We held our first support group meeting of 2017 in February, hosted by our resident psychologist Fiona Tzouramanis. The topic up for discussion was “maintaining motivation after surgery and beyond”, something vital for our patient’s success long-term for weight loss as well as maintaining weight afterwards.
One of the topics discussed during the meeting was the “Stage of Change” model – this is a model of behaviour change which views the process of changing as problematic behaviours occurring in a series of stages:
Contemplation – the person starts to acknowledge that there is problem and begins to think about change (before surgery).
Determination/Preparation – the person is considering change in the immediate future and takes small steps towards change (before surgery).
Action – At this point the person feels confident to make the change (takes steps towards surgery and/or has surgery).
Maintenance – this means you can keep the change going with your current plan. Confidence in this phase is maintained (after surgery, this phase is usually where most of our patients will stay for a while)
Permanent Exit/Termination – this occurs once change is completely integrated into a person’s lifestyle. (this stage does happen with weight loss patients but not always).
Relapse – this means the person returns to the original behaviours, will go back to pre-contemplation. (this stage can also occur with weight loss patients).
Looking at this model, most patients will stay at the maintenance phase long-term and eventually go into the permanent exit stage. What we don’t want is our patients going into the relapse stage as this is where motivation is at its lowest.
There is one more important stage we need to point out. This is the lapse/slip stage that is common for all patients post operatively, usually 2-3 years after surgery. It can happen when a person has an occasional slip, for example the person has had bigger portions than usual, is eating too much sugar, hasn’t exercised for a few weeks, is engaging in emotional eating etc. At this stage the person needs to reach out for support and re-focus and get back on track. This brings us to the next stage of motivational change patients need to be aware of – the critical mind.
It is often the critical mind that gets us into trouble – we listen to it and feel hopeless, angry at ourselves and depressed. This mindset is not conducive to motivation, in fact it is the opposite. This critical mind usually creeps in during the lapse/slip phase and when we focus on it, our motivation drops even further.
So how do we overcome the critical mind?
Write down these inner critical thoughts, what are they telling you? Write them and look at them from a distance, observe them. Put the phrase “I am having the thought that…” in front of the critical thought and then put the phrase “I notice I am having the thought that….” in front of the thought. The idea is to create some distance from the thoughts in order for them to have less power over you. This exercise is called diffusion of thoughts, it assists you to be separate from the thought so you are then able to take the right action towards change.
Lastly, always be kind to yourself, recognise we all have an inner critic, recognise that we all fail at our goals at times. Look at it as a setback, not failure, keep moving forward towards positive change.
As always our support group attendees found the information discussed very interesting and useful, helping them continue to maintain an ongoing healthy lifestyle change. If you would like to attend our next support group meeting (17th of May) then please call our team on 02 9553 1120 and they will be able to book you a place.
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