As I walk this path, I can start to see certain truths in a way that I never saw before. So, here is my list of 20 truths behind Weight Loss Surgery.
1. It's NOT the easy way out....
I don't know where this idea came from, but it's a pervasive one. Interestingly, I don't think I've actually heard a skinny person ever say this, and I've only ever heard the "Easy Way Out" commment from people who struggle with weight. I could go on and on about how this is tied to some idea that fat people should have to face some sort of punishment for their weight, and what this says about our culture... but that's a blog post for another day.
Instead, I will simply set forth an "easy" 45 day challenge to anyone who has the idea that WLS is an easy way out:
- We'll start you off with an all liquid diet for one month. This would be your two-week pre-op diet and two-week post op liquid diet. While we quickly learn that every surgeons approach is different and some are more lenient than others in the pre-op requirements, but this is the industry standard. By the way, all of that liquid has to be low fat, low carb,caffeine free, non-carbonated, low calorie and high protein,
- In the middle of your month, you need to go and have major surgery that removes 85% of an organ of your body. If you can't make that happen, try having a friend punch you repeatedly in the stomach for a similar effect. Immediately after this, you are expected to get up and start walking... and don't stop. Ever.
- Also, while you are at it, for the second two weeks ( representing post-op) you can only take in about 1-2 ounces of any liquid in any given 30 minute period. And, you can't use a straw. And you have to get at least 64 ounces of water in a day... but not 30 minutes before or 30 minutes after taking in any of the liquid you ingested that contains protein. Seriously. Try it!
- After your one month all liquid, you may now have soft foods. Only soft foods. Still low carb, low fat, no caffeine, low calorie and high protein. At this point, you will be eating about 600 calories a day. Also, every bite you take in needs to be chewed into a liquid.. about 40-60 chews per bite. Oh, and you should call that friend to come and punch you in the gut every time you eat anything, because that's what it feels like.
- Easy, right?
If someone can tell me what part of this challenge is easy, I'm all ears.
2. .... but it is easier.
Okay... I know what I just said.. it's not the easy way out. But that doesn't mean it's not easier. How can these two things co-exist? Well, there are a few ways. First of all, after the difficult pre and post-op all liquid period, you lose weight... fast. I lost the first 35 lbs in that month. That's a three-to-five year old child that I took off my back. Anyone who carried around something that size for years and got it off their back that quickly is going to be able to move easier, because they have the muscle memory to work harder on moving, and working out becomes much much easier. Also, the fact that you simply cannot physically eat as much will make you almost automatically calorie deficient on any given day. Even now, I can eat a MAX of 1000 calories a day, but I burn 1500 just existing, even if I don't get my consistantly-shrinking-ass off the sofa.
Additionally, my new tiny tummy comes with a Pavlovian response that has quickly conditioned me. There are things I cannot eat because they make me feel terrible. Like," I have to lay down and I feel sick for a few hours" terrible. Fortunately, many of these things are bad for me anyway: Sugar. High fat. Carbonated drinks. It's easier because my sleeve is that friend who punches me in the gut every time I eat something I shouldn't.
Also, and this is controversial, but there are hormonal changes that happen. Not every doctor agrees, but basically there is a hormone that is released by the stomach that tells our brains we are hungry. If you have Gastric Sleeve and have 85% of your stomach removed, you also remove 85% of that hormone production organ. Simply put, I never get physically hungry.
So, to pretend that this method isn't easier would be a lie. A person who doesn't get physically hungry and even when they do they can't eat more than a few ounces and working out is easier because they are pretty buff from all that weight they just shed quickly.. the "easier" factor is at play. And here is the plain old-fashion truth: Nobody would be able to do this without Weight Loss Surgery, because it would be torture. That is what makes it easier, but not easy.
3. You lose weight really really fast...
Especially at the beginning. So fast it makes your head spin. There were days in those first couple of weeks where I would lose 2 pounds in a day, and another 2 the next day. It was shocking.. and addictive.
4. .... and yet it's not fast enough.
It doesn't matter how much progress you have made. After such extreme losses in those first few weeks, you suddenly become disappointed at what would be, by any other standard, an amazing success. A two pound loss in a week is perfect in the "normal" world. but in WLS world, that feels like a miserable failure compared to those weeks where you lost 10 pounds. I have joined dozens of Weight Loss Surgery forum boards and social media groups, and on a daily basis I see the posts. " I'm 30 days out and I've only lost 25 pounds". It just really messes with our sense of "normal".
