Connie Stapleton PhD

Are you old enough to remember the movie Kindergarten Cop? Arnold Schwarzenegger stars as a policeman who, on assignment, poses as a kindergarten teacher in order to catch a criminal. In the famous scene, he is in front of his class of 5-year-olds, rubbing his head. One of the kids asks, “What’s the matter?” Arnold, the cop/teacher, responds, “I have a headache.” The child, offering his wisdom, suggests, “Maybe it’s a tumor,” to which Arnold replies, “It’s NOT a TOOMAH.” In the case of bariatric surgery and the questions patients ask about their post-op “diet,” most bariatric professionals speak in terms of the lifestyle and dietary changes that accompany post-op living. The majority of patients, both pre-op and post-op, understand that one of the goals of preparing for bariatric surgery is to begin making healthy, positive changes to one’s lifestyle. Which, of course, is code for changing behaviors (primarily eating and exercise). Hence, the popular phraseology that “bariatric surgery requires accompanying lifestyle changes” in order for one to maintain the weight loss they experience during “the honeymoon” stage. For many (most?) people who have bariatric surgery, being on a “diet” of one sort of another has been a way of life prior to having a bariatric surgical procedure. Atkins, Paleo, low carb, low fat, vegan, gluten-free, DASH diet, ZONE diet, Jenny Craig, Whole 30, Weight Watcher’s, very low carb, Sugar Busters, etc. etc. etc. Sound familiar? When I hear post-op patients talking about “going on a ‘diet,’” I really want to scream, “THIS ISN’T ABOUT A ‘DIET’! It’s about LIFESTYLE CHANGES!” Don’t get defensive here if you have gone on a “diet” as a post-op. I understand that if you have regained weight, and are working with a bariatric professional, there may be a “diet” of sorts prescribed. That’s not what I’m referring to when I talk about my frustration. It’s when a post-op continues the diet-as-a-way-of-life mentality that I feel frustrated, and sad, actually. Living life “on a diet” can be (and is, for some people), a way to: 1) avoid other things (feelings, relationships, etc.) by focusing all of their thoughts and attention on “the diet,” 2) remain obsessed with food (which may be an indication of a food addiction and/or my first point), 3) remain connected with others as “dieting” may have been the basis of their relationship with family members or friends, 4) attempting to have some area of control in life, and/or 5) lots of other things. Regardless, dieting as a way of life is probably not a healthy way to live (for most people). Sidenote: I add that “for most people” part because, sure as I’m sitting here, if I don’t say that, somebody is gonna get really ticked off and start thinking about how that isn’t the case for THEM and THEN they may miss the point of the whole article… The POINT, by the way, is… choosing to have bariatric surgery is also choosing to make healthy, positive lifestyle changes. IF you want to sustain the weight you lose as a result of the surgery – and your efforts. And YOU are in it to win it. SO… here’s how to change your thinking from making changes in your “DIET” to making changes in your lifestyle: AWARENESS: Learn the difference between a “diet” and a “lifestyle change” if you don’t already know. Discuss this with your bariatric professionals, your support groups and your family members. Help those in your life understand the difference, as well. IF you fear not living on a “diet,” then perhaps consider getting some counseling to look into the reasons being “on a diet” is emotionally important to you. ACCEPTANCE: Realize that if you want to live the rest of your life at a healthier weight, then lifestyle changes in the way of “diet” (as in what you eat), as opposed to “A DIET,” such as the ones name above, are necessary. And the healthy dietary changes need to a lifestyle… meaning you continue them every day, one day at a time. In addition, the lifestyle changes necessary to life your healthiest life can include things such as increased physical activity, exercise, learning healthy coping skills, developing a healthy support system, etc. ACCOUNTABILITY: Find ways to be accountable for engaging in healthy lifestyle behaviors. Maintain food and exercise journals. Participate in support and/or accountability groups. Work out with others. Start a walking club. Start a support group. Take responsibility for your health. This day. Every day. ATTITUDE: Work to have a more positive attitude about the difficult parts of the journey. Read positive quotes. Maintain a gratitude journal. Encourage others. Talk to yourself when you’re grumpy and remind yourself that will not lead you in the direction you want to go! COMMITMENT: Make a list of the reasons you are working so hard to develop a healthier lifestyle and every day, SEVERAL times a day, state out loud your commitment to doing so. OUT LOUD! Your brain will hear you and respond in a positive way. EFFORT: Unless you do the doing, nothing much will happen in the way of results. So this EFFORT thing needs attention every day. Get help to get you going if you need to! Yep – that means: Ask. For. Help. You can do that! Your SELF matters. Be as loving toward yourself as you are to others. You are just important as every other person. Using these 4 ACES will get you to the place where a healthy diet is part of your healthy LIFESTYLE!

