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Bariatric Surgery

Addressing Your Eating Habits

Weight loss is a matter of burning more calories than you consume by eating less and exercising more. Anyone can follow just about any diet for a set period of time and lose weight, but once someone returns to his or her "old ways," often the weight returns. The real challenge is to make changes that are both appropriate and achievable.

Begin to think about when you eat, why you eat and how you eat:

Why is it so important to think about eating habits?

The reason is that bariatric surgery does not fix eating habits. For example, if you struggle with emotional eating before you have gastric bypass surgery, you will still struggle with emotional eating after you have gastric bypass surgery. Your eating habits can and will have an impact on how much weight you lose after your surgery and how well you can maintain your weight loss.

The goals of the following information are to help you to:

  1. identify the eating habits or behaviors with which you struggle;

  2. gain a better understanding of what gastric bypass surgery can and cannot do; and

  3. use behavioral strategies and basic problem solving skills to replace your former eating habits with healthier, non-food habits.

What habits and behaviors do you struggle with?

You may think that old habits die hard, so why bother? Our eating habits can make us eat when we're not hungry, and therefore lead us to take in more calories than we need. This is clearly an obstacle in trying to lose weight because weight loss only occurs when we eat less and exercise more, or when we take in fewer calories than we burn. Very simply, adopting healthier, non-food habits can help you to reduce your calorie intake.

Remember: The only reason to eat is because you are hungry. If you are not hungry, you have no reason to put food in your mouth.

"Hungry" is defined as an empty or growling stomach. Individuals with diabetes may need to eat a little bit when their blood sugar is too low, which is fine.

Habit #1: Eating too fast.

Why is eating fast a problem? It's a problem because when we eat too quickly, we are not able to recognize when we are full and ultimately end up eating too much.

Strategies to address this bad habit:

  1. Put your fork or spoon down in between each bite. Watch the secondhand on your clock go around for one full minute before taking your next bite. Meanwhile, chew your food slowly and thoroughly. Savor the flavor!

  2. Do not watch TV, read or drive while you are eating. You tend to eat faster when you are trying to do something else at the same time. Try to just sit down, relax and enjoy every bite.

  3. If you are right-handed, try eating with your left hand, and vice versa. The awkwardness will slow your pace and help you to enjoy the taste and texture of your food.

  4. Set a timer for 20 minutes and try to make your meal last that long. It takes your stomach 15-20 minutes to send the signal to your brain that you are full.

  5. If possible, eat in front of a mirror occasionally. This will help you visualize how big your bites are and how fast you are eating.

  6. Try waiting one minute before you start eating. During that time, commit yourself in your mind to eat slowly and stop when you are full.

Habit #2: Being accustomed to large quantities (heaping portions) of food

Why are large portions of food a problem?  The problem is that they lead to eating too much.

Strategies to avoid this problem:

  1. If you do not already have them, purchase some measuring cups, spoons and a food scale. These items are not expensive and can be found at stores like Wal-Mart, K-Mart, and even your local dollar store!

  2. Use your measuring cups, spoons and food scale. Use them to show yourself how appropriate portions appear, and also to prevent yourself from overeating. Measuring your portions will be tedious at first, but eventually you will be able to "eyeball" it.

  3. Use smaller plates, bowls, cups and utensils to help control your portion sizes.

  4. Forget the "clean plate club" way of thinking. Do not feel obligated to finish every morsel of food on your plate, even if you did measure out all of your portions. In fact, it may be a good idea to get into the habit of always leaving one or two bites left on your plate. Yes, there are people in other parts of the world, and even in our own country, who do not have enough to eat. However, you overeating does not help them one bit! In fact, you are actually hurting yourself by "cleaning" your plate!

  5. Restaurants always serve very large portions of food. To avoid overeating when dining out, push one half of your food aside (or cut your sandwich in half, etc.) as soon as it comes to your table. Immediately ask your server for a take-out container in which to place the food.

  6. Always eat your food out of a bowl or off of a plate. Never eat directly out of the box/bag/container, etc. It is nearly impossible to keep track of your portions when doing this. Instead, check the nutrition facts panel to determine a serving size, measure or count out one serving, and put the rest away!

Habit #3: Snacking, or eating out of boredom

Why is snacking or eating out of boredom a problem? Basically you're just eating too much. The better question to ask is, why are you snacking? Are you really hungry? Are you sitting in front of the television or studying? Are you bored?

Strategies to overcome this problem:

  1. Keep a food diary that includes the date, the times, the food/beverages you consume and the portion sizes, if possible. This acts as a visual aid and a self-monitoring tool to show you exactly what and how much you are eating. Remember, there are no right or wrong answers, so be honest with yourself! Even if you splurge, just write it down and try again tomorrow.

  2. Don't skip meals! This will just make you hungrier and more likely to overeat or snack at a later time. Remember to eat something for breakfast as well! Breakfast gets your metabolism going in the morning. Some quick breakfast ideas include: a medium-sized piece of fruit with 1 cup of nonfat, artificially sweetened yogurt, or 1 slice of wheat toast with 1 teaspoon of jam and 1 cup of skim or 1% milk.

  3. Set a rule in your house that there is no eating in any other place in the house but the kitchen or dining room. Do not eat in front of the television. No televisions in the kitchen!

