Changing Eating Habits Ain’t That Easy

Bob played football in high school. He was lean and he was good. But after high school, he put on more pounds year after year. Then came the day when Bob’s best friend Mike died suddenly of a heart attack.

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As Bob put on his suit for the funeral, he became aware of how poorly it fit. It was tight, constricting. As he looked in the mirror to see where to adjust the suit, he saw his best friend. Mike had been overweight, too.

As Bob put on his suit for the funeral, he became aware of how poorly it fit. It was tight, constricting. As he looked in the mirror to see where to adjust the suit, he saw his best friend. Mike had been overweight, too.

The next week, Bob went to a personal trainer. He said, “Jack, I need you to help me lose weight and get fit.” Then Jack heard something he’d never heard before from a client. “Jack, I have gained 40 pounds over five years. I want you to help me lose 40 pounds over the next five years.

One thing we know with certainty is that quick weight-loss methods don’t work long term. Changing eating habits works. Bob understood that. Do you?

If you truly want to lose weight and become healthier, ask yourself: Are you ready to decide to commit to long-term change? It ain’t easy, but it is do-able.

To change to a habit, you must first be committed. Then you must find a technique that works and commit to the technique

Bob had a strong emotional connection to why he wanted to change. He will never be able to drink a beer and tell some of those quirky jokes that only he and Mike got, because Mike is gone. And now he sees himself going down the same path.

Bob was shocked into waking up. Most of us have to dig a little deeper to find the emotional connection to why we want to lose weight. Its important to spend some quiet time and know why.

Get to know your emotional connection to why you want to lose weight. Then commit

Can you visualize eating, drinking, and working out like an athlete? Or like a slob that falls asleep watching TV and wakes up with Cheetos all over his shirt?

Model your emotional memories like the person you want to be

 Chip away at habits. Know what works. Ask daily how well you did and never beat yourself up.

Ask yourself how well you did today and how you can do better tomorrow

Habits are powerful tools to achieve permanent change. Habits are the routine things we do without thought, as if we were on autopilot. Developing new habits doesn’t happen overnight. Some say it takes 21 days to change a habit, but I like to think in terms of chipping away and getting better and better. You must have a clear emotional view of where you want to be, and not focus on how long it may take. If you’re aware of how you feel as you change, you will get to your goal. Learn to love the journey and have expectations that are real.

For quick results, become aware of how you feel as you change, because those feelings happen daily if you’re on the right path

What does our brain like?

Our brain doesn’t like to be told that it can’t have something. It doesn’t like overcoming obstacles. Our brain likes to continue doing what it knows. Why?

Forgive me a moment while I speak in neurological terms: A specific thought develops a neural pathway to that thought. Neural pathways get stronger and wider the more they are used. Pathways that are used frequently and repetitively are coated with a sheath that makes it even more energy-efficient. Such functions as walking and chewing are powered by strong neural pathways. You accomplish such actions subconsciously, as if on autopilot.

Like Pavlov’s dog that was conditioned to salivate with the sound of bell, we have triggers that send a thought down the pathway of least resistance, and the pathway of least resistance is old habits. “You can’t teach an old dog new tricks”—it’s a cliché that traces the path of least resistance.

Resistance is built into change, and you will feel that resistance as you try to change. That’s where free will comes into play.

Success is not given to us, no matter how gifted we are. Instead we create our success by the things we think, say and do. That sounds like it’s driven by the conscious mind, but I would like to share the story of how DNA married free will and became successful

DNA married free will and became successful

DNA is amazing. It’s made up of four base pairs. How those base pairs are arranged in sequence determines all life, as we know it. It’s hard to believe four things make up all life but it’s true. DNA is our program. It gives us certain traits. We may be programed to be an athlete or a scientist or an artist. DNA makes RNA and RNA makes proteins. Proteins are responsible for how we feel and act. For example, adrenaline makes us want to fight or flee.

Oxytocin makes us want to bond and love. RNA records information. Every thought we have ever had is recorded in the RNA in the cells of our body. Neural pathways lead to those thoughts. Certain things trigger the pathway to the recorded RNA thought and then the RNA makes the proteins to make our body want to act in that way.

