Week 24: Anne's Story

When it comes to weight challenges, we've said many times that "it's not about the food." That how it was for Anne (not her real name). She told me her story during a clinic visit last week, and gave me permission to share her story with you.

*****

68 yo Anne presented to the clinic for her Women's Health Exam. She has lost over 65 pounds through Weight Watchers. She is ready to begin swimming again. She feels very envigorated, and feels this is largely due to a recent event which enabled her to reconcile her past family history of abuse.

Anne was raised by an alcoholic father and an enabling mother, in a home with three abusive older brothers and one younger brother. It was common in her household to hear arguing between the parents, and it was common for her mother to be struck by her father to the point of injury.

The boys were the priority in the family. Anne recalls hours of insults from her father, directed at her. She was repeatedly called a "whore," and "no good." If she studied late, her father would rage, "Go to bed; what do you think you are doing?" If her grades were less than perfect, he'd begin an opposite tirade - belittling her once again. She could never find a balance that pleased him.

The parents divorced when Anne's mother finally had enough - when her mother was 72. Later, the father died. Her mother became more demanding on Anne's time, and the brothers came by only once a year - never producing any substantive support. Anne became the caregiver - at least the one who did the shopping, the laundry, and the errands.
 
At the same time, Anne was struggling with increasing weight and other health problems. She tried numerous diets, but without long-term success.

A couple of weeks ago, Anne went to visit her brothers. She stayed in one of their homes. Memories of abuse in a childhood controlled by the men in the family, came flooding back. At one point during her visit, Anne was cold and went to turn up the thermostat. Her brother barked, "Don't do that," raising his hand as if he was about to strike her.

At that moment, Anne flashed back to five-year-old Anne, sitting at the top of the stairs in terror, listening to her parents argue. Adult Anne went to bed in tears that evening, dreaming that her threatening brother was trying to kill her.

Anne left the vist early, contemplating her childhood on the return trip to Seattle. She had spent a lifetime protecting that five-year-old Anne - by tending to her career, by buying a home, and by not marrying into another abusive partnership that replicated her parents' marriage.

She appreciates now that food was always her comfort - insulating her against the harshness of her father and the inability of her mother to protect her.

Anne is now ready to nurture the adult Anne, and she is beginning to explore the forms that nurturing might take.

She is confident that she will continue to lose weight and continue to swim.

As she says, "It was never about the food."

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Sound familiar? If you, too, have used food as a comfort, try to identify what caused the need to seek this comfort. What served you as a child may not be needed as an adult.

 

Take care; we're all in this together.

Linda Gromko

www.LindaGromkoMD.com

Week 23: Odds and Ends that Keep Us Afloat

On Thursday, June 19, we had a small, but productive group. Here are some of the odds and ends we shared. Perhaps they'll help you!

1. Water aerobics:

We reviewed that there are excellent deep and shallow water aerobics classes offered at our local recreation centers. A group of us attended one on a Thursday evening, had great fun and exercise - for a mere $6 each. Check your local Parks and Recreation Department.

2. So what to do about a swim suit?

Nobody seems to like how they look in a swimsuit, at least in the over-50 crowd. But here's a resource that came up:

From Junonia.com

 



Junonia.com sells active wear, including swimsuits like the one at right, for women from size XL through 6X. They carry swimsuits, athletic wear, swim cover-ups, even swim shirts. They even market swim separates!

Land's End sells swim separates also, and in a broad range of sizes. Both vendors have great return policies.






3. Snacks, anyone?

If you are looking for the crunchy variety, try to find "Good Bean" snacks. Made of chickpeas (garbanzo beans), these come in a  variety of flavors, i.e., cinnamon, spicey, sea salt, etc. Drugstore.com or Amazon.com carry these. They're not inexpensive - but they may get you through the day with far less caloric impact than so many of our favorites.
 

The Good Bean

None of these ideas will win a Nobel Prize in anything, but sometimes a simple solution can keep us going through another day.

 

Remember, we're all in this together.

 

Linda Gromko, MD 

Week 21: Time for a Movie!

Looking for an interesting film that resonates with your nutrition/weight management efforts? Try this one!

"Fed Up" takes the viewer on a fascinating analysis of the American diet. According to this film, the problem is sugar. It's in so many processed foods - and clearly contributes to our nationwide rise in diabetes, obesity, hyperlipidemia, etc. Efforts to increase activity, i.e., Michelle Obama's "Let's Move" campaign, just aren't enough!

"Fed Up" draws a frightening parallel to the tobacco industry. The brain's response of the sugar addict looks much like that of the cocaine addict on a PET scan. It's projected that today's generation of young people will have shorter lifespans than their parents! And government subsidization of corn farming, nationally-branded fast foods in public schools, and the super-sizing of soft drinks leaves the viewer to question what can possibly be done to arrive at a sane balance.

Go see it. Eat your whole fruits and vegetables.
We're all in this together.

Linda Gromko, MD

Week 20: Treatment Plan Exercise

Here is our exercise from last week's group:

"You are a health care provider. A new patient comes to establish care with you. He/she is bright, funny, and well educated. You like him/her instantly. Your patient explains to you that their main frustration is their weight. Your patient explains that this has been an issue for many years, and that they have tried numerous approaches with varying degrees of success.

Knowing what you know, what are your recommendations for your patient?"

Here are some of our group members' ideas:

• Examine their reasons for wanting to lose weight
• Talk with them about their goals/objectives: staying the same/weight loss?
• Ask if this is a reasonable time to tackle weight loss goals
• Ask what the patient can or will do to lose weight
• Ask the patient to meet with you frequently
• Suggest, "if you stumble, just get right back up."
• Ask your patient if they are willing to track their food intake and exercise routines, so you can review them together
• Explore your patient's sources of support
• Create with your patient a practical plan for a short term approach - as well as longer-term strategies
• Suggest tools, i.e., My Fitness Pal, Sparkpeople, for tracking.

The next question: "Your patient returns with some success, though not as much weight loss as the patient desired. What do you recommend now?"

Our group's ideas:

• Review the original plan
• Remind them that if they are trying to lose weight, any loss is good
• Check if their expectations are realistic, or just "wishful thinking"
• If your patient isn't following their specific program, find out where they are deviating and explore if this is making a signigicant difference
• Explore why the patient is/is not staying with their plan
• Explore: is this realistic at this time? If not, adjust goals, add exercise, just keep going
• Are there factors which sabattoge the patient's efforts?
• If your patient isn't succeeding, leave a door open - a way back without shame or the sense of failure.

A wise group, don't you think? One of our themes was that we really do know what we need. But sometimes, when we depersonalize a question, i.e, "what would you do for your best friend in this situation?" - we find our own best advice.

Our third question involved when to recommend weight loss surgery, and we'll continue on this topic next week.

Remember, we're all in this together.
Linda Gromko, MD