Total Wellness and Bariatrics

09/23/2024

09/20/2024

Asparagus
1 cup
5 grams carbohydrate
3 grams fiber
3 grams protein
They are related to leeks, garlic and onions.
Asparagus is dated as far back as 160 BC and is even depicted on Egyptian tombs.
Rich in saponins- the phytonutrient that can decrease cancer risk.
Most asparagus is grown in Peru.
The name comes from a Greek work meaning “sprout.”
Lightly coat with olive oil and season with salt and roasts at 425 degrees for 8-12 minutes turning once. When tender, sprinkle with parmesan cheese and return to the oven until melted.

09/18/2024

Components of Fitness
Aerobic
Flexibility
Strength
Core
Balance
Flexibility
Improves joint range of motion that can help reduce your risk of injury and reduce pain and stiffness.
Training should target the major tendon areas — neck, chest, shoulders, back, hips, legs and ankles. Some joints need stability (the knees and lumbar spine) and other joints need mobility (ankles, hips, thoracic spine and shoulders). The goal is to improve the range of motion in these joints.
Stretching is also a great way to decrease stress. Combining deep breathing with
stretching activates the parasympathetic nervous system — which is the system of “rest and digest” instead of “fight or flight.”
Keep these tips in mind:
Warm up for 5-10 minutes before stretching —walking is great!
Hold the stretch for 15-30 seconds
Remember to breathe and don’t bounce during the stretch.
Beginner stretching in a chair.
Chair Stretches Class. Seated Total Body Flexibility Routine
Relaxing Full Body Stretching Routine for Stress & Anxiety Relief
Mild discomfort or tightness can be common when stretching, but you should stop any stretch that causes pain.

09/16/2024

09/13/2024

Almonds
23 kernels, 1 ounce
6 grams protein
6 grams carbohydrate
3.5 grams fiber
14 grams fat
Excellent source of Vitamin E.
Almonds can help stabilize blood sugar.
Almond blossoms rely solely on bees for pollination.
They are related to peaches, cherries, plums and apricots.

09/10/2024

Components of Fitness
Aerobic
Balance
Strength
Core
Balance
Flexibility
Balance is important for almost everything you do — from walking to tying your shoes.
Maintaining and building balance can help prevent falls.
Balance training strengthens your core and if you haven’t been active, this is a good place
to start. Start easy and build up balance. Activities range from simple to more complex
movements. Tai Chi and yoga are more intense ways to build balance.
Start with weight shifts---- > then single leg balance--- > then work upper and lower
body together- (ie bicep curls standing on one leg)---> then Tai Chi
Beginner balance moves using a chair for support.
10 Exercises for Balance and Fall Prevention // Full Follow Along Workout
10 Minute Standing Abs & Balance Workout for Seniors & Beginners
More advanced balance exercises.
TRAINING FOR BALANCE #1 | 15 minute home workout.. Ashley Freeman
Balance Training Exercises
If you carry a lot of weight around your midsection, or are pregnant, choose balance
exercise carefully.

09/09/2024

Components of Fitness
Aerobic
Strength
Aerobic Exercise
Core
Balance
Flexibility
Using the large muscle groups to increase the heart rate.
Try walking, cycling, dancing, jogging or swimming.
Or use cardio equipment: treadmill, elliptical, stair climber, rowing machine.
Lowers blood pressure, increases good cholesterol, improves mood, helps build strong
bones and improves lung function.
Work up to 150 minutes a week. 30 minutes 5 days per week.
Exercise can be done in 10 minute intervals and work up.
Beginner cardio workouts:
15 min CARDIO WORKOUT | Beginner Friendly | Low Impact | All Standing
15 min CARDIO AEROBICS WORKOUT | All Standing | Low Impact | No Squats | Mov…
30 minute fat burning home workout for beginners. Achievable, low impact results.
Advancing cardio- add light weights with cardio workouts:
Fun low impact, all standing workout
Low impact, high intensity intermediate home cardio workout
As your body adapts to aerobic exercise, you can combine weight resistance training in
the same workout for maximum results.
Is the intensity enough?
Talk test: if you can talk then you are probably working out at a sufficient intensity. If you
can sing, you are not working out hard enough.
Remember: Warm up and stretch, invest in a good pair of shoes, include your family and
friends, find something you love and turn on the music!
If you experience lightheadedness or dizziness, you may need electrolytes.
If you experience shortness of breath, chest, shoulder or jaw pain, or tightness in the
chest, you should stop exercising and contact your doctor.

