Obesity Bias, Weight Shaming, and Attitude Adjustments

As someone who has experienced obesity bias from youth until now, and having experienced the social norms of average weight, it bothers me when I see reality shows that do this:

Extreme Weight Loss

http://chrispowell.com/examiner-com-chris-powell-tells-what-it-takes-to-qualify-for-extreme-weight-loss/

If you can't see what's wrong with this picture in terms of the obesity bias that exists in the world, or you think these shows are great, stop here.

Are you still with me?  You see, when someone with obesity is publicly put on an industrial platform scale to be weighed on national television, the problem is both cultural and personal. Our culture's obsession with intrusiveness on private matters is disturbing.  I know, she's consented to this awful public display, but it's not a far fetch to say that she's seeking attention.  As a therapist, I know certain attention-seeking behaviors are not appropriate or effective in building long-term mental health and wellness.

You see, weight bias and fat shaming are known not to encourage weight loss.  There are more and more studies out there that reinforce the idea that this type of "shame display" does not lead to strong mental health and reinforcement of positive longevity of good behavior development.

So, when I try to point out the negative aspects of a show that people think are "doing good things" it's not me trying to disregard the feelings of anyone or their people, it's me trying to tell you that this is not the most effective way to reinforce positive habits of health.  If you feel the need to put yourself on display to the world, and then you regain, there are deeper seeded issues that need to be addressed. It's not the weight, it's a lack of nurture and a sense of neglect to be a grasp on.  We need to get you to where you love yourself.

I maintain my statement on shows like The Biggest Loser and Extreme Weight Loss, neither show is a practical guide to long term health development.  In fact, both of these shows make "pseudo-celebrity" status of their contestants, and well, if some is already inflicted with a gregarious personality, it could only exacerbate histrionic personality symptoms, which would be a downward spiral once the attention is no longer on them.

More important than teaching people how to lose weight, is how to approach health in a practical manner.  It is not realistic for someone at home to watch a TV show where someone is given a home makeover, $25k on a Wal-Mart gift card, and one-on-one celebrity fitness guru instruction.  There is more power in teaching someone to self motivate, drive their own emotional being (teaching emotional control from outside influences) and guide a self directed, practical search for health.  Light the fire of desire, not the candle for limelight.

Because once the limelight is gone, the drive and desire will fade.  The cycle of negative thinking will ensue, and the person will be worse off, but with a lot of nice gym equipment in their home.  (Personally, that part makes me a little jealous, I need a home gym, damnit! Don't we all?)

Anyway, I digress.  Are you surprised?  If you know me, definitely not.  My message here is that when you work in healthcare you have to have regard for personal feelings, attitudes and bias. You have to break the bias that exist in your own mind.  I once found myself particularly caustic with two dietitians who were waxing poetic about some "skinny girl in their class" and I made the mistake of telling them I thought it was inappropriate to speak about her. #1, she's not there, and #2, what if she struggled with her weight as well. What if, "being that skinny girl" was a negative self perception she had and the result of an eating disorder? 

It's just not appropriate to talk about someone in that context.  We should not use negative adjectives to describe people. "Fat" or "Skinny" are not terms of endearment, "chunky" or "chubby," "thin" or "svelte," people are emotional beings, and weight issues are an emotional subject matter.  Putting someone on display for their struggles is not a way to help.  It's the way of shaming, public humiliation. It is neither useful or helpful, it is plain staging humiliation. 

Now for the attitude adjustment.  I've also touched on this before.  Someone else's weight is not your business unless that person chooses to make it your business.  Believe me, if someone wants your help, they will ask for it specifically and directly.  It will be clear and apparent that you have been chosen as an authority for their considerations for their health.  I am appalled when I hear about clinicians making remarks about patients' obesity.  I am even more appalled when I hear about people intrusively making someone else's health their business.  As this has recently happened to me, and my primary care physician was just as appalled by the behavior as I was.  Thankfully, my PCP understands that this was done out of concern, my doctor called to let me know this was done, and told me he was supportive of me and respects that I know what is best for me.

