Almost Five Years Post-Surgery: Weight Re-gain and Decision to Use Ozempic

I'm five years (minus four months) post-surgery. I'm not happy with my weight, or with my eating. 

Satiety cues have greatly diminished. I can eat more at any given meal, and have to be super careful to find an artificial stopping point. Worst of all, cravings are back -- intense feelings of needing to eat something carbohydrate, especially at night. I've learned a lot about these cravings over the years. It's not hunger, but it's also not emotional eating or stress eating. It's an addiction, and it takes more than willpower to shut down.

So, to recap.

Shortly after hitting the 50-pound weight loss, I re-gained five pounds. That's fine. I knew that minus-50 was not sustainable. 

About a year after that, I re-gained five more pounds. I wasn't thrilled about that, but I accepted it, and I could live with that weight.

I maintained that minus-40 weight for three years. 

And since then, I've re-gained 10 more pounds. Now I'm seriously unhappy with my weight again, and I don't want to let this go any further.

I want to note that I never got thin. Minus-fifty wasn't even thin. I look and feel significantly better than I did pre-surgery. My bloodwork is in the normal range again. But I am still my chunky, shapeless self. Meaning, the weight re-gain is significant.

For a while, I was really beating myself up, blaming myself for letting the tiny stomach expand. But I gave that up. No one knows how permanent weight-loss surgery is. It was originally thought that lap-band surgery was the fix. Now that is no longer used, because most people re-gain everything. The data on the "permanence" of gastric sleeve surgery looks at five years: if a patient retains the weight loss after five years, it's considered permanent.

Even that data is incomplete. Most people who have the surgery aren't tracked. Most people aren't part of a study, and many study participants drop out because they've re-gained weight. So the long-term prognosis is unknown. What's the point of beating myself up?

I've tried repeatedly to lose the weight I've re-gained. It starts out well: I lose a half-pound per week. Then, after three or four weeks, weight loss stops, and eventually those few pounds return. I do not want to return to the diet yo-yo! But I also don't want to be this weight.

I did a lot of research and decided to try Ozempic. Our provincial health care and our extended insurance doesn't cover it, because I don't have diabetes, and because my BMI is under their threshold. It's a sizeable expense, so it was a big decision. 

It's also impossible for me to tell if this is a rationale decision based on health, or if I'm back to obsessing on the number on the scale, if I'm having disordered thinking again. I can't sort it. I don't have the perspective. 

My hope is that a few months on Ozempic will lead to 15 to 20 pound weight loss, and I'll return to the state where it was easy to maintain that, and transition off Ozempic. I honestly don't know how realistic this is, but I'm trying it.

I had my first dose this morning. Stay tuned.

Small Weight Gain, Part 2 (Update)

Thank you to everyone who commented on my previous post, both in comments and by email. 

Confession: I was reluctant to write that update, because weight gain feels like failure. And thinking that weight gain feels like failure, is in itself a failure. This is how thoughts of my weight become obsessive. I'm fighting against it. I'm telling myself all the things I would tell any friend who was experiencing this.

Here is why I'm concerned with even a small re-gain: this is how I gained all the excess weight in the first place, a small increment at a time. 

Yes, I am getting lots of exercise, eating healthfully, and not overeating. But what if the amount I am eating causes me to continue to gain weight, a bit at a time, until all my hard work is undone?

I'm not saying this will happen. But it's what I'm afraid of. 

A few folks have suggested getting in touch with Wonderful Registered Dietitian who is available locally. That's a great idea: more support, and from an expert. I recall that the last time I felt panicked about eating, a session with her was very helpful. I will contact her this week.

Thank you as always for your support.

17 Months Post-Surgery: Small Weight Gain and Trying Not to Panic

In January, I decided to stop tracking my eating. My intake was so consistent over days and weeks and months that tracking felt useless. I had been planning to update this blog with that information... and now there's some new, less pleasant news. I've re-gained some weight. 

