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First off, I just want to say this very important thing, if you take nothing else away from this article, let it be this- People’s reactions to you are based on their relationship with themselves, not you. Always. Someone who is living at peace with themselves will have no need to harshly criticize, no desire to humiliate, and no feelings of unresolved jealousy. Sadly, once you understand this, you also realize how many people in your life are unhappy with themselves on some level. It makes it a little easier not to take things personally, but I would be lying if I said those things don’t hurt anymore. So how do you deal with friends and family members who are not living at peace with themselves? What practical steps can you take to be at peace with yourself so that you are able to reject those statements and hurtful judgments instead of internalizing them? Here’s the bottom line- You will always have people in your life who do not wish you well, who want to see you fail. If you do not learn to look past them and stay focused on you and your progress, and live at peace with yourself- you will experience re-gain. I love the words from Eleanor Roosevelt, “No one can make you feel inferior without your consent.” 1) Start with yourself- You need to be at peace with yourself. Who you are, what you weigh, your progress level, etc. Easier said than done, I know. But working towards that will allow you to bypass other’s opinions of you because you know who you are and where you’re going. A simple way to begin embracing yourself is positive self-talk. Start by looking into the mirror as often as you can, and saying things to yourself like, “I am a beautiful, peacefully person and I love me.” Say hello to yourself. “Hi Ash, you are a wonderful, beautiful person and I am SO proud of you.” It’s going to feel super painful and may trigger some emotions. Process those as they come, don’t shy away from the feelings that embracing yourself brings. If you need to cry, do so. If you smile, embrace it. Enjoy yourself. Changing that negative narrative in your head that so many of us carry around, is step one. 2) Be honest- When someone says something that’s offensive, it usually comes from one of 2 places: a poor relationship with themselves, or a lack of education. Use your best judgment to determine which it is. Keep in mind, there are a LOT of myths and misinformation surrounding bariatric surgery. Don’t assume people know more than they do. Think back to before you became an expert on Bariatric Surgery. How many questions you had, how many myths you thought were accurate. Seek to educate. But be honest, if someone makes a hurtful comment, let them know. Keep it simple, “Hey, that was uncalled for.” or “Please don’t say things like that to me.” Try to stay calm and in control. 3) Take a break- If you need a break, take one! Go for a walk, get out of the house, go listen to music alone. Don’t feel bad for needing a break. Family time can be stressful, don’t allow others to jeopardize your progress. When you’re stressed and anxious, you’re more prone to overeating which puts you back on that harmful cycle you’re working so hard to stay off of. Give yourself permission to stay home sometimes too, you don’t need to be at every single family gathering. It’s okay to opt out. People may get offended, they may try to make you feel guilty, but remember- it’s not about you. It’s all about how they feel about themselves. Those who are at peace with themselves will support you and do their best to understand where you’re coming from. 4) Stay focused- This is a tough one. Holidays pull our focus in so many directions, it’s easy for us to lose focus on our goals. Be proactive about making plans for yourself for food and exercising during the holidays. Being ahead of the game and staying on top of your plans will make you feel peaceful and accomplished. When you feel this way, your confidence is harder to shake and you will feel more secure. When you’re focused on a goal, it consumes your focus and the other things that pop up to derail you just fade into the background. Stick to your routine, take your supplements, and stay on track. You can do this! 5) Stay connected- Join a support group in-person or online, find an accountability buddy, hire a coach, or grab a friend who will keep you focused without judgment. Someone you can call, text or write to keep them updated so they can provide you with the encouragement you may not be getting from others this season. Having connection fills an emotional need that many try to fill with food. If you’re getting that need met, you won’t be as tempted to eat for comfort. Connection is something we all need, so make it a priority to have someone in your corner this holiday season. Remember, at the end of the day- this season is temporary. All the food, all the family, all the hustle and bustle. The things that can make or break this season. It’s all temporary. You are what you carry into the New Year. Your health journey is what lasts. Keep your sights on the long term. You can do this, I believe in you!

