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Season’s Eatings?

And so it begins.  The season of over-indulgence or FREAKING THE HELL OUT IN CAPS!! over food.  Where do you stand?  I sit firmly in the middle, here, eating my half bagel with butter, while I write this post.   

DSC_4824I noted something interesting online at the beginning of the week.  

Everyone was on a diet.

(Disclaimer, because I gets The Shit for what I write, including the use of profanity:  Not YOU, Not EVERYONE, dear.)

Curiously, lots of WLS'ers were discussing the "plans" for the week's eating's, the Season's Eating's. 

And, I know this coming Monday, I'm going to see the "OMG! I GAINED 3-4-5-6-7-8 LBS! over the holiday!" posts. 

Followed by, "I've got to gain control before Christmas!"  so I can:

  • Eat ___________
  • Drink __________
  • Generally Be Merry in front of friends and family

Lots of WLS'ers were talking about how they might just cut back to save calories for the holiday, others by dropping a few extras here and there, and more than a few, were liquid dieting this week, in preparation for Thanksgiving.  A couple, fasting, cleansing, or forgoing food.

I wondered why? 

Since we have weight loss surgery, especially in the earlier post op stages, it isn't really possible that we can physically do that much caloric damage to truly undo good work that we have already done.  You cannot undo 100-150-200 pounds weight LOST in a single turkey dinner.  You can't even undo your good work in your whole DAY of turkey carcass destruction.

Consider what you ACTUALLY ATE in the course of the special day.   (G'head write it down.  I'll wait.)  Here's my day, by memory, at 8:45pm the day after, so forgive me if I have it wrong:

  • 6am-11am – Coffee, soy…
  • Breakfast 11am – Deli Chicken Breast
  • Thanksgiving Dinner – Coffee with cream, Pumpkin Bisque, Peas and Mushrooms, Turkey with Gravy, Ham and Mustard Sauce, Coffee with cream, plain whipped cream (in lieu of the desserts because sugar kills me and I had already had enough in the bisque, I can tell at this point when it's too much!)
  • Thanksgiving Evening, at the in-laws – Over several hours, creamed onions, 3 small chocolate chip cookies, Cranberry Wine, Sugarfree Cheesecake
  • Home, late – Wheat bread, ham, mustard…. bed.

Even with the decadance of some of those foods, the "damage" was hardly any worse than any other day that I simply ATE without "diet head" thinking.  In fact, if I might add it up, it could be a typical day.  Just saying.  Now, I was OUT to dinner, at a restaurant, where I was not tempted all day to pick at ANYTHING, so I did not get my paws on my usual pre-dinner noms.  This would have been olives, pickles, cheese, etc., which would have led to no dinner.  That's my usual routine. Truth.  I don't know if this changes anything overall, but I did enjoy having dinner OUT instead.

Now, realize you cannot gain that much FAT that quickly.  You have gained fluid, you have gained salt.  You have gained um, poop.

Relax. 

You won't continue eating Thanksgiving day meal-style forever, will you?  Then, you should be back to your normal weight in no time.  Go to the bathroom would you? Come back.  Feel better?

It really isn't such a BIG DEAL.  In fact – WHY are you ON THE SCALE the DAY AFTER YOU HAVE EATEN more salt, fat and, well, butter than your stomach as likely seen in six months anyway? 

Certainly it is more calories than you might allow in a regular day, understandably, most of us wouldn't typically have indulgent foods around all the time.  (If you often have pecan pie, sweet potatoes with marshmallows, stuffing with sausage and apples, you may be concerned… but really?)

Is it really necessary to stress for a week or more for one meal or one day of indulgent over-eating? 

Yes, if you're planning to cut back the food prior to that day, you I suppose I think that you must be planning to truly out-do the limitations of your stomach and your weight loss surgical procedure.

I read recently of people removing the liquid from their gastric bands for holiday eating, just to enjoy eating MORE and more variety.  Taking a band-holiday to overeat.  That is, interesting? 

But the thing with a gastric bypass, we can't take a break from our surgery.  We OWN it. 

The only way you are going to cheat and overeat your bypass surgery is to graze and constantly push the limits.

