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Straight Talk! Becoming More Assertive



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The world doesn’t seem to like overweight people. Discrimination against the obese is widespread and many patients have provided me with examples to illustrate just how common it is in everyday life. The truth is; I knew this already because I’ve been there myself! The demeaning treatment takes its toll. Most of my patients report that their self-esteem and self-image has suffered due to their weight. Many patients also describe how their weight has impacted their intimate and social relationships, as well as their careers.

Therefore, overweight people would have to develop some pretty strong coping mechanisms to make it through their days without going off the deep end. There are three common coping strategies that people describe prior to weight loss surgery: 1) trying to be funny, 2) tolerating a lot of mistreatment from others and being “a doormat,” and 3) becoming bitter and angry and keeping others at a distance. Each of these strategies has its problems, but there is a common resolution.

I. The funny guy

It may seem to be a stereotype, but I can attest to the fact that a lot of overweight people are funny. Whether morbidly obese people are significantly funnier than thin people is uncertain, but I’ve spent a great number of hours laughing on the job. Unfortunately, the humor is often self-deprecating. It’s an adaptive strategy…survival of the funniest.

Obese patients (and others) describe two functions that self-deprecating humor can serve: 1) I cut myself down before you have a chance, which seems to protect me while at the same time disarming you, and 2) it may endear me to you…we often like the funny guy. The strategy is simple: My sense of humor is a characteristic you might find attractive should you find my appearance to be unattractive.

There are many reasons why heavy people should abandon this strategy – if for no other reason than it generally backfires in the long run. However, there is often a temporary benefit, which is why it persists. It’s probably less likely that you’ll insult me now that I’ve just insulted myself – but in the long term it will probably make you feel more comfortable insulting me, given that I’ve demonstrated that I’m seemingly comfortable with it. Even if you believe you’re comfortable with these barbs, I would argue that you’re not, and in either case it serves to erode your self-esteem. Some might argue that you eventually get used to it, but actually most patients tell me that they hear fat jokes often enough that they start to believe it. At some point, you start to believe it even though you don’t want to.

II. The doormat

The doormat is basically the funny guy without the sense of humor. The doormat just takes it all in…the jokes, the comments, the sneers, the constant diet suggestions, and on and on. The doormat has very low self-esteem and believes that he may actually deserve poor treatment from others because he is overweight. Like the funny guy, the doormat believes all of the comments and is often quite depressed. The doormat might be more isolated than the funny guy because he lacks the strategy of humor to attempt to win others over.

III. The bitter and angry loner

The bitter and angry loner doesn’t take a lot of garbage from others; he dishes it out! This person is angry at the world and fends others off, not through humor, but by being a bear. The bitter and angry loner isn’t seeking to be endearing to others, but rather to keep others away from him. The strategy is “I’ll hit you before you hit me!” While it does defend him from other people’s comments and opinions, he’s not having a particularly good time of it, and it isn’t truly keeping his esteem from being diminished. This type of patient will tell me that other people are mean and nasty and that he’s ok being a loner because there is nobody in the world that is worth his time anyway. The problem is that he doesn’t really believe this. He desperately wants to be proven wrong and to have meaningful relationships with others. As you might expect, it’s not easy for him to make new friends. He doesn’t want to get hurt so he is defensive and very hard to get close to.

What happens to people who use these coping strategies following weight loss surgery?

I am known for telling my patients that weight loss surgery will take care of “fat body” long before it does anything for “fat brain.” Put simply, you will lose weight much faster than you will lose the perception that you are overweight, and faster than you will repair the emotional damage that being overweight has caused. For many patients, being overweight was a major ingredient in the formation of their personality…and personality doesn’t change so quickly. Sometimes, these coping styles decline gradually with reductions in weight, but more often it takes work for them to change and it is imperative that you try to accelerate the process. In theory, the task is rather simple – act as if you were thinner and your “fat brain” will catch up with your “thinner body.” Think about how people who are not concerned about their weight act in social situations and “act as if” you were one of them. We know that it is not as easy as it sounds, but it doesn’t have to be terribly complicated either.

IV. Assertiveness

The term that describes the behavior we are looking for is “assertive.” There are a number of definitions of assertive and volumes have been written on this subject. Put simply, assertive means that you are communicating in such a way as to defend your rights and pursue your goals, while respecting the rights and goals of others. Assertiveness, like all forms of communication is both verbal and non-verbal. You are communicating by both what you say and what you do. By being assertive, you are demonstrating to others that you think well of yourself and expect others to treat you with the same amount of respect as they would want from you. Being assertive means speaking directly and honestly. Being assertive does not mean that you are cocky or arrogant. In fact, you can be assertive and quite friendly. You’re simply displaying self-respect through your words and actions.

Contrast assertive with the two other types of behavior: passive and aggressive. Passive means that you are sacrificing your rights and goals for the benefit of others, while aggressive is when you are sacrificing others’ rights in the pursuit of your own wishes and goals. Put another way, passive is when you allow yourself to get trampled by others while aggression is when you are trampling over others in pursuit of your own objectives. Assertiveness is the win-win scenario. That’s not to say that everyone is happy, but the intention is that nobody gets hurt.

Let’s now briefly go back to our three coping strategies. When an obese person is being self-deprecating through humor or allowing others to do the same, she is really being passive. The jokes may appear adaptive and harmless, but the consequence is generally that you feel badly about yourself. This is not to say that you need to abandon your sense of humor, but the focus of the joke needs to change. When a person is being a doormat and simply absorbing the comments and mistreatment of others, she is again being passive. When a person is being bitter and angry, he is being aggressive.

