Written by Dan Goodall for ObesityCoverage.com
Weight loss surgery will enable you to lose a lot of weight quickly. But we’ve all heard of, or know someone who has had weight loss surgery and years later gained the weight back. This is not a failure of the surgery. This is a failure of the patient to change their habits after surgery.
In The Power Of Habit, Charles Duhigg shows how our daily, mostly unnoticed habits can have profound effects on our lives. It turns out that our mind seeks-out familiarity. We crave habit. When our habits are healthy and positive they can create a tri-athlete or set a career on a path to new heights. When these habits are destructive they can destroy our minds and bodies.
Most of the time, we don’t realize that we’ve created destructive habits. But we all have them. Unhealthy habits can slowly but surely add extra pounds, decrease activity, and get us into destructive relationships with food.
Unfortunately, habits are not always easy to change and can take time. So the time to start changing your habits is before surgery. We’ve laid out five simple habit changes that will propel your weight loss journey to success.
It is our hope that once you make these five simple changes, it will give you the momentum you need to make bigger lifestyle changes that will keep the weight off forever.
Why Habit Changes?
When you wake you wake up in the morning, what is the first thing you do? Do you hit the snooze button? Do you go directly to the coffee pot? Do you do something as simple as brush your teeth?
Our bodies like habit because there is safety in habit. Habits require less thinking and habits almost always lead to a reward.
When you hit the snooze button, you get that extra ten minutes of staying in your warm comfortable bed. When you go for the coffee pot, your body anticipates that first sip of caffeine. When you brush your teeth you get that morning film off of your teeth, end up with fresh breath and the knowledge that you’ve staved off tooth decay for another day. Habits are the driving force behind much of what we do, day in and day out.
Think of what brought you to this website. Perhaps you were searching the internet. But how and when did you get online? In all likelihood, habit brought you here. You were working, and in-between projects, you like to refresh Facebook. Then, as is typical, you decided you’d spend a few minutes searching the web. This is where you continued your research of weight loss surgery and found this site. Or you just put the kids down for bed. You came downstairs, flipped on the TV and opened up your iPad, laptop, or smartphone. Whatever brought you to this article, the act of getting here, was probably a direct result of a habit.
When a smoker tries to quit smoking, the strongest cravings come from habitual cues. The smell of coffee in the morning can trigger a strong craving for nicotine. Driving past the gas station where you’d buy your cigarettes and morning coffee can create a very strong craving. A large meal and the feeling of fullness creates another craving. This is one of the reasons habits are so difficult to change.
We don’t realize that these subtle cues exist but our minds and bodies take notice. And because our minds crave habit, we are constantly bombarded with unconscious signals to feed our habit. Just finished dinner? Our pancreas starts releasing insulin in anticipation of the sugary dessert that is soon to come. And if we don’t get it? That rush of insulin could make us sleepy. Our minds may actually sense fullness or tiredness as a need for a sweet treat.
And the reward? Its a dose of simple carbohydrates (sugar) that give us a subtle rush of energy or, in the case of a smoker, the nicotine that triggers a dopamine release.
Without changing our habits, the best gastric bypass, Lap Band, gastric sleeve surgery in the world will not be successful long-term. Whether you’ve already had weight loss surgery or are only considering it, the time to change is now. These five simple habit changes should be implemented now. Starting now will start your weight loss surgery journey on the right foot. The hope is that you’ll understand how important habits are and slowly but surely more positive habits will become part of your daily routine.
The Habits Behind What We Eat
Let’s take a quick look at food and how habits drive where we eat, what we eat, when we eat, and how much we eat.
Where we eat is directly related to habit. When you eat at home, where do you eat? Is it at the dinner table? Or is it in front of the TV? In your bed?
If it’s at the dinner table, you eat there because you’ve always done that. You’re probably asking what’s the reward of eating at the dinner table? It could be time with the kids, the ease of cleaning up, or the sense of pleasure that comes from keeping an organized life – the kitchen table is for eating, the couch is for TV, etc.
If you eat in front of the TV, think about why? It’s probably because you get the mental stimulation of whatever may be on TV. But studies show that your mind actually does less thinking when you are watching a show. So the real benefit is that your brain gets to relax. But a relaxed brain is a brain on auto-pilot. And a brain on auto-pilot is not a good thing when eating is involved.
