Jamie Mills , RDN, CD-N (aka “The Sleeved Dietitian”) on Breaking Plateaus and Maximizing Nutrition After Bariatric Surgery

Despite what anyone says, bariatric surgery is NOT the easy way out. Much like GLP-1 medications, it’s just a tool. To truly succeed, you need a full toolbelt—one that helps you overcome restriction, food guilt, fear of failure, and the uncertainty of how to eat post-surgery. The good news? You don’t have to navigate it alone. With the right education, support, and resources, you can create the post-op life you’ve always dreamed of.

In this episode, Jamie Mills, aka The Sleeved Dietitian, shares her inspiring journey of overcoming PCOS, a lifelong struggle with weight, and how bariatric surgery helped her achieve lasting change. After undergoing VSG in 2017, Jamie lost over 135 lbs and gained a new life, but she quickly realized that post-op support was seriously lacking. Now, as an award-winning registered dietitian nutritionist, Jamie is closing that gap and empowering women to thrive after surgery.

Listen in to hear Jamie’s top protein hacks for busy people, her secret to busting through plateaus (spoiler: it’s about adding more, not less!), and why the restrictive post-op diet isn’t meant to last forever. She explains how to transition into a sustainable way of eating while embracing empathy and understanding throughout the weight loss journey.

References

Connect with Jamie:

Website: https://thesleeveddietitian.com/

(Use code “drmatthea” for $20 off the $99/month TRIBE membership program)

Instagram: @thesleeveddietitian

Tiktok: @thesleeveddietitian

Book: The Easy Way Out: Why Bariatrics Isn't Cheating Obesity, It's Treating It

Audio Stamps

01:27 - Dr. Rentea's guest, Jamie Mills, also known as “The Sleeved Dietitian”, shares her background as a registered dietitian specializing in bariatrics.

05:30 - We hear some of the top nutritional challenges that patients face after weight loss surgery.

12:35 - Jamie shares her best protein suggestions, highlighting quick, high-quality options to help patients meet their nutritional needs.

15:35 - Jamie emphasizes that meal planning doesn't have to be complicated or time-consuming and shares simple, prep-ahead options for busy people.

21:27 - Jamie shares her secret to busting a plateau and reminds us that the goal isn’t always about losing w

All of the information on this podcast is for general informational purposes only. Please talk to your physician and medical team about what is right for you. No medical advice is being on this podcast.

If you live in Indiana or Illinois and want to work with doctor Matthea Rentea, you can find out more on www.RenteaClinic.com

Premium Season 1 of The Obesity Guide: Behind the Curtain -Dive into real clinical scenarios, from my personal medication journey to tackling weight loss plateaus, understanding insulin resistance, and overcoming challenges with GLP-1s. Plus, get a 40+ page guide packed with protein charts, weight loss formulas, and more.

April 30/30 registration.

