Live Life newsletter issue two

Easter Friday 2009 fell on 10 April. Exactly 3 years to the day since I had my gastric band surgery! A very appropriate time, I think, to go back over my successes (and a few failures) since that day. Before my surgery I weighed a tad over 100kg with a BMI of 41. I undoubtedly fell into the ‘morbidly obese’ range. I had the typical co-morbidities (health problems) related to obesity. As well as being prescribed medications for these, I was also taking medications for an inflammatory problem which was making my weight control even more difficult.

Needless to say I’d been on every diet known to humankind. I was exercising regularly. So, when, at the end of 2005 my GP said in desperation that “we’d reached the end of the road” and then asked me to consider gastric banding, I went away shaken. However, after a week of researching websites, talking to my immediate family and consulting a psychologist, I returned and asked him to refer me to a specialist.

The penny had dropped. At 64 years of age I’d finally begun to understand how my morbid obesity was seriously impacting on my health. I decided it was time to take control of my life and to act.

Within 15 months of the banding and with exercise my weight was down to less than 60kg, my BMI in the healthy range and to this day I consider my decision to have gastric banding the best I have ever made. Now, 36 months down the track, I still weigh less than 60kg and am very proud of myself for maintaining my original weight loss. I also love the fact that at 67 I can now happily wear size 10 skinny jeans. Occasionally people don’t recognis e me and I unashamedly admit to smiling inwardly when I have to re-introduce myself.

Weight loss, however, does not come without a cost. It is hard work. Every day brings its challenges. My gastric band is a weird animal. One day it will let me eat a particular food; next time I go to eat the same thing, I just can’t manage it. This can be difficult when eating out and I have now learned to order mainly vegetarian dishes of entrée size. My diet has changed drastically over time and my choices are generally much healthier.

I belong to a support group and we recently discussed the issue of ‘head hunger’ as opposed to emotional hunger and real hunger. Understanding the difference or knowing what it actually feels like to feel full was discussed by Kim in her story in an earlier edition of this newsletter. I must admit I have rarely been hungry since the gastric banding and occasionally need to remind myself that it is time to eat. I count this as another success as I seem to have effectively wrapped my head around portion size and been able to stick to it.

One very positive aspect following my banding has been the praise and support I have had from my various medical specialists. Not only are they pleased with my weight loss, several have asked me to speak to patients who they believed would also benefit from weight loss surgery. The most outstanding case in point is a woman who started out being very resistant to the idea of gastric banding and, after reconsidering her original stance, had the surgery, lost weight and has now been joined on her journey by her husband!

In June 2008 I underwent major spinal surgery and have recovered well. The fusion and bone graft have relieved the severe pain I experienced over several years. However, as the surgeon pointed out, the 7 hour operation would not have been possible if I had been my original 100+kg.

Yes, gastric banding was a life-changing decision. In my case it was also a life-saving decision.

If you have had weight loss surgery and would like to share your story with us please email your story of approximately 500 word length and a before and after photo to bariatricedge@its.jnj.com

This recipe has been taken from BandFOOD by Helen Toouli, a book of mouth-watering recipes suitable for patients who have undergone a restrictive weight loss surgery procedure.

To purchase a copy for $28 (including postage + handling), please email helentoouli@optusnet.com.au, or contact Adelaide Bariatric Centre by calling (08) 8177 1503 or faxing (08) 8177 1357. Please note that credit card payment is preferred.

Just as you become comfortable with your new way of eating, life will throw you a curve ball. You may encounter people or situations that may not support your new healthy eating practices.

Eating out, eating with other people, celebrations, vacations all can pose challenges to your new lifestyle. At times, you may feel that you are not well supported by friends and family. Your best line of defence is pre-planning. Planning ahead is critical because it allows you to anticipate difficulties and strategize effective ways to cope with them.

Taking Control of Your Eating Triggers
Identifying, preventing, and managing your emotional eating triggers and temptations are very important for long-term success. Emotional eating, sometimes known as “comfort eating,” “head hunger,” or “mouth hunger,” can generally be defined as eating for any reason other than physical hunger. Triggers can come in the form of experiences—both internal (thoughts and feelings) and external (sights, sounds, and smells of food)—that cause you to be tempted to eat, even when you are not physically hungry.

