No Failures: For Melody
There's been a lot of discussion lately on one of the forums I read about failure, whether it's duodenal switch surgeries "failing" or patients "failing" the surgery. I know there are rare cases where people's surgeries fail -- where they heartbreakingly lose less than 30% of their excess weight. My heart goes out to them. I've known two who've been successful after having had revisions.
But that isn't what I'm writing about today.
Because what I've been thinking about as I read these threads, read blog entries like Sparkly-Jules and think about my own struggles, what I want to write about is the problem some of us have with carbohydrate addiction. I know not everyone suffers from this, but there are enough of us (in my opinion anyway) to make this worth bringing up.
I didn't need very much help keeping to a good low carb plan post-op because I knew how to do it from being part of USC's Lifestyle Redesign program for a year prior to surgery. The program is run out of the hospital's occupational therapy program and based on the idea that a lot of problems many people have with weight are due to sugar consumption and carbohydrate addiction. For clients that suffer from this addiction, which can go hand-in-hand with hypoglycemia and insulin resistance, the addiction to simple carbohydrates is a profound one that carries with it emotional as well as physical components.
This program is a good one, and not just in my opinion. Dr. Antoine, back when he was at USC, was very supportive of it, and indeed for USC employees seeking bariatric surgery, 3 months of this program is strongly encouraged. The program worked for me, to a point, I lost almost 80 pounds. But my metabolism was wildly out of whack by then. I stalled at 270, went off the program and regained the weight, finally deciding to have weight loss surgery.
I have a binder that's almost 3 inches thick with all the materials from a year of weekly meetings in it so I can't really talk about all of it. However, as people discuss knowing they need to stop eating chips, crackers, bread, sweets or stop drinking Coke but find themselves unable to, I wanted to say, of course you're struggling to do this. It's really really really hard. The drive to eat is one of the most powerful animal drives, right up there with breathing. And, for those of us who are sensitive to carbs, once we get in the addiction mode (what USC's LRD calls "bad blood sugar") our bodies feel like we're starving without it.
In addition, carbs are comfort foods. They make us feel good and have positive associations. I've found post-op that however bad they may make me feel in an hour or two, sweets go down much easier than protein. My mouth craves them. It's not hard at all the understand and believe that digestion of sugar starts instantly.
So what's the solution? The program uses modified versions of two popular low carb diets. One is The Five Day Miracle Diet by Adele Puhn and the other is The South Beach Diet by Arthur Agatston. The program director makes the case that both books are full of glib bad writing and self-promotion, but the content and diet plans are excellent. Both use a very strict low carb phase coupled with the gradual adding back of complex carbohydrates as our blood sugar becomes more "normal" and sugar cravings recede. My opinion is that reading both books has value. I tend toward South Beach myself, but both do a good job explaining carb addiction.
In either case, the hard part is the first 4-7 days while the cravings are still there -- literally going through sugar withdrawal. One of the things I liked best about the 'SC program was that the difficulty of doing this wasn't underestimated. In fact, they encouraged us to think of it as a required medical treatment. To spend a week or so getting ready -- get rid of all the simple high carb food in the house letting family know that it could come back in a week (maybe) but it couldn't be at home for 7 days, buy high protein healthy foods that we liked, use the books to make a week's worth of menus. They also pushed us to start the program on a Friday, taking the day off of work and also taking the following Monday off as the first 4 days are the hardest and there's no need for extra stress.
And it does, in my experience, work. After a week of not eating simple carbs, I don't crave them anymore. It's not that I don't want them or like them -- they always taste good -- but I don't feel a burning need. For me this isn't just about losing or maintaining weight, but about feeling in control of myself, not feeling the urge to eat myself into a sugar numbness. As much as I love sugar, it makes me feel pretty crappy and always has.
I was thinking about this when we were discussing how hard it is to do what we know we need to. It is hard. And it should be treated as such. Melody and everyone else who's identified with your comments, don't belittle yourself for struggling with this. It's really hard. But you can do it.
Think of how much you've already done.
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