Dare to Be 100: Obesity Is Not a Disease

As a Certified Bariatric Nurse, Program Director and someone personally affected by severe obesity who sought surgical treatment over 12 years ago, I am deeply offended by the comments in this article.

Dr. Bortz makes reference articles in 1934 and 1968 and service to the AMA 30 years ago. Might medicine have changed in the past 30-80 years? Why yes, I believe it has. Research by well respected experts illustrates multiple causes and contributing factors to obesity. To refer to Bariatric surgery as malpractice when it has saved hundreds of thousands of lives, my own included, alludes to a complete lack of comprehension and understanding of both the causal factors and the complex metabolic consequences of excess weight.

References in this article to “gut surgeons” and “appetite drug hucksters” belittle the knowledge of experts working in the field of Bariatric medicine and surgery. It defies the expertise and research of professional societies such as the ASMBS, TOS and the ASBP. I work with those affected by obesity and severe obesity every day. I welcome the opportunity to discuss my work with you.

I challenge anyone reading this article to move past the decades old rhetoric to review current information.
http://www.obesityaction.org
http://asmbs.org
http://www.obesity.org
http://www.asbp.org
http://www.nejm.org/doi/full/10.1056/NEJMoa1200225
http://www.nejm.org/doi/full/10.1056/NEJMoa1112082

Thank you,
Pamela R. Davis, RN, CBN
Bariatric Program Director
Chairman of the Board, Obesity Action Coalition
Read the Article at HuffingtonPost

Power Up Your Breakfast with Protein!

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I have always been a bit of a snob about protein shakes. I had my gastric bypass 12 years ago. “Way back when…” we didn’t have to drink protein shakes. Note, I didn’t say we didn’t “need” to, I said we didn’t “have” to. As bariatric surgery has continued to evolve, so has the post surgery nutritional counseling. Now don’t get me wrong, I’m plenty far enough out to chew my protein for breakfast-eggs, yogurt, I love them both, the issue is I don’t take the time to do so. I find myself at 10:00 AM or so ready for lunch because duh, I skipped breakfast because of meetings, etc. so I decided it was time to try some shakes and see what all the noise is about. I mean after all, we have multiple offerings available in our office, why not experiment?

First, I knew I couldn’t handle any “floaters” so I had to find something to use other than just a shaker cup and I didn’t want to buy something new so I looked around my kitchen and thought surely my milk frother would work somehow. It worked perfect. Seriously, I believe this is the trick to making thick, creamy shakes. Pour your cold carb-master milk in a glass, use the frother to thicken it, then add any sugar-free syrups, then last add the protein powder a bit at a time.

Second, I didn’t think plain ol’ water mixed with powder seemed very appetizing on any level. Fortunately, our wonderful Kroger (makers of the delicious carbmaster yogurt) just came out with carbmaster vanilla milk! One serving has 60 calories, 11 grams of protein and only 3 grams of sugar-sold! The picture to the right is what carbmaster milk looks like after a few seconds of being whipped with the bonjour milk frother. Image

Third, I didn’t want that overwhelming protein “smell” You know what I’m talking about-if it smells like Purina, I’m not going to eat it or drink it! Since I’m adding 11 grams of protein with the milk, I could use half the amount of protein powder recommended.

Below are the recipes I’m loving so far! I plan to experiment even more this week so check out our program’s Facebook page as I’ll be posting additional recipes there.

The Coffee Alternative:
1 scoop Bariatric Advantage Iced Latte Protein Powder (this has a bit of a cinnamon taste)
1 cup Vanilla Carbmaster Milk
2 pumps Torani’s sugar-free brown sugar cinnamon syrup
Blend with the milk frother and you will have a rich, creamy shake with 24 grams of protein and 150 calories replaces that morning drive by to Starbucks.

The Elvis Shake:
1 scoop Bariatric Advantage Banana Protein Powder
1 cup Vanilla Carbmaster Milk
3 pumps Torani’s sugar-free peanut butter syrup
Blend with the milk frother and you will have a rich, creamy shake with 24 grams of protein and 150 calories that would be worthy of Elvis.

Sunrise on the Beach:
1 scoop Bariatric Advantage Orange Cream Protein Powder
1 cup Vanilla Carbmaster Milk
3 pumps Torani’s sugar-free coconut syrup
Blend with the milk frother and you will have a rich, creamy shake with 24 grams of protein and 150 calories that makes you want to head for the beach!

