Amanda Dutton LPC

So, I think I might be able to help on this one. Food addiction - or really, an eating disorder - has actually been shown to be fundamentally different from other addictions in that you *can* recover from it. Although we call ourselves "food addicts" we aren't really, because food isn't something that we can abstain from 100%, like other addictions. It's a process addiction, meaning the addiction is the behavior instead of the substance. As we work on the recovery from the disordered eating behavior, we can learn how to become a (hate this word) "normal" eater. BUT... We can still have a relapse if we get too comfortable! If it helps to think of yourself as being in lifelong recovery (it's how I still choose to think about it at 14 years out), then rock on. Either way is fine! I'm super proud to read what you wrote about how good it feels for food to not be the main focus in your life! Doesn't it feel awesome?? ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Born and raised in GA - about 45 mins north of Atlanta. [emoji4] ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Totally a valid question! It does seem like "born and raised" Southern folks - especially those of us with deep family roots - would have a harder time with weight. For me, food was always around. My grandmother (Granny) was my caregiver shortly after my parents returned to work up until I could drive. She had a garden, raised chickens and cooked everything in lard or Crisco - even some of the vegetables. Fried chicken every Tuesday. Giant handmade biscuits ("cathead" biscuits). Sweet tea in the fridge at all times. Every family gathering revolved around food - holidays, birthdays, weddings, funerals - everything. Not cleaning your plate was not an option. She was raised during the Great Depression and had 7 kids - you did NOT waste food. And as was said before, you ate no matter whose home you were at and what time it was - it was disrespectful not to. Bless their hearts. 🤣 ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

And "how's yer mama'n'em?" or calling any and everybody "sweetie," "honey," or "darlin'." [emoji6] - born and raised north GA girl [emoji137]‍♀️ ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

I have a legitimate question, please? Speaking as a therapist and a RNY vet. What is it about taking away the supervised program that is attractive to those of you that are seeking surgery? Is it that it takes away one of the multiple hoops we already have to jump through or is it that it shortens the length of time before scheduling surgery? The biggest reason I ask is because it seems kind of scary for me because so many folks I work with (and folks here, too) are already saying that they felt so unprepared for life after surgery, I'm afraid that shortening the timeframes even more will make it even worse. So much of the medically supervised time should be for the "pre-work." I just really worry that this is a secret way for insurance to come back later and say "see, this bariatric surgery thing isn't working. All these people are gaining their weight back. We should stop covering it." I know, I know - it sounds like a conspiracy theory, but I deal with insurance companies not wanting to pay for services so often (3 sessions after a suicide attempt? Sure, that'll be plenty! [emoji849]), it just wouldn't surprise me. 🤷‍♀️ ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

With a sleeve, you may not have to adjust meds. As an RNY, I had to have mine changed from XR to regular because of issues with absorption due to not having access to stomach acid and because we lose those first few feet of intestines where things are absorbed. Since the sleeve became more popular BECAUSE those issues didn't happen (malabsorption), and the anatomy change wasn't causing the lack of access to stomach acid to break down medications, that is what makes me suspect that you won't need to change. Totally making an educated guess based on my own experience and that of my clients, though. 🤷‍♀️ Definitely still ask your doc. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

You cannot permanently stretch your pouch. Your stomach is an elastic organ. So, yes, it can be pushed to holding more than it should, but it shrinks back to normal size after the meal is processed. The only thing the "pouch reset" really does is get you to slow down and recognize that you only need a certain amount of food to actually be satisfied. See screenshot from article by Dr. Roshini Rajapaksa, MD, assistant professor of medicine at the NYU School of Medicine. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Especially the facility in Tijuana that BariatricPal setup. Those doctors chose to go work there because they support the need for affordable surgery and the US won't support it. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

It's definitely different for every surgical program. Generally, most surgeons say it's 60-80 because that is simpler than what the true recommendation is, which is about 1/2 of your goal or ideal weight. So since goal for women averages out to be around 120-160 (depending on lots of factors, but it's pretty much the typical range), that's where the 60-80g comes from. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

