Issue #173 September 15, 2009

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In This Issue


* Pill Power
* Need Body Image Stories
* Hear from a Back on Track Member
* Research Article: Gastric Bypass Surgery and our Immune System
* Recipe: Braised Pork with Sun-Dried Tomatoes
* Double Success Story: Frank and Laura Casper

Pill Power

Hello Barbara
A couple of years ago you mentioned a diet pill you recommended for anyone regaining after gastric bypass. Could you give me the name of that pill and where to get it. Thanks.

Kathy Allen

Hi Kathy,
There are 3 diet medications that are used currently.  There are more, but these 3 seem to be the most frequently prescribed.

Meridia affects the area in your brain that controls hunger so that you have a greater sense of fullness and satisfaction.

Meridia has the potential to increase blood pressure and heart rate. Patients taking Meridia lose an average of 5% to 10% of their weight. In a 12 month study, that resulted in a 10 to 14 pound weight loss depending upon the strength of the does.

Phentermine is a stimulant like an amphetamine that works on the hypothalmus gland which controls your appetite. Phentermine alone has been found to be safe, but when combined with fenfluramine making phen fen, it can cause a lung disease.

Xenical interacts with food that you eat to block the absorption of fat. The over-the-counter name for Xenical is Alli which is available without a prescription. By blocking fat absorption, Xenical decreases the number of calories that you actually absorb. Xenical does have a slight to extreme side-effect of causing diarrhea depending upon the amount of fat you eat.  The more fat you consume, the worse it is.  Therefore the side-effect deters you from eating fat.

There are 3 additional medications that will apply for FDA approval probably by the end of the year. They are:

Qnexa, Contrave and Lorcaserin
Qnexa seems to be the pill that everyone is excited about.  Clinical trials have shown the most weight loss with few side effects. The drug combines phentermine which is the good phen from the phen fen drug and topiramate, a drug used for epilepsy. It is the combination of the 2 drugs that makes Qnexa effective.

How effective is it? In the latest phase 3 trials covering 28 weeks at 32 clinical sites, patients lost an average of 19.8 pounds over 28 weeks when on a full dose, 18.2 pounds when on a half dose, and 3.2 pounds when taking a placebo. The results for Qnexa are better than any other diet drug on the market. Look for Qnexa in 2010.

The other 2 diet drugs in FDA trials, Contrave and Lorcaserin have not received as much attention as Qnexa, mostly because their results aren’t quite as good.

The question remains whether to take a diet drug.
I must admit that I am a believer that if there is something safe that will help with your weight loss, as long as you are combining it with healthy food choices and exercise, then consider it and talk with your doctor. Obesity is a chronic condition. Many of us, even following surgery, especially after 3 or 4 years, start to struggle. There are medications for other chronic conditions that most people wouldn’t think twice about taking.  I think we are sometimes a little hard on ourselves and still believe that we are at fault and failures because we gain weight.  Sometimes we are at fault, but sometimes we need help.

Please Send Your Body Image Stories

I will be speaking to psychologists about the subject of body image in the near future and would like to be able to relate some stories to them.  If after your surgery you had a difficult time accepting your new body, please email me at

If you don’t want to write out your entire story, we can also talk by phone to get more of the details. Thanks so much.

From a Back on Track Member

Dear Barbara,
I wanted to write to tell you that I love your Back on Track Program. It has really helped me get back to where I need to be. I love the members, and the encouragement they give is amazing. I don't feel alone. As much as our families say they are supportive, they a lot of times just don't get it.

Thank you for all that you do, Barbara

Diana Johnson


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`?

 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.

Research Article:
  Gastric Bypass Surgery and
  our Immune System

Researchers at Michigan State University are studying the effects of gastric bypass surgery on the immune system, and are also studying the effects that obesity and morbid obesity have on the immune system. We know that gastric bypass surgery has beneficial effects on many diseases, but what happens to the immune system? Is it compromised because we cannot initially consume a nutritious diet? And does the loss of weight and the benefits to our general health, make up for the lack of initial nutrition? These are areas being studied by Pam Fraker, a professor in the Department of Biochemistry and Molecular Biology at Michigan State University as she works with surgeon Pandu Yenumula at Sparrow Hospital in Lansing, MI to find the answers.