If you’ve made a commitment to change your diet, learn a new exercise routine, start or complete a project, be more assertive, or maybe connect with your intuition on a daily basis, know that you DO have the POWER to follow through with this. Set an intention to connect with and magnify your inner strength and focus. Often when we set out to make changes in our life we start obsessing about it and think way too far into the future which can overwhelm us: then we just say “Oh the heck with this: I’ll never be able to do that huge project or maintain that habit forever, why even bother?” If you notice your thoughts going in that direction slow down, take a deep breath, and get out of your head and into your body. Come back to the present moment. Take another breath. Ask “Is there one simple thing I can do in this moment to honor my commitment?” That might mean just not putting a piece of chocolate in your mouth in this moment: That’s it you did it! And I know you can do that again in the next moment!! Perhaps you will be guided to make a phone call. Pick up the phone and make that call. Or, there might not be anything you need to do in this very moment so relax into the not doing. It is important that you keep yourself surrounded by upbeat positive people and that you raise the vibrations of your surroundings as much as possible. Burn sage, put a crystal on your night stand or desk at work, keep plants and flowers in your environment, listen to uplifting music. Shield yourself from negative energies. Many of you who are drawn to read this are highly intuitive empaths: your are like psychic sponges who absorb the energies of the people near you and your environment. As part of your morning routine surround yourself with a beautiful white light ( or whatever color feels most safe and loving for you). The only thing that can penetrate this light is love and healing energies, no negative energy can pass through this. If you believe in angels, spirit guides, or any other sort of deity invite them to be with you throughout the day guiding you and keeping your thoughts and feelings uplifted and positive. Whenever possible remove yourself from negative situations, decline to engage in gossip or fear based conversations. Anger, negatively, jealousy and fear will only cause you pain. Clear your energy field daily: meditate, spend time in nature barefoot, take baths in epsom sales, move your body, drink plenty of water, etc. Law of Attraction/Source Energy is rooting for you and right by your side giving extra added energy to your thoughts. So keep your thoughts and focus on what you DO want to manifest. See yourself as happy fulfilled and loved….and know that is is so….. Feel gratitude knowing that your life is moving in the direction of your dreams gaining more and more momentum as your willingness to believe and receive all that is being offered to you opens and increases. BELIEVE and RECEIVE!! I'm sending you so much love! Go have an awesome day!! ❤️ Louisa!!

Another helpful addition is “Added Sugars”, which is found under the carbohydrate information. Naturally occurring sugars are primarily from fruit (fructose) and dairy (lactose). Vegetables and grains can also contain a small amount of naturally occurring sugar. For added sugars, look for the words sugar, syrup, agave, molasses, juice, beet sugar, brown sugar, turbinado and honey. Now that we have the total and added sugars, you can determine if the food or beverage is something you can work into your eating. While there are no formal guidelines, limiting foods and fluids to products that have less than 5 grams of added sugar is a starting point. A rule of thumb for carbohydrate foods is to eat the food that is closest to the farm. That means the least processed the better. For example, a peeled apple is better for you than applesauce. Applesauce is better for you than juice. One hundred percent real fruit juice is another way to say “sugar water” for bariatric patients. The Nutrition Facts Label will list naturally occurring sugars, but you won’t see added sugars listed. So, juice is a high sugar item. Your dietitian will assess your activity level, blood sugar readings, body composition and tolerances to help you find a healthy carbohydrate goal to work into your eating. We now have a better tool to hunt down the added sugars in our foods and beverages. Happy hunting!

In this space remember the importance of prioritizing good self caretaking, talking more kindly to and about yourself, embracing and feeling your feelings, setting boundaries, declining to engage in gossip or negative chatter, walking away from low energy people and situations, being gentle with yourself, not putting unrealistic demands on your time or energy, and understanding that it’s actually GOOD to be SELFish. Bring to the forefront of your mind your innate knowing of the absolute necessity of nurturing your soul with things like art and music and movement and nature and deep conversations with people you love, respect and admire. Let this Valentine’s Day be a Reminder that you need to Love YOU FIRST. That you need to be your most significant other <3! Live In Love, Louisa

