Connie Stapleton PhD

Bariatric Realities
I’m doing this series called “Bariatric Realities” as a result of many frustrations. In this case, the energy generated in my body and brain, as a result of these annoyances, is my motivation for developing this series. I need to “get it out,” put my thoughts and feelings on paper - and on video - and share them. I want to talk about what I see and hear, day in and day out, from the patients I work with. These vulnerable men and women tell me about the realities of dealing with weight issues, the struggles related to getting extra weight off and keeping it off, and the underlying emotional hurdles interfering with their progress.


Bariatric Realities
I’m doing this series called “Bariatric Realities” as a result of many frustrations. In this case, the energy generated in my body and brain, as a result of these annoyances, is my motivation for developing this series. I need to “get it out,” put my thoughts and feelings on paper - and on video - and share them. I want to talk about what I see and hear, day in and day out, from the patients I work with. These vulnerable men and women tell me about the realities of dealing with weight issues, the struggles related to getting extra weight off and keeping it off, and the underlying emotional hurdles interfering with their progress.
I’m frustrated that patients, whether they are seeking medical weight loss assistance or opting for weight loss surgery, are given only part of the story and only part of the solution. The emphasis in all bariatric programs, obviously, is on meal planning and “behavior modification.” These are, of course, essential elements of weight loss and healthy weight management, but they are only part of the deal. The emotional components related to weight issues – shame, self-esteem, body image, family of origin issues, past trauma, relationship changes following weight loss – these and many other crucial, emotional/psychological issues are so often ignored.
Not to me, they aren’t. And these will be addressed in this series.
In addition, I want to inform other professionals in the medical, psychological and psychiatric fields about things patients (and, to be fair, some professionals) know, but the scholarly types won’t listen to, because what I have to say isn’t “evidence based.” Meaning there are no formal research studies or statistics to verify or validate what I, and so many others, know to be true. Oh, I am a believer in, and supporter of evidence based research – without a doubt! And yet, so many topics that need to be addressed in the area of weight loss have not been formally researched, nor do they always lend themselves to scientific investigation. (Not to mention, the evidence found in evidence-based research is very often conflicting and ever changing. That, however is another paper…)
I will address those very real problems related to weight loss and maintenance that are largely ignored due to a lack of research-based evidence. And yet, those topics are so very, very real.
Here’s a sneak peak at the types of things I’ll be addressing in the Bariatric Reality series.
Alcohol Use After WLS
This topic is widely debated by patients and professionals alike. It is, indeed, discussed at the professional meetings. In fact, just a few years ago, a big fuss was made at one of the largest bariatric surgery professional meetings about brand new research related to Alcohol Use Disorders following weight loss surgery. The actual researchers presented findings of their newly published data recently released in The Journal of The American Medical Association (JAMA): Prevalence of Alcohol Use Disorders Before and After Bariatric Surgery. The authors reported a 2% increase in Alcohol Use Disorders at the 2-year post-surgical assessment.
Is this information helpful? Of course it is! Does it tell much of a story, really? If you ask those of us who work day in and day out in surgical weight loss programs, I’d venture to say that the majority would report that this 2% statistic at two years post-op doesn’t even begin to tell the reality of the problems we see with “Alcohol Use Disorders” following weight loss surgery… some a year after, some two years after, some five years after. And it’s not just alcohol. It’s also abuse of pain medications, spending, promiscuous sexual behavior and eating disorders.
And tell me… how many WLS patients who have “Alcohol Use Disorders” haven’t returned to their bariatric centers for follow up to be included in the research results? How many haven’t mentioned anything about “Alcohol Use Disorders” to the multidisciplinary team? A lot.
Yet we can’t present the very real information from patients who tell us about their friends who won’t come see the doctor after their surgery … the ones they are worried about because the person of concern isn’t eating but is consuming the majority of their calories from alcohol. We can’t count, or report on, the patients whose won’t come in for a follow-up and who drink so much they are falling down and hurting themselves. There is no “data” to indicate the number of patients calling and insisting they need more or higher doses of pain medication and become hostile or abusive to the staff when told the doctor won’t prescribe any more. We don’t have “numbers” for the patients who sit in my office and cry because they are sleeping with anyone who shows any interest in them. We have no data on the number of patients who tell me and other providers around the country that they meet strangers at motels for sex, something they never did before. How do we help educate other professionals about very real, very dangerous “anecdotal” reports of problems, when, alas, we have no DATA?
No, this type of information is not discussed at the “professional” meetings because we don’t have scientific evidence. But these things are happening. They are real. And they need to be talked about. So I’ll talk about them and hope someone listens. A lot of someones – so that people won’t be afraid to ask for help for these issues, knowing they’re not alone. And so that professionals may – just may – stop pretending these things aren’t happening because there are no “numbers” to support the reality.
Food Addiction
Last year, I spoke at a national weight loss conference for overweight and obese patients. The moderator of the panel of which I was a part, felt strongly that food/eating is not an addiction. He therefore posed this question to the audience of approximately 200 people: “How many of you consider yourself to be a food addict?” Nearly every hand in the audience shot up immediately. I explained to him, and to the audience, that the hallmark of addiction is knowing something is a problem and has caused problems (think of all the health-related problems associated with obesity), wanting to stop (wanting to lose weight) having made many attempts to stop (consider all of the prior dieting), but not being able to stop (most people regain any lost weight from dieting and feel hopeless about being able to make permanent changes to their eating and exercise behavior). These people who consider themselves food addicts are addicted to food/eating, physically and/or emotionally. They know their weight is causing serious problems in their lives, they want to stop, but they cannot. That’s addiction.
“Where’s the evidence, Connie?” Well, I don’t have it. And I can’t find that many others do, either. I did find a “scholarly article” from 2013 of a study of 652 adults from the general population in Newfoundland, in which the prevalence of “food addiction” was 5.4%. The majority of other “scholarly articles” that even discuss food addition focus primarily on Binge Eating Disorder or the “neurobiology” of food addiction. Often the conclusions are similar: professionals differ on their beliefs about the idea of whether or not “food addiction” is real.
Ask your patients. They believe food addiction is real.
So if, at the professional meetings, we can only discuss food addiction based on the “research,” it seems we are limited to debating the existence of food addiction, or to sharing the percentage of “food addicts” in Newfoundland. How, then, are we supposed to talk to professionals about the myriad of non-scientifically-researched REAL issues that patients experience in their REAL lives?
I’m frustrated.
Bariatric Realities is my new outlet. I will talk in REAL language about the REAL issues experienced by the REAL patients I work with all day long. I hope it will get others talking! Share your REAL thoughts, feelings and observations with me and other readers! THANKS!
The NEXT TOPIC for Bariatric Realities: Genetics and Sources of Weight Problems – What ARE You Accountable for?
Connie Stapleton, PhD
connie@conniestapletonphd.com
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Twitter: @cstapletonphd
LinkedIn: Connie Stapleton, PhD

Connie,
Thanks so much for this article! These are some really good tips for accepting yourself if you realize you’re always putting yourself down or feeling inadequate. You have great ideas for being realistic about what you want from life and what you can demand and expect from yourself without asking for so much that you’re setting yourself up for failure.
In addition, this whole issue and article provide a good reminder that the eating issues we have dealt with for years before surgery and since aren’t always just about the weight. If we don’t get to the heart of the matter, they will show up somewhere else, either on the other end of the disorder spectrum as you talk about here, or in something like a mental disorder (say, depression) or replacement addiction.
Thanks for the great insights!

What made this interesting to me, was the specificity. Like, actual examples of the experience. I have issues, but not these, which I find oddly reassuring.
Really, i don't feel guilt or even really worry about what I have eaten. I am diligent in the sense that I keep a close eye, but I don't feel the desire to punish myself with excessive exercise, for example, if I eat more than planned. In fact, I view exercise as a tool to keep my body ready to do the stuff I WANT to do like hiking, horseback riding, snowshoing, cross country skiing etc. Exercise in and of itself is not really a big focus for me anymore, it is kind of like basic hygenie I guess.
I had about a 10# regain this last summer and in the past I would have faced that with one of two approaches, both essentially panic responses:
- what the heck, give up, stop weighing, buy bigger pants
-panic, try some program lose 30# and regain 50
Instead, I stayed calm and decided first to focus on stopping gaining. I made small changes and stabilized. Then I thought, hmmm, what do I need to do to lose a few. I made some more small changes - going back to basics of course. I am back under goal again but it took several months. This was a low stress way to address it. what I also noticed was those 10# felt horrible because my snugger jeans wouldn't zip anymore, but nobody around me even noticed. It is not like the Earth stops rotating because Jane put on 10#... there is something to be said for putting these things into perspective.

Thank you so much for such an educational, enlightening, and useful article.
By the way, several years ago, before I started even considering Weight Loss Surgery, my eating disorder therapist at the time recommended your book Eat it Up! I read some of it back then. But, not until I was in the process of having surgery did I read it carefully, cover to cover.
Now, it is one of the books I recommend on a regular basis to people who are going through this process.
Thank you.

Wow, what a great article! Thanks for bringing Orthorexia Nervosa to people's attention. I've seen the behavior in people before, but never knew it as an actual disorder.

I'm in the process of getting therapy for these very issues! It's not easy to learn to be objective and realistic about yourself when you have an eating disorder because your reasoning is flawed, and thoughts that you feel are valid and logical are often completely skewed by the disorder.
If anyone reading this has noticed these problems... get help! We didn't go through a life-threatening, life-altering surgery only to keep treating our bodies poorly. You deserve to take fantastic care of yourself, and if you need help to do that, there's no shame in it.
Thanks for the post. It was a good read and a reminder that this is always going to be a journey of health, not a destination.

I got a text this week from a former client who moved out of the state a while back. This woman, who I will call Mattie, had weight loss surgery four years ago. She lost the majority of her excess weight and has maintained that weight loss. She’s even had a baby and continues to maintain her weight loss!
Mattie asked me a few questions. We exchanged a few texts before I told her I would send her an email with some thoughts. I was actually on the treadmill at the time and haven’t quite mastered accurate texting while hustling on the treadmill (and watching my guilty pleasure, The Young and The Restless) while I walk!


Here’s how our messages went...
I got a text this week from a former client who moved out of the state a while back. This woman, who I will call Mattie, had weight loss surgery four years ago. She lost the majority of her excess weight and has maintained that weight loss. She’s even had a baby and continues to maintain her weight loss!
Mattie asked me a few questions. We exchanged a few texts before I told her I would send her an email with some thoughts. I was actually on the treadmill at the time and haven’t quite mastered accurate texting while hustling on the treadmill (and watching my guilty pleasure, The Young and The Restless) while I walk!
Here’s how our messages went:
Mattie: “I want your professional opinion… Orthorexia nervosa and body dysmorphia… real or not real?”
I honestly had never heard of orthorexia nervosa, so, while contemplating whether or not I like the new actor playing Billy Abbot, I looked up orthorexia nervosa. Here’s the definition from the National Eating Disorders Association (https://www.nationaleatingdisorders.org/orthorexia-nervosa):
“Those who have an “unhealthy obsession” with otherwise healthy eating may be suffering from “orthorexia nervosa,” a term which literally means “fixation on righteous eating.” Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity. They become consumed with what and how much to eat, and how to deal with “slip-ups.” An iron-clad will is needed to maintain this rigid eating style. Every day is a chance to eat right, be “good,” rise above others in dietary prowess, and self-punish if temptation wins (usually through stricter eating, fasts and exercise). Self-esteem becomes wrapped up in the purity of orthorexics’ diet and they sometimes feel superior to others, especially in regard to food intake.
Body dysmorphia, just to get the formal definitions over with, is a clinical diagnosis in the Diagnostic and Statistical Manual (DSM V), the guidebook used by psychiatrists, psychologists, and other health care professionals. People who have Body Dysmorphic Disorder are:
“preoccupied with one or more nonexistent or slight defects or flaws in their physical appearance.” Keep in mind that the emphasis is on nonexistent or slight defects, not something that is clearly visible. “‘Preoccupation’ is usually operationalized as thinking about the perceived defects for at least an hour a day… The preoccupation must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”
“At some point, the individual must perform repetitive, compulsive behaviors in response to the appearance concerns. These compulsions can be behavioral and thus observed by others – for example, mirror checking, excessive grooming, skin picking, reassurance seeking, or clothes changing. Other BDD compulsions are mental acts – such as comparing one’s appearance with that of other people.”
Now that you know what we’re talking about, I’ll continue with our text conversation. In response to Mattie’s question about whether or not orthorexia nervosa and body dysmorphia are real, I responded: “Yes, real.”
Mattie: “Thank you.”
Me: J J J J
Mattie: “I’ve been doing a lot of research on eating disorders and the psychological issues that come with them when I came across these.
Me: Do you think you have those issues?
Mattie: I don’t know. I think I may but I feel crazy saying that. I need to do some
more research to know for sure but from everything I’m reading it describes me pretty well. I seem to have gone to the opposite extreme from where I was three years ago.
Me: That means you haven’t dealt with the issues but are acting them out on the
other end of the spectrum.
Mattie: That’s what I’m scared of.
Me: Yeah, but you would not be exploring it if you weren’t willing to work on things.
Mattie: Very true. I just feel like it’s all in my head but then again, not. It’s deeper
than just my thoughts. It’s almost like these other little voices outside of myself telling me what to think and how to act.
Me: What are the voices saying and whose voices are you hearing?
Mattie: They are mine and the voices of lots of other people I have known throughout my whole life. Most of the time they are just telling me whatever I do isn’t good enough and that I have to do more. No matter what, don’t mess up because it’s impossible to undo. All my flaws are being pointed out along with the mistakes I make and how much I still need to do. Last week I had a full-blown panic attack because I ate some rice with my meal and felt like I could feel it going through my system and turning into fatter things and a big old stomach. After I finally calmed down I ended up at the gym doing cardio for 2 ½ hours. Stuff like that happens more than I care to admit. Sometimes when I think about it I freak out so much I actually get sick. All of this makes me wonder if the surgery wasn’t the result of my brain saying ‘you should do this because it will make you prettier and healthier.’”
Me: I’ll email you… too much to say and I’m on the treadmill.
I also didn’t want to miss finding out if Billy was in cahoots with Phyllis or if he was backing out of their deal…
The more I thought about all I wanted to say to Mattie, the more I decided others would benefit from the information. I’m certain she’s not the only one struggling with many of the issues she brought up.
To begin with, a great many people who have weight loss surgery find themselves engaging in behaviors that are unhealthy two to three years later. I’ve worked with patients who start drinking excessively, shopping themselves into financial distress, sleeping with people they don’t even want to be sleeping with, abusing/becoming dependent on pain medication, returning to unhealthy eating behaviors and starting to regain weight, spending too many hours exercising, behaving in other forms of bulimic behavior, engaging in anorexic behavior, and, I now learn from Mattie, orthorexia nervosa.
It’s fairly predictable. For the first year to 18 months, people are thrilled because they are losing the weight they struggled to shed for so long. It’s exhilarating to see the results they so longed for. It is an exciting time and the body is doing what it is supposed to do following the surgery. As the body heals and weight stabilizes, sometimes people begin to engage in behaviors they may not even understand themselves.
So what is the explanation for a return to eating unhealthy food in spite of knowing the misery of having been morbidly obese and experiencing significant health issues as a result? What sense does it make to become anorexic or orthorexic or alcoholic or a shopaholic or to engage in any sort of behavior to the point it creates problems in your life?
To mental health professionals, it makes perfect sense. We understand that for many people who struggle with weight issues, there is emotional baggage beneath the surface. Weight loss surgery doesn’t treat “head issues.” When people have weight loss surgery, they lose the option (at least for a time) to use food as a coping mechanism, an attempt to avoid dealing with things that are under the surface.
Mattie was quick to point out what is at the heart of the real problems, the issues underlying one’s weight and focus on food… it’s the voices of various people from your past who have told you things similar to what Mattie continues to hear in her head:
You could have done better.
You could have done more.
You got all A’s but one B… why wasn’t that an A?
Why can’t you be more like your sister?
If you keep gaining weight, no one will marry you.
You’ll never amount to anything.
It’ll just never be ‘good enough.’

