Bari Better, Inc.

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I am Amanda Reyna, Bariatric Recovery Mindset Coach. I help people successfully go through Bariatric (Weight Loss Surgery) and maintain their weight loss long term. My clients go from feeling disheartened by weight regain and/or complications and relationship struggles to achieving emotional healing & a sustainable, healthy lifestyle. I give support Preop, PostOp, Post Honeymoon Phase & Post Revision, transforming your mindset & relationship with food. Bari=Bariatric, Better=I am better after having my surgery in 2016 & enjoy every single day of my successful journey. My husband and I Co-Founded Bari Better, Inc. (2018) after seeing the struggles people face on their Bariatric journeys. I have a Nurse🩺MSN background (thesis done on Bariatric Coaching). We provide general wellness & lifestyle Coaching, which should not be construed as Medical advice & should not replace your consultation & advice from a Medical Professional. Our videos are for informational purposes only.

I have a question for you: Are you ready? Are you 100% committed to change your lifestyle? If so, then my online Bariatric Coaching is for you!

Amanda: Welcome back everyone, today we are talking about Bariatrics and exercises, and this is our fourth and last question for today's interview and I would like to hear from Dr. Botezelli, how often should the exercise be performed whether it is before or after you have your Bariatric surgery?

Dr. Botezelli: So, more is better, if you can do it every day, it is better, doing like 20 minutes per day, it's better than doing one hour every other day and this is also more reliable. So, if you want to start slow (as we said in the previous segment), like trying to take your stairs instead of the elevator, start to do walking across the street, go walking to the grocery, start to do some squats near your desk, in your house, more is better. If you can do it for like 20-30 minutes per day, it's amazing. The ideal would be one hour per day, every day, but you don't need to start with that. It's better to start slowly, changing your daily routine, so during work, you can take a couple of breaks, before lunch time for example (if you have 30 minutes or 60 minutes of lunch time, do 15 minutes of exercise then have your lunch). When I go back home, before I start preparing my dinner or before I take a shower, just do 10-15 minutes of exercise, so you can break exercises throughout the day, it doesn't matter that much, especially because you're starting, you can break exercising in different sessions. Usually, when I prescribe exercise, I send two routines for my clients, so they can’t escape. Like run (high intensity exercise) in 30 minutes and then you can break in two circuits, like two sets of 10-12 minutes each, and then there is a break in the middle. So, you can start your day doing one set of that exercise and another set when you get back home, so you have around 25-30 minutes of exercise. Or if you want, you can do the one-hour exercise. The difference with the one-hour exercise is that you burn more calories, so it's more efficient to lose weight, you lose weight faster. But the other exercise (specially before and after Bariatric surgery), will do the job to keep your muscles and your overall health. You don't need to start like trying to run a marathon (I see these mistakes all the time), people wanting to go to the gym like six-seven times per week, it may be a too stressful situation because you're changing too much variables, you feel pain in your body, so start slow, it is the longevity of your strategy, it is like years and years and years. I always remind people that you did not gain weight in one month or two months, don't expect to lose weight in one or two months, this is not going to happen, you need to see that's like a lifestyle change, a life change, this is the important part.

Amanda: And we talk about lifestyle change in the Bariatric journey all the time in our Bariatric Wellness Coaching, that is exactly what we do. And that is something really important that you mentioned, because I remember when you sent me my exercise routine, in the beginning I was able to rest one day and for me, it was so important to really keep it as a habit, and you and I have had many sessions about this. Sometimes people say “I'll do it today” or “I'll just skip it tomorrow” and then tomorrow comes and then the next day comes and it's easier for you to say I will skip that, but then I will do more exercise, and it's not really about that. For me, for my own routine and my own habit, I didn't feel like I really needed to rest. I rested for a couple weeks in the beginning, but as you and I have been talking about my routine and as I built more strength and more energy to and all of that with my eating habits and everything that was a combination of all, I felt better doing more exercise. In the beginning it was 30 minutes, then later I was doing 45 minutes and it wasn't affecting me. Then, I increased it to one hour. 

Amanda: Hello everyone, welcome back to our third segment of today’s interview with Dr. Botezelli on Bariatrics and Exercises. What are the most recommended exercises from your practice that you recommended to Bariatric patients either before they have the surgery or after they had the Bariatric surgery?