If so you might be an EMPATH. An empath is a person with the ability to sense the mental or emotional state of another individual. An empath can psychically feel the emotions, feelings, energy and even thoughts of others. A few common traits of an empath: Highly intuitive Emotionally sensitive (often labeled by others as “overly sensitive” or “too emotional”) Can feel in their own bodies the emotions of others Often absorb other people’s energy Frequently feels overwhelmed in crowds Typically have accurate initial gut feelings about people/situations Need a lot of alone time Have big hearts and can be taken advantage of Because they can see and sense problems (and what needs to be done to resolve them) in other people’s lives they often feel responsible to fix them. What’s all this got to do with food? If you are an empath there is a good chance you are not using food to manage YOUR energy but to manage OTHER PEOPLE’s energy. It’s like you are psychic/energy sponge who absorbs other people’s energy throughout the day, whether it be the co-worker who is cranky, the happy giggly girl in line at Target, your good friend who is going through a break up, or the heated political debates on television. When you unknowingly absorb these energies you can be left feeling anxious, drained, depressed, overwhelmed, and even confused by the end of what seemed to be a normal, productive ‘uneventful’ day. Such feelings can be a trigger to overeat. If you are familiar with emotional eating you KNOW that overeating is a good way to escape or calm such emotions. So what’s an empath to do to stop from picking up and taking on everyone else’s emotions? Start to notice energy. Notice how you feel in different situations, around various people. Connect to your body: does your body feel calm and relaxed around this person or uptight and anxious, do you have a knot in your stomach, are your shoulders scrunched, do you feel the need to be defensive, or do you feel calm and safe? Notice how you feel in a cluttered room vs. a bare room, how you feel listening to different music, how you feel when you wear certain colors, etc. Protect your energy; before you leave the house in the morning imagine yourself being protected by a sparkly white or golden bubble and the only thing that can penetrate this bubble is love and healing energy, no negative energy can get through this beautiful circle of light. If you’ve been around someone who’s uptight anxious or angry literally brush their energy off your body with your hand. Hold your hands about and inch away from your body and brush around your head, down your opposite arms, down your chest stomach and legs. Or even just shaking your hands down by your side with the intent of shaking off their energy can help. If you are in a conversation with someone who is angry or anxious you can imagine you are behind a one way mirror and everything they say just bounces right back to them, or imagine you are wearing a suit of teflon and everything they say just slides right off. Stretch your body (we hold emotions in our muscles… when you stretch it helps release stored emotions). Spend time in nature. Walk barefoot in the grass. Take a bath in epsom salt. Create a transition ritual for when come home from an event, or work, or school, etc. It can be something like deciding to change your shirt and while changing your shirt ask that any energies that you've absorbed that are not yours be released saying ”I now release any energies that I may have absorbed that are not mine. I send them to be transmuted to light and love and sent back to their rightful owner!” Spend time near water. Meditate. I am seeing this more and more in my practice that energy sensitive people often struggle with food or some other addiction as a way to manage all the intense emotions of the world these days. If this article resonates with you it is important to understand that this is very real and that you begin to truly honor your intuition and energy sensitivities. Then set out to learn positive self nurturing rituals to protect and heal you own energy. I will be offering Zoom groups to discuss emotional eating, eating as a reflection of self love and respect, and learning to notice and protect your energy. If you have any questions or comments do not hesitate to contact me!

Why Does It Matter? Support during your Weight Loss Surgery journey can help you succeed. It is motivating to know that the people who love you are on your side. Through the long days of diet restrictions and dramatic lifestyle changes, your journey will be easier if your family members and friends pitch in however they can, whether with verbal encouragement or concrete changes such as avoiding eating off-limits foods in front of you. Still, it is important to remember that you CAN succeed, whether or not you get the support you hope for. Get to the Heart of the Matter First, make sure you know why they are against your weight loss surgery. It is often because they are afraid for your safety. They may know people – or know people who know people who know people – who had complications from Weight Loss Surgery. You can talk to them about the real risks of surgery – using statistics rather than hearsay – compared to the risks of remaining overweight. Still, do not assume that your safety is why they are negative about your decision. It is important to let them express their concerns and to address them directly. These are some other common reasons why your family and friends might have a negative gut reaction to your exciting news. They may be worried that you won’t be able to stick to the Weight Loss Surgery diet, and that you’ll be disappointed with the results. They may think you don’t need it. A lot of family members have trouble seeing how overweight you are, and understanding how much