Bariatric Girl

It sorta hit me today that it is really difficult to explain what lies in the future for the weight loss patient. Some people take years to research the surgery and then there are hasty ones (like me) that decided in fifteen minutes! I have explained many times that I didn’t care if I died during weight loss surgery because I was so miserable that I didn’t want to live. I had just lost my mom a few months before and was deeply depressed.

Regardless of how long you took to make the decision, when you have the surgery you are ready to get that weight off quickly! How can we not believe that our lives will become magically perfect? It seems an impossible task to actually get this across because we are brutally aware (as an obese person) just how difficult life is. Carry one hundred extra pounds on your body for a week straight and it will take a toll. On top of that you are treated much differently than the “normal” person.

When I first became thin I was really hyper aware of how many people would speak to me that would have never even noticed me before. Deciding that I must move on and not resent them was one of the best decisions I ever made. I felt like I had so much negativity in my life as an obese person…why would I want even a little bit more?

I think losing weight is sort of like getting something new in your life. It doesn’t matter if you think about getting a new toy when you were a kid or as an adult. At first this “new” thing is exciting but when you’ve seen it every day for a period of time, it’s just not as exciting. This happens with your weight loss after surgery so we call it the “honeymoon period”. About the time you are feeling like “is that all there is?” you better start looking for a new toy. It isn’t quite that simple but I’m saying that we need to find the joy of life and be proactive in our recovery from obesity. I totally believe the reason we do so well during the honeymoon period is because it is a new “high”. We have switched from food to a new life. What happens when the honeymoon period is over?

If we haven’t dealt with why we were obese in the first place, we will reoffend and if you don’t return to food, you might pick something else that’s bad juju.

“If you don’t learn….you will return.”
quote by me

I’d love for you to read an article in Psychology Today.

CLICK HERE FOR ARTICLE

Good info regarding what it takes to elevate dopamine release. I’ve also read that music helps as well.

With all the opportunities available on the internet or in your community, there are plenty of things to choose from to give new attention to. We are just starting to understand this thing…this weight loss journey we take….and if you are reading this and you don’t think addiction is part of it, check out a list like “the top ten characteristics of addiction” and there’s one term that always makes the list.

You’ll always see denial…so before you deny, make sure and learn as much as you can about this obesity thing or you might be right back to where you started.

Denial…
not just a river in Egypt.

There are always studies being done. Sometimes you don’t even know exactly what the study includes. I am always looking for data regarding weight loss surgery and it amazes me when “studies” are done and someone who knows little about the life of a WLS patient comes to a conclusion. I’m not complaining…I’m just saying that when I read the results of a story published (see link below) I want to scream “I know something about that!”

http://well.blogs.nytimes.com/2007/10/17/a-tragic-risk-of-weight-loss-surgery/

The study talks about a higher suicide rate after weight loss surgery. They talk about drug overdoses too. Well duh….

Speaking from experience, I have had many occasions to talk to several hundred members in various stages of their journeys. I believe that we are food addicts and guess what happens when you take away our drug of choice? If we are not properly educated we will find another. The other issue to take into account is the honeymoon period. (The year or so after weight loss surgery is the honeymoon period) The first year after weight loss surgery we are on a new “high” because no matter what we do….pretty much…. we are losing weight! WOOOO HOOOOO!!! The party is on. That is a most critical time because if you don’t use that time to retrain yourself to eat differently, you will most likely fail. 

I have seen many people carry on as usual (no changing of lifestyle) and when the honeymoon party is over they crash. At this point they seem to have a few choices. They can make the lifestyle change they should have in the beginning (it’s much harder at this point), they can choose another drug of choice, or they can go back to the original drug of choice.

Back to the suicide thing….so….if you decide to choose another drug of choice and it’s actually drugs, you may very well overdose. If you go back to food and gain the weight back, the feeling of failure may be entirely too much to endure. After all you do it in front of your friends and family and EVERYONE knows you failed. You also might be one of those unlucky ones that has a friend or family who will tell you “I told you it wouldn’t work”.

I believe so much that we have to get the word out about food addiction and we must learn what it takes to overcome this disease. There is a phenomenal comment in the article about suicide. I’m sorry for the length of this post but there is just so much to share. The following is from Dr. Gerald Williams and it’s brilliant.

As I read these blogs, I am simply floored. Over the past 20 years I have likely conducted more pre-bariatric psychological evaluations (+2000) than any other psychologist that I am aware of. During this past 20 years I have had 2 bariatric patients attempt to take their lives with 0 deaths. I do not know if that makes me an expert, but I can probably be on safe ground being called “experienced in the field.”

