Weight loss + age = ugh

I'm very, very happy about my weight loss, but that in combination with advancing age is not a pretty sight. Yesterday I had my husband take a photo of me when I got home from work, mainly to show how Jack, one of our new strays, has gone from fearing human touch to seeking it (especially when the human is holding a dog biscuit in her hand). I was interested to note that I have a backbone, but not so happy to see the stuff going on in the vicinity of my neck and chin. Jack is the dog on the left, and our longtime resident Blackie is the one on the right. I'm the one wearing purple, in case you were wondering if that was me or ET.

 

Back to School

September’s here, and it’s back to school season. Back to the basics, back to reading, writing, and arithmetic. Actually, any time is a good time for a band refresher course. It’s easy to lose your focus and take a few too many side trips to the land of potato chips and chocolate while you trudge along the bandwagon trail. When bandsters ask how to get back on track, the most common response I’ve heard is a very sensible one: BACK TO BASICS. So I suggest that you re-read the basics in Bandwagon: the 21 rules for success (chapter 6) and the 15 band eating skills (chapter 12). You don’t have a copy of Bandwagon? That’s easy enough to remedy. You can order both Bandwagon and Bandwagon Cookery by clicking on one of the ordering options on the left hand side of this blog page. Bandwagon Cookery print version is available on Amazon, and Bandwagon’s 2^nd edition is now available in Kindle format on Amazon: Click HERE to go to those Amazon listings.

THE 3 R’S

While you’re waiting for your copy of Bandwagon to arrive, let’s talk about the 3 R’s: Readin’, ‘riting, and ‘rithmetic. What are the 3 R’s of band success?

1.  R is for Reading – learn to read your body’s signals about hunger, satiety, and restriction.

2.  R is for (W)riting – keep a food and exercise log. Studies show that people who keep a food log lose more weight than those who don’t.

3.  R is for (A)rithmetic – weight loss, as hard as it can be to achieve, involves very basic arithmetic. As long as you burn more calories than you consume, you will lose weight. This doesn’t mean that you have to count calories to lose weight, or count calories for the rest of your life, but if you’re struggling and not sure why, try calorie counting for at least one week. Online tracking programs (like such as those at sparkpeople.com, livestrong.com, and choosemyplate.gov) make it easy to log your food intake and calculate your calories. And by the way, calorie counting is meaningless if you’re not weighing and measuring your food. Yes, more arithmetic!

YOUR REPORT CARD

       I haven’t seen a report card for some 38 years, but I clearly remember the looming importance of each semester’s report card. In elementary school, we were graded on effort as well as achievement. Tell us honestly: what’s your WLS effort grade today?

       I’ve seen 2 different trends in other bandsters’ WLS journeys:

1.    Weight loss is relatively easy in the beginning, when you’re at your heaviest and also most gung-ho, but eventually it gets harder as you get smaller (and burn fewer calories), the novelty of your band wears off, and your underlying eating issues (like stress eating, emotional eating, etc.) aren’t addressed.

2.   Weight loss is hard in the beginning, when you don’t yet have enough fill in your band, but eventually you and your band click and the weight loss gets easier.

       Both situations #1 & 2 require extra effort on your part sooner or later. Neither situation is better or worse, but your awareness and understanding of your situation can help you deal with it with less “poor me” and more “go me.”
       I’ll illustrate this with an example from a frivolous but always fascinating aspect of life: hair. I have straight, thin hair, and not a lot of it. I wish it were thicker, curlier, shinier, but it’s not. With the help of my hairdresser, I can make my hair look better, but agonizing about it does not do a single thing to make my hair curl. And I’m not going back to my 1980’s poodle perm, thank you very much.
       Similarly, I have an inborn intolerance for idleness and am easily bored, especially when it comes to food and exercise. I wish that weren’t so, but it is. With the help of my dietitian, food magazines, and cookbooks, I manage to plan and prepare healthy, delicious, interesting meals. With the help of my fitness instructor, I manage to participate in a wide variety of fitness classes that are never boring.

SOME ROOM FOR IMPROVEMENT?  

       On the back of my report card was a space for my teacher to write comments about areas in which I exceled or (more often) I needed to improve. Mine usually had to do with talking and clowning during class too much (what a surprise). So, what opportunities for improvement await you this semester? Mine is to back to planning and logging my food every day. Further, I need to start paying more attention to the resulting nutritional data rather than logging and moving on.
       If I don’t pay attention to the data, I can’t evaluate the quality of my food intake, but I’ve been logging about 1200-1300 calories a day without taking the time to notice some major inconsistencies in my macronutrients, especially protein. I need to pay attention to my protein intake not just because my body needs good-quality protein to repair the muscles I stress during my daily workouts, but because low protein intake often represents maladaptive eating. Rather than slow down and eat carefully so that solid protein doesn’t cause me problems, I take the easy way out and eat the easy stuff, almost always in the form of carbs that don’t offer much satiety value.
 

One Year Later

Today is the one year anniversary of my VSG surgery. The good news is that I've lost 47.2 pounds since then. This morning I weighed 117.6 pounds (14.4 pounds below my weight goal, and 113.4 pounds down from my highest recorded weight) and recently I discovered that I can wear size 7 jeans. I can't remember ever wearing that size before. (I do remember that when I was in high school, I hated that I couldn't shop at a mall clothing store called 5-7-9. For sure, I wasn't smaller than a size 5 then.)

