12 Stages of Transformation after Weight Loss Surgery

When grief occurs in our lives, we deal with the pain my moving through different stages such as shock, denial, depression, and acceptance. After weight loss surgery, patients go through a similar journey. There are twelve stages weight loss that tend to be typical for every patient. The stages were developed by Katie Jay, MSW, CTA-certified Wellness Coach Director, who also happened to be a weight loss surgery patient. These stages and other resources can be found at http://www.nawls.com/public/1646.cfm.

Read below to find if any of these stages sound familiar to you. Being aware of the different stages can help you stay positive and on the path to the the ultimate goal and last stage, FREEDOM. 

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12 Stages of Transformation

The Decision Point is when a patient has decided to have weight loss surgery. This is a big decision. It sometimes takes years to make this decision because the patient is confident they can lose the weight on their own, or they believe there is a stigma attached to weight loss surgery.  Making the decision is just the first step and comes with a lot of work: finding the right surgeon, getting the pre-surgery work up completed, having insurance approve the surgery, and ultimately being scheduled for surgery. 

http://www.weightzonefactor.com/blog/
the-16-word-diet-how-to-manage-portion-control/

The Shock and Awe stage occurs when the patient realizes how little he or she can eat. Most patients, within the first six months, are only able to eat one half-cup of food per meal. Others are full after just a few bites. This is the time to learn what the feeling of contentment, rather than fullness feels like. Patients also quickly learn how painful overeating can be. The huger hormone is no longer prevalent, so eating less becomes significantly easier.  

http://www.chuckrowtaichi.com/
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Grief and Loss develops when the patient feels sad about the loss of some foods, rituals, or even friends. If everyone continued to make the same food choices and hold on to past eating habits, weight loss wouldn’t occur. Significant changes must be made. There are foods to be avoided, those high in sugar. Check the nutrition label, if the food has more than 10 grams of sugar per serving, it is not a healthy choice. 

There are rituals around foods we have with friends and family. When those rituals are disrupted, tension can arise. It's difficult for a person fresh from surgery to say no when a friend or family member offers a delicious food or alcoholic beverage. The more the patient practices saying no, the easier it becomes. Friends and family may not always learn to accept the new changes in the patient’s diet. 

The Miracle is when the patient feels invincible, like they will never overeat again. Immediately after surgery, the hormone that makes us feel hugely is no longer being produced. Patients tell me that they sometimes set alarms to remind themselves to eat; and the weight seems to be falling off without a lot of effort during this stage. 

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Testing Limits stage occurs when the patient goes back to foods that use to trigger overeating, such as sweets. This stage can be tricky and may lead to “dumping syndrome” if patients eat too much. 

Other boundaries are occasionally tested as well. Relationships can change, interpersonal boundaries can shift, and transfer addictions can begin to take hold. This stage is a great time to follow up with the psychologist that did the surgery clearance. They have the advantage of knowing the patient’s history and can be a great resource for building the skills needed to adapt to the new lifestyle. 

When limits are tested, but boundaries are not formed, problems such as weight gain can occur. If a spouse or family member wasn’t on board with surgery to begin with, relationships can become tense. The patient is now doing more for themselves, and the spouse can feel left out or upset that old rituals are no longer the norm. 

http://www.mattnorman.com/
whats-your-measuring-tape/

End of Invincible is when the “honeymoon” ends and the patient’s eating can more easily affect weight-loss or weight-maintenance. Remember when the first plateau occurred? A patient may be stuck at a certain weight for weeks or even months. Measuring circumference of the arms, waist, hips, and thighs each month becomes imperative at this time. While the number on the scale may not move, inches can still be lost, proving that weight loss is still occurring, but muscle is also developing. 

Keeping a journal can be beneficial. Writing down, and looking back at the positive things that are happening can help bring back the motivation to keep moving forward. The patient may have a few more pounds to lose, but diseases are reduced, exercising is easier, and shopping for clothes is now fun. Gaining of five-pounds is not a reason to give up after so many of these positive things have happened.

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Give Up or Change occurs when patients realizes if they don’t make changes, they will gain weight or stop losing. When a patient reaches this point, it is imperative to find a support group or meet others who were successful after weight loss surgery. On average, most patients gain back about 10-percent of what they have lost. This gain doesn’t mean it is time to give up.  For example, think back to how much better you feel now that some weight has been lost. Have the comorbidities such as diabetes, high blood pressure, hypertension, obstructive sleep apnea, GERD, or PCOS improved since the weight was lost?

Learning occurs when the patient opens up and learns to pinpoint what their real problems are (not what they assume they are). Sometimes what is holding a person back from losing the weight is not just the food they are eating, but also the lifestyle they are living. Occasionally the people we surround ourselves with can bring us down. Other times we need to fit in an extra 10-minutes of exercise a day. Maybe the weight isn't coming off because alcohol intake has increased. All of these issues can hamper our ability to meet weight loss goals. 