  • You CAN physically overeat in a single sitting, but that's absolutely ridiculously uncomfortably painful for many of us. 
  • You CAN physcically overeat certain types of foods in a single sitting, but it can cause super cool side effects like dumping and late dumping for many of us.  (For those who do not dump, it can be hard to gauge when to stop eating.)
  • You CAN overeat anything if given enough time.   One bite at a time.  Believe me.  It CAN be done.

I'm an idiot, PERFECTLY NORMAL even at almost seven years post op. 

  • I dump all the time by accident. There isn't any warning in some foods.
  • I overeat and I don't realize I am full until, I am walking around hoping not to spit up.  It comes with owning a bypass.  A few bites of lettuce today and I was nauseous.  It just happens sometimes.  <shrug>
  • I graze.  I snack.  I forget that I should probably have a meal, and instead, it's a meal of… cheese.
  • I fail.  ALL THE TIME.
  • So?

But, Thanksgiving was just another day.  Just food. 

And, the upcoming holidays and four thousand parties?  They are just that, just parties, and just food.  Food is not a big deal.  It does not and should not predict my behavior.  I eat when I am hungry, not because it's a holiday and there is a meal.  OMG BUFFET!?  No.  Not really.  There's the cheese and here I am.  I will take what I want and have fun doing something else.  (Like, realizing there are six different choices of TEA over there!) 

The food is NEVER worth the feeling afterward.  Ever.

I wonder what it would be like if we just let it go — and relaxed a bit.  Eating in moderation, within our limits of our diet plans but not restricting and dieting like crazy so that we are GOING crazy all the time around the holidays.  How about it?

 

 

Tips to Eating Thanksgiving Dinner, Not Your Feelings

The tips below are written for "normals" but work just as well for us WLS'ers as many of us deal with the same eating issues.
Give them some thought.

  • Depending on what time turkey dinner is served, eat a light breakfast – enough that you will be hungry for dinner but not too hungry.  Keep in mind that if you are hungry for dinner, it will taste better.  If, however, you are too hungry when you eat, you will tend to overeat and eat too fast to enjoy the food. 
  • If your family is like many, there will be lots of food lying around before dinner starts.  Do not snack on these before dinner; again, you want to feel hungry (at about a 3 on a 10 point scale) before dinner.  However, if it looks good to you, consider saving some to eat during dinner.  Wrap it up in a napkin, if you want.  Often times, just knowing you can have the treat later, will diminish the need for it NOW. 
  • Only put on your plate the foods you love.  Challenge yourself to pass up the salad that your Aunt Suzy made just because you don't want her to feel bad.  This scenario is often an underlying issue for compulsive eaters and will only hurt you in the end. 
  • Eat your favorite foods first, when they will taste the best. As your stomach begins to fill up, foods will not taste as good. Enjoying all the good stuff first may support you in stopping before your stuffed.
  • Half way through your meal, stop eating and check in with your body.  Notice where you are on the hunger scale (see my article "Put Your Hunger on the Scale" on my website). When you start to feel full, slow down or stop eating.  Make sure you can take home leftovers.  For example, ask your host for leftovers – "Mom, this turkey and gravy is DELICIOUS! I really want to eat more now but I am too full. Would you mind if I take some home to enjoy tomorrow?"  Again, making this happen and reminding yourself of it can help ease your desire to continue eating the yummy food.
  • If you begin to feel overwhelmed with family, consider taking a walk, talking to someone you like, or even hiding out in the bathroom for a bit.  It's often hard to let yourself feel the pain or sadness of a difficult interaction with family members.  However if you do nothing but just be aware of your feelings, you'll ultimately feel better than if you lose control and have to cope with the added physical discomfort and emotional guilt of eating to cope with those family feelings.
  • Save room for pie!  If your family is like mine, pie seems to come way too soon after dinner.  Remember that you can always say, "I'm not hungry yet, I'll wait to eat my slice later" and be sure your favorite is saved for you.  Trust me, you will enjoy your pie more if you are hungry when you eat it.
  • Spend some time giving thanks and appreciation to yourself, your growth, people in your life, pets that you love.  Create a new family ritual or just do this yourself or with friends.
Picture 18

“Designated Fat Girl” author, tells us that “Gastric Surgery Cured My Food Addiction.”