That’s where free will comes into play. We get to choose our thoughts. And in turn, our thoughts signal RNA which proteins to make. The proteins that are made drive our actions.

Eat Food that Makes You Feel Like the Real You

This is an excerpt from my new book coming out soon. The book is a follow-up to the bestselling weight loss surgery book Skinny Jeans at Last:

Think for a minute: What is the real you?

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What activities do you enjoy most, yet make you uncomfortable because of your weight? What represents success to you? What are your goals? Picture them.

Here’s a goal I hear regularly in my medical practice, and so I ask: Where are those skinny jeans? I know you have a pair. We all do. Are they hiding in the back of the closet? Do you yearn for the day that they live, every day, in the front of the closet?

Fitting into those skinny jeans feels like the sun rising to a blue-sky day after a long and hard winter. You feel alive. That feeling results for many reasons—including the fact that you are healthier. Does fitting into those skinny jeans seem like the real you?

If carrying extra weight keeps you from feeling like the real you, it’s time to do something about it. Can you remember what it feels like to feel healthy and fit? Is anything more valuable?

You’ll never find the right path unless you know where you’re going. Can you clearly picture what you’re trying to achieve?

The other day, I saw a billboard for a weight-loss method. It said, “Look good naked.” If that’s how you picture looking good, recall an image of yourself looking good naked each time you find yourself feeling the resistance to doing what’s required to achieve your goal. For example, say you decide to keep all snack food out of the house. But somehow a bag of your favorite cookies made it home. The rule is: eat one helping and throw the rest away.

Our subconscious doesn’t like throwing away food and you’ll resist doing it. When you feel that resistance, remember what it feels like to look good naked. I’ll share more tools and examples later, but in the meantime, be aware that with each success habit is accompanied by resistance to doing it.

We suffer suffer from infobesity. There are many books out there that deliver good advice, yet even when we use that advice, we continue to get bigger and bigger.

The advice is often conflicting and confusing. One expert may say that eating bananas causes belly fat and another may say that bananas give you an important fiber that helps get rid of belly fat.

Do you feel lost in the muck of all this advice?

The best barometer for what works is you. The solution is you. There’s nothing in this book you don’t already know, at least intuitively. But you may not be applying what you know. You may not even be aware of what you know—and awareness is the key to all change. This book brings awareness to what you already know as true and what will work for you.

The problem with all the expert advice is that we’re dealing with poorly understood body system. The experts mislead us into to believing they have it all figured out—in something of a “god complex.” However, our body system—and what we can call our “gut brain”—is very complex, and no one understands how it all works together despite, god-like pronouncements.

Diet and nutrition experts talk about the number of calories in food and about burning calories. Yet, the science behind food calories is very poor. Did you know that the calories listed on food labels are measured by burning food in a scientific device called a “bomb calorimeter”? Our bodies don’t work that way! Our bodies don’t burn food like the flame in a bomb calorimeter, yet that scientific “method” is taken as dogma. I will share more of the story later—and the story of scientific misconception gets worse.

The calorie is a measure of energy, and when applied to food, calorie-counting poorly measures the energy it gives our bodies. How do you know how much energy food gives you? You know by observing how much energy you feel after eating.

What works in complex and poorly understood systems is the trial-and-error method. It worked for Edison when he perfected the incandescent light bulb, and it will work for you. In fact, I like to call this the “trial-and-success”. The end game is feeling like the real you—not feeling like a bomb calorimeter.

Are you ready to learn the art of making that picture of yourself come alive, of achieving the goal of becoming the real you?

And it is an art. The masters don’t paint masterpieces every painting. They pay attention to what strokes, brushes, and paint combinations work and eventually a masterpiece emerges. It’s important to observe how food makes you feel. Everyone is has different tastes, and we respond differently to various foods. Some tolerate milk, some don’t. Some can eat eggs, some can’t.

The food you should eat is the food that makes you feel like the real you.

What About the “Feel Good” Diet?

The words we use to ourselves and others matter. Some words open us up. Some words shut us down. And when it comes to weight loss, the words “Eating healthy” shut us down.

