The "honeymoon" is over - The long, winding road beyond and how I have begun to navigate it

Hey everybody, I wanted to talk about some things I have been dealing with. A good place to start would be how I spent the last week. 

Personally, I spent Christmas here in Arizona. Christmas Eve we had dinner with my wife's cousin and exchanged presents there. I made a funny little music video of the gift opening frenzy and posted it on my Myspace (myspace.com/bialowitz) 

The food cravings were pretty bad, and I did great up until Christmas Eve; then for two days I broke a lot of the rules and ate as much as Ralph (my pouch) would allow me to. 

On one hand I was dissapointed because I gave in to temptation, but on the other hand I felt somewhat encouraged when I realized that in years past those holiday binges would have included at least three times as much food, tons of sugar and about a five pound weight gain for the week. 

This year I DID overeat, BUT my "tool" helped keep me from doing too much damage. Is this a good way to approach things? Is it healthy? Is it - dare I say - "rationalizing" my inappropriate behavior? 

Good questions, I'm not a professional so I don't know the absolute answer, but I think it is OK. As you journey beyond the honeymoon phase of WLS and enter the maintenance phase you can struggle a little bit. I know I have. You think to yourself, OK I lost the weight, now what? Do I keep dieting? Answering that question can be a bit more of a challenge then you would think. I've been struggling to answer these questions for myself and ellicited the professional help of the wonderful nutritional and psychiatric practicioners at Duke in seeking an answer. 

What I got from the conversations is yes you need to continue to diet, but you can't look at it as a diet, it all goes back to those two all-important words: "lifestyle change" -you know, that thing you committed to back when you jumped on board for surgery. 

The way I have been eating is the way I will need to eat for the rest of my life.  You mean I will have to eat this way for the rest of my life?" Yup, pretty much. 

That answer is a little bit sobering. Remember back when you were just recovering from surgery and you were lying there asking yourself "what the heck did I just get myself into?" Yeah, it's kind of like that feeling all over again. It makes me feel like I have sentenced myself to a life term in "food prison." The psychiatrist introduced me to that term - food prison. She said I would need to try to make sure that I don't live my life stuck in a "food prison." 

It means losing the diet mentality. Losing the "all or nothing" mentality that a lot of us adopt. You know, that feeling that you get when you equate your eating choices, weigh-in results, and commitment level with either total success or total failure. You set yourself up for an emotional roller coaster ride that you don't need to ever even go on. It's unhealthy. The goal is to feel "normal" - and "normal" people do not let those kind of things get to them the way some of us do (at least not to the same extent). 

So what does this all mean? What can I take away from this advice? 

To ME, it means that yes I will continue to have some limitations on what I can and can't eat. I will always have to avoid refined sugar or face the consequence of dumping. That's fine, I knew that going in, and I have been managing by finding sugar-free alternatives to get sweets-fix. 

It means that I will have to continue to watch my portion sizes and follow the rules about not drinking and eating. However, it also means that I need to stop looking at all carbs as my enemy - I don't need to lose anymore weight and carbs DO have a place in a healthy diet. 

It means that if I desire, sometimes I don't have to weight three hours between feedings. Do normal people use their watches to dictate when they eat? No. So why do I need to. If I eat when I fell hungry, that is OK. That might sound like the wrong approach, but let me just say, I am not saying I feel it is alright to eat every hour, what I am saying is that if you eat one meal two hours after your previous meal and the next one four hours after, it is not the end of the world. Most of the time, if you let your hunger (not appetite - big difference - remember physical vs. mental) dictate, you will average out to about every three hours between feedings or five or six times a day. If I do this, and don't obsess about the schedule as much I will be less likely to feel like I am living in a regimented "food prison." 

I think it is the regimented part that makes us feel like we are stuck in a diet mentality or in a food prison. For that reason - counting grams of protein; measuring ounces of food at a meal; counting how many times I chew; how many minutes between drinking and eating - all of those "rules" - I'm going to stop obsessing about them. 

This is something I am advocating for myself because I have been doing this for nine months now, and it has become a habit. I don't even need to think about it. This is how I eat now. At first, I had to make a concerted effort to abide by these rules, but now I have trained myself, it is second nature. Wait a second - one might say I may have actually adapted real "lifestyle change!" 

So you see I am trying to shift my thoughts about the rules and regimens of post-op WLS life from likening them to a food prison, to something more like this: they're more like a brace used to help straighten out crooked bone-structure. It's more like a swing-trainer that someone uses to engrain muscle memory for that pefect golf swing. It's more like a tool that people use to help themselves adapt to their new plumbing the right - the healthy - way. 

I guess that's my take on negotiating the path from honeymoon to maintenance, from diet to lifestyle change. From WLS newbie to graduate. From Morbidly Obese to - umm, healthy. I fully acknowledge that I'm by no means at the end of my struggle, it's more like I have paddled hard and navigated past the violent surf near the shore, and now I have to learn to stay afloat in an efficient and healthy way.

So for those of you have succesfuly gone down this road, do you have any additional advice? For those who are headed that way, does any of this make sense? Any feedback would be greatly appreciated!

