Weight Loss

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Wednesday, April 11, 2007

Is this Dieting?--part 2

Today I was supposed to have appointments with my surgeon and my nutritionist. Somehow, the message from my surgeon's office telling me that he would not be in today did not reach me. Not only was he not in, but I got there when they went to lunch. They close for an hour and switch to an answering service. I had to wait an hour for them to tell me that my appointment was cancelled. Bleh.

I thought about cancelling with the nutritionist, but decided to see her anyway. It was an additional hour's wait, but I was already there. We both agreed that I would need fewer than the generally recommended 1200 cal per day to lose, based on my record keeping, and that I probably won't be able to achieve that without some restriction. She thinks he might give me a fill before 6 weeks. I rescheduled my appointment for next Weds, which will be just over 5 weeks post op. HOPEFULLY he will fill my band and I can get this thing rolling.

Then tonight I went to my first support group meeting at the hospital. It was an interesting experience...a lot of the information I got was the same stuff we talk about online on OH.com. It was the little tidbits of info that will probably have me coming back again. The group leader, Dale, spoke a lot about "releasing the ghrelins" (hormones that stimulate hunger feelings), enough that it made me think of releasing The Hounds, which made me laugh a little. It's catchy, it sticks with you. I was struck by how much the people who have been banded for any significant length of time wanted to talk about what they knew, and how much of that differed from what the group leader said. In other words, people are doing the wrong things and spouting it to other people, and they were reluctant to listen to any suggestion that it might be better to do things a different way. Bandsters are a chatty, moderately informed group who often forget that they too are still learning--not just these Bandsters, but most I have had contact with, in my observations. One guy brought up the idea of having to "avoid certain foods forever" because they are just triggers. Dale disputed this idea, talking about what he called the "abstinance violation" phenomenon, which is just the basic idea that if you make certain foods forbidden and then you eat them, you set yourself up to give up and binge. I agree with this idea, and the thought that "dieting" is not sustainable in the long term. Rather than avoiding these "trigger" foods, we should be trying to learn how to deal with them and eat them in a moderate way, occasionally. It seems to me that many people who seek weight loss surgery resign themselves to the idea that they will just have to diet for the rest of their lives. They've given up on the idea that they can eat moderate amounts of anything, and as long as they usually choose healthy foods, can indulge in the occasional "treat" as long as it is a controlled portion and they just do it occasionally.

I was also struck by people talking about how when they had proper restriction, their cravings for certain foods--any foods, in some cases--disappeared. One woman talked about being too tight for a long time, and vomiting for months, but not saying anything because she was losing lots of weight. She ultimately had to have her band unfilled for a few months because of all the inflammation all that vomiting had caused, and she ended up regaining 35 lbs. She had also exacerbated a hernia and had to have a new band placed. She said that once she was unfilled, all those food cravings came back just like before. It is unclear whether this phenomenon is entirely psychological or if it is a hormonally mediated thing; probably a combination of both, but restricting the stomach results in restricting foods, and when you choose the right foods, those ghrelins go down and you supposedly lose those cravings. How cool is that? (As long as you aren't barfing, that is.)

One woman reported having been stuck 47 times for one fill (how is that possible?) and ending up with punctured tubing proximal to the port, which had to be replaced surgically. Again, no restriction for months while waiting for that to be diagnosed, fixed, and healed. That would suck. I'll keep that in mind when my surgeon wants to let his fellow do my fills.

So, is this dieting? It seems the answer is No. I do not plan on going back on diets, although that may change when I hit a plateau in my weight loss. The point here is to stop doing all the damage that yoyo dieting has done over the years, and start learning to eat smaller portions of a variety of foods, and maintain weight with the help of the band. So my post-support group scoop of gelato at Mio Gelato on NW 23rd? I have no guilt about that.

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