Connie Stapleton PhD

We’ve never really talked specifically about "confidence" and "arrogance" per se, but we talk about narcissism and selfishness and how destructive they are to our Recovery from Obesity. That makes it entirely understandable that many recovery "newbies" could easily confuse the two. If a person comes from (a perceived place of) “nothing” into a big, new life of potential “everything,” the pendulum can (and often does) overcompensate (swings wildly in the other direction). In other words, if you start from a place where you’re thinking you have little value (perhaps based on your weight) – it is sometimes the case that to people appear to be … overvaluing themselves (think a posted selfie … or two or three… each day for a solid year). Is either of those extremes a healthy place to be… or could it be that they may actually represent the same issue? There is a continuum on which most “issues” can be placed. Think a straight line with a far left side, a center, and a far right side (sounds like politics, right?)! On that continuum we are talking about at the moment, there is a line of unhealthy to healthy behaviors. Think of feeling insignificant on the far left of the line, feeling confident in the middle, and feeling arrogance on the extreme right end of the line. In other words, sometimes when a person goes from a place of feeling insignificant (in this case, perhaps related to being obese), sometimes they "overshoot" the goal of having confidence and end up acting "arrogant." And this is true for many other “issues” we could put on that imaginary line. Think “completely independent/I don’t need anyone” as being on the far left, healthy independence being in the center and “totally dependent on others” as being on the far right end. Here’s the deal: both the far left and the far right “issue” actually represent the same thing … an unhealthy extreme… of the same problem. Think about it. A person who feels/acts terribly insignificant AND a person who feels/acts arrogant are both acting out the same issue… feelings of poor self-esteem. The healthy place to be on a continuum of healthy self-esteem is in the middle… feeling/acting confident. It truly is often the case that people swing from one end of the extreme to the other. It can look very different, but to those who understand this tendency of human behavior… it makes perfect sense. Balance lies in the middle of extremes. In this case, confidence is the healthy place of balance between feeling and acting insignificant and feeling and acting arrogant. In the example of someone who acts like they don’t need anyone else in their life, whether for companionship or ask assistance from on one of the scale to the person who is so “needy” or dependent on the other, the issue is the same – dependency. On one end is the person who refuses to acknowledge the need for depending on others at times. On the other end is the person who can’t seem to think for themselves, go anywhere alone, or be alone for five minutes. The healthy place of balance is in the middle – being someone who has healthy dependency… can manage on their own at times and knows they need others, as well. In recovery, the goal is to allow the pendulum to settle, rather than swing wildly, and arrive at the center of the continuum! (Hmmm…pendulums and continuums…who knew?) A great way to encourage balance is to listen to trusted friends who are willing to tell you things you might not want to hear. And…get ready to say "Ouch!" because it often hurts… Fortunately, if you are open to considering the possibility that your trusted friends might be right, you open yourself to the possibility of health and peace of mind in recovery. Doesn't that seem like a healthy trade-off? A little hurt for a lot of healing? If you were to place yourself on that continuum of self-worth/self-value, where do you think you'd be? No judgment -- Remember, AWARENESS and ACCEPTANCE are critical to recovery, so if you don't admit stuff, you can't change it.

Sometimes you have an incredible experience, and you feel grateful for the connections you have made and for the opportunity to be part of a powerful event. You even have the chance to process how incredible it all was with the other people involved in putting it all together. Remarkable. Satisfying. Rewarding. We got to partake of that recently. How often does it happen that the next day, as you’re in the process of getting back to the business of everyday life, that you have a completely random incident that sends a message to your soul that what you are working so hard to do is important and can have such a powerful impact on lives? We had that happen very recently. We came to Shreveport at the invitation of Katy and Dr. George Merriman, who are the brilliance behind Surgical Specialists. The producer of the powerful documentary All of Me, Alexandra Lescaze, was also with us in Shreveport. Along with Dr. Merriman’s staff, we were part of an impactful evening for men and women who have had, who are considering, or who are in the process of preparing for weight loss surgery. The Merriman’s provided a healthy meal for the participants as they viewed All of Me, a story highlighting the impact of weight loss surgery on real lives. A panel discussion followed. Just a word about this. To begin with, it is rare that a bariatric practice takes the time and effort to host events for patients. It is even less often that an entire staff emphasizes the importance of therapy for their patients as a part of the weight loss journey. I have extreme gratitude for the knowledge and passion Dr. Merriman and Katy Merriman, along with their incredibly insightful nutritionist, have in relation to this reality. We, The Post Op & The Doc followed the panel discussion with a short presentation highlighting the need to work through underlying personal issues that prevent people from keeping weight off when they lose it. We shared our “Recipe for Recovery,” warned against “Food Porn,” and shared our Gotta Do Ems. The audience was receptive and awakened to the realities of life after weight loss surgery, and sent away with specific suggestions for making the most of their Recovery from Obesity. The Merriman’s then hosted us to a truly phenomenal dining experience. A quiet, intimate atmosphere that allowed for wonderful conversation, good humor and an opportunity to share knowledge and experience. After dinner, we sat in our hotel room with Alexandra and further processed the positive impact that realistic information and an emphasis on the importance of therapy has on people going through the process of weight loss surgery - and into what Cari refers to as “the Bariatric After Life.” And of course, when Alexandra went to her room, we continued to yammer away until we fell asleep practically mid-sentence! The alarm went off in the morning just moments after we both woke up. This meant we needed to get a move on, as we had to jump aboard the shuttle to the airport 45 minutes later. Which we did, after the hotel staff finally decided who was going to drive the van. For some reason, this appeared to be quite an ordeal. There were no other passengers, so we made idle chitchat with the driver as we began our 12-minute journey to the airport…. We chatted about the pretty day; was he from the area; blah, blah. This led to the inevitable question of why we were in town. We said we were at an event and had just been there for the weekend. He assumed the event had been at the convention center near the hotel. No, we said it was a smaller event. What was the topic, he asked. Weight loss surgery. LapBand? All forms. Then he said, “I lost a lot of weight with yoga and bike riding. I used to weigh 283 pounds. I keep trying to get a friend of mine to have weight loss surgery. He needs it badly.” “Really!” we said, without wanting to pry into his life or launch into the benefits of weight loss and weight loss surgery – or his personal life. A few moments of silence followed, before he offered, “And therapy. I had lots of therapy.” “Really!” We responded again, not having mentioned anything about “the Doc” being a psychologist. (But inside we were both thinking, “WHAT? Did he just say therapy? He just offered that he’d had a lot of therapy as part of his weight loss journey? And out of nowhere? Cool!) “Yep. I had a great therapist. He told me to go home and look in the mirror and say, ‘I love you, Sam (not his real name). You’re an all right guy.’ I went home and tried that, but all I could hear was, ‘You fat fu#^er!’ ‘You’re a piece of sh*#!’ That voice was so loud. I just heard it all the time. But I stood in front of the mirror every day for 90 days and said, out loud, ‘I love, you, Sam. You’re an all right guy.’ And that other voice – it went away!” “That’s really awesome. Good for you!” (Our thoughts were something like, “My God! Very cool… but how bizarre that he is sharing all this with us.”) “And it was easy to lose weight after that. It wasn’t even about the food. It’s about a loving relationship with yourself. It’s about the truth. It’s about always telling the truth – to yourself and others. It’s about living the truth.” “Wow! That’s really powerful.” (Of course, we’re thinking, “HOLY SH*#! This guy has some incredible insight and has really done some great work.”) “Yep. I had to get through all of that childhood stuff. I had a really great counselor.” Our thoughts, “DAMN! We wish he could share that message with the people at the event last night… and with everyone, actually! At that point we each shared our experiences of having been through a lot of therapy. Part of what we do, we told him, is try to help people having weight loss surgery understand the necessity of utilizing therapy as part of the process. We shared that we believed he could help a lot of people. He said, “I don’t know. Kids have mushy brains but adults… they really gotta want help if anything is gonna sink in.” We talked later about children and their “mushy” little brains and the impact harsh words have on their self-esteem, their hearts and their souls. Sam apparently believed that as children become adults, those “mushy” brains harden and solidify, along with the negative messages entombed within. Maybe in the brain-hardening process, people’s hearts and minds “set” at the same time. Perhaps that’s true to an extent. It seems that for many adult brains, as well as for their hearts and minds, the hardness is a shell that can be fairly easily cracked and at least partially dissolved. It requires a dose or two or a thousand of a compassionate, trusting listener. It requires vulnerability, the willingness to share one’s truth. As a side note, we, The Post Op & A Doc recently watched a Ted Talk by Brene Brown on vulnerability. It was extraordinarily powerful! We encourage you to watch it. Our conversation became slightly lighter in tone, as our 12 minutes was winding down… and because Sam had missed the exit to the airport, having been engrossed in our discussion. “How long did it take you to get good at the yoga?” Doc asked. “It took me about six months to get really comfortable with it. I stopped lifting weights all together and replaced it with yoga, which I do three times a week. When you learn to do the breathing that goes with yoga, it’s a powerful experience. I’ve become so much more aware of myself, my thoughts and feelings, other people and their emotions, as well. I also follow the work of Caroline Myss.” “No WAY!” the Doc exclaimed. “One of her books, Anatomy of the Spirit, is one of the books that has helped me make the most sense of my life.” “Yeah. I love all of her stuff. She’s made a huge difference in so many people’s lives.” A short silence, which he broke with, “It’s nice to know there’s an afterlife. It makes it easy to sit back and enjoy life and connect with other people. I’ve had so many experiences to know there’s life after this.” “We agree, Sam.” We also agreed we could take a lesson from this man who truly has a sense of peace about him… “Yeah. Caroline Myss. She’s made an impact on a lot of lives… including mine. She gives it to people straight,” Doc added, thinking of The Post Op and the Doc’s “firm and fair” approach to working with people. As are Katy and Dr. George Merriman. As is Lisa, their dietician. The weekend was coming full circle as we pulled up at the airport. Sam said, “I don’t usually drive the shuttle. I’m an engineer at the hotel and just help out when they need me to. And I don’t usually tell people all of that.” “We appreciate you sharing those parts of your life with me, Sam. You made my day.” We hugged. We gave him a couple of bucks and told him to enjoy a cup of coffee. He said, thanks, he would. We walked into the airport, grateful for that experience with a kind, highly self-actualizing man. And for the affirmation that what we are doing – encouraging people to get therapy as part of the process of life after weight loss surgery: to work through negative self-talk, to deal with childhood issues that interfere with a healthy present, to learn healthy coping skills and to accept their feelings. To live life fully in Recovery from Obesity. And to know the simplistic joys in life. Like Sam does. Cari De La Cruz and Connie Stapleton, Ph.D. The Post Op and The Doc info@apostopandadoc.com