Dr. Botezelli: So, I like to compare our muscles to an elastic (when you pull it in the beginning it is pretty easy, then it starts to get harder, that is our body). If you are starting to exercise right now, it's like a new thing that you want to change your life, so you're doing the Bariatric surgery and then you decide to do exercise, every kind of exercise that you do, will produce good results in your body, tremendous results. If you talk about an athlete, they train a lot, so the elastics pulled all the way, so it's super hard to get improvements. But in the beginning, if you are sedentary, if you don't exercise that much, anything you do will produce really good results and fast results, so we see improvements by 30-40% of strength and endurance in 1-2 months, it is pretty fast, our body would adapt pretty fast. The point here is you need to do both endurance and strength exercise. The strength exercise will help you to keep your muscles, to make the muscles grow, to make the muscles bigger, even though you are in a caloric restriction, you are keeping your muscles. And this is important, because remember, in the two previous topics of this interview, when you do the Bariatric surgery, usually you lose a lot of muscle, so when you build this muscle before and after the surgery, you are increasing your metabolism, you are increasing the capacity of your muscle to generate power and burn calories. The endurance exercise is pretty important because of two things: first, endurance exercise (when I say endurance, I say biking, elliptical, running, swimming, even walking, you don’t need to start running), it burns a lot of calories and most of the calories from fat, so it will reduce your triglycerides, it will improve your cholesterol in your blood, and also you prepare your body to get more oxygenated, so you produce more red cells, you get better quality of your blood, your blood will carry more oxygen, this is amazing before the surgery and after the surgery to recovery. We need oxygen to activate our metabolism and help with the regeneration of your body. Both exercises are great

(we need both endurance and strength exercises) they are quit of mandatory before and after the surgery, because this way you keep your muscles and you spend more energy and you will affect your metabolism to prepare you for the surgery and to prepare you for a new routine and new life after the surgery.

Amanda: Great point! Please, clarify to our listeners/viewers with more examples as a lot of people don’t understand the word cardio and the difference between endurance and strength exercises before and after Bariatric surgery.

Dr. Botezelli: Endurance or cardio, is the exercise that you do for a very long time, because you have to sustain this exercise for a very long time, it is a lower intensity, so your body needs to get more efficient and break the energy, the substrates, fat, carbohydrates in a really good efficient way. So, if you need to run 1 kilometer, for example, or walk for 1 kilometer, usually, because it is a lower intensity exercise, your body will need to break down more fat, so this way you will burn more fat. “Ok Diego, if burning fat is a good way and I want to lose fat, should I do endurance exercise all the time?” Not all the time, because endurance exercise will make your body more efficient, you won’t grow muscle, because the amount of muscle that you have, with that muscle, you can walk for like five, 10, 20 kilometers, so your body will not try to grow your muscle. 

Amanda: Hello everyone, Amanda here, CEO and Co-Founder of Bari Better, Inc. where we provide online Bariatric Coaching in English, Spanish and Portuguese and today, I am interviewing Dr. Jose Diego Botezelli (he has a PhD in Metabolism and Physiology) and today we are talking about Bariatrics and exercise. Thank you so much for being with us in our second segment of today's interview and I would like to talk to you and ask what is actually the importance of physical exercise now after clients have already gone through the Bariatric surgery, no matter what kind of Bariatric surgery you had done.

Dr. Botezelli: Essential! You can not have a successful strategy after Bariatric surgery if you don’t do exercise and the reason is when you do the Bariatric surgery, what happens is you lose a lot of weight, but as you're not eating that much you start to lose muscle. So, if you don't do exercise to prevent this muscle loss, what happens is your metabolism will start to reduce. Our muscles are like our engines, like a car engine (bigger your muscle, more fuel you consume). So, imagine if you see a bodybuilder: they guy is pretty big, like 300 pounds of pure muscle, they need to eat like 5,000, 6,000, 7,000 (thousand) calories a day. If you don't start to exercise after a Bariatric surgery, your metabolism will start to decrease. Why? You start to lose muscle. Our muscles, we need to exercise them to keep them. This is really easy to see if you break a bone, or you see someone who breaks a bone and puts a cast. After just four weeks, when they set up the cast in the hand for example or in the arm, the cast is pretty tied. After 2 weeks, you can see that you can stick like two fingers between the cast and the arm, why? Because you are losing muscle mass, because you are not using that muscle. And then we started to reduce our metabolism. So, in one of our first conversations, you send me your Bioimpedance, which is an analysis that will check your body fat.

Amanda: Please, elaborate a little bit more on Bioimpedance, because a lot of my clients say they had their Bioimpedance done or they say they had something done, and a lot of times they don't have the explanation, or they don't have the deepest understanding about it. So, as general information I remember one of the sessions I had with you, you went over with me, I totally understood my numbers and that made so much sense to me and then we totally revamped my exercise program and I needed it because I was losing a lot of muscle mass and then you went into details and explained to me. Please, clarify to our viewers and listeners, because people need to know that.

