Let me start this off by saying that one of my biggest pet peeves is what I call “newbie regain gawking.”
That is, watching longer-term post-ops like a hawk for the purposes of “avoiding the mistakes that led to their regain.”
Because…you know…nothing makes me feel better than thinking about being someone else’s cautionary tale…
But that’s not to say there aren’t things that new post-ops could (and should) learn from the mistakes of their predecessors about how to avoid regain. My thing is that usually these inquiries are misplaced.
Yes, what you eat is important. Yes, how you move is important. But even more important is instilling the mindset that drives you to do these things, consistently, for the rest of your life. (Yes, THE REST OF YOUR LIFE.)
Knowing that obesity is a chronic, life-long condition and knowing that there is not any point in our lives when we don’t have obesity, it stands to reason that building a healthy mindset is probably the best thing you can do for yourself, especially in the early phases after surgery when hunger is least likely to be a problem (and if it is, it’s a far smaller problem than it will be in the years to come).
To that end, I have three things I believe new post-ops can do now to avoid regain later.
#1: Master the Basics
One of the most curious things that I see new post-ops do (myself included) is almost as soon as we have surgery, having been loaded down with the basic rules of living and losing weight, immediately seek to start testing and breaking those rules. Like…can we really never eat and drink together again? Do we really have to take vitamins for the rest of our lives? Drinking 64 oz. of water…that’s negotiable, right?
I acknowledge 5 pretty universal rules that nearly every surgical practice has after weight loss surgery:
- The greatest share of your calories should come from protein. (Exact ratios vary but most practices agree protein should be the largest macro-nutrient contributing to your caloric intake.)
- No eating and drinking together.
- Daily vitamin supplementation for life.
- Develop a routine of physical activity.
- Get adequate hydration throughout the day.
But here’s the deal. Nobody expects you to master all these things straight out of the operating room. It takes time. In fact, it may take a few weeks or even months before you are hitting your protein target. It may take you a while to start getting enough fluids. It may take even longer to figure out how to get your fluids, protein and vitamins without feeling stuffed to the gills.
However, instead of trying to find a way around the rules, it behooves you to keep working at the basic rules until you get them down. Then start working on ways to make the process easier and more convenient to your lifestyle.
How does this help you avoid regain later? The basic rules of bariatric surgery are designed to encourage you to eat the right amount of nutrients, get the right amount of hydration, and expend the right amount of calories to stay within a normal weight range. Now the details may change in those rules. You may at some points need more (or fewer) calories. You may need to increase your hydration. You may need to change your exercise and activity. But using these rules to develop a habit and culture of health will ultimately help you to “keep your head in the game” and avoid regain.
#2: Ditch the “all or nothing” mentality
You know what that is. It’s that little voice that tells you that because you “screwed up” and ate a whole tortilla chip that you have FAILED, FAILED, FAILED!
Yeah. That voice. It really needs to go fall in a hole.
It is also that voice that convinces you that you should wait to exercise until you can go “all in.” It’s also the voice that tells you that you aren’t allowed to celebrate your progress (or buy new clothes) until you get to your goal weight.
Where the hell did that voice come from and where do we send it back???
All or nothing doesn’t work. And, in reality, it doesn’t really fit anyone’s life in any realistic way. We are not perfect. We are human. Sometimes we will slip up. And while it’s important to learn from that, it’s also important not to “throw the baby out with the bathwater,” as the old saying goes. Don’t negate a lot of progress for a little mistake. Acknowledge it. Learn from it. And keep moving forward.
Also, because we are human, we are works in progress. That progress is not only something to look at and be proud of, but it also motivates us to keep moving forward. So don’t wait until you have done everything to celebrate anything about your process. You don’t have to throw a party for every pound you lose, every minute you work out, every ounce of water you drink, but do acknowledge where you came from and where you are now.
How does this help avoid regain? In two ways. First, when you ditch all or nothing, you recognize that, pardon my French, shit sometimes happens. And that when it happens, you can’t dwell too long. You have to get back up and keep trying. If you don’t try you are guaranteed to fail. If you do try, you have a fighting chance.
