Amanda Dutton LPC

A complete bariatric program is SO important for us! I'm sad to hear that the first doctor felt that a nutritionist would steer you wrong. I, too, feel that you made the right call by switching. We need all the support we can get, before and after surgery, so being in a program that takes a "whole person" approach is key. Good luck in your journey, and keep us updated!

What defines you? Is it your home? Your job? Your family? Your weight? What about your purpose? Is it to make more money? To retire in the Bahamas? To run away and live in the mountains with a pet squirrel named George? Are their pieces missing from the puzzle that make it hard to see how you will get from where you are to where you want to be - to your purpose? We often spend our lives working for others, doing things for others, helping others. Taking care of ourselves and focusing on our own needs as a means to work toward our own goals 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 selfLESS? Yep, you read that right. Self-LESS. Let me give you a scenario...see if this sounds familiar... Imagine that you wake up in the morning, your child is in the bed with you (laying sideways, foot wedged in your kidney, as usual) and as you're getting up, you realize you've overslept and that child is going to be late for school. You then rush to get him ready, grab some breakfast as you run out the door, call your boss (who of course, sounds frustrated), apologize and offer to stay late (again), and rush to the school. You get to work, apologize again, and are reminded that you are presenting at a meeting in an hour. As you scan through e-mails and vaguely hear your voice mails, there is a message from your mother reminding you about dinner at her house tonight. You make a mental note to call her. Rushing into the meeting, you apologize (again) for being late, but you handle the meeting like a champ. After the meeting, you continue your day, pausing every time someone asks you to do something and responding to their requests. That's what you do. Finally heading out the door at 7:30pm, you realize you've missed a call from your mother, and suddenly it hits you that you forgot to call her back. You call her back as you're rushing to her house, apologizing (yep, again) and thanking her for picking up your son (yet again). By the time you get home, there is barely time to shower and fall in the bed (with a precious foot jammed in your kidney), and hope that you set your alarm this time. Sound familiar? Where's the time for you? Not a moment of it anywhere. So what happens when you get sick? Or injured? Or have a nervous breakdown because you Just. Can't. Even. 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. 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: 1. 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. 2. Set aside a specific time for you 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. 3. 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. Are there some specific ways that you already practice self care? Share in the comments and you may give a push to someone else!

Excellent job, VSGAnn! Planning is so important for us. Taking that time is an important part of staying on track and helping to derail bad choices during the day due to lack of a plan!

It is very hard when you are in a helping field, but even more important I feel. We are naturally givers and it's hard to make time for ourselves. Scheduling time for yourself takes some of the guilt away. I felt that guilt for such a long time until I started to "work myself sick." Then it became evident I couldn't fully be there for my clients if I didn't take care of myself. That really helped when I took this perspective.

That's awesome when you have the support of a spouse! So glad that you consider self care sacred and that you have the support to make it happen. Hope you and your husband continue to do well!

Yes! I completely agree! The dietitian that leads the support group I recently began helping just talked about making time for meals last night! A very important part of self care for anyone, but especially us!

That's such a great plan! I have my self care time between my agency job and my practice, about 30 minutes as well. Just quiet time to decompress and get myself centered. And a nice hot shower before bed REALLY is essential for me, too. I've never been a morning person, and showers always put me in sleep mode!

We often spend our lives working for others, doing things for others, helping others. Taking care of ourselves and focusing on our own needs as a means to work toward our own goals 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 selfLESS? Yep, you read that right. Self-LESS. Let me give you a scenario...see if this sounds familiar... Imagine that you wake up in the morning, your child is in the bed with you (laying sideways, foot wedged in your kidney, as usual) and as you're getting up, you realize you've overslept and that child is going to be late for school. You then rush to get him ready, grab some breakfast as you run out the door, call your boss (who of course, sounds frustrated), apologize and offer to stay late (again), and rush to the school. You get to work, apologize again, and are reminded that you are presenting at a meeting in an hour. As you scan through e-mails and vaguely hear your voice mails, there is a message from your mother reminding you about dinner at her house tonight. You make a mental note to call her. Rushing into the meeting, you apologize (again) for being late, but you handle the meeting like a champ. After the meeting, you continue your day, pausing every time someone asks you to do something and responding to their requests. That's what you do. Finally heading out the door at 7:30pm, you realize you've missed a call from your mother, and suddenly it hits you that you forgot to call her back. You call her back as you're rushing to her house, apologizing (yep, again) and thanking her for picking up your son (yet again). By the time you get home, there is barely time to shower and fall in the bed (with a precious foot jammed in your kidney), and hope that you set your alarm this time. Sound familiar? Where's the time for you? Not a moment of it anywhere. So what happens when you get sick? Or injured? Or have a nervous breakdown because you Just. Can't. Even. 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. 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: 1. 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. 2. Set aside a specific time for you 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. 3. 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. Are there some specific ways that you already practice self care? Share in the comments and you may give a push to someone else!