Transcript

0:28

Welcome back to another episode of the podcast. So whenever I bring someone on the podcast, you know, listening, we don't bring random people on here. I either have been following them a long time. I myself am either in their memberships, reading their books, having really liked what this person has to offer. And so today I am so excited to have Jamie on. She's a registered dietitian has an amazing membership book. Other different handouts, like we're going to talk about all of this, I was so excited when your team reached out because I had already been following you a long time. I've learned so much from you. And I know that basically everyone that listens to my podcast, they're either on a GLP one, a lot have gone through bariatric surgery. Actually about 60 percent of my practice at this point has had a history with bariatric surgery. And so, you know, You just provide such great evidence based information that is so helpful on so many different levels. Can we start out today with you just introducing yourself, who you are, how you help people? I know I said a little, but just that people have a little bit of context when we start. Absolutely. Thank you for having me on. So I'm Jamie. I am a registered dietitian and I specialize in bariatrics. I always feel that even I'm sure you've talked about this on your podcast to clarify that bariatrics is the field that treats obesity, both with surgery and medication. So I help in both aspects. But primarily, I have started off in this field really supporting people on the surgical end of things, and the reason for that is I had surgery myself. So, a lot of people know me as the sleeved dietitian on Instagram, which is funny because a lot of people think the sleeved means like a sleeved, like, tattoo, which is not true. It's funny and ironic because I do have many tattoos, so it makes sense and I get that. Well, I have the double mooning. Yeah, but the sleeved, which is, I didn't actually have tattoos when I made money. Anyways, I digress. The sleeved means, the surgical sleeve. I had the vertical sleeve gastrectomy in 2017. A little backstory to that. So I struggled with my weight my whole life. I had childhood obesity. I was over 200 pounds by the time I was 10. When I was 14, I was diagnosed with PCOS, polycystic ovarian syndrome, and my weight was just a roller coaster my whole life. A lot of people do assume that I became a dietitian after my weight loss surgery, and while that's technically true, I did pass my RD exam and finish up school. Post bariatric surgery, I was well on my way to becoming a dietitian before that decision. So I like to do all the things all at once. It's very much in my nature. So during my clinical internship, my dietetic internship year, the last year of school doing all the clinicals and all the really hard stuff, it's when I had my surgery. So What I realized through having weight loss surgery was there's just not a lot of support, especially for post bariatrics. I remember thinking so many times, because I had so much anxiety and hesitations, and I felt this Immense amount of shame and almost like a hypocrite because of what society had told us about it being this this cheat this easy way Out I'm like, oh my god, like here I am about to be a dietitian and I myself am struggling still and need more help And I ended up having surgery. My dietitian was wonderful I enjoyed my surgical center, but it still very much felt like here is your post op diet On your way, good luck. And I remember thinking, I'm like, okay, I have a degree in nutrition and I am struggling. How in the world is anyone who doesn't have a background in this figuring this out? Cause it's not just simply following the diet. It's like, how do I make this my life? So fast forward. That's really what I do now is I support people with how do you actually take what your surgery center or your dietitian or your you know, doctor is telling you to do and do it. We work through a lot of the barriers, the lifestyle changes. We work a lot on, you know, mindset shifts. So it's not just a diet, but, you know, a way of life. And that is really what I support people with. And we talk a lot about the nuances. It's not one size fits all. I talk a lot about how obesity is a very complex disease. And everyone, it's kind of like a big puzzle. Everyone's puzzle pieces are a little bit different and everyone needs different tools and resources. and ways of managing it. So that's really, what I do now. And of course now with GLP 1s being what they are, so many of my patients are on GLP 1s. I've been on GLP 1s now twice in my life. Once, about two years ago, I struggled with a little bit of regain, nothing crazy, but it ended up being the right choice for me. Got off the GLP 1, got pregnant, and now I am six months postpartum and back on a GLP 1. So I speak a lot about that journey too. Yeah. Oh my God. First of all, congratulations. That's been really fun to follow up. And I wanted to say everything you're saying resonates so much, how it's like you can know all the information, but how do you actually implement it? Implement it. And when you're talking about how it's so complex and also not being the one size fits all, this is something that I find as well, that people think it's, you know, one diet plan, one, this one, that's like, no, it's going to have to really be tailored. I thought of some questions ahead of time, but I'm also really open to just kind of seeing where our conversation goes. But what I thought we could start with, because I, this is an area I don't see people talk enough about, and I'm wondering if you can maybe speak to a few of the top nutritional challenges that patients face after weight loss surgery, because I know there's several different types, but what do you, what do you see as a problems that they encounter? So I could probably list about 10 of these, but I'll start with one of the most common ones. when it comes to the post op diet. So bariatric patients need a heavy emphasis on protein. And I like to explain, it's not that bariatric patients need more protein than the average population, it's that your stomach size is so limited in what it can hold that protein is so essential to avoid protein calorie malnutrition and muscle wasting and really ensuring your, you know, your overall metabolic health. So getting enough protein in, especially when certain proteins, you know, might not make you feel good, or they, you know, everything kind of tastes and feels different. So making sure that you're getting adequate protein is a, is a big challenge, especially, you know, when it comes to following that typical prescribed post op diet. The other two challenges are ones that I don't see talked about enough. Number one, eating enough. So there is a huge misconception that after weight loss surgery, you're going to eat itty bitty teeny tiny portions for the rest of your life. And while the first six months to a year, you are eating very small portions, usually somewhere between anywhere from two to six ounces, really depending on your surgery and everyone's restriction is very different, which I could talk about that all day long. But I like to explain to people, it's not that your stomach's going to stretch in the sense of like you ruined your surgery, but the stomach is a muscle and as you heal and the internal sutures go down and inflammation goes down, your stomach does regain some of that elasticity, which means it's going to expand a little bit and you can and should be able to eat more. So I see so many patients feeling like, Oh my god, I ate a few more bites, I'm going to ruin my sleeve, I'm