You know what is best for you.  Don't allow someone to come up to you and make your health their business. And while you may think publicly expressing your concern for a stranger is appropriate, remember, you are not the authority over them.  You may think you are being compassionate, but you are not their doctor, nor do you know where they are in their journey. Be mindful of the people in this community who are still struggling and have other conditions contributing to their weight retention.  Is it true?  Yes.  Is it useful? More than likely, no. Is it kind?     Meh.  Will it come across as KIND?  If no, then proceed to STOP. 

It is time for our to be confidently in charge of our health and stick up for ourselves when people rudely and intrusively make our health matters their problem.  It's not their problem, it's ours.  We own our health, we take responsibility for all matters, whether we can control them or not, we take control by educating ourselves and making good decisions. That means in our actions, words, attitudes and behaviors. 

If you are a member of this community and you are trying to capitalize on other members of this community selling some product or service, it is in my nature to analyze, criticize and be concerned for other people who are not as discerning.  Please do not exploit your own post op success as an authority, work within your education and scope.  If you have a certification from XYZ organization that holds no clout, I have the professional and educational background to back my position that you should not be doing what you're doing in the capacity in which you do it.  End of story. 

CMS decides Your Life Doesn't Matter

As always, Ted Kyle of ConscienHealth sums it all up for us nice and neatly for us. The Centers for Medicaid and Medicare Services (CMS) have unfortunately made will have injurious consequences. It's going to get messy, and not messy in a way that will be cleaned up easily. It's going to cause people to lose their lives due to a lack of quality care and strict standards. Sadly, the group that will bear the brunt of this decision is.... Surprise, the poor and elderly.  Shame on you, CMS.  Shame on you, Congress (for your current lack of concern for healthcare in this country.)  I wish these public servants would put their egos aside and work for the people, not the corporations.

This decision has far-reaching consequences due to the guiding force that is CMS.  Insurance companies use the policies and protocols of CMS to make their own decision making models for their policy holders. This decision will trickle down to every individual who has dealings with bariatric surgery.  I guess the only good measure that might occur is that some surgeons may be more willing to see patients who've undergone procedures with other surgeons.  Maybe.  I mean, it certainly hasn't been helpful that so many refuse to perform follow up care on other surgeon's patients. Heck, most doctors shy away from it because they lack a knowledge and understanding of bariatrics. Honestly though, their malpractice insurance isn't anything to scoff at, so I don't blame them for taking a stand on their professional liability, but... everyone needs care. A patient presents with you a variety of symptoms, construct-- patient has had bariatric surgery, what kind and how do you adjust your treatment approach?

Let's go back to the undermined group in our American society today though.  That group that is so under-served, we don't even talk about them.  The working poor, the people who work so hard but have nothing in the means of healthcare.  No back up, no access to care, just their paychecks and the mercy of primary care doctors willing to see them for well-appointments for less than their average wages.  Those Americans wishing for a healthy life, should have access to the available treatments for obesity.  People who are educated enough to know they need to do something for their health, but can't because their employers have written them out of the quality equation.  It's sad but true, let's all get Federal Government Health Insurance, we are as deserving of it as the people who are suppose to be serving us.

But I digress, as of 2011, there were 48 million uninsured Americans. That number isn't shrinking, employers are shrinking coverage to quality treatment.  Healthcare providers are scurrying and in panic over the confusion of Obama care.  Let's stop making up programs and start providing CARE.  Let's stop trying to save the world and save our people home, Make Americans Well.  Let's find ways to support our nation by giving everyone the same access to treatment options if and when they want them, and support them in the follow up of their choices.

Let's educate our society about the benefits and the RISKS involved in surgical weight loss procedures.  Let's stop ignoring the fact that some procedures fail at an alarming rate of 40-60% .  Don't turn a blind eye to this statistic and blame the individual when the wrong treatment was selected.  Where is the compassion?  It's gone. We would rather shame people with obesity as a society than help them. The haves versus the have nots will always have a louder voice.  Be compassionate, you never know what someone else's story is until you listen to them. I won't turn a blind eye to the problems I see in the care continuum of bariatrics.