The bad news is that I still miss my band and I'm still finding it hard to live with my sleeve. But in a way, that doesn't matter. I've said in the past that if gastric bypass was the only bariatric surgery available to me in 2007, I would've had gastric bypass surgery despite the risks and compromises it might involve. Similarly, if  I was considering WLS for the first time today and the sleeve was the only procedure available to me, I would have VSG surgery, even knowing what I know now. I feel very lucky that I was able to have Lap-Band surgery. It set me on a path to a life of health and mobility that's more wonderful than I ever could have imagined.

Scrawny?

The other day I got my already short hair cut even shorter - a crew cut. When I told my aunt T. about it, she requested a photo. This morning before I left for work, I had Mr. P. take a few pix of me. The first one was focused on my chest (funny how guys focus on that part of the female anatomy, even after 25 years of marriage), so I made him take 2 more shots. The 2nd is me in a classic BBTB pose (born-to-be-bossy). The 1st one makes me look scrawny, which is hard for me to wrap my mind around. A few weeks ago I had gone down to 12 lbs below my goal weight, but now I'm back to 10 lbs below that. When I look at myself in the mirror, I don't see the thinness any better than I used to see my fatness. It's a bizarre situation for a former fatty to find herself in.

What do you think?

The other thing I keep focusing on is my turkey neck. Fortunately the bossy pose minimizes that!

Immortal

Until I turned 50, I never had a sense of my own mortality. My elderly mother had been reminding me that she wasn’t going to live forever, but somehow I thought that she and I were both immortal despite the fact that I was morbidly obese and troubled by a host of health problems. I had undergone more surgeries, medical procedures and treatments, and taken more prescription medication, than my mother had in her entire life.

In the years that followed that milestone birthday, I lost a lot: my job, my 90-year-old mother, 100 pounds and my old lifestyle. At the same time, I learned there is truth in the old saying, “You’re only as old as you feel.” That truth wasn’t always rejuvenating. I often felt lost and confused. I had attained an age that was unimaginable to me as a 20-year-old. Other than perfunctory contributions to 401K and IRA funds, as a young woman I had made no plans for my middle and later years. That might be just as well, because in truth, my expectations for myself at age 20 were far smaller than my expectations are now, as I hover on the edge of my 60^th birthday.

A few years ago I told a young coworker that I was 56 years old. Now I don’t remember why I shared that information with him, but I hope I never forget Garrett’s response: “You are not 56!”

I offered to show him my driver’s license. He shook his head and said, “You don’t act like you’re 56.”

Although for much of my life my mother had admonished me to act my age, I took Garrett’s comment as a compliment. One benefit of being 50+ is that I care a lot less about what other people think of me, not because I want to act outrageously but because I want to be true to myself, because I trust myself enough now to worry less about the mistakes I might make, and because I know I will learn from them as they happen.

Friends, family, and business associates who’ve known me for 10, 20, 30 years tell me they’ve been surprised by my new lifestyle. I shut the door on a high-paying, high-stress, mostly sedentary business career that sent me all over the globe as I worked 70- to 80-hour weeks and ate myself into obesity. I joined a fitness center; took a low-paying, lower-stress, part-time retail job; wrote and published five books; and recently joined the board of directors of OutsideIN, a new non-profit business that provides jobs and training for chronically unemployed workers who rely heavily on public resources for their survival.

My non-profit work pays me not in monetary income but in what Mom used to call spiritual income. Although we welcome volunteers of any age, I believe I have far more to offer now, at 50+, than I did in my youth. It’s work that draws on all my past work experience and allows me to use my unique talents, some of which had lain dormant for decades. It also requires me to stretch and learn new things. I’m especially happy about that because I believe that the moment we stop learning is the moment we’re ready to go home forever.

The photo below shows me at the fitness studio wearing a favorite t-shirt. Its imprint describes my new identity at 50+ years. One of the most surprising things about being 50+ is that I’ve evolved from being a fearful, pessimistic Miss Rainy Day, to an upbeat, optimistic Little Miss Sunshine. Even as the aging process challenges me, often slows me, and sometimes pains me, I wake up every morning eager for the new day. Perhaps time is becoming more precious to me as my fund of new days dwindles, but for now I’m going to go on believing that I’m immortal.

 

Let's Make a Deal!

C’mon down! Let’s make a deal!

But not a deal for a new refrigerator or a Florida vacation. Let’s make a deal to stop trash-talking ourselves.

A study done at the University of Arizona found that men and women whose self-talk is negative (such as “My butt is so big,” “I’m so ugly”, or “I just can’t stop overeating”) experience more depression and lower self-esteem than those who don’t indulge in self-denigration. That kind of self-talk adds to your sense of helplessness, not just in eating but in every aspect of your life.

Trash-talk is hard to avoid in a society that deifies thin celebrities whose weight is often higher than their IQ (Aach, Jean! Talk about trash talk!). I don’t know about men, but conversation amongst women tends to stray into fat talk all too often. I know I've commiserated with friends who’ve gained enough weight that they can’t fit into most of their wardrobe…a problem I've faced myself many times, both before and after weight loss surgery. We could moan about that kind of thing for hours, time that would be better spent on coming up with a solid action plan to deal with weight gain, and end the trash talk with a pep talk.

