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Cognitive Ponderings on the Therapeutic Interventions of Obesity Recovery
Monday, August 5, 2013
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Anorexia after Bariatric Surgery
How much weight loss is too much? When do you put the breaks on weight loss and find a balance of weight maintenance? It's often a slippery slope that isn't properly monitored by surgeons, nor does the internet properly provide enforcement of good behaviors. We like the "positive" feedback received from people "Liking" our photos on Facebook or Instagram, but sometimes, social media has a way of encouraging negatives. Self perception that your waistline needs to be piddled down to nothing, social media only serves to enable poor health as positive successes, the smaller the waist line gets. The cognitive work necessary to develop a new, healthy body image is not being properly executed in treatment plans across the board in Centers of Excellence. If you're seeking "Likes" on the internet for your latest side shot post, and your waist is so tiny that you appear sickly, you *might* be struggling with anorexia. Contrary to popular belief, anorexic behaviors include eating restrictively in both food types, timing, and content, and keeping secrets about food/refusing to talk about eating behaviors as problematic.
When patients come to a bariatric surgical center, they are often battling the exact opposite of anorexia, they are frequently binge, emotional, or inconsistent eaters. They are often so anxious to have surgery, they become offended that a professional counselor might suggest treatment planning for counseling services. The stigma of counseling and psychology is often met with resistance, and the notion that, "They are not crazy!"
No one said you're crazy, sometimes preparing yourself for the road ahead, understanding what a healthy self-concept is and how to execute that without developing more cognitive distortions, and learning healthy lifestyle behaviors needs a trained professional.
Obsessing over anything is harmful to your cognition. If you can't stop thinking about your weight, if you're unable to let go and enjoy life, the cognitive work needs to be address. Cognition and Transfer Addiction are the two most under-utilized treatment options for obesity.
I have said it many times, but I will say it again. *This is worth repeating.*
The difference between a coach and/or trainer and therapist is that the therapist can recognize and treat depression, anxiety, eating disorders, cognitive distortions, and severe mental illness, whereas a coach might approach things with a solution-focused training philosophy, a therapist is processing the behavioral patterns and diagnostic criteria while remaining non-biased, compassionate and discerning of a client's intentions. We are A LOT more liable for *your actions* when you leave our presence, than an online coach or trainer. We must take precautionary measures at all times to insure our client's safety and intention to themselves and others.
"Body image assessments tend to vary focus, ranging from an evaluation of the cognition related to body image disturbance, affect and/or behavior to other others that focus less on subjective dissatisfaction and concentrate instead on perceptual disturbances that may contribute to body image distortion." More research is needed on the effects of online social media bariatric communities and their affect on, and relationship with disturbances in self image and eating disorders.
When patients come to a bariatric surgical center, they are often battling the exact opposite of anorexia, they are frequently binge, emotional, or inconsistent eaters. They are often so anxious to have surgery, they become offended that a professional counselor might suggest treatment planning for counseling services. The stigma of counseling and psychology is often met with resistance, and the notion that, "They are not crazy!"
No one said you're crazy, sometimes preparing yourself for the road ahead, understanding what a healthy self-concept is and how to execute that without developing more cognitive distortions, and learning healthy lifestyle behaviors needs a trained professional.
Obsessing over anything is harmful to your cognition. If you can't stop thinking about your weight, if you're unable to let go and enjoy life, the cognitive work needs to be address. Cognition and Transfer Addiction are the two most under-utilized treatment options for obesity.
I have said it many times, but I will say it again. *This is worth repeating.*
The difference between a coach and/or trainer and therapist is that the therapist can recognize and treat depression, anxiety, eating disorders, cognitive distortions, and severe mental illness, whereas a coach might approach things with a solution-focused training philosophy, a therapist is processing the behavioral patterns and diagnostic criteria while remaining non-biased, compassionate and discerning of a client's intentions. We are A LOT more liable for *your actions* when you leave our presence, than an online coach or trainer. We must take precautionary measures at all times to insure our client's safety and intention to themselves and others.
"Body image assessments tend to vary focus, ranging from an evaluation of the cognition related to body image disturbance, affect and/or behavior to other others that focus less on subjective dissatisfaction and concentrate instead on perceptual disturbances that may contribute to body image distortion." More research is needed on the effects of online social media bariatric communities and their affect on, and relationship with disturbances in self image and eating disorders.
