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Definitely watch the alcohol. When you're out, think of yourself as the designated driver. A DD doesn't drink plus there's always water.

Absolutely ma'am! You may be drinking too many calories... 5oz glass of wine is about 100 cals 1.5oz of alcohol is about 100 cals not to mention any mixers... Don't over do it. You came all this way, don't sabatoge yourself.

Hey y'all. I'm a new member and this is my first time posting here. It's been an incredibly long time since I talked to ANYONE who has had RNY, and I'm just trying to reach out and find others who maybe understand what I've been/am going through. I had my surgery when I was WAY too young. I was 23, and totally confused being healthy with being thin. About a year and a half into it I had lost about 150 pounds, but became severely depressed. Then that thing none of us thinks is going to happen to us happened to me--my mysterious food addiction transferred to opiates, then to alcohol, then to alcohol AND opiates, and unfortunately I made it all the way to meth, where I stayed for way too long. I've been clean for a little over 2 years, and I'm actually making positive moves in my life, but I feel very unhealthy and not as happy as I wish I was. I've also become addicted to sugar, ugh... ANYWAY. I should probably save anything more for the "Journeys" forum, just wanted to throw a line out there and see if anyone else has experienced something similar to this? Or if maybe there is an addiction transfer forum/post someone can direct me to? I'd greatly appreciate it. Thanks for reading. Have a good one <3

Milk thistle tea also helps detox the liver. It is not only overweight people that have fatty livers, btw. For those who are not required to be on a liquid diet, some foods that kept me going preop (and not all in one day): Jumbo grilled shrimp with lots of zucchini, grilled fish with broccoli steamed in a pan with a drizzle of olive oil, soup with egg in it, dressing made of balsamic vinegar and spices to go with any raw veggies, roasted chicken with a drop of gravy and two little potatoes, grilled steak with the fat cut away and a side of greens, baby carrots for when I was ravenous and felt I had the worst munchies, a few turkey pepperettes, and sushi (once). I had rye bread on one day with my chicken breast, topped it with organic greens and tomatoes and a slice of high quality cheese. A little bit of Montreal Streak Spice makes all meat and veggies very tasty. Lost 12 pounds in 7 days. I also ate non fat gelato a few times in the first few days (it's usually non fat anyway so the flavour is there) when I was having a sweet tooth meltdown. I figured it wasn't much more calories than the sugar free pops which tasted like chemicals (very hard on the liver), and it was much better than really caving in to the high calorie sweets. I think if one of your weaknesses is a sweet/carb tooth then you will lose weight as soon as you curb those carbs. Note: I was not told to go on a liquid diet and am so relieved as it seems so harsh. There seems to be a big difference between doctors but mine is one of the best in my country, people fly from coast to coast to have him do their surgery (He's done in 20 minutes) and very on top of the latest developments so I was very impressed at his willingness to make changes to his previous pre-op requirements as new info arises. Post op I understand the need for liquid diets because of the healing process, but to hear pre-op people taking sleeping pills and weeping, feeling dizzy and unable to function, severely depressed, bashing themselves, breaking down and eating junk, all because they are following an extreme diet is alarming. But who would ever fight back? And who on earth would defend a heavy person's right to eat? ANyhow, I think that by training yourself to think about positive choices rather than Forbidden Foods, you start to move from a negative mindset (restriction! Not allowed! Bad! Evil fatty! Weak!) to a positive mindset (quality! delicious! Worthy of my heathy happy self! Loving choice!). Of course, detractors will disagree and surely a diet of chemicals and powders and vanilla/chocolate flavoured liquids that has you weeping and tormented makes all the sense in the world. Some may see it as proof of your future commitment. If you have a doctor that forces you to do this to qualify, that is one thing, and good luck/hang in there, but if you are given the choice to make decent choices and stick to low carb, you will be much happier and may lose a lot of weight in a positive way as well. For those who say the doctors always know what's best, your health is also your responsibility. You are your only advocate. DO what you have to but always think things through. If someone tells you to do things that make you ill, does it matter what their credentials are? I once had a doctor tell me I should drink alcohol like everyone else does if I'm having trouble getting to sleep. Did I? No. I had another doctor give me a severe ear infection by sticking the ear scope from my infected ear into my good ear. So, think about everything you are told to do and take good care of yourself.