Let’s say it’s true that some obese people spend a great deal of time “doing” things for other people. Why do obese people do that? Is it because they truly care only for others? Or perhaps they feel “obligated” (lest people think badly of them or less of them)? Maybe they do so much for others for fear they won’t be included by others if they don’t? Maybe they do so much for others because it makes them feel better about themselves? Here’s another question: What, exactly, does that “caring for others” look like? In a lot of “obese homes,” the obese parent(s) feed their children junk food because they don’t want to “deprive them” of “fun foods” that “other kids get to eat…” In other words, they “selflessly” take care of their kids by feeding them junk. How, exactly is poor nutrition caring for a child? Could it be that the obese parent(s) feels guilty about their own, poor eating behaviors? Maybe they don’t want to have to explain why they are “allowed” to eat one way, but the kids are expected to eat another? Could it be that the obese parent(s) really want the junk food at home for themselves and use the kids as an excuse for having it there? “I wouldn’t want them to have to be deprived because I can’t have it.” Makes you think. Doesn’t it? Obese people are definitely going to find ways to take care of (feed) their obesity – with frequent trips to the fast food drive-thru, late night runs to the market to pick up ice cream, or having dinner at the all-you-can-eat buffet (because it’s a “good value” for the money). Obese people create ways to take care of their own “needs” very well. They take great pains to ensure there are always emergency treats squirreled away in the pantry or bottom drawer at the office, just in case. They’ve always got some cookies, chips or candy in the car (so they won’t starve.) Does this make them selfish? Not in and of itself… What makes the behaviors of the obese person selfish are the consequences to other people… Read on. Let’s talk for a minute about the many obese people who have co-morbid diseases including high blood pressure, high cholesterol, sleep apnea and diabetes (to name a few). Diabetes and each one of these diseases individually kill people every day. The combination of obesity with any of them (and obese people usually have several co-morbid diseases, especially as they get older), increases the likelihood of a premature death. Ah – but, “I can always take medicine” and “more medicine” and “more medicine” to treat those other diseases. The reality? In effect, many obese people are saying, “I’d rather take more and more and more medications, all of which have side effects, than to change my eating and eliminate the need for the medications. By changing my eating behaviors… I could eliminate the diseases. But I’d rather eat.” Right now, you might be thinking: Obese people like to eat – everyone needs to eat – how is that selfish? Easy: It’s not just about the food. Let’s talk about the effects on others of the above-mentioned behaviors. What happens when an obese person’s health declines to the point that he/she isn’t able to walk easily? Perhaps they eventually need a scooter to get around? And maybe they become couch-bound or bed-bound? The ability of the obese person to get around on their own affects everyone involved in their lives – especially if the non-obese members want to engage in outside family activities. Spouses and kids often forego sporting activities, extra-curricular events, and social gatherings because it creates too many problems for the obese parent, who is unable or unwilling to drive the kids to events, is too embarrassed to attend events, or is unable to get around once they get to an event. Kids and spouses often have to cater to the obese parent at home by fetching them food, books and TV remotes. Family members have to help with activities of daily living such as bathing and dressing the obese family member. Many a teenager has dedicated considerable time to care-taking for obese parents and in the process, misses out on an important developmental stage of life. The obese person needs help attending numerous doctors’, wound care and physical therapy appointments. Ultimately, the obese person’s needs dictate what others can and cannot do. That doesn’t sound all that “selfless,” especially when an obese adult, like an adult alcoholic or adult compulsive shopper or adult cigarette smoker has options for seeking treatment and therapy. Yes, there are many contributing factors to obesity, many that a person has no influence over (genetics, diseases). There are even more contributing factors to obesity that one can influence (environment, food choices, exercise). On the contrary, the above examples sound like the actions of a person who is looking out for “number one” – not someone more concerned with the needs of others…which sounds suspiciously like the definition of selfish, don’t you think? Now, don’t get us wrong, being selfish isn’t necessarily a negative thing…there are healthy ways to be selfish, including: Going to the gym regularly to take care of your health, even if it means you’ll miss some television time with the family. Not bringing junk food into the home – even if the kids might like it – because it’s not good for your health, or theirs. Spending money on vitamins and supplements each month, even if it means you’ll have less money for “entertainment” or “dining out.” Basically, healthy selfishness means that you take care of yourself in healthy ways. You take care of yourself AND keep in mind the important people in your life and how your actions will affect their lives as well. It’s important to note that being selfless is not necessarily better than being selfish, because selfless people often ignore their own needs and wants, resulting in their feeling unworthy, unvalued or unimportant. And most of the time, also leads to their feeling resentful (being the “victim” of always doing for others … although it’s really being the victim of their unconscious neediness). That’s not a good thing, either! In other words, both extremes – being selfish and being selfless - are equally unhealthy. Of course, this couldn’t be an article by A Post Op & A Doc without noting that seemingly “selfish” or “selfless” people (whether obese or not) are not “bad,” which the words (selfish especially) connotes. Like anyone whose lives on the continuum of dysfunction (which means all of us), obese people have learned to use food for what is referred to in the world of psychology as “experiential avoidance.” This means food and the obsession on food, weight, scales, recipes, food shows, etc. keeps them from dealing with “unacceptable” thoughts, feelings, memories, and/or physical sensations (such as anxiety, sadness, etc.). Don’t believe us? That’s okay. Getting to that awareness is a process. What’s important is to understand that we are not “dissing” anyone for being “selfish.” Ultimately, it’s important to be grateful for eating and food that was, at one point in time, for most obese people, a way to cope with situations or people that caused emotional distress. The “selfish” or “selfless” behaviors we are talking about are the long-term result of not dealing with life by numbing with food because one didn’t have the skills. In life today, as an adult, you can learn (and, we believe, have the ability to respond = responsibility,) to learn to deal with life stressors in healthy ways … without “using” food or other numbing agents (shopping, alcohol, other drugs, gambling, etc.). Hopefully, you’ll read this as an invitation to dig deep into your issues, learn healthy responses to life, and be a healthy “selfish” or “selfless” person. Ultimately, a healthy, balanced person understands and meets their physical, emotional and spiritual needs while keeping in mind the needs of others. Does this sound like something many obese people practice? We would argue that it doesn’t. Adults who haven’t known how to meet their needs in balanced ways, can now take the opportunity to learn healthy “selfish” and “selfless” ways of behaving. (Note: it usually requires therapy in addition to changing behaviors). Wait… this is getting deep! Why is this article called “Me, My Selfie & I”? In this fast-paced, Facebook world, where everyone has a camera phone, people spend all day connecting with other people through status updates and tweets about what they’re doing, where they’re going, what they’re eating, how they’re dressed, and who they’re dating. And, it often doesn’t seem to matter how mundane it is. Apparently everyone thinks their “friends” need to know, “Hey! I’m at Starbucks, drinking a sugar-filled Frappuccino with whipped cream and criticizing that guy at the next table. And, just to convince you I’m actually there, here’s a picture of ME and my drink (but not the annoying guy at the next table.)” “Hey! Guess where I am now? I’m in the try-on room in the junior department of that cool clothing store and I can’t believe I fit into a size medium. Don’t believe me? Here’s a picture of my butt in some teeny jeans. Don’t think that’s my butt? Here’s a picture of me in front of the mirror, holding my phone towards the mirror so you can see me… with my real butt in my teeny jeans. Whoo-hoo! I rock!” “Now I’m at the gym, sweating a lot. See? Here I am with sweat running down my face. Phew!” “After that workout, I’m hungry, so here I am at the restaurant eating this amazing food. (See the food? See me with the food? Oh, I had to have the person at the next table take my picture so you could see me and the food at the same time.)” “Man, it’s been a long, hard day…so now it’s time for some ‘me time’ at the nail salon. I’m having a pedicure (here’s a picture of my feet – I had them put little diamonds on my big toes. I really love my toes…) Here’s a picture of me wearing new shoes so you can see my painted toenails.” And that was just today. Maybe you think that sounds nasty or sarcastic or absurd, but we ask you: how many of your Facebook friends fit that description? Maybe YOU fit that description…? Okay, it’s true that when people lose a lot of weight, they feel good about themselves and are no longer afraid to have their picture taken. This is a sign of increasing confidence (you say). It’s evidence that the person finally cares about him or herself (you contend). There is nothing wrong with having a lot of pictures of you (you believe) – after all, you spent a lot of years on the other side of the camera. You’re making up for lost time. Well, we won’t argue about someone’s self-confidence, self-worth or belief about their appearance, but will say that, at some point, 4,000 pictures of you on your Facebook wall can give others the impression that you don’t have any friends or family in your life – or, at least none that you care enough about to include in your photos. It can seem pretty selfish…which makes us wonder why they don’t call Selfies, “Selfy-ishes.” Maybe you see yourself in this article. Maybe you don’t. Maybe you can understand how selfish obesity really is…and maybe you recognize that you need to work on achieving a balance of “healthy selfishness” in your own life. Whatever the case, next time you think you need to post a selfie…why not invite someone to join you in the shot? You can still hold the camera, if it makes you feel better. Cari De La Cruz and Connie Stapleton, Ph.D. The Post Op and The Doc info@apostopandadoc.com

The Post Op: What a strange title for an article about Recovery From Obesity, unless of course, Roxy is obese…which, she isn’t. She is actually a big dog with a stubborn streak. She’s a lot like me (The Post-Op), which is where the idea of this story originated. It can be easy to make life more complicated than it is, especially with complicated instructions and rules, but if you’re a dog, you really only hear about two words at a time so, you’d better make those words count! If you’ve ever had a dog, you know that common commands – uh, behavior modifications – are “sit”, “stay” and “heel.” My personal favorites are “speak” (for obvious reasons) and “Drop it! Leave it! That’s not yours!” The last one usually involves things like my dirty laundry, clean socks, or the cat’s food, but basically, the message is to step away and leave it alone. Think about junk food in the break room at work. Oooh…tempting, but if you want what you say you want when you choose to have weight loss surgery (improved health and less weight), and if you try to tell yourself you “can’t have it,” chances are, you’ll want it even more. That’s where a seemingly “negative” instruction works really well. Next time you feel the pull of the chocolate chip cookies, try this: “Drop it! Leave it!” This works equally well in the cookie aisle at the grocery store or the family reunion picnic! And applies to more than just cookies! What if it’s not food that’s giving you the problem? What if you keep finding yourself in the midst of family or Facebook drama and “just can’t stop it”? Well, next time you’re seduced by the drama say, “Drop it! Leave it!” That kind of behavior is not healthy; it’s distracting and destructive, and who needs that? Are you starting to understand why the subtitle of this article is, “Letting go of Stinkin’ Thinkin’ and Bad Habits in Recovery From Obesity?” Yes? No? Not exactly? Roxy didn’t understand the message the first time either, so I’ll hand it over to The Doc! The Doc here! I loved it when Cari first used her humungous, solid-muscle dog Roxy as an example for “dropping” and “leaving” things. If you’ve ever had a dog, you know exactly how sternly you sometimes tell the pooch to “DROP IT” or “LEAVE IT!” I had a beautiful Doberman for a while (sadly, she died at the age of 6 from a heart condition common to the breed). One time on a walk (yes, she was on a leash), a tiny little toy dog ran up to her and Lucy (my Doberman) snatched her up like a rag doll and started tossing the yelping little pup to and fro in the grips of her Dobie-sized teeth. You can imagine how loudly and firmly I yelled at her to “DROP IT” and “LEAVE IT!” (She did and the