth, bouillon, low-sugar clear protein drinks, all work during this initial phase. Protein waters and low-sugar clear protein drinks are a good way to start adding protein back in to your diet from the very beginning. If you have no issues, somewhere between days 3-7 you’ll add other liquids, called full liquids that you can’t see thru, such as milk, soy milk, and sugar free drinkable yogurt as you continue to heal. Milk, soy milk and drinkable yogurt all contain protein So you can see you’re starting to include protein sources right away as you did with the clear liquid protein drinks. You may also drink high-protein low-calorie liquid supplement drinks with 20 or more grams of protein and around 200 or less calories. You can also try powders that you stir into milk to meet your protein requirements during this full liquid phase. How many grams of protein should you have each day on full liquids? Aim for 60-70 grams total so read the nutrition labels closely. Look at the serving size and then how many grams of protein are in that serving. Try to keep your carbohydrate intake around 50 grams per day. For example if you’re having a blended, drinkable vegetable soup, again, check the nutritional label and see how many total grams of carbs are in a serving. If you drink half a serving, cut those numbers in half. Depending on your surgical center you may stay on full liquids 1-2 weeks while other centers suggest up to 21 days or about 3 weeks. So, how are you doing? Hanging in there? I know you can do this tough work. Keep going. After these 2-3 weeks on a full liquid diet, it’s typically time to move on to a pureed then mashed, soft diet such as scrambled or boiled eggs, soft meatballs, vegetables that are cooked and peeled (notice the word peeled for right now) and soft peeled fruit…again peeled for right now. The ideal way is to start with smooth, blended or pureed foods and work you way to foods that are more mashed than blended and then to soft foods. Tip 1: you will fill up much more quickly than you did before surgery so eat your protein food first and chew it so well that it becomes pureed almost like baby food in your mouth. You still want to eat that 60-70 grams of protein a day so starting with it first helps you be successful with that daily goal. Tip 2: don’t miss this…now is the time to separate liquids from solid food. What does that mean? Drink your beverages 15-30 minutes before you eat and 30 minutes after you eat. Why? Your capacity for food is much smaller and you want to get in the needed calories and nutrition for your body. You will accomplish this more easily by separating liquids from food and will not have as many side effects.  Remember 8+ cups of water or 2 plus liters is what you are aiming for each day along with your food. At 4-6 weeks out from surgery and you are doing well, it’s about time to add some solid foods to your diet including legumes (or all types of beans and split peas cooked soft), fresh vegetables, fresh fruit and a small amount of starchy foods such as baked or mashed potatoes, corn or peas. Notice when we talk about carb foods such as fruit, veggies or potatoes, we’re not talking about more refined carbs like candy, cakes, cookies, etc. Why? These refined or also called simple carbs set you up for dumping syndrome that occurs if you eat foods high in sugar and fat. Symptoms of dumping syndrome include light-headedness, sweating, rapid heart rate, cramping and abdominal pain, nausea and diarrhea. That’s the last thing you want right now as you are healing. About 6-8 weeks have passed now and you did it. You’ve progressed and are now ready at this 6-8 week point to transition to a regular, healthy, balanced diet. This step is so important. You’ve had surgery, yes, and you will eat less, true, but you will still eat regular nutritious foods that provide you with broad spectrum nutrition and satiety or that feeling of fullness. Did you catch that? One of the big reasons to move forward to healthy regular foods is to help prevent weight regain and feel satisfied from the various foods that you eat. So if you’re thinking, Oooh, not sure i want to go back to real food, that’s what got me in trouble to start with and I don’t want to gain weight, remember that your focus is on real healthy nutritious and tasty foods yes, but also on smaller portions and foods that are lower in calories.  If you are dealing with any pain, nausea or vomiting be sure and consult your bariatric dietitian. We’ll be talking about what a healthy diet and lifestyle for the long haul look like in an upcoming podcast. Well done, pat yourself on the back for me. Don’t forget to join me in the NEW private FB group …the Bariatric Surgery Success community. This is a great place to ask questions about your diet and the things we talk about in the podcast like today. You’ll see the link to join in the weekly newsletter or you can join right now from the website Breakingdownnutrition.com You’ll see the JOIN button on the homepage. AND if you’re not receiving the newsletter, sign up while you’re on the homepage. You’ll be the first to know about new podcast episodes, freebies and other resources. Have a good week and I’ll see you in the Facebook group.    

Congratulations, you’ve made a big decision to have bariatric surgery and begin a new journey for your health. Way to go. Bariatric surgery is a terrific tool to help you lose weight. But keep in mind from the very beginning that it’s not the sole answer. Surgery is just one of the spokes in the wheel to success. Hand in hand with surgery is your lifestyle and the willingness to make changes that become part of the way you live from now on. Begin to prepare for surgery with these five steps to get you in the best place possible from a nutrition standpoint. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 41. Recently in the podcast 3 Surprising Health Benefits of Chocolate, we talked about how surgery doesn’t change your brain or desires for certain foods. Part of successfully incorporating the occasional chocolate in your eating plan is understanding and practicing mindful eating or being aware of what you eat, why you eat it and how much you’re eating. So if you haven’t grabbed my Freebie, 6 Tips to Eat Mindfully, be sure and do that now. I’ll put the link in the show notes but you can also find it on my homepage Breaking Down Nutrition. Link for Mindfulness Freebie: https://bit.ly/3mMS3wM Depending on where you have surgery, your surgical center may have a pre-surgery nutrition evaluation with a dietitian and maybe a pre-surgery diet and supplement schedule. Be sure and follow these guidelines closely and whatever else they suggest or require. Additionally let’s look at five steps you can do now. Remember that these changes to your behavior and lifestyle not only benefit weight loss but can substantially improve related health issues such as diabetes or non alcoholic fatty liver disease or fat in the liver. 1. Start now to become aware of how much you eat and get a good estimate of the number of calories you consume each day. How to do this? I love using an app on my phone/online or both whichever is easier for you. There are many to chose from. Three of my favorites are NutritionIX, Lose It! and My Fitness Pal. I’ll put the links to these three in the show notes. Ok, so your thinking, really, what a pain in the patootie. I hear you but will tell you, once you start (if you’re honest with yourself), a food record kept for a week or two, ongoing if you want, is a real eye-opener. The caveat here is being honest with yourself. We have a tendency to log what we feel good about and not the real stuff right? Don’t miss this. Log the real stuff, what you really eat and how much. To make lasting lifestyle tweaks you want to see patterns. For example, do you snack at night most every night in front of the TV? Do you eat when you’re stressed? Do you reach for goodies when you’re upset? If you log what you eat along with what’s going on when you eat it, you’ll start to see trends. These trends are the key to your journey and behavior changes. Why does this matter? Finding your patterns and then working to make behavior changes will help prevent that dreaded weight regain that you hear about and hate. Food Record Apps: NutritionIX LoseIt! MyFitnessPal 2. Start cutting back now on beverages with added sugars such as soda. If beverages with added sugars are a part of your lifestyle, you may notice weight loss when you cut down. Significantly increase the amount of water you drink daily as you cut back on the sweetened beverages. Dehydration following surgery is a common issue so get used to drinking a lot of water now. OK, you get sick of plain water. I hear that often. Instead of flavored carbonated water which you’ll be cutting out before and after surgery, add slices of orange, lemon, lime, cucumber or pieces of fresh basil to add flavor. How much should you drink? Aim for 64 ounces a day or almost 2 liters. 3. Start to pay attention to portion sizes. When you start a food log, you look at what you eat, how you feel when you eat it and also at how much you eat. This is where mindfulness or mindful eating comes into play. Change doesn’t happen overnight. You’ve likely been eating a certain way for a long time so remember one small step at a time that becomes a new behavior or lifestyle for you. Don’t expect perfection or you’ll set yourself up for failure as you’ll feel like you can never do this. You can, you can do it. It takes time and that’s OK. It took time to get where you are and this is the beginning of a new journey not an overnight unrealistic success story. Don’t expect it. What to do. One of my strategies is to use a salad plate instead of a dinner plate as well as a small glass. Food on a small plate looks like a lot and reduces the feeling of deprivation. Same with the glass. So put the dinner plates away now and begin to watch portions. Make them smaller. 4. Start on bariatric supplements. You’ll likely receive a list of vitamin and mineral supplements to take. In the past, we didn’t have good bariatric products so regular over the counter supplements were suggested. Today, there are numerous high quality bariatric supplements to meet your needs. Consider starting a good bariatric multi vitamin-mineral supplement. You may need additional calcium, vitamin D, iron and vitamin B-12 so have this discussion with your health care team. If you missed it, listen to podcast number #33 5 Things to Know about Vitamin D, Bariatric Surgery and Your Bones The podcast will give you more information on how much vitamin D you need. 5. Start to be picky about your food choices. Cut back on foods that are highly refined meaning they’re typically low in fiber and/or high in added sugars and fat such as sweets, candy, cakes and cookies along with chips, bagels, white rice and white bread. Choose more fresh fruits and veggies, nuts and seeds, whole grains and lean protein choices such as beans, salmon, tuna and turkey or chicken. Remember there are no good or bad foods only more healthful choices. When foods are labeled good and bad, you start to feel good and bad about yourself because of what you chose to eat.  Listen closely. Food does not make you good or bad, remember that. It’s just food and you can make smart choices. Don’t forget to join me in the NEW private FB group, the Bariatric Surgery Success community. You’ll see the link to join in the weekly newsletter or you can join right now from the website. You’ll see the JOIN button on the homepage. And if you’re not receiving the newsletter, sign up while you’re on the homepage. You’ll be the first to know about new podcast episodes, freebies and other resources. Have a good week and I’ll see you in the Facebook group.      

