Have you been diagnosed with Binge Eating Disorder, or Bulimia? Do you have a bad relationship with food? Are you prone to comfort eating, stress eating, secretive eating, or weight fluctuations due to your eating patterns? Are you overweight or obese? Do you struggle to feel good about your body? Are you considering weight loss surgery as a solution to your eating or weight problems?
Jacques has substantial experience and training in helping people with these problems. He has been on radio and in online magazines discussing the psychology of weight and eating, and he has presented his PhD research at several national conferences. Jacques’ PhD (which you can download here) argued that the reason why up to 95% of people fail to keep weight off long-term is because most weight management efforts (diets, gym programs, weight loss pills, self-help books, and the rest!) underestimate the importance of each individual’s unique combination of psychological factors. To come up with better solutions, Jacques argued, we have to understand the problem better – and that’s what his research sought to do. Jacques used scientific methods and a sample of over 1,000 Australian adults of all shapes and sizes to test and come up with a good model for better understanding the complexity and individuality of weight problems. Instead of relying on just a person’s BMI and two or three extra medical details, Jacques’ model encourages clinicians to make decisions about best treatment for an individual based on a large range of biological, psychological, social, demographic, environmental and behavioural factors.
Completing a PhD in the area of weight and eating has led to Jacques working with an increasing number of people who are struggling with their weight, body image, or unhealthy eating and exercise patterns. As well as seeing clients individually for these issues, Jacques also runs a monthly support group for people who have undergone weight loss surgery (usually either gastric banding or gastric sleeving), called the “Better Life, Better Lifestyles” group. Applying his research findings to his own particular psychological profile, Jacques made the decision in August 2014 to have the sleeve gastrectomy (also known as ‘gastric sleeve’) operation to assist him manage his own weight. So, guided by his detailed and current knowledge of the area, his wealth of clinical experience in the area, and having lived the experience of struggling with weight, eating, and body image issues, Jacques is uniquely well-positioned to help individuals get to the heart of their struggles.
Obesity is a chronic and serious condition, and over the past 35 or so years, obesity has become a global epidemic, with Australia being one of the worst-affected nations. Almost two-thirds (63%) of Australian adults are overweight or obese, up from 38% only 25 years ago, and rates have been steadily accelerating by 1% per year since the 1980s. People and institutions from a range of industries and professions (some with more noble intentions than others) have devised hundreds of ways for people to lose weight, and over the decades we have become much better at helping people lose more weight, more quickly. Unfortunately, relapse rates remain at a staggering 80-95%; that means within five years of losing significant weight, and despite half a century of dedicated multidisciplinary research into this area, almost everyone regains most (if not all, or more) of the weight they lost in the first place.
Naturally, people have been asking why. Why do diets fail? Why do people regain weight, or return to unhealthy eating patterns, or drop the new exercise routine, even when it’s really important for them not to? And, what can be done about it? Getting some answers to these questions is what made me turn to doing a PhD on the aspects of weight control that drive our eating and exercising behaviours. Most professionals nowadays acknowledge that for people who are carrying an unhealthy amount of excess fat (that’s the definition of obesity, by the way; obesity is an excess of fat for what is healthy for the body – and a BMI is only one way to try and guess whether a person is healthy or not in this respect. Losing weight and keeping it off long-term is more complicated than the old mantra of “energy in, energy out”. Sure, the mechanics of weight management ultimately involve how much energy goes into your body, and how much comes out, but there is an ocean of literature based on scientific evidence that suggests that there’s a lot more going on in that picture than “liking all the bad foods” or “being too lazy to exercise”. Those attitudes are outdated and unhelpful – sometimes even harmful.
So, what else is going on? The short answer is that in almost all individual cases, it’s a complex picture. To give you a sense of the enormity of this picture, have a look at just the short-listed variables I investigated in my PhD research (i.e., nowhere near the full list of variables thought to influence a person’s weight and shape – just the ones I focussed on from the perspective of a psychologist):
– Social expectations
– Socioeconomic factors
– Food availability and affordability
– Environmental factors such as exposure to advertising and neighbourhood safety
– Physical health and family history of health problems
– Family history of weight and eating problems (both genetic and family behaviours)
– Personal weight history
– Nutrition intake
– Physical activity
– Sedentary behaviour
– Previous and current weight loss attempts
– Different emotional states (like stress or sadness)
– How individuals cope with emotions
– Eating disorder symptoms (like purging)
– Mental illnesses
– Self-esteem and self-worth
– Quality of life
– Personality factors
– Coping styles
– Self-belief and self-determination; how in control someone feels of their own life direction
– Beliefs and attitudes about food, their body, weight changes, physical activity and eating
– General thinking styles
– Knowledge about nutrition and exercise
The area is too complex to summarise in any meaningful way in a sentence or two, suffice to say that telling an overweight person to “cut down the fatty foods and go for a walk”, or a binge eater to “find other ways of coping with those strong feelings” is usually a woeful underestimation of how much is going on in that person’s struggle. When I’m working with someone who is asking for help with their weight, body image, eating or exercise, I use my knowledge about the above areas to try to understand each individual’s unique vulnerabilities, and we plot a way forward together from there.