Saturday, August 3, 2013
Cognitive Medicine: Positive Thoughts & Scientific Certainty
Food Addiction is the often overlooked as a substance abuse
issue, and logically so, how can one be addicted to something necessary to
survive? We tell ourselves we need more of it than we really do. It’s simple
though, we seek to find pleasure in consumption, and research shows that sweet,
salty, and fatty foods activate the same sensors in your brain as drug and
alcoholic addiction. Some of us just don't need more than 1200 calories a day, our metabolic functioning is impaired, and our bodies just don't know what to do with the excess. Our furnaces simmer at a lower fire than other people. We must develop the balance of positive thinking toward development of better cognition and design an action plan that works for us. What we need is a total eclipse of thought. Consume what we need, expend
what we don’t, and find balance when we have over or under done things. For the last eleven months, I have purposefully rejected
accountability to what went into my mouth at all times. Yep, there, I said it. I decided that I didn’t want to continue to
live in the misery of thinking I had failed. I went from loving food with limitlessness, to embracing my relationship with strict boundaries.
13 years ago, when I had decided I needed to lose weight, I embraced a healthy, active lifestyle by getting a dog. Hannah has been the reason I get up and walk every day. Before age 21, I never really exercised. In 2002, I participated in my first 10k race. Walking it took me 2 hours and 15 minutes that first year. Later on, I came in my best time at 1 hour and 40 minutes in 2010. That was the best I had ever done. It was also 1 ½ years after my Lapband was installed and before the band began to cause me extreme anxiety from the variable issues with tightness. I was eating like a dietitian, as I like to say. My delusion was that I would run marathons, but honestly, lifelong obesity and recovery from obesity, is hard on the heart. Extreme exercise after your body has been through so much stress can not be good for the heart. I now advocate for strength training in the form of pilates, weight lifting, and HIIT (High Intensity Interval Training.)
13 years ago, when I had decided I needed to lose weight, I embraced a healthy, active lifestyle by getting a dog. Hannah has been the reason I get up and walk every day. Before age 21, I never really exercised. In 2002, I participated in my first 10k race. Walking it took me 2 hours and 15 minutes that first year. Later on, I came in my best time at 1 hour and 40 minutes in 2010. That was the best I had ever done. It was also 1 ½ years after my Lapband was installed and before the band began to cause me extreme anxiety from the variable issues with tightness. I was eating like a dietitian, as I like to say. My delusion was that I would run marathons, but honestly, lifelong obesity and recovery from obesity, is hard on the heart. Extreme exercise after your body has been through so much stress can not be good for the heart. I now advocate for strength training in the form of pilates, weight lifting, and HIIT (High Intensity Interval Training.)
While in Austin from 2007 – 2008, I had really gotten
exceptionally better at portion control and diligent logging and journaling
about what caused me to eat poorly, how did I feel, process the bad episodes
with intention, understand events and reactions that would make me cave to a
moments that care forgot. Well, I see through it all now much more clearly in
this relapse. I realize that it is no
longer an option to not be strict with myself.
I need to measure and account for what goes into my mouth at all times. We all have different goals and needs in our personal
journeys, unique motivational activations. We all process our relationships
with food and others in a different light. I get that. I study it daily, and I
clearly see my own faults in myself.
I’m a solutions oriented counselor in my day job, I talk to
people on the phone about their interest in medical and surgical weight loss
programs I conduct a motivational interview where I question them with
clarifying intention and solve a problem: give them an action plan. Some are
easy, medical or surgical, this way or that way, here’s an event you should go
to, let’s get you started. However,
weight is a sensitive subject, and sometimes I have had people break down on
the phone with me. I have people who
suddenly, without notice, might have a false perception of context, and think
I’m just a receptionist type person who is only answering the phone.
I had an interesting conversation with someone who just
suddenly after a few seconds of silence where I was entering information into
the computer, accused me of passing judgment on her as being a crazy fat
person, and I had to calmly reassure her that I was a trained counselor. I
understood her and was not judging her. I promise, I’ll never think you are
crazy, I will just try to figure out what is getting in your way and help you
move it, mentally. I’m not thinking you’re crazy because you’re calling us for
help. I’m not judging you. I am not a
doctor, but so while your medical problems are concerns and attributions to
your mission, I can’t tell you what to take, not even for a headache. (With the
exception of providing evidence based information from professional societies
conducting non-biased research, I know a thinkg or two about the common
knowledge of bariatric vitamin and nutrient deficiencies.) All in all, I am a therapist with a lot of
compassion and empathy for everyone’s struggle, and if I had all the time in
the world, I would want to hear everyone’s story.