Beautiful!

I can't say for certain the reason(s) patient treat the lifestyle as a 'diet.' Perhaps one reason is that many patients are so used to living on a 'diet' they are like a fish out of water if they are NOT on a diet! It saddens me to think that bariatric treatment teams act as though patients are on a 'diet' following surgery. It's really about a healthy lifestyle to include a healthy diet (meaning the foods you eat, as opposed to a diet like Jenny Criag or the like).

Love your thoughts! Thanks for sharing.

I'm certain you have a lot of wisdom and experience that you are sharing with others on this journey! Thank you for the feedback!

You are so right! Thank you for setting me straight!

Very cool! So glad it's working for you!

I am all about whatever works!!!!! Because there are so many things that can and a person has to do what works for them!

LOVE your attitude! A winning one, for sure! Thank you for sharing!

Much wisdom in your words! Thank you for sharing!

Well said! Just sharing some thoughts. They certainly do not apply to everyone and your points are valid and well taken! Thanks for sharing!

In the case of bariatric surgery and the questions patients ask about their post-op “diet,” most bariatric professionals speak in terms of the lifestyle and dietary changes that accompany post-op living. The majority of patients, both pre-op and post-op, understand that one of the goals of preparing for bariatric surgery is to begin making healthy, positive changes to one’s lifestyle. Which, of course, is code for changing behaviors (primarily eating and exercise). Hence, the popular phraseology that “bariatric surgery requires accompanying lifestyle changes” in order for one to maintain the weight loss they experience during “the honeymoon” stage. For many (most?) people who have bariatric surgery, being on a “diet” of one sort of another has been a way of life prior to having a bariatric surgical procedure. Atkins, Paleo, low carb, low fat, vegan, gluten-free, DASH diet, ZONE diet, Jenny Craig, Whole 30, Weight Watcher’s, very low carb, Sugar Busters, etc. etc. etc. Sound familiar? When I hear post-op patients talking about “going on a ‘diet,’” I really want to scream, “THIS ISN’T ABOUT A ‘DIET’! It’s about LIFESTYLE CHANGES!” Don’t get defensive here if you have gone on a “diet” as a post-op. I understand that if you have regained weight, and are working with a bariatric professional, there may be a “diet” of sorts prescribed. That’s not what I’m referring to when I talk about my frustration. It’s when a post-op continues the diet-as-a-way-of-life mentality that I feel frustrated, and sad, actually. Living life “on a diet” can be (and is, for some people), a way to: 1) avoid other things (feelings, relationships, etc.) by focusing all of their thoughts and attention on “the diet,” 2) remain obsessed with food (which may be an indication of a food addiction and/or my first point), 3) remain connected with others as “dieting” may have been the basis of their relationship with family members or friends, 4) attempting to have some area of control in life, and/or 5) lots of other things. Regardless, dieting as a way of life is probably not a healthy way to live (for most people). Sidenote: I add that “for most people” part because, sure as I’m sitting here, if I don’t say that, somebody is gonna get really ticked off and start thinking about how that isn’t the case for THEM and THEN they may miss the point of the whole article… The POINT, by the way, is… choosing to have bariatric surgery is also choosing to make healthy, positive lifestyle changes. IF you want to sustain the weight you lose as a result of the surgery – and your efforts. And YOU are in it to win it. SO… here’s how to change your thinking from making changes in your “DIET” to making changes in your lifestyle: AWARENESS: Learn the difference between a “diet” and a “lifestyle change” if you don’t already know. Discuss this with your bariatric professionals, your support groups and your family members. Help those in your life understand the difference, as well. IF you fear not living on a “diet,” then perhaps consider getting some counseling to look into the reasons being “on a diet” is emotionally important to you. ACCEPTANCE: Realize that if you want to live the rest of your life at a healthier weight, then lifestyle changes in the way of “diet” (as in what you eat), as opposed to “A DIET,” such as the ones name above, are necessary. And the healthy dietary changes need to a lifestyle… meaning you continue them every day, one day at a time. In addition, the lifestyle changes necessary to life your healthiest life can include things such as increased physical activity, exercise, learning healthy coping skills, developing a healthy support system, etc. ACCOUNTABILITY: Find ways to be accountable for engaging in healthy lifestyle behaviors. Maintain food and exercise journals. Participate in support and/or accountability groups. Work out with others. Start a walking club. Start a support group. Take responsibility for your health. This day. Every day. ATTITUDE: Work to have a more positive attitude about the difficult parts of the journey. Read positive quotes. Maintain a gratitude journal. Encourage others. Talk to yourself when you’re grumpy and remind yourself that will not lead you in the direction you want to go! COMMITMENT: Make a list of the reasons you are working so hard to develop a healthier lifestyle and every day, SEVERAL times a day, state out loud your commitment to doing so. OUT LOUD! Your brain will hear you and respond in a positive way. EFFORT: Unless you do the doing, nothing much will happen in the way of results. So this EFFORT thing needs attention every day. Get help to get you going if you need to! Yep – that means: Ask. For. Help. You can do that! Your SELF matters. Be as loving toward yourself as you are to others. You are just important as every other person. Using these 4 ACES will get you to the place where a healthy diet is part of your healthy LIFESTYLE!

