The Fix.

Are you an addict?  Do you need a fix?

Addiction is essentially a compulsive dependence on a behavior (e.g., gambling) or substance (e.g., caffeine) that persists despite negative consequences. A hallmark of addiction is denial (‘I can stop anytime’); thus you must recognize that there is a problem before you can begin to address it.  Battling that addiction is tough. The habit is merely a symptom of the psychological condition. By definition, an addict is vulnerable, so it is easy to see why it is common for a recovering addict to transfer his addictive behavior to other parts of his life, sometimes without even realizing it.  This is ‘replacement’ or ‘substitute’ addiction, also called “switching.”

A dear friend of mine is a recovering drug and alcohol addict. She said that in rehab, they told her that the most common substitute addictions are sugar and sex, but they may also be exercise, work, smoking, dieting, overeating, drugs, shopping, cleaning, or a host of other activities. It’s still addiction. Even if the substitute is not in itself a bad thing, like work or exercise, it is clear that spending an excessive amount of time working or exercising can be harmful. You’ve changed the outward manifestation of your addiction, but you’re still addicted. You may not know it, but the people around you probably do.

I’ve known people who choose not to drink because their parents were alcoholics; their drug of choice is food, specifically sugar. One of my acquaintances quit drinking hard liquor and now only drinks beer. And we all know ex-smokers who gain weight because they eat candy instead of smoking. They simply replaced one habit with another – and that is not recovery. Your brain still craves the reward, the ‘high’ of whatever you did to satisfy the craving; it’s just finding another way to get the fix.

So let’s bring this closer to home. After a lifetime of obesity/food addiction and unsuccessful, yo-yo dieting, you have weight loss surgery. You have changed your eating habits; you are losing weight and getting healthier. However, you now smoke twice as many cigarettes as you used to. Or now, under the guise of ‘celebrating’ your weight loss, you max out your credit card at the mall. Or maybe you have become obsessive about working out. Or you become overly flirty and promiscuous in an effort to demonstrate your attractiveness. Or you become preoccupied with proving something at work, becoming an overachiever or workaholic. Or you spend countless hours online.

Whatever your replacement addiction may be, legal or not, it is like a rebound after a romantic breakup – it is a short-term, feel-better coping mechanism. It helps you escape the downside or negative consequences of your behavior. At best, it may not be harmful, but at worst, it certainly can be.

The problem is not the activity itself – it’s the obsession.

The need.
The craving.
The dependence.
The preoccupation.

So what can you do about it? Well, recognizing that you’re switching is a good start. Then you must realize that you need help dealing with it. Help might mean behavioral therapy with a professional. It might be a 12-step program, counseling, or a support group. It might be developing other ways to deal with the stresses in your life or adopting new pastimes. It might be as simple as enlisting friends and family to hold you accountable or to help keep you away from challenging situations.

To me, it proves that I can’t do this alone. Left to my own devices, I would substitute one thing after another after another. For years, when I dieted, I would smoke more; when I tried to quit smoking, I’d eat more. When I finally quit smoking for good, I gained a lot of weight. Now that I’m not overeating, I find that I’m shopping more and spending more idle time online. (I’m also writing more, but I think that’s a good thing.) I have to be very careful not to let the habit gain the upper hand because I know it can easily happen.  My brain still wants that fix.

I’ve come to the understanding that my obesity was not just about food. Facing myself and overcoming my compulsive behavior takes a lot of work and a lot of time. The key is in finding the balance in your life. You want to cultivate productive, healthy habits and behavior but not form detrimental attachments to them. It’s tough. I’m glad that Mr. Stuck and I are working on this together. I’m grateful to every one of the people who come to the same WLS support group we attend, because their insight and encouragement is what keeps us coming back.

I’m not a psychologist or counselor. I offer neither authority nor expert opinion on addiction. I know there are people out there in much worse situations than I, and I do not mean to downplay their struggles toward recovery. I just want to acknowledge that an addict doesn’t have to have a needle in his arm or a bottle of vodka hidden in the bathroom cabinet. It could be the guy on the treadmill, the boss who stays late every night, or the woman next to you with the Diet Coke.  It could be me.

