Preventing Weight Re-Gain

While it has been said many times before, bariatric surgery is merely a tool. It is possible to not use that tool properly and see results that you would not prefer. We are talking about weight regain after bariatric surgery. Unfortunately, this is sometimes a problem, but there are ways to prevent it and manage it if you have already gained.

A common problem and one of the largest determinants of how well you will do with weight loss post-surgery is exercise. When you lose weight rapidly, you typically lose muscle mass, whether you notice it or not. If you do not exercise to build that muscle mass back up, your metabolism will slow down. So not only are you not burning calories from doing exercise, but you’re also burning fewer calories throughout the day due to a slower metabolism. Muscle is the most metabolically active tissue in the body, meaning that it burns more calories than any other tissue. This is why it is essential to incorporate a combination of cardiovascular activity and strength training for a minimum of 30 minutes a day 5 days per week. More exercise will likely produce better results.

Another very common problem is drinking with or too close to your meal. If you drink just prior to a meal, during a meal or after a meal, your food is mixing with liquid, becoming softer and ultimately moving through your pouch more rapidly. This leaves you feeling hungry and may lead to eating more. Eating more leads to weight gain. In order to prevent this, you are asked to stop drinking anything 30 minutes prior to your meal and not drink anything until 30 minutes after your meal. Even small sips can sabotage your efforts. Along with this concept, if you’re choosing many soft foods and liquids, you will find yourself hungry and able to eat more. The majority of the time, you want to choose solid foods for your meals as these will fill you up quicker and keep you full longer.

One other common problem is grazing or excessive snacking. Picking at foods throughout the day can add up to many extra calories. Grazing often doesn’t fill you up or satisfy you and is done out of boredom or because the food looks good. It does not make sense to eat if you are not hungry. It is best to go for a walk, write in a journal, call a friend or somehow otherwise distract yourself from the situation that is leading you to eat.

By controlling each of these behaviors, we can continue on the journey of weight loss and not worry about weight gain. After all, you had the surgery in order to lose weight, so let’s make good use of the tool that you have.

The Truth About Holiday Weight Gain

How Much Weight Do We Really Gain?

Most people think the average American gains about 5 pounds over the holidays. According to a study in the New England Journal of Medicine, most of us gain an average of 1 pound (5 pounds for overweight people) between Thanksgiving Day and New Year’s Day. The reality is, we fail to lose that 1 pound of holiday weight gain. And that adds up to a lot of weight gain over the years.


Why Do So Many of Us Gain Weight over the Holidays?

When you think about it, the holidays really boil down to just three days: Thanksgiving, Christmas, and New Year’s. If you gorge only on those three days, you probably wouldn’t cause too much damage.

However, many of us take on that holiday mentality of six weeks of nonstop feasting. And we use the “I’m so busy” excuse and put our exercise routine on the back burner.

So start preventing weight gain NOW is crucial!

Don't Let Your Scale Define You!

Repeat after me. “I am not a number.” Owning a scale is both a good and bad thing. It can be your ally by providing you with feedback. Weighing in only once a week (at the most) lets you know when you’ve been losing weight and when your weight loss has stalled. More frequent weighing in (daily or even multiple times a day) can be problematic because daily fluctuations in weight occur due to things like water retention, or what time of the the day you are weighing. People sometimes let the number on the scale dictate their mood for the day. Does this sound familiar? Down a pound? Yay! It’s going to be a great day! Up a pound? What’s the point of even trying? I’m just going to go eat some cookies. DO NOT let the scale control your life! Your body weight is no reflection of who you are, your strength, your intelligence, your kindness, your beauty, or your worth. Focus on eating for good health, for nourishment, and exercising for strength and energy. Use clothes fit as indicator of how you’re doing in your journey for a healthier weight.  DO NOT let a number on a scale define who you are or how much joy you have in your life!

Workout Wednesday: Aerobic Exercise – What Counts?

Aerobic or “cardio” exercises make you breath harder and cause your heart to beat faster.

Intensity tells us how hard our bodies are working during an activity. Light daily activities such as driving, cleaning, cooking, or doing the laundry doesn’t count toward the guidelines. That is because your body isn’t working hard enough to get your heart rate up.

1) Moderate-intensity aerobic activity: are activities that make you work hard enough to raise your heart rate and break a sweat. During these activities you are able to talk, but not sing. Check out some activities that require moderate effort:

  • Walking fast

  • Doing water aerobics

  • Riding a bike on level ground or with few hills

  • Playing doubles tennis

  • Pushing a lawn mower

2) Vigorous-intensity aerobic activity: are activities that make you breath hard and fast, and your heart rate has gone up quite a bit. At this intensity level, you won’t be able to say more than a few words without pausing for a breath. Check out some  activities that require vigorous effort:

  • Jogging or running

  • Swimming laps

  • Riding a bike fast or on hills

  • Playing singles tennis

  • Playing basketball

Try this aerobic exercise routine this week. Go from zero to 10 in 30 minutes!

Aerobic exercise routine

For more information on aerobic exercises guidelines, watch this video. 



