Mary Jo Rapini

If you have a smartphone of use Facebook, you probably have run across or played Candy Crush Saga as well as other popular games. Playing them is innocent and fun, but when you can’t stop playing them and you begin avoiding real life because you’d much rather spend time lining up candy in a row to score points, there’s a problem. Although that may sound funny, it’s very serious. More than 93 million people play more than 1 billion times a day according to the game’s maker, “King Digital Entertainment.” Dr. Natasha Dow Schull, an Anthropologist and associate professor at Massachusetts Institute of Technology, studies addiction and games and reports that what hooks people onto games such as Candy Crush is called “Ludic Loop.” The idea is it’s between you and the machine and your job is to do the task again and again. You never know what the reward will be or whether you get the reward, but the repetitive task and intermittent reward keeps you trying. It removes you from the real world and soon you lose time spent involved in the game. She likens Candy Crush and other games as gambling on steroids. These games provide a way to escape the real world. You enter a world of “Machine Zone;” just you and the machine and no time limits. Games have other addictive components. Things like: Feedback is quick. They are nice to you...they make you feel like a winner even when you’re not. There’s always more. The game goes as long as you do. It taps into your inner child. Games can be played socially. Although the game seems innocent enough, if you are playing non-stop or using it to replace loneliness, relationships or feelings you are unable to deal with in real life, it could suggest you have a deeper issue. Here are suggestions that can help you set boundaries to maintain balance in your life and still enjoy your game time. Since you lose track of time in a game begin documenting how much time you are Limit games to times you are off work. Playing over the lunch hour may prevent you from Never let your game time replace time with family or friends. Kids need attention and Keep track of data used on your smartphone. Game apps can become expensive if played hours each day. When a game becomes more important to you than relationships it’s time to become reinvested in your real life. That means taking a break from all gaming for at least 30 days. This will help you re-discover the life you've replaced with games and afford you insight into why you felt the need to escape in the first place.

Have you ever caught yourself watching TV at night and feeling lonely, bored or sad? Your partner may be sitting next to you or in their favorite chair, but you get up anyway; making the routine trip to the freezer to fix a bowl of ice cream, which will provide the comfort you are craving. It may not be ice cream; your comfort food may be a bag of Doritos, a pizza delivery, or a can of coke and leftovers from dinner. You aren’t really hungry, you may feel miserable, but the effort it would require to hug your partner, or become intimate with them isn’t as easy or comforting as food. People who struggle with weight often times struggle with intimacy as well. This struggle extends beyond their family, and affects their personal friendships as well. Eating for comfort may lead to more isolation. The more weight people gain, the less they want to mingle and the more they worry about what others will think or say. Have we become a society of people medicating with food in order to feel better? Have we stopped turning to loved ones for support and comfort in lieu of food? Yes and no. Although overeating has always been a problem, the stress of technology speeding up our lives and forcing us to bring home more work, or never leaving work at work, we are all working more and more, and feeling less and less connected with those we love most. We return home feeling exhausted and overwhelmed. Rewarding ourselves with food is a lot easier than becoming vulnerable and open to criticism from our partner or friends. There are other reasons more people are turning to food for emotional comfort rather than a relationship. You don’t have to leave your home to get comfort. Food delivery is available within blocks of our homes. Food is easy; you don’t need to invest any effort or time. You don’t have to get dressed to enjoy comfort food. You don’t have to look handsome, desirable or pretty for food. Food doesn’t judge you, leave you, or criticize you. Eating a delicious dinner is longer and more enjoyable for many people than sex (the average length of lovemaking is less than ten minutes). Food doesn’t cheat on you. Food is available anywhere, anytime, and for any reason. Food may be tied to memories of love and childhood which makes you feel loved. Food doesn’t require a partner. So is it a bad thing if we prefer gourmet truffle macaroni and cheese along with a filet mignon and a fresh garden salad with gobs of ranch dressing? Is it bad to add chocolate mousse if you’ve had an especially rough day and need an additional reward? It’s not a judgment call of right or wrong, but it can be adding to your unhappiness and health. Intimacy with another is important. When you are intimate with someone they want you to be healthy; choosing food for comfort rather than reaching out to them would be hurtful or a sign of rejection. There are other reasons you need to find comfort in one another rather than food. Below are a few. Intimacy shared with another gives you a deeper connection. Intimacy doesn’t leave you with guilt, feeling disgusted, or body hate. Intimacy helps you lose weight, not gain. Intimacy lowers your heart rate. Intimacy lowers your blood pressure. Intimacy won’t cause diabetes. Intimacy is good for your heart. Intimacy improves your thinking. Intimacy is exercise and exercise is good. Intimacy won’t leave you feeling isolated. Intimacy doesn’t take your mobility away. Intimacy doesn’t cost anything. Intimacy doesn’t make your hips, knees or ankles hurt. Intimacy makes your brain work better. Everyone understands the feeling of working and having a bag of chips or a package of cookies nearby only to realize at the end of their task the bag or package is completely gone. They were eating them mindlessly. Eating to calm anxiety is more and more common. The primary reason for relationships growing apart is due to couples choosing other vices to fill the void they feel. Becoming aware of your behavior and what you are eating, as well as writing down what you eat (we forget) is a good way to begin eating less and becoming more in touch with the emotions you are repressing with food. A simple practice of not eating past 7 or 8 pm can help you lose weight, and communicate more with your partner, family or friends. Breaking the habit of turning to food is not easy, but with practice it does work. Intimacy and sex are better for you than food! –Mary Jo Rapini

Being single just as being in a relationship is a lifestyle choice, but what happens when you are tired of being single with no apparent relationship in sight? Do you become depressed, find yourself eating more and feeling like a loser? If you answer yes, then it’s time to re-think and renovate how you think about your status of single. A relationship is a lifestyle, not a destination. Being single is a lifestyle too, not a destination. Quit putting off living and doing the things you want until you find someone. Live in a place you love. Why wait to have the place of your dreams? This is an opportunity to have the type of furniture and décor you want. If you like eating off china, eat off china. Travel and learn. There are many single travel groups and you will get a diverse world view when you travel with others. Who knows, you may end up making a great friend. Immerse yourself into a project or a cause that is meaningful to you. The great thing about being single is you don't have to be accountable to anyone else. Doing what makes you feel good about who you are is a mood elevator. You won't have time to focus on what you don't have if you focus on all you have to do. Dress in clothes that flatter you, and make you feel good about being you. When you're single there is no one you have to impress, which ironically impresses others due to your independence. Explore your faith. There is never a more opportune time to mediate, read and pray. If you aren't solid in your faith, improving the relationship you have with your faith will improve many other areas of your life. Stop moping and get re-involved with your life and your single lifestyle. Relationships are built on great friendships and great relationships begin with liking yourself in your current lifestyle.

The recent statistics from the CDC (Center for Disease Control and Prevention) has reported that about one-third (33.8%) of U.S. adults are obese. That number rises every day, and keeping up with it is more difficult than keeping up with your stocks. I work with the finest bariatric surgeons in the U.S. They are dedicated to helping their patients lose weight in an effort to thwart diseases, and minimize current disease progression. I also run several 12-step food addiction groups in the city of Houston and online in many cities. I talk to morbidly obese patients everyday. I teach them, counsel them, eat with them, and spend endless hours reading their journals. These patients have a story to tell, but we aren’t listening and we continue asking the wrong questions. To be sure, obesity is genetic and many times the social milieu of obese patients I work with is chaotic with issues of abuse, abandonment, shame, ridicule, and anger. The genetic role helps explain the body type; the way food may be processed, stored, and proportioned. It cannot explain what keeps the person from changing the behavior that contributes to obesity. In my work, during step 4 of the 12-step addiction group, the group members begin making amends. They look at how their behavior got them where they are. They quit thinking about how they were abused, and begin to consider how they hurt/abused others. The step is painful, gut wrenching and overwhelming for all of these patients. It is also the step I ask them, “How do you benefit from being obese?” At first they look at me as if I am crazy. After all, they are weight loss surgery patients, and have gone to extremes to lose weight. They laugh, shake their head, and say, “Mary Jo, what are you smoking?” Then the room gets quiet. One of the bravest patients will say, “My obesity gives me an excuse. I am not held to the same standards as others; they don’t expect it, because I am morbidly obese.” Another will chime in, “My obesity keeps men away; I was sexually abused by my dad for 4 years of my life.” A statistic that no one likes to talk about was one mentioned in Bariatric Times in 2007. As many as 20 to 40% of obese women have been sexually molested, harassed and/or perpetrated (they know it’s higher than that but can’t ascertain the exact amount). Yet another will talk about how her/his marriage is so distant that food has become their lover/best friend. They are lonely, and they eat to comfort that incredible sense of loss. Another part of my job focuses on the group that failed the weight loss surgery. If you have never been morbidly obese, or gone through a weight loss surgery only to have the weight come back, you cannot understand the depth of failing these patients feel. They are cursed by their unresolved reasons for going back to food. They don’t understand it, and often those who love them most don’t either. A Gastric Bypass, Gastric Sleeve, Lap Band, or Duodenal Shift is never going to successfully keep weight off if the patient has no idea why they are eating, and experience a fear of stopping. Many of the cravings patients feel are emotional; totally unrelated to real hunger. How can a weight loss surgery of any kind manage emotional hunger? It cannot. When we evaluate patients who struggle with obesity we talk frequently about denial. I am beginning to think they are no more in denial than we, the health care professionals. We can talk food all we want, but most of my patients know what healthy food is; they could write a cookbook with the calorie count included! They know food like most of us know our lover. What they need help with are the tough questions. One of those questions is, “What are the benefits you are experiencing from your obesity?” We have to ask this, and we should ask it prior to weight loss surgery so we can begin the process of helping them understand this part. People drop old behaviors when they are no longer benefiting from them. You don’t need to be a weight loss surgery patient to begin the yoyo dieting process. If weight protects you from receiving attention, and you have been sexually abused in your childhood, then when you begin losing weight you are going to turn to food to manage the anxiety you feel when a man gives you eye contact. When patients begin to understand what they are protecting or avoiding with their weight, they can effectively work a weight loss program and keep the weight off. It is also important to look at obese children’s homes especially if there is a substantial weight gain. Many times, something is going on at home that is causing this child to medicate their anxiety with food. Society continues to be judgmental and negative with obese people. One thing is clear: shaming or ignoring obesity is not helping curb or decrease the numbers.

