Thursday, November 22, 2012

Learned Helplessness

The term is often used in psychology to describe exposure to an unfortunate circumstances that evolved into one's inability to cope with adversity and unwillingness to see solutions present to change one's own situation.

The number one most important thing to learn is self control.  Absolutely everything in our lives and our ability to accomplish anything is the ability to control one's self.  Be it for managing your time, your money, your behaviors. You must ask yourself:

What do I want? How can I get it? Who can help me? 
When will I accomplish this goal? What will it take?

I see this daily in clients.  Their excuses usually scream "I'm not committed to this completely" or "I am unwilling to take full responsibility for my actions" or, my personal favorite, "I've got a plan to get started."

Honestly, I see this in my own patterns when it comes to exercise.  I often exercise only when it's convenient for me, I make excuses about going early in the morning when I know it's the only time I'm going to have in my day to do so.  We all have times when we are afraid of moving out of our comfort zones.


How do we create a new normal? Our comfort zones must become uncomfortable.  It's the decision that I am not going to let the excuses in my head stop me from creating vibrant, positive changes in my life.

We must establish a new standard in our lifestyles. Start slow.  Yesterday, I went to the gym with my mother.  She hasn't been to the gym in 4-5 months due to surgery and she was able to walk a mile.  I hit the gym hard as I could for my recent addition of the honeymoon 10 pounds. But frequently, people burn out so quickly.  My mom had it right to take it slow.

Case in point, if I don't start back at the gym at a moderate pace and comfort level, if I charge forth ahead and try to run 5/mph after a month long break, I'm asking for aches and pains and burn out. Adjusting to a new schedule can be challenging, so take it easy.

  1. I jog in place while folding the laundry. 
  2. I walk the dog every morning for 15-20 minutes after I wake up. 
  3. I take the stairs. 
  4. I park at the back of parking lots.
  5. I measure how far I go with a pedometer on my phone. 
  6. I hula hoop in front of the TV at night for at least 20 minutes. 
  7. I go to the gym 3 times a week for at least 90 minutes. 
  8. I eat breakfast.  Protein shakes on workout free days and plain oatmeal or puffed millet on gym days.
  9. I eat a piece of fruit (banana or orange) as a mid-morning snack.
  10. I close the kitchen after dinner. 
Do you have your list of 10 things you do consistently for your health?  I have many more, but I would love to hear what other people are learning to change unhealthy habits!

Thursday, November 1, 2012


We all have to learn to own our actions.  I understand the struggles of my clients so much, sometimes I have to deal with my own personal struggles too. This became apparent together with regard to grief and loss. I am grieving the loss of my band. I am addressing that by taking care of myself and working on several projects in my life, career, home and personal right now.

Right now I'm struggling with compliance to my own eating plans, due to lack of planning.  Life changes occur, and we get off track.  The key really is to overcome the urge to eat your way through circumstances in your life.  Ownership.

Did you eat healthy today?  Me: So-so.

Breakfast: Chike Strawberry Burst; 2 cups of coffee with Sugar Free Pumpkin spice sweetener.

Lunch: 2 small Reeses' cups, 2 small Kit-Kats' and a kid's size CLIF brownie bar*;  Burger and medium fries with a Diet Coke at 4pm

*This was completely and totally emotionally eating from the sadness I was experiencing from visiting Children's Hospital ICU, I'm owning it here and now. 

Dinner: 2 cups of Kale with 2 T Lite Raspberry Vinaigrette with 2 T Dried Cranberries and 1/4 c. pistachios.

My strategy there was that I did well for breakfast, screwed up lunch, and recovered at dinner. If you're going to screw up during the day, don't let it be at breakfast.  What's the biggest way to get on the wrong track?  Missing breakfast, in my opinion! Coffee is essential, but I always make it a "no calorie" hit with SF creamer or Almond milk and Stevia ( > 50 calories from beverages in a day.) Often, I will have a protein shake or oatmeal or greek yogurt with frozen raspberries and a few nuts. These are staples.  

This is one of the measures I take to prevent myself from engaging in poor eating behaviors.  The one I have recently fallen short with though has been packing my lunch.  It's such a simple thing to do, but I have not bought what I need to pack my ideal lunch that "keeps me on track."  My number one "keeping on track" lunch is 3 oz. deli meat, 1 oz. cheese on a sandwich thin.  This with a piece of fruit will stave off hungry for 3-4 hours. I like to think about my meals as perfect meals. A good balance of protein, fiber and carbs, in that order. I've recently moved away from products with hydrogenated oils and avoid MSG in the whole foods I consume.

So, I'm working on and redefining my accountability measures for my diet and exercise program in my life.  I didn't talk much about exercise, but I'll tell you this, HIIT is the way to go.  I frequently will jog for a minute in place to get my heart rate up and keep blood flowing to feel good and energized during the day. I've downloaded a pedometer on my phone that's always running, and my goal is to continually make sure that I am walking at least 3 miles a day at a minimum. I meet or exceed that goal at least 3 times a week with addition to other workouts.  Could I use some improvement in this area?  Heck yeah. Always room for improvement.

