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Try to see their side.
You are asking them to see it from your perspective, so it is only fair that you try to see it from theirs. What are the reasons they may be against your Weight Loss Surgery, and how can you address them? In many cases, their concerns are legitimately about your well-being, and things you should consider if you have not already. They may worry that:
You will not hit your goal weight this time since they’ve seen disappointment before. You will suffer complications from surgery. You will regret having a permanent Sometimes, their concerns are selfish but still worth discussing. They may worry that:
You’ll stop feeling attracted to them. You will pressure them to give up their own favorite foods while you eat healthily. They will feel left out. You will not want to spend time with them. Reassure them.
Address their concerns directly. Explain why you feel the surgery is safe, and how much research you have done to learn about it as well as find a surgeon. Tell them why you think Weight Loss Surgery will work for you even if previous diets have not.
Let them know that you need to do this for yourself, not for them and that this will not change the way you feel about them – you will still love your SO, and respect your parents, for example. Tell them how you see yourself spending time with them after surgery, so they can be comfortable.
Write it down and practice.
Starting the conversation can be the scariest part of telling them. Before you bring up the subject, write down what you plan to say. This is a good exercise for you to do anyway since it encourages you to think through all of the doubts around Weight Loss Surgery. Writing it down and practicing can make it easier for the words to come when you decide to bring it up.
Include them in your plans.
Often, your spouse and parents, and others who care about you, just want to help. They may be afraid if they do not how to help. When you talk to them, let them know how important they are to you, both in life in general and in this important period of your life. If you tell them specifically what they can do to support you, they may feel more at ease with your decision and more confident in their roles.
You might ask them to:
Pick up your children from school when you are recovering from surgery. Go with you to the store to pick out protein powders and measuring cups and spoons. Ask you each night how you are doing. Cook healthy meals with you. Prepare for anything.
The conversation may be as difficult and unfulfilling as you feared. Or, your SO, parents or other loved ones may be surprisingly supportive once they realize that you have done your research and are serious about making the lifestyle changes needed for success. They may even be interested in getting healthy with you and ask for your help and support in exchange for theirs.
Stay strong and independent.
As much as you long for your SO and other loved ones to support you wholeheartedly, it may not happen. Try not to let it get you down, though. If you are sure about what you want, go for it, with or without them. They will come around sooner or later, and if not, you may be better off without their negative influence. Letting them know that you have made up your mind regardless of their support may actually convince them to help you since there is no point in standing in your way.
Stay independent in the sense that you realize that you do not need them. Your success does not depend on their approval, and you are not doomed to fail if they stand in your way. Get the support you need from others as you move forward.

Consider this: you can be 10 times more likely to achieve your goals if you make New Year’s resolutions than if you do not. That statistic may motivate you to take a little care in setting your goals for this year. So, here are a few tips for setting resolutions that you can keep.
Make Them Realistic
We all want to hit goal weight and stay there, but is that realistic for you? Probably not, if you are more than 70 to 100 lbs. overweight and have not yet had weight loss surgery. A more realistic resolution might be to schedule your surgery and then lose an average of 5 to 10 lbs. per month after surgery.
These are some additional examples of unrealistic and realistic resolutions.
Get to the gym every day. Work out at the gym or walk 5 days per week. Follow your diet perfectly. Get back on track within a day of losing control. Avoid all restaurants. Check the nutrition facts beforehand and make healthy choices when you order. Plan all meals and snacks ahead of time. Keep protein bars and other healthy protein snacks on hand for when you need them unexpectedly. Make Them Specific Yes, you want to lose weight for example. But how much do you want to lose? Your resolution might include the number of pounds you want to lose or the BMI you want to hit. It might be to lose back the pounds you regained after weight loss surgery a few years ago. Here are some other examples of specific resolutions to consider.
Drink at least 64 ounces of water per day. Attend two support group meetings each month. Eat at least two servings of fish per week. Eat at least 65 grams of protein per day. When you make your goals specific, you know whether or not you are making progress towards them and when you hit them. That is motivating, and it keeps you honest with yourself.
Consider the Process
A goal is an endpoint. Your resolution might be to achieve those goals, but it should also include the process, or “how” you are planning to get there. If your resolution is to eat five servings of fruits and vegetables per day, your process might include storing canned and frozen vegetables so they are always available, keeping washed and cut fruits and vegetables in the fridge for snacks, and adding a half-cup of vegetables to your omelets.
Here are some more examples of ways you can focus on the process.
To hit your pre-op weight loss requirements, swap water for soda and side salads for fries. To get to the gym more often, lay out your clothes and shoes the night before, and figure out which workout you will do once you are at the gym. To move closer to your weight loss surgery, find out how to get approval for insurance reimbursement (or how you will finance your surgery) and which surgeons are your top choices. To get your blood sugar levels down, healthify your carb choices by identifying which are sugary and refined, and swapping them with high-fiber, unrefined whole grains, beans, and fruits. Stay Accountable
Your resolutions are important to you, so make them a priority and hold yourself accountable. One way is to use the buddy system. You can either find a buddy with resolutions similar to yours, or just use a buddy who is willing to hold you accountable. Check in regularly with each other on your progress, encourage each other, and ask the tough questions if either of you are falling off track.
Another way to hold yourself accountable is to use a log. Use an old-fashioned pencil and paper log, or opt for an online or smartphone app. Depending on your resolution, you can record thoughts, feelings, and progress, as well as food intake, weight, and exercise. Seeing your efforts in black and white can keep you honest and motivate you to keep going.
Be Patient with Yourself
Recognize that you won’t do it all at once, and that you will make mistakes. Set smaller incremental goals so that you can see progress in January, but keep the big picture in mind and realize that your resolutions are long-term. The big payoffs will come later in the year if you stick with your resolutions.
Also, have a plan to forgive yourself, because things will go wrong. Dust yourself off and get back up, because you can achieve your goals!

Like pretty much everything else in your life, the holidays are a whole new ballgame after weight loss surgery. Your weight loss surgery diet is strict. It doesn’t include fatty foods and sugary desserts. Going off your weight loss surgery diet can stall weight loss and also cause complications. You could be prone to dumping syndrome if you have the gastric sleeve or gastric bypass, and lap-banders can face obstructions and acid reflux with the wrong foods or too much.
If you let your guard down for the rest of November and December, you can find yourself slipping off of your diet and feeling pretty unhealthy. But by keeping your eyes open and planning ahead, you can keep yourself on track and get through the holiday season feeling proud of yourself.
Watch Carefully to Avoid Extra Calories
Calories show up everywhere at this time of year. Sometimes they don’t even seem that bad, but they add up quickly. Have a bite here and a handful there without paying much attention, and you might be disappointed when you weigh in on New Year’s Day. Don’t let calories slip into your diet.
First, be aware of the extra calories that are around. They can include any of the following. Lunch or dinner out when a friend or family member comes to town. Chocolate truffles on the secretary’s desk or the break room at work. Cookies from well-meaning friends and family who want you to taste-test their creations. Sweetened, pumpkin-spice coffee instead of calorie-free regular coffee. Food court fare when you’re holiday shopping at the mall. Holiday parties, potlucks, and dinners. Stick to Your Good WLS Habits
The first line of defense is to stick to your regular good everyday weight loss surgery habits. Log every bite of food you take to keep from getting in hundreds of extra calories from sneaking in a taste here and there. Even if you have to estimate the calories in some of your food, especially if you eat out or at a party, you can keep more discipline if you log your food.
Also, think about your other healthy habits. Keep drinking water between meals. And, protein is still all-important. Make sure you have some at each meal and snack. Focusing on finding lean protein can keep you focused when you’re faced with all kinds of other unhealthy choices.
Arm Yourself Against Temptation
If you’re starving and you’re face-to-face with a basket of chocolate-covered pretzels, you might opt for the sugary, high-carb snack. Unless that is, you have your own weapon. Keep some high-protein and low-calorie choices with you at all times so you never need to go for the junk food in desperation. We have many health snack options at the BariatricPal Store! Take them with you to work, or in your car, purse, or pocket. You can have them if you’re stuck in traffic or at the mall at mealtimes.
Almonds packed in 1-ounce portions. Beef jerky (not fatty beef sticks). Apples Cheese sticks Roasted soybeans or garbanzo beans Tuna pouch Work around Your Cravings You don’t need to deprive yourself completely at holiday time. If there’s a particular taste you want, there’s a good chance you can satisfy your craving with a healthier alternative. For example, you can have lean ham and turkey breast instead of brisket and turkey with the skin on it. Roast green beans with onions, rosemary, and balsamic vinegar instead of having green bean casserole, bake sweet potatoes instead of having candied ones, and puree cauliflower or carrot instead of making mashed potatoes.
Use the same strategy for desserts. Go for sugar-free cocoa mix instead of chocolate fudge when you’re craving chocolate. Munch on plain popcorn while your friends are passing around the caramel corn. For breakfast, make high-protein oatmeal pumpkin pancakes instead of regular pumpkin pancakes.
Plan for a Few Treats
Almost everyone has a few holiday treats that are irresistible. There may be some family recipe that you’ve had at every Christmas for as long as you can remember, or maybe a coworker brings in her cinnamon rolls made from a secret recipe. Whatever it is, you feel as though the holidays are incomplete without it.
There’s no reason not to plan for one or two key treats. Just be sure you plan for them and stick to a single serving. Savor it, and concentrate on the flavors and on the memories and feelings it brings up. Then get right back on your regular diet.
There are a couple of reasons why some weight loss surgery patients might be better off skipping even the occasional special holiday treat. First, don’t start if you’re not sure you can stop. If you’re not confident that you can stick to a single serving, it’s best not to start eating.
Second, some weight loss surgery patients can’t tolerate all kinds of junk food. Fried and doughy foods are risky for lap-band patients, since they can obstruct the band. Gastric bypass and vertical sleeve gastrectomy patients are at risk for dumping syndrome from eating too much sugar or fat at once. And, no weight loss surgery patient should eat too much, since that can stretch the pouch or sleeve.
The holiday season is a happy time, but it’s a struggle if you’re trying to lose weight and get healthy. You can prevent it from sneaking up on you and interfering with your weight loss by staying alert and having a plan.

