Barbara Thompson

Weight Loss Surgery


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


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Issue #161

March 1, 2009


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In This Issue


* Magic Bullet
* Am I Losing Fast Enough?
* Gaining Weight and Desperate
* Recipe: Almond Chicken Pear Salad
* Success Story: Maureen Gonzales

The Magic Bullet

If you have ever heard about a miracle diet that will melt away the pounds while you sleep and longed for that, then you will be interested in the article that I recently wrote for WLS Lifestyles Magazine.

Am I Losing Fast Enough?

I have a question about weight loss after surgery. Can you give me some idea based on your own experience of what an expected weight loss will be during the different stages after surgery? For example, what can one expect during the first three weeks while they are on liquids and what can be expected during the soft food stage?

I had laparoscopic RNY surgery 16 days ago. Before surgery, I was told by some of the nurses and dieticians that the weight would melt off after surgery. As of today, I have lost 19.5 lbs which does not seem like a lot. I want to make sure I am not expecting too much too fast or that I am not behind the point I should be at. I want to be sure that I am on track based on an average because I know that everyone is different. I keep telling myself the weight will really begin to fall off when I start the soft phase at three weeks. I had the surgery to rid myself of the “Fat Freeloader” I had been carrying most of my life and to correct some medical conditions. I drink my protein drinks and other liquids on schedule and exercise every day. What is realistic? Can you help?


Hi Diahann
Congratulations on your surgery! There is a general rule for weight loss after surgery, but it is very much a rule of thumb. Patients tend to lose 20 pounds the first month or 2 followed by a couple of months of 15 pounds of weight loss for awhile and then it gradually slows until you have lost approximately 70 to 80% of your excess weight. This is dependent upon a number of factors:

1.      If you lost weight prior to surgery. If so your weight loss following surgery will be less because you have already gotten rid of the water weight which is so easy to lose.

2.      If you have a great deal of weight to lose. If you are on the higher end of morbid obesity according to your BMI, or are super morbidly obese, then you will lose weight faster.  Those who have less weight to lose will lose weight more slowly but have a greater chance to reach their goal weight, generally speaking.

3.      Weight loss is dependent upon your age.  If you are older, your metabolism is slower and you will lose weight more slowly.  The older you are the more important it is to exercise so that you can increase your metabolism.

4.      Speaking of exercise, you will lose more weight if you exercise. You will also lose more weight if your protein level is higher. These factors really do make a difference because they affect how much muscle mass you are able to maintain and grow.  This directly impact metabolism.

5.      It depends upon how many times you have “yo yo” dieted and how long you have been obese. These factors affect the set point of your weight which is the weight which your body wants you to maintain.  This set point is not always a healthy weight. Nature is always trying to get us to gain weight so that we are prepared for the coming famine and lack of prey to hunt down with our spears.  Nature doesn’t know that going from home to work we pass 5 fast food restaurants and a grocery store.

6.      It depends upon whether you are taking medication that causes you to gain weight such as some anti-depressants or if you have a disease or condition that makes it more difficult to lose weight.

These are some of the major factors that make it impossible to accurately say how fast you should be losing weight.  But I would say that losing 19.5 pounds in 16 days means that your weight is melting off.  In fact, you may be losing weight too fast.  I have seen many patients who lose in excess of 20 pounds the first month only to reach a plateau until their bodies have caught up with the weight loss. But then it all seems to even out.

Just that you are showing so much concern indicates to me that you will do very well.  I will be waiting for your success story next year!

  Gaining Weight and Desperate

I am sitting here in tears reading your newsletter about regaining weight. Every issue is mine. I am 3 1/2 years post-op. I lost 170 lbs but have regained about 30. I seem to always be hungry. I fill up fast but a little while later I am hungry. I crave something sweet all the time. It seems I am always depriving myself. I know that word is wrong, but it is how I feel.  Then if I get angry at my husband, we have been married 40 years and happy but you know it does happen, I go to food right away. Where do you suggest I go for help? I am at a loss and getting depressed.  The surgery was not easy. I love buying clothes and feeling good but see this slipping away. 

Your newsletters are wonderful. Maybe you can suggest other things for people like me. We are in desperate need of help, as much as people wanting the surgery! 

Thank you so much.


Dear Sheryl,

I think there are many of us who feel your pain. You are describing what all of those in my Back on Track Program and thousands of people who have had surgery more than 3 years ago are going through.  It is a very complex problem, but please let me offer just 3 tips based upon what you wrote.

1. “I seem to be always hungry. I crave something sweet all the time.”
  I believe that those of us who have been or are morbidly obese are very sensitive to carbohydrates. When we eat carbohydrates like white bread and pasta and especially sweets, it causes our blood sugar level to spike. After awhile our blood sugar level then drops and our bodies, that enjoyed the spike of energy that goes along with a spike in our blood sugar level says to us, “Hey, do that again, I liked it!” We then feel cravings, cravings for something sweet. It is very important for you to keep your blood sugar level stable so that you are not feeling those cravings. To keep your blood sugar level stable, cut out all carbohydrates for at least 5 days. Eat a diet very heavy in protein but be sure to drink lots of water.  You will no doubt go through a withdrawal, but it will be worth it. Then gradually reintroduce good carbohydrates into your diet like fruits and vegetables. Avoid getting too hungry. That should really help your cravings.
2. “I fill up fast but a little while later I am hungry.”

