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#1
Old 12-29-2016, 08:14 AM
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My 600-lb Life on TLC

I find myself watching this in a slow-down-as-I-pass-a-car-wreck kind of way. I caught the episode on 12/28 of Pauline Potter.

I know these are reality shows, edited to provide the most drama. But what strikes me in many of these episodes is the lack of psychological counseling. Dr. Nowardan treats the physical side with surgery but are they skipping over the mental side? I saw one episode where the patient met with a nutritionist, but I haven't seen any where they meet with a mental health specialist. Am I just not tuning into those shows?

In Pauline's case, she said she was in too much pain to exercise and thought losing four pounds after her surgery was just fine, when Dr. Now said she should be losing 10-15 pounds a week. At one point she eats a salad, despite knowing she shouldn't eat salad because it fills her up and doesn't leave room for protein.

For the first year, she fought him in regards to pain medication, exercise, and the rate of weight loss. After her surgery she refused to get out of bed and walk, and Dr. Now had to implant an air filter in her leg to prevent a blood clot. It was only after she had surgery for an ulcer that she got serious about her maintenance and after care.

I'm always glad to see the success stories, but I wish the show would do a better job in showing the totality of the experience, that it's not just a simple surgery and you're on your way to better health. You have to also address the issues that got you to this point in the first place.
#2
Old 12-29-2016, 10:36 AM
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I'd think a major obstacle is patients who refuse/won't acknowledge the psychological aspects of their problem.

You can't force psychological help on people. If they don't realize that they need to alter their thought processes they're not going to, and attempting to force that change is likely to only make them more stubborn.
#3
Old 12-29-2016, 10:50 AM
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I agree. Pauline kept saying that she wanted to lose the weight for this reason and that, but when it came down to her actually DOING THE WORK she balked.

I haven't seen the show address the psychological aspect of morbid obesity.
#4
Old 12-29-2016, 11:01 AM
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They do show psychological therapists working with the patients on that show. That part is not emphasized though.

I'm not sure what the HIPPA laws would say, but a good reality show would be featuring talk therapy for various problems with various people. I guarantee it would be a smash.
#5
Old 12-29-2016, 11:52 AM
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I'm assuming the patients sign releases, otherwise they wouldn't be able to show the surgery, right? Perhaps there's no similar release for mental health.
#6
Old 12-29-2016, 12:25 PM
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Yes, you can have a similar release for mental health. Probably not as common, and has to be done separately and specifically for mental health.
#7
Old 12-29-2016, 01:52 PM
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I've seen most of it, I think, and quite a few of them do visit counsellors. Possibly more do but their counsellors don't agree to be filmed.
#8
Old 12-29-2016, 02:16 PM
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I watch this show a lot. In late September I started working to lose 100lbs (27 down!), and I discovered that I find this show to be motivational and/or inspiring. I also had a mother who was addicted to food and got up to 350lbs, so part of me sympathizes with the enablers. I think I've seen most of the episodes by this point.

As Two Many Cats and SciFiSam said, often they do show counseling; usually the person's initial session. I have a feeling that therapy happens more often than we see, and it's just that the patient doesn't want to share that part publically (or the therapist doesn't).

Quote:
Originally Posted by ivylass View Post
I wish the show would do a better job in showing the totality of the experience, that it's not just a simple surgery and you're on your way to better health.
Wow, I've never gotten that impression from an episode. In fact, Dr. Nowzaradan always requires people to lose a certain amount of weight before he'll approve them for the surgery: they have to prove that they can make the needed changes, otherwise surgery will be useless (as he says repeatedly). I often see him tell people that they can't expect the surgery to be magic, which is always a little sad because usually you can tell that's exactly what the person was hoping for. I actually just watched an episode where it took a guy 1 full year to be approved for the surgery.
#9
Old 12-29-2016, 02:42 PM
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That wasn't my intent. I meant that there's more to it than just the physical aspect, there's also a mental aspect that needs to be addressed. In Pauline's case she rationalized eating fast food all the time because she couldn't stand up long enough to cook/they were traveling/she doesn't know anyone, so this is her entertainment, etc.

Congrats on losing the 27 pounds! How are you doing it?

