I've Had a Relapse (Expletives Deleted)

Since my RNY gastric bypass surgery a little over three years ago, for the first time in my adult life, "dieting" has not been part of my life. Don't get me wrong, I eat very carefully. I've spent the last three years retraining my eating and exercise habits. But as far as old-fashioned dieting goes, I don't do it any more and I never intend to do it again.

One of the most important lessons I have learned is that I am not fat; I have a chronic disease called obesity. And make no mistake about it, obesity is a disease as much as diabetes, cancer or heart disease. I had surgery for my obesity just like my husband had surgery to repair a deformed heart valve. And just like he had to change his habits after surgery, so did I.

Dealing with the disease of obesity requires a radical lifestyle change. I have completely changed many of my habits from where and how I shop to when and what I eat. Meals and snacks have to be planned ahead of time. This requires sitting down once every two weeks, actually writing down a plan, and making a shopping list. When I'm fully compliant, I enter the plan into a program that analyzes the nutritional and caloric content of everything I eat. Eating according to a plan takes away the "grazing" aspect.

Even three years later, it's way too easy to eat mindlessly. In an effort to learn to control my mindless eating I have some hard and fast rules that work for me.

1. I don't eat out of bags or boxes. Food must measured out into a single serving portion and put in or on a dish before I eat it. I eat my meals from a salad plate and snacks go in a four ounce bowl. Putting food in a dish makes me aware of how much I'm eating and it makes me feel like I get to eat "the whole thing."
2. I don't eat in the car. For the last 30 years I always ate breakfast in the car on the way to work. That includes, but is not limited to, such healthy and nutritious breakfast foods as pop tarts, Krispy Kreme donuts, cinnamon rolls, kolaches, sausage biscuits, Egg McMuffins, and Breakfast on a Bun. I can't even imagine eating any of those things today. Although I do occasionally fantasize about Cinnabons. But I digress. My "behind the wheel" cuisine was not limited to breakfast either. I often ate sandwiches or burgers in the car as I ran errands at lunch and it was not unusual for me to take along a bag of chips or cookies as a snack.
3. I never fail to take my vitamins and supplements. I take them every single day exactly as instructed by my surgeon.
4. I drink 60-80 ounces of water every day. I never drink carbonated beverages or high-calorie drinks. I don't drink any liquid with my meals or for 30 minutes after a meal. That 30 minutes gives my food time to digest more slowly and gives my brain time to receive the message that I have eaten.
5. I eat lean protein first, then if I have room, I eat vegetables and carbohydrates. I only eat one serving of fruit a day. I limit my sweets to one serving of dark chocolate every evening.
   
6. I do some kind of exercise for thirty minutes at least three times a week. This doesn't have to be strenuous exercise, usually it's just walking or bicycling.
   

Okay, those are the rules that work for me. But, truth be told, lately I've been non-compliant with my own rules. Nothing big, just a couple of extra pieces of chocolate after dinner or bringing the whole package of graham crackers to the sofa instead of just a serving which is two graham crackers. And, it's been to cold to exercise outside and, honestly, I just haven't done any exercise since Christmas.

I'm not what's known in post-op circles as a "scale ho." I rarely step on the scales at home. I'm just not obsessed with what the number says. I know when I've put on a few pounds because my jeans get tight. Then I know it's time to tighten up on compliance with the rules and get those few pounds off. Sometime around Thanksgiving I realized that my favorite jeans were too tight to be comfortable. But, hey, it was the holidays, so I just wore a bigger pair and kept on going. Imagine my surprise when I visited my surgeon's office on Saturday for my three year follow up, I weighed in at 197, up 22 pounds from my post-operative low of 175.

Before-300 pounds & After-175 pounds

What the heck?! How did a couple of pounds turn into 22 pounds. (Expletives are deleted here.) Honestly, my doctor was great. No fussing, no complaints, only encouragement from Dr. Patel. The only dietary change he told me to make is to add a daily protein shake to my routine. That should help me feel more satisfied which will make me eat less. Hopefully when I visit him again in April, I'll be wearing my favorite jeans, which are a size 12.

What all this amounts to is that I've had a relapse, just like with any other disease. It's just a relapse of obesity. And just like many other diseases, there is no cure. This is a chronic condition, but it can be controlled. I know what I have to do, I know how to do it and I know I can do it. I have the tool, I have the training, and I have the will.But I'm not going on a diet. I'm just getting back to basics with my plan for dealing with obesity. Just wait and see ... in a few months I'll be able to say "Grams Made It" back into her size 12 jeans.