Or it could be you.

 

For further reading on this subject, check out the book Eat It Up! The Complete Mind/Body/Spirit Guide to a Full Life After Weight Loss Surgery by Dr. Connie Stapleton, a licensed psychologist and certified addiction counselor.  Eat It Up! shows you how to create and maintain balance in your life and helps you on the journey to your well-being.  In addition, Dr. Stapleton is the ‘Doc’ to Cari De La Cruz’s ‘Post-Op’ on their Facebook page, A Post-Op & a Doc, where you can find wit and wisdom and lots of support.  Check them out!

 

photo credit Alan Cleaver

 

 

A False Sense of Security.

Mr. Stuck and I recently spent some time down at our lake property for a much-needed mini-vacation. We let the days and our imaginations determine our activities: we swam, boated, and fished, and we visited a local small-town festival. We spent time in conversation, watching the fish rise on the lake and spotting the same paddle boarders gliding by each day. And, as usual, we brought way more food and supplies than we actually needed and lugged a lot of it back home.

The simple, amusing observation that we always seem to over pack for our trips sparked an interesting conversation one day. I called us ‘contingency packers’ because we are the king and queen of ‘just in case.’ I’ll bring extra food, just in case someone runs out of hot dog buns or prefers peanuts to Cheetos. I’ll bring soda (that we don’t drink) just in case the kids want some. I’ll add Tylenol, ibuprofen and aspirin to the first aid kit just in case someone has a preference; I’ll bring feminine supplies just in case someone else needs them. I’ll bring extra socks, shirts, and jackets, just in case someone gets wet or cold and has no change of clothes. You get the idea.

Now, there’s nothing wrong with being prepared. In fact, it’s great advice. Mr. Stuck, being the former Boy Scout that he is, has a full complement of hand and power tools that he tosses into the truck for such occasions, just in case he has to repair some wiring, fix a flat, or perform some mechanical miracle while we’re away from home. I have always appreciated his foresight and ability in those situations. Granted, he’s been able to pull off amazing things in less-than-ideal circumstances, but he’d much rather have resources available to him when he needs them, and I completely understand. Most of us, I’m sure, would agree.

The problem lies in how to find a happy medium between the essentials and our unforeseen needs and wants. Do I really need to bring 3 bottles of sunscreen just in case I run out? Probably not. Do I need to pack 6 T-shirts, when in reality I will probably only wear 3? No, I don’t. Do I need to bring hot dogs AND brats AND chicken sausages AND cheesy hot links to make everyone happy? No. But I do.

At one point, I thought that if I could make lists and follow them, I could vanquish my over packing tendencies. Unfortunately, my lists, though short at the beginning, grew longer and longer. I kept adding more things. I couldn’t make a clear determination between what I truly needed and what I thought I needed, so I took it all. Having all that stuff available made me feel in control. It gave me a (false) sense of security. Even with my good intentions, the problem just got worse: if some was good, then more was better.

Is this manner of thinking part of the reason I was obese? Probably.

I began to see parallels between having ‘stuff’ and having food. I couldn’t distinguish between real hunger and emotional hunger, so I ate when I didn’t need to, and I always ate more than necessary. Food, like ‘stuff,’ meant comfort and security. Sound familiar? The baggage I take with me on vacation mirrors the weight I carried with me most of my adult life and the disorganized mess in my home. The junk in my house is the junk in my diet is the junk in my suitcase is the junk in my head. The things I did to cope had no effect on what actually happened. In reality I was out of control – way out of control.

I used to joke that my messy desk was the sign of genius; now I know it’s just the sign of my inability to make a decision. I used to think that ‘contingency packing’ showed that I was prepared; now I see that it’s proof of my insecurity. I used to think I was unhappy because I was fat; now I understand that I was fat because I was unhappy. What I’ve found over the past year is that losing weight didn’t ‘fix’ me. In fact, it made me see that I needed more fixing than I realized. My obesity wasn’t the cause of my emotional issues; it was a symptom.