I'm concerned, and trying not to panic or obsess.

Since hitting my lowest weight of minus-50 pounds, my weight has fluctuated within 3 or 4 pounds of that weight. From everything I've read, that is normal. The lowest weight after bariatric surgery is not usually the final destination; most people re-gain about 10% of their total weight loss, and settle there. Since I lost 50 pounds, I thought gaining 3 or 4 was not a big deal. 

But now I've gained a few pounds over that. And this is really scaring me. 

Some people do re-gain weight after gastric sleeve surgery. How much weight, and the cause of the re-gain really varies.

Is this new, slightly higher weight my "true" new weight, and I need to accept that? Or have I been eating too much? Did the few times I was uncomfortably full after eating stretch my stomach pouch? That is possible to do -- but I imagine that everyone who has had bariatric surgery sometimes gets uncomfortably full, while they are still adjusting to their new capacity. How much repeated fullness would it take for the pouch to permanently expand?

These questions are spinning around in my head, and there are no clear answers.

I'm still getting a lot of exercise, and still eating well and healthfully. I have identified a few eating habits that I can tighten up, a few little eating habits that have gotten away from me. Those are easy enough to tweak. But my past experience with the effect of small diet tweaks have on my weight are not at all good.

I guess the only thing I can do is ensure my diet is meeting the post-surgery standards, and try not to obsess on the number. The former, easily done. The latter, a much greater challenge.

What Is My Ideal Weight? Why I Don't Have a Goal Weight

Motivational advice has become a cottage industry during the pandemic. Advice on how to set goals, how to reach goals, how to adjust your attitude, how to stay motivated, how not to sabotage yourself, how this and how that, have proliferated online like mushrooms after a rainstorm. 

Many people are experiencing "motivation fatigue". On social media, you see a lot of  "stop telling me how to meet my goals... I just want to get through the day".

85% goal-setting: it's not SMART

Most motivational advice involves goal-setting -- especially so-called SMART goals. If somehow you've managed to escape this over-used acronym, it stands for Specific, Measurable, Achievable, Relevant, and Timely. The company I work for is obsessed with SMART goals. We're always writing them, planning for them, evaluating them, re-assessing them. 

But while I'm forced to use SMART goals in my professional life, I consciously don't use them in my personal life. My problem with SMART goals are the S and the T. For me, specific goals with deadlines are exactly what I don't need. 

Since recognizing that my biggest obstacle was all-or-nothing thinking -- since understanding that 85% thinking would be a healthier way to live -- I have chosen not to create specific goals and never to give myself a deadline. (There are some exceptions to this... because even 85% thinking is subject to 85% thinking!)

Instead, my life goals are all about process. 

Here are two examples of process goals from my life. 

• Rather than say, I will read x number of books this year, I say, I want to devote more time to reading, and come up with strategies to help me do that.


• For the past year, I have been re-learning how to play piano. My goal is simply to continue to learn how to play. The process of learning is the goal.

For me, as soon as I attach a specific -- I will read 30 books this year, I will learn how to play Summertime -- the experience is ruined, or at least diminished. If I can play Summertime but I still make mistakes, have I failed? What about a more complicated version of the song -- does my simple version "count"? What if I start a book and don't finish it, does that count? What if I read only 28 books -- what happens? 

I do use habit-tracking. I track various healthy habits that I want to incorporate into my life, and I like to see as many x's in as many boxes as possible. But not every box is checked every day. Some days, all the boxes are empty! And some days they are extra full. I find the act of tracking habits to be motivating, so I use it. But my goal-setting is general, rather than specific, and has no timeline attached.

If you know that staying motivated is difficult for you, and your habits run more to procrastination, then goal-setting and SMART goals could give you structure and direction. But if, like me, you are too disciplined, and your habits run more towards obsession and perfectionism, then SMART goals can become straightjackets.

So where does this leave me in terms of weight loss?