Mattie made it clear that it’s not just the voices of others she hears, but also her own. There’s a simple reason for this: Children learn what they live…and then they live what they learned. The negative messages you heard about yourself from others as you were growing up are what you learned as you grew up. Every time you repeat those messages to yourself in the present, you are living what you learned. As an adult, you’re reinforcing to yourself the negative things you initially heard from others about you.
The solution? Simple – yet very difficult! You have to make a commitment to yourself to no longer talk to yourself about yourself in negative terms. Even if you don’t believe yourself at first. And you have to put a lot of effort into changing and restating the negative messages you repeat about yourself so they are at least neutral:
· You could have done better.

o When you hear this message, change it to, “Maybe I could have done better, and yet I can’t change the outcome of this situation. I’ll think about what more I might be able to do the next time this situation arises.” · You could have done more.

o When you hear this message, change it to, “There’s probably always more that could be done in a given situation. That’s as much effort as I was willing to put into this situation at this time.” · You got all A’s but one B… why wasn’t that an A?

o When you hear this message, change it to, “Perfection doesn’t exist, nor did I want to put forth the effort for that particular endeavor. I’m pleased with the results.” · Why can’t you be more like your sister?

o When you hear this message, change it to, “I can’t be more like her because we are different people and I’m learning to like myself just fine.” · If you keep gaining weight, no one will marry you.

o When you hear this message, change it to, “I’m learning to accept myself the way I am and I don’t want to marry or have close relationships with anyone who doesn’t accept me as I am.” · You’ll never amount to anything.

o When you hear this message, change it to, “Never amount to anything according to whom? I’m becoming more and more comfortable with who I am and what I want in life. That’s what matters.” · It’ll just never be ‘good enough.’

o When you hear this message, change it to, “I’ve come to terms that I am, indeed, ‘good enough,’ and I like myself this way.” What makes this different is that people say, “I tried, but it doesn’t work.” Well, keep trying. The reality is you are battling years of negative messages and your brain has literally developed neural pathways so you slip back into those well-worn paths quite easily. In order to develop new neural pathways that are more optimistic toward self, it will also take thousands of repetitions. If you were learning to speak a completely foreign language, it would take days and weeks and months of repetition before the new language would come easily. It’s the same thing with positive self-talk. The good news is, you can benefit from positive changes as soon as you start talking better about yourself. Remember, no one is putting you down at this point in your life except you. (If there are others degrading you, then you need to learn healthy boundaries and tell those people to stop and/or get them out of your life.)
The negative self-talk is part of the deal and changing that is a huge part of the solution. But, WAIT – there’s MORE! Of course there is! There’s actually a lot more, but this is supposed to be a short article, which it already isn’t. Therefore, I will only address one more essential issue related to weight regain and/or the transfer to another unhealthy behavior after weight loss surgery. In Mattie’s case, the transfer has been to a rigid attitude about eating healthy foods, feeling tremendously guilty if she eats anything but healthy foods, followed up by a form of bulimia known as exercise bulimia, as evidenced by her working out for 2 ½ hours after eating some rice.
Regardless of what unhealthy behavior a person switches to following weight loss surgery, what needs to be addressed is the purpose the behavior serves. This points, also, to looking at what purpose food and/or obesity served prior to weight loss surgery. Simply stated, an almost obsessive focus on food, whether that is thinking about what one is going to eat next, pouring over recipes, relentless counting of calories and grams, watching every show on the Food Network, exercising excessively, obsessing about healthy foods, is a coping skill. In the adult world, people are capable of learning and understanding that these eating and food-related behaviors are unhealthy in that they negatively affect health and relationships. The reasons people remain engaged in these negative behaviors, in spite of knowing they are detrimental to their physical, emotional and relational health include the possibilities that: 1) they have addictions (to food, or other substances/behaviors), and weight loss surgery does NOT treat food addiction, 2) they are tremendously afraid of feeling their own feelings and are terrified of dealing with past emotional issues; what’s more, people often deny having any past issues they need to deal with in the first place. Trust me… we all do. Every human being has had some painful experiences in their lives. People are terrified of what I call cleaning out their emotional closets because they literally fear experiencing feelings. Here’s why: when people experience feelings from past losses and hurts, they feel it with the same intensity at which they felt it at the age they were when it happened. That frightens adults and they avoid dealing with their past at all costs. And these costs can be high; anyone who has had weight loss surgery understands the physical and emotional costs that being obese bears.
Here’s the deal: if people don’t dig into whatever they are avoiding emotionally, or address any addictions head on, and if they don’t learn healthy adult coping skills, communication skills, and how to set healthy boundaries, then they WILL switch to another unhealthy behavior to use a coping skill (another name for avoiding reality and feelings).
In Mattie’s case, she swung to the opposite end of the eating continuum. Either end of an issue often means the person is just acting out the same unhealthy coping skill in the opposite way. You often hear of people who are not at all religious becoming overly immersed in a religion. Same problems… just acting them out in opposite ways. Hence, my response to Mattie as she described “having gone to the opposite extreme” with her eating behavior, when I said, “That means you haven’t dealt with the issues but are acting them out on the other end of the spectrum.”
My suggestion to Mattie and to anyone else who is engaging in any disordered eating behaviors, anyone who has regained weight, and anyone who has begun engaging in other addictive or unhealthy behaviors following weight loss surgery: Get into individual and/or group therapy with a therapist who understands “family systems” counseling and/or addiction counseling. Talk about issues underlying your addiction to food (your emotional dependency on food), any losses you experienced throughout your life that you haven’t dealt with, and any trauma/abuse you have experienced at any time in your life. Work with a therapist to learn and develop healthy coping skills to implement into your adult life, how to implement healthy boundaries in your adult life, with yourself and with others, and learn healthy communication skills. Read about these same topics, and add to the reading list the topic of “re-parenting the self.”
Orthorexia nervosa and body dysmorphia are real, as are bulimia and food addiction and transfer addiction. Weight loss surgery can inadvertently open the door for these problematic behaviors. Do what I always tell people to do: Get Help and Get Happier!
Thank you, Mattie for bringing these topics up to me. I hope this has helped you and many others! Oh – and by the way, I’ve decided I like the new Billy Abbot… so far!
Connie Stapleton, Ph.D.
www.connie@conniestapletonphd.com
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I got a text this week from a former client who moved out of the state a while back. This woman, who I will call Mattie, had weight loss surgery four years ago. She lost the majority of her excess weight and has maintained that weight loss. She’s even had a baby and continues to maintain her weight loss!
Mattie asked me a few questions. We exchanged a few texts before I told her I would send her an email with some thoughts. I was actually on the treadmill at the time and haven’t quite mastered accurate texting while hustling on the treadmill (and watching my guilty pleasure, The Young and The Restless) while I walk!


Here’s how our messages went...
I got a text this week from a former client who moved out of the state a while back. This woman, who I will call Mattie, had weight loss surgery four years ago. She lost the majority of her excess weight and has maintained that weight loss. She’s even had a baby and continues to maintain her weight loss!
Mattie asked me a few questions. We exchanged a few texts before I told her I would send her an email with some thoughts. I was actually on the treadmill at the time and haven’t quite mastered accurate texting while hustling on the treadmill (and watching my guilty pleasure, The Young and The Restless) while I walk!
Here’s how our messages went:
Mattie: “I want your professional opinion… Orthorexia nervosa and body dysmorphia… real or not real?”
I honestly had never heard of orthorexia nervosa, so, while contemplating whether or not I like the new actor playing Billy Abbot, I looked up orthorexia nervosa. Here’s the definition from the National Eating Disorders Association (https://www.nationaleatingdisorders.org/orthorexia-nervosa):
“Those who have an “unhealthy obsession” with otherwise healthy eating may be suffering from “orthorexia nervosa,” a term which literally means “fixation on righteous eating.” Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity. They become consumed with what and how much to eat, and how to deal with “slip-ups.” An iron-clad will is needed to maintain this rigid eating style. Every day is a chance to eat right, be “good,” rise above others in dietary prowess, and self-punish if temptation wins (usually through stricter eating, fasts and exercise). Self-esteem becomes wrapped up in the purity of orthorexics’ diet and they sometimes feel superior to others, especially in regard to food intake.
Body dysmorphia, just to get the formal definitions over with, is a clinical diagnosis in the Diagnostic and Statistical Manual (DSM V), the guidebook used by psychiatrists, psychologists, and other health care professionals. People who have Body Dysmorphic Disorder are:
“preoccupied with one or more nonexistent or slight defects or flaws in their physical appearance.” Keep in mind that the emphasis is on nonexistent or slight defects, not something that is clearly visible. “‘Preoccupation’ is usually operationalized as thinking about the perceived defects for at least an hour a day… The preoccupation must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”
“At some point, the individual must perform repetitive, compulsive behaviors in response to the appearance concerns. These compulsions can be behavioral and thus observed by others – for example, mirror checking, excessive grooming, skin picking, reassurance seeking, or clothes changing. Other BDD compulsions are mental acts – such as comparing one’s appearance with that of other people.”
Now that you know what we’re talking about, I’ll continue with our text conversation. In response to Mattie’s question about whether or not orthorexia nervosa and body dysmorphia are real, I responded: “Yes, real.”
Mattie: “Thank you.”
Me: J J J J
Mattie: “I’ve been doing a lot of research on eating disorders and the psychological issues that come with them when I came across these.
Me: Do you think you have those issues?
Mattie: I don’t know. I think I may but I feel crazy saying that. I need to do some
more research to know for sure but from everything I’m reading it describes me pretty well. I seem to have gone to the opposite extreme from where I was three years ago.
Me: That means you haven’t dealt with the issues but are acting them out on the
other end of the spectrum.
Mattie: That’s what I’m scared of.
Me: Yeah, but you would not be exploring it if you weren’t willing to work on things.
Mattie: Very true. I just feel like it’s all in my head but then again, not. It’s deeper
than just my thoughts. It’s almost like these other little voices outside of myself telling me what to think and how to act.
Me: What are the voices saying and whose voices are you hearing?
Mattie: They are mine and the voices of lots of other people I have known throughout my whole life. Most of the time they are just telling me whatever I do isn’t good enough and that I have to do more. No matter what, don’t mess up because it’s impossible to undo. All my flaws are being pointed out along with the mistakes I make and how much I still need to do. Last week I had a full-blown panic attack because I ate some rice with my meal and felt like I could feel it going through my system and turning into fatter things and a big old stomach. After I finally calmed down I ended up at the gym doing cardio for 2 ½ hours. Stuff like that happens more than I care to admit. Sometimes when I think about it I freak out so much I actually get sick. All of this makes me wonder if the surgery wasn’t the result of my brain saying ‘you should do this because it will make you prettier and healthier.’”
Me: I’ll email you… too much to say and I’m on the treadmill.
I also didn’t want to miss finding out if Billy was in cahoots with Phyllis or if he was backing out of their deal…
The more I thought about all I wanted to say to Mattie, the more I decided others would benefit from the information. I’m certain she’s not the only one struggling with many of the issues she brought up.
To begin with, a great many people who have weight loss surgery find themselves engaging in behaviors that are unhealthy two to three years later. I’ve worked with patients who start drinking excessively, shopping themselves into financial distress, sleeping with people they don’t even want to be sleeping with, abusing/becoming dependent on pain medication, returning to unhealthy eating behaviors and starting to regain weight, spending too many hours exercising, behaving in other forms of bulimic behavior, engaging in anorexic behavior, and, I now learn from Mattie, orthorexia nervosa.
It’s fairly predictable. For the first year to 18 months, people are thrilled because they are losing the weight they struggled to shed for so long. It’s exhilarating to see the results they so longed for. It is an exciting time and the body is doing what it is supposed to do following the surgery. As the body heals and weight stabilizes, sometimes people begin to engage in behaviors they may not even understand themselves.
So what is the explanation for a return to eating unhealthy food in spite of knowing the misery of having been morbidly obese and experiencing significant health issues as a result? What sense does it make to become anorexic or orthorexic or alcoholic or a shopaholic or to engage in any sort of behavior to the point it creates problems in your life?
To mental health professionals, it makes perfect sense. We understand that for many people who struggle with weight issues, there is emotional baggage beneath the surface. Weight loss surgery doesn’t treat “head issues.” When people have weight loss surgery, they lose the option (at least for a time) to use food as a coping mechanism, an attempt to avoid dealing with things that are under the surface.
Mattie was quick to point out what is at the heart of the real problems, the issues underlying one’s weight and focus on food… it’s the voices of various people from your past who have told you things similar to what Mattie continues to hear in her head:
You could have done better.
You could have done more.
You got all A’s but one B… why wasn’t that an A?
Why can’t you be more like your sister?
If you keep gaining weight, no one will marry you.
You’ll never amount to anything.
It’ll just never be ‘good enough.’

Mattie made it clear that it’s not just the voices of others she hears, but also her own. There’s a simple reason for this: Children learn what they live…and then they live what they learned. The negative messages you heard about yourself from others as you were growing up are what you learned as you grew up. Every time you repeat those messages to yourself in the present, you are living what you learned. As an adult, you’re reinforcing to yourself the negative things you initially heard from others about you.
The solution? Simple – yet very difficult! You have to make a commitment to yourself to no longer talk to yourself about yourself in negative terms. Even if you don’t believe yourself at first. And you have to put a lot of effort into changing and restating the negative messages you repeat about yourself so they are at least neutral:
· You could have done better.

o When you hear this message, change it to, “Maybe I could have done better, and yet I can’t change the outcome of this situation. I’ll think about what more I might be able to do the next time this situation arises.” · You could have done more.

o When you hear this message, change it to, “There’s probably always more that could be done in a given situation. That’s as much effort as I was willing to put into this situation at this time.” · You got all A’s but one B… why wasn’t that an A?

o When you hear this message, change it to, “Perfection doesn’t exist, nor did I want to put forth the effort for that particular endeavor. I’m pleased with the results.” · Why can’t you be more like your sister?

o When you hear this message, change it to, “I can’t be more like her because we are different people and I’m learning to like myself just fine.” · If you keep gaining weight, no one will marry you.

o When you hear this message, change it to, “I’m learning to accept myself the way I am and I don’t want to marry or have close relationships with anyone who doesn’t accept me as I am.” · You’ll never amount to anything.

o When you hear this message, change it to, “Never amount to anything according to whom? I’m becoming more and more comfortable with who I am and what I want in life. That’s what matters.” · It’ll just never be ‘good enough.’

o When you hear this message, change it to, “I’ve come to terms that I am, indeed, ‘good enough,’ and I like myself this way.” What makes this different is that people say, “I tried, but it doesn’t work.” Well, keep trying. The reality is you are battling years of negative messages and your brain has literally developed neural pathways so you slip back into those well-worn paths quite easily. In order to develop new neural pathways that are more optimistic toward self, it will also take thousands of repetitions. If you were learning to speak a completely foreign language, it would take days and weeks and months of repetition before the new language would come easily. It’s the same thing with positive self-talk. The good news is, you can benefit from positive changes as soon as you start talking better about yourself. Remember, no one is putting you down at this point in your life except you. (If there are others degrading you, then you need to learn healthy boundaries and tell those people to stop and/or get them out of your life.)
The negative self-talk is part of the deal and changing that is a huge part of the solution. But, WAIT – there’s MORE! Of course there is! There’s actually a lot more, but this is supposed to be a short article, which it already isn’t. Therefore, I will only address one more essential issue related to weight regain and/or the transfer to another unhealthy behavior after weight loss surgery. In Mattie’s case, the transfer has been to a rigid attitude about eating healthy foods, feeling tremendously guilty if she eats anything but healthy foods, followed up by a form of bulimia known as exercise bulimia, as evidenced by her working out for 2 ½ hours after eating some rice.
Regardless of what unhealthy behavior a person switches to following weight loss surgery, what needs to be addressed is the purpose the behavior serves. This points, also, to looking at what purpose food and/or obesity served prior to weight loss surgery. Simply stated, an almost obsessive focus on food, whether that is thinking about what one is going to eat next, pouring over recipes, relentless counting of calories and grams, watching every show on the Food Network, exercising excessively, obsessing about healthy foods, is a coping skill. In the adult world, people are capable of learning and understanding that these eating and food-related behaviors are unhealthy in that they negatively affect health and relationships. The reasons people remain engaged in these negative behaviors, in spite of knowing they are detrimental to their physical, emotional and relational health include the possibilities that: 1) they have addictions (to food, or other substances/behaviors), and weight loss surgery does NOT treat food addiction, 2) they are tremendously afraid of feeling their own feelings and are terrified of dealing with past emotional issues; what’s more, people often deny having any past issues they need to deal with in the first place. Trust me… we all do. Every human being has had some painful experiences in their lives. People are terrified of what I call cleaning out their emotional closets because they literally fear experiencing feelings. Here’s why: when people experience feelings from past losses and hurts, they feel it with the same intensity at which they felt it at the age they were when it happened. That frightens adults and they avoid dealing with their past at all costs. And these costs can be high; anyone who has had weight loss surgery understands the physical and emotional costs that being obese bears.
Here’s the deal: if people don’t dig into whatever they are avoiding emotionally, or address any addictions head on, and if they don’t learn healthy adult coping skills, communication skills, and how to set healthy boundaries, then they WILL switch to another unhealthy behavior to use a coping skill (another name for avoiding reality and feelings).
In Mattie’s case, she swung to the opposite end of the eating continuum. Either end of an issue often means the person is just acting out the same unhealthy coping skill in the opposite way. You often hear of people who are not at all religious becoming overly immersed in a religion. Same problems… just acting them out in opposite ways. Hence, my response to Mattie as she described “having gone to the opposite extreme” with her eating behavior, when I said, “That means you haven’t dealt with the issues but are acting them out on the other end of the spectrum.”
My suggestion to Mattie and to anyone else who is engaging in any disordered eating behaviors, anyone who has regained weight, and anyone who has begun engaging in other addictive or unhealthy behaviors following weight loss surgery: Get into individual and/or group therapy with a therapist who understands “family systems” counseling and/or addiction counseling. Talk about issues underlying your addiction to food (your emotional dependency on food), any losses you experienced throughout your life that you haven’t dealt with, and any trauma/abuse you have experienced at any time in your life. Work with a therapist to learn and develop healthy coping skills to implement into your adult life, how to implement healthy boundaries in your adult life, with yourself and with others, and learn healthy communication skills. Read about these same topics, and add to the reading list the topic of “re-parenting the self.”
Orthorexia nervosa and body dysmorphia are real, as are bulimia and food addiction and transfer addiction. Weight loss surgery can inadvertently open the door for these problematic behaviors. Do what I always tell people to do: Get Help and Get Happier!
Thank you, Mattie for bringing these topics up to me. I hope this has helped you and many others! Oh – and by the way, I’ve decided I like the new Billy Abbot… so far!
Connie Stapleton, Ph.D.
www.connie@conniestapletonphd.com
FB: https://www.facebook.com/connie.stapleton.923
Twitter: @cstapletonphd
LinkedIn: Connie Stapleton, PhD
YouTube: Connie Stapleton

I got a text this week from a former client who moved out of the state a while back. This woman, who I will call Mattie, had weight loss surgery four years ago. She lost the majority of her excess weight and has maintained that weight loss. She’s even had a baby and continues to maintain her weight loss!
Mattie asked me a few questions. We exchanged a few texts before I told her I would send her an email with some thoughts. I was actually on the treadmill at the time and haven’t quite mastered accurate texting while hustling on the treadmill (and watching my guilty pleasure, The Young and The Restless) while I walk!


