Songbird7777

The Struggle Often Continues
For some patients, Weight Loss Surgery can lower your interest in food, so you are not constantly thinking about it. There’s no question Weight Loss Surgery can help you gain control of your eating, but it’s unlikely to eliminate your struggles with food disappear. A few lucky Weight Loss Surgery patients really do stop being tempted by food. The rest, who make up the vast majority of Weight Loss Surgery patients, continue to struggle.
You still may be hungry, enjoy salt, fat, starch, or sugar, or be tempted to use food as an emotional crutch. Your family members may continue to insist on keeping high-calorie foods in the house, or pressure you to eat things you shouldn’t. Your friends may still be going out to eat and inviting you to join them in ordering high-fat, high-sugar items.
“Why Me?” Isn’t Appropriate
It’s easy, even natural, to think of yourself as unlucky. Why should you have to struggle with food? Why should you have to monitor every bite you take, while some people don’t? The fact is, almost everyone does. Ask almost any skinny person how they stay skinny, and you’ll get some variation of the same answer: “I work hard for it.”
Just like you, they are aware of what goes into their bodies. They sometimes may be hungry; they sometimes may want to eat more than they should. But they, like you now, take responsibility for their decisions. They may:
Skimp on portions if they over ate at the previous meal.
Choose healthy foods first.
Have a strategy for dealing with emotions and boredom that doesn’t involve eating.
Have a support system that promotes healthy behaviors.
Accept It and Manage It

If you find you still have a rocky relationship with food after weight loss surgery, don’t conclude that WLS didn’t work for you. Instead, accept that you will need to fight the cravings and urges for months, years, or life, and start making a plan. Don’t be afraid to ask for help in developing strategies – whether you ask other BariatricPal members or an always-thin person you admire!
Persist in Order to Get the Answers You Need
We all want to be able to trust our doctors. You want to believe your surgeon takes care of all aspects of your Weight Loss Surgery, including your post-op, long-term nutrition. But it doesn’t always happen like that. Nutritional counseling may not be part of your surgery package, or you may only get a limited amount of generic information.
Or, your surgeon may simply not know how to help you nutritionally. Remember that many doctors have no more than an hour of nutrition education in medical school. To become a weight loss surgeon, doctors need to learn surgery. There is no dietary education requirement.
If you need help finding strategies to satisfy hunger – physical or head hunger – and your surgeon and primary care doctor are not able to help, keep looking. A session with a nutritionist may be more affordable than you think, and worth every penny.
Your Emotional Support System and Your Relationship with Food
The support system you built so carefully can come in handy right about now. Take advantage of your ability to talk to a therapist or psychologist if you have one to bring up your concerns. Discussing your ongoing struggles with portion sizes, food choices, and over-frequent nibbling with a mental health professional can help you come up with some strategies that work for you.
Group sessions are also appropriate forums to talk about food struggles and strategies. Though it may feel embarrassing at first to admit you’re still thinking about food a lot, you will find nearly everyone in that room did or does have that same experience.
Most Weight Loss Surgery patients do not find their surgery instantly eliminates their food struggles. You can take months or years to come to terms with a food addiction, and it may be something you need to learn to live with for life, but in a healthier manner than before Weight Loss Surgery. Be honest with yourself and those around you, and be open to suggestions, and you can figure out strategies that work for you. Do not assume WLS did not work for you!

