Bariatric Surgery Misconceptions 3: This Is Never Going To Work

Wile E. Coyote property of Warner Bros. Inc.

The diet cycle experienced by those of us who are obese is a familiar one. We look in the mirror and sigh and/or cry. We read books, check out magazines, surf the internet. We find some new diet that looks like it might work. We try the diet. It works: for a while. Then, something happens. Maybe Real Life interferes. Perhaps we decide we can’t live on grapefruit and quinoa. It is even possible that we recognize the fact that obese bodies can not manage high-intensity interval training every day. But something interferes, the diet stops, and we gain all our weight back.

So, why would we expect bariatric surgery to be any different? And, let’s face some facts here: bariatric surgery is a heck of a lot more invasive and expensive than our usual diets.

Do we really want to invest so much if we are only going to gain the weight back anyway?

The Cold Equations

Here’s the truth: about 20% of bariatric patients eventually suffer some sort of regain.

Don’t get me wrong: that is a big number. For one in five people that go through bariatric surgery, the lowest weight they achieve after surgery will not be their stopping point. They will eventually creep back up to some other weight.

But notice what is not being said here: 20% of patients do not regain all their weight. They hit a low weight, then eventually add some weight back to that. The number of patients who end up regaining all their weight is so low that I can’t even find reliable numbers on the phenomenon.

Let’s say my desire for beer and Oreos finally takes me out back and roughs me up. As a consequence, I gain 50 pounds from my current 192. This leaves me, bruised and depressed, at 242 pounds.

In other words, I would still be 50 pounds lighter than where I started this process. And no doctor is ever going to tell you that a permanent weight loss of 50 pounds is bad for an obese person.

Heck, when I started this process, I was hoping to lose around 50 pounds.

The Hows And Whys

Regain is not an exact science. Some people decide they can’t live without certain elements of their old diet. There are those that determine they do not want to exercise. There are even a few people who lose too much (the mind boggles) and have to regain to be at a healthy weight.

The other thing to remember is that the process does not have to stop with regain. A person who regains still has the ability to identify the elements of their lifestyle that are not contributing to weight loss. You can always fight back.

Will it be at as easy as it was during the “honeymoon period” after surgery? Nope, not at all. But the fact is, the honeymoon ends for all of us. At some point, the “free” weight loss ends and the work of maintenance begins. That work is the same whether you have stayed at a stable weight or regained 20+ pounds.

Once again: bariatric surgery is a single tool to use in your fight against obesity. And any long-term weight loss is contributing to your overall health. If regain should happen, don’t give up. Just remind yourself that it could be (and has been) worse, and keep on fighting.

And put down the Oreos, for goodness sake.

Avoiding Oreo Alley and Beer Boulevard,

Jeremy

Bariatric Surgery Misconceptions 2: Goal Weight

Goal Weight

A great many of the issues I talk to people about make me genuinely empathetic. I can relate to something in their experience – if not the specific event, at least the way they feel about it. This is only enhanced with bariatric patients – after all, I’ve been through most of what they are going through.

However, there is one “bariatric subject” that I have no grasp of. Sadly, it is the one subject that just about everyone talks about:

Goal Weight

Your Doctor, Your Scale, And You

Go visit any bariatric forum, Facebook group, or message board. I guarantee, within the first 5 posts, you will see some version of the following message:

“Help! My goal weight is (X), and I am stuck at (Y)!!! What am I doing wrong???”

Goal weight, for the uninitiated, is the weight your doctor thinks you should settle in at after bariatric surgery. It tends to be the #1 fixation of bariatric patients. It is also, in my opinion, just about the most worthless of metrics.

Ever since the day I read an article that pointed out that the entire 2004 U.S. Women’s Volleyball Team were “obese” according to BMI, I have been suspicious of weight as a measurement of health. Need some more recent proof? Dwyane “The Rock” Johnson is, with a Body Mass Index of 34.1, obese.