When your brain goes on auto-pilot it is much harder to pay attention to what you’re eating. And the brain’s desire to go on auto-pilot can actually encourage you to get to that couch quicker at the expense of making a healthy meal. You may just grab a bag of chips, a coke and a Hot Pocket so that you get your reward of ‘auto-pilot brain’ as quickly as possible.
If the reward is that sense of fullness and contentedness that comes after a large meal (from exorphins which are similar to endorphins but they come from wheat containing products), you may rush to fill that empty feeling in your stomach as quickly as possible with whatever is available. Your mind may actually interpret the feeling of an empty stomach as a very strong signal to eat. And while the feeling of an empty stomach is a signal to eat, our habit of filling that void quickly with exorphin producing foods has strengthened the signal from a simple reminder to a, ‘I need food NOW’ craving.
Eating out adds a lot of calories and your choice of restaurant (if you want to call fast food joints restaurants) is often dictated by habit. If you work, you probably have about an hour for lunch and when you are home and busy, you may even have less time than that. Since most of us do not have unlimited funds, money plays a role as well. Fast food makes sense because it saves time and it’s cheap. But we know it’s not healthy. Nowadays, there are plenty of ways to bring lunch or eat healthy on a budget. And you can do it quickly. It can be as simple as preparing meals in advance or choosing healthy options at Panera Bread or the Salad Bar at Whole Foods.
Habit Change #1 – Eat at the dinner table and eliminate fast food for good.
Most of us have tried to eliminate fast food from our diets at one point or another. Instead of giving you multiple ways to do this (do a quick google search – ‘how to eliminate fast food’ – and you’ll find many great articles with healthy alternatives to fast food), you need to understand why you keep going back to fast food.
Here’s what happens when we drive by a fast food restaurant. We see the big yellow arches or a purple and pink bell that reminds us to, ‘Think outside the bun.’ These familiar visual cues create an immediate reminder of what’s inside. Often, we might not even notice hunger until we see these friendly signs. Then our nose is filled with a familiar smell of grilled meat, frying oil and fat. This further triggers hunger and our mouths may actually start watering.
When we walk in there is little thought needed to decide what we want. The latest and greatest burger, wrap, or taco is featured front and center. If we don’t want the latest taco made of Doritos we rarely need to read the menu since our bodies have already started craving familiarity. Big Mac, Whopper, Fajita Pita, Gordita – our stomach is already sending signals to our brain telling us what it’s expecting.
It’s so easy and comfortable that our brains can go into auto-pilot mode. The food arrives fast and we get to fill that horrifying empty stomach feeling quickly. These are rewards and our body starts to crave those feelings.
We get our 32 oz drink of sugar filled soda. We sip our Coke or Dr. Pepper and wait for our number to be called. The sugar and caffeine start to work their magic. We feel energized. We win the lottery and our number is called. We sit down with our tray of food. The 32 oz of Coke is so sweet that our bodies start craving fat or salt to balance it out. Our bodies are then assaulted with salt, fat and more sugary drinks that make our mouths water, stimulate appetite, make us thirsty. The thirstiness that’s created from the onslaught of salt makes that 32 oz coke taste so much better. And the fat from the burger balances out the 60 grams of carbs we just drank. The bun releases exorphins that make us happy. That dreaded empty stomach feeling is gone and our body rewards us by releasing more endorphins.
Where we eat is often driven by habit, by safety, and by all of the rewards that are mentioned above. Once you start to realize why you choose the unhealthy option over the healthy option and know that you will not get the immediate pleasure you are used to receiving from the unhealthy option, there is hope for change. But be prepared for a slow change. It takes smokers years to fully eliminate cravings for cigarettes. We’ve been eating our entire life. The rewards that our body has become accustomed to are strong and your body will rebel. Your inner voice will try its best to trick you into allowing just one more fast food meal. But once you give into your inner voice just once, your inner voice will become stronger, craftier, crave more.
If you have kids you’ll understand this analogy. I have a 5 year old boy. If I tell him he can’t have candy but then he yells and yells and cries for 20 minutes until I finally give in and he gets his candy. The next time, I say ‘No’ to candy, he knows that it may take 20 minutes but Dad will give in. But this time I’m going to be tough. I won’t give in. But now its been 30 minutes and he’s still screaming and yelling for his candy. I can’t take any more and I give in. I’ve inadvertently created a habit. I’ve reinforced the screaming and crying and begging by giving in.
