Category Archives: Weight Management

Taking Cortisol Out of the Closet

Cortisol ImpactWhen I was a Master’s degree student, not much was mentioned about hormones. Sounds silly now because the counseling education now has become more integrated with neuroscience. Still, we overlook the impact of hormones in the psychological symptoms people experience.

Stress is a common experience that people report in a counseling session or a chat with friends. Stress does not discriminate. Age, race, gender, or job title. It’s still there. If we’re looking for Stress, we’ll find it hiding in plain sight among people with addiction, people worried about money, people who are away from family and feel homesick and people who are homeless with no one to help them. Students can’t concentrate, can’t remember because they are stressed. Old people too. It’s just different fear, but still they complain of forgetfulness and fear losing their mental abilities.

It doesn’t end there. There are thoughts that intrude, out of the blue. “Did I lock the door? Did I turn off the stove?” and “Does he/she still love me?”

There is no one “out there” asking these questions. We know that the brain is responsible for communicating with the body. So, when the brain senses external information from the environment, like having to take a test, it alerts the body about a perceived threat. This is good news, to some extent, because we need to get a boost of adrenaline, focus our attention, and get moving. Thoughts about the meaning of failing the test can create a life-or death belief about failing the test. This triggers the brain to send out signals to other bodily organs prompting the heart to speed up, the mouth to get dry, decrease hunger, dilate pupils, and the release of adrenaline or epinephrine.

If the nervous system is responsive, once the test has been taken and the student leaves the room, the nervous system slows down, heart rate returns to normal, pupils become normal and hunger returns.

But, what if something doesn’t work that way?  What if the stressor (the test, for example) is not present but the person reacts as if something is there?  What if we are living in a constant state of stress? Now, we get into the realm of learning more about the impact of thoughts, memory, imagination, beliefs, and perception. When a person experiences increased levels of stress, this translates to an increase of the stress hormone, Cortisol. This plays a major role is what comes to be known as Depression, Anxiety, Panic Attacks, Hives, Irritable Bowel Syndrome, Insomnia, Muscle Tenseness, Headaches, Teeth Grinding, and more. When we are stressed, our body automatically stops focusing on boosting our immune system against other things, digesting our food, or any other “non-necessary” processes in that moment, so it can focus on handling “the immediate threat”.

The good thing is we know more about this cycle. We understand the immune system is compromised by stress and people catch more colds and viruses and stay sick longer. We also know we need Cortisol. Like salt sprinkled on our food throughout the day, we need a sprinkling of Cortisol throughout the body and a lot of it when we need to act quickly.

More good news: we can lower the level of unhealthy Cortisol. Here are some tips but know this is not everything and your medical doctor should always be consulted when you try something new.

1) Exercise. The recommendation is 30 to 60 minutes per day. But, anything counts. Pick something that fits your needs and physical abilities. As with most things, moderation is a good motto. Your Cortisol level will increase during exercise (what?). However, cortisol levels begin to decrease once exercise is complete.

2) Mindfulness. There are so many books, research articles, videos that you can learn all you want to learn about mindfulness practice with just a little effort. Mindful practices decrease activity in the stress response pattern and promote feelings of relaxation, calm, renewal.

3) Breathwork. You may recall when you are stressed your breathing is altered. We hold our breaths, breath very shallow, and feel like we can’t take a deep breath. Breathwork is practicing and learning about the way breath can affect cortisol, thus reduce stress. Diaphragmatic breathing and many other breath exercises puts you in more control of how you function and how you feel.

4) Thought Patrol. Hans Selye is credited with being the professor who pioneered stress research. One of his quotes is worth writing here. “It’s not the stress that kills us, it is our reaction to it.”

Many therapeutic techniques, such as Cognitive Behavioral Theory, addresses the power of thoughts, particularly those that are crystal-ball thoughts or rooted in the past.

In summary, Cortisol exists for a reason, and it keeps us healthy and functioning well during life experiences. At the same time, it can get on the fast train and travel all over our bodies carrying the wrong messages or too many messages. If you learn about its role in your life, you can work toward helping yourself to have wellness instead of Stress.

