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 #64

February 15, 2005

Hi everyone,
I have been doing a lot of reading on change lately and it makes me wonder what really made all of us change.  In the success story below, you will read what made Debbie change. With her, it was her doctor telling her that if she didn’t lose weight she would die in 3 years.  With me, it was the herniated disk in my back becoming unbearably painful. But it was also the look on my daughter’s face when I had to use a wheel chair when we were at Disney World.

Drop me a line so that I can share it with others.  I think that our reason to change needs to stay foremost in our minds so that we can reach back and remember that strong motivation and just how it felt when we reached that point when we couldn’t take it anymore. Share your thoughts with me at Barbara@WLScenter.com

In This Issue


* The Next Newsletter Might Be Late
* Insurance Coverage
* Research Article: Bariatric Surgery: Separating Fat from Fiction
* The Choices We Make
* Plastic Surgery CD
* Recipe: Crab Cake with Orange Dill Sauce
* Success Story: Debbie Holmstrom

The Next Newsletter Might Be Late
Please note that the March 1st newsletter might be a few days late due to business travel requirements.


Insurance Coverage

Dear Barbara,
I have begun the process to have gastric bypass surgery. I went to a required educational seminar put on by the surgeon. I made a follow up appointment that night.  At the appointment with him he said my insurance BCBS was very good and he has had no problems with them. He has gone ahead and scheduled more appointments with more doctors and I got a claim summary from my insurance company for the first office visit and it covered the correct portion of it. Does this mean that my insurance has agreed to cover the procedure? I do meet the criteria with a 55.4 BMI.  Should I ask the surgeon at my next appointment?  Ordered your book. Can't wait to read it. Thanks. Cindy T.

Hi Cindy,
No it doesn’t mean that your insurance will cover the entire procedure.  They are agreeing to just cover the one appointment - so far. But it does look good.  If your surgeon is experienced, he probably has office staff that will take care of all the paperwork for you. Just stay on top of the paperwork and don’t let things go more than 2 weeks at a time without checking where things are.  By this I mean, if your paperwork has been submitted and you haven’t heard anything for 2 weeks, call the insurance company and find out if they have an answer.  It is amazing how paperwork gets lost.

Good luck!


Research Article:
          Bariatric Surgery
               Separating Fat from Fiction
Thiesen, Kathleen. “Bariatric Surgery” Separating Fat From Fiction,” National Underwriter Life and Health, Vol. 109: 2,  Jan. 10, 2005,  p. 25.

This revealing article appeared recently in a publication geared toward the health insurance industry.  It is a discussion of weight loss surgery and the cost of the surgery to the insurance industry. In the article, the author recognizes that weight loss surgery is effective, sometimes dangerous and definitely expensive. She looks at the $25,000 cost for the surgery and the 140,000 surgeries performed in 2004 and the cost to the insurance industry is $3.5 billion dollars. I had never done that math, so the figure made my jaw drop.

While we know that the cost of our care if we do not go through surgery is far higher, it takes the insurance industry 3.5 years to recover those costs.  They mention that during that time, an employee is likely to either change jobs or the company is likely to change insurance providers. So for the company to recoup the cost it paid is unlikely.

There are several things that the author points out to the insurance industry. If we are at all interested in the future of weight loss surgery either for ourselves or for those who come after us, we have to be aware of what the insurers’ concerns are:

1) The $25,000 cost goes up significantly if there are complications, so they are looking at the likelihood of complications.  They site studies that show doctors who have performed more surgeries have fewer complications.

2) They are also interested in the outcomes of the surgery.  Are we successful?  Has their $25,000 (or $3.5 billion) been a good investment or are we just regaining the weight and asking for either another surgery or a return of our health problems.

They mention the Centers of Excellence as a bright spot on the horizon.  They are a bright spot for the insurance industry and for us as patients. 

The Choices We Make

Hello Barbara,
I just finished reading your Feb 1st newsletter and read the questions you answered under the “blog” section.  I have a question pertaining to the one in particular where the woman had her surgery in September of last year and feels like she is eating too much. 

You stated that at four months out she should be eating around 900 calories. I am 10 months out and wanted to know what the “norm” is for someone that far along? I also know that I can eat a lot more. It’s very scary and I am so close to reaching that 199 mark but I keep fluctuating between 207 & 211. I’m scared that I won’t “make” it and I know that some of the food choices I make are not good. I do tend to “graze” and/or overeat more on the weekends.

