Alex Brecher

Regardless of how marijuana is taken (i.e. smoked, inhaled or eaten) the effects are the same. The majority of people who use marijuana describe a sensation of relaxation and euphoria (the “high”). Some people however react badly to the drug which can result in a state of panic, anxiousness and fear, or in some cases even hallucinations if they take too much.
Of particular relevance to bariatric or weight loss surgery, is the fact that marijuana impacts the part of your brain that controls appetite. Have you heard of the “munchies”? Yep, that’s right, the “munchies” are a real thing! Marijuana can increase your appetite, causing you to eat more, which obviously is not great if your goal is weight loss.
Interestingly, a recent study on weight and marijuana use actually showed that marijuana use may very slightly (and we mean VERY slightly) reduce body weight (about a 0.5% reduction in BMI) (1). This study however was conducted on a group of people with an average BMI of 27 kg/m2, which is way below the average bariatric or weight loss surgery patients’ BMI pre-surgery. This unfortunately means that this mild weight loss effect cannot be applied to the typical bariatric or weight loss surgery patient.
We did however find one recent study done in 2016 that is more relevant to the bariatric or weight loss surgery population (2). The study was run on a group of 50 patients (62% being RYGB patients) all 2 years after surgery. The results of the study showed that the patients who had smoked marijuana within the last 30 days and the patients who had started smoking more since surgery, were all more likely to have disordered eating habits, specifically “loss of controlled food intake” (2). Although the study did not look at weight outcomes related to marijuana use, we know that disordered eating habits such as grazing and bingeing are risk factors for weight regain after bariatric or weight loss surgery.
In conclusion, we do not yet fully understand the effects of marijuana use after surgery with respect to weight loss and longer term weight maintenance outcomes. The field of research is still very young (3). Regular marijuana use however may pose medical risks after surgery, therefore speak with your surgeon if you have been prescribed marijuana for medical reasons. Furthermore, if you choose to use marijuana for recreational reasons on a regular basis, it is worth discussing this habit with your bariatric nurse and dietitian.
– Monica & Lisa
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References:
1. http://onlinelibrary.wiley.com/doi/10.1002/hec.3267/full
2. http://www.sciencedirect.com/science/article/pii/S1550728915002063
3. https://www.ncbi.nlm.nih.gov/pubmed/24913244

Why Must You Follow the Pre-Op Diet?
The very strict diet that you follow for days or a couple weeks before surgery is intended to shrink the size of your liver and reduce the fat surrounding it to improve your surgeon’s vision in the area and access to the area during surgery.
Before that, your surgeon or health insurance company may require you to follow a less strict diet for a longer period of time. This can help you lose weight for a safer surgery and faster recovery. It also assures the surgeon and your health insurance company that you are serious, and that you will be capable of making the post-op dietary changes that you need for weight loss success.
Here is a little extra motivation to follow the pre-op diet, even if you are paying out-of-pocket for your surgery or your health insurance coverage does not require it. Any responsible surgeon will cancel your surgery if you do not follow it. This could be if you do not hit your weight loss goals and are not showing that you are capable of making the necessary dietary changes, or it could be while you are asleep and your surgeon has just gone in for surgery and discovered there is too much fat around your liver and spleen to perform surgery safely. Follow your pre-op diet!
Weight Loss Diet
Not every surgeon requires a longer term weight loss diet before starting your official pre-op diet, and you also may not need one if you are not planning to have your health insurance cover your surgery. This diet might last for 6 weeks to 6 months. It could be very structured, often with a low-carb theme, or it could be up to you to lose weight however you can.
Full Liquid Diet
A full liquid diet technically includes all liquids, but you should not have fruit juice or sugar-sweetened beverages since they just add calories without protein or many other essential nutrients. You can usually have:
Protein Shakes Broth and Protein Soup Water, Flavored Water, decaf coffee and tea, and other non-carbonated, low-calorie beverages. Gelatin and Protein Gelatin Vegetable juice Your surgeon may also allow you to have one meal a day consisting of a salad or vegetables and a serving of lean protein, such as chicken or tuna. A liquid diet is not fun, but it can be nutritionally adequate. You can follow it safely for days or weeks if your doctor tells you to do so. This is the diet you will be following for a few days to weeks post-op, too.
Clear Liquid Diet and Pre-Op Fast
A clear liquid diet includes only clear liquids; that is, you cannot have the protein shakes you had on a full liquid diet. Instead, you are stuck with water and other hydrating, low-calorie beverages, plus gelatin and sugar-free ice pops. Your surgeon may have you follow a clear liquid diet for only a day or two. It is not nutritionally adequate or safe unless your doctor is supervising you.
Final Fast
For at least 8 hours or overnight, according to what your surgeon says, you will fast before surgery. This is for safety reasons to prevent problems when you have anesthesia. Your pre-op instructions will likely forbid even plain water.
Differences Between Surgeons
Why do you see so many different pre-op diet plans? What if your surgeon says something different than what we say here? Follow your surgeon’s instructions! There is no single correct pre-op WLS diet. The one that is right for you is the one that you and your surgeon agree on based on your surgeon’s experience and your own situation.
For more information, check out the Pre-Op Diet Forums to see what others have posted and to post your own questions. With all the uncertainty surrounding your pre-op diet, one thing is sure: help is available on BariatricPal!

An Unpredictable Scale
You are in the small and lucky minority if you lose weight as quickly as you hoped and as regularly as you expect. Everyone else should be prepared for many, many weeks when weight loss comes slowly or not at all. Lose patience, and you might give up on your Weight Loss Surgery journey. Stay patient, and things will eventually turn out right.
Focus on the process, such as healthy choices each day, rather than the outcome, such as the scale number or your pants size. You can control your choices, and if you are making the right ones, the outcomes will come. They may just not come when you expect them.
A Frustrating Healthcare System
One of the biggest tests of anyone’s patience is navigating the system. In this case, you might be trying to figure out your health insurance system and get the reimbursement letter you deserve. Or, you might have more trouble than you had hoped when trying to contact your surgeon. Don’t let these nuisances throw you off. Your perseverance may save your life.
Incomprehensible Relationships
Anyone who has Weight Loss Surgery is almost certain to have changes in their relationships. When your lifestyle changes, so too may the way you interact with family members and friends. You are working hard to stay on your healthy plan, but they may be working hard to support you and/or understand you. Be patient while there is friction, as it can often turn out okay.
You had better be prepared to return the patience if you want to keep your relationships. While you should not feel obligated to tolerate rudeness or anyone who undercuts you, you may need to get ready to have some tolerance for ignorance or friction due to changes in your lifestyle and attitude. Be ready to clearly explain your surgery to the important people in your life, and how it might affect them. Try to keep in mind that a sudden fit of anger from your SO might be a display of a moment of weakness while supporting you, for example, by keeping favorite foods out of the house.
Not Knowing the Answer
You might ask 25 people the same question and get 25 different answers. Your surgeon may recommend something different than your friend’s surgeon. You may get opposite advice from patients who each swear that their own experience was the “right” one. This gets frustrating!
The truth is that, in many cases, there is no single correct answer. The best you can do is to be patient as you dig to find the best answer for your individual case. Understand that you are receiving everyone’s best guess, and the answer – for you – is something that can be determined only after gathering input from those you trust, and mixing their advice with your own intuition. Carry the patience one step further, since you may find out by trial-and-error that your first guess was wrong!
Diet
You have no doubt studied the Weight Loss Surgery diet and seen warnings about feeling too full, dumping syndrome, and developing intolerances for former favorite foods. Reading about these and experiencing them are two different stories, though! Since they are out of your control, your best bet is to accept and deal with them, not to fight them.
Being patient can help you succeed in your weight loss surgery journey. It can keep your weight in check long term, and also keep you mentally fit for minimizing the stresses linked Weight Loss Surgery. Keep practicing it, and your efforts will be worthwhile.

Pumpkin also delivers a punch of potassium, a comely amount of copper, an interesting bit of iron, a pleasing amount of magnesium and a fair amount of fiber. A caution for bariatric patients is the 10 grams of carbohydrates found in a ½ cup pumpkin puree.
And who doesn’t love carving Jack-O-Lanterns with your children (or just for you) for All Hallow’s Eve? Who has not posted adorable pictures of their kiddos in your local Pumpkin Patch? You can prepare your own pumpkin puree or stock up on the canned type. Perhaps our greatest love of pumpkin awaits us at Thanksgiving with our beloved pumpkin pie. One estimate says Americans eat 50 million pumpkin pies at Thanksgiving.
Alas, a pie is known as a confection loaded with sugar and fat. What is the bariatric patient to do? Modify the recipe, of course! Lower the sugar and fat and pump up the protein is the goal. Try the Pumpkin Pie pudding recipe on the BariatricPal website. If you need a pumpkin treat before Thanksgiving, there are many pumpkin-flavored protein shakes, protein bars and yogurts in the stores right now. So, pumpkin can be a health partner this season. Enjoy!