Here’s how our messages went...
I got a text this week from a former client who moved out of the state a while back. This woman, who I will call Mattie, had weight loss surgery four years ago. She lost the majority of her excess weight and has maintained that weight loss. She’s even had a baby and continues to maintain her weight loss!
Mattie asked me a few questions. We exchanged a few texts before I told her I would send her an email with some thoughts. I was actually on the treadmill at the time and haven’t quite mastered accurate texting while hustling on the treadmill (and watching my guilty pleasure, The Young and The Restless) while I walk!
Here’s how our messages went:
Mattie: “I want your professional opinion… Orthorexia nervosa and body dysmorphia… real or not real?”
I honestly had never heard of orthorexia nervosa, so, while contemplating whether or not I like the new actor playing Billy Abbot, I looked up orthorexia nervosa. Here’s the definition from the National Eating Disorders Association (https://www.nationaleatingdisorders.org/orthorexia-nervosa):
“Those who have an “unhealthy obsession” with otherwise healthy eating may be suffering from “orthorexia nervosa,” a term which literally means “fixation on righteous eating.” Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity. They become consumed with what and how much to eat, and how to deal with “slip-ups.” An iron-clad will is needed to maintain this rigid eating style. Every day is a chance to eat right, be “good,” rise above others in dietary prowess, and self-punish if temptation wins (usually through stricter eating, fasts and exercise). Self-esteem becomes wrapped up in the purity of orthorexics’ diet and they sometimes feel superior to others, especially in regard to food intake.
Body dysmorphia, just to get the formal definitions over with, is a clinical diagnosis in the Diagnostic and Statistical Manual (DSM V), the guidebook used by psychiatrists, psychologists, and other health care professionals. People who have Body Dysmorphic Disorder are:
“preoccupied with one or more nonexistent or slight defects or flaws in their physical appearance.” Keep in mind that the emphasis is on nonexistent or slight defects, not something that is clearly visible. “‘Preoccupation’ is usually operationalized as thinking about the perceived defects for at least an hour a day… The preoccupation must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”
“At some point, the individual must perform repetitive, compulsive behaviors in response to the appearance concerns. These compulsions can be behavioral and thus observed by others – for example, mirror checking, excessive grooming, skin picking, reassurance seeking, or clothes changing. Other BDD compulsions are mental acts – such as comparing one’s appearance with that of other people.”
Now that you know what we’re talking about, I’ll continue with our text conversation. In response to Mattie’s question about whether or not orthorexia nervosa and body dysmorphia are real, I responded: “Yes, real.”
Mattie: “Thank you.”
Me: J J J J
Mattie: “I’ve been doing a lot of research on eating disorders and the psychological issues that come with them when I came across these.
Me: Do you think you have those issues?
Mattie: I don’t know. I think I may but I feel crazy saying that. I need to do some
more research to know for sure but from everything I’m reading it describes me pretty well. I seem to have gone to the opposite extreme from where I was three years ago.
Me: That means you haven’t dealt with the issues but are acting them out on the
other end of the spectrum.
Mattie: That’s what I’m scared of.
Me: Yeah, but you would not be exploring it if you weren’t willing to work on things.
Mattie: Very true. I just feel like it’s all in my head but then again, not. It’s deeper
than just my thoughts. It’s almost like these other little voices outside of myself telling me what to think and how to act.
Me: What are the voices saying and whose voices are you hearing?
Mattie: They are mine and the voices of lots of other people I have known throughout my whole life. Most of the time they are just telling me whatever I do isn’t good enough and that I have to do more. No matter what, don’t mess up because it’s impossible to undo. All my flaws are being pointed out along with the mistakes I make and how much I still need to do. Last week I had a full-blown panic attack because I ate some rice with my meal and felt like I could feel it going through my system and turning into fatter things and a big old stomach. After I finally calmed down I ended up at the gym doing cardio for 2 ½ hours. Stuff like that happens more than I care to admit. Sometimes when I think about it I freak out so much I actually get sick. All of this makes me wonder if the surgery wasn’t the result of my brain saying ‘you should do this because it will make you prettier and healthier.’”
Me: I’ll email you… too much to say and I’m on the treadmill.
I also didn’t want to miss finding out if Billy was in cahoots with Phyllis or if he was backing out of their deal…
The more I thought about all I wanted to say to Mattie, the more I decided others would benefit from the information. I’m certain she’s not the only one struggling with many of the issues she brought up.
To begin with, a great many people who have weight loss surgery find themselves engaging in behaviors that are unhealthy two to three years later. I’ve worked with patients who start drinking excessively, shopping themselves into financial distress, sleeping with people they don’t even want to be sleeping with, abusing/becoming dependent on pain medication, returning to unhealthy eating behaviors and starting to regain weight, spending too many hours exercising, behaving in other forms of bulimic behavior, engaging in anorexic behavior, and, I now learn from Mattie, orthorexia nervosa.
It’s fairly predictable. For the first year to 18 months, people are thrilled because they are losing the weight they struggled to shed for so long. It’s exhilarating to see the results they so longed for. It is an exciting time and the body is doing what it is supposed to do following the surgery. As the body heals and weight stabilizes, sometimes people begin to engage in behaviors they may not even understand themselves.
So what is the explanation for a return to eating unhealthy food in spite of knowing the misery of having been morbidly obese and experiencing significant health issues as a result? What sense does it make to become anorexic or orthorexic or alcoholic or a shopaholic or to engage in any sort of behavior to the point it creates problems in your life?
To mental health professionals, it makes perfect sense. We understand that for many people who struggle with weight issues, there is emotional baggage beneath the surface. Weight loss surgery doesn’t treat “head issues.” When people have weight loss surgery, they lose the option (at least for a time) to use food as a coping mechanism, an attempt to avoid dealing with things that are under the surface.
Mattie was quick to point out what is at the heart of the real problems, the issues underlying one’s weight and focus on food… it’s the voices of various people from your past who have told you things similar to what Mattie continues to hear in her head:
You could have done better.
You could have done more.
You got all A’s but one B… why wasn’t that an A?
Why can’t you be more like your sister?
If you keep gaining weight, no one will marry you.
You’ll never amount to anything.
It’ll just never be ‘good enough.’

Mattie made it clear that it’s not just the voices of others she hears, but also her own. There’s a simple reason for this: Children learn what they live…and then they live what they learned. The negative messages you heard about yourself from others as you were growing up are what you learned as you grew up. Every time you repeat those messages to yourself in the present, you are living what you learned. As an adult, you’re reinforcing to yourself the negative things you initially heard from others about you.
The solution? Simple – yet very difficult! You have to make a commitment to yourself to no longer talk to yourself about yourself in negative terms. Even if you don’t believe yourself at first. And you have to put a lot of effort into changing and restating the negative messages you repeat about yourself so they are at least neutral:
· You could have done better.

o When you hear this message, change it to, “Maybe I could have done better, and yet I can’t change the outcome of this situation. I’ll think about what more I might be able to do the next time this situation arises.” · You could have done more.

o When you hear this message, change it to, “There’s probably always more that could be done in a given situation. That’s as much effort as I was willing to put into this situation at this time.” · You got all A’s but one B… why wasn’t that an A?

o When you hear this message, change it to, “Perfection doesn’t exist, nor did I want to put forth the effort for that particular endeavor. I’m pleased with the results.” · Why can’t you be more like your sister?

o When you hear this message, change it to, “I can’t be more like her because we are different people and I’m learning to like myself just fine.” · If you keep gaining weight, no one will marry you.

o When you hear this message, change it to, “I’m learning to accept myself the way I am and I don’t want to marry or have close relationships with anyone who doesn’t accept me as I am.” · You’ll never amount to anything.

o When you hear this message, change it to, “Never amount to anything according to whom? I’m becoming more and more comfortable with who I am and what I want in life. That’s what matters.” · It’ll just never be ‘good enough.’

o When you hear this message, change it to, “I’ve come to terms that I am, indeed, ‘good enough,’ and I like myself this way.” What makes this different is that people say, “I tried, but it doesn’t work.” Well, keep trying. The reality is you are battling years of negative messages and your brain has literally developed neural pathways so you slip back into those well-worn paths quite easily. In order to develop new neural pathways that are more optimistic toward self, it will also take thousands of repetitions. If you were learning to speak a completely foreign language, it would take days and weeks and months of repetition before the new language would come easily. It’s the same thing with positive self-talk. The good news is, you can benefit from positive changes as soon as you start talking better about yourself. Remember, no one is putting you down at this point in your life except you. (If there are others degrading you, then you need to learn healthy boundaries and tell those people to stop and/or get them out of your life.)
The negative self-talk is part of the deal and changing that is a huge part of the solution. But, WAIT – there’s MORE! Of course there is! There’s actually a lot more, but this is supposed to be a short article, which it already isn’t. Therefore, I will only address one more essential issue related to weight regain and/or the transfer to another unhealthy behavior after weight loss surgery. In Mattie’s case, the transfer has been to a rigid attitude about eating healthy foods, feeling tremendously guilty if she eats anything but healthy foods, followed up by a form of bulimia known as exercise bulimia, as evidenced by her working out for 2 ½ hours after eating some rice.
Regardless of what unhealthy behavior a person switches to following weight loss surgery, what needs to be addressed is the purpose the behavior serves. This points, also, to looking at what purpose food and/or obesity served prior to weight loss surgery. Simply stated, an almost obsessive focus on food, whether that is thinking about what one is going to eat next, pouring over recipes, relentless counting of calories and grams, watching every show on the Food Network, exercising excessively, obsessing about healthy foods, is a coping skill. In the adult world, people are capable of learning and understanding that these eating and food-related behaviors are unhealthy in that they negatively affect health and relationships. The reasons people remain engaged in these negative behaviors, in spite of knowing they are detrimental to their physical, emotional and relational health include the possibilities that: 1) they have addictions (to food, or other substances/behaviors), and weight loss surgery does NOT treat food addiction, 2) they are tremendously afraid of feeling their own feelings and are terrified of dealing with past emotional issues; what’s more, people often deny having any past issues they need to deal with in the first place. Trust me… we all do. Every human being has had some painful experiences in their lives. People are terrified of what I call cleaning out their emotional closets because they literally fear experiencing feelings. Here’s why: when people experience feelings from past losses and hurts, they feel it with the same intensity at which they felt it at the age they were when it happened. That frightens adults and they avoid dealing with their past at all costs. And these costs can be high; anyone who has had weight loss surgery understands the physical and emotional costs that being obese bears.
Here’s the deal: if people don’t dig into whatever they are avoiding emotionally, or address any addictions head on, and if they don’t learn healthy adult coping skills, communication skills, and how to set healthy boundaries, then they WILL switch to another unhealthy behavior to use a coping skill (another name for avoiding reality and feelings).
In Mattie’s case, she swung to the opposite end of the eating continuum. Either end of an issue often means the person is just acting out the same unhealthy coping skill in the opposite way. You often hear of people who are not at all religious becoming overly immersed in a religion. Same problems… just acting them out in opposite ways. Hence, my response to Mattie as she described “having gone to the opposite extreme” with her eating behavior, when I said, “That means you haven’t dealt with the issues but are acting them out on the other end of the spectrum.”
My suggestion to Mattie and to anyone else who is engaging in any disordered eating behaviors, anyone who has regained weight, and anyone who has begun engaging in other addictive or unhealthy behaviors following weight loss surgery: Get into individual and/or group therapy with a therapist who understands “family systems” counseling and/or addiction counseling. Talk about issues underlying your addiction to food (your emotional dependency on food), any losses you experienced throughout your life that you haven’t dealt with, and any trauma/abuse you have experienced at any time in your life. Work with a therapist to learn and develop healthy coping skills to implement into your adult life, how to implement healthy boundaries in your adult life, with yourself and with others, and learn healthy communication skills. Read about these same topics, and add to the reading list the topic of “re-parenting the self.”
Orthorexia nervosa and body dysmorphia are real, as are bulimia and food addiction and transfer addiction. Weight loss surgery can inadvertently open the door for these problematic behaviors. Do what I always tell people to do: Get Help and Get Happier!
Thank you, Mattie for bringing these topics up to me. I hope this has helped you and many others! Oh – and by the way, I’ve decided I like the new Billy Abbot… so far!
Connie Stapleton, Ph.D.
www.connie@conniestapletonphd.com
FB: https://www.facebook.com/connie.stapleton.923
Twitter: @cstapletonphd
LinkedIn: Connie Stapleton, PhD
YouTube: Connie Stapleton

I got a text this week from a former client who moved out of the state a while back. This woman, who I will call Mattie, had weight loss surgery four years ago. She lost the majority of her excess weight and has maintained that weight loss. She’s even had a baby and continues to maintain her weight loss!
Mattie asked me a few questions. We exchanged a few texts before I told her I would send her an email with some thoughts. I was actually on the treadmill at the time and haven’t quite mastered accurate texting while hustling on the treadmill (and watching my guilty pleasure, The Young and The Restless) while I walk!