Picture 18

I never heard of this author, nor had she been a presence on the message forum this post was placed on before.  These type of posts usually disappear before forum members actually see them, because, well they are spam.  "Hi, buy my book!"  But this time, it's different.  The product is perfectly targeted for our community, a book written by a post gastric bypass patient about her experiences. 

How long does it take to publish a book?  The author had surgery in 2008, and the book was released in 2010.

But, here's the main issue:  the author states that "gastric surgery cured her food addiction."  However, in an article published October 25th, 2010, she was addicted to food.

Wait, what?  How?  That's just… amazing!  If this is true, where is the miracle cure that most of the WLS community is missing out on?  And, if she's got the answer inside this book?  RUN!  DO NOT WALK!  

Personally, years to realize that I   even had an issue WITH food, I laughed at my pre-operative psych testing and nutritional counseling.  "Is this really necessary?"  When I shared the truth of some of my husband's pre-operative eating habits, it was looked upon with shock, not acceptance.  One doesn't get to 370 pounds on vegetables.  (And, seven years later, he still doesn't.) 

Stomach surgery is not going to change what is inherently wrong in your head.

The author states that she's had a gastric bypass in 2008, and that she's cured from food addiction, in two weeks, apparently… as that Salon article was published in October 2010:

"I do make the claim that gastric cured my food addiction…and that's because I am no longer physically able to abuse food.  My experience with gastric has made it so I get violently ill if I attempt to overeat.  Is that everyone's experience?  No, but it is mine, and that is the story I am sharing.  I also had terrible complications from gastric, but I know that's not evereyone's experience either.  This is just my story.  I've often said food addicts are at a real disadvantage because unlike say an alcoholic or drug abuser, a food addict has to continue consuming the substance they abuse…there's no getting away from it.  But one of the advanatages some food addicts has is that with a tool like gastric bypass, they are able to treat their addiction in a way not afforded to other substance abusers.  Does that mean all of my problems went away?  Certainly not, because as anyone with an addiction will tell you, once you stop abusing the substance,  you're left with trying to find out why you're inclined to hurt yourself in the first place.  And that is the really hard problem to work on, one that I am sure I will be saddled with for the rest of my life."

And… she's currently struggling to EAT 1000 calories a day, right now. 

"I'll say this one last thing and then I'm done trying to make my point: I had my surgery two and a half years ago and I struggle to fit in 1,000 calories a day. At my worst, I was eating in excess of 10,000 calories a day. I no longer abuse food. It's just a fact. My surgeon says gastric affects people in different ways (hence all the complications I had)…and one of the effects, for me, is that I can't abuse food. And once I learned I couldn't, I slowly, over time, lost the need or want to do so."

A cure indicates that quite possibly, the problem (food addiction in this case) is gone forever. 

This might indicate that the source of the issue has been altered somehow. 

We are quite aware that the source of overeating and inappropriate eating behaviors is not located in the digestive tract, it's in our brains.  And, so far as I know, the only brain surgery for weight loss is in the trial phases.

The author mentions several instances where she ate until she made herself violently ill, at a very early stage post operatively.  "4-5 times" of entire bags of potato chips.  Is the cure that vomiting and dumping makes her feel so horrid that she no longer has the urge to binge?

The author stated that she struggles currently, to get in 1000 calories.  And, that possibly this results from her complications. 

She explained that her weight loss came easily due to malnutrition.   She had a very rough time. 

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I suppose I could find it very easy to say that I had cured my food addiction if I couldn't EAT either!

As gastric bypass patient who gets dumping syndrome and reactive hypoglycemia nearly daily on random food choices, I understand that you might do ANYTHING TO AVOID GETTING SICK. 

She states:   

"My experience with gastric has made it so I get violently ill if I attempt to overeat."

But, avoiding the normal side effects of a gastric bypass is not "curing food addiction," is it?  Like the author, I cannot overeat because I will get ill.  But, that isn't because I am cured.  That's because I prefer not being ill.

