Vanishing Velez

I know that one of my pre-operative requirements to qualify for a gastric sleeve is to complete a psychiatric evaluation. From what I can tell, this evaluation is mostly to make sure that you are not suicidal, are not in active psychosis/on antipsychotic medications, an do not have a substance abuse disorder. I am neither of those things, so I have a feeling that my evaluation is going to be a very transactional process.

I have had 3 friends get weight loss surgery in the past few years. I was talking to 2 of them recently, and both expressed to me that they were struggling with some of their weight loss because they did not get their relationships with food in order before having the surgery, so they never were able to address the emotional triggers with food. Since I believe that I only need one appointment with the psychiatrist to qualify, I decided to take my friends’ advice and speak with a therapist specifically about my relationship with food.

Now before I get started, I do want to clarify that I have been seeing a therapist pretty consistently for the last 4-5 years. However, when I brought up my thoughts regarding weight loss surgery to my regular therapist and requested assistance with my relationship with food, he suggested that I meet with somebody else in his practice. So that is what I will be discussing here.

---

So far I have had two meetings with this new therapist. I know that I said that I would update after every appointment, but the first appointment was really more of an intake, so I’m going to talk about both in one post.

My first appointment was pretty straightforward. She asked me about why I was interested in therapy. We talked about what I wanted to accomplish, how I thought she might be able to help me, etc. Then we did a bit of talking about why I was considering weight loss surgery and why I thought that therapy needed to be a part of that process.

I explained to her that I wanted to do this the right way. If I’m going to have weight loss surgery because I can’t get my weight under control, I don’t want to lose 100 lbs. and then start gaining it all back because I didn’t address the underlying issues.

We talked about how I have a tendency to mindlessly pick at food if it’s in front of me whether I am hungry or not. How I have a habit of getting minorly obsessed with a certain food for a while, and just want that all the time. For example, recently I’ve been obsessed with quesadillas. If I think that I’m hungry, that’s my go to food. It’s not like it’s because it’s a ‘safe’ food or anything like that-it just happens to be what I constantly default to.

At the end of our first session, she gave me homework. What she asked was that for 3 days she wanted me to keep a mini food log. Here is what she specifically asked for:

For roughly three days, with all meals and snacks, record the following:

-brief description of what was eaten (exact quantities are not necessary)

-time of day ingested

-hunger level before eating (1 is painfully stuffed, 2.5 is quite full but not painful, 3-3.5 is satisfyingly full, 5 is not full nor hungry, 6.5-7 is noticeably hungry but can still accomplish tasks at hand, 10 is distractingly ravenous)

-emotions or thoughts precipitating the snack or meal

-emotions or thoughts during the snack or meal

-satiety level after eating (1-10, same scale as above)

So I did.

This was a really interesting exercise, because I don’t think that I’ve ever really taken the time before to think about my thoughts or emotions about food. I guess that in my head food has always been pretty transactional. But realistically, that’s just not true. I definitely comfort eat, over eat, eat unhealthy things, etc. If food was really transactional, I doubt I would be in this position now.

So I gave her my thoughts at our second session, which happened yesterday. Here are my comments for the 3 days:

Add Text here from word doc at home

One of the things that we determined while going through these logs is that I really struggle with recognizing hunger cues-especially early ones. I have a tendency to eat on a schedule, and if that schedule does not exist, then I don’t always remember to eat. For example, if I’m home by myself, it might be 2pm before I get hungry–or I get hungry earlier, and then get distracted by something else and literally forget that I was hungry. I know, I know, you’re asking ‘how can you forget that you were hungry’. I expect that that is an ADHD thing. When I am focused on other activities, I sometimes stop paying attention to other things.

But because I eat on a schedule, I also regularly eat when I’m not hungry, because that is the only time I can eat. An easy solution to this is to get up earlier and eat breakfast before the baby gets up. This will make a much larger gap between breakfast and lunch. Another option is to just schedule my lunch later-but then it could be too close to dinner.

Anyways-

My homework for this week is to do a bodily check in every day. Here is my homework:

Write down once per day with no distractions for at least five minutes any and all bodily cues. Temperature, restlessness, pain, pressure, emotions, and where they show up in the body. What feelings arise for you in response to these sensations? Do more emotions arise for you when you acknowledge that you are feeling a certain emotion? 

When you notice you are craving something sweet or salty when you are full after a meal, try a warm herbal tea. Sweet options include the fruity teas like lemon or raspberry, and saltier/spicier options could include a ginger/turmeric tea with some electrolytes added. The ritual of preparing the tea the way you like it and mindfully enjoying it is usually much more emotionally satisfying than quickly consuming a sweet or salty prepackaged food.

If you can get around to it this week, here is a great beginner yoga video. Try to pay close attention to the breath cues the instructor gives and how they correlate to each movement. Excellent way to increase communication between body and mind.

So now, I’m in the process of buying a pack of electrolytes. She did recommend a brand, but I have not tried this brand yet, and do not want to put the name out there if it is not something that I endorse or at least have tried and can comment on. I also have not tried this yoga video, but I have done yoga before. I like that this one is only 10 minutes.

The reason she recommended yoga is because we are focusing on bodily awareness, so paying attention to how we move our bodies is a part of that. Also, with my ADHD, it can be difficult to just sit and meditate. I 100% agree with that.

I think that the check ins are a good idea because how can I track my hunger cues if I can’t acknowledge how my body is feeling.

For those who have had weight loss surgery, did you have therapy sessions outside of the required psych evaluation?