No one can tell you how much weight you'll lose from bariatric surgery. Post-surgical weight loss is measured as percent of excess weight loss (%EW). Estimates run from 40%EW to 80%EW. That's wide range! Plus, your ideal weight is also expressed as a range, usually plus or minus 20 pounds. So I can't say with any certainty how many pounds of excess weight I have, and I can't predict how many of those pounds I'll lose!

And the lowest weight you reach after surgery is likely not your final destination; most people re-gain around 10% of the weight they lost.

So what's a realistic goal? Who knows!

I probably have 70-ish pounds of excess weight. But is losing 70 pounds a realistic goal? Who knows!

In the back of my mind, I did think it would be good to lose at least 50 pounds, and right now that seems likely to happen. But if ultimately I lost 45 pounds, and my health outcomes improved greatly, is that a failure, and should I obsess on losing five pounds more? No and no. 

TL;DR: I'm trying really hard to not obsess on the number on the scale, but to focus on health and how I feel. That's why I've chosen not to have a weight goal. I'm going to continue doing what I'm doing and we'll see where it takes me.

Getting Perspective and Finding Balance... with a Lot of Support

I had a tough week, wrestling with my old eating-disorder demons, but I am feeling much better! 

Friends and readers of this blog: you helped me tremendously, through your comments, emails, and texts, plus I had an excellent talk with WRD. 

I'm grateful that my writing lets me reach out to people, because I don't think I would have talked about it otherwise. A big Thank You! to you all.

* * * *

When you are involved in an eating disorder, your focus becomes very small. How many calories have I eaten, what does the scale say, how many minutes did I exercise, how many calories did I burn. How many hours can I go without eating. Can I eat less than I did yesterday. I think this is true for any addiction. The world becomes boiled down to your obsession.

Using the food-tracking app contributes to this addictive thinking, too. Food tracking is important, and portion size is important. But the downside is an over-reliance on external counts, when your goal should be mindful or conscious eating. 

While I was thinking this way, I purchased a kitchen scale. Dietitians don't recommend this; they prefer using visual cues, like those pictured here. But for many foods, those are not working for me. A medium-sized apple or a small banana -- fine. But I want to see what three ounces of salmon looks like, how many grams of ground bison I'm using per meatball, how much one chicken thigh weighs. I won't use it forever, but right now it feels like a useful tool. 

I knew this kind of addictive thinking would be a danger; it was my greatest fear about bariatric surgery. That didn't prevent it from happening, but it did minimize the damage. It was one crappy week. In the long run, just a learning experience. I'm sure it will re-surface, and next time I'll be even better prepared . . . I hope.

* * * *

"What did we learn today?"

Mkk reminded me that there have been so many positives in this experience. This may sound silly, but I had lost sight of that. That gave me the idea to write down all the positives.

J suggested printing out the list of positives and reading it aloud three times a day. Another great idea! This helped me slow down my thinking and re-focus. J also reminded me that what I'm doing is hard work, and I should give myself some credit.

M suggested being easier on myself, and continued to cheer me on.

A suggested focusing on my actions rather than thoughts, and not punishing myself for my thoughts. An entirely new perspective for me.

R shared her own experience with obsessive thinking, being "sucked into the spiral," as she called it. She suggested re-framing my urge to weigh myself as normal curiosity, without worrying if I am on a slippery slope.  

Also this: Let yourself be proud of the weight you have lost and also give yourself permission to eat a bit more sometimes. I'm printing this in big, bold letters and pinning it to my bulletin board.

My partner suggested I reach out to WRD, and even though I said, "What's the point, I know exactly what she'll say," I called anyway. And guess what? I didn't know what she would say! Newsflash: trained professionals know more.

* * * *

Here are some things that WRD reminded me of.