09/08/2024

09/06/2024

Macadamia nuts
10-12 nuts, 1 ounce
2 grams protein
4 grams carbohydrate
2 grams fiber
22 grams of fat
High in monounsaturated fats.
Can help reduce inflammation markers.
Native to Australia. Youngest edible tree nut, it’s less than 200 years old.
They are the most expensive nuts.
Macadamia nuts are a hard nut to crack- that’s why they aren’t sold in their shells.
The Macaw has a strong enough beak to break the shell.

09/05/2024

Components of Fitness
Aerobic
Flexibility
Strength
Core Strength
Core
Balance
Strengthening your core helps with balance, stability and preventing falls.
The core includes all the abdominal muscles around your waist and your back muscles.
These muscles protect the spine.
Exercises can be done at home without any equipment or using light weights and
compound movements. If you are new to core work, use your own body weight to start
and work up to compound moves.
Beginner workouts:
Planks, bridges, right side planks, left side plank, swimmers.
Core Workout For Beginners - 10-Minute Follow Along
More advanced.
Strengthen Your Core - Just 6 Minutes A Day!
Hollow hold and bridge hold
2 Best Core Exercises For Beginners
More advanced core workouts:
Exercises to improve your core strength.
https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/core-strength/art-20546851
7 core stability exercises.
https://www.acefitness.org/resources/everyone/blog/6313/7-core-stability-exercises/
7 exercise without weights
Bodyweight 10 Minutes Ab and Core Workout
20 Minute Full Body Workout- Compound moves. Work up to this type of exercise.
If you are currently experiencing back pain, be sure to consult your doctor before starting.

09/02/2024

We are excited to announce our September POTM, Jen Chappel!
“My life dramatically changed 7 years ago when I was diagnosed with Lupus, Rheumatoid Arthritis, and a handful of other chronic autoimmune conditions. After years of different diets and medications to help with all of the joint pain and inflammation, I decided to take a leap of faith and contact Total Wellness. I had done a lot of research and read many success stories about lives that had been changed by bariatric surgery. At this point in my life, a change was absolutely crucial as I had a one year old son to keep up with!
Thanks to Dr. Dill and her team I have been given a second chance to live the life I’ve been missing out on. Since my surgery in September of 2023 I have reduced my daily medication significantly to just one pill a day to help regulate my Lupus and I have lost nearly 90lbs! All of my other autoimmune conditions are currently under control! What a blessing it is to be able to live an active lifestyle again that I could only dream of before meeting the team at Total Wellness. I will be forever grateful for this experience and the kindness and encouragement that Dr. Dill and her team have shown me through this entire process.”

08/30/2024

Avocado oil
1 TBSP
14 grams of fat
0 grams carbs or protein
Can reduce inflammation and protect against heart disease.
Can help reduce LDL cholesterol and Triglycerides.
Unrefined oil is cold pressed which preserves the flavor.
Contains Vitamin E —a powerful antioxidant.
Can be therapeutic for Alzheimer's, epilepsy and dementia.

