Wednesday, December 14, 2011

Essentially Recovered...

This week, the topic for the new group I am attending for my personal recovery was to answer this question.

"I will know I am essential recovered when..."

It is a difficult question to answer. My answer was simple, "Every day I am in recovery. Every day I must eat, every day I must make choices.  Some days I make poor choices, which means I have relapsed."

Now, I'm not talking about the tiny taste of a piece of fudge that I've wanted for the past few weeks due to all the holiday sweet treats that until today I had successfully passed by with ease.  I have had peanut butter fudge on the brain for a while now though.  I've wanted to make it, but I knew I'd eat the whole pan.  Unfortunately, today at work there was a tray of chocolate fudge, peanut butter fudge, and toffee on the table.  I passed by it several times, and then decided to take a sliver of toffee no more than 1/2" inch by an inch, took a bite and spit it out.  It was quite possibly the worse toffee I've had, nothing like what I could make.  Later, I decided I would taste the peanut butter fudge.  Again, I took the smallest of pieces, tasted a quarter of it enough to know it was not as good as I could make, and spit it out.  Neither experience produced the perceived outcome of sugary pleasure I sought, but I did not deny myself the experience. The experience turned out to be unsatisfying. I don't regret it, I just won't let temptation get the best of me again anytime soon.

I will always be a recovering food addict though.  I've learned to stop myself insomuch that I will not indulge in something that does not speak to the foodie in me, but I still struggle with my food addictions.  I obsess over recipes on the internet, I admit to my love of food.  I have broken my addiction to the Food Network, in fact, the channel is blocked on my TV.  Parental controls are not just for parents.  Sometimes, we have to put measures in place to save us from ourselves.  I have established certain boundaries to avoid situations where I will be tempted.  I try never to go to Sam's Club on Saturdays, as I prefer not to be tempted by the sampling stations.  Luckily, I have a business membership and go between 7am and 10am before these people have set up their enabling little booths of temptation.

So, I will know I am essentially recovered when I am not obsessed with food?  Doubt that will ever happen.  I have found I am obsessed with these questions, "Have I gotten all my protein today?  What did I eat that caused this acid reflux tonight?  Did I get enough water today?"  While these are healthy questions to be asking myself, I still have to think about the addiction daily.  I still have to eat and account for everything I put into my body.  I still am an addict, the difference is that my addiction is to something that I must have to sustain life.  The only viable answer I have heard has been that the addiction is to sugar, fat and carbohydrates.  Those are the types of foods I craved.

If I had to really narrow it down, maybe the true answer is, "I know I am essentially recovered when I don't want ice cream."  Then, I'll really know the paradigm shift has occurred in my brain and I am no longer an addict. However, I doubt that will happen... Greek yogurt has been a great replacement, but my addiction for gelato will never truly be cured.  I have vowed to treat myself to a small gelato when I have been compliant with my healthy eating behaviors and exercise routine, once a month (on the 3rd.)  It's a small, measurable trade-off to indulge in while still keeping with my commitment to better health.

Monday, December 5, 2011

Letting Go

Tonight, I attended a support group held weekly that I had never been to before.  The topic of tonight's discussion was "Letting Go."  A topic I've often discussed with clients and worked through myself, but tonight, I admitted to myself that I had let go of many toxic relationships.  Of course, the one relationship in particular was my relationship with the person who supported and encouraged me to have surgery.  It was difficult for me to do this, but I let go of this relationship not that long ago.  Within the last year, I finally made the decision that I had held onto the friendship too long.  It was time, way past time, actually.

This person had supported toxic behaviors, despite being supportive of my decision, it was just not a good situation.  I wanted to hold on because we went through Katrina together, we cared about (and once loved each other,) we could remain friends... in the end, I saw we are better off not communicating it was truly me that had held on when this person had left the friendship long before I made the decision to end it.

