It’s NOT a DIET!
In the case of bariatric surgery and the questions patients ask about their post-op “diet,” most bariatric professionals speak in terms of the lifestyle and dietary changes that accompany post-op living. The majority of patients, both pre-op and post-op, understand that one of the goals of preparing for bariatric surgery is to begin making healthy, positive changes to one’s lifestyle. Which, of course, is code for changing behaviors (primarily eating and exercise). Hence, the popular phraseology that “bariatric surgery requires accompanying lifestyle changes” in order for one to maintain the weight loss they experience during “the honeymoon” stage.
For many (most?) people who have bariatric surgery, being on a “diet” of one sort of another has been a way of life prior to having a bariatric surgical procedure. Atkins, Paleo, low carb, low fat, vegan, gluten-free, DASH diet, ZONE diet, Jenny Craig, Whole 30, Weight Watcher’s, very low carb, Sugar Busters, etc. etc. etc. Sound familiar?
When I hear post-op patients talking about “going on a ‘diet,’” I really want to scream, “THIS ISN’T ABOUT A ‘DIET’! It’s about LIFESTYLE CHANGES!”
Don’t get defensive here if you have gone on a “diet” as a post-op. I understand that if you have regained weight, and are working with a bariatric professional, there may be a “diet” of sorts prescribed. That’s not what I’m referring to when I talk about my frustration. It’s when a post-op continues the diet-as-a-way-of-life mentality that I feel frustrated, and sad, actually.
Living life “on a diet” can be (and is, for some people), a way to: 1) avoid other things (feelings, relationships, etc.) by focusing all of their thoughts and attention on “the diet,” 2) remain obsessed with food (which may be an indication of a food addiction and/or my first point), 3) remain connected with others as “dieting” may have been the basis of their relationship with family members or friends, 4) attempting to have some area of control in life, and/or 5) lots of other things.
Regardless, dieting as a way of life is probably not a healthy way to live (for most people).
Sidenote: I add that “for most people” part because, sure as I’m sitting here, if I don’t say that, somebody is gonna get really ticked off and start thinking about how that isn’t the case for THEM and THEN they may miss the point of the whole article…
The POINT, by the way, is… choosing to have bariatric surgery is also choosing to make healthy, positive lifestyle changes. IF you want to sustain the weight you lose as a result of the surgery – and your efforts.
And YOU are in it to win it. SO… here’s how to change your thinking from making changes in your “DIET” to making changes in your lifestyle:
- AWARENESS: Learn the difference between a “diet” and a “lifestyle change” if you don’t already know. Discuss this with your bariatric professionals, your support groups and your family members. Help those in your life understand the difference, as well. IF you fear not living on a “diet,” then perhaps consider getting some counseling to look into the reasons being “on a diet” is emotionally important to you.
- ACCEPTANCE: Realize that if you want to live the rest of your life at a healthier weight, then lifestyle changes in the way of “diet” (as in what you eat), as opposed to “A DIET,” such as the ones name above, are necessary. And the healthy dietary changes need to a lifestyle… meaning you continue them every day, one day at a time. In addition, the lifestyle changes necessary to life your healthiest life can include things such as increased physical activity, exercise, learning healthy coping skills, developing a healthy support system, etc.
- ACCOUNTABILITY: Find ways to be accountable for engaging in healthy lifestyle behaviors. Maintain food and exercise journals. Participate in support and/or accountability groups. Work out with others. Start a walking club. Start a support group. Take responsibility for your health. This day. Every day.
- ATTITUDE: Work to have a more positive attitude about the difficult parts of the journey. Read positive quotes. Maintain a gratitude journal. Encourage others. Talk to yourself when you’re grumpy and remind yourself that will not lead you in the direction you want to go!
- COMMITMENT: Make a list of the reasons you are working so hard to develop a healthier lifestyle and every day, SEVERAL times a day, state out loud your commitment to doing so. OUT LOUD! Your brain will hear you and respond in a positive way.
- EFFORT: Unless you do the doing, nothing much will happen in the way of results. So this EFFORT thing needs attention every day. Get help to get you going if you need to! Yep – that means: Ask. For. Help. You can do that!
- Your SELF matters. Be as loving toward yourself as you are to others. You are just important as every other person.
Using these 4 ACES will get you to the place where a healthy diet is part of your healthy LIFESTYLE!