• I'm much more physically active now than I was before the surgery. When you're physically active, your body requires more fuel.
• The goal of a forever eating plan is not to hit a calorie limit or range every day. It's to eat healthfully and mindfully. In fact, although I'm using a caloric guideline from the hospital in Mexico, the Canadian bariatric centres don't use a calorie target at all!
• We need different amounts of food on different days. Some days you are going to be hungrier. When that happens, try to make good food choices, and eat slowly and mindfully. And if you don't... forgive yourself and move on.

There's also the mental checklist for when you want to eat.

• Am I truly hungry or perhaps bored or stressed? 
• Have I eaten enough protein today? Enough healthy fat? Both contribute to feelings of satiety.
• Am I well hydrated? If you haven't been drinking enough, you may feel hungry when your body is actually thirsty. This is definitely a pitfall for me! Working at my workplace, rather than home, and wearing a mask all day is also not conducive to adequate drinking.
• What would be a healthy and filling snack to eat right now? I actually keep a list in the kitchen of healthy snacks to bring to work, to avoid coming home overly hungry.

* * * *

Every one of you reminded me to be kind to myself. Thank you.

The Challenge of Obsessive Thinking (the Eating Disorder Spectrum)

Obsessive thinking is back. 

I'm remembering how awful this feels, how it sucks up energy, how it clouds the mind, making rational decision-making a monumental task.

Obsessive thinking about diet and weight is one reason I gained so much weight. I had been so trapped in the dieting cycle, so unhappy with my own unrelenting focus on my weight, that once I liberated myself from it, I was afraid to take one step towards it again. That wasn't the only reason for my weight gain, but it was definitely in the mix.

Now I have to monitor my eating and weight very carefully. That's what I agreed to when I decided to have the surgery. Most days it's all right. But sometimes I feel the obsession creeping back. 

About one day each week, I feel noticeably hungrier, and I eat a little more. I tell myself that this shouldn't matter. I tell myself: 

• It's one day a week. Most days I am well within the low end of the preferred calorie range.
• It's only about 300 calories.
• It's only because I'm hungry. I'm not eating out of boredom or from stress.
• Even with this few hundred extra calories, I'm eating way less than I did before the surgery.
• I'm getting a lot of physical exercise, so a few extra calories once a week is not going to hurt my weight loss.
• This is a lifelong process. It's not going to be perfect every day.

I run down this checklist of rational thought, but the truth bounces off the wall of obsessive thoughts, and I can't convince myself. I think about these extra calories... and think, and think, and think. The thoughts run around a hamster wheel in my mind.

The next step down this slippery slope is weighing myself. 

This week I searched for -- and found -- where my partner has hidden the scale, and jumped on. It's my form of bulimia. My obsessive thoughts are triggered and I reach for the scale.

This is what I was afraid of, and I do not want to do this.

Last night I told P a bit of this, and he suggested I ask someone about it, like WRD. I said I knew exactly what WRD would say. She'd say exactly what I'm telling myself. But I should tell her anyway. She always has good ideas, maybe she knows some tricks that I haven't tried. 

I do not want to do this!

Using an App to Track Nutrition and Exercise: Pros and Cons

Most people who track their diet and exercise use an app on their mobile device. I decided to track everything manually, beginning with the first day of the pre-surgery fast.

I have a beautiful blank notebook that I had never used. It was a gift, associated with a very special memory. (The book was a gift from my mother, a souvenir of our trip to France together in 2014.) I decided that this huge life decision deserved this special book. 

In the notebook, in addition to diet and exercise, I've included my questions for the dietitian, notes from my dietitian sessions, any pain or discomfort I experience, any milestones, challenges, and so on. It's a record of my bariatric journey. 

I really like having a record of all this on paper, and associating it with a very joyous memory. I'll continue to use the book to record notes from my dietitian sessions, and any other issues (qualitative rather than quantitative evidence, as we say in the information biz).

But now that I'm moving into a permanent bariatric diet, I realized an app would be very helpful. I chose SparkPeople, and I signed up for the "premium" (paid) version right away.