First, I strongly believe that we, as a society, must “un-demonize” morbid obesity. To do so we must conceptualize morbid obesity for what it is, a brain-based neurological disorder. For too many years now we have approached morbid obesity as purely a psychiatric or psychological disorder, a lack of will power, or a flawed personality. Instead, we need to look at brain functioning. In the most simplistic terms, we develop “pathways” in our brains. These are very elegant sequences of neurons or brain cells firing in different areas of our brains. The more frequently that pathway is activated, the stronger and more easily it becomes for that pathway to continue firing. In morbid obesity, we have taken a very primitive and necessary pathway that is sometimes called a “primary drive” (hunger and satiation) and expanded into areas of emotional functioning wherein food takes on an emotional meaning or purpose. The pairing of a very powerful primary drive pathway with our equally powerful limbic or emotional pathways creates a very resilient and dysfunctional pathway which exists solely to perpetuate eating. we’re bombarded with advertisements which reinforce the continued firing of this pathway. Our brains have a lot of survival safety measures programmed in. To simply stop the eating creates an incredible level of anxiety and agitation in the morbidly obese individuals brain and often creates frantic attempts to restore food intake. The brain fully realizes that a disruption in food intake is not a superficial event but rather is a threat to its continued existence. Remember, historically, starvation has killed more of our species than any war or pestilence. We are the survivors. Our brains in particular are very sensitive to starvation. When our brain senses rapid weight loss it mobilizes its resources to do almost whatever is necessary to stop the weight loss and regain the weight. This is what makes dieting so difficult. Yo-yo dieting is the ongoing struggle between our physiology and our psychology. Obesity is therefore more in your brain than your belly. These dysfunctional pathways have a label in mental health, we call them “obsessive-compulsive disorders”. (If God were to grant me one wish, it would be to eradicate the obsessive-compulsive disorders from this world.) All obsessive-compulsive disorders (OCD’s) are anxiety or fear-based disorders. These OCD’s are again dysfunctional pathways. Remember however, fear feeds on itself. For example, if you fear not being loved, you do not have to experience rejection for that fear to grow. The simple experience or thought of that fear strengthens that pathway. Unfortunately therefore, this particular pathway feeds on itself and grows without encouragement.

Secondly, morbid obesity should be treated as a neurological disorder. Medications have their place but they will typically only serve to buy time. (Don’t let me undersell time though, it is one of our most precious commodities.) We should treat morbid obesity like we treat epilepsy or diabetes. As a multifaceted disorder, like epilepsy or diabetes, we should treat the medical, the psychological, and the neurological aspects simultaneously. To do any less is to guarantee failure. The prognosis for success is however quite good. Early identification is the key to successful treatment. Prior to the surgery the pre-bariatric candidate should be evaluated by a team of professionals including physicians, dieticians, and psychologists. If disorders of impulse control or judgment are identified, referral to the appropriate professional must occur. Rejection must not occur. After the surgery, the bariatric surgery patient must participate in follow-up services including at minimum individual or group therapy and support groups. Treatment must focus on changing not just physical and psychological functioning, but brain functioning. (Throughout our lives our brains our constantly revising, reinventing, and literally physically changing their structure to adapt to demands in our lives.) To do this, the bariatric patient must work with a professional skilled in changing both psychological and brain functioning. These are very treatable pathways and disorders. There should be individuals in your community with these skills.

When I read these accounts, it was obvious to me that many bariatric patient were not properly educated, evaluated and treated prior to their surgery and seemingly tossed to the winds post-surgically.

Does bariatric surgery work? Yes, it does but it must be approached with the utmost care, self-evaluation, and good judgment.

For any shortcomings stemming from psychology and neuropsychology, I would like to offer my apology.For those of you still out there “In the wind”, I would encourage you to contact a mental health professional skilled in working with pre and post bariatric surgery patients.

P.S. I don’t have a book published but after reading these blogs I’m thinking maybe I should. What do you think?
Gerard R. Williams Ph.D.
(810)630-1152
Clinical NeuropsychologistLicensed Psychologist
— Posted by Gerard R. Williams Ph.D.