going to stretch my stomach out. And it just ensues this, like, panic, and there's a huge comparison trap on social media, it's like, Oh, but they're full after two bites, I need to, like, I'll finish my plate. So there's, A ton of this, right? I see this. Why are we comparing? Because some of them are doing more volume based eating, but like the calories look equal. It's like, why are we doing at all? And I think it's because we end up after surgery with this like tunnel vision. It's like, this is what I'm supposed to do. I am now a bariatric patient. A lot of people hold their self worth to their food, like how much they're eating, which can very quickly turn down a very disordered road if it's not something that you're actively working on. And along with that, the third thing that is a huge challenge. So, you know, accepting and acknowledging the fact that you can and should be able to eat more. And part of why I say should is no one is meant to eat such a restrictive diet long term. When you are right out the gate. It is very common to be eating eight, six, 800 calories or less per day. That is not sustainable long term, nor should that be the goal. As you're able to eat more, you are encouraged to do so because I ended up seeing people who never expand their diet, who never add foods back in. And yes, it's restrictive for a reason. You know, that first year you're full of, after just your protein, you're not eating tons of carbs, you're not eating tons of other things. But as time goes on, we should be integrating those back in. And that kind of leads me to my next challenge is Feeling like you have to eat bariatric friendly all the time and bariatric friendly really is high protein, low carb, low sugar, which is ideal for weight loss, ideal for hitting those protein needs. But as you're able to eat more, you should be having more variety. And I try and explain to my clients and the people in my membership, you know, all foods fit, just not all the time. Like, yes, we still need to prioritize. We still need to have protein first, but, you know, you should get back to a relatively, normal balanced diet and I think a huge challenge is accepting that You can eat a variety of foods and trusting yourself to do so So these last two pieces of nutrition challenges aren't necessarily like hitting that protein hitting that water. Like yes, those are challenges but the bigger picture, again, really ties back to that lifelong nutrition struggle. So I really help my, my clients prioritize their goals. We still want to lose weight and keep it off, but also finding that balance where you can have variety because no one was meant to live on the super, super strict post op diet long term. And that's something that I think I could talk all day about also, but you know, a lot of the times, you know, back to what I experienced firsthand, there's not a ton of post op support. It's like you progress to solid foods. You have this teeny tiny limited list of protein only or veggie only foods, and then no one is there to support you. to increase over time or to add foods back in and unfortunately many bariatric centers don't believe in the philosophy I believe in and say no this is your strict post op diet you follow lifelong and we know that that doesn't work lifelong so that's something that is really hard for my client to reconcile with. Because while I never tell them not to follow their bariatric diet, it's my job to educate them and empower them to go back to their surgery center and say, Hey, I'm three years post op and struggling with regain because I'm trying so hard to avoid carbs, but then I'm binging and snacking at night. So how do we just add that balance in initially so that that scenario doesn't happen? Totally. Oh, you bring up such good stuff. What's this, this, the process evolving over time, I think people struggle with whether it's on a GLP one or post surgically everything you're talking about. It's so interesting because I think people want to be like, I found the way I'm sticking to it and I never change. And with our body, unfortunately, it's adapting all the time. And also our needs, like if you're perimenopausal, postmenopausal, very different than when you were. Maybe 19, 20 years old, right? So it's like things are always changing. Hormone levels are changing all the things. It's very telling also too, just like the strict diet culture. So for example, I have a really good family friend and he struggles immensely with his weight. Always has. Him and I have had a lot of conversations over the years and he's so stuck on this medically supervised diet he did at least 10 or 12 years ago because he lost about a hundred pounds. He's like, but that's what worked for me. And I'm like, It didn't work though, because you lost it super quickly, kept it off for like a month and immediately gained it back, but you're so hyper fixated, like that's what worked. And we see that a lot where it's like, I had surgery and in the, in the first year, all I did was measure my protein and that's all I ate. And I was so quote good. And I was so strict. That's what worked. I have to go back. And I'm like, no, we have to evolve. And that concept right there is really, really challenging. Yeah. Definitely. So, okay. Along those lines, I want to dig more into, I find that people often struggle to get enough protein in and something that's really great about this applies to both the post bariatric patients, but also GLP one patients often volume is an issue, right? What are some of the top sort of protein ideas that you have? So we definitely want the most bang for our buck. So really high quality. sources of lean proteins is going to be ideal, specifically when it comes to surgery. And this can also definitely be true for people who are just starting off their GLP 1 journeys. You do want to rely on some supplements. We don't want to always, food first is always a fantastic approach, but Again, the bariatric community surgical patients and GLP 1 patients are not the average population. So it is totally a okay to rely on protein shakes as long as you need to, but I want to emphasize as long as you need to because what I end up seeing is people not progressing, just relying on protein shakes. So a very common theme I see in my community is people will have, you know, or protein bars, which is fine, but then are not making high protein meals or snacks and just choosing whatever other foods they want. It's like, well, I had two protein shakes, so I hit my 60 grams so I can kind of eat whatever I want. We don't want to see that. As you're able to eat more, both with surgery and on GLP 1, you definitely want, I have like a meal plate method that I use with my clients where it's like, this is how we progress our diet. But as far as, so aside from like having the shakes and supplements when you need to, Any of the animal sources of meat, if you eat animal products, is going to be the ones of most like, high biological value. You're going to get all the essential amino acids. You can also get that, of course, with soy based products too. But what I've found that works well for me and a lot of my clients, and this might be not what every dietician would recommend, but Convenience is key. Don't make it hard on yourself. Like, I really suggest for people, like, choose the protein foods you like and are quick. I know for me, if I have to create a complicated meal every time I eat or prep it fully, it's not gonna happen. Like, honestly, one of my favorite sayings is good enough is good enough. Like, get that rotisserie chicken. Get the rotisserie chicken, shred it up, put a little bit of sugar