An Unpredictable Scale
You are in the small and lucky minority if you lose weight as quickly as you hoped and as regularly as you expect. Everyone else should be prepared for many, many weeks when weight loss comes slowly or not at all. Lose patience, and you might give up on your Weight Loss Surgery journey. Stay patient, and things will eventually turn out right.
Focus on the process, such as healthy choices each day, rather than the outcome, such as the scale number or your pants size. You can control your choices, and if you are making the right ones, the outcomes will come. They may just not come when you expect them.
A Frustrating Healthcare System
One of the biggest tests of anyone’s patience is navigating the system. In this case, you might be trying to figure out your health insurance system and get the reimbursement letter you deserve. Or, you might have more trouble than you had hoped when trying to contact your surgeon. Don’t let these nuisances throw you off. Your perseverance may save your life.
Incomprehensible Relationships
Anyone who has Weight Loss Surgery is almost certain to have changes in their relationships. When your lifestyle changes, so too may the way you interact with family members and friends. You are working hard to stay on your healthy plan, but they may be working hard to support you and/or understand you. Be patient while there is friction, as it can often turn out okay.
You had better be prepared to return the patience if you want to keep your relationships. While you should not feel obligated to tolerate rudeness or anyone who undercuts you, you may need to get ready to have some tolerance for ignorance or friction due to changes in your lifestyle and attitude. Be ready to clearly explain your surgery to the important people in your life, and how it might affect them. Try to keep in mind that a sudden fit of anger from your SO might be a display of a moment of weakness while supporting you, for example, by keeping favorite foods out of the house.
Not Knowing the Answer
You might ask 25 people the same question and get 25 different answers. Your surgeon may recommend something different than your friend’s surgeon. You may get opposite advice from patients who each swear that their own experience was the “right” one. This gets frustrating!
The truth is that, in many cases, there is no single correct answer. The best you can do is to be patient as you dig to find the best answer for your individual case. Understand that you are receiving everyone’s best guess, and the answer – for you – is something that can be determined only after gathering input from those you trust, and mixing their advice with your own intuition. Carry the patience one step further, since you may find out by trial-and-error that your first guess was wrong!
Diet
You have no doubt studied the Weight Loss Surgery diet and seen warnings about feeling too full, dumping syndrome, and developing intolerances for former favorite foods. Reading about these and experiencing them are two different stories, though! Since they are out of your control, your best bet is to accept and deal with them, not to fight them.
Being patient can help you succeed in your weight loss surgery journey. It can keep your weight in check long term, and also keep you mentally fit for minimizing the stresses linked Weight Loss Surgery. Keep practicing it, and your efforts will be worthwhile.

In ancient times, sailors would make sure they were staying on course by referring to the location of the North Star. A constant light in an otherwise black sky, the North Star kept sailors clearly focused on which direction they were traveling and where they wanted to go. However, the skies over the ocean could become cloudy and stormy and sailors might lose sight of the North Star. Sometimes sailors lost their way and became lost at sea.

The quest for weight loss and long-term weight maintenance is much like journeying a great distance over an enormous ocean under an endless black sky. Like the sailors of old, to be successful on your journey you need to be clear about where you’re going. You need to stay on course. You need to remain focused. Like sailing across the ocean, losing weight can be stormy and treacherous. Your brain, like the ocean, is not your friend. Your brain is not terribly interested in your desire to lose weight. Your brain is busy trying to maintain your current weight. Trying to lose weight is putting your brain is at war with itself. Your forebrain is the thinker who understands that you want to lose weight. It agrees that losing weight is a good idea. Your midbrain is not logical. It’s a perpetual 2-year-old who is hungry and cranky and likes potato chips, candy, hot dogs and deep fried chicken. This is going to be a very difficult journey, and one that is going to go on for a very long while. What can you do? Look for your North Star(s).

It goes without saying that you know your goal, right? In fact, it seems quite simple. You want to lose weight and keep it off for good. If you’re like most people, you’ve had this goal for many years and you’ve probably had some success in pursuit of this goal. But there’s a problem with your goal. Believe it or not, weight loss is not your true goal. Your real goal is not to lose weight. Your real goal is to accomplish and experience what you believe losing weight will provide. Therefore, you actually have multiple, specific goals. These are the reasons that inspire you to keep sailing when the ocean gets stormy. These are the reasons that keep you on course. These are your North Stars.

To make it across, you must keep your North Star(s) squarely in view. Here’s how to keep away the storms and stay focused:

1) Think long and hard about why you want to lose the weight. Yes, you want to lose weight…but why? What’s in it for you? Take out a piece of paper and put a line down the middle from top to bottom. On the top of the left column write: “What I will gain if I lose the weight and keep it off.” On the top of the right column write: “What I could lose if I don’t lose the weight.” Think of the left side as the “positives” of losing weight and the right side as the “negatives” of not being successful. The left side is what you want; the right side is what you don’t want. As a general rule, positives motivate us more effectively and more consistently than negatives. However, our fears (the negatives) do have a place on the list. Some examples of positives include: improved health, reduced need for specific medications, improved mobility, wearing the clothes you want, improved confidence, and pride in your accomplishment. The negatives are probably more obvious to you: specific health problems, limitations in mobility, frustration, various difficulties in your personal, social and other areas of functioning.

Don’t try to write the list all at once. Write down whatever comes to mind right now, but allow other reasons to come to you over the next several days. Take your time. When a specific motivation comes to mind, write it down and add it to the list. Consider asking loved ones for their thoughts. You may never be 100% finished with the list, but you can always add more items later. You’ll know you’re truly ready to begin your weight loss journey when you read the list and deeply feel the emotional impact of each of the items. As you well know, the struggle to lose weight and keep it off is very emotional. If the items on the list don’t move you, you need to revise the list. When it’s complete, this list is your North Star.

2) Make several printed copies of the list. Make a small one to keep in your wallet or purse. Make another to keep in your car. Make another to keep in your office. Make a document containing the list on your computer and keep it on your desktop, laptop, tablet and cell phone. Put a printed or electronic copy everywhere you spend your time.

3) Read the list every day, over and over and over and over. This list needs to be etched on your brain and be in the front of your mind as often as possible. You need to read the list every morning when you wake up, multiple times per day, and before you go to sleep at night. The list needs to be as familiar as possible and as accessible as possible. Rehearse it like a speech.

4) Read the list before you eat and every time you eat. Read the list when you’re cooking or serving yourself food. Read the list just before you start to eat your meal. Read the list just before you place your order in a restaurant. Read the list when you’re about to get up from the couch and wander into the kitchen. Read the list just before you go into the mini-mart to grab a snack when you’re out running errands.

If the reasons to make choices consistent with your goals are not in the front of your mind when you are about to choose what or whether or not to eat, they might as well not be in your mind at all. We always seem to know each and every reason why we shouldn’t have eaten that cookie just after we eat it. It’s only by being aware of those reasons before we eat it that can help alter our behavior. (In case you’re wondering why, it’s a forebrain-midbrain thing. Once your cranky 2-year-old midbrain gets the cookie, she’s happy and quiets down, therefore you can now clearly hear your forebrain and all of her brilliant reasons not to eat the cookie….albeit too late.)

Having this list is the single most important part of your weight loss journey, and quite frankly the rest of your efforts might be pointless without the list. Here’s why: no learned behavior is ever fully unlearned. Once a particular relation occurs it never returns to zero strength so you never forget that you love donuts, candy, potato chips or chicken wings. These foods will never become completely unappealing because the brain never forgets. Therefore, you have to practice reminding your brain of what you hope to accomplish by losing weight and why eating donuts, candy, etc. is incompatible with those goals. Your brain may never forget just how yummy those foods are, but if you maintain your focus on your goals and avoid overeating those foods (or learn to eat better foods or learn to engage in new behaviors that replace eating), the impulse to eat those foods weakens and you gain habit strength and confidence in new behaviors that are consistent with your goals and avoid getting lost at sea.

All weight loss efforts falter when the reasons for persevering weaken. If you have a bright, shining North Star, a setback is just a setback. You just keep on sailing and don’t become adrift. You’re still clear on where you’re going. Even if you have a donut, you can refer right back to your list, view it as an “oops” and get back on track. In fact, when your reasons for losing weight are solid and deeply personal, you might even choose to have an occasional donut, knowing that it won’t cause you to lose your way.

None of what I’m suggesting in this article is intended to minimize the importance of other skills in helping you achieve your weight loss goals. You know that losing weight and keeping it off is very difficult and that your brain and body are unrelenting in trying to sabotage your best efforts. Therefore, if your specific reasons to embark on this weight loss journey are unfamiliar, vague or uninspiring, it’s very unlikely that you will make it across a very treacherous, dark ocean. Take the time to make the list and keep your North Star shining bright. My best wishes to you for smooth sailing.

