How to Reach Goal Weight and Stay There

Bariatric surgery is the only effective long-term treatment for obesity.  Studies show that most who undergo bariatric surgery keep at least 50% of their weight off for ten years or longer.  And with that weight loss, there are many improvements to health, vitality, and quality of life. But, the reality is that some people do gain a portion of their weight back. What causes that, and what can you do to prevent it?

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Expect a Slight Gain

Our bodies are set up to store energy in fat cells for times of famine. Weight loss surgery works by disrupting the tenacious survival mechanisms that the body has in place by:

  • Limiting the amount of food that can be eaten at one time.
  • Influencing hormonal changes that promote weight loss.
  • Motivating positive lifestyle changes as weight is rapidly lost.

Over time, however, there is a slight increase in food intake. The hormonal help is not as strong. And people tend to resort back to some not-as-healthy lifestyle habits. Due to these and potentially other factors, about half of the people see some regain after two years. The average weight gain is eight percent. 

Some Things are Out of Your Control

 Set your weight expectations based on individual circumstances. Some of the factors that influence weight are out of your control. They may limit the amount of weight you initially lose and the amount you can keep off. Consider:

  • Although weight loss often cuts the number of pills needed for a wide range of health conditions, some “weight-positive” drugs may be required. Review your medication list with your primary care doctor and discuss possible substitutes for any that have weight gain as a side effect.
  • Physical Activity Limitations. A robust activity level helps to boost metabolism. Injuries, painful conditions, or merely a lack of time may constrain the amount of movement done each day. Be sure to move as much as possible with the limitations you have.
  • Older people may see a slower rate of weight loss and fewer pounds lost. Keep in mind that even smaller amounts of weight loss provide many health benefits and improve life quality.
  • Medical Conditions. Some medical conditions, such as hypothyroidism, PCOS, metabolic syndrome, and diabetes, involve the body’s energy balancing systems. Work with your primary care physician to manage these conditions so optimal weight can be lost.

It is All about a Healthy Lifestyle

Studies have found that most regain is not from factors out of one’s control or problems with the surgery itself. It is mainly due to poor compliance with healthy dietary and lifestyle practices. To lose weight and keep it off, this is where you need to focus your attention.

Take Advantage of the Rapid Weight Loss Phase

Year one is often referred to as the honeymoon period. Even if you don’t exercise or follow the “rules,” you’re likely to see significant weight loss.  But, sliding through with minimal effort isn’t in your best long-term interest. It is time to ramp up your efforts, reach your weight loss goals, and develop habits that will help you stay healthy. Make these efforts during year one:

  • Regular exercise increases weight loss and decreases muscle loss—setting you up with a higher metabolism to help offset the natural decrease in hormonal help.
  • Rather than just eating smaller portions of highly processed foods, establish healthy eating habits that will fuel your success long-term.
  • Work on coping skills to navigate stressful situations without leaning on food for comfort.

Healthy Eating

Habits are formed from repetition.  At first, they require a conscious effort but eventually become automatic. We all tend to eat what is easiest at the moment. By doing a little planning and prep, healthy foods become the easy choice—no willpower required.  Healthy eating habits after surgery include:

  • Between meals, drink calorie-free fluids. Shoot for at least 64 ounces a day-more if possible. Avoid fruit juice, sugar-sweetened drinks, and alcoholic beverages.
  • Eat without distractions (TV, computer, etc.), so you can eat slowly, chew thoroughly, and focus on feelings of fullness. Stop eating when you feel comfortably full or sense that one more bite will be too much.
  • Measure or weigh foods most of the time to keep portions in check. Be aware that meal size tends to get slightly larger over time. Using smaller plates, bowls, and eating utensils also helps.
  • Drink between meals rather than with meals. Practice the 5/30 rule in which you stop sipping on fluids 5 minutes before a meal and don’t resume until 30 minutes after the completion of the meal.
  • Plan 6 small meals/snacks. Eat every 2 ½ to 3 hours. Skipping meals does not increase weight loss.
  • Avoid calories between planned meals and snacks. This time is reserved for calorie-free fluids.
  • Choose high-quality foods that are mostly prepared at home. Build your diet on lean protein sources; add fresh vegetables, fresh fruits, and small amounts of whole-grain foods and healthy fat sources.  Use the Barix Meal Planning Guideline or Barix Food Guide to help you plan.
  • Eat the right carbs. Limit foods with added sugar and highly processed foods. Your body thrives on the right amount of carbohydrates from fresh vegetables and fruits, low-fat dairy, and whole grains.
  • Keep late-night snacking from derailing your weight loss. Plan a healthy protein-rich snack in the evening and keep “snacky” foods out of the house.