It sounds like you may have stretched your pouch. There are a couple of things you can do about this.

You can go on a liquid protein diet for a day or two. You should then feel your pouch – become reacquainted with it. It is a very hard thing to do, but again, it is worth it.

You can also try eating food with more water volume and high fiber, again such as fruits and vegetables. This way of eating is called volumetrics. Here is a Web MD article about volumetrics. .

And lastly you can look into revisional surgery like the stomaphyx procedure. If the opening from the pouch into the intestines has stretched, or if your pouch itself has stretched, then the stomaphyx procedure will make both smaller. Some patients are also having a band placed around their pouch.

3. “If I get angry at my husband, I go to food right away.”
  This says that you are using food to soothe your emotions rather than to sustain yourself.  Anytime that you use food in a way other than as just food, you are engaging in emotional eating. You need to discover why you do this and remedy it, otherwise you will always have a problem with food. You can be helped with counseling.

You would be an excellent candidate for my Back on Track program.  There you will get lessons, advice and support to get through this. Details are below.


Get Help to Get

Back on Track with Your Weight.

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 for 2009?

 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.

  Almond Chicken Pear Salad

Almond Chicken Pear Salad

2 cups boned and skinned chicken breast halves, cooked and cubed
½ cup green or sweet red peppers, sliced lengthwise
¼ cup diced celery
¼ teaspoon seasoned salt
½ cup plain low fat yogurt
2 Tbl. low fat mayonnaise
½ tsp. prepared mustard
¼ tsp. ground ginger
2 fresh ripe pears cut into 1 inch cubes
2 tsp. slivered almonds, toasted

Toss together chicken, green or red sweet peppers and celery. Sprinkle with seasoned salt. Combine yogurt, mayonnaise, mustard and ginger. Add to the chicken mixture and slowly add in ripe pears. Serve on individual lettuce lined plates.  Sprinkle with almonds. Note: be sure that the pears are ripe before using them.

Makes 4 servings.  Each serving:
213 calories, 7 grams of fat. 16 grams of carbohydrates, 21 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:
  Maureen Gonzales

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

I never thought I would be writing a success story. I always felt “normal” inside, but it was others that made me notice I was obese.  When I was 22 years old in 1993 I had a little girl and while pregnant I gained 150 pounds with her.  I was thin my whole life until then so I didn’t know how to eat right. I always just ate whatever I wanted. 

After gaining that weight while pregnant, I only lost 30 pounds after giving birth.  I went on every diet like everyone else. I tried everything, even Phen-fen.  I was desperate.  I lost 90 pounds doing the “non” fat approach, gained it back and then some. I then lost 75 pounds on Weight Watchers and kept that off for 3 years then gained it back and then some. 

For years I was in denial saying I was happy being fat and if anyone didn’t like it they didn’t have to look, and they shouldn’t speak to me about it.  I couldn’t help not seeing the laughing behind my back at restaurants or if I was shopping for clothes.  Then when my daughter was in school I walked up on her fighting with her friends defending me because they were making fun of me. I was devastated.

In 2004 I met the love of my life. He loved me at 300+ pounds for who I was!  We got married in October 2006.  A few months later I was at my lowest point in my life because I realized my husband was taking care of me all the time.  We would go out to eat and I couldn’t fit in the seats and he would just say “it is ok honey I will get a different chair without arms.” Talk about embarrassing!  He didn’t even bat an eye.  We would go to movies and I would sit sideways in the seats yet he didn’t care.  He would drop me off by the door of a store so I wouldn’t have to get out of breath walking through the parking lot.  I am 35 years old, and I thought to myself, ‘this is crazy!! I was too young to act like this.’ 

My back hurt, my knees hurt, everything hurt! I went to the doctor and he told me I had high cholesterol and that I was a candidate for gastric bypass surgery.  I went home crying to my husband.  Later that year I came home, sat my daughter and husband down and said I had decided to have the surgery and I needed their 110% support. They both said “absolutely!”  I called my doctor and got started.  I went to all the doctors’ appointments, they tested me for everything and in a few weeks I was approved and they wanted to get me right in!  I scheduled my surgery on my birthday March 20th 2007.  I thought it was a perfect day, the day I was reborn!

I was so scared, and that is an understatement.  I cried all the way to the hospital that morning. I thought I had made the wrong decision.  Dr. Endo of the John Muir Weight Loss Center, Concord, Ca. performed my surgery. In my eyes, he is my life saver.  I woke up from the operation and had absolutely no pain whatsoever.  I was having a hard time keeping my eyes open, but it was weird I felt wide awake.  I was in the hospital overnight and went home the next day.  I never had any pain. just a little tenderness.  I can say it was not that easy after a few days not being able to eat whatever I wanted, but I stuck to the diet because I didn’t want to hurt myself.

It has been 2 years now and I have lost 135 pounds!  My weight went from 306 pounds to 171 pounds.  I hit that goal in 1 year.  I went from a size 26/3x to a 12/Large.  I feel absolutely fantastic and have no regrets. It was the best decision I ever made.

I couldn’t have done it without the love and support of my family and friends.  I finally look like I always felt I was on the inside!

Maureen Gonzales
Concord, CA

Congratulations Maureen


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