An Unpredictable Scale
You are in the small and lucky minority if you lose weight as quickly as you hoped and as regularly as you expect. Everyone else should be prepared for many, many weeks when weight loss comes slowly or not at all. Lose patience, and you might give up on your Weight Loss Surgery journey. Stay patient, and things will eventually turn out right.
Focus on the process, such as healthy choices each day, rather than the outcome, such as the scale number or your pants size. You can control your choices, and if you are making the right ones, the outcomes will come. They may just not come when you expect them.
A Frustrating Healthcare System
One of the biggest tests of anyone’s patience is navigating the system. In this case, you might be trying to figure out your health insurance system and get the reimbursement letter you deserve. Or, you might have more trouble than you had hoped when trying to contact your surgeon. Don’t let these nuisances throw you off. Your perseverance may save your life.
Incomprehensible Relationships
Anyone who has Weight Loss Surgery is almost certain to have changes in their relationships. When your lifestyle changes, so too may the way you interact with family members and friends. You are working hard to stay on your healthy plan, but they may be working hard to support you and/or understand you. Be patient while there is friction, as it can often turn out okay.
You had better be prepared to return the patience if you want to keep your relationships. While you should not feel obligated to tolerate rudeness or anyone who undercuts you, you may need to get ready to have some tolerance for ignorance or friction due to changes in your lifestyle and attitude. Be ready to clearly explain your surgery to the important people in your life, and how it might affect them. Try to keep in mind that a sudden fit of anger from your SO might be a display of a moment of weakness while supporting you, for example, by keeping favorite foods out of the house.
Not Knowing the Answer
You might ask 25 people the same question and get 25 different answers. Your surgeon may recommend something different than your friend’s surgeon. You may get opposite advice from patients who each swear that their own experience was the “right” one. This gets frustrating!
The truth is that, in many cases, there is no single correct answer. The best you can do is to be patient as you dig to find the best answer for your individual case. Understand that you are receiving everyone’s best guess, and the answer – for you – is something that can be determined only after gathering input from those you trust, and mixing their advice with your own intuition. Carry the patience one step further, since you may find out by trial-and-error that your first guess was wrong!
Diet
You have no doubt studied the Weight Loss Surgery diet and seen warnings about feeling too full, dumping syndrome, and developing intolerances for former favorite foods. Reading about these and experiencing them are two different stories, though! Since they are out of your control, your best bet is to accept and deal with them, not to fight them.
Being patient can help you succeed in your weight loss surgery journey. It can keep your weight in check long term, and also keep you mentally fit for minimizing the stresses linked Weight Loss Surgery. Keep practicing it, and your efforts will be worthwhile.

An Unpredictable Scale
You are in the small and lucky minority if you lose weight as quickly as you hoped and as regularly as you expect. Everyone else should be prepared for many, many weeks when weight loss comes slowly or not at all. Lose patience, and you might give up on your Weight Loss Surgery journey. Stay patient, and things will eventually turn out right.
Focus on the process, such as healthy choices each day, rather than the outcome, such as the scale number or your pants size. You can control your choices, and if you are making the right ones, the outcomes will come. They may just not come when you expect them.
A Frustrating Healthcare System
One of the biggest tests of anyone’s patience is navigating the system. In this case, you might be trying to figure out your health insurance system and get the reimbursement letter you deserve. Or, you might have more trouble than you had hoped when trying to contact your surgeon. Don’t let these nuisances throw you off. Your perseverance may save your life.
Incomprehensible Relationships
Anyone who has Weight Loss Surgery is almost certain to have changes in their relationships. When your lifestyle changes, so too may the way you interact with family members and friends. You are working hard to stay on your healthy plan, but they may be working hard to support you and/or understand you. Be patient while there is friction, as it can often turn out okay.
You had better be prepared to return the patience if you want to keep your relationships. While you should not feel obligated to tolerate rudeness or anyone who undercuts you, you may need to get ready to have some tolerance for ignorance or friction due to changes in your lifestyle and attitude. Be ready to clearly explain your surgery to the important people in your life, and how it might affect them. Try to keep in mind that a sudden fit of anger from your SO might be a display of a moment of weakness while supporting you, for example, by keeping favorite foods out of the house.
Not Knowing the Answer
You might ask 25 people the same question and get 25 different answers. Your surgeon may recommend something different than your friend’s surgeon. You may get opposite advice from patients who each swear that their own experience was the “right” one. This gets frustrating!
The truth is that, in many cases, there is no single correct answer. The best you can do is to be patient as you dig to find the best answer for your individual case. Understand that you are receiving everyone’s best guess, and the answer – for you – is something that can be determined only after gathering input from those you trust, and mixing their advice with your own intuition. Carry the patience one step further, since you may find out by trial-and-error that your first guess was wrong!
Diet
You have no doubt studied the Weight Loss Surgery diet and seen warnings about feeling too full, dumping syndrome, and developing intolerances for former favorite foods. Reading about these and experiencing them are two different stories, though! Since they are out of your control, your best bet is to accept and deal with them, not to fight them.
Being patient can help you succeed in your weight loss surgery journey. It can keep your weight in check long term, and also keep you mentally fit for minimizing the stresses linked Weight Loss Surgery. Keep practicing it, and your efforts will be worthwhile.

“The secret of change is to focus all of your energy not on fighting the old, but on building the new.”
- Socrates

Everyone does well out of the gates. We all impress ourselves when we start, what we believe to be, a new lifestyle change. However, "out of the gates," can mean different things for different people; for some it is two months, for others (usually depending on how strong the addiction or habit is) it can be two minutes.
But what do we do when we fall from grace? The research on relapse (with any addiction; food, drugs, alcohol) is that recidivism is the rule not the exception. So why do we get so down on ourselves when we fall short of our goals? Why is it so hard to get back on the horse with the same vigor we had when we started? And how do we give ourselves a renewed sense of hope and motivation for change once we've fallen?
One magical ingredient in the secret sauce (and one of many concepts I talk about in my book and my wls courses) that is lifestyle change is the novelty effect. The new plan to quit something or change a bad habit is something unlike we have ever done before, so we hope that we can achieve something we have never done before. The problem is that the moment we slip, that novelty loses its magic - and each time we start over, it loses its power to give us hope.
So the solution is to cultivate more novelty. Our ability to continually grow and change is largely limited by our creativity. The more creative we become, the easier it is to take a different approach to change. To open a window when life seems to shut the door.
In other words- what I am telling you, is that the only secret to long term weight loss maintenance is the knowledge that there isn't only one secret. There is no ONE diet that will forever change someone. Eventually people get tired of eating bacon and eggs every meal on Atkins, or grapefruit, or cabbage soup- but the thread they all share is their novelty. This is why all of them can work initially.
Even as powerful as weight loss surgery is- people still find that they start to plateau or even gain the weight back if they aren't simultaneously addressing the behavioral and psychological factors that got them there in the first place. They too, must also continuously be creative about renewing one self throughout their lifetime.
So the following is for all of you who are struggling today. Those that feel they have lost their way and perhaps feel disenchanted or disappointed. Below is a recovery "map" I created a long time ago for my clients, some struggling with substance abuse, others with food. It all works the same. Print it out, or copy and paste it in the notes section of your phone and take 20 minutes to fill it out with the things that are personally meaningful for you. This is not THE answer to long term recovery from addiction, but it is a fresh approach for many who feel stale at the moment:
Baptism
- Some ceremony to signal a renewed sense of hope and a fresh start. One client trying to recover from substance abuse, buried all of his wine and liquor bottles in his yard. Another client had a "garbage party" with her kiddos, and they loved smashing all the processed foods they had in their pantry and throwing them in the trash.
Associations/triggers
list all of the things that get you into trouble (being at a bbq, wanting to celebrate something, holidays, 7-10pm at night, date night, etc)
Coping Skills (what gets you through the crave waves)
These are the behaviors that you do INSTEAD of the addictive behavior. Extra credit if you are able to make a coping skill for each trigger listed above.
Higher Desires/Vision of Self
when you let go of your attachment to food and all the self loathing, mental, and physical heaviness it brings- what are you freeing your life up for? will you write a book? will you do more outdoor activities with your kids? do you want to resume an activity you once loved as a child? Is there a role model that inspires you that has done what you want to do?
Cons
Why are you doing this in the first place? These are the things that are hard to keep in mind when our reptilian mid brain (see last article) is at the wheel. What is personally meaningful? Does it age you? Does it make you feel out of control? Do you dread going on airplanes because you know you'll need an extender? does it prevent you from going to amusement parks with your kiddos?
Spirituality (religion gets us into heaven, spirituality gets us out of hell)
All addiction is what disconnects us from our deeper self and edges us further and further away from God (or whatever you like to call it) and our deeper spirituality. Spirituality is what allows us to move into the unknown, be comfortable with discomfort, and have faith that everything will be ok. It can include a gratitude practice, volunteering, play, aligning one self with nature, connecting with a spiritual e newsletter (mind body green, daily om, etc), generosity, etc.
Daily Recovery Ritual (symbolic gesture to self every day that we are consciously devoting time to our recovery)
What are the things you can do daily to symbolize to yourself that today is a new day? Keep it realistic or you won't do it. Vitamins, meditation, lemon water, supplements, self care, reaching out to a loved one, exercise, etc.
Reward System
What will you do for yourself if there is a certain period of time reached where you meet your goals? Will you get a massage at the end of every month? Will you plan a vacation after three months of solid goal hitting? Will you reward yourself with one day per week of going to the movies in the middle of the day and playing hooky if you're on the straight and narrow for five days?
Strategy
This is your "what." What are you doing daily to ensure that you are in alignment with your goals? Are you reading something fresh all the time? Do you make a timeline of your addiction and how it has affected your life? Do you go to local support meetings each week? Do you keep in touch with an online community? Do you make sure to give yourself small breaks while with the kids every day? Do you have a self care space set up in your house? Do you talk to a partner about how to change behaviors of theirs that might be hindering your efforts? can they get a mini fridge? Do you do acupuncture to balance your chi? Do you do yoga to manage your depression? Do you find a therapist?
Recovery Resources (try to hit one each morning)
what resources are in your pocket when you are feeling weak? bariatricpal.com? WLS journeys on Instagram? The Fix, Reddit, unique blogs documenting their weight loss journey, wls and vsg searches on Pinterest, etc.
Good luck on your fresh start!

