ThinCVT

What surgery DOESN'T do - a must read for newbies and veterans

28 posts in this topic

This article, by Susan Marie Leach, was posted on another forum and it may be some of the very best advice I've read for anyone considering WLS....or for those that may have "forgotten" what is really important in the recipe for success.....


There has been a sudden explosion of advice and opinions floated out there by a brand new crop of bariatric experts. I would like to make a few points that I feel have been lost in the shuffle of bariatric information that is all around us. Generally, having more information is helpful, but just because someone writes something, does not mean that it is so. Present company included – although I have a pretty good track record over the last ten years for accuracy and consistency.

This surgery is not a walk in the park. It takes a concerted effort to actually live in a way that is diametrically opposed to the way we have been living for most of our lives. You don’t just wake up after bariatric surgery and find that you no longer have a taste for a Krispy Kreme. You have to develop that disdain and disinterest in such foods by finding other things that while are not a Krispy Kreme, give you just as much or even more happiness than the soft squishy donut when paired with weight loss.

My RNY surgery was in 2001 and I can assure you that I would not have had a shot at keeping off 125 of my original 150 lost if I had not stopped eating the crap responsible for my morbid obesity in the first place. Many of the current crop of advice givers, most still in the ‘honeymoon’ phase of one to three years, don’t seem to grasp this concept as they have not yet lived through it. I have done it too along this journey – loudly proclaiming that the twenty pound bounce was ‘an excuse’ – but I was just a couple of years post op and holding the line quite well so it was reality for me at that time.

The phrase Honeymoon Period is an often quoted and vague concept to some (sort of like saying ‘Gold Standard’ when referring to RNY surgery – what does that really mean?) Marriage is rough in the long run – but when we first get married, we live in that fog of bliss for a brief moment called a Honeymoon, where all is good and the reality of money, housecleaning, laundry, kids, money and personal habits have not had a chance to drive us mad.

Ditto for bariatric surgery. When we are first turned into surgically altered freaks we have no idea that we are not actually steering the car. Or better yet, we do not realize that we have absolutely nothing to do with our massive seven month weight drop. Some folks are already off the path at this point, snickering all the way ‘I am eating all my favorite stuff, nothing is making me sick and I am still losing weight, hehehee.’ or my all-time favorite justification for early Krispy Kreme eating, ‘I have lost 55 pounds in four months, I must be doing something right.’ Nope, during the Honeymoon Phase – we could have been washing down Fluffernutters with McDonald’s shakes and still have lost that first 85 pounds.

Reality Check: If you have ever been on a diet, think back to what you had to do in order to lose even 45 pounds. How many salads with lemon juice, horse urine injections, public WW weigh-in humiliations, pots of cabbage Soup, making yourself throw up after meals, and prescription speed cocktails did we endure for a forty five pound loss? Why would this suddenly get so easy that we could have our internal organs rearranged and not have to change our eating habits as well? Give that some thought.

Folks who are two years post op have no idea what it’s like at six years post op when what you have been doing not only comes to a screeching halt but seems to reverse itself and the weight begins to creep back on while you watch in shock and horror as every bite seems to count. Things that didn’t matter suddenly do matter – in a bizarre Revenge of Pretzels and Drinking with Meals.

If you have not used surgery as a turning point in life – a line in the sand, you are eventually in for a world of bigger hurt and guilt than you could ever imagine. What I am getting to in a delicate way is this: Don’t let people BS you that you can simply eat whatever you want in smaller amounts and not only lose on down to a size eight, but keep it off forever.
We have a serious personal responsibility after bariatric surgery to take care of the body that we have willingly cut apart and rearranged. While the surgeons have got the procedures down to a science it’s not simple, nor is any of it truly reversible or non-invasive. Don’t minimize what you have done. It’s a big deal and the changes are drastic. Don’t order the Pasta when you go out to dinner – don’t put the bag of chips in your cart at the grocery store – don’t even go there and order the side of fries – don’t eat the rest of the macaroni and cheese on your 6 year old’s plate as a habit – think about where those moves got you.

