Barbara Thompson

Weight Loss Surgery


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Hosted by Barbara Thompson
Author of:
Weight Loss Surgery:
Finding the Thin Person Hiding Inside You.

Issue #147

August 15, 2008


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In This Issue


* Ask Barbara: Underweight?
* Nutritional Surprises
* Recipe: Layered Chicken and Shrimp Enchilada Casserole
* Success Story: Barbara Bailey

Ask Barbara: Underweight?

I have a problem that I haven’t seen in anyone else, nor have I seen anyone else address it. I am almost 6 years post-op. I started at 385 lbs. and I am now at 115 lbs. I never had a goal that I was shooting for so when I cracked the 200 lb mark I was overjoyed. When I bought a skirt that was a size 8; I stood on a table at the mall, in the food court and I told anyone that would listen, that I just bought a size 8. I was crying with joy. I then started with plastic surgeries. I never really was on a diet. After each surgery I would drop another 10-20 lbs.

Before I had my surgery I went through 2 years of extensive therapy to find out why I was the way I was. I figured out what my demons were. I went from eating and anger being a coping mechanism to now becoming a person that really hates to eat. If I didn’t become dizzy, I could go forever not eating. It is a chore to have to eat. I think every minute of the day about my weight just as I did when I was fat (which means as far back as my first clear memories, about age 6). Yes, I am still in therapy. I have never had the bounce back weight. I am 5’6” and I struggle to stay at 115 lbs. I find that with clothes, some size 0’s are too big.  Has anyone else that you know of struggled with this problem?

Do you have any words of wisdom for me? I feel like I am one sickness away from being put into the hospital with a feeding tube.

Kim from Buffalo

Dear Kim,
Amazingly, even though you are only 115 pounds and 5’6”, your BMI is in the normal range, but barely. You are on the very edge of being underweight. 

It is very good that you are still in therapy. From my layman’s point of view, you do have an eating disorder. If you are not eating until you feel dizzy, that indicates that there is a problem.  Additionally, you are obsessing about your weight.

Yours was the second letter that I received this week from someone concerned about being underweight, so your condition unfortunately is not unique. There has been so much more awareness about weight loss surgery patients regaining weight, many patients are terrified of this and are avoiding a healthy eating pattern fearing weight regain.

Apart from the psychological therapy you are receiving, perhaps you can set up an appointment with a nutritionist or dietician for nutritional counseling.  What you will probably learn is that you should be eating approximately 1400 calories or  more to maintain your weight and even gain a little. Buy a calorie book and track your calories. If you are regaining too much weight, scale it back. When selecting your daily food, eat your protein first, followed by vegetables, fruits and then carbohydrates in the form of whole grains. Also remember to include some fat in your diet from olives, olive oil, avocados or fatty fish such as salmon, trout, mackerel, fresh tuna and shrimp. It is important to not approach regaining by eating just any unhealthy food that you can find.

Have faith in yourself and in the surgery. At some point you will have to learn a healthy way to eat, or your weight will start to affect your health.

Nutritional Surprises

Nutrition Test

Many of us have informally studied nutrition in our quest to lose weight, believing that there just might be a magical combination of food that would make us slim. But there are still things that we have to learn. Test your knowledge of nutrition by taking the test below.  I think that some answers will surprise you.

1. What has more fat, a peanut butter and jelly (PBJ) sandwich or a bacon, lettuce and tomato (BLT) sandwich?

  1. PBJ
  2. BLT
  3. Both have about the same

2. Foods from the meat, poultry, fish, dried beans, eggs, and nuts group are an important source of?

  1. Iron
  2. Fiber
  3. Beta-carotene
  4. Calcium

3. Which of these is added to the food label because people sometimes don't eat enough of this?

  1. Fat
  2. Calcium
  3. Sodium
  4. Cholesterol

4. Choosing ground turkey rather than ground beef saves you a lot of fat and calories.

  1. True
  2. False

5. Soy bean milk is much better for you than cow’s milk.

  1. True
  2. False

6. Veggie chips have significantly fewer calories than potato chips.

  1. True
  2. False

7. The milk, cheese and yogurt group are important for?

  1. Strong bones
  2. Teeth
  3. Muscles
  4. All of the above

Click here for the answers

Attention Nurse Educators

Preparing for COE Status?