08/29/2024

How does being overweight affect your mental health?
A substantial amount!
Obesity and depression often go hand in hand.
A 2020 meta-analysis found that adults with excess weight have a 55% higher risk
of developing depression over their lifetime, while people with depression have a
58% increased risk of obesity.
That’s alarming!
Although both conditions have treatment options, seeking help can be challenging
because of embarrassment, self blame, or the stigma surrounding obesity and
depression. “Eat less and move more” or “look on the bright side” hasn’t brought
much relief to those suffering.
Key advice of “eat better, try exercise and get a good night’s sleep” may seem
overwhelming when it hurts to move and you can’t sleep.
Let’s unravel some of the physical and mental challenges with both of these
conditions:
Poor sleep. Being overweight can make sleep hard due to chronic joint pain or
other conditions such as sleep apnea and depression often manifests as an inability
to sleep (racing thoughts, worry, etc). Poor sleep increases perception of hunger
and decreases the resolve one needs to make problems better.
Low energy. It’s difficult to carry around a larger body and it’s difficult to have
motivation when your energy is low.
Social isolation. Being overweight makes it more difficult to join in activities that
require a lot of walking or activities where one may need to be a certain size
(travel, amusement parks, movie seats, bleachers, etc). Depression usually leads
to less interest in things you would otherwise enjoy.
Relationship challenges. Connections to family and friends can weaken when
they do not understand why you can't or don’t want to join in activities or when you
have to rely on friends or family to do things for you. A depressed person might not
be able to meet other’s emotional needs and the relationship can suffer.
Altered stress hormones. This is where there is a perfect storm that is only
barely understood. Obesity raises and changes stress hormones and depression
does too- especially cortisol. There are changes in the fat tissue that stresses the
body and changes in the mind that affect the body.
It’s good and bad news that there’s a body and mind connection. Many times
people focus on the physical burden of obesity but there is a strong psychological
burden for many who suffer.
The good news is that weight loss shows improvement in physiological health (how
you sleep and energy levels) and also in cognitive health (decreased thoughts of
hopelessness). Changing the body can help change the mind and changing the
mind can help change the body.
Weight loss surgery is considered the most durable way to lose a substantial
amount of weight. Your body and your mind—and your friends and family will thank
you when you overcome the perceived obstacles and seek treatment for your
weight. You are not alone when it comes to obesity or depression and there are
tools to help you be able to “move more” and “sleep better.”

08/27/2024

Take back your taste buds!
What you eat as an adult is influenced by where you’re from and who raised you. If you
were served “kids foods” as a child like chicken nuggets, hot dogs, and pizza, then as an
adult, you may favor those foods because they are familiar.
If you’re in that situation, there is good news. Genetics and culture don’t need to
determine your food likes, you have control over exposure. You can expand your palette
by trying new things. It will take effort, multiple attempts and getting out of your comfort
zone, but your new favorite foods may be yet to be discovered.
If you zoom out from your upbringing to a world view of food, the cuisines vary in
each culture. There are rich flavors and variety in French, Asian, Mediterranean or
Korenan cuisine. Few of those cultures offer a “kids” menu. Children eat the same foods
as adults.
If you feel like you have the palate of a 10 year old, try these tips:
● Start Small. Try something new each week. Get out of your comfort zone.
● Cut back on processed foods and foods with added sugar. Processed foods have
intense flavor enhancers that can dull the flavor of other foods. These foods have
hijacked our taste buds.
● Savor foods. Let the textures stand out. Think about what you are eating.
● Chew the food well. As it mixes with saliva, it will bring out the flavors.
● Experiment. Sample cuisines from around the world. Be brave!
● Make a commitment to try foods again even if you didn’t like them the first time.
The more times you’re exposed to a new flavor or texture, the more likely you are
to like it. It takes effort and experimenting but it works.
● Try to develop your palate for savory. Try bitter foods.
● Stop smoking and cut back on coffee.
“What you eat today is what you crave tomorrow.”
People “like what they eat rather than eat what they like.”
We get 10,000 new taste buds about every 10 days!
Food preferences can change over time.
Keep trying new foods!

08/23/2024

Walnuts
14 halves, 1 ounce, ¼ cup
4 grams carbohydrate
2 grams fiber
4 grams protein
18 grams of fat
Excellent source of Omega 3 Fatty Acids
99% of walnuts grown in the US are in California’s Central Valley.
The oldest food tree known.
Try them toasted with seasonings.
https://walnuts.org/recipe/rosemary-and-sea-salt-walnuts/
https://walnuts.org/recipe/toasted-spiced-walnuts/

