In addition to the risks during surgery, there are also lasting side effects after the procedure, such as an inability to absorb certain vitamins and minerals and an intolerance to specific foods. Finally, the surgeries are not a guarantee against future weight gain. Research from McGill University in Canada suggests that 20 percent to 35 percent of gastric bypass surgeries are considered failures because of weight regain after ten years. In a separate study published in the medical journal Obesity Surgery, 79 percent of patients who had undergone bariatric surgery reported weight regain--though only a third of them regained a significant amount. ("Significant" was defined as 15 percent of the weight they'd lost. For instance, if someone lost one hundred pounds and gained back fifteen or more pounds, it was considered significant.) Further research from Switzerland indicates that 40 percent to 45 percent of people fail to achieve sufficient weight loss two years after having the lap-band surgery partly because of complications. Let's talk about this process of discovery. Hopefully, a story from Oprah Winfrey can be helpful. She writes, "I realize now that even though I have had the kind of career that brings with it an element of power, versions of my childhood abuser continually showed up in my life disguised in other forms... I allowed abusers to cross boundaries rather than confronting them. My childhood history of physical and sexual abuse conditioned me to be silent... I pushed those feelings down with food" (2017, 126). She goes on to talk about her own aha moment. One day she was visiting her father. She'd already achieved immense success in her life, yet she found herself submissively taking orders from one of her past molesters for over-easy eggs. She was shocked by her speechlessness. "Looking back, this was a seminal moment for me. I reverted to the silence of my nine-year-old girl self, who thought that speaking up would cause me to be blamed... Making that connection feels like a light bulb has finally been switched on. Aha!

Not only have I broken open, I've broken through!" (2017, 126-127). It was in that moment that Oprah understood that she was still living by the survival strategy she'd used as a child--to be silent, to be invisible. All her popularity and the respect that she had in her world wasn't enough for her to stand her ground, to refuse her abuser. She recognized that her emotional freedom was still being held hostage by her past, and she could so clearly see the tentacles of her abuse still strangling her in the present. Not only was her strategy no longer needed or wanted, it now was hurtful to her. She could change it. But awareness had to come first. I hold to the rather old-fashioned belief that each of us is blessed with particular gifts given to us by God, and that it is our sacred obligation to identify, to cherish, and to exercise those gifts for the betterment of ourselves and of those in our lives. I believe that the more responsibility you exercise toward yourself, the more responsible you can become toward others. I believe that one of the greatest gifts you can offer the other people in your life is your authentic self, rather than your fictional self. From the authentic self flows a peace and clarity that can only benefit and enrich the lives of those you love. The process of reconnecting with your authentic self will be an incredible experience. Living in daily authentic congruence will yield a joy and freedom of indescribable proportion. An intention, from etymology again, is a plan, an aim, a direction of the mind towards a purpose, in-towards, tendere-stretch. It has more power and meaning than a goal. How many goals are set on New Year's Eve to fail on New Year's Day? Intentions have motivation and direction. Interesting is the comment from Marie Diamond that intentions are a healing process to heal the blockages and restrictions that have prevented you from achieving your intentions to date. Worth thinking about, don't you think? Goals can be something you move towards.

They exist in the realm of tomorrow. You sometimes associate being happy with the time when you have achieved a goal and disappointment when you haven't. Intentions are a focused journey that have faith to the level in creating a belief that it is already happening. Just like you did with gratitude, state intentions as if they are already in the present moment. The reason that anxiety and depression have such an impact on your body and mind is the brain does not register time. Imaginary or real, exist in the now. Today I will notice the many magical messages meant especially for me. I will know that the people, creatures, words or songs that cross my path were all meant to be met with my awareness. I will allow my life to tell me stories, to inspire and nourish me, and to guide me on my way. Today I will awaken to my life. I will raise my head and lift my eyes. I will refresh my spirit with each step I take, knowing that my life is as rich and bountiful as I make it. Knowing that gifts great and small tickle me for my attention in every moment. Today I choose to have magical eyes, and to experience my world anew. The two most common types of bariatric surgery are the adjustable gastric band (AGB), or lap band, and gastric bypass (also called Roux-en-Y gastric bypass, or RYGB). The point of AGB surgery is to shrink the normally football-sized stomach to the size of a golf ball by wrapping a silicone band around it, making it impossible to eat very much at any one sitting. However, with time, you can stretch the stomach, and if you're not careful, you can override the band, regaining weight. The second procedure, gastric bypass, involves connecting the stomach to the middle of the small intestine. (It normally attaches to the first of the three sections of the small intestine.) Food is typically broken down and absorbed at the beginning of the small bowel, so if you bypass a large portion of it, you reduce the number of calorie-containing nutrients (carbs, protein, fat, and alcohol) that the body can absorb. In addition, the stomach is sewn, leaving just a small pouch.

As with lap-band surgery, the stomach can stretch, so it's possible to undo the effects of this operation by overeating. However, because the procedure also helps limit calorie absorption, it's more effective than AGB. That's why gastric bypass makes up 80 percent of all bariatric surgeries. There is an even more drastic version of this operation, in which the stomach is connected even farther down the small intestine, so you absorb very little of your meals. That procedure, called biliopancreatic diversion with duodenal switch, is riskier and rarely performed. Often, when someone is ready to leave therapeutic treatment, they'll jokingly say something like, "Yay! I'm healed." Hopefully, they've discovered the beauty and freedom of being in the present moment and being their true self. That process is far from over, but they're sensing they're ready to fly on their own. They've broadened both their understanding and their skill set. Change, growth, and healing are processes--they're journeys, not destinations. Your vulnerabilities, whatever they are, will come around to haunt you every now and then, even after the good work you've done in this book or with a therapist. Situations will trigger old wounds. Irrationalities in your thinking will seep back in--maybe due to fatigue, maybe due to you not paying attention or catching yourself. It's not that healing never occurred or that your own previous insight and change wasn't real. But in your humanity, in your imperfection, you may tend to slip back into an old survival strategy. Even Oprah won't catch every time she falls into the pattern that she recognized in that light bulb moment. You must be very, very careful not to let others in your life dissuade you from your task. People truly do fear change, particularly when it involves their most personal lives and relationships. They may become especially frightened if what you are doing might involve requiring more from them. If the people closest to you get the idea that the "price of poker" is about to go up, that you are all of a sudden going to stop being the silent and obedient sheep and start expecting more from yourself and others, they may get threatened in a big way.

You can be sensitive to that and help them to a degree, but you must let them own and be responsible for their own feelings. This is about you; it is not about them. We are going to begin by demystifying your past and this concept of "self." Once we turn the floodlights on over your self-concept and put your past under the microscope, you are going to hear yourself saying, "Oh! Now I get it--now I see what has been driving my life. More importantly, I now see what I can do to let my authentic self take control!" If you're ready to begin this process of discovery, read on. So if an intention is the direction of the mind towards something then you have the freedom to decide what that is. Set your own intention. Be the director and leading part in your intention movie. Many people get stuck on wanting to know what their purpose is before they start to make intentions. Just start with something that makes you happy or feel good. Start with something small and attainable to build your faith, build your confidence. You would not start a marathon without any smaller intentions first. Maybe one mile. Before that learning and achieving a good running style would be helpful. Common sense really. The satellite navigation analogy has been used a lot to compare to life. It is a good one. You have to programme in where you are going or there will be no instruction available. Set your internal intention with its destination address. In other words, where you are going.