Ep 284: Years Out and Still Learning: The Long Game of Bariatric Life with Jason Smith and Natalie Tierney

Nobody tells you that the hardest part of bariatric surgery isn't the surgery. It's year five, when life is full, and your bariatric brain goes quiet.Jason and Natalie are back for a real, unfiltered catch-up and this one is for every patient who's thought, "I don't even think about it anymore." Because here's the thing: bariatrics doesn't stop asking things of you just because you stopped thinking about it.Jason shares what happened when a routine gym session turned into an ER visit with a heart rate of 29. Yes, 29. And the wake-up call that followed: a medication he'd been on for years was quietly working against him, because his body had changed so dramatically that the prescription he was given as a very different person no longer fit the person he is now. A physician told him he needed a pacemaker. Another told him to go home and stop taking one pill. The lesson in between? You are a patient for life, not just for the first two years.Natalie opens up about something a lot of long-term post-op patients feel but rarely say out loud: the guilt of not wanting to check in with the bariatric community anymore. Five years out, thriving in a new career as a teacher, and hitting the wall where bariatric life just isn't at the front of the line every single day. She calls it the "I just can't" season, and she wants you to know it's real, it's normal, and it doesn't mean you've failed.Together they get into:Why your medications may need to change years after surgery (and why nobody is checking unless you ask)What "white coat syndrome" (a fear or anxiety around doctors and medical settings) looks like for people who've been heavy patients, and why it doesn't go away just because things are going wellThe difference between pre-op and post-op body literacy: knowing the difference between "I feel fine" and "I actually feel good"Why wins in the bariatric journey don't always look like the scale movingWhat it means to be a patient "forever" and how to hold that truth without burning outHow bariatrics keeps handing you new lessons whether you asked for them or not (Jason's new analogy: an advent calendar of epiphanies that never ends)This episode is also a love letter to BariNation itself. While April is at ASMBS (the American Society for Metabolic and Bariatric Surgery, the largest professional organization in the field), big things are happening behind the scenes in the world of obesity treatment. The conversation is shifting. Patients are being centered. The gap between doctors and patients is getting a lot of attention, and BariNation is right in the middle of that work.If you've ever been years out and felt like bariatric life snuck up behind you, this is your episode.Want to be one of the first to know about our exciting, upcoming changes? Join our email list! Click HERE to join. And we promise- no spam, ever!BariNation is now officially a nonprofit foundation. If this podcast, this community, or this conversation has ever helped you, consider supporting the mission at BariNation.org. Every dollar keeps the lights on and the mic hot. Become a donor at www.barination.orgFind us everywhere: Instagram, TikTok, YouTube, and the BariNation Community at BariNation.org.

You've been fighting your weight for years. You've tried everything. And now you're finally ready to find someone who can actually help. Where do you start? Your primary care doctor? The websites that offer you another miracle? Should you do what Serena Williams is doing and see a bot doc?In this episode, April sits down with Dr. Charles Thompson, a bariatric surgeon practicing in Brooklyn and Queens, New York, to give you a real, practical roadmap for finding an obesity medicine provider who will treat you like the whole person you are, not just a number on a scale.Here's what you'll walk away with:What to actually look for when evaluating a provider (hint: it's not the letters after their name)Where to search, including which websites are worth your time and which ones to approach with cautionWhat to ask at your very first appointment, and why the best providers will ask you questions firstWhy it is absolutely okay to leave a provider relationship that isn't working for you, and why that is not a failureDr. Thompson also breaks down the real difference between having insurance coverage for bariatric surgery or obesity medications and actually being able to use it, including why so many patients with qualifying conditions are still being denied care and what you can do to fight back.You'll also hear him say something that almost no surgeon ever says out loud: "It's not your fault." He means it, and he explains exactly why.Plus: April shares the story of her own path to surgery, why word-of-mouth changed