Here’s how our messages went...
I got a text this week from a former client who moved out of the state a while back. This woman, who I will call Mattie, had weight loss surgery four years ago. She lost the majority of her excess weight and has maintained that weight loss. She’s even had a baby and continues to maintain her weight loss!
Mattie asked me a few questions. We exchanged a few texts before I told her I would send her an email with some thoughts. I was actually on the treadmill at the time and haven’t quite mastered accurate texting while hustling on the treadmill (and watching my guilty pleasure, The Young and The Restless) while I walk!
Here’s how our messages went:
Mattie: “I want your professional opinion… Orthorexia nervosa and body dysmorphia… real or not real?”
I honestly had never heard of orthorexia nervosa, so, while contemplating whether or not I like the new actor playing Billy Abbot, I looked up orthorexia nervosa. Here’s the definition from the National Eating Disorders Association (https://www.nationaleatingdisorders.org/orthorexia-nervosa):
“Those who have an “unhealthy obsession” with otherwise healthy eating may be suffering from “orthorexia nervosa,” a term which literally means “fixation on righteous eating.” Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity. They become consumed with what and how much to eat, and how to deal with “slip-ups.” An iron-clad will is needed to maintain this rigid eating style. Every day is a chance to eat right, be “good,” rise above others in dietary prowess, and self-punish if temptation wins (usually through stricter eating, fasts and exercise). Self-esteem becomes wrapped up in the purity of orthorexics’ diet and they sometimes feel superior to others, especially in regard to food intake.
Body dysmorphia, just to get the formal definitions over with, is a clinical diagnosis in the Diagnostic and Statistical Manual (DSM V), the guidebook used by psychiatrists, psychologists, and other health care professionals. People who have Body Dysmorphic Disorder are:
“preoccupied with one or more nonexistent or slight defects or flaws in their physical appearance.” Keep in mind that the emphasis is on nonexistent or slight defects, not something that is clearly visible. “‘Preoccupation’ is usually operationalized as thinking about the perceived defects for at least an hour a day… The preoccupation must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”
“At some point, the individual must perform repetitive, compulsive behaviors in response to the appearance concerns. These compulsions can be behavioral and thus observed by others – for example, mirror checking, excessive grooming, skin picking, reassurance seeking, or clothes changing. Other BDD compulsions are mental acts – such as comparing one’s appearance with that of other people.”
Now that you know what we’re talking about, I’ll continue with our text conversation. In response to Mattie’s question about whether or not orthorexia nervosa and body dysmorphia are real, I responded: “Yes, real.”
Mattie: “Thank you.”
Me: J J J J
Mattie: “I’ve been doing a lot of research on eating disorders and the psychological issues that come with them when I came across these.
Me: Do you think you have those issues?
Mattie: I don’t know. I think I may but I feel crazy saying that. I need to do some
more research to know for sure but from everything I’m reading it describes me pretty well. I seem to have gone to the opposite extreme from where I was three years ago.
Me: That means you haven’t dealt with the issues but are acting them out on the
other end of the spectrum.
Mattie: That’s what I’m scared of.
Me: Yeah, but you would not be exploring it if you weren’t willing to work on things.
Mattie: Very true. I just feel like it’s all in my head but then again, not. It’s deeper
than just my thoughts. It’s almost like these other little voices outside of myself telling me what to think and how to act.
Me: What are the voices saying and whose voices are you hearing?
Mattie: They are mine and the voices of lots of other people I have known throughout my whole life. Most of the time they are just telling me whatever I do isn’t good enough and that I have to do more. No matter what, don’t mess up because it’s impossible to undo. All my flaws are being pointed out along with the mistakes I make and how much I still need to do. Last week I had a full-blown panic attack because I ate some rice with my meal and felt like I could feel it going through my system and turning into fatter things and a big old stomach. After I finally calmed down I ended up at the gym doing cardio for 2 ½ hours. Stuff like that happens more than I care to admit. Sometimes when I think about it I freak out so much I actually get sick. All of this makes me wonder if the surgery wasn’t the result of my brain saying ‘you should do this because it will make you prettier and healthier.’”
Me: I’ll email you… too much to say and I’m on the treadmill.
I also didn’t want to miss finding out if Billy was in cahoots with Phyllis or if he was backing out of their deal…
The more I thought about all I wanted to say to Mattie, the more I decided others would benefit from the information. I’m certain she’s not the only one struggling with many of the issues she brought up.
To begin with, a great many people who have weight loss surgery find themselves engaging in behaviors that are unhealthy two to three years later. I’ve worked with patients who start drinking excessively, shopping themselves into financial distress, sleeping with people they don’t even want to be sleeping with, abusing/becoming dependent on pain medication, returning to unhealthy eating behaviors and starting to regain weight, spending too many hours exercising, behaving in other forms of bulimic behavior, engaging in anorexic behavior, and, I now learn from Mattie, orthorexia nervosa.
It’s fairly predictable. For the first year to 18 months, people are thrilled because they are losing the weight they struggled to shed for so long. It’s exhilarating to see the results they so longed for. It is an exciting time and the body is doing what it is supposed to do following the surgery. As the body heals and weight stabilizes, sometimes people begin to engage in behaviors they may not even understand themselves.
So what is the explanation for a return to eating unhealthy food in spite of knowing the misery of having been morbidly obese and experiencing significant health issues as a result? What sense does it make to become anorexic or orthorexic or alcoholic or a shopaholic or to engage in any sort of behavior to the point it creates problems in your life?
To mental health professionals, it makes perfect sense. We understand that for many people who struggle with weight issues, there is emotional baggage beneath the surface. Weight loss surgery doesn’t treat “head issues.” When people have weight loss surgery, they lose the option (at least for a time) to use food as a coping mechanism, an attempt to avoid dealing with things that are under the surface.
Mattie was quick to point out what is at the heart of the real problems, the issues underlying one’s weight and focus on food… it’s the voices of various people from your past who have told you things similar to what Mattie continues to hear in her head:
You could have done better.
You could have done more.
You got all A’s but one B… why wasn’t that an A?
Why can’t you be more like your sister?
If you keep gaining weight, no one will marry you.
You’ll never amount to anything.
It’ll just never be ‘good enough.’

Mattie made it clear that it’s not just the voices of others she hears, but also her own. There’s a simple reason for this: Children learn what they live…and then they live what they learned. The negative messages you heard about yourself from others as you were growing up are what you learned as you grew up. Every time you repeat those messages to yourself in the present, you are living what you learned. As an adult, you’re reinforcing to yourself the negative things you initially heard from others about you.
The solution? Simple – yet very difficult! You have to make a commitment to yourself to no longer talk to yourself about yourself in negative terms. Even if you don’t believe yourself at first. And you have to put a lot of effort into changing and restating the negative messages you repeat about yourself so they are at least neutral:
· You could have done better.

o When you hear this message, change it to, “Maybe I could have done better, and yet I can’t change the outcome of this situation. I’ll think about what more I might be able to do the next time this situation arises.” · You could have done more.

o When you hear this message, change it to, “There’s probably always more that could be done in a given situation. That’s as much effort as I was willing to put into this situation at this time.” · You got all A’s but one B… why wasn’t that an A?

o When you hear this message, change it to, “Perfection doesn’t exist, nor did I want to put forth the effort for that particular endeavor. I’m pleased with the results.” · Why can’t you be more like your sister?

o When you hear this message, change it to, “I can’t be more like her because we are different people and I’m learning to like myself just fine.” · If you keep gaining weight, no one will marry you.

o When you hear this message, change it to, “I’m learning to accept myself the way I am and I don’t want to marry or have close relationships with anyone who doesn’t accept me as I am.” · You’ll never amount to anything.

o When you hear this message, change it to, “Never amount to anything according to whom? I’m becoming more and more comfortable with who I am and what I want in life. That’s what matters.” · It’ll just never be ‘good enough.’

o When you hear this message, change it to, “I’ve come to terms that I am, indeed, ‘good enough,’ and I like myself this way.” What makes this different is that people say, “I tried, but it doesn’t work.” Well, keep trying. The reality is you are battling years of negative messages and your brain has literally developed neural pathways so you slip back into those well-worn paths quite easily. In order to develop new neural pathways that are more optimistic toward self, it will also take thousands of repetitions. If you were learning to speak a completely foreign language, it would take days and weeks and months of repetition before the new language would come easily. It’s the same thing with positive self-talk. The good news is, you can benefit from positive changes as soon as you start talking better about yourself. Remember, no one is putting you down at this point in your life except you. (If there are others degrading you, then you need to learn healthy boundaries and tell those people to stop and/or get them out of your life.)
The negative self-talk is part of the deal and changing that is a huge part of the solution. But, WAIT – there’s MORE! Of course there is! There’s actually a lot more, but this is supposed to be a short article, which it already isn’t. Therefore, I will only address one more essential issue related to weight regain and/or the transfer to another unhealthy behavior after weight loss surgery. In Mattie’s case, the transfer has been to a rigid attitude about eating healthy foods, feeling tremendously guilty if she eats anything but healthy foods, followed up by a form of bulimia known as exercise bulimia, as evidenced by her working out for 2 ½ hours after eating some rice.
Regardless of what unhealthy behavior a person switches to following weight loss surgery, what needs to be addressed is the purpose the behavior serves. This points, also, to looking at what purpose food and/or obesity served prior to weight loss surgery. Simply stated, an almost obsessive focus on food, whether that is thinking about what one is going to eat next, pouring over recipes, relentless counting of calories and grams, watching every show on the Food Network, exercising excessively, obsessing about healthy foods, is a coping skill. In the adult world, people are capable of learning and understanding that these eating and food-related behaviors are unhealthy in that they negatively affect health and relationships. The reasons people remain engaged in these negative behaviors, in spite of knowing they are detrimental to their physical, emotional and relational health include the possibilities that: 1) they have addictions (to food, or other substances/behaviors), and weight loss surgery does NOT treat food addiction, 2) they are tremendously afraid of feeling their own feelings and are terrified of dealing with past emotional issues; what’s more, people often deny having any past issues they need to deal with in the first place. Trust me… we all do. Every human being has had some painful experiences in their lives. People are terrified of what I call cleaning out their emotional closets because they literally fear experiencing feelings. Here’s why: when people experience feelings from past losses and hurts, they feel it with the same intensity at which they felt it at the age they were when it happened. That frightens adults and they avoid dealing with their past at all costs. And these costs can be high; anyone who has had weight loss surgery understands the physical and emotional costs that being obese bears.
Here’s the deal: if people don’t dig into whatever they are avoiding emotionally, or address any addictions head on, and if they don’t learn healthy adult coping skills, communication skills, and how to set healthy boundaries, then they WILL switch to another unhealthy behavior to use a coping skill (another name for avoiding reality and feelings).
In Mattie’s case, she swung to the opposite end of the eating continuum. Either end of an issue often means the person is just acting out the same unhealthy coping skill in the opposite way. You often hear of people who are not at all religious becoming overly immersed in a religion. Same problems… just acting them out in opposite ways. Hence, my response to Mattie as she described “having gone to the opposite extreme” with her eating behavior, when I said, “That means you haven’t dealt with the issues but are acting them out on the other end of the spectrum.”
My suggestion to Mattie and to anyone else who is engaging in any disordered eating behaviors, anyone who has regained weight, and anyone who has begun engaging in other addictive or unhealthy behaviors following weight loss surgery: Get into individual and/or group therapy with a therapist who understands “family systems” counseling and/or addiction counseling. Talk about issues underlying your addiction to food (your emotional dependency on food), any losses you experienced throughout your life that you haven’t dealt with, and any trauma/abuse you have experienced at any time in your life. Work with a therapist to learn and develop healthy coping skills to implement into your adult life, how to implement healthy boundaries in your adult life, with yourself and with others, and learn healthy communication skills. Read about these same topics, and add to the reading list the topic of “re-parenting the self.”
Orthorexia nervosa and body dysmorphia are real, as are bulimia and food addiction and transfer addiction. Weight loss surgery can inadvertently open the door for these problematic behaviors. Do what I always tell people to do: Get Help and Get Happier!
Thank you, Mattie for bringing these topics up to me. I hope this has helped you and many others! Oh – and by the way, I’ve decided I like the new Billy Abbot… so far!
Connie Stapleton, Ph.D.
www.connie@conniestapletonphd.com
FB: https://www.facebook.com/connie.stapleton.923
Twitter: @cstapletonphd
LinkedIn: Connie Stapleton, PhD
YouTube: Connie Stapleton

I got a text this week from a former client who moved out of the state a while back. This woman, who I will call Mattie, had weight loss surgery four years ago. She lost the majority of her excess weight and has maintained that weight loss. She’s even had a baby and continues to maintain her weight loss!
Mattie asked me a few questions. We exchanged a few texts before I told her I would send her an email with some thoughts. I was actually on the treadmill at the time and haven’t quite mastered accurate texting while hustling on the treadmill (and watching my guilty pleasure, The Young and The Restless) while I walk!


Here’s how our messages went...
I got a text this week from a former client who moved out of the state a while back. This woman, who I will call Mattie, had weight loss surgery four years ago. She lost the majority of her excess weight and has maintained that weight loss. She’s even had a baby and continues to maintain her weight loss!
Mattie asked me a few questions. We exchanged a few texts before I told her I would send her an email with some thoughts. I was actually on the treadmill at the time and haven’t quite mastered accurate texting while hustling on the treadmill (and watching my guilty pleasure, The Young and The Restless) while I walk!
Here’s how our messages went:
Mattie: “I want your professional opinion… Orthorexia nervosa and body dysmorphia… real or not real?”
I honestly had never heard of orthorexia nervosa, so, while contemplating whether or not I like the new actor playing Billy Abbot, I looked up orthorexia nervosa. Here’s the definition from the National Eating Disorders Association (https://www.nationaleatingdisorders.org/orthorexia-nervosa):
“Those who have an “unhealthy obsession” with otherwise healthy eating may be suffering from “orthorexia nervosa,” a term which literally means “fixation on righteous eating.” Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity. They become consumed with what and how much to eat, and how to deal with “slip-ups.” An iron-clad will is needed to maintain this rigid eating style. Every day is a chance to eat right, be “good,” rise above others in dietary prowess, and self-punish if temptation wins (usually through stricter eating, fasts and exercise). Self-esteem becomes wrapped up in the purity of orthorexics’ diet and they sometimes feel superior to others, especially in regard to food intake.
Body dysmorphia, just to get the formal definitions over with, is a clinical diagnosis in the Diagnostic and Statistical Manual (DSM V), the guidebook used by psychiatrists, psychologists, and other health care professionals. People who have Body Dysmorphic Disorder are:
“preoccupied with one or more nonexistent or slight defects or flaws in their physical appearance.” Keep in mind that the emphasis is on nonexistent or slight defects, not something that is clearly visible. “‘Preoccupation’ is usually operationalized as thinking about the perceived defects for at least an hour a day… The preoccupation must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.”
“At some point, the individual must perform repetitive, compulsive behaviors in response to the appearance concerns. These compulsions can be behavioral and thus observed by others – for example, mirror checking, excessive grooming, skin picking, reassurance seeking, or clothes changing. Other BDD compulsions are mental acts – such as comparing one’s appearance with that of other people.”
Now that you know what we’re talking about, I’ll continue with our text conversation. In response to Mattie’s question about whether or not orthorexia nervosa and body dysmorphia are real, I responded: “Yes, real.”
Mattie: “Thank you.”
Me: J J J J
Mattie: “I’ve been doing a lot of research on eating disorders and the psychological issues that come with them when I came across these.
Me: Do you think you have those issues?
Mattie: I don’t know. I think I may but I feel crazy saying that. I need to do some
more research to know for sure but from everything I’m reading it describes me pretty well. I seem to have gone to the opposite extreme from where I was three years ago.
Me: That means you haven’t dealt with the issues but are acting them out on the
other end of the spectrum.
Mattie: That’s what I’m scared of.
Me: Yeah, but you would not be exploring it if you weren’t willing to work on things.
Mattie: Very true. I just feel like it’s all in my head but then again, not. It’s deeper
than just my thoughts. It’s almost like these other little voices outside of myself telling me what to think and how to act.
Me: What are the voices saying and whose voices are you hearing?
Mattie: They are mine and the voices of lots of other people I have known throughout my whole life. Most of the time they are just telling me whatever I do isn’t good enough and that I have to do more. No matter what, don’t mess up because it’s impossible to undo. All my flaws are being pointed out along with the mistakes I make and how much I still need to do. Last week I had a full-blown panic attack because I ate some rice with my meal and felt like I could feel it going through my system and turning into fatter things and a big old stomach. After I finally calmed down I ended up at the gym doing cardio for 2 ½ hours. Stuff like that happens more than I care to admit. Sometimes when I think about it I freak out so much I actually get sick. All of this makes me wonder if the surgery wasn’t the result of my brain saying ‘you should do this because it will make you prettier and healthier.’”
Me: I’ll email you… too much to say and I’m on the treadmill.
I also didn’t want to miss finding out if Billy was in cahoots with Phyllis or if he was backing out of their deal…
The more I thought about all I wanted to say to Mattie, the more I decided others would benefit from the information. I’m certain she’s not the only one struggling with many of the issues she brought up.
To begin with, a great many people who have weight loss surgery find themselves engaging in behaviors that are unhealthy two to three years later. I’ve worked with patients who start drinking excessively, shopping themselves into financial distress, sleeping with people they don’t even want to be sleeping with, abusing/becoming dependent on pain medication, returning to unhealthy eating behaviors and starting to regain weight, spending too many hours exercising, behaving in other forms of bulimic behavior, engaging in anorexic behavior, and, I now learn from Mattie, orthorexia nervosa.
It’s fairly predictable. For the first year to 18 months, people are thrilled because they are losing the weight they struggled to shed for so long. It’s exhilarating to see the results they so longed for. It is an exciting time and the body is doing what it is supposed to do following the surgery. As the body heals and weight stabilizes, sometimes people begin to engage in behaviors they may not even understand themselves.
So what is the explanation for a return to eating unhealthy food in spite of knowing the misery of having been morbidly obese and experiencing significant health issues as a result? What sense does it make to become anorexic or orthorexic or alcoholic or a shopaholic or to engage in any sort of behavior to the point it creates problems in your life?
To mental health professionals, it makes perfect sense. We understand that for many people who struggle with weight issues, there is emotional baggage beneath the surface. Weight loss surgery doesn’t treat “head issues.” When people have weight loss surgery, they lose the option (at least for a time) to use food as a coping mechanism, an attempt to avoid dealing with things that are under the surface.
Mattie was quick to point out what is at the heart of the real problems, the issues underlying one’s weight and focus on food… it’s the voices of various people from your past who have told you things similar to what Mattie continues to hear in her head:
You could have done better.
You could have done more.
You got all A’s but one B… why wasn’t that an A?
Why can’t you be more like your sister?
If you keep gaining weight, no one will marry you.
You’ll never amount to anything.
It’ll just never be ‘good enough.’