Practice does not make perfect. Yep, you read that right. If you are hoping for perfection in the journey after weight loss surgery, you may be setting yourself up for disappointment. There are going to be setbacks along the way, so how do you prepare for that? Depending on how you approach this journey, you may enter it “gung-ho” thinking “I'm in this to hit my goal in the quickest time possible and I'm going to stay there no matter what!” That is an awesome attitude! I think it is great! However, when a setback occurs, it's best to be prepared so that it doesn't hit you so hard that you fall on your butt in shock and not know how to jump up and keep pushing forward again. Here are some key things to remember. You are not perfect. Sorry, but it's true. Neither am I. None of us are. It's a fact that we all have to embrace and accept. If we can come to terms with the fact that there WILL be setbacks, we will get a lot closer toward are goals than if we get discouraged by every bump in the road. There is something to be learned from a setback. So you gave in and had some of your “old” favorite food. Was it fabulous? Okay, cool. What did you learn from the experience? Did you dump? Have guilt? Feel disappointed? Take a moment to really listen to your mind, heart, and body to determine what you learned and go forward from there. Success is long term. You did not gain the weight overnight, and you won't REGAIN it all overnight, either! Don't beat yourself up over one setback. If you start being too hard on yourself, go back to #2 and check in again. Live through it, learn from it, and don't press the repeat button. Be kind to yourself. Take note of the small successes along the path of your journey. You chose not to partake in your “old” favorite food? Bravo! Do something nice for yourself that DOESN'T involve food. You came up with a new recipe that is a WLS-friendly version of something you love? Way to go! Share it with friends as you binge watch your favorite series. There are so many obstacles that you will face in your new life, don't overwhelm yourself trying to get everything perfect. There's no such thing. Just aim for “close enough” and you'll stay on track.

Depending on how you approach this journey, you may enter it “gung-ho” thinking “I'm in this to hit my goal in the quickest time possible and I'm going to stay there no matter what!” That is an awesome attitude! I think it is great! However, when a setback occurs, it's best to be prepared so that it doesn't hit you so hard that you fall on your butt in shock and not know how to jump up and keep pushing forward again. Here are some key things to remember. You are not perfect. Sorry, but it's true. Neither am I. None of us are. It's a fact that we all have to embrace and accept. If we can come to terms with the fact that there WILL be setbacks, we will get a lot closer toward are goals than if we get discouraged by every bump in the road. There is something to be learned from a setback. So you gave in and had some of your “old” favorite food. Was it fabulous? Okay, cool. What did you learn from the experience? Did you dump? Have guilt? Feel disappointed? Take a moment to really listen to your mind, heart, and body to determine what you learned and go forward from there. Success is long term. You did not gain the weight overnight, and you won't REGAIN it all overnight, either! Don't beat yourself up over one setback. If you start being too hard on yourself, go back to #2 and check in again. Live through it, learn from it, and don't press the repeat button. Be kind to yourself. Take note of the small successes along the path of your journey. You chose not to partake in your “old” favorite food? Bravo! Do something nice for yourself that DOESN'T involve food. You came up with a new recipe that is a WLS-friendly version of something you love? Way to go! Share it with friends as you binge watch your favorite series. There are so many obstacles that you will face in your new life, don't overwhelm yourself trying to get everything perfect. There's no such thing. Just aim for “close enough” and you'll stay on track.

