Before & After is both a memoir and a cookbook—an intimate account of Leach's own transformation as well as a guide for those who have undergone or are considering the procedure. As Leach has learned in the six years since her operation, weight-loss surgery is not an event with a finish line or a goal weight—it is the beginning of a new way of life.

This edition of Before & After has been updated with all that Leach has learned on her post-op journey. It includes a foreword by Leach's surgeon, advice from a nutritionist, answers to more frequently asked questions about weight-loss surgery, a whole chapter on meal plans for different post-operative stages, suggested menus for early food stages, additional questions and answers affecting longer-term post-ops, and new information about products that have entered the marketplace.

Most notably, this edition showcases a wealth of new recipes that utilize the latest in light and healthy ingredients for smart and savory results, including everything from Asian Meatballs with Peanut Sauce and Turkey Tenderloin with Apple Chipotle Chutney to sugar-free Pistachio Gelato and Lemon Almond Sponge Cake. Each recipe makes about four servings, but includes a measured serving for WLS people along with a calorie/carb/fat/protein count. Leach has recipes for every step of the way, from tastes-like-the-real-thing milk shakes for those first post-op days to an entire Thanksgiving menu.

Before & After is a journal of Leach's own inspirational story, where she shares her ups and downs, her tips and techniques, but mostly it's a book of hope for anyone who has a serious weight problem.