Kari, I totally understand everything you are going to as well. I had been researching for a long time before I even mentioned that I was looking into it to anyone. Once I went to a seminar and decided was when I started to tell people. My BF doesn't understand the emotional and mental aspects of it, but he is 100% supportive of any decision I would make to make myself healthier. I've had mixed reactions from family and friends, but I just chose like John not to be around those that were not going to be supportive of me. I don't have many friends that struggle with weight and I'm the anomaly in my family. People who don't have food issues don't understand that it is an addiction just like alcohol or drugs. If you were drinking too much and said you were going to get hlep for it everyone would ber so happy for you. Same with drugs, MOST people don't understand the addiction to food. You've made a FABULOUS choice for yourself, if you follow the rules with a little help from your BAND it will be the best choice you've made!! AND you're not alone, we're all here to help along the way!!

Cyn, I was told that you can drink alcohol, but it's considered "empty" calories. So if you drink, maybe just one won't hurt your calorie intake. You'll do good. I was afraid too, but I needed the help. I haven't had a fill yet (surgery 8/10 and fill 9/11) but I have a friend that had surgery too and we sort of help each other. This website is wonderful and everyone will be a big help.

Rubbing alcohol works decent enough. My doctor sent me home with a packet of adhesive remover, try asking to see if they can spare some because this is what works best as it was made for this.

It's definitely the sugar alcohol! I have to limit myself on protein bars now. I know some of the Quest Bars do not have it. GNC carries them and also you can find them online.

Really there have been relatively few things to change from my perspective of "normal". The amount of food I eat has definitely changed. But I can eat meat, salads, most fruits without issue. It takes me longer, but I finish my small portion about the same time they finish their larger ones.... I have changed the types of things I drink. I do have alcoholic drinks on occasion, and even occasionally mix something with some carbonation---never beer, it is way tooooo carbonated! But it has not made me feel an outcast. I have changed the dept. I shop in, but now I can shop with my friends as opposed to leaving them in Misses to go to Plus sizes. Sometimes in the summer, I miss guzzling Water when I am working out....in fact this one truly irritates me sometimes!!! It isn't always fun trying to keep in mind to eat healthy. I mean we have so much less room to get our nutrients in, that I try to keep that in mind, and I do sometimes miss the days I didn't give that a second thought. But not thinking about it, led me to be almost 300 pounds, and on multiple prescription meds----I no longer take any. Sometimes looking in the mirror I see more wrinkles than I used to...now whether I would have seen them even with the excess weight --- who knows, I am 2 years older---I may have had them anyway! I have never had my restriction to be super tight. I have hunger control where I am---and rely on myself for the stricter portion control---I have a fear of being too tight. It has/is working for me. What little things I miss----got me into the shape that was killing me! Hell there are times I really miss cigarettes too---I want one! But I would NEVER start smoking again! I look at it the same way---I did what I did to save my own life and improve my health. No regrets that matter.....I love the changes in my life, and knowing my life is likely going to be longer due to them! Kat

I hoping someone can help me out. I just got banded on May 18th and although i feel perfectly normal.. i drank way to much alcohol this past saturday. I know its ok to drink wine and non carbonated drinks. I was drinking vodka and pineapple juice. Besides the cal intake, which i can handle.. is my band already affected by it? Someone calm me down because i keep on thinking i did something bad to my band. Thanks!! Mio

You may not I have ... but I have. I work in sales, in a male industry. My job includes a lot of travel and entertainment. That means closing down the bar and then being good to go the next morning. Would I get fired if I couldn't drink, no. But it would definitely lower my capital in my company. If I just sat there drinking water while everyone else drinks, I would either be not a team player, or assumed to be a recovering alcoholic. Right or wrong, that is the reality in some companiies/industries.

from what I have heard, if you have nicotine, alcohol, or recreational drugs in your system the day of your surgery the doctor will cancel your procedure.

