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So why don't you deserve to be thin?

Friday, May 15, 2015

I have a patient that I just love. She is the type that comes in on valentine's day wearing big a big cloth diaper pinned over her jeans and carrying a red bow with a heart shaped arrow. On St Patrick's day she came in dressed as a leprechaun. She is fun and spunky and smart - a retired registered trauma nurse - and FAT.
We started out talking about why as a nurse, she knew what health consequences she faced as being overweight. She knows what she needs to do to take the weight off. I gently brought up possible psychological blocks that can undermine a persons weight loss efforts.

When I first started working with overweight patients as a fitness and weight loss coach I used to start out asking why they wanted to lose weight and I found that most people gave the same pat answers: To be healthier, To have more energy, To fit cuter clothes, To fit clothes they already own, To look good at an upcoming wedding, class reunion, etc. I would try and motivate my patients using these "incites" only to find that it wasn't working and they ultimately ended up feeling frustrated and marginally thinner in time for their event.

I wised up and started wondering why despite my educational efforts, cheering efforts, and constant reminders of what's motivating them, they failed to reach their goals. I hit upon the "ah ha" moment when I asked a patient the blunt question: So if you KNOW what to do to lose weight and you're NOT doing it, what's keeping YOU fat?? Wow, I did not expect to uncover so many deep psychological roadblocks to weight loss. Some were especially tragic like childhood sexual abuse and their fear of looking "sexy" when they got thin or people who unconsciously undermined their weight loss as kind of a test for their spouse. "If he loves me despite me being fat, he must truly love me". I had to figure out how to help these people get past these emotional weight loss barriers and it often involved referring them to professional psychological counselors. But we had a starting point and once admitted and verbalized, these patients often were able to move forward and achieve success that many so desperately were denying themselves.

Back to my lively patient to whom I posed the same introductory question. She thought and thought. She was sent home with the assignment to think and think some more. Nope, she ultimately replied. No deep unseating of any emotionally traumatic history that hindered her efforts. Lazy? Nope. Perfectionist (like me) who had trouble admitting it called for do-overs if she veered off her strict diet plan? Nope.

I finally decided that it wasn't worth wasting our sessions to plumb for deep issues when maybe she actually was the exception to what I had become to think of as "the rule". It was as frustrating as the first year of my marriage when I kept trying to plumb deep emotions out my husband only to find that he was quite happy living emotionally shallow. His motto is why look for drama? It works for him...

So I moved on and asked my patient to keep a food diary for a week on paper and bring it in which is the usual next step in my weight loss curriculum. She cheerfully came in the next week wearing a purple wig and star shaped glasses and watched as I scrutinized her well kept diary.

Hmm... What's with the bowl of Lucky Charms cereal every night at 9 p.m.? "Oh, she replied, just one of my guilty little pleasures". And the lunch meal full of saturated fats and carbohydrates at Popeye's Chicken? "Yeah", she slowly replied dragging out the words, "Another one of my guilty little pleasures". The fries and chocolate shake at Steak and Shake? "Ditto" she said while starting to look embarrassed. I laughed as the light bulb went off in my head. Wow! How could I have missed it? This woman had more "guilty little pleasures" than Carters has little pills. A classic rebel. She lived her life and her RN career as a by the book, no nonsense, trauma nurse who dedicated her life to helping others. So what did she do just for herself?

She broke the rules. She rewarded herself with a "guilty little pleasure". She earned it, she deserved it.

The trouble is that her "guilty little pleasures" were wrecking her health. So I asked her point blank "Why don't you deserve to be thin?" Isn't good health a reward, not to mention more energy, cuter clothes, etc.? "Well", she sputtered. "Well I" she sputtered again. "I guess that I do!" she exclaimed. Because she DID want to be healthy and full of energy to keep up with her husband, grown kids, and grandkids. She didn't need to eat the wrong things as a reward for working hard all her life, helping others -- which she agreed was a reward in itself. The lives that she helped to save by following the book. She still had one life to save -- hers.

We began brainstorming "guilty little pleasures" that wouldn't undermine her weight loss efforts. One at a time she began changing these "guilty" pleasures and started substituting Not so guilty pleasures. A pedicure, a bowl of popcorn sprinkled with salt, a bubble bath with a small glass of white wine and a candle. She found that shaking these bad habits actually made her feel more rewarded by re-gaining some of the need to control that she thought had retired with her. (Yep, there is a little control freak after all in her murky emotional waters).

So -- why don't YOU deserve to be thin? What's keeping you fat? If you need some help picking those emotional scabs in your life check out the SP articles on motivation and emotional eating by clicking "articles and videos" on the tool bar and click again on "motivational articles". I spent an entire evening reading one article after another. Powerful stuff!

I'll leave you with a confession -- my "guilty little pleasure"? I never miss a season of watching "The Bachelor" or "The Bachelorette".

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  • no profile photo CD6913562
    1799 days ago
    What a super blog -- I "liked" it and hope it gets wide-spread readership. You're on to something really important here!
    2265 days ago
    A wonderfully clever re-frame to get folks to think about the purpose and / or needs their fat and / or fat-inducing habits are meeting.

    Thank you for sharing yet another gem of wisdom with us Joanne!

    2265 days ago
  • no profile photo CD4592528
    What wisdom God is giving you as you seek to help others! I'm so glad you shared. I've been allowing too many "guilty little pleasures" myself and yesterday was a turning point. I tried on some summer pants and knew there was no way I could sit at my desk all day in them. I talked with the guy at work who has decided to be kind and bring in fresh pastries each morning -- and told him it was like me being kind and inviting him to go drinking every night after work. (Funny thing is, this guy has been really changing his diet and has lost quite a bit of weight -- and has been consistent with gym time. For him, somehow one pastry in the morning is working ... but for me, 1/2 a pastry in the morning just gets me craving sugar all day! I even stayed away from the great big basket of goodies the high school sent over to thank us for letting them do 2 weeks of AP testing at church. Did a Wendy's salad for lunch.I MUST get myself back on track without the "guilty little pleasures"!! Your blogs and your encouragement have meant a lot to me over the years. Thanks for staying faithful to your goals and for encouraging us to do the same!!
    2266 days ago
  • no profile photo CD4114015
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    2266 days ago
    This blog is sensational! Thank you for taking the time to post it. You hit it right on the nail!
    2266 days ago
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