Escaping the Prison of Obesity. This is my presentation to the Ohio Association of Occupational Health Nurses in Columbus, Ohio on November 3rd 2018. During the removal of a tumor from my neck my vocal cords were damaged and I lost my voice. I had recovered about 25% of my voice by the time of this presentation.
When you lose a significant amount of weight, heck when you lose any noticeable amount of weight, people will ask questions. People are not shy about asking personal, probing, and sometimes very silly questions. Many WLS patients are a bit apprehensive about fielding questions – even people who would, on almost any other subject, be an “open book.” The question that drives this fear is probably the most obvious and logical question someone could ask: “How did you lose weight?”
The apprehension comes from the fear that their answer: “I had weight loss surgery,” will be followed by a response of… “Oh, I thought that you did it yourself,” or the dreaded, “Oh, you took the easy way out.”
It may be that people respond with these types of reactions due to an ignorance of WLS, it may be a reflection of some jealousy or resentment they may hold toward the successful WLS patient, or, at worst, it could be a desire to insult or offend.
Regardless of the reason, such a response is hurtful to the WLS patient and is perceived as totally devaluing their efforts… the costs, pains, risks, fears, and hard work that all successful weight loss endeavors require.
I love being asked the question: “Bill, how did you lose all that weight?” But before I explain why, and how I answer, let me first suggest that “weight loss surgery” is an incorrect answer to the question.
A person loses weight one way and one way only… they take in less calories than their body burns. It’s been that way since day one, and will likely be this way till the end of time. Its simple math, addition and subtraction, learned in the first grade – 54 years ago in my case! Add the calories eaten and subtract the calories burned to power bodily functions (heart beating, lungs breathing, body temperature) and calories burned from exercise or other physical activity.
Weight loss surgery is not the reason you lost weight. To believe such passes all of the credit for achieving weight loss to something outside your control. It would indeed be taking the easy way out.
When I am asked the $100,000 question, here is how I answer:
Person: “Wow, Bill, you look great… you’ve lost a lot of weight! How did you do it?
Me: “Well, I lost weight the only way anybody can… I took in less calories than I burned up. To put it simply, on a daily basis, I eat well and I exercise. I eat well to limit the calories that go into my body and I exercise regularly to increase the calories my body burns.
Most of my life I had difficulty eating well, that is, managing my calorie intake, so to assist me with that goal I had gastric bypass, which helps me limit the amount of food I eat at any one time. It doesn’t choose what I eat, so I must be certain to choose highly nutritious foods. It is a lot of work, but well worth it. And of course to burn calories I work out on a daily basis. My gastric bypass doesn’t help me with that… it hasn’t once yet got me up off the couch and sent me to the gym!”
At this point, if the person asking me how I lost weight was not familiar with gastric bypass, they likely want to know more. And if they had any inclination to be less than supportive, they quickly reconsider as my enthusiasm and excitement for what I have achieved is obvious and undeniable. I am a freight train of unrepentant excitement that nobody wants to try and derail.
Gastric bypass, the vertical sleeve, and the lap band are tools. Tools compensate for our limitations.
Fifty-four years of life had taught me that I didn’t have the ability to manage my eating. Try as I did (and I tried all the diets and weight loss plans out there), I simply didn’t have the skill, strength, ability, intestinal fortitude, whatever you want to call it, to manage my food intake. Some people are born with the innate ability to self-manage this aspect of their life. I wasn’t.
Consider a short person trying to paint their ceiling. No matter how hard they call on their internal strengths and intestinal fortitude, someone five foot tall cannot paint their ceiling without the aid of a ladder – a tool that allows them to overcome certain physical limitations they face so that they can unleash their skills and energy to achieve their goals. The ladder doesn’t paint the ceiling for them. It doesn’t select the color or neatly trim the moldings. A ladder, like WLS, is simply a tool that someone can use to accomplish their goal of brightening up their home. The WLS patient simply uses their surgery as their tool to help them lose weight and maintain weight loss for the rest of their life.
Does this conversation make any sense?:
Person 1: “Wow, your room looks nice, you’ve done a great job of painting. I like the style and color of what you did to the ceiling! I really… hey, wait a minute, is that a ladder I see over there in the corner?”
