CaitlynR

I find this discussion about therapy interesting and wanted to add my thoughts.
I am a clinical psychologist (doctoral level) and work full time as a psychotherapist. I very rarely would say someone "needs" therapy. This may be more about semantics than anything else, but I may certainly recommend therapy, at times strongly, and would advise someone that therapy will likely be helpful or that I am concerned that without therapy there will likely be a lower quality of life, or higher risk of suicide or other poor outcomes. "Need" only typically is only mentioned in cases of imminent risk to self or others or legally mandated situations. This may mostly be a clinical choice as many people will give pushback to the more directive tone of "need" versus professional recommendation and encouragement.
That said, I recommend therapy, many times without the heavy emphasis of a formal recommendation, very freely, both as a therapist and just a person. I very much believe in therapy, both as a practitioner and a client. I have no problem with others, with limited psych knowledge or knowledge about the person, recommending therapy. I believe many to most people can benefit in some way from therapy. There is very little risk, and cost is typically only in terms of money and time (versus medications or other medical options with a greater number and severity of potential risks and costs which must be weighed against potential benefits). The major risk I see is seeing a mediocre or worse therapist. I think educating yourself in advance on the basics of therapy and what to look for in a good therapist is very helpful so you know when you need to switch, as well as knowing sometimes someone is a great therapist but for many potential reasons are a poor fit for you in particular. A good one will not take offense at all for being asked for a transfer as our whole goal is for the client to benefit even if that is with someone different.
One thing that I notice is that some people (not necessarily anyone here) will recommend therapy or say someone needs therapy in a way I feel reflects stigma of therapy or mental illness. The implication often is the person has a mental illness that needs to be treated by a professional (something that absolutely should not be determined by anyone other than a professional after a thorough assessment, and in my opinion a MH professional, but that's a separate topic). A similar implication is when it is known the person has a mental illness, and is told to go to therapy or take medications as a way of invalidating their current experience. In other words (the message is), if their emotions, thoughts or behavior are being attributed to a mental illness, they do not need to be considered as valid as those same emotions/thoughts/behavior displayed by someone without a known history of mental illness and the person should take care of this problem through treating it until it conforms to some standard the speaker holds.
To take this a step further the implied message behind this can be the more harmful "wow, you have some serious problems/are being very irrational/'crazy', etc.". This is a way of distancing oneself and labeling the other person as in the category of "other" as opposed to the speaker and other normal/understandable/"sane" people. That kind of message can be extraordinarily harmful both in perpetuating societal stigma and increasing self-stigma. It is typically not intended to be harmful but hard to challenge as since it is formed through the lens of existing stigma and ignorance the person is likely to be defensive (such as when a unintentional but overt racist or sexist comment is challenged).
In summary: it should be safe to suggest therapy to anyone if you feel therapy may be genuinely helpful. The OP is at the very least going through a time of adjustment and stress, with stated distress about current eating pattern, so I would recommend therapy as an option. Just make sure you don't tell someone (or imply) they have a mental illness or that what they are going through is part of a known mental illness (at least in the context we are talking here). Always try to be aware of your areas of limited knowledge and bias.

If we all were always "on track on eating clean" none of us would have any problems. I would guess most of have episodes of eating the wrong foods, too much food, lose our minds.....etc. The difference between failing and being successful is not the complete absence of "I think I just lost my mind" episodes but the ability to get right back to it once the episode is over. Failing from time to time is part of the process.......so don't confuse it with "being a failure". It's a process, a journey and to think you're never going to slip is not being realistic. I have a little saying in my bathroom "I fall down, I get up and meanwhile I keep dancing". Keep dancing and you'll reach your goal.

Ok, so it happened. Whether anyone else did this really doesn't matter, because you need to focus on you.
Do you have a psychologist that is part of your journey? You need to get control of this immediately, or the surgery was for nothing. Your head needs to be in the right place, and you need help getting it there.

Thank you all so much for the outpouring of support, it means a great deal to me. I'll have a longer reply when I have more time but I wanted to share my appreciation.

Thank you all so much for the outpouring of support, it means a great deal to me. I'll have a longer reply when I have more time but I wanted to share my appreciation.