To read the entire article, go to

Thanks to Sheryl Lamarand for recommending this article to me.

  Braised Pork with Sun-Dried Tomatoes
I love anything that includes sun-dried tomatoes.  That rich tomato taste enhances any meal. If you are like me, you will love this pork recipe featuring sun-dried tomatoes.

Braised Pork with Sun-Dried Tomatoes

12 sun-dried (not oil packed) tomato halves
¾ lb. well-trimmed pork tenderloin, cut into 1-inch wide strips
1 ½ teaspoons balsamic vinegar
1 teaspoon olive oil
4 cups small broccoli florets
1 red onion, diced
1 cup chicken broth, defatted
1 cup dry white wine
1 clove garlic, minced
¼ teaspoon salt
2 teaspoons capers, rinsed and drained

1.  With kitchen scissors or a small sharp knife, cut the sun-dried tomatoes into thin strips. Set aside. In a medium bowl, toss the pork and the vinegar. Set aside.

2.  In a large non-stick saucepan, heat the oil until hot but not smoking over medium heat. Add the broccoli and onions and cook, stirring occasionally, until the onion is softened, about 5 minutes. Add the broth, wine, the sun-dried tomato strips, garlic, and salt. Bring to a simmer, cover, and cook for 3 minutes to reduce slightly and blend the flavors.

3.  Add the capers and reserved pork mixture. Cover and cook until the pork is cooked through, about 5 minutes. Divide the mixture among 4 plates and serve.

Makes 4 servings:

Each serving:
254 calories, 27 grams carbohydrates, 29 grams protein, 5 grams fat.

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

Double Success Story:
   Frank and Laura Casper

I want to offer special thanks to Laura and Frank Casper for sharing their story of their double success.  Here is their story:

Dear Barbara,
I enjoy reading your monthly newsletter.  My husband and I are both RNY post-ops and have had incredible success so far (knock on wood).  After our health continued to decline, we both decided to pursue bariatric surgery a little over five years ago.  We started doing research and trying to learn about the surgery and weigh the risks and benefits. 

After being referred to a weight loss surgery program in late 2004, we were both put on a waiting list until our HMO could fit us into their very busy surgery schedule.  There was very little prep work or requirements.  All we did was ask for the surgery, get rejected once (as everyone told us would happen), ask again and get approved.  There was no testing, classes, support groups or pre-op weight loss required.  Before we reached the top of the surgery list, our circumstances changed and we relocated, so we had to start all over with our new HMO. 

We were referred to a bariatric surgery program again in late 2005.  With this program, there were a considerable number of pre-surgery requirements, including attending classes, numerous medical tests, support group meetings, and a loss of 10% of our highest weight.  I was sure that my HMO was doing everything to continue to put hurdles in my path.  It seemed like every time I completed one of their requirements, there were new ones to conquer.   I convinced myself that my HMO would rather see me die of the complications that come with morbid obesity, and I spent a lot of time feeling sorry for myself and crying at support group meetings.

It took me almost a year to “get my head in the right place” and stop feeling like a victim.    Once everything clicked into place mentally, I started seeing success.  Within about four to five more months, I completed the rest of the required steps and was approved for surgery. 

Shortly before my surgery date arrived, there were more medical complications, so my surgery was postponed four different times.  Not only was I dealing with diabetes, high blood pressure, high cholesterol, cellulitis, migraines, back pain,  severe obstructive sleep apnea, obesity hypoventilation syndrome, anemia, severe depression, suicidal tendencies, edema, GERD, a heart murmur, and complications from Lyme Disease, during the process, I was diagnosed with Cushing’s Syndrome and chronic kidney disease.  I was devastated every time my surgery was postponed and again felt like it might never happen, but I was able to stay on program and continue to lose weight. 

