WLS Center E-Newsletter
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Weight Loss Surgery:
Finding the Thin Person Hiding Inside You.
I arrived home
from a week in San Diego and my daughter announced that she likes
green beans. As inconsequential as that sounds, I was stunned. My
daughter has an aversion to vegetables that we have dealt with all
her life and suddenly, now that the house sitter made them, she
likes them. Go figure! We have a rule in our house. At dinner,
my daughter doesnít have to eat everything on her plate, but she
does have to taste everything. So for 17 years, she has had a
single green bean every time I have made them. Finally, she likes
them just as I do.
We are profound
influences in our childrenís lives. All these years of my eating
green beans have been working on my daughter. I eat green beans
and now finally she does. We know that in so many ways, our
children eventually mimic our good actions as well as our bad.
What better reason for us to decide to have weight loss surgery than
to show our children that we chose health. We are showing that we
hold ourselves in enough esteem to want to reach out and grab the
best life that we can have. By having surgery, we are not only there
for them longer, but we can influence what future paths they may
take. Considering that morbid obesity has a strong genetic
component, our decision to have surgery can affect them in ways that
we do not at first realize. We can help to influence them to chose
health for themselves as well.
In This Issue
* Exercise Telephone Seminar Coming Next Week
* Program Fees
* Stalled Weight and Exercise
* ASBS Meeting Report
* Recipe: Multi Bean Salad
* Success Story: Patricia English
* How Do You Maintain Your Weight?
You Canít Reach Goal without It
Concerned that you are not losing the weight
that you want? Then you absolutely must sign onto the
ďExercise: You Canít Reach Goal without It.
Wednesday June 23rd
8:00 PM Eastern Time
$19.95 (Plus phone charges as
What You Will Learn:
* Starting your exercise program from day
one, regardless of your physical condition
* Preventing plateaus
* Getting the motivation to just do it
* Overcoming mental obstacles
And much, much more. There are a lot of free
handouts with this telephone seminar.
Click here to register or to find out more.
In the last issue of the e-newsletter I
defended having to pay program fees and several of you nicely
disagreed with me. I certainly respect your points of view and
find them all very valid. Here are some of the responses I
From Pam Kreinest:
I would like to
make a comment about the program fees charged by some of the
physicians here in Jacksonville, FL.
charges $6000.00 before surgery! Another charges only $1000.00.
Why the disparity in prices? It is beyond me since the insurance
industry pays the same amount. I am discouraged that some are
outrageous and make it difficult for patients to use their
services due to the amount needed up front. I am ready for
surgery but cannot come up with the $6000.00 needed to have it
done. Just a comment...
Fram Ana Jarosz of Hobe
I read your June newsletter regarding
additional fees charged by surgeon and your response to the woman
who was asking if this was possible. I disagree with part of your
While I realize that managed care companies
are reimbursing small amounts to providers, the provider of
service has signed a contract stating that they will accept what
the insurance company pays them. If that lady's plan pays at
100%, then she cannot be charged anything by the surgeon for
services related to the procedure he already filed a claim with
the insurance company for. I'm sorry, but, itís up to the surgeon
to decide whether or not he wishes to participate in a program and
if he does, he has to accept those fees and cannot charge the
patients. To do so is in violation of the contract he signed with
the insurance company.
I had something similar happen to me with the
first and second surgeons I consulted with for my bariatric
surgery. They both wanted $5000 above what the insurance would
pay. My plan had approved me for the surgery and was paying 100%,
no deductible, for the procedure and hospitalization. I went to a
third surgeon who stuck by the contract he had signed with my
insurance company. To me, itís a matter of character if the
surgeon does not abide by the contract and takes money from the
patient. If they are that lacking in character and ethics, then,
I don't want them cutting into my body. I can't trust them.
From Shirley Warren:
I just read the
June 1 E-newsletter regarding program fees. Please advise
Christina to check with her insurance company regarding the charge
of program fees by her physician. In most instances if a physician
agrees to accept insurance assignments via their contract, it is
not legal for them to charge the patient extra fees beyond the
contract fee. If a patient requires follow-up visits past the
initial post-op period, these visits should be covered as a
regular physician appointment. I know this to be true for my own
insurance company and also for the Medicare program. Thank you for
Pfeiff in Massachusets:
just read your response to the Program fees question that was
posed to you.
I have to disagree with a part of
the statement. The physician is getting paid for every after
visit you go to following surgery. Those visits are not part of
the surgery fee!
