Keep CALM with the CALM Plan

calm

The CALM plan is something I learned during the course of my support group workings with Alexa Sparkman. Alexa is a nutrtitionist in the Austin, TX area. She has a wonderful program called “Overcoming Mind Hunger.” You can visit her website at http://www.sparkmannutrition.com if you are interested in learning more about it.

In her support groups, which I have taken multiple times, Alexa talks about the CALM plan for handling cravings.  There are four steps or actions to take with the CALM Plan. They are:

  • Connect to consciousness – This is where your previous training comes in. Connecting to consciousness means that you are present in your mind and you know what’s going on. You are aware that you are having a craving.
  • Alleviate anxiety – As an aware individual, you understand that you are having some difficulty overcoming this craving. You are able to regulate your emotional mind and get back into a calmer place. You can do this. You can overcome your craving.
  • Logical liabilities. These are the lies you tell yourself to make it okay to emotionally overeat. For example, “I had a rough day, so I deserve that ice cream sundae.” As you go through the process, you will figure out what your logical liabilities are. Access them and let them have free reign. Tell them you know what they’re trying to do and they will go away.
  • Mobilize and move on. Your craving, by this time, has probably passed. You can now go back to your life, craving free. Cravings don’t last and we don’t have to give into them just because we have them. You have a choice.

The important thing for you to remember is that the CALM plan takes time to work. It is not a tool you can put in your toolbox overnight. Like anything worth having, it requires skill and practice. I cannow use the CALM plan when I have a craving. I know it will pass, usually in less than 5 minutes. I used to be scared of cravings. I am not anymore.

You can use the CALM plan. It will work. I promise. I will be offering my own support groups. They are six weeks long and free to the public. They begin the first full week in August (we skip Labor Day week) and then finish up around the 15th. I will have more information here and at my Facebook site.

I hope I can provide help for people the same way Alexa did for me. Good luck and keep ‘CALM.’

 

Hunger and Hormones

hungerHunger is something we feel when we need to eat. When you emotionally overeat, you may be ‘hungry’ before your body is physically ready to be. You can increase your hunger hormones by overuse. In this article, we’ll talk a little bit about hunger and hormones so you can learn a bit about the science behind hunger and hopefully, how to make it work for you.

What is hunger?

Hunger, for our purpose of definition, is a physical sensation in the stomach. It is our body’s way of saying that we need to eat in order to stay alive. Hunger is a primal human need and one we should not ignore.

What hormones drive hunger?

There are two hormones that drive hunger in the human body, they are leptin and ghrelin. Leptin, for its part, is a hormone, that is made by the fat cells. It is supposed to decrease your appetite. Ghrelin is a hormone that increases appetite. It also plays a significant role in the body’s weight.

What’s weird is that leptin, the appetite suppressant hormone, is more prevalent in a body that is heavier. It’s just that obese people tend to ignore the signals that leptin brings. That’s where emotional hunger and emotional eating (overeating) come into play.

Can hunger be psychological?

Absolutely. People can get hungry for reasons that are not physical. Many overeaters are emotional overeaters. Cues other than physical hunger pains and pangs can lead them to eat. Have you ever eaten because you were bored, sad, mad or glad? Then, you’ve engaged in emotional eating.

Want to know more about ghrelin?

Ghrelin, which increases your appetite, is released primarily in the stomach. It’s a thought signal that tells your brain you are hungry. You would expect it to increase if someone is undereating and decrease if a person is overeating. When children do those things, ghrelin seems to work this way. However, something seems to change as we grow up. We seem to control ghrelin more than it controls us.

Some German researchers have discovered that ghrelin levels play a role in determining how quickly hunger comes back after we eat. Normally, the levels skyrocket before you eat. They then go down for about three hours after so you shouldn’t be physically hungry for at least three hours after eating.

What do we know about leptin?

Leptin, however, seems to be the bigger player in the body’s quest for energy balance. This is the appetite suppressor. Some researchers think that leptin may regulate ghrelin. Leptin tells the body it has enough fat to survive. The more fat you have, the more leptin is in your blood. However, the amount of sleep you get and the time you last ate can have a significant effect on leptin. Studies have shown that rats can develop an insensitivity to leptin. It seems that this may be transferred to humans and is why obese people can ‘ignore’ leptin’s cues.

What happens to hunger hormones after sleeve surgery?

Well, it seems that ghrelin is reduced after sleeve surgery. Because it’s produced in the stomach and about 70% of the stomach goes away with this surgery, there is less ghrelin being produced. This may explain why people who have the sleeve surgery report less hunger. Sleeve patients also report feeling more satiety between meals.

