Posts Tagged ‘Self-esteem’

I am a Winner, and Winners…

Friday, November 12th, 2010

An Article and Exercise by Katie Jay, MSW, Certified Life Coach
Director, National Association for Weight Loss Surgery
www.nawls.com

I-am-a-winnerI have been going to dog-training classes. My dog is not the problem. I am. I can’t seem to be consistent in my approach to Ruby, so in her confusion she misbehaves.
It’s my responsibility to set boundaries with Ruby so that she knows what to do, but I feel inadequate. I’m too busy. I forget to practice. I’d rather do something else. I have to work. I have a million excuses.

My resistance creates unwanted consequences

For awhile Ruby’s indiscretions (a.k.a. my unwillingness to train my dog) were tolerable. She chewed a pair of my son’s tube socks. She ate the cat’s food. She pulled on the leashwhen I walked her.

But things have gotten worse. Ruby nips me to let me know it is time for her walk. She dines on litter-box fare (yuck!). She jumps onto the furniture when we turn our backs.

I have to get past my resistance

If I continue to let Ruby get away with these antics, and inevitably let things get worse, my life is going to get a lot more chaotic. And the consequences will become dire.

(Sadly, it’s at this point that many families give their pets back to the adoption agency. The problem goes from cute to annoying to intolerable.)

Resistance undermines weight loss surgery progress, too

When my hunger came back after weight loss surgery, it was almost cute at first. I ate half of a french fry and one bite of a dessert at a wedding reception. I felt petite and in control.

I was resisting my surgeon’s guidelines, but rationalized that I followed most of them

For awhile my indiscretions (a.k.a. my unwillingness to follow my plan) were tolerable. I wasn’t gaining weight and I felt great.

But things got worse. I started eating popcorn every night. I quit exercising at the gym. I ate toast with butter at bedtime.

And my food cravings got worse

So, I pushed my limits ever further. As this happened, I began to negotiate with myself about everything. Could I eat this at 3pm if I ate less of something at dinner?

How many calories is that snack food and maybe it’s okay to eat if I skip my protein drink (thus avoiding the extra calories).
It was annoying to always be negotiating with myself, pushing the boundaries. The consequences became more dire; I gained a few pounds.

Now my behavior felt intolerable to me

A few pounds is not a big concern in the vast scheme of things. But it is at this point that many weight loss surgery patients give up. But I didn’t give up.

Like Ruby, I needed clearer limits

I was in pure resistance mode. I was out of control and looking for trouble. Unlike my dog, though, I could identify my resistance and make a decision to set better limits for myself. So, that’s what I did.

I used my husband’s motto to challenge myself

As my biggest cheerleader, Mike has always supported me in my efforts at self improvement and with my dream to help others overcome obesity.

During times when I have felt uncertain or fearful or discouraged he has put his hands on my shoulders, looked me in the eyes, and made me repeat after him:

“I am a winner.”

He makes me say it until I really feel it. Sometimes I get really mad at him, but he persists until he breaks my resistance.

One morning, Mike noticed I did not write down a food plan or seem to have any intention of making one. So, he made me say that phrase. It’s hard to feel resistance and feel like a winner at the same time. So, for a few moments, as we looked into each other’s eyes, I felt like a winner.

Over the course of that day I decided to keep saying it to myself

I got past my resistance to healthier eating using my own version of Mike’s saying:

“I’m a winner, and winners _____________________.”

I filled in the blank depending on what I was doing. So, when I wanted to eat fast food for lunch, I told myself:

“I’m a winner, and winners eat *healthy*, great-tasting meals.”

When I wanted to skip going to the gym, I told myself:

“I’m a winner, and winners exercise daily.”

And when I wanted to eat that french fry, I told myself:

“I’m a winner, and winners eat healthy fats, not trans fats.”

Everyone wants to win

When I look at my choices from the vantage point of being a winner, it’s easy to see which choices will serve me well and which ones won’t.

