Notes from Support Group

I learn so much from our support group leader, Abby. Here are tonight's notes. The hormone Leptin increases with sleep deprivation. Leptin increases hunger. Abby talked about Prochaska's model of Change State Process. You can read about it here http://www.cellinteractive.com/ucla/physcian_ed/stages_change.html but essentially it means fake it 'til you make it. Someone was talking about feeling guilty for what they ate and Abby said that guilt is driven by arrogance. This is an interesting concept and she described it this way. You would have to believe you are super human to believe that you will not fail or stumble. To believe that you are not going to fail at some point after surgery implies that you are arrogant enough to think you are super human. One of the other things she talked about was one of the causes of dumping. In a normal stomach, 20 or 30 grams of sugar is nothing because it is diluted and spread throughout the stomach cavity. In a pouch, 20 or 30 grams of sugar is a very concentrated amount in relation to the size of the pouch. If someone with a normal sized stomach ate an equivelent ratio of sugar, they would also get sick and dump. This was day 4 of the pouch test and ironically the hardest for me. The day wasn't bad, but I ended up doing what I've avoided all along and was ravenous. I had a tough time finding time to eat and didn't get to eat before SG. By the time I got home I was starving and it was hard to get balanced again. I stuck with what I was supposed to eat, but probably ate more than I should have.

I hate coming home from work hungry cause it sets me all up to eat more than i should and forgoet about this diet/program/eating thingy. so when i was on my way home last night i was starting to htink about what i could eat to make the hunger go away right away. why do we think when we get hungry that we aren't going to eat again? i just want to make it go away! i had an extra water in the car so all the way (30 minunites) home i sipped that thing. when i got in i popped the lean cusine in the micro changed clothes took the dog out while it cooked then when i came in i sat down and ate. it worked out good. tonight i'm going to be sure to have an extra bottle of water handy for the ride. last night when i was knitting and watching my programs - monday nights i do not like ot miss comedy tv - i was feeling alitle bit of hunger so i made myself a cup of decaf and a big bottle of ice water. sat and drank that. filled me up! of course i was up most of the night in the bathroom hahahaha its now a concstant thing of dieting. but i did do well with this 5 day thing. i was fuller longer. do you write everything down? that was a big help to me and so far i'm keeping that going. even when i had tootsie pops i wrote them down! those suckers have 60 cals!

Hmm interesting but I dont know if I agree with guilt for me means arrogance...I know there is going to be slip ups and YES after I do them I still feel guilty but I accept that it will happen that Im not superhuman though I WISH I was would make things alot easier LOL AS for this 5day test...I dont feel like Im on a diet at all...Im not hungry...I seem to really be eating more often then before, but less....just healthier things, no****ching calories just carbs and the weight is still coming off. Im just wondering if this will last. I sure hope so.....

This is good stuff. Who is Abby? She sounds extremely qualified to be leading WLS SGs, especially in terms of the emotional/psychological aspects of the issues. I continue to beat this drum -- this is not WW or Jenny Craig! I'd sure love to be a fly on the wall of your next meeting - hey, maybe you can tape record it somehow and mail it to me!!! M.

My surgeon has paid professionals who lead the support groups. For those who are 4 months out and more, we get Abby who is a psychologist one meeting and two weeks later, a licensed dietician and they rotate back and forth. She has another group for the lap banders and another group for those who are pre-surgery and up to 4 months out. I really can't complain about the support groups at all and there is no charge. Someone just sent me the article below from one of the surgeon's psychologists. by David Engstrom, Ph.D. You probably remember hearing quite a bit in your classes at Scottsdale Bariatric Center about the importance of mindful eating after bariatric surgery. We all hope you are still following the 30-20-30 rule and of course, not drinking liquids with your meals. Beyond these basics, it's important to stay mindful of several old behaviors that can be traps and impede weight loss. Since we all need little reminders every once in awhile, it is important for you to reflect on your eating behaviors after surgery, since control of these makes your ultimate success far more likely. Consider if you will, what we call the Five Gs of non- mindful eating. They are gulping, grabbing, gorging, grazing and goodies. I will almost guarantee that every human being has done one (or maybe all) of these. We will examine them one at a time. Gulping: Basically, gulping is about fast eating. Many people who are candidates for bariatric surgery are fast eaters to begin with. Most rapid eaters find that their eating speed slows down significantly after having either a bypass or band. When you think about it, our eating speed is something that doesn't change much throughout our normal lifespan. Of course when we eat too fast, our brain doesn't receive signals of satisfaction from our stomach until it is overfilled. You can prevent gulping by slowing your pace and enjoying the smell, taste and texture of your food. Grabbing: This is a good example of "eating on the run". It is the "fast grab" that many people do in convenience stores, airports and shopping malls. It is largely made up of impulsive, non-selective eating which is not driven so much by physical hunger as by convenience and spur-of-the moment food decisions. You can most easily avoid this trap by carefully planning your eating, so you don't get stuck in a mall or airport, physically hungry at 5PM with no eating plan. Gorging: Essentially, gorging is about "big food". So many restaurants these days have increased portion sizes that it is very easy to gradually accommodate more food. We all begin to think that this is the norm. If you have been to restaurants like the Claim Jumper or the Cheesecake Factory, you understand the meaning of gorging and big food. Just remind yourself of the way you felt when you had your first mindful meal with the dietitian a week after your surgery. Stay in tune with feeling "satisfied". Grazing: We all have a basic drive to graze, or mindlessly nibble on snack food during the day. There are probably several reasons for grazing, including the old dieting rules of eating many small meals throughout the day as well as mental states like boredom or the stress brought on by time pressure. Grazing is a self-defeating behavior after surgery. It is most often done just because the food is "there", and available, like that bowl of peanuts on your table. To avoid it, you may have to get rid of foods that trigger the urge or if that is not possible, learn some incompatible behaviors like taking a walk, drinking water or practicing relaxation at those times when you're most likely to graze. Goodies: Any food that you can visualize as being "forbidden" or "sinful" could probably fall into this category. We all have urges for goodies that may stem from the comforts of our childhood or from the stress-relieving properties these foods brought about in the past. More often than not, they are things that are more processed and not terribly good for us anyway, like overly salty and greasy foods or those that are full of sugar. These are almost always the "center of the supermarket" foods **** cream, cookies, chips or candies). This is an area where you just have to draw the linem don't buy them!!! Stick to the "edges" of your market (produce, eggs, cheese or other protein ) and you'll be much better off. These are just a few of life's little mindless eating traps that you should take care not to fall into. When you eat in a non-mindful way, you are really going on automatic pilot, paying less attention to food choices and especially to our eating behaviors. Try to remember which of the 5 Gs has given you the most trouble in the past, and plan mindful, healthy ways to reduce its impact.