Man, I would give a lot to be obese like The Rock. Just sayin’.

Weight is only one of several factors that determine health. But it tends to be the one thing that bariatric patients focus on. Why? Probably because we all have scales at home, and can check that number constantly. Seriously – I have more than one friend that feels compelled to weigh every day.

Functional Weight

We seriously need to stop with this obsession over numbers and start concerning ourselves with overall health.

Today, I can run 15 minutes straight. A year ago, I could walk about 10 minutes before collapsing on the couch and hyperventilating for half an hour. That, to me, is worth greater attention that the number on my scale.

My “goal weight” is officially 185 pounds. I may never get there, having slowed my weight loss way down by starting up again at the gym. I couldn’t care less. My clothes are still fitting differently every week. I am on my way to being able to run in a 5K in 2 months. By the end of the year, I hope to be able to bench-press my body weight.

In short, I am much more interested in what my body can do than what it weighs.

Body weight varies for all kinds of reasons. Water retention. Illness. Over- and under-eating. Any one of these things can cause that scale number to not move, or even move the wrong way!

But you have to ask yourself: what can I do now that I couldn’t do before weight loss surgery? How has my quality of life improved? More importantly, what can I do to continue improving it?

And the numbers of your BMI or on your scale will give you no help with that whatsoever. Find goals that actually mean something: participate in an event. Try on a new swimsuit. Take up a new hobby.

If you are healthy enough to do everything you want to do, weight is nothing but a number.

Just go ask The Rock. He’ll tell ya.

Though I Am Still Obsessed With The Number On The Treadmill,

Jeremy

 

A Week of Bariatric Surgery Misconceptions

Recently, I’ve been seeing a much larger number of negatively themed posts about bariatric surgery. “The Dark Side of Bariatric Surgery.” “Bariatric Surgery: What Your Doctor Isn’t Telling You.” “I Wish I Never Had Bariatric Surgery!” Whether this is a cycle I just happen to be catching up with, or some genuine pushback I don’t know. Whichever it is, there are some genuine questions being raised by these objections to bariatric surgery. So, as a veteran of the bariatric surgery process, I would like to offer a little personal insight. This week I would like to chat about the objections/issues I keep seeing time and again First up: depression.

Does Bariatric Surgery lead to Depression?

The story goes something like this: “I was perfectly happy before I had bariatric surgery. Now I am depressed!” I’ve even seen some major articles by medical journals talking about this issue.

Here’s the problem: depression and obesity are actually linked. If you are obese and not already depressed, you are among the minority. Not only is obesity likely to cause depression, but depression is likely to cause obesity. They share common risk factors.

Now, here is what can happen: a bariatric patient falls prey to “golden ticket syndrome.” They think that since they have had bariatric surgery, their lives will now be stress-free. This pleasant feeling lasts until Real Life Happens. Something goes wrong, and they are suddenly just as stressed out as they were before surgery. Plus, they have a whole bunch of new rules that have to be followed. On top of that, they are cut off from what was likely their #1 way of dealing with stress: eating.

Suddenly, they are thinking “My life was so much better before I had surgery!”

Remember, surgery is a tool – it is not a solution in and of itself. (Though it does act like one for the first few months after surgery.) Life won’t change just because your weight has.

Pushing Back

So, then, how to deal with encroaching depression after you’ve had bariatric surgery?

First, try the post-surgical secret weapon: exercise. According to the Mayo Clinic, exercise can ease the symptoms of depression. If you are feeling a little blue, a bit down in the dumps, strap on your sneakers and hit the gym. Run a mile. Meditate. Remind yourself that you are now healthier than you were before surgery, and you have many more options than you did at the start of this process.

Second, surround yourself with emotionally healthy people. Maybe talk to that one person at work who seems calm in every crisis. Pick up the phone and call a friend or family member who isn’t constantly talking to you about the problems of their personal life. Look for people who will add stability to your life – you already have enough chaos, right?

