The War for Independence: Stand Up for Yourself 

Being tolerant of others is important to me, whether it’s their beliefs, habits or point of view but I do admit that sometimes I really have to work at it, especially when it comes to being helplessly dependent on someone. I admit it: I have no tolerance for learned helplessness. I see a lot of it when it comes to poor eating habits or just the whole “I can’t” attitude. On My 600 lb Life, Dr. Nowzaradan fights this learned helplessness a lot and I share his frustration. I’ve seen many of his patients insist they can’t walk, they can’t exercise or they ‘have to eat’ what their families eat because they ‘have no choice!’

By the time many of his patients show up in his waiting room, they are so large they can barely walk or stand and many of them are in wheelchairs.  Some are on gurneys because they have not stood up for years.  They do not have a physical deformity or medical condition that will prevent their standing or walking, other than the super morbid obesity that brought them to Dr. Nowzaradan, and yes, super morbid obesity is the classification for anyone with Body Mass Index of 50 or more.  For reference, I have a BMI of about 44 (I am morbidly obese).

They have choices, even if they think they do not: they’re choosing the family’s junk food. They can stand up, they can walk and they can exercise: they are choosing not to try. For whatever reason, they are opting to stay an invalid or to stay unhealthy and unhappy. Being ill, dependent, or needy fills a need in them that they might not be aware of. They have chosen to stay in the bed or the wheelchair and not work at getting better. They are choosing to remain helpless! I recall one patient who practically cried and whimpered every time the doctor asked to her stand up, until he got really pushy about it and then she defended herself pretty handily.  It suited her to be strong then, but when it comes to working to make herself better, it was easier to cry and have someone bring her the milkshake and the ice cream.

Yeah, I am being b*tchy about it.  I have no tolerance for the “poor me- I’m so helpless and in pain” attitude.  It makes me absolutely nuts. I am sure they are in pain, because I have felt that kind of pain where your knees, legs and feet ache from your weight; where your back is sore from keeping your great big gut standing up straight (or close to it); and where even sitting or lying down is either painful, hard to breathe or both.  Yep- definitely been there.  I know what it’s like when you don’t want to stand up because your knees or your hips will pop, crack or burn and when you lie down in bed, you have to have pillows to prop you up so you won’t suffocate under the weight of your own chest.  Been there too! It’s not a good place to be: it’s scary and it’s lonely, but they are there from choice.  Literally all the choices they have made have led them there and the choices they are continuing to make are keeping them there.

I’d like to say I am not passing judgment, but yes, I am.  It’s not because I’ve been there and I got out of it so they can too! It’s just plain simple reality: my choices were what got me there and my choices are what got me out of it.  It’s one of the things that used to frustrate me horribly when I was also super morbidly obese (I had a BMI of 75).  I knew that I needed to make changes to get better, but at the same time, I didn’t know what changes to make.  I kept trying different things hoping something would stick, because for me, not trying is the same as giving up.  There were days when I thought “yeah, just give up! It’s easier!” and when I did, I confess I was just too stubborn to accept it.  My only concession was that, even if I wasn’t successful, at least I would keep trying.

So many of them show up at Dr. Now’s door without first trying to help themselves.  Granted there are almost as many who have tried diets, bariatric surgery and other weight loss strategies and I applaud their attempts.  They have been proactive and are still working at helping themselves.  I went to a bariatric surgeon myself (he was a total butthead, BTW) and opted not to have the surgery.  It’s the ‘helpless- I have no choice’ patients that I have no tolerance for.

They may not believe that they have choices, but they do.  They can choose to let someone else make the decisions for them or they can choose to make their own.  There is a reason I use the word “work”- because it is work to get better.  It’s hard and it’s frustrating and there are days you really want to cry and give up and have a tantrum.  It takes a long time and will probably be one of the hardest things you’ve ever done. There will be days when you see someone else doing something easily and without thought and it will make you angry that it’s so much harder for you, but crying “it’s not fair!!” won’t fix it or make it any easier.  And I would like to say it gets easier the more you do it, and in some ways it does.  The more active you are, the more weight you lose, the more you practice making healthy food choices, the easier it is to keep doing them, but it took you a long time to get unhealthy, and it takes a long time to regain the health you lost.  I have been doing this for literally 1000 days and I am still not where I want to be as far as my weight or my health.  There are no short cuts and, when you relapse (aka screw up), it takes time just to get back to where you were when you “relapsed,” let alone make progress from there!

In some ways, I can see how it easier to be unhealthy and helpless and leave everything for someone else to do.  You don’t have to wash the dishes, do the grocery shopping, run errands, do laundry or even go to work (super morbid obesity is a disability in most states).  You can lie in bed and read, watch tv, be online, or whatever else you want to do.  You can be helpless and not responsible for your condition.  I get it: not only is it easier but you can also get everyone’s pity because you are so helpless and in such pain.  I am very familiar with sympathy junkies and Munchhausen syndrome: “Look at me- I hurt so much! Poor me- I can’t take care of myself! I am so helpless!” I can see the appeal: choose hard and sometimes painful work that possibly goes on forever or choose to lie in bed and have everyone else feel sorry for you and take care of you.

I honestly don’t think I could do it.  It’s not that I’m “so responsible” or “so active” or a “dedicated worker” or anything like that.  I like to do things myself and being helpless means having to put up with someone else.  Ironically, I don’t have the patience to be helpless and wait for someone else to take care of me: my inherent selfishness makes me a very independent person. I have been where these ‘helpless’ patients are:  In 2003, I broke my arm and my leg and needed surgery.  I have a pin under my knee holding my leg together and a plate and five screws in my wrist.  I was about 400 lbs at the time and the anesthetist didn’t want to put me under unless he had to (he had to) and it was almost four months before I was able to take care of myself again.  I couldn’t use a wheelchair or crutches because of my broken wrist and I couldn’t walk because of the broken leg.  I couldn’t get up, couldn’t dress myself and all I could do was lie in bed and read, watch tv or go online (just like them).  It nearly killed me.  I had six weeks of recovery from surgery and  then I had nearly two months of physical therapy for my wrist and my leg since I had been immobile for so long.  Yes, it was a lot of work! It was hard and it was sweaty and it hurt! And when the doctor asked if I wanted to do more PT, I said yes! They gave me exercises to do at home, and I admit, I didn’t always do the leg exercises (I figured I’d just walk more) but I did the work to get me out of the bed and back on my own.

 

I learned the hard way that our choices can keep us feeling sick or they can help us to get better.  Ironically, the choice I made that ultimately helped me improve my health so much really didn’t have much to do with eating: I quit a job that was making me miserable. Leaving that job had a snowball effect: it caused me to do things differently and as a result, I made different choices that had positive effects on my eating and my health.  When I hear a patient saying that he has no idea if he’s eating under the calories Dr. Now recommended because his mom keeps track of that, I wanted to tell him that’s part of his problem! “Dr. Now wants me at 800 calories.  I have no idea what that is in actual food.” (It’s a Sourdough Jack and a Chobani Blueberry yogurt!) He is handing over responsibility for his health and his food choices to someone else!  This patient weighed close to 1000 lbs and could barely stand up- what was his excuse for not taking control of his own food choices? He had none.

None of us is helpless unless we choose to be. Barring injury or illness, we literally make our own beds and we can choose to wallow in them or we can choose to get up.  It is rarely easy, but choosing to lay there and give control of your life to someone else is much much more painful.

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