Here's to each of us delving deep into our self reflections and insight into what prevents us from getting the results we want.  Real results come from ownership.  The hardest person to be honest with is yourself.

Friday, July 27, 2012

Am I Hungry?

"Most diets are restrictive and unsustainable, leaving the dieter feeling guilty and disappointed. My goal is to help people recognize and cope with their triggers for overeating, rediscover joy in physical activity, and effectively nourish their body, mind, heart and spirit."
--Michelle May, M.D.

If you haven't already figured something out about me... I am a bit obsessed with assessment tools. I enjoy taking them, analyzing them, and trying to figure out how to use that information for my clients and myself.  I tend to over analyze my own choices, and dissect how to interpret my answers to better myself, but I can't always expect that same level of interpretation from my clients

The above quote is something I came across weeks ago as I was perusing the internet and discovering doctors who are practicing in the field of obesity and bariatrics. Dr. May gets it. The root of the problem lies in our ability to eat mindfully, or rather, acknowledge when we feel true hunger or when we don't and our ability to implement the action of not eating, rather than mindlessly grazing or snacking on things our bodies just don't need when it would be better for you to hydrate and exercise to curb head hunger, binge or emotional eating episodes. 

I recommend you take the quiz and talk about it with someone.  It doesn't have to be a counselor or psychologist, but you might share it with these professionals if you do see them, but it could just be a trusted friend who understands the struggles of overeating. I promise that you will learn something about yourself.  It will get the wheels turning about your behaviors that maybe preventing you from reaching your desired weight. 

The key to success is self awareness. With each day, we should strive to discover a new facet of ourselves in order to become our best, well self.

Thursday, June 21, 2012

Invincible Thinking

I'm sure we all wished we had super powers at some point in our lives where we felt out of control or we wanted to know what was going to happen. While the daydream of not being susceptible to ordinary recourse, reality is that we must be accountable in our daily lives, be it to our bodies in the form of calories, fat, sugar, carbohydrates, alcohol ingested, to our families, to our job and careers, but most of all, to ourselves.

Sometimes, the hardest person to tell the truth to is you.  The blinders go up, the problem is ignored and those few pounds, as some point, become 20, 30, 50, 100 or more.  How is it we came to this point where we lost accountability, lost sight, ignored a problem for so long that it became an epidemic?  There are many reasons I could postulate on how the media and government have encouraged an obesity epidemic, but truth be told, the responsibility lies within each of us. At some point, the choice was ours to continue to do things we new were not helping. 

Invincible thinking is often associated with severe psychiatric disorders, but anyone who has played video games has engaged in the idea that it would be pretty cool to have the ability to fly, x-ray vision, 9 lives... Do we engage in invincible thinking to perpetuate our obesity? Are we expecting that 5,000 calorie meal to not become fat on our bodies? Do we selectively ignore the calorie latent meal or do we eat in ignorance to the content of our meals?  Or is it a combination of both? 

And then there's alcohol.  Let me draw the picture for you.  I'll speak to the post ops of Gastric By-Pass and Vertical Sleeve surgeries first, these are the most commonly done that change the integral functionality of your organs. (While this information does apply to LapBand as well, the process of absorption of alcohol is not compromised, essentially your body stays the same, you don't get drunk as fast as someone with the former procedures because the stomach changed, just the amount the stomach can hold at one time. However, the same applies here...) As obese and formerly obese people, we are more susceptible to cirrhosis of the liver due to fatty liver disease or over-working of the liver from having processed large amounts of fatty foods over years of fat accumulation. When you add alcohol into the mix, time speeds up, processing of the alcohol must occur more quickly, and BOOM, there's a blackout. 

Kidney functioning becomes more impaired more quickly because the body is absorbing the alcohol at a faster rate. It's like your body on speed, moving quickly through those liquid libations and aging your liver and kidney much more quickly than the ordinary person.

Now, the real question is why is it that someone rarely or never drank before weight loss surgery would suddenly become a drinker?  Consider the changes occurring in self concept.  A formerly obese, shy person suddenly is receiving attention, positive praise and attraction from their preferred or the opposite sex.  The need to communicate but the anxiety of communication is easier with a few drinks. It's simple, alcohol makes coping with reality easier.  It makes you feel good.  It's a drug that aids in one's ability to deal with inhibition.

The trouble with that is if you aren't in control and the alcohol is, who knows what could happen.  The invincible thinking may start with the first sip, and the last sip may not be remembered until you wake up in the ditch. And by ditch, I mean an actual ditch, a hideous hangover, or worse, in the hospital waking up days later, not know what exactly happened. (This is not a person account but rather, a worse case scenario.)