Nor is overeating to the point of esophagus stuffing and subsequent nausea is not a cure.  It's a WARNING.  This is a sensation only weight loss surgery patients KNOW.   Fun stuff right there.

Many of us chose the bypass because of the nasty effects of dumping, and it's slap-your-wrist function.  "Don't eat that ice cream, you will get sick!"  Because, it works.  It's a nasty little reminder.

It's not a cure for food addiction.  I GUARANTEE YOU THAT 100%.  Perhaps gastric bypass triggers a bit of remission, "a relatively prolonged lessening or disappearance of the symptoms of a disease." 

I have countless bypasser friends and acquaintances (raise your hands, or not) whom…

  • fail to get in necessary calories or macro-nutrients
  • have had complications that cause lack of intake
  • overeat
  • eat sugar to fall asleep
  • plan to eat crap at certain times
  • binge
  • eat inappropriate foods "on purpose"
  • eat just enough not to get sick
  • chew and spit
  • lick salty snacks
  • liquefy solids
  • vomit
  • drink liquid calories
  • So on,  so forth, and don't even get started on the transfer of these habits to OTHER issues.

Many will find any way around the bypass, and any way around the "sick."  For those fortunate/not fortunate enough to dump, they have a hard time not avoiding excess junk, as it's just so easy to eat.

Certainly there are other reasons as to why people become morbidly obese to begin with, not simply food addiction or other emotional causes.  Such as medications, illness, and genetics, however:

"Despite obesity having strong genetic determinants, the genetic composition of the population does not change rapidly. Therefore, the large increase in . . . [obesity] must reflect major changes in non-genetic factors." 

Hill, James O., and Trowbridge, Frederick L. Childhood obesity: future directions and research priorities. Pediatrics. 1998; Supplement: 571.

Admittedly, there are some of us who feel somewhat apathetic about food after weight loss surgery.  I don't really care about the food in the way that I did pre-operatively.  But, I would never say that I am cured, because the beast of addiction resurfaces in any way it CAN, even if it doesn't come out a food addiction.  Because of this I must remain cognizant that YES I AM LIKELY TO PICK UP A HABIT.  I am aware that my past as a morbidly obese person stems from over eating.  I am aware that I have family history of obesity AND addiction. 

If I don't fulfill the addiction to FOOD, I will fulfill it SOME OTHER WAY.  Always.  Even with harmless <coffee> habits.  Think about it for a moment.  Since you had weight loss surgery, if food is no longer your OBSESSION?  What IS IT?  I guarantee you replaced it.  (Put down that crochet needle, I see you.  LOL.)

The degree to which learning and memory sustain the addictive process is only now being appreciated. Each time a neurotransmitter like dopamine floods a synapse, scientists believe, circuits that trigger thoughts and motivate actions are etched onto the brain. Indeed, the neurochemistry supporting addiction is so powerful that the people, objects and places associated with drug taking are also imprinted on the brain. Stimulated by food, sex or the smell of tobacco, former smokers can no more control the urge to light up than Pavlov's dogs could stop their urge to salivate.

Read more: http://www.time.com/time/magazine/article/0,9171,986282-5,00.html#ixzz15eOWfsbt

I am afraid that some of us don't know this going in to our weight loss surgery journey — and if we hear that "gastric surgery cured my food addiction" — we're being sold on something that does not exist. 

Unhappy, obese individuals may see weight loss surgery as an answer to their problems. They believe that their lives will become easier if they lose the weight. However, many psychologists believe that without therapy, the addictive behaviors could remain or even become more harmful. As the excitement of losing weight begins to wears off, the underlying unhappiness is still there, and an individual will still try to find some way to fill the void.

http://www.docshop.com/2007/10/22/bariatric-surgery-stands-no-chance-against-an-untreated-food-addiction

I challenge the author to write a book in several years, on the same topic, after reaching and maintaining a massive weight loss without transfer addiction. 

This is a very long interview, and raises about fifty questions worth asking.  

 Related links –

Heightened suicide risk after weight-loss surgery

Please don't respond with, "Yeah, but…I didn't!"  Please take this seriously.  It happens.

