Top 10 Mistakes WLS Patients Make

I came across this article posted on Bariatric Foodie and I really wanted to share it here on my blog too. It's all pretty basic, common-sense stuff... but just like with anything else, it is really good to get back to basics once in a while! It helps to keep focused on the way we need to live our new lifestyles.

I have to say that right now, none of these are an issue. So I feel pretty great knowing I'm doing things "right"! But I also know it will get harder as time goes on... especially after losing all of my weight and feeling "safe"... I plan to return to this list on a regular basis and make sure my focus is in the right place. I've added it to my sidebar under "helpful articles" as well, if anyone would like to reference it in the future.

So here's the list!

1^st Mistake:  Not Taking Vitamins, Supplements, or Minerals

Every WLS patient has specific nutritional needs depending on the type of surgery you have had. Not only is it a good idea to ask your surgeon for guidelines, but also consult with an experienced WLS nutritionist. Understand there is not a standard practice that all surgeons and nutritionists follow in guiding WLS patients. So, it is important to do your own research, get your lab tests done regularly, and learn how to read the results.

Some conditions and symptoms that can occur when you are deficient in vitamins, supplements, or minerals include:

Osteoporosis; pernicious anemia; muscle spasms; high blood pressure; burning tongue; fatigue; loss of appetite; weakness; constipation and diarrhea; numbness and tingling in the hands and feet; being tired, lethargic, or dizzy; forgetfulness, and lowered immune functioning.

Keep in mind, too, that some conditions caused by not taking your vitamins, supplements, or minerals are irreversible. For example, a vitamin B-1 deficiency can result in permanent neurological deficits, including the loss of the ability to walk.

  

2^nd Mistake:  Assuming You Have Been Cured of Your Obesity

A "pink cloud" or honeymoon experience is common following WLS. When you are feeling better than you have in years, and the weight is coming off easily, it's hard to imagine you will ever struggle again. But unfortunately, it is very common for WLS patients to not lose to their goal weight or to regain some of their weight back.

A small weight regain may be normal, but huge gains usually can be avoided with support, education, effort, and careful attention to living a healthy WLS lifestyle. For most WLSers, if you don't change what you've always done, you're going to keep getting what you've always gotten -- even after weight loss surgery.

3^rd Mistake:  Drinking with Meals

Yes, it's hard for some people to avoid drinking with meals, but the tool of not drinking with meals is a critical key to long-term success. If you drink while you eat, your food washes out of your stomach much more quickly, you can eat more, you get hungry sooner, and you are at more risk for snacking. Being too hungry is much more likely to lead to poor food choices and/or overeating.

4^th Mistake:  Not Eating Right

Of course everyone should eat right, but in this society eating right is a challenge. You have to make it as easy on yourself as possible. Eat all your meals--don't skip. Don't keep unhealthy food in sight where it will call to you all the time. Try to feed yourself at regular intervals so that you aren't as tempted to make a poor choice.

And consider having a couple of absolutes: for example, avoid fried foods completely, avoid sugary foods, always use low-fat options, or only eat in a restaurant once a week. Choose your "absolutes" based on your trigger foods and your self knowledge about what foods and/or situations are problematic for you.

5^th Mistake:  Not Drinking Enough Water

Most WLS patients are at risk for dehydration. Drinking a minimum of 64 oz. of water per day will help you avoid this risk. Adequate water intake will also help you flush out your system as you lose weight and avoid kidney stones. Drinking enough water helps with your weight loss, too.

6^th Mistake:  Grazing

Many people who have had WLS regret that they ever started grazing, which is nibbling small amounts here and there over the course of the day. It's one thing to eat the three to five small meals you and your doctor agree you need. It's something else altogether when you start to graze, eating any number of unplanned snacks. Grazing can easily make your weight creep up. Eating enough at meal time, and eating planned snacks when necessary, will help you resist grazing.

Make a plan for what you will do when you crave food, but are not truly hungry. For example, take up a hobby to keep your hands busy or call on someone in your support group for encouragement.

