Long term success? Be Prepared!

Cappy responded to a post earlier today about some statistics of regain. It made me think about our tool and how we use it. It occurred to me that nearly everyone is given a solid plan for the weight loss stage. We have post op stages to get us to solid foods, we know how many carbs and proteins we should be eating. We are given calorie limits.

I had a great plan for weight loss. I followed it to the letter about 98% of the time. Yes, I had a few side trips on my way to goal, but I followed my plan closely enough to reach goal in just over 7 months. I was ecstatic.

What I did not have was a solid plan for maintenance. To stop weight loss I started eating non fat frozen yogurt. You see, my restriction was still in high gear. I couldn’t add to my meals and if I ate another dense protein meal then I would not be hungry at regular meal times. Adding a calorie dense food like the frozen yogurt seemed like the thing to do at the time. What that did however, was open the door to sugar.

I was fine for the next 6 months. I had a bit of a gain between 12 and 18 months out, but I was working out like a son of a gun and my muscle mass was growing. I was okay with this gain. I continued to eat fairly well, but the treats were coming back in with more frequency.

Fast forward to 2 years post op. MAJOR STRESS. This stress lasted about 18 months on and off. I ate my way through this stress all the while maintaining a healthy VSG plan for 3 meals a day. It’s what I ate between those meals was utter crap. This is when the regain really took off.

What I did not have was a solid maintenance plan in place. I can not urge each and every one of you on this journey who have not yet gotten to goal to prepare for maintenance by planning out well ahead of time a solid maintenance plan. Talk with successful VSGers who have gone ahead. Hell, talk to people like me who have made mistakes and take those mistakes to heart. Create a plan with your NUT or surgeon.

A plan provides a safety net for when things get stressful or off kilter. We all spent years eating in ways that supported obesity. Just because we have surgery and lose weight doesn’t mean we also have to the tools to maintain our new weight. I realize that for myself I knew how to gain weight and lose weight. I NEVER was successful at maintaining weight.

Now on my way back down, I am already putting a plan in place for when I re-reach my goal weight. No more winging it. No more playing it by ear. I have some pretty severe food issues. And like an alcoholic in recovery needs a plan in place to maintain sobriety, I too, will need to have a plan to keep from eating the wrong foods long term.

 If you want to maintain long-term success, put a proven plan in place and get the support you need to follow it.

My maintenance plan is simple.  I multiply my goal weight by 10 and that is my calorie allowance for the day.  My goal is 136 and I spread 1360 calories into four meals of 200 calories and two larger meals of close to 300 calories.  It has worked for me.

That is an interesting method. I have read about it before. For me to maintain my weight at about 175 or so I needed to eat more than 1700 calories - granted I was exercising a lot.  I wonder if the formula is slightly different for men. Do you know by chance??? Also, may I ask - Do you also track protein and carbs within that range? Have you found a good balance between carbs and protein for maintenance?  Thanks!

I do track protein and carbs but can eat whatever I want as long as the calories stay in range. 

I weigh daily and cut back on calories if I start to gain.  The calories that you need to maintain may be higher.  The multiply by 10 comes from Weigh****chers.  I became a lifetime member in 1973.  Their plans have changed many times since then but if you really add up the points or whatever system they are using, it still comes down to calories.

White Dove...Thank you for this. I am not at Maintenance yet. However, I did ask my Surgeon at my 6-month Check-up about what my eating plan would be at Maintenance. I was very disappointed in her answer. She said to just keep doing the same plan I was on! That does not make sense to me. I am going to follow your Maintenance Plan instead!

I would ask a nutritionist..not the surgeon.  You may get a better answer.  

Thank you, kairk. Your post is going into my permanent files.

psychoticparrot

I love the idea of planning maintenance and have been thinking about this.  Lordy,  I have always stunk at this in the past and am super worried.  

I have good peeps (dietician, exercise, therapist) in my corner but I don't know if any one of these people have a solid post massive weight-loss plan for me.  

I will be searching the forums for "proven plans" for sure.  Structure will be key. 

Thanks for bringing it up! 

You are so right.  That is where I fell off the horse.  Support is hard to find though. The support group that I go to is a pep fest for newbies and I don't feel like we talk enough about the stumbling blocks and how to prepare and work through them. 

