Leaderboard

The first meeting with a patient preparing to have weight loss surgery, whether it be sleeve, bypass, or balloon, carries so much hope, anticipation, and excitement- that you can almost cut it with a knife. For many people, by the time they have reached the point of considering weight loss surgery, they have gained and lost hundreds of pounds. They finally have a beacon of hope in what was once a desolate psychological place of despair and hopelessness. Trying to emphasize the need for simultaneous behavioral and psychological change, often makes me feel like Rachel Dratch in her SNL portrayal of Debbie Downer. The reality is that there are many people who go into the surgery, carrying a magic bullet fantasy who don't intend to change anything about their lifestyle or psychological landscape, and that actually still works - for a while.... The sheer reduction in portion size over time would dictate that most will lose a significant amount of weight. There is no other way of losing weight that has such a fail safe element to prevent "cheating," or "relapse." You simply can't go overboard after the surgery, or you will get very sick and regret it. However, after the party is over. All the folks have gone home, all the social reinforcement has diminished, and six to twelve months post- you are still faced with the demons that got you here in the first place; depression, past trauma, abuse, a bad relationship, lack of purpose, addictive propensities, boredom, loneliness, lack of a sense of self efficacy, etc. Your Psychological Tool Belt is Here. Baptism - go back to the drawing board when you know you've gotten off track. I am in the midst of potty training my three toddlers at the moment and am reminded of her directive if the kids start to have accidents more frequently that we need to go back to square one and do another three day round of the pants off dance off, where we are sequestered to our home for 72 solid hours so that I can act like a psychological seismograph and quickly put a peeing kid on the potty mid stream. Same thing applies to bad habits or addiction. To have the same motivation and gusto you once came out of the gates with, you have to go back and come out of the gates again. Perhaps this means reading the literature that got you motivated to change in the first place. Maybe this means going back to OA meetings. This could mean training for a half marathon. Whatever helps to signify to you that another major shift is coming. Psychological Absolvement- This is a layer of guilt that I see many who relapse, carry. This serves no one. In fact, it sometimes perpetuates the problem because when we feel bad, we do badder (that's a word right?). Understand that this journey you are on is not a simple downhill road, but a twisting, winding, and sometimes uphill battle. This struggle is all part of your process. In any true change process or metamorphosis there is significant struggle, whether it be the caterpillar in its cocoon, or the crucible in the kiln. Higher Desires- Make a list of what you at your best self feels and looks like. Are there famouss people or celebrities that have recovered from addiction that inspire you? Are there people in your life that live it with vigor that you would want to emulate? Environmental prompts- make sure your life is surrounded by items that inspire and motivate you. It could be a beautiful quote on your mirror, a poem on your bedside journal, a beautiful picture on your phone's wallpaper, making sure your favorite health sites are showing up first in your social media feeds, making an effort to tune out negative social media, or triggering/toxic people. Whatever the things are that you know lend to you being your best self, need to be in place. Think of it like psychologically nesting for change. Cons list- you need to have a list on your person or on your phone of all the reasons you did this in the first place; heart disease, hypertension, sleep apnea, chronic pain, not being able to keep up with the grandkids, poor sex life, feeling of embarrassment in public, social isolation, etc. These can be powerful reminders of why we started such an endeavor in the first place. Spirituality- This doesn't mean religion but it can. If you have a solid faith- wonderful, use that. Allow your guiding principles to help you during your most vulnerable weak moments. If you don't have any form of spirituality - think about what that might look like for you; yoga, mindfulness, realignment with nature, serving your community. Spirituality allows us to connect with our soul. It allows us to be in a place of openness and vulnerability without knowing all the answers. It provides us with the opportunity to have faith that everything is going to be alright even though things are really uncomfortable right now. Daily/Weekly- What are you daily and weekly rituals that keep you on the right track? Make a list of the things you know you need to be doing daily and weekly to signify you are in a good space. Maybe daily it is drinking hot lemon water in the morning, meditation or "bed"itation, prayer, exercise, vitamins, meal prep. Then maybe weekly it is acupuncture, therapy, journaling, volunteering. Try starting with these tools and see if you don't start to feel a sense of renewed motivation. For more tools, please check out the full psychological tool belt here. For my free supplemental course on weight loss, click here.

