Katy Harvey, MS, RD, LD, CED

Meet Diane*. She had struggled with her eating and body image as far back as she can remember. Having been on every diet under the sun, she still couldn't keep the weight off. In fact, she had dieted herself up to her highest weight ever. When her doctor suggested bariatric surgery she decided it was her only hope. Fast forward to a year after surgery, and Diane has started regaining the weight she lost. There was an initial "honeymoon" period during which she lost weight relatively easily, but now it's creeping back on. She finds herself grazing on food throughout the day, and notes that her stomach holds more food than it did a few months before. Diane cancels her upcoming appointment with her surgeon because she doesn't want to face the embarrassment of getting on the scale and fears ridicule from the surgeon over what she's been doing with her eating. So she avoids in order to save face. (And who can blame her, right?). Time goes on, and eventually Diane is back at her pre-surgery weight. She's devastated. And ashamed. And mad at herself. "I failed again. I'm such a loser," she thinks to herself. But the truth is - SHE DID NOT FAIL. And she certainly isn't a loser. Diane was suffering from an eating disorder. How is this possible? How come nobody told her? Didn't her surgeon see it? Had she done this to herself? Despite efforts to screen people for eating disorders prior to surgery, they often go undiagnosed. Studies suggest that roughly 30% of people seeking bariatric surgery actually have an eating disorder - with binge eating disorder (BED) being the most common one. Realizing you have an eating disorder after bariatric surgery can be a shock. Many times, people don't realize it until they have regained some or all of the weight they lost. The eating disorder finds ways to have you eat "around" your surgery. As a dietitian who specializes in BED, I have treated tons of people who have an eating disorder after bariatric surgery. And what I can tell you is that recovery is possible. You are not alone, and there are people out there who can help. If you think you might have an eating disorder, click here and start healing your relationship with food today. You deserve it. *Name and certain details have been changed for privacy.

What the heck is "mindful eating" anyway? It might sound like some hippie thing, but it backed by real science. You'll be losing weight and feeling great again, all while enjoying food to the fullest. Check it out here! Mindfulness basically just means paying attention to something - without judgment. Mindful eating is paying attention to your food, and to your appetite cues - again, without judgment (that's the hard part!). Dieting vs. Mindful Eating: Diet = Weight gain: 95% of people who diet will regain the weight they lost within 5 years. 2/3 of those people will regain more than they lost, ultimately resulting in overall weight gain. All about willpower and rigidity. Relies on external cues. Restrictive and depriving. Food & body are the enemy. Mindful Eating = Weight loss: Studies show that mindful eating programs result in weight loss, fewer calories consumed, lower fat intake and increased self-confidence (Timmerman et al., 2012) All about trust and acceptance. Relies on internal appetite cues. Permissive and satisfying. Food & body are the ally. Which would you prefer? For me, I'd much rather give mindful eating a shot. Especially since dieting was what led up to most people having bariatric surgery in the first place. Step-by-step how to eat mindfully: Pick a calm and quiet place to sit down and eat. Check in with your hunger. Are you physically hungry? If not, wait until later when you are hungry. The food will be much more satisfying if you enter the experience hungry. Choose a food that will be satisfying. Give yourself permission to eat that food without judgment (toward the food or yourself) or guilt. Use all of your senses - look at the food, touch the food, smell the food, taste the food, feel it in your mouth, move it around and notice the way the texture and taste changes as you chew. Chew slowly and thoroughly. As you swallow, feel the food going down your esophagus and into your stomach. Notice how the food feels in your stomach. Ask yourself if you want more. If so, take another bite and repeat until you feel satisfied. At the end, take a moment to express gratitude for the experience, for the food, and for your body. Carry the awareness of mindful attention to other areas of your life - you'll be shocked at what a big difference this makes! Be patient with yourself. The practice of mindful eating is just that - a practice. Your mind and attention will wander, you will inevitably catch yourself judging yourself or the food. That's ok - it's normal. Just notice it, and return your attention to the experience. Practice this as often as you are able. Of course, it's not possible to eat mindfully 100% of the time, so don't be rigid with it. As you get more skilled at mindful eating, it will become more effortless and second nature. See, I told you this wasn't just for hippies! Mindful eating is very doable for all of us. We just have to make the conscious decision to do it. Paying attention to our food and our bodies allows us to get infinite more pleasure out of life. Give it a shot and let me know what you think. Share your experience in the comments below. What was it like to pay close attention to the taste and texture of the food? What was it like to refrain from judgment about yourself for eating the food? What surprised you about mindful eating?