NEW YORK (Reuters Health) – Severely obese people who undergo weight-loss surgery may have a higher-than-average risk of suicide in the years following the procedure, a new study finds.

Splendalicious.

What Caffeine Actually Does to Your Brain

Splendalicious.

Post WLS’ers are special.  Ask them what they took up since surgery.  😡 

I ♥ Coffee

Coffeecoffeedidyousaycoffee?

Oh, and those of us with special headaches tend to take to this as well:

Red Bull

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What Caffeine Actually Does to Your Brain – Lifehacker

For all of its wild popularity, caffeine is one seriously misunderstood substance. It’s not a simple upper, and it works differently on different people with different tolerances-even in different menstrual cycles. But you can make it work better for you.

Caffeine Doesn’t Actually Get You Wired

Right off the bat, it’s worth stating again: the human brain, and caffeine, are nowhere near totally understood and easily explained by modern science. That said, there is a consensus on how a compound found all over nature, caffeine, affects the mind.

Every moment that you’re awake, the neurons in your brain are firing away. As those neurons fire, they produce adenosine as a byproduct, but adenosine is far from excrement. Your nervous system is actively monitoring adenosine levels through receptors. Normally, when adenosine levels reach a certain point in your brain and spinal cord, your body will start nudging you toward sleep, or at least taking it easy. There are actually a few different adenosine receptors throughout the body, but the one caffeine seems to interact with most directly is the A1 receptor. More on that later.

Enter caffeine. It occurs in all kinds of plants, and chemical relatives of caffeine are found in your own body. But taken in substantial amounts—the semi-standard 100mg that comes from a strong eight-ounce coffee, for instance—it functions as a supremely talented adenosine impersonator. It heads right for the adenosine receptors in your system and, because of its similarities to adenosine, it’s accepted by your body as the real thing and gets into the receptors.

More important than just fitting in, though, caffeine actually binds to those receptors in efficient fashion, but doesn’t activate them—they’re plugged up by caffeine’s unique shape and chemical makeup. With those receptors blocked, the brain’s own stimulants, dopamine and glutamate, can do their work more freely—”Like taking the chaperones out of a high school dance,” Braun writes in an email. In the book, he ultimately likens caffeine’s powers to “putting a block of wood under one of the brain’s primary brake pedals.”

It’s an apt metaphor, because it spells out that caffeine very clearly doesn’t press the “gas” on your brain, and that it only blocks a “primary” brake. There are other compounds and receptors that have an effect on what your energy levels feel like—GABA, for example—but caffeine is a crude way of preventing your brain from bringing things to a halt. “You can,” Braun writes, “get wired only to the extent that your natural excitatory neurotransmitters support it.” In other words, you can’t use caffeine to completely wipe out an entire week’s worth of very late nights of studying, but you can use it to make yourself feel less bogged down by sleepy feelings in the morning.

These effects will vary, in length and strength of effect, from person to person, depending on genetics, other physiology factors, and tolerance. But more on that in a bit. What’s important to take away is that caffeine is not as simple in effect as a direct stimulant, such as amphetamines or cocaine; its effect on your alertness is far more subtle.

Read the WHOLE HUGE ARTICLE here.

{dagger}

Dopamine Determines Impulsive Behavior

No, really?  (Wonders if they should do a study on the post WLS communty – and then pass out the drugs.)

Brain scans illuminate the internal connection among the neurotransmitter, impulsiveness and addiction

Scientific American

Binge-shoppers and serial daters might perpetually be living at the whim of their latest impulse, and now research is getting to the biological basis of their seemingly random behavior. Impulsivity has long been linked to the neurotransmitter dopamine, which is involved in learning and reward. And a new model helps to illuminate the connection between the two. The work is described in a study published online July 29 in Science.

A team of researchers led by Joshua Buckholtz, a PhD candidate in neuroscience at Vanderbilt University, proposed that people who were more impulsive might have less active dopamine receptors in their midbrain but their brains would be more likely to fire off large quantities of the neurotransmitter when stimulated.

To verify their hypothesis, the researchers used PET scans to watch the brains of 32 healthy and psychiatrically normal test subjects ages 18 to 35 (who had no history of substance abuse) while they were taking a classic test to measure impulsivity. Before the first testing round, subjects had taken a placebo pill, but before the second, they were given an oral dose of amphetamine, which can stimulate the brain's reward pathways, mobilizing dopamine.