You're getting good advice in this thread. In addition, you sound extremely well informed about the surgery, grounded in your expectations as well as attuned to your own body. recipes for success in my mind.

Dont tell your parents if you think that will cause an undue amount of stress for both you and them. You're still a few months out from surgery, so you can reevaluate this strategy at various points in your journey. My advice to you at this early pre-operative stage would be to focus on your own needs. I posed the same question to this board when I was pre-op and it was recommended to me that I re-evaluate telling my parent (who I knew would freak out and be unsupportive) once I had a surgery date. Ultimately I chose not to tell and I'm pleased with that decision. I'm 10 months post op now.

My chosen field (journalism) is also intellectually demanding with longgggg hours, many spent sitting and writing. But it's also personally fulfilling, I know I'm serving the greater good and not many people are cut out for performing the job at the level I've attained. What's amazing is that I made it as far as I did while morbidly obese, which I fully know was holding me back. Not only do employers inherently trust and respect me more now that I'm thinner (not saying this is right, it isn't) but I simply have more intellectual and physical energy since regaining my health. It feels like my synapses are properly firing for the first time in years. I honestly think I had fat brain in retrospect, that sometimes my thoughts were sluggish.

That said, I also have experience with depression. There were times pre-op when I would cry everyday. I struggled to get out of bed and go to work in the morning. As a psychologist yourself, I don't have to tell you the importance of discussing this with your physician. What I can say is that for me the increased energy and activity levels have helped improve my mental health across the board. I went through some really difficult personal stuff over the last few months, unrelated to surgery, and the newfound mental acuity combined with therapy and medication helped keep me from slipping into a deeper state of sadness. I honestly felt better equipped to handle life's obstacles and the reason for that, I think, is the confidence that comes from knowing I have taken charge of my health in a way most people never do in heir lifetime.

It is nice to see someone well informed.
Don't tell you parents. You don't have to, it will make them stressed out and unhappy and add stress to your life.
If you suffer from depression and take medicine for it then you need to discuss WLS with your Psychiatrist. WLS is very taxing mentally. You need a good therapist and a lot of support. The hormone dumping and all the changes your body goes through is really rough. Increased depression to the point of having suicidal thoughts is a real possibility.
You only eat a limited amount of calories for a short period of time. You will have enough energy. You body will burn the fat is has for energy and the Protein and other foods you eat will fuel you.

You have good insight toward yourself, but it sounds like your job takes a huge toll on you emotionally, mentally and thus physically.
Ask yourself where you will be in 5-10 years if you don't have the surgery? Can you sustain the job stress along with regular life and deteriorating health?
Don't tell anyone you don't want to tell, that may sound harsh but self preservation takes precedence over being judged for a decision you really need to make without feeling as if it would hurt them more, but it actually hurts you more.
Good luck in your decisions. Let us know.

First if all let me say I'm sorry for the loss of your brother.
I also agree that you have a good hold on your situation and a good attitude going in.
With that said, the most important thing I can say is , you have one life to live, and you have to do what us right for you. I can understand your parents fears but when it comes down to it, you have to live in your body. No one but you . I am a firm believer that you must do what makes you happy first. Your health takes precedence over everyone's feelings, thoughts, concerns, fears and anxieties. If you fell this is right for uou, then go for it. Save your life and your health because you never know what age your parents are going to live to be and you just might be taking care of them at some point. And you don't want to be overweight and sick and regretting that you didn't take this route.
If it is easier , do not tell them. Just do it and when they start to notice, just say, I have been going to a nutrionist and she is really helping me make progress. Sometimes it's best to not tell your parents everythung. I am struggling right now because I cannot tell my sisters. It's hard but I made this decision and my husband supports me 100%. I have told no one else but a niece who had the surgery. No one in my family knows, none of my friends know. I don't owe them any explanations or need their approval. It's my body. My parebts,are deceased now for overy 25 yrs. My mother was always overweight and struggled. If she were five today she would have had the surgery first.
Next, give it to God. Pray and have faith. If it's right the path will open. Follow your heart and you can never go wrong. God Bless.

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I think who you tell is your business. It's your life, you body, your future! Not telling is not being dishonest in my opinion.

