Saturday, June 29, 2013

A few things Paleo - Avocado and Coconut!

Chocolate Avocado Mousse & Coconut Whipped Cream

Anyone who knows me well, knows I enjoy making tasty food. I have really transformed that habit into making healthy tasty foods. I love avocados and coconut, both are healthy fats that are utilized in the brain functioning to regulate neural synapses firing patterns. Omega 3 fatty acids, when taken on a regular basis, help to improve executive function in ADHD children. Don't make me pull up that research, it's been a while since I was knee deep in that stuff, but it is certainly applicable to obesity--- your brain functions best on healthy, natural foods.

4 ripe avocados, mashed
1 T. cocoa powder
2 T. honey
1 T. powdered stevia
1 t. vanilla extract
1 T. coconut oil
1/2 c. dark chocolate chips, or 4 oz. unsweetened chocolate

Use stick blender to blend to blend all ingredients except chocolate chips. Melt chocolate chips on low heat and blend into mousse. Let set for an hour in the refrigerator.

Coconut Whipped Cream --- this was an experiment that came out well! I didn't know if the coconut fats would mimic the HWC fats.

1 can coconut milk
1 T. coconut oil
1 T. powdered stevia
1 t. vanilla

Mix together. Put into whipped cream container. I used 3 CO2 cartridges because I didn't know if it would work. I refridgerated the mixture, waited 2 hours, and I had coconut whipped cream. Color me impressed... tomorrow I shall use it with my coffee...

Love people, cook them tasty food. 

Take good care of yourself. 

Friday, June 28, 2013

It's not about Blame, it's about Change

Obesity is a disease, as much as alcoholism is a disease.  It's part of our genetics, conditions, choices and behavior within our environment.  It is a complex relationship with our mind and body.  As someone who has experienced uncontrolled hunger that willpower could not overcome, and at other times, felt to be in control of, that makes sense to me-- that it is driven by the impacts of hormones in our bodies. The relationships between our hormones: insulin, ghrelin, leptin, testosterone, estrogen, and the processes activated in the brain between dopamine and seratonin, fed by the circulation of water and nutrients--  are all working together to support our biochemistry and are influenced by all of these factors.  It is certain there are people who eat an unhealthy diet and have no instances or struggles with obesity, and others, who suffer dearly, starving into desperation as certain foods act as a drug for them. We are all impacted by certain substances differently.

Many people have inaccurate opinions, pass judgment, and entertain prejudices towards those who suffer from Obesity, and it is an abomination that there are still people who think it is acceptable to be insensitive to those who do. 

I am sad to say that I know for a fact that there are many very smart people in the medical field that fail to consider that we all differ as individuals and that obesity is not merely caused by overeating, or rather, eating the wrong foods. While I agree with the "Wheat Belly" and Paleo theories, I fear tunnel driven opinions to undermine quality standards, education, support and structural services to aid bariatric patients may be cut from insurance, rather that included and encouraged. Let us lobby that these things DO NOT occur. Bariatric patients need to be able to see their surgeons 1-2 times a year at 3-5 years out. Continuation of care, follow up, and interfacing with multiple MD caretakers has much, much merit in our evolving medscape.

There are notable prejudices that come with obesity treatment. Learning to treat someone with empathy, and while this is not a skill of every surgeon, when their demeanor comes across as compassion: sympathetic pity and concern for the suffering and misfortune of others-- we should treat patients with tenderness and benevolent concern .  It is unfortunate that surgeons can not walk a mile in their patients shoes, though, they could try walking a mile with their patients. I am a big believer in walk and talk therapy.  Trusting relationships and programs built around success are what bariatric service providers need to develop.  Community awareness, education services, commitments to each patient's success. That is the future I would like to see.  To ensure success at the highest rates possible, we must lobby to change our society.

If hospitals would integrate food as medicine kitchens (over pharmacies) as they have wellness centers for exercise physiology and physical therapy, we could change a lot. Attitudes and perceptions are skewed in this "Fight from Obesity," it's not a fight, it's a progressive movement toward change, societal paradigm shifts in attitude and access to care. Support groups should be available every single week.  Topics should be covered on every element of lifestyle change. Our people must push for community gardens and turn around the marketeers to cater to low calorie options at restaurants and in schools.  No one should live in a food desert, community markets should carry natural food products produced locally, and we should make our food at home as often as possible.

Every Step Counts. Why limit "Walks from Obesity" to once a year or even once a month. Once a week with someone who will hold you to your commit, and once on your own every week is both therapeutic for mind and body. But truthfully, the Walk from Obesity is EVERY SINGLE DAY. 20k, 15k, 10k... whatever you can do to move forward. With the help of surgery, we are able to conquer many metabolic imbalances that occur from obesity.

But it is not the end all, be all for everyone. I don't like the idea of obesity drugs, but they have their place in the profit margins of "Big Pharma." With side effects yet to be discovered, we risk developing more dependency on psycho-pharmcology. Everyone has an opinion, but we're all out to make a buck.  There's a difference between an honest buck and a buck of persuasive luck. Good marketing of fads has long driven the weight loss industry. But this thinking that bariatric surgery, which has proven to be an effective form of weight reduction when behavior changes are also made, should not be shot down, deregulated, and allowed to be done in environments that do not support the long term outcomes but rather, hack a gut alteration and send a patient on their way. That is not what this medical specialty area needs, what it needs are constantly examined and improved methods to drive the health of society.

Body Transformation or Body Dysmorphia?

