Why Bariatric Surgery is Not the Right Choice for Everyone

It’s not an easy fix. There…I said it. I can’t count the number of times someone has talked about bariatric surgery and referred to it as the easy way to lose weight. I’ve heard it from skinny people, overweight people, people who lost weight “the hard way”, and even people who’ve had the surgery. And I know a lot of people who have struggled to lose weight through diet and exercise, only to fail over and over again, so they see bariatric surgery as their last resort to losing weight, only to see it fail, too.

Did I mention it’s not an easy fix? Because it’s not. There are many different options for bariatric surgery these days, but even from the original days of the gastric bypass down to the now fashionable gastric sleeve, the choice to have this elective surgery is a hard one. Most surgeons and weight loss clinics require patients to go through intense screening before surgery. Nutrition counseling, psychological evaluations, and diagnostic sleep studies are just a few of the pre-op requirements. One friend had to produce records proving she had been attending regular Jazzercise classes for a certain length of time before her surgery. Patients must also start the process of altering their diets to shrink their stomachs and to prep for the kinds of foods they will be limited to once they’ve had the surgery.

One of the reasons I chose not to have bariatric surgery is that I just don’t think I can give up so many foods I love. For instance, bariatric patients can’t have carbonated beverages, like sodas, beer, or champagne. I’ve known people with older surgeries (like gastric bypass) who could not have bread or peanut butter. I can’t imagine never having another peanut butter sandwich for the rest of my life, much less giving up my beloved Coca-Cola…it was all I could do to make myself switch to Coke Zero when I found out I was diabetic. In addition to the foods bariatric patients must give up, there are many things they can’t eat anymore, like spicy food, greasy food, and often beef…all things I love.

Bariatric patients have to eat very tiny meals, but even when they eat all the right things in the right amounts, sometimes they still get sick. Some patients are sick more often than they are not. The surgery and the ensuing dietary changes often cause gastric distress, dumping syndrome, gallbladder attacks, pancreatitis, intolerance of foods they used to love, and even changes in the patient’s blood sugar levels. To make it worse, some well-intentioned patients go right back to their old eating habits, eating all the greasy fried food, carbs, and bubbly soft drinks that made them overweight in the first place simply because they haven’t addressed the real issues of their eating disorder.

In order for a bariatric patient to realize success after their surgery, they absolutely must change the way they think about and react to food. Have you ever heard the saying, “What got you here won’t get you there?” It’s absolutely true. You cannot fix a problem with food by continuing to eat the same things you ate before. A successful bariatric patient (or any weight loss practitioner, really) must come to terms with the mental muddle that caused them to gain weight in the first place, and they must change those patterns permanently. And that is no easy feat. If it was, we would all be a healthy weight.

I’ll admit that I am no expert on weight loss (see that last sentence in the previous paragraph), but I’ve seen enough people get on and off the bariatric merry-go-round to catch on to what many of them do right (and wrong), so I’d like to pass on my best tips for weight loss, and please don’t judge me by the fact that I have a hard time keeping to them myself.

• Small portions rule. A bariatric patient often has a stomach about the size of your fist, so if you are eating more than that, you are probably stretching out, and thus undoing all the hard work your surgeon did to help you lose weight. Stop it. Go back to the small portions you started with and don’t go back to your old eating habits.

• Nix the greasy fried food, high carbs, and empty calories. It’s really hard on your digestive system, and this is the junk that made you gain weight in the first place. Stick to nice, healthy proteins and veggies. If you can’t remember what healthy meals look like, go back to your nutrition counselor and get a list or examples.

• Say no to soft drinks, beer, and anything bubbly. This stuff may taste good, but it often has empty calories, and the carbonation can actually expand your stomach that you just paid that doctor to reduce. If you absolutely have to have the taste of a Coke, let it go flat and be sure to choose a zero-calorie version.

• Stop eating out. Yes, you read that right. Stop. Eating. Out. Restaurant food is over-portioned, high-calorie, high fat, high carb and just wrong, wrong, wrong for anyone trying to lose weight. Yes, I see that mile-high pile of chicken and waffles. Just no.

