By Lori Skurbe, RD, MPH, CDE
Dietitian’s Corner is a monthly column for post-op and pre-op patients of bariatric surgery in NJ written by Prime Surgicare’s Lori Skurbe. Lori has been a dietitian for over 20 years with an extensive background in weight management, bariatric nutrition and diabetes education. She has worked at the local, state and national levels of The Academy of Nutrition and Dietetics, and she has served as president of the New Jersey Dietetic Association.
I often see many patients exercise diligently during the warmer months – walking, biking, swimming and other outdoor activities, but as soon as it gets cold and dark, the exercise falls off the map. I get it — getting dark before 5 pm and plunging temperatures do not make for a great exercise atmosphere, but the cold reality is – IF you don’t exercise or exercise enough, you will not reach your weight loss goal, and even worse, you will start to regain! So what can you do to make sure your exercise is consistent all year round? Below are some tips to get you through the winter and beyond!
Regardless of how you approach your physical activity, the important thing is to stay motivated and consistent throughout the year. Exercise is a critical part of weight loss and an essential part of maintaining the weight you worked so hard to lose!
What do you do to stay on track with your physical activity during the winter? Leave a comment below. We would love to hear from you!
After weight loss surgery (WLS), you will adopt an improved method for adding fuel to your body in a healthier way, by consuming high-protein, low-fat and low-carb meals. Weight regain is more likely to happen when WLS patients veer away from the bariatric meal plan and fall back on old eating habits.
One way to stay on track is to modify higher-calorie, high fat and/or high sugar recipes to make them more bariatric friendly.
When you change a recipe, the first thing to consider is the purpose of each ingredient — some provide flavor, some offer texture or structure (particularly when making baked goods) and others are used as a binder or for moisture.
With the holiday season fast approaching, I’d like to offer a few ways to prepare your favorite family recipes, but with fewer calories, fat and carbs.
If the ingredient is required for flavor or moisture/binder, you can readily change them. For example, when making dips, use fat-free plain Greek yogurt instead of sour cream. In this case, the sour cream is there to bind the other ingredients and provide moisture.
Greek yogurt serves the same purpose as sour cream, but with far fewer calories and more protein and other important nutrients.
Holiday and everyday recipes can be modified by changing ingredients that add the most calories – usually fats and sugars.
To lower the fat, try these suggestions:
To reduce sugar, try these easy and delicious substitutions:
When modifying a recipe, make one change at a time, so you know how each change affects the recipe’s outcome. Keep a record of how you adjusted the recipe.
Modifying recipes is a great way to make some of your family favorite recipes more bariatric friendly. In addition, by making holiday favorites more healthful, you can stay true to your bariatric plan and not gain weight over the holiday season.
I would love to share your favorite bariatric-friendly recipe with our other patients and our monthly bariatric support group meetings. Please email them to me at email@example.com or leave a comment below.
Prime Surgicare’s one-of-a-kind Bariatric Success Program offers a five-pronged approach to preparing and ensuring your long-term weight loss success, including private visits with bariatric nutritionist, Lori Skurbe.
To find out more, register for one of our free monthly bariatric seminars or webinars, or call our weight loss surgery specialists at (732) 982-2002 to schedule your private consultation.
“You can fully enjoy socializing at your favorite restaurant with friends and family after bariatric surgery,” says Prime Surgicare dietitian Lori Skurbe, MPH, CDE. “The only change is what you eat, drink and the size of your portions.”
Lori provides private nutritional counseling to our patients before and after weight loss surgery. She also facilitates the monthly bariatric support group meetings at CentraState Medical Center in Freehold, which also include Prime Surgicare bariatric surgeons and staff.
“Some patients experienced pushback in restaurants when they ordered child-sized meals or only the appetizer,” Lori explains. “So we created business cards which outline the medical necessity for you to consume reduced-sized meals.”
If you’d like to have one of our bariatric ID cards, you can print one from the image shown here or we would be happy to give you a card at your next office visit.
Lori recommends patients who order full-size meals ask their server to bring a take-home container when their food is served.
“This way, you can separate what you will enjoy during the meal and remove the excess food for tomorrow’s lunch and sometimes even dinner!”
Dr. Seun Sowemimo also reminds people they can personalize their meal and even order off the menu in more places than you might realize. “I have an aversion to heavy sauces and prefer my protein to be prepared without fat or oils,” he says. “I also don’t care for that heavy feeling after I eat potatoes or pasta, so I substitute them with a second vegetable or extra salad.”
“Remember, you are in charge of what you eat when you dine out,” says Dr. Seun. “Order your meal in a way that makes you feel satisfied, not guilty.”
