by Marilyn Armstrong co. 2003 (write to author for re-print permissions)
Okay. Time to shove my (unasked) oar in these waters.
I am a gastric bypass patient (3/4/02) who has had multiple complications. In
fact, I still have multiple complications. AND I have lost much more weight than
I intended and am now downright skinny, although others seem more disturbed by
it than I am. And no, I do NOT regret the surgery. Sure the complications have
made my life difficult. Sometimes, my life has been beyond difficult ...
downright impossible. But thin is STILL better.
I am not complaining.
I also greatly question Weight Watchers' stats. Do they count the dropouts who
do not lose weight, cannot keep on track, and are too embarrassed to continue to
come to meetings? Or do they only count those who stay in the program? This is a
pretty self-selecting sample. The people who stay with the program are, for the
most part, people who are succeeding at it so the statistics will clearly show
that IF YOU CAN STAY WITH THE PROGRAM, YOU WILL LOSE WEIGHT. Maybe you'll even
keep it off, although I doubt they have tracked the stats on those who do well,
then stop coming. What happens to them?
I lost weight on every single diet I was ever on until right before surgery when
my battered metabolism just gave up and refused to lose weight no matter how
little I ate. Jennie Craig got me down 85 lbs. and I kept it off (or most of it,
anyway) for more than ten years ... then stuff happened and I threw in the
towel, regained all of the weight I lost and added about 40 bonus pounds. Why?
It's a long boring story and I'll skip it for the nonce.
So here I am, 19 months post op.
Am I happy with my weight? Yes, although I admit that 10 - 15 more pounds would
probably look a bit better ... but I'm a little frightened of trying to gain
weight and in any case, I figure once the docs get my other issues sorted out,
I'll probably put on a few pounds as a matter of course. My body has a natural
set point and after I can eat more normally, I expect that I'll find it.
Am I happy about food? No. I really can't eat much and am highly limited in my
choices. It has certainly taken the fun out of food for me, but I have learned
to enjoy table talk and ambiance and discovered that there are other reasons for
dining than just eating. Would I like to be able to eat a bit more normally?
Sure, but life goes on regardless.
Has my marriage fallen apart? No, it hasn't. Is it better? No, it's about the
same as it was. Whatever problems we had before, we have now. The strong points
are still strong. The weak points are still weak. IMHO a lot of people have
crappy relationships and all it takes is one big precipitating event and the
whole house of straw comes tumbling down. Are morbidly obese people inclined to
have crappy relationships more than "regular" people? What do YOU think? Take a
person who feels physically poorly much of the time, probably has a self-esteem
issue -- if not from some childhood issue, than certainly as a result of being a
very fat adult in a society that idolizes "thin" and voila -- low self esteem
served up on a silver platter.
I know a lot of divorced couples. I've been divorced too. In fact, the stats in
the northeast are something like 1-in-3 regardless, and probably among certain
professions (like media, say -- and yes, I do speak from experience here) it's a
lot higher. Also higher in cities than in the country. Also higher among those
with higher incomes. Divorce is very very very common in our society and a
sampling of ten couples who didn't make it post WLS hardly constitues a
meaningful sample. Among the Weight Loss Surgery (WLS) couples I know -- maybe
30 couples in all -- only one actually went to divorce ... but they weren't in
great shape before. Other couples had a bunch of issues to sort out, but thus
far (in this last 19 months that I've been paying attention to this stuff) seem
to be working it out ... as least as far as they are concerned. Others might
argue the point and some of them would probably be better off divorced ...
Should there be a better way to lose and keep off weight than massive
reconstruction of the digestive tract? Yes, I really wish there were. This
procedure is very drastic and not for the faint of heart. If you are doing it so
you'll look better in your clothing and that's all, well, that's not good enough
to get you through any rough times that might develop. But I think most of us
did it because we believed that it was the last-best chance for a healthy life.
In some cases, it was do or die, quite literally. As for me, I was either going
to lose at least 100 pounds or probably be confined to a wheelchair for the
remainder of my time on earth. That was not much of a choice.
Now, about psychological components to obesity.
I tend to think that as many psychological components as there are, there are
far more sociological components. Certain ethic groups are far more food-centric
than others ... certainly my background (Jewish) celebrates every single event
in the human life by preparing and consuming inordinate amounts of food. My
Italian daughter in law and a whole bunch of Italian friends say that it was the
same for them. Oh hell, my Black (excuse me, African-American ... my husband --
who is non white -- absolutely HATES being called African-American, by the way)
friends and family say the same thing. Many many ethnic groups celebrate life by
overeating. It is a cultural imperative and gets pretty hard-wired into your
brain. Even though I don't eat very much, I still cook and when I do, I still
cook too much. I am programmed. And I still get a nice warm fuzzy feeling
watching others eat, even though I can't really participate. I am a result of my
conditioning. As are we all.
