Episode 75: The Truth About Alcohol and Bariatric Surgery

In this episode of the Pound of Cure Weight Loss Podcast, Dr. Matthew Weiner breaks down the surprising connection between gastric bypass surgery and alcohol metabolism. You’ll learn why a single drink can hit harder post-op, how the altered digestive system impacts blood alcohol levels, and what this means for addiction risk after surgery. If you’ve had bariatric surgery—or work with patients who have—this episode offers must-know insights into post-surgery physiology, safety, and long-term success.

Whether you’re questioning if you can still enjoy alcohol or are concerned about the risk of transfer addiction, Dr. Weiner separates myth from fact in a way only he can.

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Transcript

Matthew Weiner (00:00)
Hi everybody, I'm Dr. Weiner, I'm here with Deidre. Welcome to the Pound of Cure podcast. We've got another Q and A session.

As those of you who know our practice or have listened to our podcast before know, Deidre is a nurse practitioner in our practice. She and I really work as a team. She assists me in the OR. She's really an integral part of our surgical program and really our non-surgical program too. Anybody having surgery has seen and met with Deidre and understands she's been doing this for a while and she really has a lot of expertise and is great at helping patients navigate the before and after parts of surgery.

Welcome, Deidre. Good to have you on again.

Deidre Schodroski (00:37)
Thank you.

Matthew Weiner (00:39)
All right, so we've got a Q &A session today, correct?

Deidre Schodroski (00:43)
Yes, we're going to answer some questions about bariatric surgery. Our pack has this.

usually focused on GOP1 medications and there's a lot of new news coming out about that today. But today we're going to talk more about surgery. So I found a couple of questions that came from patients that will help us kind of explain some of the things that can happen after a gastric bypass and sleeve to go

So our first question from one of our patients is, had a gastric bypass about five years ago and I've been having some upper abdominal pain after eating and I'm nauseous all the time. I think I eat pretty well and I'm drinking plenty of water. The only things I take are my multivitamin and sometimes I take excedrin migraine for headaches. Why does my stomach hurt all the time? I think that this...

Matthew Weiner (01:29)
What do you think, Deidre?

Deidre Schodroski (01:31)
this question really addresses probably a marginal ulcer. The first thing is that this patient had a gastric bypass. And after gastric bypass, you can no longer take NSAIDs, which include ibuprofen, motrin, aspirin, naproxen, Celebrex, Mobectoridol. And what a lot of people don't realize is that many medications for migraines and...

Cold and flu medications and things like that contain NSAIDs. Excedrin migraine has aspirin in it. Now they do make a version now with Tylenol, which is great, but it has aspirin in it and so she's probably taking the Excedrin migraine and not realizing she's taking an NSAID and has likely developed an ulcer at the connection between her intestine and stomach, which we call the gastrointestinal astimosis, the T.J. Anastimosis. So that particular area because of where NSAIDs break down

in your stomach is at very high risk for developing ulcers. ⁓ So NSAIDs is the primary risk factor, but also exposure to cigarette smoke and marijuana smoke and vaping and alcohol use can also cause ulcers. So ⁓ now the good news is, is that most ulcers are very treatable. You can just treat them with a course of medication for one to two months. We typically do ⁓ Pantoprazole, which a lot of bypass patients have already been taking after surgery anyway, so they're familiar with it to help.

decrease acid production. We'll add a second antacid, is usually either medication called misoprostol or famididine to attack, to suppress the acid production from a different source, a different pathway. And then, ⁓ and then we'll also give you a medication that you drink to kind of coat the lining of the, the anastomosis, the connection between the intestine and stomach to help protect the ulcer from food and other insults and let it heal. So usually after one to two months of those medications, the ulcer is healed and people feel better. But at the same

Matthew Weiner (03:21)
you

Deidre Schodroski (03:25)
time you also need to

stop the cause which is typically NSAIDs or mostly exposure to cigarette smoke is another big one.

