Jean McMillan

I did something similar. I bought a beautiful skirt that was about 2 sizes too small, hoping that one day I could wear it. Sort of a motivation garment. Every time I saw it in my closet I was reminded of the future's "maybe". When I could finally wear it, I felt like a million bucks every time I put it on. The sad part is that eventually it became too big for me...or should I say I became too small for it...

Amen to that! One of the nicest compliments I got when I'd lost 30-40 lbs was, "I the outfit you have on. It fits!" The American Cancer Society has long understood the relationship between looking good and feeling good. They have a program called "Look Good, Feel Better" that partners with Cosmetologists and provides spa days and other services for women with cancer. I know I definitely feel much better about myself when I take the time to do my hair and makeup and accessorize on weekends and days I work from home. It's a challenge during weight loss, but I'm determined to wear clothes that fit now. I've been lost in shapeless knits and elastic waistbands for too long, and I'm ready to look as good on the outside as I know I'm going to feel on the inside. I know constantly buying clothes can get expensive, but this is a peeve of mine. As people lose weight, I feel it's SO IMPORTANT to wear clothes that fit your ever shrinking body! Not only does it just make you look more put together, it makes you FEEL more put together, thus encouraging continuing positive behaviors that got you there! Even if it's just a few nicer pieces you can mix and match until you have to buy the next size down. We lived our lives being frumpy and wearing over sized, ill fitting clothes to hide our bodies. Why continue to do that as we get smaller? We need to flaunt our confidence and success to the world!

Shoes! I'd forgotten about shoes! Pre-op I wore size 8-8.5. Now I wear size 6.5-7. Too bad shoes are expensive. And I'm bit uncomfortable with wearing anything from Goodwill that can't be washed before I put it on. You're smart to start to envision your future now. Health, lifestyle, relationships...so many things change as your weight goes down. And I'm glad to encounter someone who realizes the importance of taking good care of your appearance no matter what your body size. I think it's a sign of strength and good health (mental and physical). As a pre-op, I would tear off my work clothes the instant I came home (well, not that very instant...as soon as I got to the bedroom) and put on something from the loose, bland, I-don't-care-about-me, please-don't-stare-at-me wardrobe in my closet. You didn't have to ask me how I felt back then - you could see it in one glance.

Are you glad or sad about what’s tucked away inside your clothes closet? Today is Saturday, a day off for some of us, and a good day for peeking at the hidden trash and treasures. Let’s have a look in mine… My clothes closet is hidden deep within the house. It’s a very small interior room, the one where we’d hide if a tornado came our way. I’m glad to have it, but for most of the time we’ve lived in this house, that closet has not been a place I enjoyed visiting. The not-so-secret evidence of obesity was hidden there – 10 sizes of clothing (from 24 on down) in “slimming” styles and colors – souvenirs of my many trips up and down the scale. But unless you’re expecting a tornado, the closet is a lousy place to live. Let’s open the door, let the light shine in, and ask ourselves the $64 million dollar question: WHY ARE WE HANGING ON TO ALL THIS STUFF? Let’s grab a jumbo trash bag and get busy working on a Goodwill donation or a batch of goodies for the local consignment store. What, do I hear groaning? The short fat girl who dwells inside me whines, “But we might need them again someday!” LET ‘EM GO! The other day, I cleaned out my clothes closet. I had done that before, about 6 months into my WLS journey, with great difficulty. I was fond of some of those outfits even though they could work as window drapery as well as clothing. I had spent a lot of money on my work wardrobe, to say nothing of the shoes. I feared that the instant those clothes were gone, I’d gain 50 or 75 or 100 pounds and need them all again. I had little faith that my post-op weight loss would be any more lasting than my weight loss had been in previous dieting attempts. Eventually I acquired enough new-to-me, smaller-size clothing that the closet was about to explode, so I made myself cull out the big stuff and haul it off to the Goodwill Store. Getting rid of it turned out to be a relief, and then of course I had the fun of filling up the closet with more clothes in smaller sizes. Back to the Goodwill Store I went...again and again. In the 8 years following my WLS, I’ve dealt with some unexpected medical problems that led to band removal and a sleeve revision. While all that went on (and on, and on), I regained 30-35 pounds, and sizes 12 and 14 appeared in my closet again, followed all too closely by a few size 16’s. Eventually I lost that weight regain. When seasons changed and I hunted for something warm or cool to wear, I was delighted to find that most of that clothing was too big. I had nothing to wear! That’s what I call a First World problem, something foolish to complain about when so many Third World people have little or no food, clothing or shelter. But…there’s no denying that morbid obesity is also serious problem, so I can’t bring myself to downplay my weight loss success. The weird part of this is that saying goodbye to the big stuff wasn’t as easy as I thought it would be. You’d think that weeding out mountains of Goodwill donations would be a festive occasion, but my inner fat girl begged, “OK, get rid of the 14’s if you must, but please, please keep the 12’s! You never know!” I’m happy to report that I managed to ignore her. In the past 4 years I’ve waved goodbye to the big sizes and welcomed back the small sizes. No, we never know for sure what’s going to happen in the future, what unexpected event will drive our weight back up or our weight management commitment back down. But we don’t need to see constant reminders of past failure, and we shouldn’t give space in our closets or our minds to the negative stuff that weighs us down and slows our forward footsteps. So, whoever you are, whatever surgical procedure you had or will have, whatever your weight or clothing size is today, I challenge you to clean out your closet. Look at every single garment in there and ask yourself: does this fit my body now? does this fit my lifestyle now? is this required by law (state, federal, religious, or employer)? does this make me look and feel great? Any garment that gets 2 or more “No” answers goes in the Goodbye Pile. Simple enough, isn’t it? No, it’s not easy. I go through this at every change of season and probably always will, because my inner fat girl will never forget what pre-op life was like. The only residents of my closet are one fat girl outfit (that I drag out and try on when I’m having a fat day) and way too many adorable size 4/XS outfits. Spring is (I pray) just around the corner here in Tennessee, so I’ve been trying on my warm weather clothing and cheerfully telling the rejects, “Goodbye!”