Guess how many pounds of chocolate the average American consumes yearly? Over 11. My girlfriend said she’d rather have chocolate than sex. Good thing her passion for chocolate comes with surprising health benefits and a melt-in-your-mouth flavor. Chocolate’s always been popular for its taste and mouth feel. It’s been deemed the most craved food. Personally I never met a chocolate I don’t like…well, white chocolate but then technically, it’s not really chocolate. The idea that dark chocolate is good for health is not new. Think about red wine and green tea. They are good for you because they contain compounds called flavonoids or naturally occurring plant substances which have health benefits. Guess where these flavonoids are also found naturally? Cocoa beans and chocolate. Chocolate benefit #1: these naturally found flavonoids in chocolate may improve blood flow, reduce blood pressure and lower lousy or LDL cholesterol. Chocolate benefit #2: You’ve no doubt heard the word microbiome or in this case I’m referring your gut. It seems that beneficial microbes in your gut feed on chocolate, ferment it and produce anti-inflammatory compounds which may decrease inflammation of heart tissue and reduce long-term risk of stroke. Chocolate is also a source of fiber. The undigested fiber in cocoa is broken down in the gut and can be combined with prebiotics to also produce anti-inflammatory compounds. The good news is that the number of healthy gut microbes increases and the less healthy microbes decrease. Chocolate benefit #3: Dark chocolate also contains the beneficial minerals iron, magnesium, potassium and phosphorus. Here’s where it becomes important for you to make smart decisions. You’ve had surgery but that changed didn’t change your brain nor the occasional desire or craving. So even after bariatric surgery when you’re back to eating regular food in smaller portions, you’ll likely have the occasional desire for chocolate. So what to do? Depends on you. If you skip the chocolate are you ok with that? If so, fabulous. Or do you feel you have denied yourself of something you really love? What happens if you continually deny this desire for chocolate? In my experience it’s not unusual to give in and eat way more than if you have allowed yourself that small piece when you wanted it. So back to making that smart choice. First, remember that added sugars and sugar alcohols can cause dumping syndrome. Everyone is different but for many, it doesn’t take much added sugar to start symptoms. The caveat here is that the benefits of chocolate can turn ugly by the addition of less healthy ingredients such as added sugars or sugar alcohols, trans fat or hydrogenated fat, and butter oil and coconut oil, both of which contain a lot of saturated fat. So it’s up to you to be the label sleuth and look at the Nutrition Facts label and closely read the ingredient list of different chocolate. The longer the ingredient list, the more likely it is that less-healthy items that have been added will take away from the cocoa’s or chocolate’s potential health benefits and potentially kick off dumping. Choosing a small piece of your favorite dark chocolate is the smartest way to go. You’ll get that fabulous flavor and mouth feel. Plus if you compare chocolates, you can find numerous good quality ones with few added ingredients you don’t need. Again, remember what can happen if you really want chocolate and deny yourself over and over. You’re likely to have a craving that results in eating a lot more chocolate than you need and probably chocolate with added ingredients you don’t want. Instead just allow yourself a small piece when you really want it. Yes give yourself permission to have it and enjoy it. N0 guilt. Then you control the portion, get the benefits and don’t end up overeating on chocolate filled with added ingredients you don’t need. And you keep dumping syndrome out of the picture as well. Whether you prefer chocolate to sex or not, you can enjoy dark chocolate for it’s fabulous taste, reap the potential health benefits and work it into your eating plan by using these smart strategies. Don’t forget to join me in the NEW private Facebook group: Bariatric Surgery Success community. You’ll see the link to join in the weekly newsletter or you can join right now from the website BreakingDownNutrition.com You’ll see the JOIN button on the homepage. If you’re not receiving the newsletter, sign up while you’re on the homepage. You’ll be the first to know about new podcast episodes, freebies and other resources. Have a great day!    

Have you gone thru bariatric surgery only to find that you’re still hungry more often than you thought you would be? Why are you hungry? I have some interesting new research to share about our brains and why we eat. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 39. Don’t forget to join me in the NEW private FB group…the Bariatric Surgery Success community. You’ll see the link to join in the weekly newsletter or you can join right now from the website. You’ll see the 'join' button on the homepage. If you’re not receiving the newsletter, sign up while you’re on the homepage. You’ll be the first to know about new podcast episodes, freebies and other resources. The one thing about science is that it’s constantly changing. That’s a good thing as research teaches us more and more, but it can be frustrating too. I remember as a young dietitian my Dad had been put on a heart healthy diet which, at the time, severely restricted eggs. This was before we knew that it was the total saturated fat in our diet that was more important than the cholesterol in an egg. I remember trying to share this new research and diet changes with my Dad who wouldn’t hear of it. He had been told one way and that’s the way it was. After all what did I know, I was just his baby girl. Throughout the pandemic, you’ve no doubt heard that the science keeps evolving as we learn more about the virus. Well it keeps evolving in the field of nutrition and obesity medicine too. And some of what we’re finding out gives us new insight into that dreaded weight regain after significant weight loss and after bariatric surgery. Obesity has always been considered an outcome of eating too much. So much ugly goes with that idea such as weight bias, shaming, bullying or the assumption of a lack of self control. Sure your genes, the environment and the amount of calories eaten do all play a role. In fact, the intake of macronutrients like protein and carbs can affect the production of neurotransmitters or brain chemicals like dopamine and serotonin that then affect appetite. The amount of protein and carbs that you eat are important but should not be the only focus. New research suggests that perhaps overeating does not cause obesity. Overeating does not cause obesity but rather the disease of obesity causes overeating. Let me repeat that… overeating does not cause obesity… but rather the disease of obesity causes overeating. Research suggests that obesity is a disease and should be treated that way. It’s a disease that causes a malfunction or dysfunction from the medical view point in the regulation of your appetite and it’s connected to the brain. New emerging research suggests that signals which physically tell us we’re hungry or we’re full are controlled by your brain. It appears that the brain is not only involved in regulating hunger and feeling full but also with eating for pleasure or what’s called hedonic eating. Hormone regulation is controlled by the brain and this hormone regulation plays a large part in appetite control. In obesity, there seems to be a malfunction in these signals that the brain’s sending out. Maybe you’ve heard of hormones called leptin and ghrelin? When your stomach is full, the brain signals for the release of leptin as a appetite control. In obesity, this signaling has its wires crossed and is not working correctly. This may lead to being hungry and overeating when you’re actually full. The hormone ghrelin is tied to stimulating the desire to eat and it may work overtime. (Let me mention that one of the benefits, at least short term, of sleeve gastrectomy is a decrease in the production of ghrelin due to the removal of a significant part of the stomach resulting in a decrease in appetite.) And guess what happens as a result of these messed up signals? You never feel satisfied and feel that constant hunger. Don’t miss this as it’s really important to know. When you lose significant weight as you have thru surgery, the opposite of what you think should happen often does. You think you should feel full and not as hungry but that malfunctioning signal that tells you that you are full isn’t doing it’s job and the hunger hormone ghrelin often increases. No wonder you’re frustrated but now you and we as health care providers are beginning to understanding why this may happen. Additional research suggests that GLP-1 (whose real name is glucogon-like peptide-1) may have an important role in regulating appetite as it can also acts as a hormone. It’s a player too in signaling with the brain whether you’ve had enough to eat or you’re hungry. What’s really interesting is that medications using this GLP-1 may be good news for a malfunctioning appetite. And some of these are on the market now and are used in the treatment of diabetes. Weight regain is a big issue after significant weight loss and weight loss surgery. It’s not unusual to see weight regain a year down the track following a large loss. Why? One of the reasons may be that the body is releasing more hormones that make you think you’re hungry. When you lose weight, the body will work to regain the weight unless this appetite regulation or signaling starts to function correctly. Don’t get me wrong, behavior change, exercise, healthy eating, realistic portions, and the right percentage of macronutrients like protein and carbohydrate all continue to be important part of your journey. But there are potentially more options in the form of medications that may end up playing a role too and partnering with these others lifestyle changes. Think of it like high blood pressure or diabetes, sometimes lifestyle changes are not enough and medication is needed. When obesity is treated as a disease, it’s the same thought process. Sometimes lifestyle changes are not enough. As we learn more about the many hormones related to weight and how their levels are affected, I can’t wait to see what new developments continue to come forth to work along with behavior changes and nutritional strategies. New developments that will hopefully add additional options to help with weight regain. I’ll keep you posted as I hear more. 