Mattie made it clear that it’s not just the voices of others she hears, but also her own. There’s a simple reason for this: Children learn what they live…and then they live what they learned. The negative messages you heard about yourself from others as you were growing up are what you learned as you grew up. Every time you repeat those messages to yourself in the present, you are living what you learned. As an adult, you’re reinforcing to yourself the negative things you initially heard from others about you.
The solution? Simple – yet very difficult! You have to make a commitment to yourself to no longer talk to yourself about yourself in negative terms. Even if you don’t believe yourself at first. And you have to put a lot of effort into changing and restating the negative messages you repeat about yourself so they are at least neutral:
· You could have done better.

o When you hear this message, change it to, “Maybe I could have done better, and yet I can’t change the outcome of this situation. I’ll think about what more I might be able to do the next time this situation arises.” · You could have done more.

o When you hear this message, change it to, “There’s probably always more that could be done in a given situation. That’s as much effort as I was willing to put into this situation at this time.” · You got all A’s but one B… why wasn’t that an A?

o When you hear this message, change it to, “Perfection doesn’t exist, nor did I want to put forth the effort for that particular endeavor. I’m pleased with the results.” · Why can’t you be more like your sister?

o When you hear this message, change it to, “I can’t be more like her because we are different people and I’m learning to like myself just fine.” · If you keep gaining weight, no one will marry you.

o When you hear this message, change it to, “I’m learning to accept myself the way I am and I don’t want to marry or have close relationships with anyone who doesn’t accept me as I am.” · You’ll never amount to anything.

o When you hear this message, change it to, “Never amount to anything according to whom? I’m becoming more and more comfortable with who I am and what I want in life. That’s what matters.” · It’ll just never be ‘good enough.’

o When you hear this message, change it to, “I’ve come to terms that I am, indeed, ‘good enough,’ and I like myself this way.” What makes this different is that people say, “I tried, but it doesn’t work.” Well, keep trying. The reality is you are battling years of negative messages and your brain has literally developed neural pathways so you slip back into those well-worn paths quite easily. In order to develop new neural pathways that are more optimistic toward self, it will also take thousands of repetitions. If you were learning to speak a completely foreign language, it would take days and weeks and months of repetition before the new language would come easily. It’s the same thing with positive self-talk. The good news is, you can benefit from positive changes as soon as you start talking better about yourself. Remember, no one is putting you down at this point in your life except you. (If there are others degrading you, then you need to learn healthy boundaries and tell those people to stop and/or get them out of your life.)
The negative self-talk is part of the deal and changing that is a huge part of the solution. But, WAIT – there’s MORE! Of course there is! There’s actually a lot more, but this is supposed to be a short article, which it already isn’t. Therefore, I will only address one more essential issue related to weight regain and/or the transfer to another unhealthy behavior after weight loss surgery. In Mattie’s case, the transfer has been to a rigid attitude about eating healthy foods, feeling tremendously guilty if she eats anything but healthy foods, followed up by a form of bulimia known as exercise bulimia, as evidenced by her working out for 2 ½ hours after eating some rice.
Regardless of what unhealthy behavior a person switches to following weight loss surgery, what needs to be addressed is the purpose the behavior serves. This points, also, to looking at what purpose food and/or obesity served prior to weight loss surgery. Simply stated, an almost obsessive focus on food, whether that is thinking about what one is going to eat next, pouring over recipes, relentless counting of calories and grams, watching every show on the Food Network, exercising excessively, obsessing about healthy foods, is a coping skill. In the adult world, people are capable of learning and understanding that these eating and food-related behaviors are unhealthy in that they negatively affect health and relationships. The reasons people remain engaged in these negative behaviors, in spite of knowing they are detrimental to their physical, emotional and relational health include the possibilities that: 1) they have addictions (to food, or other substances/behaviors), and weight loss surgery does NOT treat food addiction, 2) they are tremendously afraid of feeling their own feelings and are terrified of dealing with past emotional issues; what’s more, people often deny having any past issues they need to deal with in the first place. Trust me… we all do. Every human being has had some painful experiences in their lives. People are terrified of what I call cleaning out their emotional closets because they literally fear experiencing feelings. Here’s why: when people experience feelings from past losses and hurts, they feel it with the same intensity at which they felt it at the age they were when it happened. That frightens adults and they avoid dealing with their past at all costs. And these costs can be high; anyone who has had weight loss surgery understands the physical and emotional costs that being obese bears.
Here’s the deal: if people don’t dig into whatever they are avoiding emotionally, or address any addictions head on, and if they don’t learn healthy adult coping skills, communication skills, and how to set healthy boundaries, then they WILL switch to another unhealthy behavior to use a coping skill (another name for avoiding reality and feelings).
In Mattie’s case, she swung to the opposite end of the eating continuum. Either end of an issue often means the person is just acting out the same unhealthy coping skill in the opposite way. You often hear of people who are not at all religious becoming overly immersed in a religion. Same problems… just acting them out in opposite ways. Hence, my response to Mattie as she described “having gone to the opposite extreme” with her eating behavior, when I said, “That means you haven’t dealt with the issues but are acting them out on the other end of the spectrum.”
My suggestion to Mattie and to anyone else who is engaging in any disordered eating behaviors, anyone who has regained weight, and anyone who has begun engaging in other addictive or unhealthy behaviors following weight loss surgery: Get into individual and/or group therapy with a therapist who understands “family systems” counseling and/or addiction counseling. Talk about issues underlying your addiction to food (your emotional dependency on food), any losses you experienced throughout your life that you haven’t dealt with, and any trauma/abuse you have experienced at any time in your life. Work with a therapist to learn and develop healthy coping skills to implement into your adult life, how to implement healthy boundaries in your adult life, with yourself and with others, and learn healthy communication skills. Read about these same topics, and add to the reading list the topic of “re-parenting the self.”
Orthorexia nervosa and body dysmorphia are real, as are bulimia and food addiction and transfer addiction. Weight loss surgery can inadvertently open the door for these problematic behaviors. Do what I always tell people to do: Get Help and Get Happier!
Thank you, Mattie for bringing these topics up to me. I hope this has helped you and many others! Oh – and by the way, I’ve decided I like the new Billy Abbot… so far!
Connie Stapleton, Ph.D.
www.connie@conniestapletonphd.com
FB: https://www.facebook.com/connie.stapleton.923
Twitter: @cstapletonphd
LinkedIn: Connie Stapleton, PhD
YouTube: Connie Stapleton

Quit dancing around the subject and start using the STAPLE ingredient in the Recipe for Recovery: COMMITMENT. If you're guilty of doing the RECOVERY HOKEY POKEY, it's time to put your WHOLE SELF IN!


The Recovery Hokey Pokey
You put your right thigh in.
You put your right thigh out.
You put your right thigh in…
and it jiggles all about…
You do recovery hokey pokey and
it turns you inside out
Yhat’s what it’s all about!
Weight loss. There’s simply nothing like it. The pounds come off. You feel great. People notice how much “better” you look. The scale is showing numbers you haven’t seen since high school. And then…it stops. Everything stops. The great feeing…the compliments…the scale.
Maybe this “losing weight” thing isn’t all it’s cracked up to be after all. What happens when all the excitement fades? What happens to the motivation? What happens to that “high” you felt when you jumped out of bed to greet the day each morning at the beginning of the weight loss adventure? What happens to the excitement of doing exercises you’ve never been able to do before?
Oh – reality! Yes, reality and the ordinariness of life sets in and now you don’t feel so inspired to do the things you need to do to get what you say you want. You know – improved health and a better quality of life. Those are the reasons most people (initially) state as their reasons for having weight loss surgery.
“I don’t think I’ll work out today because…I’m tired and deserve to sleep-in.”
“Maybe I’ll workout tonight, after work, when the kids are asleep.”
“Gosh! I had a long day, and the kids are down…maybe I should get some sleep while I can. I’ll exercise in the morning.”
“You know, I haven’t eaten anything ‘bad’ in a long time; I ‘deserve’ a little treat for all of my hard work. I’ll just have a little bowl of something sweet.”
“I’m really hungry. Maybe I’ll just eat the other half.”
“Who brought the donuts? I wonder if there’s a “plain” one in there…that wouldn’t be so bad.”
Sound familiar? Your enthusiasm wanes, then your motivation flies out the window, and whammo! You’ve lost enthusiasm for the commitment you made to your healthy recovery. What happened? What is commitment, anyway?
A commitment is a promise you make to yourself to do something or to be loyal to someone or something. We love the definition of commitment from Urban Dictionary:
“Commitment is what transforms the promise into reality.
It is the words that speak boldly of your intentions.
And the actions which speak louder than the words.
It is making the time when there is none.
Coming through time after time after time, year after year after year.
Commitment is the stuff character is made of;
The power to change the face of things.
It is the daily triumph of integrity over skepticism.”
by Ashbash January 13, 2005
Your commitment to living a healthy lifestyle can be a promise you make to yourself, to your children, or to your entire family. Commitments that you write down and share with others are more likely to be maintained. Stating your commitment to your healthy lifestyle every day (out loud is best) will remind you of the promises you made to follow through with the behaviors that result in improved health and a better quality of life – the reasons you chose to have weight loss surgery.
SO – when you wake up each morning, maybe sing this version of the Recovery Hokey Pokey:
I put my whole self in.
I put my old habits out.
I put my best effort in…
And I get good results out!
I stop recovery hokey pokey –
And I get rid of all self-doubt!
THAT’s what it’s all about!
Are you singing the Blues or Happy Days in your Recovery? Tune into the June APODCast on June 17, and you just might hear The Doc might sing The Recovery Hokey Pokey.

There’s no doubt weight loss surgery helps you eat less. Whichever type you get replaces your regular stomach with a smaller pouch (or stoma or sleeve). But your struggle with food isn’t automatically over the minute you get out of surgery. The sooner you accept and confront this, the more weight you can lose, and the easier your weight loss journey is likely to be.
Whether you get the adjustable gastric band, gastric sleeve, gastric bypass, or another type of Weight Loss Surgery, your Weight Loss Surgery is a restrictive procedure. It helps you fill up sooner, stay full longer, or be unable to tolerate certain foods. (And yes, some procedures such as the gastric bypass are malabsorptive – they reduce nutrient absorption – but all of them restrict food intake).


The Struggle Often Continues
For some patients, Weight Loss Surgery can lower your interest in food, so you are not constantly thinking about it. There’s no question Weight Loss Surgery can help you gain control of your eating, but it’s unlikely to eliminate your struggles with food disappear. A few lucky Weight Loss Surgery patients really do stop being tempted by food. The rest, who make up the vast majority of Weight Loss Surgery patients, continue to struggle.
You still may be hungry, enjoy salt, fat, starch, or sugar, or be tempted to use food as an emotional crutch. Your family members may continue to insist on keeping high-calorie foods in the house, or pressure you to eat things you shouldn’t. Your friends may still be going out to eat and inviting you to join them in ordering high-fat, high-sugar items.
“Why Me?” Isn’t Appropriate
It’s easy, even natural, to think of yourself as unlucky. Why should you have to struggle with food? Why should you have to monitor every bite you take, while some people don’t? The fact is, almost everyone does. Ask almost any skinny person how they stay skinny, and you’ll get some variation of the same answer: “I work hard for it.”
Just like you, they are aware of what goes into their bodies. They sometimes may be hungry; they sometimes may want to eat more than they should. But they, like you now, take responsibility for their decisions. They may:
Skimp on portions if they over ate at the previous meal.
Choose healthy foods first.
Have a strategy for dealing with emotions and boredom that doesn’t involve eating.
Have a support system that promotes healthy behaviors.
Accept It and Manage It

If you find you still have a rocky relationship with food after weight loss surgery, don’t conclude that WLS didn’t work for you. Instead, accept that you will need to fight the cravings and urges for months, years, or life, and start making a plan. Don’t be afraid to ask for help in developing strategies – whether you ask other BariatricPal members or an always-thin person you admire!
Persist in Order to Get the Answers You Need
We all want to be able to trust our doctors. You want to believe your surgeon takes care of all aspects of your Weight Loss Surgery, including your post-op, long-term nutrition. But it doesn’t always happen like that. Nutritional counseling may not be part of your surgery package, or you may only get a limited amount of generic information.
Or, your surgeon may simply not know how to help you nutritionally. Remember that many doctors have no more than an hour of nutrition education in medical school. To become a weight loss surgeon, doctors need to learn surgery. There is no dietary education requirement.
If you need help finding strategies to satisfy hunger – physical or head hunger – and your surgeon and primary care doctor are not able to help, keep looking. A session with a nutritionist may be more affordable than you think, and worth every penny.
Your Emotional Support System and Your Relationship with Food
The support system you built so carefully can come in handy right about now. Take advantage of your ability to talk to a therapist or psychologist if you have one to bring up your concerns. Discussing your ongoing struggles with portion sizes, food choices, and over-frequent nibbling with a mental health professional can help you come up with some strategies that work for you.
Group sessions are also appropriate forums to talk about food struggles and strategies. Though it may feel embarrassing at first to admit you’re still thinking about food a lot, you will find nearly everyone in that room did or does have that same experience.
Most Weight Loss Surgery patients do not find their surgery instantly eliminates their food struggles. You can take months or years to come to terms with a food addiction, and it may be something you need to learn to live with for life, but in a healthier manner than before Weight Loss Surgery. Be honest with yourself and those around you, and be open to suggestions, and you can figure out strategies that work for you. Do not assume WLS did not work for you!

Recovery from Obesity is a choice and, while your Recovery is unique, the ingredients in the Recipe for Recovery are not. What that means is, you determine what matters most in your life and then choose HOW to use the ingredients (Awareness, Acceptance, Commitment, Attitude, Accountability, and Effort) to live fully.
Before we get much further, let’s explain what we mean by “Recovery from Obesity.”


Is Recovery from Obesity…
…being skinny? No.
.,..a number on the scale? No.
…being cured and never having to worry about weight again? No.
Is Recovery improved health and quality of life? Yes.
Recovery from Obesity is learning to live life on life’s terms by making the next wise choice one day at a time. Recovery from Obesity is following the Recipe for Recovery to live FULLY and become your healthiest physical, mental, emotional and spiritual self. You choose HOW to use the ingredients in the Recipe for Recovery to create your own healthy life! Recovery is a mindset, so it’s up to you to come to terms with the good, the bad and the ugly!
THE POST-OP: My Recovery journey began when I lost weight (the good), but stalled when I came face-to-face with the realities of the disease of obesity and my compulsive overeating (the bad and the ugly). I wanted to be cured of obesity and hoped surgery would do the trick. I wanted to be “normal” and didn’t want to worry about gaining weight again. I quickly learned that there is no such thing as “normal” and had to decide whether I wanted to spend my life worrying about gaining weight, or managing my obesity. The choice was mine, and I chose Recovery, starting with AWARENESS of my disease. Since then, I have had to ACCEPT some difficult realities.
Here are a few of the things I’ve learned to ACCEPT about myself:
I ACCEPT that I do not have an “OFF” switch around certain foods. Once I start, I won’t stop until I am sick or run out of food. Therefore, I ACCEPT that those foods are off limits for me. Period.
I ACCEPT that I have shrinkles on my belly, butt and legs. Needless to say, I choose not to wear a bikini.
I ACCEPT that I cannot take anti-inflammatory meds (NSAIDs) to treat my joint pain because I had weight loss surgery and am prone to ulcers.
I ACCEPT that I am susceptible to anemia and Vitamin deficiency and must be vigilant about taking my Iron and supplements.< br> I ACCEPT that I don’t like to workout, but I know I have to if I want to be healthy.

That’s the short list of stuff I had to come to terms with (ACCEPT) if I wanted what I said I wanted in my life – to live fully, free from the unhealthy obsession with food and weight. Of course, these are just “physical” things. Doc, what about the mental and emotional realities in Recovery?
THE DOC: As Cari very often says, obesity is “all about the food but is not about the food.” Clearly, food is part of the problem when one is obese, and yet, obesity is so much more than just the food. For example, some people are “emotional eaters,” turning to food when they are upset, angry, bored, worried, etc. They eat in response to feelings. In this case, it’s not really about the food. Learning to deal with emotions in healthy ways is the issue!
If you are an emotional eater, then choose to ACCEPT the following:
ACCEPT that food is an unhealthy way to cope with feelings.
ACCEPT that you may need to learn about healthy coping skills via reading books and articles or, you may need to attend therapy.
ACCEPT that there may be unresolved issues related to the learned behavior of turning to food as a coping skill and ACCEPT that in order to live fully in Recovery from Obesity you will need to address those underlying issues.