I know I said my next article was going to be on causes of obesity, but I got carried away tonight doing some investigating about the professional medical guidelines for alcohol use after weight loss surgery. In summary, the gist of the recommendations are: “Patients undergoing bariatric surgery should be screened and educated regarding alcohol intake both before and after surgery… patients should be made aware that alcohol use disorders (AUD) can occur in the long term after bariatric surgery.” (From: http://asmbs.org/resources/alcohol-use-before-and-after-bariatric-surgery.) Bariatric Realities – Medical Professionals’ Guidelines about Alcohol Use & WLS I know I said my next article was going to be on causes of obesity, but I got carried away tonight doing some investigating about the professional medical guidelines for alcohol use after weight loss surgery. In summary, the gist of the recommendations are: “Patients undergoing bariatric surgery should be screened and educated regarding alcohol intake both before and after surgery… patients should be made aware that alcohol use disorders (AUD) can occur in the long term after bariatric surgery.” (From: http://asmbs.org/resources/alcohol-use-before-and-after-bariatric-surgery.) Well, now. Those are some non-specific medical recommendations by medical professionals who are the predominant leaders and caregivers of the surgical weight loss population. Education and awareness. Hey – I am all about education and awareness. Great things, education and awareness. And yet, I’m gonna say that as a recommendation, that is a very “PC” non-recommendation recommendation, when one considers that we are talking about 1) ALCOHOL and 2) WEIGHT LOSS SURGERY patients. Consider these educational nuggets and facts I found that WLS patients really ought to be aware of: Psychologist Stanton Peele, writes, “readers now know that scientifically, it's not alcohol that causes people to live longer, but it is simply being with others and that they are less socially isolated when they drink that prolongs their lives. After all, alcohol is a toxin.” (italics and bold added) (From https://www.psychologytoday.com/blog/addiction-in-society/201011/science-is-what-society-says-it-is-alcohols-poison. My comments: Yes – alcohol is a toxin, and that means POISON. Those of us in the medical field really ought to know that people are not supposed to ingest poison. But the recommendations do not say, “Do NOT ingest the toxin, alcohol.” No, no, no… they say be educated and aware. Dr. Charles S. Lieber, M.D., M.A.C.P., in a publication for the National Institute on Alcohol Abuse and Alcoholism, writes, ““A complex interplay exists between a person’s alcohol consumption and nutritional status,” and … alcohol and its metabolism prevent the body from properly absorbing, digesting, and using essential nutrients” (italics added.) Dr. Lieber does indeed, educate us about the nutritional value of alcohol: “Alcohol would not fall under the category of an essential nutrient because not having it in your diet does not lead to any sort of deficiency. Alcoholic beverages primarily consist of water, pure alcohol (chemically known as ethanol), and variable amounts of sugars (i.e., carbohydrates); their content of other nutrients (e.g., proteins, vitamins, or minerals) is usually negligible. Because they provide almost no nutrients, alcoholic beverages are considered ‘empty calories.’ Therefore, any calories provided by alcoholic beverages are derived from the carbohydrates and alcohol they contain.” (italics added) My comments: People who have weight loss surgery (other than the band) experience absorption issues to one degree or another. Nutritional deficiency is one of the concerns the medical professionals monitor in the months and years following WLS. We stress to patients the importance of taking vitamin supplements for the rest of their lives to help ensure proper nutritional balance. And yet, rather than saying, “Alcohol use is unwise after WLS,” or “Don’t drink alcohol after WLS,” the governing body of health professionals for bariatric surgery recommends being “educated” and “aware.” Is that happening? Are the physicians and surgeons and nutritionists and mental health professionals educating patients and making patients aware that ALCOHOL IS A TOXIN THAT CAN INTERFERE WITH VITAMIN ABSORPTION – and it should not be consumed after weight loss surgery? I can’t answer that, although I know we do this at the programs I work with. If it’s not happening, why not? Having a background in direct sales, which, ironically, was incredible education for my later career as a psychologist, I was taught to “anticipate the objections.” Many health care professionals may be pooh-pooh’ing the vitamin deficiency issue associated with alcohol, stating it’s only those who