When The Honeymoon Is Over

One of the exciting benefits of bariatric surgery is feeling in control of your eating behavior. For the first time in your life, you may feel free of constant hunger, a preoccupation with food, and the urge to eat. Feeling in control of your eating and losing a lot of weight is thrilling and such a boost to your self-esteem. You may want to shout from the rooftops, “I’m in control and I can do anything!”

You may find this feeling of control is permanent. This is good. Like many patients, you may find that your feeling of control decreases over time. This is bad. Although you continue to be limited in the amount of food you can eat at any one time, your hunger, preoccupation with food and urge to eat returns. Depending on the kind of bariatric surgery you have had, giving in to these things can result in a long-term weight loss plateau, some regaining of weight, and the feeling of failure.

The disappointment of decreased control over your eating is not unlike that felt when the honeymoon period of marriage ends and real life as a married person begins. Fortunately, people in happy marriages realize there are skills that, when practiced faithfully, contribute to marital satisfaction and success in spite of disappointments, stresses, and strains of daily living. Along with the assistance of your bariatric surgery tool, there are skills you can practice that will help you have enough control over your eating to support your weight loss goals.

Since my areas of focus is psychosocial skills, that’s what I want to share with you. Before I do, I must emphasize how important it is for you to take your vitamins, eat a balanced diet, and schedule regular meal times. If your body is not getting the nutrients it needs on a regular schedule, of course you’ll be hungry, be preoccupied with food, and feel a compelling urge to eat. If you are having trouble meeting the nutritional needs of your body, please consult with you surgeon and/or the professional(s) on staff to help you learn good nutritional habits. This may be all you need to regain control. And don’t forget how important regular exercise is to normalize your appetite.

If you are meeting the nutritional needs of your body, getting some regular exercise, and still feel out of control of your eating, some simple behavioral skills may help you increase control. One skill that can help you is self-soothing. Self-soothing is important because one of the main reasons people overeat is to try to cope with stress. Since early childhood most people are conditioned to eat as a way to feel better when they feel bad. Eating does help people feel better, but only for a little while. Overeating in response to stress usually ends up making people feel worse than they felt before they started to feel better! Instead of eating in response to distress try the following things:

Breathe deeply to promote calm feelings. If you will slow your breathing for several minutes, you will feel calmer. This is because breathing slowly triggers the release of endorphins (the body’s powerful chemical of well being) into the bloodstream. You can slow your breathing by inhaling and exhaling about 10 breaths per minute. Another way to slow your breathing is to inhale for the count of 4, hold your breath to the count of 4, and exhale to the count of 6 or 8 (whichever is most comfortable for you).

Identify areas of your body where you feel a tightness or tension, such as your face, neck, shoulders, and upper back. Focusing upon one area of your body that feels tight or tense at a time, contract the muscles in this part of your body for about 5 seconds and then release the contraction. Continue this process working through every tight or tense area of your body. Repeat until you feel that the tightness or tension is gone. Let your body go limp. Allow your body to slump like a rag doll and feel very heavy. Think about your body feeling comfortably warm and cozy.

Form a relaxing image in your mind. Imagine being is a special or favorite place where you can feel safe, relaxed, and peaceful.

Engage in this self-soothing exercise until you are so relaxed that you do not have to eat to feel better. You may increase the benefit of this exercise by playing some pleasant music. It is helpful to practice this exercise frequently to condition, or teach your body what it feels like to be soothed or relaxed. Don’t be discouraged if it takes some practice to achieve the effect that you want. Any time you spend doing this exercise will be time you are not stress eating.

Another reason people overeat is because they are trying to use food to satisfy unmet needs. If those needs are not physical needs that can be satisfied by food, no amount of eating will help you feel better. If you are eating to try to satisfy unmet needs, it is important to identify your needs and to find a more helpful way to meeting them. Feelings commonly associated with unmet needs are boredom, loneliness, sadness, anxiety and anger.

In his book, Emotional Eating: What You Need To Know Before Starting Another Diet, Edward Abramson gives a step-by-step plan for identifying, understanding, and satisfying unmet needs without overeating. Mr. Abramson suggests a program of self-nurturing behaviors and attitudes to replace emotional overeating. Self-nurturing behaviors include the following: Participating in activities that bring pleasure, purpose and measure to your life. These activities can be as simple as taking a walk, planting a garden, reading a book, keeping a journal, doing craft projects, taking a class, or learning a new skill. Connecting with others. This involves staying in regular contact with family and friends, participating in clubs and religious activities, and/or doing volunteer work.

Self-nurturing thoughts involve:

Replacing critical, self-defeating thoughts with positive, self-supportive thoughts. This includes saying “I can” instead of “I can’t”, “I will” instead of “I won’t”, “I deserve” instead of “I don’t deserve”.

Committing to progress instead of perfection. It is okay to make mistakes and learn from them. You don’t have to do anything (even following your weight loss program following bariatric surgery) perfectly. Take one day at a time and do the best you can for that day. Tomorrow is a new day and a fresh start.

Giving yourself permission to pursue your life dreams rather than feeling like you don’t deserve or are not entitled to them. You may not get everything you want or achieve all of your goals, but you are entitled to pursue them. Whatever you do accomplish or achieve can enrich your life.

It may be helpful for you to know that most people even those who are not overweight sometimes feel out of control and overeat. So, if you find yourself engage in these behaviors, consider yourself normal. The skills discussed above can help you regain control over your eating behavior and support your weight loss goals.