Dr. Botezelli: So, in this kind of analysis, we check the amount of fat, muscle and water, pretty much. Some of them check other things like bone density and those things, but usually the main numbers are body fat and lean mass. So, body fat: our fat doesn’t spend that much calories per day, it is almost nothing, because it's just storage, it should not spend energy. You don’t want to store energy inside of a place, in a cell where you spend energy. The more fat mass you have, usually lowers your metabolism. Higher lean mass, higher metabolism. So, what happens after a Bariatric surgery? Usually, because people starts losing a lot of weigh (if they lose like 30 kilos for example, usually this would be 15 kilos of muscle and 15 kilos of fat, or 20 kilos of fat and 10 kilos of muscle), so you are reducing your metabolism and it gets harder and harder and harder. So, if you read your Bioimpedance  and your level of fat it's over 30%, means that you are obese. And for a man over 20% of fat means you are obese, and over 30% of fat for women, means obesity. I see clients, not Bariatrics, but I see many clients who are lean in weight, but when I check their body fat, it is 34-35%, actually they are obese.

Amanda: Hello Everyone, Amanda here (CEO and Co-founder of Bari Better, Inc., where we provide online Bariatric Coaching in English, Spanish and Portuguese), and today, I have the pleasure and honor of interviewing one of our Board Advisors, Dr. Jose Diego Botezelli (he is originally from Brazil, he is now living in Canada, he has a PhD in Physiology and Metabolism, we have been meeting on a weekly basis and today’s interview topic is on Bariatric and Exercise. I also like to tell you that Dr. Botezelli prescribes online exercise and nutrition plans and today I have the pleasure to have four segments with him in this interview, and before we get started I would like to talk about Bari Better, where we do not provide any Medical advice and we only provide general Wellness and lifestyle Coaching, we should not be constructive of medical advice and should not replace your consultation or any advice from a Medical professional, so you should not rely on Bari Better or any information provided by Bari Better, Inc. for any Medical decisions and also all the interviews that we perform at Bari Better are for information only and Bari Better, Inc. is not responsible for the information provided by the person being interviewed. So, with that being said, welcome Dr. Botezelli, it is a pleasure to have you with us today.  

Dr. Botezelli: Thank you so much Amanda!  

Amanda: I would like to have you introduce yourself and give a little bit more information about your background.   

Dr. Botezelli: I'm Dr. Botezelli, I have a Bachelor in Kinesiology and a Master and PhD in Physiology and Metabolism. I have a Post Doctorate in Nutrition, Exercise and Metabolism from the University of Campinas in Brazil, and another Post Doctorate in UBC (Canada), where I was studying self Physiology. Now, I have my own company, I help people around the world lose weight. I have clients in Dubai, Ireland, Australia, Brazil, South Africa, England, Italy, Spain, etc. My main strategy is trying to bring new strategies and new habits for people to lose weight in a healthy, reliable and sustainable way.

Amanda: That's a great point: healthy, reliable and sustainable way! With all your background and experience, what is the importance of exercising as your routine during your pre-op phase, before you even have a Bariatric surgery?

Dr. Botezelli: So, if you are going for a Bariatric surgery, it means you are overweight or obese and the problem with overweight or obese, you have insulin resistance, you have some problems and you have usually bad habits. And when I say bad habits, it is not like judging or something like, but it is not correct habits. So, we need to produce, build new strategies and we also need to improve your overall health. This will help, make your surgery more successful, less complications in the surgery, also doing exercise, specially physical exercise that make you to produce muscle mass, like strength exercise, functional (you can just use your body, you don’t need fancy equipments, you don’t need to run 10 kilometers per day, just use your body, our body is a pretty massive weight, so we can use our body to do working balance, work coordination, rhythm, work everything), and this will help our muscle mass to get more healthy. When you go for Bariatric surgery, one of the things that happen is that you can lose a lot of weight, but usually this weight is fat and muscle. Starting a workout, exercise routine before the surgery, will allow you to recover the muscle mass faster and also prevent this muscle breakdown that is a huge problem after Bariatric surgery. As we know, around 80% of people who have the Bariatric surgery, they become obese again, they do not reach  the same weight, but they become obese again, because you do not change the causes of the obesity.

