BariatricLife | Jaded Bariatric

The bariatric journey: 3 ways to practice body acceptance

“When will I feel like myself again?”

That’s one of the most frequent questions I hear from post-op patients. Recently I looked through journals from my first two years after my surgery. This exercise recalled that I struggled with the same issue. My second-year post-op was full of changes, my freshmen year in college. Not only still adjusting to a changing body size-wise but also the remnants of puberty and being on my own away from my parents.

I’ve lived more years after my bariatric surgery than prior. The first year, I didn’t quite feel like myself, but over time I learned (and continue to learn) that my body is always changing. This is what helps me keep perspective.

Appreciate your prior body and your changing body

It can be easy to demonize your old self, in a world that exalts dieting, extreme exercise, and weight loss – no matter the cost. Recognize all the beautiful memories you experienced before your surgery. For me, it included family vacations, first kiss, engineering camp, summers in NYC with my sister, doing a split at 400+lbs ( a skill I aspire to achieve again, one day).

Having bariatric surgery at 16, my pre-surgery body is connected to my childhood. When others try to talk bad about my old body, it’s not just body shaming, and it’s body-shaming a child. And I recognized I would never want to body shame a child or anyone.

By appreciating our bodies in their pre-surgery form, we can still enjoy those pictures and memories from the past. We thank our body for the wellness it provided to keep us going each day.

Bodies changing is proof we’re living life.

Our bodies aren’t the same as when we were born, right? I no longer have tonsils, but do I complain? No.

Stretch marks and loose skin will happen. Over time, our bodies inevitably change. When it’s happening so fast, it can be overwhelming.

Celebrate true NSVs

Non-scale Victories(NSVs), this term used to describe purely non-scale victories. Unfortunately, in today’s curated world, it’s become scale-based victories in disguise. Fitting into a specific size is not a scale based victory. Flying without a seatbelt extender is an odd but scale based victory, there’s no standardized length for seatbelts in airplanes. I’ve flown where I’ve had inches to spare; the next flight needs a seatbelt extender.

While one of the goals of bariatric surgery is weight loss, acknowledge the NSVs. Some of mine include:

No longer need oxygen to sleep. No sleep apnea.
Excellent blood pressure and cholesterol
Not contracting type 2 diabetes
Holding a Plank position for 90 seconds
Able to do 40 seconds of non-stop jumping jacks
Tricep extension at 15lbs

You might think the first victories are scale-based, but they aren’t. I’m still obese, and for some, bariatric surgery does not cure sleep apnea or other so-called “obesity diseases.” Bariatric surgery does alter the body in a way that type 2 diabetes will disappear, or effects lessen much. However, even that benefit is not weight-dependent.

During movement and exercise, celebrate being able to run up those stairs, stretch that far, lift that weight. Those abilities can be endurance training based then weight-based, surprising to some. My first time in a class, some are in awe that I keep up with good physical fitness. I’ve been dancing, swimming, exercising my whole life, my body’s conditioned.

Keep that in mind when you are exercising: bodies are different. If you lost weight and still struggle with some exercises, it takes time and conditioning.

Invest in your Mental Health

At the beginning of the bariatric journey, we spend so much time researching the best protein powders, hunting down bariatric friendly recipes, bookmarking clothes, and focusing on the physical part of the journey. The mental part often is neglected. Usually, there’s one appointment that serves as a psych evaluation, and then we’re on our own.

It’s invaluable to take care of your mental health. Writing in a journal helps. I also recommend a counselor or therapist on an individual or family basis. Based on your health insurance, it might be an untapped resource. Many colleges, mental health non-profits offer peer counseling. There are also online options like Betterhelp.

What about bariatric support groups?

Support groups have their place, especially positive spaces. Often, there’s way too much emphasis on the number on the scale and encouragement of unhealthy behaviors. Complimenting me on my weight loss does not help when I’m depressed. There are times when I’m frustrated I didn’t bring Tylenol to dance practice, or my hunger is out of sync. It’s not just about the number on the scale. If you’ve regained the majority or more your weight, bariatric support groups can be especially tricky. Eating disorder groups can be awkward spaces for bariatric patients.

Individual mental health work gives you the space to talk about bariatric struggles without focusing on weight.

Which of these practices are currently apart of your life? How are you working towards loving yourself along the journey?

Let me know in the comments or on the ‘gram!

Bottoms Up?

It’s been about three months since I joined the greater bariatric community. More support and body positivity than I expected. The welcome has been warm and accepting. With the distance of the internet, I can step away from what enrages me and jaded me away from support groups in the beginning.

One of the most interesting aspects is how selective the food police can be. As if in one breath, they seem to condemn sparkling water and applauding vodka crystal light spritzers. The food police berate people for turning to Facebook for advice, yet on one matter, there’s a clamor of “I did this early, no big deal.”

Bariatric surgery feels unique in its nutritional guidance, there appears to be no general consensus. Perhaps this conflicting advice is based on surgery type? Years post-op?