As an obese child, I began ballet and tap lessons at 4. Into adolescent and teenage years, I became
so apathetic to this routine, and couldn’t find enjoyment in it. The only exercise I every deliberately got
was Wednesday ballet classes. I hated
them with a passion, as I was too obese to be graceful, and flexible enough to
bend and contort myself in every which way.
Funny, Nanette means, “full of grace.”
My graces are my kind heart, intentional inquiry, studious
knowledge, joyful heart, and counselor’s ear Not my ability to pleat across a
church room studio with a bunch of skinny girls who felt sorry for me. Because I know, the looks and stares didn’t
really lie, and no matter how beautiful a people those girls are, at the time,
in that moment, I perceived it to be that.
What you perception tells you is often what you will be.
Developing iron clad
positive-thinking, goal directed planning, structured, scheduled meals and
movement; that is how we take the first step in addressing obesity. We accept that portion control and exercise
are essential. We take journaling and logging exact intake as an evidence based
personal data study to our doctor and say, “Look doc, this is what I did, and this
is what did or did not happen with weight reduction.” I do not discount the
genetic susceptibilities, medication side effects, or outside determinants of
obesity, and proper medication, hormonal balance, proper nutrition, disease
management, a positive attitude and self advocacy are essential to the
treatment plan. Environmental influences
and choice are primary controllable factors for the individual. We are all individuals, who function uniquely
toward our motivations for health of mind and body.
As an advocate for a obesity prevention and treatment
programs, it is with medicine and cognitive that are our health and wellness. I think we have to employ all courses of
action: medicine, education, advocacy, and community involvement. In an ideal
world, we would have a community garden in every mile of every city, where we
could all walk there to get our food each day.
Every park would be a community recreation center where we meet to learn
about healthy lifestyles. We would work
with each other to change, not ridicule those who are trying from those who may
see themselves as better off than the other because they are stronger, or
perceive themselves to be wiser. We will
all respect the notion that we all have an impact from each other’s presence in
the world.
Friday, July 19, 2013
Knowledge changes everything
As this week closes out, I realize today why it is so important for people to have the right job for them. It changes a lot of our overall happiness with life. My knowledge of bariatrics is challenged, all the time. My knowledge of metabolic disorders is challenged, and I rise to the challenge. My continual efforts to read and educate myself on what we know between science and what we're doing in society and government is important to me.
Today, I had the opportunity to speak to a patient who had weight loss surgery 30 years ago. While I wasn't shocked that she didn't know the exact name of the procedure she'd had, once she described it to me I knew the exact name, without hesitation. I connected with her and earned her trust and was able to help her with ease. It was one of those moments that I was impressed with my brain, it didn't feel so broken.
It's easy to feel broken. We can feel tired, worn out and desperate for change, but life has a way of knowing when change will come. We have control over what we do, what we say, what we put in our mouths and what comes out. When positive things start to happen, it seems like it becomes easier to bring in more positive. Positivity is abundant as dreams come true if you open your heart to it.
When I think of how I show my authenticity with clients, I show it by being patient, kind, nurturing, inquisitive, non-judgmental with a little bit of humor and a lot of love for listening, empathizing, problem solving, creating, collaborating and designing a better life. Reaching out for help has a lot of stigma attached to it. You have to be able to trust a strange with your story and how it ends. Who you trust and how they process your concerns-- will they act in your best interest to facilitate conversation that will motivate positive behavior and action?
When I think of how I show my authenticity with clients, I show it by being patient, kind, nurturing, inquisitive, non-judgmental with a little bit of humor and a lot of love for listening, empathizing, problem solving, creating, collaborating and designing a better life. Reaching out for help has a lot of stigma attached to it. You have to be able to trust a strange with your story and how it ends. Who you trust and how they process your concerns-- will they act in your best interest to facilitate conversation that will motivate positive behavior and action?
Counseling is not Freudian psychoanalysis or Gestalt talk therapy. While I do think it is highly beneficial to talk to an empty chair when you're struggling with the words you need to describe your pain, it is finding the release for all the anger, fear, hurt and pain in a counseling session. That's what counseling is. You have a place where you can describe the ugly truth, how you really feel about anything and everything and what you can do to move away from that negativity.
