What my shrink said about weight regain

[Ann2]

My shrink works with a number of bariatric patients and has seen many people go through this process. Toward the end of yesterday's session, I asked: "What issues do you see patients struggling with who regain weight? And by that I don't mean that they're eating too much. I'm really asking what's going on inside them that leads them to regain?"

After thinking a moment, he said: "What I mostly see is that they're struggling to find new reasons and new motivations to focus on their weight and fitness.

"After they hit their goal weights, many of the rewards they got while losing weight go away. They're no longer motivated by seeing the scale move down. After a while, their family and friends get used to what they look like and stop commenting on their weight loss or weight. Even people who were their strongest supporters during the weight loss phase no longer offer supportive comments. And when this positive reinforcement disappears, that has a negative effect on the patients.

"So then they must find new goals and new motivations to maintain their weight and to be fit. And for some folks that's not easy."

So that's one shrink's brief observations about the cause of WLS patients' weight regain. However, I'm sure that's not the end of our conversation.

P.S. I'm not at maintenance yet; I've got 16 pounds until goal. But when I get there I'm definitely giving hubby a list of positive statements he has to say to me every week.

[suzn358]

You go Ann! Wow, you're losing so fast. That's fantastic. Almost to goal.

[PITSTOP]

Wow, I never thought about it that way but I can see how that can happen. Positive reinforcement is a powerful motivator and when that is taken away Im sure its hard to find something else as impactful to replace it with. I just started my journey so Im not even close to just "maintaning my weight" but this is great to know now so I can give myself a head start on mentally preparing myself to adapt and overcome some of those issues in the future. As always, thanks for sharing Ann.....

[GoPackGo]

Great info. Thanks!

[RehabNurse]

I have not been sleeved yet (surgery date is 2/2), so take my comments with a grain of salt.

I know that I am at a high risk of relapse (read: regain) because I've lost significant amounts of weight in the past through diet and exercise, yet still managed to regain all the weight plus more.

A former psychologist asked me, "Does depression run in your family?" I told her that I wouldn't know because my family members are not the types of people who avail themselves of mental healthcare.

She said, "Well, is there any family history of self-medication? I'm referring to problem drinking, substance abuse, pathological gambling, overeating and so on."

I told her that perhaps 75 percent of my adult family members have been addicted to drugs in the past, or are current users. Many people in my family are compulsive eaters. My own father used hard drugs for several years, then became a problem drinker, and now he's a compulsive gambler.

A light bulb came on. I realized I was eating to distract myself from emotional pains and past childhood traumas. I realized that my family members used drugs, drank to excess, or ate compulsively to numb their emotional pain.

I also realize I am at a higher risk for regain because 1) I've regained in the past, and 2) I have an unhealthy relationship with food.

I am also at a higher risk for addiction transfer. Many of the people in my life who had bariatric surgery can no longer eat massive amounts of food to numb their pain, so they've picked up another unproductive habit to numb their pain. Some people smoke cigarettes like choo-choo trains when they were previous nonsmokers. Some people become problem drinkers. One former coworker became addicted to sex at age 50. Others are compulsive shoppers who spend money they really do not have.

Anyhow, that's my take on weight regain. In addition, I have metabolic issues that leave me prone to easy regain. I'm hypothyroid and insulin-resistant.

[Joe Poppa]

Thanks Ann.

I love the irony of using the term for a psychologist, "shrink", regarding weight loss.

[BillyJ]

Addiction transfer is something I always think about. I never acquired a taste for alcohol or cigarettes and I after being cheated on in the past, I can not see myself doing that to someone else. So what else is there? As far as the positive motivation, I can see that as a reason for regaining. You lose the support and the accolades.

[groundedsteve]

Ann you bring up one of my biggest fears. How to avoid this as potential in the future is something I think of constantly. I've read these blogs for over a year and I am particularly interested in hose who are years out with their vsg and what have they done to maintain success. I think and hope that trading the emotional Buzz we got from food for the buzz we get from exercise is the answer. Because I know me and I will not do well without some sort of external validation in my life. Unfortunately I don't have a spouse to validate me, albeit with imposed lists, so I have to get it elsewhere. I do think we all represent a population of folks who need something and we have to fill it with something. It'd be great if it was just living life well but that probably won't be enough. So I'll run and lift weights and hopefully I'll know enough not to over do it. Besides exercise and other vices (alcohol ...etc) what are some ways to fill this need?

[Lee6Lee]

My shrink works with a number of bariatric patients and has seen many people go through this process. Toward the end of yesterday’s session, I asked: “What issues do you see patients struggling with who regain weight? And by that I don’t mean that ‘they’re eating too much’. I’m really asking what’s going on inside them that leads them to regain?”

After thinking a moment, he said: “What I mostly see is that they’re struggling to find new reasons and new motivations to focus on their weight and fitness.

"After they hit their goal weights, many of the rewards they got while losing weight go away. They’re no longer motivated by seeing the scale move down. After a while, their family and friends get used to what they look like and stop commenting on their weight loss or weight. Even people who were their strongest supporters during the weight loss phase no longer offer supportive comments. And when this positive reinforcement disappears, that has a negative effect on the patients.

“So then they must find new goals and new motivations to maintain their weight and to be fit. And for some folks that’s not easy.”

So that's one shrink’s brief observations about the cause of WLS patients' weight regain. However, I’m sure that's not the end of our conversation.

P.S. I’m not at maintenance yet; I’ve got 16 pounds until goal. But when I get there I’m definitely giving hubby a list of positive statements he has to say to me every week.

Thank you for sharing. What wonderful insights!

Just read through the comments. We ALL needed to hear this.

[sraebaer]

Not sure, I have been at goal since summer and still get compliments daily. People think I keep losing weight. The other day someone even asked if I had a personal stylist for my clothing. (No, I have the Kohls sale rack.)

At first the compliments are nice, after a while they make you feel like, "Wow, I must have been horribly FAT and gross!"

[Aquajog]

The person that I walk/ run with is a retired letter carrier . So from having to walk miles daily to being retired it was easy to start gaining weight.. To prevent this she walks/Runs daily . To keep herself and now me motivated , she signs up fora 5 K almost every month!
I have completed 4 and have Disney in Feb. It is a great motivator .Since I spent the money I will make myself get up and moving.

[MBL]

IMO At some point we need to ask ourselves WHY we need the comments of others in order for us to do the right thing and maintain our own health.

[JAG322]

Ann,
As always you've brought up excellent points. First let me say you've done fabulous loosing so well. Glad you're able to attain your goals in roughly 6 months. Those thoughts haunt me in the back of my mind...all the "what nows" then come the "what ifs"...sometimes it hard to keep the whole picture in view but I think if we all draw it out where we started to our goals and all the difficult times it took to get to goal it may keep it real for some of us. I guess what I'm saying is that if we're having a hard time with creating new goals we should keep in mind where we came from and not loose sight of how easy it may be for us to "slip"...idk...that's what keeps me focused...fear of what once was.
As always, thanks for all the help and things to ponder on.

[Terps]

Great question you asked your shrink and thank you sharing the response. I know several folks who have gained weight after losing with WLS. I think having some therapy at some point in the journey serves many of well.

[Lee6Lee]

IMO At some point we need to ask ourselves WHY we need the comments of others in order for us to do the right thing and maintain our own health.

I wish I'd thought of that one.