The paid level has many good features, but the reason I'm using it is to eliminate advertising. Something I use every day, both on my computer and my phone, cannot be plastered with ads. I'm fortunate that I can easily spend another $5/month. Not everyone can, and there are free versions of all the weight-loss apps.

There are many advantages to using a mobile app for nutrition and exercise tracking. However, for me, there are also disadvantages. In some ways it makes my life easier... in other ways it makes things more challenging.

Advantages

The advantages to using an app are obvious.

1. When you enter the food you've eaten, it automatically enters the nutritional value -- calories, protein, and anything else you might be monitoring, such as carbs, fat, vitamins, and so on. No need to look up anything.

2. It tracks and calculates your totals daily, weekly, monthly, and all-time. No need to look back through your week or month, no need to add anything. 

3. Once you've eaten a food, and entered it into the app in a way that reflects your habits (brand, portion size, method of cooking), the next time you eat it, you just tap or click on it. Easy.

4. You can group foods and ingredients that you eat together. For example, I grouped "milk, 1%, 16 ounces," "frozen berries, 1 cup," and "protein powder, whey, unsweetened, 1 scoop" into "protein smoothie". I'll do this with everything I cook, too. 

For me, these are the advantages. The app saves me time and repetitive work.

5. If you are not accustomed to tracking your habits, using an app would make it easier, and hopefully increase the likelihood that you'll continue tracking.

6. If you need more support, the popular apps offer articles, blogs, recipes, workouts, and so on, and also have communities that support and encourage each other. Goddess knows there is no shortage of any of these things online! But it does put everything in one place, which might help you focus. 

Disadvantages

The disadvantages to using an app are less obvious, unless you already have a good awareness of eating disorders.

1. Most apps track your exercise against your eating. They encourage the idea of exercise as a way of eliminating calories: "I walked 30 minutes today, now I can eat more!" 

This can be the first step down a very dangerous road. 

- We do not only expend calories when we exercise. We burn calories every moment, with every breath, all day, even when we're asleep. 

- There are so many reasons to get regular physical exercise, for both your physical and mental health. Exercise lowers blood sugar, lowers blood pressure, reduces the risk of heart attack, stroke, and diabetes, combats fatigue, helps regulate mood, boosts metabolism, and more. A life that includes regular physical exercise is a healthier, happier life than one that does not. Weight-loss apps encourage you to think of exercise solely in terms of calories burned.

- Tracking exercise against eating can very quickly lead to feeling that you have to "burn off" everything you eat -- that eating anything without exercising afterwards will lead to weight gain. 

Have you ever excused yourself before eating something by referencing your exercise? As you're about to take your first bite, you say (either out loud or to yourself), "It's OK, I'm going to the gym later today." 

Maybe you say it once as a joke. Or maybe you think it all the time. Maybe you privately believe you don't deserve to eat unless you have exercised. Or that eating food without specifically pairing that food with exercise will cause you to gain weight. This is called exercise bulimia. In this case, the purging associated with bulimia takes the form of exercise.

In the paid level of the app I'm using, you can turn off the "track exercise against eating" function. I've done that... and now the app tells me "Calories Burned: 0".

2. The app tells you "calories left to eat for the day". 

Tracking calories over time is useful and important. I get that. Post weight-loss surgery, it would be very easy to eat a tiny bit more every day or every week, gradually increasing your capacity -- and ultimately preventing or even reversing your weight loss. 

However, basing your food choices on "calories left to eat for the day" could also create a dependence on the calorie counter, rather than learning how to assess your own hunger. Last night I noticed the app told me I had 250 calories left to eat for the day. But I was done eating. I had no interest or desire to eat anything else. 

The previous night, I had minus 300 calories left -- that is, I ate 300 calories too many. I had been genuinely hungry, and ate too fast (my ongoing challenge), not giving my brain enough time to register the food intake. 