This question made me think about what else I hold on to that isn't healthy.  Coincidentally, around the same time I let go of this relationship, I also let go of a very toxic job.  A job that had me regaining the weight I'd lost in the first two years post-op.  Now that I'm back in the mental health field working on my LPC license and certification in bariatric counseling, I recognized that stress in my life came in the form of pounds.  There is so much I have let go, but also, so much that I have found I am more assertive about that is TRULY IMPORTANT.

Before surgery, I was overly concerned with many things that did not matter.  Now, I am truly finding what matters to me and what I am worth.  I am worth the time and energy it takes to keep in touch.  I keep in touch with my true friends now, I make the time to see them, I don't make excuses because I am embarrassed about the size of my waistline.  I don't worry about what people think of me with regard to my fatness, but rather I worry about whether I am acting in a way that is befitting to my profession.  I am living my personal life in a way that I am proud of my behavior at all times?

I ask myself this often.  I am making the good choices I want my clients to make?  Am I eating the way a post-op should eat?  If the answer is not yes, then I am not doing what I need to do to be mentally well and capable of counseling post-ops.  This is a major reason for my personal decision to not drink alcohol any longer.  I have removed it from my social interactions as a way to truly, genuinely act as myself and not be under the influence of anything other than my own mind.  I have let go of toxicity in my social life, and I am making meaningful relationships and connections without allowing social anxieties to creep in.  I am comfortable with myself and with others.

I won't judge those who do drink responsibly.  I won't judge those who are not able to drink responsibly.  I understand the nature of addictions, and I realize we are all in our own place, at our own time, and must get to where we need to be in order to find what we consider healthy.  However, if I see someone endangering themselves, I will address this as gently as I can.  I am concerned, but I do not want to offend anyone.  My decisions are for me, and your decisions are for you.  We are all our own people.

Weight loss surgery does not change who you are, but it will change how you view yourself.  You will find yourself in ways you never imagined.  I remember feeling my hipbone for the first time.  Yes, the very first time, I'd been overweight all of my life, that hipbone had last been that close to my epidermis when I was 5.  I have also found that I am assertive in my behaviors where it counts.  Once upon a time, I was extroverted and confident because I didn't care what people thought about me as an obese woman. Now, I am extroverted and confident because I care about others and want to help anyone who needs it.

I have let go of shame.  I have let go of judgment.  I have let go of my arrogance about obesity.  It is a health problem, it is not an aesthetic problem. Some of us are simply just genetically pre-disposed to obesity, the disease.  Fight the disease, not the person.  Find yourself, let go of the rest.  Find peace and love for you and all of those around you.  Love yourself the way you are but work toward a better you.

Wednesday, November 30, 2011

You are in control

I don't care how you cut it, you are always in control.

Mind over matter, we can each choose how we respond to stimuli every single day.  As a counselor, I see it every day, people living up to the labels which are placed on them.  People giving in and not thinking about their actions, people using a stigma to justify their behaviors rather than thinking through the decisions and not acting on impulse.

I admit, I do it myself too.  Sometimes, I just don't want to think about what I put in my body.  Sometimes, I just want to go out and order something I know I shouldn't or even can't eat.  I've gotten better though, I might not be 100% well at doing it right all the time, but I'm working at 99%.  I mean that with diet and exercise, I am working on giving it 99%. If we always work on giving in 99%, that means we're only messing it up 3.56 days per year.  If 3.56 days per year, you're doing it right, you've got nothing to worry about.

A friend of mine has a very simple saying that comes to mind every time I am presented with potentially making a bad choice. I hear it in my head in his voice, so this makes it particularly meaningful, "Girl, we all know right from wrong, chose right!" Chose right means to me that while I'm in the grocery store, I don't let my eyes spend more than 2 seconds on a potential pantry hazard. Pantry hazards are the things I throw away when I do my pantry purge. These items include, but are not limited to: potato chips, cookies, snack cakes*, and pretty much anything that has empty calories I never should have bought in the first place.