I am making a conscious effort to change that, but some habits die hard (like I have a Starbucks Grande Mocha Frappuccino Lite with my protein powder every morning – I know I shouldn’t have one every day but it’s a treat I enjoy and they put the protein in for me, which is cool.  It keeps me full until lunchtime. But I know that even though it’s lite – sweetened with Splenda – it is still high in carbs & sugar – I am really addicted to them, though, and have a hard time NOT having one every morning when I get in to work…) and it’s a struggle at times to just say no. 

I am a much better person today in all ways than before my surgery – I have lost around 122 pounds but I feel that it should be more (in 10 months)…I want to succeed so bad and lose at least another 25 pounds…then, I can have the plastic surgery and all that to deal with – one step at a time, I know! 

Anyway, I guess the main question is HOW MUCH SHOULD I BE EATING?  Thank you so much for your help!  I really enjoy your monthly newsletters and look forward to hearing from you!

Sharon L. Tupper

Dear Sharon,
First let me congratulate you on losing 122 pounds.  That is absolutely fantastic! With that said, let’s look at what you are doing to yourself.

It’s all about choices and the ability to truly change.  You are at your most critical time right now when it is the easiest to lose weight. If you want to lose those last 25 pounds, then you have got to get with it.

You are having a Starbuck’s Grande Mocha Frappucino Lite with protein powder every morning because you are addicted to them.  That’s OK as long as you realize that a Grande is 180 calories and if you have it with whipped cream it is 310 calories. So let’s assume that you are not having the whipped cream.  You are also adding protein powder to it.  I don’t know how many calories are in the protein powder, but that probably at least 200 calories.  So that’s almost 400 calories in the morning. Plus you are getting in a lot of caffeine. Not good. The grazing on the weekends is also not good.

If you truly want to lose additional weight, you should eat between 1,000 and 1,200 calories per day and you should be exercising.  Use a food journal. Add up those calories and see if all of those calories for the Starbuck’s are worth it.  It may be and you may want to cut elsewhere. 

Just remember that most patients regain weight starting about the 2nd year.  So you may be at the 207 to 211 point right now, but think a year from now being at the 227 to 231 point.  Will you be happy?

You are at a critical point right now.  You look good and it is very hard to keep that motivation up. You have some choices to make in what direction you will take and these are all choices that only you can make. Take care.


Plastic Surgery CD

At the end of January we had the telephone seminar on plastic surgery and it was terrific. 

We are taking orders for the $19.95 CD and will be shipping them next week.

We have also added the plastic surgery CD to the Super Package Deal but kept the same $59.95 price.  This is a package savings of $38.80 over the original individual item cost.

Here is what the participants said about the seminar:

I thought it was very informative. It was great talking with a professional without the pressure of having to go for an appointment just to get some questions answered.  It was relaxing and it helped to have information that will further me when it is time to go to the next step.  Just like your book Barbara, any and everyone who is going to have a procedure done should be well informed before making the decision.   It is great to hear from a professional in the privacy of your own home first so you can make an informed decision before contacting the doctor of your choice.  But it was also great to learn what to look for in a Doctor as well.  I am glad I know now what to look for and what questions to ask.  Having that information going in is a great relief.  Thank you so much for the opportunity to have spoken with a well renowned Dr. to relieve the fears of the next surgery.

Linda from California

I found the Plastic Surgery telephone seminar very informative and useful.  You did a great job of asking questions that covered the topic very well.  Dr Rubin was a real expert and could answer the questions using his vast experience in this area.  Thanks for asking the question that I sent to you via e-mail.  I would definitely listen in on future telephone seminars. Maureen in New York

This teleseminar was very informative and helpful!  I am 13 months post-surgery and am now at the point of needing to interview plastic surgeons, so this was very timely for me.  Barbara's questions were excellent and hit a wide variety of topics.  Dr. Rubin was extremely well-spoken and explained everything in layman's terms.  Taking breaks in the middle and at the end for Q&A was also very good because we learn just as much from interacting with other patients as we do from doctors!  Thank you for an excellent teleseminar!

