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Over the 8 years I have met with weight loss surgery patients, the one concept I find myself going over and over is this idea of becoming full from within. The idea that if we don't fill ourselves up intrinsically- we will always need some thing to fill the void, whether it be food, gambling, sex, drugs, or alcohol. The problem is- we always end up on empty, psychologically.
The next question often becomes, "ok so how do I fill myself up psychologically? I don't think I will ever be fulfilled because I have never been truly happy. I was not born a naturally happy person? I've spent most of my life feeling empty- how do I turn it all around now? I grew up with unhappy parents, how am I to unlearn all of that early programming?'
"Wondering if you're happy is a great shortcut to being depressed." - Annette Bening, 20th Century Women
I think, unfortunately happiness gets a bad rap. There is a wide misconception that for us to be fulfilled, or full from within- we need to be blissfully happy all the time, and that's just not the case. Not only is it untrue, but it is an unrealistic standard and one that sets people up for disappointment. Rather than always questioning how we SHOULD be feeling, we should just practice acceptance of whatever temporary state we happen to be in at the moment with non-judgement and non-attachment. Like busses, moods come around every five minutes.
Even therapist's aren't immune to life's ups and downs. Believe it or not, as a psychologist who literally wrote a book on Happiness, I have to remind myself certain mantras that help me keep my own life in balance and my happiness and fulfillment sustained. I actually have a list on my phone that says "things to remember," and page through it daily, when I'm feeling off track.

So if you're feeling off track yourself- first understand that you're human and give yourself a break + then thumb through my personal list of happiness tips, little pearls I've gained in my 37 years on this planet, and see if any of them might help to increase your happiness quotient today:
1) In silence, the heart begins to finish its unfinished business. I think I picked this up from a book I read about Sufism. In any case, I liked it and it stuck. Oftentimes, we think that we must actively and aggressively pray, yet Sufis believe that it is in the stillness that God comes to us.
Whenever my life gets a bit too chaotic with all the "should-ing" all over myself- I remind myself that it is often when I take pause, let go, and let God- that what is truly important, rises to the surface and I begin to reclaim my life instead of it claiming me.
2) Do more want-to's vs. have-to's every day. Someone once told me that the "have-to's" will never be done. I repeat- they will never be done. So we might as well splice in some time for the things that we thought we were going to do once they were done.
Take the scenic route to work, take a long walk and listen to that book on audible that you have been wanting to read for the last few months,go shopping with a friend, get a massage, take an extra long lunch and sit out in the sun, or just curl up with your loved one or pet.
A wise man once said "time you enjoy wasting, is not wasted time," and I couldn't agree more.
3) Happiness is not the absence of problems, but the ability to deal with them. I remember when I was in grad school, thinking "if I can just finish school- then I'll be the relaxed, happy go lucky person I want to be," then it morphed into, "once I get licensed," then "once I get married," then "once I have kids..." You get the idea.
It is not the situations or circumstances in our lives that determine if we are a happier person or not. It truly is the way in which we approach them as they come, that determines what type of person we are and how happy we will be. In the "car of life," that we all have to drive, will you wear stilettos or uggs?
4) Connection with others is key to fulfillment. I am an introvert by nature. I enjoy my downtime, and require coming back to my home base in silence, to relax and unwind. However, there is something inherent in our very nature about the need to feel connected to the world around us- introverts included.
My best girlfriend from childhood came out for a week a while back, and so I was unable to get caught up in the hamster wheel of daily activity. I was forced to be fully present and engaged with her for four days in a row. As a result, I was actually more grounded, more at peace, less anxious, and more optimistic about the future.
Whenever we notice our egoic drives propelling us towards isolation, judgement, rumination, or comparison- we should remind ourselves to get out and connect with our fellow man, and fakebook doesn't count.
5) Like attracts like. Happy attracts happy. When we find ourselves feeling left out, isolated, or out of touch with those around us- it is important to look at our recent focus. Are we always dwelling on the negative, gossiping about someone? You know the saying "what sally says about susie, says more about sally than susie."
Although, many of us sub-consciously believe that if we can just "get it out" about whatever is chipping away at us- it will somehow allay our negative feelings- it really doesn't. In fact, research supports that when we ruminate on negative feelings, it actually increases our negative feelings.
This doesn't mean we should all be superficial and "surface-y" towards everyone, but that we should work a bit harder to find the happy.
6) To receive abundantly, ironically we must give abundantly. It is engrained in our DNA to wake up each morning with a needs list: "when will I get that bonus?" "when will I hear back about that promotion," "when will she call me back?"
Yet, spiritually I truly believe that when we make the shift from "what can I get," to "what can I give?" It is a complete gamechanger. It's almost as if the universe aligns with us and says "yep you finally figured it out."
7) Choose your thoughts like you choose your clothes. Our minds are quick and fast like ferraris. They are an intricate and complex machine designed for ultimate performance, but just like we must use the right fuel for a Ferrari, we must also carefully select and filter which thoughts we allow to permeate our consciousness.
When you notice yourself feeling down, take a cognitive step back and look at what thoughts you were having. Most are unproductive. Choose to let them go. The same tool that created the problem (our mind) is not likely going to solve the problem.
8) Legitimately and truly don't care about what others think or do. I can honestly say that this is still a work in progress for me. I was born a people-pleaser, but as I get older, I realize the more I try to make others happier with me, the less happy I am with myself.
9) Go out into the world with your heart, not your brain. Yes, our brain is required for some part of our days. Otherwise, our bills wouldn't be paid, our tasks wouldn't get done, and our goals wouldn't be met. But, other than that- when we greet people, meet people, share with others, observe, smile, walk- it is quite a different experience to live in our heart space, in that emotional space that is more visceral than verbal.
10) Relish in the remarkable ride. I watched a movie a while back called "about time," and it was all about a man who had time travel figured out. He lived his day once all hurried and bothered about the little stressors of life, but then went back to live it again. He said he would just rest in the moment, relax, and relish in the remarkable ride that was his life.
I love this. After all the late notices have come, all our debt has fallen or risen, our weight has gone up and down, our kids get a failing grade in school, our lover breaks our heart, our cars break down... it always ends the same: none of us get out alive. So why not just sit back and enjoy the ride?

