About two months before my Roux-En Y gastric bypass procedure, I sought to gain an insight into what people who underwent weight loss surgery and had succeeded in losing weight (and maintaining that weight loss) did differently than others. What acts or strategies did they utilize that other, less successful, WLS patients did not?

I hoped to find at least a couple of tips and tricks that just might make this difficult Journey to Fitness a bit simpler.

So I searched the Internet for Success with Gastric Bypass.  If you do this, you will find a well-published study (http://www.colleencook.com/PDF/SuccessHabitsOriginalArticle.pdf) that lists six “success habits” found to be common in people who achieved long-term success with gastric bypass. I was excited to click on the link and learn what simple tricks others have employed to make their GB experience so successful. What I found was a bit… well, Simple:

1. Successful patients manage what they eat,
2. Successful patients drank water (and not drink carbonated, sweetened, caffeinated, or alcoholic beverages),
3. Successful patients took daily multiple vitamins and calcium,
4. Successful patients slept 7 hours per night on the average,
5. Successful patients exercised regularly,
6. Successful patients took personal responsibility for staying in control.

So the secret to losing weight and maintaining that weight loss is to take personal responsibility to eat well, exercise, and get sleep. Simple… and frankly, something we already know. You lose weight by taking in fewer calories than your body burns, and you burn more calories by increasing your level of physical activity.

Turns out, weight loss/management and a healthy lifestyle is Simple… it’s just not Easy.

What I really wanted to find were tips and tricks to make weight loss Easier.   How great would it be to come across a study titled: “Six Tips for Easy Weight Loss and Maintenance.”

This Simple vs Easy scenario plays out with alcoholics and gamblers, where the Simple answer to their problem is this: Don’t drink/gamble. However simple this solution, the act of implementing this solution can be very, very difficult (not easy). The Simple part of the answer deals with facts, logic, formulas, math, etc., while the Easy/Hard part of the answer deals with our emotions, fears, desires, personal strengths and weaknesses, time, environment, wealth/income, etc.

The issues related to implementing a new lifestyle are so closely tied to our own personal strengths and weaknesses… to our ability to work with and not against our own personality, emotions, and deep-seated fears and hopes. Looking closely at my history and knowing, as I believe I do, what does and what does not motivate me, I wrote down what I believed to be the four biggest BARRIERS to my success:

• Conflicting Priorities – I always say that exercising is important to me, but I never make time.
• Dishonesty (w/ myself/others) – I act as if everything is OK, yet I am in bad shape and my body is failing.
• Poor Planning & Implementation – I fail to follow through, don’t hold to a schedule, and lack commitment.
• Recklessness & Sabotage – overeating and drinking, pretending MORE is always better and desirable.

It is reasonable to conclude that to create an environment where I might more easily implement my Journey to Fitness… to create the conditions where doing whatever is necessary to make success is my ‘first-choice’, and where I build a will that is stronger than any impediments… will need a monumental change…in me.

I set out to craft my own set of guidelines or strategies that I believed would make eating well, getting regular exercise, and living a healthy lifestyle Easier to achieve, and thereby maximizing my chances of success with GB.

I came up with these:

Strategy #1 – Prioritize: Put First Things First

And it goes like this… You are First.   It should go without saying, but if you are not healthy, if your condition is such that you cannot take full advantage of the opportunities that life offers you – to travel, to play and recreate, to experience first-hand the wonders of nature, to share activities with your friends and loved ones, to take part in your hobbies and express your passions, then you MUST prioritize your life and put yourself and your health first.

I am sorry, but this one is not negotiable… If you cannot do this, you cannot make the Journey.

Someone once told me that this rule was establishing a right to be selfish. It sure sounds like it: ‘I am First.’ Sounds self-centered, selfish, maybe even conceited.

I disagree. I think weighing 400+ pounds is an ultimate act of self-centered, selfish conceit. As a 400+ pound person you make everyone adjust around your condition… you always get the front seat in the car and the isle at the theater, your clothes cost more at the Big & Tall store, you wear out your side of the bed faster, you create worry and fear in the minds of your friends and family.

This rule does not authorize or legitimize a right to be selfish, it in fact it mandates that you get those self-centered issues under control and out of your being before you move forward with WLS and the Journey to a New Life. It mandates that you look at your life and make some decisions about what you really want and prioritize your time and energies accordingly.

• You say family comes first, but your actions suggest otherwise (work hours, travel, distractions).
• You say you like ‘simple’ things but continue to buy bigger and newer ‘stuff.’
• You say you’d like to ‘give back’ but you don’t donate your money or volunteer your time anywhere.

