Are You a Fence Sitter?


This is the second article in my series related to Prochaska and DiClemente’s stages of change.

The first stage of change, as discussed in a previous article, is the pre-contemplation stage. As a recap, this is the stage when ignorance is bliss, and you are not ready or willing to even consider a major lifestyle change.

Today’s article will address the second stage of change, the contemplation stage. In this stage, you find that you have moved from ignorance to fence-sitting. You are still not ready to embrace change, but you will embrace ambivalence.

This is when you first begin to think about the pros and cons of changing your behaviors. While you are not truly considering a change within the next few weeks, you may ask yourself some open-ended questions.

Among WLS patients, I find three main areas in which we find ourselves wishing and hoping to change. These areas of challenge pertain to exercise, food choices, and supplements.

Let’s talk about exercise first. This often is the most difficult of the three; for me personally, it has been one of the biggest hurdles to overcome. Many of you know by now, that I really do not enjoy exercise that much, and one of the main reasons why we got our dog Biscuit was so I would have to take her for walks around our neighborhood.

If exercise is your arch-nemesis, take time to contemplate what would happen if you committed to walking (either with or without a dog) for 5 minutes a day. And, then consider what would happen if you didn’t make this commitment.

Although some people can maintain their weight without exercise, we know that not exercising can make weight maintenance more difficult. This is a good example of a pro and con you might be analyzing in the contemplation stage.

Another main area of concern for WLS patients is food choices.

This comes as no surprise to veteran WLSers. We knew when we signed up for the surgery that we would have to modify our food plans. But knowing and doing are two different things.

Perhaps initially, for example, you thought you could simply eat smaller portions of the same kinds of foods you ate before your surgery. Maybe you thought you could control your overeating, that you could have just one cookie or a few potato chips.

The contemplation stage, in this example, would be a time to consider the pros and cons of bringing your trigger foods into your home or of finding yummy substitutions that you are less likely to overeat, or that won’t cause as much harm.

The last main area in which WLS patients struggle has to do with taking vitamins and supplements. It’s hard to measure how vitamins and supplements affect success because you can’t see them working, per se; although you can tell if they are successful by checking the results of your lab work and paying attention to how you feel.

One of my clients told me she was tired all the time. She wanted to focus on her sleep schedule and berated herself when she couldn’t get herself to go to bed earlier. As part of our discussion about this I suggested she get some lab work done. It had been two years since she had done this.

Turns out her iron was way too low. Turns out she hadn’t been taking it. “I’m too busy to keep up with that stuff,” she insisted.

I find the omission of vitamins and supplements somewhat common. Usually, bariatric women have their reasons. Usually they have to do with time and money.

Perhaps today’s financial challenges are affecting you. Maybe you are tempted to cut some corners. My first bariatric dietitian, Sally (she was awesome!), told us to take the highest quality of vitamins and supplements we could afford, and that generic and “grocery-store vitamins” are far better than not taking anything.

In the contemplation stage, you educate yourself and deeply consider the pros and cons of exercise, food choices, and taking vitamins and supplements. Perhaps you’ll come to see that when you are committed to your health, you will want to find a way to meet your body’s needs.

Weighing your pros and cons, or contemplation, is a vital step in the change process. Don’t change yet, though. That’s the next step!

Your Assignment

Are you doing something that is jeopardizing your health or wellbeing? Pick an area of concern regarding your WLS lifestyle. Write it down at the top of a page and underneath, in two columns, make a list of the pros and cons of changing this behavior. Don’t actually change, though! That’s the next step.

Reference: Prochaska and DiClemente’s (1983) Stages of Change Model

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