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Behavior Modification
Changing your behavior begins with awareness and education. Once you know the proper steps to begin a healthier lifestyle, the rest is up to you! Medical Center Hospital Bariatric Clinic is here to support you in this mission, so we’ve provided the following guidelines to help you better understand how changing your behavior can be simple and effective:

• Always plan ahead for holidays, social events and even your daily eating routine

• Eat meals at scheduled times if possible

• Avoid eating while watching TV or reading

• Eat in designated area

• Slow down! Eat small bites and always chew well

• When you are full-STOP! Put the food away immediately

• Avoid snacking in between meals

• Avoid drinking liquids with your meals

The Four Rules for Post-Operative Success
Although these rules are essential to your post-operative success, you can start applying each and every one of these principles before surgery. You don’t have to wait to change your life through following these simple guidelines.

Thanks to these four easy steps, you don’t need to worry about counting calories, fat or carbohydrates ever again. It’s important not to follow any other program, whether it’s off the internet or from another surgical office. Your surgery is a tool to be used with these “four rules” and experience shows that unless you follow them, we cannot predict any weight loss results.

Age, overall health and genetics make each person’s progress a little different from other patients. Don’t compare your progress to another patient-either your weight loss, the amount you eat or how much you can exercise. As long as you follow the “four rules” you are on the road to success. With commitment and dedication, you can expect to achieve the same long term success within one year.

When patients reach a ‘plateau’ and stop losing weight, it is usually because they are not following these simple but very important rules!

1. Protein First Every Meal
   Eat the protein portion of your meal first-Every Meal-one to three meals per day. Eating protein helps the body feel full and sends a signal to stop eating.
   
   Protein is also very important to building tissue in the body. Muscle, organs, your brain-everything is built with proteins. The body does not necessarily need three meals a day so listen to your hunger cues and don’t worry about the clock, at the beginning, after they can tolerate solid food, most patients only eat one or two meals a day.
    

2. No Snacking Between Meals
   Eating anything flavorful or containing calories in between meals is considered snacking. Do not eat between meals at all! If you absolutely have to snack, the only snack that is acceptable is protein. After six months, beef or venison jerky is acceptable, but only if you feel like you have to eat something. The main problem with snacking on flavorful food is that it contains glucose or some other sugar. You feel good when eating sugar and when that sugar is gone, one to three hours later, your brain sends a message to snack again.
   
   Snacking actually makes you hungrier and it will slow down or even stop your weight loss. And depending on how much or how often you snack, you can actually gain weight!
   
   Remember that surgery has only changed your digestive system and not your eating habits. Your commitment to a change in lifestyle is the key to making the surgery work for you for the rest of your life.
    

3. Drink Water 48 to 64 oz Per Day Minimum
   The importance of water can’t be emphasized enough. Especially in the beginning, when you can only tolerate a mouthful at a time, it is so important to continually sip water all day. Make sure you drink 48 to 64 oz. a day minimum—that’s 2 to 3 quarts per day. Use your timer and shot glass. If you stay on schedule, 1 shot glass every 15 minutes you will reach your goal.
   
   Eventually, you will be able to drink 2 to 4 oz. at a time. No tea, soda (with or without sugar), coffee, or juices are allowed. Drinking flavorful liquids actually encourages snacking and flavored drinks with sugar can cause dumping-making you very sick.
    

4. Exercise
   Exercise every day for at least 20-30 minutes. Walking is a fantastic exercise and is probably the easiest way to get started exercising. We understand that in the beginning you may struggle with a simple walk down the hall and that your energy level can be very low. Your job is to move your body a little more every day. At 4 to 8 weeks (everyone is different!); you will mostly feel back to normal. After you have been cleared by your physician, you may begin other forms of exercise. Eventually, incorporating both aerobic and resistance training into your daily exercise routine will help you remain healthy, at a healthy weight, for the rest of your life.