Connie Stapleton PhD

4 hours ago, blizair09 said:

I follow a low carb/high protein/high healthy fat way of eating and have done so for the past almost 2 years (including the food stages post-op). To many, this is a Keto diet; to me it is a permanent way of life. I have no intention of bringing carbs or sugar back into my life at any point. I worked hard to make food nothing more than fuel, and I am going to continue to live that way. (I know that this approach isn't for everyone, but it has helped me to lose 225 pounds and beautifully maintain that loss...)

I look at the word diet as "how I eat," and not a program to lose weight. I don't need to lose weight anymore.

Beautiful!

On 1/13/2018 at 6:35 AM, summerset said:

Then why do so many patients treat it like one? Fault of the treatment team because they seem to treat it too often like one, too?

1

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

Love your thoughts! Thanks for sharing.

On 1/11/2018 at 11:25 AM, orionburn said:

I think this is one of the key takeaways. I don't consider myself to be on a "diet" any longer. In days of old being on a diet meant cutting out junk food, eating more salads, etc. It was always intended to be short term. Now that I've cut out so many things of old I don't consider myself to be dieting. What I eat now I consider to be normal.

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

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

On 1/11/2018 at 5:09 PM, Tealael said:

This has some helpful information however vegan is a life style not just another diet.

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

29 minutes ago, dreamynow said:

Ya. My skinny friends all diet every day. - they watch everything they eat. Exercise. Drink juice cleanses. Do Protein Shakes and bars. Only indulge once in a blu moon if at all. Their diet is their lifestyle. And even though they have only needed to lose after baby weight gain- they live by the newest diets and exercise craze ( right now it’s peleton) - WW, Atkins , whole food—. They have done them all. They are just way better at dieting then I was! I consider myself on a diet. Because that’s what it is. So true about ‘mindset’ code word for making good choices. The newest code word is ‘grit’ - for not giving up. Whatever works works. Obviously we are trying to make good choices to that our life changes - hence lifestyle changes. - and dieting gives structure which for me helps with making the right choice or only choice.


HW. 289
SW. 284
Height. 5’8

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

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

Much wisdom in your words! Thank you for sharing!

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

Are you old enough to remember the movie Kindergarten Cop? Arnold Schwarzenegger stars as a policeman who, on assignment, poses as a kindergarten teacher in order to catch a criminal. In the famous scene, he is in front of his class of 5-year-olds, rubbing his head. One of the kids asks, “What’s the matter?” Arnold, the cop/teacher, responds, “I have a headache.” The child, offering his wisdom, suggests, “Maybe it’s a tumor,” to which Arnold replies, “It’s NOT a TOOMAH.”

In the case of bariatric surgery and the questions patients ask about their post-op “diet,” most bariatric professionals speak in terms of the lifestyle and dietary changes that accompany post-op living. The majority of patients, both pre-op and post-op, understand that one of the goals of preparing for bariatric surgery is to begin making healthy, positive changes to one’s lifestyle. Which, of course, is code for changing behaviors (primarily eating and exercise). Hence, the popular phraseology that “bariatric surgery requires accompanying lifestyle changes” in order for one to maintain the weight loss they experience during “the honeymoon” stage.

For many (most?) people who have bariatric surgery, being on a “diet” of one sort of another has been a way of life prior to having a bariatric surgical procedure. Atkins, Paleo, low carb, low fat, vegan, gluten-free, DASH diet, ZONE diet, Jenny Craig, Whole 30, Weight Watcher’s, very low carb, Sugar Busters, etc. etc. etc. Sound familiar?

When I hear post-op patients talking about “going on a ‘diet,’” I really want to scream, “THIS ISN’T ABOUT A ‘DIET’! It’s about LIFESTYLE CHANGES!”

Don’t get defensive here if you have gone on a “diet” as a post-op. I understand that if you have regained weight, and are working with a bariatric professional, there may be a “diet” of sorts prescribed. That’s not what I’m referring to when I talk about my frustration. It’s when a post-op continues the diet-as-a-way-of-life mentality that I feel frustrated, and sad, actually.

Living life “on a diet” can be (and is, for some people), a way to: 1) avoid other things (feelings, relationships, etc.) by focusing all of their thoughts and attention on “the diet,” 2) remain obsessed with food (which may be an indication of a food addiction and/or my first point), 3) remain connected with others as “dieting” may have been the basis of their relationship with family members or friends, 4) attempting to have some area of control in life, and/or 5) lots of other things.