I must admit, over the last 3 years of my life I have been able to minimize the amount of hazardous waste products I bring in from the grocery store, but there's always room to improve. That's a monetary savings right there. $3.50 for a bag of chips over $2.50 for a bag of apples is a savings. It's the effort it takes to peel, core and eat the apple that often gets in the way. I hate to see anything go to waste, the pantry hazards just appear to linger longer. A few things sneak into the house here and there, and I'm always glad when I purge the pantry to see that I'm not throwing away an empty bag. Most often, it wasn't something I purchase for myself anyway.

I do my best to exhibit self control in my grocery shopping trips by always having a list. Last week, I successful went down the chip aisle, analyzed all my salty snack cravings, and passed the opportunity on each to make a bad decision. It was pretty rewarding to see myself make it down the aisle, assess my primary trigger foods (Golden Flake Cheese Puffs & Zapp's Spicy Tomato Chips, I'm looking at you) and gleefully walking away from those and others without looking back, until now. The moment that I did it though, I felt no desire to ruin all I'd worked hard for. I realized I was in control and I could not be tempted.

It's a constant battle though. It's a battle that we can always win when we're in control of our thoughts to assess our impulses and emotional triggers. Just keep fighting the urge to "do bad" and you'll always win.

Wednesday, November 23, 2011

Digging Deeper, Finding Wellness/Balance

The journey to have weight loss surgery is often a long one.  A number of failed diets over many years, regained pounds multiplied by stress and life, feelings of hopelessness, years of depression, and hopefully, an acceptance that therapy may play a role in helping you understand where the urge to overeat comes from- what is it within you that has caused weight gain?

For each of us, it's different yet often similar experiences that brought us to armor ourselves with adipose tissue.  The gain did not occur overnight, it was gradual and the emotions behind it were deeply rooted.  Often, when the pressures of life were out of hand, be it harshly judging parents, poor parenting, trust issues, lack of self esteem, uncertainty, or traumatic events, we turned to food.  It was reliable, it made us feel good.  I can't depend on you, but I can depend on this Snickers to soothe me.

What do you do when food can no longer soothe?  It's not uncommon to have transfer addictions post weight loss surgery.  We may well "commit to our physician's requirements for the first year" but it seems like after that they just become mere suggestions for some.  Bad habits creep back in, new bad habits develop, or some become overly obsessed with calorie counting, exercise and watching the scale like a hawk.  Introducing the dangers of alcohol and drugs to the weight loss surgery after life bring up a host of issues.  Often the stomach, be it banded, pouched, or sleeved, your weight and body is no longer what it used to be.  If you've also developed the habit of drinking fast and go out on an empty stomach, there's possibility that it won't be too long that you've blacked out and done something you'll regret.

You may drink to feel better, to socialize, to meet new people.  You're receiving attention you may or may not be comfortable with, you may find a new side to yourself.  Realize, exploring your new self sober is the best way to gain knowledge of your true self.  If you are suddenly getting a lot of attention from the opposite sex, be cautious about your involvement.  Develop an understanding of what you will and will not put up with and have respect for yourself.  The repercussions of only one one night stand can have an impact on the rest of your life.  Take responsibility for your actions before they happen.


I'm repeating that because it's applicable to every aspect of this journey.  It's as simple as having a plan when you dine out, to having a plan when you go to a bar, to knowing what your expectations are from the opposite sex, down to engaging in healthy, positive behaviors at all times.

Now, let's talk about the extremes of post-op behavior - that seem healthy, but are actually extreme, obsessive-compulsive actions that could be counter productive to your overall wellness.  What is reasonable when it comes to dieting and exercise?  1-2 hours?  You be your own gauge, but if you've developed a leniency toward exercise bulimia, or you find yourself obsessing over calorie counting for months at a time, then you binge on something ridiculous, you're going to extremes.  BALANCE IS KEY.