The same is true with food. Your body will send you signals every time you pass a fast food restaurant. ‘Just this once,’ your inner-voice will say. ‘You don’t have time for anything else and if you don’t eat now, you’ll be hungry all day,’ your inner-voice will plead.
‘Since you missed breakfast, your blood sugar will get low.’ Once you give in just once, the cravings get stronger and your inner-voice gets smarter. Just like a little kid learning how to manipulate mommy and daddy.
The only solution is completely cutting out unhealthy habits that have strong rewards, like fast food.
Knowing why we crave these unhealthy foods, understanding the triggers and being prepared for the rationalizations that your mind will inevitably heave at you, is the first step to conquering bad food habits.
“Starting today, no more fast food. And you must eat at the dinner table.”
Habit Change #2 – Eliminate soda (including diet sodas) and dessert
Habit change #1 is relatively easy for most of us. Habit change #2 is difficult. Sugar is a very addictive food. Yes, sugar is addictive. According to Wikipedia, Sugar Addiction is the term for the relationship between sugar and the various aspects of food addiction including: “bingeing, withdrawal, craving and cross-sensitization.” Some scientists assert that the consumption of sugar could have a heroin like effect.
Over the past decade, the American food industry has created a fat-free version of almost every food product. Creating a fat-free version of most food products reduces the ‘taste’ to the consumer. To compensate for their less tasty fat-free version of their food, sugar is added. Typically, the fat is replaced with high fructose corn syrup. High fructose corn syrup is a very inexpensive sugar substitute derived from corn. Most food manufacturers use this because of the cost savings. Some studies show that rats gained more weight eating high fructose corn syrup than they did eating table sugar. Regardless, sugar is a habit and it’s addictive and its intake needs to be reduced in whatever form it is consumed.
What’s the reward from eating sugar? It’s the simple, quick carbohydrates that give you a quick boost of energy and the pleasing taste.
To change this habit, you’ll have to have willpower and determination. And if you can’t change this habit prior to weight loss surgery, you may want to reconsider having surgery. Weight loss surgery is not the easy way out. The surgery is difficult, recovery is not fun, and there are risks. And frankly, if you’re not going to change your diet, then you’re not a good candidate for weight loss surgery.
So start today. Eliminate soda. If you drink caffeinated soda, you will want to find a replacement for the caffeine. Try to find a healthy alternative. I’ve found that most people who drink soda, typically do not enjoy plain black coffee or even an unsweetened latte. Try green or black teas. If those don’t work consider implementing a plan to reduce your caffeine intake over time. This may be done over a week or two. Reduce your soda consumption by 25% each day. If you drink 10 sodas per day, you’d reduce down to 7 the first day. The second day, reduce down to 5 sodas. The following day, drink 4 sodas and so on until you are able to eliminate soda completely.
“Its important that you don’t replace soda with another sugary drink.”
Just like beer, coffee is an acquired taste. So if you’re switching from soda to plain black coffee, realize very few people like black coffee at first. It takes time. But caffeine withdrawal is not easy and unsweetened coffee will get you your caffeine fix while eliminating the sugar.
Why can’t you drink diet soda? Firstly, there are some studies that show diet sweeteners can increase food cravings. Regardless of those studies, drinking diet soda creates a habit. Your body gets used to the sweet taste and comes to expect sweetness in other foods as well. Your taste buds get used to sweeter flavors and foods that are not filled with sugar will be less tasty.
Finally, after weight loss surgery, you’re not going to be able to drink carbonated beverages for a while. And, many surgeons suggest that you eliminate them completely because they cause gas, put undue pressure on your new stomach, and fill your smaller stomach with a nutritionally worthless substance.
The best replacement for soda is water. So start incorporating more water into your daily diet.
Create a new habit of filling up your water bottle before you leave the house.
After you’ve eliminated soda, move on to desserts. Dessert can be a habit. As I discussed earlier, your body gets used to eating a large meal and then the sudden rush of energy that comes in the form of simple sugar (dessert). The body starts to release insulin and if you don’t have enough sugar in your system you can physically feel tired. It’s a vicious cycle.
