Author: Helen Gibbs

Starting in 2021, I will be working in partnership with Mark Grant (Southern Weight Loss) to provide a comprehensive service for clients before and after private weight loss surgery.

Considering weight loss surgery? Here are some things to think about

Weight loss surgery will only benefit you if you are willing to make lifestyle changes to work alongside the reduced intake you will experience because of physical restriction created by surgery. It will not let you “eat what you want.”

If you eat for emotional reasons or because of past trauma, you need to work on the reasons you eat. A fair number of clients I see who have the need for weight loss surgery can be eligible for sensitive claims counseling.

Weight loss surgery seldom normalizes body weight. You are likely to be overweight or obese when you achieve your goal weight. The weight loss is to improve function and health, not to achieve cosmetic perfection. You will still find yourself judged as a big person, even if you achieve the weight loss goal we calculate as a successful outcome.

You will have skin folds. If you want a surgical revision of skin folds you will need to work with a plastic surgeon. Skin revision is seldom done in the public system unless there is a health problem caused directly by the excess skin.

Food is more than nutrition

A Maori woman who had weight loss surgery said to me once, “I wish I had known how tough it would be attending events on the marae when I can only eat a little bit of food”. Although she had been extremely public about her journey, the social and cultural pressures that occurred when at events where she was receiving manakitanga were substantial.

The challenges you face with food won’t go away with surgery, and this can put you at increased risk of co-addiction.

Do I recommend weight loss surgery?

After over 25 years of working with a specialist interest in weight management, I am confident that surgery is the primary treatment option for some clients. I have one person starting that journey at the moment and another who I am thinking we should discuss whether she starts down the pathway.

Here are some things to ask yourself if you are thinking of surgery

• What is my reason for wanting weight loss surgery?
• How will my losing weight affect my relationships with others?
• If someone in my close circle of relationships starts sabotaging my weight loss efforts either during the preparation or post-surgical period am I willing to confront that behavior and potentially lose the relationship?
• Am I willing to make efforts to understand the reasons I eat, including participating in psychotherapy if necessary?
• Am I willing to work on being physically active every day and make choices to spend less time undertaking inactive leisure?
• Am I willing to either explain why I can’t eat more, or just say “no thanks” when there is social and cultural pressure to eat?
• Am I willing to accept I will still be judged as an overweight person by society and by people in health who do not understand the nature of weight loss surgery?

If you are considering surgery and want to talk about it, please do not hesitate to make contact with me.

Recently I was asked if the meal box options were healthy. Because I am a cook-from-scratch girl I asked the clients to send me the recipe sheets of the meals they really liked and I reviewed them. This is one company only but it is some good points to look at and think about when deciding if your meal box is healthy.

1. Most of the per person servings were 3,500kJ (900kcal) which is fine if you are active, male and not wanting to lose weight. For many of them it would be possible to reduce the portion size by ¼ to ⅓ and still feel full.
2. Many of them are quite high in sodium. If there is more than 1000mg sodium in a serving then this is 3g of salt which is about the amount we should have in the whole day. When I looked closely, I suspect that much of the sodium comes from either the spice blends (salt is commonly added to these) or some of the processed ingredients such as tortillas or pesto.  The two ways of reducing sodium would be to omit any salt in the recipes and to use spice blends without salt. I have a set of spice blends that I will share. I also recommend if you are buying your own to replicate these recipes you use the FoodSwitch App to find the lower sodium options.
3. Some are heading up into the unacceptable range for saturated fat in the recipe. It was common to see small amounts of butter added to improve recipes – most of it unnecessary like the salt.  With ingredients like cheese, coconut milk and cream there would be ways of using less or using reduced fat options instead.
4. I have less problem with the use of oil, but unmeasured things like “dash, splash and drizzle” can add up in terms of total amounts added. For the record aim for 1tsp per person per meal when you are adding oil
5. Many of these could do with a fibre boost and if you were recreating the recipes you would reduce the amount of meat and increase pulses and bean to achieve this.

I just completed the consultation with the couple who made the query and they are going to have a go with making the changes discussed. We talked about the importance of food skills, and I dedicate the seasoning mixes below to their efforts. All mixes will last 6 months in sealed containers so you can make in advance, label them well and use them during this winter to make yummy options.

Tex- Mex Seasoning

• 1 TBSP                  chili powder
• 2 tsp                      paprika powder
• 2 tsp                      ground cumin
• 1 tsp                      garlic powder
• 1 tsp                      onion powder
• ½ tsp                     chili flakes
• ½ tsp                     dried oregano
• ½ tsp                     ground black pepper
• 1 pinch                  ground cinnamon
• 1 pinch                  ground cloves

Caribbean Jerk Seasoning

• 1 TBSP   onion powder
• 1 TBSP   garlic powder
• 2 tsp                      cayenne pepper
• 2 tsp                      smoked paprika (regular paprika is fine)
• 1 tsp                      allspice ground
• 1 tsp                      black pepper ground
• ½ tsp                     red pepper flakes
• ½ tsp                     cumin ground
• ½ tsp                     nutmeg ground
• ½ tsp                     cinnamon ground
• 1 TBSP                  brown sugar
• 1 tsp                      thyme dried
• 1 tbsp                    parsley dried

Tandoori spice mix

• 2 tsp                      sweet paprika
• ½  tsp                   ground cumin
• ½  tsp                    ground coriander
• ¼  tsp                    ground turmeric
• 2 pinches             chilli powder
• 1 tsp                      garam masala
• ½   tsp                   dried mint

Paste

Mix 2 TBSP with ⅓ C yogurt and 2 tsp lemon juice to get a paste, refrigerate for 12 hours.

