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Difficult to hold my tongue


Scarlett
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12 hours ago, StellaM said:

What is ? Specialist counselling for teens with eating issues ? Lucky.

 

Yes. We also have mental health care coverage that would cover this after a deductible. Not only that, it covers medically necessary visits with a registered dietitian and various procedures & surgeries that assist with weight loss. Obesity is a serious health issue and there is coverage available accordingly. Our insurance plan is nothing special - this coverage is commonly available. 

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2 minutes ago, StellaM said:

 

Wow, that's great.  I hope when Scarlett's dss is working etc and has insurance, he can prioritise accessing these services.

He has insurance through his step dad.  But the deductible is very vey high.  It would be interesting to hear how dss responds to the idea he needs mental health care for his eating.  

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2 hours ago, Scarlett said:

He has insurance through his step dad.  But the deductible is very vey high.  It would be interesting to hear how dss responds to the idea he needs mental health care for his eating.  

 It is not just for his eating.  I think your DH and you are too close to the situation to see it.  It will help him in many ways not just for his eating.   In fact, his doctor should have suggested it to you all.

 Wasn’t this the same child who had issues with bed wetting a few years ago?  

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6 hours ago, Carrie12345 said:

 

My mental health copay is $170 with a many thousand dollar individual deductible. I think that's closer to the norm these days than a $25 copay.

Mine used to be $70 with a $500 individual and $1500 family.  It was amazing, and we were able to move practices and therapists until we found the best fits.  I would have put my cat in therapy if it had been allowed, lol.

Our "best fits" are no longer in the region, so it's back to square one and rice and beans if an issue is severe enough.

The hardest (imo) department of mental health care is the most life threatening and dramatically debilitating issues. Finding care for disordered eating or moderate depression TENDS to be (not always, of course) much easier than, say, suicidal tendencies or severe personality disorders.  Specialists are limited, facilities are limited, an individual's rights are an enormous component, and there's a whole other (limited) billing and coverage system for that type of need/care.  I don't like the idea of "grading" mental health issues but, yeah, the families in the most distress TEND to be the ones with the most trouble getting adequate help.

 

Yikes - $170 is more than double what providers in my state get reimbursed from the highest paying insurance company. Do you live in a very HCOL area?

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When talking about access to mental health care, there are a range of different provider types, and it's easier to get in with some than others.  We know many people who have gotten short-term counselling to deal with anxiety, a particular stressor, a marriage issue, grief, etc.  In our area, there are people with some sort of masters degree who do this type of counselling.  Insurance covers all or part, depending on the plan.  The wait to get an initial appointment is around a week or 2.  If you need something more..intensive, for lack of a better word...involving a psychiatrist, for example, it's much more difficult.  There are fewer of them and the wait can be very long.  If you need something more specialized, I can imagine that the wait could be even longer, because there are even fewer specialists.  And, I live in a semi-rural community that is almost a suburb of a small city.  We have a small hospital in our community, and I sometimes hear helicopters coming and going.  I had wondered why, since for a complicated major trauma I'd go to the university medical center that is 30 minutes away.  But, our little hospital serves everybody who lives in the 100 miles north of us - we get their heart attacks and such at our competent (but not a trauma center) hosptial.  I can't imagine that there would be much in the way of mental health services in an area that doesn't have enough people to support a decent hospital.  

And, the whole issue of weight is so complicated.  My stick-thin inlaws were always critical of fat people, because they ate so much...they seem shocked that my 'could stand to lose 30 lbs self' eats 1/2 of what they do.  My whole family tends towards jolly, and when we get thin, it means that our lifestyle is supporting hours of physical activity every day and/or we are watching everything that we eat.  And, it's also really hard to have kids who are metabolically different.  I have one kid that I am always reminding to eat and another who would, if left to their own devices, use snacking as entertainment.  It is difficult to be trying to keep calorie-dense foods on hand for one kid while trying to encourage less frequent, lighter snacks for the other.

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26 minutes ago, Carrie12345 said:

Nope. Lower than average.

 

Huh - interesting. And that was the insurance company's contracted rate? That's crazy high - I have heard of therapists charging their clients the balance between what the therapist charges and what the insurance company charges (which is not allowed, but some do anyway). I wonder if they were attempting to do something like that?

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47 minutes ago, AmandaVT said:

 

Huh - interesting. And that was the insurance company's contracted rate? That's crazy high - I have heard of therapists charging their clients the balance between what the therapist charges and what the insurance company charges (which is not allowed, but some do anyway). I wonder if they were attempting to do something like that?

It actually is allowed if the provider hasn’t entered into a contract with the insurance company. 

