Why "EIM" is Bariatric Baloney!

If I told you we were giving $100 to every person who correctly guessed which woman in the images above had just said ‘Everything in Moderation’ before diving into her food, who would you choose for the easy win? Be honest.

I’ll have what she’s having
If I had a friend who ate salad with ‘Meg Ryan’s When Harry Met Sally’ abandon, you think we’d be friends forever because she eats like a slim person! In real life the Pizza Eater says ‘EIM’ because no one gleefully says ‘Everything in Moderation’ before attacking a Salad. To the contrary, it’s what someone says when looking for verbal justification to eat Carrot Cake at The CheeseCake Factory. They don’t care who says it, as long as they hear it!

Worst. Dietary. Advice. of. All. Time.
“Everything in Moderation! Don’t deprive yourself. Unhealthy foods are only unhealthy in excess. Balance is important. Eat anything you want as long as it is in moderation.”

Here’s the problem, moderation works for very few people. You know this is true! You’ve tried it over and over and over again. If the ‘moderation thing’ worked, you would not be sitting here reading this with most of your stomach cut away or gone, with intestines rearranged, or a silicon band pinching off part of the organ. Let it go… give it up. Abandon that ship. It has not worked your entire life and isn’t working now. (unless you are in the Honeymoon Phase and if so, hate to tell you, but you’re not driving the car yet)

Don’t We Suck at Willpower?
There really are some very unhealthy foods. Why would anyone want to moderate foods like soda, chips, fast food, cake, candy and fries back into their life while trying to lose weight? Especially after all that we have gone through in having bariatric surgery.

The biggest problem with moderation is that it relies on willpower and as I recall we sort of sucked at willpower. At least I did.

Ben & his friend Jerry
Think of the times you grabbed a pint of Cherry Garcia and a Spoon. How many times did you EVER return a 1/2 full container back to the freezer? Thankyouveramuch. Why would anyone expect it to be different after bariatric surgery?  Especially to a ‘Sleever’ who does not get sick with sugar. Many of the foods we justify eating by claiming ‘EIM’ have been modified to be super tempting, high in carbs and sugar, calorie dense and without satiety that tells the brain to STOP. The odds are stacked against you by the food industry and your willpower cannot overcome the urge to keep eating.

Pouch is the New Moderation
Our Moderation Meter did not work, that’s why we were morbidly obese. In order to help us to lose 100 pounds, we had moderation surgically installed in the form of a 4 ounce pouch, leaving us to simply make the right choices. Don’t mess up your opportunity: Everything in Moderation is bariatric baloney.

Non Negotiable
After living 14 years with RNY surgery, the ‘everything in moderation’ people appear to hit the wall a lot harder because they ‘everything in moderationed’ themselves into eating the same food that created their need for surgery. I have to give them credit thought, as the EIM folks in our support group are a tenacious bunch who will fight you all the way up the scale. It is time to give up the foods that were responsible for your near demise. Stop clinging to bread and chips! Turn in that ‘free pass card’ and make the tough changes.

Black and white goals without room for interpretation or justification are easier to reach than soft goals. “I will eat better”, “I will exercise more, “Everything in moderation”, are vague goals that allow plenty of wiggle room for us to get what we want for the moment without regard to tomorrows consequences. I will eat better? Better than what?

The Skinny
There are entire food categories that it is healthier for us to stop eating. Rather than BS myself that I can have ice cream, English muffins or cheese fries in moderation, I have scratched them off the list and and have found new things to like that don’t steal away my hard earned weight loss and sink my happiness. By letting go of Everything in Moderation we’ll find ourselves in a much better place in twenty years.

32 thoughts on “Why ‘Everything in Moderation’ is Bariatric Baloney

  1. kim says:

    Thank you!  I am almost one year out and 5 lbs from the goal my surgeon set for me.  My personal goal was even lower than that.  I have been stuck at this wall since the Holidays.  I really needed to hear this today to get myself back together and act right.

