I feel like Jerry Maguire after writing this!

[Guest guest]

I'm not quite sure how to say it, and of course I'm also not sure if

I'm right, but my gut instincts have always told me that the

addiction model is the wrong one to embrace for obesity, especially

in relation to weight loss surgery.

First of all, we are warm-blooded mammals - food is not only

SUPPOSED to be a comfort to us, it's genetically hard-wired. An

animal who needed to eat to live but did not derive enjoyment from

eating would be at a huge genetic disadvantage, lacking a major

competitive incentive for survival. Addiction is a complex of

physical and emotional factors, but one very large component is that

there is a differential in how individuals react physically to

intoxicating substances, and some of those physical reactions make

for easier habituation and the body's perception of a physical need

for a particular substance. We glibly speak of " addictive

personalities, " but in truth the single greatest determining factor

for the overwhelming majority of addicts is an " addictive

physiology. " Now, since most addicts cannot change their

physiologies, an array of psychological resources may be and often

is the best way to battle these addictions. For example, there's no

doubt that going to Alcoholics Anonymous meetings works better for

most alcoholics than taking Antabuse, a drug which makes them

violently nauseous if they drink alcohol. This is despite the fact

that we all know that aversion therapy can be effective - but rarely

for addicts.

This discussion has also skirted the other obvious major factor,

which is that no one has to use an intoxicating substance at all. It

is not physically or psychologically required for survival or even

for enjoyment. But we all gotta eat! We are, quite literally,

dependent on food, and when we start from a point that says that we

need to end our dependence on food, we are fighting not just out own

nature - which may need to be fought or tamed - but we are fighting

human nature. One of the end results of bariatric surgery, happily,

is that you are both less dependent on food (and more dependent on

supplements in pill and liquid form, and don't you forget it!), you

are also dependent on less food, not to mention physically

incapable - as if you had taken Antabuse for food - of overeating

(at least, not in the same fashion that most of us are shamefacedly

all too familiar). So while you most certainly need a broad armament

of psychological tools to deal with both pleasure and with stress

(and if you didn't, what would I be doing in a SUPPORT GROUP, huh?),

I do not think you should think of yourself as an addict.

Another reason the addiction model is popular is that we have come

to equate addiction with disease not so much because of the

physiological and/or psychological truth of that equation, but

simply because we have come to equate " disease " with " difficult to

cure " or " requiring a sustained, supported, psychological method to

cure " - and they are NOT the same. Obesity is NOT, in most cases, a

separate and discrete disease. Obesity is instead ACCOMPANIED and

CHARACTERIZED by a number of physical characteristics, disorders,

conditions, and, yes, diesases, all of which are caused by the

physical and psychological stresses of excess weight. Bariatric

surgery can remove the excess weight, but it does not necessarily do

anything to heal the psychological and emotional damage wrought by

years of obesity, nor does it touch the psychological factors or

habits that led a person into obesity. This is why we have

psychological screening and training and preparation and education -

LOSING 150 pounds will more or less automatically make you

physically healthier (or at least remove some major risks), but it

doesn't automatically make you happier or better able to cope - and

as annoying as I sometimes find her, the things I learn from someone

like Gity have damn near as unassailable a track record as the

surgery itself. But please be aware - whether or not they are tried

by addict-recovery groups, the tools WE learn like meditation,

visualization, mindful breathing, relaxation DO NOT WORK for

alcoholics or drug addicts, but they work for us!

It is so tempting to say that obesity is our disease and food is our

addiction, because it lets us rationalize the difficulty in

reversing our various diseases and our EXCESSIVE dependence on food.

