Life is not binary

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There’s this concept in my coaching program called “the magic of mirroring.” When listening to clients, there’s often this inner dialogue going on where you completely relate to what they are saying, and as you go on in dialogue providing guidance, you hear yourself answering your own struggles. Speaking with one of my “practice” clients, we got into a conversation about being good or being bad.  Why is it that we take this all or nothing approach to so many things? We say, “I eat really well, except when I am bad.” We let this notion of being “good” allow us to indulge in “bad” things as a reward, or we punish ourselves for being “bad,” by spiraling into more “bad” behaviors.

Life isn’t that clear cut. And for people who have struggled with weight loss, it’s time for a new way of thinking. We’ve been shamed into thinking that we are being bad if we make a poor food choice or if we chose to sleep in over going to the gym. It’s time to listen to that voice in your head and tell it to STFU.

This a-ha moment I had made me very conscious of my inner monologue and how often I think of things in terms of good or bad. I have rephrased my self-talk. I only choose food that will nourish me because that’s just how I eat now. I choose to eat this way because I am proud of my success and I don’t want to go back to my old way of life.

Is it all butterflies, unicorns, and roses?  Hell no, but the awareness of that negative self-talk is the best answer to defeat it when things are tough. Weight loss after gastric bypass surgery isn’t just automatic. Well, part of it is — in the beginning, but there’s a lot of work that goes into making smart food choices, getting proper nutrition and supplementation, showing up for exercise, and creating consistently healthy patterns with sleep and stress management. I hear myself telling fellow patients that it’s a marathon, not a sprint, and I stop and listen to myself. Health coaching is the thing that will keep my inner evil voice quiet and will keep me focused on my own health and wellness.  And that, my friends, is good.

Clean Eating: Bariatric Style

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There’s so many resources about diet after bariatric surgery when you are post-surgery to about 6 months. Moving from liquid, to puree, to solid stages during weight loss comes with a lot of guidelines. What life looks like post-weight loss is not nearly as well-documented. I know when I was researching surgery, I followed so many blogs of people who were going through weight loss, and they all seem to get to a certain point and then stop documenting the journey. Even my own blogging has slowed down now that I have reached maintenance.

This week in my health coach training, one of our assignments is to create a resource for my clients about clean eating. Do you need to recreate the wheel for bariatric patients? I think not.

Here’s some guidance from our curriculum:

  1. Keep It Whole
  2. Experiment with Home Cooking
  3. Limit Refined Carbohydrates
  4. Maintain Consistent Eating Times and Try Not to Skip Meals
  5. Balance Your Plate

Let’s put the bariatric spin on this.

There are rules we have to follow as bariatric patients (and they may vary from surgeon to surgeon, so it’s important to follow YOUR program). First and foremost, we must take our vitamins and supplements. For me, this means a bariatric formulated multi-vitamin, calcium with vitamin D, vitamin B-12, and 60-80 grams of protein specifically from protein supplement. Since we’ve got through a major surgery to reroute our digestion, supplementation to ensure proper absorption of these nutrients is critical.

Emphasize Quality Over Quantity

This applies to your supplements as well as food. I have chosen bariatric formulated products to ensure maximum absorbtion. It is expensive? Not compared to feeling like crap and being 90 pounds overweight. It’s all relative. We have one body in this lifetime and we’ve already put it through a lot to get to where we are going, so invest in your health.

The same goes for the rest of the things we eat. We’re so limited on how much food we can intake. In the beginning, I was fine with 1/4 cup serving sizes for meals, but as I got more into my exercise program, I gradually increased to 1/2 cup per meal, and now that I am in maintenance, I can eat much more — depending on the food, but the quality of that food matters.  Since we can only eat so much, nutrient dense food is the way to go. So:

  1. Choose Whole Foods

When planning meals, think of choosing the most unprocessed food and keep it simple. I always include a protein source as my primary food and eat that first, followed by whole vegetables and fruits. I lean towards a plant based diet, so protein sources can include beans, lentils, tempeh, tofu, or hummus but I will also include vegetarian sources like eggs, cottage cheese, string cheese, greek yogurt, or other reduced fat cheese. Occasionally I will eat chicken or fish, but try to choose organic and sustainably raised animal products when I do choose them. I will typically pair these foods with organic fruit or vegetables, usually fresh, sometimes frozen. Simplicity is the key.  I will meal prep simple “lunchables” that are roughly the same quantities that I can mix and match over the course of the week and have prepped and ready to go to throw in my lunch bag.