  4. Set a rule to stop eating two or three hours before bed. For example, if you normally go to bed at 11 p.m., stop eating after 8 or 9 p.m.

  5. If you don't buy it, you won't eat it! Don't bring snack foods into your house that you know you should avoid and those foods that you know will tempt you.

  6. Keep a very boring kitchen and refrigerator. If you are not preparing a meal, keep the lights out in the kitchen. Take the light bulb out of your refrigerator if you can. Store high calorie snack foods in opaque containers that you cannot see through, or place them in cupboards on high shelves where you cannot see them. Out of sight, out of mind!

  7. If there are any remaining goodies in your house that are just calling out your name, throw them away! Put them down the garbage disposal or in the garbage can. Eliminate the temptation completely! Again, there are people in other parts of the world, and even in our own country, who do not have enough to eat. But overeating and snacking does not help them in any way, but it does hurt you!

  8. Break the habit of snacking out of boredom. Keep a list handy of things you can do instead of eating when you feel bored. For example, instead of eating when you are bored you can walk the dog, do some yard work, clean out an old messy drawer, call a friend, etc. Do anything to keep your mind occupied, but do not eat!

Habit #4: Emotional eating

Why is 'emotional eating' a problem?  Using food as a comfort mechanism means you are eating for a reason other than hunger - and there is no other reason you should be eating.

Strategies to address this problem:

  1. Use your food diary to record how you feel before you start eating. If you are eating for any other reason besides hunger, do not eat!

  2. Again, keep a list handy of things you can do other than eat when you feel depressed, frustrated, overwhelmed, angry, etc. Directly address the emotion in some other, more constructive way.

  3. Develop a support system of friends, family members and other gastric bypass patients you can call when you need some encouragement. These people can talk you out of eating when you know you shouldn't! They can help remind you of how far you have come and help you to keep your goals in sight.

  4. Think positive! Instead of dwelling on the foods and the habits you need to avoid, think about the foods you can have and the things you can do.

  5. Get involved in activities/hobbies that interest you and that you enjoy. Doing this can help you feel better about yourself and not want to overeat.

  6. Don't be a perfectionist! You are going to have good days and bad days, times of ironclad willpower and times when it seems you have no willpower at all. When you have a bad day, forgive yourself and move on. Remember, you can give in, but you can't give up!

  7. Set realistic goals for yourself. You can easily set yourself up for failure by setting unrealistic goals. Examples of realistic goals include: measuring portions and keeping a food diary six out of seven days a week; putting your fork down between each bite; and losing one or two pounds each week.

Habit #5: Binge Eating

Why is binge eating a problem? Though binge eating is quite different from just overeating in general, it is detrimental in the same way in that it leads you to eat when you are not hungry and consume more calories than you need.

Definition of Binge Eating Disorder

  1. Eating, in a specific time period, a large quantity of food that is definitely more than what most people would eat in a similar time period under similar circumstances.

  2. Binge eating disorder is accompanied by a sense of lack of control - you cannot stop yourself.

  3. Some indicators of that loss of control can include:

    • eating much more rapidly than usual

    • eating until uncomfortably full

    • eating large amounts of food when not physically hungry

    • eating alone, in private, due to shame or embarrassment

    • feeling disgusted with oneself, depressed and/or guilty after binging

  4. Binge eating disorder causes the one who suffers from it much distress.

  5. Episodes of binge eating occur at least two days per week over a six month period of time or more.

  6. Binge eating disorder is not associated with purging behaviors (self-induced vomiting, laxative use, excessive exercise, etc.).

There also is a subcategory of binge eating disorder referred to as a partial syndrome eating disorder, where episodes of binging are less frequent or less severe than full syndrome binge eating disorder. Grazing is also a subcategory of binge eating disorder, defined by eating small amounts of food, all day long. It is important to note that some studies have found that the patients who suffer from binge eating disorder before their surgery shift to a grazing behavior after surgery. The negative behavior does not go away.

Additional Tips for Adopting Healthier Eating Habits

Here are some additional tips for healthier eating:

  1. If you fail to plan, then you plan to fail! Plan a menu ahead of time. It doesn't have to be fancy or complicated, nor does it have to be for one full week. Simply jot down the meals you want to prepare ahead of time. This is a way of preparing yourself so that when you feel hungry, you have a plan in place for what to make. You do not have to agonize at the last minute about what to prepare. This may seem troublesome at first, but once you make it a habit, it will become second-nature.

  2. Use the menu you prepared ahead of time, make your grocery list and stick to it! Remember to never go grocery shopping when you are hungry because you will end up buying more than you need.

  3. Start your grocery shopping in the produce section first and work your way around the outside walls of the grocery store. Fill your cart first with fresh fruits and vegetables, then lean cuts of fresh meat. Skip the bakery section, but select low fat dairy products before heading for any of the goodies in the aisles.

  4. Avoid eating according to the clock. Just because everyone at work is going to lunch at noon does not mean that you should, unless you are truly hungry. The only reason to eat is because you are hungry!

  5. Avoid nibbling while cooking, or you may end up eating twice as much. Instead, drink a glass of water or another non-caloric beverage while cooking.

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