WLS Center E-Newsletter

A FREE publication from


Hosted by Barbara Thompson
Author of:
Weight Loss Surgery:
Finding the Thin Person Hiding Inside You.

Issue #43

March 15, 2004

I was shopping in Bed, Bath and Beyond 2 weeks ago and in the checkout lane I seemed to recognize the woman in front of me. She looked at me, smiled, looked away and then looked back. I knew we were both thinking the same thing, “Do I know you?” I was the first to say it.  After throwing out possible points of connection, we realized that we knew each other from our local weight loss surgery support group. The next thought that we both shared was that I had done well and she had not.  I knew from our previous talks that she always struggled.  She never had those months when the weight fell off, and now she had regained quite a bit.  She felt bad and I knew it, but it was not entirely her fault. Many people have this problem and I am happy that it is starting to be addressed as you will read in the research article that follows.

In This Issue


* Research Article: “Outeating” Weight Loss Surgery
* Advice on Grazing
* “It’s All About Food” CD Available Now
* Tax Deduction for Weight Loss Surgery
* Recipe: New York Cheesecake
* Success Story: Becky Creswell
* Spreading the Word in Hershey, PA and New Jersey

Research Article:

        “Outeating Weight Loss Surgery”

“Outeating Weight Loss Surgery: High-Calorie Grazing Negates Results,” Wall Street Journal – Eastern Edition, 2/24/2004, Vol. 243, Issue 37, p D1.

It is every weight loss surgery patient’s nightmare, “What if I am the one person that weight loss surgery doesn’t work for.” This recent Wall Street Journal article focuses on just that concern.  There is a small portion of patients that will regain much or all of their weight by grazing their way back.  Even though it remains difficult to eat large amounts of food, eating small portions all day long can result in a lot of calories being consumed.

It is difficult to know how many patients experience this weight regain because they tend to be lost to follow up, but it is estimated to be between 5% and 20%.  Dr. Alan Wittgrove, the current president of the American Society for Bariatric Surgery is quoted as saying, “We know there is a portion of the patient population that will not be successful. Sometimes the operation fails them, but sometimes they fail the operation.”

It may very well be that patients who have their surgery in hospitals where there is no aftercare program are the most vulnerable to regaining weight since there is little guidance on how to eat, the importance of exercise and the unavailability of psychological counseling to deal with eating problems. This is adding fuel to the movement on the part of the American Society for Bariatric Surgery to establish Centers of Excellence much the same way as they are set up for cardiology and organ transplants. These will be hospitals that must prove their competence by having done a certain number of surgeries, can document patient success and have a program of support for patients.  It is assumed that patients will want to have their surgery performed at these centers because they will feel more confident in their care and outcomes and hopefully insurance companies will approve surgeries from these centers more readily. We will be hearing much more about these Centers of Excellence in the months to come. 

Advice on Grazing

Dear Barbara,
I am 14 months post-op, and 110 pounds down.  I have gone from a size 24 to a 10.  I have been on a plateau for several months now, and just recently I gained 5 pounds, and have noticed my clothes are feeling tighter.  I know this is possible, but I know the reason why this is happening is not normal.  It is not the usual expected outcome of gaining some of the weight back that I am experiencing.  I have a real problem with eating junk food.  I crave foods like chocolate and potato chips.  I also have a problem with "grazing".  I have found that I can eat almost anything, as long as I pace myself.  My question is how do I discipline myself to stop these bad habits before I gain more than 5 pounds?  I hope you can help me with this horrible problem.  I am desperate!

Teresa Hicks
Warrensburg, MO

Dear Teresa,
It is wonderful and exciting right after we have surgery and we feel like we have control over food for the first time in our lives. And it is very scary to discover that you are again out of control. The inevitable thought is that the lack of control will continue and you will regain all of your weight. But you have taken the first 2 steps to regaining control.  You have recognized the problem and you have asked for help.  Good for you!

I understand junk food because I love it. And the junk food seems to be doing you in. You have a serious case of carb craving.  The more carbs we eat, the more we crave.  I really believe that those of us who are morbidly obese are very carb sensitive. If I begin my day with what is considered breakfast food such as cereal, toast or (heaven forbid) pancakes, I am hungry all day and am constantly looking for something to eat.  So what I do is to always start my day with protein and to delay eating any carbs at all for as long in the day as I can. 

However since you are so out of control, it would be a good idea to totally break that cycle by eating almost no carbs for 2 days and then gradually reintroduce only complex carbohydrates back into your diet. For instance, do not eat any potatoes, white rice or white bread. You can eat vegetables, and a little of whole grain bread (not made with white flour) and wild rice.

If after your best efforts you are still grazing and you can’t control it, call your surgeon and ask for a referral to a psychologist with whom you can address eating issues.  Sometimes we just can’t do everything alone.  There is help out there that can make a lot of difference to you. I wish you the very best.

Teresa would like to hear from anyone else that has a similar problem.  She can be emailed at teresahicks@charter.net.

If you would like to ask me a question and agree to my sharing it in a future e-newsletter, send it to me at Barbara@wlscenter.com and indicate “E-newsletter Advice” in the subject line and mention that I can use the question in the e-newsletter somewhere in the email.