We've all heard the words “guilt” and “shame” throughout our lives, but do you truly understand the difference? How do we know when we are “guilty” of something and when we are “ashamed” of something? In this post, I will try to explain the difference and how each of these are important to understand as we recover from our love affair with food and how to overcome she guilt and shame associated with our addiction (and yes, it's time to admit that we are addicted to food). Have you ever done something in your life that you wish you hadn't? Sure, you have. We all have. If someone says that they haven't, then I would like to meet them. Granted, we can say “everything I have done has made me the person I am today, so I don't regret anything,” and I think that's awesome, but still, there are those things we might have done differently at least. "Guilt" is your conscience, what tells you that what you are doing is wrong and that you “know better.” Maybe you were 5 years old and stuck a piece of candy in your pocket at the grocery store. Maybe you broke something at your Aunt Judy's house and blamed it on your sister. Whatever it was, you felt guilt because you were the one that had performed the “action” or the “behavior.” “Shame” is what you feel when you ignore your guilt and do the behavior or action anyway. Let's say that you took the candy from the store, and when you got home and started to eat it, your mom found out and was furious. She took you back to the store and made you apologize. That feeling you had, along with embarrassment, was shame. Shame makes you feel that you are a bad person, that internal dialogue that results in addressing your self-perception. How Guilt and Shame Relate to Food Addiction When related to our addiction to food, guilt and shame can come when we fall off the wagon after our surgery (in addiction, this is referred to as a “relapse”). Let's say we choose to eat a food that we know is not good for us after surgery. First we feel guilty for eating the food (the behavior), then we feel shame because we may perceive ourselves as a bad person, a failure, etc. This kind of thinking, when not addressed effectively, can lead us down the path of ongoing negative self-talk that can cause repeated relapse due to feeling that we have failed ourselves. Think back to times where you may have not done so well on diets prior to surgery. Perhaps a “slip up” on the diet caused you to think “that's it, I screwed up. I might as well give up.” Sound familiar? That's addict thinking. One relapse and the addiction rears its head and we are back in full-force. Reframing the Thoughts So, how do we reframe that “shame” and “guilt” so that a possible relapse doesn't derail our progress? Own up to the mistake – don't hide from the fact that we made a mistake. We all have slip ups from time to time. Take responsibility for it. This is our new lifestyle and we signed up for this for a reason. Accept the consequences, if there are any, and accept them with grace. We are responsible adults, and we have to act as such. Be proud of your accomplishments so far and not ashamed of a mistake that can be repaired. Fix the mistake – What went wrong? Was there a stress that overwhelmed you? Were you in a situation that put you around a food that was just too tempting? What can you do differently to prevent this particular situation from happening again? Figure out what the cause was that lead to the relapse and how to make it different. If you recognize the situation and change it, and it still happens, then the situation was not the issue. It may be time to dig a little deeper into yourself and see if you have truly identified the mistake. Ask forgiveness – Surprised by this one? There are others that are probably on this journey with you. Perhaps your support people are aware that you slipped and have verbalized or otherwise made you aware of their disappointment. As part of owning up to the mistake, ask forgiveness and ask for their help. Taking the time to reach out to them and acknowledge that you know they are there will go a long way to keep you on track. Forgive yourself – above all, DO THIS! - seriously, this is most important. You must forgive yourself for this fall. It's life. We have to get up and move forward. Was it wrong? Yep. Do we feel bad about it? Sure. Did it make us put back on 50 pounds that we lost? Nope. Get up, wipe your eyes, keep moving. Shame and guilt don't have to be ongoing reminders of our past. Using the steps above, we can grow in many areas of our lives, not just in recovery from our bariatric surgery and our love affair with food. Try these steps with other areas in your life in which you may be feeling shame or guilt.

FocusOnMeNow, It's so hard to take ownership of the fact that we aren't perfect and that we are sometimes going to make mistakes. I'm glad that you've gotten to that point - it's definitely freeing, as you said!

Vulnerability is courage. That's awesome!