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2 hours ago, TechWife said:

It actually is allowed if the provider hasn’t entered into a contract with the insurance company. 

 

Yes, it is. I was assuming (probably incorrectly) that Carrie12345 was talking about an in-network provider. The range of reimbursement rates I've seen (or heard of from therapists in nearby states) is from about $50 to less than $90/hr. 

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On 7/4/2018 at 3:57 PM, Pen said:

 

I don’t know. Would they really check for things like that?

And in addition to genetics things like HDAC5 enzymes may be implicated  ...

I think the studies where they take a slim mouse and an obese mouse give each a fecal transplant from the other —then after that which mouse is thin and which obese reverses are pretty interesting. 

Being able to drink a whole gallon in one day would also mean a physically pretty big stomach capacity I’d think.  I have trouble getting in my 6-8 cups of water each day. It’s a lot just in terms of volume. 

 

Luna has this diagnosis. Tentatively. We don't know yet if she will level off as she gets older. She has possible atypical Prader-Willi. Some symptoms are low weight gain, FTT followed by insatiable hunger after age two. She's 3.5 and not overweight yet, but her growth curve is skyrocketing. Officially, though, she just normal and healthy. I think the only reason we have this sort-of diagnosis is because she had a lot of other developmental problems as well. 

I'm sure there are other factors at play. But if his medical care was in fact neglected as Scarlet has said, and his parents are pretty uninvolved/not advocating for him, then I doubt he would have a diagnosis. 

Though, in my experience, emotional/ psychological health is a much more common factor in obesity than physical health conditions, Scarlet has said that all aggravating conditions have been ruled out and essentially this is a matter of choices. Which I tend to think is true. But to be that overweight (and I am close) there has to be some disordered thinking somewhere. Especially if he has been given sound nutritional advice and is just not interested in following it, or able to control binge behavior. 

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On 7/4/2018 at 4:20 PM, Pawz4me said:

I'm surprised that so many seem to think drinking a gallon of milk--or anything--indicates a problem simply due to the drinking (volume). 

Milk is not a drink. It is a food. So for us yeah that's a lot. Same for Coke. Not a drink, but a dessert. Coffee and tea are drugs / herbal. None of those would be considered a remedy for thirst in our home.

If you are thirsty, drink water, lemon water, ice water.

Not that kids don't drink milk. They do. But it is part of a meal or a snack--not hydration.

On 7/4/2018 at 8:26 PM, Lady Florida. said:

The only syndrome I'm familiar with is Prader Willi Syndrome. In that case yes, other things are affected including intellectual development and muscle tone. 

Honestly, compared to me a lot of fat people have similarly amazing appetites.How can I describe it? I'm not hungry until 11 am. I am not hungry after 8. I eat a couple big meals a day. I am not tempetd to snack. Like... At all. Chocolate doesn't look good to me. In a cafe it requires ZERO WILLPOWER to get an Americano. None. None at all.

I am totally healthy and I know people who exercise willpower every moment of every day to deal with food. Most of them are either obese or have an eating disorder. Every time I say "no" they say "but it is so tempting!"

It's just not to me. I am not hungry.

So I think there is a massive nationwide gut health issue that may be severely affecting people at a level they cannot control, frankly. And I would not put it past industry to thwart research on it. Praeder Willi may be extreme, but truly, if you think about compulsion to eat, compared to a slim person such as myself, many fat people may indeed have that level of compulsion through a different mechanism.

I would not be even slightly surprised if Scarlett's stepson were a victim of a combination of stress, poor gut health, and other issues that make it extremely difficult for him to say "no" to snacks and food.

It is absolutely within the realm

On 7/5/2018 at 3:54 PM, StellaM said:

In terms of detaching, the mantra I find helpful (and it comes from AA) is:

I didn't cause it, I can't cure it.

You did not cause your dss' issues with food and weight. 

You can't cure his issues with food and weight.

 

I agree that this is not Scarlett's fault. However there is something she can do which is make a huge effort to love her stepson and to show that unconditionally. 

Not give up on the weight thing, but to go at it from a much deeper angle. From the center of his heart. Tell him you need him to know you love him regardless of his weight. And that it's his journey. And then focus 1000% on other stuff. Everything else he dreams of. College. Books. Video games. Anything.

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5 hours ago, Tsuga said:

Milk is not a drink. It is a food. So for us yeah that's a lot. Same for Coke. Not a drink, but a dessert. Coffee and tea are drugs / herbal. None of those would be considered a remedy for thirst in our home.

If you are thirsty, drink water, lemon water, ice water.

Not that kids don't drink milk. They do. But it is part of a meal or a snack--not hydration.