Experimenting happens when a patient goes through a trial and error process to discover what really will works for them. Not everyone is the same; different approaches work for different people. For instance, I have heard from a patient that the Paleo-diet works the best because carbohydrates upset her stomach. While another feels that having a slice of wheat toast each day helps increase frequency of bowel movements.  Testing the waters is imperative to find out the best fit for yourself. 

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Self Trust and self care eventually develop as patients learn to love themselves and their bodies. Weight loss surgery is not about getting patients into a two-piece bathing suit, it is about improving health. We want our patients to live healthy lives for a longer period of time. When the patient can accept that they, learn to love themselves. 

Mastery is when the patient regains some control and begins to experience some peace of mind with food, their body, and the scale. 

http://www.sergiospeaks.com/self-improvement/
6-powerful-ways-to-boost-your-self-confidence/

Freedom finally happens when the patient sees that what they really want to do, and what they must do to stay healthy, are one in the same. 

Where are you on this weight loss journey? Do some of these stages sound familiar to you? What stage did you struggle with most? What advice would you give to someone in that stage?

Recipe Corner:

Pork Steaks with Blueberry and Apple Sauce

Serves 4

Time: 30 minutes

Ingredients:

2 apples

1 large leek

1/2 head cabbage

1 pint blueberries

2 tablespoons Extra Virgin Olive Oil

4 lean pork steaks

Directions: 

1. Peel and grate the apples. Thinly slice and rinse the leeks. Finely shred the cabbage (or buy it pre-shredded to save time). Place the apples in a saucepan over a high heat. Add 1 tablespoon of water and bring to a boil until the apples soften. Stir in the blueberries to warm through and transfer to a serving bowl. 
2. Heat a large pan over a high heat, pour in 1 tablespoon of the oil and add the pork steaks. Brown for 1 minute on each side, reduce the heat to medium-low and fry for 4 minutes on each side. Transfer pork to plate and keep warm. 
3. Add the remaining tablespoon of oil to the pan, increase the heat to high and stir-fry the leeks for 3 minutes, or until softened. Add the cabbage and stir-fry for another 2 minutes, or until the cabbage is tender. Transfer the pool and vegetables to four warmed plates and add a large spoonful of blueberry and apple sauce to the top of the pork loins before serving. 

Each serving provides about 300 calories, 30 grams of protein, and 6 grams of fiber. 
Recipe from Reader's Digest: Super Foods Super Easy copyright 2013. 

Cajun Steak with Kale 

Serves 4

Time 45 min

Ingredients:

Steak: 1 pound flank steak trimmed

1/4 teaspoon salt

1/4 teaspoon garlic powder

1/4 teaspoon thyme

1/4 teaspoon oregano

1/8 teaspoon cumin

1/8 teaspoon paprika

1/8 teaspoon chili powder

1/8 teaspoon red peper

1/8 teaspoon ground black pepper

Kale: 1 tablespoon olive oil

1 garlic clove, mined

1 pound kale, stems removed and chopped

1/4 cup water

1 teaspoon red wine vinegar

1/4 teaspoon salt

1/4 teaspoon ground pepper 

Directions: 

1. Remove steak from refrigerator and let sit and room temperature for 15 minutes. Preheat the broiler. Combine 1/4 teaspoon salt and next 8 ingredients (through 1/8 teaspoon pepper). Sprinkle both sides of the steak with spice blend. Place steak on a broiler pan coated with cooking spray. Broil 6 minutes on each side or until desired degree of doneness. Cover and let rest 5 minutes. Cut steak diagonally across grain into thin slices. 
2. For kale, heat a large skillet over medium heat. Add 1 tablespoon oil and minced garlic to pan; cook 1 minutes, stirring constantly. Add kale and 1/4 cup water to pan; cover and cook 5 minutes or until tender. Remove from heat; stir in vinegar, salt, and black pepper. Arrange 1 cup kale and 3 ounces of steak on 4 plates. 

Provides 300 calories, 28 grams of protein, and 5 grams of fiber. 

http://www.cookinglight.com/food/in-season/kale-recipes/cajun-steak-frites-with-kale-recipes

High Protein Hormel Chili with No Beans

Serves 1

Ingredients:

1 cup Hormel Turkey Chili with no beans

1 Scoop Unjury unflavored protein powder

Directions:

1.  Place chili in a microwave safe container and microwave until warm. 
2. Allow chili to cool to 140 degrees (if it is hotter, the protein powder will clump) 
3. Stir in the protein powder until well incorporated. Enjoy!

Provides 280 calories, 44 grams of protein, and 4 grams of sugar. 

http://www.unjury.com/blog/unjury-unflavored-with-hormel-turkey-chili-no-beans/