Relationships often change after a person loses a significant amount of weight. It can be difficult for both people in a relationship to deal with their thoughts and feelings related to the changes that seem to be brought about by weight loss. If you are struggling with relationships after losing weight, whether they are marital, friendship or family relationships:
ACCEPT that changes in relationships are common after weight loss.
ACCEPT that the changes need to be addressed openly and directly, that feelings need to be acknowledged and discussed, and that wants and needs change for people.
ACCEPT that sometimes people need help from a professional to get through periods of significant change in relationships.

“Self” often changes after weight loss surgery… self-esteem, self-image, and self-efficacy. Along with the changes in “self”:
ACCEPT that these changes can affect one in positive ways and in potentially unhealthy ways.
ACCEPT that others may accept or reject the changes, may Celebrate or dismiss the changes, may change with your or may choose not to change.
ACCEPT that you may feel uncomfortable with the changes as your body and mind adjust to them.

People sometimes report being disillusioned about not being “happy” after losing weight, which they expected they would be. If this is the case for you:
ACCEPT that “happiness” is an inside job and not based solely on your weight, size, appearance.
ACCEPT that there are other aspects of yourself to explore including your personality traits, your talents, your interests, your behavior toward self and others.
ACCEPT that “happiness” is closely related to your thoughts, then examine your thought patterns and ACCEPT that only YOU can choose if they will be positive or not!

Obviously, we could write for days about how ACCEPTANCE of the “good, the bad and the ugly” is a necessary part of Recovery from Obesity. What do you need to ACCEPT in order to move closer to obtaining those things related to obesity that are the most meaningful to you? What do you need to ACCEPT that is directly about the food and what do you need to ACCEPT that is not directly related to food, but does affect your eating and exercise habits?
Stick with the winners, get outside help when you need to, stay open-minded, use the ingredients of the Recipe for Recovery to live the healthy life you want…AND, be sure to join us daily on our Facebook page for ongoing motivation, education and inspiration. You can’t do this alone, and no one can do it for you!

Quit dancing around the subject and start using the STAPLE ingredient in the Recipe for Recovery: COMMITMENT. If you're guilty of doing the RECOVERY HOKEY POKEY, it's time to put your WHOLE SELF IN!


The Recovery Hokey Pokey
You put your right thigh in.
You put your right thigh out.
You put your right thigh in…
and it jiggles all about…
You do recovery hokey pokey and
it turns you inside out
Yhat’s what it’s all about!
Weight loss. There’s simply nothing like it. The pounds come off. You feel great. People notice how much “better” you look. The scale is showing numbers you haven’t seen since high school. And then…it stops. Everything stops. The great feeing…the compliments…the scale.
Maybe this “losing weight” thing isn’t all it’s cracked up to be after all. What happens when all the excitement fades? What happens to the motivation? What happens to that “high” you felt when you jumped out of bed to greet the day each morning at the beginning of the weight loss adventure? What happens to the excitement of doing exercises you’ve never been able to do before?
Oh – reality! Yes, reality and the ordinariness of life sets in and now you don’t feel so inspired to do the things you need to do to get what you say you want. You know – improved health and a better quality of life. Those are the reasons most people (initially) state as their reasons for having weight loss surgery.
“I don’t think I’ll work out today because…I’m tired and deserve to sleep-in.”
“Maybe I’ll workout tonight, after work, when the kids are asleep.”
“Gosh! I had a long day, and the kids are down…maybe I should get some sleep while I can. I’ll exercise in the morning.”
“You know, I haven’t eaten anything ‘bad’ in a long time; I ‘deserve’ a little treat for all of my hard work. I’ll just have a little bowl of something sweet.”
“I’m really hungry. Maybe I’ll just eat the other half.”
“Who brought the donuts? I wonder if there’s a “plain” one in there…that wouldn’t be so bad.”
Sound familiar? Your enthusiasm wanes, then your motivation flies out the window, and whammo! You’ve lost enthusiasm for the commitment you made to your healthy recovery. What happened? What is commitment, anyway?
A commitment is a promise you make to yourself to do something or to be loyal to someone or something. We love the definition of commitment from Urban Dictionary:
“Commitment is what transforms the promise into reality.
It is the words that speak boldly of your intentions.
And the actions which speak louder than the words.
It is making the time when there is none.
Coming through time after time after time, year after year after year.
Commitment is the stuff character is made of;
The power to change the face of things.
It is the daily triumph of integrity over skepticism.”
by Ashbash January 13, 2005
Your commitment to living a healthy lifestyle can be a promise you make to yourself, to your children, or to your entire family. Commitments that you write down and share with others are more likely to be maintained. Stating your commitment to your healthy lifestyle every day (out loud is best) will remind you of the promises you made to follow through with the behaviors that result in improved health and a better quality of life – the reasons you chose to have weight loss surgery.
SO – when you wake up each morning, maybe sing this version of the Recovery Hokey Pokey:
I put my whole self in.
I put my old habits out.
I put my best effort in…
And I get good results out!
I stop recovery hokey pokey –
And I get rid of all self-doubt!
THAT’s what it’s all about!
Are you singing the Blues or Happy Days in your Recovery? Tune into the June APODCast on June 17, and you just might hear The Doc might sing The Recovery Hokey Pokey.

Quit dancing around the subject and start using the STAPLE ingredient in the Recipe for Recovery: COMMITMENT. If you're guilty of doing the RECOVERY HOKEY POKEY, it's time to put your WHOLE SELF IN!


The Recovery Hokey Pokey
You put your right thigh in.
You put your right thigh out.
You put your right thigh in…
and it jiggles all about…
You do recovery hokey pokey and
it turns you inside out
Yhat’s what it’s all about!
Weight loss. There’s simply nothing like it. The pounds come off. You feel great. People notice how much “better” you look. The scale is showing numbers you haven’t seen since high school. And then…it stops. Everything stops. The great feeing…the compliments…the scale.
Maybe this “losing weight” thing isn’t all it’s cracked up to be after all. What happens when all the excitement fades? What happens to the motivation? What happens to that “high” you felt when you jumped out of bed to greet the day each morning at the beginning of the weight loss adventure? What happens to the excitement of doing exercises you’ve never been able to do before?
Oh – reality! Yes, reality and the ordinariness of life sets in and now you don’t feel so inspired to do the things you need to do to get what you say you want. You know – improved health and a better quality of life. Those are the reasons most people (initially) state as their reasons for having weight loss surgery.
“I don’t think I’ll work out today because…I’m tired and deserve to sleep-in.”
“Maybe I’ll workout tonight, after work, when the kids are asleep.”
“Gosh! I had a long day, and the kids are down…maybe I should get some sleep while I can. I’ll exercise in the morning.”
“You know, I haven’t eaten anything ‘bad’ in a long time; I ‘deserve’ a little treat for all of my hard work. I’ll just have a little bowl of something sweet.”
“I’m really hungry. Maybe I’ll just eat the other half.”
“Who brought the donuts? I wonder if there’s a “plain” one in there…that wouldn’t be so bad.”
Sound familiar? Your enthusiasm wanes, then your motivation flies out the window, and whammo! You’ve lost enthusiasm for the commitment you made to your healthy recovery. What happened? What is commitment, anyway?
A commitment is a promise you make to yourself to do something or to be loyal to someone or something. We love the definition of commitment from Urban Dictionary:
“Commitment is what transforms the promise into reality.
It is the words that speak boldly of your intentions.
And the actions which speak louder than the words.
It is making the time when there is none.
Coming through time after time after time, year after year after year.
Commitment is the stuff character is made of;
The power to change the face of things.
It is the daily triumph of integrity over skepticism.”
by Ashbash January 13, 2005
Your commitment to living a healthy lifestyle can be a promise you make to yourself, to your children, or to your entire family. Commitments that you write down and share with others are more likely to be maintained. Stating your commitment to your healthy lifestyle every day (out loud is best) will remind you of the promises you made to follow through with the behaviors that result in improved health and a better quality of life – the reasons you chose to have weight loss surgery.
SO – when you wake up each morning, maybe sing this version of the Recovery Hokey Pokey:
I put my whole self in.
I put my old habits out.
I put my best effort in…
And I get good results out!
I stop recovery hokey pokey –
And I get rid of all self-doubt!
THAT’s what it’s all about!
Are you singing the Blues or Happy Days in your Recovery? Tune into the June APODCast on June 17, and you just might hear The Doc might sing The Recovery Hokey Pokey.

Quit dancing around the subject and start using the STAPLE ingredient in the Recipe for Recovery: COMMITMENT. If you're guilty of doing the RECOVERY HOKEY POKEY, it's time to put your WHOLE SELF IN!


The Recovery Hokey Pokey
You put your right thigh in.
You put your right thigh out.
You put your right thigh in…
and it jiggles all about…
You do recovery hokey pokey and
it turns you inside out
Yhat’s what it’s all about!
Weight loss. There’s simply nothing like it. The pounds come off. You feel great. People notice how much “better” you look. The scale is showing numbers you haven’t seen since high school. And then…it stops. Everything stops. The great feeing…the compliments…the scale.
Maybe this “losing weight” thing isn’t all it’s cracked up to be after all. What happens when all the excitement fades? What happens to the motivation? What happens to that “high” you felt when you jumped out of bed to greet the day each morning at the beginning of the weight loss adventure? What happens to the excitement of doing exercises you’ve never been able to do before?
Oh – reality! Yes, reality and the ordinariness of life sets in and now you don’t feel so inspired to do the things you need to do to get what you say you want. You know – improved health and a better quality of life. Those are the reasons most people (initially) state as their reasons for having weight loss surgery.
“I don’t think I’ll work out today because…I’m tired and deserve to sleep-in.”
“Maybe I’ll workout tonight, after work, when the kids are asleep.”
“Gosh! I had a long day, and the kids are down…maybe I should get some sleep while I can. I’ll exercise in the morning.”
“You know, I haven’t eaten anything ‘bad’ in a long time; I ‘deserve’ a little treat for all of my hard work. I’ll just have a little bowl of something sweet.”
“I’m really hungry. Maybe I’ll just eat the other half.”
“Who brought the donuts? I wonder if there’s a “plain” one in there…that wouldn’t be so bad.”
Sound familiar? Your enthusiasm wanes, then your motivation flies out the window, and whammo! You’ve lost enthusiasm for the commitment you made to your healthy recovery. What happened? What is commitment, anyway?
A commitment is a promise you make to yourself to do something or to be loyal to someone or something. We love the definition of commitment from Urban Dictionary:
“Commitment is what transforms the promise into reality.
It is the words that speak boldly of your intentions.
And the actions which speak louder than the words.
It is making the time when there is none.
Coming through time after time after time, year after year after year.
Commitment is the stuff character is made of;
The power to change the face of things.
It is the daily triumph of integrity over skepticism.”
by Ashbash January 13, 2005
Your commitment to living a healthy lifestyle can be a promise you make to yourself, to your children, or to your entire family. Commitments that you write down and share with others are more likely to be maintained. Stating your commitment to your healthy lifestyle every day (out loud is best) will remind you of the promises you made to follow through with the behaviors that result in improved health and a better quality of life – the reasons you chose to have weight loss surgery.
SO – when you wake up each morning, maybe sing this version of the Recovery Hokey Pokey:
I put my whole self in.
I put my old habits out.
I put my best effort in…
And I get good results out!
I stop recovery hokey pokey –
And I get rid of all self-doubt!
THAT’s what it’s all about!
Are you singing the Blues or Happy Days in your Recovery? Tune into the June APODCast on June 17, and you just might hear The Doc might sing The Recovery Hokey Pokey.

Quit dancing around the subject and start using the STAPLE ingredient in the Recipe for Recovery: COMMITMENT. If you're guilty of doing the RECOVERY HOKEY POKEY, it's time to put your WHOLE SELF IN!


The Recovery Hokey Pokey
You put your right thigh in.
You put your right thigh out.
You put your right thigh in…
and it jiggles all about…
You do recovery hokey pokey and
it turns you inside out
Yhat’s what it’s all about!
Weight loss. There’s simply nothing like it. The pounds come off. You feel great. People notice how much “better” you look. The scale is showing numbers you haven’t seen since high school. And then…it stops. Everything stops. The great feeing…the compliments…the scale.
Maybe this “losing weight” thing isn’t all it’s cracked up to be after all. What happens when all the excitement fades? What happens to the motivation? What happens to that “high” you felt when you jumped out of bed to greet the day each morning at the beginning of the weight loss adventure? What happens to the excitement of doing exercises you’ve never been able to do before?
Oh – reality! Yes, reality and the ordinariness of life sets in and now you don’t feel so inspired to do the things you need to do to get what you say you want. You know – improved health and a better quality of life. Those are the reasons most people (initially) state as their reasons for having weight loss surgery.
“I don’t think I’ll work out today because…I’m tired and deserve to sleep-in.”
“Maybe I’ll workout tonight, after work, when the kids are asleep.”
“Gosh! I had a long day, and the kids are down…maybe I should get some sleep while I can. I’ll exercise in the morning.”
“You know, I haven’t eaten anything ‘bad’ in a long time; I ‘deserve’ a little treat for all of my hard work. I’ll just have a little bowl of something sweet.”
“I’m really hungry. Maybe I’ll just eat the other half.”
“Who brought the donuts? I wonder if there’s a “plain” one in there…that wouldn’t be so bad.”
Sound familiar? Your enthusiasm wanes, then your motivation flies out the window, and whammo! You’ve lost enthusiasm for the commitment you made to your healthy recovery. What happened? What is commitment, anyway?
A commitment is a promise you make to yourself to do something or to be loyal to someone or something. We love the definition of commitment from Urban Dictionary:
“Commitment is what transforms the promise into reality.
It is the words that speak boldly of your intentions.
And the actions which speak louder than the words.
It is making the time when there is none.
Coming through time after time after time, year after year after year.
Commitment is the stuff character is made of;
The power to change the face of things.
It is the daily triumph of integrity over skepticism.”
by Ashbash January 13, 2005
Your commitment to living a healthy lifestyle can be a promise you make to yourself, to your children, or to your entire family. Commitments that you write down and share with others are more likely to be maintained. Stating your commitment to your healthy lifestyle every day (out loud is best) will remind you of the promises you made to follow through with the behaviors that result in improved health and a better quality of life – the reasons you chose to have weight loss surgery.
SO – when you wake up each morning, maybe sing this version of the Recovery Hokey Pokey:
I put my whole self in.
I put my old habits out.
I put my best effort in…
And I get good results out!
I stop recovery hokey pokey –
And I get rid of all self-doubt!
THAT’s what it’s all about!
Are you singing the Blues or Happy Days in your Recovery? Tune into the June APODCast on June 17, and you just might hear The Doc might sing The Recovery Hokey Pokey.

Quit dancing around the subject and start using the STAPLE ingredient in the Recipe for Recovery: COMMITMENT. If you're guilty of doing the RECOVERY HOKEY POKEY, it's time to put your WHOLE SELF IN!


The Recovery Hokey Pokey
You put your right thigh in.
You put your right thigh out.
You put your right thigh in…
and it jiggles all about…
You do recovery hokey pokey and
it turns you inside out
Yhat’s what it’s all about!
Weight loss. There’s simply nothing like it. The pounds come off. You feel great. People notice how much “better” you look. The scale is showing numbers you haven’t seen since high school. And then…it stops. Everything stops. The great feeing…the compliments…the scale.
Maybe this “losing weight” thing isn’t all it’s cracked up to be after all. What happens when all the excitement fades? What happens to the motivation? What happens to that “high” you felt when you jumped out of bed to greet the day each morning at the beginning of the weight loss adventure? What happens to the excitement of doing exercises you’ve never been able to do before?
Oh – reality! Yes, reality and the ordinariness of life sets in and now you don’t feel so inspired to do the things you need to do to get what you say you want. You know – improved health and a better quality of life. Those are the reasons most people (initially) state as their reasons for having weight loss surgery.
“I don’t think I’ll work out today because…I’m tired and deserve to sleep-in.”
“Maybe I’ll workout tonight, after work, when the kids are asleep.”
“Gosh! I had a long day, and the kids are down…maybe I should get some sleep while I can. I’ll exercise in the morning.”
“You know, I haven’t eaten anything ‘bad’ in a long time; I ‘deserve’ a little treat for all of my hard work. I’ll just have a little bowl of something sweet.”
“I’m really hungry. Maybe I’ll just eat the other half.”
“Who brought the donuts? I wonder if there’s a “plain” one in there…that wouldn’t be so bad.”
Sound familiar? Your enthusiasm wanes, then your motivation flies out the window, and whammo! You’ve lost enthusiasm for the commitment you made to your healthy recovery. What happened? What is commitment, anyway?
A commitment is a promise you make to yourself to do something or to be loyal to someone or something. We love the definition of commitment from Urban Dictionary:
“Commitment is what transforms the promise into reality.
It is the words that speak boldly of your intentions.
And the actions which speak louder than the words.
It is making the time when there is none.
Coming through time after time after time, year after year after year.
Commitment is the stuff character is made of;
The power to change the face of things.
It is the daily triumph of integrity over skepticism.”
by Ashbash January 13, 2005
Your commitment to living a healthy lifestyle can be a promise you make to yourself, to your children, or to your entire family. Commitments that you write down and share with others are more likely to be maintained. Stating your commitment to your healthy lifestyle every day (out loud is best) will remind you of the promises you made to follow through with the behaviors that result in improved health and a better quality of life – the reasons you chose to have weight loss surgery.
SO – when you wake up each morning, maybe sing this version of the Recovery Hokey Pokey:
I put my whole self in.
I put my old habits out.
I put my best effort in…
And I get good results out!
I stop recovery hokey pokey –
And I get rid of all self-doubt!
THAT’s what it’s all about!
Are you singing the Blues or Happy Days in your Recovery? Tune into the June APODCast on June 17, and you just might hear The Doc might sing The Recovery Hokey Pokey.