I’m in New Zealand today, where I have been for the past three weeks. It has been a privilege to work with a number of bariatric professionals from different disciplines associated with the Foundations Healthy Living Retreat. During this five-day retreat, a small group of post-operative bariatric patients live together, eat together, exercise together, learn together and share with one another. Various staff members share their expertise about healthy living. Topics include much more than how to eat well and exercise. Participants learn the importance of focusing on personal values in all areas of their lives, discover the importance of positive self-talk, address self-sabotage and learn the importance of living mindfully. Coping skills, communication skills, and boundary setting skills are discussed. The topics of shame and vulnerability are explored, as well. Participants get what all bariatric patients in all corners of the world need following bariatric surgery: the Foundations of Healthy Living. Hmmm… good name for the retreat! What I think as I look around me are the many “non-coincidences” in my immediate surrounding. I do not believe that my being here, halfway around the world, is a coincidence. To begin with, Dr. David Schroeder, a bariatric surgeon, and his wife, Andrea, are, in many ways, absurdly similar in personality to my husband Steve and myself. David and Steve are both kind, intelligent, rational, left-brain thinkers who are mild-mannered and soft-spoken. Andrea and I, on the other hand, while also kind and intelligent, are passionate, passionate and more passionate. Translated, we are thinkers and DO-ers, we are upfront and direct, and are most definitely whatever the opposite of soft-spoken is. Oh, loud. That’s it! Andrea and David are passionate about their work in the bariatric field. They are zealous about the physical health of surgical weight loss patients and are also super passionate about the patients’ psychological health. The Schroeder’s know that the journey of recovering from obesity takes a lifetime and includes the physical and the psychological wellbeing of each person. Andrea created the Foundations of Healthy Living Retreat and they have been hosting the retreats for the past five years. It is definitely not a coincidence that David reached out to me after reading my first book, Eat It Up! Our professional philosophies are very much in sync. My work, with great help from Steve, is all about addressing the psychological needs of patients while their physical needs are being medically managed. David and Andrea, like Steve and myself, dedicate much more than our careers to providing bariatric patients with education and support. We address the WHOLE person, pre-operatively and after weight loss surgery. We put our hearts and souls into the work we do because we are convinced by the feedback our patients provide that they want and need much more than the surgical procedure can provide in order for them to live healthy lives, both physically and psychologically following bariatric surgery. Since meeting in 2011, I have learned a great deal by working with both Andrea and David. The Schroeder’s have twice brought me to New Zealand where I have had the opportunity to learn from and contribute to, the lives and education of their patients and staff. Andrea and David, as well as every person presenting information at the retreat, address bariatric patients from a whole person perspective. Each participant is treated respectfully and compassionately, as a human being who is much more than a bariatric patient. Their emotional support needs are emphasized, as a success following bariatric surgery involves more than dealing with a person’s biological innards. Is it a coincidence that Andrea and David, in New Zealand, know the same things that Steve and I know in the US? We all know and work toward, helping patients and bariatric professionals realize that bariatric patients have tremendous emotional and psychological needs that require attention. Behavior modification by itself is not enough when it comes to sustaining weight loss. If it were, well… wouldn’t more people have kept weight off after diets and bariatric surgery? Is it a coincidence that the bariatric patients I have talked with during individual sessions, along with the participants at the retreats, all from New Zealand, talk about the exact same issues as the bariatric patients I have worked with in the US for the past 15 years? I’m not talking about the physical problems. I’m talking about the lack of self-care this population acknowledges. Not just in their eating and exercise behaviors. These people talk about a great lack of self-value that translates to a lack of proper self-care. The greatest common denominator aside from the physical co-morbidities of the bariatric patients I have spent time with in both countries boils down to this: I don’t believe I’m good enough. That, my friends, is the definition of shame. Our bariatric patients need to heal from the shame that draws them back into unhealthy habits. Healing from shame requires much, much more than a bariatric procedure in an operating room, or “theater,” as they call it in New Zealand. It is not coincidental that bariatric patients across the globe suffer from shame. It is tragic that so few bariatric professionals around the world are willing to provide the full spectrum of care that patients require in order to be able to follow through with behavior modification techniques. Deep shame will eventually extinguish behavior modification efforts. How long before more bariatric professionals get it? How long before more than a handful of patients get the emotional support and psychological care they need after bariatric surgery? How long before we provide a truly comprehensive program to help our patients eliminate shame and establish self-acceptance? The shame belongs to the programs and professionals who do not provide a comprehensive program… because those programs simply aren’t good enough. (Along with the Schroeder’s, I will be offering residential retreats through bariatric centers in the near future. For more information, contact me at connie@conniestapletonphd.com.) I’m grateful for the non-coincidences that have led to meeting Andrea and David Schroeder. I am not surprised to see and hear that the patients in our very distant geographical countries are so very similar. Mostly, I am thrilled to know that there are professionals and patients who know that the Foundations of Healthy Living go way beyond medical care alone! For now, patients can participate in the GAIN While You Lose 10-week program. This is a great way for patients around the country (and the world) to have access to the same topics discussed in the Foundations of Living Retreat. This class includes an hour and a half “lesson,” taught live but available online or via recorded session, followed by weekly homework to make the information applicable to each person’s life. (http://www.conniestapletonphd.com/onlin…/weight-loss-program) Why aren’t we currently doing retreats in the US? Are you, the patients, willing to pay to attend? Are you willing to take the time and spend the money to invest in yourself? Do you value yourself enough to work on your emotional issues? You’ve most likely been willing to pay hundreds to thousands of dollars for weight loss programs, powders, gimmicks and scams. What about actually finding a way to find self-acceptance, a requirement for being able to follow through with behavior modification tools? Patients: there is no shame in having problems. It is tragic to me if you know there are problems, but choose not address them. Please seek the help you need! After all: YOUR HEALTH is YOUR RESPONSIBILITY. THIS DAY. EVERY DAY.