I realized something this week after a patient came into clinic very depressed that she wasn't doing well enough, that she didn't feel like she was getting the support she needed, but, most forefront in her mind, she was depressed about the person she had left behind after her surgery.

We all go through some point in our life when we want to make oneself better - better at our job, as a parent, as a friend, better about taking care of oneself. We get so excited about what lies ahead - the prospects, the thought of dreams accomplished, that it is hard to believe that we would miss the part of oneself that was so unhappy with life and looking for a better shot at it. We anticipate how great life will be with a promotion or when we lose 50 pounds, but just because we worked hard for the promotion or the weight loss doesn't mean that the effort stops there. We must continue to work hard so that we continue to climb the ladder or just so that we don't get knocked off it. If you lose 60 pounds, you will feel great, you will be happier with the way you look, but you will have to monitor yourself hard and work to keep that weight off.

Yesterday, the patient discussed missing that person who didn't have to analyze food, and didn't have to think about exercise. She missed the person who could just eat and eat. This is an common stressor among post-op bariatric patients and/or in the human population in general, mostly because it is not something expected to happen to us when we set out to make a life altering decision. My patient described it as 'burying a friend'. That can be exactly what it feels like - that you have buried your best friend, but I challenged her to look at it a different way. Your best friend is always going to want what is in your best interest. Use that best friend to keep you focused on the journey ahead and pushing forward, the farther you get and more you keep going, the prouder your best friend is going to be of you. Don't let that buried best friend turn you around and head back down the path you just came up on - you can't bring that buried friend back to life, you can only sit at the grave site and mourn the time away.

For your sanity allow yourself to think about where you started, it will only help you to appreciate how far you have come. You made a life altering decision for a reason, don't let yourself get sideswiped into revoking a promise you made to yourself!