You can no longer claim benefit from both sides of the problem – behaving in a self-centered manner (weighing 400+ pounds), all the while professing that you put your family (or your job, or…) ahead of yourself. When in reality you fail both yourself and your family (or job, etc.).

Strategy #2 – Learn to be Brutally Honest

I contend that nobody gets to weigh 400+ pounds without lying to themselves and others a great deal. Everyday. About everything. Some lies are small, such as telling yourself that clothing manufactures must have begun labeling their products smaller and smaller – that is, what used to be an Extra Large is now labeled Large, hence your need to move up to a 2XL. The clothing has just gotten smaller you assure yourself. Other lies are bigger, such as telling your spouse that it wasn’t you that ate the whole pizza.

I’ve lied when asked about how many times I went through the buffet line. “It’s none of their business,” I’d think, so why should I be honest with them? However, the lie is actually more for me than for them. I need to deny my actions to me even more than to another person.

In 2008, I ran into a very old friend that I hadn’t seen in over 20 years. Al was always in good shape, but here 20 years later, at 52 years old, he looked exactly as he did at 32, trim and healthy. One sight of Al and all I could think of was: “What’s his secret?” I will never forget both the look on his face and the sound of his voice when he answered that question with “I eat right and exercise.”

What!? No magic pill? No miracle exercise program? Not what I wanted to hear. Lie to me Al. I’ll lie to myself later and convince myself that you are the lucky beneficiary of fantastic genes, or that you must have some physical condition that keeps you thin and trim. No Bill, nothing like that, just simple math and the courage to be truthful with yourself.

This honesty extends to after surgery also. Learn to tell everyone, everything (they will ask), about your surgery, your recovery, the highs and lows, the good and bad, the ugly and the uglier. Use the words you’ve despised for so long… say: “I was obese,” or “I couldn’t do it on my own,” or “I had weight loss surgery.”   Tell all the details honestly and openly. Look, if you are succeeding at losing weight, everybody will see it and they will ask questions. Use these opportunities as a chance to self-talk, to be your own therapist. Work out your issues by talking them out. Plus, you’ll be surprised just how interested people are in what you’re doing… in how it works… in what it means for you. Share.

Get used to telling your story over and over. Tell it honestly and without any agenda. You’ve got a lot of lies and half-truths from when you were fat to balance out. Never sugar coat your experience, never dilute nor enhance the truth, don’t duck facts and history. Accepting what you are (vulnerable, susceptible, corruptible, etc) and what you’ve done (poor self-management), is essential for planning and implementing who you’ll be from here forward.

Strategy #3 – Don’t Consider WLS until You Have a Pre and Post-Surgery Diet and Exercise Plan

Once you make the decision to pursue a WLS option, you need to begin the development and use of a Pre and Post Nutrition & Exercise plan. The idea is that your chances of success in any effort are greater when you develop and use a plan.

• Planning breeds ownership. When you make a plan you own the plan.
• Planning allows for the ability to adopt and change along the journey.
• Planning provides both a road map and a timeline that can keep you on track.

Why include a Pre surgery plan?

The result you want (the difference between describing yourself as you are now and describing yourself as you’d like to be) requires:

1. Permanent changes in the way I eat – specifically, I need to eat first to fuel my body. This will likely change the types of foods I eat and I will likely eat less food (less calories) overall.

1. Permanent changes in my activity level – specifically, I will be engaging in aerobic and other endurance activities, and weight lifting/strength training. My activity level will increase in both frequency and intensity.

Permanent means for the rest of your life. When does the rest of your life start? How about now!   It may take anywhere from three to twelve months for your WLS to be scheduled. You will be required to have a physical and a psychological evaluation before the surgery can be scheduled. There is no reason to put off making the lifestyle changes now.

Planning that includes pre surgery will create an environment where I am more likely to succeed in my goal of losing weight and maintaining that weight loss. Since gastric bypass is only a tool to aid with weight loss and weight maintenance, a plan should begin before surgery and incorporate surgery into the overall plans. Otherwise you are doing one of two things:

1. You are procrastinating making an actual lifestyle change. You won’t create and start a pre surgery nutrition and exercise plan because you don’t really want to change and therefore you are not ready for WLS
2. You believe WLS will do the work for you… that after WLS you’ll be thinner, your temptations all assuaged and you weaknesses all overcome by the surgery. You are not prepared for the work you will have to do and therefore you are not ready for WLS

Planning for only post WLS nutritional and exercise needs creates an environment where I am more likely to fail at achieving my weight loss and weight maintenance goals. It will leave me unprepared for the sudden changes that WLS may impose upon me.