In the second example, calorie tracking was very helpful. I can look at the daily total and remind myself to continue trying to eat more slowly. In the first example, tracking would encourage me to eat when I wasn't hungry.

* * * * *

I plan to continue to use SparkPeople, both on my computer and on my phone. But I want to stay aware of these pitfalls. I'm hoping awareness, plus my own discipline, is enough to keep me from falling into them. 

But honestly, I'm a bit nervous about it. My January 1 weigh-in is coming, and thinking about stepping on the scale, I'm already getting anxious. I'm not freaking out or anything close, but this is nagging in the back of my mind. 

Week 7: Protein Requirements, the Tiny Stomach, Clothing

I've been introducing soft foods into my diet in a totally random and haphazard way. 

I'm still eating the pureed food I prepared. We bought more muffin tins, so I was able to make larger batches, fill the cups with half-cup portions, and freeze several tins. But I'm also eating canned fruit, oatmeal, soup that has not been pureed, well-cooked sweet potato, a scrambled egg, peanut butter, and so on. 

I'm gradually weaning myself off the pureed foods, but I will probably keep some of that in my diet for a long time.

Getting enough protein

I'm completely sick of smoothies, but without them, it's very difficult to meet the protein requirements while not overeating -- even while adding protein powder to foods like soup or oatmeal. Some days I give myself a break from the smoothies, but when I calculate the grams of protein on those days, it's always borderline. 

Experimenting with different flavours in the smoothies hasn't helped. I'm sick of drinking so much frothy liquid. But I must do it. 

Once I'm done with all the transition phases, and I'm on a regular post-bariatric eating plan, the protein requirements will be reduced. Still a lot, and still very important, but the difference between 70-120 grams/day (post-surgery) and 60-70 grams/day (regular bariatric diet) is significant. 

So, for now, smoothies it is.

The tiny stomach

Learning to eat more slowly continues to be a painful challenge. 

Last night, for example, I wanted the 16 ounces of milk that I normally use for a smoothie, mixed with this turmeric "golden mylk" blend. It was late and I wanted to finish it up and go to bed. Instead of sipping the milk, I glugged about half of it. 

The results were agonizing -- sharp pain, nausea, bloating -- and lasted more than two hours. 

Looking back through my food diary, I see this is happening less frequently, so I've made some progress. I guess I just have to keep trying.

Clothing

A few readers have asked me about buying new clothes. I'm not rushing to do that any time soon. Like many women, my history with chronic dieting and body image can make buying clothes a stressful and unpleasant experience. 

This has improved a great deal by shopping online, and by my hard work at self-acceptance. But even so, I don't want to buy clothes in a smaller size until I am sure I can maintain that size. Honestly, clothes shopping is not something I even want think about yet.

However... there are some clothes at home that I'm thinking about.

I have a large number of graphic tees -- the kind I wouldn't wear to work, but generally wear all weekend and while working from home -- that I really like, that haven't fit for several years. These are shirts with logos of a certain sports team, from social-justice activism, and so on. I never got rid of these. They were already larger than I liked, and were in good shape... so I just hung on to them, and tried not to think about them.

Now I am gradually starting to wear them again. That's pretty cool. 

The other exception is a collection of professional wear, especially beautiful jackets (the kind some people call blazers or suit jackets). 

Beginning a new career in 2013, I needed new clothes, first for interviewing, then for working. Making peace with my body -- at that time largest I had ever been -- I found a great store that sold plus-size petites. I know that sounds like an oxymoron, but when you are short and heavy, this is an incredible lifesaver. They also made shopping easier, with salespeople you can book in advance, so you can shop by yourself, but still have someone going back and forth to get different sizes and ideas for outfits.

This store's clothes were exactly the right mix of dressy and casual, and I started building a new professional wardrobe. The jackets were especially brilliant -- really stylish, but still classic, and they fit beautifully. 

