Issue #171 August 15, 2009

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In This Issue


* Our New Look
* Chew Then Spit
* Obesity Action Coalition: Survey Results
* Insurance Woes
* CD Special
* Recipe: Grilled Flank Steak and Vegetable Salad
* Success Story: Stevie Blair

Our New Look

Welcome to our new format. We are making the newsletter easier to read by presenting it when you open your email rather than having to click to go to the newsletter site. I hope you like it. 

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Chew Then Spit

Hi Barbara,
I had surgery a month ago and experienced dumping twice. I am in Phase II. I am terrified of that happening again, so now I have been chewing some foods and spitting it out. This seems to be a practice that others in my support group do also.  Is that wrong?


Hi Geraldine,
I am so sorry to say that yes, it is wrong on many levels. By chewing food and spitting it out, you are not getting the nutrients and the calories that you need. You can become malnourished. If you continue, very shortly your body will go into starvation mode and you will stop losing weight because your body will hold onto every calorie that it can.

You are also starting a dangerous pattern. What you are doing is suggestive of bulimia, the act of eating and then throwing it up. That is a behavior that I am sure you don’t want to mimic.

Dumping can be terrible, but you need to learn to eat so that you do not dump. You didn’t mention in your question what it was that made you dump.  Most often it is something sweet. However, patients will also dump because of eating simple carbohydrates, high fat food or especially at your stage, milk products. Many people become lactose intolerant following surgery.  This condition often resolves itself after a few months.

When eating a particular food, check the number of grams of sugar that it contains.  In general, most people can tolerate 15 grams of sugar, but that does not mean that you can tolerate that amount. You can start eating little or no grams, and then increase the number of grams to determine your tolerance level.

I am not recommending that you eat sugar, but there are many foods that are very healthy and good for you that do contain grams of sugar.  These are foods that are naturally sweet as opposed to those with added sugar.

I am so glad that you asked that question.  I am sure that there are people who are eating and spitting out their food and you gave me an opportunity to address this practice. I wish you the very best.


Summer is here! Get Back on Track!


Back on Track with Barbara

Internet Mentoring 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 this Summer?

 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.

Obesity Action Coalition:
  Survey Results

A big “thank you” to all of the people who responded to the survey about the Obesity Action Coalition (OAC). It was really enlightening.  What we discovered is that most of you do not understand what the Obesity Action Coalition is all about. You found that the membership fee of $20 is just about right. But you made it clear that without understanding how the Obesity Action Coalition affects you, you are not going to join.

So let me just reiterate what the OAC is all about and what you receive.

Our advocacy work is focused on increasing access to obesity treatments, working on the federal and state levels on obesity legislation and policy, battling obesity stigma and discrimination and encouraging others to be proactive advocates

Membership fee also includes

  OAC Magazine

  Electronic Newsletter

  Free Educational pamphlets and Poster

Insurance Woes

Dear Barbara,
I am 9 months out from Roux-n-Y surgery and have lost 100 pounds.  I feel great, I’ve had no complications, and my co-morbidities are disappearing.  I no longer need medication for cholesterol and high blood pressure.  And I am down to 1 pill per day to control my diabetes, and probably won't need that soon.

My Cobra insurance expires Oct. 1st and I am told I am uninsurable by the major insurance companies.  It doesn't seem to matter that I'm already much healthier than I have ever been in my adult life. The underwriters won't come near me.  My only offers are for a $5,000 deductible with an $1,100 monthly premium.

Are others experiencing this same situation and are there any solutions?

Thanks so much for your help.


Dear Anne,
One month ago, I reported on a study that showed the complication rate following weight loss surgery had dropped by a considerable amount.  The rate previously showed a 40% complication rate.  The study was done examining rates from surgeries done in 2001 and 2002. This was a very widely read study and was one that the insurance industry has latched onto.

You are suffering from the results of that survey.  The insurance industry does not care about you as an individual.  They see you as someone who had gastric bypass surgery and has a 40% chance of developing a complication that they will have to pay for.

This new study found that complications have dropped by more that 50%, but it will take awhile for the insurance industry to become aware of this study and start to base their decisions on it. 

In the meantime, many of us who buy private insurance have to suffer with the very high deductibles and premiums.

To see the article concerning this new study, click here.

Recipe: Grilled Flank Steak
  and Vegetable Salad
This is the perfect time of the year to fire up your grill. This recipe includes all of the vegetables that are now in season, for a delicious and healthy meal.


7 Tablespoons balsamic vinegar
2 Tablespoons plus 1 teaspoon Worcestershire sauce
1 clove of garlic, minced
1 teaspoon dried thyme
1 pound well trimmed flank steak
1 ¾ pounds small red potatoes, thickly sliced
½ pound green beans cut into 2-inch lengths
2 bell peppers (1 red and 1 yellow or orange) halved lengthwise and seeded
2 Tablespoons coarse-grained mustard
¼ cup apple juice
1 Tablespoon olive oil
¾ teaspoon salt
4 cups torn leaf lettuce


1.  Place ¼ cup of the vinegar, 2 Tablespoons of the Worcestershire sauce, the garlic, and thyme in a sturdy plastic bag. Add the steak, squeeze the air out of the bag, seal, and marinate at room temperature for 30 minutes or up to 2 hours in the refrigerator.