Are you feeling blocked up? You know, constipation. Last week we had a discussion in the new private facebook group about what a pain constipation can be after surgery or any time. Let’s talk about some tips to help relieve it. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 38. This is the first podcast under the new name but you shouldn’t have any trouble locating it. The feed to your favorite podcatcher remains the same and it will continue on where Beyond Bariatric Surgery left off. It’s been a frantic few weeks so if you’re having an issue with anything, let me know. You can contact me easily thru the website. You’ll see the contact us link at the top of the page. Website: Breaking Down Nutrition Don’t forget to join the NEW private FB group, the Bariatric Surgery Success community. You can join right now from the website as well. You’ll see the JOIN button on the homepage. Last week in the new private Facebook group, there was a lot of dialogue on constipation. You’re probably thinking…really…you sit around and talk about pooping. If you’ve had trouble pooping since surgery, you know why we’re talking about it. It’s one of the most common complaints after surgery especially sleeve gastrectomy and lap band according to my bariatric dietitian colleagues who work with bariatric surgical centers. Depending on your surgery and your body, your bowel movements may or may not be the same as before surgery which is typically a normal side effect. Before surgery, maybe you had a poop daily but after you may be going only every other day. Remember, you are your own unique person so if you’ve not had a bowel movement in several days or if having a movement becomes painful or uncomfortable get back in touch with your surgical center and physician. Most have their own protocol for constipation depending on how far out from surgery you are and what type of surgery you had. It’s not unusual to need to take a stool softener for the first month or so after surgery but again ask what the suggested protocol is for your specific situation. Do you feel like you’re on a roller coaster you can’t get off and go back and forth between dumping syndrome and constipation? Dumping syndrome is related to the type and amount of carbs that you eat. Remember you can listen anytime to podcast number #32 on 4 ways to prevent dumping syndrome from dumping on your day. There’s also a freebie with some great tips just waiting for you…download it on the homepage. Podcast: #32 4 Ways to Prevent Dumping Syndrome from Dumping on Your Day Website: Breaking Down Nutrition But if constipation makes you feel like a cement block is in your gut, let’s talk about how to help relieve it from a nutrition perspective.  Constipation can occur for a number of reasons. Run thru this checklist with me and ask yourself how many of these speak to you. Any or all of these items can increase the chance that you’re constipated. Here we go… Are you eating less food? Are you taking an iron supplement? Are you abdominal muscles weak? Are you taking pain medications? Are you drinking less water and other fluids than perhaps your body needs? Is your exercise or activity level down? Is your diet missing foods high in fiber?   How many of these did you answer yes to? Looking at constipation from the nutrition perspective, typically about one month after bariatric surgery you can start to increase your consumption of higher fiber vegetables, beans and lentils which help prevent constipation and work to help with regular bowel movements. Typical fiber intake goals range from 25-30 grams daily or about 15 grams for every 800-1000 calories you eat. A gastric band, sleeve gastrectomy or gastric bypass greatly reduces the ability to consume large amounts of fiber-containing foods so you know that it can be challenging to get enough fiber day to day. It becomes really important to choose as many high fiber vegetables and fruit along with lentils and beans as you can when you start adding them your diet. By the way, lentils and beans have an added bonus of containing protein. An overall bonus of fiber is that it makes you feel more full and is helpful in combating weight regain. Nuts are also a nice source of fiber but portion size is super important since they’re so high in calories. Ok a little science 101. I know it’s temping to add a fiber supplement or a laxative when you feel blocked but don’t rush into it. There are two types of fiber, soluble and insoluble, and both play a role in promoting regular poops. However, many fiber supplements contain just one type. Plus fiber supplements can make constipation more of a problem if your intake of fluid is not adequate. When it comes to fiber supplements and laxatives more fiber or numerous laxatives can make constipation worse not better. Remember that concrete block feeling? More is not better. Here’s why dietitians love food sources for fiber. Most food sources contain both types of fiber, soluble and insoluble, and are less likely to worsen constipation and more likely to help you be regular. Bonus: Adding fiber from food sources is a big win for you. Why? Have you heard the word microbiome? Or health of your gut? These soluble and insoluble fibers go into your gut, into the large intestine and break down and thrive to make a health microbiome. This is a major reason that variety in your diet from all of these food fiber sources is so important to your long term success and health. Tip: start by adding high fiber foods slowly to avoid gas and bloating. As you add foods with fiber, increase your fluids…they are team mates. Spread fiber sources throughout the day versus loading up at one meal. Try soft-cooked lentils, split peas and beans which are all terrific sources of fiber. Non-starchy vegetables, nuts and seeds all are good choices too… remembering portion control for nuts. Beans, oatmeal, fruits with skin, vegetables and whole grains all contain fiber. Should your physician or dietitian suggest a fiber supplement, add it slowly and increase the amount slowly to minimize gas and bloating just like you do when adding more fiber from food sources. And don’t forget your fluid. As we just talked about, these are teammates working hand in hand to help you prevent constipation and relieve it when it happens. Drinking water is not doubt one of the most important thing you can do for constipation. Aim for at least eight, 8-oz glasses of water each day or around 64 ounces total which is close to 2000 milliliters.  To get this much fluid will require that you sip frequently from a water bottle throughout the day so set timers on your watch or phone, put a water bottle or other beverage right beside you, find one of those bottles that blinks or beeps to remind you to drink, whatever it takes to get the job done. Constipation is something you want to prevent if possible because of potential problems with hemorrhoids, hernias and intestinal blockages. So if you’re taking an iron supplement which tends to increase the likelihood of constipation, it may be necessary to take a stool softener for the first month or so until you can drink more fluids and eat more fiber. Stool softeners such as Colace are available over–the-counter. Again this is a question for your health care provider. Your physician may put you on some type of laxative if a problem continues but your goal is to not take laxatives on a regular basis. Your bowels could become dependent on these medications and this makes it hard for normal bowel movements to occur. Walking and daily activity and exercise help with regularity as well so discuss with your medical team how quickly you can be moving around. Before I wrap up let’s talk a little about protein. It’s the one macro nutrient you need every day and a lot of it. This never changes. Sometimes it’s constipating, especially some of the shakes and supplements. Protein sources typically contain little to no fiber. What to do: look for products such as a shake or supplement with added fiber of about 5-7 grams per serving. Constipation doesn’t have to be a pain for you. It’s knowing what to do to prevent it and relieve it when it happens. The two biggest steps that should become a daily part of life from now on are 64 ounces or 2000 milliliters of fluid every day and fiber from as many food sources as possible. Remember that certain medications, supplements and even lack of physical movement all play a part. Don’t hesitate to have this conversation with your dietitian or physician if you need to. Have a good week and I’ll talk to you soon.  

Do you think agave syrup and honey are better for you than high fructose corn syrup or sugar? You hear so many conflicting opinions on added sugars that’s it confusing and you don’t know what to believe. Right? Let’s bust some sugar myths. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Beyond Bariatric Surgery podcast episode number 37. This is the last podcast under the Beyond Bariatric Surgery name. If you listened to last week’s podcast on why avocados should be on your plate regularly, you heard that this podcast has always been about making your transformation and your journey the best it can be. Because your success is my number one focus, the podcast is getting a new name that fits this focus better. Next week the Beyond Bariatric Surgery podcast will transition to it’s new name, Bariatric Surgery Success. The podcast will provide the tools you need for your transformation. As we work on topic ideas, I would love to hear from you about the tools you need, questions you have, and topics you want to know more about. If you haven’t already, you can contact me easily from the homepage of our website. You’ll see ‘contact us’ at the top of the page and I do read all of your emails. Website: https://BreakingDownNutrition.com If you read the Breaking Down Nutrition newsletter each week, you’ll find out this week how to join the NEW private facebook group or you can join right now from the website homepage as well. Link above. You’ll see the JOIN button. This private facebook group will be your community where you can ask questions from the podcasts, suggest a podcast topic, share a success you’ve had, and find a supportive community who cares. If you’re not receiving the newsletter, sign up while you’re on the website. Ok let’s bust some sugar myths. Do any of the sugar darlings of the internet such as agave syrup or honey deserve a health halo? Probably not. I know what you’re thinking. Isn’t agave made from the same plant as tequila? Yes it is. Agave nectar or syrup is popular to sweeten teas and health drinks and is used by chefs in desserts and cocktails. The darker syrup is good on pancakes or waffles. There’s even a raw version for raw foodies. But that doesn’t make it better. #1 of the three things to know. Agave is one more sweetener choice in the ‘added sugars’ category that already includes honey, maple syrup, sugar, raw sugar, and high fructose corn syrup (HFCS) among others. The word ‘sugars’ refers to all of these. Agave and sugar have almost the same number of calories per teaspoon. You may have heard that agave syrup and honey are more 'natural' than other added sugars such as high fructose corn syrup or white sugar. Remember that the word ‘natural’ has no legal definition and means whatever you want it to mean. Actually, most added sugars have very similar processing methods which leads us to myth #2.  Let’s bust it. Sucrose or what you know as white sugar along with HFCS, fruit juice concentrate and agave nectar all undergo the same manufacturing processes. These processes include extraction, filtration, enzyme treatment and concentration. This may surprise you but because of these manufacturing processes, one choice is no more natural than another. Busting myth #3. First a little scienceb101. Digestion and absorption of sucrose and HFCS differ only slightly. Sucrose or sugar is comprised of one molecule of fructose and one molecule of glucose stuck or bonded together. With HFCS (as well as honey and fruit juice concentrate), fructose and glucose exist in free form, not bonded. They do not require this glucose-fructose bond to be broken in the small intestine. However, and this is the big take away. Once the digested sugars reach the bloodstream via absorption, this difference disappears and sucrose and HFCS are absorbed the same way. When any of these sugars are digested and reach the bloodstream, any differences disappear and the glucose and fructose act the same way in the body.  They: Deliver the same sugars At the same ratios To the same tissues Within the same time frame To the same metabolic pathways So the body doesn’t see them differently. What does this mean to you? It’s all about personal preference. Natural means what? Whatever you want it to mean. Your choice for added sugar should be based on personal preference. Remember none of the added sugars get a health halo. There are all sugars. After bariatric surgery and for your journey, less is more when it comes to added sugars. Because they just love to cause trouble in your gut, they’re known for causing symptoms of dumping syndrome….nauseas, bloating, diarrhea, sweating, abdominal cramps, etc. You likely know exactly which you may have experienced. So going back to what does that mean to you? There are a lot of names for added sugars so be sure and read labels closely. You’ll see many more names like beet sugar, molasses, nectar and others. The first three to five ingredients make up the majority of a product so see where the added sugar falls in the ingredient list. Keep added sugars to zero or a minimum. Aim for no more than 5-10 grams or one to two teaspoons. Remember that 4 grams equals one teaspoon and there are 4 calories per gram so 5 grams is about 20 calories. You may find you cannot tolerate added sugars at all without dumping symptoms or you may tolerate a very small amount. The feedback I hear in groups on dumping syndrome after added sugar intake really varies person to person. Give yourself time after surgery before adding it yourself or thru food with added sugars.This is a long term smart strategy, not just after surgery. 

