I have something important to tell you today about success with weight loss surgery. When you hear it, it may strike you as obvious, but I’d be willing to bet that your surgeon never mentioned it to you. Don’t begrudge him or her for that, because this particular crucial thing is something no surgeon can give you anyway. It’s something that no insurance policy covers, no pharmacy sells, and money can’t buy. You may already possess this thing in some degree, but do you have enough to ensure weight loss success?

THE KEY

This very important thing, the key to weight loss success, is self-esteem.

Success requires positive self-esteem in a part of your life that’s never before given you a lasting good feeling about yourself: weight loss. If you were good at that, if you knew you were good at it, you probably wouldn’t need bariatric surgery in the first place. You’d already be maintaining a healthy weight, happy about that, and working on attaining goals in some other area of your life, such as qualifying for the Olympic pole-vaulting team.

Self-esteem plays a role in many areas of human endeavor, and psychologists have identified it as an important predictor of relative outcomes. They believe that your level of self-esteem affects (or even predicts) the results of your efforts and activities, be they academic, athletic, professional, interpersonal, you name it. Their studies show that a person with high self-esteem (whether generalized, like “I’m a good person”, or specific, like “I’m a good tennis player”) is more likely to succeed at a given task than someone with low self-esteem.

Although the Stuart Smalley School of Positive Affirmations would have you believe that chanting, “I’m good enough, I’m smart enough…” six times a day will bolster your self-esteem, it’s not quite as simple as that. While I agree that our thoughts and beliefs about ourselves have an enormous effect on our behavior, self-esteem often involves feeling rather than thinking. Let’s demonstrate how that works through 3 short interviews with Jean.

Interview #1:

“Jean, are you a good car mechanic?”

“Heck, no.”

“How do you feel about that?”

“Perfectly fine.”

[Translation: Jean knows she’s not a good mechanic and feels just fine about

that because it’s not something that engages her emotions at all. Her self-

esteem in this area is neutral.]

Interview #2:

“Jean, do you have a flat abdomen?”

“Heck, no.”

“How do you feel about that?”

“Lousy. It makes me feel unattractive, I struggle to find attractive clothing to hide my

belly, and I feel frustrated that none of my exercise routine seems to improve my

mid-section.”

[Translation: Jean knows her abdomen is not flat and feels unhappy about the

way she looks and feels. Her self-esteem in this area is negative.

Interview #3:

“Jean, are you a good writer?”

“Heck, yes.”

“How do you feel about that?”

“I feel wonderful about it. I love writing. It’s fun, challenging, and interesting. When

I’m writing, I feel that I’m a talented and worthwhile person.”

[Translation: Jean knows she is a good writer and feels happy about it. Her self-

esteem in this area is positive.]

The final step of this educational exercise is to look at the following list of endeavors and predict which one Jean will be most likely to succeed at. Choose one of the following:

1. Rebuild her car’s engine.
   
2. Compete in and win the swimsuit competition at a beauty pageant.
   
3. Write and publish a book.
   

Yes, you’re absolutely right. Endeavor #3 is the most promising one for Jean given the current state of her self-esteem. Not only does she enjoy writing, she has succeeded at it in the past and has plenty of confidence that she can do so again.

CATCH 22

So, let’s take it as a given that positive self-esteem about weight loss is important for success with our bariatric surgery. We know objectively (through the weight on the scale in our bathroom or doctor’s office) that we’ve never enjoyed long-term success with weight loss, and we presumably feel miserable about that. It’s affecting our health, our relationships, and our careers in ways that make us unhappy enough to seek bariatric surgery. Our self-esteem in this area is negative, yet we need positive self-esteem in order to succeed.

Sounds like a classic “Catch 22”, doesn’t it? But wait, it gets worse! For many people, negative self-esteem erodes not just one area (like weight management) but many areas in our lives. For some of us, negative self-esteem so pervasive that it taints every cell of our being: “I’m a bad person, and I feel bad about that.” That doesn’t mean that we’re hopeless neurotics or that our negative self-esteem is a permanent and unvarying feature in our lives. A few years ago, I had a very nasty telephone argument with someone whose company provides an important service to me. In fact, we were both nasty, and two days later I regretted that I had acted so obnoxiously. For an entire day, the balance in my self-esteem account was in the red. I’d have been struck dumb if you’d asked me to name even one good thing about me. The next day, I bought that guy a coffee and apologized to him face-to-face. Life went on and my self-esteem account balance crept back up above zero.

Thanks for the reminder. For me, learning to keep things in perspective really helps to make life more manageable.

Perspective is a highly under-rated thing, isn't it?

When I look out the window at my worktable, I can see a neighbor's barn (we live way out in the boondocks, where barns and cows are more populous than shopping malls and poodles). From here, it looks tiny, but in fact it's huge. It's just one of his barns (we're in the agri-business heartland) and he can fit several pieces of modern farm equipment in it, things that look like they just landed from Mars and are getting ready to take over the world.

That's why I have to constantly supervise my own thoughts and make sure I'm reacting to real things in the appropriate degree to achieve the end I so very much desire.

Thanks for the reminder. For me, learning to keep things in perspective really helps to make life more manageable.

Jean, thanks for this article! Self-esteem really is necessary, because if we’re not worth anything, why would we work hard to get better? I love the examples you chose. They make your points so clear…and you are such a good writer.

its a part of it surely, but i know many obese people who think they look wonderful and dont see themselves as fat. So it needs some serious help.

The self-image of obese (or any other) people is complicated, isn't it? I've been contemplating that for years. On one hand, you have obese people who don't see themselves as obese, and apparently don't recognize the health risk that poses. On the other hand, we're living in a society that holds up "skinny" as divine, is extremely critical of the obese, and yet goes on super-sizing every meal we eat. In that setting, it's hard to keep your balance.

its a part of it surely, but i know many obese people who think they look wonderful and dont see themselves as fat. So it needs some serious help.