“Words are tears that have been written down. Tears are words that need to be shed. Without them, joy loses all its brilliance and sadness has no end.” Paulo Coelho Via Mary Jo Rapini’s Food Addiction Group Karen Askins Nov. 17, 2014 It all started out as another lie, not one intention to ever try- Once again I wanted an easy fix, because I was up to my usual tricks. I knew the words I needed to say, for her required signature to start me on the way- This time surgery would be the lucky charm, hopefully there would no lasting harm. She probably knew as well as I, that I was sick and would probably soon die- If I didn't get myself together, and start making me a whole lot healthier. I wanted to believe that it was only about food, not about everything that was affecting my mood- But she said I was eating to not deal with life’s pain, adding up yearly to a significant weight gain. I have always latched on to some current craze, the other surgeries, pills, diets, and starvation days-Maintenance was the problem that was never addressed, it would always come back quicker than I confessed. Just twelve steps, how hard could that be? I decided to try and just kind of see- So the first month I did as little as I could, of all the work I was told that I should. Step two was the first time I wrote in the book, I thought I'd write anything- who was going to look? What I found was not what had been expected, instead of a diet plan, it was like church resurrected. Higher Power this and surrender to that, what did that have to do with being so fat? Be of service, have faith, and listen to the call, meditation and prayer were suggested for all. What was the problem? I did all of that, lots of pretty feathers sitting in my hat- This would be a breeze once a month to meet, I could do this group and not miss a beat. The women there were all nice enough, but they had problems that were really tough- And then there was the tiny psychotherapist Mary Jo, what in the world could she possibly know? The irony of it all was that I already knew in my heart, the two words I resisted from the very start- After time was wasted denying the fact, I finally admitted that I was a Food Addict. That in itself was enough to make me blue, but there were also my legs and hands severely cramping every night like on cue- One doctor said vitamin deficiency, one RLS, and still another dehydration, all I knew was I couldn't take the horrible, all night sensation. The doctor had me try several medications- finally Flexeril, it would dull the pain, and he said, “As needed, just refill”- It didn’t get better on 10 mg. once a day, but he finally got it right when he said with 40 they’d go away. I didn’t hear any warnings about side effects, my other medications were not really checked- My mind became a blur and life started getting worse, I blamed everyone, God, and mainly the step study as my curse. For months I thought I was going to be like my grandmother, who had dementia worse than any other- She was functional one day and not lucid the next, that was me all because I didn't want my legs and hands to flex. When I could think straight, I was really on top of it, doing what I could to get my mind and body fit-But it was up and down around and back, my emotions were like a roller coaster track. I felt so depressed and couldn't always comprehend right, but I was sure that I still had pretty good insight- Still trying to believe it was a food issue and really wanting to win that battle, to try and not make every plate, fork, and spoon rattle. The “win” was bittersweet as my “perfect” life fell apart, and I hurt everyone I loved with all of my heart- There was no satisfaction with me as the boss, and my peace and happiness were at a complete loss. Beating myself up and causing more pain, literally drove me completely insane- It was all I could do to survive. I hated the way I was living; my husband kept saying that I was just barely existing. I was brought to my senses several times along the way, obviously though, I was still there to play- Panic attacks, totaling our truck, being paralyzed by fear, weren't even enough to see my way clear. I think I knew that the medicine wasn’t good but kept taking each prescribed dose, and it turned who I was into someone different, someone very gross- It made the original goal to deal with food addiction, a journey that was more like science fiction. Here I am in Mexico where I was forced to stay, mortified to wake up in basically a “detox unit” yesterday- Where everyone must have thought I was a long time street druggie, until they figured out it was a legitimate prescription written just for me. The doctor took away the Flexeril, allergy, asthma--all of my needed prescriptions, and the pain started back much to my aggravation- They brought in food- a lot of fattening Mexican stuff, and when I refused, the nurse threatened to get mean and tough. She gave me IV’s and a bottle of Ensure, and yelled, “You eat or you drink this!” as I tried to keep my composure- It was bad enough this mess I was in, no way was I going to eat that junk and screw up surgery once again. Doing last minute planning just two weeks before my son’s wedding I was forced to get aid, my family cried and yelled that I should I have known better, but mostly they prayed- And within 24 hours of passing out cold, my mind felt almost clear, and I had to get bold. With plenty of time here to sort it all through, I asked myself, “What in the world am I going to do?” Then there on the table left by my husband in plain view, was Mary Jo on Facebook clearly coming through. Yesterday, Sunday, Nov.16, her post spoke loudly and went straight to my heart, that is what made me decide I needed a fresh start- The picture screamed, “Be still- I’ve got this.” It was a message from God, and her added words stung like a lightning rod. She wrote what I knew but needed to hear, it was hard for me to swallow, but I gave her my ear- How could I ever have been so remiss? Her lecture ended with, “… trust God to be God, he’s got this- his promise.” I am pretty sure that I have been given a choice, self-destruct or stop and listen to His voice- It is now or never, and now is looking really good, for me to be honest and deal with what I should. All the fertility treatments, my children being my husband’s family blood and not mine, my mom’s death, my friend Barbara dying on Flight 77 on 9/11--all of that and more over time- To be strong for everyone else I always pushed away pain, and sucked down the food with no way to abstain. For several months I was crying most of the time and not actually comprehending what was making it so tough, but I think I kept trying to get through it because I was afraid of even more bad stuff- The confusion in my head sometimes made me think I wanted to die, but I had enough snap to question if I would get the chance to look God in the eye. So I read and studied when I could, but I would lose sight, I was in turmoil, and it was like I was in a life and death fight- To be truthful the cause wasn’t really food, nor 100% the medicine, and definitely not liquor, I know now the actual battle was over control between me and my creator. Realizing way too late that I am ready to begin, the opportunity of a lifetime that is quickly coming to an end- Wanting what I had started the step study for- a plan of action, to keep myself from eating even if it means being in traction. Mary Jo sent the answer to that and much more- what an idiot I have been, the wife, the mother, the one who everyone knew to be the “wonderful Christian”- Knowing much better, I had tried on my own to run the show, thinking I would eventually win- I guess like at a Las Vegas casino. She told us that she had felt God’s love. Not me, I went to Hell, but both had experiences we can surely tell- Grateful I didn’t make it my final destination, because I was given a chance for a needed transformation. Being as old as I am and with the “good life” I have led, no way should I have gotten so close to being dead- The truth is I did it to myself trying to go solo, sending life as I knew it down to practically zero. Mary Jo’s near death experience was a blessing to us all, she was sent back with a mission and accepted the call- To share God’s love, mercy, and grace, I can tell it’s authentic by the glow on her face. She told how it changed her own way of thinking, prayer, surrender, service, and love all linking- How she helps people and how she really cares, has inspired me to want to spend the rest of my life in His care. I feel that now I have a new purpose for which I must live, with love unconditional to receive and more for me to give- I have to let go and to be sure of my intention, and not just use this experience and God as a brief intervention. It's the gift of relearning what life is really all about, that the 12 step study journey gave me without a doubt- Something I never thought I would ever need, because I was always living “perfectly” I knew indeed. My inventories and amends were minor to compare, I needed a transplant or a full heart repair- May Jo said she pleaded with God not to send her away, but if He hadn’t, I would have never had this day. To know with 100% assurance, that I do have it in me for the endurance- It's really about how I used to live but more recently kept struggling to concede, the hardest thing for me was “the faith of a mustard seed.” The food addiction thing will be for all of my time, always aware of why I eat and on what I must dine- But that’s not the triumph of my battle when all is said and done, it is that I waved the white flag and allowed God back as number one. I am thankful from the bottom of my heart, for the group and Mary Jo’s words that guided me toward a new start- The path I took was awful to trudge for a year, but the journey gave me my wings and brand new flight gear. I took the long road with all the pot holes and detours, but I finally get it I know for sure- There is a sense of clarity and my mind is peacefully at rest, I am only going forward and will give it my best. The replay button has to go; it has to be left behind, in order to get through each new day with a clear, sane mind- I have done some stupid (mostly recently) things in my life, but the worst thing I did was cut God out with a knife. It is hard to believe that just a few days ago, I was so bitterly miserable from my head to my toe- Feeling horrible to be imprisoned that way, but now I am free, because I was reminded that there is a better life with the one who really cares for me. Strength and help for everyone else has always been there, but I never took time for myself to receive care- I don’t have all the answers nor can I say I’m not afraid, but I know I can trust that His loving hands on me are laid. I truly believe with all of my heart and soul, that our group was brought together each one with a role- Dana, Kathryn, Anita, and I came with one common thread, to learn to keep food from running our head. I learned a lot about them; sometimes more than I thought I needed to know, but God used them all to show me the way I should go- And that life is uncertain and forever changing, and that He is the only constant with love and forgiveness so amazing. Kathryn with her wit, humor, and wisdom to share, already knew there would be so much more for me there- She’s successfully been in recovery for an impressive amount of time, a real testament to me that being an addict is no crime. Anita Joy was given the perfect name, her face and her smile allude to why she came- To help bring that joy and light to the darkest place I could know, because she shares His love wherever she goes. Dana sat beside me just beautiful to see, ten years younger but way ahead of me- She shared her heart’s burden and taught me a lesson, about judgment and compassion sending me straight to confession. We were a small group. I’m sure there could have been more, but God’s plan was for there to be only four- Who would have guessed that the answer to managing an addiction to food, would be to relearn from all of them that God is so good? They never had a chance to know who I really was, since for more than half of our time together I was totally buzzed- They were too nice to say what my children and husband told, that for the definition of a fool I had broken the mold. I can’t believe I didn’t stop what was happening and see, the very thing many of my friends have asked for help for their loved ones from me- To steer them away from what could destroy their mind, the only difference was theirs were bought on the street and prescribed were my kind. I didn’t have an actual near-death experience, but as far as genuinely living, from that I was the farthest distance- The painful lesson I learned which I want to share with all, is that everything will fall into place, even managing a food addiction, when your life is lived listening to the Higher Power’s call. Writing this all down was for my often annoying, analytical brain, attempting to make sense of it all and understand that my suffering doesn’t have to have been in vain- It will be here to remind me just in case I ever forget, and going backwards suddenly becomes a major threat. I don't know what the future will bring, it’s too late now, but I wish from the beginning I had taken more advantage of this 12 step group thing- We are going to disband. Each one will go her way, but I will remember and thank God daily for them as I pray. I wish there was a way to make the ones like me who will come through this group understand from day one, that the only way they will conquer the food addiction thing is to give the program and their Higher Power their all even though it may not seem like much fun- Mary Jo, please tell them for me that whatever it is on their journey they may face, that their life is worth the fight and for them not to wait like I did to claim God’s marvelous grace.