everything for her, and why she built BariNation for the exact moments when you need a Nation behind you.Download and print our free step-by-step guide to finding your provider from the show notes. Use it, share it, come back to it. Click HERE to access it.Obesity is a disease. You deserve care. And now you know how to go get it.A Note About BariNationBariNation is a nonprofit podcast and patient community built on the belief that obesity is a disease and that every person fighting it deserves education, community, and care. If this post helped you, consider supporting our mission at BariNation.org/donate. Your support makes conversations like this one possible.Enjoyed this episode? Share it with someone who's been waiting for permission to take the first step. And if you're already in The Nation, you know what to do. See you in there.Find Dr. Thompson: BrooklynQueensSurgical.comJoin the BariNation community: barination.mn.coSupport our mission: BariNation.org/donate#BariNation #BariatricSurgery #ObesityMedicine #ObesityAwareness #WeightLossSurgery#FindABariatricSurgeon #ObesityIsADisease #BariatricCommunity #InsuranceDenial #MetabolicHealth#ASMBS #ObesityTreatment #BariatricProvider #WeightManagement

“We are built for scarcity, not abundance.” Most people think obesity is simply about willpower or lifestyle choices, yet its history reveals a long tradition of misconceptions, stigma, and ineffective, somewhat barbaric treatments. In this eye-opening episode, Dr. Nini Peterson, PhD, takes us on a fascinating journey through the history of obesity, showing how misconceptions have persisted for centuries despite advances in science and medicine. Discover how ancient carvings and medical texts from 30,000 years ago to the 19th century reveal haunting echoes of today’s struggles with weight and treatment. You’ll learn how old fallacies, like “eat less, move more,” have hampered progress and how biology, environment, and genetics play critical roles that modern science now understands better than ever.We break down:The historical perceptions of obesity across cultures and eras and their impact on stigma, shame, and treatment.The evolution of treatment options, from ancient dieting and surgical experiments to today's promising medications and surgical innovations.The misconceptions that still influence doctor-patient relationships and how invalidating these myths can be detrimental to health.The importance of a holistic, individualized care team and why finding the right "fit" in treatment is crucial for long-term success.How understanding the disease’s history helps us combat shame, advocate for ourselves, and pursue effective, compassionate care.This episode is a must-listen for anyone living with obesity or those supporting loved ones in their journey. If you’re tired of outdated advice, want to cut through the stigma, and are eager to understand the true complexity of obesity, this conversation will inspire hope and empower action.Join April Williams as she has a no-holds-barred conversation with Dr. Peterson, an experienced psychologist and obesity expert, who reveals how shifting our understanding of obesity from blame to compassion opens the door to better treatment, more support, and a brighter future.You’ll leave with a new perspective on this chronic disease, fostering hope that meaningful change is possible, and it starts with knowledge. Perfect for patients, caregivers, clinicians, and advocates committed to a science-backed, patient-centered approach. The time to rethink obesity is now, are you ready?Explore the rich history of obesity, its treatment evolution, and the importance of personalized care in managing this complex disease.History of Obesity PresentationKey TopicsHistory of obesity and treatmentImpact of environment and culture on obesityThe role of behavioral health in obesity careAdvances in obesity medications and surgeryThe importance of holistic, individualized treatmentThe BariNation FoundationThe BariNation Podcast is a production of the BariNation Foundation, a 501c3 nonprofit that advances metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. The Foundation's mission is to walk alongside individuals pursuing medical, surgical, and comprehensive care, supporting real decisions, challenges, and victories that influence long-term health with the support and guidance of obesity medicine experts.Learn more about the BariNation Foundation and make a tax-deductible donation by going to BariNation.orgSound Bites"We are built for scarcity, not abundance."