If both parents are obese, each of their children has an 80% chance of being obese. The percent decreases to 40% if one parent is obese. What if both parents are of normal weight? Children have only a 13% chance of being obese. Overweight children are more likely to become overweight adults, and you know what a hard road that is to go down if you yourself have struggled with obesity.
How can you keep your children healthy and prevent them from suffering from the physical and emotional problems that can happen as the result of obesity? These are some ideas for handling the situation in positive ways.
Never Shame Them
Do not blame your children for being overweight, or make them feel bad about themselves or their bodies. Always let them how proud you are of them and how much you love them. Overweight children need more support than ever if they are feeling different from their peers or even bullied at school.
Pinpoint the Causes
While it is easy to say, “It just happened,” or, “It is unavoidable,” the truth is more likely that you can identify some causes of your child’s weight problem. They might be happening at home or at school.
Examples include:
Not enough exercise – did you know kids are supposed to be active for 60 minutes a day? Too much junk food – how often do you opt for fast food for a quick meal while driving your children to activities, or send them to school with chips or a soda in their lunch because they are convenient? Too much screen time – a good limit is a total of 2 hours online or in front of a computer, television, or video game console. Offering dessert as a reward – never use food as a reward or imply that healthy foods are a chore to get through before dessert. Involve Your Pediatrician
Doctors do not always recognize childhood obesity or know how to treat it. Bring it up if your child’s pediatrician does not directly address it. You may be entitled to extra help through your health insurance plan. Possibilities include nutritional counseling, enrollment in a weight control program, and sessions with an exercise physiologist.
Be a Role Model
It may not always seem like it, but children look up to their parents. You can help them out by modeling the healthy behaviors you want them to show. You can do that by following your weight loss surgery diet and exercise program – or eating right and being active, just like you want your children to do. Eat a proper breakfast, snack on fruit and vegetables, and make it a point to get active every day. By doing these things, you will help your children learn how to act healthy, as well as keep them from feeling isolated if you force healthy behaviors on them.
You can also be a role model with your attitudes. Complain about your diet to your friends, not to your children. In front of your children, embrace your healthy lifestyle. Kids need to see how much fun you think it is to walk to the library or supermarket, how delicious you find that snack of peanut butter and apple slices, and how neat it is to pack a healthy lunch instead of taking money for the vending machine at school.
Make It Easy
Like you, kids will naturally choose the easy option. So, make the right choices the easy ones for them. Leave washed grapes and string cheese sticks in the fridge for them to grab quickly, and have a fruit bowl on the counter for easy access for snacks. Keep unhealthy treats out of the house or leave them out of sight so they are only for occasional times.
Give Them Control
Let your children be in charge as appropriate for their ages. You can give them options such as:
“Do you want me to cook zucchini or broccoli in the tomato sauce?” “Do you prefer a salad or tomato soup with your sandwich?” “Do you want to shoot hoops would you rather walk to the library?” You can let older kids help you in the kitchen or pack their own lunches from among healthy choices that you offer. That way they can be proud of their own actions.
You may have struggled with your weight for years, but that does not mean you cannot give your children a healthy start. Apply what you have learned throughout your weight loss surgery journey, keep a positive attitude, and stand with them the whole way, and your children can be as healthy as you want them to be.

Today, during one of my pre-op psych evaluations, I heard a woman say “I just feel like once I start losing weight and start feeling so much better about my self- I will stop doing all the destructive things that got me here. Don’t you think?”
My response was “no I don’t agree.” I went on to explain that hers was a common assumption, a dangerous “magic-bullet” fantasy about what weight loss surgery can do.
Here’s why: The part of our brain that is responsible for the thought : “wow I look so much better, I better not mess this up,” or “I feel better than I have ever felt in my life, I am a changed person,” is not the same part of the brain that wakes us up in the middle of the night and says: “go on, finish that 1/2 pint of Chunky Monkey in the freezer, there’s only a little bit left anyway, and I have been so good here lately.”
We are dealing with two very different brains; the frontal cortex and the reptilian mid brain. The frontal cortex is the most newly developed (relative to other parts of the brain) part of the brain. It is the component that separates us from animals. It gives us the ability to think about consequences, plan, and execute. It is the “higher” part of ourselves, that often says “why do I keep on doing the same things I keep saying I won’t do anymore?” Or “I feel so out of control. This _______ (eating, smoking, drinking, gambling, pick your poison) is a temporary solution that produces long term pain. I have to find a different way.”
Our reptilian midbrain is the Commodore 64 to our MAC; it is the palm pilot to our iPhone; the horse and buggy to our Prius; the Tommy Lee to our Oprah. Our midbrain is antique equipment, long ago evolved to keep us alive and hence the reason it is still with us today- it keeps us alive. Our midbrain contains the parts of the brain that make us recoil at the site of a snake or a spider in our peripheral vision. It is hardwired to not have to go through superfluous channels of the brain that might otherwise say “hmmm what is that crawling over there? How do I feel about that? Oh its just a spider, my aunt had a collection of spiders, maybe I should collect things, etc etc.” We just jump, and process later.
That very system has helped humans survive for thousands of years. There is an adaptive quality to a brain that proverbially acts and asks forgiveness later. That very old structure once kept us out of harm’s way when a pack of tigers were first seen galloping across a horizon, or when a rivaling tribe could be heard in the far off distance, threatening to pillage our territory.
Our midbrain is associated with learning and reward. Learning what makes us feel bad, what eats us (in the past that would be in a literal sense- like tigers, but presently it might be a mercurial supervisor or unending debt), and even more relevant to this article- what makes us feel good. When our brains come across something that makes us feel good (ex: sex, drugs, food), we are then flooded with an influx of the powerful neurotransmitter- dopamine. Just like not everyone that is exposed to drugs will develop an addiction, not everyone that eats a Nutella crepe will develop a food addiction.
Much of the research on obesity currently, postulates that food addiction, no dissimilar than alcohol or drug addiction- is a reward system dysfunction or dysregulation, born out of genetic predisposition. It’s almost as if some brains think “if one slice of pizza feels good, how would four slices of pizza taste?”
To break these two very different parts up in a different, more basic way; our frontal cortex is the voluntary, while our midbrain is the involuntary.
This very dangerous fantasy, many people carry into weight loss surgery is a myth that I try to dispel quickly. This type of “magic bullet’ thinking is the very thing that gets so many gastric bypass and sleeve patients into trouble years down the road. No one wants to look at triggers. No one wants to sit with a therapist and devise a strategic coping plan. We want a pill, a surgery, a 16 minute solution to a 40 year old problem.
This is not to say that weight loss surgery is not a solution, just that its only part of the solution.

Despite our best intentions, we are still in some ways animalistic, hedonically-driven to feed our most basic impulses. This is part and parcel of why recidivism is the rule not the exception when it comes to recovery from most addiction. So what does this mean? Are all weight loss surgery patients destined for disappointment and disenchantment when the WLS honeymoon ends? No. But the answer to long term change lies more in two-pronged approach to long term weight loss success; surgery + behavioral change.
Simply thinking ourself slim is a fantasy. Think about your specific triggers for eating. For some it is that golden hour when all the kids are in bed and Narcos is queued up on your Netflix. For others it is that 2-3pm mid day slump. For some - it is when they are alone, the only time they can eat with abandon free from others’ judgement or their own embarrassment.
Whatever your triggers- the key is to identify what need is being met in that moment and to find a non-food alternative to meet each particular need ( many people have multiple triggers for over eating). If it is because its “your time,” after the kids are in bed- maybe you invest in a foot massager, or cultivate a self care space with textures, aromatherapy, candles, and books. If your trigger is that mid day slump, maybe you develop a yoga routine easily done in the office to help re-energize you. If it is the secretive quality to the trigger of being alone and eating, maybe it is finding another thing that is just your own that no one knows (going to a movie in the middle of the day, getting an overly priced facial on your lunch hour, playing hooky with your kid one day, etc).
The rule of the brain is : what fires together, wires together. So over time- if you have paired 8pm, Narcos, and nachos- you have created a neurological super highway. The moment 8pm rolls around, you are likely already getting the chips ready and didn’t even realize the thought pathway that just occurred. The idea is to repair our triggers with alternative behaviors and over time “clip those wires” or create “toll roads” to our superhighways (aka neurosynaptic pruning), so that we no longer experience such strong urges and can call upon the higher structures of our frontal cortex to guide the way again.
When we are in the midst of addiction, it is important to understand that our frontal cortex is not at the wheel. It has been duck taped and tied to a chair in the basement by our hedonic midbrain who is used to getting what it wants when it wants it. The closer we come to accepting this principle, the closer we come to being more mindful of our midbrain’s powerful rationalizations and sick contracts and see them for just that. We are better able to dis-identify from the thought, knowing it is not coming from our best self, but from our most carnal self.
Think of that distant cousin that only shows up when they need something, the Uncle Eddy that tells you he’ll move the RV when he leaves next month, indifferent to how it makes you feel. Except in addiction- that distant cousin has taken over, pretending its you until you can no longer tell the difference.
References
http://brainspotting-switzerland.ch/4_artikel/Corrigan & Grand 2013 Med Hyp paper (proofs).pdf
Blum K, Chen AL, Giordano J, Borsten J, Chen TJ, et al. The addictive brain: all roads lead to dopamine. J Psychoactive Drugs. 2012;44:134–143. [PubMed]
Avena NM, Gold JA, Kroll C, Gold MS. Further developments in the neurobiology of food and addiction: update on the state of the science. Nutrition. 2012;28:341–343. [PMC free article] [PubMed]
Gearhardt AN, Yokum S, Orr PT, Stice E, Corbin WR, et al. Neural correlates of food addiction. Arch Gen Psychiatry. 2011;68:808–816. [PMC free article] [PubMed]
Saper CB, Chou TC, Elmquist JK. The need to feed: homeostatic and hedonic control of eating. Neuron. 2002;36:199–211. [PubMed]
Stice E, Yokum S, Zald D, Dagher A. Dopamine-based reward circuitry responsivity, genetics, and overeating. Curr Top Behav Neurosci. 2011;6:81–93. [PubMed]
Blum K, Sheridan PJ, Wood RC, Braverman ER, Chen TJ, et al. The D2 dopamine receptor gene as a determinant of reward deficiency syndrome. J R Soc Med. 1996;89:396–400. [PMC free article] [PubMed]
Comings DE, Flanagan SD, Dietz G, Muhleman D, Knell E, et al. The dopamine D2 receptor (DRD2) as a major gene in obesity and height. Biochem Med Metab Biol. 1993;50:176–185. [PubMed]
Noble EP, Noble RE, Ritchie T, Syndulko K, Bohlman MC, et al. D2 dopamine receptor gene and obesity. Int J Eat Disord. 1994;15:205–217. [PubMed]
Blumenthal DM, Gold MS. Neurobiology of food addiction. Curr Opin Clin Nutr Metab Care. 2010;13:359–365. [PubMed]
Volkow ND, Wang GJ, Fowler JS, Telang F. Overlapping neuronal circuits in addiction and obesity: evidence of systems pathology. Philos Trans R Soc Lond B Biol Sci. 2008;363:3191–3200. [PMC free article] [PubMed]
Volkow ND, Wang GJ, Baler RD. Reward, dopamine and the control of food intake: implications for obesity. Trends Cogn Sci. 2011;15:37–46. [PMC free article] [PubMed]

