Dr. Colleen Long

A large percent of pre-op weight loss surgery candidates feel that once their waistline changes, so will their thinking, and their dead wrong. Today, during one of my pre-op psych evaluations, I heard a woman say “I just feel like once I start losing weight and start feeling so much better about my self- I will stop doing all the destructive things that got me here. Don’t you think?” My response was “no I don’t agree.” I went on to explain that hers was a common assumption, a dangerous “magic-bullet” fantasy about what weight loss surgery can do. Here’s why: The part of our brain that is responsible for the thought : “wow I look so much better, I better not mess this up,” or “I feel better than I have ever felt in my life, I am a changed person,” is not the same part of the brain that wakes us up in the middle of the night and says: “go on, finish that 1/2 pint of Chunky Monkey in the freezer, there’s only a little bit left anyway, and I have been so good here lately.” We are dealing with two very different brains; the frontal cortex and the reptilian mid brain. The frontal cortex is the most newly developed (relative to other parts of the brain) part of the brain. It is the component that separates us from animals. It gives us the ability to think about consequences, plan, and execute. It is the “higher” part of ourselves, that often says “why do I keep on doing the same things I keep saying I won’t do anymore?” Or “I feel so out of control. This _______ (eating, smoking, drinking, gambling, pick your poison) is a temporary solution that produces long term pain. I have to find a different way.” Our reptilian midbrain is the Commodore 64 to our MAC; it is the palm pilot to our iPhone; the horse and buggy to our Prius; the Tommy Lee to our Oprah. Our midbrain is antique equipment, long ago evolved to keep us alive and hence the reason it is still with us today- it keeps us alive. Our midbrain contains the parts of the brain that make us recoil at the site of a snake or a spider in our peripheral vision. It is hardwired to not have to go through superfluous channels of the brain that might otherwise say “hmmm what is that crawling over there? How do I feel about that? Oh its just a spider, my aunt had a collection of spiders, maybe I should collect things, etc etc.” We just jump, and process later. That very system has helped humans survive for thousands of years. There is an adaptive quality to a brain that proverbially acts and asks forgiveness later. That very old structure once kept us out of harm’s way when a pack of tigers were first seen galloping across a horizon, or when a rivaling tribe could be heard in the far off distance, threatening to pillage our territory. Our midbrain is associated with learning and reward. Learning what makes us feel bad, what eats us (in the past that would be in a literal sense- like tigers, but presently it might be a mercurial supervisor or unending debt), and even more relevant to this article- what makes us feel good. When our brains come across something that makes us feel good (ex: sex, drugs, food), we are then flooded with an influx of the powerful neurotransmitter- dopamine. Just like not everyone that is exposed to drugs will develop an addiction, not everyone that eats a Nutella crepe will develop a food addiction. Much of the research on obesity currently, postulates that food addiction, no dissimilar than alcohol or drug addiction- is a reward system dysfunction or dysregulation, born out of genetic predisposition. It’s almost as if some brains think “if one slice of pizza feels good, how would four slices of pizza taste?” To break these two very different parts up in a different, more basic way; our frontal cortex is the voluntary, while our midbrain is the involuntary. This very dangerous fantasy, many people carry into weight loss surgery is a myth that I try to dispel quickly. This type of “magic bullet’ thinking is the very thing that gets so many gastric bypass and sleeve patients into trouble years down the road. No one wants to look at triggers. No one wants to sit with a therapist and devise a strategic coping plan. We want a pill, a surgery, a 16 minute solution to a 40 year old problem. This is not to say that weight loss surgery is not a solution, just that its only part of the solution. Despite our best intentions, we are still in some ways animalistic, hedonically-driven to feed our most basic impulses. This is part and parcel of why recidivism is the rule not the exception when it comes to recovery from most addiction. So what does this mean? Are all weight loss surgery patients destined for disappointment and disenchantment when the WLS honeymoon ends? No. But the answer to long term change lies more in two-pronged approach to long term weight loss success; surgery + behavioral change. Simply thinking ourself slim is a fantasy. Think about your specific triggers for eating. For some it is that golden hour when all the kids are in bed and Narcos is queued up on your Netflix. For others it is that 2-3pm mid day slump. For some - it is when they are alone, the only time they can eat with abandon free from others’ judgement or their own embarrassment. Whatever your triggers- the key is to identify what need is being met in that moment and to find a non-food alternative to meet each particular need ( many people have multiple triggers for over eating). If it is because its “your time,” after the kids are in bed- maybe you invest in a foot massager, or cultivate a self care space with textures, aromatherapy, candles, and books. If your trigger is that mid day slump, maybe you develop a yoga routine easily done in the office to help re-energize you. If it is the secretive quality to the trigger of being alone and eating, maybe it is finding another thing that is just your own that no one knows (going to a movie in the middle of the day, getting an overly priced facial on your lunch hour, playing hooky with your kid one day, etc). The rule of the brain is : what fires together, wires together. So over time- if you have paired 8pm, Narcos, and nachos- you have created a neurological super highway. The moment 8pm rolls around, you are likely already getting the chips ready and didn’t even realize the thought pathway that just occurred. The idea is to repair our triggers with alternative behaviors and over time “clip those wires” or create “toll roads” to our superhighways (aka neurosynaptic pruning), so that we no longer experience such strong urges and can call upon the higher structures of our frontal cortex to guide the way again. When we are in the midst of addiction, it is important to understand that our frontal cortex is not at the wheel. It has been duck taped and tied to a chair in the basement by our hedonic midbrain who is used to getting what it wants when it wants it. The closer we come to accepting this principle, the closer we come to being more mindful of our midbrain’s powerful rationalizations and sick contracts and see them for just that. We are better able to dis-identify from the thought, knowing it is not coming from our best self, but from our most carnal self. Think of that distant cousin that only shows up when they need something, the Uncle Eddy that tells you he’ll move the RV when he leaves next month, indifferent to how it makes you feel. Except in addiction- that distant cousin has taken over, pretending its you until you can no longer tell the difference. References http://brainspotting-switzerland.ch/4_artikel/Corrigan & Grand 2013 Med Hyp paper (proofs).pdf Blum K, Chen AL, Giordano J, Borsten J, Chen TJ, et al. The addictive brain: all roads lead to dopamine. J Psychoactive Drugs. 2012;44:134–143. [PubMed] Avena NM, Gold JA, Kroll C, Gold MS. Further developments in the neurobiology of food and addiction: update on the state of the science. Nutrition. 2012;28:341–343. [PMC free article] [PubMed] Gearhardt AN, Yokum S, Orr PT, Stice E, Corbin WR, et al. Neural correlates of food addiction. Arch Gen Psychiatry. 2011;68:808–816. [PMC free article] [PubMed] Saper CB, Chou TC, Elmquist JK. The need to feed: homeostatic and hedonic control of eating. Neuron. 2002;36:199–211. [PubMed] Stice E, Yokum S, Zald D, Dagher A. Dopamine-based reward circuitry responsivity, genetics, and overeating. Curr Top Behav Neurosci. 2011;6:81–93. [PubMed] Blum K, Sheridan PJ, Wood RC, Braverman ER, Chen TJ, et al. The D2 dopamine receptor gene as a determinant of reward deficiency syndrome. J R Soc Med. 1996;89:396–400. [PMC free article] [PubMed] Comings DE, Flanagan SD, Dietz G, Muhleman D, Knell E, et al. The dopamine D2 receptor (DRD2) as a major gene in obesity and height. Biochem Med Metab Biol. 1993;50:176–185. [PubMed] Noble EP, Noble RE, Ritchie T, Syndulko K, Bohlman MC, et al. D2 dopamine receptor gene and obesity. Int J Eat Disord. 1994;15:205–217. [PubMed] Blumenthal DM, Gold MS. Neurobiology of food addiction. Curr Opin Clin Nutr Metab Care. 2010;13:359–365. [PubMed] Volkow ND, Wang GJ, Fowler JS, Telang F. Overlapping neuronal circuits in addiction and obesity: evidence of systems pathology. Philos Trans R Soc Lond B Biol Sci. 2008;363:3191–3200. [PMC free article] [PubMed] Volkow ND, Wang GJ, Baler RD. Reward, dopamine and the control of food intake: implications for obesity. Trends Cogn Sci. 2011;15:37–46. [PMC free article] [PubMed]

Every time I sit down with someone to do their VSG and Bypass psych pre-op evaluation- they are understandably nervous and on edge. My first question is: "Has anyone explained to you the reason for why you need a psychological evaluation?" and there answer is always, "no, I have no idea why I am here." I explain to them the reasons are threefold: 1) to make sure they understand the risks, benefits, and outcomes of the surgery, 2) to understand any psychological/behavioral ties to food that would benefit from behavioral recommendations/modification, and 3) to help the surgeon understand one's personality as it relates to a healthcare context, to better inform treatment. 1) Most people have been able to go over the risks, benefits, and outcomes with their medical team, but if not- I make sure last minute questions are addressed before they proceed. 2) During the evaluation- we talk about the patient's unique eating behaviors and how to modify them to help with maximum weight loss after the surgery. For instance, last week- I met with a guy who said he normally has a bowl of cereal at night in front of the TV and it provides him with a sense of "contentment." We talked about other ideas to create that same sense of contentment without sabotaging his weight loss surgery outcome, such as reaching out for support, taking a hot bath, listening to music, meditating, journaling, and/or creating a self-care ritual each night before bed. 3) The results of psychological testing provide me with really strong insight into each person's psyche as it relates to a medical setting. For instance, some results will say- " this person is uncomfortable talking about health care issues with strangers and may require more prompting than the average patient," or " this patient is likely to look compliant by being overly agreeable, but has a tendency to venture out on their own, and therefore frequent follow up is recommended," or " this person is uncomfortable in the patient role and will become increasingly agitated in the event of long-term health issues." The 3rd piece of this evaluation is of concern to some, but for the most part- it is meant to help better inform their treatment plan. If a surgeon understands that a patient is more apt to look compliant but "go rogue," they are probably going to incorporate more frequent follow up to make sure that person has the best chance of success. In the end- a psychologist's goal is not to be a hurdle in a patient's weight loss journey, but a catalyst.

Licensed psychologist, Dr. Colleen Long has worked in the field of bariatrics for 10 years and discusses the ins and outs of the pre-op psychological evaluation to put anyone getting ready to go through the process at ease. Every time I sit down with someone to do their VSG and Bypass psych pre-op evaluation- they are understandably nervous and on edge. My first question is: "Has anyone explained to you the reason for why you need a psychological evaluation?" and there answer is always, "no, I have no idea why I am here." I explain to them the reasons are threefold: 1) to make sure they understand the risks, benefits, and outcomes of the surgery, 2) to understand any psychological/behavioral ties to food that would benefit from behavioral recommendations/modification, and 3) to help the surgeon understand one's personality as it relates to a healthcare context, to better inform treatment. 1) Most people have been able to go over the risks, benefits, and outcomes with their medical team, but if not- I make sure last minute questions are addressed before they proceed. 2) During the evaluation- we talk about the patient's unique eating behaviors and how to modify them to help with maximum weight loss after the surgery. For instance, last week- I met with a guy who said he normally has a bowl of cereal at night in front of the TV and it provides him with a sense of "contentment." We talked about other ideas to create that same sense of contentment without sabotaging his weight loss surgery outcome, such as reaching out for support, taking a hot bath, listening to music, meditating, journaling, and/or creating a self-care ritual each night before bed. 3) The results of psychological testing provide me with really strong insight into each person's psyche as it relates to a medical setting. For instance, some results will say- " this person is uncomfortable talking about health care issues with strangers and may require more prompting than the average patient," or " this patient is likely to look compliant by being overly agreeable, but has a tendency to venture out on their own, and therefore frequent follow up is recommended," or " this person is uncomfortable in the patient role and will become increasingly agitated in the event of long-term health issues." The 3rd piece of this evaluation is of concern to some, but for the most part- it is meant to help better inform their treatment plan. If a surgeon understands that a patient is more apt to look compliant but "go rogue," they are probably going to incorporate more frequent follow up to make sure that person has the best chance of success. In the end- a psychologist's goal is not to be a hurdle in a patient's weight loss journey, but a catalyst.

