The Day I Threw Down With the Founder

One of the primary sources for support and information for those of us going through bariatric surgery is the World Wide Web. We can find medical info, tips and recipes, "journey" blogs like Misdirected and The World According To Eggface, and good old fashioned "support" sites.

Early on in our process, a friend introduced us to a closed Facebook group for bariatric surgery support. The support group (who I will not name, you'll see why shortly) was an outreach arm of a company that manufactures, among other things, protein shakes.

The group was a bit disconcerting, to say the least. The atmosphere was very similar to attending a group of religious fundamentalists. Here, though, the "devil" was carbohydrates, and the holy writ was something like "Drink our protein shakes every day, lest ye experience regain."

I tried, I really did. I spent months on this group, looking at recipes, investigating nutritional advice, reading about other people's experiences with bariatric surgery. But I was perpetually taken aback when the group leaders would brutally slam members whenever they would mention the forbidden word: carbohydrates.

The primary enemy, as this group's moderators see it, is anyone teaching that Everything In Moderation (EIM, as they called it) was a reasonable diet after surgical recovery. Nope, they very mention of adding white rice, or a potato, or pasta to a post-surgical diet was enough to send them into full-on frenzy: "EIM is a ticket to failure! Any carb ingestion will ultimately doom you to a regain, and ruin your diet! Carbohydrates are what caused your obesity!" (All paraphrased, but you get the point.)

Oddly, one of the primary products this group was promoting was a program to re-start weight loss after a regain, centered around purchasing their protein shakes.

For months I had remained silent. But this morning, a member of the group posted a copy of her Phase 3 diet - you know, the diet handed to her by her surgical team. But, after all the anti-carb info she had received from this support group, she was a little uncomfortable with the carbs included in this diet. 

This is what fearmongering gains you, you see. Lor just finished this transitional diet, on her way back to normal foods. It includes several soft foods that would not be considered low-carb friendly. Things like applesauce, mashed potatoes and the like. Things that are retraining the recovering stomach into digesting food, and not pure liquid. This poor woman was worried that the minuscule amounts of "unhealthy" carbs in her recovery diet would somehow damage her attempt to lose weight via bariatric surgery. 

Was this woman encouraged, that this was a temporary phase, intended by her doctors and nutritionists to ease her through a two week period?

Nope. A group moderator instantly jumped in with the following:

Moderator: "I wouldn't touch those foods with a 10-foot pole!!! Here are some awesome choices!!!" 

The "awesome choices", of course, included a recommendation for the company's protein shakes.

This was just too much for me. Where was the advice to "follow your surgical team's instructions."? What, exactly, was the basis for the expertise that allowed this moderator to direct this questioner to an alternate source of nutrition, rather than the one dictated by her surgical team? I removed the muzzle I have been wearing for several months, and replied:

Me: "Every time I start to get comfortable with the ***** group, something like this happens: ***** directly contradicting advice from a patient's medical team, all in the name of selling more protein shakes. I am fully aware that ***** is in business to sell shakes. But the number of times I have seen this kind of ***** activity makes me very uncomfortable. The fact that someone represents themselves as ***** on this group does NOT supersede advice from your surgical team, folks.

Asterisks represent redacted names and identities, not expletives.

Within 10 minutes, the Founder of the group had appeared. Her initial post told me that I was "missing the message" if I thought the group was doing this to sell shakes. This was not surgical advice - this was nutritional advice - advice that was being used by surgeons across the country because it worked! Hundreds of people were regaining weight because they weren't obeying the advice found in this group!

All in all, it was a very "How dare you?" kind of post.

Why no quotes here? Because within 20 minutes of her very angry post, she edited it to a much more friendly tone. But, as far as I was concerned, the damage was done here. Any site that is directly opposing medical advice, and then responding quickly, defensively, and angrily when called on it, is probably not a source I need for assistance with my weight loss. I replied to that effect, then left the group.

It's too bad, really. Some of the recipes were great.

Back In Search Of Sane Bariatric Surgery Support,

- Hawkwind

Scary Stories

Photo Credit: Magda's Maggots via Compfight cc

I spend a LOT of time (probably too much) hanging around on message boards and forums relating to obesity surgery. I don't input very much - after all, I am not a "vet" yet, have not earned my surgical scars and all that. Every once in a while, I will put up a link to here on Misdirected if I feel it is especially relevant, but other than that - I lurk.

There are quite a few encouraging tales to be found out there. Formerly 600-pound men who are now avid wilderness hikers. A previously obese woman fitting into her wedding dress for the first time in 25 years. A grandmother getting into a swimsuit for the very first time in her life. The stories can be really heartwarming and encouraging to those of us just getting ready to take the plunge.

But I have recently been paying a lot more attention to those "other" stories": 

• "I lost 100 pounds but gained it all back..."
• "I am going through a bad time in my life and can't stop eating..."
• "My husband just left me and all I want to do is cry and eat..."
• "After 5 successful years, I am regaining again and I don't know why..."

Entry after entry of people whose surgery is not working out for them for one reason or another. Scary stuff.

