When it comes to weight loss and building a healthy life there are three basic things you must get right to succeed: 

  1. Your Nutrition 
  2. Your Exercise
  3. Your Mindset

On their own, each of these pillars on their own can help you lose some weight or prevent you from gaining more weight over a short time frame. But rarely does anyone want to lose weight for a few months; most people want to lose weight and never regain it. Yet many people find losing weight and maintaining that weight loss is extremely difficult, if not impossible. Most weight regain is due to the lack of a solid program that includes these three pillars of weight loss. These three pillars establish themes for changes you’ll be making, and for the most success possible, you’ll want to plan for all three themes throughout your journey.

Building your weight-loss plan around these three pillars not only increases your chances of losing the body fat you need to lose, but also lets you build an appreciation for movement, awareness of your habits, and knowledge about the things that can sabotage your success. 

Nutrition

Eating. We all know eating too much can make us fat, yet it’s hard to figure out what the right amounts are. I would guess that most people don’t have a clue about how to eat in order to lose weight. I wouldn’t call that a failure: With hundreds of diets, each giving different and contradictory advice—eat five small meals a day, fast on alternate days, follow a keto diet, drastically reduce fat consumption—it’s almost impossible to know what is right. For many people this is why weight loss surgery (bariatric surgery) is a great option: it removes much of the mystery and confusion about food consumption, and provides you with a single set of guidelines to follow. 

After your weight-loss surgery, your diet and manner of eating will vary depending on where you are in the progression of your weight loss. But although there will be  restrictions on the amount of food you can eat due to the surgery, there are still ways to cheat the system, whether willfully or unintentionally. Some of these cheats come from a lack of education on the rules you need to follow (such as eating and drinking at the same time, grazing, not eating enough protein, and more that I’ll explain later). Other times these cheats result from old eating habits and desires that come back into your life. It’s these cheats that make the eating and nutrition part of weight loss surgery less easy than you expect. 

Here’s an example. One of my clients who had gone through bariatric surgery stalled out on her weight loss after about eight months post-op. We started to look for changes in her life that could be contributing factors in this lack of weight loss. I had her keep a food journal for a few days. This was less about listing everything she ate than about increasing her awareness of what she was eating. It’s not always bad food choices such as ice cream and chips but often the quantity of food. In this client’s case, the food log showed that she was indeed eating more food than she should, mostly by grazing instead of eating distinct meals. Because she wasn’t keeping to distinct mealtimes, by which I mean finishing her meals in about 20 minutes and not eating again until the next meal, she created a situation where she never felt full. It was all too easy for her to add more food into her day. On top of that, her food journal showed that her new job created new stresses, and she was eating more because of that. After a few months of working with a registered dietitian to help her with her reestablish a better meal schedule and food choices, she started to see a loss in weight again.

While weight loss surgery helps with limiting food, it isn’t a cure for bad food choices and bad food habits. They may be a bit limited or go away for a while, but if you are not actively working to create good eating habits, they will come back. 

Exercise 

Exercise isn’t about aiding actual weight loss (even for people who haven’t had this surgery experience minor weight loss effects from exercise), it’s actually a poor substitute for changing your food intake for weight loss.

If you ate 3,000-plus calories a day pre-surgery, and post-surgery your max limit is 1,000 calories, then you are going to lose weight. If you exercise, such as walking for 60 minutes, you’ll burn about 300 calories. When you look at the daily difference between that 2,000-calorie deficit with weight loss surgery compared to the 300-calorie deficit with exercise, you can see why exercise shouldn’t be seen as a major part of your fat loss. But this isn’t an excuse to not exercise; instead it’s a lens that will help you see exercise in a different way. 

Where exercise shines is in almost every other aspect of a healthy life. It  promotes lower blood pressure, helps you sleep better, strengthens your immune system, builds stronger more fatigue resistant muscles, gives you stronger bones, improves cognitive function, builds stronger heart and lungs, helps you move easier, reduce your A1C, reduces anxiety and depression, reduces the risk of cancer, improves digestion, increases your self esteem and energy level among many other things. 

Without exercise in your daily life you are leaving a lot of positive, healthy results out of your life. 

Mindset

This is the pillar that ties everything together. While bad habits around diet and exercise can be part of the reason that you need this surgery in the first place, it’s an unhealthy mindset that allowed these habits to grow. Everyone who undergoes this surgery shares some traits and behaviors, but what got you to the point of obesity is unique to you. While Mindset is the pillar most people ignore, paying attention to your own unique issues and finding a healthy path to managing them is crucial to your success. 

This surgery provides you with a tool, a tool that triggers the physical transformation of your body. But your mental transformation—how you think about yourself, how you cope with stressful situations, your attitudes toward food, and more—require a different kind of tool, one that there’s no surgical help for. That’s a mindset adjustment.


How this tool changes your body will affect you as a person in different ways. Some people will look at you differently; some people will actually “see” you for the first time. You will hear comments that are meant to be nice, but can come off as hurtful. Some people in your life may not like how you have changed, and they will disappear, or their behaviors and attitudes toward you may change, and unfortunately, not for the better. This isn’t always an easy path. 

As with exercise and nutrition, getting a professional to help can go a long way. If you decide to go this route, take the time to find someone who truly supports you and your journey. You’ll want  someone you feel comfortable with, but still will challenge you. Although you will go through a psychological assessment before your surgery it is limited to a few sessions, which is really not enough to create a change. To truly build a strong mindset around the changes this surgery brings, you need to dedicate yourself and put plenty of time toward it. I would suggest that if you don’t already have a mental health professional, take time before your surgery to find one. 

One of my clients had never talked with a therapist before her psychiatric evaluation that was part of her pre-surgery requirements. Around six months post-op—the time of the “six-month monster” —her weight loss came to a halt and she actually started gaining. She began to realize that maybe there is more to this than diet and exercise. I mentioned adding a therapist to her journey, yet she didn’t really think that was necessary. When, after a few more months she still wasn’t seeing a weight loss, I mentioned therapy again, as a way to help her uncover what part of her mindset was keeping her from what she really wanted. At that point she was more open to the idea. Through a bit of trial and error she found someone who fit her needs and personality. A few months after that, her weight loss started again. While I can’t say for sure that the therapy is what did it, her work on her mindset did help her discover some habits and thought patterns that improved her self-awareness. She still feels she has a long way to go, but as she says, “now that I see what I need to do, the journey is more exciting.”

As Kelly McGonigal, PhD, writes in her book on the science of self-control, Willpower Instinct: “Without self-awareness, the self-control system would be useless. You need to recognize when you’re making a choice that requires willpower (such as a craving or want); otherwise, the brain always defaults to what is easiest.” Making the right choice in different situations—when you’re at a party, feeling blue, or even celebrating something—requires more than willpower. It requires you to know yourself and your motivations, so that you can direct your choices in line with your goals.

Taking time to understand yourself, your habits, and your strengths will only boost your success with your weight-loss journey. 

When it comes to being successful with your weight loss, getting these three pillars right is critical. There is a good chance one or more of these pillars is not really that strong in your life, and that is fine. Awareness of the pillars and of your strengths and weaknesses is a good start. What you will see in this book, then, is a discussion of how you can prepare and proceed for success with all three pillars. So if you’re just starting out with any of the pillars, you’ll find suggestions to help you get started. And if you’re anxious about how to handle nutrition, exercise, or changes in your outlook post-surgery, you’ll find help with that, too.