GBLady41

Love at First Sight
I was enthusiastic about the promise of the lap-band from the moment I first heard about you. Could you be the tool that could end my struggles with weight? Could it be possible that there could be an end to my unhealthy relationship with food? Could I say goodbye to the liquid diets, the low-carb diets, the fat-free diets, and all the other fad diets I had tried?
You had worked for my friend; could you work magic for me, too? I dared to hope. I got surgery in July of 2003.
Honeymoon and Beyond
Surgery went as expected, and you lived up to your promise. I lost weight – nearly 100 lbs. – and hit a healthy BMI. I felt better than I ever had. Sure, you made me work hard for every pound, but each victory was so sweet that there was no question that I would not follow your guidance.
In so many ways, the honeymoon period did not seem to end. Life has gotten better and better as I have gained confidence that I can maintain goal weight and prevent regain. Not once did I look back with regret.
A Helping Hand for a New Lease on Life
With the lap-band, I was able to gain control of myself and my life. I enjoy life’s events for themselves, and not for the food that comes with or after them. I am able to keep up with my children, who are my greatest joys. I have energy and confidence.
You have made my relationship with food better, and that is liberating. I eat when I am hungry and stop when I am full. I give in to my cravings and become satisfied with only a reasonable amount of the food I craved. There have been bumps along the way, but you have been my dependable gauge and silent cheerleader throughout.
My Life and My Livelihood
Along with my health, you also gave me my career. Out of necessity, I started LapBandTalk.com as soon as I came home from the hospital after surgery because I needed the help of other patients. Not in my wildest dreams did I think that impromptu discussion forum would become my career.
To LapBandTalk, I added other boards for the other weight loss surgery types, and they eventually became BariatricPal to recognize that we are all in this together. I am now honored and grateful to be able to call my life’s work my true passion – helping people through weight loss surgery. Nearly 15 years after I started a discussion board to help myself, BariatricPal now includes the forums, the store with protein products and bariatric vitamins, and even a full-service program for weight loss surgery in Mexico – at BariatricPal’s own hospital. I have gotten to meet and work with all kinds of wonderful patients, surgeons, and others in the weight loss surgery community.
Time to Part Ways
It is on a bittersweet note that I bid you, my lap-band, farewell. I have no real choice; multiple medical professionals agree that the safest decision is for us to part ways. I have been struggling with acid reflux (GERD) for a few years, and symptoms are getting worse, especially after my Lap-Band slipped. I also have been diagnosed with pre-Barrett’s esophagus and severe erosive gastritis, most likely caused by my lap-band. I will get my lap-band removed and opt for gastric bypass to help me maintain my goal weight.
The lap-band may not last forever, as it was meant to. I know the I will succeed with the Gastric Bypass because I already have the skills I need to eat right. Of course, I am a little worried. How could I not be, after having been so successful with you as my partner for 15 years?
But as is necessary with anything in life, I will do my best. I will take what I have gained from you, my lap-band, and carry it forward. Thank you, and farewell.

I have become much more health conscious and logical since having my gastric bypass weight loss surgery in 2003. And I have witnessed that just as there is a method for obesity, there is a method for weight loss. As a result, making good food choices for your bariatric life can be as simple as swapping out unhealthy foods and cooking methods for their healthy versions. I promise you will love cauliflower rice, zoodles, and air-fried veggie chips so much that you’ll never feel deprived of your potatoes and pasta again.

Say buh-bye to the habits that kept you trapped in mounds of flesh and fat. And say hello to easy-to-prepare home-cooked meals of whole foods.

INVEST IN SEVERAL QUALITY SMALL APPLIANCES AND LEARN NEW, HEALTHY WAYS OF PREPARING FOODS.
Investing in a few high-quality small appliances and kitchen tools will pay for themselves with the money you save on processed convenience foods — and you’ll be rewarded with highly nutritious foods and superior taste!

