Your Health…By the Numbers

Your Health…By the Numbers

The scale is one way to measure your success after weight loss surgery, but it certainly isn’t the only way. Weight loss surgery brings about so many positive changes to health and well-being and can be measured in many ways.

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Biomarkers are measurements used to get insight into your overall health. It’s important to take an active role in your health and know your numbers as you work to improve it.


During the first year after surgery, it’s hard not to compare your weight loss with others who have had surgery. Keep in mind, a person who has 200 lbs. of excess weight is going to lose more pounds in a given period of time than someone who has 100 lbs. of excess weight. Rather than measuring pounds lost, a more meaningful way to use the scale is to look at the percentage of excess weight lost. On average, an expected weight loss at 6 weeks is 10-15% of excess weight, 20-25% at 3 months, and 50-65% at one year. Since the expected weight lost numbers are averages, some will lose more at these milestones and some less.

After your weight has stabilized, it’s important to step on a scale regularly. To keep yourself on track, have an upper weight that is acceptable. If you see a number higher than that upper number, it’s time to take a good hard look at your food and exercise behaviors and see if there have been any changes. You can always check in with your Barix Nutritionist for some insight.


Body mass index uses both height and weight to gauge if your weight puts you at risk for weight-related health problems. The easiest way to get your BMI is to search “BMI calculator” and then simply input your height and weight. BMI ranges indicate if you are underweight, normal weight, overweight, obese, or morbidly obese. This can give you a general indication if your weight is or isn’t where is should be.

The BMI measurement has some drawbacks. It does not take into account age, gender, ethnicity, or body composition (amount of muscle, bone, and fat).

Waist Circumference

Waist circumference is an indicator of visceral fat–the fat that surrounds the heart, liver, kidneys and other internal organs. The amount of fat in your midsection is a more accurate predictor of obesity-related disease risk than overall body fat. A higher amount of visceral fat increases the risk of heart disease, high blood pressure, diabetes, sleep apnea, and colorectal cancer.

A waist measurement that is 50% or less than height is ideal. For example, a 6 ft (72 inch) man should aim to keep his waist less than 36 inches, while a 5 ft 4 in (64 inch) woman should keep her waist under 32 inches.

To accurately measure your waist, use a cloth tape measure on bare skin. Place the measuring tape at your natural waistline, above your belly button and below your rib cage—at the spot where a crease forms when you bend to the side. Stand relaxed without holding your stomach in or pushing it out.

Blood pressure

Blood pressure is another number to pay close attention to. It often has no symptoms, yet high blood pressure can damage blood vessels and lead to heart attack or stroke and cause problems with your kidneys and eyes. Numbers should be below 120 for the upper systolic reading and 80 or below for the lower diastolic reading. Numbers over 130 and 80 indicate high blood pressure.

If your blood pressure is under 120/80, that’s a great sign that your heart is not over-exerting itself to pump blood. Weight loss surgery effectively lowers blood pressure in the majority of patients.

Resting Heart Rate

A normal resting heart rate, the number of times your heart beats per minute while completely at rest, is around 60-100 beats per minute. Within this range, your cardiovascular system is working efficiently. Check your resting heart rate first thing in the morning by placing your fingers over your wrist or the carotid artery of your neck to get your pulse. Count the number of times your heart beats in 10 seconds and then multiply that number by six.

To keep your resting heart rate within a healthy range, be sure to get regular exercise; stay hydrated; limit caffeine, nicotine, and alcohol; and eat a healthy varied diet rich in lean protein, vegetable, fruit, nuts and legumes.

Blood Sugar

Typically, when you eat, your blood sugar rises. With the help of insulin, excess sugar moves out of the bloodstream and into cells where it is converted to energy. If your body doesn’t create enough insulin or it isn’t used effectively, too much sugar is left in the blood.

Keeping blood sugar levels within normal ranges is important since elevated levels can cause damage to the eyes, kidney, nerves and heart. A fasting blood sugar, after not eating for 8 hours, should be under 100 mg/dl. A random blood sugar level, taken anytime, should be less than 140 mg/dl. An A1C, or glycated hemoglobin, reflects blood sugar levels over the last 3 months and should be less than 5.7.

Weight loss surgery has been shown to be more effective than medications at treating type 2 diabetes in obese individuals. Many will find their type 2 diabetes significantly improved or resolved after surgery.