It wasn’t until 2016 that I learned that carbonation was “forbidden” to bariatric patients; or that I shouldn’t drink liquids while eating. We’re all coming from a different place.

However, there is one surgeon’s guideline that has not changed: alcohol. After bariatric surgery, alcohol is a serious issue. Laparoscopic or not, Bariatric surgery is an intensive surgery, and it takes time to heal. Abstaining from alcohol for 6 months to a year based on your surgeon’s guidance is essential. Your doctor’s advice is based on their experience, your body may can’t handle alcohol till later. Also, it’s important to remember during the healing process, we’re not eating nearly enough substantial calories to handle alcohol.

At my year check-in, I was 17, moving to college in the fall. My doctor, in grave terms, gave me this advice:

Drink a glass of water after each drink
Don’t chug beer
Don’t take shots, ever
Take shots? Just go straight to the hospital.
As a nerdy engineering student, it took almost 4 years post-op before I tested this theory. Don’t misunderstand me, I drank alcohol, but it was usually Smirnoff ice and mixed drinks.

At a friend’s 21^st birthday, there was a line of flaming shots: Disaronno with Dr. Pepper chaser. To this day I remember the feeling, I got half the shot down and then

-BAM –

lava down my esophagus directly to my pouch. Then the most intense cramping pain in my upper abdomen. I felt dizzy, I couldn’t see straight. My then-boyfriend took me urgent care, where I was given a slurry of charcoal and electrolytes.

It was the first and last time I ever took a shot.

There are times when we grow from painful experiences and are the better for it. I genuinely believe this leads me to be a responsible drinker and even avoiding transfer addiction.

What’s transfer addiction? Before my surgery, I could eat a pizza in a sitting or several scoops of ice cream. I turned to food often when I was happy, stressed, or depressed. After bariatric surgery, that’s a lot harder to do. Sure, I can still enjoy most foods but I’ll admit it is still awkward to crave something, give in to the craving only to eat a few bites and be over it. It’s not the same dopamine hit that it was.

For some bariatric patients into they keep chasing after that dopamine rush. They may find it in drugs and alcohol.

Wait a minute I thought you said drinking was painful? Why would anyone do that?

I said drinking shots were painful. While I don’t have much to compare pre-surgery, I have noticed compared to others I can “hold my liquor” quite well. When I drink liquor or beer, the buzz never hangs around long, which can keep you drinking to also chase after the buzz. One exception: without food on my stomach, drinking wine is a miserable experience. Dizzying headaches that take liters of water and time to wear off.

This is why waiting 6-12 months before consuming alcohol is essential. It gives you time to get used to your new eating lifestyle. Time to feel the weird pang of disappointment where you’re both full yet want to eat more, then realize you can’t. To find other ways of developing healthy coping behaviors.

Lastly, know that most people don’t become alcoholics post-surgery. There’s also evidence that gastric banding is less likely to lead to this (source).

If you think you’re struggling with transfer addiction, it’s imperative to get help and support.

Useful Links
Bariatric Wisdom on Transfer Addiction
Alcohol: http://www.alcoholscreening.org/
Drugs: http://www.drugscreening.org/

Isn’t it Ironic

Whenever anyone asks me what is the top benefit of having bariatric surgery, I don’t have to think hard..

It’s my health being taken seriously.

What do I mean?

If you’ve ever been overweight, then you know where I’m coming from. As an obese child, whenever I was sick, it was always blamed on weight. Sprained ankle, asthma, eczema, lethargy, the solution was still weight loss. At seven, I had my tonsils, adenoids, and uvula removed, the added benefit the doctor said: “the soft food diet should help her drop those pounds.” It didn’t. Eventually, I avoided the doctor at all costs, trying to feign well when I was suffering.

Nowadays, when I’m at a healthcare provider(HP), our conversations go like this:

HP: *reading chart* you had gastric bypass?
Me: yes, in 2002.
HP: that’s young! How much did you regain?
Me: I’ve kept off x lbs. My highest was X.

HP: Wow, that’s great. Let’s get some tests and see what’s wrong!

Still not entirely sure of the why? Is it because surgery is the most drastic action? Is it the side effects of rewiring your insides that have been shown to prevent certain diseases? Personally, I’d like to think it’s because I am in good health. But I know better.

Friends and family, some smaller than me, relay stories of long battles to diagnose PCOS, vitamin deficiencies, mental health issues, even cancers. The reason? Doctors told them weight loss is a panacea. Insurance wouldn’t cover blood tests or CPaps until X pounds were lost or enrollment in nutrition classes to show they could demonstrate “self-control.” Instead of compassionate care, they get shamed, pamphlets, and diet pill prescriptions.