It's really hard to lose 10% of your body weight in order to qualify

for bariatric surgery - but NOT because you are a food addict, but

because it is really hard for ANYBODY to lose 10% of their body

weight, and even harder for an obese person unaccustomed to physical

exercise. It is hard to start exercising - but NOT because you are a

food addict, and NOT because you prefer the rush you get from eating

to the rush you are supposed to get from exercising. (As some of you

have probably heard me say at meetings, I have NEVER gotten an

endorphin rush from exercising in my life. I HATE exercise and find

it crippingly boring. Even when I was a teenager and an active

athlete, I hated practice and training - and I did not enjoy the

meets and competitions so much more that it made the time I

perceived I was wasting in training worth it to me. But it is

glaringly obvious to me that when I exercise, I FEEL better ALL THE

TIME because I am healthier and have more wind and energy - so THAT

is worth it to me. To those of you who do get endorphin rushes from

exercise - I envy you desperately!) It is hard to change your eating

habits - but NOT because you are a food addict, but because all

habits are hard to change, and you must eat all the time and unlike

someone addicted to intoxicants, you cannot use avoidance strategies

to solve your problems, because you cannot and must not avoid food.

I am single and I live by myself (except for the cat, who does not

eat people food). I have heard many bariatric patients say that

their path is made more difficult by the presence and needs and

habits of families, especially wives and mothers who are shopping

and cooking for their families. I am utterly certain that my path

has been easier for the absence of those factors. If we all were

truly addicts, I would be faced with the inverse but exactly

functionally equivalent problem of not having anyone to police me as

I shopped or ate - but that is not the case, and not because I am

better at this than anyone else, but because my path is easier and

the amount of self-discipline it takes me not to buy a bad food is

TRIVIAL - whether you compare it to the amount of self-discipline an

addict requires not to get a fix, or even the amount of self-

discipline it takes for a working mom not to eat a bad food that she

feels she wants to buy and serve to her children. The difference is

that neither the mom nor me are addicts.

We all know that one of the things we need to succeed is to take

responsibility for our own lives and health. Part of that success is

not making excuses. I think that the addiction model is, for us,

mostly a big source of excuses. Surgery will cure many of the

physical conditions, disorders, and diseases caused at least in part

by our obesity, and our various therapies and techniques may or may

not help cure the psychological conditions, weaknesses, and, rarely,

diseases, that accompanied and contributed to our obesity. Addicts

are not cured in the same way we are. We are not " in recovery. " Most

of us RECOVER. Recovering addicts are involved in a constant

struggle and can never be certain they will not relapse. While we

have risks of relapse, they are not of the same nature. Many if not

most of us successfully change our habits and spend little

psychological capital therafter in avoiding reverting to previous

habits - and often suffer little ill effects from our slips. How

many bariatric patients do you know that have an unstated goal of

reaching a certain weight, then " I can eat most anything I want,

just less of it and it will have less impact on me. " I know lots. If

they were addicts, they would be, quite literally, doomed to

failure. Since we are not addicts, even this half-assed approach of

letting the surgery do almost all the work often succeeds.

We are luckier than the generations who preceded us, who did not

have this safe alternative to ending their obesity. Let's leave

behind the outmoded addiction model that they began to embrace.

Randy

> >

> > Hello everyone!

> >

> > My name is . I received my approval for the Kaiser

Permanente

> > Bariatrics Program in July of last year (2005). I was thrilled.

I

> > went to orientation on September 17th, 2005, where they

discussed

> the

> > 10% weight loss, and the fact that I had to quit smoking for at

> least

> > 3 months before they would allow me to have surgery.

> >

> > I attended the Kaiser Smoking Cessation Program and quit smoking

on

> > October 18th, 2005. I haven't have a cigarrette since. I put

my

> 10%

> > weight loss efforts on hold until after I quit smoking, assuming

it

> > would be harder to quit smoking than it would be to lose the

> weight.

> > HUGE mistake!

> >

> > Since I've quit smoking, I've gained 12 more pounds -- not

lost!

> > Despite hundreds of attempts to lose the 10%, I'm constantly

giving

> > myself excuses why it is okay for me to just cheat today and

start

> > again " tomorrow " -- only to cheat all over again the next day!

> >

> > I'm so confused. I sincerely want the surgery... more than

> anything

> > I've ever wanted. I do not understand why I am sabotaging my

own

> > weight loss! I often wish I had lost the weight before I quit

> > smoking... because before quitting, I could stick to a diet for

a

> > good three months and lose at least 40 pounds.

> >

> > I badly need a mentor. I'm looking for someone who has had the

> > surgery in the San Leandro, California, area that I can meet up

> with

> > and get some pointers and that can help me become excited and

> > motivated for the surgery. Also, any other support you can give

me

> > would be more than welcomed!