So many people approach their weight as the singular problem.  It's usually not.  There are usually underplaying the psychological struggles they're having with food-- that's why you hear people say "How do I pass the psychological assessment process and get the green light to surgery?"  You wanna know how?  You learn to be 100% honest with yourself.  You dig deep, real deep.  You look at compulsive, obsessive, binge, and overeating behaviors with no filters.  You say to yourself, I got here over the long haul, and you realize the work is going to take a lot of time and effort to find health.

You also learn humility.  That even when you're doing it all right, you might meet biological forces that provide resistance.  Unseen resistance with the naked eye-- hormones: thyroid and metabolism-- medical conditions that will make it difficult, even with surgery, for you to get to a health weight.  BUT, you will persist in your efforts because you have and understand the importance of SUPPORT and EDUCATION. You won't shun the weekly or monthly groups your doctor's office has available to you or you will seek out support online and find others who are rooting for you.

Oh, wait... back to the CMS decision.

Those support groups and education efforts of your surgeons' offices will be at their discretion.  Never mind, giving you the tools to help yourself and stressing the underlying importance of addressing the psychological and emotional basis for your obesity isn't important.   Moot points... Well, I'm done.  Stick a fork in me. All arguments I have are invalid because a small lobby from the State of Michigan decided that MBSAQIP (Formally known as the Bariatric Centers of Excellence) standards are not as important as their own agenda. Credentials are a money making industry too, but respect is give to organizations that are run by the leaders in the medical field.  ASMBS and ACS are THE agencies in the US that provide standards of continuing education in surgery.

This all boils down to egos and agendas.  We're not on Congress' agenda.  We're not on CMS's agenda. If you don't have money in this country, you are powerless. Sad, but true.

We can only hope the all of the Congress persons will realize that every life is valuable.  Each person on this Earth has purpose.  The impact we can have in our generation to make sure others will live the longest and healthy lives possible.  Our digital age gives us access to one another to build ideas into realities. Find your passion.  Do good things for yourself and others.

Social Desensitization & Obesity Perception

As a society, have we become socially desensitized to obesity?  Or is it that we've developed a distortion of normal?  Yesterday, Ted Kyle of ConscienHealth posted a blog titled "Shopping for Obesity," which brought me back to an incident over the weekend.  My husband, you see, leads a sheltered life.  He'd never been to Sam's Club before this weekend, when we just so happened to be out and about together shopping.  I needed a new printer, so my trusty Sam's Club membership comes in handy when purchases, such as this arise.  Costco was all the rage here this weekend, our first in the state had opened in MidCity, so everyone was talking about it.  My husband's reaction:  what's the big deal?

So, we go to Sam's Club, he grabs the first printer we see (which happened to be the one I intended on purchasing anyway) and we set off to pick up oatmeal, apples, and along the way he grabs a can of mixed nuts.  When I'm ready to check out, he trails off to buy a pretzel and escape the madness.  Of course, I'm just going about my business, not really paying attention to the people around me, but rather, probably fiddling with my cell phone to avoid speaking to anyone I encounter.  I'm not very social in public when I'm oriented to a single task-- usually, to get in and out as quickly as possible.

As Jonathan licks his fingers clean of pretzel salt, he lends over to me in a whisper and says, "Did you notice anything odd in that store?"  I stumble over the throngs of people and say, "No, why?" He goes on to say, "So, you didn't notice the inordinate number of obese people in that store today?"  Well, no.  I didn't, honey. I imagine that with two-thirds of the population classified as overweight or obese there would be some people who fall into that category.  So, we questioned this phenomenon, and there, in Ted's post was the exact situation we encountered.  The overabundance of food supply and the enlarged waistlines of the American consumer present in our Saturday trip to purchase a printer.