Lipid Profile

This set of tests measures different kinds of fats in your blood. If they are elevated, they can lead to narrow or blocked arteries, heart attack, and stroke. LDL (bad) cholesterol should be less than 100 mg/dl, HDL (good) cholesterol should be 60 mg/dl or higher. Triglycerides should be under 150 mg/dl. Weight loss surgery improves lipid profiles, most are able to stop medications.

Lifestyle Habits  

Biomarkers are important because they provide insight into your health status, but even more important may be the lifestyle habits that help you to reach normal biomarker values.

Water Intake

Staying hydrated is essential for overall health. Sixty-four ounces a day is a good amount to shoot for, although the amount needed to stay hydrated varies based on variables such as age, gender, activity level, climate, and food consumed. Another way to monitor hydration status is to check the color of your urine. Anything darker than a pale yellow color is a good indication that you’re not drinking enough water.

Food Intake

The type and amount of food intake is key to optimal health, especially after weight loss surgery, when volume is limited.

  • Build your diet on lean protein options after weight loss surgery–just enough to meet your individual goal.
  • Add in a good variety of vegetables; 3-6 ¼ cup servings per day. A higher intake of vegetables is associated with a lower risk of many health problems.
  • Fresh fruits provide vitamin, minerals and fibers. Eat 2-4 ¼ cup servings each day.
  • Whole grains round out your diet. Eat 4-6 ¼ cup or ½ slice servings.
  • Limit higher fat foods and avoid foods with more than 2 grams of added sugar.
  • Eat fresh, unprocessed food as much as possible.
  • Shoot for 25 to 35 grams of fiber daily. If you’re not able to eat enough fruit or vegetables to reach this number, add flaxseed, wheat bran, or a fiber supplement.
  • Limit alcohol or don’t drink at all.


The amount of time that you spend sitting throughout the day has an enormous impact on your health. After just 2 hours of sitting, metabolism slows by 25-50%, blood sugar levels increase, good cholesterol decreases and circulation slows. Body pain and stiffness, obesity, diabetes, heart disease, some types of cancer and even early death can be a result of this sedentary lifestyle. How can you add more movement to your day?

  • Pace while talking on the phone or while watching TV.
  • Build more movement into your daily activities—park further away, take the steps, walk during kids practices, and stand whenever possible.
  • Cut back on sedentary activities to 2 hours or less per day—computer use, TV time, and reading.
  • Make time for 30 minutes of exercise daily.
  • Build up to at least 10,000 steps a day.


Aim for 7-9 hours of quality sleep each night. The body needs that amount of time to fix tissue, make hormones, grow muscle, and process the information and learning of the day into memories. A lack of sleep can make you hungrier — and make junk food more appealing. Adequate sleep is linked to a lower risk of high blood pressure, diabetes, heart disease and obesity. Power down your electronics and get the rest you need.


Putting healthful lifestyle habits in place and nailing healthy biomarker numbers is awesome. Your body will let you know that it is healthy and reward you with a higher quality and enjoyment of life. Here are just a few rewards you’ll most likely experience for your efforts.

  • You can reach down and tie your shoe effortlessly.
  • Your mood and confidence improve. You’re ready to live life to the fullest.
  • You feel stronger and have more energy.
  • You have fewer aches and pains. It’s much easier to move your body.
  • You clothes will fit better and you’ll be able to shop in a “regular” store.
  • You will be more motivated to go places and do things.
  • You are more likely to try new things.
  • You’ll take fewer medications.
  • Your skin may look younger.
  • You can tackle that treadmill, 5K run, spinning class or whatever your heart desires—weight no longer hinders you.
  • Vacations are more fun—starting with the flight.


1/2 cup butter melted
2/3 cup erythritol
3 large eggs
½ teaspoon vanilla extract
½ cup almond flour
1/3 cup cocoa powder
1 tbsp gelatin (optional)
½ teaspoon baking powder
¼ teaspoon salt
1/4 cup water

Preheat the oven to 350F and grease an 8×8 inch baking pan. In a large bowl, whisk together the butter, sweetener, eggs, and vanilla extract.

Add the almond flour, cocoa powder, gelatin (if using), baking powder, and salt. Whisk until well combined. Stir in the water to thin the batter.

