MY PERSONAL FORMULA.
The scientific definition of regain.
I was interested, some time back, to stumble upon a generally-accepted scientific definition of ‘weight regain after bariatric surgery’, in an academic journal. Apparently, when a patient’s weight stabilises within 3% of “nadir” (lowest ever recorded post-surgery weight), this is considered a “maintenance plateau” and great success ?.
Any gain in excess of this 3% is viewed, in the literature, as “regain”.
Each year, in January, I make it my goal return to my ‘nadir’, which albeit slightly low for me, ensures that it remains within my reach and in my orbit.
The bariatric psychology of long vacations.
This is particularly important, in January, as I have also noticed a peculiar trend within myself. As you may know, we as a family take our primary annual holiday in December, and I’m quite careful with my eating over that period. Because it’s a long period – nearly 4 solid weeks away – and if I fall off the wagon, it could be disastrous. So, while I’m not ridiculous and obsessive, I’m certainly particularly mindful, careful and aware. And we’re very active when away, which psychologists in private practice generally are NOT. So it all comes out in the wash and on return no real harm has usually been done. I think, this year, I’d gained 2 pounds, on touch down.
The backlash of complacency.
Ironically though, in exhaling and settling back into my life, I’ve found that I can become overly self-congratulatory and sloppy with my eating. I then tend to experience POST-holiday gain, once the pressure is off and the risk averted! Aren’t humans weird?!
And so, here I sit, at my desk, on a Sunday morning, as I do – contemplating my life, and the week ahead.
In terms both of my ‘annual pilgrimage to nadir’, and the need to course-correct my ‘post-holiday complacency pounds’, I’m mapping out a 40-day plan. And as I was completing this plan in my journal, I glanced at my laptop and felt gently inspired to write this process up for you, in the hope that it might be useful to those of you struggling to get a handle on post-festive season on-track eating, or to get back on track more generally.
For me, it starts in the mind, the heart, and the spirit.
I think I’ve been very honest and frank about the fact that I won’t appeal to every bariatric patient, and my content won’t resonate with or be useful to every single person who’s ever had a sleeve or a bypass. There are different causes and mechanisms of obesity, and different understandings of its treatment.
I write, create videos and design self-help programs for the person whose eating is compulsive. Urge-based.
Anxious. Emotional. Bingey. For the people who feel they would eat so much better were they just able to have a better handle on themselves, their emotions, their reactions, responses and ability to navigate overwhelming pressure, stress and upset without needing to medicate with sugar, carbs and any other food of choice.
And I also write for the person who might identify slightly less with this, but feels her/himself to be relying solely on willpower to get through an impeccable eating day. Willpower runs out, and by 5pm it’s so much easier to be choosing baked goodies than tuna salad, even if just for lack of meal prep, than for a fight with a boss or spouse.
And so my content often speaks to the tools and skills of conscious choice, mindful awareness, and strategically directing our attention, rather than hoping for some sort of emotional gusto to power us through to sustainable success.
In this vein, when getting back on track, this is my method and my formula, in the main:
I need a meeting with myself, and a clear statement of intent.
I don’t decide randomly in the shower that “I’m strict from today”, or it’s “pilgrimage to Nadir” from today… Rather, I take my journal, light a candle, seat myself quietly, and write down the outcome I am working towards achieving.
I state it as a goal – in bold, in writing, on a fresh page in my journal.
Yours will be different. Your journey is uniquely yours.
Mine, today is: To release 10lbs, to be < nadir, by the 28th February.
When Motivation Runs Out, My “BIG WHY” and Commitment Kicks In.
The next step is to remind myself WHY this is important… The ‘oompf’ and ‘gusto’ of sign-on motivation will get me through until Tuesday. But what then?
What when my friend arrives from a different city and there are menu choices, and the warm naan looks good? What about when my husband carts in bags of treats, as he tends to do? What about when I’m exhausted on Friday evening, and wonder about ‘a little something’, or ‘starting again tomorrow’? What about when that annoying little voice tries to take my endeavour hostage?
Then I need to be able to remind myself that I am most well, as a whole person, when I am not spiralling into regain and obesity. That I am most emotionally and mentally well when I am in remission from binge-eating and compulsive-eating. Then I have to remind myself that, while mindful moderation as a lifestyle choice seems to work for me, there is also a very critical tipping point where moderation begins to err on the side of excess, and experience has taught me that the antidote is to completely reset the decks and implement mindful abstinence as self-care.
I call to mind the truth from James Clear’s “Atomic Habits” that “we should be more concerned with our current trajectory than our current results’, and ask myself where I might be one year from today if I don’t implement austerity measures in response to laxity.