free barbecue sauce, whatever you want on it, enjoy it. You know, I love low carb chicken nuggets. I love the, I think they're called like Simply Bear. They're like a low carb chicken tender. I throw those in the air fryer. It's got like seven grams of carbs and like 20 grams of protein. That to me is so much more enjoyable than the dry baked chicken. And it's so similar in nutrient content. So pick Especially when I was right, first post op. I was still doing my clinical rotations in school, so I needed really quick, easy options. A lot of times I had turkey, deli meat, and cheese roll ups in my bag, or like a meat stick, or a yogurt. Work smarter, not harder. So just those quick, simple protein options, you don't have to reinvent the wheel. That was actually what I was going to ask you, because I find that people being really busy, busy working professionals, what you're, I mean, prime example, you're talking about going to school, graduating, all the things. But I find, yeah, if it's not easy, people can't stick with it. Yeah. So I actually have a free meal planning guide on my website that is really helpful for like speaking fully to like this method that I use, but. I think people also get in their heads, like, well, I need to prep all my meals. And looking to social media, you see, you know, these influencers who have these pretty glass containers with everything perfectly measured and portioned and weighed and tracked. And I'm like, That looks awful. Which, if you like that, more power to you. Can I tell you, I wanted to be this in the past and I'm gonna level with you, I couldn't even have the containers clean on time. I was like, I can't even maintain the, the like, I can't tell you how many times I've bought, not glass, but how many times I've bought containers promising myself I'm gonna meal prep and then I'm so aggravated trying to fit them in my cabinet, I throw them out. Like, for me, that doesn't work. So, What I suggest is like, loosely prep. So have two to three protein options in your fridge. Have two to three veggie options. Have two to three carb options. So what that might look like is, okay, I've got hard boiled eggs in the fridge for the week, check. I have rotisserie chicken that I shredded in there that I can use on salads or wraps, check. I have, you know, I did, ground turkey taco meat, you know, that's in there, check. Or chili, whatever. Like, pick two to three just easy to grab protein options. Same with veggies. You know, microwave that steamable bag of broccoli. Take one cucumber, wash it, slice it, and put it in the fridge for the week. Bell peppers, whatever. Like, one simple step of, okay, I got home from the grocery store, let me wash the English cucumber I got. I can grab and go. Same with, like, the carb option. Maybe that's, you know, a low carb wrap. Maybe you prep some baked sweet potato. Maybe you have some, you know, clementines on the counter or a banana, which, yes, you are allowed to have fruit. You know, just pick, grab, and go options that you can mix and match. And, again, my free meal planning guide kind of goes over that in more detail. But meal planning or meal prep, in whatever term you like to use, doesn't have to be this strenuous process. It can be as simple as I have My rotisserie chicken. That's an example I use a lot because I love a good Costco rotisserie chicken. You shred it up, put it in the fridge, add it to a salad, add it to a wrap, you know, make a chicken salad out of it, whatever. It's easy. You know, cans of tuna, whatever, like make it easy. Because if you have to spend a ton of time, and some people thrive off of that more structured approach. Those people are not listening. I'm just here to tell you, we don't attract the people that want to do like elaborate meal planning and like cook. I'm in good company because I, and you know, it's funny because especially like as a dietitian, I think people like to assume that I like to cook and all that. I just made the absolute easiest. I'm going to just share real quick. The easiest meal last night for, for protein. So last weekend, my husband asked if I could make beef stew because he loves it in the wintertime. I'm sure. I got a big thing of stew meat from Costco. I did half of it for his other half month. He wanted me to do the rest of the stew meat. Found a recipe on Pinterest. I threw, I thought about it, threw it in the crock pot, put a ton of salt, pepper, garlic seasoning, and a couple slices of butter on top and just let it slow cook all day. Delicious. Yeah, delicious. We're gonna pair it with veggies and potatoes tonight. So good. It's so easy. Literally, I mean, I let it slow cook for like six hours, but took all of less than a minute and a half to prep it. Like, that's the kind of easy I want. If I have to wash tons of dishes too, hard no. Oh, I'm with you. So I'm a vegetarian. And like, for me, it's, do we have cottage cheese? Do we have Greek yogurt, hard boiled eggs? And it's funny when you bring up the like one thing quickly. So I literally had groceries delivered this morning. Like the weekend got away from me and Sunday night I was like, okay, by seven to 9am delivery was here by seven 30. I literally caught up a green pepper. Cause I was like, okay, for lunch today or whatever, we'll make sure to incorporate this. So yeah, it's like the easier where you can just make that one thing. I really love that because I think that. People think they're gonna have to get super creative, they're gonna have to like put all this work in and it's, you're never gonna sustain it unless you love it. And if you do, hallelujah, we're likely, we're not talking to you right now. It's actually like, you know, like for me in this season of life, it's a whole new level of busy, like I, My baby just turned six months this weekend, which is crazy, but I, you know, I'm trying to lose the postpartum weight now and I'm busy. And sometimes I forget to eat between being on a GLP one, but also I'm solely focused on him and running a business. So I need things, even though in a perfect world, we want to sit there and be mindful of the food on our plate, which I do preach that very much. That's me, like maybe half the time or less the other, like 60, 70 percent of the time. I've got a baby in my arms, and I'm grabbing a cold, air fried, low carb chicken nugget from the night before and doing my very best. And that's what I mean when I say good enough is good enough. And, but what I find is, people end up hyper fixating on how bad they did, how bad that is. They have this, I, this made up idea of what good and bad is. And I'm like, if it works, it works. Don't fix what isn't broken. I would so much rather see you grab a baby. Again, rolling with the same examples, the low carb chicken nuggets and pair it with some cucumber slices and, you know, call it a day versus try not to eat something or try just to have a protein shake or try to be quote, so good and perfect that you end up snacking or binging in the evening and night. And that is the most common theme that I see. A hundred percent. I see that too. People are like, I'm not hungry until two o'clock. I'm like, but every night, every night we're having the same situation go down. I'm like, yeah, So, okay, I want to pivot for one moment because people are going to take me out if I don't ask you this. So everyone always wants to know how to bust a plateau. They want the secret to what it's going to be. So if someone is they're working on things, they're like, I should be further down. Like that's reasonable for them to continue losing weight. Right. I always like to say that first because oftentimes people have