2.  Meanwhile, in a large pot of boiling water, cook the potatoes for 4 minutes. Add the green beans and cook until the potatoes are firm-tender, about 6 more minutes. Drain and rinse under cold water; set aside.

3.  Preheat the grill to a medium heat. Spray the rack – off the grill-with nonstick cooking spray. Grill the steak and bell peppers, covered, turning occasionally, for 10 minutes or until the steak is medium rare. Be sure not to cook the steak beyond medium rare, as it tends to become tough.

4.  Let the steak stand for 10 minutes before thinly slicing. For the tenderest slices, cut the steak across the grain, holding the knife at a sharp angle to the cutting board.

5.  In a large bowl, combine the remaining 3 Tablespoons vinegar, remaining 1 teaspoon Worcestershire sauce, the mustard, apple juice, oil, and the salt. Add the potatoes, beans, and lettuce to the dressing, tossing to coat. Cut the peppers into 1-inch wide strips and add to the salad bowl, tossing to coat. Divide the steak and salad among 4 plates and serve warm or at room temperature.

Makes 4 servings. Nutritional information for each serving:
389 calories, 24 grams protein, 49 grams carbohydrates

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

Success Story:
   Stevie Blair

I want to offer a special thanks to Stevie Blair for sharing her inspiring story:

Dear Barbara,
I come from a large family of six girls. Being the youngest and last chance for a boy, I ended up with the name Stevie. My sisters and I were blessed with my mother's genes and eventually all of us had a weight problem.

Thinking back, I started to gain weight around the 3rd or 4th grade. I had watched my sisters try every crazy diet around, and eventually I had tried pretty much all of them as well. Weight loss was a monkey on my back for most of my young adult life.

After the birth of my daughter, I knew I had to make a change. I had lost my mother when I was 22 and vowed that I would not do the same to my daughter. I decided to have weight loss surgery to help me deal with my increasingly serious weight problem.

I gave careful consideration when choosing my procedure. Knowing my eating style and patterns, I decided that the best tool for me would be one that provided portion control as well as a consequence if I abused sugar. I had RNY gastric bypass surgery on July 10th, 2006.

My starting weight was 310 pounds and I have since lost 126 pounds. It has been wonderful to finally have physical freedom from my weight. Having worked for a bariatric clinic before, I was well prepared for and informed about the surgery I chose. I had 5 years experience taking patients from informational seminars to surgery. What I learned after having my procedure was that there was so much the post-op community needed as far as support and education! 

After my surgery I sought work in another bariatric program. I was so blessed to find this small specialty hospital not far from where I lived! Their program was almost 2 years old. I immediately pushed open the door and said "Hi, my name is Stevie Blair, and I would like to work in your bariatric program." Plain as that! Having never really had the guts to sell myself before, I was so passionate about this that I transformed into a very confident, almost pushy gal!  

After being hired on a temporary basis, I was determined to show my worth! I grew their support groups from 12 in attendance once a month to 20-40 attendees twice a month! I welcome all pre and post-op patients regardless of where they had their surgery.

I started a monthly newsletter in February 2008 for our post-op population and am currently working on my 19th issue. I took the back on track certification program and look forward to launching a 12-week program for my patients sometime this fall. I am also currently taking a course to be a certified Bariatric Life Coach. I am positive this will help our post-op program!  I hope one day to be a counselor for post-op patients. 

We recently hosted our first Walk from Obesity here in Rancho Cucamonga, Ca and had the pleasure of hosting the walk in Beverly Hills, Ca. I work out with my trainer, Janet Bannowsky at Anytime Fitness here in Rancho Cucamonga and have been so delighted to see most of my support group join the gym as well!

Since my weight loss, my sister Casey (funny how we have boy's names) was inspired to have weight loss surgery. I told her not to worry, that I would take care of her, and I fought her insurance for approval. On June 30th, 2008 she had gastric bypass surgery here at my hospital. I served her first protein shake in a champagne glass and am happy to report that she has lost over 100 pounds so far. We are working on getting insurance approval for her husband now.

My passion is to teach balance to our bariatric community. We must give equal attention to nutrition, supplements and fitness to succeed long term. I am hoping to plan a retreat for the near future with a cooking class, physical trainer, and life coaching exercises. I will let you know how that comes out. Cross your fingers for me!

Barbara, I hope to be as successful as you one day. I am working hard to get funding for my "Bariatric Gym." If all goes well, it will be your one-stop post-op shop! Physical trainers would be on hand to show patients the correct way to work out and there would be an area where we can have support group meetings and workshops. I also want to have a protein shake bar and supplement shop. I want to do so much and understand that it takes time and money, but I have such a strong feeling deep in my soul that something big is coming. I will be able to help the bariatric community, and be a successful provider and mentor for my beautiful daughter.

Stevie Blair

Congratulations Stevie


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