While I expect a lot of it is hormone change, I sort of see it also as coming off of a lifetime addiction. Watching people I love battle drug and alcohol addiction, I know that extreme irritability, depression and mood swings are all part of the package when you try to detox or break an addiction. Specifically on Atkins, I did induction for 2 weeks and I was such an emotional, irritable mess I couldn't handle it and I had to stop and revert back. Once I brought carbs and sugar back into my diet it was as though I was magically re-aligned again.

Hollow is a great word! I have had at least one 'hungry all day' day. I had stomach issues prior to surgery and have been taking prilosec for about 5 years. So, to me, the hungry wasn't like an acid feeling - if I am comparing it to the burn I have had previously. I do avoid spicy and citrus tho. And straight alcohol. Except for lemoncello : ) And I think I have only had one or two sips of LC in 7 weeks! : (

pnw218, I'll keep you posted if I eventually try some alcohol. I'll probably post something if I'm feeling no pain 'cause I usually think things like that are pretty funny at the time. What a goof ball.

I went to a crab feed 2 weeks out from surgery and had vodka cranberry, no issues at all. It was mostly cranberry and I sipped it for a long time. I think if you just have one small glass and sip it over a period of time you will be ok. We are not in a prison, we are talking real life here, we are going to be in situations where we are around alcohol and need to learn how to handle it in our own way. Best of luck on your decision.

So im kinda curious how drinking alcohol is after post op is quicker or longer i mean what are your experiences with it ????

Moscato ws my favorite evening drink when sitting in a cafe in Rome late at night. It is so fruity and delish. The alcohol content tends to be lower than other wines so it may be "safer" to have a glass when you are cleared for alcohol. Every doctor is different about when a patient can have alcohol. For example, my doctor said 3 months.

I had a tough time with clears (first 10 days for my doctor). Hot tea, chicken broth, apple juice, and Gatorade in the hospital. Propel Zero, Gatorade G2, Vitamin Water, unjury and nectar Protein powders (only certain ones, and with water only) at home. Some drink Isopure, but I found it revolting. Any clear liquid was ok by my doctor, as long as it was low carb and/or sugar free (and alcohol free!). Due to gas discomfort and swelling, I didn't hit my recommended Fluid or protein intake levels until I got on "full liquids" (days 11-20). Once I was allowed to have milk and once the gas disomfort subsided, hitting my daily protein goals was easy. I still have problems hitting my 64 ounces per day fluid goal, however that's only because I forget to drink when I'm sitting at my desk at work. The key (especially early) is small, frequent sips - max 2 oz. per 15 minutes according to my surgeon. I always have some sort of protein or water drink in front of me, as I'm still not on mushies yet (day 18). My best day before day 11 was 48 ounces, and I felt like that was pushing it. Some have an easier time, some tougher. Just be patient. As for protein powders during my clear phase, Unjury strawberry sorbet mixed with lemon Propel Zero or Crystal Light wasn't too bad, kinda like pink lemonade. Also, I liked a couple of the Nectar protein powders (I bought a sample pack from bariatricpantry.com to get me through the clears and to try them before buying a tub). Oh, and you might find plain water boring now. I used to drink 3/4 gallon of ice water per day, now I don't like it. I must spruce it up with lemon, Crystal Light, or drink one of the aforementioned bottled brands. Good luck and welcome to the post-op world!

