Friday 9/9/2016 ~ The Mental Side of Weight Loss

     I recently had the occasion to have an extensive conversation with two women who struggle with their weight.  Neither is a WLS patient but my theme here is about the mental component ~ REGARDLESS of your choice of diet/exercise/surgery.  Both ladies expressed their understanding of their mental and/ or emotional struggle with food and their diet.  Both women professed being an addict, an emotional eater etc.  Both are also intelligent and articulate adults, successful in their lives in many ways and with the insight to understand this component of their struggle.

     What fascinates me, and what I always seem to come back to, is how anyone can be that intelligent and have that insight and understanding and yet taken no steps to deal with that portion.  Specifically when it comes to weight loss surgery I think it’s imperative that the system we use to evaluate and prepare people for the surgery include a lot more mental health evaluation and or treatment when necessary.  I think the reality is no matter what path you choose if you’re looking to control obesity, lose weight, be healthier whatever it is ~ if there is an underlying emotional mental component that makes it difficult for you to maintain those changes and you don’t deal with that the behaviors that cause your situation you will never maintain success long term.

     My personal stance about ” food addiction” is that it’s a real thing.  I think that the processed foods in our nation are designed in labs with the intent to make us addicts.  I think that since the 60s really we’ve been raised on those foods and the chemical changes in your brain are scientifically proven.  Couple that with the fact that unlike other addictions,  for instance drugs or alcohol, as a food addict you’re not able to eliminate the “people places and things” because you need food to survive and food is such an integrated part of all of the things we participate in socially in our society that you have to be able to change your relationship with food, but keep the relationship.  

     I completely understand that the immediate impact on both your life and those around you does not equate when you’re looking at a food addiction say versus a heroin addiction.  I understand that the crisis mode, the threat to life, and that kind of thing is quite different in terms of both timeframe and catastrophic results.  However I don’t think those differences negate the reality that when you were addicted to food it is a very big obstacle to overcome.  

     I see a ton of research over this last 20 years on different types of weight loss surgery, different types of diets, new ideas in devices, development of medically sound ways to manage your weight.  I don’t however see the same amount of research and devotion to understanding the whole of the person including their mind.  The programs that exist that I’m familiar with regarding weight loss surgery generally have one visit with the psychiatrist basically to just make sure you’re not in a severe depression, and then they sign off and send you on your way back to the surgeon.  

     Now in the surgeons defense he’s a surgeon he’s(she) is not a psychiatrist or a psychologist,  they not qualified to change your behaviors or to help you change your behaviors.  The surgeons job is to give you a tool, a surgical tool, to help you manage your weight loss.  I think it’s unfortunate that so many people don’t become their own advocate and review if their situation indeed does include a mental emotional component.  I also understand not everyone’s  does and I’m not speaking to those people.   I’m not saying that every obese person is addicted to food or need psychological help.  I do think it’s fair to say there’s a good portion of people struggling with their weight however that that is a component.

     I believe that both as a society and on a personal level how we take accountability for our journey, as well as these programs and research into weight-loss could do a better job of being a more comprehensive treatment system and including the possibility of food addiction or emotional eating.  I think the brain needs work too actually treating those things pre-surgery or pre-device or along with the diet could have a tremendous impact on success.  I think that a spotlight on this piece of the puzzle would go along way towards helping reduce the obesity epidemic in our country, and I think for just overall mental health it would make a big difference in the number of people who suffer with clinical depression.  I also think this would help alleviate the percentage of people who either regain their weight or have to go back and have revisions because they regain their way and they feel like the first surgery “didn’t work”.

     From every angle ~ from a business perspective when it comes to the cost of healthcare and what insurance companies pay for comorbidities and revision surgeries and ongoing treatment after surgical procedures.  To a physical level,  where if helping the mental and emotional side of things can help physically make our bodies and our lives more healthy.  From a physical standpoint of not having so many failed surgical procedures to lose weight where somebody is then going back under the knife and assuming all the risks that come along with that again.  To a mental health standpoint where when someone has issues and they actually deal with them it’s likely that not only their weight may be impacted in a positive way but their general mental health is going to improve as well.  It’s like the trifecta of positive outcomes and it saddens me that it seems that this piece of the puzzle receives little to no attention both in our personal lives and on a grander scale.  The weight loss programs, the diets, the surgical programs, the population research all seems very heavily focused on the physical to the complete exclusion of the mental and emotional and I believe that this really needs to change.

     On a very personal level I think it needs to change with each individual.   If you’re considering some specific extreme diet or some surgical procedure I encourage you strongly to evaluate what role your mental health may play in your struggle with obesity.

     If you in fact find that there is a part of your struggle that’s related to that then do something about it even if your “program” doesn’t require it.  I think it has to start with the individual and THEN I think in arenas where you have a collective voice (if it’s talked about more and given more attention on a personal level) the professionals who help with obesity may start to wake up and think “oh this IS a piece of the puzzle, we need to concentrate on this more”.  In the meantime however regardless of where popular research and medical treatment is that you can in fact make a choice for yourself to say this is a part of the puzzle I’m going to deal with even if nobody else is.

     I’m not sure how we get to that point I think it’s on a person by person basis.   I’m always amazed when I sit and have a conversation with two amazing, intelligent, articulate people like I did the other day who are actually saying to me things like “I’m addicted to sugar”, ” I’m an emotional eater” and yet they are taking no steps to help themselves by addressing those things.  I’m not criticizing them, I think they are in fact the “norm”, and I believe that we need to change the norm.  Speak out, speak up, be your own advocate and educate yourself ~ don’t just work on the number on the scale ~ work on your “whole”! ❤️
As always ~ I thank you reading ~ see you next time.

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