Check out a few basics to get you started:
• Coleman grill for amazing grilled meats, fish, and vegetables! Take this portable grill on road trips, too!
• Slow cooker or electric pressure cooker make food very tender and easier to digest.
• Osterizer is the best blender I’ve ever had for frozen protein shakes and smoothies — and it’s far cheaper than a Vitamix!
• Cuisinart food processor for chopping cauliflower into rice to pureeing cashews into nut butter or roasted cauliflower into mashed potatoes, and more.
• Wok pan for quick and healthy stir-fry meals in minutes.
• Vegetable spiralizer to make grain-free noodles from zucchini (zoodles) or sweet potatoes.
• Air-fryer for healthy veggie fries, crunchy veggie chips and more!

Want the Bariatric Diet Tips that I have culled from experts in health and wellness and have enabled me to maintain a 120+ pound weight loss? Get more life-changing bariatric diet tips: READ NOW.

Living larger than ever,
My Bariatric Life

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]

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.

Drinking liquid calories (although the stomach limits the volume of food that you eat, it doesn’t prevent you from being able to drink large amounts of calories), Not delaying your fluids from your solids (drinking and eating at the same time - only after surgery - appears to result in the rapid transit of the food you eat, in other words it “flushes” the food out of the stomach the same way flushing the toilet with water empties the bowl. This results in an empty stomach and a true physical hunger leading you to eat more. This is often confused with people thinking or feeling as if they have stretched their pouch), Grazing/Picking and nibbling (surgery operates on the stomach, not the mind, thus the reasons that may have lead some people to overeat before surgery may remain, such as emotional eating, stress eating, using food as a coping mechanism, etc. Some other reasons for weight regain that are less common but still possible include:
An enlarged gastric pouch A fistula Intestinal adaptation New medications that may induce weight gain (i.e. anti-depressants, some forms of chemotherapy, etc) A poorly controlled thyroid (synthroid doses need to be adjusted after rapid weight loss). For further nutrition advice or to read our blog, visit our website and like our Facebook page for up-to-the-minute information:
Bariatric Surgery Nutrition
Bariatric Surgery Nutrition