Bariatric Advantage products are available at Centennial Center for the Treatment of ObesitySugar Free Torani syrups are available online and at multiple retail outlets; vanilla carbmaster milk is available at Kroger.

Now, you can shake shake shake your booty while you shake shake shake your breakfast. How’s that for time management? Breakfast and a work-out.

BariBelle

Walk in Our Shoes

It's very easy to belittle someone or a group of "someones" when you have not "been there, done that."

It’s very easy to belittle someone or a group of “someones” when you have not “been there, done that.”

I would like to take a moment today and respond to a recent New York Times article, titled “Our Absurd Fear of Fat,” written by Paul Campos. Earlier this week, a meta-analysis (combination of several studies) was published in The Journal of the American Medical Association. The analysis reviewed data from epidemiological studies to determine the connection between body mass index and mortality. As a result, the meta-analysis determined that individuals affected by excess weight (overweight) or obesity have a lower mortality rate than individuals classified as “normal” weight.

Mr. Campos takes an all too often short-sighted approach when discussing this analysis and only furthers the bias and stigma facing the millions of Americans affected by the disease of obesity. Furthermore, Mr. Campos is twisting the study by ignoring a major finding: Obesity at all levels increases the risk of death. Obesity carries with it a host of related disease greatly impacting an individual’s quality of life and health, such as type 2 diabetes, hypertension, sleep apnea, GERD, some cancers, and much more. Make no mistake about it; if you’ve ever battled obesity, you know first-hand the lack of understanding of society when it comes to this disease. In fact, this can be clearly illustrated in the severe lack of safe and effective treatment options for the disease of obesity we contended with until very recently.

The full blog post is on the OAC blog: http://www.obesityaction.org/walk-in-our-shoes, please check it out and post your comments either here or on the OAC blog post.

BariBelle

2012 in review

The WordPress.com stats helper monkeys prepared a 2012 annual report for this blog.

Here’s an excerpt:

600 people reached the top of Mt. Everest in 2012. This blog got about 5,700 views in 2012. If every person who reached the top of Mt. Everest viewed this blog, it would have taken 10 years to get that many views.

Click here to see the complete report.

The Year of the Snake

2013 is the Year of the Snake

2013 is the Year of the Snake

I’ve spent a lot of time today thinking about how to welcome the new year on this blog. What to write about, what to write about? A new year, a new me? Nah, I kind of like the old one. A new beginning? Nope, nothing from 2012 is officially “closed.” Motivational rah, rah, rah? I don’t think so-not exactly my style. Then it hit me-I posted this picture and the full description of those born during the year of the snake on my Facebook page a few days ago. I’ve read the description several times and while I do agree with most of it (the positive components), I don’t see eye to eye with some of the less flattering traits (doesn’t mean they’re not entirely true, it just means I don’t agree with them) So, today’s blog post is all about me! Whether it’s the focus of the year of the snake, a mid-life crisis or peri-menopause, I don’t know, but I feel compelled to make a few life commitments.

I mentioned mid-life crisis, that’s kind of funny. Since I’m 47 years old, I’m not exactly sure I have as many years left on the planet as I’ve seen whiz by already. For 2013, I’m going to concentrate on living up to the year of the snake.

“People born during the Year of the Snake are said to be endowed with wisdom and with deep philosophical understanding. They are born thinkers who excel in finding solutions to complex problems. In matters of business they can be shrewd, biding their time in making a deal only to strike like lightning and make a killing when they judge the moment is right.”

As such, I will continue to weigh the facts, think about the intended/desired result and plan accordingly after considerable contemplation.

“Even when they are at their laziest, their minds are working overtime, laying their schemes and hatching their plots for the future.”

I can definitely vouch for this being true. My mind never quits working, as a result it is very difficult to de-stress, to relax and to just “un-plug.” After 12 years of not taking a true vacation, the wonderful trip Reo and I took last month has motivated me to actually take more “vacations” as opposed to simply taking “time off” from work. We already have two vacations planned for 2013.

“They can be treacherous creatures who delight in intrigue and who wouldn’t think twice about double-crossing someone in order to save their own skins. Their calculating natures will never forgive or forget a slight.”