Last edited by ivylass; 12-29-2016 at 02:42 PM.
#10
Old 12-30-2016, 07:19 AM
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I saw the episode on 12/29 about Paula. It that episode, it did show her going the therapy to address her issues, so it is whatever the patient is comfortable with sharing. But isn't counseling a normal part of the treatment for morbid obesity? I think they should address that in the show, even if they don't highlight that for all the patients.

I was amazed at her transformation, and it wasn't just her weight loss. At the beginning she was dying her hair green and blue, but at the end, she was more like a poised professional. Even her voice sounded more mature. I hope her daughter got her weight issues addressed as well.
#11
Old 12-30-2016, 08:04 AM
Nope! I said stop!
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I watch this too, and I'd say about a third of the shows he refers them for counseling.
#12
Old 12-30-2016, 12:05 PM
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Quote:
Originally Posted by ivylass View Post
Congrats on losing the 27 pounds! How are you doing it?
Thanks! I started with a medically supervised weight-loss program run by a local hospital: three months of a low-calorie diet that was mostly meal replacement products, plus weekly meetings that included exercise sessions and nutritional, behavioral, and exercise lectures. Counseling was available through the program, but I decided to engage a private therapist because I'm determined to make this change a permanent one. I learned how to eat better and what my target calorie intake should be, and how to start exercising effectively. The program ended 3 weeks ago, and since I've been all on my own I've lost two more pounds.

Right now I'm grateful that I live alone: I can't imagine trying to make this kind of lifestyle change with others in the house who can/want to eat differently. That's a huge issue for so many of the people on the show. A friend of mine who is also morbidly obese recently started working with a bariatric doctor and has lost 9 pounds in the past month, even though her husband and kids -- who she cooks for -- are all skinny and love their carbs. She's my hero!

Quote:
Originally Posted by ivylass View Post
But isn't counseling a normal part of the treatment for morbid obesity? I think they should address that in the show, even if they don't highlight that for all the patients.
I'm actually ok with the focus they give it. Everyone that weight has psychological issues they need to address, but not everyone needs therapy to do it. I don't think anyone who is overweight is going to watch that show and think it's just about the surgery. People who are fat tend to know they have issues, they're just really good at ignoring them.

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Originally Posted by IvoryTowerDenizen View Post
I watch this too, and I'd say about a third of the shows he refers them for counseling.
Sounds about right. But I do think that's only what we see. I bet a lot more people get referred/go to a therapist and we just don't see it on the show (for privacy reasons, show length reasons, etc.).
#13
Old 12-30-2016, 01:27 PM
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I think participants should have treatment, therapy and frugs for depression and anxiety BEFORE surgery. They'll be returning to the same self and family pathologies, I think they should be better prepared before undergoing life changing surgery.

Clearly, with a few exceptions, these folks are poor if not downright impoverished; given that junk food is far, far cheaper than healthy chow I'd like to see nutrition classes for the entire family. I've noticed that family tends to also have weight issues.
#14
Old 12-30-2016, 02:11 PM
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Quote:
Originally Posted by ivylass View Post
I saw the episode on 12/29 about Paula. It that episode, it did show her going the therapy to address her issues, so it is whatever the patient is comfortable with sharing. But isn't counseling a normal part of the treatment for morbid obesity? I think they should address that in the show, even if they don't highlight that for all the patients.

I was amazed at her transformation, and it wasn't just her weight loss. At the beginning she was dying her hair green and blue, but at the end, she was more like a poised professional. Even her voice sounded more mature. I hope her daughter got her weight issues addressed as well.
I remember her - one of the best ones. Generally it is a pretty positive show and the participants seem to have a fair amount of control.
#15
Old 12-30-2016, 03:24 PM
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Originally Posted by SciFiSam View Post
I remember her - one of the best ones. Generally it is a pretty positive show and the participants seem to have a fair amount of control.
I watched one. It was a man who met Dr. Now when he was admitted via the ER. He was motivated to lose weight because he was told and knew that he could die if he didn't. And yet he had food hidden all over his hospital room. I wondered how he did that. I mean, he could barely move and I am not exaggerating. Astonishingly and totally unexpectedly for an uplifting reality show, he died. I don't think I ever saw a reality show end so badly.
#16
Old 12-30-2016, 05:57 PM
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I like what Paula said at the end...she basically had to unlearn and relearn everything she thought she knew about food and exercise and nutrition.

