Don't Be the Chicken and Cheetos Lady
Reasons for a psychologist's denial of certain patients for weight loss surgery
Posted Apr 12, 2017
I have worked as a psychologist, providing psychological evaluations prior to bariatric weight loss surgery for the past eight years. For the most part, people need a power tool to help them lose and keep off the weight they have lost over and over again in their lives. The gastric sleeve, bypass, and now balloon are those tools. However, every once in a while, I will encounter someone who believes these procedures are the magic bullet.
I can pick this up in five seconds when I learn that this person has:
- no exercise plan to maintain their weight loss
- a barrage of excuses as to why they can’t exercise anymore
- zero insight into why they are overweight (“I don’t know why I am overweight, I just eat steamed vegetables and grilled chicken mostly.”)
- a lack of motivation or understanding for why they also have to engage in behavioral modification in addition to the surgery
“Why would you reveal all of this?” you ask. Aren’t I giving away the keys to the kingdom to anyone who reads this and wants to pass a psychological evaluation? Perhaps, but who are you really cheating if you don’t go within and face the real demons that got you here in the first place?
When I ask people about their eating styles, I tend to group them into four categories:
1) emotional eater - someone who uses food when they are bored, stressed, tired, lonely, sad, or even happy in addition to eating when they are hungry
2) skip and binger - someone who fails to think about food until it is too late, and when they are ravenous end up going for whatever is available which is usually some type of carb and calorie laden fast food
3) miscellaneous - someone who just recognizes that they eat too large of portion sizes and/or the wrong types of food
4) food addict - usually someone with a history of other addictions, trauma, and a significant amount of weight to lose. They usually have comorbid psychological diagnoses that have been unaddressed or ill-addressed.
Out of the four categories, the 4th is the most troubling for a psychologist. This particular person is most correlated with the patient who fails to address their core issues, eats “around the sleeve,” or bypass, experiences dumping syndrome, comes back a year later and asks for the bypass, or a different procedure.
This is the person who, ironically, is usually the most resistant to my recommendation that they seek therapeutic support prior to the surgery. They want it done YESTERDAY. They want it NOW. It is this type of thinking that got them into trouble in the first place. The impulsivity and lack of emotional regulation.
I’ve witnessed people fail to address their maladaptive eating patterns and never quite get to their goal weight. I had a male that would buy a bag of pepperonis at the grocery store and snack on them all day and couldn’t understand why he wasn’t losing weight. This daily “snack,” which was a mental security blanket, served as a veritable IV drip of fat and calories throughout the day.
I’ve had a woman who figured out how to ground up her favorite foods into a liquid form because she never quite let go of her attachment to “comfort foods.” One of her most notable liquid concoctions consisted of chicken and Cheetos. I’ll just leave that for you to chew…er, swallow.
They say with drug and alcohol recovery, you “slay the dragon,” but with food addiction recovery, you have to take it for a walk three times a day. If you don’t fundamentally shift your relationship with this dragon, you’re going to get burnt when you are walking it.
My number one tip for transforming your relationship with food is to start looking at eating the same way you do as brushing and flossing: You don’t necessarily salivate at the idea of what type of toothpaste you will use, where you will do it, who you will do it with, right? You just do it twice a day because you don’t want to lose your teeth and you want to maintain healthy gums.
Food has to be thought of in the same way. You fuel up. You don’t use food as a place to define your quality of life. You don’t use food to Celebrate. You don’t use food to demarcate the end of a long day. You don’t use food to help you feel less alone. You figure out healthier coping alternatives to meet these needs.
Loneliness - call a friend for support
Celebrate - get a massage
Demarcate the end of a long day - start a tea ritual and use essential oils
Another reason you must say goodbye to comfort food is that it triggers the pleasure center of the brain, which ignites our dopamine, which perpetuates the addiction. Many people think we are just telling them to get rid of the comfort food because of the carbs or calories, but there are unique and harmful chemical consequences to ingesting these types of food we know are bad for us.