 Awareness &Monitoring

  • One of the most effective habits is to keep a food (and exercise) log. Doing this increases awareness of eating patterns, food choices, and calorie intake.
  • Weigh weekly. Weight naturally fluctuates within a few pounds. Set an acceptable top weight. If you reach that weight, it is time to take action. Look at what has changed and reach out for help. Weight gain does not mean that you have failed. It means that you need to make some changes and get back on track quickly.
  • Attend scheduled follow up appointments. Your healthcare team is there to support you. Regular check-ins help keep you well-nourished and on target.
  • Support groups and accountability partners can help you keep a healthy mindset. There will be bumps along the way, and those who have gone through the same thing are often the best ones to help.
  • Be mindful when you eat. Pay attention to bite-size, chewing well, and stopping when comfortable.
  • Work on building skills and putting strategies in place to limit emotional eating, late-night eating, and triggers that lead to poor food choices.

Physical Activity

Increased physical activity is associated with more weight loss and a higher quality of life after surgery. Inversely, a low activity level is a crucial predictor of weight regain.  You’ll want to build up to at least 10,000 steps a day and add strength training 2-3 times a week. Here are some easy ways to increase your activity:

  • Park farther away. Walking into a store or your office from the far end of the parking lot can boost your heart rate. If you live close enough—give up the car altogether and walk or bike instead.
  • Have a sitting job? Make efforts to stand more often, take mini walks, or do 3 minutes of exercise (leg lifts or squats—or bring in a set of dumbbells) each hour. Can you work at a standing desk? After just 2 hours of sitting, metabolism slows by 25-50%; blood sugar levels increase, good cholesterol decreases, and circulation slows. Use your lunchtime to take a walk or to work out right at your desk.
  • Schedule it into your day. Exercise deserves a priority status—after all, it is an investment in your health and well-being. Put it on the calendar and treat it as an essential appointment.
  • Get up a little earlier. Morning exercise rocks–start your day more energized and focused.
  • Multi-task. Walk with a friend to socialize and exercise at the same time. Watch a TV show, inspirational video, or educational clip as you cycle or walk on a treadmill.
  • Use a fitness app for structured exercises adapted to the time, space, and equipment you have available.
  • Are you watching TV? Walk in place during the show or bust out some sit-ups and squats during the commercials.
  • Sign up for a charity 5K with a buddy. Once you have the date on your calendar, the training begins. With a goal ahead of you and a friend by your side, it’s easier to stay motivated.
  • Tracking exercise helps to motivate (Wow, I’m up to 20 squats!), measure progress, and keep you on track.
  • Sometimes you need to choose something over nothing. If you cannot get your full workout in, do what you can. Short spurts of effort can add up. It is all about the habit. When there is a time carved out for exercise, use it. That way, the routine stays in place, even if the workout isn’t an all-out effort.
  • When you need to communicate, make a phone call instead of sending a text or email. Get up and walk around the block, or pace while talking on the phone.
  • Turn up the tunes and turn household chores into a workout session. Sweep faster, scrub harder, add in some bicep curls between tasks, and you’ll be working up a sweat in no time.

Manage Stress

Build up stress management skills before you need them. Practice healthy ways to cope with small stressful situations, so when more significant stressors show up, you’ll be able to limit or avoid emotional eating.


Sleep has a massive impact on weight. Sleep deprivation has been found to change the regulation of appetite and energy expenditure. Without eating one single extra morsel, a sleepless night can increase weight. A string of sleepless nights can add up. Adjust your lifestyle to make sleep a top priority.

