Your copy of The Manual
Many people who have bariatric surgery do not understand that we are all figuring this out as we go along. Some people need a clear path and get upset when we change the ‘rules’, but rolling with the punches is an essential part of life!

I have always believed that we need to be iron clad in adhering to strict rules of engagement right out of the hospital – as if we knew what healthy eating was, we would not have needed SURGERY! I laugh when people ask me why I didn’t just eat the way I do now, without the surgery. While it seems like a brilliant question (and people are very proud of themselves for thinking of it), it’s like asking someone to change history without the benefit of hindsight. (Didn’t you see that loose gravel so close to the edge of the Grand Canyon?)Ben & Jerry's Schweddy Balls

Petite flower or food hog?
The fact is, we did not know how to make good food choices. Own it. Our meter for REASONABLE was broken. I was a food hog. In order to increase to and maintain a weight of nearly 300 pounds there were days that I am quite certain that I consumed five to ten thousand calories. There were days when I shopped solely for an eating experience and I KNOW you understand what that means and you don’t have to admit it, but silently nod right now. I would intentionally buy a whole as opposed to half of a double meat sub with extra mayo and oil vinegar dressing, a large bag of Doritos, a six pack of root beer, two pints of Ben & Jerry’s and an Entennmann’s Ultimate Crumb Cake. I am afraid to add that all up, but I am sure its closer to 10,000 calories than 5000 calories.

Take it all away!
Obviously, I was misinformed or chose to ignore any information I had regarding making good food choices. In order to facilitate permanent change for the miserable condition I found myself in, I had a surgical intervention to help gain control over my Morbid Obesity. While the surgery forced portion changes, I could have chosen to continue to eat the same foods responsible for my near demise.

Instead I figured out that if I ate solid protein foods and all but eliminated all carbs I would strip down my choices to the bare bones where I could then rebuild my new life with food. This mindset worked then and it works now for new post op bariatric patients or reborn regainers.

Everything in Moderation?
Sure, a popular WLS mantra is still ‘everything in moderation’ but it makes me laugh. It is also said only in years two through eight while you can still coast along. Notice that no one ever says this while contemplating a Kale Salad. It’s said while they are looking at a Birthday Cake. My moderation monitor was not working the week before bariatric surgery while I was pounding down steaks and Ben & Jerry’s not just like there were no tomorrow, but because there was no tomorrow! Telling someone in hindsight, with great flourish while one stands atop a soapbox that they can eat all good foods in moderation from the first few weeks onward is funny. I think it is quite possibly a good idea on paper but a flawed plan for action.

Soup Leaks
I remember being VERY confused when soup didn’t fill me up at ten days post op and it took me forever to figure out the difference between lactose sugar and regular sugar in dairy products when buying yogurt, so I know that is is very confusing for you too. Keep It Silly Simple works, so lets not change it. We all learn in due time.

The Short Version? No Carbs.
Eliminating everything but protein and the carbs that have stuck to it, creates fullness or satiety, keeps you full for a very long time, and cuts down on the likelihood for justification of foods we should not be eating. The biggest battle at six months post op is Head Hunger and if you are eating too many vegetables and pita chips and not enough protein first you are TOAST. (pun intended) It took me a few years to be comfortable with my explanation of how yogurt that doesn’t have sugar as an ingredient can have 18 grams of sugar that is not harmful. Good carbs versus bad carbs – processed carbs versus unprocessed carbs – and the mother of them all SIMPLE carbs versus COMPLEX carbs. For a new post op… How about NO carbs? You have to admit that its much easier to remember. There we go, NO CARBS. Keeping it real, keeping it simple, keeping it real simple.

Whole Grains for $800 Alex
Whole Grains is a catchy phrase everyone tosses around right now, as in ‘We Should Eat More Whole Grains’. Thanks for the info, but who knows what that really means? Seriously. Quick, name five whole grains. Is rice a whole grain? I dunno. What about hmmmmm? I can’t even think of another example. Oh, what about quinoa? Why yes, Hermione, but while it is a certainly tasty whole grain – I am only recently comfortable cooking it and I am a Food Network watching, Cookbook reading, Foodie. Oh wait, just found out Quinoa is a seed!

Add more Whole Grains to your diet… yeah okay… SURE, thanks and I will keep that in mind. By the way, that doesn’t mean we can eat sandwiches on whole wheat bread as even whole wheat bread contains mostly processed white flour, but nice try. Here are some whole grains courtesy of Wikipedia – don’t hurt yourself running out to get some – Amaranth, Barley, Buckwheat, Bulgur, and Farro.

Sweet Potato Wars
After that first fast fifty pounds that we drop in those early weeks, we began to figure out that ZUCCHINI was okay and probably didn’t contribute to our BMI of 47. So we added a few soft vegetables. What about PEAS? No, peas are evil and so are carrots! You said eat colorful vegetables – peas and carrots are colorful. Yes, but they are high in sugar and thus high in carbs – eat zucchini and tomatoes instead! While it seems rather silly in retrospect to make a big deal about the carbs in peas compared to the carbs in Brussels sprouts, it served purpose to make us aware of what we shoved into our mouth.

One of my most shocking pre op moments, was the day I read the Nutrition Stats on the back of the Ben & Jerry’s container WHILE eating from it with a spoon, and discovered to my horror that it was not ONE Serving. Debating the carb content of peas, while amusing today, at least shows that I was committed to needed lifestyle change. Can four month post ops eat peas? I think peas and carrots are excellent choices and I admit that I was a bit excessive in my direction. However, who knows, paying that close attention was part of the process and taught me to read labels so I am sticking to it.

But potatoes never hurt anyone!
By the time we are one year post op, we have hopefully cleaned our pantry of the foods that were our trigger foods for binging and gorging and haven’t run back to them for comfort. This is an important defining point in our bariatric time line and it divides the road for many of us. Some stick to the protein first followed by vegetables path, while others have gone back to eating familiar preop foods using physical restriction as their only weapon in this battle. We never hear from many of them again… as they fall into the abyss. Some manage, many don’t.

Eat your vitamins
Whatever our modus operandi, it appears to work best to bring our food group choices down to the bare protein minimums to force change and lose the bulk of our weight. Do without while you figure it out! Once we get to be a couple of years post op and have learned to live differently and most important live HAPPILY with our choices, we do need to make careful adjustments – by adding more vegetables and fruits. We need to EAT our vitamins, rather than rely on a handful of pills. What is important at this stage is NOT fall back into the fast food and boxed food mentality – that is where many go wrong.

When we can consume a larger volume years after our initial surgery, while its still important to focus on protein, we have to fill up the remaining space with Good Stuff like salads, green beans, quinoa, black beans, sweet potato, greens, apples, berries – BUT keep a careful eye on how we feel. While we are minimalists at first, once the light bulb goes on and we GET IT, we can transition to a small portion, healthy person, who makes great lower fat choices, who wouldn’t eat a box of Little Debbie Pies, or a Super Sized Big Mac meal on a bet.

Falls from the wagon are non lethal
At fourteen years post op is this the be all and end all? Probably not, but no one is writing this script in advance and while I would love to have a path to follow, it appears that we are writing this one as we go along folks and what works and how we react to it changes as each day passes. All we can do is under any circumstance, simply do our best, and avoid self-judgment, self-abuse and regret.