Skinny Starters
There is sure to be food out from the second you arrive at the party. Munch on chips and dip for the minutes or hours as soon as you get there, and you will probably down more carbs and calories than you should have in a day. Instead, try munching on Protein Chips, Cheese Crisps, or any kind of cut, raw vegetables. You can up the gourmet factor by making open-faced bruschetta-like appetizers with tomatoes and feta or mozzarella on Protein Rusk Bread.
Skinnier Side: Purple Cabbage Salad
Try making a red, white, and blue salad using shredded purple cabbage as your “blue” base. The red can come from strawberries, and you can dot it with white pieces of tofu. Dress your coleslaw with lite Asian vinaigrette, and each serving will have over 100 calories less than regular coleslaw.
High-Protein Semi-Soft Foods Side: Egg Salad WLS-Style
If cabbage is a little beyond where you are after WLS, opt instead for a low-calorie version of egg salad. Use hard-boiled eggs or egg whites and the usual seasonings such as paprika, lemon juice, pepper, hot sauce, or mustard. Then, save over 100 calories per portion by using Calorie-Free Mayo instead of regular. It even comes in flavors such as Chipotle, Honey Mustard, and Ranch.
Protein Centerpiece: Sugar-Free Barbeque
A barbecue has the potential to yield the ideal WLS-friendly main course if you get a lean protein, but a grilling occasion can go terribly wrong, too. Consider barbecue ribs with nearly 1,000 calories, or beef patties with over half their calories from fat. Instead, try chicken breast, shrimp, or fish with calorie-free, sugar-free BBQ Sauce for a punch that is nearly pure protein. Of course, skip the bun to save more calories and carbs.
Instead of buttery grilled corn, almost any grilled vegetable makes a better choice. Try eggplant, zucchini, bell peppers, asparagus tips, or mushrooms. If you want to marinate them first, use a low-fat, sugar-free option, such as balsamic vinegar or Cajun seasoning.
Red, White, and Blue Dessert
Aren’t those July 4 cakes decorated to look like an American flag beautiful? Here’s an idea: keep the cake intact and get your red, white, and blue dessert from a more healthful source. Try strawberries or raspberries and blueberries in creamy Vanilla Protein Pudding to get a satisfying dose of antioxidants, fiber, and protein without any added sugar.
Your Independence Day barbecue can be just as celebratory as ever, but a lot healthier this year with some planning. Look for the high-protein, low-carb choices, but make sure they have the flavors you love, because loving life is part of being healthy!

Stalls Happen
Your surgeon will probably tell you about your likely weight loss. You might hear numbers such as 70 to 100 lb. in the first year, or up to 10 to 20 lb. in the first couple of months. Those might be realistic and turn out to be accurate for you, but what might also be true, that your doctor did not tell you, is that weight loss may not be steady.
You might lose 75 lb. in a year, which is an average 1.5 lb. per week, but you are not going to lose 1.5 lb. every week for a year straight. You may lose 5 lb. in one week, 3 lb. in another, 0 lb. in another, and, some weeks, even gain weight.
You are almost sure to encounter stalls, or plateaus, or periods of weeks or even a month when you do not lose weight, even if you are eating right. Your doctor may not tell you about stalls ahead of time, but you can handle them better if you are prepared right out of the gate.
Your Metabolism May Plummet
As you lose weight, you need fewer calories to sustain your basic body functions. Furthermore, when you exercise at a lower body weight, you burn fewer calories doing the same workout at the same intensity than you did when you were heavier. On top of that, your body may go into starvation mode and use even fewer calories as it becomes more efficient at using what you give it.
While there is little that you can do to prevent a slower metabolism, you can at least be aware of it. Also, you can take heart knowing that you are likely to be able to exercise longer and at a higher intensity to offset some of the reduced body weight.
It’s Freezing!
Brrr…! Remember the days when you were the hottest one in the room, and all you wanted was to stop sweating? Those may be in the past. Part of the slowed metabolism can be due to your body’s new mechanism to save energy, which means turning down the thermostat. Another possibly surprising side effect of weight loss is that having less cushioning (body fat), so sitting in chairs or lying in bed can be less comfortable.
People Can Still Hurt You
You probably know that Weight Loss Surgery does not change who you are, but your doctor may forget to tell you that it does not change other people, either. You may no longer get flack for being overweight, but people can still be hurtful. They can tell you…
You took the easy way out with Weight Loss Surgery.
You have not lost much weight. Clearly, Weight Loss Surgery did not work.
You lost so much weight that you look sick.
All you care about now is your diet and exercise plan.
Your Social Life May Change
Some friends will stick by you. Others may desert you. If some of your friends have just been “eating buddies,” or people you go out with to the bar or restaurants, you may need to exercise self-control at the bar or restaurant, find new activities to do with those friends or find new friends. You stand to gain wonderful new friends who share your new interests, such as walking, going to the gym, or cooking healthy fun foods.
The Skin Stays
Losing body fat will not give you a movie star’s appearance. It may not even be all that you need to lose. You may have loose skin that flaps, chafes, and interferes. There is a chance that you will want to get skin removal surgery for cosmetic, comfort, or medical reasons.
Beware Replacement Addictions
You may have been addicted to food. It may have provided comfort, entertainment, and companionship. Give it up, and you are likely to find something to replace it. Alcohol is a common replacement addiction, but you can do better! Stay aware of your emotional and physical needs, and you can be mindful of what replaces food in your life. Exercise, within reason, is a common choice; another healthy option is to make some great friends who are supportive and make you feel good.
Your doctor will tell you a lot about what to expect after weight loss surgery, but she may leave out several important items. Go in with open eyes, and you can prepare better and come out farther ahead.