A few words about compulsion and emotional eating. I know that some of the things I just said are actually impossible for some of you. You don’t want to eat certain foods but are driven to do so. You don’t know why you are not able to stop buying or eating chips or the donuts at the coffee machine in the office and you feel as if you are a failure because of it. During the last four years in particular I have learned more about emotional disorders than I would have ever dreamed possible unless I had not been living through it by proxy. You are not able to fix this by yourself or stop eating these foods simply by willing yourself not to. Weight loss surgery is not the answer to fixing your life.

If you have already had bariatric surgery and find that you are upset over lack of control in your life, are careening out of control, obsessed with not being able to comfort yourself with massive bowls of food, are not able to keep relationships, can’t help stuffing even good foods mindlessly into your mouth, have fallen into deep sadness, look at others who are losing weight with hurt and jealousy, and find yourself crying out for attention – get professional help. Your situation may not have a lot to do with being morbidly obese – being morbidly obese is probably a symptom of situations you have had in your life that were not your fault.

The brilliance of Connie Stapleton PhD nailed it and I am paraphrasing here but she said that having bariatric surgery will not do anything for you other than physically making your stomach smaller. That is it. You will have the exact issues and emotions you have always had. There is the distinct possibility that if you fix your life or at least attempt to do so, that you will be able to take control of all aspects of life, including your eating patterns.

Treat yourself with kindness and love, know who you are taking advice from, and if you feel a bit lost it is a very good thing to find a professional so you can talk through what is on your mind. Life is a Journey – but a Bariatric Journey is even more challenging if we don’t pull together and help each other.

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What an outstanding article. Thank you for posting it. :)

Connie77 likes this

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Great article.  Too bad, as we have seen here, it won't resonate with everyone and probably with those that need it the most.   Its amazing how there are people who still refuse to believe 5 years from now is any different then that first year -  despite 'veterans' giving stories, warnings, advice and the reality of it all.  I wish people didn't have to learn the hard way.  I wish *I* didn't have to learn the hard way! 

WendyH, BelleCurves, GAviv and 6 others like this

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While I don't like being referred to as a "freak", because I'm not - the blog post confirmed many of the beliefs that I have held about bariatric surgery. I know that in the beginning, it's not me doing all the heavy lifting - it's my smaller stomach. I do have to put in work after my initial success. I want to be able to be one of the long-term success stories. I have drawn a line in the sand with my surgery and I hope I can maintain this mindset. 

Ficklemom, Dela73 and Radhika like this

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I know that in the beginning, it's not me doing all the heavy lifting - it's my smaller stomach. I do have to put in work after my initial success. I want to be able to be one of the long-term success stories. I have drawn a line in the sand with my surgery and I hope I can maintain this mindset. 

You and me both. 

tmcgee, Snippets and bcd like this

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I have heard most of that advice and those warnings given here already in one form or another, but WOW that piece is very well said.

Once I understood the concept of the Honeymoon, I have always been especially on the lookout for folks who were more than a couple years out of surgery. I know that's where the real battle is, and am very much looking for the successful folks' coping strategies and methods.

Snippets, Dela73 and GAviv like this

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I found this article helpful, although it makes me worry a bit that I have a problem coming up in the next few years since I am now two years out and everything is going very well....

WendyH and Dorothykirton like this

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I found this article helpful, although it makes me worry a bit that I have a problem coming up in the next few years since I am now two years out and everything is going very well....

It does get harder after a couple of years, we just need to remember what we had to do to get the weight off in the first place, looking beyond the surgery into lifestyle food choices and portion sizes. Someone I know who had it a year or two before I did warned me that you can defeat it "one m&m at a time". Exactly right!

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I found this article helpful, although it makes me worry a bit that I have a problem coming up in the next few years since I am now two years out and everything is going very well....

Ditto for me.  That's why I liked this article. Kind of a red flag for me to remember things may change and I cannot become mentally complacent.  I think we all need to be proactive in developing the psychological strategies needed to deal with whatever our WLS evolution brings, regardless of what stage we are in.

