Body Image Issues After WLS

1
Body Image Issues After WLS

• By
• Gregory S. Jones, Ph.D.
• Health Psychologist
• Behavioral Health
• Surgical Weight Loss Center
• Marquette General Health Systems

2
Objectives

• Briefly discuss post-surgical adjustment issues
  of bariatric patients.
• What is body image?
• How does body image affect us?
• What shapes our body image?
• How to improve our body image!

3
Post-Surgical Psychological Adjustment Issues
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Interpersonal, intrapersonal and lifestyle changes
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Interpersonal Issues

• Family issues
• Competition with family members.
• Familys perception that took the easy way out
• Shifts in roles within the family
• Change agent in the overall system

6
Interpersonal Issues

• Partners/spouses
• Increased insecurity changes in intimacy
• Loss of protection or no longer can hide for
  SA survivors
• Unconscious sabotaging
• Good marriages get better bad marriages get
  worse

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Intrapersonal Issues

• Fear of failure
• Focused more on the numbers versus the overall
  changes
• Reduced or eliminated illness co-morbidities
• Reduced medications
• Im so afraid I am going to disappoint everybody

8
Intrapersonal Issues

• Body image issues
• I still feel fat although I lost 172 pounds
• My body is so ugly, especially with all that
  skin hanging
• Everyone tells me that I look sick
• I cant believe that I still hate myself

9
Lifestyle Changes

• Adopting new lifestyle changes impacts
• Health behaviors (eating, physical activity)
• Social activities
• Time management issues (new interests)
• Struggles with old habits

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Depression and Anxiety

• May increase or develop following surgery
• Physiological changes
• Psychosocial adjustment
• Worried about relapsing
• Body contouring issues

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What is body image and how does it affect us?
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What is Body Image?

• the picture of our body which we form in our
  mind
• It involves our perception, imagination,
  emotions, and physical sensations about our
  bodies
• Changes throughout life
• Can be positive or negative!

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What is Body Image? (Continued)

• Psychological in nature
• Influenced by self esteem
• Learned about what is expected culturally
• Both men and women suffer from body image
  dissatisfaction! (not liking ones body or
  specific body parts)

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Body Image and Self Esteem

• Body image helps form self image
• Culturally some of us learn that how we look
  defines who we are
• Sothe worse we feel about our body, the worse we
  feel about ourselves
• Self esteem how worthy one feels

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Body Image and Eating Disorders

• Body dissatisfaction is the single strongest
  predictor of risk for developing an eating
  disorder!

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Terms

• mirror psychosis
• fat person syndrome bariatric online groups
• Body Dysmorphic Disorder(300.7)

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What shapes our body image?
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Medical Contributors That Can Affect Body Image

• Aging
• Alopecia
• Cancer
• Cosmetic Surgery
• Diabetes
• Skin Disorders and Scarring

• HIV and AIDS
• Lupus
• Menopause
• Oral Health
• Pregnancy
• Thyroid disorders
• Others

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What Contributes to a Negative Body Image?

• Media
• Culture
• Interpersonal messages
• Personal
• Diseases/health concerns

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Sociocultural Influences

• Media
• What types of messages do you see communicated
  to men and women through advertisements/TV
  shows/characters?
• About women? Men?
• What is seen as sexy, successful, popular?

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Sociocultural Influences (Continued)

• Culture
• What are images of successful men/women in this
  culture?
• What does our culture say about heavy vs. thin,
  muscular vs. lean?
• Culture of shame around body image
• Size discrimination
• Fat stigma
• Hatred of fat prejudice

22
Interpersonal

• What messages do we get from parents, friends,
  coaches, and others?
• Childhood teasing
• Loved ones sometimes disapproving
• Negative judgments
• Comments by parents and friends

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Personal
What personal characteristics contribute to a
negative body image?

• Perfectionism
• Low self-esteem
• All or nothing thinking

• Difficulty focusing on positive qualities
• Life would be better if

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The Perfect Woman
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Female Body Images

• Large breasts, placed high on chest
• Small waists
• Round buttocks
• Highly sexualized and often shown with red lips,
  heavy lidded eyes, slightly open mouth, and even
  erect nipples
• Partially undressed or naked
• Skin tight clothes
• Mainly white, even when they are racialized

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Samus Aran Super Metroid
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Lara Croft Lara Croft Series
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Kurenai Red Ninja
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Anna Tekken 5
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BloodRayne
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Nina Williams Death by Degrees
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Cat Woman
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Rumble Roses
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Wrath Unleashed
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Need for Speed Underground 2
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Playboy The Mansion
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Leisure Suit Larry
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The Perfect Man
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Male Body Images

• Large shoulders
• Thin waist
• Thin hips
• Usually exaggerated hyper-masculine body, but
  diversity is showing up
• Well defined muscles
• Non sexualized
• Fully dressed in appropriate clothes for situation

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Duke Nukem
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Anarchy Online Men
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Wrath Unleashed
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Manhunt
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Madden NFL
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Halo 2
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Grand Theft Auto San Andreas
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Grand Theft Auto San Andreas
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Grand Theft Auto San Andreas
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Red Ninja
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Need for Speed Underground 2
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Playboy The Mansion
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Leisure Suit Larry
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How to improve body image?
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Treatment

• Individual psychotherapy
• Cognitive-behavioral (e.g., cognitive dissonance)
• Integrative personality approach
• Support groups
• Bibliotherapy

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Improving/Developing a Healthy Body Image

• Focus on HEALTHY HABITS
• Regular exercise
• Healthy eating habits
• General physical well-being

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Improving/Developing a Healthy Body Image

• Happiness only comes from within
• Your body is only PART of who you are
• focus on the assets you feel more positive about!

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(Adapted from Body Love Learning to Like our
Looks and Ourselves, Rita Freeman, Ph.D.)

• Listen to your body
• Be realistic about size, appearance
• Exercise regularly in an enjoyable way
• Expect normal weekly and monthly changes in
  weight and shape

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(Adapted from Body Love Learning to Like our
Looks and Ourselves, Rita Freeman, Ph.D.)

• Work towards self acceptance and self forgiveness
  
• Ask for support and encouragement from friends,
  family, etc.
• Decide how to spend your energy-pursuing the
  perfect body image or enjoying life!

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Case of Linda

• 28 year old female
• African-American
• Married
• College Professor
• 1 of 9 female relatives severely overweight
• Big Girl and Tiny

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Case of Shelly

• 34 year old female
• Caucasian
• Married
• Homemaker
• Athletic
• basketball and softball scholarship at Big Ten
  University
• Amazon woman

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Thank you!!!!!