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In ancient times, sailors would make sure they were staying on course by referring to the location of the North Star. A constant light in an otherwise black sky, the North Star kept sailors clearly focused on which direction they were traveling and where they wanted to go. However, the skies over the ocean could become cloudy and stormy and sailors might lose sight of the North Star. Sometimes sailors lost their way and became lost at sea. The quest for weight loss and long-term weight maintenance is much like journeying a great distance over an enormous ocean under an endless black sky. Like the sailors of old, to be successful on your journey you need to be clear about where you’re going. You need to stay on course. You need to remain focused. Like sailing across the ocean, losing weight can be stormy and treacherous. Your brain, like the ocean, is not your friend. Your brain is not terribly interested in your desire to lose weight. Your brain is busy trying to maintain your current weight. Trying to lose weight is putting your brain is at war with itself. Your forebrain is the thinker who understands that you want to lose weight. It agrees that losing weight is a good idea. Your midbrain is not logical. It’s a perpetual 2-year-old who is hungry and cranky and likes potato chips, candy, hot dogs and deep fried chicken. This is going to be a very difficult journey, and one that is going to go on for a very long while. What can you do? Look for your North Star(s). It goes without saying that you know your goal, right? In fact, it seems quite simple. You want to lose weight and keep it off for good. If you’re like most people, you’ve had this goal for many years and you’ve probably had some success in pursuit of this goal. But there’s a problem with your goal. Believe it or not, weight loss is not your true goal. Your real goal is not to lose weight. Your real goal is to accomplish and experience what you believe losing weight will provide. Therefore, you actually have multiple, specific goals. These are the reasons that inspire you to keep sailing when the ocean gets stormy. These are the reasons that keep you on course. These are your North Stars. To make it across, you must keep your North Star(s) squarely in view. Here’s how to keep away the storms and stay focused: 1) Think long and hard about why you want to lose the weight. Yes, you want to lose weight…but why? What’s in it for you? Take out a piece of paper and put a line down the middle from top to bottom. On the top of the left column write: “What I will gain if I lose the weight and keep it off.” On the top of the right column write: “What I could lose if I don’t lose the weight.” Think of the left side as the “positives” of losing weight and the right side as the “negatives” of not being successful. The left side is what you want; the right side is what you don’t want. As a general rule, positives motivate us more effectively and more consistently than negatives. However, our fears (the negatives) do have a place on the list. Some examples of positives include: improved health, reduced need for specific medications, improved mobility, wearing the clothes you want, improved confidence, and pride in your accomplishment. The negatives are probably more obvious to you: specific health problems, limitations in mobility, frustration, various difficulties in your personal, social and other areas of functioning. Don’t try to write the list all at once. Write down whatever comes to mind right now, but allow other reasons to come to you over the next several days. Take your time. When a specific motivation comes to mind, write it down and add it to the list. Consider asking loved ones for their thoughts. You may never be 100% finished with the list, but you can always add more items later. You’ll know you’re truly ready to begin your weight loss journey when you read the list and deeply feel the emotional impact of each of the items. As you well know, the struggle to lose weight and keep it off is very emotional. If the items on the list don’t move you, you need to revise the list. When it’s complete, this list is your North Star. 2) Make several printed copies of the list. Make a small one to keep in your wallet or purse. Make another to keep in your car. Make another to keep in your office. Make a document containing the list on your computer and keep it on your desktop, laptop, tablet and cell phone. Put a printed or electronic copy everywhere you spend your time. 3) Read the list every day, over and over and over and over. This list needs to be etched on your brain and be in the front of your mind as often as possible. You need to read the list every morning when you wake up, multiple times per day, and before you go to sleep at night. The list needs to be as familiar as possible and as accessible as possible. Rehearse it like a speech. 