Res Ipsa, tmcgee, Raeme and 1 other like this

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Just thought I'd bump this for the new newbies

HealthyJen and Res Ipsa like this

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Good reminder ThinCVT.  The journey is a lifetime.  There is no final victory, just daily achievements.

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4 hours ago, PapaG said:

The journey is a lifetime.  There is no final victory, just daily achievements.

You are so right.  This is a lifetime journey - an amazing journey, but still a lifelong one.  :rolleyes:

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This was a great read, a real help and I think it should be pinned.
Thank you for writing it.

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7 hours ago, LeeC said:

This was a great read, a real help and I think it should be pinned.
Thank you for writing it.

Done!

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Whatever we had to do in the beginning BEFORE surgery to lose weight is what we will have to do to keep it off AFTER surgery, no liquid diets, just good HEALTHY eating. Our stomachs (or sleeves, I hate that term) will always help us, I am amazed at how after one year post op I still have so much restriction when eating protein. This lifelong journey for us "easy gainers" will always have to be "watered" and "pruned" as us gardeners would say. That in itself is sobering but a true fact of MY life. I have learned to be happy WITHOUT food, I will not be controlled by what goes in my mouth....

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Edited by latina63
Me and my youngest Christmas
LeeC, Snippets, ThinCVT and 1 other like this

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Thanks for this article. I'm pre-op so I'm going to keep it and read it weekly.  

 

 

Shirleymac likes this

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Yes, that is a great article and a sober reminder that this is a tool that we will use everyday to eat healthier for the rest of our lives. And that if we do falter, we get right back up and keep going rather than throwing our hands up and giving up! You have to keep your eye on the "prize" and not loose sight of that because you will unwrap it everyday by eating foods that will keep you feeling and looking good. I have lost over a hundred lbs back when I was in my 20's and kept it off until mid 40's so I do know how to do it and keep it off without surgery but I have tried for 4 yrs now over and over only to fail and ended up gaining it all back and then some. Maybe I got lazy, maybe it was menopause perhaps both but I just couldn't do it anymore and felt helpless as I watched the scales creep up. The decision to have WLS has given me hope and feel like this is a second chance to achieve my goals! Thanks and will use this article from time to time for reality dosing as needed to keep me on track.

ThinCVT, LeeC and Sleevalicious like this

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I was searching for something entirely different and came across this for the second time.  I'm a little over a year out and reading it now is even different than when I first read it a little over six months ago.  I don't think this can be said enough. 

LeeC, JulieW and ikantspel like this

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I just had my bypass a couple weeks ago and came to this site looking for support and insight. The article was well written and very informative. I have gone under the knife but had I read this first I might have tried a bit harder to work on some other issues first since my diet was fairly healthy before and I'd trained myself to leave the junk foods in the stores. Now I will work on them and continue reading healthy foods, only in moderation.

ThinCVT likes this

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42 minutes ago, ManyVoices said:

I just had my bypass a couple weeks ago and came to this site looking for support and insight. The article was well written and very informative. I have gone under the knife but had I read this first I might have tried a bit harder to work on some other issues first since my diet was fairly healthy before and I'd trained myself to leave the junk foods in the stores. Now I will work on them and continue reading healthy foods, only in moderation.

It's never too late to start working on whatever "issues" led to your obesity.  I was two years postop before I finally admitted I needed help and started seeing a therapist.  I had lost all my excess weight and had maintained that loss for over a year, but I was far from happy.  My therapist, an antidepressant and some hormone level adjustments has turned my life around almost as dramatically as surgery.  Turns out the psychological and physical aspects of obesity are very much a package deal.

wishing you all the best...you are just at the beginning and have a whole new, wonderful life in front of you.

cinwa and Aussie H like this

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On 12/24/2015 at 9:00 AM, ThinCVT said:

The brilliance of Connie Stapleton PhD

  Connie Stapleton is brilliant! She is the doctor who gave me my  psychological evaluation. She has a book called 

Eat It Up! The Complete Mind/Body/Spirit Guide to a Full Life After Weight Loss Surgery

 that I have ordered.

