The battle

Over the last few weeks I have had a number of discussions with people who have had WLS and others who are interested in the process, possible outcomes and any significant down sides. Almost all of the folks who have had surgery have regained some of the weight originally lost. That seems to be a forgone conclusion. The reasons why on the other hand are very complex. Several simply reestablished the eating habits they had before the surgery and the regaining of weight was inevitable. They had not accepted the fact that their excess weight was a function of their own eating habits. A lot of excuses are made for weight gain and frankly the absolute realization that it is their problem seemed impossible to accept. They see themselves as the injured party and the weight loss is not the result of their own behavior but something that affected them externally.  A couple of post-WLS folks had dropped the weight and felt uncomfortable or even unhealthy at the maximal point of the weight loss. If they paid attention to their diet, they gained some of the weight loss back, but did finally reach a weight level where they felt comfortable in their own skin (and clothes).  This is an important realization. Once you find that point, you can relax and just focus on maintaining it. If you pay attention to what and when you eat, the equilibrium point in the weight profile can be maintained.

I have made this point before about those individuals looking at WLS as a strategy. Some seem to feel that it is the final answer to their weight issues and if they lose weight they will be healthier, more energetic and happier. And most of the time that is true. But WLS will not rid you of heart disease issues or other health issues. It is true that diabetes will probably disappear with the weight loss, but if you regain weight after the WLS it will return. It is highly weight dependent. WLS will change your life. It will not give you a new one however. You will have to deal with the probable weight gain and know how to minimize it. You will note that I said “Minimize it”. It is a fact that will occur. Your surgeon can give you the opportunity to lose weight, but they cannot keep you from regaining it. That is up to you

Eric

I met a young man at a local thriftstore the other day. I have seen him in several of the local Goodwill stores and he has started to recognize me as well. He stands out. He currently weighs between 300 and 400 pounds and is about 5 feet 10 inches tall. Lots of tattoos on his neck and arms. He has been very polite in all of our interactions, and I told him that I had once weighed 300 pounds. He looked at me carefully and asked how I had lost the weight. I told him weight loss surgery. That opened a flood gate of questions, concerns and a clear dialogue was developed. He was in the early stages of the 6 month program at Kaiser leading to potential weight loss surgery. The program requires you to make a concerted effort to loose weight on your own, before they will do WLS. They provide weekly group meetings to help you in the process. He seemed happy with the progress he had made and looked forward to the weekly guidance sessions. He told me he didn’t have too many risk factor issues like heart problems, diabetes and other physical problems.  But I wasn’t sure he was telling me the complete truth.

We spent some time discussing the surgery (proposed gastric sleeve) and what were things he could anticipate down the road after the surgery. I l=told him about the rapid weight loss amd some of the dietary problems I encountered. I also told him about my current battle to take off some of the weight I gained after that first amazing year of weight loss. The psychology of the weight loss process is extremely important in that post-surgery world. Failure to exercise, increased snacking, and eating the wrong kinds of foods can all be part of a problematical resolution. I asked him about why he felt he needed to have the surgery and he told me about failed attempts to lose weight in the past. Now he said he was doing it for himself. He was going to try to lose the weight so that he could be healthier, happier and in a better place. He had the right attitude and I wished him luck. But it is not just luck. It is the will to not go back to where you were before you lost weight.  There is no alternative that says that you can return to your old habits. There are sacrifices that have to be made. As this blog has stated many times this WLS should not be a sentence of dull, tasteless food or the ability to go out to restaurants and eat with your friends. It opens new life vistas that while they do have some restrictions on how much you eat, do not restrict you at all about the types of foods you eat. So Eric, get through this early stage process and get the surgery done as soon as possible. You will be starting a whole new life. Get started as soon as possible.

Teaching kids to cook

I kind of entered a new phase in my Eight Bites progress. While I still struggle a bit every day with what and how much I eat I am not as obsessed about it as I have been. I am working at the gym four days a week, walking on the treadmill and lifting weights. Exercising the abdominal core and trying to strengthen the legs and back. My shoulder hurts all the time so I have done little work on that, limiting my exercise to the abdomen, back and legs.