Jill from Maryland

To order the CD so you can get important information about plastic surgery,

Click Here

Recipe: Crab Cakes with Orange Dill Sauce

1 pound cooked fresh crab meat
4 teaspoons butter, divided
1/4 cup finely chopped celery
1/4 cup minced green onion
1 Tablespoon minced fresh chives
1 jalapeno chile, cored, seeded and minced
1/4 cup lite or low fat mayonnaise
1/4 cup soft bread crumbs
1 teaspoon fresh lemon juice
Salt and white pepper to taste
1 large egg, slightly beaten

Prepare the orange dill sauce

In a large skillet, sauté celery, onions, chives and chile pepper in 1 teaspoon of butter until limp. Put in a large bowl and add the crab meat, mayo, bread crumbs, lemon juice, salt and pepper.  Mix well. Fold in the egg until it holds together.

Divide into 8 portions and shape into flat round cakes. Put onto a baking sheet covered with waxed paper. Cover with plastic wrap and refrigerate 3 or more hours so they will hold together when fried.

Heat 3 teaspoons of the butter in a skillet and sauté cakes about 4 to 5 minutes per side until crisp and browned.  Add more butter if needed.  Serve with sauce. 

Orange-Dill sauce
2 Tablespoons light or low fat mayonnaise
1 teaspoon grated orange zest
1 Tablespoon fresh orange juice
1 teaspoon minced fresh dill weed

Combine all ingredients, cover and refrigerate at least one hour.

Calories: 225 for 2 cakes plus sauce

Success Story: Debbie Holmstrom  

I want to offer a special thanks to Debbie Holmstrom. Here is her story:

My name is Debbie Holmstrom. I am 51 years old and I have always had a weight problem.  I have known no other lifestyle.

I was to the point in my life that I had gone to the doctor totally depressed about my weight and the way I was feeling.  I had begun walking with a cane, because it took every effort to just walk across the room. I hurt all over.  I always felt bad.  The doctor looked me right in the eyes and said, “You know you probably will not live to see your 52nd  birthday.”  My heart jumped into my throat.  At that time I was 49.  I had tried every diet and program around with no permanent success.  I would lose 50 pounds and gain 70. Lose 100 and gain 120.   Something had to be done.

I joined a water aerobics class and overheard a very pretty lady talking about how she had “already lost 75 pounds.”  She was talking about her gastric bypass surgery.  I was curious so I asked her all about it.  She said that it was the best thing she had ever done and would do it again in a heartbeat!  That sounded like an answered prayer to me.  I researched the doctor and found that I had complete trust in him and that was all I needed.

I had my surgery on Aug. 15, 2002. I checked in at 338 pounds. and wearing a size 30/32.  I am 5’5.  A year and a half later I weighed 155 pounds and wear a size 8/10.  Today, I go up and down from 155 to 160.   My husband who has always been overweight saw what a difference in my life the surgery was making.  He saw that:

I got off of so many medicines!

I can now walk across the room or walk 3 miles at a time and without getting out of breath!

I can fit in an airplane seat with no extensions! And I can go to the movie theater and
sit in only one seat.

I shop in the “normal size” clothes department, although I still grab the large sizes and have to put them back. It has taken two years to finally see the real me in the mirror, and I love it!

I have met so many wonderful friends through the water aerobics class and the monthly meetings my doctor provides.

 I can cross my legs!

I can easily go into a bathroom stall and not have to stand way back just to close the stall door!!!

I can fit into a booth when we go out to eat!

I can go out to eat without worrying about people and kids staring at me saying
“look at her, she’s so FAT!”

Men hold the elevator doors open for ME!

And just last week, at the “McDonald’s” the little clerk at the counter asked if I was a model!  I looked around to see who she was talking to, and she said, “Are YOU a model?” I said “No, but you just made me feel like a million dollars!”

My husband, Fred, decided to have the surgery.  He had his gastric bypass RNY surgery on Oct. 17, 2003.   He weighed 360 pounds at the time of his surgery.   He was wearing 5X clothes.  He is 5’10”.  He will be 66 this year and is down to 220 pounds and wearing “larges”!   He still has some to lose yet, but he said he feels like a new person!   He looks wonderful! I am so very proud of him!

We will celebrate our 20th wedding anniversary in July this year.  We are planning something really special.

This surgery not only saved our lives, but gave us a brand new life together, a healthy life.  Would we do this surgery again?  YOU BET YOUR LIFE ON IT!

Debbie Holmstrom

Before After

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.  

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.barbarathompsonnewsletter.com/

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