  2. Tammi Goff says:

    This post really hits home!  I have a co-worker who had RNY 3 years before me & has taken “EIM” as her mantra.  She convinced me that “one little bite won’t hurt.”  Maybe not her, but for someone like me who can stop at “one little bite,” that sort of thinking is disastrous.  I KNEW better, but went ahead and had that “one little bite”, all the while, trying to convince myself that “EIM” was true.  Several lbs of regain later, the scale & the mirror don’t lie, and neither do the clothes hanging in my closet that no longer fit!  I had to do a major overhaul of my pantry, then started following your Back on Track plan.  I’m not where I want to be, but on my way to losing the regain – even managed to lower BF by 2.7% so far!  It all boils down to keeping that commitment to the lifestyle change & being honest with ourselves.  Thank you, Susan, for the much-needed kick in the pants!

  3. Rachael Henry says:

    GBS was the best thing I ever did for myself. I FINALLY was happy with myself (okay the excess skin bugged me) but then….I got pregnabt. And pregnant again. That alone wouldn’t have been enough to sidetrack me, as I did everything like I was supposed to. The complications got me. I developed all sorts of extremely high risk attributes both times and after #3 i found myself riding a couch for the 2nd year in a row, just to survive.

    Needless to say, I’ve put back on a lot of what I lost. Now it’s time to reclaim myself again. I doubt a revised is possible, so I am trying S.M.s way of going back to basic. It’s slow….but it’s going.

  4. Lisa says:

    I think that’s true for most people. However, there are some that can actually do moderation. Not everyone got obese because of eating problems. I see no reason that a small piece of cake at a birthday party, or ordering something you wouldn’t normally eat on a special day is detrimental to your health. I agree that it’s important to keep perspective…but to say you will never have a treat again because it’s unhealthy…is unreasonable. 

    • Susan Maria Leach says:

      No one said you can never have a treat again. Did you think I said that? Nope. I said we have to find NEW TREATS to love, because the old ones didn’t work out too well for us. And yes, we did ALL have eating problems. We took in too many calories for what we metabolize to the tune of more than 100 pounds overweight… Morbid Obesity. ‘Denial ain’t just a river in Egypt’. I spent too many years telling people about my bad metabolism and my thyroid issues. While medical issues are real… it does not change the fact is that I ate more than I burned and did not exercise. That is true for 100 percent of us whether we want to accept it or not. We deal with tens of thousands of bariatric post ops and there are too many people who are back to 350 pounds again and we are working to help them to focus on protein first and kick those carbs to the curb forever. They did not all gain back ALL their weight because their surgery failed, many simply had too many special occasions and pieces of birthday cake and justified too many exceptions. I stand on statement that Moderation didnt work well for us in the past, or we wouldn’t have needed surgery to get out from under the weight. With all due respect, you are likely 3 to 5 years post op… and from where you stand, it is true for you, but it doesnt work for most long term. There are always exceptions and you may be one of them. Peace. Susan

  5. Coral Kelly says:

    wow, thanks for telling it like it is. I need this. I’ll have to read it again to remember more of it but right now I’m thinking I need to get my protein drinks out and take them on a regular basis. I’m four years out and have gained back 20 lbs.

  6. Cathy Johnston says:

    One year ago I had sleeve surgery, lost 100+ lbs, and feel great. At 73 years of age, I think this has been quite an accomplishment. I have been reading these notes almost daily for the last 3 months and have learned so much about habits that I had not seen in myself before
    . I have not tested eating the “junk” I had eaten before surgery and am so thankful for that. If I have not needed ice cream, Hershey’s chocolate, potato chips, sweet rolls, etc., in the last year, I do not need it now. True confession time!!!! I did have a bite of a Russian Tea Cake (round cookie filled with butter and pecans and rolled in powdered sugar) at a luncheon 2 days ago and it did not taste good. I am sure if I had finished it, I might have learned to like it. But, for now I do not trust myself. I do not want to be a slave to those cravings anymore. I do not want to always be thinking how I can treat myself to “something good” and then take the time to look for it. A year seems like a long time but it is not long enough for me to think I can handle moderation. Thank you for reminding me that moderation is not the answer for everyone and that includes me.