But the exercise has been going on for almost a year. What is new is that I am teaching middle school kids how to cook. A local charter school has a restaurant on its site that is no longer functioning as a working restaurant. Now while fully capable with commercial stove, stainless work areas, sinks and refrigeration it is use as an overflow class room for the music program, another home ec cooking class and chorus class. I found out about it, while working for the Jamie Oliver Food Foundation and their Big Rig cooking project. While I felt that the actual teaching of kids (and adults) could be done more effectively, the philosophy of the program regarding eating better, simpler, and more earth friendly was a good one.

I contacted the principal of the charter school and provided her with information on my background and then with a class plan. She got District permission for me to carry out an initial three week class for 12 kids ranging in age from 12 to 14. The initial class had seven boys and four girls. I got a list of the kids, and any potential food allergies and issues before the class. One girl had peanut allergies, but the rest were fine. I spent about a month getting ready to teach the class, getting ideas in place, locating pots and pans, bowls and getting knives ready. I wanted to make it interesting and fun, but I also wanted to ensure that the kids had the basic understanding that kitchens can be dangerous places, full of hot things, sharp things, and slippery things.

That first class was interesting. The kids were enthusiastic and happy, so I worked hard to keep them that way. They each got a Chef’s knife and a paring knife, a cutting boards and a towel. Then we began. Cutting skills are a significant component of the cooking process. The process goes from gaining comfort in handling the tools, to working with the preparation of ingredients, to reading recipes, to cooking the dish. I decided that the first class would focus on developing cutting skills and reducing the fear of the knives. Slicing, dicing, and chopping were the tasks for the day, but I also wanted to create something they could eat. So each kid had a tomato to slice and dice, an onion, half a bell pepper, a half of a cucumber, some garlic, and some parsley and cilantro. They each made a mixture of tomato, onion, peppers, cucumber, garlic, and cilantro, stirred it up and made a salsa. I provided them some freshly made tortilla chips and they were each able to enjoy their very own salsa. I asked them to set aside some of the chopped tomato, some chopped garlic, chopped basil and parsley to make a topping for crostini. I had made some bruschetta toasts for them and they topped the toasts with the tomato, and garlic, added some Parmigiano Reggiano and had a new taste sensation.

The next class had them preparing the ingredients for pasta with a light tomato sauce, sausage, broccoli rabe and cherry tomatoes. With a lot of the Parmigiano added they really loved this dish. I showed them how to make basil pesto with olive oil, garlic, walnuts, Parmigiano and pecorino cheeses, and lots of basil. They blended it up and made a very nice pesto that we used to top linguini. The first pasta used Orecchiette and that also was new dish for them. The third class was yesterday and I had asked them what they wanted to prepare. The decision was to make chicken piccata and salmon teriyaki. So I split them up into groups making the lemon sauce, pounding the chicken, making the teriyaki sauce, and the cream cheese topping for the lemon tarts. They were all busy and got all the tasks done quickly. Then it was time to move to the stove and heat things up. They floured and sautéed the chicken dipped it in the piccata sauce and set it aside to continue to heat. Then they sautéed the salmon fillets, topped them with the teriyaki sauce, sesame seeds, and chopped green onions. The food was moved out to the dining room and the kids ate their work. Even though some didn’t want to eat the salmon, they at least tried it.  Sapore means to love flavors and that was what I wanted them to understand. They were a pretty adventurous lot. The lemon tarts went down quickly as well as some lemon sorbet I had made earlier. We talked about the experiences that they had and got some feedback. The kids were still enthusiastic and seemed to have fun, and all thanked me and said goodbye. I sat for a few minutes just to center myself and then cleaned up the kitchen, packed the car and went home. The first workshop was over. Apparently the next one is already filled and will start soon. 

Checking in

It has been awhile since I last wrote. A lot has changed in the last few months. It has been over 5 years since I had my weight loss surgery. Weight has been rapidly lost, clothes sizes rapidly changed and life was getting better. I had moved to Italy in 2008 after the surgery and begun cooking with Amore Sapore.  The cooking was the easy part. The hard part was dealing with all the personalities in the small group. But in that first year I lost about 135 pounds. I felt good and I had gone down considerably in size. I loved the ability to buy nice fitting clothes and wear them with a certain degree of pride. I had accomplished a lot and I was proud of myself. I did get some unfortunate resistance to my loss from my partner.  It was not easy for her to accept that I weighed substantially less than she did. It was just one of many problems we had. Those problems led ultimately to a divorce and we both moved on. 