As far as energy, I had my sleeve on a Wednesday and was back to working on the following Monday. (Sedentary job here too). I was only tired the first two days and I feel the majority of that was due to anesthesia and the lack of sleep I got the days leading up to surgery.

I was around 366 at surgery (392 at my highest) so quite a bit larger than you... But once I dropped down to around 350, my energy definitely went up and I started moving more. I started walking before surgery and try to get a minimum of 1.5-2 miles a day. I wasn't expecting to run a marathon immediately , I just know I have to keep moving, whatever that may consist of.

I will say for the emotional aspect, my hormones have been a roller coaster at times. I was told this was due to the release of hormones as the fat drops off. I went through an acne stage which I have never dealt with before and I have had some major mood swings from time to time. More impatient/angry than depression for me.

I'm reaching 3 months out next week, so no expert at all. Just sharing my experience so far!

Hi Caitlyn! I don't have magic answers. What I *can* say is that I'm struck by how you have a very realistic handle on your situation. That's just impressive, and it says to me that you are well on your way to success. As far as the job, I'm only 3-1/2 weeks out and returned to work today (at home, just reading and answering my mails from the last few weeks). I didn't notice any particular cognitive fuzziness. As far as the mood effects, I do read that some people have them, but after the first few days of being a little freaked out, I haven't had any problems. As I said, I'm only a few weeks out, but I feel like I'm doing well!
You are intelligent, realistic and positive: try to have faith in yourself. Please keep us posted! [emoji8]


RNY 14 April 2017
SW: 295 lb / 134 kg
GW: 187 lb / 85 kg (I'll see when I get there)

I am very happy to be here and have enjoyed reading this site over the past few weeks. I would love to get down some of my thoughts and hear any feedback anyone has for me. I tend to write essays so I apologize for the length.
I am scheduled to meet with a surgeon in two weeks. I also have the psych eval and nutritionist appointment as well as some medical tests that day. The hospital is almost two hours away so I'm packing as much as I can into each trip. I have bcbs fep so still have the 3 months supervised program which has not started.
I weigh 278 and have been around this weight or higher (highest around 300) for at least 10 years. I am 35, normal weight as a young child but as soon as I hit puberty quickly became obese. I am not saying it is all genetic, but I know that is part of it. My parents and brother all suffered with obesity or morbid obesity. My brother had gastric bypass surgery several years ago, and to make a long story short he had complications, and died two years after the surgery at age 30. This was not from the surgery but was medically fragile since the surgery. My parents blame the surgery although I do not. They have made it clear that they would be very, very upset if I chose bariatric surgery.
Despite this, I have considered this for years. I try to base most of my major decisions on good data. I know that long term weight loss in significant amounts (like, 100 lbs) is quite statistically improbable. I have successfully kept 20-30 lbs (back and forth in this range) off for 6 years. Despite that I am concerned about my health. I have high blood pressure and take three medications to maintain this. I am in the prediabetic range for blood sugar. I see my dad with worsening neuropathy from diabetes type 2 despite really hard work on a very low carb diet. My paternal grandpa lost 3 of his limbs from this disease before he died. Despite being fairly young my knees are starting to hurt when using stairs. I worry that I won't have very long ahead of me. I honestly have come to terms with how I look and while being thinner would be nice, that is not a major motivation for me. Sickness and early death from health consequences of morbid obesity terrifies me.
I work full time as a clinical psychologist at a Veterans Affairs. The work is my passion and I would not want to do anything else. However it can be very stressful. It is also very cognitively and emotionally demanding and therefore exhausting while being super sendentary. My salary also supports my family (son and sahd husband). I have recurrent major depression. I am doing very well, taking medication and when needed connect back with therapy. I always live with the fear of depression relapse due to fear not being able to keep up at work and how hard the last one was on me and my family (4 years ago).
Fears: will such low amounts of calories allow me to have sufficient cognitive energy to do my job well? Will the mood effects bring on another episode of depression? Should I hide having surgery to my parents, which feels dishonest, or tell them the truth and live with their anger and fear of losing their only remaining child? Will I be able to regularly engage in moderate exercise which honestly I haven't done since my early 20's?
If you made it to the end, thank you. I don't expect answers to the above questions but feels good to tell them to people who might relate. Any thoughts welcome. Any experiences of going through this while maintaining a demanding job are appreciated.