In the first part of the series, we looked at a recent study comparing results of weight loss with NBC’s “Biggest Loser” to weight loss with weight loss surgery. At least in the short term, weight loss was similar, with Biggest Loser contestants coming out ahead at 7 months with the gap narrowing by 12 months.
Some articles and research are available, but wouldn’t it be nice if there were a way to compare Biggest Loser and bariatric surgery side by side? Here’s our summary of how the groups lost weight and what the results were.
Methods
In case you’re not aware, the “Biggest Loser” is a reality television show that is a weight loss competition. Morbidly obese contestant compete on the Biggest Loser ranch to lose the most weight. Every 7 to 10 days for 13 weeks, a contestant is voted off and eliminated from the competition. From week 13 to 30, the remaining contestants go home and return for the finale, where the contestant who has lost the most weight is crowned the Biggest Loser winner. They lose weight with intense exercise and a restricted diet.
This study compared roux-en-Y gastric bypass (RYGB) patients. They lose weight because their smaller stomach forces them to eat smaller meals. In addition, they need to limit sweets and fatty foods to avoid gastrointestinal symptoms.
Diet
Biggest Loser contestants ate similar amounts of to RYGB patients. In the Biggest Loser, contestants ate at least 70 percent of their baseline needs, calculated by a formula based on their fat-free mass. A contestant who weighs 220 pounds and has 50 percent body fat would be asked to eat at least 1,000 calories per day. The diet includes lean protein, fruits, and vegetables, and restricts processed foods.
In comparison, RYGB patients often eat a similar number of calories. They too focus on protein, followed by vegetables and fruits. Also, they limit sugary and fatty processed foods.
Exercise
Here’s the big difference. Four hours of exercise a day, anyone? Biggest Loser contestants exercise 90 minutes per day six days a week with the trainers, plus up to 3 hours daily on their own. That adds up to up to 31.5 hours a week – basically a job!
Weight loss surgery patients are asked to exercise, but to work up to it. They may have goals such as working up to 20 or 30 minutes daily, and getting up to 60 to 90 minutes most days over the long run.
The Logistics: Support and Cost
Biggest Loser contestants have a lot of support. On the show, they see a trainer six days a week. They have a doctor – Dr. Huizenga – to monitor their health and progress. In contrast, most RYGB are on their own – they don’t have the luxury of a trainer each day. They tend to follow-up with their surgeon once or a few times over the months following surgery. They may have support groups to help.
Bariatric surgery is expensive, no question. The procedure, plus pre-op workups and post-op appointments, can be thousands or tens of thousands of dollars. Biggest Loser? Diet and exercise sound inexpensive, but can you afford to exercise for 31.5 hours a week? Can you afford to see a doctor whenever you want?
What about the cost of benefits provided to contestants, such as having room and board at a weight loss resort for several weeks? The list price for a guest at a Biggest Loser Resort is about $2,500 weekly. For 13 weeks, as on the Biggest Loser, that’s a cost of $32,500. Makes RYGB seem cheap!
Weight Loss
What about the important thing – weight loss? Turns out the results are pretty similar…at least in the beginning. After 7 months, the Biggest Loser group lost an average of 108 pounds, while RYGB patients were at an average of 78 pounds down. By 12 months, RYGB patients were down by 89 lb. on average. And Biggest Loser patients? They were no longer being followed – who knows what happened after their season of the show ended?
It stays a little cloudy later on, too. Biggest Loser hasn’t published statistics on the long-term success of its contestants. In contrast, RYGB has been shown to be successful in studies that have tracked patients for 5 or even 10 years.
Health Effects
Both groups had improvements in some measurements of health. Blood pressure, blood sugar, chronic inflammation, and “good” HDL cholesterol improved. Strangely enough, Biggest Loser contestants had an average increase of total cholesterol from 168 to 192, and of “bad” LDL cholesterol from 105 to 126.
Also curious was the decrease in metabolic rate – or the number of calories burned at rest. Biggest Loser contestants’ metabolisms dropped more the RYGB patients’, even though Biggest Loser contestants maintained more of their lean tissue while dropping more fat.
Okay, so what’s the take-home message? One might be that the way that is best for you to lose weight depends on your individual situation. If you have the time and money to train Biggest Loser-style, maybe you would prefer that to going under the knife. If you need a permanent tool for long-term assistance with losing weight, and maybe even if your health insurance will chip in, weight loss surgery may be for you. What do you think?

