Fat Look, Thin Look

I'm on a million mail order mailing lists, and I know why. I used to work for a mail order company and remember well how the mailing list manager would specify customer characteristics when renting other companies' mailing lists: the customer must live in one of these zip codes, have ordered at least $50 worth of merchandise in the past 6 months, not have a (fill- in-the-blank ethnic) surname (sorry, but it's true), and so on.

I was on the mailing list for every catalog of fat girls' clothes in the United States. Fat look? We got it.

But in the 6 months or so, I've begun receiving new catalogs. Thin look? We got that, too.

This morning I threw out a Victoria's Secret catalog that had entertained my husband more than it did me (I have never, ever bought anything from VS). This afternoon I received an Intimate Apparel catalog from Old Pueblo Traders, which sells what my New England friends call "Meme" clothes (in Tennessee, that'd be "Meemaw"). I had to laugh at the contrast between the 2 catalogs.

Victoria's Secret swimwear is promoted with phrases like "Beach Sexy", "Very Sexy", and so on.

Old Pueblo's swimwear is promoted with phrases like "Chlorine Resistant", "Modest", and "Camouflages Hips".

I don't think either look is quite right for me. What do you think?

QOTD: what if band surgery doesn't work for me?

If it doesn't work - your body can't tolerate the band, you have serious complications, or you don't lose enough weight - you can have the band removed. You can also have additional , revisional surgery to a different weight loss surgery procedure.

But:

1. Your insurance might pay for band removal due to serious complications, but probably not just because you changed your mind and wish you had chosen a different procedure in the first place.

2. I think I've said it before, but I'll say it again: NO weight loss surgery procedure of any description is going to work magic for you. So give it your best shot.

What is the BMI and why does it matter?

The BMI was developed by a statistician as a method of determining obesity based on the height and weight of the individual. It does not take into account muscle mass, bone density, gender, or age, so all it does is provide rough measure of body composition. It has been an international standard for obesity measurement since the 1980’s and, accurate or not, the medical and insurance communities use it to qualify patients for weight loss surgery. Some medical professionals believe that your body fat percentage is a better way of judging your obesity and the attendant health risks. Even a "skinny" person can have high body fat percent (the fat can lurk in your viscera where no one can see it). The distribution of your fat is also important. In overweight people (BMI 25+), a high waist circumference is associated with an increased risk for type 2 diabetes, dyslipidemia, hypertension and cardiovascular disease. If you are overweight (BMI 25+), an unhealthy waist circumference is (as a general rule) above 35 inches for women, or above 40 inches for men.

A woman named Kate Harding has done a study of people of all shapes and sizes. The photographs (with BMI captions) on her site will make you think twice about whether BMI is a good measure of obesity. Check it out at: http://kateharding.net/bmi-illustrated/ .

Acai Berry?

The acai berry seems to be everywhere these days - there's an ad for something with acai berry in it on just about every website I cruise past - even our local Starbucks knock-off serves an acai berry smoothie. I hadn't paid much attention to it, but today the aesthetician who does my facials told me that her daughter, who is a nurse practictioner, recommends acai berry to patients who are trying to lose weight because it seems to increase your energy and boost your metabolism. I did a little googling looking for side effects or other reasons not to try it and didn't find much other than a warning that not every acai product sold on the Internet actually contains enough properly-processed acai to be helpful.

So I got a bottle of the brand this nurse practictioner recommends (Natrol). You take one 1000-mg capsule twice a day. It's a huge capsule so I opened it up and dissolved it in my Crystal Light (couldn't taste it).

If I had my druthers, as my mom used to say, I'd get a fill instead of taking acai berry, but my original bariatric surgeon is out of business (long story) and the earliest appointment I could get with another surgeon isn't until July 29th (which seems like it's 12 years away).

Stay tuned for progress reports...

QOTD: Can I lose 100% of my excess weight with the band?

You sure can.

Don't be put off by the common saying that you'll only lose 50% of your excess weight with the band.

It's more accurate to say that losing 50% of your excess weight qualifies you as a weight loss surgery success.

Your chances of losing that much weight without surgery aren't great. I read recently that only half of the participants in a study lost as much as 5% of their body weight through diet alone. So if you had 100 lbs to lose, with a starting weight of 250 lbs, you might lose 12.5 lbs through diligent dieting, or 50 lbs through weight loss surgery. Sounds good to me.

Some people lose no weight, and some people lose 100%+ of their excess weight with the band.

And even losing just 12.5 lbs could have a great benefit to your health.

