I had Gastric Bypass Surgery, in conjunction with a total lifestyle and movement overhaul a little over three years ago now. I hit and exceeded clinic goals and my own. Makes for good reading, right? What's that? You're noticing that there's no 'Two Year Update' on the blog? Well, that's true.
I didn't do a two-year update and here's why: in having hit maintenance, I did as so many do and I floundered a little. Didn't know what to do with not having a 'goal' anymore. The day to day goal that it was suggested I take on wasn't meaningful enough to keep me motivated. Moving into the weight maintenance part of this is HARD.
Don't get me wrong, I set myself to other goals, and succeeded little by little at those too. They were measurable, attainable. Things were moving on that front.
But this was a year where my use of the tool was put to the test: winter, vitamin deficiencies, three deaths in the extended family, medical and interpersonal challenges, kids and their eccentricities, and just plain old life rolled into one. It was a serious opportunity to fall back on my old habits of eating for stress relief and comfort. For a while,I bought into the lie that if you stumble, you're failing.
I won't lie, it was tough. Because I really like Peanut M&Ms, and cheesecake.
But I want to keep what I have more than I want to go back to where I was. It became pretty clear I'd have to fight for it like anyone else that loses weight and wants to keep it off. You see my dear, as I've always said, weight loss surgery isn't a panacea. It's just a tool. And it takes a lot of effort to keep working all the tools day to day, under pressure. It made me a discouraged body, especially since it fell in that period of time where people stop giving such lovely feedback on the work you're putting in.
So what was a girl to do?
Well, I needed to invest myself back in the process. To make sure that I continued to give back to the people coming after me in this process, so I didn't forget where I came from. I needed to keep plugged in with the people who'd cheered with and for me during the pre-op and weight loss phase. They would now be the ones with whom I'd fight in the trenches for my maintenance.
When a fellow group member suggested we start a maintenance support group satellite and asked me to help admin, I hopped on board, both for motivation and accountability.
I ran a back to basics informational series, facilitated discussion topics for them and would you know? I was very much not alone. Turned out, we were all suffering in silence, until someone spoke up. And when one spoke, then others found the courage to speak as well.
The courage to talk about the hard things like 'not keeping off 100% of the weight'.
To discover how it's 'normal' to experience 'bounce back' to a degree after massive weight loss.
To give voice to the unspeakable fear that we'd gain it all back.
To realize there are actually two challenges to manage about regain: recognizing regular bounce back, and then allowing that to be worsened by black and white thinking that says "I gained some back, it's all coming back. I can't do this."
To manage the reality that surgery doesn't solve all the problems.
To use the support we provide each other to formulate a game plan that would make it possible for that not to happen.
But I was ever so close to 150 total lost. Silly me, I have a thing for round numbers. So I pushed it a little further and by my birthday that year, I registered 157, a grand total of 150 pounds lost. Where I stayed for all of a week. It wasn't maintainable, and I was physically miserable. But hey, most people were cheering me on, so it wasn't a problem, right?
By two years I'd had the 'bounce back' occur. Mentally, it's hard to gain weight after you've worked so hard to lose it. I was so concerned about negative comments. People can be cruel. Especially when you use a tool that carries some stigma, and they wouldn't mind seeing you fail. I was so concerned about criticism that I didn't even want to do a blog update. No celebratory pics to showcase how much of my loss I'd maintained. Nothing inspirational to see here. Move along folks.
But, get this... I was a little bewildered when the clinic wasn't at all worried about me at the two-year appointment. No negative comments at all. They considered me to be doing well, and perhaps that should have been a clue. But I didn't really register that at all.What I did do though is decide to continue the mental work this past year to make maintenance a reality.
It has paid off, but when it came time to have to get on the scale for the medical records again this year I wasn't less pre-occupied. It's kind of surprising how after all this time, the scale can still take up a lot of mental space. I suppose I can be like a dog with a bone that way.
Do you know? I attended my three-year appointment recently, and I had conflicting feelings because my weight had been bouncing around recently, and I had a pleasant surprise. My two-year and my three-year numbers were only three pounds apart. At the two-year mark 175, and at the three year 178. Maintaining within an acceptable range .