As social media content development guru for my company, I came across an article yesterday that drove it home, "Is he healthy? Exposure to Obesity Changes Perceptions of Weight Status in Others."  We've been desensitized to appropriate size.  Not only in portion control but in what's considered normal in actual human physique.  Now, here's where I get personal about my journey in weight loss and gain and all the psychological distortions I've gone through in this process.  It's my personal, in-depth analysis of self.

I've never known a normal weight.  Therefore, when I lost weight and was a "normal weight" I wasn't entirely sure what to do with myself.  I enjoyed it, but I almost felt uncomfortable in this new body that I had.  It wasn't what I was used to at all.  It was the new normal, but my mind didn't have a chance to get caught up with my body.  As I have regained the weight after my band removal, I am more familiar with this size but more uncomfortable in this body.  Then there's the skin-- with the weight loss, the skin was just a necessary burden after having lost 180 lbs.  Now, I've only lost 80 lbs, it's just flab and fat, not skin.  I tolerate it a little be more openly because it's not just hanging there, being a burden.  Now, I have 100 lbs. to lose, again.

So, what does the counselor say to this, "How do you feel about that?"  Well, I definitely don't like my regain.  I definitely have paid attention to what I've eaten and exercised and still found myself in this place.  This place where I was once comfortable for so long, and now I am not.  I know I have to accept myself where I am right now to move forward in a healthy way.  I continually question whether or not having another surgery is going to make anything better or if it's just going to put a temporary relief on a lifelong problem.  I don't want to struggle with regain anymore.

I've broken down, broken out, and processed all I can about what got me here.  All I know is, I have to be come excruciatingly meticulous about what goes into my mouth and how I exercise my body and what I think about how I'm doing that.  How much I put needs to be an exact to a science.  What I do needs to be quantifiable in the gym.  It's not just time and type of cardio but keeping a record of weights in strength training.  It needs to be following a plan, rather than haplessly doing something because I'm there.

I think as a society, we're all working with a distorted view of size.  The new normal that should be developed is an old *societal* standard. However, you have to find where you are most comfortable.  In many ways, I feel like I cheated.  The band forced a diet of starvation and bulimia for an extended period of time, and my accountability tanked.  Now, the accountability must be exact, measurable. Those SMART goals we all should be making-- our dreams and our goals need to be specific.  They can't just be "I want to lose weight" and I want to lose it as quickly as possible without concern for my health.  They simply must be, "I am going to lose weight as a product of eating the right foods in the right portions. The byproduct of my efforts will be weight loss."

Back to my husband, he's not insensitive to obesity-- he's just never been obese.  He's learned what he's learned about weight bias and size discrimination and obesity from listening to me.  However, he's still one of these people who thinks that weight loss is easy, eat less, lose weight.  For so many of us, that's not the battle we are fighting.  We're fighting deeper seeded wars against ourselves.  My empathy for people with obesity is deep because I've outwardly fought this fight since I was seven years old.  My social cognition is in a state of acceptance for others as they are.

My perception of self is to accept myself as I am.  That doesn't mean I'm not driven to change the size of my body, I am, I think, talk and do things to it to drive that change every day.  But I don't go around judging other's place in their world.  I just don't have the knowledge of them to make judgments of their current body size, nor would I want to because I understand how much that judgment hurts when realized. I think we each need to realize that someone else's obesity is not our business unless they ask for help.

"Prophet"-izing your weight loss successes is great to a point. (Profiteering on your success inappropriately is another blog altogether!)  People will be happy for you, but you may turn them away in your gloating.  People will say you took the easy way out.  Accept that their words aren't meant to hurt you, and that yes, you made your success more attainable with surgery. It's certainly not easy to make the decision to go under the knife, and you can't take it back once it's done. Realize that it's okay to have surgical help to resolve your obesity. Never, ever forget the struggle you had, the emotional pain that you experience, and the harsh judgment you felt, heard, saw and experienced.  Think twice before you say to someone, "I have the key to success."