    • Donna says:

      My goodness I agree. One bite of a no-no food will push me over the legal limit!!
      I also dump really bad, I am 10 years post op RNY, it just isn’t worth it. Dumped from day one, also have no gallbladder so that could have something to do with it.

    • Donna says:

      My goodness I agree. One bite of a no-no food will push me over the legal limit!!
      I also dump really bad, I am 10 years post op RNY, it just isn’t worth it. Dumped from day one, also have no gallbladder so that could have something to do with it.

  7. Natasha says:

    Thank you for this! I am only 5 DAYS post op and feeling really well. A lot of people have a lot of questions for me and I’ve already shared this with them. This is so incredibly true for us bariatric folk, but also very true for anyone and everyone too. Love it! 😉 

  8. Island Sneezer says:

    Our family eats primarily organic whole foods with unhealthy treats in moderation. My hubs is 140 lbs at 5’9″ and struggles to keep weight on. I’m 290 lbs at 5’4″ and struggle to lose weight (I’m currently pre-op). We eat the same meals, except he eats at least double what I eat… Can you explain why some people can eat whatever they want with no weight gain or health consequences and others can’t? I’m constantly berated by health care professionals, told it’s my fault I’m fat for eating too much and not moving enough. My hubs has the exact same lifestyle with more excess in the caloric department and is encouraged to eat more treats cause he’s so thin…. Is it any wonder fat people get discouraged and want to have a little treat now and then? I recently spent 6 weeks carefully weighing, measuring and logging my meals. I exercised everyday. Only lost 1.9 lbs in that time. A week later I had regained it. Was that because I was over indulging or stopped exercising? Nope… My period was a month late due to PCOS… Oh, but I must have done something wrong, right? People only regain by overeating the wrong foods and not exercising… Wrong. WLS treats the symptoms of whatever is causing the weight gain, not the root cause. There is no cure for PCOS so I’m getting WLS too, but I resent being told I’m fat because I’m a lazy pig. Nobody works harder than fat people. 

    • Susan Maria Leach says:

      Dear Island Sneezer,
      We are in agreement. Since we obviously have to resort to surgical intervention we have a problem with calories taken in versus burned. I am not discounting that we have metabolic issues. I DO have a horrific thyroid problem and even with RNY surgery, its difficult. Its not fair and it used to anger me, but now I accept that its the way it is and I take full responsibility to change it. In spite of metabolic issues, we have choices: do nothing and stay the way we are, eat whatever we want and use the 4 ounce pouch restriction until it stops working, or buckle down and change food choices to lose the weight by working with the surgery instead of fighting it. My not liking that my metabolism sucks isn’t going to make me lose weight. Getting on the elliptical and doing 20 minutes of Hi/Low to Aerosmith will but only if I am not eating bread and fries in moderation.

      With our bariatric business we have dealt with tens of thousand of post ops over the last ten years and there is a definite trend that the folks laughing and saying ‘I don’t deny myself, Everything in Moderation’ are the ones who gain the most weight back early on. In fact more gain it ALL back than anyone really realizes. I also think people often resent they ‘cant’ have something which makes them want it even more. Emotional eating needs therapy. I may give myself PERMISSION, but I don’t take it. I don’t deny myself, I make the conscious choice to not eat it. Its often in the way we look at things.

      There are always exceptions, but in general, we do need to stay on the wagon most of the time and learn to live without the EIM foods, until they have lost a grip on us. I stand by my statements. No one says Everything in Moderation when ordering the Kale Salad, its always the audible justification before ordering something fattening. When I am back to 160 pounds again, I am sure I will have a slice of pizza. However, I know that I can’t EIM myself down to 160… I would never get there. Ciao, Susan

    • Donna says:

      I’m the same height as you and almost 6 years Post OP RNY. I eat between 1000-1200 calories a day to maintain my 117 lb weight. I work out 4-5 days a week. I’ve also been on 40 mg a day of prednisone for almost 6 months, but haven’t regained a pound. After wls I had to find that sweet spot where the calories in balanced with the calories burned. Is it less than others, especially those who have never had a weight problem? Hell yes. Each body is a bit different and we have to work with what we’ve got without comparing ourselves to anyone else. Can I eat sweets and empty carbs? No. Never, or I wouldnt meet my goals of maintaining a 185 lb weight loss. Do I feel deprived? No. To me, id feel deprived if i regained and lost the ability to do cartwheels in the yard with my great grand daughter. My health and fitness is more important than the taste of cake or chips. Good luck to you.