OK, if this post isn’t already long enough, I have to include my comment. So here it is:

Wow….I read in amazement one of the best discussions regarding WLS ever! I wanted to comment on nearly every post. Seven years ago I had weight loss surgery in 2001 (gastric bypass) and I have been at goal weight since. It was a battle that I fought every inch of the way but in the process I learned a great deal about what is REALLY going on because I live it every day. I have been a member of a large online support group for seven years. I did not have adequate aftercare… mostly due to the lack of it in 2001. By participating in the support group, I not only learned the very pitfalls of this disease but learned that by participating, I was keeping myself accountable to myself and others. This online group is the largest research study anyone could ask for… a living, breathing, group that grows in power and self education every day but has so much catching up to do.

You who say it is not an addiction have never walked in my obese shoes. An incredible description of addiction: Uncontrolled use despite negative consequences. That certainly described my obesity. I have some of the most profoundly addicted relatives on earth and my addiction was clearly food. The parallels are too numerous. As Mary Jo Rapini said, we are too much in a hurry to get the weight off and we’ll worry about everything else later because we assume the obesity is the only thing in our way. If you are not prepared for the reality that your brain must be fixed, you WILL crash…to the point of suicide. It’s not like you can just tell them and they are immediately OK. It takes time. You also have many professionals in the field that have yet to even mention the word addiction. Why is aftercare not required? There are many reasons. We don’t know to ask, the doctor doesn’t know, or the insurance doesn’t pay for it. If it is due to lack of insurance coverage, we are all out of luck. It seems every day I hear about yet another company refusing coverage for weight loss surgery itself….even if it is deemed medically necessary.

Every time anyone remotely close to the WLS community hears the words “quick fix” they are repelled. I had RNY open surgery (cut me open) and was in the hospital for five days. As we are speaking about here, the change is extremely difficult and when left to our own devices, we flounder. This rarely constitutes a “quick fix”. Secondly, if I chose any method that takes me from 30 years of obesity to 6 years of goal weight, why does my method matter as long as I am healthy??? I no longer have high blood pressure, sleep apnea or back pain. As many know, it has cured their type 2 diabetes.

You will also offend us every time you say the “old fashioned way”. I am so incredibly impressed with anyone that does it without surgery. I am SO impressed! In fact I did it several times. The only time I was thin for any length of time was in college for 2 years. I STARVED MYSELF to death so I am so proud for anyone that could do it without surgery and keep it off… but I could not…and I tried EVERYTHING.

The other day I realized that I had a tough time picking up a 40 pound sack of bird food but I was expected to be willing to exercise with 130 extra pounds on me. Do this experiment and live in my shoes. For one week, strap on four thirty pound bags of dog food and do everything you have to do. After 30 years like that you’ll be ready to do ANYTHING to get it off…especially an easy way…if one existed.

Dr. Williams you are excellent! I wish there were way more around like you. I have often spoke and written about being one of those “in the wind” and the numbers of post-ops lost is astounding!! There are a few of us trying to “pay it forward” for patients coming in behind us because of this exact situation. It is really difficult because we are just post-ops trying to help and many times even some of the professionals are standing in our way because we don’t have medical credentials.  I am beyond grateful for the professionals that consider us valuable. Mary Jo Rapini is one of them. Many long term post-ops certainly know enough from experience that bariatric medicine is vastly misunderstood…even by some of the professionals. What do I have to back this up? Every bit of this is viewable online…the sexual and shopping addiction shortly after being thin for the first time, the new problem with alcohol, the low self esteem issues that never seen to improve, the lack of knowledge about coping mechanisms, and always looking to the future for the happiness we cannot seem to catch. We look for the future to make us happy because we have not learned about living in the now or knowing that happiness comes from within.

Dr. Williams, I have saved your post and I hope you don’t mind if I share it. There are way more “in the wind” than you can imagine. I do know this…what we are doing is not getting the word out fast enough. How do we get everyone in “the know” on some simple basics? It took way too long to get the message out about how surgery is the smallest part of this journey and many don’t realize how much the brain is involved. The lack of education available for patients and pros is scary. As a post-op, I have a limited ability to spread the word. I have started with a website but it is not near enough and there are thousands that need help. Thanks Dr. Williams!
Yvonne McCarthy
— Posted by Yvonne McCarthy

Enough said on this one…..

Here’s a video I did a couple of years ago to put on my profile at obesityhelp.com. It’s called “Participating in Life”. By the way..the sound you hear when my before picture is seen is a jail door closing. I thought it was more than appropriate.

Wow….I did a search on weight loss surgery and blogs and it’s horribly confusing. Changing anyone’s mind is probably nearly impossible….you know…the ones that have been blogging for months or years about the evils of WLS. Some of them are really mad. How very sad that they cannot step back from where it all went wrong and see their way to success. I have so much good info in my head to share with others to keep them from being one of those really angry post-ops.
So how can I best help?

