Personal
Accountability
Through a success habit study, we found that most
successful long-term gastric bypass patients are those who are weighting
themselves regularly. They each have a profound sense of personal
responsibility for their success, regard their surgery as a tool,
and are committed to always knowing where they are: They are keeping their
weight in check.
Daily
Check-Up Questions
1. I took responsibility for my actions
today. J Yes
L No
2. I feel in control of myself
today.
J Yes
L No
3.
I will do my best to master the “Success Habits”
principles one more
day.
J Yes
L No
Success Habit
Principle #1
1.
Regular Weighing
2.
Setting Weight-loss Goals
3.
Portion Control
Regular Weighing:
1.
Select a day and time to weigh yourself each week. Mark it on your day
planner and set up an e-reminder message to prompt you.
2.
Select a weigh-in location. At home, Coastal office, hospital or
clinic, or gym.
3.
Create your manual or online weight-loss chart to track your progress.
Setting Weight-loss Goals:
1.
Gather any records you can of your weight through the years; old Weight
Watcher® logs, doctor’s charts, health records, etc. Review and analyze your
ups and downs and see if you can identify what your circumstances were then:
You were at your lowest, highest, healthiest etc.
2.
To help you select a goal weight, try to select a particular size that
you would like to be. Find someone of your same height and or build who is
about the size you would like to be and estimate their weight.
Portion Control:
Throughout the first several
months following surgery, as this small, newly-created stomach pouch heals, it
expands a bit and the scarring around the anastamosis (pouch outlet) relaxes
and stretches. Within a year’s time, a two-ounce pouch can accommodate more
volume. Thereafter, it will usually hold approximately six to eight ounces
(3/4 cup-one cup) of food at a time.
It is important to learn to
listen to your body and to recognize what “Full” feels like.
Knowing and understanding the
importance of properly sized meal portions during both the weight loss phase
and the weight management phase is a key factor to your success. Successful
patients know that, in addition to making sure they don’t overeat, they must
also make sure they eat enough to feel comfortably satisfied.
Eating until we feel full at
meals ensures that we get that very important feeling of satiety. Without it,
we feel hungry and pretty soon we are constantly snacking or grazing
throughout the day. Grazing throughout the day results in a higher calorie
intake for the day that we would have eaten if we had focused on eating three
high quality meals, where we ate until we were full.
Satiety
It’s important for us to begin
by learning what satiety is and how it is achieved. To do so, we must first
understand the differences between hunger and appetite.
Hunger is the primary
physiological drive to find food to eat. It is driven by several internal and
external forces that work together to provide the body with food in order to
extinguish the desire to eat. Hunger is the true need for nourishment.
Appetite, however, is
simply the desire to eat and has little to do with nourishment. Most
weight-loss surgeries are restrictive procedures that allow the patient to
have the feeling of satiety; to feel full and satisfied on very little food.
Satiety is the state of
being full or gratified to or beyond the point of satisfaction.
The feeling of satisfaction or
fullness is only one of the factors influencing the level of our satiety.
There are both internal and learned factors which influence how often we have
the desire to eat.
1.
Internal Cues
Eating to survive – real hunger
Cravings for sweets
Inherent set point – genetics
2.
Learned Eating Cues
Social or ritual eating
Habitual eating
Food – mood
Foods we choose to eat play an important part in how long
we are able to stay full. Examples:
Beans and lentils contain
anti-nutrients, which delay their absorption so they make people feel full
longer.
Fatty foods are not satisfying
even though people expect them to be.
The more protein a food
contains, the longer it will satisfy.
Three
Principles for Gaining and Maintaining Satiety
- The pouch needs to be truly filled with adequate wall
distention with each meal (i.e. no snacking).
- Keep the pouch filled over time and slow down the
emptying time (by eating solid foods and avoiding liquids for fifteen
minutes before and one and one half to two hours after eating.) We
understand this to be the most important lifestyle change after the
weight-loss surgery procedure.
- Finally, adequate protein is needed with each meal.
We emphasize the need for three meals a day including breakfast (defined as
the first meal of the day which is eaten within one to two hours after
arising). The “enemies” are high calorie liquids. Snacking and
consuming high calorie liquids cheat the patient because the calories are
taken in without offering significant satiety.
Hunger and
Satiety
1.
Begin a weight-loss journal. Start by writing down those times when
you think you are hungry and the circumstances surrounding those times. Have
you eaten recently? Are you craving something in particular? Analyze your
findings.
2.
Make a list of those foods that cause you to feel full. Which foods
stay with you the longest? Then make a list of the foods that don’t seem to
fill you up or stay with you long. Adjust your meal plans accordingly.
3.
Slow Down! It takes time for your mind to recognize the signal of
satiety. Time yourself to be sure you are taking 20 to 30 minutes to eat each
meal.
Success Habits Check List
- Regular Weighing
- Setting Goals
- Portion Control
- Regular Exercise
- Journal (food & exercise diary) for Accountability
Knowledge is power. Embrace your tool. Educate
yourself on protein, vitamins, carbohydrates, fluid intake, and exercise.
Adopting Good Eating Habits
Here are a few tips that
patients have found to be helpful in establishing good eating habits:
- Eat only this takes discipline, but it is an
important habit to incorporate. Learn to sit down and simply eat and
enjoy your meals. Don’t eat on the run or while doing anything else.
- Eat slowly to avoid discomfort and aid in
eating proper quantities, it is important to take at least 20 to 30
minutes to eat each meal.
- Chew food thoroughly make a conscious effort
to chew your food thoroughly to aid in the digestive process.
- Don’t drink while you are eating It’s
important to avoid drinking with your meals in order to ensure that you
are eating the proper quantities of good, solid food.
- Use a small plate. Our eyes are often bigger
than our stomachs (especially now!). Using a small plate will help keep
portion size down and you’ll waste less food. (If eating out split a meal
or request to-go container immediately, split meal)
- Measure Two or four ounces of food is a good
rule of thumb for new patients. The volume you can eat will increase
during the first year, until you can eat about six to eight ounces at one
year and thereafter. It’s easy to lose track of just how much you are
eating and so it’s a good idea to keep things in check by measuring
periodically.
- Eat protein first. Always eating protein
first ensures good nutrition and helps to curb the appetite.