Psychology and Nutrition Evals

Jun 28, 2009

As part of my surgeon's pre-op education program, I've been required to attend two classes (nutrition orientation, which has already been covered, and a behavioral modification class, due 7/2). In the past week, I have seen both the nutritionist and psychologist on an individual basis.

I am continually impressed by the staff; I keep my expectations low when it comes to 'customer service', but I can say with confidence that when I am there for my appointments, I feel relaxed and then empowered on my way home. They are making my big decision very easy to put hope and faith into.

With the psychologist, I discussed my background and situation while growing up--quite a typical story. She was keen on my work schedule, which truthfully is out of the ordinary. I am an independent contractor specializing in art and design. I also offer copy writing and branding services. All of these things I do from wherever I please, able to connect with clients on an international scale. Since I have such an open schedule, I was able to take every appointment on the first available opening, enabling me to zip right through towards a surgery date. Explaining this was fun and exciting. I think she was intrigued.

We went on to my history of dieting and exercising, which as anyone could guess has been one failure after another. She sent me home with a very profound (at least to me) subject to contemplate; obesity is a physiological problem, not psychological. I have always thought the other way around. According to her, diets are money-hustling traps that cause people to work hard towards an inevitable failure. Supposing that a person has achieved their goals with satisfaction, as soon as the specific diet is deterred from or stopped, the body responds to this 'freedom' in a way that often reverses the entire effort. She emphasized the 'starvation' mode that the body enters into when diets (which involve restrictions of any kind, including calorie intake, low carb, low fat, etc) are implemented; the body will fight against this endeavor for every pound it can keep because it is inherently designed to recognize when a person's eating habits have changed.

She was quite to the point and left no real room for me (in the interest of time I'm sure) to really think it through aloud, but I understand that many diets are designed with bonafide interest in teaching a person to eat and live healthily. Obviously, calorie restriction and closely monitoring sugar and fat intake are the most important things. It is when a diet involves supplements and/or pills that then qualify it as a 'program' that sets people up for failure. Unless the person is comfortable with spending on these expensive products for the rest of their lives, as soon as they stop, the body begins to work as it only knows; it uses what it needs and stores what it doesn't. We can assume that a diet program's supplements make it easier to manage hunger or block certain things from absorbed or stored. Applying the psychologist's conclusion that diets do not and never will work seems logical. Our willpower can and will faulter (as it's only human); the way your body works is more or less out of your hands (no pun intended, ha).

This is how I analyzed her point. I feel that because her case is very convincing, that I am simply programmed by society's insistence on living 'thinly' before even considering simply living 'healthily'. The diets are always focused on empowering the mind before the body; the response to success is supposed to motivate you--but what about your body? Is it really working as triumphantly as you feel? No, you are the one with feelings. Your body is always the same; when you are feeling free to eat and do as you please, there are those times when excess is simply inevitable. There--that was her arugment--that what drives you can only do so much. You cannot train your body, only your mind.

So, do I want to rely on being rigid for the rest of my life? Fearing failure again, resulting in spending more money on supplements or restricting myself from variety? It exhausts me just thinking about it. It is impossible. I am too eager to live life without that burden.

I can't say I am still on the fence about this one; I am more convinced than ever now that I've written it down. The goal--my goal--after having this surgery, is to give my body a chance to work a little differently. Instead of fearing that an entire buttery roll will shove me right off the wagon if I break down and go for it, I would rather learn to recognize that the roll is too much anyway. I want to be able to look at something, healthy or not, and know exactly how much I am allowed. It is a mind-body synch that I am seeking through RNY--a way to achieve success and maintaining it because it will become 'natural' for my body to communicate effectively that the hunger is gone, so all that may be left is head hunger. By channeling head hunger towards other things--living an adventurous, active life for example--health and being thin are simply things that fall into place. I won't have to force it there and live in fear of losing it anymore.

I received a report in the mail yesterday, which is a two and a half page summary of what we talked about, how she feels about it, and why she thinks I am able to make an informed consent to surgery. I was never nervous about the potential to 'fail' this evaluation, but she wrote it in such a way that made me feel even stronger about my determination.

The nutrition evaluation was more or less a repeat of the orientation, which was conducted in a group setting. The fluid and protein intake cited in my literature (a binder full of research, paperwork, and information from the clinic) was adjusted to meet my needs (calculated from height). After that, it was a general review along with a cordial introduction. I got to know a little bit about her and she was able to give me advice and guidance according to what she learned about me.

There was a short quiz near the end of the appointment that I passed without any wrong answers. We reviewed each question. This is a 'forever' change; the repetition is a little tiring, but I understand and appreciate why it is required. I learn new things every day through internet research--I am very lucky and grateful to have a nutritionist here locally to go to with questions or concerns about this surgery. I feel that my time and money (I payed $500 for the program, and the insurance is taking care of the rest) is being spent to its fullest potential.

I will be starting the lab work next week, beginning with having my blood drawn. There are some X-rays and an upper endoscopy that I will have to get out of the way before I see the surgeon again to determine when to schedule the surgery date.

I am very confident that I have made the right decision for myself. I am becoming eager to mark the surgery date on my calendar.

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