it interferes with your life and health. They may feel insulted. Parents especially may feel as though they have failed if they see you, their child, opt for surgery. They may feel threatened. Your significant other, for example, may be comfortable in the relationship you have had for years, and may worry that the way you feel about him/her will change as you lose weight. They may not know what it means for them. Friends may worry that you won’t want to hang out with them anymore, especially if your time together tends to revolve around food or if they think of you as their dependable “fat friend.” Whatever the true concern is, address it directly. Reassure your friends and family that you are doing this for you, and that you will not become a different person. Offer Them a Role Some friends and family members may feel overwhelmed by your news of Weight Loss Surgery, and that can lead to their negative response. Surprisingly, offering them ways to be more involved in the experience can actually help change their minds. They may feel better about your WLS once you tell them the details about the prep, procedure, and diet, and may even be grateful if you let them know specifically what they can do to help. Address Meal Times Directly Food is central to relationships at home and in social settings, so it is understandable if your loved ones are worried about how your upcoming Weight Loss Surgery will affect the time you spend together. If you think this may be a concern, discuss meals at home and in restaurants with your friends and family. Let them know that you will still be present at the table and interested in being good company, even if you are not eating as much as them or ordering the exact foods that they are. If you are comfortable with the situation, they are more likely to be. Agree to Disagree In most cases, family members mean well. It may be hard to remember or see in the heat of the moment, but they often do genuinely want the very best for you. If you have already tried your hardest to convince them to support your Weight Loss Surgery decision and they are not ready to do so, your next hope is to keep them as an ally in other aspects of your life. Hopefully, you and they can agree to disagree about your Weight Loss Surgery. You can let them know that you respect their opinion and will not be pressuring them to support your WLS. In exchange, you can ask them to continue to be your friend regardless of whether you are a bariatric surgery patient. Be Patient Sometimes, it just takes time. Your own Weight Loss Surgery success may be the best argument for why your loved ones should support you. It may take weeks, months, or a year, but they may come around as they see how happy you are, and as they realize how much they miss you. Bariatric surgery is a lot easier when everyone you love supports your decision, but that’s not always the case. Don’t let resistance from family members and friends get you down, though. They’re probably trying to act in your best interest, and in most cases, you can still get Weight Loss Surgery while keeping strong relationships with them.

Bigger from Birth…And Then College Hit Michele was always big. She was at the top of her height and weight charts from the time she was an infant. She remembers times in her childhood when she couldn’t or wouldn’t participate because she was so big. She didn’t like physical education or sports, and the other children teased her. Food was a comfort. Michele describes the situation as a vicious cycle. The more kids teased her, the worse she felt. The worse she felt, the more she ate. The more she ate, the more she weighed. The more she weighed, the more she got teased. College was a disaster in terms of her weight. Forget about the freshman 15. What about the freshman 40? And the sophomore 40? Add to that the junior 40, the senior 40, and, for good measure, the super-senior (fifth-year) 67, and you now know how Michele Elbertson got to be 427 pounds at the age of 22 years. A Young Weight Loss Surgery Patient with New Relationships Michele made the decision to get the lap-band on her own. She needed a tool to help her control how much she ate, but understood that it was up to her to control what she ate. She only told her parents about her decision after she was sure about it. They were supportive, and have been since then. Michele has taken full advantage of and responsibility for the band. She has lost 260 pounds – 260 pounds! – in less than four years. As she says, she’s a determined person who will accomplish anything she sets her mind to. Michele began to “eat to live” rather than “live to eat.” As her relationships with food and exercise changed, so did her relationships with some friends. She lost some friends whose relationships centered only on food. She gained many more, though, through her new activities. She says the friends she’s gained through running and fitness far outweigh those she lost by changing her lifestyle. An Athlete Is Born Michele ran her first 5k after losing 100 pounds – when she was still 327 pounds. She was hooked. She loved the training, the atmosphere of the race, and the accomplishment. She has never looked back. Since then, she has run countless other races, including 38 half-marathons, 6 marathons, and a 50-miler ultra-marathon. She has also competed in triathlons. Now at an athletic 159 pounds, Michele has her sights on even greater challenges. In the near future, she wants to run a 100-miler and complete