> >

> > I am starting off today on a low-carb diet. I'm really going to

do

> > my best from this point forward to lose the 40 pounds I need to

> > lose! (I originally only needed to lose 27, but I've put on 12

> > pounds since Kaiser weighed me and they will not re-weigh me

> because

> > the surgeon has already determined my goal weight.)

> >

> > Please help. I'm desperate for someone supportive to be on my

> side.

> > I live in a house of overweight people who constantly have junk

> food

> > around, and I haven't yet had the strength to turn off my bad

> > habits. I'd give anything for someone with will power to take

over

> > my body for a couple months to lose this weight!!

> >

> > I'd love to hear from you all!

> >

> >

>

[Guest guest]

WOW Randy So good! We do need food for survival, and it is wired as a pleasure, but I think people look at it as an addiction because when the pleasure for food is so strong and they give up so many other things and food becomes so more important than it needs to be. So it's not to say we don't need to eat and it's great to enjoy what you eat, just learning that so much shouldn't be focused on the food and it will make this journey so much easier. Take care. Donnajackpoint_94401 wrote: I'm not quite sure how to say it, and of course I'm also not sure if I'm right, but my gut instincts have always told me that the addiction model is the wrong one to embrace for obesity, especially in relation to weight loss surgery.First of all, we are warm-blooded

mammals - food is not only SUPPOSED to be a comfort to us, it's genetically hard-wired. An animal who needed to eat to live but did not derive enjoyment from eating would be at a huge genetic disadvantage, lacking a major competitive incentive for survival. Addiction is a complex of physical and emotional factors, but one very large component is that there is a differential in how individuals react physically to intoxicating substances, and some of those physical reactions make for easier habituation and the body's perception of a physical need for a particular substance. We glibly speak of "addictive personalities," but in truth the single greatest determining factor for the overwhelming majority of addicts is an "addictive physiology." Now, since most addicts cannot change their physiologies, an array of psychological resources may be and often is the best way to battle these addictions. For example, there's no

doubt that going to Alcoholics Anonymous meetings works better for most alcoholics than taking Antabuse, a drug which makes them violently nauseous if they drink alcohol. This is despite the fact that we all know that aversion therapy can be effective - but rarely for addicts. This discussion has also skirted the other obvious major factor, which is that no one has to use an intoxicating substance at all. It is not physically or psychologically required for survival or even for enjoyment. But we all gotta eat! We are, quite literally, dependent on food, and when we start from a point that says that we need to end our dependence on food, we are fighting not just out own nature - which may need to be fought or tamed - but we are fighting human nature. One of the end results of bariatric surgery, happily, is that you are both less dependent on food (and more dependent on supplements in pill and liquid form, and

don't you forget it!), you are also dependent on less food, not to mention physically incapable - as if you had taken Antabuse for food - of overeating (at least, not in the same fashion that most of us are shamefacedly all too familiar). So while you most certainly need a broad armament of psychological tools to deal with both pleasure and with stress (and if you didn't, what would I be doing in a SUPPORT GROUP, huh?), I do not think you should think of yourself as an addict. Another reason the addiction model is popular is that we have come to equate addiction with disease not so much because of the physiological and/or psychological truth of that equation, but simply because we have come to equate "disease" with "difficult to cure" or "requiring a sustained, supported, psychological method to cure" - and they are NOT the same. Obesity is NOT, in most cases, a separate and discrete disease. Obesity is instead

ACCOMPANIED and CHARACTERIZED by a number of physical characteristics, disorders, conditions, and, yes, diesases, all of which are caused by the physical and psychological stresses of excess weight. Bariatric surgery can remove the excess weight, but it does not necessarily do anything to heal the psychological and emotional damage wrought by years of obesity, nor does it touch the psychological factors or habits that led a person into obesity. This is why we have psychological screening and training and preparation and education - LOSING 150 pounds will more or less automatically make you physically healthier (or at least remove some major risks), but it doesn't automatically make you happier or better able to cope - and as annoying as I sometimes find her, the things I learn from someone like Gity have damn near as unassailable a track record as the surgery itself. But please be aware - whether or not they are tried

