Weight Loss Surgery - can you give me advice to speak to a relative who needs post-surgery counseling?




weebleswobble
10-28-2009, 04:46 PM
Hi...

My 60-65 yo step-MIL had bariatric surgery about 2 years ago. It was either a sudden decision or they waited to tell us until a week before the surgery. I don't know the details of weight or surgery.

My husband's family is very conflict-avoidant...many people in the family have passed away due to addiction issues (including my husband's mother) and nobody talks about it. The zinger is, they are are all mental health professionals and she waived the pre and post surgery counseling.

SHE LOOKED SO GOOD THIS SPRING. WOOOW.

The problem? She's now eating more than I am (I'm consistently losing weight on the south beach diet)...like, I was speechless as we ate dinner last week and I had a chicken breast & vegs and she had rolls and potatoes and dark meat and no vegs... and then, 2 hours later, she pulled out pretzels, and cut a brick of kraft cheese (is that a 8 oz brick?) the long way and ate it whole like a banana. The rest of us (5 people) ate a 2 pound box of strawberries and split a few sugarfree russell stover chocolates that she offered us (and she had a few of those as well). She's only 5' tall and can't fit into a size 16 jacket that is too big for me (and I'm 5'6 and 222).

My bottom line...this lady has been my husband's other mother for 25 years, he lost his mother 20 years ago, and if he loses this one (especially due to a destructive addiction) it will be really hard on him. And I know there's really nothing I can do to get her to change...

I am hoping that she will comment on my weight loss...it would be my one chance to say something to her about how easy compliance with the South Beach Diet is. Both she and my FIL are mental health practitioners. My husband and I are ministers, and they are not particularly 'religious' so it is a challenge for me to compel them to change their dysfunctions (believe it or not, this isn't their only one ;) .... )

any suggestions?


jiffypop
10-28-2009, 05:23 PM
wow. i am always amazed at the things people do and how they rationalize. and i'm ASTONISHED that her insurance company would allow her to waive the counseling. unless, of course, she's a self-pay.

but that still doesn't get to the problem here - and i hope you realize that, at some point, you might have to step away from her behavior.

some strange things happen with some folks who undergo WLS, especially those with addictions/compulsions. TV has made sure that we all know that some folks start sleeping around, others become compulsive shoppers, and still others crawl inside a liquor bottle. And quite a few return to their original drug of choice: FOOD,

but it's not really about the food - it's about the addiction - and doing south beach isn't going to resolve these issues [even though it's one of the healthiest options for folks who've had gastric bypass].

if only we could learn to substitute EXERCISE for some of this addictive eating and other behaviors - just think how much healthier we'd be!!!

So, IMO, the Q is how do you move an addict to change behavior, especially when they're in such denial?

the only thing i can suggest is seeing if there's something you can do with the STages of Change model - but if someone is in denial, i'm not sure what you can do.

A really good diabetes educator might be able to help - they have to retrain diabetics into changing their eating habits. and believe it or not, it's not about WHAT we eat, but more about HOW we eat - the amount of food we put in our mouths, the way we chew and swallow, how quickly we eat, etc etc etc. and all of this requires that we pay attention to the HOW and that we make every conscious effort to change it.

those folks who say that it takes 3 weeks to make a new habit haven't attempted to change a lifetime of eating habits!!! it takes longer, perhaps because eating and food have such emotional components.

these are just a few thoughts, weeble [LOVE the name!!!]. i hope someone else chimes in -

weebleswobble
10-28-2009, 05:47 PM
Things are just so strange at this house. For example, they often don't go to extended family functions because 'mom's' son lives with them (read: sponges off them and doesn't work and sorta goes to school once in a while although he is nearly 40 and has an associate's). If 'dad's' children express concern about the son's sponging or alcohol consumption, mom gets very defensive. Dad has problems with the permanent residency of the son but enables whatever mom wants to do, and mom wants son there, and mom wants son enabled.

When I invited them to Thanksgiving at my parents' home when I found out they had had dinner there just the 3 of them, she seemed offended, and said "We three are important enough to eat by ourselves."

and I was like, oooookay.

They do diabetes compliance counseling.

I wonder if I should just have a long conversation with them about how that works with diabetics...over the family dinner table and then turn it on her and ask "so do you work with people who have bariatric surgery, and how's that working for you, anyway"
I'm willing to throw myself under the bus, for the team....


kaplods
10-28-2009, 06:26 PM
You can't MAKE people choose healthy habits. If she's a mental health professionas, especially doing diabetes compliance counseling, she knows that her actions aren't meshing with the advice she would give her patients.

For many years, I worked in the mental health, substance abuse and law enforcement fields - giving people advice on how to make healthy choices (mentally, physically, socially and legally). I KNEW when I was giving advice that I wasn't myself following (even though my issue was food, not residential burglary or meth). I suspect that your SMIL KNOWS that she isn't following the advice she would give someone else.

So how do you get someone to take action when they know better?

I don't think there is an answer there. Say something if you want to and are prepared for possible negative consequences, but don't hold your breath for change.

ladybugnessa
10-28-2009, 07:31 PM
Sadly there is NOTHING you can do. They are adults. they make their own choices and if you speak up you will just alienate them more.

weebleswobble
10-28-2009, 09:42 PM
Yes, Nessa, Kaplod...I know I can't make her do it.

I don't need her/them to change. They live in another state, I don't depend on them. I do, however, need my husband to not go all soap opera-ish when she ends up doing whatever happens when her diabetes comes back and whatever other complications happen...

Well, what I did was send a note to my sister in law. She'll have a good perspective and an opinion. I appreciate your perspectives.