Therapy is not solely counseling though, and many people get the same contemplative satisfaction from recreation, entertainment, and sports. Simply put though, if you do these things to avoid thinking about negative situations and decline action toward coping and processing your emotional pain, it may catch up to you. It may prevent you from leading the life you could have lived. In order to lead the life we want to live, e have to talk about what it is we want. Do you know what you truly want? Understand your motivations and live your dreams!
Tuesday, July 16, 2013
Exploitation of Self... and others.
Over the years, I've realized that there are many people on this Earth who will stop at nothing to make a buck. While I understand their entrepreneurial spirit, this week I have seen more than I'd like of new lows. First, I've blogged before about the impracticalities of The Biggest Loser, but the recent uproar in the media with Tara Costa, The Biggest Loser 2009 contestant and her endless legal battles, really upset me. Not that she is exploiting her reality TV show fame, though there is that, it's the selling of her image and the "fired because she gained weight" part that outrages me.
http://video.foxbusiness.com/v/2546539407001/biggest-loser-tara-costa-on-getting-sued-for-weight-gain/?playlist_id=937116503001
I must note, I hate the way this male Fox reporter questions her and gets her on the defensive. He bullies her. "Lead a positive, healthful lifestyle." says Costa, and I wish her the best with becoming a physical education teacher. Let's hope the government moves to bring back physical education is ALL school. What outrages me is that she has to defend her weight. But to add insult to injury she had a lawsuit with him in the first place, and clearly, all this is about is money and her body image.
On the juxtaposed, we have Tammy Jung, but in the same arena of money earners who don't mind exploiting themselves for a dime:
http://js.dailymail.co.uk/femail/article-2321812/Tammy-Jung-23-feeds-5000-calories-day-funnel-hope-obese-internet-star.html
No. Words.
"My career ambition is to become as popular as possible and I hope I just continue to make lots and lots of money."
It's hard to understand why someone who was not obese would want to become obese for profit to me. I realize my moral upbringing does influence the way I define appropriate behavior. As a counselor, self awareness is essential, however, I don't think this is me viewing my moral code through a foggy lens. My therapist's intuition is that there is much more deep-seeded conflict in this young lady's life that we are not hearing the story on. While I understand mental health issues, I don't understand why one would deliberately deteriorate their health for money. It's JUST MONEY. It means nothing in the end. The quality of your life right now is ALL YOU HAVE. I could go on about this, but I won't. It will just upset me and make me feel helpless because I can't do anything for her.
Next up, Let's talk about the BOY SCOUTS OF AMERICA. Do they need anymore bad press coverage? Seems to me they are looking for it. I can't understand WHY they would ostracize the young adolescents members that need them the most. http://www.scouting.org/scoutsource/HealthandSafety/risk_factors.aspx
And I quote, "Excessive body weight increases risk for numerous health problems. To ensure the best experience, Scouts and Scouters should be of proportional height and weight. One such measure is the Body Mass Index (BMI), which can be calculated using a tool from the Centers for Disease Control here: http://www.cdc.gov/nccdphp/dnpa/bmi/
. Calculators for both adults and youth are available. It is recommended that youth fall within the fifth and 85th percentiles. Those in the 85th to 95th percentiles are at risk and should work to achieve a higher level of fitness."
Umpfhhh... So, you mean to tell me that overweight and obese male adolescents wouldn't benefit in the reduction of their excess weight by participating in scouting? Seems to me to go against their motto: On my honor I will do my best to do my duty to God and my country and to obey the Scout Law; to help other people at all times; to keep myself physically strong, mentally awake, and morally straight.
If "a Scout" is trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent-- aren't they also NOT A BULLY. Don't they their peers with respect and help them to improve themselves together? Let's outcast the overweight and obese kids, not include them so they can feel lonely and discluded from normal adolescent activities. You know what happens when kids are ostracized, lonely, and discluded from physical activity? They show increased depression, anxiety, anger and lethargy.
How does that solve the obesity epidemic?
It doesn't.
It does nothing to move society forward and away from obesity. It encourages bullying.
And while I'm on the topic of bullying and people asking you for your money. Please do not join "secret groups" on Facebook that ask you to spend $49.95 for support. There's plenty of free support and weight ins available from your peers. When someone asks you for money for their support, they are no longer your peer, you are their customer. All you are to them are $$, when you stop giving them $$, they will likely no longer support you. They might even bully you when you aren't successful. Is that what you really need when you are down in the dumps and seeking help because you fell off the wagon?