really unrealistic expectations of their body. But if they've been at a certain place for, let's say six months and nothing's moving, do you have. Ideas that you suggest to them. Totally. First off, I want to say I appreciate you giving the scenario of like, okay, I've been in the same spot for six months and have more weight to lose. Because so often people like, it comes to me in a panic, Jamie, I'm at a stall, I'm at a stall. I'm like, you're not going to lose weight every week or even every month. Like that doesn't necessarily constitute a plateau or a stall. I get, I understand, or people say, well, I only lost half a pound in the last two weeks. I'm like, but you still lost. So you're, you're still going down. So. Slower weight loss is not, is not the same thing. So couple of things here. I think if we're talking specifically post surgical patients, sometimes your body really does just need time, especially this is, I see this happen a lot when people fall into that trap of, I only ate 600, 800 calories a day for a year. Now I'm able to eat more and I can't, for the love of God, get the skill to move. It's like, well, no matter what, we're going to be in a bit of a surplus. We're not going to lose weight yet. That's where, In that scenario, that is when I really suggest working with a dietician and work on, you know, slowly increasing calories, maybe doing some strength training, rebuilding, you know, that metabolism a bit, but more commonly when I'm, I shouldn't say more commonly, but what I'm often recommending to people is very surprising for breaking, breaking a plateau. And I always ask them to add more to their routine. So for me, I, I like all of our goals to come from a place of abundance, not scarcity. So rather than hyper focusing on taking the carbs away, taking the sugar away, less of this, less of that, I want us to simply figure out where we can add more. So I would encourage you, even if you're, you know, doing really great with your diet, and you know, you're hitting your protein and water goals. Can we do more protein? Can we do more water? Can we do more veggies? Can we do more steps in a day? Can we get more sleep, please? You know, try, like, how can we get more of the things that are going to serve us? Because oftentimes people are not resting. Our bodies cannot differentiate between sources of stressors. So if you're stressed with work, stressed with kids, stressed with, you know, holidays, running around, not sleeping enough. not eating enough, which stresses your body out. You're, you're going to run yourself into a hole. So, and then you're, you know, overstressing about the scale. Let's get like a good night's sleep. How can we get one to two more hours of sleep? Which I will say, again, nuances with every single suggestion. I get it, when you have a new baby, that's not always realistic. That is the exception. But for the majority of people, if you are able to, please. But it's like, okay, let's say you're hitting, you know, 60 to 80 grams of protein, which is ideal after surgery, or ideal after a GLP 1. Can you get to 90 to 100 grams? Can we add, again, you want to be mindful, you don't need too, too much protein, but my point is your body might need a little bit more. Can we, usually I say, well, let's add more veggies. Most people are not adding high fiber veggies in even once a day. It's like, okay, well, can we add just one more serving? Can we add one more serving of fruit? Can we add, you know, just one more glass of water? Can we, you know, because when we focus on what we can do, we're less likely to beat ourselves up for what we can't. So just mentally, that's very helpful. But two, what I find is that adding more approach. I remember, I think it was about a year or two ago, I did like a reel where I was talking just about this. And I remember asking people, I have a challenge. I want you to focus on more protein, more fiber, more water for one week and come back to this post. The amount of came back and were like, I broke my plateau. I'm like, see, because We end up in this restrictive state and again what ends up happening is we're in this restrictive state and it actually does lead to the snacking, grazing, binging that we're not even being aware of. So how can we add more of the the positives so that we're less focused on the negatives? And I find for a lot of people that approach does really help with stalls. You have said, so I was taking notes like a maniac here and you said so many amazing things. One that was like, this is a throwaway that, oh my gosh, we need to highlight it on a billboard that the body can't differentiate these different store sources of stress. Right. A million percent of that. Like I'm thinking about last week. So it was like, just happened to be one of the busiest weeks ever. A lot like longer work hours than ever, every single day. Do you know this weekend I have never in my life, like I always go to bed at nine. I know I go to bed early. But I normally get up at like five something and I slept till eight, both Saturday and Sunday. I know you probably want to shoot me right now, but, but my point is I was like, wow. And then I also took a nap on Sunday. I never do any of this, but it was like. It was not human what I put my body through the week previously. And I had to realize, I do really well with rest, with the walk, with water. I had to reset. It wasn't, I can't expect the scale to keep going down with that, right? I love that you said that too, because I will say, My baby, as of the last, three weeks, is, sleeping through the night. Not gonna lie, it's been phenomenal. He did wake up at, like, five today, and we struggled to get back down, so today was a little bit early. But, I, same thing, I have part time child care, and I'm still trying to run a So I'm working in the evenings when he's asleep, when he's not with our sitter or I'm not working in the evenings. I'm a full time mom. I'm the one primarily getting up at night because he screams if my husband tries. So today actually our, our caregiver got here at seven and I was like, I'm just going to go back to sleep for an hour. And I was supposed to go to the gym. I slept till. Like 10 o'clock and I was like, Oh my God. And I'm going to try and fit out a workout later today. If I don't make it, I don't make it because my body needed that more than it needed to push myself to go to the gym and then like drag my feet through today. So I don't know. I just, it must've been a lot for me too. Cause I knocked out and I don't ever do that. Yeah. It's like the listening, but I just love that because I, I think about, I sometimes with patients in November and December, a lot of people have a lot of stuff going on between like holidays or travel, things like that. And I'm like, Hey, can we actually make the goal to just maintain, maybe we're not actually trying to keep losing during this period. Right. Cause I love that you said that because I have a group coaching program right now and I gave all the women in the program permission to just maintain and the sigh of relief they all have. They're like, I never thought of that. But that's. And some of them are actually finding, even though their focus is maintaining, they're actually still losing. That's what I was going to say. Because they're not stressed. Exactly. They're like, we weren't working on losing. I don't know. I forget if it was two, three pounds that the, in the past month, but she was like, but then I was less stressed and I wasn't as worried. Isn't that so funny? Yeah. I know. I love that we're on the same wavelength with that. Yeah. I have, I have two, two clients in that