Tracey, 32, has struggled with weight her entire life. After years of trying every diet, she opted for gastric bypass surgery when she was 27. Two years later, Tracey had shed 200 pounds and was on cloud nine. "I was at a high when I was down at 176 pounds," she recalls. "It's like living on a cloud - I could do no wrong and it felt great!"

However, Tracey's happiness started to disappear as the lost weight started to reappear. Little by little, she tested her body to see if it could handle many of the unhealthy foods that led to her initial high weight. Having gained back 100 of the pounds she had lost, Tracey's attitude has hit a new low. "I’m sad, I’m depressed," she says. "I’m very frustrated with myself. I get down a lot ... I cry a lot."

Tracey's story is not an isolated one, according to Dr. Michael Dow of TLC’s Freaky Eaters. "Almost half the people who have gastric bypass are unsuccessful in maintaining the changes in diet and exercise that are recommended," he says, adding that perhaps emotional triggers that aren't fixed by gastric bypass could result in weight gain. "If you’re going through something like a breakup and you haven’t figured out what you are going to replace [using food] in your life, whether it's strengthening your relationships or being really adamant about the gym and nutrition, the weight will come back on quickly." Tracey admits that she did use food to relieve the stress of a big event in her life. "I had moved from upstate New York to Florida," she explains. "So I had moved 1,200 miles away from my family, and to nothing - I didn’t have a job. And food was a comfort."

Dr. Dow's approach to Tracey's situation was to have her create a bucket list of thin, a list of the things she would do if she felt happy and had the health and the body that she wanted. "The most important thing," Tracey reveals, "is that I want to be able to spend more time with my nephews. I have two little nephews. I want to be able to chase them around a theme park, I want to be in pictures with them. It’s very hard to be in the picture when you don’t want people to see you."

"It is so much more about what you add to your life rather than what you take away," Dr. Dow adds. "Serotonin and dopamine are released when you eat sugar, carbohydrates and high fat. Tracey can’t have those foods hardly at all anymore, so what are the things that you are going to add to your life so you’re still going to be feeling good? Ironically, the more you focus on those things, the easier it will be to lose weight."

Dr. Dow recommends that anyone considering gastric bypass surgery should make sure they have support. "Before you go into the physician's office and they’re going to cut you open, go to a free 12-step Overeaters Anonymous meeting or go see a therapist for at least eight sessions so you can figure out and prepare yourself," he says. "So you can ask yourself, 'Is this the right decision for me? What are the things that I need to be aware of, and what changes emotionally am I going to have to make and how do I sustain them?'”

In addition to the advice from Dr. Dow, Rachael gives Tracey a year membership at Curves Health Clubs and Fitness Centers to help get motivated. "I need to do this for my life, my health," Tracey firmly states. "I want to live a long time. I don’t want to be heavy anymore."

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