I struggle daily with the baggage in my life, whether it’s the clutter in my car, the piles of unfolded laundry on my couch, the stacks of paper on my desk, or the vestiges of my obesity-wired brain telling me I ‘need’ a cheeseburger. I still can’t discern very well between what I think I need and what I actually do need. I still have terrible impulse control. And I still have trouble ‘letting go’ – of emotions, of habits, of material possessions.

But now I feel an urgency to make a clean sweep. I want to simplify my life and de-clutter my home. I just don’t need all that stuff anymore.

 

 

Group Hugs.

Last night was another successful meeting of our WLS support group.  I cannot emphasize enough how important these meetings are to me: the interaction of people in all stages of WLS and the guidance of the bariatric program manager make it educational as well as entertaining.  If you are considering bariatric surgery, you NEED these meetings.  If you are scheduled for surgery and are completing your pre-op obligations, you NEED these meetings.  If you are post-op, in any phase, you NEED these meetings.  Why?  Because we talk about things that you need to know.  We ask the questions you might be too afraid or too embarrassed to ask.  We care about each other: we throw our support behind our members when they are struggling, and we celebrate their successes.  It’s like group therapy.  When was the last time you received a round of applause? 

Weight loss is difficult for a lot of us.  We struggle with the physical part, and we struggle with the mental part.  Having surgery isn’t an easy fix, and it doesn’t abolish the need for eating right and exercise; you still have to make those changes to stay in recovery from obesity.  People who believe, as I used to, that surgery is ‘cheating’ or the easy way out, have not gone through it.  I had surgery, and I’m still in the stage where the weight comes off pretty quickly.  But it does slow down, and my appetite is returning, and I still have to consciously stay on track.  Let me say right here that without the support of my family, my friends, and the WLS group, I would be having a lot more trouble with that.

What keeps our group so successful and engaging is our leader and facilitator, Connie.  Connie comes to each meeting with a topic or two that she wants to bring up for discussion; she gives us recipes and tips, articles of interest, and suggestions for books or blogs to read. But what I appreciate most from Connie is her honesty.  As a bypass post-op, she gives us examples from her own experience.  As a bariatrics nurse and program manager, she gives us her professional opinion and observations.  And as a wife and mother, she gives us the human, personal side of being in recovery from obesity.  Often her husband is there as well, giving his perspective.  The meetings are interesting and interactive; everyone participates, not because they have to, but because the environment is comfortable and supportive. 

One of the ladies made a very revealing point last night.  R has just begun her 6 months of pre-surgery appointments, which for some of us are a battery of nutritionist visits, psychological and sleep evaluations, and tests, such as EKG, barium swallows, and endoscopies.  She said she’d been obese since she was a child; she has no idea how she will look or feel after she loses weight.  Over the years, she said she developed a ‘victim’ mindset, where she could blame obesity for so much of the unhappiness in her life.  She could feel sorry for herself and make excuses.  She said it became a way of life.  Then she admitted that she was scared, because once she has surgery, she won’t have that crutch anymore.  She wonders what she will do once she has reason to be happy. 

That really made me think.  We’ve all been scared of change.

If you have spent your life shaming yourself and allowing others to shame you for your obesity, if you have cultivated feeling sorry for yourself because you can’t jump in the pool with the rest of your friends, if you have nurtured that self-loathing that we are famous for – then it IS scary to change.  Change of any type is daunting anyway.  You must realize that the whole persona that you have developed over a lifetime of obesity is a construct; it is not the real you, even though you might believe it to be.  It is a shell that has hardened over the person you are. 

Everything from the clothes you choose to wear to your facial expression, your body language, and speech, is a response to your negative self-perception. 

·       Your drab, monotonous wardrobe enables you to fade into the background and not attract attention to yourself. 

·       Your facial expression is often sour and forbidding, making others less likely to engage you; you rarely look anyone in the eye. 

·       Your body language says many things: I hate how I look; I am ashamed of myself; I am not worthy of your attention or love; my body is in pain and so is my spirit.

·        Your speech may be quiet and hesitant, as if you would rather shrink into the floor than talk; or you may be loud and defiant, as if daring anyone to challenge you.  That chip on your shoulder? It’s more like a 2 x 4, my friend.