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Eating healthy feels like a chore your parents have been nagging you to do, but you resist; “Sit up straight.” “Take out the trash.” “Clean your room.” “Do your homework.” And, of course, “Clean up your plate.”

What if we thought of nutrient eating and pleasure eating as the “Feel-good” diet? We all want to feel good, right?

If you want to feel better today, eat better today.

You’re the only one that can judge how you feel, and what makes you feel better, and what makes your feel worse. One hour after eating a meal, do you feel like hitting the couch, or do you have energy to do something you love? Scientists have spent tremendous effort trying to measure energy production in relationship to food, when the way to measure how much energy you get from eating is simply asking yourself how you feel and then measuring it on your personal scale.

The only proven method for long-term weight loss and healthy-eating success is changing habits. Such change is difficult, which I’ll address in more detail on another post.

If you feel the change, actually taste it, you have an emotional mental image to recall. This image this helps give up the natural resistance to change. When you have repetitively experienced what it feels like to eat a small volume of nutrient food that tastes good and feel energy and vitality after eating, you’re on a path that will change your life. This is true when it comes to food, but also works in many other life challenges.

As a Houston weight loss surgeon, I’ve seen many times how the power of using emotional images can bring about real change.

The model of recalling the “feel-good” experience after some difficult task helps you give up the resistance to performing that task.

And, over time, you becomes who you are….

a person who feels good…

and it shows.

Eating better with just the goal of better health rarely works. Eating better because you know what it feels like to eat well and feel good—now that works.

Melinda Talks About Her Experience with Having the Sleeve Gastrectomy

In this video, Houston weight loss surgeon Dr. Clifton Thomas talks with Melinda about her recent experience having the sleeve gastrectomy 4 weeks ago. She’s already lost 20 lbs, and says she has more energy than ever.

Before having surgery, Melinda says she’d heard horror stories about what it would be like after surgery. To her surprise, she’s had no problems and is finding that it really easy as long as you follow the prescribed eating plan.

If you’re considering bariatric surgery  and would like to know how to choose a Houston weight loss surgeon that’s right for you, visit our “Choosing a Surgeon That’s Right for You” page here.

Casey Shares Her Experience with Bariatric Surgery and The Benefits She’s Seen After One Week

Houston bariatric surgery patient Casey talks about life after the sleeve gastrectomy.

In this video Casey sits down for a short interview to share her experience from having bariatric surgery. One of the big things for Casey is that she is sleeping so much better than before after just one week!

Not only that, but her drive towards food is now gone and her energy level is back. She says she feels she can be more active than ever before!

If you’re considering Houston bariatric surgery and would like to know how to choose a doctor that’s right for you, visit our “Choosing a Surgeon That’s Right for You” page here.

Embrace Those Emotions

We are all resistant to change, when it comes to changing eating habits after surgery. The key is tapping those specific emotions that make us feel better – that make the change worth it. For some it’s fitting into those Skinny Jeans.

For others it’s just being able to keep up with their kids as they are trying to ride a bike. That was the turning point in Jason Leadingham’s life. You can read about his story here. I ask patients to give me specifics when it comes to capturing and embracing these emotions. These are the emotions that inspired me to write Skinny Jeans…at Last!

Learn more about Houston weight loss surgery and setup a free 30 minute consultation on our appointment page.

How Does Weight Loss Surgery Help to Reverse Diabetes?

We are seeing more news articles recently on the benefits of weight loss surgery for people with diabetes. In fact, recent studies have shown that weight loss surgery has worked much better at reducing and even reversing diabetes than medication.

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The two types of surgeries that we’re referring to are the gastric bypass and the sleeve gastrectomy.

During a gastric bypass the upper part of the stomach is divided from the rest of stomach. This shot glass size stomach is then connected to the upper part of the small intestine. So food goes into this small size stomach, into the small intestine, into the large intestines, and then after digestion and fermentation to the toilet.

Food does not go into the other greater size portion of the stomach, or into the second portion of the intestine called the duodenum. Food bypasses these areas.

As I mentioned earlier there are many chemicals that work by biofeedback that live in this area and the way they affect our body metabolism changes. All because food did not pass through that area or bypassed that area of the intestine.