And as for other fees, the
nutritionist gets paid for every visit too. They do not share the
doctor's fee. They bill their visit themselves, even if it is the
same day as the doctor.
agree that insurance companies do pay very low prices for such
major surgeries, but that is a fight for the doctor's offices to
guess I am lucky that I had my surgery a year ago when this
Program fee was not yet in place.
And I must say that after a year
I am doing great! I am down 117 pounds and feeling wonderful.
saw you when you spoke to our support group in Boston and was
thrilled to hear you speak. Way to go! You are quite
motivational! Continue that great work!
If you would like to re-read
what I wrote on program fees, click here
Stalled Weight and Exercise
I received the following question from Sheri Heam and thought
it might be helpful if Jon Gestl, who is
our guest for the upcoming telephone seminar on exercise,
would answer her question. :
I am a 35 year old Mom and nurse who had open RNY surgery on
April 14th, 2003. I am thrilled with what has happened
thus far but also a little disheartened. My surgical weight was
348 pounds on a 5'2" frame. I was miserable in so many ways. I am
currently at 200 pounds and stalled out.
My surgeon had said that in order to get to goal I really had
to make exercise a daily part of my day and requested 45 minutes a
day 5 days a week. I have been so good at this. We joined the
YMCA and for the past almost 2 months I have been getting up at
4:30 am and doing cardio exercises 5 to 6 days a week followed by
weight training every other day.
I have noticed inches coming off and I feel great but my loss
has stalled completely. I haven't gained but I haven't lost a
pound!!!! I can't help but get a bit concerned and upset that I am
not losing anymore weight. I want to lose another 60 pounds. I
know you have the telephone seminar coming up but do you have any words
of wisdom? Thanks for any input you may have for me.
Sheri Hearn, R.N.
Although you are understandably frustrated, I'm delighted for you.
Believe it or not, you are right on track!
First, the fact that you exercise 5 to 6 days a week (getting
up at 4:30AM no less) and have done so regularly for two months is
reason enough to celebrate. Making exercise a daily, habitual
part of life is the hardest part of the process. It is an
absolute necessity. Kudos for your persistence!
Second, that you are not seeing dramatic weight loss at this
point doesn't surprise me at all. Having never regularly
exercised, it stands to reason that your metabolism is probably
slower than average. Metabolism, or the speed at which your body
uses energy, controls the rate of fat burning. It is affected by
genetics, diet patterns, and by the amount of muscle you carry.
Since fat is burned in the muscle, the more muscle mass you
develop (through resistance training) the higher your metabolism
will become and the more calories your body will burn, both at
rest and during exercise. However, dramatic change to the
metabolism doesn't happen overnight, or even two months, but
through consistent effort; you are definitely on the way to
increasing your metabolic rate.
Finally, even though you are not experiencing overall weight
loss, you state you notice a loss in inches. This indicates that
you are indeed losing fat content, but are
substituting the weight with muscle. Muscle is much denser than
fat and takes up less room on our frame. A loss of even 5 pounds
of fat and a gain of 5 pounds of muscle mass, even though you
can't see it on the scale, will have a noticeable effect on the
body. And, most importantly, it will help to increase your
After a year of rapid weight loss, it is certainly frustrating
to experience the process slowing down. But realize that the
surgery is just a beginning, helping you to "level the playing
field." As hard as it going to be, the focus for you now needs to
be in noticing changes in your overall appearance rather than
overall weight loss. Losing inches, decreasing your clothing
size, and increasing your energy level will indicate continued
As your doctor said, exercise needs to become a daily part of
your life in order to achieve your goal. Weight loss will
continue, just not at the rate experienced in your first year
Keep up the great work!
ASBS Meeting Report
The American Society for Bariatric Surgery met
in beautiful San Diego, CA June 12th thru the 18th.
There were more than 2200 surgeons, support group leaders,
psychologists, dieticians and nurses in attendance. Every year it
grows bigger and bigger. And every year it seems that there is a
particular point of controversy.
The first year I attended, the controversy was
the introduction of the lap band. The next year the controversy was
about all of the new practices that were jumping onto the bariatric
band wagon. One year the controversy was whether the surgery was
better done laparoscopically or as an open procedure. This year the
hot topics were the Center of Excellence concept and problems with
The Centers of Excellence will be those
practices that apply to become a Center who are then approved by the
American Society for Bariatric Surgery because they meet certain
requirements. The requirements include having completed a minimum of
125 cases, have a complete aftercare program, and have proven
outcomes. Patients will ultimately be safer and more successful by
having their surgery at a Center because the practice will be
experienced and prepared to meet patient needs through a support
group and available services such as psychological and nutritional
counseling. Insurance coverage should then become easier as well.