This food is sugar, sodium and cholesterol free. It’s a good choice for your bariatric plate. Any guesses? OK, Think about guacamole. What comes to mind? You got it. Avocado. Say what? You‘ve heard you shouldn’t eat it because of the fat? I’ve got a lot of good news to share in just a minute. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Beyond Bariatric Surgery podcast episode number 36. If you’ve been a listener then you know this podcast is all about you…making your transformation and your journey the best it can be. Because your success is my number one focus, the podcast is getting a new name that fits this focus better. I’m excited to share this news with you first. You’re so supportive to me and I want to host a podcast that fits your journey and champions your success. In the coming weeks the Beyond Bariatric Surgery podcast will transition to it’s new name: Bariatric Surgery Success. The podcast will provide the tools you need for your transformation. I’ll continue to cover all types of topics as I do now on nutrition and health and I’ll also bring in guests to address bariatric issues outside my specialty. I would love to hear from you about the tools you need, questions you have, and topics you want to know more about. You can contact me easily from the homepage of our website, https://BreakingDownNutrition.com You’ll see ‘contact us’ at the top of the page. I want to hear what’s on your mind. If you receive the Breaking Down Nutrition newsletter each week, you’ll be the first to see the new artwork for the podcast and the first to find out how to join the private FaceBook group that will be starting soon. This private group will be your place to ask questions you might have from the podcasts, suggest a podcast topic, share a success you’ve had, and find a supportive community who cares. If you’re not receiving the newsletter, take care of that right now and sign up at the bottom of our website homepage, again https://BreakingDownNutrition.com Back to that avocado we love so much in guacamole or just sliced up and added to any dish. In it’s natural state right off the tree, avocado is all that…sugar free, sodium free, cholesterol free and a source of good fat. Plus an avocado contains at least 20 different vitamins and minerals including vitamin C, folate, vitamin E, copper, iron and zinc. It’s a who’s who of nutrition. Wait a minute, you just heard me say that it’s cholesterol free but yet it’s high in fat. What gives? Let me clear up this confusion as the avocado is a rather unique fruit. Cholesterol is only found in animal products and this is a fruit so it’s naturally cholesterol free. Think about most fruit. What macro is it mainly made of? Yes, carbohydrate. But avocado is different. A fruit yes, high in carbs, no. Instead it’s high in healthy fats called monounsaturated. This fat helps keep you feeling full or what’s called your satiety value so this fat can help curb hunger and help prevent weight regain. Avocado benefits also your bone health: one of those 20 vitamin and minerals that make up this superstar is vitamin K. It’s typically left out of the ‘how to keep bones healthy’ conversation that mainly focuses on vitamin D and calcium. Essential for bone health, vitamin K can help increase the amount of the mineral calcium that is absorbed by the body. Did you know that only one quarter of an avocado provides you about 12% of the vitamin K you need every day? But don’t miss this…if you’re taking a blood thinner like warfarin, don’t start eating large amounts of avocado quickly because of the vitamin K content. It needs to be a gradual increase and if you’re having your INR or PT levels monitored, it doesn’t hurt to let your health professional know you’ve added avocado to your diet IF you are consuming it regularly. They need to be aware of vitamin K rich foods that might alter a test. Avocados also contain natural compounds called phytosterols. Why should you care? Because they help lower LDL cholesterol, the lousy type you don’t want elevated. What a tasty way to get this benefit. Remember we said that the better-for-you fat is called monounsaturated? It also has a positive effect on cholesterol and heart health. The majority of the monounsaturated fat in avocado is what’s called oleic acid and guess what, it’s also the major component of olive oil. It’s a two for one benefit. And an extra bonus of the monounsaturated fat content is that it helps your body use beneficial antioxidants such as beta-carotene. Here’s a little cooking tip: avocado oil has a high smoke point so can take high heat in cooking such as when you stir fry. One more benefit worth chatting about.  If I say potassium, what comes to mind…banana?  You know it to be a good source of potassium right? A large banana averages 480 milligrams of potassium. Avocado probably isn’t top of mind as a potassium source but should be as a single avocado averages 975 milligrams. So it certainly ranks right up there with bananas for adding potassium to your daily diet. As you can hear, avocado is one of those rare fruits with a nutritional profile worth sitting up and paying attention to. Sugar, sodium and cholesterol free. Over 20 vitamins and minerals including potassium and vitamin K plus healthy fat and phytosterols that fights again lousy cholesterol levels. And one slice or 15 grams of avocado is only about 25 calories or 105 kilojoules kJ. Since most information online uses calories with a small c, we’ll assume here for our purposes that calories with a small c and calories with a large C are the same (even though technically they are not). This super star fruit definitely needs a place at the table. Enjoy your week.

How would you like to burn 400-500 calories in the next hour? Let’s get in a pool and make it happen. Did you know that water workouts can benefit you whether you’re preparing for bariatric surgery, already had surgery, are an athlete, elderly or just want to change up your workout routine? I have five benefits to share that may move water workouts to the top of your fitness list. Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Beyond Bariatric Surgery podcast episode number 35. Let’s go beyond bariatric surgery together and talk about everything you need to move on. Thanks so much for listening today. It’s you that makes my podcasts all worthwhile. It’s actually cool here today in Florida so you might be wondering why I’m talking about water workouts but if you’re in Australia and that part of the world, your enjoying summer. Water workouts including swimming or running in deep water where your feet don’t touch the ground are popular cardiovascular conditioning exercises with at least five benefits. #1. The buoyancy of water creates an environment for an aerobic workout without the strain on the skeletal system. Injuries are rare, making deep-water running a good training option if you’re an athlete prone to repetitive stress injuries, if you’re elderly and susceptible to fractures or you just want a lower impact workout. These workouts also are smart to help with weight loss before surgery or after surgery, about four weeks down the track when you’ve been cleared by your medical team to exercise. Water workouts are fun…I love them…and since it’s low impact exercise, it’s a good way to get back into your regular groove of some type of movement. #2. Your heart rate can be 10-15 beats per minute lower in water due to natural resistance against the body’s surface. The result is a decrease in blood pressure and improved lung function. Wearing a flotation device or what’s called a wet vest, such as an AquaJogger, can assist in maintaining good posture and form that allows for an effective workout. It’s my favorite way to work out. Our heat is so intense here in Florida, especially in the summers, that water workouts became my go-to years ago. I use an AquaJogger and some days I add hand weights and booties that make you work harder as you jog. Be sure and watch the super short video of Regina, one of my dietitian buddies and collaborators, showing you an AquaJogger, water weights and how she uses them. Resources: The video is on the page with this podcast on our website https://BreakingDownNutrition.com Link to Video:  https://www.breakingdownnutrition.com/blog/5-benefits-of-water-workouts-before-and-after-bariatric-surgery While I’m thinking about it, be sure and sign up for the Breaking Down Nutrition newsletter while you’re there. The newsletter is where I share all the news first…new freebies, podcast episodes, recipes, whatever’s going on and it’s also a way for you to hit reply to the newsletter and communicate with me. I read all your email and love hearing from you. By the way, I actually wore out my AquaJogger after years of use and had to replace it. For me, water workouts are a major stress reliever. Benefit #3 for water workouts. Pool water temperature is usually lower than your body temperature, which increases your metabolic rate or rate at which your body burns calories. Who doesn’t love that? #4. Water workouts can help improve your blood glucose or blood sugar level and have a positive effect on lipids like the cholesterol family. #5. Of course I’ve got to mention the calorie burn, which is 400-500 calories for an hour workout…not bad. These five benefits make water workouts effective ways to improve and maintain your health plus they are a terrific way to help lose weight as you prepare for surgery and then to help prevent that dreaded weight regain.  

Oh how we love our coffee and tea. But can you have caffeine after bariatric surgery? As a dietitian, I hear different answers on this from other dietitians and medical professionals. There’s a lot of buzz on bariatric surgery and caffeine. What are the current science-based recommendations and why? Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Beyond Bariatric Surgery podcast episode number 34. Let’s go beyond bariatric surgery together and talk about everything you need to move on. This podcast is all about you…making your transformation and your journey the best it can be…sharing what you need to know and how to do it. Have you heard that caffeine is dehydrating so if you drink something that contains caffeine, you then need to drink even more water? Or maybe you heard that you can’t drink anything that contains caffeine because if you do, it will cause you to become dehydrated? Let me say right now that the recommendations on caffeine that I share here on the podcast may be different from what you’ve been told. They’re based on the most current science. It’s always important to check with your surgeon or bariatric dietitian before you change your diet. They may not want you to have caffeine for a specific reason. The older science said that caffeine in fluids was dehydrating and therefore required extra water to make up for it. The current science, which has been out for a while now, says that caffeinated fluids are as good as other fluids for keeping you hydrated. In fact the American Society for Metabolic and Bariatric Surgery who makes many recommendations for care after surgery suggests avoiding caffeine for at least the first thirty days after surgery while your body is still sensitive and healing and then checking in with your bariatric dietitian or surgeon if you want to add caffeine back to your diet. Let’s put caffeine aside just for a moment. Did you know that dehydration is among the top reasons for readmission to the hospital after surgery? Dehydration happens when your body runs low on fluids and can’t function as it should. Fluids do so many beneficial things in the body but when you think specifically about burning calories after your surgery, fluids help burn stored fat calories for energy. Often your thirst mechanism doesn’t tell you to drink enough so it’s important that this become a new habit or put back on the radar if you drank a lot of fluids before. Bottom line, drink even when you’re not thirsty. Aim for 64 ounces a day total from all your fluids. If eight ounces equals one cup, then we’re talking about eight cups. Keep a water bottle with you. It helps you to remember and it’s always handy. How can you tell if your drinking enough fluids? Look at your urine. I want you to pee and then take a look. If you’re drinking enough, your urine will be clear or a light color. Darker urine is your sign to drink more unless you’re taking medications or supplements that could change urine color. A good question to ask your medical team if you’re taking meds. Some signs of dehydration to watch for: thirst, headache, hard stools and constipation, or dizziness when you stand up. Always reach out to your surgeon’s office if you can’t drink enough fluid to stay hydrated. Ok, back to caffeine specifically. As we just talked about, caffeine is not a problem for dehydration, so at some point you’r likely to add coffee and/or tea back to your daily diet. What’s typically added to your coffee or tea? What usually partners with it? Think about some of the high calorie flavored coffee drinks…cream or full fat milk, sugar, flavored surgery syrups. These can easily be calorie bombs and ruin all your hard work. Good news. There are several things you can do to cut the calories and enjoy your beverage:     If you add caffeinated coffee or tea back to your day, start with a caffeine-decaf mix. See how the caffeine affects you and then gradually work your way to full throttle on the caffeine.   Use a zero calorie sweetener or syrup if you need sweetness. Try to stay away from sugar or else use a very tiny amount of it or a tiny amount of honey. Remember these carbohydrates can cause dumping. The last thing you want to do is add a bunch of calories back to your diet thru your coffee and then have dumping syndrome. Not fun. Let’s prevent that.   Add a little bit of non fat milk. Why? Double bonus: protein and calcium. Milk contains both. Every little bit adds up.   Caffeine is not related to dehydration but caffeine can be nemesis for a couple of reasons that are worth asking yourself if they’re an issue for you. 1. Caffeine irritates GERD or reflux as well as heartburn. It’s smart to nix the caffeine until the situation is resolved. 2. Did you know that caffeine is a hunger suppressant? I hear you. You’re thinking, that’s great. It will help me keep my calories under control. And before you had surgery, that’s true. But when you’re recovering from surgery, the last thing you need is to not be hungry. Why? Because you have protein goals you’re trying to meet for healing as well as to keep your muscle mass when you’re already eating significantly less calories than before. Remember muscle mass is your calorie burning machine. If you’re not hungry, it gets hard to take in the protein your body is asking for.   A successful surgery already decreased your hunger and appetite for weeks after and if you drink fluids containing caffeine, do you see where it could reduce most of your desire to eat at all? Talk about making it hard to get in protein, this will do it. 3. One last reason that caffeine is often avoided for a while is the speed at which food moves thru your system or what’s called increased gut motility. Did you ever drink a cup of coffee only to need to poop or go number two soon after? If so that’s an effect of your gut moving things thru more quickly. After surgery this could be a problem if you’re digestive system has been significantly altered. You may be moving thru food that is not completely digested. Remember the issue for caffeine is not dehydration but rather other potential issues where it could play a part such as GERD, suppressing your hunger when you need to eat, or pushing food thru your system too quickly. That’s why as I say most every week, your case is specific to you. It’s important to me that you have the best success possible on your journey forward. So ask about caffeine intake as it relates to your surgery. Before I go, thank you for letting me know that dumping syndrome is a real pain point for you. You asked for a cheat sheet to go with the podcast #32 on dumping syndrome so I’ve put together a freebie just waiting for you: 4 Tips to Keep Dumping Syndrome from Dumping on Your Day. Let me know how you like it and which tip works best for you….have a great week.  

