Weight Loss Surgery - In Which I Throw Out My Scale.. Or, Am I Anorexic Now?




imp
01-11-2013, 05:30 PM
I am almost eight months post-op, and I have a confession to make: my scale was running my life. So I threw it out.

Now, I know what you're thinking: you should not throw out your scale, you're not even a year postop, how are you going to monitor yourself, etc. And all these are valid points, and points I have thought about seriously.

Here's the thing: right after surgery I really wanted my scale. I wanted it to tell me what I couldn't see in the mirror: how much I was losing from one day (hour) to the next. People on my surgery support board were vocal about the need to weigh once a week, or less - but I wasn't hearing that. I was weighing every day, every other day, twice a day, six times a day, three times and taking the average, you get the idea.

It was kinda okay for the first six months, while I went from 232 to 200 to 199 to 175 to 167 (my surgeon's goal for me) to 150 to 140. Around 140, I tried really hard to be good and weigh once a week. I lied to myself and said I wasn't restricting my intake or letting myself forget to eat in order to hit 135. But I was, and the scale quit moving. It just... stopped. At 140. Wouldn't go lower. And I started getting really frustrated, and restricting my intake. If I'd managed to lose so much, why couldn't I get below 140? I stopped weighing out of frustration - but I couldn't eat, either.

Then, one day, I was at a Sam's Club with my mom. It was early December, I guess. And they have these cool booth thingies that will tell you everything from your blood pressure to your visual acuity to your BMI right on it. And the Sam's thingy said I weighed 128 with a 22 BMI. I was fully dressed, in cowboy boots and a jacket, no less. That's when I decided my scale was busted. I came home and threw it out.

Since then, I haven't weighed much. I got on one scale at someone's house that said I was 135, and one scale in a store that said I was 118. For the last couple of weeks I haven't weighed at all.

Instead, I have decided to watch my clothes and my protein, fluids and vitamin intake. I have resolved to make myself eat properly - at least four times a day. 60 grams of protein at minimum. This is.. hard for me. I'm better about it at work when I'm on a set schedule. Not eating is a whole lot easier than eating, now. And I'm not yet at a place where I can really see how I look in a mirror - I have the common issue of body dysmorphia, post-op.

Right now I am sitting here in an XS cami under a big, baggy size M sweater and size 4 jeans. I have eaten twice today - well, once and half a monster protein shake that should have given me 40 grams but since I've only managed half of it, I've gotten a total of 30 for the day. I'm short by half my protein goal. I still need to take my vitamins. I was pretty good and got my protein and vitamins in yesterday, but that's no excuse to not do it today. I am not remotely hungry - the idea of food makes me kinda wanna hurl.

My hair is now in a jaw-length bob, and my stylist says I do have some regrowth - but warned me about skipping vitamins and protein. I can't eat eggs or milk or chicken (I know right) or pork. So I need to go get some seafood or red meat (not ground, I can't do ground meat). I need to go take my vitamins.

I kinda think I have an eating disorder, you guys. Wouldn't be the first time - I used to have a ballet master who told us to eat "banana seeds and steam" to get our weights down. I was honest about this preop and my team felt that my outlook was good and that I would cope well post-op.

But eight months postop I now wear the same size I wore in high school. Cognitively, I think I should be at goal, right? If I fit in my high school cheerleader outfit and I have 35" hips, I'm at goal, yes? I have seen a therapist in the past to deal with my brain issues and my control issues, and I have coping skills in place - but I'm having trouble forcing myself to eat. I get sick a lot when I try. I can dry heave at the drop of a hat with no warning.

So I'm thinking that my surgeon needs to evaluate my weight and my progress and let me know when it's too much. My mother says I used to run around at under 100 pounds all the time, so it's kind of okay if I get to a size 0 now. To be honest I would not have a problem with being a size 2, but a 0 seems extreme. I'm already bony in spots and I like boobs, I want to have some. I'm probably carrying 8-10 pounds of skin around as it is. I am also not a fourteen year old professional ballet dancer anymore - I'm 40harrumphthing years old and I've pushed two kids out of these hipbones.

I dunno. I don't really know what to do with myself right at the moment. I need to eat more. I'm glad I threw out my scale. I just want to be healthy. Right now, I'm not sure if I'm really healthy, that's all. I really hope this is a phase of severe dysmorphia that's a result of the fast weight loss, and that I'll get it handled soon.

Anyone else dealt with this kind of thing?


jiffypop
01-11-2013, 07:27 PM
WHEW! so glad you've come back to us!!!!

i've experienced something along these lines, but not exactly. But let's get a few things out of the way here.