Foods that have a Nutrition Facts label are helpful. This label lists the amount of nutrients in one serving of the food. If the package has two servings and you eat the entire package, then you need to double the amount of protein listed. If there isn’t a Nutrition Facts Label available, you can use online databases to determine protein. A helpful nutrition database is http://nutritiondata.self.com. The information is provided in the Nutrition Facts Label format and comes from the United States Department of Agriculture.
Food scales and measuring cups will help with measuring your protein. One ounce of cooked meat is 7 grams of protein. Meat includes fish, chicken, turkey, pork, beef and game meats. Is your meat portion the size of a deck of cards or the palm of a medium size woman’s hand? If so, that is 3-4 ounces, which is 20-25 grams of protein. If your meat portion is a ½ cup, that’s 20 grams of protein. Is your meat portion is the size of a hockey puck or checkbook? That’s 3 oz. and provides 21 grams of protein.
Tracking your intake with an app or an online program is another way to track your protein. Our program uses the Baritastic app to track intake. Helpful features include uploading the foods’ barcode or speaking into your phone to detail your food choices. Be aware of what portion size you choose. A recent patient told Baritastic that the food choice was rotisserie chicken. The patient selected 1 serving. As it turns out, 1 serving of rotisserie chicken on this app is half of the chicken. Selecting the most accurate portion requires searching through the list of options to find the portion that is closest to what you actually ate. If you prefer a written journal, you can use the food lists from your nutrition guidelines to help calculate your protein.
So, is your protein measuring up?

Cooking methods. If you tolerated a saucy chicken pot-pie, it doesn’t mean roast chicken will go down just as comfortably. Dryer methods of cooking (like broiling, roasting, grilling, and pan-frying) tend to be more difficult to tolerate. Moist cooking methods on the other hand (like steaming, braising, stewing, simmering, poaching) that involve liquids or a sauce are typically better tolerated. Also, be careful when microwaving, as the process of reheating foods can dry them out. A good way to keep the moisture in is by resting the lid on the container (not sealed) and stir after each minute until ready. If you’re reheating dry foods remember to sprinkle in some water, broth, tomato juice, milk, or low-fat gravy to add additional moisture. Mechanical reasons like not chewing well enough and taking large bites. You should always be sure to cut your food into small pieces—as small as your pinky fingernail to start—and chew your food until it’s puree in your mouth before swallowing. Remember that digestion starts in the mouth! Emotional stress and anxiety can tighten the upper digestive system which makes food more difficult to tolerate. Do you find you eat more comfortably at home or on the weekends compared to at work? If so, your tolerance issues could be related to stress or anxiety. Always be sure to eat in a calm environment and start your meals by taking a few deep breaths to relax and decompress. Some patients feel more comfortable eating alone at first (i.e. in their office instead of in the cafeteria). Eating while multitasking! When you are eating, you should only be eating. We know that this is a tough one to practice, but eating while driving, watching TV, cleaning, working through lunch, etc. can distract you from taking small bites and chewing well. Do your best to put away distractions during meal times. If you choose to eat lunch in your office, mute the volume on your computer and turn off the monitor so you’re not tempted to check your email in between bites. Posture. It sounds silly to discuss, but it’s true, poor posture can negatively affect digestion. If you are eating while slouched or reclined on the couch or awkwardly propped up on pillows in bed, chances are that you will experience some tolerance issues. When you are eating, you should ideally be sitting in a chair pulled close to the table with your bum as far back as possible and with your back nice and straight. Eating at the table in your kitchen or dining room will also give your meals and snacks more structure. Generally speaking, it’s a good habit to limit food and eating to only the kitchen and dining room. Excerpt from "The Complete Guide to Weight Loss Surgery: Your questions finally answered".
Available on Amazon.com, Amazon.ca, or our website (PDF download).

How many surgeries were done?
The data show that there were 215,666 total bariatric procedures done in 2016. That is a lot if you compare to 2011 – it is an increase of 36.5% over the course of 5 years, but it is not much if you compare it to the over 20 million Americans who are eligible for bariatric surgery based on criteria of a BMI over 40 or a BMI over 35 plus a related condition. In fact, only 1% of eligible Americans get weight loss surgery.
Why is the gastric sleeve taking over?
The gastric sleeve is gaining momentum, and quickly. It has leaped from 28,124 procedures in 2011 to 125,318 in 2016. It has jumped from making up 17.8% in 2011 of the total to 58.1% in 2016. Why has the gastric sleeve become so popular, so quickly?
There is a lower risk of nutrient deficiencies and dumping syndrome compared to gastric bypass. It helps fight hunger by lowering levels of the hormone ghrelin. It is relatively safe for higher-BMI patients. It has similar weight loss as gastric bypass, and lower reoperation and complication rates than gastric band. Why would anyone not choose the gastric sleeve?
The gastric sleeve may appear to be the choice du jour according to the numbers, but even so, not everyone chooses it. These are some hesitations with the gastric sleeve.
It is so new that there is no long-term research on it. We just do not know if it stays effective for years and decades. It is permanent. Done. There is no going back, even if the patient really, really begs. Some patients have trouble getting enough calories and protein and continue to depend on supplements for a long time post-op. What are the non-sleeve choices?
While 58.1% of patients opt for the sleeve, the other 39.9% do not. In fact, nearly 1 out of 5 patients opt for gastric bypass, and biliopancreatic diversion/duodenal switch (BPD-DS) has held steady at 0.6%. These are some reasons to consider other types.
The gastric bypass has a long history. It can be successful long-term with weight loss, and it is famous for its ability to resolve diabetes quickly. The lap-band is reversible. Even though the band has dropped 86.93% since 2011, there were still 7,310 new bands in 2016. The BPD-DS may still be the best for higher-BMI patients. What does the research say?
Good news – weight loss surgery works! At least, that is what the majority of the research studies conclude, whether they are looking at the sleeve, bypass, band, or another method. All surgery types have a risk of complications, and all have a risk of mortality of under 1%. BMI can drop 7 to 14 or more kg/m2, and diabetes, sleep apnea, hypertension, and other obesity-related conditions can get better.
Is the gastric balloon going to be a factor?
Time will tell whether the gastric balloon is going to be a factor in the overall bariatric surgery statistics. The FDA approved it only in 2015, and it jumped from 0 in 2011-2014 to 0.3% (700 procedures) in 2015 to 2.7% (5,744 procedures) in 2016. The balloon is not a true bariatric surgery; it is not permanent, it leads to less weight loss, and it is intended for lower-BMI patients. This means that it may not be in competition with the true bariatric surgery procedures, although it is likely to become more common as it becomes better known.
What is the deal with so many revision surgeries?
If weight loss surgery techniques are always advancing, why are revisions becoming so much more common? They comprised 6% (9,480) of the total in 2011, but 13.9% (30,077) in 2016. It could be because some of the previous (failed) surgeries were done using older techniques, and are now ready for serious help – a revised procedure.
Why are 99 out of 100 eligible Americans not getting Weight Loss Surgery?
There are a lot of reasons eligible Americans are not getting Weight Loss Surgery. They include:
Cost. Fear of complications or death. Not knowing where to start. Lack of support from family, friends, and healthcare providers. Fear of failure. Lack of long-term commitment to lifestyle changes. What can health professionals and patients do to help eligible patients get the Weight Loss Surgery they need?
Surgeons and other bariatric professionals can help by making sure they reach out to eligible patients. They can explain their options, and promise to provide the nutritional and psychological support patients need for success and to feel confident in their success. They can organize support groups and provide additional resources for patients to get advice and encouragement anytime.
What can health professionals and patients do to help eligible patients get the Weight Loss Surgery they need?
Patients can do their part by asking questions to learn about their best options. They can express their doubts and fears to surgeons to come up with strategies for success. They can reach out to friends, acquaintances, and online groups for support.

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.