“Most people overestimate the risk of bariatric surgery and underestimate the risk of living long-term with obesity.”Chapters00:00 The History of Obesity and Its Treatment07:23 Understanding Obesity as a Disease19:54 The Stigma of Obesity and Its Impact26:45 Patient-Care Team Dynamics in Obesity Treatment27:24 Navigating Life After Surgery33:32 The Paradox of Treatment40:15 Evolution of Obesity Treatments42:56 Evolving Understanding of Health and Behavior Change45:45 Redefining Success Beyond the Scale49:44 The Complexity of Health Perception53:17 The Importance of Seeking Help55:51 Understanding the Risks of Obesity and Treatment58:45 The Journey to Bariatric Surgery01:03:34 Finding the Right Care Team01:07:15 The Need for Integrated Health ApproachesNini Peterson BioNinoska "Nini" Peterson, PhD is a Staff Psychologist with the Cleveland Clinic’s Bariatric & Metabolic Institute (BMI) and an Adjunct Assistant Professor at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University in Cleveland, OH.Her clinical and research interests include psychosocial MBS evaluations, lifestyle treatment of obesity, binge eating treatment, self-monitoring, body-image disturbance, and psychology group treatment/support groups. She has published in peer-reviewed journals on these topics, and has authored/co-authored 3 textbook chapters for SAGES and APA on the role of the behavioral health provider in MBS and pre-surgical psychological MBS evaluations, respectively.She is the current Integrated Health - Director Elect (2025-2026), former Integrated Health Secretary (2024-2025) and has served on the IH Leadership Counsel since 2021. Nini is also a current member (2017-present) and past Chair (2023-2025 of the IH Support Group Committee, and member of the Health Equity Committee (2023-present). She is a proud member of the inaugural 2024 ASMBS-IH Fellowship class (FASMBS-IH).LinksBariNationFoundation

Clinical psychologist Dr. Rachel Goldman, PhD joins BariNation hosts April Williams and Jason Smith to discuss the psychological and behavioral tools every person needs to navigate life's hardest moments, especially those living with the chronic disease of obesity.Drawing from her new book When Life Happens, Dr. Goldman breaks down CBT into accessible, actionable tools for building emotional resilience, managing stress, challenging unhelpful thoughts, and developing a growth mindset. Essential listening for bariatric surgery patients, anyone managing chronic illness, and anyone stuck between knowing what to do and actually doing it.This episode is supported by AdventHealth Central Florida and the Metabolic Health Institute. If you've struggled with weight loss, you know it's a lifelong journey. At AdventHealth's Metabolic Health Institute, they address the root cause of weight gain with a whole-health approach, from lifestyle support and medication to bariatric surgery. Learn more at http://www.AdventHealthWeightLoss.comWhat You'll Learn:Build a Mental Health Toolbox — One tool is never enough. Dr. Goldman explains why you need at least three coping strategies and the critical difference between self-care tools (preventative) and stress management tools (acute), and why they're actually the same tools used with different intention.The CBT Core: Your thoughts don't just feel bad, they directly shape your behavior. Dr. Goldman walks through how identifying unhelpful thoughts, examining the evidence, and reframing can rewire the brain over time through neuroplasticity. The goal isn't to eliminate negative thoughts; it's to reduce how long you stay in them. Cognitive Distortions That KeepYou Stuck — All-or-nothing thinking, jumping to conclusions, and "should" statements are three of the most common distortions in people with obesity. Dr. Goldman explains how CBT helps patients identify, challenge, and reframe these patterns instead of accepting them as truth. The Diet Failed You.You Did Not Fail the Diet. — A powerful reframe Dr. Goldman used with bariatric patients at Bellevue: the surgery failed the patient, not the other way around. This directly challenges the internalized shame that comes from years of failed diets and reframes it through the lens of obesity as a complex, chronic, progressive disease.Growth Mindset vs. Fixed Mindset — Years of "nothing works" can create an entrenched fixed mindset. Dr. Goldman connects Carol Dweck's research to the lived experience of obesity patients and explores how flexible thinking and self-compassion begin to shift the pattern.Toxic Positivity: What It Is and Why It's Harmful — "Positive vibes only" invalidates real experience and suppresses important emotions. Dr. Goldman explains the spectrum from toxic positivity to toxic negativity, where healthy realistic optimism lives, and why body acceptance is more sustainable than body positivity for bariatric patients.Self-Care Is Not a Bubble Bath — Self-care is anything you do for yourself that is preventative and builds you up before life happens. Showing up to a support group, listening to a podcast, sleeping, and breathing exercises all count. It's a non-negotiable daily practice, not