Honestly, compared to me a lot of fat people have similarly amazing appetites.How can I describe it? I'm not hungry until 11 am. I am not hungry after 8. I eat a couple big meals a day. I am not tempetd to snack. Like... At all. Chocolate doesn't look good to me. In a cafe it requires ZERO WILLPOWER to get an Americano. None. None at all.

I am totally healthy and I know people who exercise willpower every moment of every day to deal with food. Most of them are either obese or have an eating disorder. Every time I say "no" they say "but it is so tempting!"

It's just not to me. I am not hungry.

So I think there is a massive nationwide gut health issue that may be severely affecting people at a level they cannot control, frankly. And I would not put it past industry to thwart research on it. Praeder Willi may be extreme, but truly, if you think about compulsion to eat, compared to a slim person such as myself, many fat people may indeed have that level of compulsion through a different mechanism.

I would not be even slightly surprised if Scarlett's stepson were a victim of a combination of stress, poor gut health, and other issues that make it extremely difficult for him to say "no" to snacks and food.

It is absolutely within the realm

I agree that this is not Scarlett's fault. However there is something she can do which is make a huge effort to love her stepson and to show that unconditionally. 

Not give up on the weight thing, but to go at it from a much deeper angle. From the center of his heart. Tell him you need him to know you love him regardless of his weight. And that it's his journey. And then focus 1000% on other stuff. Everything else he dreams of. College. Books. Video games. Anything.

I agree with all you have bolded and have something to add about my own experience. FOR ME, I notice there is a strong sugar addiction component. Having sugar makes me want more sugar/carbs and more food in general. Once I cut added sugars largely, or entirely, from my diet, I stop wanting them. I don’t have to struggle to refuse cookies or a candy bar. Literally yesterday, I noticed I had a package of Hershey chocolate bars, meant for making S’mores and thought this:

”Oh, look, I forgot these were in here. Maybe I will eat one...

Well. I don’t really want one. No, I think I will not.” 

 

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I’m not sure  why you think you know more about what is going on in my house than I do but just to clarify we have had him to the doctor many times, especially since he moved here two years ago. His doctor actually is an obesity  and weight loss expert. So there has been a lot of education about blood sugar levels, carbohydrates, and the need for fat and protein. He has had many many blood test, and although I cannot name everyone of them I can tell you that the doctor is satisfied with what he’s done thus far.  Not sure how it works where you live but here the insurance companies rule the world and I cannot ask for and demand genetic testing when his doctor does not think it is necessary. Unless of course I want to pay out-of-pocket. And although I know some of you think my husband and I should get second jobs in order to pay for anything necessary, we do not agree with that philosophy for a 17-year-old boy who has a lot of other options that he has dismissed. 

 Also he is not  responsible for preparing all of his meals. He does get his own lunch, he is home and I am at work, but I cook most evenings.  Mostly I take issue with the way you are portraying me as leaving him to fend for himself. I mean he is 17 years old and yes he is capable of doing a lot for himself.  Including meal prep if he so desires. He has no problem preparing meals if he wants something or if I ask him to help with the family dinner. He is in the culinary arts program and really enjoys that. 

 

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Blaming behavior on genetics is not what I am trying to do. There is a huge environmental and stress / psychological component to it.

I'm not saying you don't understand but to get you to a point where you can see that quantifying the issue isn't going to help because of such a big envornmental and psychological component.

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On 7/8/2018 at 9:37 AM, Scarlett said:

He has insurance through his step dad.  But the deductible is very vey high.  It would be interesting to hear how dss responds to the idea he needs mental health care for his eating.  

 

High deductible insurance plans, especially for lower income families, is pretty much like having no insurance at all. The state of insurance in our country is shameful. 

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2 hours ago, HeighHo said:

  The other issue is that the young man is responsible to make his own meals.

 

 

I have to say that I think it would be weird if a 17-yr-old was not expected to make any of his own meals. 

Edited to add: particularly a 17-yr-old in a culinary arts program, lol

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8 minutes ago, katilac said:

 

I have to say that I think it would be weird if a 17-yr-old was not expected to make any of his own meals. 

Edited to add: particularly a 17-yr-old in a culinary arts program, lol

 

Ha! And I'd expect him to cook for me as well!

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On 7/8/2018 at 10:37 AM, Scarlett said:

He has insurance through his step dad.  But the deductible is very vey high.  It would be interesting to hear how dss responds to the idea he needs mental health care for his eating.  

 

I wouldn't put it that way to him, that's just making him feel like a crazy person.  I don't know why you'd say that or let him think that was accurate?

