Fat chance

Fat chance

Losing hundreds of pounds is possible, but only with the right mindset and support system

By Patti Carmalt-Vener 01/30/2014

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Dear Patti,
Where do I start? I’m 29, weigh more than 500 pounds, am 5 feet 9 inches tall, and am currently not a candidate for gastric bypass surgery. 

My mother died from obesity complications when I was a baby. When I was 6 my father left me with my grandparents, who loved me, but both died when I was a teenager. My only family is my half-brother; he cares but is emotionally exhausted taking care of me and has started visiting less frequently. He’s frustrated I haven’t lost weight and I don’t blame him. I’m okay financially and own three apartment buildings inherited from my grandparents. 
Five months ago I realized I was depressed and completely isolated. Since mobility was increasingly difficult, I had everything I needed delivered. I realized I couldn’t take care of myself anymore and moved into a very nice retirement home. Although it felt like I was giving up, it has been really nice to have people around. With the help of my physician, I set up a nutritionist, personal trainer/weight management consultant and a psychotherapist to make weekly home visits. I felt so excited about my new life, but between the move and the exercise, my back, hips and knees really started to hurt. I felt discouraged, didn’t listen to the nutritionist and gained more weight. I don’t want to disappoint everybody again and I’d hate to think all the money I’m spending is for nothing. This morning I wanted to quit, but even though trying to accomplish such extreme weight loss feels like I’m trying to crawl across the whole US on hands and knees, I really want to succeed. I’m just not sure how.
 
— Bill

Dear Bill,
Part of you is a true survivor, a wonderful part of your personality that wants to grow, change, take better care of yourself and be happier. In spite of losing all four of your caretakers at a very young age, you have this determination to overcome your difficulties and move on. You’ve found this marvelous “kind parent” aspect of yourself that has created this new environment and supportive setup; that’s very exciting. Every morning I want you to spend at least a half hour lying down or relaxing in a comfortable chair and meditatively connecting to that part of you. Every day promise yourself that you won’t give up, no matter how hard it gets. There will be days when it takes every ounce of determination you can muster to even get out of bed, but by staying focused, making health your priority, working hard and allowing nothing to interfere, you can have significant weight loss.
I’m very pleased you’re under medical supervision. Obesity can contribute to other health problems and, therefore, medical care is a must. To lose a major amount of weight and keep it off, weight control must become a lifetime commitment where you completely change the role of food in your life and make exercise a regular part of your daily routine. 

Take a realistic problem-solving approach, select reasonable goals, develop a clear action plan and plan for less-than-perfect circumstances. Accept that the new way you’ll be eating isn’t a diet; it’s how you’re going to live for the rest of your life. When you have a lot of weight to lose, it will take longer to reach your goals but will be extremely rewarding when you do. Concentrate on your health rather than each and every pound you lose. When you’re very large, moving and holding up your body for even five minutes can seem like an impossible feat, and struggling to lose more than 100 pounds will be fraught with challenges. To stay motivated, focus on your daily accomplishments and remember that for every pound you lose, your health improves.
Schedule your support team visits throughout the week so you’ll feel less alone. Reach out to peer support, too. If you can’t get out much, the Internet has many groups, chats and blogs for those with similar problems. Sharing your experiences — or even just reading about others — can be tremendous support. Let your brother know how much you appreciate his help but, for now, you might want to let others take care of you rather than him. Focus on how you can give back to him. I have a feeling that if your grandparents could see what you’re accomplishing, they’d be proud and happy. 

Patti Carmalt-Vener, a faculty member with the Southern California Society for Intensive Short Term Psychotherapy, has been a psychotherapist in private practice for 23 years and has offices in Pasadena, Santa Monica and Canoga Park. Contact her at (626) 584-8582 or email pcarmalt@aol.com. Visit her Web site, patticarmalt-vener.com.

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