Conquering the Weight Loss Plateau

By: Kristen Shaben, MS, RD, LDN

Nothing is more frustrating than eating right and exercising regularly only to have your weight loss slow down or stop.  This aggravating reality is known as a weight loss plateau.  Here are some quick tips for conquering the plateau and continuing with successful weight loss.

-Evaluate your protein

- Eat protein at each meal and snack for a total of 60-100 grams per day.  It will keep you full, satisfied, and healthy. 

-Choose leaner cuts of meat.  Meat is a great source of protein, but fatty meats pack a lot of calories. Choose chicken, fish, and lean cuts of beef and pork.

-Eat regular meals and snacks to keep your metabolism going

-Maintain a regular eating pattern starting with a good breakfast.  Eat three meals each day and have a healthy snack if 3-4 hours will pass between meals.

-Don’t deprive yourself of healthy foods in an effort to cut calories.  Focus on protein and fruits and vegetables.

-Watch your sodium and increase your fluid intake

- Minimize salty processed foods and use a little less salt at the table.  A high salt diet can lead to fluid retention and weight gain. 

-Increase your intake of decaffeinated, non-carbonated sugar free beverages.  If water is getting boring, add some squeezed lemon or Crystal Light.

-Change up your exercise routine

-Try a new activity to rev up your metabolism and keep you motivated. 

-Add 5-10 minutes to each of your workouts.  This small increase can add up to 30-60 minutes per week, increase your calorie burn, and boost your metabolism.

-Add some strength training to increase your muscle mass and tone up.

-Make an appointment with our dietician and exercise physiologist.  We can help you evaluate your habits, make small changes, and stay motivated for continued success.

Most importantly keep your perspective!  Plateaus are a normal part of weight loss.  Don’t let it get you down or lure you back into old habits.  You will conquer the plateau!

Posted in Nutrition, Obesity | Leave a comment

Eating on Autopilot

By: Heather Colomb, LCSW, LCAS-P, Southeast Bariatrics Social Worker

A large majority of America’s obese population have mindlessly ignored the inner regulatory process of fullness. Our relationship with food becomes conditioned as we age. If you reflect on the process of hunger beginning in infancy, we are tuned into our bodies messages. Babies eat in a balanced way and have the skill to stop eating when full. Young children typically view meals as a secondary function of life, using food as a necessary fuel to play. Have you ever noticed that children’s reaction of being called for dinner is seen as an unwelcome interruption to their play and activity? Children are called several times to come to the dinner table, then sit down to eat and eat just enough to satisfy their appetite.

Everyone is born with a built in appestat, an internal appetite thermometer. However, as children grow older, the once purposeful relationship with food becomes tangled with thoughts and emotions. Research has found that after the age of five, we begin to navigate away from our built in appestat and rely on the amount of food on our plate to determine the amount of food required to satisfy our appetite. Thus, by kindergarten, the greedy eye, nose, and mouth override the intuition of stomach and cellular hunger. Mindless eating, binge eating, overeating, emotional eating, and “the clean plate club” all condition us to detach from our appestat. This typically results in weight gain often times losing touch with our innate ability to regulate food intake.

Weight loss surgery is helpful in combating these habits, however patients must relearn the process of healthy eating. This requires mindfulness of the body’s signals of hunger, eating, and fullness. Learning to eat mindfully is a necessary skill to transform your relationship with food.

“Mindfulness is deliberately paying attention, being fully aware of what is happening both inside yourself, in your body, heart and mind, and also outside, in your environment. Mindfulness is awareness without judgment or criticism” -Jan Chozen Bays

Components of mindful eating (from University of Wisconsin Integrative Medicine)

Am I Hungry? A huge part of mindful eating is being aware, that is, not eating as a reflex. When you feel hunger, pause, and bring awareness to that moment. Perhaps your mind/body/spirit needs something other than food to nourish it. Breathe deeply a few times, and do your best to determine the source of your appetite. Dr Bays, in her book Mindful Eating: A guide to Rediscovering a Healthy and Joyful Relationship with Food, describes seven types of hunger.

1.   Eye hunger: the type of hunger that causes us to eat even when our bodies are full, after seeing the dessert menu, or driving by a billboard of a big, juicy burger. Much research has shown that it is very powerful and can override all other signals of fullness.

  • Serve a meal for yourself as you would for guests, on your best plates and silverware.
  • Look at something beautiful or interesting, truly contemplate and appreciate it for a few minutes, imagine its energy flowing into you and nourishing you.

