A testimonial from the website of the hospital I will be banded..... insipires me whenever I feel like I need a pick-me-up... just wanted to share.

I have found that there are certain "stones" that you must claim as your own and use with almost religious zeal to keep the tool of bariatric surgery sharp and effective. I think every person who has this surgery builds their own cairn out of the stones that they discover work best to encourage them. So here are a few of mine.

Stone #1—Quiet Reflection

This one takes different forms for different people—prayer and meditation, transcendental sauntering, yoga, sitting quietly, being. Take your pick, but this is an important discipline as it keeps the bariatric patient in touch with the one thing that our weight and former dependence on food distanced us from—our feelings. You must think about how you feel, stay aware of how you feel and set your compass each and every day to make all of the choices that keep you feeling good, feeling lean, and feeling in control.

Stone #2—Meaningful Movement

Do something. For me the compliance to this particular "stone" is profoundly personal and it took me almost four years to figure out that I would exercise far more consistently if I would work out early in the morning versus in the evening when I almost always had a conflict or flagging motivation. Committing to a time that no person or event could challenge and making it virtually impenetrable from interlopers made this one of the most significant assurances for me. If I start with this stone on the cairn—even if it is just a 45 minute energetic walk—everything else seems to fall in place. Put simply, if I even reluctantly walk over and pick up this stone (no matter how heavy) and carry it to my weight loss cairn each morning, I know that I will virtually run and, with little effort, pick up the rest of the stones that day and stack them on the monument of the day's success. Make this stone anything you like—for me it is walking, rowing, dancing, or maybe a touch of light weightlifting that I should actually do more often.

Stone #3—Liturgical Vitamin Ceremonies

My vitamin consumption has become an almost holy symbol of my intent to honor the body this surgery gave me. I bought a tea box (a wooden box with 12 square compartments) that sits next to my favorite chair. Every morning and night I open it up to behold the vitamin selection that assures my good health. There they all are—the multi vitamin, the Co-Q10, the calcium, the Colace (still needed from time to time). I take vitamins several times a day, and each time I take one, I whisper "I am good to me."

Stone #4—The Security of Staples

Always, always, always have the staples you need to stay the course for good health. This takes discipline and a list (laminated and always with you). For me, the staples are hard boiled eggs, fat free cottage cheese, Montreal steak spice, Lite Havarti cheese, apples, blueberries, fat-free yogurt, and Crystal Light. These must be in my reach at almost all times or I will most assuredly make the same bad choices that caused my weight gain. Make your own list and carry a small cooler in your car everyday if you must—and I have—so that you have no excuse. Never, never go home without knowing that you have the staples you need there. I do better without too much choice.

An important related "stone" to this one was a hard one for me to acknowledge and eventually convince the rest of my family to join me in honoring. I cannot have any food in my house that is not desirable for a weight-loss patient to consume. Once that first year of no appetite passes and hunger makes its inevitable return, the same temptations you once knew will be back. Even though you will feel rotten if you succumb, it is just too tempting. I find the de-temptation of the home environment and replacing it with staples (symbols of on-going health) is critical for me. Any family member frustrated by this strategy can find plenty of excuses to sneak out of the house for a non-healthy treat.

Stone #5—Surround Yourself with Stone Masons

This has to do with the ongoing support we all need in life to achieve any of the goals we set before us, particularly the goal of good health after weight-loss surgery. For some, this may mean participating in support groups. I have had a mixed reaction to formal groups for bariatric patients. Prior to surgery, I found the groups to be absolutely inspiring with so many stories of success transformation. They were a remarkable source of hope during a time of despair.

However, not long after my surgery, I found that most support groups were negative. The participants focused on what wasn't working, what they couldn't eat, or what they didn't like. Since I had been totally prepared for the changes that my surgery was intended to bring, I did not find what I wanted in a group. Look intentionally for a support group that absolutely encourages the excitement (and yes, reality) of a body that has been readjusted completely to bring about a transformation. Yes, our cups may now be literally half full, but our lives and futures are virtually overflowing. Surround yourself with people who see it that way and, do as I did, select your own personal support team. The people on that team are your stone masons who will help you set the stones you choose in place and secure them for life.

Stone #6—Celebrate and Play

At least once a quarter, take a day to do nothing but celebrate. Keep a list of the things that you always said that you would do when you lost the weight—take a hike, ride a horse, go to a concert, climb a mountain, go sit on the beach and watch a sunset, shop, etc. Write down everything you can imagine and, like a bucket list, do them one by one. Plan these important days, give them to yourself and review the stones in your weight-loss structure. If you can, take the day off on your surgery anniversary and honor your good health.

Stone #7—Share the Joy

Take some of the new energy of life that is most certainly one of the extraordinary benefits of weight-loss surgery and give it away to somebody who needs it. Do this in whatever way the world calls you to give something back. People carry "weight" in very many ways and I think we end up with an obligation once ours is gone, to help others carry their own or lose it as the case may be.

Stone #8—Lighten Up and Face the Facts

The reality of my numbers is as follows. The last time I weighed prior to surgery, I was a precious but substantial 327 pounds. I would lose a total of 167 pounds, 18 of which have found their way back. Of course, this predictable weight gain is a fact that strikes sheer terror in the heart of any person who has struggled with weight loss and knows how easy and devious the return of pounds can be. However, using the stone stacking method described here, I have discovered how to maintain my weight within about a two-pound fluctuation over the past year. Put simply, the balance of stones and habits for me that I have in place right now will accommodate maintenance. What I also know is that if I want to be as lean as I have been (which I very much would), I will have to exercise a bit more and trim some additional calories out of my diet to create that outcome. These are facts, not magic and not a failure of the surgery. Just a reminder that I will have to continue to use my stones in different ways everyday for the rest of my life to sharpen the tool of my surgery and create the monument to good health that I want my cairn to be .