We hope you are all staying healthy and finding ways to continue working on your health goals while you are at home. As you may know, Northwest Weight & Wellness clinic has converted to virtual visits, and our surgery center has closed due to Governor mandate to cancel all elective surgical procedures. Due to this, most of our team is either working from home to continue to support your healthcare needs, or they are also spending time at home with family, waiting for the opportunity to serve you all again. We hope to reopen the clinic to in-person visits when the “Stay Home, Stay Healthy” restriction lifts, and we should be able to reopen our surgery center after the mandated restriction on elective surgeries lifts mid-May. This could change of course, however, if we all do our part to slow the spread of COVID-19, we should be back to normal operations in no time.
As many of you are doing your part to “Stay Home, Stay Healthy” we would like to assist you with the “Stay Healthy” part of your time at home by providing you with tools and options for continuing to work towards your goals. Perhaps you are awaiting surgery, participating in our Medical Weight Loss program, or you are years out from surgery and are focused on maintaining your goals. Whatever stage you are in with regard to your health journey, we are still here to support you. We have virtual visits available with our Surgeons, Nurse Practitioner, Registered Dieticians, Nurse Psychiatrist and Exercise Physiologist. If you have a surgical benefit, we can still continue to support you as you work towards your surgery date. If you are experiencing weight re-gain during this time of isolation, you are not alone! Please do not hesitate to reach out if you need.
The best way to approach these times of uncertainty is to continue to stick to a routine. Get up in the morning at your usual time, start the day with a morning ritual. This could be a walk, reading a book, or listening to an inspirational podcast. Make sure you have a plan for what you will eat each day, and schedule time for exercise and self-care. Make good use of this time at home to focus on taking care of your health and well-being.
Our dieticians have put a list of helpful tips together for managing your diet during this time which you will find below. Our Exercise Physiologist Amanda has also been posting at-home exercise routines frequently on Facebook, please make sure you have liked our page for these frequent updates: https://www.facebook.com/nwweightwellnesscenter/
If you have any questions about any of the suggestions listed below, please contact us by phone: 425-224-8200, by email: info@nwwls.com, or via your patient portal.
In Good Health,
The NWWC Team
Weight Loss Strategies
Weight loss is difficult to achieve and maintaining the weight loss can be even more challenging. It requires constant attention, perseverance and lifestyle changes. Below are some strategies for losing the weight and keeping it off. They are more effective when used together, but any that you incorporate into your life will help. And remember, it took you a lifetime to learn your current habits, so changing them will not happen overnight. Be patient!
#1: Weigh and measure the foods you eat to keep yourself accountable. This is especially important when you first start a weight loss plan. It will give you a sense of what a reasonable portion size looks like. Come back to this practice periodically to make sure those portion sizes haven’t crept up.
#2: Keep a detailed food diary. This is a great way to create awareness about your food habits, learn about the nutritive quality of your foods, monitor your hunger and fullness cues, and support your weight loss or weight maintenance efforts. You may be surprised by the number of calories you are consuming each day. Plus, you may be less likely to eat something if you have to write it down. You can keep a log electronically or on paper. Baritastic, MyFitnessPal, and SparkPeople are free apps you can download for your smart phone.
#3: Weigh yourself regularly. According to data from the National Weight Control Registry, people who weigh themselves daily are more successful at losing weight and keeping it off than those who weigh less frequently or not at all. At a minimum, you should weigh yourself or take body measurements once a week.
#4: Buddy up. Find someone to check in with weekly about how things are going. Use this person to bounce ideas off of and for moral support. Make sure you choose someone who can give you the kind of support you need.
#5: Eat protein with your carbs.Carbs are processed by your body very quickly, causing you to be hungrier soon. Protein slows down the digestive process. It keeps you full for longer, holding those hunger pangs at bay.
#6: Keep trigger foods out of the house. The decision to eat a food comes at the grocery store. If there is a food you know you cannot resist, set yourself up for success by not bringing it home.
#7: Slow down your pace of eating.Your brain needs at least 20 minutes to get the signal that your stomach is full. Start with your protein foods and produce (vegetables and fruits). After that, you might not feel hungry or have room for the carbs.
#8: Increase your activity.To support your weight loss efforts, you’ll need 250 to 300 minutes/week of aerobic exercise. This would be 50 to 60 minutes per day but you don’t need to do it all at once. Break it into 10 minute bouts to fit it in throughout the day. In addition to aerobic exercise, you’ll need strength and flexibility training 2-3 days/week. Strength training maintains your muscles, increases your metabolism, and reduces insulin resistance.