My Weight History
I have been overweight for almost my entire life, and I can trace it back to before primary school began (let’s ignore the Easter bonnet and the flattering 80s attire for a moment).
Looking at it more objectively as an adult, I can see how a number of factors in my early life predisposed me to my ongoing weight struggles (and indeed, the obesity literature has consistently found that early life plays an important part in adult obesity). I was raised in a culture, and a family, that seems to place food at the centre of most important experiences. My family also has many obese people in it, quite a number of whom have struggled with their weight for decades, and many of whom have elected to have bariatric surgery (in its various forms) over the years. The culmination of these variables in early life, including family environment, culture, and most probably genes, was this: from a young age, I developed the tendency to eat a lot and frequently, to eat for reasons other than hunger, and to not exercise very much. With age, these issues compounded, and as my identity developed, along with it came beliefs about myself relating to my body, my control over my eating and exercise, my worth (helped along by pretty consistent weight-focussed bullying throughout my schooling years), and my lack of experience regulating my emotions in healthy ways. I was smart, I was funny, I was likeable and popular, but I struggled a great deal with this one domain of my life. The more my weight got to me, the more I ate. I rarely dieted, I never exercised; I just kept going. Then a number of things happened in my mid-20s. By this time, I was tired of excluding myself from relationships, I was tired of the physical limitations, and I was certainly tired of the daily humiliations that one usually encounters, if not endures, at that size. By the time I decided to do something about my weight, it was just about all I could think about. I would write lists of the reasons I had to lose weight, trying to motivate myself. Here’s one such list that I dug up recently:
- I’d probably stop having heart palpitations
- I would have much more energy
- I could go to theme parks again without worrying or feeling the stress on my body
- I would feel happier from the serotonins and the other highs of exercise
- I could sit in a chair without arm rests digging into my sides which is embarrassing and sometimes uncomfortable
- I would feel more comfortable getting in and out of my car, and I could sit in someone’s car without worrying about the seat belt as I do, and flights would be much more comfortable
- I could sit on deck and ash chairs, and plastic tables without spending the whole time worrying I will break them or deciding not to sit on them at all
- My back and joints would no longer be sore – doing up my shoelaces wouldn’t be an ordeal
- I wouldn’t avoid going to the doctor so much
- I would be adding years to my life, and more quality to every one of those years
- I would enjoy going to the cinema more; no squishy seats, and no worries moving past someone to get to my seat
- I could look in the mirror and find it easier to think something other than “I’m disgusting”
- I would swim in public again
- I would have much better skin
- I could live a healthier lifestyle that’s enjoyable – how many times have I turned down offers to go sailing, walking, tennis, the beach, skirmish, etc?