So, do you now understand hunger and hormones better? If not, there are lots of articles on the internet that can help. Remember, I am not a medical doctor or a nutritionist. I am a life coach specializing in emotional overeating and bariatric surgery. This is for informational purposes only.

 

Why you should take a pre-surgery pic and pics along the way?

deanna100lbslostOkay. This should be a no-brainer for you all. This is my 100 lbs lost picture. It was taken at Christmastime 2017, about 6 months after my sleeve surgery. A year before that, I weighed 387 lbs. I felt like I had come a long way. I had.

I did take a pre-surgery pic. I had several. I hate looking at them. In fact, I hated having my picture taken at all. Still not a huge fan. I’m kind of un-photogenic. I think I look better in person to be honest.

However, I want you to take a  few pre-surgery pictures if not for your sake then that of your family and friends. Despite whether or not you love yourself, they love and and want images of you. These pictures will also be great reminders of the person you were before surgery and how far you’ve come since surgery.

Take pictures along the way. I should’ve taken one every month. I didn’t. I’m doing them every six months. It works for me. I know – I’m not taking my own advice, but…well, maybe I’ll start a monthly picture from now on. How’s that for compromise – and I’ll even post it here.

I took a picture yesterday on my one-year sleeve-a-versary. I have lost a total of 133 lbs. Wow. I’m thrilled. I have intentionally stalled my weight loss to a more healthy 1-2 lbs a week with the help of my nutritionist because we believe that extreme weight loss is not healthy for the body.

I’m not telling you what to do. Not at all. I’m just sharing what works for me. My goal weight is about 70 lbs away, but I think about 30 of that will be skin from the skin removal surgery.

I do plan to get that about a year after I reach my goal weight which is about 40 lbs away per my calculations. Not bad. I hope to reach it by June of 2019. Maybe sooner. I’m in no rush. I believe that the images we take can help us to celebrate more than what the numbers on the scale say.

Pictures show us in a real way how far we’ve come. I don’t look like the person I was last June. I sure don’t feel like her. I am happy with my progress and I want you to have that joy so take those pics and post them. Celebrate yourself. You are worth it and you are working this tool to the max.

Love and light to you.

Is keto right for me?

ketosteakSo many bariatric patients are asking if the keto diet is the proper diet for them. Note that I am not a nutritionist or a doctor. I am not an expert. For me, the keto diet does not work. I honestly feel that it’s a fad and, as bariatric patients, we should concentrate on eating the healthiest, best food possible since we’re so limited. Having said that, there are many good things about keto that you can apply to a bariatric life. If you want to do keto, I’m not here to judge or stop you. I want you to educate yourself further and be informed. I would also suggest that you don’t follow the normal keto diet, but one that has been adapted specifically for bariatric patients.

So, what is a keto diet? 

A keto, or ketogenic diet, is basically a low-carb, moderate protein and high fat diet that is supposed to put your body into ketosis.

What is ketosis? 

Ketosis occurs when you’re body is using fat as energy (ketones) and not carbs. Your liver will create ketones instead. Acetoacetate is the most common ketone. It’s created from the breakdown of fatty acids. Acetoacetate is then broken down into BHB or Acetone. The Acetone can account for the bad breath and smelly waste during your beginning phase of the keto diet.

 What can you eat on a keto diet? 

You are encouraged to eat low-carb foods like:

  • Meat
  • Fish
  • Eggs
  • Greens like kale, arugula, swiss chard, etc.
  • and Broccoli.

You can also eat high-fat foods like:

  • Avocado
  • Sour  Cream
  • Olive Oil,
  • and  Marrow.

What about water?

You should drink plenty of water (between 40 – 68 oz a day at least) especially when you are in the early stages of ketosis. Alcohol and soda, including diet, is not encouraged, which should be fine for most bariatric patients. We’re not supposed to have carbonation. It can stretch the stomach. Some coffees and teas are okay, but sweeteners are not.

Now, bariatric keto plans are even more restrictive. You generally have to limit your calories to around 1,000 per day. You should get your 60 – 75g of protein and avoid really high-fat foods so you don’t dump. If you do decide to follow the keto plan, please get some assistance from a bariatric keto professional or support group.

Don’t attempt to go it alone.

 

 

 

 

My Life-Long Stuggle with Obesity, Part 2

oneyearanniversary.JPGWhere did we leave off? Oh yes, I was in despair and just dxed bipolar. At this point, I went into an outpatient program at Shoal Creek Mental Hospital in Austin. It was run by Penny Kruger. She’s a DBT master. DBT stands for Dialectical Behavior Therapy. It helps you control your impulses and be more mindful. DBT literally saved my life. I began working with her after the program was finished. I went to support groups for years.

