"You don’t get to be *insert my start weight here* without fucked up eating patterns."

"You don’t get to be *insert my start weight here* without fucked up eating patterns.

This is a direct quote from something my dietician said to me on Monday. 😅
(Although she said my actual start weight).  (I'll be ok to share what it was one day, by the way.  No time soon though!)

It may sound brash or a strange thing to say in a dietician consultation, but it was actually quite the comfort to hear this.

Ever since I started this journey properly (as in, decided on a surgeon), I've been regularly seeing both a bariatric surgery dietician and a bariatric surgery psychologist.  Obviously both are accredited in their individual fields for general help in their areas, but they choose to specialise in assisting people who are or have undertaken weight loss surgery (WLS).  I believe my psychologist will only see WLS patients now!  (She doesn't see any clients who don't.  She still counsels in any area you need to talk about; it's not just WLS related talking, but her client base are WLS patients only).

When I first announced to my GP that I wanted to have WLS, the first thing she said was that I need to make sure that I find a surgeon who takes a holistic approach, and incorporates both dietetics and psychology within their team, as these aspects are crucial for long term success.  From my own research, most WLS surgeons do have teams that include these, but they vary surgeon to surgeon in terms of how much it's encouraged that you use them.  Some surgeons have them as part of their 'official team', ie a dietician and psychologist who work alongside them in their physical clinic, and some surgeons just have recommended people you can contact.

My original surgeon had a very strict plan in place as to how often you had to see his.  I remember going to visit for my very initial consultation, and I firstly spoke with his head nurse.  I was a 'WLS freshie', as in, I was bright eyed and eager and uneducated.

She showed me an A4 piece of paper, which had the process that their clinic followed, to do WLS.  The first step was to have the initial consultation with her.  TICK!

My eyes wandered down the page, as I took in all of the other things I had to tick off.

Rightttttttt down the bottom of the typewritten A4 page, was 'Surgery'.  It was at the very bottom of a long list of pre-work that they needed me to do first.

It was surprising, but comforting, that they were so detailed, and this proved to be the main catalyst for why I ended up choosing to go with them (originally, until I changed my mind!)

As part of their protocol, they required all of their patients to visit their:

Dietician:           2x before surgery / 1x after surgery

Psychologist:    1x before surgery / 2x after surgery

So, 3x total each.  You could always see them more as you saw fit, but those numbers were the clinic's minimum requirements.

Conversely, my actual surgeon (the one I ended up swapping to), had no such requirements.  You had to see one of his dieticians before surgery, because you had to be educated on your pre-op diet, but aside from that, I don't believe they had any mandatory visits that you had to tick off.

So my original surgeon required me to see the psychologist 3x in total.  My actual surgeon didn't require me to see the psychologist at all.

To date I've seen mine 13 times.😂

I've taken full advantage of the holistic view that my GP originally mentioned, and have made it a (self motivated) priority to see them both regularly.  (I've seen the dietician 8 times).

And I will continue to do so!  I feel so lucky, in that I adore both the psychologist and dietician, so it's easy to want to continue appointments.  The irony is not lost on me that I can say that about a dietician.  No offence to the worldwide cohort of dieticians and nutritionists out there, but up until now, I was not a fan of them.  To be fair I can't even recall having a terrible experience with one, to make me form this overarching opinion.  I must have talked to one at one stage though, because I've always been very anti them.  I was losing my mind when I got diagnosed with gestational diabetes (GD) in pregnancy and was forced to see a GD dietician.  I visited them (internally) kicking and screaming.  (Fortunately they decided I didn't need to continue to see them, and immediately released me from their books).

But the reason I hated the idea of them so much, (I'm sure they're all lovely people!) is that I didn't need to be told what to eat.  I may be fat, but I do know what to eat.  I just don't!  A dietician, in my mind, was never going to solve that issue for me.  I needed a weight loss psychologist.

Anyway, the dietician that I was paired up with from my original surgeon was just the best.  I was happy enough to see her initially because I knew that she had a specific task to do for me: to educate me on the pre-op diet, and to coach me through safely introducing foods again to my rerouted and surgically altered digestive system.  That was fine.  I was cool with that.  It was about physical restrictions.  No problem.  I needed an expert for that, yes.  That was okay.  What wouldn't have been cool was if she had lectured me on how to eat a balanced diet and discussing the food pyramid.🙅

She did all that (the coaching through restrictions), but she's also been almost like a weight loss psychologist herself.  She's very understanding, respectful and I guess also 'accomodating' of my history with food.  She's done more for me than just coach me on the physical food restrictions and reintroductions.  Obviously I discuss more psychology based stuff with my psychologist, and definitely see her more, but the dietician has been a surprising highlight to my 'health team'.