• Get some accountability. Find a friend who is trying to lose weight, too, and then hold each other’s feet to the fire. Seriously. When you have an accountability partner who has the same goals as you, it will facilitate making the right choices. You can celebrate your wins (even the little ones) and you can talk each other down from the ledge.  Just be sure not to choose an accountability partner who will enable your bad choices. Let them know you expect them to tell you “no” and to remind you why you want to make the right choice.

• Keep a food journal. Document everything you eat and drink. But don’t stop there. While you’re at it, stop a moment and think about why you ate what you ate. Was it a craving? If so, what prompted it? Was it an impulse? What was the trigger? Was it because you had too many choices, or even too few? Really account for what you eat, how much you eat, when you eat, and why you eat. You might be surprised to find some patterns in there, and a pattern is an opportunity to change.

• Remember why you chose to have that surgery and to lose weight in the first place.  It was a hard choice and the path here has not been easy. Remember what you dreamed of when you started this journey – a healthy mind in a healthy body. So, every time you need to make a choice about food, ask yourself, “Is this in alignment with the life I want to live? Does this get me closer to or farther away from my goal?”

I hope that those of you who have elected to have bariatric surgery will find some help in these tips, and if you are considering bariatric surgery, that you will talk with your doctor about the many facets of weight loss surgery. It’s not just a decision to make a permanent physical alteration to your body…it is a life-long decision to live, eat, and think differently about food. It won’t be easy, but it does work…if you do the work.

Have you had bariatric surgery, or have you contemplated it? If you’ve had it, has it worked for you, or did you have early success and then struggled to continue? I’d like to hear about it. You can comment here, or join us over on the MMC Chat group.

 

The Ongoing Battle I Fight

Let me get one thing straight before I begin: I LOVE FOOD. My whole life I have been a foodie. I know this may sound weird because I grew up in a small town and the opportunities to try new things were limited. But I collected cookbooks and watched food shows dreaming of food adventures. We would eat at a “fancy” restaurant twice a year for my mom’s birthday and again on Mother’s Day, and I was always adventurous. Nowadays, eating adventurously is the norm for me, especially since my boyfriend of nine months is a chef. However, there’s one problem… I love food, but food does not love me.

Let’s talk genetics. Can we fight genetics? It’s similar to fate, right? I talked about my genetics in a previous blog and how unfortunate they were. For many years, being fat has been equated with being lazy or unhealthy. I can imagine people thinking “all she probably does is sit around and eat.” Until about 20 years ago, genetics wasn’t considered a reason some people were obese, especially healthy and athletic people. According to the article “Obesity and Genetics: Nature and Nurture,” about 43% of the population have the FTO gene that “predisposes them to gain excess weight.” In other words, if you are not careful to balance your life choices, you could easily gain weight. I used to joke that if I even looked at food, I would gain weight. If you looked at my family, you would see that many of them have fought the battle and lost.

These days, it is all about female empowerment and fat acceptance. Women are freer with their bodies, and they no longer feel like they need to cover up or wear a wardrobe that hides their curves. Growing up in small-town Texas, that wasn’t always the case. My grandmother saw early on that I had the predisposition to be a bigger child and she tried her hardest to steer me in the right direction. By the time I hit middle school, I had been through so many fad diets, and it grew worse as I got older. Aside from my weight gain, it was always a struggle to find nice outfits for a large female that weren’t geared toward an older woman. When I hit high school, I had no fashion sense. I wore “big and tall” t-shirts and bike shorts from the men’s section or oversized shirts with outdated flowers from the women’s department. The closest plus-size store for women was three hours away from where I lived, and we could only afford to drive that far once a year. A single shirt there usually cost around $50 and my family struggled financially, so, I made do.