Matthew Weiner (03:32)
Yeah,

yeah. There's a couple of just absolute things you can't do after a gastric bypass. A gastric bypass is a great surgery, but it comes with rules. We talk a lot about alcohol. I think we're gonna talk a little bit more today about it, but avoiding alcohol at all costs after a gastric bypass is, in my opinion, absolutely crucial because of the ulcer risk and because of what we'll talk about a little bit later, the risk of addiction.

But, the big, the reason behind ulcers is that we've changed the anatomy. our GI anatomy, it really changes the pH quite a bit. The stomach is very acidic, then we release bile, which is alkaline, the opposite of acidic. And so our intestine is designed at different places to be more or less acid tolerant.

And the problem with a gastric bypass, and this is really the fundamental flaw of this surgery, thankfully it affects a small percentage of people, but when it does, it can be quite challenging. As Deidre mentioned, they tend to be responsive to medication, but sometimes they're not. ⁓ And the problem is is that we connect an acid intolerant segment of the small intestine right up to the stomach, which releases acid.

Now most of the acid produced in the stomach is produced lower down, not up high where the gastric pouch is. So depending on how your stomach is kind of made and where the acid is produced, you may make a lot of acid in the upper part of your stomach or not. And if you make a lot of acid in the upper part of your stomach, that can cause an ulcer. Another big problem, and we typically see ulcers in patients

more commonly who've had surgery a long time ago, partly because it may just be that this is something that the risk accumulates over time, but also a long time ago, we made the pouch much larger. Now we make it fairly small. A small pouch means less acid, less acid means less risk of ulcers. So something else in patients who have ulcers that we need to look at is their pouch size. And that impacts a couple of things. Number one, it impacts

the acid production, it also impacts our ability to revise this surgery. And Deidre and I, we've done 50, 60 of these ⁓ GJ revisions for ulcers over the, and we have people from all over Arizona coming to us for this surgery. It's a very challenging surgery. It can take quite a bit of time. ⁓ We've seen pretty much every extreme of this, the complication of these ulcers that exist.

Deidre Schodroski (06:04)
philosophy revisions. Yeah. Right.

Matthew Weiner (06:21)
⁓ And the key component that determines whether or not the surgery is easy or hard is what's the size of the gastric pouch, right?

Deidre Schodroski (06:34)
Right, if the pouch is

big enough, there is room to...

reset around the ulcer and create a new pouch and new connection with healthy tissue. And then those patients typically do much better. I've actually seen three of them, three patients that we did the surgery on in post-operative, know, different times post-operatively in the last three weeks and they're all doing fantastic. So you just feel much better. You can't eat when you have an ulcer. You don't feel good all the time. And so once you're able to eat comfortably and drink comfortably, your quality of life just really improves. ⁓

Matthew Weiner (06:45)
Much better, yeah.

Yeah.

Ulcers are miserable. They're a miserable thing to live with. And chronic ulcers, you know, we've seen this, and a lot of times, unfortunately, and I actually just got consulted on this in the hospital yesterday, you know, we see this in the end stage. The patient shows up, you know, I think this guy weighs 130 pounds. He's been kind of bounced around between a bunch of different doctors. Nobody can kind of figure out what's going on.

he has a large ulcer, he can't eat, and now he has severe malnutrition. And I think, you the key is you never wanna get to that point. And if you're out there and you're kinda struggling with an ulcer, eating is not comfortable for you, you may be feeling like, hey, I can barely eat, I might be getting signs of malnutrition, early intervention in this situation is critical. Because if you get way too far past this,

then you have severe malnutrition, which we have to fix first before we can even do a surgery. And that can be a real challenge. ⁓ My experience with this has been that ulcers are treatable problems, but they require the lifestyle changes that Deidre mentioned earlier, avoiding NSAIDs, avoiding alcohol, avoiding tobacco smoke, vape smoke, marijuana smoke, steroids are another one. And also timely and early intervention by a surgeon.

who performs lots of revision surgeries. ⁓ Those are really the key components to this.

