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.

 

 

 

 

 

 

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.