To be truly full from within means that our “tank” is mentally full. In other words, our self, although beaten up, bruised, and broken sometimes as a result of our journey down each of our unique life’s path - is repaired and felt as whole again. Like a patchwork quilt that only gets stronger as a result of its many tears and reparations. How does one achieve this, you ask? Borrowing from Aaron Beck’s cognitive triangle - we have three components of the mind that work to repair the self: THOUGHTS, FEELINGS, BEHAVIORS. These are the different components that must be running on all four cylinders to ensure that we aren’t at risk of developing or perpetuating an unhealthy relationship with any of the topics mentioned above, for the purposes of this article, specifically - food. Thoughts To Repair The Self Mindfulness Based Cognitive Therapy is a 25 cent term to describe the process of looking at the old tapes we run in our minds day in and day out for years upon years, and stopping them in their tracks, and replacing them with new ones. A hallmark approach in Byron Katie’s book “Loving What Is,” is to continuously challenge one’s thoughts by asking “is that really true?” 13 If we deem that we can’t say with absolute certainty that a thought is true, then we can replace it with a more constructive thought. For instance, if we find ourselves with a running narrative that goes something like “you are just never going to be someone that stands out, it’s ok you have other good traits,” then what is the behavior and feelings that it produces? Perhaps the person goes on feeling invisible like many people who are overweight feel. Maybe the person gives up on trying to stand out in the way they look and participate in life. Feelings To Repair The Self For my clients suffering from depression, I will often assign them a task of doing one social event, one bout of exercise (if they have never been inclined to exercise), and one learning activity (lecture, take a CE, attend a webinar, go to a pottery class, painting class, attend a speaking event). Many of them balk at the idea. Some of them have been doing things their way for years and there is an undercurrent of fear related to breaking their routine. It is almost as if the depression has a voice that says “don’t do it, you will only feel worse.” We must realize that when we have depression, our mind is sick. It is no longer serving us, and the messages are coming from crossed wires. In order to uncross those wires, we must physically and literally put one foot in front of the other and re-engage in those activities that we know from the research lead to a sense of happiness or at least contentment. Behaviors To Repair The Self One of the biggest misconceptions about our mind is the idea that we must feel a certain way to engage in certain behaviors. In other words, we must first feel happy if we are going to go to a social event and relate to others in a positive way. However, the cognitive triangle mentioned above is tri-directional14, meaning our behaviors can influence our feelings and/or thoughts, and vice versa. This is powerful information. This means that we don’t have to wait for happiness or joy to come around to engage in behaviors we know lead to more happiness. In fact, one of my first interventions with my patients who suffer from depression is the “just do it” approach, meaning they are given the task of doing three behaviors they don’t necessarily feel like doing in the six days in between their next therapy session. To explain depression via a very simple analogy- it is like the flu for the mind. What do you typically do when you have the flu? You cancel your appointments, stay in bed, drink lots of water, and get lots of rest. The reasoning is that if we minimize the number of life events for a brief bit of time, we will heal more quickly, and we do. BUT, this is not the case with depression. The same intuition we use to combat the flu is the antithesis of what we must do to combat depression, yet somehow our instincts tell us to do the opposite. When we feel depressed, our inclination is to isolate, do less, and wait for the clouds to part. The problem with this is that this type of behavior is what feeds the depression. Suggested Behaviors Benevolence - reaching out to others and getting out of our own head, focusing on how to make someone else’s life or day better through connecting or giving. Play- engaging in something that requires enough effort that we can’t run old unhelpful tapes (I’m not good enough, other people must be more disciplined than me, things will never change, etc), but provides us with enough fun that we leave the activity feeling light, like surfing, artistry, building, writing, playing an instrument, etc. When we are kids, we spend about 95% of our day playing and even trying to find play in our responsibilities (have you ever watched a kid brush their teeth or get dressed? it is never a straightforward buttoned up process). Yet, as adults - we flip that on its head and spend 95% of our time being a human doing vs. a human being. Learning- engaging in novelty is something our brain requires to feel happy and fed. It could be as simple as learning a new card game, all the way to enrolling in an MBA course. When we allow our minds to do what they are best at - our minds give back to us. Connection- We are social creatures by nature. There is a physiological rewiring process that occurs as result of being in near proximity to other humans. It is how we survived so long ago, and our minds still provide the payoff. We are not meant to live in isolation, yet so many of us drift in this direction when they are depressed. Even introverts require some social connection. While extroverts tend to thrive and recharge their batteries on social connection, it is true that introverts recharge in their solitude. However, there is a difference between being alone vs. lonely. As introverted as you may think you are, none of us are immune to going from alone to lonely if we don’t make time for some social connection. Exercise- There are about 99 reasons to exercise and happiness is one. I’m not going to waste space and wax poetic about the many benefits of exercise because I’m sure you’re well aware. But in addition to producing endorphins that have been proven to make us feel better, as far as weight loss goes- it also makes us less likely to put junk in our bodies. Ever do an intense sweat session and then make a beeline to the nearest McDonald’s? I didn’t think so.

What does it mean to be “full from within?” "This concept refers to the idea that we no longer have this psychological “black hole,” that needs to be fed through external things such as; food, drugs, alcohol, spending, relationships, gambling." ~ Dr. Colleen, The Psychology of Finally Being Full From Within To be truly full from within means that our “tank” is mentally full. In other words, our self, although beaten up, bruised, and broken sometimes as a result of our journey down each of our unique life’s path - is repaired and felt as whole again. Like a patchwork quilt that only gets stronger as a result of its many tears and reparations. How does one achieve this, you ask? Borrowing from Aaron Beck’s cognitive triangle - we have three components of the mind that work to repair the self: THOUGHTS, FEELINGS, BEHAVIORS. These are the different components that must be running on all four cylinders to ensure that we aren’t at risk of developing or perpetuating an unhealthy relationship with any of the topics mentioned above, for the purposes of this article, specifically - food. Thoughts To Repair The Self Mindfulness Based Cognitive Therapy is a 25 cent term to describe the process of looking at the old tapes we run in our minds day in and day out for years upon years, and stopping them in their tracks, and replacing them with new ones. A hallmark approach in Byron Katie’s book “Loving What Is,” is to continuously challenge one’s thoughts by asking “is that really true?” 13 If we deem that we can’t say with absolute certainty that a thought is true, then we can replace it with a more constructive thought. For instance, if we find ourselves with a running narrative that goes something like “you are just never going to be someone that stands out, it’s ok you have other good traits,” then what is the behavior and feelings that it produces? Perhaps the person goes on feeling invisible like many people who are overweight feel. Maybe the person gives up on trying to stand out in the way they look and participate in life. Feelings To Repair The Self For my clients suffering from depression, I will often assign them a task of doing one social event, one bout of exercise (if they have never been inclined to exercise), and one learning activity (lecture, take a CE, attend a webinar, go to a pottery class, painting class, attend a speaking event). Many of them balk at the idea. Some of them have been doing things their way for years and there is an undercurrent of fear related to breaking their routine. It is almost as if the depression has a voice that says “don’t do it, you will only feel worse.” We must realize that when we have depression, our mind is sick. It is no longer serving us, and the messages are coming from crossed wires. In order to uncross those wires, we must physically and literally put one foot in front of the other and re-engage in those activities that we know from the research lead to a sense of happiness or at least contentment. Behaviors To Repair The Self One of the biggest misconceptions about our mind is the idea that we must feel a certain way to engage in certain behaviors. In other words, we must first feel happy if we are going to go to a social event and relate to others in a positive way. However, the cognitive triangle mentioned above is tri-directional14, meaning our behaviors can influence our feelings and/or thoughts, and vice versa. This is powerful information. This means that we don’t have to wait for happiness or joy to come around to engage in behaviors we know lead to more happiness. In fact, one of my first interventions with my patients who suffer from depression is the “just do it” approach, meaning they are given the task of doing three behaviors they don’t necessarily feel like doing in the six days in between their next therapy session. To explain depression via a very simple analogy- it is like the flu for the mind. What do you typically do when you have the flu? You cancel your appointments, stay in bed, drink lots of water, and get lots of rest. The reasoning is that if we minimize the number of life events for a brief bit of time, we will heal more quickly, and we do. BUT, this is not the case with depression. The same intuition we use to combat the flu is the antithesis of what we must do to combat depression, yet somehow our instincts tell us to do the opposite. When we feel depressed, our inclination is to isolate, do less, and wait for the clouds to part. The problem with this is that this type of behavior is what feeds the depression. Suggested Behaviors Benevolence - reaching out to others and getting out of our own head, focusing on how to make someone else’s life or day better through connecting or giving. Play- engaging in something that requires enough effort that we can’t run old unhelpful tapes (I’m not good enough, other people must be more disciplined than me, things will never change, etc), but provides us with enough fun that we leave the activity feeling light, like surfing, artistry, building, writing, playing an instrument, etc. When we are kids, we spend about 95% of our day playing and even trying to find play in our responsibilities (have you ever watched a kid brush their teeth or get dressed? it is never a straightforward buttoned up process). Yet, as adults - we flip that on its head and spend 95% of our time being a human doing vs. a human being. Learning- engaging in novelty is something our brain requires to feel happy and fed. It could be as simple as learning a new card game, all the way to enrolling in an MBA course. When we allow our minds to do what they are best at - our minds give back to us. Connection- We are social creatures by nature. There is a physiological rewiring process that occurs as result of being in near proximity to other humans. It is how we survived so long ago, and our minds still provide the payoff. We are not meant to live in isolation, yet so many of us drift in this direction when they are depressed. Even introverts require some social connection. While extroverts tend to thrive and recharge their batteries on social connection, it is true that introverts recharge in their solitude. However, there is a difference between being alone vs. lonely. As introverted as you may think you are, none of us are immune to going from alone to lonely if we don’t make time for some social connection. Exercise- There are about 99 reasons to exercise and happiness is one. I’m not going to waste space and wax poetic about the many benefits of exercise because I’m sure you’re well aware. But in addition to producing endorphins that have been proven to make us feel better, as far as weight loss goes- it also makes us less likely to put junk in our bodies. Ever do an intense sweat session and then make a beeline to the nearest McDonald’s? I didn’t think so.

Dr. Colleen talks about 8 simple behaviors that can help you really see the change you've been seeking in your life. Maybe if you are reading this, you have already begun to change. Maybe you have been chewing on the prospect of change but find yourself doing the same thing from week to week? Today's article is short and sweet. Below, I will outline the top 8 behaviors to implement on the daily to bring change forth or take the current progress you've made to the next level: 1. find a book, any book that deals with the change you want to happen (this can be someone else's success story, or a self help book, or my book ). The idea is to refresh your inner template for why you want to change in the first place. 2. Create a reading list of the resources you know help to keep you on the right track and make a point to read an excerpt for 10 minutes each morning to start your day (podcasts, blogs, IG story, my full from within course, a favorite book, an online support community, etc). 3. Yoga/meditation- create a space for the mind and body to heal. You will be surprised how much easier change is to implement when mind and body have been given the gift of stillness and when we shift from human doings to human beings. 4. Take self care breaks EVERY DAY. Doesn't mean you need to go to a spa every day. Make it a priority to carve out self time every day. If you were recovering or sick in the hospital you would have no problem giving yourself a break in an effort to recover. Change is also recovery from what was broken. 5. Exercise. 6. Create a gratitude practice. Change is often times about what is not working. However, gratitude helps us to focus on what is working. We can get so mired into the myopic view that we are wrong and everyone else must be doing it right. It is important to balance our view of our path with this practice. I highly recommend the gratitude app- which allows you to include pics from your day and serve as an ongoing gratitude feed. 7. Sit down and write down the reasons why you are changing in the first place. I know many of you think "of course I know why I'm doing this." However, it is important to reconnect with your core self frequently to get all of the motivation needed to change. You may be surprised what else was there waiting for you. 8. If it is food that you are trying to change (in terms of what you are eating or how much). This week try thinking "Yay, I don't have to eat that way anymore," vs. "ok now the vacation is over and its time to pay the piper." That's it. Good luck on this next chapter! PS- What are you struggling with? Did you read my book? Was there something missing you would have like to read? Was there something more you wanted to know about? What do you struggle with psychologically when it comes to WLS?

