Maybe I Shouldn't, but I Did

I've been thinking a lot the last couple of days about a post from a blogger which was critical of one of my posts. If you have been reading my blog, you know the one. If not, please read it now.

I know I shouldn't worry about it. I know I didn't mean my post the way some people took it. I know this person probably only read the one day and has no idea who I really am. But, it just bothers me that there may be others out there that feel the same way about me. I just don't think it's fair to be judged on one post. I don't think it's fair to have all their readers judging me on what this person wrote ABOUT me and their interpretation of me and what I wrote.

I know part of this is that self doubt issue I was talking about earlier. I know part is the little fat girl in me wanting approval that worries about people not liking her. But, a lot of it is the physician in me that wants to make sure that the facts are not lost here. I really want people to understand why I posted that rant AND what it is really about.

It was not about trashing people who've had or will have or want to have or NEED to have WLS. What educated self-respecting physician would? What decent person would? It was not about trashing people who struggle with making the right choices. We all have. I have. That post was about pointing out the fallacies in the thought processes I was seeing in some blogs. Am STILL seeing. SOME were by WLS people, SOME weren't. There are some bloggers out there that I am just going to stop reading because they clearly don't get IT....yet. And that's ok. We've all been where we don't get IT or we wouldn't be obese. I hope they get it and soon. I wish everyone success here.

Hell, my job every single day is to try to make people feel better, live healthier. It goes against everything I am and stand for to try to stand in someone's way or make them fail or doubt themselves or be their "6 foot tall, buck-toothed, horror-film style bunny" that "jumped out from behind the bushes and just SWALLOWED ME (them) WHOLE." The fact that someone took my words which were really more about how I was feeling at the time than anything and turned them into some kind of attack just confuses me and frankly hurts my feelings.

My post, that rant, came out of frustration with this drive in me to help people who say they want help, but won't accept it. OR who won't even admit to themselves they need help. OR when given help and the tools, won't use them and help themselves. Do you have any idea how frustrating that is for me? Probably not. It is especially frustrating now that I've finally gotten IT. I see through all their excuses and rationalizing because I've used them all myself. I just want them to stop hurting themselves, that's all. I want them to understand. To be ready to change. To show them the light.

But you can't make them change. You can't MAKE someone get IT. I know this. I do. And I'm OK with people who aren't ready yet. I don't judge them. I'VE BEEN THEM!! It's the people that say they're ready to change, but when it gets down to the work part, you find out they don't mean it because they won't do the work.

And let me be clear, my statements about everyone needing to make healthy food choices (banded or not) and get regular exercise is not OPINION. Surely everyone knows that, right? I want to give you some information. This is medical information, not advice. Sometimes I worry about some of the stuff I read. Some of the things people say out here in bloggerville are just either wrong or misinformed. I'm not trying to hurt anyone. I'm not trying to win an argument. I just want to help. I'm not going to name names or call them out the way this other person did to me. Most of these things all go back to the fact that you have to work on the mental aspects of this journey to really be successful. I'm sorry, but you do.

Somewhere I read that one of the "banders" said their surgeon didn't even want her to diet because that's how she got to be 350 pounds in the first place. As a physician, I'm pretty used to patients having selective hearing. Sometimes people only hear what they want. (All married women know this already, btw.) This really worried me. I am 99% certain that no reputable surgeon would tell their patient not to worry about eating healthy foods. I am 99% certain that no bariatric surgeon would tell a patient they can eat whatever they want and as long as it is smaller portions, they'll lose weight. I am 100% certain that following a diet did not make someone 350 pounds. What makes someone gain that much weight is not being able to follow a diet long term. Not being able to say no to certain foods. Not exercising regularly.

I'm not judging that person or ANY person for being obese. I'm one of you. But the facts are these: You can't just eat whatever you want. You can't. I'm sorry. Not all the time anyway. Not even most of the time. Not even if it's just a little bit because you have a band. Why? Because it just isn't good for your body.

I am pretty darned sure that what that surgeon meant was that "diets" don't work, not that you shouldn't worry about what you are putting in your body. There was a lovely post today on that word. It's all about how you view your eating. I hope that surgeon was trying to get across the need for a change in ATTITUDE regarding food.

If your surgeon says don't worry about it, eat what you want or that with the band you can eat like a "normal person", find another surgeon. They aren't doing you any favors. What we think of as eating like a "normal person" is not necessarily the healthiest way of eating. I have plenty of skinny patients who eat like shit and end up with heart attacks.

