Wednesday, June 1, 2011

Genie's Story: "Diet is a Four Letter Word!" Lap Band Series, Part II

For anyone who is overweight or obese, there are often emotional and psychological components that are overlooked or not understood by the medical profession which is always willing to treat the physical aspect of a disease. But the emotional and psychological components, even the spiritual well being of an individual who is battling weight gain must be dealt with, if there is to be significant success with losing and keeping weight off. Each individual story is different, so of course, doctors and researchers (who are used to painting with a broad brush and are taught to study apart from  in depth ethnography, with broad cohorts of data using statistical analysis, surveys and longitudinal studies) scrutinize only what they are looking for. Many times they miss the big picture, the forest for the trees, never mind the specific individual's case. That is not to decry the medical professions' and researchers' fabulous advances. It is to encourage our circumspection when dealing with medical issues like obesity.

My background in research is ethnography. I only can tell someone's story and experience through extensive, in-depth interviews. In that telling, I try to be as accurate as possible and read between the lines where necessary, always going back to the source for further review and information. In this series on Lap Band Surgery, you will read Genie's comments in the hope of better understanding one woman's struggles with obesity and morbid obesity, not for lack of will power or motivation to diet, often the easy assumption of reporters on the subject. "Oh, those obese people need to make more of an effort; they need to up their willpower." My dear folks. I WISH IT WERE THAT EASY. IF IT WERE, NO ONE IN THIS COUNTRY WOULD BE OBESE. So much for thin folks reporting on an extremely complicated subject they do NOT understand nor empathize with (To keep their jobs, broadcast journalists must remain uber attenuated for the cameras.).
I do not completely understand morbid obesity per se. But I do know that I can identify with Genie's situation because I do understand MY STORY of obesity and from that I know how to extrapolate to others who have battled the fats. Though I never made the decision to get Lap Band because I am sorely afraid of surgery and deathly afraid of going under anesthesia, I read recently that the weight threshold for Lap Band surgery has been lowered. Today I would qualify if I hadn't lost weight. Would I have opted for it? I don't know, given my fears. Should others opt for it? Genie thinks cosmetic appearance shouldn't be the reason to get Lap Band; disease complications should be the determining factor. I agree with her. But I only know what happened to me; I cannot speak for anyone else. And the only thing that moved me to lose weight was a dream that I would die if I didn't. I had come to the end of the road; there was no where else to go. Genie's situation was similar and it was vastly different from mine.


"Diet is a four letter word!" Losing weight is a psychological and emotional issue with me. Maybe it goes back to my mother and her wanting me to lose weight, despite what I wanted. She would ask me, "How much weight have you lost this week?" We would struggle around this issue and of course, I rebelled. The problem with diets for me is that they are temporary. I would get on a diet for an occasion or some reason and look forward to the time when I would be off the diet because it was so restrictive. And I didn't want a lifestyle of restriction. I didn't want to deal with, "You have to keep away from these foods for the rest of your life." It was more like, I will follow this diet, lose weight, then have what I want to eat when I'm over it. And after a while, after 10 or 20 or 30 pounds, then the diet protocol became nullifying and an emotional event or pressure or lack of familial support, or stress at work or some other trying issue or anxiety would set me to craving comfort and I would satisfy my emotional and psychological needs with comfort foods not on "the diet." This became habitual; it was why I gained weight in the first place and why I continued to gain and lose and gain weight again. The underlying factors, psychological and emotional issues always led me to sabotaging the diet that was depriving me from comforting myself. I can see that very clearly as I analyze my past behaviors.

So for me a diet represents the "can't haves." My mother instilled that in me: "You can't have that. It will make you fat." I resented her attitude toward me and it is what I don't like about diets; their selectivity and rejectiion of the foods that gave me comfort and emotional satiation. When it comes right down to it, the restriction is a metaphor for emotional and psychological restriction: of support, of love of kindness of forgiveness. Comfort food made me feel happy; it was a mood elevator. It was Genie taking care of herself, a coping strategy. So whether I have been conscious of this in the past or not, a diet worked the opposite of a coping strategy. I had to defeat the diet to return to my sense of well being. Selecting the foods I wanted to eat that were off the diet allowed me the opportunity to end feelings of emotional deprivation. Eating the caloric comfort foods quelled my anxieties. 