I was sitting in my office with a client the other day who’d had bariatric surgery several years ago. “It just didn’t work for me. I’ve tried everything. I don’t know what else to do.” She was looking down in shame, and I could tell she was feeling totally defeated.
“This is a really common struggle,” I said, “And I want you to know it’s not your fault.” She looked at me in disbelief.
The same advice over and over again
You see, most people are accustomed to seeing a dietitian and being silently scolded and told to “eat this, not that...blah, blah, blah.” It’s the reason that a lot of people avoid seeing a dietitian - because it feels like you’re in the principal’s office.
Truth be told, most people already know what they “should” be eating after surgery. Heck, they even knew before having surgery, but that knowledge wasn’t enough. And it still isn’t. If information were enough to solve a person’s weight problems, bariatric surgery wouldn’t exist.
Thus, here you are in a frustrating dilemma: Knowing what you should be doing, but not being able to do it consistently.
So now what?
It’s time to start thinking about things differently. If what you’ve been doing isn’t working then STOP DOING IT.
That same old dieting advice that didn’t work for you before surgery isn’t going to work after either. Don’t worry, I can help. I have worked with hundreds of people who have had weight loss surgery. From that work I have honed in on some key factors that will actually make a difference for you.
3 Secrets to Success
Do the things that matter. It’s easy to get bombarded with information and overthink it. You can spin your wheels doing things that don’t matter. I had a client who kept trying all these special protein-fortified foods and finally I told him, “You’re spending a lot of energy on these special foods, and you’re still gaining weight. Let’s look at some other factors that might be impacting you.” He wasn’t seeing that his lack of sleep and snacking were working against him. Once we targeted those issues he started losing weight again.
Implement a system. Don’t rely on willpower. Willpower doesn’t work because it’s finite, and it gets depleted by everyday stressors. You’ll inevitably find yourself lacking willpower with food when you most need it if you don’t have a system. Ever been through a drive thru on the way home from work after a stressful day? That’s because your willpower was depleted earlier at work. If you have a system for dealing with stressors at work such as automation of tasks, delegation, stress management techniques, and perhaps a wind-down ritual at the end of the day, you’re much less likely to hit the drive thru on the way home. And your dinners could be automated by a rotating monthly calendar or a delivery system such as Blue Apron. Make yourself a route to drive home that doesn’t go by any fast food restaurants, and BAM! we’ve created a system.
Develop habits. People who are successful at something have boring habits. It’s never quick and easy like we’re led to believe. You don’t accidentally win an Olympic gold medal. And you don’t win it with magical solutions either, like taking supplements. Nope, it takes years of intentional and intense training. Same thing with your eating. You don’t accidentally or magically lose a ton of weight just by having surgery and taking vitamins. And you certainly don’t accidentally keep it off for the long run. You need habits that you stick to every single day. Things such as planning your meals ahead of time, grocery shopping on a specific day of the week, exercising at the same time each day. These are the habits that will pay off over time.
Systems and habits reduce the cognitive load of having to make lots of tiny decisions all day long. Just like willpower, our decision-making ability gets fatigued and we start to take the easy way out. If something is a habit you’re much more likely to do it - rather than sitting there trying to decide whether or not you feel like doing something. Chances are there are plenty of times you’re not going to feel like going to the grocery store, or cooking dinner, or exercising. If you only do it when you feel like it you’re probably not going to lose weight.
What to do today
Today, sit down and take a look at what you’re really eating. Don’t lie to yourself, it won’t help. Be brutally honest. Write it all down. Then identify ONE thing that you want to change. Something that if you did it, would actually make a significant difference. Find a way to implement a system around this change, and do it until it becomes a habit.
The result: You’ve now shown yourself that you can make sustainable behavior change. You can repeat this process over and over again to create new systems and habits. Keep doing it, and I promise you’ll start losing weight and feeling better, having more energy, feeling more confident. You’ll feel like you’re in control of your life. And that’s pretty awesome. If not, you can always check out this site for more in-depth help getting back on track.
Have you made any changes that made a big impact on your weight loss? What did you do to stick with it? Let me know in the comments.
Katy is giving away a free gift to help Bariatric Pal readers get moving, have more energy, and feel great.