In my job as a bra fit specialist, I hear women slam their own bodies day in and day out. Their breasts are too big, too small, and/or one is bigger than the other. Their breasts sag from weight loss, weight gain, pregnancy, nursing, aging – all perfectly ordinary life events that somehow end up damaging the woman’s self-esteem even if everything else in her life is going well. From time to time I’ve heard briskly myself tell an unhappy customer, “OK, now that I know what you don’t like about your girls, let’s talk about what we can do to make them look better,” because I just couldn’t bear hearing another word of self-hatred.

Maybe you feel as helpless to change your thinking as you feel about changing your eating behavior. The field of cognitive behavioral psychology is based on changing maladaptive thinking in order to change your behavior. Maladaptive thinking is thinking that seems to help you adjust to a problem. So if your 42DDD bra is too small, you think, “There’s nothing I can do about it, it’s all because of having those three babies in just three years.” Cognition is the process of acquiring knowledge and understanding (about yourself, your world, other people, events) through thought, experience, and your senses. If you can shift the way you interpret all that data, you can begin to change the way you react to it (your behavior).

That’s different from the good ol’ Freudian psychodynamic approach that places blame (or gives credit) to your unconscious mind and personality for the things (dysfunctional or not) going on in and around you. I’m not against that psychodynamic model, per se, but it seems to me that changing the way I interpret data has got to be easier and more successful in the long run than trying to change the innermost, essential Jean. I’m not sure I even want to change her, and I don’t have the time or money to spend 130,000 minutes a year (50 minutes a day, 5 days a week, for 10 years) musing about the meaning of a random dream. That weird dream could be full of important symbolism, sure, but it could also be the random result of tired and jangly nerve endings as my tired old brain tosses a mixed dream salad (ask me for the recipe!) out of disparate moments of the day that just ended.

In the context of weight and eating management, the difference between these two psychological approaches is that the cognitive behavioral one asks, “How do I eat?” while the psychodynamic one asks, “Why do I eat?” I’ve benefited from psychodynamic therapy in the past, but none of the insights I gained about why I eat has done much to change how I eat. In other words, you can change your behavior without knowing all the why’s and wherefores that led to that behavior. They’re interesting, even fascinating, to know, but that knowledge doesn’t necessarily make the work of behavioral change easier or more effective or longer-lasting.

First, here’s a short example of cognitive change. In my fat days, I loved to eat. Eating gave me great pleasure; all too often, it was my only pleasure. Nowadays, I love to eat. The food still tastes good (my experience of it), but the way I think about that food (my cognition of it) has changed. Now it is only one of many pleasures in my world. The change in my cognition of food has changed my behavior around it. I’m less likely to overeat it because it’s competing with so many other good things for my time and attention, things that are also important to me and interest me and are often healthier for me.

Now I’ll give you a different example, ever so slightly exaggerated for the purpose of making my point crystal clear. After 9 years of intensive, twice-weekly psychodynamic therapy, you come to understand that you overeat candy because your mother spanked you for wetting your pants at church during Easter service when you were 5 years old, thus shaming you and sending you right straight to the delights of your Easter basket, all of it consumed in just 15 minutes as soon as you got home and raced into your bedroom closet to suffer and gorge in peace, which of course made your sore bottom feel sooo much better. Of course, since then you’ve several times been tempted to smack your own child for misbehaving in public, and you’ve come to see that your own mother was actually a saint compared to your evil sister-in-law, but here you are on Good Friday evening, gazing with rapt delight at the contents of your children’s Easter baskets and wondering if they’ll notice that all the chocolate crème eggs are gone come Sunday morning. Is thinking about your mean mommy going to stop you from unwrapping one of those yummylicious treats and popping it into your mouth while you remind yourself that crème eggs only come once a year and how can you possibly survive a whole year without eating at least one?

 

 

 

So in conclusion to an article on a topic that pretty much has no end, I will paraphrase Camilla Mager, a clinical psychologist in New York who specializes in the psychology of women and eating disorders. Mager suggests the following steps for improving body image and self-esteem:

 

1. Avoid reading magazines or looking at images (on television, online, billboards, etc.) that reinforce your body image problem.

 

2. Pay attention to the tone you use when talking to or about yourself. Would you talk that way to anyone else? Probably not. Try to be less critical of yourself. That doesn't mean you should pat yourself on the head, say, "There, there, honey," and dish yourself up a gallon of ice cream. That means something more like, "Try, try again."

 

3. Focus on what your body is capable of - your strengths - instead of weaknesses (often more perceived than real) or what it's not doing.

 

4. When you find yourself in a fat talk conversation with friends, commit to not engaging in that kind of discussion. Change the subject, give a friend a pep talk, or announce that it's time for you to head over to the gym.

 

 

Wherever You Go

One of my novels (unpublished) tells the story of a young woman who hates her life. She decides to change it by staging her own kidnapping and escaping to a new life with a new identity. It’s a very intriguing idea, one that has occurred to me as an option (or cop-out) for me from time to time, but there’s one serious flaw in it that my book’s heroine soon discovers.

And that is something my friend Shannon mentioned a few months ago:   WHEREVER YOU GO, THERE YOU ARE      

 

The wherever you go, there you are statement is so true and so inescapable that it can hurt, and until you make friends with yourself and accept your past misdeeds as past, you’ll be mighty cranky when the naughty parts seem to stalk you wherever you go. Many times in the past I’ve done something major to improve my life, like take a new job in a different part of the country, only to find myself reacting to my boss, my coworkers, and work situations in the exact same dysfunctional ways as I had in the previous job. At times I’ve wanted to tell myself, “Just leave me alone!”, but I’m stuck with me. My job now is to figure out which parts of me are worth keeping and which parts need revamping or discarding. As I wrote in Bandwagon, I will always have a short, fat girl inside me, just waiting to get out. One day, I hope to live with her in harmony. In the meantime, I sometimes ask her, “Who invited you, anyway?”