I’m thinking all I can do is to share my experience.

I also can’t imagine blogging for years against something evil. Why would you want to live that every single day and why would anyone read it? I guess they are stewing in the mess and can’t break out of it. Perhaps it is the perfect example of a little thing called “The Hole in the Sidewalk”. Here’s my post from last year. This is from my blog on Obesityhelp.com where I have been a member for 7 years.

A hole in the sidewalk

I sometimes describe myself as being ADD but now I’m starting to realize I’m compulsive.

hmmm.

New label.

Old labels..fat, lazy, unclean, no willpower.

I started thinking about how I must have it perfect or not at all. That can be so debilitating. When I asked myself why it had to be perfect, it’s because I have to know where things are because it makes me crazy to look for something that I know I have and cannot find. Why? Because it’s hard for me to stay on course if something distracts me and looking through drawers, closets, whatever will distract me every time. I call them “kitties”. My mantra is “step away from the kitties!”

If you don’t understand yet let me explain it this way. I love cats…a bit too much. I plead insanity because they were my life when I was obese. I wanted someone to love me even being fat. I don’t care WHO you were, I knew you would love me better if I wasn’t fat. Even if it was because I was healthier, I knew that my obesity was the thing that stuck out for all the world to see!

Except the cats.

The cats thought I was their “everything”….and I was! Right now I’m crawling out of the hole in the sidewalk. Please read this from http://www.bariatricradio.com/

A HOLE IN THE SIDEWALK
Which Chapter Are You Living?
By John Jolliffe, MFT

You had Bariatric Surgery because you were sick and tired of sick and tired. You wanted a tool and Bariatric Surgery had demonstratable evidence of success. Like all relationships the challenge comes after the honeymoon where if you want to succeed you will learn to accommodate, compromise and make allowances with this new life partner. Post-operative patients are indeed married for life with a commitment that will mature over time. Plateaus, consumption failures, dumping and discomfort are just part of the learning curve. If you commit to a support group or more formal aftercare program, don’t panic or get ahead of the story, you will maximize your success and benefit from sustained weight loss and control.Remember change is really an exchange. Hopefully, you trade in your normal way of being in your world for a more efficient, more mature and managed quality of life.We maintain the radio broadcast known as Bariatricradio.com to guide you through the complexities of your commitment to health and a better quality of life for you and those you love.In my private practice, I often ask my clients to read Portia Nelson’s “Autobiography in Five Short Chapters,” requesting them to observe which chapter from the five listed best describes where they find themselves today. I find there is so much included for us to discuss in each chapter, brief as they may be. I decided to include the Five Chapters with this week’s article for your deliberation. Read it carefully, then call me and discuss what you discover about the maturity of your commitment. Which chapter best describes your life today?

Chapter 1
I walk down the street. There is a deep hole in the sidewalk. I fall in I am lost…I am helpless It isn’t my fault. It takes forever to find a way out.

Chapter 2
I walk down the same street.There is a deep hole in the sidewalk. I pretend I don’t see it. I fall in again. I can’t believe I am in the same place But, it isn’t my fault. It still takes a long time to get out.

Chapter 3
I walk down the same street. There is a deep hole in the sidewalk. I see it is there.I still fall in…it’s a habit. My eyes are open. I know where I am. It is my fault and I get out immediately.

Chapter 4
I walk down the same street.There is a deep hole in the sidewalk.I walk around it.

Chapter 5
I walk down another street.

I had been pretty regularly doing chapter 4 and 5. Ha ha haaa. (wicked laugh) I have it whipped! I knew I was going to make it in this journey!

Then it happened.

Someone was removed from my life and I had no control over the situation and felt guilt over whatever I contributed to the outcome. The funk hit me like the old days….DAMN, I forgot how awful this feels. I remember in my brain…. but I had forgotten in my heart.

I won’t go into the details but it involved shoulder pain, trigger points, trigger point injections and it hurt so badly that I had to hit the couch…for days. I was in the “hole in the sidewalk” but I didn’t get out immediately. I even KNEW this but I still couldn’t get out.

I KNOW what I’ll do!I’ll get on the message board and help someone, that always works.

This time it didn’t. I felt so incompetent that I didn’t dare try to answer someone’s question or offer advice. What if I gave them wrong information? My next best strategy was to accept that I will come out of it but it might take more time than I am accustomed to allow for. This time I didn’t have a choice. It takes however much time it takes.