I am sure that Sandi had she lived to see this weight loss would have approved and been proud of me.  She had gone through a similar process and lost almost 150 pounds, which frankly she kept off better than I have. When you lose that much weight you begin to see that you are very much different than what you were used to. The mirror is no longer an enemy, to be ignored if at all possible. It wasn’t vanity, it was more like satisfaction and success, finally.  After I left Italy I began a slow but steady increase in weight and regained about forty of the pounds I had lost.  The eating impetus was more emotional and snacking was a problem.

When I married Kathlyn she had gone though a lot of the same things as I had. Weight loss surgery, and the sudden death of her long time husband. She had also tried to date and develop relationships with men that were not as successful as she had before. All of these responses were similar in my case.  So here we are, closing in on two years of marriage. She retains a wonderful senxe of humor and makes me laugh, I cook for her and she proudly told me the other day that in the last year she had only gained three pounds.  I guess my Eight Bites philosophy is working at least for us. I have lost about eight pounds and slowly sliding down on the scale. I have started to go to the gym three to four times a week and working with a personal trainer once a week. I know I feel pretty good and have been lifting a lot of weight, treadmilling and rowing.  

In the last couple of weeks, I have been trained as a Food Champion with the Jamie Oliver Food Revolution and will be starting to teach kids and adults about making good nutritious meals simply, easly and with some fun. Hopefully they will take away the inherent stigma we attach to cooking now days. It really seems that most kids no longer go into the kitchen with their mom or dad and cook. Probably because mom and dad are wound up in just trying to make ends meet and resort to getting takeout, or microwaveable meals. So we will teach them some simple dishes, and include knife skills, kitchen equipment use and maintenance, and sanitation. It will be a fun time until the 20^th of December when the Big Red truck leaves to head to its next stop. The local food champions will hopefully continue  to teach the kids in other venues including Boy’s and Girl’s Clubs and schools.  

So here it is almost Thanksgiving and I am preparing to cook some dishes for the family gathering. I have made a flourless chocolate almond cake, a flourless pumpkin soufflé cake, a lemon tart, and am in the process of doing a few more things tomorrow.  So this Thursday will pass. Next week I will start the Jamie Oliver program.  Have a good Thanksgiving. Stay in the moment and try everything you like, but just make those tastes rather than platefuls.  

Five years out

For the last few days I have been rereading my earlier posts from this blog. Back in 2009 when I started this I was very excited after the surgery and the weight dropped dramatically and quickly. From June 4 2008 to June 4 2009 I lost 130 pounds and went from a size 56 jacket to a 42. My waist went from 45” to 34”. I was happy and somewhat arrogant about how I looked. I bought clothing that was so much smaller than I had purchased and it was fun wearing a medium shirt rather than a 3XL. I weighed less than I had weighed as a sophomore in high school. I was cooking, teaching cooking classes and was quite content. I was getting a little grief from my wife at the time about what a clotheshorse I had become and I believe she was not happy about my significant weight loss. I believe she was jealous of it. Since I did most of the cooking and she was eating what I cooked, her weight had gone up while mine had gone down so quickly. This became a source of conflict and potentially lead in part to our divorce.

Over time as my body accepted the weight I found that I started very slowly to gain again. Not anything significant but enough for me to notice. As it increased over a year or so, I started to become concerned. I was still trying to eat my eight bites each meal I found that I had started to eat little things between meals. My stomach cleared the food from the meal and I felt I could put some more into it. Easy! But as weight continued to be gained, I became more and more concerned and began looking for some simple answer. The problem was that there was no simple answer. There was only complexity. As weight was gained, my blood sugar started increasing and I was returning to a diabetic life. That was not what I wanted and was the overriding reason I had the surgery in the first place.