Scary stuff. Again, I can't speak from personal experience.  Alcohol is not something I have struggled with pre or post op.  The moment I realized if I drank alcohol I could eat whatever I wanted as a post-op, I got scared. When I spoke to my surgeon about this, I got an answer that I refused, his mistake to tell a mental health counselor that it's okay to have a few drinks.... tsk. tsk.  There has to be an explanation as to why he would tell me it's okay to drink, because it my mind it's not okay to drink excessively or to the point where I am not in control.

I won't say I never, ever drink.  I never, ever drink more than one drink, and I drink less than once a month.  I can not drink red wine, the acid reflux is awful enough, and the rare occasion I drink white wine it is only one glass.  Recently, while celebrating my friend's birthday we met a very generous friend visiting from California who made it his job to buy a round of shots about every half hour.  It took a heck of a lot of convincing for me to continually refuse shots.  I would excuse myself from the pool when I saw him coming just so I didn't have to have the discussion again.  Drinkers can be pushy.

You have to develop a strong sense of self and purpose to continually refuse alcohol when you see others having a good time and enjoying themselves.  It's hard, but I continually told myself it was worth it.  We must learn to do this with food as well.  There is always something else you could be doing than grazing mindlessly on food. The empowerment comes from knowing that I was doing something good for myself.  The encouragement that you're making the right decision has to come from within.  The support won't always be there, standing up for ourselves or learning to take ourselves out of the situation of temptation is essential.  If you know you can't refuse, then make the right choice for you. Living in The Big Easy, I realized very early on that temptation would always be there, so I had to be the one in control.

So, next time you feel invincible... realize you're only invincible if you can remember what you're doing, when you're doing it. *Avoid Food Amnesia* The moment you choose to eat, drink (or smoke, or engage in casual sex or whatever your vice is), engage the stop button.  Ask yourself what's the worst think that could happen?  Are you willing to take that risk? Are you in a safe environment?

What's the benefit of this action? What's the worst thing that could happen? 

Tuesday, June 12, 2012

Pre-Surgical Assessment Disparities

It has come to my attention that there is a HUGE disparity in the pre-surgical psychological assessment requirements. I have heard stories of surgeons not requiring it at all, mostly in the case of self pay patients. I can't argue this one, as I was self pay and all my surgeon asked was that I write out my case history to represent all my attempts in the past at dieting and my therapeutic intervention history. However, in the event that an insurance company requires psychological assessment, there seems to be no formal, professionally accepted standard of assessment. Some patients report having to fill out a brief questionnaire, while others report 2-3 hours of personality assessment and interview with a psychologist.

Why is this harmful to the future outcomes of bariatric surgery patients?  Glad you asked.  There are certain indicators that may show a patient is susceptible to regain.  Past dieting history is the number one most important factor indicating success - if a person has not shown they can stick to a strict diet for at least 30 days at a time, that's a red flag no clinician should be willing to ignore. However, when you don't thoroughly assess for Axis II (better known as personality disorders) you discount the potential for deceptive factors of a client's character.

I know, I know... people don't lie to their therapists. Yes, sure they don't. Everyone wants the help of a trained therapist and everyone is willing to cooperate.  I know this to be a fallacy. Every day, I can tell you that my clients try to pull a fast one on me, they aren't committed to therapy for one reason or another because telling the truth makes them vulnerable.  In the instance of pre-qualification for surgery, patients are more worried about not being approved and they will hide what they think *might* disqualify them.

Honestly, the only thing that I've ever heard a clinician say would disqualify someone for surgery was a psychotic disorder, where the patient was unable to make good judgments on their own and could not be trusted to follow the post-op requirements due to their lack of mental capacity. All other instances have resulted in the clinician recommending a certain amount of counseling prior to surgery. Some clients will comply with this gladly, others will resist and even choose not to have surgery to avoid having to talk about the underlying problems contributing to their weight gain.

All I can say about the latter is that the person is doing a disservice to themselves by not taking the recommendation to seek more therapy prior to surgery. The weight loss journey after surgery is a totally different experience than just plain dieting and sticking to a diet. The weight loss journey after surgery is not an option. It's necessary, it's not a choice, it's a way of life. It is what it is, you have to commit to taking care of yourself all the time, not just when you feel like doing the right thing. The result of failure to follow doctor's orders puts a patient at risk... of death.  I am not trying to be the whistle blowing alarmist, but there is still risk involved when you have invasive surgery to change your stomach, guts and intestines.

Of course you can choose to do what you know what you're not suppose to do. We all have "free will." However, in the long run, it will catch up to you. We can't hide from our problems forever. They will manifest in some way, shape or form in areas of life that may be unrelated to affected area.