You did it. You’ve had bariatric surgery and your transformation is happening. Did you know that your body also goes thru a lot of changes in how it uses the vitamins and minerals found in food? Maybe you’ve heard you need to take vitamin D. If so, how much do you need to take and do you get it from food or a supplement? Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Beyond Bariatric Surgery podcast episode number 33. Let’s go beyond bariatric surgery together and talk about everything you need to move on. This podcast is all about you and making your transformation the best it can be. I'm sharing what you need to know and how to do it. In your body, vitamin D wears many different hats. It’s responsible for working with the minerals calcium and phosphorus to help them absorb correctly. And you’ve probably heard that Vitamin D prevents and treats osteoporosis or weak and brittle bones. It’s also very important in maintaining a strong immune system. But did you know that 50-80% of people who have bariatric surgery have a vitamin D deficiency? How do you know if you need to take vitamin D? The best way to find out is to ask your health care provider to check your vitamin D level with a blood test. There are other types of tests that can be run but this is a common one to start with. Let’s look closely at your 5 things to remember about vitamin D and bone health: 1. When you have that blood test checking for your vitamin D level, 30 & 75  are your numbers to keep in mind. Lab measurements vary country to country. For example, a serum 25-hydroxy vitamin D level, that’s what your blood level of vitamin D is called, is technically measured as nanograms per mililiter (ng/mL) in the US with 30 or above being the number you’re aiming for regardless of the type of procedure you’ve had. In Australia and other countries, the measurement is in nanomoles per liter (nmol/L) so the equivalent number is 75 or above. Current guidelines for bariatric surgery suggest that the blood level should be maintained at greater than 30ng/mL in the US or (>75 nmol/L) in Australia. This gives you a basis for discussion with you health care provider. 2. Bariatric clinical guidelines suggest supplementation on an individual bases to maintain this vitamin D level at 30. What does this mean to you in supplements: a daily dose of 2,000 to 3,000 IU (50-75 mcg) per day. Notice this time I start with supplements instead of food. It’s hard to get the amount you need after surgery without a daily supplement. Know right now that you will vary in how you respond to this dose. Also some health care professionals will recommend supplements daily, some several times a week, others monthly. Just depends on your blood work and other health conditions you may have. Tune in closely here for this tip: Take your supplement with food as this can increase how much of the vitamin D your body absorbs. 3. Yes, you can get vitamin D from sunlight: about 10-15 minutes to the face, arms and hands at least twice a week, no sunscreen; but it’s usually not enough to keep your level where you need it due to changes in how your body absorbs it. Also, if it’s not possible to be outside or you are dark skinned, concerned about skin cancer or even depending on where you live, the sunlight idea is not going to work to bring you up to the level you need or keep you there. After bariatric surgery, you need more vitamin D so supplements are the answer here. 4. You can add foods fortified with vitamin D to your daily diet. Fortified means that vitamin D is added to the food product such as added to milk, orange juice, nutrition bars, and breakfast cereals. For example, one cup of milk averages 100 IUs of vitamin D.  You can see it would be hard to get 2000-3000 IUs from food each day. 5. Don’t forget vitamin D’s playmate…calcium. Not only are you at risk for a low calcium intake prior to surgery, but the body’s ability to absorb it decreases after surgery. Think of vitamin D and calcium as team players so you need adequate amounts of each every single day to keep your bones healthy and strong. They work together. How much you need depends on your surgery.  If you and your health care provider are working to build your levels back up, you’ll want to take vitamin D that we just mentioned, 2000-3000 IUs every day plus 1200-1500 mg of calcium citrate if you had adjustable gastric banding, vertical sleeve gastrectomy, or Roux-en-Y gastric bypass. If you had bilio pancreatic diversion with duodenal switch you will likely need more calcium, 1800-2400 mg daily. Remember these are the bariatric guidelines but your case is specific to you, so please discuss it. As we wrap up, let’s quickly review these 5 things  that are so important for your successful transformation: 1. Have a blood test checking for your vitamin D level. 2. Get vitamin D from sunlight: about 10-15 minutes day when you can to help out but not to be the sole answer. 3. Add foods fortified with vitamin D to your daily diet. 4. Take your supplement with food; remember 2000-3000 IUs every day. 5. Don’t forget vitamin D’s teammate: calcium…important to take daily too I hope you’re enjoying these Beyond Bariatric Surgery podcasts. Don’t forget you can sign up for my weekly newsletter so you are the first to hear about new episodes and all the news and freebies of course. Head on over to BreakingDownNutrition.com and sign up on the home page. You’ll also see two freebies you can get as well if you haven’t…one on mindful eating and one on protein. Have a really good week.  

Stomach ache, sweating, headache, dizziness, nausea…even diarrhea. Experiencing dumping syndrome is no fun, it wrecks your day and can interfere with your weight loss journey. Let’s talk about four smart strategies to help prevent this dumping. You’ve had bariatric surgery. Are you experiencing dumping syndrome? You’re not alone, up to 30% or more of everyone who’s had bariatric surgery experience dumping syndrome. With stomach ache, sweating, headache, dizziness, nausea, and even diarrhea as common symptoms, dumping syndrome ranks right up there as one of the most undesirable effects of bariatric surgery. What is it? The name dumping sounds intimidating but also kinda gross. What is your body doing? It’s actually rapid emptying of food from the stomach into the intestines. Dumping syndrome can be grouped into two different types; early and late. Early dumping syndrome occurs almost right away…about 10-30 minutes after you’ve had a meal while late dumping syndrome occurs about one to three hours after you’ve eaten. So which one is bothering you? Or both? You can have both. Yes, dumping occurs frequently especially when you eat a meal high in carbohydrates. This is important to your journey and success. Too many carbs or the wrong type of carbs can cause havoc in your gastrointestinal track or let’s just say…your gut. While more people experience early dumping syndrome than late dumping syndrome, you can experience both even years after surgery. You may be asking me right now…Why does this dumping happen? Let’s have a short physiology class. I’m a big believer that knowledge is power…the more you know, the better you can feel as you go thru your transformation. After bariatric surgery, parts of the stomach may be removed or bypassed which cause food to be improperly digested or undigested in the stomach when you eat. In early dumping syndrome, the undigested food then enters the small intestine and draws water from the stomach and other surrounding tissues causing the small intestine to become bloated and cramped. This can lead to diarrhea, nausea, and vomiting. Do you remember when early dumping syndrome typically occurs? Early dumping syndrome occurs almost right away…about 10-30 minutes after you’ve had a meal. In late dumping syndrome, the undigested (particularly high-carb) food rapidly enters the small intestine and gets rapidly broken down into glucose or sugar and then gets absorbed into the bloodstream. The rapid increase in sugar level in the bloodstream causes your pancreas to release huge amounts of insulin in order to lower the sugar level in the blood back down. However, the pancreas releases too much insulin and ends up causing hypoglycemia or low blood sugar. Low blood sugar leads to symptoms such as weakness, trouble concentrating, and a high and irregular heartbeat. While late dumping usually starts one to three hours after eating high-sugar or high carb foods that are more processed and low in fiber, it can take longer for you to feel the symptoms of hypoglycemia. I recommend talking to your physician on how to manage your hypoglycemia if this happening. I want to stop here a second and mention that if you drink alcohol or have been wondering if you can and how it would affect you, be sure and listen to podcast #30 Bariatric Surgery and Alcohol Buzz: What You Need to Know. Alcohol can also cause hypoglycemia and a super quick buzz/intoxication so understand what’s happening to your body. be sure and listen. The link is below in the resources. Now you’ve got a good idea of what’s happening in your body to cause Dumping Syndrome, how do you prevent it? Experiencing dumping is no fun, wrecks your day  and can interfere with your weight loss journey. Practice these four smart strategies to help prevent this dumping: 1. Eat small meals 5 or 6 times per day Since dumping occurs when a large amount of food enters the intestine too quickly, you may find that eating smaller meals throughout the day can prevent that. 2. Drink fluids between meals not with meals Fluids increase the volume in the stomach which leads to dumping. Drink water at least 30 minutes before and after meals to stay hydrated and avoid dumping. 3. Consume foods with higher protein and fiber Unlike carbs, protein is digested in the stomach thus slowing down the movement of food from the stomach into the intestines which lessens the chance for dumping. Then Fiber acts as buffer and prevents food from absorbing too quickly.  Go back and listen to podcast #31, Does Protein Help Prevent Weight Regain…you’ll understand even better the tie between protein, weight loss, and control of dumping. See Resources below. 4. Consume less simple carbohydrates and fats The majority of carbs and fats that you consume get digested in the small intestine, thus food high in carbohydrates and fats enter the small intestine very quickly as we mentioned already. So the more protein and smaller amount of carbs eaten with the protein, the better. Notice I didn’t say NO carbs. Just be smart. And here, when I say eat less simple carbohydrates, I’m talking about ones that have very little or no fiber and very little nutrition. Resources: #30 Bariatric Surgery and Alcohol Buzz: What You Need to Know #31 Does Protein Help Prevent Weight Regain?