No.
I didn't think so either.
Now, I must go do the duty. A solid hour at the gym, every single day.
http://video.foxbusiness.com/v/2546539407001/biggest-loser-tara-costa-on-getting-sued-for-weight-gain/?playlist_id=937116503001
I must note, I hate the way this male Fox reporter questions her and gets her on the defensive. He bullies her. "Lead a positive, healthful lifestyle." says Costa, and I wish her the best with becoming a physical education teacher. Let's hope the government moves to bring back physical education is ALL school. What outrages me is that she has to defend her weight. But to add insult to injury she had a lawsuit with him in the first place, and clearly, all this is about is money and her body image.
On the juxtaposed, we have Tammy Jung, but in the same arena of money earners who don't mind exploiting themselves for a dime:
http://js.dailymail.co.uk/femail/article-2321812/Tammy-Jung-23-feeds-5000-calories-day-funnel-hope-obese-internet-star.html
No. Words.
"My career ambition is to become as popular as possible and I hope I just continue to make lots and lots of money."
It's hard to understand why someone who was not obese would want to become obese for profit to me. I realize my moral upbringing does influence the way I define appropriate behavior. As a counselor, self awareness is essential, however, I don't think this is me viewing my moral code through a foggy lens. My therapist's intuition is that there is much more deep-seeded conflict in this young lady's life that we are not hearing the story on. While I understand mental health issues, I don't understand why one would deliberately deteriorate their health for money. It's JUST MONEY. It means nothing in the end. The quality of your life right now is ALL YOU HAVE. I could go on about this, but I won't. It will just upset me and make me feel helpless because I can't do anything for her.
Next up, Let's talk about the BOY SCOUTS OF AMERICA. Do they need anymore bad press coverage? Seems to me they are looking for it. I can't understand WHY they would ostracize the young adolescents members that need them the most. http://www.scouting.org/scoutsource/HealthandSafety/risk_factors.aspx
And I quote, "Excessive body weight increases risk for numerous health problems. To ensure the best experience, Scouts and Scouters should be of proportional height and weight. One such measure is the Body Mass Index (BMI), which can be calculated using a tool from the Centers for Disease Control here: http://www.cdc.gov/nccdphp/dnpa/bmi/
. Calculators for both adults and youth are available. It is recommended that youth fall within the fifth and 85th percentiles. Those in the 85th to 95th percentiles are at risk and should work to achieve a higher level of fitness."Umpfhhh... So, you mean to tell me that overweight and obese male adolescents wouldn't benefit in the reduction of their excess weight by participating in scouting? Seems to me to go against their motto: On my honor I will do my best to do my duty to God and my country and to obey the Scout Law; to help other people at all times; to keep myself physically strong, mentally awake, and morally straight.
If "a Scout" is trustworthy, loyal, helpful, friendly, courteous, kind, obedient, cheerful, thrifty, brave, clean, and reverent-- aren't they also NOT A BULLY. Don't they their peers with respect and help them to improve themselves together? Let's outcast the overweight and obese kids, not include them so they can feel lonely and discluded from normal adolescent activities. You know what happens when kids are ostracized, lonely, and discluded from physical activity? They show increased depression, anxiety, anger and lethargy.
How does that solve the obesity epidemic?
It doesn't.
It does nothing to move society forward and away from obesity. It encourages bullying.
And while I'm on the topic of bullying and people asking you for your money. Please do not join "secret groups" on Facebook that ask you to spend $49.95 for support. There's plenty of free support and weight ins available from your peers. When someone asks you for money for their support, they are no longer your peer, you are their customer. All you are to them are $$, when you stop giving them $$, they will likely no longer support you. They might even bully you when you aren't successful. Is that what you really need when you are down in the dumps and seeking help because you fell off the wagon?
No.
I didn't think so either.
Now, I must go do the duty. A solid hour at the gym, every single day.
Saturday, July 6, 2013
Treat me like you would anyone else...
I'd like to address a topic that is somewhat intangible and taboo because it's just not always grasped by everyone. Bedside manner and word choice in how doctors and surgeons present with obese patients. I find the time surgeons really spend with their patients greatly lacking in depth. The patients they advise to change, to lead a healthier life, that education part falls far too short. It's embarrassing to hear stories of patients being operated on and being set out to fend for themselves. No guidance and poor advice or thoughtless direction-- there's really is no excuse in this day and age.