So, what do I propose?  I propose standardization of the basic psychological assessment process. There are a few very good tools that can be administered in a 2-3 hour time frame, including time for clinical interview and assessment feedback. The Beck Depression Inventory, The MMPI (Minnesota Multiphasic Personality Inventory), the EAT-26, which is available online and more focused on the Anorexia and Bulimia perspective but still provides a thorough assessment and is clinically useful, as well as the ACORN assessment. While this is just a baseline of what should be examined, it is my belief that these tools, intake interview, and intervention should all be utilized before going under the knife.

I welcome your thoughts and experience on this matter... 

Monday, June 4, 2012

Drama is so passé...

Arrogance is a fuel that feeds a nasty fire.  We are all vulnerable creatures, we all have feelings, and we all make mistakes. It shouldn't be about measuring up to others, but setting the standard for yourself. Some will choose an unhealthy standard that will be shared and spread like wild fire. Some will gain an understanding that their words are hurtful to others, and realize that their impact has viral, negative effects on others. Sensor what you share with the world.

The one thing I have to constantly be concerned about in the mental health profession is my professional liability. If you choose to have a YouTube Channel and share your experience, consider how healthy your message is and how it will influence others. Be responsible about what you say. Don't hate. Don't perpetuate negativity. Don't call people names.

If you read through my blog, you will understand that I have no financial investments in putting myself out there on the internet. I respect those who are honest about their intentions. I respect those who share information with others to help them in a positive way. I respect that each and every one of us has freedom of speech, BUT with FREEDOM comes RESPONSIBILITY.

To those of you who find this vlog and want the help I offer, please email me at  I can not practice outside of the state of Louisiana, but I will find a local professional in your area who has experience with the bariatric community and understands the impact of obesity, can provide size acceptance and motivation to help you find the change you need.

You don't deserve to be bullied by your peers. You don't deserve to hear negative messages (especially not from strangers.) You do deserve to be accepted where you are and understood by those whom you choose to share your journey. What you are willing to change and how you go about changing it is up to you. Don't subscribe to unrealistic standards, ideals and misinterpretations of healthy living. Your balance is not my balance and everyone's balance will eventually be adjusted, changed and rethought throughout our journey. Be realistic, mindful and considerate of other's individual journey, their place in this world and the opportunity you have to be a positive force without hurting them.

We've all experienced a lot of hurt having been an obese people. I do not know one obese or formally obese person who was never called a name. There is a girl from high school who nicknamed me "Jambalaya" which was hurtful to me at the time, but ya know what, she's a friend on Facebook now and I don't judge her for being a bullying teenager because I'd like to believe she's grown out of that type of behavior. I don't know for sure, but I would never confront her on this because it's been 20 years, and I'm better than that. I'm over it. I find it amusing now.

What I don't find amusing is Hatred, Bullying, Name Calling, and directed Negativity toward your peers (or anyone, for that matter.) It serves no purpose, it makes people feel like crap, and it causes drama. Don't we all have issues we could identify we need to work on rather than creating new ones for others?

I'm off my soapbox. I'm done with these issues.
Please, people. Be Socially Responsible, Be Genuine, and Understand your Influence and Impact. Or get off the internet and get a life.

And learn how to spell something if you supposedly have a degree in it.

Sunday, June 3, 2012

Starvation Justification

Recently, I had a colleague feel the need to justify her eating habits to me.  Naturally, I did my best to listen to her and reflect her feelings about her food choices, but I did not comment on solutions or what I thought about these patterns she disclosed to me.  I find it best to not get into deep discussion with colleagues about such specific issues they have with food because it is not a therapeutic invention, no, not an admission to another professional that you aren't taking the care of your body that you know you should.

The issues discussed and the issue I have had to deal with my most in my personal life is starvation.  I don't mean days of starvation but hours into half days of just ignoring the the fact that I need to fuel my body.  This is something I believe lead my path to obese life. From age 7 to age 30, I rarely ate upon rising. Between 7 and 20, 75% of the time, I neglected my body for the first 6-8 hours of the day by not eating.  I wouldn't eat at school, I wouldn't get up early enough before school to think about food, and I definitely wasn't eating at school.

I was ashamed to eat.  Cognitively, I felt like "well, if I don't eat, they can't say my eating is making me fat." Fat luck justifying that, when I would binge eat in the afternoons because I was starving. It was never healthy stuff in high school either. It was, honestly, gross stuff like Doritos and Spaghetti-O's or cookies and cream ice cream, or Snickers bars.  Stuff I wouldn't imagine eating now, but back then, it was what I wanted. I've come a long way when it comes to "what I want to eat." I've reframed my brain to crave cucumbers and pickles and Quest bars. But back then, I told myself I didn't like the healthy stuff.

Early post-surgery, I complained that I couldn't eat early in the day. I would refuse to drink even a protein shake until at least 10am. My resistance was high because I felt how tight my stoma was in the mornings. I aggressively got fills in my band because I wanted the weight to come off NOW. That got me into trouble in the long run, but now with an empty band and the emotional wellness to say, "This is what I need to eat, when I need to eat it," I'm doing things right, making the good choices for maintenance will always take effort.