Not knowing what procedure she had (she doesn't reveal anything about herself) are the procedures reversible? Can she have another procedure on top of the first? I'm just mostly worried that she'll be out of luck.

Thanks!
Weeble. :)

[not speaking about y'all or MIL but I got morbidly obese because I had a horrible thing happen to me and I hated myself and wanted to die. Now that I realize that I was trying to kill myself every time I was eating, I approach food in a completely different manner, and I am stronger than the food. I am a minister and seminarian, and spend all my time working to make myself a better spiritual coach in other people's struggles...and I realized I was a really big hypocrite with the food thing. I'm sure we can agree that many people are at a basic level trying to fill some sort of basic need with food.]

kaplods
10-29-2009, 12:08 AM
I do, however, need my husband to not go all soap opera-ish when she ends up doing whatever happens when her diabetes comes back and whatever other complications happen...

This also is out of your control. If this woman has been a parent to your husband - he's going to grieve in whatever way he grieves, regardless of whether or not she "brought it on herself." You can't protect him from that.

It doesn't make a death or serious illness of a loved one any easier to bear because the person was complicit in their own situation. Love doesn't work that way.

I know you want to spare your husband the pain - but there's nothing you can do to keep him from being hurt, or from being as hurt as much or in whatever whay he's going to be.

You can tell him that you're concerned about his mother - and concerned about his reaction to any consequences she may face, but ultimately he has to come to terms with her issues mostly on his own. You can be there for him, but you can't prevent or probably even lessen the grief.

jiffypop
10-29-2009, 10:03 AM
aaaaah. the plot thickens! thanks for the additional info, weebles. my one suggestion for you is to work with your husband - rather than your SMIL. no matter what - if SMIL's diabetes returns, if she regains all her weight - the aging process is occurring, sadly, and her life will end at some point.

and, although she has some degree of control over the way it ends, and whether it's sooner or later, it's inevitable [please accept my apologies if i'm offending you - it's not my intention].

sooo, at some point, your husband will have to deal with her decline - and while we hope it's delayed as long as possible, it's still gonna happen. you have a much bigger role in how your husband prepares himself for this than you can possibly have for your SMIL's choices.

please let us know what your SIL says - we're all just shooting in the dark here.

and we understand COMPLETELY about using food for emotions and anything other than hunger. it's a struggle. and in order to be successful at ANY weight management plan, it's something we all have to deal with. even surgery.

you're always welcome around here!

weebleswobble
10-29-2009, 01:44 PM
Nope, Jif, Kap, I don't think you can speak too frankly--we're all here to bare our own souls and call a spade a spade. My husband and I spend all day watching families do the self-destructive "lemming" thing...and we've both identified that MIL is self-destroying. He knows (and has said as much) that WLS without counseling(for her) was a fruitless act and she is once again killing herself.

I think the difficult thing for me is that I have worked so hard to be spiritually and physically healthy...as has my husband and my sister in law and her partner (and our FIL with his own health issues but he has remained silent, he was literally once a silent monk)...and it's a very disappointing dynamic for the four of us to assemble at MIL's home and not only watch what has been going on, but also we are forced to be 'a little bit complicit' in the dysfunction for the time we are there.

Additionally, MIL is vocally critical of our pediatrician encouraged south beach based family health plan, she thinks we are denying her 12 yo granddaughter treats and being overly restrictive (my daughter has not gone through puberty, is 5' tall, weighs 150, is having a hard time finding clothes because she doesn't have a woman's figure but doesn't fit in girls' sizes. She's a pastor's kid and has 50 grandmas who are always offering her cake. Most importantly, SHE wants to not be fat, and wants us to help reinforce the healthy eating plan!!!) and will feed my DD whatever she wants when I'm not looking. This time, she "only" let her sneak extra sugar free chocolates, so my daughter complained about stomach pains on the 5 hr drive home...

I don't want to have a discussion with my daughter about grandma's bad decisions and destructive lifestyle, but at this point, I guess I need to explain to her that grandma is not offering her good things and is not a positive role model where food is concerned (because grandma talks about how she is and gives advice).

WLS (done right) must be absolutely terrifying. It is one thing to start a diet. If it doesn't work out, you can always stop and take a break and start again in a week or a month or a year. You don't have (much) debt or scar or recuperation from a diet. WLS isn't plastic surgery magic...it's hard work and a real risk....and once you've done it, you're committed.

They should have some sort of program for friends and family of WLS...how to be supportive, what to watch out for, danger signs, etc...so things don't get to this point.

You gals are wonderful role models. See ya on the skinny side.

:)
Weeble

weebleswobble
10-29-2009, 10:39 PM
So, SIL wrote back. it seems that according to the forms submitted to the insurance, counseling was performed. Coincidentally, the form submitted was signed by a counselor who is a long time buddy of my MIL/FIL. yeah, oops.

SIL has also tried to model good food habits rather than directly address MIL's issues. Perhaps next time we're there together we'll loudly compare recipes or gush about how great I look or how easy my weight loss has been (SIL just ran a marathon and got married, so last time we gushed about her).

jiffypop
10-30-2009, 10:25 AM
Great news, weeble!!! you have a partner in crime!!! and a strategy. and your daughter might be able to jump into it as well - asking questions and such while you're all together - about making good choices or whatever.

keep us posted!

weebleswobble
10-30-2009, 02:35 PM
I can see it now. Kid will sound like the child in the Advent/Seder reading. "Why DO we LIGHT this CANdle TOday AND onLY eat UN reFINED carBOhyDRATES?"