When I feel like a winner, I am much happier to do the next right thing — to resist the temptation to overeat or to pick unhealthy foods.

Do you want to feel like a winner?

No, you can’t borrow Mike! Go stand in front of your mirror, and look into your own eyes. Smile broadly and say, “I’m a winner!”

The Surgical Specialists of Louisiana are committed to helping our patients achieve a healthy lifestyle and a healthy weight. Whether you are interested in weight loss surgery or medically supervised weight loss counseling, we can help you take control of your eating and your weight. Watch an online seminar now or take a weight loss quiz to help you get started.

This article is from Small Bites, the email newsletter for the National Association for Weight Loss Surgery.

Subscribe today and get your F’REE report, The 10 Most Common Mistakes Weight Loss Surgery Patients Make at www.10WLSmistakes.com.
(c) 2007 National Association for Weight Loss Surgery, Inc. All rights reserved.

Make Your Life Easier and Find More Satisfaction …Drop some rocks!

Friday, October 29th, 2010

An Article and Exercise by Katie Jay, MSW, Certified Life Coach
Director, National Association for Weight Loss Surgery
www.nawls.com

Louisiana_Drop_RocksImagine that your job in life is to swim across a fast-moving river carrying a bag of rocks. People often fill their bags with too many rocks, including rocks that don’t belong to
them.

A fast-moving river can be hard to get across even under the best of conditions. And it’s nearly impossible to cross when you are carrying a heavy burden.

We live in a busy world. Often success is measured by how much we do, how busy we are, and how heavy the load is that we carry.

Weight Loss Surgery patients are faced with a choice after surgery, because we have chosen to add some hefty rocks to our bags — the responsibility of making our rigorous WLS lifestyle a priority — our ability to carry lots of other rocks will be limited.
By the very nature of our WLS we carry a lot of rocks in our bags: taking vitamins and supplements, monitoring our labs, exercising, losing and maintaining weight, drinking water, eating enough protein, dealing with food obsession, being prepared for any eating situation, adjusting our self image, fighting urges to graze or overeat or eat sweets…I could go on and on!

This added burden for WLS patients makes it imperative that we be deliberate in the number and size of the rocks we carry.

Because we carry the extra burden of the WLS lifestyle, we must take a realistic look at our lives and adjust our obligations accordingly.

If you are carrying other people’s rocks unnecessarily; i.e., doing all the work for the team at your job, volunteering again because no other parent will step up, making cookies for a friend’s party; you might want to rethink what you’re doing.

Carrying too many rocks is risky business. And carrying your WLS rocks and everyone else’s just might make your sink.
Keep these three things in mind, and begin to work on not making yourself carry such a huge bag of rocks:

  1. Everyone has to carry rocks, but the people whose loads are the lightest tend to set good boundaries, value themselves, and take an honest look at their capabilities.
  2. When you carry someone else’s rocks, and they are capable of carrying their own rocks, you don’t do yourself or them a favor.
  3. Making brave choices about which rocks you will carry — and which ones you will not carry — will bring you more rewards than you could ever imagine.

Just remember, you don’t have to do everything everyone expects of you. You can say no to eating at a restaurant that triggers you to overeat. You can ask your husband or wife not to bring chips into the house. You can even say no to running an errand for a friend, if running that errand would interfere with your healthy habit of eating before you get too hungry.

The river may rage in my life, but I am determined to carry as light a load as possible. How about you?

An Exercise:

Make a list of the rocks in your bag — your various responsibilities. This week, drop at least one of the rocks that doesn’t belong to you.

The Surgical Specialists of Louisiana are committed to helping our patients achieve a healthy lifestyle and a healthy weight. Whether you are interested in weight loss surgery or medically supervised weight loss counseling, we can help you take control of your eating and your weight. Watch an online seminar now or take a weight loss quiz to help you get started.