Again, BALANCE IS KEY.   Daily exercise for 30 minutes is a reasonable, bare minimum.  Excessive exercise for weeks on in without giving the body a break is extreme.  Consider resting yourself 1-2 days a week.  I use the rule of exercise 4 days a week for 1 hour or 5 days a week for 1/2 hour. This is my balance.  Prior to surgery, I went through extreme periods of exercise bulimia where I worked out every single day at 5:45am, came home from work and repeated this process, but still I did not have the balance in my eating habits.  I was working out so much that I built up more *head* hunger, that I felt it was okay to binge in the evenings.  That went on for a period of two years before I realized my self defeating behavior.

Then I found balance.  I used my formula of 4/1 or 5/.5 and I ate reasonably.  My body plateaued for 4 years at or around 265.  It resisted change.  I fought for change, and my body had a mind of its own.  I looked at whether or not I was having "food amnesia," I went to therapy to deal with my issues, and still, I fought the scale and the scale won.  It took me 10 years to make the decision that I had tried everything, I had done all I could, I needed something more to help me through to healthiness.

Now, I live an alcohol and drug free life.  All drugs, I no longer take any medication for anything.  Nothing for anxiety, depression, mood.  I have developed positive self talk, improved self esteem, and appreciation for the gift of weight loss surgery.  I have accepted my body for what it wants to be, where it wants to be, and though I would like to be down to this or that weight, I realize that scale doesn't matter.  What matters is how I feel every single day about my successes.  The journey includes the successes and the mistakes.  We all will make mistakes in this journey.  What mistakes are we willing to change, or how have our behaviors contributed to the problem, and where are we unwilling to compromise?  This is about that.  What are you willing to give up?  Where can you find a balance between what you want and what you need?

You don't have to spend thousands of dollars on therapy. (However, if it's covered by your insurance, do it.  Some of us aren't so lucky!) You just have to reflect on the mistakes you've made and understand how you can apply yourself to do better. Each and every day, make conscious, mindful decisions about what you put into your body, what you get out of each day, and how you live your new life.  Are you counting your blessings?  Are you thankful for what you've received?  I am.

I am thankful for sobriety. The other day a good friend and personal trainer I know asked me, "So, you've given up everything?  No vices?  You won't even have a drink with us?"  I simply responded, "Yes."  I have given up everything.  No, I won't have a drink with you tonight.  But yes, I will have a drink with you in the future.  My balance is simply to understand where and when indulging in something is appropriate, meaningful and deserved, not just because it's Friday night.  I don't need alcohol to relax and have a good time.  I enjoy the company of friends without it.  If they are uncomfortable with my sobriety, that's their problem, not mine.

Several years ago, these words would not have come from me.  I've grown and prospered so much, and for that, I am thankful.

Sunday, November 20, 2011

Bariatric Breakthrough Challenge comes to Slidell!!!

Join the Bariatric Breakthrough Challenge! DECEMBER 3rd in Slidell!!! 


The Bariatric Guru™ Announces the Team for the Bariatric Breakthrough Challenge Conference Series!

MobileAL- Erin and Ben Akey and the entire Bariatric Guru™ Team are excited to announce the speakers for their upcoming nationwide conference series, The Bariatric Breakthrough Challenge.  Over the next twelve months, this series will be presented at twenty-five to thirty bariatric centers throughout the country and is sponsored by Bariatric Advantage.

The Bariatric Breakthrough Challenge is a motivating, inspiring, and lively educational program for post-operative bariatric patients. It’s an eight-hour educational seminar focusing on the lifestyle challenges and changes following bariatric surgery. The Bariatric Breakthrough Challenge educates, encourages, and motivates participants toward permanent lifestyle change and success.