Choosing a plastic surgeon after weight loss is an important personal decision. Someone told me that you do not buy a procedure, you buy a plastic surgeon (Read: Understanding Post-Bariatric Plastic Surgery). I completely get that now, having gone through a total body contouring and facelift, but it wasn’t always that way.
When I was beginning my plastic surgery after massive weight loss, I did not understand just how much obesity had deformed my body. It was later made clear to me that I was a much more challenging case than women seeking plastic surgery whom had never been morbidly obese. Add to that, I was more prone to complications during surgery and recovery owing to my former health conditions (diabetes, hypertension, etc).
Dr. Joseph F. Capella underscores the inherent challenge, “Many surgeons have come through their training not having been exposed to post-bariatric body contouring. Because of that these surgeries are not considered traditional procedures, in the sense that they’ve been honed over decades like many of the other plastic surgery procedures. And so what plastic surgeons may do is use these more traditional procedures and apply them to the post-bariatric patient, which often will lead to sub-optimal results.”
How does the massive weight loss patient choose the right plastic surgeon? After all, while there is rigorous training, and requirements for a plastic surgeon to become certified by the American Society of Plastic Surgeons, just as there are for a bariatric surgeon to become certified by the American Society for Metabolic and Bariatric Surgery, there are no rigorous requirements and certification for a sub-specialty in bariatric plastic surgery. What is a patient to do?
Dr. Capella recommends “For each of the procedures you’re considering, ask the plastic surgeon: How often do you do them and how many have you done? The doctor should make other patients readily available to you who have had these plastic surgeries done. And, of course, the doctor should have a wide array of images to show you of hopefully body types that are similar to yours.”
My additional advice:
Travel out of state if you must to find a plastic surgeon who specializes in the massive weight loss patient’s special needs.
With all due respect to patients who travel outside the country for their surgery, selecting a plastic surgeon who is certified by the American Board of Plastic Surgery is an essential step to ensure the best training and credentials.
I have corresponded with too many bariatric patients who’ve had complications after plastic surgery and had their surgeons ignore them. Don’t let this happen to you. Be sure that your surgeon will be responsive 24/7 during the many weeks and months of recovery, come what may.
Of course, all of us gathered here on BariatricPal understand the value of connecting on the Plastic Surgery Forum with patients who candidly share their surgical experiences and discuss their plastic surgeons. Be sure to tap into this very valuable resource.
Last but not least, personal compatibility is an essential element in the patient-physician relationship. You must feel comfortable talking to your plastic surgeon about all of your concerns. And you must have that sense of trust that s/he has your highest good as top priority no matter what may come.
The bottom line: Plastic surgery should be a life-changing experience for the better. For further reading, I highly suggest my article “18 Insider Tips for Plastic Surgery.”
Living larger than ever,
My Bariatric Life

Fat-Shaming sucks. Addiction-Shaming sucks. Bald-Shaming sucks. Shaming-Shaming sucks. There’s no way around that. It’s just plain true. There is too much shaming going on all around us.
My question is: As good as it is to call the world out on their shaming behaviors, would we maybe be better off working on ourselves and, if we are health care professionals, working with our patients, to focus on the ways they shame themselves? AND OTHERS? At least simultaneously to trying to put an end to “Other-Shaming.”
The purpose of this post is twofold:
· To have each reader assess themselves in regard to their own shaming-ness, and
· To suggest we help individuals stop shaming themselves while we simultaneously encourage the masses to stop.
There are Tweets and Posts galore inviting us, inciting us, and urging us to help stop the Fat-Shaming done by society! I agree these are worthwhile efforts and must be done.

