Hi, Christy.
It takes willpower. You've got that. Also, you've got experience as well as motivation.
The trouble with carbs, especially sugars, is they are almost like a drug of addiction. Once you give in without imposing any controls, you crave more. So you need to be strong with yourself and also have a really effective inner talk whenever you face situations that give you little alternative.
I have my own heirarchy of what I can allow myself to eat, in what order.
You've also discovered what I discovered - fast food is generally high carb as well as high fat. Even food that looks healthy will tend to have hidden carbs and/or hidden fats. It becomes a case of "cherchez le fats" or "cherchez le carbs".
I first discovered this when trying the Atkins diet about three to four years ago. I'd been on the diet for a week before I had to go out to see doctors, do shopping etc. I got hungry and was looking for something I could allow myself. I was on 30 g carbs daily, at the time. That's practically nothing.
Then I saw a health food shop/upmarket boutique which was selling rice paper rolls. They used soaked rice paper (like wonton sheets) to wrap up snow pea sprouts, some sliced cooked chicken breast, some bean sprouts and possibly some lettuce - couldn't tell through the rice paper, not in detail. The rice paper was carb but it was only a thin layer on the outside, surely it wouldn't contribute much...
So I bought one. It tasted good - but when I looked inside after I took a bite, I realised that inside, it must have been about 40% rice vermicelli - pure carbs! OK, that was my daily allowance of carbs, gone in one bite! On a healthy food item!
The Atkins diet taught me one very important bit of information - people who make and sell fast food are in the business of filling tummies at the lowest cost. This means they use MORE carbs than a healthy cook does at home. Carbs are cheap calories. Customers leave in general more satisfied, cravings filled. They'll be back.
I also learned - low-fat is bad for you because it's generally higher in simple sugars. If you must go low-fat, then read the nutrition labels very carefully and avoid anything with added sugars (or even higher natural sugars). it stands to reason - take out the fat from milk, for example, and another 4 mls out of every hundred mls gets added to make up the volume. That's 40 mls in a litre. And in tat 40 mls per litre, is 40 mls worth of extra lactose. That's why skim milk tastes sweeter. They haven't added anything; just taken out the fat. Which takes out volume. Which gets replaced by skim milk. You drink skim milk - your body gets a sugar hit form the lactose. No fat in it, to slow down the sugar absorption. WHAM! Straight to your pancreas, to pump out more insulin.
My current diet is more forgiving than Atkins. However, there are no simple carbs in it. Instead, all carbs have to be wholegrain. No potatoes, no sugar. Load in the fibre. No fat (as far as possible). Sauces permitted, within sensible range.
So, when eating out on the run and needing to grab a healthy meal - I have an exclusion list, in order of NEED TO AVOID.
Avoid, beginning with the highest need to run the other way, going down to "eat it if desperate":
AVOID:
1) Sugar (includes confectionery, sweetened drinks, fruit juice, smoothies)
2) Fruit (one piece allowed per day - so save your one piece for a time when you can really savour it)
3) Other carbs - a small amount of plain rice is the only exception. NO BREAD AT ALL WHEN OUT - again, one or two slices of wholegrain bread is the exception, with salad filling. NO BREAD ROLLS.
4) Fat - avoid the obvious stuff. Be aware that just about all meat available when you go out, has been deep-fried. If you must eat something, go for a serve of lean meat on its own and make sure it's well-drained.
This list leaves very little remaining, that you can eat when away from home.
So here are some options:
YOU CAN EAT:
1) sushi. Try to go for ones with less rice, more other stuff. My preferred sushi is sashimi salmon wrapped around rice, and topped with roe. I eat two small pieces and make that last. Also on the list - MY sushi place does a rice paper roll which IS NOT stuffed with rice vermicelli. Good stuff, right through - sprouts, lettuce, lean protein.
2) salad - but buy your own, from a greengrocer. Avoid buying salad from a fast food shop - they try to sneak in carbs or fat into their salads to bulk them out and have you coming back for more. Have a close look at these salads next time you're out and about. Salads in shops are carefully layered. The seafood salads are made with a lot of shredded lettuce underneath, seafood extender mixed through and a few yummy looking prawns (large shrimp) arranged apparently haphazardly on the top. Greek salads - often made with cows' milk feta (not the traditional goat or sheep cheese), lots of lettuce (not very traditional) and olives (not often the good Kalamata olives) again carefully arranged, with the feta, to disguise the lack of anything substantial. A caesar salad - it barely qualifies as a salad. It's certainly not healthy. You can make a healthier one yourself, but avoid the bacon and the croutons. even the anchovies are greasy. Take all that out, and all that is left is lettuce. And maybe an egg.
So buy your own fresh greens and make up your own salad.
3) Lean low-fat protein - a bag of prawns, fresh from the fish shop. Eat immediately. Trouble is, they often ned peeling, which if you're on the tun, you haven't got time for. So other options - Indian. Chicken tikka. Whole chicken thigh fillets, marinated in spices and yogurt, oven-baked. Grab a handful of serviettes to clean up, because the spice stains your fingers. Or there are chicken kebabs - thigh fillets again, threaded onto a skewer, rolled in flour and deep-fried. Not great, but much healthier than most apparently healthy options.