Refusing to starve myself takes planning. You won't find me caught dead without a backup meal. Be it a mix a meal soup, pre-measured protein shake in my blender bottle, or protein bar, I am never without something that will curb my hunger and refuel my body. It took me a long time to realize I couldn't ignore myself, ever. Even those of us who understand the in's and out's of the psychology of it all experience resistance.  This addiction is unlike any other, the need to feed will always be there.

The need to plan for fueling is necessary. My doctor has preached to me that "you should be eating solid foods, not shakes" but shakes work for me on the go. They keep me in line. They provide the protein, and they work. So, I don't buy that need to have solid foods at every meal, ticket. I have a need to do what works for my lifestyle and my day. Understanding my typical day is difficult for most people, even my significant other. I'm in my car, at schools, at client's homes, at my office (for very brief periods), stopping at CVS or Walgreens to use the bathroom because my office is my car. It's hectic. I long for the days when I have a clinical setting that isn't constantly revolving. It's coming, soon, but until then, I need to do what works for my hectic schedule.  I'm fine with protein shakes, heck, I LIKE THEM.

So, find what works.  Starvation does not.  It's essential to eat or drink your nutrients within the first 1-2 hours of rising. Take in at least 100-150 calories, it gets your body ready and your brain in motion. It's for the best, really!

Saturday, June 2, 2012

What is Normal Eating?

Normal eating behavior, to me, sounds like something far fetched, unrealistic and rarely done.  Honestly, when I hear the term "normal eating" I wonder what exactly is normal when more and more of our population is becoming obese. However, if we deconstruct the meaning behind "normal eating" we uncover what should actually be termed "acceptable eating" and "eating for wellness" rather than "normal eating."  If we were to consider the "norm" here, we would be looking at most American's habit of fast food or dining out at least 3-5 times a week.

Acceptable eating behaviors after weight loss surgery means: 1) Always making healthy food choices and 2) Monitoring the volume and quality of food you eat.  Healthy food choices after bariatric surgery is always being mindful of and minimizing the number of carbohydrates and sugars you take in while maximizing the amount of protein and fiber. While you may eventually be able to "get away with" eating foods from your former life, make it your practice to choose lean protein and low carbohydrate foods at least 90% of the time. When you rebuild that tolerance of sugars and carbs to be the norm again, you are putting yourself at risk for regain.

Volume of food increases over time.  Often, this occurs as we revert back to ignoring satiety. Satiation is that stopping point where you are satisfied with what you've had because it fulfills your body's need for energy, not your stomach's capacity. Some may say, "Well, I don't feel full ever."  If that's the case, you understand that your body's needs are only between 1/2-3/4 cup of food. Measure it out, take care of your maximum intake before you start, so you will know where to stop.

Quality of food is what I liken to eating at a fine dining establishment. If you're ever been to a 4 or 5 star restaurant, you'll notice that the plates come out with these small portions but the menu touts these inflated prices.  Well, good food costs more, but the care you take with your body and what you put into it is invaluable. Value your body, feed it slowly, with care and high quality ingredients. You deserve it!  Anyone who has made the decision to have weight loss surgery makes a decision to place a higher value on their life.  That bag of Cheetos or Doritos that just cost you 99 cents won't give you the satisfaction of feeding your body high quality protein will.

So, this "normalized eating" thing is really understanding and respecting quality and nutrient dense foods that will fuel you like a well oiled machine. If you put crap into your body, you're going to get crap out of it... Errh, okay, maybe let's not use that analogy.  What I'm saying here is that when we've made the decision to take extreme measures to improve our health, we must make the extreme decision to change what and how much it is we fuel our engine with daily.  Be kind to your body. Fuel it well.

Tuesday, May 29, 2012


This world tries to label everyone and everything, forcing things into categories, compartments and stereotypes that do not define who someone is but what they are expected to be.  Often, as clinicians, we are forced to diagnose someone to appease insurance companies to pay for our services when we truly do not want to attach a label to a client for fear that they may live up to or grow into a diagnosis.  I see this with my work with children, where parents want to get them X diagnosis so they can qualify for Y services and get Z check.  It happens, all the time, every day, and it's not fair to the child or client.

Recently, I read a blog post by someone I truly like as a member of the WLS community about the high school labels we fit into here in this community.  I also read a response to that post by another dear friend, and responded to her post online.  I respect both of these women dearly, their voices are valuable and their personalities are bold enough to influence many.  However, I've seen what goes on between groups and cliques and I am appalled that so many people with similar goals can not get along and accept each other and their differences with loving kindness.

I believe part of this confusion is the name, or rather, "Label" attached to one of these groups and the misconception that what it stands for is "Bad." While one could misconstrue that the group of women (and men) are trying to defy the norms of weight loss surgery, that's not it.  The philosophy behind the group is that we are not the "norm", we do not want to be the norm, and we do not fit into a pigeon-holed category of post-ops. It's that we are each an individual, first and foremost, and secondly, we stand for finding who you are before and after surgery.

