As I adjust to my new lifestyle post bariatric surgery I find myself also settling into a new way of looking at the food I eat. As mentioned in a previous post, dieting and tracking calories, protein, sugar etc. all used to have a very negative connotation for me.
Now – in the post op bariatric life I rely on reading nutrition labels and tracking my protein intake and portion sizes to ensure my body functions well and doesn’t revolt against me (ie. too much sugar and dumping syndrome). I now see tracking macros, ensuring I get enough water in the day, and taking my vitamins as self care, because, unlike the diets I’ve tried before, there are real and serious consequences to not taking care of myself.
To explain that last concept a little further – before surgery I knew certain types of food, in large portions, not taking vitamins or drinking water would be detrimental to my overall health. But the results of that detriment would take years to show. In a post op lifestyle the results of not taking care of myself can have an almost immediate affect if not an affect within weeks not years. This is one more reason why I see weight-loss surgery as a tool for lasting weight loss management.
I read a statistic yesterday from a bariatric surgeon in the US that said, if your BMI is over 35 you have a 1% chance of loosing weight without surgery and sustaining weight loss. I don’t love this statistic because I know there are has to be more than 1% that loose weight through diet and exercise and can maintain the weight loss- but I definitely feel like I had reached the end of my dieting rope when I decided to have surgery.
The following is look back at all of the diets I’ve tried and how I felt about each.
Simply for Life
One of the first questions asked in the preparation for weight loss surgery is “what diet changes have you tried in the past, and where any successful”. Simply for life (SFL) was my first real structured diet with the accountability of going into an office once a week, presenting food diaries and being weighed in. This was before the advent of apps on smart phones to track intake, and everything was hand written onto a calendar style sheet of paper. I’ve mentioned before that there is a right way and a wrong way to follow any diet. For instance weight watchers (funny enough the only diet program I hadn’t tried) is a points based system. There were adults in my life who would say they are doing weight watchers but then eat chips, cookies and pop – but make sure everyone knew they were counting points. I thought even at a young age, “I’m not sure that’s how it’s supposed to work”.
The idea behind SFL was to teach you about nutrition and portion sizes. That you are eating “simply to live”. I remember the phrase “eat to live don’t live to eat” being thrown around a lot. For me the restrictive no sugar, low carb, low fat diet translated into – deprive your self of salt, sugar and flavour in general and then binge the night after weigh in. Whether I’m remembering the actual rules SFL set out for eating, or only remembering my distorted interpretation of those rules, the diet was not sustainable. Well, not sustainable if I also wanted to preserve my mental health. Most of what I thought about nutrition and dieting would be built on the foundation of my experience with SFL, which looking back was as sturdy as a pile of sticks.
I was active during this time – I participated in rec sports and was a member at a curves gym that also offered Zumba!
Isagenix was the next real program I remember trying for longer than a few months. The gist was 2 meal replacement shakes per day and only 1 well balanced meal. Then once a month* (I’m pretty sure it was per month but also could’ve been weekly) I would need to do a fasting day. This meant no food or drinks besides water, and this extremely unpalatable cleansing juice provided by the company. At the time I was working shift work and the early morning shake, substantial lunch and evening shake were honestly not all that bad. I would reserve the fast day for a day I didn’t have to work and could just grumble around the house hangry. Those fasting days were psychologically very taxing. During this time I was also involved with a fee for service fitness group at my local goodlife. It was honestly the best shape I had been in in my 20’s.
After deciding to stop the Isagenix program because it was expensive and the results were not sustainable physically or emotionally I did continue to use Protein shakes for occasional meal replacement.
At the age of 25 I developed migraines for the first time in my life. While in the midst of trying to find the trigger of migraine headaches one theory that popped up was the possibility of having developed a gluten intolerance. At the time it was the only thing that I could note as a trigger in my day to day life. I always knew that if I ate too many bread products in a day I would have IBS like symptoms but somehow headaches were also linked. In the end it was determined that it was my oral contraception and that yes, gluten can increase systemic inflammation, but it wasn’t the sole cause.
None the less I had almost a full year of a gluten free diet. Again, there is a right way and a wrong way to follow any diet. Finding a gluten free bakery and having a box of sweet treats in one sitting wasn’t going to affect my weight and overall health. When I would avoid all carbs I felt great! This was probably lending to the fact that gluten free bread products tend to have a higher glycemic index, meaning the food is turned to sugar faster in your body than regular bread products. At the end of the day consuming a lot was consuming a lot of fast sugar that my body didn’t necessarily need.
Ugh, I almost forgot my short 3 month foray into this weight loss drug. I think it was deliberately pushed out of my brain. Orlistat is an oral medication that is taken with meals and works by blocking the enzyme that breaks down fat in your diet. The undigested fat then passes through your stool. It does not have an affect on calories consumed from sugar and other non-fat foods. This medication was unpleasant to say the very least and had the smallest affect on my weight when compared to anything else on this list. If I ate any more that 13 g of fat per meal the after affects were so, so very, unpleasant.
Knowing at this point in my mid 20’s that higher levels of fast sugars in my diet made me feel pretty rotten I did a lot of research on the keto diet. Eating so few carbohydrates that your body goes into a state of ketosis and burns fat for energy. Every single human on the face of this earth responds differently to different diets. The jury is still out as to why but modern medicine is researching a mixture of factors such as genetics, ancestry and environmental factors.