- I’d be able to wear the clothes that I like, rather than the ones that sort-of fit
- I would probably sweat less
- I would be able to go on an overseas adventure, starting with my dream destination, Egypt
I was baffled; I had this seemingly inexhaustible list of reasons to change my weight, which seemed to weigh me down almost as much as my 150+ kilos, and yet I did nothing. Any attempts to control my eating or to exercise more were short-lived. “What will it take?”, I wondered to myself almost daily. And after years trapped in this state of agitation, it was seemingly the smallest thing that finally tipped me into change. I had still been smarting from the recent shame of inconveniencing a whole bridal party. Though they were very obliging and polite, we hunted for quite a while to find a place that could accommodate the groomsmen with matching suits including one at my size. And then came the final humiliation. Some friends and I had decided to go skydiving. None of us having any experience in such things, we went ahead with our booking without any of us thinking to check if there were weight limits. I spotted the oversight only a week out from the big date, and decided to phone ahead. When I told the lady what I weighed, she sort of dismissively scoffed, stated in a matter-of-fact way that I’d “simply snap the parachute”, and abruptly ended the call. I took on the role of filming their landing, and dutifully cheered from the sidelines, but I was gutted. I wrote to myself that week:
I’m actually scared for my health. I’m worried that the occasional pinches in my chest are signs of worse things to come. 56kg at ten years old, 110kg by grade twelve, and now close to 150kg and not even 24yo. Regardless of whether I have spent my whole life not liking the way I look, and regardless of whether I would cope with spending the rest of my days inhibited by my weight, it’s my health that has me worried the most. Do I not exercise because I’m not motivated enough and should try harder, or is the fact that I’ve never tried harder a sign that this is beyond me? At what point do I concede defeat? At what point do I say to myself, “I can’t beat this with strong will and desire for the outcome alone – I need help”? Is it even a matter of not trying hard enough, of not prioritizing my health, of giving up too easily…or is the fact that I’ve never stuck to a diet or exercise program for more than two months a sign that this issue will always be too difficult to tackle? My weight has been on my mind – right there at the front of my mind – every single day in the last 18 months at least. In the past six months it’s been hard to escape because of the physical pain I experience every single day in my lower back. It feels like my muscles are struggling to support me. I’m even having trouble doing up my shoe laces. It’s awkward to get out of a car, almost every chair I sit on cracks and creaks and moans, I get dizzy from doing something as simple as standing up! I stopped fitting into most clothes brands years ago – and practically the only clothes left that fit me, Target-brand clothes – are starting to hug my body even at the largest size they come in, 7XL! There are thousands of reasons to lose weight, and yet yesterday I ate a whole packet of biscuits, the day before it was an obscene amount of pizza, the day before that something else… It is a question of lack of motivation, or is it a lack of ability – a fundamental weakness that will see the odds stacked up against me every single time? I would say that I’ve fixated – actually obsessed – on this issue every day for the last 18 months of my life, and yet what have I done about my weight, other than let it get to me? I figure, it’s time to get my priorities right. Before I spend $10,000 on an operation, and see it fail like so many others in my family, I have to be willing to look at if that money would be better spent on an eating disorder specialist, or a psychologist, or personal trainer, or nutritionist, or all of the above. I have to be willing to give up my savings in order to save my life!
And with that, I was off.
My Weight Loss Attempt
Not one to do things by halves, I threw myself into a really proper weight loss attempt. I consulted an experienced psychologist, bought a treadmill for home, and made some simple but reasonable changes to my diet and eating. Within three weeks I’d lost six kilos, and after losing 17 kilos but not managing to go down more than one shirt size, I consulted a dietician. I learnt that I was accidentally starving my body by eating too little, forcing my body to hold onto its reserves in my stomach area, which is why I was losing kilos but not centimetres from the waistline (the literature calls this ‘abdominal obesity’, and it is dangerous to heart health). With some (very welcome!) expert-recommended changes to my diet (I remember being gobsmacked when she essentially doubled my number of meals and introduced peanut butter as a snack), my shape started to change, and my energy levels picked up. It was time to tone up, and so I joined the gym and enlisted the help of an excellent personal trainer who invigorated my very tired treadmill routine with a variety of cardio and strength training exercises that were challenging, safe, rewarding, and much more interesting…and my body thanked me for it! I also worked with a physiotherapist, to try to unlearn the bad habits my muscles had learned from a lifetime of sedentary behaviour. In only one year, my weight and shape changed dramatically. And, I made the most of my newfound confidence, from the kind of travel I’d toiled over in my fantasy lists… …to a number of other gratifying conquests… …and on it went, until I’d lost about 60 kilos and more than 30 centimetres from my waistline. My medical profile (blood pressure, cholesterol, blood sugar levels, joint soreness, etc.) was that of a healthy person, I had a new vigour for life, and for all intents and purposes, I was a changed man.