What Your Doctor Can’t Tell You
If you are considering bariatric surgery, you’ve probably done some research. You may have looked up “gastric bypass” on the internet, read some blogs, or perhaps you’ve gone so far as to discuss the possibilities with your doctor.
You may have a decent grasp of the physical side of this surgery. But there are some things even the best surgeon can’t tell you. I’m talking about the emotional side of taking this life-changing step. The emotional roller coaster of trying and failing to lose weight does not disappear when you decide to use bariatric surgery to get control of your life. But, it does become easier when you know what to expect, and when you see that you are not alone.
I speak with authority on the subject of bariatric surgery and the emotional struggle that goes with it — I’ve been there. Seven years ago, I had a gastric bypass. This process took me from being barely able to function to living a magnificent life as an authentic and productive person.
But it wasn’t a walk in the park. As a person who has been through the surgery personally, and as a clinician (I am a licensed Marriage and Family Therapist) I bring deep experience to this subject. And I’m anxious to share what I learned.
I want to make it clear up front that I am speaking as a clinician and someone who has been through weight loss surgery and the difficult recovery process — I am not a nutritionist or medical practitioner.
The full tale of my own personal journey is recorded in my book Recovering My Life: A Personal Bariatric Story and in videos and Facebook posts I recorded during and after my surgery.
I began emotional eating as a response to childhood trauma. And, though I had dieted over and over again since high school, I weighed over 200 pounds at the birth of my second child. At that point, my medical problems included sleep apnea, high cholesterol, high blood pressure, and hypoglycemia (low blood sugar).
By the time my third child was born, I was pre-diabetic, with gestational diabetes. Many days, I was too tired from sleep apnea to even get out of bed. I could barely take care of my kids, and I felt like the worst mom on the planet.
Fighting My Way Through
I had always thought only slackers had weight loss surgery. But when a friend had a gastric bypass, she convinced me that, for people with weight loss resistance, this was a good option.
I consulted my doctor. He approved, and I began fighting my way back to health. And it was a battle. I made mistakes, but I learned from them, and I persevered.
Today, I have maintained my weight loss, and I am healthy. I am a better mom to my kids, and I have a thriving group practice and run a nonprofit foundation I created to assist people in our community to heal the brokenness in their lives. And I met and married my second husband and have a great marriage.
If you’re thinking about bariatric surgery, or if you’ve already had a procedure done, it’s important to move forward with all the information you need — including the physical and emotional ups and downs.
My recovery was a difficult journey, but I would do it again a million times over. Knowing what I know now wouldn’t eliminate the challenges I had to overcome before and after surgery. But, it would make the whole thing less scary.
That’s what I hope my story does for you — help you avoid the mistakes I made and feel more confident in your success.
Understanding Weight Loss Struggles & Bariatric Surgery
Causes of Morbid Obesity What is Bariatric Surgery? Getting Ready for Surgery
Mental & Emotional Preparation Advocating for Yourself After Surgery is Approved
Building Support Planning Pre-Surgery Weight Loss What You Will Need Immediately After Surgery
In the Hospital The First Few Days at Home Ongoing Recovery
Physical Issues Emotional Issues Other Issues Potential Issues After Weight-Loss Surgery
Emotional Challenges Health Problems Relationships Understanding Weight Loss Struggles & Bariatric Surgery
Why Do People End Up Morbidly Obese
Well-meaning acquaintances, friends, and relatives may suggest that you’re “taking the easy way out” by pursuing bariatric surgery. They can make you feel guilty for even considering this as a last resort. Why can’t you just lose the weight on your own?
Genetic predisposition. Some are genetically predisposed to gain weight, even when they exercise, even when they try to diet. Certain hormone imbalances and disorders can also make it hard to stay at a healthy weight.
Emotional eating. The barrier that keeps most morbidly obese people from losing weight is that our eating is connected with our emotions. Early on, many of us learned to use food as a way to cope. Food for us is not just fuel; it’s the way we deal with life’s problems and blows.
Regardless of the particular cause, some of us have been on one diet or another all our lives. We have lost the same 50, 70, or 100 pounds over and over. In fact, our attempts to lose weight have made us worse off. Along with the health effects of too much weight, we carry the shame of failure and frustration.
Weight and Your Wellbeing
The physical health problems associated with obesity are many and serious: high cholesterol, high blood pressure, acid reflux, gall bladder disease, congestive heart failure. Type two diabetes, hypoglycemia, asthma, sleep apnea and other sleep problems, fertility problems, arthritis, lack of energy. Knee and back pain, gout, migraines, psychosocial stress. Even scarier: liver disease, increased risk of cancer, risk of stroke, and earlier death.
Associated emotional problems that stem from these conditions can also make it harder to overcome them. For example, you may be struggling with depression, anxiety, and guilt. Sometimes, the biggest problem we have to face is the low self-esteem that goes along with being the biggest person in the room.
What Is Bariatric Surgery?
Bariatric surgery is not a cosmetic procedure. We may hope to look better after losing weight, but the best reasons for undergoing this major surgery are to extend and improve our lives.
The common term for bariatric surgery is “weight-loss surgery.” It means any surgical procedure on the stomach or intestines that aims at weight loss. Doctors have been performing these surgeries since the 1950s, with a good success rate.
The most common procedures are lap band, with a success rate of 47%; gastric sleeve, with a success rate of 80%; and gastric bypass, which has an 85% success rate. Another procedure, duodenal switch, has a success rate of 95%, but is more complicated and less common in the U.S.
These procedures support weight loss while requiring lifestyle changes. Drastic weight loss can motivate you to keep on the road to better health.
Whichever procedure you choose, pre- and post-operative education is key to developing lasting, healthy habits.
Getting Ready for Surgery
Mentally and Emotionally Preparing
Convincing others — and yourself — this is the best solution
Your first job is to conquer your own hesitance about weight-loss surgery. Even asking about it takes courage. Then, when you’ve reached the point of seriously considering it, you need to be prepared for a long haul.
You will need to get lots of people on board with your decision. First, your family — maybe not extended family, but certainly the people you live with day to day.
Next, you need your doctor to approve your decision. No matter how much you hate to get weighed, you will need a referral from your primary physician. And, you need to convince your insurance carrier that bariatric surgery is necessary for your health and to prolong your life.
Navigating Relief and Fear
You will probably feel a profound sense of relief just to know there’s a solution to obesity- related health problems. But along with that relief comes worry. It’s major surgery. Things could go very wrong. You might even die. Will having surgery be worth it?
What if you can’t get the weight off during those post-surgery months? What if you can’t keep it off and all this trouble and pain is for nothing? After all, you’ve tried and tried to lose weight and it hasn’t worked — or only worked for a short time.
Then there’s having to consult with medical personnel and, even worse, insurance representatives, to advocate for yourself. You’ll have to talk about your weight, which means confronting the shame that goes with it.
You may worry that people will think you’re weak — that you’re taking the easy way out. How do you overcome that prejudice? Especially since part of you still shares it.
Overcoming Resistance
And what about all those hoops you have to jump through? You have to have at least six months of records showing your weight on a regular basis and detailing your attempts to lose it. When you can’t bear the sight of your own body, much less the weight on the scale, how are you going to face that challenge?
Your research, from articles to videos, shows people who’ve had bariatric surgery eating impossibly small portions. You hear about all the restrictions ahead: first, a liquid diet; then mashed food; then, even when you get back to “normal,” ongoing restrictions, such as not drinking with meals. How will you ever be able to eat normally again — how will you ever be able to eat out?
These are mental challenges it won’t be easy to meet. But if you want to be well again, if you want a long, productive life, it is possible to work through them.
Advocating for Yourself
I was fortunate that my primary care physician was willing to support my bariatric surgery decision from the beginning. But you may have to work to convince your medical advisor that this route is good for you. Advocating for yourself isn’t easy, especially if, like most of us who suffer from morbid obesity, you don’t like calling attention to yourself and your weight.
To succeed, you must learn how to speak up for yourself. Here are some suggestions.
Decide what you want. Believe in yourself! Know the facts. Educate yourself about bariatric surgery and potential issues. Plan. You need a strategy for recovery and ongoing lifestyle changes. Gather support. It’s helpful to have family, friends, and people who have similar issues on your side. Target your efforts. Find the best medical practitioner. Find the right person at your insurance company to plead your case to. Express yourself clearly. Tell doctors and insurance agents that you are interested in surgery and why you feel you need it. Stick to the point, and don’t give up if they say “no.” It may help to role play scenarios with a friend or family member who supports your decision. Assert yourself, but don’t lose your temper. Respect the rights of others, but ask for what you need, and then listen. Finally, don’t give up. Be firm and persistent. Follow through on what you promise. (Those six months of weight-loss records, for example.) After Surgery Is Approved
You’ve made the decision to have bariatric surgery. You’re both excited and scared about taking this serious step toward improving your health and your life, but you’re going to do it. Now you need to build your support system. Nobody goes through such a major life change, such a serious physical challenge, without help.
Find Your Team
Choosing the right people to support you on your journey is one of the most important decisions you have to make. You will need to depend on family, friends, acquaintances, and even strangers who have gone through this experience before you. The most important quality to look for in your team is respect and support for your decision.
You will need help with ordinary tasks and responsibilities while you are undergoing and recovering from surgery. A few needs:
Someone to care for your children and pets while you’re in the hospital and perhaps during recovery at home Help cooking meals and cleaning the house Someone to accompany you to the hospital and be your advocate when you can’t do that yourself Help dealing with the inevitable emotions and stresses of major surgery and a major lifestyle change First, you have to overcome your reluctance to ask for help. Then, you have to reach out. Share your needs with family and friends who are sympathetic to your goals. If they’re not on board, you don’t have time for them right now.
If it feels right to you, you can use social media to reach out. Contact your church, work friends, fellow hobbyists, and people you’ve come to know in other ways. Trust that there will be someone who can help.
Be Informed and Follow Your Doctor’s Advice
Use the resources available through your medical advisors. Seek out a sympathetic nurse.
A therapist can help you deal with the emotional consequences of surgery and also the issues that led to your obesity in the first place. If you don’t have a therapist, maybe it’s time to make that connection. Find a good therapy group.
And above all, follow your doctor’s advice! Learn as much as you can about what will be happening to your body and mind, but trust the experts.
Plan for an Extended Recovery
Your time in the hospital may be only three to four days, but it will take longer for you to feel “recovered.” The period (about nine months) when you are relearning how to eat and coming to terms with the smaller size of your stomach is crucial to your long-term success. There will be lots of ups and downs. Be ready for a long road to full recovery.
Having support from friends and family is important, but this is the time to get involved with a support group. Being with others going through the same experience can give you the perspective you need to keep going.
Even if your physical recovery is swift and relatively painless, you will have to learn how to deal with the changes in your life. If, as with many, food has been the way you deal with past trauma, uncomfortable feelings, your need for independence, or any other of life’s problems, you no longer can depend on that comfort. If food has been your addiction, you now have to kick the addictive response to it. There will be setbacks. You need to be prepared to bounce back from them.
Lose Weight Before Surgery
Your bariatric surgeon is likely to require you follow a weight-loss plan for a number of months (six is common) before surgery. The reasons: to make sure you really are committed to your goal of losing the excess weight, and to help you be as healthy as possible going into surgery.
This can be a frustrating time. You’ve tried so many diets and exercise programs before, and none have worked. You hate thinking about your weight, and your program requires you weigh yourself daily and keep records of your weight, food intake, and exercise. You’ve made a major decision and are anxious to get it over with. But again, following your doctor’s advice is the shortest and best way to reach your goal, no matter how frustrating it feels.
Confront Your Fears
To make this transformative decision, you’ve already had to overcome lots of fears. Some of your fears involve others’ opinions. “What will people think?” Some arise from self-doubt. “Am I being selfish?” These are not frivolous concerns. Believe in yourself and face them. Your decision to take care of your health so that you can be there for your loved ones is a good one. Trust in yourself.
Another very real fear is the fear that anyone feels when they are about to undergo major surgery. You could die. This is not a frivolous thing. It’s serious. But the vast majority of people who have surgery don’t die from it. So, face your fear realistically.
At last, the big day is here. Your surgery is performed. You wake up in the hospital. Are you a different person? Is it all over now? Not yet. The journey of recovery has begun, and it will take resilience.
Immediately After Surgery
In the Hospital
If you have built your support team, you will have fewer worries going in. Your family and home responsibilities are covered, and you have people to support you in the hospital and after you return home. But that doesn’t mean there won’t be challenges.
During the initial stages of recovery, hospital staff will be checking your blood pressure, oxygen levels, and more. You may feel as though you are always being poked and prodded at, with little privacy. Thankfully, this stage doesn’t last forever,
Your doctors will advise you about the physical challenges that may follow bariatric surgery: constipation, dumping syndrome (nausea, vomiting, and weakness caused by eating high sugar meals, sodas, and fruit juices), possible infection of the wound, and possible leaks in the new connections. But medical advice may not give you the information you need about the emotional side effects.
One consequence of the surgery I noticed immediately: I no longer felt like eating. My hunger hormones were gone for a period of time. I had to force myself to eat, and I felt weak. Others report that they felt hungry during the post-op period while on a liquid diet.