Honestly, my weight rarely comes up as a cause. Even when I think it’s my weight. After my mother passed away, my blood pressure was rising, so was my weight. My doctor was rightly concerned. I tried to pass it off on weight gain. “Not so fast,” she points at my chart on the computer screen. “You were this weight 4 years ago and your blood pressure was great. That’s not it.” Must admit, that interaction made me like my doctor even more.

I’m not entirely exempt. First visits are full of nurse’s assumptions that I must have diabetes and “awful” eating habits, one bite away from a heart attack. For a while, I had a doctor that required me to get my blood sugar tested. As someone with reactive hypoglycemic who has never been even pre-diabetic, it seemed a waste of time. Finally, I asked the nurse, “Why do we do this every time?”.
“It’s your demographic: African American, female, obese.”

In the categories of people who get shoddy health care, overweight Black women, are really high on the list. Healthcare providers don’t listen to our concerns, brush them off, or assume our non-compliance. Personally, I think this for a lot of discriminatory reasons including race, gender/gender identity, and class. Didn’t realize how much class was a factor till they learn I’m an engineer. Canceling appointments are now considered “she’s busy” not “she doesn’t care about her health”, eating fast food infrequently no longer gets the response “Well you ought not to eat it at all”. No, now it’s “I know your job must be very demanding.” I often get passes for being an engineer and I still feel conflicted about that.

Being treated as a human being at the doctor, what a difference it’s made. I’m still obese but I no longer experience the level of fat-shaming in healthcare. Which goes to show you it’s not all about a number on the scale. Allot of is about societal “norms” and control.

Feverpitch

In May 2002, I had open RNY bariatric surgery. I was 16 and my life would never be the be same…

17 years ago, my parents and I made a decision that changed my life. At the time, we couldn’t begin to fathom how much. At 16, I had roux en y gastric bypass surgery. Bariatric surgery. Weight loss surgery.

One hazy May morning in 2002, parts of my young body were permanently rearranged. The date is not clear, I had a panic attack on the operating table on the scheduled date. They had to postpone the surgery. Luckily, my parents were patient, understanding, and gainfully employed.

I do not regret having bariatric surgery. Nor do I have any contempt for my parents. They sincerely believed without “the surgery” (as it’s known in my family), I would not be here today. Whether this is true can never genuinely be known.

I’ve been one of the lucky ones. Many have complications, needing feeding tubes or even dying. Still more were promised a long term weight loss solution, only to regain much or more weight. Others were promised deliverance from “fat illnesses” such as high blood pressure, CPAP, challenging to find veins. They later realize these things aren’t as weight-dependent as some medical professions would like us to believe.

This journey has primarily been a solitary walk. My friends and family have been there to support me. However, I never found myself in a support group, a team, working towards the same goal. As a teenage bariatric patient, there were few my age. Being in a group of adults was awkward and unfamiliar. Without major complications and expected results, I hummed along through college as an “acceptably fat” young woman.

As an adult, far past the honeymoon phase, I attempted joining my local bariatric support group. There I listened to tales of bariatric kryptonite, aka Starbucks drinks; the hushed confessions of weights hidden in underwear or binges to “make weight” to qualify for the surgery. I spoke out. Candidly. After a few weeks, I was asked not to return. It was likely for the best for everyone.

It was a shock to see patients that I didn’t consider very overweight having the surgery. My introduction to bariatric surgery was that it would prevent my early demise. Becoming thin was never my goal. Hearing stories about those who gained weight, stuffed weights to qualify, I judged. I was asked not to return.

In hindsight, I do regret being so judgemental. Compassion and understanding of those people’s mental anguish and their eating disorder is a kinder approach. Like many of you, I’m still learning and growing.

In online support groups, I vent out loud to my screen or my journal rather than seem unhelpful. I try to keep the gems, discard the rest, but there’s still a lot of unhealthy thinking and behaviors. It wasn’t right for my health, and I saw others being hurt. For most people, losing 50,60,100,150lbs and no longer needing insulin, a CPAP, etc. would rightly be a crowning achievement. Unfortunately, as a bariatric patient, sometimes you still feel like a failure.

After bariatric surgery, it’s challenging to feel that you belong.

Exclaim about your weight loss? You took the “easy way out” or “you’re still fat.” Body positive and loving yourself? Is that even possible after you turned your insides around to lose weight? Sometimes, I feel like a fraud around fat positive folk.

Still being obese, I get a lot of unsolicited weight loss advice. Albeit much of it stops when I mention I lost 150lbs, some will press on “how much more are you going to lose?” More? How much can a body take? Personally, I’ve met my goal for the surgery: no more sleeping with an oxygen mask, no diabetes, good blood pressure, cholesterol. Also, I can shop for clothes in stores where I live.

These days I’m more focused on being kind to my body. For me that means getting my protein in, staying hydrated, and not eating things that make me sick. Which might be different from what makes you ill.

My goal is to continue being a successful bariatric patient and offering an honest view on life on the other side.

Oh, and taking my vitamins every day for the rest of my life.

(they’re not kidding about that one.)