drink heavily who are at risk for this type of vitamin deficiency. That information, to the best of my knowledge, is relevant for persons who have not had weight loss surgery. What’s more, we don’t know the extent to which people are drinking many years after WLS. Most of the research, as noted in the ASMBS Guidelines/Statements entitled ASMBS position statement on alcohol use before and after bariatric surgery, states, “The existing studies do not present a uniform picture regarding the overall prevalence of lifetime or current alcohol use disorders (AUD) in patients seeking bariatric surgery. The vast majority of the existing literature is retrospective, with small sample sizes, lack of control groups, and low response rates. There are also varying definitions of alcohol disorders (“high-risk” versus “misuse” versus “abuse/dependence”) in the bariatric surgery literature.” In other words, this research does provide some information, but remember, we don’t really know that much because there isn’t enough research on enough people over a long enough period of time. We don’t then, know the actual affect that alcohol use has on vitamin absorption for WLS patients. We DO know that vitamin deficiency is a concern, so WHY aren’t we telling people not to drink? Not only is alcohol a toxin for our bodies, “Alcohol is actually classified as a drug and is a known depressant. Under this category, it is the most widely used drug in the world. According to the National Institute of Alcohol Abuse and Alcoholism (NIAAA)” (italics and underling added). http://www.medicinenet.com/alcohol_and_nutrition/article.htm My comments: I am literally chuckling now at the absurdity of this situation. The situation being the medical professionals, all having a code of ethics that reflects the “do no harm” sentiment, ignoring potential harm for their patients. Please note that we would all consider alcohol as being “empty calories” and having sugar/carbohydrates and certainly no protein. PLEASE let it be the case that the mental health practitioners around the world who deal with surgical weight loss patients are telling them, “Don’t eat empty calories. Eat a lot of protein. Limit the simple carbs and sugar. And refrain from consuming your calories from liquids. NO STARBUCKS. BUT, HEY - GO AHEAD AND DRINK THOSE SUGAR/CARB LADEN, EMPTY, NUTRITION-ROBBING TOXIC CALORIES IN ALCOHOL, THAT ARE, BY THE WAY, THE MOST WIDELY ABUSED DRUG IN THE WORLD.” Honestly, that sentence should be the entire article. But WAIT! There’s MORE! I really love this last tidbit I’ll share with you. It’s so much nicer for me when I can find it online so it’s not that mean, alcohol-hating Dr. Stapleton being the one to blame! “The truth is that no one needs alcohol to live, so regardless of what you've heard or want to believe, alcohol is not essential in our diets. Did you know that a glass of wine can have the same calories as four cookies? How about a pint of lager – surprised to hear it’s often the caloric equivalent of a slice of pizza? You do not need to be an alcoholic for alcohol to interfere with your health and life.” https://www.drinkaware.co.uk/check-the-facts/health-effects-of-alcohol/appearance/calories-in-alcohol Do you hear this, people in the medical profession? Are you giving the OK for your patients to eat four cookies “now and then,” or “in moderation,” or “not for the first six months, or year after surgery?” Do you realize that you may be DOING HARM by giving your patients “permission” to drink alcohol? “But our job is not to be the watchdog or decision-maker for people.” Another potential objection to my dismay about the recommendations being for “education” and “awareness,” rather than a direct, “SAY NO TO ALCOHOL” stance. I agree that no one can make the decisions about what people can or cannot do, or what they will or will not do. People in the medical field do tell people things like, “Don’t get that wet or you could get an infection,” “Keep the splint on for the next six weeks if you want to heal properly.” There ARE dos and don’ts that are educational and increase awareness. What’s the real issue that medical professionals don’t take a hard stance on alcohol after WLS? I don’t know. I do know that I did my dissertation on medical doctor’s attitudes toward addiction. Turns out it is much like that of their attitudes toward obesity: many don’t know that much about it, very many do not feel comfortable working with it, and most don’t care about/understand it. To top it all off, HERE’s the real kicker… Not only do the medical AND some of the WLS organizations not tell people, “Don’t drink alcohol,” THEY PROVIDE ALCOHOL AT THEIR EVENTS! I can’t say any more. Connie Stapleton, PhD connie@conniestapletonphd.com Facebook: Connie Stapleton Twitter: @cstapletonphd LinkedIn: Connie Stapleton, Ph.D.