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.

Make a List
How can you chase what you want if you have not identified it? How will you know you have found what you are looking for if you did not know you were looking for it? You may have thought about making a list of motivators for weight loss surgery and weight loss. Have you considered making a list of what you want to get from your efforts? Making a list of what you want can help you figure out how to get it.
The first article in this series might help you put together a list. It could include some of the following, and any of your own items.
More confidence in social settings. Saying “yes” to anything – movies, restaurants, and airplane trips – without thinking about whether you fit in the seat. Staying away from the doctor’s office. More time with family because now you have the energy. Attitude: Gains over Losses
It’s all about the attitude. You do lose a lot – besides weight – when you commit to Weight Loss Surgery and the Weight Loss Surgery diet, but you will not be doing yourself any favors if you focus on the losses. It is easy to feel discouraged and feel sorry for yourself if you focus on some of your losses: no more soda, no more free-for-alls at the all-you-can-eat buffets, no more eating whatever, whenever – because you literally cannot stomach it anymore.
Cliché as it may sound, you are more likely to succeed when you put a positive spin on it. Also cliché but true: practice makes perfect. You can train yourself to think positively just by practicing. Don’t think about losing dessert at the restaurant; think about gaining the ability to enjoy friends and family without focusing on sugar. Don’t think about giving up your mornings sleeping in because you have to exercise; think about gaining better nights of sleep because you no longer need a CPAP machine and gaining clear-headedness that will carry you through the day.
Celebrate!
It is human nature to respond to successes. When you are doing well at something, you are likely to continue to do it. In the same way, you are more likely to stick to your Weight Loss Surgery meal plan and exercise program when you realize how well you are doing. Recognize each victory with a celebration.
Some of your celebrations could be a tangible reward, such as a massage for hitting a weight goal or a new workout outfit when you meet your goal of hitting the gym 20 times in a month. For other victories, you might be able to give yourself the positive reinforcement you need with a simple sign of recognition, such as placing a gold star on the calendar to mark your difficult but healthy choice to pass up the bread basket in favor of a side salad. Eventually, even giving yourself a physical or mental pat on the back might be enough to remind yourself how good it feels to be moving in the right direction.
Put Yourself Out There
The gains are yours for the taking, but sometimes, you may have to make an extra effort to take some them. This is especially true with some of the gains having to do with people. Put yourself out there at work or in social settings, and you may get some of the most rewarding gains of weight loss surgery journey.
When you show off your new confidence, people will respond to you. Add to that some clothes that you are proud to wear, and you are more likely to get the job and land the business deal. You will find it easier to enjoy the moments with old friends and to make new ones.
The weight loss surgery journey has so much to offer, so do not let yourself miss out! Know what you stand to gain and keep your eyes open for opportunities to make those gains, and your weight loss will be only one benefit of the entire journey.

Freedom from Medical Chains
Medical benefits are probably most closely related to weight loss, but they are still worth noting as a “side” benefit of Weight Loss Surgery. As you lose weight, you may have improvements in blood sugar control, blood pressure, and cholesterol levels. You may have less joint and back pain. You may have fewer trips to the doctor, and be able to take fewer medications.
Better Sleep
Never underestimate the power of sleep! Losing weight can help you sleep more deeply so you feel better all day, every day. Your sleep can improve as you feel more comfortable in bed, and if you had sleep apnea that goes away or diminishes with weight loss. Just think how good life could be if you did not have to did not have to use a CPAP machine!
New Food Finds
Strange but true…there is a whole food world aside from burgers, burritos, fries, and bagels. Who knew that you might end up loving to start your day with oatmeal cottage cheese protein pancakes? Your favorite snack could turn out to be kale chips with parmesan. Dinner might be roasted cauliflower with grilled salmon – something you might never have considered when your go-to was mac and cheese from a box.
Sure, you might miss a few foods, but you might notice that you are loving all kinds of new health foods, and the way they make you feel. On top of it, eating slowly can help you savor each bite and enjoy the textures and flavors more.
Saving Money
Saving money probably was not your main reason for considering weight loss surgery, especially if your insurance is not footing the bill. Still, Weight Loss Surgery could be a financial gain in the long run as you consider some potential savings.
Lower medical bills for doctors’ visits, prescription medications, and complications such as complications of diabetes. Fewer sick days taken from work. Lower food bills as you eat less and potentially eat more homemade food. Fewer “extras,” such as higher prices of plus-sized clothing or needing to reserve two seats on a plane. More Meaningful Relationships
Were your relationships built around food before Weight Loss Surgery? Did you consider your friends your best eating buddies, with each of your meetings at a restaurant or each other’s houses for a (unhealthy) meal? Weight loss surgery frees you up to explore other interests. Deepen your relationships with your friends as you walk together or meet at museums or other sights instead of depending on food to bring you together. And, if you do meet for a meal or snack, feel good knowing you can focus on the conversation as you eat slowly.
Confidence
Ultimately, weight loss surgery is for you, and you can benefit inside as you look better on the outside. You can gain confidence from your new looks, maybe as you fit into clothes you love, or you see a few muscles popping out. Confidence also comes from your achievements. If you can do something as hard as going through Weight Loss Surgery and sticking to all those healthy lifestyle changes, you can do pretty much anything you set your mind to.
Energy
Energy is a wonderful thing, but it may be in short supply when you are carrying around extra pounds. Lose a few, and you might feel your endurance explode. You can keep up with your kids, enjoy a day at the mall or beach, and go on vacations. Getting through the work day can be easier. Life is better all around when you have energy.
Bariatric surgery is a weight loss tool, and it is so much more. Use it properly, and you can make great gains in many areas of your life. Part 2 of the series – to be published soon – will discuss ways to get what you deserve – maximum gains from Weight Loss Surgery!

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!

