{Aired 07.15.14}

Today’s topic is one that is not strictly about plastic surgery but it does affect one’s decision for surgical intervention. What’s really behind the growing epidemic of eating disorders and obesity?.  Many women & men are turning to bariatric surgery or often to plastic surgery to treat this problem.  Recently, the   AMA     has labeled obesity as a disease – does this diagnosis hurt or help the average person affected by weight gain?  What effect does obesity have on disease, especially those affecting women.  Our special guest today – Mary Jo Rapini who has worked with individuals choosing bariatric surgery as an option.

Special Guest: Mary Jo Rapini is a Licensed Professional Counselor, Psychotherapist, Speaker and Author

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Mary Jo Rapini, LPC

Mary Jo Rapini, LPC

Our show topic today focuses on one of the key reasons people seek plastic surgery.   Women and men are unhappy with their bodies for one reason or the other.  At the root of many of these requests lies one culprit:  the issue of weight. This issue will cover the spectrum of someone gaining a few pounds to gaining 100 pounds or more.   At the heart of all it – we have to honestly look at this epidemic to  determine why.

The answer to that one question may just lie at the heart of the problem.  No lasting solution will come if that question is not recognized and understood.  Oftentimes, there is a revolving door that some people are willing to go through in having the same procedures done over and over again.  The root cause of the problem may never have been dealt with.

For some people it is minor – maybe they’ve gained 10 pounds and have tried everything to get it off.  Exercise, proper diet and nutrition are what they do. For others, the issue of weight gets to be out of control and can lead to a very dangerous and unhealthy situation – where the body takes on a disproportionate amount of fat.  Many people erroneously believe that certain plastic surgery procedures will eliminate their problem.  The truth is, with massive weight gain, it is important for individuals to honestly assess what’s eating them.  What got them there in the first place?

Dealing with the Issue

Mary Jo: I actually consult patients before bariatric surgery, whether if it’s their first, second or third surgery and most of the reason underling that, for whatever the reason that caused them to over eat was not resolved. And it’s not the weight loss it’s maintaining the weight. If you have not dealt with your issue of why you turn to food for comfort or friendship you are not going to be successful with the weight loss surgery.
Joan Jefferson: It becomes a revolving door. I’ve seen people come in for plastic surgery for liposuction and they are back in a year.
Mary Jo: And what we are seeing now is that insurance companies are not likely to do the revision surgeries at least not without a psych evaluation or attending a 12 step food addiction group. The insurance companies are getting wind of a bigger issue. And I like to get a look at the big picture. I like to look at the whole family. Who is the enabler? Because I can guarantee you that someone in that family is actually enabling that person to continue to turn to food and it’s actually someone who is insecure and needs them.

Listen to the whole segment here. 

What is Obesity?

Obesity is a serious disease with symptoms that build slowly over an extended period of time. The National Institutes of Health (NIH) define morbid obesity as:

  • Having a Body Mass Index (BMI) of 40 or greater
  • Or, having a BMI of 35 or greater and one or more co-morbid condition

There is a genetic factor to this issue but there is still no reason for anyone to not choose to eat healthy and exercise.  The stigma that surrounds being overweight or obesity problems can also be damaging to a person’s self image.

MJ: Women are judged within the first 1/4 of a second on her weight and hair. Ask any women on the street she will confirm. She feels it everyday.
JJ: For some reason we have a tough time looking at the issues that underlie these weight issues.
MJ: Especially if it’s anything you feel ashamed about, or embarrassed you are just going to push that way down.


 The Guilt that Goes with Weight Gain

JJ: The effect of weight gain impacts a person, how do they deal with that? 
MJ: Some of my patients will say I am so successful in every are of my accept this one. They are the ones that will avoid the issue completely and go out of their way to create a fantastic career and family but when it comes to this one area (weight gain) it’s almost like they needed an outlet and they feel very guilty and ashamed about it. 
JJ: Would you say these people are also perfectionist?
MJ: I would say that a lot of patients that are morbid obese are perfectionist but more they like completion and not openness. 
JJ: Is there a pay off to not facing these issues?
MJ: Yes…I run a 12 step food program and ask my patients to go home and write down all the good reasons for being obese. They look at me 

like I’m insane and say but there isn’t, that’s why I’m here but there are payoffs to everything a human does. For women they will say I can walk outside at night alone and nobody messes with me or when I’m in a group no one touches me because I have a lot of padding, no one notices me or at work no one asks me to do extra work.

JJ: So you are saying this is on a conscience level? 
MJ: Yes! 
Listen to the entire segment here.

The Fear of Examining Our Feelings

Our feelings are a big component to weight gain and we tend to shone these topics rather than explore them. And out guest Mary Jo has alluded that many morbidly obese people gain weight and use it as a shield.
MJ: Sexual abuse is actually a reason for  morbid obesity in more women than men.  It’s getting more attention because everyone has ignored this mainly because the patients have been resistant to talking about it and teaching us about it because of the shame and they don’t realize until they are going through the psyche evaluation for bariatric surgery of what the problem is. Many of them have locked in away in their mind so far just bringing up the subject for a minute makes them want to eat, makes them shaky, cry and relive it all again. But until them can do that no surgery is going to  be successful for them. 
JJ: And this effects so many women.
MJ: Yes about 60% of morbidly obese women have had sexual abuse. 
JJ: How has food used as a shield?
MJ: Well molestation happens the first time at a young age and usually by someone they know and love. Food is accessible and they learn very quickly that if they get chubby they will be left alone and this is quite effective especially if the girl is older. The worst thing you can do to a child is sexually abuse them, for them to grow up and get over it and live a healthy life is extremely difficult. 
Listen to the entire segment here.

Risks Associated with Morbid Obesity

Increase weight has been linked to the following health risks:

  • Breast Cancer
  • High Blood Pressure
  • Heart Disease
  • High Cholesterol Levels
  •  Diabetes
  • Respiratory Problems
  • Acid Reflux
  • Degenerative Arthritis
  • Cancer
  • Skin Infections
  • Infertility

Mixed Messages about Eating

How do we reprogram our old way of thinking – “You must clean your plates!” You must realize that you are not a garbage can and you should think of yourself as a spiritual being having a human experience. These two must connect and will not be able to connect if you cannot walk or connect with other people. You must think of yourself as a higher being. If you do not love yourself you will put junk in your body and not be inspired to eat healthy.

Listen to Joan and Mary Jo here.

Special thank you to Mary Jo Rapini. Follow her conversations here:


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