Psychological Aspects of Bariatric Surgery, Identifying Emotions

I subscribe to two WLS print magazines, both if whi*****lude access to online material.  Today, I received the latest from WLS LIFESTYLES (http://www.wlslifestyles.com) and one article in particular caught my attention.  Most of us have heard that (possibly even anticipate or are experiencing) rapid loss of significant weight post-op will either lead to new psychological issues or expose those that have been buried, literally, under layers of fat for many years.  Most of us have heard of "transfer addiction" and are familiar with the havoc that our journey may create in our relationships with spouses, family, and friends.  However, unless and until these issues happen to us, I don't think we can truly appreciate their significance and the need for a strong safety net, which may include professional counseling.

For now, I am just going to post the article here.  Later, I may decide to share more of my personal issues.  I will tell you that I am seeking professional help (I left a voicemail for a therapist yesterday afternoon and am awaiting a return call so that an appointment can be set). 

~Namaste~

Amy

Psychological Aspects of Bariatric Surgery, Identifying Emotions

By: Lori Sperling Nevins, MSW, LCSW

People who suffer from the disease of morbid obesity do so in immeasurable ways, from the daily stress of not feeling well physically to the indignities and humiliations of a “fat phobic" culture to the internalization of others’ criticisms as low self-esteem and shame. Those who struggle with this disease have often developed a “disordered relationship with food" that works hand-in-hand with genetic and metabolic influences to form the disease of morbid obesity.

Many issues face the pre-operative bariatric patient including portion adjustments, slow and mindful eating and separation of fluids and solids at mealtime. In a parallel fashion, there are numerous psychological issues that are apparent as a patient prepares for bariatric surgery. We often speak in these terms when describing a patient’s struggle with morbid obesity:

• emotional eating or “head hunger"
• addiction to high glycemic carbohydrates, or the “white foods" and
• “mourning the loss of food" and our relationship with food as we have come to know it.

as well as the emotions that correspond to them such as:

• anger
• sadness
• anxiety
• boredom
• fear and anticipation of change

The continuity of the above points is potentially a significant undermining force to any patient who is considering bariatric surgery. Therefore, it is crucial that these issues be addressed prior to the surgery date, as part of the patient’s pre-operative evaluation and education process. In conjunction with the identification and exploration of the above mentioned issues, it is essential for a pre-operative patient to start to locate, identify and evaluate support systems, as a part of a structured aftercare program that will maximize the patient’s potential post-surgery outcomes. Patients must create and implement alternate coping skills, other than eating, in their lives to satisfy emotional responses to daily life stressors. Such skills as:

• Individual and /or group therapeutic participation
• Meditation, yoga and visualization to soothe anxiety and fear
• Walking and other aerobic exercise to combat anger, sadness and boredom
• Journaling/recording one’s own weight loss experiences can be very motivational

When psychological factors have been identified along with physical factors, as both have probably contributed to a patient’s struggle with morbid obesity, one can then begin to structure their plan for recovery in both the immediate and longer term post-operative healing period. The healing of the mind and spirit maximizes the patient’s opportunity for an optimal post-surgery outcome as a bariatric surgery patient.

Lori Sperling Nevins, MSW, LCSW is a clinical social worker who has been working in bariatrics for the last 8 years in the areas of Westchester County, New York as well as Fairfield County, Connecticut. As a Bariatric Program Coordinator and primary group leader, she synthesizes the work of team members who prepare patients for surgery and maintain patient follow-up in a supportive medical, nutritional and psychosocial aftercare program meant to maximize surgical outcomes. Ms. Nevins educates her bariatric patients on the effects of family history, individual life experiences and addictive behaviors that have contributed to the growing epidemic of morbid obesity. Ms. Nevins contributes regularly to WLS Lifestyles magazine, as well as maintains blog entries on the website.

WLS Lifestyles - www.wlslifestyles.com – E-Newsletter Copyright 2007

Posted in the following forums: WA, VSG, VSG'rs with 150 to go, BMI over 50, Dr. Srikanth

Thank you for sharing.  I know on my weight loss journey it certainly isn't the cutting calories because of my reduced stomach size that has been the biggest change; the mental and emotional changes are the biggest.  I remember shortly after getting sleeved I got upset with my husband about something and,  I would normally use food to calm my nerves and settle down, I realized I couldn't do that and I burst into tears.  I had a long cry to release those feelings of anger about not being heard.  I should have done that for years but always used tears as a last resort because I considered it a sign of weakness.  I also had to keep from obsessing over food so I played literally hours of online Scrabble and I learned to take a bath with candles when I was really stressed rather than head for the refrigerator.  I turn to this website almost everyday, usually several times a day, for moral support.  Lots of changes, and I still have more to accomplish, even after 8 months.  The emotional journey is also the hardest to put into words and so different for everyone.  Thank you for sharing.  

Love your avatar!  OM!

Thank you for sharing.  I just pasted this to someone on my state forum who is being treated for depression.      There is a lot to deal with some much change going on with our bodies.

I have tons of issues and I am work, work, working my way through them.

it is nicer doing it without being obese, for sure.

I don't think as many WLS folk take this stuff as seriously as they should. I know you get all caught up in other issues but the emotional stuff will come and bite you in the butt sooner or later.

thanks for posting it, Amy.

Jackie  currently battling the transfer addictions COFFEE and SHOPPING

I'd stay and post more but I have to get over to ebay....