08/21/2024

From Tina-As a dietitian, these are some of my favorite things patients or their spouses have told me after they had weight loss surgery:
“I don’t set out my clothes anymore at night. I used to do that because if I woke up in a good mood, it would make me in a bad mood when I had to try to find something to wear.”
“When I get off work, I drive home in the slow lane and listen to music so I can be calm when I see my family. This has worked better than stopping by the vending machine and eating potato chips on the way home.”
“I have to think of a new goal this January. Every year- for the last decade-I say I’m
going to lose 75 lbs, and now that I’ve done it, I need to move on to something else.”
“I can tie my shoes again.”
“My husband saw me in a bathing suit for the first time in our whole marriage.”
“Instead of eating, I am pacing around my desk. I”m learning to manage stress and
anxiety in a new way and it actually helps!”
One husband said, “Thanks for giving me my wife back. She is herself again. She used to like to watch movies and now she is doing it again. It was something she always loved but stopped doing.”
An elementary school principal shared, “I can walk with a coworker down the hallway
and not get breathless having a conversation.”
“I can walk up to the bleachers again and watch my kids play sports.”
“I can play on the floor with my children and not worry about how I’m going to get up.”
One of my favorite memories is when a patient called me from Big O Tire, to let me
know she was able to fit in the chair easily and just 8 weeks prior she had left crying
because she didn’t fit.
And another patient called to tell me that every time she gets out of the car she feels
like she’s missing something. She said, “what I’m missing is 75 lbs of me!” I can get in and out of the car now without any trouble.”
My heart warms up just recalling these wonderful things people gain by losing weight with bariatric surgery. It’s an amazing tool for lifestyle change.
These are things we could all take for granted. Let's cherish the results and the moments.

08/20/2024

Weight loss journeys and obstacle courses — what they have in common:
Anticipate hurdles and develop good strategies to overcome them.
It takes mental and physical strength to overcome hurdles.
Sometimes, despite your best efforts, you may have a setback.
Learn lessons from trip ups.
Get inspiration from others.
Listen for those who cheer you on and want you to win.

When the road to weight loss seems long, what will keep you going?
Obstacles typically come when you are exhausted — what will you say to yourself?
What will keep you motivated to finish the race?
What are reasons to keep going?
How far have you come?
What’s the best thing you’ve learned about yourself so far?
What good things have you learned about yourself along the way?
Who are the people that help you cross the finish line?

08/16/2024

Ghee
1 TBSP
14 grams of fat
0 grams carbs or protein
It is clarified butter- it doesn’t contain water or lactose.
High in Omega 3 fatty acids.
Contains the medium-chain triglyceride- Butyric acid which improves gut health.
Handles high heat.
Used in Indian and Middle Eastern cuisines.

08/14/2024

Many of us have been watching the Olympics and are in awe of the determination. Some Decisions are Life-Changing.
Steeplechase runners know about facing obstacles and overcoming hurdles. They
expect them —literally —in their path.
Watching Kenneth Rooks win a silver medal in the men’s 3,000m steeplechase at
the Paris Olympics was exciting to say the least. If anyone can teach a lesson
about overcoming obstacles, it’s Kenneth.
In July 2023, he fell in the steeplechase race while competing at the USATF
outdoor championships. He rolled twice, got back and went on to win the race!
https://youtu.be/wT1ody_cpCA?si=Lztcd3izxPSQpPzK
After winning the silver medal, he referred back to that race, “I think the lesson
that I learned is that it’s really important to just choose to keep going,” ... I made
that decision to get up and keep going.”
That’s what distinguishes a winner — the choice to get back up and keep going.
For anyone on a weight loss journey, that choice to keep going- despite setbacks
is an important response.
Just like a runner prepares for steeplechase by training for hurdles, you too can
anticipate and prepare for a sometimes challenging course on your weight loss
journey by keeping these things in mind:
Believe in yourself.
Find your rhythm.
Falls are inevitable.
If you fall down, you can get back up.
Learn from those around you.
Keep your eye on the finish.
Have others cheer you on!
There may not be an olympic medal at the end or your weight loss journey, but it
can certainly be rewarding and life changing.
Weight loss surgery can help you stay the course, minimize trip up triggers and
help you anticipate and navigate obstacles with confidence. Weight loss surgery
helps you get in your rhythm and will help you cross the finish line.
We want to be part of the team that cheers you on! Decide to keep going!

BYU's Kenneth Rooks fell with 6 laps to go in the men's steeplechase final at USATF Nationals, but he got back up and rallied past the favorites to win the n...