Which person died on the show? My Google-fu is bringing up two, a man named Henry Foots and a Haitian woman.
#17
Old 12-30-2016, 10:04 PM
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Originally Posted by Biggirl View Post
I watched one. It was a man who met Dr. Now when he was admitted via the ER. He was motivated to lose weight because he was told and knew that he could die if he didn't. And yet he had food hidden all over his hospital room. I wondered how he did that. I mean, he could barely move and I am not exaggerating. Astonishingly and totally unexpectedly for an uplifting reality show, he died. I don't think I ever saw a reality show end so badly.
Another reality show about morbidly obese people featured a man who weighed 800 pounds and was on a ventilator - and late one night, the nurses caught him with 3 girls in his room! He was also having food delivered.

I used to work at a hospital that did bariatric surgery, and the psychiatric evaluation led to more disqualifications for surgery than every other reason combined. Most of those patients were in the 250-350 pound range.
#18
Old 12-31-2016, 01:05 AM
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I remember him on my 600 LB Life but I do not remember this special about his death. I think they may have pulled this together after he didn't make it to the end of his 600 pound contract.
#19
Old 12-31-2016, 10:54 AM
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I remember the deaths. There have also been a few people who were simply uncooperative/unsuccessful; Dr. Nowzaradan had to pretty much kick them out of the program. I feel horrible for those people but I like seeing those episodes, because each of them started out with the best of intentions and doing what they had to (for at least a little while) and it reminds me to not rest on my laurels. I've only lost 25% of what I need to, and it would be super easy to get right back to where I was three months ago.

(Ok, so, my relationship with the show might be a little more personal than most... )

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Originally Posted by nearwildheaven View Post
the psychiatric evaluation led to more disqualifications for surgery than every other reason combined
Oh wow, that never even occurred to me...I wonder if the people on the show go through a psych eval before filming starts...
#20
Old 12-31-2016, 01:56 PM
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I bet they do. They follow these people for years, so it wouldn't be much of a show to get three months in and find out the person can go no further.

Misnomer, are you incorporating exercise into your routine?
#21
Old 12-31-2016, 02:13 PM
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I've watched quite few of these. The doctor is horrible at dealing with/treating the psychological part of his patients' issues. On camera, he pretty much just says "You're a lazy liar." and then repeats it more insistently when the patient fails to lose weight. The patients also don't seem to get counseling until deep into the process - sometimes several months after they've had weight loss surgery, rather than before (there's often a "first meet" with a counselor filmed.)
His approach does work for some patients, but I did just see an episode where the patient didn't lose weight until she found a different doctor, probably someone who was able to communicate more productively.
#22
Old 01-01-2017, 03:57 PM
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Quote:
Originally Posted by amarinth View Post
I've watched quite few of these. The doctor is horrible at dealing with/treating the psychological part of his patients' issues. On camera, he pretty much just says "You're a lazy liar." and then repeats it more insistently when the patient fails to lose weight. The patients also don't seem to get counseling until deep into the process - sometimes several months after they've had weight loss surgery, rather than before (there's often a "first meet" with a counselor filmed.)
His approach does work for some patients, but I did just see an episode where the patient didn't lose weight until she found a different doctor, probably someone who was able to communicate more productively.
We are seeing only a tiny percentage of the process, carefully edited to entertain us. I wouldn't assume too much based on what we are shown.

That said, the good doctor does have an interesting bedside manner.


mmm
#23
Old 01-01-2017, 04:02 PM
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Is Dr Now at his ideal weight? He seems pudgy to me.
#24
Old 01-01-2017, 06:52 PM
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Originally Posted by Two Many Cats View Post
Is Dr Now at his ideal weight? He seems pudgy to me.
He needs to lose 40 lbs. in the next month. Who's bringing him food?