Despite being overweight and bullied for it growing up, I was a pretty athletic child. The only sport I didn’t play (because it wasn’t offered) was soccer. I was even part of a running club in school called the “Elite Fleet.” None of this athleticism helped me lose weight. Aside from genetics, my family was poor, so we didn’t have the healthiest diet. My mom worked two jobs and oftentimes chose McDonald’s or cup noodles over cooking meals at home. If my mom worked late, I usually had cereal for dinner. Needless to say, my childhood was carb-heavy.

Because I was athletic and healthy, I maintained my weight throughout high school and continued to be pushed through fad diets by my grandma. For example, I was taken to weight-loss seminars, and hypnotherapists, and I was even taken to get my ear stapled once because it was said that the ear staple curbs hunger. According to the Mayo Clinic, “proponents of ear stapling claim that the staples stimulate a pressure point that controls appetite, leading to weight loss.” However, the Mayo Clinic says that ear stapling probably won’t work and it may cause ear infections. As I grew older, I developed a sense of body dysmorphia and depression that led to secret binge eating. I began to feel ashamed of my body, which worsened my depression and binge eating.

Throughout my life, I tried a few diets that did work, but they were never long-term solutions. For example, I tried Weight Watchers twice in my life, and both times it worked well. Weight Watchers is all about accountability and fellowship. If you are not familiar with the concept, you track your food using a point system. You go to weekly meetings and have weekly weigh-ins. The meetings and the weigh-ins held me accountable, and I lost weight doing the program. Unfortunately, programs like Weight Watchers can be costly, and after a time on the program, I wasn’t able to afford it anymore. I tried to keep up with the principles after I left the program, but the accountability was what originally kept me on the diet, and once on my own, I eventually lost my way.

Other diets/weight loss tricks I have tried unsuccessfully:

• Am 300
• Garcinia Cambogia
• Stacker 3000
• Adkins Diet
• Genesis Diet
• Juice Diet
• Herbalife
• Levell

 

In 2018, I started a low carbohydrate diet. The bane of my existence has always been sweets. Both of my parents were diabetic, and I knew I was headed toward that path. A low carbohydrate diet has been the most successful diet that I have been on to date. I don’t consider it a diet but more of a lifestyle change. I cut back drastically on eating sweets and added sugars, I focus mostly on getting protein in my diet and leafy green vegetables but that was only the stepping stone on my path to better health. I was slowly losing weight but not quick enough to better my health. 

 

My doctor suggested I have bariatric surgery and it was the hardest thing a binge eater could do, both emotionally and psychologically, which I will talk about in a future blog. Post-surgery I have consistently kept a low-carbohydrate diet and I have been successful at losing and maintaining since surgery, but every day is a constant struggle to go back to my comfort zone.

Things I do to try and maintain and continue to lose weight:

• Meal replacement shakes: This is mainly to keep my protein up, but a high protein shake in the morning helps me have a great start to my day.
• Small meals instead of large ones: Before surgery, I preferred to eat this way as well. If I eat small meals, I can maintain my energy and stay more alert.
• Limit what I drink to mostly water: I try to drink as much water as I can throughout the day. If I drink something besides water, it will be coffee or tea. Getting enough water is important to me because I feel crappy if I don’t drink enough of it.
• Cheat days are okay: One thing I’ve learned over the years is that an extremely strict diet will only backfire. So, I reward myself occasionally.
• If you fall off the wagon, pick yourself up: Every day is a new day! Don’t beat yourself up for gaining a pound or giving in and eating that slice of cake. You can start again tomorrow.
• Stay active even for a little bit: As a teacher, I move around a lot at work, which keeps me active. When I worked from home during quarantine, it was hard to stay active while sitting at a desk all day. Even if you just walk a little bit, staying active is important.

In conclusion, I am still learning the ins and outs of my body as I gain, lose, or maintain. There is never an exact science to weight loss that I have found. There also isn’t a quick fix. My best advice is to stay positive and always leave room for self-care. One of the biggest things I’ve learned throughout this journey is to love myself and the mess my body is and to strive for inner peace and not perfection.

I want to hear from our readers. What diets have you tried and failed at? Do you have any tips and tricks you would like to share? Let’s continue the conversation in the comments and on our Facebook Group: MMC Chat.

