What's So Bad About Cheating on the Post-Op Diet?

No, it’s not great that you could only eat three McNuggets. And yes,cheating is a big deal, and I’m going to tell you why. You’re not going to get away with this one. Miss Jean has eyes in the back of her head. She sees the cookie crumbs on your face and the neon orange faux cheese film on your guilty fingers.

SOME DEFINITIONS OF CHEATING

The word “cheat” has two main connotations. One is cheating in the sense of lying and deceiving. It’s intentional dishonesty. You know what you’re doing is wrong, but you do it anyway. The other connotation of “cheat” is unfaithfulness. Unfaithful to a vow or promise you made to another person or to an organization.

When someone cheats you, do you just shrug and say, “Oh well, he was having a bad day”? Let’s say you bought a car that you thought was brand new, and later discovered that the dealer had fiddled with the odometer and charged you full sticker price for a car with 1200 miles on it. Would that be okay with you?

And what if your spouse, the person you trust with your life, cheated on you by sleeping with your best friend, would you be able to just shrug that off?

If your child got a B+ grade by cheating on a test by copying answers from the student at the next desk, would you be proud of him or her?

And what if you found out that a coworker betrayed you by using the great idea you confided to him or her and taking credit for it when it worked out splendidly? Would you still be eating lunch with that coworker?

Or what if you donated money to a political candidate who you admired, and he or she spent it on a vacation in the Bahamas instead of on re-election expenses. Would that be okay with you? Would you vote for that candidate ever again?

I’ll take a guess at your answers to these questions. In none of the situations I’ve described would you be happy or proud. In fact, you’d be disappointed and angry. So just how can you think it’s no big deal to cheat on your post-op diet?

EXCUSES, EXCUSES

I can hear grumbling in the room. I think I just heard someone saying, “I had to eat that mashed potato. I was so hungry and miserable and cranky from being on liquids for a week, I couldn’t stand it another minute.” I do understand very well how you felt, but in the big picture of world hunger, where babies die because their mothers eat so little that they don’t produce enough milk for nursing, your and my hungry misery is a big So What.

And someone else is whispering, “My best friend’s surgeon let her eat mashed potatoes on her third day post-op, so it must be okay for me to do that too, even though my surgeon told me to wait until my 15^th day post-op. It’s not my fault that every surgeon has a different post-op eating protocol.”

While it’s true that surgeons’ eating instructions vary widely, you signed on with your surgeon, not your best friend’s. Presumably you chose your surgeon because you and/or your insurance company believe that he or she is well-qualified in laparascopic bariatric surgery. During your psych evaluation, you affirmed that you understand what the surgery involves and that you can and will follow instructions. You nodded when the shrink asked if you’re ready to make all the lifestyle changes needed for success. You nodded when the dietitian asked if you understood your pre- and post-op eating instructions. You scribbled your own name on a sheaf of release papers to indicate that you were informed about the risks involved and despite those risks, gave your surgeon permission to perform surgery on you.

In addition to all of that, you spent weeks or months jumping through hoops to prove your need for bariatric surgery. Perhaps you suffered through a six-month pre-op diet. You had lots of medical tests and evaluations, most of them not much fun, because you were so eager to get your weight loss show on the road. You had surgery, suffered some degree of discomfort from your incisions and gas, and finally heaved a sigh of relief because all the struggles are over now.

But then you discovered that there are still more struggles to survive because of that stupid post-op liquid diet. Yet despite jumping through all those hoops, in less than 60 seconds you blow it by popping a Cheez Doodle in your mouth, and justify that with the aforementioned misery excuse.

And man oh man, that must have been some really serious misery, because evidently it drove out of your mind all the very good reasons for faithfully following that post-op diet progression. You forgot that one of the most common causes of band slips is the patient’s failure to follow the post-op diet. You forgot that food can get stuck in the stoma or esophagus and cause an obstruction or vomiting. You forgot that vomiting can disturb the position of the band, especially when you’re a new post-op and your stomach is still healing from surgery. You forgot that in order to move mashed potatoes or Cheez Doodles through your digestive system, your esophagus and stomach must expand and contract, which can disturb the position of your band and cause it to slip. You forgot all the promises you made to your bariatric team and to yourself about healthy eating and weight loss success, because you were so miserable and just a few little cheat bites are no big deal.

I’ll try to give you the benefit of the doubt. Maybe you thought that being able to eat the Cheez Doodles without having any uncomfortable side effects or complications like a stuck episode, a PB, sliming, chest pain, esophageal dilation or spasms means that it’s okay to eat the Cheez Doodles. Well, I’m here to tell you that’s a wrong assumption. Cheating eating can cause problems without you ever knowing it until it’s too late. Cheating eating is just plain foolish.

YOU’RE NOT ALONE

Now here’s the good news. You’re not alone. Nobody enjoys the post-op diet progression. If any of us were good at following diets, we might not need bariatric surgery in the first place. And only infants enjoy a liquid diet. But in a sense, as a new post-op you’re a bariatric infant who must consume liquids because your body isn’t ready yet to handle anything else. Cheating on your post-op diet is cheating your health in a major way.

If you already cheated once or twice or ten times, that’s not a good reason for continuing to cheat, so don’t do it again! I believe we should begin any project as we mean to go on. If you can’t follow your post-op diet, exactly when are you going to begin your healthy post-op lifestyle? Are you going to wait until after your first fill, or your second fill, or at some hazy time in the future? If so, don’t come running to me when your scale stays stuck on a number you hate. NOW is the time to begin your healthy lifestyle. NOW is the time to practice good band eating skills and making good food choices and controlling portion sizes. Doing that may not be easy, but it’s not impossible either. Losing a massive amount of weight is a big, tough project, but if you respect your band, it's going to be easier than any of your past weight loss attempts. Let me clarify that: it's going to be easier if you follow instructions.

In addition to that healthy lifestyle, there’s another very good reason to stick to your diet. At some point you’re going to have to face up to your past and acknowledge that food and eating have been a major problem for you. The fact that you’re struggling with your post-op diet is a symptom of that. There’s no shame attached to that struggle. As mentioned above, if we didn’t struggle with eating, we wouldn’t need bariatric surgery at all. So I suggest that you look at the post-op diet (and your pre-op diet too, for that matter) as a rite of passage. During this rite, you’ll be painfully aware of just how many food devils you possess, because without food to shut them up, they’re going to be jumping up and down and screaming for your attention. But their wish is no longer your command. You’re going to send them a clear signal: that you’re not going to submit to their demands any more. From now on, you’re going to follow your surgeon’s and dietitian’s eating instructions no matter how much commotion those devils make. You’re in charge now. As the saying goes, today is the first day of the rest of your life. Do yourself a favor, and make it a day without Cheez Doodles!