mmm
#25
Old 01-01-2017, 10:12 PM
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The only one I remember was Melissa, and she ended up being successful and became a counselor to people who were attempting lose weight as well. (I just hope she ditched that asshole husband of her's)
#26
Old 01-02-2017, 04:44 PM
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There was a previous version of this show that featured Dr. Now, his son (also a bariatric surgeon) and a therapist. The therapist was very involved in the process and I thought she had the most interesting insights. Now with this iteration, the son is a producer (I think) and the therapist is nowhere. I hope she's still doing the same thing for these people.
#27
Old 01-02-2017, 08:13 PM
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Tonight was the episode with Milla, and I must say, she was the most promising of them all. No whining, no cheating, she made sure she ate right and exercised, and finally got outside of her head so she could stand for the first time in nearly three years. The episode only showed her getting her weight down enough to remove a lymphedema, which was nearly 40 pounds, and get down low enough to get the gastric bypass surgery.

I wonder how she's doing.
#28
Old 01-02-2017, 11:42 PM
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I like this show. We go on occasional binge-watchings of it before it all gets too sad and we have to try something else. It's good anthropological material, and occasionally uplifting. My favorite so far is Olivia. I don't know what it was about her, but she had me rooting for her from the start. I'm glad she found the success she did.
#29
Old 01-03-2017, 10:50 AM
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Quote:
Originally Posted by ivylass View Post
Misnomer, are you incorporating exercise into your routine?
Yep! Like I said, "I learned how to eat better and what my target calorie intake should be, and how to start exercising effectively." I'm doing both cardio (with a treadmill) and some simple weight training (with a dumbbell set). This morning I walked a mile.

I know objectively that's not far/much, but for me it's awesome!

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Originally Posted by Mean Mr. Mustard View Post
He needs to lose 40 lbs. in the next month. Who's bringing him food?
#30
Old 01-03-2017, 11:47 AM
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Originally Posted by Misnomer View Post
Yep! Like I said, "I learned how to eat better and what my target calorie intake should be, and how to start exercising effectively." I'm doing both cardio (with a treadmill) and some simple weight training (with a dumbbell set). This morning I walked a mile.
We all started somewhere. Congratulations! You'll be running marathons in no time!

I did see the one with Randy, who lost weight TOO fast and ended up in the hospital. He had an enlarged heart and Dr. Now was concerned he wouldn't be strong enough for surgery. That's the first time I've ever seen Dr. Now tell someone to slow down their weight loss.
#31
Old 01-03-2017, 12:12 PM
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Quote:
Originally Posted by Biggirl View Post
I remember him on my 600 LB Life but I do not remember this special about his death. I think they may have pulled this together after he didn't make it to the end of his 600 pound contract.
Technically, that program was about John Keitz, and predates the 600-lb life series by a number of years.

If I can remember the details. . . .

He was bedridden, and he and his wife lived in the house previously owned by his parents. They were unable to pay the taxes on it, so it was seized, and they were evicted.

He had a handicapped daughter that he and his wife took care of, also several siblings (none of whom were mentioned in the doc), who would have nothing to do with him or his wife.
#32
Old 01-05-2017, 08:50 AM
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Last night was Brandi and Kandi, morbidly obese twins.

I am confused by something. If these people can lose 30-50 pounds in a month with diet and exercise, why don't they just continue to do that instead of getting the surgery?
#33
Old 01-05-2017, 12:10 PM
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I have wondered this myself.

Also, months after the surgery, people are shown eating a normally sized plate of food. I thought the reduced size of the stomach made that impossible.
#34
Old 01-05-2017, 12:53 PM
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Quote:
Originally Posted by ivylass View Post
Last night was Brandi and Kandi, morbidly obese twins.

I am confused by something. If these people can lose 30-50 pounds in a month with diet and exercisea, why don't they just continue to do that instead of getting the surgery?
I wonder about this as well. Maybe it's more of a psychological exercise so patients have a taste of losing weight and practicing overcoming pathological issues with food.

Do really big people rapidly lose weight when their calories are radically cut down? Even if I starved myself, there's no way I could lose 12 pounds a week!
#35
Old 01-05-2017, 01:03 PM
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I liked Brandi and Kandi's episode last night, it was interesting to see the dynamics between them.

This episode brought to mind how many of the folks on the show seem really immature for their ages, as if -- like drug taking at a young age can cause -- they are developmentally arrested in childhood, when parental care shielded one from most of the big, bad world (or should have had parental care; many of the participants have really screwed-up parents).