Understand that after dinner you will probably crave sugar. And be prepared for your inner voice to rationalize a small piece of candy or half a piece of cake. Then more rationalizations will come, ‘You’ve already had half a piece of cake, your diet is already ruined for today. You might as well have another piece.’ And your body may already be secreting significant amounts of insulin. If you don’t get that sugar you might feel tired.
“Be prepared for inner-voice rationalizations. Be prepared to feel lethargic.”
But the lethargy goes away as your pancreas adjusts to life without large influxes of sugar. In fact, one of the best things about cutting out sweets is an increase in sustained energy. But this takes time. Give yourself 2 weeks of no dessert and no sodas and notice how you feel. The cravings will slowly start to dissipate. Your energy will start to increase and you might actually choose to go for a walk after dinner.
“Cutting out sweets leads to more energy which leads to more healthy habits.”
Habit Change #3 – Take The Stairs
In the 21st century our daily activity is minimal. In the earlier times, walking or riding your horse was more prevalent. Working on the homestead or farm was commonplace. If something needed fixing, we fixed it. Today, we wake up, walk 10 feet to our garage and then commute 30 minutes to work. When we arrive at work, we park, then walk 20 feet to the nearest elevator. We then sit at our desk and turn on our computer.
It’s common for us to sit at our desk for hours, only to get up for a snack, coffee, or lunch. Then it’s back to the elevator and another 20 feet to our car and 30 minutes later we are back home.
If something is broken at home, we call the repair guy. This gives us more time to feed those bad habits.
We have many luxuries in the 21st century that makes it increasingly easy for us to not do much physical activity. Our body gets used to doing less. This habit of taking the elevator feeds other bad habits. Your mind gets used to choosing the easy path. When there are two options to get your child to school that is only a mile away from the house, you will likely choose the easy option. You’ve programmed your brain that way. It’s become a habit to drive, to use the elevator, to call the repairman.
Habit change number three is simple but it makes a difference and it’s the first step towards bigger changes pertaining to activity. Take the stairs.
I’m not going to ask you to train for a marathon, or invest in a gym membership. Instead, this simple change will put you on the path to more energy, a different way of thinking, and lead to more habit changes that increase activity down the road.
If you are physically unable to take the stairs because you physically can’t make it up or down that many flights of stairs, then go as far as you can and take the elevator the rest of the way. Work your way up to being able to walk all the way up and down the stairs.
And this change isn’t just for those people that work in offices in a high-rise. Anytime you have the option to take the stairs instead of an elevator, you should.
After successful weight loss from your surgery, you will be more encouraged, more likely to continue this trend and choose to train for a marathon or join a gym. But remember, make these changes habits. If you’re going to go to a gym, do it on a regular schedule and create a healthy reward to encourage your habit.
This is a mindset change. Taking the stairs is the first step. Eventually, you will start to look for ways to increase activity whenever possible.
Habit Change #4 – Watch 1 Hour Less TV Per Day
I realize not everyone watches an hour or more of TV per day. But the majority of Americans watch plenty more than one hour of TV per day.
We work hard during the day and after dinner we are exhausted, mentally and physically. It’s easy, relaxing, and enjoyable to sit down on the couch, put our feet up and not have to think for a few hours at night. However, this is a bad habit and it’s self-fulfilling.
When we hit the couch our brains quickly go into auto-pilot mode. Our bodies know its time to relax and our metabolism slows down, muscles relax and our body prepares to rest.
Let’s look at this from a habit perspective. Let’s say our routine is, work, dinner, kids, tv, bed. Our bodies quickly get used to that routine. And we look forward to the auto-pilot at the end of the day. We look forward to letting our muscles relax when we sit back and put our feet up. Our body begins to send strong signals that we need to sit on that couch and relax because it wants the reward of auto-pilot. Our bodies artificially feel tired because, like a little kid, it knows if it keeps sending those signals, eventually you will listen and your body and your brain will get the reward of shutting down.
As you can imagine, this creates a self-fulfilling bad habit. The more you get used to sitting on the couch, the more your body tells you that its tired and you need to relax.
It may seem counter-intuitive to think that the more we exercise the more energy we will actually have throughout the day. But its true, exercise creates energy.