a reward.Imposter Syndrome as a Feature, Not a Bug — The most surprising reframe of the episode: imposter syndrome may actually be useful. Dr. Goldman explains eustress (positive, motivating stress) and why a measured level of imposter syndrome drives preparation, humility, and growth. April and Jason share deeply personal experiences of imposter syndrome in bariatric advocacy.Community, Vulnerability, and Asking for Help — The people who feel they have no right to take up space in a support group are often the ones who need it most. Asking for help is brave, not weak.Practice Your Tools Before You Need Them — Like a fire drill, tools must be practiced in calm moments so the response is automatic when life gets hard.📖 When Life Happens by Dr. Rachel Goldman: whenlifehappensbook.com 🔗 Dr. Goldman: @DrRachelNYC | BariNation: barination.org | @bari.nation Hosts: April @actively_april | Jason @tha_smithsonian_Supported by AdventHealth Central Florida and the Metabolic Health Institute. Whole-health obesity care from lifestyle support to bariatric surgery. AdventHealthWeightLoss.comBariNation Foundation*is a 501c3 nonprofit advancing metabolic wellness through evidence-based education and stigma-free support. Donate at barination.org #BariatricSurgery#MentalHealth #CBT #WhenLifeHappens #DrRachelGoldman #ObesityMedicine #BariNation #GrowthMindset #StressManagement #ToxicPositivity #ImposterSyndrome #BodyNeutrality #WeightLoss #BariatricSurgery #MentalHealth #CBT #GrowthMindset #wls #wlscommunity

In this engaging conversation, Aimee Rothe, a board-certified bariatric nurse and post-op bariatric patient, shares her journey from being a medical provider who sought treatment for her obesity after a harrowing experience with a patient, when she was over 400 lbs, to being a provider in the field of obesity care.She emphasizes the importance of normalizing obesity treatment, individualizing care for patients, and overcoming the stigma associated with weight loss surgery and onboarding adjunct treatments such as GLP-1’s. The discussion highlights the emotional challenges faced by patients post-surgery, the role of support groups, and the need for ongoing care and understanding from healthcare providers.Aimee advocates for a compassionate approach to obesity treatment, encouraging patients to seek help and not feel ashamed of their journey.Keywordsbariatric surgery, weight loss surgery, VSG, Gastric Bypass, metabolic syndrome, SADI-s, obesity care, individualized treatment, patient support, emotional health, chronic condition, healthcare, normalization, weight loss, patient-provider relationship, GLP-1, Type 2 diabetes remission, sleep apnea, PCOS, high blood pressureTakeawaysObesity is a chronic medical condition, not a failure of willpower.Bariatric surgery should be viewed as a treatment, not a last resort.Individualized care is crucial for effective obesity treatment.Patients should not feel ashamed or stigmatized for seeking help.Support groups play a vital role in the emotional journey post-surgery.The journey of weight loss is a marathon, not a sprint.It's important to normalize conversations about struggles with obesity.Patients should maintain open communication with their providers.Utilizing multiple treatment modalities is acceptable and necessary.Healthcare providers must understand the complexities of obesity and support their patients.Chapters04:55 Meet Amy Rothe: A Journey from Patient to Provider08:25 Understanding Obesity as a Chronic Condition11:55 The Importance of Individualized Care in Obesity Treatment16:06 Normalizing Conversations Around Obesity and Treatment20:24 The Role of Support Groups in Bariatric Care25:56 Navigating Body Image and Relationships Post-Surgery30:12 The Emotional Journey of Bariatric Surgery35:08 Understanding the Reality of Uncomfortable Situations38:15 Breaking Points and the Decision for Surgery42:34 The Importance of Individualized Care in Obesity Treatment47:39 Normalizing Multiple Modalities of TreatmentGuest BioAimee Rothe, BSN, RN, CBN, CEN, TCRN, NHDP-BC serves as the Hospital Program Director of Metabolic and Bariatric Surgery at a hospital in Birmingham, Alabama. Under her leadership, the program maintains multiple national recognitions, including designation as a BCBS Blue Distinction Plus Center for Bariatric Surgery, an Aetna Institute of Quality for Bariatric Surgery, an Optum Center of Excellence for Bariatric Surgery, and an American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Comprehensive Center. Aimee is a Certified Bariatric Nurse and is active within the American Society for Metabolic and Bariatric Surgery. She serves on multiple national committees, represents the nursing discipline as a Member-at-Large on the ASMBS Integrated Health Leadership Council, and acts as the Integrated Health Board Liaison