Maybe if you are reading this, you have already begun to change. Maybe you have been chewing on the prospect of change but find yourself doing the same thing from week to week? Today's article is short and sweet. Below, I will outline the top 8 behaviors to implement on the daily to bring change forth or take the current progress you've made to the next level: 1. find a book, any book that deals with the change you want to happen (this can be someone else's success story, or a self help book, or my book ). The idea is to refresh your inner template for why you want to change in the first place. 2. Create a reading list of the resources you know help to keep you on the right track and make a point to read an excerpt for 10 minutes each morning to start your day (podcasts, blogs, IG story, my full from within course, a favorite book, an online support community, etc). 3. Yoga/meditation- create a space for the mind and body to heal. You will be surprised how much easier change is to implement when mind and body have been given the gift of stillness and when we shift from human doings to human beings. 4. Take self care breaks EVERY DAY. Doesn't mean you need to go to a spa every day. Make it a priority to carve out self time every day. If you were recovering or sick in the hospital you would have no problem giving yourself a break in an effort to recover. Change is also recovery from what was broken. 5. Exercise. 6. Create a gratitude practice. Change is often times about what is not working. However, gratitude helps us to focus on what is working. We can get so mired into the myopic view that we are wrong and everyone else must be doing it right. It is important to balance our view of our path with this practice. I highly recommend the gratitude app- which allows you to include pics from your day and serve as an ongoing gratitude feed. 7. Sit down and write down the reasons why you are changing in the first place. I know many of you think "of course I know why I'm doing this." However, it is important to reconnect with your core self frequently to get all of the motivation needed to change. You may be surprised what else was there waiting for you. 8. If it is food that you are trying to change (in terms of what you are eating or how much). This week try thinking "Yay, I don't have to eat that way anymore," vs. "ok now the vacation is over and its time to pay the piper." That's it. Good luck on this next chapter! PS- What are you struggling with? Did you read my book? Was there something missing you would have like to read? Was there something more you wanted to know about? What do you struggle with psychologically when it comes to WLS?

This time of year, we are constantly bombarded with messages of change- so much so, that many of us throw our hands up in the air and say "I don't make resolutions anymore," or my favorite "I don't believe in resolutions." Try to make a big change with one simple tool this time. I know so many of you are in some way thinking about how you'd like to hit the reset button in 2018. One of the most common issues clients face is the discrepancy between their long term desires and their short term actions. Here's a quick 5 minute tool, that if you use it as a framework each Sunday (or whatever the day before your week starts is), will change your life in terms of how you feel you manage your time. Use my following 6 point framework to help organize your week and start to feel like you are finally living your life instead of it living you.... PS- "Mike" is my partner, so feel free to change that category to someone in your life that helps to support you throughout your week Psssst... If you want to receive periodic tips on the psychological aspects of VSG and WLS, please shoot me an email at talkdoc126@gmail.com or friend "drcolleen long" on Facebook and let me know you're interested in support. I'm also taking half off my Full From Within Ultimate course today through January 8th with promo code HALF2018 - if you want to really hit the reset button and step up your eating game in 2018. Just as a reminder, in the course, you receive: and weight, from a psychological perspective. The catalyst you need to rebuild motivation and/or stop yourself from plateauing, or worse- re-gaining the weight. In this course you will get: the ULTIMATE weight loss guide which is chock full of resources including apps, websites, and books to make your weight loss journey as easy as possible understanding of how to create a new relationship with food understanding WHY you eat vs. just focusing on WHAT you eat eliminate overeating and bingeing journal challenges to help you critically think about how these principles will be applied to your new life tips on how to stay slim in a work from home culture, where food is always readily accessible guided hypnosis to target the deeper subconscious that is so difficult to change and can impede our goals despite our best intentions daily habits of highly successful weight loss how to become a natural exerciser yoga & mindfulness for weight loss how to navigate the psychosocial aspects of weight loss such as family, friends, and social events hard and fast tips to get rid of the grey area that gets so many people in to trouble behavioral steps that will help make this attempt feel "real" and solid identifying the triggers of over eating whether it be emotional eating, lack of planning, cognitive distortions, etc the ONE fundamental shift that must take place so that this doesn't feel like yet another diet practical real life psychological coping strategies to avoiding over-eating and food addiction recovery from food addiction visual tools that will help in your weight loss journey learning to define a new quality of life personality factors to consider that can effect your weight loss success clipping your psychological addiction wires- unpacking emotions related to excessive calories

I know so many of you are in some way thinking about how you'd like to hit the reset button in 2018. One of the most common issues clients face is the discrepancy between their long term desires and their short term actions. Here's a quick 5 minute tool, that if you use it as a framework each Sunday (or whatever the day before your week starts is), will change your life in terms of how you feel you manage your time. Use my following 6 point framework to help organize your week and start to feel like you are finally living your life instead of it living you.... PS- "Mike" is my partner, so feel free to change that category to someone in your life that helps to support you throughout your week Psssst... If you want to receive periodic tips on the psychological aspects of VSG and WLS, please shoot me an email at talkdoc126@gmail.com or friend "drcolleen long" on Facebook and let me know you're interested in support. I'm also taking half off my Full From Within Ultimate course today through January 8th with promo code HALF2018 - if you want to really hit the reset button and step up your eating game in 2018. Just as a reminder, in the course, you receive: and weight, from a psychological perspective. The catalyst you need to rebuild motivation and/or stop yourself from plateauing, or worse- re-gaining the weight. In this course you will get: the ULTIMATE weight loss guide which is chock full of resources including apps, websites, and books to make your weight loss journey as easy as possible understanding of how to create a new relationship with food understanding WHY you eat vs. just focusing on WHAT you eat eliminate overeating and bingeing journal challenges to help you critically think about how these principles will be applied to your new life tips on how to stay slim in a work from home culture, where food is always readily accessible guided hypnosis to target the deeper subconscious that is so difficult to change and can impede our goals despite our best intentions daily habits of highly successful weight loss how to become a natural exerciser yoga & mindfulness for weight loss how to navigate the psychosocial aspects of weight loss such as family, friends, and social events hard and fast tips to get rid of the grey area that gets so many people in to trouble behavioral steps that will help make this attempt feel "real" and solid identifying the triggers of over eating whether it be emotional eating, lack of planning, cognitive distortions, etc the ONE fundamental shift that must take place so that this doesn't feel like yet another diet practical real life psychological coping strategies to avoiding over-eating and food addiction recovery from food addiction visual tools that will help in your weight loss journey learning to define a new quality of life personality factors to consider that can effect your weight loss success clipping your psychological addiction wires- unpacking emotions related to excessive calories

Well, how did you do? One of the biggest "foodie" holidays of the year just passed us by, which can be a MAJOR trigger for those who struggle with food addiction. If you're shaking your head in regret, please read on below to learn how to quickly get back on track. Well, how did you do? One of the biggest "foodie" holidays of the year just passed us by, which can be a MAJOR trigger for those who struggle with food addiction. If you're one of the lucky few, who is able to look back over the holiday proudly, and say "there is nothing I would have changed," then congratulations! I am genuinely interested in reading your comments below about what worked for you; did you remove yourself from the triggering environments, distract yourself by playing a card game or talking with another family member trying to do the same, did you re-read your bariatric surgery "why's," to reinforce your motivation that day, or was there something else that worked to keep you on track? "It's not how we fall. It's how we get back up again." - Patrick Ness For those of you who are shaking your head in regret this morning, you are not alone. There are thousands of other WLS patients who struggled to stay on track over the holidays. The biggest struggle I've hear throughout the years is that the motivation is dented, diluted, or zapped when one first gets off track from their plan. Enter code CYBERSALE to get my Full From Within Psychological Tools for WLS patients course 50% off today only. There is a lot of psychology behind this. Part of the magic in resolutions is their novelty: an implicit contract within the self that says "this will be unlike anything I've ever done before." When we relapse (or "slip" as I prefer to call it), the self goes "oh wait a minute, I know how this goes, maybe this is no different than before, who am I to think I could do this, I have no willpower, etc., etc., etc." So the idea is to find a new plan. It can be bits and bobs of the one you had before, but it needs to have that new car smell again to have longevity. I am including an excerpt of an earlier article I wrote about how to do just that: What do we do when we fall from grace? The research on relapse (with any addiction; food, drugs, alcohol) is that recidivism is the rule not the exception. So why do we get so down on ourselves when we fall short of our goals? Why is it so hard to get back on the horse with the same vigor we had when we started? And how do we give ourselves a renewed sense of hope and motivation for change once we've fallen? “The secret of change is to focus all of your energy not on fighting the old, but on building the new.” - Socrates Everyone does well out of the gates. We all impress ourselves when we start, what we believe to be, a new lifestyle change. However, "out of the gates," can mean different things for different people; for some it is two months, for others (usually depending on how strong the addiction or habit is) it can be two minutes. But what do we do when we fall from grace? The research on relapse (with any addiction; food, drugs, alcohol) is that recidivism is the rule not the exception. So why do we get so down on ourselves when we fall short of our goals? Why is it so hard to get back on the horse with the same vigor we had when we started? And how do we give ourselves a renewed sense of hope and motivation for change once we've fallen? One magical ingredient in the secret sauce (and one of many concepts I talk about in my book and my wls courses) that is lifestyle change is the novelty effect. The new plan to quit something or change a bad habit is something unlike we have ever done before, so we hope that we can achieve something we have never done before. The problem is that the moment we slip, that novelty loses its magic - and each time we start over, it loses its power to give us hope. So the solution is to cultivate more novelty. Our ability to continually grow and change is largely limited by our creativity. The more creative we become, the easier it is to take a different approach to change. To open a window when life seems to shut the door. In other words- what I am telling you, is that the only secret to long term weight loss maintenance is the knowledge that there isn't only one secret. There is no ONE diet that will forever change someone. Eventually people get tired of eating bacon and eggs every meal on Atkins, or grapefruit, or cabbage soup- but the thread they all share is their novelty. This is why all of them can work initially. Even as powerful as weight loss surgery is- people still find that they start to plateau or even gain the weight back if they aren't simultaneously addressing the behavioral and psychological factors that got them there in the first place. They too, must also continuously be creative about renewing one self throughout their lifetime. So the following is for all of you who are struggling today. Those that feel they have lost their way and perhaps feel disenchanted or disappointed. Below is a recovery "map" I created a long time ago for my clients, some struggling with substance abuse, others with food. It all works the same. Print it out, or copy and paste it in the notes section of your phone and take 20 minutes to fill it out with the things that are personally meaningful for you. This is not THE answer to long term recovery from addiction, but it is a fresh approach for many who feel stale at the moment: Baptism - Some ceremony to signal a renewed sense of hope and a fresh start. One client trying to recover from substance abuse, buried all of his wine and liquor bottles in his yard. Another client had a "garbage party" with her kiddos, and they loved smashing all the processed foods they had in their pantry and throwing them in the trash. Associations/triggers list all of the things that get you into trouble (being at a bbq, wanting to Celebrate something, holidays, 7-10pm at night, date night, etc) Coping Skills (what gets you through the crave waves) These are the behaviors that you do INSTEAD of the addictive behavior. Extra credit if you are able to make a coping skill for each trigger listed above. Enter code CYBERSALE to get my Full From Within Psychological Tools for WLS patients course 50% off today only. Higher Desires/Vision of Self when you let go of your attachment to food and all the self loathing, mental, and physical heaviness it brings- what are you freeing your life up for? will you write a book? will you do more outdoor activities with your kids? do you want to resume an activity you once loved as a child? Is there a role model that inspires you that has done what you want to do? Cons Why are you doing this in the first place? These are the things that are hard to keep in mind when our reptilian mid brain (see last article) is at the wheel. What is personally meaningful? Does it age you? Does it make you feel out of control? Do you dread going on airplanes because you know you'll need an extender? does it prevent you from going to amusement parks with your kiddos? Spirituality (religion gets us into heaven, spirituality gets us out of hell) All addiction is what disconnects us from our deeper self and edges us further and further away from God (or whatever you like to call it) and our deeper spirituality. Spirituality is what allows us to move into the unknown, be comfortable with discomfort, and have faith that everything will be ok. It can include a gratitude practice, volunteering, play, aligning one self with nature, connecting with a spiritual e newsletter (mind body green, daily om, etc), generosity, etc. Daily Recovery Ritual (symbolic gesture to self every day that we are consciously devoting time to our recovery) What are the things you can do daily to symbolize to yourself that today is a new day? Keep it realistic or you won't do it. Vitamins, meditation, lemon Water, supplements, self care, reaching out to a loved one, exercise, etc. Reward System What will you do for yourself if there is a certain period of time reached where you meet your goals? Will you get a massage at the end of every month? Will you plan a vacation after three months of solid goal hitting? Will you reward yourself with one day per week of going to the movies in the middle of the day and playing hooky if you're on the straight and narrow for five days? Strategy This is your "what." What are you doing daily to ensure that you are in alignment with your goals? Are you reading something fresh all the time? Do you make a timeline of your addiction and how it has affected your life? Do you go to local support meetings each week? Do you keep in touch with an online community? Do you make sure to give yourself small breaks while with the kids every day? Do you have a self care space set up in your house? Do you talk to a partner about how to change behaviors of theirs that might be hindering your efforts? can they get a mini fridge? Do you do acupuncture to balance your chi? Do you do yoga to manage your depression? Do you find a therapist? Recovery Resources (try to hit one each morning) what resources are in your pocket when you are feeling weak? bariatricpal.com? WLS journeys on Instagram? The Fix, Reddit, unique blogs documenting their weight loss journey, wls and vsg searches on Pinterest, etc. Good luck on your fresh start! Need extra motivation? Use code "CYBERSALE" to get my course: Full From Within Ultimate Psychological Tools for WLS patients half off today only, or try my FFW mini for free.