2.   Nose Hunger: scents and flavors entice us to eat, such as smelling the movie theater popcorn.

  • Before eating, smell your food. How many smells can you detect? How does the taste change as you breathe in and out? How long does the taste linger after you swallow?
  • Sit quietly and smell a spice, vanilla, or incense. Sniff your partner or your baby’s head. Let these aromas fill you up.

3.  Mouth Hunger: the mouth is a “sensation junkie” constantly wanting new flavors and     textures. When we do not pay attention to what happens in our mouth as we eat, the mouth feels constantly deprived.

  • Fill your plate with foods of several different textures, e.g. cold, crunchy carrots and warm, creamy potatoes. Focus your attention on the sensations in your mouth. Chew each bite 15-20 times, noticing the intricate movements of your tongue. Swallow and notice how your mouth hunger has changed.

4. Stomach Hunger: Many sensations contribute to “hunger pangs,” but they are not always a signal that your body needs fuel. Your stomach may ask for food because you haven’t eaten all day or simply because it is lunchtime. You may confuse the anxious feeling in your stomach as hunger. Learn more about stomach hunger by delaying eating when you feel hungry. Notice the sensations, feelings, and thoughts you are experiencing. Does the feeling pass? Do you feel stomach hunger at the same time each day? Are you hungry each time a deadline is approaching or when you think of a friend that you miss?

  • If your stomach is asking for something sweet, notice how you feel. Are you tense? Maybe your body is not asking for food right now but needs a break. Stretch and take a few deep breaths, enjoy a walk outside, or slowly savor a cup of tea.

5.   Cellular Hunger: your body craves what it needs to optimally function, but most of us have lost our ability to hear what it is saying.

  • Before you decide what to eat, or while at the grocery store, ask your body what it needs. Maybe it is bright-colored vegetables or some sustaining healthy fat and protein. Perhaps you are just thirsty. This may sound strange or difficult, but just listen to what your gut tells you.

6. Mind Hunger: Thoughts such as “I should eat less fat,” “I should eat more at lunch because I may not have time to make dinner tonight,” and “I deserve an ice cream cone” are examples of mind hunger. What your mind tells you changes based on the latest scientific study or your life situation. It can cause you to get caught up in extremes of “eat this, not that,” habits which can’t be sustained long term. “Dr. Bays writes, “When we eat based upon the thoughts in the mind, our eating is usually based in worry.”

  • This form of hunger cannot be satisfied by food but is satisfied when we quiet our minds.

7. Heart Hunger: Feeling emptiness in your heart is part of being human. We all seek out foods that help us feel happy. Perhaps you crave apple pie when you are lonely because  it reminds you of holidays when your family was together. According to Bays, “Most unbalanced relationships with food are caused by being unaware of heart hunger. No food can ever satisfy this form of hunger. To satisfy it, we must learn to nourish our hearts.”

  • If you eat a comfort food, take a small serving of it. Slowly enjoy each bite and imagine it filling your heart with whatever it is you need.
  • When you eat, think of all the energy you are getting from your food, from the sun that grew the plants, from the animals, from the truck driver or the cook. Be grateful and feel that energy fill you up.
  • Fill your heart in other ways: call a loved one, nurture your garden, make a gift, listen to music, or play with a pet.

Dr. Bays states that the most important mindful eating exercise is to ask yourself, “What type of hunger am I experiencing?” each time before you eat. Only stomach and cellular hunger are satisfied by food. Other forms of hunger will only be temporarily suppressed. Rather than eating as a reflex, you can use this information to decide whether to eat or not. Even if you decide to eat a cookie, don’t criticize yourself. By being mindful of what it is you actually need, and then also being mindful of how eating affects that feeling, you gather lots of information. Then next time you are hungry you can use what you know to make better decisions.

More Ways to Eat Mindfully

After reading about the types of hunger, mindful eating may seem like a huge task that requires intense self-reflection. If you are not ready for that yet, you can still slow down your meals and be more mindful in several easy ways.

• Eat with chopsticks.

• Eat with your non-dominant hand.

• Eat sitting down.

• Eat without TV, newspaper or computer.

• Go around the table and each say something you are grateful for. A great activity for kids!

• Before you eat, sit quietly for at least 30 seconds. Smell your food, and think about where it came from. Picture it growing or roaming in its environment. Think about the steps that food took to end up on your plate…growth, harvesting, processing (hopefully not much), transportation, purchase, and preparation. Give Thanks.