by addict-recovery groups, the tools WE learn like meditation, visualization, mindful breathing, relaxation DO NOT WORK for alcoholics or drug addicts, but they work for us! It is so tempting to say that obesity is our disease and food is our addiction, because it lets us rationalize the difficulty in reversing our various diseases and our EXCESSIVE dependence on food. It's really hard to lose 10% of your body weight in order to qualify for bariatric surgery - but NOT because you are a food addict, but because it is really hard for ANYBODY to lose 10% of their body weight, and even harder for an obese person unaccustomed to physical exercise. It is hard to start exercising - but NOT because you are a food addict, and NOT because you prefer the rush you get from eating to the rush you are supposed to get from exercising. (As some of you have probably heard me say at meetings, I have NEVER gotten an endorphin

rush from exercising in my life. I HATE exercise and find it crippingly boring. Even when I was a teenager and an active athlete, I hated practice and training - and I did not enjoy the meets and competitions so much more that it made the time I perceived I was wasting in training worth it to me. But it is glaringly obvious to me that when I exercise, I FEEL better ALL THE TIME because I am healthier and have more wind and energy - so THAT is worth it to me. To those of you who do get endorphin rushes from exercise - I envy you desperately!) It is hard to change your eating habits - but NOT because you are a food addict, but because all habits are hard to change, and you must eat all the time and unlike someone addicted to intoxicants, you cannot use avoidance strategies to solve your problems, because you cannot and must not avoid food. I am single and I live by myself (except for the cat, who does not eat people

food). I have heard many bariatric patients say that their path is made more difficult by the presence and needs and habits of families, especially wives and mothers who are shopping and cooking for their families. I am utterly certain that my path has been easier for the absence of those factors. If we all were truly addicts, I would be faced with the inverse but exactly functionally equivalent problem of not having anyone to police me as I shopped or ate - but that is not the case, and not because I am better at this than anyone else, but because my path is easier and the amount of self-discipline it takes me not to buy a bad food is TRIVIAL - whether you compare it to the amount of self-discipline an addict requires not to get a fix, or even the amount of self-discipline it takes for a working mom not to eat a bad food that she feels she wants to buy and serve to her children. The difference is that neither the mom

nor me are addicts. We all know that one of the things we need to succeed is to take responsibility for our own lives and health. Part of that success is not making excuses. I think that the addiction model is, for us, mostly a big source of excuses. Surgery will cure many of the physical conditions, disorders, and diseases caused at least in part by our obesity, and our various therapies and techniques may or may not help cure the psychological conditions, weaknesses, and, rarely, diseases, that accompanied and contributed to our obesity. Addicts are not cured in the same way we are. We are not "in recovery." Most of us RECOVER. Recovering addicts are involved in a constant struggle and can never be certain they will not relapse. While we have risks of relapse, they are not of the same nature. Many if not most of us successfully change our habits and spend little psychological capital therafter in avoiding

reverting to previous habits - and often suffer little ill effects from our slips. How many bariatric patients do you know that have an unstated goal of reaching a certain weight, then "I can eat most anything I want, just less of it and it will have less impact on me." I know lots. If they were addicts, they would be, quite literally, doomed to failure. Since we are not addicts, even this half-assed approach of letting the surgery do almost all the work often succeeds. We are luckier than the generations who preceded us, who did not have this safe alternative to ending their obesity. Let's leave behind the outmoded addiction model that they began to embrace. Randy> >> > Hello everyone!> > > > My name is . I received my approval for the Kaiser Permanente > > Bariatrics Program in July of last year (2005). I was thrilled. I > > went to orientation on September 17th, 2005, where they discussed > the > > 10% weight loss, and the fact that I had to quit smoking for at > least > > 3 months before they would allow me to have surgery.> > > > I attended the Kaiser Smoking Cessation Program and quit smoking on > > October 18th, 2005. I haven't have a cigarrette since. I put my > 10% > > weight loss efforts on hold until after I quit smoking, assuming it > >