Make a List
How can you chase what you want if you have not identified it? How will you know you have found what you are looking for if you did not know you were looking for it? You may have thought about making a list of motivators for weight loss surgery and weight loss. Have you considered making a list of what you want to get from your efforts? Making a list of what you want can help you figure out how to get it.
The first article in this series might help you put together a list. It could include some of the following, and any of your own items.
More confidence in social settings. Saying “yes” to anything – movies, restaurants, and airplane trips – without thinking about whether you fit in the seat. Staying away from the doctor’s office. More time with family because now you have the energy. Attitude: Gains over Losses
It’s all about the attitude. You do lose a lot – besides weight – when you commit to Weight Loss Surgery and the Weight Loss Surgery diet, but you will not be doing yourself any favors if you focus on the losses. It is easy to feel discouraged and feel sorry for yourself if you focus on some of your losses: no more soda, no more free-for-alls at the all-you-can-eat buffets, no more eating whatever, whenever – because you literally cannot stomach it anymore.
Cliché as it may sound, you are more likely to succeed when you put a positive spin on it. Also cliché but true: practice makes perfect. You can train yourself to think positively just by practicing. Don’t think about losing dessert at the restaurant; think about gaining the ability to enjoy friends and family without focusing on sugar. Don’t think about giving up your mornings sleeping in because you have to exercise; think about gaining better nights of sleep because you no longer need a CPAP machine and gaining clear-headedness that will carry you through the day.
Celebrate!
It is human nature to respond to successes. When you are doing well at something, you are likely to continue to do it. In the same way, you are more likely to stick to your Weight Loss Surgery meal plan and exercise program when you realize how well you are doing. Recognize each victory with a celebration.
Some of your celebrations could be a tangible reward, such as a massage for hitting a weight goal or a new workout outfit when you meet your goal of hitting the gym 20 times in a month. For other victories, you might be able to give yourself the positive reinforcement you need with a simple sign of recognition, such as placing a gold star on the calendar to mark your difficult but healthy choice to pass up the bread basket in favor of a side salad. Eventually, even giving yourself a physical or mental pat on the back might be enough to remind yourself how good it feels to be moving in the right direction.
Put Yourself Out There
The gains are yours for the taking, but sometimes, you may have to make an extra effort to take some them. This is especially true with some of the gains having to do with people. Put yourself out there at work or in social settings, and you may get some of the most rewarding gains of weight loss surgery journey.
When you show off your new confidence, people will respond to you. Add to that some clothes that you are proud to wear, and you are more likely to get the job and land the business deal. You will find it easier to enjoy the moments with old friends and to make new ones.
The weight loss surgery journey has so much to offer, so do not let yourself miss out! Know what you stand to gain and keep your eyes open for opportunities to make those gains, and your weight loss will be only one benefit of the entire journey.

Freedom from Medical Chains
Medical benefits are probably most closely related to weight loss, but they are still worth noting as a “side” benefit of Weight Loss Surgery. As you lose weight, you may have improvements in blood sugar control, blood pressure, and cholesterol levels. You may have less joint and back pain. You may have fewer trips to the doctor, and be able to take fewer medications.
Better Sleep
Never underestimate the power of sleep! Losing weight can help you sleep more deeply so you feel better all day, every day. Your sleep can improve as you feel more comfortable in bed, and if you had sleep apnea that goes away or diminishes with weight loss. Just think how good life could be if you did not have to did not have to use a CPAP machine!
New Food Finds
Strange but true…there is a whole food world aside from burgers, burritos, fries, and bagels. Who knew that you might end up loving to start your day with oatmeal cottage cheese protein pancakes? Your favorite snack could turn out to be kale chips with parmesan. Dinner might be roasted cauliflower with grilled salmon – something you might never have considered when your go-to was mac and cheese from a box.
Sure, you might miss a few foods, but you might notice that you are loving all kinds of new health foods, and the way they make you feel. On top of it, eating slowly can help you savor each bite and enjoy the textures and flavors more.
Saving Money
Saving money probably was not your main reason for considering weight loss surgery, especially if your insurance is not footing the bill. Still, Weight Loss Surgery could be a financial gain in the long run as you consider some potential savings.
Lower medical bills for doctors’ visits, prescription medications, and complications such as complications of diabetes. Fewer sick days taken from work. Lower food bills as you eat less and potentially eat more homemade food. Fewer “extras,” such as higher prices of plus-sized clothing or needing to reserve two seats on a plane. More Meaningful Relationships
Were your relationships built around food before Weight Loss Surgery? Did you consider your friends your best eating buddies, with each of your meetings at a restaurant or each other’s houses for a (unhealthy) meal? Weight loss surgery frees you up to explore other interests. Deepen your relationships with your friends as you walk together or meet at museums or other sights instead of depending on food to bring you together. And, if you do meet for a meal or snack, feel good knowing you can focus on the conversation as you eat slowly.
Confidence
Ultimately, weight loss surgery is for you, and you can benefit inside as you look better on the outside. You can gain confidence from your new looks, maybe as you fit into clothes you love, or you see a few muscles popping out. Confidence also comes from your achievements. If you can do something as hard as going through Weight Loss Surgery and sticking to all those healthy lifestyle changes, you can do pretty much anything you set your mind to.
Energy
Energy is a wonderful thing, but it may be in short supply when you are carrying around extra pounds. Lose a few, and you might feel your endurance explode. You can keep up with your kids, enjoy a day at the mall or beach, and go on vacations. Getting through the work day can be easier. Life is better all around when you have energy.
Bariatric surgery is a weight loss tool, and it is so much more. Use it properly, and you can make great gains in many areas of your life. Part 2 of the series – to be published soon – will discuss ways to get what you deserve – maximum gains from Weight Loss Surgery!

Freedom from Medical Chains
Medical benefits are probably most closely related to weight loss, but they are still worth noting as a “side” benefit of Weight Loss Surgery. As you lose weight, you may have improvements in blood sugar control, blood pressure, and cholesterol levels. You may have less joint and back pain. You may have fewer trips to the doctor, and be able to take fewer medications.
Better Sleep
Never underestimate the power of sleep! Losing weight can help you sleep more deeply so you feel better all day, every day. Your sleep can improve as you feel more comfortable in bed, and if you had sleep apnea that goes away or diminishes with weight loss. Just think how good life could be if you did not have to did not have to use a CPAP machine!
New Food Finds
Strange but true…there is a whole food world aside from burgers, burritos, fries, and bagels. Who knew that you might end up loving to start your day with oatmeal cottage cheese protein pancakes? Your favorite snack could turn out to be kale chips with parmesan. Dinner might be roasted cauliflower with grilled salmon – something you might never have considered when your go-to was mac and cheese from a box.
Sure, you might miss a few foods, but you might notice that you are loving all kinds of new health foods, and the way they make you feel. On top of it, eating slowly can help you savor each bite and enjoy the textures and flavors more.
Saving Money
Saving money probably was not your main reason for considering weight loss surgery, especially if your insurance is not footing the bill. Still, Weight Loss Surgery could be a financial gain in the long run as you consider some potential savings.
Lower medical bills for doctors’ visits, prescription medications, and complications such as complications of diabetes. Fewer sick days taken from work. Lower food bills as you eat less and potentially eat more homemade food. Fewer “extras,” such as higher prices of plus-sized clothing or needing to reserve two seats on a plane. More Meaningful Relationships
Were your relationships built around food before Weight Loss Surgery? Did you consider your friends your best eating buddies, with each of your meetings at a restaurant or each other’s houses for a (unhealthy) meal? Weight loss surgery frees you up to explore other interests. Deepen your relationships with your friends as you walk together or meet at museums or other sights instead of depending on food to bring you together. And, if you do meet for a meal or snack, feel good knowing you can focus on the conversation as you eat slowly.
Confidence
Ultimately, weight loss surgery is for you, and you can benefit inside as you look better on the outside. You can gain confidence from your new looks, maybe as you fit into clothes you love, or you see a few muscles popping out. Confidence also comes from your achievements. If you can do something as hard as going through Weight Loss Surgery and sticking to all those healthy lifestyle changes, you can do pretty much anything you set your mind to.
Energy
Energy is a wonderful thing, but it may be in short supply when you are carrying around extra pounds. Lose a few, and you might feel your endurance explode. You can keep up with your kids, enjoy a day at the mall or beach, and go on vacations. Getting through the work day can be easier. Life is better all around when you have energy.
Bariatric surgery is a weight loss tool, and it is so much more. Use it properly, and you can make great gains in many areas of your life. Part 2 of the series – to be published soon – will discuss ways to get what you deserve – maximum gains from Weight Loss Surgery!

Ask Questions
Your advocate should get the information you need. Ask your surgeon how you can best prepare for surgery, what you can do to recover faster, and which mistakes he or she sees most often so you can avoid them. Find out how to contact your surgeon for post-op questions, and learn where you can go for support group meetings.
You will need to ask plenty of other questions, too! As your own advocate, don’t be shy about asking anyone about anything. Read everything you can online and on BariatricPal, then use the forums to ask about anything you’re not sure about. You are sure to get all kinds of helpful hints that you never expected!
Provide for Your Needs
Life does throw curve balls, but your basic needs stay predictable. You know which foods and fluids you will need in any given day, so make sure you have them. Plan your menu for each day and go grocery shopping for the week so you are sure to always have the food you need around.
Always keep a stash of “extras” in case of unplanned circumstances. Have instant protein meals and other staples in your pantry for last-minute meals. Keep protein bars and nuts in your car, your gym bag, and at work. Have different flavors of protein powder for whenever you find yourself hungry and without other options.
You can also help yourself out by planning ahead. For example, if you’re going to a party, make sure you will have the foods that you will need for that time without needing to wait until after the party to eat or depending on the host to provide healthy proteins. Stick a protein bar or some nuts in your pocket or purse, or bring a healthy dish to share and nibble on yourself.
Be Your Own Planner
If you were taking care of a child with certain needs, you would schedule them in, make sure your child had the materials needed, and get your child to where he needed to go. If you have children, you may keep track of their homework, take them to after-school activities, and make sure they get the nutritious meals and proper sleep that they need. You would keep healthy foods around and provide them with the pencils and sports equipment that they need for school and extracurricular activities.
Why wouldn’t you be just as good to yourself? Provide the same level of self-care for yourself as you do for your family. Keep healthy foods on hand, and schedule your own exercise and meal planning in and keep your commitment just like it was school.
Prioritize your commitments, just like you would do for your children. Your meal prep and workout time is important, but so is relaxation time with your family or friends, or by yourself. Over the long term, balancing work and play can keep you on track but satisfied.
Speak up When Necessary
Keeping quiet can sometimes seem easier or more considerate to others, but keeping a low profile can work against you sometimes. Learn when it makes sense to speak up for yourself. For example, at restaurants, the server may be willing to bring you what you ask for (like a slab of plain chicken breast or the kids’ meal), but will not even know that is what you want (and need) if you do not say something out loud. You may find that you need to explain your weight loss surgery as a medical condition to get your server to honor your request.
These are some other times when you should not keep your mouth shut:
When someone pressures you to eat something that's not on your diet. When you do not understand your surgeon’s or nutritionist’s instructions. When you need help around the house or preparing your food. Learning to be your own best advocate can pay off in a big way, as you will always have someone looking out for your best interests. It is one more thing you can do to help yourself succeed in your WLS journey.