I'd just say, a therapist could help you possibly find out some of the origins of your eating problem, which might or might not help - sometimes it does help to know, and maybe deal with that rather than the symptoms.  That could be all kinds of things, from just bad habits from childhood, to trying to get control as a kid, to depression, to stress relief.  It's like figuring out what the bacteria actually is so you can choose the best antibiotic to fight it.

But more than that, many therapists are really good at suggesting strategies for practical issues.  Things like how to break bad habits, or what to do on days when you feel less able to say no, or what to do to alleviate stress in new ways.  The fact is for most of us, we learn this stuff over time, often by experimenting, not always well.  A good therapist has a lot of experience helping people find these strategies more efficiently, and making them work in their lives.

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I don't know about genetic testing at this point.  As far as I know, it won't be able to give him a way to make a behaviour change which now is the issue.  If he's made a change that should have had an effect, and was not, then I'd think about trying to find out more.

I really think getting some strategies for changing habits would be his best bet, especially if the person had ones especially for food issues and exercise. Changing habits is difficult at the best of times, and diet is a really difficult thing to change even if you are not overweight or inclined to be.

But it needs to be presented as something he could access if he wants - just like any change of habit, the will has to be internal.

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16 minutes ago, Bluegoat said:

 

I wouldn't put it that way to him, that's just making him feel like a crazy person.  I don't know why you'd say that or let him think that was accurate?

I'd just say, a therapist could help you possibly find out some of the origins of your eating problem, which might or might not help - sometimes it does help to know, and maybe deal with that rather than the symptoms.  That could be all kinds of things, from just bad habits from childhood, to trying to get control as a kid, to depression, to stress relief.  It's like figuring out what the bacteria actually is so you can choose the best antibiotic to fight it.

But more than that, many therapists are really good at suggesting strategies for practical issues.  Things like how to break bad habits, or what to do on days when you feel less able to say no, or what to do to alleviate stress in new ways.  The fact is for most of us, we learn this stuff over time, often by experimenting, not always well.  A good therapist has a lot of experience helping people find these strategies more efficiently, and making them work in their lives.

I or dh would of course say it nicely.  I mean good grief....we aren't stupid.  But even using language like your bolded above, I do wonder how he would respond.  

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2 minutes ago, Scarlett said:

I or dh would of course say it nicely.  I mean good grief....we aren't stupid.  But even using language like your bolded above, I do wonder how he would respond.  

 

Why?  How do you think he'd conceptualize that?  He understands the idea of spiritual advice, right?  It's not a totally different concept, when you have a behaviour that is causing you trouble, there is usually a reason, or an origin for it, and getting help from people with more experience can help a lot. I'd have thought most 17 year olds can think at that level.

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I overheard him talking to his friend who is even more overweight than dss.  The were having a good old 'laugh' about their weight.  I don't think either one of them think it is funny, but they often joke about it.  A week or so ago, the friend had on a really nice shirt which I didn't recognize....I complimented him and ask him if it was new.  Yes, he says, I am so fat I had to get a new shirt.  Then he pulls his suit jacket as if to close it and it won't close...and he says, 'this fit me last year.'  And I had no idea what to say....I was making all sorts of 'hmm' noises....and then dss and him start talking about how they are about to die of a heart attack or stroke (friend is having chest pains and is going for testing this week) and dss says, 'yeah, me and my high blood pressure--stroke'....and it went on for a minute and then friend said something funny and everyone laughed including me....then I said, 'hey you are joking around but this is serious.  Both of you need to be concerned about these things.'

It is difficult to know what to say.  This friend is the son of my friend that has the lymes…..so obviously discussions of weight aren't taboo in this circle....but I find it very awkward to hear them joke around about it.

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Just now, Bluegoat said:

 

Why?  How do you think he'd conceptualize that?  He understands the idea of spiritual advice, right?  It's not a totally different concept, when you have a behaviour that is causing you trouble, there is usually a reason, or an origin for it, and getting help from people with more experience can help a lot. I'd have thought most 17 year olds can think at that level.

Of course he can.  My initial feeling is he would say he doesn't want or need a therapist.  But I could be wrong.  Dh is suppose to talk to him soon.  We have been crazy busy and dss works so many evenings that dh rarely sees him. And dss is at his moms right now for a few days.

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9 minutes ago, Scarlett said:

I or dh would of course say it nicely.  I mean good grief....we aren't stupid.  But even using language like your bolded above, I do wonder how he would respond.  

It probably depends on how mental health issues have been dealt with and discussed in your family, and on his mom's side. We treat mental health issues no differently than physical health issues, so . . not an issue here. I'd guess it would be different in families who stigmatize mental health issues.

