Body Image and Issues after Weight Loss Including discussions about excess skin and reconstructive surgery

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Old 10-26-2010, 10:09 AM   #1  
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I'm filled with crazy thoughts lately.

1) I keep wanting to lower my goal weight each time I get close. I wanted to be a "normal BMI" at 200. When I got close, I thought I'd shoot for 195. Then I noticed there was still fat and I aimed at 190. Now that I'm nearing 190 I still see ALOT of fat and I'm thinking at least 185 or 180. Part of it is perhaps fear of telling myself I'm in "maintenance mode" when I always want to strive to be healthy and to exercise. I'm afraid that once I hit some sort of self-selected goal that I'll change what I've been doing.

2) I know that lifting weights and building muscle is the best thing I can be doing. It is important for so many things and the more muscle you have the faster your metabolism and the greater ability you will have to lose fat. YET, I don't want to gain weight. Silly isn't it? The affirmation I get from the scale going down is something that I look forward to. If I start lifting weights again the scale is going to go up. Not only in the sort term as I'll be retaining some water due to DOMS, but over time I will be adding pounds of muscle. I keep delaying going to the gym to lift weights (I'm just running for cardio) until I hit some sort of weight that I'm happy with. Maybe if I get down to 180 I can give myself the leeway of perhaps going up to 190 long term if I am able to add some muscle. Hopefully I can get the same affirmation from seeing the body fat percentage go down as I've seen the scale go down. Perhaps not.

3) The body image thing is crazy. In the shower when I look down at my gut I think how much fat is still there hanging off my body. The "apron" of skin that hangs way down below my waist is at least 2 inches thick. I'm thinking skin is thin, 2 inches is ALOT of fat. That is not even counting the fat filled skin that hangs off my butt and inner thighs. I don't think anybody else really sees me as fat, why do I? I'm wearing clothes that other people that I don't think are fat are wearing. Today I actually have on a "small" sized shirt. I'm wearing size 32 pants and I'm almost wearing size 30 jeans. My BMI is right in the normal range, yet I can't help but see my body as huge. The appearance of the loose skin does crazy things with the mind.

Anyway, I think I need to just write these things out. Perhaps other people have crazy thoughts like me.
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Old 10-26-2010, 10:20 AM   #2  
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hi matt, i completely understand. i hope you are very careful here. i kept wanting to go below goal, because i didnt know how to "stop" losing, i had done it for soooo long, and i was afraid of life without loss, (if that makes any sense)....i wish i would have to talked to someone about it (like a eating disorder professional therapist), i wish i would have shouted from the rooftops, help me! but i didnt, as a result i gained 160 lbs all back.
i also think part of the reason i wanted to keep "lowerng" goal was so i could have some wiggle room. i wiggled all right.......sigh.
i just hope you find someone or something that can help you.....i would much rather have that loose skin i had, than be this miserable weight again. besides, the clothes i wore hid everything i needed them too. remember loose skin does not equal fat.
you've come so far....i hope you find a way to figure this out...i wish i would have..
good luck and congrats, terrific weight loss!
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Old 10-26-2010, 10:51 AM   #3  
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Matt, the hardest time in my weight loss journey -- by far -- was the months immediately after I reached goal. I was floundering and unsure what to do and it sounds like you're there too.

I knew that I was very, very good at weight loss. I had my habits and patterns and felt comfortable in them. But -- was I good at maintenance? Could I keep the weight off? I thought it was a totally different ball game (turns out I was wrong) and I thought that I didn't know how to play.

So, like you, I decided to keep on going with weight loss. For no good reason at all, I decided to get down to 128.5 pounds, just because it was half my starting weight and I thought it would be fun to say I lost half of myself. I managed to get down to 133 or so but at that point my bodyfat percentage was 12.5%, on the edge of too low for a woman, so even I knew it was time to stop.

The crazy thing is that I was eating 800 - 1000 calories a day, doing 90 minutes of cardio and lifting and it wasn't hard. It felt familiar, comfortable, and safe. I had a weight loss goal to focus on so I was happy. Like I said, I was confident that I could LOSE weight -- it was life after weight loss that I was terrified about. No one was talking about maintenance in 2002 and 3FC didn't have a Maintainers forum. I was lost.

But I made the transition after I had the huge revelation that maintaining a large weight loss looks pretty much just like losing. OK, if I'm good at weight loss, that means that I'm good at maintenance. Woohoo! Even today, nine years later, I have the same habits, I eat the same foods, I do the same exercise -- and the scale stays the same.