Here’s a few examples:

  • Eggs with sliced tomatoes
  • Cottage cheese with sliced peaches
  • Tempeh with hummus in a lettuce wrap
  • Kale and red cabbage salad with beans or hummus
  • Roasted root vegetables with grilled chicken

You are only limited by your imagination.

2. Experiment with home cooking

Food prep keeps things fun and interesting. Typically I will find a recipe on Pinterest that I will make as an entree to have for lunch or dinner for the week, or I will find some kind of plant-based salad to make that can be paired with a protein source or just enjoyed as a snack between meals. My pinterest account has a collection of bariatric friendly and plant-based recipes that I will adapt based on my current nutritional needs.

I am still recovering from my kidney surgery, so I have had to adapt my portions and my food to a reduced intake due to reduced exercise quantity and intensity. Eating at home really helps me to control what I take in, reduce the amount of sugar, salt and carbs I eat, and the quality of food. And home cooking doesn’t have to mean elaborate meals. Choosing one or two recipes a week keeps things interesting, and helps keep things simple. Use herbs and spices and find homemade recipes for things like salad dressing to avoid any additional additives outside of “real” food. Once you find recipes that are easy, you can adapt them to fit your own nutritional needs and your creativity.

3. Limit refined carbohydrates.

Actually, really just leave these out. I’m not an “everything in moderation” advocate. For most bariatric patients, refined carbohydrates is what got us into this mess.  Sugar, flour, rice, pasta and the like. There are some people who can work these back into their diets, but I know how easy it can be to go back to old habits. My recommendation is to steer clear of processed foods and find whole food alternatives to your favorites. Bariatric Eating is a great resource for recipes to help keep those cravings at bay.

I have been experimenting with whole grains, like millet, quinoa, and freekah. I find that I can use them as a condiment. I will add a tablespoon or two to a salad to provide some density and add fiber and protein. It’s satisfying enough, but doesn’t trigger any cravings for me. I am intentionally avoiding food like edamame or chick pea pasta, because I know if will be a trigger for me. I am a realist, and I see how quickly I can gain weight if not following the bariatric diet recommendations. I don’t want to be that person who gained all their weight back and more after gastric bypass.  I’ve just worked too hard for that. Everyone needs to find their own tolerance level.

4. Maintain consistent eating times and try not to skip meals

One of the most important things for me was to create a schedule/routine for myself around my meals. On a typical workday, I do a protein shake before my workouts, eat a small mid morning meal when I get to work, walk at lunchtime and then have a small lunch at 1ish, eat dinner around 6 and then have a shake before bed, or have my shake as a mid afternoon snack. This has worked well for me once I met my goal weight. I’m currently a few pounds higher than my goal weight which I attribute to being a limited activity, so I am reducing the number of snacks I have and really focusing on nutrient dense and lower calorie meals.  It’s HARD, but sticking with the routine helps me from getting too far off the rails.

5. Balance your plate

I have always tried to have a good balance of protein, carbs and fat at each meal, but the fat typically comes from healthy sources like nuts and seeds, avocado, or olive oil. Carbs are never simple carbs – they are typically vegetables or fruit, and I stick with he lower glycemic fruit like melon and berries per bariatric recommendations. I do my food prep and thinking about variety and creating balanced meals. Very often food prep for me is just making sure everything is washed and chopped and ready to go for mix/match salads, stir fries, or snacking.

So there’s my bariatric take on the IIN clean eating recommendations. When working with clients, I stress that everyone has their individual needs and can typically figure out which foods work best for them, but I look forward with helping clients with those discoveries to encourage variety, simplicity, and health — whether they choose a plant-based approach or not.

