PB Ain't Just Peanut Butter Anymore

I met with my new therapist on Friday and I was really pleased with her. Of course the first time was spent catching her up on my past and what I'm trying to do now. She seemed very receptive to my Intuitive or Normal Eating goals and tackling the emotional issues behind my eating. Next time I plan on taking some of my literature in with me (mainly the Food and Feelings workbook and Karen's new book "Nice Girls Finish Fat") and show her what I'd like to focus on with her in sessions.

In the meantime, I have been taking a more serious look at the LAP-Band surgery. First I went to my local hospital/surgeon's web site and went over all of their extensive information about the surgery and what happens after in their program. Then I went exploring on the web and found some blogs by people who have had the surgery. Not "success" stories hand-picked by bariatric surgery offices that only say how wonderful it is, but uncensored, unfiltered accounts by real people.

I have to say I am not convinced to have the procedure done. I learned a new term today -- Productive Burp, or PB as it's abbreviated on all of these blogs. This occurs once the band is in place when you eat food too quickly or the piece is too big to fit through the opening, and it all comes flying back out. Somewhere I read a recommendation to carry plastic bags with you wherever you go to collect these PBs. Bloggers wrote about PBing into an empty bottle and horrifying their friends with what could also be called Projectile Barfing. This didn't sound very fun at all.

But do you want to know what caused the biggest reaction? When I read that I couldn't drink carbonated beverages any more. I love my seltzer water (flavored, but no sugar or artificial sweeteners), and I looked at that information with a huge amount of sadness. There was a list of other foods that could also cause problems -- fibrous foods, beef, peanut butter (hey, I could PB on PB!) among others -- which all added up to me feeling uneasy about the whole thing.

Is that petty? Am I missing out on something that might benefit me because some foods or beverages would have to be eliminated or greatly reduced? I never eat raw onions because they upset my stomach, but I don't feel bad about that, because it benefits me in the long run. Maybe I would eventually feel the same way about seltzer water and steak. I guess I just don't like those decisions being forced on me.

What bothered me the most, though, was the general feeling from these blogs that they couldn't lose weight fast enough, that the band wasn't limiting their food intake enough, and their doctors were in agreement with this. One blogger said the doctor told her she should only be able to eat half of a frozen diet dinner, which just sounded crazy to me. It just smacked of that extremist diet mentality that I've worked so hard to recover from these last few years.

If any of you know more about this, please let me know. I just know I feel great about the future as far as my therapy as involved, but very wary about the surgical route. I should probably listen to my intuition, right? Or am I just afraid of making a serious commitment?

Decision Time

Well, I survived Tuesday's appointment. I didn't lose a lot of weight since last month -- 2 pounds -- but I consider that a miracle after all the picnics, reunions, birthday dinner and cake, and don't forget the carnival!

It's also amazing when I consider that summer for me has been a disaster stress/food wise for the past several years. The screwed-up family schedule, some part of the house in construction/remodeling chaos, and a variety of other elements I won't mention here always seems to lead me in three possible outcomes: tears, anxiety or mindless eating. I had one such crying bout the other morning when I got overwhelmed by all of it and everyone involved. And while I did kind of let myself go on a free-for-all around my birthday (as most "normal" people do, I think), the majority of my month was really good as far as IE goes.

I am not a fan going to the doctor, which was proven scientifically over this past six months. When I first come in they take my blood pressure and it's always high because I'm so anxious and nervous, but by the end my doctor takes it again and it's always 10 points lower. But I believe having that monthly appointment really helped to keep me on track and accountable. And while I had that monthly supervision, it helped me stay on track and start to establish some new habits that I believe are starting to stick.

I will admit, after the appointment I went home and "splurged": I had two cookies for a snack, allowed myself some fried food for supper, and then in the evening had a small ice cream sundae. That's it. No bags of chips, boxes of cookies, or quarts of ice cream. Compared to even the beginning of the year, this was small in comparison to previous "splurges". And you know what? It didn't agree with me at all! All that rich food upset my stomach, and the next morning I was GLAD to get right back to my "regular" food. A major milestone!

I'm going to admit something here, which I've only told a few people. There was an ulterior motive/reason for these monthly visits. In January when I first went to the doctor he wanted me to consider getting the LAP Band surgery. A requirement to be approved for it is a documented six-month, doctor-supervised weight loss plan. This last visit was the six-month mark, so technically I'm done and I should now make a decision about the surgery.