You bet it's hard to give up the high from the scale going down but this is where you have to talk to yourself. Your rational mind *knows* that it's time to stop. From your post, it's obvious that you know what you should do but you're terrified that you're going to lose your focus and start regaining. Like me, you're very good at weight loss but you have no idea about maintenance. I get it, I really do.

I know this is a scary and uncertain time for you. You're not nuts! In many ways, we big losers are in uncharted territory and there aren't any road maps for where to go from here. That's why we're here to help you.

For what it's worth, my advice is to stop focusing on scale weight and start focusing on body composition. You need to be in the gym lifting weights like yesterday. It is the best thing you can do for yourself at this point! Don't sweat whether or not the scale goes up. Once we reach a normal BMI, scale weight isn't nearly as important as body composition. Get someone in your gym to caliper you regularly and focus on that number. So long as what you're adding is muscle, no worries. You'll look better, feel better, and be able to maintain better.

One of the many benefits that I found to weight training was integrating my body and my head back together. When I was obese, my body was a ball and chain that I dragged around with me. It wasn't part of "me" and I ignored it as much as possible. Working out makes us focus on our bodies, rather than ignoring them or pretending they're not part of us. Watching ourselves doing an exercise in the mirror forces us to see our bodies working and muscles growing. It makes us see the function and beauty of a body that works. I really wouldn't be surprised if your body image starts to change from "still fat" to strong and fit once you start your muscle building.

What you're going to find in the next few months is that transitioning from weight loss to maintenance is seamless. Nothing you do is going to change -- except for your awesome muscle building! Your toolbox of skills and habits will be the same for maintenance as it was for weight loss. A day in your life six months from now is going to look like a day in your life six months ago, and for the rest of your life. Don't fear maintenance -- you are a weight loss superstar and that means you already possess every bit of skill and knowledge you need to be a maintenance superstar.
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Old 10-26-2010, 11:40 AM   #4  
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Matt, Meg wrote this all wonderfully and I hope you heed her advice.

If there was something I wish I could change, I wish I had started lifting weights earlier. Nothing has shrunk my body and given me better body composition more than lifting weights.

So many people have this fear they will gain, and all of us lifters will keep saying "Don't worry! It is hard for even men to gain muscle!" But like many others, you won't allow yourself to believe it until you TRY and SEE!

I encourage you to pick up the weights and start, do you care about a number on the scale or looking fantastic?

It has to click for you, like it did for me. I could stand on a scale and have it say 180 lbs but still be the same size and you know what, I would be okay with that because I look great right now! I know I'm healthy, I feel the difference, the number just doesn't matter anymore.

It's just a convenient way of tracking weight loss! You know this, I can tell from your posts. You just have to cross over and see for yourself so that you can accept this knowledge.
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Old 10-26-2010, 11:49 AM   #5  
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well said meg!
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Old 10-26-2010, 12:41 PM   #6  
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Oh my Matt...you have been an inspiration to so many and I hate to see that you are feeling this down. I understand where you are coming from with the desire to go below your current goal weight. But I will endorse what my fellow 3Fcers have told you. I believe its time to stop focusing on the scale and start focusing on your body.

Nothing helps you to feel great about your body than seeing well defined muscles and feeling strong. I think its time for you to start incorporating weight training in your routine, abandon the scale for now and judge your weight based on how your clothes fit.

Have you thought of doing surgery to remove the excess skin? It might help you to feel better too.

In the meantime, know that we are all rooting for you.......
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Old 10-26-2010, 01:18 PM   #7  
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Thank you so much Meg for that response!! (and everyone else too).

It means a lot to me to have so many supportive people here
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Old 10-26-2010, 01:44 PM   #8  
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Quote:
Originally Posted by Meg View Post
I really wouldn't be surprised if your body image starts to change from "still fat" to strong and fit once you start your muscle building.
I loved Meg's entire post, but this in particular struck me. Matt, building muscle makes a person feel powerful.

You do not wear you weight as a number on your forehead. No one knows what you weigh unless you tell them. Muscle certainly can make the scale do funky things. I'm sure you've read a post or two about that. I'm still considered overweight by a good 15 pounds! But I don't feel overweight at all, and frankly, I don't think I look it. I owe that all to muscle.

I can't say for certain, but I really don't think there's fat in that excess skin you have. The top layer of skin may be thin, but there's a lot more involved than that. I tell you, if you had that removed you'd lose AT LEAST 10 pounds on the operating table! If your skin had retracted you would weigh a lot less than you do. There's no question in my mind about that.