tiny dog was fine!) There may be times you need to use the same degree of firmness with yourself… when it comes to unhealthy food choices, the use of negative self-talk and negative other-talk (gossip, comparing, snarking). I get sad when I think of how “natural” it is for most of us to verbally, mentally and emotionally abuse ourselves with thoughts and words. We (theoretically) wouldn’t treat the ones we love with harsh, critical words. I say theoretically because, tragically, it often is our loved ones we treat the worst (along with ourselves). Many of us talk more kindly to co-workers and store clerks and passers-by than we do to our own spouses and/or children. BAD HABITS, indeed! Sad habits, for sure. And what power our words have. Much stronger than the ability of my Doberman to literally drag me down the street when I “walked her.” Our words cut to the core. Think about it… you can probably recall with ease the most hurtful comments that have been uttered to you - about you. I’ll bet your kids can recall the harshest things you have said to them, no matter how long ago it’s been. And your spouse? Hopefully they aren’t so accustomed to hearing you speak negatively and critically about them (and you) that they barely notice it any more. You can change this by DROPPING IT (the negative words) and LEAVING IT. This is not who you want to be. Put GOBS of effort into changing your self-, and other-talk so it is kinder, gentler, and more encouraging. (This can only be done with practice, practice and more practice). How about food choices and exercise habits? Are you doing well in these areas? If you are, we extend tremendous congratulations to you because, for the obese and formerly obese, making healthy food choices (to include portion size) and getting exercise were not in the category of “long-standing habits.” Quite the opposite. Poor eating habits and life as a couch potato were more the standard habits. When you decided to have weight loss surgery, you were, in effect, saying “DROP IT,” and “LEAVE IT” in a firm voice to yourself when it comes to unhealthy foods and a sedentary lifestyle. DROP IT… that is not the same as “maybe I’ll have a cookie just this once.” LEAVE IT… means “leave it alone”… walk away or get it out of your house (as opposed to “leave it there” to torment you until you cave…). Cari and I hear it a lot, and you may be thinking it as you read this, “It’s not as easy as you make it sound.” We know it’s not easy to change long-standing bad habits, whether they are negative self- and other-talk or eating and exercise habits. That’s why you need to have tools (for changing behaviors) like you have the tool of WLS to make it easier to eat less and therefore, to lose weight. The following are some tools to help you change your long-time negative habits into healthy new habits you can use for the rest of your life: Practice kind self- and other-talk. When you hear yourself (in your head our out loud) saying something unkind, stop yourself as soon as you catch it, and change it into something neutral or positive. Get support. The Post Op & The Doc are forever saying, “You can’t do this alone… and no one can do it for you!” So DROP IT (the idea you don’t need help) and LEAVE IT (the false pride). Instead, utilize the support that is out there for you. Write things down. When you’re upset or even when you feel accomplished, write it down! Getting the negative stuff down on paper will help unburden you from going over and over and over the same negative thoughts in your head. If you’re feeling happy or proud, your written word can be used as a reminder that you CAN get through the rough times and as a guide for how to get through another difficult time in the future. Celebrate success. Whether it’s engaging in positive self-talk, stopping the gossip train, making healthy food choices, or getting your exercise completed, celebrate with a written page about how proud you are of yourself by sharing your success at support group, or by encouraging another to do the same! Make use of goals. Cari and I refer to daily goals as “Gonna Do ‘Ems.” Each day, set a small, achievable goal for health, and a second goal for life that is related to some other area of your world. Remind yourself in the morning that you’re Gonna Do these things TODAY! Maintain daily accountability to yourself and to another. At the end of the day, check in with yourself regarding your Gonna Do ‘Ems and let someone else know what you did. Then celebrate in a positive, non-food related way. OK, Cari – sum it all up! The Post Op: Recovery From Obesity is serious business, and it’s easy to want to give up and give in. After all, most of us have years and years of practice (in dog years, I had 280) with negative self-talk and unhealthy behaviors, and very little experience with healthy self-talk and behaviors. It’s really easy to do what “comes naturally” (too often, the negative). BUT, consider the fact that the “natural” behaviors weren’t always natural; you learned and perfected negativity over time until, one day you were able to be mean and destructive to yourself without even thinking about it. That means in order to undo years of negative thought and behavior, you’ll have to put forth consistent effort and do some training, just like my dog. The good news is, by following the steps The Doc explained above, you can start modifying your unhealthy behaviors and begin treating yourself in a kinder, healthier way TODAY. By the way, I don’t yell at Roxy. I say it and expect her to listen. Perhaps you should try the same thing with yourself. Don’t yell… just say it: “Drop It. Leave it.” And carry on with your healthy new self! Cari De La Cruz and Connie Stapleton, Ph.D. The Post Op and The Doc info@apostopandadoc.com P.S. Be sure to watch our APODCast this month on Wednesday, March 19th titled “DROP IT, ROXY!” For details, go to our Facebook page at https://www.facebook.com/APostOpandADoc.

Think about junk food in the break room at work. Oooh…tempting, but if you want what you say you want when you choose to have weight loss surgery (improved health and less weight), and if you try to tell yourself you “can’t have it,” chances are, you’ll want it even more. That’s where a seemingly “negative” instruction works really well. Next time you feel the pull of the chocolate chip cookies, try this: “Drop it! Leave it!” This works equally well in the cookie aisle at the grocery store or the family reunion picnic! And applies to more than just cookies! What if it’s not food that’s giving you the problem? What if you keep finding yourself in the midst of family or Facebook drama and “just can’t stop it”? Well, next time you’re seduced by the drama say, “Drop it! Leave it!” That kind of behavior is not healthy; it’s distracting and destructive, and who needs that? Are you starting to understand why the subtitle of this article is, “Letting go of Stinkin’ Thinkin’ and Bad Habits in Recovery From Obesity?” Yes? No? Not exactly? Roxy didn’t understand the message the first time either, so I’ll hand it over to The Doc! The Doc here! I loved it when Cari first used her humungous, solid-muscle dog Roxy as an example for “dropping” and “leaving” things. If you’ve ever had a dog, you know exactly how sternly you sometimes tell the pooch to “DROP IT” or “LEAVE IT!” I had a beautiful Doberman for a while (sadly, she died at the age of 6 from a heart condition common to the breed). One time on a walk (yes, she was on a leash), a tiny little toy dog ran up to her and Lucy (my Doberman) snatched her up like a rag doll and started tossing the yelping little pup to and fro in the grips of her Dobie-sized teeth. You can imagine how loudly and firmly I yelled at her to “DROP IT” and “LEAVE IT!” (She did and the tiny dog was fine!) There may be times you need to use the same degree of firmness with yourself… when it comes to unhealthy food choices, the use of negative self-talk and negative other-talk (gossip, comparing, snarking). I get sad when I think of how “natural” it is for most of us to verbally, mentally and emotionally abuse ourselves with thoughts and words. We (theoretically) wouldn’t treat the ones we love with harsh, critical words. I say theoretically because, tragically, it often is our loved ones we treat the worst (along with ourselves). Many of us talk more kindly to co-workers and store clerks and passers-by than we do to our own spouses and/or children. BAD HABITS, indeed! Sad habits, for sure. And what power our words have. Much stronger than the ability of my Doberman to literally drag me down the street when I “walked her.” Our words cut to the core. Think about it… you can probably recall with ease the most hurtful comments that have been uttered to you - about you. I’ll bet your kids can recall the harshest things you have said to them, no matter how long ago it’s been. And your spouse? Hopefully they aren’t so accustomed to hearing you speak negatively and critically about them (and you) that they barely notice it any more. You can change this by DROPPING IT (the negative words) and LEAVING IT. This is not who you want to be. Put GOBS of effort into changing your self-, and other-talk so it is kinder, gentler, and more encouraging. (This can only be done with practice, practice and more practice). How about food choices and exercise habits? Are you doing well in these areas? If you are, we extend tremendous congratulations to you because, for the obese and formerly obese, making healthy food choices (to include portion size) and getting exercise were not in the category of “long-standing habits.” Quite the opposite. Poor eating habits and life as a couch potato were more the standard habits. When you decided to have weight loss surgery, you were, in effect, saying “DROP IT,” and “LEAVE IT” in a firm voice to yourself when it comes to unhealthy foods and a sedentary lifestyle. DROP IT… that is not the same as “maybe I’ll have a cookie just this once.” LEAVE IT… means “leave it alone”… walk away or get it out of your house (as opposed to “leave it there” to torment you until you cave…). Cari and I hear it a lot, and you may be thinking it as you read this, “It’s not as easy as you make it sound.” We know it’s not easy to change long-standing bad habits, whether they are negative self- and other-talk or eating and exercise habits. That’s why you need to have tools (for changing behaviors) like you have the tool of WLS to make it easier to eat less and therefore, to lose weight. The following are some tools to help you change your long-time negative habits into healthy new habits you can use for the rest of your life: Practice kind self- and other-talk. When you hear yourself (in your head our out loud) saying something unkind, stop yourself as soon as you catch it, and change it into something neutral or positive. Get support. The Post Op & The Doc are forever saying, “You can’t do this alone… and no one can do it for you!” So DROP IT (the idea you don’t need help) and LEAVE IT (the false pride). Instead, utilize the support that is out there for you. Write things down. When you’re upset or even when you feel accomplished, write it down! Getting the negative stuff down on paper will help unburden you from going over and over and over the same negative thoughts in your head. If you’re feeling happy or proud, your written word can be used as a reminder that you CAN get through the rough times and as a guide for how to get through another difficult time in the future. Celebrate success. Whether it’s engaging in positive self-talk, stopping the gossip train, making healthy food choices, or getting your exercise completed, celebrate with a written page about how proud you are of yourself by sharing your success at support group, or by encouraging another to do the same! Make use of goals. Cari and I refer to daily goals as “Gonna Do ‘Ems.” Each day, set a small, achievable goal for health, and a second goal for life that is related to some other area of your world. Remind yourself in the morning that you’re Gonna Do these things TODAY! Maintain daily accountability to yourself and to another. At the end of the day, check in with yourself regarding your Gonna Do ‘Ems and let someone else know what you did. Then celebrate in a positive, non-food related way. OK, Cari – sum it all up! The Post Op: Recovery From Obesity is serious business, and it’s easy to want to give up and give in. After all, most of us have years and years of practice (in dog years, I had 280) with negative self-talk and unhealthy behaviors, and very little experience with healthy self-talk and behaviors. It’s really easy to do what “comes naturally” (too often, the negative). BUT, consider the fact that the “natural” behaviors weren’t always natural; you learned and perfected negativity over time until, one day you were able to be mean and destructive to yourself without even thinking about it. That means in order to undo years of negative thought and behavior, you’ll have to put forth consistent effort and do some training, just like my dog. The good news is, by following the steps The Doc explained above, you can start modifying your unhealthy behaviors and begin treating yourself in a kinder, healthier way TODAY. By the way, I don’t yell at Roxy. I say it and expect her to listen. Perhaps you should try the same thing with yourself. Don’t yell… just say it: “Drop It. Leave it.” And carry on with your healthy new self! Cari De La Cruz and Connie Stapleton, Ph.D. The Post Op and The Doc info@apostopandadoc.com P.S. Be sure to watch our APODCast this month on Wednesday, March 19th titled “DROP IT, ROXY!” For details, go to our Facebook page at https://www.facebook.com/APostOpandADoc.

