My… How the Focus Changes!

[Connie Stapleton PhD 342]

The Doc: “What made you decide to have Weight Loss Surgery at this particular time in your life?” I ask every patient I see for a pre-surgical psychological evaluation. The responses to this question nearly always revolve around health. “I want to get off so many medications.” “I need to get rid of this diabetes.” “I want to be healthy enough to see my children/grandkids grow up.” “I want to be able to do things I can’t now because of my weight.” “I want to be healthy enough to walk/go places with my family/ride amusement park rides/not have to use a seat belt extender on an airplane.” The vast majority of the time, when people make the decision to have weight loss surgery, their health has become an issue that interferes in their quality of life. Sure, some people are interested in the benefits of being able to wear smaller clothing, many are interested in being less discriminated against, and most are enthusiastic about seeing the scale show a much lower number. It is safe, however, from my experience of having completed over 3000 pre-surgical evaluations, to summarize people’s reasons for wanting to have weight loss as being 1) seeking improved health and 2) seeking an improved quality of life.

The Post Op: All I know is, by the time I dragged my size 30 behind into the doctor’s office to talk about getting the weight off, I was sick…and I was tired…and I was sick and tired of being sick and tired. It sounds trite, but it was true. My obesity was mentally, physically and emotionally exhausting, and every day represented weight gained and battles lost. At 320 pounds, I was Alice, and I’d been stuck down the rabbit hole of obesity and poor health for so long, I was willing to do anything to get out – yes, even take a swig from that bottle on the table with the “drink me” tag. In my mind, weight loss surgery was a magic potion and I was about to get really small. I didn’t know how it would feel when I got there, but I knew I’d be set free. I believed my life would get better and I’d be healthier if I could just get…smaller.

The Doc: Fast-forward two years after surgery. The weight has melted off! The scale, of, course, never seems to reflect a low enough number. No matter – people are taking many fewer medications than they had to prior to surgery. And they are riding roller coasters and Ferris wheels and they are going on airplanes and not needing seatbelt extenders. They are going bike riding and hiking and playing with their children and grandkids like they have dreamed of doing. In other words, the majority of post-ops at around the two-year mark, do have improved health and do have a better quality of life.

The Post Op: Losing large amounts of weight in a short period of time really messes with your head. One day, you’re buying double-digit stretchy pants and tops in the plus-size section, and the next, you’re venturing into the foreign world of single-digit labels on non-spandex jeans and fitted suits. Yesterday, you couldn’t find a single “before” photo but today you’ve got a thousand “after selfies” and attention from people you aren’t even sure you like. It’s exciting and new… and confusing… Somewhere along the way, you lost the plot, stopped focusing on your health and started focusing on your image. Like so many post-ops, you’ve learned that losing weight doesn’t guarantee happiness, hopefulness or health. So, with that said, can you refocus your focus and choose to live in Recovery From Obesity? What do you think, Doc?

The Doc: It’s been really interesting observing the journey of post-ops, two of whom are my closest friends. After the initial weight loss and the joys of experiencing many of the NSV’s (non-scale victories, on the off chance you don’t know what NSV stands for, many people start whingeing (pronounced win – jing), a term the Post Op and I learned on our trip to work with bariatric folks in New Zealand. It means whining! “I don’t want to exercise.” “I’m tired of restricting myself.” “But sometimes I just need chocolate.” And then there’s the gossiping. “Have you seen so-and-so? She’s regained so much weight.” “Do you think I look smaller that that woman?” And, of course, there’s a continued? new? renewed? obsession with numbers! ““If I could only fit into a size smaller.” “Just ten more pounds and I would be satisfied. Really.” And what I actually find the saddest is the addiction to food… “I watch all of the shows on the food Network.” “Look at the ‘bad’ food I ate… I posted it on Facebook!”

My, how the focus changes! No longer do people seem to remember the reasons they had surgery… they appear to overlook the fact that their health is improved and the quality of their lives is vastly improved. All of a sudden the numbers on the scale, the size of the clothing and how they compare in size to other people are the focus. And maybe the saddest part from my perspective is that no matter how much weight they’ve lost, so many people are dissatisfied. They either want to lose more weight, hate their body just as much as before weight loss, or find some other thing(s) to focus on that were never mentioned as being important prior to surgery.