If you’d like to work with me in therapy or coaching to work on the mental aspects of weight loss and stress management, I’d love to hear from you. We can talk it over and decide the best way forward. Questions? Email me at patriciabrawley@earthlink.net.

BARIATRIC SURGERY – THE UGLY SIDE THAT NO ONE TALKS ABOUT

videoblocks-young-woman-looking-at-her-mirror-reflection-with-disgust-ashamed-of-fat-body_rvhbqgrcx_thumbnail-small01I am noticing more and more that weight loss surgery as a solution for obesity is all the rage. It used to be that only people severely obese (on the verge of death due to major health complications and no ability to exercise anymore) would have Bariatric surgery performed to save their life. Its original purpose was to help save lives of those who were struggling severely and had no other options.

Today, there are young people and relatively healthy people having this operation and they sometimes weigh in at 250 or less pounds.

While these operations can be a really good option for folks who really need it, they should not be used as an easy way out of weight loss for healthy people who still have the ability to exercise and diet and lose weight using other tools.

What people do not realize is that there may be major psychological, social, and spiritual affects (depending on your own belief systems).

In the United States, we’ve developed a system of psychological evaluation to address the reasons why someone is having the surgery and test their mental competence, but it can be difficult to impossible to predict what will happen to a person following the operation. The body is not the same as it was before. Drastic physical and emotional changes occur within the body following Bariatric surgery.

Patients have to be extremely disciplined and militant in their self-care following these operations to just live a relatively normal life. The reason is there are going to be vitamin deficiencies and limitations in the body that were not previously there. That means they have to have regular vitamin injections and eat several times a day with extremely small portions among other things like further psychological evaluation and support after the operation. They may be told that they cannot exert themselves like they used to because they could deplete the small amount of water or vitamins they ingest in the small portions they are now forced to live with.

Most patients who decide to go through with the operation may say they are committed to all of this, but are they?

Let’s think realistically. We have busy lives and live in a society that is constantly busy and offers limited time for breaks at work or even at home. This makes it very challenging to stay on top of special diets and other practices that are suddenly part of life post op. And, if someone didn’t do a good job of disciplined dieting and exercise before the operation, it’s not likely they will follow a stringent plan after surgery either, and not doing so could cause major damage to the body and even become fatal.

People who choose to do these operations are choosing to give themselves a health condition with life-long consequences, and they need to be aware of that.

There are hormonal changes related to vitamin deficiencies that could even push people into old age.

There can be profound psychological impacts, some of which are still unknown.

What does the mother with 3 kids do when she has run out of energy and can’t keep up with her kids because she can’t consume enough nutrients?

Further, some people are traveling to other countries to have these operations performed for less money, but the healthcare is not as good and the pre and post op activities are not nearly as stringent as they are in the U.S. They cannot be held liable if they cut too much away or do something that causes a major internal infection in the stomach.

Let’s also take a step back and think about what happens physically, emotionally, and spiritually as well.

To put this into perspective, we have a second brain in our gut. Our gut brain is directly connected to our real brain via the Vagus nerve that runs through the body. When we are excited, scared, angry, nervous, in love, or making major decisions, we always feel it in our gut, right? When our bodies go into fight or flight mode to protect us, we release adrenaline that is felt in the gut. So, what happens when we cut away 80% of our guts, which is the system our body was designed with to process nutrition AND emotion?

Patients simply may not have the capacity to have the stamina or health level they were able to achieve prior to the bypass.

It’s no surprise that losing tons of weight in a rapid amount of time would have a psychological impact on patients. However, it isn’t known how deep that rabbit hole can go. We do not have all the stats we need yet, and there are variables involved as well, so information is not being publicized enough. Medical information around these procedures is in its infancy.

That said, it has been known for years that stomach surgery for obesity frequently has long-term neuropsychiatric effects including Wernicke’s and other encephalopathies (Neurology 1987;37 196-200), depression and substitute addiction.

In the relatively small number of cases I’ve observed, there were instances of stomach infections and other stomach and digestion-related health issues on top of deficiencies. This even resulted in death for some.