So here we are on June 2, 2013, 5 years out from the date of my WLS on June 4 2008. And things have changed for me. My weight is back to 220 pounds which is still 80 pounds less than I was but 50 pounds above where I had been. It has been an increase of about a pound a month since June 2009. A gradual increase but still, what am I doing?  And more importantly what am I doing wrong? I have to buy XL shirts now and my waist has increased from 34” to 38”. I am not happy about this process. But more importantly my doctor has put me back on diabetic medications in an effort to reduce my daily and long term sugar levels.

I have refocused upon the type and quantity of food at each meal and particularly focused on what I want  to eat (and must not) between meals. I have focused on riding the stationary bike each morning, eating less in each meal, and trying to stay busy during the day so I am not tempted to eat between meals.

My goals are:

1: Stop the weight gain.

2. Start to reduce the weight by about a pound or two per month.

3: Increase my activity as much as my body will tolerate.

4: Focus on eating my eight bites at the normal meal times.

5. Steel myself from the desire to eat between meals.

6. Be happy and healthy where I am.

So today I have to be confident I can accomplish what I need to do. To be a healthier person. I be a better man than I have been. So I will go on with my plans and try to accomplish my goals. Not unrealistic ones, but ones that can be achieved as long as I have the will. 

Eight Bites on a cruise ship

 I just returned from a ten day cruise to Alaska. I will not say on which cruise line because I was a bit disappointed in them. But going on a cruise after weight loss surgery (WLS) can be a bit scary. Cruising is really just about wasting time between meals. They feed you often and a lot on cruise ships and you can get carried away. I set out to be sure that I did not over eat and yet enjoy the culinary offerings of the various dining areas.  

Breakfast can be eaten either in the dining room (Deck 6) or at the buffet on Deck 14. Sitting up on the higher deck gave you a great view of wherever you were and was almost always very busy for breakfast. On the trip we ate breakfast at the buffet every morning but one. The buffet always included lots of fruits, hot and cold cereals, toast, croissants, muffins, bagels, and a wide variety of sweet rolls and Danish. The main menu items ranged from breakfast staples like pancakes, French toast, sausages, bacon, and eggs in various forms. They also had fish, including smoked fish and a variety of ethnic dishes, which included fried rice, oriental eggs (deep fried hard boiled eggs in a crust), and vegetables.  

After my WLS and the subsequent removal of my gall bladder last year, the volume that I am able to eat has been reduced substantially. At home breakfast is my major meal due to the fact that my stomach (or what is left of it) is empty. I often eat eggs, a piece of toast, or oatmeal or granola. So at breakfast at the buffet with its wide selection I was able to take small amounts of a variety of food items and then eat what I wanted. I would take a single egg (fried, oriental or poached), a small croissant, some butter and jam, a sausage link or a small spoonful of corned beef hash. I always skipped the pastries, and took only small amounts of fruit. I ate slowly and instead of focusing on cleaning my plate, I concentrated on enjoying the flavors and talking with strangers sitting next to us. The conversations were almost always lively and interesting. And the side benefit was to slow down the eating.  

I bought a ticket for specialty coffee drinks so I had my morning capuchinno (and maybe and afternoon one as well).  

Lunch was normally at the buffet as well. Lots of meats, cheeses, breads, pre-made sandwiches, fruits and a lot of hot dishes as well. I was singularly unimpressed with the majority of the hot dishes at the buffet. For some reason they didn’t keep them hot and often they were lukewarm and often cool. I realize that cooking 10,000 meals per day is a logistical problem; I do believe that hot food should be served hot. I normally took a few pieces of cold meat and cheese or the individually made sandwiches (a vitello tonnato sandwich was quite good), and a diet soda. The cookies were my downfall. They made a molten chocolate chocolate chip cookie and an excellent oatmeal raisin cookie and we offer took 4-6 cookies back to the cabin for later.  

Dinner was always in the main dining room and was ordered off the menu. There were dishes that were always available (fettuccini alfredo, medallions of beef, and shrimp cocktail) as well as daily dishes that included three appetizers,  a couple of soups, and salad, three main courses, and three to five desserts. The appetizers were normally small and in general were good. A smoked duck breast and a small filled puff pastry shell with chicken, sweetbreads and wild mushrooms in a cream sauce were nice. I decided to limit my main dishes to those I have not had before or have not had in a long time. Some were successful (a shrimp curry) and others were not (roast pheasant with a cranberry sauce).   

