The major issue I am facing now is to qualify for the surgery. I am facing several sessions with the psychologist, and those are the ones that really scare me. The psychologist has all the power to stop me, or to allow me to get surgery. I really need to focus on this.
I found this article on PubMed which helped me a lot. I am going here to summarize how I'm going to go about ensuring that the psychologist will take me seriuosly.
"The core parts of the clinical interview include reasons for seeking surgery, weight and diet history, current eating behaviors, understanding of the surgery and its associated lifestyle changes, social supports and history, and psychiatric symptoms (current and past)"
So, let's explore these one by one:
1) reasons for seeking surgery: improve current medical problems, enhance mobility and energy. I don't have unrealistic ideas regarding the changes that will come about in my life following weight loss: I'm not going to want to become a model, marry one, etc!
My goal weight is actually going to be 20kg more than the expected weight per my height and age - that is being realistic, although that means a weight loss of 60kgs!
2) Weight and diet history: this is going to take a long time digging back into memory. I've been trying for more than 40 years, and I have memory blackouts in the middle. Will come back to this one
3) Current eating behaviour: I go from one week of strict diet, to one week of "normal" eating (read here huge portions, lots of carbs, fatty foods) and takaways. Then back to cycle again.
4) Understanding of the surgery and its associated lifestyle changes: a lifestyle change is exactly what I am looking for. I need the proverbial kick in the butt to get started. The physical reactions that are going to happen when eating certain things post-surgery are going to be so severe that I'll be good as gold, paralyzed by fear. Good, that's it. Is this what a psychologist wants to hear? Probably not - I need to work more on this one.
5) Social supports and history: history of support? Could talk a lot about it. From invites to dinners, to mates calling me out to the pub for endless drunken nights and associated pub grub, to family so concerned about me to call out for a sudden, unpleasant, horrible intervention. As if that is what was needed. But really, family has always tried to help - the more they tried though, the more I ate. Don't ask me why, that is the way it has always been. My boyfriend falls into the group, and he's super supportive, but again: when I'm asked to diet, I eat; and eat; and eat to my death.
6) Psychiatric symptoms (current and past): oh where do I start. Had depression bouts since I was 18, then in a cycle - since then and up to 10 years ago when the right "cocktail" was found and I've been perfect ever since.
I cannot get prepared to fool a psychologist into clearing me for surgery (people say) .... or... can I?
I need to get in touch with my psychiatrist and give him a real kick in the butt - he needs to support me. I've knownk him since we were sixteen years old so I feel I can talk to him on the level: he has to get real with me and stop shouting to stop eating and start moving. He should know better than that.
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