• Concentrate on your arm movements as you bring your food to your mouth.

• Chew your food 10-15 times per bite. Pay attention to taste and texture and how it changes. Swallow when the food is uniformly smooth.

• Set down your utensils between bites. Rest for a few seconds before gathering the next morsel.

• Take a sip of water, tea, or black coffee between bites.

• Put the proper portions of food on your plate and try to make the meal last at least 20 minutes.

If you are interested in more information on mindful eating or participating in a mindful eating group at Southeast Bariatrics, please contact our office to make an appointment with Heather Colomb.

Posted in Behavior Modification, Mental health, Obesity | Leave a comment

Bariatric Surgery to Treat Diabetes

Diabetes is a complex and chronic disease that can result in large vessel disease to the heart, brain and blood vessels and small vessel disease to the kidneys, eyes and nerves. These diseases ultimately lead to premature death if diabetes is not controlled—diabetics have twice the risk of death as non-diabetics. The cost of diabetes is estimated to be $174 billion per year.

In the United States, it is estimated that 26 million people, 8.3% of the population, suffer from diabetes. This number has tripled since 1980 and is projected to almost double by 2034. The increase is in almost direct proportion to the increase in obesity in our society. About 60% of diabetics also suffer from obesity.

Bariatric, or weight loss surgery, is currently the most effective and successful method of treating severe obesity and has become more accepted as a treatment for type 2 diabetes. A large meta-analysis of over 130,000 patients published in the American Journal of Medicine in 2009 found that bariatric surgery improved or resolved diabetes in 86.6% of patients. The Amercian Diabetes Association currently recommends bariatric surgery for patients with a body mass index (BMI) of >35kg/m2 and type 2 diabetes that has been difficult to control with lifestyle and medical management. The International Diabetes Federation even suggests surgery has an option for patients with BMI 30-35 with poorly controlled diabetes.

Two new articles published in the April edition of the New England Journal of Medicine have reinvigorated the issue of using bariatric surgery to treat diabetes. Both studies, one from the Cleveland Clinic and one from Cornell, evaluated medical treatment of diabetes vs surgical treatment in randomized prospective trials. Both showed clear advantages in improvement and remission of diabetes with surgery over medical therapy.

Diabetes is a brutal disease and we need to use every tool we have to treat it–prevention, lifestyle management, medicines or surgery.  Based on our current understanding and the current published data, bariatric surgery has to be considered a primary treatment for patients suffering with both diabetes and obesity.

David Voellinger, MD

www.southeastbariatricsblog.com

www.southeastbariatrics.com

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Posted in Bariatric Surgery, Diabetes, Obesity | Leave a comment

SEB Insider 5.29.2012

Nuts about Nuts!

created by Heather Mackie, MS, LDN, Registered Dietitian and Territory Manager for Celebrate Vitamins
 

 NUTS IN GENERAL:

  • Incredibly NUTritious
  • Great source of protein
  • Helps to reduce the risk of coronary heart disease
  • Adds fiber to the diet which may lower cholesterol
  • Adds healthy omega-3 fatty acids, calcium, and other nutrients, like Vitamins E and B

 SOY NUTS:

  • Have 40% less fat than peanuts and are easier to digest than peanuts, potato chips, and many other snacks…so crunch away!
  • Are terrific plain, or you can use them in salads, sandwiches, stir-fry, in soups, or anywhere you would like some crunch
  • They’re SOY good for you!
Type of Nut Calories Fat (g) Protein (g)
Almonds, 1 oz (23 kernels) 164 14.4 6
Walnuts, 1 oz (14 halves) 185 18.5 4.3
Peanuts, 1 oz (30 lg or 60 sml) 166 14.1 6.7
Macadamia, 1 oz (10-12 kernels) 204 21.5 2.2
Pecans, 1 oz (20 halves) 196 20.4 2.6
Cashews, 1 oz 163 13.2 4.3
Pistachios, 1 oz (49 kernels) 162 13 6.1
Brazil, 1 oz (6-8 kernels) 186 18.8 4.1
Mixed Nuts, 1 oz 169 14.6 4.9
Sunflower Seeds, 1 oz 165 14.1 5.5
Soy Nuts, 1 oz 128 6.1 11.2
Soy Nuts, Honey Roasted, 1/3 cup 140 6 10

 

As you can see nuts can be a great source of protein — just remember to watch the calories and fat grams. 