Actually it was pretty easy to maintain my Eight Bites eating. The buffets allowed me to take a bit of different things and try them. If I didn’t like them, I just left them on the plate. It made it easy to eat limited amounts and yet try a lot of different things. Lunch was lunch. I just focused on eating sufficient protein and not eating too much. Dinner was by definition an exercise in limited consumption. The appetizers were generally small bites. I normally didn’t eat the soup or a salad, and while the main courses were OK they were nothing to write home about.  

In discussions with other passengers, some were enthusiastic about the food and others had the same problems I did. Working as a chef did not give me any great insight onto why things weren’t that great. Foods were often not served at the correct temperature, and flavors were bland and under-seasoned. So while I enjoyed the trip, I did not particularly enjoy the food. This allowed me to eat the things I wanted to eat in the amounts that made sense. I did not eat the overly sweet desserts at lunch and dinner, and never left the table overly full and uncomfortable. 

 

When I got home I found out that I had lost an additional three pounds so not only was I able to eat Eight Bites I was able to do so, enjoy the trip, and not over-indulge.  

Cook big, eat small

It is hard to cook Eight Bites for one or two people. The stores simply don’t sell products in small volumes. You have to buy pork chops in a family pack, chicken breasts-6 per package, or 2 pound bags of carrots. It is very hard to shop when you are cooking small bites and have limited storage space in the freezer.  But sometimes it is really necessary to cook big and then eat little. Just because these recipes make a fair amount of food, it is however not necessary to overeat. The remaining food can be put in the fridge for leftovers or frozen in good storage containers for later use.
Each recipe here is designed to be eaten at the time you cook it, and then suggestions for leftovers are discussed. Since proteins are important to the WLS eater the three main recipes are meat recipes. The first is lamb shoulder chops, cooked in a braising liquid of garlic wine, and stock. It cooks low and slow in the oven for about 3 hours at 300 degrees. The second is an interesting Asian-flavored ground turkey meatballs in a sweet, sour and spicy sauce. And the third dish is a pork shoulder roast.

Braised lamb with garlic wine
This dish uses the relatively inexpensive lamb shoulder chops. Buy them and freeze them when they are inexpensive.
Ingredients:
6-8 lamb shoulder chops
2 large onions, slices
6 cloves of garlic chopped fine
2 carrots, sliced
2 roasted red peppers (peeled. seeded and chopped)
Olive oil
Salt and pepper
1 cup Garlic wine (Put 10 cloves of garlic into a bottle of a reasonably priced red wine, recork and allow to sit for 1 month). I sometimes take a half gallon of Burgandy and add 20 cloves of garlic then reseal it and put it under the sink.
Saute onions, garlic, carrots and peppers in olive oil in a heavy oven proof pan until they are wilted and nicely browned. Dredge the chops in a seasoned flour and saute in a small amount of vegetable oil to brown. Place the chops on top of the vegetables. Add 1 cup of the garlic wine, two cups of beef or chicken stock and then water to bring the fluid up to the meat, but do not cover the meat with the braising liquid. Cover the pan well with foil to seal and place in a 300 degree oven for three hours.
Remove the chops and keep them warm, then bring the pan juices to a boil on top of the stove and cook the braising liquid down by half or more. Serve the meat with scalloped potatoes and some of the sauce.
Leftovers: These lamb chops are very tender and when removed from the bone and heated in a saucepan  can be served over wide noodles and sprinkled with chopped green onions. Or make the meat into a hash with potatoes for a terrific breakfast.