Would You Like to Have

Obesity Sensitivity Training for

Your Hospital Staff?

(Guess What - It May Be Free)

Speaking for Hospitals

If you are a bariatric coordinator or nurse educator and need obesity sensitivity training for your hospital staff, contact me at 877-440-1518 or  Obesity sensitivity training is a Center of Excellence requirement. I can help you find sponsorship that your hospital may qualify for.

Layered Chicken and
  Shrimp Enchilada Casserole

This is a recipe from a new cookbook entitled 90 Ways to Ditch Your Diet by the bariatric chef, Chef Dave Fouts.  Click the link at the bottom of this recipe to order your own copy.

Layered Chicken and Shrimp Enchilada Casserole

Serves 12

1 Tbl. canola oil
1 pound shrimp, peeled and deveined
1 pound boneless skinless chicken breast, cut into half inch cubes
1 large onion, chopped
2 cloves of garlic, minced
28 ounces canned tomatoes, diced
15 ounces unsalted canned puréed tomatoes
2 Tbl. chili powder
2 tsp. cumin
1 cup low-sodium canned black beans, drained
¼ cup black olives, sliced
2 tsp. cilantro
2 cups low-fat cheddar cheese, shredded
24 corn tortillas
¾ cups light sour cream
¾ cups salsa


    1. Preheat oven to 350° F.
    2. Heat oil in a large skillet; and add shrimp, chicken, onions, and garlic.
    3. Brown and drain fat when done.
    4. Add diced tomatoes, puréed tomatoes, chili powder, cumin, and black beans.
    5. Bring mixture to a boil; cover and simmer 20 minutes.
    6. Add olives and cilantro.
    7. Line a 9 x 13 inch baking pan with 8 corn tortillas.
    8. First, layer one third of the meat mixture over tortillas, then layer one third of the cheese. Repeat with remaining ingredients, reserving the last one third of the cheese.
    9. Bake uncovered for 30 minutes.
    10. Sprinkle with remaining cheese and let sit for approximately 15 minutes before serving.
    11. Serve with salsa and sour cream.

Nutritional Facts per serving:

Calories 310, fat 7g., carbohydrates 36g., fiber 6g.

You can get a copy of Chef Dave Fouts's new book that features 90 recipes for breakfast, lunch and dinner by
clicking here.

If you have a recipe that you would like to share in future issues of this newsletter, please send it to me at

Back on Track with Barbara Program

Are you...

Suffering from emotional eating and can’t stop?
Grazing on carbohydrates and can’t control it?
Lacking inspiration to lose the weight you have regained?
Feel you don’t know what to do now that you have had surgery?
Dying to be in better shape with warm weather here?

 Then you are in luck! My Back on Track Internet Mentoring Program is just what you need!

View a FREE Lesson and Listen to a FREE Telephone Seminar by
clicking here and scrolling down to the bottom of the page.

Success Story:
  Barbara Bailey

I want to offer a very special thank you to Barbara Bailey for sharing her story with us.       

In October of 1977, I weighed 165 lbs. Over the next 30 years I gained between 5 and 10 lbs a year and was unsuccessful at taking the weight off. I would try to diet and exercise, only to lose weight and regain it.

In the Summer of 2006, several things happened to me that have changed my life.

  1. My daughter shared with me a procedure called  “lap band surgery.”
  2. I was taken out of my job as a Fast Track Nurse and was given a position as an Emergency Room Nurse.
  3. After two months as Emergency Room Nurse, I was given the opportunity to transfer to the Cardiopulmonary Dept. as a Cardio Pulmonary Rehab Coordinator.
  4. In October I weighed 260 lbs for my work annual physical.

I hated being in the Emergency Room, I was depressed and very upset. I felt like my professional life was doomed.

When given the opportunity to be the Cardiac Rehabilitation Nurse, I knew I could not be successful giving my patients advice on how to be healthier, if I was not healthy myself. So I started investigating this thing called Lap Band Surgery.

I looked at the web site for Memorial Health Bariatrics in Savannah, GA. I spoke to the employee health nurse at my job that had gastric bypass surgery. And I went on line to

On Nov. 1, 2006, I drove myself to Memorial Health Bariatrics (MHB) information session in Savannah. I can remember my first thought when I walked in and saw the other people also coming to hear what those from the practice had to say. My thought was ‘this is not for me, I am not that big, but I drove all this way, so I’ll stay and hear what they have to say.’

