"Nailing" Weight Loss

November Notes

As Abraham Maslow said in his essay The Psychology of Science "I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail."   Maslow first said this in 1966.  Not much has changed in the ensuing half-century.

The first Saturday of October I attended a Sleeve Gastrectomy course in Washington, DC.  The course was taught by five well known surgeons, all of whom have performed hundreds of Sleeve Gastrectomy procedures.  To hear them talk you would think that the Sleeve is the greatest weight loss operation ever invented.  While they acknowledged that there were occasionally complications and that they could be significant the predominant message was exuberance.  I heard from these surgeons that the Sleeve was magic.  Hmm….  Not so fast.

A week later, I attended a 2 day Lap-Band conference in NYC.  At this meeting, 20 high volume and successful Lap-Band surgeons met to discuss the current state of weight loss surgery and specifically the role of Lap-Band surgery in treating the scourge of morbid obesity.  One of the more interesting things to note was that at least two of the twenty surgeons were themselves Lap-Band patients.  When asked, most of the surgeons answered that a Lap-Band would be their procedure of choice for a morbidly obese friend or family member.  Hmm… Again.    And back to the hammer and nail we go.

Maslow’s broader point is that we make do with what we have, we strive to make progress and solve problems with our available tools, and that while this may be expedient and at times even prudent it runs the risk of missing greater opportunity and success.  Lap-Band surgeons do bands and Sleeve surgeons do sleeves.  Is one operation better than another? NO!  Is one operation the correct answer for all patients?  NO!  In our own lives, will one approach to weight loss work all of the time?  NO!  And more importantly, is the approach that we are taking the best one for us?

When we are “emotional” (sad, mad, hurt, insecure, stressed) we are a hammer and food is our “nail.”  We presume that our problems will be solved by eating and if not solved at least mitigated.  If only this were true.  It is the same mistake that alcoholics make when they hope that a “drink will make things better.”  It is the same false hope that a gambler clings to as he makes losing bet after losing bet. Enabling spouses and parents and friends make the same mistake when they repeat the same failed behaviors over and over again in the hopeless pursuit of a better outcome.

We must stop emotional eating.  It doesn’t work!  Whatever brief pleasure or respite from our misery that a cup cake, a french fry, or a dish of ice cream offers it will soon be outdone by the guilt, and shame and pounds that it adds to our condition.  We need to find a new way to deal with our emotions.  There is new path, a new direction and  we just need to find it and choose it.  We are all where we are because of the choices we make.  Just the other day I had a patient tell me “I NEED A FILL!”  “Why” I asked.  The answer “because last night I ate a whole bowl of mashed potatoes!”  To which I responded with a two part question “why, if you are trying to lose weight would you eat mashed potatoes and don’t you know that all the “fills” in the world won’t stop you from eating them?”  The patient’s reply “IT WAS AN ACCIDENT.”  Accidents happen on dark and icy roads.  They happen on slippery sidewalks.  ACCIDENTS DO NOT HAPPEN AT THE DINNER TABLE.  We eat what we buy and prepare and put on our plate.  We eat what we choose to eat.  There are absolutely no accidents when it comes to what we put in our mouths.

Last weekend, I took a two day intensive competitive pistol shooting class.  The instructors were all active or retired Police or Military.  As I and my classmates struggled to learn and master the required techniques our teachers would scream “FASTER, SAFER, FOCUS, ETC…..”  After several particularly grueling drills we were told “we don’t practice to ‘get it right’ we practice so we ‘can’t get it wrong.’”  Hmm…Obviously in some endeavors “failure is not an option.”  Weight loss for most of us is not a “life or death” proposition though it might be close and for some it truly is.  That said, there is no question in my mind that if we adopt an attitude of “practicing till we can’t get it wrong” that we will improve our weight loss and our weight maintenance. 

When we feel stressed we have to practice making better choices-food or otherwise.  We have to try new techniques, explore other options, think out of the box and by all means avoid “just pounding another nail.  We are facing a challenging stretch.  Thanksgiving, Christmas, New Years-it is a tough time to be losing or maintaining a healthy weight.  Temptation and stress abound but you can manage it, you can beat it.  You are not alone.  Come to Support Group-there are two every month.  Sign in to Adam’s Family our on-line Support Group.  Come to the office to check in with me or Julie or Marianne.  Have a Nutrition visit with Jane.  Come and talk to Dr. Newman.  We are all here for you-to support you, to encourage you, to help you on your journey.  You have MANY TOLLS IN YOUR TOOLBOX.  Use them!

Wishing you all a very happy, healthy and festive holiday season.  I look forward to seeing you soon.

Adam