If the key to weight loss success is self-esteem, and you’ve got none stashed in the pantry where you used to keep cookies and potato chips, where do you go to find some? HOW WE GOT HERE In Part 1 of this article, I introduced the idea that positive self-esteem is the key to weight loss success. In Part 2, I’ll talk about why so many obese people have a negative self-esteem Now let’s have a quick look at how we came to be such sorry specimens. Any psychologist or sociologist will tell you that some of the most troubling factors contributing to low or negative self-esteem (on the levels of individual people as well as the aggregate of citizens called American society) are a person’s physical appearance, weight, intelligence and peer pressure. Very often all four of those factors are tightly intertwined. In an elementary school cafeteria, Jane, an obese girl with a tray piled high with food winces at her classmates’ teasing. Unable to find a friendly place to eat her lunch, she sits down alone and cries at the sound of other kids’ voices: “Fatso!” One of the school bullies shoves Jane’s lunch onto the floor and laughs, “You didn’t need that food, Fatty!” Jane heads to the lavatory to cry in private. She hides in a stall and hears the popular girls chanting, “Fatty Fatty, two by four, can’t fit through the bathroom door!” I’m sure you’ve guessed by now that Jane’s name is actually spelled Jean, and that the school cafeteria scene above lives in my distant memory. Even when I don’t consciously think about that unhappy incident, it and many others like it formed my beliefs and feelings about myself a long, long time ago. Sometimes I feel that I’ll never get them all weeded out of me. In my case, that ancient stew of negative self-esteem flavored my life with some miserable symptoms: hypersensitivity to criticism, perfectionism, guilt, shame, irritability, a defensive attitude, a sense of defeat and insignificance, and a persistent, low-grade “fever” of dissatisfaction with myself, my life, and everybody else. And yet, despite all that, at age 62 I can call myself a success, not just at weight management but at a host of other things. No, car repair is not one of those things, but on the whole I’m doing pretty well. I have my husband, my friends, and my own determination to thank for that. If I can turn myself around, you can do the same for you. Low self-esteem is not something that gets fixed overnight, and having bariatric surgery is not the cure. Choosing surgery is a wonderful first step, but it’s not the end of the journey. So please, be kind to yourself! I’m not talking kind in the sense of indulgence but in the sense of a loving caretaker who understands that you’re weak and believes that one day you’ll be strong. WHERE ARE WE GOING NEXT? Psychologists say that self-esteem is linked to a sense of competence – the awareness that you have the knowledge, skills, and resources needed to accomplish a task. It’s unlikely that you’re going to start your weight loss journey with a strong sense of competence regarding weight loss. In fact, it’s quite likely that your self-esteem in that area is torn down and tattered from all the diet and weight battles you’ve fought and lost in the past. No matter how much information you’ve gained from your pre-op education, you don’t yet have a history of weight loss success to buoy you along. So how do you even begin to feel good about your ability to make the lifestyle changes required for weight loss - make good food choices, control portions, take tiny bites, avoid grazing and so on? I’ll adapt the take tiny bites strategy to this effort. You tackle the weight loss project one tiny bite at a time. You repeat the effective actions of making good food choices, controlling portions, taking tiny bites and avoiding grazing over and over again until you’ve learned how to do it with less effort and more enjoyment. You seek and acquire the knowledge, skills and resources to help you succeed. You seek assistance from your surgeon, your support group, your family and friends. All this work may never become fun for you, but in my case, weight loss made it all worthwhile. TODAY’S WEIGHT LOSS SUCCESS FORECAST IS… Does the importance of positive self-esteem mean that you’re doomed to failure if your self-esteem isn’t already strong on the day of your bariatric surgery? Certainly not. If you take on the challenge of a weight loss winner’s lifestyle one tiny bite at a time, your WLS journey can actually help you increase your overall self-esteem while decreasing your weight. Each step you take, each new behavior, each pound you lose, will prove to you how capable and worthy you truly are. From time to time, you may have to ignore or silence the voice of self-doubt. I like the way my friend Lisa counsels self-doubters. She says, simply and firmly, “You can do this.” So when your inner Doubting Thomas (or Thomasina) whispers (or shouts), “Forget it! No way! Lost cause!” take a deep breath and tell her “I can do this. I will do this.” Eventually you’ll turn your eating behavior around, reach your weight loss goal, and finally feel proud of what you’ve accomplished.