Are you a food addict? How do you find Recovery?

Let me speak to the shock part first. Yes, I drank - a lot – in college. So did everyone else I knew. So did everyone in my family. In fact, most of the people in my family drank a whole lot more than I ever did! After I got married, I quit drinking on a regular basis. When I did drink after that, I usually drank to get drunk – true. It’s also true that I drank less after I got married because I started taking codeine – very rarely, at first – for bad migraine headaches. Over time, however, I took it daily because codeine helped me to not feel. Anything. At most, I took maybe three in a day. I thought addicts took lots and lots of pills! So when I was given the alcohol and drug addiction screening, I was certain I wouldn’t meet any criteria for alcoholic, and most definitely not for drug addict. Well, I got one heck of a case of the “Yeah buts…” in a hurry when the therapist said, after scoring my test, “Connie – you’re an alcoholic and a drug addict.” As she talked to me about the items that indicated addiction on the test, every one of my responses to her started with, “Yeah, but…” For example, “Yeah, but I could have answered that question either way.” “Yeah, but I don’t drink nearly as much as most of the people I know, especially the people in my family.” “Yeah, but, drug addicts take a lot of pills throughout the day.” “Yeah, but I was able to take care of my kids and work and go to school.” “Yeah, but I’ve never been in trouble with the law.” When I had exhausted all the “Yeah, buts” I could think of, imagine or create, I got quiet and let it sink in. I am an addict. And then I felt it. Relief. It made sense. What made sense to me about my being an addict is understanding, for the first time, the reasons I continued to do things that went against my own values. I started to understand the reasons I did things I said I would never do. It began to make sense that things I promised I would stop doing seemed impossible to stop doing. I am an addict. I have a disease that “hijacks” the brain. When I am in active addiction of any kind: the disease of addiction that affects my brain doesn’t allow me to listen to reason but stays locked in denial mode the disease of addiction that affects my emotions keeps me in a protective mode so I defend myself by blaming other people and things for my behavior the disease of addiction that affects my spiritual self says, “do what feels good in the moment” and hides the part of me that says, “what I value is good and decent” the disease of addiction that affects my social self, brings out the loud, obnoxious, hurtful voice I am capable of using the disease of obesity that affects my physical being takes dangerous risks, eats poorly, doesn’t exercise and doesn’t care Accepting the truth that I am an addict was a relief. NOT AN EXCUSE. I understood my poor choices better. It made sense that it was so difficult for me to follow through with the convictions I made to myself and the promises I made to others. I began to understand why my behaviors went against the person I wanted to be. Addiction is a brain sickness and a soul sickness. And a protector. All at the same time. Food, alcohol, shopping, pain medication, and other things I engaged in addictively protected me from my feelings. That is what I wanted most of all. To not feel. I didn’t want to feel the reality of my sadness, my anger, my pain and my shame. The trade-off for not feeling was to use addictive substances/behaviors and betray myself by doing things I was embarrassed about, ashamed of, and seemingly unable to control. Being an addict was in no way an excuse for the behaviors I engaged in. It’s very uncool to use being an addict as a way to avoid taking responsibility. “I danced with the boss’s husband at the holiday party. What can say – I was drunk.” NOT COOL. “I told her off but she had it coming and besides – I was drunk and couldn’t keep my mouth shut.” NOT COOL. For food addicts, it is similarly bogus to make excuses for overeating because the kids were acting up, you were late for work and got yelled at, your mother was sick, or your spouse ticked you off. Each one of us is 100% responsible for our behavior – even if we have addictions. If we have an addiction, once we realize that truth, we are responsible for getting help and learning healthy ways to deal whatever life brings us. We are responsible for learning to deal with our feelings in appropriate ways. We are responsible for learning to work through losses, past abuse or neglect, present hardships, frustrations with family and friends, and all of life’s realities. Without the use of addictive chemicals or actions. The addictive substance or behavior, whatever it is, isn’t the problem. Sure, alcohol is a problem for alcoholics. Certain foods are problems for food addicts. Shopping is a problem for shopaholics. But those are only the surface problems. Addictive substances and behaviors are symptoms of the real problems, which are almost always rooted in shame: “I’m not good enough.” That shame stems from many possible places. To treat addictions, we must first remove the substance or behavior. No, one cannot eliminate food from their life. But they can eliminate the food(s) that cause them problems. Once we are free of chemicals or the addictive behaviors, we can work on the real problems and choose who we want to be. When we don’t “use,” our actions can reflect our values. “Connie – you’re an addict.” WHAT A RELIEF! I understood why I couldn’t STOP doing things I didn’t really want to do. I finally knew there was hope. I knew I could learn to live life in healthy ways and according to my values. But I first had to be willing to live without the addictive chemicals and behaviors. So I needed help. I couldn’t do it alone. And I didn’t have to. Together, we can support one another into a life of RECOVERY. What a relief!