This article is from Small Bites, the email newsletter for the National Association for Weight Loss Surgery.

Subscribe today and get your F’REE report, The 10 Most Common Mistakes Weight Loss Surgery Patients Make at www.10WLSmistakes.com.

(c) 2007 National Association for Weight Loss Surgery, Inc. All rights reserved.

Is Obesity the Last Acceptable Form of Discrimination?

Wednesday, February 10th, 2010

weightdiscriminationprevalent

Obesity remains a socially acceptable injustice and often referred to as “the last acceptable form of discrimination.” Overweight individuals are often the subject of jokes in the media which can translate to real life discrimination. In this article, printed with permission of the Obesity Action Coalition, Rebecca Phul, PhD discusses the difference between “stigma” and “discrimination” and what legal ramifications, if any, can take place to protect overweight individuals.

Weight Discrimination: A Socially Acceptable Injustice

By Rebecca Puhl, PhD

Obesity is highly stigmatized in our society. Overweight and obese individuals are vulnerable to negative bias, prejudice and discrimination in many different settings, including the workplace, educational institutions, healthcare facilities and even within interpersonal relationships.

Unfortunately, weight bias remains very socially acceptable in North American culture; it is rarely challenged, and often ignored. As a result, thousands of obese individuals are at risk for unfair treatment, and there are few outlets available to provide support or protection.

What is the difference between “stigma” and “discrimination?”

Weight stigma or bias generally refers to negative weight-related attitudes toward an overweight or obese individual. These attitudes are often manifested by negative stereotypes (e.g., that obese persons are “lazy” or “lacking in willpower”), social rejection and prejudice. Weight stigma includes verbal teasing (e.g., name calling, derogatory remarks, being made fun of, etc.), physical aggression (e.g., hitting, kicking, pushing, shoving, etc.) and relational victimization (e.g., social exclusion, being ignored, avoided, or the target of rumors).

Many obese individuals report being treated with less respect or courtesy than thinner persons and being called names or insults because of their weight. Thus, weight stigma can emerge in subtle forms, or it can be expressed directly.

Discrimination is distinct from stigma and negative attitudes, and specifically refers to unequal, unfair treatment of people because of their weight. For example, an obese person who is qualified for a job but is not hired for the position because of his or her weight may have been the victim of weight discrimination.

Other examples include being denied a job promotion or fired from a job because of one’s weight; being denied certain medical procedures or provided inferior medical care because of one’s weight; or being denied a scholarship, a bank loan or prevented from renting or buying a home because of one’s weight.

In each of these cases, the behaviors directed toward the obese individual depict inequitable treatment with no justifiable cause, and legal recourse may be an appropriate response in these situations.

Obesity Discrimination on the Rise

Despite the increasing prevalence of obesity, it appears that incidences of weight discrimination are only becoming worse.

In our research, we examined trends of weight discrimination throughout a 10 year period from 1995-2005 and found that the prevalence increased by 66 percent during this decade, from 7-12 percent of the general population. This finding was not a result of increasing obesity rates, but rather specifically demonstrates that more people are experiencing weight discrimination.

How common is weight discrimination?

Given the social acceptability of negative attitudes toward obese individuals, it may not be surprising to learn that weight discrimination is common in the United States.

In a recent study, we examined the prevalence of multiple forms of discrimination in a nationally representative sample of 2,290 American adults and found that weight discrimination is common among Americans, with rates relatively close to the prevalence of race and age discrimination. Among women, weight discrimination was even more common than racial discrimination. Among all adults in the study, weight discrimination was more prevalent than discrimination due to ethnicity, sexual orientation and physical disability. Almost 60 percent of participants in our study who reported weight discrimination experienced at least one occurrence of employment-based discrimination, such as not being hired for a job.

On average, a person’s chances of being discriminated against because of weight become higher as their body weight increases. In our study, 10 percent of overweight women reported weight discrimination, 20 percent of obese women reported weight discrimination and 45 percent of very obese women reported weight discrimination.