Is this the real you?  I think not.  I think the real you was lost in there somewhere as the protective shell got thicker and harder as the years went by.  The real you, the vital you, the you with dreams and ambitions, struggles silently against the literal and figurative weight of obesity.

M, who proudly said she’d never missed a meeting, shared that when she was heavy, she hid herself in brown, black and gray.  Now, she’s celebrating her post-surgery body and spirit with bright colors and fun accessories because they make her happy.  She said, “Don’t wait!  Do it now!  Wear the colors that you love!”  She’s right.  Don’t wait until you decide you’re ‘thin enough’ to wear red, or horizontal stripes, or bold prints.  Start making yourself happy now.

My mother used to admonish me to stand up straight and look people in the eye, and I always did.  As I got heavier, however, my posture suffered, and because I was so miserable, I just slumped.  I kept my eyes on the ground as I walked, not only because my balance wasn’t so good, but also because I was unhappy and didn’t want to see the reactions of others as they passed.  Recently, I have found myself walking with a more confident stride and a smile on my face for the people I meet.  There’s a lightness to my step that hasn’t been there in a long time.  It feels good.

It’s time to dig deep and reacquaint yourself with the person you really are inside.  It’s time to remember the things that made you happy and to encourage them.  It’s time to put a smile on your face, especially when you look in the mirror.  It’s time to stop judging yourself by others’ criteria and let the real you shine.  This is a journey.  As we shed the pounds, we can shed the old assumptions and attitudes, too. 

We can either complain because the sun is in our eyes or bask in its warmth.  Which will you choose?

 

photo credit: roland

No Apologies.

Is ‘fat’ really the worst thing a human being can be? Is ‘fat’ worse than ‘vindictive’, ‘jealous’, ‘shallow’, ‘vain’, ‘boring’ or ‘cruel’? Not to me.
– J.K. Rowling

So, as an important part of building the new, healthier us, Mr. Stuck and I go to a  monthly weight loss surgery (WLS) support group.  Normally there are 15-20 people there for the two-hour meeting; they range from those who are learning about WLS options to pre-op and post-op patients.  We’ve been going for over a year, and we really enjoy it.  It is run by a bariatrics R.N., Connie, who is also a couple of years post-op.  (I highly recommend to anyone considering WLS that they find a group and go.  You learn so much.)

We arrived a few minutes into the meeting, while people were introducing themselves around the circle.  We took our seats and listened until our turn came.  We gave our names and a brief update (surgery type, surgery date, how we were doing).  I noticed there were a few new faces tonight, but I didn’t see Cindy, my “surgery sister.”  (She and I had realized just before our surgeries that we were scheduled for the same day, so we connected in that way, dubbing ourselves “surgery sisters” for fun.)  She is a lovely, vibrant woman who seems to lead a busy, stressful life.  I liked her from the start.

A few minutes later, Cindy arrived.  She made her way to a chair, and I noticed how refreshed she looked.  Even though she was dressed casually, in a yoga-style jacket and pants, she was made up and looked very nice.  She had a smile on her face and a light in her eyes.  I was glad to see her.

When it was Cindy’s time to talk, she took a deep breath.  She apologized for being late, but said she was doing well, 6 weeks post-op like me.  She said she had discovered something, and she wanted to ask the rest of us about it: self-esteem.

She said she had been thinking about how heartbreakingly sad it is to, as she put it, “apologize yourself out of life.”  She said, “I spent all these years apologizing — for everything — and smoothing things over.  I swallowed it all; food, shame, anger, hurt.  I pushed it down.  I made it go away.  But I’m done.  I’m not apologizing anymore.  I’m not sorry, and I’m not rude, but I’m done.  Now, it’s about me.  It feels crazy as I adjust to this new body and new life.  Am I hungry or not?  What do I want to do?  I feel powerful!  I feel joyful!  I feel blessed.  And I want everyone to feel that way.”

She asked around.  “Did you feel it, too?  Did you find it?”  She continued, choking back emotion.  “I thought I was a good person.  I am a good person.  I thought I had it good — I thought my self-esteem was fine.  I’d get up, clean — but I didn’t know.  I didn’t know!  I can’t tell you how different it feels from thinking you have self-esteem to really having it.  You can tell people about self-esteem and self-image all day, but the reality is, you can’t.  They won’t know.  They have to live it.”