for the ASMBS Alabama State Chapter. In 2017, Aimee underwent bariatric surgery to address her own chronic medical condition. That experience strengthened her commitment to guiding patients through the bariatric and obesity medicine journey while advocating for recognition of obesity as a chronic, treatable disease. Her work centers on improving patient outcomes, strengthening evidence-based education, and advancing best practices in metabolic health management. She is also focused on building stronger collaboration across medical specialties, expanding outreach efforts that encourage earlier intervention, coordinated care, and open dialogue about obesity and its associated conditions.LinksAimee Rothe Contact Informationmizzerrn@gmail.comWeightManagementUABStVincentsBariNation Membership Community: BariNation.mn.coThe BariNation Podcast is a production of the BariNation Foundation, a 501c3 nonprofit that advances metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. The Foundation's mission is to walk alongside individuals pursuing medical, surgical, and comprehensive care, supporting real decisions, challenges, and victories that influence long-term health with the support and guidance of obesity medicine experts.Learn more about the BariNation Foundation and make a tax-deductible donation by going to BariNation.org

The BariNation Podcast is a production of the BariNation Foundation, a 501c3 nonprofit that advances metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. The Foundation's mission is to walk alongside individuals pursuing medical, surgical, and comprehensive care, supporting real decisions, challenges, and victories that influence long-term health with the support and guidance of obesity medicine experts.Learn more about the BariNation Foundation and make a tax-deductible donation by clicking HERE going to BariNation.orgIn this conversation, April Williams and Katie Booker, licensed therapist and bariatric patient, explore the critical connection between the mind and body, particularly in the context of bariatric surgery. They discuss the importance of recognizing disconnection, identifying signs of it, and the strategies to reconnect. The conversation emphasizes the role of community support in the healing journey and provides practical tips for movement and mindset. The overarching theme is that transformation is a continuous journey, requiring patience, self-compassion, and a willingness to engage with one's body and emotions.KeywordsObesity, Bariatric Surgery, Advocacy, Healthcare Barriers, Community Support, Patient Stories, BariNation Foundation, Metabolic Surgery, Roux-enY, Gastric Bypass, VSG, Gastric Sleeve, DS, Duodenal Switch, SADI-S, Obesity Medications, GLP1’s, Ozempic, Wegovy, Mounjaro, Zepbound, Mind-body Connection, emotional health, mindfulness, self-compassion, Healing Journey, Weight Loss, Disconnection, Personal GrowthTakeawaysOur bodies and minds are designed to be connected.Disconnection can manifest in various ways, especially for bariatric patients.Identifying signs of disconnection is crucial for healing.Mindful movement can help re-establish the mind-body connection.Community support is essential for emotional healing and growth.Self-compassion is key in the journey of transformation.It's important to recognize that transformation is a lifelong process.You can always start again, no matter where you are in your journey.Practicing mindfulness can enhance awareness of hunger and fullness cues.It's okay to feel conflicting emotions at the same time.Chapters00:00 The Importance of Mind-Body Connection08:43 Understanding Disconnection in Bariatric Patients16:16 Identifying Signs of Disconnection22:50 Strategies for Reconnecting Mind and Body24:30 Understanding the Body-Mind Connection30:22 Recognizing Trauma and Its Impact35:42 The Journey of Reconnection42:47 Embracing Self-Compassion and Healing48:30 Navigating Emotions and Self-Compassion50:00 The Four Pillars of Bariatric Success52:04 Mindful Movement and Body Awareness55:40 Mindset Strategies for Reconnection01:01:22 The Role of Community in Healing01:04:58 The Journey of Transformation and PatienceKatie Booker BioKatie is a mental health therapist in New York State that specializes in trauma. She is certified in EMDR, is a registered play therapist, and completes bariatric psychological evaluations for pre-surgery approval. She offers a unique perspective to the mindset work of bariatric surgery as a bariatric patient herself.PDF of Katie's Class: https://drive.google.com/file/d/1IslQ-N59bmE7ZY7yaeni9K7O6IH_4rWw/view?usp=sharing

