Schmincke

A couple of weeks ago I was driving to an appointment and I saw a really large man walking down the street. Because of his size and the near 100 degree temperature, I knew he had to be extremely uncomfortable. As I pulled into my parking place I glanced in my rear view mirror and watched this man trip with a force that propelled him like a rocket to the concrete. I bolted from my car and ran to him...his arm was already bloody.


"Let me help you up". He had salt and pepper hair and perhaps the kindest sky blue eyes I have ever seen.
With a perfect Texas drawl he said "Little lady you're gonna have to pack a little more lead in the rear to help me up!" My heart was breaking for him. I grabbed him by his good arm and we rocked....1, 2, 3, and I pulled with everything I had. No matter how much I wanted to help this man, I couldn't get him off the ground. He explained he was walking to work and I at first got the impression he was trying to get some exercise. I asked him to stay put and I'd get some help and as I ran into the building, there were just a few tiny women and elderly people that could be of no help. By the time I got back out, a man had stopped to help him up. He was hurt....I told him there was a doctor inside, would he please come in? I know he was both surprised and ashamed that I would help him. He chuckled and said he was alright (he wasn't). As he walked out of my sight he said "It's time to go on that diet".
Of course I knew he'd been on hundreds of diets, just like I had. It was the perfect time to have shared my story but yet it wasn't. I wish I had at least gotten his contact information so that maybe my signature on my email would perhaps spark a conversation.
Maybe he didn't have a car and had to go into work anyway for fear of losing his job because of his size. Maybe he couldn't afford to call for an ambulance. So many "maybes". Every day since then I have considered waiting at that parking space to see if I could locate him again. He felt so much embarrassment and I wanted to tell him that I knew there was a perfectly loving man inside trying to get out. I wanted to tell him so many things but most of all that I didn't see him as just a morbidly obese man....that he was just as valid and worthy as anybody and the shell he lived in did not make him "less than".
I fell a few weeks before that and was in extreme pain so I could only imagine what he was dealing with. Tears ran down my face for the rest of the day. Call me silly for wanting to do this but I'm going back to try to find him. I want him to know why I didn't judge him that day.
And why I cried.
p.s. I just added this because I do want everyone to know that I would NEVER give anyone unsolicited advice because I have seen it happen and someone got the response "I've already had WLS". Much like asking a woman if she's pregnant....not until I see the crowning of the baby's head would I ever ask when someone's baby is due. I just wanted to make sure everyone understood that.
*Note- I wrote this in 2011 and reread it the other day. I decided to share it here because the comments left on this blog post were so memorable and heartfelt. If you'd like to read them you can see them here.
I've been back to that same parking spot every month basically at the same time of the day ever since that day. I have unfortunately never found him again. If I ever do, I hope he'll let me take a picture with him so you can see his beautiful blue eyes and the kindest face you could ever imagine.

You know that you will never hit your goal weight if you intentionally try to cheat on your diet by sneaking bites or deciding not to log certain foods. But what if you think you are doing everything right and are still not losing the weight you expect? Hidden calories may be to blame. Figure out the sources of hidden calories in your diet, and you just may have a weight loss breakthrough!


Overeating is Possible after WLS

You got WLS so that you could lose weight, but it is important to remember that WLS is only a tool. To lose weight, you need to use that tool properly. If you fall into the trap of thinking that WLS automatically leads to weight loss, you might never hit goal weight. As a reminder, these are how the lap-band, vertical sleeve gastrectomy (VSG), and gastric bypass can help you lose weight.
Lap-band: The lap-band creates a small pouch, or stoma, to help you fill up faster so that you eat less.
Vertical sleeve gastrectomy (VSG): The surgery removes most of your stomach and creates a small sleeve out of the remaining portion. The gastric sleeve restricts the volume of food you can eat and it reduces hunger by reducing the amount of ghrelin, which is a hunger hormone.
Roux-en-Y gastric bypass: The surgery restricts food intake by creating a small pouch, and reduces nutrient absorption by having food from your stomach bypass much of your small intestine.

Your weight loss surgery will not work for you if you cheat in these ways.
You eat more frequently – and take in more calories – than your surgeon suggests without feeling the restrictive effects of the adjustable gastric band.
You eat sugary, fatty high-calorie foods. The lap-band, especially, is unlikely to cause you to develop dumping syndrome. That is good because you will not get the unpleasant symptoms, but it is bad because it does not prevent you from eating sugar, starch or fat. Even with a stoma size of just 4 ounces, or a meager 1/2 cup, you could fit in 400 calories’ worth of M&M’s in with room to spare.
You drink fluids when you are eating solids so that you are able to consume more at a single meal or snack. Drinking fluids while eating solid foods can also cause your stomach, sleeve or pouch to empty faster so that you get hungrier sooner.
You sip on beverages that provide calories but do not fill you up.