When a trigger happens, it is important to be prepared with alternative activities other than eating that you genuinely like and make you feel good.

Saboteurs
Some people may not be helpful in your efforts to live a healthy lifestyle. Some may just be indifferent. For example, they may bring high-calorie foods into the house even though you are trying to avoid them.

Others may become threatened by your weight loss. They may talk to you about people who haven’t done well after surgery and try to undermine your success. Be honest; tell them how their behaviours are discouraging you from achieving success. If they don’t change, you may need to limit the time you spend with them.

Find supportive friends/family.
When faced with saboteurs, be honest and ask for their support.
Let them know that it is difficult for you when they encourage you to eat certain foods. You may find that they do not even realise what they are doing.
Explain that your new eating and exercise plan is making you healthy and giving you more energy. Describe improvements in blood sugar, high blood pressure, or sleep problems. Share with them that you are able to travel comfortably, play on the floor with your children, and shop for clothes in a regular store.
When friends or family bring food, just say, “Thanks, I’m just not hungry right now,” or give the food away.
Reassure them. You may want to tell them that your relationship will remain intact and strong throughout your journey.
Invite them to participate in your new activities by taking them to the gym, going for a walk, taking a cooking class, or having them over for a healthy dinner.
Be sensitive to how others may interpret your enthusiasm. They may take it personally and feel that you are commenting on their shortcomings.
If all else fails, you may have to limit the amount of time you spend with saboteurs until they are better able to cope with your new diet and lifestyle.
Show confidence in taking charge of your own life.

Your support network
Surround yourself with a support network of people who want you to succeed. This network includes your healthcare team, family, and friends. Attend virtual or live support groups where people share their experiences and where you can be comfortable with others who understand you.

Who: Your Spouse/Partner/Significant Other
How he/she can help: A supportive partner can make all the difference in your day-to-day weight loss journey. A general source of encouragement, he or she may be an exercise buddy, give you pep talks and moral support, help you with grocery shopping and cooking, walk with you through the challenges, and celebrate your successes with you.

Who: Your Extended Family
How they can help: You may come from a family with a history of obesity. You may have other family members who are dieting, who have had weight loss surgery or who are considering having it. With or without a family history of obesity, there are a number of ways your extended family can help. Organising a walk together, sharing recipes, working together to make family gatherings less food-oriented or providing a quick chat in times of need are all ways your family can contribute to your weight loss success.

Who: Friends
How they can help: Good friends are a priceless source of support for weight loss surgery patients. They listen and provide a sounding board; they can offer advice without being judgmental. Good friends are genuinely happy for you when you succeed! Enlist your friends by letting them know what kind of help you would like from them, and express your appreciation for the help they give.

Answer: Weight loss surgery is like other major surgeries. The best preparation is to understand the obesity surgery risks and potential benefits and to closely follow your doctor's instructions.

Understand the surgical process and what to expect afterwards.
Talk to people who have had weight loss surgery.
Write a letter to yourself and your surgeon explaining your reasons for having the obesity surgery and outlining your plans to maintain your weight loss after surgery.
Start a journal about your experience. Record how you feel now, the obstacles you encounter, the things you hope to be able to do after obesity surgery.
Get a letter of support from your family. It helps to know you have people behind you, waiting to help.

To physically prepare yourself, strictly follow your doctor's guidelines. These usually include, but are not limited to:

Follow your surgeon's pre-surgery diet instructions strictly.
Be certain to follow your surgeon's instructions regarding any medications you may be taking to control other health conditions.
Arrive on time, with supplies from home for a two- to eight-day hospital stay depending on your procedure.
Remember to bring your Hospital Admission Form, your Health Fund details and your doctors referral to the hospital on the day of your admission

Question: What can I do before the appointment to speed up the process of getting ready for obesity surgery?

Answer: Select a general practitioner if you don't already have one, and establish a relationship with him or her. Work with your doctor to ensure that your routine health maintenance testing is current. For example, women may have a pap smear, and if over 40 years of age, a breast exam. And for men, this may include a prostate specific antigen test (PSA).