It’s easy to get caught up in the perfectionism psyche when things are changing so quickly after bariatric surgery. You imagined yourself thin, fit and svelte, but really, you did not comprehend what it would be like to have hanging flesh on your body after you worked so hard for that body. Have you caught yourself thinking, “I just don’t like the way I look in the mirror,” while naked.  Today’s blog is about how to have a healthy mentality about your body after weight loss surgery, considerations for a reasonable time frame to pursue plastic surgery, recognizing unreasonable body image issues, understanding self harm, and working through those issues with a therapist, and stopping unproductive negative self talk.

In the case of the bariatric surgery patient, self acceptance has its limitations, but we must live with the understanding that a model perfect body isn’t going to happen. Where does the line get drawn in the sand between trying to achieve a figure that you can be happy with and living with an obsession with the knife?  It’s certainly possible for anyone to become addicted to ANYTHING. However, in the bariatric transformation from obese to healthy, thin, or slim, if money is no object: is there a such thing as an addiction to plastic surgery?  Better yet, is there room for concern about those members of the community who begin the journey of going under the knife?  Should professional psychologist and mental health professionals look at case history in order to determine if that person will be stable enough to withstand the psychological impacts of plastic surgery, or will it become obsessive?

There’s no way to screen for risk in this regard.  However, the question has been posed that maybe those with personality disorders with a history of cutting might take this journey to extremes.  Like I said, anything is possible with anyone, at any point in time.  Having unlimited resources to indulge in plastics, self harm in pursuit of perfection is certainly obvious with many mega-stars.  Michael Jackson certainly too it to an extreme if you think in terms of his numerous plastic surgeries and history of mental and psychological abuse, albeit extraordinarily talents, he brought it to the max.

Influenced by media, society’s expectations of a perfect body are skewed. We have to love ourselves, and under no uncertain terms should be not love our body, imperfections and all. An otherwise successful, yet dissatisfied bariatric patient’s excess skin removal, coupled with destructive behavior patterns are indicative of a more severe diagnosis of body dysmorphic disorder diagnosis, or even, pronounces issues of self harm included, going under the knife that could be indicative of a borderline personality disorder. How do can we tell the difference?

To identify behaviors as unhealthy and unproductive as a chronic mental illness, one must look at the client’s ability to control the obsessive negative thoughts, (i.e. you can't stop thinking about a flaw in your appearance — a flaw that is either minor or imagined) when your appearance seems so shameful that you don't want to be seen by anyone.  Body dysmorphic disorder is intensely obsessive, image and appearance are often thought about for many hours a day. The perception of your flaws causes you significant distress and has an impact on your ability to function in your daily life. If one seeks out numerous cosmetic procedures or excessively exercise to try to "fix" the perceived flaw but is never satisfied.

The three essential factors I would use to determine an unhealthy obsession with appearance (occupies more than 90 minutes a day, of persistent negative thoughts about self) body image issues, overanalyzes the perception of others on the individual (implied or stated), personality disorder, and GAF (Global Assessment of Functioning) Score.  Any client with a score below 65 on the scale would be of concern to me, as a clinician.

So, how do we define an unhealthy obsession with your body, perfectionism and surgical methods to alter one’s appearance?  Where do self harm/self injury, perfectionism, and personality disorder come into play here?  There’s a certain level of desperation that is a driving motivator to change, but when does it become a disorder?  That’s subjective.  However, there are some issues to consider when moving forward to the transformative body reconstructive surgeries.  A healthy cognition about when that should be done is essential. 

In my former journey with the Lapband, my mother pestered about my bat wings. I always said, “Let me get to my maintenance weight for two years, and then we’ll talk plastics.” Good thing I never got to that point, else when the band came out I and the slow path of my body fighting back with regain set in, I would have been a helluva messy rubber-banded skin.  If nothing, I am logical, methodical and grounded in my decision making—after 6 months, I knew that the Lapband had been a HUGE mistake. (That’s another post, I have been meaning to write out my Lapband trauma during hurricane Isaac for 10 months now, I owe the public that story. I want to tell it.  It’s just tough to tell it through the therapeutic lens while I’m still working out the details on revision, and I still don’t know when that can or will happen.)

My intentions with blog are to discuss the perfecta of concerns I have for the WLS community.  All of us are crazy, varying degrees of crazy, yes, but some have had more severe mental illness histories than others.  Analysis of previous history of self harm should not preclude patient disqualification, however certain support services should be available to those patients who find themselves forming harmful habits and/or destructive thinking patterns as the transformation of an obese body becomes slimmer.

Signs are inclusive but not limited to negative feelings or thoughts, depression, anxiety, tension, anger, generalized distress, self criticism, self injury, low mood, poor self confidence, preoccupation with dangerous behaviors, purposefully engaging in harmful acts, urges that cannot be distracted from or satisfied, negative/harm act results in pleasure, spending endless time alone in a room avoiding others, and/or 
disruptive influence on interpersonal, academic or other areas of life functioning. 

If you find yourself constantly thinking about these issues, you have options and alternatives.  While I it is important to work with a trained professional, keep in mind that developing hobbies and interesting that help to take the focus off of your dissatisfaction help to low your risk:
  • Paint, draw, or scribble on a big piece of paper with red ink or paint
  • Express your feelings in a journal
  • Compose a poem or song to say what you feel
  • Write down any negative feelings and then rip the paper up
  • Listen to music that expresses what you’re feeling
  • If you cut to calm and soothe yourself
  • Take a bath or hot shower
  • Pet or cuddle with a dog or cat
  • Wrap yourself in a warm blanket
  • Massage your neck, hands, and feet
  • Listen to calming music
  • Call a friend (you don’t have to talk about self-harm)
  • Take a cold shower
  • Hold an ice cube in the crook of your arm or leg
  • Chew something with a very strong taste, like chili peppers, peppermint, or a grapefruit peel.
  • Go online to a self-help website, chat room, or message board
  • Exercise vigorously—run, dance, jump rope, or hit a punching bag
  • Punch a cushion or mattress or scream into your pillow
  • Squeeze a stress ball or squish Play-Doh or clay
  • Rip something up (sheets of paper, a magazine)
  • Make some noise (play an instrument, bang on pots and pans)
  • Substitutes for the cutting sensation
  • Use a red felt tip pen to mark where you might usually cut
  • Rub ice across your skin where you might usually cut
  • Put rubber bands on wrists, arms, or legs and snap them instead of cutting or hitting