Regardless, dieting as a way of life is probably not a healthy way to live (for most people).

Sidenote: I add that “for most people” part because, sure as I’m sitting here, if I don’t say that, somebody is gonna get really ticked off and start thinking about how that isn’t the case for THEM and THEN they may miss the point of the whole article…

The POINT, by the way, is… choosing to have bariatric surgery is also choosing to make healthy, positive lifestyle changes. IF you want to sustain the weight you lose as a result of the surgery – and your efforts.

And YOU are in it to win it. SO… here’s how to change your thinking from making changes in your “DIET” to making changes in your lifestyle:

• AWARENESS: Learn the difference between a “diet” and a “lifestyle change” if you don’t already know. Discuss this with your bariatric professionals, your support groups and your family members. Help those in your life understand the difference, as well. IF you fear not living on a “diet,” then perhaps consider getting some counseling to look into the reasons being “on a diet” is emotionally important to you.
• ACCEPTANCE: Realize that if you want to live the rest of your life at a healthier weight, then lifestyle changes in the way of “diet” (as in what you eat), as opposed to “A DIET,” such as the ones name above, are necessary. And the healthy dietary changes need to a lifestyle… meaning you continue them every day, one day at a time. In addition, the lifestyle changes necessary to life your healthiest life can include things such as increased physical activity, exercise, learning healthy coping skills, developing a healthy support system, etc.
• ACCOUNTABILITY: Find ways to be accountable for engaging in healthy lifestyle behaviors. Maintain food and exercise journals. Participate in support and/or accountability groups. Work out with others. Start a walking club. Start a support group. Take responsibility for your health. This day. Every day.
• ATTITUDE: Work to have a more positive attitude about the difficult parts of the journey. Read positive quotes. Maintain a gratitude journal. Encourage others. Talk to yourself when you’re grumpy and remind yourself that will not lead you in the direction you want to go!
• COMMITMENT: Make a list of the reasons you are working so hard to develop a healthier lifestyle and every day, SEVERAL times a day, state out loud your commitment to doing so. OUT LOUD! Your brain will hear you and respond in a positive way.
• EFFORT: Unless you do the doing, nothing much will happen in the way of results. So this EFFORT thing needs attention every day. Get help to get you going if you need to! Yep – that means: Ask. For. Help. You can do that!
• Your SELF matters. Be as loving toward yourself as you are to others. You are just important as every other person.

Using these 4 ACES will get you to the place where a healthy diet is part of your healthy LIFESTYLE!

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

This week I started a weekly Wednesday night Facebook Live series called food Addiction: FAIR and FIRM. During the program, I commented that when I was told, “Connie, you’re an addict,” after the initial shock wore off, I felt a tremendous sense of relief. For the first time in my life, certain things made sense to me.

Let me speak to the shock part first. Yes, I drank - a lot – in college. So did everyone else I knew. So did everyone in my family. In fact, most of the people in my family drank a whole lot more than I ever did! After I got married, I quit drinking on a regular basis. When I did drink after that, I usually drank to get drunk – true. It’s also true that I drank less after I got married because I started taking codeine – very rarely, at first – for bad Migraine headaches. Over time, however, I took it daily because codeine helped me to not feel. Anything. At most, I took maybe three in a day. I thought addicts took lots and lots of pills!

So when I was given the alcohol and drug addiction screening, I was certain I wouldn’t meet any criteria for alcoholic, and most definitely not for drug addict. Well, I got one heck of a case of the “Yeah buts…” in a hurry when the therapist said, after scoring my test, “Connie – you’re an alcoholic and a drug addict.” As she talked to me about the items that indicated addiction on the test, every one of my responses to her started with, “Yeah, but…” For example, “Yeah, but I could have answered that question either way.” “Yeah, but I don’t drink nearly as much as most of the people I know, especially the people in my family.” “Yeah, but, drug addicts take a lot of pills throughout the day.” “Yeah, but I was able to take care of my kids and work and go to school.” “Yeah, but I’ve never been in trouble with the law.”

When I had exhausted all the “Yeah, buts” I could think of, imagine or create, I got quiet and let it sink in. I am an addict. And then I felt it. Relief. It made sense.