Paperwork and Documentation
Photo ID. Credit card, checkbook, and/or cash. List of contacts. List of questions and notebook to take notes. Insurance card, letter of reimbursement acceptance, or any other paperwork. A list of your medications. Passport or passport card Visa Bring a photo ID and any money you will need. You may not need any if you are going to a local hospital and your insurance covers your surgery. You may need a lot if you are self-pay and payment is due at the time of service. Bring money for any incidentals, such as a taxi ride home or to the airport. Bring any insurance paperwork you have if your insurance is helping to cover your surgery. Also bring a list of contacts such as family and friends that you can call if you need help. Include your doctor on the list. You or your surgeon may need to ask about medical conditions or medications that you are on.
You need to bring the proper documentation if you are going outside the country for your bariatric surgery. At the least, you need a passport or passport card, and to be on the safe side, you should be sure it expires at least 6 months after your scheduled return date. You may need a visa for some countries, although not for Mexico if you are American.
Clothing
Slippers or socks with non-slip rubber soles or grips. Loose-fitting clothes to wear home. A change of underwear. You will wear the hospital’s gown, but should bring something loose-fitting to wear when you are discharged. Be sure the waist is very loose and the outfit is easy to slip on since you will be in some pain and will not be very agile after surgery! A gown or dress can be best. Non-slip slippers or socks will let you walk around when you can without needing to put on shoes and without risking falling when you are tired and weak.
Do not take expensive clothes, tight fitting clothes, or accessories.
Toiletries
Toothbrush, toothpaste, deodorant, soap or body wash, shampoo, and conditioner. Lip balm and lotion or Vaseline. Hair ties. Baby wipes Just take the basics. Keep your teeth clean, and take what you need for a shower, if you have time to take one. You might feel very dry after surgery. Lip balm can keep your lips from getting too chapped, while lotion can keep your skin moisturized. A scrunchie or elastic hair band can keep your hair out of your face if you have long hair, and baby wipes can help you freshen up without much effort.
Go light with your toiletries. Do not bother taking makeup since you will not have time to put it on, and you probably will not have the energy, either!
Electronics and Entertainment
Phone and charger. Book or eReader with books on it. Crossword puzzles or other paper or electronic games. Movies. Do not forget your charger for each device!
Time will probably pass very quickly in the hospital and you may not have a chance to get to any of your entertainment. You may also be too tired or distracted to focus on it.
Food and Drink
Tea bags and water enhancers. Protein powders and shakes. Water bottle. Protein blender bottle. Your first priority after weight loss surgery will be to stay hydrated. Water can taste funny, so you might want to pack some water enhancer powder or flavor drops. Decaffeinated herbal tea bags are easy to pack, too. Just make sure you let the tea cool before you sip it so it does not hurt your surgery scar. A water bottle and protein blender bottle can be useful for the trip home.
You do not need to take any solid food since you will not be eating it for several days to weeks after weight loss surgery.
For Your Health and Comfort
Pillow. Medications. Ear plugs and face mask. CPAP machine. Gas-X. Throat lozenges. A pillow on your lap can make your ride home much more comfortable. It can also help you sleep better in the hospital if you are fussy. Ask the hospital about which medications to bring, whether you should bring your own CPAP machine, and how they feel about you using GAS-X to combat your post-op flatulence.
Do Not Bring
Jewelry. Irreplaceable keepsakes, such as photos. A simple rule of thumb is if you do not need it and do not want to lose it, do not take it. This goes for pricey items, such as designer handbags and jewelry, and for anything irreplaceable, such as family photos.

Reversibility
Each Weight Loss Surgery (WLS) type is designed to be permanent. However, the Adjustable Gastric Band (AGB) is fully reversible if necessary since the surgeon can remove the band from around your stomach. The Gastric Bypass (RNY) can be reversed, although the procedure is more complicated. The Gastric Sleeve (VSG) is absolutely irreversible since it involves removing most of your stomach from your body. Because of its reversibility, the AGB may be the choice for some younger patients or for those who do not want to take a dramatic step that affects their actual body parts.
Invasiveness and Recovery
The AGB is least invasive and has the shortest recovery time. It can even be an outpatient procedure, and you could get back to work in a week. This might be the only realistic option if you have very little sick leave available or you do not want to tell work colleagues about your surgery. The RNY and VSG are inpatient and require longer recovery times
Safety: Complications and Side Effects
Some risks of the AGB are band slippage or leakage, or erosion of the band. You could have vomiting or reflux if your band is displaced or filled too tight. Since the band can be removed, most of the complications can be stopped by emptying or removing the band.
The VSG has a higher rate of complications than the band. They can include leakage at the suture site. Nearly a quarter of RNY patients have complications of some sort, with more serious ones including staple line separation or leaks. You might opt for the AGB if you have a lower BMI without many health issues, or you might be more willing to take on RNY risks if your BMI is higher and you are more concerned about obesity-related issues such as diabetes.
The risk for nutritional deficiencies is higher with RNY and VSG. You can greatly lower your risk by taking the appropriate nutritional supplements, but you need to be prepared to take your bariatric vitamins for life. The effects of vitamin and mineral deficiencies can include osteoporosis, anemia, and nerve damage.
A Sweet Tooth and Dumping Syndrome
What are you looking to get out of your WLS? If all you need is help with portion control, AGB may be for you. It only helps with portion control, and it is up to you to make healthy food choices. On the other hand, the gastric bypass is best if you are looking for a tool to help you avoid sweets. That is because of the malabsorptive nature of RNY.
With RNY, your food passes through the lower part of your small intestine with less digestion than it would before surgery. Sugars that get to your small intestine can give you symptoms of dumping syndrome, including weakness, extreme fullness, diarrhea, nausea, and vomiting. Foods that cause dumping syndrome tend to be sugary and high-carb foods, such as candy, soft drinks, cakes, and pastries. Dairy and alcohol can also cause problems.
Most patients who get RNY have dumping syndrome at some point. Dumping syndrome can be beneficial because it gives you extra motivation to eat right – you know that if you grab that brownie, you may be headed for hours of misery! That can be a good reason to choose RNY. However, if the thought of dumping syndrome scares you, RNY is not for you!
There are many factors to consider as you choose your WLS type, but keep in mind that the decision is individual. You need to choose the WLS type that will work for you, even if it is not the one that worked for someone else. The decision is something to make after one or more serious conversations with your surgeon.

Freedom from Medical Chains
Medical benefits are probably most closely related to weight loss, but they are still worth noting as a “side” benefit of Weight Loss Surgery. As you lose weight, you may have improvements in blood sugar control, blood pressure, and cholesterol levels. You may have less joint and back pain. You may have fewer trips to the doctor, and be able to take fewer medications.
Better Sleep
Never underestimate the power of sleep! Losing weight can help you sleep more deeply so you feel better all day, every day. Your sleep can improve as you feel more comfortable in bed, and if you had sleep apnea that goes away or diminishes with weight loss. Just think how good life could be if you did not have to did not have to use a CPAP machine!
New Food Finds
Strange but true…there is a whole food world aside from burgers, burritos, fries, and bagels. Who knew that you might end up loving to start your day with oatmeal cottage cheese protein pancakes? Your favorite snack could turn out to be kale chips with parmesan. Dinner might be roasted cauliflower with grilled salmon – something you might never have considered when your go-to was mac and cheese from a box.
Sure, you might miss a few foods, but you might notice that you are loving all kinds of new health foods, and the way they make you feel. On top of it, eating slowly can help you savor each bite and enjoy the textures and flavors more.
Saving Money
Saving money probably was not your main reason for considering weight loss surgery, especially if your insurance is not footing the bill. Still, Weight Loss Surgery could be a financial gain in the long run as you consider some potential savings.
Lower medical bills for doctors’ visits, prescription medications, and complications such as complications of diabetes. Fewer sick days taken from work. Lower food bills as you eat less and potentially eat more homemade food. Fewer “extras,” such as higher prices of plus-sized clothing or needing to reserve two seats on a plane. More Meaningful Relationships
Were your relationships built around food before Weight Loss Surgery? Did you consider your friends your best eating buddies, with each of your meetings at a restaurant or each other’s houses for a (unhealthy) meal? Weight loss surgery frees you up to explore other interests. Deepen your relationships with your friends as you walk together or meet at museums or other sights instead of depending on food to bring you together. And, if you do meet for a meal or snack, feel good knowing you can focus on the conversation as you eat slowly.
Confidence
Ultimately, weight loss surgery is for you, and you can benefit inside as you look better on the outside. You can gain confidence from your new looks, maybe as you fit into clothes you love, or you see a few muscles popping out. Confidence also comes from your achievements. If you can do something as hard as going through Weight Loss Surgery and sticking to all those healthy lifestyle changes, you can do pretty much anything you set your mind to.
Energy
Energy is a wonderful thing, but it may be in short supply when you are carrying around extra pounds. Lose a few, and you might feel your endurance explode. You can keep up with your kids, enjoy a day at the mall or beach, and go on vacations. Getting through the work day can be easier. Life is better all around when you have energy.
Bariatric surgery is a weight loss tool, and it is so much more. Use it properly, and you can make great gains in many areas of your life. Part 2 of the series – to be published soon – will discuss ways to get what you deserve – maximum gains from Weight Loss Surgery!