Deidre Schodroski (08:37)
Yeah, I think the take home message here, and this is the case for any issues that you may experience after gastric bypass, because it's not a forgiving surgery, right? You have to follow the rules, is follow up with your bariatric surgeon. You know, don't let this go by the wayside. If you're having a problem, call your bariatric surgeon and make an appointment, because we are really in tune with what the causes of these issues can be, and you know, less chance of you getting bounced around without knowing what the real cause is, and we can fix the problem, so.

Matthew Weiner (09:06)
Yeah,

and Deidre and I, our practice, it's really become over the last probably two or three years, we've just, ⁓ revisions and kind of re-dos and that type of stuff from other surgeons, from people all over the country, that's become a bigger and bigger part of our practice. I like these surgeries, I think they're challenging, but you really can make a huge difference for people and kind of get them back on track. So if you're out there,

and really struggling. ⁓ We do take patients from all over the place and we are able to kind of handle these more difficult cases. anyway, all right, next question, Dieter, what else do we got? I love the surgery talk. We don't talk about surgery enough, you know? I know.

Deidre Schodroski (09:46)
All right, next question is, I know me too, me too, all day.

Okay, I was told during my bariatric evaluation that I have a small hyaluronia. I've also had bad acid reflux for years. Will this affect my surgery? Should the hernia be repaired at the same time as my weight loss surgery? And will my reflux get better or worse afterward? Also, can hernias come back?

Matthew Weiner (10:13)
Yeah, we never face this, right? Have we ever seen this before? Yeah.

Deidre Schodroski (10:15)
Yeah, only 10 times every day. high

level hernias are very common with obesity because of the increased abdominal pressure. Also, some people are just born with a diaphragm that maybe isn't as structurally, you know, the structural integrity is not as great as others. You know, it's thin and fragile and people can get a hernia, but it's very, very common with obesity. And also as you get older, the same thing, your risk goes up.

Matthew Weiner (10:23)
Yeah.

So let's talk about what a hi,

don't burn. Yeah, is first.

Deidre Schodroski (10:43)
Okay, so your diaphragm, which is the muscle that allows you to breathe right in between the chest and the abdomen, there's a hole in the middle called the hiatus. And that's where the esophagus goes through to get to your stomach, basically. And in some people, that muscle is weak and the hole becomes too large. And when that happens, the pressure in the abdomen is higher than in the chest, and it can push the stomach up into the hiatus, and the stomach becomes stuck

above the diaphragm in the chest and that can cause a lot of problems. The most common problem is reflux. That's the number one symptom with a hyaluronid. And now not everybody experiences reflux, but many times they do experience like dyspepsia or bloating, difficulty eating.

feeling like things get stuck when they swallow. And for some people, epigast, or know, esophageal spasm, which is contraction of the muscle of the esophagus and stomach, and it can be quite painful. And so again, it's very common with obesity. And so we see this all the time. Now, when you do an endoscopy, which some people know they have a high level of hernia because their GI doctor has seen it on endoscopy, it's a little bit subjective because the cameras

Matthew Weiner (11:33)
Yeah.

Deidre Schodroski (12:00)
the inside of your esophagus, but the hernia, which is the hole in your diaphragm, is on the outside of the esophagus, so you can't see the hernia directly. And so we can't always get a very ⁓ good, you know...

view of how big the hernia actually is. But when we go into the abdomen for bariatric surgery, we can visualize the hernia directly and we can make a decision at that time if it needs to be fixed. And with the sleeve, because of the increased risk of reflux with the gastric sleeve, just because of the anatomy of the sleeve and the way the sleeve is made, we almost always fix the hernias. With the bypass, there's no reflux after a bypass because again of the anatomy of a bypass. And so we will make it an objective opinion once we get in there and see

the hernia and decide whether or not it's appropriate to fix it because of course hernia repair is not without risk either so it's it's balance between the risks and benefits.