08/13/2024

There is a strong connection between osteoarthritis (OA) and obesity.
OA is a degenerative and progressive joint disease. Being overweight puts more
pressure across the joints and being overweight causes the fat cell to release
inflammatory cytokines that cause further damage to joints. The knees, hips and
ankle joints help with mobility and they are negatively affected by both the extra
weight and fat cell inflammation.
Experiencing joint pain is one of the most common physical reasons why a person
may want to lose weight. Can you relate?
“My knees and hips hurt!”
According to the Obesity Action Coalition (OAC):
● The higher the BMI, the more severe the joint pain symptoms and severity.
● Aperson with obesity is 60 percent more likely to develop arthritis than
someone of normal body weight.
● Force across the knee joint is 3 times one’s body weight while walking, 6
times one’s body weight while stair climbing and 10 times one’s body weight
while jumping.
No wonder it hurts to climb stairs! That’s a lot of pressure.
The good news is that weight loss is one of the best ways to relieve the pressure
and prevent further damage. Consider these facts from OAC:
● For women with obesity, for every 11 pounds of weight lost, the risk of knee
osteoarthritis drops more than 50 percent.
● Weight-loss can significantly improve the symptoms of patients with
osteoarthritis by restoring function and quality of life and preventing more
than 100,000 total knee replacements each year.
● Intensive weight-loss will reduce inflammation and joint loads sufficiently to
alter disease progression.
● Both exercise training and weight-loss decrease overall inflammation.
There’s enough pressure in life without adding pressure to your joints. It’s time to
lose those extra pounds.
________________________________________________________________
If you are overweight, it’s probably not surprising that extra weight can cause
damage to your joints — you’ve likely felt it- especially in your knees and hips.
The force across the knee joint is three times your body weight when walking and
six times your body weight when climbing stairs.
If you are 250 lbs, that's 750 lbs of pressure while walking and 1500 lbs of pressure
going up stairs. No wonder it hurts!
If you are 300 lbs, that’s 900 lbs of pressure while walking and 1800 lbs of pressure
climbing stairs.
That amount of pressure may be hard to imagine, but it might validate the aches
and pains you feel with walking or going up stairs.
There’s enough pressure in other areas of life to have pressure and pain in your
knees and hips. Lose weight to stop the damage caused by obesity.
__________________________________________________________________
Obesity is the most modifiable risk factor for osteoarthritis.
__________________________________________________________________
The earlier the onset of obesity, the more damage is done to the joints.
_________________________________________________________________
Weight bearing joints allow us to hold up our body weight. The ankles, knees and
hips are the primary weight bearing joints. The more you weigh, the more pressure
on your joints. Overtime, carrying around extra weight puts too much pressure on
these joints and they can wear out which makes it painful or difficult to do
necessary things like stand, walk or go up stairs. This painful condition is called
degenerative joint disease (DJD) and it increases with extra weight.
Reduce your risk of joint damage by losing weight. The risk for joint damage
increases with higher BMI and women tend to fare the worst. Women with BMI >
25 had significantly higher risk of developing osteoarthritis than those in a normal
weight (BMI < 24). For women, every 11 lbs of body weight lost reduces risk of DJD
by 50%.

08/09/2024

Coconut oil
1 TBSP
14 grams of fat
0 grams carbs or protein
Most beneficial form is cold pressed, unrefined, or virgin coconut oil.
High in medium- chain triglycerides. (MCT).
Can help ease digestion.
It supports the immune system due to high levels of healthy fats. Fights off fungus, viruses
and bacteria.
Can minimize risk of insulin resistance because MCT can be absorbed directly into the liver
and converted to energy.

