So my return here for the two-year mark has me wanting to think out loud about some stuff, I guess. I do really like this space for thinking through things.
I often feel pretty out of step with the general discourse here or elsewhere in WLS support internet space. I have a sense of myself as a "bad" patient, I think, someone who gets away with things, who breaks or bends or disregards the rules, who doesn't work hard enough. The constant vigilance! The culinary monotony! The things that aren't delicious! How do people do it? I feel simultaneously concerned that I should be doing it and delighted that it seems like I don't have to.
For example: you hear a lot of people talking about how they gain on fourteen hundred calories a day, twelve hundred calories a day, a thousand calories a day. I am not one of those people. I don't track, but I have been a disordered eater and a recovering disordered eater for long enough that if I stop and think about it and adjust for the human tendency to underestimate, I can ballpark my daily intake in my head. I would say it is pretty much always north of fifteen hundred, probably more likely usually around 1800-2200. There are definitely days it's above that, too—sometimes I go out for ice cream/fall face-first into a box of See's candy/drink three cocktails instead of two Jameson-and-sodas/end up reverting to symptomatic late-night-secret-eating habits while visiting my parents/pull an all-nighter fueled by sour cream and onion chips and citric-acid sour apple gummy straws/have a terrible hangover that ABSOLUTELY REQUIRES as much of the neighborhood's best bacon egg & cheese on a roll as I can comfortably contain. That makes sense as an estimate, because when I go to my favorite calculator and calculate my approximate total daily energy expenditure (TDEE) I get a number just above 2200, which is to say, if my normal range is at or just below that mark, and then there are some higher days, I am eating in a way that maintains the weight I'm at now. Energy balance is a beautiful thing. This number suggests that I have a normal human metabolism, which is particularly delightful news given that my endocrine system has been borked since childhood.
I'm tempted to say that I have a hunch that folks who swear they gain on a thousand calories tend to underestimate their own consumption (which is an empirically observed phenomenon and not a personal flaw) but it's also true that a lifetime of dieting is a predictor of metabolic damage (it's also empirically observable that people who've lost a lot of weight often need to be more active and consume less than people of the same weight who've been weight-stable most of their lives). I wonder if the years I spent as a superheavyweight (this is the technical term for the weight class, not negative self-talk!) powerlifter, training twelve hours a week and radically increasing my caloric needs and then increasing my intake to match them helped me repair some metabolic damage. I also wonder if because of the degree of peace I came to with fatness I'm simply content at a higher weight than some others might be, which means I don't have as much of the psychological need to fight my body all the time to maintain a weight lower than the one to which it's internally calibrated (even after the recalibration effect of a surgery like the VSG, which is one of the reasons I chose it in the first place).
I also eat regular food, mostly, which seems sort of not to be the way of things for a lot of folks after WLS. I keep Fairlife high-protein milk in the house for coffee (though I sometimes use regular whole milk and sometimes buy half-and-half), and Breyer's Delights protein ice cream in my freezer, but on the whole, I just eat regular things. (Not always the same things I ate before surgery, but things that are normal food items.) It's a holdover from ED treatment, really—they did whole milk there, no reduced-fat things, and I never switched back; also diet foods make me uncomfortable because they feel shamey. And I dislike artificially sweetened things, as a rule, except Diet Coke; yes I know it maybe kind of gives you cancer and Alzheimer's but I simply do not have the energy to deal with rather than indulge my Diet Coke habit; there is a lot going on over here and it doesn't even crack the top ten on the priority list.
Yesterday I had four strips of bacon and two-thirds of a piece of toast with mayonnaise and two fried eggs for breakfast; I finished the egg toast with half a grapefruit a few hours later; I slugged coffee with Fairlife chocolate milk all morning and much of the afternoon; I had six homemade chicken & vegetable dumplings (pan-fried) for a late lunch; I had some feta cheese with tomato and olive oil and garlic and about half a pint of protein ice cream for dinner; I had four ginger chews before bed. Oh, and some home-brewed kombucha, because I'm that person these days (frankly, I worry about the sugar but apparently the yeasts eat most of it).
Today I had another egg toast (four strips of bacon and two fried eggs on top of tomato, scallions, and feta cheese; it was a significant achievement in the field of breakfast and kept me full all day), more coffee and Fairlife chocolate milk, a prefab ma po tofu for dinner, some protein ice cream as a snack, a jerky and two ginger chews even as we speak. This one's on the lower end of things. I'm okay with that.
Like pretty much I'm a normal person. I do still have significant volume restriction—I notice it most when I eat out with others, when I am conscious of how little it looks like I've eaten in comparison—but these are pretty normal amounts of food for a human to consume. Which I enjoy! But which also seems out of step sometimes. Equally unusual: I employ no diet plans (i.e. I eat carbs, albeit in relative moderation that has more to do with space in my modified anatomy—and not just the "good" ones, either—and I have no macros and I have no calorie goal and I will try a bite of anything. And if failing to plan is planning to fail, baby, I'll take the F. I run out the door running ten minutes late figuring I'll grab something later a lot.
I have also been known to play pretty fast & loose with the no-drinking-and-eating rule. I could maybe experiment to see if it matters—it honestly hasn't really felt like it does for me. If I drink while I eat, I take little sips slightly less often than I would ideally like to until it's been an adequate amount of time.
But here's the thing: when I really think about it, I actually do think I'm a pretty good WLS patient.