We recommend limiting nuts to no more than 3-4 times each week. 

Also, be careful with the serving sizes — you should only be covering the flat part of the palm of your hand (not including your fingers)!

So, Go Get Nuts About Nuts!

Posted in Behavior Modification, Nutrition | Leave a comment

SEB Insider 4.10.12

Have you ever found yourself mindlessly reaching for a pint of Ben and Jerry’s as soon as you walk in the door after a miserable day?
 
by Heather Colomb, LCSW, LCAS-P
Southeast Bariatrics Social Worker

 

In honor of Emotional Overeating Awareness Month, the challenge for the month of April is to feel those uncomfortable feelings without using food as a coping mechanism. If you overeat when feeling stressed and/or upset, ask yourself these questions:

Do I try to fill a void with food?

Does the food fill the ache?

Does food do what I want it to do?

Eating is a mood-altering experience which stimulates brief feelings of euphoria and happiness. Research has proven that food consumption, similar to alcohol or drug consumption, stimulates the release of neurotransmitters. The euphoric producing neurotransmitter dopamine floods the brain when eating refined and processed carbohydrates. Once this pattern of overindulging is established, you experience compulsive urges to stimulate the pleasure center of the brain through food. This patterned response to emotional distress is a significant component of obesity.

Emotional eating suggests that you use food to cope with your unpleasant emotions and problems. Eating for comfort may temporarily soothe or numb your feelings. However, the aftermath of emotional overeating is generally associated with feelings of remorse, pain, disgust, anger, and guilt. There are many reasons that people overeat such as boredom, replacing love, stuffing, grief, depression, or anxiety. This patterned behavior creates a destructive habit of avoiding the underlying problem at hand. Remember, you live the way you eat!

To effectively change this pattern, you must first identify your triggers.

When do you tend to overeat?

What are you feeling?

What lead up to the binge?

What time of day is it?

After the trigger and emotions have been pinned down, replace the urge to overeat with a new activity. Take your dog for a walk, call a friend, exercise, or go for a drive. Distract yourself from the urge to overeat. Accept that food may temporarily comfort you, but only temporarily. If you avoid giving in to your urge, you will feel empowered and in control. Changes, no matter how small, bring you closer to your goal of overall health.

If you have the tendency to emotionally eat, memorize this phrase:

DON’T comfort myself with food

If I’m upset, don’t eat to seek comfort!

It won’t solve the problem and

I’ll just feel worse.

No matter how you categorize your unhealthy relationship with food (friendships, substance use, shopping, etc.), destructive habits require lifestyle modifications to sustain changes long-term. Our thoughts shape our mood; therefore thoughts effect our behaviors and choices. This is wonderful news because we have a choice in how we feel! The realization that you are mostly responsible for how you feel is empowering. When we take responsibility for our own life, the choices we make, and our life experiences we make conscious decisions about how to respond rather than react to problems. Positive thinking produces a positive mood thereby decreasing the likelihood of emotional eating.Make a commitment to get back into the driver’s seat of your life and health. Who is driving the bus… you or your emotions? Begin taking small steps to modify your lifestyle in order to improve overall health and wellbeing. Don’t find yourself being “emotionally mugged” by overeating. Weight loss surgery and dieting change your relationship with your body. This does NOT change your relationship with food or your internal struggle to maintain weight loss. You will have the same brain in a different body. Surgery will not make you whole or fill the voids in your life. You must work through your feelings and past experiences in bite-sized pieces. This is by no means an easy process. Contemplate this – how much do I want my wholeness? Do I want to find peace and contentment in my relationship with food? If you are determined to find contentment and wholeness in yourself rather than food, it’s time to make thinking and lifestyle modifications to create lasting change. The REAL work begins AFTER surgery!

If you are at your wit’s end and continue to experience difficulty controlling your impulses to emotionally indulge, call our office to schedule a therapy session so we can work together to find solutions to these frustrating obstacles. Don’t be hesitant to let staff know how we can collaborate to improve your success with weight loss surgery.

“The best solution for emotional eating is for you to become an ace detective. Treat your emotions as intriguing mysteries to be solved, not pains to be numbed. Your long-term weight loss depends on it. By calling your emotions ‘clues’ instead of ‘crises’ you can discover your emotional-eating triggers and develop an action strategy instead of a reaction response”. -Katie Jay & Julia A.F. Persing, Small Bites: Daily Inspirations for Weight Loss Surgery Patients
Posted in Bariatric Surgery, Behavior Modification, Nutrition | Leave a comment

SEB Insider 3.12.12

Why am I not tolerating certain foods after my surgery?