Ghost, This really does seem like one of those situations that more effort either needs to be made during the yr for more interaction or less effort during the holidays. I personally do not see the point in having your holidays so stressful for someone ( although your dad) who a relationship has to be so forced. Also for your husband , I use to try to force a relationship on my husband with his father. I "thought" they needed to be closer. I would call his dad and put him on the phone . Finally i told hubby you need to be closer to your dad , he told me " NO I dont YOU do NOT know what he put us through as kids, ( it was a VERY bad child hood, his father was an alcoholic and drug addict , my husband ended up living on his own at 14) I have no desire to be around him unless ihave to " And when I stopped calling , the calls stopped. He doesn't call now . He doesnt send pics, he has no desire to even be in contact. Sometimes just because we are family does not mean we get along and can be around each other. GOod luck i hope ya'll have a good holiday . Try not to stress so much. Love Mindy

Not sure of the long term stats. I basically had the lapband because it is far less invasive. Bypass is a major surgery. I also heard that with bypass there is a "dumping" syndrom that can happen. You aren't allowed sugar of any sort and no alcohol. That was a huge factor for me. I didn't want to give it up. Good luck in your decision.

My surgery was yesterday, May 21st. It was a long day, but I think it went well. We were supposed to get there at 7 a.m. for a 10 a.m. surgery slot. DH was worried about being late, so we got there at 6:30 a.m. We checked in, and were taken to a small walled-in room where the nurse went over my vitals with me. I changed into the ultra-fashionable gown, opening to the back, as well as the socks with the tread design. Once I laid down on the gurney, they put the massaging things on my legs, and connected the air. A scopolamine patch was placed behind my ear for possible nausea. It's supposed to last three days. The IV of saline was started, and we waited. Julie, Dr. Clark's Physician's Asst, came in to check on not long before 9, and said that they were getting ready to do a bypass, and that I was next after that. She also gave me a goody bag. The goody bag had several items from On-Q, a pain moderating apparatus. I had it when I had my last intestinal surgery, and wondered if I would have it for this, since this was going to be laproscopic. She said no, it was just some goodies she wanted to give me. On-Q is an IV type set-up where thin lines are run on each side of an incision to deliver morphine right to the incision, instead of having the morphine affect the whole body. I really liked it how it worked, but I'm glad I didn't get it for this surgery, and I don't think I needed it at all. The items in the goody bag were a pedometer/FM radio combination and a set of pens, all embossed with "On-Q". The nurse gave me a shot of Heparin in the leg. That stuff burns going in! It's not unbearable, but it does sting. The IV was turned up pretty high to really pump in the saline, and I got up at about 9:30 to pee. The nurse said that they do this so that the patients will void their bladders, since they want empty bladders for surgery. After I got up, they turned the drip rate down. Dr. Wong, the anesthesiologist came in, introduced himself to me, and he told me what would happen once we got to the ER. I've been operated on before, so I wasn't worried about that part. I ended up getting wheeled into surgery at 10:52 a.m. Dr. Wong put a strap over my forehead that held monitors for my sleep rate, and my arm was stretched out to the side. An injection was made in the