How often does it happen that the next day, as you’re in the process of getting back to the business of everyday life, that you have a completely random incident that sends a message to your soul that what you are working so hard to do is important and can have such a powerful impact on lives? We had that happen very recently. We came to Shreveport at the invitation of Katy and Dr. George Merriman, who are the brilliance behind Surgical Specialists. The producer of the powerful documentary All of Me, Alexandra Lescaze, was also with us in Shreveport. Along with Dr. Merriman’s staff, we were part of an impactful evening for men and women who have had, who are considering, or who are in the process of preparing for weight loss surgery. The Merriman’s provided a healthy meal for the participants as they viewed All of Me, a story highlighting the impact of weight loss surgery on real lives. A panel discussion followed. Just a word about this. To begin with, it is rare that a bariatric practice takes the time and effort to host events for patients. It is even less often that an entire staff emphasizes the importance of therapy for their patients as a part of the weight loss journey. I have extreme gratitude for the knowledge and passion Dr. Merriman and Katy Merriman, along with their incredibly insightful nutritionist, have in relation to this reality. We, The Post Op & The Doc followed the panel discussion with a short presentation highlighting the need to work through underlying personal issues that prevent people from keeping weight off when they lose it. We shared our “Recipe for Recovery,” warned against “Food Porn,” and shared our Gotta Do Ems. The audience was receptive and awakened to the realities of life after weight loss surgery, and sent away with specific suggestions for making the most of their Recovery from Obesity. The Merriman’s then hosted us to a truly phenomenal dining experience. A quiet, intimate atmosphere that allowed for wonderful conversation, good humor and an opportunity to share knowledge and experience. After dinner, we sat in our hotel room with Alexandra and further processed the positive impact that realistic information and an emphasis on the importance of therapy has on people going through the process of weight loss surgery - and into what Cari refers to as “the Bariatric After Life.” And of course, when Alexandra went to her room, we continued to yammer away until we fell asleep practically mid-sentence! The alarm went off in the morning just moments after we both woke up. This meant we needed to get a move on, as we had to jump aboard the shuttle to the airport 45 minutes later. Which we did, after the hotel staff finally decided who was going to drive the van. For some reason, this appeared to be quite an ordeal. There were no other passengers, so we made idle chitchat with the driver as we began our 12-minute journey to the airport…. We chatted about the pretty day; was he from the area; blah, blah. This led to the inevitable question of why we were in town. We said we were at an event and had just been there for the weekend. He assumed the event had been at the convention center near the hotel. No, we said it was a smaller event. What was the topic, he asked. Weight loss surgery. LapBand? All forms. Then he said, “I lost a lot of weight with yoga and bike riding. I used to weigh 283 pounds. I keep trying to get a friend of mine to have weight loss surgery. He needs it badly.” “Really!” we said, without wanting to pry into his life or launch into the benefits of weight loss and weight loss surgery – or his personal life. A few moments of silence followed, before he offered, “And therapy. I had lots of therapy.” “Really!” We responded again, not having mentioned anything about “the Doc” being a psychologist. (But inside we were both thinking, “WHAT? Did he just say therapy? He just offered that he’d had a lot of therapy as part of his weight loss journey? And out of nowhere? Cool!) “Yep. I had a great therapist. He told me to go home and look in the mirror and say, ‘I love you, Sam (not his real name). You’re an all right guy.’ I went home and tried that, but all I could hear was, ‘You fat fu#^er!’ ‘You’re a piece of sh*#!’ That voice was so loud. I just heard it all the time. But I stood in front of the mirror every day for 90 days and said, out loud, ‘I love, you, Sam. You’re an all right guy.’ And that other voice – it went away!” “That’s really awesome. Good for you!” (Our thoughts were something like, “My God! Very cool… but how bizarre that he is sharing all this with us.”) “And it was easy to lose weight after that. It wasn’t even about the food. It’s about a loving relationship with yourself. It’s about the truth. It’s about always telling the truth – to yourself and others. It’s about living the truth.” “Wow! That’s really powerful.” (Of course, we’re thinking, “HOLY SH*#! This guy has some incredible insight and has really done some great work.”) “Yep. I had to get through all of that childhood stuff. I had a really great counselor.” Our thoughts, “DAMN! We wish he could share that message with the people at the event last night… and with everyone, actually! At that point we each shared our experiences of having been through a lot of therapy. Part of what we do, we told him, is try to help people having weight loss surgery understand the necessity of utilizing therapy as part of the process. We shared that we believed he could help a lot of people. He said, “I don’t know. Kids have mushy brains but adults… they really gotta want help if anything is gonna sink in.” We talked later about children and their “mushy” little brains and the impact harsh words have on their self-esteem, their hearts and their souls. Sam apparently believed that as children become adults, those “mushy” brains harden and solidify, along with the negative messages entombed within. Maybe in the brain-hardening process, people’s hearts and minds “set” at the same time. Perhaps that’s true to an extent. It seems that for many adult brains, as well as for their hearts and minds, the hardness is a shell that can be fairly easily cracked and at least partially dissolved. It requires a dose or two or a thousand of a compassionate, trusting listener. It requires vulnerability, the willingness to share one’s truth. As a side note, we, The Post Op & A Doc recently watched a Ted Talk by Brene Brown on vulnerability. It was extraordinarily powerful! We encourage you to watch it. Our conversation became slightly lighter in tone, as our 12 minutes was winding down… and because Sam had missed the exit to the airport, having been engrossed in our discussion. “How long did it take you to get good at the yoga?” Doc asked. “It took me about six months to get really comfortable with it. I stopped lifting weights all together and replaced it with yoga, which I do three times a week. When you learn to do the breathing that goes with yoga, it’s a powerful experience. I’ve become so much more aware of myself, my thoughts and feelings, other people and their emotions, as well. I also follow the work of Caroline Myss.” “No WAY!” the Doc exclaimed. “One of her books, Anatomy of the Spirit, is one of the books that has helped me make the most sense of my life.” “Yeah. I love all of her stuff. She’s made a huge difference in so many people’s lives.” A short silence, which he broke with, “It’s nice to know there’s an afterlife. It makes it easy to sit back and enjoy life and connect with other people. I’ve had so many experiences to know there’s life after this.” “We agree, Sam.” We also agreed we could take a lesson from this man who truly has a sense of peace about him… “Yeah. Caroline Myss. She’s made an impact on a lot of lives… including mine. She gives it to people straight,” Doc added, thinking of The Post Op and the Doc’s “firm and fair” approach to working with people. As are Katy and Dr. George Merriman. As is Lisa, their dietician. The weekend was coming full circle as we pulled up at the airport. Sam said, “I don’t usually drive the shuttle. I’m an engineer at the hotel and just help out when they need me to. And I don’t usually tell people all of that.” “We appreciate you sharing those parts of your life with me, Sam. You made my day.” We hugged. We gave him a couple of bucks and told him to enjoy a cup of coffee. He said, thanks, he would. We walked into the airport, grateful for that experience with a kind, highly self-actualizing man. And for the affirmation that what we are doing – encouraging people to get therapy as part of the process of life after weight loss surgery: to work through negative self-talk, to deal with childhood issues that interfere with a healthy present, to learn healthy coping skills and to accept their feelings. To live life fully in Recovery from Obesity. And to know the simplistic joys in life. Like Sam does. Cari De La Cruz and Connie Stapleton, Ph.D. The Post Op and The Doc info@apostopandadoc.com

The Doc: Post-ops – this one’s for you! (However, if you're a pre-op, you'll benefit a bunch by reading this before your procedure!) A friendly warning for everyone reading this article – pre- or post-op – these words are not for the faint of heart! You're going to be asked some questions and also asked to be 100% completely honest with yourself as you answer the questions! Don’t worry too much. The questions are few in number. You don’t even have to tell anybody else your answers, but if you tell yourself even a “little white lie” you’ll be doing yourself a great disservice. The reason? Recovery from obesity requires being completely honest with yourself about what you are doing and what you’re not doing to manage a healthy weight. Then you have to honestly decide what you are willing to do if you want what you told your weight loss surgery medical team you wanted: your health back and to be able to do things you couldn't when carrying an extra 100 + pounds. The Post Op: Sounds ominous, doesn’t it? Just what are these questions? Can you flunk the test? The good news is, this isn’t a test, but the questions can test your patience a bit, and might be challenging to answer. The goal is honesty, so just do your best and don’t worry, we’ll go easy on you. It won’t take long to figure out that there are many more questions where these came from (and the answers will likely be the same!) What the Nutritionist told you (and hopefully the psychologist, your PCP and the WLS surgeon, as well): 1. In some way, shape or form, during your pre-surgical preparation, the dietician told you that in order to keep your weight off over time, you are going to have to eat “healthy” portions of the right foods (and by “healthy” we do not mean “healthy” = huge; we mean “healthy” as in nutritionally healthy portions = measured/reasonable amounts of food). Questions: a. Did you get this message during your pre-surgical preparation for WLS? b. Did you agree that you would, indeed eat “healthy” portions of food after the surgery (with an implied, forever more)? c. Did you mean what you said when you agreed to maintaining “healthy” portions of the right foods after surgery? (I’m fairly certain you did mean it.) d. ARE YOU DOING IT? Are you maintaining “healthy” portions of the right foods ever since you’ve had WLS? a. If not, what’s up??? b. If not, what are you willing to do in order to get back on track with this? 2. In some way, shape or form, during your pre-surgical preparation, the dietician told you that in order to keep your weight off over time, you need to eliminate or reduce/minimize the simple carbs that you eat (meaning white rice, white potatoes, pasta, white bread, most “baked goods,” “junk food,” and sugary foods (most “baked goods,” candy, soda, sweet tea, cake, cookies, etc.). Questions: a. Did you get this message during your pre-surgical preparation for WLS? b. Did you agree that you would, indeed eliminate or reduce/minimize the simple carbs that you eat (meaning white rice, white potatoes, pasta, white bread, most “baked goods,” “junk food,” and sugary foods (most “baked goods,” candy, soda, sweet tea, cake, cookies, etc.)? c. Did you mean what you said when you agreed to eliminate or reduce/minimize the simple carbs that you eat (meaning white rice, white potatoes, pasta, white bread, most “baked goods,” “junk food,” and sugary foods (most “baked goods,” candy, soda, sweet tea, cake, cookies, etc.)