I listened to Cindy as the words rushed out of her mouth unbridled.  Everyone was understanding and respectful, even as she talked much longer.  “Why don’t we think we are worthy?  Why don’t we see ourselves as equal to everyone else?  Why do we have to apologize for being who we are, living our lives, and taking up space?  Why do we convince ourselves we don’t deserve to be happy?  We have just as much right to be happy as anyone else.  We DO deserve to be happy.  We are worth it!”

With that, she sat back, still very emotional.  One of the ladies got up, walked over to Cindy and gave her a hug.  Connie pointed to one of the new faces and asked him to introduce himself to the group.  He told us he was a couple years post gastric band surgery.  As he told his story, another regular, Merele, arrived.  She looked a bit flustered.  When it was her turn to speak, she said, “I am so thankful for you all.  You have no idea how much it helps me to be here.  You are all family.”

Merele went on to say that she was several months post-op; the ‘honeymoon period’ of having no appetite was over and it was difficult for her.  She said she was really struggling with that.  Merele, like Cindy, was very emotional as she shared how she is finally giving herself permission to be happy.  She said, “I have stopped worrying about other people.  It’s okay for them to have their meals, but I can’t pay attention to that.  This is my new life.  This is ME!  I had to make this huge change, and it’s for the better, but it’s scary.  I have to make my own choices, and I choose to live.  I don’t want to die inside as well as outside.”  Merele also got a hug.

As I listened to these ladies, I took notes.  No apologies.  Choosing happiness.  Change can be scary.  Struggles.  Joy.  Self-worth.  Cindy  said, “I’m 60 years old, and I should have known this when I was 40.  My daughter is 30.  I want her to be happy, too.”

 ***

So many lessons in life.  I am no more of an expert than anyone else is.  Do I have self-esteem?  Not really, but I can feel a spark of change in how I view myself.  But I also feel that I have wasted a lot of time, and I feel guilty about that.

I wasted my sons’ youth as their obese mother who was unable to wrestle on the floor with them or run footraces across the yard.  Subsequent injuries and illness made everything worse physically, and my self-image sank, as well.  Pretty soon, I was referring to myself as dowdy and dumpy, and all the negative voices in my head became reality.  I was a slob. I was tired and lazy.  I felt helpless.  I was unable to change my situation.  I was unhappy.  I was depressed.  I felt guilty because I wasn’t better, thinner, prettier, more fun, younger, in better shape, smarter, whatever.  And as we all know, that cycle of negative self-fulfillment just rolls along.  Overeating>Guilt>Depression>Overeating>Guilt>Depression.

I have been slender for short periods of time after stringent dieting and self-denial. Each time I felt a rush of confidence in my new look, enjoying the compliments and approval.  But each time that confidence was hollow, and fear hid in its shadow.  I was always afraid — that I would gain the weight back (I always did), and that I was a failure.  I saw that people who had never looked at me twice were now friendly to me, and that just underscored it.  No matter what kind of a person I was inside, whether I was smart or funny or kind, it meant nothing if I wasn’t worth looking at.  That is what they taught me.

So then I would feel phony.  And angry.  The fat that had always been my armor, my permission to be a mouthy smart-ass, was gone, and I’d wish it back.  ‘Life was easier fat,’  I’d tell myself.  I didn’t have unwanted attention from random men.  I didn’t get the catty looks and competition from women.  I wasn’t viewed as a threat, I guess.  I didn’t have to care about my looks, because nobody was looking, anyway.  And then it became easier to tell myself I wasn’t worth it.  I couldn’t do it — it was too hard.  I had failed again.  You see, I pretended to have confidence, but I didn’t really have it, and as soon as the doubt crept in, it was easy to cave.

Getting your head straight after weight loss is tough, and it’s a constant struggle.  The old you vs. the new you.  The negative vs. the positive.  Excuses vs. reason.  Old habits vs. new choices.  Apologies vs. confidence.  It’s a daily fight, because surgery doesn’t change your head or your heart.  As you adjust to the new reality and the possibilities surgery has given you, you still fight the hurtful words in your head when you look in the mirror.