Tolerating foods after weight loss surgery can be a very frustrating process.  Unfortunately, there is not one list of foods and recommended progression that will work for all patients across the board.  However, use this handout as a general guide to assist you when advancing your diet as recommended by the surgeon.  It may benefit you to meet with your nutritionist during this time if you struggle to come up with food ideas.  Keep in mind if a food doesn’t work, wait 2-4 weeks and try it again.  It does take time – but it does get better!

  • Moisture
    • How is it prepared? 
      • Often cooking in a Crockpot, baking, and rotisserie are the most commonly tolerated cooking styles. 
      • You want to prepare food that maintains its moisture while cooking. 
    • Fat content? 
      • More Fat = Increased Food Tolerance.
      • Opposite of everything we have ever learned in our previous dieting history, in the early post-op stage, it might actually be beneficial to eat foods with a little higher fat content. 
      • Fat of food can be determined by the cut of a meat
        • For example, surprisingly choosing a ribeye might be more tolerable than choosing the sirloin.
      • Fat of a food can also be determined by white meat vs. dark meat
        • Dark meat is more likely to be tolerable due to the higher fat content.
    • Temperature of food?
      • Even though we should prepare our food in a safe manner, it helps to only cook food to the safe temperature.  Cooking it beyond this safe temperature can often result in dry foods that will be less tolerable.
      • Investing in an inexpensive meat thermometer (found at any grocery store/discount store) will help you to cook food safely while keeping moisture.
    • Sauce/Gravy?
      • Even though in our dieting history we have learned to not include sauces and gravies, a low-fat sauce or gravy might make a food more tolerable.
    • Is it a leftover?
      • Often re-heating food in the microwave dries it out.  Consider adding a low-sodium broth to foods while heating them to keep moisture.

  • Emotion
    • Often certain emotions can lead to food intolerances.  Some emotions attributed to this include anger, anxiety, worry, feeling rushed, stress, etc.  The emotions cause the esophageal muscles to tighten thereby making food less tolerable.
    • In order to resolve this issue – it might help to relax prior to meal times.
      • Try 10 deep breathes to relieve the stress around eating
      • Try a hot, herbal, decaf tea 30 minutes prior to eating

 

  • Behavior
    • Chewing
      • Not chewing your food to an applesauce consistency may cause you to vomit.
    • Eating too fast
      • Eating food too fast often results in eating too much (not allowing your brain time to realize the stomach is full) which can result in vomiting.

 

  • Volume
    • Is it too much?
      • Obviously eating too much may cause you to vomit.  If your “baby pouch” is full and we are still putting more food in the stomach – it has no where to go but back up.

 

  • Type
    • Maybe it just isn’t time for this food yet?
      • Everyone is different when it comes to what they can tolerate at what time.  So it’s important to try foods frequently, but also to follow the recommended progression. 
      • Start trying raw fruits and vegetables at 3 months post-op.
      • Start trying toasted bread around 4-6 months post-op.
      • Start trying pasta or rice around 9-12 months post-op.
      • Keep in mind not everyone follows this progression perfectly.  Some may take longer and some may be able to advance earlier.  Also some foods will work for most but won’t work for one individual. 
        • For example, most patients can’t tolerate eggs immediately following surgery.  However, hard boiled eggs are usually the first type of egg to be tolerated versus scrambled eggs.  However, I have known a few patients to be able to tolerate scrambled but not hard boiled.

 

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Posted in Bariatric Surgery, Behavior Modification, Nutrition | Leave a comment

SEB Insider 1.23.12

No More Winter Excuses:  Equipment FREE Total Body Workout

by Sarah Jones, Exercise Physiologist for Southeast Bariatrics

So, I hear it almost every day in my exercise appointments with clients: “It’s so cold outside! There is no way I am exercising outdoors in that weather!”  “It takes at least 15 minutes to even warm up my car! It’s such a waste of time…”

I completely understand these type of barriers when it comes to getting in your activity for the day, but there must be a compromise at some point during the game.  Otherwise, in the end, you are only hurting yourself!  Next time you attempt to convince yourself that skipping exercise due to the weather is okay…STOP and pull out this EQUIPMENT FREE in-home Workout Routine instead.  There are more-than-I-can-count benefits to exercising on frequent and consistent basis BESIDES weight loss and heart health.  Ever thought about your joints, especially in the winter time?  Frequent activity keeps them loose and flexible, causing less strain and decreased pain.  Ever experience seasonal depression?  Frequent activity releases mood-elevating horomones, a.k.a. endorphins, that push those winter blues to the side.  Having a hard time sleeping?  Getting in your daily exercise can boost your body’s ability to enter into the most important sleep cycle more efficiently!  Your nightly snooze should be more about QUALITY, not neccesarily quantity. 