  9. Christine says:

    I’d tend to believe that each person is an individual, and if you are practicing ‘mindful eating’ techniques; moderation has it’s place (not using ‘everything in moderation’ as a justification).  I’m personally a firm believer in Geneen Roth’s ‘guidelines’ laid out in her Women, Food, and God even for barriatric surgery patients to learn a way to live and put down the battle with food for life.  These same guidlines are also taught in a very similar way in Michelle Mae’s “Am I Hungry” workshops and she now conducts them specifically for those who have undergone barriatric surgery – as she noted more and more attendees who were former barriatric surgery patients fighting regain.  

    I also heard about this organization on NPR this a.m.  . . .   I am sure there would be those who would say any deviation from AA/NA pricipals is complete heresey.  Yet, it appears the only study conduted on this organization has shown extremely positive feedback/results. 


    Mostly, I would say, we are not cookie cutters of each other . . ..we should be looking to be truthful with ourselves, but for some, mindful eating is a relief from white knuckle sobriety of rules eating.  I applaud what works for each of you.

    • Susan Maria Leach says:

      Thank you for your insightful email. The problem is that many surgeons offices perform the operation and are of the mindset that we should be able to figure out on our own how to ‘eat healthy’ after surgery. If we knew what eating healthy was, we would in many cases not have needed surgery. Mindful eating is a wonderful solution. Making calculated choices rather than act upon urges of the moment with later regrets.

  10. Mona Partridge says:

    I needed to hear this a year ago!! I agree totally that EIM is the wrong way to go. I had Gastric Sleeve on 2/21/13 and it is the best thing that I have ever done for myself. I was chronically ill for two years prior, with out diagnoses. I lost 85 lbs and was down to 176. I am a carbaholic and always will be. I crossed the line!!! I grieved for the foods I couldn’t have! I wondered what I had got myself into? I know now if I could go back to that one moment, I would tell myself I got healthy! That moment I long for, I battle every single day to get back to where I was. My weight is 204 now. I try to stay away from the carbs and if I get beyond 3 days I can do good, but if I cave into the cravings which I do I know I have to start back at the beginning and detox all over again. The battles seems to so much harder than before. There are no easy answers, I know I look for them everyday. I just feel out of control and the mind game is 100 times worse than before. Thanks for listening.

  11. Brenda says:

    This “sleever” gets sick (dumps) with too much sugar. Some say sleevers don’t dump, but believe me, it’s dumping.

    • Susan Maria Leach says:

      I am for RNY and bariatric surgery IF people take responsibility to take care of themselves long term. I am afraid that non compliance and self inflicted complications from deficiencies will stop this surgery from being growth, availability and popularity.

  12. Brandy says:

    Just because YOU lack willpower to actually stick to the “moderation” part, does not mean that everyone else does too. Life is about more than my weight. My surgery was not because I gobbled sweets like a hog (did you seriously eat a whole point of B&J’s?? Jesus), but because I have physical mobility issues. Even eating normally causes weight gain when you are.bedridden. The surgery is helping me lose weight so I can get moving in a normal way again, at which point I have NO intention of depriving myself from all treats for eternity. If that’s the life you want, you are welcome to it. But it’s not the life I want. I am capable of eating a few spoonfuls of the ice cream and then putting it down.