I've also noticed that many people on the show seem to have really deep-seated anger related to traumatic childhoods. If the old saw that depression is internalized anger is true, I sure hope they do get appropriate after care that may include antidepressants.
#36
Old 01-05-2017, 01:20 PM
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Originally Posted by Jennshark View Post
This episode brought to mind how many of the folks on the show seem really immature for their ages, as if -- like drug taking at a young age can cause -- they are developmentally arrested in childhood, when parental care shielded one from most of the big, bad world (or should have had parental care; many of the participants have really screwed-up parents).
Yes, the food itself acts as a drug. If every time you feel depressed, or anxious, or bored, or any emotion, you deal with it by eating, you never learn any skills about how to regulate your emotions or deal with your real world problems. That leaves you in the same position as a very young child who doesn't know how to handle being upset except by throwing a tantrum.
#37
Old 01-05-2017, 01:57 PM
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Originally Posted by MLS View Post
Also, months after the surgery, people are shown eating a normally sized plate of food. I thought the reduced size of the stomach made that impossible.
Not necessarily impossible, although I'd have to wonder how many months after the surgery they were able to eat a "normal-sized" meal without discomfort.

My wife had bariatric surgery years ago, before we even met. It was a fairly invasive procedure, and had a long recovery time - something that has been reduced considerably with more modern laparoscopic methods. I'm sure Dr. Now has these newer techniques under his belt, which might explain how quickly his patients were able to get back to the dinner table.

During her recovery, she went from not being able to eat anything, to being able to consume only liquids, then on to soft foods, and finally on to "real" foods. Today, roughly 15 years later, her ability to eat is somewhat limited at the top end - "all-you-can-eat" Brazilian steakhouses like Fogo de Cho would be a waste of money for us - but a normal meal is ... well, normal.

Interesting side effects have arisen as well, though - she now has trouble absorbing certain B-vitamins, and dairy products cause a reaction similar to lactose intolerance - not that she ever really enjoyed drinking milk like I do anyway.
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#38
Old 01-07-2017, 12:47 PM
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Originally Posted by Jennshark View Post

Do really big people rapidly lose weight when their calories are radically cut down? Even if I starved myself, there's no way I could lose 12 pounds a week!
It's my understanding that the heavier you are, the easier it is for you to have substantial weight loss in the beginning. For people who are just overweight, not obese, losing 1-2 pounds a week is safe and reasonable. But if Dr. Now is expecting 30-50 pound weight loss in a month, that's 7-12 lbs a week. His patients are capable of doing that if they stick to his regimen.
#39
Old 01-07-2017, 01:25 PM
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Originally Posted by ivylass View Post
It's my understanding that the heavier you are, the easier it is for you to have substantial weight loss in the beginning. For people who are just overweight, not obese, losing 1-2 pounds a week is safe and reasonable. But if Dr. Now is expecting 30-50 pound weight loss in a month, that's 7-12 lbs a week. His patients are capable of doing that if they stick to his regimen.
A 600 lb person may be burning 6000-10000 calories a day even if sedentary. if they cut down to 1000 calories a day, that is a 5000-9000 calorie a day deficit. So in those situations, losing 60 lbs of fat in 2 months is possible. But for most people, you can't lose that much weight and have most/all of it be fat. But if you are 300 lbs (especially if a guy since they have more muscle mass) you can probably lose 1 lb of fat a day in the beginning since you'd be burning 4000+ calories a day. Penn Jillette lost something like 100 lbs in 3 months by eating 1000 calories a day.

Christina did an episode, here is what she looks like 2 years later. She looks a lot better but sadly is still crippled by body insecurities.

Last edited by Wesley Clark; 01-07-2017 at 01:27 PM.
#40
Old 01-07-2017, 01:31 PM
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Originally Posted by ivylass View Post
Last night was Brandi and Kandi, morbidly obese twins.