Matthew Weiner (12:49)
Yeah,

with hiatal hernia size matters. That's the single most important thing.

Deidre Schodroski (12:57)
Absolutely.

Matthew Weiner (13:00)
And as Deidre mentioned, with sleeves we're really aggressive and we fix pretty much every hiatal hernia. And we've adopted a mesh technique there. For many years, there's been a lot of criticism, appropriately so, of mesh repair of hiatal hernia. We've developed a technique where, first of all, we use a very small amount of mesh. We don't put this huge sheet of mesh. And again, just like hiatal hernias, mesh with mesh, size matters. The more mesh you put in,

the more problems you can have with it. We also use a absorbable mesh, which is a relatively new product that's been out for maybe about five or six years. And I feel a lot more comfortable putting something that eventually will disappear because any kind of revision surgery with mesh still in place is extremely difficult and complicated. We've only done a few of those thankfully, and they are hard and challenging and much higher risk than a traditional hyaluronic repair. ⁓

Deidre Schodroski (13:53)
Very

Matthew Weiner (13:58)
With gastric bypasses, we're more selective in what we repair because as Deidre mentioned, it's such a good anti-reflux or anti-heartburn surgery to begin with. We don't necessarily need to fix a heart or hernia and the less you do in the operating room, the better. I tell patients this all the time. It's not like going to the grocery store and picking up a quart of milk at the same time you're grabbing some bread. It's just one little trip down the island, no big deal. The whole while you're in there,

line of thinking in the operating room does not hold water. ⁓ While you're in there taking out my gallbladder, why don't you also take out half my pancreas? ⁓ You're gonna have a very different experience because taking out half your pancreas is an extremely severe and morbid surgery. And so you really have to avoid this. I just wanna do it in one surgery while you're in there kind of approach.

Deidre Schodroski (14:29)
Thanks.

You look right.

Matthew Weiner (14:54)
because it really can lead to some bad decisions and some bad long-term outcomes. ⁓ But yeah, hiatal hernias are super common. They are just part and parcel of what we do as a bariatric surgeon. I think the key in this patient's situation is, if you trust your surgeon, trust the way they're gonna handle the hiatal hernia, because it's a very sophisticated, nuanced decision about whether to fix it.

⁓ and someone who's done this thousands of times, and at this point, that's kind of where we are, ⁓ you get good at making these decisions. I think the other thing that, and this is another real advantage I have working together with Deidre, is that especially she's really super involved in managing the patients long-term after surgery. So she brings that into the operating room too, and she can understand, hey,

If we fix the hiatal hernia, this is how people do, and if we don't, this is how they do. So that's a, you know, it's a difficult decision, and one that really comes from experience. So.

Deidre Schodroski (16:00)
I mean the good news

is that outcomes after hyaluronic repair are usually very good. Most people don't experience any more of difficult recovery than prior.

Matthew Weiner (16:04)
Yeah.

Deidre Schodroski (16:08)
than without a hernia repair. So, ⁓ hernias can recur, especially after sleeve. And I saw a patient recently, actually just yesterday, and she had a sleeve with a hernia repair with mesh about a year ago, and she had a recent endoscopy because she was having terrible reflux, and it showed that her hernia had recurred, and now she has severe erosive esophagitis, so inflammation of the esophagus from the reflux. Which brings us back to the revision. ⁓ A good treatment for her would be ⁓

Matthew Weiner (16:10)
Yeah, yeah.

Yeah.

Deidre Schodroski (16:38)
convert, you know, maybe depending on what the anatomy shows, conversion from sleep to bypass where there's no reflux with a hyaluronic repair.