The BariNation FoundationThe BariNation Podcast is a production of the BariNation Foundation, a 501c3 nonprofit that advances metabolic wellness for people living with obesity by providing evidence-based education, stigma-free support, and meaningful connections in the moments that shape daily life. The Foundation's mission is to walk alongside individuals pursuing medical, surgical, and comprehensive care, supporting real decisions, challenges, and victories that influence long-term health, with the guidance of obesity medicine experts.Learn more about the BariNation Foundation and make a tax-deductible donation by going to BariNation.orgEpisode SummaryIn this episode, April Williams and Monique Coleman, a bariatric patient and Certified Fitness Instructor and BariNation community member, discuss the many barriers faced by women in the Black and Brown communities in navigating family and cultural bias in their journey to access bariatric care. The importance of representation, the power of community support in overcoming stigma and misconceptions about obesity, and treatment options are key to changing perceptions faced by those battling the disease now and for future generations.KeywordsObesity, Bariatric Surgery, Black and Brown Community, Representation, Advocacy, Healthcare Barriers, Community Support, Race and Health, Patient Stories, BariNation Foundation, Metabolic Surgery, Roux-enY, Gastric Bypass, VSG, Gastric Sleeve, DS, Duodenal Switch, SADI-S, Obesity Medications, GLP1’s, Ozempic, Wegovy, Mounjaro, ZepboundKey Takeaways from the Conversation:Representation Matters: Individuals are more likely to engage with resources when they see others who share similar backgrounds and experiences.Breaking the Stigma: Obesity is a lifelong disease, not a moral failing. Treatment options like Roux-en-Y or VSG should be accessible and stigma-free.The Power of Advocacy: Sharing your personal story can empower others to reclaim their lives and advocate for the care they deserve.Community is Everything: Finding a safe space—like the BariNation Foundation—can help overcome the isolation often felt during a health journey.Guest Name & BioMonique Coleman is a Wellness & Motivation Coach for Women Over 40, founder of Curvy Fit Fitness & Healthy Living With Monique, and a bariatric surgery and GLP-1 wellness advocate. At 46, she empowers midlife women to stop procrastinating, move their bodies with confidence, and feel good in their skin again.Five years post-bariatric surgery and navigating perimenopause, Monique combines mindset, movement, and real-life strategy to help women break free from shame, food noise, and self-doubt. Through fitness events, virtual programs, speaking, and community building, she creates safe spaces for women to heal, grow, and show up boldly in the second half of life.Chapters00:00 Introduction and Background02:47 Representation and Community06:37 Cultural Barriers to Treatment10:50 Reclaiming Life After Surgery12:42 The Journey of Self-Discovery15:22 Overcoming Barriers to Care17:45 The Role of Community Support19:51 Understanding Obesity as a Disease21:30 Advocating for Yourself23:42 The Importance of Empathy in Healthcare25:47 The Journey of Healing and Self-Discovery27:45 Individualized Health Journeys29:20 The Importance of Representation in Healthcare31:21 Documenting the Bariatric Journey33:38 Navigating Cultural Barriers in Health35:16 Empowerment Through Advocacy39:20 Understanding Obesity as a Disease41:00 The Role of Community in Healing44:08 Creating Safe Spaces for Conversations52:31 Sharing Your Story as EmpowermentResourcesBariNation Foundation - barination.orgSupport This Work, Become a Donor- https://barination.givecloud.co/fundraising/forms/8NDR96EKBariNation Support Community- https://barination.mn.coMonique Coleman's Social Media - IG @healthylivingwithmonique1Community Room Zoom Link- https://us02web.zoom.us/j/84398962120

Today changes everything.In this special episode of the BariNation Podcast, we officially announce the launch of the BariNation Foundation, a federally recognized 501(c)(3) nonprofit organization dedicated to supporting people fighting the chronic disease of obesity.Founded by patients, built by patients, and guided by experts, the BariNation Foundation exists to bring knowledge, community, and hope together, without barriers.In this episode, April Williams is joined by co-founders Jason Smith and Natalie Tierney, along with Melanie Lindell, Christine Mason, and Lori Dustin, to share:✔ Why BariNation transitioned into a nonprofit✔ What 501(c)(3) status means for patients✔ How this expands access to lifelong obesity care✔ Why patient voice must remain central in obesity treatment✔ The future of bariatric surgery, GLP-1 medications, and metabolic care✔ How you can become a Foundational DonorOur MissionThe BariNation Foundation exists to bring knowledge, community, and hope together to support people fighting the disease of obesity.We are treatment-agnostic and committed to supporting individuals pursuing:Bariatric surgeryGLP-1 medicationsMedical