We have all likely had the experience of discomfort after eating a larger amount of food than usual or eating something we know fully well our body does not tolerate. In some cases, it can be easy to move on from that one incident, but what happens when one meal or one day of being “off” turns into a pattern? For times that you have off eaten, here are a few strategies to implement:
Strategies for Off Eating to Get Back On Track
Avoid “All-or-Nothing” Thinking and the “Next Monday” Phenomenon
The body is in a constant state of homeostasis, as in, it is constantly working to maintain some degree of equilibrium. Many individuals notice that overeating one day may naturally lead to a decrease in appetite the following meal or the following day. This is your body working to achieve equilibrium.
However, if we approach our food choices as something that is “good/bad” or “right/wrong,” it can lead to feeling that if we mess up, it isn’t “worth it” to get back on track, or that it “doesn’t matter” what else we eat the rest of that day. And that isn’t the case.
One off-plan meal doesn’t have to mean that you throw in the towel for the rest of the day or week. You can always make a different decision for your next meal, or even reduce the amount of the less healthy option at that meal, and eat again when you feel hungry.
What you do every day matters more than what you do once in a while.
Identify Your Triggers
Do you notice a pattern when you go off plan? Does it happen when you feel stressed, anxious, depressed, lonely, happy, or bored? Is it because someone else is eating something? Or because the food is simply in front of you and/or available? Does it happen when you sit down to watch TV in the evening? It is important to be aware of your triggers.
First and foremost, be able to identify where you are struggling. Some of these situations may be subconscious, or you may have habits that have been practiced for so long they have become second nature.
It can also be helpful to work on changing your mindset. Consider telling or reminding yourself that you can eat/do whatever you want because you’re an adult, but that you’re choosing not to eat X food because you know it doesn’t serve you in the long run. Thinking about how your future self would feel can be a helpful strategy.
You can also work to minimize your exposure to certain trigger foods or situations. We already make so many decisions on a daily basis, that throughout the course of the day our willpower naturally decreases.
Therefore, at the end of a long day, if you are exposed to your personal trigger, it can be harder to avoid that temptation. Storing certain foods on a higher shelf in your pantry (or in a place you don’t see as often), or not buying those foods and keeping them out of the house can be helpful. Consider making less healthy options inconvenient and healthier options more convenient.
Forgive Yourself & Make a Plan to Get Back on Track
If you happen to have an “off” meal or an “off” day, get back on track as soon as possible. The longer we continue the unhealthy behavior, the harder it will be to get back into the healthy routine.
Did you stop at a fast food restaurant on your way to work because you forgot to prepare your food the night before? That’s okay. Maybe instead of the deep fried side item, you can choose a piece of fruit instead.
When you get hungry again, consider making a conscious effort to choose a meal that contains satiating protein and fiber from non-starchy vegetables or fruit to help you feel more full and satisfied and less likely to continue making less healthful choices.
And then forgive yourself and try not to dwell on the previous decisions you have made. Studies also show that the more stressed and anxious you are about a food or meal, the less efficiently you digest that meal.
Maintain Personal Accountability
Once you have returned to your usual healthy habits, implement behaviors that help to maintain accountability. Studies show that weighing yourself is helpful for maintaining or achieving weight loss.
However, there is controversy over how frequently you should do so. Some individuals find that weighing daily holds them accountable, while others find that to be too stressful. If the act of weighing yourself daily feels daunting, consider weighing just weekly, but try to do so at the same time of day.
In addition to weighing yourself, consider also keeping track of your measurements or taking progress pictures. Since muscle is more dense than fat, it is possible to lose inches and not pounds.
Also, consider keeping a food journal. Simply the act of writing down or logging everything you eat and drink, even if you aren’t counting grams of protein or other macronutrients, can hold you accountable to your daily food decisions and make you more aware of your choices.
You could also take it a step further and make notes of how you feel after eating certain meals or tracking your blood sugar after meals to really be able to assess how certain foods or meals affect your health
Bariatric surgery is considered one of the best treatments for severe obesity; however, it is not a quick fix and still involves changes to one’s diet and lifestyle. Anyone who has had bariatric surgery can attest to it; that it is not the “easy way out.” Making healthy choices and combating previous eating and grazing behavior will likely still be challenging even when 80% or more of the stomach has been removed or divided.
