"Just This Once Won't Hurt . . ." @ the carb monster!
WORTH A REPOST!!!!! JAMIE
"Just This Once Won't Hurt . . ." by Ken Miller
I've had the opportunity to closely watch the weight-loss journeys of hundreds of WLS patients during the last several years as I've studied those who are very successful and those who struggle. Almost everyone has plateaus along the way. Some lose weight rapidly and consistently; they reach their goal weight quickly and are able to easily maintain their weight when they get there. Meanwhile others lose weight much more slowly and some never reach their goal weight. Most of those who lose slowly, with extended plateaus along the way, usually struggle much harder to maintain their weight once they reach their goal than those who lost weight quickly and consistently.
The number one factor that affects a WLS patient's rate of weight-loss and the ease with which they are able to maintain their weight after they reach their goal is the intake of refined carbohydrates. When they start their journey everyone wants to know . . . "How fast will I lose weight?" "Do you think I can actually lose all this weight?" "Do you think I can do it in a year?" Those are difficult questions to answer because we can't predict, just by looking at them, which people will lose quickly and which ones will lose slowly.
Last week I received an email from a woman who is about to undergo a Roux-en Y procedure two weeks from now. She included a table that she'd created that listed her short term weight loss goals leading all the way from where she is now, down to her final goal weight. Each line of the table represented a month and she listed the amount of weight she was planning to lose during that month. She knew she would lose weight more rapidly in the first few months and that her weight-loss would slow down as she approached her goal so her monthly goal list started out with losses of 30 pounds in each of the first couple of months and gradually decreased those amounts until she was predicting a loss of 5 pounds during each of the last couple of months. Her list of goals looked reasonable to me; I believed it was possible for her to achieve them, and I told her so. Then I expressed some thoughts about the key factor that I believe will determine whether she will be successful or not.
Oh, one more thing . . . did I mention that she wants to lose 260 pounds in one year? I told her that normally I would never suggest to the general patient population that they could (or should) expect to lose that much weight in one year, but I knew something about her that I couldn't know about most other patients. I knew she had already lost 150 pounds during the past year BEFORE her surgery! She did it by studying and following The Success Habits of Weight-Loss Surgery Patients. You see, she joined BSCI as an online member about a year ago, expecting to have surgery in the near future and she wanted to get started on adopting the new lifestyle she would need to be successful for the long-term after surgery. She was disappointed several times during the next year as her insurance was denied and she had to file appeals to get them to reconsider her situation. But, during that time, she continued to stay with us. She read all about the Success Habits? principles and she watched and listened to others who posted messages about their experiences as they were going through their weight-loss journey. And I believe she paid attention to who was following the Success Habits? principles and who was cheating themselves by only following them part of the time. I'm quite sure she recognized what I have witnessed . . .The number one factor that affects a WLS patient's rate of weight-loss and the ease with which they are able to maintain their weight after they reach their goal is the intake of refined carbohydrates. Of course there are rare exceptions, but my observations clearly show these two facts:
Those WLS patients who say to themselves, "Just this once won't hurt anything . . . I'll go back to no carbs tomorrow," and eat refined carbohydrates struggle to reach their goal weight and then, if they do reach their goal, they have a much harder time maintaining their weight than those patients who don't.
Those WLS patients who eat only complex carbohydrates and who do not eat any refined carbohydrates lose weight rapidly and consistently and they have a much easier time maintaining their weight during the following years.
So, here's my advice to those who might be interested; Don't make the mistake of saying to yourself, "Just this once won't hurt anything." IT WILL. The consequences of that decision won't be immediately evident to you; it will take time before they show up. But, they WILL show up, and by the time they do, it will be too late to go back and "fix it".
Don't cheat yourself out of the final success that you can achieve and maintain for the rest of your life, by trading it for "Just this once . . ." The Carb Monster shows no mercy; not today, and not tomorrow, or next year.
I know that's very black and white advice. It's not sugar coated; it doesn't taste good, or feel good, and it might create fear in some WLS patients who have already cheated themselves. I hope so. The good news is that the sooner you banish the Carb Monster from your life, the easier the rest of the journey will be for you. I also hope it will scare every new patient enough that they'll use those initial few months following surgery to banish the Carb Monster forever. There will never be an easier time to do it. It only gets harder later.
I expect there will be those who want to express their opinion on this subject . . . both those who believe they are exceptions to what I've said, and those who are willing to take a couple of minutes out of their lives to warn other WLS patients about what happened to them when they said, "Just this once won't hurt . . ."