I also found a good therapist, Laura McDowell, who I see to this day. My psychiatrist, J. Bernard Cordoba is there to help me as well. Alexa Sparkman, who runs support groups for Overcoming Mind Hunger, is a nutritional counselor who taught me how to actually learn what hunger and satiety were. As a bulimic, I never felt full. I needed and still need these professionals to help me navigate my life.

I got help. I finally gave up trying to do it on my own. I lost some weight, but not a lot. I had a lap band done in 2010. It was not a success. I mean I lost weight. I was about 400 lbs before surgery. My highest weight ever was 444. Yes, I had trouble typing that. It’s unacceptable to me. I am disgusted by it, but I own it.

The first time I walked into Alexa’s support group, I could only eat pudding and soft foods. If I tried anything more ‘intense’, I would get stuck and have to go back to the surgeon to un-fill my band. Three years of that and I had had enough. The new surgeon decided he wanted me to have the duodenal switch. One side effect was uncontrollable diarrhea. Thanks, but no thanks. I fired the doctor and left bariatric surgery behind.

Or so I thought.

I tried over the next few years to lose weight on my own. I went gluten free, cutting out most carbs. I had a little success, but regained almost all the weight I had lost from the band. I felt like a real loser. I was down, but not out. Then, I busted my meniscus. This was on December 13, 2016. All I did was step down on it.

The weight I was carrying on my legs had finally harmed them. I was a little surprised that it took that long. The orthopedist would not help me. He said I was too fat. I hired a new orthopedist who said she wanted to help me but could not do surgery until I got down to a 40 BMI. I mad an appointment with a surgeon and began the process to have the sleeve.

My sleeve operation was on 6/6/17. I like to think of it as my re-birth-day. I don’t look at food the same way. I don’t eat food the same way. I have lost over 130 lbs. I am not morbidly obese anymore. I am just obese and heading towards overweight. I can shop in department stores.

I can fit in restaurant booths, bathroom stalls, plane seats and more. I go to concerts. I climbed Mt. Bonell, the tallest point in Austin. I don’t need knee surgery anymore. No, I don’t. I’ve taken enough stress off my joint to manage the pain with shots.

My orthopedist was proud, but I was prouder. I knew how hard I worked to get there.

I am proud of my accomplishments, but I know I am not done. The sleeve is a tool that helped me get my life back. Things aren’t perfect. I may need my gall bladder out. I may have a GI disease which caused a lot of my problems with the lap band and makes eating certain foods an impossibility right now.

I don’t care what challenges life throws at me, anymore. I have honestly overcome so much in my life. This is nothing. I love my new life and I am grateful to the professionals and friends I have rooting me on.

If you doubt doing this surgery, that’s understandable. If you can find another way, do it. I encourage you no matter what. Weight loss is not easy. Please don’t go on a diet. Change your life. You have to want it and you have to be willing to change, but it’s so worth it. I can help you. I can support you. I have been you. I hope you know that now because of my story.

Now, I get to write the next chapters and they will be happier than the last ones. I know this to be true.

Missed part one? Read it now.

My Life-Long Struggle with Obesity, Part 1

BeforeOkay, please bear with me as this post may get a little long. I am going to try and condense it some, but it’s emotionally charged and difficult to write. I am doing this to share my story with you and because well, I think some of you, at least, can relate to it. I want you to know you are not alone and you should NOT be ashamed.

When I was a baby, I hated eating. My parents told me they force-fed me. Yup. Can you imagine? By the time I was two, I was a stress eater. Carbs were my go-to. Donuts, cookies, cake. My mother tells me this. At the age of four, I began to put on weight as I started school and discovered that I had severe anxiety that would go untreated for decades.

Food was my comfort. My best friend. I had trouble making and keeping friends. I was a shy, overweight child. I got teased and picked on. Some of the taunts remain with me to this day. I know that children can be cruel without realizing it, but sometimes adults can be too. I was made to feel ashamed of my unruly body for decades. I still carry some of that shame, I am sorry to say.

My mother and nonna (Italian for grandmother) would encourage me to ‘mangia’ (eat) in one breath and in the next chastise me for gaining weight. We were fed pasta 6 nights a week for years and had big Sunday family dinners that lasted for hours. I was also sometimes the only kid at Weight Watchers or Diet Workshop. Oh God. Those memories are still hard to conjure up. People were nice enough, but I knew I didn’t belong. I didn’t want to either.