Lastly, get some help. Clinical depression is every bit as real an illness as obesity is. Get yourself a counselor or other medical professional who can help you through the rough patches. Most insurance plans cover some kind of mental health treatment. Utilize the resources available to you.

Be Good To Yourself

It is worth repeating: you are still you, even after bariatric surgery. The responsibilities, relationships, and stresses you took into the surgical suite are still waiting on the other side. All surgery has done for you is given you a healthier and more stable platform from which to operate. Life was not better when you dealt with stress by sitting in a darkened room eating a whole package of Double-Stuffed Oreos.

Remember, taking care of yourself does not stop with leaving the hospital post-bariatric surgery. It actually only begins there.

Though, as someone diagnosed with clinical depression, I do admit to sometimes missing Double-Stuffed Oreos Therapy.

Protecting Myself From Poor Life Choices,

Jeremy

 

 

 

 

Defeating The Wall

A few weeks back, Lor and I discovered indoor rock climbing as an aspiration. We asked questions, grabbed flyers, and made plans for our eventual return. We even started specific training programs, so that we would be ready for the challenge when the time came.

So, of course, when the opportunity came to tackle rock climbing without training or preparation, we threw ourselves right in.

There Stands The Wall

Hinkle Family Fun Center, here in Albuquerque, is a family-themed activities parks. Miniature golf? Yup, they’ve got it. Ticket-dispensing video arcade? Yeah, that too. Bumper cars? Laser Tag? Paintball? Yup, all of the above.

So, how about a 32-foot climbing wall?

Turns out they have one of those as well. While purchasing our tickets for our visit yesterday, our nephew was completely focused on the possibilities of Laser Tag. Lor and I, however, could not take our eyes off The Wall.

“We totally have to climb that,” I whispered to her as we went off to drive the go-karts.

“Oh, absolutely.” she agreed.

All day long, we kept orbiting around The Wall as we ran ourselves ragged trying all the other activities. Finally, mid-afternoon, when the excitement of the park had begun to pale for even our nephew, the time had come. The three of us walked up the hill and placed ourselves in line for The Wall.

Looking Up

Have you ever had the opportunity to look straight up 32 feet?

If not, go find your nearest 3-story building. Stand right up next to it, then envision yourself climbing it. That is exactly what we were about to do.

I appointed myself as the official photographer for the adventure and sent Lor and our nephew to head up first. Lor, normally fearless, was subdued.

“I don’t think I can do this.” she whispered to me as we moved to the front of the line.

I patted her on the back and told her she would be fine. She steeled herself and walked through the gate to meet her destiny.

The attendant who helped her get in the harness made a joke that the cable “had only broken twice.” This was probably not helpful to Lor’s state of mind.

But, she did it anyway:

See what I mean about 32 feet being a lot taller up close?

To Dream The Impossible Dream

At last, the intrepid pair had returned to the ground, and it was my turn to tackle The Wall. Our nephew graciously agreed to ascend it with me so that some stranger wouldn’t have to listen to me whimpering.

The initial ascent wasn’t bad, as these things go. It was an interesting exercise in trying to figure out where to place the feet in order to get the maximum lift to the next set of hand holds.

After repeating this process a few times, with my nose stuck about 6 inches away from the surface in front of me, I made the mistake of looking down. I gulped in terror and looked off to the side instead. My nephew had climbed 3/4 of the way up while I was barely halfway.

However, if there is one thing I possess, it is stubbornness. I flattened myself against the wall and resolved to never look down again. Then I resumed my ascent.

A few minutes later, I had arrived:

I just noticed my nephew and I are dressed like “twinsies”.

Winded, but triumphant, I reached a trembling hand forward and slapped the button at the top of the wall.

Nothing happened.

After my descent, I was informed that the buzzer is broken. Talk about a letdown.