#9: Remember your motivations. Why do you want to lose weight? To get on the ground and play with your children/grandchildren? Ride an airplane without a seatbelt extender? Improve your diabetes or health conditions? Go for long hikes? Whatever your reasons, keep them in the forefront of your mind. When you are tempted to go off your plan, use this reason to keep you on track. Use self-talk, positive mantras on post-it notes, or pictures to keep your motivations on your mind.
#10: Get enough sleep.Studies suggest that lack of sleep can wreak havoc on levels of hormones that regulate hunger and fullness. Lack of sleep can particularly lead to carbohydrate cravings. Get 7- 8 hours per night and talk to your doctor if you are having trouble sleeping.
#11: Practice stress management.People often eat in response to emotions rather than hunger. Keeping your stress levels in check can prevent non-hunger eating. Make a list of enjoyable activities you can use to reduce stress such as meditation, walking, reading, talking with a friend, or taking a bath.
Are you familiar with the Mediterranean Diet? While it’s not actually a diet, you can consider it a style of eating used by people that live near the Mediterranean Sea. Research suggests that a Mediterranean eating pattern can lead to health benefits such as: improved cardiovascular health1, improvements in blood sugar in people with type 2 diabetes2, and decreased risk of Alzheimer’s disease3.
Foods that are encouraged4:
Fruits and vegetables
Whole grains
Beans and legumes
Seafood
Olive oil
Nuts and seeds
Foods to eat in moderation:
Poultry
Dairy
Eggs
Foods to limit:
Sweets, candy, desserts
Red meat, such as beef, lamb, or pork
Want to experiment with this way of eating? Here are some tips for incorporating a Mediterranean eating pattern into your daily life:
Start your day with a bowl of oatmeal topped with walnuts and berries.
Replace a bag of potato chips or pretzels with a handful of nuts as a snack.
Top your salad with baked salmon for added heart-healthy protein.
When cooking, use olive oil in place of butter.
Replacing a meat-based meal with beans. For example, use black beans in your tacos instead of ground beef.
Grab a piece of fruit rather than a slice of cake for dessert.
A Mediterranean eating pattern can provide potential health benefits and is relatively easy to follow. Why not start the new year by incorporating these guidelines into your eating habits. Have questions? We’re here to help! For more information on how to include these tips in a way that works for you, make an appointment with one of our registered dietitians.
Sources:
Carson JAS, Lichtenstein AH, Anderson CAM, Appel LJ, Kris-Etherton PM, Meyer KA, Petersen K, Polonsky T, Van Horn L; on behalf of the American Heart Association Nutrition Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Peripheral Vascular Disease; and Stroke Council. Dietary cholesterol and cardiovascular risk: a science advisory from the American Heart Association. Circulation. 2019;140. doi: 10.1161/CIR.0000000000000743.
Esposito K, Maiorino MI, Bellastella G, et al. A journey into a Mediterranean diet and type 2 diabetes: a systematic review with meta-analyses. BMJ Open 2015;5:e008222. doi: 10.1136/bmjopen-2015-008222
Lourida, Ilianna, et al. “Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review.” Epidemiology, vol. 24, no. 4, 2013, pp. 479–489., www.jstor.org/stable/23486687.
Ball, Serena, and Deanna Segrave-Daly. The 30-Minute Mediterranean Diet Cookbook.: 101 Easy, Flavorful Recipes for Lifelong Health. Rockridge Press, 2018.
JoAnn had a sleeve gastrectomy at NWWC in October 2017.
What is the best part about this journey?
How great I feel about myself! My blood pressure is down. I feel ten years younger. My sleep apnea is better. I am off acid reflux medicine. I can walk up and down stairs without huffing and puffing. My ankles and knees don’t hurt anymore. I can fold my arms across my chest and cross my legs easily. Sex is better!! So much better. I can drive my car more comfortably since my belly doesn’t hit the steering wheel. I can paint my toes again. I can use any bath towel in the house; before I had to use those giant bath towels and we only had a couple. I can scratch any part of my back by myself. Since I am not stressing about my weight and appearance anymore, I can use my brain energy to think of other more creative things. I literally have more time to think and focus.
I feel amazing. I have so much energy. I feel like “JoAnn” again.
What has been the hardest part?