The honeymoon period. The time period after the surgery, when the weight is coming off without much effort, and you feel like it was the best decision you ever made. The compliments are coming from everyone, you're fine with taking the supplements, the protein shakes, heck, you're even okay with losing some hair – it'll grow back, right? But what about when you've reached “that” point? The point where the weight loss has slowed. The “head hunger” has started and, well, the “fun” has worn off. Reality sinks in that this “real life.” This is something that you need to keep up with. This is now your...gulp...”everyday” life. The honeymoon period. The time period after the surgery, when the weight is coming off without much effort, and you feel like it was the best decision you ever made. The compliments are coming from everyone, you're fine with taking the supplements, the protein shakes, heck, you're even okay with losing some hair – it'll grow back, right? But what about when you've reached “that” point? The point where the weight loss has slowed. The “head hunger” has started and, well, the “fun” has worn off. Reality sinks in that this “real life.” This is something that you need to keep up with. This is now your...gulp...”everyday” life. Did you expect to have depression creep in? Or maybe creep back in? Most of us thought this surgery would correct our mood issues, thinking that losing the weight would help get rid of that which was bothering us. So what happened? Why are we sad, frustrated, mad? Why aren't we...well...happy? A lot of this can be attributed to losing our primary coping tool to deal with depression and stress: mindless consumption of food. We may not have realized it at the time, but food was our comfort, our companion, sometimes the only thing that was there for us when nothing/nobody else was. Now, that support is no longer something we can reach for in hard times to get us through. We are physically and emotionally missing/grieving our former “companion.” Our coping tool. Sometimes, our best friend. So what do we do? First, we have to look at the physical way food was affecting us. Not just related to weight, but in our brain. Food was giving us satisfaction in a way that was “rewarding” receptors in our brain that control the chemical dopamine. Dopamine is a chemical that makes us feel good. This is the same chemical that is triggered when someone uses drugs or alcohol. Yep, scary thought, huh? That's why we often hear about “food addiction.” We are literally “feeding” that addiction when we overeat. That's hard to accept, I know. Second, we have to look at WHY we may be overeating. What thoughts do we have that lead us to seek food as comfort? Are they thoughts about ourselves? Are we thinking that “I'm so fat” or “I shouldn't even try” or maybe even “Why do I even bother?” Sometimes the addiction is so deep, it's hard to identify the thoughts that made the behavior start. Then it may be more helpful to think about the feelings. What feelings direct us to start overeating? Is it anger? Boredom? Defeat? Do the words or actions of another make us feel “less than” and lead to lowered self worth, thus leading to the desire to overeat? The concept of looking at Thoughts-Feelings-Behaviors is at the core of Cognitive Behavioral Therapy, a standard therapeutic method of behavioral therapists. Finding a therapist that can help us figure out the source of how these 3 things work together to lead us on the path to overeating can go a long way toward correcting the behavior. The key to CBT is retraining those thoughts to become more positive, leading to more positive feelings and behaviors. Often, we get stuck with “ants” - Automatic Negative Thoughts – and they are hard to undo. With the assistance of a therapist that is trained in CBT, particularly one that is familiar with bariatric surgery, we can retrain our brains to think more positively about ourselves, thus leading to be less dependent on food to nurture feelings of happiness. What kind of “ANTs” do you want to get rid of? Can you think of a chain of Thoughts-Feelings-Behaviors that you would like to change? What would you rather that chain look like instead?

Carole, Thank you so much for your reply! I was going to pull specific quotes from it for my response, but I realized I was keeping more of it than I was going to leave out, so I just quoted the whole thing! I would have responded sooner, but your response really made me think. I had to take a step back and rethink the way I used the word "relapse" in my article. Being that I also do a lot of work with folks who are in recovery from substance abuse, the term "relapse" is often used because in substance abuse, ANY use after entering recovery is considered a relapse. However, after I read your comment, it made me rethink my use of the word as it applies to us. Being that we cannot completely do without our "drug of choice" so-to-speak, I think that you are correct. Using the word "lapse" as in "lapse in judgement" makes much more sense. A full relapse would be more appropriate if we completely chose to stop following the bariatric lifestyle completely rather than just made a one time poor choice. That being said, I have changed the wording in the article to reflect the correction. Thank you so much for your feedback! That's why we all have to help each other on this journey. Even at almost 11 years out, I love knowing that there is still more to learn!

Thank you, Mountaingal! I'm glad you found it useful!