“It’s All About Food”

           CD Available Now

On January 14th I did an hour long telephone seminar with bariatric chef David Fouts. He talked about eating and cooking following surgery and the session was fabulous. If you were unable to attend, you can now buy the CD.  It is available here: http://www.wlscenter.com/Teleseminar/ChefDavid/ChefDavid.htm

The CD is so popular that every place I speak, I sell out of the CD. And it is no wonder. Here is what some people are saying about it:

Even though I'm 7 months after surgery, 150 lbs less, attend support group every month, and have access to over 200 WLS friends via the Internet daily- I learned something new with every question!!
Rick Fisher    PA

I thought the telephone seminar was fantastic.  It gave me a lot of information that really helped me to realize why I do some of the things I do!
Gloria Hutchinson     NJ

My surgery is scheduled for 2 weeks from now, so I know I have lots to learn.  There was good content and lots of excellent hints that it would take months to gather on your own.  It is much more meaningful coming from someone who has experienced gastric bypass.  He did a good job of using his own experience to highlight a point.
Diane Rasmussen    Minnesota

Get your copy today! 

Tax Deduction for Weight Loss Surgery

If you itemize deductions and you paid for weight loss surgery out of pocket for yourself, your spouse or dependent; remember to deduct the cost of the surgery and all related expenses.  The IRS designated obesity a disease in April 2002, therefore there is an allowance for treatment of the disease, but it has a high threshold. You can deduct the cost for treatment for obesity, including weight loss surgery, over 7.5% of your adjusted gross income. For example if your adjusted gross income was $50,000 last year, you could deduct medical expenses over $3750.

Deduction guidelines can be found in IRS Publication 502.


      New York Cheesecake

Weight loss surgery is very much about attaining a normal life, and a normal life includes indulgences every once in awhile.  Many thanks to Carol from New York for sending in this great cheesecake recipe.  It makes a great special occasion dessert.


I found this wonderful recipe for cheesecake using equal.  I tried it and just loved it. So did the rest of my family! Hope you like it.  It's great for that time when you need a sweet fix!  Thanks, Carol 

New York Cheesecake
1-1/4 cups graham cracker crumbs
4 tablespoons margarine, melted
3 packets Equal sweetener
2 packages (8 ounces each) reduced-fat cream cheese, softened
1 package (8 ounces) fat-free cream cheese, softened
18 packets Equal sweetener
2 eggs
2 egg whites
2 tablespoons cornstarch
1 cup reduced-fat sour cream
1 teaspoon vanilla
1 pint strawberries, sliced (optional)

Mix graham cracker crumbs, margarine and 3 packets Equal sweetener in bottom of 9-inch springform pan. Reserve 1 tablespoon of crumb mixture. Pat remaining mixture evenly on bottom and 1/2 inch up side of pan. Bake in preheated 350ºF oven until crust is lightly browned, about 8 minutes. Cool on wire rack.

Beat cream cheese and 18 packets Equal sweetener in large bowl until fluffy; beat in eggs, egg whites and cornstarch. Mix in sour cream and vanilla until well blended. Pour mixture into crust.

Place cheesecake in roasting pan on oven rack, add 1 inch hot water to roasting pan. Bake in preheated 300ºF oven just until set in the center, 45 to 60 minutes. Remove cheesecake from roasting pan, sprinkle with reserved crumbs and return to oven. Turn oven off and let cheesecake cool 3 hours in oven with door ajar. Refrigerate 8 hours or overnight.

Remove side of pan; place cheesecake on serving plate. Garnish with sliced strawberries.

Makes 16 servings.

If you have a recipe that you would like to share in future issues of this newsletter, please send it to me at Barbara@wlscenter.com

Succses Story:

           Becky Creswell

I want to offer a special thanks to Becky Creswell for sharing her success with us     Here is her story:

Dear Barbara:
My story begins, like so many others, with years of yo-yo dieting.  I began my weight gain in 3rd grade, linked to a sexual molestation by a neighbor boy.  I overate from then on in order to deal with my feelings.  Back then, nobody asked "why" to weight gain; they just assumed that I was lazy and eating the wrong foods.  My life of dieting commenced. 

I was raised by a physician father who struggled with his own weight issues so he was bound and determined to make his children thin.  Sadly, this was beyond his control but for years, he kept trying to control my weight any way possible.  I remember years of put-downs, rigorous exercises, strict diets, fasts, and unbelievable self-esteem issues.  Looking back now, I can't believe how "normal" my weight was and how athletic and healthy I was despite this entire negative environment. 

I proceeded to prove to Dad that I was fat and ballooned to 280 pounds!  My entire adult life was consumed with the next diet, learning how not to diet and feeling depressed and unlovable.  I continued to be active through all my ups and downs on the weight loss roller coaster but never felt "good" about my accomplishments.  The glass was always half-empty to me; I was never good enough or thin enough.

In 1992, I married a wonderful but thin man, who loved me literally through thick and thin!  We met when I was an active 220 pounds and during our marriage, I blossomed to 280 pounds again. 

For the rest of Becky's story with photos, Click Here

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.

How Do You Maintain Your Weight Loss?

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 to include in a mini e-book on the secrets of success of weight loss surgery patients. 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 weight loss.

Send your stories to Barbara@wlscenter.com

Permission to Reprint

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Reprinted from Barbara Thompson’s free e-newsletter featuring helpful information and research material to help patients succeed following weight loss surgery. Subscribe at http://www.wlscenter.com

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