Via Mary Jo Rapini’s Food Addiction Group Karen Askins Nov. 17, 2014 It all started out as another lie, not one intention to ever try- Once again I wanted an easy fix, because I was up to my usual tricks. I knew the words I needed to say, for her required signature to start me on the way- This time surgery would be the lucky charm, hopefully there would no lasting harm. She probably knew as well as I, that I was sick and would probably soon die- If I didn't get myself together, and start making me a whole lot healthier. I wanted to believe that it was only about food, not about everything that was affecting my mood- But she said I was eating to not deal with life’s pain, adding up yearly to a significant weight gain. I have always latched on to some current craze, the other surgeries, pills, diets, and starvation days-Maintenance was the problem that was never addressed, it would always come back quicker than I confessed. Just twelve steps, how hard could that be? I decided to try and just kind of see- So the first month I did as little as I could, of all the work I was told that I should. Step two was the first time I wrote in the book, I thought I'd write anything- who was going to look? What I found was not what had been expected, instead of a diet plan, it was like church resurrected. Higher Power this and surrender to that, what did that have to do with being so fat? Be of service, have faith, and listen to the call, meditation and prayer were suggested for all. What was the problem? I did all of that, lots of pretty feathers sitting in my hat- This would be a breeze once a month to meet, I could do this group and not miss a beat. The women there were all nice enough, but they had problems that were really tough- And then there was the tiny psychotherapist Mary Jo, what in the world could she possibly know? The irony of it all was that I already knew in my heart, the two words I resisted from the very start- After time was wasted denying the fact, I finally admitted that I was a Food Addict. That in itself was enough to make me blue, but there were also my legs and hands severely cramping every night like on cue- One doctor said vitamin deficiency, one RLS, and still another dehydration, all I knew was I couldn't take the horrible, all night sensation. The doctor had me try several medications- finally Flexeril, it would dull the pain, and he said, “As needed, just refill”- It didn’t get better on 10 mg. once a day, but he finally got it right when he said with 40 they’d go away. I didn’t hear any warnings about side effects, my other medications were not really checked- My mind became a blur and life started getting worse, I blamed everyone, God, and mainly the step study as my curse. For months I thought I was going to be like my grandmother, who had dementia worse than any other- She was functional one day and not lucid the next, that was me all because I didn't want my legs and hands to flex. When I could think straight, I was really on top of it, doing what I could to get my mind and body fit-But it was up and down around and back, my emotions were like a roller coaster track. I felt so depressed and couldn't always comprehend right, but I was sure that I still had pretty good insight- Still trying to believe it was a food issue and really wanting to win that battle, to try and not make every plate, fork, and spoon rattle. The “win” was bittersweet as my “perfect” life fell apart, and I hurt everyone I loved with all of my heart- There was no satisfaction with me as the boss, and my peace and happiness were at a complete loss. Beating myself up and causing more pain, literally drove me completely insane- It was all I could do to survive. I hated the way I was living; my husband kept saying that I was just barely existing. I was brought to my senses several times along the way, obviously though, I was still there to play- Panic attacks, totaling our truck, being paralyzed by fear, weren't even enough to see my way clear. I think I knew that the medicine wasn’t good but kept taking each prescribed dose, and it turned who I was into someone different, someone very gross- It made the original goal to deal with food addiction, a journey that was more like science fiction. Here I am in Mexico where I was forced to stay, mortified to wake up in basically a “detox unit” yesterday- Where everyone must have thought I was a long time street druggie, until they figured out it was a legitimate prescription written just for me. The doctor took away the Flexeril, allergy, asthma--all of my needed prescriptions, and the pain started back much to my aggravation- They brought in food- a lot of fattening Mexican stuff, and when I refused, the nurse threatened to get mean and tough. She gave me IV’s and a bottle of Ensure, and yelled, “You eat or you drink this!” as I tried to keep my composure- It was bad enough this mess I was in, no way was I going to eat that junk and screw up surgery once again. Doing last minute planning just two weeks before my son’s wedding I was forced to get aid, my family cried and yelled that I should I have known better, but mostly they prayed- And within 24 hours of passing out cold, my mind felt almost clear, and I had to get bold. With plenty of time here to sort it all through, I asked myself, “What in the world am I going to do?” Then there on the table left by my husband in plain view, was Mary Jo on Facebook clearly coming through. Yesterday, Sunday, Nov.16, her post spoke loudly and went straight to my heart, that is what made me decide I needed a fresh start- The picture screamed, “Be still- I’ve got this.” It was a message from God, and her added words stung like a lightning rod. She wrote what I knew but needed to hear, it was hard for me to swallow, but I gave her my ear- How could I ever have been so remiss? Her lecture ended with, “… trust God to be God, he’s got this- his promise.” I am pretty sure that I have been given a choice, self-destruct or stop and listen to His voice- It is now or never, and now is looking really good, for me to be honest and deal with what I should. All the fertility treatments, my children being my husband’s family blood and not mine, my mom’s death, my friend Barbara dying on Flight 77 on 9/11--all of that and more over time- To be strong for everyone else I always pushed away pain, and sucked down the food with no way to abstain. For several months I was crying most of the time and not actually comprehending what was making it so tough, but I think I kept trying to get through it because I was afraid of even more bad stuff- The confusion in my head sometimes made me think I wanted to die, but I had enough snap to question if I would get the chance to look God in the eye. So I read and studied when I could, but I would lose sight, I was in turmoil, and it was like I was in a life and death fight- To be truthful the cause wasn’t really food, nor 100% the medicine, and definitely not liquor, I know now the actual battle was over control between me and my creator. Realizing way too late that I am ready to begin, the opportunity of a lifetime that is quickly coming to an end- Wanting what I had started the step study for- a plan of action, to keep myself from eating even if it means being in traction. Mary Jo sent the answer to that and much more- what an idiot I have been, the wife, the mother, the one who everyone knew to be the “wonderful Christian”- Knowing much better, I had tried on my own to run the show, thinking I would eventually win- I guess like at a Las Vegas casino. She told us that she had felt God’s love. Not me, I went to Hell, but both had experiences we can surely tell- Grateful I didn’t make it my final destination, because I was given a chance for a needed transformation. Being as old as I am and with the “good life” I have led, no way should I have gotten so close to being dead- The truth is I did it to myself trying to go solo, sending life as I knew it down to practically zero. Mary Jo’s near death experience was a blessing to us all, she was sent back with a mission and accepted the call- To share God’s love, mercy, and grace, I can tell it’s authentic by the glow on her face. She told how it changed her own way of thinking, prayer, surrender, service, and love all linking- How she helps people and how she really cares, has inspired me to want to spend the rest of my life in His care. I feel that now I have a new purpose for which I must live, with love unconditional to receive and more for me to give- I have to let go and to be sure of my intention, and not just use this experience and God as a brief intervention. It's the gift of relearning what life is really all about, that the 12 step study journey gave me without a doubt- Something I never thought I would ever need, because I was always living “perfectly” I knew indeed. My inventories and amends were minor to compare, I needed a transplant or a full heart repair- May Jo said she pleaded with God not to send her away, but if He hadn’t, I would have never had this day. To know with 100% assurance, that I do have it in me for the endurance- It's really about how I used to live but more recently kept struggling to concede, the hardest thing for me was “the faith of a mustard seed.” The food addiction thing will be for all of my time, always aware of why I eat and on what I must dine- But that’s not the triumph of my battle when all is said and done, it is that I waved the white flag and allowed God back as number one. I am thankful from the bottom of my heart, for the group and Mary Jo’s words that guided me toward a new start- The path I took was awful to trudge for a year, but the journey gave me my wings and brand new flight gear. I took the long road with all the pot holes and detours, but I finally get it I know for sure- There is a sense of clarity and my mind is peacefully at rest, I am only going forward and will give it my best. The replay button has to go; it has to be left behind, in order to get through each new day with a clear, sane mind- I have done some stupid (mostly recently) things in my life, but the worst thing I did was cut God out with a knife. It is hard to believe that just a few days ago, I was so bitterly miserable from my head to my toe- Feeling horrible to be imprisoned that way, but now I am free, because I was reminded that there is a better life with the one who really cares for me. Strength and help for everyone else has always been there, but I never took time for myself to receive care- I don’t have all the answers nor can I say I’m not afraid, but I know I can trust that His loving hands on me are laid. I truly believe with all of my heart and soul, that our group was brought together each one with a role- Dana, Kathryn, Anita, and I came with one common thread, to learn to keep food from running our head. I learned a lot about them; sometimes more than I thought I needed to know, but God used them all to show me the way I should go- And that life is uncertain and forever changing, and that He is the only constant with love and forgiveness so amazing. Kathryn with her wit, humor, and wisdom to share, already knew there would be so much more for me there- She’s successfully been in recovery for an impressive amount of time, a real testament to me that being an addict is no crime. Anita Joy was given the perfect name, her face and her smile allude to why she came- To help bring that joy and light to the darkest place I could know, because she shares His love wherever she goes. Dana sat beside me just beautiful to see, ten years younger but way ahead of me- She shared her heart’s burden and taught me a lesson, about judgment and compassion sending me straight to confession. We were a small group. I’m sure there could have been more, but God’s plan was for there to be only four- Who would have guessed that the answer to managing an addiction to food, would be to relearn from all of them that God is so good? They never had a chance to know who I really was, since for more than half of our time together I was totally buzzed- They were too nice to say what my children and husband told, that for the definition of a fool I had broken the mold. I can’t believe I didn’t stop what was happening and see, the very thing many of my friends have asked for help for their loved ones from me- To steer them away from what could destroy their mind, the only difference was theirs were bought on the street and prescribed were my kind. I didn’t have an actual near-death experience, but as far as genuinely living, from that I was the farthest distance- The painful lesson I learned which I want to share with all, is that everything will fall into place, even managing a food addiction, when your life is lived listening to the Higher Power’s call. Writing this all down was for my often annoying, analytical brain, attempting to make sense of it all and understand that my suffering doesn’t have to have been in vain- It will be here to remind me just in case I ever forget, and going backwards suddenly becomes a major threat. I don't know what the future will bring, it’s too late now, but I wish from the beginning I had taken more advantage of this 12 step group thing- We are going to disband. Each one will go her way, but I will remember and thank God daily for them as I pray. I wish there was a way to make the ones like me who will come through this group understand from day one, that the only way they will conquer the food addiction thing is to give the program and their Higher Power their all even though it may not seem like much fun- Mary Jo, please tell them for me that whatever it is on their journey they may face, that their life is worth the fight and for them not to wait like I did to claim God’s marvelous grace.