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Just now, Pawz4me said:

It probably depends on how mental health issues have been dealt with and discussed in your family, and on his mom's side. We treat mental health issues no differently than physical health issues, so . . not an issue here. I'd guess it would be different in families who stigmatize mental health issues.

No one here stigmatizes mental health.  Who knows about his moms house....but he compartmentalizes the two houses and he just would not tell her about it if he felt she would be negative about it.  I really don't think she would be against it though.  She is more of the kind to be fine with anything anyone else is doing for him....just as long as she isn't having to do anything herself.

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9 minutes ago, Scarlett said:

Of course he can.  My initial feeling is he would say he doesn't want or need a therapist.  But I could be wrong.  Dh is suppose to talk to him soon.  We have been crazy busy and dss works so many evenings that dh rarely sees him. And dss is at his moms right now for a few days.

 

Well, yeah, sometimes kids need to think about something.  I'd try and present it as really concrete and practical, rather than something like sitting around discussing your bad dreams about your mother and toilet training.  I think most kids can relate to that practical help.

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Scarlett, do you think that he would consider bariatric surgery? I wouldn't recommend it without a comprehensive program that includes counseling for any disordered eating issues, but it has been the only thing that has worked for me. (My issues were metabolic vs. psychological, but the surgery also helped my underlying metabolic problem). You have been very kind in cheering me on, so I just thought I would throw it out there. For the people in my cohort who did have psychological reasons for eating, our program was very helpful. I am almost six months out and down nearly 50 lbs. The larger people in my cohort are down 100 lbs. already. I wasn't super big to start, and generally didn't let my weight hold me back, but it is lifechanging for most of the people in my group. It's been an amazing gift for all of us, and 100% covered by insurance.

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13 minutes ago, SeaConquest said:

Scarlett, do you think that he would consider bariatric surgery? I wouldn't recommend it without a comprehensive program that includes counseling for any disordered eating issues, but it has been the only thing that has worked for me. (My issues were metabolic vs. psychological, but the surgery also helped my underlying metabolic problem). You have been very kind in cheering me on, so I just thought I would throw it out there. For the people in my cohort who did have psychological reasons for eating, our program was very helpful. I am almost six months out and down nearly 50 lbs. The larger people in my cohort are down 100 lbs. already. I wasn't super big to start, and generally didn't let my weight hold me back, but it is lifechanging for most of the people in my group. It's been an amazing gift for all of us, and 100% covered by insurance.

Surgery should be an absolute last resort. Scarlett's SS hasn't even really bought in to the idea of weight loss, so I don't believe a good surgeon would even do it. The calorie restriction and portion size would likely not even be healthy for a still-growing adolescent, and there are lifelong implications to a surgery like that. If he is ready to restrict calories that much, he'd lose the weight on his own and surgery wouldn't even be necessary. 

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21 minutes ago, HeighHo said:

 

Agree.  However, if one is trying to eat nutritiously and control calories, its difficult if one does not have control over all meals or the food supply. 

One thing this lad can do to help himself is get on myfitnesspal and plug in the meals. wont cost anything since the house already has internet access. 

He is offered a variety of healthy options.  And he has been told we will buy him any food that he wants that will help him in his efforts to lose weight.  

 

We have suggested many many things including myfittnesspal.  He knows how to acces a lot of things.  He knows there are several options that cost money that we have offered to pay for.  We can't make him do any of it.  

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23 minutes ago, SeaConquest said:

Scarlett, do you think that he would consider bariatric surgery? I wouldn't recommend it without a comprehensive program that includes counseling for any disordered eating issues, but it has been the only thing that has worked for me. (My issues were metabolic vs. psychological, but the surgery also helped my underlying metabolic problem). You have been very kind in cheering me on, so I just thought I would throw it out there. For the people in my cohort who did have psychological reasons for eating, our program was very helpful. I am almost six months out and down nearly 50 lbs. The larger people in my cohort are down 100 lbs. already. I wasn't super big to start, and generally didn't let my weight hold me back, but it is lifechanging for most of the people in my group. It's been an amazing gift for all of us, and 100% covered by insurance.

 

8 minutes ago, hippiemamato3 said:

Surgery should be an absolute last resort. Scarlett's SS hasn't even really bought in to the idea of weight loss, so I don't believe a good surgeon would even do it. The calorie restriction and portion size would likely not even be healthy for a still-growing adolescent, and there are lifelong implications to a surgery like that. If he is ready to restrict calories that much, he'd lose the weight on his own and surgery wouldn't even be necessary. 

I don't think his doctor would be on board with that option yet.  