Impacts of Grazing Behavior on Weight Regain
One of the potentially problematic eating behaviors after bariatric surgery is grazing. Individuals that may have struggled with grazing before surgery often return to that same habit after surgery.
The authors of one study cited that as many of 80-94% of patients who engaged in grazing before surgery returned to this pattern around six months post-operation. Additionally, it is often seen that individuals that had binge eating disorder pre-operatively turned that behavior into graze eating after surgery with a prevalence potentially as high as 61%.
However, it may be difficult to truly determine the prevalence of graze eating since it varies depending on factors, including the length of time from surgery, lack of diagnostic definition, poor reporting, and/or poor screening tools. In one systematic review, the authors found the prevalence of grazing after surgery to range from 17 to 50% [https://www.mdpi.com/2072-6643/9/12/1322/htm]. Again, individuals that had engaged in it pre-operatively were more likely to engage post-operatively as well.
What’s the Difference Between Grazing and a Snack?
But what is the difference between grazing and just having a snack? Typically grazing involves eating repetitive, unplanned meals or snacks throughout the day or over an extended period of time. The terms “picking & nibbling” or “snacking” may also be used.
Grazing is often related to feelings of a loss of control (https://pubmed.ncbi.nlm.nih.gov/25213792/) but isn’t necessarily part of the criteria. In fact, the authors of one study have determined there may be two subtypes of grazing: compulsive and non-compulsive.
Non-compulsive would typically be related to mindlessly snacking throughout the day or eating more frequently in an unplanned manner.
Compulsive, in contrast, would be characterized by feelings of losing control around eating. The authors also found a greater prevalence and link to generalized anxiety disorders in those with compulsive grazing.
Since grazing results in consuming food more frequently throughout the day, this can naturally lead to an increase in total calorie intake, and thus a lack of desired weight loss and/or weight regain after surgery.
As reported in the systematic review, the authors of two different studies found that during the first 18 to 24 months post-op, many of the study participants still achieved adequate weight loss (defined as greater than 50% excess body weight loss). However, the authors of those same studies also found significant weight regain in those same individuals. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748772/)
The authors of one study reported that the prevalence of grazing increased as the time from surgery increased. At six months post-op, the prevalence was only 16%, but by two years post-op, the prevalence had increased to 45%. Those that also experienced a loss of control reported significantly more grazing than those that did not. (https://pubmed.ncbi.nlm.nih.gov/25213792/)
Types of Foods Eaten After WLS
It might also be helpful to consider the type of food individuals are eating after surgery. “Slider foods” is a term used to describe foods that are either mushy consistency upon eating or turn into a mushy consistency quickly after chewing.
The most common foods attributed to this category include mashed potatoes and gravy, ice cream, etc., including crunchy carbohydrate “snack” foods such as crackers, pretzels, chips, etc. These foods generally lack protein and fiber, which are two important factors that promote satiety.
Highly processed snack foods may also increase grazing behavior for several reasons. One related to the fact they are mostly slider foods as previously discussed, another related to the high simple carbohydrate content, which may alter glucose levels and increase the risk for reactive hypoglycemia, and another related to the hedonic effect of, or the pleasure one receives from eating, these foods.
Reactive hypoglycemia specifically seems to occur more frequently after bariatric surgery; it results in a sharp increase in glucose after a meal, followed by an even sharper increase in insulin, resulting in a subsequent drop in blood glucose.
With that drop in blood sugar, the body and brain will naturally crave sugar or carbohydrates to return blood sugar to the normal range as quickly as possible. If corrected with a meal or snack containing only carbohydrates or simple sugars, this cycle will likely repeat itself, resulting in more frequent eating episodes to maintain blood sugar levels.
Work with a mental health provider if you identify as someone struggling with a loss of control around eating or feel that you are eating for other reasons than physical hunger.
Set a meal/snack schedule. This may be especially helpful for those who do not feel the same hunger sensation as before bariatric surgery. Ideally, eating every 3-5 hours is a good habit to adopt that avoids eating too frequently or infrequently.
Focus on solid foods as much as possible. In the early post-op phase, it will be necessary to focus on supplemental protein drinks and soft foods as the stomach heals. However, once you can comfortably tolerate solid foods, it is important to include more of them in your diet. Relying too heavily on soft and slider-type foods will increase the likelihood of more frequent hunger and/or grazing as soft foods and liquids may not promote as much satiety.