5. Stalls are torture... and universal
Most Weight Loss Surgery people spend months ( or years) preparing for their surgery, and we watch and people talk about their "stalls" in weight loss, and it doesn't matter that we tell ourselves to expect it... we are still CRUSHED by it. The first time has been dubbed "The Dreaded Three Week Stall" by WLSers. It happens to everyone, and it sucks! Especially since this is the time that we generally start eating something that doesn't require a spoon. It becomes really easy to tie these two things together ( although they aren't linked). Weight loss stops for a week or two and we feel like crap about it. There is no emotional preparation you can do. You will question what you've done and you will feel like you are doing something wrong. And you will be doing everything right! This will continue for your entire journey. You will stall for weeks... not a pound of loss for days and days and days. Then, suddenly, one day, you step on a scale and you've lost 4 pounds in 24 hours. You will do everything in your power to figure out what you did "right" in the past 24 hours. You will try to replicate it and it won't work.
There is no way to avoid stalls and no way to stop yourself from feeling bad about them.
6. You won't see your progress....
People will start to tell you how you are getting smaller, but you will not see it. Even the pictures you take won't really feel like the progress you are seeing on the scale, in your clothes and in the looks on people's faces. You will still be fat in your head... maybe forever.
7. ... except in certain places.
Then, suddenly, one day you realize a difference somewhere in your body. Most of these are NSVs- Non-Scale-Victories. Big ones, like suddenly you can cross your legs like a girl. Or you realize there are inches between you and the side of your bathtub. Or you realize you can feel your clavicle bone. Or you realize you actually have to struggle to give yourself a double chin. Or you realize that walking is really really easy! These are amazing moments that we live for!
8. People treat you better....
Seriously. I know that people don't mean to do this, but thinner people are treated better in general. Suddenly, you realize that people respond more positively to you. People smile at you more. Men open doors for you. In fact, once you become aware that you are being treated better by others, it becomes disarming. For a brief period of time, I thought maybe it was just me. Maybe it was my new positive outlook on life, or my new found confidence? But, after reading many many posts my many other WLSers, I can tell you 100% that obese people are just not treated as well by the general public.
Also, you will get praise from a lot of people, and dealing with that praise can be it's own challenge. I personally found it difficult to take compliments after years of being prepared with self-depreciating whit to protect my thin-skinned fat girl. It is difficult to be a person who has been conditioned to try to hide yourself, only to end up being the focus of people's attention. When that happens, you realize that this is much more complicated than just losing weight, and that you need to change your brain and spirit to match your new smaller body.
9. ... except for those who don't.
So, this is a tough one. People who are close to you sometimes might not react as positively. These reasons can vary, but here are a few examples of how WLS can be hard on loved ones.
- We feel good about ourselves- either for the first time in a long time or the first time in forever. Simply put, feeling good will change us into people who our loved ones simply don't recognize. I had someone in my life make repeated comments to me about my new found love of makeup after losing my first 40 pounds. It was hurtful because their comments to me were along the lines that I was being vain. I've never been accused of being vain in my whole life! It hurt that I was finally feeling good enough about myself to want to look nice, only to feel like I was being bashed for it. Now, that person didn't mean to hurt me, but it did.
- There will be people who will not know how to handle a person who felt bad about themselves all the time, and now doesn't. People with low self-esteem need to be handled much differently than people with confidence... and the people who love us don't always know how to approach us now.
- One friend, in an honest moment, told me something profound. She said that she could see herself saying something that might hurt me, not because she wanted to hurt me or because she would begrudging of my successes, but because my successes highlighted that she's not having the same kinds of success. This isn't the same a jealousy... it is just a bit of a sting for her. I love this friend for telling me this- it was a brutally honest thing for her to say. I felt bad- I don't want this to make my friend hurt. But, we all know that watching someone else succeed at something feels like it's pointing a giant flashing neon signs at our own failures.
- Some people will watch you like a hawk and question everything you do. They will ask you if you are allowed to eat this or that, or tell you it's not 'healthy" to only eat 600-900 calories a day. They will question you all the time to make sure you are holding up your end. It stings a bit to feel like you can't be trusted to take on this challenge on your own. Of course, this is also the same mentality that assumes that all obese people just lack will-power, which simply isn't always the truth.
So, amazingly, you can be treated better by strangers, and very differently by loved ones. Deep, right?
10. Droopy Drawers
So, after that last serious topic, we need something a bit more lighthearted. My underwear never fits. I buy smaller panties and they are falling off me a week or two later. This is a problem I feel like I just cannot get ahead of. Your underwear falling off is not a good feeling- or a good look! If you suspect a neighbor or a co-worker of having Weight Loss Surgery, there is one way to know for sure: They will be the ones who are reaching into their pants to pull up their underwear every 4 minutes.
11. You don't want to be "That Person"
The one who tells everyone how awesome WLS is. You try really hard to not get all braggy on the subject. You try really hard to not have it be the topic of conversation.. but it always seems to come back to your surgery.