? (I’m fairly certain you did mean it.) d. ARE YOU DOING IT? Have you eliminated or reduced/minimized the simple carbs that you eat (meaning white rice, white potatoes, pasta, white bread, most “baked goods,” “junk food,” and sugary foods (most “baked goods,” candy, soda, sweet tea, cake, cookies, etc.)ever since you’ve had WLS? a. If not, what’s up??? b. If not, what are you willing to do in order to get back on track with this? What the Physician told you (bariatric surgeon and/or primary care physician): 3. It is important that you utilize the first 12 – 18 months (the “honeymoon period”) to establish healthy lifestyle habits regarding food and exercise. a. Did you get this message during your pre-surgical preparation for WLS? b. Did you agree that you would, indeed utilize the first 12 – 18 months (the “honeymoon period”) to establish healthy lifestyle habits regarding food and exercise? c. Did you mean what you said when you agreed to utilize the first 12 – 18 months (the “honeymoon period”) to establish healthy lifestyle habits regarding food and exercise? (I’m fairly certain you did mean it.) d. ARE YOU DOING IT? DID YOU DO IT? Are you/Did you utilize the first 12 – 18 months (the “honeymoon period”) to establish healthy lifestyle habits regarding food and exercise? a. If not, what’s up??? b. If not, what are you willing to do in order to get back on track with this? 4. It is important that you engage in and maintain some form of physical exercise (keeping in mind your physical conditions) more days of the week than not, in order to maintain your weight loss. e. Did you get this message during your pre-surgical preparation for WLS? f. Did you agree that you would, indeed engage in and maintain some form of physical exercise (keeping in mind your physical conditions) more days of the week than not, in order to maintain your weight loss? g. Did you mean what you said when you agreed to engage in and maintain some form of physical exercise (keeping in mind your physical conditions) more days of the week than not, in order to maintain your weight loss? (I’m fairly certain you did mean it.) h. ARE YOU DOING IT? Are you engaging in and maintaining some form of physical exercise (keeping in mind your physical conditions) more days of the week than not, in order to maintain your weight loss ever since you’ve had WLS? a. If not, what’s up??? b. If not, what are you willing to do in order to get back on track with this? What the Psychologist/Mental Health Provider told you: 5. It is important that you fully understand that unless you do what the doctor and nutritionist tell you to do for the rest of your life, you can (and most likely will) regain your weight. Are you willing to follow through with the nutrition and exercise guidelines after surgery in order to keep the weight off? (And if you’re lucky, they encouraged you to seek therapy if you struggle). a. Did you get this message during your pre-surgical preparation for WLS? b. Did you agree that you would, indeed, do what the doctor and nutritionist told you to do for the rest of your life, or you could (and most likely would) regain your weight? c. Did you mean what you said when you agreed to do what the doctor and nutritionist told you to do for the rest of your life, or you could (and most likely would) regain your weight? (I’m fairly certain you did mean it.) d. ARE YOU DOING IT? DID YOU DO IT? Are you doing what the doctor and nutritionist told you to do in order to prevent regaining your weight? a. If not, what’s up??? b. If not, what are you willing to do in order to get back on track with this? ARE YOU WILLING TO GO TO THERAPY? The Post Op & The Doc: Above we have noted five topics basic to nearly every surgical weight loss program in this country: 1) the need to eat healthy portions of healthy foods, 2) the need to minimize simple carbohydrates, 3) using the first year to learn and implement healthy habits, 4) engaging in, and maintaining healthy support, and 5) it is possible to regain weight after WLS if you don’t follow what you were advised to do. The Post Op & The Doc have seventeen years collectively working in this field. We have seen and talked with thousands of patients who have shared with us that they did hear this information before surgery, they agreed to do what they learned, and they meant it. Yet many have been unable to follow through. That’s normal. It’s difficult to make the behavioral changes needed to keep weight off. If you start to regain, you can catch yourself and get headed in a healthy direction. Many people are doing what it takes to get back on track so that they can get and keep their excess weight off. They do what they set out to do when they decided to have weight loss surgery: Improve their health and have the ability to do more of the things they want to do. The best way to get into the habits needed to maintain a healthy weight or to get back on track is to use the Gotta Do Em's. The Gotta Do Em's are what it takes to get and keep weight off: 1. Make Healthy Food Choices 2. Maintain Portion Control 3. Exercise Regularly 4. Drink Water 5. Eat Breakfast 6. Plan Your Meals and Follow Your Plan 7. Keep a Food Diary 8. Keep an Exercise Diary 9. Use a Healthy Support System 10. Get Individual and/or Group Therapy There are lots of excuses for not following the Gotta Do Em's. It would be easy to say that you were overwhelmed with all of the information you were given pre-surgery and couldn’t possibly understand everything you agreed to. It would easy to say that you were just trying to get your forms completed so you could qualify for surgery and you therefore agreed to whatever you needed to. It would be easy to say you didn’t know then what you know now, so you were committing to things you weren’t prepared to honor. Well, none of that matters because, the truth is, you can do what you said you would do and, if you really want what you say you want (improved health and a better quality of life), you must do those things you said you would. The good news? You don’t need to do them alone. In fact, as A Post Op & A Doc always say, “No one can do this for you, but you can’t do it alone.” We all need support to sustain the Gotta Do ‘Em's. So utilize the support offered by your medical team, your program’s support group, and the people who love you and do the things you said you’d do! You’ll feel great about yourself and will get the results you were looking for as you headed into weight loss surgery. A Post Op & A Doc have a copy of the Gotta Do ‘Em’s (and a lot more free handouts for you) at www.conniestapletonphd.com/apod and on our Facebook page at http://www.facebook.com/apostopandadoc . Cari DeLaCruz (The Post Op) cari@apostopandadoc.com www.conniestapleton.com/apod Connie Stapleton, Ph.D. (The Doc) connie@apostopandadoc.com www.conniestapleton.com/apod

The Post Op: Sounds ominous, doesn’t it? Just what are these questions? Can you flunk the test? The good news is, this isn’t a test, but the questions can test your patience a bit, and might be challenging to answer. The goal is honesty, so just do your best and don’t worry, we’ll go easy on you. It won’t take long to figure out that there are many more questions where these came from (and the answers will likely be the same!) What the Nutritionist told you (and hopefully the psychologist, your PCP and the WLS surgeon, as well): 1. In some way, shape or form, during your pre-surgical preparation, the dietician told you that in order to keep your weight off over time, you are going to have to eat “healthy” portions of the right foods (and by “healthy” we do not mean “healthy” = huge; we mean “healthy” as in nutritionally healthy portions = measured/reasonable amounts of food). Questions: a. Did you get this message during your pre-surgical preparation for WLS? b. Did you agree that you would, indeed eat “healthy” portions of food after the surgery (with an implied, forever more)? c. Did you mean what you said when you agreed to maintaining “healthy” portions of the right foods after surgery? (I’m fairly certain you did mean it.) d. ARE YOU DOING IT? Are you maintaining “healthy” portions of the right foods ever since you’ve had WLS? a. If not, what’s up??? b. If not, what are you willing to do in order to get back on track with this? 2. In some way, shape or form, during your pre-surgical preparation, the dietician told you that in order to keep your weight off over time, you need to eliminate or reduce/minimize the simple carbs that you eat (meaning white rice, white potatoes, pasta, white bread, most “baked goods,” “junk food,” and sugary foods (most “baked goods,” candy, soda, sweet tea, cake, cookies, etc.). Questions: a. Did you get this message during your pre-surgical preparation for WLS? b. Did you agree that you would, indeed eliminate or reduce/minimize the simple carbs that you eat (meaning white rice, white potatoes, pasta, white bread, most “baked goods,” “junk food,” and sugary foods (most “baked goods,” candy, soda, sweet tea, cake, cookies, etc.)? c. Did you mean what you said when you agreed to eliminate or reduce/minimize the simple carbs that you eat (meaning white rice, white potatoes, pasta, white bread, most “baked goods,” “junk food,” and sugary foods (most “baked goods,” candy, soda, sweet tea, cake, cookies, etc.)? (I’m fairly certain you did mean it.) d. ARE YOU DOING IT? Have you eliminated or reduced/minimized the simple carbs that you eat (meaning white rice, white potatoes, pasta, white bread, most “baked goods,” “junk food,” and sugary foods (most “baked goods,” candy, soda, sweet tea, cake, cookies, etc.)ever since you’ve had WLS? a. If not, what’s up??? b. If not, what are you willing to do in order to get back on track with this? What the Physician told you (bariatric surgeon and/or primary care physician): 3. It is important that you utilize the first 12 – 18 months (the “honeymoon period”) to establish healthy lifestyle habits regarding food and exercise. a. Did you get this message during your pre-surgical preparation for WLS? b. Did you agree that you would, indeed utilize the first 12 – 18 months (the “honeymoon period”) to establish healthy lifestyle habits regarding food and exercise? c. Did you mean what you said when you agreed to utilize the first 12 – 18 months (the “honeymoon period”) to establish healthy lifestyle habits regarding food and exercise? (I’m fairly certain you did mean it.) d. ARE YOU DOING IT? DID YOU DO IT? Are you/Did you utilize the first 12 – 18 months (the “honeymoon period”) to establish healthy lifestyle habits regarding food and exercise? a. If not, what’s up??? b. If not, what are you willing to do in order to get back on track with this? 4. It is important that you engage in and maintain some form of physical exercise (keeping in mind your physical conditions) more days of the week than not, in order to maintain your weight loss. e. Did you get this message during your pre-surgical preparation for WLS? f. Did you agree that you would, indeed engage in and maintain some form of physical exercise (keeping in mind your physical conditions) more days of the week than not, in order to maintain your weight loss? g. Did you mean what you said when you agreed to engage in and maintain some form of physical exercise (keeping in mind your physical conditions) more days of the week than not, in order to maintain your weight loss? (I’m fairly certain you did mean it.) h. ARE YOU DOING IT? Are you engaging in and maintaining some form of physical exercise (keeping in mind your physical conditions) more days of the week than not, in order to maintain your weight loss ever since you’ve had WLS? a. If not, what’s up??? b. If not, what are you willing to do in order to get back on track with this? What the Psychologist/Mental Health Provider told you: 5. It is important that you fully understand that unless you do what the doctor and nutritionist tell you to do for the rest of your life, you can (and most likely will) regain your weight. Are you willing to follow through with the nutrition and exercise guidelines after surgery in order to keep the weight off? (And if you’re lucky, they encouraged you to seek therapy if you struggle). a. Did you get this message during your pre-surgical preparation for WLS? b. Did you agree that you would, indeed, do what the doctor and nutritionist told you to do for the rest of your life, or you could (and most likely would) regain your weight? c. Did you mean what you said when you agreed to do what the doctor and nutritionist told you to do for the rest of your life, or you could (and most likely would) regain your weight? (I’m fairly certain you did mean it.) d. ARE YOU DOING IT? DID YOU DO IT? Are you doing what the doctor and nutritionist told you to do in order to prevent regaining your weight? a. If not, what’s up??? b. If not, what are you willing to do in order to get back on track with this? ARE YOU WILLING TO GO TO THERAPY? The Post Op & The Doc: Above we have noted five topics basic to nearly every surgical weight loss program in this country: 1) the need to eat healthy portions of healthy foods, 2) the need to minimize simple carbohydrates, 3) using the first year to learn and implement healthy habits, 4) engaging in, and maintaining healthy support, and 5) it is possible to regain weight after WLS if you don’t follow what you were advised to do. The Post Op & The Doc have seventeen years collectively working in this field. We have seen and talked with thousands of patients who have shared with us that they did hear this information before surgery, they agreed to do what they learned, and they meant it. Yet many have been unable to follow through. That’s normal. It’s difficult to make the behavioral changes needed to keep weight off. If you start to regain, you can catch yourself and get headed in a healthy direction. Many people are doing what it takes to get back on track so that they can get and keep their excess weight off. They do what they set out to do when they decided to have weight loss surgery: Improve their health and have the ability to do more of the things they want to do. The best way to get into the habits needed to maintain a healthy weight or to get back on track is to use the Gotta Do Em's. The Gotta Do Em's are what it takes to get and keep weight off: 1. Make Healthy Food Choices 2. Maintain Portion Control 3. Exercise Regularly 4. Drink Water 5. Eat Breakfast 6. Plan Your Meals and Follow Your Plan 7. Keep a Food Diary 8. Keep an Exercise Diary 9. Use a Healthy Support System 10. Get Individual and/or Group Therapy There are lots of excuses for not following the Gotta Do Em's. It would be easy to say that you were overwhelmed with all of the information you were given pre-surgery and couldn’t possibly understand everything you agreed to. It would easy to say that you were just trying to get your forms completed so you could qualify for surgery and you therefore agreed to whatever you needed to. It would be easy to say you didn’t know then what you know now, so you were committing to things you weren’t prepared to honor. Well, none of that matters because, the truth is, you can do what you said you would do and, if you really want what you say you want (improved health and a better quality of life), you must do those things you said you would. The good news? You don’t need to do them alone. In fact, as A Post Op & A Doc always say, “No one can do this for you, but you can’t do it alone.” We all need support to sustain the Gotta Do ‘Em's. So utilize the support offered by your medical team, your program’s support group, and the people who love you and do the things you said you’d do! You’ll feel great about yourself and will get the results you were looking for as you headed into weight loss surgery. A Post Op & A Doc have a copy of the Gotta Do ‘Em’s (and a lot more free handouts for you) at www.conniestapletonphd.com/apod and on our Facebook page at http://www.facebook.com/apostopandadoc . Cari DeLaCruz (The Post Op) cari@apostopandadoc.com www.conniestapleton.com/apod Connie Stapleton, Ph.D. (The Doc) connie@apostopandadoc.com www.conniestapleton.com/apod