Knowledge and Skills

It is easy to improve knowledge and skills in 2020. The information and help needed are at our fingertips.

  • Learn while you exercise by watching videos or podcasts.
  • If you don’t know how to prepare foods from scratch-learn.
  • Spend time reading labels and ask questions when you’re not sure.
  • Read up on emotional eating and practice stress management techniques.

Get it off and Keep it off

Having weight loss surgery is about so much more than reaching a healthy weight. It’s about transforming your life, reclaiming your health and well-being, building your confidence, having new opportunities, and living life to the fullest.

The commitment and daily efforts to make healthy food choices and get enough intentional exercise are well worth the payoffs. Not surprisingly, the lifestyle habits that help you maintain a healthy weight also help you live a long, full, vibrant, and active life.


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Thanksgiving Celebrations – Pandemic Style

Since this year’s holiday celebration will probably be a little different, we’ve compiled a list of ideas to get your creative juices flowing. Be flexible and change it up a bit to keep your celebration be meaningful and safe this year.

Focus on gratitude

Ask every family member to share one thing they are grateful for each day of November. Depending your family’s size and distance, share via post-it notes on the fridge, text messages, social media, or at the dinner table.

Share with others

Drop off a favorite dish, a card of encouragement, a holiday decoration, a poinsettia plant, or a DVD of a favorite holiday movie to someone at higher risk and not able to get out much. Consider doing this once a week as a family-taking turns to think of people and small gestures that would make their day.

Host a virtual dinner with a video

  • Coordinate the time and menu and share recipes ahead of time. That way, you can all enjoy a few of the family favorites together.
  • If you live nearby, have each family prepare a dish, divide into portions, and meet in a contact-free way to divvy up the goods. Then simply heat back up in individual homes and enjoy together.
  • Prepare a special holiday toast to share what you are most thankful for.

Order a meal to go

Sometimes the stress of cooking a large meal from scratch is just too much. Many restaurants and grocery stores offer family-sized meals to-go. You’ll be stress-free and supporting local businesses. 

Play or watch games together virtually  

There are online games available for free. This site did a good job listing them:

If you’re more of a football family, gather around your perspective TVs and video chat or group text to root for your favorite teams.

For techy families

Have each family create a slideshow or video of the things they’re thankful for. Share on Thanksgiving Day.

For the kids (young and old)

  • Make “thanks” calls. Help your child make a list of people to call, email, or text and express their appreciation to on Thanksgiving.
  • Make “thank you” signs for essential workers, healthcare heroes, first responders, teachers, and others and place in your front yard.
  • Paint rocks with messages of gratitude, then on Thanksgiving Day, go on a walk together and leave the rocks for others to find and enjoy.
  • Find a COVID-safe way to give back to your community by volunteering, donating, or meeting a special need.

In-person gatherings

The Center for Disease Control has put out a pretty extensive list of guidelines to stay safe if you are gathering in person this year.

Focus on what you can do

However you decide to celebrate the holidays this year, get excited and put your energy into the things you can do to make the season special.

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Will My Insurance Pay for Weight Loss Surgery?

At Barix Clinics, we work with many commercial insurance plans, such as Aetna, Blue Cross and Blue Shield (BCBS) and Blue Care Network (BCN), Priority Health, United Health Care, and Medicare.

Which Procedures are Covered?

In general, insurance companies that cover weight loss surgery will cover gastric sleeve, gastric bypass, adjustable gastric band surgeries, and other less common weight loss surgery procedures.

Weight Loss Surgery Improves Many Health Issues

Most insurance companies recognize that weight loss surgery improves or resolves a host of weight-related conditions such as type 2 diabetes, high blood pressure, heart disease, and more. Many individuals need fewer medications to treat their weight-related conditions.

The American Heart Association, the International Diabetes Foundation, and the American Diabetes Association have issued statements about weight loss surgery’s effectiveness.

Bariatric surgery is a proven winner in the battle against
many weight-related health concerns.

Ask This Question Before Choosing an Insurance Plan.

Many people with company-provided health plans or Medicare have options they can choose among during open enrollment. Doing a little bit of research now can help you make bariatric surgery a reality next year.