>>> Share your tips and tools for dining out after weight loss surgery on Dr. Seun’s Facebook page.
Everyone’s lifestyle is unique — the way you work, exercise and when and what you enjoy eating. That’s why we created Prime Surgicare’s Bariatric Success Program, comprised of five exclusive bariatric resources tailored to meet your ‘real-life needs.’
“The bariatric journey is much more than just an operation,” Dr. Seun explains. “We created a comprehensive lifestyle change program to help every patient achieve their weight loss goals quickly, safely and permanently.”
To find out more, register for one of our free monthly bariatric seminars or webinars, or call our weight loss surgery specialists at (732) 982-2002 to schedule your private consultation.
Everyone has to meet with a dietitian before Weight Loss Surgery (WLS) to meet insurance requirements. Some people may look at this as a box they need to check or another hoop to jump through along with all the other specialists they need to see to get approved for surgery.
Instead, look at these meetings with your bariatric dietitian as a chance to learn as much as you can about how your diet will change and how you can begin making those changes. Meeting with a bariatric dietitian is an important part of your WLS journey to begin to learn a new way of eating. Nutrition is the cornerstone of WLS success — even with surgery — if you are not following the bariatric way of eating, you will not maximize your weight loss and will regain.
Below are 5 questions you should ask at your meetings with your bariatric dietitian:
Changing habits is hard work and takes patience and perseverance. Don’t wait until you have your WLS to make changes – habits change the longer and consistently you practice them! When you start you WLS journey at your first nutrition visit – you have taken the first step in a healthier, happier you!
What questions do you have about your weight loss? Leave a comment below. We would love to hear from you!
“Weight Loss Surgery is just a tool.” We have all heard this statement many times, but it is absolutely true – Weight Loss Surgery (WLS) does not work, unless you adopt the healthy eating and exercise habits required to lose and sustain your weight loss. Changing habits is hard work and takes a lot of effort. Old habits are always waiting in the wings to jump back in and take over, which can slow down weight loss or cause weight regain. Falling off track can happen to anyone, but there is a way to get back on track. Below are 7 tips to help you get back on a path to success!
If you are not losing or if you are regaining weight, it is worth time and effort to re-evaluate eating and exercise habits to get back on track to success and better health. For further assistance, make an appointment with the dietitian to evaluate your habits and find out more about our exercise programs. We are here to help and are invested in your success!
What do you do to keep up with your weight loss? Leave a comment below. We would love to hear from you!
Summer time is often a fun time of year. Many people go down the shore, have family vacations, backyard BBQs and more social events. For a Weight Loss Surgery (WLS) patient navigating through the food and beverages can be very challenging. Below are tips to stay on track and still enjoy the summer.
Be Mindful of Your Bariatric Plate
Even at summer time gatherings you still want to get your protein in and get it in first. The good news is most BBQs and picnics have some type of healthy protein. Look for grilled chicken or burgers (no bun) to enjoy first. Eat vegetables are second and carbs are last, if you have “room.”
Watch Your Portions
Even though our WLS helps keep the portions at bay, our eyes can still be bigger than our appetite. Use small plates and bowls to limit the amount of food in front of you and minimize grazing.
It is very important to stay hydrated all year round and get in 64 or more ounces of calorie free, caffeine free beverages daily. However, during the hot and humid summer months, you are more likely to become dehydrated if you are not careful. Make sure you are sipping appropriate fluids between all meals.
Caution with Alcohol (beer, wine, liquor and mixed drinks)
More social gatherings can mean more alcoholic beverages. Keep in my mind an occasional adult beverage is usually not a problem. However, alcohol is very high in calories and can affect your ability to lose weight and maintain weight loss. In addition, Weight loss surgery patients do not process alcohol the same way they did before surgery. WLS patients get drunk faster and on much less alcohol – so be very careful when you drink – have a designated driver. If you feel your drinking is becoming a problem – do not hesitate to get help.
Summer is the best time to be active! Walking, biking, swimming, jogging, hiking and summer sports can make staying active easier. Make sure your social calendar does not take away time from your regular physical activity.
Control Your Options
If it is appropriate, bring a dish to a BBQ or picnic that is bariatric friendly, such as marinated grilled chicken, fresh fruit salad or cut up, raw vegetables with a low calorie dip. When you can bring your own food, you control what you eat.
When traveling, do a little research to find out what types of restaurants are in the area you will be visiting. Many restaurants have their menus online and many chain restaurants have the nutrition information online. This information can help you make more healthful meal choices. If it is possible, stay at a hotel that has a kitchen in the room so you can cook more of your meals – not only is this cheaper, but it puts you in control over what you eat.