But you’ve got to remember you’re winning this time.  No apologies.

photo credit cod_gabriel

Adjustments.

I used to say that I intended to go out of this life with the same stuff God gave me coming in: I still had tonsils, appendix, gall bladder, adenoids and reproductive organs.  Well, I still have all of those, but I exchanged my hips a few years back for a new, aftermarket set made of gleaming titanium.  So I guess I can’t say that anymore.  And in another week, I’ll give away something else: most of my stomach.

Next week, I’ll undergo the procedure known as a Vertical Sleeve Gastrectomy (VSG), or ‘sleeve,’ in which a large portion of my stomach will be laparoscopically removed.

Image: Laparoscopic Sleeve Gastrectomy
http://www.virginiamason.org/SleeveGastrectomy

The decision was a long time in coming.  Despite a lifetime of being overweight and dieting, I had never considered surgery as a way to lose weight before a few years ago.  At that time, I had only considered restrictive gastric banding.  More recently, several friends and family members underwent bariatric surgery, and as I saw their results and spoke with them more, I began thinking it might be my best hope to return to a healthy weight.  Mr. Stuck had already been working toward his own surgery and healthy weight goal, so I had the added benefit of involvement with his process, too.

I did my ‘due diligence’ and read up on the types of surgeries available; who would benefit from what type; what co-morbidities would likely improve after surgery; risks and benefits; and long-term results.  I joined an online chat group to read real stories and questions.  I spoke with my doctor, who was enthusiastically supportive.  And so I made the decision to work my way through the prerequisites for surgery.

To have this surgery, I have had a psychological examination, sleep study, blood work, EKG, barium swallow, and 6 months of dietary oversight by a nutritionist (in which I lost 30 lbs).  I found out that I am an otherwise healthy obese person who has sleep apnea, but I don’t have elevated blood pressure, diabetes, or high cholesterol.  Contrary to popular belief, I am psychologically normal (who knew?).  I have a hiatal hernia, which means my stomach bulges up through my diaphragm, but I’ve never had more than mild symptoms from it.  Right now I am in the pre-surgery diet phase of two protein shakes and one light meal per day.  The day before the procedure will be full liquids.

Although I am healthy now, there are no guarantees I will remain so, especially given a familial history of cancer, diabetes, and high blood pressure; and really, obesity increases my risk of everything.  I need to lose the weight to decrease that risk.  But I also hope that losing the amount of weight that I need to will also improve my health by improving my quality of life issues like arthritis, sleep problems, and general aches and pains.

There will be a lot of adjustments to make following the surgery, but I am committed.  Where I used to think that surgery was the ‘easy way out’ for weight loss as opposed to the blood, sweat and tears of dieting, exercise and discipline, I now know that it’s not ‘either-or.’  I will have the surgery and I will also diet, exercise, and discipline myself to change my relationship with food.  But I will have the tool of surgery to help me.

You could say that life is basically a series of adjustments, from the womb to the outside world; from a child to an adult; and from a single person to a couple or family, perhaps.  Some adjustments are easy, some are voluntary, and some are life-changing.  This one is has a little of all of that, and more.  I will be adjusting from obesity to health.

I don’t intend to bore you all with “I lost 3 more lbs!” posts.  I will write about it, yes, but maybe just to tell you about my flying-squirrel arm flaps or my hair falling out.  I may crow a bit when I’ve reached a milestone, and I may whine when I mourn for the Bubba Burgers of my past (I confess, I am addicted to cheeseburgers), but I won’t subject you to much of it, I promise.  And I won’t use the terms ‘fat shaming’ or ‘body shaming’ because I detest them.  But I will share with you some of the lessons I’m learning on my way to a healthy life.

I will never be thin, but I do hope to cross my legs again someday.
And sit on the floor and get back up again.
And sit comfortably on a plane.
And wear Spandex to Walmart.

juuust kidding.

 

 

 photo credit thenext28days and MotiveWeight