The Post Op: I’ve seen this play out a thousand times, Doc, and it makes me so sad to realize that many people who desperately want to be free from the prison of obesity actually imprison themselves by the tyranny of numbers, the scale and their clothing size! As you sagely point out, far from living a life in Recovery, many post-ops lose sight of what they said matters most and focus on the food, the food and the food! You call it an unhealthy obsession – I call it addiction, but either way, it’s not the goal of life after weight loss surgery…at least, not in my book. What’s missing from the equation?

The Doc: Where’s the gratitude? Somehow, the life-saving, life-enhancing weight loss surgery that was done to improve one’s health and improve their quality of life, and that DID exactly those things, often morphs into what we believe are simply manifestations of that same disease of obesity. Because, as Cari often points out, “obesity is all about the food but not at all about the food.” And she’s right! Obesity includes a mindset, an attitude, an obsessiveness on food, size, and weight. Perhaps most tragically, there is a self-defeating component that lives on when one becomes obsessed with their eating, their weight, their sizes and/or what others are eating, what others weigh and what size others are wearing.

Again, I ask, “Where’s the gratitude?”

The Post Op: In my case, genuine gratitude was a mystery. I mean, I’d spent a lifetime focusing on my compromised health, physical limitations, poor quality of life, disappointments, shame and failures. Clearly, going to the doctor wasn’t a reason to Celebrate, because I believed I’d be “blamed” for my condition, then blithely be told to “move more and eat less.” And I know I’m not alone – I talk to many post-ops who share my misunderstanding about the power of gratitude and the importance of practicing it in everyday recovery. Of course, when the focus is on the negative, it doesn’t even occur to you to consider something positive! Maybe that’s why I view gratitude as the unsung gift of Recovery and work hard to work on it every day.

The Doc: Maintaining what is commonly referred to as “an attitude of gratitude” can have a positive overall affect on your life. By focusing on the ways your health has improved, you feel pleased and grateful for the changes in your life, regardless of the weight your body has settled at. Focusing on the ways the quality of your life has improved after weight loss results in being grateful for being able to participate more actively and fully in your own life! Take the time and literally make a list of the things your weight loss has resulted in regarding your health and quality of your life.

The Post Op: I get it. Lists are usually filled with work you have to accomplish before the day ends (things to do today), or before you die (bucket list), but they aren’t usually things you look at to feel good. I say it’s time to change that paradigm and start making lists of things you’ve already done (or, get to look forward to!) Your gratitude list doesn’t have to be a thing of literary genius (which means it doesn’t have to rhyme, be written in haiku or iambic pentameter, and doesn’t even have to include complete sentences!) Your list can include positive words, pictures, names of people you love – whatever – but it has to be a real list…so why not start now by considering some of the things The Doc mentioned? In case you’re wondering my list starts like this: 1. I’m eternally grateful for the opportunity to work with an amazing and compassionate friend to help others find the joy of Recovery From Obesity. How about you?

ACTION STEP: Download a GRATITUDE APP (any one will do) for your smart phone and make a practice of typing in a minimum of three things each day that represent your improved health and/or the improvements in your quality of life. If you’re open to it, you will experience an overall improvement in your daily attitude.

[Stevehud 1,790]

There is an even worse after effect sometimes. People become so caught up in the healthy lifestyle they forget they ever had a weight struggle to begin with and criticize the health and eating habits and weight of others. They become what they themselves decried prior to their weight loss.

[Sharpie 3,306]

oh Steve that is a true statement. I find sometimes successful weight loss brings out all the "experts". I tell people who ask me questions about dieting that if I were such a great dieter I wouldn't have needed surgery. I only know what my doctor tells me. But, sometimes I catch myself looking at a obese person and thinking wow they should do something about that weight. I think it's human nature an part of the process is that we sometimes think we have found the answer. In reality we all have had the same struggle and I have the fear that I will fail every day. I guess that is why I read posts on here and watch all the obesity shows on t.v I have recommended lapband surgery to several people who have asked but I don't offer advice without them asking.

[My Bariatric Life 764]

That's probably self recrimination...

There is an even worse after effect sometimes. People become so caught up in the healthy lifestyle they forget they ever had a weight struggle to begin with and criticize the health and eating habits and weight of others. They become what they themselves decried prior to their weight loss.

[Swampdoggie 477]

Great, thought provoking article. Good to be reminded of what's important. Thanks

[VSGAnn2014 12,992]

Good piece.