I asked her, sensitive and tentatively on Monday, whether she has other clients with binge eating disorders / behaviours, and she threw her head back almost laughing and exclaimed "yes!  Of course!  That's why there's such a thing as weight loss surgery!"

In retrospect it was a silly question.  But I was feeling quite low in confidence and was starting to feel like the only person who's ever had an issue with overeating.

I've been struggling a bit with old habits creeping in and its been getting to me.  You don't want to spend thousands of dollars and physically alter your body, for it not to work.  I mean, every weight loss venture, you want it to work!  But this time feels like there's a lot more (expensive) stake.

And of course, it's not that it's *not* working, it's just that its fucking scary when you realise how vulnerable you actually are.  

-I decided to have the surgery.

-I had the surgery.

-I dealt with all of the restrictions.

-Now I have an altered digestive system AND free reign of food, so now it's 1000% up to me.

And I've said this before, it's not like surgery fixes your brain.  You go to hospital one morning and a few hours later you've been cut at and rewired physically.  But that's it.  Decades of learned behaviours don't get fixed in that hour in theatre!  (I wish they did)...

Have you ever heard of people talking about how it's still possible to stuff up weight loss surgery because you can find ways around everything, for example, melting down a Mars Bar and drinking it through a straw?

It's an old adage that's been around for years.  Years and years before I even remotely contemplated having surgery myself.

To be honest it was probably a contributing factor as to *why* I never seriously considered doing surgery myself.

Not that I would ever melt down a Mars Bar and drink it.😅

But I guess I've starkly realised this month, that you don't have to melt down a Mars Bar to stuff up weight loss surgery.  (I mean, you can bloody EAT a regular Mars Bar like before, anyway!  Why would people even need to melt it??😜)

But there's so many other things you can do, and that's really scaring me.  

This whole journey has had it's 'hards'.  It was 'hard' to navigate the process of having WLS.  It was 'hard' doing pre-op.  It was 'hard' to recover from major surgery.  It was 'hard' having 3 months of restrictive eating.

But this part feels the hardest -  coming to the realisation that it's VERY easy to still 'overeat' (whatever that means for you).

I haven't fixed old behaviours.  I've been trying!  And I'm making progress!  But the issues are still there and will take longer than a day in surgery to resolve, or at least manage.

And that's why my dietician said what she said on Monday: "You don’t get to be *insert my start weight here* without fucked up eating patterns."

I was discussing the old behaviours that I've noticed creeping up.  (I feel like I officially 'binged' for the first time since surgery 2 weeks ago).😞

She looked at her computer, and she said "Kate, I don't think you're ever going to completely cure your binge eating behaviours."

That statement took the breath out of me.  I was instantly crushed.

I felt like she'd lost hope in me, and that she'd deemed me a failure.

That's not it whatsoever, but I've been feeling low and that's how I initially took it.

(Two days later, I remembered that I'd already realised this fact years ago!  More on that another day).

But on Monday this is what was the catalyst for her to comfort me by saying what she said, about how you don't get to my size without fucked up eating patterns.

It was so true and just so comforting to hear in that moment, because I was feeling pretty failure-ish!

A minute later she also said: (I scribbled these in the notes of my phone so I could remember them):😁

"You can’t expect to unfuck yourself in 3 months".

Again, true.  (Well, its actually been 4 months since my surgery, but I'm sure the same statement still stands for 4 months too).

And it'll be the same for 5, 6, and so on.

I guess I just have to remember that I accepted a few years ago that I will always have an issue with eating behaviours.  And as much as it was confronting to be told that this this week and remember that it's actually likely true, it's actually not as scary as it could sound.  It's probably a fact, and the sooner you can accept stuff, the more freedom you acquire.  And that in turn gives you more time to deal with things.  And manage them, which is all I need to do.

I've given myself this HUGE, helpful tool to catapult me forward, but it's always going to need management, and new strategies and habits, which are technically within my control.  Frightfully hard, and marred by my eating disorders, but literally still, within my control.

I'm making progress, I'm making improvements, I'm inching forward and I'm making better choices overall.  And maybe this is simply a good time to remind myself that life, and success, is never quite linear, and all I can do is to keep trying.

xx

P.S. Apparently you can get these: 

You don't even need a straw 😉