Interested in setting up a free coaching session? Contact me and we’ll set something up. You will help me develop my coaching skills, and we can work to find some tips to help you achieve your health and fitness goals too.

 

 

 

 

 

 

Staying positive in a world full of negativity 

Making lasting lifestyle changes takes work. A lot of work. And when social sites are part of the equation for your support system and connecting with helpful resources, it’s important to check in with yourself about the value of your social network and its content. 

I’m not even talking about the news and political climate. That’s a whole other ball of wax that I just can’t get into. I’m talking about your friends. We all have a friend or two who use Facebook as a way to vent, complain, namedrop, finger point, and basically bitch. 

Sometimes you just have to keep scrolling. Scroll, scroll, scroll. It’s so easy to let the negativity sink in, but if the positive support from your social network outweighs the negative, just scroll on by. Or hide them. Or de-friend. Your comfort zone gets tested every day, so do what’s best for you. 

But sometimes, life calls for a digital detox. Find sources of positivity outside of your social network. Like with nature and real people. Or give your dog or cat a hug. And if you don’t have a cat or dog, adopt one! Pets are great medicine. 

Fill your journal with positive affirmations and revisit them when you need a boost. Pinterest is always a great source of inspiration if you can’t completely break free of your phone. 

This post is brought to you by Dionne Warwicks’s “Walk on By.”

Coach Training Update: It’s Go Time! (plus amped-up iced matcha protein lattes)

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Time flies when you are having fun. It’s the middle of August! How exactly did that happen? This means I am exactly a quarter of the way through with my Health Coach Training Program through the Institute for Integrative Nutrition. This quarter marks a few important milestones in the program:

  1. The first test!  It’s been quite a while since I have had to take any kind of a test with a consequence. We’ll have 4 during the course of this program, and we have to pass 2 of the 4 with a score of 70% as a graduation requirement. I am happy to report that this overachiever passed with flying colors. Quite honestly, the content of the program has held my interest, and by doing the assignments and participating in discussions, it’s definitely helped with retention.
  2. Health Histories. We’re getting into the meat of the program. Meeting with potential clients (unofficially, as we can’t take on clients until the 6 month point). I mentioned when I started this blog that I would be looking for people who are interested in being my willing volunteers to help me try out my new skills as a health coach. I’ve now had a couple of meetings, one via phone and one in person, with one lined up for next week.  Graduation requirements call for us to submit 6 health histories over the course of the program, but it’s anticipated we’ll do many more than that – to the tune of 2 a week over the course of the next 9 months.

So…everything is going according to plan.

Yesterday I took my show on the road and discovered a great coffee shop in Woodland, Morgan’s Mill. It was such a great atmosphere to meet with potential clients (and quite honestly, I may go there for my telecommute days just to get a change of scenery.

Yesterday also marked a first for me — my first matcha latte! (I am so un-hip!). As a bariatric patient, I need to be very careful about wasted calories and excess sugar, so I scoped out the offerings ahead of time. An iced matcha latte with unsweetened almond milk and sugar-free vanilla syrup was the accompaniment for my coaching session (pictured above).

This inspired me to come up with my own bariatric version — protein-packed too!

Really, this isn’t rocket science. I looked up a few things for inspiration on Pinterest, ordered myself some matcha powder off Amazon, and came up with my own recipe.

Vanilla-Matcha Iced Protein Latte

Ingredients

Directions

  1. In a mason jar, pour the hot water over the matcha and shake or stir well.
  2. Using a blender (I used my Nutribullet), combine almond milk, the matcha mixture, protein powder, Torani, and blend well.
  3. Fill the mason jar full of ice, and pour blended latte over ice.
  4. Enjoy!

Iced matcha latte in mason jar

The finished product has 29 grams of protein, 11 grams of carbs, and 5 grams of fat but is a satisfying and hydrating drink for these hot summer days. You can read more about the health benefits of matcha, high in anti-oxidants. Great way to start the day!