But I became complacent. Honestly, having tasted this freedom and confidence, I didn’t think I could have – or would have – ever allowed myself to willingly go back to my previous lifestyle and all its shackles. I was unfortunately wrong. After a bad break-up, the emotional eating resurfaced, as did the overly critical and rigid beliefs about myself, and my old patterns that were so conducive to a sedentary, food-centric life. The first 10 kilos of weight regain didn’t overly concern me. Cockily, I’d say to my friends, “I’ll get on top of it – it’s fine!” But the weight gain continued, and it became harder to exercise, harder to feel invested in making good choices. And over the next five years, I went on to regain all of my lost 60 kilos, and 10 extra for good measure. Once more I found myself wondering what it would take for me to regain control of my life again. What must have been over 20 times, I began diet and exercise regimes in earnest, and every time I failed to maintain the impetus that had buoyed and propelled me to success previously. It turned out that the answer to my question – “what would it take?” – was not one… …but two… …hospitalisations for chest pain. With a long history of abdominal obesity, a significant weight loss relapse following a stellar and genuine attempt at a lifestyle overhaul, and a family history of stroke, diabetes, obesity, and heart disease, I was understandably despondent. And, having completed a PhD that explored how to determine what the best treatment is for different kinds of overweight and obese individuals, I was in the unique position of being my own world expert on knowing what was right for me next. After an involved decision-making process, with little fuss really, I decided to have surgery. I had the sleeve gastrectomy in August 2014.
Bariatric Surgery and Life After Surgery
Honestly, it’s early days yet. Much like with my previous attempt involving a personal trainer, dietician, physiotherapist, psychologist and the gym, my current weight loss attempt through surgery seems to be yielding above-average results. With much more humility than last time, and more caution, I am enjoying what benefits I’m experiencing, but not taking them for granted. One thing I’m doing differently this time around (again, having a PhD-level familiarity with the literature helps with knowing what pitfalls to avoid!) is being more realistic with my expectations. My approach is completely different this time – and so I can’t expect the same results. For example, I can’t expect tight skin and a more proportionate shape if I’m choosing to let my smaller stomach do all the work, instead of exercise and fitness. I’m also making the most of my years of seeing health professionals; I certainly don’t feel like my previous attempt was a waste of my time or efforts. For example, I go to the beach, even though I don’t have a ‘beach body’, which I haven’t been able to do before. And the last time I was this big, I certainly wasn’t nearly this kind on myself, or this at peace with my flaws, or this content with my life in all its messiness.
Already I’ve had some real challenges with my old eating habits resurfacing during times of stress post-surgery. But, with a renewed focus on my health, a rich history of experiences to draw from, and an awareness of some of the pitfalls of surgery (people can and do relapse from this, too!), I’m taking it a day at a time.
What are your expectations of surgery?
Almost universally, people who have struggled with weight problems tend to set unrealistically ambitious goals for weight loss, regardless of their chosen weight loss method. Common examples of this that I see in therapy are when clients: – Have an unrealistic timeframe for weight loss (“I should have lost more by now!”) – Expect a steady, linear decline in weight (weight loss through surgery can be staggered) – Expect to lose all their excess weight through surgery (average weight loss varies with each type of surgery, but none of them are reliably linked to losing 100%, or even 90%, of excess weight) – Assume that surgery will finally release them from some complex problems (“When I lose that weight, I’ll finally be able to…be myself/love myself/find a partner/stop eating junk”…etc.) – Mix up weight goals with aesthetic ideals (“When I reach x kg I’ll have a flat stomach”) For a lot of overweight or obese people, surgery facilitates some wonderful changes. However, it is really helpful to go into surgery with realistic expectations of what the outcomes are likely to be, and what else is needed to help get you there. Not only is it helpful, but important; research tells us that people who go into weight loss attempts (including surgery) with unrealistic expectations are more likely to be disappointed, and this disappointment increases the risk of relapsing into the sorts of states and behaviours that lead to weight regain!
Have you thought about which type of surgery is best for your particular struggles?
As you can see from the long (but nowhere near exhaustive!) list of factors that can influence a person’s weight, it can be worth your while to consider how the strengths and weaknesses of each different kind of surgery might interact with your particular risk factors. To demonstrate this using just one example, consider that people who go for gastric banding are more likely to encounter problems with tolerating certain food textures post-surgery (common examples are lettuce, bread or drier meats such as chicken breast) than people who choose gastric sleeving or gastric bypass. On the other hand, gastric banding tends to be a lower-risk procedure, and it is reversible (i.e., the band and port can be removed), whereas gastric sleeving and bypass involve permanent and irreversible changes being made to the digestive system. This is where understanding your particular vulnerabilities becomes an invaluable asset in your decision-making. To provide an oversimplified example, all other important factors being equal, someone whose weight struggles stem almost exclusively from making poor food choices might reconsider gastric banding in favour of the gastric sleeve (“I don’t trust myself and I don’t want to risk it – if a grilled chicken salad turns out to be harder to consume than a chocolate thickshake, I know I’ll opt for the shake every time”). Alternatively, someone who has put weight on due to an increasingly sedentary lifestyle might feel sufficiently confident choosing a reversible, lower-risk operation (“My eating’s always been ok, but since I busted my knee and got the desk job 7 years back, it’s been a losing battle”). If you are looking at the pros and cons of each type of surgery, and how each maps onto your particular patterns and vulnerabilities, including a psychologist in your team can be a great strategy for success.
