Barbara Thompson

Weight Loss Surgery


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Weight Loss Surgery:
Finding the Thin Person Hiding Inside You.


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Issue #156

Jan 1, 2009


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In This Issue


* Research Article: Depression after Weight Loss Surgery, a New Wrinkle
* Back on Track Special
* Stevia Makes Its Debut
* I Like Weight Loss Surgery BecauseÖ
* An Easy Way to Pay It Forward
* Recipe: Asparagus and Avocado Wrap 
* Success Story: Melissa Foster

Research Article:
  Depression after Weight Loss Surgery,
  a New Wrinkle

Several research studies have shown that weight loss surgery patients suffer from depression post-op. But a new study out of the University of Pittsburgh may show why the problem is more difficult to treat.

A study was conducted by Dr. Giselle Hamad in which she tested the blood of a woman who was taking an SSRI (serotonin reuptake inhibitor) anti-depressant called sertraline. The woman was tested before and after the surgery. In the study, her blood was tested before taking her morning dose of her anti-depressant and then every 30 minutes for the next eight hours. Here are the results:

Before surgery, the blood level of her anti-depressant was:
17.5 ng/ml before taking the medication
41.6 ng/ml at the peak level after taking the medication

After surgery, the blood level of her anti-depressant was:
11.1 ng/ml before taking the medication
14.4 ng/ml at the peak level after taking the medication

Naturally after surgery when her anti-depressant was not being absorbed, the patient complained of moodiness and irritability. Many surgeons have attributed posat-op depression to problems of patients adjusting to surgery or finding that their circumstances have not improved significantly with their loss of weight.

Further study needs to be done, but this may explain not only the depression of patients, but it may contribute to weight regain.  As post-op patients are unable to cope without the absorption of their anti-depressant and turn to food to calm and comfort them.

SSRIís are a widely prescribed anti-depressant and trade names of some of the drugs include: Celexa, Cipramil, Lexapro, Prozac, Luvox, Paxil, Zoloft, and Zelmid.

If you feel that your anti-depressant is not working well enough, talk to your prescribing physician.

Frangou, Christine. SSRI Absorption Plummets after Gastric Bypass: Case Study. General Surgery News, Vol. 35:09, Sept. 2008.

Get help with that New Year's resolution to

get Back on Track with your weight.

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Feel you donít know what to do now that you have had surgery?
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Stevia Makes Its Debut

Coca-Cola and PepsiCo will begin marketing soft drinks sweetened with stevia in 2009.

Stevia comes from a wild shrub native to the mountainous regions of Paraguay and has been known and cultivated there for centuries.  Stevia has also been used as a sweetening agent for many years in about a dozen countries.

Stevia was first presented to the US Department of Agriculture in 1921.  It has never been approved as a sweetener in the US and has been sold here only as a dietary supplement, not as a sweetener. It has been used as an additive to sweeten food. This move by the US Food and Drug Administration allows stevia to be used initially in 2 soft drinks with more products to be added in 2009. The FDA has not approved the use of stevia but they also have not objected to its use. This will be this first time that stevia will be added to a product prior to its being sold.

The Center for Science in the Public Interest has issued a press release condemning the move claiming that research into any harmful effects of the stevia should have been conducted first.

Those in favor of stevia like it because it is 300 times sweeter than sugar, it is a natural product and is calorie free.

For articles on the addition of stevia to soft drinks, go to

I Like Weight Loss Surgery BecauseÖ

I like weight loss surgery because, if you are careful, you can fit into formal wear for New Yearís Eve that you havenít worn for 3 years!

That happened to me last night. And I didnít go into my closet a week ahead of time to try anything on.  I just knew that whatever I felt like wearing would fit. OK.  How different that scenario is from my pre-surgery days when I needed a new outfit every year because my weight kept climbing.

If you would like to share a thought on what you like about weight loss surgery, send it to me at 

An Easy Way to Pay It Forward

The Obesity Action Coalition will be sending a letter to President Elect Barack Obama right after the inauguration urging him to focus on the fight against obesity. You can sign on to the letter to show your support.

Click on the OAC logo

and then click on the Sign On button.

Asparagus and Avocado Wrap

Here is a great lunch selection to get your New Year off to a healthy start. 

Asparagus and Avocado Wrap

24 asparagus spears
1 ripe avocado, pitted and peeled
1 tablespoon lime juice
1 clove garlic, minced
1 Ĺ cups cooked long-grain white rice
3 tablespoons plain nonfat yogurt
3 whole wheat tortillas, 10 inches in diameter
1/3 cup fresh cilantro leaves
2 tablespoons chopped red onion

Steam asparagus until just tender, about 5 minutes. After cooking, rinse the asparagus in cold water and drain.