Grab just the meat, ask for NO RICE. They will only give you a very small serve (because usually when you get takeaway Asian, they pad it out with a lot more rice tan you realise). Get into the habit of being satisfied with less, because if you take out the volume of the rice, you're still getting a great deal of nutrition in just the meat. If you still feel empty, have a big drink of water to make up the volume, because you have now eaten enough to stop you from passing out with hunger, you don't need to eat any more.
An interesting trick to teach yourself what is safe to eat and what is not - wear lipstick. A good, all-day one. If you need to re-apply your lipstick completely, after eating then what you just ate was far too greasy. Remember, for next time.
So, the fast version of the above list - no sugar. No fat. Nothing with bread rolls. Only wholegrain. No serves of rice with anything you order. Drink water. Eat less by volume.
But you're craving the taste of sugar? OK, this makes sense, especially with your diabetes. You CAN turn this around.
First, think about how your mouth feels and tastes, about half an hour AFTER you've had sugar (or bread, or rice, or other carbs). You know that sour taste you get? Often it's what drives you to reach for another sweet, or another sandwich. You associate that taste with being hungry, but you're not. That taste is the hangover from your LAST carb hit; a trace amount stays in your mouth (hence tooth decay) and a combination of your saliva and friendly bacteria partly digest the sugar, and the resultant compound has that sour taste. It ALWAYS happens. Even cleaning your teeth cannot totally prevent it. We might reach for a mint to get rid of the sour taste - but the mint so often is also made with sugar, and it happens again! It takes almost no sugar, to cause this effect.
You did well before, because when you stopped eating carbs in quantity (especially sugar) this taste was gone. You then felt no need to eat more sugar, you had no reminder. But begin eating sugar, and tis turns into craving.
There is a way. Look for artificially sweetened sweet things to give you a taste of something sweet, without the sour after-taste. You may need to experiment, because some still give you the sour taste.
One that does not, is Isomalt. It tastes exactly like sugar, because chemically, it IS sugar. BUT - it is an isomer, a mirror image of the sugar molecule. Because sugar is a more complex molecule than, say, water, your body doesn't recognise the mirror image. You can taste it, but your body can't use it. The saliva in your mouth can't begin to digest it and neither can the bacteria. You can leave a pile of Isomalt lying around and ants won't recognise it.
It has a cost, though - if your body doesn't recognise it, it will go right through you. In small amounts this is not a problem. But if you pig out and eat half a packet, the Isomalt concentration in your GI tract will drag water along with it, and you will find that you've got gripy wind and diarrhoea. It's not a sensitivity reaction or anything nasty - it's purely osmosis in action. Go easy on the sweets and you'll be fine. Ration them.
But Isomalt sweets do not leave that sour taste in your mouth half an hour later. Nor do they contribute to tooth decay, or aggravate your diabetes, or anything else.
I grab about three or four, and put them in my pocket. I make those last until my next meal, and haven't had a problem. Mind you, I did have problems before, until I realised why I had bellyaches!
The packets do come with a warning "excess consumption can have a laxative effect" but tat is why.
Now you've had a chemistry lesson as well as a lesson in nutrition.
My gastroenterologist did talk about lap band surgery with me; he said I wasn't a candidate. He also said it's not pleasant and is not a way out to avoid willpower - you need even more willpower with lap band surgery. But he did put me on diet pills. We talked about it, so I had some say in what he gave me. I'm on the ones which stop your body going into famine mode when you diet. They're also supposed to curb your appetite, but I am still hungry all the time. However, I keep telling myself I'm not needing to eat as much as my eyes tell me I want. I am not about to fade away to a shadow! So I cook a lot, try to make sure it's healthy, and try to make sure there are other people to feed. If what I've cooked is healthy, I can eat a serve of it too. When everyone else has white rice with their meal, I eat brown rice. I cook up a batch of brown rice and keep it, cooked, in the fridge for a few days. I reheat my serve of rice in the microwave separately.
The other thing I've had to do - is do all this with medical supervision. My GP and my gastroenterologist are working as a team. That way, when people try to sabotage me, I can point to my doctors and say, "go argue with them about it."
And people DO sabotage! It is amazing to discover who does it to you, and how, and you then wonder why. The saboteurs are the ones who keep offering you cake & biscuits, who pile food on your plate (especially food you shouldn't have), who keep telling you how pale or sick you look, what a terrible colour you have. Saboteurs will also discourage you from exercising, or tell you it's your fault when you come home tired, or with aching muscles.
Ignore them. Ask your doctor if you're not sure if you're overdoing things.
I've been enjoying being able to breathe better especially at night; not having that horrible pinching sensation in my middle, which I suspect was my liver getting pinched between my rib cage and my abdominal muscles; enjoying good skin and hair; enjoying being able to almost read the scales without having to lift bits of my body out of the way.
The first three, I had within two weeks.
And for exercise - we bought Wii Fit. I've posted separately about that. It's great, it involves the whole family in getting fit and healthy, it's a lot of fun too.
I'm looking better, I'm feeling better, I'm hoping I can keep most of this off when my diet pills are stopped in six weeks' time. That's when my specialist orders more tests and we discover if I've been successful in turning around diabetes and liver damage.
Good luck!
Marg