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Lexi was about to enter the lunchroom when she caught a glimpse of Carl, seated at the lunch table with a small cup of water and a baggie of vitamins and supplements. Though they'd been friends for a few years, she quickly darted into a hallway, realizing she'd rather have lunch alone. Ever since Carl's weight loss surgery six months before, he had begun spending the lunch hour barraging her with surgery horror stories, criticizing co-workers' eating habits and hammering her with fashion advice while she slumped in her chair, chewing and looking at her watch. On the rare occasion that he asked how she was doing, he didn't wait for a response before turning the subject to himself. She didn't understand what happened—he'd been a good friend before, someone whose company she could enjoy when work was tough. But these days, it was all about him.

Carl, like many people who have had a successful weight loss surgery, had a case of "entitlement attitude." Lynn Meinke, PhD, is a Professional Certified Coach (PCC) with experience as a nurse and psychotherapist who is based in Philadelphia. She currently serves as lead therapist on an eating disorders unit and describes entitlement attitude as a self-centered outlook. "It's about someone putting their rights ahead of everything else … it's like, ‘I've lost this weight, taken this decision, and now the world owes me a life. I'm entitled to this attention and I'm going to make up for lost time.'" Friends and loved ones, like Carl's friend Lexi, are often alienated by entitlement attitude, finding it obnoxious and repelling.

"The truth is that we're not entitled to anything," Meinke continues. "That's a lie and a perversion of reality." Can't survivors celebrate, taking their just desserts—even if they can't eat them? Don't post-ops have a right to shed their pasts along with their weight, beat their chests and roar, "Look at me now, world!"?

Dr. Meinke believes that the thrill of surviving is exciting and should not be skipped. Just don't expect other people to join you for long if your focus is only on yourself. It turns out surviving isn't the end of the road, after all. Next stop: thriving. Here's a model Meinke designed to illustrate this:

Victim
"I'm fat. I'm stupid. I'm ugly. My life is awful. It's not my fault. I'll never have the things I want. Nobody will ever love me or be attracted to me."

Survivor
"I've survived! I'm making up for lost time, and the world owes me for it! There are no rules, after all! Eat your heart out, everybody! I can do whatever I want! I'm high on life! Me, me, me!"

Thriver
"I'm grateful. I'm thankful. Everything I have is a gift. What can I do to refocus and enhance my life? How can I contribute to others? I'm listening! I'm motivated! I'm learning!"-Victim-Survivor-Thriver Model ©Lynn Meinke, 2008

When you look at this model, it's plain to see that the survivor phase is a time of celebration, but staying in it too long can be debilitating—you have to realize that as long as you're in the entitlement phase, you're not completely healed. Like a kid in a candy store, the entitled survivor grabs impulsively at everything she wants in life, gorging herself on what she feels she's been denied. Of course, she's soon sick to her stomach. "Mommy," she whines, "the candy made me sick."

"No," her mother corrects her gently. "Candy does not make you sick. Your eating too much of it is what made you sick.

Meinke likens the "thriver" phase to growing up. No longer an impulsive, childlike attention-grabber, the thriver has a more mature approach. A thriver says, "I'm taking care of my life. The world doesn't owe me what I want; I am the one who makes it happen. I'm going to design and create what I want, and I'm responsible for my choices." You're no longer getting what you want from someone else; as a thriver, you're all about achieving things for yourself.

When Meinke coaches people, she asks, "What do you want, and what are you willing to do to get it? And how does that affect the people you love?" Moving from surviving to thriving means taking the spotlight off yourself and shining it on others; you can listen to another weight loss surgery patient's story without having to tell them yours. In a support group you can refrain from telling somebody what to do because it worked for you and ask instead what would work for them. In Carl's case, he could ask Lexi how she was and listen to her response, even if it had nothing to do with him or his interests. "It's about bringing out the brilliance in someone else," Meinke explains. "We're not entitled to anything," she concludes. "But the good news is, we can pursue what we want and work toward it."