Melissa Bailey Arizpe, Psy.D.

Archive for the ‘weight loss surgery’ Category

Slow it Down

In weight loss surgery on May 11, 2009 at 4:22 pm

Slow it down–not only in life but in the way we approach food. When was the last time that you actually sat down and ate a meal without distractions? No television. No computer. No phone. We are always in such a hurry to do everything, get places, and take care of everyone else that it is tempting to go through that drive-thru or eat on the run. The problem with that is that we hardly remember we ate anything. Or, we eat so quickly that we get uncomfortably full and then regret eating the portion that we did.

Many patients tell me that the hardest part after surgery–especially for lapbanders–is to slow down eating and thoroughly chew up the food.  We have been programed to eat quickly and take a big ole bite of something.  The problem with this after surgery is that it will feel very uncomfortable.  There is a reason why it is important to slow down your eating.   Chewing and actually paying attention to what your are eating is part of the process to help your body and mind know when you have had enough.  When we eat too quickly, our body doesn’t have a chance to tell us that we have overeaten until it is too late.

There are a couple of ways to help with speedy eating.  Try eating only when you are sitting down at a table.  No eating in the car or in front of the television.  Put down the fork in between bites.  Count to 20 or 30 before swallowing your food.  Yes, this might take a bit more planning, but being healthy usually does.   Try this simple steps and see what happens.


Mindful Eating

In support, weight loss surgery on February 15, 2009 at 5:55 am

One of the things that weight loss surgery forces you to do is to SLOW down your eating. It is something that all of us–whether we have had surgery or not–could try. How often have you sat in front of the television mindlessly eating chips or some other snack and before you knew it–it was gone. Have you ever walked by a co-workers candy dish and before you knew it you had a handful of candy in your mouth.

Each day many of us eat mindlessly. This type of eating–eating without really thinking about what we are doing–can really stop us from achieving our weight loss goals. Jon Kabat-Zinn is a psychologist who has developed a clinic where “mindfulness” is a way of life. Mindfulness is simply learning how to pay attention to the here and now. We don’t let what has happened in the past or the worries of the future crowd what we are doing now. Think about it. If you really gave every bite that you took more attention you would probably be eating smarter.

How do you become more mindful? You can start by PAYING ATTENTION to the things around you. Also starting a meditation program each day. Think you don’t have time? Meditation can start with deep breathing for only a COUPLE OF MINUTES A DAY.

Assignment for the week—pay attention to ever morsel you put in your mouth.

Identifying your Hazard Zone

In support, weight loss surgery on January 15, 2009 at 6:17 pm

Recently I noticed that near the beach areas there are new signs posted stating “Entering Tsunami Hazard Zone” and when leaving the beach, “Leaving Tsunami Hazard Zone.”  I am not sure if these are new or if I am just now noticing them.  I guess like many others living near the beach I prefer to be in blissful denial that I actually live in a potential tsunami area.  Given what I have seen on the Discovery Channel, tsunamis do not look very pleasant.  However, realistically, I do need to give it some thought at least some time.  After all if one actually hit, I would need to have a plan of evacuation and safety.

This got me thinking.  There are a lot of areas in our lives where we could probably use signs reminding us of “Hazard zones,” particularly after weight loss surgery.  Take a minute to think about what areas for your are difficult to manage either your cravings, possible overeating or social pressures to eat.  Maybe a hazard zone might be when your work place has a potluck lunch.  Everyone is eating and overeating and wondering why you aren’t.  Another one might be the food court at the mall.  One woman in our support group described how the soft preztels in the mall seemed to call her name each time she walked past.  Maybe it is visiting your grandmother when undoubtedly she is going to serve you your favorite childhood dish and insist that you take several helpings.  A common hazard zone is mindless eating while watching television after work.

