Here’s hoping that everyone reading this is safe, healthy, and able to “shelter in place” as instructed by health experts. If you are an essential worker, you have my immense gratitude and prayers that you are healthy and safe and that you stay that way.
As pandemic uncertainty surrounds all of us for an open-ended time period, we are confronted with lifestyle changes, decisions and maybe, just maybe, some unforeseen opportunities for self-improvement. Like many of my colleagues, perhaps you are meal planning, shopping, and cooking for a larger group than usual. Certainly, “we” are not dining out and maybe “we” are consuming less take-out food than usual. Based on various sales reports, “we” are also doing a lot of (flour-forward) baking, drinking a lot of alcohol and using an extraordinary amount of toilet paper! Some of us are sleeping late, skipping meals, eating late, grazing, and snacking and possibly, sliding down a long (and structure-free) slippery slope. This might sound great for a few days, like an extended weekend or snow storm, but in terms of long-term self-care and emotional sanity, structuring your days, meals and sleep can help prevent a total derail.
As successful bariatric patients you have an important edge. You already had to engage in some very stringent lifestyle modifications, nutrition, and behavioral, both pre- and post-operatively. While it is as important as ever to stay healthy and fit, it is also stressful and unexpected circumstances, such as this pandemic, that may test your commitment to your surgery and what you know to be the proper path to follow. Let’s look at a few potential self-care scenarios and (weight and lifestyle) outcomes so you can make educated choices on how to proceed:
- (a) UTTER CHAOS Minimal meal planning, inadequate protein intake, emotional snacking & grazing through- out the day, mostly on empty calorie carbs, sweets and junk food, no vitamins, poor hydration, minimal exercise and an erratic sleep schedule.
LIKELY OUTCOME Fatigue, unstable blood sugar with mood swings, cycle of poor food choices driven partly by sleep deprivation, (potential for large) weight gain, increased anxiety/depression over pandemic and your choice to ignore self-care.
- (b) MODEST MAYHEM Some protein-focused meal planning and food preparation, increased consumption of heavy comfort foods often later in evening than usual, trying to practice portion control or “listen to” smaller stomach when full, minimal junk food or sweets, inconsistently taking vitamins, tracking intake or exercising, fair hydration and getting 6-8 hours of sleep most nights.
LIKELY OUTCOME Generally feeling well, occasional heartburn or reflux from intake of fattier comfort foods too close to bedtime, some sluggishness but resolves with exercise, waistbands feeling a bit tighter but afraid to weigh because probably gained. Definitely feel better when eating lighter foods earlier in evening, taking vitamins, tracking intake and/or exercising.
- (c) ADEQUATE EQUILIBRIUM: Mostly mindful of protein intake (80 grams/ day) by using app to track (Baritastic, MyFitnessPal, etc.), taking daily vitamins, meeting hydration goals ( >6 4 oz/day), some structured exercise but not pushing yourself too hard, getting into some old snacky habits but trying hard to portion control and make good snack choices.
LIKELY OUTCOME Feeling the stress of pandemic but using many “tools” to stay conscious and mindful of daily intake. Assuming calories burned from exercise are equivalent to extra calories consumed from snacks, weight maintenance or slow and healthy loss may be expected. If you see a weight gain, you accordingly choose to cut back on snacks or up intensity and/or frequency of exercise to arrest further gain. Feeling good about being able to manage weight in a stressful time.
- (d) MIND-OVER-MATTER: Staying the course by embracing extra time at home (if sheltering in place) by meal planning, doing more home cooking, using an app to track protein, calorie and water intake, taking daily vitamins (and reordering on line when you run out) and exercising as much as safely possible to release stress, rather than push it down. Still incorporating protein shakes or bars as meal replacements or snacks to help (1) hit protein goal, (2) when too tired to meal prep or (3) when feeling like having something sweet that’s nutritious & portion-controlled.
LIKELY OUTCOME Feeling wonderfully in control of self-care despite stress of unknown (pandemic, work, school, finances, future), experiencing either a weight loss jumpstart or continuing to lose at or above your rate prior to pandemic. Maintaining a sleep and wake schedule despite sheltering in place. Structuring days with work (if working from home) exercise, meal prep, home projects, phone calls or Facetime (to check on loved ones) and game, puzzle or movie time (alone or with quarantine partners.) You will feel proud to check-in with your health care team when it is safe time (alone or with quarantine partners.) You will feel proud to check-in with your health care team when it is safe to resume non-essential medical visits!
In all honesty, it doesn’t matter where you currently fall in terms of above scenarios, so please don’t try to jump from scenario (a) to (d) overnight! (Extreme measures such as fasting and fad diets are short-term fixes, not lifestyle changes.) As long as you realize that even under extraordinarily difficult circumstances you have the power to carve out your own path forward, even if it’s one behavior at a time!