This week I started a weekly Wednesday night Facebook Live series called Food Addiction: FAIR and FIRM. During the program, I commented that when I was told, “Connie, you’re an addict,” after the initial shock wore off, I felt a tremendous sense of relief. For the first time in my life, certain things made sense to me. Let me speak to the shock part first. Yes, I drank - a lot – in college. So did everyone else I knew. So did everyone in my family. In fact, most of the people in my family drank a whole lot more than I ever did! After I got married, I quit drinking on a regular basis. When I did drink after that, I usually drank to get drunk – true. It’s also true that I drank less after I got married because I started taking codeine – very rarely, at first – for bad migraine headaches. Over time, however, I took it daily because codeine helped me to not feel. Anything. At most, I took maybe three in a day. I thought addicts took lots and lots of pills! So when I was given the alcohol and drug addiction screening, I was certain I wouldn’t meet any criteria for alcoholic, and most definitely not for drug addict. Well, I got one heck of a case of the “Yeah buts…” in a hurry when the therapist said, after scoring my test, “Connie – you’re an alcoholic and a drug addict.” As she talked to me about the items that indicated addiction on the test, every one of my responses to her started with, “Yeah, but…” For example, “Yeah, but I could have answered that question either way.” “Yeah, but I don’t drink nearly as much as most of the people I know, especially the people in my family.” “Yeah, but, drug addicts take a lot of pills throughout the day.” “Yeah, but I was able to take care of my kids and work and go to school.” “Yeah, but I’ve never been in trouble with the law.” When I had exhausted all the “Yeah, buts” I could think of, imagine or create, I got quiet and let it sink in. I am an addict. And then I felt it. Relief. It made sense. What made sense to me about my being an addict is understanding, for the first time, the reasons I continued to do things that went against my own values. I started to understand the reasons I did things I said I would never do. It began to make sense that things I promised I would stop doing seemed impossible to stop doing. I am an addict. I have a disease that “hijacks” the brain. When I am in active addiction of any kind: the disease of addiction that affects my brain doesn’t allow me to listen to reason but stays locked in denial mode the disease of addiction that affects my emotions keeps me in a protective mode so I defend myself by blaming other people and things for my behavior the disease of addiction that affects my spiritual self says, “do what feels good in the moment” and hides the part of me that says, “what I value is good and decent” the disease of addiction that affects my social self, brings out the loud, obnoxious, hurtful voice I am capable of using the disease of obesity that affects my physical being takes dangerous risks, eats poorly, doesn’t exercise and doesn’t care Accepting the truth that I am an addict was a relief. NOT AN EXCUSE. I understood my poor choices better. It made sense that it was so difficult for me to follow through with the convictions I made to myself and the promises I made to