Spread the batter in the prepared baking pan. Bake 15 to 20 minutes, until the edges are set but the center still seems a tiny bit wet. Remove and let cool completely in the pan. Makes 12 servings.

Nutrition information per serving:  120 calories, 4 grams protein, 12 grams fat, 3 grams carbohydrate, 129 mg sodium. 

Chicken Bowl

1/4 cup fresh lime juice
1/4 cup minced cilantro
3 tablespoons extra-virgin olive oil
1 garlic clove, minced
1 teaspoon erythritol or other sweetener
1/4 teaspoon salt
1 (14 ounce) can organic black beans, drained and rinsed
3 Roma tomatoes, diced
1 avocado, diced
1 rotisserie chicken, light meat only shredded

Place the lime juice, cilantro, olive oil, garlic, erythritol and salt in a shaker cup and set aside.

Divide the chicken between 6 bowls and top each with black beans, tomatoes and avocado. Shake the dressing and pour over right before serving. Makes 6 servings.

Nutrition information per serving: 257 calories, 21 grams protein, 12 grams fat, 15 grams carbohydrate, 352 mg sodium.



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Iron Strong

Iron is a mineral essential for life. It is an integral part of oxygen transportation throughout the body and also helps to regulate cell growth and differentiation.

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Iron is found readily in many of the foods that we eat. There are two forms of dietary iron; heme iron found in animal food sources and nonheme iron found in plant foods.

If iron intake and absorption do not meet the body’s daily need for iron, the negative balance begins to impact the body. Physical symptoms of iron deficiency anemia include fatigue, pale skin appearance, poor work performance, impaired learning ability, decreased immunity–more susceptibility to infection, hair loss, spoon-shaped nails, difficulty maintaining body temperature, glossitis (an inflamed tongue), and a desire to chew on ice or eat nonfood substances such as dirt or clay.

Iron deficiency is not uncommon after weight loss surgery (50% of people may be affected.) for several reasons:

  • Less food consumed, fewer vitamins and minerals ingested.
  • Red meats, a good source of iron, may not be tolerated.
  • Fewer acids in the stomach which help iron to absorb.
  • Gastric bypass limits the intestinal area for iron absorption. 

Take Steps to Stay Iron Strong

  1. Consistently take multi-vitamin and mineral supplements with iron as recommended by your bariatric team. Imbalances or other nutrients can contribute to anemia.
  2. Consume foods that are a good source of iron.
  3. Attend regular follow up visits and have labs done as recommended to catch low iron levels early.
  4. Take a probiotic twice daily. Nature’s Bounty Probiotic 10 is a great option. It contains Lactobacillus plantarum 299v which appears to improve iron absorption from foods and supplements.
  5. If an iron supplement is recommended, maximize the absorption:
    • Take it on an empty stomach–right before bed is a good time.
    • Select a supplement that contains vitamin C or drink a few ounces of orange juice with your supplement.
    • Don’t take your iron supplement with your multi-vitamin, calcium supplement or dairy products. Calcium decreases iron absorption.

Selected Food Sources of Heme Iron

Food Milligrams per serving
Chicken liver, 3½ ounces 12.8
Oysters, breaded and fried, 6 pieces 4.5
Beef, chuck, lean only, 3 ounces 3.2
Clams, breaded, fried, ¾ cup 3.0
Beef, tenderloin, 3 ounces 3.0
Turkey, dark meat, 3½ ounces 2.3
Beef, eye of round, 3 ounces 2.2
Turkey, light meat, 3½ ounces 1.6
Chicken, leg, meat only, 3½ ounces 1.3
Tuna, 3 ounces 1.1
Chicken, breast, 3 ounces 1.1
Halibut, cooked, 3 ounces 0.9
Crab, blue crab, 3 ounces 0.8
Pork, loin, broiled, 3 ounces 0.8
Shrimp, 4 large 0.7