The body simply cannot operate the way it did before in many cases. This makes logical sense, as the amount of water that can be ingested by a human who hasn’t had this operation is drastically reduced after because of the size of the stomach. So, people have to choose to eat or drink and have expressed that they are either hungry or thirsty most of the time. This means nutrients is not handled the same way it used to be and that can cause the immune system to have to work harder as well.

Please understand that I am not judging. If you’ve had this operation or your loved one has, please don’t be angry with me. This operation has saved lives of people who would have died from high cholesterol, high blood pressure, and a number of other heart and health complications. I get that.

All I am saying is people need to consider choosing surgery ONLY when they absolutely need to have it and not as a means to lose weight faster or look more beautiful or handsome. Doing that is like burning the whole house down because it’s a mess. There are many options out there for weight loss, which include dealing with the emotional component of eating as well.

I have a short course about dealing with emotional eating, which you can find HERE.

There is still MUCH more work to be done in researching and documenting long-term effects of weight loss surgery. Below are some links to articles on the subject.

(Current Opinion in Psychiatry: September 2014 – Volume 27 – Issue 5 – p 374–379),
(https://www.psychologytoday.com/us/blog/the-truth-about-exercise-addiction/201611/the-mental-health-struggles-weight-loss-surgery)

self-harm (https://www.medscape.org/viewarticle/894158https://www.health.harvard.edu/newsletter_article/Psychological_aspects_of_bariatric_surgery), new-onset mania (Psychiatry Investig. 2015 Jan; 12(1): 152–154.),

and vitamin B1 and B12 deficiencies
(https://jamanetwork.com/journals/jamaneurology/fullarticle/786290).

**This article should not be used to treat or diagnose any condition related to bariatric surgery. This is written from one perspective based on observation and personal opinion as well as some research. You should seek medical advice from your doctor if you are considering this type of operation.

A Parable about a Hidden Force that May Be Keeping You Stuck

The sisters, Regret and Guilt, look a lot alike but they are very different.

When Regret makes a mistake she cries, “Oh, I wish I hadn’t done that!” or “Why did I do that?” or “I’m never doing that again!”

But when Guilt makes a mistake she yells, “You idiot, you blew it again!” or “You are such a loser-what’s the matter with you?” or “You might as well give up; you’re never going to get it right.”

Regret makes mistakes all the time. She figures that everybody does, especially when they’re learning something new. Regret doesn’t even really seem to mind making mistakes because she always learns something that helps her do things a little differently the next time. She even laughs at herself and shares her mistakes with others so they’ll learn too. She doesn’t care that other people sometimes do things better-but she wants to be the best she can be so she never gives up trying.

Of course, Guilt makes mistakes too but she blames herself because she believes she should know better. Instead of helping her learn, her mistakes just prove that she is a bad person and that something is wrong with her. She is often angry with herself and sometimes other people. Secretly, she feels unloved and unworthy so with every mistake she resolves to do things perfectly the next time to prove to everyone else that she is good enough.

One day, Regret and Guilt agreed that it was time to make some lifestyle changes. Regret regretted that her energy level was low and she wasn’t able to do all of the things she wanted. Guilt felt bad too-guilty that she was “too fat and lazy.”

Regret. . . messed up, then made a plan.

Like most people, Regret had been on dozens of diets and knew they just didn’t work for her. She decided that this time she would make small changes to the way she ate. She started by paying more attention to her hunger and fullness cues. It sounded simple enough but it wasn’t as easy as she thought, especially when someone brought donuts to the office. After two days of eating donuts mid-morning, she realized she needed to make a plan. She gave herself extra time in the morning to have breakfast and pack lunch. She also made a list of other things she could do when the donuts were calling her. She continually tweaked her plan to figure out what worked the best and congratulated herself on her small successes.

A few days into it, she had a really stressful day at work and was thrilled when she remembered that it was her co-worker’s birthday because that meant cake! She wasn’t hungry but had a piece of the delicious chocolate cake while she celebrated with her friend…then went back for another piece after everyone else returned to their desks. Within an hour she noticed she felt tired and a little sick-but still stressed out. Regret regretted her decision to have the second piece of cake-but not the first! She decided that next time she felt stressed she would take a short walk instead of going back for more.