IV, and I could smell the taste (if that makes sense). He said that most people just comment that they can taste something in their mouths once they get that injection, but I could actually smell what it tasted like since the taste seemed to be right up at the top front of my mouth. The oxygen mask went on, I was instructed to take deep breaths, and the next thing I knew I was back in my little walled cubicle. I think I recall being in a recovery room, and getting my mouth swabbed, but I couldn't swear to anything that happened there. After I was more awake, but still groggy, I was taken down to radiology for the barium swallow so they could check the placement of the band. Once we got there, I sat up on the edge of the gurney, and sat there for a while because I was light-headed and felt nauseated. The nurse waved an alcohol swab under my nose to help with the nausea. I finally felt ready to go in for the swallow, and they handed me a large glass full of thin barium. I almost dropped the cup, but was able to warn them before hand, so they took it from me, and gave me another minute to stand there. I finally managed to get a few drinks down, and they decided that it would be better to by-pass the standing x-rays. They put the x-ray bed down, and I laid down on it. Then the meanie doctor made me roll over a couple times. I told him that I was going to moon him for revenge for making me roll, and he just laughed. The rolling was uncomfortable, but I managed. Everything looked good, and I even got to see the screen to see what the band looked like on an x-ray. I was then taken back to the cubicle, and could definitely feel every bump when we crossed the elevator threshold or any doorway thresholds. I didn't feel them on the way down. My throat was really dry, so I was able to have ice chips and a popsicle, and that really helped. I was also given a dose of the liquid lortab, and was really happy to have that popsicle as a chaser to get rid of the taste. I was given my choice of what I wanted to try to eat. Out of the cream-of-wheat, scrambled eggs, cottage cheese, cream of chicken Soup, mashed potatoes, and pudding, I chose the eggs and potatoes. No problem getting that down. I was finally let go at about 4:30. As I was getting into the wheelchair, I told DH that I thought he should drive home. The nurse looked startled for a minute, and then she realized I was joking! We're looking for a car for our daughter, and since we were in Indy where there are several car dealerships within a few miles of the hospital, we decided (I insisted) that we not waste the opportunity. DH stopped and got me a bottle of Fiji Water to sip on for the drive. He drove through several lots so we could see what was available. If we saw anything that looked like a possibility, he got the details from the salesman, but no test drives. We just wanted to see what kind of prices are being asked. Anyway, I slept most of the way home. We stopped to fill my prescriptions on the way home. I was given liquid lortab, Ursodiol (for to prevent gall stones), and Protonix (for acid reflux). The pharmacy had to make the liquid lortab, so that took a little while. Not that I really noticed, because I was asleep in the car. Once I got home, I took another dose of lortab, and then rested a while. I went to bed at 11, and had to make a wedge to recline on using my pillows, since lying flat was not comfortable. I woke up at about 9:30 this morning. I'm still sore, coughing hurts even with a pillow against my abdomen, and it's a bit painful to take deep breaths. It's definitely bearable though. I am planning on wearing my binder for at least one week, since it feels good to have that support. Good luck to everyone else!