Dr. Wagner Improving Bariatric Experience with Single Incision Weight Loss Surgery

bariatric, weight, loss, surgery, St., Louis, MO

Dr. Van Wagner Performs Innovative Single Incision Weight Loss Surgery

Using a new weapon in the fight against morbid obesity, Van L. Wagner, MD and his Heart of America Bariatrics, LLC practice have now achieved a milestone by performing the 300th single incision weight loss surgery in St. Louis. Dr. Wagner started developing the technique he describes as PeriUmbilical Laparoscopic Surgery (PULSsm) over 1 year ago, and the technique has evolved into a revolutionary new procedure. The procedure is so unique, Dr. Wagner has a trademark patent pending. He is the only surgeon in the area using the PULSsm technique, which has a significant advance of maximal cosmetic appearance. The single umbilical incision usually heals to the point that the scar retracts into the depths of the umbilicus and the scar cannot be seen. The PULSsm technique is the ultimate in patient privacy. One major benefit Dr. Wagner says his patients enjoy is imagining the ability to wear a bathing suit on the beach with no visible scar and with no one able to tell they had weight loss surgery.

With about 11 million people in the U. S. weighing 80-100 pounds more than what’s thought to be the average weight for their size, St. Louis bariatric surgeon, Dr. Van Wagner, is using a new weapon in the fight against obesity: single-incision weight loss surgery. He says he understands weight loss surgery is a complex decision for the growing number of Americans confronting their continuing battle with weight gain, and is proud to be able to provide his patients with the new technique to make scarring virtually unnoticeable and recovery more comfortable. As the only bariatric surgeon in St. Louis specializing in the PULSsm single incision weight loss procedures, Dr. Wagner is currently celebrating the success of the 300th single incision weight loss surgery at his Heart of America Bariatric practice.

Single-incision weight loss surgery is a technique which uses small diameter medical instruments and a camera to perform the surgical procedure. Dr. Wagner makes a semi-circular incision near the navel that is about two inches in length, which is required for placement of the port in gastric banding surgery. A liver retractor, camera and two operating instruments are placed through the single incision. He then performs the surgery with the aid of the video monitor. The single-incision technique eliminates the need for multiple incisions throughout the wall of the abdomen usually required in more traditional laparoscopic weight loss surgeries, which may cut down on recovery time and post-operative scarring. Dr. Wagner performs all gastric band surgeries using the PULSsm technique, unless there is an anatomical or medical reason to use the traditional laparoscopic approach.

With more than 1,000 St. Louis laparoscopic adjustable gastric banding system procedures performed, utilizing both LAP-BAND® and REALIZE® Bands, Dr. Wagner continues to foster a successful environment for his patients from the initial educational seminars, to the first consultation, through the recovery process. Heart of America Bariatrics is also unique as it is the only practice in Missouri that uses an office-based state of the art fluoroscopic x-ray machine to perform all laparoscopic adjustable gastric banding system] adjustments, including needle localization of the port to minimize discomfort, and Upper GI contrast studies to monitor amount of restriction through the gastric band.

To further customize the bariatric surgical process, Dr. Wagner offers gastric bypass in St. Louis. He says the Laparoscopic Roux-en-Y gastric bypass (LRYGB) procedure is one of the most effective and popular procedures in the battle against morbid obesity. Instead of the traditional long tubular stomach pouch, Dr. Wagner specializes in this less invasive laparoscopic procedure, which is a newer and safer version that creates a small stomach pouch about the size of an egg, and requires less recovery time while reducing the risk of infection. While progress is monitored throughout the process at the Heart of America Bariatric center, normal daily routines are typically resumed within two to three weeks, with dramatic weight loss of up to 80% possible within the first year following surgery.

Dr. Wagner also offers the gastric sleeve in St. Louis, which is a newer bariatric procedure. According to Dr. Wagner, the use of the gastric sleeve procedure, which he performs laparoscopically with the PULSsm technique, is an ideal procedure for patients who have a lower BMI (around 50 or less) and who would not want a gastric band. He is the only surgeon in the area who performs the PULSsm technique for all his sleeve gastrectomy patients, unless the traditional laparoscopic approach is indicated for medical or anatomical reasons.

While each of these procedures is designed to help patients with their weight loss struggles, Dr. Wagner stresses that his St. Louis weight loss surgery patients need to understand significant dietary changes are required to ensure eventual success with any of these innovative procedures offered by Heart of America Bariatrics. With more than 1000 laparoscopic adjustable gastric banding procedures, 500 laparoscopic gastric bypass surgeries, 25 laparoscopic sleeve gastrectomies now performed, including over 300 patients weighing between 350 and 550 pounds, and over 575 patients with a BMI of 50 to 92, Dr. Wagner says he continues to balance experience and education in all areas of bariatric surgery to ensure the highest rate of success with all of his patients. As Heart of America Bariatrics celebrates the 300th single incision procedure, Dr. Wagner says he will continue to concentrate on making his patients more comfortable while remaining dedicated to their successful weight loss.

About Dr. Wagner

Dr. Wagner received his Medical Degree from New York Medical College in Valhalla, and completed his general surgery residency at the University of Medicine and Dentistry of New Jersey. He is board-certified by the American Society for Bariatric Surgery, of which he has also been a member since 2004. Dr. Wagner’s practice, Heart of America Bariatrics, has been recognized as a Bariatric Center of Excellence since 2006 as well.

Dr. Wagner and his Heart of America Bariatrics practice are located at the Doctors Building of South County 1400 Lemay Ferry Rd. Suite A, St. Louis, MO 63125 and be reached at (314) 776-7112 or or the Heart of America Bariatrics, LLC Facebook page.