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.

 

 

 

 

 

 

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.

 

 

 

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.