Mindfulness basically just means paying attention to something - without judgment. Mindful eating is paying attention to your food, and to your appetite cues - again, without judgment (that's the hard part!). Dieting vs. Mindful Eating: Diet = Weight gain: 95% of people who diet will regain the weight they lost within 5 years. 2/3 of those people will regain more than they lost, ultimately resulting in overall weight gain. All about willpower and rigidity. Relies on external cues. Restrictive and depriving. Food & body are the enemy. Mindful Eating = Weight loss: Studies show that mindful eating programs result in weight loss, fewer calories consumed, lower fat intake and increased self-confidence (Timmerman et al., 2012) All about trust and acceptance. Relies on internal appetite cues. Permissive and satisfying. Food & body are the ally. Which would you prefer? For me, I'd much rather give mindful eating a shot. Especially since dieting was what led up to most people having bariatric surgery in the first place. Step-by-step how to eat mindfully: Pick a calm and quiet place to sit down and eat. Check in with your hunger. Are you physically hungry? If not, wait until later when you are hungry. The food will be much more satisfying if you enter the experience hungry. Choose a food that will be satisfying. Give yourself permission to eat that food without judgment (toward the food or yourself) or guilt. Use all of your senses - look at the food, touch the food, smell the food, taste the food, feel it in your mouth, move it around and notice the way the texture and taste changes as you chew. Chew slowly and thoroughly. As you swallow, feel the food going down your esophagus and into your stomach. Notice how the food feels in your stomach. Ask yourself if you want more. If so, take another bite and repeat until you feel satisfied. At the end, take a moment to express gratitude for the experience, for the food, and for your body. Carry the awareness of mindful attention to other areas of your life - you'll be shocked at what a big difference this makes! Be patient with yourself. The practice of mindful eating is just that - a practice. Your mind and attention will wander, you will inevitably catch yourself judging yourself or the food. That's ok - it's normal. Just notice it, and return your attention to the experience. Practice this as often as you are able. Of course, it's not possible to eat mindfully 100% of the time, so don't be rigid with it. As you get more skilled at mindful eating, it will become more effortless and second nature. See, I told you this wasn't just for hippies! Mindful eating is very doable for all of us. We just have to make the conscious decision to do it. Paying attention to our food and our bodies allows us to get infinite more pleasure out of life. Give it a shot and let me know what you think. Share your experience in the comments below. What was it like to pay close attention to the taste and texture of the food? What was it like to refrain from judgment about yourself for eating the food? What surprised you about mindful eating?

I'm so sorry @snowy'smom. That feeling of being out of control is awful. Reach out to your surgeon and let them know you are struggling. You don't have to go through this alone.

Hi Rosie, I'm so sorry to hear you're having a hard time. If you go to my website https://resetbariatric.com there is an online video training that you can sign up for and watch on your own schedule that will help you get back on track. I hope this helps! Take care, Katy

Getting off track and regaining weight is so frustrating and discouraging! This is why I created a tool to help people get back on track. It's called RESET: Getting back on track after bariatric surgery. It's an online course where you watch the videos at your own pace. It can be found at https://resetbariatric.com Who am I and why should you trust me? I'm Katy Harvey, a dietitian, and I specialize in bariatric surgery and the psychology of eating. I'm also an expert in binge eating disorder and emotional overeating. I've helped hundreds of people find peace with food and their body. Let me know if you have any questions! Katy