Has shopping become a pastime for you? Many people, especially women, may answer that question yes…so how do you know when shopping has become a serious addiction instead of just bonding with friends, finding a cute outfit or having “me time?” According to the compulsive buying scale there are seven questions to ask yourself. Do you have unopened or tagged items in your closet? It is especially serious if you have forgotten you have them. Do you frequently purchase things you don’t need or didn’t plan to buy? It’s more serious if you are compulsive in regards to buying one name brand in particular. Do you medicate feelings of anger or frustration by going to the mall or a favorite boutique? Do you notice you get excited or feel a thrill when you buy? This could suggest an adrenaline rush, which is addictive with feel good hormones released when you make a purchase. After your purchase do you feel guilty or remorseful after you buy? Do you notice you rationalize your purchase to feel better? Do you conceal or hide your purchases? Do you feel anxious, out of sorts or empty if you don’t shop? If you begin to notice that you are spending more at the mall than you should be or shopping online, stopping it before it becomes out of control is possible. These suggestions may help you or someone you love. Find a new activity to substitute for shopping. Listen to music, go for a run or walk, or plan short coffee outings with your friends. Talking with friends helps develop healthy communication for managing upsetting feelings. When you are in a situation that makes you want to shop, such as a conflict with a family member, stress at work, or feeling alone, write down your thoughts and have a person in place you can talk with. Limit the amount of cash you carry and leave credit cards or debit cards at home. Always carry a shopping list to the store and don’t allow yourself to get anything not on the list. Set a dollar limit with your partner and call one another prior to spending that amount. This helps add accountability, which also helps your partner know what’s going on. A shopping addiction can lead to financial ruin as well as failed relationships. Talking with a licensed counselor can help you discover the feelings underneath your need for shopping. If your addiction has already caused problems in your relationship, more intense treatment may be necessary. Support groups such as Debtors Anonymous are helpful to the shopper and their family. It may seem innocent to go shopping with the girls, but if you are a shopaholic, it is as destructive as gambling.

Do you have unopened or tagged items in your closet? It is especially serious if you have forgotten you have them. Do you frequently purchase things you don’t need or didn’t plan to buy? It’s more serious if you are compulsive in regards to buying one name brand in particular. Do you medicate feelings of anger or frustration by going to the mall or a favorite boutique? Do you notice you get excited or feel a thrill when you buy? This could suggest an adrenaline rush, which is addictive with feel good hormones released when you make a purchase. After your purchase do you feel guilty or remorseful after you buy? Do you notice you rationalize your purchase to feel better? Do you conceal or hide your purchases? Do you feel anxious, out of sorts or empty if you don’t shop? If you begin to notice that you are spending more at the mall than you should be or shopping online, stopping it before it becomes out of control is possible. These suggestions may help you or someone you love. Find a new activity to substitute for shopping. Listen to music, go for a run or walk, or plan short coffee outings with your friends. Talking with friends helps develop healthy communication for managing upsetting feelings. When you are in a situation that makes you want to shop, such as a conflict with a family member, stress at work, or feeling alone, write down your thoughts and have a person in place you can talk with. Limit the amount of cash you carry and leave credit cards or debit cards at home. Always carry a shopping list to the store and don’t allow yourself to get anything not on the list. Set a dollar limit with your partner and call one another prior to spending that amount. This helps add accountability, which also helps your partner know what’s going on. A shopping addiction can lead to financial ruin as well as failed relationships. Talking with a licensed counselor can help you discover the feelings underneath your need for shopping. If your addiction has already caused problems in your relationship, more intense treatment may be necessary. Support groups such as Debtors Anonymous are helpful to the shopper and their family. It may seem innocent to go shopping with the girls, but if you are a shopaholic, it is as destructive as gambling.

Dr. Natasha Dow Schull, an Anthropologist and associate professor at Massachusetts Institute of Technology, studies addiction and games and reports that what hooks people onto games such as Candy Crush is called “Ludic Loop.” The idea is it’s between you and the machine and your job is to do the task again and again. You never know what the reward will be or whether you get the reward, but the repetitive task and intermittent reward keeps you trying. It removes you from the real world and soon you lose time spent involved in the game. She likens Candy Crush and other games as gambling on steroids. These games provide a way to escape the real world. You enter a world of “Machine Zone;” just you and the machine and no time limits. Games have other addictive components. Things like: Feedback is quick. They are nice to you...they make you feel like a winner even when you’re not. There’s always more. The game goes as long as you do. It taps into your inner child. Games can be played socially. Although the game seems innocent enough, if you are playing non-stop or using it to replace loneliness, relationships or feelings you are unable to deal with in real life, it could suggest you have a deeper issue. Here are suggestions that can help you set boundaries to maintain balance in your life and still enjoy your game time. Since you lose track of time in a game begin documenting how much time you are Limit games to times you are off work. Playing over the lunch hour may prevent you from Never let your game time replace time with family or friends. Kids need attention and Keep track of data used on your smartphone. Game apps can become expensive if played hours each day. When a game becomes more important to you than relationships it’s time to become reinvested in your real life. That means taking a break from all gaming for at least 30 days. This will help you re-discover the life you've replaced with games and afford you insight into why you felt the need to escape in the first place.

A relationship is a lifestyle, not a destination. Being single is a lifestyle too, not a destination. Quit putting off living and doing the things you want until you find someone. Live in a place you love. Why wait to have the place of your dreams? This is an opportunity to have the type of furniture and décor you want. If you like eating off china, eat off china. Travel and learn. There are many single travel groups and you will get a diverse world view when you travel with others. Who knows, you may end up making a great friend. Immerse yourself into a project or a cause that is meaningful to you. The great thing about being single is you don't have to be accountable to anyone else. Doing what makes you feel good about who you are is a mood elevator. You won't have time to focus on what you don't have if you focus on all you have to do. Dress in clothes that flatter you, and make you feel good about being you. When you're single there is no one you have to impress, which ironically impresses others due to your independence. Explore your faith. There is never a more opportune time to mediate, read and pray. If you aren't solid in your faith, improving the relationship you have with your faith will improve many other areas of your life. Stop moping and get re-involved with your life and your single lifestyle. Relationships are built on great friendships and great relationships begin with liking yourself in your current lifestyle.