Professional treatment for cutting and self-harm

If your concern is for a loved one because you’ve noticed suspicious injuries or that person has confided to you that he or she is cutting, pulling, scraping or harming themselves in this way, whatever the case maybe, intervention is essential.  Speak respectfully, without blame, and in a calm tone.  Address the matter with an open mind and loving heart.  You are extending a hand to someone who is hurting on the inside.

Deal with your own feelings on the matter prior to the discussion, the shocked, confused, or even disgusted by self-harming behaviors—and guilty for your loved one’s distress can be helped by acknowledging how you feel about this person’s emotional distress. Make the first step by learning about the problem and overcome any discomfort by understanding why your friend or family member is self-injuring. This will help you to see the world from his or her eyes. Avoid judgment and criticisms it is likely the route of the problem, the person is coping with society’s judgment and expectations.  Find your loved one support and make your conversation productive.  Availability to listen and find help is a key to recovery.  Communicate with them as they seek support and intervention.  Above all, be kind to yourself and others when you speak about sensitive subjects. 

Saturday, June 22, 2013

Play with your Food!

Try breakfast or snacks differently with this recipe. I left it in the oven overnight, and it was fruit crisps at first, then I brushed the top with water a few times over the course of an hour and let go 2 - 3 hours longer.


Tasty, slows you down to eat it, let it melt in your mouth. Peach leather for breakfast... I know, it sounds totally weird. But who wants to be normal?

2 c. strawberries, hulled and diced

2 c. peaches, cored and diced

sweetener, varies by fruit sweetness and taste

1 T. lemon

1 T. lime

2 scoops unflavored protein

Blend strawberries, lime, sweetner and 1 scoop of protein. Spread evenly (about 1/2" thick) on a silpat or wax paper.

Blend peaches, lemon juice, and 1 scoop of protein. Spread evenly on a silpat or wax paper.

I combined both fruits on the same baking tray lined with wax paper.

Place in oven for 12 hours at 170 degrees. Peel paper away from fruit leather, roll up, and enjoy! Makes about 12 servings, 33 calories per serving, appx.

Later... I roughly did the math on this and it was about 35 calories per 2" x 6" slice, but it would certainly depend on what kind of sweetener you want to add. I added 1 T. of agave syrup, but you could use splenda or stevia. Taste and texture will vary by sweetener choice. I may or may not have put vanilla extract in it. When I cook, I cook like Justin Wilson... my genes are to my detriment, sometimes! But God, I miss that man cooking on the PBS on a Saturday morning!!!

Little know fact, I am related to him. It's some strange story about how he's actually related to us on both sides (by married on my mom's side and by cousin to my grandpa on my dad's side), but I never paid enough attention know the whole story. What I know now it that genetics that impacts our metabolism and environment that influences our ability to choose what is essentially good for us. Redefine what "good food" is in your life. It's stuff like this that slows you down when you eat - the fruit leather, beef jerk, enjoy every bite as if it were your last.  It might be, if you pay attention to your gut as you should.

And there's always healthy Gumbo from MamPapaul's Cajun Creole Dinner Mixes (avoid the cake mixes-- even though they are good, just take my word on it.) Double family plug there, entertained you with YouTube and did a little family business marketing.  (Aren't those both things I say I don't do here?  I'll make an exception today!)

Happy Saturday, Everyone!  Go forth, and love people, make them tasty food.

Actualization, Realizations, Opportunities, Successes

I've had some pretty amazing things occur in the last few days.  A contract I've been waiting for is progressing, opportunities are presenting themselves, and blessings are numerous.  I can not say it hasn't been without a lot of hard work, dedication, and persistence on my part, but I truly appreciate those who've been there for me through some tough times.  I've only broken down once to cry, briefly last week before all the good came to me, but it only lasted for 3 minutes... I instantly caught myself and out loud, started to recount my opportunities, gifts, talents, and motivations.   You know those "mantras" I talked about in my last post.

I have had many conversations with members of the communities I belong to and what resonates with me is this:  We must forgive ourselves, but also, we must set a standard of behaviors around food that reflect a detachment from dependency that we must clear our plate and not waste, or indulge in that beignet (or three - BTW that's a French doughnut) because we can.

It's that "Because I can" attitude that keeps you where you are when you are frustrated and refuse to change your attitude toward food and exercise.  Strive for the goal to always, always choose the healthiest, best item on the menu.  Don't be shy about telling a waiter, "Please hold the bread, go light on the cheese, and bring me the dressing/sauce on the side."   Do more in the gym, push yourself to increase your physical strength slowly, deliberately.  Don't worry about the funny looks.Who cares?!  My thoughts are they better just get it right so the temptation doesn't appear in front of me.

Forgive yourself.  Then take action by not continuing the behavior that made you feel that guilt in the first place. This is such a tough lesson to learn.  Especially when we casually, continually, let our choices slide.
Choose to be careful because you care for you.  Everything you eat does matter. Every moment you make, MATTERS.  Your Weight Matters.  Don't wait to make changes, do it now.  Make every choice intentional.  When you mess up, pick your britches back up and hold yourself accountable. Self destructive thoughts and decisions will not move you toward your goals.