The problem is I'm completely undecided. I have always and will continue to swear I will never have the gastric bypass. I think it's the mutilation of a well-functioning digestive system. It's way too dangerous and full of risks, not only with the surgery itself, but with the recovery and the long-term problems of malnutrition and loss of bone density. Yes, I know some people who have had success; I also know some people who had a horrible time in recovery, some who have managed to regain a lot of weight despite the surgery, and I have read of the deaths caused by it, too. I just don't see enough positives here for me to ever consider it.

The LAP Band, however, has never received full condemnation from me. It's less invasive, doesn't involve cutting, and rerouting parts of your body, and it seems to cause far fewer problems. But I'm still leery. It still involves inserting foreign objects into your body, and there are always some risks with that.

I admit that I'm wary of the whole process of it. Going to doctors, being evaluated, all the requirements they expect of you before and after the procedure. It feels to me like I'd be selling my soul to the Weight Loss Devil. I could be totally wrong with these impressions, but after a lifetime of doctors, weight loss experts, magazine articles and news reports telling me I HAVE to do this or MUST do that, I'm very gun-shy about being forced to someone else's "rules." I've worked so hard at this intuitive eating process; what if their rules don't coincide or are the complete opposite of what I've tried to accomplish?

But then I look at recent pictures of myself and bemoan the fact that I regained all this weight from my all-time adult low a few years ago. Even though it was still extremely far from our culture's current ideal, I wish I could have that body back and think I'd do just about anything do get it. But then I realize I can't go back on another diet full of "shoulds," deprivation and perfectionism, that it nearly made me snap before, and I'm afraid that's exactly what I'd find in the LAP Band experience.

Of course, I won't know for sure unless I go to the informational meeting and find out what it's really all about. But I keep procrastinating, worried that once I get there they'll give me the hard sell and I'll be pressured into it. However, I know I'm not that weak-willed that I'll allow myself to be talked into something I know I don't want to do. I need to quit procrastinating and letting indecision rule my life.

For now, I'm concentrating on IE, because it seems to be working. Maybe not as fast as weight loss surgery, but progress is progress no matter how small. And on Friday I finally have my first appointment with my new therapist. We had a very brief phone conversation last week, and I told her I'm interested in cognitive behavioral therapy. At the appointment I'll go into more detail, and I'm really hopeful that she'll be able to help me reinforce new beliefs and more productive behaviors that will turn this weight battle around for good.

Surviving the Fourth

In a cruel twist of fate, I was scheduled for my monthly check in/weigh-in with my doctor July 7 -- yes, right after Independence Day weekend. That meant dealing with not one but two picnics laden with greasy burgers and hot dogs, mayo-laden salads and dips, and don't forget the cookies, pies and other desserts.

At first I was filled with dread; then, as the weekend approached I dealt with a big case of anxiety and fear of failure. But I sat with those feelings and did my best to use the cognitive behavioral skills I've tried to pick up along the way. The old belief was that I HAD to do not eat anything, or else I was a failure, loser, etc. And since that was impossible, why not just go "whole hog," so to speak, eat everything in sight, and just go to the doctor on Tuesday feeling miserable, embarrassed, ashamed, etc. Instead, I thought to myself, "I PREFER to eat intuitively this weekend: eat when I'm hungry, eat food I like and eat it until I'm satisfied. If I slip up a little, whether it's eating when I'm not that hungry, or eating past the point of satisfaction, there is no shame in that and it doesn't change my worth as a person."

I think it helped that both picnics were not in my home. Not only did I not have all the stress of getting the house ready for company, but we only had to make a few things and we weren't left with a pile of food when everyone left.

The first picnic was at my uncle's house, and he lives 2.5 hours away. We went there for a change, since we rarely get to see this uncle, his wife, his four kids and their families. There was lots of catching up with each other and re-connecting, plus paying lots of attention to our two-year old cousin who always steals the show, so food wasn't the end-all be-all that day. I sampled everything I wanted to, sometimes only a tiny bite, but that was enough to keep the deprivation monster at bay. I did make an effort to make some healthy choices -- I skipped the bread on my burger, and when I had the urge for snacking, I focused on the fresh fruit and vegetables that were in great supply and tasted wonderful -- and when I wanted something not-so-healthy, I made the serving small and took lots of time savoring it.