Hungry or not, a liquid diet can be a source of emotional stress. Be aware that different people react in different ways. The important thing is to keep following your medical and nutritional advice and trust that, in time, you’ll be feeling more normal.
Another potential problem is “food grief.” Food has a special meaning for people who suffer from morbid obesity, and “mourning for lost foods is a natural step in the re-birth process after weight loss surgery.” For a long time, maybe all our lives, food was our friend. We turned to it in celebration, in sadness, for comfort, for reward. Now, we can no longer turn to food. We have to find other ways to fill the void food once filled for us.
Along with the pain associated with surgery comes the challenge of managing it. The pain medication you are given in the hospital may not work for you. Keep advocating for yourself until you find one that does. It may also take time to know exactly how much medication you need. Trust your doctor, but don’t be afraid to ask for a higher dose if you are in pain, or a lower dose if you are experiencing other unpleasant side effects.
It’s worth reiterating here, I am not a nutritionist or medical practitioner. And, I am certainly not advocating for you to ignore your doctor’s advice. Rather, by telling your doctor how you feel when you’re on pain medication, he or she may be able to transition you to a more effective medicine or dosage in a safe, supervised way.
Other challenges: meeting the medical requirements for discharge from the hospital and meeting your own fears and expectations. Will you be ready to be sent home? How will you manage after you get there?
Your First Few Days at Home
Your first major challenge will be dealing with pain and managing your pain medication. If you’re like me, you will want to get off medication as soon as possible. But follow your doctor’s advice. Pain meds usually require tapering off. Quitting “cold turkey” is likely to cause withdrawal symptoms, such as feelings of anxiety or depression, trouble sleeping, headaches, night sweats, nausea, vomiting, and diarrhea. I made the mistake of not tapering off my pain meds and lived to regret it.
You — and members of your family — might be appalled at how little you eat. You might worry about not getting enough of the right nutrition — protein, for example. The combination of pain, medication, and lack of hunger hormones can mean almost total loss of appetite.
Feeling responsible for things at home may make you push yourself too hard, especially if loved ones need you. Preplanning for getting help during this early recovery period is important. You will need to have both physical and emotional support in place. Recognize that even though they care, some people won’t be able to help. But don’t be afraid to ask.
Take baby steps. Your recovery has many facets: overcoming pain and regaining your physical strength are just the beginning. Emotional adjustment to the new circumstances of this life-changing step is major and ongoing.
Therapist Lynne Routsong-Wiechers, herself a successful bariatric surgery patient, lists “Seven Steps to Improving Emotional Adjustments Post-Surgery” in her article, “Baby Steps — Emotional Adjustments to Weight-Loss Surgery.”
Follow your doctor’s orders. Ask questions when you have them and express concerns, but trust your doctor’s recommendations and prioritize your physical health. Keep a journal. You can use this to keep track of the foods you eat, as well as whether or not you are emotionally eating, but you might also choose to express what you’re thinking and feeling. This will be a private record, just for you. Remember, you are more than your diet and weight. Write down realistic goals and expectations. Celebrate when you meet them! Reflect on the past. Remember why you decided to make this change, and honor how far you’ve come. Take plenty of photos and keep your old clothes. This will help you physically see your immense transformation. Call on that support team you’ve created. Look forward to living life to the fullest! Ongoing Recovery
Physical Issues
Even after you’ve conquered the first few days after surgery, the challenges go on. This early recovery stage can last from one to six weeks. The specifics vary with the particular procedure, but here’s a general outline of your physical recovery:
Develop strategies to deal with these attacks: exercise, journaling, and deep breathing are a few suggestions. Seek help if your attacks are severe.
Focus on One Part of Your Body
You might find yourself focusing on one body part. For me, it was my double chin. I had lost inches from my waistline and was making good progress, but when I looked in the mirror and saw that same double chin, I felt like I was making no progress at all.
This kind of body image distortion, if it becomes obsessive, can lead to Body Dysmorphic Disorder (BDD), a mental health disorder. People with BDD can spend hours a day obsessing about their appearance. These obsessions and the low self-esteem that results can make them avoid social situations, have problems at work or school, or even lead to suicidal thoughts or suicide attempts.
It’s important to seek help and support if you feel yourself becoming fixated. Remember that no body is perfect, and people are much more like to think about their own “flaws” than notice yours. Practice positive self-talk and try to replace thoughts about your body with something else, such as a new hobby or activity. Now that you’ve lost weight, a whole new world is open to you!
Health Problems
It’s not uncommon for patients to regain some weight after surgery, although it’s a myth that many patients regain all their lost weight.
Regaining Weight
Regaining even a small amount of weight can feed your fear. What if you stretch the pouch and end up gaining weight back or stalling your weight-loss? What if you have to go back to the hospital for something and you gain weight because of the treatment?
About half of all bariatric surgery patients regain weight after two years. But the average regain is about 8% after reaching the lowest point, and total ten-year excess weight loss is still over 50%. The main reasons for regaining weight are: how much excess weight you carried before surgery, alcohol or drug abuse, lack of a support system, or having a psychological problem or food “addiction.”
Realize that even if you regain some weight, you are still healthier than you were before surgery. Take steps to avoid the main reasons for weight gain. Be aware of the dangers of a substitute addiction to alcohol or drugs. Get yourself a support system and use it. Get treatment if you suspect you are overeating because of food addiction.
Plateauing
Don’t lose hope if you stop losing weight for a few days. These things happen. You can overcome the weight loss plateau.
Your metabolism may have slowed because you couldn’t exercise after surgery. You can start losing weight again. Focus on getting the right amount and intensity of exercise. Track your heart rate. You should be exercising at 60 to 85% of your maximum heart rate (220 minus your age). Vary your exercise routine to keep yourself challenged. Be sure to drink enough water, and continue eating right.
Complications
I worried that something would get stuck in the very small connection between my stomach pouch and small intestine. Would I have to go to the emergency room? Could something else happen to me?
As with all surgeries, there can be complications with bariatric surgery. But this surgery is very safe (99.8% survival rate). And less than 10% of patients have a complication. Though the list of complications is fairly long, most are not life-threatening (e.g., indigestion, diarrhea or constipation, nausea and vomiting, dumping syndrome). Some can be prevented by self-care.
Stick to your bariatric diet, follow your doctor’s instructions, inform yourself about what to look for, and share your worries with your doctor.
Sutures
I had difficulty with sutures coming out before they were supposed to. Others have had infections at the wound site. Monitor the site of your surgery and consult your doctor if things aren’t going right.
Hypoglycemia
Hypoglycemia (low blood sugar) happens when after eating, a rise in blood sugar makes your body produce more insulin, which then lowers blood sugar. Unless it’s extreme, this can be managed by changes in your diet.
Nutritional Deficiencies
Common vitamin and mineral deficiencies among bariatric surgery patients are Vitamin B12, Folate and Zinc, iron, copper, Calcium, and Vitamin D. Potassium deficiency can also be a problem, causing nausea, cramping, and dry skin. Supplements may help. Consult your doctor and dietician.
Dehydration
The recommended daily intake of water — 64 ounces — may be hard to get down, particularly right after surgery. Eight cups sounds like a lot, but if you break it down to one-fourth cup every 15 minutes for eight of the twelve or so hours you are awake, it is manageable. There’s an app for reminding you when to drink at GetHYApp.com.
Clothing
Especially in the early weeks and months after surgery, when you are dropping weight fast, you may find you can’t find anything to wear. This may sound like a minor problem, but you might be caught off guard by how much you spend on new clothes as you lose weight rapidly. While you are changing sizes every week or two, you may want to find some ways to save money:
Borrow clothes or shop at thrift stores. Shop your closet. Now’s the time to wear those too small items you just couldn’t part with when you were heavier. Don’t buy too much. Get exactly what you need until the next size change. Buy just a few practical basics and splurge on accessories. Don’t buy for the future. Clothes that fit and flatter now are better for your confidence. Alter. If you can’t alter your own clothes, find someone who can and get items altered as you lose weight. Most things can be taken in. Exchange Clothing. If you’re in a support group, consider swapping clothes with other group members. Relationships
Social Life
Your new body may allow you to make new decisions: to start dating or to go to the beach. But because your body image may not have caught up with the reality of your new body, you may still have the self-doubts you had before.
Part of your mind still thinks the way you did before surgery. You may feel unattractive, even invisible. Inside, you still feel fat. Negative self-talk may still be your go-to response to interacting socially with other people.
Counseling, a support group, and self-affirmations can help. Most importantly, give yourself credit for all you have accomplished. You’ve come a long way.
Different Reactions
Sad, but true. Not all of your friends and family will react positively to the new you. Old friends, even family members, may envy or resent your new look.
Family, friends, and even strangers may have a range of reactions to the changes in you. Your children may support you, but carry a lot of anxiety, fearing that you may die. Some may become diet police, worried that you’ll regain the weight and ill health of your days of obesity. Some will trust you to know your own needs.
Know that others’ reactions don’t mean anything about you. You are taking care of yourself, and that’s a good thing.
Getting More Attention
Now that you have lost weight, you are probably getting more attention. This may make you uncomfortable. Obesity goes with isolation. In fact, some people use their weight to keep from being in the spotlight. Being noticed may be flattering, but it can also be stressful.
Jealousy
If you’re married or in a relationship your significant other may be jealous of all the attention you’re getting from other people. Your spouse might fear that the new you might leave the relationship and so may try to sabotage your efforts to maintain your weight loss.
Your overweight friends might be jealous in a different way. If monthly dinners out with your “foodie” friends were the main thing that kept you together, or if these friends are not sympathetic to your weight loss efforts, they may, consciously or unconsciously, sabotage you.
Remember to surround yourself with people who support you. Don’t judge others who may be struggling, but don’t sacrifice your progress to please them.
Guarding Against Judgment
The different way strangers and acquaintances perceive you now may make you feel flattered, but also confused and even resentful. You may wonder — do these people like you for yourself, or are they just attracted to your new appearance? Would they have liked you before?
People you don’t see every day may not recognize you. Others may make you feel that you’re being judged for your decision to have the surgery. You may be re-introducing yourself to one person and defending yourself to another.
It’s understandable that you may be struggling with your sense of self. But, remember, you are worthy of kindness at any weight. Be your own best support.
Honoring Your Accomplishment
You can’t control the beliefs and behavior of other people, but you can be true to your goals and to yourself. Keep honoring your decision, your hard work, your determination, and your truly astonishing accomplishments. Whatever others say or imply, you are a brave and magnificent person, and you deserve a magnificent life.
Embrace Your Future
Bariatric surgery is a last-resort choice for losing weight that is killing you. Deciding to go ahead with it and working through all the barriers and difficulties is not for the faint of heart. But for those who choose to go forward, it can be life-saving in many ways.
By arming yourself with information about what to expect, you can feel prepared to navigate the weight loss surgery process with greater confidence and ease. Keep coming back to this guide and check in with yourself at every step along the way.
Before, immediately after, and long after surgery, remember these key points:
Create a support system Take care of your body Believe in yourself No matter where you are in your surgery journey, you deserve the new life you have given yourself. Enjoy.
Links
https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers https://obesitynewstoday.com/gastric-bypass-success-rate/ https://www.caroladkisson.com/books/ https://www.bariatric-surgery-source.com/feeling-hungry-less-than-a-week-after-gastric-bypass-surgery-is-this-normal.html http://www.boxingscene.com/weight-loss/54558.php https://www.consumerreports.org/health/avoid-withdrawal-symptoms-from-prescription-painkillers/ http://www.obesityaction.org/educational-resources/resource-articles-2/weight-loss-surgery/baby-steps-emotional-adjustments-after-weight-loss-surgery https://www.bariatric-surgery-source.com/bariatric-surgery-recovery.html#Support_Main https://www.mayoclinic.org/tests-procedures/bariatric-surgery/basics/what-you-can-expect/prc-20019138 https://www.bariatricpal.com/topic/239270-joint-aches-and-pains/ http://www.mybariatriclife.org/chronic-fatigue-after-bariatric-surgery/ http://www.livestrong.com/article/456678-feeling-cold-all-the-time-after-a-gastric-bypass/ https://www.leaf.tv/articles/how-to-avoid-skin-problems-after-gastric-bypass/ https://www.webmd.com/diet/obesity/features/you-lost-weight-what-about-extra-skin#2 https://www.drdkim.net/ask-the-dietitian/understanding-hair-loss-after-bariatric-surgery/ http://www.yourbariatricsurgeryguide.com/psych-impact/ http://www.bmiut.com/mood-changes-bariatric-surgery/ https://www.njbariatriccenter.com/eating-out-after-weight-loss-surgery/ https://www.bariatriceating.com/2013/11/what-medications-are-off-limits-after-my-bariatric-surgery/ https://www.everydayhealth.com/weight/the-emotional-health-risks-of-bariatric-surgery.aspx http://www.yourbariatricsurgeryguide.com/psych-impact/ https://www.tijuanabariatrics.com/blog/2017/04/18/is-a-ketogenic-diet-safe-181655 https://www.ucsfhealth.org/education/dietary_guidelines_after_gastric_bypass/ https://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html#Diet-and-Life-After-Main http://www.yourbariatricsurgeryguide.com/psych-impact/ https://weightwise.com/avoid-body-image-distortion-weight-loss-surgery/ http://bariatrictimes.com/depression-after-bariatric-surgery-triggers-identification-treatment-and-prevention/ http://blog.riversidesurgicalweightloss.com/blog/manage-anxiety-after-surgery https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd https://asmbs.org/patients/bariatric-surgery-misconceptions https://www.bariatric-surgery-source.com/weight-gain-after-gastric-bypass.html https://mybariatricsolutions.com/overcoming-and-preventing-the-weight-loss-plateau/ https://www.bariatric-surgery-source.com/complications-of-gastric-bypass-surgery.html#General_Safety-Main http://gethyapp.com/ https://weightwise.com/how-to-shop-for-clothes-after-weight-loss-surgery/ https://www.bariatric-surgery-source.com/marriage-family-strangers-after-weight-loss-surgery.html

