The Best Bariatric Surgeon for suffern and middletown ny

Another Accreditation We are so Proud of!

Ramon Rivera, MD, FACS, Medical Director of Good Samaritan Hospital’s Surgical Weight Loss Institute,

and Maria Scaffidi, MPA, RD, CDN, Bariatrics Coordinator, announce that Good Samaritan Hospital’s Surgical Weight Loss Institute, a member of the Westchester Medical Center Health Network (WMC Health), has been accredited as a Comprehensive Center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®),

The 5-Day Pouch Test: Fact and Fiction

By Jessica Basso, RN, BSN

In 2007, Kaye Bailey developed what is called the 5-day Pouch Test. Kaye had gastric bypass surgery, but seven years after her surgery, she started to regain s weight. Her doctor suggested she get back to the basics. Following, her doctors order, the 5-day pouch test was born.

To Snack Or Not To Snack

To Snack Or Not To Snack

By Susan Epstein; MS, RD, CDN,

Snacking. Everyone does it. A handful of pretzels at work. A bag of popcorn while at the movies. Is this really going to slow my weight loss? What about after Bariatric Surgery? Doesn’t it make sense to eat small snacks throughout the day since the stomach is so small?

Meal Planning Tips

Meal Planning Tips

By Susan Epstein, MS, RD, CDN

When it comes to eating well after Weight Loss Surgery, meal planning and preparation play a major role. Our eating schedule varies depending on work our schedules, family commitments, social activities, and travel plans. As long as you stay organized and mindful,

65 Reasons to Exercise if You’re Over 65

By Diana Larson, RN

As you age, your body undergoes certain changes, and you may find yourself making excuses for why you can’t exercise like you used to. Changes in mobility, flexibility, and joint stiffness may leave you feeling like exercise isn’t always possible. However, the benefits of exercise greatly outweigh the risks.

Eating The Rainbow

By Susan Epstein, MS, RD, CDN

To help educate people on the importance of including a variety of fruits and vegetables in their diets, Heath and Wellness professionals use the phrase “Eat The Rainbow”. Let’s examine why it is important to include a variety of colors in your diet.

  1. Red: Fruits and vegetables with the red color contain multiple nutrients and antioxidants.

The Health Benefits of Yoga(Part One-Yoga’s Origins)

By JSCepeda

The origins of yoga began well over 5,000 years ago. Yoga is the Sanskrit word “to join” or “to unite” which melds the physical, mental and spiritual practice with breath. Therefore, yoga is the practice of joining all three aforementioned components to create a level of conscious harmony.
To better understand the origin of yoga,

A Calorie-Conscious Valentine’s Day

By Diana Larson, RN

There are some surprising facts about the number of calories in your favorite Valentine’s Day treats. SparkPeople blogger, Melinda Hershey, compared the calorie, fat, and sugar content in the most popular Valentine’s Day goodies. She concluded that, “keeping these numbers in mind can help you make smarter choices when it comes to choosing the right treats for you and the special people in your life.”

She found that eating five Hershey’s Kisses (112 calories,

How to Get Back on Track After the Holidays

By Susan K. Manez MS, RD, CDN

If visions of sugarplums are dancing through your head and you’re ready to settle in for a long winter’s nap, it may not just be your nostalgia for Christmases past. The cause for your malaise is the overindulgences at the many holiday parties and gatherings clouding your brain.

How Your Weight Affects Your Joints

By Laura DeAndrade, MSN, ANP-BC

Obesity affects all organs of the human body. It does not discriminate. One of the major systems affected in the body is the musculoskeletal system. People of any age, including teenagers, can start to feel the effects of weight on their joints even if they are only ten pounds overweight.

Excuses Take Up Time, Exercise Doesn’t Have To

By Laura Greaney, MSN, Nutritionist

I don’t have time to exercise. I can’t afford a gym membership. I’m too tired. These excuses are things I hear daily about reasons why people do not exercise. Exercise is an essential part of not only losing weight, but also having a healthy, longer life. The main point of exercise is making sure heart rate elevates.

The Importance of Attending Bariatric Support Groups

By Susan Epstein, MS, RD, CDN

People are often hesitant to attend a support group. They may wonder, “Will it be relevant to what I’m going through?” “Will I be put on the spot?”. People attend support groups for various reasons. This article will look at what you can gain from attending a support group.

Obesity – Associated Health Risks

By Jeanne Karson, NP

Obesity can cause severe damage to your body. It is the major cause of diabetes, high blood pressure, sleep apnea as well as some cancers. These diseases can lead to disability, poor quality of life and early death. The following outlines the associated risks:

So, how do we combat obesity?

What to Expect at Your Behavioral Evaluation

By Dr. Kristin Allison

Everyone entering our program at Tri-State will meet with either our staff psychiatrist or social worker at the beginning of your journey. This behavioral evaluation is different than an outside appointment with a mental health professional that may be intended to diagnosis and treat a condition, usually because you are experiencing certain symptoms that concern you.