Feeling frustrated that you've stopped losing weight, or have started regaining? Check out these 3 ways to get back on track. I was sitting in my office with a client the other day who’d had bariatric surgery several years ago. “It just didn’t work for me. I’ve tried everything. I don’t know what else to do.” She was looking down in shame, and I could tell she was feeling totally defeated. “This is a really common struggle,” I said, “And I want you to know it’s not your fault.” She looked at me in disbelief. The same advice over and over again You see, most people are accustomed to seeing a dietitian and being silently scolded and told to “eat this, not that...blah, blah, blah.” It’s the reason that a lot of people avoid seeing a dietitian - because it feels like you’re in the principal’s office. Truth be told, most people already know what they “should” be eating after surgery. Heck, they even knew before having surgery, but that knowledge wasn’t enough. And it still isn’t. If information were enough to solve a person’s weight problems, bariatric surgery wouldn’t exist. Thus, here you are in a frustrating dilemma: Knowing what you should be doing, but not being able to do it consistently. So now what? It’s time to start thinking about things differently. If what you’ve been doing isn’t working then STOP DOING IT. That same old dieting advice that didn’t work for you before surgery isn’t going to work after either. Don’t worry, I can help. I have worked with hundreds of people who have had weight loss surgery. From that work I have honed in on some key factors that will actually make a difference for you. 3 Secrets to Success Do the things that matter. It’s easy to get bombarded with information and overthink it. You can spin your wheels doing things that don’t matter. I had a client who kept trying all these special protein-fortified foods and finally I told him, “You’re spending a lot of energy on these special foods, and you’re still gaining weight. Let’s look at some other factors that might be impacting you.” He wasn’t seeing that his lack of sleep and snacking were working against him. Once we targeted those issues he started losing weight again. Implement a system. Don’t rely on willpower. Willpower doesn’t work because it’s finite, and it gets depleted by everyday stressors. You’ll inevitably find yourself lacking willpower with food when you most need it if you don’t have a system. Ever been through a drive thru on the way home from work after a stressful day? That’s because your willpower was depleted earlier at work. If you have a system for dealing with stressors at work such as automation of tasks, delegation, stress management techniques, and perhaps a wind-down ritual at the end of the day, you’re much less likely to hit the drive thru on the way home. And your dinners could be automated by a rotating monthly calendar or a delivery system such as Blue Apron. Make yourself a route to drive home that doesn’t go by any fast food restaurants, and BAM! we’ve created a system. Develop habits. People who are successful at something have boring habits. It’s never quick and easy like we’re led to believe. You don’t accidentally win an Olympic gold medal. And you don’t win it with magical solutions either, like taking supplements. Nope, it takes years of intentional and intense training. Same thing with your eating. You don’t accidentally or magically lose a ton of weight just by having surgery and taking vitamins. And you certainly don’t accidentally keep it off for the long run. You need habits that you stick to every single day. Things such as planning your meals ahead of time, grocery shopping on a specific day of the week, exercising at the same time each day. These are the habits that will pay off over time. Systems and habits reduce the cognitive load of having to make lots of tiny decisions all day long. Just like willpower, our decision-making ability gets fatigued and we start to take the easy way out. If something is a habit you’re much more likely to do it - rather than sitting there trying to decide whether or not you feel like doing something. Chances are there are plenty of times you’re not going to feel like going to the grocery store, or cooking dinner, or exercising. If you only do it when you feel like it you’re probably not going to lose weight. What to do today Today, sit down and take a look at what you’re really eating. Don’t lie to yourself, it won’t help. Be brutally honest. Write it all down. Then identify ONE thing that you want to change. Something that if you did it, would actually make a significant difference. Find a way to implement a system around this change, and do it until it becomes a habit. The result: You’ve now shown yourself that you can make sustainable behavior change. You can repeat this process over and over again to create new systems and habits. Keep doing it, and I promise you’ll start losing weight and feeling better, having more energy, feeling more confident. You’ll feel like you’re in control of your life. And that’s pretty awesome. If not, you can always check out this site for more in-depth help getting back on track. Have you made any changes that made a big impact on your weight loss? What did you do to stick with it? Let me know in the comments. Katy is giving away a free gift to help Bariatric Pal readers get moving, have more energy, and feel great.