My bariatric journey is a dynamic, living, breathing thing… Very much part of my dynamic, living, breathing LIFE. And as such, I need to stay vitally connected to it – and myself – and to where I am and what the requirements of the day are.
What Will I Need to Sacrifice / Confront, in Order To Succeed?
This is a very important question that I need to ask myself, and a different variation is as simple as “what is going wrong to cause my current dilemma, and how might I course correct?”.
My biggestpitfalls, when in a funk, are:
- Snacking and grazing, almost constantly… (especially with the boat-loads of Middle Eastern treats that have colonised my pantry).
- Ignoring the tools and skills I know, of distraction, in particular, when feeling quite bingey and compulsive. There are distinct moment when I have FELT myself CHOOSE to eat badly, and this is slovenly.
- Not meal planning.
- Not attending to exercise. There is a GREAT, fun class at my local gym. I love it, once I’m there… But I feel, on any given day, that I’d rather put pins in my eyes than throw on training apparel and get myself there! This needs to be addressed!
Who Do I Need To Be, Today, To Succeed?
So many authors I’ve read, of late, have affirmed the idea that who we’re BEING is more essential than what we are DOING. And that the FASTEST, most EFFECTIVE way to implement change is to BECOME a version of ourselves who succeeds at the change in review. This is probably a play on ‘fake it until you make it’, but with a twist… The twist is that we can all experiment with different identities as we coax and goad ourselves towards our goals. James Clear, for example, points out how much more effective it is to say “I don’t eat sugar”, than to say “I’m going to try stay off sugar”…
In this vein, it’s so useful to ask, “who do I need to be BECOME? / what version of me do I need to step into” … in order to lose this 10lbs and keep it off..?
And for me, the answers to these questions, today, are:
“I am a slim, fit, healthy, carb-conscious person, who is always calm in the presence of food and maintains her weight at 120lbs”.
And this isn’t just a superfluous academic exercise. It’s a statement of personal truth, whether currently manifest or currently hidden, and something I then write out in my journal daily, and repeat to myself, especially when being eyeballed by a slice of chocolate-fudge cake, or when wanting to flop on the couch rather than to consider meal prep for the next day!
ACTION, ACTION, ACTION!
The last piece that I commit to my journal concerns immediate action… If I have set myself a goal to release 10lbs in 6 weeks, as I have, to return to nadir… And if I know WHY I
want to do this, and why it is important… And if I know what I need to give up, in myself, and who I need to BE to effect this… Then the logical next step is simply what I need to DO. And so the final consideration is around aligned action. Thankfully, once the mindset stuff is in place, the action plan is relatively simple. This is because we’re ‘master dieters’ (not that I’m specifically suggesting a ‘diet’. I’m talking about tweaks, lifestyle modifications, returns to basics, care with macros, tracking, water, etc).
And so, for me, what I know works in this regard is:
Lower carb <50g
per day, exclusively from vegetables
Higher fat
Moderate protein
<90g per day
Sufficient water
(64 ounces / 2 litres)
All vitamins
<1300 calories
per day
And, returning full circle to the notion that the entire enterprise for me is mental and emotional, my plan simply has to include daily connection rituals… Quiet time with myself, my journal, grounding, breathing, meditation, gratitude, ‘brain dumps’ and writing about emotive issues and complexities, and the setting of
intentions to power through and succeed.
MY BACK ON TRACK MASTER PLAN MINI COURSE
I just popped this article together quickly now to assist anyone who’s struggling, on the fly.But I do have a few formal offers for people who would like some robust, sustained assistance in overcoming emotional and compulsive eating, and in being able to work strategically in their own best interests for long-term weight loss surgery success…
For quick wins, and to get you powering through to your own ‘nadir’, I have my BACK ON TRACK program. This is a VERY popular course, and gets great reviews. The beauty is that you can work through it in just a few short hours, and be strong and resolved to implement your own eating plan from a place of renewed commitment and conviction immediately thereafter.
MY BARIATRIC MIND MASTERS PROGRAM
This is a wonderful investment for people who really relate to me and my content, and who are desperate to do “the work” required to achieve long-term success. This program is designed to help compulsive and emotional eaters to understand and overcome these struggles. Let me not lie or mislead: Bariatric Mind Masters is not a
quick fix. It is an intensive program that will give you all the tools and
skills you will need to power through, but ultimately the powering through will be your choice, and will hinge on whether you take the dramatic actions required. People who dig in and engage with the course material do DRAMATICALLY well, very quickly. But this is a comprehensive program that requires commitment. It’s best for people who are quite at the end of their tether…
And then, of course, as a standalone or adjunct to either or both programs, I do provide online counselling and coaching via Zoom.