Asian spicy meatballs
These meatballs are relatively soft and easily digestible for the WLS eater. They are relatively low in fat and can be seasoned to a very spicy level or toned downed using the red chili sauce and cayenne.  Serve the first night with steamed rice. Two or three of these meatballs is the perfect size to meet you Eight Bites needs.
Ingredients
For the meatballs
1 pound ground turkey
4 cloves garlic
½ baked sweet potato
2 inch grated fresh ginger
½ cup sweet red chili sauce
2-3 Tablespoons sriracha sauce Add to taste, it’s hot
½ cup chopped parsley
½ cup chopped green onions
1 teaspoon salt
Several good grinds of black pepper
¾ cup fine cracker crumbs
1 egg
1 roasted red pepper (seeded and chopped fine
Place all the ingredients for the meatballs into a food processor with a steel blade.
Process until meat mixture is relatively smooth.
Make into 24 small meat balls and refrigerate for 30 minutes.
Roll the meat balls in a seasoned flour mixture, shake off excess.
Saute until brown in vegetable oil.
Place in a large baking dish, and pour sauce over the meatballs
Bake in a moderate oven (350 degrees) for 30 minutes or until meatballs are done.
For the sauce
1 small can of crushed pineapple
Rice wine vinegar or apple cider vinegar
Sweet red pepper sauce (found in most grocery stores in the Asian food section)
1 cup of water or chicken stock
Salt and pepper to taste
½ Cup sugar
½ Cup catsup
Mix the pineapple, catsup, sugar, and stock together. Bring to a boil. Add chili sauce and vinegar to create the sweet, sour and hot flavor you want. Start with ½ cup of the vinegar and pepper sauce then taste and add more as desired. Cook for five minutes to thicken. Pour over meatballs.
Leftovers: These little spicy meatballs make a great sandwich when warmed and placed on a toasted hamburger bun. Put some of the sauce over the meatballs. Or cook some noodles and serve the meatball over the noodles.

Crisp Roast Pork
This luscious garlicky roast pork works especially well with the less expensive shoulder roast, and it gives you a nice crispy skin. Some cooks like to remove the skin and cook it separately, but I like the mix of textures that you get when you roast the pork with the skin on. The fat layer under the skin continually bastes the meat as it roasts.
Ingredients”
2 tbsp. cumin seeds
1 tbsp. black peppercorns
2 tbsp. dried oregano
1⁄4 tsp. cayenne
12 cloves garlic
Kosher salt, to taste
1 bone-in skin-on pork picnic shoulder (about 8 lbs.)
1 cup fresh orange juice
1⁄2 cup fresh lime juice
2 tbsp. olive oil
Directions:
Toast cumin and peppercorns in a skillet over medium heat, 2–3 minutes. Transfer to a small food processor along with oregano, cayenne, garlic, and 1 tbsp. salt; process to a paste. Cut about twenty-five 1 1⁄2"-wide slits in the pork about 1" deep. Rub garlic paste all over pork, pressing it into slits. Transfer pork to a roasting pan. Whisk together orange juice, lime juice, oil, and 2 tbsp. salt in a bowl; pour over pork. Cover and refrigerate, turning occasionally, for 18–24 hours.
Remove pork from refrigerator 2 hours before you are ready to roast, to allow it to come to room temperature. Heat oven to 325°. Roast, basting every 30 minutes, until a meat thermometer inserted in thickest part of pork registers 160°, about 3 hours total. (Add 1 cup water to pan when liquid evaporates; cover loosely with foil if skin gets too dark.) Let rest for 15 minutes, then carve and serve.
Leftovers: Roast pork is one of the most useful of meats for creating a great dinner and then some amazing leftovers. Chop the pork into small cubes and mix with salsa and heat. Place in a toasted tortilla for a terrific lunch. Chop up some roasted potatoes and place in a saute pan with a bit of olive oil. Saute until the potatoes start to crisp and add some coarsely chopped roast pork, serve with some steamed vegetables for dinner.
As I stated in the beginning of this entry, it is difficult to cook small amounts of food to satisfy the nutritional demands of the WLS eater. These recipes make a fairly large amount of food, but using inexpensive cuts and cooking for prolonged periods you can get a wonderful initial meal and then several days of leftovers. I often cook two or more of these dishes at the same time, because I don’t really like to eat leftovers from the previous day. I eat one of the dishes and then over the next few days can vary the meals using a variety of meats. Just remember that you need to eat Eight Bites at these meals. Never think that if you don’t eat more you are wasting food. One of the down sides to the WLS is that as our digestive system changes, and we can eat more. It is important to remember why you had the surgery in the first place. Mangia but respect where you have come from.