Life changes, always. But life changes a lot after weight loss surgery.  Relationships end.  Friendships end. New beginnings and new relationships come and go, but bonds with new family, brothers and sisters, per se, in the weight loss surgery community are established.  The comradeship established in a group that embraces being different holds steady for those who join, and the Mothership is a powerhouse of experience and support. The group is a powerhouse of EXPERIENCE and SUPPORT.

The group does not stand for condoning bad behavior.   If you believe that, your bubble will never burst, you will live in it and think that perfectionism is possible. It's not. I hate to burst the bubble, but no one is perfect.  When we learn that we must accept ourselves and out imperfections we can move toward a happier, less stressful life without depression and anxiety.  When we can accept everyone, even those who think differently, act differently, and speak differently and who are comfortable with themselves, we show we are accepting ourselves, our faults, and our own issues.  We all have issues.

We all will struggle with obesity for the rest of our lives. "Fuel" the Ani DiFranco song keeps coming to my mind about all of this...

"and they say that alcoholics are always alcoholics
even when they're as dry as my lips for years
even when they're stranded on a small desert island
with no place within 2,000 miles to buy beer
and i wonder
is he different?
is he different?
has he changed? what's he about?...
or is he just a liar with nothing to lie about?"

So, have you changed who you are and accepted people for who they are in your journey? Where are you with your journey?  Do you still judge others negatively because you don't feel good about yourself?  It's hard not to in this world.  I admitted recently to my mother that I get sad when I see someone who is obese, not because they are obese, but because I always want to help them.  However, I know from my obese self, if someone like me, at my size now, were to approach me, a complete stranger, to try to talk to me about my weight problem.... tears would flow like a river.  This is why I am a counselor.  My clients come to me for help. I don't approach them.  I don't recruit.  I just am here when they decide they are ready for change and want support, therapy and loving kindness.  That's all I can do, and I continue to be all I can be.  I specialize in trying to remain neutral.  It's tough sometimes, and it makes me sad to see people who have the same goals to support and help this community pick at petty issues that divide and separate, rather than join and conquer. 

Monday, May 28, 2012

Embrace Yourself

Right now, wherever you are, whatever you are doing… STOP.  Take your hands off the keyboard, phone or ipad, and give yourself a hug.  It’s okay, I’ll wait for you.  Give yourself a nice big squeeze of a bear hug, as though you are in a straightjacket of love for YOU.
Now you can stop.  Okay, let’s get on with the topic of this blog post.

Never, ever let someone else’s view of your imperfections get in the way of how you love yourself.  Other people’s issues with you should never interfere with your view of yourself.  Body dysmorphia, whether that imperfection is real or imagined by you, can only cause anxiety if YOU allow it to take over your conscious mind.

Case in point, today my mother made the statement to me, “I really wish we could have your arms done before the wedding.”  This took me by surprise, really. I don’t think about my flabby arms much, I just religiously do my arm routine at home 3-4 times a week (every other day) to improve the muscle tone without the expectation that it will ever go away.  I don’t consciously think about how awful it looks.  And while yes, I agree, it does look awful, it’s not something I let bother me.

However, it’s not something I dwell on, EVER.  It’s not something I can immediately change so I don’t give it a second thought or allow it to cause me anxiety or make me feel self conscious.  Yes, I do frequently avoid wearing sleeveless shirts, but more often than not, I’m grabbing a sweater because I get cold so easily. My response was to brush it off with a, “Meh, whatever Mom.”  Obviously it bothers her more than it bothers me.  There are far better things I can think of to need to spend money on than plastic surgery.  My flabby arms are not hurting my health, so it’s not on my mind much.

For many people, such a comment coming from anyone would suddenly cause severe self conscious reactions and anxieties. For me, I see it as a reflection of my mother’s own issues with her body. Somehow, I did not get that gene that makes me dwell on things I can’t change. However, this awkward situation today got me to thinking… Maybe I’m just not that girl who worries about what other people think of me, I don’t obsess over how I look to other people. I look in the mirror and I see myself as I am and I accept that.  I don’t delve deeper into if there was less fat here or there because in the last three and a half years I’ve realized that my body will lose weight wherever it does without concern for what I think.

I have worked hard to finely tune my ability to “Let it go.”  Don't be that person that gets worked over by the idea that I must be perfect. I am imperfectly moving through this life, living and understand that what will be, will be and I am happy if I say I am happy. I am working toward change so when I've worked hard to solve a problem its resolution does not come as a surprise. It just is. I just am. I will just continue to be, do, think and learn to accept myself as I am.

I'm not saying that goals aren't important, I'm just saying that when I set them I know I will achieve them, therefore I put little emphasis on the time it takes and more thought into the path of the journey.  Enjoy the journey, always.  