Vamos sério aqui óh, no téti-a-téti, a gente? Você lembra daquele momento mais que especial, o primeiro dia que você pode cruzar a suas pernas depois de você ter a cirurgia Bariátrica? Gente, fala sério???!!! Para vocês que estão me ouvindo e são Bariátricos, sabem exatamente o que eu estou falando e como é maravilhoso ter esse sentimento! Assim que, eu espero que você esteja passando por isso nesse momento, ou já tenha passado, e se não passou, se esforce cada vez mais porque logo esse momento vai chegar e você vai desfrutar maravilhas! Aproveite muito sua jornada Bariátrica! Não deixe ninguém nem nada influenciar você porque só você pode se cuidar e ninguém mais!!!:)

Te recuerdas cuando por la primera vez pudistes cruzar tus piernas después de tu cirugía Bariátrica? Ah que momento increíble!!! Espero que lo estes viviendo y disfrutando al máximo y super saludable después de su cirugía Bariátrica!!! No se te olvide: no dejes nadie ni nada meterte en tu vida y sí que tú sigas tu camino y tu jornada Bariátrica de la manera que tú debes hacerlo y de la manera más saludable que puedas! Cuídate mucho y saludos! Disfruta tu jornada Bariátrica!!!:)

Hello, are you ready for this? Let's talk about that moment when you are able to really cross your legs after you had a Bariatric Surgery!  Isn't that a special moment? I know! I hope you're having that great sensation and feeling POSITIVE with a lot of energy like I am and I hope that you can cross your legs and feel so healthy and so great after your Bariatric journey! Enjoy it! Take good care of yourself and keep going!!! Don't let anyone or anything stop you!!!!:)

Celebrating everything with food? Does that ring a bell ? Does it sound familiar to you? Well, stick around with me until the end of the video where I am sharing with you today my Storytelling Day 5! Welcome to my channel! 

Amanda here, thank you so very much for watching me, for following my channel, for subscribing. If you have not subscribe to my YouTube channel yet, make sure to ring the bell , to subscribe, so you can get my latest videos and updates. Also, make sure that you follow us on Instagram, Facebook and we have videos posted for you very frequently. By the way, you feel like this video, make sure to give it a like and I'm providing all the links to my previous Storytelling videos below here, so if you have not watched them, make sure you don't miss it, so you can follow through!  

So, I grew up with a family where everything was celebrated with food, and when I say everything, I really mean it! I don't mean only special occasions, holidays and birthdays, I mean everything! And celebration has that connotation of happiness, right? What I also want to say is that not only when everything was happy we celebrated with food, but also, when there was something sad, food was always present as well. Like some of you (who had already shared the same situation with me), or who really understand what I'm talking about, have this conception, it's kind of an auto pilot, right? We think food and feelings!  This association is constantly present in our brains, and make us feel that we cannot change it because that's the way we have lived our whole lives, so why change it now? Keep it the same way! In my family's case, when I mean that we celebrated everything with food, let's say for example that we had just purchased or decided to go on a really nice family vacation! Well, if it was a surprise, then obviously when we were giving that surprise out, we always had food around to celebrate the surprise of the vacation with the food!  And see, the same pattern kept repeating it. For example, if there was a great grade at school or if there was a job promotion, everything had to be celebrated with food around us.

And remember when I talk to you about family vacations? Uh, yes, that's right! Family vacation... how about ALL INCLUSIVE vacation? Oh yeah! That was definitely part of my family’s patterns as well. Every time we traveled, we would look for a place specifically where they would have ALL INCLUSIVE, therefore we didn't have to worry about food, and we knew that food was present no matter where we were,  (whether we were inside of the pool even), they would offer us food on these very big resorts and all inclusive vacation places. When you were in your room? 24/7 room services! It didn't matter,  we needed to make sure that we had food all the time, 24/7, if we ever needed, next to us!   I am now aware. I have a different mindset and I'm conscious of the decisions that we had in the past (and the risks that we actually took on our own health), by the food choices and the eating behaviors we had as a family.

On my previous Storytelling Day 4, I talked about breaking the cycle, and I'm here to remind you that YOU CAN BE THE ONE, you can be that person who breaks the cycle! There is a way out: GET OUT OF YOUR COMFORT ZONE!!!  See, you when we talk about celebration, food, smelling, nostalgia, we think about when we were little, of our grandparents’ food, or our family vacations, or our family gatherings...Therefore, we feel we have to keep repeating those patterns forever in our lives, and I'm here to tell you that that is not real! This does not have to be your reality, and it's up to you to change that! 

Food does not have to be your determined factor to belong! I no longer celebrate things with food! YOU CAN ALSO break this pattern of celebrating everything with food like I did!