Let me speak to the shock part first. Yes, I drank - a lot – in college. So did everyone else I knew. So did everyone in my family. In fact, most of the people in my family drank a whole lot more than I ever did! After I got married, I quit drinking on a regular basis. When I did drink after that, I usually drank to get drunk – true. It’s also true that I drank less after I got married because I started taking codeine – very rarely, at first – for bad migraine headaches. Over time, however, I took it daily because codeine helped me to not feel. Anything. At most, I took maybe three in a day. I thought addicts took lots and lots of pills!
So when I was given the alcohol and drug addiction screening, I was certain I wouldn’t meet any criteria for alcoholic, and most definitely not for drug addict. Well, I got one heck of a case of the “Yeah buts…” in a hurry when the therapist said, after scoring my test, “Connie – you’re an alcoholic and a drug addict.” As she talked to me about the items that indicated addiction on the test, every one of my responses to her started with, “Yeah, but…” For example, “Yeah, but I could have answered that question either way.” “Yeah, but I don’t drink nearly as much as most of the people I know, especially the people in my family.” “Yeah, but, drug addicts take a lot of pills throughout the day.” “Yeah, but I was able to take care of my kids and work and go to school.” “Yeah, but I’ve never been in trouble with the law.”
When I had exhausted all the “Yeah, buts” I could think of, imagine or create, I got quiet and let it sink in. I am an addict. And then I felt it. Relief. It made sense.
What made sense to me about my being an addict is understanding, for the first time, the reasons I continued to do things that went against my own values. I started to understand the reasons I did things I said I would never do. It began to make sense that things I promised I would stop doing seemed impossible to stop doing.
I am an addict. I have a disease that “hijacks” the brain. When I am in active addiction of any kind: the disease of addiction that affects my brain doesn’t allow me to listen to reason but stays locked in denial mode the disease of addiction that affects my emotions keeps me in a protective mode so I defend myself by blaming other people and things for my behavior the disease of addiction that affects my spiritual self says, “do what feels good in the moment” and hides the part of me that says, “what I value is good and decent” the disease of addiction that affects my social self, brings out the loud, obnoxious, hurtful voice I am capable of using the disease of obesity that affects my physical being takes dangerous risks, eats poorly, doesn’t exercise and doesn’t care Accepting the truth that I am an addict was a relief. NOT AN EXCUSE. I understood my poor choices better. It made sense that it was so difficult for me to follow through with the convictions I made to myself and the promises I made to others. I began to understand why my behaviors went against the person I wanted to be. Addiction is a brain sickness and a soul sickness. And a protector. All at the same time.
Food, alcohol, shopping, pain medication, and other things I engaged in addictively protected me from my feelings. That is what I wanted most of all. To not feel. I didn’t want to feel the reality of my sadness, my anger, my pain and my shame. The trade-off for not feeling was to use addictive substances/behaviors and betray myself by doing things I was embarrassed about, ashamed of, and seemingly unable to control.
Being an addict was in no way an excuse for the behaviors I engaged in. It’s very uncool to use being an addict as a way to avoid taking responsibility. “I danced with the boss’s husband at the holiday party. What can say – I was drunk.” NOT COOL. “I told her off but she had it coming and besides – I was drunk and couldn’t keep my mouth shut.” NOT COOL.
For food addicts, it is similarly bogus to make excuses for overeating because the kids were acting up, you were late for work and got yelled at, your mother was sick, or your spouse ticked you off.
Each one of us is 100% responsible for our behavior – even if we have addictions. If we have an addiction, once we realize that truth, we are responsible for getting help and learning healthy ways to deal whatever life brings us. We are responsible for learning to deal with our feelings in appropriate ways. We are responsible for learning to work through losses, past abuse or neglect, present hardships, frustrations with family and friends, and all of life’s realities. Without the use of addictive chemicals or actions.
The addictive substance or behavior, whatever it is, isn’t the problem. Sure, alcohol is a problem for alcoholics. Certain foods are problems for food addicts. Shopping is a problem for shopaholics. But those are only the surface problems. Addictive substances and behaviors are symptoms of the real problems, which are almost always rooted in shame: “I’m not good enough.” That shame stems from many possible places.
To treat addictions, we must first remove the substance or behavior. No, one cannot eliminate food from their life. But they can eliminate the food(s) that cause them problems. Once we are free of chemicals or the addictive behaviors, we can work on the real problems and choose who we want to be. When we don’t “use,” our actions can reflect our values.
“Connie – you’re an addict.” WHAT A RELIEF! I understood why I couldn’t STOP doing things I didn’t really want to do. I finally knew there was hope. I knew I could learn to live life in healthy ways and according to my values. But I first had to be willing to live without the addictive chemicals and behaviors.
So I needed help. I couldn’t do it alone. And I didn’t have to. Together, we can support one another into a life of RECOVERY.
What a relief!