The self-image of obese (or any other) people is complicated, isn't it? I've been contemplating that for years. On one hand, you have obese people who don't see themselves as obese, and apparently don't recognize the health risk that poses. On the other hand, we're living in a society that holds up "skinny" as divine, is extremely critical of the obese, and yet goes on super-sizing every meal we eat. In that setting, it's hard to keep your balance.

Perspective is a highly under-rated thing, isn't it? When I look out the window at my worktable, I can see a neighbor's barn (we live way out in the boondocks, where barns and cows are more populous than shopping malls and poodles). From here, it looks tiny, but in fact it's huge. It's just one of his barns (we're in the agri-business heartland) and he can fit several pieces of modern farm equipment in it, things that look like they just landed from Mars and are getting ready to take over the world. That's why I have to constantly supervise my own thoughts and make sure I'm reacting to real things in the appropriate degree to achieve the end I so very much desire.

I have something important to tell you today about success with weight loss surgery. When you hear it, it may strike you as obvious, but I’d be willing to bet that your surgeon never mentioned it to you. Don’t begrudge him or her for that, because this particular crucial thing is something no surgeon can give you anyway. It’s something that no insurance policy covers, no pharmacy sells, and money can’t buy. You may already possess this thing in some degree, but do you have enough to ensure weight loss success? THE KEY This very important thing, the key to weight loss success, is self-esteem. Success requires positive self-esteem in a part of your life that’s never before given you a lasting good feeling about yourself: weight loss. If you were good at that, if you knew you were good at it, you probably wouldn’t need bariatric surgery in the first place. You’d already be maintaining a healthy weight, happy about that, and working on attaining goals in some other area of your life, such as qualifying for the Olympic pole-vaulting team. Self-esteem plays a role in many areas of human endeavor, and psychologists have identified it as an important predictor of relative outcomes. They believe that your level of self-esteem affects (or even predicts) the results of your efforts and activities, be they academic, athletic, professional, interpersonal, you name it. Their studies show that a person with high self-esteem (whether generalized, like “I’m a good person”, or specific, like “I’m a good tennis player”) is more likely to succeed at a given task than someone with low self-esteem. Although the Stuart Smalley School of Positive Affirmations would have you believe that chanting, “I’m good enough, I’m smart enough…” six times a day will bolster your self-esteem, it’s not quite as simple as that. While I agree that our thoughts and beliefs about ourselves have an enormous effect on our behavior, self-esteem often involves feeling rather than thinking. Let’s demonstrate how that works through 3 short interviews with Jean. Interview #1: “Jean, are you a good car mechanic?” “Heck, no.” “How do you feel about that?” “Perfectly fine.” [Translation: Jean knows she’s not a good mechanic and feels just fine about that because it’s not something that engages her emotions at all. Her self- esteem in this area is neutral.] Interview #2: “Jean, do you have a flat abdomen?” “Heck, no.” “How do you feel about that?” “Lousy. It makes me feel unattractive, I struggle to find attractive clothing to hide my belly, and I feel frustrated that none of my exercise routine seems to improve my mid-section.” [Translation: Jean knows her abdomen is not flat and feels unhappy about the way she looks and feels. Her self-esteem in this area is negative. Interview #3: “Jean, are you a good writer?” “Heck, yes.” “How do you feel about that?” “I feel wonderful about it. I love writing. It’s fun, challenging, and interesting. When I’m writing, I feel that I’m a talented and worthwhile person.” [Translation: Jean knows she is a good writer and feels happy about it. Her self- esteem in this area is positive.] The final step of this educational exercise is to look at the following list of endeavors and predict which one Jean will be most likely to succeed at. Choose one of the following: Rebuild her car’s engine. Compete in and win the swimsuit competition at a beauty pageant. Write and publish a book. Yes, you’re absolutely right. Endeavor #3 is the most promising one for Jean given the current state of her self-esteem. Not only does she enjoy writing, she has succeeded at it in the past and has plenty of confidence that she can do so again. CATCH 22 So, let’s take it as a given that positive self-esteem about weight loss is important for success with our bariatric surgery. We know objectively (through the weight on the scale in our bathroom or doctor’s office) that we’ve never enjoyed long-term success with weight loss, and we presumably feel miserable about that. It’s affecting our health, our relationships, and our careers in ways that make us unhappy enough to seek bariatric surgery. Our self-esteem in this area is negative, yet we need positive self-esteem in order to succeed. Sounds like a classic “Catch 22”, doesn’t it? But wait, it gets worse! For many people, negative self-esteem erodes not just one area (like weight management) but many areas in our lives. For some of us, negative self-esteem so pervasive that it taints every cell of our being: “I’m a bad person, and I feel bad about that.” That doesn’t mean that we’re hopeless neurotics or that our negative self-esteem is a permanent and unvarying feature in our lives. A few years ago, I had a very nasty telephone argument with someone whose company provides an important service to me. In fact, we were both nasty, and two days later I regretted that I had acted so obnoxiously. For an entire day, the balance in my self-esteem account was in the red. I’d have been struck dumb if you’d asked me to name even one good thing about me. The next day, I bought that guy a coffee and apologized to him face-to-face. Life went on and my self-esteem account balance crept back up above zero.