When considering a plan, be sure that bariatric surgery is not listed as a direct exclusion.

What if bariatric surgery is excluded from the health insurance plans available to you?

Contact a Barix Clinics Patient Service representative to discuss the other options available to you. 

Beat the Rush

Beat the January rush and schedule your consultation now for the end of the year. Convenient, time-saving, virtual consultations are available. You’ll meet with a surgeon who will provide information about the types of surgery and answer all your questions so you can decide if weight loss surgery is right for you.

Call Barix Clinics today to schedule your appointment: 800-282-0066.


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How Good Sleep Can Boost Weight Loss

Sleep may be just as important as diet and exercise to a healthy weight. People who get fewer than seven hours of sleep tend to weigh more. Are you one of the 40% of adults getting fewer than 7 hours of sleep a night or one of the 30% getting by on less than 6 hours?

Cutting short sleep time can increase weight. Here’s how that works:

Poor Appetite Control

A lack of sleep gets the hunger hormones out of whack. There’s more ghrelin (the hunger hormone), more cortisol (a stress hormone which can increase hunger), and less leptin (the fullness hormone). The change in these hormones can set up a raging appetite that difficult to tame.

A Foggy Brain

Skimping on sleep dulls decision-making and impulse control. Food looks more appealing because the reward centers of the brain become overstimulated. It’s a double whammy – the brain craves the food and lacks the controls to make wise decisions.

More Calories

More calories come from the increase in hunger and appeal of food, dulling of fullness signals, and limited self-control that comes with a lack of sleep. Besides, having more time awake means more time to snack and does increase calorie intake.

A Sluggish Metabolism

Skimping on sleep hits the body with an immediate hit to the metabolism by slowing the rate at which the body burns calories. Long-term, a lack of sleep lowers muscle mass reducing metabolism further.

Less Motivation to Exercise

Exercise motivation is challenging for most after getting plenty of sleep. Without quality sleep, exercise suffers.

Cells Become More Resistant to Insulin

With only a few nights of poor sleep, the ability to regulate blood sugar plummets as cells become insulin resistant. Insulin resistance means higher blood sugar, more insulin, increased hunger, and more fat storage.

Make Sleep a Top Priority

Give sleep the attention it deserves. Here are some tips for improving your sleep:

  • Follow a consistent bedtime routine
  • Establish a relaxing setting at bedtime
  • Shoot for 7-8 hours of sleep every night
  • Stay away from caffeine or any other stimulants before bedtime
  • Keep your mind off problems or worries at bedtime
  • Avoid going to bed hungry or too full
  • Exercise earlier in the day – not within six hours of bedtime
  • Make your bedroom quiet, dark, and a little cool
  • Get up at the same time every morning
  • Turn off lights and electronics



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What is the Role of Exercise in Weight Loss?

Some people love it. Most people don’t. Who has the time? Does it even matter anyway?  Here’s the real scoop on exercise and weight loss and why you should find the time and motivation to make it work for you. 


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Weight Loss is Complicated

If only it were as simple as calories in and calories out, but it is not. Dieting is a battle between the mind and the body. The mind decides that excess weight is causing all kinds of health and emotional issues and needs to go. But, the body isn’t on board with the mind’s plan for weight loss. After all, that extra weight will help you survive the next famine.  When calories are cut, the body fights back by:

  • Reducing levels of leptin (the fullness hormone)
  • Increasing levels of ghrelin (the hunger hormone)
  • Slowing metabolism so calories are used more efficiently – an effect that can last for years
  • Making food look and smell more enticing
  • Reducing energy, increasing irritability, and keeping the mind fixated on food 

Bariatric Surgery Tips the Scale in Your Favor

A tiny percentage of people lose weight and keep it off in the long-term with diet and exercise alone. Bariatric surgery disrupts the body’s stronghold on obesity. It reduces food intake, but that is just the beginning. A host of physical and hormonal changes occur that significantly increase the odds of long-term weight loss.

Bariatric surgery works to overcome the body’s resistance to weight loss. It is even more powerful when combined with regular exercise, a healthy diet, and other positive lifestyle habits.

