Penn Metabolic & Bariatric Surgery Program

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Monday, March 3, 2014

My Non-Scale Victories

Chiara Gravell had a sleeve gastrectomy at Penn Medicine with weight-loss surgeon Noel Williams, MD, in 2011. Since then, she’s lost more than 150 pounds, and has gone from being obese to completing triathlons. In this blog, she discusses weight-loss victories OFF the scale.

My weight-loss journey moved relatively slow based upon surgery standards. On average, I lost less than 10 lbs a month for the first year. (110 first year) Since my progress was slow, I decided to focus on my “non-scale victories.”You know, the little items that showed progress even when the scale moves slowly.

Seat belts

My first non-scale victory was when I flew to Europe nine weeks after my surgery. I was able to fit in the seat and use the seat belt without an extender! I was so excited. On that trip I also was able ride a Segway and walk all over Europe without my feet killing me!

As you can see, even 10 weeks out I was still heavy, however I had dropped two jean sizes! I often measured my progress in jean sizes. The first year I went from a size 24 to a size 12 in jeans! . I only changed jeans when they would literally fall off while still buttoned and zipped. What a freaky feeling, taking off pants that fit just a few weeks prior without unbuttoning or unzipping!


 

 

Triathlete

My next non-scale victories had to do with races. Finishing my first triathlon was my first major non- scale fitness victory.

Yes even 13 months out of surgery I was still obese as you can tell in the above picture, however I was much, much smaller and had a ton of athletic ability I never had before the surgery! 

 

 

Rocking the dress

Every woman wants to be able to rock the dress. Well only two years out I was able to totally rock the dress! I like to use this picture as an after picture. It was a great victory that I was still able to turn heads in my mid 40s.

Staying on trend

Last winter my big victory was being able to wear knee high boots that would zip up!! Yes I didn’t need the wide calf size just normal boots. Woo hoo! What an awesome feeling that was! I felt “normal” for the very first time ever.

My latest non-scale victory was today. I was on my bike. When I started riding my stomach went over the seat. Today not only can I see the entire seat, I can put my entire palm on the seat and see it. My stomach has recessed that much.

My weight-loss story really started after the weight loss. What I can do now versus what I could do before the surgery. I thought I was pretty and adventurous before, but now there is no stopping me. Weight-loss surgery has given me the ability to live. It is important to not only celebrate the weight loss but the victories of what it means in our lives.

Lose Weight at Penn Medicine


Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia. There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

Friday, February 28, 2014

The Big Deal With The Biggest Loser

A few weeks ago, “The Biggest Loser” winner made huge headlines.

Rachel Frederickson’s 155-pound weight loss made her the winner, and immediately put her in the national spotlight. Not for the $250,000 she won on the show, but because many people thought she lost too much weight.

Rachel started the competition at 260 pounds and finished weighing 105.

We caught up with Professor of Psychology in Psychiatry and Surgery at the Perelman School of Medicine David B. Sarwer, PhD, to discuss “The Biggest Loser,” and how viewers are impacted by watching people lose weight so fast on a TV show. Dr. Sarwer is also a member of the bariatric surgery team.

What do you think about “The Biggest Loser?”
Some feel that shows like “The Biggest Loser” may take advantage of people who are obese for entertainment. I can only assume the contestants go through various medical and psychological clearances to make sure they are good candidates for the show. Medical waivers need to be signed and contracts are written – I suspect the contestants are very aware of the exposure they will have once on the show.

Do you feel the media’s portrayal of weight loss diminishes efforts of “real” people trying to lose weight?
I think it’s important to remember that the show doesn’t reflect the way most Americans try to lose weight. Unlike the contestants on the show, most of us can’t step out of our lives to live on a ranch, have six-hour long personal training sessions, and certified nutritionists and chefs helping us eat well.

There are some people who will watch the show and understand this, but there are others who may watch the show and take it for real medical advice.

This woman had an exceptional weight loss without surgical intervention, but not everyone at home watching will have the same success.

Why is everyone so quick to comment on people’s weight?
Unfortunately, there are very few things that are “off limits” these days. It’s easy for people to criticize others when they are “too heavy” and then again when they are “too thin.”

Our mass media driven culture enjoys building people up….only to tear them down again if they stumble. People who lose weight on a show like “The Biggest Loser” have a tremendous effort ahead of them to keep the weight off. While we are all seeing covers of Rachel as a winner this week, a year from now we may see tabloids talking about the weight she’s gained back. Lost in all that coverage will be challenge that most people have with losing weight and successfully keeping it off over time.