The conference will feature both live and interactive video presentations by several leaders in the bariatric community.  Each attendee will leave feeling motivated, refocused, and inspired to move forward no matter where they are along their weight loss journey.
   Erin Akey- “The Bariatric Guru,” Host of “Fit Living” radio show which airs on Sundays from noon-1p.m. central on FM TALK 106.5 out of MobileAL and streams live online all over the world. Erin has used her post-op life to become a Certified Fitness Nutrition Coach, Certified Water Fitness Instructor, and also a Certified Lifestyle and Weight Management Specialist.  Erin is the founder and hostess of the Bariatric Breakthrough Challenge and will lead several sessions

    Ben Akey- “The Guru Chef,” Ben is the Co-founder of the Bariatric Guru and also the Director of Programming and Marketing.  Through his experiences as the support person of a bariatric patient and his fifteen years experience in the medical community, Ben has developed Support from the Kitchen and will lead this session. Ben is also the producer of the “Fit Living” radio show.

    Antonia Namnath- Founder and CEO of the WLSFA (Weight Loss Surgery Foundation of America).  Antonia is a WLS patient who took her passion and created an amazing charity that helps those who do not have the luxury of insurance coverage for WLS or the funds to pay out- of- pocket.  The WLSFA grants the life-saving gift of WLS to those who truly need it.  Antonia will introduce this great organization during the session on Paying it Forward which is all about learning to give back to our community.  The WLSFA is the primary charity of the Bariatric Breakthrough Challenge.

  Connie Stapleton, Ph.D.- Dr. Stapleton is a licensed psychologist who works extensively in the field of bariatrics.  Dr. Stapleton speaks nationally and internationally about recovering from obesity.  She is the author of Eat It Up! The Complete Mind/Body/Spirit Guide to a Full Life After Weight Loss Surgery and Get the Weight Off? Or Keep It Off.   Connie is the “Doc” in Post Op and a Doc.  Connie will lead the interactive video session on Mind/Body Synchronization and dealing with food addiction, relationship issues, and body image.  She will also be offering a CEU program to go along with the conference for healthcare professionals.

  Cari De La Cruz- The “Post-Op” in Post-Op and a Doc, motivational speaker, and ardent obesity awareness advocate.  Cari is the author of the popular blog Bariatric Afterlife™ and uses her humor and passion to help others achieve success and freedom from their food addictions.  Along with Dr. Stapleton, Cari will lead the interactive video session on Mind/Body Synchronization and dealing with food addictions.

  Dr Jacqueline Jacques – Dr. Jacques is the Chief Science Officer of Bariatric Advantage, a company dedicated to providing the best in nutrition, education and services to bariatric professionals and patients.  She has spent the past decade of her life working solely in the area of bariatric nutrition.  She is also author of the book Micronutrition for the Weight Loss Surgery Patient available through Matrix Medical Communications. She will lead the video segment on the importance of supplementation for post-op bariatric patients.

Erin is excited about this great line-up and the value each member brings with their own unique perspective and expertise. “I am so excited to have all of these wonderful people involved in the Challenge series.  I consider it a blessing to be associated with each of them and know the attendees are going to be enriched by what each brings to the table.  They cover a wide range of topics.  The events are going to be fun and you will have different speakers from the group live at each event along with me and Ben,” says Akey.

FOR MORE INFORMATION or for sponsorship opportunities, PLEASE or visit
or contact: Ben Akey at 251 709 9002. 
To schedule a Challenge at your center, please email

Thursday, November 3, 2011

How anxiety and stress effect the bariatric patient

Our bodies bare the impact of the stress in our lives.  How'd you get fat?  You used food to comfort you, most likely, when life seemed to get our of hand.  It's not uncommon for stress to originate in our core, and your stomach/pouch is affected just as it was before you had surgery.  Every felt sick to your stomach in a situation that induced stress and anxiety?  Uncontrollable elements of our lives often present themselves, and our ability to cope with these stressful situations in a constructively focused and positive way can help us to maintain weight loss.