What did you do to get back on track?

If I'm going to be completely honest with you, I need to go back to January of this year. I was at a pretty low point about my weight. I even signed up for a very expensive diet plan led by MDs. I was even given appetite suppressants to use in the afternoons (short acting). I got so disgusted with myself and the plan (because it was basically a low carb, high protein plan just like for WLS) and the support they offered (a quick in and out 10-15 minute session with someone new practically every week). I was extremely depressed. I knew I needed help.

I will try to make this as short as I can, but... - I called a parent from my school who I knew was a psychologist that specialized in working with patients with eating disorders. She set me up with a colleague and a nutritionist counselor. I also worked for a short time with my HMO's therapist and she prescribed a mild anti depressant, which I am still taking.

The nutrition counselor really led me down some interesting paths to explore different options for me. The first thing she did was take me off a diet. I was told to eat anything I wanted because "dieting" in the sense that I dieted did not work. So, I ate and ate and ate. BUT what happened is that through this process and counseling came an understanding that I had been way too hard on myself (actually downright mean and degrading) each time I lapsed and that I kept myself in this horrible vicious cycle. I read a few books. One was called Intuitive Eating. It has a lot of good stuff about the psychology and the self damage we cause ourselves through dieting. (I'm not sold on the philosophy of eating it espouses, though.) Another good one, if you can get past the New Age-ness of it, is called The Gift of Our Compulsions. It talks about how how compulsions really are messages coming from within to which we need to listen. The absolute MUST READ in my opinion is Robert Lustig's Fat Chance. Lustig is an MD who is a pediatric endocronologist. His work with metabolically challenged kids led him to research obesity extensively. This book is really a publication of his findings. It can be a bit technical at times, but it is written for Joe Public.

Through this exploration I did gain a few more pounds, but in the end they were worth it because I learned a lot about myself and my relationship with food. At one session the nutritionist brought up the idea of going on The Sugar Reset Plan. (It was developed by an RD counselor.) Well, I knew immediately that this was probably the right thing for me to do, but I had so many strong emotions around it. The more I felt those emotions (anger, fear, denial, and underlying acceptance) I knew this was something I should do. I was reacting to a lack of sugar the way an alcoholic might react to someone saying he needed an alcohol reset!

I decided to follow the plan. It was my decision (very key for me). I can veer from it anytime - I've given myself that permission (cuz if I don't, whoa.... eventually the rebel will storm the gates). The key, too, is that I modify the program to work for me. I did the modification at first with my nutritionist. So my reset has ended up looking like this:

No sugar, no added sugars, no processed foods,and avoid white flour/whole wheat flour/rice flour. My protein is to be between 100-140 grams per day, carbs under 100 (though mine are usually lower around 50-70), and I have set my calories around 1350-1400 calories per day. I do allow myself whole grains a few times per week, if I want them. I do like an occasional dish of whole grain steel cut oats, and I'm also fond of spelt and barley (very toothsome). I eat low glycemic index fruit (mainly blueberries, strawberries and raspberries) that are in season. I still have a protein shake every morning. And most of my carbs come from Greek Yogurt, cheese, the berries and vegetables. 

I started with a three day detox. I ate all the protein, vegetables, nuts, and other healthy fats to keep me sane and pounded down the water. By day 4 all cravings were gone and my mind was clear.

The best thing about following this way of eating is that it is completely sustainable and I am really free of the pull (you know that drive to eat the foods you know you shouldn't but feel like you can't help it).

I think the biggest thing about getting back on track is that I finally came to understand and ACCEPT that I have some deeply rooted issues with food. And while I am loathe to admit it, sugar is a major issue for me. I love my sweets, I do, I do! But, I find that my response to sweets is detrimental to my weight loss efforts and my continued long term health.

I think, too, knowing that obesity has caused my body to react to foods and sugar differently than in someone who has never been obese has taken the blame away from me and put it where it belongs - on physical and hormonal responses over which I have no control. The only way to avoid those inappropriate biological responses is to stay away from the food that causes it - and that food is sugar.

Sorry to be so damn long winded, but I wanted to give you the big picture. It wasn't as simple as just deciding I'm going to do "this" and be successful.