I find myself watching this in a slow-down-as-I-pass-a-car-wreck kind of way. I caught the episode on 12/28 of Pauline Potter.
I know these are reality shows, edited to provide the most drama. But what strikes me in many of these episodes is the lack of psychological counseling. Dr. Nowardan treats the physical side with surgery but are they skipping over the mental side? I saw one episode where the patient met with a nutritionist, but I haven’t seen any where they meet with a mental health specialist. Am I just not tuning into those shows?
In Pauline’s case, she said she was in too much pain to exercise and thought losing four pounds after her surgery was just fine, when Dr. Now said she should be losing 10-15 pounds a week. At one point she eats a salad, despite knowing she shouldn’t eat salad because it fills her up and doesn’t leave room for protein.
For the first year, she fought him in regards to pain medication, exercise, and the rate of weight loss. After her surgery she refused to get out of bed and walk, and Dr. Now had to implant an air filter in her leg to prevent a blood clot. It was only after she had surgery for an ulcer that she got serious about her maintenance and after care.
I’m always glad to see the success stories, but I wish the show would do a better job in showing the totality of the experience, that it’s not just a simple surgery and you’re on your way to better health. You have to also address the issues that got you to this point in the first place.
I’d think a major obstacle is patients who refuse/won’t acknowledge the psychological aspects of their problem.
You can’t force psychological help on people. If they don’t realize that they need to alter their thought processes they’re not going to, and attempting to force that change is likely to only make them more stubborn.
I agree. Pauline kept saying that she wanted to lose the weight for this reason and that, but when it came down to her actually DOING THE WORK she balked.
I haven’t seen the show address the psychological aspect of morbid obesity.
They do show psychological therapists working with the patients on that show. That part is not emphasized though.
I’m not sure what the HIPPA laws would say, but a good reality show would be featuring talk therapy for various problems with various people. I guarantee it would be a smash.
I’m assuming the patients sign releases, otherwise they wouldn’t be able to show the surgery, right? Perhaps there’s no similar release for mental health.
I watch this show a lot. In late September I started working to lose 100lbs (27 down!), and I discovered that I find this show to be motivational and/or inspiring. I also had a mother who was addicted to food and got up to 350lbs, so part of me sympathizes with the enablers. I think I’ve seen most of the episodes by this point.
As Two Many Cats and SciFiSam said, often they *do *show counseling; usually the person’s initial session. I have a feeling that therapy happens more often than we see, and it’s just that the patient doesn’t want to share that part publically (or the therapist doesn’t).
Wow, I’ve never gotten that impression from an episode. In fact, Dr. Nowzaradan always requires people to lose a certain amount of weight before he’ll approve them for the surgery: they have to prove that they can make the needed changes, otherwise surgery will be useless (as he says repeatedly). I often see him tell people that they can’t expect the surgery to be magic, which is always a little sad because usually you can tell that’s exactly what the person was hoping for. I actually just watched an episode where it took a guy 1 full year to be approved for the surgery.
That wasn’t my intent. I meant that there’s more to it than just the physical aspect, there’s also a mental aspect that needs to be addressed. In Pauline’s case she rationalized eating fast food all the time because she couldn’t stand up long enough to cook/they were traveling/she doesn’t know anyone, so this is her entertainment, etc.
Congrats on losing the 27 pounds! How are you doing it?
I saw the episode on 12/29 about Paula. It that episode, it did show her going the therapy to address her issues, so it is whatever the patient is comfortable with sharing. But isn’t counseling a normal part of the treatment for morbid obesity? I think they should address that in the show, even if they don’t highlight that for all the patients.
I was amazed at her transformation, and it wasn’t just her weight loss. At the beginning she was dying her hair green and blue, but at the end, she was more like a poised professional. Even her voice sounded more mature. I hope her daughter got her weight issues addressed as well.
Thanks! I started with a medically supervised weight-loss program run by a local hospital: three months of a low-calorie diet that was mostly meal replacement products, plus weekly meetings that included exercise sessions and nutritional, behavioral, and exercise lectures. Counseling was available through the program, but I decided to engage a private therapist because I’m determined to make this change a permanent one. I learned how to eat better and what my target calorie intake should be, and how to start exercising effectively. The program ended 3 weeks ago, and since I’ve been all on my own I’ve lost two more pounds.
Right now I’m grateful that I live alone: I can’t imagine trying to make this kind of lifestyle change with others in the house who can/want to eat differently. That’s a huge issue for so many of the people on the show. A friend of mine who is also morbidly obese recently started working with a bariatric doctor and has lost 9 pounds in the past month, even though her husband and kids – who she cooks for – are all skinny and love their carbs. She’s my hero!
I’m actually ok with the focus they give it. Everyone that weight has psychological issues they need to address, but not everyone needs therapy to do it. I don’t think anyone who is overweight is going to watch that show and think it’s just about the surgery. People who are fat tend to know they have issues, they’re just really good at ignoring them.
Sounds about right. But I do think that’s only what we see. I bet a lot more people get referred/go to a therapist and we just don’t see it on the show (for privacy reasons, show length reasons, etc.).
I think participants should have treatment, therapy and frugs for depression and anxiety BEFORE surgery. They’ll be returning to the same self and family pathologies, I think they should be better prepared before undergoing life changing surgery.
Clearly, with a few exceptions, these folks are poor if not downright impoverished; given that junk food is far, far cheaper than healthy chow I’d like to see nutrition classes for the entire family. I’ve noticed that family tends to also have weight issues.
I watched one. It was a man who met Dr. Now when he was admitted via the ER. He was motivated to lose weight because he was told and knew that he could die if he didn’t. And yet he had food hidden all over his hospital room. I wondered how he did that. I mean, he could barely move and I am not exaggerating. Astonishingly and totally unexpectedly for an uplifting reality show, he died. I don’t think I ever saw a reality show end so badly.
Another reality show about morbidly obese people featured a man who weighed 800 pounds and was on a ventilator - and late one night, the nurses caught him with 3 girls in his room! :eek: He was also having food delivered.
I used to work at a hospital that did bariatric surgery, and the psychiatric evaluation led to more disqualifications for surgery than every other reason combined. Most of those patients were in the 250-350 pound range.
I remember the deaths. There have also been a few people who were simply uncooperative/unsuccessful; Dr. Nowzaradan had to pretty much kick them out of the program. I feel horrible for those people but I like seeing those episodes, because each of them started out with the best of intentions and doing what they had to (for at least a little while) and it reminds me to not rest on my laurels. I’ve only lost 25% of what I need to, and it would be super easy to get right back to where I was three months ago.
(Ok, so, my relationship with the show might be a little more personal than most… ;))
Oh wow, that never even occurred to me…I wonder if the people on the show go through a psych eval before filming starts…