Again, this recipe isn’t rocket science, so definitely explore your own variations using your favorite protein powder or by modifying the liquid contents. Matcha is pretty strong, so you may want to start with a smaller amount and adjust for taste.

 

 

 

Living more, with less

I watched the documentary Minimalism yesterday in an attempt to calm my nerves and expand my horizons.

In my studies at Institute for Integrative Nutrition, we talk about primary food — the concept of nourishing all areas of your life, including career, relationships, spirituality, and physical activity. Home environment has been one element of my world that feels out of balance. Our 1974 house needs some work and now that we’ve been here for 17 years we have acquired a lot of “stuff.” It can be stifling.

I tend to get into nesting mode before surgeries (yes, I have had that many) and clean house from top to bottom, declutter, and get organized. It’s been almost a year since my gastric bypass surgery. I had set up my little recovery area in the living room where I planned to binge watch every Netflix series and a laundry list of movies.

Ironically, I am sitting in the same spot almost a year later and some of the same magazines and books are still stacked on the table. And of course more stuff has found its way to the coffee table along with more electronic devices and remote controls. Hmmm. That tells me something.

Last week on my personal blog, I revealed my recent cancer diagnosis. I am awaiting consultation at UCSF Urologic Oncology department and expect to have part of my kidney, along with the evil inhabitant, removed in the near future. It’s made me turn even more inside myself that I typically am. Thinking and thinking. I’m turning to my typical de-stressors to try to reduce the anxiety: journaling, medication, yoga, rest, sleep, and nutrient dense food choices. That’s only taking me so far.

So back to Minimalism. Watching that film made me thing about eliminating excess in my life.  Yeah, obviously, less stuff. I know a massive declutter effort is brewing. But what else is excess? Drama, stress, things I feel like I have to do but are really a choice. We have one life to live on this planet, and this current threat to mine has made me more determined to find joy and focus on the things I am passionate about.

I was listening to one of my podcasts, Her Rules Radio, with Alexandra Jamieson and she walked through what she calls her Fuck-It List, which she defines as her approach to developing a personalized rule book for identifying the things you want to stop doing so you can focus on getting clear about the things you want to do. I downloaded her e-Book. This is the right time for me to take a hard look at my career, relationships with people, my spiritual practice, and to some degree physical activity and do some housekeeping. Adding this to my toolkit.

My mom died at 58, and I’ve always had that number in my head as something to beat. I took my health into my hands almost a year ago and got myself to a healthy weight and strengthened my body and my spirit. I have spent too much time Googling renal cell carcinoma survival and recurrence rates, and knowing I was diagnosed early gives me hope, but the fear of what I am reading makes living more fully the ultimate goal.

Time to roll up my sleeves and get to work.

More joy, please.

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This has been a trying week for me but I’m forging ahead with my studies at the Institute for Integrative Nutrition. In this week’s module, I’ve thought a lot about the primary food of joy: the things that bring me joy, and how I can bring more joy into my life.

This level of introspection is challenging, but it’s really the key to understanding how to transform your life into one that attracts positivity, health, and happiness.

I was born in 1967, making me 50, and the same age as the Beatles’ Sgt. Pepper’s Lonely Hearts Club Band album. With the celebration of its release, I’ve been listening to a lot of their later albums on my commute. There is nothing like music you love to transport you to a different time and place, recalling memories so vivid it’s like they just happened.

Growing up in the 70s, my mom stayed home with me and my brothers. She was such an amazing mother. She taught me how to read well before nursery school, and she started my love of music with piano lessons at the age of 4. Music was always part of my life with my mom, whether it was singing along to Sesame Street or to the music in the car on road trips. The other day, Yellow Submarine came on the radio (Siriux XM has a great Beatles Channel right now), and of course I am singing along in the car and it completely brought me back to a moment driving with my mom to Northampton, MA, the little arty college town where we would have girls’ day out when I was in high school.  We sang in the car at the top of our lungs — the good old Buick Estate Wagon. Such a vivid memory, and a happy one.