Tis the season ready or not! The holiday season can be one of the most joyful times of the year with its dazzling colors, familiar music, social gatherings, and yes, food, food and more food! For those who have recently lost a significant amount of weight following WLS or have remained serious throughout the year about managing the healthy weight they have sustained since having WLS, the food-infested holiday season can present physical and emotional challenges. Tis the season ready or not! The holiday season can be one of the most joyful times of the year with its dazzling colors, familiar music, social gatherings, and yes, food, food and more food! For those who have recently lost a significant amount of weight following WLS or have remained serious throughout the year about managing the healthy weight they have sustained since having WLS, the food-infested holiday season can present physical and emotional challenges. For at least five solid weeks, food is even more ubiquitous than usual in our eating-obsessed society. It's almost impossible to avoid fanciful confections almost anywhere you go from Thanksgiving until the end of the year. Cookies, candy, fudge and a host of other home-made delights in the break room at the office. Gift baskets abounding with fruits, nuts and bottles of apple cider arrive at the doorstep. Samples of gooey baked goods with sparkling decorations are handed out from kiosks in the grocery store. And bubbly libations accompany the gourmet delicacies served at every office and neighborhood social gathering. For people who have had WLS and are serious about maintaining a healthy weight, the fact that the average American gains 7 & 12 pounds throughout the holiday season, can evoke strong feelings of anxiety. Another anxiety-producing holiday stressor can be the family gathering. Most of us spend time with relatives during the holiday season. Like food, there are lots of varieties of families; some food and some families are healthy and others are not! Regardless of the emotional health of one's family, nearly all family holiday gatherings revolve around a meal, featuring time-honored secret family recipes and dishes that aunts, uncles and cousins eagerly await all year long. At no other time of year are there so many triggers that have the potential to steer off course those who have used food as a way to deal with emotions. In her brilliant, practical book, The Beck Diet Solution , Dr. Judith Beck notes several categories of triggers that can ultimately lead to eating. Three of these categories are emotional, biological, and environmental. Identify the Triggers in this scenario: Your family has decided to have Thanksgiving dinner at your Grandma Smith's house this year. You haven't been to that house in nearly a dozen years, since moving out of state. When you were a child you adored spending time at your grandma's house. She is the person who taught you about gardening, how to sew, and how to bake. It's hard to think about Grandma Smith without recalling the smell of fresh bread wafting throughout the house. As soon as you walk in the door, the smell of her homemade biscuits mingled with the traditional aroma of the turkey and dressing takes over your entire being. Before you can turn and walk toward the kitchen, you see cousin Sally. Sally was the mean cousin when you were kids. She called you fatty Patty and always tattled to the adults when you did anything wrong. You are assaulted by her booming voice, Hey, there, fatty Patty!' What have you done to yourself? You're not fat anymore! You wish you could just punch her, but refrain from doing so as Aunt Cindy wraps you in a bear hug. That smell! Her perfume. It takes you back to the time you ate three pieces of her birthday cake before dinner. Her husband, uncle Bill had screamed at you for what seemed like an hour, but Aunt Cindy had wrapped you up in a hug then like she was doing now and she was wearing that same scent! You finally make it into the living room and see the old blue rocker that you and Grandma sat in countless evenings while she read to you. Your eyes mist with tears. However, your thoughts are interrupted by the angry sounds of two male voices coming from the next room. They were at it again. Your twin uncles. They never got along well and used to get into fist fights, scaring you when you were a child. You would take a bowl of Grandma's homemade cookies and hide in the closet upstairs until they would leave. Just the sound of their harsh tones made you turn and look for a sweet treat to take your mind off the fear you felt, even now as an adult. There are lots of triggers in this story with potential for thoughts and feelings that could lead to eating as a coping response. Emotional triggers include reminiscing on the happy memories of spending time with Grandma in the garden, while sewing and when baking in the kitchen. Cousin Sally's name-calling would certainly trigger an emotional response, as would the memory of Uncle Bill screaming at a young Patty who ate Aunt Sally's birthday cake. Biological triggers in this scenario would be the sight and smell of the food when Patty walked into Grandma's. Salivating at the thought or actual smell of the food is also a biological trigger. The sound of angry voices producing anxiety is another example of a biological trigger, as is the smell of Aunt Cindy's perfume. The blue rocking chair in the living room would be an example of an environmental trigger. The closet upstairs where Patty hid when she was a child is also an environmental trigger. Triggers and Emotional Eating Songs often evoke strong emotions. When you hear a song that played at your high school prom where you slow danced with your first love, you experience the joyful emotions you did when you were in that high school gymnasium-turned-ballroom. Holidays, and especially family holiday gatherings similarly evoke strong emotions. For an emotional eater, this can lead to high calorie disasters. In the scenario above, Patty experienced a range of emotions based on in-the-moment triggers and intensified by memories from the past. Emotional eaters often turn to food when they are experiencing emotions, sometimes as a way to avoid unpleasant feelings. It may be tempting for Patty to grab an entire pie off the counter and run to the upstairs closet to gobble the pie down in an attempt to get away from the hurt of Cousin Sally's rude remark, to forget about the smell of Aunt Cindy's perfume and the memory of being severely scolded by Uncle Tim years ago, and to quiet the sound of her twin uncles' arguing. Triggers are powerful. In order to make it safely through this minefield of eating triggers during the holiday season, a person needs to have a plan in place ahead of time and then they need to utilize the plan throughout the season! A Post Op & A Doc have created an entire program for WLS patients to help them get through the holidays while maintaining their commitment to their health. You can download the plan called APOD's GPS Great Plan for Success and take it with you as you head into the holiday season! Go to www.conniestapletonphd.com/apod/ and look on the right hand side of the page to print off your copy! The following Ten Tips can also help you prepare ahead of time for dealing in a healthy way if you are overwhelmed by the urge to eat after being triggered at the family holiday gathering. (You can use these to safely navigate the holiday trays in office break rooms, at neighborhood social gatherings, and any other place you are deluged by tempting holiday goodies!) Anticipate triggers. Think about situations you are likely to encounter throughout the holiday season that pose threats to your healthy eating habits. Make a list of probable triggers you will encounter at your family holiday gatherings and use the following steps to deal with them in healthy ways. Visualize healthy responses to triggers. Instead of responding to triggers in an unhealthy way (yelling, arguing, eating) start preparing now to respond to them in a healthy way by visualizing yourself calmly walking away from arguments. Imagine yourself walking outside and taking a few minutes for yourself to regroup before returning to the situation. Picture yourself finding a place to call a supportive friend and talking about how you're feeling. All of these healthy responses will keep you away from the high calorie options you may have turned to in the past. Learn quick relaxation techniques. When we encounter triggers, we often become tense, anxious, scared or angry. In a highly emotional state, you are more likely to react rather than respond. Reacting may mean mindless eating of empty calories. If you are able to utilize a simple, quick relaxation tool, you will be better able to respond to triggers in a healthy, rational manner. One example of a simple relaxation techniques is to very slowly breathe in and out 12 times. You can do this in a room full of people and no one will even know! Another simple technique is to slowly count to 10, 20, or 100 however long it takes you to feel calm enough to respond in a healthy way. Get away from the crowd and mentally note ten things you are grateful for. This will definitely improve your frame of mind and you can resume your activities with a better outlook, a sure defense against harmful overeating. Remind yourself why. In preparing for the holiday gatherings, write answers to these questions and have it on your smartphone or an index card to read if you feel yourself getting overwhelmed emotionally and/or feel tempted to eat things you will regret later: What are the negative consequences of eating unhealthy foods and of overeating? What are the reasons I decided to lose weight and improve my health habits? What are the benefits thus far of losing weight and improving my health habits? [*]Say to yourself, I made up my mind! When you're aware that your desire to eat/overeat has been triggered, say to yourself, I made up my mind: a. to stick to my healthy eating plan. b. to focus on relationships rather than food. c. to honor my recent weight loss by maintaining healthy behaviors during the holiday season. d. whatever else you have made up your mind about! [*]Focus on your own behavior. It's easy to get worked up about things other people are saying (perhaps they make negative comments to, or about you or others). It's just as easy to get upset over other people's behavior (family members who may be arguing, or drinking too much, or vying for everyone's attention). Focus on your own behavior. After all, you have no responsibility for anyone else's! And you have full responsibility for you own behavior which, by the way, includes what, when, and how much you eat! [*]Keep a progress piece in your pocket . A progress piece can be anything that reminds you of the progress you have made losing weight and/or improving your health. For example, if you are now able to bend over and tie your shoes after losing weight, carry a shoestring with you. If you recently flew on an airplane and no longer needed a seatbelt extender, carry your boarding pass or a picture of a plane with you. When you're tempted to engage in unhealthy eating, look at your progress piece and give yourself credit for the hard work you've done and remind yourself of the commitment you made to continue your healthy behaviors. [*]STOP. Imagine a large STOP sign in your mind that you can pull out whenever you need to before indulging in food (or behavior) that you will later regret. [*]Set boundaries. If people give you a difficult time for eating healthy (Why can't you just have one bite? or You must have a piece of Aunt Sally's pie or you'll hurt her feelings.), set boundaries by saying, I've made up my mind to eat healthy, even on Thanksgiving. I don't expect you to understand, but I hope you will respect my decision. [*]Plan your work and work your plan. Take an index card (or make a note on your smart phone) with any of the above suggestions or other things that work for you to help you get through difficult food and/or family situations so that you maintain your healthy lifestyle behaviors. Read your reminders any time you feel the need to and UTILIZE them! Happy holidays to you and your families! Enjoy the relationships they last so much longer than the food!