Weight Loss and What I Learned When I Quit Smoking

Fifteen years ago, I did something that I thought I would never do – I quit smoking. After 25+ years of a pack-a-day (or more), I stubbed out that last cigarette and never touched them again. I won’t say it was easy (I had a lot of help), and I’ve often wondered if the same principles and techniques could apply to other aspects of my life. Take, for instance, weight loss. 

I’ve been struggling with my weight most of my adult life. Although I was skinny as a kid and teen, I was not healthy, and from an early age, I learned a lot of very unhealthy habits that haunt me to this day. For one, I always thought I was fat, a misconception that was set in motion by society, the media, friends, family, and even my band director. So I skipped meals, took a very inconsistent approach to exercise, and basically did everything you’re not supposed to do. Even so, I was still a relatively healthy weight when I married my husband, Mark, and I really hadn’t gained much by the time I gave birth to my youngest son at the age of 29. Yeah, I gained a few pounds here and there, which mostly started when I went to work at a 9-to-5 desk job at the corporate office of a supermarket chain (so much food everywhere!). I went from a scrawny, mal-nourished kid to a stressed-out wife and mother of two who just couldn’t stop eating. I ate because it was there (lack mentality), I ate because it tasted good (looking for some pleasure and variety in my life), and I ate because I was stressed, depressed, anxious, jealous, and every other negative emotion you could name (can I have some dopamine and endorphins, please?) Over time, I gained more and more. Age and all that emotional eating eventually took their toll, and I wound up gaining more than 100 pounds, developed diabetes, and was diagnosed with estrogen-positive cancer. As it turns out, estrogen is a byproduct of too much fat.

Now here I am, 5 years after my initial diagnosis, and I’m no closer to losing this weight than I was when I started. In fact, after a change in medications, I wound up gaining 30 pounds – negating all the progress I had made. To make matters worse, the extra pounds have added to my insulin resistance, raising my blood sugars, and causing all kinds of physical discomforts. Right now, my greatest fear is that the increase in heart palpitations (something I’ve experienced since childhood) and the general fatigue are an indication of something even worse (like heart disease) brought on by diabetes and obesity. What will it take to be healthy again?

And that brings me back to smoking cessation. I had tried to do it many times before that fateful day in 2007, but every time I tried, I failed…mostly because I didn’t really want to quit. Deep down inside, there was a part of me that didn’t want to quit; I was just going through the motions because someone else in my life convinced me I should. So, I would quit for a day, a week, a month, 3 months, and then I would just give in – relieved that I didn’t have to pretend anymore. I also think that a big part of that failure was that I didn’t really believe it was something I could do. I heard tale after tale of smokers who quit but still craved, sometimes 20 or more years later. That sounded pretty miserable to me. So I convinced myself that it was better to just keep smoking than to make my life miserable, craving something I could never have. It took me a long time to work up the nerve to quit smoking for real. Six months, in fact. I gave myself six months to keep smoking and swore to myself I would quit at the first of the year. And then I spent that time convincing myself that I really did want it. By the time I actually quit, I was desperate to do so. I talked to my doctor, got all the tools I needed to be successful, and I quit – no looking back and no excuses. Now I’m ready to apply those principles to losing weight (with a few modifications, of course), and I’m hoping this time will be the last time – the time that I actually succeed. So what did I learn from my journey to stop smoking?

• Decide that you want it: You have to really, really, really want this for yourself. Not for your family, not because you should. You have to want it more than anything else. Take some time and figure out your why. Write a letter to yourself outlining why you want to do this – why you must do this. Get real about it. By the time I went to my doctor, I was crying because I was so desperate to quit. That’s the only way this will work. Convince yourself that you will do whatever it takes and then do it!