Guess what.... You don't have their "key to success."  You only have your own "keys to success."  Finding one's own keys to success is an individual experience-- some may need others to help, some may not.  It's never, ever appropriate to go up to a complete stranger and assume you know how to fix their obesity because you've fixed yours.  You're keys don't fit in their door.  Walk away, or learn to be tactful, LISTEN to them and their STORY, and you might just walk away having learned something from someone you thought you could fix.  I learn more from my clients about myself when I listen and hear their stories.  

Your "Keys to Success in Recovery from Obesity" are not the same as someone else's-- Lose your perception of fixing others' problems, stop and listen to their story, and don't try to fix them.  Compassion can go a long way without offering "quick-fix" solutions.

The truth about my band...

I made the big mistakes, I broke some cardinal rules.  I aggressively filled my band for the first year, while I had free visits to see my doctor for fills. I had heartburn in the second year, and I could not sleep at night from this.  It would resolve, come back, resolve, then I'd gained.  I gained 10 lbs. in year 2.  My struggle to eat anything in the morning caused me to stay on soft foods for a long time.  In the third year, I had everything taken out. I still had issues keeping stuff down on a regular basis. The bad days started to out count the good days.  But I didn't go to the doctor because I didn't have insurance.  I attempted to go to the Charity Hospital Emergency in April 2012.  They told me to follow up with my surgeon.  At that point, if I'd had insurance, my band would have come out.  The problem was that serious.

But I didn't get that service.  I know, obesity surgery isn't on the top of the list of severe diseases that any insurance company wants to cover, but I made below the poverty line at that time.  I still got denied Medicaid benefits. What is really awful though, is even now I still don't have insurance. I work on temporary contract with the responsibility to pay my own taxes, and it just isn't affordable for me when my entire year of medical expenses is less than $1,000 out of pocket. I do have an emergency policy, if God forbid, I become critically ill but my "pre-exisitng condition" was not covered in that policy.  I will just die. And I still don't make much more than I did last year, when I worked for a Medicaid clinic that didn't provide insurance or even guaranteed work for its employees.

Our government cares more about fighting wars in other countries to kill people, in their conflicts, which we really should stay out of, which neglects everyone here at home. It takes away from education, health, and peace of mind.  We are a country at a constant war against taking care of people at home. No one person should have to without medical care.  When that is taken care of here, then let's offer our hand to other nations. Let's be the role model our forefathers had planned for us to be.  Let's be the peace leaders, the wise, calm, considerate model country of American humanitarian philosophy, but let's take care of our own people first, let's stop acting like keeping people at home healthy is not important.

I don't get publicly critical about in the government issues.  I have few friends whom have political views similar to my own, so I just don't talk about it.  My views a very different than most of my family.  I really wish anyone with medical insurance who can see a doctor would understand the neglect those of us who go without experience.  It cost me about $80-120 to see my primary care doctor to get two prescriptions twice a year.  No testing, no X-rays, no sleep study.  If I want that, it can cost me anywhere between $200-600.
That's a lot of money when you make wages below the poverty line.

Everyone says, "Well, why don't you get insurance through your husband's employment?"  Don't you think if I could, I would?  It's not financially beneficial for me to get on his plan.  Sure, he's an attorney, but the firm he works for is really small.  The unfortunate part it all is corporate greed that drives the decision for employers to not cover spouses. The skimpy plans, the denial of services...

But, I don't understand it.  I don't get it at all.  Because in my true nature to the core of my being, I believe everyone deserves the same chances at being healthy, well, and enjoying a very long life.

Tell me that it's okay to let people be sick and die.

Tell me.

Please.

Why?

It irks me that my story could have been different if I'd had the same benefits as Medicaid patients. That last year of my life with the Lapband would have gone differently. That life-threatening visit to Charity Hospital Emergency Room would have played out with a different story. I would have at least had the option to go to the OR for a revision within a few weeks or a month or two, rather than having to wait six months for my surgeon who'd ignored the problem because I didn't have insurance. I see it every day, people who don't work, get government assistance, have quality health care that I could never afford as a working individual. It's a crime and shame.  