Remember, they only had documented the first year at 162, They never saw me drop as low as I did. In their perspective, I am well within the expected range of bounceback and I am now maintaining well. When I asked the dietician about it all he shared with me a point of interest: It is completely normal to gain 1-2 pounds from aging alone with no other changes. With all the other things I've got going on right now, I'd say that's kind of exceptional.
In retrospect, I should have stopped losing weight at 170. I was 170 when I got married in 2000, and I've put six term babies through my body since then. But none of that occurred to me at the time, when things got hard. I had the projected acceptable 'bounce back', but because nobody was talking about it, I thought I was starting to fail. Having to add different foods back into my diet in order to avoid the dizziness turned out to be a mental trip too, and trying to adapt to 'normal' life not so very easy either.
To be frank, it's a little like living in the twilight zone. Like 'normal' people, but not at all, because I constantly have to think about how what I put in my mouth will affect me. I don't tolerate 'lots of sugar' so well. Also, the line has moved as to how much I can take in before dumping sets in, but there is still a strong punishment for poor food decisions.
So my adjusted weight range is 170-180- this keeps me from dizzy spells and I move well and feel generally well. Could I lose ten more pounds and be at the bottom of that range? Yes. But what woman my age doesn't want to lose ten pounds? Oooops my 'normal' is showing. Normal, what is that anyway? It's a dryer setting!
So what does all of this mean? If I were to choose the middle of my acceptable range as my 'goal weight' and compare it against how much weight I've lost, my weight today, I have lost 98% of my excess weight. Shut the front door! I guess that's not too shabby after all.
On a bloodwork level, last year my vitamin D was low and that seemed to have righted itself with appropriate supplementation in my vitamin regime. Iron is the going concern now, and we're investigating a little further because the numbers came out a little wonky.
What tools am I using to maintain?
CALORIES: Still trying to keep in the 1500 calories per day range
PROTEIN: 80-100g protein per day.
FLUIDS: Over 16 cups of fluid per day.
FITBIT-: Yes I'm still wearing that thing, and I get moving. I use it to justify my lack of gym time. If I can hit 10,000 steps I don't care about the gym. I've got a whole bunch of coloured bands for it. It's kind of funny actually, matches the warbrobe. Probably looking to grade to an Alta eventually.
TRACKING: when I don't I am much more prone to do whatever feels good. So yes, at least intermittent tracking is going to be a life long tool for me.
MENTAL WORK: Balance is really important. It's really easy to go back to the mental gymnastics and diet mentality.
SUPPORT: I have "been there, done that" kind of people who can speak sense to this situation and encourage me.
I talked before in other posts about needing to reset my defaults. I really don't eat well naturally. I have to maintain the habit. So what is the best plan? The plan I'll use for life. If it's not maintainable, I'll stop doing it and I'll gain weight. Period.
So, ironically, I'm working every tool that even the people who don't choose Gastric Bypass have to work in order to succeed. Could I have done it without including this tool? Internist said nope. Not medically likely. So I work all the tools together. Shoots that whole 'easy way out' argument out of the water, doesn't it?
There are lots of things gastric bypass won't fix. Having had gastric bypass complicates treatment of some of the things I have going on medically also. Fortunately, I've got a good medical team that is willing to work with me on treating as many things with nutrition and vitamins as possible. That's really invaluable.
So I've been all over the map on this journey.
It begs the question: What does success look like? Well, I think that will vary depending on whatever life throws me at the time. But I will sum up the current view of success with a set of pictures.
I had someone once suggest to me that perhaps I don't want to post my pictures (as frequently as they do) because I've gained back so much that I'm ashamed. Yes, it was a low blow, and hardly supportive. They were several steps behind me in the process and hadn't quite hit the maintenance stage and all that it brings with it yet, to be fair. That honeymoon period is a pretty big sweet spot and can make a person think 'regain can't happen to me'.
Well, I figure that posting infrequently to make more of an impact is the better way to go.
I'd like to address the above thought, so I chose to wear clothing I was wearing at my one year mark for my three-year photo updates. I still own both the pink cardigan and wear it occasionally, but my kid wanted to wear blue for the family photos and Mark and I had to wear blue to accommodate. So the black cardigan you get. I figure that being able to wear this at three years out served as commentary enough.