Wednesday, May 23, 2012

Protein Shake Price Comparison Chart

I know this information must be useful to someone out there who is considering weight loss surgery and is on a budget, or who has had weight loss surgery and on a budget.  Everything seems to cost more lately, so I compile the most popular protein shakes in this list. I tried to include those I know are the tastiest, but I have not included which I prefer.  Please feel free to comment as to which you like the best. I will say, the one that's the most expensive is the one I like the least!

Wednesday, May 2, 2012

Preparing for life after bariatric surgery

Life before bariatric surgery was very different. The opportunity to eat whatever, whenever didn't have the tag attached to it of "how's that going to go down." Each of us has to find the right time to begin and not look back from the past poor decisions.  Establishing good habits in the here and now will lead you to a successful journey, no matter where you are in that journey. The decision to make good food choices needs to be motivated by a desire to be <healthier, thinner, more energetic.> This is an exercise in <insert your reasons here> defining your goals as realistic. It's important to start simply with a few good habits than trying to take on a list of new tasks all at once.  Our a level of commitment to a new program can be determined by so many factors, and  our collateral influences (support systems) and environment play a role in our ability to succeed. Set yourself up for success by recognizing your personal readiness to commit to well defined, specific goals.

Goal setting has to be realistic, meaning it has to work for you. It's not practical to make a goal that you will "give up <ice cream, soda, potato chips, etc.> right now" without considering your readiness to commit to that goal.  Practical goal setting makes goals attainable. I will use sodas as an example because it's an easy target. The "liquid candy" of sodas is most often a complex habit developed over time; it's a psychological dependency established on sugar and/caffeine that is often easier to move away from if you allow yourself to minimize usage over time. Cold turkey doesn't always cut it. A realistic goal would be to state, "I will reduce my soda intake from 5-6 cans per day to 2-3 cans per day."  Once you've reached the reduction rate established, you can revise the goal to something more like this, "I will reduce my soda consumption from 1-2 cans per day, to 1 can 2-3 days per week." This sets up a measure of success that is clear, quantitative, and realistic.

There are several key tenets of post-bariatric life that will ensure your success rate. Our busy lives often have us being pulled in multiple directions at one time. Grasping the healthy habit of slow eating is so important. A bite is about the size of a dime. <I heard you gasp...> Yes, a bite should be about the size of a dime, ok maybe at most a quarter.  How about chewing?  My general rule has been to chew, chew, chew, until you've chewed about 25-30 times before you swallow.  Then wait until you feel the food hit your stomach. After 15-20 minutes of practicing these small bites, ask yourself, "Do I feel full? Am I still hungry?" Then take another bite.

Next up, let's talk about drinking.  We also must be mindful of taking it slow when it comes to liquids.  Learning to slip, not chug our liquids is very important to keeping the body hydrated at a constant rate while not stretching your pouch by filling it up like a water balloon. If you hear yourself gulp, you've probably taken in too much.  About 1/2 ounce to one ounce of liquid is gentle enough for the pouch to process at a time.  I'm sure you've heard by now, soda is a "no-no."  I hate to wag a finger, because I've pushed the limits on this one too, but it's really a habit that needs to be broken before you undergo surgery. The success in achieveing these small goals will help you moving forward with your weight loss journey and pre-surgical weight loss requirements.

There are several other important post-bariatric living principles that patients should work on becoming acclimated to for life long success. In my efforts to manage this blog more consistently, I will address awareness of emotional triggers and alternative, healthy behaviors to engage in when you feel <insert emotion here> due to <specific life stressors.> If you're sick of me putting things in <less than/greater than> signs, you might be concentrating on the wrong issues. That's a topic for another blog, because if you're overwhelmed by small issues like that, we might have bigger problems to discuss.

Wednesday, April 25, 2012

The Importance of Communication and Follow Up with your doctor

I knew I had an appointment today with my surgeon, and I was completely ready to get a fill in my otherwise empty band. I woke up this morning, after having coughed all night long, with a fever, sore throat and a pain in my stomach.  I knew I needed to go though, for the sake of follow up, though I am 3 years and 3 months out, I think it's still necessary to spend the time communicating with your doctor.  It may only be 5 minutes, but your doctor needs to know what's going on.  The reason I coughed all night?  I took my vitamins too late.  They sat in my pouch for hours. I knew better, but it just slipped my mind that it was already 11:30pm, way to late to be taking my vitamins. For the most part, vitamins should be taken with food. Cardinal rule broken there. Sometimes, even those of us who are years out, need to be refreshed in the simple order of things. Mistakes are made, it's best to just recover from them quickly and get back on track.