Perfect example. I love to go to restaurants. Of course, now, my choices are limited and I have leftovers that will feed me for days. But, I still want to go out with my husband and friends. Every time I try to go anywhere, the other person will say " Oh, no- where can you go, since I know you can't eat just anything". Honestly, I can figure out something to eat at pretty much every place, and if I can't, it's totally okay because I'm likely not physically hungry anyway!
Additionally, my surgery will come up as a matter of course of people talking about my weight loss. I had a woman come up to me... a woman I don't know very well., but is, honestly, larger and would likely benefit from WLS.. and say in the most polite way " I hope I'm not offending you, but is your butt getting smaller?". She didn't know about my surgery, and I told her flat out how what I had done and how well it's worked. I tried to not flat out say " You should do this", because that would be both rude and presumptuous, but I basically said to her that it was the best thing I've ever done. Now, if someone flat out asks me about it because they want to get it, I will go on and on and on... just like the people I know who had WLS did when I was getting ready for my surgery.
Like becoming a parent, I am enjoying the process, but looking forward to that time where this new and different phase fades and I can return to being a normal person again. So, I don't want to be that person whose life is all about her surgery, but it's difficult to avoid, and it's not always my fault.
12. Our perception of food consumption is, like, way f*@&ed up!
First of all, let's talk about how little we actually need to survive. It was SHOCKING to me that I could get by and feel great on so little food. I would look at my My Fitness Pal, have 300-400 calories on my all liquid phase, and feel like a rock star. I kept waiting for that feeling to end. I waited for the fatigue and horrible exhaustion that I thought would come with taking in so few calories.. That time never came. I have not been able to consume more than 1,000 calories in a day in four months, and I still feel fantastic. I think back now at times where I thought I had low blood sugar, or thought I was cranky because I hadn't eaten, and I realize now how much of that stuff is not an actual physical reaction. Now, please do not get me wrong: I am NOT saying "it's on our heads", because biological responses to emotional stimuli is just as real as physical reaction. But, I am saying that the idea that we needed to consume so many calories just to get through the day is not that our bodies need that much.
Next, lets talk about what it's like for WLSers to watch "normal" people eat. Again, I don't want to be that person- but now, with my tiny meals ( 4-5 ounces of anything at a time), I am completely shocked at how much people can really put into their stomachs. I will go to lunch with a friend and I get a water ( honestly, it's just to because they look at you sideways if you don't get a drink. Remember, I can't drink anything with my meals for 30 minutes before or 30 minutes after). They get a sweet tea or a soda, easily 20 ounces of liquid, and they can polish it off in a matter of minutes... and I'm slightly taken aback by it. Now, please understand, I DID THE SAME THING! I could finish off glass of coke and need a refill before the order was even taken at a restaurant. Now... well, now if I could have soda ( which I can't), that same glass of soda would take me an hour to finish. I love my husband dearly, but have sat there, somewhat shocked to watch him eat a sandwich seemingly without ever actually chewing it! Not only can I not eat that much, but each and every bite has become very purposeful, because if it's not chewed well, it doesn't sit well. I begin to think to myself that I didn't really even appreciate food when I had a full sized stomach, because I barely took the prime opportunity that most people enjoy about eating- tasting my food!
Also, the sizes of portions are now shocking to me. I ordered a "Petite Wedge Salad" at a California Pizza Kitchen that was ( I kid you not) on the "Small Plates" part of the menu. I actually questioned the waitress if she gave me the right one. This thing was easily a quarter of a head of lettuce, and I could only eat about 1/8th of it. I consider myself very fortunate to say that I don't understand how I ever consumed that much food, and never even took the time to enjoy it.
13. We are cheap dates....
The best part is how cheap it is to take me out for a meal. I try to get kids meals when I'm out.. and when I do I only eat maybe 1/3 of it. If there isn't a healthy kids meal option that I can have, I'll go for a soup or an appetizer. A meal at a restaurant hasn't cost more than $5 in months.
14. ... who waste food all the time
I can only eat 1/2 a banana. 1/2 an apple. Things that spoil quickly are so wasted on me! And learning how to recook an appropriate amount of food is really really hard. I am constantly asked in restaurants if my food is okay, simply because I can't eat very much of it. This is a lesson a learned early: If you are a person who had WLS but you like going out to restaurants, ask for a to go box right away. I put away the food I know I won't be able to eat right off the bat. It saves me from having to explain to the server staff, and keeps me from the regrettable moment featured in truth #15.