What made sense to me about my being an addict is understanding, for the first time, the reasons I continued to do things that went against my own values. I started to understand the reasons I did things I said I would never do. It began to make sense that things I promised I would stop doing seemed impossible to stop doing.

• I am an addict. I have a disease that “hijacks” the brain. When I am in active addiction of any kind:
• the disease of addiction that affects my brain doesn’t allow me to listen to reason but stays locked in denial mode
• the disease of addiction that affects my emotions keeps me in a protective mode so I defend myself by blaming other people and things for my behavior
• the disease of addiction that affects my spiritual self says, “do what feels good in the moment” and hides the part of me that says, “what I value is good and decent”
• the disease of addiction that affects my social self, brings out the loud, obnoxious, hurtful voice I am capable of using
• the disease of obesity that affects my physical being takes dangerous risks, eats poorly, doesn’t exercise and doesn’t care

Accepting the truth that I am an addict was a relief. NOT AN EXCUSE. I understood my poor choices better. It made sense that it was so difficult for me to follow through with the convictions I made to myself and the promises I made to others. I began to understand why my behaviors went against the person I wanted to be. Addiction is a brain sickness and a soul sickness. And a protector. All at the same time.

Food, alcohol, shopping, pain medication, and other things I engaged in addictively protected me from my feelings. That is what I wanted most of all. To not feel. I didn’t want to feel the reality of my sadness, my anger, my pain and my shame. The trade-off for not feeling was to use addictive substances/behaviors and betray myself by doing things I was embarrassed about, ashamed of, and seemingly unable to control.

Being an addict was in no way an excuse for the behaviors I engaged in. It’s very uncool to use being an addict as a way to avoid taking responsibility. “I danced with the boss’s husband at the holiday party. What can say – I was drunk.” NOT COOL. “I told her off but she had it coming and besides – I was drunk and couldn’t keep my mouth shut.” NOT COOL.

For food addicts, it is similarly bogus to make excuses for overeating because the kids were acting up, you were late for work and got yelled at, your mother was sick, or your spouse ticked you off.

Each one of us is 100% responsible for our behavior – even if we have addictions. If we have an addiction, once we realize that truth, we are responsible for getting help and learning healthy ways to deal whatever life brings us. We are responsible for learning to deal with our feelings in appropriate ways. We are responsible for learning to work through losses, past abuse or neglect, present hardships, frustrations with family and friends, and all of life’s realities. Without the use of addictive chemicals or actions.

The addictive substance or behavior, whatever it is, isn’t the problem. Sure, alcohol is a problem for alcoholics. Certain foods are problems for food addicts. Shopping is a problem for shopaholics. But those are only the surface problems. Addictive substances and behaviors are symptoms of the real problems, which are almost always rooted in shame: “I’m not good enough.” That shame stems from many possible places.

To treat addictions, we must first remove the substance or behavior. No, one cannot eliminate food from their life. But they can eliminate the food(s) that cause them problems. Once we are free of chemicals or the addictive behaviors, we can work on the real problems and choose who we want to be. When we don’t “use,” our actions can reflect our values.

“Connie – you’re an addict.” WHAT A RELIEF! I understood why I couldn’t STOP doing things I didn’t really want to do. I finally knew there was hope. I knew I could learn to live life in healthy ways and according to my values. But I first had to be willing to live without the addictive chemicals and behaviors.

So I needed help. I couldn’t do it alone. And I didn’t have to. Together, we can support one another into a life of RECOVERY.

What a relief!

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

On 4/23/2017 at 7:35 AM, Newme17 said:

That was a wonderful and truthful read. Thank you for all you do! To your husband and the other couple as well. You're on point about the shame, lack of self respect, we all (even those who aren't obese) could use healing in every aspect of our lives. For a WHOLE body, WHOLE mind, and a WHOLE spirit. It's a continuous journey to be and stay whole, some need outside help (therapy, etc), some get spiritual help (a Godly miracle), and some are so strong they combat the negatives on their own. Many blessings to all who are getting help in all areas of their lives.

