Tuesday, 9 June 2015

Keeping myself in check

Every once in a while the OH (Obesity Help) forum I belong to (which focuses on different types of WL surgeries and I found on that is for my surgery and the people in ON too!) posts various articles.  This one mentions some pitfalls I might have and I thought after my discussion about with the Nurse about measuring I thought of other areas I might slip up in.  So here I go dissecting this article....My thoughts are in bold and italicised


The first of these issues is prior psychological history. This includes: depression, bi-polar disorder, obsessive-compulsive disorder, attention deficit disorder, external locus of control, and “magical thinking”…which may lead to discontinuation of necessary psychotropic medications.
**I have Susanne for this one.......I don't think I would give up the "happy pills" no matter how much I lost.

Secondly, the issue of abuse is a possible saboteur after surgery. Was there physical abuse, sexual abuse, and/or verbal abuse? If this is not addressed prior to surgery it will not be a surprise to see an anxious patient six months post surgery due to the feeling that they have lost their “protective cover.”

**I didn't have the abuse that went with the "hiding" my "layer" was from the obsession of being told "no" and the DH has been very supportive through all of this.

Thirdly, a low self-esteem may lead to a patient not being successful after weight loss surgery. The patient may experience a sense of failure if they go off track (since it is a total life- style change, they can expect to go off track once in awhile). There may be lack of accountability; many patients are socially immature, or not wanting to take responsibility.
**The only thing I get upset about is when I step on the scale and see a stall and that is my own accountability since I am putting the food in my mouth.  I know when the scale doesn't move I think about what I ate and it often linked to a white carb.  So I am just needing to be mindful when I am thinking about a sandwich/wrap/burger/toast/pizza and anything else.

Fourthly, if the patient suffered from past grief or trauma that wasn’t dealt with prior to surgery, this can make a patient fail. I have sat in my office many times talking to patients who gained their weight back after not being ready to give up losing someone close to them who had died, or a past rape that they had never dealt with.
**Again I have Susanne.

Lastly, and perhaps the most frustrating for the patient, is a history of addiction. This can present as a history of smoking, drug use, drinking, or food. Cross addictions are a reality; they really do happen. In fact, the Betty Ford Center in Rancho Mirage, CA is seeing an influx of bariatric patients with new addictions checking in for help. Addictions do not go away!
**This I know I don't I have but I have a food addiction.  This is often the case when I get cravings and I think about the cravings until I get that little B.L.T.  I had that the other night with Smartfood popcorn.  I ended up getting a bag, ate 3 kernels and left the rest on the microwave.  I had popcorn for the next 3 nights LOL

**Another article from the OH board.


If you had a food addiction prior to surgery, you will most likely have one after the surgery. Sometimes you can anticipate changing addictions…but with a food addiction, many times you do not. You end up overeating many of the foods you did prior to surgery.

Food addictions can present themselves in many forms. They may present as compulsive overeating, night eating syndrome, binge eating disorder and many other forms of eating that reflect an unhealthy relationship with food.


• Fear of gaining weight while eating
• Feelings of loss of control when eating
• Having thoughts about food and eating other than at mealtimes
• Thinking of food with feelings of guilt or shame
• Repeated attempts at dieting
• Self-consciousness or embarrassment about eating
• Lying about eating habits
• Eating to relieve stress or
• Eating when not hungry
• Fearful that you may not be able to stop eating when you should
**My addictions are; repeated attempts at dieting, lying about eating (closet eating), eating when not hungry (because I closet ate and now it is supper time with the family) and the fear of not being able to stop eating when I should and we (Susanne and I) believe that is why I measure everything.

If you know prior to surgery that you have a food addiction, tell the psychotherapist and dietician.  If we know about it prior to surgery we can guide you so that after the surgery, you will be successful. You may also want to be honest with your surgeon and tell them about your addiction to food. Most patients are not addicted to all food. They have foods they prefer and they use these foods for comfort. They use certain foods to numb themselves or to stop anxiety. Since this journey of weight loss and management after surgery can be overwhelming at times and stressful, you can understand how you may be tempted to turn to comfort foods just as you did in the past.

