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Doing Life Together

Doing Life Together

The Psychological Side of Weight Loss Surgery

posted by Linda Mintle

Lose it for lifeWhen Governor Chris Christie announced this week that he had weight loss surgery this past February, he made headlines. Christie has often talked about his weight, has been the brunt of late night jokes and seemed to roll with the punches. But Christie, like 220,000 other Americans decided to take action on his personal war on obesity. He had gastric banding surgery, a type of weight loss surgery in which a small band (ring) is placed over the top of the stomach and tightened in order to reduce food intake .

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When I read Christie’s reasons for the surgery, I was assured, having conduced pre-surgical psychological evaluations for weight loss surgery patients. The most important thing in terms of mental health is to have the surgery for the right reasons.

Surgical treatment for obesity is often recommended for patients whose obesity is refractory obesity or obesity-related medical conditions that pose serious health consequences. Surgical intervention is reserved for those with a BMI (body mass index) of 40 or greater, or a BMI between 30 and 40 with obesity related health conditions.

The two most used procedures are gastric bypass and gastric restriction. Surgery related death is less than 1% for low-risk patients, and less than 2% for high-risk patients for either procedure. The goal of surgery is to reduce the stomach reservoir so that a sense of fullness is gained from a smaller volume of food. Obviously with less food intake, weight loss occurs.

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Surgery can achieve maintainable losses of 40% to 60% of pre-surgery weight. But weight loss is a complicated psychological as well as physical feat. Unfortunately, the psychological state of a patient is not always considered when recommending this option. Increasingly, more surgeons are interested in psychological screenings for medically qualified patients.  Unfortunately, far too many surgeries are still performed without taking this necessary step.

Positive personality changes can accompany weight loss (Stunkard et al., 1986). Patients often report feeling less helpless, more stable, improved mood, etc. Other patients experience negative psychological post-operative changes (Loewig,1993).  It is unsound practice not to screen for possible negative effects.

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We know that those who have surgery for medical reasons do better than those who undergo surgery for psychosocial reasons. So we need to ask: What does weight loss mean to a patient? What are his/her expectations? Are there serious pre-operative psychological problems? Will weight loss negatively affect the person’s psychological functioning?

For example, those with severe psychological disturbance may see surgery as the end-all to their problems. When post surgery weight loss occurs and psychological disturbances remain, patients can dive into depression and other psychological disorders.

Some patients have used obesity to cover traumatic events such as sexual abuse. When pounds are dropped, they feel vulnerable and scared. If fear and anxiety were channeled through food and food is no longer available as a coping mechanism, problems can arise.

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Obese people who spend years fighting social discrimination, attacks on self-esteem, and rejection may view surgery as a way to gain an acceptable body.  When the physical body conforms to social expectation, the attention can be overwhelming and difficult to handle.

Furthermore, many obese patients do not know how to determine their internal emotional states. They often see all needs as hunger needs. Emotional based eating does not go away with surgical weight loss.

The key, then, is to screen patients for psychological issues prior to surgery and address those issues in an attempt to avoid negative long-term effects. It appears that those who do best with weight reduction via surgical treatment are those who are psychologically healthy.

 

 

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One Thing Tweens and Teens Want, But Should They?

posted by Linda Mintle

teen singingThey look at Justin Bieber and all his success and think, “I can do that. I can be discovered on You Tube too!”

So they post, upload, pin and tumblr– all in the hope of one thing–becoming famous!

That’s right, a third of teens and tweens surveyed say it is important for them to be famous.

And those kids who want to be famous use social networks. Social networks allow them to create their own image, manage and control it.

According to Temple University psychologist, Laurence Steinberg, social media allows teens to imitate what is like to be famous. He also thinks that adults play into this by posting videos and pictures of their kids on Facebook and You Tube.

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Add society, especially reality TV, where the goal is to be discovered and kids think, this is worthy to pursue.

But is this desire to be famous and self-promoting a good thing?

Generally speaking, NO.