Lose Weight at Penn Medicine

Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia. There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.


Tuesday, February 25, 2014

Eat Right for American Heart Month


Registered dietitian and bariatric program nutritionist Danielle Rosenfeld, MS, RD, LDN, shares some tips to eat well for heart health.

In honor of American Heart Month, I give you the challenge of taking a step back from your day-to-day routine to evaluate your current diet and lifestyle habits. Are you smoking regularly? Do you engage in regular physical activity? Do you get routine check-ups and monitor your blood pressure, cholesterol and blood sugar?

Heart disease is the number one  killer of Americans but the good news is we can significantly reduce the risk of heart disease by promoting a healthy diet and lifestyle.

For the first time, the American Heart Association has defined what it means to have ideal cardiovascular health, known as “Life’s Simple 7." Taking these steps can help to add years to your life!
  1. Eat a healthy diet
  2. Avoid smoking
  3. Maintain a healthy weight
  4. Engage in regular physical activity
  5. Manage blood pressure
  6. Take charge of cholesterol
  7. Keep blood sugar, or glucose, at healthy levels
Eating a healthy diet is one of the best weapons to utilize, and one of the few things we have control over. Here are some simple steps to help you eat better and reduce your risk for heart disease.
  1. Buy less junk! If it’s not available in your home, you’re much less likely to eat it. Buy more fresh produce, nuts, fiber-rich whole grains, beans, and lean proteins such as fish.
  2. Challenge yourself to experiment with new foods. Follow the Penn Medicine Weight Loss Blog and try a new recipe each week! This will help you to introduce new (and nutritious) foods to your whole family.
  3. Cut down on saturated and trans fats, cholesterol and added sugars. This can be achieved by simply reducing your consumption of sweetened beverages, high fat meats and solid fats (butter) as well as white (refined) starches.
  4. Eat your omega-3 fatty acids. These fats are anti-inflammatory and may help to lower your risk of coronary artery disease. Choose oils that provide omega-3’s such as olive, organic canola and flaxseed. Avocados, walnuts, almonds, fish, and chia seeds are also excellent sources!
  5. Choose fresh and frozen foods over canned. Canned foods tend to have much more salt. Aim to eat less than 1500 mg of sodium per day.
  6. Stick with healthy cooking methods. Bake, broil, roast, stew or stir-fry to reduce the calorie and fat content.
  7. Skip the salt and use plenty of fresh herbs and spices to impart flavor in cooking.
Just making a few healthy upgrades can have a significant impact on your health. This February (and all year long), feel inspired to make a positive change in your diet. Maybe it’s simply switching to whole wheat bread, or perhaps it’s switching from butter to olive oil. The small things make all the difference!

Lose Weight at Penn Medicine


Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia. There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

Monday, February 24, 2014

5 Things You Need to Know About Life After Bariatric Surgery

Lisa Harris of Clementon, NJ, was a self-proclaimed “yo-yo” dieter her whole life. Moved by her father’s dying request to get healthy, Harris had gastric bypass surgery at Penn Medicine with Alan Schuricht, MD, FACS. 

The road to bariatric surgery can be a long journey for some. There are months of planning, pre-operative testing, medical clearances, and nutrition classes beforehand. Insurance is cleared, surgery is scheduled, and then all of a sudden you’re on a different path.

If your head is spinning after surgery and you start to feel overwhelmed, remember these tips:

Everyone has buyer’s remorse. 

I don’t care what procedure you had done, at some point or another during your post-op phase you’re going to say, “What did I do to myself?” This is completely normal. Remembering why you had weight-loss surgery can chase those thoughts away. Everyone has a different motive, but it could be related to diabetes, blood pressure, or just a general desire to have a new, healthy life. Keep your eye on the prize.

Get yourself a good post-op support system. 

You shouldn’t feel abandoned once you’ve had surgery. Friends and family are important, but remember to attend your support groups. People that see you on a daily basis might not notice the drastic differences in your shrinking form. Your new friends at support group will see you once a month and you will be able to really see a difference and encourage each other. It’s important to hear every once in a while: YOU look fantastic!!

Make sure you have important things gathered before your surgery. 

As a single mother, I had no other adults in my house. My first night home after surgery, I was literally stuck in bed. My insides hurt to move in some ways, and I had to get up to use the bathroom. It took close to 30 minutes for me to push, pull and drag myself out of bed that night. After that, I had a kitchen chair next to my bed for the remainder of my healing. The chair worked as a handle to leverage myself out of bed. I also found it easier to sit on the chair than bed when dressing in the morning.