The holidays remind us of family get-togethers sharing food, laughter and bonding. If you are a food addict, the holidays may be one big guilt ridden binge. Food addicts think about food and have memories of food too, but they will most likely be linked with memories of hiding food, being punished by withdrawal of food, or being abandoned from loving relationships and using food for comfort. This is one reason the holidays are so stressful for people who struggle with food addictions. The frenzy and excitement brings stress, and food addicts comfort and calm their stress with food. Most people gain 3 to 5 pounds over the holidays. After the holidays one of the reasons many people become depressed is due to their out of shape bodies. Waiting until the New Year to shed a few pounds usually finds you carrying the additional weight you gained during the holidays into spring. By planning your holidays to include exercise and healthy choices, you don’t have to gain weight and you can still have a wonderful holiday. Why does overeating happen more during the holidays? Variety brings back emotional memories, images and feelings. The holidays come only once a year and are stressful…food is comforting for many. When we are stressed, upset or feeling lonely sugar can give us a high. Food is associated with good friends, parties and feeling connected. How do you avoid overeating? Before a party eat something hot. Things such as soup are wise choices so your tummy will be full. Avoid over drinking…in most cases over drinking causes overeating in that order. Make the holidays more about relationships than food. Try a small variety of many things instead of eating a whole pan of one thing. Exercise at least 10 minutes each day. This helps you relieve stress and is much healthier than food. Eating won’t help you deal with a breakup, boredom, or isolation, but reaching out for a good friend will. Avoid going to parties alone and when you go with someone ask them to help you limit your intake. Eat until you are comfortable and then stop. Overeating is hard on your heart, liver and stomach. Journal your feelings so you won’t have to eat them. Learn to say “NO” to someone who is pushing food on you. Bring your lunch to work and limit yourself to one holiday goodie in the work kitchen. Preparing yourself and your family to focus more attention on the meaning of the holidays and less on food served will strengthen your family’s communication and bring a deeper sense of gratitude for one another. –Mary Jo Rapini

There was an interesting article in the New York Times about a young woman who had a Lap-Band weight loss surgery after years of suffering the emotional journey of an overweight kid. The story was very honest about what to expect with this type of surgery, and it also tracked the journey of the young woman. The story is of interest to many as more and more teens and adults are turning toward the option of weight loss surgery. The latest number of weight loss surgeries performed in the United States is 220,000 per year. That is a seven-fold increase over the past 10 years according to the New York Times article. Weight loss surgeries do save lives and also improve quality of lives for sure, but they aren’t for everyone. The surgeons do the surgery and are skilled at centers of excellence, but unless the patients come back, join support groups and stay in contact with dieticians, falling off track is way too easy and, unfortunately, many of them do, including the young woman in the NYT story. I run several food addiction groups in Houston, and was featured as the psychotherapist for TLC’s show “Big Medicine.” On the show, I worked closely with Drs. Robert and Garth Davis. We tried to give the viewer an honest look at what happened with the weight loss surgery and the journey after. My work now is primarily with revisions. Revisions are the surgery done when the first weight loss surgery failed. My office is full, as are my support groups. What happened to the patients that so eagerly came into our offices feeling empowered and ready to give up their morbid obesity forever? They are replaced with patients who hang their head feeling like they failed. Even though they feel defeated, the ones I see are the fortunate ones who were able to step out of their shame cycle, call their insurance company and ask for a second chance. They need a second chance because neither they nor we (the health team) had a full picture of what was underneath their weight. They couldn’t see it prior to surgery, and since they are their own historians telling us their story, we are blinded also. I believe in weight loss surgery, but I believe more in the knowledge we impart to the patient prior to and after the surgery. Performing an alteration, such as a weight loss surgery, is a huge decision, but in the case of a minor I think the whole bariatric medicine team must be on board. There has to be a built-in safety net to handle the transformation of the child as well as their family. Everyone who loves the patient must change when someone they love has weight loss surgery. The counselor, dietician, and surgeon must know all of the family members. We must know who is sabotaging and enabling that patient on an emotional level. Enablers are the people still giving the patient food as a source of love. Our bariatric treatment teams must also understand if simply making better food and lifestyle choices worked, it would have worked 20 diets ago. It did not. Obesity has an addictive component, and addictions are kept in place by denial. Most patients will tell you they are not addicted to food exactly the same as an alcoholic will tell you they aren’t addicted to alcohol. The question is: “Do you use food to comfort yourself?” If the patient says “YES,” then treat them for a food addiction. Do this because they are telling you they have a relationship with food that is emotionally based and most likely they are choosing food with high fat or high carbohydrates (not one of my patients has ever had an addiction/emotional relationship to steamed or raw vegetables). Whenever a patient feels like a failure after going through the process of weight loss surgery and everything it entails, it is heart wrenching not only to them, but to me and anyone working in this field. If insurance companies won’t cover patient care for years to come after the surgery, then we in the field are going to have to put these measures in place and make them affordable to the patients. We cannot tell a patient they need to continue in groups and follow-ups if they can no longer afford the cost. Whoever said, “Weight loss surgery is a quick fix” truly never had weight loss surgery or worked with my patients. There is nothing quick about it. Obesity is a disease and once you have it, losing the weight is the easy part, managing that loss is a life long journey.

The holidays remind us of family get-togethers sharing food, laughter and bonding. If you are a food addict, the holidays may be one big guilt ridden binge. Food addicts think about food and have memories of food too, but they will most likely be linked with memories of hiding food, being punished by withdrawal of food, or being abandoned from loving relationships and using food for comfort. This is one reason the holidays are so stressful for people who struggle with food addictions. The frenzy and excitement brings stress, and food addicts comfort and calm their stress with food. Many people don’t understand the obese person’s journey with food. Nor can they relate to actually being under the influence of the intense food cravings, but ask any alcoholic or drug addict what these cravings feel like, and a food addict will be able to recount a very similar craving. The substance most craved with food addicts is sugar, and anyone who has tried to remove sugar from their diet knows how incredibly difficult that can be. The majority of food addicts have been brought up with another addiction. Maybe their parents were alcoholics, abusive, gamblers, smokers or hoarders. The child learned it was safer to turn to food or some other substance for comfort, because turning to a human for a hug or soothing words was impossible. Many food addicts lose weight to get married, only to find that they don’t have the skills to communicate loneliness, boredom, or anxiety to their partner. They slowly begin to turn to what has helped soothe them in the past, which is food. Before long, communication is compromised in the relationship. There is severe weight gain, which begins a disastrous cycle of withdrawing from sex, and turning to food. Soon the partner isn’t happy and the food addict feels shameful and guilty. These feelings of guilt and shame lock the cycle of turning to food even more securely. Weight loss surgery can help minimize disease and help people become more confident and mobile, but if there is an underlying sugar or food addiction, the weight will be re-gained. Sometimes that is in excess of eighty pounds. How can you help if you are addicted, married or know a food addict during the holidays? The key is to plan now. Realize that your partner or friend has a bigger problem than just eating too much. They need professional help, and they need it now. Find out who is on your plan for insurance and what it allows for help with eating disorders. Begin journaling your intake and talk to your partner about journaling theirs as well. This helps you become a team and to feel supported. Encourage your partner to begin turning to you for comfort or if you are alone, have someone who can accompany you to the party. Stay close to them, and when you feel alone turn to them for conversation or hold their hand. This helps delay your sense of needing food. Help them join a food addiction group, and if they are your partner, go with them if they need your support. There are several in Houston, and “Over Eaters Anonymous” offers a 12-step program for food addicts. Your partner suffers shame and guilt every day. Try to remember this, and be gentle. There is a lot of secrecy in this disorder. If they let you in, respect that. Food addicts are hurt, and we as a society can become part of the problem or part of the solution. Most addicts of food (and other addictions) have an enabler. The enabler complains about the behavior, but also supplies the fix. People who are co-dependent or have a low self-esteem may derive their security from enabling an addict. If you live with a food addict, or you suffer a food addiction, the best thing you can do prior to going to the party or being with friends where a lot of food will be present is to have a plan. Set a time limit for yourself at the party and have someone you are accountable to who helps you stay on track. –Mary Jo Rapini *As with all addictions, interventions only work if the addict wants to heal. Harping, nagging and pleading will be met with resistance to change until the addict is ready to make the change.

Most people gain 3 to 5 pounds over the holidays. After the holidays one of the reasons many people become depressed is due to their out of shape bodies. Waiting until the New Year to shed a few pounds usually finds you carrying the additional weight you gained during the holidays into spring. By planning your holidays to include exercise and healthy choices, you don’t have to gain weight and you can still have a wonderful holiday. Why does overeating happen more during the holidays? Variety brings back emotional memories, images and feelings. The holidays come only once a year and are stressful…food is comforting for many. When we are stressed, upset or feeling lonely sugar can give us a high. Food is associated with good friends, parties and feeling connected. How do you avoid overeating? Before a party eat something hot. Things such as soup are wise choices so your tummy will be full. Avoid over drinking…in most cases over drinking causes overeating in that order. Make the holidays more about relationships than food. Try a small variety of many things instead of eating a whole pan of one thing. Exercise at least 10 minutes each day. This helps you relieve stress and is much healthier than food. Eating won’t help you deal with a breakup, boredom, or isolation, but reaching out for a good friend will. Avoid going to parties alone and when you go with someone ask them to help you limit your intake. Eat until you are comfortable and then stop. Overeating is hard on your heart, liver and stomach. Journal your feelings so you won’t have to eat them. Learn to say “NO” to someone who is pushing food on you. Bring your lunch to work and limit yourself to one holiday goodie in the work kitchen. Preparing yourself and your family to focus more attention on the meaning of the holidays and less on food served will strengthen your family’s communication and bring a deeper sense of gratitude for one another. –Mary Jo Rapini

Many people don’t understand the obese person’s journey with food. Nor can they relate to actually being under the influence of the intense food cravings, but ask any alcoholic or drug addict what these cravings feel like, and a food addict will be able to recount a very similar craving. The substance most craved with food addicts is sugar, and anyone who has tried to remove sugar from their diet knows how incredibly difficult that can be. The majority of food addicts have been brought up with another addiction. Maybe their parents were alcoholics, abusive, gamblers, smokers or hoarders. The child learned it was safer to turn to food or some other substance for comfort, because turning to a human for a hug or soothing words was impossible. Many food addicts lose weight to get married, only to find that they don’t have the skills to communicate loneliness, boredom, or anxiety to their partner. They slowly begin to turn to what has helped soothe them in the past, which is food. Before long, communication is compromised in the relationship. There is severe weight gain, which begins a disastrous cycle of withdrawing from sex, and turning to food. Soon the partner isn’t happy and the food addict feels shameful and guilty. These feelings of guilt and shame lock the cycle of turning to food even more securely. Weight loss surgery can help minimize disease and help people become more confident and mobile, but if there is an underlying sugar or food addiction, the weight will be re-gained. Sometimes that is in excess of eighty pounds. How can you help if you are addicted, married or know a food addict during the holidays? The key is to plan now. Realize that your partner or friend has a bigger problem than just eating too much. They need professional help, and they need it now. Find out who is on your plan for insurance and what it allows for help with eating disorders. Begin journaling your intake and talk to your partner about journaling theirs as well. This helps you become a team and to feel supported. Encourage your partner to begin turning to you for comfort or if you are alone, have someone who can accompany you to the party. Stay close to them, and when you feel alone turn to them for conversation or hold their hand. This helps delay your sense of needing food. Help them join a food addiction group, and if they are your partner, go with them if they need your support. There are several in Houston, and “Over Eaters Anonymous” offers a 12-step program for food addicts. Your partner suffers shame and guilt every day. Try to remember this, and be gentle. There is a lot of secrecy in this disorder. If they let you in, respect that. Food addicts are hurt, and we as a society can become part of the problem or part of the solution. Most addicts of food (and other addictions) have an enabler. The enabler complains about the behavior, but also supplies the fix. People who are co-dependent or have a low self-esteem may derive their security from enabling an addict. If you live with a food addict, or you suffer a food addiction, the best thing you can do prior to going to the party or being with friends where a lot of food will be present is to have a plan. Set a time limit for yourself at the party and have someone you are accountable to who helps you stay on track. –Mary Jo Rapini *As with all addictions, interventions only work if the addict wants to heal. Harping, nagging and pleading will be met with resistance to change until the addict is ready to make the change.