Did I put on some of the extra weight I carried because I comforted myself with
food? Yes. But most human beings do that. Just some of us either carry it to
extremes or are simply more inclined to put on and keep on extra weight.
Now, about real psychological issues. On one list on which I participated for a
long time, the subject of childhood abuse came up and a surprisingly large
number of people, mostly female, but some men too, had been abused as children.
I don't know if there's been any research to see if there is any link between
childhood abuse and obesity, but I bet there is one. But of course, that is
apocryphal. Just my gut suspicion.
America is a food-centric society these days. If you doubt this, watch the ads
on TV. Count how many ads there are for food in a given hour. I never really
noticed it until after surgery when I felt absolutely bombarded with ads for
pizza, burgers, fried chicken, ribs, Italian food, soda, beer ... and more and
more. For a while it made me crazy. Now it just makes me queasy. I look at ads
with happy (thin!) people scarfing down chunks of pizza and fried chicken and
all I can see is grease. Yuck.
Last I heard, the average woman in this country wears a size 16 ... AND our
sizes are MUCH bigger than they were 30 years ago. If you doubt that, go buy
some clothing made during the 50s based on your current size and you'll discover
that they won't fit. Americans are MUCH bigger ... in every way ... than they
used to be. We are, on the whole, overweight. Some of us are just a little
overweight, some much more so. How many restaurants sell themselves on serving
big portions, eh? The morbidly obese are not exactly their singular target
audience, so eating a lot must be a pretty prevalent phenomenon. So maybe ...
just maybe ... we who have been or still are morbidly obese somehow think that
we have ever so much more baggage than Normal People, whoever they may be.
I have a theory. It is unscientific, unproven, and as such is merely my
subjective thoughts on a clearly delicate subject.
I think most people overeat some of the time. A lot of people overeat most of
the time. Some people overeat all of the time. I don't think that psychology
accounts for it, except for a small percentage. We live in a society where food
is plentiful and cheap ... where fatty, rich food tastes really good. Food is a
social function. We get together and we eat. Because we can eat more than we
need, we do. In societies where food is scarce, people eat less. In societies
where overeating is anti-social, people are -- on the average -- thinner. Some
of us are genetically pre-disposed to gain weight and for whatever reasons, are
also more inclined to not lose it. That's why it's so common to see multiple
siblings in various sizes, even though they've all had essentially the same
upbringing. I have two siblings. My brother is overweight, but not fat. My
sister is thin. I was fat, now thin. My father was fat, lost it all, kept it off
for the rest of his life (50 years to date). My mother never let herself get
fat, but she had the discipline of a Marine drill instructor. If she gained five
pounds, she immediate increased her exercise, decreased her intake, and lost it.
Of her five siblings, 3 were heavy, 3 thin. In my dad's family, the women were
fat, the men thin, except for my father who was fat then thin. Does this prove
anything? I dunno. Does it?
Many of us have really bad eating habits. I'm not sure that bad eating habits
are quite the same as Serious Psychological Issues.
I think we beat ourselves up a lot. I think we incorporated other peoples'
judgments of us into our opinions of ourselves. I think that because we feel
that we have somehow failed, that we are more inclined to fail.
Whether it's ghrelin levels, sociological conditioning, childhood trauma, low
self esteem, some combination of the preceding or whatever, WLS works better
than any other solution for the disease of morbid obesity. The rate of long term
success for any traditional diet program is poor. And for those of us with
complicated medical issues, dieting success percentages approach zero on a close
order.
And finally, I find it interesting in a society where the average woman is
pretty hefty that somehow, those who are more than a little hefty come in for so
much abuse. Is it because the merely overweight amongst us feel somehow better
because they aren't as big as we are? And when we have surgery and lose the
weight, why do so many of them get so hostile? Maybe they feel a little
threatened, eh? Maybe even jealous?
Maybe by the time the next generation grows up, there will be better, less
drastic, solutions to overweight. In the meantime, this one works.
Marilyn
Marilyn Armstrong
Open RNY 3/4/02
Starting weight 258lb., current 110lb. (more or less) at 5'3"
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