Chermoula (Moroccan Spice)

• 2 TBSP                  ground cumin
• 1 TBSP                  ground coriander
• 1 ½  tsp                 chili powder
• 1 ½  tsp                 sweet paprika
• 1 tsp                      ground cinnamon
• ¾  tsp                    ground allspice
• ¾ tsp                     ground ginger
• ½  tsp                    cayenne
• ½  tsp                    turmeric

It is that time of year again where people will be thinking about New Year’s resolutions to lose weight. In January there will be all kinds of pills, potions and plans purchased. Most will result in bank accounts being lighter, but nothing else really changes. This is because none of these purchases is a positive first step to health.

I recently came across the idea of false first steps in behavior change. In a nutshell, when we imaging making change it is common that we buy something as an aid to improving our competence…then we find we still fail because we haven’t worked on the skills needed to make substantive changes.

We take a false first step because buying something gives us a dopamine rush that feels like we have achieved something. Our first use might also give us a dopamine surge, but if we slip up or lapse, we will believe it is our fault and stop trying within a few days or few weeks.

So how do we make positive first steps to health successfully?

Draw on what you already know about the first step to health

You know more about the first step to health than you think. You are likely to have had something you used to do in the past that falls into the “eating better” category, but you no longer do. An example might be taking lunch from home instead of buying it. Look at why you have stopped doing it, and ask yourself how you could restart it. One of the commonest reasons for stopping doing something is a perceived “lack of time”.  As a total non-morning person, I know that if leave my lunch making to the morning it won’t happen. To take lunch I need to prep it the night before and have it ready to grab and go. If I set a goal of doing it every day, I am likely to set myself up for failure, so I might say “most week days”. This allows for unexpected events and the odd forgotten pick up. Start working on this thing you have previously had success on and make notes of your success or otherwise

Examine why rather than criticise

If you lapse from doing the new behavior, use your logical mind to answer the question “So what went wrong?” “You are a lazy arse”, is not a logical mind response, so you look beyond that statement. “Why didn’t I want to make my lunch in the evening. What did I choose to do instead ?” Many of us have such strong critical narratives we struggle to look at something logically. If this is you, I recommend that you imagine you are advising a close friend. This exercise will prevent you from being casually cruel to yourself. Learning to challenge the inner critic is a major first step to health.

Try, try and try again to make the first step to health

Have you ever watched a child learning to walk? They will pick themselves up dozens of times and keep trying to succeed. We need to keep trying. Even when we feel like we are never going to make it. It is about recording and celebrating the successes. If we can change the mindset and learn from our failures rather than getting into self-criticism, we will develop that goal into a habit. Resilience and perseverance are tools in the first step to health.

Sit with the discomfort rather than trying to solve it.

If we are aware that we have a problem, it causes us discomfort. We want to get rid of the discomfort as soon as possible. Hence the impulse to buy that diet program or gym membership.  Instead, we should sit with the discomfort and use it to help focus our minds on what aspect of the problem we can solve first.  For example, you may be someone who drinks a couple of glasses of wine or beer during the evening.  If you are trying to lose weight you might start a diet plan that says “No alcohol”. Instead, sit with the discomfort and say “how could I moderate the amount I drink?”  You could recognize that the first glass is consumed fast because you are a bit thirsty. From that, you could decide you have a glass of water before you hit the drinks.  That might work or it might be a bit of a “meh” option. What could you do to that water to make it more appealing? Herbs, lemon, ice, nice glass, sparkling. All are options.  It can be a big trap at this point to think you need to spend money to make this happen. Again, sit with it and consider how you could implement this idea with minimal cost. Learnign to avoid quick fixes when we feel discomfort is a first step to health.

Borrow or hire before you buy

In the example above you might decide you will use sparkling water. Again, the impulse to solve involves buying something.  What about borrowing a SodaStream from a family member or friend for 4 weeks to see if you can stick with the change most of the time. By giving a time limit you will make an effort to either make this work and if it hasn’t you can return the item with thanks to the owner. If you can’t find one going spare, consider getting a second hand one and setting a timeline to give it away or re-sell it if you aren’t using it.

It is still OK to buy tools that will enhance your ability to do something better, but using research and finding out if you will use them before you buy them is an important step to health.

What does success look like?

I see many dozens of people who have spent thousands of dollars on failed lifestyle changes. Success is about making a change and sticking with it. It is hard to break the pattern of false first steps, and we need to realize that, like everything, making a successful lifestyle change will take practice.

If you had 6 healthy habits at the end of 2021 that you didn’t have in 2020, wouldn’t that feel great?

How does seeing a dietitian fit into this model?

The people I love working with are aware of their main problems with food, and rather than expecting a diet sheet, they want to know what to do to improve things. They also may find themselves so prone to being critical of failure that they get stuck regularly. My role may be to help you make specific goals towards change and to help you identify your self-sabotage and share tricks to overcome it.

If you had 4 new healthy habits by the end of 2021, wouldn’t you feel great?
If you want to see if you can work with me email me to arrange a 10 minute no-obligation phone call