This whole surgery thing started at least a year ago, actually even more although it is hard to pinpoint the exact commencement of the idea forming in my head. I live very near a bariatric surgery center (for the past two years) and I see it all the time. A co-worker got a sleeve gastrectomy around a year ago and looks really great. My doctor has mentioned this sort of procedure in the past, although I don’t recall exactly when.
Anyway, although I have been overweight most of my life, the idea of weight loss surgery as a real option is relatively new to me. I used to think a lot about losing weight and I tried various things, from Weight Watchers to a weight loss “boot camp” and while I would sometimes look better for a little while, none of my results were long lasting and I would plateau before gaining all of the weight back again.
I am actually glad that I did not consider this surgery in my twenties. I mean, sort of. Obviously if I had lost weight earlier, I would have prevented damage to my body as well as “bounced back” more easily with the increased skin elasticity that comes with youth. On the other hand, I would have been doing it for the wrong reasons, at least as far as I am concerned now.
I have a long history of low self-esteem. My body image is, unsurprisingly, negative. I have not liked how I look for too long to remember now and have even had the thought that if I like myself, the fat wins. This was not an emotionally healthy way to live my life. I am not saying that I became pleased with my body or anything but I did learn to accept myself. The whole body positivity thing that seems to be spreading around the internet (unfortunately not as fast as meanness spreads but assholes are notoriously quick and plentiful) has helped me. I learned to like my curves or at least appreciate them. Sure, I’m not a waif or anything but I have a damn hourglass figure (well, maybe a two hourglass). I have a prominent bosom and hips of comparable width with a waist which is only about 3/4 the circumference. Sure, I have fat rolls but they aren’t so horrible as they could be and overall, I actually carry my weight pretty well although I do know that I could never pass for anything but plus-sized. It’s all relative, I guess.
So, what I mean by “the wrong reasons” is that if I had done something like this in my twenties, it would have been for aesthetic reasons. It doesn’t matter how much I theoretically understand about the long term consequences of excess weight or how much my father lectured me about my health, I was a normal twenty-something in the way that I felt a certain amount invincible. What I didn’t feel was pretty.
Now, however, despite growing to accept my body for what it is and even like myself a little, I realize that my weight is a real detriment to my health in both the long and short term. At 34 years old, I should not be on so many drugs. While surgery carries inherent risks, they are easily dwarfed by the risks of continuing for years with my various obesity-related conditions. So now, I am actually considering this surgery despite the physical ramifications, not because of them. I am worried about loose skin and drooping breasts. I am worried about thinning hair due to nutrient deficiency and weird elephant thighs. I know that my thighs and skin and whatnot aren’t great now but sometimes the devil you know is better (so to speak). I have no idea what shape I might become after this procedure (and the ensuing weight loss – right after the procedure I should be about the same from the outside).
I first went to an informational session about the surgery in December of 2016. I planned to discuss the idea of surgery with my [retired doctor] father while visiting my parents over Christmas but I chickened out. In fact, I did not even mention it to him until after I had been to my first diet documentation (more on that later) appointment. It’s not that I thought he wouldn’t approve, it’s that I knew he would and I was afraid that he would be so encouraging of it that I would feel pressure to go ahead with the surgery and I really wanted to make my own decisions. I was pleasantly surprised that he really held back with his opinion. He did some research and appreciated that which I had done as well and was very supportive while not being specifically encouraging. I think that must have been kind of hard for him because he often does know what is best for my health and just wants to help but I chafe at direction and needed to do this on my own. I can’t say that his opinions had nothing to do with my decision to go ahead with the surgery but I did not feel pressured in any way to proceed and I think that is one reason that I was able to do as much as I could to set myself up for success. Otherwise, I am kind of afraid my self-sabotaging instincts might have taken over.
So, in order for my insurance to cover the surgery, I had to have a psych evaluation (no problem, I’ve been seeing psychologists for decades), a note from my primary care physician (which she was happy to write) and six months of medically supervised dieting documented by a doctor. Because Barix Clinics is kind of a factory for this sort of thing, they provide doctors for that very purpose, so I started seeing one on a monthly basis. She met with me very briefly and reviewed my food diary which I kept (and printed out when I remembered) using the app MyFitnessPal. Every month she would tell me something to work on and we would see if that helped with weight loss: no chips or crackers, increased protein, no snacks; that kind of thing. Despite being [mostly] compliant, I lost only a few pounds over the course of six months but that wasn’t really the point, it was just a hoop to jump through for the insurance company.
Finally, that was done and I was ready to schedule my procedure. I picked a date that my parents would be visiting from Georgia and bit the proverbial bullet. Fortunately, they were coming at the end of a week-long audit that I had scheduled at work and could absolutely not miss, so I was able to pick a date just after that. Then there was nothing left to do but wait and fret.
I started my diary on Monday, August 21st, 2017 here is the first entry:
I scheduled my surgery weeks ago but now it actually feels real. This is probably because today I (a) paid the 20% deposit or whatever and (b) spent like $70 on protein powder which will become a major part of my diet.
I am terrified both of failure and success but I do think that the gastric sleeve procedure will be good for my health. I have read a ton of pro/con lists and testimonials and the pros heavily outweigh (pun intended) the cons. I will be fighting against not only my love of food but also my desire not to be wasteful. It can be really hard not to clean my plate, especially when I am close to being done.
My scale is stuck on stones as a unit of weight, which is weird but at least is relatively easy to convert into pounds (multiply by 14). I will round [slightly] down to a height of 5’6” in order to calculate my BMI.
My theoretical goal weight is 150 lbs which is on the heavy side of healthy. It translates to a BMI of 24.2 (A “normal” weight for my height is 115 – 154 lbs). A shorter term goal I have is to get my BMI in the “overweight” range instead of obese. My target there is 180 lbs (BMI 29.1) which is still no small amount of weight to lose.
I am not at my highest weight ever (~250 lbs) but at 240-ish, I am pretty darn close.
I have talked to three women at my work who have had this surgery with varied results. Well, not too varied, they have all lost weight although it has been several years to a few months since their respective surgeries but the levels of weight loss have not been the same. The one thing they have in common though is that they are all happy that they had the procedure, even with a BMI still in the obese range, it has worked wonders for co-morbidities and an overall feeling of health.
I did receive a piece of advice today that I had not heard before – start working my muscles! Obviously, diet and exercise are both important parts of any weight loss program but the specific advice was to ward off muscle loss which one co-worker experienced after her surgery. I have always been relatively strong – and proud of my strength so it will be important for me to maintain it. I wonder where I could fit a weight set in my tiny apartment though.
Diet Goals (per day) for the next two weeks:
1200 – 1500 calories
Less than 150g carbohydrates
At least 25g fiber
Less than 20g sugar
At least 70g protein
After two weeks, I will have my pre-surgical appointment and will probably be given a more specific diet to follow for the final weeks.
Drugs I am currently taking (per day):
Levothyroxine (112 mcg 1x) – Hypothyroidism
Sertraline (150 mg 1x) – Depression
Atorvastatin (40 mg 1x) – Hypercholesterolemia
Losartin-Hydrochlorothyazide (50-12.5 mg 1x) – Hypertension
Metformin (1000 mg 2x) – Diabetes
Glyburide (10 mg 2x) – Diabetes
Cetirizine (10 mg 1x) – Allergies (OTC)