This is one of the descriptors I have a bit of an issue with-while true I have an elephant’s memory and never forget, I admittedly also find it difficult to forgive especially after multiple “infractions.” I give second chances. I give third chances. Fourth, fifth and sixth chances? Not so much. I sincerely hope no one ever feels I have or would double-cross them as I much prefer to work with others than to work against them. Having said that, the following may sound a little harsh; however, it is truly how I feel. When someone makes reference to “being thrown under the bus” my thoughts are maybe they shouldn’t stand in front of it with their eyes closed and their fingers in their ears. I take responsibility when I am wrong and I accept accountability for my actions. I take responsibility for leadership decisions I make and accept accountability for the decisions and actions of my staff; therefore, I expect that quality in others. In 2013, I will strive to be a more forgiving person.

“They can be lazy and self-indulgent. Their innate elegance can at times be ostentatious.”

I would never, ever describe myself as lazy. I can be and admittedly am self-indulgent. Whether it goes back to being an only child or whether it’s part of that “mid-life crisis” mentioned previously, I am of the mindset if I want it and I can afford it, why shouldn’t I have it? I grew up in that era of having a formal living room that was only used three times a year-Easter, Christmas and when the preacher came to dinner. My “formal” dining room is our dog’s room with a loveseat where I sit down and enjoy pure unadulterated puppy love every afternoon. Not only does my room get more use than my parents living room, I enjoy the company of the dogs much more than the folks that would be “formally” entertained. Growing up you saved your “good clothes” for a special occasion. What’s more special than waking up in the morning and having one more day on the planet? Going forward, everyday I will eat off the “good plates” while sitting in the “formal” dining room and wearing my “good” clothes. Why? Why not?

“A Snake can be counted on to carry a project through to the end. Their decisions are quick and firm, but they are formed by first impressions, on sympathies and feelings logically assembled in their minds — rather than by simple facts alone.” Just ask anyone I work with or volunteer with and they’ll verify this is true. I am never going to allow anything that has my name, my department’s name or my company’s name on it appear as half-done or mediocre. My preferred method of work is that all projects be completed correctly, the first time, ten minutes ago! “The Snake will fight and plod for anything they believe in and allow nothing to stand in his or her way.” I have a reputation. That reputation is that I am like a dog with a bone and “will not let it go until I have what is needed.” Correct. I relish that reputation. The patients I am blessed to work with are my priority. The staff I am allowed to lead are my priority. The volunteers I am honored to serve are my priority. “At ease in all circumstances and possessing uncommon self-discipline, the Snake achieves great heights and honors in his or her career, enjoying the well deserved respect of an admiring entourage.”  I have been very fortunate and very grateful to have previously received the Middle Tennessee Case Manager of the Year award and the national CMSA Award of Service Excellence.

“The Snake is freer with himself than he is with his money! The fatal flaw in the Snake’s character is, in fact, a tendency to exaggerate — in helping friends as with everything else. If a Snake does somebody a favor, he becomes possessive toweard them in an odd way, so that finally he is more a hindrance than a help.” 

Hmmm, I do definitely tend to over-extend myself by volunteering a lot! Am I a smotherer? Maybe, I could see that perception. I will work on giving without commitment.

“Both men and women of the sign have elegant and stylish taste in clothes; the men are sexy and always have a bit of the dandy about them, and the ladies are seductive and rave over smart accessories.”

Finally, I now know where the love of all things Coach and Kate Spade comes from! In order to truly live up to the Year of the Snake, I feel I should immediately order something from the Kate Spade online sale…

“As with real snakes, which hibernate in the cold season and come out when it’s warm, Snake people shine in the hot months. And the Snake born at midday in the heat of a tropical summer will be happier than one born in the middle of an icy night in winter.”

I was born in the middle of the day on June 26th. In general, I am a very happy person. A blessed person. A thankful person. A giving person. I hope what most would describe as a kind person.

Welcome 2013 and the Year of the Snake-this is going to be OUR year!

BariBelle

Letter to Santa (from two adopted shelter dogs)

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Merry Christmas everyone! Geordie and Brady Davis here and we are so excited mom is letting us post our letter to Santa as guest bloggers on her site. We pointed out to mom she had been a little negligent of her blog recently and the cuteness of us is just what she needs to get it back on track. We’ve been trying every morning to type our letter to Santa while mom’s checking her email and Facebook, but not having thumbs makes it really hard. So, mom agreed to type our letter to Santa and in exchange, we agreed to let her post it here.

Dear Santa,

Geordie and Brady Davis here. Since a lot has changed for us in the last year or so, we’re thinking we may need to remind you who we are. 