 

HAVE SHELL, WILL TRAVEL

Like it or not, adult humans tend to carry a carapace of beliefs and behaviors everywhere we go. The carapace thickens and hardens as the years go by, becoming a portable home that protects our soft inners from weather, injury, and predators. That shell may not be beautiful, but it’s safe. The idea of shedding it is scary: imagine a poor vulnerable turtle without its shell; but as our needs and goals change, our shells may need to change also. If an entire layer of your shell was formed on the assumption that you’re doomed to fail at weight loss, or that food is the only thing that can comfort you when you’re hurt, it’s not going to serve your weight loss journey very well.

I’ve never done well with giving up a belief or behavior all at once, cold turkey, but then, I haven’t had to deal with something the size and strength of a heroin or tobacco addiction. On the other hand, peeling away the protective shell layer by layer could try the patience of a saint. As you’ve heard me say before, I prefer to tackle the easy stuff first, so that I have enough confidence to sustain me when I get to the hard stuff. For example, instead of switching from whole milk to fat free, I switched to 2%, then 1%, before I was able to enjoy fat free milk.

It is possible, though, to make big changes fairly fast if the reward (or punishment) is significant. In the past, one of my jumbo-sized bad behaviors was speeding when driving. Eventually my speeding ticket collection sent me to traffic school, with a one-year probation period during which any moving violation would automatically revoke my Tennessee driver’s license. We live out in the country, in an area with no public transportation, so my speeding habit got a very quick makeover. Now I’m a slower, safer driver, and I still have my license.

 

LIGHTEN THE LOAD

Sometimes giving up or changing a negative or dangerous behavior feels far scarier than living with the unpleasant consequences of continuing the behavior. This is especially true of eating behaviors, because the basic act of eating is essential to our existence, so anything that threatens that takes on enormous importance. If I need to give up compulsive shopping, I’m going to be miserable, but I’ll survive. If have to give up compulsive eating, I feel like I’m going to die because all my eating is compulsive, and without eating, I’ll perish. Of course, to lose weight in a healthy manner, I don’t have to give up eating altogether, but it sure feels that way at times.

One of the reasons I approve of (if not enjoy) pre-op diets is that they require you to alter your eating behavior RIGHT NOW, so you can ease into the practice of healthy eating and not have to begin an overwhelming job the day after surgery, or the day after the first fill, when so many other things in your post-op life are still so strange and new. Waiting until the very last minute to jump on the nutritional bandwagon seems to me like a set-up for failure.

 

LAYER BY LAYER

One special challenge in changing our turtle shells is that sometimes the really tough layers are completely invisible to us, and they’re difficult to acknowledge (never mind change) even when another person, or the evidence of our own senses, finally shows them to us. I went through a period in my late 20’s during which I carried a big chip on my shoulder and did my best to be a bitch. It may have been an overreaction to the preceding period of depression and submissiveness. At the time, I lived in an apartment with an upstairs neighbor who worked at a bank every day and partied hearty every night. I wore a track into the carpet with my trips up the stairs to knock on his door and complain about the noise. After a few months of that, I was furious when this banker had his 5 year-old daughter (on loan from her mom for the weekend) lean out the window as I walked through the parking lot and yell in her sweet girly voice, “Look at the bitch! Look at the bitch!”

 I happened to have a friend then who socialized with the banker sometimes. I told her the “Look at the bitch!” story hoping for insight about the banker, or at the very least a nice dose of sympathy, but it didn’t work out the way I wanted because my friend said in a reasonable tone, “But Jean, you ARE a bitch.” After which I decided I was proud of being a bitch rather than trying to find a way to get along with the banker better.

I hope I’d handle a situation like that better nowadays. I’ve been gradually chipping away at the bitch layer of my shell for years now, but it’s still there, traveling with me wherever I go.

 

TO GET WHERE YOU WANT TO GO…

A while back, my friend Tom quoted a wonderful post from the marcandangel.com blog. It was a list of ten daily reminders to keep your mind centered and your spirits lifted. Number 3 on the list is this:

Sometimes to get where you want to go, you have to do what you are afraid to do. You must be brave and push forward. Miracles occur when you give as much attention and energy to your dreams as you do to your fears.

 

In my case, the most fearful thing I had to do in order to succeed with my band was not drinking skim milk, surviving a liquid diet, or giving up bread. The most fearful thing was giving up my emotional attachment to food. In the nearly 6 years since I was banded, I’ve made a lot of progress with that, but the attachment is still there. It forms one of the innermost layers of my turtle shell. Working on that layer will probably be a lifetime job for me. At times I’m not even sure I truly want to get rid of it altogether. At times I’m afraid that if I shed my shell completely, I won’t be able to survive. On the other hand, I seem to be doing fine without that thick old bitch layer. So I’m going to pay attention to my dreams rather than my fears and pray for a miracle.

 

From this day forward

June is for weddings, isn’t it? Sunshine, blue skies, white gowns, white flowers. I was married the first time 38 years ago. After a four year courtship, Joe and I exchanged our wedding vows in front of a Catholic priest, a Presbyterian minister, and 40 guests consisting of family and friends. We walked out of the church and into our married life with “until death do us part” in our young minds. Six years later, we divorced. Eventually each of us married again, this time to the right partner, and we’re all still happily married today. As the saying goes, practice makes perfect. 