I tried doing yoga ….my shoulder said “NO”!Oh my God, if I don’t do yoga I’ll gain the weight back. I was in the hole and couldn’t see that yes…. I might gain back a few pounds…. but I will get them off when I get out of the hole in the sidewalk. I KNOW THAT. I believe that….but right now I’m in a hole! All I have to do is step out. I decided that I would do some things that were piled up…so many things to do. All I can do is start, so I did. Even though I am in pain, it felt better to get those things done. I was starting to get out of the hole. Today I made myself do yoga. I decided I would do the positions that didn’t involve my shoulder. I got out of the hole today. I know this because I’m here writing this.

My plan?

I’m walking to the next block so I can take a different street…knowing full well there will be days when I take this street again. I’ll walk right back down the wrong street and fall in the hole but next time I will be ready. I will be armed (no pun intended) with the experience I gained from the time spent in the hole in the sidewalk. Maybe I thought I’d never fall in the hole again but I will. Strategy will help so I will plan and do things to help deal with it. I hope to see you on the other street OK? hugs, Y

Today I became Bariatric Girl and I’m gonna talk about…..

Weight loss surgery

The positive side.

First let’s talk about who’s fer it and who’s agin’ it?

Those of us that have had WLS are already aware of who’s agin’ it. Oprah has made it known that she’s against it. Dr. Phil was until lately. Apparently his nephew had the surgery. Kudos to Dr. Phil for being open minded and not sabotaging it.

If you do a search you’ll see scads of blogs exclaming the sheer evil of WLS. If you fail and you’re really mad you can join discussion groups and talk about it all day long. There are several people that have made it their life’s work….all they live for is to point out how horrible WLS is, reporting every positive report as a lie.

It’s pretty much frowned upon by society….I mean I was obese for 30 years and now I’m not. I’ve been told that I took the easy way out and I didn’t do it the old fashioned way. I’m not sure why it matters what method I used to get from 30 years of obesity to 6 years as a “normal” person. After trying everything else known to man, I could not get the extra hundred pounds I was carrying off. Well, I got them off but I couldn’t keep them off….until surgery.

So here I am (Christmas 2000).

My mom had died a few months before and I was devastated. A few days after this picture was taken I heard about weight loss surgery and made an appointment….the first one I could get.

There’s way more stuff in between then and now but let’s just say it all worked out.

And here I am today:

Enjoying a life I never thought possible.

And I’m in touch with several thousand members on a website that had the same experience….

A positive one.

I know people have died…I am fortunate that I haven’t known anyone…. except Alice.

She committed suicide because she couldn’t get the surgery.

On top of everything else, I volunteer hours at a time on a website so that I can help the ones that come in behind.

There are reasons for most of us regarding our past obesity. I’m going to step right up and admit that I was a food addict. Yeah…for a couple of years after the surgery I was thinking I didn’t eat that much. That’s why it’s a sign of addiction….that would be the denial part. I had major genetics working against me but that wasn’t all of it.

So after a couple of years I saw the parallels of addiction in our behavior including our need for coping mechanisms. When you do something to the point that you hate yourself, it’s addiction. A great description….

Uncontrolled use despite negative consequences.

You could have offered me a million dollars, you could have threatened my family’s lives and I couldn’t keep the weight off. For me, weight loss surgery was sort of like rehab. I got surgery that gave me a pretty much guaranteed chance to get on a level playing field with the “normal” people….if you follow the rules. If I could just have that…let me start over from scratch…I won’t screw it up. Easier said than done but I did it.

You can do it too if you know how.

I have spent an outragious amount of time trying to pay it forward and I will continue so but I’m branching out. I want to make a difference and I want people to know that there are a lot of people just like me instead of seeing all the people that are just plain mad for a long list of reasons.

I believe a good part of success is how you treat your surgery. If you respect it, nurture it…you get a good result. If you disrespect it, unappreciate it…you will probably mess up. It’s no free ride and it’s certainly not the easy way out.

My old WLS site was http://www.rydobesity.com/. RYD Obesity was made up of three people. RYD stood for Ramon, Yvonne and Debra….all three of us successful weight loss surgery patients. We met on obesityhelp.com. On May 2-4th of this year we put on an event that was incredible. This is the video we opened with. I had each person send their before and after pictures. It didn’t matter if they had just started or were old timers like me.

So here’s a start at the good side of weight loss surgery…