Today, while at lunch with my *so called* niece (she is first cousin, once removed,) and I likened daily personal nutrition management to the constant leveraging of your choices.  The idea of Weight Watchers points system makes sense.  I just felt so traumatized by WW for being their youngest member, ever, back in 1987, that I will never step foot into one of their meetings.  I *WILL NOT* pay for group support services that can be found for free. I am not motivated by paying their weekly fees, I'm actually extremely frugal by necessity.

Anyway, I digress. When you know you are going out for a meal, your other meals that day should compensate by being much smaller. If you're doing it well, likely you should plan the day before and the day after to be relatively light eating days. Plan ahead, it's such a simple gesture that can make all the difference in the world toward your overall weight loss success.

Another recent revelation for me is that people need to learn how to address cruel, mean words and actions in others.  After being cat called walking on the sidewalks in my gated community last week, by an AT&T driver, no less, I was anger.  I asked myself, "Does this person think it's appropriate to act that way toward me with derogatory flattery?" I was so furious, I contacted my friend Stephanie, a call center manager for AT&T, and asked her how I could write a letter of complaint. I was mad. It subsided after a few hours when something else disturbed me.  The mean things people say and do to us in real life.  The awful, harsh judgments that occur daily toward those who suffer from obesity.  It is likely the last unprotected part of our population when it comes to being given equal rights in society, the workplace, and with our own families and friends.

A friend recanted today of a young lady who went home for the holidays and had lost some weight.  While everyone was happy for her and told her she looked great, her step-father made it a point to say to her, "You've still got a long way to go."  My heart sank for her.  Why would anyone, ever say such a mean spirited, insensitive thing to someone who is being successful in their efforts?  Why are people so mean to each other? If you're going to fat call someone, make sure you take a good look yourself-- you're not perfect and the obesity struggle is harder on some than others.

In sessions, I often use the Gestalt "empty chair" method.  I'm over that.  Confront these people when they do it. I know it's hurtful, but voice that you are hurt by their words in the moment.  Make it clear that what they said it not acceptable, that the words they do not hurt you anymore.  Make them feel like the jerk they are.  Even if they are so cold as to not care, return the sentiment.  Say, "That's mean. I don't need your ridicule."  Say it out loud, "I do not like your words." Voice disapproval of their behaviors to them directly if they are hurtful to you. They have no place to comment on your struggle unless you invite criticism and constructive feedback.  Likely, these are not the people you want either of those things from. Be brave enough to speak up for yourself.

Rejoice in your successes.  Analyze your failures.  Make a plan.  Take action.  See Success. 

Monday, June 17, 2013

The Internet is NOT your therapist

I have concerns about some folks in the WLS community.  My concern is for people who are putting it ALL out there on the INTERNET.  The problem with putting your emotional soul on the internet is: Putting your EMOTIONAL SOUL on the INTERNET.  To me, that seems like the epitome of vulnerability.  There can be serious ramifications to pouring out your soul to strangers.  You compromise your confidentiality.

Aren't there some things in your life you want to remain private?  Think about the what if's in it.  One of the most important lessons I learned in therapy (as a counselor) was it was okay to live in omission to the public.  My clients don't need to know every last detail of the hurts and pains I've been through.  Privacy has its perks, learning when and where its appropriate to tell who and what; it's a learned responsibility to protect yourself and guard against telling others about your past. You never know when those devilish detailed you've divulged on the internet will come back to haunt you.

There are lots of people on the internet waiting to judge you.  I'm not judging you, I'm trying to protect you.  Why?  Because I have done it myself.  I have spoken my mind and been knocked down. I have had people tell me I shouldn't speak my mind.  Hypocrisy of this post: I'm telling you right now not to put it ALL out there, not to not speak your mind, but that you should be discerning about what you throw out there for people to use as ammo.  I know you don't want that.

The deeper issue is that your vulnerability should be addressed with someone who knows how to handle it.  Someone who can put you in a positive place after you tear it down, rebuild it, and move forward.  The internet will continuously tear you down.  Even once you've processed what it, you may or may not have had good guidance on how to restructure your cognition.

Your cognition, self perception, and wholeness is found within. Everyone has a different variable belief in their locus of control.  Many people are motivated by looking in the mirror and not liking what they see-- and will not blame others for where they are currently.  You can do two things with that:  hate yourself and do nothing OR love yourself and do everything to change what you see.  Then, there are people who don't care what they see in the mirror.  It's not that they don't love themselves, it's quite the opposite, they aren't caught up in what they see in the mirror, they are involved in larger pictures of what they can do to help others believe in themselves and their ability to make positive changes.

If you haven't figured it out yet, I'm that latter example.  I am not ashamed or embarrassed of my regain or my struggles. Sure, I don't like the baby belly (no, I'm not pregnant, sometimes I wish I was though due to the regain's likedness to a baby bump.) I live through them and am happy with myself either way. I am active, healthy and honest. I know what I do and do not do and what got me here.  I have always learned lessons the hard way.  And honestly, I've committed to losing the regain the natural way. The hard way. It'll make me appreciate and respect the process again.

However, if you are one of those people who look in the mirror and see flaws and faults and feel like you're not good enough to do whatever it is you want to do with your life, then let's look at that issue. You should never, ever be shamed of where you are right now if you've made a decision to change your health.  That's the first step.  A healthy cognition includes the ability to be resilient when you do make mistakes. Don't be angry with #1, just set your expectations higher for yourself.  Decide to do more to address the problem.

Many people have poor self-esteem because there is a huge discrepancy between reality and their own expectations.  This is why making small, attainable goals makes sense.  We construct elaborate ideas of how we should be, but there's a stop gap between the here and now and the planning for the future.  Think through what that image you have in your head would act, think, feel, and be regarded by others.  That last one is a kicker, because how you look toward others is a concept so many get caught up in that becomes a detriment to #1.