Set an intention to be loving and respectful to you every day.
Drink plenty of water every day.
Intentionally move your body every day.
Spend 5-20 minutes in sacred silence every day.
Say only Kind and Loving things to and about yourself
Say "Thank You" to compliments.
Listen to and speak with your body throughout the day.
Eat life-affirming high energy foods.
Pay attention to your intuitive hunches.
Notice energy.
Protect your energy (ask/pray that you not take on others' energy/anxiety, before you leave your house imagine you are surrounded by a protective shield/bubble that will only allow positive loving energy to penetrate, no negatively get get through... If you are talking with someone who is particularly negative you can imagine you are standing behind a one way mirror and everything they say to you just bounces right back to them, or you can "put on your teflon suit" i.e. nothing sticks!!)
Clear your energy: meditate, stretch, take a bath in epsom salt, spend time in nature, create a releasing ritual
Before you say or do anything take a deep BREATH…Connect with your inner wisdom and ask if what you are about to say or do will support your Highest Good. Intend that your words and actions be grounded in the energy of LOVE
Don’t say or do ANYthing that doesn't feel right.
Live in the moment (pay attention to your breathing: this will always bring you back to the present moment.)
Count your blessings/feel gratitude every day.
Be ever mindful of living in the energy of LOVE.
Live in Love,
Louisa