Freedom from Medical Chains
Medical benefits are probably most closely related to weight loss, but they are still worth noting as a “side” benefit of Weight Loss Surgery. As you lose weight, you may have improvements in blood sugar control, blood pressure, and cholesterol levels. You may have less joint and back pain. You may have fewer trips to the doctor, and be able to take fewer medications.
Better Sleep
Never underestimate the power of sleep! Losing weight can help you sleep more deeply so you feel better all day, every day. Your sleep can improve as you feel more comfortable in bed, and if you had sleep apnea that goes away or diminishes with weight loss. Just think how good life could be if you did not have to did not have to use a CPAP machine!
New Food Finds
Strange but true…there is a whole food world aside from burgers, burritos, fries, and bagels. Who knew that you might end up loving to start your day with oatmeal cottage cheese protein pancakes? Your favorite snack could turn out to be kale chips with parmesan. Dinner might be roasted cauliflower with grilled salmon – something you might never have considered when your go-to was mac and cheese from a box.
Sure, you might miss a few foods, but you might notice that you are loving all kinds of new health foods, and the way they make you feel. On top of it, eating slowly can help you savor each bite and enjoy the textures and flavors more.
Saving Money
Saving money probably was not your main reason for considering weight loss surgery, especially if your insurance is not footing the bill. Still, Weight Loss Surgery could be a financial gain in the long run as you consider some potential savings.
Lower medical bills for doctors’ visits, prescription medications, and complications such as complications of diabetes. Fewer sick days taken from work. Lower food bills as you eat less and potentially eat more homemade food. Fewer “extras,” such as higher prices of plus-sized clothing or needing to reserve two seats on a plane. More Meaningful Relationships
Were your relationships built around food before Weight Loss Surgery? Did you consider your friends your best eating buddies, with each of your meetings at a restaurant or each other’s houses for a (unhealthy) meal? Weight loss surgery frees you up to explore other interests. Deepen your relationships with your friends as you walk together or meet at museums or other sights instead of depending on food to bring you together. And, if you do meet for a meal or snack, feel good knowing you can focus on the conversation as you eat slowly.
Confidence
Ultimately, weight loss surgery is for you, and you can benefit inside as you look better on the outside. You can gain confidence from your new looks, maybe as you fit into clothes you love, or you see a few muscles popping out. Confidence also comes from your achievements. If you can do something as hard as going through Weight Loss Surgery and sticking to all those healthy lifestyle changes, you can do pretty much anything you set your mind to.
Energy
Energy is a wonderful thing, but it may be in short supply when you are carrying around extra pounds. Lose a few, and you might feel your endurance explode. You can keep up with your kids, enjoy a day at the mall or beach, and go on vacations. Getting through the work day can be easier. Life is better all around when you have energy.
Bariatric surgery is a weight loss tool, and it is so much more. Use it properly, and you can make great gains in many areas of your life. Part 2 of the series – to be published soon – will discuss ways to get what you deserve – maximum gains from Weight Loss Surgery!

Freedom from Medical Chains
Medical benefits are probably most closely related to weight loss, but they are still worth noting as a “side” benefit of Weight Loss Surgery. As you lose weight, you may have improvements in blood sugar control, blood pressure, and cholesterol levels. You may have less joint and back pain. You may have fewer trips to the doctor, and be able to take fewer medications.
Better Sleep
Never underestimate the power of sleep! Losing weight can help you sleep more deeply so you feel better all day, every day. Your sleep can improve as you feel more comfortable in bed, and if you had sleep apnea that goes away or diminishes with weight loss. Just think how good life could be if you did not have to did not have to use a CPAP machine!
New Food Finds
Strange but true…there is a whole food world aside from burgers, burritos, fries, and bagels. Who knew that you might end up loving to start your day with oatmeal cottage cheese protein pancakes? Your favorite snack could turn out to be kale chips with parmesan. Dinner might be roasted cauliflower with grilled salmon – something you might never have considered when your go-to was mac and cheese from a box.
Sure, you might miss a few foods, but you might notice that you are loving all kinds of new health foods, and the way they make you feel. On top of it, eating slowly can help you savor each bite and enjoy the textures and flavors more.
Saving Money
Saving money probably was not your main reason for considering weight loss surgery, especially if your insurance is not footing the bill. Still, Weight Loss Surgery could be a financial gain in the long run as you consider some potential savings.
Lower medical bills for doctors’ visits, prescription medications, and complications such as complications of diabetes. Fewer sick days taken from work. Lower food bills as you eat less and potentially eat more homemade food. Fewer “extras,” such as higher prices of plus-sized clothing or needing to reserve two seats on a plane. More Meaningful Relationships
Were your relationships built around food before Weight Loss Surgery? Did you consider your friends your best eating buddies, with each of your meetings at a restaurant or each other’s houses for a (unhealthy) meal? Weight loss surgery frees you up to explore other interests. Deepen your relationships with your friends as you walk together or meet at museums or other sights instead of depending on food to bring you together. And, if you do meet for a meal or snack, feel good knowing you can focus on the conversation as you eat slowly.
Confidence
Ultimately, weight loss surgery is for you, and you can benefit inside as you look better on the outside. You can gain confidence from your new looks, maybe as you fit into clothes you love, or you see a few muscles popping out. Confidence also comes from your achievements. If you can do something as hard as going through Weight Loss Surgery and sticking to all those healthy lifestyle changes, you can do pretty much anything you set your mind to.
Energy
Energy is a wonderful thing, but it may be in short supply when you are carrying around extra pounds. Lose a few, and you might feel your endurance explode. You can keep up with your kids, enjoy a day at the mall or beach, and go on vacations. Getting through the work day can be easier. Life is better all around when you have energy.
Bariatric surgery is a weight loss tool, and it is so much more. Use it properly, and you can make great gains in many areas of your life. Part 2 of the series – to be published soon – will discuss ways to get what you deserve – maximum gains from Weight Loss Surgery!

Mindfulness basically just means paying attention to something - without judgment.
Mindful eating is paying attention to your food, and to your appetite cues - again, without judgment (that's the hard part!).
Dieting vs. Mindful Eating:
Diet =
Weight gain: 95% of people who diet will regain the weight they lost within 5 years. 2/3 of those people will regain more than they lost, ultimately resulting in overall weight gain. All about willpower and rigidity. Relies on external cues. Restrictive and depriving. Food & body are the enemy. Mindful Eating =
Weight loss: Studies show that mindful eating programs result in weight loss, fewer calories consumed, lower fat intake and increased self-confidence (Timmerman et al., 2012) All about trust and acceptance. Relies on internal appetite cues. Permissive and satisfying. Food & body are the ally. Which would you prefer? For me, I'd much rather give mindful eating a shot. Especially since dieting was what led up to most people having bariatric surgery in the first place.
Step-by-step how to eat mindfully:
Pick a calm and quiet place to sit down and eat. Check in with your hunger. Are you physically hungry? If not, wait until later when you are hungry. The food will be much more satisfying if you enter the experience hungry. Choose a food that will be satisfying. Give yourself permission to eat that food without judgment (toward the food or yourself) or guilt. Use all of your senses - look at the food, touch the food, smell the food, taste the food, feel it in your mouth, move it around and notice the way the texture and taste changes as you chew. Chew slowly and thoroughly. As you swallow, feel the food going down your esophagus and into your stomach. Notice how the food feels in your stomach. Ask yourself if you want more. If so, take another bite and repeat until you feel satisfied. At the end, take a moment to express gratitude for the experience, for the food, and for your body. Carry the awareness of mindful attention to other areas of your life - you'll be shocked at what a big difference this makes! Be patient with yourself. The practice of mindful eating is just that - a practice. Your mind and attention will wander, you will inevitably catch yourself judging yourself or the food. That's ok - it's normal. Just notice it, and return your attention to the experience.
Practice this as often as you are able. Of course, it's not possible to eat mindfully 100% of the time, so don't be rigid with it.
As you get more skilled at mindful eating, it will become more effortless and second nature.
See, I told you this wasn't just for hippies! Mindful eating is very doable for all of us. We just have to make the conscious decision to do it. Paying attention to our food and our bodies allows us to get infinite more pleasure out of life.
Give it a shot and let me know what you think. Share your experience in the comments below.
What was it like to pay close attention to the taste and texture of the food?
What was it like to refrain from judgment about yourself for eating the food?
What surprised you about mindful eating?