  
  

• Get help: No one can tackle addiction alone. Enlist the help of your doctor; they will be one of your biggest advocates. There may be medications and other resources that will help. And don’t overlook the benefit of support groups – they help keep us accountable. With the help of my doctor, I was able to use a well-known medication to help curb my desire to smoke. The prescription came with daily email support that helped me figure out the how, when, where, and why of my habits, and an online support group helped me work through my cravings and restructure my life to avoid temptation. Noom and Weight Watchers are both good options for support. You and your doctor can decide if medical intervention is necessary.

  
  

• Tracking is important: Not only is it important to track your weight to monitor your progress, but logging your meals (everything you put in your mouth!) can help you see patterns in your behaviors. But more than just logging the food you eat, use this to track your cravings, too. Record what you are doing, how you feel, and anything else that might help reveal a pattern in your cravings or behaviors. Part of my smoking cessation was to track every cigarette and craving for a week before I started my medication and for a week after. That was very enlightening! I realized that I had several activities that always lead to smoking a cigarette: rising first thing in the morning, after eating a meal, driving my car, and right before I went to bed every night. Knowing this helped me devise a plan to break the habits. Track your food cravings and see if there are some patterns…I bet there are!

  
  

• Remove the association:  Many of the things we do as we go through our daily lives trigger cravings. We’ve learned to associate food with certain activities. We’re a lot like Pavlov’s dogs in that way. Maybe we always eat popcorn when we watch a movie. Or Friday is donut day at the office. The best way to break a bad habit is to replace it with a better one. When I quit smoking, I quickly realized that getting in my car was a sure-fire trigger to want a cigarette. So to break the habit, I changed the habit. Instead of getting in the car and lighting up, I decided to get in the car and crank it up. Singing at the top of your lungs to your favorite song is a sure-fire way to kill that craving…at least for the length of the song. Keep doing that over and over again, and pretty soon you will have forgotten about the cigarette. To break the habit of smoking after a meal, I got up and immediately started washing dishes. By changing my actions at the end of dinner, I removed the temptation and eventually changed the association. To change your reactions to food triggers, you can make substitutions (water), change your environment (go for a walk), or do a different activity (read, sing, dance…). The possibilities are endless.

  
  

• Change the negatives into positives:  We all have little dialogs going on in our heads. We tell ourselves we “should” do this or we beat ourselves up when we make a mistake. When you think about why you want to lose weight, don’t tell yourself you “should” – convince yourself that you “want to” lose weight. Tell yourself, “I am choosing ______ because _________.” Right now, I’m telling myself “I am choosing not to go get a snack because I want to finish this blog.” If I can hold myself off long enough, if I can make it my choice, then I don’t feel deprived, and in all likelihood, that craving will go away before I get to the end of this paragraph. Remember (and remind yourself) that this is your choice. You are the one in control here. And if you do lose a little control now and then, just get back on track. No need to abuse yourself over it.

  
  

• Find an accountability partner: Or partners. Join up with like-minded friends who won’t mince words when you need the truth, and can give you the little push you need to stay on track. Ideally, they can be a workout buddy, a source of healthy recipes, and even a shoulder to cry on when needed. Support groups are also great for accountability. Visit the group frequently (online groups work just as well as in-person) and share your results. Just remember to be honest, and don’t let anyone shame you. Share what works for you, learn what works for them, explore different options together, enjoy some laughs, and tackle some of those hard topics – it will be worth it.

  
  

• Distance yourself from bad influences: Temptation is everywhere, and sometimes even our friends and family can be the cause of it. Learning new habits means that sometimes you just have to remove the possibility of making a bad choice. It also means sometimes you have to set boundaries. When I quit smoking, I made a conscious choice to avoid the other smokers in my life. I didn’t want to be around them because I didn’t want to be tempted by something I had decided was a bad choice for me. I didn’t go to places where people smoked and I didn’t hang around the people who did. That’s easy enough for an ex-smoker, but it’s not so easy for someone trying to lose weight. You can’t just avoid food. And while I haven’t known a single smoker who tried to convince me to smoke, I have had lots of people offer me food, even insisting that a little bit wouldn’t hurt. But the truth is, a little bit does hurt, and for someone to push food on you knowing that you’ve made a different choice is the worst kind of sabotage, and they aren’t really your friend. Set your boundaries. If they can’t stick to it, then just avoid them for a while. Get your reactions under control. Once you can do that, then you can confidently resist their temptations and you might even be able to have that little nibble of pie…but you probably won’t want to