Second, if you acknowledge your successes along the way, as opposed to waiting to cross the proverbial “finish line,” even if you’ve “gone off track” or “fallen off the wagon,” you acknowledge that you have come a long way from where you started. You aren’t beginning at square one. You aren’t reinventing the wheel. You are simply returning to the work you’ve already done and you are moving it forward. It’s amazing how empowering that thought is versus, say, “I messed my entire surgery up and I’m a failure!” Like…seriously? Does that motivate you to do great things for yourself? (If it does, you are very, very different from me.)
#3: Make goals that have nothing to do with weight loss (or body image)
This is the piece of advice I wish I could have given new post-op Nik. Because new post-op Nik had a dream. It seemed like a good dream. A solid dream. New post-op Nik wanted to look like Beyonce.
Now, forget that I do not have Beyonce’s genes. My family doesn’t look like her (my family looks like me…before surgery!) and there’s the simple fact that I am not her and she is not me. But that was my dream, y’all.
And it almost came true. But in my head (of “all or nothing”) almost doesn’t count. So I got mad. And I rebelled. Because if I can’t look like Beyonce, dammit, I should be able to eat Doritos!!!
(That thinking was all types of busted, by the way…)
What I wish I had done sooner was make a few goals that have nothing to do with weight or body image, but with my abilities and quality of life. Now let me be clear: I am not saying weight goals are bad. I am saying weight goals in the absence of any other kind of goals can bite you in the butt. I am also saying that making non-weight loss related goals where your end expectation is weight loss (which I call “sneaky weight loss goals”) does the same thing. At the end of the day, you are giving the scale the loudest narration in your success story. And the thing about that is that the scale will stop eventually. It’s supposed to! And many of us don’t know how to deal with that when it happens. So we end up going off the rails a bit, gaining a few pounds and…voila! We are now on a mission again. Lather, rinse, repeat.
I’m not saying making non-weight loss or non-body image goals is a cure-all, but it goes a long way. So how do you do it? Start with what you want. If you’ve always wanted to be more active, pick something you like doing and make goals at getting better at it. (True fact: I have always wanted to be good at playing volleyball. I’m not. But I’m having a blast trying!) The key here is to choose things that keep you healthy and bring you joy. But the good news is, anything counts! Fake salsa dancing to your favorite Latin music? That counts. Becoming the champion in your family’s three-legged race at the family reunion? Totally counts. Being that person who takes long walks and photographs the most beautiful trails your community has to offer? That counts!
How does this help avoid regain? First of all, it puts an emphasis on a healthy lifestyle. We often confuse the things we do to lose weight as constructing a healthy lifestyle. Sometimes our efforts constitute a healthy lifestyle. Sometimes they are simply things we do that cause weight loss but aren’t necessarily health or sustainable. Only you can tell. But when you put a goal behind something healthy that isn’t about weight loss or body image, you move yourself closer to being healthy for the sake of being healthy. Which ultimately works to help you keep regain at bay by supporting habits that work against weight gain.
“So why does this even matter, Nik?”
I’m glad you asked that question.
It matters because at the start of our post-op lives I think we do recognize we’ve made a life-long change…it takes a minute for us to absorb that we made a life-long change.
When stuff gets real is when a strong “head game” comes in handy. Those habits, mindsets, goals and habits you make now can keep you on a trajectory of good health even when the scale has stopped moving, even when folks stop gushing over how much and how fast you are losing, even after you stop tumbling down the clothing size chart. And what’s more, a healthy mindset recognizes that you continue to improve in so many ways, even after you are maintaining.
So…sure. While it may seem helpful to you, as a new post-op, to look at the eating and exercise habits of longer-term post-ops as a lesson (although for God’s sakes please be careful about verbalizing that!) it’s a far, far greater gift to make sure you’re building a solid foundation for a sustainably healthy lifestyle.