Benefits of Losing Excess Fat

Bariatric surgery makes weight loss much more likely. Great – that’s the goal. When excess fat is lost, a slew of benefits are gained, including:

  • Better blood sugar/insulin regulation
  • Lower risk of heart disease
  • Lowered blood pressure
  • Improved cholesterol levels
  • Decreased risk of heart disease and stroke
  • Reduced risk of certain cancers
  • Improved mobility
  • Reduced joint and back pain
  • Decreased risk or improvement in symptoms of osteoarthritis
  • Improvement of sleep apnea

Lose Weight, Lose Muscle?

But, when the body loses fat, it also loses muscle, and that’s a problem. Muscle loss can have adverse effects, including:

  • Reduced balance and increased risk of falls
  • Decreased ability to walk and exercise
  • A loss of heart tissue—remember the heart is a muscle too
  • Increased risk of infections
  • Poor insulin and blood sugar regulation
  • A shorter life span—a higher ratio of muscle to fat improves life expectancy
  • Slowed metabolism–muscle mass is the most significant factor impacting the rate at which your body burns calories 

Look for Fat Loss, Rather than Weight Loss 

The goal then is to maximize fat loss while minimizing muscle loss. Two behaviors can help accomplish this goal: 1) meeting daily protein goals and 2) getting regular exercise.

To meet daily protein goals:

  • Eat six small protein-rich meals throughout the day.
  • Eat protein first at each meal, balanced with small servings of vegetables, fruits, and whole grain.
  • Obtain the majority of daily protein with lean meat/fish/poultry, low-fat dairy, and beans. Use protein supplements if unable to meet your protein goal with foods.

In addition to meeting daily protein goals, regular exercise is the other key to maximize fat loss and minimize muscle loss.

How Does Exercise Help Keep Muscle Tissue?

Muscle size increases when it is challenged with higher levels of resistance or weight. During exercise, muscle fibers are injured. The body repairs the damaged muscle fibers by fusing them, increasing their strength and size. Regular activity also enables the hormones needed for muscle growth to be more effective.

Other Health Benefits of Exercise

Regular exercise has benefits that go beyond weight control. It is incredibly good for mental health – reducing stress, anxiety, and improving outlook. It lowers the risk of many diseases – heart disease, diabetes, obesity, osteoporosis, and some forms of cancer. The capacity for physical activity increases along with energy. Sleep improves.

Exercise helps us feel better and have more energy. Blood sugar and insulin levels are better regulated. Stress hormones decrease. The likelihood of making better food choices is improved. Regular exercise builds confidence,  which then spills over to other aspects of life.

See how a foundation of regular exercise builds health? 

How Much and What Kind of Exercise is Best? 

Exercise needs to be consistent, challenging, and long-term to be most effective at maintaining or building muscle.

According to the Physical Activity Guidelines for Americans 2015 – 2020, adults should engage in muscle-strengthening exercises at least twice weekly.

Strength training activities include:

  • Lifting free weights
  • Using stationary weight machines
  • Resistance band exercises
  • Exercises that use body weight, such as pushups, squats, or lunges
  • Strength training classes in person or on-line (check out YouTube)

Aerobic or “cardio” activity is vital for overall fitness and health too. It helps burn fat, especially dangerous belly fat. It also supports muscle growth and function. Adding quick sprints to your walk or job provides an interval workout, which is especially helpful in preventing muscle loss.

Current guidelines recommend at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity each week. That’s just a 30-minute brisk walk five days each week. You can also combine strength building and cardio exercises – think kickboxing, circuit training, or pause the treadmill every 10 minutes for a set of squats or curls.

The Bottom Line

Maximizing fat loss and minimizing muscle loss is essential for long-term weight maintenance and overall good health. The winning combination to achieve this goal is bariatric surgery, regular exercise, and healthy food choices. They work together to create a change in body dynamics that tips the scale in weight loss’s favor. Hormones are helpful, metabolism is maintained, energy surges, and food cravings are minimized.

It is worth the time and effort to make regular exercise part of your daily routine. Your health depends on it.

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