If you have the band or not, eating things like cheeseburgers or french fries or cake or ice cream or bacon on a regular basis isn't good for you. It's not whether weight is an issue or not. Am I saying you can never ever have these foods? No. But they should be rare treats. Period. And banders who eat this way are not only endangering their weight loss, but their overall health. If all you can eat is a little bit and what you choose to eat is 1 McNugget, 4 fries and a 1/4 of a shake, you are hurting yourself. You might lose weight for a while because your overall calories are down. But these foods have no nutritional value, or at least very little. That leads to metabolic changes and changes in your brain chemistry. These changes slow your metabolism and make your brain send out signals that you want and need more of these bad foods. Over time it can cause nutritional deficits that lead to serious health issues.

This is not opinion. It is science. Telling me: I don't like veggies. I don't like fruit. I don't like fish. I don't have time to cook. I don't know how to eat healthy. I can't afford healthy foods. It's just hard for me to give up the things I like so much. Doesn't change the facts. If you want to be healthy and keep the weight off forever, you have to do eat healthy things.

And exercise.

It is not my opinion that exercise is necessary to long term health. It is scientifically proven. Having the band you may be able to lose weight for a while and let this slide because your intake is so reduced, but that doesn't make it OK. Multiple studies have shown cardiovascular benefit with reduction of incidence in heart attacks and stroke in patients who exercise regularly, with or without weight loss. The American Heart Association says that the level of exercise needed to see this benefit is at LEAST 20 minutes 3 times weekly. Here are specifics:
From the AHA:
Do moderately intense cardio 30 minutes a day, five days a week
Or
Do vigorously intense cardio 20 minutes a day, 3 days a week
And
Do eight to 10 strength-training exercises, eight to 12 repetitions of each exercise twice a week.

Moderate-intensity physical activity means working hard enough to raise your heart rate and break a sweat, yet still being able to carry on a conversation. It should be noted that to lose weight or maintain weight loss, 60 to 90 minutes of physical activity may be necessary. The 30-minute recommendation is for the average healthy adult to maintain health and reduce the risk for chronic disease.


This stuff is a culmination of many research studies. These guidelines are put together by some of the leading minds in science, the best physicians in the country.

So....if you want to lose weight and keep it off, you really really need to exercise. Band or no band. That may mean you have to turn off True blood or hey, how about instead of watching Biggest Loser, you turn the TV off and workout. Or even workout WHILE watching TV. I love TV. I don't want to miss my shows either. That's what TIVO is for. The fact is I've finally realized that I'll give up whatever it takes to see my grandkids grow up. Will you?

It's not ALL about the scale or what size I wear.

When I read on blogs things like: I can't afford a gym. My gym is too far away. It's too hot to exercise. My knees/back/joints hurt when I exercise. I don't like exercise. I'm just not athletic. I don't have time. I'm so tired when I get home from work. I can't exercise at home, I need my home to be my sanctuary. I don't want to get a treadmill or bike or whatever at home because I don't want to be one of those people who has one, but never uses it. I feel silly exercising. I'm too embarrassed to walk outside. I bought these new shaper shoes for running so when I start running it will be even better. I'm only going to exercise 2 times a week because I know that's all I'll do forever and I don't want to give up and just stop all together. I'll get started now that the kids are in school.

It just makes me nutso. I hear this all the time from patients. All. The. Time. Exercise is not easy. Sometimes it hurts. Sometimes it's no fun. But you need to do it. NO you HAVE to.
I stole this from my fellow MD over at Writing to Wellness...


I can't say it any plainer than that. This is now posted in my exam rooms at the office. I do not expect everyone to join a gym. I do not expect everyone to get a trainer. I do not expect everyone to lift weights or do push ups or 5Ks or DVDs or buy a Wii fit. I do expect everyone to move somehow. Yoga, walking, swimming, biking, zumba, dance naked to your favorite Billy Joel song. I don't care, but move EVERY DAY. It is absolutely necessary to your survival.

As I posted earlier, I've come a long way. I've got a long way to go. There is still self doubt at times. There are times when I falter. There are times I feel frustrated. But there are never times when I want to quit. There aren't times where I make excuses to myself or others. I hope not anyway. I personally need good examples and support from people who are doing IT. I feel sorry for people who don't get IT.

And my friends that are really making changes and trying and pushing themselves to be healthy, even when it's hard, even when they don't want to, I will be here for you to cheer you on in your successes and lift you up if you stumble. But, if you start down the road of denial and self-deception, I care enough about you to point it out. Even at the risk of making you mad. I expect the same from you.

Sorry this was so long. I feel better now. Good night.