Rates for men were lower, with 3 percent of overweight, 6 percent of obese and 28 percent of very obese men reporting weight discrimination. This finding also tells us that women begin experiencing weight discrimination at lower levels of body weight than men.

What legal action can be taken for victims of weight discrimination?

Unfortunately, there are few legal options available for individuals who suffer weight discrimination. Currently, there are no federal laws that exist to prohibit discrimination based on weight.

With the exception of one state law (Michigan) and a few local jurisdictions that address discrimination on the basis of weight or appearance (e.g., San Francisco), the vast majority of people who experience weight discrimination in the U.S. must pursue legal recourse through other indirect avenues.

In particular, obese individuals have depended on the Rehabilitation Act of 1973 (RA) and the Americans with Disabilities Act of 1990 (ADA). Most cases filed under these categories pertain to weight-based discrimination in employment settings, and only a few cases have been successful. In addition, whether it is appropriate for obesity to be considered a “disability” under the ADA is questionable and could perpetuate bias further.

Overweight people who are not “morbidly obese,” but who experience weight discrimination cannot file claims under the ADA because they are not considered disabled under this law. It places an unfair burden for individuals to prove that their obesity is debilitating and disabling in order to obtain fair and equitable treatment in the workplace.

These unresolved issues, in addition to public perceptions that place blame on obese people, have led to inconsistent court rulings and often deter obese individuals from taking any legal action.

Clearly, legislation is badly needed to protect individuals from weight discrimination. Massachusetts recently introduced legislation (House Bill 1844) to prohibit weight-based discrimination in employment settings. The hearing was held on March 25th 2008, with no opposition present at the hearing, and all expert testimonies were in favor of the bill. No decision has yet been made, but if this bill passes, it will be an important step in encouraging other states to follow suit.

Reducing weight bias requires major shifts in societal attitudes, and national actions are needed to establish meaningful legislation to ensure that obese persons receive the equitable treatment they deserve.

This article first appeared on www.OAC.org. Reproduced with permission from Obesity Action Coalition. Please visit www.oac.org

The Surgical Specialists of Louisiana are committed to helping our patients achieve a healthy lifestyle and a healthy weight. Whether you are interested in weight loss surgery or medically supervised weight loss counseling, we can help you take control of your eating and your weight. Join us for a free seminar or take a weight loss quiz to help you get started.

About the Author:

Rebecca Puhl, PhD, is the Director of Research and Weight Stigma Initiatives at the Rudd Center for Food Policy and Obesity at Yale University. Dr. Puhl is responsible for coordinating research and policy efforts aimed at reducing weight bias.

References:

Puhl R, Brownell KD. (2001). Bias, discrimination, and obesity. Obesity Research, 9:788-805.

Puhl, R.M., Andreyeva, T., & Brownell, K.D (2008). Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. International Journal of Obesity. doi: 10.1038/ijo.2008.22

Andreyeva, T., Puhl, R.M., & Brownell, K.D (2008). Changes in Perceived Weight Discrimination Among Americans, 1995-1996 through 2004-2006. Obesity. oi:10.1038/oby.2008.35

Brownell, K.D., Puhl, R., Schwartz, M.B., Rudd, L. (Eds.) (2005). Weight Bias: Nature, Consequences, and Remedies. New York: Guilford Publications.

Body Image vs. Health Risk: What’s Your Motivation for Weight-Loss Surgery?

Friday, December 18th, 2009

By David Engstrom, PhD, ABPP, FAClinP

Self-EsteemBody image is loosely defined as a person’s perception of their own physical appearance, or the internal sense of how one’s body appears to others. Although it is a complex subject, research suggests:

1. Body image dissatisfaction is greater in women than in men.
2. A person’s body image is often dramatically different from the way their body actually appears to others.