an Ironman. Both are feats that most people wouldn’t even dream of. Marathons, Ultras, and Ironmans Now, not everyone’s a distance runner or triathlete, so to understand Michele’s accomplishments, here are a few facts about these endurance sports. A marathon is 26.2 miles. All marathons are 26.2 miles. An ultra-marathon is anything over 26.2 miles. Michele’s recently completed ultra-marathon was 50 miles, and she is training for a 100-miler. A triathlon includes swimming, biking, and running. An Ironman triathlon consists of a 2.4-mile swim, a 112-mile bike ride, and a 26.2-mile marathon. Fitting It All in Every Day Michele works out 6 days a week. Currently, she’s training for an ulta-marathon and is running 5 days a week and lifting weights 3 times. She also does Zumba classes. She takes a rest day once a week. Michele has built her life to be able to accommodate her training schedule. She recently quit her teaching career to focus instead on helping others achieve their fitness and health goals. She is a personal trainer and group fitness instructor. Working at a gym is pure genius – it leaves her with no excuse not to get her workout in! Eating Like a Bariathlete How do you have energy to train like an athlete and work full-time while losing over 200 pounds in 4 years? Ask Michele. Here’s how she eats and works out in a typical day. 7:00 a.m. breakfast: almonds and yogurt or eggs/romaine lettuce 9:00 a.m. snack: protein bar Workout, such as running, lifting, or group fitness class, such as Zumba or bokwa Noon. lunch: soup or salad, usually the largest meal of the day 2:00 p.m. snack: cheese and crackers or something small, equivalent to 200 calories (may include a fruit or vegetable) 4:00 p.m. snack: hot tea 6:00 p.m. dinner; lean protein, veggie, possibly a carb 7:30 p.m. snack: lemon water/hot tea. The number of calories Michele eats during a day is 1,800 (her resting metabolic rate) plus half of the calories she burns through exercise. So, if she runs 10 miles and burns 1,200 calories in exercise, she’ll eat 1,800 plus 600 calories, or 2,400 calories. She allows herself an occasional treat meal with junk food, but still counts those calories. The Accolades Michele is more than your typical bariatric patient, and she’s been getting the recognition she deserves for her extraordinary achievements. These are a few recent examples. Runner’s World magazine Cover Contest Finalist. Makeover on the Rachel Ray Show. Local feature on 6ABC Action News in Philadelphia. Dealing with Negativity – Don’t Worry About It One of the most striking things about Michele is her drive. She has worked very, very hard to get where she’s at today. She’s lost 60 percent of her body weight through being very disciplined every day. And, she has run marathons. Anyone who has run a marathon can tell you that it is was harder than they had ever imagined. Anyone who hasn’t run a marathon cannot imagine how difficult it is. But with all the publicity, Michele has receive a lot of nasty comments. How is she supposed to react when people slam her? They say she hasn’t accomplished anything, that the band has done it all. In fact, they basically say what a lot of weight loss surgery patients hear all the time from people who don’t know any better. So how does Michele react to negativity? She doesn’t want to respond directly and add “fuel to the fire.” She knows they don’t know anything about her, and she’s probably done more exercise and worked harder than they ever have. So, she just goes about her business. Leading by Example Michele says she hopes her successes and story will give others hope. She describes herself as a “real person” and “very down-to-earth,” and she hopes others will see that they can accomplish what she has. In the future, she would like to travel to seminars as a motivational speaker. In the meantime, we congratulate her on her amazing story and wish her well in her 100-miler this spring!

The 3rd Annual National Obesity Care Week (NOCW), October 29th through November 4th, seeks to ignite a national movement to ensure anyone affected by obesity receives respectful and comprehensive care. [Insert your organization’s name] is proud to join the Campaign, which was founded by The Obesity Society, the Obesity Action Coalition, Strategies to Overcome and Prevent Obesity Alliance and the American Society for Metabolic and Bariatric Surgery. All NOCW supporters recognize the 5 Reasons to Care: Obesity is a serious disease. Weight bias is faced by many. Healthcare providers need to have positive, helpful conversations about weight with their patients Science-based weight management options are available for treatment. We need your help passing the 2017 Treat and Reduce Obesity Act (TROA). Although we must educate people about these 5 reasons to care, we must also address barriers to care, such as weight bias in both society and among the medical community. We need more voices – your voice – to reach our goal of achieving better care. You can join us and take action to change the way that you care about obesity by taking the Take 5 Pledge. The Take 5 Pledge is intended to inspire action by addressing the 5 reasons to care and encourage us to change the way that we care about obesity. More information about National Obesity Care Week and their Take 5 Pledge, including information and resources, is available on www.ObesityCareWeek.org. Mark your calendars, and join us in recognizing National Obesity Care Week, October 29th – November 4th.

