Amanda Dutton LPC

The honeymoon period. The time period after the surgery, when the weight is coming off without much effort, and you feel like it was the best decision you ever made. The compliments are coming from everyone, you're fine with taking the supplements, the protein shakes, heck, you're even okay with losing some hair – it'll grow back, right?
But what about when you've reached “that” point? The point where the weight loss has slowed. The “head hunger” has started and, well, the “fun” has worn off. Reality sinks in that this “real life.” This is something that you need to keep up with. This is now your...gulp...”everyday” life.
Did you expect to have depression creep in? Or maybe creep back in? Most of us thought this surgery would correct our mood issues, thinking that losing the weight would help get rid of that which was bothering us. So what happened? Why are we sad, frustrated, mad? Why aren't we...well...happy?
A lot of this can be attributed to losing our primary coping tool to deal with depression and stress: mindless consumption of food. We may not have realized it at the time, but food was our comfort, our companion, sometimes the only thing that was there for us when nothing/nobody else was. Now, that support is no longer something we can reach for in hard times to get us through. We are physically and emotionally missing/grieving our former “companion.”
Our coping tool.
Sometimes, our best friend.
So what do we do?
First, we have to look at the physical way food was affecting us. Not just related to weight, but in our brain. Food was giving us satisfaction in a way that was “rewarding” receptors in our brain that control the chemical dopamine. Dopamine is a chemical that makes us feel good. This is the same chemical that is triggered when someone uses drugs or alcohol. Yep, scary thought, huh?
That's why we often hear about “food addiction.” We are literally “feeding” that addiction when we overeat. That's hard to accept, I know.
Second, we have to look at WHY we may be overeating. What thoughts do we have that lead us to seek food as comfort? Are they thoughts about ourselves? Are we thinking that “I'm so fat” or “I shouldn't even try” or maybe even “Why do I even bother?” Sometimes the addiction is so deep, it's hard to identify the thoughts that made the behavior start.
Then it may be more helpful to think about the feelings. What feelings direct us to start overeating? Is it anger? Boredom? Defeat? Do the words or actions of another make us feel “less than” and lead to lowered self worth, thus leading to the desire to overeat?
The concept of looking at Thoughts-Feelings-Behaviors is at the core of Cognitive Behavioral Therapy, a standard therapeutic method of behavioral therapists. Finding a therapist that can help us figure out the source of how these 3 things work together to lead us on the path to overeating can go a long way toward correcting the behavior. The key to CBT is retraining those thoughts to become more positive, leading to more positive feelings and behaviors.
Often, we get stuck with “ants” - Automatic Negative Thoughts – and they are hard to undo. With the assistance of a therapist that is trained in CBT, particularly one that is familiar with bariatric surgery, we can retrain our brains to think more positively about ourselves, thus leading to be less dependent on food to nurture feelings of happiness.
What kind of “ANTs” do you want to get rid of? Can you think of a chain of Thoughts-Feelings-Behaviors that you would like to change? What would you rather that chain look like instead?

Have you ever done something in your life that you wish you hadn't? Sure, you have. We all have. If someone says that they haven't, then I would like to meet them. Granted, we can say “everything I have done has made me the person I am today, so I don't regret anything,” and I think that's awesome, but still, there are those things we might have done differently at least.
"Guilt" is your conscience, what tells you that what you are doing is wrong and that you “know better.” Maybe you were 5 years old and stuck a piece of candy in your pocket at the grocery store. Maybe you broke something at your Aunt Judy's house and blamed it on your sister. Whatever it was, you felt guilt because you were the one that had performed the “action” or the “behavior.”
“Shame” is what you feel when you ignore your guilt and do the behavior or action anyway. Let's say that you took the candy from the store, and when you got home and started to eat it, your mom found out and was furious. She took you back to the store and made you apologize. That feeling you had, along with embarrassment, was shame. Shame makes you feel that you are a bad person, that internal dialogue that results in addressing your self-perception.
How Guilt and Shame Relate to Food Addiction
When related to our addiction to food, guilt and shame can come when we fall off the wagon after our surgery (in addiction, this is referred to as a “relapse”). Let's say we choose to eat a food that we know is not good for us after surgery. First we feel guilty for eating the food (the behavior), then we feel shame because we may perceive ourselves as a bad person, a failure, etc.
This kind of thinking, when not addressed effectively, can lead us down the path of ongoing negative self-talk that can cause repeated relapse due to feeling that we have failed ourselves. Think back to times where you may have not done so well on diets prior to surgery. Perhaps a “slip up” on the diet caused you to think “that's it, I screwed up. I might as well give up.” Sound familiar? That's addict thinking. One relapse and the addiction rears its head and we are back in full-force.
Reframing the Thoughts
So, how do we reframe that “shame” and “guilt” so that a possible relapse doesn't derail our progress?
Own up to the mistake – don't hide from the fact that we made a mistake. We all have slip ups from time to time. Take responsibility for it. This is our new lifestyle and we signed up for this for a reason. Accept the consequences, if there are any, and accept them with grace. We are responsible adults, and we have to act as such. Be proud of your accomplishments so far and not ashamed of a mistake that can be repaired.
Fix the mistake – What went wrong? Was there a stress that overwhelmed you? Were you in a situation that put you around a food that was just too tempting? What can you do differently to prevent this particular situation from happening again? Figure out what the cause was that lead to the relapse and how to make it different. If you recognize the situation and change it, and it still happens, then the situation was not the issue. It may be time to dig a little deeper into yourself and see if you have truly identified the mistake.
Ask forgiveness – Surprised by this one? There are others that are probably on this journey with you. Perhaps your support people are aware that you slipped and have verbalized or otherwise made you aware of their disappointment. As part of owning up to the mistake, ask forgiveness and ask for their help. Taking the time to reach out to them and acknowledge that you know they are there will go a long way to keep you on track.
Forgive yourself – above all, DO THIS! - seriously, this is most important. You must forgive yourself for this fall. It's life. We have to get up and move forward. Was it wrong? Yep. Do we feel bad about it? Sure. Did it make us put back on 50 pounds that we lost? Nope. Get up, wipe your eyes, keep moving.

Shame and guilt don't have to be ongoing reminders of our past. Using the steps above, we can grow in many areas of our lives, not just in recovery from our bariatric surgery and our love affair with food. Try these steps with other areas in your life in which you may be feeling shame or guilt.