Don't allow the frustration of getting there impact your happiness. When you get there, the happiness you thought would be at the end of the rainbow is not definitive. You must continually work on the new, and if you've properly addressed the old, it may or may not creep back into your life.  Be brave and bold enough to build internal strength to not let the opinions of others hurt you.  

The origin of self esteem issues can come from so many places: family, career, social, and financial issues can impact how you feel about yourself.  I'm here to tell you than none of that matters.  What matters is the voice inside you. What do you say to yourself daily?  What are your mantras you repeat to yourself daily?  We all need attachment to positive thoughts that motivate us to do whatever it is that will get us where we want to be.  These affirmations will keep you together when you're weak and hold you up when you're strong. 

Let your affirmations reflect your love for yourself.  Let them resonate a belongingness to the world and your community. Seek to build relationships with people who you can emulate positivity to-- help them build themselves up as well, don't allow the people you choose to socialize with beat themselves up in your presence.  Be the shining example of good. 

Deal with rejection in healthy ways.  Find a way to process it without internalizing blame. Don't automatically assume it was you, that you weren't good enough.  Consider that they weren't good enough to be in your life. You are choosing to walk away just as they did, maybe for different reasons though.  No use of crying over spilled milk. 

No matter how you cut it, some people struggle more with self esteem than others.  If you've become used to being around people who judge others harshly or lived with the criticism of a verbally abusive person, it takes a lot of practice to become uplifted in your internal dialogue. If you've been told you're something all your life, you believe it.  This works both ways--- if you're told you're beautiful all your life and suddenly someone tells you you're not, self doubt can kick in and blow up a range of emotions you never thought possible, and vice versa.  

This phenomenon in the weight loss surgery community occurs frequently.  When you've been fat all your life and suddenly people start to notice you because you're not.  It's very possible to become angry or confused by people's comments, positive or negative.  But if inside you tell yourself nothing anyone can tell you will change the affirmation you tell yourself: "I am beautiful. I am brave. I love myself." 

The thing about obesity is that many who have suffered from it have lots of practice with having thick skin from ridicule, on the contrary, many have thin skin in talking about the problem of their weight.  We have to accept that what occurs on the outside, the things people say, do, and how they act are only permanent perceptions if we let them continue to occupy space in our minds. 

If you believe and act out of goodness, you will bring goodness into your life.  When you make mistakes, and we all make mistakes, accept them, *resiliency in action here* move forward, and love everything about YOU. Do not allow the distortion to cloud your judgment.  You are beautiful, mistakes, flaws and faults, you deserve to be here. 

Understand the limitations of where you are right now in your journey.  Don't hate things you can't change immediately. As long as you are working on whatever it is you are attempting to change, those negative thought processes of wallowing in self pity are destructive to the end goal. Assess your strengths and weaknesses, but don't dwell on them. Make a plan to address your shortcomings, write in your journal about what it is you want to do and do it.  Set realistic expectations for your self. Choose to make realistic changes about your health every single day, journal it. Write down three goals you can accomplish today regarding your health. Small stuff, things like today I will exercise, follow my nutrition plan, and appreciate myself and my dedication to these goals. At the end of the day, did you? If you feel the need to tell the world about your journey, do so responsibly.

Find appropriate social support to reinforce positive behavior choices.  If you are recovering from obesity, find ways to socialize without food. If you suffered from alcoholism, you wouldn't hang out in bars.  So, if you're recovering from obesity, don't center your social activities around food.  You can just as easily find outings that focus on exercising together. This is just another reason why using walk and talk therapy is a great way to process your experiences with your peers.

Find ways to contribute positively to others. Build other's self esteem, it will impact your own. Be a quality member of your community, volunteer or just offer a listening ear to someone who is understanding of your struggles and successess. Find things to do that will boost your self esteem in positive ways. Find your cool crowd. If you struggle to keep up, find gain perspective on what you value in your friendships.  Do you provide honest, intelligent, loyal, and kind friendship to others: friends and acquaintances alike? Are your friends dedicated to what's important to you in your journey to good health?  Do you have friends you can spend quality time with to go to the gym rather than go out to eat on a Friday or Saturday night?  Build these circles.  They can be your rock. 

This is a journey of growth and development.  Surround yourself with support, love and kindness. Find activities will promote good health to do with your loved ones.  Share what's appropriate with those who are important. Maybe it's just me, but I don't think it's appropriate to seek validation from the internet, it's not just an empty relationship it's a black hole. Find depth in your real life and live with love. 

Thursday, June 13, 2013

GREAT Support Systems

We ALL need support systems.  Not everyone in our lives will be good support systems, even those closest to us, may not be the best to go to with the good, the bad and the ugly of our internal dialogue struggles.  We all need uplifting people in our lives.  We all need good support and love from one another.

I have found that in so many people in this community.  People who are brave enough to say something to you, do something, and offer help, be it through friendships or professional relationships. There are good people out there doing good things because they want to inform others before they make the mistakes that they've made in the past. They want to support you in achieving your goals by keeping you informed, accountable and let their love of good ooze over into whomever needs it.

There are many groups online that are free and offer great support.  However, this post is going to go against one of my tenets-- I am going to back two programs I believe are 100% worth the money and the investment of your time.

