Issue #178 December 1, 2009

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In This Issue


* Exhausted and Bruised
* Thoughts on Plastic Surgery
* Recover Program
* Recipe: Beef Medallions with Shiitake Mushroom Sauce
* Success Story: Jean Manseau

Exhausted and Bruised

Dear Barbara,
I had gastric bypass surgery December 2008, and have lost 135 pounds. I am having a hard time finding vitamins that don't hurt my stomach, and that donít make me sick. So while I feel better having lost the weight, I am always exhausted.  I've also noticed that I am bruising very easily; I mean major bruising. It looks like someone has beaten me up. My doctors have checked all my blood work and everything is normal.  Do you have any ideas about this? 
Thanks Lisa

Hi Lisa,
I am not a medical professional, but it does sound as if you are deficient in iron. The exhaustion and bruising are common symptoms. However they are symptoms of other problems as well, such as adrenal or thyroid problems.

When checking your iron levels, please be sure that your doctor has checked your ferritin levels. That is often overlooked.

For more information on this, check my November 1, 2006 newsletter for the article entitled ďMore on Blood Iron Levels.Ē There is a very revealing article on checking for iron levels.


Thoughts on Plastic Surgery

Hi Barbara,
I just wanted to thank you for putting my story in your newsletter about the excess skin after surgery. I have had SOOOO many responses! So many people who feel exactly the way I do.

I would sometimes feel guilty about hating my body, when the overall result to begin with was to just be healthier, which I am.  I never expected to have so many others express the same problems and insecurities.

Just out of curiosity, are you an advocate of plastic surgery? Everyone that responded to me was expressing a desire to have the skin removed, but of course, with the expense, it is not an option for most of us. Do you see a possibly in the future that bariatric surgeons would make it more affordable for their patients?

Thanks for everything!
Colleen West

Hi Colleen,
It is always such a relief to find that there are others who feel the way that you do. 

Regarding my thoughts on plastic surgery, I am an advocate of anything anyone wants to do as long as it is healthy. For instance, if someone was obsessed with plastic surgery, and was having one surgery after another, never satisfied with the way he or she looked, that to me is unhealthy. I donít feel that we had weight loss surgery for health and not for cosmetic reasons, therefore should be happy with what we have.  Thatís not reality, and it really is no oneís business but the person that wants to have plastic surgery.

Personally, I had plastic surgery.  I had a face lift about 2 years after my weight loss surgery.  I carried a lot of weight in my face, and I was left with skin that pulled my face down. I was always being asked what I was so sad about.  I finally went to a plastic surgeon, Dr. Dennis Hurwitz,  and asked him to make me look as happy on the outside as I felt on the inside. I certainly need to have plastic surgery on other parts of my body, but have chosen not to. My decision is based on three considerations: 1) expense, 2) fear of the pain, and 3) I am content with my body.

I do however want to comment on your question, ďDo you see a possibly in the future that the bariatric surgeons would make it more affordable for their patients?Ē It is not the fault of bariatric surgeons who donít do plastic surgery.  It is the fault of plastic surgeons, as well as the insurance community. 

Plastic surgeons should be doing more to advocate to the insurance industry to have plastic surgery covered for weight loss surgery patients.  The reason they donít is because they would much rather have business that is self-pay as opposed to business that is financed by insurance companies.  Insurance companies use their leverage, and pay far less than someone who is paying a full bill themselves. Insurance companies pay a discounted bill.

I also fault insurance companies that will only recognize plastic surgery as cosmetic, and not as a physical and emotional health issue. I have received the letters and heard the heart-breaking stories of people who are suffering from excess skin, and fear intimacy, because of how they look with their clothes off, who have problems walking because their excess thigh skin is flapping, and who suffer with infections from skin on skin rubbing raw. I agree that weight loss surgery is for the most part only Ĺ of a surgery for many people, with plastic surgery being a necessary second surgery. But how do we fight that battle when we are still fighting the battle to have weight loss surgery covered?

It will be a long time before plastic surgery will be covered following weight loss surgery, unless there are significant changes following health care reform. But without the plastic surgery community leading the charge, I donít have high hopes.

For more information regarding plastic surgery, order my CD,
Plastic Surgery: The Inevitable Next Step,
recorded with Dr. Peter Rubin, a plastic surgeon that specializes in plastic surgery for weight loss surgery patients.

For the next 2 weeks only, we are offering
this CD for the special price of $9.97.