Selected Food Sources of Nonheme Iron

Food mg per serving
Ready-to-eat cereal, 100% iron fortified, ¾ cup 18.0
Oatmeal, instant, fortified, 1 cup 10.0
Soybeans, boiled, 1 cup 8.8
Lentils, boiled, 1 cup 6.6
Beans, kidney, boiled, 1 cup 5.2
Beans, lima, boiled, 1 cup 4.5
Beans, navy, boiled, 1 cup 4.5
Ready-to-eat cereal, 25% iron fortified, ¾ cup 4.5
Beans, black, boiled, 1 cup 3.6
Beans, pinto, boiled, 1 cup 3.6
Molasses, blackstrap, 1 tablespoon 3.5
Tofu, raw, firm, ½ cup 3.4
Spinach, fresh, boiled, drained, ½ cup 3.2
Black-eyed peas, boiled, 1 cup 1.8
Grits, white, enriched, quick, 1 cup 1.5
Raisins, seedless, packed, ½ cup 1.5
Whole wheat bread, 1 slice 0.9
White bread, enriched, 1 slice 0.9


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Make it Happen

Make it Happen

We all have dreams, goals and ambitions—things we’d like to accomplish, places we’d like to go, people we’d like to help. How do we get from here to there? It’s not as easy as you’d think. After all, each year only 8% of people fulfill the New Year’s resolutions they make. Why is it sometimes so difficult to move beyond hoping and dreaming to accomplishment?

The answer may lie, at least partially, in the number of excuses that we make or don’t make. Honestly, we all make excuses from time to time, but if we are not living the life we desire, excuses may be getting in the way. We invent excuses to defend our behavior, put off taking action or to evade responsibility. Excuses can have some real power that may stifle our lives.

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Excuses limit us.

Excuses have the power to limit us – to keep us from reaching our full potential. They can stop us from taking a shot at success–from growing and branching out. Giving into excuses can leave us settling for a mediocre unfulfilling life. Relationships, health, career—every aspect of our lives can be impacted. We encounter new opportunities daily, but if our minds are riddled with never ending excuses, we will never challenge ourselves to reach new heights.

It’s rare that people regret working towards a dream or taking a chance, even if it doesn’t work out the way they had hoped. Most people do, however, regret the things they did not attempt.

Why do we do it?

What’s up with excuse making? If it keeps us from going where we want to go, why do we do it? Sometimes, we make excuses because we simply don’t want to do something and giving an excuse seems easier than just saying no. Beyond the simple not wanting to do something that isn’t a priority for us, excuse making may signal that something deeper is going on. Many times that something deeper is fear—a fear that can trap us in the safety of our comfort zone. Fear–what are we afraid of? It depends on the person and the situation. We may be afraid of failure, of success, of embarrassment, of uncertainty, of taking responsibility, of making mistakes, of having to sacrifice, or of not having the needed resources.

Fear of Failure– Fear of failure can be immobilizing, causing us to do nothing and stopping our forward progress.  We may be aware of it—“I’m terrified of getting up in front of that group and making a presentation.” Or it may subconsciously undermine our efforts. We all experience some failures in life—it’s a part of growing, learning, and moving forward. Failure has positive aspects. We can learn from it, we become more resilient, we gain confidence in our ability to overcome challenges and not give up, and we can gain valuable insights that may not have been otherwise apparent. If we can change our perspective about failure and see it as a logical part of moving forward, the power it holds may dissipate.

Failures stop us only if we let them.

In everything we do, there’s a chance that we will fail. To improve your comfort level with the risk of failure:

  • Think through all of the possible outcomes of your action including the best and worst case scenarios. If you can live with the possibility of the worst case, then it may make sense to move forward.
  • Have contingency plans for all potential outcomes.
  • Rather than jumping off a cliff, start with small steps on the way to bigger goals to build your confidence.

Fear of Success–Success can be downright scary. Achieving success means you are entering uncharted territory, exposing yourself to new pressures and opening yourself up to be scrutinized. You may not be sure that you are up to the challenge. After all, on some level, it’s more comfortable to stay in a familiar situation. It may help to realize having some fear with any change is normal. When you have doubts about your ability to handle success, replace those doubtful thoughts with powerful positive images. Remind yourself about the positive aspects to achieving success.

Some of the fear of success can have to do with relationships and that changes that can occur when your life improves. If the success you are on the brink of is positive for you, work through the relationships. Others may fear the changes in you and your relationship more than you do. Reassure them that you’re the same person, just improved. Keep in mind that success gives you more resources and adds to who you are and to what you bring to the world. 

Fear of Embarrassment—Embarrassment can prevent us from asking for advice about how to handle uncomfortable situations—such as a money or health problem. A recent study showed that if we put ourselves into the role of an observer, it is easier to overcome the fear of embarrassment or humiliation. If you find yourself feeling anxious in a social situation, think of yourself as a detached onlooker, rather than the center of attention. This simple perspective change may lower your level of discomfort.