"Letting Go: How to let go of old hurts so you can heal" Letting go. “Let go” of a kite string and your kite soars to the heavens. “Let go” of a rope during tug-of-war and it drops. Sounds easy! In daily life, people say, “let it go” This refers to “letting go” emotionally, or no longer being upset by people or situations. If you aren’t “letting go”, you must be “holding on”, meaning you are clinging to some negative emotion(s) that prevents you from getting on with life. Sounds easy. Letting go of a kite string or a tug-of-war rope is easy. What about “letting go” of hurt resulting from your mother calling you derogatory names? How easy is it to “let go” of the fear you felt as you watched your father beat your mother? Is it easy to “let go” of your own habit of referring to yourself as “stupid”? No - letting go of emotional issues is not easy. There are similarities to the process of letting go of emotional issues and letting go of a kite string or a tug-of-war rope. Having a fight with your husband about which route to take to the movie theater may upset you for a few minutes, but letting go of the frustration should be as easy as letting go of a kite string. Some emotional issues are more like a tug-of-war game. If the game isn’t important to you and you let go of the rope, you won’t be upset with yourself. In real life, this is like going shopping with a girlfriend and hoping to have lunch at a new deli. Turns out she has her heart set on Italian food. Because you are not concerned about where you eat, you “let go” of your initial disappointment that she doesn’t want to go to the deli, and you eat Italian. You don’t “hold on” to the frustration. You “let it go” and enjoy your day. If the tug-of-war game means a lot to you, you will hold on to the rope longer. If your opponent is physically stronger and it becomes clear that you are going to get hurt if you continue to hold, you “let go” of the rope so you don’t get rope burns. In life this could be like attempting to resolve an emotional wound with a sibling who treated you badly throughout high school. She regularly made fun of you in front of friends. You have “held on” to the pain for years and want to “let go” of the power that the feelings, and your sister, still have over you. You confront her: ”I felt angry when you made fun of me in front of my friends all through high school. I was hurt because I looked up to you and wanted you to like me. I am choosing to let go of my anger toward you and will no longer be intimidated by you”. Your still-cruel sister laughs at you and calls you “ridiculous”. No matter. You didn’t talk to her so she would agree with you. You talked to her so you could stop being intimidated by her and so you could let go of painful emotions. You put up a good fight at the tug-of-war match and smartly “let go” of the rope (stopped fighting with your sister) before she hurt you further (like getting rope burns). Many emotional issues are like this. It’s good to stay in the game to demonstrate your strength and willingness to fight for yourself. If the others involved don’t respond in healthy ways, it may be good to let go of the rope. That doesn’t mean you have “lost”. It means you have done what you needed to do and have chosen to “let go” in order to avoid getting hurt further. In life this means standing up for yourself. It means protecting yourself from harmful people and situations. It means taking yourself seriously and treating yourself with the care and respect you treat your best friend. Sometimes we hold on to painful emotions for too long and for unhealthy reasons. This is equivalent to holding on too tightly to the rope in tug-of-war and ending up with badly burned hands. A woman may blame her husband for not being a good partner. She complains to her friends that “he doesn’t want to go anywhere with me”, and “he doesn’t hold my hand”. In therapy, she recognized that it was easier to “hold on” to resentment toward her husband than to admit she is afraid of intimacy and did not make attempts to improve her marriage, either. How do we let go of emotional issues? Identify the issues (this often requires therapy): childhood wounds and being angry with mom/dad/whomever betrayal by friend/spouse/whomever a history of being harshly criticized/called names and having residual low self-esteem Recognize thoughts and feelings related to the issues: I am angry with my father for beating my mother and brother; it was very scary to witness that. I am hurt that my friend shared what I told her in confidence. I think it was rude. I am sad that I was called names and am angry that my self-esteem was damaged. I think it’s terrible that parents can treat their children so cruelly. Determine what we need in order to “let go” (meaning that the issue no longer has power over our lives). My father is deceased, but I need to talk about and feel what it was like when I was a child. I need to talk about how situations in my present life remind me of back then and how I sometimes feel like I did then. I also need to learn to respond to my situations in the present from an adult perspective and not that of a scared child. I need to let my friend know how badly I was hurt. I need to remember that she may or may not apologize for her behavior and that my purpose for sharing my feelings with her is so that I don’t develop resentments toward her or keep negative feelings inside myself. I need to hear her side of the story and see if I can understand her perspective. Then I need to determine if this is a healthy friendship and if I want to continue in it. I need to tell my parents how badly they hurt me and affected my self esteem. I need to stop calling myself derogatory names. I need to stop using low self-esteem as an excuse for not taking healthy risks. Follow through with action, remembering to let go of the rope if there is danger of additional hurt. Sometimes people are stubborn and because they need to win they will hold on long after their hands are badly burned. We need support in the way of healthy friends or a trained therapist to “let go” of past hurts. We need to let go of past hurts to help ourselves heal. Connie Stapleton, Ph.D. www.conniestapletonphd.com WLS Magazine 4/12

"Letting Go: How to let go of old hurts so you can heal" Letting go. “Let go” of a kite string and your kite soars to the heavens. “Let go” of a rope during tug-of-war and it drops. Sounds easy! In daily life, people say, “let it go” This refers to “letting go” emotionally, or no longer being upset by people or situations. If you aren’t “letting go”, you must be “holding on”, meaning you are clinging to some negative emotion(s) that prevents you from getting on with life. Sounds easy. Letting go of a kite string or a tug-of-war rope is easy. What about “letting go” of hurt resulting from your mother calling you derogatory names? How easy is it to “let go” of the fear you felt as you watched your father beat your mother? Is it easy to “let go” of your own habit of referring to yourself as “stupid”? No - letting go of emotional issues is not easy. There are similarities to the process of letting go of emotional issues and letting go of a kite string or a tug-of-war rope. Having a fight with your husband about which route to take to the movie theater may upset you for a few minutes, but letting go of the frustration should be as easy as letting go of a kite string. Some emotional issues are more like a tug-of-war game. If the game isn’t important to you and you let go of the rope, you won’t be upset with yourself. In real life, this is like going shopping with a girlfriend and hoping to have lunch at a new deli. Turns out she has her heart set on Italian food. Because you are not concerned about where you eat, you “let go” of your initial disappointment that she doesn’t want to go to the deli, and you eat Italian. You don’t “hold on” to the frustration. You “let it go” and enjoy your day. If the tug-of-war game means a lot to you, you will hold on to the rope longer. If your opponent is physically stronger and it becomes clear that you are going to get hurt if you continue to hold, you “let go” of the rope so you don’t get rope burns. In life this could be like attempting to resolve an emotional wound with a sibling who treated you badly throughout high school. She regularly made fun of you in front of friends. You have “held on” to the pain for years and want to “let go” of the power that the feelings, and your sister, still have over you. You confront her: ”I felt angry when you made fun of me in front of my friends all through high school. I was hurt because I looked up to you and wanted you to like me. I am choosing to let go of my anger toward you and will no longer be intimidated by you”. Your still-cruel sister laughs at you and calls you “ridiculous”. No matter. You didn’t talk to her so she would agree with you. You talked to her so you could stop being intimidated by her and so you could let go of painful emotions. You put up a good fight at the tug-of-war match and smartly “let go” of the rope (stopped fighting with your sister) before she hurt you further (like getting rope burns). Many emotional issues are like this. It’s good to stay in the game to demonstrate your strength and willingness to fight for yourself. If the others involved don’t respond in healthy ways, it may be good to let go of the rope. That doesn’t mean you have “lost”. It means you have done what you needed to do and have chosen to “let go” in order to avoid getting hurt further. In life this means standing up for yourself. It means protecting yourself from harmful people and situations. It means taking yourself seriously and treating yourself with the care and respect you treat your best friend. Sometimes we hold on to painful emotions for too long and for unhealthy reasons. This is equivalent to holding on too tightly to the rope in tug-of-war and ending up with badly burned hands. A woman may blame her husband for not being a good partner. She complains to her friends that “he doesn’t want to go anywhere with me”, and “he doesn’t hold my hand”. In therapy, she recognized that it was easier to “hold on” to resentment toward her husband than to admit she is afraid of intimacy and did not make attempts to improve her marriage, either. How do we let go of emotional issues? Identify the issues (this often requires therapy): childhood wounds and being angry with mom/dad/whomever betrayal by friend/spouse/whomever a history of being harshly criticized/called names and having residual low self-esteem Recognize thoughts and feelings related to the issues: I am angry with my father for beating my mother and brother; it was very scary to witness that. I am hurt that my friend shared what I told her in confidence. I think it was rude. I am sad that I was called names and am angry that my self-esteem was damaged. I think it’s terrible that parents can treat their children so cruelly. Determine what we need in order to “let go” (meaning that the issue no longer has power over our lives). My father is deceased, but I need to talk about and feel what it was like when I was a child. I need to talk about how situations in my present life remind me of back then and how I sometimes feel like I did then. I also need to learn to respond to my situations in the present from an adult perspective and not that of a scared child. I need to let my friend know how badly I was hurt. I need to remember that she may or may not apologize for her behavior and that my purpose for sharing my feelings with her is so that I don’t develop resentments toward her or keep negative feelings inside myself. I need to hear her side of the story and see if I can understand her perspective. Then I need to determine if this is a healthy friendship and if I want to continue in it. I need to tell my parents how badly they hurt me and affected my self esteem. I need to stop calling myself derogatory names. I need to stop using low self-esteem as an excuse for not taking healthy risks. Follow through with action, remembering to let go of the rope if there is danger of additional hurt. Sometimes people are stubborn and because they need to win they will hold on long after their hands are badly burned. We need support in the way of healthy friends or a trained therapist to “let go” of past hurts. We need to let go of past hurts to help ourselves heal. Connie Stapleton, Ph.D. www.conniestapletonphd.com WLS Magazine 4/12