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

I’m in New Zealand today, where I have been for the past three weeks. It has been a privilege to work with a number of bariatric professionals from different disciplines associated with the Foundations Healthy Living Retreat. During this five-day retreat, a small group of post-operative bariatric patients live together, eat together, exercise together, learn together and share with one another. Various staff members share their expertise about healthy living. Topics include much more than how to eat well and exercise. Participants learn the importance of focusing on personal values in all areas of their lives, discover the importance of positive self-talk, address self-sabotage and learn the importance of living mindfully. Coping skills, communication skills, and boundary setting skills are discussed. The topics of shame and vulnerability are explored, as well. Participants get what all bariatric patients in all corners of the world need following bariatric surgery: the Foundations of Healthy Living. Hmmm… good name for the retreat!

I’m in New Zealand today, where I have been for the past three weeks. It has been a privilege to work with a number of bariatric professionals from different disciplines associated with the Foundations Healthy Living Retreat. During this five-day retreat, a small group of post-operative bariatric patients live together, eat together, exercise together, learn together and share with one another. Various staff members share their expertise about healthy living. Topics include much more than how to eat well and exercise. Participants learn the importance of focusing on personal values in all areas of their lives, discover the importance of positive self-talk, address self-sabotage and learn the importance of living mindfully. Coping skills, communication skills, and boundary setting skills are discussed. The topics of shame and vulnerability are explored, as well. Participants get what all bariatric patients in all corners of the world need following bariatric surgery: the Foundations of Healthy Living. Hmmm… good name for the retreat!

What I think as I look around me are the many “non-coincidences” in my immediate surrounding. I do not believe that my being here, halfway around the world, is a coincidence. To begin with, Dr. David Schroeder, a bariatric surgeon, and his wife, Andrea, are, in many ways, absurdly similar in personality to my husband Steve and myself. David and Steve are both kind, intelligent, rational, left-brain thinkers who are mild-mannered and soft-spoken. Andrea and I, on the other hand, while also kind and intelligent, are passionate, passionate and more passionate. Translated, we are thinkers and DO-ers, we are upfront and direct, and are most definitely whatever the opposite of soft-spoken is. Oh, loud. That’s it!

Andrea and David are passionate about their work in the bariatric field. They are zealous about the physical health of surgical weight loss patients and are also super passionate about the patients’ psychological health. The Schroeder’s know that the journey of recovering from obesity takes a lifetime and includes the physical and the psychological wellbeing of each person. Andrea created the Foundations of Healthy Living Retreat and they have been hosting the retreats for the past five years.

It is definitely not a coincidence that David reached out to me after reading my first book, Eat It Up! Our professional philosophies are very much in sync. My work, with great help from Steve, is all about addressing the psychological needs of patients while their physical needs are being medically managed. David and Andrea, like Steve and myself, dedicate much more than our careers to providing bariatric patients with education and support. We address the WHOLE person, pre-operatively and after weight loss surgery. We put our hearts and souls into the work we do because we are convinced by the feedback our patients provide that they want and need much more than the surgical procedure can provide in order for them to live healthy lives, both physically and psychologically following bariatric surgery.

Since meeting in 2011, I have learned a great deal by working with both Andrea and David. The Schroeder’s have twice brought me to New Zealand where I have had the opportunity to learn from and contribute to, the lives and education of their patients and staff.

Andrea and David, as well as every person presenting information at the retreat, address bariatric patients from a whole person perspective. Each participant is treated respectfully and compassionately, as a human being who is much more than a bariatric patient. Their emotional support needs are emphasized, as a success following bariatric surgery involves more than dealing with a person’s biological innards.

Is it a coincidence that Andrea and David, in New Zealand, know the same things that Steve and I know in the US? We all know and work toward, helping patients and bariatric professionals realize that bariatric patients have tremendous emotional and psychological needs that require attention. Behavior modification by itself is not enough when it comes to sustaining weight loss. If it were, well… wouldn’t more people have kept weight off after diets and bariatric surgery?

Is it a coincidence that the bariatric patients I have talked with during individual sessions, along with the participants at the retreats, all from New Zealand, talk about the exact same issues as the bariatric patients I have worked with in the US for the past 15 years? I’m not talking about the physical problems. I’m talking about the lack of self-care this population acknowledges. Not just in their eating and exercise behaviors. These people talk about a great lack of self-value that translates to a lack of proper self-care. The greatest common denominator aside from the physical co-morbidities of the bariatric patients I have spent time with in both countries boils down to this: I don’t believe I’m good enough. That, my friends, is the definition of shame.