Have you ever done something in your life that you wish you hadn't? Sure, you have. We all have. If someone says that they haven't, then I would like to meet them. Granted, we can say “everything I have done has made me the person I am today, so I don't regret anything,” and I think that's awesome, but still, there are those things we might have done differently at least. "Guilt" is your conscience, what tells you that what you are doing is wrong and that you “know better.” Maybe you were 5 years old and stuck a piece of candy in your pocket at the grocery store. Maybe you broke something at your Aunt Judy's house and blamed it on your sister. Whatever it was, you felt guilt because you were the one that had performed the “action” or the “behavior.” “Shame” is what you feel when you ignore your guilt and do the behavior or action anyway. Let's say that you took the candy from the store, and when you got home and started to eat it, your mom found out and was furious. She took you back to the store and made you apologize. That feeling you had, along with embarrassment, was shame. Shame makes you feel that you are a bad person, that internal dialogue that results in addressing your self-perception. How Guilt and Shame Relate to Food Addiction When related to our addiction to food, guilt and shame can come when we fall off the wagon after our surgery (in addiction, this is referred to as a “relapse”). Let's say we choose to eat a food that we know is not good for us after surgery. First we feel guilty for eating the food (the behavior), then we feel shame because we may perceive ourselves as a bad person, a failure, etc. This kind of thinking, when not addressed effectively, can lead us down the path of ongoing negative self-talk that can cause repeated relapse due to feeling that we have failed ourselves. Think back to times where you may have not done so well on diets prior to surgery. Perhaps a “slip up” on the diet caused you to think “that's it, I screwed up. I might as well give up.” Sound familiar? That's addict thinking. One relapse and the addiction rears its head and we are back in full-force. Reframing the Thoughts So, how do we reframe that “shame” and “guilt” so that a possible relapse doesn't derail our progress? Own up to the mistake – don't hide from the fact that we made a mistake. We all have slip ups from time to time. Take responsibility for it. This is our new lifestyle and we signed up for this for a reason. Accept the consequences, if there are any, and accept them with grace. We are responsible adults, and we have to act as such. Be proud of your accomplishments so far and not ashamed of a mistake that can be repaired. Fix the mistake – What went wrong? Was there a stress that overwhelmed you? Were you in a situation that put you around a food that was just too tempting? What can you do differently to prevent this particular situation from happening again? Figure out what the cause was that lead to the relapse and how to make it different. If you recognize the situation and change it, and it still happens, then the situation was not the issue. It may be time to dig a little deeper into yourself and see if you have truly identified the mistake. Ask forgiveness – Surprised by this one? There are others that are probably on this journey with you. Perhaps your support people are aware that you slipped and have verbalized or otherwise made you aware of their disappointment. As part of owning up to the mistake, ask forgiveness and ask for their help. Taking the time to reach out to them and acknowledge that you know they are there will go a long way to keep you on track. Forgive yourself – above all, DO THIS! - seriously, this is most important. You must forgive yourself for this fall. It's life. We have to get up and move forward. Was it wrong? Yep. Do we feel bad about it? Sure. Did it make us put back on 50 pounds that we lost? Nope. Get up, wipe your eyes, keep moving. Shame and guilt don't have to be ongoing reminders of our past. Using the steps above, we can grow in many areas of our lives, not just in recovery from our bariatric surgery and our love affair with food. Try these steps with other areas in your life in which you may be feeling shame or guilt.

Moveandgroove, You have had quite the journey! If my math is right, that means 3 surgeries in 2 years (wls, gallbladder, aneurysm)? Your body has gone through some pretty traumatic experiences in a relatively short amount of time! That is something that you should be proud of working through! So, let's take a step back and look at what may be going on here. You went from running to recovering from a significant surgery. You had a period where not only could you not exercise, you also could not work. What I get from that is hearing someone that had to go from being active to sedentary very quickly - which may have triggered some of the feelings of "old habits" possibly coming back ("I am terrified...I won't stop gaining...I don't want to waste the surgery..."). What's fueling your doubt? This setback? Does it feel familiar, like a setback in a diet? If it does, step back and look at it again - this is not the same. You have a beautiful tool in your arsenal that you didn't have before. Use it. Go back to basics and pretend it is day one. I remember a very similar time in my own life, about 3 years when I was diagnosed with Rheumatoid Arthritis and though I was going to be put on long term steroids. I thought I was done with my weight loss forever. Take one step at a time, one foot in front of the other. The fact that you are still reading, still posting, still asking....that says that you still want this. You can do this. You will do this. Get back out there and walk a little. Don't focus on running, just walk. Remember, even baby steps get you closer to your goal. Take care! Amanda