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

An Unpredictable Scale
You are in the small and lucky minority if you lose weight as quickly as you hoped and as regularly as you expect. Everyone else should be prepared for many, many weeks when weight loss comes slowly or not at all. Lose patience, and you might give up on your Weight Loss Surgery journey. Stay patient, and things will eventually turn out right.
Focus on the process, such as healthy choices each day, rather than the outcome, such as the scale number or your pants size. You can control your choices, and if you are making the right ones, the outcomes will come. They may just not come when you expect them.
A Frustrating Healthcare System
One of the biggest tests of anyone’s patience is navigating the system. In this case, you might be trying to figure out your health insurance system and get the reimbursement letter you deserve. Or, you might have more trouble than you had hoped when trying to contact your surgeon. Don’t let these nuisances throw you off. Your perseverance may save your life.
Incomprehensible Relationships
Anyone who has Weight Loss Surgery is almost certain to have changes in their relationships. When your lifestyle changes, so too may the way you interact with family members and friends. You are working hard to stay on your healthy plan, but they may be working hard to support you and/or understand you. Be patient while there is friction, as it can often turn out okay.
You had better be prepared to return the patience if you want to keep your relationships. While you should not feel obligated to tolerate rudeness or anyone who undercuts you, you may need to get ready to have some tolerance for ignorance or friction due to changes in your lifestyle and attitude. Be ready to clearly explain your surgery to the important people in your life, and how it might affect them. Try to keep in mind that a sudden fit of anger from your SO might be a display of a moment of weakness while supporting you, for example, by keeping favorite foods out of the house.
Not Knowing the Answer
You might ask 25 people the same question and get 25 different answers. Your surgeon may recommend something different than your friend’s surgeon. You may get opposite advice from patients who each swear that their own experience was the “right” one. This gets frustrating!
The truth is that, in many cases, there is no single correct answer. The best you can do is to be patient as you dig to find the best answer for your individual case. Understand that you are receiving everyone’s best guess, and the answer – for you – is something that can be determined only after gathering input from those you trust, and mixing their advice with your own intuition. Carry the patience one step further, since you may find out by trial-and-error that your first guess was wrong!
Diet
You have no doubt studied the Weight Loss Surgery diet and seen warnings about feeling too full, dumping syndrome, and developing intolerances for former favorite foods. Reading about these and experiencing them are two different stories, though! Since they are out of your control, your best bet is to accept and deal with them, not to fight them.
Being patient can help you succeed in your weight loss surgery journey. It can keep your weight in check long term, and also keep you mentally fit for minimizing the stresses linked Weight Loss Surgery. Keep practicing it, and your efforts will be worthwhile.

“The secret of change is to focus all of your energy not on fighting the old, but on building the new.”
- Socrates

Everyone does well out of the gates. We all impress ourselves when we start, what we believe to be, a new lifestyle change. However, "out of the gates," can mean different things for different people; for some it is two months, for others (usually depending on how strong the addiction or habit is) it can be two minutes.
But what do we do when we fall from grace? The research on relapse (with any addiction; food, drugs, alcohol) is that recidivism is the rule not the exception. So why do we get so down on ourselves when we fall short of our goals? Why is it so hard to get back on the horse with the same vigor we had when we started? And how do we give ourselves a renewed sense of hope and motivation for change once we've fallen?
One magical ingredient in the secret sauce (and one of many concepts I talk about in my book and my wls courses) that is lifestyle change is the novelty effect. The new plan to quit something or change a bad habit is something unlike we have ever done before, so we hope that we can achieve something we have never done before. The problem is that the moment we slip, that novelty loses its magic - and each time we start over, it loses its power to give us hope.
So the solution is to cultivate more novelty. Our ability to continually grow and change is largely limited by our creativity. The more creative we become, the easier it is to take a different approach to change. To open a window when life seems to shut the door.
In other words- what I am telling you, is that the only secret to long term weight loss maintenance is the knowledge that there isn't only one secret. There is no ONE diet that will forever change someone. Eventually people get tired of eating bacon and eggs every meal on Atkins, or grapefruit, or cabbage soup- but the thread they all share is their novelty. This is why all of them can work initially.
Even as powerful as weight loss surgery is- people still find that they start to plateau or even gain the weight back if they aren't simultaneously addressing the behavioral and psychological factors that got them there in the first place. They too, must also continuously be creative about renewing one self throughout their lifetime.
So the following is for all of you who are struggling today. Those that feel they have lost their way and perhaps feel disenchanted or disappointed. Below is a recovery "map" I created a long time ago for my clients, some struggling with substance abuse, others with food. It all works the same. Print it out, or copy and paste it in the notes section of your phone and take 20 minutes to fill it out with the things that are personally meaningful for you. This is not THE answer to long term recovery from addiction, but it is a fresh approach for many who feel stale at the moment:
Baptism
- Some ceremony to signal a renewed sense of hope and a fresh start. One client trying to recover from substance abuse, buried all of his wine and liquor bottles in his yard. Another client had a "garbage party" with her kiddos, and they loved smashing all the processed foods they had in their pantry and throwing them in the trash.
Associations/triggers
list all of the things that get you into trouble (being at a bbq, wanting to celebrate something, holidays, 7-10pm at night, date night, etc)
Coping Skills (what gets you through the crave waves)
These are the behaviors that you do INSTEAD of the addictive behavior. Extra credit if you are able to make a coping skill for each trigger listed above.
Higher Desires/Vision of Self
when you let go of your attachment to food and all the self loathing, mental, and physical heaviness it brings- what are you freeing your life up for? will you write a book? will you do more outdoor activities with your kids? do you want to resume an activity you once loved as a child? Is there a role model that inspires you that has done what you want to do?
Cons
Why are you doing this in the first place? These are the things that are hard to keep in mind when our reptilian mid brain (see last article) is at the wheel. What is personally meaningful? Does it age you? Does it make you feel out of control? Do you dread going on airplanes because you know you'll need an extender? does it prevent you from going to amusement parks with your kiddos?
Spirituality (religion gets us into heaven, spirituality gets us out of hell)
All addiction is what disconnects us from our deeper self and edges us further and further away from God (or whatever you like to call it) and our deeper spirituality. Spirituality is what allows us to move into the unknown, be comfortable with discomfort, and have faith that everything will be ok. It can include a gratitude practice, volunteering, play, aligning one self with nature, connecting with a spiritual e newsletter (mind body green, daily om, etc), generosity, etc.
Daily Recovery Ritual (symbolic gesture to self every day that we are consciously devoting time to our recovery)
What are the things you can do daily to symbolize to yourself that today is a new day? Keep it realistic or you won't do it. Vitamins, meditation, lemon water, supplements, self care, reaching out to a loved one, exercise, etc.
Reward System
What will you do for yourself if there is a certain period of time reached where you meet your goals? Will you get a massage at the end of every month? Will you plan a vacation after three months of solid goal hitting? Will you reward yourself with one day per week of going to the movies in the middle of the day and playing hooky if you're on the straight and narrow for five days?
Strategy
This is your "what." What are you doing daily to ensure that you are in alignment with your goals? Are you reading something fresh all the time? Do you make a timeline of your addiction and how it has affected your life? Do you go to local support meetings each week? Do you keep in touch with an online community? Do you make sure to give yourself small breaks while with the kids every day? Do you have a self care space set up in your house? Do you talk to a partner about how to change behaviors of theirs that might be hindering your efforts? can they get a mini fridge? Do you do acupuncture to balance your chi? Do you do yoga to manage your depression? Do you find a therapist?
Recovery Resources (try to hit one each morning)
what resources are in your pocket when you are feeling weak? bariatricpal.com? WLS journeys on Instagram? The Fix, Reddit, unique blogs documenting their weight loss journey, wls and vsg searches on Pinterest, etc.
Good luck on your fresh start!