Our bariatric patients need to heal from the shame that draws them back into unhealthy habits. Healing from shame requires much, much more than a bariatric procedure in an operating room, or “theater,” as they call it in New Zealand. It is not coincidental that bariatric patients across the globe suffer from shame. It is tragic that so few bariatric professionals around the world are willing to provide the full spectrum of care that patients require in order to be able to follow through with behavior modification techniques. Deep shame will eventually extinguish behavior modification efforts.

How long before more bariatric professionals get it? How long before more than a handful of patients get the emotional support and psychological care they need after bariatric surgery? How long before we provide a truly comprehensive program to help our patients eliminate shame and establish self-acceptance?

The shame belongs to the programs and professionals who do not provide a comprehensive program… because those programs simply aren’t good enough. (Along with the Schroeder’s, I will be offering residential retreats through bariatric centers in the near future. For more information, contact me at connie@conniestapletonphd.com.)

I’m grateful for the non-coincidences that have led to meeting Andrea and David Schroeder. I am not surprised to see and hear that the patients in our very distant geographical countries are so very similar. Mostly, I am thrilled to know that there are professionals and patients who know that the Foundations of Healthy Living go way beyond medical care alone!

For now, patients can participate in the GAIN While You Lose 10-week program. This is a great way for patients around the country (and the world) to have access to the same topics discussed in the Foundations of Living Retreat. This class includes an hour and a half “lesson,” taught live but available online or via recorded session, followed by weekly homework to make the information applicable to each person’s life. (http://www.conniestapletonphd.com/onlin…/weight-loss-program)

Why aren’t we currently doing retreats in the US? Are you, the patients, willing to pay to attend? Are you willing to take the time and spend the money to invest in yourself? Do you value yourself enough to work on your emotional issues? You’ve most likely been willing to pay hundreds to thousands of dollars for weight loss programs, powders, gimmicks and scams. What about actually finding a way to find self-acceptance, a requirement for being able to follow through with behavior modification tools?

Patients: there is no shame in having problems. It is tragic to me if you know there are problems, but choose not address them. Please seek the help you need! After all: YOUR HEALTH is YOUR RESPONSIBILITY. THIS DAY. EVERY DAY.

@OKCPirate

Sorry for the delayed response. You posted, "Dr. Stapleton, I'm really not nit picking, but why would you call obesity a "disease" as opposed to a "condition." I think a case can be made for those who really messed up their internal set points with years of yo-yo dieting it might be akin to a disease, but for some it is choice.

The disease model is used in a number of complicated dependency issues, and while I agree there are some complicated brain issues with compulsive behaviors which can get so out of control that human rational will power is ineffective for creating change, for some though this is used as an excuse for inaction.

It is an important semantic difference to me. It's what makes WLS a tool to me, not a magic wand or cure. I still have to work the program to get the results. Something for consideration, rhetoric, labels and words matter."

The reason I describe obesity as a disease is because the American Medical Association refers to it as such. And clearly, there are numerous physiological issues at play when obesity is present, regardless of the particulars. People have opinions about this on both sides of the fence. I understand what you are saying and if the semantic difference is important to you, then I would stick to what you're comfortable with. I wholeheartedly agree that WLS is not at all a magic wand or a cure. Maintaining a healthy weight requires a great deal of consistent effort and defining obesity as a disease or not doing so does not change that fact. Similarly, if one has cancer or asthma or any number of other diseases/ailments, in order to obtain the most favorable outcomes, consistent effort and the choice for healthy behaviors is necessary. Thank you for your insights and observations.

@@4MRB4PHOTO Thank YOU for commenting!

@@Inner Surfer Girl Thanks so much! Appreciate you reading it!

I’m guessing most of us understand that the disease of obesity is a complicated one. There are a number of factors that contribute to obesity. Some of these factors you may be very aware of; others you may be surprised about. Some of the causes of obesity are things you cannot do anything about; other causes of obesity are things you can influence.

BARIATRIC REALITIES: Causes of Obesity – What Factors can YOU Influence? (Part One of Three)

I’m guessing most of us understand that the disease of obesity is a complicated one. There are a number of factors that contribute to obesity. Some of these factors you may be very aware of; others you may be surprised about. Some of the causes of obesity are things you cannot do anything about; other causes of obesity are things you can influence. It’s important to recognize the difference. Why? For starters, you can stop beating yourself up over the things you can’t do anything about. It’s also important that you focus on putting forth effort where it will get you the best results! It’s essential for both doctors and those suffering from obesity to have a mutual understanding of these causes of obesity and which people can influence, so that:

1) Doctors can develop or increase empathy for the struggles of those suffering with obesity. When doctors better understand that many people with obesity have struggles that go beyond fighting their biology which negatively impact their weight, the doctors can more compassionately and appropriately address these issues and refer patients to see other professionals, if need be.