Fall into Healthy Eating

By Susan Epstein, MS, RD, CDN

The days are getting shorter. The leaves are changing color. Sweaters are coming out of the closet, to hide the definite weight gain the colder months bring. Fall has arrived and it’s the time of year we indulge in festive holiday foods that makes Mr. Sweater our close friend in hiding our new bulge.

What is Metabolic Syndrome?

By Laura DeAndrade, MSN, ANP-BC

Metabolic syndrome is the clinical term for a series of risk factors that can put you at risk for other health conditions like coronary heart disease, stroke and diabetes. When a person meets three out of the following five criteria’s, they are said to have metabolic syndrome.

  1. A large waistline – otherwise known as “abdominal obesity”.

The Mental Health Benefits of Exercise

By Michelle Lossino, LCSW

Besides being an important part of weight loss, there are many mental health benefits of exercise.

  • Reduces stress.
  • Can assist in alleviating anxiety and depression; regulate mood.
  • Releases endorphins – which create feelings of happiness and euphoria.
  • Improves self-confidence and positive self-esteem.

Your “Wow” Moments

By Susan Epstein MS, RD, CDN

Patients often describe one of their favorite added benefits of their weight loss surgery as a “WOW” moment. These are moments when patients realize their lives have changed drastically and it’s an awesome feeling!
At times when the journey is more challenging, these moments are easily forgotten.

The Mental Game of Weight Loss

By JSCepeda

The scale and your feet meet for the trillionth time in the last thirty-five years. Meetings include, but are not limited to the night before a blind date and your favorite dress couldn’t zip. Distressed, but determined to get into the dress, you duct taped the zippered sides together and paired it with a black sequined cardigan,

Maintenance Dietary Guidelines

By Susan Manez, MS, RD, CDN

Now that you have achieved your goal weight, the most difficult part of your journey has begun. When actively losing weight your diet plan is much more structured and restrictive, but when it is time for you to maintain your weight there are a lot more variables.

Cooking for Your Family After Bariatric Surgery

By Susan Epstein MS, RD, CDN

We all know how important sitting down to a family dinner is. With everyone on busy schedules, it’s a time to connect and hear about one another’s day. Often patients are concerned that after Bariatric Surgery, they will not be able to eat dinner with their families.

The Secret First Step for Successful Weight Loss: Getting Organized

By Susan Epstein, MS, RD, CDN

We often hear about the “fundamentals of weight loss”, eating less, exercising more, staying motivated, and getting enough sleep. However, we rarely hear how critical a role “organization” plays in weight reduction. Setting a routine and planning ahead are very important. Often this is the first step in achieving successful weight loss.

Mindfulness-Tips for Mindful Eating

By Diana Nunziato, RN

Mindfulness has been defined in Psychology Today, “as a state of active, open attention on the present” (2016). You are able to observe your thoughts and feelings from a distance, without judging them as being good or bad, when you practice mindfulness. Instead of letting your life pass you by,

Sleep and Appetite

By Michele Lossino, LCSW

It is estimated that people spend almost 25 years of their lives sleeping. Sleep affects all aspects of our lives, from our mood to our job performance. On average adults need 7-8 hours of sleep a night. Many factors can interfere with your ability to get proper sleep. For example,

The Importance of Support Groups Before and After Bariatric Surgery

By Jessica Basso, RN, BSN

Support Groups are a great way for patients to help assist each other, throughout the weight loss journey both pre and post operatively. Everyone’s weight loss journey will be a different and unique experience. With support from family, friends, coworkers, neighbors, and other WLS patient’s, studies have found individuals have increased success losing and maintaining weight when attending support groups.

Natural Versus Added Sugar

By Susan Epstein, MS, RD, CDN

There is a lot of confusion when it comes to defining carbohydrates and sugars. It gets more complicated when you see terms like “natural sugar” versus “added sugar”. What does it all mean?

Carbohydrates are one of the 3 macronutrients which can be used as energy sources (the other 2 are proteins and fat).

Emotional Challenges After Weight Loss Surgery

By Jessica Basso, RN, BSN

Bariatric surgery has become very popular over the years to help individuals weight struggles healthier. With Bariatric surgery, many lifestyle changes need to take place in order for success to be achieved. Not only physically do changes occur but also emotionally, so let’s talk about some of the emotional challenges that may arise with WLS:

  1. Relationship Changes.

Tips to Pre-Plan Meals

By Vincenza Garcia, RD, CDN

If you’re thinking about losing a few pounds, there are a few ingredients you need to ensure your success. First, you should have a sensible eating plan that is in line with your goals. Second, you should structure a reasonable exercise routine that incorporates both aerobic activity and strength training to ensure you receive maximum benefit from your efforts.