One of the troubling things is that prior to or after surgery, your surgeon may tell you that
a “sliver of cheesecake” or other trigger foods is okay for you to taste after surgery. This is analogous to telling a recovering alcoholic that they can have a small glass of wine, or to tell a smoker they can have one puff of a cigarette. We know this would be unethical advice, but at the same time, we say it to our weight loss patients frequently. Perhaps what would be a better stance to take is to ask patients prior to surgery to list their “trigger foods” and then counsel them on how to switch to a healthy food in the place of the “trigger food.” Patients tell me that unlike an alcoholic, they have to eat (an alcoholic doesn’t have to drink). This is true, but patients don’t have to eat the foods they are eating. No one becomes obese from eating healthy foods (fruits and vegetables). I don’t know any patients who are addicted to carrots and broccoli. I think the firmness of a treatment team to guide the patient after surgery and tell them prior to surgery that their “trigger foods” will no longer be acceptable for them would be much more helpful then to tell them to live a “healthier life style after surgery.” Patients tell me frequently that they are planning to live a healthier lifestyle after surgery, but if they have an underlying food addiction that hasn’t been dealt with a healthier lifestyle will be a temporary thing (the honeymoon phase of bariatric surgery lasts 6 to 12 months). After that the old patterns of eating will kick in.
**I think that I have changed how I eat.  This paragraph focuses on the "no/never again" aspect and I have learned that this is my trigger. 


Prior to surgery, have a set amount in mind of your limit in weight gain. The most discouraging part of the surgery may be if you gain weight back after losing it. This is frustrating and it mostly happens when we don’t pay attention to what we are eating and we turn to old habits of eating. After your surgery, have a talk with yourself and decide how much weight you will use for “fluctuation.” I usually encourage patients to have a 3-5 lb. limit. If at any time after your surgery you gain 3-5 lb., call or email your psychotherapist and dietician and tell them you went over your set limit. We will respond by going over your diet and your thinking. If we catch it early we can usually help you turn things around within a two week time. If you allow yourself to go into a “shame cycle” where you are embarrassed to get on a scale or you deny you are gaining and don’t want to deal with it, then we won’t be able to help you. Remember you are the boss of your treatment team. If you don’t tell us your problem we cannot help you.
**My margin of error is only a pound right now.  I have seen folks guff at 5 pounds, but eventually over 4 weeks of it makes that 20 pounds.  That is a number I really don't want to see since I have done so much up to this point.

Lower your sweet volume. If you know you are addicted to sweets, make a vow to clean every sweet thing out of your kitchen, office drawer, and day to day life. If you are addicted to sweets, eating a little bit after surgery is like getting a little bit pregnant. It doesn’t exist.
**This made me chuckle.  I have even talked to Susanne about various things and she has helped me make "yes/no will/won't" decisions.  There is no "I might do this" either.

Keep your hunger in check. You know what happens if you get overly hungry. Don’t let it happen. Eat a little bit every three hours.
**I have a timer and normally I will have a craving before the timer goes off LOL

Remind yourself with a rubber band. Find a nice big tight rubber band. Place it on your wrist near your watch so you won’t forget to wear it every day. Whenever you are out and about and thinking about eating “comfort food” or something that isn’t healthy, snap the rubber band. The stinging of the rubber band will distract you so you will be able to get in touch with how often you are thinking of sabotaging your weight loss. It will also show you if the addiction is stronger than your will. If the addiction is stronger, it is time to call your treatment team for additional support.
**Ummmmm no.  The rubber band isn't for me.

As I have said to a few folks, I think if I didn't get my mental state figured out, I wouldn't have been able to use the tool of the Tiny Tummy to its full potential.  I keep thinking back to "that guy" who went home and ate pizza just after surgery and tore everything up inside and died.  We won't know why he did it, but I am glad that I am on the right track. 

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