others. I began to understand why my behaviors went against the person I wanted to be. Addiction is a brain sickness and a soul sickness. And a protector. All at the same time. Food, alcohol, shopping, pain medication, and other things I engaged in addictively protected me from my feelings. That is what I wanted most of all. To not feel. I didn’t want to feel the reality of my sadness, my anger, my pain and my shame. The trade-off for not feeling was to use addictive substances/behaviors and betray myself by doing things I was embarrassed about, ashamed of, and seemingly unable to control. Being an addict was in no way an excuse for the behaviors I engaged in. It’s very uncool to use being an addict as a way to avoid taking responsibility. “I danced with the boss’s husband at the holiday party. What can say – I was drunk.” NOT COOL. “I told her off but she had it coming and besides – I was drunk and couldn’t keep my mouth shut.” NOT COOL. For food addicts, it is similarly bogus to make excuses for overeating because the kids were acting up, you were late for work and got yelled at, your mother was sick, or your spouse ticked you off. Each one of us is 100% responsible for our behavior – even if we have addictions. If we have an addiction, once we realize that truth, we are responsible for getting help and learning healthy ways to deal whatever life brings us. We are responsible for learning to deal with our feelings in appropriate ways. We are responsible for learning to work through losses, past abuse or neglect, present hardships, frustrations with family and friends, and all of life’s realities. Without the use of addictive chemicals or actions. The addictive substance or behavior, whatever it is, isn’t the problem. Sure, alcohol is a problem for alcoholics. Certain foods are problems for food addicts. Shopping is a problem for shopaholics. But those are only the surface problems. Addictive substances and behaviors are symptoms of the real problems, which are almost always rooted in shame: “I’m not good enough.” That shame stems from many possible places. To treat addictions, we must first remove the substance or behavior. No, one cannot eliminate food from their life. But they can eliminate the food(s) that cause them problems. Once we are free of chemicals or the addictive behaviors, we can work on the real problems and choose who we want to be. When we don’t “use,” our actions can reflect our values. “Connie – you’re an addict.” WHAT A RELIEF! I understood why I couldn’t STOP doing things I didn’t really want to do. I finally knew there was hope. I knew I could learn to live life in healthy ways and according to my values. But I first had to be willing to live without the addictive chemicals and behaviors. So I needed help. I couldn’t do it alone. And I didn’t have to. Together, we can support one another into a life of RECOVERY. What a relief!

Listen to the clinical description of food addiction?... this is a place to start on our road to Recovery!

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

Thank you so much for the feedback. I agree with you WHOLEHEARTEDLY about every single one of us being able to benefit from healing in all areas of our lives. It's a forever journey, this healing!

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