We have WEBCAMS and INTERNET now. It's not difficult to support your patients as a group anymore. Every surgeon could spend one hour a month in an online seminar, facilitated on a different topic, each month... Why Not? I feel like, to me, the tech savvy counselor who, when free for an hour or so, will jump on cam and just talk with my peers, this is a simple gesture that really could go a long way. I just do it because I like to hear people's stories and understand -- because they share a single common factor with me: the struggle with obesity.
I have heard too many instances of our peers writing of their experiences with primary care doctors who don't recommend surgery because they have not taken the time to educate themselves about the advances in surgical techniques. It's their responsibility to take part in the follow up care necessary, but they just don't understand a bariatric patient's needs. Every primary care doctor should understand that obesity is not a condition to blame on their patient. Blaming an obese person for being obese is not going to send the message that needs to be sent.
The message that needs to be sent is this: "I am your doctor, I care about you. I want you to care about yourself by taking an interest in becoming healthier." How do you do that? Well, there are so many prescriptions for healthy, without drugs, without surgery. If either of those things are used, it should not be shamed, it is just one element in a myriad of factors that can reduce body fat.
It's the head stuff we're so hesitant to talk about, all around. All around, nobody wants to talk about feelings. Obesity is a topic that evokes heavy emotion in those of us who have suffered with it. It hurts our hearts, literally and figuratively. Who hasn't experienced negativity toward them because of their weight? *No one.* Not even thin people, because they are just as scrutinized, because no one can be happy with what God gave them, they seek perfection constantly. Just be. Be happy with what you have and who you are, just for a minute.
Take in the moment in knowing that it is the way you feel about yourself that matters most. While so many of us want so much to be at a place where we are happy with our bodies, it is how we present who we are today that makes all the difference. Content with one's self. Right now, BE. Be happy. Treat others with respect, you will if you show yourself respect too. Respect that you're working toward BIG GOALS, at small paces. Tiny, daily steps... it's a hard road, a tough journey, a difficult road that you can never predict accurately, you just have to roll with what is put in your path.
One last thought, when a doctor makes you feel uncomfortable and does not listen to you, speak up for yourself. Tell them when you feel they are being insensitive toward you because you are carrying extra weight. Call them out on their poor bedside manner. They are taught to question everything, NOT judge you. Assess and advice, not judge and be insensitive. Hush that voice inside you that tells you negative things like your opinion is not valid, your feelings don't matter. THEY MATTER 100% OF THE TIME.
This is how you advocate for yourself. It's how you start a movement. It's how you make the system change. It's how you develop a model for care that includes the validity of every patient's feelings on their health. Our healthcare system, surgeons, doctors, nurses, techs, counselors and social workers, ALL need to understand that being insensitive to obese patients is not what they deserve. They all must be given the opportunity to rethink their philosophies on how to treat obesity as a disease, just as alcohol and drugs are given that status, even more so, this is a much more unique to the individual's genetic and social identity.
Treat me like you would anyone else. Without shame or blame. With Love. With Compassion. With Care.
We have WEBCAMS and INTERNET now. It's not difficult to support your patients as a group anymore. Every surgeon could spend one hour a month in an online seminar, facilitated on a different topic, each month... Why Not? I feel like, to me, the tech savvy counselor who, when free for an hour or so, will jump on cam and just talk with my peers, this is a simple gesture that really could go a long way. I just do it because I like to hear people's stories and understand -- because they share a single common factor with me: the struggle with obesity.
I have heard too many instances of our peers writing of their experiences with primary care doctors who don't recommend surgery because they have not taken the time to educate themselves about the advances in surgical techniques. It's their responsibility to take part in the follow up care necessary, but they just don't understand a bariatric patient's needs. Every primary care doctor should understand that obesity is not a condition to blame on their patient. Blaming an obese person for being obese is not going to send the message that needs to be sent.
The message that needs to be sent is this: "I am your doctor, I care about you. I want you to care about yourself by taking an interest in becoming healthier." How do you do that? Well, there are so many prescriptions for healthy, without drugs, without surgery. If either of those things are used, it should not be shamed, it is just one element in a myriad of factors that can reduce body fat.
It's the head stuff we're so hesitant to talk about, all around. All around, nobody wants to talk about feelings. Obesity is a topic that evokes heavy emotion in those of us who have suffered with it. It hurts our hearts, literally and figuratively. Who hasn't experienced negativity toward them because of their weight? *No one.* Not even thin people, because they are just as scrutinized, because no one can be happy with what God gave them, they seek perfection constantly. Just be. Be happy with what you have and who you are, just for a minute.