It’s practice that will make your “marriage” to your adjustable gastric band perfect, or as perfect as any human endeavor can be. When you wake up in the recovery room after your surgery, you won’t be magically endowed with all the knowledge, experience, and habits you’ll need to succeed with your band. Even if you did tons of research, faithfully attended every pre-op educational class, and listened closely to and made detailed notes of everything your bariatric team told you, some things – important things – you’ll have to learn through the everyday experience of living and eating with your band.  

When you leave the hospital or surgery center after your surgery, you probably won’t be headed for your honeymoon quite yet. That will come later, when you’ve had enough fills to achieve optimal restriction and you begin to feel that your band is really working. The excess weight will start coming off and you’ll walk around in a dreamy pink haze, delighted with your new life partner. You might even give your band a silly private pet name, the way my husband calls me “Love Bug” (which always makes me think of my first car, a chubby yellow Volkswagen Beetle). 

Then one day, the reality of banded life will wake you up. You’ll think, “Who is this creature I’ve married?” And like Jenny, a former coworker of mine, you’ll realize that while the engagement, wedding and honeymoon were exciting and fun, the day-after-day business of marriage isn’t exciting or fun 24 hours a day. It’s hard work. It’s boring. It’s frustrating. It’s humdrum. Jenny left her new husband after only three months of marriage not because she didn’t love him, but because she didn’t love being married to him. Being a wife isn’t nearly as fun as being a bride. 

I suspect that Jenny just wasn’t old enough or mature enough to be a wife. Neither was I when I married the first time. One of the reasons most bariatric surgeons and insurance companies require a patient to have a pre-op psychological consult is to evaluate the patient’s understanding of what they’ll have to do to succeed after surgery. Are they ready for a lifetime commitment? Do they have reasonable expectations? Can they follow instructions? Are they capable of learning the new behaviors they’ll need for a productive, peaceful partnership with their band?

 

HABIT FORMING

New bandsters need dozens of new habits – something like 60-70% of my book Bandwagon is devoted to explaining those habits, so I’m not going to try to cram them all into a blog entry (anyway, I’d rather you buy and read the book!). I’ll pick one at random. Hmmm…how about EAT SLOWLY? How are you going to turn that behavior into a habit that will serve you well for the rest of your life? 

So Dr. McMillan tells you, “Eat slowly,” and you nod your assent while thinking, “Get real! I’m too busy to do anything slowly. I have 3 kids and 2 dogs, I work 2 jobs, I take care of my elderly Aunt Bertha, I coach my daughter’s softball team, I have a house to run and a spouse who’s always on the road…” Well, you get the idea. Dr. McMillan has just told you to do something that’s very simple and yet impossibly difficult, you think Dr. McMillan needs to wake up and smell the coffee, and a door in your mind slams shut. 

Actually, Dr. McMillan is already awake, has had a cup of coffee, has tended to all 11 of her dogs and all 3 of her cats, is about to leave for the fitness studio, and when she returns she will deal with a home renovation project while running her home-based publishing business off the kitchen table; tomorrow the fun will start all over again, including a 5-1/2 hour shift at her retail job and a trip to the supermarket. She’ll do the laundry, pick another batch off ticks off the new dog, cook several meals, and get someone to come look at the leaking French doors. Dr. McMillan’s friend Nina calls her the “Tennessee Tsunami”, and despite all that, Dr. M. still manages to eat slowly every time she sits down to a meal. As a pre-op, it took her maybe 5 minutes to hoover her way through a meal that would feed a farmhand, and now it can take her up to 5 minutes to chew her way through the first bite. 

The EAT SLOWLY habit (or any other habit) doesn’t become a habit overnight. It takes many, many repetitions to turn a new behavior into a habit (a British study found that it takes anywhere from 18 to 254 days of daily repetition to make a new behavior “automatic”).  I know it’s a big challenge, especially when you’re also trying to learn a few dozen other new behaviors and turn all of them into habits while somehow conquering the dozens of bad habits you already had, but I assure you, it’s worth the effort!

 

Heavy Baggage

A few years ago, I started my JCPenney workday with an unpleasant customer encounter, so unpleasant that it took me an hour or so to turn myself around. I hate letting something like that set the tone for my whole day, but if I discard the memory too quickly because of sheer discomfort, I miss an opportunity to learn something. Of course, it’s not always obvious what the lesson is, so forgive me if this article seems befuddled. Befuddlement is a common brain condition in older people whose minds are cluttered with far more experience and data than they know how to use.

So anyway, back to Wednesday morning at JCPenney. I was happily tidying the lingerie department, setting its disorder to right the way only I can (and only I enjoy), when a middle-aged female customer stomped up to me and declared, “JCPenney used to be so good. It used to be I could come here and find a dozen bras in my size. What happened? Why can’t I ever find my size now?”

I glanced up at the woman and made a quick assessment of her, not to judge her but because things like body language and dress give me clues about customers and the best way to handle them. This one was obese, well-dressed in a stylish but individual way. She had a southern accent but not much west Tennessee twang to it, which told me that she had probably traveled more widely than is common in this area (the Kentucky border is about 15 miles from here, but I know local residents who’ve never been to Kentucky). Finally, I noticed that the woman had a grim, even fierce facial expression.