So hop off the couch, turn on some music and get your rear moving!  Enjoy!

DIRECTIONS:

Do each numbered exercise a total of 15times.  Repeat twice for a total of 3 circuits!

Don’t forget to stretch after you have finished your workout!  AND always consult with your physician before starting a nutrition or exercise regimen to prevent harm or injury!

 THE MOVES: (for even better results, march or jog in place for 30 seconds in-between each move!)

1. Round the World Lunges: Step forward with the left foot and lower into a lunge, keeping the front knee behind the toe. Step back to the start and immediately step to the left into a a side lunge or squat. Step back and take the left foot back into a reverse lunge. Come back to start and repeat for 8-16 reps before switching legs.

2. Pushups (wall, modified, military): Place your hands and knees/hands and toes on the floor (beginner option: hands against the wall or counter top). Keeping your glutes and abs tight, your back should be in one diagonal line with your head and neck. Inhale as you lower yourself to the floor/wall/countertop, stopping as your elbows reach a 90-degree bend. Keep your body from touching the floor/wall/countertop. Exhale and push yourself away from the floor/wall/countertop. Don’t lock your elbows, and don’t bend your back.

3. Squats/Chair Stands: Stand erect with your knees and ankles aligned beneath your hips. Lift your chest and pull your shoulders back and down. Look straight ahead with chin parallel to the floor. Bend your hips and move your buttocks backward as if you were going to sit on a chair. Keep your weight on your heels. Draw your navel inward toward the spine and continue to travel backward and downward. Do not allow your body weight to shift to your forefoot or your knees to move forward over your toes. (Actually sit down on the edge of a chair for beginner option) Push off with your heels and drive the body upward. Do this as you continue to keep your upper body erect. Contract the hamstring and glute muscles until the hips are fully extended. Do not lock your knees.

 4. Walking Plank:   Assume a pushup position, either on hands and toes or hands and knees. Your body should be a straight line from your head to your ankles. Brace your core by contracting your abs as if you were about to be punched in the gut. Slowly bend right elbow, then left until you are on elbows and toes. Reverse the movement to return to the starting position. Repeat switching the leading arm each time. This can also be done against the wall as if you were doing a wall pushup.

5. Seated Leg Extension:   Begin seated in a chair, feet flat in front of you, palms grasping chair edge at sides or front. EXHALE: Keeping left foot planted and upper body still, extend the right leg (bending from the knee) until it is parallel with the floor. Hold here for 2 counts and then (optional) pulse up and down for 3 counts (not shown). INHALE: Bend knee to lower right leg back to floor to complete one rep. Complete all reps on one side and switch.

6. Seated Superman:   Begin seated in a chair, feet flat on the floor in front of you, knees bent at 90 degrees. Keeping abs tight and shoulders back and down slightly bend at the waist. Raise booth arms straight out in front of you, elbows are soft not locked. This is your starting position. From there keeping arms straight raise them toward to ceiling as far as you can, squeezing your back muscles at the top of the movement. Slowly lower to starting position and repeat until set is complete.

 7. Arm Circles:  Stand with your feet spread about shoulder width apart. Stretch your arms out to your sides so that your body is in a T formation. Hold your arms stiff and push your muscles out tight as if you were pushing against something. The great thing about these arm exercises is that you get resistance exercise without equipment. Just the force of holding your arm muscles tight and firm as you circle creates resistance. Let your palms face out, with your thumbs pointing upward. Make small circle motions backward with your arms. Then face your palms in and point your thumbs down and reverse to forward arm circles. Do about 15 to 20 arm circles in each direction.