Matthew Weiner (16:45)
Right. Yeah, and you know the presence of mesh makes that you know, you fix a heidel hernia? My my hunch is and and I don't know this case, you know, well, it sounds like I might soon though Is that? ⁓ That we just revise to a bypass and see how that goes just do the safe thing safe straightforward thing because I think When someone has a heidel hernia in most circumstances because with sleeves even though there is recurrence

Deidre Schodroski (16:57)
Yeah.

Right. Right.

Matthew Weiner (17:14)
It's usually not a huge, it's not half the sleeves in the chest. It's maybe a top part, but it's enough to get that valve out of the abdomen and into the chest. And once that valve is in a negative pressure space, it's just stented wide open. And that with some angulation downstream causes wicked reflux. And if you just convert to a bypass, you might get 90 % of the reflux with 10 % of the risk if you were to fix the the hiatal hernia at the same time.

Deidre Schodroski (17:16)
Right. Right.

Right.

Right. Right.

Matthew Weiner (17:43)
and redo a mesh repair. So again, complicated, difficult decisions, ⁓ but ones we're typically able to manage. I think that's the take home point is that hideal hernias are manageable. This is a solvable problem. ⁓ Rarely, if at all, do I feel like we see patients who just have a hideal hernia and we can't fix it and it's a mess and it's causing all kinds of terrible symptoms. We can almost always.

fix it and get things, get patients in good shape.

Deidre Schodroski (18:15)
Yep,

again another surgery where you feel much better afterwards. So, okay. Next question is about post-op recovery. ⁓ I got a message from the patient, I'm three months out from gastric

Matthew Weiner (18:19)
Totally. All right, what do we got next, Deidre?

Deidre Schodroski (18:27)
the holidays are coming up and I would like to have one drink at Thanksgiving. Is it okay to drink alcohol after gastric bypass?

Matthew Weiner (18:33)
Yeah, so I mean this is really something I feel very passionate about. I think the one thing that I really think is so critically important in bariatric surgery is patient education. And if you look at my 500 videos on YouTube, I think I can stand behind the fact that I do really care about this. And this surgery is a decision you're making.

and it's one that you're saying, I'm gonna do this, I'm gonna let this person rearrange my anatomy forever, and I'm trusting that I'm gonna make a decision that improves my health. these surgeries aren't perfect, they do have side effects, there are things that can happen, they tend to be treatable. Being overweight is really terrible, and anybody out here listening to this probably either has experienced it in the past or is currently experiencing it.

It's really miserable being 100 pounds overweight. It is not a pleasant way to live. ⁓ There are few things that are worse than being 100 pounds overweight, and I believe that alcoholism is one of them. And so with a gastric bypass in particular, I don't think this is transfer addiction. I don't think this is you can't have food and now you're turning to alcohol.

I think this is that alcohol hits your brain in a different way because it goes right through the stomach, directly into the small intestine, is rapidly absorbed and we see different alcohol absorption curves after a gastric bypass than we do before. And so it's like an intravenous drug where typically you drink and it takes 20 minutes before it sets in with a gastric bypass patient.

it hits you immediately and it comes up and it can come down quickly and these rapid changes in your alcohol levels can be more addictive and the rate of alcoholism that's published is 4%. We do about 200 gastric bypasses a year, which means we, if we're not doing everything we can, we're creating eight alcoholics a year. That is a lot, year after year. And so,

I think the only way to absolutely prevent that is zero alcohol. Now, if this person chooses to ignore that, has a drink in a controlled setting, understands the risks, has talked to their family about it, make sure that it's one drink and only one drink, I think they'll be okay. But what's the best advice I can give you? To make sure you don't suffer this absolutely

devastating complication of a gastric bypass, don't ever drink. You don't ever drink, it's 0%. Yeah, but yeah, that's a tough decision. I think you can do it, but be careful. Be careful. Even if you had zero, yeah, if you were a total non-drinker before, you still have that risk. yeah, I almost worry about those patients more.

Deidre Schodroski (21:36)
It is.

Right. Yeah. I just make sure I counsel.