I did try the keto diet for a little under a year. I do not think I followed it to the T but I drastically changed what I was eating. My meals were smaller, high fat and high protein. I was not exercising as much as I should have and may have been burning muscle more than fat. In the beginning I felt great but eventually started to feel really run down. One day I decided I needed to find a way to incorporate all food groups, but still somehow loose weight.
I have only good things to say about Noom. Did it necessarily work for me? not really- BUT- do I think someone starting out on a lifestyle change journey would benefit from the Noom program – ABSOLUTELY. Noom is a mixture of lifestyle, psychological and diet related advice in a neat interactive app format. Similar to my “know it all” approach to the weight loss clinic later in life I had a “this is information I already know” approach to Noom. Not proud of that poor attitude but it was enough to make the program not effective for me and therefore I decided not to continue spending money on it. I really was my own worse enemy.
Circling back to my first thought though – if you are someone who is making steps to change your lifestyle for the first time I think Noom is an amazing option. It is knowledgable about changing food habits while also being psychologically safe.
Calorie Counting & Personal Trainer
In my late 20’s I tried the road not previously travelled. I spent *too much* money on a personal training program and I downloaded the first rendition of MyFitness Pal.
My only regret about personal training was the amount of money spent. In all fairness I started that journey with unrealistic expectations and was disappointed that I didn’t have the before and after pictures I was expecting. My trainer did an amazing job, and to anyone wanting to increase strength and learn how to work out I would totally recommend working with them. I didn’t keep up the other end of the bargain. I didn’t work out on off days and I was in a terrible relationship that involved a lot of enabling with food, and no emphasis on physical activity. I think if I had the disposable income again in the future I would revisit working with a trainer again one on one.
Intake counting was/is a lot easier with apps that can scan the products bar code and automatically be in your food diary. MyFitnessPal has come lightyears in terms of development from 2017 to 2021. In the past when I would decide to hunker down and ‘count calories’ or track my food it would always start out great, but then would break down slowly over time. It would be either a meal too complex to record properly, or something I felt guilty about eating and didn’t want on record. One missed day would turn into 2 or 3 and then the tracking would stop altogether. There were times when that same restrictive, negative feelings from the SFL days would creep back in and discourage me from continuing on with tracking. As discussed above I currently use MyFitnessPal post op to track protein intake and my thoughts process has dramatically changed.
Veganism can definitely be a whole blog post on it’s own. So I will skim the surface of my history. In the summer of 2017 I had a sudden change in how my body handled dairy and high animal fat foods. I was working as a camp nurse and one evening watched the What the Health documentary on Netflix. Now I know that a well done documentary can convince most people to believe anything, but this set off a spark in me to investigate the benefits of a plant based diet further. I watched Forks Over Knives and decided to do a Plant Based Nutrition Certificate from Cornell University. I was determined to go into this lifestyle change with as much information as possible. My little brother was also considering a change to veganism and we decided to do it together.
I made this choice for a few reasons. I was hoping a whole food plant based diet would be beneficial for my overall health and help with a lot of the inflammation I was having and I disagree with the toll mass farming has on animal’s lives and the environment. At first the change was easy, and I felt better than I had in many years. So much so, that I wasn’t even tempted to break back into animal based foods because the change was so significant I didn’t want to revert back.
Slowly after about 8 months of strict veganism I started to have bites of meat or dairy when travelling or out for dinner with friends (you know sharing food pre COVID). I continued to only eat plant based when buying groceries or cooking for my self but I wasn’t 100% strict at all times. As I broke away I would still listen to my body. If I had a certain dairy product and my body rejected it I would avoid. If I had a week of eating animal based foods and I was feeling run down I would reset to plant based for a few weeks.
At the end of the day I do feel a plant based whole food diet is what is absolutely the best for humans and for the environment. In a post op world I’ve opened up to poultry, eggs and some dairy as protein sources but still eat a mostly plant based diet. My partner is a vegetarian and my brother is still following a vegan lifestyle so I’m the odd one out.
Saxenda in an injectable medication that is self administered sub cutaneously. It comes in a pen format very similar to that used for insulin in diabetes. It is a GLP-1 like medication that affects your appetite and insulin in the body. I remember when it was first prescribed I was resistant (surprise, surprise) but I was told “this drug will give you the same effect temporarily that having surgery gives you permanently”.
After trying and finding short term success with Saxenda is honestly a huge factor in my acceptance of weight loss surgery. I realized how different my life was without a constant feeling of hunger pain and how easy it was to control portion sizes. Eventually, I realized that Saxenda is not a long term solution because; I didn’t want to take a needle everyday of my life, it was cost prohibitive, and I was having side effects.
I am grateful for my experience because it opened my eyes to how surgery could help me in the long term.
At the end of the day its about your personal relationship with food. I’m not saying that any of these diets, apps or drugs are WRONG. I’m simply sharing my experience and how, for me, my relationship with food and eating sabotaged all pre surgical weight loss attempts. I will continue to say, I’m only at the very beginning of my journey with bypass surgery as a weight loss tool, and I know I have many hurtles ahead of me. I hope this sort of reflection on my past will be helpful in knowing how to deal with challenges in the future.