Leepers, These are my 3 favorite things you said in your response. Especially because you said them ALL. You pointed out key things that we all need to remember. 1) we have to stay honest with ourselves - to stay on track with the plan means we have to watch what goes in our body and the energy that comes out. Both of those matter; 2) we have to be honest about the fact that it DOES feel good to look in the mirror and see our progress. Yes, we are doing this journey for more than just our appearance, but darn it! It is a great side effect! and 3) we have to be honest about our relationship with food. We didn't become the way we were by accident. I love that you have that self-awareness. I applaude you for that. Amanda

James, thank you for taking the time to comment! I am so grateful! Your story is awesome! I love that you have a plan for being at home or traveling so that you can stay on track. I also love that you bring up that it is okay to have complex carbs in moderation during maintenance. Those complex carbs actually help our bodies produce enough insulin to cause the chain of events that lead to serrotonin production (our mood regulating chemical). Without serrotonin staying in balance we are also prone to depression, so it sounds like you have found your "balance." Congratulations!

Ana92212, thank you for your reply! You said something really awesome that I hope others note - you went to your nutritionist for help. You sought support! I love it! I also love that you are "in a good place." That mental attitude will help keep you well. Keep up the good work!

The honeymoon period. The time period after the surgery, when the weight is coming off without much effort, and you feel like it was the best decision you ever made. The compliments are coming from everyone, you're fine with taking the supplements, the protein shakes, heck, you're even okay with losing some hair – it'll grow back, right? But what about when you've reached “that” point? The point where the weight loss has slowed. The “head hunger” has started and, well, the “fun” has worn off. Reality sinks in that this “real life.” This is something that you need to keep up with. This is now your...gulp...”everyday” life. Did you expect to have depression creep in? Or maybe creep back in? Most of us thought this surgery would correct our mood issues, thinking that losing the weight would help get rid of that which was bothering us. So what happened? Why are we sad, frustrated, mad? Why aren't we...well...happy? A lot of this can be attributed to losing our primary coping tool to deal with depression and stress: mindless consumption of food. We may not have realized it at the time, but food was our comfort, our companion, sometimes the only thing that was there for us when nothing/nobody else was. Now, that support is no longer something we can reach for in hard times to get us through. We are physically and emotionally missing/grieving our former “companion.” Our coping tool. Sometimes, our best friend. So what do we do? First, we have to look at the physical way food was affecting us. Not just related to weight, but in our brain. Food was giving us satisfaction in a way that was “rewarding” receptors in our brain that control the chemical dopamine. Dopamine is a chemical that makes us feel good. This is the same chemical that is triggered when someone uses drugs or alcohol. Yep, scary thought, huh? That's why we often hear about “food addiction.” We are literally “feeding” that addiction when we overeat. That's hard to accept, I know. Second, we have to look at WHY we may be overeating. What thoughts do we have that lead us to seek food as comfort? Are they thoughts about ourselves? Are we thinking that “I'm so fat” or “I shouldn't even try” or maybe even “Why do I even bother?” Sometimes the addiction is so deep, it's hard to identify the thoughts that made the behavior start. Then it may be more helpful to think about the feelings. What feelings direct us to start overeating? Is it anger? Boredom? Defeat? Do the words or actions of another make us feel “less than” and lead to lowered self worth, thus leading to the desire to overeat? The concept of looking at Thoughts-Feelings-Behaviors is at the core of Cognitive Behavioral Therapy, a standard therapeutic method of behavioral therapists. Finding a therapist that can help us figure out the source of how these 3 things work together to lead us on the path to overeating can go a long way toward correcting the behavior. The key to CBT is retraining those thoughts to become more positive, leading to more positive feelings and behaviors. Often, we get stuck with “ants” - Automatic Negative Thoughts – and they are hard to undo. With the assistance of a therapist that is trained in CBT, particularly one that is familiar with bariatric surgery, we can retrain our brains to think more positively about ourselves, thus leading to be less dependent on food to nurture feelings of happiness. What kind of “ANTs” do you want to get rid of? Can you think of a chain of Thoughts-Feelings-Behaviors that you would like to change? What would you rather that chain look like instead?