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I’m Geordie (the smart one). You came to see me last year which was my first year with mom and dad. I still didn’t know them really well, but I knew choosing them to be my new parents would be a good idea. When I first found myself all alone in Gallatin, Tennessee, being a smart dog, I figured if I went to one of the local schools there would be lots of good people there, maybe even someone who would want to take me home. Well, instead I found myself in the Nashville Metro pound. I was literally on death row, scheduled to be executed the next day for a crime I didn’t commit. Oh wait, I guess the crime was not having a family, maybe I was guilty. On the day before my planned execution, EmmyLou Harris’ wonderful organization, Bonaparte’s Retreat http://www.bonapartesretreat.org/#!/Home came and rescued me. They only rescue dogs like me, who are on death row. They placed me in a temporary foster home with a wonderful woman named Kate. Another great organization, Mars Petcare sponsored an annual adoption day and that’s when I first met mom and dad.

Out of all the dogs there, they chose me! There were a couple of other people who filled out an adoption application, but mom called every day until Kate came to see them. She brought me with her and I got to stay! Those first three months were so great-I was the only dog, the top dog, they took me everywhere-to the toy store, to the park and even just riding around so I could bark at motorcycles.

Then, it happened. I saw mom on the computer and she was gushing over another dog. His name was Dillard and he was on the Tennessee Death Row Dogs site. He was at the Clarksville-Montgomery County Animal Shelter. He was sooooooo furry you couldn’t even tell from the picture what kind of dog he was. So off we went, me and mom in the car driving to Clarksville to see another dog. “Dillard” had just been picked up by a rescue and was at the beauty shop so we had to go there to check him out. Come to find out, there was a dog under all that fur, a Cocker Spaniel. I stayed in the car while mom met him, she liked him a lot so I got to go in and meet him. Well, I decided to let him know right away who’s boss so I peed all down mom’s leg-she’s mine! That didn’t stop him, he just sat there in her lap like he thought he belonged there or something! Next thing I know, Dad is there too and well, long story short, I got a new “little” (although he’s older, he’s still little) brother. We all decided Dillard was a totally dorky name so after much thought we decided to go with Brady (mom won’t let me say words like what I wanted to name him) after Tom Brady. I don’t know how Brady came to be at the shelter the day after Christmas, he won’t talk about it. Either it’s too depressing or too awful to share. I know how he feels. Life on the streets is bad enough, but being dumped by your family at four years old, that sucks too. Here’s Brady’s picture, he kind of blends in with the furniture.

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So now that you remember who we are, we just wanted to let you know that this year for Christmas, we don’t need a thing. We have a mom and dad who love us, who spoil us rotten (mom’s phrase) and give us lots and lots of love. We have two brothers who aren’t as furry as we are and they walk on their hind legs all the time, but they’re pretty cool too. Every day we have full bellies, warm beds, toys and a big yard to run in. Every day we get hugged and kissed and reminded that we are the best dogs in the whole world.

“So this year Santa, we were wondering, could you make sure every shelter dog gets a home like ours?”

With Much Love and Much Gratitude,

Geordie and Brady Davis

P.S. IF you have some extra tennis balls rolling around the sleigh, I could perhaps take those off your hands-you know just to make sure they don’t cause a sleigh wreck or anything.

Labor Day Celebration at the Davis House

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I know, I know, I preach all the time about not celebrating with food and here I am blogging about our Labor day cookout. Well, the reason for that is simple, we had such a good time celebrating each other-not the food. We did eat, but it was not the focus of the day. I specifically asked everyone NOT to bring a dish. I really enjoyed preparing healthy substitutions that looked great, tasted great and made it easy for healthy to be the default choice because ALL the options were healthier (I say healthier because we had several items that were sugar free, while we all know that doesn’t mean calorie free, it was a better option for our diabetic attendees.) Below are my recipes-I believe in cheap, easy and tasty. Feel free to not take the easy way out like I did and make more things from scratch!

Appetizers:

Home-made guacamole (I made WAY to much, but with the extra sprinkle of lime juice, it’s still green!)

  • 6 Hass avocados
  • 1 can Rotel diced tomatoes with lime cilantro seasoning
  • 1/2 of 1 small can diced jalapenos
  • 1/2 cup diced purple onion
  • generous sprinkle of red wine vinegar
  • two generous splashes of lime juice
  • pinch of pink Himalayan salt (treasure find at TJ Maxx)
  • several cranks of ground coarse black pepper

I mixed everything but the avocados together in a bowl, then smushed up the avocados and added it all together and mixed-yum, yum, yum!