I have some challenges ahead of me, but I’ve been trying to summon joy to my life where I can to help me process the shock of a cancer diagnosis. Music brings me joy, calms my overactive worrying tendencies, slows the heart rate, revisits happier times, and gives me strength. I feel less alone knowing I have these memories to power me through this, and my mother was one of the best role models in my life. Now SHE was brave. I will channel her influence in my own journey, and share my experience with my clients in the future.

I found this great quote: “Joy is a decision, a really brave one, about how you are going to respond to life.” (Wess Stafford) I will keep this in my heart in the weeks to come.

And meanwhile, back to The Beatles (Abbey Road, to be exact).

Battling Weight Bias When You are Battling Obesity

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I call myself an obesity ass-kicker because it’s a battle I’ve fought for more than 30 years. And I’m winning! But the process isn’t easy, and along the way I have experienced weight bias by the very people who are supposed to help us achieve health: doctors!

Look at the state of health in our country. According to a recent New York Times article, one in every three people is obese. I can’t even imagine how much money is spent treating obesity-related diseases. That’s what doctors are trained to do. Treat diseases.

Raise your hand if you’ve been told by a doctor you need to exercise more and eat less. I know I have. Countless times. It took me years to get someone to actually look at me as a whole person and try to connect the dots between obesity, thyroid issues, a pituitary tumor, and the inability to lose weight, in spite of the 1200 calorie a day diet. Just treat the symptom and there’s no need to investigate the root cause.

That’s why it’s more important than ever to empower yourself to be your own advocate through the healthcare system. I’ll have a story on that in the future.

The driver for this post is this article shared by the Obesity Action Coalition, Barriers to Obesity Care and How to Create a Support Team. I react when I read that someone isn’t being offered the best medical options because of their weight. As an overweight person with knee pain, I was told it’s arthritis and there’s nothing to be done and I should stop running. Oh, and lose weight. That’s it. No guidance, no alternatives, nothing. I’ve been there.

However, I have also been lucky to have physicians who advocated for me, helped empower me to make decisions that led me to a healthy weight, helped me work with the insurance company to appeal bariatric surgery denial, and get me to a bariatric surgeon who understands the science of obesity and the challenges for someone who has struggled their entire lives and fighting an uphill battle against their metabolism and co-morbidities.

It takes work to build a support team, to research so you know how to ask the right questions, to understand not just “diet” but nutrition and lifestyle changes needed to be successful, and to navigate the complexities of insurance and the healthcare system.  This gives me hope that the rise of holistic health coaching can be a compliment to medical care for people like me who battled obesity. There’s some great suggestions in this article about how to put together a medical team for support, but kicking obesity’s ass requires so much more support. I was fortunate to have a mentor through my weight loss process — another bariatric patient who could answer questions or tell me what to expect, cheer me on, or kick me in the butt when I needed it. That emotional support really completed the picture for me and launched me on this journey to becoming a health coach.

Completing the puzzle for bariatric patients

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When I was researching bariatric surgery for myself, I was initially given very little guidance from the referring doctor. Pinterest became my friend, and I discovered a few valuable resources, namely Reeger Cortell’s Weight Loss Surgery Podcast, which I recommend for anyone considering bariatric surgery and for post-surgery patients at any and every stage. I have links to a few other resources on my personal blog. I also joined a number of different Facebook “support” groups.

On these groups, you’d see questions like:

I’m six weeks out from surgery. When can I eat pizza again?

No joke. This is the one that I always cite as an example of a SMH moment. You’ve undergone major surgery, with many risks, and you’re thinking about pizza? I see people making taco shells out of cheese or pizza with wonton wrappers — basically continuing the same eating patterns that resulted in the need for surgery.