would be harder to quit smoking than it would be to lose the > weight. > > HUGE mistake!> > > > Since I've quit smoking, I've gained 12 more pounds -- not lost! > > Despite hundreds of attempts to lose the 10%, I'm constantly giving > > myself excuses why it is okay for me to just cheat today and start > > again "tomorrow"-- only to cheat all over again the next day! > > > > I'm so confused. I sincerely want the surgery... more than > anything > > I've ever wanted. I do not understand why I am sabotaging my own > > weight loss! I often wish I had lost the weight before I quit > > smoking... because before quitting, I could stick to a diet for a > > good three months and lose at least 40 pounds.> > > > I badly need a mentor. I'm looking for someone who has had

the > > surgery in the San Leandro, California, area that I can meet up > with > > and get some pointers and that can help me become excited and > > motivated for the surgery. Also, any other support you can give me > > would be more than welcomed!> > > > I am starting off today on a low-carb diet. I'm really going to do > > my best from this point forward to lose the 40 pounds I need to > > lose! (I originally only needed to lose 27, but I've put on 12 > > pounds since Kaiser weighed me and they will not re-weigh me > because > > the surgeon has already determined my goal weight.)> > > > Please help. I'm desperate for someone supportive to be on my > side. > > I live in a house of overweight people who constantly have junk > food > > around, and I haven't yet had the

strength to turn off my bad > > habits. I'd give anything for someone with will power to take over > > my body for a couple months to lose this weight!!> > > > I'd love to hear from you all!> > > >>Donna JordonDSJordon@...

Talk is cheap. Use Yahoo! Messenger to make PC-to-Phone calls. Great rates starting at 1¢/min.

[Guest guest]

Here here, Randy. I have a real problem with the AA model for so-called food addiction. I think it puts us in this role of "victim", never knowing when the other shoe is going to dro, and we'll fall of the wagon and skyrocket back to our former weight, much like a reformed addict who falls off the wagon may plummet down to the gutter because of an unstoppable bender. I think there are certain foods that for some people are "triggers", they do give you a little rush of endorphins or whatever (sugar for lots of people, salty stuff for others)...and some people may make a conscious choice to never eat any of that stuff ever again. And that's a fine choice to make...and from a nutritional stand ponit, an intelligent choice to make. But, I just don't think it's absolutely 100% required for everyone. I might be one of these "half-assed" people that you are talking about. I don't

know. I know that I exercise routinely. I know that I take my vitamins. I know that I try to make good choices about what I eat at least 85% of the time. The other 15% of the time i indulge: a little bit of wine, a little bit of cheese...maybe a bite or two of dessert. But, that kind of behaviour I do with a wary eye. I don't want the proportion to change so that it's 50/50. And I watch my weight, and accordingly adjust the ratio whenever I creep up a lb. That's because I'm learning about my new body, learning how many calories it takes to sustain 155 lbs. vs. 261.5 lbs. But, I just feel that sometimes people get addicted to support groups, or addicted to the notion that they are an addict. Like it's a club, or a comfort, in some way. I get support from this online group...and Pam and and I work together, and we talk. I get support from others in my

life who may not have had the surgery, but who are trying to eat healthily for other reasons. What I've had to learn is that I frequently ate because I was emotional: happy, celebratory, sad, lonely, bored, depressed, frustrated, angry. And sure, people use alcohol and drugs for the same "self-medicating" reasons. But, I think that weight issues are more akin to "problem drinkers", as opposed to alcoholics. In order to overcome problem drinking, some people quit drinking altogether, or save it for a special occasion. Obviously, we can't do that with food. But, the similarity there is that there isn't a real driving addiction that is bringing us back to the bottle. Rather, it's maybe because we really like the taste. And we like feeling comforted by it...and we don't like facing up to the harsh realities of our life, so it dulls our senses a bit. But

problem drinkers can learn how to drink appropriately. They just need to be aware of their tendency to drink too often...and they need to apply behavioural tools to correct their problems. They need to have that, "Hey, I'm drinking too much tonight...I need to moderate myself." awareness. Just like we do. They need to start realizing that if they over-indulged one night, they need to give their body a rest for a few days...and they need to take a more moderate approach the next time they drink. They need to think about more constructive ways to deal with their emotions so that they don't repeat the pattern of over-consumption. This surgery fixes our body in many ways: we absorb fewer of the calories we do eat, and we are unable to eat the quantity we used to eat. For many of us, there are certain things that just don't agree with our bodies anymore. For me, bread, rice and pasta and certain