Something that helped me in the pre-op phase to wean off caffeine was to start buying both diet coke and caffeine free diet coke. I would start fixing 1-to-1 mixed when I drank it and slowly switched over to just caffeine free. Same with coffee (bought regular and decaf and kept mixing in the decaf as I used up the big can so by the end of it, I was ready to fully go decaf. By then, I could switch out the soda for water, since I was off caffeine, and still have coffee, since it was decaf. At 14 years out, I'll get a diet dr pepper as a treat sometimes and I drink half-caf coffee (I buy one can of each), but I get in all my water, so it works. ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

It's definitely a personal choice. I think it's totally appropriate for you to do whatever makes you feel comfortable. You may decide to not say anything for awhile and then one day change your mind - or not! Everyone in my circle knew because it had been a long decision process for me and I wanted the accountability. Eventually, the transformation was significant and it stuck, so it was something I was proud to share. Now, I've made my journey my life purpose, so I definitely share with everyone I encounter if the opportunity arises and it keeps me even more accountable (I'm a therapist and I coach bariatric surgery patients, too). ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

It sounds like you have a good grasp on the reasons why we slow down as we go (like having less to lose over all), so that's awesome, first of all. You're already ahead of many people that may not even realize that! Also, you're looking at the month rather than day-by-day, so kudos to you! Having slow and fast months is totally normal. Even a slow month is kind of a plateau. Being 4 months out, your body is still healing, so there is still going to be inflammation that causes your body to hang on to fat a little longer for fuel to heal. As long as you are moving, staying on plan with nutrition and vitamins/supplements and getting in your water, you should be fine. I remember having those same thoughts then suddenly having a loss shortly after. Keep us updated! [emoji175] ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

A 2 month old horse, a human head and a chihuahua! ~SW: 278 CW: 165~ RNY 1/5/2005 "What got you here won't get you there."

My waddle is just the motivation I need to drop my shoulders and lift my head in pics. Or figure out how to gobble. [emoji38] Sent from my SM-G930V using BariatricPal mobile app

North GA girl here! A week from now I will be 14 years post RNY! Happy to offer any words of encouragement and support (and some laughs from blunt reality) if y'all want! Sent from my SM-G930V using BariatricPal mobile app

In my experience, it seems like we have been in the diet mentality for so long that we're convinced that "thin=happy." That's such backwards thinking! In the media, especially diet commercials, we're shown pictures of larger people in disheveled clothes, eating terrible food and looking miserable while the thinner and more attractive (by society's standards) people are happy and doing exciting things. We are fed (pardon the pun) the idea that our self esteem and happiness is contingent on our weight when we are kids (being bullied, jokes by family, left out of teams) and it sets our expectations for the future. If we can wrap our brains around understanding that our self esteem is within our control and not dependent on the opinions of others, we can start feeling more determined to make changes that stick. THAT could be, and honestly IS the key to real, longterm weight loss surgery success. *steps off soapbox* Sent from my SM-G930V using BariatricPal mobile app

MJ shouldn't be an issue; however, like others have said: 1) depending on how far out you are from surgery, watch out for coughing 2) be aware of if you are prone to food cravings 3) possibly opt for oil, sublingual tincture, or canna coffee 4) there are also creams and lotions if you want to try topical. 5) check out if transdermal patches are available where you are I'm a daily user of CBD oil vaped or sublingual for RA and fibro, and I've had good luck with a couple brands. MJ isn't accepted in my state yet so 🤷‍♀️ Sent from my SM-G930V using BariatricPal mobile app

Hey! I haven't posted on BP in ages, but got back on and came across your post, so I thought I'd offer an encouraging response. I'm 14 years post RNY and have RA & also take Humira. I've had no issues with it being effective, since it's an injectable and not oral. I also take Gabapentin for fibromyalgia and it hasn't been an issue either. My RA wasn't diagnosed until about 5 years ago, but I have had signs for years. I also use a topical NSAID with no issues (Voltaren gel), again, since it's not oral, but I don't use it often. Hope that helps! ~SW: 278, CW:168 & proud!~