2) People struggling with their weight can evaluate the numerous factors impacting obesity and work toward accepting those things they cannot influence. In addition, they can take responsibility for putting forth effort into those aspects of their struggles with weight that they can positively impact.

All righty, then! Let’s look at three of the main contributing factors of obesity and then talk about each one, emphasizing what, if anything, each person can do to have a positive impact on their weight.

Genetics

Culture and Environment

Metabolism

Genetics

Obesity definitely has some genetic determinants, as researchers have clearly discovered. If there are a lot of obese people in your extended family, you have a better chance of being obese than someone from a family without a history of weight problems.

Although there are many more obese people in the current population than in previous generations, this cannot all be linked to genetics. The genetic composition of the population does not change rapidly. Therefore, the large increase in obesity reflects major changes in non-genetic factors. Listen to this… According to the Centers for Disease Control and Prevention (2002): “Since 1960, adult Americans have increased in height an average of 1 inch but have increased in weight by 25 pounds.” So in 50 years, the human species has grown taller by only an inch but heavier by 25 pounds. That tells us there is more than genetics influencing weight gain in this country.

PATIENTS: Even if you have a genetic predisposition for obesity, there are other factors involved, including the food choices you make and whether or not you exercise on a regular basis. Some of these behavioral factors are habits learned in your family, so what appears to be a genetic predisposition may be a familial pattern of unhealthy habits that can be broken.

DOCTORS: Remind yourself that patients cannot “eat less/move more” and have any effect on their current genetic makeup. Acknowledge to patients their genetic predisposition for obesity in a compassionate manner. Help to gently educate them about the factors affecting their weight that they can influence. Do so in a “firm and fair” way, providing encouragement rather than admonishment.

Culture And Environment

In addition to one’s genes, a person’s culture and environment play a large role in causing people to be overweight and obese.

The environment and culture in which you were raised impacts how and what you eat. Some people were taught to eat everything on their plate and couldn’t get up from the table until they did so. Others never sat at a table for a meal but watched television while they ate. Some kids are fed well-balanced meals while others exist on fast food or microwaved mac and cheese with hot dogs. In some cultures, simple carbs make up a substantial part of every meal. In other cultures, fruits and vegetables are consumed regularly. When you are a child, you’re not in charge of buying the groceries or providing the meals. You did learn, however, about what and how to eat from those with whom you lived. And guess what that means? How you feed your children is what they will think of as “normal” and will most likely be how they eat as adults. (I’m always concerned when weight loss surgery patients tell me their kids are “just fine” even though they eat the same unhealthy foods as the obese parent. It’s only a matter of time before the kids start to gain weight and have health problems as a result of their unhealthy diet and learned eating behaviors.)

PATIENTS: Although your genetic composition cannot be changed, the eating behaviors you learned in your family, from your culture, or developed on your own can be changed. You alone now determine what kind, and how much exercise you do and what and when you eat. Your behavior is completely within your control. Work toward accepting the fact that you are in charge of, and responsible for, your behavior and every food choice you make. For every choice, there is a consequence, positive or negative. And NO EXCUSES! It doesn’t matter how busy you are, whether you get a lunch break at the office or whether you have to cook for a family. Even if you have five kids in different activities and spend your life taxi-ing them from one place to another, you are the adult and you are responsible for how you eat and how you feed your children. It takes a very responsible person to acknowledge, “Although I have a genetic predisposition for obesity, I am responsible for making healthy choices about my eating and exercise. For me and for my children.” Focusing on what you do have control over rather than that over which you are powerless, leads to believing in your capabilities. So take charge and make positive changes happen!

DOCTORS: Engage your patient in a discussion about the cultural and environmental factors that helped shape their current food choices and exercise behaviors. Empathize with them, noting they are going to have to put forth consistent effort to change years of bad habit formation. Encourage them to get support, whether it is from friends with a healthy lifestyle, a health coach, a personal trainer, or the use of free online exercise videos. Help them set a short-term, reasonable goal and set an appointment with you to follow up. Remember, docs: That which is reinforced is repeated. Reinforce even small steps forward you see in your patients. This can go a long way in encouraging them to continue making healthier choices. A step forward is a step forward. Notice and praise every single step forward your patient makes!