Not all surgeons require the liquid diet. Mine didn't at all and he has done over 1800 sleeves. Just Atkins style for a week low carb. And I get a last supper the night before surgery including alcohol. I feel very blessed!

You’ll probably find your own strategies for getting through the holidays without gaining weight and without getting into trouble with your gastric sleeve, gastric bypass or Lap-Band. Here are a few tips to get you started. Follow Your Weight Loss Surgery Diet Rules Go back to the basics if you want to stay on track this holiday season. Portion size rules are still in play. A quarter-cup of mashed sweet potatoes is very different than a few large ladles. Measure everything you can. When it’s not possible to measure, eyeball the portion sizes. Enough is enough, and another bite is too much. Stop eating when you’re barely full. It’ll keep you from gaining weight or from getting dumping syndrome or feeling sick. Choose protein first, whether it’s turkey, ham, or the egg whites from deviled eggs. Go for vegetables and fruit next, whether it’s salad, roasted veggies, cut raw veggies on a vegetable platter, or a fruit salad. Keep moving. Make time for your regular workouts. On the days when things get too busy, think about moving as much as possible. Go for walks whenever you can as long as the weather does not involve icy conditions, white-outs or other dangerous situations. Always Be Prepared You don’t always know when they’ll happen, but challenging situations are sure to hit. Always be prepared so you can come out on top. For example, you can keep some almonds and yogurt at work so you have a high-protein snack available at any time. That’ll help you stay away from the chocolate-covered raisins on the secretary’s desk. Also, plan activities that will keep you out of the kitchen. When you’re off work and at home without anything to do, you might find yourself wandering over to the fridge. Keep yourself busy with anything that will keep you away from the fridge, whether it is meal planning, taking a walk, doing needlepoint, or going to the mall. Make Holiday Recipes Healthier Make healthy substitutes for holiday favorites. Try broccoli slaw or grated turnips fried in cooking spray instead of potato latkes deep-fried in oil, and serve with apple slices and Greek yogurt instead of sweetened apple sauce and sour cream. Turkey or ham instead of duck or brisket. Roasted root vegetables with rosemary or green beans with almonds instead of green bean casserole. Roasted sweet potatoes or acorn squash instead of candied yams or sweet potato pie. Baked apples with cinnamon instead of apple pie. Hot tea with a cinnamon stick instead of hot cider or spiced hot wine. Be a Good Guest and Host How does that help you lose weight? When you’re a guest at someone’s party or event, bring a dish to share. The catch is that you make it a healthy dish. If there’s nothing else healthy for you to eat, you can always keep munching on the dish you brought. If you’re hosting a holiday party or dinner, you can still serve everyone’s favorite dishes. Just make sure to make some dishes that you can enjoy, too. The following are good party dishes. Shrimp cocktail Skewers with cherry tomatoes, mushrooms, and low-fat mozzarella or feta cheese Stuffed tomatoes with fat-free cream cheese and olives Salad with spinach or mixed greens, pistachios, and cranberry vinaigrette Chicken and vegetable skewers Roasted Brussels sprouts with chestnuts and sage Fruit salad Spoil Yourself You are someone who is entitled to eat only the very best, and not someone who must eat everything that is available. Think of yourself as picky, not deprived. Unless, of course, you are afraid of dumping syndrome or you have certain food intolerances, you can eat your favorite holiday foods. Just keep the portions small, and choose only the ones you truly want. You’ll feel better deliberately eating a few controlled and measured bites of your aunt’s sausage stuffing than you will if you skip it and later eat a cup of it, plus some mashed potatoes and gravy, because you feel deprived. Want It When Willpower Runs Thin Want it. We all run out of willpower around this time of year. Instead, think about your “want power.” It’s not about, “I need to gather the willpower to pass up this cinnamon roll.” It’s about, “I’m going for a walk in about an hour, and I’m going to feel way better during it if my stomach isn’t bugging me because of a cinnamon roll.” Drink Water. Drink Water. This tip has so many benefits! Drinking water instead of alcoholic beverages can save tons of calories. Choose water or hot tea instead of cider, hot chocolate, and other caloric drinks. There are other reasons to drink water. Sip on water at parties. As long as you’re circulating the room with a glass of water in your hand, you won’t be able to carry and eat from a loaded plate. Plus, your weight loss surgery diet doesn’t let you eat solid food while you’re drinking water. Choose the water over the solid food for most of the party, and you. Enjoy the Company, or Pretend to This may be the only time of year you get to see certain friends or family members. Take advantage of it. Focus on them, and not on getting seconds and thirds. You may actually find that you enjoy your holiday events more when you notice the non-food aspects of them. Socialize even if you don’t like the company, because it’ll keep you from digging into high-calorie food that you don’t need or want. Look at it this way. If someone told you you could lose weight and the only thing you’d have to do is listen to your coworker’s friend’s husband talk about his snail collection for an hour, you’d do it, right? Well, do it. You can stay healthy this holiday season as long as you focus and plan ahead. Once you do, you’ll feel very proud of yourself, and with good reason. Happy Holidays!