The Struggle Often Continues For some patients, Weight Loss Surgery can lower your interest in food, so you are not constantly thinking about it. There’s no question Weight Loss Surgery can help you gain control of your eating, but it’s unlikely to eliminate your struggles with food disappear. A few lucky Weight Loss Surgery patients really do stop being tempted by food. The rest, who make up the vast majority of Weight Loss Surgery patients, continue to struggle. You still may be hungry, enjoy salt, fat, starch, or sugar, or be tempted to use food as an emotional crutch. Your family members may continue to insist on keeping high-calorie foods in the house, or pressure you to eat things you shouldn’t. Your friends may still be going out to eat and inviting you to join them in ordering high-fat, high-sugar items. “Why Me?” Isn’t Appropriate It’s easy, even natural, to think of yourself as unlucky. Why should you have to struggle with food? Why should you have to monitor every bite you take, while some people don’t? The fact is, almost everyone does. Ask almost any skinny person how they stay skinny, and you’ll get some variation of the same answer: “I work hard for it.” Just like you, they are aware of what goes into their bodies. They sometimes may be hungry; they sometimes may want to eat more than they should. But they, like you now, take responsibility for their decisions. They may: Skimp on portions if they over ate at the previous meal. Choose healthy foods first. Have a strategy for dealing with emotions and boredom that doesn’t involve eating. Have a support system that promotes healthy behaviors. Accept It and Manage It If you find you still have a rocky relationship with food after weight loss surgery, don’t conclude that WLS didn’t work for you. Instead, accept that you will need to fight the cravings and urges for months, years, or life, and start making a plan. Don’t be afraid to ask for help in developing strategies – whether you ask other BariatricPal members or an always-thin person you admire! Persist in Order to Get the Answers You Need We all want to be able to trust our doctors. You want to believe your surgeon takes care of all aspects of your Weight Loss Surgery, including your post-op, long-term nutrition. But it doesn’t always happen like that. Nutritional counseling may not be part of your surgery package, or you may only get a limited amount of generic information. Or, your surgeon may simply not know how to help you nutritionally. Remember that many doctors have no more than an hour of nutrition education in medical school. To become a weight loss surgeon, doctors need to learn surgery. There is no dietary education requirement. If you need help finding strategies to satisfy hunger – physical or head hunger – and your surgeon and primary care doctor are not able to help, keep looking. A session with a nutritionist may be more affordable than you think, and worth every penny. Your Emotional Support System and Your Relationship with Food The support system you built so carefully can come in handy right about now. Take advantage of your ability to talk to a therapist or psychologist if you have one to bring up your concerns. Discussing your ongoing struggles with portion sizes, food choices, and over-frequent nibbling with a mental health professional can help you come up with some strategies that work for you. Group sessions are also appropriate forums to talk about food struggles and strategies. Though it may feel embarrassing at first to admit you’re still thinking about food a lot, you will find nearly everyone in that room did or does have that same experience. Most Weight Loss Surgery patients do not find their surgery instantly eliminates their food struggles. You can take months or years to come to terms with a food addiction, and it may be something you need to learn to live with for life, but in a healthier manner than before Weight Loss Surgery. Be honest with yourself and those around you, and be open to suggestions, and you can figure out strategies that work for you. Do not assume WLS did not work for you!

I often tell patients, “The surgery does what the surgery does.” What I mean by this is that weight loss surgery almost certainly will affect how much food you can eat, but may do little to change what you eat. Weight loss surgery does not make you suddenly crave healthier and less caloric food. You have to make those choices for yourself. Additionally, while losing weight may make it easier for you to adopt a more active lifestyle, surgery itself will not make you suddenly fall in love with exercise. So making health behavior changes in addition to having surgery remains critical. So what specific health behavior changes have been shown to improve outcome? 1. Document what you eat – Many people strongly dislike writing down what they eat but there is evidence that this helps people after weight loss surgery as it does with non-surgical approaches. The reason is likely that documenting what you eat gives you valuable information about your behavior and allows you to make changes when necessary. Consider that your actual weight is the end product of what you eat, so weighing yourself gives you the results, but not the information necessary to make changes. For many, weighing themselves is a pass-fail exam. Either I’m a good boy or a bad boy. Consider that you can’t actually change your weight…you change what you eat and/or exercise, and that is what helps change your weight. Many people seem to have little or no objection to weighing themselves so why do so many people despise writing down what they eat? Writing down what you eat is the truth teller. It forces you to acknowledge what you are doing. To avoid seeing the truth, you can either change what you eat or stop writing it down. Unfortunately, many people choose the latter. The good news is that in the smartphone era, there are literally dozens of apps and other technological devices that can make documenting your food and activity level extremely easy. If you do a little research you can find one that is right for you. 2. Exercise – You probably saw this one coming as well because it makes