The first is Fit and Flourishing. Erin Akey is one of those amazing support system for me.  She has built her career around helping bariatric patients through her Bariatric Guru programs. She has a weekly radio show, Fit Living Radio. Currently, Erin is recovering from back surgery, a spinal fusion, which for a personal trainer is a thorn in her normally very active side/back.  So, she's starting a challenge on June 15 through August 15 (Ends day 1 of Your Weight Matters Convention in Arizona!) I invite you to join us here: 60 Day Move Your Butt Challenge. This program is 100% FREE, and the challenge is to collectively get 10,000 miles in the group.  If you LOVE this group, think about signing up for Erin's Online Personal Training for $12.99 a month.  You'll get access to a certified personal trainer, Erin, and soon to be Nutritionist (Erin's just gone back to school to get a second degree in Food & Nutrition at Bama. I forgive her for that Bama part, she is a NOLA girl, through and through, her other degree IS from Tulane!)

The other great group of ladies who I truly admire in this community, A Post Op and A Doc.  Talk about funny and witty and amazingly fun support, knowledge, and expertise packaged into interactive sessions weekly.  Cari, the Post-Op, and Connie, The Doc, were some of the first personalities I encountered at my very first WLS event, the ObesityHelp conference in New Orleans in September 2011.  I took Connie's Continue Education program, "Understanding the Obese Patient". That's what us counselors have to have to continue our qualifications for licensing in our states (CEU's.) It was this event, Connie's program, that made me realize I had to focus my career on helping bariatric patients. I had to take my experience as a patient and offer up my knowledge and experience through my professional lens.

Connie and Cari offer a free weekly chat on Spreecast, as well as upcoming paid programming Recovering From Obesity. This program will be 12 weeks, one and half hour group meetings online, on Monday evenings.  I know for sure whoever has the opportunity and resources to attend this program will benefit from it tremendously. You can reserve your spot now for $50, the full program fee is $300. Certainly worth every penny if you have the means and are willing to commit to those 12 weeks with these great ladies.

The disclaimer:  None of these three amazing women have asked me to do this.  I do this because I know and have been affected by their reach and care in this community.  They do good work.  I don't normally promote paid services, but I realize, as a clinician, that free does not always have the same impact as paid services.  There are many free support services out there.  They are amazing enough to offer those to you too!  That's why I love and admire them for their continued contributions to the WLS community.

I continue to offer my services to this community for free as well.  If you are struggling and are in need of a therapist, I am here. Please email me at  I will help you locate a counselor in your area who specializes in the diverse, complicated issues associated with the struggles of obesity and bariatric surgery.  FOR FREE. ALWAYS.  If you are in Louisiana, I'm also happy to discuss with you my services and sliding scale fees for counseling services. I am currently a Counselor Intern in the State of Louisiana, and I have to abide by certain restrictions due to being a candidate for licensure. However, I'm no spring chicken, I received my master's degree in Counselor Education in 2006 from the University of New Orleans, and I have specialized in treating patients with depression, anxiety, learning disorders, and the affects of obesity.  I believe in using motivational interviewing, cognitive behavioral therapy techniques, and existential therapy to help people recover from their personal experiences, we all have an opportunity to live a better live through empowering our minds and shaping our environments.

Wednesday, June 12, 2013

Hearts & Hurts Don't Fade Away

#wlsrealizations You tell yourself it hasn't changed your relationships with people you love... but then you realize otherwise. :-( You lie to yourself and say this person is no longer in my life and that's good because of the hurt and pain we have caused each other, but that not knowing why.... that's more hurtful than anything.

It just dawned on me tonight, WLS may have contributed to the loss of a friend. No, this friend didn't die, this friend just went away. No response to my emails. No explanation as to why she deleted me and never calls anymore. This happened over a year ago. I emailed, no response. I let it go. It wasn't worth worrying about because this friend has "gone away" before.

This friend and I have been through a lot together. Quite literally, we have lost our shit together. We have been down weird, strange, awkward roads and lived bizarre realities, stranger times, once upon a time. We've grown up now. I told myself, lie #1, that we just grew apart and now that she has kids and I don't, she chose to leave my life. It hurt. I won't say I didn't cry, that would be lie #2. But I told myself it was for the best.
You see, this person had surgery 3 months after me. Didn't want me to know about it. I found out about it. I was so happy for her. She chose more wisely, bravely than I did, had a different procedure. She chose something that was still investigational at the time. (I like to think it's because she way smarter than me in the scientific sense, but at the time, I think she just did better research. I look back and realize I was naive, and used poor logic in thinking that not cutting part of my stomach out was a good thing-- rather, squeezing it with silicone would be better--- little did I know the rejection my mind and body would go through.)  She's been more successful than me, since my band is out, I'm slowly regaining weight, and not without trying to keep it off. I'm proud of her success, but I hate that I can't tell her that.

I hate that my best friend is gone. For all the history and love I have for her, all the things that have passed that we did as stupid college kids, I know she's still one of those soul mates in my heart. That we can laugh and cry and goof off like old times if we just looked at each other and said, "I'm sorry."

Actually, whatever it was, "I'm so seriously sorry." If I likely said some asinine thing that made no sense, had no validity, was illogical, offensive or ignorant, whatever it was, I just want to say sorry and have her back in my life. I accepted the loss as likely something that was good. We got in trouble together. A lot. Like, who do you wake up next to you in jail kind of trouble... but that was once upon a time. We've grown out of that kind of behavior. I know I have. I'm pretty sure she has. I wish we could be grown up together.

This is probably one of the most personal posts you will ever see here. I didn't even cry writing it because I had accepted the unexplained confusion over a year ago. I just let it go... Or so I thought. Until something strange and rather ridiculous brought it back up out of the blue. It brought the blues back....

Putting it out there, saying it, I miss you like hell.

“There is one emotion that is stronger than fear, and that is forgiveness.”

Exciting News: Your Weight Matters

YWM2013 Convention badgeI have great news.  Great EXCITING NEWS!