Too often social gatherings are about the foods and beverages and not about the people! When we take the focus off food – we become empowered! Try not to make social events and vacations about the food, make them about family, friends and fun!
Navigating the summer social scene can still be fun and not cause weight regain or put your weight loss at a stall. With some pre planning and mindful eating you can stay on track!
What plans do you have for your summer? Leave a comment below. We would love to hear from you!
Most Weight Loss Surgery (WLS) patients know they need to change their lifestyle habits (diet and exercise) to lose weight and keep it off. What many may not know is that diet and exercise are not enough – what is missing? Your bariatric surgery support group! Research shows that regular attendance of a bariatric surgery support groups is vital to your success both short and long term.
Bariatric surgery support groups are a place where all patients (post ops, pre ops or prospective patients) can learn more about what to expect after surgery from people who have actually had the surgery.
Most support groups have a topic planned for each meeting to help educate patients and allow patients to share their experiences to help others. Some topics we have had at our support group meetings are: emotional eating, food addiction, fitting in fitness, addiction transfer and non-scale victories to name a few.
Getting Back on Track
Some WLS patients have gotten off track, fallen back on old habits and may be experiencing weight regain. Returning to your bariatric support group for guidance and to reconnect with other patients and your bariatric surgery team is a good place to start to lose that regained weight. You will find you are often not alone in your struggle and many can offer support and advice.
Long Term “Veterans”
Many WLS patients who have had surgery 3 or more years ago find it important to stay connected to other WLS patients and their bariatric surgery team to stay on track. Staying involved with their WLS support group not only helps them, but helps newer post ops and pre op patients get advice and support from someone who has been in their shoes.
Making New Connections
Even though you may have a supportive family and friends, it is not the same as having friends who are also WLS patients. Many WLS patients meet and make new friends through their bariatric surgery support group.
Bariatric surgery support groups are a place where WLS patients can feel “safe” sharing their feelings, thoughts, triumphs and challenges with other patients. Friends or family outside of the bariatric community may not fully understand what you are going through.
People who regularly attend a bariatric support group may lose more weight than their peers who do not. In addition, WLS patients who attend a support group may have a better chance of maintaining their new healthy weight.
For all the above reasons, attending a WLS support group provides the support, education, comradery and a safe place to discuss your weight loss journey. At our office we provide monthly support group meetings, usually the second Wednesday of the month from 6-7 pm. Check our website primesurgicare.com or call the office at 732-761-1740 for dates, time and location.
Are you part of a great support group? Leave a comment below. We would love to hear from you!
We understand it can be hard to fit in fitness, which is why we have fitness groups at Prime Surgicare. Usually once a month on a Saturday morning the Trailblazers, Trotters and Trekkers meet to bike, jog or walk for one hour on the Henry Hudson Trail right here in Freehold. This is a great opportunity to get out, get some fresh air, make new friends and burn some calories! We usually meet during the warmer months – May through October.
Check out our Prime Surgicare Fitness Groups page. Here you can find more information about when and where our fitness groups meet. You can also call the office at 732-761-1740 for more information!
Do you have any fitness routines? Leave a comment below. We would love to hear from you!
When people have Weight Loss Surgery (WLS), they often do not realize how quickly they get “full” after eating just a few bites. Your brain (or your eyes) tell you to eat more, but there is no room. For some people this is a relief as they always felt hungry and glad they are now satisfied with meals. For others, sadness, depression and even anger can set in as you do not seem to have the same pleasure in eating as you did before. Food used to be a comfort, your best friend and you may have enjoyed cooking for others – those pleasures are no longer there. This is called food mourning.
How do you cope?
Enlist the help of a bariatric dietitian to help you learn how to manage food choices and a therapist (psychologist or other licensed behavioral health specialist) that has a background in bariatric surgery to help you learn how to manage the depression, anger or sadness you may be feeling.
Some find it helpful to learn new ways to enjoy foods and create new recipes that your whole family will enjoy. It can be helpful to channel your love of food into a more balanced and healthy eating style. In addition, eating slowly post-op not only helps you tolerate foods better, it can also help you savor each bite. Think about quality not quantity.
A therapist can help you learn better coping strategies to get through this part of your WLS journey. The tools that you learn will help you throughout your journey and in other aspects of your life. For additional support, talk to the bariatric surgeon and come to our free monthly support group meetings. Our support group is well attended by bariatric patients who have been in your shoes and can offer sage advice to help you get through this challenging time.
You are not alone if you feel like you miss food after WLS, it is a real phenomenon. Talk to your bariatric surgeon, dietitian, and/or therapist and attend support group regularly to help you get through this challenging time in your weight loss journey.