YES. talk to your surgeon. YES consult the dietician. YES have a chat with a therapist if you feel you need some extra help finding a path through these emotions.

now. here we go. You're only 8 months out - not even halfway through the honeymoon period, and you've reached [below] your goal weight, but you are dealing with what I've been thinking of as the PENDULUM. you know the one - it goes from overeating to undereating. from one extreme to the other. And not feeling hungry doesn't help this one bit.

I'm not sure why this happens [another way to say that is that i don't know why we do this to ourselves]. Maybe it has to do with the fact that just about all of us have major control issues, and perhaps some OCD, and with the surgery, we switch our focus from eating to not eating.

All i know is that I personally have to find some peace about eating, just as you do. I haven't owned a scale in years [sometimes that's NOT a good thing, though]. I don't want to be obsessed about what's going into my mouth. I want to eat decent, healthy food, in appropriate amounts, and then GET ON WITH MY LIFE!!!

work in progress.

So, other than being able to fit into your tiny clothes [yay!], run around with your family [double yay!] and work, what would getting on with your life look like - in your heart??

it must have been very hard going from a ballerina to someone who couldn't dance, and now, perhaps you can start taking classes again. At the very least, it'll help you actually FEEL your body and help you live in it again.

When i was a child, i took ballet lessons for a couple of years, and i loved it. However, i'm too tall, too klutzy, and just too big [and i don't mean weight wise, at least not then. when i look at old pics, i see the large joints, hands, and feet of a great dane puppy!]. And I'd love to do so again - in the complete privacy of my house with all the curtains pulled down tight!

Please don't listen to your mother. You're not a teenager any more, and what worked then won't work now [usually doesn't - on so many levels]. Keep plodding along - your goal of 60 grams of protein and your liquids is right on. but please see your surgeon as well. it's time to work on your HEAD now.

imp
01-11-2013, 11:24 PM
Jiffy, you're a godsend. I mean really.

My eating has been a topic of conversation with my hubby for a few months now. His concern is not my size (never has been), but whether I am healthy. His take is similar to yours - that I am having some head issues. Your pendulum metaphor is a great illustration for what I'm dealing with now. He thinks I could use ballet as a negotiating tool with myself. I can dance if I eat, if I meet my protein goals, if I take my vitamins. That could work.

So I'm thinking that maybe I'll go talk to some local dance studio owners and find out what it would cost to rent space a couple of mornings a week. Not for class, but for me. I think you're right - I need to just live in my body for a little while, see it in a mirror, and dance in it. I like the idea of putting myself through class a few times a week.

And, yes. I'm gonna call Doc and go in, be honest, and see what he has to say. I skipped the last two followup visits because I think I didn't want to deal with this. But I kinda need to deal with this in order to be healthy. So I'm going.

Thanks, Jiffy :)


Moving Forward
01-12-2013, 12:14 AM
This is why I love 3FC! Imp, I read to the end and felt compelled to respond, but I've not been in your shoes and didn't quite know what to say. Jiffy, I agree that you are a godsend for Imp. :)

jiffypop
01-12-2013, 12:36 AM
<you ladies are very kind>

IMP - a slap on the wrist for skipping two appts with your surgeon. you are too early post-op to be doing that. Call on Monday. PROMISE? pinky promise? please?

I'm not sure that holding ballet hostage to your eating is in your best interests. It's a form of exercise that you LOVE - it holds so much meaning for you, and symbolizes - <fill in the blank here> freedom? your person-hood? whatever it is, it's very important to you.

And let's face it, if you don't eat properly there's no way you'll have the energy to dance! Making this important part of your life contingent on your eating habits would simply reinforce the food issues [i think, at least - i know it would for me].

My personal goal is to stop the internal food battles - the punishment/reward cycle, the 'good girl' vs 'bad girl' stuff

Can't wait to hear what the studio owners say!

Few people understand a few things about those of us who've qualified for the surgery. First of all, when we're really heavy, we don't really live in our bodies - if we had any sort of body consciousness, we would probably have been so miserable that we would have done something sooner. And second, after the surgery, we lose weight so very fast that our brains can't keep up with our body changes. Sometimes it's funny [like when i stood in front of a glass door, unable to open it because there was a woman standing between the door and me - and she was quite slim, and dressed like i was, but it sure wasn't me!]. And sometimes it's not.

And a slimmer body moves so much differently than a severely overweight one. it takes some getting used to.

It's not really about the food, is it? it's about self-image, emotions, coping strategies, perceptions.. I hope that some of the new people who've shown up to explore surgery check in on this thread. This is where the real battle is.

Zeitgeist
01-12-2013, 08:28 AM
Imp,

I recall struggling with some of your same issues around the same point in my journey as well. Not so much the low weight, as I can't seem to break 165 lbs, but the desire to not eat and how tempting it was to skip meals to lose more. But then my appetite came back and my ability to eat more occurred. I don't know if it is a stage most WLS patients go through, but I do recall wondering if I was developing an eating disorder (actually, it would be "developing a NEW eating disorder", as the way I ate preWLS was definitely dysfunctional).