What will you do with your feelings instead?
Occasionally, I am confronted with a very dramatic situation in therapy: someone has taken the step to put an end to a lifetime of emotional eating through weight loss surgery, but with very little or no planning for how to deal with those emotions once overeating becomes much harder. It would be a bit like if the well-meaning mayor of a town shut down all power stations in an effort to reduce the town’s carbon emissions, but without organising and introducing any alternative sources of energy. In my experience working with people who have ended up in this position, the outcome can be: severe depression or increased distress; a sharp increase in the consumption of ‘liquid calories’ (ice creams, chocolate, milkshakes, very creamy foods, etc.); or the development/escalation of alternative unhealthy coping strategies, such as self-harm or substance use. It may be tempting to tell yourself that emotional eating will be a thing of the past once you’ve had surgery because your body will no longer allow it, but much better would be to go into surgery with some clarity about the healthy new ways you will manage the emotional states that would normally lead to overeating. Unsure whether this applies to you, or whether it’s something to seek help for? A handy question to ask yourself is: “What function does my eating serve; what does it give me?” If your answers primarily fall into the category of ‘neutralising or changing how I feel’, then it’s likely this is something you’d benefit from being aware of.
What support do you have in place for this change?
Some people I work with underestimate the gravity of the decision to undergo weight loss surgery. They buy the shakes for the pre-surgery liquid diet, they arrange the necessary leave from work or study in anticipation of recovery time at home, they dutifully stockpile the vitamin and fibre supplements, and they organise extra help for the practical things in the first weeks post-surgery, like getting the kids ready for school in the morning. However, it’s been my experience that these same very capable and organised people don’t put as much planning into the psychological and social challenges that surgery may bring. A random selection of examples: how to feel ‘normal’ at dinner parties and special occasions, how to handle extra attention from others in response to weight and body changes, (people over 40 will particularly relate to this one) how to combat the “finish the plate” mentality, and managing unexpected disappointments. It’s easy to be caught off guard by these obstacles, especially with so many positive changes to anticipate and experience! Having a think ahead of surgery about putting some supports in place, including strategies for managing not just the physical changes but the psychological and social ones too, will set you in good stead for a better transition to your new life.
What will surgery give you?
Why are you having surgery? It may seem like a straightforward question, but unpacking it can lead to surprising material well worth exploring. This is especially true given that the obesity literature has pretty consistently linked different weight loss motivations with different outcomes (i.e., your likelihood of relapsing back into weight gain longer-term seems to be in part influenced by the reasons you’re trying to control your weight in the first place; it matters whether you are driven by a desire to enhance your appearance, or whether you’ve been prompted by a recent health scare, or whether you’re struggling to keep up with an active family or the physical demands of your job.) There is another important, related benefit to exploring what you want to get out of surgery. In short, people get way too hung up on what the number on their bathroom scale is doing, and this in turn predisposes a lot of individuals to relapse over time. After the initial weight loss phase of bariatric surgery is over, people often describe to me feeling disappointed that they have not reached their goal weight, or they lament that they lack the motivation to work so much harder to lose much smaller amounts of weight. This disappointment and frustration can lead to emotional eating, and the incremental weight changes can be so small that people lose hope that they will ever reach their targets. To combat these problems, I encourage surgery patients to make sure their goals reflect what’s important to them. Sure, the number on the scales is one goal – but what other ways can you measure and track your progress? It might be: an easing of back or knee pain; how long you can play with your kids outdoors for; how comfortable you feel at parties; changes in your energy levels; how quickly you can get out of bed; the snugness/looseness of certain articles of clothing; how far your partner can wrap his/her arms around you when you hug; improvements in blood sugar levels, cholesterol levels, blood pressure, etc.; a change in the kinds of holidays you can plan and enjoy; increases in fitness levels; a reduction in your waistline (associated with heart disease); and so on.
Is this a tool or a cure?