Connie Stapleton, PhD
Connie Stapleton, PhD is a licensed psychologist who has worked in the WLS community for decades, conducting pre-surgical evaluations, doing pre- and post-op individual and group therapy, speaking an national and international conferences, and writing books and articles. Connie has an online show called ConnieCasts (learn about them on her Facebook page and YouTube Channel). The ConnieCasts feature invited guests from the WLS community throughout the country to share their experience and knowledge on a variety of weight loss topics including Regain, Food Addiction, and many others. Connie also does online pre-surgical evaluations and personal therapy for people in GA and SC. Check out the MindPrep video series at www.MindPrepvideo.com and Connie's website at www.conniestapletonphd.com
I'm certain you have a lot of wisdom and experience that you are sharing with others on this journey! Thank you for the feedback!
On 1/11/2018 at 11:25 AM, orionburn said:I think this is one of the key takeaways. I don't consider myself to be on a "diet" any longer. In days of old being on a diet meant cutting out junk food, eating more salads, etc. It was always intended to be short term. Now that I've cut out so many things of old I don't consider myself to be dieting. What I eat now I consider to be normal.
Love your thoughts! Thanks for sharing.
On 11. Januar 2018 at 4:52 PM, FluffyChix said:@Connie Stapleton PhD With all do respect, while I have mad respect for your PhD and knowledge, this is just folderall and semantics. Lifestyle Changes are simply the fad term for today as is "mindfulness." 20 years ago it was called CBT, but few embraced it because it didn't have the right spin.
I agree. You take a look into the box that has a label stamped on that reads "lifestyle changes" and when you take a look inside the box you see something in there that would have been called "being on a diet" some years ago.
Too many lifestyle changes are really diets in disguise (maybe that is why they don't work longterm - just like diets).
On 1/12/2018 at 8:38 PM, Tealael said:Nice, are you still Protein oriented like most surgeons want or do you not focus on that. I know vegan lifestyle and wls is tough...
Protein? What’s that??? Lol i don’t focus on any macro or micro nutrients, just good wholesome foods.
I’ve also read the book by bariatric surgeon Dr Garth Davis, called Proteinaholic. He’s got loads of sources and science behind the western diet craze of protein, specifically animal Proteins. It’s a great read if you’re interested.
56 minutes ago, Newme17 said:I’ve also read the book by bariatric surgeon Dr Garth Davis, called Proteinaholic.
I read his "WHEAT BELLY" series of books and online contributions a couple of years ago.
3 hours ago, Rainbow_Warrior said:I read his "WHEAT BELLY" series of books and online contributions a couple of years ago.
I’m not sure if it’s along the same lines of where he’s at now, I’ll look in to it. I know he wrote some books previously that he had to backtrack and say he was wrong (obviously after the science proved he was).
On 1/13/2018 at 6:35 AM, summerset said:Then why do so many patients treat it like one? Fault of the treatment team because they seem to treat it too often like one, too?
I can't say for certain the reason(s) patient treat the lifestyle as a 'diet.' Perhaps one reason is that many patients are so used to living on a 'diet' they are like a fish out of Water if they are NOT on a diet! It saddens me to think that bariatric treatment teams act as though patients are on a 'diet' following surgery. It's really about a healthy lifestyle to include a healthy diet (meaning the foods you eat, as opposed to a diet like Jenny Criag or the like).
10 hours ago, Connie Stapleton PhD said:It saddens me to think that bariatric treatment teams act as though patients are on a 'diet' following surgery.
I don't know if some members of treatment teams really view it as a permanent, lifelong diet but I sometimes get the impression that they do, e. g. when patients are given instructions like "eat only x amount of calories a day, don't eat more than x grams of fat and x grams of carbs a day and exercise x times a week" - that sounds like your usual dieting advice (since a view years all "dieting advice" seems to be marketed as "lifestyle changes") and a surefire way to obsession and burnout in the long run.
QuoteI can't say for certain the reason(s) patient treat the lifestyle as a 'diet.' Perhaps one reason is that many patients are so used to living on a 'diet' they are like a fish out of Water if they are NOT on a diet!
Maybe you're right with this.
I can remember after post-surgery nutrition class was over and the nutritionist clearly said to ditch the low-fat stuff that two patients were talking about "buying skim milk, low-fat cheese and low-fat curd". I was thinking "WTF?? What exactly did the nutritionist talk about only 15 min ago?? Why aren't people just glad that they will never have to eat this awful stuff again?"
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I believe the issue is rooted in the fact that the word "diet" has two separate meanings.