Stress effects our whole self, body, mood and behavior.  Recognize the symptoms on the body: headaches, memory problems, constant worry, muscle tension, pain, diarrhea or constipation, tightness in the chest, rapid heart beat, upset stomach, sleep issues, and change in sex drive are common. Your mood can be effected by experiencing anxiety, sense of being overwhelmed, lack of focus and motivation, irritability, anger, depression, sadness, and restlessness.  Changes in behavior are commonly seen in angry outbursts, eating patterns, drug and alcohol use, tobacco use, marijuana use or abuse of prescription drugs, and social withdrawal.

Each person has unique internal and external stress triggers.  External factors are generally life events out of our control, involve other people or elements of uncertainty, can be related to work, home, relationships, financial factors, children, family, overextending yourself, or caring for ailing loved ones.  Internal factors are how we cope with the external situations, negative self talk, unrealistic expectations (of self or others), inability to accept uncertainty, perfectionism, and lack of assertiveness.  Building your positive internal dialogue, having self confidence, and a sense of well-being can help you to achieve a better outlook.

Learning steps to manage your stress symptoms and having a reliable support structure in your life can help you understand and recognize these symptoms.  Your ability to tolerate stress symptoms can be maximized when you have a solid support structure to turn to in times of need.  If you isolate yourself from others, you become more vulnerable to the negative impacts of stress.  Regain control of your environment.  Have you forgotten the rules your surgeon gave you in the educational seminars you went to?  Take another educational class, such at the Bariatric Guru's Breakthrough Challenge, find a qualified mental health professional for therapy, find a friend who can meet with you regularly to check in and participate in a healthy activity with you.

Address your emotions in a positive way through intensive therapy, working through your anger about how others now see the "new you" is part of the overall process.  You've probably gained a lot of confidence in how you look, but have you address how you feel about society's views of obese persons?  Some people internalize this anger, ignore it, and then implode with negative feelings and emotions toward their friends and loved ones for recognizing their success.  The internal backlash of positive attention are sometimes reflected in self-defeating behaviors, such as eating foods that are not the most healthy choices or drinking alcohol just because you can.  You know it's not good for you, but you do it anyway even though your surgeon told you not to (for the first year, but realize, you've changed your insides - you must take control of your actions and not stress your system by using alcohol in excess = alcohol in excess = lowered inhibitions = ability to eat more = negative thoughts and feelings about yourself, and possibly, engaging in activities you wouldn't normally engage in with possible regrets.)

Examine your outlook on life.  Congratulate yourself on the success you have had in the past, and prepare yourself for success in the future.  Having an optimistic attitude will improve your overall sense of self so that you can embrace the challenges ahead and take the bull by the horns.  You ultimately have control of your life and you CAN make the changes necessary to be successful again.  Deal with the negativity by facing it, participate in activities such as yoga, pilates, or tai chi that can help you to refocus your energy in your core. Find activities that soothe you that do not involve food.  Read or listen to books on tape, education and entertain yourself so that you are not thinking about the addictive substance: food.

Plan your mealtimes and feel confident about being prepared for social situations.  If you know a certain group of friends will want to dine out, plan ahead!  Check out the restaurant, or carefully peruse the menu when you arrive to find smaller plates of healthy options.  Eating out can sometimes invoke anxiety in post-operative bariatric patients.  Get into the healthy habit of sharing.  Don't be shy about ordering an appetizer or soup for an entree.  Ignore the funny looks or odd questions you might get from wait staff when you ask for a glass of ice and soup as an entree, or politely tell them, "Yes, that is ALL I'll be having this evening, thank you."

Analyze the situation, assess the positive, find hope and handle the stressful situation with grace, kindness and compassion.  Recovery from addiction, and yes, this is a life-long journey in the recovery from food addiction, will always be a part of who you are.  You will have times where you want to eat the whole bowl of potato salad this is seven year old me, stating to my mom if I didn't have a granny or a momma, that's what I'd do... Now, I don't eat it because I love myself and I want to be happy, healthy, and confident I can be mentally strong each day in my recovery.  We all have our story, we all should be heard, and we should all love ourselves enough to recognize when our stress and anxiety levels have gotten out of control.  Reach out to those who are there to hold you up, and keep moving forward with a healthy, happy heart.