Resting Metabolic Rate

Resting Metabolic Rate (or RMR) is simply the energy needed to keep the body functioning when it’s at rest. In other words, RMR describes how many calories it takes to live if you’re just relaxing. Resting Metabolic Rate can vary quite a bit from one person to another, which may help explain why some people gain weight more quickly than others. And why some people seem to find it more difficult to lose weight than others. There are some factors related to metabolism that you can’t change, but there are actually some that you can influence and change.

Things you cannot change about metabolic rate:

• Metabolic rate decreases with each passing decade, which means the older you are, the slower your metabolism gets, making weight loss more difficult.
  
• Sorry ladies - Men generally have a higher metabolism, meaning they burn calories more quickly than women.
  
• You can inherit your metabolic rate from previous generations - which can be a benefit… or not.
  
• An underactive or overactive thyroid gland can slow down or speed up metabolism.
  

Some things you can do to influence your metabolism and burn more calories include:

• Eat small, frequent meals.
  
• Drink ice Water.< br>
• You can boost metabolism temporarily with aerobic exercise.
  
• You can boost metabolism in the long run with weight training.
  

PATIENTS: I’ll bet you didn’t there was much of anything you could do that would increase your metabolism. I’m hoping you choose to implement the ways you can help your body burn more calories. And what do you know? They are completely consistent with healthy post-op behaviors that you’re supposed to do anyway:

1) Eat small, frequent meals. CHECK.

2) Drink water (so add ice and boost that RMR). CHECK.

3) Engage in exercise, both aerobic and weight bearing. CHECK. There’s no reason NOT to anymore! (That’s a slogan from a really old commercial…) The point is, your specific RMR is both something that is unique to you, and that will slow down with age, is gender-influenced, and can be affected by thyroid issues. Accept the things you cannot change and DO the things you can to get the most out of your own, unique RMR. You DO have choices! Opt not to make excuses and JUST DO THE THINGS YOU CAN!

DOCTORS: I’m pretty sure that educating patients is in your job description. Even though you have an allotted set of minutes during which to accomplish all your goals with a patient, point out the ways they can boost their metabolism while you’re looking into their ears, or hitting them on the knee with that little hammer. Present it as a, “Hey! Guess what I was reminded of today?” sort of thing. It’ll probably be absorbed better than a mini-lecture. Leave yourself a sticky note in the patient’s folder to bring it up in your next session… and then a new educational point for the next meeting, along with the small goal you set with them so you can be sure to praise them for their efforts!

Patients and Doctors and all Allied Health Professionals: We need to work together to do the following:

1) End Fat Shaming

2) End Blaming

3) End Lecturing

4) Encourage reciprocal AWARENESS and ACCOUNTABILTIY

5) Encourage reciprocal EDUCATION and DISCUSSION

6) Encourage reciprocal GOAL-SETTING and FOLLOW-UP

Stay tuned for Part Two of BARIATRIC REALITIES: Causes of Obesity – What Factors can YOU Influence?

@@beinghappy2day

Transfer addictions do happen, I believe. My point in writing this article is in relation to the governing body's recommendations. My point is not about being absolute or overbearing... it's specifically related to the bariatric professionals who are the "leaders of the pack." My position is that this governing body needs to have a more definite RECOMMENDATION, based on the fact that alcohol is a toxin that can have deleterious effects on the absorption of essential nutrients, in addition to other possible negative effects.

Thank you for posting!

@@My Bariatric Life

Wow! You have made some incredible decisions for your health! Awesome! Thanks for sharing!

@@Babbs

I definitely agree that the bariatric team need only give patients education and information. As I keep reminding people, my issue is about the governing body of the bariatric team not making a sound medical recommendation. My point is not about being absolute or overbearing... it's specifically related to the bariatric professionals who are the "leaders of the pack." My position is that this governing body needs to have a more definite RECOMMENDATION, based on the fact that alcohol is a toxin that can have deleterious effects on the absorption of essential nutrients, in addition to other possible negative effects.

Continue making the healthiest choices for you!