7^th Mistake:  Not Exercising Regularly

Exercise is one of the best weapons a WLS patient has to fight weight regain. Not only does exercise boost your spirits, it is a great way to keep your metabolism running strong. When you exercise, you build muscle. The more muscle you have, the more calories your body will burn, even at rest!

8^th Mistake:  Eating the Wrong Carbs (or Eating Too Much)

Let's face it, refined carbohydrates are addictive. If you eat refined carbohydrates they will make you crave more refined carbohydrates. There are plenty of complex carbohydrates to choose from, which have beneficial vitamins. For example, if you can handle pastas, try whole grain Kamut pasta--in moderation, of course. (Kamut pasta doesn't have the flavor some people find unpleasant in the whole wheat pastas.) Try using your complex carbohydrates as "condiments," rather than as the center point of your meal. Try sprinkling a tablespoon of brown rice on your stir-fried meat and veggies.

9^th Mistake:  Going Back to Drinking Soda

Drinking soda is controversial in WLS circles. Some people claim soda stretches your stomach or pouch. What we know it does is keep you from getting the hydration your body requires after WLS--because when you're drinking soda, you're not drinking water! In addition, diet soda has been connected to weight gain in the general population. The best thing you can do is find other, healthier drinks to fall in love with. They are out there.

10^th Mistake:  Drinking Alcohol

If you drank alcohol before surgery, you are likely to want to resume drinking alcohol following surgery. Most surgeons recommend waiting one year after surgery. And it is in your best interest to understand the consequences of drinking alcohol before you do it.

Alcohol is connected with weight regain, because alcohol has 7 calories per gram, while protein and vegetables have 4 calories per gram. Also, some people develop an addiction to alcohol after WLS, so be very cautious. Depending on your type of WLS, you may get drunker, quicker after surgery, which can cause health problems and put you in dangerous situations.

If you think you have a drinking problem, get help right away. Putting off stopping drinking doesn't make it any easier, and could make you a lot sicker.

First Week in Therapy

I didn't blog sooner because there wasn't that much to say about the first appointment I had. It was two hours long, but it was mostly about her getting to know me and my history. She was pretty impressed at all the work I put into getting ready for the appointment. We pretty much spent the session going through all of those points and talking about them. I had a good first impression of 'Dr. Kate' and I felt pretty confident she would be able to help me... I just didn't have a whole lot to share since I did most of the talking in the first session.

My homework for the first week was pretty simple. She wanted to me to keep a food journal, but to try and do so without trying to change anything I ate, and she wanted me to try very hard to stay in a non-judgmental place of observation. She didn't want me feeling guilty or assigning 'good' and 'bad' to what I ate.

This turned out to be easier than I thought. I didn't have to measure foods or count calories or points, just write down generally what I ate, what time, and any feelings I may have had.

I had one bad day - that Monday. It was the first day of period week and I was extra hungry, so I found myself eating and eating... but then even once I was no longer hungry, it seemed to turn into a food fest for me. I just kept munching all day long and I felt myself feeling really crappy afterward. Very lethargic and most of all guilty for having been so out of control.

I struggled with 'admitting' all of this in my food journal. It's funny, in the past when food journaling on Weight Watchers, there were times I'd omit things even though no one was ever going to see it besides me. Here I am actually going to show the journal to her, and I actually managed to write down every single thing I had eaten, and how out of control I had felt. Miraculously, I think it actually helped me... because in the past that would have turned into 2-3 days of the same behavior, but this time it stopped after one day and I had a pretty good week of normal eating.

Besides the food journal and being aware of any emotional eating, the other homework I had for my first week was to come up with at least 5 "self-care items"... see, she doesn't only focus on Intuitive Eating... she includes that as a part of Intuitive Self Care. I really like that she is trying to help me improve all areas of my life because I know that all areas of my life have something to do with my health. I obviously have plenty of emotional issues and food is how I deal with them.