sugary things just don't make me feel very good....or they fill me up instantaneously, and so by eating them, I'm depriving my body of valid nutrition that I need. SO, while I occasionally eat those things, I can eat very little...and in the long run, it generally doesn't feel worth it to me, so I don't do it very often. I don't miss it. You know, my weight was an albatross around my neck for the longest time. I thought about it incessently...either ideas about diets, or dreams about being thin, or angry or shame-filled thoughts about the state I was in. I'm done with being obsessed about food and diets. I'm done with that. I employ the tools, and I've had great success. And, let's be honest, I'm not quite a year out, so I may be in for a rude awakening some day. It may start to get a lot harder. But hey...I just don't think

so. I pay attention to my exercise and my nutrition. I notice when I'm emotional and I may be tempted to buy things I really dont' want to have in the house. I talk to myself about it when I'm at the store: "You know, if this is around, I'm just going to eat it all. Do I really really want this? Do I need it? Is there a smaller quantity I can buy? Is there a single serving that I can divide into three or four servings (my sized servings)? Is there someone I can give the rest away to? Am I willing to eat a very small amount and then throw the rest away, or freeze it for later?" And then when I eat something, I take a bite and I think, "Is this worth the calories? Does it taste good enough to justify them?" If not, after the first (or maybe second small bite...I throw it away. Period. It just isn't worth the calories to me anymore. I focus on the

taste, and I enjoy it...much as I might enjoy wine. I take my time, I drink (eat) just enough to enjoy it, but not so much as to be tipsy, drunk, sick, full...fill in the blank. And mainly, I don't obsess. I hardly ever think about "who I was" when I was fat. That was someone else, I've been reborn into a new carcass. I don't think of myself as a former fatty. I think of myself as a thin and healthy person, who must do certain things to remain thin and healthy. And you know what? Every person I know over the age of maybe 25 who is thin has to think about it from time to time. Every person I know that is thin thinks about being moderate in the days following a big feast or a period of over indulgence. I'm not an addict. I am somebody who used to be a problem eater. I have employed tools, and I am cognizant of my behaviours. I have measuring devices

in play: a certain pair of pants, the scales...just the general mental assessment of how I'm doing on the nutrition factor. At any point, I could choose to chuck all of the tools, I could choose to ignore my behaviours...and I might gain some of this weight back, despite the malabsorption and smaller tummy. Just as a problem drinker could choose to go back to the excess drinking pattern. But, I choose to keep it in control, because my life is so much better now. And I seek out help when I need it...and I try to be honest with myself about what I'm eating and how much. I keep myself in check with my scale so that I don't get into self-denial. And I don't think a real addict could do that...not without having to struggle and focus all of the time, every minute of every day. And like Randy said, it just isn't that hard. Others may be different and may have a more entrenched and complicated relationship with food (used as a means of self-medication). I certainly had a pretty deep entrenchment, but I've been doing internal work for a long time (I highly recommend Geneen Roth books that talk about breaking free of compulsive overeating). For me food was safety, nurturance, a rage blocker. For me, fat was a way to protect me from predators (I was molested for many years as a child). But in the end, I figured out different ways, more constructive ways, to handle all of the things that food provided. Except for one: nutrition. So, food is now fuel for my body. Nutrition. And I enjoy it, still. I appreciate it for what it does for my body...and I appreciate high quality, well-prepared food. ANd I'm glad that I haven't completely lost my ability to enjoy it. (I did for a while post-op...eating

food was a chore.) But, food is not my friend, my lover, my analyst, my protector, my companion, nor is it my punching bag. And I am so thankful that this surgery, combined with my mental re-education, has completely changed my life. I am a much healthier person, not just physically...but psychologically. SO many people have mentioned the change in me. I'm calmer, less melancholy. I am more firm with my boundaries. Anyway, my two cents. Robynnjackpoint_94401 wrote: I'm not quite sure how to say it, and of course I'm also not sure if I'm right, but my gut instincts have always told me that the addiction model is the wrong one to embrace for obesity, especially in relation to weight