Much like the tsunami warning areas, you  have to identify the boundaries of your hazard area.  Once you have identified the warning zones, make a plan ahead of time.  Part of the reason for the “Tsunami Hazard Zone” signs are to prompt us to think about what we would do should we be faced with such a disaster.  It is all in the planning.  So let’s think of it this way:

1.  Identify your hazard zone–what areas are most difficult for you to stay on track with the post-operative lifestyle?  Actually sit down and make a list.  Write it out.  Writing things down even if we never look at them again can be a powerful way to get the information to really sink in.

2.  Plan your evacuation–Have a back-up plan in mind BEFORE you enter the hazard zone.  It doesn’t help to be in the middle of the disaster and not have a plan.  If you have a plan on how to handle the after work mindless eating danger zone before you walk through the front door, you will more likely be successful in not ingesting extra calories.  Can you go for a walk?  Can you meet with a friend instead of going right home?  How can you break up your routine?  We are creatures of habit even though we don’t like to think so.  Mix it up.  Before going to the mall knowing that the soft pretzels will wield power over you, load up on protein so you aren’t so hungry.  Walk on the other side of mall.

3.  Review your plan regularly.  Even when we live within the hazard zones, it is important to review our evacuation plans often.  Again, we are creatures of habit.  The more we go over something the more likely it is going to stick.  Remember how every time you are an on airplane they go over the safety features, yahdahyahdah….  even if you have flown thousands of times, in the event of a “true” emergency you will probably know what to do because you have heard it so many times.  The same goes for your hazard zones after surgery. Remind yourself regularly what your weak spots are and how you can overcome them.

If necessary, make a sign much like the “Entering Tsunami Hazard Zone.”  You can do this by putting it in one of your many electronic devices–your phone, Outlook, etc.  “Tuesday–Family Dinner–Hazard Zone–need plan.”  This gets your mind thinking and brings up the evacuation plan you already thought about.

Success after surgery is really about planning.  Taking one day–sometimes one meal at a time.    Blissful denial is no longer an option.

It’s been a year and now what?

In support, weight loss surgery on January 8, 2009 at 3:31 pm

For those of you who had surgery a year ago or more, you may be noticing that you are starting to slide back to some of your old habits. Before you had surgery, some of you may recall the doctor or the psychologist telling you, “now remember 12 to 18 months after surgery, you will need to use all of those skills you learned in the beginning to keep things going.”   Unfortunately, in the excitement and the blur of assessments that are required prior to surgery, a lot of patients don’t remember everything that was told to them in the “pre-surgery” days.

Let’s review some of the basics.   Your decision to have surgery was not just to go on another diet–it was to make a lifesytle change.   It was to change how you managed your entire life.  For many of you, one of the thing we discuss before surgery is how part of being successful is focusing on yourself for the first time in your life.  Many people come to surgery after doing everything for everyone else and putting themselves at the bottom of the priority list.  When we rush around and take care of everyone but ourselves, we ultimately slip on healthy eating habits, exercise and overall life balance.  You are the priority.

For those of you who see this as selfish, if you are not healthy then you cannot fully be available to help others.  You will be too tired, overwhelmed and then tend to be resentful because you are “doing everything” and no one else is helping.   Helping yourself is not selfish.  It makes yourself more available to others.  The optimal you–not the tired and overwhelmed version.  So, this means that first thing in the morning you need to take a couple of moments for yourself to plan your day.  Plan your meals. Plan your exercise or activity for the day.   Where will I get my protein today?  How will I deal with that birthday lunch at work today?  What healthy snacks can I pack in case I have cravings?  Taking care of you, takes thought and planning.   You would do it for other people–why not yourself?

Being a year or more post-surgery can be more of a challenge because the weight might not be coming off quite as quickly as it did in the beginning.   The scale might not move everyday.  The solution–everyday–yes everyday–renew your decision to have surgery and your decision to take care of yourself!

Preparing for the Holidays—How prepared are you?

In support, weight loss surgery on December 23, 2008 at 6:39 am

For most of you, your holiday season is well on its way. The tree is trimmed. The parties have been planned for weeks. The gifts have been purchased and wrapped. Holiday cards have been mailed.