Guilt. . . disaster struck!

Guilt liked the idea of using hunger and fullness too-but she had failed on so many diets that she doubted she would do any better with this approach. She told herself that this was her last chance to get it right so every time she felt like eating she made sure she was hungry first. She felt great because she was doing it perfectly! After a week of only eating when she was hungry, disaster struck. She had already eaten most of her lunch at her desk when her boss showed up with cake to celebrate Secretary’s Day. She had a piece even though she wasn’t hungry. Within a few minutes she was berating herself for her terrible mistake, knowing that she had failed at this too. She gave up and went back for a second piece. She felt so bad about herself that she picked up a pizza and ice cream on the way home. After all, she couldn’t even get this right so what was the point?

Although Guilt was well intentioned, her unrealistic expectations and the shame and blame she heaped on herself were preventing her from learning, improving, and forgiving herself when she made choices that didn’t work out well. She even felt guilty for feeling guilty!

Perfection is not possible–or necessary.

She finally asked her sister for help. Regret explained that while there’s always room for improvement, toddlers fall down many times before becoming proficient at walking. They may cry but they don’t feel ashamed. Instead they get up, make adjustments, and try again. Her favorite words of wisdom:   Perfection is not possible–or necessary. When you make a mistake, don’t miss the lesson. Small changes slowly add up to big changes.

*This article was originally written by Dr. Michelle May, M.D. founder of “Am I hungry.” This information does not take the place of medical treatment

21 Weight Loss Mistakes

This article is about the mistakes people make when they’re trying to lose weight. Many of them I have made myself.

You know what they say, “Learn from your mistakes.”. Better yet, learn from others’ mistakes. Here they are.

1.) Not starting is the first mistake people make. How many excuses do we make? Ugh!

2.) Stopping too soon after starting the weight loss journey. People give up too early. They will try one thing and give up. Be willing to try different things.

3.) We are not machines and a one-size-fit all approach is usually not going to work. You are unique. You will need your own unique way to accomplish your goal. Maybe you can eat the packaged weight loss meals and go on your merry way while others need to eat more (or less, even!) or drink more water or… – you get the point.

4.) This mistake builds on #3. It’s fine to start out on a name-brand program but, as soon as you can, switch to your own program. Maybe you like the entrees but you have a better idea for breakfasts or snacks. You have not failed with their program. You can measure the effectiveness of your choices.

5.) Not having a schedule. irregular eating, skipping meals, and watching food one day and not the others, make it harder for you to meet your goal. Start with one day of regular meals composed of healthy foods and then do that the next day. Baby steps.

6.) Apologizing to oops! days. Don’t. If you ate the cake, you ate the cake. It’s okay. Start over. It’s not the end of the world. You do not owe anyone an apology for your choices. Of course, we are hoping you continue to make good choices for yourself!

7.) Do you worry about what others want to eat? Don’t. Focus on what you need to eat today. If you have children who love fast food , indulge them once a week. Pay attention to what your body needs to feel healthy and achieve an ideal weight. Your intuition is highly appreciated for this.

8.) Don’t clutter up your kitchen with every cookbook, gizmo, blender and tool you see for sale. If you can’t estimate what a serving is, use guidelines like “a deck of cards” or use a food scale or measuring cup. These are already in your kitchen.

9.) When you slap foods together without much thought or interest, you will lose interest in the process. Learn to enjoy the process of putting nutritional meals together for yourself. Give your favorites a name, like you see on the restaurant menu selections or in cookbooks. It’s not oil and vinegar, it’s “Susie Que Yummy Tummy Shrinker salad dressing” for example.

10.) If your goal to lose weight is vague and your time to do it is soon, your brain doesn’t really get hooked on the idea of change. Write down your goal(s), Then write down what you will do by when. For example, “By next Sunday, I will have exercised 7 times.”.