Right. Yeah.

Matthew Weiner (21:54)
because their guard is down. They never worried about their alcohol intake.

Deidre Schodroski (21:56)
Right, Yeah, just

make, I just counsel patients to just make sure they're really aware of the risks and, you know, make sure they limit anything that they do. So.

Matthew Weiner (22:02)
Go.

⁓ Another

important point on that, especially in women, one alcoholic beverage can put you over the legal limit for driving.

Deidre Schodroski (22:16)
Absolutely. Yep. Especially if you've lost a lot of weight, then it's even worse. yeah.

Matthew Weiner (22:19)
Yes. Yeah. Yeah. So

zero alcohol with driving after a gastric bypass.

Deidre Schodroski (22:29)
Yeah, no, I think that's the best advice. ⁓ Okay, and then our last question is also about post-operative recovery. ⁓ I had a gastric bypass last Tuesday, and I am just, I'm really struggling with water. It doesn't taste right. It's hard to drink, and I am so tired of the protein shakes. I feel like I'm regretting this decision. What is wrong? What am I doing wrong? I hear this a lot. The first week can be a little rough, and I do hear patients say, what am I doing wrong?

Matthew Weiner (22:30)
Yeah.

Yeah.

Deidre Schodroski (22:57)
Nothing, you're not doing anything wrong. The gastric bypass is a huge adjustment to your body. There is a huge hormonal change in your GI system, which also affects the hormonal pathways in your brain, in your hypothalamus, your lower small intestine, your pancreas, pretty much every system in your body, your reproductive hormones. And because of that, ⁓ your taste change dramatically.

and you get full fast and you stay full longer and everything's 100 times sweeter and even smells can be different. I read a comment today that said nobody talks about the tape change and smell after gastric bypass. I mean, that's true. People are like, why did my feet smell? They don't. It's just you had a bypass, you know? It's, I mean, everything is way more intense for at least three to four months after gastric bypass.

Matthew Weiner (23:32)
you

Deidre Schodroski (23:47)
And so it's not that uncommon. 15 % of patients or more can't drink plain water anymore. They don't like things that they liked before surgery. They can't drink the protein shakes because they're too sweet or they're too thick, even if they drank them every day before surgery. And so we have to learn how to kind of manage those little problems. And it gets better with time. Even at the end of the first week, people feel significantly better than they do the first few days. know, once you're able to start soft foods and you're eating, you're kind of back into a routine and you're

brain, your head hunger is quelled by being able to eat something, it makes a huge difference. And by three to four months, most people are in a very good routine. But there are tricks that you can use to help you get through that initial period. The biggest thing, the most important thing after surgery is hydration, for sure. I mean, you plenty of protein stores. If you don't get all of your protein right away, which most people can't because there's just not a room for both your fluid and protein, you're not going be monogreased in the first week or two. But if you don't get all your fluid in, it only takes a day or two before you just don't

feel

good, right? You just feel nauseous and headaches and dizzy and then you really don't want to drink because you don't feel good so you just want to sleep all the time.

Matthew Weiner (24:49)
Thanks.

Deidre Schodroski (24:54)
So hydration is the most important thing. So what I remind patients is that you can drink anything you want that's sugar free, as long as it's not carbonated. If you can't drink water, keep trying different things until you can find something that you like and then just stick with that. You can put fruit in your water or you can do unsweetened tea or you can do bottled water. Bypass patients are so fickle, sometimes they like bottled water, even different types instead of tap water. You can do coffee, you can do Powerade Zero, whatever you prefer, whatever works for you. Staying hydrated is most important thing.

And then for protein shakes, which the offers of sweeteners and the sweetness of protein shakes can be very difficult to tolerate, we recommend doing whole fruit shakes, making your own shakes. Using Greek yogurt and milk and fruits and vegetables. We have a new app that has ⁓ AI dietitian called Sage. And I'm always referring patients to Sage for ideas on how to make high protein smoothies. They can put them there, I had a gastric bypass, I wanna make a...