Chances are, if you are considering surgery for weight control, you have struggled with your eating (perhaps on and off) for a long time. It has been my experience that people often arrive at surgery usually feeling that they have exhausted other less permanent, less invasive, or less risky options for successful long-term weight management; surgery is their last, best hope for success. It’s probably for this reason that one of the most common complaints I hear from men and women who have had bariatric surgery is, “I thought it would fix my eating – but I’m still overweight!” Like VLCD (Very Low Calorie Diet) shakes, expensive home gym equipment, hypnosis for weight loss, ‘low joule’ celebrity cookbooks, the 5/2 fasting diet, and a thousand other techniques, bariatric surgery should not be seen as a cure to weight problems, but a weight management tool. Where there is a will, there is a way, and people do find other ways to maintain unhealthy eating behaviours even after surgery. Relapse rates might be slower, or smaller, but it’s dangerous to think of surgery as a fix-all for weight problems, chronic disordered eating habits, or unhappiness. I see people run into trouble when they think about surgery as a cure, complete solution, or panacea to their weight and eating woes. For a minority, surgery really does result in a nearly-effortless long-term weight management solution with very few complications. However, for the vast majority, surgery gets people part-way to their goals (for example, even with removal of two-thirds to three-quarters of the stomach, i.e., gastric sleeving, surgery patients can expect to lose 60-70% of their excess body weight). Getting the rest of the requires extra strategies and resources. As so many people I’ve worked with can attest to; weight loss resulting from surgery alone can be disappointing for people, and people certainly do manage to adapt their surgically altered bodies to still allow really unhealthy eating patterns. In effect, it’s unhelpful to think of surgery as a cure to your weight or eating problems; it is much better to treat it as a tool to be used to help you in your journey to weight control.
How will you know you need more help?
As with most weight loss attempts, health kicks, or lifestyle changes, getting going is easier than keeping on going. Having spent the majority of my PhD years trying to get to the heart of why so many people relapse back into their old habits (sometimes despite great success!), I have an appreciation for just how tricky it is for most people to keep momentum up, and weight management through surgery seems similar in this respect. Many people who have shared their surgery story with me told me that they started off well and were vigilant with sticking to their new recommended healthy lifestyles, but the energy and momentum of their first months or year waned over time, and it became easier to slip into old habits. Looking at the data using long-term weight maintenance as the only outcome measure in large-sample, well-controlled, scientifically rigorous studies, it is clear that bariatric surgery is currently the most effective weight control method we have to offer people to date. However, it is not a cure, it is not without its challenges and pitfalls, relapse (and certainly continued unhappiness) is possible even with surgery, and so knowing when to seek help is important. If you have found these questions thought-provoking or informative, you might benefit from making an appointment to discuss your surgery with a psychologist.
***PLEASE NOTE: This group has been discontinued***
On the last Tuesday of every month, from 6:30pm – 8:00pm, Jacques runs the “Better Life, Better Lifestyle” support group at the Better Life Centre in Kelvin Grove. This group is for people who have undergone bariatric surgery (all who fit this description are welcome; the group was originally run for people who’d had gastric band surgery, but since Jacques took over in 2013 it has broadened to include people who have had gastric sleeving or other surgeries). This is an open group, and people at any stage of their surgery journey are welcome to attend. Attendance is only $15 (collected on the night), and notifying Jacques of your attendance is essential (read on for more information about attendance). The group was originally formed to assist its members to sustain the benefits of their surgery. This is at the heart of the group; Jacques facilitates discussion between members that provides them with a unique opportunity to meet and talk about their lives. The group is also an opportunity for Jacques to share evidence-based information relating to the psychology of eating and weight management. Previous group meetings have included: discussing (and going through) the latest apps to help people manage their eating; sharing recipe books and other literature specifically geared towards surgery patients; watching videos of world experts presenting relevant information; experiential exercises such as mindfulness exercises and in-session goal setting; and provision of website links, handouts and other material to help participants with their journey. Shortly after every meeting, Jacques sends out a flyer summarising the previous meeting, and providing the details for the next one. Missed a meeting? Click on the flyers below to see what you missed, and to make sure you catch the next one:
Better Lifestyle Group -November 25th 2014
Better Lifestyle Group -October 28th, 2014
Better Lifestyle Group -September 30th, 2014
Better Lifestyle Group -August 26th, 2014
Better Lifestyle Group -July 29th, 2014
Better Lifestyle Group -June 24th, 2014
Better Lifestyle Group -May 27th, 2014
Better Lifestyle Group -April 29th, 2014
Band Buddies Jan 14 flyer