sense. Regular exercise is a way of burning calories and losing weight that does not involve changing what you eat. Given how difficult it is to lose weight and keep it off, it would be silly not to take advantage of one of the few methods known to work. Ironically, it might not work the way you would expect. Many people who lose weight through exercise notice that it helps them not just by burning off calories, but also by affecting their food choices. In other words, when you discover how difficult it is to burn off 250 calories on a treadmill, you may think twice before having that chocolate bar afterwards. Not everyone finds this effect, but for those who do, it can make a big difference. When deciding what form of exercise to do, consider that you don’t need to become an Olympiad or a marathon runner. Many of the positive effects of exercise have been documented with just walking 30 minutes 3-4 times per week. If rigorous exercise is enjoyable for you, that’s great. But any time spent engaged in activity is beneficial...especially if you would otherwise be sitting on the couch watching all of those tempting food advertisements on television! 3. Stress Reduction – An increasing amount of research has documented a relationship between stress and weight gain. The obvious connection is that many people use food as a means of comforting themselves from distress, commonly called “emotional eating.” An interesting new discovery is that is that some people who report high levels of stress gain weight even when their calorie intake is unchanged. How is that possible? There is the suggestion that stress hormones and other chemicals may affect how our body metabolizes food and stores food. So even if you’re eating the same foods and the same number of calories, what your body does with those calories can vary. If you’re going to be successful in reducing stress, you need to begin by discovering what “pushes your buttons” and take steps to change. One first step could be to document the things that you find to be stressful. Sometimes just writing down your problems makes them less frightening now that they’re just words on a page. For other people, writing their sources of stress naturally leads them to write what they might do about them. Another good idea is to investigate some simple stress management techniques. Many refer to them as relaxation or meditation exercises. As discussed earlier, there are a number of excellent smartphone apps and other technology-based methods of relaxation that you can explore. No one is better than the rest so just find one that works for you and begin to incorporate relaxation/meditation into your daily routine. If reducing your stress requires more than practicing relaxation techniques, consider speaking to a psychologist or other mental health professional to get the help you need. 4. Get some sleep – Here’s another suggestion that you’ve probably seen in the media recently. There is growing consensus of an obesity-sleep connection. Like exercise, the benefits of sleep are more than meets the eye. The obvious connection is that if you’re up longer, you become hungrier and are likely to eat late at night. This interpretation is not wrong, however, new research suggests that people who get 7 or more hours of sleep tend to maintain lower weights even when people with fewer hours of sleep consume the same amount of calories. How is that possible? Again, it’s not just how many calories we eat…but what our bodies do with those calories. Unfortunately, an increasing number of people are so busy between their work and social lives (not to mention all those tempting television shows) that sleep is not a priority. Just know that making sleep the last priority comes at a cost. Consider how we train children to sleep. We create a nighttime ritual to ease kids to bed. There’s dinner, wind down time, then bath time, maybe reading a story or two in bed, and then lights out. Many adults however have a terrible routine. Eat a big dinner at 9pm, catch up on emails and pay bills, watch television for an hour or so and then fall asleep on the couch and stumble into bed at 2AM only to have to wake up three or four hours later. Try to change your sleep habits by changing your nighttime ritual. Eat an earlier dinner. Try to pay bills and check your emails at another time. Use the evening as wind down time. Rather than fall asleep on the couch, watch a set amount of television or Internet time and then turn it off and “put yourself to bed.” Begin by trying to go into bed a half-hour early every night for a week and see how you feel. If you notice some improvements in your level of energy, mood, appetite or other factors, see if you can make it permanent. 5. Join a Support Group – Some research has demonstrated that patients who participate in support groups lose and maintain more weight than those who don’t. Of course it may depend on the content of the group and who attends, but adding a social element to your weight loss and weight maintenance goals seems to help. This may relate to the accountability factor discussed earlier. If “we’re all in it together,” there may be more of a commitment to stick to your goals to help out the group. Or perhaps it motivates you not to be the one group member who is falling behind. Either way, participating in support groups seems to have benefits both in terms of weight loss as well as emotional well being after surgery. There are other suggestions of course, such as improving your diet by reducing carbohydrates in favor of lean protein and a more plant-based diet. However, for many people, changing their diet can push all of those emotional “diet” buttons; so before you make those changes (or in addition to making those changes), strongly consider some of the changes recommended above. There is evidence that the benefits are additive. For example, many people find that when they exercise, they sleep better and in turn these changes help them manage stress better. The key is to acknowledge whether or not some of the factors above are problem areas for you and to begin making small changes. Sometimes small changes can lead to big results!