Get the Go-Ahead
Step 1: get your doctor’s approval! This can give you confidence that you are on the right track and that you are going to be safe while exercising. Find out whether you have any exercise restrictions such as type of exercise or a safe heart rate. Once your doctor gives you the okay, you have no more excuses!
Walk, Swim, or Bike
The first goals of an exercise program for beginners are often to get your heart rate up and burn a few calories. Walking, swimming, and stationary biking can be the safest and most comfortable options for many weight loss surgery patients.
Start at a slow, easy pace without pushing yourself before you are ready. Only go for a few minutes at the beginning, and work up gradually as you get into better shape. Focus on yourself, and don’t compete with others’ paces or workout lengths. Stay positive, since it gets easier as time goes on! Pump Some Iron
Walk into a co-ed gym, and you are likely to see two groups. The men are lifting weights, while the women are focused on cardio and tied to machines such as ellipticals, treadmills, and bikes. Which group should you be in?
Both! While cardio, or aerobic exercise, burns calories and helps your heart, blood sugar, and other health measures, strength training has its own benefits. It helps you lose weight by building muscles, which burn more calories all day, and it improves your bone health. Strength training does not bulk you up; it makes you toned and lean. You have all kinds of options.
Lifting dumbbells or barbells. Using weight machines at the gym. Pulling on resistance bands. Trying exercises that use your own body weight as resistance. Work on each of your major muscle groups, including biceps (front of arms), triceps (back of arms), shoulders, chest, back, hips, quadriceps (front of thighs), hamstrings (back of thighs), calves, and core – your abs and obliques. The ultimate goal is to work each muscle group at least two days per week, making it tired but not straining.
You might want to ask a trainer or an experienced friend for help with ideas for exercises, as well as for demonstrations on proper form. You do not want to get injured!
Do a Full Workout
What is the difference between a workout and a full workout, you ask? The workout is the main part of your exercise, such as a brisk walk and/or a weight lifting session. A full workout starts earlier and ends later because it includes:
A 5 to 10-minute warmup such as slow walking or easy cycling to gradually get your heart up from its resting rate to its workout rate. Your main workout, such as brisk walking, an aerobics class, or a tennis match. A 5 to 10-minute cool-down, such as slow walking on the treadmill or in the pool. 5 to 10 minutes of stretching to keep your muscles loose. The full workout takes a little longer, but keeps your injury risk down and lets you get more out of your workout and entire exercise program.
Be Realistic
Some exercises may not be comfortable or feasible when you are carrying around extra weight. Do not fight with yourself or get down on yourself. Just be patient. Do what you can, and you will gain new skills as you get in better shape.
Exercise can be one of your greatest gifts to yourself on the weight loss surgery journey. It is hard and getting started is hard, but the rewards are well worth it. Good luck!