I wore these jackets for several years. I must admit, dressing well and having clothes that fit nicely increased my confidence. 

Then one day I noticed with horror that the jackets no longer fit as well as they should; they were too snug. Then no longer fit, full stop. I kept them, but stopped wearing them.

A couple of years ago, my partner and I relocated, and these jackets are now too dressy for my present situation. I bought some sweaters -- long, open-front cardigans -- to wear over dressy t-shirts. This let me change my look and buy larger-size clothing without feeling awful about no longer fitting into those jackets.

Now I am looking forward to putting on these jackets, and buttoning them, and feeling that I have reached a goal -- not the final destination, but a landmark along the way. However, I don't want to go near the jackets until I am certain that they will fit. So I'm waiting.

My State of Mind: Checking In on the Dark Side of This Journey

I'm feeling very positive about this whole experience so far, but at the same time, I'm also working hard to keep my more negative concerns in check.

You may recall I was concerned about the surgery triggering past behaviours that were harmful to my mental health (here and here). Having bariatric surgery means being very attentive to food choices and portion size. It also means monitoring your weight regularly -- my single-biggest trigger.

These negative thoughts and behaviours are already percolating in the back of my mind. Over the past month or so, I've calculated and recalculated what my final weight may be. Healthy weight is expressed as a range, and the expected percentage of weight loss from surgery is also a range. I'd sit there using the calculator on my phone or computer: what if I lose this much, I'll be this weight, and if I lose this percentage, I'll be that weight -- in all different combinations, thinking myself in circles -- and all to no avail, since I cannot predict the future -- and since ultimately, I have no control over the numbers. You can stick to the plan 100%, but you can't control how many pounds you lose.

Thank goodness I can now talk about this and express it in writing. Eating disorders are almost always secret obsessions, layered in shame. The secrecy allows the disordered thinking to snowball without any other, more rational input. 

Eventually I disclosed to my partner that I was doing this. He immediately reminded me that I'm going through this process for my health, not for the number on the scale. And, he said, I'm also avoiding future weight gain. I hadn't thought of that! Even if my "percentage excess weight loss" is on the low end of the range, my weight will stabilize there. As long as I follow the guidelines, I won't continue to gain more weight as I get older -- which up until now, has been happening with each turn of the calendar.

This is also why I'm writing about this: to get it out of my mind. There's no easy solution to behaviours that harm our mental health. They require mental discipline, to recognize the obsessive thoughts as they creep in, and talk yourself out of them. And if I need more help, from WRD or a therapist, I'm totally willing to go there.

The Name of This Blog

Why is this blog called 85 percent thinking?

In my mid-30s, I was writing professionally, and had a run for a while writing about eating disorders. It was through that work that I first recognized my own disordered thinking about food and dieting. I reached out to one of the therapists I had spoken with, and worked with her for some time. It was difficult work and it had an enormous impact on my life.

One of my biggest pitfalls, something I've worked hard to recognize and reduce over years, is All Or Nothing thinking. All Or Nothing is a poisonous trap that prevents us from participating fully in our lives -- and it's often part of an eating disorder syndrome.

This therapist taught something she called 85 percent thinking. Whatever you're doing, whether it's eating healthfully, getting more physical exercise, or any other goal, if you're doing it 85 percent of the time, you're doing well. 

We're not machines that can be programmed to perfection. We're humans, with real lives, full of things we cannot control. That accounts for the other 15 percent.

To do anything well, especially to learn new habits, we need discipline and commitment and inner strength. But to be human, we also need compassion, and flexibility, and forgiveness -- and we must extend that to ourselves. For many people, especially women, it's much easier to be kind to others than it is to be kind to ourselves. That, too, is the other 15 percent.

That's 85 percent thinking.

Will the Surgery Trigger Destructive Behaviours?

I mentioned that I've struggled with an eating disorder.