  
  

• Write a new script:  You can’t always avoid temptations, but you can learn to react differently to it. I remember when I first quit smoking, I hated walking past people smoking in parking lots or near the entrance of stores. In the past, it always made me crave a smoke, but in that last go-round, I decided to try a little psychology instead. Every time I smelled cigarette smoke, I told myself it stank and I would make a gagging motion and hurry to get away from it. Over time, this reaction became a reality – I actually did think it was stinky, and I wanted no part of it. To this day, the smell of cigarettes makes me gag. Okay, so telling ourselves that food tastes gross is probably not going to work, because we all know how delicious it really is, but you can try a variation like, “That’s too salty”, “that’s too sweet”, or even “that is going to make me feel bad after I eat it.” Keep saying it every time you are tempted…you may actually start to believe it, but most importantly, you will have made the choice not to eat that tempting treat. If you keep doing that over and over and over again, you will have made a tremendous amount of progress. So just keep telling yourself whatever you need to tell yourself and believe it!

  
  

• Watch out for social media:  Friends and family aren’t the only food pushers out there. Food is everywhere. I can’t count the number of food temptations that slide across my Instagram and Pinterest feeds every day. Even if they are healthier options, too much of a good thing can go the wrong way. I never realized how many references there were to cigarettes until I quit smoking. Suddenly, I saw it everywhere: on tv, in movies, ads in magazines, pictures of friends on Facebook… If you can’t stay off social media altogether, unsubscribe, unlike, block, or mute temptations that show up in your feed. Ask that friend who’s always sending recipes and pictures of decadent desserts to please stop. Watch out for food in books, magazines, television, and movies, too. There’s a scene in the movie Julie and Julia that literally makes me want to lick the screen – it might not be a good movie to watch if you’re trying to go low carb.

  
  

• Set S.M.A.R.T. goals:  Although this isn’t really related to smoking, it is very relevant to weight loss. Setting yourself up to succeed is just as important as wanting to quit (or lose weight) in the first place. We talked about setting SMART goals in our first topic for 2022. Make both short- and long-term goals, and make sure they are Specific, Measurable, Actionable*, Realistic*, and Time-based.

  
  

• Reward yourself:  My husband quit smoking three years before I did, and when he made it to one year, he rewarded himself with a brand new iPod. It was a fairly new gadget at the time, and he felt like he earned it. I have to agree. My Noom program encourages setting up a reward system as well, with different kinds of rewards: healthy, tangible, self-care, and social. An example of a healthy reward might be splurging on dinner at a healthy restaurant, trying a new workout class, or even taking a nap. My husband’s iPod is a great example of a tangible reward. For me, a new outfit or a music download is the perfect reward for a short-term goal. Self-care is a reward many of us tend to forget about, but don’t pass up the opportunity to reward yourself with some self-care when you’ve earned it. I like getting a mani-pedi, but you could also opt for a massage, a quiet afternoon of reading at the library, or one of my favorites – crafting. The last category of rewards is social, and that could mean coffee with a friend, going to a movie, or even a special afternoon of fun with your children or grandchildren. Whatever you decide for your rewards, choose something for each category and then use them intermittently throughout your progress. But don’t allow yourself to get too cozy or come to expect those rewards on a regular basis because you don’t want to set up an unhealthy cycle of expectation.

  
  

Going back through the lessons I learned when I quit smoking has helped me become more aware of some of the negative patterns in my struggle with weight loss. I’m hoping these new insights will help me break the old habits and conquer this beast once and for all. I’m ready to step into my new life as a healthy, happy, and active grandma, wife, and mother. I'm ready to make that change. Want to join me? Join the conversation in our MMC Chat Group. 

•Some sources use Achievable and Relevant