Although there is a certain amount of
competitiveness going on with practices and vendors, this
professional association is very proactive in dealing with issues
facing the field. The Centers of Excellence will help to ensure
that patients are receiving the highest quality of care and the
opportunity for the greatest amount of success. You will no doubt
be hearing a lot more regarding the Centers of Excellence in the
months to come.
Multi Bean Salad
I would like to thank Karen Perna from
Chandler, AZ for
the following recipe. This is a great summer salad.
1 16 oz. package frozen shelled edamame
(soybeans)-cook lightly, drain, let cool
OR 1 16 oz. can of soy beans, drained
1 16 oz. can cut green beans, drained
1 16 oz. can red kidney beans, drained
1 16 oz. can garbanzo beans, drained
1 medium sweet onion, cut into strips
1 large green pepper, cut into slices
Combine the following ingredients for the
3/4 cup Splenda
1/3 cup canola oil
2/3 cup white vinegar
1 1/2 tsp. salt
1 tsp. ground black pepper
Put all the vegetables in a large bowl, pour
marinade over, toss lightly, cover tightly and refrigerate for 10-12
hours (mix, turn over or lightly toss occasionally to distribute the
Note: Other beans may also be added but try to
avoid beans that are very soft. I pick which beans to use based on
their protein value....and what is on sale :-)
If you have a recipe that you would like to
share in a future issue of this newsletter,
please send it to me at
I want to offer a special thanks to Patricia
English of Louisiana. Here is her story:
I really enjoy receiving your newsletter. You have
many inspirational stories, wonderful articles, and lots of recipes.
It was through researching weight loss surgery that I found your
site and was led to Dr. Hargroder in Baton Rouge Louisiana.
My highest weight was 241 pounds. I had high
blood pressure, painful joints in my back, hips, and knees, and high
cholesterol and was taking medicine daily for these conditions. I
had been on numerous diets to lose weight only to regain it plus
some. My dad's father died of a heart attack in his early 40's. My
dad also has high cholesterol and high blood pressure, and my
dad's mother has high cholesterol, high blood pressure, and heart
problems. My uncle had a heart attack while I was having my surgery
so that made me that much happier I had made this decision to go
through this surgery.
My motherís weight is 350 pounds and has high
cholesterol/ high blood pressure, diabetes, arthritis, renal
problems and, heart problems. And the list goes on and on. I could
see myself in the same shoes as my Mother in a few more years. I did
not want to go through what she is going through now. I have 2
children and a husband and I want to spend a few more years being
able to do things with them. It was seeing my mother like this that
led me to my decision to have a laparascopic RNY on October 9th,
I went into the surgery apprehensively and
thinking "Do I really want to give up this lifestyle of sweets and
high fat foods?" My decision of course was yes and it was the best
decision I have ever made in my life. If you ask me if I'd do it
again, I'd say YES!!.
After the first 6 weeks post-op my cholesterol
was down from over 350 to 201. I went down to 141 pounds after 8
months and lost another 6 pounds after I had to have a hysterectomy
2 months ago and I am now down to 135 pounds. I have lost a total of
106 pounds. YEAH!! I am down to the weight I was in high school and
can still not believe it.
I feel better than I have felt in several
years. I enjoy doing more things. I am active with riding with my
husband on his motorcycle, something that I hated riding on before
because I was so big.
I would like to thank you for your encouraging
newsletter that led me to make the best decision of my life. Again,
thank you and God bless you!! You are doing a great service to all
the people that have had weight loss surgery or who are considering
I love good news. If you have good news,
a success story to share, or inspiration, please send it to me at
Barbara@wlscenter.com so that I can include it in future issues.
I am again low on success stories, so if
you are 1 or more years post op and have a story to share, please do
so. And please email before and after pictures.
How Do You Maintain Your Weight Loss?
More Success Stories Needed for My
Are you 2 or more years post-op? If so, I need
to know what your secret is for maintaining your weight. I will be
using your story in my next book on maintaining
your weight loss long term. You must write at least 1 full page. Anything
less than 1 page will not be useable. I also need your before and
after pictures sent via email. I need to know how you eat, what you
do for exercise, and any tips that you have to offer. This will be a
tremendous help to people who are having the common problem of
weight gain following surgery, or are struggling to maintain their
Send your stories to
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from Barbara Thompsonís free e-newsletter featuring helpful
information and research material to help patients succeed following
weight loss surgery.
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