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Just now, hippiemamato3 said:

Surgery should be an absolute last resort. Scarlett's SS hasn't even really bought in to the idea of weight loss, so I don't believe a good surgeon would even do it. The calorie restriction and portion size would likely not even be healthy for a still-growing adolescent, and there are lifelong implications to a surgery like that. If he is ready to restrict calories that much, he'd lose the weight on his own and surgery wouldn't even be necessary. 

 

That's a fundamental misunderstanding of how obesity and bariatric surgery work.  Overcoming obesity is not simply a matter of having the will to restrict calories, or to burn more calories than you eat.  

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37 minutes ago, Scarlett said:

He is offered a variety of healthy options.  And he has been told we will buy him any food that he wants that will help him in his efforts to lose weight.  

 

Has he clearly heard what you consider those foods to be and in what quantities you are willing to buy those foods?  I know that my teens can be impulsive and extreme as they try out new ideas, whether it comes to diet, studying, sleeping habits, and even doing laundry.  For example, if they heard that Grandma was suffering from osteoporosis and they needed to be careful to get enough calcium, the next trip to grocery store would probably result in a basket full of milk, yogurt, 20 different kinds of cheese, some ice cream, etc.--enough calcium for a small army.  It takes them some time and experience to navigate a new way of doing things in a moderate way.  I may know that there is no way they can eat that much cheese (or that it would be healthy to do that long term), but try to focus on they are attempting to make some positive changes.  Given that he has been told his milk consumption and his steak consumption this week were a problem (which could be foods he was going to in his effort to lose weight), that he might be a bit bewildered.  

I am not suggesting that you should, or that it would be healthy, for him to eat an unlimited amount of those items, I am just sharing this as something I have learned about how something that seems so obvious to me many not be so obvious to my teens and I either have to spell it out specifically or be patient as they experiment with the ideas themselves.  

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1 hour ago, jdahlquist said:

Has he clearly heard what you consider those foods to be and in what quantities you are willing to buy those foods?  I know that my teens can be impulsive and extreme as they try out new ideas, whether it comes to diet, studying, sleeping habits, and even doing laundry.  For example, if they heard that Grandma was suffering from osteoporosis and they needed to be careful to get enough calcium, the next trip to grocery store would probably result in a basket full of milk, yogurt, 20 different kinds of cheese, some ice cream, etc.--enough calcium for a small army.  It takes them some time and experience to navigate a new way of doing things in a moderate way.  I may know that there is no way they can eat that much cheese (or that it would be healthy to do that long term), but try to focus on they are attempting to make some positive changes.  Given that he has been told his milk consumption and his steak consumption this week were a problem (which could be foods he was going to in his effort to lose weight), that he might be a bit bewildered.  

I am not suggesting that you should, or that it would be healthy, for him to eat an unlimited amount of those items, I am just sharing this as something I have learned about how something that seems so obvious to me many not be so obvious to my teens and I either have to spell it out specifically or be patient as they experiment with the ideas themselves.  

He and his doctor talked at length about nutrition and weight loss.  He was given a guideline.....Foods to avoid, foods to eat and foods to eat in moderation.....something like that.  So there is a plan in place.  The list is very very long though.....so I don't aways know what he would prefer to have off the list.

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3 hours ago, Pawz4me said:

It probably depends on how mental health issues have been dealt with and discussed in your family, and on his mom's side. We treat mental health issues no differently than physical health issues, so . . not an issue here. I'd guess it would be different in families who stigmatize mental health issues.

 

Kids can certainly pick up on attitudes from outside of their family, so it's not fair to say this would never be a problem in families who don't stigmatize mental health issues. 

Do you have young adult children? I do, and I promise you that they have thoughts and attitudes toward many things that they certainly didn't get from us, lol. Parenting young adults would be a cakewalk if they didn't insist on having their own thoughts, ideas, and attitudes ?

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5 hours ago, SeaConquest said:

 

That's a fundamental misunderstanding of how obesity and bariatric surgery work.  Overcoming obesity is not simply a matter of having the will to restrict calories, or to burn more calories than you eat.  

 

A huge part of the aftercare of bariatric surgery is calorie restriction and tiny portions. Is it not? 

ETA: I know for a fact that it is. A good friend of mine had this surgery 2 years ago. 

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1 hour ago, katilac said:

 

Kids can certainly pick up on attitudes from outside of their family, so it's not fair to say this would never be a problem in families who don't stigmatize mental health issues. 

Do you have young adult children? I do, and I promise you that they have thoughts and attitudes toward many things that they certainly didn't get from us, lol. Parenting young adults would be a cakewalk if they didn't insist on having their own thoughts, ideas, and attitudes ?