What are you thankful for this year? Your home? Your job? Your family? What are the other people in your life thankful for? What about your family? Your co-workers? Your friends? Do you ever wonder if any of them are thankful for YOU? We often spend our lives working for others, doing things for others, helping others. Where’s the time for you? Taking care of ourselves and focusing on our own needs is usually WAY down on the list, if it’s on the list at all. It feels selfish. So, what if I told you it was actually self-LESS? Yep, you read that right. Self-LESS. Stop. Breathe. Read this very carefully: If you don’t take care of yourself, you can’t take care of anyone else. Go back and read that again. And once more. Think about it: What happens when you get sick? Or injured? Or have a nervous breakdown because you Just. Can’t. Even. Again: If you don’t take care of yourself, you can’t take care of anyone else. Are you hearing that? That’s not selfish, that’s self-LESS. If you don’t take time for YOU, you won’t be able to do anything for ANYONE ELSE. You will break, you will fall, you will crumble. Give yourself a moment to let that sink in. While you are doing that, take a look at a few suggestions at how to make that happen: Give yourself permission to say “no.” Let’s go ahead and get the hard one out of the way first thing. You aren’t responsible for making sure that everyone gets everywhere or that they get everything they want. Granted, young children have more needs than adults, but I’m betting that if you sit back and think for a moment, there are times that if you said “no,” the individual would either: a) just do without it, or find some other way to make it happen. Often, you’re the “go to” person because people realize that you’ll say YES. Set aside a specific time for your self care and treat it like an appointment you can’t miss. You know that doctor’s appointment it took you 2 months to get? And how you made sure that nothing stood in the way of you getting to that appointment? Yeah, treat your self care time just as special. Program it in your phone. Write it on the calendar. Let your family know that you have an appointment that you can’t miss and that you won’t be available. You need this. Expect others to push your boundaries. Especially in the beginning. They won’t be used to you being so assertive, so the attempts to make you feel guilty for not dropping everything to attend to their needs may ramp up for awhile. It’s okay! Remember, this is expected. You’re preparing for it now, by reading this, so when it happens you will already know that it is temporary. By sticking to your boundaries and not giving in, IT WILL GET BETTER. If you give in now, you have shown that if they push hard enough, they will eventually get there way. Don’t stop. Remember: we cannot be good caregivers if we don’t practice self care. It’s not selfish, its self-LESS.

So, what if I told you it was actually self-LESS? Yep, you read that right. Self-LESS. Stop. Breathe. Read this very carefully: If you don’t take care of yourself, you can’t take care of anyone else. Go back and read that again. And once more. Think about it: What happens when you get sick? Or injured? Or have a nervous breakdown because you Just. Can’t. Even. Again: If you don’t take care of yourself, you can’t take care of anyone else. Are you hearing that? That’s not selfish, that’s self-LESS. If you don’t take time for YOU, you won’t be able to do anything for ANYONE ELSE. You will break, you will fall, you will crumble. Give yourself a moment to let that sink in. While you are doing that, take a look at a few suggestions at how to make that happen: Give yourself permission to say “no.” Let’s go ahead and get the hard one out of the way first thing. You aren’t responsible for making sure that everyone gets everywhere or that they get everything they want. Granted, young children have more needs than adults, but I’m betting that if you sit back and think for a moment, there are times that if you said “no,” the individual would either: a) just do without it, or find some other way to make it happen. Often, you’re the “go to” person because people realize that you’ll say YES. Set aside a specific time for your self care and treat it like an appointment you can’t miss. You know that doctor’s appointment it took you 2 months to get? And how you made sure that nothing stood in the way of you getting to that appointment? Yeah, treat your self care time just as special. Program it in your phone. Write it on the calendar. Let your family know that you have an appointment that you can’t miss and that you won’t be available. You need this. Expect others to push your boundaries. Especially in the beginning. They won’t be used to you being so assertive, so the attempts to make you feel guilty for not dropping everything to attend to their needs may ramp up for awhile. It’s okay! Remember, this is expected. You’re preparing for it now, by reading this, so when it happens you will already know that it is temporary. By sticking to your boundaries and not giving in, IT WILL GET BETTER. If you give in now, you have shown that if they push hard enough, they will eventually get there way. Don’t stop. Remember: we cannot be good caregivers if we don’t practice self care. It’s not selfish, its self-LESS.