program specifically who I was like, I don't, and I, you know, hard conversations, especially as bariatric patients. One is also in a GLP one too. And it's like a lot of people never, especially if you've struggled with your weight your whole life, if you've had surgery, if you're on a medication, no one has ever given you permission, not even yourself permission to just not lose weight. Oh my gosh, I know. And you, and as someone who struggled their entire life, I get it. It's like you're in this mad rush to hit that weight loss goal. The time's going to pass anyways. Let's maybe pace it a little bit better. And it's okay, like it's okay to not always be working towards weight loss. Ultimately, if that's your main goal, it's still my main goal right now after, you know, this past season of life. But I don't have to get there in one day. And it's okay to kind of take the pedal off the gas for a minute and just coast. And I think that's really, really hard for people specifically because no one has ever given them that permission. Especially if you're similar to me where you've been overweight since you were a child or a teenager. Everyone has harped on your weight your entire life. Every doctor, every person. So you just have it ingrained in you like, I have to lose weight. I have to lose weight. And I remember a couple of years ago, I've been in therapy since before my weight loss surgery. And I highly suggest it honestly to every human on this planet, but specifically the bariatric community. And I remember I had hit, like, my previous, like, lowest weight, this was years ago, like, I think I was, like, maybe two years post op. And she said to me, she's like,'Cause I felt like I still had to keep going, and at that point I did not. And she was like,'Jamie, who would you be if you weren't the girl who had to lose weight? And I just started crying because at that point in my journey, I didn't know. Like I had no idea who I was outside of my identity of having to lose weight. I've come a long way since then, and it's actually made losing weight, this go around after having a baby, much more enjoyable because I don't have all my eggs in one basket. That's not who I am. It's a part of my life. It's not my full life. And I think that's really, that took a lot of Like that conversation with my therapist was well over like five years ago, but that has taken a lot of hard in our work because my identity was so wrapped up in being the big girl who always had to lose weight. Thank you for sharing that. I feel everyone's going to be able to relate that's listening. I just had a patient write me over the weekend, what are ideas that you have for, for me being content now because they've reached maintenance and they're, They're struggling with that, you know, that again, like you're saying, if you're not, because what I always tell people is what's the rush, because what magical gets to happen at the end, right? We're the same person on the way down that we are at the end. So if we're always searching and wanting something different, it's very hard then at the end to be okay with where we are. To not always get reward two out of the scale going down. I, so that really hit me like a ton of bricks also. So I also, after losing just to kind of like generally give like a real quick synopsis of my journey, after my weight loss surgery I lost like 112 pounds, I kept it off for a little over two, almost three years, started to trickle back up a bit, gained about 25 pounds back, went on a GLP 1, lost another like 50, but in between that, after that initial weight loss, and then I regained almost 70 pounds during my pregnancy, so love that for me, back down again. But, All that to say, when I had hit that first low point after surgery, I did go through three rounds of skin removal. So I had some major plastic surgeries, but I remember thinking, because after, like, I got to my lowest weight then and didn't need to lose more than my head, I kept thinking again. I'm like, no, it's the skin. Once the skin is gone, then I'll be happy. Yes. Once this loose skin isn't masking, quote, how tiny I am under there, then I'll be happy. After my first round of skin removal, the body dysmorphia that took off and ensued was wild because it wasn't what I envisioned. And this promised myself like, oh, you'll be happy with your body image. You'll finally actually look thin. Like these mean like thoughts I would tell myself after you get to that point, like, then you'll be happy. And it's like, well, no, that wasn't it. That was a hard. hard pill to swallow because in my head, well, once the skin's gone, then I'll be happy. And you start to realize, because I spent a lot of my life, most of my life, especially growing up with obesity, especially as a child and like adolescent, I played with every problem on my way. I'm like, well, the reason I don't go out and socialize is because I don't have friends because I'm, I'm big, which I had. couple of close friends, but I was never like that girl going out and doing things. You know, the reason I don't go out on dates or I don't, people don't ask me out is because I'm a big girl. Like every problem I had in my life or like down point in my life, I pinned on my weight. And when you get to the end of it and you're like, wait, the problems I had before are my problems now. Like the things that stress me out, you know, worrying about, you know, just like the average human worries, like worrying about bills, worrying about this, being stressed about whatever, like. It doesn't all just go back to your weight. And in my head, I, this is going to sound so ignorant, but growing up the way I did, I truly believed if you were like a naturally thin person or someone who didn't struggle with your weight, Like, what in the world do you have to complain about? Like, what do you have to be upset about? I really didn't think then people had problems, or if they did, I thought it was stupid. I'm like, at least you don't have this problem, because it was such a big looming struggle for me my whole life. I think everyone can relate to this, though, that like, again, same with me with childhood overweight and obesity, that when you've struggled your whole life, you think if that could be solved, like, all the rest of this goes away. Because it's such a big problem, and again, it's a focal point. that everyone kind of pinpoints in your life and that you hyperfixate on. So again, that took a lot of therapy, a lot of inner work, you know, looking at my own judgments and figuring that out. That was, because it's hard, you get to, and there's, there really is no end to this journey, and I think that's hard too. You kind of think like, ah, I got the weight off, check, done, and it does not work like that, especially knowing that obesity is a disease. And I, I think this, I don't want to pivot too far, but I think this is another important point to like, look at your own bias. Like when I first had my surgery, I can remember not meaning to judge other people. Like I'm not like a judgmental person, but we all have that in our voice. And I remember seeing other people in the community sharing about regain or gaining all their weight back. And I remember thinking that would never be me. Like I can never By the way, that's very common with the data. That is like the reason I started my clinic because of the shame that a patient was crying in front of me. How she had regained. And I was like success is, is considered less than 50 percent regain within 10 years. So that's right. Yeah. Right. And at the time I remember even ignorantly thinking to myself, I'm like, well, I'm going to always stick to this. I'll never be that person. And the message I have for every single person is not any one person is immune to struggles or regain. And I talk about this in my book. I'm like, in that moment, the universe heard me and said, ah, we're going to teach her a lesson. And again, I gained about 25 pounds back in that left me pretty distraught. I'm like, what in the world? And it felt like no matter what I did, this Despite helping all these other people, my PCOS symptoms were coming back, like all these struggles like were compounding again and it was very, very scary. And I don't think it's, at that point, especially even with my schooling, nobody was really talking about obesity as a disease. So really understanding the complexities of it, and I talk about this a lot, everybody is going to regain at least some of their weight. 