Person 2: “Yes.”
Person 1: “Oh… [sounding less than impressed] I thought you did it yourself. I guess you took the easy way out.”
Ridiculous. 🙁
Be proud of what you have done for yourself. NEVER feel bad about using the correct tool for the job you’ve undertaken. You have accomplished something that very few humans are capable of. You turned your life around and now lead a healthy lifestyle because you were smart enough to select – and utilize – the tool you needed to accomplish a goal you set for yourself. You did that. YOU!
I am often asked for lessons learned. Here are my three running rules:
1) Never, never, ever give up,
2) Remember that you’re doing this for YOU and you’re worth the effort and investment, and
3) You will make mistakes and suffer a setback or two – when this happens refer to #1 and #2 above.
And above all know this:
You are capable of more than you can imagine,
You can do this,
Don’t overcomplicate things,
Eat well and exercise,
Believe in yourself,
Do a little better today than you did yesterday.
It’s the journey that gets you there, not the surgery.
A better life, a new life awaits… GO CLAIM YOURS!!
I was recently asked if I wish I had undergone WLS earlier in my life. At age 54, after two decades of trying to manage my weight – and failing miserably, I underwent the RNY procedure and in one year lost one-half of my 404 pound body. Better yet, I’ve maintained that loss for four more years.
You lose weight by taking in fewer calories than you burn up. This is accomplished by managing the food you put into your body, and by managing the energy you burn through exercise and activity. Until I weighed 350 or so pounds, I had no trouble with exercising. I played sports, rode my bike, hiked, and kept active with my three sons. But I couldn’t seem to manage my eating. No matter how much I exercised, my calorie intake continued to exceed my calorie burn, and over time I went from 190 pounds to 404 pounds.
The last straw in my decent into an unhealthy life came when I went above 350 pounds and it became almost impossible for me to engage in the types of physical activities I loved and regularly enjoyed. The decrease in exercise only made the situation worse and soon I weighed over 400 pounds.
WLS gave me the tool I needed to manage my food intake. From the day my surgery gave me the gift of food management, I have eaten well and exercised, causing a calorie deficit that facilitated a 202 pound weight loss. Today that same tool helps me manage myself such that I’ve maintained the weight loss and built a strong, healthy and fit body.
So with all of my success coming at the end of my 50’s (I’m now 59 years old – almost five years post-op), it would seem a logical question for someone to ask me: “Don’t you wish you’d have had WLS earlier in your life?”
Of course I’d have preferred to have stayed at 190 pounds through my 30’s, 40’s and early 50’s. It would have allowed me to have even more fun with my kids, play sports even more intensely, explore the world more completely, avoid a couple of health issues, and saved me tons of embarrassment and heartache. Yes, I wish that I hadn’t become overweight and obese. But do I wish I’d have had WLS earlier? Maybe, but probably not.
In the WLS world we say that with surgery we’ve made a life-style choice to travel a different path. We describe this path as a new life-long Journey. And we have. And it is.
However, since surgery only gives us a tool we can use to self-manage our journey, our success with WLS depends on us being able to use the tool for that purpose. And our being able to use this tool is a direct result of the things we’ve learned in life, our outlook, our attitude, our mental toughness, our resolve to accomplish this goal. It’s the total of all we are that gives us the resources we need to overcome the weaknesses and failures we’ve suffered. That and the tool of WLS.
At thirty years of age there was much I hadn’t yet learned… I hadn’t faced the adversity of building a career, the challenge of fatherhood, I hadn’t gained a true and honest picture of what and who I am, I still possessed the idealized vision of myself I held in my teens and twenties. I hadn’t grown to understand me. And without that background, I wouldn’t have been able to use the tool that WLS gave me to make the changes required for my Journey to Fitness.
To me, my life before WLS and my life after ARE my life. My only life. WLS is simply a point of demarcation – a date on the calendar of MY life. An important date for sure, but not one that can stand alone. I don’t believe that WLS would have worked for me at forty years of age any more than getting married at fifteen or retiring at thirty would have worked for me. I wouldn’t have been prepared.
My grandfather used to have a colorful saying: “There are some things you just can’t explain to a virgin with words and pictures.” WLS is something that worked for me at fifty-four years of age because I was ready for it, my experiences giving me the experiences to manage the process. I believe that until I possessed these experiences, WLS would have been another failure in my attempts to manage my weight.
