I’m not a party pooper, a killjoy or a spoilsport but believe it’s important to bust possible myths linked to weight loss and weight loss surgery. Last week someone said to me: “Please don’t change, you are so empathetic while also being straight down the line.” Hopefully what I write here won’t be too straight down the line for you to hear.
Over the years I have witnessed considerably more than a thousand people who have started their weight loss journey and the stages are almost predictable, although not always in the same order. Many begin simple thinking “I want to be thinner”; some truly believe weight loss will ‘make everything better’ and most of us count the days, hours and even minutes until we have our surgery for whatever reason we want it. Discovering, researching and being referred to an experienced team are the first steps.
Things have changed in the last 10 years or so. Now people tell me they have watched the procedure on YouTube, spoken to or know someone who has had surgery (band, sleeve bypass, etc). “My doctor told me I should have this surgery but my specialist told me I should have this surgery”. This is a double-edged sword in my view particularly as many doctors still know so little about weight loss surgery and believe it a magic wand that will contribute to reducing their prescribing bills.
Whatever, it is not unusual for people to really believe they are semi experts by the time they come for assessment. So let’s explore what this journey may mean for us as individuals. Let’s look beyond the obvious.
WLS – the procedure is probably what we are told. What happens after the procedure is, in the long term, often not what we expected.
Stages and Phases
Not only does this include discovery, questioning yourself and others, research and finding the right team but may include: reeling at the cost – am I worth it?, biting the bullet and going for it anyway. Completing the clinical, medical and psychological processes also ‘required’.
Getting excited as the time line progresses, nervous, “Have I made the right choice or decision?”
Count down until op day.
Stage 2: Usually the briefest stage
Having the procedure, waking up, feeling physical discomfort. Emotionally relieved, happy and wondering what the heck have I done? Should I have done this? Is it going to work? Of course it will, I’m not going to ‘fail’ having spent all this money, energy or time.
Stage 3: With a band
Slow size and shape change, self doubt, doubt in the team, have they conned me, have I conned myself? Band adjustments, changing food and eating behaviours seeing some change – rarely fast enough or ‘enough weight’.
Another band adjustment realising how much volume you did actually eat. Seriously changing how, what, when and why you eat.
Being totally euphoric about your weight loss, loving the positive input from people you know, wanting to shout out to every fat person you meet that ‘this is the way’. Changing your relationship and thoughts with food and fluid.
As time goes by, thoughts about not eating ‘enough’, grieving for the things you can no longer consume and accepting (or not) that you will have some difficulty for the rest of your life with certain foodstuffs.
Deciding to try to eat wisely and in a healthy way. Slowing down further and wishing you could rush through a sandwich for lunch rather than pacing yourself and taking your time.
Stage 4: As time goes by
Realisation, denial, anger, bargaining, depression. It takes a long time to lose 6, 7, 8+ stone. Trudge, trudge, plod, plod, boring… yawn yawn… is it worth it?
I don’t want to be fat again but didn’t think it would be this hard/permanent. I wish it was easier. It was easier, more comfortable, before. This is hard work and I was quite comfortable in some things before.
Comments change from positive to: are you well? How much have you lost? Or don’t lose any more weight you will look gaunt.
Emotionally it’s getting tough. Where self-soothing with food would help in the past it’s no longer possible unless it’s with junk food (which always goes down).
How to find other ways to meet your emotional needs
My clothes are too big I’d better not throw them away as I may need them again if I put weight on. Buying new clothes. Oops, I bought too much too soon…now these are too big. Throwing fat clothes away, keeping ‘that one favourite item. Buying more clothes, changing from picking up large sizes to pulling smaller sizes from the rails.
Changing, becoming assertive, saying ‘No’, not wanting or taking rubbish from others and trying to balance confidence and assertion versus aggression. Often people get promotion at work at this stage.
Wondering: what’s next?
Stage 5: Long term acceptance
Disheartened, disappointment, actualisation, acceptance. No-one told me that you can gain weight even if you have had weightloss surgery. I thought when I’d got ‘there’ everything would be better. Relationship changes, ‘you’ve changed’, you used to be so happy, etc, etc.
When I got ‘there’ that would be that and I would be thin and never have to worry again. I didn’t realise that I would lose all my benefits, my free prescriptions and be more able to work but now can’t find a job.
“I still hate exercise” or “I have discovered I like exercise”.
I’m frightened I’m not losing any weight and I think I am beginning to gain. I’d rather be dead than fat again and there’s not much difference but no-one told me how difficult and permanent it would be. What if something goes wrong? What if I gain all my weight back?
Life goes on… and we grow into reality of life as a person who often still has the disease of obesity even when in a smaller sized body.
No one and nothing can change us but ourselves.
Mrs Sharon E. Bates MSc RN RM is a registered nurse and midwife who has experience as an NHS manager. She is a professionally qualified and experienced humanistic counsellor and has achieved a Master Practitioner in eating disorders with The National Centre for Eating Disorders where she is a co-facilitator. Sharon has particular expertise having undergone weight loss surgery in 2000.
Sharon trained with Dr Vincent Frering in Lyon, France and was a pioneer in the UK specialising and establishing weight loss surgery teams in the UK. She works predominantly in Bristol as a Specialist Bariatric Nurse. Sharon is a member of the International Federation for the Surgery of Obesity (IFSO) and can be contacted via firstname.lastname@example.org
She has written a book for those thinking of gastric band surgery (not well edited folks!! – SB) She has also developed some apps for weight loss surgery with a colleague and friend.