It’s tough being around loud, pushy people who voice every emotion they feel when they feel it. On the opposite end of the spectrum and easier to be around are quiet people who don’t complain and keep their feelings to themselves. As it turns out, your body begins suffering physical symptoms when you hold unresolved emotional feelings inside. Research supports that the more the emotional baggage is felt internally, the worse it is for the body. Nowhere is this demonstrated as clearly as heart disease or with emotional issues such as depression and anxiety. Women’s bodies are another area that suffers from emotions held in is. According to experts in mind/body medicine, our emotions affect our bodies because they are linked to our bodies via our immune, endocrine and central nervous systems. Just as a broken heart affects our heart and can lead to death, what we feel affects our body and how effective it works. For women, emotions such as unresolved grief or anger at a partner can cause intestinal problems and headaches as easily as it can cause chronic pelvic pain, and many other bodily issues. Holding in emotions weakens your body’s immune system which make it tougher to ward off colds, infections, and when you do get sick you have a more difficult time getting well. Observing a list of body functions affected when women (or men) hold in their emotional baggage is staggering. This is why when you become ill it is so important to evaluate what you are feeling, and what you have been feeling for the past six months because some illnesses, such as rheumatoid arthritis, may take months to become symptomatic. Constipation or diarrhea, as well as stomach pain/ulcers Back/Neck pain Depression Insomnia High blood pressure Anxiety/Depression Weight gain or loss (eating disorders always have an emotional aspect) Sexual problems Rheumatoid arthritis Fibromyalgia Asthma Cancers (for example, pancreatic cancer may present with depression before the patient is symptomatic with cancer) Emotional healing is very different from physical healing. When I worked with cancer patients I was reminded of this fact many times. The tumor went away, and the body healed, but the mind lingered sometimes for years over the experience of losing hair, a body part and/or trust in your body. Counseling becomes a wonderful way to release pent up feelings so you can heal emotionally. There are many ways you can help your loved one or yourself unpack your emotional baggage. Try these suggestions and practice them frequently. Laugh as much as you can. Watch funny videos and allow yourself to laugh out loud. Cry when you need to, don’t hold it in, and just let it flow. Practice voicing, “I’m angry.” You don’t have to do an action with it, just say it out loud and say why. Mindful actions. Before you take any medication for a headache, tummy ache, backache, to stay awake, or to fall asleep, ask yourself what am I holding on to. Begin jotting things down. This small action offers huge rewards. Massages are a common treatment for people who have gone through horrendous crisis, and they’re also a wonderful treatment for fibromyalgia and rheumatoid arthritis. Breathe and let go of held in emotional pain as the therapist works on the body part that holds the physical pain. Medical care has come a long way with advancements in treating so many illnesses. Your body is more than physical though; there is an emotional and soulful part, which is more complicated to treat. Knowing yourself and being able to express uncomfortable feelings is healthy, not only for your mind, but for your body and soul as well. –Mary Jo Rapini

In our weight conscious society and a generation of obese children, it’s easy to begin placing one’s worth on their weight. In fact, girls especially are obsessed with the scale and feel judged according to their weight. It’s common to see morning news anchors or talk show hosts growing thinner and thinner. There comes a point, as with any obsession, when you cross the line between looking good and looking unhealthy. The host of Lifetime Television’s show, “How to Look Good Naked,” recently was quoted as saying “Zero is not a size, it’s a warning sign.” But is size zero perceived as a warning sign or as a status to attain? A survey taken among random ages asked women if they would give up five years of their life to be thinner. Many of them said a very loud, “YES.” Most people know when they look good and feel good. They can also tell you what their weight is when they feel their healthiest. Very rarely is that weight correlated with being too thin. Most people feel best when they have enough weight to help them feel energetic and vibrant, but not too much, which can cause fatigue, sore muscles, and joint pain. The body gives warning signs when you are too thin. Below are a few of those warning signs. Having a body mass index of less than two to three points below what is normal for your height and weight. Suffering from anemia or a lack of vitamins and minerals can be a sign of excessive binging and purging to lose weight. For women, irregular menstrual cycles or no cycles can be a sign of being too thin. Having dark circles under your eyes, or poor skin color are signs of malnourishment due to starving to be thin. Feeling dizzy or confused are both signs of not eating. Self-esteem is built on how we feel about ourselves. For women, body image is a large contributor to developing a healthy self-esteem, but it is minimized if the child has interests and achievements in other areas. Parents play a huge role in encouraging interests and supporting their child’s activities. It is not men as much as it is women ourselves who objectify our bodies. We critique our bodies and our friends’ bodies, and feel judged because we may feel we too are being critiqued. Children grow up hearing their moms lament about being too heavy, or not being in shape. Before the child is eight they are concerned with their weight, and how they compare to their friends. If you notice your child is focusing more and more on weight, and less and less on their attributes, it may help you to help them focus on the healthy habits that will lead to healthy self-esteem. Here are a few suggestions: Find groups or activities that share your common interests. Worry less about weight, and focus on a healthy exercise and diet plan. Educate yourself and have a career goal and dream. Befriend rather than compare yourself to women of all ages, careers and ethnicities. Focus on what you want, instead of how you look compared to your friends. When parents join their child and the family works as team to help each member succeed, weight becomes less of an issue and healthy living becomes more. –Mary Jo Rapini

It’s tough being around loud, pushy people who voice every emotion they feel when they feel it. On the opposite end of the spectrum and easier to be around are quiet people who don’t complain and keep their feelings to themselves. As it turns out, your body begins suffering physical symptoms when you hold unresolved emotional feelings inside. Research supports that the more the emotional baggage is felt internally, the worse it is for the body. Nowhere is this demonstrated as clearly as heart disease or with emotional issues such as depression and anxiety. Women’s bodies are another area that suffers from emotions held in is. According to experts in mind/body medicine, our emotions affect our bodies because they are linked to our bodies via our immune, endocrine and central nervous systems. Just as a broken heart affects our heart and can lead to death, what we feel affects our body and how effective it works. For women, emotions such as unresolved grief or anger at a partner can cause intestinal problems and headaches as easily as it can cause chronic pelvic pain, and many other bodily issues. Holding in emotions weakens your body’s immune system which make it tougher to ward off colds, infections, and when you do get sick you have a more difficult time getting well. Observing a list of body functions affected when women (or men) hold in their emotional baggage is staggering. This is why when you become ill it is so important to evaluate what you are feeling, and what you have been feeling for the past six months because some illnesses, such as rheumatoid arthritis, may take months to become symptomatic. Constipation or diarrhea, as well as stomach pain/ulcers Back/Neck pain Depression Insomnia High blood pressure Anxiety/Depression Weight gain or loss (eating disorders always have an emotional aspect) Sexual problems Rheumatoid arthritis Fibromyalgia Asthma Cancers (for example, pancreatic cancer may present with depression before the patient is symptomatic with cancer) Emotional healing is very different from physical healing. When I worked with cancer patients I was reminded of this fact many times. The tumor went away, and the body healed, but the mind lingered sometimes for years over the experience of losing hair, a body part and/or trust in your body. Counseling becomes a wonderful way to release pent up feelings so you can heal emotionally. There are many ways you can help your loved one or yourself unpack your emotional baggage. Try these suggestions and practice them frequently. Laugh as much as you can. Watch funny videos and allow yourself to laugh out loud. Cry when you need to, don’t hold it in, and just let it flow. Practice voicing, “I’m angry.” You don’t have to do an action with it, just say it out loud and say why. Mindful actions. Before you take any medication for a headache, tummy ache, backache, to stay awake, or to fall asleep, ask yourself what am I holding on to. Begin jotting things down. This small action offers huge rewards. Massages are a common treatment for people who have gone through horrendous crisis, and they’re also a wonderful treatment for fibromyalgia and rheumatoid arthritis. Breathe and let go of held in emotional pain as the therapist works on the body part that holds the physical pain. Medical care has come a long way with advancements in treating so many illnesses. Your body is more than physical though; there is an emotional and soulful part, which is more complicated to treat. Knowing yourself and being able to express uncomfortable feelings is healthy, not only for your mind, but for your body and soul as well. –Mary Jo Rapini