8. Standing/Seated Crunches:   Stand with feet shoulder-width apart (or seated in a chair for a beginner option), abs engaged and knees slightly bent.  Lift left arm straight overhead and right leg slightly out to the side. Pull elbow across body as you lift your right leg, bending knee 90 degrees, pull your leg across your body towards the left elbow. Repeat 15 times. Switch legs and arms, repeat 15 times.

www.southeastbariatrics.com

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Posted in Behavior Modification, Exercise | Leave a comment

SEB Insider 11.28.11

A Time for Celebration

by: Maggie Cady, LCSW at Southeast Bariatrics

I had the opportunity to attend the Walk from Obesity, hosted by Southeast Bariatrics,  Saturday November 5, 2011. As usual when attending an event, I wore layers, expecting with each passing hour, I would take off another garment. Not on this Saturday. It was cold. You can see your breath cold. It was especially cold for me, as I spent the last 10 years living in the deserts of Arizona.

As I arrived, so much had been done the night before and even that morning. The vendors were eager to share information about their services and goods. Patients were eager to share their experience and aspirations.  Families were proud to support and encourage their loved ones. The walkers were ready to walk! It was a time and place where the stigma of obesity was squashed, and the reality of ‘making your life the best it can be’ an ever present sentiment. And that sentiment applied to everyone, regardless of where you were in your personal wellness journey. It was a day of real celebration.

I had a special opportunity to volunteer at the last ‘cheering section’ along the route. I say special because you never know who else you will be paired with in these kinds of events. I had the pleasure to volunteer with a wonderful, gregarious woman. She was 5 or so years post-op, and feeling quite good about her progress.

But there was more to her progress than the obvious outcomes and predicted benefits of bariatric surgery. She explained to me that some time ago, when she was post-op, she was able to care for her dying husband. She provided hands on care, facilitated arranging and getting to appointments, and did this on increasingly less sleep all the while. We discussed caring for folks who are passing–that this is not an easy task in any respect. Although she never stated this outright,  I imagined that her ability to care for him was much different than it would have been without bariatric surgery. She did not show any complaint or grimace in her recollection. She held firm to her belief that he deserved her help, and she was glad to be able give it. 

During her husband’s decline she continued to maintain her own appointments and upkeep. She kept looking and moving forward. Her ability to stay on track, although not always perfect, allowed her the physical ability to care for spouse, in the most tender of moments. And it allowed her to achieve the better health outcome she had hoped for herself. My hat goes off to this delightful woman, because at any instance she could have given up and given in. Today she is still “working at it”. And although she may still have ground to cover on her weight loss journey, she is far from where she started.

I didn’t have to thank her for sharing, because, well, she shares a lot. But I do appreciate the gift she gave me. Which is to remember to hold on to what you know is right for yourself, to do what you know is the best thing to do for yourself, even when an easy way out presents itself.

She is from New York. She did not complain about the cold.

www.southeastbariatrics.com

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Posted in Bariatric Surgery, Exercise | Leave a comment

SEB Insider 10.20.11

The Fall Season brings the Promise of Fruits and Veggies

By: Mara M. Davis, Registered Dietitian at Southeast Bariatrics

 

As we say farewell to the summer months and hello to the fall, some of the fruit and vegetable items we previously consumed may become more costly with the new season upon us.  As we transition into fall, what new seasonal fruits or veggies can we add to our nutrition routine? What about a hearty homemade vegetable soup, butternut squash, or a fresh salad with cranberries, pears and walnuts? Vegetables such as edamame, artichokes and arugula are greater in production this time of year, which fortunately makes our wallets greater in size, too.   

To be adventurous, experiment with different fruits or vegetables you never thought about eating before. Eat them fresh or use a creative recipe to prepare a new dish. Eating healthy is not equivalent to food that is boring in taste or flavor.  Putting in a little more effort could really pay off big and make food tasty and enjoyable!  Fruits and veggies can provide a wealth of nutrients and protective phytochemicals, such as fiber for good colon and cholesterol health and antioxidants to protect against damaging toxins. Consuming at least 4 servings a day of fruits or veggies is a gift you give to yourself to help nourish, replenish and improve your body. After all, remind yourself of that infamous saying, “you are what you eat!”  So start exploring this season’s great harvest of fruits and veggies at your local store, food share or farmers market.

