Fear Factor

[Guest guest]

Hi Oakie,

It's a good question you raise and one I've thought a lot about. In some

ways I agree with those who see the lingering fears you describe as needed

motivating factors. It is important not to forget what we have learned about

new ways of eating and to keep DOING those new things. But I think what we

need is more as a respectful vigilance than a lingering FEAR. FEAR should

relax considerably over time (like by year 3 or so) into a more confident

feeling that combines caution and practical wisdom.

Let's picture a simple example since we both like metaphors.;o) You would

wisely bring your umbrella along on a day you know it's going to pour rain.

You could say you're afraid of getting wet, right? But that's a different

kind of fear than you would have if you had to wear an expensive suede outfit

outside all day in the rain and you are AFRAID you will ruin it completely.

This sounds more like the kind of FEAR you are describing and I think that

kind of lingering fear/dread is a problem.

That heavy dreading and hyper vigilance you described keeps you from feeling

IN CHARGE of your new situation. It also puts you off-balance in a constant

way and makes you more vulnerable to new bumps in the road ahead. You need

to feel like you are in control now. It's not the scale, or your appetite,

or your family who eat all the wrong things no matter how hard you try to set

a healthy example etc. etc. etc. who run the show...you do. An increasing

sort of sturdiness is what you need to develop.

True stability comes with getting 'off the diet' at last and into a new

mindset. It's a mindset of your very own - it doesn't depend on anyone else

and it's bolstered by a deep seated trust in yourself. It's a mindset that

says " At last I know how to do this and I have all the tools I need. " It's a

mindset that also says: " I may screw up once in a while but that won't be the

end of the world because my basic HABITS are healthy now and I will get right

back into them again. " This is how you recognize stability when you achieve

it. It also presumes that you are continually practicing and fine tuning

your own new healthy eating habits. Stability is crucial for long term

maintenance and I think it's very hard to have stability when the scale makes

you feel like a contestant on Fear Factor every time you approach it.

Having said this I hasten to add that it is not easy for any of us to develop

trust around the subject of body weight and it doesn't happen quickly. A

deep trust in our bodies new plumbing must develop in order to ease FEAR out

of the driver's seat. It's helps enormously to have good follow up care.

But you can do this on your own if you work at it diligently. There's good

literature available on Relapse Prevention although most of it is related to

drug and alcohol abuse. You need to adapt it to your situation but it isn't

difficult to do. The Tactics of Change (Fish, Weakland and Segal)has a

marvelous chapter on interventions that I often recommend to patients even

though it is written for clinicians. It's important to get into your own

head a bit to understand what's driving your urges. You can get pretty good

at manipulating yourself away from them with practice.

It's not hard to understand why Bariatric patients have a tough time trusting

anything related to weight loss when everything ever offered by medical

science to help before has ultimately failed. Not only did these previous

schemes fail to help us achieve healthy weights but they frequently left us

in worse shape than when we began. Many of us even ended up heavier than

when we began. All of us were more and more deeply disillusioned with each

attempt that failed. And worst of all the proponents of all those failed

diets usually convinced us that the problem was not the UNWORKABLE solution

but our own lack of 'will power' or inability to do it right ... whatever

'it' was at the time.

I think all of us wonder at some point whether we will find a way to mess

this opportunity up as well. It makes perfect sense to feel that way. And

that's why it takes lots of time and practice to make real trust in yourself

stick to your bones at last. You may need to 'fall off' your planned eating

routine and regroup with your healthy new habits many times before you can

TRUST that you will really be able to do this reliably for life. The more

times you have failed before surgery the more tests you will likely set for

yourself post-op. But that's OK. Every time you climb back in charge you

make your long term maintenance more assured.

So maybe in the end we are a little like contestants on our very own FEAR

FACTOR show. But we won't conquer the fear the first time out on the limb

and no one will give us 50K for going back to the healthy life (Dang!) But

the best things always take time to build and I doubt anyone reading this

would trade the life they have today and return to morbid obesity for any

amount of $!

Carol

Shrinkin' in Philly

RNY - Raper - HUP

Lost 135lbs & numerous co-morbidities.

Note:

As a family therapist going through this process I have been appalled by the

lack of good aftercare for the emotional side of Bariatric surgery.

I am currently piloting a CBT program in Ambler, PA to help patients maximize

their Bariatric surgery outcomes and improve long term stability and

maintenance.

You can check it out on www.myselfdesign.com

Consulting services are also available for therapists

working with Bariatric patients for the first time.