FORT WORTH, Texas September 23, 2014 — I am entering phase I of my bariatric journey: The pre-op diet. The diets differ for each pre-operative bariatric patient, depending on weight, health and surgeon’s preferences. My provider requires a two week partial liquid diet. That means two to three protein meal replacement shakes a day, then a high protein, low-fat, low-carbohydrate meal. Meal replacement shakes should be high in protein. I found a brand that tastes good with thirty grams of protein per serving. In my mind I saw meat or beans of some kind, favorite vegetables and a small amount of rice, a couple of crackers or something else if I had the room. That didn’t sound like I would sacrifice much. I can definitely do this.
The reason for the pre-op diet is to de-fat the liver. A fatty liver is rigid and not easily maneuvered. It needs to be flexible for the surgeon to lift out of the way during surgery so he/she can to get to the stomach. Livers are very delicate and bleed easily. The less the doctor has to move it the safer the surgery.
While the next two weeks are definitely doable, I planned dinners ahead and made sure all necessary items were in my kitchen so I had no excuse not to stick to the plan. I also decided my family would eat what I ate. It would be easier for me and they could benefit as well.
That first meal consisted of marinated chicken breasts cooked on the grill (recipe below), salad of lettuce, plum tomatoes, cucumber and green pepper with Balsamic Vinegar dressing, and dinner rolls for my family. I was too full to even want any bread.
The second day was top sirloin steak, marinated and grilled, salad with yogurt-based dressing (half the calories of regular dressing), green beans and French bread. Again, I was too full to eat the bread. The doctor’s directions stressed to stop eating when I started to feel full. I suspected this is part of the training for after surgery. After all, besides the gastric sleeve I’m learning how to eat all over again. And thankfully for me it hasn’t been real difficult.
I joined a gastric sleeve group on a social network site that has been a great inspiration for me. Seeing the before and after photos is very exciting. However, I noted that many of these fine people feel cheated or deprived during this stage. Why don’t I? I’m not a doctor or a psychiatrist but I suspect it is because I’ve already had many years of psychotherapy. In it I have learned that I eat for protection and comfort. And while I’ll spare the details of why I felt that way, I have dealt with these issues and for the most part overcome them.
If that has happened, then why am I still fat? My doctor told me we have a hormone called ghrelin that tells us to eat. When a person is overweight and has been for some time our stomachs stretch out which means more surface area to produce ghrelin. The hormone leptin, stored in our body fat, tells us to stop eating. Logic would have us believe obese people would be able to stop eating more easily than our slim counterparts. Not so. Scientists theorize that too much leptin makes our bodies de-sensitized to it. That means the message that tells our bodies to eat is much stronger than the one telling us to stop eating.
Taking a step back it seems to me, at least on a physiological level, that obese people cannot control appetite any more than a middle-aged woman can control hot flashes.
However, this is no excuse for not accepting the responsibility for one’s life and attempting to regain health. There is a lot of help out there. But it does provide more understanding as to why we obese are the way we are. It’s not the only reason, but it is a crucial one.
All went well until about day three of my pre-op diet. My body started screaming for carbohydrates. It was like a two-year old throwing a temper tantrum. In my mind I became an immovable force who let the tantrum run its course as I did with my own children when they were toddlers. I was determined. To go back was no longer an option. It’s the same mindset I adopted when my husband had a heart attack and six bypasses which spurred me to quit smoking cigarettes. Once steeled in my decision I put them down, walked away and never looked back. I’m believing for permanent success once more.
While all this was happening I also continued on my treadmill four to five days a week as well as cleaning houses. On my treadmill I listen to my iPod while exercising for an hour and cleaning lasts about five to six hours a day twice a week.
I can’t wait to continue my exercise, as well as add weight lifting, now that my caloric intake is much smaller. The very thought of looking decent in a bathing suit next summer is actually starting to look believable. Regular sized clothes in stores no longer seem so out of reach.
Join me next week for the conclusion of Phase One of my journey.
Claire’s marinade for chicken or steak
½ cup olive oil
½ cup balsamic vinegar
1 tablespoon dried rosemary
¾ teaspoon salt
½ teaspoon pepper
2-3 heaping spoonfuls minced garlic (I use it from a jar)
1 cup water
Pour into 2-cup measure olive oil and balsamic vinegar. Grind rosemary using a mortar and pestle, add to measuring cup. Add all other ingredients and beat with wire whisk.
Poke holes in meat with tenderizer, front and back then place in gallon sized zipper bag or plastic container. Whisk marinade once more and pour over meat. Marinade for at least 30 minutes or overnight in refrigerator turning meat at least once.
Grill or broil until chicken to 165 degrees, or steak to desired doneness.