100 percent to what you're saying. It's not a failure. It's a chronic disease that's very hard to manage. And the other thing, this is why I think that community is so important. And definitely I want to make sure here at the end that you tell us about yours, because if you are not talking to other people, or if your physician is not educating you on the data, you feel like I'm the only one where this is happening. And then you make it a willpower problem instead of listen. Some metabolic adaptations are taking over, some things we need to change. It's a very different approach versus when we also put shame into it. Makes it really heavy to take action. It's also really hard because I've experienced this first. So the bariatric community on Instagram is beautiful and lovely and I love the social media community. It's, you know, a huge part of my journey and where my personal community is. But there's a lot of judgment amongst each other because we're projecting our own insecurities. Again, like that thought of, I see this a lot, Brant, and now I have a lot more empathy and compassion for these people too. But when you are first out the gate after weight loss surgery and you're in that quote honeymoon phase, it's like, It is easy to look at other people and say, well, what did she do wrong to be gaining her way back? That'll never be me. But you don't know the struggles till you approach them and that's not to sound be like Some people have mistaken what i'm saying saying. Oh, you think i'm gonna fail? No, no, no It's I tell people this too. It's like once you've done this long enough either for yourself or working with people you realize that that this is not a reach the summit and you're done. This is for life. You have to keep figuring out how can I continue to see what works for me? How can I stay on track for myself? Different periods are going to look differently, post baby looks very different than when someone's going through menopause. Like it's just a different period. And we have to, the quicker we can learn amongst even the Bariatric community. There's a lot of judgment towards each other, even if it's not really recognized. It's easy to say, well, if you just do what you're supposed to, you keep it off, look at me, I'm doing great. And even if it's not said in those words, there's a lot of that kind of energy and undertone in certain people's, you know, posts and things. And I understand that, but then it's like, you come up to a point where you're like, oh wait, now I get it. It just, things change over time. And surgery is, A beautiful, amazing, incredible tool, as are the GLP 1s. But it's still a very complicated disease. And I think having more compassion for each other As well as from providers is very much still needed because the shame that is attached to it and I faced, it's crazy, I have never faced more judgment in my life than when I spoke to the very after community about going on a GLP one for the first time. Yeah. That was in 2022. So I had gone to the AS, I had gone to the ASMBS conference, American Society for Metabolic and Bariatric Surgery conference in 2022. And there was a panel talking about like the medications and this is before they were becoming more mainstream. I had already like caught wind of them just like working in the field, but that It wasn't in the media yet, right? So I remember one of the dietitians talking on the panel saying, what do you do when your patient regains? Not if, but when. And I, that really stuck with me, but they talked about the GLP ones and how incredible they are, especially for post surgical bariatric patients. So I went and sought out my own care, got on one. And I remember it was that August of 2022, I came on and I spoke very openly on my platform about it. I got either one of two responses. Oh my god, thank you, I've been on one and haven't told a soul because I've been so ashamed. Or I got, well, if you were actually doing what you were supposed to, you wouldn't need it. Or I got a lot of criticism too, saying, how are you going to support people on their weight loss journey with your nutrition approach if you can't keep it off yourself? I got a lot of, you must be like a bad dietician. And that was really hurtful. So what was great, I talked a lot about this in my book, but what was crazy to me is I got more judgment from the very community I was part of from other surgical patients. And I was one of the first people in that particular niche space online that was really openly talking about it. And since then, many others have, which I remember joking at the time, I'm like, don't worry, guys, I'll take one from the team. I know many of you are on them and aren't saying. Anything else trailblazers, which I feel in a way this was me and some other obesity med doctors when we were talking about how low this is, like years ago on Tik TOK. It's like, everyone was like, meds are going in a shortage because of Tik TOK doctors. I will never forget this. I was working in a clinic and the pharmacist was bashing quote unquote, the Tik TOK GLP one doctors. And I was thinking, yeah, I'm, I'm one of them saying there's options that people should go out and seek it. Right. But exactly. You advocate for the people you care for. I know. And so it's, it's whenever you're kind of trailblazing, you're like, look, this is, I mean, whenever people aren't talking about stuff, it's often what needs to be said. So I think it's super powerful that you were willing to do that because that's what ultimately leads to the change where people will be able to seek out the help that they need. I got a lot of like passive aggressive comments. I got a lot of nasty comments from people that I had even like, thought I'd become like friendly with on Instagram and supported each other. Like it was a really strange place to be in at that point in time. I don't regret talking about it at all. And I'm not taking credit for being like the very first person to talk about it. I just, at the time, not many people with larger platforms were talking about it. So it was super important to me to kind of take that shame away initially. And since then I've supported many people on them. And now they're so much more widely accepted, thank goodness. But it was just, it was a really strange experience to. Have the surgical bariatric community Again, some of them were like, oh my god Thank you so much. I've been thinking about going on one or my doctor recommended it and I felt so shameful versus other people basically saying, well, you're a hypocrite. It's like, this is like pot calling kettle black here because we all had surgery and everyone's told us we took the easy way out. Don't you get it? It's like, what do you mean? Like, so that was as not even as a dietician in this space, but just personally as a