Well, how did you do? One of the biggest "foodie" holidays of the year just passed us by, which can be a MAJOR trigger for those who struggle with food addiction. If you're one of the lucky few, who is able to look back over the holiday proudly, and say "there is nothing I would have changed," then congratulations! I am genuinely interested in reading your comments below about what worked for you; did you remove yourself from the triggering environments, distract yourself by playing a card game or talking with another family member trying to do the same, did you re-read your bariatric surgery "why's," to reinforce your motivation that day, or was there something else that worked to keep you on track? "It's not how we fall. It's how we get back up again." - Patrick Ness For those of you who are shaking your head in regret this morning, you are not alone. There are thousands of other WLS patients who struggled to stay on track over the holidays. The biggest struggle I've hear throughout the years is that the motivation is dented, diluted, or zapped when one first gets off track from their plan. Enter code CYBERSALE to get my Full From Within Psychological Tools for WLS patients course 50% off today only. There is a lot of psychology behind this. Part of the magic in resolutions is their novelty: an implicit contract within the self that says "this will be unlike anything I've ever done before." When we relapse (or "slip" as I prefer to call it), the self goes "oh wait a minute, I know how this goes, maybe this is no different than before, who am I to think I could do this, I have no willpower, etc., etc., etc." So the idea is to find a new plan. It can be bits and bobs of the one you had before, but it needs to have that new car smell again to have longevity. I am including an excerpt of an earlier article I wrote about how to do just that: What do we do when we fall from grace? The research on relapse (with any addiction; food, drugs, alcohol) is that recidivism is the rule not the exception. So why do we get so down on ourselves when we fall short of our goals? Why is it so hard to get back on the horse with the same vigor we had when we started? And how do we give ourselves a renewed sense of hope and motivation for change once we've fallen? “The secret of change is to focus all of your energy not on fighting the old, but on building the new.” - Socrates Everyone does well out of the gates. We all impress ourselves when we start, what we believe to be, a new lifestyle change. However, "out of the gates," can mean different things for different people; for some it is two months, for others (usually depending on how strong the addiction or habit is) it can be two minutes. But what do we do when we fall from grace? The research on relapse (with any addiction; food, drugs, alcohol) is that recidivism is the rule not the exception. So why do we get so down on ourselves when we fall short of our goals? Why is it so hard to get back on the horse with the same vigor we had when we started? And how do we give ourselves a renewed sense of hope and motivation for change once we've fallen? One magical ingredient in the secret sauce (and one of many concepts I talk about in my book and my wls courses) that is lifestyle change is the novelty effect. The new plan to quit something or change a bad habit is something unlike we have ever done before, so we hope that we can achieve something we have never done before. The problem is that the moment we slip, that novelty loses its magic - and each time we start over, it loses its power to give us hope. So the solution is to cultivate more novelty. Our ability to continually grow and change is largely limited by our creativity. The more creative we become, the easier it is to take a different approach to change. To open a window when life seems to shut the door. In other words- what I am telling you, is that the only secret to long term weight loss maintenance is the knowledge that there isn't only one secret. There is no ONE diet that will forever change someone. Eventually people get tired of eating bacon and eggs every meal on Atkins, or grapefruit, or cabbage soup- but the thread they all share is their novelty. This is why all of them can work initially. Even as powerful as weight loss surgery is- people still find that they start to plateau or even gain the weight back if they aren't simultaneously addressing the behavioral and psychological factors that got them there in the first place. They too, must also continuously be creative about renewing one self throughout their lifetime. So the following is for all of you who are struggling today. Those that feel they have lost their way and perhaps feel disenchanted or disappointed. Below is a recovery "map" I created a long time ago for my clients, some struggling with substance abuse, others with food. It all works the same. Print it out, or copy and paste it in the notes section of your phone and take 20 minutes to fill it out with the things that are personally meaningful for you. This is not THE answer to long term recovery from addiction, but it is a fresh approach for many who feel stale at the moment: Baptism - Some ceremony to signal a renewed sense of hope and a fresh start. One client trying to recover from substance abuse, buried all of his wine and liquor bottles in his yard. Another client had a "garbage party" with her kiddos, and they loved smashing all the processed foods they had in their pantry and throwing them in the trash. Associations/triggers list all of the things that get you into trouble (being at a bbq, wanting to Celebrate something, holidays, 7-10pm at night, date night, etc) Coping Skills (what gets you through the crave waves) These are the behaviors that you do INSTEAD of the addictive behavior. Extra credit if you are able to make a coping skill for each trigger listed above. Enter code CYBERSALE to get my Full From Within Psychological Tools for WLS patients course 50% off today only. Higher Desires/Vision of Self when you let go of your attachment to food and all the self loathing, mental, and physical heaviness it brings- what are you freeing your life up for? will you write a book? will you do more outdoor activities with your kids? do you want to resume an activity you once loved as a child? Is there a role model that inspires you that has done what you want to do? Cons Why are you doing this in the first place? These are the things that are hard to keep in mind when our reptilian mid brain (see last article) is at the wheel. What is personally meaningful? Does it age you? Does it make you feel out of control? Do you dread going on airplanes because you know you'll need an extender? does it prevent you from going to amusement parks with your kiddos? Spirituality (religion gets us into heaven, spirituality gets us out of hell) All addiction is what disconnects us from our deeper self and edges us further and further away from God (or whatever you like to call it) and our deeper spirituality. Spirituality is what allows us to move into the unknown, be comfortable with discomfort, and have faith that everything will be ok. It can include a gratitude practice, volunteering, play, aligning one self with nature, connecting with a spiritual e newsletter (mind body green, daily om, etc), generosity, etc. Daily Recovery Ritual (symbolic gesture to self every day that we are consciously devoting time to our recovery) What are the things you can do daily to symbolize to yourself that today is a new day? Keep it realistic or you won't do it. Vitamins, meditation, lemon Water, supplements, self care, reaching out to a loved one, exercise, etc. Reward System What will you do for yourself if there is a certain period of time reached where you meet your goals? Will you get a massage at the end of every month? Will you plan a vacation after three months of solid goal hitting? Will you reward yourself with one day per week of going to the movies in the middle of the day and playing hooky if you're on the straight and narrow for five days? Strategy This is your "what." What are you doing daily to ensure that you are in alignment with your goals? Are you reading something fresh all the time? Do you make a timeline of your addiction and how it has affected your life? Do you go to local support meetings each week? Do you keep in touch with an online community? Do you make sure to give yourself small breaks while with the kids every day? Do you have a self care space set up in your house? Do you talk to a partner about how to change behaviors of theirs that might be hindering your efforts? can they get a mini fridge? Do you do acupuncture to balance your chi? Do you do yoga to manage your depression? Do you find a therapist? Recovery Resources (try to hit one each morning) what resources are in your pocket when you are feeling weak? bariatricpal.com? WLS journeys on Instagram? The Fix, Reddit, unique blogs documenting their weight loss journey, wls and vsg searches on Pinterest, etc. Good luck on your fresh start! Need extra motivation? Use code "CYBERSALE" to get my course: Full From Within Ultimate Psychological Tools for WLS patients half off today only, or try my FFW mini for free.

What do we do when we fall from grace? The research on relapse (with any addiction; food, drugs, alcohol) is that recidivism is the rule not the exception. So why do we get so down on ourselves when we fall short of our goals? Why is it so hard to get back on the horse with the same vigor we had when we started? And how do we give ourselves a renewed sense of hope and motivation for change once we've fallen? “The secret of change is to focus all of your energy not on fighting the old, but on building the new.” - Socrates Everyone does well out of the gates. We all impress ourselves when we start, what we believe to be, a new lifestyle change. However, "out of the gates," can mean different things for different people; for some it is two months, for others (usually depending on how strong the addiction or habit is) it can be two minutes. But what do we do when we fall from grace? The research on relapse (with any addiction; food, drugs, alcohol) is that recidivism is the rule not the exception. So why do we get so down on ourselves when we fall short of our goals? Why is it so hard to get back on the horse with the same vigor we had when we started? And how do we give ourselves a renewed sense of hope and motivation for change once we've fallen? One magical ingredient in the secret sauce (and one of many concepts I talk about in my book and my wls courses) that is lifestyle change is the novelty effect. The new plan to quit something or change a bad habit is something unlike we have ever done before, so we hope that we can achieve something we have never done before. The problem is that the moment we slip, that novelty loses its magic - and each time we start over, it loses its power to give us hope. So the solution is to cultivate more novelty. Our ability to continually grow and change is largely limited by our creativity. The more creative we become, the easier it is to take a different approach to change. To open a window when life seems to shut the door. In other words- what I am telling you, is that the only secret to long term weight loss maintenance is the knowledge that there isn't only one secret. There is no ONE diet that will forever change someone. Eventually people get tired of eating bacon and eggs every meal on Atkins, or grapefruit, or cabbage soup- but the thread they all share is their novelty. This is why all of them can work initially. Even as powerful as weight loss surgery is- people still find that they start to plateau or even gain the weight back if they aren't simultaneously addressing the behavioral and psychological factors that got them there in the first place. They too, must also continuously be creative about renewing one self throughout their lifetime. So the following is for all of you who are struggling today. Those that feel they have lost their way and perhaps feel disenchanted or disappointed. Below is a recovery "map" I created a long time ago for my clients, some struggling with substance abuse, others with food. It all works the same. Print it out, or copy and paste it in the notes section of your phone and take 20 minutes to fill it out with the things that are personally meaningful for you. This is not THE answer to long term recovery from addiction, but it is a fresh approach for many who feel stale at the moment: Baptism - Some ceremony to signal a renewed sense of hope and a fresh start. One client trying to recover from substance abuse, buried all of his wine and liquor bottles in his yard. Another client had a "garbage party" with her kiddos, and they loved smashing all the processed foods they had in their pantry and throwing them in the trash. Associations/triggers list all of the things that get you into trouble (being at a bbq, wanting to celebrate something, holidays, 7-10pm at night, date night, etc) Coping Skills (what gets you through the crave waves) These are the behaviors that you do INSTEAD of the addictive behavior. Extra credit if you are able to make a coping skill for each trigger listed above. Higher Desires/Vision of Self when you let go of your attachment to food and all the self loathing, mental, and physical heaviness it brings- what are you freeing your life up for? will you write a book? will you do more outdoor activities with your kids? do you want to resume an activity you once loved as a child? Is there a role model that inspires you that has done what you want to do? Cons Why are you doing this in the first place? These are the things that are hard to keep in mind when our reptilian mid brain (see last article) is at the wheel. What is personally meaningful? Does it age you? Does it make you feel out of control? Do you dread going on airplanes because you know you'll need an extender? does it prevent you from going to amusement parks with your kiddos? Spirituality (religion gets us into heaven, spirituality gets us out of hell) All addiction is what disconnects us from our deeper self and edges us further and further away from God (or whatever you like to call it) and our deeper spirituality. Spirituality is what allows us to move into the unknown, be comfortable with discomfort, and have faith that everything will be ok. It can include a gratitude practice, volunteering, play, aligning one self with nature, connecting with a spiritual e newsletter (mind body green, daily om, etc), generosity, etc. Daily Recovery Ritual (symbolic gesture to self every day that we are consciously devoting time to our recovery) What are the things you can do daily to symbolize to yourself that today is a new day? Keep it realistic or you won't do it. Vitamins, meditation, lemon water, supplements, self care, reaching out to a loved one, exercise, etc. Reward System What will you do for yourself if there is a certain period of time reached where you meet your goals? Will you get a massage at the end of every month? Will you plan a vacation after three months of solid goal hitting? Will you reward yourself with one day per week of going to the movies in the middle of the day and playing hooky if you're on the straight and narrow for five days? Strategy This is your "what." What are you doing daily to ensure that you are in alignment with your goals? Are you reading something fresh all the time? Do you make a timeline of your addiction and how it has affected your life? Do you go to local support meetings each week? Do you keep in touch with an online community? Do you make sure to give yourself small breaks while with the kids every day? Do you have a self care space set up in your house? Do you talk to a partner about how to change behaviors of theirs that might be hindering your efforts? can they get a mini fridge? Do you do acupuncture to balance your chi? Do you do yoga to manage your depression? Do you find a therapist? Recovery Resources (try to hit one each morning) what resources are in your pocket when you are feeling weak? bariatricpal.com? WLS journeys on Instagram? The Fix, Reddit, unique blogs documenting their weight loss journey, wls and vsg searches on Pinterest, etc. Good luck on your fresh start!