Let me guess...before your surgery and especially after, you’re told to consume protein, protein, protein! Why is it so important? Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Beyond Bariatric Surgery podcast episode number 31. Let’s go beyond bariatric surgery together and talk about everything you need to move on. So back to protein and why it’s so important. Not just for a bariatric lifestyle, protein is important for everyone. All of the cells in your body are made up of protein and we need it to keep us healthy. In fact, did you know that the word protein comes from the Greek  proteios meaning primary or of prime importance. During surgery, significant changes are made to your digestive system. These changes vary depending with the type of surgery but all involve some level of malabsorption or the inability of nutrients to be properly absorbed and then used by the body.   After bariatric surgery protein helps you heal the wound, form enzymes and hormones, and it works to build and maintain muscles. Fat free mass or muscle mass, by the way, is the calorie burning machine in the body which improves body composition...meaning more muscle mass and less body fat mass. Think of it this way. Protein helps to keep your metabolism stoked. Another bonus is that protein keeps you feeling full ultimately helping to prevent that dreaded weight regain.To have the best bariatric success in your transformation and journey, monitor your body and your protein intake closely.  There are some signs that you're not getting enough protein. YES, protein is so important that your body will show signs if you’re not getting enough. Protein is critical for muscle mass so if you’re not getting enough you’ll notice muscle loss and weakness. You’ll also see that your hair is thinner and nails are weaker and more brittle. After surgery you’re eating significantly less calories but you need more protein. As you’ve probably found out already, this can be tough, right? So what’s the smartest strategy as you go thru your transformation? Your smartest strategy for success is to make protein THE priority in meals and snacks. By eating nutrient-dense foods packed with protein, you can make sure that your body is getting everything it needs to rock your new lifestyle and help prevent weight regain.  So what is a nutrient dense food exactly? Nutrient-dense foods have relatively high amounts of nutrients meaning vitamins and minerals compared to their calories. So something like an apple is nutrient-dense because it provides a wide variety of vitamins and minerals for a low amount of calories while something like chips are calorie-dense because they provide basically zero nutrition for a lot of calories.  Do you know how many grams of protein you need daily? The recommendation for protein is 60g to 90g... everyday. Yes, you heard that right...everyday...from now on. Tall order I know but oh so worth it. Remember I said your smartest strategy for success is to make protein THE priority in meals and snacks? In order to get in that much protein supplements can help. Protein powders are widely available and can be used in many different recipes. I’ll do a podcast on choosing the best protein powder in the coming months. On top of eating enough protein, you also want to eat the right protein. I know you're probably thinking, really, there’s more to this protein? Yes! Here’s what’s important to know. Protein is made up of amino acids...think of them like lego building blocks... and there are nine of them that your body needs from your diet because the body cannot make them. These are called essential amino acids and can be found in what’s called complete protein sources such as meats, poultry, fish, diary, eggs. Quinoa, and soybeans are complete planted based protein sources in that they contain all 9 essential amino acids in the amounts needed by the body.  So as we wrap up, your takeaway is that protein is your smartest strategy to help prevent weight regain. Make it THE priority in your meals and snacks. Aim for 60-90 grams a day. Let me help you a little…grab the FREEBIE: The 5 Fast-Ways Guide to Add Protein to Your Diet. Link below. Try some of these easy ways to add more protein to your day. Have a great week and I’ll talk to you to you soon. Freebie: https://bit.ly/3migTnU

Should you drink alcohol after weight loss surgery? If so, how much can you drink and how fast will you become intoxicated. Let’s talk about it in just a minute. Thanks so much for all the love you showed me after my first new episode that posted last week. And a shout out to Katiein2021. I hope you’re listening. Thank you for your 5 star review on Apple podcasts. I’m glad to hear you find the podcasts so helpful. It’s my passion and my goal. I’m happy to know you’re a long time listener and thank you, I’m glad to be back too. Let’s get on with this discussion on alcohol. Should you drink alcohol after weight loss surgery? If so, how much can you drink? The Quick Answer It depends on how far along you are since your surgery. The general guideline is that you should not drink alcoholic beverages until at least 6 months (up to 1 year) after surgery. And it’s important to consult your healthcare provider about drinking alcohol after your surgery just to be sure. We’re all different, surgeries vary and you are unique so have this conversation.  So why is it that you can’t have alcohol until after 6 months post-surgery? During the early months after surgery, you are rapidly losing weight and you‘ll be most sensitive to toxic effects of alcohol. Those effects include hypoglycemia or low blood sugar. Alcohol can low blood sugar. Typically you’re already following a low carb diet and drinking alcohol reduces the supply of glucose to your brain causing a loss of coordination and balance, slurred speech, poor vision, and confusion. These are all conditions that mimic and look like those associated with intoxication. You can see how the result from a drink or two could be both hypoglycemia and intoxication.   Low blood sugar can cause dizziness or even loss of consciousness. On top of low blood sugar, alcohol inhibits the absorption of B vitamins such as B12 and thiamine. Even without alcohol, you may already be struggling with getting in these vitamins due to surgery. Deficiency of these B vitamins may make you weaker and have less energy. Alcohol contains a lot of empty calories...which is the opposite of nutrient dense. Basically it’s calories and no nutritional benefit to the body so you have to think about and make the decision in terms of how important it is to you. Let’s dig deeper. One of the big changes after surgery: Alcohol Sensitivity If you’ve had alcohol already, did you notice that you got more tipsy from just a few sips? Were you thinking to yourself...hey, what’s going on here…I've only had a few sips and feeling a buzz. That’s because alcohol absorbs way faster after weight loss surgery especially if you had gastric bypass or a gastric sleeve. Couple that with the suggested rule of not drinking and eating at the same time and BOOM you become extremely sensitive to alcohol. In fact, research has found that the blood alcohol content in people who’ve had weight loss surgery is about 50% higher than people who have not had surgery and it requires a lot less time for this blood alcohol level to peak. That means that that it could take you only part of a drink or one drink to become intoxicated enough to not be able to legally drive. Did you miss that? Listen closely…this is really important. It could take you only part of a drink or one drink to become intoxicated enough to not be able to legally drive.  I don’t want to wrap up without mentioning Alcohol and Addiction Transfer Did you know that food addiction prior to surgery could transfer to addiction in other substances such as alcohol? IF you want to know more about alcohol and addiction transfer, listen to my podcast #27 with psychologist Dr. Connie Stapleton (link below). She answers some tough questions about alcohol and addiction transfer and gives you a lot to think about. Remember…drinking alcohol after surgery, even in very small amounts, can cause intoxication much more quickly than you ever thought possible and likely cause hypoglycemia or low blood sugar. Having surgery alters your lifestyle but it doesn’t take away the enjoyment of life. Someone is always throwing a party, event  or celebration with various food and drinks. So what do you need to know to navigate the bariatric lifestyle for your next event? Here’s how you can drink smartly if you make the decision to include alcohol: Don’t drink on an empty stomach. Enjoy your drink after finishing your meal. Drink slowly. Since alcohol absorbs very fast, make sure you take sips throughout a long period of time. Know when to stop and opt for non-alcoholic beverages instead. Be sure and take your bariatric vitamin and mineral supplements Have a designated driver since your balance and brain function can be affected by very small amounts of alcohol Want to work on your mindful eating as you think about including alcohol? Grab the 6 tips to Eat Mindfully freebie. Link below. Resources: #27 Dr. Connie Stapleton: https://www.breakingdownnutrition.com/blog/27-alcohol-issues-after-bariatric-surgery FREEBIE 6 Tips to Eat Mindfully: https://bit.ly/3mMS3wM

You’ve had bariatric surgery and now that scale is starting to creep back up and you don’t like it at all. You’ve heard that going keto is the answer, right. But is it? Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Beyond Bariatric Surgery podcast episode number 29. Let’s go beyond bariatric surgery together and talk about everything you need to move on. Thanks so much for being here. If this is your first podcast, I appreciate you listening. If you were a prior listener you know I’ve been on a lengthy hiatus due to some major incidents and tragedies in my office and at home. As I’ve come out of the darkness, I’m so grateful to once again be behind the microphone. I hope you find these episodes to be just what you need in your day-to-day journey and transformation after surgery. Resources mentioned: FREEBIE: The 5 Fast-Ways Guide to Add Protein to Your Diet https://bit.ly/3migTnU

OK, be up front with me. Have you achieved what you set out to do whether it’s your weight, health or other goals? When was the last time your needs, your health, your weight, YOU were a priority?  As we wrap up our first podcast season let’s find out why this is so hard plus how to put strategies in place to help prioritize that ME time and achieve what you set out to do. Email guest Jenne Turner, health psychologist: jenne.t@bigpond.net.au

Was alcohol part of your lifestyle before you had bariatric surgery? Could alcohol be an issue after surgery? Is it tied to weight loss OR to your desire for food? Let’s ask psychologist Dr. Connie Stapleton some of these questions. Ways to contact Dr. Connie: http://www.conniestapletonphd.com twitter: @cstapletonphd    Instagram: https://www.instagram.com/cstapletonphd/ YouTube: https://www.youtube.com/user/ConnieStapletonPhD Facebook: https://www.facebook.com/conniestapletonphd/