08/07/2024

What is the connection between obesity and GERD?
To state it briefly, the connection is strong. The higher the BMI, the worse and more
frequent GERD symptoms become.
When stomach contents back up into the esophagus, it can feel like a burning
sensation in your chest or even cause a bitter taste in your mouth.
What you are feeling or tasting is stomach acid. In medical terms, “heartburn” is
called GERD (gastroesophageal reflux disease).
Although the discomfort can last several hours, there is a bigger problem.
Stomach acid can damage the esophagus.
Obesity is one of the most common reasons people suffer with GERD in part
because too much belly fat puts pressure on the stomach. This extra pressure
causes the lower esophageal sphincter to weaken and instead of closing and staying
shut, it weakens and opens and stomach contents go the wrong direction — back
into the esophagus.
The damage that occurs can become serious. It might start with inflammation or an
ulcer and then lead to more serious conditions such as Barrott’s esophagus which is
the main risk factor for esophageal cancer.
Surgical weight loss has shown a greater improvement in controlling GERD than
surgical treatment for GERD alone.
If you are suffering with GERD, here are some things to know:
The key lifestyle intervention is losing weight.
BMI > 30 risk of GERD is significantly higher.
The higher your weight, the higher your risk of developing complications.
The more weight that is lost, the more there is resolution of symptoms.
Obesity is the most common cause of GERD. Don’t let the symptoms keep getting
worse as they can lead to more serious issues than heartburn. Explore surgical
weight loss options if you have not been able to lose and maintain a healthy weight
on your own.
A Scandinavian study found that people with excess weight may be up to 6 times
more likely to have GERD than those with normal body weight.
Obesity is the most common cause of GERD.
More than 60 million Americans experience symptoms of GERD monthly and almost
half of those on a daily basis.
Men with BMI > 35 are 3.3 times more likely to have GERD symptoms than men at
normal body weight and women fare even worse, they are 6.6 times more likely to
have GERD.
Some likely dietary triggers for GERD:
Caffeine
Alcohol
Carbonation
To***co
Chocolate
Spicy foods
These foods may relax the sphincter and cause food and stomach acid to go into
the esophagus.
Reasons that GERD is higher in people affected by obesity:- Increase in intra-abdominal pressure- Hiatal hernia is more prevalent- More sensitive to acid in the esophagus- Vagal nerve abnormalities. This means that obese people may secrete more
bile and pancreatic enzymes which make the stomach acid even more
irritating to the lining of the esophagus.

08/01/2024

We are excited to announce our August POTM, Michael Morales! "I first became aware of the severity of my obesity way back in the 90s, when I reached 330 pounds. It was a few years before I started working on it, but lots of failure made me realize I needed help. After the death of my father at 66 years old in 2020, I knew it was time to get serious. I started the pre-surgery diet at 304.9 pounds in August 2021, and today I hover around 180. I walk an hour a day, time-restrict my eating (grazing kills!), and spend a few hours in the gym each week. My company requires a blood panel every year, and it's been amazing to see all my levels fall into normal range. Since my surgery, I actually enjoy life! I enjoy meals and being out with friends. I enjoy my clothes. I enjoy meeting new people and just being myself. I can keep up with my grandkids and don't have to sit on the sidelines of life, limited by my own body. In other words, I have found a lot of joy where I previously couldn't!"

07/31/2024

High blood pressure is called hypertension.
About 75% of people with hypertension are obese.
High blood pressure is often called the silent killer because it doesn’t show
symptoms. However if left undiagnosed and untreated, it causes damage to the
blood vessel walls that can lead to heart disease, kidney failure, strokes and even
blindness.
Hypertension means the force of the blood that pushes against your vessels is too
high. It causes tiny tears in the blood vessels.. When the body tries to repair these
tears, it can cause a build of plaque that leads to heart disease.
It can lead to serious problems with the heart, can cause stroke and is one of the
leading causes of kidney disease.
High blood pressure can damage your arteries and your heart. The high pressure
against the artery walls causes them to stretch. The artery walls thin out and can
rupture causing a stroke or aneurysm.
Many people who undergo bariatric surgery can see improvements in blood
pressure within the first week after surgery. As they continue to make lifestyle
changes and lose weight, many patients are able to get off medications completely.
The Journal of the American College of Cardiology found that bariatric surgery is
more effective in controlling hypertension rates in people with obesity than blood
pressure medication alone.
Bariatric surgery may initially help control blood pressure by lowering certain
hormones in the body. Further weight loss and the accompanying motivation may
also allow a person to make key dietary and lifestyle changes that can get
hypertension under control without the need for ongoing medications.
Bariatric surgery can help reduce inflammation in the body that can lead to
hypertension.
Bariatric surgery and the accompanying weight loss can allow a person to have a
more active lifestyle and prevent or reverse many diseases such as diabetes and
hypertension.
If you are struggling with hypertension and considering weight loss surgery, it is not
contraindicated. In fact, it can help control and reverse hypertension with the
accompanying lifestyle and dietary changes.