I guess I was up against it. By the time I was a teen, I was about 180. I was still athletic and well, I danced ballet, tap and jazz. I wanted more than anything to do toe ballet. My instructor would not sign off on it because my legs were ‘too heavy.’ I am bottom heavy, shaped like a pear. This broke my heart and when I broke my ankle a few months later, I decided it was time to give up on that dream.

When the ankle broke, my parents, who didn’t take me to the hospital right away, felt guilty. They fed me over and over again to show how sorry they were. I didn’t have the strength or the desire to fight the food and I ballooned up to 240. I was the fat freshman on crutches. I stood out like a sore thumb when all I wanted to do was blend in.

I was harrassed and teased mercilessly. I ate lunch alone and was humiliated by the prospect of going to school every day. However, school was my safe haven. Things at home weren’t great either. I was also getting pressure to lose weight from my nonna, who believed appearances were important. As a perfectionist and straight-A student, I was once told, “you’d be perfect if you lost weight.”

I was also told that I should do what my cousin did to lose weight. My cousin had just gotten out of the hospital for bulimia. My nonna told me that at the age of 14. I resisted the advice for several months because I felt it was wrong. Then, after going to the park wiht a friend, and being teased mercilessly by some boys whose faces I will never forget but names I don’t even know, I stuck my fingers down my throat for the first time but not the last.

I vowed to lose weight any way possible. I drank pickle juice. I vomited. I overexercised. I got down to 160 but I looked about 130. I have a big frame. I am not meant to be small. I went back to school as a sophomore transformed. I had friends and attention.

But I had lost my soul.

I would struggle with bulimia until I was 40. The only time I kicked it was when I was pregnant with my two children, ages 21 and 15. Bulimia is not a weight loss method. It helped me become morbidly obese, but I couldn’t stop the behavior. My weight spiraled out of control during my pregnancies and in-between them.

I was also unmedicated bipolar but did not know that until I was 35 and diagnosed after a near-suicide attempt in front of my husband and young children. I was in that much pain. I regret it. Deeply.

I had become that which I hated the most and I wanted to die. I thought obesity had defeated me. Don’t worry, it didn’t.

(To be continued. Read part two here.)

What’s the best bariatric diet to follow?

Man, oh man, are y’all going to hate this answer. The best bariatric diet to follow is the one that works for you. Yes, there’s a lot of debate on the internet about bariatric diets. After the post-op progression, you pretty much can eat whatever. Many people go keto, which I don’t recommend. I will talk more about keto in another post.

However, you will have to re-learn to eat. You will want to avoid over-processed foods with lots of chemicals. Eat fresh whenever you can. If you can also eat organic, that would be great, but it’s not necessary. Produce like fruits and veggies are great. Lean proteins like chicken and fish are fantastic.

Now, having said that, I can NOT eat animal protein. It makes me physically ill. It’s something that happens to about 20% of us according to my surgeon, Stephen Fass, MD. They didn’t tell me that ahead of time.

I found out rather by accident. Right now, I eat a gluten free, vegan diet. I have found that cheese and other animal products don’t like me. This is not going to be the case for most people. As a general rule, you should avoid simple carbs like white rice, semolina pastas and so forth.

You should also avoid high sugar, high fat foods that could cause dumping. If you have questions on what bariatric diet to follow, you should probably check with a nutritionist. You will need to learn to eat for your new tummy. It takes time to re-learn how to eat as a bariatric patient. Your findings will most likely be different from mine and from everybody else. You are unique and foods that like you back are the foods you should stick to.

It takes a lot of mental toughness to figure out how to eat as a bariatric patient. You certainly can do it. I did it. Many other people have done it. Try to steer clear of fads and just eat good, healthy food. That’s the best advice I can give you. Eat for your new tummy and celebrate you.

You’re worth it.

 

How long does it really take the stomach to heal after the sleeve?

This question is a toughie because it varies widely. Different people heal at different rates. Some heal faster; some heal slower. I don’t know, but I tend to think that I’m on the slower side. I can honestly only speak to my experience so that’s what I’m going to do here.

I don’t want you to feel discouraged or upset. I, do, however, want you to realize that even after surgery you should take care of your ‘new stomach’. It’ll thank you for it. Your body has just undergone a major trauma. It needs to heal from this.

How long should I take it easy after surgery? 

Most people take the week off after their surgery to rest and recuperate. This is a good amount of time for the initial healing to begin. If you can’t get this time off, please try to do the best you can to rest as much as you can during this time. Your body needs sleep to repair and heal itself.

How long did it take me to feel better after surgery? 

Physically, I felt fine the week after. I was able to do most things. Your doctor will encourage you not to lift anything heavy for a while and you should definitely keep your two-week post op visit so that the surgeon can check your incisions and make sure you’re healing properly. I felt tired even after that full week off. I am lucky that I work from home and can rest when I need to. So, I did.

