It's surprisingly hard to measure success at WLS. First you have to decide on a goal. It isn't weight for everyone--some people have a size goal, which is nebulous because in some clothes I'm a 6, others an 8, and there are still occasional garments I find that I can't be comfortable in less than a 12. Cut and brand make all the difference. But choosing a weight isn't much better. How do you choose a goal weight? Is it what your doctor gives you? (That's usually based on BMI.) Or is it a weight you used to be at that you thought was "right?" My goal is the one that sounded closest to being "normal" sized without getting too bony. But the BMI at that target weight is still technically "overweight". And even though I remember what I looked like when I was my goal weight (I thought I was fat then, but looking back realize it was a healthy weight for me), I'm older and constructed differently now, so it might not hang the same way on me. I've always known in my mind and heart that I might make my target weight lower when I get there--I won't know if I picked the right number until I see it on my scale.
But let's assume the target weight is your perfect physiologic goal weight. When are you a success? When you "hit" it? When you've lived at it for a month, a year, 5 years? When you seem stable at that weight? Can you be a success before then? How about when your obesity related comorbidities are a distant memory, when you are off your BP meds and CPAP, when you are reasonably fit? The surgeons consider "success" at WLS to be 60% of excess weight lost--which I have already surpassed. So does your goal fall at 60% lost, or 100% lost? Is success before or after your tummy tuck?
I was just thinking about this because I've read several blogs by blog buddies lately who have reached their goal (or very close to their goal) and now are struggling with a few pounds regained for various, perfectly good (but I'm sure, stressful and scary nonetheless) reasons. It just drives home that point that we have never "arrived" really, it's always something we have to maintain, or re-achieve, and sometimes life interferes with that or makes it harder. I think that must be part of why so many people are subconsciously scared to reach their goal. What do you do then? How do you maintain? Most of us know how to LOSE weight and how to GAIN it, but have little or no experience with maintaining a healthy weight. Myself included!
I have glimpses of success frequently these days, although I remain 12 lbs above my (first) goal weight. I see myself in a store window sometimes and wonder who that slim person is. My hubby frequently asks me (mostly joking, I think) to stop losing weight. After all, this is uncharted territory for both of us--I weigh less than I ever have since he's known me. I wear sizes that I didn't even hope to achieve when I was first researching WLS. Like so many women, I "didn't want to be skinny, just healthy"--although skinny was definitely the cherry on top of the sundae that we all desperately wanted. When I check out my excess skin (yes, I have it), I realize that what's underneath is even smaller than I imagined. But I really, really want to reach my goal.
I've felt like I've been plateaued for the last 3 months, but when I look on the progress graphs on Fitday, it's been a slow, bumpy, but sort of steady decline. In 4 months I've lost 12 lbs--that's not great in Lap Band terms, but not bad for being near goal either, especially with anesthesia school factored in. My classmates were talking about having gained weight in the last 6 months, and I didn't say a word because I'm probably the only one who has lost weight the whole time. And when I found a BMI calculator that could figure my actual BMI at 5'3.75" (my real height, not the 5'3" I've been using) I discovered that I'm just overweight now, at 29.8. Woot! Those little decimals make all the difference.
Of course, there really isn't any answer to the question of when you are a "success"--it's a philosophical question, and I'm sure it means something different to each person. To me, I can't consider myself a success until I've reached my first goal. I'll know it's "real" when I've maintained it for a good long time. There are lots of places to post your "before and after" pics, and I just can't post an "after" until I feel like an "after". I wonder if that will ever really happen. Will I ever feel like I "arrived?"
Monday, June 23, 2008
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2 comments:
Very insightful post. I think you're right. Only you can decide what success is for yourself. God knows, I'm so tired of hearing "society's" definition of success. It's usually superficial and valueless. For me, I'll be successful losing my comorbidities. Everything after that is icing on the cake.
You know, your second career could be writing....
Gwen, this is a great post.
I have talked to a lot of people who feel "lost" after they reach goal because then they get this feeling of "what now"? What do they focus on or obsess over, what is the next goal. Success is what you define it and it doesn't have to be related to weight. I always thought that I would be a "success" if I only could lose weight. Now I realize that with or without the weight loss I am a success in life. It just helps me feel better about myself. Congrats on your BMI! That must feel fantastic. :)
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