Interview with Dr. Botezelli – What is the importance of Physical Exercise before Bariatric Surgery?

Bari Better Dr Bozelli 

Amanda Interviews Dr. Botezelli

Topic:Segment 1:

Bariatrics and Exercises – What is the importance of Physical Exercise before Bariatric Surgery?

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. So, if you are 300 pounds, you do a Bariatric surgery, you can lose about 100-150 pounds, but after four or five years, because you do not change the causes of the obesity, one usually becomes obese again and we want to prevent this with exercise. So, exercise is a really good matter to lose weight, of course, to burn calories, to control our hormones and also to improve the results of Bariatric surgery. Bariatric surgery itself is a really good strategy to make you lose weight, it is a good push, a kick-start way, but it is not the only way! So, we need to remember that is one strategy, but we need a life change. Starting physical exercise is super important, we are producing/creating new habits, we are training our body for what is coming after Bariatric surgery. With exercise, we are increasing our basal metabolism, increasing our muscle mass and changing our routine and changing our lives.

Amanda: I love what you said and you already know my story (that I had the Bariatric surgery), and I follow your plan, your exercises, and that it’s great, you are in Canada, I am in the United States, I greatly appreciate how everything we do is done online.
One thing that we talk a lot about is habits, and that’s exactly the point here. For those of you how don’t know, I had Bariatric Gastric Bypass surgery and as a Bariatric Coach, I now help clients who are preop, postop or had to go to a revision surgery (whether is because they had regained so much weight that they have to go back for another procedure, or because of other issues from the previous surgery). So, it is very important to talk about habits here. I remember sharing with you that before my surgery, I was already doing exercise. Obviously now, I have way more endurance, I can do way more when you give the exercise prescription to me. Yes, now I can do things that I never thought was possible for me to do. But it’s exactly that: HABITS! I remember my Bariatric surgeon telling me: “Amanda, just go to the gym, do exercise” and it does not have to be like spending 10 hours, 2 hours even in the gym (people have missing understanding of that), but it is really moving, starting to move, knowing your limits (of course, I always tell my clients to make sure and check with their Doctors what exercises that can or can not do, with/if you have any limitations). For me, it was really important to have that activity even before surgery. Another thing, in my case (every case is different), my Bariatric surgeon prescribed me protein shake for 2 weeks before my surgery to decrease the fat around my liver, that was something that helped me even before my surgery. What you are saying is key, make sure that we don’t have bad habits.

Dr. Botezelli: Yes, keeping the same routine. Of course, with the Bariatric surgery you won’t be able to eat too much at one time, but I know patients in Brazil, for example, after they had the Gastric Bypass, they were drinking condensed milk, because they were not preparing their minds, because it is a change of life, it is a change of new habits. We work with rewards, that is how our brain works (if you get a new iPhone, a new car, etc), and these kinds of rewards, if you are depressed, anxious, tired, sad, happy, and then you come home after a day of stressful work and then you get something sweet for you while watching Netflix, a TV show, something that you really like, this is the reward (we associate this habit of eating something that is not healthy but our brain loves, because it is an evolution process. We do not find any kind of food, any sort of food in nature that has sugar, salt and fat, as we have in chocolate, for example, this is nature’s golden, it is so much energy inside a piece of cookie/candie. So, when you eat this, although it can not be like that pleasure because we just eat this all the time, for our brain, inside of the neurons of our brain, this is pleasure, this is reward like we found the golden pot here, because it is in nature). Right now it is winter here in Canada, it is cold, dark/gray outside, it is harder to find food/fruits/leaves in the forest, so you don’t have energy. All the time that you have these energies, it is a reward. Like ok, we now have this huge amount, super high energy, insulin peaks, changing all your hormones, and usually, you are eating this watching a series, or playing a game, or watching comedy, this is like a rewarding mechanism that is really really hard to break, so we need to break this by eating healthy, trying to do exercise, so this will break this rewarding system of bad habit. It’s hard, I know, I love doing exercise (that is why I do what I do), but I know for like 89% of people it is hard to do exercise because they do this not like something that they should do for their lives. I usually compare this to work (I love my job, but if I could make money doing nothing, everybody would be like “I want my salary and I will just stay home”), but it’s the same with diet, we need to find the pleasure things in a diet, same thing with exercise, we need to find pleasure exercise. Remember one of the first things that I told you? We can do weight lifting, we can do functional exercise, but you need to find something that you like and you told me you love basketball! I said yes, then you need to go to basketball, you need to play, you need to find your reason to do exercise. And weight-loss is like a shallow objective, because when you lose weight (for example, I want to lose 10 kilos, then I lose 10 kilos, and then what? You don’t have the target anymore, you say “whatever” and then you start going back to the old bad habits again. You need the purpose to do that. Even physical exercise, “why do I want to start physical exercise before bariatric surgery?” because I want to change my life, I want to get like a better surgery, I want to have less chances of risks during the surgery and you start to prepare your body. The surgery itself it’s a pretty stressful situation. If you, after the surgery, need to change all your routine, you can’t eat because your stomach is smaller now, now you have to exercise, now you have to change everything, these are too many changes at one time, so start before. Start earlier with exercise, diet, even before the Bariatric surgery, so you just separate the stress, you will have smaller changes all the time, it’s hard to change everything in your life just like from one day to another and you see this all the time.

Amanda: That is why consistency is key! I greatly appreciate all your input on exercise before having Bariatric surgery. Thank you!

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