The After-Action Report

So, having tackled this wall, what does this mean for our eventual visit to the 45+ foot walls at Stone Age?

Our plans have not changed. Though we were both winded and terrified, it was a good fear – kind of like a roller coaster. I can also report that today I am sore in all the places I have been emphasizing with my new workout routine. Hands, forearms, lats and quads are all feeling like I climbed a wall yesterday. I am apparently on the right track at the gym.

A year ago I still weighed 285 pounds, and would not have been allowed near The Wall.

Just sayin’.

Sore But Triumphant,

Jeremy

Spring Break

Is Daily Exercise Really Feasible

A common complaint that I receive from readers is that I have an unfair advantage. That is to say, I do not have a “real” job, and I do not have kids, which gives me a leg up on being able to make lifestyle changes that are too difficult for a “normal person”.

Personally, I find the idea that suffering from a brain-bending disability gives me some kind of an advantage a little off-putting. Be that as it may, I am fond of telling people that the time exists in any schedule to make lifestyle changes. It is simply a matter of finding that time and repurposing it.

This week we are enjoying our yearly ritual of our nephew spending his spring break with us. And I am suddenly finding that maybe there is something to these complaints after all.

The Iron Fist Marathon Event

Since our surgeries last year, Lor and I have a pretty fixed schedule. I get up and write for a minimum of two hours every morning. We spend 2 hours at the gym every day. Since I began my Personal Trainer program another few hours a day is spent on coursework. Meanwhile, Lor usually works while I am studying. We fit in meals, television, gaming, and errands around that core of six – eight hours a day. (7 days a week, by the way, no 5-day work weeks for us.)

Yesterday, the three of us spent over eight hours binge-watching the first half of the “Iron Fist” series on Netflix. (Totally recommended if you are a comics geek like the three of us.)

I will grant that at least we managed to make it to the gym yesterday. But that is it. I spent maybe half an hour writing. No time was spent studying. Lor took the day off. And I, predictably, worried.

The Shoe On The Other Foot

Lor was philosophical. We only have a few short years to spend with our nephew while he is young, she pointed out. Soon, he will have no interest in traveling a few hundred miles and hanging out with his aunt and uncle for weeks at a time. We need to take advantage of the opportunity while we have it.

And I completely agree. But my concern was this: if we had our own child at home, would every day be like this? Am I a complete hypocrite for telling people that they have the time to make lifestyle changes? Does my disability really give me some kind of leg up on getting healthier that most do not enjoy?

I spent most of the day grumpy as hell, unable to get out of my own head. I am sure that Lor and my nephew would have been happier if I had just left them to enjoy the marathon while I worked through my crisis.

Be Good To Yourself

But here’s the thing: I am getting more out of this visit than I have in a long time. My increased health has meant that I have been more alert, more engaged, and more interested in my nephew than I have been in past years.

Thanks to surgery and lifestyle changes, I can reasonably expect to be around when he graduates from high school. And from college. I will probably be present at his wedding, and for the births of his kids.

If he was my son, could I afford to have not made these changes, no matter what the daily cost in time was?

Yesterday, and the rest of this week, will be aberrations in my schedule to be sure. But every minute I get to spend with my nieces and nephews is time well spent. If I worked at a “real” job, there is every chance that I would have taken the majority of this week off from work entirely.

We have plans for hikes, for a visit to a trampoline park, to play laser tag during this week. None of which I could have done last year. I would have dropped him off, then waited for him to finish. This year I will participate in all of it.

All because I have invested the time.

Your Personal Challenge

So, no, I do not think I am a hypocrite. I think the time is there in every daily life to get healthy. Maybe you can’t join a gym because of time constraints. But you can skip one tv show a day and work out at home. You can walk while at work. You can make changes to your diet.

An hour out of every day today will mean a whole lot more tomorrows to spend with your loved ones.

Playing Lazer Tag and binge-watching Iron Fist.

On Vacation,

Jeremy