Attitudes come in all sorts of “flavors,” including the obvious, of course: a positive attitude or a negative attitude. Some attitudes might be considered rather bland: cooperative, compliant and tolerant.
What flavor is your attitude? Are you complacent, entitled, enthusiastic, apathetic, grateful, superior, confident, hostile, cautious, suspicious, inferior, sincere, persistent, flexible, decisive, humble, jealous, judgmental, courteous, competitive, gloomy, sarcastic, sympathetic, cynical, critical, caring, earnest, jovial, hopeful?
How important has your attitude been to your journey in your Recovery From Obesity? Recovery from obesity is both a set of behaviors and a mindset (ATTITUDE) about your health, your sense of self worth, and your willingness to do what it takes to have the health you want and to feel about yourself the way you want to feel about yourself.
ATTITUDE IS THE FLAVORFUL INGREDIENT IN THE RECIPE FOR RECOVERY and it makes all the difference in how you approach your Recovery from Obesity. Your ATTITUDE also influences how you choose to use the other ingredients in the Recipe for Recovery: Awareness, Acceptance, Commitment, Accountability and Effort


Attitudes come in all sorts of “flavors,” including the obvious, of course: a positive attitude or a negative attitude. Some attitudes might be considered rather bland: cooperative, compliant and tolerant. These are desirable attitudes, in most cases, and yet some people may not consider them to be very flavorful. On the other hand, a sassy attitude, an exuberant attitude, and a highly determined attitude may be considered a bit more “flavorful.” In some Zumba classes, the instructor encourages participants to add some personal “flavor” to their moves!
What flavor is your attitude? Are you complacent, entitled, enthusiastic, apathetic, grateful, superior, confident, hostile, cautious, suspicious, inferior, sincere, persistent, flexible, decisive, humble, jealous, judgmental, courteous, competitive, gloomy, sarcastic, sympathetic, cynical, critical, caring, earnest, jovial, hopeful?
How important has your attitude been to your journey in your Recovery From Obesity? Recovery from obesity is both a set of behaviors and a mindset (ATTITUDE) about your health, your sense of self worth, and your willingness to do what it takes to have the health you want and to feel about yourself the way you want to feel about yourself.
Attitude is the FLAVORFUL ingredient in A Post Op & A Doc’s RECIPE for Recovery from Obesity. You choose your attitude throughout the day and your attitude most certainly can add flavor to any given moment, whether that is specifically related to the food/weight loss aspects of your Recovery from Obesity or the non-food aspects of your Recovery.
Examples of attitude and food/weight aspects of Recovery from Obesity:
SCENARIO 1: The boss brings pizza, hot dogs, chips, brownies and every variety of sugary drink you can imagine for a Memorial Day office picnic. You choose the flavor or your attitude (keeping in mind what your behavior will likely be in response to the flavor of your attitude)!
A HOSTILE Attitude: “What a jerk, bringing in all kinds of junk food. Doesn’t she care about the health of her employees? And look at them…they know I’m not supposed to have that kind of crap and yet they bring their plates heaped with food with them to chat with me. How rude!”
A DECISIVE Attitude: “Okay, so it's not the kind of picnic I like to attend these days, but it doesn’t matter what food is served. Anywhere I go, I am prepared with a Protein Bar and a Protein Drink. I’m glad for the camaraderie with my co-workers! And I’ll be grateful for feeling good about my choices!"

SCENARIO 2: You are scheduled to meet your personal trainer in 30 minutes. You are comfortably settled in on your couch watching a favorite TV program when you notice the time and realize you need to get moving in order to be there on time. You choose the flavor or your attitude (keeping in mind what your behavior will likely be in response to the flavor of your attitude)! A COMPLACENT Attitude: “Ah… I’ve already paid for the sessions. I can skip one. I’ll let him know I’m not gonna make it tonight. He’ll probably be glad to get to go home early.”
An ENTHUSIASTIC Attitude: “You know what? It might be nice to stay home and relax tonight but I made up my mind to get and STAY healthier. Exercise is part of the Recipe for Success, so I’m gonna get moving so I’m there on time.”
An ENTHUSIASTIC Attitude: “Well! It might be nice to stay home and relax tonight but I made up my mind to get and STAY healthier. Exercise is part of the Recipe for Success, so I’m gonna get moving so I’m there on time.”

Examples of attitude and non-food aspects of Recovery from Obesity:
SCENARIO 1: Your sister-in-law, herself overweight, continues to make negative comments about your appearance since you’ve lost weight.
A JUDGMENTAL Attitude: You think to yourself, “You just want me to feel bad so I regain some weight. You want me to feel badly about myself because you feel badly about yourself.”
A HUMBLE Attitude: You think to yourself, “I feel sad listening to her make comments about my appearance. Before I lost weight, I would do that to others who had lost weight. It sure didn’t make me feel better and it doesn’t look like this is making her feel any better. I’ll talk to her about it later when all these people aren’t around.”

SCENARIO 2: A close friend sits you down to share her observations with you. She tells you she is worried about you because you seem to be seeking attention in sexually inappropriate ways since you’ve lost so much weight. She is kind and compassionate as she shares this with you.
A GRATEFUL Attitude: You thank her for sharing her observations with you, admitting you were enjoying some flirtatious attention but concerned that you might be giving messages you don’t intend to send.
A CRITICAL Attitude. You tell her you know that she is saying those things to you because she is jealous that you are getting attention that she obviously wants. Just a thought: in all of the examples above, all of the negative attitudes were “A” and the positive attitudes were “B.” Perhaps consider switching these two.


• • •


ATTITUDE makes all the difference in how you approach your Recovery from Obesity. Your ATTITUDE also influences how you choose to use the other ingredients in the Recipe for Recovery: Awareness, Acceptance, Commitment, Accountability and Effort. Ultimately, your ATTITUDE has a large impact on your long-term success in managing a healthy weight and in how you approach life!
It’s your choice as to how to use the ingredients in the Recipe for Recovery! Choose wisely!

Attitudes come in all sorts of “flavors,” including the obvious, of course: a positive attitude or a negative attitude. Some attitudes might be considered rather bland: cooperative, compliant and tolerant.
What flavor is your attitude? Are you complacent, entitled, enthusiastic, apathetic, grateful, superior, confident, hostile, cautious, suspicious, inferior, sincere, persistent, flexible, decisive, humble, jealous, judgmental, courteous, competitive, gloomy, sarcastic, sympathetic, cynical, critical, caring, earnest, jovial, hopeful?
How important has your attitude been to your journey in your Recovery From Obesity? Recovery from obesity is both a set of behaviors and a mindset (ATTITUDE) about your health, your sense of self worth, and your willingness to do what it takes to have the health you want and to feel about yourself the way you want to feel about yourself.
ATTITUDE IS THE FLAVORFUL INGREDIENT IN THE RECIPE FOR RECOVERY and it makes all the difference in how you approach your Recovery from Obesity. Your ATTITUDE also influences how you choose to use the other ingredients in the Recipe for Recovery: Awareness, Acceptance, Commitment, Accountability and Effort


Attitudes come in all sorts of “flavors,” including the obvious, of course: a positive attitude or a negative attitude. Some attitudes might be considered rather bland: cooperative, compliant and tolerant. These are desirable attitudes, in most cases, and yet some people may not consider them to be very flavorful. On the other hand, a sassy attitude, an exuberant attitude, and a highly determined attitude may be considered a bit more “flavorful.” In some Zumba classes, the instructor encourages participants to add some personal “flavor” to their moves!
What flavor is your attitude? Are you complacent, entitled, enthusiastic, apathetic, grateful, superior, confident, hostile, cautious, suspicious, inferior, sincere, persistent, flexible, decisive, humble, jealous, judgmental, courteous, competitive, gloomy, sarcastic, sympathetic, cynical, critical, caring, earnest, jovial, hopeful?
How important has your attitude been to your journey in your Recovery From Obesity? Recovery from obesity is both a set of behaviors and a mindset (ATTITUDE) about your health, your sense of self worth, and your willingness to do what it takes to have the health you want and to feel about yourself the way you want to feel about yourself.
Attitude is the FLAVORFUL ingredient in A Post Op & A Doc’s RECIPE for Recovery from Obesity. You choose your attitude throughout the day and your attitude most certainly can add flavor to any given moment, whether that is specifically related to the food/weight loss aspects of your Recovery from Obesity or the non-food aspects of your Recovery.
Examples of attitude and food/weight aspects of Recovery from Obesity:
SCENARIO 1: The boss brings pizza, hot dogs, chips, brownies and every variety of sugary drink you can imagine for a Memorial Day office picnic. You choose the flavor or your attitude (keeping in mind what your behavior will likely be in response to the flavor of your attitude)!
A HOSTILE Attitude: “What a jerk, bringing in all kinds of junk food. Doesn’t she care about the health of her employees? And look at them…they know I’m not supposed to have that kind of crap and yet they bring their plates heaped with food with them to chat with me. How rude!”
A DECISIVE Attitude: “Okay, so it's not the kind of picnic I like to attend these days, but it doesn’t matter what food is served. Anywhere I go, I am prepared with a Protein Bar and a Protein Drink. I’m glad for the camaraderie with my co-workers! And I’ll be grateful for feeling good about my choices!"

SCENARIO 2: You are scheduled to meet your personal trainer in 30 minutes. You are comfortably settled in on your couch watching a favorite TV program when you notice the time and realize you need to get moving in order to be there on time. You choose the flavor or your attitude (keeping in mind what your behavior will likely be in response to the flavor of your attitude)! A COMPLACENT Attitude: “Ah… I’ve already paid for the sessions. I can skip one. I’ll let him know I’m not gonna make it tonight. He’ll probably be glad to get to go home early.”
An ENTHUSIASTIC Attitude: “You know what? It might be nice to stay home and relax tonight but I made up my mind to get and STAY healthier. Exercise is part of the Recipe for Success, so I’m gonna get moving so I’m there on time.”
An ENTHUSIASTIC Attitude: “Well! It might be nice to stay home and relax tonight but I made up my mind to get and STAY healthier. Exercise is part of the Recipe for Success, so I’m gonna get moving so I’m there on time.”

Examples of attitude and non-food aspects of Recovery from Obesity:
SCENARIO 1: Your sister-in-law, herself overweight, continues to make negative comments about your appearance since you’ve lost weight.
A JUDGMENTAL Attitude: You think to yourself, “You just want me to feel bad so I regain some weight. You want me to feel badly about myself because you feel badly about yourself.”
A HUMBLE Attitude: You think to yourself, “I feel sad listening to her make comments about my appearance. Before I lost weight, I would do that to others who had lost weight. It sure didn’t make me feel better and it doesn’t look like this is making her feel any better. I’ll talk to her about it later when all these people aren’t around.”

SCENARIO 2: A close friend sits you down to share her observations with you. She tells you she is worried about you because you seem to be seeking attention in sexually inappropriate ways since you’ve lost so much weight. She is kind and compassionate as she shares this with you.
A GRATEFUL Attitude: You thank her for sharing her observations with you, admitting you were enjoying some flirtatious attention but concerned that you might be giving messages you don’t intend to send.
A CRITICAL Attitude. You tell her you know that she is saying those things to you because she is jealous that you are getting attention that she obviously wants. Just a thought: in all of the examples above, all of the negative attitudes were “A” and the positive attitudes were “B.” Perhaps consider switching these two.


• • •


ATTITUDE makes all the difference in how you approach your Recovery from Obesity. Your ATTITUDE also influences how you choose to use the other ingredients in the Recipe for Recovery: Awareness, Acceptance, Commitment, Accountability and Effort. Ultimately, your ATTITUDE has a large impact on your long-term success in managing a healthy weight and in how you approach life!
It’s your choice as to how to use the ingredients in the Recipe for Recovery! Choose wisely!

Recovery from Obesity is a choice and, while your Recovery is unique, the ingredients in the Recipe for Recovery are not. What that means is, you determine what matters most in your life and then choose HOW to use the ingredients (Awareness, Acceptance, Commitment, Attitude, Accountability, and Effort) to live fully.
Before we get much further, let’s explain what we mean by “Recovery from Obesity.”


Is Recovery from Obesity…
…being skinny? No.
.,..a number on the scale? No.
…being cured and never having to worry about weight again? No.
Is Recovery improved health and quality of life? Yes.
Recovery from Obesity is learning to live life on life’s terms by making the next wise choice one day at a time. Recovery from Obesity is following the Recipe for Recovery to live FULLY and become your healthiest physical, mental, emotional and spiritual self. You choose HOW to use the ingredients in the Recipe for Recovery to create your own healthy life! Recovery is a mindset, so it’s up to you to come to terms with the good, the bad and the ugly!
THE POST-OP: My Recovery journey began when I lost weight (the good), but stalled when I came face-to-face with the realities of the disease of obesity and my compulsive overeating (the bad and the ugly). I wanted to be cured of obesity and hoped surgery would do the trick. I wanted to be “normal” and didn’t want to worry about gaining weight again. I quickly learned that there is no such thing as “normal” and had to decide whether I wanted to spend my life worrying about gaining weight, or managing my obesity. The choice was mine, and I chose Recovery, starting with AWARENESS of my disease. Since then, I have had to ACCEPT some difficult realities.
Here are a few of the things I’ve learned to ACCEPT about myself:
I ACCEPT that I do not have an “OFF” switch around certain foods. Once I start, I won’t stop until I am sick or run out of food. Therefore, I ACCEPT that those foods are off limits for me. Period.
I ACCEPT that I have shrinkles on my belly, butt and legs. Needless to say, I choose not to wear a bikini.
I ACCEPT that I cannot take anti-inflammatory meds (NSAIDs) to treat my joint pain because I had weight loss surgery and am prone to ulcers.
I ACCEPT that I am susceptible to anemia and Vitamin deficiency and must be vigilant about taking my Iron and supplements.< br> I ACCEPT that I don’t like to workout, but I know I have to if I want to be healthy.

That’s the short list of stuff I had to come to terms with (ACCEPT) if I wanted what I said I wanted in my life – to live fully, free from the unhealthy obsession with food and weight. Of course, these are just “physical” things. Doc, what about the mental and emotional realities in Recovery?
THE DOC: As Cari very often says, obesity is “all about the food but is not about the food.” Clearly, food is part of the problem when one is obese, and yet, obesity is so much more than just the food. For example, some people are “emotional eaters,” turning to food when they are upset, angry, bored, worried, etc. They eat in response to feelings. In this case, it’s not really about the food. Learning to deal with emotions in healthy ways is the issue!
If you are an emotional eater, then choose to ACCEPT the following:
ACCEPT that food is an unhealthy way to cope with feelings.
ACCEPT that you may need to learn about healthy coping skills via reading books and articles or, you may need to attend therapy.
ACCEPT that there may be unresolved issues related to the learned behavior of turning to food as a coping skill and ACCEPT that in order to live fully in Recovery from Obesity you will need to address those underlying issues.

Relationships often change after a person loses a significant amount of weight. It can be difficult for both people in a relationship to deal with their thoughts and feelings related to the changes that seem to be brought about by weight loss. If you are struggling with relationships after losing weight, whether they are marital, friendship or family relationships:
ACCEPT that changes in relationships are common after weight loss.
ACCEPT that the changes need to be addressed openly and directly, that feelings need to be acknowledged and discussed, and that wants and needs change for people.
ACCEPT that sometimes people need help from a professional to get through periods of significant change in relationships.