11.) Don’t pay others to do it for you. It may be tempting to sign up for the saran-wrap lose weight program that promises to shed a quick 10 pounds for you. Do you really want to do this? I hear you. You’re thinking yes, but I’m here to remind you that, in the end, you have to do it yourself for you!

12.) Having too many goals can be overwhelming. Pare down your goals to groups — get healthy, earn more money. Break each goal into doable chunks and write down what you’ll do by when as noted in #10 of this list.

13.) Even introverts need a support group. Don’t think you have to do everything alone. However, don’t spend any time around people who don’t support you and your goals. Find friends or neighbors in your community or social groups that are like-minded.

14.) Don’t go on weird food diets. Choose foods that are normal but better. Chicken does not have to be fried to be enjoyed.

15.) Don’t believe everything you read about weight loss. Choose what is useful to you.

16.) Don’t try to impress others with foods that make them look at you funny. Shop and prepare wonderful meals that humans eat.

17.) How many times are you on the scales? Once a day is enough and some people weigh once a week. You do want to keep track but you do not want to be constantly weighing yourself and you definitely don’t want to compare your weight to others. Nope, don’t do it.

18.) Don’t be a meanie if a friend loses weight before you do. Personal attacks are not attractive on anyone. If anything, ask questions about what worked for them? We can all tweak little things for big success.

19.) Do you know why you want to lose weight? Really? I should have asked if you know why you want to make a lifestyle change. It’s like saving money. If I don’t have an idea of what I would like to do with that money, I’m not likely to save as much. But, if I know I can go on vacation with that money, hey… give me that quarter. Remind yourself of all the benefits you will have from this journey.

20.) Are you scales stuck or is your creativity on hold? There are many ways to get this process started and put behaviors in place that help you meet your goals. Don’t be a copycat if it’s not working for you.

and

21.) Nobody likes a know-it-all. If you are successful, celebrate! But, don’t become the kind of person on a mission to tell the rest of us how we should do what you did. Help us. Teach us. Challenge us. Support us. That will make people want to know what you know.

The Last Spoonful Of Jam – To Eat Or Not To Eat

I’m not young or skinny, although I’ve been both.

I know the month and year when I gained weight and the most I’d ever weighed. I can tell you the outside story of why that happened but, for the life of me, I can’t tell you why those pounds stayed around after the traumatic event passed. Oh, they play hide-and-seek but I always find them. Or, do they find me? It doesn’t matter.

I’m now trying to get to the root of this problem and figure out what type of eater I have become. I figure that will help create meaningful goals and plans for change. No need to plan to stop eating bread if I don’t eat bread anyway. No need to add more cardio if I’m already doing in hour a day. Get my drift? It goes deeper.

Morning breakfast gave me a good test. I like a spoonful of jelly / jam with my toast. I don’t eat that every morning but it was toast morning and I had the peach jam jar in my hand spooning out the last of the jam. I had enough for the toast, but there was about one spoonful left in the jar. Suddenly, I felt like I was in the crosswalk of New York traffic and didn’t know which way to go. Should I eat the spoonful or throw the jar away with the spoonful in it? The jam didn’t have a smidgen of peach in it, it was purely sugar that I didn’t need. Then, there’s my husband’s habit of retrieving jars from the trash and surely he would scold me for throwing away food.

Well, I ate it. Then, the analysis came. I wanted to get to the bottom of it (pun intended) :) Was this the lesson of childhood of “clean your plate”? Greed? Waste not want not? The “Mikey Will Eat It” habit of eating leftovers whether they were good or not?

It was certainly not unconscious eating or eating from starvation, although you might have wondered the way I wolfed it down. Maybe it was eating before anyone could see me. Am I a Secret Eater like some folks are secret drinkers?

This is turning into a mystery game.

My question to you — Would you have eaten the last spoonful or not? Why?

If you aren’t sure, maybe my food personality quiz will help you decide. Sign up at the following link and download and print it free. It gets to the heart of your emotional eating triggers. Click on the button below, enter your name and e-mail address and get instant access to the food personality quiz. Check it out. You may never look at weight management the same!

Please let me know. I may be the only person who would!

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