So, what happens when you're so off track, you've gained 5, 10, 15, or even 30+ back after surgery?  It's important to go back to your doctor.  Your doctor should have a list of trained psychologists, dietitians/nutritionists, counselors/social workers, and/or personal trainers who can get you back on the loser's bench.  Sometimes, we need the help of a trained professional to understand our disordered eating behaviors and lost motivation we had went we eagerly started our journey. Each of us has our individual disordered behaviors, both in our nourishment practices, lack of motivation with exercise, life stressors, food addictions, and/or transfer addictions that may need serious attention. Reach out. If you need help, email me.  I will be happy to find someone, wherever you are, to help you! 

Monday, March 26, 2012

Saturday Group


Hi, my name is Nanette Wilson and I am a Counselor Intern (#5099) with the Licensed Professional Counselor Board of Examiners.  I have a Master's degree in Counselor Education from the University of New Orleans (2006) and I am seeking to gain experience in conducting weight loss surgery group therapy sessions. Becoming a Licensed Professional Counselor takes 2 years and 1500 direct contact hours, and is conducted under the supervision of a Licensed Professional Counselor Supervisor. I am currently 6 months into the process and seeking to specialize my skills in bariatric counseling, pre and post op counseling. Individual counseling will not be required but encouraged if issues that should not be worked on in the group are recurring for some members. I've decided to take on pro-bono clients in Louisiana who have undergone bariatric surgery and would like to participate in group therapy. The group will be available,free of charge to anyone who is interested and emails me to sign up. The group will be limited to 6-8 people. If anyone is interested and lives in the New Orleans area, please let me know.

This group will take place on Saturdays at a local library where we could meet in a conference room. If you or anyone you know is interested, please message me. 
 Also, if anyone participating in the group is interested in individual therapy outside of the group, I will see clients on a sliding scale fee ($25-$50/per session) as I can not currently take insurance because I am not yet licensed as a Professional Counselor.  
If interested, please contact me by email at  I will require a brief intake questionaire over the phone to get some information from you regarding your experience with counseling and your currently weight loss surgery status/progress. 

Monday, March 12, 2012

Evaluating Your Impulse Control

The essential key to success after weight loss surgery is impulse control.  Sure, you were able to follow so many diets and exercise programs for weeks and months, even years on in, but when it came to the slip ups, were you able to own it and take new actions?  Let's look at the bigger picture.

In order to be successful as a post-bariatric surgery patient, you must learn new health habits that are sustainable.  If you commit to the lifestyle for the first 6 months and then revert back to old habits, you will inevitably gain weight back.  This is a learning experience when it happens, and hopefully, if it has happened to you, you've found resiliency and jumped back on the wagon.  However, if you continue to struggle with impulse control issues and you don't keep accurate records of your food and calorie input and output, you may see yourself on the failure end of WLS.

The key is owning your behaviors and actively making efforts to change those behaviors.  I recently ran had a visit with my great aunt and she said to me, "I'm so happy to see you're maintaining your weight loss after surgery because "so-in-so" seems bigger than before."  I refrained from calling her out on this third person judgment of "so-in-so" because I don't know "so-in-so"'s circumstances, but I can make a solid assumption that she isn't practicing impulse control or following the rules her doctor gave her.

Why?  Why not?  What is it that keeps us from truly changing our habits?  There are usually deeper seated control issues going on underneath the weight gain and food addiction.  It's the way they've learned to cope with stress, anxiety, and depression by using food.  Those behaviors have not been unlearned when the doctor when in to perform surgery.  This is why the movement should be to work with a Professional Counselor to process the client's motivation to change and their ability to control the impulse to reach for food to soothe themselves.

Ask yourself a few questions:

Am I ready and willing to spend time preparing my foods at home for my work day and in the evenings?

Do I understand what good post-bariatric surgery food choices are?

Do I comprehend the size of my pouch?

Generally, post-surgery, your pouch will be the size of a walnut.  It will inevitably stretch some, but the idea is not to have it stretch to the size of a baseball but rather possibly a golf ball. You must commit yourself to planning ahead or having a plan when you're out of the house.  If you fail to plan, you plan to fail.  I keep a list of good choice WLS friendly meal options out, I look for high protein options when it comes to soups and order that as my entree or find an high protein entree and order it sans rice with extra soft steamed veggies.

Another big issue is alcohol. Anytime you consume alcohol your ability to make good judgments is compromised.  This can be a big problem when you're post-surgery and your consumption levels can cause severe problems, such as low inhibitions or blackouts.  You must become increasingly aware of the effect drugs and alcohol have on your ability to make good decisions.  Seek professional help if you find yourself risking your safety due to a transfer addiction.

So where is your impulse control?  Are you able to make good choices all the time?  Are you still struggling with making good choices and grab those cookies when you've had a stressful or emotional day?  What's behind the emotions of those bad habits?  It's wise to seek out a Professional Counselor that specializes in Dialectical Behavior therapy for binge eating disorder or food addictions.  If you need help finding one in your area, please feel free to email me and I would be glad to locate someone to help you!