I do plan on a longer-term basis—I think about what I want to have in my fridge for the week, and I certainly consider my nutritional needs a priority in that planning. I build around protein options (and try never to eat a meal without a substantial protein hit, and ideally not snacks without them either). I keep an eye on what I have a tendency to overeat (chocolate, popcorn, those perfectly sweet-salty butter toffee cashews from the coop, sesame sticks, pasta, takeout, good bread) and make changes if things are going overboard (stop bringing them into my house for at least awhile, figure out what I need to/can sub in for them)—I don't just beat myself up about it and get into cycles of compulsivity, I actually just change the thing (I mean, it takes a minute, but for awhile I was overeating chocolate and now I'm not). I batch-prep things I want to be able to grab quickly (beans, tuna and chicken salad, poached shrimp, dumplings for the freezer). I try to add a little greenery to every protein thing. I usually keep a protein bar and a stick of jerky or two in my bag so I don't have to eat any old thing if I'm running around the world (I also eat a lot of drugstore string cheese; so sue me).
I've expanded my culinary horizons in ways that work for me, and enjoying expanding them keeps me getting pleasure out of my kitchen life, which is super self-caring for me. I'm really having a tofu moment. I've also established new rhythms in the kitchen that work for me now around what and how I'm eating. I've done some pickling and fermenting (kombucha; I'd like to start doing sauerkraut again). My favorite want-a-food-experience-don't-actually-need-one-want-one-anyway snack is just chopsticking (bought, not homemade) kimchi right out of the jar. I also like hot sauce and spiciness in general way more than I did before surgery—I think it's about sensation. I want more POW from my food now, often. Which has the interesting effect of making a lot of easy-to-overeat foods kind of less thrilling.
I was scrupulously compliant when scrupulous compliance was necessary. The only thing I ever advanced on early was seltzer, and that very cautiously and only slightly before my surgeon had said I could try it. I weighed and measured food, tracked it, counted my calories, hit my numbers, took my vitamins, and drank my water. I still take my vitamins and drink my water—I'd let it lapse, then noticed that it was affecting me and got it back on track (I literally text my partner every day she's not here with a picture of a palmful of vitamins).
Even though the amount of food I eat is a pretty normal amount of food for a human to eat, it's also true that it's not historically a very normal amount for me. Like, six dumplings would have seemed like not enough dumplings. I really like dumplings and sometimes I'm mad that I can't eat more of them. (Sometimes I eat eight dumplings. Sometimes six is fine.) A box of mac and cheese definitely felt like not enough mac and cheese, like it just looked so small; if I get one now it lasts two meals and maybe a snack (also I still glow it up with extra cheese, which definitely makes me feel like a bad WLS patient, but honestly otherwise what's the point?). And when I see the box, it doesn't look so small anymore. It's getting to be normal, is the thing: I'm recalibrating. A few weeks ago I caught myself exclaiming over how giant the ice cream cone I'd just been handed was, and then felt like it was a kind of jerky diet-culturey thing to say (especially in the context of my family), but the thing was, it just looked so giant! (It was objectively giant.) A recalibration of perception. Another recalibration: figuring out what my hunger and fullness cues are now. When I worked with an ED nutritionist for years, we did a lot of this: rating hunger and fullness in the food logs I kept for her. I realized recently that I'm figuring out when I'm hungry post-VSG. It's a different sensation: it's not in my stomach anymore so much as in my gut. I think that it has something to do with my actual body needing fuel even if my stomach isn't yet actively distressed by its emptiness. I had to look for it a long time in order to find where it had gone. But I'm catching on. It's there if I look.
The point is, there's getting to be an auto-pilot in there, I think. I mean, that's what I'm hoping. I feel self-conscious about saying that I eat like a person and my weight is stable; I feel like someone's going to swoop in here and slap my hand and tell me I should be weighing and measuring and counting and don't I see I'm still quite fat? But I'm doing what works for me. This works for me. I guess I think the reason that I'm actually a pretty good WLS patient is that I'm in command of my own choices. Could I do the weighing and the measuring still? Yes, sure, I guess. Could I lose another ten, fifteen, twenty, even thirty pounds if I did it really rigorously? Yes/probably/maybe. Do I think the effort is worth the reward? Not really. There are a lot of things in my life that need my energy right now! It is frankly kind of insane! I don't have the brain space. But I do think it's potentially worth it to see if I can take another little step down without doing those things, just paying a little more attention. And I definitely think it's worth it to squelch any symptomatic eating that threatens my long-term stability. I feel good about the fact that I'm not denialist, avoidant, or helpless about that. That needs my attention, it gets it, my attention can change the behavior. That's reassuring.
I definitely don't want to sound like I have everything all together. I am still paying a lot of attention to this thing. I have some moles to whack that other people probably don't—symptomatic behavior and the things that trigger it, my slightly intense aversion to being too diet-y, etc. I worry because when I'm making a conscious effort to eat on the lower end, I am also on and off the scale all day, just like I was my freshman year of college when the disorder really got me, closed the walls in around me. And I'm sure that someone will think that my consumption of a box of mac and cheese every couple or three months is a slippery slope to hell. Please don't comment to tell me so! I respect your opinion but am okay with the choices I'm making. That's sort of the thing: I'm okay with the choices I'm making. I'm making my choices consciously, with respect for reality and the difference between want and need, which puts me in the driver's seat. And as long as I'm there, I feel good about where I am.
...it turned out I had a lot of feelings about this!