Do you experience food mourning? Leave a comment below. We would love to hear from you!
For those that have had Weight Loss Surgery (WLS) eating protein based meals is important. Making sure you are eating healthfully to prevent heart disease is also important since many bariatric patients have had or still have high blood pressure and high cholesterol levels. Heart disease is still the leading cause of death in the United States.
The good news is much of the bariatric way of eating does fall in line with a heart healthy lifestyle. Here are some things you can do to stay on your weight loss journey and have a healthy heart, too!
Learning healthful eating habits and physical activity is a process – set new goals for yourself regularly to help you stay heart healthy and on track with your weight loss journey.
What goals do you have to stay on track? Please share them with us. We would love to hear from you!
With the winter chill in the air and ice and snow on the ground, many of us go into hibernation until the spring thaw.
Weight Loss Surgery (WLS) patients should be active all year round to lose or maintain their weight. It can be hard to get motivated to move during this time of year, but instead of lamenting that you can’t ride your bike, go for your walk or swim in your pool, let’s look at the fun things winter has to offer to get moving! Below are some seasonal activities to consider:
Skiing: Do you ski? Want to learn? There are many places to ski in our area. Skiing gives you a chance to be outdoors, get some fresh air and exercise in some beautiful scenery! Many people enjoy this sport and you may find you do too!
Snowboarding: Many places that offer skiing also offer snowboarding. Another great way to get outside, get moving and enjoy the winter season!
Ice skating: There are many local ice skating rinks in the area that have open skate times and skate rentals. This activity is indoors, so if you are really not a fan of the cold weather this might be an option for you!
Snow shoeing: This can be a fun activity! If you like being outside blazing through fallen snow, this might be your new activity! There are many parks and nature preserves in NJ that offer snowshoeing trails.
Hiking: The same trails people hike on during the warmer months may be open during the winter. Check with your local or state parks for more information.
The above are also great family or group activities! Get the whole family active or get a group of friends together who may also enjoy these activities! Remember to dress appropriately for the weather conditions, check the local forecast and make sure your gear is in working order so you have a safe and fun experience!
What fun activities do you do to stay active during winter? Please share them with us. We would love to hear from you!
At the end of each year, some take time to reflect on their experiences over the past year. Now is a good time to take stock in how you are doing with your Weight Loss Surgery (WLS) journey. Some things to think about are:
What have you accomplished this past year?
What are you most proud of?
What was your biggest success(s)?
What was your biggest challenge(s)?
How did you overcome that challenge(s)?
What did you learn about yourself?
What do you wish could have done better/differently?
What event or individual most influenced your WLS journey?
The above questions can help you understand how far you have come, where you have been and also help you figure out where you would like to be in 2017. Based on your responses to these questions, you can determine what weight loss goal(s) you want to set for the upcoming year.
Having goals helps us stay on track, remain focused and minimize setbacks. People who set a goal that is truly meaningful, usually have a much better chance of reaching that goal, rather than making a generic New Year’s resolution.
What are your goals for 2017? We would love to hear what plans you have below!
Have a Happy and Healthy 2017!
The holidays are a wonderful time of year where we celebrate giving and togetherness with family and friends. However, all of the holiday preparations can get out of control and lead to increased stress.
For many people who have had weight loss surgery (WLS), stress can lead to increased eating and less time for physical activity. Not to mention the holidays are fraught with all types of obstacles to sticking to your bariatric eating and exercise plan. How can you get through the holiday season with the least amount of stress? See the list below for some tips to remain calm and joyful during the holiday season.
What are your suggestions to minimize stress over the holidays? Please share with us what you do to remain calm and joyful over the holiday season. We would love to hear from you!
At our last support group meeting the topic was: What Do You Wish You Knew Before Weight Loss Surgery (WLS) to Better Prepare You for Life After Surgery? What followed was a lively discussion on the long term issues people face post op. Here is a summary of the key points we discussed:
Does anyone else have any thoughts on this topic? Please send us your comments – we would love to hear them!
Many people ask if they can have a “drink” once in a while after weight loss surgery (WLS). According to the American Society for Metabolic and Bariatric Surgery (ASMBS) the use of alcohol is not advised after weight loss surgery.
Alcohol, whether it is beer, wine, liquor or mixed drinks, contains a lot of calories and minimal nutrition. The poor nutrient content and high calories found in alcohol can sabotage your weight loss goals and may cause weight regain. In addition, your body absorbs and metabolizes alcohol differently after WLS. Many people find they get “drunk” faster and with much less alcohol than before surgery. Alcohol is absorbed more quickly, is “stronger” and takes longer for blood alcohol levels to return to normal after WLS. These variations in how alcohol affects WLS patients are more prominent in those who have had the gastric bypass, but similarly affect people who have had the sleeve gastrectomy.