15. One bite too much
When I had a normal stomach, one more bite was always possible. Even when I said I couldn't eat another bite, I really could and it wouldn't hurt me. Now, that is not the case at all. There is literally a bite that if I put it in my mouth and swallow it, I will go from being happy and satisfied to needing to lay down because I feel horrible. Just one bite... and even a small bite at that. I have even put bites in my mouth and realized what I've done and had to spit it out into a napkin. Learning that line is hard, but here is something even harder: Learning that you have to leave that food on the plate.
I cannot tell you what conditioned me to believe that a bite on a plate is made to be put into my mouth, but it happens to me all the time. I won't need to eat it, or even want to eat it.. but there is some strange drive in me to put that food into my body. It is a very powerful drive. My solution is out of sight out of mind, and I either tuck it into the to-go box or physically make the plate go away. This is something that causes mental somersaults, because you can KNOW you shouldn't have it, but resisting it is very much a mind-over-matter thing.
16. Belly Fat is EVIL
So,, I've lost all this weight... 65 pounds. And, I'm only down 4 pants sizes. Everything in me says that I'm failing, because I feel like I should be smaller... and I am smaller... everywhere but my belly. All of my clothes are way too big everywhere... except my belly. I should be down another 2 sizes if I was going by how baggy my pants are around my legs and butt, but that "stubborn" belly fat ( that's a thing, ya know... they actually refer to belly fat as stubborn!) just will not go down. So, none of my clothes fit properly. It's super annoying!
17. "I can see it in your face!"
You can look at quick weight loss like concentric circles. You will lose from the outside first... face, fingers, hands, feet, arms, legs, neck. Extremities will lose first, and that bitchy stubborn friend from Truth #16 will go slower. But, that loss in your face makes a shocking difference in how you look. People will tell you over and over and over again that they can see it mostly in your face... and it's the truth.
18. Pre-op is long, hard, scary and necessary... Post-op is eye-opening!
For most people, having WLS is officially "elective" surgery. We don't have to have it. It's not technically required to save our lives ( although it does!). There is something about that kind of surgery that makes going under the knife scarier. I've had several surgeries, and none of them scared me like this one did. Perhaps it's the amount of buildup to it. For me, it was 6 months from first PCP referral to the operating table.. and that entire 6 months was about prepping for this change. I became obsessed with finding the best protein supplement for me, practicing getting in enough water, and doing so much internet research I could tell you anything about WLS. Going through all the requirements was torture, and insurance approval was torture ( I was denied the first time because of a mistake on my birthday on one piece of paper, delaying my surgery an extra month). Getting my date was a moment of glee. I finally new my timeline, and could prepare for my new life ( and say goodbye to my old one).
Two week pre-op all liquid is almost universally agreed to be the worst part of the whole thing. You have your complete stomach and you can only have liquids for 14 days. It really is just horrible! But, all of this is a part of the process, and it's important to know that those days will become really important to you in the days just after your surgery. Those days of feeling like you are going to die without food, in contrast to those days where you know you cannot eat anything ( and honestly, you don't want to) helps you to understand how much of our desire for food is head hunger. Those days help us realize the difference. I think that two-week pre-op was actually the most crucial part of my whole journey. It tested both my resolve and pushed me toward making sure I didn't waste the thing that we find with truth #19.
19. "It's a tool"
This is the thing that WLSers say all the time. "It's a tool... not a magic wand". Now, a tool can be used perfectly for days and days and days, and then be used improperly and ruin everything.
Remember, oh-so-many-pages ago, when I talked about it wasn't easy? Well, I have to stay vigilant on what I can and cannot have. I will lose weight no matter what in this first year. But, there are ways to fail. There are people who don't stick to the "rules". They aren't working out. They aren't getting their protein or water. They are drinking and eating things they shouldn't be. They are wasting their tool.
The truth is that by this time next year, I will be back to eating 1200 calories a day. Still much less than I was before... but I'll also be smaller and will be burning less calories by just existing everyday. Of course, my metabolism will be higher too. But, if I go back to eating like I was, I will likely go right back to where I was before.
Someone I know who had Gastric Sleeve said to me something wise: "Take advantage of those first 6 months, because you will never get that opportunity back". I'm trying hard to do just that... take advantage of this peak time of loss and get as physically fit as possible to make sure that a year from now, staying physically fit is easier.
20. This is more than just not being fat anymore.
So much of WLS is an emotional process. You have no idea what it will do to you until it does. For me, WLS made me a much happier and less stressed out person. Seriously, my husband is shocked at how my whole personality has lightened after WLS. I'm more positive, happier and let the stresses of life slide off my back much easier than I did before. I have read about people who get depressed in the month after WLS. This is not my experience, but I can tell you that I have seen several people who struggled with depression before WLS who seem to revisit depression after WLS.
All of that said, here is the point. Changing your body is one thing, but this is also changing who you are. You have to change and challenge yourself to find success, and you have to change to deal with how others see you after WLS.
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