 

Caprese on a stick (it doesn’t get any easier)

  • Mozzarella cheese in basil and olive oil (bought at huge tub at Costco)
  • Fresh basil leaves
  • Cherry tomatoes (bought a huge container at Costco)

Spear a tomato, basil leaf and cheese ball with a toothpick-arrange on a beautiful platter. 

 

Layered Vegetable Salad (I hate cutting up vegetables so I bought everything bagged and ready to go)

  • large container of 1/2 spinach 1/2 baby greens (purchased at Costco)
  • bag of shredded red cabbage and shredded carrots (like you would normally use to make cole slaw)
  • diced red, green, and yellow peppers (off the salad bar at Kroger)
  • diced onion (off the salad bar at Kroger)
  • sliced mushrooms (off the salad bar at Kroger, hey I told you I’m lazy when it comes to veggies)
  • 1/2 package 2% shredded cheese (used for decoration more than as a full layer)
  • pre-cooked and crumbled bacon (again, a sprinkling for decoration and aroma, not as a full layer)

Layer everything in order, except for the cheese and bacon-save it to use after you put the dressing on top. The reason no amounts are listed is you can make this salad as big or little as needed based on the size of your crowd. I’ve actually used an upside down Tupperware cake carrier before for a huge crowd. The dressing recipe is where I’m so excited that everyone liked it and I totally substituted! The recipe calls for mayo and sugar which is why this salad traditionally is so high calorie. 

Salad dressing:

  • 1 large tub Fage 0% Greek yogurt
  • 1/2 cup bottled Italian dressing (you need this to thin the yogurt out a little as well as to add flavor)
  • sprinkle of pink Himalayan salt and several grinds of black pepper
  • 1 inch squeeze of Cilantro in a tube

Mix all the ingredients and spread on the top of your salad, then sprinkle with the cheese and bacon for a garnish.

 

For our protein, we had steak seasoned with only a little salt and a lot of pepper and chicken with two different marinades:

“Pam’s citrus marinade”

sprinkle chicken tenders with coarse ground black pepper, smoked paprika; place in a plastic bag and shake several squirts of liquid smoke on the tenders, add citrus salad dressing (this time I used mango vinegarette), shake-refrigerate overnight, shake again, pour off the extra liquid and grill.

“Pam’s beer tenders”

sprinkle chicken tenders with Weber’s beer butt chicken spice, place in plastic bag, pour in a beer, let marinate overnight, pour off the extra liquid and grill.  

 

For “dessert” I made a recipe I saw from Hungry girl

Mixed a Duncan Hines red velvet cake mix (the whole box) with 12 ounces of club soda (no calories) and NOTHING ELSE. Poured the mix into cupcake tins and baked as per package directions, (made 15 cupcakes) and after cooling completely, I “frosted” them with french vanilla cool whip. Each cupcake wound up having approximately 140 calories.

 

Pam’s Trifle (again, I’m all about easy!)

I bought two sugar free Angel food cakes and cut 1 and 1/3 of them up into cubes.

I mixed 3 packages of Jell-O sugar free white chocolate pudding separately (to one of the mixes I added some sugar free Torani’s raspberry syrup which made it a pretty pink color, I used this for the middle layer of pudding)

I bought two pints of raspberries and one quart of blueberries.

In your prettiest glass bowl, put a layer of angel food cake cubes, then layer one of the mixed up packages of pudding and sprinkle a few raspberries, layer another round of cake cubes, your pink layer of white chocolate pudding, another sprinkle of berries, another round of cake cubes, last layer of pudding, then cover with the remaining raspberries and blueberries. You could use any flavor of sugar free pudding and any type of berries. Make sure to refrigerate for a couple of hours first and let it set.

 

We served Crystal light margaritas (no alcohol). A good time was had by all, including the pups who really enjoyed the bites of steak Auntie Jo snuck to them.

 

Being an only child, I’m so glad I married into a family with lots of siblings and good times. I would love to hear about your Labor day celebration and any new recipes you tried. Celebrating the workers today!

BariBelle

Day Two from ASMBS

Today was a great day-lots of great information from the Integrated Health main session. Tried my hand at a second brief video blog-below.

Off to the reception and a fabulous dinner.

BariBelle

Live from San Diego…It’s ASMBS

This is my first attempt at video blogging-so it’s short, sweet, and a little hard to understand at the very beginning because of the wind. It gets better though.

Enjoy-

BariBelle

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