I was sitting in my office with a client the other day who’d had bariatric surgery several years ago. “It just didn’t work for me. I’ve tried everything. I don’t know what else to do.” She was looking down in shame, and I could tell she was feeling totally defeated. “This is a really common struggle,” I said, “And I want you to know it’s not your fault.” She looked at me in disbelief. The same advice over and over again You see, most people are accustomed to seeing a dietitian and being silently scolded and told to “eat this, not that...blah, blah, blah.” It’s the reason that a lot of people avoid seeing a dietitian - because it feels like you’re in the principal’s office. Truth be told, most people already know what they “should” be eating after surgery. Heck, they even knew before having surgery, but that knowledge wasn’t enough. And it still isn’t. If information were enough to solve a person’s weight problems, bariatric surgery wouldn’t exist. Thus, here you are in a frustrating dilemma: Knowing what you should be doing, but not being able to do it consistently. So now what? It’s time to start thinking about things differently. If what you’ve been doing isn’t working then STOP DOING IT. That same old dieting advice that didn’t work for you before surgery isn’t going to work after either. Don’t worry, I can help. I have worked with hundreds of people who have had weight loss surgery. From that work I have honed in on some key factors that will actually make a difference for you. 3 Secrets to Success Do the things that matter. It’s easy to get bombarded with information and overthink it. You can spin your wheels doing things that don’t matter. I had a client who kept trying all these special protein-fortified foods and finally I told him, “You’re spending a lot of energy on these special foods, and you’re still gaining weight. Let’s look at some other factors that might be impacting you.” He wasn’t seeing that his lack of sleep and snacking were working against him. Once we targeted those issues he started losing weight again. Implement a system. Don’t rely on willpower. Willpower doesn’t work because it’s finite, and it gets depleted by everyday stressors. You’ll inevitably find yourself lacking willpower with food when you most need it if you don’t have a system. Ever been through a drive thru on the way home from work after a stressful day? That’s because your willpower was depleted earlier at work. If you have a system for dealing with stressors at work such as automation of tasks, delegation, stress management techniques, and perhaps a wind-down ritual at the end of the day, you’re much less likely to hit the drive thru on the way home. And your dinners could be automated by a rotating monthly calendar or a delivery system such as Blue Apron. Make yourself a route to drive home that doesn’t go by any fast food restaurants, and BAM! we’ve created a system. Develop habits. People who are successful at something have boring habits. It’s never quick and easy like we’re led to believe. You don’t accidentally win an Olympic gold medal. And you don’t win it with magical solutions either, like taking supplements. Nope, it takes years of intentional and intense training. Same thing with your eating. You don’t accidentally or magically lose a ton of weight just by having surgery and taking vitamins. And you certainly don’t accidentally keep it off for the long run. You need habits that you stick to every single day. Things such as planning your meals ahead of time, grocery shopping on a specific day of the week, exercising at the same time each day. These are the habits that will pay off over time. Systems and habits reduce the cognitive load of having to make lots of tiny decisions all day long. Just like willpower, our decision-making ability gets fatigued and we start to take the easy way out. If something is a habit you’re much more likely to do it - rather than sitting there trying to decide whether or not you feel like doing something. Chances are there are plenty of times you’re not going to feel like going to the grocery store, or cooking dinner, or exercising. If you only do it when you feel like it you’re probably not going to lose weight. What to do today Today, sit down and take a look at what you’re really eating. Don’t lie to yourself, it won’t help. Be brutally honest. Write it all down. Then identify ONE thing that you want to change. Something that if you did it, would actually make a significant difference. Find a way to implement a system around this change, and do it until it becomes a habit. The result: You’ve now shown yourself that you can make sustainable behavior change. You can repeat this process over and over again to create new systems and habits. Keep doing it, and I promise you’ll start losing weight and feeling better, having more energy, feeling more confident. You’ll feel like you’re in control of your life. And that’s pretty awesome. If not, you can always check out this site for more in-depth help getting back on track. Have you made any changes that made a big impact on your weight loss? What did you do to stick with it? Let me know in the comments. Katy is giving away a free gift to help Bariatric Pal readers get moving, have more energy, and feel great.