4) Read the list before you eat and every time you eat. Read the list when you’re cooking or serving yourself food. Read the list just before you start to eat your meal. Read the list just before you place your order in a restaurant. Read the list when you’re about to get up from the couch and wander into the kitchen. Read the list just before you go into the mini-mart to grab a snack when you’re out running errands. If the reasons to make choices consistent with your goals are not in the front of your mind when you are about to choose what or whether or not to eat, they might as well not be in your mind at all. We always seem to know each and every reason why we shouldn’t have eaten that cookie just after we eat it. It’s only by being aware of those reasons before we eat it that can help alter our behavior. (In case you’re wondering why, it’s a forebrain-midbrain thing. Once your cranky 2-year-old midbrain gets the cookie, she’s happy and quiets down, therefore you can now clearly hear your forebrain and all of her brilliant reasons not to eat the cookie….albeit too late.) Having this list is the single most important part of your weight loss journey, and quite frankly the rest of your efforts might be pointless without the list. Here’s why: no learned behavior is ever fully unlearned. Once a particular relation occurs it never returns to zero strength so you never forget that you love donuts, candy, potato chips or chicken wings. These foods will never become completely unappealing because the brain never forgets. Therefore, you have to practice reminding your brain of what you hope to accomplish by losing weight and why eating donuts, candy, etc. is incompatible with those goals. Your brain may never forget just how yummy those foods are, but if you maintain your focus on your goals and avoid overeating those foods (or learn to eat better foods or learn to engage in new behaviors that replace eating), the impulse to eat those foods weakens and you gain habit strength and confidence in new behaviors that are consistent with your goals and avoid getting lost at sea. All weight loss efforts falter when the reasons for persevering weaken. If you have a bright, shining North Star, a setback is just a setback. You just keep on sailing and don’t become adrift. You’re still clear on where you’re going. Even if you have a donut, you can refer right back to your list, view it as an “oops” and get back on track. In fact, when your reasons for losing weight are solid and deeply personal, you might even choose to have an occasional donut, knowing that it won’t cause you to lose your way. None of what I’m suggesting in this article is intended to minimize the importance of other skills in helping you achieve your weight loss goals. You know that losing weight and keeping it off is very difficult and that your brain and body are unrelenting in trying to sabotage your best efforts. Therefore, if your specific reasons to embark on this weight loss journey are unfamiliar, vague or uninspiring, it’s very unlikely that you will make it across a very treacherous, dark ocean. Take the time to make the list and keep your North Star shining bright. My best wishes to you for smooth sailing.

An Unpredictable Scale You are in the small and lucky minority if you lose weight as quickly as you hoped and as regularly as you expect. Everyone else should be prepared for many, many weeks when weight loss comes slowly or not at all. Lose patience, and you might give up on your Weight Loss Surgery journey. Stay patient, and things will eventually turn out right. Focus on the process, such as healthy choices each day, rather than the outcome, such as the scale number or your pants size. You can control your choices, and if you are making the right ones, the outcomes will come. They may just not come when you expect them. A Frustrating Healthcare System One of the biggest tests of anyone’s patience is navigating the system. In this case, you might be trying to figure out your health insurance system and get the reimbursement letter you deserve. Or, you might have more trouble than you had hoped when trying to contact your surgeon. Don’t let these nuisances throw you off. Your perseverance may save your life. Incomprehensible Relationships Anyone who has Weight Loss Surgery is almost certain to have changes in their relationships. When your lifestyle changes, so too may the way you interact with family members and friends. You are working hard to stay on your healthy plan, but they may be working hard to support you and/or understand you. Be patient while there is friction, as it can often turn out okay. You had better be prepared to return the patience if you want to keep your relationships. While you should not feel obligated to tolerate rudeness or anyone who undercuts you, you may need to get ready to have some tolerance for ignorance or friction due to changes in your lifestyle and attitude. Be ready to clearly explain your surgery to the important people in your life, and how it might affect them. Try to keep in mind that a sudden fit of anger from your SO might be a display of a moment of weakness while supporting you, for example, by keeping favorite foods out of the house. Not Knowing the Answer You might ask 25 people the same question and get 25 different answers. Your surgeon may recommend something different than your friend’s surgeon. You may get opposite advice from patients who each swear that their own experience was the “right” one. This gets frustrating! The truth is that, in many cases, there is no single correct answer. The best you can do is to be patient as you dig to find the best answer for your individual case. Understand that you are receiving everyone’s best guess, and the answer – for you – is something that can be determined only after gathering input from those you trust, and mixing their advice with your own intuition. Carry the patience one step further, since you may find out by trial-and-error that your first guess was wrong! Diet You have no doubt studied the Weight Loss Surgery diet and seen warnings about feeling too full, dumping syndrome, and developing intolerances for former favorite foods. Reading about these and experiencing them are two different stories, though! Since they are out of your control, your best bet is to accept and deal with them, not to fight them. Being patient can help you succeed in your weight loss surgery journey. It can keep your weight in check long term, and also keep you mentally fit for minimizing the stresses linked Weight Loss Surgery. Keep practicing it, and your efforts will be worthwhile.