At first your body will rebel and you’ll feel more tired than ever. This is because you’re teaching your body a new routine. Your body learns that it has to stay active to get you through the day. And if you teach your body that shut-down time is when you lay on your bed instead of when you sit on the couch, you will find that you have more energy until you lay down to sleep. In order to do this you have to get off of the couch and stop letting your body think its time to shut down.
Reduce your couch/TV time by 1 hour. Your body will fight it at first, but this change alone will give you more energy at the end of the day. Use it to be more productive, go for a walk, fix something that you’ve put off fixing, clean up, organize, etc.
“Don’t watch TV in bed. This causes issues with sleep which can add weight, but it also reinforces the habit of TV.”
Habit Change #5 – No Food After Dinner
I used to get up with my kids almost every night because they are horrible sleepers (primarily because we never did a great job teaching them sleep habits). Often, I would go upstairs into their room and our middle child would almost always say, ‘I’m thirsty,’ or ‘I need milk.’ I would walk back down the stairs, make a bottle and bring it back up. He would sip on the bottle and fall back asleep. By doing this, I was inadvertently creating a bad sleeping habit for my little boy. Waking up in the middle of the night, signaled he was thirsty. So, every time he woke up, thirsty or not, he would call out for us and milk. Then, the sucking on a bottle until he fell asleep created another bad habit. Sucking made him feel safe and allowed him to fall back asleep. And I had created a monster.
I wasn’t sleeping well. And a lack of sleep, studies now show, leads to hunger. Somehow, I got into the habit of grabbing a cookie or a piece of chocolate or chips, or whatever crossed my path in the pantry, every time I went downstairs to fill that sippy cup or bottle.
I gained about 15 pounds in less than 6 months just from snacking at night. And I would wake up with even less energy than before I started snacking at night. Believe me, I was already exhausted from my lack of sleep. The rush of sugar at night made my sleep quality even poorer, and I would essentially wake up with a sugar crash. I was irritable and cranky.
Regardless of when you eat at night, its not a good idea. It later became a habit for my wife as well. After she put the kids down, her first stop was a glass of wine and the pantry for a snack. Fishy crackers, wheat thins, even a healthy banana. It didn’t really matter what she ate. She had created a habit as I had. And within a few months she noticed that she had gained some weight.
Food habits are easy to create when you’re not paying attention. The cravings are stronger when you’re tired. At nighttime, your body needs a restful sleep and doesn’t need a lot of calories. Your dinner should be ample enough so that you don’t feel hungry at night. You’ll sleep better, you’ll wake up happier and you’ll lose weight.
Cut out all food and sugar filled drinks after dinner. This includes wine or beer. There are plenty of calories and sugars in alcoholic drinks. Its ok to have a few drinks after dinner when you’re out with friends but not at home. Its too easy to create a habit when you allow yourself a glass of Chardonnay after dinner.
“Its surprising but this simple habit change can lead to pounds of weight loss. Try it. Don’t let your inner voice tell you different.”
Be strong. No food after dinner.
We’ve since been diligent about eliminating milk at night for our middle child. He switched to sucking his thumb at night so he could continue the habit that we created. We are still working on eliminating the thumb sucking. But we don’t have to get up every night. We sleep better, I don’t snack after dinner and I’ve lost more than the 15 lbs that I gained.
Habits And Weight Loss Surgery Success
Understanding why you do what you do is the first step towards change. Your bad habits and their associated rewards may be different than those listed in this short book. Being able to recognize those habits and change them is essential to weight loss surgery success. Truly, they are essential to weight loss success, with or without surgery.
Weight loss surgery, be it gastric bypass, sleeve gastrectomy, or Lap Band surgery, is only a tool. The tool of weight loss surgery will get you to a place where you see results, you lose weight, you look and feel better. But after you get there, it’s up to you to keep the weight off.
Choosing surgery is a scary and major decision. You will lose weight. But it doesn’t guarantee you will keep the weight off. It doesn’t guarantee you will feel better about yourself. It doesn’t guarantee you will be healthier or have more energy. Those changes come from you and the decisions you make. Don’t let those decisions create bad habits. Make those habits healthy and positive. Take your career, your body and your life to a new place. Start today.