Here are two recipes that can help you get started:

 Arugula Salad with Citrus Vinaigrette (20 minutes for preparation; Yields 4 servings)

 Ingredients

  • 1/3 cup freshly squeezed grapefruit juice
  • 1/3 cup freshly squeezed orange juice
  • 1/3 cup extra virgin olive oil
  • salt to taste
  • 6 ounces arugula – rinsed, dried and torn
  • 1 pear, cored and sliced
  • 1 red bell pepper, thinly sliced

Directions

  1. In a jar with a tight fitting lid, combine grapefruit juice, orange juice, olive oil, and salt. Shake vigorously.
  2. In a salad bowl, combine arugula, pear, and red pepper. Drizzle dressing over salad, and toss to coat. Serve immediately.

*Add broiled or grilled white or dark meat chicken or baked salmon for extra protein*

Nutritional Information

Amount Per Serving (w/out added protein): Calories 229 | Total Fat 19.1g Cholesterol 0mg

Roasted Vegetable Risotto (20 minutes preparation time, 30 minutes cook time, ready in 50 minutes; Yields 8 servings)

**1/3 cup of risotto = 1 serving of carbohydrate**

 Ingredients

  • 1 pound asparagus, cut into 2-inch lengths
  • 2 cups whole baby carrots cut in lengthwise quarters
  • 6 green onions, cut into 1-inch pieces
  • 3 medium assorted peppers (yellow, red, green), cut into 1-inch strips
  • 2 medium zucchini or yellow squash, cut into diagonal slices
  • 1 cup halved fresh medium mushrooms
  • 2 teaspoons chopped fresh rosemary leaves
  • 3 1/2 cups Swanson® Vegetable Broth
  • 1 tablespoon olive oil
  • 1 1/3 cups uncooked Arborio rice (risotto)
  • 1/2 cup grated low-fat Parmesan cheese

Directions

  1. Preheat oven to 425 degrees F. Spray 17×11-inch roasting pan with cooking spray.
  2. Mix asparagus, carrots, onions, peppers, squash, mushrooms, rosemary with 1/4 cup broth in prepared pan.
  3. Roast 20 minutes or until done, stirring once. Prepare risotto while the vegetables are roasting.
  4. Heat oil in saucepot. Add risotto. Cook and stir for 2 minutes. Add 1/2 cup broth and cook until broth is absorbed. Add remaining broth, 1/2 cup at a time, stirring until all broth is absorbed before adding more. (Total cooking time: 25 minutes)
  5. Add vegetables and cheese. Heat through. Serve immediately.

Nutritional Information

Amount Per Serving: Calories 224 | Total Fat 3.5g | Cholesterol 4mg

Powered by ESHA Nutrient Database

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SEB Insider 9.27.11

Excuses No More! How to Enhance your Exercise Routine during this Unpredictable Weather Season.  Sarah Jones, BS, Exercise Physiologist

Ok—so Summer has officially come to an end and Fall is finally here!  The weather has been pretty nice the past few days; however Charlotte always seems to be unpredictable—super cool one day and blazing hot the next—and I have a feeling the crazy heat might show itself again! Here are just a few ways to protect yourself when exercising outdoors during the warmer days of Fall! (No more excuses for missing a workout!)

Drink up. Prepare yourself by getting in 8 ounces of water before you head out, then another 2-4 ounces every 15 to 20 minutes during your workout.  It’s hard to guzzle down a bottle of water, so make sure you set aside time before and after to get in the appropriate amount!

Follow the 3 L’s. Clothing-wise, go with Lightweight, Light-colored, and Loose-fitting. And leave the cotton at home (unless you enjoy wearing the equivalent of a heavy wet rag); instead, reach for attire made with tech fabrics like Coolmax and Dri-Fit—they wick sweat to keep you cooler.

Protect yourself. It takes time for your skin to absorb sunscreen, so apply it at least 30 minutes pre-workout. (Cloudy? Slather it on anyway—damaging UV rays can still penetrate, even in cooler temperatures!) And don’t forget your hat and sunglasses.

Head for the trees. Route-wise, shady beats sunny every time.

Ease up. When it’s super-hot, you need to cut your body some slack. Keep to moderate intensity, trim 10 minutes or so off your workout time, and exercise in the morning (before the earth has absorbed the heat of the day).

Know when to stop. Taste one of those myriad beads of sweat as they dribble down your face. Super-salty? You’re probably losing too much water and sodium—and that can lead to cramping or dehydration. Head back inside pronto. Ditto if you feel nauseated, weak, or dizzy during your workout. Remember, hydration, hydration, hydration!!

www.southeastbariatrics.com

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Posted in Bariatric Surgery, Behavior Modification, Exercise, Nutrition | Leave a comment