I am confused by something. If these people can lose 30-50 pounds in a month with diet and exercise, why don't they just continue to do that instead of getting the surgery?
The main problem with obesity treatment isn't weight loss, it is weight maintenance. The human body is designed to survive famines and starvation, and it does that by regaining lost weight after you lose it by increasing the appetite and decreasing metabolism (among other things). So you lose 100 lbs, but then your body tries to get you to regain it (because your body is trying to prepare you for the next famine, it wants you to get fat again) and most people end up back where they started.

Bariatric surgery helps suppress the appetite which makes it easier to not only lose weight, but keep it off. W/o the surgery people would lose less weight and they would keep less weight off.
#41
Old 01-14-2017, 04:08 PM
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Anybody see the Ashley R episode?

What was the condition on her skin that her mother scrubbed off with an abrasive sponge at the beginning? She seemed to have a lot of dark, rough patches.
#42
Old 01-14-2017, 05:44 PM
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Originally Posted by SpoilerVirgin View Post
Yes, the food itself acts as a drug. If every time you feel depressed, or anxious, or bored, or any emotion, you deal with it by eating, you never learn any skills about how to regulate your emotions or deal with your real world problems. That leaves you in the same position as a very young child who doesn't know how to handle being upset except by throwing a tantrum.
I really like this reply --well done!
#43
Old 01-14-2017, 05:58 PM
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Originally Posted by MLS View Post
Anybody see the Ashley R episode?

What was the condition on her skin that her mother scrubbed off with an abrasive sponge at the beginning? She seemed to have a lot of dark, rough patches.
Maybe a vitiligo type issue? Or is vitiligo always light patches on darker skin?

I really liked Ashley. Her husband and family were so sweet and supportive, very different than many we've seen on the series. She was still working, socializing, and really invested in changing. I got a bit verklempt when she and Daniel went out on their first "real date" to the little bistro

Was she really tall as well? At times she seemed more than 6'.

How shitty that their nice car's wheels and tires were stolen! I hope TLC paid for replacements, those babies must be a few thousand.

To counter this ep's loveliness I watched Charity, she of the amazing buttwings and strange 20yo "fiance." She's just plain yucky and disturbing.
#44
Old 01-14-2017, 07:19 PM
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There seems to be a common theme in that the people are using food to avoid dealing with emotions. When that's taken away, they don't have any coping mechanism. Ashley R seemed so sweet and anxious to have a real life (I got the impression she and her husband don't have sex due to her weight) and I was glad to see she got therapy to address her childhood trauma.
#45
Old 01-31-2017, 07:12 PM
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Has anybody seen the latest episode, about Kirsten?
#46
Old 01-31-2017, 07:17 PM
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Yes...I hope that whole family got some counseling.
#47
Old 02-01-2017, 09:21 AM
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It sounds like she never had a healthy relationship with her father. And her son, eating Cheetos and a Slurpie in front of her and laughing...screwed up all around.
#48
Old 02-01-2017, 10:47 AM
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Originally Posted by Jeep's Phoenix View Post
Yes...I hope that whole family got some counseling.
I second this.

This is the first time I've been truly surprised by someone: I really didn't expect her to be able to turn it around. I mean, I kind of knew she had to because there was still a lot of time left in the episode, but I still didn't think she would. I'd be interested in a followup episode sometime.
#49
Old 02-01-2017, 03:48 PM
Member
Join Date: Sep 2012
Location: Near Seattle, WA, USA
Posts: 3,354
It was hard to feel compassion for Kirsten. I felt so badly for her son. Yes, he was acting like a jerk, but he was 14 and stuck with his obese mother in a crummy apartment in Texas. The whole kid's life has been about her obesity.
#50
Old 02-01-2017, 04:34 PM
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Join Date: May 2000
Location: Cloud Cuckoo Land
Posts: 28,738
I saw some of the Kirsten ep, but none of the others. It was liberating because I could laugh at and feel superior to a fat person, just like a normal! Jebus, she is a whiny, annoying bitch. "Poor me! Nobody will help me!" Bitch is lucky her mom hasn't killed her. And her breakfast was what I eat in two days! She's one of those who needs a fork lift to get her out of bed, but mom said she manages to make it to the kitchen at all hours.

Sorry for my sympathy-free tone, but I'm one of the lazy ones. Not a liar about what I eat, I just generally don't care. But I'm making an effort, which "allows" me to feel superior.
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