obesity treatmentLifestyle-based treatmentLong-term metabolic careOur VisionA future where there are no barriers to accessing lifelong obesity care and support, financial, educational, technological, or systemic.Our ValuesPeople FirstScience Over StigmaCommunity as CareAccess Without BarriersPartnership & IntegrityHope with HonestyWhy This MattersMore than 100 million Americans live with obesity.Hundreds of thousands undergo bariatric surgery each year.Millions are navigating GLP-1 medications and metabolic treatment.And too many are doing it alone.The BariNation Foundation is building a bridge between:PatientsCliniciansResearchersIndustryAnd real-world lived experienceSupport the MissionAs a 501(c)(3), donations are tax-deductible where state law allows.Become a Foundational Donor and help eliminate barriers to obesity care.🔗 https://barination.givecloud.co/fundraising/forms/8NDR96EKEvery deductible dollar goes directly toward:Podcast educationCommunity support groupsAdvocacyFree educational resourcesPatient access initiativesThank you for watching, sharing, and supporting the BariNation Podcast and now, the BariNation Foundation. We could not do this without your support and we are deeply grateful for you.⏱ Timestamps00:00 – The Big Announcement05:00 – Why Nonprofit Status Matters10:00 – Patient Voice at ASMBS15:00 – Expanding Support Beyond Bariatric Surgery20:00 – Sustainability & Financial Stewardship30:00 – Our Mission, Vision & Values35:00 – How to Support the Foundation

Have you ever worked so hard to lose weight, only to feel frozen at the idea of intentionally putting weight back on your body?You’re not alone. And this episode is for you.In this BariNation Podcast episode, we sit down with Kayla Girgen, RD, LD, CPT, registered dietitian, personal trainer, and author of the new book Ruck Fit, to break down rucking through a bariatric lens, the fears, the resistance, and why this simple practice may be one of the most powerful (and overlooked) tools for post-op metabolic health.Rucking is simply walking with weight, and while that sounds straightforward, for bariatric patients, it can bring up a lot of hesitation:“I worked so hard to lose this weight—why would I add it back?”“What if I hurt myself?”“What if it doesn’t actually help?”Kayla meets those fears head-on with science, compassion, and real-world experience.Episode Quotes:"It might sound dramatic to say that rucking saved me, but shouldering the load helped me reclaim my sense of self, perseverance, and inner peace." Kayla Girgen“Rucking's going to help preserve that muscle and help make sure that you can maximize your blood sugar management...By adding weight back in the form of a weighted vest or a ruck, you help provide that weight bearing stimulus that helps tell your skeleton, hey, we still need this bone density."What We Cover in This EpisodeWhy Bariatric Patients Hesitate to Try RuckingThe emotional and psychological resistance to “adding weight back”How fear, all-or-nothing thinking, and perfectionism keep us stuckWhy doing nothing often feels safer than trying something newWhat Rucking Actually Is (and What It’s Not)Walking with a weighted vest or backpack (ruck)Why rucking is low-impact, scalable, and accessibleHow rucking is different from traditional cardio or gym workoutsMuscle, Bone Density, and Post-Op StrengthWhy rapid weight loss can increase risk of muscle and bone lossHow rucking provides the weight-bearing stimulus your skeleton needsWhy preserving muscle matters more than “burning calories”Metabolic Health & Flexibility Explained SimplyWhat metabolic flexibility actually means (without medical jargon)Why bariatric patients often feel hungry quickly or “carb dependent”How rucking helps muscles access fuel without relying on insulinWhy this matters for insulin resistance, inflammation, and long-term healthMental Health, Burnout, and ConsistencyHow rucking supported Kayla through panic attacks and burnoutWhy rucking helps people escape the “all in or all out” cycleThe underrated mental health benefits of movement + natureHow to Start Rucking (Without Overdoing It)How much weight to start with (hint: less than you think)Weighted vest vs backpack: pros, cons, and posture considerationsCreative ways to ruck without going on a long walk (yes, housework counts)Why not every walk needs to be a ruckCommunity, Connection, and Real-Life SupportWhy rucking works well in groups (even at different fitness levels)How community reduces fear and builds confidenceWhy post-pandemic connection matters more than everAbout Kayla Girgen & Ruck FitKayla Girgen, RD, LD, CPT is a registered dietitian, certified personal trainer, and movement educator who discovered rucking during a season of burnout and anxiety. Her new book, Ruck Fit, explores:The history of ruckingThe science behind why it worksHow rucking supports metabolic, mental, and physical healthPractical, beginner-friendly guidance to get started safelyThis episode brings the book to life, especially for bariatric patients navigating movement after weight loss surgery.Thinking About Trying Rucking?If this episode sparked questions like:“Is rucking safe after bariatric surgery?”