Have you ever been called big-boned, chubby, fatty or other hurtful names? I'm talking to Marty Wolff who calls himself the ‘Chubby Whisperer’. He’ll share his experience with name-calling, his struggle with obesity, appearance on NBC’s The Biggest Loser, bariatric surgery and his mission now. Find out more about Marty: Ted-x Talk https://youtu.be/AbGhAGfVtrs Speaking Site http://chubbywhisperer.com Podcast "Chubby Talk" subscribe on iTunes and Stitcher Our Facebook page: http://facebook.com/beyondbariatricsurgery Our Facebook group: https://www.facebook.com/groups/bariatricsurgeryeating/

Have you heard the saying “Life is 10% what happens to you and 90% how you respond to it.” Dan Grieb has applied this saying and mindset to every aspect of his life – from fatherhood to business, health to wealth, and everything in between. Dan will share his journey, how he accomplished his ultimate physical goal after surgery as a triathlete and what you don’t want to miss… the belief he had prior to weight loss that he no longer has. Contact Dan Grieb: Website: hometosell.com Dan's personal facebook page: https://www.facebook.com/dgrieb Team facebook page: https://www.facebook.com/DanGriebTeam/ Dan email: dan@hometosell.com

Have you been diagnosed with polycystic ovary syndrome or PCOS? Felicity was rocked by the news that she would never conceive children normally when diagnosed with polycystic ovary syndrome or PCOS at only 24. After struggling with her weight since her early 20s, she was diagnosed with PCOS and told she would likely never get pregnant. Felicity joins me on the podcast to share with you her story of discouragement followed by hope and a happy ending. You have to hear her story.

So you’ve had bariatric surgery and you know some people take bariatric vitamins. But you’ve also heard they’re not necessary. Who’s right and why? On today's podcast, Amanda Clark, bariatric dietitian and our podcast content director is here to help you cut thru the confusion surrounding bariatric multivitamins. Creator and author of the Portion Perfection kits for Weight loss and for Bariatrics, Amanda believes that when you see how much is right to eat, and you have practical tools to help you… you have a much greater understanding of what to do and how to do it. Let’s jump right in and ask Amanda what is a bariatric multivitamin and what makes it different from a general multivitamin? Listen now and don't miss a single tip.  Get your BN Multis

Have you lost a lot of weight whether thru diet and exercise or bariatric surgery? Now that you’ve succeeded with weight loss, are you interested in body contouring surgery to take care of that loose skin but have no clue where to start or what questions to ask? Stay right where you are. Let’s talk to plastic and cosmetic surgeon Dr. Richard Maxwell and ask him all kinds of questions. Joining me on the podcast via Skype from Melbourne Australia is specialist plastic surgeon Dr. Richard Maxwell. Gaining extensive experience in post trauma surgery following motor vehicle and industrial accidents, Dr. Maxwell then moved into Cosmetic Plastic Surgery where he has a passion for transforming bodies after extreme weight loss thru diet and exercise or bariatric surgery. Thank you for sending in your questions. Dr. Maxwell answers them and more. You can find out more about Dr. Maxwell on his website https://www.maxwellplasticsurgery.com.au  

When you think about your weight, whether you want to lose weight or maintain, what do you think about? Food? Sure. Your diet? Of course. Plus we all know exercise is an important part of the puzzle, right? Is exercise considered movement? Or how is it different? Is movement just as beneficial? Does it burn calories? Let's talk to exercise physiologist Jennifer Smallridge and find out. When she’s not working with clients, Jennifer is an academic lecturer in the fields of Exercise Science and Human Anatomy.   Jennifer has a special interest in helping people to get moving before and after weight loss surgery, as well as behavior change of any type to live a healthier, more fulfilling life. She’s a strong believer in the use of exercise as medicine. A physiotherapist or physical therapist treats patients and uses several techniques to treat and manage injuries and pain, whereas an exercise physiologist helps to get people moving despite the fact that you may have physical limitations. It’s based on the principle that every human body would benefit from the right type of exercise. Jennifer says it's her role to know the response that the body has to exercise and then how to prescribe exercise for maximum benefits.  You can find out more about Jennifer on her website or Melbourne Health and Nutrition Specialists Facebook - https://www.facebook.com/melbhealthspecialists/ Instagram - https://www.instagram.com/health_specialists/

We see a lot of chatter about carbohydrate in our Bariatric Surgery Eating Group on Facebook. Some people think carbs are bad and try to never eat them, others fear carbs and still others love carbs… especially the less healthy ones. Are you confused and don’t know what to believe about carbs? Every friend tells you something different? To make it more confusing, some post surgery medical teams advise very little carbohydrate in the diet while others caution their patients not to cut carbs too low. This idea that carbs are bad is flat-out wrong diet information and leads to unhealthful eating. Let’s get the carb facts you need. Joining me via Skype from El Paso, Texas is registered dietitian nutritionist and bariatric dietitian by day Jenifer Tharani. She founded Archaic Nutrition & Lifestyle, a nutrition & wellness practice that helps clients manage diabetes, enjoy heart health, and achieve desired weight loss. Her focus is a whole foods approach instead of clinging to super foods or fad diets as a short cut to health & wellness. Jenifer's website: https://archaicnutrition.com/ Instagram: https://www.instagram.com/SouthAsianDietitian/ Facebook: https://www.facebook.com/archaicnutrition/ Obesity Action Coalition Reference: http://www.obesityaction.org/wp-content/uploads/What-is-Dumping.pdf

Are you struggling to become pregnant and don’t know what to do? You’re already well aware there’s a list of reasons why women don’t get pregnant and you’re feeling frustrated. But did you know that what you eat in the months leading up to conception drastically impacts your chances of conceiving? Weight problems are common among reproductive age women putting them at increased risk for problems with fertility and pregnancy. Some women have chosen bariatric surgery specifically to improve their fertility so they can start or add to their family. How prevalent is infertility related to weight? Let’s talk to fertility dietitian Melanie McGrice. Joining me via Skype from Melbourne Australia is Melanie McGrice who’s an Advanced Accredited Practising Dietitian with a special interest in fertility and pregnancy. Melanie runs online programs for women who are pregnant or trying to conceive.  She’s the author of ‘The Pregnancy Weight Plan’ and runs the Youtube channel ‘Nourish with Melanie’. Melanie's YouTube Channel: https://www.youtube.com/channel/UCEMqzbbepjpirMANLvA2TEQ Melanie's Website: http://www.melaniemcgrice.com

Do you feel like you blink and it’s another New Year? Have you thought about the New Year and what you want to accomplish? Do you have dreams that you hope come true? I do. Do you set goals or resolutions with a plan of action or do you wait and see where life takes you? A new year is the time for a fresh start with a clean slate…your motivation’s high and anything seems possible…right? Did you know that over 40% of people make new year’s resolutions yet 80% of those resolutions fail within 3 months? Why is that? Can we do better? Or are we going about it the wrong way? Maybe you think about making resolutions and your ‘but’ gets in the way. No, not your b-u-t-t…butt...not your booty.  I’m talking about the ‘b-u-t’ but that keeps you stuck in your rut and prevents you from moving ahead, reaching your goals and making your dreams come true. You know the ‘but’…you would like to take that yoga class ‘but’ or you really need to get more sleep ‘but’ or you know you should eat healthier ‘but’ it never seems to happen. Joining me on the podcast from Australia is resident psychologist on Australia’s The Biggest Loser: Transformed, Glenn Mackintosh. Glenn is back to help you kick the ‘but’ out of your life and make sure your New Year’s resolutions are beneficial… not a bust. Click to find out more about our courses and to sign up for courses Check out Glenn's psychological profile for weight management Check out Glenn's other programs to help you transform  

Do you gain weight during the holiday season? Many people do. What can you do differently this year and still indulge in all of the festive fun? Amanda Clark, bariatric dietitian and our podcast content director, joins me to share seven real world tips to help you steer clear of those holiday food traps.

Did you know that food and what’s in food meaning the vitamins, minerals and other nutrients such as protein affects your mood? Food, your brain and your mood are so interconnected. In part two of the food-mood connection, let’s talk more about the food you choose to eat, what’s in the food you choose to eat and how it can influence your mood. She’s back…joining me on the podcast is our content director and bariatric dietitian Amanda Clark. In part one of the food-mood connection we identified a lot of different foods you can eat more of to improve mood. If you missed episode #8 go back and listen. Thank you for your feedback. You asked us to delve even deeper. Cathy asked "So say we’re already eating really well but are still experiencing some mood issues like depression, are there some particular nutrients that are beneficial for mood?" We answer her question and share even more tips in part 2. My favorite green smoothie on the Pinterest Best Smoothie Recipes board: https://www.pinterest.com/pin/112238215685306006/  

Has a friend told you to have your vitamin B-12 level checked or to take vitamin B-12 for your brain?  Did you know it’s important after bariatric surgery too? Vitamin B-12 plays a role in keeping your brain healthy and helping to prevent Alzheimer’s disease. It’s a critical nutrient that your body cannot make and it’s very important after bariatric surgery. Let’s talk about why you need it and where to get it. Joining me on the podcast from Orlando Florida is bariatric clinical dietitian Gayle Brazzi Smith. Gayle is the Bariatric Dietitian for the Bariatric & Laparoscopy Center at Orlando Health. She is committed to a patient-first approach to providing nutrition services to both bariatric inpatients and outpatients in Central Florida. You can find out more about Gayle at http://www.jawadmd.com or contact her at Gayle.BrazziSmith@orlandohealth.com

Are you considering bariatric surgery? Do you think you may have binge eating disorder? The trifecta of binge eating, obesity and bariatric surgery can create a complex health situation. We'll share information that's very real, honest and helpful. If you are thinking about bariatric surgery, you have come to this place for different reasons. No two of you are challenged by food or have gained weight for the same reason. Take the time to talk with a professional trained in eating disorders and bariatric surgery. It can help in the decision process as well as helping in the recovery journey to make your surgery a success. Joining me from Orlando Florida is Karen Beerbower, a registered dietitian nutritionist and certified eating disorder dietitian. Karen serves on the Senior Advisory Board for the International Association of Eating Disorder Professionals known as (iaedp), and is an iaedp Fellow. For years she was an instructor training bariatric physicians and brings her knowledge and experience to her patients in Orlando as well as through tele-health. You can find out more about Karen on our website http://www.KarenBeerbower.com