Losing Weight Prior to Weight Loss Surgery

By Laura DeAndrade, MSN, ANP-BC

Upon your first visit into our office, you will hear our staff stress the issue of not gaining weight during the pre-surgical process. We encourage weight loss of any degree prior to surgery. Not only is this weight loss beneficial for your overall health, but it can reduce your overall risks during surgery.

Body Image Disturbance After Weight Loss Surgery

By Laura DeAndrade, MSN, ANP-BC

Everyone has different perceptions of what they will look like after weight loss surgery. For most, it’s thinking about the thinnest time of your adult or teenage life. Many people assume that losing weight is the best way to boost an already suffering body image. The truth is many who undergo a massive amount of weight loss,

New Changes to The Nutrition Facts Label

By: Susan Epstein, MS, RD, CDN

Good news! The nutrition facts label is getting a makeover! On May 20, 2016, the FDA (Food and Drug Administration) announced new rules for food labels. The new food labels will be updated, making them easier to read and understand. As a result, consumers will have an easier time making informed food choices.

What Are Your Bowels Telling You?

By: Laura Greaney, MSN, Nutritionist

Discussing your bowel movements with people seem to be a bit taboo. When I ask people if they are having any issues with their bowel movements their responses normally begin with “I don’t want to be gross.” Paying more attention to your stool can greatly help with determining what you need more and less of.

Are You Being Fooled by Food Labels?

By: Laura DeAndrade, ANP-BC

Have you ever wondered exactly what your food labels meant?  Are you being lured into purchasing items that are otherwise not very healthy simply because you fell for a marketing scheme?  Chances are that mostly everyone has picked one food over another because it included the words “all natural” or “multigrain”. 

Eating Healthy at a BBQ

By Susan Epstein, MS, RD, CDN

Summer is finally here! Part of the fun of summer includes lazy afternoons and backyard barbecues with family and friends. So many classic cookout foods including hotdogs, potato salad, and coleslaw, are not the healthiest choices. How can a person stay on track? Here are some tasty tips to help you enjoy the summer without straying from your healthy eating habits:

The Unspoken Side Effects of Weight Loss Surgery

By: Laura Greaney, MSN Nutritionist

Prior to bariatric surgery you should have an in-depth idea of possible side effects and complications of the actual surgery. You will learn about possible slipped bands, erosions, gastric leaks, dehydration, and vomiting. However, what about common side effects people fail to mention. Things that most of you will experience but may not realize if it’s “normal.” Remember,

Dealing With Hunger

By: Susan Epstein, MS, RD, CDN

Statistically, the greatest concern of pre-op bariatric patients is dealing with hunger. “Will I feel hungry after surgery?” “Will I be able to keep hunger pangs at bay?” This article will address these issues and will give you a few suggestions on how to deal if hunger strikes.

Stocking Your Tool Box: Pt. 2

By: Diane Nunziato, RN

We all need a tool box stocked with the right tools to succeed in life as well as before and after weight loss surgery. Just as a mechanic needs the right tools to repair our cars, without the correct tools, we are just set up for failure.
As we mentioned in Stocking Your Tool Box with the Right Tools Part One,

Foods that Fight Inflammation

By: Susan K. Manez, MS, RD, CDN

Many people suffer daily with pain, swelling, weakness, and a vast array of ailments. While some of these conditions are incurable and/or must be treated with medications, many are improved or even resolved with dietary changes. There are many foods that are considered “anti-inflammatory”. What does this mean?

Surrounding Yourself With Support

By: Susan Epstein, MS, RD, CDN

Changing your lifestyle and reaching your weight loss goal takes a lot of hard work! Doing this on your own can be difficult and lonely. A good support system is vital to help you achieve success. The following are some ideas to surround yourself with the support you need.

Obesity and Cardiovascular Disease

By: Laura DeAndrade, ANP-BC

Cardiovascular disease is the number one killer in the United States and studies now show that elevated body mass index (BMI) in overweight and obese people isn’t simply linked to heart failure – it has been proven to cause it.

BMI is a simple measure of weight-for-height used to classify overweight and obesity in adults.

Eating On the Run

By: Susan Epstein, MS, RD, CDN

We all live busy lives. Sometimes our busy lifestyles make having well balanced homemade meals very challenging. We are all looking for fast, easy, tasty foods that will fit into our busy lives. Here are some tips to help you stay healthy in today’s hectic world:

  1. Plan ahead.

Eating and Drinking After Weight Loss Surgery

By: Laura DeAndrade, ANP-BC

Nearly all bariatric programs will have specific recommendations regarding your eating and drinking patterns after surgery. The most consistent recommendations are to:

  • Focus on good, lean proteins
  • Drink a minimum of 64 ounces of no calorie or low calorie fluids daily
  • Take vitamin supplements
  • Avoid drinking with meals

These guidelines were made many years ago and are still in place today.