Fear of Uncertainty – Moving out of our comfort zone can make us, well, uncomfortable and we don’t like that feeling. We need to keep in mind that the controllable, predictable life we strive to create and stay anchored to is just an illusion. Nothing stays the same forever. Things can and do change in a heartbeat. We can let uncertainty of change keep us up at night or choose to let go of our attempt at control. We can do our best to accept that whatever tomorrow brings, knowing that we will learn from it and make the best of it.

Fear of a Lack of Resources – Resources can take many forms—time, money, education, and knowledge. We all have the same number of hours in a day. When we are passionate and focused, time is prioritized to meet our goals. If not, maybe this goal isn’t that important to us at this point in time. The lack of money may mean that better financial restraints or creative financing is needed. Education and knowledge can be gained via self-teaching, researching and working with someone who has already done what we are trying to do.

Stop Making Excuses

You’ve seen how and why excuses hold us back, now it’s time to figure out how to stop making them and start getting what we want out of life.

Start by defining what it is that you want. Start with a big overall goal or two and then break that goal down into smaller, more manageable steps. Once you have specific and measurable goals, it easier to stick with the steps you have set up.

Take responsibility for taking the actions needed to reach your goals. It’s not up to someone else to make this happen, it is up to you.

Making changes and overcoming those fears that hold us back takes effort. It’s not the easy road. Stay motivated by visualizing the goals you have defined. Watch motivational videos and put motivational quotes where you can see them. Each day take at least a few minutes to work on your goals. It may be doing research, networking with others, writing out your plan in more detail, learning a skill that will help you, or taking the steps you have already defined.

Don’t compare yourself to others. We each have our own set of skills, resources, personalities and life situations. Our version of success may look very different than someone else’s—and that is okay. Your success is your success. Focus on your strengths, not your weaknesses. If you’ve moved ahead and are better off, then you are successful.

You Have the Power to Change.

You have the opportunity to reach your potential, but it will take work, dedication, and some risk. You will face daunting obstacles. You will have some failures that you can learn from and use to refine your goals. Find your purpose, define your goals, research, plan, and set your sails. It’s an exciting life out there—go and find it!

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Motivation Monday

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Fall Fun!

Fall Fun

Weight loss surgery helps you to get off the sidelines and back into the game of life. Below is a list of fun fall activities to help you do just that. Grab your family and friends and head out to enjoy these great fall activities.

Visit a local pumpkin farm. In addition to u-pick pumpkin patches, many also offer hay rides, corn mazes, food fairs, and more festive fun and activities.

Forget sugary donuts from the cider mill. Instead make your own protein mini muffins to enjoy—sugar free! Here’s how:

Fill your planters and flower beds with fall favorites—you can’t go wrong with mums.

Have a bonfire to enjoy the cooler evenings. Adapt s’mores to fit your new low-sugar lifestyle. Here’s how: use sugar-free marshmallows (purchase online), graham crackers and bite-size Hershey’s sugar-free chocolate bars.

Enjoy the changing leaves and crisp fall air via train. Look for day trips for a fun family excursion.

Pick apples at a local orchard. Then enjoy an apple fresh from the tree or bake up a no-added-sugar apple treat.

Take a hike or bike ride through a local park.

Get lost in a corn maze and use your wits to find a way out.

Sip warm apple cider on the porch. A low-sugar alternative is sugar-free Alpine Spiced Apple Cider.

Now that you’re no longer timid in front of the camera, it’s time to take your family Christmas photo. You’ll be all set to get your holiday cards out on time.

Carve a pumpkin and toast the seeds.

Check out local antique stores. Enjoy the stroll through memory lane or hunt for a particular piece to freshen up your home décor.

Walk outdoors on a foggy morning and enjoy the crisp fall air.

Autumn is the perfect time to run a race. Look for local races that are a distance just outside of your comfort zone and see just what you can accomplish.

Make a batch of chili and freeze it in small-portion containers.

Start Christmas shopping before the weather turns brutally cold. As Christmas draws near, you’ll appreciate your forethought.

Whatever sounds appealing to you, get out and do it. It’s time to enjoy all that fall has to offer.


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