The hardest part of my journey was making the decision to do it. I had taken every pill and done every fad diet. When I tried so many times to lose weight and was unsuccessful, I blamed myself. I thought I just hadn’t tried hard enough, I wasn’t strong enough, I had no will power, and I was destined to spend the rest of my life with obesity. I thought if that if I couldn’t do it myself, then surgery would be like a cop-out, like cheating. I thought people would judge me. I thought, “Wow, this is SO drastic. They will be cutting one of my organs and it’s permanent.” I was worried about how painful it would be… would it really work… can I take time off work… how much will this cost me… there are so many appointments… My excuses went on and on.
Getting the support from my family and friends was scary. I thought they would all make fun of me or tell me I was copping out or taking the easy way out. But they backed me and that was comforting. They said, “If you decide to do this, we support you 100%.” I wish I would have done it 10 years earlier. I wasted 10 years because I was so unhappy with myself.
What goals did you set for yourself? Have you made progress towards those goals?
JoAnn gets a wedding day lift from her boys
A few years ago, I wrote my “dream list” in the back of a notebook. I tried to use positive affirmations in hopes that my dreams would come true someday. Well, recently I found that notebook. I had forgotten about this list although I had dreamed of those things often. My “dream list” was:
A crimson Ford Explorer
The house of my dreams
For my twin boys to go to college
To be fit and thin again
To marry the man of my dreams
As I read the list, a tear came to my eye and I got goosebumps.
In my driveway sits a crimson Ford Explorer.
We bought the house of our dreams last November. I got the keys on my birthday.
My twins are in their 3rd year of college at UW & Western.
I lost over 100 pounds and feel better than I have in 20 years.
After spending 12 years together, I got married to the love of my life on August 24th
I got everything I dreamed of and didn’t even realize it until I read the list. I am happier than I have ever been in my life. My two older children have great jobs and homes and I am so proud of them as well. Life is GOOD!!! Everything is better. I could go on and on. I need to make a new list!
What advice would you give those who want to pursue weight loss surgery?
JUST DO IT! Making the decision is the hardest part. I listened to a lot of testimonials before doing this. When they got too negative, I would turn them off. I was terrified. But why be ashamed to help yourself? Why not get surgery to help your heart, your breathing, your health? Once you decide to do it, just think positively and do everything your doctor tells you to do. You will be brand new again!
I was sitting in the waiting room one day and had almost reached my goal weight. A lady in the waiting room asked me, “Why are you here?” I told her that I had had surgery. She said, “You don’t look like you were ever fat. I’m too afraid to do the surgery so I’m getting a diet plan.” I told her, “Just do it. It’s the best thing I did. You’ve tried everything. It’s not a cop-out.”
I see people and I know how they feel. I wish they could feel as good as me right now. There’s a lovely person inside there that’s suffering. I just want to help them. It’s so worth it.
Thanksgiving is arguably the biggest food holiday in this country. People are encouraged to eat to the point of needing to sleep. How do you enjoy the holiday after surgery when your relationship with food has changed?
First of all, food doesn’t need to be everything. Enjoy time with family and friends with non-food activities. Participate in a “turkey trot” walk or jog. Turn up the music and dance with your kids, grandkids, nieces, or nephews. Pull out the board games. Watch old family videos. There are lots of ways to spend your day without the focus on food. But eventually, you will be seated around the table for the big meal.
Turkey – Enjoy this protein-based food! Each ounce of turkey has 7 grams of protein and even the dark meat is relatively low in fat. The dark meat (legs, wings, and thighs) is more moist than the light meat so you may tolerate the dark meat best. Keep the skin on the turkey while it’s cooking to lock in the moisture. If you deep-fry or pan-fry your turkey, avoid eating the skin soaks up the oil and may feel too greasy for your stomach.
Gravy – Gravy is a condiment. Just like salad dressings, you can put some on the side and dip each bite of turkey into it. If you are sensitive to high-fat foods, gravy will likely be too rich for your stomach. Trader Joe’s makes boxed turkey gravy that is low in fat and still has good flavor.
Potatoes – The nutrition profile really changes based on how your potatoes are prepared – mashed, baked, roasted, twice-baked. Potatoes are a starchy vegetable and they contain many nutrients in their skins. Sweet potatoes are very high in vitamin A, which is how they get their orange color, but they are still a starchy vegetable. Because of their dense, starchy texture, they may feel heavy in your stomach. You can slim down mashed potatoes by using skim milk or plain Greek yogurt to add creaminess in place of butter or cream. You can also swap cauliflower in place of potatoes for a dish lower in calories and carbohydrates that feels lighter on your stomach.