It's an unfortunately circumstance to be put in.  I've lost a lot of money over it.  I missed work a lot when I was sick from Lapband complications for those last two years.  I've been bitter about it.  I am getting better though.  I am trying to not be so hard on myself when I know I am eating right, exercising, and doing what is within my capabilities to try to lose weight that I lost before.  The research isn't encouraging though.  The weight is getting harder to take off because of age, metabolism, my dieting history, and the mild feeling of hopelessness I get when I realize that this is hard. 

It's hard with weight loss surgery to help and it's hard without it.  I could be considered depressed, but honestly, I don't let those moments get to me for too long.  I try to combat the mental torture of not knowing when I will be able to get back to where I was, with the confidence that I am doing what I can to lose weight.  It's just not working.  It's not good enough to undo the damage I've done.  That damage being to trust a device and to trust that I'd have health care that would make my weight loss surgery situation right. 

I don't know when or how, but I know it won't do me any good to be depressed about it. It defeats the purpose of trying to live a healthy life and positive attitude.  I just wish my experience would have played out differently.  I wish I year ago, I wouldn't have been on the verge of death.  But I will count my blessings, it could have been much, much worse.  

Ways and means...

I've just wrapped up the most amazing conference I've ever attended (okay, it was 3 weeks ago, but I didn't post this when I wrote it!)  I don't know where or how to start this post. I guess I'll start with the thought I woke up with in my head this morning...

"I never want to try to lose weight again. I'm not going to lose weight anymore.  I am going to 'gain health.'"

For years, I have tortured myself over numbers.  Numbers on a scale that had no value other than to degrade my sense of accomplishment or to enable my pride in success.  It was a bipolar relationship that served me not.  It was a false sense of security.  It was unhealthy.

Even those of us who have education to tell us we shouldn't obsess over the little things... do.  We want to attach measures of success to this device that is faulty and provides only a false sense of security.  It means nothing.  In zero gravity, it has no purpose... it is a grave digit, a dirty secret to some, but to me, it meant I was finally able to shed the shield of darker days.  I was living and not hiding from my weighty secret.

Avoidance.

I avoided addressing the number on the scale for the first twenty-two years of my life.  I was told I was beautiful by my parents, but they were concerned about my weight.  They tried to help me.  I resisted.  I did not want to talk about my weight. It was the literal elephant in the room.  So, when they drug me to Children's hospital and that mean old doctor and dietitian insisted I ate buffalo meat for 6 months, I complied... to a point.  Then I hid in the closet and devoured 6 or 8 boxes of girl scout cookies to sulk in my "starvation."  I hated that everyone wanted to control me.  I hated that I wasn't just naturally like everyone else in my grade.  From the first time I went to the nurse in first grade to get weighed every Friday to Weight Watchers at 8 years old to the time I graduated from LSU, I resisted listening to them because the message was negative.  You're too fat.

When I decided to take control of my health at twenty-two, I initially was very successful. I went from weighing 353 lbs at a doctor's appointment with Dr. Danton (I remember this moment clearly) to starting Atkins and dropping 75 lbs relatively easy. I became more active. I worked out. I didn't let anyone's negative perception skew my goal to be healthier.  I just worked at it, but I stalled I stalled at 275 lbs for four years.  I remember torturing myself on the scale and trying to understand why it wouldn't do anything.

Then came the Lapband, that worked to a point.  Until year two when things started to go awry, I couldn't eat in the mornings, I got terrible acid reflux, I became an insomniac because I would lay in bed for hours at night feeling tortured. It felt like I was constantly being choked.  How pleasant is that?  I have conceded with my experience, the Lapband was not for me.  I know it works for some, it did not for me.  Anxiety played a role in it, but also, just general, constant uncomfortable always on my stomach.  That constant clenching was intolerable for me.

Is banding where it's at though?  So many other options are due on the market.  The FDA is approving new weight loss drugs that may or may not be a good option for consumers.  My only advice to anyone is to consume wisely.  Do not think you can have a surgical procedure and never have to worry again.  Your weight and your ways are a battle you can win by doing right for yourself.  Do good, be well.