First, how many kids will actually make it and are spending valuable time investing in possible fame? Remember those American Idol contestants who actually thought they had the talent to win? Their families and friends were right there encouraging them when they clearly had no talent for singing. Reality check! They were wasting their time on something that would never happen. So if talent and practice are involved in becoming famous, you have to have and do both.But so many teens think it just happens or overestimate their talent.

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The pathway to fame now includes:

1) Being arrested. How many shooters and bombers have had this goal in mind?

2) Being born in a wealthy family. Fame is based on entitlement, a problem we see among teens today.

3) Having outstanding physical beauty. Beauty eventually fades, and an emphasis leads to eating disorders and body image problems, both on the rise among teens.

4) Have an affair with someone famous. This is just wrong to begin with, much less getting famous for it.

5) Release a sex tape. I don’t have to explain!

6) Become a reality TV star like Teen Mom or Kate Gosselin who think this is a way of life.

Come on teens, how about goals like serving others, making a difference in the world, being a person of integrity, etc.?

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Fame is fleeting and self-serving. And have you noticed how few people handle fame well. Most self-destruct.

Time for a reality check on what is important. Fame doesn’t make the list!

 

 

 

 

 

Source: Yalda Uhis, researcher at UCLA’s Children’s Digital Media Center presentation at the Society for Research in Child Development (April, 21013)

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6 Signs of a Failing Relationship

posted by Linda Mintle

couple arguingKim and Mark were hopeless romantics when they fell in love. But lately, the marriage was faltering and both were considering divorce.

When they came to see me, I saw six signs of distress that told me things were not good. Check your marriage for these signs and get to a marital therapist now if these represent you.

1) Kim and Mark began every discussion with anger and criticism. The way a discussion begins predicts how it ends 96% of the time. If one partner uses a harsh start up (negative, accusatory, etc.), the marriage has a chance of failing.

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2) The couple was hardly talking. Both had checked out emotionally and erected a stone wall around their emotional lives. Negative interactions that contain criticism, contempt, defensiveness and stonewalling lead to divorce.

 

3) Mark continued to distance from Kim because he could not handle the negativity she constantly pointed out in the relationship. Being overwhelmed by the negativity of one person causes the other to become flooded by intense feelings of negativity and then to disengage emotionally.

 

4) Mark refused to talk and Kim pursued him even more, but neither was connecting. The physical body becomes overwhelmed and the person can’t maintain the discussion. Thus they opt out physically and emotionally.

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5) Kim tried many times to engage Mark and talk about problems but he had checked out emotionally. The partner’s attempts to repair conflict fail. 

 

6) When I asked them about their relationship, they had nothing positive to say. The past is recalled with a negative view.

 

So if your relationship is failing, don’t opt out, but look for these signs and get help.

We know how to repair marital difficulties.

Most couples divorce over fixable problems. And God wants you to take marriage seriously and honor the covenant.

 

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Could Your Kiss Be Toxic?

posted by Linda Mintle

lipsYou look at him across a crowded room, your eyes meet. You move towards him, and embrace.

He’s the love of your life and reaches down to kiss you.

WAIT….Stop the script. Could that kiss be toxic?

Yes, according to a study at the University of California-Berkeley’s School of Public Health.  They tested 32 brands of lipsticks and glosses and found lead, cadmium, chromium, aluminum and five other  metals, some that could be toxic! The concern is over the level of metals in the lipsticks/glosses. Some were toxic enough to pose health risks in the long run. The issue here is that users ingest and absorb the substances that have been tied to such risks as stomach tumors. The heavier user you are, the more of the toxic metals you ingest.

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The advice of the researchers. Don’t panic but use your lipstick sparingly.

I would also think twice about letting young children play with lipstick and use it as well.

The counter argument is that these metals occur nationally in our air, soil and water and impact our food. Toxicologist Linda Loretz says exposure from lip products is minimal compared to metals in food we ingest from our diet.

For me, now that I know, I’m going with bare lips more often!

 

Source: USA TODAY, Lipstick study opens up concerns about carcinogen, Health and Wellness, May 2, 2013

 

 

 

 

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