loss surgery.First of all, we are warm-blooded mammals - food is not only SUPPOSED to be a comfort to us, it's genetically hard-wired. An animal who needed to eat to live but did not derive enjoyment from eating would be at a huge genetic disadvantage, lacking a major competitive incentive for survival. Addiction is a complex of physical and emotional factors, but one very large component is that there is a differential in how individuals react physically to intoxicating substances, and some of those physical reactions make for easier habituation and the body's perception of a physical need for a particular substance. We glibly speak of "addictive personalities," but in truth the single greatest determining factor for the overwhelming majority of addicts is an "addictive physiology." Now, since most addicts cannot change their physiologies, an array of psychological resources may be and often is the best way

to battle these addictions. For example, there's no doubt that going to Alcoholics Anonymous meetings works better for most alcoholics than taking Antabuse, a drug which makes them violently nauseous if they drink alcohol. This is despite the fact that we all know that aversion therapy can be effective - but rarely for addicts. This discussion has also skirted the other obvious major factor, which is that no one has to use an intoxicating substance at all. It is not physically or psychologically required for survival or even for enjoyment. But we all gotta eat! We are, quite literally, dependent on food, and when we start from a point that says that we need to end our dependence on food, we are fighting not just out own nature - which may need to be fought or tamed - but we are fighting human nature. One of the end results of bariatric surgery, happily, is that you are both less dependent on food (and more

dependent on supplements in pill and liquid form, and don't you forget it!), you are also dependent on less food, not to mention physically incapable - as if you had taken Antabuse for food - of overeating (at least, not in the same fashion that most of us are shamefacedly all too familiar). So while you most certainly need a broad armament of psychological tools to deal with both pleasure and with stress (and if you didn't, what would I be doing in a SUPPORT GROUP, huh?), I do not think you should think of yourself as an addict. Another reason the addiction model is popular is that we have come to equate addiction with disease not so much because of the physiological and/or psychological truth of that equation, but simply because we have come to equate "disease" with "difficult to cure" or "requiring a sustained, supported, psychological method to cure" - and they are NOT the same. Obesity is NOT, in most cases,

a separate and discrete disease. Obesity is instead ACCOMPANIED and CHARACTERIZED by a number of physical characteristics, disorders, conditions, and, yes, diesases, all of which are caused by the physical and psychological stresses of excess weight. Bariatric surgery can remove the excess weight, but it does not necessarily do anything to heal the psychological and emotional damage wrought by years of obesity, nor does it touch the psychological factors or habits that led a person into obesity. This is why we have psychological screening and training and preparation and education - LOSING 150 pounds will more or less automatically make you physically healthier (or at least remove some major risks), but it doesn't automatically make you happier or better able to cope - and as annoying as I sometimes find her, the things I learn from someone like Gity have damn near as unassailable a track record as the surgery

itself. But please be aware - whether or not they are tried by addict-recovery groups, the tools WE learn like meditation, visualization, mindful breathing, relaxation DO NOT WORK for alcoholics or drug addicts, but they work for us! It is so tempting to say that obesity is our disease and food is our addiction, because it lets us rationalize the difficulty in reversing our various diseases and our EXCESSIVE dependence on food. It's really hard to lose 10% of your body weight in order to qualify for bariatric surgery - but NOT because you are a food addict, but because it is really hard for ANYBODY to lose 10% of their body weight, and even harder for an obese person unaccustomed to physical exercise. It is hard to start exercising - but NOT because you are a food addict, and NOT because you prefer the rush you get from eating to the rush you are supposed to get from exercising. (As some of you have probably heard

me say at meetings, I have NEVER gotten an endorphin rush from exercising in my life. I HATE exercise and find it crippingly boring. Even when I was a teenager and an active athlete, I hated practice and training - and I did not enjoy the meets and competitions so much more that it made the time I perceived I was wasting in training worth it to me. But it is glaringly obvious to me that when I exercise, I FEEL better ALL THE TIME because I am healthier and have more wind and energy - so THAT is worth it to me. To those of you who do get endorphin rushes from exercise - I envy you desperately!) It is hard to change your eating habits - but NOT because you are a food addict, but because all habits are hard to change, and you must eat all the time and unlike someone addicted to intoxicants, you cannot use avoidance strategies to solve your problems, because you cannot and must not avoid food. I am single and I live by

