By: Sarah Galzerano, Jefferson Health — New Jersey
Building confidence and self-esteem after bariatric surgery, like all things, takes practice. It can be difficult to overcome low self-esteem without first understanding what body image is and what factors may have played – or may still play – a role in yours.
Body image is both the mental picture you have of yourself and what you physically see when you look in the mirror, explains Stephanie Ferroni, APN, psychiatric nurse practitioner with Jefferson Health – New Jersey. Self-esteem is how you value yourself as a person. Both contribute greatly to your emotional and physical well-being.
“When you have a healthy body image and feel more comfortable with yourself, you’re more likely to take care of yourself,” Ferroni said. “On the other hand, if you have a negative body image, you may neglect your body’s needs.”
Influences on Body Image and Self-Esteem
Various factors may come into play. Establishing a healthy perception of oneself can feel like an uphill battle in today’s world, says Ferroni. “Psycho-social influences, primarily from the media, can alter how we perceive our appearance. Whether it’s on social media or TV, we are constantly bombarded with images of stereotypical ‘beauty.’ When you lack self-esteem, this subconscious comparison can trigger your ‘inner critic.’”
In addition to looks, media also heavily highlights diet culture, says Andrea Bookoff, MS, RD, bariatric dietitian. “There are several fad diets that encourage us to lose weight and cut out certain foods, rather than focus on our overall health. This mentality is engrained.”
Common environmental factors that might hinder self-esteem and confidence include abuse, bullying, and lack of approval from authority, adds Ferroni. However, it’s not just external factors that can take a toll.
Low self-esteem is a vicious cycle that often coexists with other mental conditions, such as depression, anxiety, addiction, obsessive-compulsive disorder, disordered eating, and body dysmorphic disorder. If you have one of these, your risk for another is naturally higher, she explains. “Some people try to cope, overcompensate, and gain a sense of control with drugs, alcohol, and even food.”
Tackling Body Dysmorphia
If you ever feel like the person you see in the mirror appears completely different than the person everyone else sees, you’re not alone. Body dysmorphic attitudes are not uncommon among the bariatric community – and those who have struggled with their weight in general – continues Bookoff.
“Body dysmorphic disorder is characterized by persistent and intrusive thoughts that your appearance is flawed. There might be a hyper-focus on a particular ‘defect,’” explains Ferroni. Body dysmorphic disorder may result from a combination of factors described above. Even after someone alters their physical appearance, body dysmorphia can persist, as it is related to body image, not necessarily physical appearance.
What You Can Do
Building self-esteem is crucial, continues Ferroni. “When we learn to love ourselves, we strive for a better life, happier relationships, more fulfilling careers, and recovery. This starts with awareness of deep-rooted feelings we have about ourselves.”
It’s important to admit and accept that you can’t do it alone, says Cristy Polizzi, Bariatric Wellness Program Coordinator. “We see many bariatric patients who are caretakers. During this journey, self-care is a must. You have to be able to shift your mindset to succeed; bariatric surgery, as a tool, can’t work with these barriers.”
If you think you might need professional help, remember that reaching out is a sign of strength, adds Ferroni. Your bariatric care team can help identify what is going on and coordinate with a mental or behavioral health specialist.
There is still much you can try on your own to boost your self-esteem and emotional well-being:
Shift your mindset: Focus on positivity, self-love, and self-care, says Polizzi. “Use positive affirmations. Speak kindness into your life. Write yourself uplifting reminders on sticky notes – things that focus on your strengths – and place them in places you see most, such as the steering wheel of your car, coffee pot, or mirror.”
Prioritize time for yourself: You can’t run yourself into the ground and expect your health to improve. Always make time for yourself, even if it starts with just a few minutes a day, continues Polizzi. Do things you enjoy. Positive reinforcement can help boost confidence and secure a sense of self, adds Ferroni.
Practice mindfulness: Studies show that mindfulness may yield promising stress-reduction benefits, says Ferroni. “Mindfulness – which typically involves timed breathing exercises and focusing on one’s internal physical being – can help bring one’s attention into the present moment, without judgment.”
Challenge your fears: Often what you think is going to happen is internalized due to the fear of the unknown, suggests Polizzi. “We’ve all been there; we build an inner monologue of ‘what ifs’ and what could happen.”
It may help to walk through a scenario or event in your head prior, adds Bookoff. “Try to pinpoint your concerns and determine possible solutions. What can you do to make this go the right way – a way you’re comfortable with? If you’re nervous about going to the gym, maybe the solution is to take a friend or go during a time when it isn’t busy.”
Get involved: It’s not uncommon to feel apprehensive about putting yourself out there, says Ferroni. However, community involvement – especially with a group of people who know what you’re going through – can help you feel supported and motivated.
Jefferson Health – New Jersey offers several support programs for bariatric patients to help them stay connected, including an open forum support group, men’s peer-to-peer group, and a mindfulness and meditation class.
“Support groups emphasize that you’re not alone. The feelings you have aren’t abnormal,” said Polizzi. “Our groups foster a strong sense of community, where people can learn from others even before they have surgery, teaching them what to expect. This can make a world of difference.”
To showcase patients’ successes, there’s also an annual “fashion show” (which has been held virtually since the pandemic). Participating in the fashion show isn’t just about getting to “soak up” the well-deserved spotlight, continues Polizzi. It’s about advocacy and getting to share your story. Many patients reach the point where they want to help others experience a similar journey to health.
Take your time: Confidence doesn’t come overnight, says Bookoff. It comes from small changes – small goals and non-scale victories – that gradually build up over time.
Also, there’s no “one size fits all,” reminds Ferroni. “People are unique. Your journey and emotional and physical approach will happen in a different way and at a different pace, and that’s ok.” For more information on bariatric surgery education and support resources, click HERE or call 609-707-7298.
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