Have you ever caught yourself watching TV at night and feeling lonely, bored or sad? Your partner may be sitting next to you or in their favorite chair, but you get up anyway; making the routine trip to the freezer to fix a bowl of ice cream, which will provide the comfort you are craving. It may not be ice cream; your comfort food may be a bag of Doritos, a pizza delivery, or a can of coke and leftovers from dinner. You aren’t really hungry, you may feel miserable, but the effort it would require to hug your partner, or become intimate with them isn’t as easy or comforting as food. People who struggle with weight often times struggle with intimacy as well. This struggle extends beyond their family, and affects their personal friendships as well. Eating for comfort may lead to more isolation. The more weight people gain, the less they want to mingle and the more they worry about what others will think or say. Have we become a society of people medicating with food in order to feel better? Have we stopped turning to loved ones for support and comfort in lieu of food? Yes and no. Although overeating has always been a problem, the stress of technology speeding up our lives and forcing us to bring home more work, or never leaving work at work, we are all working more and more, and feeling less and less connected with those we love most. We return home feeling exhausted and overwhelmed. Rewarding ourselves with food is a lot easier than becoming vulnerable and open to criticism from our partner or friends. There are other reasons more people are turning to food for emotional comfort rather than a relationship. You don’t have to leave your home to get comfort. Food delivery is available within blocks of our homes. Food is easy; you don’t need to invest any effort or time. You don’t have to get dressed to enjoy comfort food. You don’t have to look handsome, desirable or pretty for food. Food doesn’t judge you, leave you, or criticize you. Eating a delicious dinner is longer and more enjoyable for many people than sex (the average length of lovemaking is less than ten minutes). Food doesn’t cheat on you. Food is available anywhere, anytime, and for any reason. Food may be tied to memories of love and childhood which makes you feel loved. Food doesn’t require a partner. So is it a bad thing if we prefer gourmet truffle macaroni and cheese along with a filet mignon and a fresh garden salad with gobs of ranch dressing? Is it bad to add chocolate mousse if you’ve had an especially rough day and need an additional reward? It’s not a judgment call of right or wrong, but it can be adding to your unhappiness and health. Intimacy with another is important. When you are intimate with someone they want you to be healthy; choosing food for comfort rather than reaching out to them would be hurtful or a sign of rejection. There are other reasons you need to find comfort in one another rather than food. Below are a few. Intimacy shared with another gives you a deeper connection. Intimacy doesn’t leave you with guilt, feeling disgusted, or body hate. Intimacy helps you lose weight, not gain. Intimacy lowers your heart rate. Intimacy lowers your blood pressure. Intimacy won’t cause diabetes. Intimacy is good for your heart. Intimacy improves your thinking. Intimacy is exercise and exercise is good. Intimacy won’t leave you feeling isolated. Intimacy doesn’t take your mobility away. Intimacy doesn’t cost anything. Intimacy doesn’t make your hips, knees or ankles hurt. Intimacy makes your brain work better. Everyone understands the feeling of working and having a bag of chips or a package of cookies nearby only to realize at the end of their task the bag or package is completely gone. They were eating them mindlessly. Eating to calm anxiety is more and more common. The primary reason for relationships growing apart is due to couples choosing other vices to fill the void they feel. Becoming aware of your behavior and what you are eating, as well as writing down what you eat (we forget) is a good way to begin eating less and becoming more in touch with the emotions you are repressing with food. A simple practice of not eating past 7 or 8 pm can help you lose weight, and communicate more with your partner, family or friends. Breaking the habit of turning to food is not easy, but with practice it does work. Intimacy and sex are better for you than food! –Mary Jo Rapini

In our weight conscious society and a generation of obese children, it’s easy to begin placing one’s worth on their weight. In fact, girls especially are obsessed with the scale and feel judged according to their weight. It’s common to see morning news anchors or talk show hosts growing thinner and thinner. There comes a point, as with any obsession, when you cross the line between looking good and looking unhealthy. The host of Lifetime Television’s show, “How to Look Good Naked,” recently was quoted as saying “Zero is not a size, it’s a warning sign.” But is size zero perceived as a warning sign or as a status to attain? A survey taken among random ages asked women if they would give up five years of their life to be thinner. Many of them said a very loud, “YES.” Most people know when they look good and feel good. They can also tell you what their weight is when they feel their healthiest. Very rarely is that weight correlated with being too thin. Most people feel best when they have enough weight to help them feel energetic and vibrant, but not too much, which can cause fatigue, sore muscles, and joint pain. The body gives warning signs when you are too thin. Below are a few of those warning signs. Having a body mass index of less than two to three points below what is normal for your height and weight. Suffering from anemia or a lack of vitamins and minerals can be a sign of excessive binging and purging to lose weight. For women, irregular menstrual cycles or no cycles can be a sign of being too thin. Having dark circles under your eyes, or poor skin color are signs of malnourishment due to starving to be thin. Feeling dizzy or confused are both signs of not eating. Self-esteem is built on how we feel about ourselves. For women, body image is a large contributor to developing a healthy self-esteem, but it is minimized if the child has interests and achievements in other areas. Parents play a huge role in encouraging interests and supporting their child’s activities. It is not men as much as it is women ourselves who objectify our bodies. We critique our bodies and our friends’ bodies, and feel judged because we may feel we too are being critiqued. Children grow up hearing their moms lament about being too heavy, or not being in shape. Before the child is eight they are concerned with their weight, and how they compare to their friends. If you notice your child is focusing more and more on weight, and less and less on their attributes, it may help you to help them focus on the healthy habits that will lead to healthy self-esteem. Here are a few suggestions: Find groups or activities that share your common interests. Worry less about weight, and focus on a healthy exercise and diet plan. Educate yourself and have a career goal and dream. Befriend rather than compare yourself to women of all ages, careers and ethnicities. Focus on what you want, instead of how you look compared to your friends. When parents join their child and the family works as team to help each member succeed, weight becomes less of an issue and healthy living becomes more. –Mary Jo Rapini

Research supports that most people are more able to lose weight if they adapt a total lifestyle change and have an exercise buddy. That’s one of the reasons couples can be so successful if they work together to help each other become more active and eat healthy. Women use food to manage emotions such as anger, boredom, loneliness, and anxiety more than men do. Therefore, if women can talk to their partner about how they are feeling, many times this alone will help them curb their munching. Men have more tendencies toward drinking and watching TV than women. If women are able to encourage their partner to go for a walk or a bike ride with them, this helps him cut calories and become healthier. Working together can also lead to a closer connection with each other. You have a shared vision; rather than worry about your partner sabotaging you, they are going to be motivating you. Before you begin, it is important to understand a few basics about men’s and women’s bodies in relationship to losing weight: Men lose faster. They have more muscle mass, faster metabolism and more water. Therefore, the same exercise and diet will be reflected differently on the scales. Women lose slower, and the body fluctuates more due to menstruation as well as our higher fat content. Women get hungrier than men with strenuous exercise. Women’s bodies are designed to give birth, so what we burn we feel the need to restore. Both men and women can be addicted to trigger foods, but it is more common with women. If your partner understands this, you can ban specific foods from your home. How to begin a couple’s exercise program: Choose an exercise you both want to do. It should be done at a level that you can continue to talk to each other, thus enhancing your emotional connection, as well improving your cardiovascular health. Choose the number of times each week you will engage in this activity and the time. If you are a morning person and your partner is an evening person, maybe you can go together on the weekends and separately during the week. Don’t compare your weight loss with your partner. What is important is you are encouraging each other. Congratulate each other more on their clothing size as they lose weight and how they appear. Are they more energetic? Do they seem happier? These are the things to notice. Take turns cooking healthy. Make dinners at home special. This will save you money as well as save you unwanted calories. If you feel a binge coming on, alert your partner that you need additional support to stay on track. Many times just telling someone else will stop the binge in its track. Supervise yourself only. Don’t become the sergeant to your spouse. The goal is to get healthier and whittle away the waist, not your marriage. Prepare for more intimacy. Women especially desire sex more when they feel better about their bodies. Sometimes losing one or two inches from her waist can turn a woman into a sex goddess. Be consistent. It takes about 30 days to make a behavior a habit. Everyone has the money and means to live a healthier lifestyle. With weight loss, as with everything else, you get better results when you encourage rather than shame. The more couples engage in activities, the happier they report their marriage. The more couples share a vision, the happier they report being. Losing weight with your partner achieves both of these. A few more tips to remember….. Reward yourself: Every time one of you hits a goal, reward yourselves together. The reward must be something uneatable. Split restaurant meals: Whenever you dine together, cut your calories in half by splitting meals. Make sure sex is part of your exercise. Sex burns calories and reinforces the team spirit. Don’t make dining a date: Make your date nights “movement nights”. Take a walk, golf, bowl, or shoot pool. Focus on health not weight. If you focus on getting healthier you can embrace your life style with more determination than if you focus on being able to fit into a particular suit. Teams are formed with like minded people. When you and your partner agree together that your team will be the best team, weight loss and healthy living are sure to be achievable goals. –Mary Jo Rapini For more information and MONTHLY FREE RELATIONSHIP TIP go to: www.maryjorapini.com Talk to me on my fan page: http://www.facebook.com/maryjorapini Tweet me: @ Mary Jo Rapini Get your “MOJO MOMENT” each day on Fox 26 at 9a.m.CST. http://houston.cbslo...er-the-breakup/ http://houston.cbslo...fter-infidelity http://khmx.radio.co...mary-jo-rapini/ Join me every Monday and Thursday Morning for “Mind, Body, Soul with Mary Jo” on Fox 26 Houston at 9 a.m

