It’s not just your weight that changes….
Ask anyone who has ever lost a significant amount of weight, and they will tell you that it is quite astonishing how you are suddenly viewed differently by the world. Everyone suddenly comments on your appearance and tells you how amazing you look. Sounds nice? And yes, it is, but there is the little bit of you that wonders “well, did you think I looked rubbish before?”
I am going to share some personal experiences in this blog. I had metabolic bariatric surgery in 2017, in the form of a gastric sleeve. I was lucky enough to be able to have it done privately in the UK. I had always had a bit of a battle with my weight. I was a slim child, but once puberty hit, I could gain weight easily. I remember doing A levels fuelled only by a yoghurt and an orange because summer uniform meant a slimmer skirt and could probably name the WW point value of any food going by the time I was 21. It was the 90s, thinness was highly valued. Pregnancy one and postnatal mental illness and medications meant the weight went on very quickly. By the time I had child number 2, seven years later, I had probably done every diet going – low calorie, low fat, low carb, very low-calorie diets, liquid diets, intermittent fasting – you name it, it had been done. And I lost and re-gained weight. Baby number two and more post-natal mental illness started the whole experience again. But this time I just got bigger, despite doing HIIT twice a week, eating well, going on two weight loss camps, finding myself licking an ibuprofen for the sweet coating was the low point there!
When I found out I had gallstones, after 2 years of suffering pain that I thought was because I was greedy and had indigestion (diagnostic overshadowing on myself, I am a Dr!) I decided I would ask the surgeon to do gallbladder removal and a gastric sleeve at the same time. The story of the surgery and how I was treated by healthcare professionals post-operatively is for another blog.
Afterwards, the weight came off. Significantly. I revelled in new clothes, a new confidence as I felt like me again, and being able to move around the world more easily. I did a 10k run at my heaviest and the difference running a few months post operatively was extraordinary, I felt like I was flying! Life felt easier as a smaller person again, and I felt so much healthier and able to do things. It was brilliant.
But other things changed too, things you may not consider. I found being told I looked amazing increasingly upsetting (I know, that sounds odd) and never once posted a “before and after” picture and have grown to hate them whenever I see them anywhere. It felt like the “before” me was somehow devalued because I was bigger, but it is just the same me, with all the same thoughts and feelings. I applied again for jobs that I had tried to get unsuccessfully before the surgery and got them. I was invited to talk publicly more and I was considered someone who was worthy of listening to, which hadn’t always been the case before the operation.
Working in the obesity space for the last 8 years, and being a doctor and GP for 25 years, I know that my story is not unusual. Both in how the weight came on over years, and how I found life after the weight loss surgery.
When someone loses a significant amount of weight, it changes how they feel about themselves and how the world views them. This can affect all aspects of their life including personal relationships, relationships with friends and family, employment prospects, educational achievement and psychological wellbeing. These changes can be both positive and negative and the adjustment and adaptation of the person and their loved ones can be challenging. The changes and judgements are known to affect women more than men and is applicable to people of all backgrounds and ethnicities.
Unexpected reactions to weight loss
In the previous blog we talked about societal weight stigma, and ask you can imagine, if someone has spent a significant proportion of their life subject to that, especially if it includes childhood, it will have played a significant role in how they view themselves. Friends may have got used to them being the person who is bigger and in romantic relationships, especially if both partners have overweight or obesity, if one loses a significant amount of weight, the dynamic can be challenged and the person who hasn’t lost weight, may feel under pressure or even jealous. We hope people would be happy for us when we are happy, but sometimes unexpected reactions to weight loss happen.
Non-scale victories – the best bit!
It is very common for traditional weight loss organisations to discuss weight loss in terms of a goal – perhaps losing 10% of bodyweight or reaching an “ideal BMI”. What we know is that even with meds, sometimes a normal BMI may never be achievable if someone is starting at a very high bodyweight. Surgery and meds in combination may be the best option for an individual in that situation and expert advice is key, which we at Genwell can provide alongside a metabolic bariatric surgeon.
It can therefore be much more positive and helpful to focus on so much more than one’s relationship with gravity.
When I was bigger, I really wanted to experience a few things when I had lost weight. I wanted to ice skate (my legs had become too painful to lace up the boots) and I wanted to be comfortable taking pictures with my family and children that didn’t just include my face. On holiday, I wanted to be able to walk on the beach without it feeling like a herculean effort and I wanted to be able to walk in and out of the sea with confidence. I wanted to be able to go out for dinner without having to look for pictures of the venue online to see if the chairs would be ones I could fit in and I wanted to enjoy food without feeling guilty about making “good” choices.
I wanted to buy clothes in normal shops again and I wanted NOT to be the person on the plane that people looked slightly disappointed at when they realised I was sitting next to them. I wanted to be able to wear dresses with waists again and I wanted to be able to wear heels without my feet getting sore!
(These things may well be things that people who are slim never ever think about. I know I didn’t before I got to my heaviest, but I can guarantee that those with obesity think about them a lot)
Celebrating these things is so much more exciting than a number on a scale. They mean more in our life. When I got back on the ice, I shed a tear. I spent more money than I should have in my favourite clothes shop, and I purchased a lot of pretty shoes! I was more than a head hiding behind my kids in holiday pictures and I did up the plane seatbelt with complete satisfaction. These things meant everything to me.
In all of the discussion about non-scale victories and psychological changes, we haven’t even started on health changes. We know, as mentioned in blog one, the health benefits of these medications that are independent from weight loss, and celebrating these is hugely important as well. Being able to move more, seeing an improvement in your blood pressure and cholesterol and a reduction in your visceral fat percentage are all fabulous and encouraging and we can help you monitor and celebrate these achievements.
At Genwell, we know that these things matter to you. We want to know about them, we want to discuss them with you and help you be able to achieve them, we want to celebrate them with you. We want to see the holiday pictures that you can love. We may occasionally discuss numbers on the scale, but we know that that isn’t the thing that changes your life. It’s the things you can now do that matter.
We can also help you through the psychological, relationship and body image changes that come with weight loss and help you to navigate the good and the challenging. We will be there with you for the journey and beyond.