“The secret of change is to focus all of your energy not on fighting the old, but on building the new.” - Socrates Everyone does well out of the gates. We all impress ourselves when we start, what we believe to be, a new lifestyle change. However, "out of the gates," can mean different things for different people; for some it is two months, for others (usually depending on how strong the addiction or habit is) it can be two minutes. But what do we do when we fall from grace? The research on relapse (with any addiction; food, drugs, alcohol) is that recidivism is the rule not the exception. So why do we get so down on ourselves when we fall short of our goals? Why is it so hard to get back on the horse with the same vigor we had when we started? And how do we give ourselves a renewed sense of hope and motivation for change once we've fallen? One magical ingredient in the secret sauce (and one of many concepts I talk about in my book and my wls courses) that is lifestyle change is the novelty effect. The new plan to quit something or change a bad habit is something unlike we have ever done before, so we hope that we can achieve something we have never done before. The problem is that the moment we slip, that novelty loses its magic - and each time we start over, it loses its power to give us hope. So the solution is to cultivate more novelty. Our ability to continually grow and change is largely limited by our creativity. The more creative we become, the easier it is to take a different approach to change. To open a window when life seems to shut the door. In other words- what I am telling you, is that the only secret to long term weight loss maintenance is the knowledge that there isn't only one secret. There is no ONE diet that will forever change someone. Eventually people get tired of eating bacon and eggs every meal on Atkins, or grapefruit, or cabbage soup- but the thread they all share is their novelty. This is why all of them can work initially. Even as powerful as weight loss surgery is- people still find that they start to plateau or even gain the weight back if they aren't simultaneously addressing the behavioral and psychological factors that got them there in the first place. They too, must also continuously be creative about renewing one self throughout their lifetime. So the following is for all of you who are struggling today. Those that feel they have lost their way and perhaps feel disenchanted or disappointed. Below is a recovery "map" I created a long time ago for my clients, some struggling with substance abuse, others with food. It all works the same. Print it out, or copy and paste it in the notes section of your phone and take 20 minutes to fill it out with the things that are personally meaningful for you. This is not THE answer to long term recovery from addiction, but it is a fresh approach for many who feel stale at the moment: Baptism - Some ceremony to signal a renewed sense of hope and a fresh start. One client trying to recover from substance abuse, buried all of his wine and liquor bottles in his yard. Another client had a "garbage party" with her kiddos, and they loved smashing all the processed foods they had in their pantry and throwing them in the trash. Associations/triggers list all of the things that get you into trouble (being at a bbq, wanting to celebrate something, holidays, 7-10pm at night, date night, etc) Coping Skills (what gets you through the crave waves) These are the behaviors that you do INSTEAD of the addictive behavior. Extra credit if you are able to make a coping skill for each trigger listed above. Higher Desires/Vision of Self when you let go of your attachment to food and all the self loathing, mental, and physical heaviness it brings- what are you freeing your life up for? will you write a book? will you do more outdoor activities with your kids? do you want to resume an activity you once loved as a child? Is there a role model that inspires you that has done what you want to do? Cons Why are you doing this in the first place? These are the things that are hard to keep in mind when our reptilian mid brain (see last article) is at the wheel. What is personally meaningful? Does it age you? Does it make you feel out of control? Do you dread going on airplanes because you know you'll need an extender? does it prevent you from going to amusement parks with your kiddos? Spirituality (religion gets us into heaven, spirituality gets us out of hell) All addiction is what disconnects us from our deeper self and edges us further and further away from God (or whatever you like to call it) and our deeper spirituality. Spirituality is what allows us to move into the unknown, be comfortable with discomfort, and have faith that everything will be ok. It can include a gratitude practice, volunteering, play, aligning one self with nature, connecting with a spiritual e newsletter (mind body green, daily om, etc), generosity, etc. Daily Recovery Ritual (symbolic gesture to self every day that we are consciously devoting time to our recovery) What are the things you can do daily to symbolize to yourself that today is a new day? Keep it realistic or you won't do it. Vitamins, meditation, lemon water, supplements, self care, reaching out to a loved one, exercise, etc. Reward System What will you do for yourself if there is a certain period of time reached where you meet your goals? Will you get a massage at the end of every month? Will you plan a vacation after three months of solid goal hitting? Will you reward yourself with one day per week of going to the movies in the middle of the day and playing hooky if you're on the straight and narrow for five days? Strategy This is your "what." What are you doing daily to ensure that you are in alignment with your goals? Are you reading something fresh all the time? Do you make a timeline of your addiction and how it has affected your life? Do you go to local support meetings each week? Do you keep in touch with an online community? Do you make sure to give yourself small breaks while with the kids every day? Do you have a self care space set up in your house? Do you talk to a partner about how to change behaviors of theirs that might be hindering your efforts? can they get a mini fridge? Do you do acupuncture to balance your chi? Do you do yoga to manage your depression? Do you find a therapist? Recovery Resources (try to hit one each morning) what resources are in your pocket when you are feeling weak? bariatricpal.com? WLS journeys on Instagram? The Fix, Reddit, unique blogs documenting their weight loss journey, wls and vsg searches on Pinterest, etc. Good luck on your fresh start!

Today, during one of my pre-op psych evaluations, I heard a woman say “I just feel like once I start losing weight and start feeling so much better about my self- I will stop doing all the destructive things that got me here. Don’t you think?” My response was “no I don’t agree.” I went on to explain that hers was a common assumption, a dangerous “magic-bullet” fantasy about what weight loss surgery can do. Here’s why: The part of our brain that is responsible for the thought : “wow I look so much better, I better not mess this up,” or “I feel better than I have ever felt in my life, I am a changed person,” is not the same part of the brain that wakes us up in the middle of the night and says: “go on, finish that 1/2 pint of Chunky Monkey in the freezer, there’s only a little bit left anyway, and I have been so good here lately.” We are dealing with two very different brains; the frontal cortex and the reptilian mid brain. The frontal cortex is the most newly developed (relative to other parts of the brain) part of the brain. It is the component that separates us from animals. It gives us the ability to think about consequences, plan, and execute. It is the “higher” part of ourselves, that often says “why do I keep on doing the same things I keep saying I won’t do anymore?” Or “I feel so out of control. This _______ (eating, smoking, drinking, gambling, pick your poison) is a temporary solution that produces long term pain. I have to find a different way.” Our reptilian midbrain is the Commodore 64 to our MAC; it is the palm pilot to our iPhone; the horse and buggy to our Prius; the Tommy Lee to our Oprah. Our midbrain is antique equipment, long ago evolved to keep us alive and hence the reason it is still with us today- it keeps us alive. Our midbrain contains the parts of the brain that make us recoil at the site of a snake or a spider in our peripheral vision. It is hardwired to not have to go through superfluous channels of the brain that might otherwise say “hmmm what is that crawling over there? How do I feel about that? Oh its just a spider, my aunt had a collection of spiders, maybe I should collect things, etc etc.” We just jump, and process later. That very system has helped humans survive for thousands of years. There is an adaptive quality to a brain that proverbially acts and asks forgiveness later. That very old structure once kept us out of harm’s way when a pack of tigers were first seen galloping across a horizon, or when a rivaling tribe could be heard in the far off distance, threatening to pillage our territory. Our midbrain is associated with learning and reward. Learning what makes us feel bad, what eats us (in the past that would be in a literal sense- like tigers, but presently it might be a mercurial supervisor or unending debt), and even more relevant to this article- what makes us feel good. When our brains come across something that makes us feel good (ex: sex, drugs, food), we are then flooded with an influx of the powerful neurotransmitter- dopamine. Just like not everyone that is exposed to drugs will develop an addiction, not everyone that eats a Nutella crepe will develop a food addiction. Much of the research on obesity currently, postulates that food addiction, no dissimilar than alcohol or drug addiction- is a reward system dysfunction or dysregulation, born out of genetic predisposition. It’s almost as if some brains think “if one slice of pizza feels good, how would four slices of pizza taste?” To break these two very different parts up in a different, more basic way; our frontal cortex is the voluntary, while our midbrain is the involuntary. This very dangerous fantasy, many people carry into weight loss surgery is a myth that I try to dispel quickly. This type of “magic bullet’ thinking is the very thing that gets so many gastric bypass and sleeve patients into trouble years down the road. No one wants to look at triggers. No one wants to sit with a therapist and devise a strategic coping plan. We want a pill, a surgery, a 16 minute solution to a 40 year old problem. This is not to say that weight loss surgery is not a solution, just that its only part of the solution. Despite our best intentions, we are still in some ways animalistic, hedonically-driven to feed our most basic impulses. This is part and parcel of why recidivism is the rule not the exception when it comes to recovery from most addiction. So what does this mean? Are all weight loss surgery patients destined for disappointment and disenchantment when the WLS honeymoon ends? No. But the answer to long term change lies more in two-pronged approach to long term weight loss success; surgery + behavioral change. Simply thinking ourself slim is a fantasy. Think about your specific triggers for eating. For some it is that golden hour when all the kids are in bed and Narcos is queued up on your Netflix. For others it is that 2-3pm mid day slump. For some - it is when they are alone, the only time they can eat with abandon free from others’ judgement or their own embarrassment. Whatever your triggers- the key is to identify what need is being met in that moment and to find a non-food alternative to meet each particular need ( many people have multiple triggers for over eating). If it is because its “your time,” after the kids are in bed- maybe you invest in a foot massager, or cultivate a self care space with textures, aromatherapy, candles, and books. If your trigger is that mid day slump, maybe you develop a yoga routine easily done in the office to help re-energize you. If it is the secretive quality to the trigger of being alone and eating, maybe it is finding another thing that is just your own that no one knows (going to a movie in the middle of the day, getting an overly priced facial on your lunch hour, playing hooky with your kid one day, etc). The rule of the brain is : what fires together, wires together. So over time- if you have paired 8pm, Narcos, and nachos- you have created a neurological super highway. The moment 8pm rolls around, you are likely already getting the chips ready and didn’t even realize the thought pathway that just occurred. The idea is to repair our triggers with alternative behaviors and over time “clip those wires” or create “toll roads” to our superhighways (aka neurosynaptic pruning), so that we no longer experience such strong urges and can call upon the higher structures of our frontal cortex to guide the way again. When we are in the midst of addiction, it is important to understand that our frontal cortex is not at the wheel. It has been duck taped and tied to a chair in the basement by our hedonic midbrain who is used to getting what it wants when it wants it. The closer we come to accepting this principle, the closer we come to being more mindful of our midbrain’s powerful rationalizations and sick contracts and see them for just that. We are better able to dis-identify from the thought, knowing it is not coming from our best self, but from our most carnal self. Think of that distant cousin that only shows up when they need something, the Uncle Eddy that tells you he’ll move the RV when he leaves next month, indifferent to how it makes you feel. Except in addiction- that distant cousin has taken over, pretending its you until you can no longer tell the difference. References http://brainspotting-switzerland.ch/4_artikel/Corrigan & Grand 2013 Med Hyp paper (proofs).pdf Blum K, Chen AL, Giordano J, Borsten J, Chen TJ, et al. The addictive brain: all roads lead to dopamine. J Psychoactive Drugs. 2012;44:134–143. [PubMed] Avena NM, Gold JA, Kroll C, Gold MS. Further developments in the neurobiology of food and addiction: update on the state of the science. Nutrition. 2012;28:341–343. [PMC free article] [PubMed] Gearhardt AN, Yokum S, Orr PT, Stice E, Corbin WR, et al. Neural correlates of food addiction. Arch Gen Psychiatry. 2011;68:808–816. [PMC free article] [PubMed] Saper CB, Chou TC, Elmquist JK. The need to feed: homeostatic and hedonic control of eating. Neuron. 2002;36:199–211. [PubMed] Stice E, Yokum S, Zald D, Dagher A. Dopamine-based reward circuitry responsivity, genetics, and overeating. Curr Top Behav Neurosci. 2011;6:81–93. [PubMed] Blum K, Sheridan PJ, Wood RC, Braverman ER, Chen TJ, et al. The D2 dopamine receptor gene as a determinant of reward deficiency syndrome. J R Soc Med. 1996;89:396–400. [PMC free article] [PubMed] Comings DE, Flanagan SD, Dietz G, Muhleman D, Knell E, et al. The dopamine D2 receptor (DRD2) as a major gene in obesity and height. Biochem Med Metab Biol. 1993;50:176–185. [PubMed] Noble EP, Noble RE, Ritchie T, Syndulko K, Bohlman MC, et al. D2 dopamine receptor gene and obesity. Int J Eat Disord. 1994;15:205–217. [PubMed] Blumenthal DM, Gold MS. Neurobiology of food addiction. Curr Opin Clin Nutr Metab Care. 2010;13:359–365. [PubMed] Volkow ND, Wang GJ, Fowler JS, Telang F. Overlapping neuronal circuits in addiction and obesity: evidence of systems pathology. Philos Trans R Soc Lond B Biol Sci. 2008;363:3191–3200. [PMC free article] [PubMed] Volkow ND, Wang GJ, Baler RD. Reward, dopamine and the control of food intake: implications for obesity. Trends Cogn Sci. 2011;15:37–46. [PMC free article] [PubMed]