“When is the right time to start?”“What if I’m scared I’ll fail?”You’re exactly who this conversation is for.👉 Leave a comment,👉 Email us at [email protected], or👉 DM us inside the BariNation CommunityWe’ll be inviting Kayla back to go even deeper—and your questions help shape those conversations.Links and Resources:BariNation Newsletter Sign- Up: https://barination.kit.com/ea1ff73fb9Metabolic Flexibility Blog: https://kaylagirgenrd.com/metabolic-flexibility/BariNation Support Community: https://barination.mn.co

Metabolic health is more than weight loss—it's about addressing the root causes of obesity as a disease. Today’s episode is sponsored by AdventHealth and we were excited to sit down with Dr. Damon Tanton, Executive Medical Director of AdventHealth Central Florida's Metabolic Health Institute, to explore how insulin resistance drives weight gain and metabolic dysfunction. Dr. Tanton explains why treating obesity requires whole-person care rather than focusing solely on diet and exercise. We discuss the root causes of metabolic syndrome and how personalized care is transforming lives by addressing hyperinsulinemia and reversing metabolic damage before it becomes irreversible.What You Will Learn in this Episode:✅ Why insulin resistance is the foundation of metabolic health issues and how hyperinsulinemia causes your body to store fat rather than burn it for energy preferentially.✅ Why whole person care and personalized treatment are essential for long-term success, and how AdventHealth Central Florida's approach eliminates shame and judgment from obesity medicine.✅ How understanding the cause can determine the best treatment course, and how bariatric surgery and GLP1/GIP medications work as potent insulin sensitizers that can reverse years of metabolic damage and reduce inflammation throughout the body.Tune in, and don’t forget to join the BariNation Community to attend community meetups, watch exclusive bonus content and support the podcast for as little as $5 per month! You can also contribute to BariNation and become a Drive To Thrive Supporter with a one-time or recurring donation.TIMESTAMPS: 00:00 Metabolic health, obesity medicine and understanding insulin resistance and hyperinsulinemia06:56 Why obesity is a physiological, not a behavioral issue, and obesity is not your fault 18:52 How visceral fat triggers the metabolic disease cascade and the domino effect28:30 The importance of early intervention in metabolic syndrome30:43: Discussion of personalized individualized care and the frustration with healthcare 38:20 Whole person care approach at AdventHealth Central Florida 44:34 Overcoming shame and judgment in obesity treatment and creating trust between patient and doctor55:50 Life gained through metabolic wellness and authenticity, and when is the best time to have surgery1:00:22 Jason shares how his life has changed, and Dr. Tanton encourages being your authentic self to the listener KEY TAKEAWAYS: 💎 Insulin resistance affects over 100 million Americans and is the underlying cause of 70% of all diseases, including cardiovascular disease, cancer, anxiety, and reproductive problems. Addressing hyperinsulinemia is the key to reversing metabolic health decline.💎 The medical system has been backwards for decades, blaming patients for behavioral issues instead of addressing the science first. Personalized care that treats the whole person without judgment is essential for sustainable results.💎 Bariatric surgery and GLP-1 medications are not just weight loss tools—they're powerful treatments that correct physiological dysfunction by dramatically lowering insulin levels and reducing inflammation throughout the body.ABOUT THE GUEST: Damon Tanton, MD, is board-certified in endocrinology, diabetes and metabolism. He serves as Executive Medical Director of the Metabolic Health Institute at AdventHealth and sees patients at AdventHealth Medical Group in Orlando, Florida. A University of Miami School of Medicine graduate, he completed his residency at Wright-Patterson Medical Center and fellowship in endocrinology at Lackland Air Force Base. He specializes in diabetes, insulin resistance, obesity treatment, PCOS, and thyroid disorders.AdventHealth Central Florida - InstagramAdventHealth Orlando - WebsiteAdventHealth Central Florida, Damon Tanton, MD,AdventHealthWeightLoss.comRESOURCES MENTIONED: BariNation WebsiteBariNation - EmailBariNation - Partnership Monthly Membership BariNation’s How to Find an Obesity Specialist Guide