These chemical changes are magic.

Some recent five year studies now show the sleeve gastrectomy to be equally as effective as the gastric bypass. It seems to have many, if not all of the chemical changes we get with the gastric bypass – the chemical changes that normalize our metabolism and make it easier to choose healthy eating habits.

The operation is less complex than the gastric bypass, and less complexity translates into fewer complications.

During a sleeve gastrectomy the upper portion of the stomach is turned into a tube shape by removing about two thirds of the stomach and the lower third, the antrum is normal. Patients feel full on a small volume of food. But the magic is in the chemical changes.

The gastric bypass probably still has an edge on the sleeve gastrectomy in diabetic patients, but time will tell.

Most diabetic patients who have a gastric bypass are off insulin within the first week of surgery and often the first night of surgery – absolutely amazing and due to those chemical changes that normalize our metabolism.

Learn more about Houston weight loss surgery and how to know if you’re choosing the right surgeon by checking out our page on How to Chose a Surgeon That’s Right For You.

The Number One Secret to Staying in Those Skinny Jeans

The secret to staying in those skinny jeans is staying focused. Staying focused for the rest of your life.

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What it is like to fit into those skinny jeans needs to be an ever present thought. The two variables most responsible for our obesity are not likely to change – our genetics and our calorie rich environment.

What does staying focused look like? Allison had gastric bypass nine years ago and has keep her eighty-five pounds off. She has a small frame, so eighty-five pounds is a lot. She is gorgeous. She often gets compliments on her appearance.

Allison has faithfully kept all her doctor follow up appointments. If you find someone that had a gastric bypass or sleeve gastrectomy that has regained significant weight, ask them, “When was the last time you saw your bariatric surgeon?”

Almost always you will get a vague answer full of excuses.

We teach all patients that one of the best things they can do if they begin to regain significant weight is to start seeing their bariatric surgeon monthly until they are back on tract. The act of scheduling the appointment, arranging time to make the appointment, walking in and weighting, and sitting in the exam room keeps those inner voices actively thinking about weight loss.

Then we can focus our discussion about what part of the eating rules they are struggling with and what to do about it.

To learn more about Houston weight loss surgery options and how to know if you’re choosing the right surgeon check out our page on How to Chose a Surgeon That’s Right For You.

Go Additive Free and See How Your Body Responds

Exercise along with losing weight, and maintaining a healthy weight is very important to our long term quality of life.

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It makes us fit. Fit to enjoy life more fully. It improves our mental well-being and is excellent at relieving stress. Exercise is all about developing a habit.

I think it takes one to two years to develop a habit to the point that you no longer have to talk yourself into exercising.

Visualize yourself signing up for an expensive gym membership, then driving to the gym and then sitting in the car trying to talk yourself out of going in. Suddenly everything seems more important.

The same is true when we try to develop good eating habits. Visualize and remind yourself over and over the things you notice about yourself when you are exercising on a regular basis. Use that visualization to help you give up the resistance of doing the simple do-able thing like getting out of your car and walking into the gym. And give up equating sweating and intensity of exercise with weight loss.

If not, you will be disappointed and quit. Do not quit. Develop the habit and the intensity can come later.

The two most important tools for success is to find the time of day that is least likely to be interrupted and to build in some method of accountability. For some, doing a form of exercise first thing in the morning before the hectic day starts works. For others, finding a partner and agreeing to make each other accountable works. If they have an excuse to not show up, give them a hard time, every time.

How about those bathroom scales? I think they give more bad information than good. In a hospital setting we weigh patients often daily. It is not because we think they are metabolizing fat and muscle or gaining fat and muscle. It is because we want to know what their water balance is. If the weight increases over night we know they are retaining fluid/water for some reason, and the reverse is true as well.

They are useful at home however for the same reason. It tells us what our water balance is. I recommend only weighing if you feel as though you are retaining fluid. If your weight goes up overnight, you are. You did not grow fat, or muscle, or bone. It could be for hormonal reasons such as menstrual periods, some medical problem, or side effects of some medicine. Most likely it is because you have been eating salty food.

Most people are salt sensitive and will retain water after eating salty food They will gain water weight that can be seen on the scale and felt in the puffiness of their fingers.