I have two young adult sons. My youngest is the same age as your oldest, so I'm a few years ahead of you in terms of experience in that area.

I do not need anyone to "promise" me anything about young adult children nor attempt to give me lectures on what parenting them is like.

Please re-read my post and note that it started with the word "Probably." And I obviously did NOT say it would "never" happen otherwise. I said "I'd guess . . ."

(And I don't mean to be snippy. Truly I don't. But this I think is one of those things that people maybe mean when they complain about the board being contentious lately. Twisting someone's words so . . .why? Why not just post your own point of view w/o twisting mine?) 

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2 hours ago, Scarlett said:

He and his doctor talked at length about nutrition and weight loss.  He was given a guideline.....Foods to avoid, foods to eat and foods to eat in moderation.....something like that.  So there is a plan in place.  The list is very very long though.....so I don't aways know what he would prefer to have off the list.

 

What foods are allowed with no moderation needed, I wonder?  Maybe greens or other non high glycemic index, non starchy or sugary raw whole vegetables without any dressings? 

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I have no opinion on whether surgery would be a good fit for Scarlett's son, but found this article interesting. It emphasizes the emotional elements which can be underlying and contributing to weight issues, and how important addressing them can be.

https://www.bbc.com/news/health-44685874

My weight has always fluctuated. At my heaviest, I was 35 and a half stone (222kg).

Before then, I was working regularly and I was walking to and from work. But then, I lost my job and I stopped playing football.

When the weight started to pile on, that was when my mental health really went down.

It's a vicious circle. When I'm depressed, I eat - and when I eat, I'm depressed.

I've never had any support for my depression. I've just been put on antidepressants and sent away.

I've had to handle things myself and I think my eating is my way of handling it. I knew I was doing damage to myself - but I couldn't stop myself.

 

Quote over, back to my own comment:

If I heard the interchange between the two young men who were both overweight described above, I'd be wincing. Many truths are spoken in jest, and many jokes are ways to approach subjects which are too painful to speak of seriously. 

Editing to add that Scarlett clearly saw the awkward nature of their jokes, and tried to address it. I just personally wouldn't assume they really find the situation funny.

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3 hours ago, Scarlett said:

He and his doctor talked at length about nutrition and weight loss.  He was given a guideline.....Foods to avoid, foods to eat and foods to eat in moderation.....something like that.  So there is a plan in place.  The list is very very long though.....so I don't aways know what he would prefer to have off the list.

Can he help you plan the grocery shopping off that list every week? It doesn’t sound so much like a plan as a suggestion at this point. A plan would lay things out methodically. So much of each kind of thing in a day. What does avoid mean? Is it never allowed, allowed once per week or twice, etc? What is moderation? What is a serving size? What should I eat at each meal each day? Those are the components of a plan. If you do the grocery shopping, the two if you can plan his week or two weeks of food together before you go. Then he knows what he’s doing each day and doesn’t have to constantly analyze and make decisions.

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41 minutes ago, scholastica said:

Can he help you plan the grocery shopping off that list every week? It doesn’t sound so much like a plan as a suggestion at this point. A plan would lay things out methodically. So much of each kind of thing in a day. What does avoid mean? Is it never allowed, allowed once per week or twice, etc? What is moderation? What is a serving size? What should I eat at each meal each day? Those are the components of a plan. If you do the grocery shopping, the two if you can plan his week or two weeks of food together before you go. Then he knows what he’s doing each day and doesn’t have to constantly analyze and make decisions.

 

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 If he also knew what was to be used for meals you were planning it could cut down on eating the steak meant for dinner even if you haven’t labeled it. 

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2 hours ago, hippiemamato3 said:

 

A huge part of the aftercare of bariatric surgery is calorie restriction and tiny portions. Is it not? 

ETA: I know for a fact that it is. A good friend of mine had this surgery 2 years ago. 

Actually, not for all.  It should be but there are some doctors who do not have a follow up program for beyond a surgery check a few weeks after. They really just do the procedures and no counseling, no real follow ups.  Sets the person up for failure. We met a few when DH was attending the meetings before his WLS.  They were coming back for revisions or to go sleeve to bypass. And then you also have those who didn’t deal with issues correctly before hand and will be able to eat the same amounts before surgery.  They will slowly continue to add calories and larger amounts.  One of the people that had surgery around the same time as DH is now over 100 lbs overweight. 

