get back on track 2

Get Back On Track After Bariatric Surgery by a Professional and Patient

June 17, 2020

How does weight regain even happen to a RNY patient from 2002? I mean I’m a Certified Bariatric Nurse (CBN) for Pete’s sake. I work with this every day! I support patients to get back on track. I should know how to prevent going off track, right?

Well, in case you forgot, knowing and doing are two totally different animals.

Our bariatric program is 12 years old. I actually had to go to another facility in 2002, as we had not started our program yet. I have been in nursing for 45 years, so I should know all about nutrition, right?

Knowing and Doing are Two Different Things

Well, as I said earlier, knowing and doing are two different things. Couple that with the fact that I run a monthly support group. Does that make me a hypocrite? No! It proves that I’m human and no different than my patients.  It also makes me passionate and more importantly compassionate to pitfalls.

So how does it happen? Anyone in the bariatric field knows that surgery can be a double-edged sword for the patient.  Yes, we can put a whole host of diseases into remission, but the surgery also has a metabolic component to it. It changes our metabolism so that our bodies learn to run on fewer calories so that when we eat like a “normal” person, we regain weight.

Let’s take a moment to get a better perspective on how this works. Generally speaking, as bariatric patients, we limit ourselves to 50 carbs per day to lose weight. Once we get to goal weight, we can do 50-100 carbs per day depending on how our individual bodies react to them.

But the plain simple answer is that we return to old habits despite the fact that we tell ourselves that “it will never happen to me.”  We become complacent and worse yet, we become lazy.

We stop tracking our food, we restart regular/diet soda, we don’t measure our portions, we turn to fast food, we eat our emotions.

The Problem With "I'll Show Them"

Has someone hurt your feelings or given you criticism that was less than constructive and suddenly you think, “I’ll show them.” The problem with that kind of thinking is like you are drinking poison and expecting the other person to get sick. Not helpful!

I’ll use myself as a perfect example: I have a lot of unresolved issues with my parents who are now deceased. Anyone who knows me knows that donuts are my personal kryptonite. Other things, not so much.

I once read a book, The End of Overeating, by Dr. David Kessler, MD, that stated if one food (above all others), is your trigger, you are trying to recreate a memory.  Hmmm…. What memory in my past could I be trying to bring back?  So in the name of testing this theory, I bought a donut.  As I sat in my car eating it, tiny little flashbacks began of my mom and me at the kitchen table sharing a giant box of glazed donuts. I grew up in a very chaotic house with a raging alcoholic for a dad and an undiagnosed bipolar mom.  That was the closest she and I ever came to bonding, hence “trying to recreate a memory.”

Donuts will always hold that memory for me, but remember, “the truth will set you free.”

We need to create a “bariatric toolbox” to soothe ourselves when something goes wrong.  Here’s the caveat though, it can’t be food, nicotine, soda, shopping, etc.  There really is such a thing as transfer addictions. We need to learn to soothe ourselves without causing harm.

So How Do We Get Back On Track?

By taking a hard and critical look at ourselves. By reinstituting those habits that obviously worked for us in the beginning. Those habits that I just mentioned.

What if I’m past my “honeymoon period” can it still be done? Glad you asked that!  I regained 30# when I was seven years out of surgery.  Yes, it was twice as hard to get it off the second time, but guess what?  Your tool is still intact and is still working!  It’s just waiting for you to restart some healthy habits.

Get back in touch with your body cues as you work on getting back on track. Are you thirsty (dehydration is common), are you dealing with head hunger (that’s a tricky one)? Lapsed on your vitamins? Don’t even get me started on that one, just do it!  Stopped going to support group?  You need to get back with your people. Do you hate protein shakes? Tough! Find one you do like!  Premier Protein makes a lot of new flavors.

Finally, remember that it only takes 20 or 30 pounds to make many of your old meds necessary again. You can do this!  You are in control of this!  Nobody is coming to save you but you!

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Sherri Forgey

ABOUT THE AUTHOR

Sherri Forgey, RN, CBN is a certified bariatric nurse. She currently works at Schneck Medical Center in Seymour, IN. Sherri works with patients to educate and support them through the Weight Loss Surgery process. Sherri is a post-op, she had weight loss surgery in 2002. She is very active in the support group and patient outreach activities outside of the medical center to give insight and help both pre-op and post-op WLS patients through all phases of bariatric surgery.