On the basis of all that, I quickly decided that a humorous approach (my favorite) was not going to work with this customer; nor was my fallback “You just let me take care of you, honey,” approach appropriate. I asked her in a neutral tone of voice, “What size are you looking for?”

The bra size she named is an odd one, but hardly surprising considering this woman’s size. I was an odd size too when I was obese, so I felt that I was speaking compassionately when I asked her what features she prefers – underwire, wire free, wide straps, thin straps, etc.

She pointed at what I call a fashion bra (as opposed to an everyday, purely functional one) that I knew isn’t made in her size. “Never mind all that. I want something like this one. Do you have it? Do you have my size?”

I was about four words into my, “No, but let me suggest…” explanation when she burst out angrily, “Just show me! Show me! Where are the size 44’s?”

For a moment I was taken aback by her rudeness. Then I felt my mother’s school-marm manner come over me. I lifted my right index finger to signify, ‘Just one minute’ and said sternly, “If you’ll let me finish my sentence, I’ll tell you.”

The instant that sentence left my mouth, I wanted to grab it back. But as my husband likes to say, you can’t unring a bell. My mind searched frantically for something that would rescue the situation. While I floundered, the customer said, still angrily, “You don’t have it, do you? I knew it! Well, that’s fine. That’s just fine. Thank you very much!” and stomped away toward the exit door.

I thought, “Well, that went well,” and went back to sizing push-up bras.

The worst part of that massive failure to communicate was that I truly felt compassion for that woman and did understand her frustration in searching for clothing to fit and flatter an obese body. I wished I could run after her and say, “I wasn’t always skinny!” but that was my baggage to carry, not hers. I could read all I want into her expression, convinced that I recognized her weight struggles and her desire to blame her obesity on everyone, including JCPenney, but herself – but we were strangers and had no real knowledge of each others’ truths. I’m not even sure of my own truths all the time, never mind truths belonging to a stranger.

TRAVELING LIGHT

My encounter with the angry fat lady that day reminded me that my weight loss surgery helped me lose more than 100 pounds of body weight. It also took some heavy emotional baggage off my hands. I’m not convinced that the baggage leftover from my travels in the land of obesity is entirely and permanently gone. I think it’s stashed away in the attic gathering dust and cobwebs. The keys to all those bags are in a small box in my dresser drawer. They’re unlabeled and jumbled in with house keys, car keys, and a few luggage tags containing defunct addresses. I don’t dare throw that mess of keys out for fear I’ll need them again some day…kind of like my fear that I’ll need my size 24 jeans again some day.

But I’m traveling light these days. A handful of keys that weighs maybe three ounces is a much lighter burden than the beliefs and feelings I used to carry along with those 100 extra pounds.

You eat anything you want and you still lose weight!

My brother (18 months my junior) is a highly intelligent man. This was proven decades ago, when IQ tests performed while his teachers and parents tried to figure out why he was such a miserable little bugger showed a genius level IQ. I know that sentence sounds unsympathetic to my brother, but we were all miserable - our parents, his teachers, me, and my brother.

When I first talked with him about weight loss surgery, many years later, this highly intelligent and (by then) well-read man said, "Wow! So, you have the surgery, and then you eat anything you want and you still lose weight!"

Well, no. Not really. In fact, nothing like that.

During the 6 years of my weight loss surgery journey, I have (over and over and over again) witnessed bariatric patients who came out of the operating room after surgically successful procedures still wondering why they couldn't eat anything want and still lose weight. Their disappointing weight loss was and is a perpetual puzzle to them because somehow they had not grasped that behavioral change is required for weight loss success.

It's easy to label those patients as stupid or ignorant or deluded, or to blame their bariatric team for failure to properly educate those patients about what would be required of them both pre- and post-op. All of those things could be a factor.

In March 2012, almost 6 years since the start of my own WLS journey, I attended 2 sessions of a required pre-op nutrition and education class. My BMI then made me obese, but not morbidly so. I had gained weight after a complete unfill and was preparing to say goodbye to my beloved band due to medical problems aggravated by my band, planning to revise to vertical sleeve gastrectomy in the same procedure.

The dietitian leading the class was a perky, pretty 20-something girl, adorably pregnant, who had clearly never struggled with her weight before. Her slightly condescending attitude was hard to take, but about halfway through the class I thought I could understand her attitude. She had just named a long list of foods we should not eat after surgery (fried foods, candy, baked goodies, soda, alcohol, salty snacks, etc.) when I heard a woman nearby say bitterly, "I don't know. That seems like an awful lot to give up."

Since I had known the before and after of WLS, I was strongly tempted to respond to her, but I held my tongue (wisely, for once).

I don't know just why so many people think that WLS is magic, that you can eat anything you want and still lose weight, that you don't have to give up a single food or behavior or attitude in order to succeed. Maybe we can blame that attitude on the media, or maybe we can blame it on the deeply-entrenched denial that tends to go along with obesity. But the fact is, you can't eat anything and still lose weight unless you're dying of cancer or AIDs or some other fatal disease, and probably don't want to eat a single bite of anything anyway. And I'd trade dying of cancer for WLS sacrifices and success any old day.

A Victim of Obesity

I’m seeing a disturbing proliferation of victimhood these days. Every day the media broadcast reports about victims of crime – of scams, fraud, theft, murder – and victims of acts of God, like weather, fire, and floods. My heart goes out to those victims because I feel a kinship to them. I too have experienced violence, loss, trauma, and pain. But I am not a victim. I’m a survivor.