As you age, your metabolism slows down. Older people also tend to have less muscle mass than younger people, which also reduces metabolic rate. This is why we encourage older patients to add light weight-bearing exercise to their fitness routines.
So how do you keep that furnace burning in order to burn calories, even if you’re already achieved your goal weight?
There are many simple tools to accomplish this task. I’ve outlined my favorites below:
Exercise
This weapon is key to maintaining and increasing metabolism. Seniors, take note−The Centers for Disease Control and Prevention (CDC) recommends people 65 and older get 2.5 hours of moderate-intensity aerobic activity every week and perform weight-bearing exercises on all the body’s major muscle groups at least twice a week.
At any age, indoctrinate a 30-minute daily work-out, just like brushing your teeth and eating lunch, into your daily routine.
Sleep
To increase the chances of boosting metabolism, adults should get seven to nine hours of sleep each night. Getting too little shut-eye can significantly alter your body’s processes enough to predispose you to gain weight.
(Do you ever feel hungry for no reason when you’re exhausted and then reach for the wrong foods to boot?)
De-Stress
When you’re tense, your body releases cortisol, a hormone produced by the adrenal system that is linked to weight gain. It can also significantly weaken your immune system and open the door to acute and chronic illnesses.
Turn to regular physical activity, deep breathing, a quiet evening stroll, or professional help from a psychologist or counselor if you are experiencing chronic stress.
Eat and Drink
(First and foremost, follow your bariatric practice's instructions on post-op nutrition.)
Eating the right foods−clean proteins, fruits and vegetables−fuels your metabolism firing on all cylinders. As soon as you awaken, charge-up those calorie burners by feeding them a protein and a fruit (think omelette with feta cheese, spinach and veggies and a cup of berries).
Eat small meals throughout the day but stop by around 7 p.m.
Staying hydrated is key to maintaining good health. Keep a glass or refillable water bottle with you throughout the day. You are properly hydrated if your urine is nearly clear.
Other than choosing the right foods to eat and finding spiritual solace in your life, these tools serve as a roadmap to good health, including maintaining a healthy weight.
Best of all, once you’ve adopted these tips, you will look and feel better--sooner than you think.

So why is it so hard to keep the weight off, and what can you do about it? It can be harder to keep the weight off than lose it in the first place because:
You might gradually be less strict with your food choices as the occasional treat becomes more frequent and bigger.
Your restriction may not feel as, well, restrictive as it did right after surgery.
Your metabolism is slower and you don’t need as many calories as you did before.
You don’t have the motivation that comes from seeing the scale go down as a reward for your good eating habits.

But a little challenge doesn’t have to get you down! After all, you’re a WLS patient, and you’re in it for the long haul! Here are some things to think about as you are losing weight, approaching goal weight, or even working on maintaining your goal weight. This is just Part 1 of the two-part series, so stay tuned for Part 2!
I Hate Counting Calories!
Yes, logging your food can be tedious. Some people even find that counting calories makes them anxious or causes them to fixate on food. Maybe immediately post-op you could skip the calorie counting and still lose weight because you had so much restriction. Maybe, in the beginning, you forced yourself to log foods for a few weeks or months.
What if, when you’re at or near goal weight, you can’t face the thought of counting calories? You still have a few options that can work.
Go back to the meal plan you got from your surgeon or nutritionist and stick to it. If it says ½ cup of oatmeal, it doesn’t matter whether you know how many calories that half-cup contains. You can be certain that if you follow the plan, your total daily calories will add up to the amount in the plan.
Log once a week. This can help you stay on track as you make sure your portion sizes are still working out for you and you are choosing the low-calorie, high-protein foods you think you are.
Focus on another nutrient, such as protein. If you hit your target grams of protein, stick to small portions, and make sure all of your protein and other foods are the nutritious ones you’re supposed to be eating – think lean proteins, vegetables, and healthy fats, for starters – you have a good start towards eating the way you should.

Carbs Are the Devil!
Maybe it’s carbs, maybe it’s sugar, maybe it’s pizza, or tacos, or ice cream that you avoid in your weight loss efforts. Whatever it is, there’s a good chance you’re trying to avoid it as you lose weight. Weight loss surgery patients can be tempted to go low-carb, paleo, or sugar-free. That’s fine, as long as you can keep it up long-term.
If you can’t, you’re setting yourself up for a rough time. What happens when you hit goal weight and you flip a mental switch in your head? What if you go from low-carb to letting cookies, bread, and pasta back into your diet? What if you go off paleo and find all sorts of processed foods that are delicious and convenient? What happens next time you come face to face with an order of chicken wings and dipping sauce for the table?
You may be better off planning for a diet that will work long term. While you are still losing weight or while you are early in the maintenance phase, take inventory of your feelings. Be honest about what you can and cannot live without, and develop a plan to address it. Then practice!
These are some possible ways to approach your food fears.
Think “healthy, portion-controlled carb” instead of “low-carb.” Aim to get in healthy carbs such as oatmeal, lentils, fruit, sweet potatoes, and yogurt rather than avoiding all carbs.
Consider the good and bad of the paleo diet. While the guidelines to avoid processed foods and refined sugars can’t hurt, it really necessary to avoid nutrient powerhouses such as beans (think: protein, fiber, and potassium)? And is it really possible to avoid all processed foods for the rest of your life? What happens if you run short on time? A good strategy may be to get in the habit of reading labels so you develop your ability to choose healthy (or at least, “healthier”) packaged meal helpers.
Make up your mind about trigger foods. Are you the type who can be satisfied with one potato chip when you get a craving? Or are you best off avoiding the chips altogether? Is there a similar substitute, such as kale chips, that can work for you? If you’re not sure, experiment so you know how best to handle cravings.