So while it is interesting to ponder, I really don’t waste much time looking back. I am who I am because of what I’ve done, what I’ve experienced, and how I respond to the twists and turns that life throws me. To wish it any different is to wish I was other than who I am. And I’ve got to say, I’d miss me if I was anybody else!
“Am I the same person I was before I lost weight?” Many people who have achieved significant weight loss ask this question. I’m one of them. We want to know if, and if so, how much and in what way, the significant physical change that we have undergone has changed us as a person.
Perception
A ‘person’ is a complex concept. But let’s make it easy and use a basic definition. A person is me or you or any of the hundreds of other people we interact with or cross paths with every day. Each of these people are unique and the result of a special but ever-changing blend of many variables, such as:
In my case, I’m half the person I used to be, having lost 200 pounds and kept it off for four years. I now wear a large shirt versus the 5XL that I used to wear, while my pants and sport coats are similarly reduced in size. My body is fit from daily exercise and I stay very active, running, riding my bike, and playing soccer. I look, feel and act totally different than I did before I lost weight. Some people, upon seeing me for the first time after I had lost weight, didn’t recognize me. They didn’t know that I was me! One person, whom I had known for six years, even introduced himself to me, believing that we were meeting for the first time. There are times that I don’t recognize myself, as when I see someone walking toward me and prepare to move out of their way or say hello, only to realize that I’m actually looking at a reflection of myself, and I hadn’t even recognized it as me.
So, as most of the physical ‘me’ has completely changed, am I still the same person I was when I was fat? Have the extreme physical body changes I’ve sustained been a catalyst for changes to the other variables of my personhood? Are my moral and character values still the same? Has my personality changed? Do I have a different mental capacity/intelligence than before? To what extent has my self-image changed?
Self-Image
According to David Schlundt, a psychologist at Vanderbilt University, over the course of our lives, our sense of self-image develops through a complicated interplay between cultural ideals, life experiences and accumulated comments by others. The result is, inevitably, a distortion of reality.
My self-image is influenced by:
Yes, my self-image has changed as a result of my weight loss.
My self-image has to have changed, because I don’t look or move the same, and I’m more capable, confident and self-assured. People perceive me differently and therefore react to me differently than they did before I lost weight.
Fitting In
In years past, I sometimes found myself playing the “Big Guy” stereotype. It’s not a totally bad role to play, when owning that ‘space’ is granted to you by the people around you. Example: When my wife Colleen and I would travel by car with two or three other couples, I always rode in the front seat of the car (even when I wasn’t driving). Why? Because it was always offered to me by everyone, probably because I was 100 pounds bigger than the next biggest person, and everyone could see that I’d be more comfortable in the front seat.
Yes, sometimes it was just easier (or maybe I had just mastered it) to play into the stereotype, to just work the Big Guy persona into my self-image, than to fight it and try to replace it with another image, role, position, etc. The role was known and practiced, even if at times socially or physically awkward and uncomfortable. And although I had become good at extracting the good or useful parts of the role and limiting the downside, it was still a handicap and a burden that I always had to deal with in every personal interaction.
But stereotypes often create a situation called self-fulfilling prophecy. This happens when an established stereotype causes one to behave in a certain way, which leads the other party to behave in a way that confirms the stereotype. [M. Snyder, E. Tanke, E. Berscheid]
Now, physically I’m normal, even average. I automatically fit in. I don’t have to overcome the reality of being abnormal. As such, in every personal interaction in which I now engage, there is less stress and less of a burden on me to prove my worth and establish an identity (other than one tied to my weight) before the conversation or relationship can move on. Now I enter a new personal relationship with much more room to present a ‘me’ I want others to see.
Bias and Prejudice of Others
Six years back, I was sitting on board a Delta flight scheduled from Ft Lauderdale, FL to Columbus, OH. I had boarded early and was already settled into my aisle seat about eight rows from the front of the plane. I was watching people board the plane wondering who would draw the seat assignment between me and the window. A woman entered the plane, walked down to my row and indicated she had the window seat.