myself (except for the cat, who does not eat people food). I have heard many bariatric patients say that their path is made more difficult by the presence and needs and habits of families, especially wives and mothers who are shopping and cooking for their families. I am utterly certain that my path has been easier for the absence of those factors. If we all were truly addicts, I would be faced with the inverse but exactly functionally equivalent problem of not having anyone to police me as I shopped or ate - but that is not the case, and not because I am better at this than anyone else, but because my path is easier and the amount of self-discipline it takes me not to buy a bad food is TRIVIAL - whether you compare it to the amount of self-discipline an addict requires not to get a fix, or even the amount of self-discipline it takes for a working mom not to eat a bad food that she feels she wants to buy and serve to

her children. The difference is that neither the mom nor me are addicts. We all know that one of the things we need to succeed is to take responsibility for our own lives and health. Part of that success is not making excuses. I think that the addiction model is, for us, mostly a big source of excuses. Surgery will cure many of the physical conditions, disorders, and diseases caused at least in part by our obesity, and our various therapies and techniques may or may not help cure the psychological conditions, weaknesses, and, rarely, diseases, that accompanied and contributed to our obesity. Addicts are not cured in the same way we are. We are not "in recovery." Most of us RECOVER. Recovering addicts are involved in a constant struggle and can never be certain they will not relapse. While we have risks of relapse, they are not of the same nature. Many if not most of us successfully change our habits and spend

little psychological capital therafter in avoiding reverting to previous habits - and often suffer little ill effects from our slips. How many bariatric patients do you know that have an unstated goal of reaching a certain weight, then "I can eat most anything I want, just less of it and it will have less impact on me." I know lots. If they were addicts, they would be, quite literally, doomed to failure. Since we are not addicts, even this half-assed approach of letting the surgery do almost all the work often succeeds. We are luckier than the generations who preceded us, who did not have this safe alternative to ending their obesity. Let's leave behind the outmoded addiction model that they began to embrace. Randy> >> > Hello everyone!> > > > My name is . I received my approval for the Kaiser Permanente > > Bariatrics Program in July of last year (2005). I was thrilled. I > > went to orientation on September 17th, 2005, where they discussed > the > > 10% weight loss, and the fact that I had to quit smoking for at > least > > 3 months before they would allow me to have surgery.> > > > I attended the Kaiser Smoking Cessation Program and quit smoking on > > October 18th, 2005. I haven't have a cigarrette since. I put my > 10% > > weight loss efforts on hold

until after I quit smoking, assuming it > > would be harder to quit smoking than it would be to lose the > weight. > > HUGE mistake!> > > > Since I've quit smoking, I've gained 12 more pounds -- not lost! > > Despite hundreds of attempts to lose the 10%, I'm constantly giving > > myself excuses why it is okay for me to just cheat today and start > > again "tomorrow"-- only to cheat all over again the next day! > > > > I'm so confused. I sincerely want the surgery... more than > anything > > I've ever wanted. I do not understand why I am sabotaging my own > > weight loss! I often wish I had lost the weight before I quit > > smoking... because before quitting, I could stick to a diet for a > > good three months and lose at least 40 pounds.> > > > I badly

need a mentor. I'm looking for someone who has had the > > surgery in the San Leandro, California, area that I can meet up > with > > and get some pointers and that can help me become excited and > > motivated for the surgery. Also, any other support you can give me > > would be more than welcomed!> > > > I am starting off today on a low-carb diet. I'm really going to do > > my best from this point forward to lose the 40 pounds I need to > > lose! (I originally only needed to lose 27, but I've put on 12 > > pounds since Kaiser weighed me and they will not re-weigh me > because > > the surgeon has already determined my goal weight.)> > > > Please help. I'm desperate for someone supportive to be on my > side. > > I live in a house of overweight people who constantly have junk

> food > > around, and I haven't yet had the strength to turn off my bad > > habits. I'd give anything for someone with will power to take over > > my body for a couple months to lose this weight!!> > > > I'd love to hear from you all!> > > >>