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Your Psychological Tool Belt is Here



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Once the honeymoon is over from weight loss surgery, get your psychological boost here.



The first meeting with a patient preparing to have weight loss surgery, whether it be sleeve, bypass, or balloon, carries so much hope, anticipation, and excitement- that you can almost cut it with a knife. For many people, by the time they have reached the point of considering weight loss surgery, they have gained and lost hundreds of pounds. They finally have a beacon of hope in what was once a desolate psychological place of despair and hopelessness.

Trying to emphasize the need for simultaneous behavioral and psychological change, often makes me feel like Rachel Dratch in her SNL portrayal of Debbie Downer.

The reality is that there are many people who go into the surgery, carrying a magic bullet fantasy who don't intend to change anything about their lifestyle or psychological landscape, and that actually still works - for a while....

The sheer reduction in portion size over time would dictate that most will lose a significant amount of weight. There is no other way of losing weight that has such a fail safe element to prevent "cheating," or "relapse." You simply can't go overboard after the surgery, or you will get very sick and regret it.

However, after the party is over. All the folks have gone home, all the social reinforcement has diminished, and six to twelve months post- you are still faced with the demons that got you here in the first place; depression, past trauma, abuse, a bad relationship, lack of purpose, addictive propensities, boredom, loneliness, lack of a sense of self efficacy, etc.

Your Psychological Tool Belt is Here.

Baptism - go back to the drawing board when you know you've gotten off track. I am in the midst of potty training my three toddlers at the moment and am reminded of her directive if the kids start to have accidents more frequently that we need to go back to square one and do another three day round of the pants off dance off, where we are sequestered to our home for 72 solid hours so that I can act like a psychological seismograph and quickly put a peeing kid on the potty mid stream.

Same thing applies to bad habits or addiction. To have the same motivation and gusto you once came out of the gates with, you have to go back and come out of the gates again. Perhaps this means reading the literature that got you motivated to change in the first place. Maybe this means going back to OA meetings. This could mean training for a half marathon. Whatever helps to signify to you that another major shift is coming.

Psychological Absolvement- This is a layer of guilt that I see many who relapse, carry. This serves no one. In fact, it sometimes perpetuates the problem because when we feel bad, we do badder (that's a word right?). Understand that this journey you are on is not a simple downhill road, but a twisting, winding, and sometimes uphill battle. This struggle is all part of your process.

In any true change process or metamorphosis there is significant struggle, whether it be the caterpillar in its cocoon, or the crucible in the kiln.

Higher Desires- Make a list of what you at your best self feels and looks like. Are there famouss people or celebrities that have recovered from addiction that inspire you? Are there people in your life that live it with vigor that you would want to emulate?

Environmental prompts- make sure your life is surrounded by items that inspire and motivate you. It could be a beautiful quote on your mirror, a poem on your bedside journal, a beautiful picture on your phone's wallpaper, making sure your favorite health sites are showing up first in your social media feeds, making an effort to tune out negative social media, or triggering/toxic people. Whatever the things are that you know lend to you being your best self, need to be in place. Think of it like psychologically nesting for change.

Cons list- you need to have a list on your person or on your phone of all the reasons you did this in the first place; heart disease, hypertension, sleep apnea, chronic pain, not being able to keep up with the grandkids, poor sex life, feeling of embarrassment in public, social isolation, etc. These can be powerful reminders of why we started such an endeavor in the first place.

Spirituality- This doesn't mean religion but it can. If you have a solid faith- wonderful, use that. Allow your guiding principles to help you during your most vulnerable weak moments. If you don't have any form of spirituality - think about what that might look like for you; yoga, mindfulness, realignment with nature, serving your community.

Spirituality allows us to connect with our soul. It allows us to be in a place of openness and vulnerability without knowing all the answers. It provides us with the opportunity to have faith that everything is going to be alright even though things are really uncomfortable right now.

Daily/Weekly- What are you daily and weekly rituals that keep you on the right track? Make a list of the things you know you need to be doing daily and weekly to signify you are in a good space. Maybe daily it is drinking hot lemon Water in the morning, meditation or "bed"itation, prayer, exercise, Vitamins, meal prep. Then maybe weekly it is acupuncture, therapy, journaling, volunteering.

Try starting with these tools and see if you don't start to feel a sense of renewed motivation. For more tools, please check out the full psychological tool belt here. For my free supplemental course on weight loss, click here.

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What a great article. Thank you for writing it.

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Well said.

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    • Prdgrdma

      So I guess after gastric bypass surgery, I cant eat flock chips because they are fried???  They sell them on here so I thought I could have them. So high in protein and no carbs.  They don't bother me at all.  Help. 
      · 1 reply
      1. NickelChip

        It's possible for a very high fat meal to cause dumping in some (30% or so) gastric bypass patients, although it's more likely to be triggered by high sugar, or by the high fat/high sugar combo (think ice cream, donuts). Dietitians will tell you to never do anything that isn't 100% healthy ever again. Realistically, you should aim for a good balance of protein, carbs, and fat each day. Should you eat fried foods every day? No. Is it possible they will make you sick? Maybe. Is it okay to eat some to see what happens and have them for a treat every now and again? Yes.

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      · 1 reply
      1. NickelChip

        I actually watched cooking shows during my pre-op, like Great British Baking Show. It was a little bizarre, but didn't make me hungry. I think it was also soothing in a way.

    • Clueless_girl

      How do you figure out what your ideal weight should be? I've had a figure in my head for years, but after 3 mths of recovery I'm already almost there. So maybe my goal should be lower?
      · 3 replies
      1. NickelChip

        Well, there is actually a formula for "Ideal Body Weight" and you can use a calculator to figure it out for you. This one also does an adjusted weight for a person who starts out overweight or obese. https://www.mdcalc.com/calc/68/ideal-body-weight-adjusted-body-weight

        I would use that as a starting point, and then just see how you feel as you lose. How you look and feel is more important than a number.

      2. Clueless_girl

        I did find different calculators but I couldn't find any that accounted for body frame. But you're right, it is just a number. It was just disheartening to see that although I lost 60% of my excess weight, it's still not in the "normal/healthy" range..

      3. NickelChip

        I think it's important to remember that the weight charts and BMI ranges were developed a very long time ago and only intended to be applied to people who have never been overweight or obese. Those numbers aren't for us. When you are larger, especially for a long time, your body develops extra bone to support the weight. Your organs get a little bigger to handle the extra mass. Your entire infrastructure increases so you can support and function with the extra weight. That doesn't all go away just because you burn off the excess fat. If you still had a pair of jeans from your skinniest point in life and then lost weight to get to the exact number on the scale you were when those jeans fit you, chances are they would be a little baggy now because you would actually be thinner than you were, even though the scale and the BMI chart disagree. When in doubt, listen to the jeans, not the scale!

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      1. This update has no replies.
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      Now that I'm in maintenance mode, I'm getting a into a routine for my meals. Every day, I start out with 8-16 ounces of water, and then a proffee, which I have come to look forward to even the night before. My proffees are simply a black coffee with a protein powder added. There are three products that I cycle through: Premier Vanilla, Orgain Vanilla, and Dymatize Vanilla.
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