I had a harder time coming up with self care items than I thought I would. Part of the problem is a lot of the things I thought of cost too much for me to do them on a weekly or monthly basis... like pedicures and massages. I still put them on the list but without any sort of regular timing. I will probably get a pedicure this coming week with a friend, but it may be 2 months before I get another one. (I haven't gotten one since before my wedding six months ago!) I put massage on the list, but I'm planning to get one at the massage school clinic so that it will be cheaper and I won't expect as much. I'm so picky about massages since I am a massage therapist myself, and I haven't been completely happy with any of the massages I've gotten, even when I've paid a LOT.

The third item on my list was "make more time for digital scrapbooking." Even though I have plenty of TIME to scrapbook, I just don't do it very often. I get into a lazy mode where all I want to do is 'veg' and I don't want to put any energy into anything. Thus the lack of blogging, keeping up on photos, scrapbooking, whatever it may be. Lately my scrapbooking track record is once a month or even less... for something I actually enjoy doing! Why is that? So I really need to start making some creative time for that.

The fourth item on my list was "find somewhere to sing with a group." I was in choir in high school and it was such a great thing for me. I also used to love singing at church. I haven't done either of these things in so long. I haven't even been to a church since I moved here almost four years ago. I don't really know where I stand with my faith and that's one thing that has kept me from going. I felt like going just to enjoy the music was blasphemy or something. I also haven't tried to join any choirs since I can't site read. In high school the choir director would sing each part and I'd learn by ear... but when I tried to join in college, that didn't happen and so I was completely lost trying to learn my part.

I didn't have a 5th item on my list when I went, but after the fact I realized making time for my blogging and pictures should be #5.

So... now for the 2nd appointment, which was on Black Friday. Ian took me since he had the day off and that was really nice to have his company on the drive. He did meet Dr Kate, but he didn't join the session. She said she'd love to have some couples sessions with us in the future but this was only our 2nd one so we had plenty to work on without him.

Anyway, she asked me to tell her about my week. I asked if she wanted to see the food journal and she said I didn't have to share. But I wanted to so she gladly looked it over. We talked about the out of control eating the one day and how I felt about it.

We talked about things that had happened with my best friend... the bad stuff from a couple weeks ago, but also the really good stuff that happened this week, which was that Sarah was incredibly supportive. I totally admitted to her about my Monday and how bad it was, and she made me feel so much better. She said it's a process, and there's going to be hard times but she is going to be there for me through all of it.

Let's see.... as for my self-care list, she thought everything I came up with was great. She especially liked the singing idea. I told her I hadn't gone after it because I wasn't sure if it was really ok to go to church just to sing. But she said spirituality comes in many different forms, and it's something I have to figure out for myself, and that if singing and worship makes me feel good and nourishes my soul, then it's definitely something I should pursue. I see her point and when I told Ian that, he instantly agreed... which really surprised me because he's so anti-organized-religion... but he totally thinks I should go if it would make me happy to sing like that. So I guess I will start looking into it! I feel more excited about it now and I really miss singing on a regular basis.

As for the things on my list that I have to "make time for"... this brought up a whole conversation about organizing and structuring my time. I think this is a really important area for me. Ever since I stopped working last year, my time has been very unstructured. At first I loved the feeling of freedom that came along with that. Being able to do what I wanted, when I wanted.. it's not something we often get to do in our adult lives. But now that I've settled into it, I've found that I'm really not making good USE of my time anymore. I have enough time to do school and to keep up on hobbies, and exercise, and whatever else... but I find myself just in this zombie state half the time where I feel lazy and just don't want to do anything. I know a lot of that is lack of energy from my weight, and my sleep apnea... but I need to try to change that.

She said I really need to find a way to structure my time.. not necessarily by the hour, or planning out what is on certain days... but just experimenting with different things and figuring out what works best for me. For example do I want to do school work an hour or two a day, or like 6 hours a couple days a week. When do I want to make time for my scrapbooking. What time of day works best for me to exercise. I am supposed to experiment with all of this stuff this week and try to see what works best for me. I don't even know if I'll HAVE time to scrapbook this week because there is so much I want to get done around the house while Ian is in Boston... but I am sure going to try.

OK I feel like I am really rambling here so I better wrap this up... but basically that's a lot of what we talked about the first couple of weeks and what I am working on. This week my appointment is on Thursday so I will report back again after that!