As someone who is headed down the path within the next few months, this post offers so much insight into the journey just ahead. I too am hoping to get away from the "Diet" mentality and make the tool do most of the work for me.  If I can get away from the binge and boredom bulk eating (and I think the tool will at least "limit" the offenses) I know I can live with the forced lifestyle changes.  For instance, I do not mind having a protein shake twice a day to limit my personal "food prison". However, I also know that I will always have these bulk cravings. But if the tool restricts that, I'll be way ahead.  Instead of having HUGE diet failure, I may have only minor ones.  And if the tool restricts the "type" of failue, that's a plus too. But I think you make a subconcious point midway through your post when you say the word "habit".  So what if you have some cravings or ate "bad" on the holiday. The real revelation is that you stopped far short of where you would have prior to 9 months ago. And that in itself is a huge victory and it is a result of your 9 month positive habit buidling and lifestyle changes. I wish you continued success.

Michael, First, if there’s one thing I can’t tolerate, It’s a Long Winded Post! So you find yourself transitioning from Losing, To Living with the New Life. "So for those of you have successfully gone down this road, do you have any additional advice? For those who are headed that way, does any of this make sense?" Sounds completely Normal to me. What I would pass on is that folks who have been at a Normal Range BMI For their whole life, Don’t "Live on a Diet," and neither should we. Then again, "They" don’t fixate on food and see it as a drug, comfort, etc… And neither should we. It’s tricky. All of us get and stay Obese for different reasons. Thus our histories vary wildly. Some are "Emotional Eaters," Using Food as a Numbing Refuse from everyday stress and anxiety. Others (like myself) just had a life-long misinterpretation of what "Full" meant. Others developed early habits that kept them eating High Fats, High Carb/Sweets And never developed a taste for Nutritional food. For some Obesity came on them after a life of being normal sized, Others were Obese or Morbidly Obese as far back as memory serves. All of these variables change the way one views the way We now respond to those old patterns of eating and living. I post on a Board that has many 5 year+ post-ops And the one thing they tend to agree about Is there is No ONE Way to deal with maintenance. For some, they find that eating anything they want in moderation works fine, Others rely on abstinence from certain "trigger foods." Many have held at goal with no gain, And others have successfully lost back down to goal after a significant (20+lb.) regain. The "obsession with WLS Rules" is VERY Helpful early on. Being a realist and being conscious of daily choices seems to work better for the long-term. Back when I was at nearly 400 lbs, I used to use an analogy when talking to students… (When a Student would find themselves at the end of a semester And suddenly it dawned on them that months worth of neglected studies Were about to result in an 'F,' and they would beg points over One particular project,) I would often say- "It wasn’t THIS French Fry that made me Fat." Same holds true today. One weekend of over eating and celebrating with family and food Won’t be THE Problem. In the Long run, it’s the culmination of daily choices. A dripping faucet left unchecked, Will run up the water bill a hell of a lot easier than a weekend Of car-washing and excessive lawn watering. "engrained muscle memory…" Sounds like my approach to maintenance. I rely on Habits that I developed during my first couple of years post-op. One thing to add to that. Remain conscious of your choices even when new Habits Are working. Poppa Hotrolls (NoWhereMan) (Jay) had a post about this very topic some years back- He used to post on the "Grads Board" before moving to the Message Board at QuixoticWLS… Just passing it on here- "Here’s my thought as I hit the three-year mile marker. Most of us who are on the Web have run across the Darwin Awards, tales of colossal stupidity that are Urban Legends for the most part. One of the best is the guy who buys the recreational vehicle and drives it off the lot. He gets it out on the highway and is enjoying the road. It dawns on him that he would enjoy is more if he had something to drink, so he sets the cruise control, gets out of driver's seat and heads for the refrigerator in the back. Of course the results are predicable. The RV crashes. This Darwinian Superstar failed to understand the difference between the cruise control and an auto pilot. What has this to do with WLS? At the three year mile-marker, I would say just about everything. Here in Grad Land, we hear again and again of folks struggling and failing (yes I said ‘failing’) w/ WLS. One of the problems is that many did not appreciate how WLS works. Like our Darwinian Dimwit, they thought it would be an auto-pilot sort of effect. At three years either you are succeeding w/ WLS or you are already in a ditch somewhere w/ your tires in the air. The successful learned that WLS is like power steering, power brakes, cruise control, etc., that it enables them to control a mechanism that previously was beyond their ability. How do we say it so often? "It’s a tool!" The controls are within our reach, but we still have to attend to them. You can build a vehicle with all the amenities that one can imagine and engineer, but there is nothing like an attentive driver to keep it on the road. I will never be normal. I will never be able to turn around and just let this thing take care of itself. And if we had a lick of sense, we would realize that most of the svelte among us have to do the same thing. Today is a new day to pay attention to road. It is not straight, nor is it always smooth. When events occur, we have to adjust. If we get off the road, we have to find a path back on to the main road. But more than anything else, we have to pay attention to the road we are on. We can never, and I repeat never, simply assume this machine drives itself."

Keep up the Great Work, and know that the "Honeymoon" Typically lasts through first 18 months, So you’ve still got some time to tune-up those habits. Best Wishes- Dx