Stuffing – This staple of the Thanksgiving plate might not feel good in your stomach since it is bread-based. Bread products tend to swell up in the stomach and make you feel uncomfortably full. You can try a small amount of the real deal or experiment with reducing the bread and adding more vegetables. Eggplant, butternut squash, mushrooms, and chickpeas can add bulk to a stuffing in place of bread.
Green Beans – The casserole version with cream of mushroom soup and fried onions will likely be too rich for your stomach. How about roasting your green beans and topping with good quality Parmesan cheese? Or sautéing with some garlic and olive oil? These are great cooking methods for any Thanksgiving vegetable including Brussels sprouts, broccoli, and carrots.
Dessert – Sweet foods can be as problematic for the stomach as high-fat foods. They can cause dumping syndrome in extreme cases, or nausea in more mild cases. For many people, a couple small bites are all they need to feel satisfied with sweets after surgery. If that’s your situation, have some of the real deal and savor each small bite. If you are looking for a slightly larger quantity, there are lots of bariatric-friendly dessert ideas, including protein shake ice cream, sugar-free pudding “cheesecakes”, and protein balls.
My favorite bariatric food resource is The World According to Eggface blog: http://theworldaccordingtoeggface.blogspot.com . Shelly has been blogging about delicious bariatric-friendly recipes for 13 years. Use the ‘Search’ function to find Thanksgiving recipes that will delight everyone at your table, whether or not they’ve had surgery. Happy Thanksgiving!
Ken had a sleeve gastrectomy at NWWC in July 2018.
What is the best part about this journey?
The best part of this journey was the reward for following through with all the advice. When I came in in February 2018 and spoke to Dr. Chock, she told me, “You’re going to need to make a lot of changes and it’s not going to be easy. It’s not a magic pill or a magic bullet but it will be worth it.”
After that, I quit smoking and drinking alcohol. I used to make craft beer and it was something I really enjoyed. Quitting all of that was a feat that seemed almost impossible. It was somebody’s Everest or somebody’s 4.0 at the end of grad school or a moon landing. All of those insurmountable changes… it has taught me that I can do anything.
What has been the hardest part?
I had a serious complication two weeks after surgery. I had a clot and was readmitted back in Alaska. It was scary but it really taught me how fragile everything was. That was the linchpin that got me fully committing myself to everything. I was walking laps every hour and was working out for 7 days in the hospital. I begged the nurses to allow me to exercise and they let a friend bring me a dumbbell.
The hardest part of the entire journey was relearning and coping with my stressors. I was a really bad stress eater. Three months post-op, I caught myself stress eating and I got full to the point that I threw up. I thought, “I can’t do this. This whole time I’ve been stress eating and it has got to stop.” I spoke with my boss and my wife and I quit my job and decided to go back to school. I’m now finishing my Bachelor’s degree to become a teacher.
I had to reinvent myself. I realized I couldn’t stress eat anymore. You could say that I made the right choice in the “choose your own adventure” book of life. The choice that I made that has resulted in a path that is going to end way further down the line with a longer life.
What goals did you set for yourself? Have you made progress towards those goals?
Ken competing in the Northern Fitness Games CrossFit Competition
I had always wanted to become a firefighter. When I was finally able to pass the fitness test, I felt that I had made it to the moon. I am now a carded basic firefighter and wildland firefighter.
My activity level is where I’d always dreamed it would be. I’ve surpassed my fitness level from when I was in the Marines. I run 7 miles every Sunday. I can do a GORUCK hike with 50 pounds on my back. I can go to CrossFit and I’m actually good at it. While I have to make a few modifications, my fitness level and strength is through the roof. I used to make fun of CrossFit and I think deep down inside, it’s because I wasn’t good at it. Now that I can do it, it has changed my tune. These are things I wasn’t able to do before.
My next step is the Boston Marathon. I’m doing a walking marathon next March in New Mexico. I’m hoping to climb Mount Hood in the next 4 years and Denali in next 10 years.
I ended up becoming a personal trainer. I work with people who have gone to the local bariatric facility here in Alaska. I went through surgery. I know what it’s like. I can help these folks.
I’ve hit my goal weight and have been maintaining for over 5 months.
What advice would you give those who want to pursue weight loss surgery?
I’m a goal-oriented person. It’s what keeps me going. Make a goal and keep it. Start small and go larger. You’re not getting any better just sitting there complaining. If you get up and do something, you are better than you were the day before. It might not be noticeable at first but the results compound themselves.