This article was originally published in the June 1, 2004 edition of the BSCI eNewsletter.
http://www.bariatricsupportcenter.com/index.php?module=pagesetter&func=viewpub&tid=3&pid=3
1
This was well times - - and confirms my suspisicans about why I am satlled in place. My next step was going ot be to religiously track my blood sugar, but its not really needed to tell me that I hav e been hammering the carbs. The walk up call comes at a time I needed it most. Thanks for posting an article that will help many of us who are "standing still".
kudos for putting it out there!
Cheryl:
You are welcome..You are just over 1 yr out, a time that the honeymoon has ended and the rest of your life has begun, build on the healthy habits you have formulated over the past year and consider the following if you are off track....*I wrote this...)
DO YOU NEED TO GET BACK-ON-TRACK?
You dreamed this would be the last time you would need to lose weight. Weight loss surgery was the answer to your weight loss failures of the past. You were doing so well. Weight seemed to fly off so to speak in the beginning, almost effortless. No matter what you did you couldn't possibly take in enough to not lose weight. For many this was the first time in your life you didn't experience physical hunger. You felt full on so little. You were limited in the variety of foods you could have. Sugar, fats or large portions made you sick. If you didn't chew well enough, or slow down to eat or if you drank with our food you got sick. Dumping syndrome, although not an intentional part of weight loss surgery works as a strong behavior modifier. Who wants to experience nausea, vomiting, sweating, chest pain, palpitations, diarrhea, fatigue, and lethargy and have to lie down for one cookie? But over time your motivation wore off. Fast forward a year or two, you heard the window slam shut, the golden period tarnish and well quite frankly the honeymoon is over. This is normal & expected but you still are surprised & horrified! Denial works for a while but after the ' 10-20 pound bounce back weight' hits you decide you can no longer live in denial. Your clothes don't fit and you are scared to death. Many think their pouches have stretched. In reality it could possibly be a mechanical problem, but most likely it is the honeymoon period ending. You are then faced with the questions, "Did I use my time wisely?" & "Did I make the lifestyle changes needed to be successful long-term"? If you answered yes to both of these questions then congratulations & do not read any further. But if you can't answer yes to these questions and you find yourself OFF-TRACK, keep reading!
You remember hearing about it months ago, bariatric professionals educate regarding its existence & significance; it has many names, 'Window of opportunity', 'Golden period' & 'Honeymoon phase'. Did you really believe, understand and utilize it? Or did you think that weight loss surgery was magic and you were invincible? The first 12-24 months after weight loss surgery is a time of change, growth and rebirth for many. It is the beginning of a wonderful journey. It affords us to experience life unchained by Morbid Obesity and all its limits & complications. You have heard this mantra before a thousand times, weight loss surgery is only a tool and they operate on your stomach not your brain! What you sometimes forget is it isn't the end of your food issues.
You are not alone! Do not allow yourself to be alone! It is in isolation that you continue to struggle and stay off-track. Your surgery hasn't failed; you are just not using your tool to its potential that is all. It is there still; you need to get back to basics though. And yes this means you now have to work harder than the tool! Remember it isn't the surgery alone that makes us lose weight it is the lifelong lifestyle & behavioral changes you make that enable us to lose weight and keep it off. It is the tool that gives us the opportunity to make these changes. It levels the playing field for weight loss and maintenance with those who are not Morbidly Obese! In this delicate time many things happen: dumping may decrease or stop, you are able to eat a larger variety of foods, you can eat larger quantities of food, you get over the newness of surgery and may let some habits slide, the malabsorbtion may decrease as the body tries to normalize! Basically life happens.
So how to get back to basics? You have to just take one step at a time; it doesn't have to be all or nothing that is old thinking! Getting and staying on-track and making is the global goal. Now break down the lifestyle habits you need to stay healthy and on-track. What do you feel you can conquer first? Write down your goal for the week, then work on it, once you have one goal under your belt start on another, be patient and kind to yourself, no one said this was easy! It is hard and no one is perfect! But you can change. The negative habits didn't happen overnight so neither will positive ones! But they wont happen if you don't start somewhere! Asking for help and admitting the problem is a great first step! Life will always be busy but you need to place health as a top priority and taking care of yourself has to be more important than anything else.