I have worked as a psychologist, providing psychological evaluations prior to bariatric weight loss surgery for the past eight years. For the most part, people need a power tool to help them lose and keep off the weight they have lost over and over again in their lives. The gastric sleeve, bypass, and now balloon are those tools. However, every once in a while, I will encounter someone who believes these procedures are the magic bullet.
I can pick this up in five seconds when I learn that:
this person has no exercise plan to maintain their weight loss a barrage of excuses as to why they can't exercise anymore zero insight into why they are overweight ("I don't know why I am overweight, I just eat steamed vegetables and grilled chicken mostly.") a lack of motivation or understanding for why they also have to engage in behavioral modification in addition to the surgery "Why would you reveal all of this?" you ask. Aren't I giving away the keys to the kingdom to anyone who reads this and wants to pass a psychological evaluation? Perhaps- but who are you really cheating if you don't go within and face the real demons that got you here in the first place?
When I ask people about their eating styles, I tend to group them into four categories:
1) emotional eater- someone who uses food when they are bored, stressed, tired, lonely, sad, or even happy in addition to eating when they are hungry
2) skip and binger- someone who fails to think about food until it is too late, and when they are ravenous end up going for whatever is available which is usually some type of carb and calorie laden fast food
3) miscellaneous- someone who just recognizes that they eat too large of portion sizes and/or the wrong types of food
4) food addict- usually someone with a history of other addictions, trauma, and a significant amount of weight to lose. They usually have comorbid psychological diagnoses that have been unaddressed or ill-addressed.
Out of the four categories, the 4th is the most troubling for a psychologist. This particular person is most correlated with the patient who fails to address their core issues, eats "around the sleeve," or bypass, experiences dumping syndrome, comes back a year later and asks for the bypass, or a different procedure.
This is the person who, ironically, is usually the most resistant to my recommendation that they seek therapeutic support prior to the surgery. They want it done YESTERDAY. They want it NOW. It is this type of thinking that got them into trouble in the first place. The impulsivity and lack of emotional regulation.
I've witnessed people fail to address their maladaptive eating patterns and never quite get to their goal weight. I had a male that would buy a bag of pepperonis at the grocery store and snack on them all day and couldn't understand why he wasn't losing weight. This daily "snack," which was a mental security blanket, served as a veritable IV drip of fat and calories throughout the day.
I've had a woman who figured out how to ground up her favorite foods into a liquid form because she never quite let go of her attachment to "comfort foods." One of her most notable liquid concoctions consisted of chicken and Cheetos. I'll just leave that for you to chew...er swallow.
They say with drug and alcohol recovery- you "slay the dragon," but with food addiction recovery, you have to take it for a walk three times a day. If you don't fundamentally shift your relationship with this dragon, you're going to get burnt when you are walking it.
My number one tip for transforming your relationship with food is to start looking at eating the same way you do as brushing and flossing: You don't necessarily salivate at the idea of what type of toothpaste you will use, where you will do it, who you will do it with, right? You just do it twice a day because you don't want to lose your teeth and you want to maintain healthy gums.
Food has to be thought of in the same way. You fuel up. You don't use food as a place to define your quality of life. You don't use food to celebrate. You don't use food to demarcate the end of a long day. You don't use food to help you feel less alone. You figure out healthier coping alternatives to meet these needs.
Loneliness-call a friend for support
Celebrate- get a massage
Demarcate the end of a long day- start a tea ritual and use essential oils
Another reason you must say goodbye to comfort food is that it triggers the pleasure center of the brain, which ignites our dopamine, which perpetuates the addiction. Many people think we are just telling them to get rid of the comfort food because of the carbs or calories, but there are unique and harmful chemical consequences to ingesting these types of food we know are bad for us.
If you are ready to take a modern approach to weight loss and stop dieting for good- check out my wls/vsg psychological support course here for free.

1. Hummus. Despite being made from chickpeas, the average store bought hummus has only 1 gram of protein per tablespoon. Instead, opt for homemade hummus, homemade black bean dip or homemade Tzatziki (made with Greek yogurt) as dips for your veggies.
All of these dips are significantly higher in protein when made at home compared to their store-bought counterparts. 2. Chicken broth. Surprisingly, the average store bought chicken broth has only 1-3 grams of protein per cup. For this reason, your bariatric team likely recommended you choose higher protein soups immediately after surgery (ex. milk based soups or pureed legume soups).
Instead, opt for more filling thicker soups, such as a curried lentil soup, a roasted red pepper black bean soup or a hearty chili. 3. Cream cheese. Despite ‘cheese’ being in its name, the average store bought cream cheese has only 1 gram of protein per tablespoon.
Instead, opt for ricotta cheese (with a sprinkle of sunflower seeds and a drizzle of honey!) or peanut butter on your morning toast. 4. Quinoa. Quinoa is a filling grain product not because of its protein content, but more because of its fibre content. While quinoa is the only grain listed as a ‘complete’ protein, it only has 2 grams of protein per ¼ cup of cooked quinoa.
Always top your quinoa with a true protein source such as meat, fish, legumes, tofu or tempeh to make your meal truly balanced. Quinoa should not be the main event! 5. Almond/Cashew/Rice/Coconut milk. Despite these beverages having ‘milk’ in their name, these alternative milks contain on average a measly 1 gram of protein per cup.
Instead, opt for cow milk or soy milk when you are looking to add an extra splash of protein to your cereals, oatmeal or smoothies. Moral of the story? Don’t let misleading product names or sneaky advertising fool you! Get the facts. Always double check the nutrition facts tables on the back of your foods to learn the full story.
- Monica & Lisa