Recover Program

The Obesity Action Coalition has teamed with Bariatric Advantage to provide vitamins to patients in need. The program is called the Recover Program. To date, the OAC and Bariatric Advantage have helped nearly 200 people in 30 states and have provided more than $20,000 worth of supplements. This is only one of many services offered by the Obesity Action Coalition that supports patients.

Bariatric Advantage has indicated they likely can provide up to $100,000 worth of supplements in 2010 so the Obesity Action Coalition has the ability to help many more people during these tough economic times.  More details on applying for the assistance program can be found by clicking the Recover icon on the OAC web site,

Recipe: Beef Medallions
   with Shiitake Mushroom Sauce

Beef Medallions with Shiitake Mushroom Sauce

1/2 tablespoon olive oil
2 shallots, minced
1 large garlic clove, thinly sliced
2 beef medallions, about 4 ounces each, trimmed of all fat
4 ounces shiitake mushrooms, stems removed
1/4 cup dry red wine
1/2 cup low-sodium canned beef broth
1/2 teaspoon crushed dried thyme

  1. In a heavy cast-iron or nonstick skillet, heat olive oil over medium-high heat. Add the shallots, garlic, and steaks. Cook steaks 2 1/2 to 3 minutes per side, turning once, for medium-rare. Transfer steaks to a carving board and keep warm.
  2. Add the mushrooms to the skillet, raise heat to high, and sautť for 2 minutes per side. Transfer mushrooms to a small bowl.
  3. Discard fat from skillet. Add wine to the skillet and stir to deglaze the pan, loosening any browned bits. Add beef broth and thyme. Cook, stirring, until reduced by half. Return mushrooms to skillet.
  4. Thinly slice steaks on the diagonal. Pour any steak juices into the sauce. Arrange steaks on heated serving plates and spoon mushrooms sauce over the meat. Serve hot.

Per serving: 260 calories, 27 g protein, 12 g fat , 6 g carbohydrates, 1 g fiber

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

Internet Mentoring Program

Are you:

Suffering from emotional eating and canít stop?
Grazing on carbohydrates and canít control it?
Lacking inspiration to lose the weight you have regained?
Feel you donít know what to do now that you have had surgery?
Dying to be in better shape`?

 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:
  Jean Manseau

I want to offer a special thanks to Jean Manseau for sharing her success with us. Here is her story:

Dear Barbara,
My Name is Jean Manseau. I had gastric bypass surgery Sept 19th, 2007 performed by Dr. Chapman at Eastern Carolina University in Greenville, NC. I am grateful, and feel blessed to have a second chance for a better and healthier life.

It has not always been easy. I look at everyday as a gift, and if I'm proactive and make the best choices, then I can make the most out of my second chance at life every day. I exercise to have shape, reduce stress, and control what I eat. I weigh everyday just so the pounds don't creep up on me when I'm not looking. I take my bariatric vitamins every day to help me stay healthy. I use protein drinks to keep my hair and muscles. Most importantly, I listen to my body, and act or respond accordingly. I know if I eat too many carbs, not only do I have food cravings, but I also can retain water weight.

I stop and have conversations with myself all the time. If I think I'm hungry, I ask myself if I'm thirsty first, and drink about 20 oz of water. If I'm still feeling hungry, then I eat. I have an ulcer so I make sure itís not just the gnawing hunger pains from my ulcer. If it isnít time to eat, I think, ĎOh how about a big juicy steak.'  If the thought of that makes me nauseated, then I'm not really hungry, and I find something else to do to distract myself.

I don't cross the sugar line at all. I have never even tried. I don't want to know if I tolerate sugar. It's just not worth the price I would pay if I could tolerate it. So in my head I can't, and I won't. I don't drink with meals, not even a sip. I wait my 30 minutes after a meal. I still don't use a straw, or drink anything with carbonation.

The surgery was a tool to help me lose weight, not do it for me. I still have to do my part, and I try to remember that every day.

What this surgery gave me was control. I went from having to buy nothing but stretch pants, to fitting into a size 6 pair of jeans without having had plastic surgery. I had my 2 year check up and my labs are great.  I would do it all again in a heartbeat.

Jean Manseau

Congratulations Jean

Sadly, I am out of success stories.

If you have reached your goal weight (or close to it), you have a success story to tell.  Be proud of your wonderful achievement and let the world celebrate with you.

Send your success story with before and after photo files to me at and I will include your story in a future newsletter.

If you need help with the photo files, contact


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