There is no doubt that there is still a great deal of stigmatization and moralizing about obesity and excess weight in this society. Many scientific studies demonstrate this point. They show that people with excess weight, in comparison with their normal-weight counterparts, are often perceived as being:

  • “Less intelligent”
  • “Lonelier”
  • “Having less self-control”
  • “More lazy”

While these perceptions are often not true, they still persist and can have a marked effect. We have all heard remarks like, “she ought to just push herself away from the table,” or “he should get to the gym.”

To the outside world, the reasons people with morbid obesity seek bariatric surgery may be a mystery. The obvious reason might be to “look better” or to “feel better about their bodies.” The bottom line is that society still too often views this procedure as the “easy way out,” or a “quick fix” for lifelong problems.

Perceptions and Social Stigma

Although body image seems to develop naturally as we mature, there is probably a large part of our body image that is socially derived, from these real or imagined perceptions, judgments and comments of other people. When you add this social stigma to a person’s previous failure at dieting, already low self-esteem and poor body image, it is not difficult to imagine that the idea of significant weight loss through surgery is appealing for a number of reasons.

Despite the fact that a primary goal of bariatric surgery is to prevent, improve or cure medical health problems or co-morbidities, the psychosocial effects of the surgery are just as powerful and important. Several recent studies have reported dramatic positive changes in the body image of patients following weight loss surgery. So what really motivates people to seek this surgery in the first place?

Weight Loss Surgery Motivation

First, a few facts about motivation itself. There are four types, or sources, of motivation.

  • External motivation is often initiated by outside sources, like friends, family or doctors. “They made me do it.”
  • Guilt-driven motivation is, as one might expect, a result of trying to escape from negative feelings. “I would feel badly if I didn’t do it.”
  • Identified motivation is a result of wanting to be like, or identifying with, someone else who is doing the behavior in question.
  • Internal motivation is when the desire to change arises within the person. “I like doing it…it’s fun.” Studies that examined motivation to exercise or to lose weight have shown that the most enduring source of behavior change is internal motivation. That is, the more a person’s motivation comes from within, as opposed to some outside agent (e.g., doctor, spouse), the more likely it is that behavior change will continue.

It is clear that there are many sources for motivation, and they should be examined carefully, especially when the subject is weight-loss surgery. At our practice, we have examined the motivating factors for a group of 65 of patients who were seeking bariatric surgery. They were each asked about their primary motivating factors, including:

  • Health concerns, including medical co-morbidities
  • Improvements in self-esteem, including feelings of self-worth and enhanced body image
  • Increasing physical functioning, including better mobility and ability to accomplish physical tasks
  • Business or job advancement
  • Increased social attractiveness

They were asked to rank-order their reasons for seeking surgery, from 1 (most important) through 5 (least important). The results of this assessment are shown below.

What is your most important reason for seeking bariatric surgery?

Health Concerns                               62%
Increase Physical Functioning            11%
Improve Self-Esteem                         19%
Business or Job Advancement             5%
Social Attractiveness                          3%

One clear finding here is that health concerns far outweigh all other categories of motivation for bariatric surgery. These may represent either current or future concerns about physical health and well-being. When motivation to improve physical functioning is added to health concerns, the total for both represents nearly three quarters of all primary reasons.

Body Image and Self-Esteem

Although “body image” was not a separate category, it is assumed that this issue is incorporated into the categories of “improve self-esteem” and “social attractiveness.” Together, these two areas were primarily endorsed by 22 percent of the respondents.

People obviously choose to have bariatric surgery for many reasons, and these cannot easily be broken down into distinct categories. While our data suggests that health concerns are well in front of other reasons, there were secondary reasons, including body image, which play a part in their decision-making as well. Of equal importance is the person’s source of motivation. Be sure to examine yours, and make certain the decision is an internal one!

This article first appeared in the OAC News Vol.3/ Issue 4 July 2008.  Reproduced with permission from Obesity Action Coalition. Please visit www.oac.org