Supports Really Can Make A Difference!
By: Ranesa McNally, LCSW-CCategory: Weight Loss Surgery
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As a post-bariatric patient of four years and a licensed therapist, I have had the opportunity to witness first hand the impact of positive supports on the successful outcome of bariatric surgery for hundreds of patients. Initially, it appears most patients can identify natural supports preoperatively without difficulty. During the pre-operative evaluation, patients identify their doctors, significant others, family members, friends, co-workers and spiritual advisors as sources of support. Many patients have, or are scheduled to attend support groups, pre- and post-operatively as mandated by their chosen bariatric program. Some patients can even identify those persons who may be at risk for having a negative impact on their success through the process. It is recommended that many patients receive individual counseling to address emotional eating issues, or other mental health related issues prior to surgery, as well as attending support groups and nutritional counseling. Most patients follow through with the recommendations of their surgeons and nutritionists, and make the adjustments they can before surgery. All this is fine and dandy UNTIL… supports are no longer mandated, or suddenly some very supportive persons pre-operatively are suddenly not so supportive.
This is the time when seeking out other long-term supports is imperative. It is understandable that some people are uncomfortable in a group setting. It is also understandable that some people are very private and have difficulty sharing their personal struggles with strangers. Some people are embarrassed to express that their spouse, close family, friends, are being downright demeaning during a time when they are trying so desperately to build self-esteem, and try things they never would have dreamed prior to surgery. To be successful and motivated long-term, one must first be willing to ask for the support they need. This in itself can be extremely difficult, as the majority of bariatric patients I have encountered seem to be THE caregiver and are accustomed to being the one people come to for help, not the person asking for help. Initially, this may cause anxiety and stress in itself, at times causing people to fall back into emotional eating without recognizing that they are using food as a coping mechanism, and as a way to not deal with asking for the help they need.
Usually, once patients recognize why they are resorting to this behavior, or even beginning to think of eating as a way to cope, they seek help. This is very common and can be avoided by planning to continue with outside supports after surgery. Often issues of concern may not arise until a year, maybe two years post-surgery, when the issue of getting off those last 15- 20 pounds can be frustrating. Or, suddenly, some people realize they are gaining back a few pounds (PANIC). These are the times people need that support group or individual counselor for a reality check. The recognition that the surgery will not make mom, sibling, or supposed friend treat you with respect, save the marriage, or keep you thin forever with no effort inevitably sinks in. This is a scary and confusing time and keeping the support around you can help to ground you. If you initially attended support group with your bariatric program, and feel the group is too big, or is just not what you need at the time, research web sites set up specifically for bariatric patients in all stages. If you like the group concept but want a more intimate setting, lots of patients set up a group in their neighborhood or with a few other patients they have grown close to. For one on one attention, find an individual counselor who specializes in working with bariatric patients. There are many options available that were not so common even five years ago. The procedure has gotten much more attention, and the research is now consistently showing a pattern of higher rate of success for patients who use supports throughout their journey. This is an exciting time and while challenges may arise, know that you do not have to fight this battle alone, and you are not the only one to experience difficulty after bariatric weight loss. By allowing others to assist you, you will find you can give yourself permission to put yourself first, and be a stronger individual for having the courage to reach out and accept all life has to offer.
Ranesa McNally, LCSW-C is a WLS patient of four years and has been in private practice as an individual therapist in the Baltimore, Md. area since 2004. Ranesa conducts assessments and has provided individual counseling for WLS patients both pre- and post-surgery. She works closely with local Center For Excellence bariatric programs and is active in speaking at various support groups in the area.
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