Breaking Up With Your Ex For Good – The Maintenance Grind

[Dr. Nick Nicholson 20]

The thing about torrid love affairs is they never end with a clean break. Sure, you have every reason to think it’s over. You changed your phone number, attended a weekly support group, burned every picture of the two of you together and started dating a healthier, saner person - one your friends actually like. But passionate romances don’t die until the second or third bullet. There’s always at least one steamy reconciliation before the thing is finally stone cold dead.

You’ll run into your ex at the store and go a little weak at the knees, or you’ll send a gushing e-mail on a lonely Friday night, or you’ll decide that avoidance is childish and the grownup thing to do is at least be friends. Before you know it, you’re right back where you were, and after the initial exhilaration dies you realize your mistake. Nothing’s really changed and you’ve wasted time and emotion yet again on someone who isn’t and never will be good for you.

An unhealthy relationship with food is eerily similar.

You may be stunned to learn that you’re so in love with the simple act of eating. One of the most common things bariatric surgeons hear on follow-up visits is, “I never realized what a relationship I had with food”. You thought your weight problem was from ignorance over what to eat, or faulty childhood messaging, or not making time to care for yourself, or your grandmother’s genes. That may be where it started, but that’s not what kept it going.

After surgery, you figure out the truth. You’ve been embedded in a romance as sticky and hard to leave as Richard Burton and Elizabeth Taylor’s on-again-off-again love affair.

Just like lovers in a doomed romance, you’ll be tempted to drift back into your old relationship with food. And it’ll sneak up on you when you’re most vulnerable, right when you think you’ve got the whole thing whipped.

Here’s what happens. Your surgery gave you a massive head start. It forced you to change your eating habits, it did away with your hunger pangs and allowed you to drop weight at breathtaking speed. You got positive reinforcement from the immediate success of your new behavior and from the fact that you just flat out felt better. Every week contains a little drama in the form of unaccustomed praise, changed relationships, different activities, and new clothes.

But the excitement will wane. Life will settle down, just like someone who’s had a thrilling engagement with lots of gifts, a fabulous wedding, an extended honeymoon, and the first couple of scary post-marriage fights and rapturous make-up sessions, but now has to get used to day-to-day married life with the spouse who leaves a trail of potato chips in his wake and the mother-in-law who calls three times a day. In other words, life will become normal, and, at times, even mundane.

Even more sobering, your body will adapt over time. You’ll be able to undo the straitjacket put on your system by the surgery.

For those who had a gastric bypass or vertical sleeve operation, two things come into play that will test your resolve. First, you’ll get hungry again. Even though the surgery bypassed ghrelin, the hunger hormone, other hormones will ramp up to fill the void, and most patients will start feeling hungry again, anywhere from six to twenty-four months after the surgery.

Second, your new stomach will adjust and toughen up, just like babies’ feet callous as they learn to walk. It will expand a bit, and its cells will change to create more and thicker mucus which cushions the food you ingest, making it easier to eat bigger quantities and varieties of food.

If you had the gastric bypass surgery, a third issue will come into play. The dumping syndrome that’s kept you from eating sugar will disappear in most patients. So the piece of cake that would have made you violently ill six months ago won’t cause a problem now.

For lap band patients, two issues can lure you back into your old lifestyle. First, you’ve figured out how to cheat, and you’re familiar enough with the band that you’re no longer worried about hurting yourself if you thwart its restriction. You can drink high calorie milk shakes or put your favorite food in a blender and eat as much as you want.

Second, you rely on the lap band to limit your food intake like a surgical shock collar rather than taking control of your own behavior, creating a negative reinforcement method of diet control that starts to grate on you. You have your surgeon decrease the saline in your lap band for special occasions, like Thanksgiving, and then put in enough saline “to make me throw up” when you want to lose more weight instead of taking the steering wheel and driving your own eating and exercise plan. Over time, you’ll begin to resent the choke hold the band has over your body and you’ll grow tired of the twice-monthly maintenance visits to your doctor.

That’s why the first six months after your operation should be treated like a sprint, wringing every benefit you can from the surgery while you’ve got all its mechanical and behavioral benefits going for you – the compliments, the falling scale numbers, the lack of appetite, and the physical inability to eat too much. This time won’t last forever, and those six months will be the best shot most people ever get at losing their excess weight.

You’ll learn to listen to your body to tell you when you need food. You’ll figure out what it feels like when your glucose is low, which means you need energy and should put some fuel in your tank. You’ll be able to tell the difference between real hunger versus head hunger, between needing energy and just mindlessly following an eating habit, between desiring food versus needing food.

There is no finish line. There is no moment when you can say, okay, I’ve won that battle and I can forget about it. Like a recovering alcoholic has to pay attention to what he drinks for the rest of his life, you’ve got to be vigilant about diet and exercise for the rest of yours.

But, you say, that sounds depressing. Surely life wasn’t meant to be quite so restrictive. That’s just too hard.

Actually, it’s not. It’s just conducting yourself in a fashion that’s consistent with your goals, something you’ve been doing your entire life with your job, your marriage, your family, and your friends.

Think about it.

The things you’re proudest of in life are the things that have required the greatest work and sacrifice - your education, your children, your marriage, your career. Maintaining a healthy weight is no different and it’s something you should pat yourself on the back every day for doing.

You’ve tasted what life is like without the suffocating excess weight. Your new habits are far less restrictive than the physical, social and emotional limitations your old weight burdened you with.

It’s time to kick your dysfunctional romance with food out of your life forever.

[DLCoggin 1,788]

Nicely done!

[Sharpie 3,306]

very factual article...

[KAATNS 1,473]

Well said!

[Wendydarling19 310]

Fabulous article!! Can't wait for my surgery!! 10 more days : )

[lisacaron 5,075]

As a band patient I have to say that the first 6 months has been anything but a sprint in the area of weight loss. It has been a time for hands on learning about having the band in the body and part of a new life style to be lived.

The band does not jump start weight loss for every patient like the by pass or sleeve. For most it takes a period of 6 months to get to an optimal level of satiation with food.

In that time we are learning to eat with proper mechanics and nutrition. I agree that first six months is the time for you make the life style changes that your new body (the one you now have after surgery whether it is the reconfiguring of your organs the removal of parts of them, or the addition of a band) requires.

It is the honeymoon phase for some but it can be a bit of hell for some who are banded as the hunger is not dissipated necessarily after surgery and comes only from reaching that optimal fill restriction which takes time for most patients.

[Successful4me 51]

Fabulous article!! Can't wait for my surgery!! 10 more days : )

Good Luck to you. I was banded 12/22/10. 104lbs less. U can do it.