I wish I had the time, money, and access to see a therapist. If you do, I would highly encourage you to seek guidance. I'm also a bit concerned about skipping appts so recently after your surgery. You want to make sure your labs are ok; much easier to stop a downward progression than try and bring up tanked levels.

As for throwing out the scale, I think it is wonderful that you were able to do it. Concentrating on food, clothes, vitamins, exercise instead seems healthier to me.

I don't know about you, but I'm anxious for the day when I have all this food/body hyper-vigilance reduced or gone. It would be so nice to have everything under control/structured, so that I don't have to worry about protein, food choices, vitamins etc., and that I just do what I need and that is that.

imp
01-12-2013, 09:28 AM
Oh, therapy. Yeah, I have no medical insurance at the moment. But what I do have is my old therapist, now retired. She and I went around my issues for about five years once, so if it comes to that, I can talk to her and get to the heart of things pretty quickly.

Jiffy, I do think you're right that tying my intake to something I love doing could set me up for further restriction. There is the possibility that I'd decide to be thinner, because ballet was always my reason for restricting my intake when I was young. I wanted to be Balanchine-thin and long-legged on a short, curvy-inclined body. Now I just wanna be little and cute :) After I stopped dancing professionally I grew four inches.

I also think the dysmorphia is somewhat normal, to an extent. I don't feel like I'm having an unreasonable reaction to losing 100 pounds or thereabouts in under eight months. But neither do I want to say "oh, what I'm doing is fine" - it's not. Skipping appointments is not okay. Last time I saw my surgeon was at his birthday party in September, and I was in a size 12 then and still had my hair.

It's been easy for me to tell myself that my doc knows what's up with me and would let me know if there was a problem - his office manager is one of my mother's closest friends and has known me since I was a child. My doc is on my Facebook - I posted about drinking coffee recently and got busted on it :) But I know, as a nurse, that I need the labs. I'm very late for labs. And I think a face to face with Doc is necessary. So if they're all back from vacay on Monday, I'll make the appointment and keep it. Since my dad had surgery before I did, he's already said he'll go with me just for fun. I do have a pretty great support network :)

Y'know, the thing that bugs is that I really thought I had this thing wired. I expected my weight loss to be slow, to be able to eat kinda whatever, to lose gradually (like my dad) and not really have to deal with the head stuff, because I'd already dealt with the head stuff. I was wrrrronnnnggg :)

jiffypop
01-12-2013, 10:16 AM
Y'know, the thing that bugs is that I really thought I had this thing wired. I expected my weight loss to be slow, to be able to eat kinda whatever, to lose gradually (like my dad) and not really have to deal with the head stuff, because I'd already dealt with the head stuff. I was wrrrronnnnggg

:lol3: :rofl:

It doesn't go away - it shows up in the strangest places and forms. At the end of this month, it'll be 11 years since my surgery, and i'm STILL getting slapped in the face with the head stuff.

it sounds like you have a good plan - and that you're facing what's going on - SOOOO important.

and PS - i always wanted to be little and cute - at 5'8" at the age of 11 and size 9 feet, it took YEARS to accept that this wasn't gonna happen - ever.

imp
01-12-2013, 12:11 PM
and PS - i always wanted to be little and cute - at 5'8" at the age of 11 and size 9 feet, it took YEARS to accept that this wasn't gonna happen - ever.

Girl, I feel you. My daughter was taller than I am in fifth grade. She outgrew my shoes in third grade. Now she's 5'9", size 10 feet only because she refuses to wear an 11, and I pulled her out of dance classes at age six because those limbs were only going to cause her injury and frustration. She still thinks I should have left her in. Actresses, huh.

And guess what? She's absolutely beautiful. Tall, gorgeous, able to wear a 32" inseam and leap a lane of traffic in a single bound. You're absolutely beautiful, too :) So there.

imp
01-27-2013, 11:49 AM
So, I saw Doc this past Monday and... he kicked my butt for me. In the nicest way possible, but still.

Turns out that yes, I do need to see my GP and get some dang labs. A whole laundry list of labs. For uninsured me this is a bit of challenge at the moment, but I will get it done as soon as possible, because it is a priority.

Also, he's not mad about my current weight. He is mad about my current level of intake. Weight-wise, I'm below goal and a success. Intake-wise, I fail. So he and I came to terms and the terms are as follows:

1. I am allowed to be as bratty as I want on my patient-led subjective chart notes and I am free to mouth off at any time, as per usual. He wouldn't know me otherwise, so my snot-nosed bratness is A-okay and I can continue to do that, but in order to do that I have to show up for appointments.