I won't share my future plans, but I will say this.  I have the confidence in myself each and every day to eat healthy, move more and live with enough satisfaction that my actions matter. My life matters.  I care about how others address this problem in their own lives and work toward social awareness and the betterment of our communities.  I don't know if I'll ever have the opportunity to have WLS to help me.

I must address this as politely as possible.  I don't want to offend anyone.  BUT please recognize that weight loss surgery is only an opportunity-- I hate the "tool" concept.  You know what a "tool" is to me?  A tool is something that helps you in your work.  It makes your job easier.  So, when people say, "Weight loss surgery is the easy way out" and that ticks you off, then you turn around and call your procedure a "tool," you've just negated your belief system, IMHO.  Your weight loss surgery procedure is an opportunity for you to get healthy, learn to listen to your body more closely, and a way to good health.  You have to put in ALL the work, because at any point and time, you could fall down the slippery slope to bad habits again.

Don't do that.  Cherish your opportunity.  Realize that someone (or a collective someones-- called your insurance group policy) spent a lot of money betting on your success.  Or, if you were like me, you spend a lot of money out of pocket for that opportunity.  Realize your opportunity is bigger than yourself.

Have the determination to get out and do it.  DO what you NEED to do to gain health.  Gain life and develop a routine of fulfilling exercise and creative, healthy nutrition.  Feel good about your choices every single day.  "Take good care of yourself" is not just a mantra, it is the way of life.

Lying, Cheating, and Stealing

I'm tired of the lies people tell themselves to justify their behavior.  We all do it to some extent, but when it comes to lying to people in public when you put yourself out there as a "bari-celeb" I'll dub them, then you really lose all credibility in my mind.  When you behave like a jerk to other people in the community and think that your success matters to them, well, I think you've let your head get to you.

Cheating... there are lots of people who "cheat" on their bariatric nutrition plan.  They do.  We all need a little something special from time to time.  But when you make a vlog about how you eat pizza and act like walking away for 20 minutes is a practical option to food digestion management, I really think you're full of crap.  Yes, I do.  There's no one in this world who can take an extra crispy bite of pizza and then walk away for 20 minutes.  If you're having to wait that long, there's probably something else you're doing.

Stealing... there are a lot of people online who blindly follow others who've put themselves out there.  The bari-celebs will swoop in like sharks to get your money with their MLM coaching programs that bare no accreditation whatsoever.  These are not people who care about your well-being, I promise.  They are people who want to take your money so they can fund their own personal lifestyle. Their lifestyle change included becoming rich and "famous" so they could profit from your vulnerable need to connect with successful people.

Look around.  There are successful people willing to talk to you for free. 

Also, there are unsuccessful people here who were successful and had surgery that didn't work for them. There's more to be learned from those people who screwed it up, than those who want you to perceive them to have done nothing wrong in this journey.

Recently, there were a few heated posts about Rex Ryan.  I dropped my "weighing in" on the topic when I realized that I was talking to an audience that didn't want to her about what went wrong for me with my LapBand.  I am very happy to discuss with anyone what happened.  My stomach became convulsive, to the point where I could not keep anything down.  I had stuck episodes on occasion, I had that uncomfortable feeling many times, more than I would like to admit, but my doctor considered me successful.  My message is and has always been, it can happen to you anytime. Wouldn't you want to know about what happened so you can try to prevent it?  I realize the banded gastric procedures are not for everyone. I was one of the unfortunate ones it was not for, even though I was successful with it for 3 years. The last 6 months were hell.  So, instead of calling me a band hater, why don't you ask me what the hell happened and why it when wrong so you can learn from my horror?

But no... people want to pull wool over their eyes and act like it's all pooping rainbows all the time. It wasn't. I know some people are successful with it, but just because you're successful with it, doesn't mean you know everything about what could go horribly wrong with it in the future.  Grow up.  And if you get paid to promote it, don't even talk to me about it.  I'm not stupid, when someone pays you to promote something, you don't talk about the side effects, complications and hazards.  Why not?  Wouldn't it be beneficial to explain how those things happen to some, what those stats are, and how to prevent them?  Isn't that the socially responsible thing to do in corporate America?  No.