The use of alcohol after WLS can be dangerous for many reasons. When you become intoxicated quickly, it can impair your judgement and your ability to safely drive or operate heavy machinery. In some WLS patients, it may lead to alcohol dependence, organ damage and weight regain.
Since alcohol is absorbed and metabolized differently after WLS, patients are more vulnerable to becoming addicted (especially in those that already have an addiction, even if that addiction is to food). After WLS, people cannot get the same “high“ from food, so they switch to alcohol because it works faster and is stronger. Alcohol addiction can replace the food addiction or other addictions, which is called Cross Addiction or Addiction Transfer.
Alcohol irritates the lining of the stomach and can damage other organs, even your brain. In addition, drinking alcohol can affect your ability to lose or maintain your weight as you are consuming lots of empty calories and the lack of inhibition increase your chances of making unhealthy food choices.
If you can stop drinking — do it! If you cannot stop drinking — GET HELP!! Call our office at 732-414-2707 or speak to your primary care physician to get information on your treatment options. Alcoholism can ruin your life – not just your weight loss.
Questions, comments or concerns? Send me a message below! I’d love to hear from you.
Shadle, Benjamin, MD, Should WLS Post-ops Drink Alcohol After Surgery?, July 15, 2016, ObesityHelp.com, accessed 9/8/16.
Stapleton, Connie, Drinking Alcohol After Weight Loss Surgery, September 30, 2015, ObesityHelp.com, accessed 9/8/16
Wilson, Cathy, Crossing the Line to Cross Addiction, December 15, 2014, ObesityHelp.com, accessed 9/8/16
Staying hydrated after Weight Loss Surgery (WLS) can be a challenge. You can no longer guzzle down your water or other beverages the way you did before WLS — you now have to sip fluids slowly. You can no longer eat and drink at the same time — you have to get your fluids down in between meals. You also cannot drink a lot at one time as you may get full quickly. In addition, physical activity and hot weather may increase sweating, which increases your need to drink even more fluids each day.
We recommend getting in 64 or more ounces of calorie free (or very low calorie – 10 or fewer calories per serving), non-carbonated and caffeine free fluids in daily. If you are having trouble getting in your fluids, here are some tips:
If you have any further questions about staying hydrated – do not hesitate to call the office at 732-414-2707 or leave a comment below. We are happy to help!
Summer months are often filled with trips to the shore, BBQs and family vacations. Whether you’re taking a day trip or traveling for an extended period of time, some pre-planning is necessary to help weight loss surgery patients stay on track. Below are some tips to help guide you when planning a family vacation or even a business trip.
Whether you are driving, flying, taking a train or going on a cruise, you want to make sure your food environment is supportive of your weight loss/maintenance goals.
If you are driving make sure you bring a cooler that has bottled water or any calorie free beverages to stay hydrated. Pack protein-rich, high fiber foods such protein drinks or bars that you can grab in a pinch if you need a quick meal. Also pack fresh fruit and 100 calorie packs of nuts if you need a quick snack and nothing else is available.
If you’re traveling by plane or train, call the airlines, transit company or travel agent to find out what type of meals (if any) will be served. You may be able to get a lower fat, healthful option if you ask.
If you’re going on a cruise — do not make the trip about the food and beverages. Take advantage of the onboard activities and ports of call.
In addition, most cruise lines offer special “spa menus” with more healthful options so you can still enjoy your meals while staying on track. You will also find many cruise lines have state-of-the-art fitness centers and walking/jogging tracks on board so your physical activity does not take a vacation.
Check out what type of eateries are in or around your destination so you can review the menu options beforehand and plan what your best choices are. Many restaurants have their menus online and some chain restaurants have the nutrition information on their websites. You can also find menu information in smart phone apps such as My Fitness Pal.
Book a hotel that offers rooms with a kitchen. This allows you to bring in your own food and increases your control over what you eat. It’s also a lot more healthful (and cheaper) to cook some of your meals instead of dining out all the time.
Always remember your bariatric basics which are:
Most restaurants offer grilled, baked or broiled meat, seafood and poultry, a variety of vegetables and healthy carbs for the choosing. Don’t come back from your trip heavier than you left. You worked so hard to lose the weight, a little pre-planning can help you continue to lose or maintain your weight, even when traveling.
If you have any further questions, do not hesitate to call the office at 732-414-2707 or leave a comment below.