Today, during one of my pre-op psych evaluations, I heard a woman say “I just feel like once I start losing weight and start feeling so much better about my self- I will stop doing all the destructive things that got me here. Don’t you think?” My response was “no I don’t agree.” I went on to explain that hers was a common assumption, a dangerous “magic-bullet” fantasy about what weight loss surgery can do. Here’s why: The part of our brain that is responsible for the thought : “wow I look so much better, I better not mess this up,” or “I feel better than I have ever felt in my life, I am a changed person,” is not the same part of the brain that wakes us up in the middle of the night and says: “go on, finish that 1/2 pint of Chunky Monkey in the freezer, there’s only a little bit left anyway, and I have been so good here lately.” We are dealing with two very different brains; the frontal cortex and the reptilian mid brain. The frontal cortex is the most newly developed (relative to other parts of the brain) part of the brain. It is the component that separates us from animals. It gives us the ability to think about consequences, plan, and execute. It is the “higher” part of ourselves, that often says “why do I keep on doing the same things I keep saying I won’t do anymore?” Or “I feel so out of control. This _______ (eating, smoking, drinking, gambling, pick your poison) is a temporary solution that produces long term pain. I have to find a different way.” Our reptilian midbrain is the Commodore 64 to our MAC; it is the palm pilot to our iPhone; the horse and buggy to our Prius; the Tommy Lee to our Oprah. Our midbrain is antique equipment, long ago evolved to keep us alive and hence the reason it is still with us today- it keeps us alive. Our midbrain contains the parts of the brain that make us recoil at the site of a snake or a spider in our peripheral vision. It is hardwired to not have to go through superfluous channels of the brain that might otherwise say “hmmm what is that crawling over there? How do I feel about that? Oh its just a spider, my aunt had a collection of spiders, maybe I should collect things, etc etc.” We just jump, and process later. That very system has helped humans survive for thousands of years. There is an adaptive quality to a brain that proverbially acts and asks forgiveness later. That very old structure once kept us out of harm’s way when a pack of tigers were first seen galloping across a horizon, or when a rivaling tribe could be heard in the far off distance, threatening to pillage our territory. Our midbrain is associated with learning and reward. Learning what makes us feel bad, what eats us (in the past that would be in a literal sense- like tigers, but presently it might be a mercurial supervisor or unending debt), and even more relevant to this article- what makes us feel good. When our brains come across something that makes us feel good (ex: sex, drugs, food), we are then flooded with an influx of the powerful neurotransmitter- dopamine. Just like not everyone that is exposed to drugs will develop an addiction, not everyone that eats a Nutella crepe will develop a food addiction. Much of the research on obesity currently, postulates that food addiction, no dissimilar than alcohol or drug addiction- is a reward system dysfunction or dysregulation, born out of genetic predisposition. It’s almost as if some brains think “if one slice of pizza feels good, how would four slices of pizza taste?” To break these two very different parts up in a different, more basic way; our frontal cortex is the voluntary, while our midbrain is the involuntary. This very dangerous fantasy, many people carry into weight loss surgery is a myth that I try to dispel quickly. This type of “magic bullet’ thinking is the very thing that gets so many gastric bypass and sleeve patients into trouble years down the road. No one wants to look at triggers. No one wants to sit with a therapist and devise a strategic coping plan. We want a pill, a surgery, a 16 minute solution to a 40 year old problem. This is not to say that weight loss surgery is not a solution, just that its only part of the solution. Despite our best intentions, we are still in some ways animalistic, hedonically-driven to feed our most basic impulses. This is part and parcel of why recidivism is the rule not the exception when it comes to recovery from most addiction. So what does this mean? Are all weight loss surgery patients destined for disappointment and disenchantment when the WLS honeymoon ends? No. But the answer to long term change lies more in two-pronged