One of the things that (usually) keeps me sane in the kitchen is the Clean Up As You Go Rule. When I was single, it was easy to enforce. Then I married, and my kitchen sanity took a beating. I love to cook, and that’s been a big help at every stage of my weight loss journey. Finding WLS-friendly food at restaurants or in vending machines has rarely been an issue for me, because I’d rather cook and eat at home. Eating my way around the world during business travels was fun at the time, but the weight I gained through the years was not in the least fun. I realize not everyone shares my love of cooking (in fact, some of you hate it), so when I wrote Bandwagon Cookery, I took pains to make the book entertaining. This is an excerpt from the book. If reading it doesn’t change your thinking about cooking, I hope that at least it amuses you. KITCHEN SANITY: CLEAN UP AS YOU GO aka The Beef Broth Story One of my mom's cardinal kitchen rules was: clean up as you go. It's possible to take this to ridiculous extremes. My Aunt Jeanne (for whom I was named) was not a great cook but she was a dedicated dishwasher. If you were cooking anything in Jeanne's kitchen and let go of it for a minute (let's say you were stirring the sauce and put the spoon down while you spent 30 seconds searching for the dried basil), she would wash it. You'd reach out your hand for that spoon and it'd be gone...over to the dish drainer. And then there's my husband, Mr. P., who is (in more ways than one) cut from the same piece of cloth as Jeanne. In the small kitchen of our first home, the food prep area was to the left of the sink. We stacked anything that needed to be washed to the right side of the sink. After years of cleaning up after myself, I certainly appreciated it when Mr. P., would automatically, without being begged, coaxed, or bribed, wash anything that was sitting on the right side of the sink. But one Sunday I spent something like 49 hours (yes, I do know there are only 24 hours in one day, but it felt like 49 hours) making my own beef stock. I roasted a cow's worth of beef bones, then I boiled them in huge vats (lobster pots, actually) of water with onions, carrots, celery, and herbs. Then I drained the stock, put it back in the vats, and added crushed eggshells to help "clarify" the broth. (By now you're thinking, "You are a very sick lady, Jean", and I agree, and you haven't even heard yet all the gory details about the time I boned and stuffed a game hen into a chicken into a turkey before adding gourmet stuffing and roasting the whole thing one Thanksgiving). Then I poured the broth into large bowls and left them to cool for about 10 minutes while I washed my hands, visited the bathroom, and had a hit of wine. Refreshed, I returned to the kitchen ready to pour this fabulous stock into freezer containers and… it was gone! Mr. P. had discarded every last drop, carefully washed all the bowls, and was sitting virtuously at the kitchen table reading the Sunday newspaper. The kitchen counters were clean and tidy...and the stock and everything I'd used to make it had disappeared. "Where is the stock?" I screamed. Mr. P. looked up from the financial pages and said, "What stock?" (OK, I just added the financial pages for fun. He would only read the financial pages if there were ads in there for guns and knives - hey, not a bad idea!). "The stock I left on the counter!" "You mean that brown stuff in the bowls?" "Yes, the brown stuff in the bowls! Where is it?" "I threw it out and washed the bowls. Why?" For a moment I was speechless (hard to imagine, I know). I looked at the gleaming, empty kitchen counters and thought of all the work I had put into that stock. What was more important, a loving husband or 20 quarts of beef stock? And always having sensible priorities, I said, "What the f***ing f***?! That was the f***ing beef stock I've been working on all day, and you threw it out? Why would you do that?!" He carefully set the newspaper on the table and said (slowly, and with equal care, as any sensible man must do when dealing with a loved one's psychotic break), "It was on the right side of the sink. That's where we put everything that needs to be cleaned, right? On the right hand side of the sink?" Silence again. How could he think that those bowls brimming with fragrant, glorious, homemade beef stock were something that needed to be discarded? Was he totally witless? Or was I? Because he was right: I had put them in the Goodbye Zone. I shook my head at him ("You got me!"), wearily refilled my wine glass and retired to the living-room with two dogs who were probably thinking, "That beef stock sure would've tasted good poured over my kibble."