A few things about bariatric surgery: whether you choose a sleeve gastrectomy or Roux-en-Y gastric bypass, the surgery is on your stomach, not your brain. Your sleeve or bypass is just a tool and part of the equation. And it’s a very powerful tool! To some degree, the weight loss will continue over the course of 12-18 months. Some people lose with easy, while some people have to follow the dietary guidelines to a T (that’s me — more on this later). And incorporate exercise immediately post surgery. Behavior change is key. And building healthy habits needs to happen before surgery.

Some bariatric programs have amazing support. Orientations, nutrition classes, guidelines for supplementation following surgery, meetings with psychologists and nutritionists, and active support groups. It’s obvious, however, from observing the conversations in these Facebook groups that people are not researching this surgery prior to permanently altering their bodies, nor do they receive proper pre-surgery education or post-surgery follow-up. This education and support is something I see as a gap in the bariatric surgery process.

I’m one of the most fortunate patients. Not only am I a rule-follower who thrives on structure and rules, but I also had a fantastic surgeon who provided excellent guidance both before and after surgery. She teaches the nutrition classes herself, and is far more knowledgable about nutritional needs, malabsorption, quality of supplementation, adjusting for stubborn metabolisms, and other guidance following surgery. Her practice now has a private support group ( which I’ll add that I helped start up and function as an admin), and she is actively participating in the discussion.

As a health coach, I can help close that gap by coaching from experience. I am still working on reinforcing the positive lifestyle changes required for being an obesity ass-kicker. The most important thing I have learned is that everyone has their own unique journey. People lose weight at different rates, people have difference medical co-morbidities that may change how their bodies’ metabolism functions, and people react differently to certain foods. Guidelines are just that – guidelines. Everyone has a unique prescription for unlocking their optimal health, even bariatric patients. They just need to discover what that is. I still have more discovery to do in order to hit that sweet spot, but I am enjoying what I am learning from the process.

And the answer to the question “when can I eat pizza again?” — for me, it’s never. However, the exploration of more appropriate options is all part of the fun.

Welcome, and My “Why”

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Welcome to Off the Plate, a health and wellness blog that will accompany my future practice as an integrative nutrition health coach. I recently started studying at the Institute for Integrative Nutrition. I am in the midst of my own personal journey to optimal health and wellness, and along the way, I realized that I can share my experience with others to help them achieve their goals.

In July 2016, I underwent gastric bypass surgery and my life was forever changed. I am now an obesity survivor — an obesity ass-kicker. This journey has been a long one, having been obese since I was in my teens (and literally on one diet or another since I was 11). When I decided to have bariatric surgery, I researched the lifestyle changes, I read books and blogs, and committed to making this change permanent.

Stress, anxiety, lack of sleep, and a variety of endocrine and metabolic complexities prevented me from losing weight, no matter how much I exercised, and despite following nutritional guidance from my doctors. Although the surgery radically changed my digestion and absorption of nutrients, it didn’t change my brain. I had to make those changes myself:

  • Adopting a more positive outlook on life
  • Identifying stress triggers and learning how to manage them
  • Incorporating a daily gratitude practice
  • Changing my self talk with daily affirmations
  • Practicing meditation and yoga
  • Journaling
  • Establishing routine exercise goals
  • Building daily rituals to reinforce these lifestyle changes

In my quest to learn more about how food — a whole foods approach to nutrition — can impact weight loss and metabolism, I found this health coach training program and it was immediately apparent to me that I had found my purpose.

My goal is to inspire and support others on their health and wellness journeys to identify and achieve their goals, providing support for nutrition, but also providing support for the nourishment off the plate: nourishment for the body, mind, and spirit.

You’ve all heard the expression, “having too much on my plate.” How many times have you let the wrong priorities guide your life, depriving you of a healthy self-care practice? It’s time to get some things off the plate so you can start feeding the areas of your life that are the most satisfying. I can help you find your own approach to creating that balance in your life.

While I won’t officially be seeing clients for the first six months of this program, I am offering free guidance during this time to a limited group who in turn will help me refine my coaching skills, participate in health history sessions or provide feedback on pilot programs I would like to offer. If you are interested in this introductory coaching proposal, contact me at marilyn.clark@offtheplatehealthcoach.com.