Below are some ideas to help you refocus and get back on track. Remember everyone's needs are individual so use the following as a guide in how to break down habits. It is meant to help you feel not so overwhelmed. If you held on to some basic fundamental pouch rules you are ahead of the game. How many are you already doing? You may not be as off-track as you thought! Look at the positive and build on that!
Follow-up:
Ø Resolve to recommit to your lifelong aftercare program. When was the last time you went to see your bariatric surgeon, clinical nutritionist, dietician, primary care provider? When was the last time you had a complete set of labwork? Life-long follow-up is necessary for your health and can be a motivating factor for your long-term success! Do not feel ashamed of regain, empower yourself and surround yourself with professionals who can assist you on your journey!
Fluid:
Ø Resolve to drink 64 ounces daily, this will keep you full longer and keeps a small amount if tension on the pouch. Make sure most fluid is non-carbonated, non-caffeinated, non-alcoholic & non-calorie. In other words don't drink your calories! Many times when you think you are hungry you are simply thirsty! Fluid load before meals, by drinking a cup or two of water before you eat you can curb that hunger.
Ø Do not drink with meals and wait 1-2 hours after meals to start drinking, or you will just make yourself hungry again sooner! You can eat a lot of food by sipping with meals and washing the food down because the pouch has no pyloric valve controlling the flow of food, it is now a leaky drain and after a little time you have more room in the sink to fill so you can all eat a while after you eat.
Vitamins:
Ø Resolve to take a multivitamin, calcium citrate, B12 sublingually or parentally as directed by your labwork. And of course any other supplements you may need such as iron, magnesium, thiamine, zinc, Vitamin A, D, E.
Meals:
Ø Resolve to journal your food either online or in a notebook. You can't possibly know what you are eating or need to change until you visually see it! This also helps you be aware & accountable to yourself. Some free sites for this are: http://www.fitday.com/
http://www.onlinefitnesslog.com/
http://www.dietagenda.com/
http://www.nutrawatch.com/
http://www.sparkpeople.com/
Ø Resolve to eat ONLY 3-4 small meals a day over 10-20 minutes no longer, and NO grazing. Just because you may only eat a few bites here and there, over the course of a day you can eat thousands of calories mindlessly NEVER getting full! Portions are important! Measure, don't guess that handful of peanuts you think is ¼ cup may really be a ½ a cup!
Ø Eat protein first! Composition of meals should approximate: 50% protein leaving 25% of meal for veggies/fruit and 25% high fiber, multi-grain carbohydrates. Avoid sugar and refined carbohydrates such as candy, cookies, cake, crackers, bread. These refined carbohydrates are a 'waste of space' and you can easily consume many calories with little nutritional value, and they'll make you hungry sooner! It doesn't have to be 100% of the time but should be the way you eat more like 90% of the time! Many people seem to be carbohydrate sensitive while others are calorie sensitive. Finding the balance that works for you is imperative. "Diet plans" work because people are mindful, accountable and usually eat less. It is still about calories in and out for most of us.
Exercise:
Ø If you are not exercising start by resolving to exercise 30 min 3x a week, then increase to 60 min 3x a week or 30 min 6x a wee****il you are exercising 30 min daily (or more)! It helps you cope with stress, so you don't turn to food, it will help the weight loss and also give you energy! You will feel better about yourself and be less apt to go for the food.
Support:
Ø Resolve to either get involved in a local support group monthly. Weekly would be better but at least once a month. There are also many online support groups that can help also. Or get into therapy to deal with your food issues and look at why you are sabotaging your happiness. Most of us have food issues and we all need to face them eventually. The surgery is a great help but the brain is slow to change.
It is hard work but looking at the issues and wanting to deal with them is the first step! Be proud of yourself for that and you can do it. What purpose is food serving for you? Do you need to hold on to old unhealthy habits of numbing your emotions with food or can you develop new, healthier habits to deal with stress? Today is a great time to start, not to change everything but to change one thing. Stop the excuses! If you wait you may have another 20 pounds to work on. Holidays and parties are always going to happen, you can always find an excuse to wait or a reason why you can't. Its difficult but search within yourself and find a reason why you can and do it. Remember why you started this journey and what you told yourself not so long ago! The power of positive thinking is yours! Think progress not perfection! You are worth it!
Feel free to join me on: http://health.groups.yahoo.com/group/OSSG_Off_track/
Take Care,
Jamie Ellis RN MS NPP
Lap RNY 10/9/02 Dr. Singh
320/163 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"