Whole food smoothie with 30 grams of protein. Give me 10 recipe ideas and it'll give it to you in 30 seconds. You know, so that is the best way to handle not being able to tolerate these processed pre-made shakes that you probably loved before surgery, but now we're a hundred times too sweet. So.

Matthew Weiner (26:06)
Yeah, I think you really hit on one of the keys, which is trial and error. Just if it doesn't work, try something else, ⁓ right? Dilute it down. And our brain has really a very powerful ability to determine

Deidre Schodroski (26:12)
or something else.

Matthew Weiner (26:21)
what we're going to tolerate before we eat it. That's just this nutritional intelligence that we evolved with because we're hunter and gatherers. And so, you know, we were very good at taking a tiny bite of a poisonous berry and recognizing, hey, this is poisonous, don't eat more of it. ⁓ And so you have to make sure you pay very close attention to your body, the taste signals, and kind of get creative and try different things. I think the big mistake you can really make is like,

Go down the list that your surgery practice gave you exactly and follow exactly what that is. Modify it, adjust it based on what you feel like you're gonna tolerate. I think the second thing I wanna talk about is the regret. ⁓ That is incredibly common. ⁓ And patients are often afraid to talk to us about it because even saying it out loud makes it real. And I think if you ask people at one week, do you regret your surgery? I would bet.

I don't know, you see more people in that range than me, Dieter. What do you think?

Deidre Schodroski (27:23)
I I wouldn't say half, but it is a huge adjustment and.

And the other thing is because of hormonal change, you're also very emotional after having a major surgery. can see hormonal change, mood swings are very common. And so people kind of get into this cycle of what's wrong, get a little bit of depressed and get anxiety about food and all of that gets better. know, so talk to provider about it. Talk to myself or Dr. Weiner or Zoe. We can walk you through, we can help you find solutions. then, you know, inevitably by three or four months, as everything starts to settle down, people just feel so much better. And then

Matthew Weiner (27:30)
Yeah.

Yeah.

Deidre Schodroski (27:57)
In a year, they're like, I'm so glad I did this surgery. I can't believe I ever thought that I didn't, that I made a mistake. So.

Matthew Weiner (27:59)
Yeah.

Yeah, no,

for sure, for sure. I think the important message, that regret doesn't last. ⁓ Another interesting kind of point, and you talked about hormonal change, just calorie deficit alone causes depression. In my first book, I've talked about the Minnesota starvation experiment, ⁓ where they restricted calorie intake on people as part of an experiment, and the rates of depression went through the roof.

So when you're getting very few calories in, a starved brain isn't slow or not sharp, it's depressed. And so getting enough calorie intake, and that's where those homemade smoothies, because they actually tend to be quite high in calories, ⁓ but that's perfect. That's actually a plus at that early stage after surgery. yeah.

Deidre Schodroski (28:48)
All right, yeah.

Well, and high in vitamins too, and that's another thing that

can affect your emotions and vitamin efficiency. So, well then, excellent.

Matthew Weiner (28:59)
Totally, absolutely. Yeah.

All right, well thank you, Deidre, for joining us. Another great episode. I think a lot of questions that we get from our surgical patients. So anyway, if you're out there, our practice is located in Tucson, Arizona. We really see people from all over the Southwest and even beyond. And we have a smartphone app called Pound of Cure that, as Deidre mentioned, has an AI dietician. And we're really

Deidre Schodroski (29:06)
Yeah.

Matthew Weiner (29:27)
working to make that a great resource for anybody trying to lose weight, whether it's GLP-1s, bariatric surgery, nutrition, ⁓ so that you can have the absolute best support that's possible. ⁓ And so feel free to download that app on the Google Play Store, the iOS app store.

Deidre Schodroski (29:45)
Thank very much.

Matthew Weiner (29:46)
See you next time.