2. I must eat every two hours. He does not care if I ever eat another carb in my life as long as I eat protein every two hours forever. My stomach is apparently a little small and a whole lot twitchy, and my protein is pretty obviously deficient even without lab work to verify. Five times a day is acceptable, six or seven is better. Calories do not count. Fat does not count. Only protein counts for me at this point.

3. If I do not consistently manage 80 grams of protein per day at minimum, I can expect unpleasant future doc-me interactions. I can also expect to be bald and sick.

4. I am no longer allowed to use the espresso bean as a primary form of nourishment. It's not the caffeine that's the problem, it's the tannins. Doc thinks I may be prone to marginal ulcers that heal quickly and scar, leading to symptoms of a mild gastric outlet (stricture) issue. If I continue being a coffee and tea snot, there is a very real likelihood that I will find myself with cameras down my throat to check for said stricture, and if it's there, revision or reversal of my surgery. OH NOES.

5. Just for clarification, I was never allowed to have coffee, I just had it.

6. If one does math, one learns that I cannot be eating 1000 calories and 60g protein per day based on my reported food intake - that in fact I was eating more like 400-600 calories a day and about 30 grams of protein, and my metabolism broke. We are now in the process of fixing my metabolism not so I will get thinner, but so I will be healthier. I'm as thin as I need to be now.

7. My exercise level is fine as it is. No changes there, no need to up anything or do any more. He was happy with my anaerobic muscle building (i.e., deadlifting my teenage patient).

8. If my weight loss becomes excessive, see number 4. And since I will be following up like a good girl, he'll know. Right now it's okay, but I've lost five pounds this week since I started eating more, so we'll just have to watch it.

9. Zinc. 200 mg a day to keep my hair in my head. Not 50, 200. TWO HUNDRED. Four hundred would be fine, too. And take my damn vitamins. Three times the normal adult dose of everything, please and thank you.

10. I might have a teensy eating disorder which could be causing psychosomatic nausea, but since I seem very self-aware about that, he is inclined to think that while I may have OCD eating tendencies, that can work to my advantage in getting me healthier, hence the very concrete schedule and instructions. However, he does think I might really have margin issues, a kinda-small stomach, and a resulting mild gastric outlet problem which may or may not improve with time, so we're gonna watch that too.

That's about it. I'm working really hard on this, so that I can BE successful instead of just looking successful.

Oh, and they still want me to be in the commercial that's filming next month. Heh. :)

jiffypop
01-27-2013, 03:43 PM
Thank goodness you kept your appointment! and even MORE thank goodness that you have A SMART, KNOWLEDGABLE doctor who has laid down the law.

now - YOU are expected to check in with us every couple of days. we are here to help you - you can rant and rave all you want - as long as you keep up your protein. and your WATER [and other non-caffeine, non-bubble bevs].

and your vitamins [who knows - you might even inspire me to take the blasted things!]

So, how are you getting in your protein? yogurt? eggs? meat? cheese? fish? chicken? or protein shakes and bars? you KNOW which ones have the vitamins...

Zeitgeist
01-30-2013, 07:00 AM
I'm really glad you shared your update, Imp. How have you been doing with the rules?

imp
01-30-2013, 08:27 AM
This is me, updating :) Since I work 4 12s a week (with an hour commute, one way) I'll be checking in on my days off.

It's easier to schedule my intake and stick to it on work days. On days off, I don't have a kiddo on a schedule. As a private nurse for one child, I live on her schedule at work, and it's very easy to eat something every couple of hours - even if it's 11 am before I eat, I'm still managing to get something in every couple of hours. I usually do a protein shake on the way to work.

I can't eat eggs or yogurt, which has complicated matters. And most protein bars have way too many carbs for me. So I buy deli roast beef, rare, and really good cheese, and crab meat and shrimp. I also eat pumpkin seeds, hemp seeds, and raw almonds. And on work days I'm also good about vitamins. Four zinc pills is a pain in the butt, though.

Water is the other fun thing. I am working on that. With my surgery, standard protocol is that water itself is tough on the electrolyte balance - those of us with MGB don't metabolize sodium or potassium particularly well. In fact, in the first months after surgery we're asked to get our fluids from the low-calorie electrolyte replacement drinks, or V8. Now that I'm farther out, I can have water, but I have to be sure that I also have some light salt (sodium and potassium) on hand. I actually do salt licks, like you do for tequila shots, before I drink water.

This week I haven't been carting around my low-cal G2 because I've been carting around a small truckload of protein, and I can tell I'm a little bit volume depleted. Today, I need to get lots of fluids down the hatch. And remember my vitamins. Oh, and eat a couple of steaks.

Good stuff: melted muenster over a small steak is heavenly. Crab legs are delightful in drawn butter. Shrimp is my friend. So are the Smart for Life green tea protein bars, but those are a little hard to find here and I think I might be out of them.

I haven't stepped on the scale yet. I'll probably give it another week.