It took me a full month to feel really strong again. I did begin exercising once the doctor cleared me to do it and it helped with the fatigue.

How long did it take my stomach to heal post-surgery? 

That question is harder to answer and why I advocate for a post-surgery progression diet plan. I do believe that you need to follow it to make sure your stomach is ready for ‘real food’. Your tummy needs time to readjust to eating and digesting. That takes about a month.

For me, I can honestly say that six months after surgery, I still felt the need to be gentle with my stomach. That’s just me and I know I was being overcautious. I just knew how much of a change my body had been through and wanted to honor it.

What you do is up to you and what you feel is what you feel. Honor your new stomach by giving it time to rest and heal and it will thank you for it.

 

Will it hurt? The surgery, that is.

Bariatric surgery is a big deal. If you’re having the sleeve like I did, you are removing a good portion of your stomach. For me, it was abou 70% of the stomach that went bye-bye. That’s major surgery and nothing to take lightly.

Now, will it hurt? 

Yes and no. There is not any pain during the procedure because you will have anesthesia. Most anesthesiologists are very good about keeping you pain-free and relatively happy. You will be mostly knocked out for the procedure and wake up in recovery after it’s done.

What happens when I wake up? 

You will feel some soreness, but the hospital staff will most likely keep you well medicated. If you are going home the same day, they will give you prescriptions for liquid pain killers. They will tell you to take them every 4-6 hours. I took mine every four hours the first day and a half to stay ahead of the pain, and it worked very well for me.

Did you have any discomfort? 

Now, yes I did. They do ‘blow you up’ with gas so that they can perform the surgery. The gas pain is not comfortable at all. I felt a strong pain in my shoulder area. It was relieved when I started to pass gas.

I also had some mild stomach pain. It was nothing unmanageable. I felt very good except for a bit tired after my procedure. I took good care of myself and allowed myself a whole week to rest. If you can, I recommend you do that too.

Now what should I watch out for? 

You want to watch out for any signs of infection. I was lucky and didn’t have to deal with this. Not everyone gets so lucky. You could wind up with a wound infection site. Some surgeons, unlike mine, use staples. My surgeon used steri-strips that tend to be easier on the system and less likely to cause infection.

Staples can become inflamed. If they are red and warm to the touch, you should assume you have an infection and at least call your surgeon. You may want to head down to the ER too. It’s not something you want to play with. Not at all.

The other type of infection is systemic and internal. You will want to be on the lookout for fever, nausea and vomiting. If you have all three of these symptoms, get help, especially if your fever is over 100. You could have a very serious side effect and need hospitalization.

Don’t take it lightly. This is major surgery. You will have some pain and discomfort, but anything out of the norm should be reported to your surgeon. Remember, that surgeons differ and the instructions they give you may be different than the ones I was given. I am NOT a medical professional. I am a life coach. If you are ever in doubt, question your surgeon.

Badass Book Reviews: No One Ever Got Fat from Calories

R. Belldon Colme is an acquaintance of mine. He will be appearing on my Bariatric Badass podcast, which will air soon. I will have more information for you shortly. He’s a pioneer in the coaching industry. He’s a health and fitness coach who works with you on nutrition. I believe he knows more about nutrition than most nutritionists do and I know he knows more than most doctors or surgeons do.

He, however, is not a big fan of bariatric surgery. I plan to ask him why when he comes on my podcast. Basically, he seems that it doesn’t do the trick or help us to eat as well as we could. Belldon believes in a whole foods diet, a return to the eating we used to do intuitively before obesity became the epidemic it is.

He is also an opponent of “Big Food”. It’s like “Big Pharma” and it tries to keep us sick and addicted. Most junk foods are just that, junk. We shouldn’t be filling our bodies up with the stuff. It’s not to our best benefit.

Belldon tells us about how calories aren’t really a unit of measurement and we should stop counting them. They are a fabrication and a fallacy sold to us by nutritionists and big food to help keep us fat. He advocates a return to balanced eating. There are four food groups in Belldon’s Shiwu Zen. They are greens, vegetables, proteins and carbs.

You will learn all about getting adequate water and nutrition in his book. You will also find the best and most complete explanation of metabolism that I have yet to find. I find this book to be very interesting and engaging from the get go. Belldon doesn’t shy away from his own story. In fact, he presents it to you in such a way that you can’t help but realize that he walks the walk. As a coach, I admire that.

If you’re ready to read this life-changing book, go ahead. I encourage you. If you want to hear the podcast first, I’ll post links when they’re live.