Why Does My Breath Smell After Bariatric Surgery?

By: Laura Greaney, MSN

Congratulations, you have foul-smelling breath after bariatric surgery! Though this may seem like a trick, having rotten breath after bariatric surgery usually means you are losing excessive weight rapidly. This is a good thing. Many people often report their mouths feel dry or sticky right after surgery, regardless of what they do.

Drinking Alcohol After Bariatric Surgery

By: Jessica Basso; RN, BSN

For individuals that have undergone bariatric surgery specifically the gastric bypass and the sleeve gastrectomy the effects of alcohol can be stronger and faster. You may feel the effects from drinking much sooner than you would prior to having surgery because our bodies change and so will the way that your body metabolizes alcohol.

The Greatest Challenge: Dealing with Head Hunger

By: Susan Epstein, MS, RD, CDN

Statistically, the greatest concern of pre-op bariatric patients is dealing with hunger. “Will I feel hungry after surgery?” “Will I be able to keep hunger pangs at bay?” This article will address these issues and will give you a few suggestions on how to deal if hunger strikes.

Bariatric Surgery & NSAIDS

By: Jessica Basso, RN

Let’s discuss the definition of NSAID’s. NSAID stands for Nonsteroidal Anti-Inflammatory Drugs. There is a broad range of drugs that contain NSAIDS. The most well-known drugs would be Advil, Aleve, Ibuprofen, Motrin, and Aspirin, all of which, fall into this category of medication. The two main uses for NSAIDS are for fever reduction and to help decrease inflammation and/or pain.

Why is it Important to Keep a Food Diary?

By Jeanne Karson, CBN, ANP-C

Studies show that keeping a food diary is one of the most successful ways to lose weight. In fact, it has been the cornerstone of many successful weight loss programs. Research shows that those who keep a food diary is a great way to be objective about what it is that you’re eating.,

Weight Gain and Menopause

By Susan Epstein, MS, RD, CDN

Most women gain weight as they age. Is this inevitable? Is there a connection between menopause and weight gain? Can anything be done to prevent this weight gain?

Statistics show that during a two year period, menopausal women gain between two and ten pounds. Many women notice their clothing fitting more snugly,

What Happens To Our Bodies When We Don’t Consume Enough Protein

By Laura DeAndrade, ANP-BC

Our bodies are always working hard to keep all of the essential body processes working. Optimal nutrition plays an integral role in the efficiency of these processes. Neglecting our diet and particularly our protein intake, will begin to display negative effects. Over time, these negative effects can cause a lot of stress and harm to our bodies.

Mindful Eating

By Jody MacHugh, CBN, FNP-BC, RNFA

Has this ever happened to you?

You see a candy bowl on someone’s desk at work and before you know it, you’ve already eaten 5 pieces? You’ve finished an entire meal and didn’t even recall what it tasted like? You are stressed at work and suddenly find yourself reaching for potato chips to “make yourself feel better?”

Why am I so gassy?

By Laura Greaney, MSN, Nutritionist

Passing gas is a part of normal day life and everyone does it. However, sometimes after bariatric surgery people begin to recognize it more. It may be louder, smellier or more frequent but patients say they notice it more. This often leads to people feeling embarrassed in social settings or increasing anxiety.

The Powerful Benefits of Walking

By Jessica Basso, RN

Walking is a very beneficial form of exercise. It is estimated that 80% of Americans do not get enough exercise. The Surgeon General suggest that Americans need to start walking because it can help reduce and treat chronic illnesses. Walking is considered a moderate form of exercise which helps prevent and reduce the severity of chronic diseases such as high blood pressure and diabetes.

Tips for Meal Preparation

By Vincenza Garcia, RD, CDN, CPT

If you’re thinking about losing a few pounds, there are a few ingredients you need to ensure your success. First, you should have a sensible eating plan that is in line with your goals. Second, you should structure a reasonable exercise routine that incorporates both aerobic activity and strength training to ensure you receive maximum benefit from your efforts.

Reading Food Labels: The Why and The How

By Susan K. Manez MS,RD,CDN


  • Allows you to choose foods and beverages that fit within your eating plan
  • Provides you with information about the nutrition quality of the foods and beverages you are consuming
  • Helps you compare items so you may make the best choices for you and your family


    Below are the steps you need to take to properly read nutrition facts labels:

  1. Serving Size – This is the portion that all nutrients listed on the Nutrition Facts label are based on.

Ways to Burn 100 Calories

By Diana Nunziato, RN

We burn calories throughout the day with almost every activity we do. Calories can be burned gradually over a period of time or rapidly with intense periods of exercise. The amount of calories burned is proportional to the length and intensity of the activity. According to Erin Whitehead, a Health and Fitness writer for the website,