    • Susan Maria Leach says:

      Dear Brandy, Like others who fight to hang on to bad habits, you may have a hard lesson in your future. You comment about the Ben & Jerry’s was meant to rattle me, but it doesnt as MOST people with or without surgery have eaten a pint of ice cream, Next time you play troll, choose a better slam. Since you qualified for surgery, you also ‘gobbled’ something ‘like a hog’ and it was not KALE. Physical mobility or not, you packed in the calories my friend, as that is the math of morbid obesity. I truly wish you the best of luck with your weight loss. Bariatric surgery only lasts a few years, after that its ALL diet and exercise and moderation. Which did NOT work for any of us before.

  13. Ginnie says:

    I have to admit that, within reason, I follow EIM. I absolutely cannot eat anywhere near my old quantities. I never order a dessert, but if someone is having one, I’ll have a bite or two, I had GBS, and have to be very careful with sugar. I don’t order fries, ever, but I will take one or 3 from my partner’s plate. And I thankfully cannot do fried food. I watch my carbs and keep my protein high. I’m14 years out and have kept it off. We didn’t have all the great guidance newer surgeries have. I’m learning a lot from all of you.

  14. Sheila says:

    This is all really “inspiring”! I know what I need to do. I need to quit making excuses. There are way too many “special” occasions. Holidays, picnics, birthday parties, work parties… If you have “just a little” at every one, it adds up to a lot.

  15. Lisa TR says:

    I am actually really impressed by this blog post and enjoyed reading all the comments. I think some things should be forbidden because they are too risky to have. It’s true, we don’t ever talk about moderation of the many other varieties of healthy whole foods we ought to eat, only in regards to things that have little to no nutrient value. Sure, I believe in moderation – salads, healthy proteins, a variety of cruciferous vegetables, leafy green vegetables, colourful vegetables…and the right amount of healthy fats. yes, I will take some of all of those “in moderation!” a little of each of those things. So yes Susan I think you’re 100% correct here.

    Side note, I also would like to say that I am allergic to most of the ingredients in your shakes. I know I’m a minority but I cast my vote for a dairy free, thickener free, sucralose free shake. I would love to see a dairy free, gum free, shake that is sweetened with stevia and natural flavours. Like made with Bovine or marine collagen, no gums, and just your lovely flavours and stevia! Right now I get those ingredients separately and make my own or use a brand I won’t say here. But if you made one, I would try it. The flavours seem amazing. Otherwise I usually enjoy the support and learning in your groups. Thanks again for addressing EIM – something that always bothered me!

  16. LINDA COMADENA says:

    Amazing shares from the hearts of these members. I am 1 & 1/2 years out from GBP. I had severe complications from surgery, it ruptured 7 days post surgery and my surgery leaked and opened up. I got septis and almost died, they did several revision surgeries and i was in 3 hospitals and took 20 ambulance rides from hospital to hospital. I was on a feeding tube fir months, total time 6 months total hospital time. The worst was a bed sore on my butt that took months to finally heal. I lost all of my hair. I looked a mess but i am so happy and healthy now, and after good vitamin supliments i grew back even better thicker beautiful hair.Bottom line. I am very happy i had GBS lodt 110 lbs. I am learning so much about my journey and the path i need to go through. I would do this again, i am just lu ky i did not die with my complications. I really need to read all of these posts.

  17. Mary Sue Keep says:

    I totally agree with your blog. I am almost 11 months out from vsg and I am already having some problems with carby snacks. I have justified that I will be able to eat chips in moderation because I can’t eat that much of them right now, but I have noticed that I can eat more the farther I get out from surgery. I also crave cereal and can eat quite a bit. I don’t eat bread, pasta or rice, but I’m starting to see that I will have to add chips and cereal to that list. I’m so glad I found this site before I do any more damage to myself!

  18. Gwendolyn Bias says:

    I read somewhere the way to tell when when your pouch was full. And it gave a list of items:

    You would start hiccuping
    You start burping
    And you will vomit or dump
    You will get diarrhea
    Your stomach or pouch will quiver


  19. Janet says:

    I tried moderation but one bite is not enough and two is too many for this food addict. Abstaining from flour and sugar and not taking the first bite is hard but not as hard as climbing back on the wagon after one bite leads to days/weeks /months of being back into NOMB foods.

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