Kathleen, When someone says that weight loss surgery is "taking the easy way out," I have to shake my head. They have no idea what it's like to walk this path. In a sense, losing weight after WLS is indeed easier, and more successful,l for me. That's one of the reasons I had surgery in the first place! I have a morbidly obese acquaintance who tells me that although she's glad WLS has been successful for me, she could never do it, because she feels like she ought to be able to lose the weight on her own. So on top of being miserable because of all the ways obesity compromises her health and wellbeing, she's also miserable because she feels like a failure. Jean

Eight years ago, I weighed twice what I weigh today. Thanks to bariatric surgery, I’ve lost 116 pounds. Sometimes I look in the mirror and still see Fat Jean. And sometimes I look in the mirror and see Slim Jean, and I think “What the heck happened?” What happened is that, as an acquaintance once said, I’ve lost an entire person. And what also happened is that I’ve gained an entire person. One who likes to dress in nice clothes that show off her nice parts. One who longer wishes she were invisible, is willing to chat with complete strangers, and can drive past McDonald’s and not feel French fries pulling her into the drive-through line. And this is a person who’s willing to try new things, even as my hair grows silver and my mind and body grow slower and my energy diminishes…but so far, it hasn’t diminished to my pre-op activity level: sitting for hour after hour in a big, soft armchair with a mystery novel and 2 small dogs on her lap and a bag of potato chips within easy reach. Please God, don’t ever let me return to that! But it’s not God’s job to prevent that. It’s my job. Forever and ever, amen. Because this journey never ends. And that’s OK. Because the day I take this weight loss and my new, energized, interesting life for granted is the day my Bandwagon veers off the road and into a deep, deep ditch. I’m determined to stay on the WLS path. I marvel almost every day not just at my size 4 wardrobe but at my mostly wonderful quality of life. So please don’t be discouraged if, despite WLS, you find yourself plodding down the road hand in hand with your old food devils or trapped on a weight loss plateau. Sometimes we need to revisit old places, if only to help us remember how far we’ve come and motivate us to climb the next hill.

When I was maybe 6 months post-op, a WLS veteran mentioned that the mental journey takes longer than the physical one. At the time I thought, "Oh, don't tell me that! I've already had more than enough of this recovery stuff." Turns out she was right. But I have to say that it has all been so worthwhile.

"...that didn't look like couch upholstery or tablecloths" made me laugh. My mom (who also struggled with obesity) used to say her clothes were made by Omar the Tentmaker. I hope that no WLS newcomers were hurt by the "Lane Giant" reference. If a WLS outsider had said something like that, I'd have been hurt, but I'm not an outsider, and I have the emotional and surgical scars to prove it.

Cringed because I used the term "Lane Giant"? I'm sorry if that offended you. I can only speak from my personal experience. I DID feel like a giant when I was morbidly obese. I often felt like the elephant in the living room, this huge creature that everybody knew was there but no one dared mention. When I went to the mall and ducked into Lane Bryant, I felt ashamed. Perhaps poking fun at Lane Bryant is one way that Fat Jean tries to balance out that old humiliation.