A DAY IN THE (VICTIM)HOOD

Before we get into the meat of this article, I want to ask you a question: are you a victim?

Don’t tell me the answer yet, but keep it in your mind while you read the rest of this article.

Victimhood can be alluring. It garners attention, assistance and pity that you can milk for the rest of your life if you play the role well. You don’t have to be responsible for rebuilding your life or restoring what you lost. That doesn’t appeal to me, though. It sounds boring and tiresome, and it discourages laughter, which I find even more healing than tears, so why does victimhood continue and even proliferate? Let’s take a closer look at how obese people like us become victims.

 

WHO ARE THE VILLAINS?

Every victim needs at least one villain. Who or what are your villains?

Me – I got a lousy genetic legacy. I inherited every strand of obesity DNA my mother’s gene pool had to offer (plus the ones for thin hair and crooked teeth). We won’t discuss the humor genes I also got from her, though. Humor doesn’t enhance my victimhood. But that’s okay, because I’m actually not a victim.

While we’re blaming obesity on our ancestors, we need to look at the flip side of the nature versus nurture coin. I got a raw deal there, too. Neither of my parents encouraged exercise or sports. In fact, they ridiculed physical fitness programs and encourage scholarship and mental fitness instead, so I ended up being a very smart, very fat intellectual. And that’s fine, because I have a college degree and an impressive resume as a result. And anyway, I’m not a victim.

Another popular villain nowadays is addiction. Addicts will do anything to support a drug or other destructive habit. We need ever-increasing amounts of our substance just to prevent withdrawal, never mind to get high. For my brother, the substance is methadone. For me, it’s food, especially sweet or salty or fatty or chocolatey or otherwise nutritionally evil food, and it’s even easier (and cheaper) for me to score a hit of my substance than it is for my brother to score some of his. Baskin Robbins, McDonald’s, Lays and Duncan Hines are just a few of the virtually inescapable pushers I know. It’s sad but true, but I can overcome it, because I am not a victim.

Let’s not forget our celebrity-worshipping society and the flood of images of impossibly buff men and skinny women that wash over us every single day. The media and the likes of Victoria Beckham, Kate Moss and Angelina Jolie constitute a vast and powerful band of villains. The siren song of “Thin Is In” sounds all around me, but it doesn’t matter because I can shut my eyes, turn down my hearing aids, and remember something important: that I am not a victim.

In addition to obesity, I suffer from another incurable, chronic, debilitating disease that’s scientifically been linked to obesity. The pain and fatigue of fibromyalgia and myofascial pain syndrome haunt me every day, with villainy that threatens to suck all the joy out of my life. But I’m not going to let pain get the better of me, because I am not a victim.

 

VICTIM OR VICTOR?

 

Now let’s go back to the beginning of this article, where I asked if you’re a victim. I want to hear your answer to that question now, after you’ve read the article. Think carefully before you speak.

Okay, here goes. Are you a victim? Really, truly, a victim?

No?

That’s great! Neither am I. Like you, I’ve chosen to win the weight loss battle, conquer the villains, and emerge the victor. I’m not going to settle for anything less than that, and neither should you. So grab your swords, my friends, and fight back now!

Ask not what Jean can do for obesity...

…But what obesity can do for Jean?

The overeating I’ve devoted so much of my life to can be called a coping skill, and the excess fat it created cloaked me like shield, cushioning me from life’s blows even as it caused me a host of other problems including shame. I couldn’t admit to shame over what had happened to me (shame because I believed I had caused the abuse), so in effect I transferred that shame to my weight. As if there was a gremlin living inside me who insisted on hanging out a sign for all to see: IT’S ALL JEAN’S FAULT. If I couldn’t be angry at my family, I could be angry at myself.

At the same time, the act of overeating helped to keep me numb, so I didn’t have to feel deeply all of the stresses in my life. (I know I’m not alone in that one, because even people with a happy childhood turn to food for comfort and numbing.) If I’d been fully conscious of the all the distress in my life, what would my alternative have been? Probably suicide, either directly (via carbon monoxide) or indirectly (like a single-car crash or an “accidental” drug overdose).

Coping mechanisms help us adapt to stressful situation, reduce or eliminate a stressor, and/or change our own emotional reaction to a stressor. Not all coping mechanisms are negative (that is, harmful to us or the people around us). Proactive coping helps us reduce the stress of a difficult challenge by anticipating what it will be like and preparing for how we’re going to deal with it. Social coping helps us find support from others, and meaning-focused coping helps us focus on the meaning of and lessons learned from stressful situation.

Good nutrition, exercise and sleep all make it easier for us to cope with stress. And humor (a personal favorite) helps us turn around a painful experience.

Another benefit obesity has offered me is bariatric surgery, because taking such a “drastic” means of reducing my weight put overeating on the shelf long enough for me to get a clearer picture of my life, my problems, and what I need to do about all of that. It’s as if obesity was the slow train to clarity, delivering me to the weight loss surgery station with 90 pounds of baggage (to say nothing of the emotional baggage). And there, without a mountain of food before me every minute of every day, the coast was clear and my vision (internal and external) also became clear.