Prove it to yourself, do the trial above. Eat salt free Monday to Friday, then eat salty food Friday and Saturday, and wake up Sunday and see how you feel. Then visualize how it felt Monday to Friday, and remember that feeling when thinking about eating salty food and ask yourself, is it worth it?

Learning the nutritional value of food, learning to count calories, learning about metabolic rates and glycemic indexes all are very good.

There are many books on the subject and I highly recommend one from a friend of mine, Robert Moore, called The Body of Knowledge System.

To learn more about Houston weight loss surgery options and how to know if you’re choosing the right surgeon check out our page on How to Chose a Surgeon That’s Right For You.

Sleeve, Bypass, Band or Duodenal Switch – How Do i Choose Which is The Right Procedure for Me?

Houston weight loss surgeryBarry Swartz, the author of The Paradox of Choice, points out that we live in a time of abundant choices, which often causes anxiety. He says one way to reduce anxiety is to have a clear picture of your goal and what you need to do in order to achieve your goal. He also says to be careful on choosing based on emotion.

I would add to also have a clear picture of the amount of risk you are willing to take to achieve your goal. First off, dieting has never been proven by any long-term study to help a person lose 50 or more pounds long-term. It’s clear that diets are not the path for almost everyone carrying that much or more excess weight.

So which is the right surgical procedure for you?

It is the procedure that will give you long-term weight loss success with the least possible risk. One must also consider the risk of failing to achieve success. In other words, all those serious medical problems and day-to-day difficulties will not go away if you fail. And that has serious consequences.

The gastric bypass and duodenal switch are complex operations. The sleeve gastrectomy and the lap band are much less complex. The more complex, the more risk of complications. This is true even among the greatest of surgeons.

I will share the pros and cons of each of these procedures, but first I would like to share my story of why I now only perform the sleeve gastrectomy. I had to revise this chapter because in the first edition of this book, I was still performing all three procedures. I would educate the patient and then ask them to choose. Now I can’t justify the extra risk, including the risk of failure, from the other procedures.

It’s my belief that everyone is a genius in some way. They have a particular skill set that makes them good at something. Laparoscopic surgery started big time in 1990 with gallbladder surgery. I quickly found that laparoscopy fit my skill set and began doing advanced procedures much earlier than most. I attended a live tel-seminar where Dr. Kelvin Higa did a laparoscopic gastric bypass. I knew immediately that this was for me.

It fit my skill set, background and educational, as well as my love for GI surgery. So I traveled to Dr. Higa to learn from the master. I also did a mini fellowship at Southwestern Medical School in Dallas, Texas. I performed my first laparoscopic gastric bypass in January 2000.

I was amazed that patients would come in with this huge list of medications and almost immediately after surgery would no longer need them. There were a few complications along the way and they were challenging to treat. Regardless, it was clear that the benefits of the gastric bypass tremendously outweighed the risk of complications. So, I became a big fan of the laparoscopic gastric bypass. Around the beginning of 2002, I attended a masters conference on weight loss surgery. The room was full of the most experienced surgeons. After going over the pros and cons of bypass versus lap band, a question was asked of the audience,“Which procedure would you choose for yourself if you were the patient?”

One after another approached the microphone and said they would choose the lap band for themselves because it was least likely to have a complication and they could not afford to have a complication. I was amazed. To me, the band was just another version of past procedures that had too high of a failure rate. However, during the conference a light bulb went off. Patients, like these surgeons, should have a choice of how much risk they are willing to take. So I immediately started the training process, and became one of the first five in Texas to be approved by the FDA for the procedure. I performed my first lap band procedure in November of 2002. I did my last lap band in 2012.

During this time there were many surgeons that only performed lap band surgeries.. I felt they did not offer the bypass because it was too technically difficult for them. Without doubt, the bypass was a superior operation. It did a much better job resolving diabetes and hypertension and these were issues for most of our patients.

Patients chose the band more than the bypass because it was a safer operation. So over time, I was doing 60% bands and 40% bypasses. The bypass patients rarely had a surgical complication and the office follow up was easy as well. Patients just seemed to lose weight effortlessly and rarely had issues.