Take in the moment in knowing that it is the way you feel about yourself that matters most. While so many of us want so much to be at a place where we are happy with our bodies, it is how we present who we are today that makes all the difference. Content with one's self. Right now, BE. Be happy. Treat others with respect, you will if you show yourself respect too. Respect that you're working toward BIG GOALS, at small paces. Tiny, daily steps... it's a hard road, a tough journey, a difficult road that you can never predict accurately, you just have to roll with what is put in your path.
One last thought, when a doctor makes you feel uncomfortable and does not listen to you, speak up for yourself. Tell them when you feel they are being insensitive toward you because you are carrying extra weight. Call them out on their poor bedside manner. They are taught to question everything, NOT judge you. Assess and advice, not judge and be insensitive. Hush that voice inside you that tells you negative things like your opinion is not valid, your feelings don't matter. THEY MATTER 100% OF THE TIME.
This is how you advocate for yourself. It's how you start a movement. It's how you make the system change. It's how you develop a model for care that includes the validity of every patient's feelings on their health. Our healthcare system, surgeons, doctors, nurses, techs, counselors and social workers, ALL need to understand that being insensitive to obese patients is not what they deserve. They all must be given the opportunity to rethink their philosophies on how to treat obesity as a disease, just as alcohol and drugs are given that status, even more so, this is a much more unique to the individual's genetic and social identity.
Treat me like you would anyone else. Without shame or blame. With Love. With Compassion. With Care.
Friday, July 5, 2013
A Recipe and a Thought
Wedding Cake Protein Shake
1 scoop of Vanilla Pure Protein (By far my favorite economical protein supplement, available at Sam's Club for $20 for 20 servings)
1/2 c. Greek Yogurt (Great Value brand, non-fat is 11g protein @ 60 calories)
1/2 t. vanilla extract
1/2 t. almond extract
3/4 c. Almond Milk (Blue Diamond, unsweetened original or unsweetened vanilla @ 30 calories per cup)
Blend with ice. Drink or pop in the freezer for a few hours, stirring every 20 minutes or so. Great alternative to ice cream! Stir in some chopped almonds and frozen raspberries for a low calorie, high protein meal.
As a pre-op, a meal consisted of several items to me. There was a meat, a veggie, a carb and a drink. I am happy to say that I have moved away from all sodas long before weight loss surgery (though, I was never much of a soda drinker to begin with) and exclusively drink water or unsweetened coffee or tea. Even since the LapBand was removed, I continue to not drink during meals. But a "meal" becoming 10 or 12 oz. of a protein shake, still is really not a meal to me. I never adopted the thought that these "meal replacements shakes" were going to be my way of life. I'm too much of a foodie.
This shake really helps to sort out my negative feelings about giving one of my favorite things up. Wedding cake. I am a sucker for it, sugar free wedding cake snowballs are my favorite summer treat. Now, this Wedding Cake ice cream or protein shake is a go to "meal" for me, any day of the week.
1/2 c. Greek Yogurt (Great Value brand, non-fat is 11g protein @ 60 calories)
1/2 t. vanilla extract
1/2 t. almond extract
3/4 c. Almond Milk (Blue Diamond, unsweetened original or unsweetened vanilla @ 30 calories per cup)
Blend with ice. Drink or pop in the freezer for a few hours, stirring every 20 minutes or so. Great alternative to ice cream! Stir in some chopped almonds and frozen raspberries for a low calorie, high protein meal.
A "meal," what does that mean anymore?
As a pre-op, a meal consisted of several items to me. There was a meat, a veggie, a carb and a drink. I am happy to say that I have moved away from all sodas long before weight loss surgery (though, I was never much of a soda drinker to begin with) and exclusively drink water or unsweetened coffee or tea. Even since the LapBand was removed, I continue to not drink during meals. But a "meal" becoming 10 or 12 oz. of a protein shake, still is really not a meal to me. I never adopted the thought that these "meal replacements shakes" were going to be my way of life. I'm too much of a foodie.
This shake really helps to sort out my negative feelings about giving one of my favorite things up. Wedding cake. I am a sucker for it, sugar free wedding cake snowballs are my favorite summer treat. Now, this Wedding Cake ice cream or protein shake is a go to "meal" for me, any day of the week.
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