Research supports that most people are more able to lose weight if they adapt a total lifestyle change and have an exercise buddy. That’s one of the reasons couples can be so successful if they work together to help each other become more active and eat healthy. Women use food to manage emotions such as anger, boredom, loneliness, and anxiety more than men do. Therefore, if women can talk to their partner about how they are feeling, many times this alone will help them curb their munching. Men have more tendencies toward drinking and watching TV than women. If women are able to encourage their partner to go for a walk or a bike ride with them, this helps him cut calories and become healthier. Working together can also lead to a closer connection with each other. You have a shared vision; rather than worry about your partner sabotaging you, they are going to be motivating you. Before you begin, it is important to understand a few basics about men’s and women’s bodies in relationship to losing weight: Men lose faster. They have more muscle mass, faster metabolism and more water. Therefore, the same exercise and diet will be reflected differently on the scales. Women lose slower, and the body fluctuates more due to menstruation as well as our higher fat content. Women get hungrier than men with strenuous exercise. Women’s bodies are designed to give birth, so what we burn we feel the need to restore. Both men and women can be addicted to trigger foods, but it is more common with women. If your partner understands this, you can ban specific foods from your home. How to begin a couple’s exercise program: Choose an exercise you both want to do. It should be done at a level that you can continue to talk to each other, thus enhancing your emotional connection, as well improving your cardiovascular health. Choose the number of times each week you will engage in this activity and the time. If you are a morning person and your partner is an evening person, maybe you can go together on the weekends and separately during the week. Don’t compare your weight loss with your partner. What is important is you are encouraging each other. Congratulate each other more on their clothing size as they lose weight and how they appear. Are they more energetic? Do they seem happier? These are the things to notice. Take turns cooking healthy. Make dinners at home special. This will save you money as well as save you unwanted calories. If you feel a binge coming on, alert your partner that you need additional support to stay on track. Many times just telling someone else will stop the binge in its track. Supervise yourself only. Don’t become the sergeant to your spouse. The goal is to get healthier and whittle away the waist, not your marriage. Prepare for more intimacy. Women especially desire sex more when they feel better about their bodies. Sometimes losing one or two inches from her waist can turn a woman into a sex goddess. Be consistent. It takes about 30 days to make a behavior a habit. Everyone has the money and means to live a healthier lifestyle. With weight loss, as with everything else, you get better results when you encourage rather than shame. The more couples engage in activities, the happier they report their marriage. The more couples share a vision, the happier they report being. Losing weight with your partner achieves both of these. A few more tips to remember….. Reward yourself: Every time one of you hits a goal, reward yourselves together. The reward must be something uneatable. Split restaurant meals: Whenever you dine together, cut your calories in half by splitting meals. Make sure sex is part of your exercise. Sex burns calories and reinforces the team spirit. Don’t make dining a date: Make your date nights “movement nights”. Take a walk, golf, bowl, or shoot pool. Focus on health not weight. If you focus on getting healthier you can embrace your life style with more determination than if you focus on being able to fit into a particular suit. Teams are formed with like minded people. When you and your partner agree together that your team will be the best team, weight loss and healthy living are sure to be achievable goals. –Mary Jo Rapini For more information and MONTHLY FREE RELATIONSHIP TIP go to: www.maryjorapini.com Talk to me on my fan page: http://www.facebook.com/maryjorapini Tweet me: @ Mary Jo Rapini Get your “MOJO MOMENT” each day on Fox 26 at 9a.m.CST. http://houston.cbslo...er-the-breakup/ http://houston.cbslo...fter-infidelity http://khmx.radio.co...mary-jo-rapini/ Join me every Monday and Thursday Morning for “Mind, Body, Soul with Mary Jo” on Fox 26 Houston at 9 a.m

The recent statistics from the CDC (Center for Disease Control and Prevention) has reported that about one-third (33.8%) of U.S. adults are obese. That number rises every day, and keeping up with it is more difficult than keeping up with your stocks. I work with the finest bariatric surgeons in the U.S. They are dedicated to helping their patients lose weight in an effort to thwart diseases, and minimize current disease progression. I also run several 12-step food addiction groups in the city of Houston and online in many cities. I talk to morbidly obese patients everyday. I teach them, counsel them, eat with them, and spend endless hours reading their journals. These patients have a story to tell, but we aren’t listening and we continue asking the wrong questions. To be sure, obesity is genetic and many times the social milieu of obese patients I work with is chaotic with issues of abuse, abandonment, shame, ridicule, and anger. The genetic role helps explain the body type; the way food may be processed, stored, and proportioned. It cannot explain what keeps the person from changing the behavior that contributes to obesity. In my work, during step 4 of the 12-step addiction group, the group members begin making amends. They look at how their behavior got them where they are. They quit thinking about how they were abused, and begin to consider how they hurt/abused others. The step is painful, gut wrenching and overwhelming for all of these patients. It is also the step I ask them, “How do you benefit from being obese?” At first they look at me as if I am crazy. After all, they are weight loss surgery patients, and have gone to extremes to lose weight. They laugh, shake their head, and say, “Mary Jo, what are you smoking?” Then the room gets quiet. One of the bravest patients will say, “My obesity gives me an excuse. I am not held to the same standards as others; they don’t expect it, because I am morbidly obese.” Another will chime in, “My obesity keeps men away; I was sexually abused by my dad for 4 years of my life.” A statistic that no one likes to talk about was one mentioned in Bariatric Times in 2007. As many as 20 to 40% of obese women have been sexually molested, harassed and/or perpetrated (they know it’s higher than that but can’t ascertain the exact amount). Yet another will talk about how her/his marriage is so distant that food has become their lover/best friend. They are lonely, and they eat to comfort that incredible sense of loss. Another part of my job focuses on the group that failed the weight loss surgery. If you have never been morbidly obese, or gone through a weight loss surgery only to have the weight come back, you cannot understand the depth of failing these patients feel. They are cursed by their unresolved reasons for going back to food. They don’t understand it, and often those who love them most don’t either. A Gastric Bypass, Gastric Sleeve, Lap Band, or Duodenal Shift is never going to successfully keep weight off if the patient has no idea why they are eating, and experience a fear of stopping. Many of the cravings patients feel are emotional; totally unrelated to real hunger. How can a weight loss surgery of any kind manage emotional hunger? It cannot. When we evaluate patients who struggle with obesity we talk frequently about denial. I am beginning to think they are no more in denial than we, the health care professionals. We can talk food all we want, but most of my patients know what healthy food is; they could write a cookbook with the calorie count included! They know food like most of us know our lover. What they need help with are the tough questions. One of those questions is, “What are the benefits you are experiencing from your obesity?” We have to ask this, and we should ask it prior to weight loss surgery so we can begin the process of helping them understand this part. People drop old behaviors when they are no longer benefiting from them. You don’t need to be a weight loss surgery patient to begin the yoyo dieting process. If weight protects you from receiving attention, and you have been sexually abused in your childhood, then when you begin losing weight you are going to turn to food to manage the anxiety you feel when a man gives you eye contact. When patients begin to understand what they are protecting or avoiding with their weight, they can effectively work a weight loss program and keep the weight off. It is also important to look at obese children’s homes especially if there is a substantial weight gain. Many times, something is going on at home that is causing this child to medicate their anxiety with food. Society continues to be judgmental and negative with obese people. One thing is clear: shaming or ignoring obesity is not helping curb or decrease the numbers.

There was an interesting article in the New York Times about a young woman who had a Lap-Band weight loss surgery after years of suffering the emotional journey of an overweight kid. The story was very honest about what to expect with this type of surgery, and it also tracked the journey of the young woman. The story is of interest to many as more and more teens and adults are turning toward the option of weight loss surgery. The latest number of weight loss surgeries performed in the United States is 220,000 per year. That is a seven-fold increase over the past 10 years according to the New York Times article. Weight loss surgeries do save lives and also improve quality of lives for sure, but they aren’t for everyone. The surgeons do the surgery and are skilled at centers of excellence, but unless the patients come back, join support groups and stay in contact with dieticians, falling off track is way too easy and, unfortunately, many of them do, including the young woman in the NYT story. I run several food addiction groups in Houston, and was featured as the psychotherapist for TLC’s show “Big Medicine.” On the show, I worked closely with Drs. Robert and Garth Davis. We tried to give the viewer an honest look at what happened with the weight loss surgery and the journey after. My work now is primarily with revisions. Revisions are the surgery done when the first weight loss surgery failed. My office is full, as are my support groups. What happened to the patients that so eagerly came into our offices feeling empowered and ready to give up their morbid obesity forever? They are replaced with patients who hang their head feeling like they failed. Even though they feel defeated, the ones I see are the fortunate ones who were able to step out of their shame cycle, call their insurance company and ask for a second chance. They need a second chance because neither they nor we (the health team) had a full picture of what was underneath their weight. They couldn’t see it prior to surgery, and since they are their own historians telling us their story, we are blinded also. I believe in weight loss surgery, but I believe more in the knowledge we impart to the patient prior to and after the surgery. Performing an alteration, such as a weight loss surgery, is a huge decision, but in the case of a minor I think the whole bariatric medicine team must be on board. There has to be a built-in safety net to handle the transformation of the child as well as their family. Everyone who loves the patient must change when someone they love has weight loss surgery. The counselor, dietician, and surgeon must know all of the family members. We must know who is sabotaging and enabling that patient on an emotional level. Enablers are the people still giving the patient food as a source of love. Our bariatric treatment teams must also understand if simply making better food and lifestyle choices worked, it would have worked 20 diets ago. It did not. Obesity has an addictive component, and addictions are kept in place by denial. Most patients will tell you they are not addicted to food exactly the same as an alcoholic will tell you they aren’t addicted to alcohol. The question is: “Do you use food to comfort yourself?” If the patient says “YES,” then treat them for a food addiction. Do this because they are telling you they have a relationship with food that is emotionally based and most likely they are choosing food with high fat or high carbohydrates (not one of my patients has ever had an addiction/emotional relationship to steamed or raw vegetables). Whenever a patient feels like a failure after going through the process of weight loss surgery and everything it entails, it is heart wrenching not only to them, but to me and anyone working in this field. If insurance companies won’t cover patient care for years to come after the surgery, then we in the field are going to have to put these measures in place and make them affordable to the patients. We cannot tell a patient they need to continue in groups and follow-ups if they can no longer afford the cost. Whoever said, “Weight loss surgery is a quick fix” truly never had weight loss surgery or worked with my patients. There is nothing quick about it. Obesity is a disease and once you have it, losing the weight is the easy part, managing that loss is a life long journey.