Maintenance has its share of challenges, but you can overcome them to be able to experience all the joys of hitting that goal weight you dreamed about for so long. Just like you did when you were getting ready for weight loss surgery and losing weight, you can take a carefully planned approach to maintenance that considers your own preferences. Stay tuned to Part 2 of the two-part series!

Finding unflavored protein in a single serve packet will allow you to sample a brand without having to buy the larger container first. Single serve packets of whey protein isolate are available online with Bariatric Fusion, Jay Robb and Unjury. Whey protein powder is also found in the bulk bins at Sprouts Farmers Market. You can buy a small amount to taste test. Our patients have also liked the larger containers of unflavored whey protein by brands like Inspire , Isopure (GNC, online) and online (online). Keep in mind, whey protein must be kept under 140 degrees, otherwise, it will curdle. Soy protein isolate is also available. Brands include GNC and brands like NOW Foods and Genisoy, which are available online and some natural foods stores. These will be in larger containers. Sprouts Farmers Market also has soy protein in their bulk bins, so that you can buy a small amount to taste test. Sometimes you can get a sample taste of unflavored protein in stores that sell natural foods, supplements and sports nutrition products. Ask about the return policy if you don’t like the product. There are many other brands of unflavored protein powders on the market. If you have a group of bariatric buddies, perhaps the buddies can buy different brands to try and share. This cuts the cost of taste testing. May your protein status be awesome!

Craving sushi?

You likely will not be able to tolerate your favourite sushi rolls because of the rice and seaweed wrap, however there are several other equally satisfying options on every Asian-style restaurant menu to consider.
Indulge in an order of tartar or sashimi. These rice-less options are easier to digest. Don’t be afraid to ask if your favourite sushi rolls can be made with a cucumber wrap instead of the traditional seaweed wrap. This is often a ‘low carb’ option on sushi menus. Order a side of edamame beans. These soybeans are not only a good source of protein, but they are also rich in fibre. Try a protein rich Asian soup. Asian-style restaurants often have a traditional soup with eggs, tofu, chicken, and/or shrimp. Prioritize the solid pieces and leave most of the broth behind. Salmon or tuna salad. Most sushi restaurants have a simple green salad with a seared piece of fish and a flavourful salad dressing.
Sandwiches & Wraps·
Choose a sandwich on toasted bread. If it is a large sandwich, remove the top piece of bread. Great options include: chicken salad, egg salad, tuna salad and deli meats. Wraps are also a good option. Opt for baked chicken rather than crispy chicken.
Breakfast egg sandwiches
Choose a breakfast wrap or a toasted english muffin sandwich. Skip the bacon and sausage.
Salad
Almost all restaurants now have a green salad with chicken. Again, opt for grilled chicken instead of crispy chicken. Other high protein options include: taco salads, chickpea salads and bean salads.
Chili
Whether you choose the vegetarian or meat version, chili packs a lot of protein. They are also very easy to digest making them the perfect option if you have recently transitioned to solid food.

Here are some other helpful tips to challenge those old fast food habits:
Skip the combo option… yes, even if it’s cheaper! Don’t order a drink. You will be less tempted to drink and eat at the same time if you don’t have a refreshing beverage staring you down during your meal. Eat in the restaurant instead of in the car. If you are driving and eating, food is more likely to block. You can’t be mindful if you are multitasking! Choose foods described as: grilled, baked, sautéed, broiled, steamed, boiled, etc. more often. These cooking methods are lower in calories. Many corner stores and gas stations now have ‘grab and go’ options in their fridges such as sandwiches, salads, protein shakes, yogurt parfaits, etc. Next time you get gas, make a mental note of 3 appropriate meal options you could choose if you were in a pinch.
Bon appétit!

- Lisa & Monica