The most important new trait that will need to be learned and implemented is to eat by design and election… what to eat, when to eat it, how much to eat. Eating well is to be a life-long endeavor, with habits developed through constantly electing to follow my designed nutrition plan. The more I practice eating via design and election, the easier it will be to adopt to the following:

• Eat well while working through the administrative details of scheduling my WLS (pre surgery),
• The first six months after surgery where I have absolutely no appetite and very limited food options,
• The time that my appetite returns and I have to deal with real feelings of hunger,
• The increase of options (temptations?) once my stomach can tolerate a wider range of foods,
• Eating after I have achieved my targeted weight loss,
• Special occasions that offer nutritional challenges – Thanksgiving, parties, Halloween, St Patrick’s Day, etc.

The second important new trait that will need to be learned and implemented is to exercise by design and election… when and where to exercise and what exercise to do. Exercising is to be a life-long endeavor, with habits developed through constantly electing to follow my designed exercise plan. The more I exercise via design and election, the easier it will be to make it habitual.

Strategy #4 – Living with Control and Within Limits

There are dozens of possible methods to sabotage a weight loss effort. There are likely hundreds of reasons why we might sabotage ourselves and our weight loss results. We often engage in reckless behavior, sometimes planned, but usually spontaneous, reckless behavior can surface anywhere at any time and can derail the best of plans.

Dealing with the deeper reasons of why someone would sabotage their own efforts can be a long and involved process. I am sure that some people won’t be able to progress without working those issues out first, then pursuing weight loss and lifestyle changes. I am much less oriented toward discovering the psychological explanations behind these feelings in me and much more toward designing the paradigm of developing self-control and living within limits.

Like many gastric bypass patients, I had a challenge reintroducing foods to my new stomach. I threw up a lot.

People would see this happening and say, with the best of intentions, “You’ll just have to learn your limits.” It sounds like good advice. It sounds logical. But it’s only good advice if your goal is to find and then eat at the limits of your new stomach – to eat up to the edge of throwing up.

After much reflection on this subject, it occurred to me that a better goal is to learn to provide your body the fuel and nutrients it needs to perform for you. In doing this, you will likely need nowhere near the ‘limit’ of your new stomach.

In fact, knowing your ‘limit’ isn’t useful at all. Back when I weighed 404 pounds, I used to know my limit: six Big Macs! Knowing that limit didn’t help me at all. I don’t need to know my limits to know and manage my needs.

The Sabotage of Time/Focus/Attention

It is so much less effort to sit around and debate the simple ‘facts’ of weight loss, rather than work on actually starting the hard changes we need to make. This is why we spend so much time with calorie counters, Deal-A-Meal folders, nutritional labels, designer diet plans, etc., because they shift the focus from making changes in ourselves, to debates about what percent of your diet should be carbs vs protein vs fat.

Hey, let’s debate calorie counts of foods or the accuracy of nutritional labels with each other rather than confronting the changes we need to make in ourselves. Debating if eating 1200 calories a day with a distribution of 40/30/30% (carbs/protein/fats) is better than eating 1200 calories a day distributed 30/40/30%, all the while eating 3600 calories a day while having this debate – is an act of sabotage – act now, fine tune as you go, but make a change in yourself now.

Overcoming my reckless and self-sabotage actions and learning to live in control and within limits will make implementing my weight loss and proper eating plans easier, and therefore more likely that I will succeed at achieving my goals.

“How Did You Do It?” I know people who have undergone gastric bypass, lost weight, and are afraid of the question: “How did you do it.” They are afraid of the reaction of some people who say: “Oh, I thought you did it yourself.” There are people who do not understand that you did indeed, do it yourself. Against all odds, and at great personal cost and risk, you did it. Let me say it again: YOU DID IT!

Let that soak in for a second… for a minute. Revel in it. You did it. Nobody else did it for you. Nobody else experienced the pain, the fear, the cost. Nobody else will be making the same life-long commitment that you did for yourself. It is you. Do not let anyone try to make you feel less than proud about your accomplishment. EVER. Celebrate what you’ve done, what you’ve accomplished. Let it show in the happy expression on your face, in the excited words of your voice, in the exuberance of your attitude and your body language. It is nearly impossible for someone to make you feel bad about what you’ve achieved or how you’ve accomplished it when you are beaming with pride and self-confidence. Your joy will overcome their ignorance (or their jealously, or their callousness) every time, easily seen by anyone watching the interaction.