It was a very pleasant flight and we struck up a long conversation, discussing everything from our children and our careers, to politics and our personal philosophy on life. A couple of gin and tonics for each of us likely helped the conversation flow and the time fly.
As the plane was in final approach to land, I turned to her and mentioned just how much I enjoyed the flight and our interesting conversation. What she said next was worth hearing. She agreed that it had been an enjoyable flight, and then said: “When I was walking down the aisle I looked up and saw you in the seat next to mine and though ‘Oh, he’s a big guy, but then you ended up being a nice guy,’ who knew?”
I’m a nice guy? Hey thanks! Wait… what? So it’s a surprise when a big guy is a nice guy? Big guys aren’t usually nice guys? I wasn’t sure what she meant, and I really didn’t want to know. I enjoyed the conversation so much I didn’t want to ask and potentially get upset by hearing her reasoning and logic. I didn’t want to spoil the moment by suddenly gaining insight on how people might see me as not nice simply because I’m larger than the average person.
Her words have stuck in my head for six years now…. because even if the gin and tonics were responsible for her actually saying it out loud, I believe what she said reflects what she believes and perceives about people of size, and therefore controls and directs how she acts towards large people – and by my reaction, would shape how I see myself.
The way we perceive ourselves in relation to the rest of the world plays an important role in our choices, behaviors and beliefs. Conversely, the opinions of others also impact our behavior and the way we view ourselves. – Kendra Cherry, Psychology Expert
The feedback I receive from other people today is greatly different from what I had received previously. Today, nobody recoils at the thought of sitting in the airplane seat next to me. I don’t start every personal interaction with the burden of proving that I’m not a “grumpy fat guy.” I don’t have to work hard to receive the ‘benefit of the doubt’ from strangers – even for things that have nothing to do with weight or size. I don’t have to work against anybody’s preconceived notions about what or who an overweight person is, to gain their trust, acceptance and favor.
Bias and Prejudice in Ourselves
When I was seven months post-op, I sat down to write a blog post about what I was experiencing as my body morphed from fat to fit. I was trying to document how it felt to be a different sized person, a different looking person, a person who took up less space and stood out in a crowd much less than before. I was having some trouble putting my thoughts down on paper when I came across the blog of ‘Lisa,’ a gastric bypass patient who had lost a significant amount of weight. Lisa said:
Does completely changing your appearance change who you are inside? I think somewhat it does. Especially to the extent that you allowed yourself to be defined by being overweight. If you saw yourself as fat, and let that image dictate your behavior to any extent, then suddenly becoming skinny will literally blow your mind. Imagine waking up tomorrow as a different race than you are now. Yeah, you’re still you. But then again, you’re not. You fit into society differently. People treat you differently. You see yourself differently. – Lisa, Blogger
Imagine waking up tomorrow as a different race or gender …noodle on that for a while.
More than just changing my starting point of each new personal interaction I engage in, I’ve changed my relationship with myself. I see me differently. I start my relationship with myself at a different point also. I see that I no longer have certain barriers, specific burdens, real handicaps to overcome, or to explain to myself (lie?), in order to gain my own trust, acceptance and favor. It’s easier to be me.
Bias and Prejudice of Others – Again
I am the only man in four of the five exercise classes I take each week. Just me and 15 to 25 woman. It works for me, and I don’t believe that the women have a problem with me being in the class. It’s taken a year or so, but I’ve gotten to know a few of them, and they’ve come to accept me as a part of their class. We talk a lot before and after class, speaking often about our children, work, parents, the city, schools and such. So it was exciting for me when I ran into my kickboxing classmate ‘Karen’ one evening at an uptown event. It took a minute for us both to be sure we recognized each other – being that we weren’t dressed in our workout spandex. A few minutes into our conversation I mentioned my wife, Colleen. Karen stopped me and said, “You’re married?” “Yes, I am,” I said, “31 years now.” “But you don’t wear a ring,” she said. I told her that I do have a wedding ring that was too small for me to wear when I was 400 pounds and too big now that I’m 200 pounds. And, I mentioned that I don’t really like wearing jewelry, watches, or other accessories. I reminded her that I had mentioned Colleen in several previous conversations. But she was stuck on the ring. “That’s false advertising,” she said. “There are lots of single women that see you without a ring and will think you are available.”