Are you struggling to lose weight following bariatric surgery? Maybe, you have stopped losing weight. Do you remember our guest Joanne Ballantyne who stopped losing weight very soon after her surgery? Amanda Clark, Joanne’s dietitian, sent her for a metabolism test to find out what was going on. In this episode, I’ll talk with Mark Barrett, the physiotherapist who performs these tests. For the past 10 years Mark has used gold standard equipment at his Jupiter Health Metabolism Clinic to perform metabolism analysis for people from all over Australia…particularly for bariatric surgery patients at key stages during the process. The name of the testing is Indirect Calorimetry for REE and EEE. Find out more about Mark on his website http://www.jupiterhealth.com.au and Facebook https://www.facebook.com/PhysioLogic

Do you notice you’re hungrier when you’re tired? Does lack of sleep or poor sleep affect your weight? We live in a world that goes 24-7, which makes it difficult to turn off, doesn't it? I’ve wondered how much of the weight problem we have today is influenced by sleep – we’re up late, we’re on electronic devices, we have 24-hour retail outlets and shopping online. What do you think? Let's talk to Amanda about how sleep or lack of it could affect your body and your weight. Joining me via Skype from the Gold Coast of Australia is our content director and bariatric dietitian Amanda Clark. Besides keeping the podcasts and me on track, you may recall that Amanda has spent 15 + years helping over 2000 patients. Creator and author of the Portion Perfection kits for Weight loss and for Bariatrics, Amanda believes that when you see how much is right to eat, and you have practical tools to help you, you gain a much greater understanding of what to do and how to do it.

Have you lost weight and find that the reactions from your family, friends and …even strangers have changed? Lately there’s been conversation in our Facebook Group… Bariatric Surgery Eating… about personal relationships and how they’re affected by significant weight loss. Have you experienced this too? Perhaps this is something that’s worth thinking about before bariatric surgery. Let’s find out in this podcast. Joining me via Skype from the Gold Coast of Australia is registered health psychologist Linda Valmadre. Founder of Bariatric Psychology Services she’s a member of the Australian Psychological Society with 12 years of experience working across a broad range of issues including complex trauma and domestic violence. Linda has a special interest in bariatric psychology to support her clients with relevant strategies to help them achieve and maintain their healthy weight goals for life. Don't miss Linda's positive strategies for dealing with relationships after surgery. Check out Linda's website at http://www.bariatricps.com.au

Are you considering bariatric surgery but feel overwhelmed with all the information? Wondering where to begin and what to do so you have the best success and outcome? Joining me via Skype from Western Australia is Cynara Stalenhoef who’s going to share her story of preparation and success after overcoming major obstacles. A Virtual Assistant specializing in Digital Marketing Automation by day and wife and mom of two kids ages 10 and 8 by night, Cynara had a gastric sleeve in February 2016 and lost 57 kg / 125 pounds /9 stones. If you're considering surgery, you don't want to miss this episode. You can find out more about Cynara on our website BeyondBariatricSurgery.com.com, just click on podcasts for her episode and then the show notes. Cynara's Facebook page: http://www.facebook.com/theshrinkingwife

Do you still shop for clothes trying on much larger sizes than you need…after your weight loss? Katie said “in my youth I lost 45 kg (99 lbs) dieting and felt fatter than what I was so much so that the shop assistant stopped me and said, you need smaller sizes love.” Mary said… "I lost 70kg (154 lb) but still felt like I was 140kg (308 lbs)." What’s going on here? Joining me via Skype from Boston, Massachusetts is clinical psychologist Dr. Elayne Daniels, a recognized leader in the field of body image and eating disorders, as well as in yoga-integrated treatment. She completed her predoctoral, postdoctoral, and advanced postdoctoral fellowships at the Yale University School of Medicine. Dr. Daniels provides psychotherapy services as well as being a Registered Yoga Teacher with specialized training in yoga-integrated psychotherapy for people with anxiety, depression, eating disorders, and/or trauma. Listen now as we talk about phantom fat. You can find out more about Dr. Daniels on her website http://www.drelaynedaniels.com or Facebook at https://www.facebook.com/DrElayneDaniels

Are you worried about money? Have you lost your job and concerned about paying bills? Maybe you’re going through a divorce. Maybe your bariatric surgery is more stressful than you thought it would be. Food and your mood are so interconnected. Let’s talk about this connection and how... what you choose to eat can influence how you feel. Joining me via Skype from the Gold Coast in Australia is bariatric dietitian Amanda Clark who’s also the content director for this podcast. You met her on the first podcast…3 things someone should have told you about bariatric surgery. Besides keeping me on track you may recall that Amanda has spent 15 + years helping over 2000 patients. Creator and author of the Portion Perfection kit for Bariatrics, Amanda believes that when you see how much is right to eat, and you have practical tools to help you, you gain a much greater understanding of what to do and how to do it. Listen now!

When I say ‘zombie eating’ what immediately comes to mind? Mindless eating, emotional eating maybe? Let’s put the brakes on before this zombie eating happens and stop ourselves from needing to eat for emotional reasons. To help us put the brakes on, resident psychologist on Australia’s The Biggest Loser: Transformed, Glenn Mackintosh is back for a follow up interview to our podcast on emotional eating… but with a focus on managing your moods. You can find out more about Glenn on our website http://BeyondBariatricSurgery.com, just click on 'Podcasts' for his episode and then the show notes. Or check out our Facebook page: http://www.Facebook.com/BeyondBariatricSurgery More Marvelous Methods worksheet. Get the free download: http://bit.ly/2rqZRIJ

Joanne had gastric bypass surgery. Four weeks later she stopped losing weight. Has this happened to you? Why is it happening? Joanne Ballantyne joins me via Skype from the Gold Coast of Australia. Joanne’s a businesswoman who runs online training courses in the food industry. At 62, Joanne says she’s lived her life on one diet or another with very little success. You can find out more about Joanne on her website: http://www.cftqld.com.au or on Facebook at: https://www.facebook.com/CFTQld/ Joanne faced a lot as a young girl with spinal surgery and not walking for almost a year. Then she had her stomach stapled followed by a lapband which was later removed. She was brave to consider yet more surgery...a big decision. Listen to the podcast as Joanne shares her story. She talks openly about how her weight loss stopped one month after bypass surgery, her third surgery, and what she and her team are doing about it. You don't want to miss it.

Have you tried tapping…aka…Emotional Freedom Technique also called EFT? In a previous episode we spoke with Dr. Peta Stapleton, the clinical psychologist from Bond University in Australia. She helped us understand how tapping, which she referred to as psychological acupuncture or acupuncture without the needles can help with food cravings. Now it’s your turn to give it a try. Joining me via Skype from Cape Town, South Africa is Helen Mouton who had gastric bypass surgery in 2007 and has been regularly using tapping as part of her ongoing success since 2015. In fact Helen told me that her story has been 10 years of ups and downs with a final weight that she accepted as a WIN! In fact she signs her email with …little steps in the right direction. I think that’s telling. Helen will talk us through the actual tapping process that she follows. Helen's info: Facebook: http://facebook.com/SimplyHelenCherry or Twitter: @Helen_Mouton Be sure and check out the online courses on our website too.

Have you heard of a psychology technique called tapping that’s beneficial for food cravings and weight loss including bariatrics? Tapping has also been called psychological acupuncture… or acupuncture without the needles. Joining me via SKYPE from Australia is Dr Peta Stapleton, a registered Clinical and Health Psychologist and Program Director of the Masters of Clinical Psychology program at Bond University. She’s a world-recognised researcher in the field of Emotional Freedom Techniques or EFT commonly known as ‘tapping’. Dr. Stapleton will share stories about how tapping has helped clients with weight issues and how it may help you too. Don't miss the next episode where I'll speak with Helen who's had bariatric surgery and uses tapping everyday. She'll tell us exactly how it's done and you'll hear the words she uses in her tapping script that help her control her weight.

What are some of the biggest factors contributing to successful bariatric surgery? How do you measure milestones? Joining me is Brenda Hoehn who has her Bachelor’s and Master’s degree in nursing and is a member of The American Society for Metabolic and Bariatric Surgery. She’s the nurse coordinator for the Bariatric Surgical Weight Loss Program at Saint Francis Medical Center in Missouri, a part-time Life Coach and a bariatric surgery patient herself. You can find out more about Brenda on her website BrendaHoehn.com. I love the fact that Brenda is both a patient and a health perspective. We'll talk about the advantages and disadvantages, why she had surgery and where she is today.

Would you kill for a cookie? French fries? Do you eat when you’re hungry, mad or stressed. Emotional eating can affect you, bariatric surgery or not. Resident psychologist on Australia’s The Biggest Loser: Transformed, Glenn Mackintosh, joins me on the podcast to talk about the missing piece in emotional eating…the psychology angle. Glenn is a member of the Australian Psychological Society and consults with bariatric patients pre and post surgery. You can find out more about Glenn on our website http://www.BeyondBariatricSurgery.com, just click on PODCAST, or on our Facebook page which is http://facebook.com/BeyondBariatricSurgery

Have you gone thru bariatric surgery and wonder why no one ever told you certain things? Let’s go beyond bariatric surgery and talk about everything you need to move on. How you eat, when and what you eat are critical to your success. There’re at least 3 things about eating after bariatric surgery someone should have told you. Today bariatric dietitian Amanda Clark joins me. Together, Amanda and I want to create a community with you. This is a global community as I’m in the US and Amanda is in Australia. We’re here to discuss and direct you to tools that help you get the best results from your surgery so you can move on and stop worrying about your weight. Amanda believes that when you see how much is right to eat, and you have practical tools to help you, you gain a much greater understanding of what to do and how to do it. Join us and listen now. Plus be sure and check out our website at http://BeyondBariatricSurgery.com