How Hidden Calories Might Be Throwing You Off

What if you think you are following your weight loss surgery diet diligently? You measure your food whenever you can, you use your dietitian’s food list when you go grocery shopping, and you order chicken and vegetables when you go out to eat. You get protein at every meal, and you drink plenty of water each day.

Hidden calories are the ones that creep into your diet. You might not know you are eating them, or you might think that you eat so few “extra” calories that they don’t matter in your diet. But, they do impact your weight loss. An extra 20, 50, or 100 calories here or there really affects your weight loss. Remember that a pound of body fat equals 3,500 calories. That’s an average of 500 calories per day to lose a pound a week. If you are getting hundreds of hidden calories a day, that could easily be a pound a week that you’re not losing.

Where Are the Hidden Calories?

Good question! They can be almost anywhere.
Starches are not necessarily unhealthy, but they should only be part of your meal after you eat your protein and vegetable or fruit.
Protein is the first thing you should eat at each meal and snack, but it is also a source of calories. Fatty meats and poultry with the skin can have 100 or more extra calories per 3-ounce portion compared to lean meats and chicken or turkey breast.
Healthy foods can be high-calorie. A handful of nuts or dried fruit or a big spoonful of peanut butter can have 200 to 300 calories.
Condiments can wreck your diet. A tablespoon of mayonnaise has 100 calories, a tablespoon of jam has 50 calories, and a tablespoon of salad dressing has 80 calories. Ketchup, teriyaki sauce, and marinades can have 15 to 20 calories per tablespoon.
Restaurant foods can be tricky. Vegetables that you think are steamed can have butter in them, and chicken, fish and other proteins that you think are good choices can come in sauces with 100 or 200 calories per serving. Portion sizes can be several times what you need: a 12-ounce steak is 4 to 6 WLS-sized portions, and a 3-cup plate of pasta is 6 to 8 WLS-sized portions.

o Examples of each of the below. Carbs: toast, crackers. Eat celery. Smaller pasta, more protein meatballs.
o Protein. It’s a nutrient, but it’s also a source of calories. Esp. if with sugar/carbs in supplements, or hi-fat protein foods. Bacon
o Healthy hi-cal foods: nuts, pb, dried fruit (fresh). Portion sizes. Avocado.
o Condiments. Fatty dressings (choose low-fat), use less (use herbs), sugary
o Portion sizes. MEASURE. Nibbling without measuring, eyeballing. You get 60 extra calories every time you take a piece of cheese that is the size of your thumb (1.5 ounces) instead of weighing it to make sure that it is only 1 ounce.
o beverages
o Restaurants: salads, fat added to “grilled” foods or steamed vegetables, beverages, “healthy” bagel instead of low-cal doughnut
o Eating too frequently. Tips for if you’re starving (protein, no fluid with meal); tips to make meal smaller (if you’re eating so many meals, don’t need to be big)

The Good News
The good news is that small changes add up to big calorie savings.
Have an ounce of low-fat cheese instead of full-fat, and save 50 calories.
Have a quart of regular or sparkling water instead of a quart of a sports drink, and save 200 calories.
Skip the bite of cookie dough after you finish baking for your children, and save 100 calories.
Have 3 ounces of 95% lean ground beef instead of 85% lean ground beef, and save 70 calories.
Rinse the spoon instead of licking it after you serve yourself peanut butter, and save 30 calories.
Spread peanut butter or tuna on 3 large celery stalks instead of 6 triscuit crackers, and save 90 calories.
Have one-third of a cup of pasta with your meatballs instead of a full cup, and save 120 calories.

This works for exercise, too. Every little bit helps. When you walk for just an extra half-mile, or about 10 minutes, you burn 50 extra calories.
Start to think about where extra calories may be coming into your diet, and see what you can do to limit them. You’ll be happier with your weight loss results!

What is your heart's desire - the thing you want so much that it takes up most of the room in your heart? A partner, child or friend? A job, home or vacation? Or is it weight loss - the thing that brought you to BariatricPal in the first place?