At the time, I didn’t know what I was getting myself into. When I promised my surgeon to exercise for 30 minutes every day, I thought it was just for the sake of burning calories. Little did I know that exercise would one day be at the top of my list of stress- and depression-reducers. I won’t claim that surgery erased all my bad habits, but for once in my life I was able to acknowledge that they were indeed bad, unhelpful habits, and then to work on ways to change them. This will sound oversimplified, but I can’t change a behavior until I understand that it’s not working for me any longer. It’s the time-honored first step of the 12-step tradition: first, I had to admit that I was powerless over food, and that my life had become unmanageable because of it.

If I had my life to do over again, would I again choose overeating and obesity as survival techniques? Of course not. But I think I’ve done enough self-blaming and punishment for my eating and obesity, and if I can gather together a few crumbs of knowledge and understand from my bad old fat days, all the better. I agree with Socrates than an unexamined life is not worth living. While it’s gratifying to see that my books and articles help (or at least amuse) other people, their greatest benefit is to me. Writing them is a form of the meaning-based coping skill that I mentioned above. Meaningless events are frightening to me. Reflecting on my experiences and deriving some meaning and purpose from them reduces their power to hurt me. Although I joke that I’m the World’s Greatest Living Expert on Everything (a title I inherited from its originator, my mom), when I write articles like this one, I’m learning as I go along. That’s a life-affirming action for me. When I run out of things to learn, it’ll be time for me to rest forever.

I’ve been sniveling a lot in the past 6 months because my life with the sleeve has been full of surprises, many of them unpleasant. One of the things that’s making it possible for me to keep putting one foot ahead of the other, painful as that might be, is my belief that there are some lessons for me to learn from this experience. And like many life lessons, I may not get the punch line until the end. Better late than never.

It does get better

My friend VA, who had band with plication surgery in June 2012 and has lost 113 lbs so far, gave me permission to share her Before and Now pix, and a great blog entry she wrote a few days ago.

It is hard to really make someone who hasn’t been there yet believe that is does get better.

Most people get to the first few days, think it is too hard and therefore they are doing it wrong and just give up. Well, it IS hard. Sorry, I know that is not the answer you want, but it is the truth.

You just have to remind yourself that the habits you are trying to break are ones that you have had for years – do you really expect to break them overnight and for it to be a piece of pecan pie?

I can tell you though that it is so, so worth it. Once you get past those first few weeks and you are feeling amazing and loving the changes your body is going through, you will look back and thank yourself for pushing forward.

You just need to start. Set small and realistic goals and make one change at a time.

The main reason you should be doing this is for yourself and for your health. There are going to be negative people no matter what you do.  Well sadly you can’t stop them having that opinion, but who cares what anyone thinks.

Make the right decision for you and I wish you all the luck.  

The first line of this entry is very powerful: It is hard to really make someone who hasn't been there yet believe that it does get better.

It's also hard to make others understand that weight loss requires hard work (with or without surgery), but that all that hard work is so worth it. VA's Before and Now pix will give you visual evidence of that. The change in her physical size is amazing, but even more amazing is the avalanche of changes going on inside this wonderful person. You're right, VA, it is so worth it.

    

Did my band fail me, or did I fail my band?

The first time I heard the catchy title of this article was in a magazine article written by fellow bandster and author Cher Ewing. Her article told the story of losing weight at a great rate at the start of her band journey, then slowing to a halt for month after month. She wondered if her band had failed somehow, but she was also honest enough to take a good hard look at her behavior and realize that actually, she had failed her band. She had become a happier, busier person, and also a somewhat complacent one. She decided to jump back on her bandwagon and finish her journey.

That article made a big impression on me. The idea that we can and do fail our bands was quite new to me at the time. Since then I’ve seen ample evidence of the truth of this, and many people have criticized me for talking about it. It sounded to them like I was blaming unsuccessful bandsters for their weight loss failure. I’m sorry that it came across that way, but I stand by my conviction that when any human enterprise fails, we must look for the causes (and the cures) in every nook and cranny. Your bandwagon stalls at the side of the road. First, check the fuel supply – is it adequate? Next, check the tires – are they inflated? And the driver – what about the driver? Is the driver properly trained and motivated? Perhaps the failure can be blamed (if blame you must) on a combination of factors: the driver forgot to fill the fuel tank; the wagon ran over a nail that pierced a tire; or maybe the driver should have chosen a different wagon altogether – maybe a jet ski or a skateboard?

Sometimes, no single or obvious cause for medical failure can be found. It’s very, very frustrating. Doctors deal with dilemmas like that every day, when all the examinations and tests reveal nothing clear or significant and yet the patient is still sick. Even diagnosing a medical problem can be complicated, never mind curing or treating it. For those of us without formal medical training, who are relying on what we read or hear from our doctors, friends, and online acquaintances about band problems, it’s an overwhelming and baffling business.

 

That was certainly my experience when my band problems began 15 months ago. For months I struggled to keep my balance in my ever-shifting WLS journey. Eventually I gave up trying to identify and understand every little detail, because doing that was taking too much of my energy when I needed to devote my energy to figuring out what to do next and then doing that. During that time, I lost my band and eventually had VSG surgery, and for the next 6 months or so, I had to concentrate on adapting to and dealing with my disappointment with my sleeve.

 

Although both my band and my sleeve were/are successes in that they helped me lose my excess weight, I'm not sure if it's even possible to call one a success and the other a failure. I'm trying (again) to get used to be a thin person and to adjust my expectations of myself and my sleeve. I'm often tired and struggle to decide what task to put at the top of my to-do list, but I pledge to make my health a top priority going forward. It's not something I ever want to take for granted.