People who had the higher impulsivity scores had the lowest activity in the midbrain D2/D3 autoreceptors, which are in charge of receiving dopamine. But under the influence of the amphetamine, these impulsive individuals released much more dopamine than those who were less impulsive.

To see how these changes might be related to substance abuse—which has also been linked to dopamine abnormalities—the researchers polled the subjects about how much they wanted more of the amphetamine after the experiment ended.

"The people who had the highest levels of dopamine release reported subjectively stronger cravings after we gave them the drug," Buckholtz says. These findings "suggest a neurobiological link between human impulsiveness and drug abuse vulnerability," the researchers noted in their paper.

But what causes these individual differences? "Our best guess is that perhaps there's some inherited or environmentally mediated predisposition to having lower midbrain dopamine autoreceptor availability," Buckholtz says.

The evidence for genetic inheritance is strong, and another recent study, published earlier this month in Psychological Science, found people with a certain dopamine receptor type—known as DRD4—had different drinking habits than those without it. Specifically, test subjects with this variant were more likely to drink heavily if they had seen others doing the same while those without that variant kept their drinking moderate even when surrounded by heavier boozers.

The new results also suggest the potential for pharmacological interventions, Buckholtz notes. Some drugs for psychiatric conditions related to dopamine dysfunction, such as schizophrenia, work in broad strokes with "kind of a sledgehammer approach," he explains. Homing in on particular receptors and firing patterns might help develop drugs that could modulate in a "more targeted and perhaps nuanced way," he says, helping people with a broad range of dopamine-related ailments.

"Individuals vary widely in their capacity to deliberate on the potential consequences of their choices before they act," note the authors of a new study on the impulsive tendency. "Highly impulsive people frequently make rash, destructive decisions."

The study –

Dopaminergic Network Differences in Human Impulsivity

Joshua W. Buckholtz,1,2,*,{dagger} Michael T. Treadway,1,{dagger} Ronald L. Cowan,3,4 Neil D. Woodward,3,4 Rui Li,5 M. Sib Ansari,5 Ronald M. Baldwin,5 Ashley N. Schwartzman,1 Evan S. Shelby,1 Clarence E. Smith,3 Robert M. Kessler,5 David H. Zald1,3

Dopamine (DA) has long been implicated in impulsivity, but the precise mechanisms linking human variability in DA signaling to differences in impulsive traits remain largely unknown. By using a dual-scan positron emission tomography approach in healthy human volunteers with amphetamine and the D2/D3 ligand [18F]fallypride, we found that higher levels of trait impulsivity were predicted by diminished midbrain D2/D3 autoreceptor binding and greater amphetamine-induced DA release in the striatum, which was in turn associated with stimulant craving. Path analysis confirmed that the impact of decreased midbrain D2/D3 autoreceptor availability on trait impulsivity is mediated in part through its effect on stimulated striatal DA release.

 

1 Department of Psychology, Vanderbilt University, Nashville, TN 37240, USA.
2 Neuroscience Graduate Program, Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37240, USA.
3 Department of Psychiatry, Vanderbilt University, Nashville, TN 37240, USA.
4 Psychiatric Neuroimaging Program, Vanderbilt University, Nashville, TN 37240, USA.
5 Department of Radiology, Vanderbilt University, Nashville, TN 37240, USA.
{dagger} These authors contributed equally to this work.

ASMBS: Bariatric Patients at Risk of Substance Abuse

MM notes – could have told you so.  Again, have you read Weighty Secrets? 

http://www.youtube.com/watch?v=q1Y8FfU39gs

ASMBS: Bariatric Patients at Risk of Substance Abuse

By Charles Bankhead, Staff Writer, MedPage Today
Published: June 30, 2010
Reviewed by Zalman S. Agus, MD; Emeritus Professor 
University of Pennsylvania School of Medicine and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

LAS VEGAS — Some bariatric surgery patients may trade one type of addiction for another, according to a small study of patients who entered substance abuse programs after surgery.