Stick to the plan your doctor gives you. 

If your plan says you can have non-fat cottage cheese at week three, don’t try it at week two just because so-and-so on the Internet said their plan has it on week two. There is always a good reason for differences in post-op plans, which can vary from the procedure that’s been done and/or healing times for internal suturing.

As you lose weight, your clothes are going to fall off. 

Easily. Here’s a bunch of post-op wardrobe tips that can help.
  • While you’re still pre-op, go to a discount store and pick up a couple pairs of cheap stretch pants or sweat pants. Get one size smaller than what you wear now. You’ll need these at about 2-3 weeks post-op. Don’t spend a lot, they’re not going to last long.
  • When it’s time to go back to work, take a trip to a thrift store. Take a friend with you. Most thrift stores arrange things by color, so you’ll have to sort through to find sizes that might fit. That’s where the friend comes in. When you start out at a size 3X and you can now fit into a size L, sometimes your brain hasn’t quite registered it yet. With a friend by your side, you can hold up an article of clothing and ask if they think it’ll fit you. Always try things on before you buy. Shopping at thrift stores can save you a lot of money when your wardrobe needs constant refreshing.
  • Another benefit to shopping at thrift stores is giving back. I donated the vast majority of my clothes back to thrift stores, along with many items I bought for interim sizes. Don’t forget to get a receipt. Over the nearly 3 years since my surgery, I’ve donated well over $2,000 worth of clothing, and it makes a difference when filing your taxes.
  • When you’re buying clothes, consider buying a couple things that are snug. You’ll be surprised at how fast your body changes and you’ll be able to fit into them sooner than you think.
  • Don’t skimp on undergarments. For the women out there, there is nothing better than good support. Splurge and have a professional bra fitting. I went to the well-known bra store in the mall. Fittings are free, they bring you as many bras to try on as you want, and you can find something that makes you look and feel phenomenal. Spending $50 on a bra isn’t too bad, and once you know the right size for your body, you can shop elsewhere. But make sure you splurge on at least one. I was mistakenly wearing a 40C when I should have been in a 36DD. The right bra DOES make a difference!
  • Also on the undergarments, there are many manufacturers of shapewear. I found a great item that I love – so much that I’ve got five of them. It’s called a Torset Top. There’s a few brands of these available, in different styles and colors. Basically it’s a tight camisole with a low scoop in front. It’s worn with a bra and makes a nice smooth line under all your clothes. A quick search on the Internet will show brands and retailers.
At nearly 3 years post op, I still have people ask if I’m still losing weight, or if I’ve stopped losing weight, or if I met my goal.

What you tell people is up to you and your own comfort level. My standard response to most questions is now, “I’m getting there!” as I smile and walk away.

To recap, don’t let the post-op process get to you. There’s going to be a period of mourning your old lifestyle, but look at the new, healthier you that’s emerging! Plan ahead as much as you can, keep an open mind and a positive outlook and you’ll get through just fine.

Lose Weight at Penn Medicine

Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia. There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

Friday, February 21, 2014

Penn's David Sarwer Breaks Down the Basics of Bariatric Surgery With WHYY

To learn about the challenges of being successful after weight-loss surgery, WHYY Radio sat down with David Sarwer, PhD, a professor of psychology in Surgery and Psychiatry with Penn Medicine’s Bariatric Surgery program.

“We make sure that patients have realistic expectations of what the surgery can do for them, the changes that they need to make, and one of the most important things is to make sure that the timing in their lives is right," says Dr. Sarwer. "It's important that you're doing this at a time when you can really dedicate time and energy to taking good care of yourself," said Sarwer.

Listen to the full interview with Dr. Sarwer here.

Let Penn Help You Lose Weight For Good


Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia. There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

Wednesday, February 5, 2014

Meet Octavia Pickett-Blakely, MD, MHS

Octavia Pickett-Blakeley, MD, MHS, is assistant professor of medicine and director of nutrition and small bowel disorders in the Division of Gastroenterology at Penn.

Dr. Pickett-Blakeley works closely with the Penn Metabolic and Bariatric Surgery Program at Penn.

“As a gastroenterologist, I see patients with gastrointestinal disorders like reflux,” says Dr. Pickett-Blakely. “As bariatric surgery permanently alters the gastrointestinal tract, it’s important for us to be involved in the management and care of patients considering and undergoing weight-loss surgery.”