Mash the avocado and mix well with the lime juice and garlic.

In another bowl, mix the rice and yogurt together.

Heat a large frying pan (not one with a nonstick surface) over medium heat. One at a time, heat the tortillas in the hot pan until softened, about 20 seconds per side.

Lay the tortillas flat on a clean work surface. Spread the avocado mixture equally among the tortillas. Top each with an equal amount of the rice mixture, asparagus, cilantro, and onion.

Fold in both sides and the bottom of each tortilla up over the filling; then roll to close. Cut each wrap in half.

Makes 6 servings.
Each serving:
192 calories, 6 grams of protein, 5 grams of fat, 31 grams of carbohydrates and 6 grams of protein.

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:
  Melissa Foster

I am getting very low on success stories.  If you havenít done so already, please send me yours along with your before and after pictures. It is how you can give back for what you gain from this newsletter.

If I used your story in past newsletters, your updated story and new photos are welcome.

Send your story and pictures to me at

I want to offer Melissa Foster special thanks for sharing her story with us.

Hi Barbara!!
After seeing your latest newsletter, I was compelled to finally send you my own personal success story.  Much like your last your success story, my journey hasn't been all rainbows as far as my eating is concerned.  When I watched your video on your latest newsletter, well you really hit the nail on the head for what happened to me in my own personal journey.  Let me start from the beginning if I may.

My name is Melissa Foster and I had surgery in 2006 when I was 29 years old just before I approached my 30th birthday.  I had met my husband several years prior. He had weight loss surgery and was very successful in his journey losing from 380 lbs. down to 200 lbs.  He was my inspiration; however with me being a nurse I was still skeptical about the procedure.  Like many, I had lost hundreds of pounds throughout my life only to gain the weight back and then some. I began doing my own research on weight loss surgery for a couple years looking at online sources and as many books I could get my hands on. 

The year before I had my weight loss surgery I had gotten up to 328 lbs. and developed type two diabetes, hypertension, high cholesterol, back and foot pain and stress incontinence.  I was so very young and this was affecting not only my health, but my career also.  I felt like I was becoming disabled at a very young age. Life couldn't go on this way any longer.  In the words of my family physician, "I was a walking time bomb." 

I was able to lose a lot of weight prior to my surgery, about 50 lbs.  I was 280 lbs. on surgery day, December 4th, 2006.  I reached goal on November 7th, 2007, losing 140 lbs.  I continued to lose down to 133 lbs.  At this point I started hearing all sorts of feedback about my weight being too little and how I needed to start gaining it back.  I mainly heard this from family members.  This was the part of my journey I was not prepared for.  Well my pre-op binge eating disorder reared its ugly head and I started dabbling in foods I had never tried since surgery and feeling like "I can't make my family happy."  It was a very upsetting, lonely place to be.  This wasn't all my family members, but several very important ones to me. 

I started to get psychological therapy and that helped a lot but it wasnít a "cure."  I have to work at it daily.  It is still hard to believe that my family could actually not be happy for my success.  It wasn't until recently that I really truly grasped this idea and now understand that my happiness really comes down to me.  I have gained about 10-15 lbs. back from my lowest, weighing around 145 lbs.  I am 5'5" and very active. I have gained lots of muscle from weight training and I also run.

I wear a size 4/6 and I am very ecstatic about my overall success. My plastic surgeon says I have 10-15 lbs. to lose in skin so I am slowly accepting my weight gain but I know if I am not careful I can easily gain the weight back. Surgery isn't a "cure all." 

So thank you for that latest video, it really hit home for me.  Family can be very wonderful but also can be the ones that hurt us the most because we love them so dearly and really do care about their opinions of us, sometimes too much.

I am now 2 years post-op. My husband is 7 years post-op and we are working on developing a site for weight loss surgery patients to go to and feel supported. We plan to launch the site after the new year. We are also going to write a book and we are very excited about these major goals we are setting out to achieve.  I see this as the rainbow at this point in my journey.  I won't call it the end, as the journey never ends. 

I have learned so much about myself through this process and I never want to stop learning either.  I also want to keep "paying it forward." I do believe that is how we all end up successful on this journey.  We should never be doing this alone and knowing there is a community out there to help support us even when the going gets rough and it isn't all rainbows all the time. 

Your newsletter has truly touched me and inspired me.  Thanks for letting me share my story.

Melissa Foster

Here is a link to the video Melissa referred to:

Congratulations Melissa


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