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
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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.

In my work, I find that one of the most common explanations people give for their struggle with diets and with obesity is “I’m a food addict.” When asked what this means, most people explain that their inability to maintain the weight lost from diets and the fact that most or all of the weight eventually returns is proof of their “food addiction.” Additional evidence they cite is that their eating is “all or nothing,” that they can completely avoid so-called “forbidden foods” or binge on them with regularity, but nothing in between.
This kind of reasoning is called reasoning from the converse. This is where you have a conclusion or an end state and you then go backwards to explain the cause and use the existence of the end state as proof of the cause. This invariably leads to circular logic that goes nowhere. Here’s how it works: “I am a food addict which explains why I cannot moderate my intake of certain foods, and my inability to moderate my intake of certain foods proves that I am addicted to them and am therefore an addict.” But does it? There is actually another, more accurate explanation.
There are three facts that must be considered:
1) 95% of people will regain most or all of the weight they have lost on a diet within five years.
2) Many, if not most diets teach avoidance of “forbidden foods,” not moderate consumption of them.
3) Very few diets or weight loss regimens are successfully maintained indefinitely.
These facts are very important to our discussion because they are true for almost EVERYONE who has tried to lose a significant amount of weight. Therefore, either everyone who has failed to keep their weight off following a diet or eventually resorts to eating “forbidden foods” is a “food addict” or there are other explanations for this phenomenon.
But why is it that so many of the people I meet are eager to call themselves “food addicts?” Most people are uncomfortable acknowledging that they are addicted to alcohol or illicit substances such as cocaine or heroin, so why is being a so-called “food addict” easier to acknowledge? I believe it is because the label “food addict” removes the feelings of guilt and shame that so many people experience when they regain weight after all of the work they expended in losing it. It is absolutely heartbreaking to lose the weight, have people notice that you’re thinner and then a year later you’ve regained the weight and everyone knows it. It would be very tempting to blame this on a disease called “addiction.” “It’s not my fault that I regained the weight and am obese again…I’m a food addict.” I can certainly understand the desire to be free from responsibility from your obesity or weight regain; however, it’s not necessary to fall back on the explanation that you are a “food addict.” Perhaps if we looked at the facts about weight loss, there would be no need for all of the guilt and shame and the resulting need to explain it away by calling it an addiction.
Review the facts that I mentioned earlier. The overwhelming majority of people regain the weight they have lost from a diet, very few diets teach moderate eating of “forbidden foods” (so you’re left with only knowing how to eat them or not eat them), and most people find it very difficult if not impossible to stay on a regimen of controlled eating for extended periods of time. These are the problems faced by almost all human beings who try to lose weight, not just those who are “food addicts!” So what is the explanation when someone actually succeeds in losing weight and keeping it off? Great question…and the answer is not that these rare souls are not “food addicts” or that they are “recovered food addicts.”
The National Weight Control Registry (NWCR) is an organization that keeps tracks of “successful weight losers” who have lost 30 pounds or more and have kept it off for at least one year. What should immediately catch your eye is that “success” is defined as losing 30 pounds and keeping it off for one year. So if losing 30 pounds and keeping it off for one year is considered “successful,” if you’re morbidly obese and manage to lose 100 pounds and keep that off for several years that would be incredibly successful! Extensive research has been done on these folks over the years and the most recent study has discovered 7 common habits which most of the 6,000 people studied have in common. 6,000 participants in a study is a strong number of people and one where the conclusions drawn are likely very robust.
Interestingly, the researchers noted that 90% of the folks in this study who finally lost the weight and kept if off had a previous history of losing weight and putting it back on. Therefore, the overwhelming majority of people were not successful on their first try. The seven habits of successful “losers” were: 1. Engaging in 200+ minutes of exercise of moderate intensity per week, 2. Limiting TV watching to less than 10 hours per week, 3. Eating a low-calorie, low-fat diet with less than 30% of calories from fat, 4. Consistency – relatively little food variety and the same daily pattern of eating, 5. Eating breakfast, 6. Avoiding emotional eating and binging and limiting consumption of fast food to less than once weekly and, 7. Monitoring yourself such as documenting calories and/or fat. Notice that every one of the seven habits is just that…a pattern of behavior. There is no mention of the characteristics of the 6000 people. It’s not about who they are, but rather what they did and continue to do.
So what do we make of this “food addiction?” Neuroscience is recognizing the difficulty human beings have in resisting certain foods that we can call “engineered foods” that are high in sugar, salt and other additives. These foods are designed by fast-food companies and food manufacturers to be irresistible because they cause certain reactions in the brain that make it hard for us to say no. But these are challenges for us all. In fact, mass consumption of these “engineered foods” is likely one of the great contributors to the obesity epidemic. They explain why we, as a society, are getting fatter. Perhaps we will discover that some individuals (for neurological or other reasons) have a more difficult time resisting these “engineered foods” enriched with sugar, salt and other additives, and that these individuals are the true “food addicts.” But what would knowing that you are one of these individuals change? What would a “food addict” do differently to lose weight and keep it off?
The addiction model says that the addict should completely abstain from using the substance or drug. Should “food addicts” avoid all food (impossible) or just the ones they are “addicted” to? And how would we know which ones those would be? The most commonly cited addictive “substance” in food is sugar, but we’re not at all certain. There is also another problem. Much of the research on binge eating indicates that designating certain foods as completely “forbidden” and avoiding them results in feelings of deprivation and their becoming even more desirable which often results in binging on them when you finally give into temptation.
Perhaps someday there will be treatments for true “food addicts” if “food addiction” actually exists. What is more likely however; is that these folks will simply have to work even harder than most of us to stick to the seven habits that are detailed above. In the meantime, consider giving up the label of “food addict” and instead, recognize that losing weight and keeping it off is a tremendous challenge, but an achievable one. If you’re thinking of beginning to address your own personal “battle of the bulge” either for the first time or the twentieth time, or if you’re feeling hopeless and thinking there is no point in even trying, fear not…most successful losers apparently made several unsuccessful attempts before they finally got it right. And if you are thinking of starting yet again…the seven habits detailed above are a great blueprint to follow.