Dozens of times I have been met with the “Oh” reaction from people who just heard me answer their “How did you do it” question with ‘gastric bypass’. Their look of amazement morphing into that of ‘less than impressed.’ And dozens of times I’ve changed their opinion by simply being so overjoyed to talk about the surgery and how I now manage myself successfully – how I eat right and exercise. Truth be told I couldn’t care less if they think I took the easy way out, or if they are impressed with what I’ve accomplished. Usually I am telling my story as a form of self-reinforcement. I hold my own ‘group session,’ my own motivational talk, my therapy. But most importantly I speak the truth… I don’t lie, to myself or others, about what got me into trouble, about my struggles to get deal with my weight issues, or about the fantastic tool that gastric bypass is and how I’ve been able to use it to achieve my dreams.

I find that most people are inspired by my story and that they find my honesty refreshing. Almost everybody has an issue that plagues their life. Almost everyone lies to themselves about something they know is ruining their life, something they need the courage to change. Alcoholism, gambling, addictions of all sorts. I’ve had people breakdown and cry, right in front of me, as I was telling my story. Hearing me speak truthfully about my own weaknesses, my own failings, they realize they’ve been lying to themselves and others for so long, and they want out. Out of their bad habits, out of lying, out of what scares them, and into whatever I have found. And I want it for them.

Yeah, there are people who don’t right away see gastric bypass as a real and legitimate weight loss method. I love running into those people. I love the opportunity to tell my story and bare the truth in front of them. I love being able to be open and honest and to share the supreme joy I have at what I’ve gone through and what I’ve accomplished. And when they look at me again, this time with respect and awe in their eyes, I know that honesty, with myself and with others is essential to my success. There is no other way.

One of my four principles for success with gastric bypass, and perhaps for any weight loss or weigh management attempt is to learn to be brutally honest – both with yourself and with others. I contend that nobody gets to weigh 400+ pounds without lying to themselves and others a great deal. Everyday. About everything.

Some lies are small, such as telling yourself that clothing manufactures must have begun labeling their products smaller and smaller – that is, what used to be an Extra Large is now labeled Large, hence your need to move up to a 2XL. The clothing has just gotten smaller you assure yourself. Other lies are bigger, such as telling your spouse that it wasn’t you that ate the entire pizza (must have been the refrigerator gremlins… and besides, you drank a diet soda with it and therefore didn’t really get all the calories you might have, had you not been so responsible!).

Deep inside we all know what causes weigh gain… taking in more calories than you burn up. It has been that way since the beginning of time. Its simple math. We know it, we just don’t like it, and therefore invent convenient alternate truths to avoid dealing with it. We deny. We lie. And along the way we willingly allow ourselves to be seduced by fad diets, magic weight loss pills, and “no exercise, eat what you want, miracle weight loss programs” that sell for three easy payments of $49.95!

In 2008 my mother passed away. A very old friend that I hadn’t seen in over 20 years read her obituary and showed up at the funeral home to pay respects. Al was always in good shape, but here 20 years later, at 52 years old, he looked exactly as he did at 32, trim and healthy. During those same 20 years I had gone from being 30 pounds overweight, to 150 pounds overweight. I had tried several fad diets, a medical supervised diet, started and stopped many exercise programs, and was fighting depression about my weight. One sight of Al and all I could think of was: “What’s his secret?” I will never forget both the look on his face and the sound of his voice when he answered that question with “I eat right and exercise.”

Not what I wanted to hear. No magic pill? No miracle exercise program (that only takes 5 minutes a day without sweat)? Lie to me Al. I’ll lie to myself later and convince myself that you are the lucky beneficiary of fantastic genes, or that you must have some physical condition that keeps you thin and trim. No Bill, nothing like that, just simple math and the courage to be truthful with yourself.

I would gain another 70 pounds over the next two years before I allowed myself to hear the truth… before I started telling myself and others the truth – I eat more calories than I burn up. By then I was over 400 pounds and it was nearly too late. But the truth was, and is, that if you want to manage your weight, to lose excess weight and keep up that weight loss for life, there is only one truth you need to focus on and it is this: You must manage the calories you take in and the calories your body burns.

There should be nothing new here for anyone that struggles with weight issues. Sure there can be complications that make living this truth harder for you than for others… diabetes, heart conditions, and other physical ailments can make it hard to restrict calorie intake or exercise to burn calories. But the truth is still the truth.

These days I give plenty of people their own ‘Al’ moment… people I haven’t seen in a while walk up to me in amazement at my transformation. They last saw me at 400+ pounds and now see me at half that weight. They always ask, as I did to Al, “How did you do it?” And I always answer with two truths, “I burn up more calories than I consume, and I do that with the assistance of gastric bypass.”

I’d like to hear about your experiences.