Defining Myself after Weight Loss Surgery In order to define who you are after weight loss surgery, it’s important to answer a few questions. The most important question may be “Who do you want to be”? However, before you answer that question, let’s walk down the road of your past and define who you have been. You will discover qualities about yourself that you want to hold on to and develop as you move forward in life. You will also discover some things about yourself that it is time to permanently abandon. Life after bariatric surgery is most assuredly about redefining yourself. You have gone from seeing yourself, and being seen by others, as “the fat person” to being “that person who had bariatric surgery and has lost so much weight”. It’s easy to find yourself wondering who you are at this point, many pounds lighter than you were not so very long ago. You’re probably tired of all of the comments and questions related to how much weight you have lost and how you have done it. It’s time to start living the new life you have worked so hard for. However, you may be confused about who you are now that you have lost so much weight and the hype of the weight-loss process is over. You may find yourself staring into the mirror wondering, “WHO AM I”? Let’s find out, starting by identifying your “titles” or the “hats that you wear”. Imagine you have a wall in your house with a great big board affixed to it. On the board are a number of hooks. On each hook hangs a hat and under each hat is a small sign with a label, one for each of the roles you play. For example, you may have a multicolored, floppy hat to represent the many dimensions and of being a “mom”. There may be a fedora or a nursing cap or a chef hat with a label underneath that says “working professional”. Is there a whimsical hat with a sign that says “friend”? A hat to represent yourself as a daughter? a woman? a spouse or partner? a dancer? a pianist? a photographer? a volunteer? a mentor? a student? Make a list of your titles and alongside the list, state the benefits and drawbacks for you in each of these roles. Are there any roles that you want to eliminate? Are you at a place in your life where you no longer want to play some role on your list and that you can responsibly let go of? Maybe your parents forced you to play a musical instrument as a child and you continue to play in a community orchestra even though you don’t want to. Would now be a good time to say good-bye to being a “musician”? There are some roles you may have that you wish you didn’t, but you accept them because you are a responsible person. For example, you might wish you had a sun visor on the wall where your professional hat is because you want to be retired. However, you keep the hat of the working professional because you are a responsible person and have a family to feed. (Idea: Hang the visor underneath the professional hat as a reminder that the retirement hat is one you will be wearing one day!) Is there a role you would like to add to your life? Would you like to become a tap dancer and add a top hat to your wall? Are there some roles you love that you already have but would like to improve on? Would taking parenting class help you to be an improved version of “mother”? Now make a list of words that you use to describe yourself and that other people use to describe you. Make this list of words descriptive of your personality. For example, are you “bubbly”, “grumpy”, “responsible”, “gossipy”, “adventurous”, “whiney”, “moody”, “outgoing”, “a good listener”, “lazy”, “serious”, “silly”, “friendly”, “mean”, “motivated”, “introverted”, “lively”, etc.? Be sure to include the names you have been called related to your obesity, such as “fat”, “chunky”, and “husky”. Were you called “smart”, “stupid”, “idiot”, “baby doll”, “princess”, “daddy’s girl”, “spoiled”, or “alcoholic”? Next to each of these descriptive words, write down your feelings related to each of these labels. Which of these things do you want to continue to be? Which do hope to never hear again in reference to you? Okay. You’ve got a really great start toward answering the question, “Who Am I”? You have identified the roles you currently play in life. You have identified words and labels that describe you. You have chosen which ones you like for yourself and which ones you are ready to leave behind. To get rid of the ones you are ready to discard from your life, write the words or labels on separate pieces of paper. Next, light a fire in the fireplace or a large coffee can and drop each piece of paper into the fire, and say out loud, “I am no longer a ‘fatso’”. Then throw the word into the fire and refuse to ever refer to yourself as that again. Do this with each word and label you are getting rid of. The final steps to figuring out who you are at this time in your life are to verbalize and write down who you want to be! Simply state out loud and then write down, “I want to be and will be “a person who thinks positively about myself and others”. “I want to be and will be “a person who plans what I eat every day and sticks to my plan”. I want to be and will be “a person who exercises 60 minutes a day, five days a week”. I want to be and will be “a person who focuses on gratitude throughout the day”. That’s the easy part. The more difficult part is to determine specifically what you are going to DO in order to be each of the things in your list. For example, “I will be a person who thinks positively about myself and others by stopping all judgmental thoughts as soon as I am aware that I am having them and by immediately replacing all negative thoughts with positive ones”. “I will be a person who focuses on gratitude throughout the day by writing down one thing I am grateful for three times each day”. By specifically defining your goals and visualizing yourself doing them, you will do them and become the person you imagine yourself to be. Picture yourself eating healthy meals. See yourself walking the dogs. Imagine yourself giving genuine compliments to others. Picture yourself looking into the mirror and smiling kindly at yourself. Decide who you want to be by: identifying who you have been deciding what parts of your previous self you want to keep and what parts you want to discard determining specific things you want to do and specific ways you want to behave. Choose to become the person you were born to be before the “genuine you” got lost beneath unhealthy extra weight. “Who Am I”? Whoever you choose to be! Connie Stapleton, Ph.D. 4/12 WLS Magazine

Defining Myself after Weight Loss Surgery In order to define who you are after weight loss surgery, it’s important to answer a few questions. The most important question may be “Who do you want to be”? However, before you answer that question, let’s walk down the road of your past and define who you have been. You will discover qualities about yourself that you want to hold on to and develop as you move forward in life. You will also discover some things about yourself that it is time to permanently abandon. Life after bariatric surgery is most assuredly about redefining yourself. You have gone from seeing yourself, and being seen by others, as “the fat person” to being “that person who had bariatric surgery and has lost so much weight”. It’s easy to find yourself wondering who you are at this point, many pounds lighter than you were not so very long ago. You’re probably tired of all of the comments and questions related to how much weight you have lost and how you have done it. It’s time to start living the new life you have worked so hard for. However, you may be confused about who you are now that you have lost so much weight and the hype of the weight-loss process is over. You may find yourself staring into the mirror wondering, “WHO AM I”? Let’s find out, starting by identifying your “titles” or the “hats that you wear”. Imagine you have a wall in your house with a great big board affixed to it. On the board are a number of hooks. On each hook hangs a hat and under each hat is a small sign with a label, one for each of the roles you play. For example, you may have a multicolored, floppy hat to represent the many dimensions and of being a “mom”. There may be a fedora or a nursing cap or a chef hat with a label underneath that says “working professional”. Is there a whimsical hat with a sign that says “friend”? A hat to represent yourself as a daughter? a woman? a spouse or partner? a dancer? a pianist? a photographer? a volunteer? a mentor? a student? Make a list of your titles and alongside the list, state the benefits and drawbacks for you in each of these roles. Are there any roles that you want to eliminate? Are you at a place in your life where you no longer want to play some role on your list and that you can responsibly let go of? Maybe your parents forced you to play a musical instrument as a child and you continue to play in a community orchestra even though you don’t want to. Would now be a good time to say good-bye to being a “musician”? There are some roles you may have that you wish you didn’t, but you accept them because you are a responsible person. For example, you might wish you had a sun visor on the wall where your professional hat is because you want to be retired. However, you keep the hat of the working professional because you are a responsible person and have a family to feed. (Idea: Hang the visor underneath the professional hat as a reminder that the retirement hat is one you will be wearing one day!) Is there a role you would like to add to your life? Would you like to become a tap dancer and add a top hat to your wall? Are there some roles you love that you already have but would like to improve on? Would taking parenting class help you to be an improved version of “mother”? Now make a list of words that you use to describe yourself and that other people use to describe you. Make this list of words descriptive of your personality. For example, are you “bubbly”, “grumpy”, “responsible”, “gossipy”, “adventurous”, “whiney”, “moody”, “outgoing”, “a good listener”, “lazy”, “serious”, “silly”, “friendly”, “mean”, “motivated”, “introverted”, “lively”, etc.? Be sure to include the names you have been called related to your obesity, such as “fat”, “chunky”, and “husky”. Were you called “smart”, “stupid”, “idiot”, “baby doll”, “princess”, “daddy’s girl”, “spoiled”, or “alcoholic”? Next to each of these descriptive words, write down your feelings related to each of these labels. Which of these things do you want to continue to be? Which do hope to never hear again in reference to you? Okay. You’ve got a really great start toward answering the question, “Who Am I”? You have identified the roles you currently play in life. You have identified words and labels that describe you. You have chosen which ones you like for yourself and which ones you are ready to leave behind. To get rid of the ones you are ready to discard from your life, write the words or labels on separate pieces of paper. Next, light a fire in the fireplace or a large coffee can and drop each piece of paper into the fire, and say out loud, “I am no longer a ‘fatso’”. Then throw the word into the fire and refuse to ever refer to yourself as that again. Do this with each word and label you are getting rid of. The final steps to figuring out who you are at this time in your life are to verbalize and write down who you want to be! Simply state out loud and then write down, “I want to be and will be “a person who thinks positively about myself and others”. “I want to be and will be “a person who plans what I eat every day and sticks to my plan”. I want to be and will be “a person who exercises 60 minutes a day, five days a week”. I want to be and will be “a person who focuses on gratitude throughout the day”. That’s the easy part. The more difficult part is to determine specifically what you are going to DO in order to be each of the things in your list. For example, “I will be a person who thinks positively about myself and others by stopping all judgmental thoughts as soon as I am aware that I am having them and by immediately replacing all negative thoughts with positive ones”. “I will be a person who focuses on gratitude throughout the day by writing down one thing I am grateful for three times each day”. By specifically defining your goals and visualizing yourself doing them, you will do them and become the person you imagine yourself to be. Picture yourself eating healthy meals. See yourself walking the dogs. Imagine yourself giving genuine compliments to others. Picture yourself looking into the mirror and smiling kindly at yourself. Decide who you want to be by: identifying who you have been deciding what parts of your previous self you want to keep and what parts you want to discard determining specific things you want to do and specific ways you want to behave. Choose to become the person you were born to be before the “genuine you” got lost beneath unhealthy extra weight. “Who Am I”? Whoever you choose to be! Connie Stapleton, Ph.D. 4/12 WLS Magazine