What I don’t see very often on Social Media are statements encouraging people to get help to stop shaming, bullying, and beating up on themselves. We want an end to shaming, an end to bullying and an end to domestic violence. Check it out! All of that occurs within many an individual’s head!
Here are some recent posts from social media, along with my posted responses:
“Stand up to #weightbias! Sign the #petition to end fat-shaming and weight bias today.”
My response: “Yes, please! Also work to stop #SelfShaming and #SelfBias. Sign up for therapy in your community!”

“Why We Need to Ban the F Word: Fat-Shaming”
My response: “If you believe people deserve to be treated well (and I do), please start by treating yourself well in your thoughts, words and actions.”

“Once a person has obesity, it’s too late." One more way to #dismiss people with #obesity.”
My response: “I hate that people dismiss those with obesity. I hate even more how those with obesity often dismiss themselves in so many ways.”

“I believe that the morbidly #obese population is stigmatized, abused, neglected and mistreated by most facets of society.”
My response: “I hate it, but those suffering from morbid #obesity also abuse, neglect, and mistreat themselves through negative self-talk, self abuse.”

“Don't blame the person, rather treat the disease.”
My response: “Don't blame patient for factors related to obesity they can't influence. Hold them accountable for those they can.”

Please be clear about the message I am sending. I do hate the very real fact that society shames people who suffer from obesity. I hate that many people, including doctors and other health care providers, solely blame individuals for being obese. It’s horrible that a person is dismissed because they carry extra weight. No doubt.

I know from both my personal and professional work, as well as from life experience, that I can influence my own behavior a lot more quickly than I can influence the masses.

Typically, a person has an emotional connection to an issue if they are working to right some wrong related to that issue. Not all, but many people fighting to end societal Fat-Shaming, have “some skin in the game,” as they say. I am one of those people. Much of my work is done in a bariatric center where we aim to help those suffering from obesity, both physically and emotionally. Many health care providers, people who are personally struggling with their weight, along with family members and friends, all work together to try to end fat-shaming. Keep on keeping on with those efforts because they are worthwhile!

In the meantime, are you, regardless of your size, weight, color, or religion, looking within yourself in an attempt to “clean your own side of the street?” Do you have biases about other groups of people being stigmatized? And more importantly, are you aware of, and working on, the ways you stigmatize, dismiss and shame yourself?

Calling a person who suffers from obesity an ugly name, overlooking them for a job, dismissing their opinion or making a critical comment to or about them is wrong. It is equally despicable that people say things like, “I wouldn’t date a bald man,” or “He wouldn’t be right for the job. He’s bald.” My husband is bald and he struggles emotionally because of it. Have you (to include anyone suffering from obesity, alcoholism, drug addiction or any other ridiculed member of society) made ugly comments about bald people?

It is disturbing that subjectively unattractive people are considered less intelligent, are helped less frequently by the public if they have a flat tire, and are hired secondarily to “beautiful” people. Have you (to include anyone suffering from obesity, alcoholism, drug addiction or any other ridiculed member of society) made ugly comments about unattractive people?

How dismissive it must be to be a person who is part of an ethnic minority to have people call you a hateful name, to overlook you for a job you are very qualified for, or assume negative things about you. Have you (to include anyone suffering from obesity, alcoholism, drug addiction or any other ridiculed member of society) made disparaging comments to or about minorities?

Religions are always good fodder for shaming, dismissing and bashing. Have you partaken?
“You don’t look like one of them,” said my doctor to me when I shared that I am a recovering alcoholic and addict. One of them.
A patient in a therapy group of people suffering from obesity said, “I cannot, for the life of me, understand why an alcoholic doesn’t just stay away from the bar.” To which I responded, “What is it like for you when someone asks why you can’t just push away from the table?”
Wrong is wrong and it is wrong when any of us engage in dismissive or shaming conversation or behavior. Check yourself. Youre human and that means you have your own prejudices. You’ve likely engaged in your own dismissive comments about groups other than the one(s) you’re most closely aligned with. Relax, I’m not shaming you! I’m asking you to look at your own side of the street. Does it need sweeping? We all need to keep a broom nearby because we are all guilty of judging others at times.
In my work, it is a priority to help people stop shaming themselves. Negative self-talk is a powerful way in which we shame ourselves. Yes, you do it, too! “I’m such an idiot!” “How could I have done such a stupid thing?” “What is wrong with me?” “I don’t know why I even bother. I never follow through anyway.” The list of examples illustrating negative self-talk, or stinkin’ thinkin’ is endless. Every single negative statement you make about yourself is dismissing the value of the person you are.
Ironically, the shaming statements people make about themselves are representative of their own internal shame. The negative self-talk says, “There’s something wrong with me.” “I don’t feel ok about myself.”
Isn’t it odd that we run around making a fuss about stopping the masses from shaming people when we spend some much time shaming ourselves? I’m thinking we would all be better off if we “swept our own side of the street” first. When we treat ourselves more tolerantly and we are accepting of others who we tend to dismiss, then it’ll make more sense to focus on what the masses are doing wrong.