Why Psychologists Deny Certain People for Weight Loss Surgery and How to Not be One of Them I have worked as a psychologist, providing psychological evaluations prior to bariatric weight loss surgery for the past eight years. For the most part, people need a power tool to help them lose and keep off the weight they have lost over and over again in their lives. The gastric sleeve, bypass, and now balloon are those tools. However, every once in a while, I will encounter someone who believes these procedures are the magic bullet. I can pick this up in five seconds when I learn that: this person has no exercise plan to maintain their weight loss a barrage of excuses as to why they can't exercise anymore zero insight into why they are overweight ("I don't know why I am overweight, I just eat steamed vegetables and grilled chicken mostly.") a lack of motivation or understanding for why they also have to engage in behavioral modification in addition to the surgery "Why would you reveal all of this?" you ask. Aren't I giving away the keys to the kingdom to anyone who reads this and wants to pass a psychological evaluation? Perhaps- but who are you really cheating if you don't go within and face the real demons that got you here in the first place? When I ask people about their eating styles, I tend to group them into four categories: 1) emotional eater- someone who uses food when they are bored, stressed, tired, lonely, sad, or even happy in addition to eating when they are hungry 2) skip and binger- someone who fails to think about food until it is too late, and when they are ravenous end up going for whatever is available which is usually some type of carb and calorie laden fast food 3) miscellaneous- someone who just recognizes that they eat too large of portion sizes and/or the wrong types of food 4) food addict- usually someone with a history of other addictions, trauma, and a significant amount of weight to lose. They usually have comorbid psychological diagnoses that have been unaddressed or ill-addressed. Out of the four categories, the 4th is the most troubling for a psychologist. This particular person is most correlated with the patient who fails to address their core issues, eats "around the sleeve," or bypass, experiences dumping syndrome, comes back a year later and asks for the bypass, or a different procedure. This is the person who, ironically, is usually the most resistant to my recommendation that they seek therapeutic support prior to the surgery. They want it done YESTERDAY. They want it NOW. It is this type of thinking that got them into trouble in the first place. The impulsivity and lack of emotional regulation. I've witnessed people fail to address their maladaptive eating patterns and never quite get to their goal weight. I had a male that would buy a bag of pepperonis at the grocery store and snack on them all day and couldn't understand why he wasn't losing weight. This daily "snack," which was a mental security blanket, served as a veritable IV drip of fat and calories throughout the day. I've had a woman who figured out how to ground up her favorite foods into a liquid form because she never quite let go of her attachment to "comfort foods." One of her most notable liquid concoctions consisted of chicken and Cheetos. I'll just leave that for you to chew...er swallow. They say with drug and alcohol recovery- you "slay the dragon," but with food addiction recovery, you have to take it for a walk three times a day. If you don't fundamentally shift your relationship with this dragon, you're going to get burnt when you are walking it. My number one tip for transforming your relationship with food is to start looking at eating the same way you do as brushing and flossing: You don't necessarily salivate at the idea of what type of toothpaste you will use, where you will do it, who you will do it with, right? You just do it twice a day because you don't want to lose your teeth and you want to maintain healthy gums. Food has to be thought of in the same way. You fuel up. You don't use food as a place to define your quality of life. You don't use food to celebrate. You don't use food to demarcate the end of a long day. You don't use food to help you feel less alone. You figure out healthier coping alternatives to meet these needs. Loneliness-call a friend for support Celebrate- get a massage Demarcate the end of a long day- start a tea ritual and use essential oils Another reason you must say goodbye to comfort food is that it triggers the pleasure center of the brain, which ignites our dopamine, which perpetuates the addiction. Many people think we are just telling them to get rid of the comfort food because of the carbs or calories, but there are unique and harmful chemical consequences to ingesting these types of food we know are bad for us. If you are ready to take a modern approach to weight loss and stop dieting for good- check out my wls/vsg psychological support course here for free.

Some WLS patients still feel like there is a missing element to their long term weight loss. Healing old psychological wounds can be key. Author of Full From Within, psychologist Dr. Colleen Long, explains just where to start. “ The wound is where the light enters you.” - Rumi When I work with pre and post-op bariatric surgery patients, I consistently go over this idea of being "full from within." Many people question, "what does that mean for me? What does that look like?" My response is that for one to be truly full, we must first clear out the old toxicity, wounds, and hurtful schemas we've picked up throughout the years. How does one get over a hurt? There is not "getting over." You go through it. You have to feel it to heal it. If you have underwent gastric sleeve, bypass, or balloon surgery and still feel like there is a missing piece- it is likely that there are some deeper psychological toxicities that need to be cleared. The first step to doing so is sitting still, sitting with the feelings, and it is in stillness that our heart finally starts to answer the questions our mind has failed to thus far. Yet so many have been taught not to feel. That there must be an easier way- a shortcut. 1 in every 8 Americans is on some form of psychotropic medication. 1 In his book, Anatomy of an Epidemic, science journalist Robert Whitaker states that since 1987, the percentage of the population receiving federal disability payment for mental illness has tripled; among children under the age of 18, the percentage has grown by a factor of 35.1 While Whitaker recognized that in the short-term, these medications help people to feel better, he started to realize that over time- drugs make many patients sicker than they would have been if they had never been medicated. 1 He does not make the argument that all people should stop their meds. He believes in the utility of them, just more sparingly than they are currently utilized. However, throughout my years in the practice of therapy- I have noticed a trend of moving people away from feeling. Crying is actually a symptom in the DSM-V. We have pathologized a human feeling! When psychiatrists and therapists witness a patient tearful too many times in session, their next conclusion is that something must be wrong and they must be medicated. This frustrates me so much as a clinician and as a person who has done her share of work in her own personal therapy. When we are broken, we are broken open. Being broken is a starting point, not a symptom that something has gone awry. It is at the point of our deepest pain and grief that we have the greatest opportunity for growth. I find myself telling patients over and over- “you can’t “get over” it, you must “go through” it.” Yet, so many of us have been indoctrinated to think that if we spend more than a day being sad, we must have depression, or if we feel nervous a little bit longer than we’d like to- we must have an anxiety disorder. We definitely “are Bipolar” if we have a mood swing. We have been taught to not feel the yin, only the yang of our emotions. It’s societally acceptable to talk about how happy your weekend was, or how much fun you had on vacation- but watch the uncomfortable shifting in chairs that takes place when you open up about how you just haven’t felt like yourself lately. In our world of quick fixes, where we can have a conference across the world, over a computer, communicate a message in two seconds via text, or post a picture that all of our family can see instantly- we also want instant relief for our suffering. Yet, suffering is part of the human condition. It is through experiencing our deepest sorrows, we are able to appreciate our greatest joys. But we must first be willing to sit in the muck. "Out of the mud, grows the lotus." -Thich Nhat Hanh Part and parcel of any addiction (food, drugs, alcohol, etc.) is that the addict is particularly uncomfortable with being uncomfortable. However, the cure is right there for the taking. “So what does this look like in real life?” you ask. “How do I open the wound, bring in the light, and clear out the infection that started all of this in the first place?” You start with presence. You start with a still and open heart. You start with a spiritual vulnerability that allows you to be at peace with not knowing what will happen next. You sit broken open and wait for the light to enter over time. The most important piece in all of this is being able to create a consistent forum where you hold the space. This could be a therapist’s office, it could be a weekly walk with a friend, a journal practice, or it could be as simple as a prayer every night. You set the priority to hold the space and to sit in the muck. Maybe it starts with emotions that have no words? Maybe it starts with visceral, physical feelings, that you have to simply sit with for a while? Maybe you are lucky enough to immediately put in words where your wound all started and its just floating around in your thoughts, waiting to be articulated? Perhaps it starts with a behavior you tend to do all of the time that you know comes from a place of pain? Case Study: I had a client who continuously posted on social media sites. She had a constant need to feel recognized and admired. She knew there was something behind it and wanted to get to the bottom of where this was coming from. Session over session, we sat with that need. We talked about what she wanted to get from each of those posts and why she was still “on E,” left with an empty psychological tank. The short story of Narcissus goes that he disdained people who loved him. After Nemesis noticed this he lured him to a pool that cast his own reflection. Narcissus fell in love with this pool, not realizing it was merely an image. Unable to leave the beauty of his reflection, he lost his will to live. He stared at this reflection until he died. 59 Growing up, this client never quite got the love and admiration we all need from our parents. When we love something so much and don’t get that back- it is that unrequited love that leaves a narcissistic wound. It doesn’t necessarily always start with parents. It can be a formative romantic relationship, but it usually starts with parents. When we are flying from couch to couch saying “look at me mommy I’m superman!” and our mom says “get off that couch now!” instead of “look at how strong and powerful you are,” we begin forming the wound. Unfortunately, without recognizing this- many people will go throughout their life trying to heal it through other people or other things instead of within themselves. (recall the wizard of oz’s moral of the story). It was up to this client to stop the instinctual need to post and each time she had this inclination to look within for what she needed. Eventually, she developed a muscle for self validation, and the posting behavior stopped. The lesson in this case study is to hopefully help guide you to your wound. If we have a food addiction and feel out of control, you can bet we have a wound. Instead of distracting through bad habits, addictions, unhealthy relationships, or external wants- it is time to finally create a place of presence to start the healing process. Mind Meal: Sit in silence for at least 15 minutes. Visualize in your mind’s eye your heart with a bridge of white light to your head. What does it say? Where is the pain? Where is the wound? How might you start filling yourself up for good? Want to learn more about how to be truly full from within. Check out Dr. Colleen's latest book aimed at helping one focus on why they eat vs. what they eat, and stop the "diet yo-yo" for good. You can also sign up for her free course : Full From Within, here. 1 Retrieved: June 2, 2017 https://www.madinamerica.com/author/rwhitaker/