I should note that I’ve met my share of heavy people who were comfortable being assertive long before they had surgery and lost weight. They are the ones who refuse to hide in shame or make excuses to the rest of the world. These folks often acknowledge their size but will not allow it to be an excuse for mistreatment from others. They simply refuse to allow an entire social interaction to go in a certain direction solely because of their weight. They respect themselves too much to allow that to happen. They view their weight as one aspect of themselves, and not one that justifies shame and abuse from others. After weight loss surgery, these folks generally adjust rather quickly and often report feeling whole again. Such patients often tell me that their image in the eyes of others is apparently now commensurate with their appearance. They act like they deserve respect and they now look the part.

If you see a bit of yourself in the funny guy, doormat, or angry and bitter loner you can work towards achieving the same assertive endpoint.

V. Getting to work

The funny guy and the doormat are trying to speak up. These two have been avoiding confrontation by either laughing things off or simply ignoring them. They need to learn to address others more directly and stop letting things slide. The bitter and angry loner has been avoiding people or yelling and screaming at others to get them to back off. He needs to try and tone things down a bit and learn to play nicer with others.

Clothes shopping is a perfect opportunity to practice becoming more assertive. When shopping for clothes, many overweight folks can recall being greeted by a rude or disinterested salesperson. Before a single word has been exchanged, there is an opinion forming. Even if it turns out that a particular store doesn’t have something in your size, there is an appropriate way for a salesperson to express this fact. The manner in which an obese person can be told by a salesperson that they don’t have a particular size need not be any different than a tall person is told the same fact, but generally it isn’t. Don’t allow it! If the salesperson seems reluctant to give her full effort, indicate that you expect to be treated the same as any other customer, and if after repeated efforts to find something, you are unable you will gladly concede. Don’t be funny and make jokes about it, and certainly don’t be a doormat and simply head for the exit. If you see yourself as the bitter, angry type; resist the urge to jump down the salesperson’s throat. Causing a scene will not make her want to help you and you will not be gaining self-respect or her respect either.

Insist that she help you in the same way she would help someone who was a size 4. Notice, we’re not taking no for an answer (passive) and were not verbally assaulting the salesperson (aggressive), we’re simply asking for the same treatment that anyone else would receive (assertive). Whether you are buying a sweater, negotiating the terms of a mortgage, or ordering a Decaf latte it doesn’t matter. Any time that you are dealing with other people in this context, you are within your rights to insist that you are treated with respect.

In conversation with friends and family, make efforts to get the focus off of your weight. People who are unconcerned about their weight don’t talk about their weight. Neither should you. Imagine talking about how you were heavy for the next 20 years! It gets old after awhile. Recall that one of the reasons you had surgery was to make your weight a non-issue. Hopefully you will be hearing some compliments and words of encouragement. Take it all in, but then try to talk about all of the other things going on in life…what you are doing and what things you aspire to do…just like everyone else!

Certainly do not tolerate negative comments about your progress. Everybody thinks they’re an expert. Many people will tell you that you should have lost more weight by now or they will comment negatively if they see you eating a piece of chocolate. In the past, the funny guy would have made a joke about the comment and the doormat would have said nothing or might have agreed. The bitter and angry loner would have shot an insult back, perhaps throwing in some colorful language in for good measure…but not today! Politely let them know that you and your surgeon (the two true experts) agree that things are going as they should and that you appreciate their concern. If you wish, you can then let them know how they could be more supportive. Let’s assume that people make these silly comments because they are trying to help. Your job is to educate them as to what they can say or do to be helpful.

Unfortunately, there may be an individual who doesn’t seem to be championing your cause. Perhaps this person is threatened by your weight loss. Maybe they don’t like the fact that you’re now in the limelight and they want to knock you down a peg. Let them know (assertively) that you won’t stand for it. Take them aside, if possible, and let them know that their comments are upsetting and unwarranted and that you would like them to stop. Maybe they didn’t even realize they were saying things that you found upsetting.

If this diplomatic approach does not work, do not become aggressive. Be increasingly assertive. Make a statement that is more forceful, or when they say things in the company of others, immediately comment that you find their comments to be inappropriate and would like them to stop. They will actually be embarrassing themselves in front of others, and that should do the trick. If not, you need to question whether or not you want to continue the relationship. Unfortunately, after weight loss surgery many folks learn that the people they thought were friends were not such good friends after all.

VI. Going forward

At this point, you want to seek out opportunities to experiment and flex your assertiveness muscles. Make it a point to practice these skills as often as possible. The world does a fine job of putting us in situations where we need to express ourselves and make our wishes known. Don’t shy away from these situations. Also make it a point to practice some of the more subtle non-verbal forms of assertive communication. Work on making more eye contact and maintaining a more assertive posture…no slouching! Face people when you speak to them, rather than angling off to the side. The use of hand gestures is often a sign of assertiveness; practice these as well. With continued effort you will no longer feel as if you are acting as if you were a different and more assertive person…you will be that person; healthier both in body and mind!

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i am beginning to believe that because i stood up for my self that the staff at the surgeons office is aqainest me having my surgery they have done every thing in their power to keep me from having the surgery even saying i am not mentally stable enough for the procedure i have received notes from all my drs saying i am mentally stable and a good candidate for the procedure personally i think all the surgeons staff has no training on dealing with people and they all are in the wrong line of work

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thank you, that was such a great article, and was very helpful to me. I, at

different times find myself playing all these roles. I hadn't thought about it

before, so I will be aware now and able to change my behavior.:thumbup::

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
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        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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