Additionally, my personality is such that I want to choose; I don't want the diet to choose. So inevitably, I would go off the diet, rebelling against the deprivation, bored and annoyed about the diet's control over my choices and frustrated that when I faced emotional turmoil, I couldn't receive the placation of food that I so needed. This is who I am; it is my personality. And every diet I tried ran counter to me. It didn't fit who I was and thus, I could eventually get around it, undermine it, manipulate it. My emotional underpinnings were more vocal and demanding than my vanity to subject myself to American cultural appearance standards which I resented for the hurtful, degrading and demeaning ostracism of individuals who are overweight.  So as I analyze my behaviors, I recognize that the diets I went on (not sure of the number, but many) did nothing for me emotionally and even exacerbated my sense of emptiness. Food made me happy. Being on a diet did not. And that's probably why I failed on diets again, and again and again. My failures made me depressed and miserable. And to forget my unhappiness, I went for my comfort foods gaining more weight. There was no end in sight. Then, I received the ultimate wake-up call. My health began to fail.

Yes, I want to be in authority and not under the control of an authority figure (the diet, my mom, etc.) The irony is that though the Lap Band "controls" me, the illusion is that I am taking authority over what foods I select to eat. This is the beauty of  Lap Band. First, I can eat everything since I am beyond the liquid stage. There are no food selection restrictions; only the portions are limited. Since I don't have diabetes, I can have ice cream if I choose. I can have snacks. I can have chocolate.

For someone like myself, this suits me better than artificially imposing a meal plan someone else made up because of carbs, calories, etc. I like various foods and I want to be able to eat them, albeit now in small bites and amounts. To measure, I use an eight ounce coffee cup and fill it, not to the brim, but in half. I have discovered that if I go over that portion and, like my mother prompted me, "finish everything on my plate because there are people starving in Africa," I become violently ill for hours. I throw up; I have stomach cramps; I feel completely unwell; I'm in pain and I'm unable to do anything about it or do anything period, until my stomach quiets down. But being this ill is good motivation for me because I know that it is my fault. I am responsible for this pain. I didn't feel the signals that I was full. Well, now my body is speaking for itself and letting me know, "Enough! Too much!" And if I ignore it, like I have done countless times before in my life, THIS TIME, I pay the price. I guess I am a slow learner. But my eating habits have been so ingrained that this is a training period for me. So, as I am retraining myself to eat just enough, the Lap Band is helping me do this.

The interesting thing is that the fallout has been positive. I have changed my eating selection habits. I am eating more healthily. I never ate veggies. Now, I'll eat a small salad and add toppings like chick peas and other vegetables which are diced and sometimes add diced chicken for protein. This really helps with my digestion and makes me feel better physically. My doctor has told me that I must not graze. I must eat slowly, but not so slowly that I am eating throughout the day "grazing." So I have one-half hour to finish my meal leisurely. Then I get up and move away from the table so I can recognize the "feeling full signs" and not continue to "feed."

So for me, Lap Band was the extreme intervention that I needed to succeed in losing weight. I was so tired of failing/ I had the will and determination, but I needed an intervention that would take me to a place of visible and tangible success. Most importantly, Lap Band was my decision, my choice. It fit my personality.

Genie's narrative is based upon phone interviews which she graciously and patiently provided, making time for me amidst her schedule of tasks (see last week). Once again, I'm grateful for her openness and honesty in sharing her story which we hope will benefit others who may be struggling with morbid obesity. Please click on comments below to wish Genie wellness and encouragement.


Carole Di Tosti said...

Thanks, again Genie.

Margo Dill said...

Genie, I think it is amazing that you are sharing your story and I think it will probably help other people!