“ The wound is where the light enters you.” - Rumi When I work with pre and post-op bariatric surgery patients, I consistently go over this idea of being "full from within." Many people question, "what does that mean for me? What does that look like?" My response is that for one to be truly full, we must first clear out the old toxicity, wounds, and hurtful schemas we've picked up throughout the years. How does one get over a hurt? There is not "getting over." You go through it. You have to feel it to heal it. If you have underwent gastric sleeve, bypass, or balloon surgery and still feel like there is a missing piece- it is likely that there are some deeper psychological toxicities that need to be cleared. The first step to doing so is sitting still, sitting with the feelings, and it is in stillness that our heart finally starts to answer the questions our mind has failed to thus far. Yet so many have been taught not to feel. That there must be an easier way- a shortcut. 1 in every 8 Americans is on some form of psychotropic medication. 1 In his book, Anatomy of an Epidemic, science journalist Robert Whitaker states that since 1987, the percentage of the population receiving federal disability payment for mental illness has tripled; among children under the age of 18, the percentage has grown by a factor of 35.1 While Whitaker recognized that in the short-term, these medications help people to feel better, he started to realize that over time- drugs make many patients sicker than they would have been if they had never been medicated. 1 He does not make the argument that all people should stop their meds. He believes in the utility of them, just more sparingly than they are currently utilized. However, throughout my years in the practice of therapy- I have noticed a trend of moving people away from feeling. Crying is actually a symptom in the DSM-V. We have pathologized a human feeling! When psychiatrists and therapists witness a patient tearful too many times in session, their next conclusion is that something must be wrong and they must be medicated. This frustrates me so much as a clinician and as a person who has done her share of work in her own personal therapy. When we are broken, we are broken open. Being broken is a starting point, not a symptom that something has gone awry. It is at the point of our deepest pain and grief that we have the greatest opportunity for growth. I find myself telling patients over and over- “you can’t “get over” it, you must “go through” it.” Yet, so many of us have been indoctrinated to think that if we spend more than a day being sad, we must have depression, or if we feel nervous a little bit longer than we’d like to- we must have an anxiety disorder. We definitely “are Bipolar” if we have a mood swing. We have been taught to not feel the yin, only the yang of our emotions. It’s societally acceptable to talk about how happy your weekend was, or how much fun you had on vacation- but watch the uncomfortable shifting in chairs that takes place when you open up about how you just haven’t felt like yourself lately. In our world of quick fixes, where we can have a conference across the world, over a computer, communicate a message in two seconds via text, or post a picture that all of our family can see instantly- we also want instant relief for our suffering. Yet, suffering is part of the human condition. It is through experiencing our deepest sorrows, we are able to appreciate our greatest joys. But we must first be willing to sit in the muck. "Out of the mud, grows the lotus." -Thich Nhat Hanh Part and parcel of any addiction (food, drugs, alcohol, etc.) is that the addict is particularly uncomfortable with being uncomfortable. However, the cure is right there for the taking. “So what does this look like in real life?” you ask. “How do I open the wound, bring in the light, and clear out the infection that started all of this in the first place?” You start with presence. You start with a still and open heart. You start with a spiritual vulnerability that allows you to be at peace with not knowing what will happen next. You sit broken open and wait for the light to enter over time. The most important piece in all of this is being able to create a consistent forum where you hold the space. This could be a therapist’s office, it could be a weekly walk with a friend, a journal practice, or it could be as simple as a prayer every night. You set the priority to hold the space and to sit in the muck. Maybe it starts with emotions that have no words? Maybe it starts with visceral, physical feelings, that you have to simply sit with for a while? Maybe you are lucky enough to immediately put in words where your wound all started and its just floating around in your thoughts, waiting to be articulated? Perhaps it starts with a behavior you tend to do all of the time that you know comes from a place of pain? Case Study: I had a client who continuously posted on social media sites. She had a constant need to feel recognized and admired. She knew there was something behind it and wanted to get to the bottom of where this was coming from. Session over session, we sat with that need. We talked about what she wanted to get from each of those posts and why she was still “on E,” left with an empty psychological tank. The short story of Narcissus goes that he disdained people who loved him. After Nemesis noticed this he lured him to a pool that cast his own reflection. Narcissus fell in love with this pool, not realizing it was merely an image. Unable to leave the beauty of his reflection, he lost his will to live. He stared at this reflection until he died. 59 Growing up, this client never quite got the love and admiration we all need from our parents. When we love something so much and don’t get that back- it is that unrequited love that leaves a narcissistic wound. It doesn’t necessarily always start with parents. It can be a formative romantic relationship, but it usually starts with parents. When we are flying from couch to couch saying “look at me mommy I’m superman!” and our mom says “get off that couch now!” instead of “look at how strong and powerful you are,” we begin forming the wound. Unfortunately, without recognizing this- many people will go throughout their life trying to heal it through other people or other things instead of within themselves. (recall the wizard of oz’s moral of the story). It was up to this client to stop the instinctual need to post and each time she had this inclination to look within for what she needed. Eventually, she developed a muscle for self validation, and the posting behavior stopped. The lesson in this case study is to hopefully help guide you to your wound. If we have a food addiction and feel out of control, you can bet we have a wound. Instead of distracting through bad habits, addictions, unhealthy relationships, or external wants- it is time to finally create a place of presence to start the healing process. Mind Meal: Sit in silence for at least 15 minutes. Visualize in your mind’s eye your heart with a bridge of white light to your head. What does it say? Where is the pain? Where is the wound? How might you start filling yourself up for good? Want to learn more about how to be truly full from within. Check out Dr. Colleen's latest book aimed at helping one focus on why they eat vs. what they eat, and stop the "diet yo-yo" for good. You can also sign up for her free course : Full From Within, here. 1 Retrieved: June 2, 2017 https://www.madinamerica.com/author/rwhitaker/

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

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

"Wondering if you're happy is a great shortcut to being depressed." - Annette Bening, 20th Century Women Over the 8 years I have met with weight loss surgery patients, the one concept I find myself going over and over is this idea of becoming full from within. The idea that if we don't fill ourselves up intrinsically- we will always need some thing to fill the void, whether it be food, gambling, sex, drugs, or alcohol. The problem is- we always end up on empty, psychologically. The next question often becomes, "ok so how do I fill myself up psychologically? I don't think I will ever be fulfilled because I have never been truly happy. I was not born a naturally happy person? I've spent most of my life feeling empty- how do I turn it all around now? I grew up with unhappy parents, how am I to unlearn all of that early programming?' "Wondering if you're happy is a great shortcut to being depressed." - Annette Bening, 20th Century Women I think, unfortunately happiness gets a bad rap. There is a wide misconception that for us to be fulfilled, or full from within- we need to be blissfully happy all the time, and that's just not the case. Not only is it untrue, but it is an unrealistic standard and one that sets people up for disappointment. Rather than always questioning how we SHOULD be feeling, we should just practice acceptance of whatever temporary state we happen to be in at the moment with non-judgement and non-attachment. Like busses, moods come around every five minutes. Even therapist's aren't immune to life's ups and downs. Believe it or not, as a psychologist who literally wrote a book on Happiness, I have to remind myself certain mantras that help me keep my own life in balance and my happiness and fulfillment sustained. I actually have a list on my phone that says "things to remember," and page through it daily, when I'm feeling off track. So if you're feeling off track yourself- first understand that you're human and give yourself a break + then thumb through my personal list of happiness tips, little pearls I've gained in my 37 years on this planet, and see if any of them might help to increase your happiness quotient today: 1) In silence, the heart begins to finish its unfinished business. I think I picked this up from a book I read about Sufism. In any case, I liked it and it stuck. Oftentimes, we think that we must actively and aggressively pray, yet Sufis believe that it is in the stillness that God comes to us. Whenever my life gets a bit too chaotic with all the "should-ing" all over myself- I remind myself that it is often when I take pause, let go, and let God- that what is truly important, rises to the surface and I begin to reclaim my life instead of it claiming me. 2) Do more want-to's vs. have-to's every day. Someone once told me that the "have-to's" will never be done. I repeat- they will never be done. So we might as well splice in some time for the things that we thought we were going to do once they were done. Take the scenic route to work, take a long walk and listen to that book on audible that you have been wanting to read for the last few months,go shopping with a friend, get a massage, take an extra long lunch and sit out in the sun, or just curl up with your loved one or pet. A wise man once said "time you enjoy wasting, is not wasted time," and I couldn't agree more. 3) Happiness is not the absence of problems, but the ability to deal with them. I remember when I was in grad school, thinking "if I can just finish school- then I'll be the relaxed, happy go lucky person I want to be," then it morphed into, "once I get licensed," then "once I get married," then "once I have kids..." You get the idea. It is not the situations or circumstances in our lives that determine if we are a happier person or not. It truly is the way in which we approach them as they come, that determines what type of person we are and how happy we will be. In the "car of life," that we all have to drive, will you wear stilettos or uggs? 4) Connection with others is key to fulfillment. I am an introvert by nature. I enjoy my downtime, and require coming back to my home base in silence, to relax and unwind. However, there is something inherent in our very nature about the need to feel connected to the world around us- introverts included. My best girlfriend from childhood came out for a week a while back, and so I was unable to get caught up in the hamster wheel of daily activity. I was forced to be fully present and engaged with her for four days in a row. As a result, I was actually more grounded, more at peace, less anxious, and more optimistic about the future. Whenever we notice our egoic drives propelling us towards isolation, judgement, rumination, or comparison- we should remind ourselves to get out and connect with our fellow man, and fakebook doesn't count. 5) Like attracts like. Happy attracts happy. When we find ourselves feeling left out, isolated, or out of touch with those around us- it is important to look at our recent focus. Are we always dwelling on the negative, gossiping about someone? You know the saying "what sally says about susie, says more about sally than susie." Although, many of us sub-consciously believe that if we can just "get it out" about whatever is chipping away at us- it will somehow allay our negative feelings- it really doesn't. In fact, research supports that when we ruminate on negative feelings, it actually increases our negative feelings. This doesn't mean we should all be superficial and "surface-y" towards everyone, but that we should work a bit harder to find the happy. 6) To receive abundantly, ironically we must give abundantly. It is engrained in our DNA to wake up each morning with a needs list: "when will I get that bonus?" "when will I hear back about that promotion," "when will she call me back?" Yet, spiritually I truly believe that when we make the shift from "what can I get," to "what can I give?" It is a complete gamechanger. It's almost as if the universe aligns with us and says "yep you finally figured it out." 7) Choose your thoughts like you choose your clothes. Our minds are quick and fast like ferraris. They are an intricate and complex machine designed for ultimate performance, but just like we must use the right fuel for a Ferrari, we must also carefully select and filter which thoughts we allow to permeate our consciousness. When you notice yourself feeling down, take a cognitive step back and look at what thoughts you were having. Most are unproductive. Choose to let them go. The same tool that created the problem (our mind) is not likely going to solve the problem. 8) Legitimately and truly don't care about what others think or do. I can honestly say that this is still a work in progress for me. I was born a people-pleaser, but as I get older, I realize the more I try to make others happier with me, the less happy I am with myself. 9) Go out into the world with your heart, not your brain. Yes, our brain is required for some part of our days. Otherwise, our bills wouldn't be paid, our tasks wouldn't get done, and our goals wouldn't be met. But, other than that- when we greet people, meet people, share with others, observe, smile, walk- it is quite a different experience to live in our heart space, in that emotional space that is more visceral than verbal. 10) Relish in the remarkable ride. I watched a movie a while back called "about time," and it was all about a man who had time travel figured out. He lived his day once all hurried and bothered about the little stressors of life, but then went back to live it again. He said he would just rest in the moment, relax, and relish in the remarkable ride that was his life. I love this. After all the late notices have come, all our debt has fallen or risen, our weight has gone up and down, our kids get a failing grade in school, our lover breaks our heart, our cars break down... it always ends the same: none of us get out alive. So why not just sit back and enjoy the ride?