When a complication did occur it was a big deal for the patient, the family and for me. I also found that many patients did not lock in the eating habits required for long-term success and over time re-gained some weight, usually about 20% of what they lost. They would tell me they were eating right, but their friends would tell a different story. In 2003, I attended a conference on laparoscopic revisional weight loss surgery- the first one ever done. Michael Gagner talked about the first ten laparoscopic gastric sleeves performed. This is the story of the beginning of the laparoscopic sleeve gastrectomy.

He was doing a duodenal switch (sleeve plus malabsorption procedure) when anesthesia asked if he find a way to end the operation early. They were having a difficult time ventilating the patient. The patient was super obese, and the breathing machine was having difficulty keeping the patient adequately oxygenated. So, he decided to do the sleeve part and come back later and do the malabsorption part. The patient lost weight very well, so he decided to start staging the operation. He would do the sleeve, and later come back to do the malabsorption part whenever they were not losing adequate weight. He found that many patients did not need the second part of the surgery and that the sleeve was adequate.

As he told the story I don’t think any of us thought this would eventually become the most commonly performed procedure. We just thought of it as another option. I started doing the sleeve in 2008. Very few knew how powerful this operation was at that time. From 2008 to 2009 very few patients chose the sleeve. First off, I did not know how powerful the operation was and many insurance companies did not approve it. By 2010, I had done enough of them that I could see the contrast between the sleeve, bypass and band.

The patients were losing weight and finding it easy to lock in and follow the eating rules required for long-term success. To this day, with more than 500 procedures performed, we have had no significant or serious complications. There are many chemicals and chemical pathways in our bodies that drive us towards bad food. It seems that once our body becomes obese, these chemicals work very hard to keep us from losing the weight and keeping it off.

Once we gain it, our body does not want to let it go. We knew that these chemicals were associated with the bypass procedure, but we had no idea that they effected the sleeve procedure as well. By 2010, we realized it. Research has shown it to be primarily related to changes in a chemical called Ghrelin, however there are many more than have yet to be discovered. The bottom line is that, by cutting out about two third of the stomach and leaving the upper third in a tube shape, our metabolism seems to normalize closer to what it was like before weight gain. We are able to get most patients off insulin and hypertensive medications the night of surgery, before weight loss has occurred due to these massive chemical changes.

I did many lap bands from 2002 to 2010 and it was like pulling teeth to get about 40% of those patients to follow the required eating rules. Subsequently, they would struggle with weight loss. Often they had mechanical issues with the band causing severe reflux esophagitis and vomiting. The typical patient that did well with the band was very good at following rules in their everyday life. They would learn the eating rules, get full on a small volume of food, and did great if no mechanical issues occurred. Because the lap band did not have the chemical changes like the sleeve and bypass, patients did not get off insulin and high blood pressure medications until they had lost significant weight.

Before the sleeve was an option, when patients were having problems, the only choice was the gastric bypass. Many patients did not want to take that risk. Now the patients can convert their band to a sleeve with relatively low risk. I quit offering the lap band and the bypass once I realized that the sleeve was low risk, had excellent weight loss, got most the patients off their medications the night of surgery, and the patients found it easy to lock in the important eating rules required for long-term success.

One of the hospitals that I use in Houston, Texas does more bariatric procedures per month than any other Houston hospital about 100 per month. Lap bands are no longer seen on the schedule at all. There are still bypasses, as some surgeons still feel that it is superior, and an occasional duodenal switch but mostly sleeves.

I think the story that I was a big fan of the bypass, did the band because it was safer, and now only do the sleeve is an important story that might help you understand why I think the sleeve is the right procedure for most patients. For those patients who do not achieve adequate weight loss with the sleeve, then the duodenal switch is a good option. The beauty is that half of the operation has already been done, and the next operation will be safer because of the weight loss achieved with the sleeve.

For most patients, the laparoscopic sleeve gastrectomy is the right choice.

For more information about what makes our Houston weight loss surgery experience different from all the rest, click here.

Disclaimer: Please note that there's no guarantee of getting the same results as each of these patients. Specific results vary by individual patient.