Changing Habits for Success After Weight-Loss Surgery

By: Dr. Glenn Kaplan

Patients who are facing bariatric surgery need to make significant changes in their eating behaviors, exercise and other life style habits. In part, the requirements for success rely on a person's ability to make psychological changes and behavior changes. As a psychologist working with bariatric patients, counseling addresses ways to learn how to make these behavior changes (habit change) and cognitive changes (one's thinking). Life is about choices, but habits often rob us of these choices by becoming involuntary responses rather than conscious decisions. It is important to sort out the good habits from the bad habits in order to bring control back into one’s life.

At What Stage Does an Action Become a Habit?

A habit is a repetitive action that becomes so ingrained that it effectively turns into an automatic reaction. The question is how do we differentiate the habits that are helpful from the ones that are destructive? Habits may become so ingrained that when we face emotional stresses in our lives we rely on the bad habit such as emotional eating (automatic response) because it has helped to sooth the emotional stress in previous situations. However, bariatric patients need to learn new stress management techniques that are more helpful, such as replacing emotional eating behaviors with more positive behaviors. It is important to remember that changing conscious thought or behavior is much easier than an unconscious thought or behavior. The first thing we need to do is develop our awareness of what is going on.

Be Aware of Actions and Take Note

One way to do this is to make a list of all the habits you think you have. Be aware of your actions and jot down those that seem to be repetitive. Just think about everyday habits. List the thoughts and feelings that are associated with those behaviors. These behaviors may include stress reactions, food, shopping, work, boredom, watching television, going out with friends or family, what you order in a restaurant or the way you perceive your body image. Now identify how often these habits occur. Once you have your habits listed, label each one good or bad. Determine whether these habits are helping you or hurting you. Now that you understand how to identify potentially harmful habits, begin to associate the thoughts and feelings related to that habit.

Think of Ways to Change Related Thoughts and Feelings

Once you have brought your potentially harmful habits into consciousness, begin to think about ways to change your thoughts and feelings related to each habit. Ask yourself what you are feeling related to each habit and what you are thinking about at that moment. Ask yourself what you are gaining from that habit. What would you gain by changing the thoughts and feelings associated with each habit if you could now change the habit into one that is more productive? Then write down the thoughts and feelings you may have associated with the new habit (behavior change). This  is the stage where you begin to feel a sense of control.

Next, compare the old habits with the new habits and choose which is more important for you. There is no right or wrong answer. This is about personal choice and to examine the priorities in your life. The next step is to substitute the more desirable behaviors, thoughts and feelings for the old. Removing or eliminating a habit without replacing it with a more appropriate behavior may leave a void that is sometimes filled by some other unintentional behavior, thought or feeling (such as a harmful habit). Remember that control is all about choices and these are YOUR choices. Successful habit change does not come overnight. It  often requires lifelong practice.

Changing Habits Summary:

• Make a list of all of the habits, or repetitive actions, that you think you may have. Include both positive and negative habits.
• Go through your list and write down the thoughts and feelings that are associated with these habitual behaviors.
• Write down how often these habits occur.
• Label each habit good or bad – determine if the habit is helping or hurting you.
• Focus on the harmful habits, and think about ways to change your thoughts and feelings associated with each habit.
• Ask yourself what you are thinking and feeling while you are engaging in the habit.
• Question what you are gaining from the habit and what you could gain by changing it into a one that is more productive. Write down this new habit.
• Jot  the thoughts and feelings you would have if you changed this habit.
• Look at your lists and compare the old habits with the new habits. Choose which is more important to you. This is YOUR personal choice.
• Begin to substitute the more desirable habitual behaviors into your life. Remember that removing or eliminating a harmful habit without replacing it with a more desirable behavior can leave a void for another unintentional behavior (that may be just as harmful).

Dr. Glenn Kaplan is a Board-Certified Clinical Health Psychologist who works with bariatric patients at the National Bariatric Center at Sky Ridge Medical Center. He can be reached at 303-434-6023.