QOTD: will I have excess skin after I lose weight?

It's really hard to predict how your skin will respond to massive weight loss. While it's commonly thought that slower weight loss (with the adjustable gastric band versus gastric bypass) is easier on the skin, but the real factors are genetics and age (skin loses elasticity as we age). Exercise certainly helps tone your muscles (and burn fat), but it won't restore stretched out skin.

When I got to my goal weight, a year after my band surgery, I had some problem areas: chicken neck, a sagging belly, bat wings on my upper arms, some of sagging on my lower arms, and slightly droopy thighs. A year later, everything has firmed up a bit, as if my body had been rearranging itself. I still have the sagging belly and my neck and thighs aren't perfect but they're better. I have more muscle definition on my arms now, but I don't think that excess skin is going anywhere soon. Here's what it looks like now (20 months post-op). I'm OK with it. I'd rather have excess skin than excess weight any day.

How could I possibly gain 4 lbs overnight?!

I suppose this could be the question of the day (QOTD).

How could I possibly gain 4 freaking pounds overnight?

Why don't I ever LOSE 4 pounds overnight?

It's got to be fluid retention. It's happened to me so many times I've lost count, but every time I freak out. This is just not right. It makes me want to go out and buy a new bathroom scale. Then I think, "What if the new scale measures even higher?"

QOTD: will I have scars after band surgery?

Maybe.

Some people scar more easily than others, in that their scars are more noticeable or take longer to fade, and some people develop keloids (overgrowth of scar tissue).

I had 5 incisions from my band surgery, and can only see 1 of them now - my port incision, which you can see on the righthand side of this photo, which was taken 11 months after my surgery. The other scar (north of my belly button) is from a mole removal that was done a few months before the photo was taken.

The other thing this photo shows you is that you may have excess skin (or flab, in my case) even after you reach your goal weight.

QOTD: is band surgery painful?

Is it painful? Sure. But the pain doesn't last long and you'll probably be given some decent painkillers. It's just a few tiny incisions plus a bigger one for the port (my port incision is about 1-1/2" long).

Everybody's pain tolerance varies. I'm a real baby about pain but I found my band surgery to be far less painful than other surgeries I've had (dental surgery, a hernia repair in my groin, an abdominal hysterectomy, a breast reduction, shoulder surgery). The gas pain (from the gas they pump in during surgery) lasted longer than the incisional pain. My port area was tender for 2-3 weeks (it's hard to turn over in bed, or get in/out of a chair, without using your abdominal muscles), but it wasn't crippling. My husband took time off from work to "help" me after my band surgery and by the time I'd been home for about 9 hours, I felt like he was underfoot and needed to go back to work.

If you're a woman who's delivered a child (whether naturally or by C-section), you've probably experienced worse pain than band surgery.

After Lap-Band Surgery

And this is a photo of me taken 19 months after lap-band surgery, wearing the first mini-skirt I've owned in 30 years. Maybe a woman my age doesn't need to be wearing a mini-skirt, but I just couldn't resist it.

Before Lap-Band Surgery

This is a photo of me taken the week before my lap-band surgery. I look like a bowling pin.

QOTD: Can you feel the band?

I can't feel my band, though I've heard a few people say they can.

I'm aware of my band when I get food stuck in it (in the stoma, actually - the small opening between the upper and lower stomach pouches). Then I feel major pain and pressure in the center of my chest. Occasionally I can feel food moving through my stoma - a weird sensation, but not painful. I don't feel the physical presence of this plastic ring in there.

I do feel my port sometimes when I bend at the waist, and I can palpate it by pressing on my abdomen near my port incision with my hand. It's a hard lump. I kind of like feeling it and knowing that it's there, ready to do its job.

A short fat girl

I've lost 90 pounds since my 1999 driver's license photo was taken, thanks to my lap-band. When I went to renew my license in August 2008 (11 months after weight loss surgery), the clerk at the motor vehicle department exclaimed, "You look like a different person now!"

I am different now in many ways. I am lighter, thinner, healthier, happier, and more energetic. I no longer live to eat...I eat to live.

I'm still a writer, artist, seamstress, wife, daughter, homemaker, dog-lover, and more. I still love to laugh and love to cook. The old Jean is still in there, somewhere.

My mother, who is short and struggled with obesity most of her life, used to say that there was a tall, thin blonde inside her just waiting to get out. I will always have a short, fat blonde girl inside me just waiting to get out. But having weight loss surgery has given me some wonderful tools for lifetime weight management.