YOUR HEART’S DESIRE
What is your heart’s desire? Be honest now, with yourself if not with me. If your heart’s greatest desire today isn’t weight loss, that’s OK. There are lots of things in our lives that are just as important, or even more important, than weight loss. After a lifetime of dieting and weight problems, my mother’s dying wish had nothing to do with her weight. Her greatest wish was that her grown children (both in our 50’s) would stop fighting with each other. Maybe your heart’s desire is that your partner will love you more (or better). That’s OK too, as long as you understand that weight loss probably isn’t going to achieve that. Maybe your heart’s desire is to become a neurosurgeon, and you somehow believe that weight loss will make your studies easier or faster, or it will ensure your acceptance to medical school (but think twice about that last one).
What if you don’t know your heart’s desire, but you hope that weight loss will help you find it? That’s entirely possible, but it may not be revealed to you in a sudden, blinding flash. You may have to go groping around in the dark for a while before you find it.
JUST WANNA BE THIN?
Is your heart’s desire simply to be thin? Are you sure of that?
Before I ask you a question, I first try to answer it myself, and it’s not easy for me to answer this particular question. For much of my life, it’s been fairly easy to talk about what I don’t want. I don’t want to be fat, I don’t want to listen to another doctor lecture me about my high cholesterol, I don’t want freak-show breasts, and so on and so forth.
When I decided to have WLS, I focused on the desire that burned most brightly in my dark life: weight loss. Intellectually I knew that things in my life other than my weight would change as a result of the surgery. My surgeon and nutritionist made it clear that I must change my eating and exercise behavior. I didn’t especially want to change those things – who doesn’t want to effortlessly lose 5 pounds a week while sitting on their butt eating potato chips and cookies? – but I nodded obediently and gave myself a stern self-improvement lecture for perhaps the 200th time in my life. I thought that weight loss was the most precious prize I could ever win. Everything else paled in comparison to it. Weight loss has indeed been a precious prize, but it has turned out to be the ruby instead of the diamond in my crown.
We tend to believe that weight loss will cure all our problems. While it will indeed solve some problems (especially health-related), it also introduces us to some brand-new ones. Like my friend Joni, who after getting her heart’s desire (a baby), was astounded to realize that caring for that baby was going to be her 24-hour-a-day job at least until he turned 18, we discover that maintaining weight loss is a lifetime job. It may not require all 1440 minutes of our attention every day, but it’s still there and it’s still work. On the whole, I’m OK with that. I’ve come to realize what a precious gift my body is after decades of despising it, so I’m willing to give it the attention and nutrition, the relaxation and pleasure, the exercise and rest that it needs to in order to carry me onward.
I discovered something else after achieving my heart’s desire. As soon as it was in my eager hands, I started looking around for another heart’s desire. Identifying that and figuring out how to get it has taken me longer than I expected, and I’ve changed my mind a few times along the way. I usually make decisions quickly, preferring to make a bad decision over no decision. What do I want now? Do I really need something else, or am I a compulsive seeker of experience and sensation? Am I still trying to fill the bottomless hole that I used to stuff with food? Or do I already possess my heart’s desire – such as a personal relationship with God – and just don’t recognize it?
Sometimes I wonder if naming my heart’s desire is so hard because I wrongly persist in thinking of it as a thing – something as tangible and solid as a book or a chair or a car. Perhaps I should look instead for a place or even a state of being.
OK, OK, don’t go to sleep quite yet. I’ll stop my philosophical meandering and tell you my secret heart’s desire.
I want to live.
After decades of self-punishment, frequent despair, and several attempts at total self-destruction, I want to live. And I want to live well, in a way that celebrates life. No more hanging back, no more wasting time. No more time spent counting the minutes until mealtime, or how many cookies are left in the Keebler package. I’ve got to stop fearfully dismissing new things because “I’ve never done that before,” or because “I don’t know how to do that.”
SO HOW DO YOU RECOGNIZE IT?
How do you recognize your heart’s desire? How do you envision and name it? Are you living your life like a shopper who doesn’t know what she/he is looking for, who says, “I’ll know it when I see it.” I know that feeling, but I wonder if a gut “that’s it” reaction always sends us in the right direction or helps us make the best decisions. No big deal when choosing a color of nail polish, but is it safe when choosing a career, a partner, or a medical treatment? While my analytical skills are overdeveloped, I also know that my built-in danger detector tends to sound the alarm when I’m facing something unfamiliar or unknown. With the alarm blaring in my ears, I back away or even beat a retreat from whatever adventure or challenge I’ve glimpsed.
About 10 years ago I spent a long weekend in Honolulu when on my home from an overseas business trip. While there, I stood at the edge of a cliff and watched other visitors snorkeling in incredibly clear water, only inches from coral, shells, and undersea life so vivid I could see it easily from my distant perch. I was filled with envy. I knew that in a tourist town it would be easy to find a way to join a snorkeling expedition, but my inner alarm sounded, and it scared me off by blaring, “You can’t do that. You don’t have a bathing suit. You’re too fat to find a bathing suit to buy, never mind wear it in public. You’re afraid of the water. You’re a lousy swimmer.”
So some of the questions I try to ask myself now when contemplating something new include:
1. Is this opportunity likely to arise again?
2. What’s the worst thing that could happen if I do it?
3. What’s the worst thing that could happen if I don’t do it?
4. Does the cost or risk outweigh the potential benefit?
BITTERSWEET
And that brings me to my final (for now, anyway) point. As I wrote in Bandwagon, saying goodbye to the excess pounds and problems can be bittersweet. We lose some beloved companions (such as our edible comforts) and discover new things about ourselves, not all of them lovable.
For example, I discovered that I am a far more selfish person than I ever would have admitted when I was obese. When I was supporting my food addiction, I believed I was the only one affected by it, but I was wrong. It saddens me now that I gave my relationship with food more time and energy than my relationships with my friends and family. I can’t go back and change that, much as I might like to. All I can do is give those people (including me) the love and attention they deserve as I go forward.