Jabsie, Ficklemom and ThinCVT like this

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This is a great read! It's something I really needed to read today. It reminded me that even though I'm more than a year out, I'm still a Newbie and have much to learn. Thanks for the link Babykinz, I just ordered the book!

I'm a data nerd and have never made any health decision without scientific proof of its validity. I did a great deal of research about weight loss for a blog I was writing in the year prior to making the decision to pursue WLS. I read endless articles, medical studies, clinical trials, etc..., and what is apparent to me is that there are physiological factors that cause compliance to be such a challenge where weight management is concerned that continue to elude the medical community. The current medical directive for obese persons continues to be diet and exercise despite the overwhelming data that shows that very few people actually comply with their doctor's instructions. Although those who have less than 50 lbs to lose are more likely to be successful, only 5% of people who have 100+ lbs to lose are able to do so without surgical intervention, and only 1% are able to keep their weight off for 5+ years.....99% of people who are 100 lbs or more overweight are unable to comply with the standard treatment for obesity. Can you imagine any other medical condition for which doctors would direct a treatment that had such a high failure rate? By contrast, people who have bariatric surgery have a 50% chance of keeping off their weight for 5+ years. It was a statistic that was impossible to ignore and is what sealed the deal for me.

But that leaves the other 50% of those who gain all their weight back after surgery. It speaks to the power of the desire/compulsion to eat has that in spite of having our digestive system significantly altered, we still are compelled to do it. So down the rabbit hole I went....what do these 50% of people have in common? As it turns out, there are common correlations that are consistent with what the author noted. The 4 most significant ones are as follows:

  • Failure to keep up with doctor's appointments - When people begin reverting to old behaviors, they often avoid their doctors and therefore forfeit the opportunity to make small course corrections.
  • Untreated/unresolved childhood trauma, in particular sexual abuse - The correlation between obesity and childhood trauma is very well documented. Those who do not professionally address these issues in a therapeutic setting are at substantial risk for becoming obese and this risk continues to be present regardless of a person's surgical status.
  • Family/living situation where others continue to engage in behavior that causes or contributes to obesity - This one isn't difficult to understand. It's pretty hard for an alcoholic to stay sober if they are living in a home with other active alcoholics. Further, the family dynamic complicates people's effort to get and stay healthy as those who are actively engaging in unhealthy eating habits may attempt to sabotage the efforts of the patient.
  • Failure to accept personal responsibility - Those who do not fully comprehend or accept that the surgery will not 'fix' their obesity are at the biggest risk of regaining their weight. As the author noted, there are many people who check out during the honeymoon phase and let the surgery do all the work for them. They come to depend on the restriction and forget that eventually, they are going to have all the same feelings and desire to eat that they had before and if they don't use this time to develop coping strategies and do the hard emotional work, they will find it just as hard (and perhaps harder) to resist their compulsions to eat.

Pretty much all 4 of the above noted correlations can be addressed with professional therapy. If I think I can lose the weight and keep it off and not address the reasons that caused me to become fat in the first place, I'm probably going to fail. The article is a clear, no nonsense reminder of that. Thank you so much for posting it.

Edited by Jabsie
Ficklemom, Rivermom and ThinCVT like this

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Jabsie... Thanks for the post and sharing your findings.  I think the 4 pillars of WLS failure you listed are spot on.  And although I don't have any deep seated childhood traumas lurking beneath the surface, and I get nothing but support from by friends and family, I still would not be where I am today in terms of maintenance if it weren't for my therapist.  It's the alternative coping mechanisms I learned for dealing with stress, emotions and life's general unpleasantness that keep me thin...and sane.

Jabsie likes this

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Great post and really helps put pre-op into perspective. Going in eyes wide open and little wider now. 

Thanks

Rivermom likes this

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My surgery is day after tomorrow. 2/21. Should I halt from doing this?

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