Drink plenty of non-carbonated & sugar-free fluids. Some individuals may confuse being thirsty for being hungry.
Reach out to your surgical team for advice and resources!
ABOUT THE AUTHOR
Michelle Bauche, MS, RDN, LD, CSOWM is a registered dietitian working for Missouri Bariatric Services in Columbia, Missouri
Many of us focus on the Thanksgiving dishes that we love and take us back to memorable times when we were younger. Sure, that is part of Thanksgiving. However, Thanksgiving is more than just about food.
Thanksgiving Past and Present
A bit of how Thanksgiving began: in 1621, the pilgrims celebrated the first Thanksgiving feast that came over on the Mayflower and the Indians in Plymouth, Massachusetts. After the pilgrims endured the challenging 66-day trip across the Atlantic Ocean, they were befriended by the Native Americans. The Native Americans taught the pilgrims how to plant and harvest crops and how to fish and hunt. The pilgrims had much to be thankful for.
So, what does this have to do with us currently? The pilgrims gave thanks to the many people that had helped them, became a part of their lives, and taught them valuable life lessons. You probably have the same thing. You have people in your life such as family, friends, co-workers, and neighbors that have done the same for you and made an impact for you.
Thanksgiving is much more than lots of food. Sure, that’s part of it but think out of the box to make your Thanksgiving Special and Memorable. Check out the meaningful ways to celebrate Thanksgiving.
Thanksgiving Is More Than Just About Food
Check out these ways to make your Thanksgiving special and memorable
Share Gratitude. Ask your Thanksgiving guests to write down on small pieces of paper what they are grateful for and share.
Sharing is Caring. Ask your guests to share something that happened this year that was special to them.
Volunteer to Deliver Food to People that Aren’t Able to Get Out. A place to consider is Meals On Wheels.
Thank You. Write thank you notes to first responders in your area. (Adding a plate of goodies wouldn’t hurt either.)
Be Active and Have Fun. Participate in a Turkey Trot in your area.
Make a Donation to Your Local Food Bank. You can make it a fun group activity. Take your family, kids, and friends to the grocery store to buy non-perishable items. Put your items in a basket or box, write a note, and ring the doorbell.
Gratitude Chains. Paper chains aren’t just for kids. Cut out thin strips of colorful paper and ask friends and family to write something on the strips they are grateful for. Tape or staple each strip into a loop, interlocking with the next paper loop until you have a beautiful chain. Use the paper chain to decorate the table or hang it over the door for a beautiful reminder of all your blessings.
Light Gratitude Candles. Use this simple object lesson to show how gratitude is most beautiful when it’s shared! Dim the room and hand out a small candle to each person at the Thanksgiving table. Start by saying something you are grateful for while you light your candle. The person next to you then shares what they are grateful for and lights their candle from yours. Eventually, the room is lit up with happy thoughts.
Play Games. Start a tradition of playing board games, trivia, card games, or play Charades.
Organize a Friendsgiving Get-Together. Start an annual “Friendsgiving” by inviting friends who also aren’t celebrating with family. Sometimes the best family is the one you create!
“Always have an attitude of gratitude.” – Sterling K. Brown (This Is Us)
“Thanksgiving was never meant to be shut up in a single day.” – Robert Caspar Lintner
“If you want to turn your life around, try thankfulness. It will change your life mightily.” – Gerald Good
“Give thanks not just on Thanksgiving Day, but every day of your life. Appreciate and never take for granted all that you have.” – Catherine Pulsifer
“I am happy because I’m grateful. I choose to be grateful. That gratitude allows me to be happy.” – Will Arnett
“Showing gratitude is one of the simplest yet most powerful things humans can do for each other.” – Randy Pausch
One of the keys to being happy is to focus on the good things in your life. People that are happy and content in their lives tend to take better care of themselves, make healthy food choices, exercise and move more, and enjoy the relationships they share with others.
Take-Aways that Thanksgiving Is More Than Just Food
Embrace the gratitude for your health and wellness! Celebrate Thanksgiving. We have so much to be thankful for.
Happy Thanksgiving to you from the ObesityHelp team! Thank you for being a member of the ObesityHelp Community, part of our social media community, visiting the website, and sharing your experiences and support.
Thanksgiving is one day of the year, but you can celebrate your thankfulness and gratitude 365 days a year.