And I've seen your pictures! You look amazing! You really do! I know you won't accept that. It's something you're going to have learn for yourself. But you are small, you can wear a size "small" because you're small! Really.
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Old 10-26-2010, 03:23 PM   #9  
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Oh, matt!

#1 actually doesnt seem crazy at all. I personally think there are many, many benefits to being at the lowest weight that is healthy for you...not just in a "not overweight" bmi category. I only feel like people run into trouble here when they cant honestly see themselves and assess their health.

#2 and #3 - I used to be like this until I had a couple revelations about the scale. I stopped weighing myself, got a trainer, and in 3 months gained 1 lb...but lost like 15inches!!!! that really helped me key in physically (not just logically) that the scale is but ONE tool. My second revelation here was that weight didnt matter, my health did. Being strong matters more than being skinny. Im going to repeat that, partially for myself.

Being strong matters more than being skinny.

Being helathy matters more than being thinner.

These arent always mutually exclusive, but there is an important prioritization.

You seem to be wrapped up (at least your headspace via this thread, not all of you necessarily) in the outward part. I care about that too, but it has really helped me to find ultimate guidance in my health and not my appearance.

The health bit has helped me to eat in a way that helps my skin issues (more antioxidants, more healthy oils, tons of water)...rather than go see a plastic surgeon.

*hugs*
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Old 10-26-2010, 03:58 PM   #10  
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I don't think that seems crazy, Matt. I think a lot of us after being so overweight for so long don't want to settle for something - we want to accomplish as much as we can with our bodies and health. I have a feeling I'll be in a similar boat.

And xty...

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Oh, matt!

#1 actually doesnt seem crazy at all. I personally think there are many, many benefits to being at the lowest weight that is healthy for you...not just in a "not overweight" bmi category. I only feel like people run into trouble here when they cant honestly see themselves and assess their health.
What kinds of benefits do you mean? I'm very curious - usually I hear doctors, the WHO and others say a BMI of like 23 is good and being at the lower end of "normal" isn't so good. Which makes NO sense to me because they say technically it's healthy and then turn around and deny it. Confusing...

I'd love to know about benefits I haven't heard about (I'm 2/3 convinced the whole "have a higher normal BMI" thing is because the USA is way overweight anyway, so anything lower seems good).
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Old 10-26-2010, 08:54 PM   #11  
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LaChicka - I think BMI is a total crap measure for an individuals health*. It is meant to be a one size fits all way to communicate basic info to people about how to aim for a pretty large target.

To be perfectly clear "the lowest weight that is healthy for you" may be fairly high end of the BMI spectrum, who knows....it depends per person.

I advocate for people who truly want to be healthy to think about it in a multi-dimensional way that is specific to the individual. Way more that scale weight factors in to that! Body composition + weight + height, food intake (not just calories or carbs or protein...but fiber, antioxidants, variance in vitamins, mineral, hopefully local and organic), exercise (not just minutes done, but how effective is it? what is the goal of it? are you strong? are you building the right muscles? is it preventing injury long term? helping build bone density? adding agility? etc), and overall quality of life.

For me specifically, my doctors have found a few reasons why keeping at my thinnest is better than just being thin enough:
- really horrible chronic pain. its almost gone now. the last 20lbs really really helped. (though going from 240 to 180 literally saved my life, wouldnt have lived with that high pain level for long)
- my blood pressure, LDL, etc are lower eating better! I could maintain 150lbs eating quite a lot of crap food, but I was def less healthy though well under healthy BMI range
- I had to get super super strong to get to 19% body fat (otherwise even at this weight I would be a higher % body fat). That muscle memory and added agility probably saved my life when a car plowed thru an intersection several months back and hit me as a pedestrian. I reflexively jumped mostly out of the way and didnt even fall down despite being put way off balance
- Im prone to some mild depression, frankly when Im stronger and completely focused on being tuned to perfect health my depression is pretty much non-existent.
- Estrogen is stored in body fat, there are schools of thought that think this increases the risk of breast cancer for every 11lbs extra you carry. Now some think this effect is reversed before menopause..who knows.

* (note from above: while I do diss BMI, it has a purpose. It serves as an easy way to compare and evaluate a population's weight without regard to height. My point is that for one person it doesnt actually provide much useful info. If the BMI calc doesnt know if my body fat % is 19 or 31 at my given weight...how does it have *any* idea if I am healthy.)
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