“Self” often changes after weight loss surgery… self-esteem, self-image, and self-efficacy. Along with the changes in “self”:
ACCEPT that these changes can affect one in positive ways and in potentially unhealthy ways.
ACCEPT that others may accept or reject the changes, may Celebrate or dismiss the changes, may change with your or may choose not to change.
ACCEPT that you may feel uncomfortable with the changes as your body and mind adjust to them.

People sometimes report being disillusioned about not being “happy” after losing weight, which they expected they would be. If this is the case for you:
ACCEPT that “happiness” is an inside job and not based solely on your weight, size, appearance.
ACCEPT that there are other aspects of yourself to explore including your personality traits, your talents, your interests, your behavior toward self and others.
ACCEPT that “happiness” is closely related to your thoughts, then examine your thought patterns and ACCEPT that only YOU can choose if they will be positive or not!

Obviously, we could write for days about how ACCEPTANCE of the “good, the bad and the ugly” is a necessary part of Recovery from Obesity. What do you need to ACCEPT in order to move closer to obtaining those things related to obesity that are the most meaningful to you? What do you need to ACCEPT that is directly about the food and what do you need to ACCEPT that is not directly related to food, but does affect your eating and exercise habits?
Stick with the winners, get outside help when you need to, stay open-minded, use the ingredients of the Recipe for Recovery to live the healthy life you want…AND, be sure to join us daily on our Facebook page for ongoing motivation, education and inspiration. You can’t do this alone, and no one can do it for you!

Recovery from Obesity is a choice and, while your Recovery is unique, the ingredients in the Recipe for Recovery are not. What that means is, you determine what matters most in your life and then choose HOW to use the ingredients (Awareness, Acceptance, Commitment, Attitude, Accountability, and Effort) to live fully.
Before we get much further, let’s explain what we mean by “Recovery from Obesity.”


Is Recovery from Obesity…
…being skinny? No.
.,..a number on the scale? No.
…being cured and never having to worry about weight again? No.
Is Recovery improved health and quality of life? Yes.
Recovery from Obesity is learning to live life on life’s terms by making the next wise choice one day at a time. Recovery from Obesity is following the Recipe for Recovery to live FULLY and become your healthiest physical, mental, emotional and spiritual self. You choose HOW to use the ingredients in the Recipe for Recovery to create your own healthy life! Recovery is a mindset, so it’s up to you to come to terms with the good, the bad and the ugly!
THE POST-OP: My Recovery journey began when I lost weight (the good), but stalled when I came face-to-face with the realities of the disease of obesity and my compulsive overeating (the bad and the ugly). I wanted to be cured of obesity and hoped surgery would do the trick. I wanted to be “normal” and didn’t want to worry about gaining weight again. I quickly learned that there is no such thing as “normal” and had to decide whether I wanted to spend my life worrying about gaining weight, or managing my obesity. The choice was mine, and I chose Recovery, starting with AWARENESS of my disease. Since then, I have had to ACCEPT some difficult realities.
Here are a few of the things I’ve learned to ACCEPT about myself:
I ACCEPT that I do not have an “OFF” switch around certain foods. Once I start, I won’t stop until I am sick or run out of food. Therefore, I ACCEPT that those foods are off limits for me. Period.
I ACCEPT that I have shrinkles on my belly, butt and legs. Needless to say, I choose not to wear a bikini.
I ACCEPT that I cannot take anti-inflammatory meds (NSAIDs) to treat my joint pain because I had weight loss surgery and am prone to ulcers.
I ACCEPT that I am susceptible to anemia and Vitamin deficiency and must be vigilant about taking my Iron and supplements.< br> I ACCEPT that I don’t like to workout, but I know I have to if I want to be healthy.

That’s the short list of stuff I had to come to terms with (ACCEPT) if I wanted what I said I wanted in my life – to live fully, free from the unhealthy obsession with food and weight. Of course, these are just “physical” things. Doc, what about the mental and emotional realities in Recovery?
THE DOC: As Cari very often says, obesity is “all about the food but is not about the food.” Clearly, food is part of the problem when one is obese, and yet, obesity is so much more than just the food. For example, some people are “emotional eaters,” turning to food when they are upset, angry, bored, worried, etc. They eat in response to feelings. In this case, it’s not really about the food. Learning to deal with emotions in healthy ways is the issue!
If you are an emotional eater, then choose to ACCEPT the following:
ACCEPT that food is an unhealthy way to cope with feelings.
ACCEPT that you may need to learn about healthy coping skills via reading books and articles or, you may need to attend therapy.
ACCEPT that there may be unresolved issues related to the learned behavior of turning to food as a coping skill and ACCEPT that in order to live fully in Recovery from Obesity you will need to address those underlying issues.

Relationships often change after a person loses a significant amount of weight. It can be difficult for both people in a relationship to deal with their thoughts and feelings related to the changes that seem to be brought about by weight loss. If you are struggling with relationships after losing weight, whether they are marital, friendship or family relationships:
ACCEPT that changes in relationships are common after weight loss.
ACCEPT that the changes need to be addressed openly and directly, that feelings need to be acknowledged and discussed, and that wants and needs change for people.
ACCEPT that sometimes people need help from a professional to get through periods of significant change in relationships.

“Self” often changes after weight loss surgery… self-esteem, self-image, and self-efficacy. Along with the changes in “self”:
ACCEPT that these changes can affect one in positive ways and in potentially unhealthy ways.
ACCEPT that others may accept or reject the changes, may Celebrate or dismiss the changes, may change with your or may choose not to change.
ACCEPT that you may feel uncomfortable with the changes as your body and mind adjust to them.

People sometimes report being disillusioned about not being “happy” after losing weight, which they expected they would be. If this is the case for you:
ACCEPT that “happiness” is an inside job and not based solely on your weight, size, appearance.
ACCEPT that there are other aspects of yourself to explore including your personality traits, your talents, your interests, your behavior toward self and others.
ACCEPT that “happiness” is closely related to your thoughts, then examine your thought patterns and ACCEPT that only YOU can choose if they will be positive or not!

Obviously, we could write for days about how ACCEPTANCE of the “good, the bad and the ugly” is a necessary part of Recovery from Obesity. What do you need to ACCEPT in order to move closer to obtaining those things related to obesity that are the most meaningful to you? What do you need to ACCEPT that is directly about the food and what do you need to ACCEPT that is not directly related to food, but does affect your eating and exercise habits?
Stick with the winners, get outside help when you need to, stay open-minded, use the ingredients of the Recipe for Recovery to live the healthy life you want…AND, be sure to join us daily on our Facebook page for ongoing motivation, education and inspiration. You can’t do this alone, and no one can do it for you!

Recovery from Obesity is a choice and, while your Recovery is unique, the ingredients in the Recipe for Recovery are not. What that means is, you determine what matters most in your life and then choose HOW to use the ingredients (Awareness, Acceptance, Commitment, Attitude, Accountability, and Effort) to live fully.
Before we get much further, let’s explain what we mean by “Recovery from Obesity.”


Is Recovery from Obesity…
…being skinny? No.
.,..a number on the scale? No.
…being cured and never having to worry about weight again? No.
Is Recovery improved health and quality of life? Yes.
Recovery from Obesity is learning to live life on life’s terms by making the next wise choice one day at a time. Recovery from Obesity is following the Recipe for Recovery to live FULLY and become your healthiest physical, mental, emotional and spiritual self. You choose HOW to use the ingredients in the Recipe for Recovery to create your own healthy life! Recovery is a mindset, so it’s up to you to come to terms with the good, the bad and the ugly!
THE POST-OP: My Recovery journey began when I lost weight (the good), but stalled when I came face-to-face with the realities of the disease of obesity and my compulsive overeating (the bad and the ugly). I wanted to be cured of obesity and hoped surgery would do the trick. I wanted to be “normal” and didn’t want to worry about gaining weight again. I quickly learned that there is no such thing as “normal” and had to decide whether I wanted to spend my life worrying about gaining weight, or managing my obesity. The choice was mine, and I chose Recovery, starting with AWARENESS of my disease. Since then, I have had to ACCEPT some difficult realities.
Here are a few of the things I’ve learned to ACCEPT about myself:
I ACCEPT that I do not have an “OFF” switch around certain foods. Once I start, I won’t stop until I am sick or run out of food. Therefore, I ACCEPT that those foods are off limits for me. Period.
I ACCEPT that I have shrinkles on my belly, butt and legs. Needless to say, I choose not to wear a bikini.
I ACCEPT that I cannot take anti-inflammatory meds (NSAIDs) to treat my joint pain because I had weight loss surgery and am prone to ulcers.
I ACCEPT that I am susceptible to anemia and Vitamin deficiency and must be vigilant about taking my Iron and supplements.< br> I ACCEPT that I don’t like to workout, but I know I have to if I want to be healthy.

That’s the short list of stuff I had to come to terms with (ACCEPT) if I wanted what I said I wanted in my life – to live fully, free from the unhealthy obsession with food and weight. Of course, these are just “physical” things. Doc, what about the mental and emotional realities in Recovery?
THE DOC: As Cari very often says, obesity is “all about the food but is not about the food.” Clearly, food is part of the problem when one is obese, and yet, obesity is so much more than just the food. For example, some people are “emotional eaters,” turning to food when they are upset, angry, bored, worried, etc. They eat in response to feelings. In this case, it’s not really about the food. Learning to deal with emotions in healthy ways is the issue!
If you are an emotional eater, then choose to ACCEPT the following:
ACCEPT that food is an unhealthy way to cope with feelings.
ACCEPT that you may need to learn about healthy coping skills via reading books and articles or, you may need to attend therapy.
ACCEPT that there may be unresolved issues related to the learned behavior of turning to food as a coping skill and ACCEPT that in order to live fully in Recovery from Obesity you will need to address those underlying issues.

Relationships often change after a person loses a significant amount of weight. It can be difficult for both people in a relationship to deal with their thoughts and feelings related to the changes that seem to be brought about by weight loss. If you are struggling with relationships after losing weight, whether they are marital, friendship or family relationships:
ACCEPT that changes in relationships are common after weight loss.
ACCEPT that the changes need to be addressed openly and directly, that feelings need to be acknowledged and discussed, and that wants and needs change for people.
ACCEPT that sometimes people need help from a professional to get through periods of significant change in relationships.

“Self” often changes after weight loss surgery… self-esteem, self-image, and self-efficacy. Along with the changes in “self”:
ACCEPT that these changes can affect one in positive ways and in potentially unhealthy ways.
ACCEPT that others may accept or reject the changes, may Celebrate or dismiss the changes, may change with your or may choose not to change.
ACCEPT that you may feel uncomfortable with the changes as your body and mind adjust to them.

People sometimes report being disillusioned about not being “happy” after losing weight, which they expected they would be. If this is the case for you:
ACCEPT that “happiness” is an inside job and not based solely on your weight, size, appearance.
ACCEPT that there are other aspects of yourself to explore including your personality traits, your talents, your interests, your behavior toward self and others.
ACCEPT that “happiness” is closely related to your thoughts, then examine your thought patterns and ACCEPT that only YOU can choose if they will be positive or not!

Obviously, we could write for days about how ACCEPTANCE of the “good, the bad and the ugly” is a necessary part of Recovery from Obesity. What do you need to ACCEPT in order to move closer to obtaining those things related to obesity that are the most meaningful to you? What do you need to ACCEPT that is directly about the food and what do you need to ACCEPT that is not directly related to food, but does affect your eating and exercise habits?
Stick with the winners, get outside help when you need to, stay open-minded, use the ingredients of the Recipe for Recovery to live the healthy life you want…AND, be sure to join us daily on our Facebook page for ongoing motivation, education and inspiration. You can’t do this alone, and no one can do it for you!

Recovery from Obesity is a choice and, while your Recovery is unique, the ingredients in the Recipe for Recovery are not. What that means is, you determine what matters most in your life and then choose HOW to use the ingredients (Awareness, Acceptance, Commitment, Attitude, Accountability, and Effort) to live fully.
Before we get much further, let’s explain what we mean by “Recovery from Obesity.”


Is Recovery from Obesity…
…being skinny? No.
.,..a number on the scale? No.
…being cured and never having to worry about weight again? No.
Is Recovery improved health and quality of life? Yes.
Recovery from Obesity is learning to live life on life’s terms by making the next wise choice one day at a time. Recovery from Obesity is following the Recipe for Recovery to live FULLY and become your healthiest physical, mental, emotional and spiritual self. You choose HOW to use the ingredients in the Recipe for Recovery to create your own healthy life! Recovery is a mindset, so it’s up to you to come to terms with the good, the bad and the ugly!
THE POST-OP: My Recovery journey began when I lost weight (the good), but stalled when I came face-to-face with the realities of the disease of obesity and my compulsive overeating (the bad and the ugly). I wanted to be cured of obesity and hoped surgery would do the trick. I wanted to be “normal” and didn’t want to worry about gaining weight again. I quickly learned that there is no such thing as “normal” and had to decide whether I wanted to spend my life worrying about gaining weight, or managing my obesity. The choice was mine, and I chose Recovery, starting with AWARENESS of my disease. Since then, I have had to ACCEPT some difficult realities.
Here are a few of the things I’ve learned to ACCEPT about myself:
I ACCEPT that I do not have an “OFF” switch around certain foods. Once I start, I won’t stop until I am sick or run out of food. Therefore, I ACCEPT that those foods are off limits for me. Period.
I ACCEPT that I have shrinkles on my belly, butt and legs. Needless to say, I choose not to wear a bikini.
I ACCEPT that I cannot take anti-inflammatory meds (NSAIDs) to treat my joint pain because I had weight loss surgery and am prone to ulcers.
I ACCEPT that I am susceptible to anemia and Vitamin deficiency and must be vigilant about taking my Iron and supplements.< br> I ACCEPT that I don’t like to workout, but I know I have to if I want to be healthy.

That’s the short list of stuff I had to come to terms with (ACCEPT) if I wanted what I said I wanted in my life – to live fully, free from the unhealthy obsession with food and weight. Of course, these are just “physical” things. Doc, what about the mental and emotional realities in Recovery?
THE DOC: As Cari very often says, obesity is “all about the food but is not about the food.” Clearly, food is part of the problem when one is obese, and yet, obesity is so much more than just the food. For example, some people are “emotional eaters,” turning to food when they are upset, angry, bored, worried, etc. They eat in response to feelings. In this case, it’s not really about the food. Learning to deal with emotions in healthy ways is the issue!
If you are an emotional eater, then choose to ACCEPT the following:
ACCEPT that food is an unhealthy way to cope with feelings.
ACCEPT that you may need to learn about healthy coping skills via reading books and articles or, you may need to attend therapy.
ACCEPT that there may be unresolved issues related to the learned behavior of turning to food as a coping skill and ACCEPT that in order to live fully in Recovery from Obesity you will need to address those underlying issues.

Relationships often change after a person loses a significant amount of weight. It can be difficult for both people in a relationship to deal with their thoughts and feelings related to the changes that seem to be brought about by weight loss. If you are struggling with relationships after losing weight, whether they are marital, friendship or family relationships:
ACCEPT that changes in relationships are common after weight loss.
ACCEPT that the changes need to be addressed openly and directly, that feelings need to be acknowledged and discussed, and that wants and needs change for people.
ACCEPT that sometimes people need help from a professional to get through periods of significant change in relationships.

“Self” often changes after weight loss surgery… self-esteem, self-image, and self-efficacy. Along with the changes in “self”:
ACCEPT that these changes can affect one in positive ways and in potentially unhealthy ways.
ACCEPT that others may accept or reject the changes, may Celebrate or dismiss the changes, may change with your or may choose not to change.
ACCEPT that you may feel uncomfortable with the changes as your body and mind adjust to them.

People sometimes report being disillusioned about not being “happy” after losing weight, which they expected they would be. If this is the case for you:
ACCEPT that “happiness” is an inside job and not based solely on your weight, size, appearance.
ACCEPT that there are other aspects of yourself to explore including your personality traits, your talents, your interests, your behavior toward self and others.
ACCEPT that “happiness” is closely related to your thoughts, then examine your thought patterns and ACCEPT that only YOU can choose if they will be positive or not!

Obviously, we could write for days about how ACCEPTANCE of the “good, the bad and the ugly” is a necessary part of Recovery from Obesity. What do you need to ACCEPT in order to move closer to obtaining those things related to obesity that are the most meaningful to you? What do you need to ACCEPT that is directly about the food and what do you need to ACCEPT that is not directly related to food, but does affect your eating and exercise habits?
Stick with the winners, get outside help when you need to, stay open-minded, use the ingredients of the Recipe for Recovery to live the healthy life you want…AND, be sure to join us daily on our Facebook page for ongoing motivation, education and inspiration. You can’t do this alone, and no one can do it for you!