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Wednesday, March 14, 2012

Behavior Modification...Part Deux

"You've done everything we've asked..."  Those were the words of MD today.  And that was the deciding factor for him to give the thumbs-up to the insurance company.  3.8# down this visit.  Blood pressure was an all-time low of 98/60 and my pulse was 68.  I was totally shocked considering what feels like overwhelming stress on the work side coupled with over-commitment of my schedule.  I can only attribute it to the peace of Jesus that He's given me.  I have no other way to explain it.

I met with the RD and the RN today too.  The RN did a blood draw to check my Vitamin D levels and the RD and I discussed a few more things on the nutrition side of it all.  I have a full hour-long nutrition "class" with her on 3/26, where we'll go over a LOT more of the post-op eating phases.  I like RD.  She's not afraid to say, "I tried it that way and it was disgusting.  This is what I think is better."  I understand that everyone's tastes are different, but it's good to know that she's tried the recipes and protein supplements.  She also provided me with some more information - one was about the importance of water and the second was about fiber (should look for a minimum of 3-5 grams of fiber per serving).  I was actually surprised to see avocados on the list of high fiber foods; not because of the fiber part (though I didn't know that either) but because I was always told to avoid avocados because of the fat content.  RD said that while they are high in fat, it's a good fat and the fiber content is a good balance.  (My paraphrasing, but that's how I understood it.)

I attended the second Behavior Modification (group) class today.  Our topic this time was "Eating Patterns".  We all introduced ourselves, advised where were were in the process, what we've already done to make those small sustainable changes and what we're still struggling with.  This gave me the opportunity to share the fact that CME and I just recently purchased smaller plates to use to help with portion control.  The response I got to that was amazing - affirmation from the LCSW and a lot of "that's a great idea!" or "I wrote that one down".  This was also a good glimpse for me as to what the support groups are like through bariatric center.  It's one of the things they really stress - to share with others; ideas, challenges, successes.  We are all on the same journey, though our paths and lives may be so incredibly different.  My struggle - snacks laying around the work place.  I wish I could call in sick anytime we have a food day at work.  Ok, I know that I'll not feel that way forever, but it really is a danger zone for me.

Some staggering statistics were shared in the class:

  • In the US, conservative estimates indicate that after puberty, 5-10 million girls and women and 1 million boys and men are struggling with eating disorders including anorexia, bulimia and binge eating disorder.
  • In a national survey 55% of women and 41% of men reported being dissatisfied with their weight.
  • In addition, up to 80% of American women are dissatisfied with their appearance.
We stopped to discuss that point.  80% of American women are dissatisfied with our appearance.  Eighty percent.  That's mind-boggling to me.  We were asked why we think that is.  I think that there are a ton of contributing factors.  I think that it starts at a very VERY young age when adults say things like, "You look so pretty!  You look like a princess!  You are adorable.  Look how cute you are!"  I've been guilty of doing just that.  I'll see a little girl and instead of complimenting her on good character, I compliment her on appearance.  Why do we do that when we should be recognizing her/him as a fearfully and wonderfully made child of God with awesome character traits.  "You are are so kind!  You are so well behaved!  You are a very generous caring person.  Look how much you love your brother!" and so on and so on.  

In addition, we are so prone to believing what the world says is beautiful.  The ultra-thin Hollywood movie star; the girl with the perfectly straight bright white teeth; the blonde (or brunette, or redhead...) that caught the attention of our [date, significant other, spouse, etc].  We have been trained, even if by accident, to compare ourselves with others.  When we don't think we live up to those expectations, how else would we feel but dissatisfied with our appearance?  That is where I have been time and time again.  But as God is taking me through this time in my life, I now see myself as God sees me...as his perfectly and wonderfully made child.

By the way, the one man in our class today said that he disagrees with the 55/41 ratio.  He said more than ever, men are starting to be more aware of their appearance and weight and the dissatisfaction is just as high as it is with women.  Is it?  Really?  (Asking because I don't know...)

Eating patterns are established as children.  We've all heard (and probably spoken these words before - or something darn near it) "Eat your dinner... there are starving kids in Africa."  or "You can have dessert if you eat all your food."  I can't say that we ever were forced to "clean our plate" at meal time, but I don't really recall being taught healthy eating habits.  We were blessed as a family and we not only had the necessities in our cabinets/fridge but we had snacks and sodas (or pops or cokes - depending on where you're from!) and had free reign to them whenever we wanted.  Portion control or serving size were not phrases I ever heard. And then Grandmama ALWAYS fixed us snacks after school, before bedtime at her house, etc.  I'm in no way trying to blame my obesity on my family...please do not read it that way.  What I'm saying is that we really didn't learn healthy habits.  I am solely responsible for the mess I've made out of my body.  I've been an adult MUCH longer than I was a child.  I have had plenty of time to correct bad habits, but haven't.

We talked a lot about binge eating (as well as some other disorders).  And though I can say that I don't medically fall into a binge eating profile, I have had my episodes of binge eating over the years.  If I really sat down and wrote about the days where that has happened, I know it would shock people.  Not only the quantity of food, but the variety and the weird things that I'd make to eat.  

Okay...so if I'm going to be transparent here, maybe I should give you a glimpse of what that would look like in past.  -deep breath-  I'd come home from work (because I don't binge in front of people...I might be judged if I did that!) and fix supper for the boys and myself.  CME would be at work.  (remember the trigger situations?  yeah, this is one of them)  The boys would go to bed at 8:00pm.  At 8:15 (enough time for them to at least be drowsy if not already asleep) I'd start:

  • bowl of cereal with milk
  • hmmm...second bowl of cereal and milk
  • peanut butter and jelly... by the spoonfuls
  • still feeling snacky...maybe should have something "healthy"... like fruit (name your fruit)
  • wow...I've had a lot of sweet stuff...maybe some crackers/pretzels/chips
  • t.h.i.r.s.t.y.  Diet Coke, please and thank you
  • salty isn't satisfying me... 
  • oooh!  I'll make icing.  (yes make it)  butter, powdered sugar, milk, vanilla.  
  • I don't care that I don't have anything to ice...i'll just eat it with a spoon.
  • Sooo sweet...maybe a few more bites of crackers to get the sweetness out...followed by another Diet Coke.
  • As I work on drinking that last soda, GUILT begins to set in.  How could I eat all that?  WHY would I eat all that?  I think I'm going to be sick - literally (though I have never thrown up from one of these nights).
  • tomorrow I will have nothing but water.
And at 10:30 when the guilt is overwhelming and I'm not too far out for a blood sugar crash, I'll head to bed.

Ugly, huh?  Truth, though.

So what I've been challenged to do is prepare a list of alternate activities for those days when I feel like a binge is the way I'm headed.  I may even post it on my refrigerator as a reminder to "Go read your book" before I start on that totally destructive path.  It's another small sustainable change that I can do!

At this point, I'm waiting to hear from the insurance company so we can work on a concrete date for the surgery.  I feel like this is going to be the longest part of it all...the wait.  However, I know that if God has given me the courage to move forward, He will give me the patience get through the next few weeks.  
"I praise you [God] because I am fearfully and wonderfully made; your works are wonderful, I know that full well." ~Psalm 139:14

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