I did have a moment that evening that could have led to disaster. My husband thinks it's an atrocity if we don't see fireworks up close and personal on the Fourth of July, so when we got home (at 9 p.m.) we went directly to the fireworks display in a nearby town to watch them with his parents, his brother and his wife. I didn't really want to go -- we had been on the road since 9 a.m. and I was feeling tired and drained. Not to mention the fact that I'm just not that crazy about fireworks. Sure, they can be beautiful, but my husband and his family aren't content unless they're sitting directly underneath them. For me, it's too loud, too bright, and fighting with the traffic when it's over is a nightmare. And that's exactly what happened. I spent most of the presentation with my fingers in my ears -- it was so loud you could feel the booming in your chest cavity -- and half the time shielding my eyes from the ultra-bright flashes. When it was over my mother-in-law asked me if I liked it, and I decided not to hold any punches, replying, "Honestly, I think I like them less and less every year." And to make the evening complete, we got stuck in a horrible traffic jam, and it took us at least 40 minutes to get home, when it normally only takes 10-12.

By the time we got home I was so put out with myself for being Miss Nice and agreeing to go when I really didn't want to that I found myself wanting to gobble down the cookies I had saved from the picnic. But I took that crucial moment to gauge my level of true hunger, and I realized I would only be eating out of anger and frustration, and what I really needed was sleep. So I did.

The next day came picnic #2, which I knew would be the hardest one to survive. This was at my brother- and sister-in-law's house, which has been an infamous location for some historic binge eating in the past. This was my husband's family's picnic, and they are well known for making five times as much food as we really need and all of it as unhealthy as possible, so there were plenty of overeating opportunities. And there really wasn't going to be anything else to do all day except sit around, talk and eat, which is always a dangerous situation for me.

Perhaps the success of the previous day carried over and gave me enough confidence in myself to stay the IE course. I stuck to the same game plan as picnic #1, except for some pre-planning on my part: I brought along a bunch of fresh fruit I had in my refrigerator and used that for my snacking. It was definitely a life saver, because otherwise I would have had very few healthy options. And because they were my favorites -- strawberries and blueberries -- I didn't feel deprived at all.

So, here we are on Tuesday, ready to walk into the doctor's office knowing I was successful in my attempts to be a normal eater. I wasn't a "perfect" eater, I didn't count a single calorie, but I used my wisdom and common sense and felt good about it. I can't guarantee I lost a lot of weight, but I'm sure I didn't gain any. And that's a huge accomplishment for me.

(Not) In Treatment

When I get a chance, I like to watch episodes of HBO's show In Treatment. I have to sneak this viewing in when my husband isn't around, because he doesn't really like the show and calls it "depressing." This makes sense because 1) he's never had a great opinion of psychotherapy and 2) the episodes can be depressing at times. Maybe because I've dealt with depression for the majority of my life I'm somehow drawn to it. Is it because I relate to it so well? I like watching people revealing their inner thoughts to an objective person and often discovering things about themselves they didn't realize before. Yes, it can be sad to see someone falling apart, but I much prefer that emotional/mental drama than some 10-minute fight scene. Which is why I in turn leave the room when my husband turns on a Steven Seagal movie. Gag!

Psychiatrists, psychologists and counselors have played a major role in my life: I just realized I've had more therapists than significant others! I've definitely gone through longer periods in my life without a boyfriend than I have without a therapist.

At the end of May my most recent counselor retired. I was supposed to be referred to another colleague in her office, but I've yet to get a phone call to schedule an appointment. Yes, I've made a phone call to check in, about a week ago. I left a message on the new referral's voice mail, but haven't gotten a reply. I think I may call the person in charge today or tomorrow and see if I can't get any further that way.

This was a tough time for me to go cold turkey. For the last four years summer have been a very chaotic, trying time for me, and I've had major issues with anxiety attacks and difficult bouts of depression over it. Therapy was crucial for me because it was precious "me" time, where I was the focus for once, and I could vent and troubleshoot problem areas in my life. And this summer is no different: yesterday I had a pretty significant melt-down that left me feeling like a fragile, cracked piece of china.

But you know what? Looking back on the day, I actually saw it as a small victory. Instead of shoving down the feelings I was having, which would normally come out later in anger, anxiety and depression, I just left those feelings fly and let myself experience the emotions I was experiencing (frustration, hurt, helplessness). Even better, I didn't go out and comfort myself with overeating after the fact, either. I did go food shopping, but I didn't think once about buying any kind of binge foods. I stocked up on salad fixin's for myself; healthy, energy-packed snacks for my daughter so she can re-fuel after gymnastics practice; and fresh veggies for last night's dinner. Last evening I did find myself attacking my housecleaning with some unusual fervor, but better that than a tub of ice cream!

While it would be nice to have a therapist to tell all of this to, I guess for now I've got enough tools in my mental arsenal to keep me going. However, I've got a lot more summer to tackle, and it would be nice to have that "corner man" (yes, I'm using boxing terminology!) to advise me.