Listen to the providers. Listen to what they have to say. They are not people with letters at the end of their name without good reason. I can tell you that Dr. Chock is an angel as far as I’m concerned. All the staff, everybody I’ve dealt with, are angels. From talking to Christine once per month to my appointments with Ginny to working with Dr. Chock, they know what they’re doing and they do it well. I know I did the hard work but the quality of care that I received was like none other.
A few years ago, I made a promise to myself: My physical and mental health is worth 4-6 hours a week. When I take time for my health, not only does my personal health get better but my relationships with my kids, husband, co-workers, family, and friends become healthier too. But I’ll admit that being a parent is one of the hardest jobs I have ever done. Throw in a full-time job and life gets very hectic. How do you possibly fit in time for fitness?
My exercise routine has changed drastically over the years. Twenty years ago, in my BC life (life before children), I never struggled to get my workouts in, even working 60+ hours per week. I often worked out in the evening to meet people. Having just moved from Montana to Washington, my exercise program was an amazing way to help me shake my homesickness. Fast forward to 2003, I’m married and working at Columbia Athletic Clubs. I was still living my BC life and I was able to exercise after work. Often my husband would meet me so we could exercise together.
In 2006, my daughter, Ella, was born. During my 4-month leave, my exercise program consisted of walking outside with Ella in a jogging stroller and DVD workouts I could do while she was sleeping. When I went back to work, I found myself wanting to get home right at 5pm to spend time with my new baby girl instead of doing a workout. On the days I wasn’t teaching fitness classes, I worked out during lunch. On the weekends, my workouts were fun and social. I took group tennis lessons with my sister and we put our kids in the club’s daycare. We were terrible at tennis but we had fun together while exercising.
In 2013, my husband and I welcomed baby number two. With my son, Jase, I was able to stay at home for 12 months but my workouts really changed. Jase was diagnosed with sleep apnea when he was 6 months old and he would wake up 1-4 times every night. I was so sleep deprived I could no longer work out while he was sleeping like I did with Ella. When Jase was sleeping, I was sleeping. The way I fit exercise into my day was to walk while Ella was at dance class. I always kept my jogging stroller in the back of my car. While Ella was in dance class for 45 to 90 minutes, I would walk the dance studio parking lot with Jase in the stroller.
In October of 2014, I joined NWWC part-time. I now had to work out with small bits of time such as walking at work between patients, walking when Ella was at dance, and using my elliptical trainer at home when my husband could watch the kids. My workouts were not one hour sessions; they were small sessions here and there. By age 3, Jase had surgery for his sleep apnea and could finally sleep through the night. I had survived 3 years of waking up 1-4 times a night. Mom WIN!
By 2016, I was a full-time mom to 3- and 10-year-olds and working full-time at NWWC. My kids had activities and my husband was working his full-time job plus had started a small business. My workouts were suffering. I felt like my weekdays were shot and I was only getting workouts in on the weekends. How in the world was I going to exercise? I had to have an honest conversation with myself, look closely look at my days, and set myself up to be successful.
I asked myself:
Can you exercise after work? Before work? On the weekends? At home? At the gym?
How many hours do you have during the weekdays? I started with 120 hours and subtracted the number of hours I worked, commuted, slept, managed household chores, and spent with family.
How many hours do you have on the weekends? I started with 48 hours and subtracted the hours I had committed to kids’ activities, household chores & errands, and family time.
How many hours per week are you willing to dedicate to your health?
I realized my windows of time were early in the morning, late evening, and weekends. I knew late night workouts were not good for me because I get hyped up and then I can’t sleep. It was beginning to look like early mornings and weekend mornings were my days to get exercise in.
I’m that annoying morning person that doesn’t hit the snooze bar when the alarm goes off. I’m used to getting up at 6:00am. But 4:45am? OMG! That’s early, people. To become a successful early morning exerciser, I had to start with my bedtime. I had been going to bed at 11:00pm but that would give me less than 6 hours of sleep. With 15 minute increments, I changed my bedtime to 10:00pm.
I also needed to get myself organized. Before I went to bed, I put my workout clothes and shoes in the bathroom, put a water bottle in the fridge, placed a sweat towel on the elliptical trainer, and placed the TV remote next to the elliptical trainer. I eliminated all excuses I could use to not get up and work out in the morning.
I’m not a perfect Pinterest mom and my house is not spotless. I am a mom that can keep up with a busy 13-year-old dancer and a crazy 6-year-old football player. Don’t think that one hour of exercise a day is being selfish and taking time away from your kids. You are actually adding time to your life by becoming a regular exerciser. You are going to be the active parent you want to be for your kids. Taking time to care for yourself will give you more time to be with your family.