I will be attending the Your Weight Matters 2nd Annual Convention at the Arizona Grand Resort!  It was unfortunate that I could not attend last year, I was sorta busy, busy getting married. It's going to be amazing! EPIC.  So, if you've said to yourself, "Wow, I'd really like to meet this Bariatric Counselor."  Here's you're chance.

Education, Advocacy and Support – Obesity Action Coalition Set to Host 2nd Annual Your Weight Matters National Convention

On August 15-18, 2013, at the Arizona Grand Resort and Spa in Phoenix, Arizona, the Obesity Action Coalition (OAC) will encourage you to “Rise to the Challenge” and will bring you the most comprehensive educational and advocacy Convention ever experienced. After hosting the Inaugural Your Weight Matters Convention in 2012, the OAC was met with such positivity and enthusiasm that warranted one response – an even better event in 2013.

Weight and health go hand-in-hand; however, few individuals realize how much their weight impacts their health. The Your Weight Matters Convention promises to continue to build from the ground up, a solid, unbiased look at weight, treatment options, weight bias, childhood obesity, nutrition, exercise and more.

In addition to educational sessions, the OAC will host a National Advocacy Training session on Thursday, August 15. The training session will provide an in-depth look at how to become an effective advocate for change and allow those interested to practice advocating with an actual legislator. This session is limited to the first 100 interested attendees.

For more information on the Convention or to view the official Convention video, please visit To view the Convention’s official Facebook event page, please visit

I-10 New Orleans - "Your Weight Matters" Billboard!  

Monday, June 10, 2013

Part 2: My personal theoretical orientation as a counselor

Because I was asked these questions in an email over the weekend, I finally sat out and wrote my evolved theoretical orientation. As a graduate student, my theoretical orientation looked quite different because I thought of it in context to the population I served: college students working through career and learning exceptionalities, anxiety, depression, and other mood disorders. The bariatric community has had a large impact on how I see the world and what I believe is my best approach to helping others with their struggles related to obesity.

I mainly use motivational interviewing, cognitive behavioral therapy, and existential therapy. Some would consider me eclectic, but I believe that motivational interviewing is my style, cognitive behavioral is my technique, and existential therapy is my philosophy. Existential therapy is the belief that we are all essentially alone in the world, and we long to connect to make meaning of life with others, but ultimately, we must find contentment in our understanding that anxiety comes from the knowledge that our validation must come from within and not from others. However, I believe patients must consider their own ecology: the elements that make up their human existence and struggle with understanding the elements contribute to their relationship with their nourishment and physiology. If their stressors come from family, trauma, abuse, neglect (of self and others,) they must find those underlying issues and identify the impact it has on their live, and understand the behaviors resulting from those stressors.

We all are unique in our needs for therapeutic intervention. Some people do well with a family systems therapy if their issues are mainly focused on their relationships with family, others may thrive with someone who specializes in faith based counseling, if they are driven by Christian beliefs. Mental health care has been long stigmatized as a negative prescription, and so many people just want to get through the assessment process and do not want to consider the organic psyche and its condition. I could put a number on the length or number of sessions, but I truly think that depends on the issues, the willingness of the patient to discuss issues, and how dedicated to changing their thinking patterns.

Common post-op issues can often be solely the result of the weight loss itself sometimes. Dealing with new attention, emotions, body image issues, self esteem... along with the change in relationships and people around them, how to handle comments, positive and negative. Some patients will feel resentment to positive comments from some people and accept some comments from others. Everyone is unique and beautiful as they are though, wherever they are in their journey. That is what I try to continually portray to everyone I encounter. No matter where you are, pre-op, post-op, band removal, revision, pre-plastics, may never get plastics, the number one important character trait is resiliency. Overcoming the negatives and focusing on the positives while you are still working toward small, attainable and realistic goals.

Anyway, my position continues in my willingness to gladly help others find a therapist for anyone who is interested in counseling services in their area. Due to licensing board regulations, I can not provide telecounseling, so I am happy to offer peer supports online in video chat. I have been a practicing counselor intern for the last 2 years, and I have about 300 hours left until I'm licensed. I've had my Master's degree for 7 years, but I did not hold positions where I had eligible direct contact with clients. I also work with patients who have not had WLS, and specialize in ADHD/behavior disorders, anxiety, depression, bipolar disorder, autism spectrum disorders, and career counseling.

This community is, by far, where my passion lies. I see the need for knowledgeable, trained professionals to work within surgeons offices to facilitate groups on a weekly basis, identify those who may be struggling, and work with individuals on a sliding scale. There is some talk of this being a requirement in the Centers of Excellence (now MBSAQIP), though I still think that's probably 3-5 years down the road, at the least, they understand the growing need to address mental health care as a significant issue.

Wednesday, June 5, 2013

New Series on Understand Counseling Theories: Part One - Understanding Theoretical Orientation

We are all unique individuals with certain needs in therapy. I hear very often people say, "I only went to therapy a few times, I didn't like my therapist."  This concerns me because not all therapists are meant for every client. Taking the time to interview your therapist about their approach to counseling is advisable. Any good therapist will give you some time on the phone to discuss their theoretical framework and approach to your specific concerns and issues.

Each therapist is going to have their unique theoretical orientation. This simply means they follow certain schools of thought in the way they interact with clients. What this means is that counselor uses certain techniques to engage clients in meaning for processing of their issues. In this series, I will do my best to explain what a therapist's theoretical orientation is and how you can choose a good fit for your reason for therapy.