I have not gone out of my way to look into relapse numbers. Normally this is the type of research I would be all over like stink on expensive cheese, but here I have held myself back. I couldn't tell you exactly why, only that it didn't feel right to be investigating failure before I have even started the process. I have been wanting to prepare myself for success, not for failure.

But the truth is out there: relapses happen. And it is scary to think that all this work, (and rearrangement of my innards) could go down the drain if I don't watch my step.  So, I have been carefully reading these relapse stories, and looking for common elements. I keep finding 3 common themes coming up time and again:

1. Lack of accountability. Most of the desperate pleas of those I see talking about their failures online are for someone to "straighten them out" or "tell them off." At home, these individuals are not getting the support they need. Maybe they live alone, maybe their family is disinterested, or maybe (most frightening) their support system is working actively to sabotage them. But they need someone to call them out, and tell them to get back on track.

2. Lack of exercise. This seems to be a major issue. I have yet to read anyone's story about how they are suffering from massive regains while they are still exercising regularly. Just about all the horror stories I have read talk about how the pressures of life, or exhaustion, or just laziness have kept them off the street, away from the gym, and placed them on the couch.

3. Emotional turmoil. The big push that starts the plummet of the cliff of a major regain seems to frequently be an emotional trigger of some kind. A lost job, the death of a loved one, the breakup of a long-term relationship (sadly common for those who have gone through bariatric surgery) all seem to be things that have forced these individuals to seek comfort where they have always gotten it in the past - from food.

Lor and I are lucky. She has me to hold us accountable to our diets, and I have her to push us when it comes to exercise. As far as emotional turmoil - we have each other to rely on if something goes wrong in either of our lives. It isn't like we're going to get divorced again. Been there, got the T-Shirt - it didn't fit.

For anyone else, I would encourage them to find a family member, community,  or friend to act as an accountability partner. My other advice would be to do it now - while things are still going well. Looking for help while you are desperate leads to bad, bad choices. Get someone in your corner right away, and keep them there - when the storm clouds roll in, you'll have someone to run to before things get out of control.

This lifestyle change that we have undertaken is hard enough without handicapping ourselves by trying to go solo. Do it with a friend, find a support group, get plugged into a relationship with a trainer - anything you can do to make sure that one bad day doesn't turn into one bad week, or one bad month, or a disastrous relapse to obesity. One thing we know about life - bad times will show up. Make sure that you have planned ahead, and have the tools you need to come out the other side with your "new self" intact.

Being Prepared Aint Just For Scouts,

- Hawkwind

A Bittersweet Birthday

Normally what is happening over on Lor's side of the journey to bariatric surgery is closed off from public view: as I have said before, it is not my story to tell. But, this last weekend was significant enough that I have asked for, and received, Lor's blessing to talk a little bit about what I saw over Lor's final pre-surgery birthday.

Lor's journey to bariatric surgery is significantly different than mine. She is active. She is proud of her looks and her shape. She is a fabulous cook, and especially enjoys baking - bread, pies, cakes, you name it, she is the one that gets the call when someone in the family needs a dessert for a special occasion. She is nowhere close to where I am on the BMI scale, and would be perfectly content to stay there. So, why, then, go through the huge life changes that surgery forces a person through? Why give up freedom to choose her own path, and instead be forced into the regimented lifestyle that she will live with for the rest of her life?

One word: Diabetes. It runs rampant in her family, it has killed several of her loved ones, and despite her youth, she has been struggling with it for years. She has taken the high road and chosen a more difficult lifestyle recommended by her doctors (and her family) so that she can remain healthy and vibrant for decades to come.

She was treated to two different birthday meals over the weekend, one by my parents, and another by her best friend. From my parents, she received a life-saving gift: a new digital scale for us to use in food prep. Our old postage scale had been returning suspicious results for quite a while, and verifying weights between the two demonstrated that we had been WAY off in many of our food measurements in daily prep. (2 oz of Kale does not fill a small child's cereal bowl, for example. It overflows the bowl and creates piles on the counter.) Lunch was filled with encouragement and speculation as to how different her next birthday would be. Though she smiled and laughed, 25+ years of experience with her showed me the tension in her shoulders and her face - her surgery does not represent freedom like mine does. 

Dinner was at a local sushi house, and was a whole different experience. Her best friend also suffers from pretty severe dietary restrictions, and here the conversation was able to deal with fears and doubts realistically - with a pro who has been there and done that in having to make changes to her life that were forced upon her by health issues. I am sure the bottle of sake didn't hurt the spirit of full disclosure much. Here, too, was another comforting thing: this was not the last time Lor would ever be able to eat at this particular restaurant. Though California rolls will vanish from the future menu, many other things (sashimi, for example) will not have to. For the first time in weeks, we were not having a "food funeral" at a restaurant. The difference in atmosphere was huge: here was a place we would be returning, not another thing we were waving goodbye to.

All weekend long she was deluged with messages from friends and calls from family members, all saying the same thing: we are proud of you and we support what you are doing for yourself. And, by the way, happy birthday. It was amazing to watch. I am always proud of her, but this weekend I was really proud of the community around her - admiring, encouraging, uplifting. You have made me very proud to also be a member of the "Loralia Fan Club."

Wishing Everyone Had Friends And Family Like Lor's,

- Hawkwind