Is mindful eating after weight loss surgery an oxymoron? (And by “mindful eating,” I don’t mean, “be mindful to never eat certain foods and never eat more than X amount per meal.”) While mindful eating is sometimes misused as just another diet, the true concepts of mindful eating such as awareness, nonjudgment, curiosity, and acceptance are very helpful after (and preferably before) weight loss surgery.
Over the last 15 years, countless individuals who have had bariatric surgery have participated in our mindful eating workshops, retreats, and trainings. We clearly recognized that their experiences and needs were different from participants who had not had surgery. More important, we feel strongly that people who are considering or who have had weight loss surgery have a right to great programs that truly help them address their relationship with food. Since that’s what we do, we developed a Mindful Eating for Bariatric Surgery curriculum for pre- and post-bariatric surgery.
Missing Tools
A lot of lip service is given to bariatric surgery being “only a tool.” The other tools that an individual needs (with OR without surgery) are rarely provided in our current diet- and weight-focused environment. Given that weight loss surgery continues to be a popular option, our hope is that anyone who is considering it will first participate in a comprehensive mindful eating program. They need enough information about the surgery, but more importantly, about their own relationship with food, to make an informed decision about what bariatric surgery may or may not do for them. Although some will decide that surgery isn’t going to “fix” their eating issues, those who proceed will have better awareness, new skills, and more tools to help prevent some of the serious complications, problems, and ongoing issues that are common but under-reported.
How Mindful Eating is Different
In terms of offering mindful eating in the context of bariatric surgery, there are some key differences. Further, mindful eating differs from a typical bariatric surgery class or support group in several ways.
- As with all of our programs, the Mindful Eating Cycle serves as the structure for learning new skills, problem solving, and deconstructing overeating episodes. (Click here to read a peer-reviewed article, The Mindful Eating Cycle: Preventing and Resolving Maladaptive Eating after Bariatric Surgery.)
- Hunger and fullness are very different after bariatric surgery, different among the procedures, and change over time. The ideal time to learn mindful eating skills is before surgery. Barring that, people who have a band procedure benefit from hunger and fullness training fairly soon after the procedure, whereas those who have a gastric bypass or sleeve often have a “honeymoon period” for 6-12 months before they experience hunger (and therefore may need to remind themselves to eat); after that, their previous difficulties may begin to resurface so they are more open to learning new skills.
- In many bariatric surgery programs, the recommended post-surgical diet is just as, if not more rigid than any other diet that patients have tried before. We firmly believe in a non-diet, non-restrictive approach – even after bariatric surgery. Our “all-foods-fit” approach simply changes to an “all-foods-might-fit” approach. We provide information about dumping syndrome, food intolerances, and other potential issues after weight loss surgery, then, as always, encourage the individual to approach eating with curiosity to discover what works for them. This is an essential shift and is part of all of our programs (including Mindful Eating for Diabetes and Mindful Eating for Binge Eating).
- Bariatric surgery is not a quick fix; it is a life-long decision. As just one example, patients need to know that vitamin/mineral supplementation and labs must be continued for life.
- Maladaptive eating, addiction, and other issues are far more common after weight loss surgery than most people realize. A pre-surgical psychological assessment and post-surgical “support groups” that focus on sticking to the post-surgical guidelines are not adequate. Pre-existing eating disorders must be ruled out before surgery, and monitored for afterward. Specifically, bariatric surgery is not an effective “treatment” for Binge Eating Disorder. While it is not clear whether they had BED before their surgery or developed it afterward, 40% of the participants at our last Mindful Eating for Binge Eating retreat had already had bariatric surgery!
Mindful eating offers weight loss surgery patients a new way to think about eating that doesn’t depend on restriction and willpower. By increasing their awareness of their environmental and emotional triggers for eating replacing those with new self-care behaviors, they gain the skills and tools to live their lives fully!