The last thing that would ever cross my mind is the thought that a woman in one of my exercise classes (or anywhere for that matter) would look at me and think “I wonder if he is available?” That just doesn’t happen to 400 pound guys. It’s not an event that I needed to consider, to prepare for. Yeah, today I weigh 210 pounds, but that reality hasn’t caught up to my mentality. I still react, in social situations, as I would have when I weighed 400 pounds.
All I could say to her was, ‘Why would anyone be interested in me being available?’ She totally turned my world upside down when she said, “Well, because you’re a really good-looking guy.”
Oh. Wait, what? Say that again!
Just a year ago I had to worry that a woman walking down an airplane aisle would object to being seated next to me, seeing that I took up lots of space, and fearing (apparently) that I wouldn’t be nice. This was the uphill battle position with which I started every personal interaction. 12 months later I was expected to understand that being seen without my wedding ring was ‘false advertising’ because a single woman may well want to know if I am ‘available.’
It plays with your self-image.
Building the Image I Want
About 12 months ago I was shopping in Kroger, walking around the store with a hand basket, gathering some fruit for smoothies, low carb yogurt, bottled water, cheese and some salad ingredients. I had gone straight to the grocery from my workout at the recreation center and therefore was still wearing my exercise clothes. As I walked up to a checkout aisle, a woman, about my same age, walked up at the same time, but then looked at me and commented, “Oh you go first, you’ll have a lot healthier items than me I’m sure.” It stuck me that she had quickly draw a whole bunch of conclusions about me from a little bit of evidence. She could see my level of fitness and that I was wearing exercise clothing. She may have seen some of the fruit and veggies that were in my hand basket. So from this she had built up a whole story in her head about who I was and what I was like – to her I was an exercise fanatic, lived and ate healthy, made better choices than most shoppers – and because of this*, I was someone she respected enough to deferentially yield her spot in a supermarket line, allowing me to proceed through checkout ahead of her.
I just might be wearing the persona of the ‘healthy guy’ more often. Looks like it gets respect and admiration from others, and I like it!
* (And maybe partly in contrast to what she felt about herself?)
So Who Am I?
I am a complex algorithm of formulas and variables, ever-changing by nature, and changed significantly by weight loss. Affected by the same fears, opportunities, love, wants, needs and desires as most people. Molded by my own experiences and the specific stimuli that barrage me daily, the education I derive from life, and the things I hold above all else… the moral truths and character values that sustain me.
I believe that when most people who have lost a significant amount of weight ask the question: “Am I the same person now that I was before I lost weight,” they mean to focus on non-physical traits. That is, they want to know if they still have the same values, the same spirituality, the same sense of right and wrong, the same moral character as they did when they were large.
It has been four years since my surgery. I’ve grown, experienced, evolved and changed during that time. Some of those changes were tied directly to my weight loss journey, but other changes would have happened naturally anyway, the result of events such as the death of a friend, our retirement, and extensive world traveling. So, are my moral and character values still the same as they were before I lost weight? No, they’ve grown, evolved, and changed over the past four years.
So am I a different person now than I was before I lost weight?
My answer is that, yes, I am a different person than I was four years ago. I cannot be the same person. Neither I, nor the people I interact with every day, will let me be the same person. My image of me has changed. The image others project or assume about me have changed – and therefore much of the world to which I react has changed. My physical transformation has leached into much of my personhood. Am I different? Yes, easily.
Reflecting on the question now, it seems rather silly to ask. Of course you become a different person when you lose 200 pounds. How could you not change? Let me suggest that this is not the question we should be asking. Maybe instead of wondering if we’ve changed, we should just accept that we have and then ask “What now?” Now that you’ve lost 200 pounds and remade yourself, what are you going to do with the rest of your life? You’ve proven that you are up to great challenges, that you can accomplish things that many other human beings cannot. So, what now?
Look at it this way, you bought into your weight loss journey as a life-changing event, you accepted that for the rest of your life you’ll eat well and exercise, so, too, accept that for the rest of your life you’ll be developing ‘you.’ That the ‘you’ we see today will yield to the ‘you’ you’ll be tomorrow. That discovering who you are is every bit as much a goal of your journey as weight loss – and every bit as important.
Enjoy!