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1.the kinds of food that a person, animal, or community habitually eats."a vegetarian diet"
synonyms: selection of food, food, foodstuffs; More -
a regular occupation or series of activities in which one participates."a healthy diet of classical music"
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2.a special course of food to which one restricts oneself, either to lose weight or for medical reasons."I'm going on a diet"
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(of food or drink) with reduced fat or sugar content.modifier noun: diet"diet soft drinks"
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My NUT is a lowfat textbook nutritionist basically. This bariatric office is only a year old and while the physician is an accomplished surgeon the staff is fairly young and inexperienced with this genre of patients, in my opinion. I just emailed last week and basically received no suggestions as to breaking my month long stall. Also I was not impressed by the group meetings - I kept asking 6 months prior to surgery and never received the information on them until the month of surgery. I went once and there was no interactions with each other - there were 2 testimonials from RNY success stories, nothing for GS and no discussions amongst attendees. And at that mtg the NUT was more interested in whispering to a colleague while the Psych led the program. He was VERY enthusiastic and engaged. I will try again in March, I have a conflict in February.
19 hours ago, Connie Stapleton PhD said:I can't say for certain the reason(s) patient treat the lifestyle as a 'diet.' Perhaps one reason is that many patients are so used to living on a 'diet' they are like a fish out of Water if they are NOT on a diet! It saddens me to think that bariatric treatment teams act as though patients are on a 'diet' following surgery. It's really about a healthy lifestyle to include a healthy diet (meaning the foods you eat, as opposed to a diet like Jenny Criag or the like).
While I absolutely know that there are things I can't "know" until I've had the surgery, such as how it feels to have little interest in food...the afterlife of post-WLS eating might potentially be one of these "you won't know til you're there times." So maybe my position on having an established isocaloric maintenance diet based on my individual metabolism might change.
However, I still look on this statement as being a little--mmm, I don't know--sanctimonious in nature? Here is why I say this...most of us do not "magically" arrive at 300+ pounds overnight. Most of us have a LIFE long issue with having "appropriate" and balanced relationships with food. Most of us are relatively ignorant about "proper" human diet composition, and the few hours we spend in classes with our RDs or support meetings are not enough to educate us thoroughly. Most of us do not really believe we have to make healthy choices after surgery. Most believe that magically, everything in moderation will work for them despite the fact that because of issues--they were never able to understand the whole idea of moderation. Moderation got me all the way to 325lbs. I'm lying to myself if I think operating on my gut is going to magically change how I process thoughts, emotions, cravings, etc.
As I've been harped at, this surgery operates on my guts--not my head. Seems to me, that it's somewhat magical thinking that a surgery that is meant to rearrange our digestive system, can magically restore a natural order of things with what goes in our mouth or down our gullets. This surgery does not operate on our minds--other than that it will alter the whole gut-brain neurochemical pathway. But this surgery is not about brain surgery. It's gut surgery.
I support this position with the dismal statistics that we as a surgical whole will only maintain 50% of our weight loss. While I agree that's way better than only 5% maintaining a 10% weight loss over 2 years, maintaining only 50% of our weight loss after substantially mutilating our digestive tract is rather SUCKY odds. Super sucky odds. It seems to be expected by our surgical team that regain WILL happen in the 2-3rd years (maybe 15-20lbs or more). Again, suckage!!!! I for one am not willing to go quietly into that good night. I want to be proactive and if that means I have to be on a lifelong diet--then a-the-forking-men to that. I certainly won't santimoniously sit and judge if someone else chooses to do "healthy choices in moderation." I will just wait and watch and review the situation in 3 years.
So then I look at the stalwart members of this board and other forums who are maintaining the initial post surgical weight losses at 10-15 years out and beyond. They share a common trait. Despite different levels of activity, ALL and I do mean without exception, ALL--every last one of them, maintains a rigorous diet protocol where carbs and calories are still measured and logged every day. ALL stay within a diet window. If they're up 5lbs, then eat like very lightly until they are back down 5lbs.
Sincerely,
Cranky and Pis*ed Off With Semantics in Houston (by the way...if the king's is nekkid, then someone ought to tell him his new suit sucks)
Edited by FluffyChix
I follow a low carb/high protein/high healthy fat way of eating and have done so for the past almost 2 years (including the food stages post-op). To many, this is a Keto diet; to me it is a permanent way of life. I have no intention of bringing carbs or sugar back into my life at any point. I worked hard to make food nothing more than fuel, and I am going to continue to live that way. (I know that this approach isn't for everyone, but it has helped me to lose 225 pounds and beautifully maintain that loss...)
I look at the word diet as "how I eat," and not a program to lose weight. I don't need to lose weight anymore.
Connie Stapleton PhD 342
Posted
You are so right! Thank you for setting me straight!
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