There are several central figures in the history of psychology. Sigmund Freud is quite possibly the most renown psychotherapist and the "Father of Psychotherapy." As the field of psychology grew, so did the theories of great thinkers and researchers alike. Freud's psychoanalytical theory provides a set of terms, guidelines, therapy techniques, ways of thinking etc. The picture comes to mind of a person on a couch exploring their experience through talk therapy. Consideration to what you seek therapy for may often dictate which orientations suit your needs. If you like the "talk it out" process and believe that a listening ear and thoughtful insight are good counseling, a psychoanalysis may be the way to go. However, most therapists' are going to use talk therapy and psychoanalysis to an extent, and their actual theoretical orientation is something they call "eclectic," which maybe a combination of many schools of thought.

Often times, our issues maybe central to the relationships in our lives.  Our family structure or relationships may post strains on our ability to cope with difficult problems or emotions. If you are seeking counseling for your marriage and family issues, a marriage and family therapist would engage you in the Family systems theory and process your issues with you through this theoretical framework. A session would look very different than an individual counseling session where the therapist practice existential counseling theories (but more on that later.)  Family systems theories are often performed as an ancillary function of their role as a leader in the community, such a priest or reverend, chief of a tribe or head of a spiritual group.  This approach can be useful with interventions for drug and alcohol abuse if the person holds those in high regard and it fits within that person's belief system. Generally, this spiritual framework will only work if the person accepts the intervention and is willing to do the work to repair broken relationships.

Generally, counselors employ the techniques of more than one theoretical framework.  You will often her them say they are "existential therapists" which means that person employs the use of more than one theoretical approach.  A counselor can practice more than one type of therapeutic intervention and even take into consideration the beliefs of their client in order to meet their needs. An individualistic approach tailored to that client's needs is the best approach by any counselor. However, some therapists choose to work within their framework and don't adapt to client's needs. A counselor who offers you a person centered cognitive behavioral therapy combination may favor may be guided by the behavioralist in their interventions but uses a person centered approach to their session style. You have a right to know, understand, and be educated on the theoretical orientation that your treatment is derived from.

Some types of theoretical orientations simply do not mesh well with Christian beliefs. Aspects of the theory might be used but be weary of a counselor who uses one of these theories for their main practice. Psychoanalysis provides a good example of the foundation of unconsciousness, this is not necessarily
against Christian beliefs but a psychoanalyst explains the unconscious through repressed sexual feelings. The family system, relationships, your overall experience with the world outside of yourself is largely determined by unconscious sexual urges in psychoanalysis. Consideration of this factor determines that Christian morality might not mesh with this framework.

While most of psychology is based on Freudian thought, it possible to counsel a Christian even though psychology is considered an analysis of abnormal behavior. The process of thinking, conceptualizing and formatting your ideas into your moral code and analyzing your cognitive dissonance may allow a person to match the inconsistency of their thoughts, words, beliefs and actions. Recognizing how your beliefs relate to your actions can change a person to live a more morally congruent life.

I know, this has nothing to do with bariatrics, weight loss surgery or weight loss--- yet.  I'll get to that part in the next post.  Next up, your personality and how it relates to your therapist.

Monday, June 3, 2013


Dear Members of the Board of Directors of WLSFA,

I am profoundly offended by the inquiries recently made by your board members to my professional colleagues regarding accusations of their prompting me to write my blog on the WLSFA.  My blog was prompted by surmounting information and concern for clients, as I had suggested pursuit of grants with your foundation. After reading over your website and reviewing the previous recipients, I did not feel comfortable leading them into exhaustive efforts that would likely lead to no result of help with their pursuit of surgical weight loss.  I could not, in good faith as a mental health counselor, direct my clients to an organization that would essentially provide them with false hope, continuing a cycle of disappointment and frustration, when your reach as an organization has continued to be so diminutive and seemingly reaches only a select few, of which are often friends of members in your Board of Directors.

As a counselor, I am obligated to my professional ethics in seeking to do no harm, which includes understanding the intentionality of my actions.  In referring one person to your organization, I would be leading them down a path of false hope, which in my opinion is doing greater harm than helping them to find the financial resources on their own to pursue surgery. The concept of your organization is honorable, but the behavior I witnessed and recount from events, witnessed in my interactions with your board, and repercussions of poor management lead me to believe that you had created your own demise before I said anything on my blog. 

Unfortunately, your vendors do know about the situation that occurred after Las Vegas.  As I attend professional conferences and have them ask me what is it that they could not put their finger on that was not right in Vegas at WLSFA, I will direct them to the tax returns and the paid vacation that you all like to take in Vegas each year while partying when the opportunity has existed for WLSFA the entire time to provide education and support. It is blatantly obvious that the only people benefiting from the existence of WLSFA are its Board of Directors and its very few grant recipients.

I won't bother to offer my suggests on how your organization could improve its operations and mission again.  I know it will fall on deaf ears, and I am not going to waste my time. I have better opportunities to advocate and support those who struggle with obesity, wherever they are in their journey.  I do not tolerate bullying, blame and shame games, accosting strangers to self promote, and ostracizing individuals for their personal struggles in their journey when it is not the business of that person-- in assuming leadership roles, one must realize their obligation to be non-biased, compassionate and understanding rather than arrogant and unkind.

I will conclude my letter by informing WLSFA that I attribute the problems in your organization to a lack of true goodwill leading your agenda. Nepotism is not the role of charity. Charities have an obligation to be compassionate and provide information and resources to all who seek their help, even when they can not directly impact the livelihood of that person. I do not see that occurring in your organization, I see enabling transfer addictions, self promotion, and nepotism as the mission.  It's not what we say that shapes our missions, it is what we do with the responsibility of leadership roles and how we meet our obligation to others with kindness and positive regard.  If you have issues with me, personally or what I have said, please contact me directly for clarification. 

Regards & GR