A lot of us spend a significant amount of time planning for the holiday season. Usually this planning involves making sure that the other people in our lives are going to have a special time and get that memorable gift. Now that you have planned for everyone else—what is YOUR plan for surviving the holiday season?

If you are like many weight loss surgery (WLS) patients you have spent part of your life doing for and taking care all of the “others” in your life—never taking the time to care for yourself. This behavior has unfortunately caused you to neglect your health and make poor choices—like eating on the run, neglecting exercise or just not taking a moment to relax. The holidays tend to exacerbate this reality tenfold.

As much as you have planned for the holidays to make it a great experience for everyone else, it is essential that you also make a plan for yourself. How are you going to manage all of the temptations that you might come across at the holiday parties? How are you going to deal with the annoying relative who says, “Is that all you are going to eat?” How are you going to manage when Grandma says, “You mean you aren’t going to have my special pie I made just for you?”

Here are some “planning tips” for you as you deal with the next week of festivities.


Make a commitment to stay on course with your protein intake. Remember the main rules after surgery are Protein, Protein, Protein. Load up on protein before you go out to that party. Or, better yet once at the party go right for the protein dishes so that you can follow your Protein first rules more easily.


If you are going to indulge during the holidays—make it a planned indulgence. Meaning that if Aunt Rose makes a great haystack cookie and you feel it is calling your name—PLAN ahead of time that this will be your choice of extravagance. This will help you avoid some of the other foods that also tend to call your name during dinner time.


For those of you who can tolerate alcohol—avoid it. I know I know.. this can be a tough one especially if you come from a good German Irish family like I do. However, once you start drinking then most of your well laid plans go to heck. Alcohol lowers your will power and suddenly you are rationalizing how those mashed potatoes could potentially count toward a protein. Not to mention that alcohol is filled with sugars, calories, carbohydrates and lowers your metabolism.


Remember—it is not your last meal. Many times I hear WLS patients—especially those who are preparing for a surgery date right after the holidays—go overboard because this is the LAST HOLIDAY they will ever be able to eat. No, it is not. There will be many more holidays to come especially given the health benefits after surgery.


Keeping in mind it is not your last meal—Remember, that the holidays are actually not about the meal—they are about spending time with friends and family. Ok, for those of you with annoying relatives this might not be the case, but bear with me. Plan—there is that word again—plan ahead for the party you are attending. Instead of focusing on the food that is going to be served, focus on the people who are attending. Maybe you have a cousin or a nephew who you haven’t given any face time for most of the year. Make it a point to actually talk to him or her. Ask how things are going. Really pay attention to what he or she is saying. You will probably find that you actually enjoyed the evening more; and, in “planning to take care of yourself” you helped someone else who really needed your attention and not your material gift or homemade cookies.


Finally, movement is everything. If you can’t exercise, then at least move as much as you can. When you hit the mall for those last minute gifts this week and parking is bad—think to yourself that this is an opportunity to get some movement in. That far off parking space is the perfect way to add steps to your pedometer. Any movement is better than none.

WLS surgery patients who are having their first post-surgery holiday season and those who are years out from their surgery date alike, all struggle with the holidays. Expect it, know that it could be difficult, but PLAN for it. If you plan ahead there are no surprises and you are not beating yourself up in the morning because of that glass of egg nog. And finally, as I always say, get some support in the matter. Those who seek out support are going to do much better.

With that said—Happy Holidays to all!

Welcome to Your Weight Loss Surgery Psychologist Blog

In support, weight loss surgery on December 21, 2008 at 8:35 am

Greetings!   This is the first of many blogs to come on succeeding with weight loss surgery!  I am a psychologist licensed in California and Arizona.  I specialize in preparing and supporting patients throughout the weight loss surgery experience.  This includes patients who have the adjustable band, gastric bypass or gastric sleeve.  Ongoing weight loss success after surgery depends on using all the support you can get.  I hope to provide helpful insights and support.

Please send me suggestions on your interests!