It's to turn a blind eye, ostracize those who speak negative words about your product, and never acknowledge the stats.  Never acknowledge that there are just some people who bands are not good for and for a good, long while, many surgeons were getting kickbacks from the company to get as many bands in as possible.  That's what they don't tell you.  It's to hard to act with integrity in corporate America.  It's to hard to have a warning label on a product that they've just installed inside you.  No, that's not good marketing.

Marketing... these perceived successful people toot their own horns so much.  But the sad part about it is they can't always empathize with you.  They never knew your story, your weight struggles, and they don't want to. They don't have the time to stop and listen to you.  They just want your money.  I'm sorry to be the bearer of bad news.  I'm sorry to be the person that has to tell you not to open your wallet for online support, and not to trust a few people's good experiences without asking yourself the question of "what are they not telling me?"  They aren't telling this... They got into this with the sole intention of making money. Because that's what people who market for a living do.  They want your money, they want your attention when they speak, but they don't want to take the time to listen to you and hear your story.

There are many of us here online that will listen to you, care about you, and support you for free.

23 Self-Regulation Executive Functions of Obesity Prevention

#1 We perceive ourselves to be successful at weight loss and maintenance and we exercise within our current limitations daily.

#2 We initiate positive behavior modifications in our lifestyles by choosing healthy foods and activities to engage in.

#3  We exert control over exert outside influences that could deter progress by modulating exposure to environments that are unhealthy.

#4  Wehonestly gauge our successesby rewarding ourselves with a feeling of satisfaction in our good behaviors, not with food as a reward.

#5 We focus on solutions to problem behaviors and select what we are ready to commit to fully.

#6 We sustain from engaging in negative behaviors and thought patterns that will disrupt our progress.  We listen to the advice of our doctors and develop a plan that works. 

#7 We stop ourselves when we find our thoughts drifting toward a poor choice, thus interrupting the behavior pattern by relying on our support systems. We don't "cheat" ourselves out of good health by making bad choices.

#8 We have become more flexible in ourability to ignore what is not good for us and shift our concerns on activitiesand experiences that will benefit our overall mood.  We do not allow food to dictate our mood.

#9 We avoid substances and/or situations that lower inhibitions nd gain confidence in our ability to control ourselves.

#10 We hold on to the principles established for our health and wellness, execute our prescribed dietary guidelines in a way we can enjoy food but not overdo it.

#11 We do not let others manipulate our values in quality and quantity.  We do not feel the need to finish anything for the satisfaction of a clean plate.

#12 We organize our lives with priority to our healthy principles, and we are not oppose to refocusing events off of food and onto physical activity.

#13 We foresee our bodies and minds becoming healthier, daily. We know what we look like as a healthy person, we see health in our future and do not obsess over what we can not control today. 

#14 We generate positive energy and attitudes everywhere we go and leave our judgment of what works for others to them.

#15 We associate our successes in the confidence we have in doing what we know is right for ourselves and accept the limitations of which we cannot control.  

#16 We balance our lives with our lifestyle choices. If it means taking your lunch everywhere you go, then let that be your signature behavior pattern.  There is nothing wrong with behaving differently than those around you.

#17 We store our gratitude in our hearts and continue to work toward our individual goals.  We share what works for us, but respect that our way is not the only way.  Find your way.

#18 We retrieve the knowledge we need and seek help from others when we know something is not right in our mind and body.

#19  We pace ourselves and have patience with attaining goals and being successful.  

#20 We manage time wisely, always.

#21 We execute our mission to become healthier by setting smart goals each day.

#22 We monitor our success in a manner that works for us. We recognize behaviors that have a negative impact on us. (For some, the scale is negative reinforcer.  Have confidence in what you're doing without the scale. If you feel guilt for eating something, you need to choose not to eat that because you do not want to feel guilt.)

#23 We correct unsatisfactory thoughts and behaviors with appropriate actions.