I think most women in our society have had eating disorders at some points in their lives, whether they realize it or not. We think our constant dieting, our obsession with our weight and size, is normal. I learned to think about eating disorders as a continuum of behaviours. When thoughts become obsession and behaviours take over your life, there is a problem!

My problem took the form of obsessive dieting and weighing myself. I was addicted to weighing myself. And it took me a very long time to quit. I put the scale in an inaccessible place... and then stood on a chair to reach it. I put myself on a regimen, only allowed to weigh myself once a day, then every other day. I succeeded a bit. I relapsed. I lied to myself. I gave up. I started again. And so on and so on. Everything you know about addictions, I did that.

OK, maybe not everything. I didn't sell the TV to buy a fix, I didn't lose my job, it didn't end my relationship. But trust me, even something seemingly harmless as stepping on a scale can strangle you.

For a time, I tried weighing myself only at the gym. I was swimming. I would leave the pool feeling great -- loose, invigorated, happy. Then I'd get on the scale and ruin my day. Day after day after week after month, robbing myself of all those good feelings.

In the past 15 years, I have tried several times to lose weight in a healthy and non-obsessive way. I lose weight verrrrry slowly, and healthy weight loss is slow anyway. So if I don't weigh myself occasionally, I'm not going to see any progress -- and you need some kind of progress as positive reinforcement.

But that word occasionally... that's the sticking point. Keeping myself off the scale has been very, very challenging, far more difficult than any dietary adjustments. Stepping on the scale is a giant trigger. It opens the floodgates to a rush of self-loathing.

Before and after surgery, there is going to be a lot of weighing. A lot of stepping on the scale. How am I going to handle that?

I don't have an answer to this yet, and I'm okay with that, for now.

But this is one of my greatest concerns about the surgery.

I've Tried It All... And I Don't Want To Go Back There (Eating Disorders Are More Common Than You Might Think)

When it comes to my weight (size, body image, etc.), I've been there and back. More than once. I gained a lot of weight in my mid-20s, and used one of the many popular diets of the day to lose it quickly. This was the first, and as it would turn out, only time in my life I was actually thin.

As the weight came creeping back, as it inevitably does, I started dieting. And dieting and dieting. I became obsessed with what I ate and with weighing myself. It was a horrible way to live.

I was like this at least 10 years, when, coincidentally, I needed to research eating disorders. I was shocked to recognize my own behaviour.

When many people think eating disorder, they imagine an extremely thin person, probably a young woman -- an anorexic. But there's a huge spectrum of eating disorders, covering a wide range of behaviours. Once I became aware, I would see eating-disorder behaviour everywhere. 

For me it took the form of being addicted to weighing myself, addicted to dieting, and obsessed with restricting my eating. I was probably only 10 pounds overweight at the time, but I was obsessed with trying to lose weight.

After recognizing this in my late 30s, I started seeing a therapist who specialized in eating disorders, and I worked hard to free myself of these obsessions. Eventually, I got there.

I stopped dieting. I stopped strictly policing my eating. I even stopped weighing myself. It took a long time, but it was glorious. It was so liberating! I gained some weight, but I was healthier, and happier. 

I also learned that the link between weight and health is greatly exaggerated. Obesity is a health risk, but those 5 or 10 extra pounds that women become obsessed with are not. They're not even extra.

But keeping people insecure and unhappy is an essential part of our consumer culture -- and the diet industry thrives on it.

So I stopped dieting, started enjoying my life -- and food -- more. I was maintaining a weight that was heavier than most people want to be, but I was healthy and felt good.

Now I've gained quite a bit more than is healthy. But I don't want the demands of bariatric surgery to undo all my hard work and my hard-earned freedom from these obsessions.

I'm afraid the surgery will be a giant trigger that sends me back to weight prison. Pre- and post-surgery, you're supposed to track your eating. And post-surgery, you need to track your weight loss.

How am I going to do that and stay sane?

I'm thinking a lot about this. I want to make it work.