approach to long term weight loss success; surgery + behavioral change. Simply thinking ourself slim is a fantasy. Think about your specific triggers for eating. For some it is that golden hour when all the kids are in bed and Narcos is queued up on your Netflix. For others it is that 2-3pm mid day slump. For some - it is when they are alone, the only time they can eat with abandon free from others’ judgement or their own embarrassment. Whatever your triggers- the key is to identify what need is being met in that moment and to find a non-food alternative to meet each particular need ( many people have multiple triggers for over eating). If it is because its “your time,” after the kids are in bed- maybe you invest in a foot massager, or cultivate a self care space with textures, aromatherapy, candles, and books. If your trigger is that mid day slump, maybe you develop a yoga routine easily done in the office to help re-energize you. If it is the secretive quality to the trigger of being alone and eating, maybe it is finding another thing that is just your own that no one knows (going to a movie in the middle of the day, getting an overly priced facial on your lunch hour, playing hooky with your kid one day, etc). The rule of the brain is : what fires together, wires together. So over time- if you have paired 8pm, Narcos, and nachos- you have created a neurological super highway. The moment 8pm rolls around, you are likely already getting the chips ready and didn’t even realize the thought pathway that just occurred. The idea is to repair our triggers with alternative behaviors and over time “clip those wires” or create “toll roads” to our superhighways (aka neurosynaptic pruning), so that we no longer experience such strong urges and can call upon the higher structures of our frontal cortex to guide the way again. When we are in the midst of addiction, it is important to understand that our frontal cortex is not at the wheel. It has been duck taped and tied to a chair in the basement by our hedonic midbrain who is used to getting what it wants when it wants it. The closer we come to accepting this principle, the closer we come to being more mindful of our midbrain’s powerful rationalizations and sick contracts and see them for just that. We are better able to dis-identify from the thought, knowing it is not coming from our best self, but from our most carnal self. Think of that distant cousin that only shows up when they need something, the Uncle Eddy that tells you he’ll move the RV when he leaves next month, indifferent to how it makes you feel. Except in addiction- that distant cousin has taken over, pretending its you until you can no longer tell the difference. References http://brainspotting-switzerland.ch/4_artikel/Corrigan & Grand 2013 Med Hyp paper (proofs).pdf Blum K, Chen AL, Giordano J, Borsten J, Chen TJ, et al. The addictive brain: all roads lead to dopamine. J Psychoactive Drugs. 2012;44:134–143. [PubMed] Avena NM, Gold JA, Kroll C, Gold MS. Further developments in the neurobiology of food and addiction: update on the state of the science. Nutrition. 2012;28:341–343. [PMC free article] [PubMed] Gearhardt AN, Yokum S, Orr PT, Stice E, Corbin WR, et al. Neural correlates of food addiction. Arch Gen Psychiatry. 2011;68:808–816. [PMC free article] [PubMed] Saper CB, Chou TC, Elmquist JK. The need to feed: homeostatic and hedonic control of eating. Neuron. 2002;36:199–211. [PubMed] Stice E, Yokum S, Zald D, Dagher A. Dopamine-based reward circuitry responsivity, genetics, and overeating. Curr Top Behav Neurosci. 2011;6:81–93. [PubMed] Blum K, Sheridan PJ, Wood RC, Braverman ER, Chen TJ, et al. The D2 dopamine receptor gene as a determinant of reward deficiency syndrome. J R Soc Med. 1996;89:396–400. [PMC free article] [PubMed] Comings DE, Flanagan SD, Dietz G, Muhleman D, Knell E, et al. The dopamine D2 receptor (DRD2) as a major gene in obesity and height. Biochem Med Metab Biol. 1993;50:176–185. [PubMed] Noble EP, Noble RE, Ritchie T, Syndulko K, Bohlman MC, et al. D2 dopamine receptor gene and obesity. Int J Eat Disord. 1994;15:205–217. [PubMed] Blumenthal DM, Gold MS. Neurobiology of food addiction. Curr Opin Clin Nutr Metab Care. 2010;13:359–365. [PubMed] Volkow ND, Wang GJ, Fowler JS, Telang F. Overlapping neuronal circuits in addiction and obesity: evidence of systems pathology. Philos Trans R Soc Lond B Biol Sci. 2008;363:3191–3200. [PMC free article] [PubMed] Volkow ND, Wang GJ, Baler RD. Reward, dopamine and the control of food intake: implications for obesity. Trends Cogn Sci. 2011;15:37–46. [PMC free article] [PubMed]