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1 minute ago, itsheresomewhere said:

Actually, not for all.  It should be but there are some doctors who do not have a follow up program for beyond a surgery check a few weeks after. They really just do the procedures and no counseling, no real follow ups.  Sets the person up for failure. We met a few when DH was attending the meetings before his WLS.  And then you also have those who didn’t deal with issues correctly before hand and will be able to eat the same amounts before surgery.  They will slowly continue to add calories and larger amounts.  One of the people that had surgery around the same time as DH is now over 100 lbs overweight. 

 

That proves my point actually - the surgery doesn't cause permanent change unless the person continues to restrict calories and portions for their entire life. The surgery itself simply reduces the size of the stomach. The lifestyle change required after the surgery is necessary for the change to be permanent. Otherwise, the stomach stretches back out and the person will stay fat or regain any weight lost. 

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2 hours ago, hippiemamato3 said:

 

A huge part of the aftercare of bariatric surgery is calorie restriction and tiny portions. Is it not? 

ETA: I know for a fact that it is. A good friend of mine had this surgery 2 years ago. 

 

Yes, the surgery does restrict calories, but only for a few years. Eventually the stomach stretches back out to its normal size. What's thought to make the difference is that the surgery dramatically changes hormonal factors and gut issues for most people in a way that lowers the body's set point, so that even when the stomach returns to a normal size the hormones aren't changed back.

The newest information about this came out a few years back when the study regarding The Biggest Loser contestants came out.  Turns out they universally regained the weight they lost on the TV show AND MORE except for the people who had the surgery. The theory was that their set point was so high their bodies drove them to eat, and they got more and more hungry until they were forced to.  There are a couple of theories about why this is.  The two most credible I've read are from these books:

The Obesity Cody by Dr Jason Fung (his theory is that the surgery has the same effect as intermittent fasting at lowering set point).

A Pound of Cure by Dr Matthew Weiner (He's actually a bariatric surgeon, his theory is that a variety of things control set point, there are some things to change it that he recommends, both to avoid surgery, and when to have surgery, and how to prevent post-surgical set point from rising again.  He says the most common reason for unexplained weight gain after surgery is going on a medication that lowers metabolism. Also he says that weight is NEVER the fault of the obese.  In his experience it is so tightly controlled by hormones and set point that there is no amount willpower in the world that can permanently overcome those urges for most people with a weight condition so severe they qualify for surgery.  He has plenty of science to back that up).

 

 

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Yes, the metabolic changes with bariatric surgery occur *independent of weight loss.* 

https://www.nytimes.com/2017/02/13/well/why-weight-loss-surgery-works-when-diets-dont.html

They aren't altogether sure why that is, but it appears to be a variety of factors including, as mentioned above, changes to the gut biome and metabolic set point. 

 

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In my case, I spent thousands of dollars on personal trainers and chefs to help me lose weight. Because of the underlying metabolic problem, I could not lose the weight. I was even taking Adderall for ADHD and my weight wouldn't budge. Now, I do the same things as before (lower carb and regular exercise), but the weight comes off. Bariatric surgery has been nothing short of a miracle for me. I only wish I had done it sooner. My labs look better today than they did in my 20s, and I've basically guaranteed that I will never get diabetes. I've probably added 5-10 years to my life, thanks to surgery.

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4 hours ago, Pawz4me said:

I have two young adult sons. My youngest is the same age as your oldest, so I'm a few years ahead of you in terms of experience in that area.

I do not need anyone to "promise" me anything about young adult children nor attempt to give me lectures on what parenting them is like.

Please re-read my post and note that it started with the word "Probably." And I obviously did NOT say it would "never" happen otherwise. I said "I'd guess . . ."

(And I don't mean to be snippy. Truly I don't. But this I think is one of those things that people maybe mean when they complain about the board being contentious lately. Twisting someone's words so . . .why? Why not just post your own point of view w/o twisting mine?) 

 

I did not intend to twist your words or your point of view, your initial post seemed to me (and still reads that way to me) to be saying that it would not be an issue as long as the family did not stigmatize mental health issues. I read again, and I think I gave a fairly direct response to it and didn't read into it. 

Yes, the first sentence started with "probably" but the second sentence states that your family did not treat mental health differently than physical health, therefore you had no problem, implying direct cause and effect. It didn't seem to leave room for the fact that a different set of parents could take the exact same attitude and still wind up with kids who feel the stigma of getting mental health treatment.  You'd "guess" that things would be different in families who stigmatize mental health issues, but you don't guess that things might be different across families even if none of them stigmatized mental health issues. 

It probably depends on how mental health issues have been dealt with and discussed in your family, and on his mom's sideWe treat mental health issues no differently than physical health issues, so . . not an issue here. I'd guess it would be different in families who stigmatize mental health issues.

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