patient in this space, that was very hurtful. It's tough. I don't think people understand how hard it is actually to put yourself out there online and to talk about this stuff, because like you said, you're absorbing it. All the comments from all the people. It's very, online's a very interesting space because people feel like they can say stuff that they would never say to your face. I mean, they would just, they would never talk in this way in a comment and a DM. They would just never say these things. I had a really funny comment recently, funny. So I had a real talking about obesity as a disease recently. Cause if you followed me for even half a second, you know, I said. I say that, literally every day and this person was like, Unfollow. You're, just take accountability for your actions. I'm obese too and obesity isn't a disease. Like, you're just trying to make excuses. And like, I, I kept like, I usually don't answer troll comments, but I felt the need to keep prying at this one. And this lady was like, big mad at me. She's like, no, you're just Not taking accountability, and you're encouraging everyone else to not take accountability, it's not a moral, it's, or it's not a disease, it is a moral failing if you're not, I'm like, I feel so bad for you because you have been told this so often that you, like, I've had other people say, I don't think obesity is a disease, I'm like, well, I don't care if you don't think it is, it is, like, that, the internalized bias, right? I mean, I, I talk about this a lot too, I, I went through this myself of being like, I did, I don't know, like five years of weight loss coaching and all these things and kept being like, I need to work harder. I need to work harder. And I remember my friends at one point that, physicians, and they said, look, just go on this already. Why are you doing this to yourself? So it was this conversation that I too thought, no, I'm going to really like, I'd already been doing stuff for five years, but no, I'm going to really buckle down for six more months., it's just, yeah, it's, it's a lot that people don't feel like this kind of ties it. And I know we're coming up on time, so maybe we'll, I'll leave everyone with this thought, but just talking about like the weight bias, you know, everyone likes to say it's the easy way out. That's why I named it my, that's the name of my book, The Easy Way Out. Whether it's surgery, GLP 1s, or both, people are like, you're cheating. You're taking the easy way out. Okay. We know it's not the easy way out. We know it's really hard, but let's play devil's advocate. Let's just say having surgery or taking these medications makes it easy. Why does that make you mad? Why does it make you mad that I could achieve a healthy, sustainable weight without struggling? Why do you want to see me struggle to get there? So like, that's the bigger question. Other people, especially in like, The gym communities and like certain like aspects like, you know, the wellness influencers. It's like, well, you're cheating. You're taking the easy way out. Okay, coming from someone who most likely has never actually struggled with obesity and their weight. Why does it make you upset to see someone with obesity actually losing weight without it being super hard? Yeah. And it's not that it makes it easy. It makes it more manageable and doable. And it levels the playing field for people who have struggled because people who've never struggled with their weight just don't, can't possibly understand. And it's, it's wild that it elicits such, such anger in people to, and again, it goes back to that weight bias and the way people in larger bodies are treated. And it's really gross. The thing I want to say here, too, is that there's no winning. So, if you don't do anything, you're, you're doing it wrong. If you do do all the things, you're doing it wrong. There's absolutely, even if you're doing stuff, that's the wrong thing you're doing. So, you're going to please no one. So, I don't like that. I really love it. Back to my, I really, a lot of things back to my social media posts, because that's where I put out, like, all my content. But I had a post recently, too, where it's like, you know, like the Twitter style, like, text. It's like, society. do anything and everything possible to lose weight. It's like, okay, has bariatric surgery and goes on GLP 1. No, not that way. Like, no, not that way. It's like, oh, okay. So I have had the best conversation today with you. I know everyone's going to enjoy so much what we talked about. Can you tell everyone real quick, tell us how they can find you, tell us what you have going on right now, just so we, and we'll make sure to link all that in the show notes as well. Amazing. So the best way to find me is at my website, www. thesleevedietitian. com. Dietitian with a T, not a C. Sometimes that confuses people, but, my social media handles are also the Sleeved Dietitian. On my website, you'll find my free resources, including that meal planning guide I was talking about, links to my services and products. My main service that I offer is my membership. It's called the tribe membership. It's an acronym that stands for the real insights of bariatric eating. It is a super robust membership when you join you get access to all of my self paced video training modules where I teach you step by step how to navigate your diet both as a bariatric patient and it's also applicable to GLP 1 patients. I've got dozens of extra modules in there. We have ones on plant based eating, traveling after weight loss surgery, pregnancy after weight loss surgery. There's dozens of guest expert calls, hundreds of recipes. We have workout videos created by personal trainers. So you have this huge like resource library of Kind of that one stop shop of the things that you need to, to get to arm yourself with education to be successful. But the real dreaming part of the membership is our live calendar. So every month we have approximately 20 to 30 live events. We have support group leaders. I leave the Q& A's and the guest expert calls, but I have an incredible team of women who have had weight loss surgery and are also professionals. We have other dietitians, we have therapists, we do emotional eating support groups, body dysmorphia support groups, we have a GLP 1 support group. We have pre op, newly post op support groups. We have so many different niche support groups. Another popular support group is our habit planning for people who are neurodivergent. There's a huge, sector of our community who has ADHD or is on the spectrum, so we have specific support groups for them. So we've been able to branch out and offer, again, that really niche support in the bariatric space. So you come on and you can, you know, go through these resources at your own pace and then still have access to. You can have access to the calendar, too, to come on for live support. It's 99 per month, no long term commitment. And I would absolutely love if you're okay with it, we could also offer a special discount of 20 off for your listeners. Yeah, that would be amazing. I mean, gosh, it's such an amazing community, right? Where it's like all these different areas that people are going to struggle with. I think you are phenomenal in this space. I would love that. That's great. So if you can get that to us, we'll make sure this is going to go up not too long from now. We will put all the show notes. Thank you so much for coming on. I appreciate all the things that you offer and I know everyone's going to be so excited to listen. Well, thank you. It was such a great conversation. I really appreciate you having me.