Patients may be referred to Dr. Pickett-Blakely before their weight-loss surgery for evaluation, but can see her after surgery if they are experiencing difficulty in changing bowl habits or reflux.

What do you like best about what you do?

I love to help feel people feel better.

What is your favorite healthy food?

Spinach and hummus are my favorite healthy foods

Favorite tips for weight loss and/or keeping off weight?

Move, move, move! Physical activity is very important for weight loss, but also for your heart.

What do you wish people knew about weight-loss surgery?

It requires a life-long commitment to your health.

Best advice for weight-loss?

Don't give up! It’s a marathon, not a sprint. Set realistic goals, and stay on track to meet them.

More about Dr. Pickett-Blakeley

Favorite movie: The Color Purple
Favorite food: Thai
Favorite place to vacation: The Caribbean
Favorite exercise: The elliptical machine
Favorite type of music to work out with: Anything upbeat
Favorite sports team: Go Redskins!
Favorite TV show: Downton Abbey
Last book you read? Little Bee
Favorite drink: Blood Orange San Pellagrino
Do you play sports? Nope!
Do you play an instrument? No.
When I get down time I like to….Read, listen to music or play with my children.

Let Penn Help You Lose Weight For Good


Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia. There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

Tuesday, February 4, 2014

"I Feel Like A Completely Different Person"- Tonia Lost 120 Pounds So Far!

Tonia was seeing signs all over.

In November, 2012, her already-poor health was taking a sharp decline. She knew she needed to lose weight, but nothing worked for her in the past.

But this time, it was a matter of life and death.

“In 2012, I had been in the hospital four times for asthma and congestive heart failure-related complications,” says Tonia. “I was at my highest weight – 439 pounds. I could barely walk from the bed to the bathroom. I knew I had to do something drastic.”

But what?

In the weeks that followed, Tonia met three different women who had weight-loss surgery.

“When I met the first woman at a party, it gave me the idea,” says Tonia. “When I met the other two women, it solidified my decision.”

Tonia, a 46-year-old mom of two began to research her options. She went to an information session, and made her appointment with Chief of Bariatric Surgery Dr. Noel Williams.

Before Surgery

Tonia wasn’t a stranger to feeling unwell. She was battling a heart condition that made it difficult for her to move and breathe. Suffering from severe asthma, exercising was nearly impossible for her.

“I was sick a lot of the time and on oxygen,” she remembers. “I could barely walk in my house, and everyone was doing everything for me - I couldn’t even wash dishes without sitting down.”

Tonia suffered from sleep apnea and was on high dosages of medications to help manage her heart condition.

But then, she began her journey toward a healthier life with Penn.

Photo courtesy of Tonia.
“Failure was not an option for me.”

“The dietitians in the program helped me learn how to eat right, and what I needed to do after surgery,” says Tonia. “My husband even changed his own habits and started to support me even before I had surgery.”

Tonia lost 15 pounds before her sleeve gastrectomy on May 6, 2013, and was ready for a life-long commitment to healthier eating and living.

“My attitude always stayed positive,” she says. “I think that’s what helped me be successful throughout the whole process.”

Tonia’s surgery went well, and her new-found healthier eating habits began impacting her entire family.

“My daughter and husband started eating better, and following my example,” she says. “Within weeks, I could walk throughout my home with no effort.”

Tonia also says she took advantage of “everything Penn had to offer” from support groups to physical therapists, to post-op appointments with her team.

“I even joined a gym!” she says. “I use the treadmill and recumbent bikes – something I never could have done before surgery.”

Since her sleeve gastrectomy, Tonia’s lost 105 pounds. She’s off most of her medication, no longer has sleep apnea, and is down from a size 30/32 shirt to an 18/20.

“I have a long way to go, but I am so far from where I used to be,” she says. “I feel like a completely different person.”

Tonia’s Tips

  • Tonia has been successful with her weight loss losing a total of 130 pounds with Penn Medicine. Here is what worked for her:
  • Research everything. It’s not an easy decision, and it requires a life-long commitment to eating differently than you are used to.
  • Think about your decision. If you pray, pray about it. Don’t make rash decisions, or they may backfire.
  • Be patient. You didn’t put on the weight overnight, so don’t expect it to be gone overnight. You will have challenges, but if you stay strong and connected to those who support you, you will be successful.

Lose Weight At Penn Medicine

Penn can help you lose weight for good. Learn how weight-loss surgery at Penn can help you lose weight and gain back your health.

Learn about weight-loss surgery at Penn at a free information session. Register here
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