By the time I made it to the operating room, I had lost 80 lbs and totally retrained my brain.  I knew this was not the easy way out, because I had worked so hard just to get to the operating room, although I still weighed 348 lbs.  I knew what I had to do and basically what to expect as a post-op, thanks to a fabulous support group and online group.  My weight loss surgery friends kept me motivated and educated. Without them, I don’t think I would have had the surgery, because I would have given up.  They gave me hope and tremendous support!

On September 5, 2007, the day of my surgery, I was suffering from the worst migraine I ever had and couldn’t stop holding my head, closing my eyes, moaning, crying and vomiting.  I think all the stress of the two year long process getting to surgery was bringing on a horrible migraine.  I was so sure that my surgeon would boot me out the door again, but he said he knew the migraine was just the result of stress.  Some drug knocked me out in the prep area.  I don’t remember my surgeon visiting, being taken to the operating room, kissing my husband and daughter goodbye, and I never saw the operating room.  When I woke up, I was being moved from the recovery room to a room in the progressive care unit, where the nurses are very experienced and knowledgeable about bariatric surgery.

My surgery was textbook thanks to an awesome bariatric surgery team.  Our program includes a severe obesity case program manager, a dietician, a social worker, a physical therapist, a pharmacist, bariatric surgeons, and others, who work well as a team to give weight loss surgery patients the best chance of post-op success.

I have lost a total of 248 lbs. (including 80 lbs pre-op) and will be two years post-op in September.  I am thrilled to be able to say I am at goal weight.  I am one of the few who has lost every pound I hoped to lose.    

My husband was with me every step of the way.  He went to all my appointments, classes, support group meetings and worked out with me.  We decided that I would “go first” and once I felt like things were under control, my husband began seriously working towards getting approved for his surgery.  On July 9, 2008, he had RNY surgery with the same surgeon who operated on me.  He is almost one year post-op and has lost 203 lbs. (including 58 lbs pre-op) and is still losing fairly quickly. 

The changes in our lives are amazing.  Neither of us is considered diabetic any more.  Neither of us requires a C-PAP to control sleep apnea.  Neither of us has blood pressure or cholesterol problems any more.  My endocrinologist says I no longer test positive for Cushing ’s syndrome.  I haven’t had a migraine since the day of surgery.  I no longer have suicidal thoughts.  I will always have kidney disease to deal with, and was told that best case scenario was to stop the further loss of kidney function, avoid dialysis (which would have started if my kidney function reached 10%) and stay off the transplant list. My nephrologist was amazed when my kidney function went from a low of 21% all the way up to 54% the last time he checked.  He said he has no idea how I did that! 

Both my husband and I feel so lucky to have been so successful.  We are trying hard to keep up with all the post-op requirements.  It has been so helpful having each other to work toward the same goal. 

Next month, we are going on a Western Caribbean Family Reunion Cruise.  We haven’t seen this side of my family in two years and it will be so much fun showing them the new and improved Frank & Laura, and seeing if they can keep up with us this time!  We are going to do things we never thought we’d ever be able to do, like going horseback riding on the beach and riding on a zip line.  I played laser tag on my son’s birthday and outscored some of the high school students!

Though I still see myself as a morbidly obese person, people call me skinny now.  It’s very weird to be able to enjoy looking at myself in the mirror and not trying to avoid mirrors and cameras. I can buy clothes in any store.  I can fit in airplane seats, restaurant booths, movie seats, chairs with arms, restroom stalls, etc!  I have blossomed mentally and socially, though I still need prescription anti-depressants to control my depression.  We attend two different monthly support group meetings, plus I am the moderator of our local online support group with almost 200 members in various stages of the weight loss surgery process.

We each used to weigh 428 lbs at our top weights.  We have lost a total of 451 lbs (so far) so we tell people we are literally half the couple we used to be!

Life is awesome and we are both so happy that we chose this option!  My only regret is that I didn’t do this years ago! 

Thanks for listening! 

Laura Casper

Congratulations Frank and Laura


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