Over the 8 years I have met with weight loss surgery patients, the one concept I find myself going over and over is this idea of becoming full from within. The idea that if we don't fill ourselves up intrinsically- we will always need some thing to fill the void, whether it be food, gambling, sex, drugs, or alcohol. The problem is- we always end up on empty, psychologically. The next question often becomes, "ok so how do I fill myself up psychologically? I don't think I will ever be fulfilled because I have never been truly happy. I was not born a naturally happy person? I've spent most of my life feeling empty- how do I turn it all around now? I grew up with unhappy parents, how am I to unlearn all of that early programming?' "Wondering if you're happy is a great shortcut to being depressed." - Annette Bening, 20th Century Women I think, unfortunately happiness gets a bad rap. There is a wide misconception that for us to be fulfilled, or full from within- we need to be blissfully happy all the time, and that's just not the case. Not only is it untrue, but it is an unrealistic standard and one that sets people up for disappointment. Rather than always questioning how we SHOULD be feeling, we should just practice acceptance of whatever temporary state we happen to be in at the moment with non-judgement and non-attachment. Like busses, moods come around every five minutes. Even therapist's aren't immune to life's ups and downs. Believe it or not, as a psychologist who literally wrote a book on Happiness, I have to remind myself certain mantras that help me keep my own life in balance and my happiness and fulfillment sustained. I actually have a list on my phone that says "things to remember," and page through it daily, when I'm feeling off track. So if you're feeling off track yourself- first understand that you're human and give yourself a break + then thumb through my personal list of happiness tips, little pearls I've gained in my 37 years on this planet, and see if any of them might help to increase your happiness quotient today: 1) In silence, the heart begins to finish its unfinished business. I think I picked this up from a book I read about Sufism. In any case, I liked it and it stuck. Oftentimes, we think that we must actively and aggressively pray, yet Sufis believe that it is in the stillness that God comes to us. Whenever my life gets a bit too chaotic with all the "should-ing" all over myself- I remind myself that it is often when I take pause, let go, and let God- that what is truly important, rises to the surface and I begin to reclaim my life instead of it claiming me. 2) Do more want-to's vs. have-to's every day. Someone once told me that the "have-to's" will never be done. I repeat- they will never be done. So we might as well splice in some time for the things that we thought we were going to do once they were done. Take the scenic route to work, take a long walk and listen to that book on audible that you have been wanting to read for the last few months,go shopping with a friend, get a massage, take an extra long lunch and sit out in the sun, or just curl up with your loved one or pet. A wise man once said "time you enjoy wasting, is not wasted time," and I couldn't agree more. 3) Happiness is not the absence of problems, but the ability to deal with them. I remember when I was in grad school, thinking "if I can just finish school- then I'll be the relaxed, happy go lucky person I want to be," then it morphed into, "once I get licensed," then "once I get married," then "once I have kids..." You get the idea. It is not the situations or circumstances in our lives that determine if we are a happier person or not. It truly is the way in which we approach them as they come, that determines what type of person we are and how happy we will be. In the "car of life," that we all have to drive, will you wear stilettos or uggs? 4) Connection with others is key to fulfillment. I am an introvert by nature. I enjoy my downtime, and require coming back to my home base in silence, to relax and unwind. However, there is something inherent in our very nature about the need to feel connected to the world around us- introverts included. My best girlfriend from childhood came out for a week a while back, and so I was unable to get caught up in the hamster wheel of daily activity. I was forced to be fully present and engaged with her for four days in a row. As a result, I was actually more grounded, more at peace, less anxious, and more optimistic about the future. Whenever we notice our egoic drives propelling us towards isolation, judgement, rumination, or comparison- we should remind ourselves to get out and connect with our fellow man, and fakebook doesn't count. 5) Like attracts like. Happy attracts happy. When we find ourselves feeling left out, isolated, or out of touch with those around us- it is important to look at our recent focus. Are we always dwelling on the negative, gossiping about someone? You know the saying "what sally says about susie, says more about sally than susie." Although, many of us sub-consciously believe that if we can just "get it out" about whatever is chipping away at us- it will somehow allay our negative feelings- it really doesn't. In fact, research supports that when we ruminate on negative feelings, it actually increases our negative feelings. This doesn't mean we should all be superficial and "surface-y" towards everyone, but that we should work a bit harder to find the happy. 6) To receive abundantly, ironically we must give abundantly. It is engrained in our DNA to wake up each morning with a needs list: "when will I get that bonus?" "when will I hear back about that promotion," "when will she call me back?" Yet, spiritually I truly believe that when we make the shift from "what can I get," to "what can I give?" It is a complete gamechanger. It's almost as if the universe aligns with us and says "yep you finally figured it out." 7) Choose your thoughts like you choose your clothes. Our minds are quick and fast like ferraris. They are an intricate and complex machine designed for ultimate performance, but just like we must use the right fuel for a Ferrari, we must also carefully select and filter which thoughts we allow to permeate our consciousness. When you notice yourself feeling down, take a cognitive step back and look at what thoughts you were having. Most are unproductive. Choose to let them go. The same tool that created the problem (our mind) is not likely going to solve the problem. 8) Legitimately and truly don't care about what others think or do. I can honestly say that this is still a work in progress for me. I was born a people-pleaser, but as I get older, I realize the more I try to make others happier with me, the less happy I am with myself. 9) Go out into the world with your heart, not your brain. Yes, our brain is required for some part of our days. Otherwise, our bills wouldn't be paid, our tasks wouldn't get done, and our goals wouldn't be met. But, other than that- when we greet people, meet people, share with others, observe, smile, walk- it is quite a different experience to live in our heart space, in that emotional space that is more visceral than verbal. 10) Relish in the remarkable ride. I watched a movie a while back called "about time," and it was all about a man who had time travel figured out. He lived his day once all hurried and bothered about the little stressors of life, but then went back to live it again. He said he would just rest in the moment, relax, and relish in the remarkable ride that was his life. I love this. After all the late notices have come, all our debt has fallen or risen, our weight has gone up and down, our kids get a failing grade in school, our lover breaks our heart, our cars break down... it always ends the same: none of us get out alive. So why not just sit back and enjoy the ride?

Addiction gets such a bad rap societally. It is one of the most difficult things to recover from, yet it is so socially stigmatized that we don’t often talk about it freely. Food addiction is the most difficult addiction, in my opinion. Think about it: what other addiction do you have to wear on your sleeve? Alcoholics can drink to excess without anyone being the wiser. Pain pill addictions go unnoticed for years. Even people with addictions to cocaine, methamphetamines, and other hard drugs can go unnoticed for years. Gambling and sex addicts also go freely into society everyday without anyone raising as much as an eyebrow. In addition to having to “wear their addictions on their sleeves,” - food addicts can’t ever have the luxury of quitting “cold turkey.” We can’t quit food. In OA they say, with drug and alcohol addiction recovery- you slay the dragon, with food addiction recovery- you still have to take it for a walk three times a day. This is why understanding why we eat vs. just focusing on what we eat is so paramount in re-establishing a healthy relationship with food. If you’d like to take my free online course that helps you with this very concept, click here. Author Laura McKowen talks about the concept of the “pregnancy principle,” when people are recovering from alcohol addiction. She talks about the idea that when a woman is pregnant it is societally acceptable to say “no” at any time. A woman can go to a party for a mere 15 minutes and say “hey I’m really tired, I think I am going to go home now,” and everyone responds with “of course, you need the rest,” or “you are caring for two now- you have to listen to your body.” So why can’t one treat themselves with the same courtesy when recovering from food addiction. If you are at a party that has a bunch of triggering foods, a co-worker’s birthday party, a potluck, a restaurant where everyone has decided to order dessert- why does it feel so unacceptable to say “hey guys thanks for the great time, but I’m going to head home now.” This is much in part due to inherent shame surrounding addiction. One feels that they should just be able to be like everyone else. Yet study after study has shown there are key genetic factors that often play into overeating, food addiction, and obesity. We shouldn’t have to have another person inside of us to give ourselves permission to take care of ourselves. Aren’t you enough? Whether you are in the beginning stages of your weight loss surgery, or 6 years post- this month, try to look at your recovery the same way a pregnant woman looks at taking care of herself. If you know something is going to be too triggering, not fun, exhausting, mentally draining- either bow out politely, or go for a short period of time and excuse yourself when you’re no longer feeling it. If you are interested in receiving more free weight loss help with the psychological part of recovery, please check out my free course here.

Addiction gets such a bad rap societally. It is one of the most difficult things to recover from, yet it is so socially stigmatized that we don’t often talk about it freely. Food addiction is the most difficult addiction, in my opinion. Think about it: what other addiction do you have to wear on your sleeve? Alcoholics can drink to excess without anyone being the wiser. Pain pill addictions go unnoticed for years. Even people with addictions to cocaine, methamphetamines, and other hard drugs can go unnoticed for years. Gambling and sex addicts also go freely into society everyday without anyone raising as much as an eyebrow. In addition to having to “wear their addictions on their sleeves,” - food addicts can’t ever have the luxury of quitting “cold turkey.” We can’t quit food. In OA they say, with drug and alcohol addiction recovery- you slay the dragon, with food addiction recovery- you still have to take it for a walk three times a day. This is why understanding why we eat vs. just focusing on what we eat is so paramount in re-establishing a healthy relationship with food. If you’d like to take my free online course that helps you with this very concept, click here. Author Laura McKowen talks about the concept of the “pregnancy principle,” when people are recovering from alcohol addiction. She talks about the idea that when a woman is pregnant it is societally acceptable to say “no” at any time. A woman can go to a party for a mere 15 minutes and say “hey I’m really tired, I think I am going to go home now,” and everyone responds with “of course, you need the rest,” or “you are caring for two now- you have to listen to your body.” So why can’t one treat themselves with the same courtesy when recovering from food addiction. If you are at a party that has a bunch of triggering foods, a co-worker’s birthday party, a potluck, a restaurant where everyone has decided to order dessert- why does it feel so unacceptable to say “hey guys thanks for the great time, but I’m going to head home now.” This is much in part due to inherent shame surrounding addiction. One feels that they should just be able to be like everyone else. Yet study after study has shown there are key genetic factors that often play into overeating, food addiction, and obesity. We shouldn’t have to have another person inside of us to give ourselves permission to take care of ourselves. Aren’t you enough? Whether you are in the beginning stages of your weight loss surgery, or 6 years post- this month, try to look at your recovery the same way a pregnant woman looks at taking care of herself. If you know something is going to be too triggering, not fun, exhausting, mentally draining- either bow out politely, or go for a short period of time and excuse yourself when you’re no longer feeling it. If you are interested in receiving more free weight loss help with the psychological part of recovery, please check out my free course here.

friend request me at Facebook.com/drcolleen and I will add you to the group

so since it is a secret/private group, I realized it can't be found through a link, so you have to friend request me and let me know you are wanting in the group, and I will add you www.facebook.com/drcolleen