I remember Dr. Angstadt saying, “diets do not work on morbidly obese patients.”

Wow I do believe that, I had watched my ex-husband try and try to lose weight unsuccessfully. And it had not worked for me either. I sat in my seat and listened to Dr. Angstadt and Glenda, the nurse practitioner talk about eating food in a certain order, not drinking fluids while one eats and waiting one hour before drinking fluids again, eating small bites, chewing food thoroughly, and setting your fork down between bites.

I heard a woman talk about forgetting to eat lunch and having a “shake” in the afternoon. I wondered what a shake was, did she mean like a McDonald’s shake?

When the information session was finished for the evening I stayed and filled out the package I had received for starting the process of becoming a bariatric candidate.  I turned it in to Stephanie.  Later, I was told my insurance would not cover my surgery. It was not an option my employer had contracted in our insurance package. MHB had a self pay option which I decided to take.

If I was going to pay $15,000 for this surgery, I needed to know that I could follow the plan for weight loss surgery.  I purchased Slim Fast protein shakes, chilled them and started to drink. The shakes were not bad. I could drink it.  I began to eat what I call the “bariatric way,” protein first, vegetables second, fruit third and only if I was still hungry would I eat carbohydrates. I also started practicing no drinking with meals, waiting one hour after I was finished eating, taking small bites, and placing my fork down between bites.

I began to feel satisfied. I stopped craving sweets and salty food. And I started losing pounds. I was aware of how the different foods tasted, and began to savory the flavors and enjoy what I was eating.

In October, 2006, when I took my new job, I also started to walk on the treadmill, which was in my department. I would walk very slowly, for 10 minutes then I gradually increased my time to 20 minutes, then 30 minutes. Now I can walk 45 – 60 minutes without any problems.  My speed when I first started was 1.0 mph. My knees and legs hurt with almost every step. Now I have no pain and my speed is 3.3mph. I can even do a short time at 4.0 mph jogging.

I had all of my clearances completed; had attended all of my classes and was scheduled for surgery on Friday, March 2, 2007. When I woke up in my room at Memorial Health, I felt good, with no pain, and no grogginess. I waited my 3 hours and got up and walked the hall one time. That wasn’t bad. The next hour I got up and walked 2 laps in the hallway, and I continued each hour I was awake to increase the distance I walked by one lap. While walking in the hall, I saw another woman who was doing the same. I spoke to her and discovered that she too had lap band surgery. Her name was Linda and she lived in Richmond Hill. She asked me to stop by her room when I walked again, which I did. We saw each other at support group meetings and started riding together and talking. Now I have a very good friend who understands the process, and we support each other.

My weight has steadily come off over the months. Two days before my 6th month anniversary after having weight loss surgery, I reached my 100 lbs weight loss. I went from 260 lbs. in October 2006 to 160 lbs. August 31, 2007.

There were times I would go shopping before my surgery and I was not able to get into a pair of jeans size 26 because they were too small. When I worked in Maryland as a nurse, I could not wear 3x scrubs because they were too small. I had to wear 5x’s. Boy was I wrong about not being big and morbidly obese in Nov. 2006 when I went to my first meeting! Today I can wear medium scrubs, size 10 dresses, and some size 10 shorts and size 12 pants.  I have so much energy, and I feel great.

Weight loss surgery has been the best thing I have ever done for myself. Being a bariatric patient has just clicked for me, and has been the easiest tool and program I have ever used  to lose weight.

I am forever grateful to Dr. Angstadt and Dr. Whipple for perfecting the surgery process, for Memorial Health for allowing the bariatric program to be available, to Glenda the nurse practitioner, Jodi, the physician assistant, Leigh Ann the office nurse and Stephanie, financial personnel, and all the office staff at Memorial Health Bariatrics, and to  all the hospital staff in the many departments that help with the success of the bariatric patient.

My life is now very happy, exciting, and I love my new attitude and relationship with food.

I love good news.  If you have good news, a success story to share, or inspiration, please send it to me at so that I can include it in future issues.
Congratulations Barbara


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