Friday, October 28, 2011

Ethics and Professionality in Bariatric Counseling

In the counseling profession, the code of ethics and responsibilities we have to keep confidentiality is a crucial element of our practice.  It's not an option, if we have a client who comes to see us, initially, we must explain to them what our code of ethics and our responsibility to them as a client is in the scope of confidentiality. 

What does all of that mean?

Simply put, if you are my client and I am seeing you in a therapeutic role and thereafter, I will always have an ethical obligation to you to minimize our contact outside of the counseling session, not disclose personal information about you as a client to anyone who you have not given me permission to discuss your case, and to always explain to you my position and role in and outside of the counseling session. Basically, if I see you at the grocery store, gym, church, school, etc, I will purposely avoid you.  If you say hello to me, I will say hello back and go about my business as I would had you not seen me.  I care about you enough to pretend to not know you to protect your privacy and not have any of your private issues potentially be discussed outside of the protected counseling environment.

I will always be upfront with my clients about my personal experience with bariatric surgery.  I cannot ethically, work in this field without telling my clients that I am a bariatric surgery patient.  My experience is not the same as other weight loss surgery patients' experiences.  I recognize and acknowledge that we all have our own reasons as to why we choose weight loss surgery as an assistive tool for us to lose weight. 
Some have major medical issues, others are preemptively electing to have surgery to prevent potential medical issues in the future.  I consider myself as part of the latter group that was anticipating that my health would decline in the long run due to excess weight.  I know that many clients are already suffering from painful, major medical issues and their reasoning behind their choice to undergo surgery maybe different from my own.

I will never use my role as a counselor to seek out my needs as a weight loss surgery patient.  I am in this field because I see a dire need for bariatric counseling in the process of long term after care.  Losing weight will not solve all of life's problems.  More often than not, the new issues are going to be challenging, changing and identifying of underlying problems that may not have been observed by "the cloak."  The cloak is all of the things we've hidden from addressing throughout our lives about what's bothering us on the inside.  What was it that made us turn to food in the first place.  How did we ignore or fail to understand our body's needs and limits?  Our internal ability to find satiation was skewed in some way.  Again, we are all different, each person is an individual and gaining this insight and understanding is crucial for adopting permanent healthy habits. 

Understanding the weight loss surgery community, online communications, and confidentiality, I will never identify in discuss a single person's experience or relay information regarding that person that could impact their life.  First and foremost, I do no harm.  I will never engage in, take sides with or include myself in the conversations that occur regarding a person's situation and/or the choices they make.  Quite frankly, I will acknowledge that talking amongst each other occurs, but as a counselor, I respect the privacy of others.  If someone seeks out help from me, they can be assured that I will take their trust in me seriously and apply my ethical standards to their confidence in me, no matter they be a paying client or an online contact asking for my help.  The only time I would ever breach confidentiality is if the person made me aware of their intention to harm themselves or someone else.  In taking any action, I will make that person aware of my duties prior to doing so and specifically know what that action is I must ethically take.

Also, as a counselor intern in the State of Louisiana, I cannot treat people who reside out of my state.  The practice of counseling must occur in the state, therefore unless I have established a face to face relationship with a client in the State of Louisiana, I will not work with a client through video conferencing mediums.  In email, I am limited in my ability to help and assist clients with their problems.  I will not offer advice but rather ask you how you can change your current situation or what it is you could do to move toward the progress you seek that you are not currently finding.  If I have the resources for professional mental health practitioners in your area, I will refer you to those resources.

This post is meant to be a documentation and clarification for everyone who I have met, become friends with, and come to know in the bariatric community.  It takes a long time to build confidence and rapport in a community. As a counselor intern in the mental health field, I want to establish clear and concise guidelines that show my clients and colleagues that I am aware of my role and responsibility to this community.   I may be seen as a newbie, but counseling is nothing new to me.  We are always learning, and we learn by doing.